Search

Tackles a variety of issues concerning national reunification and territorial integrity of China over Taiwan in 1949. History of China's administrative authority in Taiwan; Efforts of the Chinese government to protect Taiwan from foreign invasions and occupation; Origin of the issue concerning China's jurisdiction over Taiwan.

Monitoring survival in cancer is a common concern for patients, physicians, and public health researchers. The traditional cohort approach for monitoring cancer prognosis has a timeliness problem. In this paper, we propose a survivorship-period-cohort (SPC) model for examining the effects of survivorship, period, and year-of-diagnosis cohort on cancer prognosis and for predicting future trends in cancer survival. We used the developed SPC model to evaluate the relative survival (RS) of patients with liver cancer in Taiwan (diagnosed from 1997 to 2016) and to predict future trends in RS by imputing incomplete follow-up data for recently diagnosed patient cohorts. We used cross-validation to select the extrapolation method and bootstrapping to estimate the 95% confidence interval for RS. We found that 5-year cumulative RS increased for both men and women with liver cancer diagnosed after 2003. For patients diagnosed before 2010, the 5-year cumulative RS rate for men was lower than that for women; thereafter, the rates were better for men than for women. The SPC model can help elucidate the effects of survivorship, period, and year-of-diagnosis cohort effects on cancer prognosis. Moreover, the SPC model can be used to monitor cancer prognosis in real time and predict future trends; thus, we recommend its use. [ABSTRACT FROM AUTHOR]

Copyright of International Journal for Quality in Health Care is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper examines how mobile messaging apps have changed the way that people microcoordinate. It is based on five focus groups of young adults in Singapore and Taiwan. Originally, microcoordination usually assumed dyadic interaction using either SMS or mobile voice calls. Increasingly, mediated communication uses mobile messaging apps that allow multisided interactions that facilitate task-based chat groups. Groups are easily formed but can be difficult to manage. This paper advances our understanding of microcoordination via the use of messaging apps. Specifically, it provides insights into the dual roles of instrumental and expressive interaction integral to the functioning of these messaging groups, ambient-mediated sociation in the form of readily available communication partners in groups, and the emergence of meme-based coordination. [ABSTRACT FROM AUTHOR]

In this paper we test whether or not structural and morphological features inherited from the Eurasian continental margin are affecting the contemporary stress and strain fields in south-central Taiwan. Principal stress directions (σ1, σ2 and σ3) are estimated from the inversion of clustered earthquake focal mechanisms and the direction of the maximum compressive horizontal stress (S H) is calculated throughout the study area. From these data the most likely fault plane orientations and their kinematics are inferred. The results of the stress inversion are then discussed together with the directions of displacement, compressional strain rate and maximum shear strain rate derived from GPS data. These data show that there is a marked contrast in the direction of S H from north to south across the study area, with the direction of S H remaining roughly subparallel to the relative plate motion vector in the north, whereas in the south it rotates nearly 45° counter-clockwise. The direction of the horizontal maximum compression strain rate (εH) and associated maximum shear planes, together with the displacement field display an overall similar pattern between them, although undergoing a less marked rotation. We interpret the southward change in the S H, εH and the dextral maximum shear plane directions, together with that of the horizontal displacement field to be related to the reactivation of east–northeast striking faults inherited from the rifted Eurasian margin and to the shelf/slope break. Inherited faults in the basement are typically reactivated as strike-slip faults, whereas newly formed faults in the fold-and-thrust belt are commonly thrusts or oblique thrusts. Eastwards, the stress inversions and strain data show that the western flank of the Central Range is undergoing extension in the upper crust. S H in the Central Range is roughly parallel to the relative plate convergence vector, but in southwestern Taiwan it undergoes a marked counter-clockwise rotation westwards across the Chaochou fault. Farther north, however, there is no significant change across the Lishan fault. This north to south difference is likely due to different margin structures, although local topographic effects may also play a role. [ABSTRACT FROM AUTHOR]

Objective: Taiwan has launched a Family Practice Integrated Care Project (FPICP) to develop an accountable family doctor system since March 2003. We aim to report the effectiveness of this nationwide demonstration programme over a 10-year period.Methods: Papers and reports related to the FPICP published both in English and in Chinese from 2003 to 2015 were collected systematically based on keywords including 'family doctor', 'primary care', 'integrated care' and 'Taiwan'. Also collected and reviewed were national health insurance administration annual reports and related publications from Taiwan Association of Family Medicine. Quality care indicators including structure, process and outcome for programme monitoring were reported.Results: Up to June 2015, the project had enrolled a total of 10.5% of Taiwan's population. Approximately 24.9% of primary care physicians and 29.7% of community clinics joined the project to serve the members of 426 community health care groups (CHCGs). Compared to non-members, CHCG members received more preventive care services, especially in adult health examination (49% versus 19%), Pap smear (29% versus 22%), elderly influenza vaccination (42% versus 28%) and immunochemical faecal occult blood test (43% versus 31%) (P < 0.01). Members showed a markedly high level of satisfaction (>95%), especially in overall satisfaction, provision of health consultation and information, and improvement in understanding personal health condition.Conclusions: In the future, through the support of family physicians and CHCGs, a person-centred integrated health care delivery system can be an effective solution to the current barriers in the medical care system. [ABSTRACT FROM AUTHOR]

Background Foot complications are common in people with diabetes mellitus (DM), leading to increased health care utilization, heightened mortality risk, and notable recurrence rates even after treatment. This retrospective cohort study aimed to investigate the impact of repeated occurrence of DM-related foot complications on the risk of all-cause mortality and to identify the potential risk factors associated with repeated events. Methods People with DM admitted with foot complications (ulcer, skin and soft tissue infection, or osteomyelitis) from 2012 to 2014 were identified from Taiwan's National Health Insurance Research Database, with a 3-year follow-up for repeated events. We categorized the study subjects based on their cumulative number of hospital admissions with foot complications. Logistic regression was conducted to explore the potential risk factors associated with repeated diabetic foot events. Kaplan-Meier curves and Cox proportional hazard models were used to examine the associations between repeated diabetic foot events and all-cause mortality. Results In this study, 28 754 eligible individuals were enrolled and classified into 3 groups: no repeated diabetic foot events (76.1%), 1 repeated event (16.0%), and 2 or more repeated events (7.9%). Logistic regression revealed that advanced age, male sex, congestive heart failure, dyslipidemia, hypertension, nephropathy, retinopathy, neuropathy, peripheral vascular disease, diabetes-related preventable hospitalizations, and outpatient visits due to diabetic foot were significantly associated with repeated events of diabetic foot complications. Compared with those with no repeated events, the adjusted hazard ratios for all-cause mortality were 1.26 (95% CI, 1.19–1.34) for 1 repeated event and 1.36 (95% CI, 1.26–1.47) for 2 or more repeated events. Conclusions The significant association between repeated diabetic foot and elevated mortality risk highlights the critical necessity for proactive and targeted patient care within clinical practice. More research to delve into the predictive factors related to the repeated occurrence of diabetic foot is needed to provide additional insights for prevention strategies. [ABSTRACT FROM AUTHOR]

