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Background: This pilot study aimed to investigate medication nonadherence among Taiwanese patients with diabetes, hypertension, and hyperlipidemia using the Chinese version of the Two-Part Medication Nonadherence Scale (C-TPMNS) and the National Health Insurance (NHI) Medicloud system. The study revealed insights into the factors contributing to nonadherence and the implications for improving patient adherence to medications for chronic conditions. However, the small sample size limits the generalizability of the findings. Additionally, the study identified the need for further research with larger and more diverse samples to validate the preliminary findings. Methods: The study conducted surveys individuals in central Taiwan who received three-high medications and those who returned expired medications from chain pharmacies. A structured questionnaire including the C-TPMNS was administered, and additional data on medical history and HbA1c, LDL, and blood pressure levels were collected from the NHI Medicloud system. Data analysis was performed using multiple ordered logistic regression and Wald test methods. Setting interpretation cutoff point to determine medication nonadherence. Results: The study found that 25.8% of participants were non-adherent to prescribed medications. Non-adherent individuals had significantly higher systolic blood pressure (SBP ≥ 140 mmHg) than adherent participants. Non-adherence was also associated with factors such as lower education, single status, living alone, abnormal glucose postprandial concentration, and triglyceride levels. The C-TPMNS demonstrated good reliability (Cronbach's alpha = 0.816) and validity (area under the ROC curve = 0.72). Conclusion: The study highlighted the complexity of medication nonadherence with diverse determinants and emphasized the importance of tailored interventions. The findings underscored the need for region-specific research to comprehensively address medication nonadherence, especially focusing on adherence to medications for hypertension, hyperlipidemia, and diabetes. The study also identified the need for larger, more diverse studies to validate and expand upon the initial findings and emphasized the importance of pharmacist interventions and patient empowerment in managing chronic conditions and improving overall health outcomes. [ABSTRACT FROM AUTHOR]

Due to the impact of the COVID-19 pandemic, many enterprises are looking to use electronic services to avoid human-to-human contact. During this transition period, enterprises are embracing new business models and digital transformation to overcome the crisis. Similarly, the government is also in need of digital transformation in response to these significant changes. However, there is a lack of empirical research on the motivations behind government digital transformation. Consequently, this study aims to fill this gap in the existing literature. The push-pull-mooring model is suitable for explaining the process of transferring from an inherent way to a new way, such as migration and changes in switching behavior. Therefore, it is an apt framework for elucidating the process of adopting digital transformation within government agencies. In total, data were collected from 268 government employees to examine the proposed hypotheses. The results show that the motivations of digital transformation are indeed affected by the push-pull-mooring model. These motivations encompass service process inconvenience, avoid face-to-face contact, strengthen information security, top management support, fear of learning new IT, and the cost of digitalization. Interestingly, service process inconvenience and fear of learning new IT exhibit interaction effects in relation to age-related inertia. This finding suggests that government agencies can provide varied encouragement and incentives based on employees' age groups. [ABSTRACT FROM AUTHOR]

With the advent of the digital age, traditional didactic teaching and online learning have been modified and gradually replaced by "Blended Learning." The purpose of this study was to explore the influences of blended learning pedagogy on junior high school student learning achievement and the students' attitudes toward mathematics. To investigate the outcomes of the combination of Moodle online teaching platform and traditional instruction, a quasi-experiment was conducted using a pre-test-post-test control group design. ANCOVA and MANCOVA analyses showed that the blended learning experience benefitted students in the experimental group by having a positive effect not only on the learning outcomes, but also on their attitudes toward studying mathematics in a blended environment. Preliminary results indicated that male students and high-ability students were more motivated in the blended learning environment. Students gave positive feedback on the use of the Moodle learning platform for mathematics after experiencing blended learning.

