Search

Objective: The present study is to analyze the effects of the coronavirus disease 2019 (COVID 2019) outbreak and the subsequent lockdown on the outcomes of spinal metastasis patients. Methods: The study was a retrospective analysis of data from a prospective cohort study. All patients underwent surgical intervention for spinal metastases between January 2019 and December 2021 and had at least 3 months of postoperative follow-up. The primary outcome was overall mortality during the 4 different stages (pre-COVID-19 era, COVID-19 pandemic except in Taiwan, national lockdown, lifting of the lockdown). The secondary outcomes were the oncological severity scores, medical/surgical accessibility, and patient functional outcome during the 4 periods as well as survival/mortality. Results: A total of 233 patients were included. The overall mortality rate was 41.20%. During the Taiwan lockdown, more patients received palliative surgery than other surgical methods, and no total en bloc spondylectomy was performed. The time from surgeon visit to operation was approximately doubled after the COVID-19 outbreak in Taiwan (75.97, 86.63, 168.79, and 166.91 hours in the 4 periods, respectively). The estimated survival probability was highest after the national lockdown was lifted and lowest during the lockdown. In the multivariate analysis, increased risk of mortality was observed with delay of surgery, with emergency surgery having a higher risk with delays above 33 hours, urgent surgery (below 59 and above 111 hours), and elective surgery (above 332 hours). Conclusion: The COVID-19 pandemic and related policies have altered daily clinical practice and negatively impacted the survival of patients with spinal metastases. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) and its risk factors seem to be linked with deteriorated graft function and persists as the major cause of mortality in kidney transplant recipients (KTRs). Diet quality is associated with CVD prevention in the healthy population, however, less study focuses on KTRs. The study aimed to determine the association between diet quality indices and lipid profile abnormalities as risk factors for CVD in KTRs. This prospective study enrolled 106 KTRs who had functioning allografts from September 2016. Lipid profiles included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) and were based on the National Cholesterol Education Program Adult Treatment Panel III recommendations. Three-day dietary data were collected by a well-trained registered dietitian. The Alternative Healthy Eating Index-Taiwan (AHEI-Taiwan), Alternative Healthy Eating Index-2010 (AHEI-2010), and Healthy Eating Index-2015 (HEI-2015) scores were calculated and divided into quartiles and compared accordingly. KTRs' mean LDL-C, HDL-C, TC, and TG levels were 119.8 ± 36.6 mg/dL, 52.0 ± 17.9 mg/dL, 205.8 ± 43.9 mg/dL, and 160.2 ± 121.6 mg/dL, respectively. Compared with the lowest quartile, only the highest quartile of AHEI-Taiwan had lower TC and LDL-C levels. After adjustment for age, gender, energy, Charlson comorbidity index, transplant duration, and dialysis duration, logistic regression analysis revealed that the highest quartile of AHEI-Taiwan had 82% (odds ratio [OR], 0.18; 95% confidence interval [CI] 0.04–0.72, p < 0.05) lower odds of high TC and 88% (OR 0.12; 95% CI 0.03–0.58, p < 0.05) lower odds of high LDL-C, and the highest quartile of HEI-2015 had 77% (OR 0.23; 95% CI 0.05–0.95, p < 0.05) lower odds of high LDL-C. Higher adherence to a healthy diet as per AHEI-Taiwan and HEI-2015 guidelines associated with lower risk of lipid profile abnormalities in KTRs. [ABSTRACT FROM AUTHOR]

Saridoscelis Meyrick, 1894 belongs to Yponomeutidae, with 9 described species. A new species, Saridoscelis diffusolinearum Lu & Hsu, sp. nov., is described from Taiwan, with diagnostic characters provided for both sexes herein. We also proposed that S. diffusolinearum sp. nov. is close related to S. kodamai Moriuti, 1961. The new species feeds on a subalpine bush Gaultheria cumingiana Vidal (Ericaceae) further indicating that the host plant of the subfamily Saridoscelinae may restricted to Ericaceae. [ABSTRACT FROM AUTHOR]

