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This study focuses on "digital learning sheets" by exploring the effects of different design strategies of the digital learning sheet on visitors' motivation and learning outcomes. This study chose the woodcraft themed exhibition as a case study, adopting the learning sheet design principles proposed by Hooper-Greenhill in order to design three types of digital learning sheets for this exhibition. A control group of students who did not use the sheets and three experimental groups of students who used the sheets were invited to visit the exhibition for the purpose of examining the impact of different strategies of digital learning sheet design on the "learning motivation" and "learning outcomes" of the visitors. The study results show that among the four learning motivations of Attention, Relevance, Confidence, and Satisfaction, the digital learning sheet designed with the "principle of sensory exploration of physical objects" had the highest effectiveness among the various design strategies. In terms of three aspects of learning outcomes: Cognitive, Affective, and Psychomotor, the three types of digital learning design strategies do not produce significant differences in the affective impact on children. As for Cognitive and Psychomotor, students learn best when they use digital learning sheets designed with the "design principle of sensory and exploration of physical objects". The results of this study will provide future exhibition planners, digital learning designers, and educators with precise and practical references.

In Taiwan, preservation and training policies of intangible cultural assets are highly valued by the government. In this study, lacquerware art craft education as intangible cultural heritage is the subject of this study. We conducted in-depth interviews and secondary data collection to obtain research data and carried out a grounded theory data analysis method through expert meetings to explore the passing on education strategy of "lacquerware art craft" in Taiwan. Firstly, based on Bloom's educational objectives, the study analyzed three aspects of lacquer art education: cognitive, affection and skill, and proposed a "Lacquerware Art Passing-On Education Framework Diagram". Later, the analysis results of the grounded theory enable us to summarize the "Lacquerware art value and learning structure diagram". In this structure, it reveals that the Lacquerware artist's way of thinking about the craft levels can echo the system of the Three Extremes of the Tao in the Book of Changes and divide the value levels of creation into the levels of tools of livelihood, way of living and philosophy of life.

Background/Aim: Matrix metalloproteinase-9 (MMP-9) has been associated with the development and progression of breast cancer (BCa). However, the relationship between MMP-9 genetic variants and BCa susceptibility remains contentious and inconclusive. This study aimed to evaluate the association of MMP-9 rs3918242 promoter polymorphisms with BCa, with a particular focus on the risk of triple-negative breast cancer (TNBC). Materials and Methods: A case-control study was conducted involving 1,232 BCa patients and 1,232 healthy controls. The MMP-9 rs3918242 genotypes were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Results: The genotype distribution of MMP-9 rs3918242 among the control group adhered to Hardy-Weinberg equilibrium (p=0.3265). No statistically significant differences were observed in the genotype frequencies between BCa cases and controls (p for trend=0.2555). Although the homozygous variant genotype (TT) showed a potential risk-increasing effect, this was not statistically significant [odds ratio (OR)=1.43, 95% confidence interval (CI)=0.88-2.36, p=0.1869]. Similarly, allele frequency analysis indicated no significant association between the variant T allele and overall BCa risk (OR=1.13, 95%CI=0.97-1.33, p=0.1265). Additionally, no interaction was detected between MMP-9 rs3918242 genotypes and the age of BCa onset (both p>0.05). Notably, the TT genotype of MMP-9 rs3918242 was significantly associated with an increased risk of TNBC (OR=2.49, 95%CI=1.32-4.72, p=0.0072). Conclusion: The MMP-9 rs3918242 TT genotype may serve as a potential predictive biomarker for TNBC in the Taiwanese population. [ABSTRACT FROM AUTHOR]

Simple Summary: The objective of the current study was to investigate the contribution of mouse double minute 2 (MDM2) genotypes and phenotypes to the risk of renal cell carcinoma (RCC). Our findings indicate that the MDM2 rs2279744 G allele serves as a risk marker against RCC. In addition, it can interact with environmental and clinical risk factors, such as smoking, alcohol drinking, hypertension, and diabetes, to influence RCC risk. Furthermore, MDM2 mRNA levels were significantly higher in RCC patients compared to controls and varied among the MDM2 rs2279744 genotypes, with the GG genotype exhibiting the highest expression levels in both RCC patients and controls. These genotype-associated MDM2 mRNA levels may serve as a practical marker for early RCC detection, alongside MDM2 rs2279744 genotypes. This combined approach could offer potential benefits for personalized and precise early prediction and detection of RCC, which currently lacks effective early detection methodologies. Background: This study aimed to investigate the polymorphic genotypes of MDM2 rs937282, rs937283, rs2279744, and rs769412, as well as the combined effects of MDM2 genotypes and environmental factors on RCC susceptibility. Methods: A total of 135 RCC patients and 590 controls were recruited for MDM2 genotyping using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Quantitative PCR was performed to assess MDM2 mRNA levels among 30 healthy individuals and 22 RCC patients. Results: MDM2 rs2279744, but not other polymorphisms, was significantly associated with an increased RCC risk (p = 0.0133). The MDM2 rs2279744 G allele was identified as a risk factor for RCC (odds ratio [OR] = 1.49, 95% confidence interval [CI] = 1.14–1.96, p = 0.0047). Among smokers (p = 0.0070), alcohol drinkers (p = 0.0233), individuals with hypertension (p = 0.0041), diabetes (p = 0.0225), and those with a family history of cancer (p = 0.0020), the MDM2 rs2279744 GT and GG genotypes exhibited increased RCC risks. However, this risk effect was not observed in non-smokers, non-drinkers, or individuals without hypertension, diabetes, or a family cancer history (all p > 0.05). Moreover, MDM2 mRNA levels were significantly higher in RCC patients compared to controls and varied among the rs2279744 genotypes, with GG genotype exhibiting the highest expression levels among both RCC patients and controls. Conclusions: This study highlights the association between MDM2 rs2279744 genotypes and RCC risk, suggesting that genotype-associated MDM2 mRNA levels could contribute to early RCC detection. Further studies are warranted to elucidate the detailed mechanisms underlying the role of MDM2 in RCC development. [ABSTRACT FROM AUTHOR]

Background/Aim: Hallux valgus (HV) is the most prevalent deformity affecting the forefoot; however, its genetic etiology remains unclear. In the literature, vitamin D receptor (VDR) genotypes have been reported to be associated with the risk of skeletal malformations accompanied by inflammation. This study aimed to examine the hypothesis that VDR genotypes are associated with the risk of HV. Materials and Methods: The VDR rs731236, rs1544410, rs2228570 and rs7975232 genotypes of 150 HV patients and 600 non-HV subjects were determined using polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) methodology and examined regarding their associations with HV risk. Results: The results showed that none of the genetic frequency distributions of VDR rs731236, rs1544410, rs2228570, or rs7975232 were significant between the HV cases and non-HV controls (p for trend=0.4055, 0.2170, 0.7220, 0.5509, respectively). Additionally, allelic frequency analysis showed that none of the allelic frequencies of VDR rs731236, rs1544410, rs2228570, or rs7975232 were significantly distributed (p=0.2285, 0.1572, 0.9278, and 0.5547, respectively). Furthermore, stratified analysis showed that no correlation was observed between VDR rs731236 and different age groups (either younger or older than 51) or sex (p=0.3953 and p=0.9576). Moreover, no correlation was found between VDR rs731236 genotype and the risk of HV in individuals within subgroups of height, weight, or body mass index (BMI) (p=0.8317, 0.5346, and p=0.8783, respectively). Conclusion: VDR rs731236, rs1544410, rs2228570, and rs7975232 may not serve as indicators for a higher risk of HV. [ABSTRACT FROM AUTHOR]

Tissue inhibitor of metalloproteinase-2 (TIMP-2) is an endogenous inhibitor of matrix metalloproteinase-2 and is highly expressed in breast cancer (BC) cases at diagnosis. However, the genetic investigations for the association of TIMP-2 genotypes with BC risk are rather limited. In this study, contribution of TIMP-2 rs8179090, rs4789936, rs2009196 and rs7342880 genotypes to BC risk was examined among Taiwan's BC population. TIMP-2 genotypic profiles were revealed among 1232 BC cases and 1232 controls about their contribution to BC using a PCR-based RFLP methodology. The TIMP-2 rs8179090 homozygous variant CC genotype was significantly higher in BC cases than controls (odds ratio (OR) = 2.76, 95% confidence interval (95%CI) = 1.78–4.28, p = 0.0001). Allelic analysis showed that C allele carriers have increased risk for BC (OR = 1.39, 95%CI = 1.20–1.62, p = 0.0001). Genotypic together with allelic analysis showed that TIMP-2 rs4789936, rs2009196 or rs7342880 were not associated with BC risk. Stratification analysis showed that TIMP-2 rs8179090 genotypes were significantly associated with BC risk among younger (≤55) aged women, not among those of an elder (>55) age. Last, rs8179090 genotypes were also associated with triple negative BC. This study sheds light into the etiology of BC in Taiwanese women. Rs8179090 may be incorporated into polygenic risk scores and risk prediction models, which could aid in stratifying individuals for targeted breast cancer screening. [ABSTRACT FROM AUTHOR]