Background: Healthcare professionals in Taiwan are exposed to a myriad of occupational health and safety hazards, including physical, biological, chemical, ergonomic, and psychosocial hazards. Healthcare professionals working in hospitals and healthcare facilities are more likely to be subjected to these hazards than their counterparts working in other areas. Objectives: This review aims to assess current research literature regarding this situation with a view to informing policy makers and practitioners about the risks of exposure and offer evidence-based recommendations on how to eliminate or reduce such risks. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses review strategy, we conducted a systematic review of studies related to occupational health and safety conducted between January 2000 and January 2019 using MEDLINE (Ovid), PubMed, PMC, TOXLINE, CINAHL, PLOS One, and Access Pharmacy databases. Results: The review detected 490 studies addressing the issue of occupational health and safety hazards; of these, 30 articles were included in this systematic review. These articles reported a variety of exposures faced by healthcare professionals. This review also revealed a number of strategies that can be adopted to control, eliminate, or reduce hazards to healthcare professionals in Taiwan. Conclusion: Hospitals and healthcare facilities have many unique occupational health and safety hazards that can potentially affect the health and performance of healthcare professionals. The impact of such hazards on healthcare professionals poses a serious public health issue in Taiwan; therefore, controlling, eliminating, or reducing exposure can contribute to a stronger healthcare workforce with great potential to improve patient care and the healthcare system in Taiwan. Eliminating or reducing hazards can best be achieved through engineering measures, administrative policy, and the use of personal protective equipment. Implications: This review has research, policy, and practice implications and provides future students and researchers with information on systematic review methodologies based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy. It also identifies occupational health and safety risks and provides insights and strategies to address them.

Despite considerable research in geopolymer materials, the design of experiment (DOE) method has not previously been used for the analysis of geopolymers containing silicon carbide sludge (SCS) waste and/or metakaolin (MK). This study used DOE methods to quantitatively assess the correlation between factor parameters and the macroscopic and microstructural properties of SCS‐based geopolymers (SCSGPs). Statistical analysis identified Na/Si molar ratio, Na/Al molar ratio, and the dissolution rate of Al as the factors with the most profound influence on the compressive strength of the SCSGPs. Analysis of setting time and compressive strength revealed that in SCSGP samples containing 20% SCS, coefficient b in power function regression analysis was the most influential, due to the synergy between MK and SCS. The results obtained in this study using a multivariate adaptive regression splines model to establish a valuable reference for the further development and standardization of geopolymer mixture designs based on SCS. [ABSTRACT FROM AUTHOR]

Simple Summary: Lung cancer is the most common reason for cancer-related death, and patient survival is mainly dependent on tumor stage. The median overall survival of patients who are diagnosed with advanced/metastatic non-small-cell lung cancer (NSCLC) is still less than 3 years. The poor survival rates highlight the unmet need to elucidate the mechanism underlying lung cancer carcinogenesis to improve treatment responses and overall survival. The expression and function of SOX1 in the progression of lung cancer are still unclear. Through in vitro and in vivo experiments, we demonstrated that SOX1 repressed anchorage-independent growth, invasion, and metastasis. Interestingly, SOX1 performed its function by repressing hairy and enhancer of split 1 (HES1). Recent studies have shown that HES1, which is a helix–loop–helix transcription factor, performs important functions in stemness, metastasis, and drug resistance in cancer. These results suggest that SOX1 is a tumor suppressor that affects the carcinogenesis of lung cancer. The development of lung cancer is a complex process that involves many genetic and epigenetic changes. Sex-determining region Y (SRY)-box (SOX) genes encode a family of proteins that are involved in the regulation of embryonic development and cell fate determination. SOX1 is hypermethylated in human cancers. However, the role of SOX1 in the development of lung cancer is unclear. We used quantitative methylation-specific polymerase chain reaction (MSP), quantitative reverse transcription polymerase chain reaction (RT–PCR) analysis, and web tools to confirm the frequent epigenetic silencing of SOX1 in lung cancer. Stable overexpression of SOX1 repressed cell proliferation, anchorage-independent growth, and invasion in vitro as well as cancer growth and metastasis in a xenograft mouse model. Knockdown of SOX1 by the withdrawal of doxycycline partly restored the malignant phenotype of inducible SOX1-expressing NSCLC cells. Next, we discovered the potential downstream pathways of SOX1 using RNA-seq analysis and identified HES1 as a direct target of SOX1 using chromatin immunoprecipitation (ChIP)-PCR. Furthermore, we performed phenotypic rescue experiments to prove that overexpression of HES1-FLAG in SOX1-expressing H1299 cells partly reversed the tumor-suppressive effect. Taken together, these data demonstrated that SOX1 acts as a tumor suppressor by directly inhibiting HES1 during the development of NSCLC. [ABSTRACT FROM AUTHOR]

