Search

In response to the growing demand for high-resolution rainfall data to support disaster prevention in Taiwan, this study presents an innovative approach for downscaling precipitation data. We employed a hierarchical architecture of Multi-Scale Residual Networks (MSRN) to downscale rainfall from a coarse 0.25-degree resolution to a fine 0.0125-degree resolution, representing a substantial challenge due to a resolution increase of over 20 times. Our results demonstrate that the hierarchical MSRN outperforms both the one-step MSRN and linear interpolation methods when reconstructing high-resolution daily rainfall. It surpasses the linear interpolation method by 15.1 and 9.1% in terms of mean absolute error and root mean square error, respectively. Furthermore, the hierarchical MSRN excels in accurately reproducing high-resolution rainfall for various rainfall thresholds, displaying minimal biases. The threat score (TS) highlights the hierarchical MSRN's capability to replicate extreme rainfall events, achieving TS scores exceeding 0.54 and 0.46 at rainfall thresholds of 350 and 500 mm per day, outperforming alternative methods. This method is also applied to an operational global model, the ECMWF's daily rainfall forecasts over Taiwan. The evaluation results indicate that our approach is effective at improving rainfall forecasts for thresholds greater than 100 mm per day, with more significant improvement for the 1- to 3-day lead forecast. This approach also offers a realistic visual representation of fine-grained rainfall distribution, showing promise for making significant contributions to disaster preparedness and weather forecasting in Taiwan. [ABSTRACT FROM AUTHOR]

This study compared the effects of three education models, namely, the bag-of-virtues (BV), values clarification (VC), and virtue ethics (VE) models, through qualitative and quantitative approaches. In the quantitative study (Study 1), a between-subjects design was adopted in sampling 120 freshman cadets from a Taiwanese military academy. For the qualitative study (Study 2), focus group interviews were conducted with 10 freshman cadets. The results show that the VC model was the most effective among the three moral education models, followed by the VE and BV models.

Background: Acute respiratory distress syndrome (ARDS) is a common life-threatening condition in critically ill patients. Itis also an important public health issue because it can cause substantial mortality and health care burden worldwide. The objective of this study was to investigate therisk factors that impact ARDS mortality in a medical center in Taiwan. Methods: This was a single center, observational study thatretrospectively analyzed data from adults in 6 intensive care units (ICUs) at Taichung Veterans General Hospital in Taiwan from 1st October, 2018to30th September, 2019. Patients needing invasive mechanical ventilation and meeting the Berlin definition criteria were included for analysis. Results: A total of 1,778 subjects were screened in 6 adult ICUs and 370 patients fulfilled the criteria of ARDS in the first 24 hours of the ICU admission. Among these patients, the prevalenceof ARDS was 20.8% and the overall hospital mortality rate was 42.2%. The mortality rates of mild, moderate and severe ARDS were 35.9%, 43.9% and 46.5%, respectively. In a multivariate logistic regression model, combination of driving pressure (DP) > 14cmH2O and oxygenation (P/F ratio)≤150 was an independent predictor of mortality (OR2.497, 95% CI 1.201–5.191, p = 0.014). Patients with worse oxygenation and a higher driving pressure had the highest hospital mortality rate(p<0.0001). Conclusions: ARDS is common in ICUs and the mortality rate remains high. Combining oxygenation and respiratory mechanics may better predict the outcomes of these ARDS patients. [ABSTRACT FROM AUTHOR]

Mango (Mangifera indica) is a widely enjoyed tropical fruit that is rich in numerous nutrients, but it is also a common allergenic fruit that can induce anaphylactic shock in some mango-sensitized individuals. To protect allergic consumers, a TaqMan real-time PCR is developed herein by targeting the major mango allergen GAPDH gene to identify mango in foods. To prevent interference by other ingredients in the foods, an internal amplification control (IAC) is established and incorporated into the developed qPCR. Under the optimized assay conditions, the developed assay can detect mango genomic DNA down to 10 pg/μL and effectively differentiate mango from 21 other fruits and vegetables. In the incurred assay, the developed qPCR has a limit of detection (LOD) of 10 μg/g and 330 μg/g of mango powder in juice and cookie, respectively. The assay exhibits a board spectrum, successfully detecting six mango cultivars, and has good accuracy and precision as calculated intra- and inter-assay CV values < 10%. Forty commercial processed foods were simultaneously analyzed using the developed method and a qPCR method that is officially recognized by the Taiwan FDA. The sensitivity and specificity of this assay were estimated to be 85% and 100%, respectively, based on the ingredient labeling of these products. Hence, this developed qPCR is an effective method for screening mango in processed foods. [ABSTRACT FROM AUTHOR]

"Restorative Justice," firstly a research concept and later a criminal justice practice, was introduced into Taiwan at the beginning of the twenty-first century. This paper reviews how RJ grounded in the Taiwanese district prosecutors' offices and gradually grows into a grassroots social movement. We propose that the RJ advancement benefits from open-minded policymakers, dedicated academics, and innovative facilitators. The facilitators trained from 2011 to 2012 became key players to spread the RJ practices to other criminal justice sectors and beyond. In addition, the third wave of judicial reform further enabled the embedding of the RJ procedure in the Juvenile Justice Act, the Code of Criminal Justice Procedure, the Prison Act, and the Detention Act. We compare the discourse of RJ advocacy in the east and the west and address the importance of cultural sensitivity, terminology translation, and the meaning of localized practice. In conclusion, we reflect on the existing evaluation reports of the Taiwanese RJ model and provide recommendations for future development. [ABSTRACT FROM AUTHOR]

Friendship networks are relevant to adolescent weight status and lifestyle, but little is known about their relationship in an East Asian setting. Using a longitudinal cohort of Taiwanese adolescents, we studied how weight status and lifestyles might influence friendship. Simultaneously considering the influence of friendship networks, we further examined the effects of peers' lifestyles on the body weight status of adolescents. Data were retrieved from the first three waves of the Taiwan Youth Project (N = 2409; 51 % boys). Participants were asked to nominate their friends at school and to report their lifestyle factors (e.g. sleep habits, internet use, and athletic performance). Weight status was proxied by body mass index calculated from self-reported weight and height. Stochastic actor-based modeling was used for the friendship network analyses. Considering network structure, adolescents selected friends based on similarities in weight status (β = 0.147 [standard error = 0.044], p < 0.001) and lifestyle factors, such as athletic performance (β = 0.181 [0.034], p < 0.001), internet use (β = 0.156 [0.039], p < 0.001), and social jetlag (β = 0.055 [ ± 0.022], p < 0.05). In the behavior dynamics model, we did not observe any peer influence on changes in adolescents' weight status. These findings suggest a pervasive homophilic friendship selection explained by weight and lifestyle-based similarities, despite no evidence of peer influence on weight status. Stakeholders and care providers of adolescent health should be aware of the social network processes that underlie weight problems. [ABSTRACT FROM AUTHOR]

Asset-based youth development has been proposed to be associated with health behaviors and psychological well-being in adolescents. This study aims to extend the current knowledge regarding the effects of positive youth development on weight status and psychosocial health outcomes in young adulthood using a large representative longitudinal sample. Data were retrieved from the Taiwan Youth Project that comprised a longitudinal cohort of adolescents (N = 2688) surveyed at grades 7, 8, 9, and 12, and at age 22. Principal component analysis was used to construct developmental asset scores based on 35 items selected from the relevant questions at wave 1. Outcomes were standardized scores of body mass index, self-rated healthiness and happiness, depressive symptomology and deviant behaviors in the subsequent waves. Generalized estimating equation analysis was applied to assess the impact of developmental assets on these repeatedly measured outcome variables. As compared to those with the highest quintile level of developmental assets, individuals with the lowest quintile level were more likely to rate themselves unhealthy (β = 0.33 [95% confidence interval 0.26, 0.40]) and unhappy (β = 0.47 [0.41, 0.54]) and report more depressive symptomatology (β = 4.18 [3.35, 5.01]) and deviant behaviors (β = 0.63 [0.44, 0.81]). No association was found between body mass index and developmental asset scores. The results concluded a longitudinal association between adolescent developmental assets and psychological and behavioral health outcomes. Further research may be required to investigate whether positive youth development could be translated into long-term benefits in adult physical conditions, such as obesity. [ABSTRACT FROM AUTHOR]

