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Objective To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. Design A single-blind, randomized controlled trial. Setting Four hospitals. Participants Outpatients with chronic stroke and mild to moderate motor impairment (N=44). Intervention UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks. Main Outcome Measures Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment. Results The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P Conclusions BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.

The objective of this study was to evaluate the effects of a hot-water extract of defatted Camellia oleifera seeds (CSE) in carbon tetrachloride (CCl4 )-induced liver damage in rats. Wistar rats were separated into four groups including the normal (N) and CCl4 control (C) groups, which are fed a control diet, and the CCL (low-dose CSE) and CCH (high-dose CSE) groups, which are fed with a control diet plus different amount of CSE for an 8-week experimental period. Liver injury in the C, CCL, and CCH groups was induced by injecting CCl4 (i.p.) twice a week from the 5th week to the end of the study. In CCl4 -treated rats, the alanine transaminase (ALT) and aspartate transaminase (AST) activities and malondialdehyde (MDA) concentration significantly increased compared to the normal group. Lower antioxidative enzyme activities and higher proinflammatory cytokines, transforming growth factor-β (TGF-β) and hydroxyproline concentrations in the liver were also found in the CCl4 -treated group compared to the normal group. In contrast, the administration of CSE alleviated the biochemical and histopathological changes including inflammation, liver cell damage, and fibrosis caused by CCl4 in rats. Our results indicated that CSE exhibited hepatoprotective effects in CCl4 -induced liver hepatotoxicity through alleviating hepatic inflammation and fibrosis in rats. PRACTICAL APPLICATION: Camellia oleifera are widely used for edible oil production while the defatted seeds pomace is often discarded. We found that extract of C. oleifera pomace containing phenolic compounds, saponins, and polysaccharides showed protective effects chemical-driven liver damage and, therefore, may be used in further studies and developing functional foods.

Since 1986, the “push” and “pull” factors of “Migration Law” are generally used to explain the flux of immigration. Taiwan began to import guest workers in 1989 to alleviate a labor shortage. Whereas, the Taiwan government is generally reluctant to publicly recognize her dependency on unskilled migrant laborers, foreign labor policy is set for the purpose of fulfilling the economic and social needs of the country. Foreign workers are introduced to “supplement” the labor force in limited trades and quantities instead of “replacing” domestic laborers. Ironically, the total number of guest workers in Taiwan hit a record high of 714,291 in September 2019. Taiwan’s National Immigration Agency reported that 1,815 cases of trafficking were uncovered from January 2007 to September 2019. Seven hundred sixty-two of these cases involved forced labor (42%) and one thousand and fifty-three cases (58%) involved sexual exploitation. The nexus between foreign labor policy and human trafficking is evidenced in several articles in which the victims of trafficking were interviewed. They were mostly guest workers or foreign spouses of guest workers from Mainland China and Southeast Asian countries. Although Taiwan was ranked on US Trafficking Victims Protection Act’s Tier 1 country since 2010, the mindset and flawed procedures of foreign labor policy continuously depleted the opportunities for guest workers to legally migrate to Taiwan. Using guest workers’ desperation to seek better lives, traffickers and brokers exploited them without detection by criminal justice agencies. The commonly used methods are (a) fraudulent marriages, (b) legal work permits, (c) undocumented workers, (d) tourist or student visas, and (e) fishermen working on fishing vessels. Fuchs’ study found the factors of foreign labor policy heavily contributing to human trafficking including, but not limited to: (a) high placement fees and security bonds, (b) unreasonable brokers’ fees and pay deductions, (c) poor working conditions, and (d) positions of vulnerability. Although the Taiwan government has made legal progress to amend Article 52 of the Employment Service Act, Taiwan government’s policy-makers need to change their mindsets about guest workers no longer “supplementing” the shortage of domestic labor, instead they are “replacing” the domestic labors. The Ministry of Labor needs to re-consider and re-shape the philosophy behind guest workers’ legal positions and take legal actions to more seriously reform the recruitment mechanism, a (the) brokerage system, and the working regulations to prevent and protect the victims of human trafficking in Taiwan.