Background/Aim: The expression of matrix metalloproteinase 9 (MMP9) is elevated in various renal diseases, including renal cell carcinoma. However, the role of MMP9 genotype in this context remains unclear. This study aimed to investigate the association between MMP9 promoter rs3918242 genotypes and the risk of renal cell carcinoma. Materials and Methods: The MMP9 rs3918242 genotypes of 118 patients with renal cell carcinoma and 590 healthy subjects were determined using the polymerase chain reaction-restriction fragment length polymorphism method. Results: The results indicated that individuals carrying the CT or TT genotype of MMP9 rs3918242 did not exhibit an increased risk of renal cell carcinoma compared to wild-type CC carriers (odds ratio=1.20 and 2.68, 95% confidence interval=0.75-1.92 and 0.89-8.03; p=0.5270 and 0.1420, respectively). However, individuals with the CT and TT genotypes had a higher prevalence of renal cell carcinoma than those with the CC genotype when they also had hypertension (p=0.0010), diabetes (p=0.0010), or a family history of cancer (p<0.00001). No correlation was observed between MMP9 rs3918242 genotypic distribution and age (60 years or younger vs. older than 60 years) or sex (both p>0.05). Additionally, no correlation was found between MMP9 rs3918242 genotype and the risk of renal cell carcinoma in individuals with smoking or alcohol consumption habits. Conclusion: Carrying the T allele for MMP9 rs3918242 may predict a higher risk of renal cell carcinoma among individuals diagnosed with hypertension, diabetes, or with a family history of cancer. [ABSTRACT FROM AUTHOR]

Simple Summary: The objective of this study was to investigate the association between IL-8 rs4073, rs2227306, rs2227543, and rs1126647 genotypes and the risk of colorectal cancer (CRC) in the Taiwanese population. Our findings reveal that the A allele and AA genotype of IL-8 rs4073 are significantly associated with an increased susceptibility to CRC in Taiwan. This observation provides further evidence of the complex interplay between inflammation and carcinogenesis in CRC development. Furthermore, individuals with the AA genotype exhibit significantly higher levels of serum IL-8 expression. Combining IL-8 rs4073 genotyping with the assessment of IL-8 levels may have potential benefits in terms of the precise risk evaluation and early detection of CRC among patients. Interleukin-8 (IL-8), a pro-inflammatory cytokine, is upregulated in CRC and plays an important role in its development and progression. Genetic variants in the IL-8 gene may impact the risk of CRC by modulating IL-8 levels. Our primary objective was to investigate the role of IL-8 genotypes in the development of CRC. To accomplish this, we employed the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to analyze the genotypes of IL-8 rs4017, rs2227306, rs2227543, and rs1126647 in 362 CRC patients and 362 controls. Additionally, we evaluated the interactions between these genotypes and factors such as age, gender, smoking, alcohol consumption, and body mass index (BMI) status in relation to the risk of CRC. Furthermore, we utilized quantitative reverse transcription-PCR to measure the serum IL-8. The results demonstrated a significant difference in the distribution of rs4017 genotypes between the control and case groups (p for trend = 0.0059). Logistic regression analysis revealed that individuals with variant AA genotype had a 1.92-fold higher CRC risk (95% confidence interval [CI] = 1.28–2.89, p = 0.0023). Moreover, carriers of the IL-8 rs4017 AT + AA genotypes exhibited a significant association with CRC risk (odds ratio [OR] = 1.39, 95% CI = 1.02–1.91, p = 0.0460). Additionally, individuals with IL-8 rs4017 AA genotype displayed significantly elevated serum IL-8 compared to those with TT genotype at a 1.73–fold level (p < 0.0001), indicating a correlation between genotype and phenotype. In conclusion, the genotypes of IL-8 rs4017, along with their associated expression levels, can potentially serve as predictive markers for the risk of CRC. [ABSTRACT FROM AUTHOR]

Because the senior population comes from various backgrounds, how to meet their needs and to cater to their different levels poses a great challenge for aging-education instructors when designing effective projects. The goal of this paper was to present the implementation of an innovative and effective project in aging education titled The K-shape Learning Project for Senior Citizens. The project was implemented in Taitung University and lasted for five months with 140 seniors in five sessions in total. An action research approach was adopted for the course implementation and content modification throughout this project. Meanwhile, data was collected through questionnaires and interviews. The findings then emphasized four elements for other aging education professionals' references: the philosophy and goal of the project, the implementation process of the project, the perception and response of participants, and the reflection of the educators. (Contains 2 figures.)

We aimed to investigate the association between genotypes for mir146a and mir196a-2 and the risk of developing colorectal cancer (CRC). We used polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to determine the mir146a rs2910164 and mir196a-2 rs11614913 genotypes in 362 CRC patients and 362 controls. We also assessed the interactions between these genotypes and age, gender, smoking, alcohol consumption, and BMI status on CRC risk. Additionally, the serum expression level of mir196a-2 was quantified using quantitative reverse transcription-PCR. Our findings demonstrated that among the controls, the proportions of TT, CT, and CC genotypes of mir196a-2 rs11614913 were 32.3%, 48.1%, and 19.6%, respectively. As for the cases, the proportions were 24.6%, 45.0%, and 30.4%, respectively. Logistic regression analysis revealed that the CC genotype carriers had a 2.04-fold increased risk (95% confidence interval [CI] = 1.36–3.06, p = 0.0008). Furthermore, carriers of the CT + CC genotypes also exhibited a significant association with CRC risk (odds ratio [OR] = 1.46, 95% CI = 1.06–2.03, p = 0.0261). Moreover, carriers of the CC genotype had significantly higher serum levels of mir196a-2 compared to those with the TT genotype (p < 0.0001), indicating a genotype-phenotype correlation. No association was found regarding mir146a rs2910164. In conclusion, mir196a-2 rs2910164 genotypes, along with their associated expression, can serve as predictive markers for CRC risk. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the association between single-nucleotide polymorphisms (SNPs) in mir146a and mir196a and bladder cancer (BLCA) risk in Taiwan. The genotypes of mir146a rs2910164 and mir196a rs11614913 were determined in 375 BLCA patients and 375 healthy controls using PCR-RFLP methodology, and their associations with BLCA risk were evaluated. The study also measured the serum expression level of mir146a using quantitative RT-PCR. The results showed that the distributions of CC, CG and GG genotypes of mir146a rs2910164 were 31.7%, 45.6% and 22.7% in the control group, and 21.9%, 44.3% and 33.8% in the case group, respectively. In logistic regression analyses, the heterozygous variant genotype CG carriers showed a marginally significant association with increased BLCA risk (OR = 1.41, 95% CI = 0.99–2.01), while the homozygous variant genotype GG carriers had a 2.17-fold increased risk of BLCA (OR = 2.17, 95%CI = 1.46–3.21). Moreover, carriers of the GG/CG genotypes had significantly higher serum levels of mir146a than those with the CC genotype (p < 0.0001), indicating a genotype–phenotype correlation. In contrast, mir196a rs11614913 was not associated with BLCA risk. Therefore, the genotypes of mir146a rs2910164 may serve as a useful biomarker for predicting the risk of BLCA. [ABSTRACT FROM AUTHOR]

