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As an examination of the influences of a renewable energy teaching activity employing teaching aids on elementary students' knowledge of, attitude toward, and behavior of energy saving and carbon reduction, this study designed a teaching experiment in which experimental group was subjected to the teaching with four teaching aids for students to practice whereas the control group was not. Results revealed that the teaching activity significantly improved the attitude and increased some knowledge items but did not affect the behavior. The behavior was more connected to attitude and knowledge for experimental group than for control group. The formation of the positive attitude could be related to the sensory stimulation generated by the teaching aids and associated affective responses when it was analyzed from a product-trial perspective. The analysis should inspire the understanding of the possible mechanisms of how learning experiences affect attitude.

This review aimed to investigate the effect of crew ratios of on-scene advanced life support (ALS)-trained personnel on patients with out-of-hospital cardiac arrest (OHCA). We systematically searched PubMed, Ovid EMBASE, and the Cochrane Central Register of Controlled Trials databases from the inception date until September 30, 2022, for eligible studies. Two reviewers independently screened the studies for relevance, extracted data, and quality. We compared the effect of the ratio of on-scene ALS-trained personnel >50 % to those with a ratio ≤50 % among prehospital personnel on the clinical outcomes of OHCA patients. The primary outcome was survival-to-discharge and secondary outcomes were any return of spontaneous circulation (ROSC), sustained ROSC (≥2 h), and favourable neurological outcome at discharge (cerebral performance category scores: 1 or 2). Pooled odds ratios (ORs) were calculated, and the certainty of evidence was assessed. From 10,864 references, we identified four non-randomised studies, including 16,475 patients. Two studies were performed in Japan and two in Taiwan. There were significant differences in survival-to-discharge (OR: 1.24, 95 % confidence interval [CI]: 1.07–1.44, I2: 7 %), any ROSC (OR:1.22, 95 % CI: 1.04–1.43, I2: 74 %) and sustained ROSC (OR: 1.39, 95 % CI: 1.16–1.65, I2: 40 %), but insignificant differences in favourable neurological outcome at discharge. The overall certainty of evidence was rated as very low for all outcomes. Prehospital ALS care with a ratio of on-scene ALS-trained personnel >50 % could improve OHCA patient outcomes than crew ratios ≤50 %. Further studies are required to reach a robust conclusion. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the clinical outcomes of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) under rituximab induction and reinduction therapy in Taiwan. Methods: We performed a retrospective study in patients with GPA or MPA receiving rituximab therapy from August 2008 to July 2020 in seven medical centers in Taiwan. The clinical characteristics and outcomes of these patients were analyzed. Results: In total, 53 patients (18 with GPA and 35 with MPA) were included. Kidney involvement (82.9% vs. 22.2%, p <.001) and initial creatinine (3.25 ± 2.37 vs. 1.07 ± 0.82, p <.001) were significantly higher in MPA. Within 24 weeks after the first course of rituximab, there were seven deaths (five due to infection and two due to active disease) in patients with MPA (7/35, 20%) compared to 0 in patients with GPA. Of 33 patients receiving rituximab for kidney involvement, 23 survived and were free from renal replacement therapy at 24 weeks. Their chronic kidney disease (CKD) stages improved in 2 but progressed in 7, while 24 had stable CKD stages. Death or end‐stage renal disease (ESRD) was associated with infection and higher initial creatinine. Reinduction therapy for relapse was required in 18 (39.1%) of 46 survivors, which was associated with anti‐proteinase 3 (PR3) positive (odds ratio 3.667, p =.049) and younger age with a cutoff of 49.4 (AUC = 0.679, p =.030, sensitivity = 66.67%, specificity = 75%). Conclusion: Significant mortality occurred after rituximab induction, especially in patients with MPA. In survivors, age younger than 50 and anti‐PR3 positive were associated with the risk of relapse requiring reinduction. [ABSTRACT FROM AUTHOR]