Background/Purpose: Basal cell adenoma (BCA) and basal cell adenocarcinoma (BCAC) are uncommon salivary gland tumors comprising proliferation of basaloid cells. Nuclear β-catenin expression and mutations in its encoding gene (CTNNB1) are reported to be specific to BCA. PIK3CA mutations are only found in BCAC not in BCA. However, in previous studies the number of cases was relatively small. The present study analyzed 44 cases of basal cell neoplasms to identify the CTNNB1 and PIK3CA mutation profiles in this rare salivary gland tumor. Methods: The basic clinical features and detailed histological patterns of 41 BCA and three BCAC cases were analyzed. All basal cell neoplasms and a tissue microarray of adenoid cystic carcinoma (AdCC) were tested for β-catenin immunohistochemistry. CTNNB1, PIK3CA, and CYLD mutations were detected by PCR and Sanger sequencing in each case. Results: Nuclear β-catenin expression was present in 97.6% of BCA and 66.7% of BCAC cases but not in AdCC cases. CTNNB1 mutations were found in 60% of BCA but not in BCAC. None of the tested cases had PIK3CA mutations. CTNNB1 mutation trended to be more common in those cases having a predominant tubular or tubulotrabecular patterns (p = 0.059). Conclusion: β-catenin immunohistochemistry is very useful for the differential diagnosis between BCA/BCAC and AdCC. CTNNB1 mutations are common in BCA, especially those with tubular or tubulotrabecular patterns. Keywords: Basal cell adenoma, CTNNB1, Beta catenin, Salivary glands

Psoriasis is one of the most common chronic inflammatory diseases that is characterized by well-defined erythematous plaques, with typical histopathological findings of lymphocytic infiltration and epidermal hyperplasia. Topical treatments of psoriasis are either associated with limited response or with side effects. Up to date, topicals targeting neuroimmune axis in psoriasis or psoriasiform dermatitis have not been explored. Here, we investigated whether percutaneous delivery of capsaicin could attenuate the pathological change of psoriasiform inflammation. Imiquimod-induced psoriasis-like murine model was used to evaluate therapeutic effects from topical application of capsaicin. An additional model of psoriasiform dermatitis induced by direct IL-23 injection was used to identify the level of action from capsaicin in this neuroimmune axis. Cutaneous inflammation was assessed by erythema level and ear thickness change. Key cytokines, infiltrating cells in the skin, and draining lymph node cells were investigated. The results showed that capsaicin administration obstructed the activation of IL-23/IL-17 pathway induced by imiquimod, presenting with significantly reduced psoriasiform dermatitis both in gross appearance and microscopic features. Tissue gene expression of psoriatic core cytokines induced by imiquimod (including IL-23, IL-17A, IL-22, TNF-α, and IL-6) were greatly decreased by capsaicin application. This protective effect from capsaicin could be hampered by direct intradermal injection of IL-23. Conclusion: Epicutaneous delivery of capsaicin on imiquimod-treated murine skin could significantly decrease expression of multiple inflammatory cytokines and the severity of prototypic change of psoriasiform inflammation. The beneficial effect imposed by capsaicin reinforces the neuroimmune contribution towards psoriasiform inflammation and provides a potential non-steroidal therapeutic alternative for topical treatment of psoriasiform dermatitis.

Aims MED12 exon 2 mutations have been identified in most uterine leiomyomas and mammary fibroepithelial tumours. MED12 has not been genotyped in most other gynaecological mesenchymal tumours. The purpose of this study was to determine the prevalence of MED12 mutations in uncommon gynaecological mesenchymal tumours. Methods and results Sixty-eight uncommon gynaecological mesenchymal tumours were genotyped for MED12 exon 2, including 27 Mullerian adenosarcomas (including three tentatively diagnosed as ‘variant adenosarcomas’), six cellular angiofibromas, six aggressive angiomyxomas, five angiomyofibroblastomas, five superficial myofibroblastomas, five atypical polypoid adenomyomas, and 14 endometrial stromal sarcomas. Immunohistochemistry for CD10, myogenic markers, hormone receptors, MDM2, and CDK4, and fluorescence in-situ hybridization (FISH) for JAZF1, PHF1 and YWHAE rearrangement, were performed on selected cases. The three ‘variant adenosarcomas’ harboured MED12 exon 2 mutations (including p.L36R hotspot mutation, recurrent p.L39_A50del, and a novel splice site mutation). Three endometrial stromal sarcomas with JAZF1–SUZ12 or JAZF1–PHF1 fusion harboured unprecedented mutations (p.D54G in two, and p.Q48* in one). All remaining tumours were wild-type. The three MED12-mutated ‘variant adenosarcomas’ showed distinctive morphological features, including ‘fibromyomatous’ cytomorphology, a close association with adenomyosis, clustered thick-walled vessels, focal conspicuous hyalinization, and intralymphovascular tumour growth. Features of conventional adenosarcomas, including nuclear atypia, mitotic activity, periglandular condensation, and phyllodes-like architecture, were inconspicuous. All three cases showed immunoreactivity for desmin and hormone receptors, while being negative for MDM2 and CDK4; they showed no JAZF1, PHF1 or YWHAE rearrangement. Despite deep myoinvasion, these tumours followed an indolent clinical course. Conclusions These MED12-mutated adenosarcoma-like tumours might represent a distinct entity that requires more studies for its identification. MED12 exon 2 mutations seemed to have no significant role in other uncommon gynaecological mesenchymal tumours.