Background: Evidence regarding the association between daily steps recommendation and older adults' lower limb strength is lacking; thus, this study investigated whether taking at least 7,000 steps/day is cross-sectionally and prospectively related to lower-extremity performance in older Taiwanese adults.Methods: There were 89 community-dwelling adults aged over 60 years (mean age: 69.5 years) attending both baseline and follow-up surveys. This study used adjusted logistic regression analysis to explore cross-sectional and prospective relationships between their accelerometer-assessed daily steps and lower-extremity performance (five-times-sit-to-stand test).Results: This study found the older adults who took 7,000 steps/day were more likely to have better lower-extremity performance cross-sectionally (odds ratio [OR] = 3.82; 95 % confidence interval [CI]: 1.04, 13.95; p = 0.04), as well as to maintain or increase their lower-extremity performance prospectively (OR = 3.53; 95 % CI: 1.05, 11.84; p = 0.04).Conclusions: Our findings support a minimum recommended level of step-based physical activity for older adults, namely, 7,000 steps/day, as beneficial for maintaining or increasing older adults' lower-extremity performance. [ABSTRACT FROM AUTHOR]

Taiwan's most significant natural hazards are caused by hydrological extremes resulting from excessive precipitation. The threat of extreme precipitation is posed by several different types of weather patterns that affect Taiwan. This study examined the bi‐decadal changes in rainfall by defining an extreme precipitation occurrence (EPO) for a range of event durations from 1 to 24 hr. Three major weather types affecting EPO in Taiwan were identified from 1993 to 2015: the front type consisting of either a frontal zone or convective systems developing with an apparent Meiyu cloudband, diurnal rainfall events when no apparent synoptic features are present, and a tropical cyclone (TC) type according to the maximum sustained wind radius of a TC. Results show that TC‐type events have the greatest overall contribution to EPO at longer (>6 hr) durations. Diurnal/afternoon convection events contribute most to the shorter (<3 hr) duration EPO, while frontal/Meiyu systems prevail in the medium (3–6 hr) duration. EPO of almost all durations have experienced an increase, with the 3‐ and 12‐hr EPO having increased by 4.6 days each over the 23 years. However, apparent decadal‐scale variability exists in these EPO associated with the decreasing tendency of EPO after the mid‐2000s, particularly the longer duration (>6 hr) EPO associated with the TC‐type events in summer. The distinction between EPO trends for the entire island of Taiwan and for the Taipei metropolitan area alone (northern Taiwan, population of 7 million) were compared, and an intriguing interannual variation is reported in the TC‐type EPO associated with the TC season 1 year to a year and half just before an El Niño–Southern Oscillation event. The analysis here provides refined statistical distributions of extreme rainfall, and these can contribute to the revision of governmental definitions for weather disasters that are used in mitigation and response strategies. [ABSTRACT FROM AUTHOR]

Objectives: We examined the association between anogenital human papillomavirus (HPV) infection and sexual networks in men who have sex with men (MSM). Methods: A total of 253 MSM, 20 years of age and older, were recruited from the community in Southern Taiwan in 2015–2016. At baseline and at each follow-up visit, MSM were screened for HPV to identify 37 HPV genotypes. At the six-month follow-up, MSM were asked to fill out an egocentric network assessment and to report the last five persons with whom they had sex regarding the characteristics of sexual behavior with each network member. Results: A total of 182 participants (71.9%) returned for the follow-up and one third had at least one HPV type detected. A higher level of bridging network position calculated by the level of constraints in the network was significantly less likely to have HPV detection at the anal site. A high level of concurrency was associated with penile HPV detection (AOR = 3.16, 95% CI = 1.01–9.86). Conclusions: Identifying network-related characteristics can advance our understanding of high-risk populations and for prioritizing HPV vaccine recommendations. [ABSTRACT FROM AUTHOR]

Backgrounds: Oral cancer is the 4th leading cause of cancer death for males and the top cancer in young adult males in Taiwan. Tongue squamous cell carcinoma (TSCC) is a common oral cancer and generally associated with poor prognosis. Global DNA hypomethylation at the 5 position of cytosine (5mC) is a well-known epigenetic feature of cancer. Therefore, the purpose of this study was to investigate the relationship of the global 5mC content with the tumorigenesis and prognosis of patients with TSCC.Methods: The levels of global 5mC were evaluated by immunohistochemistry using tissue microarray slides of 248 surgically resected TSCC and 202 corresponding tumor adjacent normal (TAN) tissues.Results: We found that the level of 5mC in TSCC (P < 0.001) was significantly decreased as compared to TAN. Among TSCC tissues, decreased levels of 5mC were associated with female gender (P = 0.036). In addition, the global hypomethylation was associated with the poor disease-specific survival in TSCC patients (adjusted hazard ratio: 1.55, P = 0.043), especially for patients in older age group (> 50 years, P = 0.013), with moderate or poor cell differentiation (P = 0.044), early stage of disease (I-II, P = 0.046), small tumor size (T1-T2, P = 0.005), without lymph node involvement (P = 0.041), and ever received postoperative radiotherapy (P = 0.009).Conclusions: Global hypomethylation was an independent biomarker for the development and poor prognosis of TSCC. [ABSTRACT FROM AUTHOR]

Previous studies have unanimously agreed that despite the challenges of postmodernism, militaries should not and cannot be governed using an occupational model. However, what the notion of the value type of a postmodern army is should be clarified. This study investigates the changing values of postmodern militaries caused by external economic factors. For this research, a questionnaire and long-term investigation method were adopted to collect 262 cadet samples from the Taiwanese military, navy, and air force. The results of a cluster analysis showed that the cadets primarily comprised 3 types, that is, the devotion (DE) type, socially competent (SC) type, and the comfortable (CO) type. This study shows that the socially competent type best satisfies the value demands of the military. In addition, the enlistment motivations of this type of cadet are generally to alleviate family financial burdens, non-economic-related reasons, self-actualization, and patriotism. [ABSTRACT FROM AUTHOR]

In this study, an ensemble typhoon quantitative precipitation forecast (ETQPF) model was developed to provide typhoon rainfall forecasts for Taiwan. The ETQPF rainfall forecast is obtained by averaging the pick-out cases, which are screened using certain criterion based on given typhoon tracks from an ensemble prediction system (EPS). Therefore, the ETQPF model resembles a climatology model. However, the ETQPF model uses the quantitative precipitation forecasts (QPFs) from an EPS instead of historical rainfall observations. Two typhoon cases, Fanapi (2010) and Megi (2010), are used to evaluate the ETQPF model performance. The results show that the rainfall forecast from the ETQPF model, which is qualitatively compared and quantitatively verified, provides reasonable typhoon rainfall forecasts and is valuable for real-time operational applications. By applying the forecast track to the ETQPF model, better track forecasts lead to better ETQPF rainfall forecasts. Moreover, the ETQPF model provides the 'scenario' of the typhoon QPFs according to the uncertainty of the forecast tracks. Such a scenario analysis can provide valuable information for risk assessment and decision making in disaster prevention and reduction. Deficiencies of the ETQPF model are also presented, including that the average over the pick-out case usually offsets the extremes and reduces the maximum ETQPF rainfall, the underprediction is especially noticeable for weak phase-locked rainfall systems, and the ETQPF rainfall error is related to the model bias. Therefore, reducing model bias is an important issue in further improving the ETQPF model performance. [ABSTRACT FROM AUTHOR]