Soil erosion in East and Southeast Asia is believed to have increased significantly since the regional economic boom of the 1970s–1980s. However, limited records of soil erosion make it difficult to understand and indeed verify such changes. Here we present two new monthly resolved Ba/Ca records from Porites coral skeletons from southern Taiwan and central Vietnam, supplemented with some sporadic monthly and annually resolved coral δ138/134Ba data. Our records span the 1980s to the 2000s and suggest that there were intervals of elevated seawater Ba concentrations (Basw) during the intervals 1987–1995 in southern Taiwan and 1992–2001 in central Vietnam. In combination with evidence for insignificant changes in regional seawater δ138/134Ba values, model simulations, and other published coral Ba/Ca records from Lanyu (offshore southeast Taiwan) and Hainan, we infer that the intervals of high Basw values are linked to soil erosion associated with land use changes and socioeconomic developments. The increased sediment loads are also likely responsible for the recent degradation of regional coral reefs. Our study provides new insights into regional soil erosion histories, which may prove useful for guiding soil conservation and sustainable land management. Plain Language Summary: Soil erosion in East and Southeast Asia is considered a serious environmental problem. However, this issue has not been properly addressed, largely because of limited instrumental observations that would highlight the nature of the problem. Here we use new coral Ba/Ca and Ba isotope records from southern Taiwan and central Vietnam in conjunction with published records from Lanyu (offshore southeast Taiwan) and Hainan (northern South China Sea) to study the extent of soil erosion in East and Southeast Asia over recent decades. We conclude that soil erosion has been exacerbated by economic developments in the region and that this is recorded in the Ba/Ca ratios of coral skeletons. This study sheds light on how the concentration and isotopic composition of Ba in coral skeletons can provide a land use history for reference in environmental policies and mitigation strategies. Key Points: Exacerbated soil erosion by economic development registered in coral Ba/Ca records from southern Taiwan and central Vietnam since 1980 ADInsignificant difference of regional coral δ138/134Ba suggests dominant Ba sources attributed to enhanced land use by economic takeoffOur results highlight the vulnerability of coral reefs to increased terrestrial sediment input [ABSTRACT FROM AUTHOR]

Dividend tax policy is one of the important tools of government taxation. Observing the dividend tax policy and the behavior of stock prices around ex-rights will not only shed light on investment strategies, but also give us a clearer understanding of the microstructure of the capital market. Taiwan went through dividend tax policy and National Health Insurance (NHI) supplementary premium changes from 2014 to 2016. Therefore, this paper adopts the event study method to conduct empirical research on this major event period. The research conclusion points out: (1) During the research period, the company studied had a positive cumulative abnormal return before and on the ex-right day, and there was a negative cumulative abnormal return after the ex-right day. (2) When the tax reduction effect is more favorable to investors, there will be only a positive relationship with positive abnormal returns. (3) There is no statistical significance between the dividend tax reform policy and the negative abnormal return after ex-rights. The empirical results of this paper can help to better understand the pricing process of stocks by market microstructure systems such as dividend tax policies and help build a more stable stock market transaction structure. On the other hand, investors and companies can also gain their own investment or dividend policy inspiration from this research. [ABSTRACT FROM AUTHOR]

The late Holocene lacustrine environmental evolution and paleo-typhoon records are poorly understood around lowland Liyu Lake and mountain Tunlumei Pond in eastern Taiwan. In this study, we use records of diatom populations, magnetic susceptibility, total organic carbon, carbon-to-nitrogen ratio, and δ13C from two lacustrine sediment cores in eastern Taiwan to reconstruct the paleoenvironment and the paleo-typhoon records during the late Holocene. Significant changes in lithology and in multi-proxy data in the record from lowland Liyu Lake (LYL) show that LYL became hydrologically isolated by 2850 cal BP, possibly as a result of landslide-induced alluvial fan formation. Synchronous increases of the diatom-inferred lake level proxy for LYL and regional precipitation proxies reflect a strengthened East Asia summer monsoon since 1600 cal BP. Eutrophication of the water in LYL is also inferred, and this is interpreted to be related to agricultural activities, which provides evidence for changes in land use during the past 200 years. The occurrence of diatom valves in sediment of the mountain Tunlumei Pond (TLM) indicates that the pond area has been stable since 760 cal BP, which reflects an increase in the local precipitation. The decrease of diatom-inferred pH indicates an increase in the input of acid runoff from the watershed during typhoon-triggered heavy rainfall. Both lacustrine records suggest that the typhoon intensity increased during the early Little Ice Age. The sediment records in northeastern Taiwan also suggest an increase in typhoon activity during the late Little Ice Age. The asymmetric pattern of typhoon intensity during the last 1000 years is interpreted to reflect the control exerted by anomalies in both global temperature and the El Niño-Southern Oscillation intensity on typhoon tracks over several centuries. [ABSTRACT FROM AUTHOR]

The article presents a study which focuses on the survey of the three new species of the genus Stegana Meigen or diptera from Taiwan. The study uses the sequencing of the DNA barcoding fragments of the mitochondrial cytochrome oxidase I (COI) gene for the delineation of the species. Results show that two most widely distributed species among the 23 recorded species are ranging across two zoogeographic regions.