Background: Uremia is likely a risk factor for deep neck infection (DNI). However, only a few relevant cases have been reported, and evidence sufficient to support this hypothesis is lacking. The aim of the study is to investigate the effects of end-stage renal disease (ESRD) on DNI.Methods: We used the database of the Registry for Catastrophic Illness Patients (RFCIP), a subset of the National Health Insurance Research Database (NHIRD) in Taiwan, to conduct a retrospective follow-up study. Between 1997 and 2013, a total of 157,340 patients in Taiwan with ESRD who received dialysis were registered in the RFCIP, whom were matched with a database consisting of 1,000,000 randomly selected patients who represented the national population, to conduct the follow-up study for investigating the incidence of DNI in the ESRD and control cohorts.Results: In the ESRD group, 280 DNIs were identified with an incidence rate of 43 per 100,000 person-years. In the comparison group, 194 DNIs were identified with an incidence rate of 20 per 100,000 person-years. The incidence rate ratio was 2.16 (p < 0.001). Kaplan-Meier analysis indicated that the ESRD group had a significantly higher cumulative incidence of DNI (p < 0.001). According to Cox regression analysis, the hazard ratio of ESRD for DNI was 2.23 (p < 0.001). The therapeutic methods (non-surgery and surgery), performance of tracheostomy, duration of hospitalization did not differ significantly between the two groups, except more ESRD-DNI patients were admitted to intensive care units. The mortality rate of patients with DNI in the ESRD group was significantly higher than that in the control group (8.6% for ESRD vs 3.6% for control, p = 0.032). Furthermore, the Kaplan-Meier analysis demonstrated a poorer survival outcome in the ESRD group (p = 0.029). However, the individual survival outcomes following non-surgical and surgical therapies in the ESRD group did not differ significantly (p = 0.31).Conclusions: ESRD is a predisposing factor for DNI, increasing its risk by twofold. In the patients with ESRD, DNI was not associated with higher rates of surgical debridement, tracheostomy, and mediastinal complications or longer hospital stays; however, it was associated with poorer survival outcomes, regardless of the therapeutic method. [ABSTRACT FROM AUTHOR]

Many disposal concepts currently show that concrete is an effective confinement material used in engineered barrier systems (EBS) at a number of low-level radioactive waste (LLW) disposal sites. Cement-based materials have properties for the encapsulation, isolation, or retardation of a variety of hazardous contaminants. The reactive chemical transport model of HYDROGEOCHEM 5.0 was applied to simulate the effect of hydrogeochemical processes on concrete barrier degradation in an EBS which has been proposed to use in the LLW disposal site in Taiwan. The simulated results indicated that the main processes that are responsible for concrete degradation are the species induced from hydrogen ion, sulfate, and chloride. The EBS with the side ditch drainage system effectively discharges the infiltrated water and lowers the solute concentrations that may induce concrete degradation. The redox processes markedly influence the formations of the degradation materials. The reductive environment in the EBS reduces the formation of ettringite in concrete degradation processes. Moreover, the chemical conditions in the concrete barriers maintain an alkaline condition after 300 years in the proposed LLW repository. This study provides a detailed picture of the long-term evolution of the hydrogeochemical environment in the proposed LLW disposal site in Taiwan. [ABSTRACT FROM AUTHOR]

BACKGROUND: Bluetooth earphones can facilitate communications among workers engaged in manual(e.g., professional driver)or visual tasks (e.g., security guard). If workers remove their Bluetooth earphones due to poor fit, then communication effectiveness will decline, especially during manual or visual tasks. OBJECTIVES: (1) To identify which design properties of Bluetooth earphones can contribute to user comfort, and (2) to identify if person characteristics (i.e., gender and ear shapes in this study) are related to differences in comfort perception during earphone use. METHODS: 198 participants were recruited for this study.Individuals used four models of Bluetooth earphones in randomized order while performing computer tasks and then completed questionnaires on comfort perception specifically designed for this study. The 2 × 3 × 4 mixed design analysis of variance (ANOVA) was conducted to investigate the effects of gender, ear shape, and model condition. Results: The results indicated that there were significant differences in model on comfort perception. CONCLUSIONS: For earplugs, the shape of the earphone and the elasticity of material are important ergonomic concerns to improve the comfort perception. In addition, the adjustable tail length is an important ergonomic design property for the ear-hook. The information gained in this study should be useful in improving the ergonomic fitness of Bluetooth earphones. [ABSTRACT FROM AUTHOR]

Aims Inadequate self-control has been linked to behavioural and impulse-control problems such as overeating, alcohol and drug abuse and smoking. Construal-level theory ( CLT) suggests that a high-level construal (highlighting central goals associated with an event), relative to a low-level construal (highlighting means and resources), promotes self-control. Inspired by CLT, we examined whether smokers primed with a high-level (versus low-level) construal mind-set would show reductions in smoking that might be mediated by improved self-control. Design A single-factor (construal level: high, low, control) between-subjects design was employed. We used a widely employed why/how paradigm to induce high/low construal levels, whereby participants were asked to respond to questions about 'why' or 'how' they would maintain good physical health. Setting Laboratory at Kaohsiung Medical University, Taiwan. Participants A community sample consisting of 102 daily smokers participated in this experiment. Measurements The Stroop task measuring self-control was implemented after the construal-level manipulation. The dependent measure was actual cigarette consumption during an ostensible survey. Findings Participants in a high-level construal mind-set smoked fewer cigarettes [mean = 1.3, 95% confidence interval ( CI): 0.9, 1.7] than those in a low-level construal mind-set (mean = 2.6, 95% CI: 2.2, 3.0; P < 0.01). A bootstrapping analysis supported for the role of self-control ( B = −1.14, 95% CI: −1.65, −0.74, P < 0.01) as a mechanism underlying this effect. Conclusions Smokers primed with a high-level construal mind-set (i.e. cognitive abstraction) may induce greater self-control that leads to reduced cigarette consumption. Thus, reminding smokers to think abstractly about health may be an effective strategy that could help them to smoke fewer cigarettes. [ABSTRACT FROM AUTHOR]

