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In mammals and yeast, tail-anchored (TA) membrane proteins destined for the post-translational pathway are safely delivered to the endoplasmic reticulum (ER) membrane by a well-known targeting factor, TRC40/Get3. In contrast, the underlying mechanism for translocation of TA proteins in plants remains obscure. How this unique eukaryotic membrane-trafficking system correctly distinguishes different subsets of TA proteins destined for various organelles, including mitochondria, chloroplasts and the ER, is a key question of long standing. Here, we present crystal structures of algal ArsA1 (the Get3 homolog) in a distinct nucleotide-free open state and bound to adenylyl-imidodiphosphate. This approximately 80-kDa protein possesses a monomeric architecture, with two ATPase domains in a single polypeptide chain. It is capable of binding chloroplast (TOC34 and TOC159) and mitochondrial (TOM7) TA proteins based on features of its transmembrane domain as well as the regions immediately before and after the transmembrane domain. Several helices located above the TA-binding groove comprise the interlocking hook-like motif implicated by mutational analyses in TA substrate recognition. Our data provide insights into the molecular basis of the highly specific selectivity of interactions of algal ArsA1 with the correct sets of TA substrates before membrane targeting in plant cells.

Taiwanese nurses face increasingly demanding working conditions along with a distinctive culture where family members participate in medical decisionmaking. This research explores Taiwanese nurses' perceptions of patient education, with a focus on the difficulties. Data were collected by in-depth focus group discussions with nursing staff (n=53) from the medical and surgical wards of two teaching hospitals. Transcripts were analyzed and revealed six themes: source of fulfillment and pressure; excessive workload; alternating between patients; not knowing who to teach; difficulty in communication; and disrupted confidence and work rhythm. Research findings could help managers understand the difficulties faced by nurses in providing health education. Nurses should broaden the scope of patient education activities to include family members. Additionally, nurses should discuss patients' desires and expectations from family members in medical treatment and decisionmaking.

Healthcare providers use distinct medical terminology to communicate in professional healthcare settings in Taiwan. Moreover, nursing students understand the importance of acquiring a good command of this medical terminology to the development of their professional careers. Thus, using proper teaching strategies to boost student participation and interest in their studies is an important responsibility and task. Social Learning Theory has been widely used in education. According to this theory, learners learn about new models of behavior and modify old models through observation and imitation. Moreover, they gain opportunities for observation and imitation through social interaction. Team-based games that are based on this theory are designed to enhance interest in study and interpersonal interaction among learners through peer observation and study and help promote active learning and group study. This article describes the use of a team-based game to teach the strategies involved in selecting medical terminologies commonly used in clinical settings. This game has earned positive responses and evaluations from students. Nursing teachers may design diversified team-based games and use this teaching strategy to teach medical terminology as well as other subjects.小組遊戲教學策略於課程之運用—以醫學術語為例.在台灣的醫療工作環境中，「醫學術語」是醫療從業人員之間溝通交流的共同語言，護生們也一致認為運用醫學術語的能力可以協助其護理專業的發展，運用合適的學習理論與教學策略，提升學生對該課程的參與度及學習興趣是一項重要的教學責任與工作。社會學習理論已被廣泛運用於教學領域，此理論提到學習者藉由觀察與模仿，學習新的行為模式及修正舊的行為模式，並透過社會互動，得到觀察與模仿的機會。小組遊戲正是運用此社會學習理論的觀點來進行，藉由同儕觀察與學習來提升學習者的學習興趣與人際互動，有助於達成「主動學習」與「同儕學習」。因此，筆者於「醫學術語」課程中運用「小組遊戲」為教學策略之一，學生亦肯定此教學模式，且有助於提升學習成效。護理教師可設計多樣化的小組遊戲並運用此教學策略於醫學術語或其他科目。.