Abstract: Mud volcanoes (MVs) are considered important methane (CH4) sources for the atmosphere; gas is not only released from macro-seepage, i.e., from craters and visible gas bubbling manifestations, but also from invisible and pervasive exhalation from the ground, named miniseepage. CH4 flux related to miniseepage was measured only in a few MVs, in Azerbaijan, Italy, Japan, Romania and Taiwan. This study examines in detail the flux data acquired in 5MVs and 1 “dry” seep in SW Taiwan, and further compares with other 23MVs in Italy, Romania and Azerbaijan. Miniseepage from the six manifestations in SW Taiwan MVs and seeps annually contribute at least 110tons of methane directly to the atmosphere, and represents about ∼80% of total degassing during a quiescent period. Combining miniseepage flux and geo-electrical data from the Wu-shan-ding MV revealed a possible link between gas flux and electrical resistivity of the vadose zone. This suggests that unsaturated subsoil is a preferential zone for shallow gas accumulation and seepage to the atmosphere. Besides, miniseepage flux in Chu-huo everlasting fire decreases by increasing the distance from the main gas channeling zone and molecular fractionation (methane/ethane ratio) is higher for lower flux seepage, consistently with what observed in other MVs worldwide. Measurements from Azerbaijan, Italy, Romania, and Taiwan converge to indicate that miniseepage is directly proportional to the vent output and it is a significant component of the total methane budget of a MV. A miniseepage vs. macro-seepage flux equation has been statistically assessed and it can be used to estimate theoretically at least the order of magnitude of the flux of miniseepage for MVs of which only the flux from vents was evaluated, or will be evaluated in future. This will allow a more complete and objective quantification of gas emission in MVs, thus also refining the estimate of the global methane emission from geological sources. [Copyright &y& Elsevier]

Abstract: Taiwan is one of the countries with higher mobile phone penetration rate in the world, along with the increasing maturity of 3G relevant products, the establishments of base stations, and updating regulations of 3G mobile phones, 3G mobile phones are gradually replacing 2G phones as the mainstream product. Therefore, accurate 3G mobile phones demand forecasting is desirable and necessary to communications policy makers and all enterprises. Due to the complex market competitions and various subscribers’ demands, 3G mobile phones demand forecasting reveals highly non-linear characteristics. Recently, support vector regression (SVR) has been successfully employed to solve non-linear regression and time-series problems. This investigation employs genetic algorithm–simulated annealing hybrid algorithm (GA–SA) to choose the suitable parameter combination for a SVR model. Subsequently, examples of 3G mobile phones demand data from Taiwan were used to illustrate the proposed SVRGA–SA model. The empirical results reveal that the proposed model outperforms the other two models, namely the autoregressive integrated moving average (ARIMA) model and the general regression neural networks (GRNN) model. [Copyright &y& Elsevier]

Abstract: Variations of He gas concentration are widely applied in studies devoted to the location of faults and to monitor seismic activities. Up to now, its migration mechanism in soil is not fully understood. A systematic soil gas survey across an active fault in NW Taiwan provides the opportunity to closely examine the mechanism of He migration in the fault zone. Significant spatial and temporal correlations observed between soil N2 and He gas support the hypothesis that N2 is the probable carrier gas for He emission in the studied area. Based on N2/Ar ratios and N2 isotopic results, the excess soil N2 in this study is considered to be largely derived from ancient atmospheric air which was dissolved in groundwater. Furthermore, observations rule out the possibility of CO2 being the dominant carrier gas for He in the studied area based on the C and He isotopic compositions and the relationship between concentrations of these gases. At least two soil gas sources, A and B, can be identified in the studied area. Source A is an abiogenic gas source characterized by excess N2 and He, and very low O2 and CO2 content. Source B, on the other hand, is a mixture of biogenic gas and atmospheric air. The development of the fault system is an important factor affecting the degree of mixture between sources A and B. Therefore, variations of soil gas composition, in particular those derived from source A, could be a useful proxy for tracing faults in the area. [Copyright &y& Elsevier]