This study developed a novel approach to the hydrothermal synthesis of eco-hydroxyapatite (eco-HPA) from recycled limestone sludge for the removal of Cu2+ from aqueous solutions. The resulting eco-HPA was characterized using X-ray fluorescence, thermal field emission scanning electron microscope, X-ray powder diffraction analysis, and Brunauer–Emmett–Teller surface area measurements. Under a hydrothermal temperature of 120 °C and Ca/P molar ratio of 1, this study obtained the nitrogen adsorption isotherm and desorption curves indicative of hydroxyapatite. Based on the IUPAC classification system, these are the type-IV adsorption isotherm curves of a mesoporous structure with an H3-type hysteresis loop. The same sample achieved an adsorption capacity of 210 mg/g. The adsorption kinetics closely fit the pseudo-second-order kinetic model (R2 = 0.9990–1.000). Adsorption isotherms presented the strongest correlation with the Langmuir model (R2 = 0.97–0.99), exceeding that of the Freundlich model (R2 = 0.91–0.98). Taken together, these results demonstrate that the proposed eco-HAP is a viable low-cost environmentally friendly adsorbent with broad applicability for the removal of heavy metals from aqueous solutions. [ABSTRACT FROM AUTHOR]

The purposes of the present study are to provide the first data on utilization, understanding and satisfaction of the National Health Insurance (NHI) premium subsidy for families of children with disabilities in Taipei. Data from the 2001 Taipei Early Intervention Utilization and Evaluation Survey for Aged 0-6 Children with Disabilities were analyzed. In the study, a total of 1006 questionnaires were mailed, of which 340 valid questionnaires were returned, giving a response rate of 33.8%. More than one-third of families of children with disabilities did not receive any financial subsidy of National Health Insurance (NHI). Less than half of the respondents (43.8%) understood the NHI premium subsidy policy completely, while 28.7% partial understood and 27.5% still did not know this auxiliary policy. Approximately 38.5% of the respondents were specifically very satisfied or satisfied, with the NHI subsidy program. There were 18.9% respondents who felt dissatisfied or very dissatisfied with the NHI scheme for children with disabilities in Taiwan. Chi-square or t-test analyses were significant for the caregiver's age (p less than 0.05), children's disability onset and disability diagnosed age and disability level (p less than 0.01) on receiving the subsidy assistance. A multiple stepwise logistic regression revealed that the factor of "onset age of disability" was slightly significant associated with the use of NHI premium subsidy (OR = 0.966; 95% CI = 0.947-0.986). Health policies should aim to reduce the inequity in NHI premium subsidy utilization and improve their understanding and satisfaction toward this subsidy scheme. (Contains 5 tables and 3 figures.)

Although many studies have explored emergency services for children, there are few published reports of the utilization of emergency services by children with disabilities. The present study attempts to provide data regarding the utilization of, and factors affecting, emergency department visits by disabled children in Taipei. A general census of 1006 children with disabilities, identified from the Taiwan National Disability Registry System in Taipei, was conducted. The overall response rate was 38%, yielding a sample of 340 disabled children. The results showed that 30.1% of children with disabilities had utilized emergency department services over the past 4 months with an average of 1.4 visits per child. The most common reasons for emergency visits were fever (34.7%), respiratory symptoms (24.2%), abdominal pain (15.8%), injury (7.4%), and epilepsy seizures (7.4%). This study also found, using a logistic regression model, that emergency department utilization may be associated with household economic status and the reported physical health of children with disabilities. The "deficit" and "balance" household economic status groups gave odds ratios of 3.902 (95% CI = 1.469-10.364) and 3.311 (95% CI = 1.249-8.779), relative to the "surplus" group. The model also indicated that those children with disabilities who were reported as being in poor physical health had 11.359 times (95% CI = 2.968-43.469) the likelihood of using emergency care than those whose physical health was in excellent condition. The study suggests that in order to maximize the health of children with disabilities, medical care stakeholders should consider who are the most likely groups to use emergency department services and develop anticipatory guidance or preventive services for this vulnerable population. (Contains 5 tables.)

