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Kawasaki Disease (KD) is a rare febrile illness affecting infants and young children, potentially leading to coronary artery complications and, in severe cases, mortality if untreated. However, KD is frequently misdiagnosed as a common fever in clinical settings, and the inherent data imbalance further complicates accurate prediction when using traditional machine learning and statistical methods. This paper introduces two advanced approaches to address these challenges, enhancing prediction accuracy and generalizability. The first approach proposes a stacking model termed the Disease Classifier (DC), specifically designed to recognize minority class samples within imbalanced datasets, thereby mitigating the bias commonly observed in traditional models toward the majority class. Secondly, we introduce a combined model, the Disease Classifier with CTGAN (CTGAN-DC), which integrates DC with Conditional Tabular Generative Adversarial Network (CTGAN) technology to improve data balance and predictive performance further. Utilizing CTGAN-based oversampling techniques, this model retains the original data characteristics of KD while expanding data diversity. This effectively balances positive and negative KD samples, significantly reducing model bias toward the majority class and enhancing both predictive accuracy and generalizability. Experimental evaluations indicate substantial performance gains, with the DC and CTGAN-DC models achieving notably higher predictive accuracy than individual machine learning models. Specifically, the DC model achieves sensitivity and specificity rates of 95%, while the CTGAN-DC model achieves 95% sensitivity and 97% specificity, demonstrating superior recognition capability. Furthermore, both models exhibit strong generalizability across diverse KD datasets, particularly the CTGAN-DC model, which surpasses the JAMA model with a 3% increase in sensitivity and a 95% improvement in generalization sensitivity and specificity, effectively resolving the model collapse issue observed in the JAMA model. In sum, the proposed DC and CTGAN-DC architectures demonstrate robust generalizability across multiple KD datasets from various healthcare institutions and significantly outperform other models, including XGBoost. These findings lay a solid foundation for advancing disease prediction in the context of imbalanced medical data., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hung et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Improving hazards in maritime transport is essential to maintain the reliability and sustainability of the industry, ensure safety and security, and support global trade and economic growth. This paper is aimed at analyzing the hazards of passenger-cargo ferries (PCFs). The novelty of this paper is fourfold: (1) developing a revised risk matrix (RRM) model with considering the adaptability-based resilience of organization to assess PCFs' hazards, (2) identifying risk factors (RFs) in ferry navigation and developing adaptive strategies to mitigate hazards, (3) applying the fuzzy best-worst method (BWM) to determine the RFs' weight, and (4) employing the leading Taiwanese passenger-cargo ferry operator (the Taiwan-ferries case) as an empirical study to verify the proposed model. The empirical result can provide pragmatic information for ferry operators to improve the safety of their ferry navigations. Additionally, the proposed RRM model can provide a methodological reference for related research in hazard management., Competing Interests: Declarations. Ethical approval: This study was approved by the Administration Committee of College of Marine, NKUST, ROC. Consent to participate: There are no human subjects in this article; so, informed consent is not applicable. Consent for publication: The authors agree that if the manuscript is accepted by the Editor-in-Chief, it will be published in the Journal. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To investigate the psoriatic disease risk among patients with previous appendicitis., Methods: This study was a nationwide population-based case-control study about the association between the psoriatic disease risk among patients with a history of appendicitis in Taiwan. The study population consisted of newly diagnosed psoriatic disease with at least two outpatient visits, and the control group included those patients without psoriatic disease at the same index date. Patients with a previous diagnosis of appendicitis or who underwent appendectomy surgery prior to their psoriatic disease diagnosis were recorded. The odds ratio of psoriatic disease diagnosis in the two groups with and without a history of appendicitis were analyzed and compared., Results: A total of 48 894 individuals diagnosed with psoriatic disease were matched with 292 656 controls by age and gender. Notably, the proportion of patients with a history of appendicitis or primary appendectomy was significantly elevated among those with psoriatic disease compared with the control cohort (both p < .05). On average, the occurrence of appendicitis preceded the index date by 3.3 ± 2.3 years. Multivariate analysis revealed a heightened incidence rate of psoriatic disease in patients previously diagnosed with appendicitis, periodontal disease, Charlson comorbidity index score (CCIS) ≧1, and ill-defined intestinal infections. This association persisted after adjusting for confounding factors, such as periodontal disease, CCIS, Salmonella, and ill-defined intestinal infections. The odds ratios for psoriatic disease in individuals with a history of appendicitis, periodontal disease, CCIS ≧1, and ill-defined intestinal infections were 1.16, 1.008, 1.69, and 1.23, respectively, with corresponding 95% confidence intervals of 1.03-1.31, 1.05-1.11, 1.65-1.74, and 1.20-1.26. These findings underscore the independent association between appendicitis and subsequent development of psoriatic disease, even after adjusting for relevant comorbidities and potential confounders., Conclusion: Our research illustrates that appendicitis is associated with an increased likelihood of developing a psoriatic disease, despite several limitations. These limitations encompass variables such as dietary and smoking habits, alongside other potential confounding factors that were not fully considered. Moreover, inherent biases in utilizing national health insurance data, such as the absence of laboratory information, as well as the constraints inherent in a retrospective study design, should be acknowledged., (© 2024 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Importance: The incidence of inflammatory bowel disease (IBD) is increasing in newly industrialized countries but disease etiologies remain unclear., Objective: To investigate the association between physical fitness and subsequent IBD risk among children and adolescents in Taiwan., Design, Setting, and Participants: This nationwide cohort study was conducted between January 1, 2010, and December 31, 2018. Data sources included the Taiwan National Health Insurance Research Database, the National Student Fitness Tests Database, and the Air Quality Monitoring System Database. This study included students who were aged 10 years, completed physical fitness tests between grades 4 and 13, and had at least 1 year of follow-up. Data analysis was last performed on January 15, 2023., Exposures: Physical fitness tests included cardiorespiratory endurance (CE; number of minutes to complete an 800-m run), musculoskeletal endurance (ME; number of bent-leg curl-ups in 1 minute), musculoskeletal power (MP; standing broad jump distance), and flexibility fitness (FF; 2-leg sit-and-reach distance)., Main Outcomes and Measures: Subsequent risk of IBD was compared among students based on physical fitness test results. Six-year cumulative incidences and hazard ratios (HRs) were calculated after adjusting for competing mortality. Performance was reported in quantiles, ranging from 1 (best) to 4 (poorest)., Results: There were 4 552 866 students who completed physical fitness tests between grades 4 and 13; among these students, 1 393 641 were aged 10 years and were included in the analysis. Six-year cumulative incidence of IBD risk was lowest among students in the best-performing quantile of CE (quantile 1, 0.74% [95% CI, 0.63%-0.86%]; P < .001), ME (0.77% [0.65%-0.90%]; P < .001), and MP (0.81% [0.68%-0.93%]; P = .005) compared with students in quantiles 2 through 4, respectively; however, no association was observed for quantiles of FF. After adjusting for competing HRs for mortality and other confounders, better CE was inversely associated with IBD risk (adjusted HR, 0.36 [95% CI, 0.17-0.75]; P = .007). Other measures of physical fitness were not independently associated with IBD risk., Conclusions and Relevance: The results of this study suggest that CE was inversely associated with IBD risk among children and adolescents, but ME, MP, and FF were not independently associated with IBD risk. Future studies that explore the mechanisms are needed.

