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Local tour guides' English speaking competence determines inbound international tourists' travel experiences. This study investigated student tour guides' English learning by adopting role-play tasks. The communicative tasks were designed to explore how real interactions prepared English as Foreign Language (EFL) learners to become cultural ambassadors who introduce Taiwanese features to the world. Twenty-nine students were recruited from an "English for Tourism Purposes" course to interact with international students who acted as tourists. The student tour guides took turns introducing a topic unique to Taiwan. Data included recorded conversational interactions between the international and local students, comments on tour-guiding performances, and reflective notes. Adopting conversation and thematic analysis, the researcher analyzed the objective learning outcomes by observing how students performed in the tour-guiding tasks and examined the subjective viewpoints from the participants' reflective notes. The results revealed distinctive spoken features for communicative competence and the benefits of gaining a deeper intercultural understanding of how to communicate Taiwanese culture in English and developing various communication skills for interacting with foreigners. Pedagogical implications are discussed in terms of the design of English for Tourism teaching.

This study aims to assist preschools in achieving sustainable development by providing system thinking training for teachers and administrators. By promoting system thinking and PDCA, training helps preschool staff and teachers construct their knowledge and culture for organizational growth and effective operation. The research procedure encompasses stages of preparation, knowledge diffusion, knowledge adaptation, and establishing support networks. A total of 744 training participants engage in case studies, discussions, and self-evaluation activities to enhance their understanding and application of the PDCA framework. Quantitative and qualitative methods are used to collect the research participants' perceptions and intentions on this training. Research data is collected using 5-point Likert questionnaires, supplemented with open-ended questions to gather participants' perceptions and suggestions. In addition, qualitative data is obtained through onsite observation, focus groups, and individual interviews. The research results indicate that participants in the training program positively perceive the training activities. Also, those with administrative roles and from non-profit preschools exhibit higher interest and motivation for training, reflecting the need for sustainability knowledge in changing environments.

Previous research has made it clear that older learners are mainly learning for learning's sake. However, few studies have explored the intrinsic aspects of older learners' motivation in detail; also, the factors that influence their learning motivation remain under-researched and under-theorised. To address this gap, this survey-based quantitative study investigated the learning motivations of 816 older learners from an intrinsic-motivation viewpoint, and explored the predictors of these motivations, including institutional as well as personal factors. The results indicated that these older learners rated their intrinsic motivations highly (3.97/5 overall), and that such motivations could be differentiated into cognitive-oriented and social-oriented motivations. The most important predictors of intrinsic motivations for the respondents were institutional variables, especially teacher support and peer support. Importantly, institutional predictor variables were found to diminish the negative impacts of both self-reported poor health and age on these older adults' overall intrinsic motivation to learn. These findings imply that, in Taiwan, providing more teacher- and peer support is likely to increase the intrinsic motivation to learn for vulnerable older adults who are disadvantaged by health problems and old age.

Purpose: The educational environment in Taiwan's primary and secondary schools is becoming increasingly diverse and complex. This study examined the relationship between primary and secondary school principals' working values, organisational climate and organisational adaptation. Design/methodology/approach: Data were collected from the third Teaching and Learning International Survey (TALIS), which targeted 401 principals in Taiwan's primary and secondary schools, conducted in 2018 by the Organisation for Economic Co-operation and Development (OCED). In this study, a structural equation model was constructed. Findings: The results indicated that primary and secondary school principals generally had positive work values, and their schools' organisational climate and adaptation were positive. In addition, the work values, organisational climate and organisational adaptation models showed good fit for a variety of potential variables. Furthermore, the organisational climate had a mediating effect that strengthened the principals' work values and was a major factor in enhancing organisational adaptation. The results suggest that in addition to principals' positive work values, fostering a cooperative organisational climate--such as the perceived level of support from supervisors and the environment--is essential to enhance schools' organisational adaptation. Originality/value: The principal's work value has a profound impact on the creation of a school's organisational atmosphere, the cohesion of members' consensus and the organisation's contingency decision-making in response to the external environment. This study adduces more diverse recommendations for the development of school affairs.

Learning is mainly based on the students' mental activities. If they can learn spontaneously, it will help increase their interest and the effectiveness of the learning. Learning through playing will make it easier for students to learn spontaneously. The balance between gameplay and education in educational games is a key issue in designing such games. Designing educational games to be less complex and more casual makes it easier to balance education and entertainment. For courses with practical operational characteristics, combining a game with a virtual and real integration experience can increase both student interest and learning effectiveness. This research develops an augmented reality app, named "Mobile Plant", which is an app developed for the primary school plant curriculum, combining games and augmented reality to enhance students' interest in learning. A questionnaire shows that the game has positive results in terms of game difficulty and absorption of content.

This study investigated the growth trajectory of academic achievement in Math and English among 519 students in a vocational senior high school in Taiwan. Covering the complete individual learning profile, our dataset included pre-enrollment variables, periodic test scores, and college entrance examination scores. We employed a group-based trajectory model that identified three homogenous subgroups with distinct trajectories of academic achievement in Math and English and demonstrated baseline predictive factors associated with these trajectories as well as relationships between different trajectories and students' college entrance examination scores. Our analysis contributes to the literature in two ways. First, this study demonstrates that when school practices focus on improving or remediating the performance of students in the low-achievement group, the obvious decrease in performance of those in the middle is ignored. Such finding indicates the need for inclusive or specialized practices that enhance the performance of students in all groups. Second, our analysis reveals that pre-enrollment academic preparation appears to be a strong predictor of later academic performance as noted through the reproduction of pre-enrollment academic performance in students' college entrance examination scores. Therefore, upon enrollment, schools should start interventions that reflect the needs of different groups of students.