This study evaluated the correlations between spiritual beliefs and health-related quality of life (HRQOL) of hemodialysis (HD) patients in Taiwan. Participants had to complete two questionnaires: the 36-item Short Form Health Survey Questionnaire and the Royal Free Interview for Spiritual and Religious Beliefs. They were then divided into three groups according to their strength of spiritual beliefs—having no, weak, or strong beliefs. Demographic, clinical, and laboratory data among groups were compared. Correlations between spiritual beliefs and HRQOL were then determined by the analysis of covariance and the post hoc Scheffe tests. Six hundred thirty-three patients completed the study. There were more women in the group of patients with strong beliefs ( P = 0.005) and more less-educated patients in the group of patients with weak beliefs ( P = 0.005). Patients with no or with strong spiritual beliefs had higher role physical ( P = 0.01) and social functioning (SF) ( P = 0.001) scores than patients with weak beliefs. After adjustment for gender, age, marital status, education, comorbidities, and time on dialysis, patients with no or with strong spiritual beliefs were found to have higher SF scores ( P = 0.02) than patients with weak beliefs. HD patients with no or strong spiritual beliefs had higher SF HRQOL than those with weak spiritual beliefs. [ABSTRACT FROM AUTHOR]

For isolated power systems, an efficient and effective ancillary services market is one of the most important tools to ensure the system security and service quality. It is recognized that pumped storage units can play a unique role in the operation of isolated power systems. As part of the introduction of the ancillary services for Taiwan, a study was performed to identify the role and value of pumped storage units in the fast-response reserve (FRR). This paper analyzes the actual dispatching schedules of pumped storage units in the Taiwan Power System (TPS) to provide FRR when system was operated under seriously insufficient conditions for the year 2004. The results are used to quantify the value of pumped storage units in the ancillary services. Since the dispatching schedules of pumped storage units determined the cost of FRR in the TPS, the actual operating experience of pumped storage units studied in this paper can be used to evaluate the impact on the system security and to further define the role of pumped storage units in the ancillary services market. [ABSTRACT FROM AUTHOR]

AbstractBackground:Sleep disorders are common in hemodialysis (HD) patients. This study examined the relationship between quality of sleep (QoS) and religious/spiritual activity in HD patients. Methods:The study subjects were 861 HD patients from 14 dialysis clinics in Taiwan. QoS and religious/spiritual activity were evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Royal Free Questionnaire respectively. Results:There was no difference in clinical parameters between the good and poor sleepers. Although total scores of religious and spiritual activity did not correlate with global PSQI score, patients who held strong ‘spiritual’ beliefs reported more problems in ‘sleep disturbances’, while those who exercised religious beliefs more strongly reported less trouble in ‘daytime dysfunction’. Conclusion:There is no significant correlation between QoS and religious/spiritual activity globally. However, the spiritual and religious activity did associate with different components of QoS.Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Digital technology has been widely used in health care systems and disease management, as well as in controlling the spread of COVID-19. As one of the most successful countries in combating the COVID-19 pandemic, Taiwan has successfully used digital technology to strengthen its efforts in controlling the COVID-19 pandemic. Taiwan has a well-established National Health Insurance System (NHIS), which provides a great opportunity to develop a nationwide data linkage model in an agile manner. Here we provide an overview of the application of data linkage models for strategies in combating COVID-19 in Taiwan, including NHIS centralized data linkage systems and "from border to community" information-driven data linkage systems during the COVID-19 pandemic. Furthermore, we discuss the dual role of digital technologies in being an "enabler" and a "driver" in early disease prevention. Lastly, Taiwan's experience in applying digital technology to enhance the control of COVID-19 potentially highlights lessons learned and opportunities for other countries to handle the COVID-19 situation better. [ABSTRACT FROM AUTHOR]

