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This study investigated the use of an augmented reality (AR) -supported application called STEMUP to develop mobile English courses on Android and iOS smartphones. It focused on vocabulary and listening and speaking skills, in an initial assessment of the effectiveness of implementing AR-based mobile English courses. The study was conducted with English major sophomores who took an elective course, Design and Practice of Mobile Learning, at a technology university in Taiwan. A preliminary curriculum was prepared for integrating STEMUP into English courses in which students would not only learn how to develop ARbased mobile English courses but also practise target English skills with two assigned English courses on STEMUP. The results from the student questionnaire indicated that the layout design of the student-generated AR-based mobile English courses complied with several of Mayer's principles of multimedia learning and that the focus on learning with the mobile English courses met Chapelle's seven suggested criteria for the development of multimedia computer-assisted language learning. The students of English as a foreign language responded that STEMUP was an easy application for developing AR-based mobile English courses and that learning with the assigned AR-based mobile English courses was interesting and motivational. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the changes in the prevalence of myopia in Taiwanese schoolchildren over the past few decades and to analyze the risk factors for myopia. Analysis of 8 consecutive population-based myopia surveys conducted from 1983 through 2017. An average of 8917 (5019–11 656) schoolchildren 3 to 18 years of age were selected using stratified systematic cluster sampling or by probability proportional to size sampling. All participants underwent complete ophthalmic evaluations. Three drops of 0.5% tropicamide were used to obtain the cycloplegic refractive status of each participant. Questionnaires were used to acquire participant data from the 1995, 2005, 2010, and 2016 surveys. Prevalence of myopia (spherical equivalence of ≤−0.25 diopter [D]) and high myopia (≤−6.0 D) was assessed. Multivariate analyses of risk factors were conducted. The prevalence of myopia among all age groups increased steadily. From 1983 through 2017, the weighted prevalence increased from 5.37% (95% confidence interval [CI], 3.50%–7.23%) to 25.41% (95% CI, 21.27%–29.55%) for 7-year-olds (P = 0.001 for trend) and from 30.66% (95% CI, 26.89%–34.43%) to 76.67% (95% CI, 72.94%–80.40%) for 12-year-olds (P = 0.001 for trend). The prevalence of high myopia also increased from 1.39% (95% CI, 0.43%–2.35%) to 4.26% (95% CI, 3.35%–5.17%) for 12-year-olds (P = 0.008 for trend) and from 4.37% (95% CI, 2.91%–5.82%) to 15.36% (95% CI, 13.78%–16.94%) for 15-year-olds (P = 0.039 for trend). In both the 2005 and 2016 survey samples, children who spent less than 180 minutes daily on near-work activities showed significantly lower risks for myopia developing (<60 minutes: odds ratio [OR], 0.48 and 0.56; 60–180 minutes: OR, 0.69 and 0.67). In the 2016 survey, spending more than 60 minutes daily on electronic devices was associated significantly with both myopia and high myopia (OR, 2.43 and 2.31). The prevalence of myopia among schoolchildren increased rapidly from 1983 through 2017 in Taiwan. The major risk factors are older age and time spent on near-work activities. Use of electronic devices increased the amount of time spent on near-work and may increase the risk of developing myopia. [ABSTRACT FROM AUTHOR]