Three methods for ethics instruction are used in Taiwanese military education: the ‘bag-of-virtues’, value-clarification and virtue-ethics methods. This article explains, analyzes and discusses each of these, thereby giving an introduction to how military ethics is taught – and thought of – within the Taiwanese military system. Recommendations are given for how to improve the parts of the system that do not seem to live up to the stated intentions. [ABSTRACT FROM PUBLISHER]

Objectives: Mutation of the exon 3 of CTNNB1, the coding gene of β-catenin, is a crucial molecular mechanism leading to aberrant activation of the Wnt/β-catenin pathway, which is highly associated with the carcinogenesis of hepatocellular carcinoma (HCC). The prevalence and clinical significance of CTNNB1 mutations in advanced HCC remain unclear. Methods: Patients with advanced HCC and available pathologic tissues (either obtained when diagnosed at advanced or early stages) were enrolled in this study. Direct sequencing of exon 3 of CTNNB1 was performed to detect somatic mutations. The associations between CTNNB1 mutations and clinicopathologic features were analyzed. Results: A total of 115 patients were enrolled, among whom 78 (67.8%) had chronic hepatitis B virus infection. Twenty-one (18.3%) patients were found to have CTNNB1 mutations, all of which were missense mutations. The CTNNB1 mutation rates were similar among pathologic tissues obtained at advanced and early stages (17.5 and 20.0%, respectively). Patients aged over 60 years were more likely to have CTNNB1 mutations than patients younger than 60 years (32.6 vs. 8.7%, p = 0.001). The mutations were not associated with survival or other clinicopathologic features. Conclusion: In patients with advanced HCC, CTNNB1 mutations were not prognostically significant. No apparent increase of CTNNB1 mutations occurred during the progression of HCC. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In this study, I examined what channels of socialization influence the moral behavior of cadets. We conducted a regression analysis of the effects of parents' attitudes to moral education, the standard and potential curriculum of schools, peer groups, and communication media on individual ethics and discipline using 399 sample participants. The participants were recruited through a questionnaire survey on cadets from academy of military, naval, and air force, and four-year based students from R.O.C. National Defense University. The analysis results showed that the cultivation of morality among cadets was directly influenced by the school's potential curriculum (i.e., intern cadres and officers in company) and their parents' attitudes to moral education during early childhood. The results also indicated that the influence of teaching by example was more significant than that of teaching by precept. [ABSTRACT FROM AUTHOR]

Background/purpose: Despite effective vaccine programs, tetanus is occasionally observed in adults. We reviewed clinical presentation data for adult patients with tetanus in the post-vaccine era in Taiwan.Methods: We retrospectively reviewed the medical records of all adult patients (age >18 years) discharged from Chang-Gung Memorial Hospital at Lin-Ko (CGMHLK) after treatment for tetanus between January 1996 and July 2005. Data regarding demographic characteristics, clinical manifestation, treatment, and outcome were collected. To assess the features for different age groups, patients were divided into those aged ≥65 years and those aged <65 years. To identify risk factors for respiratory failure, the patients were classified as those with and without respiratory failure.Results: Twenty-three patients with tetanus, 11 (48%) women and 12 (52%) men, were included in the study. The average age was 57 ± 18 years (range 18-84 years). Eighteen (78%) patients had a history of acute injury. The average incubation period was 8 ± 5 days. The most common clinical presentation at onset was trismus (78%). Thirteen (57%) patients developed respiratory failure and underwent endotracheal intubation. The most common complication was pneumonia (30%). All the patients survived and recovered. Age ≥65 years was significantly associated with trismus, dysphagia, dysarthria, and pneumonia. Generalized tetanus subtype and pneumonia were significant risk factors for respiratory failure.Conclusion: This study revealed several characteristics of adult tetanus cases in the post-vaccine era in Taiwan. Further serological studies and improved tetanus vaccinations may be needed to ensure better protection, especially for high-risk populations. The exceptionally good prognosis for our patients confirms that appropriate treatment, including wound care, early diagnosis, proper medication, and prevention of complications, is essential in managing this traditional curable disease. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Betel quid (BQ) components induce the secretion of tumour necrosis factor-alpha (TNF-α) in oral keratinocytes, which promotes oral mucosal inflammation and oral cancer. This study was carried out to evaluate the association of TNFA genetic variants (−308G>A and −238G>A) with the risk and prognosis of BQ-related oral and pharyngeal squamous cell carcinoma (OPSCC). Design: A total of 403 subjects (205 cancer cases and 198 healthy controls) who habitually chewed BQ were recruited. The genotypes were determined by TaqMan real-time assays. Results: G allele and G/G genotype at TNFA −308 were associated with a 1.95-fold (95%CI: 1.16–3.28, p corrected =0.024) and 2.28-fold (95%CI: 1.30–4.00, p corrected =0.008) increased risk of cancer as compared to those with A allele or A/A+A/G genotypes, respectively. In addition, G allele (p =0.080) and G/G genotype (p =0.076) at TNFA −238 were associated with a borderline but statistically significant increased risk of OPSCC. The combined G/G+G/G genotype at both loci had a 2.37-fold increased risk of OPSCC as compared to those with other combined genotypes (95%CI: 1.41–4.00, p =0.001). Interactions between combined genotypes and smoking status were also found to contribute to risk of BQ-related OPSCC. There was no association of TNFA genotypes with clinicopathologic findings or the survival of OPSCC patients. Conclusions: BQ-chewers who carry the G allele or G/G genotype in TNFA −308 may have an increased risk of OPSCC. The intensity of cigarette smoking modulates the effect of the combined TNFA genotypes on risk of BQ-related OPSCC. [Copyright &y& Elsevier]

We examine the information trading around open market share repurchases on the Taiwan Stock Exchange (TSE). Because of the distinctive regulations of share repurchases in Taiwan, our samples offer a unique opportunity to test changes in information trading during share repurchases. We show that the risk of information trading significantly increases during the repurchase execution period and reverts back in the post-expiration period. It is likely that some uninformed traders leave the market in the execution period, in anticipation of higher information uncertainties. Therefore, the remaining uninformed traders collectively face higher possibility of trading with informed traders. [ABSTRACT FROM AUTHOR]

Aim of the study: Antrodia camphorata (niu-chang-chih) is a fungus native to Taiwan which is believed to be effective in preventing diseases. Recent reports demonstrate that Antrodia camphorata products induce the apoptosis of various kinds of tumor cells. In this study we determined the inhibitory effects of alcohol extract and individual fractions of alcohol extract on the proliferation of human non-small cell lung carcinoma A549 cell and clarified the mechanism underlying the anti-cancer activities. Materials and methods: Alcohol extracts of Antrodia camphorata mycelia were prepared by the serial extraction with the solvents with increasing polarity and fractionated using HPLC. Cell viability was determined by MTT assay. Apoptosis detection was carried out by subG1 analysis and annexin V/propidium iodide staining using flow cytometry. The impacts of HPLC fractions on the expression levels of apoptosis- and cancer-related proteins were evaluated by western blotting. Results: Three HPLC fractions, fractions 5–7, had robust inhibition of human A549 cells and among them fraction 6 (Fr-6) possessed the most potent effectiveness. Apoptotic assay showed that Fr-6-induced human A549 cell apoptosis by triggering the mitochondrial pathway and endothelium reticulum (ER) stress. Immunoblotting results demonstrated that Fr-6 possibly activated ER stress by lowering the expression level of calpain 1/2 small subunit and Fr-6-mediated decrease in cell proliferation might attribute to the suppressive effect on the Erk 1/2 pathway, which arose from Fr-6-derived low galectin-1 expression. Furthermore Fr-6 could diminish Rho GDP dissociation inhibitor α (RhoGDI-α) expression and subsequently activated c-Jun NH2-terminal kinase (JNK) pathway, which is linked to cell apoptosis. Fr-6 also could decrease the production level of eukaryotic translation initiation factor 5A, which is a potential cancer intervention target. Conclusion: These results suggested that the anti-cancer activity of Antrodia camphorata might be due to multiple active metabolites, which work together to induce cell apoptosis via various pathways. [Copyright &y& Elsevier]

