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Background Before 2010, guidelines recommended adenosine 6, 12, and a repeat dose of 12 mg for paroxysmal supraventricular tachycardia (PSVT). After 2010, these doses were reduced to two. This study aims to outline adenosine using trend from 2000 to 2012 in Taiwan emergency departments (EDs). Methods This was an ecological study. PSVT were drawn from one million individuals of the National Health Insurance Database. The χ2 test was used to determine an association between different adenosine doses and other antiarrhythmic drugs (OADs), including verapamil, diltiazem, amiodarone, digoxin, and labetalol. Results There were 3361 PSVT visits from 2000 to 2012; 834 (24.8%) did not receive an antiarrhythmic drug, and 2527 (75.2%) did, either adenosine with/without OADs or OADs alone. The use of an OAD was significantly different between the adenosine 6–18 mg and 19 + mg groups. Conclusions Most PSVT episodes converted with adenosine within 18 mg, and the success conversion rate was 62.2%. It could be up to 65.2% if they received more. Of the patients who did not have their PSVT reverted with

In this paper, we recognize that technological trajectories can be modeled as a series of problem-solving activities, manifesting the cyclical pattern of divergence–convergence knowledge flow. This recognition is applied to study the technological development of the thermal inkjet print head, using main path analysis and an assignee cross-citation network. Our analysis shows that the thermal inkjet print head experienced three cycles of divergence–convergence knowledge flow. Each of the cycles was evidently characterized by a problem of most concern and a referred solution. Our research contributes to explaining why, when, and how trajectories diverge and converge cyclically.

This article presents an efficient quadrature digital power amplifier (DPA) based on a complex-domain Doherty (CDD) architecture. The proposed CDD architecture allows a PA to achieve high efficiency through Doherty operation in a complex domain using two independent vectors with different amplitudes and phases. It demonstrates high efficiency when two vectors have in-phase components in the complex domain by introducing an additional efficiency peak. The proposed DPA based on a switch-capacitor PA (SCPA) employs the CDD and dual-supply Class-G techniques to enhance system efficiency (SE) and adds three additional efficiency peaks down to 12-dB power back-off (PBO). An additional efficiency peak at 6-dB PBO and two additional efficiency peaks at 2.5- and 12-dB PBOs are associated with CDD and Class-G, respectively. The prototype, fabricated in a 65-nm CMOS process, achieves 27.8-dBm peak output power ( $P_{\mathrm {OUT}}$ ) with a peak SE of 32.1%. It exhibits an error vector magnitude (EVM) of −42.0 dB (−43.3 dB) at a $P_{\mathrm {OUT}}$ of 14.7 dBm (15.4 dBm) for an 802.11ax 40-MHz (20-MHz) 1024-QAM OFDM signal with 13.1-dB (12.4-dB) peak-to-average power ratio (PAPR) at 2.2 GHz. The average SE measured with a 20-MHz single-carrier 1024-QAM signal with 6.8-dB PAPR at a $P_{\mathrm {OUT}}$ of 21 dBm is 18.4%.

The purpose of this paper is to study how people use texts and languages to interpret or make sense of the COVID-19 pandemic. We draw on the theoretical literature of framing perspectives to formulate our arguments that consider the virus a socially constructed reality. We use Taiwan as an empirical case study, using topic modeling analysis of newspaper articles. Our findings show that the language of the COVID-19 coverage combines the four frames of political evaluation, economic impact, biomedical science and social life in varying proportions. These frames are subject to changes in pandemic conditions. Implications for theory and practice are presented.

A 30.0-dBm polar digital power amplifier (PA) is implemented based on a switched-capacitor PA (SCPA) and multiple efficiency-enhancement techniques, such as Class-G, Doherty, and time interleaving (TI). The PA demonstrates six efficiency peaks and seamless efficiency curves between the peaks in the power back-off (PBO) region with the three efficiency-enhancement techniques. For the implementation of the efficient and linear Class-G technique, a linear single-supply current-reuse Class-G switch is proposed. It realizes a Class-G operation without any additional dedicated supply voltages, resulting in enhanced efficiency and reduced cost for an external power management unit (PMU). A local oscillator (LO) signal restoration technique is proposed to reduce the area and power consumption for the LO signal distribution. The prototype SCPA, fabricated in a 65-nm CMOS, generates 30-dBm peak output power ( $P_{\mathrm {OUT}}$ ) at 2.4 GHz and achieves drain efficiency (DE) (normalized DE) of 40.2% (100%), 37.9% (94.3%), 38.8% (96.3%), 36.3% (90.2%), 29.4% (73.0%), and 19.7% (48.9%) at 0-, 2.5-, 6-, 8.5-, 12-, and 18-dB PBOs, respectively. It achieves less than ±1° amplitude modulation (AM)–phase modulation (PM) distortion with a continuous-wave (CW) signal. It also demonstrates error vector magnitude (EVM) of −41.7 dB (−44.5 dB) and DE of 30.3% (36.2%) at an average output power of 19.1 dBm (23.2 dBm) for a 10-MHz 64-quadrature AM (QAM) orthogonal frequency-division multiplexing (OFDM) signal with a 10.9-dB peak-to-average power ratio (PAPR) (10-MHz single-carrier 1024-QAM signal with 6.8-dB PAPR).

