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This study investigated the conditions of abandoned, lost, discarded fishing gear (ALDFG) in natural and artificial reef zones and removed it afterward in Penghu Islands. Various feasible suggestions for improving ALDFG management were proposed for the county government to manage and reduce the generation of ALDFG in the future and maintain the marine ecosystem. This study divided the ocean areas of Penghu into five sub-areas for carrying out research and surveys. 165 boat trips of ALDFG investigation and removal were conducted from July 2018 to October 2019. The results show the ALDFG in natural reef areas is mostly large-mesh gillnets (26 %). The rest are single-layer bottom gillnets (21 %) and multi-layer bottom gillnets (20 %). In line with the recent efforts of the Penghu County Government to address ALDFG, it is recommended that the participation of citizen scientists and the promotion of ocean education can be utilized for fishery co-management in Penghu., 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 © 2023. Published by Elsevier Ltd.)

Although evidence suggests an importance of genetic factors in the development of breast cancer in Taiwanese (ethnic Chinese) women, including a high incidence of early-onset and secondary contralateral breast cancer, a major breast cancer predisposition gene, BRCA1, has not been well studied in this population. In fact, the carcinogenic impacts of many genetic variants of BRCA1 are unknown and classified as variants of uncertain significance (VUS). It is therefore important to establish a method to characterize the BRCA1 VUSs and understand their role in Taiwanese breast cancer patients. Accordingly, we developed a multimodel assessment strategy consisting of a prescreening portion and a validated functional assay to study breast cancer patients with early-onset, bilateral or familial breast cancer. We found germ-line BRCA1 mutations in 11.1% of our cohort and identified one novel missense mutation, c.5191C>A. Two genetic variants were initially classified as VUSs (c.1155C>T and c.5191C>A). c.1155C>T is not predicted to be deleterious in the prescreening portion of our assessment strategy. c.5191C>A, on the other hand, causes p.T1691K, which is predicted to have high deleterious probability because of significant structural alteration, a high deleterious score in the predictive programs and, clinically, triple negative characteristics in breast tumors. This mutant is confirmed by transcription activation and yeast growth-inhibition assays. In conclusion, we show as high a prevalence of germ-line BRCA1 mutation in high-risk Taiwanese patients as in Caucasians and demonstrate a useful strategy for studying BRCA1 VUSs.

Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan., Methods: In total, 623 terminal cancer patients under hospice consultation care from one medical center in northern Taiwan were enrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultation and patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzed retrospectively to determine significance of between-group differences., Results: By PPI sum score, 37.2% of patients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poor prognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days, respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versus good prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group. The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68)., Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.

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.

Objective: To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke, such as blood lipid profiles, diet habits and indices of body weight, through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs., Design and Setting: This was a community-based prospective study. The study population was randomly selected from communities in Taipei; potential subjects were invited by telephone to participate., Subjects: After excluding subjects whose blood pressure was normal and those using antihypertensive drugs, there were 390 participants included in the study. Subjects in the intervention group (n 293) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit. Non-intervention subjects (n 97) only acquired a general education sheet available in clinics. The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention's effect on decrease in blood pressure., Results: Significant decreases of 2.0 mmHg and 5.9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group. Additionally, intervention subjects with improvement of total cholesterol and LDL cholesterol, decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure., Conclusions: The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly, without taking antihypertensive drugs, after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme, resulting in a significant effect on stroke risk reduction.

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.

Aims: Early detection of breast cancer can improve disease mortality. The aim of this study was to evaluate the effectiveness of serum biomarkers in the detection of primary breast cancer and lymph node metastatic status., Methods: Serum samples were obtained from 55 female patients with breast cancer and 39 women without breast cancer. For these subjects, clinicopathological data were collected and serum levels of carcinoembryonic antigen, breast cancer-specific cancer antigen 15.3 (CA15-3), tissue polypeptide-specific antigen (TPS), soluble interleukin-2 receptor (sIL-2R) and insulin-like growth factor binding protein-3 (IGFBP-3) were assayed. Univariate and multivariate logistic regression were performed to evaluate the association between biomarkers and breast cancer, as well as lymph node metastatic status., Results: For breast cancer prediction, the serum level of TPS had the best predictive value, with a sensitivity of 80% at an optimal cut-off value of 69.1 U L(-1). The combination of TPS, CA15-3 and IGFBP-3 with logistic regression model increased the sensitivity to 85%. For lymph node metastasis prediction, the serum level of sIL-2R had the best predictive value, with a sensitivity of 66% at an optimal cut-off value of 286 U mL(-1). The combination of sIL-2R and TPS with logistic regression model increased the sensitivity to 69%., Conclusion: TPS may be useful in the detection of primary breast cancer, while sIL-2R may be useful in lymph node metastasis prediction. The combination of more than one biomarker with logistic regression model can improve the predictive sensitivity.

Objectives: The issue of existence of malignancy within oral leukoplakia has seldom been addressed in Taiwan. The aims of this study were to investigate the prevalence of carcinoma and dysplasia within oral leukoplakia at the time of clinical diagnosis and to identify the associated risk factors in Taiwan., Study Design: The prevalence rate of malignancy and dysplasia in 1046 oral leukoplakias at a university hospital was calculated. Univariate and multivariate analyses by the Mantel-Haenszel method and multiple logistic regression model were performed to examine risk factors associated with the presence of carcinoma and dysplasia within the lesions., Results: The prevalence rate of carcinoma was 12.9%. The relative risks for the presence of malignancy in leukoplakias on the tongue/floor of mouth and with nonhomogeneous appearance were 2.72- and 28.13-fold by multivariate logistic regression analysis, when compared with those on buccal mucosa and lesions having homogeneous surface (both P < .05). In contrast, patients who both smoked and chewed betel quid had a significantly lower risk for carcinoma than the abstainers (P < .05). A synergistic effect between the 2 major risk factors of clinical appearance and lesion site was evident. Nonhomogeneous leukoplakia on tongue/floor of mouth had a 43.10-fold higher risk compared to homogeneous lesions located on buccal mucosa or other sites (P < .05). However, homogeneous leukoplakia in buccal mucosa or other sites of the oral cavity still had the possibility of having carcinoma within the lesion. The prevalence of dysplasia was 45.6% among the noncancerous leukoplakias with risk factors similar to those for carcinoma., Conclusions: Our results demonstrate that some leukoplakias contain a malignant component. Lesions with certain features are more prone to carcinoma, but no clinical attributes can bring certitude. Therefore, all oral leukoplakias should be submitted to microscopic analysis before any definite treatment or long-term follow-up.