Two coordinate rotation approaches (double and planar-fit rotations) and no rotation, in association with averaging periods of 15 - 480 min, were applied to compute surface heat and water vapor fluxes using the eddy covariance approach. Measurements were conducted in an experimental watershed, the Lien-Hua-Chih (LHC) watershed, located in central Taiwan. For no rotation and double rotation approaches, an adequate averaging period of 15 or 30 min was suggested for better energy closure and small variations on energy closure fractions. For the planar-fit rotation approach, an adequate averaging period of 60 or 120 min was recommended, and a typical averaging period of 30 min is not superior to that of 60 or 120 min in terms of better energy closure and small variations on energy closure fractions. The Ogive function analysis revealed that the energy closure was improved with the increase of averaging time by capturing sensible heat fluxes at low-frequency ranges during certain midday hours at LHC site. Seasonal variations of daily energy closure fractions, high in dry season and low in wet season, were found to be associated with the surface dryness and strength of turbulent development. The mismatching of flux footprint areas among flux sensors was suggested as the cause of larger CF variations during the dry seasons as that indicated by the footprint analysis showing scattered source areas. During the wet season, the underestimation of turbulent fluxes by EC observations at the LHC site was attributed to weak turbulence developments as the source area identified by the footprint analysis was closer to the flux tower than those scattered in dry season. [ABSTRACT FROM AUTHOR]

Background: A case-control study was conducted to evaluate the role of adult diet on nasopharyngeal carcinoma (NPC) in Taiwan. Methods: A total of 375 incident NPC cases and 327 controls matched to the cases on sex, age, and residence were recruited between July 1991 and December 1994. A structured questionnaire inquiring complete dietary history, sociodemographic characteristics, and other potential confounding factors was used in the personal interview. Unconditional logistic regression analysis was used to estimate multivariate-adjusted odds ratio (ORadj) with 95% confidence interval (CI) after accounting for known risk factors. Results: Fresh fish (ORadj, 0.56; 95% CI, 0.38-0.83 for the highest vs. lowest tertile of intake), green tea (ORadj, 0.61; 95% CI, 0.40-0.91 for drinking ⩾1 times/week vs. never) and coffee (ORadj, 0.56; 95% CI, 0.37-0.85 for drinking ⩾0.5 times/week vs. never) were inversely associated with the NPC risk. No association with NPC risk was observed for the intake of meats, salted fish, fresh vegetables, fruits and milk. Intake of vitamin A from plant sources was associated with a decreased NPC risk (ORadj, 0.62; 95% CI, 0.41-0.94 for the highest vs. lowest tertile). Conclusion: The study findings suggest that certain adult dietary patterns might protect against the development of NPC. [ABSTRACT FROM AUTHOR]

Abstract: Typhoon Morakot (2009) caused serious damage in southern Taiwan due to intensive rainfall with long duration. The issue of greatest concern arising from the disasters brought about by this extreme event was the burying of the entire village of Hsiaolin by a massive debris flow and landslide. Based on seismological and near-surface magnetic data, this tragic scenario arose due to a combination of events, a massive landslide, the formation of a landslide dam, and the consequent debris flow when this dam was breached. The objective of this part of the study is to investigate the spatial and temporal characteristics of the debris flow induced by the landslide breach. The US National Weather Service BREACH model and the Federal Emergency Management Agency approved FLO-2D model are integrated to facilitate the investigation of this catastrophe. A series of simulations including a 2D rainfall-runoff simulation over the Cishan River basin, landslide dam breach routing, and 2D debris flow simulation around the Hsiaolin Village were conducted. Hydraulic calculations were performed to determine the equivalent top elevation of the landslide dam based on inflows computed from the 2D rainfall-runoff simulation in association with the Digital Terrain Model (DTM) and upstream constraint of the backwater inundation areas. The hydrograph of the upstream inflow which induced overtopping failure was provided by a 2D rainfall-runoff simulation using the FLO-2D model calibrated by comparison with the downstream discharge record. The longevity of the landslide dam was less than 1h, and it took only about 8 minutes to completely breach. The peak discharge rate of this massive landslide dam breach was 70,649m3/s. The dam break hydrograph was then used for upstream inflow to drive the FLO-2D debris flow simulation. The average sediment concentration by volume was 0.362. The simulated deposited sediment depth showed a reasonable match to the differences of DTMs before and after the disaster. [Copyright &y& Elsevier]