Background: In recent years, studies have shown that electronic WOM (eWOM) directly reflects consumers' post-purchase psychological perception and directly affects repurchase behavior. This information is valued by institutions in various fields. Within the scope of the evaluation of service characteristics, medical service is the least visible and most difficult service attribute to evaluate. Service organizations must have high trust attributes. Therefore, an eWOM review significantly influences people's decision-making process when choosing a healthcare provider. The purpose of this research is to combine eWOM reviews with the SERVQUAL scale in a comparative study of positive and negative eWOM reviews of a regional teaching hospital in Taiwan., Methods: This research obtained data from publicly available eWOM reviews on Google Maps of a regional teaching hospital in Taiwan over the past 10 years (from June 24, 2011, to December 31, 2021) using website scraping technology. The semantic content analysis method was used in this study to classify eWOM reviews according to the revised PZB SERVQUAL scale., Results: Statistical analysis was conducted. During the COVID-19 pandemic, positive reviews showed a downward trend. Among the five determinants of the SERVQUAL of PZB, positive eWOM reviews performed best in "assurance" with a positive review rate of 60.00%, followed by 42.11% for "reliability". For negative eWOM reviews, "assurance" performed the worst with a positive rate of 72.34%, followed by "responsiveness" at 28.37% and "reliability" at 26.95%., Conclusion: Since the onset of COVID-19 in 2020, negative eWOM has increased significantly and exceeded the amount of positive eWOM. Regardless of positive and negative reviews, what patients care most about is "assurance" of the professional attitude and skills of medical staff, which urgently needs to be strengthened. In addition, good "reliability" will help to develop positive eWOM. However, "responsiveness" as indicated by poor service waiting time can easily lead to the spread of negative eWOM. Hospital management should focus on these service-oriented qualities., (© 2022. The Author(s).)