Background: Low infection and case-fatality rates have been thus far observed in Taiwan. One of the reasons for this major success is better use of big data analytics in efficient contact tracing and management and surveillance of those who require quarantine and isolation.Objective: We present here a unique application of big data analytics among Taiwanese people who had contact with more than 3000 passengers that disembarked at Keelung harbor in Taiwan for a 1-day tour on January 31, 2020, 5 days before the outbreak of coronavirus disease (COVID-19) on the Diamond Princess cruise ship on February 5, 2020, after an index case was identified on January 20, 2020.Methods: The smart contact tracing-based mobile sensor data, cross-validated by other big sensor surveillance data, were analyzed by the mobile geopositioning method and rapid analysis to identify 627,386 potential contact-persons. Information on self-monitoring and self-quarantine was provided via SMS, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were offered for symptomatic contacts. National Health Insurance claims big data were linked, to follow-up on the outcome related to COVID-19 among those who were hospitalized due to pneumonia and advised to undergo screening for SARS-CoV-2.Results: As of February 29, a total of 67 contacts who were tested by reverse transcription-polymerase chain reaction were all negative and no confirmed COVID-19 cases were found. Less cases of respiratory syndrome and pneumonia were found after the follow-up of the contact population compared with the general population until March 10, 2020.Conclusions: Big data analytics with smart contact tracing, automated alert messaging for self-restriction, and follow-up of the outcome related to COVID-19 using health insurance data could curtail the resources required for conventional epidemiological contact tracing. [ABSTRACT FROM AUTHOR]

Abstract: The present study is proposed to investigate geochemical variations of soil–gas composition in the vicinity of the geologic fault zone of Hsincheng in the Hsinchu area of Taiwan. Soil–gas surveys have been conducted across the Hsincheng fault, to look for the degassing pattern of this fault system. During the surveys, soil–gas samples were collected along traverses crossing the observed structures. The collected soil–gas samples were analysed for He, Rn, CO2, CH4, Ar, O2 and N2. The data analysis clearly reveals anomalous values along the fault. Before selecting a monitoring site, the occurrence of deeper gas emanation was investigated by the soil–gas surveys and followed by continuous monitoring of some selected sites with respect to tectonic activity to check the sensitivity of the sites. A site was selected for long term monitoring on the basis of coexistence of high concentration of helium, radon and carrier gases and sensitivity towards the tectonic activity in the region. A continuous monitoring station was established at Hsinchu National Industrial Science Park (HNISP) in October 2005. Preliminary results of the monitoring station have shown possible precursory signals for some earthquake events. [Copyright &y& Elsevier]

Abstract: We inquire whether assessment of an individual''s upper limb function may be improved by using specific regional norms rather than consolidated global norms. Grip strengths were measured in a sample of 482 adults across Taiwan, and compared with consolidated norms. To ensure comparable conditions, our procedures were those recommended by the American Society of Hand Therapists (ASHT). Overall the mean grip strength of our sample was significantly (male 25%, female 27%) lower than consolidated norms derived from largely Caucasian populations. We investigated variables that might relate to this divergence. Results of ANOVA and stepwise multiple regression analysis showed that gender, age and palm length were effective predictors in grip strength. A regression equation was derived. When other variables were matched, palm length appeared an important discriminating factor. Further anthropometric and socio-economic factors also need investigation. Specific regional norms should provide more accuracy for ergonomists and health workers assessing an individual''s upper limb function, and may avoid errors in appraisal. This paper suggests grip strength values for Taiwan. [Copyright &y& Elsevier]

Abstract: Changes in paleorainfall intensity linked to the strength of the East Asian (EA) summer monsoon since 21cal kyr BP are inferred from the organic matter contents of a 15-m sediment core from Tung-Yuan Pond in southern Taiwan. High total organic carbon/total nitrogen (TOC/TN) values in association with increased TOC content suggest that more soil-derived material containing terrestrial organic matter (OM) was delivered to the lake during periods of increased runoff associated with extensive precipitation that resulted from intensified summer monsoons, whereas low values indicate OM possessing a dominant algal origin during weakened summer monsoons. Rainfall intensity in terms of the proportion of terrestrial OM was high in four periods: the last deglaciation (∼17.2 to ∼12.2ka), the early Holocene (∼10.6 to ∼8.6ka), the middle Holocene Thermal Optimum (∼7.7 to ∼5ka) and the late Holocene (∼4.2 to ∼2ka), whereas it was low in the intervening time periods. High TOC/TN values coincide with peak values of summer insolation, and thus the strongest EA summer monsoon during the early and middle Holocene; small drops in these ratios correspond to increasing and decreasing solar radiation in the deglacial period and the late Holocene, respectively. The four intervals with low TOC/TN ratios, as well as episodic drops of the ratios during the deglaciation and the early and late Holocene are concordant with the late last glacial (∼21 to ∼17.2ka), the Oldest (∼14.8ka), the Older (∼13.3ka) and the Younger Dryas (∼13 to ∼11.5ka), the 8.2 cold event (∼8.6–7.7ka) and a late Holocene cold event (∼5–4.2ka), and suggest a weakened EA summer monsoon during these times. Moreover, high frequency hydrological variability occurred during the early Holocene, heavy rainfall persisted during the middle Holocene, and precipitation intensity generally diminished after ∼5ka. The Tung-Yuan Pond sediment record indicates that the TOC/TN ratio can be used as a paleorainfall intensity proxy to trace variations in the EA summer monsoon strength in other small lakes. [Copyright &y& Elsevier]

