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Before the COVID-19 pandemic, Mycoplasma pneumoniae infections emerged during spring to summer yearly in Taiwan, but infections were few during the pandemic. M. pneumoniae macrolide resistance soared to 85.7% in 2020 but declined to 0% during 2022–2023. Continued molecular surveillance is necessary to monitor trends in macrolide-resistant M. pneumoniae.

Many images used in media and advertising employ visual metaphors that provide enjoyment and storytelling. This study employed an image perception questionnaire to evaluate high school students’ image preferences. The results revealed that among the adjectives provided by the researcher, high school students exhibited higher preferences for describing images as creative, symbolic, cultural, artistic, contrasting, serious, exaggerated, and rational imagery. According to the independent sample t-test results, a pronounced gender difference existed in the preference of selection from the ‘Conservative–Creative’ adjective pair to describe images. Additionally, male and female students displayed higher preferences for describing fusion metaphorical images as ‘natural’ and ‘cultural’, respectively. The preferences of students of different genders for metaphorical images were considerably influenced by the conservative, creative, natural, or cultural elements of the images. According to the results of the chi-square test of independence and phi correlation coefficient test, gender exhibited a significant but low correlation with students’ preferences for juxtaposed and replacement metaphorical images. The findings of this study can provide valuable insights for art educators to gain a deeper understanding of gender differences in students’ image assessments and preferences when viewing images, helping them select appropriate visual teaching materials.

The individual ingredients of 1,3-Propanediol, Soline, and Fucocert® (PSF) are often used as cosmetic formulations in skin care. In addition, the mixture of Lecigel, Cetiol®CC, Activonol-6, and Activonol-M (LCAA) is often used as a cosmetic base. However, whether the combination of LCAA with PSF (LCAA-PSF) exerts a therapeutic effect on psoriasis remains unclear. In this study, mice induced with imiquimod (IMQ) were divided into three groups and administered 100 mg/day of LCAA, 100 mg/day of LCAA-PSF, or Vaseline on the dorsal skin of each mouse. Weight-matched mice treated with Vaseline alone were used as controls. Hematoxylin and eosin (H&E) staining and enzyme-linked immunosorbent assay(ELISA) were used to assess tissue morphology and inflammatory cytokines. RNA sequencing analysis was used to predict the mechanism underlying the action of LCAA-PSF against psoriasis, while immunohistochemical analysis validation was used to identify pertinent molecular pathways. The results demonstrated that LCAA-PSF alleviated IMQ-induced keratinocyte differentiation/ proliferation bydecreasingthe serum levels of inflammatory cytokines such as IL-6, TNF-α, IL-23, and IL-17A and the epidermisof TGFβ, Ki67, CK5/6, and VEGF expression, which is associated with angiogenesis and keratinocyte differentiation/ proliferation. These findings highlight the antipsoriatic activity of LCAA-PSF in a psoriasis-like mouse model and suggest this may occurvia the inhibition of inflammatory factor secretionand the TGFβ-related signal pathway.

AbstractThis study combined the principles of multimedia message design with an enclosing-rectangle scaffold to facilitate instruction on deriving the area of basic geometric shapes. A pretest/posttest/delayed-posttest design was used to compare the effectiveness of the enclosing-rectangle scaffold with that of conventional dissection/rearrangement methods among low-achieving seventh-grade students. These fifty-six low-achieving students were averagely assigned to one of two teaching methods. In immediate and delayed testing, an enclosing-rectangle scaffold proved significantly more effective than the conventional approach (posttest: F (1,53) = 16.148, p =

Background: Age-related macular degeneration is the leading cause of visual deficiency in older adults worldwide. Melatonin (MT) can potentially reduce retinal deterioration. However, the mechanism by which MT mediates regulatory T cells (Tregs) in the retina is not yet fully understood. Methods: The transcriptome profiles of aged or young human retinal tissues from the GEO database were analyzed for MT-related gene expression. The pathological changes in the retina in the NaIO3-induced mouse model were quantitatively determined by staining with hematoxylin and eosin. Retinal whole-mounting immunofluorescence staining was conducted to determine the expression of the Treg-specific marker FOXP3. The phenotypes of M1/M2 macrophages were representing related gene markers in the retina. The GEO database includes biopsies from patients with retinal detachment for ENPTD1, NT5E, and TET2 gene expression. A pyrosequencing assay was performed for NT5E DNA methylation on human primary Tregs, and siTET2 transfection engineering was used. Results: MT synthesis-related genes in retinal tissue may be affected by age. Our study shows that MT can effectively restore NaIO3-induced retinopathy and maintain retinal structural integrity. Importantly, MT may assist the conversion of M1 to M2 macrophages to promote tissue repair, which may be caused by the increased infiltration of Tregs. Moreover, MT treatment may upregulate TET2, and further NT5E demethylation is associated with Treg recruitment in the retinal microenvironment. Conclusions: Our findings suggest that MT can effectively ameliorate retinal degeneration and regulate immune homeostasis via Tregs. Modulation of the immune response may provide a key therapeutic strategy.

