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Bioactive glass has high biocompatibility and bioactivity. With specific ion adding, it can show different advantages. Titanium ion can improve the mechanic strength, antibacterial ability of bioactive glass, and stability. In this study, bioactive glass with titanium ion doping by the sol-gel method via various reactive environments was fabricated successfully. The morphology was observed by scanning electron microscopy (SEM). The chemical composition was measured by energy dispersive X-ray spectrometer (EDS). By soaking in SBF, the bioactivity of samples had also been analyzed. The formula of bioglass has been optimized to make the better bioactivity.

Objectives This study aimed to evaluate the adverse clinicopathologic features of oral squamous cell carcinoma (OSCC), including margin status, depth of invasion, lymphovascular invasion, perineural invasion, and extranodal extension that significantly affect survival outcomes. Materials and methods This retrospective cross-sectional study included 341 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The Kaplan–Meier method was used to estimate survival outcomes. A multivariable Cox regression model was used to evaluate the associations of various clinicopathologic features with 5-year overall survival (OS) outcomes in patients with pN0 and pN+ tumors. Results Overall, the patients had 5-year OS and progression-free survival rates of 60.0 and 47.9%, respectively. In the pN0 group, the multivariate analysis identified a positive margin (odds ratio [OR] = 16.3, 95% confidence interval [95% CI]: 3.7–72.3; P = 0.001), depth of invasion >5 mm (OR = 2.1, 95% CI: 1.2–3.7; P = 0.012), presence of lymphovascular space invasion (OR = 5.4, 95% CI: 1.3–22.0; P = 0.018), and presence of perineural invasion (OR = 4.3, 95% CI: 1.7–11.1; P = 0.002) as independent and significant prognosticators of OS. In the pN+ group, only the presence of extranodal extension independently predicted OS (OR = 1.7, 95% CI: 1.1–2.7; P = 0.0026). Conclusions When determining survival prognosis for patients with a pN0 status, we recommended including all adverse features. In contrast, extranodal extension was the most important prognostic factor for patients with a pN+ status.

Postoperative exercise rehabilitation helps patients recover normal joint functions after total hip arthroplasty (total hip replacement surgery or THR) by strengthening the muscles that surround the replaced hip joint. However, the high cost of professionally supervised exercise rehabilitation programs limits access to program participation and, thus, to optimal recovery of normal joint functions. Therefore, the development of an effective home-based, self-monitored exercise rehabilitation program is critical to promote the optimal recovery of THR patients.This study tests the efficacy of a home-based resistance-band exercise program on mobility, functional exercise capacity, and health-related quality of life in THR patients.This study uses a preexperimental repeated measures design. A convenience sample of 30 patients who underwent total hip replacement for osteoarthritis was recruited. All patients participated in a 12-week home-based resistance training program. Data were collected at baseline and at 2, 6, and 12 weeks postoperation on the following dimensions: up-and-go time, timed walking distance, and quality of life. In addition, intervention-related adverse events and the exercise adherence rate were monitored. Generalized estimation equations were used to analyze changes in the outcome variables across time.The study included 21 women and nine men. The mean age of the participants was 67.9 years (SD = 8.1 years, range = 55-86 years). Results of the generalized estimation equations showed a statistically significant time effect for up-and-go time, 6-minute walking distance, and health-related quality of life. After 12 weeks of training, the participants' up-and-go time decreased 40.33% from the baseline measurements, with a mean change of 6.38 seconds (p.001). The 6-minute walking distance increased 41.34%, with a mean change of 117.12 meters (p.001). The score for health-related quality of life decreased 78.94%, with a mean change of 39.10 (p.001). The average exercise adherence rate was 72.63%. The average score for the feasibility of the intervention was 8.8 (range = 6-10).The results of this study support the hypothesis that a home-based resistance training program is safe, feasible, and effective for improving the mobility, functional exercise capacity, and health-related quality of life of THR patients. Considering the low cost and convenience of a home-based resistance training program, health professionals should consider this and similar exercise programs when providing guidance to THR patients.