Based on exogenous policy in corporate governance reform, this study examines how the voluntary adoption of audit committees affects firm performance and risk. We use a self-selection model to inve...

Introduction: Reducing the delay in time to primary percutaneous coronary intervention (PCI) for acute coronary syndrome patients in the non-urban emergency department (ED) is of critical importance. Conventionally, physicians in a non-PCI-capable, non-urban local emergency department (LED) require approval from a tertiary university hospital emergency department (TUH-ED) prior to transferring eligible STEMI patients for PCI procedures. To reduce the ED delay time, this study developed a direct connection between the LED and the cardiac catheterisation laboratory in the TUH (TUH cath lab). Methods: ST-elevation myocardial infarction (STEMI) patients' medical records for 2014 to 2017, from a non-PCI regional hospital located in one of the rural counties in central Taiwan and a TUH-ED in a metropolitan area in the centre of Taiwan, were retrospectively collected and classified into two categories: the LED referral (group A) and the TUH-non-referral (group B). This study compared the ED delay time between TUH non-referral patients in the TUH and LED referral patients in the LED, to determine whether a direct connection reduces current LED delay time. Results: A total of 214 patients (group A, n=62; group B, n=152) who underwent PCI procedures at the TUH were enrolled in the study. ED delay times in the LED were significantly less than the TUH-ED (45.0 v 66.0 min, p

Signals for next-generation communication systems typically have high peak-to-average power ratios (PAPR) (e.g., 10 to 13dB), forcing operation at deep output power backoff (PBO). A good efficiency at PBO is required to maintain high average efficiency. Typical power amplifiers (PAs) demonstrate degraded efficiency at high PBO levels, which causes a significant degradation in efficiency, particularly for signals with high PAPR. Efficiency-enhancement techniques using digital PAs (DPAs) have been extensively introduced (e.g., Class-G, Doherty, etc.). DPAs have been shown to be great choices for efficiency enhancement at PBO, because each DPA cell can change the operating mode while switched OFF during the mode transitions, resulting in better linearity and seamless efficiency enhancement at PBO.

Digital transmitters (DTX) or digital power amplifiers (DPA) based on RF digital-to-analog converters (DAC) are optimal for wireless transmitters in CMOS due to the small chip area, low power consumption, and ability to evolve with scaling of the transistor feature size. A DTX integrates all functions of a conventional transmitter into a single RFDAC that directly converts digital bits to RF signals (Fig. 10.7.1) [1]–[3]. It consists of digital circuits (e.g., switches, logic gates, etc.) and passive devices rather than traditional mixed-signal, frequency mixing, gain and output stages. Due to switching operation the power scales ∞CV2f, which benefits from CMOS scaling. In this work, a quadrature switched-capacitor (SC) DTX is presented that can achieve 30dB output power $(P_{OUT})$ range, utilizing no external phase modulator or digital pre-distortion (DPD). The DTX utilizes three linearization techniques and can transmit a 1024-QAM signal with up to 40MHz bandwidth.

Background Those taking proton pump inhibitors (PPIs) might have a higher risk of acute kidney injury. The long-term safety, especially the PPI-associated chronic kidney disease (CKD) is the subsequent concern. Objective This study explores the potential relationship between using PPIs and CKD in Taiwan. Methods Using a database collated by the Taiwan National Health Insurance programme, we conducted a population-based case-controlled study to identify 16 704 cases of patients aged 20 years or older with newly diagnosed CKD between 2000 and 2013. 16 704 controls were randomly selected and were matched by sex, age and comorbidities. 'Use' of PPIs was defined as when subjects had received at least a prescription for PPIs before the index date. 'Non-use' was defined as subjects who had never received a prescription for PPIs before the index date. The odds ratio (OR) for CKD associated with the use of PPIs was estimated by a logistic regression model. Results The OR for CKD was 1.41 for subjects using PPIs [95% confidence interval (CI) 1.34, 1.48] compared with subjects who had never used PPIs. Almost all major types of PPIs present a weak association with increased odds of CKD in cumulative duration and dosage regression analysis. The OR in relation to cumulative duration (per month) of PPIs use was 1.02 (95% CI 1.01, 1.02) and the OR in relation to cumulative dosage (per microgram) of PPIs use was 1.23 (95% CI 1.18, 1.28). Conclusions Using PPIs presented 1.4-fold higher odds of CKD in Taiwan health insurance claims data analysis.