Abstract Background Declines in health, physical, cognitive, and mental function with age suggest a lower level of health-related quality of life (HRQoL) in late life; however, previous studies found that the associations were weak and varied, depending on the study designs and cohort characteristics. Methods The present study examined the paradox of aging in an East Asian context by regressing the age patterns of objective health indicators (physical, cognitive, and mental function), and subjective HRQoL (12-item Short Form, SF-12), on the independent and interactive effects of age and physical function in a cohort study of 5022 community-dwelling adults aged 55 and older in Taiwan. Results Age patterns differed across measures. The SF-12 mental health score (MCS) showed a slight positive association with age and this effect remained stable after controlling for various age-related covariates. The SF-12 physical health score (PCS), in turn, was negatively associated with age. Age differences in PCS were fully explained by age decrements in objective physical health. However, consistent with the so-called paradox of aging, the association between objective and subjective physical health weakened with age. Conclusion These findings add to prior evidence indicating that — in spite of objective health decrements — subjective HRQoL is maintained in later life among Asian Chinese. Also, these paradoxical patterns appear to vary for mental and physical components of HRQoL, and future research is needed to explore the underlying mechanism. Trial registration Healthy Aging Longitudinal Study in Taiwan (HALST) is retrospectively registered at ClinicalTrials.gov on January 24, 2016 with trial registration number NCT02677831.

Abstract Background Neurocognitive dysfunction is a common symptom of various major psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar I disorder (BD). In this study, we investigated whether cognitive profiles and daily skill functioning could effectively differentiate between patients with schizophrenia, MDD, and BD. Method In this cross-sectional study, we recruited a total of 63 patients with schizophrenia, 55 patients with MDD, 43 patients with BD, and 92 healthy control subjects. We evaluated participants’ cognitive functions and functional capacity using the Brief Assessment of Cognition in Schizophrenia (BACS) and the UCSD Performance-based Skills Assessment, Brief Version (UPSA-B), respectively. Multivariate analysis of covariance was then adopted to determine inter-group differences in BACS and UPSA-B performance. Results The BACS was capable of differentiating patients with a major psychiatric disorder (schizophrenia, MDD, and BD) from healthy subjects. Furthermore, schizophrenia patients had poorer motor speed performance than patients with affective disorders. The UPSA-B, particularly the financial portion, was able to distinguish schizophrenia patients from other groups. However, we did not observe any differences in UPSA-B performance between patients with mood disorders and the healthy controls. No significant difference between patients with BD and those with MDD were observed in either cognitive function or in functional capacity. The performances of the BACS and the UPSA-B were positively correlated, particularly in the MDD group. Conclusion Considering overall performance, the BACS and the UPSA-B characterize different endophenotyping profiles in the aforementioned four participant groups. Therefore, the results support the need for comprehensive assessments that target both cognitive function and functional capacity for patients with major psychiatric disorders.

Neurolymphomatosis (NL) is an uncommon condition involving lymphomatous invasion of the cranial or spinal nerve roots. Sciatic nerve neuropathy and dysfunction represent a common cause of lower extremity symptoms in clinical practice. However, cases of recurrent lymphoma infiltrating a single peripheral nerve, such as the sciatic nerve, are rare. To date, only one case has been reported in the literature. Isolated lymphomatosis may occur sporadically in patients with lymphoma relapse. Nevertheless, the precise mechanisms underlying such cases remain unclear. The present report describes a patient with recurrent lymphoma who presented with drop foot due to sciatic nerve involvement. In this report, we highlight the importance of ultrasound for diagnosing peripheral neuropathy based on the characteristic nerve enlargement and loss of echogenicity. Our findings, together with existing evidence from the literature, support that ultrasonography, which is relatively rapid, easy, and low risk, can aid in the differential diagnosis of NL.