The growth in commercial transactions with Mainland China, Hong Kong Special Administrative Region and the Taiwan region (Taiwan) as well as the economic integration in the entire area have lead to an increase in disputes. Considering the importance of arbitration as a mechanism for resolving commercial disputes in the area, the paper discusses whether a substantial "clash" between their legal frameworks for the recognition and enforcement of foreign arbitral awards can be observed. After a critical analysis, the paper concludes that these frameworks are either subject to or modelled on the New York Convention. Yet, each has a distinct approach to the implementation, and dissimilarities arise. Furthermore, the specific legal framework for the recognition and enforcement of Mainland China awards in Hong Kong and Taiwan, and vice versa, still raises some concerns and is not fully reliable. [ABSTRACT FROM AUTHOR]

Background: The European Organisation for Research and Treatment of Cancer (EORTC) Group has developed a new multidimensional instrument measuring cancer-related fatigue to be used in conjunction with the quality of life core questionnaire (EORTC QLQ-C30). The module EORTC QLQ-FA13 assesses physical, cognitive, and emotional aspects of cancer-related fatigue.Methods: The methodology follows the EORTC guidelines for phase IV validation of modules. This paper focuses on the results of the psychometric validation of the factorial structure of the module. For validation and cross-validation confirmatory factor analysis (maximum likelihood estimation), intraclass correlation and Cronbach alpha for internal consistency were employed. The study involved an international multicenter collaboration of 11 European and non-European countries.Results: A total of 946 patients with various tumor diagnoses were enrolled. Based on the confirmatory factor analysis, we could approve the three-dimensional structure of the module. Removing one item and reassigning the factorial mapping of another item resulted in the EORTC QLQ-FA12. For the revised scale, we found evidence supporting good local (indicator reliability ≥ 0.60, factor reliability ≥ 0.82) and global model fit (GFI t1|t2 = 0.965/0.957, CFI t1|t2 = 0.976/0.972, RMSEA t1|t2 = 0.060/0.069) for both measurement points. For each scale, test-retest reliability proved to be very good (intraclass correlation: R t1-t2 = 0.905-0.921) and internal consistency proved to be good to high (Cronbach alpha = .79-.90).Conclusion: Based on the former phase III module, the multidimensional structure was revised as a phase IV module (EORTC FA12) with an improved scale structure. For a comprehensive validation of the EORTC FA12, further aspects of convergent and divergent validity as well as sensitivity to change should be determined. [ABSTRACT FROM AUTHOR]

Speciation in the face of gene flow is usually associated with a heterogeneous genomic landscape of divergence in nascent species pairs. However, multiple factors, such as divergent selection and local recombination rate variation, can influence the formation of these genomic islands. Examination of the genomic landscapes of species pairs that are still in the early stages of speciation provides an insight into this conundrum. In this study, population genomic analyses were undertaken using a wide range of sampling and whole-genome resequencing data from 96 unrelated individuals of Kentish plover (Charadrius alexandrinus) and white-faced plover (Charadrius dealbatus). We suggest that the two species exhibit varying levels of population admixture along the Chinese coast and on the Taiwan Island. Genome-wide analyses for introgression indicate that ancient introgression had occurred in Taiwan population, and gene flow is still ongoing in mainland coastal populations. Furthermore, we identified a few genomic regions with significant levels of interspecific differentiation and local recombination suppression, which contain several genes potentially associated with disease resistance, coloration, and regulation of plumage molting and thus may be relevant to the phenotypic and ecological divergence of the two nascent species. Overall, our findings suggest that divergent selection in low recombination regions may be a main force in shaping the genomic islands in two incipient shorebird species. [ABSTRACT FROM AUTHOR]

Background Intradialytic hypotension (IDH) is a common hemodialysis complication causing adverse outcomes. Despite the well-documented associations of ambient temperatures with fluid removal and pre-dialysis blood pressure (BP), the relationship between ambient temperature and IDH has not been adequately studied. Methods We conducted a cohort study at a tertiary hospital in southern Taiwan between 1 January 2016 and 31 October 2021. The 24-h pre-hemodialysis mean ambient temperature was determined using hourly readings from the weather station closest to each patient's residence. IDH was defined using Fall40 [systolic BP (SBP) drop of ≥40 mmHg] or Nadir90/100 (SBP <100 if pre-dialysis SBP was ≥160, or SBP <90 mmHg). Multivariate logistic regression with generalizing estimating equations and mediation analysis were utilized. Results The study examined 110 400 hemodialysis sessions from 182 patients, finding an IDH prevalence of 11.8% and 10.4% as per the Fall40 and Nadir90/100 criteria, respectively. It revealed a reverse J-shaped relationship between ambient temperature and IDH, with a turning point around 27°C. For temperatures under 27°C, a 4°C drop significantly increased the odds ratio of IDH to 1.292 [95% confidence interval (CI) 1.228 to 1.358] and 1.207 (95% CI 1.149 to 1.268) under the Fall40 and Nadir90/100 definitions, respectively. Lower ambient temperatures correlated with higher ultrafiltration, accounting for about 23% of the increased IDH risk. Stratified seasonal analysis indicated that this relationship was consistent in spring, autumn and winter. Conclusion Lower ambient temperature is significantly associated with an increased risk of IDH below the threshold of 27°C, irrespective of the IDH definition. This study provides further insight into environmental risk factors for IDH in patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

Background The relationship between maternal chronic diseases and congenital anomalies of the kidneys and urinary tract (CAKUT) in offspring still needs elucidation. This study aimed to comprehensively evaluate the associations between maternal chronic disease and CAKUT in their offspring. Methods Data of mothers and children were extracted from the Taiwan Maternal and Child Health Database and National Health Insurance Research Database. The concept of developmental origins of health and disease (DOHaD) was used to select maternal chronic diseases. Results The study cohort included 1 196 175 mothers and 1 628 706 offspring. Analysis showed that maternal chronic diseases, especially type 1 diabetes, type 2 diabetes, gestational diabetes, connective tissue disorders and CAKUT were highly associated with CAKUT in the offspring. Higher maternal age, abnormal birthweight (>3500 g or <2500 g), gestational age <36 weeks and birth order <2 were all associated with a higher risk of CAKUT. Maternal chronic hypertension and taking angiotensin-related drugs increased the odds ratios of obstructive kidney disease in the offspring. Offspring tended to have the same type of CAKUT as their mothers. Conclusion Maternal chronic diseases, older maternal age and abnormal birthweight are risk factors for CAKUT. Also, a percentage of patients with CAKUT were not full-term newborns. Results support prenatal counselling and health management of pregnant women with chronic diseases and extra care for infants with a high risk of anomalies. It is strongly recommended that prevention of CAKUT in offspring should start with care of the mothers' prenatal chronic diseases. [ABSTRACT FROM AUTHOR]

