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Mobile mapping technologies, for example multi-sensor integration and multi-platform mapping technology, have developed and improved over recent decades, various applications such as conventional mapping scenarios, rapid disaster response, smart city, and autonomous vehicle application arise synchronously. Especially, autonomous driving vehicles have made enormous progress. High-definition (HD) maps are key for autonomous driving because of their high accuracy and rich information of road scenes. However, how to make sure that HD maps are suitable for autonomous vehicle requirement is an important topic. The HD maps guidelines and standards in Taiwan are released since 2018 and mainly focus on point cloud and shape file format. In this paper, a procedure for the verification and validation of HD maps for OpenDRIVE and Autoware (Lanelet2) is proposed. It discusses about the verification strategies, suggestion review item, recommendation tools, and process. As shown by our preliminary results, the proposed process can conform not only in closed area but also public road. These issues can help reducing HD maps production costs. When the foundation of HD maps accomplishes, the autonomous driving techniques can naturally complement. The vision of full automation vehicle will come true rapidly in the future. [ABSTRACT FROM AUTHOR]

Large dip‐slip earthquakes have a major contribution to mountain building while earthquake‐induced landslides lower mountains simultaneously. The amount of the coseismic uplift and landslides may dominate long‐term mountain evolution. However, how earthquakes contribute to mountain evolution through coseismic uplift and landslides is less constrained in real cases. We present the regional coseismic uplift of the 1999 Mw7.6 Chi‐Chi earthquake by using synthetic aperture radar (SAR) images and GPS. The coseismic uplift pattern is consistent with field observations showing increasing movement to the north with ~8 m of uplift toward the northern end. We estimated uplifted rock volume of 2.60 ± 1.09 km3, which is five times greater than the coseismic landslide volume. Intense erosion of the Taiwan orogen may erode elevated rocks rapidly, but the uplift and landslide distributions do not match and correlate more inversely, suggesting the frontal orogenic topography should be increased rather than annulled over earthquake cycles. Plain Language Summary: Earthquakes can raise mountains but they can cause landslides to lower the mountains at the same time. For large earthquakes, mountains could reduce the size due to more landslides than uplift. It is important to analyze earthquakes occurred within mountain ranges to examine how much volume of rocks is elevated and how much volume of rocks is trampled down. Because complete observations of uplift and landslides for large earthquakes are rare, we used geodetic methods to estimate the volume of the elevated rocks for one of the largest earthquakes in mountain ranges in the world, the Chi‐Chi, Taiwan, earthquake in 1999. The volume of elevated rocks is much larger than the landslide volume, and the uplift area is close to the frontal mountains and the landslide areas are distributed in the deeper mountains. If this finding holds for other mountain ranges in similar settings, this means that large earthquakes should raise mountains, especially in the frontal part of the mountains. Key Points: We estimate the regional pattern of the coseismic uplift of the Chi‐Chi earthquakeIncreased rock volume is significantly greater than coseismic landslide volume for the Chi‐Chi earthquakeThe distributions of coseismic uplift and landslides suggest differential topographic increase at frontal orogen [ABSTRACT FROM AUTHOR]

Aim: To investigate the appropriate fasting plasma glucose threshold by which to define prediabetes in children and adolescents, based on its ability to predict incident paediatric diabetes. Methods: In a nationwide survey of diabetes and renal disease conducted between 1992 and 2000 in all school‐aged children in Taiwan, those with abnormal results in repeated urine tests received further physical examination and blood tests. Students who had blood tests for at least two time points were selected for the present study (N = 12 119). The incidence of paediatric diabetes, adjusted hazard ratio and predictive power of fasting plasma glucose were analysed. Results: The incidence of paediatric diabetes increased with increasing fasting plasma glucose levels. Groups with fasting plasma glucose >5.6 mmol/l had a higher adjusted hazard ratio. The adjusted hazard ratio of incident diabetes for participants with higher fasting plasma glucose rose continuously when using a higher threshold for fasting plasma glucose. The area under the receiver‐operating characteristic curve for fasting plasma glucose was 0.628 for predicting paediatric diabetes. The association between fasting plasma glucose and incident paediatric diabetes and the area under the receiver‐operating characteristic curve were similar in boys and girls and were higher in the age group 12–18 years. According to receiver‐operating characteristic curve analysis, the optimal thresholds, sensitivity and specificity were 4.75 mmol/l, 65% and 51%, respectively, for those aged 6–11 years and 5.19 mmol/l, 60% and 73%, respectively, for those aged 12–18 years. Conclusion: Fasting plasma glucose is associated with the incidence of paediatric diabetes. The results of the present study can be used as reference data to suggest a cut‐off value to define paediatric prediabetes. What's new?: This is one of the few studies to investigate the plasma glucose threshold to predict incident paediatric diabetes.Using a nationwide dataset, we found that fasting plasma glucose (FPG) level was associated with the incidence of paediatric diabetes.The predictive power of FPG is better in the age group 12–18 years than in the age group 6–11 years.The results of the present study can be used as reference data to suggest a cut‐off value of FPG for paediatric prediabetes. [ABSTRACT FROM AUTHOR]

First reported from Taiwan mistakenly as acral acanthosis nigricans in 1991, pigmented carpotarsal hyperkeratosis or hyperkeratosis nigricans carpi et tarsi displays a peculiar distribution of velvety brown‐grey hyperpigmented plaques symmetrically on the flexural side of the wrists and ankles and on the dorsal sides of the hands and feet. A marked epidermal hyperkeratosis with typically mild acanthosis and papillomatosis is observed in histology. Whitish maceration upon perspiration or water exposure, with exacerbation in summer but remission in winter, is common. The association with obesity, endocrine disorders, atopic dermatitis, ichthyosis or malignancy is unknown. Familial occurrence and hereditary patterns are ill‐defined. There is preliminary evidence indicating a pathogenic role of missense mutation in the transcription factor 4 gene. Treatment is empirical, with good outcome with topical retinoids and keratolytic agents. Recurrence is common, and long‐term prognosis is unclear. To be distinguished are acral acanthosis nigricans, palmoplantar keratoderma of the Nagashima type, palmoplantar keratoderma of the Bothnian type and aquagenic palmoplantar keratoderma. Most reported cases are from Southern China and are predominantly observed in men between the ages of 20 and 40 years. The currently used term 'symmetrical acral keratoderma' is non‐specific and misleading and may lead to global unawareness, underreporting or misdiagnosis of this phenomenon. Further genetic and molecular studies are required to clarify its pathogenesis and relation to palmoplantar keratoderma. [ABSTRACT FROM AUTHOR]

The Formosan wild boar (Sus scrofa taivanus) is an endemic subspecies in Taiwan. Understanding the origins and spread of the Formosan wild boar could help clarify East Asian wild boar dispersion. Although in situ domestication of the wild boar occurred at a number of domestication centers across East Asia, corroborating archaeological and genetic evidence of pig domestication on Taiwan is lacking, leading to domestication being described as cryptic. This characterization applies to the Lanyu pig--a domestic pig breed found on Taiwan. To better understand pig domestication, this study examines the sympatric Formosan wild boar and domestic Lanyu pig to build a model of potential wild boar domestication on Taiwan and elucidate wild boar domestication patterns in the region. To this end, a comprehensive phylogenetic study of the Formosan wild boar and the Lanyu pig was conducted on animals sourced from Taiwan, Lanyu, and the Philippines. Phylogenetic analyses were conducted using full mitochondrial control-region sequences from 345 wild boars and domestic pigs. These were studied in concert with existing reports on 206 Asian wild boars. Genetic characteristics and Bayesian phylogenetic tree results identified 2 wild boar lineages of remote phylogenetic relationship. These were Formosan wild boar lineage (FWBL) and Formosan wild boar with Lanyu sign lineage (FWBLYL). Molecular clock analyses indicate that FWBLYL diverged earlier than other insular East Asia wild boars and show that FWBLYL and FWBL diverged approximately 0.60 million years ago. This result supports boars of FWBLYL being the earliest wild boars to have spread and become isolated in insular East Asia. In addition, the study proposes 6 Asian wild boar dispersion routes during glacial periods. At least 3 of these events occurred in insular East Asia with subsequent geographical isolation after glacial recession. This isolation potentially led to allopatric differentiation of wild boar subspecies. Also, the similar genetic signature and phylogenetic uniqueness of Lanyu pigs to wild boars of FWBLYL suggests such wild boars were the wild ancestor of domestic Lanyu pigs. This result indicates potential in situ domestication occurring on Taiwan. Finally, pigs possessing FWBLYL's genetic signatures were continuously distributed among Taiwan, Lanyu, and the Philippines. This pattern may signify human-mediated pig dispersal routes. [ABSTRACT FROM AUTHOR]