Background and objective: Screening and identification of methicillin-resistant Staphylococcus aureus (MRSA) carriage are helpful for controlling MRSA dissemination in hospitals. The aim of our study was to determine the prevalence of nasal carriages and diversity of MRSA among patients and healthcare workers (HCWs) at two regional hospitals in Taiwan. Methods: Nasal swabs were obtained prospectively from 204 patients visiting the emergency department (ED) and 326 HCWs in two regional hospitals in Changhua, Taiwan, between February 2015 and June 2015. All the MRSA isolates were further molecularly characterized. Results: Of the 204 participating patients, the nasal carriage rates of S. aureus and MRSA were 22.1% and 7.8%, respectively. For HCWs, the S. aureus and MRSA carriage rates were 26.1% and 6.1%, respectively. There was no statistically significant difference in MRSA carriage rate between patients and HCWs (P = 0.447). Patients receiving hemodialysis were significantly associated with MRSA colonization (P = 0.012). The leading three sequence types (ST) were ST59 (16, 44.4%), ST45 (11, 30.6%), and ST239 (3, 8.3%) for all 36 MRSA isolates. ST59/SCCmec IV/t437/PVL-negative and ST45/SCCmec V/t1081/PVL-negative were the predominant clones among HCWs (30%) and participating patients (19%), respectively. Conclusion: Overall, a substantial proportion of patients visiting the ED and HCWs harbored CA-MRSA, mostly ST59 strains, in their nares. It is noteworthy that MRSA ST45 strains supplanted ST239 as the second leading nasal MRSA colonization strain in our study. Keywords: Methicillin-resistant Staphylococcus aureus (MRSA), Nasal carriage, Molecular epidemiology

Objective: To compare the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) isolates between an old, urban hospital and a new, rural hospital over the same time period. Methods: The molecular characteristics of 398 MRSA bloodstream isolates collected between 2007 and 2013 from two hospitals in Taiwan were analyzed retrospectively; 202 isolates were from the old hospital and 196 from the new hospital (opened in 2007). Results: The rate of resistance to multiple antibiotics was significantly higher in the old hospital (93%) than in the new hospital (81%) (p

ABSTRACTOnychomycosis is most commonly caused by dermatophytes. In this study, we examined the spectrum of phenotypically non-dermatophyte and non-Aspergillus fungal isolates recovered over a 10-year period from nails of patients with onychomycosis in Hong Kong. A total of 24 non-duplicated isolates recovered from 24 patients were included. The median age of the patients was 51 years, and two-thirds of them were males. One-third and two-thirds had finger and toe nail infections respectively. Among these 24 nail isolates, 17 were confidently identified as 13 different known fungal species, using a polyphasic approach. These 13 species belonged to 11 genera and ≥9 families. For the remaining seven isolates, multilocus sequencing did not reveal their definite species identities. These seven potentially novel species belonged to four different known and three potentially novel genera of seven families. 33.3%, 41.7% and 95.8% of the 24 fungal isolates possessed minimum inhibitory concentrations of >1 µg/mL to terbinafine, itraconazole and fluconazole, respectively, the first line treatment of onychomycosis. A high diversity of moulds was associated with onychomycosis. A significant proportion of the isolates were potentially novel fungal species. To guide proper treatment, molecular identification and antifungal susceptibility testing should be performed for these uncommonly isolated fungal species.

This research proposes a method for auto-monitoring the air cutting condition of a machining process, so the air cutting time can be further improved to enhance the machining efficiency. A two-way data communication module with a CNC controller was established to achieve real-time monitoring and control function via TCP/IP protocol. The module enables the identification of the executing NC block and the cutting time during machining. The spindle load current and cutting vibration signals were used to on-line diagnose the cutting state (effective cutting or air cutting), and their associated NC codes were identified and recorded at the same time, based on the executing NC block in the CNC controller. An algorithm adopting this state change information to determine effective cutting time and air cutting time was developed and used to build an intelligent air cutting monitoring system, with a friendly human–machine interface. The system can detect air cutting time, effective cutting time, machine idle time, as well as the total machining time to improve the air cutting time to enhance the machining efficiency. Verification experiments were conducted, and the results showed the proposed method can accurately detect the air cutting occurrence and its associated NC blocks in the NC program.