Consumption of a high-fat diet increases fat accumulation and may further lead to inflammation and hepatic injuries. The aim of the study was to investigate the effects of Camellia oleifera seed extract (CSE) on non-alcoholic fatty liver disease (NAFLD). After a 16-week NAFLD-inducing period, rats were assigned to experimental groups fed an NAFLD diet with or without CSE. At the end of the study, we found that consuming CSE decreased the abdominal fat weight and hepatic fat accumulation and modulated circulating adipokine levels. We also found that CSE groups had lower hepatic cytochrome P450 2E1 and transforming growth factor (TGF)-β protein expressions. In addition, we found that CSE consumption may have affected the gut microbiota and reduced toll-like receptor (TLR)-4, myeloid differentiation primary response gene 88, toll/IL-1 receptor domain-containing adaptor-inducing interferon-β (TRIF) expression and proinflammatory cytokine concentrations in the liver. Our results suggest that CSE may alleviate the progression of NAFLD in rats with diet-induced steatosis through reducing fat accumulation and improving lipid metabolism and hepatic inflammation.

Background and aim The clinicopathologic features of hepatocellular adenoma in Asian populations have been poorly defined. The study aimed to characterize this rare entity in a single institution in Taiwan. Methods In total, 45 hepatocellular adenomas from 1995 to 2018 were included and sent for pathologic review and molecular subtyping. Results The numbers of patients with hepatocellular adenoma has doubled in the recent decade. Surprisingly, men outnumbered women in our cohort (n = 26, 58% vs N = 19, 42%). A collection of clinical information revealed that overweight/obesity accounts for most of the associated conditions of hepatocellular adenoma. Only three women took oral contraceptives. There were 34 inflammatory (75%), three LFABP-negative (7%), four β-catenin activated (9%), and four unclassified (9%) hepatocellular adenomas. Ten inflammatory hepatocellular adenomas demonstrated strong and homogeneous glutamine synthetase staining and were thus also β-catenin activated. Notably, overweight and obesity were significantly associated with inflammatory hepatocellular adenoma than other subtypes (P = .029 and .056, respectively) and were strongly correlated with steatosis in background liver (P = .028 and.007, respectively). Malignant transformation (four borderline tumors and two hepatocellular carcinomas) was identified in six adenomas (two women and four men). All six hepatocellular adenomas with malignancy were β-catenin activated; β-catenin activation could serve as a biomarker for malignant progression. Conclusions The clinicopathologic features of hepatocellular adenoma in Taiwan are distinct from those reported in Western countries. Rare oral contraceptive usage and an emerging epidemic of overweight/obesity in Taiwan provides new insights into the pathogenesis of hepatocellular adenoma.

Rationale Prolonged cholestasis is a rare complication associated with endoscopic retrograde cholangiopancreatography (ERCP). Patient concerns A 68-year-old man who presented with worsening cholestasis after ERCP for the removal of a common bile duct stone. Diagnosis Total bilirubin increased up to 35.2 mg/dL after the 21st day post-ERCP. A percutaneous liver biopsy was performed and drug-related cholestasis was suspected as occurring as a result of the contrast agent. Interventions Oral ursodeoxycholic acid and cholestyramine were prescribed to the patient. Outcomes By the 7th week post-ERCP, the patient's symptoms and markers of physiological health began to resolve. The bilirubin returned to normal levels on the 106th day post-ERCP. We reviewed the literature for studies of 9 patients with jaundice more than 30 days post-ERCP, the peak of total serum bilirubin occurred on 16th ± 7th days and the recovery followed after mean time of 54th ± 22th days. Lessons Although the cholestasis was prolonged, the outcome was favorable after medical therapy. There were no long-term consequences for the patient.

Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is associated with high-risk HPV (HR-HPV) infection. Using HR-HPV messenger RNA (mRNA) in situ hybridization (ISH), we reported 6 new HMSC cases and compared their histopathology with that of sinonasal adenoid cystic carcinoma. Using p16 immunohistochemistry (IHC) and HR-HPV ISH, we retrospectively identified 6 HMSC cases. All HMSC cases were positive for HR-HPV mRNA ISH and p16 IHC. Two HMSC cases had overlying atypical squamous epithelium, and 1 had invasive squamous cell carcinoma (SCC). All HMSC cases were SOX10 positive, whereas the overlying atypical squamous epithelium and the SCC were SOX10 negative. One atypical HMSC-like case was also identified, which was positive for HR-HPV mRNA ISH, HR-HPV DNA ISH, and SOX10 IHC, but negative for p16 IHC. This study showed that HR-HPV mRNA ISH was a useful tool to diagnose HMSC and had stronger signals compared with HR-HPV DNA ISH. HR-HPV E6/E7 mRNA could be identified in the overlying atypical squamous epithelium and the invasive SCC. A combination of p16 and SOX10 IHC will be a useful screening panel for HMSC followed by confirmatory HR-HPV mRNA ISH test.

Ring-opening polymerization (ROP) of cyclic peptide monomer of γ-propargyl-l-glutamate N-carboxyanhydride (PLG–NCA) was originally initiated by non-emissive, ring-close rhodamine 6G hydrazide (R-C). However, instantaneously after adding PLG–NCA to R-C, the spirolactam ring of R-C was opened by PLG–NCA, rendering emissive, ring-open R-O to initiate ROP of PLG–NCA. The emissive R-O moiety therefore produced fluorescent R–PLG with aggregation-induced emission (AIE) properties. Moreover, R–PLG was found to exhibit photochromic properties with good fatigue resistance and long lifetime when forming metal complexes with Sn(II) and Fe(III). In the dark, irradiated metal complexes slowly (~50 min) restored to the initial state. This research provides foundation for the development of new photochromic materials with long lifetime.

This study aims to evaluate the relationships between chromosome 20q13.2 zinc finger protein 217 (ZNF217) locus amplification, ZNF217 expression, E-cadherin expression, and PI3K-Akt pathway alterations (activating PIK3CA mutations or loss of phosphatase and tensin homolog [PTEN] expression), and whether these molecular alterations can predict the clinical survival data in ovarian clear cell carcinoma (OCCC) patients. Samples and clinical data of 72 OCCC patients were collected. Chromosome 20q13.2 ZNF217 locus amplification was detected by fluorescence in situ hybridization. ZNF217, E-cadherin and PTEN expression were assessed using immunohistochemical stain. PIK3CA mutation was identified by PCR-amplified gene sequencing. Cox proportional hazard regression model was used to estimate the adjusted hazard ratios of survival. Chromosome 20q13.2 ZNF217 locus amplification was detected in 31% (22/72) of cases, and ZNF217 expression was increased in 40% (27/68) of cases. E-cadherin and PTEN expressions were decreased or lost in 44% (32/72) and 14% (10/72) of cases, respectively. Activating PIK3CA mutations were present in 35% (25/72) of cases. Thirty-three OCCC patients (46%) showed activating PI3K-Akt pathway alterations. Chromosome 20q13.2 ZNF217 locus amplification was significantly associated with decreased E-cadherin expression (P = .001). In contrast, ZNF217 expression was not related to ZNF217 amplification or E-cadherin expression. In OCCC patients with activating PI3k-Akt pathway, decreased E-cadherin expression (P = .033) and advanced Federation of Gynecology and Obstetrics stage (P = .014) predicted shorter overall survival. Two conclusions were raised in our study. First, ZNF217 plays a role in down-regulating E-cadherin expression and is a potential therapeutic target for OCCC patients. Second, E-cadherin expression is a prognostic marker for OCCC patients with activating PI3K-Akt pathway.