New variants of porcine epidemic diarrhoea virus ( PEDV), which emerged in Taiwan in late 2013, have caused a high morbidity and mortality in neonatal piglets. To investigate the molecular characteristics of the spike (S) gene of the emerging Taiwan PEDV strains for a better understanding of the genetic diversity and relationship among the Taiwan new variants and the global PEDVs, full-length S genes of PEDVs from nine 1-7 day-old piglets from three pig farms in the central and southern Taiwan were sequenced and analysed. The result of phylogenetic analysis of the S gene showed that all the Taiwan PEDV strains were closely related to the non-S INDEL strains from US, Canada and China, suggesting a common ancestor for these strains. As compared with the historic PEDVs and CV777-based vaccine strains, the nine Taiwan PEDV variants shared almost the same genetic signatures as the global non-S INDEL strains, including a series of insertions, deletions and mutations in the amino terminal as well as identical mutations in the neutralizing epitopes of the S gene. The high similarity of the S protein among the Taiwan and the globally emerged non-S INDEL PEDV strains suggests that the Taiwan new variants may share similar pathogenesis and immunogenicity as the global outbreak variants. The development of a novel vaccine based on the Taiwan or the global non-S INDEL strains may be contributive to the control of the current global porcine epidemic diarrhoea outbreaks. [ABSTRACT FROM AUTHOR]

PurposeTo investigate the epidemiological characteristics and related risk factors for primary rhegmatogenous retinal detachment (RRD) in Taiwan.MethodsThe case–control study was based on retrospective chart review of hospital patients treated for primary RRD from 1995 to 2001, inclusively. The preoperative fundus findings and refractive status were collected for each patient. Controls were selected from a nationwide survey of visual impairment in the adult population during the same period. Risk factors for RRD were analysed by logistic regression. A total of 1032 RRD cases and 3537 controls were enrolled for the study.ResultsA pronounced bipeak pattern was evident in the age distribution for primary RRD in the third and sixth decades of life. Atrophic hole with lattice degeneration was preferential to younger (20–30 years) and highly myopic individuals (−7.4±5 D), whereas the flap tear tended to occur in middle-aged individuals (50–60 years) and those with moderate myopia (−4.1±5 D). The odds ratio for primary RRD with myopia, male gender, and older age (>40 years) were 1.33/D, 2.15, and 1.69, respectively.ConclusionsMyopia is an important RRD risk factor for young Taiwanese. The increasing prevalence of myopia has predisposed the young population to RRD.Eye (2007) 21, 1056–1061; doi:10.1038/sj.eye.6702397; published online 12 May 2006 [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives To evaluate the clinical significance of GP. Mur antigen-negative blood selection for transfusion in patients with anti-'Mia' records. Background The GP. Mur RBC phenotype is prevalent (7·3%) in Taiwan. Antibodies against GP. Mur (anti-'Mia') are identified in 1·24% of our population, and anti-'Mia' screening using GP. Mur RBC has been routine for Taiwan's blood banks. However, due to the lack of commercial antibodies, only cross-matching was used to prevent transfusion of GP. Mur-positive blood to patients with anti-'Mia' in most hospitals. There is still a risk of GP. Mur-positive RBC exposure and subsequent anti-'Mia'-related transfusion reactions. Methods Since February 2014, GP. Mur antigen-negative RBCs identified by reaction with anti-'Mia'-positive serum were selected for blood recipients with anti-'Mia' records. The transfusion reactions between January 2013 and January 2014 were compared with those that occurred between February 2014 and July 2015. Results The transfusion reaction rate was significantly higher in anti-'Mia'-positive blood recipients compared to total subjects receiving an RBC transfusion before GP. Mur-negative donor RBC selection. After antigen-negative RBC selection, the transfusion reaction frequency in subjects with anti-'Mia' became similar to total blood recipients. IgG form anti-'Mia' antibodies were present in all cases of probable anti-'Mia'-related transfusion reactions. The time required for anti-'Mia' boosting after transfusion was around 4-21 days. Conclusion Selection of GP. Mur-negative RBC for transfusion to patients with anti-'Mia' records could decrease the rate of transfusion reaction and antibody boosting. This procedure should be incorporated into blood bank routines in areas where anti-'Mia' is prevalent. [ABSTRACT FROM AUTHOR]

Resistance mutations A2058G and A2059G, within the 23S rRNA gene of Treponema pallidum, have been reported to cause treatment failures in patients receiving azithromycin for syphilis. Genotyping of T. pallidum strains sequentially isolated from patients with recurrent syphilis is rarely performed. From September 2009 to August 2013, we collected 658 clinical specimens from 375 patients who presented with syphilis for genotyping to examine the number of 60-bp repeats in the acidic repeat protein ( arp) gene, T. pallidum repeat ( tpr) polymorphism, and tp0548 gene, and to detect A2058G and A2059G point mutations by restriction fragment length polymorphism. Treponemal DNA was identified in 45.2% ( n = 298) of the specimens that were collected from 216 (57.6%) patients; 268 (40.7%) specimens tested positive for the 23S rRNA gene, and were examined for macrolide resistance. Two isolates (0.7%) harboured the A2058G mutation, and no A2059G mutation was identified. A total of 14 strains of T. pallidum were identified, with 14f/f (57.5%) and 14b/c (10.0%) being the two predominant strains. Forty patients who presented with recurrent episodes of syphilis had T. pallidum DNA identified from the initial and subsequent episodes, with five cases showing strain discrepancies. One patient had two strains identified from different clinical specimens collected in the same episode. Our findings show that 14f/f is the most common T. pallidum strain in Taiwan, where the prevalence of T. pallidum strains that show A2058G or A2059G mutation remains low. Different genotypes of T. pallidum can be identified in patients with recurrent episodes of syphilis. [ABSTRACT FROM AUTHOR]

Stenotrophomonas maltophilia can cause various clinical diseases; however, pleural infections due to S. maltophilia are rare. We evaluated the clinical characteristics and outcomes of patients with pleural infections (complicated parapneumonic effusion or empyema) due to S. maltophilia who were treated at a medical center in Taiwan from 2004 to 2012. During the study period, 40 patients were treated for pleural infections due to S. maltophilia. The incidence of S. maltophilia pleural infections ranged from 2.66 per 1,000,000 patient-days in 2009 to 12.44 per 1,000,000 patient-days in 2011. Most of the patients with S. maltophilia pleural infections were immunocompromised male adults and all of the infections were acquired in healthcare settings. The majority of patients had polymicrobial pleural infections ( n = 31, 77.5 %) and the most common pathogen was Pseudomonas aeruginosa ( n = 12). The causes of pleural infections due to S. maltophilia were pneumonia due to S. maltophilia in two patients (5 %), post-surgical/tube thoracostomy in 26 (65 %) patients, and fistula (bronchopleural, esophagopleural and biliopleural) in 12 (30 %) patients. The 14-day and 30-day mortality rates were 32.5 % and 42.5 %, respectively. Pleural infections due to S. maltophilia are most commonly the result of surgical procedures, thoracostomy, and underlying fistulas. These infections are associated with a high mortality rate, especially among immunocompromised patients. [ABSTRACT FROM AUTHOR]