Aim: To investigate the association between ankylosing spondylitis (AS) and alopecia., Methods: In this cohort study, data from over 1 000 000 patients in the Taiwan Longitudinal Health Insurance Database were extracted. We selected newly diagnosed (outpatient department visit three or more times or admission at least once) patients with AS (ICD-9-CM = 720.0) from 2000 to 2012. For the non-AS comparison group, patients never diagnosed with AS were chosen from 1999 to 2013. In all, 3640 AS patients and 14 560 non-AS controls were selected. Cox proportional hazard model and Kaplan-Meier analysis were used to present the results. The adjusted hazard ratio (HR) in the Cox proportional hazard model was adjusted for age, sex, hypertension, hyperlipidemia, diabetes, atopic dermatitis, and mental disorder., Results: No increased risk of alopecia in AS patients was shown in the Cox proportional hazard model (crude HR 1.16, P = 0.595; adjusted HR 1.16, P = 0.599). Negative results are found as well in subgroup analysis of different age, sex (age 20-40 y: HR 1.03, P = 0.925; Age ≥40 y: HR 1.49, P = 0.406; Female: HR 1.17, P = 0.759; Male: HR 1.15, P = 0.667), and phenotypes of alopecia (androgenetic alopecia: HR 1.19, 95% confidence interval [CI] 0.58-2.41; alopecia areata: HR 0.98, 95% CI 0.37-2.62). A significant positive correlation is found between atopic dermatitis and alopecia (adjusted HR 8.05, P = 0.039)., Conclusion: In this population-based cohort study, we found no association of risk of alopecia and AS., (© 2022 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Taiwan`s various ethnic groups, including 16 indigenous groups, represent disparate distinct cultures and backgrounds. In long-term care, culturally safe services that reflect cultural expectations and practices must be provided to older-adult recipients of care. As frontline healthcare workers face practical challenges in providing these services appropriately, "cultural safety instructors" may be used to help facilitate indigenous cultural care. Therefore, it is vital to develop the role function and cultural competence of these instructors. In this article, related instructor qualifications, course contents, and expected results of an indigenous cultural safety instruction program are presented based on the theory of cultural competence and cultural safety. In addition, relevant perspectives on cultural safety instructors and their cross-cultural competence specific to indigenous peoples, including Dimitrov and Haque (2016) and Leininiger (1996), are integrated. It is hoped that this study promotes reflection and provides a reference on practice and policies related to long-term care for indigenous people.

Compared to other appointment methods in public hospitals, registering through the Internet or utilizing e-appointments, or registering online as an outpatient, can provide more information to the user. This research investigated the integration of unified theory of the acceptance and use of technology and information system quality in determining factors that influence the adoption of e-appointments by patients, based on the requirements of food safety consultation in Taiwan. Empirical data from 369 valid samples were assessed using Partial Least Squares (PLS). The key findings of this study indicated that patients' acceptance of e-appointments was influenced by users' perceptions (i.e., performance expectancy and facilitating conditions), along with information quality and service quality. The practical and academic implications are provided for future practitioners and scholars, and to enhance patients' usage of e-appointments in their healthcare activities.

