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新世代年輕人有獨特的習性、特質和價值觀念，即便才進入大專校院就讀，卻總是對學習顯得興趣缺缺。其實若能找到他們喜歡的教學方法，他們是樂於學習的。本研究目的即在瞭解喚起新世代年輕人的學習動機因素及其喜歡的教學方法，並探討不同科系領域和就讀地區是否有差異存在。本研究從文獻探討和六場焦點團體訪談結果自編問卷，經信度與效度檢核後，讓新世代年輕人評估相關因素的重要程度與落實程度，並且勾選喜歡的教學方法，二階段施測，回收有效問卷999份，使用相依樣本平均數t檢定、單因子多變量分析、多群組潛在結構模式等分析發現：一、喚起新世代年輕人的學習動機有實踐互動、系統講述、適性關懷、成果期待等因素，他們對這些因素大多感到非常重要或重要，至於落實程度只覺得有時如此或普通，重要程度得分均顯著高於落實程度得分。二、不同科系領域學生對於喚起學習動機因素的落實程度有顯著差異，經比較發現，人文社會領域實踐互動因素落實程度較高，而成果期待因素則是科技領域較高，至於不同就讀地區學生沒有顯著差異。三、新世代年輕人大 多喜歡「講述&專題」和「講述&小組」教學方法，且相較之下，人文社會領域較喜歡遊戲競賽和戶外參訪體驗，而科技領域則是教師講述、專題實作／個案研究／問題解決、練習法，顯示不同科系領域有不同教學需求喜好，至於不同就讀地區，學生則沒有顯著差異。 Motivation and Purpose A new generation of young people is entering tertiary institutions. These people have distinct traits and values and tend to exhibit limited interest in learning. For this population, motivation for learning is a crucial topic because it stimulates fundamental engagement in learning activities, sustaining them until successful outcomes are achieved. Taiwan’s tertiary institutions are being affected by Taiwan’s low birth rate, international competition, globalization, mobility issues, and a lack of learning motivation among students. Learning motivation is a key factor in determining whether students can adapt to higher education. Students are willing to learn when they are exposed to an engaging teaching method or when their motivation is stimulated. This study argues that the characteristics of a given subject area must be considered when developing strategies for motivating learning or implementing teaching. The research objectives of this article are as follows: (1) To assess the importance and implementation levels of various motivational factors for the new generation of young people and to further understand the differences between importance and implementation levels; (2) To explore the differences in the motivational factors within various fields and areas of study; and (3) To explore the differences in preferred teaching methods within various fields and areas of study and to compare preferences between students from different localities. Literature Review Most scholars agree that within each generation, academic goals, interests, skills, and core ideas are influenced by changes in the social environment and technological advancements. In general, the various generations can be divided into four groups: Baby Boomers, Generation X, Generation Y, and Generation Z. The current study focuses on Generation Z. According to the literature, teachers should encourage Generation Z students to take an active role in their learning. Notably, they do not want to passively accept knowledge and information, and they are easily distracted. Therefore, teachers must identify methods to attract their attention. However, learning content must be appropriately challenging (i.e., neither excessively difficult nor easy), otherwise Generation Z students will feel frustrated and bored. Finally, these students want to apply what they learn in their daily lives. Additionally, they expect teachers to adapt their teaching methods and activities in accordance with the learning levels of students. As a result, these students are often dissatisfied with traditional methods of knowledge delivery, preferring teachers who present curriculum knowledge in a systematic and specific manner. They particularly prefer interactive teaching methods, such as small group cooperative learning, thematic research, games and competitions, interviews, and the integration of technology into the teaching process. The Ministry of Education applied the SCED-F 2013 framework to classify academic subjects by intrinsic attributes. This study analyzes differences in motivational factors and preferred teaching methods between students. The International Standard Classification of Education was used to categorize students. Methodology A questionnaire was developed on the basis of a literature review and six focus group interviews. The validity and reliability of the questionnaire was evaluated. Respondents were asked to evaluate the importance and level of implementation of various initiatives, as well as their preferred methods of teaching. Generation Z individuals born between 1996 and 2012 who had attended a tertiary institution were enrolled in this study. The questionnaire was administered in two stages. The first stage involved an online questionnaire. The sampling method was based on Ministry of Education statistics, which were used to select colleges and universities in accordance with the distribution of university students across northern, central, southern, and eastern Taiwan and the outlying islands of Taiwan. Respondents were then selected in accordance with the distribution of students enrolled in various fields of studies within these institutions. In the second stage, paper-based questionnaires were administered. Teachers or students from relevant departments with low student proportions were contacted to assist in the distribution of these questionnaires. In total, 1,119 questionnaires were collected in the second stage, with 999 deemed valid. Invalid questionnaires comprised those with age inaccuracies, consecutive identical responses, or missing responses on an entire side of the questionnaire. The results were analyzed by performing the paired-samples t-test, multivariate analysis of variance, and multiple group latent class analysis. Results The learning motivation of the respondents was characterized by an interactive and practical approach, which can be leveraged to enhance their motivation for learning. The key elements of learning motivation include practical interaction, systematic presentation, tailoring to students’ needs, and the expectation of tangible results. Most of them perceived these factors as relevant and significant. However, the level of implementation was mediocre and ordinary, with the scores on the importance of these factors being notably higher relative to those on their implementation. A significant difference in implementation level was identified across disciplines. Specifically, implementation levels were significantly higher in the field of humanities and social sciences. By contrast, the level of outcome expectations was higher in the field of science and technology. The implementation level among participants from different study localities was not significantly different. The respondents preferred a combination of lectures and projects as well as lectures and group work. Humanities and social sciences students preferred games, competitions, and outdoor activities, whereas science and technology students preferred lectures by teachers, project work, case studies, and problem-solving activities. The study revealed that teaching needs varied across disciplines and that students’ preferences did not significantly differ among localities. Recommendations (1) Because of the distinct habits of the younger generation, implementing learning motivation factors that they value to effectively promote learning engagement is crucial. (2) The intrinsic characteristics of each discipline must also be considered when developing teaching activities. (3) Future research can examine the differences between awareness and implementation or expand the analysis by including additional samples or variables