Attending lectures and reading are two common approaches to acquiring knowledge, while repetitive practice is a common approach to acquiring skills. Nurturing proper attitudes in students is one of the greatest challenges for educators. Health professionals must incorporate empathy into their practice. Creative teaching strategies may offer a feasible approach to enhancing empathy-related competence. The present article focuses on analyzing current, empathy-related curriculums in nursing education in Taiwan, exploring the concepts of empathy and game-based learning, presenting the development of an empathy board game as a teaching aid, and, finally, evaluating the developed education application. Based on the learner-centered principle, this aid was designed with peer learning, allowing learners to influence the learning process, to simulate the various roles of clients, and to develop diverse interpersonal dialogues. The continuous learning loops were formed using the gamification mechanism and transformation, enabling students to connect and practice the three elements of empathy ability: emotion, cognition and expression. Via the game elements of competition, interaction, storytelling, real-time responses, concretizing feedback, integrated peer learning, and equality between teachers and students, students who play patient roles are able to perceive different levels of comfort, which encourages the development of insight into the meaning of empathy. Thereby, the goals of the empathy lesson is achievable within a creative game-based learning environment.遊戲式學習於護理教育應用—同理心桌遊教學.知識的學習可透過課程、閱讀來獲得，技術則可透過重複練習來精熟，但情意的養成乃是教學者最大的挑戰。如何透過課程有效培養醫護教育中漸受重視的同理心，創新教學是可行的嘗試。本文分析台灣護理教育之同理心教學現況、探討同理心與遊戲式學習概念、介紹桌遊創意教具發展及檢討其教學運用。本教具採學習者中心的角度，讓學生享有主控權，模擬臨床個案角色，發展多元對話。藉遊戲化身機制與同儕演練而形成多重循環學習，學生能連結並演練同理能力的情感、認知與表達三要素。透過競爭性、互動性、故事性、即時具象化（concretization）回饋之機制設計，融入平權、同儕學習等教學元素，學生能體驗不同層次之被同理感受並深化同理心意義思辨，以達同理心創意教學之目的並實踐寓教於樂之教學理想。.

Dehydroascorbate reductase (DHAR) is a key enzyme for glutathione (GSH)-dependent reduction of dehydroascorbate (DHA) to recycled ascorbate (AsA) in plants, and plays a major role against the toxicity of reactive oxygen species (ROS). Previously, we proposed that the increase of AsA regeneration via enhanced DHAR activity modulates the ascorbate-glutathione cycle activity against photooxidative stress in Chlamydomonas reinhardtii. In the present work, we use site-directed mutagenesis and crystal structure analysis to elucidate the molecular basis of how C. reinhardtii DHAR (CrDHAR1) is involved in the detoxification mechanisms. Mutagenesis data show that the D21A, D21N and C22A mutations result in severe loss of the enzyme's function, suggesting crucial roles of Asp-21 and Cys-22 in substrate binding and catalysis. The mutant K11A also exhibits reduced redox activity (∼50%). The crystal structure of apo CrDHAR1 further provides insights into the proposed mechanism centering on the strictly conserved Cys-22, which is suggested to initiate the redox reactions of DHA and GSH. Furthermore, in vitro oxidation of the recombinant CrDHAR1 in the presence of 1 mM H2O2 has minor effects on the Km for the substrates but significantly reduces the kcat. The enzyme's activity and its mRNA abundance in the C. reinhardtii cells are increased by treatment with 0.2-1 mM H2O2 but decreased when H2O2 is ≥ 1.5 mM. The latter decrease is accompanied by oxidative damage and lower AsA concentrations. These biochemical and physiological data provide new insights into the catalytic mechanism of CrDHAR1, which protects the C. reinhardtii cells from oxidative stress-induced toxicity.

Although the mechanisms underlying selective targeting of tail-anchored (TA) membrane proteins are well established in mammalian and yeast cells, little is known about their role in mediating intracellular membrane trafficking in plant cells. However, a recent study suggested that, in green algae, arsenite transporters located in the cytosol (ArsA1 and ArsA2) control the insertion of TA proteins into the membrane-bound organelles. In the present work, we overproduced and purified these hydrophilic proteins to near homogeneity. The analysis of their catalytic properties clearly demonstrates that C. reinhardtii ArsA proteins exhibit oxyanion-independent ATPase activity, as neither arsenite nor antimonite showed strong effects. Co-expression of ArsA proteins with TA-transmembrane regions showed not only that the former interact with the latter, but that ArsA1 does not share the same ligand specificity as ArsA2. Together with a structural model and molecular dynamics simulations, we propose that C. reinhadtii ArsA proteins are not arsenite transporters, but a TA-protein targeting factor. Further, we propose that ArsA targeting specificity is achieved at the ligand level, with ArsA1 mainly carrying TA-proteins to the chloroplast, while ArsA2 to the endoplasmic reticulum.