A previous study provided reference data on the age and gender distribution of anthropometric parameters in Taiwanese adults. However, there are very few large-scale analyses of anthropometric data of older adults in Taiwan. Therefore, the main purpose of this study was to describe gender- and age-specific distributions of anthropometric measurements and anthropometry assessments of Taiwanese older adults. This was a cross-sectional study conducted on 22,389 adults aged 65 years or older (8017 males and 14,372 females) who participated in Taiwan's National Physical Fitness Survey 2014–2015. All participants were recruited using stratified convenience sampling from 46 physical fitness test stations in 22 cities or counties in Taiwan. The anthropometric measurements and anthropometry assessments included in the present study were the assessments of height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). The results showed statistically significant differences in weight, height, WC, and WHR across all age groups among both male and female individuals aged 65 years and older in Taiwan. However, there was no significant difference in BMI and HC between males and females in all age groups. Anthropometric status provides an initial assessment of the overall health of the population. This study uses a representative population of Taiwanese older adults over the age of 65 for analysis and provides detailed information on anthropometric data distribution. [ABSTRACT FROM AUTHOR]

Asthma is a chronic airway inflammation disease and the diagnosis and treatment strategies remain difficult. MicroRNAs play important roles in many biological and pathological processes including asthma development. There is no study confirming the contribution of genetic variants in miR-145 to asthma etiology. We hypothesize that single nucleotide polymorphisms (SNPs) in the promoter region of miR-145 may be associated with the risk of asthma in Taiwanese. We used a case–control study to test this hypothesis. In 198 asthma patients and 453 healthy controls, the genotypes of miR-145 rs4705342 and rs4705343 were determined, and the associations of miR-145 genotypes with asthma risk and severity were evaluated. The distribution of miR-145 rs4705342 genotypes between asthma patients and non-asthmatic control groups were significantly different (p = 0.0187). In multivariable logistic regression analysis, compared with the wild-type TT genotype, individuals carrying the variant genotypes had progressively decreased risks of asthma: the odds ratio (OR) for the heterogeneous variant genotype (CT) and homozygous variant genotype (CC) was 0.77 (95% CI 0.55–1.10, p = 0.1788) and 0.41 (95% CI 0.21–0.79, p = 0.0102), respectively (p for trend = 0.0187). In allelic test, the C allele was associated with a 31% reduced risk of asthma (OR = 0.69, 95% CI 0.53–0.90, p = 0.0070). In addition, the rs4705342 variant genotypes were correlated with the symptom severity (p = 3 × 10–5). Furthermore, the variant genotypes correlated with lower miR-145-5p expression level in serum (p = 0.0001). As for rs4705343, there was no differential distribution of genotypes between cases and controls. Our data provide evidence for miR-145 rs4705342 to serve as a novel biomarker for asthma risk prediction. [ABSTRACT FROM AUTHOR]

Background/Aim: Although genetic differences in cell-cycle control genes have been associated with cancer risk, to our knowledge, no report has specifically examined the role of gene variants in childhood acute lymphoblastic leukemia (ALL). Cyclin-dependent kinase inhibitor 1B (CDKN1B; also known as p27/KIP1) is a cell-cycle regulating gene. This study aimed at investigating the association between CDKN1B genotypes and childhood ALL risk. Materials and Methods: In 266 childhood ALL cases and 266 healthy controls, the CDKN1B rs34330 and 2066827 polymorphisms were genotyped, and the association of CDKN1B genotypes with childhood ALL risk were analyzed. Results: The genotypes of CDKN1B rs34330 and 2066827 were similarly distributed between the control and case groups (p for trend=0.8718 and 0.4030, respectively). The allelic frequency also exhibited no statistical difference (p=1.0000 and 0.6666, respectively). There was no significant interaction between CDKN1B genotypes and age or sex. Conclusion: CDKN1B genotypes were not found to be minor contributors to childhood ALL susceptibility in Taiwan. [ABSTRACT FROM AUTHOR]

Background/Aim: Programmed cell death 6 (PDCD6) is up-regulated and highly expressed in early apoptotic cells. In several types of cancer, such as cervical, breast and lung cancers, the association of PDCD6 genotypes have been investigated. However, the contribution of PDCD6 variant genotypes to oral cancer has never been examined. The current study aimed to evaluate the contribution of the PDCD6 rs4957014 and rs3756712 genotypes to the risk of oral cancer in Taiwan. Patients and Methods: The contribution of PDCD6 genotypes to oral cancer risk was examined among 958 patients with lung cancer and 958 ageand sex-matched healthy controls by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP). Results: The data showed that the hetero-variant GT and homo-variant GG genotypes of PDCD6 rs4957014 were [ABSTRACT FROM AUTHOR]

Background/Aim: Acute lymphoblastic leukemia (ALL) is frequent among children. Few studies have researched the relationship between maternally expressed gene 3 (MEG3) and cancer risk. We hypothesized long noncoding RNA MEG3 polymorphisms might influence the risk of childhood ALL. Materials and Methods: In a total of 266 patients with childhood ALL and 266 healthy controls, genotypes of MEG3 rs7158663, rs3087918, rs11160608 and rs4081134 single nucleotide polymorphisms were investigated for their associations with childhood ALL. Results: MEG3 rs7158663 AG and AA genotypes were significantly associated with ALL [odds ratio=1.61 (95% confidence interval=1.12-2.31) and 2.21 (1.16-4.22), respectively]. The A allele also exhibited a statistical association with higher risk of ALL (p=0.0015). There was no positive association as for rs3087918, rs11160608 or rs4081134. Interestingly, a significant interaction between MEG3 rs7158663 and age (≥3.5 years) and gender (male) was found. Conclusion: MEG3 rs7158663 AG/AA genotypes were associated with higher susceptibility to childhood ALL. These novel findings should be validated in larger populations and different ethnicities. [ABSTRACT FROM AUTHOR]

Background/Aim: Xeroderma pigmentosum complementation group C (XPC) is reported to play important roles in DNA integrity and genomic instability, however, the contribution of XPC to oral carcinogenesis is largely uncertain. Therefore, we aimed at examining the contribution of XPC genotypes to oral cancer. Materials and Methods: The genotypes of XPC rs2228001 and rs2228000 were examined among 958 oral cancer patients and 958 control subjects by polymerase chain reaction-restriction fragment length polymorphism methodology and corresponding DNA repair capacity was checked. Results: First, the percentages of XPC rs2228001 AC and CC were higher among oral cancer patients than controls. Second, no significant association was observed regarding XPC rs2228000. Third, there was a synergistic influence of smoking and betel quid chewing behaviors and XPC rs2228001 genotype on oral cancer risk. Last, functional experiments showed DNA repair capacity was lower for AC/CC carriers than AA carriers. Conclusion: XPC rs2228001 C allele, which was associated with decreased DNA repair capacity, may interact with smoking and betel quid chewing behaviors on oral cancer risk. [ABSTRACT FROM AUTHOR]

Background: Current principles of postoperative pain management are primarily based on the types and extent of surgical intervention. This clinical study measured patient's self-anticipated pain score before surgery, and compared the anticipated scores with the actual pain levels and analgesic requirements after surgery. Methods: This prospective observational study recruited consecutive patients who received elective surgery in the E-Da Hospital, Taiwan from June to August 2018. Patients were asked to subjectively rate their highest anticipated pain level (numeric rating scale, NRS 0–10) for the scheduled surgical interventions during their preoperative anesthesia assessment. After the operation, the actual pain intensity (NRS 0–10) experienced by the patient in the post-anesthesia care unit and the total dose of opioids administered during the perioperative period were recorded. Pain scores ≥4 on NRS were regarded as being unacceptable levels for anticipated or postoperative pain that required more aggressive intervention. Results: A total of 996 patients were included in the study. Most of the patients (86%) received general anesthesia and 73.9% of them had a history of previous operation. Female anticipated significantly higher overall pain intensities than the male patients (adjusted odd ratio 1.523, 95% confidence interval 1.126–2.061; P = 0.006). Patients who took regular benzodiazepine at bedtime (P = 0.037) and those scheduled to receive more invasive surgical procedures were most likely to anticipate for higher pain intensity at the preoperative period (P < 0.05). Higher anticipated pain scores (preoperative NRS ≥ 4) were associated with higher actual postoperative pain levels (P = 0.007) in the PACU and higher total equivalent opioid use (P < 0.001) for acute pain management during the perioperative period. Conclusion: This observational study found that patients who are female, use regular benzodiazepines at bedtime and scheduled for more invasive surgeries anticipate significantly higher surgery-related pain. Therefore, appropriate preoperative counseling for analgesic control and the management of exaggerated pain expectation in these patients is necessary to improve the quality of anesthesia delivered and patient's satisfaction. [ABSTRACT FROM AUTHOR]