The objective of this study was to evaluate the functional results in patients with advanced pyriform sinus cancer treated with extended near-total laryngopharyngectomy (ENTLP) and free fasciocutaneous flap reconstruction. We reviewed the medical records of patients with pyriform sinus cancer who were treated at Kaohsiung Chang Gung Memorial Hospital, a tertiary medical center in Taiwan, between June 1998 and December 2008. This retrospective study enrolled the patients who had a stage III or IV pyriform sinus cancer and was surgically treated with ENTLP and free fasciocutaneous flap reconstruction. Thirteen patients meeting the inclusion criteria were enrolled. Three patients had stage III cancer, and ten had IVa. All were men with the age distribution ranged from 38 to 75 years. The average length of hospitalization was 19 days. Twelve (92.3%) patients could develop shunt speech postoperatively, and eight (61.5%) patients used shunt speech for their routine conversation. Eleven (84.6%) patients could ultimately return to an oral diet; the remaining two (15.4%) patients stayed dependent on a feeding tube for part or all of their nutrition. Two patients died from distant metastases, and one patient died from complications of postoperative concurrent chemoradiotherapy, while the other ten patients survived until the last follow-up without evidence of locoregional tumor recurrence. In conclusion, in the surgical treatment of patients with locally advanced pyriform sinus cancer, ENTLP and free fasciocutaneous flap reconstruction is an oncologically safe, voice-conserving, and prosthesis-free procedure which offers satisfactory functional speech and swallowing outcomes. [ABSTRACT FROM AUTHOR]

To explore the number and distribution of microaneurysms (MA) in the macula of type 2 diabetics in Kinmen, Taiwan and associated risks for early diabetic retinopathy (DR). A baseline mass screening extracts 971 type 2 diabetics between 1991 and 1993 and follow-up eye screening at 1999 was then done. Number of MA was counted and associated systemic factors collected from a centered 45° color fundus photograph of dilated eyes of type 2 diabetics (Topcon-NW5). Thirty-three (6.2%, n = 527) had MA retinopathy. Those with one eye involved ( n = 26) had two mean MA; those with bilateral involvement ( n = 7) had four mean per eye. Most MA were located temporally (mean MA = 0.79), then superiorly (mean = 0.58), inferiorly (mean = 0.46) and nasal (mean = 0.28). MA occurred at the 6,000-μm outermost ring (mean = 1.51), then the 3,000-μm ring (mean = 0.35), the 1,500-μm ring (mean = 0.26) and center 500 μm circle (mean = 0.01). After adjusting for confounding factors, early DR with MA was associated with longer duration of type 2 diabetes [odds ratios (OR) = 1.10, 95% confidence interval (CI) 1.00–1.21], higher glycosylated hemoglobin (OR = 1.36, 95%CI 1.11–1.66) and wider waist circumference (OR = 1.04, 95%CI 1.01–1.07). Our photograph grading system suggests that MA number and distribution at the macula may reflect severity of early DR and is a valid tool for predicting the progression of DR. Identifying those factors associated with MA only DR is important in developing prevention strategies for this early microvascular complication of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Second-hand Smoke (SHS) exposure is a significant public health problem that may be responsible for serious health hazards for child. This study aimed to examine the exposure status of SHS and the factors associated with SHS avoidance behavior among the mothers of pre-school children. Methods: A cross-sectional study was used to obtain a sample of the mothers of pre-school children (n = 1,020) in 30 registered kindergartens in eastern Taiwan. Overall, 919 (a response rate of 90%) completed the questionnaires. Regression models were used to identify factors with respect to the avoidance behavior of SHS. Results: The prevalence of exposure to SHS was 70% and 50% for the mothers and their children, respectively. After adjusting for other variables, mothers who were current smokers (β = -0.260, p < 0.001), had spouses who smoked (β = -0.060, p < 0.05), SHS exposure (β = -0.138, p < 0.001), and/or children with exposure to SHS (β = -0.084, p < 0.05) were found to be less likely to avoid SHS, whereas mothers with a high knowledge score about SHS (β = 0.082, p < 0.01), positive attitudes (β = 0.274, p < 0.001) and a high self-efficacy level in regard to the avoidance of SHS (β = 0.397, p < 0.001) were observed to be more likely to avoid SHS. Regression analyses confirmed that the significantly factors associated with the avoidance behavior of SHS were self-efficacy, being a current smoker, and the attitude toward the avoidance of SHS to be that of 55.5% of the total variance explained (p < 0.001). Conclusions: The high prevalence rate of exposure to SHS for mothers and their children suggests that a well-designed future intervention program should be implemented in regard to pre-school children's mothers in order to prevent these mothers and their children from SHS exposure hazards, more particularly, to strengthen the knowledge base, to enhance self-efficacy and to foster a more positive attitude toward the avoidance of SHS in the mothers. [ABSTRACT FROM AUTHOR]

