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Background: Intensive care units are critical environments where various alarm systems play a pivotal role in patient monitoring and safety. Alarm fatigue can lead to slower response times and missed alarms, compromising patient safety and increasing stress and burnout among intensive care unit nurses. Understanding how intensive care unit nurses respond to and manage these alarms is crucial in evaluating their impact on patient care and nursing well-being. Methods: This descriptive qualitative study explored the experiences of intensive care unit nurses in alarm management. Conducted in the medical and surgical intensive care units of a Northern Taiwan medical center, the study involved 15 nurses. Semi-structured interviews were utilized to investigate the working experiences of ICU nurses in alarm management and to identify their coping strategies for dealing with the constant inundation of medical device alarms. The interviews were transcribed, and content analysis was applied to identify key themes in the responses. Results: The study revealed five main themes in intensive care unit nurses' strategies for managing alarms: (1) Mastering alarm signals and acting; (2) Team monitoring for life preservation; (3) Enhancing senses and distinguishing carefully; (4) Learning from the lessons of incidents for vigilant reflection; and (5) Detach alarms' influence on daily life. These coping strategies are effective in alarm management, safeguarding patients' lives, enhancing the serenity of the clinical environment, and mitigating the physical and mental exhaustion caused by alarm fatigue. Conclusions: Intensive Care Unit nurses develop various coping strategies to manage medical device alarms, based on their experience. These strategies are crucial in maintaining patient safety and reducing nurse alarm fatigue. They can also be used for nursing education and clinical training. [ABSTRACT FROM AUTHOR]

Background: Worldwide, more than 125 million people are infected with Shigella each year and develop shigellosis. In our previous study, we provided evidence that Shigella sonnei infection triggers activation of the NACHT, LRR, and PYD domain-containing protein 3 (NLRP3) inflammasome in macrophages. NLRP3 inflammasome is responsible for regulating the release of the proinflammatory cytokines interleukin (IL)-1β and IL-18 through the protease caspase-1. Researchers and biotech companies have shown great interest in developing inhibitors of the NLRP3 inflammasome, recognizing it as a promising therapeutic target for several diseases. The leaves of Cinnamomum osmophloeum kaneh, an indigenous tree species in Taiwan, are rich in cinnamaldehyde (CA), a compound present in significant amounts. Our aim is to investigate how CA affects the activation of the NLRP3 inflammasome in S. sonnei-infected macrophages. Methods: Macrophages were infected with S. sonnei, with or without CA. ELISA and Western blotting were employed to detect protein expression or phosphorylation levels. Flow cytometry was utilized to assess H2O2 production and mitochondrial damage. Fluorescent microscopy was used to detect cathepsin B activity and mitochondrial ROS production. Additionally, colony-forming units were employed to measure macrophage phagocytosis and bactericidal activity. Results: CA inhibited the NLRP3 inflammasome in S. sonnei-infected macrophages by suppressing caspase-1 activation and reducing IL-1β and IL-18 expression. CA also inhibited pyroptosis by decreasing caspase-11 and Gasdermin D activation. Mechanistically, CA reduced lysosomal damage and enhanced autophagy, while leaving mitochondrial damage, mitogen-activated protein kinase phosphorylation, and NF-κB activation unaffected. Furthermore, CA significantly boosted phagocytosis and the bactericidal activity of macrophages against S. sonnei, while reducing secretion of IL-6 and tumour necrosis factor following infection. Conclusion: CA shows promise as a nutraceutical for mitigating S. sonnei infection by diminishing inflammation and enhancing phagocytosis and the bactericidal activity of macrophages against S. sonnei. [ABSTRACT FROM AUTHOR]

Background: In situ simulation is the practice of using simulated scenarios to improve skill implementation, train critical thinking and problem-solving abilities, and enhance self-efficacy. This study aimed to enhance nursing knowledge, skills, and attitudes toward clinical work by applying in situ simulation training to improve the healthcare of critically ill patients. Methods: This study was conducted from a medical center in northern Taiwan and included 86 trainees who received intensive care training courses from 1 June 2017 to 31 May 2019. The self-report knowledge assessment, empathetic self-efficacy scale, skill assessment, and attitudes of instructors before and after training were collected. The statistical analysis used the Wilcoxon test for knowledge and attitudes, and chi-square tests were used for skills to evaluate the learning effect. Results: The results showed a statistically significant improvement in knowledge, skills, attitudes, and empathy in nursing care. Conclusions: In situ simulation learning can be an accepted method for nursing skills in the intensive care unit. Through this study, we understood that the in situ simulation method was beneficial to nurses' care and care thinking processes. It is worth developing and evaluating integrated simulation education to enhance learning, change behavior, and promote holistic care in the nursing field. [ABSTRACT FROM AUTHOR]

Introduction: Fracture Liaison Services (FLS) has been proven effective in reducing subsequent fractures and related mortality. However, more research is needed on the impact of FLS on the 30-day readmission rate and its effectiveness in rural hospitals. This study aims to assess the impact of FLS on clinical outcomes including readmission rates, subsequent fractures, and fracture-related mortality in rural areas of an Asain country. Materials and methods: In a rural hospital in Taiwan, we conducted a two-year prospective cohort study on elderly individuals with fragility hip fractures. The study compared the clinical outcomes between the control group and the FLS-cohort group. Logistic regression analysis was used to identify factors contributing to 1-year mortality after injury. Results: 556 patients were enrolled. (304 in the control group and 252 in the FLS group) The mean age was 79.8 years. The findings revealed that the introduction of FLS did not result in significant differences in mortality, readmission, complication, subsequent fractures, or secondary hip fractures. However, there were notable improvements in the length of hospital stay and the proportion of patients receiving surgery within 48 h following the implementation of FLS. Subgroup analysis showed that FLS patients who received anti-osteoporotic treatment had lower mortality and 30-day readmission rates. Factors associated with higher 1-year mortality included male, high ASA level, and delayed surgery. Discussion: This study provides the real-life evidence of the effect of intensive FLS model in a rural hospital in an Asian country. Conclusion: While FLS did not show significant differences in certain clinical outcomes, it led to shorter hospital stays and increased timely surgeries. FLS patients receiving anti-osteoporotic treatment had better mortality and readmission rates. Further research is necessary to gain a comprehensive understanding of the impact of FLS care in rural areas of Asia. [ABSTRACT FROM AUTHOR]

Fatigue is a prevalent subjective sensation, affecting both office workers and a significant global population. In Taiwan alone, over 2.6 million individuals—around 30% of office workers—experience chronic fatigue. However, fatigue transcends workplaces, impacting people worldwide and potentially leading to health issues and accidents. Gaining insight into one's fatigue status over time empowers effective management and risk reduction associated with other ailments. Utilizing photoplethysmography (PPG) signals brings advantages due to their easy acquisition and physiological insights. This study crafts a specialized preprocessing and peak detection methodology for PPG signals. A novel fatigue index stems from PPG signals, focusing on the dicrotic peak's position. This index replaces subjective data from the brief fatigue index (BFI)-Taiwan questionnaire and heart rate variability (HRV) indices derived from PPG signals for assessing fatigue levels. Correlation analysis, involving sixteen healthy adults, highlights a robust correlation (R > 0.53) between the new fatigue index and specific BFI questions, gauging subjective fatigue over the last 24 h. Drawing from these insights, the study computes an average of the identified questions to formulate the evaluated fatigue score, utilizing the newfound fatigue index. The implementation of linear regression establishes a robust fatigue assessment system. The results reveal an impressive 91% correlation coefficient between projected fatigue levels and subjective fatigue experiences. This underscores the remarkable accuracy of the proposed fatigue prediction in evaluating subjective fatigue. This study further operationalized the proposed PPG processing, peak detection method, and fatigue index using C# in a computer environment alongside a PPG device, thereby offering real-time fatigue indices to users. Timely reminders are employed to prompt users to take notice when their index exceeds a predefined threshold, fostering greater attention to their physical well-being. [ABSTRACT FROM AUTHOR]