The present study introduced Ren'py software as a digital storytelling (DST) tool to explore the effective use of digital game design learning in promoting critical thinking among high school students. A sample of 46 high school students enrolled in "Thinking Utopia," an elective course in critical thinking for civics education, was put into groups of 3 to 4 for learning activities towards their collaborative designs of DST games. The course stretched across 9 weeks. Students' performance in critical thinking tests was also closely examined using paired‐sample t‐test analysis, which found no significant improvements; however, their interview responses were carefully studied using qualitative analysis and revealed that many of them agreed that the proposed collaborative activities for game script writing and for their collaborative designs of original hurdle questions have stimulated their critical thinking ability and contributed to the development of their other skills such as communication, problem‐solving and media literacy. Lay Description: What is already known about this topic: • Critical thinking is a key 21st century skill for students to arrive at an impartial judgement on controversial issues. • Digital storytelling and its practical value as an emerging technology may contribute to students' ability in critical thinking. • Collaboration and teamwork for design‐based learning may help students achieve deep learning. What this paper adds: • A model course plan on civics education featuring collaborative learning through digital game‐based design. • Further discussions on students' ability in critical thinking and their learning experience in a course involving collaborative design of digital storytelling games. Implications for practice and/or policy: • Collaborative learning through digital storytelling game‐based design may not promote critical thinking among high school students if they failed to initiate active discussions among themselves. • Collaborative learning through digital storytelling game‐based design among high school students may benefit other aspects of their learning, such as their skills in communication, problem‐solving, media literacy and test taking. [ABSTRACT FROM AUTHOR]

Background: The study aims to evaluate the contribution of excision repair cross-complementing group 1 (ERCC1), which plays an important role in genome integrity maintenance, to lung cancer risk. Materials and Methods: ERCC1 rs11615 and rs3212986 genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism analysis and their association with lung cancer risk was examined among 358 lung cancer patients and 716 controls. Results: The proportions of CC, CT and TT for the rs11615 genotype were 43.6%, 41.6% and 14.8% in the case group and 50.0%, 41.1% and 8.9% in the control group, respectively (p for trend=0.0082). Allelic analysis showed that ERCC1 rs11615 T-allele carriers have a 1.32-fold higher risk of lung cancer than wild-type C-allele carriers [95%confidence interval (CI)=1.09-1.60, p=0.0039]. In addition, a significant interaction between the rs11615 genotype and smoking status was observed. Conclusion: The T allele of ERCC1 rs11615 jointly with smoking habits may contribute to a higher lung cancer risk in Taiwan. [ABSTRACT FROM AUTHOR]

Background/Aim: Interleukin-16 (IL-16) is reported to play an important role in inflammation, carcinogenesis and tumoricidal processes, however, the contribution of IL-16 genotype to oral carcinogenesis is still largely unrevealed. Thus, the study aimed to investigate the contribution of IL-16 genotypes to Taiwan oral cancer risk. Materials and Methods: The genotypes of IL-16 rs4778889, rs11556218, and rs4072111 were revealed among 958 oral cancer cases and 958 control subjects by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP). Results: First, the distributions of genotypic (p=0.0004) and allelic (p=0.0001) frequencies of IL-16 rs11556218 were significantly different between the case and control groups. In detail, the frequencies of IL-16 rs11556218 TG and GG were 28.1 and 5.8%, respectively, among oral cancer patients, significantly higher compared to those among controls (25.0% and 2.7%, respectively). Second, no difference was observed regarding IL-16 rs4778889 or IL-16 rs4072111. Last, there was a synergistic effect of betel quid chewing behavior and risky IL-16 rs11556218 genotype on oral cancer risk. Conclusion: The study indicates that the IL-16 rs11556218 G allele synergistically interacts with betel quid chewing behavior, contributing to increased risk of oral cancer in Taiwanese. [ABSTRACT FROM AUTHOR]

Background/Aim: Interleukin-16 has been reported to exhibit tumoricidal effects, however, the contribution of IL-16 genotypes to lung cancer is still largely unrevealed. This study aimed at investigating whether IL-16 genotypes contribute to lung cancer susceptibility. Materials and Methods: IL-16 rs4778889, rs11556218, and rs4072111 genotypic characteristics were determined among 358 lung cancer patients and 716 controls via the polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) methodology. Results: The highlight finding is that the distributions of genotypic (p=8.6E-10) and allelic (p=0.0001) frequencies of IL-16 rs11556218 was significantly different between cases and controls. In detail, the frequencies of IL-16 rs11556218 heterozygous variant TG and homozygous variant GG were 36.6 and 7.3% among the lung cancer patients, significantly higher than those among the controls (22.5% and 2.6%). On the other way, no difference was observed regarding IL-16 rs4778889 or IL-16 rs4072111. Conclusion: The present study indicates IL-16 rs11556218 G allele is significantly associated with increased Taiwan lung cancer risk. [ABSTRACT FROM AUTHOR]

Background/Aim: The present study aimed at evaluating the contribution of IL-4 promoter T-1099G (rs2243248), C-589T (rs2243250), C-33T (rs2070874) genotypes to the risk of breast cancer in Taiwanese. Materials and Methods: A total of 1232 breast cancer patients and 1232 age-matched controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology. Results: Genotypic frequencies of IL-4 rs2243248, rs2243250 and rs2070874 were not differentially distributed between case and control groups. Consistently, there was no difference in the distribution of allelic frequencies among patients and controls. Conclusion: IL-4 rs2243248, rs2243250 and rs2070874 do not confer breast cancer susceptibility in Taiwanese. [ABSTRACT FROM AUTHOR]

Background/Aim: Mounting evidence has shown that miRNAs play a critical role in the regulation of hematopoiesis of cell proliferation and apoptosis as well as in tumorigenesis. The miR146a rs2910164 polymorphism, which is closely responsive for its expression, has been reported to associate with the risk of several solid cancers. The study aimed at examining the association of the it with susceptibility to childhood acute lymphoblastic leukemia (ALL) in Taiwan. Materials and Methods: We recruited 266 patients with childhood ALL and 266 healthy controls, and rs2910164 genotypes were determined by the polymerase chain reaction-restriction fragment length polymorphism methodology. Results: The allele G was associated with decreased childhood ALL risk (OR=0.66, 95%CI=0.52-0.85, p=0.0011). Consistently, the GG genotype was associated with a decreased susceptibility (OR=0.40, 95%CI=0.23- 0.67, p=0.0004). Patients with CG and GG genotypes were of earlier onset than those with CC genotype (p=0.0255 and p=0.0001). Conclusion: MiR146a rs2910164 G allele serves as a protective marker for childhood ALL in Taiwan. [ABSTRACT FROM AUTHOR]

Background/Aim: Matrix metalloproteinase 2 (MMP2) is up-regulated in many cancers. However, the association of MMP2 genotype to nasopharyngeal cancer (NPC) susceptibility in Taiwan remains elusive. Materials and Methods: In this study, the role of MMP2 promoter C-1306T (rs243865) and C-735T (rs2285053) genotypes were investigated among 208 NPC patients and 416 healthy controls, and their role in NPC staging and TNM classifications were examined. Results: There was no differential distribution as for the genotypic or allelic frequencies at MMP2 promoter C-1306T or C-735T between the control and case groups. Noticeably, those with MMP2 C-1306T CT+TT genotypes had a lower metastatic risk than those with CC (p=0.0295). As for staging, T and N classifications, there was no differential distribution in C- 1306T genotypes (p>0.05). Also, there was no differential distribution of C-735T genotypes according to different behavioral/clinicopathological characteristics. Conclusion: CT and TT genotypes at MMP2 C-1306T were associated with a significantly decreased risk of NPC metastasis. [ABSTRACT FROM AUTHOR]