Despite an increased focus on the healthcare rights of people of different genders and the establishment of gender policies related to healthcare in Taiwan, the promotion of gender rights in nursing education and clinical care remains unsatisfactory. Given the increasingly diversified nature of healthcare systems and nursing knowledge bases, many experienced nurses have expressed the need for self-growth through continuing education and in-service training. The professional knowledge required of nurses increases continuously, and gender issues have received little attention in conventional nursing education. Consequently, gender education has been overlooked because of insufficient teaching time and a lack of qualified teachers. In promoting online courses for nurses, the government should focus on the different nursing care needs of different genders and sexual orientations as well as design online courses based on intelligent technology that satisfy the desire of nurses to improve their gender competence. This study adopts an intelligent technology perspective in order to highlight the importance of gender competence for nurses and to propose incorporating augmented reality into case scenarios that facilitate the creation of online healthcare courses and teaching materials that enhance gender competence. This approach may effectively resolve the problem of teachers having insufficient time to provide gender education effectively. Nurses must possess diverse gender perspectives and reinforce their gender competence and cross-disciplinary integration capabilities in order to provide appropriate care for patients of different gender identities and sexual orientations.

Objective: Hypoactive Sexual Desire Disorder (HSDD) was the most common subtype of female sexual dysfunction; however, little was known about why Chinese women with HSDD were willing to seek medical help. This study aimed to identify predictive factors of seeking treatment for HSDD., Materials and Methods: 260 outpatient premenopausal women who met the DSM-IV-TR criteria for HSDD for at least 6 months were recruited. All cases were divided into groups of willing to be treated and unwilling to be treated. The main outcome measures in this study were the Sexual Desire Relationship Distress Scale (SDRDS) score, physical and psychosexual characteristics, and Health Belief Model (HBM) variables., Results: Women with willingness to be treated were significantly associated with fewer experiences of sexual assault (P = 0.033), longer relationship with a partner (P = 0.039), greater agreement about the severity of mental health injury as a result of HSDD (P = 0.008), more cues to action of sexual treatment (P < 0.05), higher self-efficacy (P < 0.05), and lesser treatment barriers including embarrassment about discussing desire problems with a physician (P = 0.026) and partner disagreement (P = 0.005). A relationship of more than 36 months (OR = 7.92), cues to action (OR = 1.70), and self-efficacy (OR = 1.76) could significantly predict willingness to be treated., Conclusions: HBM was useful in predicting treatment intent in premenopausal women with HSDD. These findings suggest ways to increase the rate of those seeking treatment in the future., (Copyright © 2018. Published by Elsevier B.V.)

Drainage canal sediments in an industrial park are generally dredged to landfill in Taiwan. The objective of this study was to evaluate feasibility employing the sediment as an adsorbent for removal of dye. The sediment contained approximately 10% of organic matter and little heavy metals. Infrared (IR) analysis revealed that carboxyl was the most important functional group for methylene blue (MB) sorption. Canal sediment could remove the most MB from water at pH 8.0 and this removal increased with increasing temperature. The MB sorption was well described by the Langmuir, Dubinin-Radushkevich, and Temkin sorption isotherms at 10°C, but it showed good compliance with Freundlich isotherm at 25°C and 40°C. The MB adsorption was a spontaneous and endothermic reaction; its maximum calculated adsorption capacity (Q m ) was 56.0 mg g -1 at 10°C by the Langmuir isotherm. The calculated values of enthalpy (ΔH°) and entropy (ΔS°) are 14.6 kJ mol -1 and 149.2 kJ mol -1 , respectively. Only pseudo-second-order adsorption kinetic model successfully described the kinetics of MB onto the sediment at different operation parameters. Activation energy of MB adsorption calculated from Arrhenius equation was 16.434 kJ mol -1 , indicating the binding between canal sediment and MB was a physical adsorption.