This study aims to propose a strategy to optimize the performance of the Support Vector Machine (SVM) scheme for extreme Meiyu rainfall prediction over southern Taiwan. Variables derived from Climate Forecast System Reanalysis (CFSR) dataset are the candidates for predictor selection. A series of experiments with different combinations of predictors and domains are designed to obtain the optimal strategy for constructing the SVM scheme. The results reveal that the accuracy (ACC), positive predictive values (PPV), probability of detection (POD), and F1-score can exceed 0.6 on average. Choosing the predictors associated with the Meiyu system and determine the domain associated with the correlations between selected predictors and predictand can improve the forecast performance. Our strategy shows the potential to predict extreme Meiyu rainfall in southern Taiwan with lead times from 16 h to 64 h. The F1-score analysis further demonstrates that the forecast performance of our scheme is stable, with slight inter-annual fluctuations from 1990 to 2019. Higher performance would be expected when the north of the South China Sea is characterized by stronger southwesterly flow and abundant low-level moisture for a given year. [ABSTRACT FROM AUTHOR]

Operational monsoon moisture surveillance and severe weather prediction is essential for timely water resource management and disaster risk reduction. For these purposes, this study suggests a moisture indicator using the COSMIC-2/FORMOSAT-7 radio occultation (RO) observations and evaluates numerical model experiments with RO data assimilation. The RO data quality is validated by a comparison between sampled RO profiles and nearby radiosonde profiles around Taiwan prior to the experiments. The suggested moisture indicator accurately monitors daily moisture variations in the South China Sea and the Bay of Bengal throughout the 2020 monsoon rainy season. For the numerical model experiments, the statistics of 152 moisture and rainfall forecasts for the 2020 Meiyu season in Taiwan show a neutral to slightly positive impact brought by RO data assimilation. A forecast sample with the most significant improvement reveals that both thermodynamic and dynamic fields are appropriately adjusted by model integration posterior to data assimilation. The statistics of 17 track forecasts for typhoon Hagupit (2020) also show the positive effect of RO data assimilation. A forecast sample reveals that the member with RO data assimilation simulates better typhoon structure and intensity than the member without, and the effect can be larger and faster via multi-cycle RO data assimilation. [ABSTRACT FROM AUTHOR]

The Model for Prediction Across Scales (MPAS) is used to simulate the East Asian winter monsoon (EAWM) over the 2011–2020 winter. The 45 day hindcasts are made with 30 km horizontal resolution and constructed to a time-lagged ensemble system. The climatology, the major modes of EAWM variability, and the blocking activities are examined. The evaluation results reveal that MPAS can simulate the climatologic characteristics of EAWM reasonably, with a surface cold bias of 4% and a positive rainfall bias of 9% over East Asia. MPAS can perform skillfully in the forecasts of surface temperature probability of East Asia and is more reliable in detecting below normal and above normal events. The features that influence the EAWM variability are also analyzed. MPAS simulates reasonably in the occurrence frequency of blocking high in both locations and duration time. The empirical orthogonal function analysis also shows that MPAS can capture the two major modes of the surface temperature of EAWM. On the other hand, it is also found that a biased sea surface temperature may modify the circulations over the Western Pacific and affect the simulated occurrence frequency of cold events near Taiwan during winter. [ABSTRACT FROM AUTHOR]

A pluvial flash flood is rapid flooding induced by intense rainfall associated with a severe weather system, such as thunderstorms or typhoons. Additionally, topography, ground cover, and soil conditions also account for the occurrence of pluvial flash floods. Pluvial flash floods are among the most devastating natural disasters that occur in Taiwan, and these floods always /occur within a few minutes or hours of excessive rainfall. Pluvial flash floods usually threaten large plain areas with high population densities; therefore, there is a great need to implement an operational high-performance forecasting system for pluvial flash flood mitigation and evacuation decisions. This study developed a high-performance two-dimensional hydrodynamic model based on the finite-element method and unstructured grids. The operational high-performance forecasting system is composed of the Weather Research and Forecasting (WRF) model, the Storm Water Management Model (SWMM), a two-dimensional hydrodynamic model, and a map-oriented visualization tool. The forecasting system employs digital elevation data with a 1-m resolution to simulate city-scale pluvial flash floods. The extent of flooding during historical inundation events derived from the forecasting system agrees well with the surveyed data for plain areas in southwestern Taiwan. The entire process of the operational high-performance forecasting system prediction of pluvial flash floods in the subsequent 24 h is accomplished within 8–10 min, and forecasts are updated every six hours. [ABSTRACT FROM AUTHOR]

Released thyroid cancer patients treated with 131I may cause a radiation risk to their family members. However, no current regulations exist in Taiwan to limit the radiation dose among patients released post-treatment. This study assessed radiation exposure to caregivers of thyroid cancer patients treated with 131I to verify whether their doses exceed the 5-mSv limit per treatment session. The study population comprised 63 patients from four hospitals and their caregivers. Dose rates at a 1-m distance from patients were quantified before their release. Dosimetry data of caregivers were obtained using personalized thermoluminescent dosimetry badges. Upon the release of patients treated with 131I, Dose rates at a 1-m distance from the patients were 3.9–55 μSv/h. The radiation doses to caregivers ranged from 0.21 to 1.7 mSv after the patients released. When the 1-m dose rate of patients upon hospital release was 50 μSv/h, the highest possible radiation dose was assessed of 4.76 mSv for caregivers. In conclusion, as the dose rates at a 1-m distance from patients upon release were <50 μSv/h, the radiation dose received by their caregivers would be in accordance with the 5-mSv limit recommended by the International Atomic Energy Agency series 40, International Commission on Radiological Protection publication 94, and National Council on Radiation Protection and Measurements Report no. 155. • Dose to caregivers of the patients with I-131 treated were measured by dosimeters. • The 63 population data were collected from 4 hospitals in Taiwan. • Current management practices were verified to be safe to caregivers in Taiwan. • The 50 μSv/h criteria to release the patients was recommended. [ABSTRACT FROM AUTHOR]

This study analyzed the temporal/spatial distribution of the high‐temperature extremes (HTEs) in Taiwan. Three major weather types for HTEs were identified: the southerly/southwesterly (S/SW) (47.6%), western North Pacific subtropical high (SH) (35.9%), and tropical cyclone (16.5%). The S/SW type features anomalous warm advection in lower atmosphere and anomalous subsidence in all the altitudes around Taiwan. Different from the S/SW type, the SH type warms the surface primarily with increasing downward shortwave radiation. In June, the S/SW type was the most common. In July, both the S/SW and SH types dominated. In August, the tropical cyclone and SH types were more common. The subseasonal variation of extreme hot days (EHDs) for these three weather types is examined. Taipei and Dawu were two HTE hot spots in Taiwan. EHDs in Taipei occurred mostly in July and August, with the SH being the major type. Most EHDs in Dawu occurred in June, with the S/SW being the predominant type. These differences likely resulted from not only the subseasonal monsoon variation but also geographical differences. The interannual variability of the summer EHDs in Taiwan was found to be related to the phase and intensity of the El Niño‐southern oscillation events. The number of EHDs increased in the El Niño decaying summers and decreased in the La Niña decaying summers. The correlation between the number of summer EHDs and the Niño 3.4 SST anomaly reaches its peak in the previous winter (November/December). The associated mechanisms were discussed in the article. Key Points: Three major weather types associated with Taiwan's extreme hot days were identifiedTaipei and Dawu differed distinctly in the number of extreme hot days for all three major weather types and the timings of their occurrenceThe number of summer extreme hot days in Taiwan significantly increased (decreased) in the El Niño (La Niña) decaying years [ABSTRACT FROM AUTHOR]