Purpose: A growing body of evidence shows an association between DNA repair protein genotypes and susceptibility to various cancers. However, few studies have assessed the contribution of the genotype of XRCC3, a homologous repair gene, to the occurrence or prognosis of childhood acute lymphoblastic leukemia (ALL). In this study, we investigated the contribution of seven XRCC3 polymorphisms to childhood ALL.Patients and methods: We recruited 266 patients with childhood ALL and 266 healthy controls. Genomic DNA was isolated from peripheral blood samples. The XRCC3 rs1799794, rs45603942, rs1799796, rs861530, rs28903081, rs861539, and rs3212057 polymorphic genotypes of each subject were determined through conventional polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis.Results: Genotypes with the rs861539 polymorphism were significantly associated with the risk of childhood ALL. The allelic distribution analyses suggested a significant association between the T allele at rs861539 with an increased risk of childhood ALL in the Taiwanese population. Polymorphic variants of XRCC3 at rs3212057 or rs28903081 did not exist in the study population. XRCC3 rs1799794, rs45603942, rs1799796, and rs861530 were not significantly associated with the risk of childhood ALL in the Taiwanese population.Conclusion: Our findings suggest that XRCC3 genotypes with polymorphisms at rs861539 may play a role in determining individual susceptibility to childhood ALL in this Taiwanese population. The polymorphism may be a potential detector and predictor of childhood ALL. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the validity and reliability of the Mandarin Chinese version of the Drug Abuse Screening Test (DAST-20) among adolescents, as well as examining the test's predictability with regard to the actual level of drug abuse.Method: A total of 100 adolescent participants were recruited with their consent, in which 49 were current drug users and 51 were non-users. Based on the frequency of their drug use, participants who had used drugs at least once every week during the past year were classified as regular users (34 participants); participants who had not reached the regular use frequency of once every week during the past year were classified as occasional users (15 participants). All of the participants were required to answer a sociodemographic questionnaire, and undergo a DAST-20 (Mandarin Chinese version).Results: The DAST-20, which has a high reliability with a Cronbach's alpha of 0.88, and a construct validity accounting for 61.87% of the variance. The area under the receiver operating characteristics (ROC) curve was 0.96 between the users and nonusers, and 0.93 between the occasional users and non-occasional users. A cut-off of three points could identify 93.5% of the drug users and 88.9% of nonusers, whereas a cut-off of six points could identify 85.3% of the regular users and 92.4% of non-regular users.Conclusions: The DAST-20 was the strongest predictor of adolescents who were regular users, occasional users, and non-users after controlling for other potential covariates. The Mandarin Chinese version of the DAST is simple to use and has a satisfactory validity and reliability. It is an effective screening tool for drug users among adolescents. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of the health promoting school (HPS)-community pharmacist partnership program that promotes students' correct medication use and enhances pain medication literacy in Taiwan.Design: Pre- and post-studies and intervention/comparison group comparisons.Setting: Primary and middle schools, along with their communities, in Taiwan.Participants: In 2013, baseline and follow-up self-administered, online surveys were received from 5,373 students enrolled in intervention primary and middle schools and from 4,643 students enrolled in comparison primary and middle schools.Main Outcome Measure: The level of medication literacy, including correct medication use knowledge, self-efficacy, and skills.Results: The development and implementation of the HPS-community pharmacist partnership program in primary and middle schools significantly enhanced students' knowledge, self-efficacy, and skills in correct medication use and pain medication literacy (P <0.001).Conclusion: The HPS-community pharmacist partnership had a positive impact on enhancing correct medication use and pain medication literacy in Taiwan. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine students' knowledge, attitudes, and behavior regarding the correct use of analgesics and to examine the related factors. Methods: A probability-proportionate-to-size sampling method was used. Thirty-three senior/vocational high schools were randomly selected. A total of 2,910 students completed the online selfadministered questionnaire in 2013. Results: Greater than one-half of the students did not know that when taking pain medication containing acetaminophen, adults should not exceed 4,000 mg per day. Approximately 22.1% of the students were unaware of the hepatotoxicity risk associated with acetaminophen. Multiple regression analysis showed that students in higher grades who had greater levels of correct analgesic knowledge, attitude, and self-efficacy, take analgesic prescriptions and use other pain management techniques, such as hot/cold therapy, relaxation, and massage, and were more likely to demonstrate correct analgesic use behaviors if they had received pain management information from family members and had read the warning labels. In contrast, students taking analgesics from drug stores or family/friends were more likely to practice poor analgesic use behavior. Conclusions: The promotion of partnerships between schools and pharmacists is suggested, along with the implementation of teachers' training workshops, students' education programs, and parent-child activities in order to enhance correct analgesic use literacy. [ABSTRACT FROM AUTHOR]

This study was an evaluation of the Health Promoting School (HPS) program in Taiwan and its effectiveness in enhancing students’ knowledge and abilities with regard to correct medication usage. In 2011, baseline and follow-up self-administered online surveys were received from 3520 middle-school and primary students from intervention schools, and 3738 students from comparison primary and secondary schools completed the same survey. The results indicated that after implementing the correct medication use HPS program, students’ knowledge and abilities concerning correct medication usage (i.e., the need to express clearly personal conditions to physicians, to check information on the medication packages, to take medication correctly and adhere to prescribed medication regimens, not to buy or acquire medication from unlicensed sources, and to consult pharmacists/physicians) were significantly increased among the students in the intervention schools (p < 0.001). In addition, students’ knowledge and abilities concerning correct medication usage were significantly higher in the intervention schools compared with the comparison schools (p < 0.001). In conclusion, the correct medication use HPS program significantly enhanced students’ knowledge and abilities concerning correct medication usage. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to develop Taiwan's Child Health Literacy Test and to undertake a nation-wide survey in order to determine the current status of Taiwanese sixth graders' health literacy, and to understand the association between health literacy, healthy behavior, and health status. Methods: Taiwan's Child Health Literacy Test was developed through the process of concept clarification, a qualitative pilot, a development pilot, and a field test. In the field test, 162,609 sixth graders (56.9%) from 2,235 schools (83.3%) nationwide completed the questionnaire. We also collected the students' dates of birth, BMIs, self-reported health and healthy behaviors. Results: The final test consisted of 32 questions with item discrimination of 0.55~1.89 and item difficulty of -1.7~0.41 according to IRT; Cronbach's α was 0.87. Based on this information, the test was deemed appropriate for basic health literacy screening among children. Nation-wide, the average score for sixth graders' health literacy was 23.97 points (total score 32 points), with a correct rate of 74.9%. Those who were "good" in self-reported health scored highest in health literacy (M = 24.29). Health literacy was significantly positively related to healthy behavior (r = .25, p< .05), and negatively to risky behavior (r = -.28, p< .05). Conclusions: This study was the first curriculum-based child health literacy test developed from the viewpoints of both teachers and pupils in Taiwan through a rigorous procedure. The nationwide survey results may serve as a reference for decision-makers at the national health education level. [ABSTRACT FROM AUTHOR]

The core abilities in correct medication usage was developed in Taiwan through the following stages: literature research and information collection, focus groups and experts meetings to discuss and develop core abilities, disseminate the education activities of these core abilities in 51 schools, and evaluative survey. Forty-four articles were abstracted for reference of voting in the focus groups. The most popular issues related to medication usage and safety were "medications provided by medical or pharmacy experts" and "how to take medications correctly". The experts meetings generated five core abilities of correct medication usages: ability to clearly express personal conditions to your physicians, ability to check information on the medication packages, ability to correctly take medications as prescribed, ability to be the master of yourself in taking medications, and ability to be friends with pharmacists and physicians. 444 teachers and 4035 students participated in the evaluative survey on the core ability of correct medication usage. The education activities implemented enhances the core ability of correct medication usage in the knowledge, attitude, and behaviors of the students and teachers. Each question in the survey was developed with a single correct response and addressed five aspects: knowledge, attitude, practice, actual use of medications, and partnership. The scale has good reliability and validity, with content validity index of 0.91 and the internal consistency reliability above 0.69, the split-half reliability above 0.77, and the test-retest reliability above 0.83. The study concluded that the five core abilities of correct medications usage in Taiwan can enhance the health literacy. Further studies are needed to evaluate the utilization in subjects with different backgrounds or health conditions. [ABSTRACT FROM AUTHOR]

In our attempt to characterize the interaction of trophic coupling between Synechococcus and pigmented nanoflagellates (PNFs), successive size-fraction experiments were performed at a coastal station on the northeast coast of Taiwan from June, 2005 to January, 2006. By estimating the growth rate and grazing rate of Synechococcus in the presence of nanoflagellates of different sizes, we truncated the food web by removing organisms with different body sizes (<2 µm, <5 µm, <10 µm, and <20 µm). The growth rates of Synechococcus ranged from −0.016 to 0.051 h−1 during the experimental period, suggesting that temperature was a primary mechanism controlling Synechococcus growth. In addition to size and relative biomass of pigmented nanoflagellates and Synechococcus, it is suggested that community structures played an important role in trophic link. Furthermore, we conclude that the trophic cascading effect in the northeast coast of Taiwan includes: 1) high grazing rates at night in the warm season; 2) the Synechococcus biomass generally exceeds the grazing threshold (6 × 104 cells mL−1); and 3) the biomass ratio of <5 µm PNFs to >5 µm PNFs should be 1:1 to 2:1. [ABSTRACT FROM AUTHOR]