BACKGROUND: The prevalence of obstructive sleep apnea (OSA) increases with age. Treatment often includes CPAP. CPAP adherence is correlated with disease severity and symptoms. We hypothesized that CPAP acceptance rates in elderly patients with OSA would be lower than in younger patients with OSA, and examined factors associated with CPAP acceptance. METHODS: We reviewed the charts of 315 subjects with OSA (apnea-hypopnea index ≥ 5 events/h) who were treated at our hospital from 2008 to 2011 with CPAP therapy. All underwent CPAP titration testing before CPAP prescription. Subjects were grouped by age: young (25-40 y, n=_ 35), middle-age (41-65 y, n = 169), and elderly (> 65 y, n = 111). Demographic variables, excessive daytime sleepiness, overnight polysomnography study variables, CPAP acceptance, and CPAP adherence were compared. Regression analysis was performed to identify factors associated with acceptance. RESULTS: The elderly subjects had less excessive daytime sleepiness and less pronounced alterations in overnight polysomnography variables than the subjects in the other groups, but had more cardiovascular comorbidities. The CPAP acceptance rate (overall 125/315, 39.7%) was significantly lower in the elderly group, compared with the younger group (31.5% vs 60%, P = .01). CPAP acceptance was associated with fewer comorbidities, higher excessive daytime sleepiness, and higher apnea-hypopnea index, but not age. CPAP adherence was not associated with age. CONCLUSIONS: CPAP acceptance is low in elderly patients in Taiwan. CPAP acceptance, instead of CPAP adherence, is the critical issue with elderly patients with OSA. [ABSTRACT FROM AUTHOR]

Background: Enterovirus 71 (EV71) infections are a significant cause of neurological disorder and death in children worldwide. Seasonal variations in EV71 infections have been recognized, but the mechanisms responsible for this phenomenon remain unknown. The purpose of this study was to examine the relationship between meteorological parameters and EV71 infection. Methods and Findings: We analyzed the number of EV71 infections and daily climate data collected in Taiwan between 1998 and 2008 and used Poisson regression analysis and case-crossover methodology to evaluate the association between weather variability and the incidence of EV71 infection. A total of 1,914 EV71-infected patients were reported between 1998 and 2008. The incidence of EV71 infections reflected significant summertime seasonality (for oscillation, p<0.001). The incidence of EV71 infections began to rise at temperatures above 13°C(r² = 0.76, p<0.001); at temperatures higher than approximately 26 °C(r ² = 0.94, p<0.05), the incidence began to decline, producing an inverted V-shaped relationship. The increase in the incidence with increasing relative humidity was positive and linear (r ² = 0.68, p<0.05). EV71 infection was most highly correlated with temperature and relative humidity in the period that likely preceded the infection. Conclusion: Our study provides quantitative evidence that the rate of EV71 infection increased significantly with increasing mean temperature and relative humidity in Taiwan. [ABSTRACT FROM AUTHOR]

Background: Weaning ventilator programs include arm exercise training to improve patient respiratory muscle strength. The effectiveness of such training should be evaluated in light of expected results. Purpose: This research evaluated the effectiveness of arm exercise training in a weaning ventilator program. Methods: We adopted a quasi-experiment methodology. Subjects were patients on ventilalors recruited from an ICU (intensive care unit) at o medical center in Taipei, Taiwan. We randomly divided subjects between training and control groups containing a total of 75 subjects each. Training group subjects received arm exercise training: Control group subjects received standard nursing core. Constructive scales used to collect data included a demographics questionnaire, ventilator weaning assessment scale, and subjective perception scale. Result: Results showed that numbers of ICU and ventilator days, medical costs, and RSI (rapid shallow breathing index) were all significantly lower in the training group than the control group: The weaning rate of the training group was higher (100% vs. 68%): The subjective perception scale of the training group was significantly higher than the control group, especially in the positive emotion domain. After arm exercise training, Pimax increased 11.1 cmH2O, Pemax increased 15.8 cmH2O, tidal volume increased 82.7 ml, maximal ventilation increased 112.3 ml, and minute ventilation increased 1L. We constructed a logistic regression model to predict, factors involved in successful ventilator weaning. We found the rate of weaning success increased an average 22.4% for every arm training exercise day. Conclusion: Arm exercise training significantly increased the weaning rate. The training program assisted patients to wean from their ventilator as soon as possible, improved patient quality of life, and effectively reduced medical resource expenditures. [ABSTRACT FROM AUTHOR]