(1) Background: Patients who are critically ill or undergo major surgery are admitted to intensive care units (ICUs). Prolonged immobilization is the most likely cause of pressure injuries (PrIs) in the ICU. Previous studies of Western populations found that effective protocols could reduce the incidence of PrIs, and the efficacy of systemic targeted intervention protocols in preventing PrIs in the Chinese population needs to be surveyed. (2) Methods: We reviewed cases of PrIs in the ICUs of Taipei Veterans General Hospital from 2014 to 2019. The ICU nurses at the hospital began to implement targeted interventions in January 2017. The incidence density of PrIs was calculated by dividing the number of PrIs by person days of hospitalizations in the pre-bundle (2014–2016) and post-bundle (2017–2019) stages. Poisson regression was performed to compare the trend of incidence densities. (3) Results: The incidence density of PrIs was 9.37/1000 person days during the pre-bundle stage and 1.85/1000 person days during the post-bundle stage (p < 0.001). The relative risk (RR) was 0.197 (95% confidence interval: 0.149–0.26). The incidence densities of iatrogenic PrIs and non-iatrogenic PrIs decreased as the RRs decreased. (4) Conclusions: Targeted interventions could significantly reduce the incidence of PrIs. Healthcare providers must follow the bundle care protocol for PrI prevention to improve the quality of healthcare and promote patient health. [ABSTRACT FROM AUTHOR]

We used the magnetotelluric method (MT) to investigate near-surface structures at the northern end of the Longitudinal Valley in Hualien City, eastern Taiwan. This valley is considered the suture zone of the arc-continental collision between the Eurasian plate and the Philippine Sea plate, making it crucial to understand the geological settings at its northern end. We conducted MT measurements along the L2 and L3 lines on the north and south sides of the city, respectively. On the L2 survey line to the north of Hualien City, our inverted image indicates that the Tananao metamorphic complex, with a resistivity of several hundred ohm-m, is in vertical contact with sedimentary rock with a resistivity higher than 1000 Ω-m. This vertical contact zone is consistent with the distribution of the Beipu fault. However, the vast area between L2A and L2E is occupied by airports and military facilities, making it challenging to lay out survey stations to clearly analyze critical regional structures such as the Beipu and Milun faults. The 2D inversion results of the L3 are consistent with past reflection seismic interpretation results. The resistivity of the metamorphic Yuli Formation, which belongs to the continental basement rock in the west, is less than 200 Ω-m. Its top dips eastward, reaching depths greater than 2.5 km at the eastern end of the L3. The rocks above the metamorphic bedrock, composed of material with a resistivity greater than 1000 Ω-meters, are likely to be sedimentary rocks of the foreland basin. The difference in geological structure between the two survey lines, L2 and L3, may suggest the possible existence of an E-W orienting fault structure in the urban area between the two survey lines. Additionally, the rapid thickening of sedimentary rocks north of Hualien City may provide indirect evidence for the detachment model proposed by Shyu et al. (Tectonophysics 692:295-308, 2016). Further studies are required to resolve the resistivity structures and fault orientations in the urban region between the two survey lines. Key points: MT methods were used to resolve the shallow structures in the collision suture zone in Eastern Taiwan. The results show that the continental metamorphic rocks have a resistivity less than 1000 Ω-m. The rocks that have a relative higher resistivity over 1000 Ω-m may be the sedimentary rocks belonging to the foreland settings. The Beipu fault may be the contact between the continental metamorphic rocks and foreland settings. The subsurface structures are different between our two survey lines and suggest a further study is needed in the area. [ABSTRACT FROM AUTHOR]

Background and Objectives: The effectiveness and safety of idarucizumab for the reversal of the effects of dabigatran have been proven. However, there remains a paucity of literature comprehensively investigating outcomes in real-world patients. This is especially true when comparing patients who were eligible for inclusion in the RE-VERSE AD trial with patients who were ineligible. As the prescription of dabigatran has become increasingly popular, the generalizability of the results to real-world populations has come into question due to the broad variability of real-world patients receiving dabigatran. Our study aimed to identify all patients who were prescribed idarucizumab and examined how effectiveness and safety varied among those patients who were eligible and ineligible for the trial. Materials and Methods: This retrospective cohort study analyzed the largest medical database in Taiwan. We enrolled all patients who were prescribed and received idarucizumab from when it became available in Taiwan up until May 2021. A Total of 32 patients were included and analyzed, and they were further divided into subgroups based on their eligibility for inclusion in the RE-VERSE AD trial. Multiple outcomes were evaluated, including successful hemostasis rate, complete reversal efficacy of idarucizumab, 90-day thromboembolic events, intra-hospital mortality, and adverse event rate. Results: In our study, we found that 34.4% of real-world cases of idarucizumab use were ineligible for the RE-VERSE AD trials. The eligible group had higher successful hemostasis rates (95.2% vs. 80%) and anticoagulant effect reversal rates compared to the ineligible group (73.3% vs. 0%). The mortality rates were 9.5%, compared to 27.3% in the ineligible group. Few adverse effects (n = 3) and 90-day thromboembolic events (n = 1) were observed in either group. Among the ineligible cases, all acute ischemic stroke patients (n = 5) received definite, timely treatments without complications. Conclusions: Our study demonstrated the real-world effectiveness and safety of idarucizumab infusion for trial-eligible patients and all acute ischemic stroke patients. However, although it seems to be effective and safe, idarucizumab appears to be less effective in other trial-ineligible patients. Despite this result, our study provides further evidence for extending the applicability of idarucizumab in real-world scenarios. Our study suggests that idarucizumab can be a safe and effective option for reversing the anticoagulant effect of dabigatran, particularly for eligible patients. [ABSTRACT FROM AUTHOR]

Introduction. This study explored the pathological constitution as it relates to low quality of life in HIV-infected MSM patients, as a reference for clinical treatment. Methods. It had a cross-sectional research design using structured questionnaires to collect data, including patient's basic data, CD4+, CD4+/CD8+ ratio, Wang Qi constitution, and WHOQOL-BREF-Taiwan version questionnaires. We considered the association between constitutions and quality of life of HIV-infected MSM patients. Results and Discussion. The project accepted 203 HIV-infected MSM participants. The three most common pathological constitutions were Yang deficiency 15.5%, yin deficiency 13.1%, and qi deficiency 11.2%. The study determined scores for various quality of life domains: psychological (13.44 ± 2.27), social relationship (13.81 ± 2.80), physiological (14.43 ± 2.41), and environmental (14.78 ± 2.21). The TCM constitution is strongly correlated with the quality of life. Excess constitution had the worst quality of life. Comparing the infected time over one year with the time of <0–2 weeks, the adjusted odds ratios (AOR) were determined for abnormal CD4+ and CD4+/CD8+ ratio (OR: odds ratio: 0.03, 0.07, respectively, p < 0.001). Compared with the Gentleness constitution, there is a significant difference between the Deficiency and Excess constitution in sleep status and negative mood by multiple regression analysis (p < 0.001). Conclusion. The Excess constitutions was correlated with worse quality of life. Even if the immune system was restored, the psychosocial domain, sleep status, and negative mood were not improved. [ABSTRACT FROM AUTHOR]