Aims and Objectives: This study aimed to clarify how nurse innovation is related to customer perception of medical service quality and experience., Background: Recently, many hospitals have put much emphasis upon the development of nurse innovation., Design: A cross-sectional study was employed., Methods: This study adopted questionnaire survey method with nurses and customers of the inpatient wards from three Taiwanese hospitals as the research subjects. After pairing, there were 294 valid questionnaires. Hierarchical regression analysis was utilised to test the possible impact of nurse innovation on medical service quality and experience., Results: In terms of the dimensions of nurse innovation, 'innovation behaviour' ranked the highest (3·24), followed by knowledge creation and innovation diffusion; in terms of the degree of the medical service quality, 'reliability' ranked the highest (4·35). As for the degree of the medical service experience, 'feel experience' ranked the highest (4·44). All dimensions of nurse innovation have no significant effects on medical service quality and experience., Conclusion: Of these three dimensions of nurse innovation, the level of innovation behaviour was perceived by the nurses as the highest. The study found that nurse innovation has no significant effects on customer perception of service quality and experience., Relevance to Clinical Practice: Hospitals shall provide sufficient resources and budget for fostering innovation development and encourage their nurses to develop nursing innovation for patents. The education and training courses on 'patient-centred' shall be enhanced among hospital nurses. Healthcare managers shall also explore the difficulties about innovation diffusion and find the solutions for nurses., (© 2016 John Wiley & Sons Ltd.)

Gender and race issues have caused rapid cultural and societal changes to affect the healthcare of indigenous women, which involves complicated, cultural meanings. The present paper begins by outlining the gender perspective and then elaborates on the present gender mainstreaming and status of indigenous women's healthcare in Taiwan. Furthermore, this paper identifies the current difficulties experienced by Taiwanese indigenous women, including those related to the lack of adequate healthcare data and gender analyses on indigenous women and the lack of regular research on healthcare strategies for indigenous women. Therefore, the present paper proposes to establish health policy references that are gender and race sensitive. The health policy not only addresses racial and gender concerns regarding healthcare information but also focuses on the analysis of indigenous healthcare information. Indigenous women's health concerns are discussed here within the framework of healthcare policy through the perspective of gender mainstreaming. Additionally, we will analyze and evaluate the effects of gender in order to establish inspection and management processes that integrate the concept of gender into policy development and implementation, thus promoting relevant health policies. During the processes of planning, implementing, and evaluating healthcare policies, women should unite to contribute toward indigenous women's health policies and gender mainstreaming.

The oriental river prawn (Macrobrachium nipponense) is a non-obligatory amphidromous prawn, and it has a wide distribution covering almost the entire Taiwan. Mitochondrial DNA fragment sequences of the cytochrome oxidase subunit I (COI) and 16S rRNA were combined and used to elucidate the population structure and historical demography of oriental river prawn in Taiwan. A total of 202 individuals from six reservoirs and three estuaries were separately collected. Nucleotide diversity (π) of all populations was 0.01217, with values ranging from 0.00188 (Shihmen Reservoir, SMR, northern Taiwan) to 0.01425 (Mingte Reservoir, MTR, west-central Taiwan). All 76 haplotypes were divided into 2 lineages: lineage A included individuals from all sampling areas except SMR, and lineage B included specimens from all sampling locations except Chengching Lake Reservoir (CLR) and Liyu Lake Reservoir (LLR). All FST values among nine populations were significantly different except the one between Jhonggang River Estuary (JGE, west-central Taiwan) and Kaoping River Estuary (KPE, southern Taiwan). UPGMA tree of nine populations showed two main groups: the first group included the SMR and Tamsui River Estuary (TSE) (both located northern Taiwan), and the second one included the other seven populations (west-central, southern and eastern Taiwan). Demographic analyses implied a population expansion occurred during the recent history of the species. The dispersal route of this species might be from China to west-central and west-southern Taiwan, and then the part individuals belonging to lineage A and B dispersed southerly and northerly, respectively. And then part individuals in west-central Taiwan fell back to and stay at estuaries as the sea level rose about 18,000 years ago.