Background Some schizophrenia patients treated with clozapine experience an inadequate response and adherence problems. The purpose of this study was to compare time to rehospitalization within 6 months in schizophrenia patients discharged on 3 clozapine regimens. Additionally, the temporal trend of prescription rate in each group was also explored. Methods Schizophrenia patients discharged from the study hospital from January 1, 2006, to December 31, 2021, (n = 3271) were included in the analysis. The type of clozapine prescribed at discharge was divided into 3 groups: clozapine plus long-acting injectable antipsychotics (clozapine + LAIs), clozapine plus other oral antipsychotics (clozapine + OAPs), and clozapine monotherapy. Survival analysis was used to compare time to rehospitalization within 6 months after discharge among the 3 groups. The temporal trend in the prescription rate of each group was analyzed using the Cochran-Armitage Trend test. Results Patients discharged on clozapine + LAIs had a significantly longer time to rehospitalization than those on clozapine + OAPs or clozapine monotherapy. The prescription rates of clozapine + LAIs and clozapine + OAPs significantly increased over time, whereas the prescription rates of clozapine monotherapy significantly decreased. Conclusions Compared with the clozapine + OAPs group, the clozapine + LAIs group had a lower risk of rehospitalization and a lower dose of clozapine prescribed. Therefore, if a second antipsychotic is required for patients who are taking clozapine alone, LAIs should be considered earlier. [ABSTRACT FROM AUTHOR]

In an interconnected world, higher education systems, the institutions that comprise them, educational policy makers, quality assurance agencies are all supposed to interact simultaneously in a global, national, and local, or glonacal, context. Like some other Asian nations, Taiwan has been developing its glonacal quality assurance framework. At the same time, it attempted to give more institutional autonomy to universities by awarding them a self-accreditation status. The main purpose of the paper is to examine transformation of QA systems in Taiwan's higher education under the glonacal context and to analyze the new development of self-accreditation. [ABSTRACT FROM AUTHOR]

Study question During controlled ovarian stimulation (COS), does the duration of premature serum progesterone (P) elevation before administration of hCG affect the outcomes of IVF/ICSI embryo transfer (-ET) cycles? Summary answer The duration of the premature serum P elevation is inversely related to the clinical pregnancy rate of IVF/ICSI-ET cycles. What is known and what this paper adds The majority of the previous studies only considered a single serum P measurement made on the day of hCG administration and the results of attempts to relate this to IVF/ICSI-ET outcomes were controversial. However, the effect of the duration of premature serum P elevation before the hCG administration on the outcomes of IVF/ICSI-ET cycles has not been studied well. Here we demonstrate that the duration of premature serum P elevation has a more significant inverse correlation than the absolute serum P concentration on the day of hCG administration with IVF/ICSI-ET outcomes. Design It is a retrospective, single-centre cohort study. A total of 1784 IVF and/or ICSI-ET cycles were included from October 2005 to June 2011. Participants and setting A total of 1784 patients underwent their IVF and/or ICSI-ET cycles in a university hospital IVF unit. The inclusion criteria include (i) age between 20 and 42 years and (ii) eligible indications for COS before IVF/ICSI. Main results and the role of chance The duration of premature serum P elevation to >1 ng/ml is significantly inversely associated with the probability of clinical pregnancy (odds ratio = 0.773, 95% confidence interval: 0.660–0.891, P < 0.001), after adjustment for possible confounders with multivariate logistic regression analysis. However, the significance of inverse correlation between the absolute serum P concentration on the day of hCG administration with clinical pregnancy rate decreased after adjustment. Bias, confounding and other reasons for caution The cutoff value we chose to define premature serum P elevation (P > 1.0 ng/ml) might not be able to be applied to different immunoassay kits and study population. The retrospective nature of this study inevitably might be influenced by some selection bias. Generalizability to other populations Older patients (>42 years) are excluded from our study. Study funding/competing interest(s) This study was supported in part by grants from the National Science Council (100-2314-B-002-022-MY3) and National Taiwan University Hospital (NTUH 100-S1555), Taipei, Taiwan. No competing interests are declared. Trial registration number nil. [ABSTRACT FROM AUTHOR]

Background: research in care home settings is often negatively focused, portraying life as sterile and devoid of meaningful experiences. Care homes have the potential to influence people's lives socially, physically and psychologically. It is important to understand what factors contribute to this.Objective: to conduct a systematic qualitative review of care home life and provide practical recommendations to enhance residents' quality of life.Methods: the following databases were searched: PsycINFO, Medline, Web of Science, EMBASE, Allied and Complementary Medicine Database and Cumulative Index to Nursing and Allied Health Literature. References from appropriate journals and individual articles were checked. Papers that fitted our selection criteria were selected. Two independent reviewers assessed methodological study quality. Thematic analysis and meta-ethnographic methods were adapted to synthesise findings.Results: thirty-one studies were identified. People in care homes voiced concerns about lack of autonomy and difficulty in forming appropriate relationships with others. Four key themes were identified: (i) acceptance and adaptation, (ii) connectedness with others, (iii) a homelike environment, (iv) caring practices.Conclusion: positive experiences in care homes can occur and are important for residents' quality of life. The review supports literature highlighting the need for relationship-centred approaches to care and emphasises the importance of understanding the resident's attitude towards living in care homes. [ABSTRACT FROM AUTHOR]

Background. We implemented a community-run and GP-supervised self-care for minor illnesses (CGPSC) program in a mountainous area where medical resources for caring for minor illnesses were scarce. In this paper, we reported the residents’ experiences and evaluations of this program. Methods. The CGPSC program was implemented through easy-access self-care medical spots (ESCMSs) that were set up in the community with following services: non-prescription medications for minor illness (MMI) service, materials for caring for minor injuries, pamphlet on self-care for minor illnesses and minor injuries and medical consultation line. Ten selected residents were trained to run the ESCMSs. All services were supervised by the GP in charge. Nine months after the opening of the ESCMSs, a survey was conducted to evaluate residents’ reactions to it. Results. Eighty per cent (n = 80) of the respondents were aware of the existence of the ESCMSs, and the MMI service was known to most residents and most utilized by them. Compared to respondents who had not used the MMI service (n = 30), those who had used the service (n = 50) considered the ESCMSs more helpful (90.00% versus 76.67%, P < 0.05) and had greater willingness to seek help from the ESCMS in the future (88.00% versus 56.67%, P < 0.01). Conclusions. The collaborative efforts of the communities and the medical staff had made the ESCMS a safe, convenient and user-friendly resource to self-care for residents in a rural area. Under the supervision of the GP, trained community residents were able to run the ESCMS smoothly and efficiently. [ABSTRACT FROM PUBLISHER]