Abstract Thyroid dyshormonogenesis (TDH) is responsible for 15%–25% of congenital hypothyroidism (CH) cases. Pathogenetic variants of this common inherited endocrine disorders vary geographically. Unraveling the genetic underpinnings of TDH is essential for genetic counseling and precise therapeutic strategies. This study aims to identify genetic variants associated with TDH in Southern Taiwan using whole exome sequencing (WES). We included CH patients diagnosed through newborn screening at a tertiary medical center from 2011 to 2022. Permanent TDH was determined based on imaging evidence of bilateral thyroid structure and the requirement for continuous medication beyond 3 years of age. Genomic DNA extracted from blood was used for exome library construction, and pathogenic variants were detected using an in‐house algorithm. Of the 876 CH patients reviewed, 121 were classified as permanent, with 47 (40%) confirmed as TDH. WES was conducted for 45 patients, and causative variants were identified in 32 patients (71.1%), including DUOX2 (15 cases), TG (8 cases), TSHR (7 cases), TPO (5 cases), and DUOXA2 (1 case). Recurrent variants included DUOX2 c.3329G>A, TSHR c.1349G>A, TG c.1348delT, and TPO c.2268dupT. We identified four novel variants based on genotype, including TSHR c.1135C>T, TSHR c.1349G>C, TG c.2461delA, and TG c.2459T>A. This study underscores the efficacy of WES in providing definitive molecular diagnoses for TDH. Molecular diagnoses are instrumental in genetic counseling, formulating treatment, and developing management strategies. Future research integrating larger population cohorts is vital to further elucidate the genetic landscape of TDH.

Background: Few data are available on the tolerance of reirradiation in patients with hepatocellular carcinoma (HCC). This study determined the clinical parameters contributing to the development of radiation-induced liver disease (RILD).Methods: We included 36 patients with HCC who received 2 courses of radiotherapy (RT) to the liver. Using α/β = 15 for tumor and α/β =8 for normal liver tissue for biologically equivalent doses in 2 Gy fractions, mean cumulative to the hepatic tumor and normal liver were 87.7 Gy15 and 31.1 Gy8, respectively. Hepatic toxicities were classified according to the Common Terminology Criteria for Adverse Events, Version 4.0. Clinical data, including liver function test results, radiological study findings, and RT parameters before and after both courses of RT were retrieved for analysis. Using multivariate analysis, logistic regression was used to identify the predictors of RILD, and Cox regression was performed to explore the prognostic factors for overall survival (OS).Results: Thirteen patients (36 %) developed RILD after reirradiation. Nine of them died because of progressive liver failure without evidence of tumor progression and were categorized to have lethal RILD. A pretreatment Child-Turcotte-Pugh (CTP) score ≥6 was the only predictor of RILD [odds ratio (OR): 15.83, p = 0.001] and lethal RILD [OR: 72.56, p = 0.005]. In addition, a CTP score ≥6 and the presence of portal vein tumor thrombosis before reirradiation were 2 prognostic factors for OS.Conclusion: Despite a limited sample size, residual liver function using a preirradiation CTP score ≥6 is a clinical parameter associated with an increased risk of RILD in patients requiring hepatic reirradiation. [ABSTRACT FROM AUTHOR]

The various types of communication technologies and mobility features in IoT on one hand enable fruitful and attractive applications, but on the other hand facilitate malware propagation, thereby raising new challenges in handling IoT-empowered malware for cyber security. Compared to the malware propagation control scheme in traditional wireless networks, where nodes can be directly repaired and secured, in IoT, compromised end devices are difficult to patch. Alternatively, blocking malware via patching intermediate nodes turns out to be a more feasible and practical solution. Specifically, patching intermediate nodes can effectively prevent the proliferation of malware propagation by securing infrastructure links and limiting malware propagation to local device-to-device dissemination. This article proposes a novel traffic-aware patching scheme to select important intermediate nodes to patch, which applies to the IoT system with limited patching resources and response time constraint. Experiments on real-world trace datasets in IoT networks are conducted to demonstrate the advantage of the proposed traffic-aware patching scheme in alleviating malware propagation. [ABSTRACT FROM PUBLISHER]