Flash floods are different from common floods because they occur rapidly over short time scales, and they are considered to be one of the most devastating natural hazards worldwide. Mountainous areas with high population densities are particularly threatened by flash floods because steep slopes generate high flow velocities. Therefore, there is a great need to develop an operational forecasting system (OFS) for better flash flood prediction and warning in mountainous regions. This study developed an OFS through the integration of meteorological, hydrological, and hydrodynamic models. Airborne light detection and ranging (LiDAR) data were used to generate a digital elevation model (DEM). The OFS employs high-density and high-accuracy airborne LiDAR DEM data to simulate rapid water level rises and flooding as the result of intense rainfall within relatively small watersheds. The water levels and flood extent derived from the OFS are in agreement with the measured and surveyed data. The OFS has been adopted by the National Science and Technology Center for Disaster Reduction (NCDR) for forecasting flash floods every six hours in a mountainous floodplain in Taiwan. The 1D and 2D visualization of the OFS is performed via the National Center for Atmospheric Research Command Language (NCL). [ABSTRACT FROM AUTHOR]

Typhoon-induced storm surges are catastrophic disasters in coastal areas worldwide, although typhoon surges are not extremely high in Taiwan. However, the rising water level around an estuary could be a block that obstructs the flow of water away from the estuary and indirectly forms an overflow in the middle or lower reaches of a river if the occurrence of the highest storm surge (HSS) coincides with the highest astronomical tide (HAT). Therefore, assessing the highest storm tide (HST, a combination of the HSS and HAT) hazard level along the coast of Taiwan is particularly important to an early warning of riverine inundation. This study hindcasted the storm surges of 122 historical typhoon events from 1979 to 2018 using a high-resolution, unstructured-grid, surge-wave fully coupled model and a hybrid typhoon wind model. The long-term recording measurements at 28 tide-measuring stations around Taiwan were used to analyze the HAT characteristics. The hindcasted HSSs of each typhoon category (the Central Weather Bureau of Taiwan classified typhoon events into nine categories according to the typhoon's track) were extracted and superposed on the HATs to produce the individual potential HST hazard maps. Each map was classified into six hazard levels (I to VI). Finally, a comprehensive potential HST hazard map was created based on the superposition of the HSSs from 122 typhoon events and HATs. [ABSTRACT FROM AUTHOR]

Methicillin-resistant Staphylococcus aureus (MRSA) causes superficial infections such as cellulitis or invasive infections such as osteomyelitis; however, differences in MRSA isolates from cellulitis (CL-MRSA) and from osteomyelitis (OM-MRSA) at the same local area remain largely unknown. A total of 221 MRSA isolates including 106 CL-MRSA strains and 115 OM-MRSA strains were collected at Chang-Gung Memorial Hospital in Taiwan between 2016 and 2018, and their genotypic and phenotypic characteristics were compared. We found that OM-MRSA isolates significantly exhibited higher rates of resistance to multiple antibiotics than CL-MRSA isolates. Genotypically, OM-MRSA isolates had higher proportions of the SCCmec type III, the sequence type ST239, and the spa type t037 than CL-MRSA isolates. Besides the multidrug-resistant lineage ST239-t037-SCCmecIII more prevalent in OM-MRSA, higher antibiotic resistance rates were also observed in several other prevalent lineages in OM-MRSA as compared to the same lineages in CL-MRSA. Furthermore, when prosthetic joint infection (PJI) associated and non-PJI-associated MRSA strains in osteomyelitis were compared, no significant differences were observed in antibiotic resistance rates between the two groups, albeit more diverse genotypes were found in non-PJI-associated MRSA. Our findings therefore suggest that deep infections may allow MRSA to evade antibiotic attack and facilitate the convergent evolution and selection of multidrug-resistant lineages. [ABSTRACT FROM AUTHOR]

The strategies of the extrapolation adjusted by model prediction (ExAMP) blending scheme, which trusts the field pattern predicted by extrapolation and allows the field intensity to be adjusted by numerical weather prediction (NWP), for rainfall nowcasting are analyzed in this study. The McGill algorithm for precipitation nowcasting by Lagrangian extrapolation (MAPLE) and the Weather Research and Forecasting (WRF) model serve as the extrapolation and NWP models, respectively. Seven 150-min rainfall nowcasting experiments with different strategies are carried out for 37 sampled periods from seven heavy rainfall events in Taiwan in 2019. The results of the overall statistics indicate that, for the extrapolation component, extrapolating the current rainfall rate estimated from the lowest dual-polarimetric radar observations is a superior strategy. The ExAMP scheme that blends the MAPLE and WRF forecasts can surpass both components in 150-min rainfall nowcasting, and an empirical limitation on the innovation of intensity during the blending procedure is found unnecessary in this study. Moreover, the spatial performance for two contrasting events reveals the ability of ExAMP in grasping the rainfall strengthening and weakening in different areas. The skill statistics separately at rainfall strengthening gauges and weakening gauges further prove the effectiveness of ExAMP even though it is effective in intensity correction instead of pattern correction. [ABSTRACT FROM AUTHOR]

In Taiwan, the coastal hazard from typhoon-induced storm waves poses a greater threat to human life and infrastructure than storm surges. Therefore, there has been increased interest in assessing the storm wave hazard levels for the nearshore waters of Taiwan. This study hindcasted the significant wave heights (SWHs) of 124 historical typhoon events from 1978 to 2017 using a fully coupled model and hybrid wind fields (a combination of the parametric typhoon model and reanalysis products). The maximum SWHs of each typhoon category were extracted to create individual storm wave hazard maps for the sea areas of the coastal zones (SACZs) in Taiwan. Each map was classified into five hazard levels (I to V) and used to generate a comprehensive storm wave hazard map. The results demonstrate that the northern and eastern nearshore waters of Taiwan are threatened by a hazard level IV (SWHs ranging from 9.0 to 12.0 m) over a SACZ of 510.0 km2 and a hazard level V (SWHs exceeding 12.0 m) over a SACZ of 2152.3 km2. The SACZs threatened by hazard levels I (SWHs less than 3.0 m), II (SWHs ranging from 3.0 to 6.0 m), and III (SWHs ranging from 6.0–9.0 m) are of 1045.2 km2, 1793.9 km2, and 616.1 km2, respectively, and are located in the western waters of Taiwan. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to determine if the triceps-reflecting anconeus pedicle (TRAP) approach combined with the precontoured locking plate can provide acceptable clinical outcomes in the treatment of comminuted distal humerus fracture.Methods: Between August 2008 and June 2014, 48 patients with Orthopaedic Trauma Association type C (21 with C2, 27 with C3) distal humerus fractures underwent open reduction and internal fixation with orthogonal precontoured locking plate fixation using the TRAP approach. Occurrences of bony union, implant failure, posttraumatic arthrosis, and heterotopic ossification were detected with radiography. Clinical assessment included evaluation of range of motion and determination of the pain score, Mayo Elbow Performance Index (MEPI) score, and Disability of the Arm Shoulder and Hand (DASH) score.Results: The fractures healed within 3 months in 25 patients (53%) and within 6 months in 23 patients (47%). The 12-month assessment revealed improved elbow movement, with the mean arc of flexion-extension of 121° (range, 100°-140°), mean arc of supination-pronation of 163° (range, 150°-180°), and mean flexion contracture of 8° (range, 0°-30°). The mean MEPI score was 81 and the mean DASH score was 11.7.Conclusions: By retaining the intact olecranon by the TRAP approach, orthopedic surgeon can get adequate surgical exposure for fracture fixation and can use olecranon as a three-dimensional template to restore the articular fragments. The promising results in this study obtain because that precise identification of the triceps muscle allowed the determination of a proper length-tension relationship for triceps reattachment. The combination of triceps tendon repair and anconeous muscle repair ensured the strength of the extensor mechanism. Therefore, the TRAP approach in combination with the usage of the precontoured locking plate can be recommended as the optimal surgical approach for the treatment of comminuted distal humerus fracture. [ABSTRACT FROM AUTHOR]

