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Grounded in career construction theory, we proposed that proactive personality (a disposition that drives people to focus on the future) influences career adaptability (the attitudes and behaviours that people use to adapt to work), which in turn influences career exploration (purposive cognition and behaviour to seek information for self-career advancement). However, psychological safety as a boundary condition may affect career adaptability's relation to career exploration. Hence, this study examined whether students' psychological safety moderates career adaptability's mediating effect on the relationship between proactive personality and career exploration. A total of 288 students who completed internships at Taiwanese sports centres or fitness clubs participated in this research. The results indicate that interns' psychological safety, functioning as a moderator, intensifies proactive personality's indirect effect on career exploration through career adaptability. The implications of this finding for students' career counselling are discussed.

Technology drives innovation and reform in hospitality education, and Facebook has become a popular educational tool to facilitate students' classroom interactions. Understanding hospitality students' attitudes toward Facebook teaching interventions is important. Based on a survey of 289 undergraduate hospitality students, first, we expand the scope of the technology acceptance model (TAM) in this study, which integrates the two factors of social interaction and information exchange into the research structure. Second, this study also proposes a new moderated mediation model to account for the internal mechanism underlying Taiwanese undergraduate hospitality students' acceptance of Facebook teaching interventions in terms of perceived usefulness and ease of use. We illuminate the foundation of the application of Facebook media technology to teaching in hospitality higher education. The theoretical contributions and educational implications of this research are also discussed.

Purpose: The purpose of this study is to explore the capabilities required by entry-level human resources (HR) professionals based on job advertisements by using text mining (TM) technique. Design/methodology/approach: This study used TM techniques to explore the capabilities required by entry-level HR professionals based on job advertisements on HR agency 104's website in Taiwan. Python was used to crawl the advertisements on the website, and 841 posts were collected. Next, the author used TM to explore and understand hidden trends and patterns in numerous data sets. Findings: The results of this study revealed four critical success factors (specific skills, educational level, experience and specific capabilities), five clusters and ten classifications. Practical implications: The results can aid HR curriculum developers and educators in customizing and improving HR education curricula, such that HR students can develop capabilities required to secure employment in the current HR job market. Originality/value: Our results may facilitate the understanding of the current trends in the HR job market and provide useful suggestions to HR curriculum developers for improving training and professional course design, such that students' competitiveness is enhanced and professional capabilities improved.

Background: The human leukocyte antigen (HLA) genes, exhibiting significant genetic diversity, are associated with susceptibility to various clinical diseases and diverse in drug responses. High costs of HLA sequencing and the population-specific architecture of this genetic region necessitate the establishment of a population-specific HLA imputation reference panel. Moreover, there is a lack of understanding about the genetic and phenotypic landscape of HLA variations within the Taiwanese population. Methods: We created models for a Taiwanese-specific HLA imputation reference panel. These models were trained with the array genotype data and HLA sequencing data from 845 Taiwanese subjects. HLA imputation was applied for 59,448 Taiwanese subjects to characterize the HLA allele and haplotype frequencies. Additionally, a phenome-wide association study (PheWAS) was conducted to identify the phenotypes associated with HLA variations. The association of the biallelic HLA variants with the binary and quantitative traits were evaluated with additive logistic and linear regression models, respectively. Furthermore, an omnibus test with likelihood-ratio test was applied for each HLA amino acid position in the multiallelic HLA amino acid polymorphisms to compare the difference between a fitted model and a null model following a χ2 distribution of n-1 degree of freedom at a position with n residues. Finally, we estimated the prevalence of adverse drug reactions (ADR)-related HLA alleles in the Taiwanese population. Results: In this study, the reference panel models displayed remarkable accuracy, with averages of 99.3%, 98.9%, and 99.1% for 2-, 4-, 6-digit alleles of the eight classical HLA genes, respectively. For PheWAS, a total of 18,136 significant associations with HLA variants across 26 phenotypes are identified (p < 5×10-8), highlighting the pleiotropy feature of the HLA region. Among the independent signals, 15 are novel, including the association of HLA-B pos 138 variation with ankylosing spondylitis (AS), and rs9266290 and rs9266292 with allergy. Through an analysis spanning the entire HLA region, we identified clusters of phenotype correlations. Finally, the carriers of pharmacogenomic related HLA alleles, including HLA-C*01:02 (35.86%), HLA-B*58:01 (20.9%), and HLA-B*15:02 (8.38%), were characterized in the Taiwanese general population. Conclusions: We successfully delivered the HLA imputation for 59,448 Taiwanese subjects and characterized the genetic and phenotypic landscapes of the HLA variations. In addition, we quantified the estimated prevalence of the ADR-related HLA alleles in the Taiwanese population. The developed HLA imputation reference panel could be used for estimation of population HLA allele frequencies, which can facilitate further studies in the role of HLA variants in a wider range of phenotypes in the population. [ABSTRACT FROM AUTHOR]