This paper empirically identifies cross-price elasticities of betel nut and cigarette consumption in Taiwan based on the Central Bureau of Statistics demand model. It compares reduction of cigarette consumption as a result of the proposed Betel Nut Health Tax with reduction of betel nut consumption as a result of the Tobacco Health and Welfare Taxes levied in 2002 and 2006, in order to determine which tax is most effective. Results from a simulated comparative analysis indicate that the Betel Nut Health Tax reduces cigarette consumption to a much greater extent than the Tobacco Health and Welfare Taxes reduce betel nut consumption. [ABSTRACT FROM AUTHOR]

The Taiwan orogen has long been regarded as a case example for studying mountain building in association with subduction processes. In this paper, we present a fully coupled thermomechanical modelling of the Taiwan collision based on a realistic viscous-elastic–plastic rheology. It satisfactorily reproduces available thermochronometric data, long-/short-term deformation patterns, heat flux and erosion/sedimentation distribution across the Taiwan orogeny. We found that a deep seated flux of Asian crustal material into the orogenic wedge should be invoked to counter-balance observed exhumation and erosion in the Central Range. However, in contrast with recent thermokinematic models of exhumation and deformation suggesting that underplating plays a significant role, we show that most constraints on exhumation and deformation can be more straightforwardly interpreted by the frontal accretion of the rheologically layered Asian crust. We finally infer that such a model is in better agreement with the basic expectation that the hot/young and buoyant Chinese continental margin should hardly be subducted beneath the cold/old and dense oceanic plate of the Philippines Sea. [ABSTRACT FROM AUTHOR]

In 1995, a combined ocean-bottom-seismometric (OBS) and multichannel seismic (MCS) survey with strong air-gun shots was carried out in the southernmost Ryukyu subduction zone. A crustal velocity structure constructed from the layer-stripping Monte Carlo inversion of three OBS/MCS profiles and the associated density models inverted from gravity data in the SW end of the Ryukyu arc-trench system are presented. Parallel to the arc in the southernmost Ryukyu subduction system, the OBS/MCS profiles show sedimentary layers of the Hoping, Nanao and East-Nanao forearc basins from west to east, warping of the arc basement and buckling of the subducted slab beneath the Hoping basement rise. The arc-parallel variation of the crustal structure may result from increasing lateral compression westward due to oblique subduction of the Philippine Sea plate and collision with the Luzon arc near the northwestern edge of the forearc region. Northward subduction and arc-parallel compression of the slab also have generated thrust faulting along the subduction interface and strike-slip faulting within the subducted slab, respectively. On 2002 March 31, an earthquake with a moment magnitude of 6.84 was induced by buckling of the subducted slab and strongly affected cities within an epicentral distance of 100 km. The velocity-interface models, the density models and the focal mechanisms presented in this paper therefore suggest that earthquakes induced by slab buckling or arc-parallel compression have been stronger but less frequent than those generated by northward subduction in the Ryukyu seismogenic zone off Taiwan. [ABSTRACT FROM AUTHOR]

In many Asian countries, physicians both prescribe and dispense drugs. This practice is hypothesized to have caused high drug expenditure and widespread prescription of antibiotics in Asia. Recently, Taiwan implemented the separation policy on an experimental basis. This paper's objective is to empirically evaluate the impact of Taiwan's reform to separate drug prescribing and dispensing on drug expenditure and total health expenditure. The research design consists of a pre/post comparison of the experimental with the control sites (difference-in-difference). Separation policy was implemented in Kaohsung and Taipei in March 1997, and expanded to Chia-yi and Taichung in March 1998. Changes in drug prescription behaviour before and after implementation in these two pairs of experimental cities were compared to Hsin-chu and Tainan (control), where separation policy was not implemented during the study period. To reduce resistance, providers in experimental sites were allowed to hire on-site pharmacists and dispense drugs through them if they chose to do so. Our study sample consists of all outpatient visits to clinics in the study sites between December 1996 and June 1998, with a total of 55.23 million claim records. The drug prescription rate, drug expenditure and total health expenditure per visit were the main outcome measures. We found that the probability of prescription and drug expenditure per visit were, respectively, 17-34% and 12-36% less among visits to clinics without on-site pharmacists, compared with the control sites. However, no difference in total health expenditure was found between these two types of visits. Hence, the separation policy could be effective in reducing drug expenditure and affecting prescription behaviour, but is less certain as a policy for reducing total health expenditure. We also found that the policy has practically no effect on clinics that have on-site pharmacists. [ABSTRACT FROM AUTHOR]

The authors used data obtained from clinic records and environmental monitoring stations in Taiwan during 1998 to estimate the association between air pollution and daily numbers of clinic visits for lower respiratory tract illness. A small-area design and hierarchical modeling were used for the analysis. Rates of daily clinic visits were associated with current-day concentrations of nitrogen dioxide, carbon monoxide, sulfur dioxide, and particulate matter less than or equal to 10 µm in aerometric diameter. People over age 65 years were the most susceptible, and estimated pollution effects decreased as the exposure time lag increased. The analysis also suggested that several community-specific variables, such as a community's population density and yearly air pollution levels, modified the effects of air pollution. In this paper, the authors demonstrate the use of a small-area design to assess acute health effects of air pollution. Am J Epidemiol 2002;155:1-10. [ABSTRACT FROM AUTHOR]