Since the volume of trade between second- and third-line cities and ports in China and Taiwan is growing steadily, ensuring the availability of shuttle shipping service within the current hub-and-spoke system has become the shared goal of government, carriers, and cargo owners. In the form of an increasingly competitive cross-strait shipping market, what key factors should carriers consider when developing a new shuttle shipping route? Hence, the main purpose of this paper was to apply the fuzzy analytic hierarchy process (FAHP) approach to evaluate key factors influencing new cross-strait shuttle shipping routes. Based on the literature and experts’ opinions, a hierarchical structure with 4 assessment aspects and 15 assessment factors was first constructed, and a FAHP algorithm model was then proposed. Finally, based on the AHP experts’ questionnaires, we used the FAHP approach to evaluate the key factors. The results showed that (1) competitive port features is the most important aspect influencing new cross-strait shuttle shipping routes for ocean carriers and (2) in order of relative importance, the top five key factors influencing new cross-strait shuttle shipping routes for ocean carriers are wharf service facilities, convenient customs clearance and administrative procedures, superior natural geographical location, computer software and hardware facilities, and adequate hinterland and cargo sources, respectively. Furthermore, some discussions and recommendations are provided in this article.

Normally waterfront development entails high profile projects that blend into the local developmental requirements and the global economic situation. While various groups often wrestle with each other during development of a waterfront, based on their own interests, seeks to find a dynamic balancing point that will satisfy the prospects and requirements of all participants. In recent years, the trend of urban development and construction is to integrate the public–private resource and capital in order to ensure the feasibility and continuity of project implementation. The large-scaled waterfront renewal has been the main characteristic of world expos and plays an important role in PPP development. In this research we have seen the how risk management is involved in waterfront development. The risk induced and shared will depend on how involved the participants are in the project and on the financial schemes used to fund any given project.

Head and neck squamous cell carcinoma (HNSCC) is an important endemic disease in Taiwan with aggressive course and dismal outcome. Dasatinib is a Bcr-bl and Src kinase inhibitor that has potential against HNSCC. We recently disclosed that EGFR degradation is critical for dasatinib-induced apoptosis. Here, we further demonstrate that AMPK-dependent ER stress is responsible for this event. Dasatinib induced ER stress which mediated EGFR degradation in a c-cbl-dependent manner. AMPK activation induced by dasatinib might be due to ATP decrease through the up-regulation of pyruvate dehydrogenase kinase 4 (PDK4). Furthermore, activation of AMPK by metformin sensitized dasatinib-induced in vitro and in vivo anti-cancer effect. The correlation of AMPK activation and EGFR expression was seen in HNSCC cells and human tumor specimens. Our results disclose that AMPK-dependent ER stress plays a crucial role in the anti-cancer effect of dasatinib in HNSCC and further activation of AMPK by metformin might enhance dasatinib efficacy.

A simple co-precipitation method was employed to synthesize a series of cubic zinc-blende phase of ZnxCd1−xS photocatalysts using Na2S as the S source. Structural, morphological and optical properties of the samples have been investigated by XRD, SEM, EDS, XRF, ICP, N2 physisorption and UV–vis diffuse reflectance techniques. The ZnxCd1−xS solid solution is not a simple compound mixture of ZnS and CdS, its XRD patterns show new structural peaks instead of mixture of original peaks. The lattice parameter a measured from the XRD patterns of the ZnxCd1−xS samples exhibits a slightly nonlinear relationship with the Zn mole fraction, which is slightly inconsistent with Vegard's law, thus suggesting that a nonhomogeneous alloy structure exists in ZnxCd1−xS solid solution. The photocatalytic H2 evolution from water splitting in the sacrificial reagents of 0.25 M Na2S/0.35 M K2SO3 under visible light at 30 °C and 55 °C were also examined in the study. It is found that ZnxCd1−xS solid solution with composition x = 0.4–0.5 shows the highest photocatalytic H2 production performance. The studied ZnxCd1−xS exhibits at least 50 h stable photocatalytic activity under outdoor sunlight irradiation.

Serial link interconnection has been proposed for its advantages of reducing crosstalk and area. However, serializing parallel buses tends to increase bit transition and power dissipation. Several coding schemes, such as serial followed by encoding (SE) and transition inversion coding (TIC), have been proposed to reduce bit transition. TIC is capable of decreasing transitions by 15% compared to the SE scheme, but an extra indication bit is added in every data word to represent inversion occurrence. The extra bit increases the transmission overhead and the bit transitions. This paper proposes an embedded transition inversion (ETI) coding scheme that uses the phase difference between the clock and data in the transmitted serial data to tackle the problem of the extra indication bit. The ETI coding scheme reduces the transition by up to 31% compared to SE scheme. The analysis and simulation results indicate that the proposed coding scheme produces a low bit transition for different kinds of data patterns. Using the optimum degree of multiplexing, width, and spacing, the ETI coding scheme achieves 30%-60% energy reduction compared with the parallel bus without overhead. Taking circuit overhead into consideration, the power saving is up to 31.71% and 26.46% at a clock cycle of 250 ps for the 90- and 130-nm CMOS technology for m=2 where m is the number of parallel wires multiplexed into a serial link.