Summary: We studied 472 elders to assess joint association of vitamin D receptor (VDR) variability and physical activity on low handgrip strength (LHS) and osteoporosis (OST). Our findings showed that higher risks of OST were associated with physically inactive elders with some specific VDR variations, highlighting the importance of promotion program for physical activity. Introduction: The aim of this study was to determine the joint association between VDR variability and physical activity on LHS and OST in community-dwelling elders. Methods: Bone mineral density of the lumbar spine (LS), the femoral neck (FN), and the total hip were measured by dual-energy X-ray absorptiometry. Four single-nucleotide polymorphisms (SNPs) (rs7975232, rs1544410, rs2239185, and rs3782905) of the VDR gene were examined in 472 participants. Results: Physical inactivity and each of the four SNPs were jointly associated with a significantly greater risk of LHS in people than that associated with each of the VDR SNPs or low physical activity alone. Physically inactive men with the AG or AA genotype of rs2239185 had a significantly greater risk of overall, LS, and FN OST than those of physically active men with the GG genotype [odds ratio (OR) 3.57, 95 % confidence interval (CI) 1.10-11.65; OR 4.74, 95 % CI 1.43-15.70; and OR 5.06, 95 % CI 1.08-23.71, respectively]. Similarly, physically inactive women with the CG or CC genotype of rs3782905 and the AG or AA genotype of rs1544410 had a significantly greater risk of FN OST than physically active women with the GG genotype (OR 5.33, 95 % CI 1.23-23.06 and OR 5.36, 95 % CI 1.11-25.94, respectively). Conclusions: VDR polymorphisms and physical activity are jointly associated with LHS and OST in elders. Health care programs should promote physical activity among elders as a cost-effective way to prevent LHS and OST, especially in those who may be genetically predisposed. [ABSTRACT FROM AUTHOR]

Summary: Evidence of the incidence and risk of osteonecrosis of the jaw (ONJ) in Asian osteoporosis populations receiving different osteoporosis medications is lacking. We found that there is no excess incidence of or risk for ONJ in osteoporosis patients >50 years old using alendronate as compared with patients using raloxifene or calcitonin under real-world conditions in Taiwan. Introduction: To provide information on ONJ in Asian populations, this study compares the incidence and risk of ONJ between patients receiving alendronate and those receiving non-bisphosphonate osteoporosis medications in Taiwan. Methods: Enrollees in the National Health Insurance Research Database (NHIRD) from 2003 to 2007, aged above 50 years, with vertebral/hip fracture, and new to osteoporosis therapy were recruited. Patients with Paget's disease or cancer during the baseline period were excluded. Patients were classified into either the alendronate or the calcitonin/raloxifene (control) group according to their exposure during follow-up. Previously proposed possible ONJ diagnosis codes were adopted as potential ONJ cases, but qualifying cases also had a repeated ONJ diagnosis within 8 weeks of the first diagnosis and received one or more broad-spectrum oral antibiotics. Cox modeling compared the risk of ONJ between the alendronate and the control groups, which were matched using propensity scores. Results were examined in series sensitivity analyses, including different cumulative dose groups. Results: We found 25 potential ONJ cases in the alendronate ( N = 18,030) and 21 in the control groups ( N = 25,615). Over the 6-year follow-up period, no increased risk of ONJ in the alendronate group in the original (hazard ratio (HR), 0.87; 95 % confidence interval (CI), 0.47-1.58) or propensity score-matched cohorts (HR, 0.86; 95 % CI, 0.44-1.69) was found. All comparison groups exhibited a similar incidence of ONJ, ranging from 6.9 to 8.2/10,000 person-years. Conclusion: Under real-world conditions, there is no excess risk for ONJ in osteoporosis patients >50 years old using alendronate as compared with patients using raloxifene or calcitonin. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted to analyze the nature of Hydrofluoric acid (HF) calls to the National Poison Control Center of Taiwan (PCC-Taiwan) between 1991 and 2010 in order to characterize the epidemiology of HF exposures in Taiwan. The study found that hypokalemia tends to occur in cases of severe HF poisoning and calcium gluconate soaks appear to be effective in decreasing local pain and tissue damage.

Aim: Thyroid hormones regulate the rate of metabolism and affect the differentiation and growth of many tissues in the body. We investigated the association between hyperthyroidism and cancer risk in Taiwan Patients and methods: A random sample of 1 000 000 individuals from Taiwan's National Health Insurance database was enrolled. We found 17 033 patients to have newly diagnosed hyperthyroidism between 2000 and 2005. These patients were recruited along with a match cohort of 34 066 patients without hyperthyroidism. Starting from index date, we followed up all patients for 4 years to identify those who developed cancer. Results: During the 4-year follow-up study, cancer was diagnosed in 1.23 % of patients with hyperthyroidism and 1.02 % of the member of the comparison cohort. Regression analysis showed that patients with hyperthyroidism were at greater risk of cancer incidence, especially thyroid cancer, compared the comparison cohort (HR: 1.213; 95 % CI: 1.022-1.440; p < 0.05 and HR: 7.355; 95 % CI: 3.885-13.92; p < 0.05, respectively). After adjusting for age, gender, diabetes mellitus, hypertension, hyperlipidemia, gout, geographic region, and income, patients with hyperthyroidism remained at increased risk of cancer incidence and thyroid cancer (Adjusted HR: 1.206; 95 % CI: 1.015-1.433 and 6.803; 95 % CI: 3.584-12.91, respectively) (both p < 0.05). The longer the duration of hyperthyroidism, the greater the risk of thyroid cancer. Conclusions: This 4-year follow up study suggests that patients with hyperthyroidism are at increased risk of cancer, especially thyroid cancer. [ABSTRACT FROM AUTHOR]

Background Alopecia areata (AA) is regarded to be mediated by autoimmune process, and manifests as patchy non-scarring hair loss with occult onset. Little is known about AA occurring later in life. Objective To define the characteristics of late-onset AA. Methods Patients with first onset of AA at age 50 years and above were retrospectively recruited from two separate institutes in southern and northern Taiwan. The onset age, patterns, severity, past history, serological findings and therapeutic responses were reviewed. Results Seventy-three AA patients were enrolled, including 49 females (67%) and 24 males (33%). The onset age ranged from 50-78 years with the median age of 57 years. Multifocal lesions (41%) constituted the most common pattern and 55% of the recruited patients had a hair loss of less than 10%. Seventeen patients (23%) had co-existent dermatological or systemic diseases while six patients (8%) had a history of malignancy. Among 27 patients (37%) with available laboratory data, positive anti-nuclear antibody, anti-microsomal antibody and anti-thyroglobulin antibody was demonstrated in 26%, 40% and 30% of them, respectively. Association with personal or family history of atopy was absent. In 15 patients of follow-up longer than 6 months, a complete hair regrowth was found in three patients with mild disease severity. Conclusion Late-onset AA is characterized by marked female predominance and milder disease activity with increasing age. The link to cancer in the old age remains to be determined. The influence of aging on the pathogenesis and prognosis of AA deserves further studies. [ABSTRACT FROM AUTHOR]