College students' graduation projects reflect their teamwork abilities. The current research develops a practical framework and causal model of knowledge-sharing behavior, cohesion, and team performance for design college students in Taiwan. Using survey data collected from 115 students who completed their graduation projects in a design college, PLS-SEM was run to test the model. In addition, 11 students who were on teams that won competitions or were shortlisted were interviewed. Results found that knowledge sharing has a significant positive effect on team performance, and cohesion has a significant positive effect on both team performance and knowledge sharing. The students with high cohesion often exhibit knowledge sharing behaviors and excellent team performance. These findings suggest project supervisors should induce knowledge sharing behaviors during the graduation project process in order to enhance student group cohesion.

This study used robot-based practices to develop an activity that incorporated the 6E model. The sixth-grade students learned interdisciplinary knowledge about how to use Arduino electronic components, microcontrollers, and hands-on tools to make a "Crab Robot." In addition, the students learned how to use Scratch programming language to control the robot and complete the "Crab Robot Crossing the Road" task. The study implemented a quasi-experimental design to examine whether the students who learned the robot-based activity using the 6E model acquired better learning motivation, learning performance, computational thinking ability, and hands-on ability than those who learned the activity through lectures. This study adopted purposive sampling to select 70 sixth-grade students from four classes, which were divided into the experimental group (6E model) and the control group (lectures). The experiment was conducted over a period of 18 weeks (for a total duration of 1,440 minutes). The results from the pretests-posttests showed that both groups of students improved their learning motivation, learning performance, computational thinking ability, and hands-on ability; however, the experimental group's scores were significantly better. More importantly, this study provides a pedagogy manuscript for instructors who want to teach mechatronics programs and programming design education.

Purpose: This study was to investigate whether there is an age dependent effect on the association between ADIPPOR1 SNP and hypertriglyceridemia for each gender. Materials and Methods: 116 individuals aged 20 and above who claimed to be healthy were enrolled and grouped into male and female populations. Blood samples were taken to determine hypertriglyceridemia and genomic variants. Sample t-tests were performed for basic comparison. To ascertain the contribution of genetic variants and age to lipid metabolism, a multivariate logistic regression analysis was conducted to identify the correlates for hypertriglyceridemia adjusting for life styles. Results: For males, individuals with hypertriglyceridemia tended to be younger (p-value = 0.02), less stressed (0.05), and have a higher proportion of ADIPOR1 minor allele carriers (0.03). However, no significant differences were found in age, stress, diet, and genetic variances in females. In regression analysis, males showed age-gene correlation with 1.5 times higher detection of hypertriglyceridemia risk when both factors were considered. In contrast, females showed no correlation between age-gene. In addition, age was positively associated with hypertriglyceridemia in females while males showed an inverse association. Conclusion: Our findings presented data that suggests age may be a contributing factor to the association between ADIPOR1 and hypertriglyceridemia in males while age showed a significant inverse association with hypertriglyceridemia. Thus, age-gene correlation may be implied during primary practice to encourage lifestyle adjustments by screening for ADIPOR1 SNP minor allele carriers to prevent cerebrovascular disease in males.

Purpose: Both metabolic syndrome (MetS) and cognitive dysfunction impair health-related quality of life (HRQOL). This study aims to determine whether individuals experiencing both MetS and cognitive dysfunction have lower HRQOL. Methods: This cross-sectional study enrolled 567 participants who attended outpatient clinics at a medical center in northern Taiwan. MetS was diagnosed according to the modified criteria for the Asian population. Cognitive function was categorized as normal, mild cognitive dysfunction, and advanced cognitive dysfunction according to the score of the Montreal Cognitive Assessment, Taiwanese version. HRQOL was assessed using the SF-36v2® Health Survey (SF-36v2). The associations of the comorbidity status of MetS and cognitive dysfunction with HRQOL were analyzed using linear regression models, adjusting for age, sex, marital status, education level, income groups, and activities of daily living. Results: Out of 567 participants, 33 (5.8%) had MetS with mild cognitive dysfunction, and 34 (6.0%) had MetS with advanced cognitive dysfunction. Participants with both MetS and advanced cognitive dysfunction exhibited the lowest scores in the physical component summary and almost all scales of HRQOL. MetS exacerbated the inverse association between mild cognitive dysfunction and the mental component summary. For those with MetS, the scores on scales of role physical, bodily pain, vitality, and social functioning worsened as cognitive function deteriorated (all Ptrend<0.05). Conclusion: As the severity of comorbidity between MetS and cognitive dysfunction varies, patients exhibited poorer performance in different aspects of HRQOL. Future research is needed to find solutions to improve HRQOL for patients with both MetS and cognitive dysfunction. [ABSTRACT FROM AUTHOR]

While the effect of Readers Theater (RT) on English oral reading fluency has been extensively investigated, research on the effect of RT on adolescents' English reading and listening comprehension was scant and yielded different results. This research aimed to explore how RT instruction influenced English as a Foreign Language (EFL) students, especially adolescents, in English reading and listening comprehension. This article conducted a 10-week quasi-experimental design involving two intact classes of 68 seventh-grade students from central Taiwan. The instruments included pretests and posttests of English reading and listening comprehension and nine students were interviewed for an in-depth analysis. The results revealed that the experimental group statistically significantly outperformed the control group on reading comprehension, but not on listening comprehension. Consequently, despite the advantages of RT instruction on reading comprehension stated in the article, interaction among learners in terms of listening comprehension is needed to be emphasized in the course when adopting the RT instruction.

Blogs are useful interaction tools to promote learners' knowledge construction and interaction in online teaching activities. On the other hand, although many studies show that mindtools facilitate learners' cognitive process, little research focus on their effects on learners' higher order cognitive thinking in blogs. This research developed a learning environment by using a mindtool-based blog to promote learners' higher order cognitive thinking in their online discussions and to assess their learning effects. The participants were 276 senior high school students from an information ethics class. A quasi-experimental research design was adopted in this research. The control group used the ordinary blogs. The Experimental Group 1 used the basic mindtools in blogs, which means that learners can use all the mindtool functions except the "Knowledge Compilation" function. The Experimental Group 2 used the advanced mindtools in blogs, which means that they can use all the mindtool functions, including the "Knowledge Compilation" function. The results indicated that both experimental groups showed better learning effects and more higher order cognitive thinking than the control group. Moreover, the higher order cognitive thinking category "Analyze" was found more often in the Experimental Group 2 than in the Experimental Group 1.