Background/aims: Surgical resection of choledochal cysts (CC) has become standard treatment. However, surgery is not universally recommended in early infancy and/or asymptomatic patients. In order to investigate the optimal timing of CC excision, we analyzed clinicopathological data and surgical results from different age groups.Material and Methods: This retrospective review included 107 patients (77 females, 30 males) who underwent CC resection at the National Taiwan University Hospital between January 1988 and December 2005. Patient demographic, clinical, and surgical data were collected and analyzed.Results: The patients were divided into three groups according to age at the time of surgery: <1 year old (group I, n = 26), 1-16 years old (group II, n = 48), and >16 years old (group III, n = 33). About two thirds of the patients in group I had jaundice, while abdominal pain related to inflammation was the commonest symptom in groups II and III. Group I suffered significantly fewer surgical complications and less severe liver fibrosis than groups II or III.Conclusion: CC surgery in infancy and in asymptomatic patients is safe and may prevent the complications of this condition. The results support a recommendation for early excision. [ABSTRACT FROM AUTHOR]

Identifying the factors related to the initiation and continuance of smoking among youth has been regarded as a crucial step for school nurses and public health nurses to develop effective smoking prevention and cessation programs in schools and communities. The purpose of this study was to investigate the factors related to adolescent tobacco use in southern Taiwan. A total of 4,500 study samples were selected at random from the students of all high schools located in Pingdong County. This process yielded 3,307 valid samples (a 73.5% response rate). Study results found 62.4% (n = 2,063) reported never having smoked before. Thirty-eight percent (n = 1,244) of participants had experience using tobacco, 59.3% (n = 738) reported being ex-smokers, and 40.7% (n = 506) were current smokers. This study found that having friends who offered cigarettes, academic achievement, father's educational level, perceived peer smoking behavior to be primary influences on smoking, attitude, and self-efficacy and significant predicators of adolescents' current smoking behaviors. Parents' marital status and having classmate who offered cigarettes were significant predictors of adolescent smoking behavior. Study findings can provide a basis for school and public health nurses to design effective smoking prevention and cessation programs in schools and community settings. This study suggests further experimental studies are necessary to test the effectiveness of tobacco control programs designed in reference to the findings of this study. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the impact of western culture adoration on coffee consumption in Taiwan. A series of three studies was performed. In study 1, content analyses of customer interviews were used to obtain topics of value-related issues, including gathering places for western foreigners, foreign drinks and culture experience, popularity and value perception of residents from upper society, brand image, and well-developed western countries. A questionnaire survey was used in study 2, and results indicated that there exists a positive relationship between the desirability of foreign culture and the adoring of foreign value in coffee consumption. Study 3 employed a 2 × 2 field experiment design to explore the impact of product-of-origin and country-of-origin dimensions on the product preferences. From the results, it was found that the impact of foreign brands on the consumer preferences for coffee and green tea was higher than the impact of local brands. In addition, the strengths of foreign brand are superior to the local ones in coffee consumption. The results of this study indicated that western culture adoration was one of the key factors in determining the consumer decisions and preferences in drink consumption. [ABSTRACT FROM AUTHOR]

A physically based distributed hydrological model was applied to simulate typhoon floods over a mountainous watershed in Taiwan. The meteorological forcings include the observed gauge rainfall data and the predicted rainfall data from a mesoscale meteorological model, the fifth-generation Pennsylvania State University–National Center for Atmospheric Research (PSU–NCAR) Mesoscale Model (MM5). This study investigates the flood responses of three Typhoons: Zeb (1998), Nari (2001), and Herb (1996), which possessed unique meteorological features and that all produced severe floods. The predicted basin-averaged rainfall hydrographs by the MM5 are compared with that interpreted by rain gauge data to reveal the discrepancies in rainfall peak amounts and time lags, and to explore their subsequent effects on flood generation. The simulated flood hydrographs at the Hsia-Yun station, which is upstream of the Shihmen Reservoir, are compared with observed flood discharges in terms of the amount and time lag of flood peaks. It is shown that the small discrepancy in rainfall peaks and phase lags could be significantly amplified in simulated flood responses of a mountainous watershed. The overall predictive skill of the distributed hydrological model with different rainfall inputs is examined with three parameters, which include the runoff ratio (RR), root-mean-square error (rmse), and goodness of fit (GOF). Although the runoff ratio for the MM5-predicted rainfall is superior to that for the observed gauge rainfall, the simulated hydrographs with observed gauge rainfall have smaller rmse and GOF values for three events. This study shows that the error in flood prediction with the mesoscale-modeled rainfall is mainly caused by the rainfall–peak difference, which arises from the inherent uncertainties in the mesoscale-modeled rainfalls over a mountainous terrain during the typhoon landfall periods. [ABSTRACT FROM AUTHOR]