The largest epidemic of avian influenza (AI) in history attacked poultry and wild birds throughout Taiwan starting January 6, 2015. This study analyzed surveillance results, epidemiologic characteristics, and viral sequences by using government-released information, with the intention to provide recommendations to minimize future pandemic influenza. The H5 clade 2.3.4.4 highly pathogenic AI viruses (HPAIVs) had not been detected in Taiwan before 2015. During this epidemic, four types of etiologic agents were identified: the three novel subtypes H5N2, H5N8, and H5N3 clade 2.3.4.4 HPAIVs and one endemic chicken H5N2 subtype (Mexican-like lineage) of low pathogenic AI viruses. Cocirculation of mixed subtypes also occurred, with H5N2 clade 2.3.4.4 HPAIVs accompanied by the H5N8 and H5N3 subtypes or old H5N2 viruses in the same farm. More than 90% of domestic geese died from this AI epidemic; geese were affected the most at the early outbreaks. The epidemic peaked in mid-January for all three novel H5 subtypes. Spatial epidemiology found that most affected areas were located in southwestern coastal areas. In terrestrial poultry (mostly chickens), different geographic distributions of AI virus subtypes were detected, with hot spots of H5N2 clade 2.3.4.4 vs. past-endemic old H5N2 viruses in Changhwa (P = 0.03) and Yunlin (P = 0.007) counties, respectively, of central Taiwan. Phylogenetic and sequence analyses of all the early 10 Taiwan H5 clade 2.3.4.4 isolates covering the three subtypes showed that they were very different from the HA of the past local H5 viruses from domestic ducks (75%-80%) and chickens (70%-75%). However, they had the highest sequence identity percentages (99.53%-100%), with the HA of A/crane/Kagoshima/KU13/2014(H5N8) isolated on December 7, 2014, in Japan being higher than those of recent American and Korean H5 HPAIVs [A/Northern pintail/Washington/40964/2014 (H5N2) and A/gyrfalcon/Washington/41088-6/2014 (H5N8): 99.02%-99.54% and A/Baikal teal/Korea/Donglim3/2014 (H5N8): 98.61%-99.08%], implying a likely common ancestor of these H5 clade 2.3.4.4 viruses. The multiple subtypes of H5 clade 2.3.4.4 HPAIVs imply high viral reassortment. We recommend establishing an integrated surveillance system, involving clinical, virologic, and serologic surveillance in poultry and wild birds, swine and other mammals prevalent on multiple-animal mixed-type traditional farms, and high-risk human populations, as a crucially important step to minimize future pandemic influenza.

The primary strategy for treating oral squamous cell carcinoma (OSCC) is therapeutic resection, with the trismus resection defect reconstructed via free flap. The most popular free flaps include the radial forearm free flap (RFFF) and anterolateral thigh free flap (ALT). This study investigated the relationships between the hospitalization period and a variety of surgical outcomes, as well as maximum inter-incisor distance (IID), in trismus patients who chewed betel nuts. Forty-nine primary OSCC patients who chewed betel nuts and underwent surgical resection and reconstruction between 2010 and 2016 were enrolled in this retrospective study. The data were from a single center in Taiwan. The outcome variable after flap recovery surgery was the duration of postoperative hospitalization. Other factors that were analyzed comprised correlations between hospitalization and a variety of factors, including postoperative inter-incisor distances (IIDs), operative time, gender, and WBC count, upon stratification into two reconstruction groups. The mean postoperative hospitalization duration in the ALT group was 22.9 ± 7.2 days, which was significantly shorter than that in the RFFF group (27.8 ± 7.0 days; p = 0.019). Two-week postoperative IID (ALT group: 16.1 ± 0.8 mm; RFFF group: 7.0 ± 0.6 mm) was inversely related to the duration of hospitalization (p = 0.022, r = − 0.372). The ALT flap is more effective than the RFFF flap to reduce the length of hospitalization in trismus patients. The ALT flap should be considered as a first-line technique in OSCC reconstruction in trismus patient reconstruction.

The shape and color of visual identity are the most important factors in the visualization of trademarks, which exert a far-reaching influence on the establishment of corporate image and brand image. Under the impact of globalization, brands have become a major factor in keeping a foothold in the consumer market, and sales are no longer limited to certain regions. Today's ideological trend of design uses localization to highlight national cultural awareness. Thus, this study's motivation is how the design trend can be effectively applied to improving a brand's international perspective. Herein, we use the semantic differential method to carry out five-element emotion vocabulary and a trademark perceptual evaluation and conduct quantitative analysis. Through the data we understand the relationship between the five elements and the elements of trademark forms and offer a deep discussion on the correlation between the five elements and the shape features. Experts' group experiment interviews and the experimental results finally extract the shape features of the elements as follows: wood's property is straight with a curve and is spindly with an outward extension; fire's property is narrow on the top and broad in the bottom and rises upward; soil's property is in the shape of a square or in a tiled shape and is centered solid; gold's property is in an arc and a sharp shape and is reserved and rigid; water's property is in the shape of a wavy curve and flows downward.