KAGRA is a newly built gravitational wave observatory, a laser interferometer with a 3 km arm length, located in Kamioka, Gifu prefecture, Japan. In this article, we describe the KAGRA data management system, i.e., recording of data, transfer from the KAGRA experiment site to computing resources, as well as data distribution to tier sites, including international sites in Taiwan and Korea. The amount of KAGRA data exceeded 1.0 PiB and increased by about 1.5 TB per day during operation in 2020. Our system has succeeded in data management, and has achieved performance that can withstand observations after 2023, that is, a transfer rate of 20 MB s-1 or more and file storage of sufficient capacity for petabyte class. We also discuss the sharing of data between the global gravitational-wave detector network with other experiments, namely LIGO and Virgo. The latency, which consists of calculation of calibrated strain data and transfer time within the global network, is very important from the view of multi-messenger astronomy using gravitational waves. Real-time calbrated data delivered from the KAGRA detector site and other detectors to our computing system arrive with about 4–15 seconds of latency. These latencies are sufficiently short compared to the time taken for gravitational wave event search computations. We also established a high-latency exchange of offline calibrated data that was aggregated with a better accuracy compared with real-time data. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Does YAP1 inhibition alleviate progesterone resistance in endometriosis? SUMMARY ANSWER YAP1 inhibition reduces progesterone resistance in vitro and in vivo. WHAT IS KNOWN ALREADY Progesterone resistance not only causes treatment failure for endometriosis but also inhibits eutopic endometrial cell proliferation, dysregulates decidualization, and reduces the success rates of pregnancy. Hippo/yes-associated protein 1 (YAP1) signaling pathway plays an important role in the pathogenesis of endometriosis. STUDY DESIGN, SIZE, DURATION Paraffin-embedded tissues containing paired endometriotic and endometrial specimens (n = 42) and serum samples isolated from normal controls (n = 15) or endometriotic patients with (n = 25) or without (n = 21) prior dienogest treatment were analyzed. A mouse model of endometriosis was also used to evaluate the effects of YAP1 inhibition on progesterone resistance. PARTICIPANTS/MATERIALS, SETTING, METHODS Primary endometriotic and endometrial stromal cells treated with YAP1 inhibitor or miR-21 mimic/inhibitor were used for the in vitro studies including decidualization induction, chromatin immunoprecipitation (ChIP), and RNA immunoprecipitation. Tissue specimens and serum from human and mouse were used for immunohistochemistry staining, exosome isolation, and microRNA (miRNA) quantification, respectively. MAIN RESULTS AND THE ROLE OF CHANCE Herein, we report, by using ChIP-PCR and RNA-IP, that YAP1 inhibits progesterone receptor (PGR) expression through upregulation of miR-21-5p. Upregulation of miR-21-5p not only reduces PGR expression but also inhibits endometrial stromal cell decidualization. Indeed, levels of YAP1 and miR-21-5p are inversely correlated with the level of PGR in human endometrial samples. In contrast, knockdown of YAP1 or treatment with verteporfin (VP), a YAP1 inhibitor, reduces miR-21-5p expression, thus leading to an increase in PGR expression in ectopic endometriotic stromal cells. In the mouse model of endometriosis, treatment with VP increases PGR expression and enhances decidualization. More importantly, VP synergistically increases the treatment effect of progestin in causing the regression of endometriotic lesions and improves the decidualization capability of the endometrium. Interestingly, treatment with dienogest, a synthetic progestin, reduces YAP1 and miR-21-5p expression in human cells and in the mouse model of endometriosis. Patients who received dienogest treatment for 6 months show a significant decrease in serum extracellular vesicle-associated miR-21-5p level. LARGE SCALE DATA A public dataset (GSE51981) containing a large cohort of endometriotic tissues is available from the Gene Expression Omnibus (GEO). LIMITATIONS, REASONS FOR CAUTION A large cohort of clinical samples is needed to verify the current diagnostic value of miR-21-5p in future studies. WIDER IMPLICATIONS OF THE FINDINGS The reciprocal regulation of YAP1 and PGR suggests that combined YAP1 inhibitor and progestin may be a better therapeutic approach for treating endometriosis. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Ministry of Science and Technology, Taiwan (MOST-111-2636-B-006-012, MOST-111-2314-B-006-075-MY3, and MOST-106-2320-B-006-072-MY3). The authors have no conflict of interest to disclose. [ABSTRACT FROM AUTHOR]

The biotas of Taiwan and Hainan Islands are of continental origin, but the manner with which historical and ecological factors shaped these insular species is still unclear. Here, we used freshwater fish as a model to fill this gap by quantifying the phylogenetic structure of the insular faunas and disentangling the relative contribution of potential drivers. Firstly, we used clustering and ordination analyses to identify regional species pools. To test whether the insular freshwater fish faunas were phylogenetically clustered or overdispersed, we calculated the net relatedness index (NRI) and the nearest taxon index (NTI). Finally, we implemented logistic regressions to disentangle the relative importance of species attributes (i.e. maximum body length, climatic niche dissimilarity [ND], and diversification) and historical connectivity (HC) in explaining the insular faunas. Our results showed that the most possible species pools of Taiwan are Zhejiang and Fujian provinces, and those of Hainan are Guangdong and Guangxi provinces. These insular faunas showed random phylogenetic structures in terms of NRI values. According to the NTI values, however, the Taiwanese fauna displayed more phylogenetic clustering, while the Hainanese one was more overdispersed. Both the standard and phylogenetic logistic regressions identified HC and climatic ND as the 2 top explanatory variables for species assemblages on these islands. Our reconstruction of the paleo-connected drainage basins provides insight into how historical processes and ecological factors interact to shape the freshwater fish fauna of the East Asian islands. [ABSTRACT FROM AUTHOR]

An analytically based method is proposed to simulate the acoustic-gravity waves in the horizontally stratified atmosphere-Earth structure generated by a point force on the Earth's surface. The method solves the linear momentum, continuity and adiabaticity equations in the atmosphere and elastodynamic equations in the solid Earth in the frequency–wavenumber domain. The time-domain waveforms are obtained by wavenumber integration and fast Fourier transform with respect to the frequency. Numerical simulations are conducted to investigate the properties of the acoustic-gravity waves, including both the high-frequency acoustic-mode waves and low-frequency gravity-mode waves. Simulations of the high-frequency responses show that disturbances in the atmosphere with three apparent horizontal velocities can be identified. They are, namely, the direct acoustic-mode wave generated by source travelling with the sound speed, the head wave generated by the seismic P -wave travelling with apparent horizontal speed identical to the P velocity, and the head wave generated by the Rayleigh wave with a horizontal speed same to the Rayleigh wave velocity. Simulations of the low-frequency responses show that the gravity-mode wave and Lamb wave can be identified. The gravity-mode wave travels with a speed lower than the sound seed and does not reach everywhere, especially the area directly above the source. The Lamb wave travels along the Earth surface with a speed of about 310 m s–1 and its energy decays with the altitude. We also apply our method to explaining the Doppler sounding data observed in Taiwan area during the 2011 Tohoku M 9 earthquake, and find good agreement between the predicted signals and observed data in the arrival time and wave envelope associated with the Rayleigh wave. [ABSTRACT FROM AUTHOR]