This paper examines how industry changes through the nonlinear view of chaos theory. Chaos theory implies that a dynamic system is nonlinear. Accordingly, we developed a triangulated analysis const...

OBJECTIVE: Out‐of‐hospital cardiac arrest (OHCA) studies are usually conducted at metropolitan medical centres. Because rural studies are rare, our study aimed to assess non‐traumatic OHCA prevalence and resuscitation outcomes in rural Taiwan. DESIGN: A retrospective observational study. SETTING: All seven designated community hospital emergency departments (ED) in Nantou County, Taiwan. PARTICIPANTS: All OHCA patients from May 2011 to March 2013. MAIN OUTCOME MEASURES: Any return of spontaneous circulation (ROSC) and survival for ED discharge. RESULTS: In the 23‐month period, 850 OHCA cases were reported; 741 (87.2%) were non‐traumatic. The overall ROSC achievement rate was 19.7%, with 16.4% case survival for ED discharge. Logistic regression identified that arrest in public (OR: 2.62, 95% CI: 1.19–5.78), witness when collapsed (OR: 2.14, 95% CI: 1.28–3.60), and cardiopulmonary resuscitation (CPR) by bystander (OR: 2.09, 95% CI: 1.02–4.26) might increase the likelihood of any ROSC; arrest in public (OR: 2.68, 95% CI: 1.10–6.50), witnessed collapse (OR: 2.26, 95% CI: 1.24–4.09) and CPR by bystander (OR: 2.79, 95% CI: 1.28–6.05) might also increase the likelihood of survival. For non‐traumatic OHCA patients conveyed to EDs via emergency medical service system (EMS), a shorter response time (OR: 1.09, 95% CI: 1.01–1.18) and travelling time (OR: 1.04, 95% CI: 1.00–1.09) might also increase the chance of survival. CONCLUSION: Compared to previous data from metropolitan areas, ROSC achievement rate was lower in rural Taiwan. Witness presence, response and travelling times affect ROSC achievement in non‐traumatic OHCA patients in rural Taiwan.

Mathews (Asia Pacific Journal of Management, 23(1): 5–27, 2006) argues for the importance of latecomer firms undertaking international expansion through the three pillars of resource linkage, leverage, and learning (LLL). We argue that these pillars can be discussed in terms of an institutional framework that explains how institutions shape resource access and economic actions. Despite their lack of capabilities vis-a-vis established multinationals, latecomers are not passive observers or recipients, but can be institutional entrepreneurs who are potentially reflexive enough to leverage their institutional linkages to acquire resources and develop learning activities for innovation, transformation, and internationalization. To illustrate our idea, we study the Taiwan-based dragon multinational, Acer, from 1976 to 2014. Three institutional blocks that underlie Acer’s engagement with institutional linkage, leverage, and learning are emphasized: the cultural system built around the norms of the Chinese family business; the political system defined by the distinct pattern of state-business relations in Taiwan; and a technological system constructed by multiple global players in the computer industry.

Introduction Maintaining the standard two-handed chest compression is difficult in high-speed ambulances in rural areas. Methods A retrospective, video-based, observational study was conducted from June to September 2013 in Nantou, a rural county of central Taiwan, to evaluate the chest compression fraction in an ambulance carriage during the travel from the scene to the hospital. The chest compression fraction was calculated as the chest compression time period divided by the ambulance travelling time period; the one-handed and two-handed chest compression fractions were also calculated. Results During the 4-month study period, a total of 102 videos that were recorded in an ambulance carriage were reviewed, including 97 cases of manual chest compressions. When there was only one emergency medical technician (EMT) in the carriage, the combined chest compression fraction was 50.6±20.7%; when there were two EMTs, the fraction was 58.3±16.0% and the fraction was 58.3±21.0% in a three-EMT scenario (p=0.221). Moreover, in the carriage, EMTs usually performed one-handed chest compressions. Conclusions The chest compression fraction was low for patients with out-of-hospital cardiac arrest in a moving ambulance, irrespective of the number of providers. Reasons for this observation, as well as the effectiveness of the one-handed chest compression require further evaluation.

This paper applies chaos theory to innovation processes, highlighting nonlinear behavior and temporal dynamics in the process of replacing old and established technologies with the newly created ones. We employed the local Lyapunov exponent (LLE) to develop our model of analysis and define the edge of chaos. To illustrate our ideas, we analyzed the development of printers during the 1976–2012 period using patent application data. The results of the chaotic model were further enriched with a real-world industry review. We discuss the implications for research on chaotic dynamics of change, evolutionary processes of innovation, and managerial practices.