Subsidiaries are important in the global strategy of multinational enterprises (MNEs). However, in the face of uncertainty and competition, the decision to divest a subsidiary from a market becomes a critical decision for MNEs. This study suggests that the factors for divesting subsidiaries are related not only to the performance of the subsidiary but also to slack resources and sunk costs. It analysed 254 subsidiaries in Taiwan and found that the better the subsidiary’s performance is, the less it would decide to divest from the market. Additionally, it was found that the subsidiary with slack resources would be a moderating variable with a positive impact. In addition, the presence of sunk costs reinforces the positive effect of slack resources on the relationship between subsidiary performance and the non-divestment of the subsidiary. Overall, this study points to the significance of subsidiary performance on decision-making and explains the influence of slack resources and sunk costs. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to investigate long‐term psychological distress and its risk factors in the burn survivors. Design: A longitudinal study with follow‐up interviews was conducted from November 2015–June 2018. A post‐burn baseline interview was conducted 6 months after the event, followed by annual surveys for three years. Methods: The burn survivors received structured assessment through telephone in the four‐wave interviews, including the five‐item Brief Symptom Rating Scale (BSRS‐5); two‐item Patient Health Questionnaire (PHQ‐2); four‐item Startle, Physiological Arousal, Anger, and Numbness Scale (SPAN‐4); and six‐item Impact of Event Scale (IES‐6) alongside demographic data and other health‐related assessment. Findings: A total of 180 respondents with the mean age of 23 years old completed the four waves of interview. Using the BSRS‐5 as the outcome, each variable had different input in psychological distress during the follow‐up years. The main finding was that the SPAN‐4 score could predict more than 62% of psychological distress between 6 months and 3 years after the disaster. The generalized estimating equation demonstrated that SPAN‐4, IES‐6, family functioning impairment, hypnotics use, adaptation to the event, and PHQ‐2 could predict psychological distress. However, the variable of follow‐up year did not exemplify significant estimation in the model. Conclusions: The results indicated that different factors had various influences on psychological distress across the four follow‐up stages. PTSD‐like symptoms, depression, and anxiety were the most common psychological problems experienced by the young burn cohort in the longitudinal post‐traumatic period. Clinical relevance: Healthcare providers should be aware of psychological consequences of traumatic events within up to a 3‐year post‐burn period, particularly post‐traumatic stress, depression, and anxiety symptoms. [ABSTRACT FROM AUTHOR]

The taxonomy of Peperomia (Piperaceae) in Taiwan is reconsidered. In the present study, six taxa are recognized, based on detailed morphological observations and ITS sequences derived from fresh material obtained from living plants. Details of the characters are discussed, including the morphology of the leaf epidermis and pollen grains. Synonyms are treated. Descriptions of the species, phenology and a key to Peperomia in Taiwan is also provided. [ABSTRACT FROM AUTHOR]

Background/purpose: The trend of suicide rates among young adults has been increasing worldwide. The study aimed to identify the suicide risks and associated psychosocial factors in a large university in Taiwan.Methods: This is a mixed-methods study using both questionnaire survey and two open-ended questions for the exploration of qualitative data. An online survey was conducted between two periods of the same semester in 2018 to collect different sources of stress and other suicide correlates. The measurement scales included the 9-item Concise Mental Health Checklist, the University Stress Screening Tool in Taiwan and the Chinese Maudsley Personality Inventory. The participants were required to fulfill two open-ended questions about stress experience and depressive symptoms in the previous month in the end of the questionnaire, which was analyzed using thematic analysis.Results: A total of 857 university students were recruited (67.9% female participants). Over a quarter of participants were under poor mental health status and more than 60% experienced stressful events in the prior year. A higher suicide risk and neurotic trait was noticed compared to the general public. These results were consistent with the qualitative findings.Conclusion: While identifying several risk factors that cumulatively conduced to higher suicide risks, neuroticism served as a key element in the increased suicide risk among the university students. Suicide prevention strategies for university students should highlight stress management for those with neurotic trait and early suicide risk identification. [ABSTRACT FROM AUTHOR]

Purpose Technology has been central and has made service innovations technically feasible and economically viable. Top management support, however, plays an important role in shaping a firm's service innovation-related strategies and decisions. This study aims to propose a theoretical framework that delineates the relationships among openness of technology adoption, top management support and service innovation within social innovation context.Design/methodology/approach This study obtained the data through a survey of 176 information technology (IT) firms in Taiwan; IT managers were selected as the data collection sources. A partial least squares analysis was used to address sophisticated data analysis issues.Findings The empirical evidence indicates that openness of technology adoption enhances service innovation within social innovation context. Furthermore, top management support facilitates the relationship between openness of technology adoption and service innovation.Research limitations/implications The openness of technology adoption captures the interactions among top management support in shaping service innovation. Researchers should examine the nature of open technology infrastructure that will foster such service innovation from social innovation perspective.Practical implications The detailed findings offer practical suggestions for firms that are compelling to invest in advanced open technologies, giving opportunities for service innovation, solving social problems and meeting the new societal challenges. Additionally, firms may foster their top management's positive intention to support service innovation by pre-planned support activities, such as allocating sufficient new service resources and qualified support technicians.Originality/value This study contributes to the evolving literature on the social innovation, service-dominant logic, and contingency theory. This analysis suggests that these perspectives offer a potentially useful view for integrating insights from different literature streams (e.g. openness, social innovation, service innovation, top management support and technology management) by examining them through a different conceptual lens, thus reinforcing existing findings. [ABSTRACT FROM AUTHOR]