Policy implementation outcomes occur through the interplay between the political interests and power relationships of actors within the underlying institutional arrangements. Using the Community Forestry Program in Taiwan as a case study, this study aims to (1) identify how the historical development of forestry policies shapes current institutional arrangements and the political interests of actors, (2) determine how institutional arrangements shape the power relationships and interactions between actors and (3) understand how these interactions produce the policy implementation outcomes. Focusing on eastern Taiwan, 24 semi-structured interviews were conducted. The respondents included officers at different tiers of Taiwan's forestry authority and the communities that had participated in the policy between 2013 and 2017. Findings from the thematic analysis reveal that the forestry officers and communities have divergent political interests and expectations for the policy, and when disagreements arose, the political interests of forestry officers often prevailed over those of the communities. These findings further exemplify the state's dominance in Taiwan's forest management, wherein local communities are placed at the periphery and power has not yet been devolved formally to the communities under the existing institutional arrangements. Amendments to the broader legal framework are required to alter the existing power relationships and achieve decentralization of forest resource management. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Could the direct contribution of genetic variants to the pathophysiology of uterine fibroids and the contribution mediated by age at menarche be different? SUMMARY ANSWER Age at menarche plays a mediation role in the genetic influence on uterine fibroids, and four causal genetic mechanisms underlying the age at menarche-mediated effects of common genetic loci on uterine fibroid development were identified. WHAT IS KNOWN ALREADY Uterine fibroids are common benign tumors developing from uterine smooth muscle. Genome-wide association studies (GWASs) have identified over 30 genetic loci associated with uterine fibroids in different ethnic populations. Several genetic variations in or nearby these identified loci were also associated with early age at menarche, one of the major risk factors of uterine fibroids. Although the results of GWASs reveal how genetic variations affect uterine fibroids, the genetic mechanism of uterine fibroids mediated by age at menarche remains elusive. STUDY DESIGN, SIZE, DURATION In this study, we conducted a genome-wide causal mediation analysis in two cohorts covering a total of 69 552 females of Han Chinese descent from the Taiwan Biobank (TWB). TWB is an ongoing community- and hospital-based cohort aiming to enroll 200 000 individuals from the general Taiwanese population between 30 and 70 years old. It has been enrolling Taiwanese study participants since 2012 and has extensive phenotypic data collected from 148 291 individuals as of May 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS We recruited individuals in two cohorts, with 13 899 females in TWB1 and 55 653 females in TWB2. The two sets of individuals are almost distinct, with only 730 individuals enrolled in both cohorts. Over 99% of the participants are Han Chinese. Approximately 21% of participants developed uterine fibroids. DNA samples from both cohorts were genotyped using two different customized chips (TWB1 and TWB2 arrays). After quality control and genotype imputation, 646 973 TWB1 single-nucleotide polymorphisms (SNPs) and 686 439 TWB2 SNPs were assessed in our analysis. There were 99 939 SNPs which overlapped between the TWB1 and TWB2 arrays, 547 034 TWB1 array-specific SNPs and 586 500 TWB2 array-specific SNPs. We performed GWASs for screening potential risk SNPs for age at menarche and for uterine fibroids. We subsequently identified causal mediation effects of risk SNPs on uterine fibroids mediated by age at menarche. MAIN RESULTS AND THE ROLE OF CHANCE In addition to known loci at LIN28B associated with age at menarche and loci at WNT4 associated with uterine fibroids, we identified 162 SNPs in 77 transcripts that were associated with menarche-mediated causal effects on uterine fibroids via four different causal genetic mechanisms: a both-harmful group with 52 SNPs, a both-protective group with 34 SNPs, a mediator-harmful group with 22 SNPs and a mediator-protective group with 54 SNPs. Among these SNPs, rs809302 in SLK significantly increased the risk of developing uterine fibroids by 3.92% through a mechanism other than age at menarche (P  <   10−10), and rs371721345 in HLA-DOB was associated with a 2.70% decreased risk (P  <   10−10) in the occurrence of uterine fibroids, mediated by age at menarche. These findings provide insights into the mechanism underlying the effect of genetic loci on uterine fibroids mediated by age at menarche. LIMITATIONS, REASONS FOR CAUTION A potential issue is that the present study relied upon self-reported age at menarche and uterine fibroid information. Due to the experimental design, the consistency between self-reports and medical records for uterine fibroids in Taiwan cannot be checked. Fortunately, the literature support that self-reporting even years later remains a practical means for collecting data on menarche and uterine fibroids. We found that the impact of under-reporting of uterine fibroids is less in our study. In addition, the rate of reporting a diagnosis of uterine fibroids was within the rates of medical diagnosis based on national health insurance data. Future work investigating the consistency between self-reports and medical records in Taiwan can remedy this issue. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to investigate whether and to what extent age at menarche mediates the causal effects of genetic variants on uterine fibroids by using genome-wide causal mediation analysis. By treating age at menarche as a mediator, this report provides an insight into the genetic risk factors for developing uterine fibroids. Thus, this article represents a step forward in deciphering the role of intermediated risk factors in the genetic mechanism of disease. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the China Medical University, Taiwan (CMU110-ASIA-13 and CMU107-Z-04), the Ministry of Science and Technology, Taiwan (MOST 110-2314-B-039-058) and the International Joint Usage/Research Center, the Institute of Medical Science, the University of Tokyo, Japan (K2104). The authors have no competing interests. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

An amphidromous goby, Sicyopterus japonicus , migrates from the ocean to upstream regions of many streams and rivers in the Pacific coasts of Japan and Taiwan. Using its mouth and fused pelvic fins (pelvic sucker), this gobiid species exhibits a rock-climbing behavior and surmounts sizable waterfalls, which block the upstream movement of many of its competitors and predators. When gobies emerge from the water to commence their climbing behavior, the change in effective density (i.e. lack of buoyancy) that occurs in this transition substantially increases the force required for adhesion. Consequently, these fish must exert adhesive suction strong enough to support their body weight against gravity during climbing on the rock surface. Suction performance for adhesion and modulatory capacity of S. japonicus were evaluated with two different sets of experimental conditions: climbing on the vertical surface with no water flow versus climbing on a 60°-inclined surface with 2 L/min flow. Individuals of S. japonicus showed 50.7% greater mean safety factor (suction force for adhesion/gravitational force) and 56.6% shorter time to reach maximum pressure differential during climbing on the 60°-inclined surface with water rushing over their bodies than during climbing on the vertical surface with no water flow. These results indicate that when climbing with drag force from flowing water, greater functional demands are imposed and therefore, S. japonicus is required to increase neuromuscular stimulation of the pelvic muscles to elevate suction performance. In addition, S. japonicus individuals at different ontogenetic stages modulate their climbing behaviors and strategies to accommodate changing functional demands as they make transitions between different inclines, as well as media, while ascending waterfalls. [ABSTRACT FROM AUTHOR]