This study aimed to investigate the interrelationship of psychological capital (PsyCap) and mindful learning for English learning engagement and the possible path from PsyCap to English learning engagement with mindful learning as the mediator for university students in Taiwan. Data from 245 Taiwanese university students were used to analyze their PsyCap, mindful learning, and English learning engagement. The results of structural equation modeling indicated that PsyCap predicted mindful learning, mindful learning predicted English learning engagement, and a complete mediation existed with mindful learning as the mediator between PsyCap and English learning engagement. The findings suggested that training and practicing PsyCap and mindful learning may be effective in facilitating English learning outcomes.

This research investigates the variables influencing willingness to communicate (WTC) in English as a foreign language (EFL) context in Taiwan. A hypothesized EFL WTC model with six layers focusing on factors related to individual differences was proposed and the EFL WTC model was reinterpreted as a serial mediation model. Ten latent variables, including openness to experience, conscientiousness, agreeableness, extraversion, neuroticism, international posture, motivation, self-perceived communication confidence, EFL WTC, and frequency of using English in the classroom, were used to construct the model. Stratified random sampling was adopted and a questionnaire was administered to 701 university students in Taiwan. The results of structural equation modeling indicated that the EFL WTC model was an adequate fit to the Taiwanese context and validated the reinterpretation of the model as a serial mediation model. The findings supported the interrelationships among different variables and provided a different perspective on WTC in an EFL context.

This study aims to examine the relationship between vocabulary proficiency and short-term memory capacity in deaf or hard-of-hearing (DHH) children. We test the hypothesis that the relationship between vocabulary skills and digit span performance could be strengthened when the digit span task encompasses cross-modal integration processes. A group of DHH children performed two types of auditory digit span tasks. Furthermore, they participated in a standardized vocabulary proficiency test, comprising two subtests: Receptive Vocabulary and Expressive Vocabulary. The verbal digit span served as a significant predictor of Expressive Vocabulary among the DHH children. Simultaneously, the auditory-pointing digit span accounted for a substantial portion of performance variation in both Receptive and Expressive Vocabulary. After considering the impact of the duration of auditory-verbal intervention through regression models, likelihood ratio tests demonstrated that the auditory-pointing digit span persisted as a significant determinant of both receptive and expressive vocabulary skills. A positive influence of the intervention was also confirmed by the present results. This study provides evidence that memory span and the ability to integrate cross-modal information could serve as significant cognitive correlates of vocabulary proficiency in DHH children. [ABSTRACT FROM AUTHOR]

Aim: In Taiwan, over 90% of dementia patients received home care. Severe dementia‐linked food refusal significantly affects nutrition, thereby straining caregivers. Family caregivers can reduce their burden by learning feeding and dementia nutrition online, thus preserving patient oral feeding. The study aim for family caregivers learn online Hand‐Under‐Hand (UH) techniques to ease feeding in severe dementia, enhancing nutrition and reducing their burden. Methods: In this quasi‐experimental study, participants in the experimental group received 2‐h UH courses online, while the control group received their usual care. The primary outcome indicators were abnormal eating behavior, nutritional status, and caregiver burden, with outcomes tracked at 0, 1, and 3 months. At the neurology outpatient clinic of a medical center in Taipei, 65 dyads—comprising patients with severe dementia and their caregivers—were randomly assigned to groups. Results: The study participants comprised 36 female and 29 male caregivers, with an average age of 58.09 years. The patient group included 43 females and 22 males, with a mean age of 83.32 years. Patients in the experimental group exhibited reduced abnormal eating behavior, and caregiver burden was reduced at 1 and 3 months, patients demonstrated improved nutritional status by month 3. Conclusions: The accessibility and convenience of online courses enabled family caregivers to use UH feeding techniques to effectively improve the nutritional status and correct the abnormal eating behavior of patients with dementia, while also decreasing caregiver burden. Geriatr Gerontol Int 2024; 24: 867–873. [ABSTRACT FROM AUTHOR]

Single-parent households have been the interest of policy since the 1990s in the Taiwanese context. As the impacts of the existing support to single-parent households remains unclear, this research is aimed at empirically comparing the distributional effects of policies on two-parent families and single-parent families with children, with the factors of gender, employment status and co-residence of the head of household being taken into account. Using data from Survey of Family Income and Expenditure for the years 1990, 2000, 2010 and 2019, the findings show that the economic gap between two-parent and single-parent families is growing. There have been clear signs of poverty mitigation for two-parent and single-parent families, showing that a general redistributive policy in Taiwan has been pursued to address poverty reduction for all families, but favour single-parent families. Based on the findings, policy suggestions are made regarding how to address single-parent families' financial wellbeing. [ABSTRACT FROM AUTHOR]

With accelerated progress of information and communication technologies (ICT), web-based instruction (WBI) is becoming a popular method for education resources distributing and delivering. This study was conducted to explore what factors influence college students' behavioral intentions to utilize WBI systems. To achieve this aim, a WBI system was developed and employed in a vocational college in Taiwan to support undergraduate courses learning. Drawing on the concepts from Technology Acceptance Model (TAM), Theory of Reasoned Action (TRA), and Social Cognitive Theory (SCT), this study proposes a nomological framework and develops an instrument for measuring college students' intention to use the WBI platform. The empirical results indicate that students show great readiness and positive intentions towards the system for their web-based learning activities and expose a possible benefit from its use in the long term. The research findings can provide instrumental suggestions for web-based instruction practices and may serve as instrumental guidelines for WBI systems to be effectively designed to advance college students' interests and activations in the virtual learning environment. (Contains 2 figures and 3 tables.)