This study investigated how relocation patterns affect disaster survivors' psychological stress on the diverse durations and spaces of relocation. It analyzed a 10-year data set of 1,236 families affected by 2009's Typhoon Morakot in Taiwan, identifying six relocation patterns through dynamic time warping (DTW). A hierarchical linear model was utilized, revealing the discernible impacts of environmental factors, sociocultural factors, and family-level socioeconomic factors on psychological stress. The study revealed that survivors who quickly found stable residences after the disaster initially experienced lower stress levels, but in the long term, their stress increased. Conversely, those with unstable residences experienced higher initial stress but lower long-term stress. Comparing similar patterns, we found that survivors who had more time for preparation and who sought opportunities, coped, or adapted to secondary stressors before long-distance relocation faced lower stress levels. These findings suggest that relocation patterns have a greater impact on the psychosocial stress of disaster survivors than time or relocation distance. [ABSTRACT FROM AUTHOR]

The theory of planned behavior is a well-established theory in predicting human behavior. However, there is evidence of an inconsistent relationship between intention and behavior. Therefore, the purpose of the current study is to further investigate the gap between intention and behavior. The study proposes intention stability as the moderator. Participants (N=154, M age = 23 yr., SD = 6.7) were recruited from Internet volleyball forums and local volleyball courts in Taiwan. Multiple hierarchical regression was used to analyze the data. The results indicated that perceived behavioral control significantly predicted game-attending behavior through intention. However, attitude and subjective norms did not significantly predict behavioral intention. In addition, intention stability moderated the relationship between intention and behavior and indicated the relationship between intention and behavior was strong when intention stability was high. On the contrary, when intention stability was low, the relationship between intention and behavior was weak. Implications and applications are discussed. [ABSTRACT FROM AUTHOR]

Objectives. This study employs the theory of threats to assess the claim of democratic elitism that elites are more tolerant, politically, than the general public. Methods. Utilizing survey data collected from social elites and the masses in Taiwan, a logit model with binary outcomes is employed. Results. The statistical results show that Taiwanese elites generally exhibit a higher level of political tolerance than the masses but that they become less tolerant when the stakes are perceived to be high. Conclusions. The empirical evidence confirms the theory of democratic elitism but with important qualifications. This finding suggests that ordinary voters in democratic polities need to continually exercise their power as the final arbitrators of state policies. [ABSTRACT FROM AUTHOR]

This article presents an overview of the field experiment called Dropwindsonde Observations for Typhoon Surveillance near the Taiwan Region (DOTSTAR). The goal is to build upon previous successful work to improve tropical cyclone track forecasts with additional observations. This marks the first time in 16 years that aircraft have been used to routinely observe typhoons. DOTSTAR investigators gather and process data with the Airborne Vertical Atmosphere Profiling System, and perform some onboard debugging/analysis and coding. Constrained by a requirement to submit flight plans to air traffic control two days in advance, DOTSTAR flew only two missions in the first season (2003). It is hoped that DOTSTAR will shed light on tropical cyclone dynamics, enhance track forecasting accuracy, and place Taiwan at the forefront of international research on this topic.

The skipjack tuna (Katsuwonus pelamis) is a mesopredator fish species with seasonal abundance in waters off Taiwan. Regional ecological and life-history information has been historically lacking for this species. In recent years, stable isotope analysis (SIA) of carbon and nitrogen has been used to assess predator feeding ecology and broader ecosystem trophic dynamics. This study evaluated comparative skipjack feeding ecology in distinct regions off Taiwan, combining traditional stomach content analysis with SIA of individuals off western (n = 43; 2020) and eastern (n = 347; 2012–2014 and n = 167; 2020) Taiwan. The stomach content analysis showed the most important prey to be ponyfish (Photopectoralis bindus) in western Taiwan and epipelagic squids (Myopsina spp.) and carangids (Decapterus macrosoma;) in eastern Taiwan from 2012 to 2014 and epipelagic carangids (Decapterus spp.) and flying fishes (Cheilopogon spp.) in eastern Taiwan in 2020, suggesting that the skipjack tuna is a generalist predator across regions. In contrast, time-integrated diet estimates from Bayesian mixing models indicated the importance of cephalopods and crustaceans as prey, potentially demonstrating more mesopelagic feeding in less productive waters during skipjack migrations outside the study regions. Skipjack off western Taiwan had a slightly higher estimated trophic position than in the waters off eastern Taiwan, potentially driven by the varying nutrient-driven pelagic food web structures. Skipjack SI values increased with body size off eastern Taiwan but not in western waters, suggesting that opportunistic predation can still result in different predator–prey size dynamics between regions. [ABSTRACT FROM AUTHOR]

Reports an outbreak of severe toxicity characterized by obstructive ventilatory impairment related to the consumption of a poisonous vegetable called Sauropus androgynus in Taiwan. Cases of toxicity to Sauropus androgynus; Telephone questionnaire survey designed to collect demographic data and information about the use of the vegetable.