Introduction: Data concerning the impact of amphetamine on male sexual functions are limited, although amphetamine has been used as an aphrodisiac., Aims: This cross-sectional study was to assess the impact of illicit use of amphetamine on male sexual functions., Methods: Male illicit drug users in a Drug Abstention and Treatment Center were recruited to complete a self-administered questionnaire, and data were compared with age-matched controls., Main Outcome Measures: The International Index of Erectile Function (IIEF) and global assessment questions were used to assess sexual functions., Results: Of 1,159 amphetamine mono-illicit drug users, the mean age was 31.9 ± 7.5 (18-57) years, and mean duration of drug use was 30.7 ± 52.2 (median 9, range 0.1-252) months. Half of them reported that drug use had no impact on their sexual functions. The other half reported drug impacts as reduced erectile rigidity and sexual life satisfaction, enhanced orgasmic intensity, and prolonged ejaculation latency time more often than the opposite effects, while they reported enhanced or reduced effect equally on sexual desire. Dosing frequency of amphetamine was associated with its impact on sexual functions, but duration of its use had little association with that. Compared with 211 age-matched controls, the amphetamine mono-illicit drug users had lower IIEF scores in the domains of erectile function, orgasmic function, and overall satisfaction, but there are no significant differences in intercourse satisfaction and sexual desire scores. The prevalence of erectile dysfunction (ED) was significantly higher in the drug users than in the controls (29.3% vs. 11.9%). The odds ratio of ED for amphetamine use was 2.1 (95% confidence interval 1.2-3.6) after adjustment for other risk factors., Conclusions: The impact of illicit use of amphetamine on male sexual functions varied among users, and their ED prevalence was higher than the controls., (© 2015 International Society for Sexual Medicine.)

Relatively few studies have addressed the risk factors of erectile dysfunction (ED) in Taiwanese- most have described ED and medical problems in the general population. In this study, the cardiovascular risk factors of ED among aborigines in Taiwan were investigated. However, alcohol dependence (AD) was prevalent in Taiwan's aborigine population. So this study also focused on the relationship among AD, the cardiovascular risk factors and ED. A cross-sectional study was conducted, and data was obtained from a baseline survey of 192 aboriginal adults (35-75 years of age). The participants' demographic data, AD, markers of endothelial function, serum testosterone, and ED status were assessed. Ninety-four (49%) of the 192 participants had a history of alcoholism and 79 (84%) of those with alcoholism had ED. The study reported that AD and hyperlipidemia, metabolic syndrome (MetS), ED, abnormality of testosterone, and high-sensitivity C-reactive protein are highly prevalent among the aborigines. Factors that may affect ED included age, AD, central obesity, diabetes mellitus, hyperlipidemia, hypertension, MetS, and testosterone. ED is highly prevalent among aborigines with the risk factors of AD, MetS, old age, and abnormal testosterone serum level. MetS, atherosclerosis, and ED are risk factors for cardiovascular diseases. Hence, an increased focus on Taiwanese aborigines with ED is necessary., (© The Author(s) 2014.)