The integration of teachers" use of technology in their instruction has been given increasing attention and emphasis. The purpose of this study was to discern the association between teachers" characteristics and advanced technology proficiency. The independent variables were gender, years of teaching experience, instructional subject, and number of teachers in each school. The dependent variable was the advanced technology assessment comprised of ten tasks. In addition, the most significant aspect of this study was the originality of data from the teachers' performance in the assessment of advanced technology proficiency conducted by Department of Education of Taichung City Government in Taiwan. The data indicated that teachers' characteristics were weakly associated with teachers' advanced technology proficiency. Finally, suggestions for the institution in charge of this assessment and for future research were provided. [ABSTRACT FROM AUTHOR]

Due to the increasingly various demands on the infrastructure and industrialization for global competition, vocational education in Taiwan is facing the turning point of renovation for its competitiveness. The purpose of this paper is to explore the theoretical structure and curriculum features of vocational education in Taiwan with the former comprised by the cluster-based curriculum and the latter by the school-based curriculum. Cluster-based curriculum not only strengthens students' capability on core courses but also provides more opportunities to allow students to switch their interests. Nevertheless, school-based curriculum has been confronted with several barriers, such as traditional expectation of school functions, the instructional routine, rigidly fixed instructional patterns, and lack of internal and external evaluation mechanism. Finally, the future research focus should dwell more on experimental design in comparing teachers' and students' perspectives toward the curricular changes. [ABSTRACT FROM AUTHOR]

The purpose of our study was to investigate whether genetic variations in lncRNA H19 were associated with susceptibility to childhood leukemia. Two hundred and sixty-six childhood leukemia patients and 266 healthy controls were enrolled in Taiwan, and two single nucleotide polymorphisms (SNPs), rs2839698 and rs217727, in H19 were genotyped and analyzed. There was a significant difference in the genotypic distribution of rs2839698 between patients and healthy controls (p = 0.0277). Compared to the wild-type CC genotype, the heterozygous variant CT and homozygous variant TT genotypes were associated with significantly increased risks of childhood leukemia with an adjusted odd ratio (OR) of 1.46 (95% confidence interval (CI), 1.08–2.14, p = 0.0429) and 1.94 (95%CI, 1.15–3.31, p = 0.0169), respectively (pfor tread = 0.0277). The difference in allelic frequencies between childhood leukemia patients and controls was also significant (T versus C, adjusted OR = 1.53, 95%CI, 1.13–1.79, p = 0.0077). There were no significant differences in the genotypic and allelic distributions of rs217727 between cases and controls. Interestingly, the average level of H19 rs2839698 was statistically significantly higher for patients with CT and TT genotypes than from those with the CC genotype (p < 0.0001). Our results indicate that H19 SNP rs2839698, but not rs217727, may serve as a novel susceptibility marker for childhood leukemia. [ABSTRACT FROM AUTHOR]

The whitefly-transmitted tomato chlorosis vims (ToCV) belonging to ihe genus Crinivirus (family Closteroviridae) affects tomato production worldwide. ToCV was first recorded in Taiwan in 1998 affecting tomato production. In this study, a local virus isolate XS was obtained, after serial whitefly transmissions from a diseased tomato plant displaying general chlorosis were collected in central Taiwan. The whole genome sequence of XS was determined from cDNA fragments amplified by reverse transcription (RT)-PCR. first using the degenerate primers for viruses of Closteroviridae and followed by degenerate and specific primers designed on available sequences of the ToCV isolates. The nucleotide (nt) sequences of RNA-1 and RNA-2 of the XS shared low identities of 77.8 to 78% and 78 to 78.1%, respectively, with genome segments of other ToCV isolates. Nevertheless, the viral RNA-dependent RNA polymerase (RdRp), heat shock protein 70 homolog (Hsp70h), and major capsid protein (CP) shared 88.3 to 96.2% amino acid (aa) identities with other ToCV isolates, indicating that XS is a new strain of this vims. Phylogenetic analyses of these three proteins indicated that all ToCV isolates from different counties outside Taiwan are closely related and clustered in the same clade, whereas the XS isolate is distinct and forms a unique branch. A one tube RT-PCR assay using primers designed from the genomic sequence of the XS was able to detect theToCV-XS in infected tomato plants and in individual whiteflies. A field survey during 2013 to 2016 revealed a highToCV-XS prevalence of 60.5% in 172 tested tomato samples, demonstrating that ToCV-XS is becoming an emerging threat for tomato production in Taiwan. [ABSTRACT FROM AUTHOR]

In this study, the mRNA levels of a diatom nitrate transporter gene, Nrt2 , were investigated in a coastal ecosystem on the western boundary of the northwestern Pacific Ocean. During the period between June 2011 and June 2013, 14 cruises were conducted, and samples were collected for nutrient-manipulation incubations, quantitative polymerase chain reactions (qPCRs), and metatranscriptome construction. Based on metatranscriptomes generated through next-generation sequencing, the dominant diatoms and sequences associated with Nrt2 as well as EFL , a qPCR reference gene, were identified. Next, primer pairs for a dominant bloom-forming diatom, Chaetoceros cf. curvisetus , were designed, and the expression levels of Nrt2 were measured by qPCR in both original (untreated) and nitrogen-deprived samples. By calculating the ratio of Nrt2 expression between these 2 samples, a Log (f Nrt2) index was developed to be used as a molecular indicator of nitrogen demand. At our study site, the nitrate and nitrite concentrations displayed a clear seasonal cycle, with high (8.75 μM) and low (0.05 μM) concentrations occurring in December and June, respectively. The Log (f Nrt2) index also varied with time in 2012, with a high value of approximately −1.44 occurring in October or November; this variation was not in phase with the nitrate trend. The regression analysis indicated that Log (f Nrt2) was inversely correlated with nitrate and nitrite concentrations. On the other hand, Log (f Nrt2) was positively correlated with bacterial abundance. This regression equation properly included values of Log (f Nrt2) that were not well explained by the nitrate and nitrite concentrations. When the Chaetoceros abundance increased, the associated low value of Log (f Nrt2) suggested the repression of Nrt2 by ammonium; apparently, the diatom utilizes ammonium as the nitrogen source to maintain its dominance in the later phase of the bloom. Since bacteria and nanoflagellates are actively involved in the uptake and release of nitrogenous nutrients, these two functional groups also control the expression of Nrt2 through important ecological processes such as competition and regeneration. [Display omitted] • This study investigated the expression level of a nitrate transporter gene, Nrt2 , in a marine diatom. • RNA-Seq was used to identify Nrt2 sequences in a dominant diatom, and the expression of Nrt2 was measured by qPCR. • Local [NO 2 − + NO 3 −] displayed a clear seasonal cycle and influenced Nrt2 expression in the diatom examined. • Bacteria and nanoflagellates correlated with diatom Nrt2 expression, suggesting competition and regeneration effects. [ABSTRACT FROM AUTHOR]

Abstract: The spread of New Delhi metallo-β-lactamase gene (NDM-1)-producing bacteria has become a growing concern to the medical community worldwide. In this study, we reported 4 NDM-1-positive Enterobacteriaceae isolates recovered from two Taiwanese patients having travel history. The β-lactamase genetic background, antimicrobial susceptibility, clonal relationships, and plasmid sizes of the NDM-1-producing Enterobacteriaceae were investigated. This report highlights the alarming introduction of NDM-1 gene among Enterobacteriaceae in Taiwan. [Copyright &y& Elsevier]