Abstract Background The tumour microenvironment (TME) is a specialised niche involving intercellular communication among cancer cells and various host cells. Among the host cells, the quantity and quality of immune cells within the TME play essential roles in cancer development and management. The immunologically suppressive, so‐called ‘cold’ TME established by a series of tumour–host interactions, including generating immunosuppressive cytokines and recruiting regulatory host immune cells, is associated with resistance to therapies and worse clinical outcomes. Main body Various therapeutic approaches have been used to target the cold TME, including immune checkpoint blockade therapy and adoptive T‐cell transfer. A promising, less explored therapeutic strategy involves targeting TME‐associated exosomes. Exosomes are nanometer‐sized, extracellular vesicles that transfer material from donor to recipient cells. These particles can reprogram the recipient cells and modulate the TME. In particular, exosomes from haematopoietic cells are known to promote or suppress cancer progression under specific conditions. Understanding the effects of haematopoietic cell‐secreted exosomes may foster the development of therapeutic exosomes (tExos) for personalised cancer treatment. However, the development of exosome‐based therapies has unique challenges, including scalable production, purification, storage and delivery of exosomes and controlling batch variations. Clinical trials are being conducted to verify the safety, feasibility, availability and efficacy of tExos. Conclusion This review summarises our understanding of how haematopoietic cell‐secreted exosomes regulate the TME and antitumour immunity and highlights present challenges and solutions for haematopoietic cell‐derived exosome‐based therapies.

Background/purpose: There is controversial evidence on the best choice for root-end filling materials in follow-up periods and treatment protocols. The purpose of this study was to evaluate the effectiveness of different root-end filling materials in modern surgical endodontic treatment. Materials and methods: A total of 16 studies with a minimum follow-up of 12-months were qualified to be reviewed, involving randomized control trials and observational studies in PubMed, Cochrane library and Scopus until September 1, 2021. The outcome of modern surgical endodontic treatment was assessed based on clinical and radiographic success. Direct comparisons were combined to estimate indirect comparisons, and the estimated effect size was analyzed using the odds ratio (OR). The comparative effectiveness of all materials for target outcomes were shown as P-score. Results: Within this network meta-analysis, mineral trioxide aggregate (MTA) had superior effects among all root-end filling materials at 12-months follow-up. (MTA: OR, 2.03; 95% CI, 0.84–4.91; P-score, 0.86; reference material, gutta-percha). In further sensitivity analyses, MTA, calcium silicate-based root repair material (RRM) and super EBA cement (Super EBA) were associated with significantly higher success rates at 12-months follow-up. (MTA: OR, 5.62; 95% CI, 1.58–19.99; P-score, 0.88; RRM: OR, 5.23; 95% CI, 1.05–25.98; P-score, 0.74; Super EBA: OR, 3.99; 95% CI, 1.06–15.04; P-score, 0.54; reference material, gutta-percha). Conclusion: MTA remains the best choice for root-end filling materials of modern surgical endodontic treatment at the 12-month follow-up. Comparative randomized clinical trials in the long-term follow-up are warranted in future investigations.

Supergiant shells (SGSs) are the largest interstellar structures where heated and enriched gas flows into the host galaxy’s halo. The SGSs in the Large Magellanic Cloud (LMC) are so close that their stars can be resolved with ground-based telescopes to allow studies of star-formation history. Aiming to study the star formation history and energy budget of LMC 4, we have conducted a pilot study of the cluster NGC 2021 and the OB associations in its vicinity near the south rim of LMC 4. We use the Magellanic Cloud Photometric Survey data of the LMC to establish a methodology to examine the stellar population and assess the massive star formation history. We find a radial procession of massive star formation from the northwest part of the OB association LH79 through NGC 2021 to the OB association LH78 in the south. Using the stellar content of NGC 2021 and the assumption of Salpeter’s initial mass function, we estimate that ∼4 supernovae have occurred in NGC 2021, injecting at least 4 × 10 ^51 erg of kinetic energy into the interior of LMC 4.

The public in southwestern Taiwan’s Kaohsiung City have expressed concern over risk of arsenic (As) to people living in six villages of that city nearby a coastal heavy-industrial area. To investigate, we first analyzed urinary total As (TAs) levels in 328 adult subjects from the Nutrition and Health Survey in Taiwan in 2005-2008 (NAHSIT 2005-8). We found the top three highest median urinary TAs levels in residents from the Penghu islands (150.90 µg/L, n = 21) and the upper northern region (78.04 µg/L, n = 56) and the southern region (75.21 µg/L, n = 33) of Taiwan. Then, urinary TAs levels in 1,801 and 1,695 voluntary adult residents of the above-mentioned six villages in 2016 and 2018 respectively were compared with those from the top three highest TAs levels of NAHSIT 2005-8. Median urinary As levels were 84.60 µg/L in 2016 and 73.40 µg/L in 2018, similar to those in the southern region of Taiwan, but far below those in the Penghu islands (p < 0.05). Finally, in 2020, we interviewed 116 healthy adult residents from the same six villages and analyzed one-spot urine samples of total inorganic-related As (TiAs), a summation of As3+, As5+, monomethylarsonic acid, and dimethylarsinic acid. Subjects consuming seafood 2 days before urine sampling (n = 15) were significantly higher TiAs levels than those not (n = 101, p = 0.028). These findings suggest that seafood consumption is probably the main source of urinary TAs and TiAs in people residing close to that coastal heavy-industrial area.