Data from nationwide population-based nutrition surveys in Taiwan were used to investigate trends and nutritional status for magnesium from 1993 to 2008. Dietary magnesium intake was estimated from 24-hour dietary recalls. Serum and urinary magnesium were also measured. In Nutrition and Health Survey in Taiwan (NAHSIT) 2005-2008, average magnesium intake was 305 mg and 259 mg for adult males and females, respectively, which is equivalent to 82-85% of relevant Taiwanese Dietary Reference Intakes (DRIs). After correcting intra-individual variation, 74-81% of adult subjects' dietary magnesium was estimated as sub-optimal. Mean serum magnesium concentration was 0.866 mmol/L and 0.861 mmol/L for the males and females, respectively. The prevalence of low serum magnesium (<0.8 mmol/L) was 12.3% and 23.7% for the males and females, respectively. There was positive association among dietary magnesium, blood magnesium, and urinary magnesium/creatinine ratio. From NAHSIT 1993-1996 to NAHSIT 2005-2008, dietary magnesium significantly increased (p<0.05), the blood magnesium and urinary magnesium/creatinine ratio decreased (p<0.05). The findings suggest that the relationships between dietary magnesium and biochemical markers among different nutrition and health surveys are not straightforward and need to be further clarified. [ABSTRACT FROM AUTHOR]

We studied the breeding biology of the Taiwan Barbet (Megalaima nuchalis) in the Taipei Botanical Garden (TBG) during the 2008 and 2009 breeding seasons. Breeding pairs produced a mean of 1.8 broods per season and had a mean clutch size of 3.0 eggs. The mean incubation period was 13.8 days, and both parents shared incubation. The mean nestling period was ~27.5 days, considerably shorter than that of other Asian barbets. The shorter nestling period may be related to the low fledgling success rate, multiple broods per season, and constant animal matter food in TBG throughout the entire nesting period. Ambient temperature influenced the amount of time spent by adults inside the nest cavity incubating eggs and brooding nestlings. Adult males provided more food to nestlings than adult females, while adult females cleaned the nest more often than males. The overall egg-to-fledgling success rate was low at 32.8%, because of infertile eggs and failure of eggs with embryos to hatch, abandonment, anthropogenic disturbances, predation, weather disturbances, and other unknown factors. [ABSTRACT FROM AUTHOR]

Climate change has been receiving wide attention in the last few decades. In order to quantify the climate variability of extreme weather events and their possible impacts on weather parameters and air quality, cold surge events in the past 45 years and the difference in characteristics of air pollutants before and after frontal passage has been examined after December 1993 in Taiwan. The potential impact of climate change on air pollutant concentration and its health implication were presented and discussed. In the past 45 years, the cold surge days (about 18.7 days, or 0.42 day/year) decreased significantly and the average lowest daily temperature for winter in northern Taiwan increased nearly 3°C (0.067°C/year). Based on the definition of cold surge in Taiwan and excluding the stagnation frontal passage, 21 cold surge frontal passage (CSFP) cases and 89 common frontal passage (CFP) events in winter (December–February) were identified in the past 12 years (1993–2005). We take the frontal passage day as the baseline and the differences in air pollutant concentrations and weather-related parameters between the two days before and after the frontal passage days were examined for each case. The averages of the above-mentioned differences during CSFP were compared to the corresponding differences during CFP. During CSFP, the air temperatures after the frontal passage were nearly 4–6°C lower than before the passage at both the background windward stations and urban stations. The average wind speed was about 4–5 m/s higher at the windward stations and less than 2 m/s higher in the major urban areas in Taiwan. During CFP, there was a 2°C increase in temperature but 1 m/s decrease in wind speeds on the day after frontal passage. Because of these meteorological differences, the concentration change of air pollutants during CSFP is significantly greater than that during CFP, especially for PM10 concentration. The difference of PM10 concentration during CSFP can be as large as 20–40 μg/m3 while that during CFP is only about 10 μg/m3. The differences in the other air pollutants such as CO, SO2, and O3 during CSFP are greater than those during CFP, but the difference is insignificant. Under the warming trend, less frequent CSFP’s are expected; the impacts on deterioration of air quality and human health are noteworthy. [ABSTRACT FROM AUTHOR]