The conservation of Taiwan Country chicken (TCC) is important due to concerns for the local breed's adaptability to the area and disease resistance. Furthermore, the genetic resource base of native chickens can be used to improve egg and meat production efficiency in commercial TCC. As the embryonic stem cells (ESCs) hold great potential for regenerative medicine and species conservation, the aims of this study were to isolate and characterize ESCs of TCC. The blastodermal cells (BCs) were isolated from the zona pellucida of stage X chicken embryos and cultured in conditioned medium for the proliferation and maintenance of BCs in vitro. The quantitative real-time polymerase chain reaction (qPCR) results showed that POUV, SOX2 and NANOG were expressed in the putative ESCs. In addition, the expression of pluripotent markers, SSEA-1 and SSEA-4, was detected. The DiI-stained ESCs were injected into the dorsal aorta of the E3.5 recipient fetuses soon after staining and the injected embryos were continuously incubated and checked on day 7 of incubation. It was shown that some DiI-positive cells were found in the 7-d-old chimeric embryos. The results demonstrated that some pluripotent cells existed in the cultured BCs for the production of germline chimeric embryos from TCC. [ABSTRACT FROM AUTHOR]

Sedative–hypnotic misuse is associated with psychiatric diseases and overdose deaths. It remains uncertain whether types of anesthesia affect the occurrence of new postoperative uses of sedative–hypnotics (NPUSH). We used reimbursement claims data of Taiwan's National Health Insurance and conducted propensity score matching to compare the risk of NPUSH between general and neuraxial anesthesia among surgical patients who had no prescription of oral sedative–hypnotics or diagnosis of sleep disorders within the 12 months before surgery. The primary outcome was NPUSH within 180 days after surgery. Multivariable logistic regression models were used to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI). A total of 92,222 patients were evaluated after matching. Among them, 15,016 (16.3%) had NPUSH, and 2183 (4.7%) were made a concomitant diagnosis of sleep disorders. General anesthesia was significantly associated both with NPUSH (aOR: 1.17, 95% CI: 1.13–1.22, p < 0.0001) and NPUSH with sleep disorders (aOR: 1.11, 95% CI: 1.02–1.21, p = 0.0212) compared with neuraxial anesthesia. General anesthesia was also linked to NPUSH that occurred 90–180 days after surgery (aOR: 1.12, 95% CI: 1.06–1.19, p = 0.0002). Other risk factors for NPUSH were older age, female, lower insurance premium, orthopedic surgery, specific coexisting diseases (e.g., anxiety disorder), concurrent medications (e.g., systemic steroids), postoperative complications, perioperative blood transfusions, and admission to an intensive care unit. Patients undergoing general anesthesia had an increased risk of NPUSH compared with neuraxial anesthesia. This finding may provide an implication in risk stratification and prevention for sedative–hypnotic dependence after surgery. [ABSTRACT FROM AUTHOR]

Phyllanthus emblica L. is traditionally used as both medicine and food in Taiwan. In this study, we evaluated the antioxidant, anti-inflammatory, and neuroprotection bioactivities of P. emblica fruit. P. emblica fruit extracts had a high content of total phenol and flavonoids, and chlorogenic acids. For antioxidant capacity, 95% ethanol-extracted P. emblica had the best DPPH radical scavenging activity, ferrous ion chelating ability, and reducing power as compared with hot water, 50% ethanol, and commercial extracts, and showed the highest reducing power and lipid peroxidation inhibition. The present results have demonstrated that the P. emblica extracts can protect the oxidative degradation of lipids by inhibiting FeCl3-ascorbate-mediated lipid peroxidation. For anti-inflammatory activity, P. emblica fruit extracts showed dose-dependent inhibition of nitric oxide in lipopolysaccharide-stimulated RAW264.7 cells and significantly high COX-2 inhibition. For neuroprotection bioactivity, P. emblica extracts had higher percentages of pheochromocytoma cell protection than commercial extracts. Hot water and ethanol extracts showed higher percentages of PC12 cell protection than commercial extracts. P. emblica hydroalcoholic extracts had a neuroprotective effect against oxidative damage, which could be due to their antioxidant and anti-inflammatory activity. P. emblica extracts could be used in daily health beverages, foods, and cosmetic products. [ABSTRACT FROM AUTHOR]

UNAIDS' HIV treatment targets require that 90% of people living with HIV/AIDS (PLWHA) receiving antiretroviral treatment (ART) achieve viral suppression and 90% of people with viral suppression have good health-related quality of life (HRQOL). This study aimed to examine the association of depression and antidepressant therapy with ART adherence and HRQOL in HIV-infected men who have sex with men (MSM). From 2018 through 2020, HIV-infected MSMs were consecutively recruited (N = 565) for the evaluation of ART adherence and HRQOL at Taipei City Hospital HIV clinics. Non-adherence to ART was defined as a Medication Adherence Report Scale score of < 23. HRQOL in PLWHHA was evaluated using WHOQOL-BREF, Taiwan version. Overall, 14.0% had depression and 12.4% exhibited non-adherence to ART. The nonadherence proportion was 21.8% and 10.5% in depressed and nondepressed HIV-infected MSM, respectively. After adjusting for other covariates, depression was associated with a higher risk of nonadherence to ART (adjusted odds ratio = 2.02; 95% confidence interval: 1.02–4.00). Physical, psychological, social, and environmental HRQOL were significantly negatively associated with depression. Considering antidepressant therapy, ART nonadherence was significantly associated with depression without antidepressant therapy but not with antidepressant therapy. The depressed HIV-infected MSM without antidepressant therapy had worse psychological, social, and environmental HRQOL than those with antidepressant therapy. Our study suggests that depression is associated with poor ART adherence and HRQOL, particularly in those without antidepressant therapy. Adequate diagnosis and treatment of depression should be provided for PLWHA to improve their ART adherence and HRQOL. [ABSTRACT FROM AUTHOR]

The aim of the study was to use a previously proposed mask region–based convolutional neural network (Mask R-CNN) for automatic abnormal liver density detection and segmentation based on hepatocellular carcinoma (HCC) computed tomography (CT) datasets from a radiological perspective. Training and testing datasets were acquired retrospectively from two hospitals of Taiwan. The training dataset contained 10,130 images of liver tumor densities of 11,258 regions of interest (ROIs). The positive testing dataset contained 1,833 images of liver tumor densities with 1,874 ROIs, and negative testing data comprised 20,283 images without abnormal densities in liver parenchyma. The Mask R-CNN was used to generate a medical model, and areas under the curve, true positive rates, false positive rates, and Dice coefficients were evaluated. For abnormal liver CT density detection, in each image, we identified the mean area under the curve, true positive rate, and false positive rate, which were 0.9490, 91.99%, and 13.68%, respectively. For segmentation ability, the highest mean Dice coefficient obtained was 0.8041. This study trained a Mask R-CNN on various HCC images to construct a medical model that serves as an auxiliary tool for alerting radiologists to abnormal CT density in liver scans; this model can simultaneously detect liver lesions and perform automatic instance segmentation. [ABSTRACT FROM AUTHOR]