Background/aim: Genetic polymorphisms in DNA repair mechanisms can modulate overall DNA repair capacity, potentially influencing individual susceptibility to cancer. This study investigated the relationship between polymorphic variations in DNA ligase 1 and the risk of childhood acute lymphocytic leukemia (cALL)., Materials and Methods: The genotypes of DNA ligase 1 rs20579 were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. The study assessed the potential association between DNA ligase 1 rs20579 genotypes and cALL risk in a Taiwanese cohort, consisting of 266 cALL cases and an equal number of age- and sex-matched controls., Results: The distribution of GG, AG, and AA genotypes for DNA ligase 1 rs20579 was 78.6%, 19.5%, and 1.9% among controls, and 76.0%, 21.4%, and 2.6% among cALL cases, respectively (p for trend=0.7111). No significant difference was observed in the distribution of AG and AA genotypes between the two groups (p=0.6340 and 0.7381, respectively). Allelic frequency analysis revealed that carriers of the variant A allele of DNA ligase 1 rs20579 had a non-significant increase in cALL risk compared to those with the wild-type G allele [odds ratio (OR)=1.17, 95% confidence interval (CI)=0.81-1.68, p=0.4583]. While no significant genotype distribution difference was noted among males (p=0.4635), females carrying the AG and AA genotypes exhibited a significantly increased risk of cALL (p=0.0328)., Conclusion: In the Taiwanese population, the variant A allele of DNA ligase 1 rs20579 may serve as a potential diagnostic marker for elevated cALL risk in young females., (Copyright © 2025, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: Upregulation of matrix metallo-proteinase-8 (MMP-8) serves as a protein-based indicator for predicting nasopharyngeal carcinoma (NPC) metastasis. Nevertheless, the role of MMP-8 genotypes in NPC has never been investigated. This study aimed to explore the involvement of MMP-8 genotypes in NPC development., Materials and Methods: We employed the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique to analyze MMP-8 genotypes, specifically C-799T (rs11225395), Val436Ala (rs34009635), and Lys460Thr (rs35866072), in a Taiwanese cohort comprising 208 NPC cases and 416 healthy controls., Results: Individuals with either heterozygous or homozygous variant genotypes of MMP-8 rs11225395 showed no significant change in NPC risk compared to those with the wild-type genotype [odds ratio (OR)=0.97 and 0.79, 95% confidence intervals (95%CI)=0.68-1.38 and 0.46-1.36; p=0.9304 and 0.4736, respectively]. Similarly, there was no significant association between the heterozygous genotypes of MMP-8 rs34009635 and NPC risk (OR=0.66, 95%CI=0.24-1.84; p=0.5738). For MMP-8 rs35866072, all individuals in the study were of the TT genotype. Furthermore, the presence of variant alleles at MMP-8 rs11225395 or rs34009635 did not result in altered NPC risk (OR=0.91 and 0.66, 95%CI=0.71-1.16 and 0.24-1.84, p=0.4876 and 0.5769, respectively). Additionally, no significant association was observed between MMP-8 rs11225395 variant genotypes and NPC risk among individuals regardless of smoking, alcohol consumption, or betel quid chewing habits (all p>0.05)., Conclusion: There was no association between the MMP-8 genotypes rs11225395, rs34009635, or rs35866072 and NPC risk among Taiwanese individuals. Moreover, no combined effects of MMP-8 genotype with smoking, alcohol consumption, or betel quid chewing habits on NPC risk were observed., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: In current literature, there is a notable lack of studies investigating the role of radiation-sensitive protein 51 (RAD-51) in pterygium diagnosis. Nevertheless, reports indicate elevated expression levels of RAD-51 among recurrent pterygium cases compared to those with primary pterygium. However, the genomic involvement of RAD-51 has yet to be explored in any population. This study aimed to assess the contribution of RAD-51 genotypes to pterygium risk in a representative Taiwanese population., Materials and Methods: RAD-51 rs1801320 genotyping was successfully conducted in a Taiwanese cohort comprising 140 pterygium cases and 280 non-pterygium controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology., Results: The distribution of RAD-51 rs1801320 genotypes (GG, CG, and CC) in the pterygium group (70.0%, 25.7%, and 4.3%, respectively) did not significantly differ from that in the non-pterygium group (73.6%, 23.6%, and 2.8% for GG, CG, and CC genotypes, respectively; p for trend=0.6337). Carriers of the variant CG and CC RAD-51 rs1801320 genotypes exhibited 1.15- and 1.58-fold increased pterygium risk, respectively (95%CI=0.72-1.84 and 0.53-4.67, p=0.6552 and p=0.5914, respectively). In the dominant model, there appeared to be a slight association between variant genotypes CG and CC and pterygium risk (OR=1.19, 95%CI=0.76-1.87, p=0.0223). Allelic analysis revealed that the RAD-51 rs1801320 variant C allele was not significantly linked to pterygium risk (17.1% versus 14.6%, OR=1.20, 95%CI=0.82-1.78, p=0.3991)., Conclusion: Variant genotypes at RAD-51 rs1801320 were firstly identified to associate with susceptibility to pterygium among Taiwanese individuals. Nonetheless, these findings warrant validation in larger and more diverse populations., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: The up-regulation of matrix metalloproteinase-9 (MMP-9) expression is a characteristic feature observed across various malignancies, including nasopharyngeal carcinoma (NPC). Nevertheless, the influence of MMP-9 genotype in the context of NPC remains underexplored. This study examined the implications of MMP-9 promoter rs3918242 genotypes on the susceptibility to NPC in Taiwan., Materials and Methods: In a cohort comprising 208 NPC cases and 416 healthy controls, genotyping of MMP-9 rs3918242 was conducted utilizing polymerase chain reaction-restriction fragment length polymorphism methodology., Results: Individuals harbouring the variant CT or TT genotype of MMP-9 rs3918242 did not demonstrate a discernible alteration in NPC risk when compared to wild-type CC carriers [odds ratio (OR)=0.83 and 0.79, with 95% confidence intervals (95%CI)=0.56-1.24 and 0.27-2.29; p=0.4205 and 0.8675, respectively]. Moreover, the presence of the variant T allele did not confer a modified risk of NPC (OR=0.84, 95%CI=0.60-1.19, p=0.3761). Intriguingly, a protective effect associated with the MMP-9 rs3918242 CT genotype against NPC risk was discerned among individuals abstaining from betel quid chewing behaviour (OR=0.51, 95%CI=0.30-0.87, p=0.0166). Notably, no significant association was established between the MMP-9 rs3918242 CT or TT genotype and NPC risk among individuals with or without smoking or alcohol consumption habits., Conclusion: Presence of the variant CT or TT genotype at MMP-9 rs3918242 did not appear to substantially contribute to an elevated risk of NPC. Notably, a protective effect against NPC risk was observed in individuals carrying the CT genotype, particularly in those abstaining from betel quid chewing., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: The activity and expression of matrix metalloproteinase-7 (MMP7) have been found to be upregulated in the late stages of endometriosis. However, the contribution of MMP7 genotype to endometriosis has seldom been examined. This study aimed to investigate the role of MMP7 promoter A-181G (rs11568818) and C-153T (rs11568819) genotypes in determining personal susceptibility to endometriosis in a Taiwanese cohort., Patients and Methods: In this hospital-based case-control study, MMP7 genotypes were analyzed in 153 endometriosis and 636 individuals without endometriosis using typical polymerase chain reaction-restriction fragment length polymorphism methodology., Results: The statistical analysis revealed that MMP7 rs11568818 genotypes were differentially distributed between the endometriosis and control groups (p for trend=0.0048). Specifically, the MMP7 rs11568818 homozygous variant GG was associated with endometriosis risk compared to the wild-type AA genotype (OR=4.59, 95% CI=1.46-14.48, p=0.0136). However, the MMP7 rs11568818 heterozygous variant AG was not associated with endometriosis risk (OR=1.57, 95% CI=0.97-2.53, p=0.0854). The frequency of than variant allele G of MMP7 rs11568818 was 12.7% in the endometriosis group, significantly higher than the 7.2% observed in the control group (OR=1.90, 95% CI=1.27-2.82, p=0.0021)., Conclusion: MMP7 rs11568818 GG genotype was found to be a novel marker for endometriosis risk in Taiwanese., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: Hallux valgus (HV) is the most prevalent deformity affecting the forefoot; however, its genetic etiology remains unclear. In the literature, vitamin D receptor (VDR) genotypes have been reported to be associated with the risk of skeletal malformations accompanied by inflammation. This study aimed to examine the hypothesis that VDR genotypes are associated with the risk of HV., Materials and Methods: The VDR rs731236, rs1544410, rs2228570 and rs7975232 genotypes of 150 HV patients and 600 non-HV subjects were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology and examined regarding their associations with HV risk., Results: The results showed that none of the genetic frequency distributions of VDR rs731236, rs1544410, rs2228570, or rs7975232 were significant between the HV cases and non-HV controls (p for trend=0.4055, 0.2170, 0.7220, 0.5509, respectively). Additionally, allelic frequency analysis showed that none of the allelic frequencies of VDR rs731236, rs1544410, rs2228570, or rs7975232 were significantly distributed (p=0.2285, 0.1572, 0.9278, and 0.5547, respectively). Furthermore, stratified analysis showed that no correlation was observed between VDR rs731236 and different age groups (either younger or older than 51) or sex (p=0.3953 and p=0.9576). Moreover, no correlation was found between VDR rs731236 genotype and the risk of HV in individuals within subgroups of height, weight, or body mass index (BMI) (p=0.8317, 0.5346, and p=0.8783, respectively)., Conclusion: VDR rs731236, rs1544410, rs2228570, and rs7975232 may not serve as indicators for a higher risk of HV., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Introduction: Most standardized patients (SPs) in Taiwan are middle-aged or older volunteers with a high retention rate and selflessly devote themselves to the service. This study explored the psychological process behind the continued altruistic behaviors of SPs to understand the formation of service motivation, professional identity, and internal transformation., Methods: Sixteen volunteers, aged 50 to 70 years, who served as SPs for 3 to 11 years in a religious hospital were enrolled in this study. Individual semistructured interviews were conducted. Each person was interviewed for approximately 120 minutes. We used a thematic analysis to analyze the interview transcripts., Results: We identified 3 major themes and 8 subthemes. The first theme, SPs' service motivation, included the following 3 subthemes: past medical experiences, acquisition of medical knowledge, and emotional connections. The second theme, SPs' identity formation, included the following 3 subthemes: role recognition, work ethic, and a sense of religious mission. The third theme, SPs' physical and psychological support, included 2 subthemes: internal transformation and personal well-being., Conclusions: The interview results showed doctor-patient or life experiences served as the impetus prompting SPs to engage in such altruistic behavior. In addition, identity formation endowed older SPs with a life purpose and a sense of fulfillment and self-actualization through fostering and training medical students. In addition, a clear recognition of the role of an SP and self-worth helped volunteers mitigate any physical and mental problems caused by negative life experiences. Standardized patients continued to complete their tasks with a positive attitude., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society for Simulation in Healthcare.)