Background & Aims: No approved therapy is available for patients with advanced hepatocellular carcinoma (HCC) who fail first-line therapy. The prognosis of these patients, especially those eligible for clinical trials of second-line therapy, is unclear. Methods: All patients who participated in clinical trials of first-line systemic therapy for metastatic or locally advanced HCC in a referral center of Taiwan between 2005 and 2011 were included. Their clinicopathologic characteristics, when the first-line treatment failed, were analyzed and correlated with the overall survival (OS) from the date of first-line treatment failure. Results: A total of 192 patients were included. Before the start of the first-line therapy, all patients had Child-Pugh class A liver reserves and Cancer of the Liver Italian Program (CLIP) scores ⩽4. After the failure of the first-line therapy, the median OS of the entire group was 4.0months. Patients with Child-Pugh class A liver reserves, when the first-line treatment failed, had significantly better OS than patients with Child-Pugh class B or C liver reserves (median, A vs. B vs. C=7.5 vs. 1.3 vs. 1.0month, p <0.001). According to the key eligibility criteria of 3 published clinical trials for second-line therapy, 41%–56% of patients were potentially eligible. Compared to patients who were ineligible for clinical trials, potentially eligible patients had longer OS with a median of 7.8–8.6months. Conclusions: Patients with advanced HCC who failed first-line therapy could have substantially improved prognosis if they had Child-Pugh A liver reserves or were potentially eligible for clinical trials. [Copyright &y& Elsevier]

The article describes a cyanide poisoning case in Taiwan involving a 32-year-old woman. The woman lost consciousness after drinking a non-alcoholic beverage and was transported to a hospital, where she was intubated. The blood gas measurements of the woman before and after intubation were cited. She was given intravenous hydroxocobalamine and she showed signs of improvement 2-3 minutes after. She was discharged from the hospital after 10 days.

Abstract: Objectives: Transitional cell carcinoma of the urinary bladder is associated with occupational exposure to 4,4′-methylenebis(2-chloroaniline) (MBOCA). A program to monitor MBOCA levels in the work environment and to screen for bladder cancer was performed at four MBOCA manufacturing factories. Methods: The U.S. Occupational Safety and Health Administration analytic method No. 24 was adopted in this study to measure air MBOCA concentrations. A total of 70 MBOCA-exposed workers and another 92 nonexposed workers were recruited for screening. Urine occult blood tests, urine cytology, tests for the urine tumor marker nuclear matrix protein, and abdominal ultrasonography were performed in all patients. Intravenous urography and cystoscopy were used to confirm the presence of bladder cancer. Results: The air concentration of MBOCA was greatest in the purification area (0.23 to 0.41 mg/m3), followed by the washing area (less than 0.02 to 0.08 mg/m3) and neutralization area (less than 0.05 to 0.06 mg/m3). This study identified a current worker with proved bladder cancer. In addition, we also identified 1 worker with suspected malignant cells on urine cytology and 1 worker with atypical cytology combined with gross hematuria. Although the prevalence of atypical urinary cells and the nuclear matrix protein 22 tumor marker was not significantly different between the MBOCA-exposed workers and nonexposed workers as a whole or when grouped by sex, the prevalence of positive occult blood was marginally significantly (P = 0.055) greater in male exposed workers (18%) than in male nonexposed workers (7%). Conclusions: The findings of this study support the conclusions from other studies that MBOCA is potentially carcinogenic to humans. Control measures are needed to prevent overexposure from inhalation and skin absorption. [Copyright &y& Elsevier]

Objective: To report obstetric outcomes in pregnant women with previous pelvic ring injury (PRI) and investigate the correlation between residual pelvic deformity and the mode of delivery., Design: Retrospective cohort study., Setting: Single medical centre in Taiwan., Population: Forty-one women with PRI histories from 2000 to 2021 who subsequently underwent pregnancy and delivery., Methods: All patients had complete PRI treatment and radiological follow up for at least 1 year. The demographic data, radiological outcomes after PRI and obstetric outcomes were collected to investigate the potential factors of delivery modes using non-parametric approaches and logistic regression. Caesarean section (CS) rates among different subgroups were reported., Main Outcome Measures: Comparisons of demographic data and radiological outcomes (Matta/Tornetta criteria and Lefaivre criteria) after PRI among patients who had subsequent pregnancy and underwent vaginal deliveries (VD) or CS., Results: There were 14 VD and 27 CS in 41 patients. Nine patients underwent CS because of their PRI history, 12 patients underwent CS for other obstetric indications and 20 underwent trial of labour. Based on the logistic regression model, retained trans-iliosacral implants did not significantly increase the risk of CS (odds ratio [OR] 1.20; 95% CI 0.17-8.38). Higher pelvic asymmetry value by Lefaivre criteria was a potential risk factor for CS after previous PRI (OR 1.52; 95% CI 1.043-2.213)., Conclusions: VD is possible after PRI. Retained trans-iliosacral implants do not affect the delivery outcome. Residual pelvic asymmetry after PRI by Lefaivre criteria is a potential risk factor for CS., (© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)

Background: Men who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection. This study aimed to assess the incidence, persistence, and clearance of anogenital HPV infections among MSM and the correlates in a 3-year community cohort study., Methods: From 2015 to 2019, MSM were recruited and followed up at 6, 12, 24, and 36 months in Taiwan. Questionnaires and anogenital swabs were collected at baseline and each follow-up visit. Thirty-seven HPV genotypes were tested and genotyped using the linear array HPV genotyping test. The incidence, persistence, and clearance rates of anogenital HPV infection and 95% confidence intervals (CIs) were estimated through Poisson regression. Correlates of the incidence and clearance rates were examined using a generalized estimating equations (GEE) model., Results: A total of 201 MSM were retained in the cohort study with a median age of 27 years (interquartile range [IQR]: 24-32) at baseline. The incidence, persistence, and clearance rates of any anal HPV infection among MSM were 43.6 (95% CI: 33.7-55.6), 23.4 (17.7-30.2), and 58.3 (45.1-74.1) per 1,000 person months (pms), respectively. The incidence, persistence, and clearance rates of any penile HPV infection among MSM were 26.8 (20.1-34.9), 13.4 (8.0-20.9), and 51.5 (37.8-68.5) pms, respectively. MSM who did not consistently use a condom in receptive sex (adjusted odds ratio [AOR]: 2.06, 95% CIs: 1.14-3.72) were more likely to acquire any anal HPV infection. Age at recruitment (1.05, 1.01-1.09) was positively associated with any penile HPV incidence. MSM with over one sex partner in receptive anal sex (0.53, 0.30-0.94) were less likely to clear any anal HPV infection. MSM who were unemployed/students (0.55, 0.30-0.98) were less likely to clear any penile HPV infection., Conclusion: High incidence and low clearance of anogenital HPV infection among MSM in the study serve as a reminder that this population needs to be targeted for HPV vaccination. It is essential for MSM to scale up HPV screening and adhere to safe sex., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhou, Tian, Lu, Yu, Li, Zhou, Lin, Strong and Zou.)