The goal of this study was to investigate understanding of in-service elementary school teachers in Taiwan about number sense, teaching strategies of number sense and the development of number sense of students. Data were gathered through interviews of nine elementary mathematics teachers, regarding their understanding about number sense. The data indicated the followings: (1) The intuitive of number sense of teachers described as good intuition or sensitive about number sense. They stress on understanding number meanings and ignore these relationships about quantity and operation; (2) The teachers have similar views about teaching strategies of number sense; (3) The teachers believe that children with good number sense have well-understood number meanings and relationships, awareness that multiple strategies exist, and recognize reasonableness of data and calculation; (4) The teachers lacked for knowledge of number sense, so that they cannot address the complete teaching strategies of number sense; and (5) The background variables of teachers are related to the understanding of number sense.

The goal of this study was to investigate understanding of inservice elementary school teachers in Taiwan about number sense, teaching strategies of number sense and the development of number sense of students; and the profile of integrating number sense into mathematical instruction , and teaching practice. Data was gathered through interviews of two elementary mathematics teachers regarding their understanding about number sense followed by observations of the teachers instructing in their mathematics classes. The data included the categorization and comparison of these teachers' understanding and teaching practices. The conclusions are as follows: The common point shared by two teachers was that in the teaching of four fundamental operations of fraction, they tended to ask the students to repeat and memorize the four fundamental operations of arithmetic or the arithmetic rules of addition, subtraction, multiplication and division of fraction. It was only the instruction valuing instrumental knowledge and could not develop the students' number sense.

Background: Older patients with cardiovascular disease (CVD) are highly susceptible to adverse drug reactions due to age-related physiological changes and the presence of multiple comorbidities, polypharmacy, and potentially inappropriate medications (PIMs). Objective: This study aimed to develop a predictive model to identify the use of PIMs in older patients with CVD. Methods: Data from 2012 to 2021 from the Changhua Christian Hospital Clinical Research Database (CCHRD) and the Kaohsiung Medical University Hospital Research Database (KMUHRD) were analyzed. Participants over the age of 65 years with CVD diagnoses were included. The CCHRD data were randomly divided into a training set (80% of the database) and an internal validation set (20% of the database), while the KMUHRD data served as an external validation set. The training set was used to construct the prediction models, and both validation sets were used to validate the proposed models. Results: A total of 48,569 patients were included. Comprehensive data analysis revealed significant associations between the use of PIMs and clinical factors such as total cholesterol, glycated hemoglobin (HbA1c), creatinine, and uric acid levels, as well as the presence of diabetes, hypertension, and cerebrovascular accidents. The predictive models demonstrated moderate power, indicating the importance of these factors in assessing the risk of PIMs. Conclusions: This study developed predictive models that improve understanding of the use of PIMs in older patients with CVD. These models may assist clinicians in making informed decisions regarding medication safety. [ABSTRACT FROM AUTHOR]

Background and objectives: Psychosocial factors affect individuals' desire for physical activity. A newly developed instrument (Tendency to Avoid Physical Activity and Sport; TAPAS) has been designed to assess the avoidance of physical activity. Considering cultural differences could be decisive factors, the present study aimed to translate and validate the TAPAS into Chinese (Mandarin) for Taiwanese youths, and further cultural comparisons are expected. Methods: Standard translation procedure (i.e., forward translation, back translation, and reconciliation) was used to translate the English TAPAS into the Chinese TAPAS. Following translation, 608 youths (mean [SD] age 29.10 [6.36] years; 333 [54.8%] women) participated in the study via a snowballing sampling method with an online survey. All participants completed the Chinese TAPAS and additional instruments assessing weight stigma and psychological distress. Confirmatory factor analysis (CFA) was used to examine the factor structure of the Chinese TAPAS and multigroup CFA to examine measurement invariance across gender (men vs. women) and weight status (overweight vs. non-overweight). Pearson correlations were used to examine the concurrent validity; independent t-tests between gender groups and weight status groups were used to examine the known-group validity. Results: Consistent with the English version, the Chinese TAPAS was found to have a one-factor structure evidenced by CFA results. The structure was invariant across gender and weight status groups evidenced by multigroup CFA results. Concurrent validity was supported by significant associations with the related constructs assessed (r = 0.326 to 0.676; p < 0.001). Known-group validity was supported by the significant differences in TAPAS total scores between gender and weight status groups (p = 0.004 and < 0.001; Cohen's d = 0.24 and 0.48). Conclusion: The Chinese version of the TAPAS is a valid and reliable instrument assessing individuals' avoidance of physical activity and sports due to underlying psychosocial issues among Taiwanese youths. It is anticipated to be applied within a large Asian population, as well as cross-cultural comparisons, for further explorations in health, behavioral and epidemiological research and practice. [ABSTRACT FROM AUTHOR]

Purpose: This study constructs an efficiency evaluation framework for assessing the human, structural and relational capital in the semiconductor industry of Taiwan. Furthermore, we analyze whether there are significant differences in efficiency across different levels concerning the industry supply chain (upstream, midstream and downstream), employee service tenure, capital scale and company establishment years. Design/methodology/approach: This study focuses on Taiwanese semiconductor companies, utilizing data sourced from the Taiwan Economic Journal (TEJ) Database for the period spanning 2017 to 2021, encompassing a total of five years. Due to the nondisclosure of intangible asset values by all companies, an effort was made to ensure a comparable baseline by excluding companies with incomplete or missing data. Finally, empirical analysis was conducted on a sample of 64 companies using the dynamic network data envelopment analysis method. Findings: (1) Overall efficiency demonstrates structural capital as the most prominent, followed by relational capital, while human capital shows relatively poorer efficiency. (2) To enhance the efficiency of intellectual capital, priority should be given to improving the efficiency of outputs related to intellectual property rights such as patents. (3) The midstream segment exhibits the best efficiency in both structural and relational capital. (4) Companies with longer employee service tenures exhibit superior efficiency in human capital in the long run. (5) Companies with extended establishment years and larger capital scales demonstrate superior efficiency in both human and structural capital. Originality/value: Reflecting on past literature, scholars have primarily focused on the relationship between intellectual capital and firm efficiency, often emphasizing the overall efficiency of intellectual capital. However, within organizations, human capital, structural capital, and relational capital are interrelated. This study, for the first time, assesses the efficiency of these three components within an organization. The research addresses the challenges in analyzing the efficiency of intellectual capital and introduces a highly contemporary approach – dynamic network data envelopment analysis (DNDEA). Using the semiconductor industry in Taiwan as a case study, this paper conducts empirical analysis in a captivating and worthy industry. Therefore, the ideas presented in this paper are original. [ABSTRACT FROM AUTHOR]