Reducing or stabilizing the stream temperature of ChiChiaWan Creek is a crucial work for Formosan Landlocked Salmon because ChiChiaWan Creek is the only one habitat for this endangered species. Planting trees in the riparian zone would be one of the alternatives. The purpose of this study was to evaluate the effects of several planting strategies on daily maximum stream temperature along the river. The results showed the effective vegetative shading angles should be more than 50° along ChiChiaWan Creek to reduce the direct solar radiation heating effectively. Upstream planting with 70° vegetative shading angle could be the most effective way among all the scenarios. However, this planting strategy could not improve the worst situations in summer because of the large solar elevation angles. The upstream planting in ChiChiaWan Creek was strongly recommended because the canopies could be easier to extend to totally cover the narrow width of river producing the most effective shades. Practicing the upstream planting with 90° vegetative shading angle can increase more than 1 km long suitable habitats for the endangered Salmon in summer. Alternatively, the west-side planting scenario was the second effective way for temperature reduction. Our result provided a useful suggestion for the authorities in charge of saving the Formosan Landlocked Salmon, particularly under the stress of global warming. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim The aim of this trial was to determine whether whole-body vibration (WBV) induced via a noninvasive oscillation platform could improve symptoms and health-related quality of life (HRQOL) in patients with chronic functional constipation. Method A single-blinded, randomized controlled trial was performed in a single hospital in Taiwan. Patients diagnosed with chronic functional constipation, as per the Rome III diagnostic criteria, were included and randomized to either the WBV treatment or no treatment (control) group. The treatment group received six 15-min sessions of WBV therapy over a 2-week period. Patients received vibrations of 2 mm in amplitude at a frequency of 12 Hz. The primary outcome was whether constipation symptoms improved, assessed by the constipation severity instrument (CSI) and the secondary outcome measure was whether there was an improvement in HRQOL. Results Whole-body vibration therapy over a 2-week period in patients with chronic functional constipation ( n = 14) significantly reduced the total CSI and obstructive defaecation subscale scores compared with control ( n = 13). However, WBV did not improve the pain and chronic inertia subscale scores of the CSI or HRQOL. Conclusion These findings suggest that low-intensity WBV induced via a noninvasive oscillation platform may be an effective therapy for reducing symptom severity in patients with chronic functional constipation. [ABSTRACT FROM AUTHOR]

Supplier selection has been a popular topic since the selection of the most appropriate supplier for cooperation is being increasingly important for the success of an enterprise. The problem is multi-criteria in nature, and a variety of multi-criteria decision making methodologies have been proposed. However, most of them did not take into account the interrelationships among the critical success factors and the fuzziness of the data involved in deciding the preferences of the factors. The objective of this research is to propose a fuzzy analytic network process model to evaluate various aspects of suppliers. With the consultation with the experts, the proposed model can consider the feedback and interdependency of factors in a network, and the factors are pairwise compared under an uncertain environment. The weights of factors can be calculated, and the final priority of suppliers obtained. Semiconductor industry becomes increasingly globalize competitive nowadays, and a good supply chain relationship is essential for a company to survive and to acquire reasonable profit. Thus, a case study of IC packaging company selection in Taiwan is presented, and the proposed model is applied to facilitate the decision process. The priorities of the factors and the ranking of the suppliers can be a recommendation or reference for decision makers when making a supplier evaluation and selection decision. [ABSTRACT FROM AUTHOR]

The septum magnet bends the injection beam before the kicker magnet. The septum magnet is located near the storage ring in the Taiwan Photon Source (TPS). As the space from the magnet wall to the vacuum chamber of the ring is less than 3 mm, the leakage field of the septum magnet thus influences the stability of the electron beam in the storage ring. The main field and the leakage field of a septum of the direct-drive type are compared to one of the eddy-current type. The effects of the vacuum chamber and \mu-metal are simulated with full-sine and half-sine current pulses with the OPERA-2D TR analysis module; measurement results are presented in this paper. [ABSTRACT FROM PUBLISHER]

'Ramsey taxes' are commodity taxes that minimize deadweight loss. Evidence has shown dramatic differences in the extent of price rigidity across goods: while the prices of some goods change frequently, the prices of other goods seldom change. This paper examines Ramsey taxes in the presence of heterogeneous price rigidity. We find that, to minimize deadweight loss, lower (higher) tax rates should be imposed on goods with rigid prices if their relative prices are too high (low) relative to the would-be situation of no price stickiness. Intuitively, Ramsey taxes remedy the relative price distortion caused by the price rigidity of some goods. We calibrate our model to data from Taiwan and the USA, showing a significant cut in welfare cost if Ramsey rather than uniform taxes are applied. [ABSTRACT FROM AUTHOR]

Blogs have been increasingly used to supplement traditional classroom lectures in higher education. This paper explores the use of blogs, and how student attitudes towards online peer interaction and peer learning, as well as motivation to learn from peers, may differ when using the blog comments feature, and when students are encouraged to read and comment on each other's work. We contrast two ways blogs affect learning engagement: (1) solitary blogs as personal digital portfolios for writers; or (2) blogs used interactively to facilitate peer interaction by exposing blogging content and comments to peers. A quasi-experiment was conducted across two semesters, involving 154 graduate and undergraduate students. The result suggests that interactive blogs, compared with isolated blogs, are associated with positive attitudes towards academic achievement in course subjects and in online peer interaction. Students showed positive motivation to learn from peer work, regardless of whether blogs were interactive or solitary. [ABSTRACT FROM AUTHOR]

Background: Cerebral infarction (CI) complicating tuberculous meningitis (TBM) is a major risk factor of permanent disability. The prevention of this complication is an important issue in the quality care of TBM patients. Aim: Our aim was to evaluate the clinical characteristics of TBM patients with CI. Methods: Ninety-one adult patients with TBM were studied between 1999 and 2007. Clinical, neuroradiological and cerebrospinal fluid data of patients with CI were compared with those without CI. Results: Thirty of the 91 patients had CI, including symptomatic CI occurring before admission in 10 patients, symptomatic CI occurring during hospitalisation in four and silent CI in 16 patients. When compared with non-CI patients, patients with CI were younger and associated with focal weakness on presentation, and had basal meningeal enhancement and hydrocephalus on brain images. Prolonged doctor delays of antituberculosis and steroid therapies, neurosurgical intervention, focal weakness and dementia as sequelae, and poor outcomes were associated with patients with CI than non-CI patients. Conclusion: Contrast-enhanced brain imaging is helpful to explore the basal meningeal enhancement in CI patients, and contributes to early diagnosis and treatment of TBM. Early antituberculosis and steroid therapies may help prevent CI in TBM patients. [ABSTRACT FROM AUTHOR]

LIANG C.-H., YANG C.-Y., LU K.-C., CHU P., CHEN C.-H., CHANG Y.-S., O'BRIEN A.P., BLOOMER M. & CHOU K.-R. (2011) Factors affecting peritoneal dialysis selection in Taiwanese patients with chronic kidney disease. International Nursing Review 58, 463-469 Background: Taiwan has the highest incidence and prevalence of end-stage renal disease (ESRD) in the world with 55 499 ESRD patients on long-term dialysis. Nevertheless, 90.96% of these patients are managed on maintenance haemodialysis (HD), with only 9.03% enrolled in a peritoneal dialysis (PD) programme. Aim: The study aim was to identify the factors affecting Taiwanese patient's selection of PD in preference to HD for chronic kidney disease. Methods: A cross-sectional research design was utilized with 130 chronic renal failure (CRF) patients purposively selected from outpatient nephrology clinics at four separate Taiwan hospitals. Logistic regression was used to identify the main factors affecting the patient's choice of dialysis type. Results: Single-factor logistic regression found significant differences in opinion related to age, education level, occupation type, disease characteristics, lifestyle modifications, self-care ability, know-how of dialysis modality, security considerations and findings related to the decisions made by medical personnel ( P < 0.05). Moreover, multinomial logistic regression after adjustment for interfering variables found that self-care ability and dialysis modality know-how were the two main factors affecting the person's selection of dialysis type. Conclusions: Self-care ability and the person's knowledge of the different types of dialysis modality and how they function were the major determinants for selection of dialysis type in Taiwan based on the results from this study. The results indicate that the education of CRF patients about the types of dialysis available is essential to enable them to understand the benefits or limitations of both types of dialysis. [ABSTRACT FROM AUTHOR]