A letter to the editor is presented about the incidence of the Japanese encephalitis virus (JEV) in Taiwan.

Despite numerous studies on the effect of a cold weather disaster on fisheries in 2008, no operational systems have been developed to monitor the threat of such an event to mariculturists in the Penghu Islands (PHI) region of Taiwan. The present study employed a suitable aquaculture site selection map of the inner bay of the PHI to reduce aquaculture losses and mortality rates of cobia (Rachycentron canadum) during extreme events. Daily marine environmental data, including sea surface temperature (SST), chlorophyll-a concentration (chl-a), and wind speed in the winter, were collected. An extreme event was defined as a period of over 11 days in a month of strong winds (>6 m/s). Four parameters in the PHI inner bay, including SST, cold-water intrusion days, chl-a, and offshore distance to the PHI coastline, were used to evaluate suitable aquaculture sites for cobia culture. The results indicated that La Niña events could not be used as a factor to detect cold-water intrusion events and select suitable aquaculture sites in the PHI. The evaluated suitable aquaculture site selection map, obtained using an arithmetic mean model and a geometric mean model, revealed that the avoidance sites during extreme events were concentrated in the northern and northwestern PHI. Suitable areas were concentrated in the southeastern areas. We further suggested that commercial cobia aquaculture operations in the PHI inner bay could be moved to the suitable sites in southeastern PHI during extreme events. [ABSTRACT FROM AUTHOR]

Background: Symptoms of smoking withdrawal are a central feature of nicotine dependence. A valid and reliable measure of these symptoms is important to better understand nicotine dependence and to develop effective interventions. Purpose: The objective of this study was to examine the validity and reliability of the Chinese version of the Cigarette Withdrawal Scale (CWS-C). Methods: This study conducted cross-sectional surveys in two phases. In the first phase, exploratory factor analysis was used to test the underlying factor structure, the criterion validity, and the reliability of the CWS-C. A reliability test was conducted to assess the internal consistency and stability of the instrument. In the second phase, confirmatory factor analysis validated the factor model that had been proposed in earlier empirical research. The total sample size used in analysis was 497. Results: The CWS-C achieved a level of efficacy that was similar to the English version. Exploratory factor analysis showed that the six factors of the instrument accounted for 80.3% of the variance. The full scale and all of the subscale items, with the exception of the appetite-weight gain subscale (r = .12, p = .09), were significantly associated with the Fagerstrom Test for Nicotine Dependence (r= .25-.50, p < .05). The Cronbach's alpha of the full scale was .93, with retest coefficient of .84. Confirmatory factor analysis confirmed that the CWS-C had six correlated factors. Field testing showed that the CWS-C is a reliable and valid Chinese-language instrument for assessing the symptoms of cigarette withdrawal. Conclusions/lmplications for Practice: The CWS-C performed well in terms of reliability and validity in several tests conducted on male Taiwanese smokers. Accurate measurement is expected to help health professionals better understand smoker quitting patterns and the severity of withdrawal symptoms and to develop improved withdrawal-symptom treatment interventions. [ABSTRACT FROM AUTHOR]