To mitigate air pollution problem, the government has been planning to build more liquefied petroleum gas stations to motivate drivers to use liquefied petroleum gas vehicles in Taiwan. Such facility allocation problem is a multi-objective optimization process considering spatial variation in the need of refueling. This study presents a stochastic multi-objective optimization model for liquefied petroleum gas station allocation (SMOMLSA) that integrates a nondominated sorting genetic algorithm II with a Monte Carlo simulation to optimally allocate liquefied petroleum gas stations according to three trade-off objectives, including investment performance, energy conversion, and business opportunity. Monte Carlo simulation procedure generates the starting location of a taxicab car in need of refueling in the spatial grid based on a probability distribution. Nondominated sorting genetic algorithm II resolves the station location problem with these multi-objectives. The SMOMLSA was validated by conducting a real-world case study. Result depicts that the SMOMLSA can provide information on the optimal allocation of liquefied petroleum gas stations for minimizing construction costs, minimizing average refueling distance for vehicles, and maximizing potential customers. [ABSTRACT FROM AUTHOR]

First P wave arrival‐time data from local earthquakes recorded by a dense geophone array deployed on the Ilan Plain and by existing permanent stations were combined to invert for high‐resolution P wave velocity structures under northeast Taiwan. With relatively high resolution, we were able to examine the structures in more detail and to investigate their significance and tectonic implications. We introduce two distinct groups of proposals for mechanisms of subduction polarity flipping in Taiwan, referred to as the "tear model" and "breakoff model." While the predicted Philippine Sea Plate boundaries differ between the two models, those of the breakoff model and the related subducting indenter model are geodynamically similar. The surface junction and the west edge of the imaged high Vp anomalous Philippine Sea Plate comply with those predicted by the subducting indenter model and thus favor the breakoff model over the tear model. While the observed high Vp anomalous region in the mantle wedge can be explained as eclogitization of previously subducted crust, eclogitization of the overriding continental crustal roots cannot be ruled out. Those beneath the Taipei Basin and the Tatun Volcano Group exhibit a pattern potentially connected to the low Vp anomalies in the mantle wedge, suggesting the involvement of the Philippine Sea slab, either by asthenospheric upwelling due to extensional collapse or by fluid migration due to slab dehydration. Those beneath the Ilan Plain exhibit a low Vp pattern extending to deeper origins in the eastern offshore region, suggesting a connection with the opening of the Okinawa Trough. Key Points: High‐resolution tomography conducted in northeast Taiwan enables us to investigate its tectonic implicationsThe imaged high Vp anomalies of the Philippine Sea Plate comply with the subducting indenter model and favor the breakoff modelShallow low Vp anomalies beneath the Ilan Plain extend to those beneath the Okinawa Trough [ABSTRACT FROM AUTHOR]

The first deep geothermal energy development project in Taiwan was launched at the Ilan Plain in northeastern Taiwan, where metamorphic rock is covered by sediments and detailed subsurface structures were poorly known. An eastward plunging anticline containing a fault system was effectively imaged in our seismic sections. However, since some rock fragments recovered from the exploration wells were still questioned, two fault structure models were proposed. One is an extensional strike-slip fault system, and the other is an active normal fault system, which depends on whether the rock fragments were affiliated with the Hsuehshan Range or with the Backbone Range. [ABSTRACT FROM AUTHOR]

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Knowledge of the crustal structure is important for understanding the tectonic framework and geological evolution of southeastern China and adjacent areas. In this study, we integrated the datasets from the TAIGER (TAiwan Integrated GEodynamic Research) and ATSEE (Across Taiwan Strait Explosion Experiment) projects to resolve onshore-offshore deep crustal seismic profiles from the Wuyi-Yunkai orogen to the Taiwan orogen in southeastern China. Three seismic profiles were resolved, and the longest profile was 850 km. Unlike 2D and 3D first arrival travel-time tomography from previous studies, we used both refracted and reflected phases (Pg, Pn, PcP, and PmP) to model the crustal structures and the crustal reflectors. In total, data from 40 shots, 2 earthquakes, and approximately 1,950 stations were used; 15,612 arrivals were selected among three transects. Using these data, we determined the complex crustal evolution since the Paleozoic era , involving the closed Paleozoic rift basin in central Fujian, the Cenozoic extension due to the South China Sea opening beneath the coastline of southern Fujian, and the on-going collision of the Taiwan orogen. The shape of the Moho, which also reflects the crustal evolution, can be summarized as follows: ~ 30 km deep to the west of Fujian, deepening toward central Fujian (~ 35 km), becoming shallower toward the Taiwan Strait (~ 28 km), deepening again toward the mountain belt of Taiwan (~ 42 km), and becoming shallower toward the Pacific Ocean (~ 10 km). [ABSTRACT FROM AUTHOR]

Background This study investigated surgery-related medical disputes and analyzed disease etiologies and the main causes of disputes in order to identify key points for the purpose of improving the quality of surgical patient care in Taiwan. Methods Reports on all surgery-related cases appraised by the Taiwan Witness Examiner Committee of the Department of Health between 2004 and 2008 were reviewed retrospectively by three senior physicians from the emergency department who specialize in both trauma and emergency general surgery. The causes of the various medical disputes were categorized under the following descriptions: operation- or procedure-related complication, anesthesia complication, inappropriate management or decision, delayed diagnosis or misdiagnosis, and unsatisfactory result. Results A total of 154 cases were reviewed, of which 39 were trauma-related and 115 were disease-related. The two leading causes of disputes in this review were found to be operation- or procedure-related complications (35.7%) and unsatisfactory results (31.8%), followed by delayed diagnoses or misdiagnoses, inappropriate management, and anesthesia complications. Among these, 74 cases (48.1%) required the care of an acute care surgeon and 40 cases (26.0%) required emergency general surgery intervention. Conclusion Surgery- or procedure-related complications and unsatisfactory treatment results constituted the major causes of medical disputes in Taiwan. The majority of these cases involved acute care surgery; thus, the establishment of an acute care surgery system should be considered to improve patient care. The management of hemorrhagic shock and incarcerated hernia should be reinforced in future medical training. [ABSTRACT FROM AUTHOR]

Tangle anomalies represent a critical quality bottleneck in the dyeing and finishing process. The key problem is that most dyeing and finishing factories in Taiwan are small and medium-sized enterprises. The operating dyeing machines can only detect entanglement through the shutdown alarm or experienced craftsmen. In this study, machine data of operating dyeing machines are collected. The time-series data image technology of the Gramian Angular Summation Field, Gramian Angular Difference Field, and Markov Transition Field is combined with a convolutional neural network to develop an entanglement detection model. Industry manufacturers cooperating with universities collected 1,750,977 pieces of production data from 1,848 batches for verification and study. The results show that the optimal detection time for entanglement detection is 220 s, using the MTF conversion method with a moving window of 20, a parameter learning rate of 0.00005, and a batch size of 200. The results are systematically introduced into the field. It has been verified that when signs of entanglement occur, an alarm can be sent to the relevant personnel to solve the problem in the shortest time. As a result, manufacturers can greatly reduce the cost of quality loss and scheduling bottlenecks caused by downtime caused by entanglement. [ABSTRACT FROM AUTHOR]

Using 10-year population data from 2000 through 2009 in Taiwan, this is the first paper to analyze the relationship between margin trading in stock markets and stroke hospitalizations. The results show that 3 and 6 days after an increase of margin trading in the Taiwan stock markets are associated with greater stoke hospitalizations. In general, a 1 % increase in total margin trading positions is associated with an increment of 2.5 in the total number of stroke hospitalizations, where the mean number of hospital admissions is 233 cases a day. We further examine the effects of margin trading by gender and age groups and find that the effects of margin trading are significant for males and those who are 45-74 years old only. In summary, buying stocks with money you do not have is quite risky, especially if the prices of those stocks fall past a certain level or if there is a sudden and severe drop in the stock market. There is also a hidden danger to one's health from margin trading. A person should be cautious before conducting margin trading, because while it can be quite profitable, danger always lurks just around the corner. [ABSTRACT FROM AUTHOR]