Background: Although a number of studies have reported on the health effects of fine particulate matter (PM2.5) exposure, particularly in North American and European countries as well as China, the evidence about intermediate to high levels of PM2.5 exposures is still limited. We aimed to investigate the associations between long-term exposure to PM2.5 and risk of cardiopulmonary disease incidence in Taiwan with intermediate levels of PM2.5 exposure.Methods: A cohort of Taiwanese adults, who participated in the 2001, 2005, 2009 and 2013 National Health Interview Surveys, was followed through 2016 to identify cardiopulmonary disease onset. Exposure to PM2.5 was estimated by incorporating a widespread monitoring network of air quality monitoring stations and microsensors. We used time-dependent Cox regression models to examine the associations between the PM2.5 exposures and health outcomes, adjusting for individual characteristics and ecological covariates. The natural cubic spline functions were used to explore the non-linear effects of the PM2.5 exposure.Results: A total of 62 694 adults from 353 towns were enrolled. Each 10-μg/m3 increase in 5-year average exposure to PM2.5 was associated with a 4.8% increased risk of incident ischaemic heart disease (95% CI: -3.3, 13.6), 3.9% increased risk of incident stroke (95% CI: -2.9, 11.1), 6.7% increased risk of incident diabetes (95% CI: 1.1, 12.7), 15.7% increased risk of incident lung cancer (95% CI: -0.9, 35.1) and 11.5% increased risk of incident chronic obstructive pulmonary disease (95% CI: -0.8, 25.2). The concentration-response curve showed that there was no statistical evidence of non-linearity for most of the disease outcomes except for ischaemic heart disease (P for non-linearity = 0.014).Conclusions: Long-term exposure to intermediate levels of ambient PM2.5 was associated with cardiopulmonary health outcomes. Our study adds value to future application and national burden of disease estimation in evaluating the health co-benefits from ambient air pollution reduction policy in Asian countries. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES In Taiwan, endovascular aneurysm repair for treating abdominal aortic aneurysms (AAA) was introduced in 2004 and became reimbursable in February 2010. We evaluated the real-world practice and safety of endovascular aneurysm repair in Taiwan. METHODS Patients who underwent repair operations for AAA (open or endovascular) from 2000 to 2016 were enrolled (n = 11485). Outcome statistics (during the index hospitalization: length of stay, rate of ischaemic bowel disease and 30-day mortality; after discharge: 30-day readmission rate, 2-year mortality, 2-year reintervention rate and 2-year paraplegia rate) were calculated for each half-year cohort. Propensity score-based stabilized weights were used to balance covariates among each half-year cohort. Interrupted time-series analysis was then performed. RESULTS The elective and emergency ratio of AAA repair was 50:50 from 2000 to 2004 and became 60:40 from 2010 to 2016. The half-year rate of endovascular aneurysm repair was 0% in 2000 to 2004/06, 83.16% in 2010 and 98.1% in 2016. Interrupted time series analysis revealed that after endovascular aneurysm repair became reimbursable, both elective and emergency groups had a reduction in length of stay (−4.2 days, P  < 0.0001; −1.5 days, P  = 0.0928) and 30-day mortality (−5.22%, P  = 0.0702; −7.76%, P  = 0.0086) but a significant increase in the reintervention rate (5.05%, P  = 0.0031; 4.36%, P  = 0.0097). CONCLUSIONS Endovascular aneurysm repair was predominantly used in treating AAAs after it was reimbursed in Taiwan. Endovascular aneurysm repair is efficacious regarding short-term outcomes but increased the 2-year reintervention rate in both groups. [ABSTRACT FROM AUTHOR]

Djulis (Chenopodium formosanum Koidz.) is a crop grown since antiquity in Taiwan. It is a BCD-genome hexaploid (2 n  = 6 x  = 54) domesticated form of lambsquarters (C. album L.) and a relative of the allotetraploid (AABB) C. quinoa. As with quinoa, djulis seed contains a complete protein profile and many nutritionally important vitamins and minerals. While still sold locally in Taiwanese markets, its traditional culinary uses are being lost as diets of younger generations change. Moreover, indigenous Taiwanese peoples who have long safeguarded djulis are losing their traditional farmlands. We used PacBio sequencing and Hi-C-based scaffolding to produce a chromosome-scale, reference-quality assembly of djulis. The final genome assembly spans 1.63 Gb in 798 scaffolds, with 97.8% of the sequence contained in 27 scaffolds representing the nine haploid chromosomes of each sub-genome of the species. Benchmarking of universal, single-copy orthologs indicated that 98.5% of the conserved orthologous genes for Viridiplantae are complete within the assembled genome, with 92.9% duplicated, as expected for a polyploid. A total of 67.8% of the assembly is repetitive, with the most common repeat being Gypsy long terminal repeat retrotransposons, which had significantly expanded in the B sub-genome. Gene annotation using Iso-Seq data from multiple tissues identified 75,056 putative gene models. Comparisons to quinoa showed strong patterns of synteny which allowed for the identification of homoeologous chromosomes, and sub-genome-specific sequences were used to assign homoeologs to each sub-genome. These results represent the first hexaploid genome assembly and the first assemblies of the C and D genomes of the Chenopodioideae subfamily. [ABSTRACT FROM AUTHOR]

Abuse of new psychoactive substances (NPS) has become a health and social issue of global concern. p -Methoxyamphetamine (PMA)/ p -methoxymethamphetamine (PMMA) with fluoro- or chloro-derivatives of amphetamine and methamphetamine were among the most common drugs found in specimens from fatal cases in Taiwan during the January 2011 to December 2018 period. A liquid–liquid extraction sample preparation protocol with highly sensitive ultra-high performance liquid chromatography–tandem mass spectrometry approach was developed for the simultaneous analysis of seven phenethylamine-type drugs—PMA, PMMA, p -methoxyethylamphetamine, 4-fluoroamphetamine (4-FA), 4-fluoromethamphetamine (4-FMA), 4-chloroamphetamine (4-CA) and 4-chloromethamphetamine (4-CMA)—in postmortem blood and urine specimens. Separation by liquid chromatography was performed by Agilent Zorbax SB-Aq column. Tandem mass spectrometry was operated in Agilent Jet Stream Technology electrospray ionization in positive-ion multiple reaction monitoring mode. An analytical methodology was evaluated using drug-free blood and urine after fortification with 100–2,000 ng/mL of the seven target analytes. Average extraction recoveries were >80%; slightly higher ion suppression was observed for PMA and 4-CA; intra-/inter-day precision (% coefficient of variation) and accuracy were in the ranges of 0.52–12.3% and 85–110%, respectively. Limit of detection and lower limit of quantitation for these seven analytes were both in the 0.5–5 ng/mL range. Interference and carryover were not significant. This relatively simple methodology was found effective and reliable for routine identification and quantitation of these seven analytes in postmortem and antemortem blood and urine specimens received in 2018. Analytical data obtained from these actual cases indicated the following: (i) compared to findings reported during the 2007–2011 period, the use of substituted phenethylamine-type drugs decreased in 2018; (ii) ketamine and 7-aminonimetazepam (the main metabolite of nimetazepam) were the most common co-ingested substances in specimens containing PMA/PMMA, 4-FA/4-FMA, or 4-CA/4-CMA; and (iii) in drug fatalities, the concentration of PMA was significantly higher than the concentration of PMMA in both urine and blood, while the reverse was true in urine specimens from antemortem cases. [ABSTRACT FROM AUTHOR]

Background: Exercise may increase the inhalation and deposition of air pollutants, which may counteract its beneficial effects. We thus examined the combined effects of chronic exposure to fine particulate matter (PM2.5) and habitual exercise on the risk of death from cancer in Taiwan.Patients and Methods: A total of 384 128 adults (≥18 years of age) were recruited for a medical screening programme between 2001 and 2016, yielding 842 384 medical-examination records. All participants were followed up until 31 May 2019. Vital data were obtained from the National Death Registry of Taiwan and the ambient PM2.5 exposure was estimated using a satellite-based spatiotemporal model. Information on habitual exercise was collected using a standard self-administered questionnaire. The time-dependent Cox-regression model was used to evaluate the combined effects.Results: A greater amount of habitual exercise was associated with lower risk of death from cancer, whilst a higher level of PM2.5 exposure was associated with a higher risk of death from cancer. The inverse associations of habitual exercise with death from cancer were not modified by chronic exposure to PM2.5. The participants in the group with a high level of exercise and a low level of PM2.5 exposure exhibited a 35% lower risk of death from cancer than those in the group with a low level of exercise and a high level of PM2.5 exposure (95% confidence interval: 28%, 42%).Conclusions: Increased levels of exercise and reduced exposure levels of PM2.5 are associated with a lower risk of death from cancer. Habitual exercise reduces the risk of death from cancer regardless of the levels of chronic PM2.5 exposure. Our results indicate that habitual exercise is a suitable health-promotion strategy even for people who reside in moderately polluted regions. [ABSTRACT FROM AUTHOR]