Young watermelon fruit was peeled and pickled for fermentation to produce a unique fermented food named xi-gua-mian (fermented watermelon) in Taiwan. In this study, we investigated the LAB microflora in xi-gua-mian. A total of 176 LAB isolates were identified; 118 cultures were isolated from the xi-gua-mian sample collected from three different farmers markets and 58 from six young watermelon fruit samples. These isolates were characterized phenotypically and then divided into seven groups (A to G) by restriction fragment length polymorphism analysis, sequencing of 16S ribosomal DNA and other genotypic analysis. Lactobacillus plantarum was the most abundant LAB found in xi-gua-mian samples collected in southern Taiwan, Tainan City and Pediococcus pentosaceus was the most abundant LAB in northern Taiwan, Taoyuan County. We found that LAB stains are similar in samples collected in the same geographic region but significant variations were observed between samples collected among different regions. On the other hand, a greater LAB diversity was observed in the young watermelon fruit samples. In addition, 10 Lactococcus lactis subsp. lactis showed inhibitory activity against the indicator strain L. sakei subsp. sakei JCM 1157T. This is the first report describing the distribution and varieties of LAB existing in the xi-gua-mian and the young watermelon fruits. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Antrodia cinnamomea - a medicinal fungus that is indigenous to Taiwan - has been used as a health tonic by aboriginal tribes and the Asian population. Recent studies indicate that Antrodia cinnamomea extracts exhibit hepato-protective, anti-hypertensive, anti-oxidative, anti-inflammatory, immuno-modulatory, and anti-cancer effects on cultured cells and laboratory animals. This study aims to explore the anti-inflammatory activity of an Antrodia cinnamomea ethanol extract (ACEE) and elucidate its underlying mechanisms of action using lipopolysaccharide (LPS)-primed, ATP-stimulated human THP-1 macrophages. Materials and methods The effects of ACEE on cell viability were studied using the MTT assay. The expressions of genes, proteins, and pro-inflammatory cytokines were measured by quantitative real-time RT-PCR, Western blotting and ELISA, respectively. The ACEE was further investigated for its effects on reactive oxygen species (ROS) production using ROS detection kit. Results Our results showed that ACEE significantly inhibits ATP-induced secretion of interleukin-1β (IL-1β), interleukin-18 (IL-18) and tumor necrosis factor-α (TNF-α) by LPS-primed macrophages. ACEE also suppresses the transcription and activation of caspase-1, which is responsible for the cleavage and activation of IL-1β and IL-18. Of note, ACEE not only reduces expression of the inflammasome component NLRP3 and the purinergic receptor P2X7R but also inhibits ATP-induced ROS production and caspase-1 activation. Furthermore, the anti-inflammatory properties of ACEE correlate with reduced activation of the MAPK and NF-κB pathways. Conclusion The results of the present study indicate that Antrodia cinnamomea suppresses the secretion of IL-1β and IL-18 associated with inhibition of the NLRP3 inflammasome in macrophages. These findings suggest that ACEE may have therapeutic potential for the treatment of inflammatory diseases. [ABSTRACT FROM AUTHOR]

This study investigates the historical changes in resource development of offshore and coastal fisheries around Taiwan from 1970 to 2021 using the mean trophic level (MTL) and Fishing-in-Balance (FiB) indices. Utilizing data from the Fisheries Statistical Yearbook, three scenarios were employed to assess the effects of highly migratory, oceanic migratory, and seasonal migratory fish species on the MTL and FiB indices. The analysis revealed a continuous increase in MTL for offshore and coastal fisheries, suggesting shifts in the trophic structure and potential over-exploitation of higher trophic level species. The FiB index for offshore fisheries exhibited a declining pattern after 1990, reflecting the depletion of indigenous fish stocks, while the FiB for coastal fisheries showed an increasing trend from 1970 until the 2000s, followed by a decrease, highlighting unsustainable fishing practices. Moreover, the study identified Scomber australasicus , targeted by Taiwanese Purse Seine, as an influential species affecting the resource dynamics of offshore fisheries. The trawling fisheries would also be a crucial issue affecting the indigenous resource dynamics of offshore fisheries in Taiwan. This study identified a fishing-down mechanism within indigenous fishery dynamics. The potential over-exploitation of fish stocks could result in long-term unsustainable practices if left unaddressed. This study advocates for enhanced fisheries management through stricter regulations on fishing gear, continuous monitoring, and adaptive management strategies. These measures are essential for achieving sustainable development goals and conserving marine biodiversity in Taiwan's waters. By addressing these critical issues, Taiwan can better manage its fisheries resources and promote ecological balance., Competing Interests: The authors declare that they have no competing interests., (© 2024 Wu et al.)