Effective pain management is crucial for patient recovery after total knee arthroplasty (TKA). Biofeedback therapy, which encourages relaxation and helps alleviate various conditions associated with stress, may help to decrease postoperative pain in patients undergoing TKA. A quasi- experimental design was used to investigate the efficacy of a biofeedback relaxation intervention in reducing pain associated with postoperative continuous passive motion (CPM) therapy. Sixty-six patients admitted to a general hospital in Taiwan for TKA were recruited and randomly assigned to the intervention or control group. The intervention group received biofeedback training twice daily for 5 days, concurrent with CPM therapy, whereas the control group did not receive the biofeedback intervention. Pain was measured using a numeric rating scale before and after each CPM therapy session on postoperative days 1 through 5. The CPM-elicited pain score was calculated by subtracting the pre-CPM pain score from the post-CPM pain score. Results of repeated-measures analysis of variance showed intervention group reported significantly less pain caused by CPM than did the control group (f = 29.70, p

In the past few decades, the integration of virtual peer review has been implemented as an instructional procedure in second-language writing courses. Previous studies have been interested in comparing the effects of different communication modes and have endeavored to find out which mode is most effective. This paper reports a study examining how a combination of three modes (face-to-face, synchronous, and asynchronous CMC) influenced and might benefit students’ peer review. The results indicate that the affordance of the three modes influenced students’ task engagement, comment categories, and perception of peer review. The results further suggest that a combination of different modes in the multiple-draft process may benefit peer review and satisfy individual preferences towards the mode for peer review. The results imply that arranging various modes appropriately at different stages of drafting and customizing peer review training in using these modes may maximize the effects of peer review in the writing process.

Purpose: To determine the perceptions of nurse practitioners (NPs) and administrators in regard to the governing and supervision of NPs, using a qualitative approach. Data sources: The study used a qualitative research design, with 14 participants recruited through purposive sampling. Data were collected through a semi-structured interview and were analyzed through content analysis to identify the concepts and themes. Conclusions: NPs in Taiwan are challenged by a number of barriers; however, they remain positive that their circumstances will improve. Implications for practice: The results indicated that clinicians and hospital managers, including NPs themselves, need to have a solid understanding of NP regulations. Communication with other disciplines and policymakers is key to success in the NP role. This study provides valuable information for NPs, other healthcare professionals, and administrators in terms of promoting the role of NPs.

There has been increasing interest in the possible applications of corpora to both linguistic research and pedagogy. This study takes a corpus-based, genre-analytic approach to discipline-specific materials development. Combining corpus analysis with genre analysis makes it possible to develop teaching materials that are not only authentic but also research-supported. An RA corpus consisting of 60 research articles from three major journals of computer science was constructed. A word frequency list derived from the corpus was analyzed to develop a vocabulary profile for the genre. Move analysis was also conducted based on a self-developed coding scheme of rhetorical moves in the target genre. The move codes were tagged in the corpus texts so that individual moves and move patterns could be retrieved for the purpose of developing research-based online teaching materials for graduate students of computer science. Numerous examples of specialized vocabulary, grammatical usage, and move structures that showcase and characterize academic computer science discourse were used in not only lessons but also learning tasks, discussion topics, and online writing models. The paper ends with a discussion of the usefulness and effectiveness of the online RA writing materials, based on student feedback and assessments.

Interstitial deletion of 16q has emerged into a recognizable pattern of congenital malformation. We report on a 9-year-old boy with short stature, psychomotor retardation, high forehead, broad flat nasal bridge, hypertelorism, cup-shaped ears, short neck, and a normal karyotype. Using high-density oligonucleotide array chip (Affymetrix 6.0) to perform parental and proband samples concurrently on three chips and interpreted as a trio set, a de novo 3.2 Mb deletion from bands q12.2 to q13 on chromosome 16 (from 52.08 to 55.3 Mb) of paternal origin was identified. The deletion was confirmed by quantitative genomic PCR and the break points were defined by junction PCR. Our study demonstrated the power of high-density oligonucleotide array chip in identifying novel submicroscopic deletions that were not detectable using G-banding cytogenetic technology. Furthermore, our result narrowed down the critical region for craniofacial features in interstitial 16q11.2-q13 deletion syndrome. In patients who have high forehead, broad flat nasal bridge, hypertelorism, cup-shaped ears, short neck and short stature, high-density array should be included in initial work up.

Chronic inflammatory demyelinating polyneuropathy (CIDP) typically presents with a combination of sensory and motor impairments. Tremor is recognized as a common and debilitating feature in CIDP, although the underlying mechanisms are unclear.Clinical tremor severity and disability scores were collected prospectively in 25 CIDP patients and compared with 22 neuromuscular controls.Postural and kinetic tremor were significantly more frequent in CIDP patients (80%) than in neuromuscular controls (35%; P 0.005). Tremor severity and tremor-related disability were also significantly greater in CIDP patients than in controls. Accelerometry data confirmed the presence of a 5.5 Hz postural tremor and a 5 Hz kinetic tremor.Tremor appears to be a common clinical feature of CIDP that results in significant disability. Sensory and motor impairment may be associated with development of tremor in CIDP. Muscle Nerve 55: 338-343, 2017.