Few studies have examined the association between environmental phthalate exposure and children’s neurocognitive development. This longitudinal study examined cognitive function in relation to pre-and postnatal phthalate exposure in children 2–12 years old. We recruited 430 pregnant women in their third trimester in Taichung, Taiwan from 2001–2002. A total of 110, 79, 76, and 73 children were followed up at ages 2, 5, 8, and 11, respectively. We evaluated the children’s cognitive function at four different time points using the Bayley and Wechsler tests for assessing neurocognitive functions and intelligence (IQ). Urine samples were collected from mothers during pregnancy and from children at each follow-up visit. They were analyzed for seven metabolite concentrations of widely used phthalate esters. These esters included monomethyl phthalate, monoethyl phthalate, mono-butyl phthalate, mono-benzyl phthalate, and three metabolites of di(2-ethylhexyl) phthalate, namely, mono-2-ethylhexyl phthalate, mono(2-ethyl-5-hydroxyhexyl) phthalate, and mono(2-ethyl-5-oxohexyl) phthalate. We constructed a linear mixed model to examine the relationships between the phthalate metabolite concentrations and the Bayley and IQ scores. We found significant inverse associations between the children’s levels of urinary mono(2-ethyl-5-oxohexyl) phthalate and the sum of the three metabolites of di(2-ethylhexyl) phthalate and their IQ scores (β = -1.818; 95% CI: -3.061, -0.574, p = 0.004 for mono(2-ethyl-5-oxohexyl) phthalate; β = -1.575; 95% CI: -3.037, -0.113, p = 0.035 for the sum of the three metabolites) after controlling for maternal phthalate levels and potential confounders. We did not observe significant associations between maternal phthalate exposure and the children’s IQ scores. Children’s but not prenatal phthalate exposure was associated with decreased cognitive development in the young children. Large-scale prospective cohort studies are needed to confirm these findings in the future. [ABSTRACT FROM AUTHOR]

Background There is some evidence that the prevalence of depression in patients with tuberculosis (TB) is higher than those in the general population. However, the incidence of depression after Mycobacterium tuberculosis infection remains unknown. Our aim was to assess the association between TB and the subsequent risk of depression. Methods We conducted a retrospective cohort study using data from the National Health Insurance (NHI) system of Taiwan. The TB cohort included 9020 patients who were newly diagnosed and recruited between 2000 and 2010. Each patient was randomly frequency-matched for age, sex and the year of index date with four people without TB from the general population. The newly diagnosed depression was followed up until the end of 2011. The relative risks of depression were estimated using Cox proportional hazard models after adjusting for age, sex, index year and comorbidities. Results The overall incidence rate of depression was 1.54-fold higher in the TB cohort as compared with the controlled cohort (8.15 vs. 5.29 per 1000 person-years, 95% confidence interval [CI] = 1.45–1.64). Stratified analyses by gender, age group, monthly income and comorbidities revealed that the adjusted hazard ratio (HR) of depression was higher in males as well as individuals older than 65 years with a low monthly income and comorbidities. Conclusion People who have been diagnosed with TB have a significantly higher risk of developing depression compared with those in the general population. We should pay more attention to this group of individuals and ensure that they are offered appropriate support. [ABSTRACT FROM AUTHOR]

This study explores the relationship between Asian dust storms (ADSs), asthma hospital admissions and average medical cost discharge. We adopt the hospitalisation data from the Taiwan National Health Insurance research database covering the period from 2000 to 2009. The autoregressive integrated moving average with exogenous variables (ARIMAX) analyses were performed to explore the relationship between ADS and asthma hospital admissions, adjusting for temperature, air pollutants and season dummy. The results show that ADS events do generate a critical influence upon the occurrences of asthma on post-ADS events from days 1 through 3, with an average of 17–20 more hospitalised admissions, and have stronger effects on preschool children, middle-aged people and the elderly. From the perspective of medical expenses, the cost of hospitalised admissions for asthma substantially rises daily, on average, by NT$634,698 to NT$787,407 during ADS event days. This study suggests that government should establish a forecast and alert system and release warnings about dust storms, so that the individuals predisposed to asthma can take precautionary measures to reduce their outdoor exposure. Consequently, personal risk and medical expenditure could be reduced significantly, especially for preschool children, middle-aged people and the elderly with asthma. [ABSTRACT FROM PUBLISHER]

Background The aim of this study was to investigate the effectiveness of group psychotherapy on depressive symptoms and four domains of quality of life in the elderly. Methods Ninety-six elderly persons were selected from one apartment building for seniors. The 15-question version of the Geriatric Depression Scale was used to screen for depressive symptoms. The treatment and control groups each comprised 12 subjects. The treatment group received one session of group psychotherapy each week for 8 weeks. The 24-item Hamilton Depression Rating Scale and the World Health Organization Quality of Life- BREF scale were used for assessment at the beginning of group psychotherapy and during the fourth and eighth weeks. Results The Hamilton Depression Rating Scale score decreased significantly in the treatment group by the eighth week of group psychotherapy compared to the control group (4.9 ± 3.6 vs 17.6 ± 6.4, respectively; P < 0.0001). The World Health Organization Quality of Life- BREF score decreased significantly in the control group by the eighth week compared to the treatment group (95.3 ± 9.9 vs 80.2 ± 10.6, respectively; P = 0.002) with Hamilton Depression Rating Scale interaction (χ2 = 2.11, P = 0.146). Analysis of the four quality of life domains showed significant differences in the psychological and social domains ( P = 0.004 and P = 0.004, respectively) but not in the physical and environmental domains ( P = 0.133 and P = 0.147, respectively). Conclusions These findings suggest that studies of the outcome of group psychotherapy must control for depressive symptoms. Quality of life may have been mediated by depression in this preliminary study. [ABSTRACT FROM AUTHOR]

Inorganic arsenic (iAs) is an established transplacental agent known to affect fetal development in animal studies. However, iAs has not been adequately studied in the general population with respect to iAs exposure during pregnancy and its impact on the health status of newborns. The aims of this study were to 1) elucidate the association between arsenic exposure and oxidative/methylated DNA damage in pregnant women, and 2) determine the association with birth outcomes. A birth cohort study of 299 pregnant mother-newborn pairs was recruited during 2001–2002 in Taiwan. We collected maternal urine samples during the 3rd trimester for measuring iAs and its metabolites. We used high-performance liquid chromatography/inductively coupled plasma mass spectrometry (HPLC-ICP-MS) for quantifications of the arsenic species. Liquid chromatography/tandem mass spectrometer (LC-MS/MS) was used to measure the 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) and N7-methylguanosine (N7-MeG) DNA damage biomarkers. Birth outcomes were collected to assess the associations with maternal arsenic exposure and the DNA damage biomarkers. Multiple regression analyses showed that maternal urinary iAs had positive associations with the methylated N7-MeG (beta  = 0.35, p<0.001) and oxidative 8-oxodG (beta  = 0.24, p<0.001) DNA damage biomarkers, and a decreased one-minute (1-min) Apgar score (beta  = -0.23, p = 0.041). Maternal N7-MeG was also associated with a decreased 1-min Apgar score (beta  = −0.25, p = 0.042). Mutual adjustment for iAs and N7-MeG showed an independent and significant prediction for a decreased 1-min Apgar score of iAs (beta  = −0.28, p = 0.036). Maternal iAs exposure was associated with both maternal DNA damage and adverse newborn health. Maternal N7-MeG levels might be a novel biomarker for monitoring fetal health related to iAs. [ABSTRACT FROM AUTHOR]