Background and Objectives: Phyllodes tumors (PTs) are uncommon biphasic breast tumors that usually occur in adult females. They are composed of a benign epithelial component and a cellular, spindle cell stroma forming a leaf-like structure. No one morphologic finding is reliable in predicting the clinical behavior of the tumor. The purpose of this study was to explore the clinicopathologic factors associated with outcome and metastasis., Methods: We retrospectively reviewed the records of 172 patients seen at Mackay Memorial Hospital from January 1985 to December 2003. Clinical data analyzed included age, presenting symptoms and signs, tumor size, location, type of surgery, time to recurrence, and metastasis. The clinicopathologic factors associated with outcome and metastasis were analyzed statistically using the chi-square test with Yate correction., Results: The mean follow-up was 71 months (range 7-237). The mean age was 37 years (range 11-73). The majority of tumors were found in the upper outer quadrant (46.0%), with an equal propensity to occur in either breast (48.8% vs. 50.0%). The pathologic diagnoses included 131 benign, 12 borderline, and 29 malignant lesions. Nineteen patients (11%) had a recurrence and three (1.7%) had metastases. The initial diagnosis of all 19 recurrent tumors were benign. Age, surgical approach, mitotic activity, and surgical margin were significantly correlated with recurrence (P = 0.029, 0.020, 0.048, and 0.00018, respectively). Stromal cellularity, stromal overgrowth, stromal atypia, mitotic activity, tumor margin, and heterologous stromal elements were significantly correlated with metastases (P = 0.032, 0.00008, 0.000002, 0.004, 0.005, and 0.046, respectively). Mammography and breast echo were not reliable for differentiating PTs from fibroadenomas (6.9% vs. 37.9% and 3.3% vs. 45%, respectively). Frozen section was of limited value (41.6%). The role of adjuvant radiotherapy and chemotherapy remains to be defined. Local excision, wide excision, or mastectomy with negative surgical margins yielded high local control rates (88.7%, 88.2%, and 100%, respectively), but local excision was associated with a relatively high percentage of positive surgical margins (18.3%). A total of 42 modified radical mastectomies were performed. The reasons for these procedures included a diagnosis of malignancy on frozen section or because the tumors were so large, they were assumed to be carcinomas. No axillary lymph node metastases were found. Fifteen patients in our series had tumors with infiltrating tumor margin, severe stromal overgrowth, atypia, and cellularity. All three patients with metastases (3/15) were in this group. Presence of metastases was significantly correlated with this group (P = 0.0000038)., Conclusions: Wide excision with a clear margin may be the preferable initial therapy, even for malignant PTs. Routine axillary lymph node dissection is not recommended. Patients have tumors with infiltrating tumor margin, severe stromal overgrowth, atypia, and cellularity are at high risk for metastases., (Copyright 2005 Wiley-Liss, Inc.)

Learning curves have been described for different health technologies, mainly new surgical or diagnostic procedures, but learning curves for a new hospital's laboratory procedures have not been systematically studied. To monitor the timeliness (turnaround time) of stat tests from the Emergency Department as a marker of laboratory quality and to address the issue of a learning curve for procedures performed in a new hospital laboratory, we employed a computerized system for collecting data of turnaround time (from order entry to result verification) on stat tests from the Emergency Department of a newly opened (July 24, 2000) 471-bed general hospital. The data collection operates without user intervention. We evaluated the turnaround times of stat complete blood count and biochemistry tests from August 2000 to December 2001. Results show that it took 6 to 12 months before the turnaround times reached a plateau, we believe that this is the learning curve of a new hospital laboratory. Computer-generated turnaround times for Emergency Department stat tests appear to be a useful tool for monitoring the quality of laboratory tests and can demonstrate the learning curve of a new hospital laboratory.

The objective of this study was to test the reliability and validity of the Taiwan Chinese version of the EORTC QLQ-C30 (version 3) and EORTC QLQ-BR23. The authors followed the guidelines of translation and pilot testing of the questionnaires. The questionnaires were given to 35 breast cancer patients under active treatment and 54 under follow-up at the National Taiwan University Hospital from November 2000 to October 2001. A retest was conducted one to two weeks after the first interview/form completion for the follow-up group. The intraclass correlation coefficients of the two questionnaires were moderate to high in the follow-up group. The Cronbach's alpha coefficients of most scales of the two questionnaires were > or = 0.70 except that of physical functioning (0.68), cognitive functioning (0.53), and arm symptoms (0.59). Correlations of scales measuring similar dimensions of the EORTC QLQ-C30 and the SF-36 were moderate. Patients in the active treatment group had more serious QOL problems due to disease and treatment. Results of this study showed that the Taiwan Chinese version of the two questionnaires had good test/retest reliability, high internal consistency in most scales, and could show the expected differences between patients in active chemotherapy and follow-up group., (Copyright 2003 John Wiley & Sons, Ltd.)