Background. The cutaneous manifestations of human enterovirus (HEV) infection are usually limited, such as hand-foot-mouth disease. By comparison, Stevens-Johnson syndrome (SJS) is a life-threatening severe cutaneous adverse reaction (SCAR), mainly caused by drugs. During the HEV outbreaks in 2010–2012 in Taiwan, we identified 21 patients who developed widespread blistering mucocutaneous reactions without any suspected drug causality. Methods. We screened possible pathogen(s) for detecting human herpes virus (HHV1–HHV7), HEV, or Mycoplasma pneumoniae infections using throat swab virus cultures, real-time PCR, DNA sequencing, immunochemistry and electron microscopy analyses. Results. Coxsackievirus A6 (CVA6) DNA was identified in the blistering skin lesions in 6 of 21 patients. Cytotoxic T lymphocytes and natural killer cells expressing granulysin predominantly infiltrated into the skin lesions, sharing the histopathological features with SJS. Intact CVA6 viral particles were identified in the blister fluids and skin lesions by electron microscopy. The phylogenetic analysis of the viral genome showed the CVA6 DNA sequence sharing higher similarity (97.6%–98.1%) to CVA6 strains reported from Finland at 2008. Conclusions. This study identifies a new variant of CVA6 as the causative agent for severe mucocutaneous blistering reactions mimicking SCAR. An awareness of this unusual presentation of HEV infection is needed in the epidemic area.

To determine the perceptions of nurse practitioners (NPs) and administrators in regard to the governing and supervision of NPs, using a qualitative approach.The study used a qualitative research design, with 14 participants recruited through purposive sampling. Data were collected through a semi-structured interview and were analyzed through content analysis to identify the concepts and themes.NPs in Taiwan are challenged by a number of barriers; however, they remain positive that their circumstances will improve.The results indicated that clinicians and hospital managers, including NPs themselves, need to have a solid understanding of NP regulations. Communication with other disciplines and policymakers is key to success in the NP role. This study provides valuable information for NPs, other healthcare professionals, and administrators in terms of promoting the role of NPs.

As globalization and rapid development of science and technology has brought huge impact on today’s world, it is important for non-English speaking countries such as Taiwan, Republic of China, to actively participate in the international community through communication in the international language, English. In higher education, dissemination of research achievements through publication of international journals has been a common degree requirement, the practice in public researchoriented universities being the noticeable example. However, graduate students who have such needs are often unprepared to demonstrate acceptable academic writing abilities in English. To facilitate effective access to research information and to promote national academic excellence through international publications, it is essential to promote writing instruction of English for Academic Purposes (EAP). Meanwhile, Web-based environments provide a viable choice of delivery of EAP courses and the computer-mediated communication tools help formation of the student body as virtual organizations as they learn with one another.

Single nucleotide polymorphisms (SNPs) are the most common sequence variation in the human genome; they have been successfully used in mapping disease genes and more recently in studying population genetics and cancer genetics. In a population-based association study using high-density oligonucleotide arrays for whole-genome SNP genotyping, we discovered that in the genomes of unrelated Han Chinese, 34 out of 515 (6.6%) individuals contained long contiguous stretches of homozygosity (LCSHs), ranging in the size from 2.94 to 26.27 Mbp (10.22+/-5.95 Mbp). Four out of four (100%) Taiwan aborigines also demonstrated this genetic characteristic. The number of LCSH regions increased markedly in the offspring of consanguineous marriages. LCSH was also detected in Caucasian samples (11/42; 26.2%) and African American samples (2/42; 4.76%). A total of 26 LCSH regions were recurrently detected among Han Chinese, Taiwan aborigines, and Caucasians. DNA copy number determination by hybridization intensity analysis and real-time quantitative PCR (qPCR) excluded deletion as the cause of LCSH. Our results suggest that LCSHs are common in the human genome of the outbred population and this genetic characteristic could have a significant impact on population genetics and disease gene studies.

Our purpose was to develop a method of using a maximal forced expiratory maneuver (MFEM) for the study of bronchoconstriction and bronchial hyperreactivity (BHR) induced in mice by ovalbumin (OA) inhalation challenge. Eight mice (group I) were sensitized and then provocated with OA. Pulmonary function testing (PFT) at baseline and after varying doses of acetylcholine challenge was performed. Eight weight-matched normal mice served as controls (group II). Pulmonary functions include MFEM, dynamic respiratory system compliance (Crs) and respiratory system resistance (Rrs). The results showed that mice treated with OA had worse PFTs than normal controls, characterized by lower MFEF 50%, FEV0.1 and Crs but higher Rrs. The OA-sensitized mice also had more severe bronchoconstriction in response to acetylcholine, characterized by greater decreases in MFEF 50%, FEV0.1 and Crs but a higher Rrs than the controls. There was a good correlation between PD20MFEF50%Ach and PD20FEV0.1Ach with PD20CrsAch and PD20RrsAch. In conclusion, the MFEM can be used to evaluate airway obstruction and BHR induced in mice by allergen challenge.