A 1000MW ultra-supercritical unit was studied to gain the energy consumption characteristics by means of thermodynamic analysis. Comparing with the designed conditions, the power generation efficiency under real operation is much less; especially under 50% and 100% rated loads. The higher superheated steam temperature and lower reheat temperature were found to explain that. At the real running, the higher superheated steam temperature induced more attemperation water, while reheat temperature lower than the designed point would decrease the power output. Aiming at solving issues about temperature control in unit operation, several details could be paid extra attention to. For instance, attemperating water comes from outlet of the high-pressure heaters would have a much slighter influence on generating efficiency.

To investigate the effects and mechanism of genistein on hepatocellular carcinoma. Cell counting kit-8 assays showed that genistein at 3, 6, and 9 µM had no significant cytotoxic effects on HepG2, SMMC-7721, and Bel-7402 cells. Cell scratch and Transwell assays identified that genistein inhibited migration of three cell lines. In three cell lines, genistein enhanced E-cadherin and α-catenin, but reduced N-cadherin and Vimentin at both mRNA and protein levels in a dose-dependent manner. Simultaneously, treatment with genistein suppressed epithelial-mesenchymal transition (EMT) induced by TGF-β. In HepG2 cells, genistein reduced mRNA, and protein expressions of nuclear factor of activated T cells 1 (NFAT1), Abca3, Autotaxin, CD154, and Cox-2. Phorbol 12-myristate 13-acetate (PMA) and ionomycin enhanced activity of NFAT1, reduced E-cadherin and α-catenin protein levels, and increased protein levels of N-cadherin and Vimentin. Transwell demonstrated that PMA and ionomycin reversed the migration inhibitory effects of genistein on HepG2 cells. In vivo, genistein inhibited the intrahepatic metastasis by reversing the EMT, which was correlated with reduced NFAT1 . Genistein inhibited hepatocellular carcinoma cell migration by reversing the EMT, which was partly mediated by NFAT1. The fact that EMT can be reversed by genistein may shed light on the possible mechanisms for its role in liver cancer therapy.

Dietary patterns are associated with morbidity and mortality of heart failure. Volume overload was the most common cause for re-hospitalization for heart failure patients. However, recommended preventive strategies of restricting excessive dietary sodium and fluid intake were found to be in vain. This study looks at the preventive dietary instructions from a cultural context, and examined the effects of sodium and fluid restriction on twelve elderly Chinese patients hospitalized with heart failure through a qualitative design. Four themes emerged from the data: medicine-food homology, salt and sodium as synonymous, activity intolerance but still wanting social connections, and barriers to asking questions. Results suggested that living with heart failure is a complex and changeable process for both patients and caregivers. Many patients reported low levels of understanding concerning their symptoms and heart function deterioration. The findings found that good communication requires cultural sensitivity, objective listening to the patient's narrative, and helping patients find meaning between their experiences and symptom control.

Eucalyptus broken wood, eucalyptus bark, sugar cane leaves and bagasse as the representative of South China typical biomass have been investigated by experimental study. The experimental study was carried out to study the devolatilization law and the fixed carbon burning law, also the NOX emission characteristics. The experiments showed that the influence of temperature on combustion, especially in the initial stage of combustion, the weight loss rate difference were up to 60%. The NOX emission experiments showed that the NOX emission of eucalyptus bark was the maximum in 700°C combustion.

Endometriosis is a common, but difficult to diagnose and manage, condition for women of reproductive age. Published studies have shown that healthcare providers and women comprehend endometriosis from different perspectives. To identify the notions behind the discrepancies between the descriptions of women with endometriosis and healthcare professionals, we explored the reported impacts and manifestations described for endometriosis. Two branches regarding the impact of endometriosis on women were categorized as follows: disability and isolation, as well as pain and intimacy. In contrast, the features of the symptoms were characterized as protean and diffusing symptoms that were simplified to obtain reductive diagnosis, and anchor versus relief. To promote healthcare for women with endometriosis, researchers must embrace a broader and more holistic approach to the investigation of emic knowledge of women with endometriosis.