The conjugates of gold nanorods and the model drug, fluorescein isothiocyanate (FITC), embedded inside polyelectrolytes (GNRs/FITC@PLE) were synthesized to study the release kinetics of FITC under femtosecond near-infrared (NIR) laser irradiation. The optical and structural properties of GNRs/ FITC@PLE conjugates before and after laser treatments were examined using UV-vis spectroscopy, confocal microscopy, and transmission electron microscopy (TEM). The release of FITC from the conjugates was induced by the heat generated from gold nanorods under laser irradiation. The concentration of released FITC was measured as the time of continuous and periodic laser irradiation was varied. Within 5 mm of the laser exposure, the release rates of FITC exhibited zero-order and first-order kinetics under continuous and periodic irradiation, respectively. Furthermore, a drug release system was designed based on the conjugates of gold nanorods and the anticancer drug, paclitaxel (PTX), embedded inside polyelectrolytes (GNRs/PTX@PLE). The conjugates were applied for in vitro studies with breast cancer cells. The release of PTX from the conjugates was triggered by NIR laser irradiation, and the inhibition rates of the cells showed strong dependencies on the irradiation modes and time. The results suggested that the multiple releases of PTX from the conjugates can be controlled by laser irradiation within a long period of time. Our system holds great potential for future therapeutic applications on breast cancers. [ABSTRACT FROM AUTHOR]

Background/Purpose: The FUT2 gene is a histo-blood group antigen (HBGA) that determines the susceptibility to Norovirus (NoV) infection. This study investigated the clinical significance of the FUT2 gene profile and HBGA expression in NoV infection. Methods: Fecal specimens were collected from children in Chang-Gung Children's Hospital with acute gastroenteritis (AGE). The medical records were reviewed for clinical data. The viral etiology of gastroenteritis was validated using molecular methods. Genomic DNA was isolated from saliva or whole blood with the Puregene B Kit, according to the manufacturers' instructions. Single-nucleotide polymorphisms (SNPs) were determined by real-time PCR assays. Results: FUT2 gene DNA was examined in 98 children with AGE. NoV was detected by RT-PCR in 44 patients (44.8%), while 54 (55.2%) had non-NoV AGE. Of the 44 NoV patients, 38 (86.3%) were secretors (no G428A mutation) and six (13.7%) were non-secretors (G428A mutation). Of the 54 non-NoV AGE patients, 28 (51.9%) were secretors and 20 (48.1%) were non-secretors. NoV-infected patients who were secretors had more frequent vomiting (P

Background: The ingestion of multiple magnets may lead to severe complications including bowel obstruction, perforation, fistula, peritonitis, short bowel syndrome, life-threatening injuries, and even death. The annual case number of high-powered neodymium magnets ingestion has been increasing in the western world and the dearth of available data demonstrates that this issue has been neglected in Taiwan. Methods: We searched the electronic medical records of our institution for patients younger than 18 years old who were diagnosed with, who had ever visited our emergency department, or been hospitalized for magnetic foreign body ingestion between January 2009 and March 2018. Demographic data including the number, shape, and size of magnets ingested, the clinical presentation, type of intervention, and complications were reviewed. Results: Thirteen patients who met the enrollment criteria were analyzed. One patient was documented between 2009 and 2013, and twelve were documented between January 2014 and March 2018. Five of the cases documented between 2014 and 2018 had ingested Buckyballs. The median age of the patients was 5 years. All of the patients with clinical symptoms had ingested more than one magnet and required endoscopic or surgical intervention. Bowel perforation or deep ulcer with impending perforation was found in three patients during surgery. Conclusion: The number of children who visited our emergency department or were hospitalized due to the ingestion of magnets has increased recently. The presence of high power of neodymium magnets in many products increases the risk of ingesting multiple magnets resulting in serious complications. Therefore, stricter policies are needed to prevent children from obtaining products that contain magnets.

Abstract Prediabetes increased risk of diabetes and diabetes‐related macrovascular and microvascular complication. Glycohemoglobin (HbA1c) is clinically used as the gold standard for glycemic control of diabetes. Glycated albumin (GA) is an early Amadori‐type glycation protein between glucose and serum albumin, which changes in a shorter period of time than HbA1c and is superior to HbA1c in reflecting fluctuations in blood glucose. In this study, we aim to assess the predictive value of GA and glycohemoglobin (HbA1c) on a progression of diabetic retinopathy (DR) in prediabetic patients in Taiwan. This study was conducted at the outpatient department of a regional hospital in Southern Taiwan, and recruited 291 patients with prediabetes from January 2016 to February 2017. Blood and urine samples were obtained from all patients after fasting for 12 hours within 1 month of enrollment. The mean age is 62.5 ± 13.0 years and there are 161 males and 130 females. A total of 24.1% of patients have DR. The average value of GA and HbA1c are 14.6% ± 2.8% and 6.0% ± 0.4%, respectively. Old age, male, high systolic blood pressure, high HbA1C, and low total cholesterol are significantly associated with DR in patients with pre‐DM. Therefore, in the prediabetic populations, high HbA1C, but not GA nor GA/HbA1C ratio, is significantly associated with DR.