A total of 118 patients with Elizabethkingia meningoseptica bacteremia at a medical center in Taiwan from 1999 to 2006 were studied. Minimum inhibitory concentrations (MICs) of 99 preserved isolates were determined. The incidence (per 100,000 admissions) of E. meningoseptica bacteremia increased from 7.5 in 1996 to 35.6 in 2006 ( p = 0.006). Among them, 84% presented with fever, 86% had nosocomial infections, and 60% had acquired the infection in intensive care units (ICUs). The most common underlying diseases were malignancy (36%) and diabetes mellitus (25%). Seventy-eight percent of patients had primary bacteremia, followed by pneumonia (9%), soft tissue infection, and catheter-related bacteremia (6%). Forty-five patients (38%) had polymicrobial bacteremia. Overall, the 14-day mortality was 23.4%. Multivariate analysis revealed E. meningoseptica bacteremia acquired in an ICU ( p = 0.048, odds ratio [OR] 4.23) and presence of effective antibiotic treatment after the availability of culture results ( p = 0.049, OR 0.31) were independent predictors of 14-day mortality. The 14-day mortality was higher among patients receiving carbapenems ( p = 0.046) than fluoroquinolones or other antimicrobial agents. More than 80% of the isolates tested were susceptible to trimethoprim-sulfamethoxzole, moxifloxacin, and levofloxacin. The MIC and MIC of the isolates to tigecycline and doxycycline were both 4 μg/mL and 8 μg/ml, respectively. [ABSTRACT FROM AUTHOR]

Summary [ABSTRACT FROM AUTHOR]

A pharmacoepidemiology study was conducted using the health insurance database in Taiwan to assess compliance with osteoporosis drug regimens and the impact of compliance on the risk for secondary fractures. Patients >50 years of age with vertebral/hip fracture who had been started on alendronate therapy for the first time only after the fracture were included. Compliance was measured using the medication possession ratio (MPR) and was included as a time-dependent covariate in the Cox model to compare the difference between compliant (MPR ≥80%) and noncompliant patients (MPR <80%) with respect to risk for subsequent hip fractures. Only 38% of the study population remained compliant during the first year of treatment. Over the 4-year follow-up period, the risk of hip fracture among the compliant patients was 70% lower than that among the noncompliant ones (adjusted hazard ratio (HR) 0.30). Among patients with osteoporosis in Taiwan who had experienced a fracture and had started alendronate therapy, compliance with the dosage regimen was suboptimal. It was also found that compliance significantly reduced the risk of secondary hip fracture up to 4 years. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Lin C, Yang C, Shih Y, Hsu H, Yang T, Cheng Y, Chang C, Hsieh L, Chen B, Lee C, Huang Y. Rubella seroepidemiology and estimations of the catch-up immunisation rate and persistence of antibody titers in pregnant women in Taiwan. BJOG 2011;118:706-712. To examine rubella seroepidemiology, and estimate rates of catch-up immunisation and persistence of antibody titers in pregnant women in Taiwan after mass immunisation. A retrospective study. Two medical centres and four regional hospitals specialising in obstetric care. A total of 43 640 prenatal rubella test results for pregnant women from 2001 to 2008. Rubella immunoglobulin G (IgG) antibody assay. Seronegativity, rate of catch-up immunization, and antibody decline. The seronegativity was 10.9% in all pregnant women. Immigrant women had higher seronegativity than indigenous women (OR 2.86; 95% CI 2.65, 3.01). Indigenous women born prior to implementation of the vaccination programmes were more susceptible (20.1%) to rubella infection than were women born thereafter (6.7%). Rates of seropositive conversion were low in both Taiwanese-born and foreign-born women (11.5 and 30.7%, respectively). The rubella antibody titers for vaccinated Taiwanese women in the 1971-1976 and after-1976 birth cohorts declined by 0.6 and 2.3% per year, respectively. This study demonstrates high seronegativity of older indigenous and immigrant women, a low catch-up immunisation rate, and the persistence of rubella antibodies in Taiwan after mass vaccination. Our study suggests that a single dose of rubella vaccine in teenagers effectively increased rubella seropositivity during their childbearing years. This finding is useful for countries that lack the resources necessary for a two-dose regimen. We recommend free rubella antibody tests to women of childbearing age and free vaccination as required. All postpartum women testing negative for rubella antibodies should be vaccinated before they leave hospital. [ABSTRACT FROM AUTHOR]

Natural infection of hantavirus in orangutans has never been reported. Enzyme-linked immunosorbent assays (ELISA), Indirect immunofluorescence assay (IFA), and RT-PCR were used to diagnosis a suspected case in a pet orangutan in southern Taiwan. Although the RT-PCR result was negative, the high IgG titer in the beginning and its dramatic drop after treatments suggested a recent Seoul-type hantavirus infection. Hantavirus transmission and its potential damage to wild orangutans should not be overlooked. [ABSTRACT FROM AUTHOR]

Background Obesity has been found to be associated with an increased risk of psoriasis in general population. However, studies addressing the relationship between obesity and clinical severity of psoriasis are still scarce, especially in Asian people. Objectives In this study, we investigated the relationship between levels of obesity and the clinical severity of psoriasis in Taiwanese psoriasis patients. Methods This was a hospital-based cross-sectional study. A total of 399 patients with chronic plaque psoriasis were recruited. Their body mass index (BMI) was calculated as weight in kilograms divided by height in metres squared and was categorized into four groups (BMI < 24, normal; 24 ≤ BMI < 27, overweight; 27 ≤ BMI < 30, mild obesity; and BMI ≥ 30, moderate-to-severe obesity). Disease severity was assessed by Psoriasis Area and Severity Index. Cumulative logistic regression models were used to estimate the association between BMI and Psoriasis Area and Severity Index. Results After adjusting for potential confounders (age, gender, cigarette smoking and duration of disease), moderate-to-severe obesity was significantly associated with an increased risk of clinically more severe psoriasis when compared with normal BMI [odds ratio, 2.70; 95% confidence interval,1.42–5.11]. There is a significant linear trend for clinically more severe psoriasis across increasing of BMI categories ( P for trend = 0.004). The effect of obesity on the severity of psoriasis was greater in men than in women (test for interaction, P = 0.03). Conclusions In psoriasis patients, obesity is associated with a more severe disease, especially in men. Bodyweight control may be important for the management of psoriasis. [ABSTRACT FROM AUTHOR]

In regions that are hyperendemic for chronic hepatitis B virus (HBV) infection, prevalence of and risk factors associated with isolated anti-hepatitis B core antibody (anti-HBc) in HIV-positive patients are less well described. HIV-positive patients who were tested for hepatitis B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs) and anti-HBc at designated hospitals for HIV care in Taiwan were included for analysis. HBV DNA was detected by real-time polymerase chain reaction in patients with and without isolated anti-HBc. Of 2351 HIV-positive patients, 450 (19.1%) were HBsAg positive, 411 (17.5%) were anti-HBc positive alone and 963 (41.0%) for both anti-HBs and anti-HBc. Compared with patients who were positive for both anti-HBs and anti-HBc, patients with isolated anti-HBc were older, less likely to have anti-hepatitis C virus antibody (anti-HCV), had lower CD4 lymphocyte counts and higher plasma HIV RNA loads. Older age (adjusted odds ratio, 1.029; 95% confidence interval, 1.015–1.043) and CD4 <100 cells/μL (adjusted odds ratio, 1.524; 95% confidence interval, 1.025–2.265) were independently associated with isolated anti-HBc by logistic regression, while presence of anti-HCV and injecting drug use were not. HBV DNA was detectable in 8.3% of 277 patients with isolated anti-HBc and 14.3% of 56 patients with both anti-HBs and anti-HBc ( P = 0.160). In a country hyperendemic for HBV infection, HIV-positive patients at older age and with CD4 <100 cells/μL were more likely to have isolated anti-HBc, suggesting that compromised immunity plays a role in the presence of this marker. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the learning effectiveness of peer tutored problem-based learning and conventional teaching of nursing ethics in Taiwan. The study adopted an experimental design. The peer tutored problem-based learning method was applied to an experimental group and the conventional teaching method to a control group. The study sample consisted of 142 senior nursing students who were randomly assigned to the two groups. All the students were tested for their nursing ethical discrimination ability both before and after the educational intervention. A learning satisfaction survey was also administered to both groups at the end of each course. After the intervention, both groups showed a significant increase in ethical discrimination ability. There was a statistically significant difference between the ethical discrimination scores of the two groups (P < 0.05), with the experimental group on average scoring higher than the control group. There were significant differences in satisfaction with self-motivated learning and critical thinking between the groups. Peer tutored problem-based learning and lecture-type conventional teaching were both effective for nursing ethics education, but problem-based learning was shown to be more effective. Peer tutored problem-based learning has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints. [ABSTRACT FROM AUTHOR]