Slip-sinkage is one of the main factors influencing the driving safety of planetary rover in soft terrain. In the environment of scarce features, based on the stereo visual sensors, the visual odometry algorithm is firstly developed to calculate the position changes of planetary rover with six degrees of freedom, which combine with the wheel speed sensor achieve the estimation of wheel slip ratios. Then, on the basis of mechanical analysis of soft terrain, choosing the slip ratio as the state variable, the coordinated driving control algorithm is designed. Simulation and experiment results demonstrate the effectiveness of the proposed control algorithm.

Taiwanese nurses face increasingly demanding working conditions along with a distinctive culture where family members participate in medical decisionmaking. This research explores Taiwanese nurses' perceptions of patient education, with a focus on the difficulties. Data were collected by in-depth focus group discussions with nursing staff (n=53) from the medical and surgical wards of two teaching hospitals. Transcripts were analyzed and revealed six themes: source of fulfillment and pressure; excessive workload; alternating between patients; not knowing who to teach; difficulty in communication; and disrupted confidence and work rhythm. Research findings could help managers understand the difficulties faced by nurses in providing health education. Nurses should broaden the scope of patient education activities to include family members. Additionally, nurses should discuss patients' desires and expectations from family members in medical treatment and decisionmaking.

Aims. This paper reports on a study carried out to establish a decision tree model to describe how women in Taiwan make the decision whether or not to have a hysterectomy. In addition, we examined the predictability of the decision-tree model. Background. Hysterectomy is the second most common surgical procedure performed worldwide. Medical professionals believe that the operation can relieve pain and prevent cervical cancer, thus improving a woman's quality of life. While most physicians advise hysterectomy even for benign uterine conditions, feminists decry the belief that the uterus has no purpose, believing that it is an important symbol of womanhood. Methods. The study was conducted in two phases. Phase I, the model development phase, was carried out to generalize data from a qualitative study of 14 women and to establish a tree model outlining their decision to proceed with hysterectomy. The second phase was the model prediction phase that applied inductive and deductive methods to data analysis and development of the decision-tree model. The model tree was then tested with 18 women who were deciding whether or not to undergo hysterectomy. Using the decision-making tree, we studied the women's thought processes and analysed their primary concerns. The study was carried out in 1999–2001. Results. The study determined 13 criteria that Taiwanese women use when deciding about having a hysterectomy. Developed in accordance with Gladwin's methodology, the model tree successfully predicted 90% of decisions whether or not to have a hysterectomy. Conclusions. Nurses working in gynaecological services should understand how women decide to undergo hysterectomy so that the proper counselling and follow-up can be provided. With further testing, our decision tree may help in this process.

The peripheral arterial vessel often appears as an elliptic shape under the constraints of the surrounding tissues. In this study, the gradient-based Hough transform was used to detect the central location of the ellipse and the lumen area of the arterial vessel non-invasively using power Doppler imaging. Sequential ultrasound images were used to construct arterial distension waveforms in both the major- and minor-axis directions for a few cardiac cycles. The common carotid arteries (CCAs) for nine healthy male volunteers (mean age 24 years), in the sitting position, were investigated in vivo. The CCAs (n = 9) had a mean diameter of 5.83mm, and the pulsatile diameter distension was 13.7+/-1.9%. The brachial artery and dorsalis pedis artery for five healthy male volunteers (mean age 26 years), in the supine position, had mean diameters of 4.03mm and 2.83mm and distensions of 16.7+/-4.6% and 15.5+/-5.4%, respectively. The movement of the arterial centre location during the cardiac cycle reflected the asymmetry of the reaction forces produced by the surrounding soft tissues. The present method can obtain the response of vessel distension to pulse pressure, as well as the constrained conditions of the arteries.