Telecommunication companies must effectively master information to remain competitive in an increasingly global market. Tremendous business opportunities have been created because of the recent rapid global communications' liberalization. Following this trend, the telecommunication industry in Taiwan will be a star industry and grow quickly in the future. This study uses questionnaires to examine how quality management practices are implemented in Taiwan's telecommunication industry. Most of the 39 telecommunication companies surveyed herein are medium-sized with fairly weak quality performance. Advanced quality management training programs (such as experimental design) are seldom implemented and the companies do not rely on a few reasonably reliable suppliers. [ABSTRACT FROM AUTHOR]

A common assumption is that regional disparities affect voting behavior in Taiwan, given the fact that voters in the south show steady support for the Democratic Progressive Party (DPP). The common sense premise is that the south provides a stable support base for the DPP. Although a pattern of political clustering appears to be taking shape, empirical data are required to test this hypothesis. The findings of this paper suggest that, first, regional factors are contingent on the influences of election type and the personal attributes of individual candidates. Second, above and beyond what appears commonsensical, the Kuomintang (KMT) shows greater regional disparities with respect to its support base than does the DPP. This article proposes that party realignment has significantly affected the KMT's support base and has particularly influenced it in the non-southern area. [ABSTRACT FROM AUTHOR]

Groundwater, a salient water resource in Taiwan, has been subject to incessant and excessive pumping, inducing serious regional land subsidence and seawater intrusion. This study aims at assessing how excessive pumping impacts groundwater variations over the Pingtung Alluvial Plain (PAP) in Southwest Taiwan using both statistical and numerical techniques. We apply nonparametric methods to analyze the changing point and annual trend in various hydro-meteorological time series (e.g., rainfall, temperature, and groundwater levels (GLs)). Afterwards, we employ an integrated surface-subsurface model referred to as WASH123D to simulate GLs under the pumping-free scenario; any discrepancies identified between simulated and observed GLs could be an indicator of unregulated/illegal pumping. We find that annual GLs exhibit a significant increasing (decreasing) trend in the western (eastern) PAP. Our numerical experiment reveals diverging trends in simulated and observed GLs, mostly at the downstream of all the major tributaries, suggesting the consequence of unregulated/illegal pumping. Furthermore, upstream pumping may reduce lateral flow towards the downstream coastal area, triggering land subsidence in remote locations. [ABSTRACT FROM AUTHOR]

In this study, we investigate the feasibility of using the Classification and Regression Tree (CART) algorithm to estimate soil water content (SWC) using commonly available meteorological parameters. We trained and validated CART models using data collected in a grassland terrain in northern Taiwan throughout the year of 2018, with the goal of providing precise information for agricultural irrigation and flood risk assessment. Results indicate the effectiveness of CART in SWC estimation, with error levels acceptable for agricultural purposes. The mean absolute error is less than 4% (v/v) for 53 out of the total 60 models in the 12-fold Time-Series Cross-Validation for SWC at depths of 10, 30, 50, 70, and 100 cm. Furthermore, the effectiveness of meteorological parameters in different sets of time shifting and parameter types are assessed. Our findings reveal that the responsiveness of SWC to parameters derived from precipitation varies with soil depth and season, with SWC dynamics in response to precipitation being more pronounced in shallower layers (≤50 cm) compared to deeper layers (≥70 cm). The influence of precipitation-derived and non-precipitation parameters on SWC dynamics is manifested in their distinct feature-importance characteristics in a CART model. This study highlights the importance of understanding characteristics of rainfall and underlying hydrological dynamics, such as evapotranspiration and soil texture, in order to make accurate SWC predictions using CART. Since CART serves as the basis for a variety of top-performing machines like random forest and gradient-boosted trees, the discoveries from this study can also help estimate SWC with these advanced algorithms. Overall, the results of this study provide practical guidance for refining machine-learning based SWC estimations, contributing to more effective agricultural water management and irrigation strategies. • Fast and efficient CART model applied to a grassland for agricultural purposes. • Only commonly accessible meteorological data is applied as the input features. • CART relies more on P & AP for shallow but more on NP for deep layer SWC estimation. • Estimation of − 10 cm SWC by CART performs well due to frequent wetting-drying process. • Response-recession characteristics of SWC are the key for training a good model. [ABSTRACT FROM AUTHOR]