In the wake of the COVID-19 pandemic, the fluctuating nurse resignation rates highlighted an understudied area in healthcare: post-pandemic challenges in clinical settings. This study, conducted from May to November 2023, employed a qualitative inquiry using focus groups to delve into these challenges. Six focus group sessions, involving 33 nurse participants recruited through snowball sampling from various hospital settings were conducted to explore their clinical experiences during and after the pandemic. Thematic analysis revealed two primary themes: the 'Invisibility of Nurses' within the healthcare system and the 'Moral Duty of Nursing Practice'. These findings illuminate a tension between the overlooked role of nurses and their ethical obligations, underscoring a critical need for policy reassessment. The study advocates for systemic changes, particularly in the undervaluation of the nursing profession and the National Health Insurance system, to address the poor working environment and mitigate long-term nursing shortages. This research deepens understanding of post-pandemic nursing workforce challenges in Taiwan, highlighting the need for policy evolution to enhance recognition and support for the nursing industry. It is suggested to provide tangible compensation to acknowledge nurses' daily care and health education for patients. A healthier working environment can be enhanced by collaborative efforts between healthcare institutions and nurses., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Objective: To compare the real-world effectiveness and tolerability of calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) and onabotulinumtoxinA in chronic migraine (CM) patients., Methods: This multicenter study involved retrospective analysis of prospectively collected data of CM patients treated with CGRP mAbs or onabotulinumtoxinA, including difficult-to-treat (DTT) patients (i.e., ≥3 preventive failures). Treatment outcomes were determined at 6 months based on prospective headache diaries and Migraine Disability Assessment (MIDAS)., Results: The study included 316 (55 M/261F, mean age 44.4 ± 13.5 years) and 333 (61 M/272F, mean age 47.9 ± 13.4 years) CM patients treated with CGRP mAbs or onabotulinbumtoxinA, respectively. At 6 months, CGRP mAb treatment was associated with a greater decrease in monthly migraine days (MMDs) (-13.0 vs. -8.7 days/month, p < 0.001) and a higher ≥50% responder rate (RR) (74.7% vs. 50.7%, p < 0.001) compared with onabotulinumtoxinA injections. The findings were consistent in DTT patients (-13.0 vs. -9.1 MMDs, p < 0.001; ≥50% RR: 73.9% vs. 50.3%, p < 0.001) or those with medication-overuse headache (MOH) (-13.3 vs. -9.0 MMDs, p < 0.001; ≥50% RR: 79.0% vs. 51.6%, p < 0.001). Besides, patients receiving CGRP mAbs had greater improvement (-42.2 vs. -11.8, p < 0.001) and a higher ≥50% RR (62.0% vs. 40.0%, p = 0.001) in MIDAS scores and a lower rate of adverse events (AEs) (6.0% vs. 21.0%, p < 0.001). However, none of the patients discontinued treatment due to AEs., Conclusions: In this multicenter, real-world study, CGRP mAbs were more effective than onabotulinumtoxinA in CM patients, even in DTT or MOH patients. All of these injectables were well tolerated. Further prospective studies are needed to verify these findings., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Background: Type 2 diabetes is a chronic disease with a significant medical burden. eHealth care integrates medicine and technology to enhance the outcomes of such patients; however, adequate eHealth literacy (eHL) is necessary for that to happen. Fostering eHL is crucial for patients with diabetes to engage with eHealth care and receive quality care and timely support. Experiential learning theory can enhance patients' eHL and skills to use eHealth care technology in their daily care., Objective: This study explored the effectiveness of an eHealth care experiential learning program in improving eHL, patient health engagement, and eHealth care use status among patients with type 2 diabetes in 3 months., Methods: In this randomized controlled trial, patients under case management services from various clinics in Taiwan were randomly assigned to either the intervention group receiving the 6-session eHealth care experiential learning program or the control group receiving the usual care. Data were collected using structured questionnaires at 3 time points: pretest, postintervention, and 3 months after the intervention. Descriptive data were presented using frequency distribution, percentage, mean, and SD. The outcomes were analyzed using a generalized estimating equation method by intention-to-treat analysis., Results: A total of 92 participants (46 in each group) were recruited in this study. Of these, 86 completed the course and follow-up evaluations with a mean age of 62.38 (SD 12.91) years. After completing the intervention, the intervention group had significantly higher posttest scores in eHL (β=19.94, SE 3.52; P<.001), patient health engagement (β=.28, SE 0.13; P=.04), and eHealth use (β=3.96, SE 0.42; P<.001) than the control group. Furthermore, the intervention group maintained these significant improvements in eHL (β=18.19, SE 3.82; P<.001) and eHealth use (β=3.87, SE 0.49; P<.001) after 3 months., Conclusions: Participating in the eHealth care experiential learning program resulted in significant improvements in eHL, patient health engagement, and eHealth use among patients with type 2 diabetes. Our interventional program can inform future clinical practice and policies to strengthen self-management skills and facilitate the use of health technology in caring for patients with chronic diseases., Trial Registration: ClinicalTrials.gov NCT05180604; https://clinicaltrials.gov/ct2/show/NCT05180604., (©Yu-Shan Cheng, Cheng-Pei Lin, Lu-Yen Anny Chen, Wei-Ren Hwang, Yi-Chun Lin, Yu-Chi Chen. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.08.2024.)

Taiwan was successful in containing the spread of the novel coronavirus (COVID-19) in 2020. One major factor in this success was the compilation and provision of comprehensive information about the pandemic. The present study proposes a pandemic intelligence system that provides data on the number of epidemic prevention professionals in each county and city, as well as daily confirmed cases, the demographics of the confirmed cases, and available resources (negative-pressure room beds and artificial ventilation apparatuses) in hospitals. Furthermore, the system provides the location of pharmacies selling masks and their current inventories, as well as the distribution of crowds at popular tourist destinations and social-distance monitoring. The most frequently used map layer in the thematic map of the pandemic is that of crowd distribution during the study period from March 2020 until the end of the same year. The case study used in this investigation for applying the system is represented by the 4-day weekend for Tomb-Sweeping Day of 2020. Through the real-time analysis of dynamic data and the integration of intelligence, the system offers a clear insight into changes in relevant information and, thus, enables the preemptive deployment of control measures by the county/city governments regarding pandemic management.