Abstract: Many studies have shown the soil gas method to be one of the most reliable investigation tools in the research of earthquake precursory signals and fault delineation. The present research is aimed finding the relationship between soil gas distribution and tectonic systems in the vicinity of the Hsinhua Fault zone in the Tainan area of Southern Taiwan. More than 110 samples were collected along 13 traverses to find the spatial distribution of Rn, He, CO2 and N2. The spatial congruence of all the gases shows that N2 is the most probable carrier gas of He, whereas CO2 seems to be a good carrier gas of Rn in this area. From the spatial distribution of Rn, He, CO2 and N2 the trace of Hsinhua Fault and neotectonic features can be identified. The spatial distribution of studied gases shows a clear anomalous trend ENE–SWS along the Hsinhua Fault. [Copyright &y& Elsevier]

The 1997/1998 El Niño event caused mass coral bleaching and mortality in many tropical and subtropical regions, including corals on Green Island, Taiwan, in the northwestern Pacific Ocean. This study analyzed coral carbon isotope ratios (δ 13 C), oxygen isotope ratios (δ 18 O), and Sr/Ca ratios for 29 years, including the 1997/1998 El Niño period, to examine how high water temperature events are recorded in coral geochemical indicators. Sr/Ca ratios in coral skeletons from Green Island show the lowest peak, means the highest temperature during the 1997/1998 El Niño period. However, we couldn't observe high-temperature events on δ 18 O. Furthermore, a negative δ 13 C shift was observed after El Niño events. The regime shift of δ 13 C might have been caused by temporal bleaching and/or a decrease in symbiotic algae due to high water temperature stress under the continuous decrease in δ 13 C in DIC due to the Suess effect., (© 2024. The Author(s).)

Healing perception is considered to increase visitors' place attachment and loyalty. This research employed structural equation modeling (SEM) to examine the structural relationship between healing perception, place attachment, environmental design, and visitors' loyalty to a place. The study investigated a metropolitan park in Gaoxiong, Taiwan, and collected 431 valid questionnaires on the site. The results showed that the environmental design affected the human perception of healing and place attachment, which substantially affected the visitors' loyalty toward the place. The healing perception powerfully impacted loyalty (0.76), which contained an indirect effect through place attachment and enhanced the direct impact of healing perception. Moreover, the environmental design had a capable direct effect (0.62) on visitors' loyalty through two full mediation paths: healing perception and place attachment. The study sheds light on designing a healing park that could enhance visitors' place attachment and strongly affect their loyalty to the park.

Patients with influenza infection may develop acute respiratory distress syndrome (ARDS), which is associated with high mortality. Some patients with ARDS receiving extracorporeal membrane oxygenation (ECMO) support die of infectious complications. We aimed to investigate the risk factors affecting the clinical outcomes in critically ill patients with influenza. We retrospectively reviewed the medical records of influenza patients between January 2006 and May 2016 at the Kaohsiung Veterans General Hospital in Taiwan. Patients aged below 20 years or without laboratory-confirmed influenza were excluded. Critically ill patients who presented with ARDS ( P = 0.004, odds ratio (OR): 8.054, 95% confidence interval (CI): 1.975-32.855), a higher Acute Physiology and Chronic Health Evaluation (APACHE) II score ( P = 0.008, OR: 1.102, 95% CI: 1.025-1.184), or higher positive end-expiratory pressure ( P = 0.008, OR: 1.259, 95% CI: 1.061-1.493) may have a higher risk of receiving ECMO. Influenza A ( P = 0.037, OR: 0.105, 95% CI: 0.013-0.876) and multiple organ failure ( P = 0.007, OR: 0.056, 95% CI: 0.007-0.457) were significantly associated with higher mortality rates. In conclusion, our study showed critically ill influenza patients with ARDS, higher APACHE II scores, and higher positive end-expiratory pressure have a higher risk of receiving ECMO support. Influenza A and multiple organ failure are predictors of mortality.