Particulate matter with diameters less than 2.5 μm (PM2.5) and ranging between 10 to 2.5 μm (PM10-2.5) were simultaneously collected at four air-quality monitoring stations in the Taichung area of central Taiwan during the period of February 12 to 22, 2004. Two different types of PM10 episodes, a nonlocal dust-storm episode and a local episode, were observed in the present study. High concentrations of coarse aerosols occurred during the dust-storm episode, whereas high concentrations of fine aerosols were present during the local episode. Relatively high levels of Na+, Mg2+, Ca2+, and Cl- in coarse aerosols were observed during the dust-storm episode. Very high concentrations of secondary aerosols ( NH4+, SO42-, and NO3-) in fine aerosols were observed during the local episode. The nitrate ion demonstrated the greatest increase in the ratios of ionic species to PM2.5 and ionic species to PM10-2.5 during the local episode. Significantly high ratios (0.444) of NO3- to NO2 in fine aerosols were present during the local episode, indicating that the relatively high formation rate of NO3- was one of the important factors leading to the increase of the NO3- to PM2.5 ratio during the local episode. Results also showed that an abundant quantity of fine ammonium nitrate was formed during the local episode, and chloride depletion probably was the major pathway to form coarse NaNO3 during this episode. [ABSTRACT FROM AUTHOR]

Generic quality of life (QoL) is an important issue in decision making related to the primary treatment of localized prostate cancer (PC). This study assessed the dynamic changes of QoL in patients with localized PC under different treatment modalities. From 2013 to 2018, we prospectively assessed QoL scores in patients with localized PC under unitary treatment using the World Health Organization Quality of Life (WHOQOL) BREF version. The trajectories of the QoL scores after different treatments were estimated using a kernel-smoothing method. Dynamic changes in the major determinants were analyzed using a mixed effects model. The clinical features of the participants in our institute were compared with PC patients in Taiwan's cancer registry. A total of 196 patients were enrolled with 491 repeated assessments. The participants shared similar clinical characteristics with the PC patients in Taiwan as a whole. Patients with lower household incomes showed statistically significant lower scores on all four domains and related facets, while PC survivors with comorbidities of anxiety and/or diabetes appeared to be affected on the physical domain and related facets. After controlling for these determinants, patients under active surveillance or observation demonstrated significantly higher QoL scores in the physical and social domains, as well as several facets belonging to these domains, in mixed models compared with patients undergoing radical prostatectomy or radiotherapy within the first year. The generic QoL scores were higher within the first year in patients receiving active surveillance or observation after controlling other significant factors. The difference diminished after one year of post management. More studies are needed to corroborate our findings. [ABSTRACT FROM AUTHOR]

Zinc concentrations in both serum and hair were assessed in 135 obese patients (51 males, 84 females) and in 57 controls (28 males, 29 females) to study the correlation between Zn and obesity. The body mass index (wt/ht²) was also measured to evaluate its relationship to the Zn level in obese individuals. The serum and hair Zn contents in obese patients were markedly lower than in normal control subjects by 22 and 34%, respectively. The Zn content was inversely related to the body mass index. Thus Zn may play an important metabolic role in the development of obesity. [ABSTRACT FROM AUTHOR]