Background/Purpose: The diagnostic and therapeutic benefits of double-balloon enteroscopy (DBE) in adults are established, but few data are available on pediatric patients. The aim of this study was to evaluate the clinical efficacy and safety of DBE in pediatric patients in Taiwan. Methods: From April 2005 to September 2015, DBE procedures performed for diagnosis or therapy of small-bowel disease in children less than 18 years of age at Linkou Chang Gung Memorial Hospital, Taiwan were evaluated. The clinical decision to perform DBE via the oral or anal approach was based on the patient's primary clinical presentation. Data on indications, endoscopic findings, treatment outcome, and complications associated with the procedure were collected and reviewed retrospectively. Result: In total, 20 pediatric patients underwent a total of 29 DBEs due to suspicion of small-bowel disease. Among them, nine patients were evaluated for suspected small-bowel bleeding, six for Peutz-Jeghers syndrome, two for chronic abdominal pain, two for chronic diarrhea, and one for suspected protein-losing enteropathy. After excluding the six Peutz-Jeghers syndrome patients, 9 of the 14 patients (64%) got a positive endoscopic finding and diagnosis in 8 of the 14 patients (57%). DBE resulted in a further therapeutic intervention (endoscopic or surgical) in 50% of the patients (10/20) without serious complications. Conclusion: DBE has a high diagnostic yield and leads to therapeutic interventions in pediatric patients and shows promise for assessment and treating small-intestinal diseases in children in Taiwan. Keywords: Double-balloon enteroscopy, Pediatric, Taiwan, Suspected small-bowel bleeding

Background/Purpose: Rotavirus vaccines were launched in Taiwan since early 2006. Our study was aimed to figure out long-term extended molecular epidemiology in acute gastroenteritis (AGE) in hospitalized young children after rotavirus vaccination in Taiwan. Methods: During the 10-year period from January 2007 to December 2016, fecal samples from children under 5 years old with AGE hospitalized in Chang Gung Children's Hospital (CGCH) were examined for enteric pathogens and they were divided into two time intervals: early post-vaccine (Jan. 2007 to Dec. 2011; EPV) and late post-vaccine (Jan. 2012 to Dec. 2016; LPV). Results: In total, 837 patients with AGE were enrolled with complete study. In the EPV period, 106 (26.7%) rotavirus and 65 (16.4%) norovirus infections were identified as major pathogens. In the LPV period, 79 (17.9%) rotavirus and 98 (22.2%) norovirus infections were diagnosed. Statistical analyses showed a significantly decreased prevalence of rotavirus infection (P = 0.002) and a significantly increased prevalence of norovirus (P = 0.034) and enteric bacterial infections (P

瞭解選擇數學領域的原因，可讓學生評估自己、教師鼓勵學生，以此達到適性發展的目的。本研究以國際數學與科學教育成就趨勢調查2011 年八年級5,042 位學生資料，進行社會認知生涯理論驗證，接著加入學校、教師和父母情境影響變項，採取部分最小平方法結構方程式模型進行分析。研究結果顯示：符合社會認知生涯理論的興趣模型和選擇模型主要路徑假設，數學職業選擇意圖受結果期待與學習興趣的直接影響，而自我效能則是產生較多間接影響；加入情境因素後，只有教師教學對自我效能具中等重要性，但要透過學習興趣、自我效能或結果期待來對數學職業意圖產生影響，直接影響的效果量偏低；其他如「學校氣氛」和「父母協助」等因素，其直接或間接影響效果也都微乎其微。本研究依據研究結果，提出 相關建議。 Understanding the reasons for selecting mathematics as their intended career can help students become familiar with their own goals and help teachers encourage their students to achieve “talent development.” By using data from TIMSS 2011 (2011 Trends in International Mathematics and Science) on 5,042 eighth-grade students from Taiwan, the current study confirmed the Social Cognitive Career Theory (SCCT) and accounted for situational variables, such as school, teacher, and parent characteristics. The partial least squares structural equation modeling results confirmed the main path hypotheses of SCCT and demonstrated that math outcome expectations and interests have a direct effect on the students’ career-choice intention, whereas self-efficacy has an indirect effect. SCCT included situational variables to demonstrate that teacher instruction had moderate implications on self-efficacy and an indirect effect on the career-choice intention, with regard to student interests, self-efficacy, and outcome expectations. Other situational variables, such as school atmosphere and parental support, had little-to-no effect on the career-choice intention. Finally, some conclusions and suggested applications were stated.

Abstract Complex hydrogels formed with chitosan (CS) and ring-opened polyvinyl pyrrolidone (roPVP) as a swellable mucoadhesive gastroretentive drug dosage form (smGRDDF) were prepared and characterized. CS/roPVP hydrogels were produced by blending CS with roPVP obtained by basic treatment of PVP. Effects of the heating time and NaOH concentration employed for preparing roPVP, and CS molecular weights (Mws), and roPVP/CS ratios on the swelling ability of the resultant hydrogels were characterized. Rheological characteristics were further examined. Results demonstrated that roPVP obtained in a 0.5 M NaOH solution heated to 50 °C for 4 h was suitable for producing complex hydrogels with CS. At a roPVP/CS ratio of 20:1, hydrogels composed of three different Mws of CS possessed optimal swelling and mucoadhesive abilities and rheological properties. In vitro dissolution revealed sustained drug release. A pharmacokinetic study exhibited that the plasma profile of alendronate followed a sustained manner with 3-fold enhancement of the oral bioavailability. In conclusion, the smGRDDF composed of CS/roPVP complex hydrogels was successfully developed and is potentially applicable to improve the clinical efficacy of bisphosphonates.