Background/aim: Renal cell carcinoma (RCC) presents a formidable clinical challenge due to its aggressive behavior and limited therapeutic options. Matrix metalloproteinase-8 (MMP-8) has recently emerged as a potential biomarker and therapeutic target for various cancers. However, the genetic involvement of MMP-8 in RCC has remained largely obscure. This study aimed to elucidate the role of MMP-8 genotypes in RCC susceptibility., Materials and Methods: The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was employed to scrutinize the genotypes of MMP-8 C-799T (rs11225395), Val436Ala (rs34009635), and Lys460Thr (rs35866072) among 118 RCC patients and 590 controls. Furthermore, potential associations between MMP-8 genotypes and age, sex, smoking, alcohol consumption, hypertension, diabetes, and family history status in relation to RCC risk were assessed., Results: No significant disparities in the distribution of MMP-8 rs11225395, rs34009635, and rs35866072 genotypes were observed between the RCC case and control cohorts (p>0.05). Individuals with CT and TT genotypes at MMP-8 rs11225395 exhibited 0.86- and 0.80-fold RCC risks, respectively (OR=0.57-1.31 and 0.42-1.55, p=0.5585 and 0.6228, respectively). Intriguingly, hypertensive individuals carrying the MMP-8 rs11225395 CT or TT genotype demonstrated an elevated risk for RCC compared to those with wild-type CC genotype (p=0.0440). No interactions of MMP-8 genotypes with age, sex, smoking, alcohol consumption, or diabetes status were evident (all p>0.05). No significant association was discerned for MMP-8 rs34009635 or rs35866072 genotypes., Conclusion: MMP-8 genotypes appear to have a modest influence on individual susceptibility to RCC. Hypertensive patients with the CT or TT MMP-8 rs11225395 genotype may have an elevated risk of RCC., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: In the literature, the studies about the role of matrix metalloproteinase-2 (MMP-2) in pterygium diagnosis are mainly based on its protein expression. The role of MMP-2 variants has never been examined. The aim of this study was to examine the association of MMP-2 genotypes with pterygium risk., Materials and Methods: MMP-2 rs243865 and rs2285053 were genotyped in 140 pterygium cases and 280 non-pterygium controls by typical polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genotyping technology., Results: The genotypic frequency of MMP-2 rs243865 CC, CT and TT were 86.4%, 12.9% and 0.7% in the pterygium group and 81.1%, 17.1% and 1.8% in the non-pterygium group (p for trend=0.3389). The variant CT and TT carriers had a 0.70- and 0.38-fold pterygium risk (95%CI=0.39-1.26 and 0.04-3.25, p=0.2982 and 0.6686, respectively). As for MMP-2 rs2285053, the genotypic frequency of CC, CT and TT were 67.1%, 28.6% and 4.3% in the pterygium group, non-significantly different from those in non-pterygium group (p for trend=0.7081). The CT and TT carriers had a 0.88- and 0.71-fold pterygium risk (95%CI=0.56-1.38 and 0.27-1.88, p=0.6612 and 0.6456, respectively). The allelic analysis results showed that MMP-2 rs243865 variant T allele was not associated with pterygium risk (7.1% versus 10.4%, OR=0.67, 95%CI=0.39-1.13, p=0.1649). As for MMP-2 rs2285053, the T allele was not associated with pterygium risk either (18.6% versus 21.1%, OR=0.85, 95%CI=0.59-1.23, p=0.4136)., Conclusion: The genotypes at MMP-2 rs243865 or rs2285053 played minor role in determining individual susceptibility for pterygium among Taiwanese., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: This study aimed to investigate the involvement of matrix metalloproteinase-8 (MMP-8) genotypes in the development of colorectal cancer (CRC)., Materials and Methods: The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to analyze the genotypes of MMP-8 C-799T (rs11225395), Val436Ala (rs34009635), and Lys460Thr (rs35866072) in 362 patients with CRC and 362 controls. Additionally, the potential associations between these genotypes and factors such as age, sex, smoking, alcohol consumption, and body mass index (BMI) status in relation to CRC risk were also assessed., Results: No significant differences in the distribution of MMP-8 rs11225395 genotypes were found between the control and case groups (p for trend=0.3836). Logistic regression analysis demonstrated that individuals with the MMP-8 rs11225395 variant CT and TT genotypes had a 0.83 and 0.77-fold risk of CRC, respectively. Moreover, carriers of the rs11225395 CT+TT genotypes were not associated with CRC risk either (p=0.2063). Furthermore, individuals with the MMP-8 rs11225395 TT genotype exhibited significantly lower odds of CRC risk compared to those with the CC genotype among non-smokers (p=0.0379). No significant associations were observed with respect to MMP-8 rs34009635 or rs35866072., Conclusion: The analyzed genotypes of MMP-8 play a minor role in determining individual susceptibility to CRC risk., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: Impaired non-homologous end-joining DNA repair capacity may have a significant role in maintaining genome integrity and triggering carcinogenesis. However, the specific impact of DNA ligase 4 (Lig4) genotypes remains unclear. This study aimed to assess the contribution of Lig4 genotypes to the risk of developing lung cancer., Materials and Methods: Polymerase chain reaction-restriction fragment length polymorphism analysis was used to examine the genotypes of Lig4 rs1805388, and their association with lung cancer risk was evaluated in a case-control study consisting of 358 lung cancer cases and 716 age- and sex-matched cancer-free control subjects., Results: The distribution of CC, CT, and TT genotypes for Lig4 rs1805388 among the cases was 45.0%, 41.6%, and 13.4%, respectively, compared to 58.0%, 36.3%, and 5.7% among the controls (p for trend=1.98×10 -6 ). Allelic analysis indicated that individuals carrying the T-allele for Lig4 rs1805388 had a 1.66-fold higher risk of developing lung cancer compared to those carrying the wild-type C-allele [95% confidence interval (CI)=1.36-2.02, p=4.04×10 -7 ]. Moreover, a significant interaction was observed between the Lig4 rs1805388 genotype and smoking status (p=1.32×10 -7 )., Conclusion: These findings suggest that the CT and TT variant genotypes of Lig4 rs1805388, combined with cigarette smoking, may contribute to a higher risk of developing lung cancer., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)