Background: Asians with atrial fibrillation carry a higher risk of ischemic stroke than non-Asians even under treatment of nonvitamin K antagonist oral anticoagulants. The purpose of the study was to observe the feasibility of intravenous thrombolytic therapy after administering a reversal agent, idarucizumab, in dabigatran-treated patients with acute ischemic stroke in Taiwan., Methods: Dabigatran-treated patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) after idarucizumab reversal were enrolled in the retrospective nationwide study. The clinical data, treatment course, and outcomes were recorded. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) score. Any intracerebral hemorrhage (ICH) after rt-PA was detected by neuroimaging studies., Results: Ten dabigatran-treated patients (6 men, mean age 71.10 ± 7.96 years) with acute ischemic stroke were included. Before stroke, the mean CHA 2 DS 2 -VASc score was 4.50 ± 1.57 and 8 patients (80%) received dabigatran 110 mg twice daily. All patients were treated with 5 g idarucizumab, following which the activated partial thromboplastin time normalized. Intravenous rt-PA (mean dose .78 mg/kg) was initiated a mean time of 11.11 minutes after idarucizumab infusion. The NIHSS score improved significantly after thrombolysis (16.0 ± 6.67 at admission to 9.38 ± 4.75 at discharge, P = .016). ICH developed in 3 patients (30%). Two of them were asymptomatic and 1 patient suffered from symptomatic ICH leading to mortality., Conclusion: Our data reconfirmed the feasibility of intravenous rt-PA for Asian stroke patients after reversal of dabigatran effect with idarucizumab., (Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Mangroves are recognized as one of the richest carbon storage systems. However, the factors regulating carbon sinks in mangrove ecosystems are still unclear, particularly in the subtropical mangroves. The biomass, production, litterfall, detrital export and decomposition of the dominant mangrove vegetation in subtropical (Kandelia obovata) and tropical (Avicennia marina) Taiwan were quantified from October 2011 to July 2014 to construct the carbon budgets. Despite the different tree species, a principal component analysis revealed the site or environmental conditions had a greater influence than the tree species on the carbon processes. For both species, the net production (NP) rates ranged from 10.86 to 27.64 Mg C ha -1  year -1 and were higher than the global average rate due to the high tree density. While most of the litterfall remained on the ground, a high percentage (72%-91%) of the ground litter decomposed within 1 year and fluxed out of the mangroves. However, human activities might cause a carbon flux into the mangroves and a lower NP rate. The rates of the organic carbon export and soil heterotrophic respiration were greater than the global mean values and those at other locations. Only a small percentage (3%-12%) of the NP was stored in the sediment. The carbon burial rates were much lower than the global average rate due to their faster decomposition, indicating that decomposition played a critical role in determining the burial rate in the sediment. The summation of the organic and inorganic carbon fluxes and soil heterotrophic respiration well exceeded the amount of litter decomposition, indicating an additional source of organic carbon that was unaccounted for by decomposition in the sediment. Sediment-stable isotope analyses further suggest that the trapping of organic matter from upstream rivers or adjacent waters contributed more to the mangrove carbon sinks than the actual production of the mangrove trees., (© 2018 John Wiley & Sons Ltd.)

The aim of this study was to assess the overall and cause-specific incidences of diabetic hand syndromes (DHS) in patients with diabetes mellitus (DM) by using age and sex stratifications.The DM and control cohorts comprised 606,152 patients with DM and 609,970 age- and sex-matched subjects, respectively, who were followed up from 2000 to 2008. We estimated the incidence densities (IDs) of overall and cause-specific DHS, namely carpal tunnel syndrome (CTS), stenosing flexor tenosynovitis (SFT), limited joint mobility (LJM), and Dupuytren disease (DD), and calculated the hazard ratios (HRs) of DHS in relation to DM by using a Cox proportional hazards model with adjustment for potential confounders.Over a 9-year period, 51,207 patients with DM (8.45%) and 39,153 matched controls (6.42%) sought ambulatory care visits for various DHS, with an ID of 117.7 and 80.7 per 10,000 person-years, respectively. The highest cause-specific ID was observed for CTS, followed by SFT, LJM, and DD, regardless of the diabetic status. After adjustment for potential confounders, patients with DM had a significantly high HR of overall DHS (1.51, 95% confidence interval [CI] = 1.48-1.53). Men and women aged <35 years had the highest HR (2.64, 95% CI = 2.15-3.24 and 2.99, 95% CI = 2.55-3.50, respectively). Cause-specific analyses revealed that DM was more strongly associated with SFT (HR = 1.90, 95% CI = 1.86-1.95) and DD (HR = 1.83, 95% CI = 1.39-2.39) than with CTS (HR = 1.31, 95% CI = 1.28-1.34) and LJM (HR = 1.24, 95% CI = 1.13-1.35).Men and younger patients with DM have the highest risk of DHS. Certain hand syndromes, such as SFT and DD, were more strongly associated with DM than with other syndromes and require the attention of clinicians.