Sensorimotor adaptation experiments are commonly used to examine motor learning behavior and to uncover information about the underlying control mechanisms of many motor behaviors, including speech production. In the speech and voice domains, aspects of the acoustic signal are shifted/perturbed over time via auditory feedback manipulations. In response, speakers alter their production in the opposite direction of the shift so that their perceived production is closer to what they intended. This process relies on a combination of feedback and feedforward control mechanisms that are difficult to disentangle. The current study describes and tests a simple 3-parameter mathematical model that quantifies the relative contribution of feedback and feedforward control mechanisms to sensorimotor adaptation. The model is a simplified version of the DIVA model, an adaptive neural network model of speech motor control. The three fitting parameters of SimpleDIVA are associated with the three key subsystems involved in speech motor control, namely auditory feedback control, somatosensory feedback control, and feedforward control. The model is tested through computer simulations that identify optimal model fits to six existing sensorimotor adaptation datasets. We show its utility in (1) interpreting the results of adaptation experiments involving the first and second formant frequencies as well as fundamental frequency; (2) assessing the effects of masking noise in adaptation paradigms; (3) fitting more than one perturbation dimension simultaneously; (4) examining sensorimotor adaptation at different timepoints in the production signal; and (5) quantitatively predicting responses in one experiment using parameters derived from another experiment. The model simulations produce excellent fits to real data across different types of perturbations and experimental paradigms (mean correlation between data and model fits across all six studies = 0.95 ± 0.02). The model parameters provide a mechanistic explanation for the behavioral responses to the adaptation paradigm that are not readily available from the behavioral responses alone. Overall, SimpleDIVA offers new insights into speech and voice motor control and has the potential to inform future directions of speech rehabilitation research in disordered populations. Simulation software, including an easy-to-use graphical user interface, is publicly available to facilitate the use of the model in future studies.

Theoretical models of speech production suggest that the speech motor system (SMS) uses auditory goals to determine errors in its auditory output during vowel production. This type of error calculation indicates that within-speaker production variability of a given vowel is related to the size of the vowel’s auditory goal. However, emerging evidence suggests that the SMS may also take into account perceptual knowledge of vowel categories (in addition to auditory goals) to estimate errors in auditory feedback. In this study, we examined how this mechanism influences within-speaker variability in vowel production. We conducted a study (n = 40 adults), consisting of a vowel categorization task and a vowel production task. The vowel categorization task was designed—based on participant-specific vowels—to estimate the categorical perceptual boundary (CPB) between two front vowels (/ε/ and /æ/). Using the vowel production data of each participant, we calculated a variability-based boundary (VBB) located at the “center of mass” of the two vowels. The inverse of the standard deviation of a vowel distribution was used as the “mass” of the vowel. We found that: (a) categorical boundary was located farther from more variable vowels; and (b) the calculated VBB (i.e., the center of mass of the vowels) significantly and positively correlated with the estimated categorical boundary (r = 0.912 for formants calculated in hertz; r = 0.854 for formants calculated in bark). Overall, our findings support a view that vowel production and vowel perception are strongly and bidirectionally linked.

Sarcopenia is prevalent in postmenopausal women but is inconclusive in total thyroidectomy and under levothyroxine replacement. We aim to analyze the determinants of sarcopenia and investigate the early detection of sarcopenia in this group. Fifty postmenopausal women with total thyroidectomy were measured for body composition via Dual-energy X-ray Absorptiometry (DXA) and Appendicular Skeletal Muscle mass divided by the height square (ASM/ht2). Handgrip strength and gait speed and Geriatric Nutritional Risk Index (GNRI) were calculated. Eight determinants associated with sarcopenia include GNRI (β, 0.042; 95% confidence interval (CI), 0.021 to 0.064), femoral neck BMD (β, 0.989; 95% CI, 0.049 to 1.929), TSH (β, 0.192; 95% CI, 0.027 to 0.357), and thyroglobulin Ab (0.657; 95% CI, 0.210 to 1.103) for ASM/height2; menopausal years (β, −3.112; 95% CI, −5.661 to −0.563) and ASM/height2 (β, 2.669; 95% CI, 1.073 to 4.265) for handgrip strength; and GNRI (β, 0.062; 95% CI, 0.019 to 0.105), T3 (β, −3.541; 95% CI, −7.019 to −0.063), and age (β, 0.043; 95% CI, 0.003 to 0.084) for gait speed. Our study confirmed a high prevalence of low skeletal muscle mass index in postmenopausal women with total thyroidectomy and revealed a number of determinants that could help early diagnosis and management this disease in daily clinical practice.