[Development of the National Languages Act [of Taiwan]. (2019, January 9). Ministry of Culture. ] incorporating Taiwanese Sign Language (TSL) evolved from Taiwan's historical linguistic ecology and intertwined with the linguistic ecology of Taiwan's Deaf community. Utilising a qualitative document analysis incorporating a language planning and policy framework [Cooper, R. L. (1989). Language planning and social change. Cambridge University Press; Reagan, T. (2022). Language planning and language policies for sign languages: an emerging civil rights movement. Sociolinguistica, 36(1-2), 169–182], we analyze how this law fits into Taiwan's multicultural milieu. Specifically, we analyze the transmission, revival, and development of TSL by legislating status, acquisition, corpus, and prestige planning for teaching TSL to hearing learners. Secondly, gaps are identified, such as establishing early TSL access to the birth to age five deaf learners and their caregivers, promoting Chinese literacy with TSL strategies, and hiring native Deaf signing teachers. Limitations and future directions for research and practice are then outlined. [ABSTRACT FROM AUTHOR]

Two Hyptis plants endemic to Taiwan, H. rhomboides and H. suaveolens, contained xanthine oxidase inhibitors. To chemically investigate more herbs of the same genus, this study aimed to explore bioactive constituents from Hyptis spicigera leaf and the aerial part of H. brevipes, which would also enrich the chemotaxonomic basis for the Hyptis plants. The EtOH extract of the plant materials was fractionated by liquid‐liquid partitioning, followed by separation over various chromatography. High‐performance liquid chromatography‐solid phase extraction‐nuclear magnetic resonance hyphenation, a sustainable and environmentally friendly instrument, was applied to accelerate the chemical investigation of each subfraction. Eighteen isolates from Hyptis spicigera leaf and 14 compounds from H. brevipes aerial part were characterized. Of these, 12 compounds are rosmarinic acid derivatives, of which 9′‐O‐methyl melitrate A (10) and sagecoumarin methyl ester (22) are tentatively identified as new compounds. In total, 25 compounds were separated and characterized from Hyptis spicigera leaf and H. brevipes aerial part. Of these, seven of them (2–4, 11, 12, 18, 20) are in common between these two species, and 17 isolates (2–4, 8‐14, 22, 23, and 26‐30) are phenylpropanoids which are commonly distributed in the Labiatae family. [ABSTRACT FROM AUTHOR]

This article discusses the effectiveness of the Sexual Attitude Restructuring (SAR) curriculum in developing positive sexual attitudes amongst Taiwanese graduate students in human sexuality. Through purposive sampling, 32 graduate students in human sexuality were selected to participate in the study. Before and after providing participants with a 16-week SAR curriculum, the Sexual Attitude Scale and focus group interviews were used for data collection using a quasi-experimental design. Findings indicate that the SAR curriculum led to positive changes in students' attitudes. This change was especially significant for those who had more conservative or negative sexual attitudes. A thematic analysis of the interview transcripts shows that the students saw their attitudes towards sexuality changing due to the desensitisation, sensitisation and integration effects of the learning activities. Based on these findings, recommendations are made for further studies and the use of SAR curriculum as part of the education of sexuality and health professionals.

Game-based learning has been gradually adopted in energy education as an effective learning tool because digital games have the potential to increase energy literacy and encourage behavior change. However, not every learner can benefit from this support. There is a need to examine how human factors affect learners' reactions to digital games for supporting learning. This study addresses this issue by developing a digital educational game and examining the effects of locus of control on behavioral intention and learning performance of energy knowledge in game-based learning. The results demonstrated that learners with internal locus of control (ILC) outperformed external locus of control (ELC) learners in energy knowledge after interacting with the game. Moreover, the proposed game can reasonably reduce the differences in the behavioral intention of the ILC and ELC learners, indicating that ELC learners significantly improved their behavioral intention after playing the game, especially their external behavioral intention in the aspects of persuasion, legal action, and political action. The findings of this study are discussed to enhance the understanding of locus of control on behavioral intention and energy knowledge in the context of digital games.

Aims/Introduction: Cardiovascular mortality risk is elevated among patients with diabetes and concurrent chronic kidney disease. However, controversy surrounds the use of aspirin for primary prevention within this population. This study aims to assess the effectiveness and safety of low‐dose aspirin for primary prevention in patients with diabetes and pre‐end‐stage renal disease. Materials and Methods: This was a retrospective population‐based cohort study using the National Health Insurance Research Database in Taiwan. The study included adults with type 2 diabetes who were enrolled in the pre‐end‐stage renal disease pay‐for‐performance program and had no atherosclerotic cardiovascular disease. We used propensity score analysis to control baseline characteristics between the two groups. Clinical outcomes including cardiovascular mortality, all‐cause mortality, major bleeding, and renal disease progression were compared between patients who first received aspirin and those who did not. Results: Between January 2012 and December 2015, a total of 2,155 low‐dose aspirin users and 6,737 nonaspirin users were identified. Following propensity score adjustment, aspirin use exhibited a comparable risk of cardiovascular death compared with nonaspirin users (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.65–1.95; P = 0.681). The risk of all‐cause mortality was similar between the two groups (aHR 1.07; 95% CI 0.92–1.24; P = 0.385). Similar risks were observed in terms of major bleeding and renal disease progression. Conclusions: In patients with diabetes and pre‐end‐stage renal disease who lacked atherosclerotic cardiovascular disease, low‐dose aspirin did not demonstrate a reduction in mortality. These findings do not support the use of aspirin for primary prevention in this high‐risk population. [ABSTRACT FROM AUTHOR]