Background/Purpose Cholangiocarcinoma (CC) is a fatal malignancy originating from biliary tracts and constitutes approximately 10–20% of hepatobiliary cancers. CC is characterized by a very poor prognosis. The definite molecular mechanisms leading to oncogenesis remain unclear. This study aimed to perform mutation analysis and copy number changes of KRAS and BRAF genes of CC in Taiwan. Methods A total of 182 cases of biliary tact CC were studied for point mutation and quantitative real-time polymerase chain reaction analysis of KRAS and BRAF genes. The obtained data were analyzed with clinical and histopathological variables and survival. Results KRAS point mutations were detected in intrahepatic CC (7.6%), common bile duct cancer (13.3%), and gallbladder carcinoma (3.3%). BRAF gene amplifications were demonstrated in intrahepatic CC (4.3%), common bile duct cancer (3.3%), and gallbladder cancer (5%). No association was observed between mutation patterns and histopathological features. The analyses of risk factors for overall survival in patients with CC revealed no significant association in age, tumor site, genetic mutation, or amplifications. The tumor stage was the significant prognostic factor. Conclusion Unlike other studies from American, European, or Japanese groups which showed certain levels of gene mutations in CC, our data revealed a rather low frequency of KRAS mutations and BRAF gene amplifications in CC in Taiwan. Tumor TNM stage was the only significant prognostic parameter in this analysis. It is crucial to gain more information of carcinogenesis, molecular mechanisms and therapeutic strategy in biliary tract cholangiocarcinoma.

Tsai J-H, Huang W-C, Kuo K-T, Yuan R-H, Chen Y-L & Jeng Y-M (2012) Histopathology S100P immunostaining identifies a subset of peripheral-type intrahepatic cholangiocarcinomas with morphological and molecular features similar to those of perihilar and extrahepatic cholangiocarcinomas Aims: S100P is a calcium-binding protein that is frequently expressed in pancreatic adenocarcinoma and perihilar cholangiocarcinoma. The aim of this study was to investigate the pathological significance of the expression of S100P in peripheral intrahepatic cholangiocarcinoma (ICC). Methods and results: Immunohistochemical staining was used to investigate S100P expression in 112 cases of peripheral ICC. The results were compared with those for perihilar and extrahepatic cholangiocarcinomas. Patients with S100P-positive peripheral ICC were more likely to have elevated serum levels of carcinoembryonic antigen (CEA) and CA19-9 than those with S100P-negative peripheral ICCs. All cases of peripheral ICC associated with intrahepatic lithiasis and all cases with intraductal/periductal growth patterns were positive for S100P. S100P-positive peripheral ICCs were highly associated with ‘bile duct’ morphology rather than cholangiolar differentiation. Nearly all cases of perihilar and extrahepatic cholangiocarcinoma were positive for S100P. Similarly to perihilar and extrahepatic cholangiocarcinomas, S100P-positive peripheral ICCs showed more frequent expression of CEA and MUC2, and were more likely to be N-cadherin-negative, than S100P-negative cases. Notably, K-RAS mutations were only detected in S100P-positive peripheral ICCs, with a frequency similar to that in perihilar and extrahepatic cholangiocarcinomas. Patients with S100P-positive peripheral ICC were more likely to have poor prognoses than those with S100P-negative tumours. Conclusions: S100P immunostaining identifies a subset of peripheral ICC that probably originates from larger bile ducts. This subset of peripheral ICCs shares common morphological and molecular features with perihilar and extrahepatic cholangiocarcinomas.