Background: In encouraging good health for people with intellectual disabilities, health promotion serves as an effective intervention. However, little is known about health promotion strategies for this sector of the population. The objectives of this study were to describe the current profile of health promotion planning among institutions caring for people with intellectual disabilities in Taiwan, and to examine differences among institutions. Method: The study employed a cross-sectional survey of 157 directors of institutions caring for people with intellectual disabilities in Taiwan. A structured questionnaire was posted to obtain information relating to the planning, budget appropriations, and decision-making processes concerning health promotion at these institutions. Results: A total of 120 directors of institutions completed the posted questionnaire. Health promotion plans were operative at 88.4% of the institutions. Among these institutions, 82 settings (76.6%) set aside funding on an annual basis for health promotion programmes for people with intellectual disabilities. With regard to budget spending, most of the respondents did not know exactly what percentage of the annual budget was spent on the health promotion programmes operating in their institutions. The process of health promotion implementation was multidisciplinary and intersectoral in terms of the staff involved. Those institutions that employed skilled nurses were more likely to run health promotion programmes than those institutions without nursing staff. Conclusions: Further research should be focused on the efficacy of health promotion programmes for people with intellectual disabilities, and on the creation of supportive environments in institutions for enabling these people to participate in the process of decision-making on health promotion issues.

This study uses metakaolin, sodium hydroxide, sodium metasilicate, and water content as the reaction variables in the application of the design of experiment (DOE) method. At the same time, the various component factors and their interactions were analyzed to understand how these factors affect the mechanical properties of a metakaolin-based geopolymer incorporated with SiC sludge (SCSGPs). The results of the statistical analysis showed that the compressive strength of SCSGPs was affected by the Na/Si molar ratio (NSR) (p-level = 0.000 <0.05), the Na/Al molar ratio (NAR) (p-level= 0.000 <0.05), and the interaction between the dissolution rate of Si (DRA). Within the design scope of this study, the maximum compressive strength of SCSGPs and the coefficients of the NSR, the NAR, and the DRA of SCSGPs was evaluated. The multiple regression analysis and the tested coefficient of r2 were also studied. The multiple regression analysis models provide an effective reference for the application of SCSGPs. [ABSTRACT FROM AUTHOR]

Species with similar ecological characters often compete with each other; however, a species may also facilitate the survival or reproduction of another ecologically similar species, although such interaction is rarely documented in birds. Here, we reported a facilitative species interaction between Asian house martins (Delichon dasypus) and russet sparrows (Passer cinnamomeus), both passerines using closed nests, in a montane farming area of Taiwan. We found that Asian house martins constructed dome‐shaped nests in human houses that provided additional nest sites for russet sparrows, secondary cavity nesters with greatly declining populations in Taiwan. Russet sparrows that used house martin nests had reproductive success comparable to those that used artificial nest boxes. However, Asian house martins avoided reclaiming sparrow‐used nests, which reduced their available nest sites. Interestingly, our results imply that man‐made structures may be used as a conservation tool to improve the breeding of the endangered russet sparrows via this facilitative interaction. [ABSTRACT FROM AUTHOR]

Background: Respiratory distress syndrome (RDS) is a risk factor that plays an important role in retinopathy in preterm infants. We used population data of infants to investigate this relationship. This study evaluated whether respiratory distress syndrome was associated with an increased incidence of ROP in preterm infants. Methods: From the National Health Insurance claims data of Taiwan in the 2000– 2009 period, preterm infants were identified to establish a RDS cohort (N = 7573) and a comparison cohort without RDS (N = 11428). We followed each infant for one year to identify incident retinopathy of prematurity (ROP) for comparison between the two cohorts. The RDS cohort for comparisons of hazard ratio (HR) with 95% confidence interval (CI) were calculated. Results: Low birth weight, an extended stay in the neonatal intensive care unit (NICU), female gender, and RDS were factors associated with an increased incidence of ROP. The ROP incidence was 2.5-fold higher in RDS children than in control (30.3 versus 11.9 per 100 person-years), with an adjusted HR (aHR) of 1.28 (95% CI = 1.18– 1.39). The incidence increased as the birth weight decreased in both cohorts, but the RDS cohort to the comparison cohort aHR decreased as the birth weight decreased, not significant for groups with birth weights less than 1500g. The aHR for RDS children was the highest for infants with a normal birth weight: 3.33 (95% CI = 2.09– 5.31). Among infants with RDS, the ROP incidence increased to 51.0 per 100 person-years in those who underwent invasive ventilation, or to 76.3 per 100 person-years for NICU stay for ≥ 30 days. Conclusion: Preterm infants with RDS are at an elevated risk of developing ROP, not limited to those with low birth weights. [ABSTRACT FROM AUTHOR]