Background: A number of studies investigating mutations of genes involved in MAPK and PI3K pathways in melanoma patients have been performed, most of which were based on Caucasian populations., Objectives: We sought to identify BRAF, NRAS, MEK1, PI3K, and PTEN mutations and further determine possible correlations with clinicopathological parameters in Taiwanese patients with acral, non-chronic sun damaged (NCSD), or mucosal melanoma., Materials & Methods: Forty melanocytic nevi, 24 dysplastic nevi, and 175 melanomas from Taiwanese patients were analysed for mutations in BRAF, NRAS, MEK1, PI3K, and PTEN genes by PCR and direct sequencing. Immunohistochemical analysis of the respective proteins in nevi and melanomas were also performed to determine possible clinicopathological characteristics., Results: In addition to the classic BRAF V600E mutation, a novel BRAF V600L mutation was identified in acral and sinonasal melanomas. A significantly reduced frequency of NRAS and BRAF mutations was noted compared with Caucasian-based studies. Increased immunohistochemical scores for pan-RAS and MEK1 and less nodal metastasis were associated with enhanced survival rates in acral and NCSD melanoma patients., Conclusions: Our findings suggest that oncogenic events may differ among melanomas in Asian patients geographically (e.g. between Japanese and Taiwanese patients). Moreover, distinct genetic alterations were noted among acral, NCSD, and mucosal melanoma patients in our study, and the expression of biomarkers correlated with clinical survival rates differentially among the various melanoma groups.

A new species of the cutthroat eel genus Synaphobranchus is described from Taiwan on the basis of 12 types and 11 non-type specimens. The new species can be distinguished from its congeners in having most of its head and abdomen naked, except for a patch of scales behind the eye, dorsal surface of trunk naked or covered by scattered scales; scales oval in shape; dorsal fin slightly before to about opposite to origin of anal fin; mean vertebral formula 28-28-131, precaudal vertebrae 50-56, total vertebrae 124-135. Comments of the congeners occurred in adjacent regions are provided.

We aimed to elucidate whether and how BRCA1 mislocalization [including membranous nuclear (MN) forms and negative patterns] is associated with the occurrence and the prognosis of breast cancer in young Taiwanese women. A case-control study was carried out to enroll 84 patients with breast cancer and 81 patients with benign breast disease. The subcellular localization of BRCA1 was examined using immunofluorescent assays on fresh tissue touch-imprinting slides to classify staining results into diffuse nuclear (DN), MN, and negative staining. Genetic variations of BRCA1 nuclear localization/transportation-related sequences were analyzed by cDNA sequencing of both nuclear localization signals (NLS) and nuclear export signals (NES). The BRCA1 antibody was verified by two other published ones. Comparisons of immunofluorescent assay with immunohistochemical and H&E staining methods were also performed. BRCA1 mislocalization conferred a 3.13-fold [95% confidence interval (CI): 1.31-7.50] risk of developing breast cancer for the MN form and a 5.79-fold (95% CI:1.58-21.23) risk for BRCA1-negative cases compared with DN staining. However, no genetic variant was found in the NES or the NLS region of the BRCA1 gene. In terms of prognosis, BRCA1 mislocalization showed a 3.5-fold (95% CI: 1.20-10.09) increased risk of breast cancer death compared with DN staining after adjusting for tumor node metastasis stage. BRCA1 MN forms and BRCA1-negative patterns led to a higher risk of carcinogenesis and a poor prognosis of breast cancer. Such BRCA1 mislocalization may not be directly caused by the genetic effects of the NLS and NES domains, but stem from nongenetic modifications (such as epigenetic silencing).