Aims and objectives To explore women's perspectives on deciding to undergo hysterectomy for benign conditions based on physicians' recommendations and the women's own judgement. Background Hysterectomy is the second most common surgical procedure worldwide. Although most hysterectomies are elective, physicians may recommend treatment that involves a loss of sexuality or ovary removal, creating a difficult choice for women. Design Qualitative, in-depth interview Methods A purposive sample of 17 women was recruited. The women had decided to undergo hysterectomy after the diagnosis of uterine fibroids. All these women had already decided not to have more children. Data were collected by in-depth interviewing, and content analysis was used to analyse the data. Results Our study revealed five themes: release from stress, inescapable fate, positive support, hoping for peace of mind and sense of trust. Conclusions The participants felt that mental and physical health were the most important considerations, noting that when women no longer want children, a uterus is useless. The women believed that they retained their womanhood, even without a uterus, and were satisfied with the outcomes of their hysterectomy decisions. Relevance to clinical practice Our findings might serve as educational and counselling reference materials for healthcare providers, ensuring that women receive appropriate care quality and have their needs met. Healthcare providers can then maximise women's empowerment, deepen their awareness of body image and their concept of self-care and help them to clearly perceive their own concerns and needs so that they can make suitable decisions.

Objectives Pancreatic cancer is one of the most aggressive and lethal cancers worldwide and there are few effective treatments. Recently, salinomycin (Sal) was reported to alter proliferation and apoptosis in various tumors. This prompted us to investigate the effect of Sal on pancreatic cancer cells and to explore the possible molecular mechanism in vitro . Methods After treatment with Sal, pancreatic cancer cell viability and apoptosis were analyzed by Hoechst 33342 staining and flow cytometry, respectively. Invasion and metastasis of pancreatic cancer cells were assayed by a Transwell migration assay. Flow cytometry was also used to assessed the fraction of CD133 + cell subpopulations. The expression of proliferating cell nuclear antigen (PCNA), Bcl-2, E-cadherin, and Wnt/β-catenin signaling-related proteins were detected by RT-PCR and western blot. Results Sal inhibited the growth and migration of pancreatic cancer cells in vitro in a dose- and time-dependent manner. We found that the proportion of CD133 + cell subpopulations decreased after treatment with Sal in pancreatic cancer cell lines at the same time. The percentage of apoptotic cells was increased after Sal treatment. Compared with control groups, Bax and E-cadherin were significantly upregulated, and Bcl-2 and PCNA were significantly downregulated in Sal-treated cells. The expression of Wnt/β-catenin signaling-related proteins (β-catenin and p-GSK-3β) was inhibited. Conclusions These results indicate that Sal could influence the cell growth and migration in pancreatic cancer cells in vitro , which may occur by inhibition of Wnt/β-catenin signaling.

The anti-tumor antibiotic salinomycin (Sal) was recently identified as a selective inhibitor of breast cancer stem cells; however, the effect of Sal on hepatocellular carcinoma (HCC) is not clear. This study aimed to determine the anti-tumor efficacy and mechanism of Sal on HCC. HCC cell lines (HepG2, SMMC-7721, and BEL-7402) were treated with Sal. Cell doubling time was determinated by drawing growth curve, cell viability was evaluated using the Cell Counting Kit 8. The fraction of CD133(+) cell subpopulations was assessed by flow cytometry. We found that Sal inhibits proliferation and decreases PCNA levels as well as the proportion of HCC CD133(+)cell subpopulations in HCC cells. Cell cycle was analyzed using flow cytometry and showed that Sal caused cell cycle arrest of the various HCC cell lines in different phases. Cell apoptosis was evaluated using flow cytometry and Hoechst 33342 staining. Sal induced apoptosis as characterized by an increase in the Bax/Bcl-2 ratio. Several signaling pathways were selected for further mechanistic analyses using real time-PCR and Western blot assays. Compared to control, β-catenin expression is significantly down-regulated upon Sal addition. The Ca(2+) concentration in HCC cells was examined by flow cytometry and higher Ca(2+) concentrations were observed in Sal treatment groups. The anti-tumor effect of Sal was further verified in vivo using the hepatoma orthotopic tumor model and the data obtained showed that the size of liver tumors in Sal-treated groups decreased compared to controls. Immunohistochemistry and TUNEL staining also demonstrated that Sal inhibits proliferation and induces apoptosis in vivo. Finally, the role of Sal on in vivo Wnt/β-catenin signaling was evaluated by Western blot and immunohistochemistry. This study demonstrates Sal inhibits proliferation and induces apoptosis of HCC cells in vitro and in vivo and one potential mechanism is inhibition of Wnt/β-catenin signaling via increased intracellular Ca(2+) levels.