Objectives: To examine how sleep patterns change over the first year following traumatic brain injury (TBI) and to determine whether specific demographic and disease characteristics predict the trajectories of sleep., Design: Prospective study., Participants: Fifty-three patients with first-ever mild to severe TBI., Main Measurements: Sleep measured by actigraphy for 7 consecutive days in the first, third, sixth, and twelfth months following TBI: Chinese versions of Beck Anxiety Inventory and Beck Depression Inventory-II (CBDI-II) measured at the same time points. Data were analyzed with a linear mixed model., Results: Sleep efficiency (the ratio of sleep time to the total time spent in bed) showed a significant upward trend during the study period. Scores on the Chinese version of the Beck Anxiety Inventory and the CBDI-II as well as the use of analgesics significantly predicted the slope of change in sleep efficiency over time., Conclusions: Poor sleep efficiency is a common symptom in the first year among patients with first-ever TBI. Healthcare providers should consider both mental health and pain issues when dealing with sleep complaints in patients with TBI.

Catalytic converters are used to curb exhaust pollution from motorcycles in Taiwan. A number of factors, including the length of time the converter is used for and driving conditions, affect the catalysts' properties during periods of use. The goal of this study is to resolve the thermal deactivation mechanism of motorcycle catalytic converters. Fresh catalysts were treated under different aging conditions by laboratory-scale aging tests to simulate the operation conditions of motorcycle catalytic converters. The aged catalysts were characterized by analytical techniques in order to provide information for investigating deactivation phenomena. The time-dependent data of specific surface areas were subsequently used to construct kinetics of sintering at the specific temperature. According to the analytical results of the catalysts' properties, the increase in aging temperature causes an increase in pore size of the catalysts and a decrease in the specific surface area. The aged catalysts all exhibited lower performances than the fresh ones. The reduction in catalytic activity is consistent with the reduction in the loss of specific surface area. The finding of catalytic properties' dependence on temperature is consistent with the thermally activated theory. In contrast, the effect of the aging time on the specific surface area was only significant during the initial few hours. The high correlation between specific surface areas measured by the Brunauer-Emmett-Teller (BET) method and predicted by the constructed model verifies that the prediction models can predict the sintering rate reasonably under the aging conditions discussed in this study. As compared to automobile catalytic converters, the differences of structures and aging conditions are made less obvious by the deactivation phenomena of motorcycles.

In Taiwan, a continuous increase in the number of motorcycles has made exhaust pollution one of the major emission sources of air pollutants. The regular testing program carried out by the Republic of China Environmental Protection Agency was designed to reduce air pollutant emissions by enhancing maintenance and repair. During the execution period, abundant testing results were accumulated to discuss pollutant emissions from motorcycles. Exhaust testing data of motorcycles in Taipei City from 1996 to 2005 were chosen as the basic data to survey changes in motorcycle exhaust. Effects of motorcycle age and mileage on exhaust pollution were studied. The introduction of advanced emission standards enhances the elimination of high-emitting motorcycles. The testing data indicate that the testing rate rose from approximately 50 to 70% and the failure rate changed from approximately 15 to 10%. The operation cycles of two-stroke motorcycles make them high-emitting vehicles. Concentrations of carbon monoxide and hydrocarbons are higher in two-stroke motorcycle exhaust than that in four-stroke motorcycles. In contrast, the concentration of carbon dioxide produced from complete oxidation processes is lower in exhaust from two-stroke motorcycles. Therefore, failure rates of two-stroke motorcycles are higher than those of four-stroke motorcycles and were also observed to deactivate more easily. On the basis of analytical results of testing data, we found that failure rates show a gradually increasing trend for motorcycles older than 3 yr or used for mileages greater than 10,000 km, and failure rates are highly correlated to the age/mileage of motorcycles. We reason that the accumulation of age or mileage means accumulating usage time of engines and emission control systems. Concentrations of pollutant emissions would increase because of engine wear and emission control system deactivation. After discussing changes of failure rates and pollutant emissions, some suggestions are proposed to improve the testing rate and effectiveness of regular testing.

To survey the hygienic quality and freshness of fresh fish and shellfish, 533 specimens of fish and shellfish were collected from fishing piers, traditional markets and supermarkets (including warehouses) in northern Taiwan during the winter (January-February) and summer (July-August) seasons for hygienic quality and freshness examinations. The indicators included total bacterial count, fecal coliform, Escherichia coli, volatile basic nitrogen (VBN) and K value judged from ATP-related compounds. It was found that the hygienic quality and freshness of fish and shellfish decreased in summer, especially for clam and mussel. The ratio of unacceptable hygienic quality or freshness of fish and shellfish was the highest in fecal coliform, followed by E. coli and others. The fecal coliform count in products from the traditional markets was the highest, followed by those from supermarkets and fishing piers. Secondary contamination seems to be the most important problem for hygienic quality and freshness of fish and shellfish.