Abstract: Return of spontaneous circulation (ROSC) from out-of-hospital cardiac arrest (OHCA) is critical for the Emergency Medical Services System. When compared to other developed countries, Taiwan has lower rate of ROSC in OHCA patients.We conducted a retrospective study of cardiac arrest using The Emergency Medical Service Dispatching Center in Northern Taiwan and The Prehospital Care System of New Taipei City Paramedic Service. Patients suffering from nontraumatic OHCA between August of 2019 to February of 2020 were included. We analyzed the cardiopulmonary resuscitation (CPR) quality parameters such as chest compression interruptions, bystander CPR, shockable rhythm, CPR interruption, chest compression fraction (CCF) average, patient transportation in buildings, and adrenaline injection during CPR. Multivariable logistic regression analysis was performed to assess the relationship between potential independent variables and ROSC.In our study, we involved 1265 subjects suffering from nontraumatic OHCA, among which 587 patients met inclusion criteria. We identified that CCF> 0.8, chest compression interruption greater than 3 times, and patient transportation in the building were the most critical factors influencing ROSC. However, patient transportation in a building was identified as a dependent predictor variable (P = .4752).We concluded that CCF > 0.8 and chest compression interruption greater than 3 times were essential factors affecting the CPR ROSC rate. The most significant reason for suboptimal CCF and CPR interruption is patient transportation in a building. Improving the latter point could facilitate high-quality CPR., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Adolescence is a critical transition period in the course of human development. Although food insecurity (FI) has been shown to be associated with adverse mental health and sleep outcomes in US adolescents, there is a paucity of research examining the relationships between FI, mental health, and sleep outcomes in Taiwanese adolescents. Furthermore, it is unknown how the change of FI over time (i.e., the trajectory of FI) is related to health outcomes., Methods: The data come from the Taiwan Database of Children and Youth in Poverty, which is a national longitudinal project measuring FI in five survey waves (2009-2017). We employed group-based trajectory modeling to classify various FI trends over the five waves using STATA. Furthermore, a generalized estimating equation analysis was conducted with FI trajectories as the independent variable to see how FI trajectory is related to mental health and sleep outcomes., Results: In total, 1921 participants aged 12-18 years in the first wave were deemed valid for the analysis. We classified the participants into four FI trajectory groups: persistently low FI (24.8%), persistently moderate FI (64.7%), declining from high to low FI (4.1%), and food-secure groups (6.4%). As compared to food-secure adolescents, the persistently moderate FI group was more likely to have mental problems (β = 0.30, [95% confidence interval 0.21-0.38]), while the other FI groups were only marginally associated with mental health problems. Moreover, adolescents in the persistently low FI group (β = 0.13, [0.02-0.23]) and persistently moderate FI group (β = 0.39, [0.29-0.48]) were found to have more sleep problems than those in the food-secure group., Conclusions: Our study describes the FI profile of adolescents from economically disadvantaged families and the difficulties they might encounter. With this information, healthcare providers can aid adolescents in the early stages of mental health problems and provide guidance when appropriate.

Deep cutaneous fungal infections (DCFI) are cutaneous and subcutaneous infectious diseases caused by fungi. Multiple genera of pathogenic fungi have been reported to cause DCFI. Herein, we report three rare cases of Pleosporales deep cutaneous infection in a southern Taiwan medical center. We evaluated the clinical manifestations, histopathological findings, pathogens, treatments and outcomes. The patients were a 77-year-old woman, a 78-year-old woman and an 81-year-old man, who lived in rural tropical areas. The lesions were erythematous noduloplaques with dark spots located on the upper extremities. Sequence-based identification showed three different fungi of the order Pleosporales, namely Nigrograna mackinnonii, Medicopsis romeroi and Parathyridaria percutanea. All three cases received 200 mg of oral itraconazole daily for 10, 2 and 8 months, respectively. Two of them are free of diseases to date, and one improved partially but did not complete the treatment. Molecular tools are helpful for the identification of DCFI to exact species, which is key to successful treatment., (© 2020 Japanese Dermatological Association.)

Cabin crews being first responders, passengers' health assurance is also one of their main responsibilities. This study explored the association among first aid affect, work-related hardiness and self-efficacy of first aid, as well as the mediation role of work-related hardiness in airline cabin crews. Three self-reporting instruments were applied in this study: one was the first aid affect questionnaire, the second was a work-related hardiness questionnaire, the third was self-efficacy of the first aid questionnaire. Data were collected from 525 cabin crew members across five airlines in Taiwan (480 females and 45 males). The results showed that both exploratory and confirmatory factor analyses indicated that three instruments had satisfactory validity and reliability. Positive significant relationships were found among cabin crews' first aid affect, work-related hardiness and self-efficacy of first aid. Cabin crews' commitment dimension of work-related hardiness turned out to be positively related to self-efficacy of first aid. In addition, the results of the study also revealed that cabin crews' work commitment plays a mediating role between their first aid affect and self-efficacy of first aid. To enhance the self-efficacy of first aid, it is necessary for the airlines to strengthen cabin crews' work commitment. Furthermore, fostering cabin crews' first aid affect is also one an important training goal.

Background: To compare the outcomes after surgical intervention, including external fixation (EF) with the optional addition of K-pins or open reduction and internal fixation (ORIF) with a volar locking plate (VLP), in patients with distal radius fracture aged > 80 years., Methods: We reviewed 69 patients with a distal radius fracture aged > 80 years who treated under surgical intervention from 2011 to 2017 retrospectively. Their demographic data and complications were recorded. Preoperative, postoperative, and last follow-up plain films were analyzed. The functional outcomes of wrist range of motion were also evaluated., Results: 41 patients were treated with EF with the optional addition of K-pins, while 28 patients were treated with ORIF with a VLP. The radiological parameters, including ulnar variance and radial inclination, at the last follow-up were significantly more acceptable in the VLP group (p = 0.01, p = 0.03, respectively). The forearm supination was significantly better in patients treated with VLP (p = 0.002). The overall incidence of complications was lower in the VLP group (p = 0.003)., Conclusion: VLP provides better radiological outcomes, wrist supination and lower complication rates than EF. Therefore, although EF is still widely used because of its acceptable results and easy application, we recommend VLP as a suitable treatment option for distal radius fracture in the geriatric population aged > 80 years.

Objective: To investigate the correlation between the utilization of nuclear medicine diagnostic procedures and the mortality of women with breast cancer., Subjects and Methods: Based on the National Health Insurance Research Database (NHIRD), we studied female breast cancer patients in 2012 who underwent whole-body bone scan, lymphoscintigraphy, or fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for possibly managing breast cancer metastases. The mortality of breast cancer was then followed up in 2017. Multiple linear regression analysis was applied to analyze the correlation between the use of any of these three nuclear medicine procedures and the mortality of breast cancer., Results: For patients with early-stage breast cancer, single lymphoscintigraphy was the most frequently performed nuclear medicine procedure, accounting for 36.4% of all three nuclear medicine procedures. For patients with late-stage breast cancer, single whole-body bone scan was the most frequently performed nuclear medicine procedure, accounting for 67.2% of all three nuclear medicine procedures. Mortality of breast cancer significantly increased with the prevalence of late-stage breast cancer (b=2.87, P=0.001) and significantly decreased in cases in which whole-body bone scan was used (b=-4.28, P=0.003)., Conclusion: The mortality of women with late-stage breast cancer was negatively related to the utilization of whole-body bone scan but not to the utilization of lymphoscintigraphy or the 18 F-FDG PET/CT scan. In women with early-stage breast cancer, no significant correlation existed between breast cancer mortality and the utilization of the above three nuclear medicine procedures.