The short-form video platform TikTok has become highly popular. This study explores how professional sports teams can effectively leverage short-form videos to promote green values such as environmental conservation and sustainable development, thereby capturing user attention and enhancing user engagement. This study primarily aimed to investigate the effects of a green brand image on green word of mouth (WOM), customer stickiness, and consumer purchase intention, with further examination regarding the moderating effect of green concerns on these relationships. Few studies have explored the presence of professional sports teams on TikTok, particularly in the context of green issues. Accordingly, this study adopts a novel method to develop specific and actionable recommendations for professional sports teams who have a presence on social media. Additionally, via the application of the Stimulus–Organism–Response theory, this study explains how the green brand image presented by professional sports teams on TikTok influences the interactive relationships among green WOM, customer stickiness, and consumer purchase intention. This study recruited 600 individuals who were either fans of the Taipei Fubon Braves, which is a team in Taiwan's professional basketball league P.LEAGUE+, or fans of other teams. After a confirmatory factor analysis, structural equation modeling was used to test the hypotheses. The results indicate positive correlations in all tested paths. The green concern of the Taipei Fubon Braves' fans moderated the relationship between green WOM and purchase intention; however, this moderating effect was not identified among the non-Taipei Fubon Braves fans. These findings introduce innovative concepts to the field of marketing, contributing substantially to both practical applications and academic research. [ABSTRACT FROM AUTHOR]

The reference evapotranspiration (ET0) information is crucial for irrigation planning and water resource management. While the Penman-Monteith (PM) equation is widely recognized for ET0 calculation, its reliance on numerous meteorological parameters constrains its practical application. This study used 28 years of meteorological data from 18 stations in four geographic regions of Taiwan to evaluate the effectiveness of an artificial intelligence (AI) model for estimating PM-calculated ET0 using limited meteorological variables as input and compared it with traditional methods. The AI models were also employed for short-term ET0 forecasting with limited meteorological variables. The findings suggested that AI models performed better than their counterpart methods for ET0 estimation. The artificial neural network using temperature, solar radiation, and relative humidity as input variables performed best, with the correlation coefficient (r) ranging from 0.992 to 0.998, mean absolute error (MAE) ranging from 0.07 to 0.16 mm/day, and root mean square error (RMSE) ranging from 0.12 to 0.25 mm/day. For short-term ET0 forecasting, the long short-term memory model using temperature, solar radiation, and relative humidity as input variables was the best structure to forecast four-day-ahead ET0, with the r ranging from 0.608 to 0.756, MAE ranging from 1.05 to 1.28 mm/day, and RMSE ranging from 1.35 to 1.62 mm/day. The percentage error of this structure was within ± 5% for most meteorological stations over the one-year test period, underscoring the potential of the proposed models to deliver daily ET0 forecasts with acceptable accuracy. Finally, the proposed estimating and forecasting models were developed in regional and variable-limited scenarios, making them highly advantageous for practical applications. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of atopic diseases has increased in recent decades. A possible link between antibiotic use during pregnancy and childhood atopic disease has been proposed. The aim of this study is to explore the association of antibiotic exposure during pregnancy with childhood atopic diseases from a nationwide, population-based perspective. Methods: This was a nationwide population-based cohort study. Taiwan's National Health Insurance Research Database was the main source of data. The pairing of mothers and children was achieved by linking the NHIRD with the Taiwan Maternal and Child Health Database. This study enrolled the first-time pregnancies from 2004 to 2010. Infants of multiple delivery, preterm delivery, and death before 5 years old were excluded. All participants were followed up at least for 5 years. Antenatal antibiotics prescribed to mothers during the pregnancy period were reviewed. Children with more than two outpatient visits, or one admission, with a main diagnosis of asthma, allergic rhinitis, or atopic dermatitis were regarded as having an atopic disease. Results: A total of 900,584 children were enrolled in this study. The adjusted hazard ratios of antibiotic exposure during pregnancy to childhood atopic diseases were 1.12 for atopic dermatitis, 1.06 for asthma, and 1.08 for allergic rhinitis, all of which reached statistical significance. The trimester effect was not significant. There was a trend showing the higher the number of times a child was prenatally exposed to antibiotics, the higher the hazard ratio was for childhood atopic diseases. Conclusions: Prenatal antibiotic exposure might increase the risk of childhood atopic diseases in a dose-dependent manner. [ABSTRACT FROM AUTHOR]

Tons of broiler livers are produced yearly in Taiwan but always considered waste. Our team has successfully patented and characterized a chicken‐liver hydrolysate (CLH) with several biofunctions. Chronic alcohol consumption causes hepatosteatosis or even hepatitis, cirrhosis, and cancers. This study was to investigate the hepatoprotection of CLH‐based supplement (GBHP01™) against chronic alcohol consumption. Results showed that GBHP01™ could reduce (p <.05) enlarged liver size, lipid accumulation/steatosis scores, and higher serum AST, ALT, γ‐GT, triglyceride, and cholesterol levels induced by an alcoholic liquid diet. GBHP01™ reduced liver inflammation and apoptosis in alcoholic liquid‐diet‐fed mice via decreasing TBARS, interleukin‐6, interleukin‐1β, and tumor necrosis factor‐α levels, increasing reduced GSH/TEAC levels and activities of SOD, CAT and GPx, as well as downregulating CYP2E1, BAX/BCL2, Cleaved CASPASE‐9/Total CASPASE‐9 and Active CASPASE‐3/Pro‐CASPASE‐3 (p <.05). Furthermore, GBHP01™ elevated hepatic alcohol metabolism (ADH and ALDH activities) (p <.05). In conclusion, this study prove the hepatoprotection of GBHP01™ against alcohol consumption. [ABSTRACT FROM AUTHOR]