Objective: This study was conducted to explore the association between sexual orientations and polycystic ovary syndrome (PCOS)-related parameters., Materials and Methods: A cross-sectional study with participants recruited from the regular outpatient clinic at the Department of Obstetrics and Gynecology at Taipei Medical University Hospital, Taipei, Taiwan between July 2012 and December 2013 was carried out. A total of 97 women met the criterion of having been diagnosed with PCOS. Among these 97 women, 89 were heterosexuals and eight were self-identified as lesbians. At the same time, 78 women without PCOS were enrolled to serve as the control group. Participants were given a standard questionnaire and had blood withdrawn for biochemical analysis of androgen parameters--including total testosterone, androstenedione, sex hormone binding globulin, free androgen index, 17β-estradiol (E2), luteinizing hormone, and follicular-stimulating hormone. The biochemical data were measured to compare the PCOS clinical parameters present in people of different sexual orientations (lesbians and heterosexuals)., Results: The women with PCOS, regardless of sexual orientation, had higher percentages and serum levels of hyperandrogenism-related clinical parameters than the women without PCOS [acne (87.5% and 60.7% vs. 23.1%), p < 0.001]; hirsutism (62.5% and 57.3% vs. 15.4%, p ≤ 0.001)]; and biochemical parameters (total T, p < 0.05 or p < 0.001, and luteinizing hormone/follicular-stimulating hormone ratio, p ≤ 0.001]. The sexual orientation of women with PCOS affected their body mass index (BMI), because lesbians with PCOS possessed higher BMI than heterosexual women with PCOS (26.5 ± 1.9 vs. 22.5 ± 0.55; p < 0.05). However, hyperandrogenism-related clinical and biochemical parameters were not significantly different statistically between women with PCOS but of different sexual orientations., Conclusion: Our preliminary data showed that sexual orientation influenced the BMI of women with PCOS, but did not affect hyperandrogenism-related clinical or biochemical characteristics. This observation requires further confirmation., (Copyright © 2014. Published by Elsevier B.V.)

This study evaluates the influence of leadership style and employee trust in their leaders on job satisfaction. 341 personnel (164 men, 177 women; M age = 33.5 yr., SD = 5.1) from four large insurance companies in Taiwan completed the transformational leadership behavior inventory, the leadership trust scale and a short version of the Minnesota (Job) Satisfaction Questionnaire. A bootstrapping mediation and structural equation modeling revealed that the effect of transformational leadership on job satisfaction was mediated by leadership trust. This study highlights the importance of leadership trust in leadership-satisfaction relationships, and provides managers with practical ways to enhance job satisfaction.

This is the third in a series of studies evaluating how transformational leadership is associated with related variables such as job satisfaction, change commitment, leadership trust, cooperative conflict management, and market orientation. The present paper evaluates the effects of transformational leadership and cooperative conflict management along with their mediating and moderating of leadership trust in the life insurance industry for two sample groups, sales managers and sales employees. The main effect of leadership trust was mediated and moderated by cooperative conflict management. Cooperative conflict management made a more important contribution than transformational leadership or the moderating effect (interaction), but these three together were the most important variables predicting highest leadership trust. Transformational leadership has an indirect influence on leadership trust. This work summarizes the specific contribution and importance of building successful leadership trust associations with employees in relation to leadership and satisfaction with change commitment.

The red-spot prawn, Metapenaeopsis barbata, is a commercially important, widely distributed demersal species in the Indo-West Pacific Ocean. Overfishing has made its populations decline in the past decade. To study conservation genetics, eight polymorphic microsatellite loci were isolated. Genetic characteristics of the SSR (simple sequence repeat) fingerprints were estimated in 61 individuals from adjacent seas of Taiwan and China. The number of alleles, ranging from 2 to 4, as well as observed and expected heterozygosities in populations, ranging from 0.048 to 0.538, and 0.048 and 0.654, respectively, were detected. No deviation from Hardy-Weinberg expectations was detected at either locus. No significant linkage disequilibrium was detected in locus pairs. The polymorphic microsatellite loci will be useful for investigations of the genetic variation, population structure, and conservation genetics of this species.

The effects of transformational leadership and satisfaction were studied along with their interconnected effects (mediation and moderation) on commitment to change in the life insurance industry in two samples, sales managers and salespersons. A multiple mediated-moderated regression approach showed mediation and moderation to have statistically significant main effects on change commitment. Transformational leadership and satisfaction made a more important contribution to change commitment while job satisfaction had a mediating and moderating role that could enhance the relationships between leadership and change commitment. This information is of importance in building successful change commitment associations with customers.