服務學習在教育改革中漸形一股潮流，臺灣教育部也訂定相關辦法與方案，鼓勵相關單位開設相關課程與活動。為求教師可以評估自己的服務學習課程成效，將從服務學習相關文獻確立核心學習內涵，再歸納檢核方法。本文以自編問卷調查詢問大專院校有帶領 服務學習活動或課程的教師，發現教師認為服務學習的公民意識與素養執行不易，且服務學習的概念尚待釐清；而且教師在服務學習的「認知」和「行為」有差距，凸顯結構化與機制化的重要。最後，針對不同服務學習核心學習內涵，教師有建議和實際採用的 檢核機制，而教師較建議者，實際採用程度也會比較頻繁。據此，未來或許可以有具體有效的服務學習操作手冊或藍圖，增加教師信心與採用頻繁度，也讓學生從中獲益。 Service learning has become a popular trend in current educational reform, and to maintain the pace, the Taiwan Ministry of Education has adopted various strategies and plans in promoting service learning courses and activities within schools. In order to help teachers evaluate the effects of their service learning classes, the author reviewed service learning literature in order to establish its core learning contents and evaluation methods. A survey questionnaire was also used to collect relevant data from teachers. Findings of the study indicate that teachers perceived that the civic consciousness and literacy of service learning are difficult to develop, and that the concept of service learning must be clarified. In addition, there are discrepancies between teachers’ “knowledge” and “practice” of service learning, suggesting the need for a basic framework and system for service learning. Finally, regarding the different core contents of service learning, it is noticed that teachers suggested and adopted a number of evaluation methods, with the more often suggested methods being adopted more often in practice. All in all, for the benefit of the students, this study recommends the development of a concrete and effective service learning manual or blueprint, in order to strengthen teachers’ confidence and adoption frequency.

課後學生自主的時間能否自己自律繼續學習，是值得關注的議題。本研究欲瞭解學生從國中到高中自律學習發展情況，以台灣教育長期追蹤資料庫的2,939個追蹤樣本，進行潛在成長曲線模型分析。在本研究的假設模型中發現：兩性學生在自律學習的假設模型無顯著差異，而且國中高自律學習的學生到高中的自律學習成長有限；國中低自律學習的學生到高中自律學習成長幅度較大。至於學生家庭社經地位愈高、父母學校參與和接納的程度愈高，學生國中時期的自律學習情況會愈好；但是學生家庭社經地位愈高、父母學校參與程度愈高，對於學生國中到高中自律學習成長有限，至於父母接納則無顯著影響關係。另外，國中自律學習良好的學生，有較良好的分析能力；但是自律學習無法有效預測分析能力的成長情況。本研究將依據上述研究結果提出相關結論與建議以供參考。 Students self-regulating their learning after school is an important topic. This study examines the development of self-regulation learning (SRL) and analytical abilities using 2,939 samples from junior high schools and senior high schools. Data were collected from the Taiwan Education Panel Survey (TEPS). A latent growth curve model was employed to analyze the data. The analysis results are as follows: No gender differences exist regarding the development of SRL and analytical ability in both junior and senior high school students in Taiwan. Junior high school students with higher levels of SRL tend to make less SRL progress during senior high school, whereas students with lower SRL levels tend to make greater progress. Junior high school students with higher family socioeconomic status, greater parental involvement and acceptance, and superior SRL levels demonstrated less SRL progress in senior high school. Additionally, junior high school students with higher SRL levels tend to have greater analytical abilities. However, the SRL level of senior high school students could not accurately predict their analytical abilities. Based on these results, this study provides a number of conclusions and suggestions for practical applications and future research.

本研究參考社會認知生涯理論的選擇模型與興趣模型，建立影響學生選擇數學職業意圖的因素結構關係模型圖，以Trends in International Mathematics and Science Study（簡稱TIMSS）2003 年國中生資料驗證之，試圖探究影響國中學生在選擇數學職業意圖的因素。本研究發現，在社會認知生涯理論的興趣模型方面，「數學學習興趣」受「數學結果期待」、「數學自我效能」的直接影響，而「數學成就」則是產生間接影響；至於社會認知生涯理論的選擇模型方面，「選擇數學職業意圖」受「數學結果期待」、「數學學習興趣」的直接影響，而「數學成就」、「數學自我效能」則是產生間接影響。上述潛在結構並無性別差異存在。最後，本研究亦根據研究結果，提出在教育實務應用與未來繼續研究上的建議。 The purpose of this study was to investigate impact factor on mathematics career-choice process used TIMSS dataset of Taiwan 8th grade students. The interest development model and career choice model of social cognitive career theory (SCCT) used to establish a latent variable model. The results showed, concerning interest development model, math outcome expectations & math self-efficacy had a direct effect on math learning interests but math achievement had an indirect effect on. As to career choice model, math outcome expectations & math learning interests had a direct effect on math career-choice intentions but math achievement & math self-efficacy had an indirect effect on. The above-mentioned hadn’t sex differences in math career choice process. Finally, some conclusions and suggestions for practice applications and future researches were suggested and proposed.