Highlights: [•] Geological structure of the site was revealed by seismic reflection surveys. [•] CO2 evaluation at the CCIP was simulated with locally refined grids. [•] Migration of CO2 plume did not penetrate low permeability formation in 500 years. [•] Solubility and residual trapping account for 46% of injected CO2 after 500 years. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to retrospectively compare the frequency, distribution, and radiographic features of osteosclerosis of the jaws between Taiwanese and American cohorts using cone-beam computed tomography. Methods: Our study comprised 400 Taiwanese and 400 American subjects. A three-dimensional model was used to measure the volume and mesial-distal distance (MDD) of the osteosclerotic lesions. A cross-sectional view was used to measure the top-bottom distance (TBD), buccal-lingual distance (BLD), and whether the lesions contacted the buccal and/or lingual cortical bone or adhered to root apices. The MDD and TBD were also measured on a panoramic reformatted view, which was used to classify the side, shape, and tooth site. The axial view was evaluated to categorize the osteosclerotic lesions as homogeneous or heterogeneous. Results: There was a significant difference in the frequency of osteosclerosis between the Taiwanese and American cohorts, as well as significant differences between these two cohorts in the measurements of volume, BLD, and MDD. No significant differences between males and females were found in either cohort. In the Taiwanese cohort the highest prevalence of osteosclerotic lesions (38 %) was found in subjects aged 40-49 years, while in the American cohort the highest prevalence (36 %) was found in subjects aged 30-39 and ≥60 years. Conclusions: The findings of our study may be of valuable clinical relevance to dental practitioners, since osteosclerosis of the jaws may have a significant impact on the osseointegration of dental implants. [ABSTRACT FROM AUTHOR]

The unusually strong typhoons and heavy rainfalls occurred recently in Taiwan have caused major landslides in many reservoir catch basins. The debris from these landslides eventually settled in the reservoir and turned into mud. From soil mechanics point of view, the mud immediately in front of the dam where the reservoir is usually the deepest is a very young, normally consolidated or under-consolidated fine-grained soil. The engineering properties of the reservoir mud are important parameters in the planning and design of schemes to remove the mud. Yet, our knowledge in this regard is very limited. For some of the major reservoirs in Taiwan, the mud is often under more than 40 m of water. How to conduct effective geotechnical site characterization under these circumstances is a challenge. The authors developed techniques to incorporate differential pressure measurements in flat dilatometer (ΔDMT) and piezo-penetrometer (ΔPu) tests to facilitate in situ measurements under water in a reservoir. A series of field ΔDMT and ΔPu tests along with representative soil sampling were conducted at Tsengwen Reservoir in southern Taiwan. The paper describes the techniques of ΔDMT and ΔPu tests, interpretation of available test data to obtain the engineering properties of the reservoir mud, and discusses implications in the future site characterization of reservoir mud. [ABSTRACT FROM AUTHOR]

The difference between S-wave and S-to-P-wave conversion (SP phase) arrival times is enhanced with rectilinear motion detector filtering to describe alluvial-sediment thickness in the Kaohsiung-Pingtung (Kaoping) plains area. A more com-plete understanding of the underground structures of the Kaoping area is provided in this paper and explains why the surrounding regions in Taiwan experience more earth-quakes than the Kaoping area. Data are based on seismic activity recorded by the portable array for numerical data acquisition (PANDA) for the period from 1995 to 1997. The difference between S-wave and 5P-phase arrival times shows that the sedi-mentary layer is thicker along the west and southwest coasts. P-wave travel-time re-siduals, high-frequency attenuation parameters Kappa, and quality factor QP, Qs, and coda waves confirm this result. We also determined the orientation of the Chaochou fault using the first motion of P-wave arrivals. To the east of the Chaochou fault, stress trends southeast-northwest, while to the west, it trends northeast-southwest. The change in stress trends east and west of Chaochou fault suggests the presence of a highly fluid accretionary wedge in the Kaoping area. The Chaochou fault forms a seismically active tectonic boundary with the uplift of the hanging wall leading to westward tilting of the basement of the Kaoping plains. We demonstrate that these features are the reason there are relatively few earthquakes in the Kaoping area. The presence of a highly fluid accretionary wedge is indicated by a thick alluvial layer in the west and southwest Kaoping coasts; the Peikung High acts as the indenter that may allow seismic energy to escape and reduce the number of earthquakes in the region. [ABSTRACT FROM AUTHOR]

Abstract: Chronic disease has gradually become a major fatality cause in Taiwan. Being afflicted with such illnesses elevate vulnerability to other complications as well. Therefore, this paper adopts a preventative perspective and ascertains the impacts of important physiological indicators and clinical test values for various chronic illnesses. The paper investigates five chronic diseases: hypertension, diabetes, cardiovascular disease, disease of the liver, and renal disease. Utilizing chronic diseases risk factors to establish early-warning criteria may reduce the complication occurrence rate. K-nearest neighbor, linear discriminant analysis, and sequential forward selection are utilized, which is divided into two parts. The first part classifies and screens both healthy persons and those affiliated with the abovementioned chronic illnesses for characteristic value determination. The second part determines the critical value of the important risk factors of each chronic illness and builds early-warning criteria to recognition the chronic illnesses. This paper uses data from a medical center in Taiwan to verify the proposed methodology. The results reveal that classifying materials and screening important factors are both positively efficient with a corrected rate of 80%. Additionally, through the important factors of early-warning criteria, not only can help patients understand the risks of suffering diseases, but also effectively offer diagnosis reference criteria for medical personnel. [Copyright &y& Elsevier]

Abstract: Background: Drug abuse is becoming more prevalent in Taiwan, as evidenced by increasing reports of drug trafficking and drug abuse-related criminal activity, and the wide use of more contemporary illicit drugs. Consequently, drug abuse-related accidents are also expected to occur with greater frequency. However, no study has yet specifically evaluated the prevalence, pattern, and outcomes of drug abuse-related accidents among patients visiting emergency departments (EDs) in Taiwan. Methods: We conducted an ambidirectional study with patients who visited the EDs of Taipei Veterans General Hospital (TVGH) and China Medical University Hospital (CMUH) due to drug abuse-related accidents from January 2007 through September 2009. Information on the patients’ baseline characteristics and clinical outcomes was collected and analyzed. Results: During the study period, a total of 166 patients visited the EDs of one of the two study hospitals due to drug abuse-related accidents. This yielded a prevalence of drug abuse of 0.1% among all patients visiting the ED due to accident and/or trauma. Fifty-six out of the 166 patients visited the ED at TVGH, most patients being between 21 and 40 years old. Opioids (41.1%) were the drugs most commonly abused by the patients, followed by benzodiazepines (32.1%). More than two-thirds of the patients (n =38, 67.9%) required hospitalization, and three patients died (5.4%). In contrast, 110 patients with drug abuse-related accidents visited the ED at CMUH during the study period. Most of these subjects had abused benzodiazepines (69.1%), were between 21 and 40 years old, and were female. Fewer than one-fifth of the patients (n =19, 17.3%) required hospitalization, with no deaths reported. There were significant between-hospital differences in terms of patient gender, drugs of choice, injury mechanisms, method and time of the ED visit, triage levels, and need for hospitalization. Conclusion: Although the prevalence of drug abuse-related accidents was low, and only three patient deaths were reported in this study, many patients presented to the EDs with severe effects and later required hospitalization. Better and timely management of such patients will help to minimize the adverse health impacts associated with drug abuse. Governmental agencies and all healthcare professionals should also work together to fight against the surging trend of drug abuse in Taiwan. [Copyright &y& Elsevier]