In order to understand the current status of rainwater harvesting (RWH) practices in Taiwan's schools, a study was carried out to examine the RWH system performance, water usage, and water quality in these sites. A total of 29 schools in various regions were selected for this investigation, including 7 in the northern, 7 in the central, 8 in the southern, and 7 in the eastern regions of Taiwan. Water quality indicators tested were: pH, temperature, conductivity, oxidation-reduction potential, suspended solid, total organic carbon, fecal coliform, and total coliform. From this study, it was found that RWH systems in these sites generally had two different designs: one that collected rainwater only, and one that collected both rainwater and grey water. From statistical analysis, it was found that water quality indicators such as suspended solids, total organic carbon, and fecal coliform were significantly affected by the water source and site location. Fecal coliforms in most of the sites we studied were high and not qualified for toilet flushing. The average water retention time of 2.4 months was long and considered to be the main reason to cause high fecal coliform counts. Finally, the benefit analysis was conducted to evaluate economic feasibility of rainwater harvesting for these schools. It turned out that 20% of them were able to gain economic benefits from using rainwater. [ABSTRACT FROM AUTHOR]

This study uses slacks-based data envelopment analysis (DEA) to examine the performance of electricity distribution districts (EDDs) in Taiwan in 2004. It also explores the relationship between a knowledge management system (KMS) and variations in the efficiency of EDDs in the Taiwan Power Company from 2000 to 2004. The findings show that the EDDs performed well in terms of managerial efficiency in 2004, and 75% of the districts exhibited an increasing performance variation when using cross-period analysis for that period. We show that there is a positive relationship between a KMS and variations in organizational efficiency. In addition, we present a decision-making matrix and conceptual map to help EDD managers improve their managerial efficiency and skills. This study contributes to the field of knowledge management research by applying the DEA model to link the performance between KMS and an organization. Several significant findings emerge from the study. [ABSTRACT FROM AUTHOR]

Solenopsis geminata (F.) was introduced into southern Taiwan decades ago and has continued to threaten the residents. Although the venom compositions of various fire ant species have been studied, the effects of environmental cues on the secretion pattern have received relatively little attention in an area with subtropical climate and high humidity, such as Taiwan. This study characterizes the effects of temperature and season on the venom compositions of S. geminata in Taiwan. Pure venom was sampled by using a microcapillary pipette and immersing the whole ant in hexane and subjected to gas chromatography-mass spectrometry analysis. The results showed that the ratio of cis C11 to trans C11 alkaloids in major workers was significantly higher than that in minor workers. No significant differences could be found in either the relative alkaloids content or the ratio of cis C11 to trans C11 alkaloids in venom of minor workers while rearing at four temperature conditions. Nevertheless, the ratio of cis C11 to trans C11 alkaloids in the venom of minor workers was the highest in spring and the lowest in winter. The results also showed that the body length, abdomen length, head length, head width, and venom volume differed significantly between major workers and minor workers of S. geminata. The venom volumes of these two castes were positively correlated with their body sizes. [ABSTRACT FROM AUTHOR]

Aims: To compare bacterial populations and antimicrobial resistance patterns between clinical and sewage isolates from a regional hospital in northern Taiwan. The dissemination of antibiotic-resistant bacteria from hospital compartments to the hospital sewage treatment plant was examined. Methods and Results: A total of 1020 clinical isolates and 435 sewage isolates were collected between July and September 2005. The percentages of Gram-negative bacteria from the clinical and sewage isolates were 87·2% and 91·0%, respectively ( P = 0·033). Escherichia coli were the leading bacterial isolates in both groups. Antimicrobial susceptibility testing showed a significant difference ( P < 0·001) in resistance to ampicillin (85·6% vs 94·1%), ampicillin/sulbactam (31·7% vs 55·4%), cefazolin (29·2% vs 71·5%) and cefuroxime (20·7% vs 61·9%) between clinical and sewage coliform isolates, respectively. Conclusions: The sewage isolates had higher antimicrobial resistance rates than the clinical isolates from the same hospital. Significance and Impact of the Study: The low efficacy of the hospital sewage treatment may contribute to the dissemination of multidrug resistant bacteria from this hospital compartments to the environment. Practices which limit the disposal of antimicrobial agents into the wastewater system may be the possible measure to prevent the selection of multidrug-resistant bacteria from sewage treatment plants. [ABSTRACT FROM AUTHOR]

Aims. To investigate the incidence of ambulatory care visits among female nursing staff in Taiwan. Background. Literature frequently indicates increased risks of needlestick injury and musculoskeletal disorders among practicing nurses. With increased workload in the healthcare system, nursing staff could also be vulnerable to other diseases. Design. A retrospective cohort study design including 27,624 female nursing staff with a contract with Taiwan's National Health Insurance (NHI) programme between 2001-2004. Methods. Information on ambulatory care visits was retrieved from the NHI claim data. Comparison groups included other female medical personnel and active non-medical working women. Incidence rates of ambulatory care visits were calculated using person-year approach. Rate ratio adjusted for potential confounders was estimated from the Poisson regression model. Results. The nurse cohort developed a total of 781,352 ambulatory care visits, representing an incidence rate of 85,285/104 person-years. Compared with the other female medical personnel, female nurses had significantly elevated incidence of genitourinary [adjusted rate ratio (ARR) = 1·20], circulatory (ARR = 1·14), mental (ARR = 1·12), infectious/parasitic diseases (ARR = 1·11) and pregnancy/birth complications (ARR = 1·07). Significantly increased incidence sustained for both infectious/parasitic diseases and pregnancy/birth complications as the nurse cohort was compared with the active non-medical working women. The nurses, on the contrary, had significantly lower ARRs than the comparison groups of neoplasm, injury, metabolic, respiratory, digestive and musculoskeletal diseases. Conclusions. Female nurses had increased incidences of certain types of systemic illness when compared with other medical personnel and with women working outside of the health industry. Whether the findings found in this study were region specific or could be applicable to other nations, requires further investigations. Relevance to clinical practice. Policy makers and hospital administrators must not overlook nurses' potentially unseen health problems. A mandatory periodical physical examination for nursing staff must be considered. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the experience of cancer-related fatigue in children of different ages in Taiwan. A total of 17 children with different stages of cancer were interviewed. The methods of data collection included interviews, participants' observations, medical chart reviews and the researcher's reflexive journals. Data were progressively analysed by using qualitative data analysis method throughout the process of data collection. The results indicated that children in all age groups used the word ‘tiredness’ or ‘weary’ instead of ‘fatigue’. Patients in different age groups described the fatigue differently. Younger children (<9 years) reported that fatigue affected their ability to participate in physical activities. Children aged 10–12 years described fatigue as extreme tiredness that affected their daily lives both physically and psychosocially by altering their daily routine and school attendance and performance. Adolescents described fatigue as unrelievable tiredness that differed from normal tiredness and had a great impact on physical and psychosocial aspect, particularly altering their future life plans and self-performance. This study shows that the definition and impact of fatigue differs among children by age group. Defining and understanding the effects of fatigue can help clinicians assess fatigue and implement effective strategies to alleviate it. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to analyse the trends of mortality and causes of death among HIV-infected patients in Taiwan from 1984 to 2005. Methods Registered data and death certificates for HIV-infected patients from Taiwan Centers for Disease Control were reviewed. Mortality rate and causes of deaths were compared among patients whose HIV diagnosis was made in three different study periods: before the introduction of highly active antiretroviral therapy (HAART) (pre-HAART: from 1 January 1984 to 31 March 1997), in the early HAART period (from 1 April 1997 to 31 December 2001), and in the late HAART period (from 1 January 2002 to 31 December 2005). A subgroup of 1161 HIV-infected patients (11.4%) followed at a university hospital were analysed to investigate the trends of and risk factors for mortality. Results For 10 162 HIV-infected patients with a mean follow-up of 1.97 years, the mortality rate of HIV-infected patients declined from 10.2 deaths per 100 person-years (PY) in the pre-HAART period to 6.5 deaths and 3.7 deaths per 100 PY in the early and late HAART periods, respectively ( P<0.0001). For the 1161 patients followed at a university hospital (66.8% with CD4 count <200 cells/μL), HAART reduced mortality by 89% in multivariate analysis, and the adjusted hazard ratio for death was 0.28 (95% confidence interval 0.24, 0.33) in patients enrolled in the late HAART period compared with those in the pre-HAART period. Seventy-six per cent of the deaths in the pre-HAART period were attributable to AIDS-defining conditions, compared with 36% in the late HAART period ( P<0.0001). The leading causes of non-AIDS-related deaths were sepsis (14.7%) and accidental death (8.3%), both of which increased significantly throughout the three study periods. Compared with patients acquiring HIV infection through sexual contact, injecting drug users were more likely to die from non-AIDS-related causes. Conclusions The mortality of HIV-infected patients declined significantly after the introduction of HAART in Taiwan. In the HAART era, AIDS-related deaths decreased significantly while deaths from non-AIDS-related conditions increased. [ABSTRACT FROM AUTHOR]