Objective: Pneumonia is the leading cause of death in patients with Parkinson's disease (PD). However, few studies have been performed to explore the risk factors for pneumonia development in patients with PD. Methods: We conducted a nationwide population-based cohort study of patients with PD to identify the risk factors for these patients developing pneumonia. Participants with newly diagnosed PD between 2000 and 2009 were enrolled from the 2000-2010 National Health Insurance Research Database in Taiwan. We compared patients with PD with an incidence of hospitalization with pneumonia vs those without, and Cox proportional hazard models were used to estimate the risk of pneumonia. Results: Of the 2,001 enrolled patients (mean follow-up duration 5.8 years, range: 2.7-14.7 years), 381 (19.0%) had an incidence of hospitalization with pneumonia during the study period. Multivariate Cox proportional hazards analysis identified older age group (≥80 years of age, hazard ratio [HR] =3.15 [95% confidence interval 2.32-4.28]), male sex (HR =1.59 [1.29-1.96]), certain geographic regions (northern, HR =1.36 [1.04-1.78], southern and eastern, HR =1.40 [1.05-1.88]), rural areas (HR =1.34 [1.05-1.72]), chronic heart failure (HR =1.53 [1.02-2.29]), and chronic kidney disease (HR =1.39 [1.03-1.90]) as risk factors for hospitalization with pneumonia in patients with PD. However, treatment for dental caries was a protective factor (HR =0.80 [0.64-0.99]). Conclusion: The results of this study highlight risk factors that are associated with hospitalization with pneumonia, and, for the first time, suggest a link between treated dental caries and a diminished risk of hospitalization with pneumonia in patients with PD. [ABSTRACT FROM AUTHOR]

The transition from childhood to teenaged years is associated with increased testosterone and a decreased iron status. It is not clear whether higher testosterone levels cause the decreased iron status, and to what extent, obesity-related inflammation influences the iron-testosterone relationship. The aim of the present study was to examine relationships of testosterone, iron status, and anti-/proinflammatory cytokines in relation to nutritional status in boys and young adolescent Taiwanese males.In total, 137 boys aged 7~13 yr were included. Parameters for obesity, the iron status, testosterone, and inflammatory markers were evaluated.Overweight and obese (ow/obese) boys had higher mean serum testosterone, interleukin (IL)-1β, and nitric oxide (NO) levels compared to their normal-weight counterparts (all p

Objective Panic disorder (PD) is characterized by panic attacks accompanied with respiratory symptoms. Internal jugular vein (IJV) alters its hemodynamics in response to respiration and which might cause cerebral blood flow (CBF) changes. In the present study, we compared (1) respiratory-related IJV hemodynamics and (2) CBF changes during Valsalva maneuver (VM) between PD and normal subjects. Methods 42 PD patients and age/gender-matched controls (14 men; 52.3 ± 11.4 years) were recruited. Duplex ultrasonography measured time-averaged mean velocity (TAMV) and lumen in IJV at baseline and deep inspiration. Lumen area <0.10 cm2 at deep inspiration was defined as IJV collapse. CBF changes during VM were recorded by transcranial Doppler (TCD). Results Compared with normal group, PD patients had significantly higher frequency of IJV collapse at deep inspiration (Left: 40.0% vs. 7.0%, p = 0.0003, Right: 17.0% vs. 0%, p = 0.0119). IJV collapse was associated with symptoms of respiratory subtype in our PD patients. PD group also had smaller lumen (Left: 0.53 ± 0.29 vs. 0.55 ± 0.26 cm2, p = 0.8296, Right: 0.63 ± 0.36 vs. 0.93 ± 0.45 cm2, p = 0.0014) and slower TAMV of IJV at baseline (Left: 11.8 ± 8.43 vs. 20.6 ± 16.5 cm/s, p = 0.0003, Right: 15.9 ± 9.19 vs. 24.1 ± 15.7 cm/s, p = 0.0062). PD patients with inspiration-induced IJV collapse had more decreased CBF during VM compared with the other PD patients and normal individuals respectively. Interpretation We are the first to show that PD have less IJV flow at baseline and more frequent collapse at deep inspiration. Inspiration-induced IJV collapsed was associated with CBF decrement during VM in PD patients. These results suggest that venous drainage impairment might play a role in the pathophysiology of PD by influencing CBF. [ABSTRACT FROM AUTHOR]

Islet-like cell clusters (ICCs) have been suggested to be a source of insulin-producing tissue for xenotransplantation in type 1 diabetes. We designed an approach to maintain the cultured rat pancreatic ICC survival and function, when cocultured with human umbilical cord mesenchymal stem cells (HUMSCs). HUMSCs in coculture have the ability to maintain ICC survival and function, for which number and insulin secretion of ICCs are increasing and lasting for 3 months, while ICCs gradually crash, which results in cell death after a period of 12 days of culture without HUMSCs. Cytokine protein array showed it has more than a twofold increase in levels of several cytokines (interleukin-6, tissue inhibitor of metalloproteinases-1, tissue inhibitor of metalloproteinases-2, monocyte chemoattractant protein-1, growth related oncogene, hepatocyte growth factor, insulin-like growth factor binding proteins 4, and interleukin-8) on coculture medium, implying an important role of these cytokines in this coculture system. These findings suggest that coculture with HUMSCs may have a significant potential to protect ICCs from damage during culture, and may be employed in a novel culture approach to maintain islet cell survival and function before transplantation.