This paper extends Alvin Toffler’s “three waves” concept into a classification framework that describes three stages and six types of port-city developments. These waterfront developments inject huge capital, but require a longer period for return on investment, and public–private partnership is commonly adopted as necessary for enhanced efficiency and risk sharing in many of the development projects. The concept of diverse developments is discussed, in which the content of development is first analyzed and then subdivided into development units grouped as having similar attributes. A corresponding leading organization for the given development unit is then chosen based upon the analyzed attributes. Using the series of steps in constructing the framework, the purpose of obtaining maximum social benefits and appropriate risk management is thus achieved. Waterfront development case studies are also included to explain advantages of adopting the concept of diverse developments. Finally, examples will be included to illustrate how this diverse development analysis can be applied in a flexible way so that competitive and high quality waterfronts can be created.

Endothelial dysfunction leads to elevation of blood pressure and vascular remodeling, which may result in tissue injuries. The aim of this study was to investigate the mechanisms and effects of antroquinonol on hypertension and related renal injuries. Rats were fed water containing 25 mg/kg/day N&omega, nitro-l-arginine methyl ester (L-NAME) to induce hypertension, and a diet with or without antroquinonol (20 or 40 mg/kg/day) for a 9-week experiment. During the experimental period, antroquinonol reduced the elevation of systolic and diastolic blood pressure. At the end of the study, we found that the antroquinonol groups had lower serum creatinine, renal endothelin-1, angiotensin II, and malondialdehyde levels and arteriole thickening. We found that the 40 mg/kg/day antroquinonol group had lower renal nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activities, greater nuclear factor erythroid-2, and heme oxygenase-1 expressions. Moreover, we also found that antroquinonol decreased proinflammatory cytokine concentrations in the kidney by modulating the nuclear factor-&kappa, B pathway. These results suggest that antroquinonol may ameliorate hypertension and improve renal function by reducing oxidative stress and inflammation in rats with endothelial dysfunction.

It has always been a daunting task for any government to allocate the budgets for public infrastructure effectively so as to maximize the benefits of the limited resources. The most important contribution this paper makes is to conduct an empirical study of the budget allocations of the six region-based road system construction plans in northern Taiwan using the transportation budget allocation model devised in this paper. After reviewing the results, the experts consulted while preparing this paper believe that these results are both objective and able to meet the actual requirements. The competent authority also believes that they are better than those obtained using their original approach. In particular, the construction of this model takes into consideration the highest-level supervisors. To a certain degree, it caters for the practices in budget allocation so that the managers are able to assume the authority corresponding to their responsibility concerning management efficiency and final outcomes.

Evaluating the competitive position of location develops global logistics hub (GLH) is a multiple criteria decision-making (MCDM) problem and it is important for governor to implement suitable strategies appropriate its environment. SWOT analysis is very important in the process of strategic formulation. Under many conditions, the evaluative criteria (indicators) are mixed with quantitative/qualitative values and the values for qualitative criteria are often imprecisely defined for decision-makers. A quantified SWOT analytical method, that integrates the method of fuzzy Analytic Hierarchy Process (AHP) method, was proposed to provide more detailed and quantified data for SWOT environmental analysis to assess the competitive relation for locations develop different types’ GLH in Pacific–Asian region. Integrating the concept of Grand Strategy Matrix (GSM), a suitable competing strategy could be suggested for location developing GLH in accordance with its competitive position.

Decision-making problems (location selection) often involve a complex decision-making process in which multiple requirements and uncertain conditions have to be taken into consideration simultaneously. In evaluating the suitability of alternatives, quantitative/qualitative assessments are often required to deal with uncertainty, subjectiveness and imprecise data, which are best represented with fuzzy data. This paper presents a new method of analysis of multicriteria based on the incorporated efficient fuzzy model and concepts of positive ideal and negative ideal points to solve decision-making problems with multi-judges and multicriteria in real-life situations. As a result, effective decisions can be made on the basis of consistent evaluation results. Finally, this paper uses a numerical example of location selection to demonstrate the applicability of this method, with its simplicity in both concept and computation. The results show that this method can be implemented as an effective decision aid in selecting location or decision-making problems.

Queuing models and simulation are two primary methods applied to container terminal planning. Queuing models tend to result in underestimated outcomes due to ships and berths not being classified by size and length. This paper classified both ships and berths using actual data and then compared the resultant differences of the scenarios with and without classification with the simulation. The comparison shows that the outcomes with and without the classification of ships and berths are located opposite to the outcomes obtained from the simulation, which was deliberately constructed and rendered sufficiently accurate results. The optimal scale of facilities of a container terminal is located between the outcomes of the two proposed scenarios. There is no longer a need to establish a complex and tedious simulation model. The method proposed in this paper provides a convenient way to determine the optimum number of berths and facilities for a container terminal.