The characteristics of pulmonary tuberculosis (TB) in the elderly are different from young patients. This leads to delay in diagnosis and higher mortality from TB in the aged population. The aim of this study was to investigate the impact of age on the demographic, clinical, radiographic characteristics, and treatment outcomes of pulmonary TB patients in Taiwan. We performed a retrospective analysis of the medical charts and chest radiographs of 83 elderly (≥60 years old) and 74 young (< 60 years old) culture-proven pulmonary TB patients from 1 August 2003 to 31 July 2006. Elderly patients showed lower frequencies of infectious TB contact history, alcoholism, cavity, and positive acid-fast bacilli sputum smears. In contrast, the elderly population had higher frequencies of chronic obstructive lung disease, heart failure, stroke, dyspnea, lower lung field involvement, pleural effusion and mortality. There were no differences between these two groups regarding sex, initial body weight, previous TB disease, hospital admission, diabetes mellitus, end-stage renal disease, neoplasm, liver cirrhosis, upper lung field involvement, cure, and treatment completion. Furthermore, age of 60 and older, lower initial body weight less than 50 kg, coexisting medical diseases, and extensive radiographic disease were factors independently associated with unfavorable outcomes. Elderly patients with pulmonary TB are more likely to present with negative sputum smears, cavitynegative lesions, lower lung field involvement and pleural effusion on chest radiographs. The prognosis is poor for the elderly pulmonary TB patients with lower body weight, coexisting medical diseases, and extensive radiographic disease. [ABSTRACT FROM AUTHOR]

Background: The Janus kinase-2 (JAK-2) V617F mutation has been recently reported in patients with myeloproliferative disorders (MPD), which is believed to underlie growth factor hypersensitivity displayed by haematopoietic progenitors in these disorders. However, its frequency has been rarely determined in Taiwanese patients. Methods: The frequency of JAK2-V617F mutation in patients with polycythaemia vera, essential thrombocythaemia and idiopathic myelofibrosis (IMF) was determined in the DNA from the peripheral blood leucocytes of 108 patients by genomic polymerase chain reaction and restriction enzyme-based assay. Results: The JAK2-V617F mutation could be detected in 28 of 33 polycythaemia vera patients (85%), 29 of 49 essential thrombocythaemia patients (59%) and 2 of 6 IMF patients (33%), but was not detected in 11 patients with myelodysplastic syndrome or another 10 with other haematological diseases. The presence of the JAK2 mutation was associated with specific MPD disease subtypes ( P = 0.007), longer disease duration ( P = 0.005), splenomegaly ( P = 0.019), a higher white blood cell count ( P = 0.002) and a higher haemoglobin level ( P = 0.036). However, the overall risk of thrombosis or bleeding was not affected by the presence of the JAK2 mutation (32 vs 17%; P = 0.22). Conclusion: The JAK2-V617F mutation can be frequently detected in the Taiwanese patients with MPD disorders and therefore should be incorporated into the initial evaluation of patients suspected of MPD. [ABSTRACT FROM AUTHOR]

AIMS: The aim of this study was to develop and evaluate the psychometric properties of a Chinese version of the Fatigue Scale-Children (FS-C-C). BACKGROUND: Cancer-related fatigue is one of the most distressing and prevalent symptoms reported by paediatric oncology patients during and after their cancer treatment. A reliable and valid instrument to measure fatigue is essential to the successful clinical care of paediatric oncology patients in Taiwan who experience this troubling symptom. DESIGN AND METHODS: A total of 108 paediatric oncology Taiwanese patients who were aged 7-12 years participated in this cross-sectional, instrumentation study. The FS-C was translated into Chinese by using an established translation/back-translation method. The psychometric testing of the FS-C-C included internal consistency, content validity, construct validity, convergent validity, criterion-related validity and known-group validity. RESULTS: The FS-C-C achieved an acceptable internal consistency coefficient. Content validity was moderately high (content validity indices ranged from 83-100%). Confirmatory factor analysis supported the three-factor model as an acceptable model fit (the goodness-of-fit index and adjusted goodness-of-fit index both were greater than 0.9; normed fit index, 0.89; root-mean-square residual, 0.15). Although the results did not support the known-group hypothesis, the convergent validity, concurrent validity and predictive validity of the FS-C-C were supported by significant associations with the PedsQL Multidimensional Fatigue Scale, the Anxious/Depressed subscale of the Child Behaviour Checklist and the generic and disease-specific scores on the Quality of Life for Children with Cancer instrument, respectively. CONCLUSION: Our newly developed FS-C-C is a reliable and valid instrument for the measurement of cancer-related fatigue intensity in Taiwanese children. RELEVANCE TO CLINICAL PRACTICE: The FS-C-C could provide useful information to guide clinical practice in assessing and managing cancer-related fatigue in childhood cancer patients in Taiwan. [ABSTRACT FROM AUTHOR]

In Taiwan, every industrial park equips a wastewater treatment plant (WWTP) to collect wastewater streaming from all the factories. These effluents, though showing high total dissolved solids (TDS) and fluctuating composition, would be a valuable water resource for industrial use after large scale purification, especially in the drought seasons. In this study, a pilot plant was installed for reclaiming the effluents from the industrial park WWTP through the membrane process. A modified spiral-wound ultrafiltration (UF) membrane with backwash function was utilized for the pretreatment of the reverse osmosis (RO) system. Evaluation results showed that the pilot plant was performing stably during the two-month operation. After the RO desalination, the quality of the reclaimed water basically met the requirement standards of intermediate-pressure boiler feedwater (150 ∼ 750 psig) of the Environmental Protection Agency, United States (USEPA). The backwashable spiral wound UF membrane provided suitable water quality for RO influent (SDI < 4) and helped reduce the cost compared to using hollow-fibre UF membrane. The total cost of recycling one-ton effluent included US$ 0.35 for construction and US$ 0.45 for operation/maintenance. [ABSTRACT FROM AUTHOR]