Studies have found lower risk of childhood cancer among Asian children. We aim to characterize the recent incidence and incidence-trend of childhood cancer in Taiwan after the National Health Insurance program was launched in March 1995. Data were extracted from the Taiwan Cancer Registry, a population-based database established in 1979. Cases diagnosed at age 0-14 from 1996 to 2010 were analyzed and categorized according to the International Classification of Childhood Cancer, Third Edition (ICCC-3). In total, 8032 childhood cancer cases were included, with a microscopic verification rate of 93.9%. The overall age-standardized rate (ASR) of incidence adjusted to the 2000 World Standard Population is 125.0 cases/million, with a male-to-female ratio of 1.3. The top five cancer types (ICCC-3 subgroup[s]; ASR per million) are acute lymphoblastic leukemia (Ia, 30.3), acute myeloid leukemia (Ib; 9.4), non-Hodgkin lymphoma (IIb,c,e, 9.0), extracranial germ cell tumor (Xb,c; 8.3), and neuroblastoma (IVa; 7.8). The median age of diagnosis was 6 years for both genders. During the study period, the ASR of childhood cancer has been increasing at a rate of 1.2% per year (95% confidence interval, 0.6-1.7%). In contrast to Western countries, China, Japan, and Taiwan have lower incidence of childhood cancer; however, Taiwan's incidence rates of childhood germ cell tumors and hepatic tumors are higher. In conclusion, this population-based study reveals that the incidence rate of childhood cancer in Taiwan is rising consistently. The high incidence of germ cell tumors warrants further investigation. [ABSTRACT FROM AUTHOR]

Abstract: The present study evaluated emergency room visit (ERV) risks for all causes and cardiopulmonary diseases associated with temperature and long-lasting extreme temperatures from 2000 to 2009 in four major cities in Taiwan. The city-specific daily average temperatures at the high 95th, 97th, and 99th percentiles, and the low 10th, 5th, and 1st percentiles were defined as extreme heat and cold. A distributed lag non-linear model was used to estimate the cumulative relative risk (RR) of ERV for morbidities associated with temperatures (0 to 3-day lags), extreme heat and cold lasting for 2 to 9days or longer, and with the annual first extreme heat or cold event after controlling for covariates. Low temperatures were associated with slightly higher ERV risks than high temperatures for circulatory diseases. After accounting for 4-day cumulative temperature effect, the ERV risks for all causes and respiratory diseases were found to be associated with extreme cold at the 5th percentile lasting for >8days and 1st percentile lasting for >3days. The annual first extreme cold event of 5th percentile or lower temperatures was also significantly associated with ERV, with RRs ranging from 1.09 to 1.12 for all causes and from 1.15 to 1.26 for respiratory diseases. The annual first extreme heat event of 99th percentile temperature was associated with higher ERV for all causes and circulatory diseases. Annual first extreme temperature event and intensified prolonged extreme cold events are associated with increased ERVs in Taiwan. [Copyright &y& Elsevier]

Abstract: In this paper, technologies from multiple disciplines are used to reconstruct the shape of the Hsiaolin landslide dam, a short-lived landslide dam (SLD), that was triggered by Typhoon Morakot. Here, the formation, failure mode and breaching process of this SLD are investigated. The results indicate that the overtopping time and the debris budget constrained the dam geometry. The inferred volume of the Hsiaolin landslide dam (15.4millionm3) is much smaller than the actual landslide volume (25.2millionm3) even considering the rock-mass dilation and debris entrainment. Meanwhile, a 46% error could be induced if an over-simplified equation (a function of the dam height, length and width) is used to calculate the dam volume. The saddle of the dam crest, which is where overtopping occurred, could be used as a reference to measure the dam height and length. Accordingly, the determined dam dimensions of height (44m), length (370m) and width (1500m) are suggested to be the representative geometrical indices that influenced the stability of the Hsiaolin landslide dam. The flow rate of the dammed river, another variable relevant to dam stability, was determined from a run-off simulation. It is suggested that, instead of the peak flow before the dam formation, the flow rate during the blockage period (2974m3/s) should be used as the training data for building a statistical model for stability predictions. Finally, the low hydraulic gradient at the toe of the dam''s surface and the high safety factor of the dam slope indicate that the piping and slope instability were irrelevant to the failure of the Hsiaolin short-lived landslide dam. It is postulated that overtopping (about one hour after the blockage) dominated the failure process of this heavy-rainfall-induced landslide dam. [Copyright &y& Elsevier]

Background: The purpose of this study was to determine the risk for cancers in patients with and without type 2 diabetes mellitus (DM) stratified by body mass index (BMI)., Methods: Patients hospitalized from January 2000 to December 2010 with a diagnosis of malignant neoplasm (International Classification of Diseases, Ninth Revision, codes 140-208.91) were included. Diabetes mellitus was defined as a fasting blood glucose of 126 mg/dL or greater or a postprandial blood glucose of 200 mg/dL or greater. The patients were categorized according to BMI criteria for Asians: normal weight, BMI of less than 24 kg/m; overweight, BMI of greater than 24 kg/m; and obese, BMI of greater than 27 kg/m., Results: A total of 42,229 patients were included, of which 24,884 (59%) were normal weight, 10,096 (24%) were overweight, and 7,249 (17%) were obese. There were 4,195 (16.9%), 2,056 (20.4%), and 1,625 (22.4%) patients with DM in the normal weight, overweight, and obese groups, respectively. Regardless of weight, the diabetic patients were more likely to have pancreas, liver, urinary tract, prostate, skin, hematological, lung, secondary, and gastric malignancies but were less likely to have cervical, oropharyngeal, nasopharyngeal, breast, or thyroid cancer. Regardless of sex or the presence or the absence of DM, the patients with more than 1 malignancy were more likely to die than were those with only 1 malignancy. Furthermore, the obese diabetic patients had higher mortality than did the obese nondiabetic patients with the same number of cancers., Conclusions: Regardless of weight category (normal, overweight, or obese), diabetic patients are more likely to have pancreas, liver, urinary tract, prostate, skin, hematological, lung, secondary, and gastric malignancies. Diabetic patients may benefit from increased surveillance for these cancers.