In this study, we investigated the molecular evolution and phylodynamics of respiratory syncytial virus (RSV) over 10 consecutive seasons (2008–2017) and the genetic variability of the RSV genotypes ON1 and BA in central Taiwan. The ectodomain region of the G gene was sequenced for genotyping. The nucleotide and deduced amino acid sequences of the second hypervariable region of the G protein in RSV ON1 and BA were analyzed. A total of 132 RSV-A and 81 RSV-B isolates were obtained. Phylogenetic analysis revealed that the NA1, ON1, and BA9 genotypes were responsible for the RSV epidemics in central Taiwan in the study period. For RSV-A, the NA1 genotype predominated during the 2008–2011 seasons. The ON1 genotype was first detected in 2011 and replaced NA1 after 2012. For RSV-B, the BA9 and BA10 genotypes cocirculated from 2008 to 2010, but the BA9 genotype has predominated since 2012. Amino acid sequence alignments revealed the continuous evolution of the G gene in the ectodomain region. The predicted N-glycosylation sites were relatively conserved in the ON1 (site 237 and 318) and BA9 (site 296 and 310) genotype strains. Our results contribute to the understanding and prediction of the temporal evolution of RSV at the local level.

Background Cognitive impairments in patients with depressive disorders have a negative impact on their daily skill functioning and quality of life. In this study, we evaluated the cognitive profiles and associated factors of patients with depressive disorders with the Brief Assessment of Cognition in Affective Disorders (BAC-A). Methods This cross-sectional study consisted of 75 patients with depressive disorders (56 patients with major depressive disorder (MDD) and 19 patients with depressive disorder NOS or dysthymic disorder (non-MDD)). We evaluated the participants’ cognitive functions at euthymic status using the BAC-A. The BAC-A includes six subtests derived from the Brief Assessment of Cognition in Schizophrenia (BAC-S) and Affective Processing Tests. The current severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HAMD-17), and we recorded any psychotropic drugs being used by the patients. Results We observed no differences in cognitive profiles in the MDD group and non-MDD group after adjusting for educational levels, severity of depression, and psychotropic drugs. Instead, the HAMD-17 scores were negatively correlated to cognitive performance in working memory, motor speed, verbal fluency, attention and processing speed, executive function, composite score, and the six indexes of the Affective Processing Test measured by the BAC-A. A longer illness duration was associated with worse performance of four indexes of the Affective Processing Test. Furthermore, benzodiazepine use was associated with a worse performance of verbal memory, and antidepressant use was associated with better motor speed performance. Conclusion The current severity of depressive symptoms and psychotropic drugs being taken, not the diagnosis category, are associated with cognitive impairments in patients with depressive disorders. Clinicians should pay particular attention to managing residual depressive symptoms and prescribing adequate psychotropic drugs in order to eliminate depressive patients’ cognitive deficits.

This study proposes a hybrid optimization method which can help users to find optimal cutting parameters which will provide better efficiency and lower power consumption for a milling process. Empirical models including performance-power consumption characteristic curves of servo motors were built, and an optimization algorithm adopting the empirical models with procedure guiding function was developed. The empirical models were built based on the measurements from planned machining experiments with different combination of machining parameters including spindle speed, feedrate, and chip load, etc. After integrating the models and algorithm, an optimization system with human machine interface, which has procedure guiding function, was developed. The system can recommend optimal machining parameters for a milling process for shorter machining time and lower electricity costs based on the original machining parameters. Finally, cutting experiments were conducted to verify the proposed system, and the results showed that the proposed method can effectively enhance efficiency by 42.06% and save 34.74% in machining costs through reducing machining time and electrical power consumption.

An epidemic of influenza B/Malaysia/2506/2004 was reported in Taiwan during the 2006-2007 flu season. We investigated the flu vaccination history and clinical and laboratory characteristics of children with influenza B infection. Methods: We enrolled children younger than 18 years old who visited one of two hospitals between November 2006 and February 2007 with influenza-like illnesses. Throat swabs were taken on their first visit and cultured for viruses. Complete and differential blood counts and blood biochemical parameters were analyzed in some children. Results: Influenza virus was cultured from 51.0% of patients (101/198), 87 (86.1%) of who were infected with influenza virus type B. The remaining 14 (13.9%) were infected with influenza virus type AH3. The 87 children (median age 7.8 years) with culture- proven influenza B virus infection were enrolled. Nine parents reported that enrolled children had been vaccinated against influenza. Leukopenia was found in 56.1% (32/57) of patients, leukocytosis in 3.5% (2/57), and thrombocytopenia in 1.8% (1/57). Thirteen of 23 patients (56%) tested for creatine kinase (CK) had elevated levels (> 160 U/L), and 11 of 23 (47.8%) had myalgia associated with raised CK (p < 0.05). Twenty-six children developed complications, including one case of pneumonia with acute respiratory distress syndrome and one case of flu-associated encephalitis. Conclusion: Most children who contracted influenza B infection had not been vaccinated. Almost half the children had leukopenia, and some had leukocytosis, but thrombocytopenia was rare. There was a significant association between raised CK levels and myalgia in influenza B infection.