The occurrence of dural arteriovenous fistula (DAVF) is rare. The clinical manifestation varies and depends on the location and venous drainage pattern. We present a case of a 57-year-old man with a left transverse sinus DAVF along with sigmoid thrombosis, cortical venous reflux, and congestion, that initially presented as parkinsonism. The patient was alert and fully oriented; however, decreased facial expressions were noted. His left forearm showed rigidity and bradykinesia, and it was difficult for the patient to smoothly perform rapid alternating movement testing. His complaints about hearing a rhythmic bruit above the left ear, particularly when lying down, alerted the physician of the presence of vascular lesions. Magnetic resonance imaging and angiography confirmed the diagnosis of DAVF. The patient received a combined surgical and endovascular approach to permanently block the fistula blood flow. The motion and movement of his left upper limb improved after fistula embolization. Images at the 1-month follow-up showed a decrease in the volume of tortuous vessels, and the fistula was completely occluded.

Disruptive innovation dramatically changes the demand of a product market in the information technology (IT) industry. In response to the impact of disruptive innovation, IT firms that may be eliminated from the competitive race actively develop innovative products and adjust their operating strategies to strengthen their survivability in the fiercely competitive market. Thus, this study explores the factors that affect firm value in the IT industry under the impact of disruptive innovation. The empirical results reveal that knowledge capital and CEO power play crucial roles in explaining firm value. IT firms with powerful CEOs and increased knowledge capital have high firm values. The effects of knowledge capital and CEO power on firm value are especially significant for founder and duality CEO firms. Furthermore, the influence of CEO power is more prominent in periods of financial crisis.

This study utilized a two-stage approach, including secondary data analysis and the DEcision-MAking Trial and Evaluation Laboratory, to identify and explore the interrelationships of determinants for the performance of the university–industry research collaboration (UIRC) at the National Tsing Hua University, one of Taiwan’s elite universities. Research results provide a visualized framework to assess UIRC performance by showing that Taiwan is heavily driven by top-down leadership, as well as institutional incentives and policies. This study also indicates that UIRC performance is overwhelmingly focused on contract-based R&D collaboration, rather than technology licensing and transfer activities, demonstrating the significant role of public R&D funding and reflecting the industrial/social demand and the type of knowledge creation and diffusion in the catching-up countries such as Taiwan are divergent from those in leading countries, such as in the The Organization for Economic Cooperation and Development (OECD) countries. Policy and managerial implications for the evolving role of universities in latecomer countries are derived and discussed.

Aims Most diabetes mellitus (DM) patients have several comorbidities; the correlation of these comorbidities with dementia in DM requires clarification. Methods Using claims data from Taiwan National Health Insurance, we identified 33,709 DM adults before the year 2000 and randomly selected 67,066 non-DM patients matched by sex and age. Subjects were followed until diagnosis with dementia, excluded due to death/withdrawal from the insurance program, or followed until 2011. We compared the incidence and hazard ratio (HR) for dementia in both cohorts. Results Comorbidities were more prevalent in DM patients, including hypertension, hyperlipidemia, stroke, coronary artery and/or kidney disease. The HR was higher for the DM cohort with comorbidities than those without: 1.88 vs. 1.46 with hypertension; 1.56 vs. 1.39 with hyperlipidemia; 1.73 vs. 1.37 with coronary artery disease; 2.36 vs. 2.29 with stroke and 1.88 vs. 1.50 with kidney disease. The HR for dementia in diabetics rose from 1.41 in those without comorbidities to 2.49 in those with ≥ 4 comorbidities. In the DM cohort, HR was 1.22 for non-insulin-users and 1.41 for insulin-users, and 1.49 for type 1 DM and 1.23 for type 2 DM. Conclusion Diabetic patients have an elevated risk of dementia, and comorbidity increases this risk.

Use of Celecoxib Correlates With Increased Relative Risk of Acute Pancreatitis: A Case–Control Study in Taiwan

This paper considers technological trajectories as a series of problem-solving activities, manifesting the pattern of divergence-convergence knowledge flow. We propose that technological trajectori...

This paper examines the diffusion of mobile payment technology in Taiwan from 2012 to 2018. To this end, we employ topic modeling, a computer-based text mining approach, to uncover the hidden struc...

A quadrature Class-G switched-capacitor power amplifier (SCPA) is implemented with a merged cell switching (MCS) and an inherent mismatch compensation for dual-supply voltage. The MCS technique improves power added efficiency (PAE) by adopting Class-G operation in quadrature IQ-Cell shared SCPA architecture in an efficient manner. The mismatch compensation technique can minimize nonlinearity from the mismatches in multiple supply voltages. The SCPA achieves peak output power and PAE of 30.1dBm and 37.0%, respectively. For 802.11g 64-QAM OFDM signal with 10.6dB PAPR (20MHz single-carrier 256-QAM signal with 7.6dB PAPR), it demonstrates an average output power of 19.5dBm (22.5dBm) and PAE of 14.7% (18.3%), while achieving EVM of −40.7 dB (-40.3dB).