Objective: To define the prescribing patterns of oral antidiabetic drugs (OADs) in Taiwan over a 7-year period (1997–2003) and to critically comment on changes observed. Methods: A cross-sectional study design was implemented using data from Taiwan's National Health Insurance Research Database between January 1997 and December 2003. Outpatients who were 18 years or older and had at least an OAD claim during the study period were identified. The unit of analysis was each OAD prescription for diabetic outpatient visits. The prescribing trends were described in terms of annual changes in prescribing rates and patterns. Results: The numbers of OAD prescriptions rose 1·23-fold. The sulfonylurea (SU) class was the most commonly used OAD, but the prescribing rates for this class declined over time. The biguanide (BG) class was the second most frequently prescribed OAD class and its prescribing rate initially increased, peaked in 2000, and then substantially decreased. The largest increase in prescribing was for acarbose use. The prescribing rates of two new classes of OAD, meglitinide (MG) and thiazolidinedione (TZD), also significantly increased within a short period of time. A trend towards combination therapy was observed away from monotherapy. The SU class was the most commonly prescribed as monotherapy. SU plus BG was the most commonly prescribed dual therapy. Triple oral therapy showed a significant ninefold increase. Conclusion: The prescribing rates of OADs are shifting from the older OADs (i.e. SUs) to newer OADs [i.e. alpha-glucosidase inhibitor (AGI), MGs, and TZDs]. The prescribing patterns of OADs are moving toward combination therapy, especially triple oral therapy. [ABSTRACT FROM AUTHOR]

Objective: Mental health impact of severe earthquakes on survivors has attracted considerable attention. Suicide represents a terminal outcome of the spectrum of potential major mental health issues spawned by severe earthquakes. This study used time-series analysis to examine the time trends of increased suicide rates after the Chi–Chi earthquake of 1999 in Taiwan in the affected counties. Method: Adult cause of death data were used to study monthly suicide rates per 100,000 adult population in the study and control counties, during January 1995 to December 2001. Box and Tiao's event intervention analysis was used to examine changes in monthly suicide rates before and after the Chi–Chi earthquake. Results: During the post-quake period, October 1999 to December 2001, the mean monthly suicide rate in the affected counties was 1.567 per 100,000, compared with the control counties’ rate of 1.297 per 100,000. Mean monthly suicide rate among the high-exposure group was 42% higher during the 26 months following the earthquake than the average for the entire observation period. Examined by time trends, the increased suicide rate registered in the first month following the quake began a monthly gradual decline by 0.7/100,000 thereafter, accounting for a total reduction of 98% in quake-related suicides by the end of 10 months. Suicide rates fell to the baseline level after 10 months. Conclusion: We found that the mean monthly suicide rate for earthquake victims was higher while the low-exposure group remained stable and consistent throughout the observation period, indicating that the impact on the high-exposure group was attributable to the earthquake. This indicates the need for providing strengthened psychiatric services during the first year following major disasters. [ABSTRACT FROM AUTHOR]

AIM: The aim of this paper is to report a study to: (a) explore Taiwanese male nurses' motivations for becoming a nurse; (b) reveal their professional developmental process in nursing; (c) understand the difficulties hindering their professional development from both professional and gender aspects; and (d) identify the strategies they use to cope with these difficulties. BACKGROUND: Hindered by historical, cultural, economic and warfare factors, the proportion of male nurses in Taiwan remains low. Taiwanese male nurses' career development process has not been well investigated yet. METHODS: A descriptive qualitative research design was used, with a convenience sample of 15 male nurses (mean age 30.8 years) with a Bachelor's degree in Nursing Science. Data were collected by semi-structured interviews and analysed by content analysis. RESULTS: Taiwanese male nurses' entrance into the nursing profession involved three phases: pre-study, study and employment. The difficulties encountered during career development were related to the gender expectations of patients and the general public. The nurses received support more from superiors than from colleagues. The strategies they used included (a) improving their professional knowledge and skills to obtain higher levels of satisfaction and better opportunities for promotion; (b) thinking aggressively about job promotion; (c) choosing specialist departments as appropriate environments for graduate study and personal growth; and (d) changing their professional track for personal growth. CONCLUSIONS: Based on the nature of nursing work and clinical experiences, Taiwanese male nurses believed that nursing was a profession suitable for both men and women. Their preparation for career development started at the pre-study phase. The major strategies they used were related to a strong desire for personal growth and professional promotion. Finally, a conceptual framework was developed to depict this complex phenomenon. [ABSTRACT FROM AUTHOR]

We studied the expanded CAG repeat and adjacent CCG repeat in 53 Huntington’s disease (HD) patients and 172 unrelated normal subjects matched to the patients for ethnic origin. The range of the CAG repeat varied from 38 to 109 in the HD patients and from 10 to 29 in the control group. A significant negative correlation was found between the age at onset and the CAG expansion, with no significant influence of the adjacent CCG repeat on the age at onset by multiple regression analysis. Allelic association using CCG repeat and 2 flanking dinucleotide repeat markers within 150 kb of the HD gene revealed linkage disequilibrium for 2 of 3 markers. Haplotype analysis of 24 HD families using these markers identified 3 major haplotypes underlying 87.5% of HD chromosomes. The data suggested frequent haplotypes in the Taiwanese population on which one or more mutational events leading to the disease occurred. Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Since market liberalisation in 1987, the Taiwan Tobacco and Wine Monopoly Bureau (TTWMB) annual statistics indicate that both the demand for imported cigarettes as well as the number of seized smuggled packs have increased with an average revenue loss of NT$4942 million over the past 15 years. The NT$10 average increase in cigarette prices after Taiwan entered the World Trade Organization (WTO) and the implementation of the Tobacco and Alcohol Tax Law in 2002 are forcing policy makers to examine smuggling even more closely. This study evaluates factors that affect an individual smoker's decision to purchase smuggled cigarettes, particularly when faced with higher prices. Design: 437 male smokers of imported cigarettes were drawn from a national interview survey on cigarette consumption, which the Division of Health Policy Research at the National Health Research Institutes conducted during the year 2000. Multiple logistic regression models were used to analyse the behaviour of purchasing smuggled cigarettes with respect to demographic factors, economic factors, smoking behaviour, and other variables. Results: Cigarette price was the driving factor most closely linked to the purchase of smuggled cigarettes—a 1% increase in cigarette price raised the likelihood of purchasing smuggled cigarettes at least 2.60 times (95% confidence interval (CI) 1.08 to 6.26). Smokers who spent more than NT$1000/month on cigarettes were twice as likely to purchase smuggled cigarettes as those who spent less than NT$1000 (odds ratio (OR) 2.34, 95% CI 1.48 to 3.70). Betel nut chewers were more likely to purchase smuggled cigarettes (OR 1.80, 95% CI 1.09 to 2.90). Smokers who opposed cigarette taxation policy were 1.69 times more likely to buy smuggled cigarettes. Personal income was not significantly associated with smuggled cigarettes purchases. Conclusions: This study evaluates what causes smokers to purchase smuggled cigarettes. We have determined that cigarette... INSET: What this paper adds.. [ABSTRACT FROM AUTHOR]

Aims: To isolate aerobic denitrifying bacteria which will be applied to piggery wastewater treatment facilities for enhanced nitrate and nitrite removal. Methods and Results: Nitrate-supplemented basal medium in airtight, crimp-sealed serum bottles containing an atmosphere of 92% oxygen was inoculated with denitrifiers, strains NS-2 and SM-3, and incubated at 30°C. After 20 h, the concentration of nitrate was decreased rapidly by both NS-2 and SM-3. Nitrite production was almost zero during the whole experimental period for both strains. Nitrogen gas production peaked at the 20 h for both NS-2 (8·20 ± 1·03 mmol l–1) and SM-3 (3·93 ± 0·16 mmol l–1). Conclusions: Strain NS-2, which produced the highest N2 concentration in this work, was identified as Pseudomonas stutzeri. This strain is the most capable of aerobic and anaerobic conversion of nitrate to N2 without forming a nitrite intermediate. Significance and Impact of the Study: Strain NS-2 is highly promising for future application in in situ piggery wastewater treatment. [ABSTRACT FROM AUTHOR]