Objective: Unicornuate uterus with a non-communicating rudimentary horn is a Mullerian duct anomaly that is unusual among all congenital uterine anomalies. The lesion presents most frequently during childhood and adolescence in an obstructive episode. It is rare in normal reproductive women. Here, we present a patient with a unicornuate uterus and a non-communicating functional rudimentary horn and report laparoscopic therapeutic management for the unicornuate uterus. Case Report: A 39-year-old woman presented with dysmenorrhea for 6 years after abdominal sterilization. The symptoms worsened and she came to our outpatient department for help. Physical examination and transvaginal ultrasound revealed a left round pelvic mass; the CA-125 level was elevated. Laparoscopy under general anesthesia for suspected chocolate cyst revealed a unicornuate uterus with a non-communicating rudimentary uterine horn. Pathology confirmed myometrium with hematometra and hematosalpinx. The patient recovered smoothly and reported no dysmenorrhea at the follow-up examination 12 weeks after surgery. Conclusion: To the best of our knowledge, tubal sterilization is a simple and easy procedure. However, in women with a unicornuate uterus and non-communicating rudimentary horn with a functional endometrium, we suggest performing ligation of the contralateral tube, leaving the tube on the side of the rudimentary horn alone. This will prevent this rare iatrogenic complication.

Objective: Obturator nerve injury is a rare complication of obstetric or gynecologic surgery. We present a rare case of obturator nerve injury due to edematous compression of the obturator fossa during the debulking operation. Case Report: A 49-year-old, gravida 2, para 2, woman complained of left thigh weakness after a debulking operation for left-side ovarian cancer. The left thigh weakness was noted on the first postoperative day due to loss of thigh adductor control. Left obturator nerve injury was, therefore, suspected after consultation with a neurologist. On the third postoperative day, electromyography was arranged, which revealed a lesion on the left obturator nerve at the pelvis. The procedures employed in the operation were reviewed: neither obturator lymph node dissection nor incision of the obturator sheath had been performed. Obturator fossa edema leading to left obturator nerve compression was suspected. The patient received bedside exercise after hospitalization and regular home exercise after discharge. Six weeks after the operation, the left thigh weakness had improved and the patient could walk freely without any assisting devices. Conclusions: Although obturator nerve injury is a rare complication of gynecologic surgery, one should always be alert to the risk of nerve injury if a patient complains of muscle weakness in the thigh. If the diagnosis is confirmed, conservative physiotherapy and rehabilitation can contribute to satisfactory results.

The purpose of this study is mainly to develop an information and communication technology (ICT)-based intelligent dimension inspection and tool wear compensation method for precision tuning. With the use of vibration signal processing/characteristics analysis technology combined with ICT, statistical analysis, and diagnosis algorithms, the method can be used to proceed with an on-line dimension inspection and on-machine tool wear auto-compensation for the turning process. Meanwhile, the method can also monitor critical tool life to identify the appropriate time for cutter replacement to reduce machining costs and improve the production efficiency of the turning process. Compared to the traditional ways, the method offers the advantages of requiring less manpower, and having better production efficiency, high tool life, fewer scrap parts, and low costs for inspection instruments. Algorithms and diagnosis threshold values for the detection, cutter wear compensation, and cutter life monitoring were developed. In addition, a bilateral communication module utilizing FANUC Open CNC (computer numerical control) Application Programming Interface (API) Spec was developed for the on-line extraction of instant NC (numerical control) codes for monitoring and transmit commands to CNC controllers for cutter wear compensation. With use of local area networks (LAN) to deliver the detection and correction information, the proposed method was able to remotely control the on-machine monitoring process and upload the machining and inspection data to a remote central platform for further production optimization. The verification experiments were conducted on a turning production line. The results showed that the system provided 93% correction for size inspection and 100% correction for cutter wear compensation.