This is a joint study of the prophecies attributed to Liu Bowen in circulation in Taiwan during the nineteenth and twentieth centuries. Liu Bowen was the courtesy name of Liu Ji, an eminent adviser to the Ming dynasty founder Zhu Yuanzhang (Ming Taizu, r. 1368- 1398). Since the late seventeenth century during the Ming-Qing transition, however, under the name of Liu Bowen, Liu Ji has been systematically mythologized as a legendary figure, becoming known as a clairvoyant prognosticator and an ingenious builder of imperial cities in modern times. In addition to a profusion of prophecies attributed to him during periods of social and political crises, he is best known as the author of a prophecy book known as Shaobing ge (Baked Cake Ballad), prophesying the events of China during the last six hundred years with incredible accuracy and proposing means of salvation. While his name and his works have been well known in mainland China, the Shaobing ge and other prophecies attributed to him were also in vogue in Taiwan under Japanese colonial rule and have remained in circulation in the island since its return to Chinese suzerainty after the Second World War. This paper is divided into four parts, with contributions shared by both authors. The first part gives a summary of the state of research on Liu Ji's Shaobing ge, tracing the inception of its prophecies in the late Ming and early Qing to the work of fiction writers and the propagandists of the anti-Manchu sectarian organizations and secret societies in the eighteenth century. Additional prophecies attributed to Liu Ji proliferated thereafter onto the 1930s. The earliest edition of Shaobing ge which the authors have seen or in their possession was printed in the late Guangxu period (1875-1908) but it was probably based on much earlier cruder manuscripts. The book has been well received in Taiwan since that time. The second part examines Taiwanese publications under Japanese colonial rule attesting to the popularity of Liu Bowen's alleged prophecies. The first source was discussions on the origin of the Shaobing ge and its purposes by Taiwanese scholars published in the Sino-Japanese Taiwan daily newspaper Taiwan Riri Xinbao, dated November 20 and December 3, 1898, the thirty-first year of Meiji. There one commentator suggested that the author of Shaobing ge may have been an adviser to the leaders of the Taiping Heavenly Kingdom in the mid nineteenth century, and pointed out that several individual prophecies later collected in the Shaobing ge were already well known in Taiwan at that time. Another Taiwanese publication gives information that Liu Bowen had been adulated by the local people as a deity of salvation and the Shaobing ge had been cited by ringleaders of the anti-Japanese Taiwanese uprising in Tainan in 1915 to presage victory. The third part of the paper examines the worship and distribution of Liu Bowen's alleged prophecies known as Liu Bowen chen or Liu Bowen xiansheng xianchu jiujiebei wen by a group of followers of the banned sectarian organization known as Yiguan Sect in the city of Gaoxiong in southern Taiwan in the 1960s. It reproduces the recently declassified police records of the Guomindang Government on these episodes with an analysis of the contents of the prophecies and the motives of the worshippers. It shows that the worshippers harbored no political agenda but aspired to blessings from Liu Bowen for a healthy and happy life. The final part of the paper gives a textual analysis of the Liu Bowen chen or Liu Bowen jiujiebei wen propagated by sectarian organizations in Taiwan with similar non-violent social goals.… [ABSTRACT FROM AUTHOR]

This paper studies whether or not investment decisions are financially constrained in a cross-ownership system of Taiwan. Different from the financial structure in the USA, subsidiaries in Taiwan are allowed to buy stocks of the parent companies. Hence, the conventional debt-to-equity ratio is inappropriate to divide firms into high and low-debt firms. Instead, a new threshold variable&ThickSpace;–&ThickSpace;the adjusted debt–equity ratio ( ADE )&ThickSpace;–&ThickSpace;is employed to divide the sample into high-debt firms and low-debt firms. A panel of 115 Taiwan-listed firms for the period 1991–1997 is used. Evidence supports the cash flow hypothesis and ADE has a notable significant influence on the financial constraints. [ABSTRACT FROM AUTHOR]

Industry transformation oriented toward high technology is being expected in the next 10 years by targeting Taiwan becoming an island of the technology. The machinery industry, which has been playing a vital role in Taiwan''s economic development in the past, should be continuously emphasized during the course of the future development. This paper presents a detailed study on the future development of Taiwan''s machinery industry along with the valuable proposals to the government policy and the investment strategy to the private sectors. The 10-year forecasting survey based on the strength, weakness, opportunity and threats (SWOT) analysis was made through an integrated professional team using the Delphi method. The derived results of market growth forecasting and the projected high potential products are further elaborated in the paper. [Copyright &y& Elsevier]

The influence of physician specialty on the outcomes of kidney diseases (KDs) remains underexplored. We aimed to compare the complications and mortality of patients with admissions for KD who received care by nephrologists and non-nephrologist (NN) physicians. We used health insurance research data in Taiwan to conduct a propensity-score matched study that included 17,055 patients with admissions for KD who received care by nephrologists and 17,055 patients with admissions for KD who received care by NN physicians. Multivariable logistic regressions were conducted to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for 30-day mortality and major complications associated with physician specialty. Compared with NN physicians, care by nephrologists was associated with a reduced risk of 30-day mortality (OR 0.29, 95% CI 0.25–0.35), pneumonia (OR 0.82, 95% CI 0.76–0.89), acute myocardial infarction (OR 0.68, 95% CI 0.54–0.87), and intensive care unit stay (OR 0.78, 95% CI 0.73–0.84). The association between nephrologist care and reduced admission adverse events was significant in every age category, for both sexes and various subgroups. Patients with admissions for KD who received care by nephrologists had fewer adverse events than those who received care by NN physicians. We suggest that regular nephrologist consultations or referrals may improve medical care and clinical outcomes in this vulnerable population. [ABSTRACT FROM AUTHOR]

In this paper, a data-driven approach was applied to improve a furnace zone of a foundry in Taiwan. Improvements are based on the historical production records, order-scheduling, and labor-scheduling data. To resolve the bottleneck provided by the company, historical data were analyzed, and the existence of large variance in the process was found. Statistical analysis was performed to identify the primal factors causing the variance, and suggestions were made and implemented to the production line. As a result, daily production increased steadily to more than 30 pots of molten metal, while the original production was 20–30 pots of molten metal and are not controllable. Such significant improvement was mainly made by standardizing the input and reducing the variance of processes. The average cycle time of each pot of molten metal was reduced from 219 min to 135 min. Our suggested improvements also reduced the foundry's electricity consumption cost by almost $240,000NT per month. In summary, data analysis can help traditional industries in identifying the main factors causing the bottleneck. [ABSTRACT FROM AUTHOR]

Abstract: A nighttime sporadic E (Es) layer responsible for range spread Es trace in ionogram and quasi-periodic echoes scattered from 5-m field-aligned electron density irregularities (FAIs) is investigated by using a ground-based 30MHz coherent scatter radar, ionosonde and FORMOSAT-3/COSMIC satellite. A comparison shows a positive correlation between the 30MHz radar backscatter and critical frequency foEs of the Es trace, which are consistent with earlier observational results. Interferometry measurement indicates that the spatial patterns of the radar echoes from the FAIs were in patchy form with vertical extent of about a few kilometers and horizontal dimensions of about 10–20km. The echo structures experienced quasi-periodic oscillations not only in vertical but also in horizontal directions with periods of approximately 5–6min. Observed Doppler velocities of the FAIs also exhibited quasi-periodic oscillations with the same periods. From their downward phase movement, these oscillations were very likely attributed to the modulations of upward propagating gravity waves with vertical wavelengths of about 10–20km. In addition, vertical shears of the FAI Doppler velocity were observed, which are believed to result from the change in the phase of gravity wave with height. A physical process is proposed in this article to account for the relation between gravity wave-perturbed neutral wind and height variation of the FAI Doppler velocity. It is believed that the oscillations in the Doppler velocity profiles are associated with the wave-induced polarization electric fields in a finite plasma structure in the azimuth direction. [Copyright &y& Elsevier]