Multicriteria decision-making (MCDM) problems often involve a complex decision process in which multiple requirements and fuzzy conditions have to be taken into consideration simultaneously. The existing approaches for solving this problem in a fuzzy environment are complex. Combining the concepts of grey relation and pairwise comparison, a new fuzzy MCDM method is proposed. First, the fuzzy analytic hierarchy process (AHP) is used to construct fuzzy weights of all criteria. Then, linguistic terms characterized by L–R triangular fuzzy numbers are used to denote the evaluation values of all alternatives versus subjective and objective criteria. Finally, the aggregation fuzzy assessments of different alternatives are ranked to determine the best selection. Furthermore, this paper uses a numerical example of location selection to demonstrate the applicability of the proposed method. The study results show that this method is an effective means for tackling MCDM problems in a fuzzy environment.

Due to the fact that manufacturing industries are moving further and further away, the separation of port and city plans, and consequently the competitiveness of Kaohsiung, compared to Hong Kong and Shanghai, is declining. The global logistics concept and organizational issues are the focus of a new proposal for urban development strategies for Kaohsiung. This research is aimed at the urban development and applies the global logistics system in the strategic formation of a future development plan for Kaohsiung. The evaluation result shows that six superior strategies were selected via a two-stage multiple objective evaluation method. The superior strategies include promoting integration of the urban renewal with the wharf redevelopment, speeding up the improvement of urban transportation, integrating the current maritime information network, and enhancing the twin-port functions. The evaluation method is workable when applied in the strategy evaluation for a large number of strategy cases.

In this paper we present a Quantified SWOT (Strengths, Weaknesses, Opportunities and Threats) analytical method which provides more detailed and quantified data for SWOT analysis. The Quantified SWOT analytical method adopts the concept of Multiple-Attribute Decision Making (MADM), which uses a multi-layer scheme to simplify complicated problems, and thus is able to perform SWOT analysis on several enterprises simultaneously. Container ports in East Asia are taken as a case study in this paper. Quantified SWOT analysis is used to assess the competing strength of each port and then suggest an adoptable competing strategy for each.

A comparison of container‐handling capacity on the basis of different handling systems, yard sizes and crane characteristics is presented. The layout of container terminals in the Taiwan ports is first examined based on discussions with experts from different consultant companies. A useful general equation is then derived and proposed to calculate the total number of 20‐foot container ground slots (TGS), or the area requirement per TGS, for different yard sizes with different handling systems based on different equipment dimensions. The area requirement per TGS is 32.1–35.1 m2/TEU, 35.4–43.3 m2/TEU and 32.9–41.2 m2/TEU, respectively, for straddle carriers system, rubber‐tyred gantry cranes system and rail‐mounted gantry cranes system. Factors like the dimensional characteristics of handling equipment, the container transhipment ratio and the average container dwell times in the container yard were incorporated into the above‐mentioned formula to compute the annual container‐handling capacities. Such analy...

Mesenchymal chondrosarcoma is extremely rare, accounting for around 1% of all chondrosarcomas. It occurs in the axial skeleton, the head and neck region and a high proportion of extraskeletal sites. Fewer than 40 cases of mesenchymal chondrosarcoma in the maxilla have been reported in English literature. The neoplasm is aggressive, with a high tendency for late recurrence and delayed distant metastasis. Here we present a 50-year-old man with palatal mucosal swelling for 6 months. The initial clinical impression was a benign minor salivary gland neoplasm. The biopsy revealed hyaline cartilage, alternating with undifferentiated small round cells, pathognomonic for mesenchymal chondrosarcoma. Diagnosis of biopsy specimens remains a challenge because of variable tumor components, and specimens may contain only one of the two neoplastic elements. The patient received radical surgery and has been disease free for 40 months. Clinicians and pathologists should be aware of this entity in the differential diagnosis of maxillofacial neoplasms, to prevent misdiagnosis and delayed intervention.

This study looks at the degrees of interference for multiple cranes that work simultaneously at six major container terminals in the port of Kaohsiung. The results confirm that there are different degrees of mutual crane interference among terminals where different operational modes are adapted in the container yards. RTG handling systems show a very high value of aggregate cranes exponent f, with nearly no interference, as long as the number of allocated cranes is no more than the number of truck lanes under each crane. While SC systems reveal a relatively larger degree of mutual interference as the number of cranes increase.