Three-quarters of Taiwan are slopes. Located at the boundary between Philippine Sea Plate and Eurasian Plate, Taiwan is subject to frequent seismic activity. Furthermore, the ongoing movement of flat terrain has caused a surge of slope development in recent years. Besides the global impact of extreme weather, typhoons and heavy rains have induced the landslide disasters and leaded to human causalities and property losses in Taiwan. With the advance of science and technology, massive volume of data is available nowadays. However, the data has become too large or complex for traditional statistical approaches to deal with. Accordingly, this research performs the assessment of rainfall-induced landslides using data mining techniques. This study focused on the landslides of remote mountainous areas in southern Taiwan caused by typhoons from 2009 to 2013. Years of records such as landslide locations and land use changes in multi-year and multi-rainfall events were collected based on the classifications and interpretations of 20 satellite images via image texture analysis. Datasets of natural environment, land cover, and rainfall predisposing factors were constructed under the platform of geographic information system. Random Forrest, Classification and Regression Tree, and Classification and Regression Tree with Artificial Bee Colony were employed to develop the potential landslide assessment model. Variances, differences, and trends of influence factors of slope land disaster were explored as well. Potential Maps of rainfall-induced landslides were generated regarding rainfall intensity. Finally, the receiver operating characteristic curve and historical disaster locations were used to verify the assessment effectiveness of rainfall-induced landslides.This study shows that our satellite image classifications reach a high degree of uniformity. The parameters in our data mining techniques are suitably modified to raise landslide producer accuracy and value of area under curve. Rainfall, slope, distance from water, density of bare land, and forest are the main disaster factors inducing landslides. Our results can provide government a basis to develop landslide hazard prevention and control programs in remote mountainous areas to help disaster prevention and resilience, especially in southern Taiwan. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of convenience and beverage stores in Taiwan provides an environment for children to access different beverages. To our knowledge, the relationship between beverage consumption types and anthropometrics in children has not been reported in Taiwan. The aim of this study was to examine the association between the consumption frequency of beverage type and anthropometrics in third-grade children., Methods: This was a cross-sectional study conducted in 10 elementary schools in 12 administrative regions distributed evenly throughout Taipei City from June 2017 to December 2018. Parents of 515 children completed a questionnaire with written instructions, which was designed to collect demographic characteristics, frequency of consumed beverage types, and anthropometrics. This study was novel because beverage types were categorized based on sugar and protein contents, namely nutritious, sugar, nutritious and sugar, and non-nutritious and sugar-free. The differences in height and body weight between intake frequencies within each beverage type were determined using analysis of variance test or nonparametric statistics, depending on the confirmation of normal data distribution., Results: Height and weight of children consuming the most nutritious beverages fell in the highest respective percentile compared with those who did not consume them (P = 0.001 and 0.035, respectively). Consumption of nutritious and sugar and sugar beverages were not associated with height, body weight, or body mass index. Children who consumed more non-nutritious and sugar-free beverages were significantly heavier (P = 0.016) and had a higher body mass index (P = 0.001)., Conclusion: This was the first study conducted on third-grade children in Taiwan showing the beverage consumption type was associated with anthropometrics. Nutritious beverages appear to be a better choice for growth in children. Nevertheless, additional related studies, including an overall assessment of children's calorie and nutrient intakes and related dietary behaviors, are warranted to provide more helpful information for policymakers., (Copyright © 2021. Published by Elsevier Inc.)

Since its outbreak in China, the Coronavirus disease 2019 (COVID-19) pandemic has caused worldwide disaster. Globally, there have been 71,581,532 confirmed cases of COVID-19, including 1,618,374 deaths, reported to World Health Organization (data retrieved on December 16, 2020). Currently, no treatment modalities for COVID-19 (e.g., vaccines or antiviral drugs) with confirmed efficacy and safety are available. Although the possibilities and relevant challenges of some alternatives (e.g., use of stem cells as immunomodulators) have been proposed, the personal protective equipment is still the only way to protect and lower infection rates of COVID-19 among healthcare workers and airway managers (intubators). In this article, we described the combined use of a plastic sheet as a barrier with the intubating stylet for tracheal intubation in patients needing mechanical ventilation. Although conventional or video-assisted laryngoscopy is more popular and familiar to other groups around the world, we believe that the video-assisted intubating stylet technique is much easier to learn and master. Advantages of the video stylet include the creation of greater working distance between intubator and patient, less airway stimulation, and less pharyngeal space needed for endotracheal tube advancement. All the above features make this technique reliable and superior to other devices, especially when a difficult airway is encountered in COVID scenario. Meanwhile, we proposed the use of a flexible and transparent plastic sheet to serve as a barrier against aerosol and droplet spread during airway management. We demonstrated that the use of a plastic sheet would not interfere or hinder the intubator's maneuvers during endotracheal intubation. Moreover, we demonstrated that the plastic sheet was effective in preventing the spread of mist and water spray in simulation models with a mannequin. In our experience, we found that this technique most effectively protected the intubator and other operating room personnel from infection during the COVID-19 pandemic.