OBJECTIVES Improving nurses' competence in resolving clinical ethical issues must start with ethics education in training and clinical practice. However, many students complain that they cannot apply classroom learning to actual clinical scenarios. This study explored ethical issues and dilemmas, and their impact experienced by student nurses in clinical practice. METHODS Focus groups were conducted with 44 first-year student nurses from a 2-year college course in northern Taiwan. Interviews were tape-recorded and verbatim transcripts were analysed using content analysis. RESULTS Students expressed and discussed their views in eight focus groups. Analysis of interviews revealed five themes: frustration at inability to help some patients; oppression caused by lower status; lack of honesty and ethical courage; powerlessness, and self-encouragement in adversity. CONCLUSIONS Taiwanese nurse ethics training was only recently introduced and the curriculum has not addressed the clinical reality in Taiwan. This reality includes limitations arising from the medical hierarchy and the socio-cultural role of families in medical decision making, which may inhibit ethical judgements and decision making. In clinical dilemmas, the most common problems faced by Taiwanese nursing students involved not knowing how to handle some situations, inability to abide by principles, and a lack of appropriate role models. Hence, we suggest that nursing ethics education should: (i) integrate scenarios involving ethical dilemmas into daily routines; (ii) give students opportunities to discuss their feelings about their experiences; (iii) allow teachers and students to talk about scenarios with ethical implications, and (iv) provide students with opportunities to reflect on clinical scenarios in order to clarify their values and learn how to respect the value of life.

Background Most people being treated for alcoholism are unable to successfully quit drinking within their treatment programs. In few cases do we know the full picture of how abstinence is achieved in Taiwan. We tracked processes of abstinence in alcohol-dependency disorders, based on study evidence and results. This research explores the process of recovery from the viewpoint of the alcohol-dependent. Methods Semi-structured interviews were conducted in two different settings, using purpose sampling, during 2003-2004. The data were analyzed using content analysis. Participants were 32 adults, purposefully selected from an Alcoholics Anonymous group and a psychiatric hospital in North Taiwan. Results We found that the abstinence process is an ongoing process, in which the alcohol-dependent free themselves of addiction progressively. This process never ends or resolves in complete recovery. We have identified three stages in the struggle against alcoholism: the Indulgence, Ambivalence and Attempt (IAA) cycle, in which the sufferer is trapped in a cycle of attempting to give up and failing; the Turning Point, in which a Personal Nadir is reached, and the Ongoing Process of abstinence, in which a constant effort is made to remain sober through willpower and with the help of support groups. We also discuss Influencing Factors that can derail abstinence attempts, pushing the sufferer back into the IAA cycle. Conclusion This study provides important points of reference for alcohol and drug service workers and community healthcare professionals in Taiwan, casting light on the abstinence process and providing a basis for intervention or rehabilitation services.

Hepatitis C virus (HCV) core protein is considered to be an attractive candidate for development of protective HCV vaccines. However, this protein may attenuate the induction of systemic immune responses due to its immunomodulatory properties. In this study, we constructed a HCV core gene-containing eukaryotic expression plamid pCI-C, and an in vivo-inducible prokaryotic expression plasmid pZW-C, and transformed the recombinant plasmids into an attenuated Salmonella typhimurium aroA strain SL7207. The resulting bacterial strains SL7207/pCI-C and SL7207/pZW-C were used to orally immunize BALB/c mice, and the immune responses specific to HCV core protein were assessed. Immunization with the recombinant bacteria SL7207/pCI-C led to a persistent drop in percentage of CD3 CD4 T cells, and induced a weak anti-core IgG production. Splenocytes from SL7207/pCI-C immunized mice developed a relatively weak proliferation response and inferior cytotoxic activity compared to those from the mice immunized with bacteria SL7207/pZW-C. Boost immunization with SL7207/ pCI-C yielded limited improvement in immune strength, while the boost with bacteria SL7207/pZW-C significantly enhanced the immune response. These results suggest that de novo synthesis of native HCV core protein may blunt the induction of immune responses. Attenuated S. typhimurium carrying HCV core protein could efficiently activate systemic cellular and humoral responses, and may be a promising strategy for the development of core-based HCV vaccines.