Introduction: In our study, we aimed to investigate the association between a traumatic brain injury (TBI) and subsequent erectile dysfunction (ED). This is a population-based study using the claims dataset from The National Health Insurance Research Database., Methods: We included 72,642 patients with TBI aged over 20 years, retrospectively, selected from the longitudinal health insurance database during 2000-2010, according to the ICD-9-CM. The control group consisted of 217,872 patients without TBI that were randomly chosen from the database at a ratio of 1:3, with age- and index year matched. Cox proportional hazards analysis was used to estimate the association between the TBI and subsequent ED., Results: After a 10-year follow-up, the incidence rate of ED was higher in the TBI patients when compared with the non-TBI control group (24.66 and 19.07 per 100,000, respectively). Patients with TBI had a higher risk of developing ED than the non-TBI cohort after the adjustment of the confounding factors, such as age, comorbidity, residence of urbanization and locations, seasons, level of care, and insured premiums (adjusted hazard ratio (HR) = 2.569, 95% CI [1.890, 3.492], p < .001)., Conclusion: This is the first study using a comprehensive nationwide database to analyze the association of ED and TBI in the Asian population. After adjusted the confounding factors, patients with TBI have a significantly higher risk of developing ED, especially organic ED, than the general population. This finding might remind clinicians that it's crucial in early identification and treatment of ED in post-TBI patients.

Pomegranate ( Punica granatum L.) fruit has been demonstrated to have the inhibitory activities to various tumors. In this study, we try to uncover the molecular mechanism underlying the inhibitory capability of Taiwanese local pomegranate fruit to urinary bladder urothelial carcinoma. The results collected from the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay indicated that the ethanol extract of pomegranate peel exhibited better inhibitory activity to human urinary bladder urothelial carcinoma T24 and J82 cells than that of pulp. Furthermore, the ethylacetate layer of peel ethanol extract was observed to have the best inhibitory activity against urinary bladder urothelial carcinoma cells. One of the eight fractions (PEPE2 fraction) collected from the ethylacetate layer with Diaion HP-20 column chromatography demonstrated the highest inhibitory activity in urinary bladder urothelial carcinoma cells. The results of the flow cytometry and apoptotic pathway studies suggested that the inhibitory activity of PEPE2 fraction were attributed to the UBUC cell apoptosis. To confirm the above results, our results of xenograft-induced bladder tumor in nude mice showed that the oral consumption of the ethylacetate layer (2, 5, 10 and 100 mg/kg) could decrease the volume and weight of T24 tumors and caused the apoptosis in the xenografted tumors, which was observed by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling assay. This study provided the likelihood that the traditionally non-edible pomegranate peel waste is re-utilized to make an affordable and promising chemopreventive product to prevent UBUC incidence or recurrence.

Recognizing the cause is essential for the management of meralgia paresthetica (MP), also known as lateral femoral cutaneous neuropathy. The aim of this study was to investigate the etiologies of MP and their influence on each other. This retrospective study enrolled referral patients with electromyographic studies who fulfilled the clinical and electrodiagnostic criteria of MP from January 2003 to December 2013. Data including age, gender, body weight, body height, occupation, and relevant medical history were collected. The etiological analysis was based on age and gender. A total of 50 patients (30 males and 20 females) were enrolled. The average age (±standard deviation) at diagnosis was 49.8±12.8years. Risk factors were identified in 29 cases (58.0%). More patients younger than 50years of age were male (73.1%, p=0.049). Peaks of age occurred between 41-50years in men and 51-60years in women. More males had a body mass index≥24kg/m 2 (69.2% vs. 31.6%, p=0.012) and ≥27kg/m 2 (34.6% vs. 0.0%, p=0.006). Overweight and obese patients were more vulnerable to occupational factors (50.0% vs. 19.0%, p=0.030). Only one case had diabetes mellitus (2%). Male middle-aged patients with a higher body mass index and certain occupations had an increased risk of MP. In contrast to the peak age distribution of the male patients, the frequency of developing MP was relatively even among the women at all ages. The cause was often obscure., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: Primary quadriceps weakness/atrophy is a rare disorder with variable etiologies; therefore, this disorder has been regarded as a clinical syndrome rather than a distinct entity. However, three affected patients of a Taiwanese family demonstrate a uniform pattern of quadriceps weakness and atrophy, their clinical manifestations and pattern of inheritance may suggest a new disease entity., Patients and Methods: Three patients in a Taiwanese kindred with selective quadriceps weakness and atrophy, which began after age 40 years, were examined. To disclose the confines of this disorder, muscle CT scans, electromyography, nerve conduction studies and muscle biopsies were performed; and to unravel and better understand the nature of this disorder, histopathological, ultrastructural, immunocytochemical and genetic studies were carried out., Results: In two patients with long-standing disease, muscle imaging showed marked atrophy and fat replacement of the anterior thigh muscles and electromyography showed a mixture of myopathic and neuropathic changes. Muscle histopathology on the mildly affected tibialis anterior showed myopathic changes with myofibrillar degeneration and secondary neurogenic alterations. Immunocytochemical staining was not diagnostic but excluded the dystrophinopathies and other well-known muscular dystrophies., Conclusion: All previously identified diseases resulting in quadriceps weakness and atrophy have been ruled out and the present disorder appears to be a new disease entity of autosomal dominant late onset quadriceps myopathy.

Catalytic converters are used to curb exhaust pollution from motorcycles in Taiwan. A number of factors, including the length of time the converter is used for and driving conditions, affect the catalysts' properties during periods of use. The goal of this study is to resolve the thermal deactivation mechanism of motorcycle catalytic converters. Fresh catalysts were treated under different aging conditions by laboratory-scale aging tests to simulate the operation conditions of motorcycle catalytic converters. The aged catalysts were characterized by analytical techniques in order to provide information for investigating deactivation phenomena. The time-dependent data of specific surface areas were subsequently used to construct kinetics of sintering at the specific temperature. According to the analytical results of the catalysts' properties, the increase in aging temperature causes an increase in pore size of the catalysts and a decrease in the specific surface area. The aged catalysts all exhibited lower performances than the fresh ones. The reduction in catalytic activity is consistent with the reduction in the loss of specific surface area. The finding of catalytic properties' dependence on temperature is consistent with the thermally activated theory. In contrast, the effect of the aging time on the specific surface area was only significant during the initial few hours. The high correlation between specific surface areas measured by the Brunauer-Emmett-Teller (BET) method and predicted by the constructed model verifies that the prediction models can predict the sintering rate reasonably under the aging conditions discussed in this study. As compared to automobile catalytic converters, the differences of structures and aging conditions are made less obvious by the deactivation phenomena of motorcycles.

The aim of this study was to establish a set of occupational safety and health (OSH) issues and development policies suitable for adoption in Taiwan. A survey was conducted on a sample of 102 experts and 235 industrial work safety personnel in Taiwan for statistical analysis of the general consensus, with the results showing such consensus in 104 individual policy indicators. Our results reveal that the most appropriate targets were considered to be annual 10% reductions in the 'occupational accident disability rate', 'occupational accident injury rate' and 'occupational diseases before 2010'. Responding to the specific question of the appropriate method of achieving a reduction in the number of accidents in Taiwan, the primary consideration for 13.4% of the experts and 10.6% of the industry personnel was 'promoting OSH awareness and enhancing the overall safety culture'. As regards the current OSH policy focus, 11.2% of the experts considered 'improving OSH legislation, standards and systems' to be the most important, whilst 8.9% of the industry personnel felt that 'recognizing work stress, overwork and emerging OSH issues' were the most important.