Distinct genetic aberrations between melanomas in different anatomical locations have been confirmed in recent years. However, the associations between immunohistochemical expression, tumor sites, and clinical parameters are not clear. We examined the correlation of protein expression and gene mutation of c-kit with clinicopathological parameters and lesion locations in patients with malignant melanoma (MM). We collected 170 melanocytic lesions, including 106 cutaneous MM from acral melanoma (AM) and nonacral melanoma (NAM) sites, 24 dysplastic nevi, and 40 common melanocytic nevi. Tissue microarray was constructed, and immunohistochemical expression for c-kit was assessed with correlation with clinical parameters. Mutation in exons 11, 13, 17, and 18 of KIT gene in genomic DNA by polymerase chain reaction sequencing was also analyzed. Immunostaining scores for c-kit were found to be statistically higher in Dysplastic Nevi than in common melanocytic nevi and MM. In addition, cytoplasmic c-kit staining was significantly correlated with poor survival in patients with AM but not in those with NAM. Twenty-nine cases of MM (including 9 NAM and 20 AM) are analyzed for mutation in exons 11, 13, 17, and 18 of KIT gene in genomic DNA by polymerase chain reaction sequencing, and no genetic mutation is found. Our findings confirm that KIT mutations, in contrast to previous white cohorts, are not common in both AM and NAM of the Chinese and do not necessarily correlate with c-kit expression. The significantly different association between the expression of c-kit immunoreactivities and the mortality risks of melanomas on acral versus nonacral sites might change site-specific targeted therapeutic concepts in melanoma in the future.

This study investigated how perceived job stress and health status differ, as well as the relationships to inbound (incoming calls) versus outbound (outgoing calls) calling activities, for call center workers in a bank in Taiwan. The sample bank employed 289 call center workers at the time of the survey, ranging in age from 19 to 54 yr old. Data were obtained on individual factors, health complaints, perceived level job stress, and major job stressors. Overall, 33.5% of outbound operators and 27.1% of inbound operators reported frequently or always experiencing high stress at work, however, the differences between inbound and outbound operators were insignificant. "Having to deal with difficult customers" was the most frequent job stressor for all workers. Musculoskeletal discomfort, eye strain, and hoarse or sore throat were the most prevalent complaints among call center workers. The relationship between perceived job stress and health complaints indicated that workers who perceived higher job stress had significantly increased risk of multiple health problems, including eye strain, tinnitus, hoarse or sore throat, chronic cough with phlegm, chest tightness, irritable stomach or peptic ulcers, and musculoskeletal discomfort (with odds ratios ranging from 2.13 to 8.24). These analytical results suggest that perceived job stress in the call center profoundly affected worker health. This study identified main types of job stressors requiring further investigation.

Background: Acoustic analysis had been well incorporated into clinical evaluation and management of children with speech disorders for many years. The aim of this study is to investigate developmental changes in vowel production in Mandarin-speaking children using acoustic study analysis., Methods: A total of 22 children from 5-12 years old were analyzed in this study. Each child read a list of speech materials consisting of 6 dissyllabic words in Mandarin phonemes and the speech samples were recorded. The digitized acoustic recordings were submitted for acoustic analysis. The acoustic parameters in this study include the first and second formant frequencies (F1 and F2) of /a/, /i/ and /u/ and the vowel space. We used the Wilcoxon rank sum test and Spearman's rho correlation test for statistical analysis., Results: The F1 values of the vowel /i/ were significantly lower in boys than those in girls (p = 0.013) by Wilcoxon ranksum test. The F1 value of the vowel /i/ was negatively correlated with children's age (rho = -0.601, p = 0.003) and their body height (rho = 0.478 p = 0.045). The F1 values of the other two vowels (/u/ and /a/), the F2 values of all three vowels and the vowel space had no association with age and gender., Conclusions: F1 acoustic parameters have developmental and gender changes in vowel production in Mandarin-speaking children. The data in this study provide references for acoustic assessment of Mandarin-speaking children.

Background: Sleep disorders are common in hemodialysis (HD) patients. This study examined the relationship between quality of sleep (QoS) and religious/spiritual activity in HD patients., Methods: The study subjects were 861 HD patients from 14 dialysis clinics in Taiwan. QoS and religious/spiritual activity were evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Royal Free Questionnaire respectively., Results: There was no difference in clinical parameters between the good and poor sleepers. Although total scores of religious and spiritual activity did not correlate with global PSQI score, patients who held strong 'spiritual' beliefs reported more problems in 'sleep disturbances', while those who exercised religious beliefs more strongly reported less trouble in 'daytime dysfunction'., Conclusion: There is no significant correlation between QoS and religious/spiritual activity globally. However, the spiritual and religious activity did associate with different components of QoS., (Copyright 2008 S. Karger AG, Basel.)