The article discusses the Industrial Applications Division (IAD) at the National Synchrotron Radiation Research Center (NSRRC) in Taiwan. The IAD works with key domestic industries to provide synchrotron-radiation (SR) analytical tools and solutions to boost industrial development. The article highlights the applications of SR technology in various industries, including semiconductors, lithium-ion batteries, polymers and carbon fibers, steel and iron metallurgy, pharmaceuticals, and micro devices. The NSRRC operates two synchrotron radiation facilities and is constructing a new beamline dedicated to industrial applications. The article emphasizes the positive impacts of SR technology on Taiwan's industries and the potential for future innovations. [Extracted from the article]

Researchers suggest that game-based learning (GBL) can be used to facilitate mathematics learning. However, empirical GBL research that targets young children is still limited. The purposes of the study is to develop a scenario-based digital game to promote children's route-planning ability, to empirically explore children's learning performance in route planning through the game, and to probe children's technology acceptance of the game. A total of 71 children participated in the study, and both qualitative and quantitative approaches were used, including an interview analysis as well as performance and content analyses of learners' route-planning tasks. The findings showed that the game had a positive effect on children's learning of route-planning strategies, that children's route-planning strategies were improved with the support of the game, and that children demonstrated high technology acceptance toward the game. This study may be of importance in offering insight into children's GBL.

Clinical resources in nursing schools are always insufficient for satisfying the practice requirements of each student at the same time during a formal course session. Although several studies have applied information and communication technology to develop computer-based learning tools for addressing this problem, most of these developments lack appropriate interactive and diagnostic services to assist students in bridging theory-practice gaps and realizing individual flaws in their nursing skills. Therefore, this study aims to develop an interactive clinical learning and diagnosis system that provides a web-based interactive learning environment and personalized diagnostic service for nursing education. An experiment was conducted in a foundations of nursing course at a nursing college in Taiwan. The experimental results show that the proposed approach is helpful to students in improving their learning motivation, performance, and attitude. Moreover, it was also found that most students showed positive perceptions toward the usage of the proposed system.

Well-designed game-based learning can provide students with an innovative environment that may enhance students' motivation and engagement in learning and thus improve their learning performance. The purpose of this study was to examine the relationships among elementary school students' flow experience and learning performances. We also investigated the gender and grade differences as well as the types of potential clusters of flow experiences and performance. Thirty-four elementary school students participated in this study. This study conducted correction analysis, difference analysis and a two-stage cluster analysis. The findings suggested that the students with higher flow experiences tended to have higher learning performances. The results of gender differences showed that female students had high performance scores and great flow experiences in the mini-educational game in this study. Moreover, the results revealed that the students of higher grade had significantly higher scores in both performance and flow experience than the students of lower grade. The result of cluster analysis fell into three categories: low performance/low flow experience students, high flow experience students and high performance/high flow experience students. On the basis of our findings, we also proposed suggestions for future game-based learning research.

This study applied storytelling in the English as a foreign language (EFL) classroom in order to promote speaking skills. Students were asked to practice speaking EFL through producing individual and interactive stories with a Web-based multimedia system. We aimed to investigate an effectiveness of applying individual and interactive storytelling on speaking skills and the potential effects of multimedia aids in storytelling to facilitate language learning. Furthermore, we explored the relationships between research variables of this study, such as speaking performance on individual and interactive storytelling, the number of animation representations, and the system actual usage, with learning achievement. Four main findings were found in this study. First, students who used the system for creating stories significantly outperformed students who did not use it on the post-test. This finding suggests that storytelling activity with support of the system was beneficial for improving speaking skills. Second, speaking performance and the number of animation representations significantly correlated with learning achievement. Students who performed well during learning activities usually studied diligently and scored higher on final test. Animations could help students remember vocabulary and practice speaking to describe their animated stories. Third, only the speaking performance on individual storytelling was found as the significant predictor of learning achievement. Students working individually on storytelling were independent; they were less distracted from others, and had more opportunity for practice. The last but not the least, most students expressed positive perceptions and attitude toward the system and learning activities. Based on these findings, we suggest that storytelling learning activities supported by the Web-based multimedia system and implementing them in EFL learning classroom can be beneficial for facilitating speaking skills. Students can remember new vocabulary better, practice speaking skills more frequently, become competent in speaking target language, and improve learning performance.

The development of a usability evaluation method for educational systems or applications, called the self-report-based sequential analysis, is described herein. The method aims to extend the current practice by proposing self-report-based sequential analysis as a new usability method, which integrates the advantages of self-report in survey research (e.g., questionnaires and interviews) and lag sequential analysis to evaluate educational systems or applications and further understand students' operational process patterns of behaviors toward the systems' interfaces. An empirical study using a drill-based game as a platform was conducted to test the effectiveness of the self-report-based sequential analysis method. The results showed the critical mediators and behavioral transfer patterns among the different area of interests during the students' overall operational process behaviors. For example, the health points and badges as rewards served as critical mediators between the rewards and feedback and health points and countdown timer, respectively. The self-report-based sequential analysis helped explore the participants' operational process behaviors in the area of interests, and why behaviors shift on area of interests that can assist to diagnose the inappropriate arrangement of area of interests. Suggestions are provided based on the results.

The OXA-48-producing hypervirulent Klebsiella pneumoniae (hvKP) strains were rarely reported. In this study, we characterized three carbapenem-resistant hvKP strains (KP2185, NCRE61, and KP2683-1) isolated from renal abscess, scrotal abscess, and blood samples in a Taiwan hospital. The three strains belonged to two different clones: ST23 K1 (KP2683-1) and ST11 KL64 (KP2185 and NCRE61). KP2683-1 exhibited the highest virulence in an in vivo model. Whole-genome sequencing analysis showed that KP2185 and NCRE61 acquired IncFIB type plasmids containing a set of virulence genes (iroBCDN, iucABCD, rmpA, rmpA2, and iutA), while KP2683-1 acquired an IncL type plasmid harboring blaOXA-48. [ABSTRACT FROM AUTHOR]