The purpose of this qualitative research was to explore and develop the process of self-empowerment for primary caregivers responsible for caring for elderly with dementia. Nine primary caregivers who lived in northern Taiwan were interviewed through a theoretical sampling procedure. In-depth, face-to-face interviews were tape-recorded and transcribed verbatim. The grounded theory method was applied for analyzing data. The six main components that emerged in this model: "filial piety", "feeling of out of control", "inner awareness", "care ability", "emotion reconstruction", and "life management". This model starts from "filial piety" and "feeling of out of control," then evokes caregivers' "inner awareness". The inner awareness powerfully influences caregivers' "care ability", "emotion reconstruction" and "life management," which account for the three inner mechanism parts in their caregiving experience. Each part comprises three stages that are influenced by "inner awareness". The lower stage of each part supports the next higher stage. The same stages in all parts parallel one another, and influence each other by providing support or creating barriers. On the other side, competition between support and barriers from the outside environment determines the completion of this self-empowerment process. Results of this research extend the knowledge in understanding the psychological processes related to caring for elderly with dementia. The findings also provide readers a positive viewpoint on the caring experiences of primary caregivers of elderly with dementia.

This paper is to present a high order statistics-based adaptive interference cancel filter (AIC-HOS) to process evoked potential (EP). In the conventional ensemble averaging method, experiments have to conduct repetitively to record the required data. In normalized LMS adaptive filter, inappropriate step size always causes deficiency. This AIC-HOS system has none of the above disadvantages. This system was experimented in somatosensory evoked potential corrupted with EEG. A gradient type algorithm is used in this AIC-HOS structure to regulate the SNR of EEG and EP. This method is also simulated with visual evoked potential and audio evoked potential. The results obtained are satisfactory and acceptable in clinical usage. The AIC-HOS is superior to normalized LMS using adaptive filter in that it converges easily. Moreover, it is not sensitive to selection of step size in stabilities in convergency.

One of the most important mechanisms for maintaining the life of human beings is their circulatory system. This research focuses on a non-invasive technique that maintains high resolution and high precision of measuring photons in the blood stream. We hope to obtain important biomedical parameters valuable for pathological diagnosis. In phase I, a non-invasive optical flow velocimetry technique is implemented for detecting the human circulatory system under the skin surface. The source of the incident photons is an He-Ne laser. The signal is transmitted and detected via a Y-type optical fiber. Optical heterodyning is used to measure the frequency difference between the reflection wave and the original incident laser wave. Then numerical simulation using Monte Carlo was used in the analysis to verify the result. In phase II, after a velocimetry specification was decided, it was modeled, tested and verified using Monte Carlo simulation. Then the apparatus were set up as directed in the model. The performance of this velocimetry is satisfactory and acceptable. This. method of implementing a velocimetry is simple, convenience and fast. Thus, no prior clinical experiment is need. Moreover, the best reading for the reflected wave is 45/spl deg/ /spl plusmn/ 2.35/spl deg/. This is a real-time and continuous detecting blood flow velocimetry. We find that this is a reliable tool for doctors when doing clinical diagnosis.

We studied the effect of mechanical pumping on the response of peripheral arteries by focusing on the pulse wave velocity (PWV) in large arterial conduit and micro-vessels. The pressure waveforms were measured simultaneously at the brachial artery (BA), radial artery (RA) and finger. Impulse pumping was operated by alternatively adding 80 mmHg pressure to the arm of normal subjects (N=10) in 3 seconds and relaxing to 0 mmHg in 7 seconds for a period of 15 minutes. After pumping the segmental arterial PWV from BA to finger decreases due to the action of the change in endothelial relaxing factor. However, we find the decrease in PWV from BA to finger after pumping was contributed from the results of BA-RA, the PWV for the micro-vessels (BA-finger) on the contrary was increased.