Abstract: Continuous cores and a suit of geophysical measurements were collected in two scientific drill holes to understand physical mechanisms involved in the large displacements during the 1999 Chi-Chi earthquake. Physical properties obtained from wire-line logs including P- and S-wave sonic velocity, gamma ray, electrical resistivity, density and temperature, are primarily dependent on parameters such as lithology, depth and fault zones. The average dip of bedding, identified from both cores and FMI (or FMS) logs, is about 30° towards SE. Nevertheless, local azimuthal variations and increasing or decreasing bedding dips appear across fault zones. A prominent increase of structural dip to 60°–80° below 1856 m could be due to deformation associated with propagation of the Sanyi fault. A total of 12 fault zones identified in hole-A are located in the Plio-Pleistocene Cholan Formation, Pliocene Chinshui Shale and Miocene Kueichulin Formation. The shallowest fault zone occurs at 1111 m depth (FZ1111). It is a 1 m gouge zone including 12 cm of thick indurate black material. We interpreted this zone as the slip zone during Chi-Chi earthquake. FZ1111 is characterized by: 1) bedding-parallel thrust fault with 30-degree dip; 2) the lowest resistivity; 3) low density, V p and V s, 4) high V p/V s ratio and Poisson''s ratio; 5) low energy and velocity anisotropy, and low permeability within the homogeneous 1 m gouge zone; 6) increasing gas (CO2 and CH4) emissions, and 7) appearance of smectite within the primary slip zone. In situ stresses at the drill site were inferred from leak-off tests, borehole breakouts and drilling-induced tensile fractures from borehole FMS/FMI logs, and shear seismic wave anisotropy from DSI logs. The dominant fast shear-wave polarization direction is in good agreement with regional maximum horizontal stress axis, particularly within the strongly anisotropic Kueichulin Formation. A conjugate set of secondary directions are parallel to microcrack orientations. A drastic change of orientation of fast shear-wave polarization across the Sanyi thrust fault at the depth of 1712 m reflects the change of stratigraphy, physical properties and structural geometry. [Copyright &y& Elsevier]

The 150km long Longitudinal Valley (LV) in eastern Taiwan is located at the suture zone of Eurasian and Philippine Sea Plate, connecting two subduction systems in northeastern and southern Taiwan. In this area, considerable seismicity as well as crustal deformation are accommodated by the Longitudinal Valley fault system (LVF), which is mainly composed of high angle east-dipping thrust faults. To better understand the subsurface structure and the fault geometry of the southern LV, we conducted shallow seismic reflection survey across the LVF from Donli to Luyeh in 2017. Totally, there are four 4-km-long seismic reflection profiles. We used two mini vibroseis trucks with sweeping frequencies from 35-200Hz as sources and the common-midpoint spacing is 2.5m with maximum 30 folds. A strong east-dipping reflector relative to the bedrock reflection down to 1.5km deep can be observed after noise suppression. Some low reflectivity zones in the east side of the profiles could be related to the muddy Lichi mélange. It is interesting to note that in the eastern Luyeh profile, the syncline with the east-dipping axis implies the Lichi segment of the LVF and the orientation of the tectonic deformation. As a result, the southern LV displays an asymmetric sedimentary basin pattern with a deeper bedrock to the east. [ABSTRACT FROM AUTHOR]

A temporary seismic network consisting of 295 land stations was deployed in 2009 in Taiwan to monitor airgun sources during an onshore-offshore experiment in Taiwan. We exploit the continuously recorded dataset to detect and map seismicity in the seismically very active Taiwan. By combining recent automatic detection and phase picking techniques, we successfully generate an initial earthquake catalog of over 8400 events. The hypoDD algorithm is used to relocate and filter these events. This network recorded smaller events than the permanent regional network because of the many stations around the high mountain ranges and the generally high station density along 6 lines. The results based on the 2009 data generally reproduce the dominant seismicity features from many years of earthquake monitoring in Taiwan. In addition, we map hitherto unknown dipping zones under the Foothills and the Central Range that may correspond to seismogenic structures. [ABSTRACT FROM AUTHOR]

Abstract: Here we tackle a tectonically important question – the upper mantle velocity structure beneath central Taiwan – with seismically interesting observations – receiver-side slab waveform effects. We use teleseismic P waveforms of the NS broadband array deployed by the TAIGER project to examine patterns of variation in arrival time, pulse width, and amplitude – measuring the first two by Gaussian fitting – and contrast measurements of earthquakes to the southeast (SE earthquakes) with those of one Sumatra earthquake in order to focus on upper mantle heterogeneities. Overall variation patterns as a function of earthquake are compatible with ray-tracing predictions. Relative reduced arrival times and amplitudes at central Taiwan stations suggest the existence of a deep aseismic slab below. From simulations of 2-D wave propagation, we conclude that lateral heterogeneity of crust and uppermost mantle primarily contributes to variations in arrival time and only secondarily to variations in amplitude and pulse width. Furthermore, discrepancies between source-side and receiver-side waveform effects, where the latter are not always amplitude-reduced, are explained by constructive interference between the fast and slow phase. Thus, the use of full waveform information can provide independent constraints to complement results of previous studies. A future extension will be to incorporate S waves and apply waveform inversion to yield quantitative constraints. [Copyright &y& Elsevier]

Abstract: In order to understand the fault zone architecture and mechanisms that caused the Chi-Chi earthquake, the Chelungpu drilling project was conducted during April 2000 through a collaborative project between Japan and Taiwan. In this study, chemical and mineralogical variations within the overall Chelungpu fault zone, including variations between less damaged host rocks, damaged zones, and fault cores caused by the Chi-Chi earthquake were examined. Slopes of TiO2 immobile isocons were consistently >1 for analyses comparing host rocks with rocks from damaged zones or with gouges from fault cores, indicating that volume loss occurred in damaged zones and the fault cores. These results strongly imply that pervasive fluid infiltration occurred within the fault zone. Volume loss within the damaged zone and fault core is interpreted to result from a two-stage process involving: (i) coseismic mechanical wearing and/or dissolution in the fault core, and (ii) fluid infiltration within the fault zone during postseismic and interseismic periods along cracks caused by seismic failure. Semi-quantitative XRD analysis indicates that the kaolinite content consistently increases from the less damaged host rocks to the damaged zone and gouges in each fault core. Mineralogic changes indicate that pervasive acidic fluid infiltration occurred within the fault zones and reacted with the feldspars or muscovite to form kaolinite. Enrichment of kaolinite and illite found in the fault zones of southern drilling site could play some role on the slipping behavior of the southern part of the Chelungpu fault. Greater volume loss in the fault core may have resulted from moderate permeability, combined with the very fine grain nature of pulverized material in the fault core, which enhanced chemical reactions including transformation of feldspars and muscovite to clay minerals. The study results indicate that pervasive fluid infiltration occurred and changed the mineralogical and chemical architecture of fault zones caused by the cyclic earthquakes. [Copyright &y& Elsevier]