Background: Patients with influenza-related acute respiratory distress syndrome (ARDS) are critically ill and require mechanical ventilation (MV) support. Prolonged mechanical ventilation (PMV) is often seen in these cases and the optimal management strategy is not established. This study aimed to investigate risk factors for PMV and factors related to weaning failure in these patients. Methods: This retrospective cohort study was conducted by eight medical centers in Taiwan. All patients in the intensive care unit with virology-proven influenza-related ARDS requiring invasive MV from January 1 to March 31, 2016, were included. Demographic data, critical illness data and clinical outcomes were collected and analyzed. PMV is defined as mechanical ventilation use for more than 21 days. Results: There were 263 patients with influenza-related ARDS requiring invasive MV enrolled during the study period. Seventy-eight patients had PMV. The final weaning rate was 68.8% during 60 days of observation. The mortality rate in PMV group was 39.7%. Risk factors for PMV were body mass index (BMI) > 25 (kg/m2) [odds ratio (OR) 2.087; 95% confidence interval (CI) 1.006–4.329], extracorporeal membrane oxygenation (ECMO) use (OR 6.181; 95% CI 2.338–16.336), combined bacterial pneumonia (OR 4.115; 95% CI 2.002–8.456) and neuromuscular blockade use over 48 h (OR 2.8; 95% CI 1.334–5.879). In addition, risk factors for weaning failure in PMV patients were ECMO (OR 5.05; 95% CI 1.75–14.58) use and bacteremia (OR 3.91; 95% CI 1.20–12.69). Conclusions: Patients with influenza-related ARDS and PMV have a high mortality rate. Risk factors for PMV include BMI > 25, ECMO use, combined bacterial pneumonia and neuromuscular blockade use over 48 h. In addition, ECMO use and bacteremia predict unsuccessful weaning in PMV patients. [ABSTRACT FROM AUTHOR]

Recent studies have demonstrated a global decline in the age at menarche. Our study aimed to determine the age at menarche of Taiwanese women born between 1943 and 1989. Data were obtained from the Taiwan Biobank. To view the trends in age at menarche, we analyzed data from 74,799 women. The mean, standard deviation, and annual percentage change in age at menarche were calculated for birth-year cohorts. The mean age at menarche of Taiwanese women born in 1943 was 14.85 years. The age at menarche decreased to 12.20 years for those born in 1989. The mean age at menarche declined by 2.65 years across the 47-year study period; hence, the reduction rate was 0.56 years per decade. This study demonstrated a downward secular trend in the age at menarche of Taiwanese women born between 1943 and 1989. This trend occurred in three stages of decline: fast (1943–1953), slow (1953–1965), and moderate (1965–1989). The age at menarche decreased by 2.65 years among Taiwanese women born in 1943 compared with those born in 1989. This decline occurred in three stages: fast (1943–1953), slow (1953–1965), and moderate (1965–1989). This significant downward secular trend in age at menarche reflects Taiwan's socioeconomic development. [ABSTRACT FROM AUTHOR]

The rate of preterm birth is increasing globally. It causes significant short-term and long-term health care burdens. A comprehensive recognition of the risk factors related to preterm births is important in the prevention of preterm birth. Our study is to investigate the incidence and maternal risk factors of preterm birth from a nationwide population-based perspective. This is a retrospective cohort study. All live births from 2004 to 2014 in Taiwan enrolled. The main data source was Taiwan's Birth Certificate Application (BCA) database. The BCA database was linked with the National Health Insurance Research Database (NHIRD) to establish any links between information on newborns and maternal underlying disease. A total of 1,385,979 births were included in the analysis. The incidence of preterm birth increased gradually in Taiwan from 8.85% in 2004 to 10.73% in 2014. Maternal age, socioeconomic status, maternal allergy and autoimmune diseases, gynecological diseases, and pregnancy-related complications were significant risk factors for preterm birth. The overall incidence of preterm births has gradually increased in Taiwan. Maternal age, socioeconomic status, certain underlying diseases, and pregnancy-related complications were risk factors for preterm birth. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the relationships between destination attachment, tourists' experiences of historical guesthouses, satisfaction and revisit intention. Historical guesthouses of Kinmen County, Taiwan were the setting for the investigation. A total of 346 questionnaires were collected and analyzed. Results showed that accommodation experiences can significantly mediate the relationships between destination attachment and the evaluations of historical guesthouses. Perceptions of human interactions between tourists and the service providers at historical guesthouses were critical for creating a highly favorable accommodation experience. The physical environment, human interactions, and satisfaction all had significant positive effects on revisit intention, with the perceptions of human interactions greatly influencing revisit intention. This study provides meaningful management implications for both the hospitality and tourism industries. [ABSTRACT FROM AUTHOR]

Patients with serious mental illness have a higher risk of hepatitis C virus (HCV) infection but suboptimal HCV care. The current study aimed to facilitate HCV treatment uptake by implementing an integrated outreach care model. Multidisciplinary outreach screening followed by HCV reflex testing and onsite treatment for schizophrenia patients was accomplished through the coordination of nongovernmental organizations, remote specialists, and local care providers. The objective was microelimination effectiveness, defined as the multiplication of the rates of anti‐HCV antibodies screening, accurate HCV RNA diagnosis, treatment allocation, treatment completion, and sustained virological response (SVR12; no detectable HCV RNA throughout 12 weeks in the post‐treatment follow‐up period). A total of 1478 of the 2300 (64.3%) psychiatric patients received HCV mass screening. Seventy‐three (4.9%) individuals were seropositive for anti‐HCV antibodies. Of the 73 anti‐HCV seropositive patients, all (100%) received HCV reflex testing, and 29 (37.7%) patients had HCV viremia. Eight patients (34.8%) had advanced liver disease, including 3 with liver cirrhosis and 2 with newly diagnosed hepatocellular carcinoma. Twenty‐three of the 24 (95.8%) patients who stayed in the healthcare system received and completed 8 weeks of glecaprevir/pibrentasvir treatment and post‐treatment follow‐up without significant DDIs or adverse events. The SVR12 rate was 100%. The microelimination effectiveness in the current study was 61.6%. Individuals with serious mental illness are underserved and suffer from diagnostic delays. This patient‐centered and integrated outreach program facilitated HCV care in this marginalized population. [ABSTRACT FROM AUTHOR]