Managerial transformational leadership skills may directly influence banking counter staff toward change commitment and improve job satisfaction and service quality, or the influence instead may be mediated by change commitment. For a sample comprised of 246 managers from four large Taiwanese banks, the following path relationships were tested: (1) the association of transformational leadership with change commitment, (2) the association of change commitment with job satisfaction, and (3) the direct or indirect (through the mediation of change commitment) effect of transformational leadership on job satisfaction. Regression was utilized to gain insight into the effects of transformational leadership and change commitment on job satisfaction. Transformational leadership may foster change by providing psychological support to the banking counter staff, enabling them to use their skills to meet the needs of individual customers in response to complex environments.

Introduction: Obesity is receiving growing research attention. However, investigations concerning the potential impact of obesity and testosterone on erectile dysfunction (ED) in young men have not been completely clarified., Aim: To identify the relationship between ED, serum testosterone level, and obesity in draftees in Taiwan., Methods: Data were obtained from a baseline survey of 364 young adult military conscripts (19-24 years old). Their demographic data, body mass index (BMI), serum testosterone, and ED status were assessed. Sixty-four subjects had ED, and 300 comprised the normal control group., Main Outcome Measures: The International Index of Erectile Function-5 (IIEF-5), Sexual Desire Inventory, and Sexual Behavior Scale were used to assess ED, sexual desire, and sexual function., Results: Three hundred sixty-four men were available for analysis. The mean age of the sample was 21.66 ± 0.92 years (19-24 years). The IIEF total score had a mean of 21.99 ± 2.34 and median of 23; 64 (17.6%) subjects had ED, although mild. The results showed an increased risk of ED among obese men and subjects with lower serum testosterone. Among the predictors of ED, obesity (odds ratio =83.97, 95% CI = 16.17-436.03, degrees of freedom [d.f.] = 1, P < 0.001) and lower serum testosterone (odds ratio = 679.84, 95% CI = 108.48-4,260.58, d.f. = 1, P < 0.001) were significantly independent factors. Testosterone levels were lower in subjects with obesity (P < 0.001)., Conclusion: This study supports the idea that BMI and serum testosterone may provide warning signs of ED and, at the same time, an opportunity for early intervention in young men., (© 2011 International Society for Sexual Medicine.)

Background: Military conscripts may experience a change in their attitude towards sex at times when sexual urges are at their peak during their physical growth. This study examines the experience, understanding, knowledge and attitudes regarding sexual activity of the military conscripts., Methods: Data was obtained from a cross-sectional survey of 1127 young adult military conscripts, and were evaluated in Southern Taiwan from January to July 2009, their demographic data, sexual knowledge, attitudes and activities were assessed., Results: Nearly 43% of the participants had performed penetrative vaginal intercourse at least once; 34% of the participants performed heterosexual oral sex at least once; almost 7% of participants had had homosexual intercourse, and 7.5% of participants had experienced homosexual oral sex in the past year. The mean sexual knowledge score based on 30 questions was 23.2 ± 4.0. The higher the educational level of the participants, the greater sexual knowledge they had obtained., Conclusion: This study found that 43% of unmarried young recruits had experienced premarital sexual activity. However, their sexual knowledge was insufficient and should be strengthened by sex education from an earlier age. College aged and adult learners also have sex education needs, especially with regard to integrating sexuality and life, being able to relate responsibly as sexual beings to others, the use of contraception, and about sexually transmitted disease.

Background: Although previous studies proved that the implementation of mentoring program is beneficial for enhancing the nursing skills and attitudes, few researchers devoted to exploring the impact of mentoring functions on job satisfaction and organizational commitment of new nurses. In this research we aimed at examining the effects of mentoring functions on the job satisfaction and organizational commitment of new nurses in Taiwan's hospitals., Methods: We employed self-administered questionnaires to collect research data and select new nurses from three regional hospitals as samples in Taiwan. In all, 306 nurse samples were obtained. We adopted a multiple regression analysis to test the impact of the mentoring functions., Results: Results revealed that career development and role modeling functions have positive effects on the job satisfaction and organizational commitment of new nurses; however, the psychosocial support function was incapable of providing adequate explanation for these work outcomes., Conclusion: It is suggested in this study that nurse managers should improve the career development and role modeling functions of mentoring in order to enhance the job satisfaction and organizational commitment of new nurses.