This study aimed to identify optimal cold-temperature indices that are associated with the elevated risks of mortality from, and outpatient visits for all causes and cardiopulmonary diseases during the cold seasons (November to April) from 2000 to 2008 in Northern, Central and Southern Taiwan. Eight cold-temperature indices, average, maximum, and minimum temperatures, and the temperature humidity index, wind chill index, apparent temperature, effective temperature (ET), and net effective temperature and their standardized Z scores were applied to distributed lag non-linear models. Index-specific cumulative 26-day (lag 0-25) mortality risk, cumulative 8-day (lag 0-7) outpatient visit risk, and their 95% confidence intervals were estimated at 1 and 2 standardized deviations below the median temperature, comparing with the Z score of the lowest risks for mortality and outpatient visits. The average temperature was adequate to evaluate the mortality risk from all causes and circulatory diseases. Excess all-cause mortality increased for 17-24% when average temperature was at Z=-1, and for 27-41% at Z=-2 among study areas. The cold-temperature indices were inconsistent in estimating risk of outpatient visits. Average temperature and THI were appropriate indices for measuring risk for all-cause outpatient visits. Relative risk of all-cause outpatient visits increased slightly by 2-7% when average temperature was at Z=-1, but no significant risk at Z=-2. Minimum temperature estimated the strongest risk associated with outpatient visits of respiratory diseases. In conclusion, the relationships between cold temperatures and health varied among study areas, types of health event, and the cold-temperature indices applied. Mortality from all causes and circulatory diseases and outpatient visits of respiratory diseases has a strong association with cold temperatures in the subtropical island, Taiwan., (Copyright © 2013 Elsevier B.V. All rights reserved.)

This study aimed to identify optimal high-temperature indices to predict risks of all-cause mortality and outpatient visits for subtropical islanders in warm seasons (May to October). Eight high-temperature indices, including three single measurements (average, maximum and minimum temperature) and five composite indices (heat index, humidex, temperature humidity index, apparent temperature and wet-bulb globe temperature), and their standardized Z scores, were used in distributed lag non-linear models. Cumulative 8-day (lag zero to seven days) relative risks (RRs) and 95% confidence intervals were estimated, 1 and 2 standardized deviations above the medium (i.e., at 84.1th and 97.7th percentile, respectively), by comparing with Z scores for the lowest risks of mortality and outpatient visits as references. Analyses were performed for Taipei in north, Central Taiwan and Southern Taiwan. Results showed that standardized Z-values of high-temperature indices associated with the lowest health risk were approximately 0 in Taipei and Central Taiwan, and -1 in Southern Taiwan. As the apparent temperature was at Z=2, the cumulative 8-day mortality risk increased significantly, by 23% in Taipei and 28% in Southern Taiwan, but not in Central Taiwan. The maximum temperature displayed consistently a high correlation with all-cause outpatient visits at Z=1; with the cumulative 8-day RRs for outpatient visits increased by 7%, 3%, and 4% in the three corresponding areas. In conclusion, this study has demonstrated methods to compare multiple high-temperature indices associated with all-cause mortality and outpatient visits for population residing in a subtropical island. Apparent temperature is an optimal indicator for predicting all-cause mortality risk, and maximum temperature is recommended to associate with outpatient visits. The impact of heat varied with study areas, evaluated health outcomes, and high-temperature indices. The increased extreme heat is associated with stronger risk for all-cause mortality than for outpatient visits., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Utilization of local Taiwan laterite (LTL) to remove aqueous cesium was investigated in this work under the conditions of various contact time, cesium (Cs) loading and temperature. Experimental results show that adsorption is instantaneous. Freundlich and Langmuir simulation results demonstrate that local Taiwan laterite has high affinity and sorption capacity for Cs at low temperatures, which may be attributed to enhanced desorption as temperature increased. Thermodynamic parameters including DeltaH, DeltaG and DeltaS were calculated and it is indicated that Cs adsorption on LTL is an exothermic, spontaneous and physical adsorption reaction. Moreover, the adsorbed Cs is distributed evenly on the LTL surface, which is confirmed by SEM/EDS mapping images. Furthermore, the absence of apparent shifting or broadening of the kaolinite signal in XRD patterns after Cs adsorption is an indication of the non-expanding characteristic of kaolinite structure.