Background and Aims Abelia (Caprifoliaceae) is a small genus with five species, including one artificial hybrid and several natural hybrids. The genus has a discontinuous distribution in Mainland China, Taiwan Island and the Ryukyu Islands, providing a model system to explore the mechanisms of species dispersal in the East Asian flora. However, the current phylogenetic relationships within Abelia remain uncertain. Methods We reconstructed the phylogenetic relationships within Abelia using nuclear loci generated by target enrichment and plastomes from genome skimming. Divergence time estimation, ancestral area reconstruction and ecological niche modelling (ENM) were used to examine the diversification history of Abelia. Key Results We found extensive cytonuclear discordance across the genus. By integrating lines of evidence from molecular phylogenies, divergence times and morphology, we propose to merge Abelia macrotera var. zabelioides into A. uniflora. Network analyses suggested that there have been multiple widespread hybridization events among Abelia species. These hybridization events may have contributed to the speciation mechanism and resulted in the high observed morphological diversity. The diversification of Abelia began in the early Eocene, followed by A. chinensis var. ionandra colonizing Taiwan Island during the Middle Miocene. The ENM results suggested an expansion of climatically suitable areas during the Last Glacial Maximum and range contraction during the Last Interglacial. Disjunction between the Himalayan–Hengduan Mountain region and Taiwan Island is probably the consequence of topographical isolation and postglacial contraction. Conclusions We used genomic data to reconstruct the phylogeny of Abelia and found a clear pattern of reticulate evolution in the group. In addition, our results suggest that shrinkage of postglacial range and the heterogeneity of the terrain have led to the disjunction between Mainland China and Taiwan Island. This study provides important new insights into the speciation process and taxonomy of Abelia. [ABSTRACT FROM AUTHOR]

Background Hospital incident reporting systems are usually evaluated on their theoretical benefit to the hospital or increase in reporting rates alone. Objective To evaluate a workflow-based response system on staff incident reporting rates. Design, Setting and Participants A prospective cohort study of incident reports made by staff members before (2006–2007) and after (2008–2009) the system was implemented on 1 January 2008 at a medical center in southern Taiwan. Pre-system and post-system data were based on 713 129 and 730 176 inpatient days and 160 692 and 168 850 emergency department visits. Intervention The addition of a workflow-based response system to a reporting system processing incident reports and intra-hospital responses. Main Outcome Measures Voluntary incident reporting rates and distribution of incident severities. Results Inpatient reports [9.9 vs. 28.8 per 10 000 patient days; rate ratio (RR): 2.9, 95% confidence interval (CI): 2.7–3.2, P < 0.001] and emergency department reports (5.9 vs. 19.2 per 10 000 visits, RR: 3.3, 95% CI: 2.6–4.1, P < 0.001) increased significantly, particularly in doctors in inpatient areas (RR: 2.7, 95% CI: 1.8–4.1, P < 0.001), emergency department nurses (RR: 9.4, 95% CI: 6.1–14.4, P < 0.001) and allied health professionals in inpatient areas (RR: 2.2, 95% CI:1.8–2.6, P < 0.001). Post-system reported incidents were more evenly distributed over five severity levels than pre-sytem incidents, moving more toward the very severe level (RR: 17.6, 95% CI: 8.4–37.0, P < 0.001) and no harm level (RR: 6.2, 95% CI: 4.5–8.7, P < 0.001). Conclusion The addition of the workflow-based response system to the hospital incident reporting system significantly increased hospital-wide voluntary incident report rates at all incident injury levels. [ABSTRACT FROM PUBLISHER]

SUMMARY Following a recent paper we use weak-motion waveforms to calibrate a model for the prediction of earthquake-induced ground-motion in Taiwan, in the 0.25-5.0 Hz frequency range, valid up to Mw 7.6. The excitation/attenuation model is given in terms of frequency-dependent seismic wave attenuation, Qs( f), geometrical spreading, g( r), a magnitude-dependent stress parameters Δσ for the excitation terms, and a site term for each seismic station used in the study. A set of weak-motion data was gathered from about 170 aftershocks of the Chi-Chi earthquake, Mw 7.6, of 1999 September 20, (17:47 UTC), recorded by 10 broad-band seismic stations. The moment magnitudes of the registered aftershocks ranged from Mw 3.0 to 6.5, and the hypocentral distances from a few kilometres to about 250 km. A frequency-dependent crustal quality factor, Q( f) = 350 f0.32, was obtained, to be coupled with the geometrical spreading function [ABSTRACT FROM AUTHOR]

This article previews the June 1, 2006 issue of "Sociology of Religion." The issue focuses on the conversion of the Chinese people to Christianity, and contains a series of articles dedicated to that topic. The conversion of the Chinese people to Christianity has been handled very differently than the conversion of other peoples to Christianity, and the articles in the issue discuss those methods. Chinese-American college students are discussed in light of their exposure to Christianity, as well as the conversion of citizens of Taiwan. Also examined are the impact of various Protestant churches in China.

Objective To assess the association of severe pulmonary arterial hypertension (PAH) with particulate matter <2.5 μm (p.m.2.5) and clinical data in patients with systemic autoimmune rheumatic diseases (SARDs). Methods We used the 2003–2017 nationwide data in Taiwan to identify patients with SARDs, including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, dermatomyositis/polymyositis and primary Sjögren's syndrome. We identified 479 cases with severe PAH and selected controls matched (1:4) for age, sex, and index year. We used conditional logistic regression analysis to determine factors associated with risks for severe PAH shown as odds ratios (ORs) with 95% confidence intervals (CIs). Results We found that severe PAH was highly associated with interstitial lung disease (OR, 8.57; 95% CI: 5.52, 13.32), congestive heart failure (OR, 7.62; 95% CI: 5.02, 11.55), valvular heart disease (OR, 3.34; 95% CI: 2.03, 5.50) and slightly associated with thyroid diseases (OR, 1.88; 95% CI: 1.18, 3.00), but not the level of exposure to p.m.2.5. Increased risk for PAH was found in patients receiving corticosteroid (prednisolone equivalent dosage, mg/day, OR, 1.03; 95% CI: 1.01, 1.05), biologics (OR, 2.18; 95% CI: 1.15, 4.12) as well as immunosuppressants, including ciclosporin (OR, 2.17; 95% CI: 1.31, 3.59), azathioprine (OR, 1.96; 95% CI: 1.48, 2.61), cyclophosphamide (OR, 2.01; 95% CI: 1.30, 3.11) and mycophenolate mofetil/mycophenolic acid (OR, 2.42; 95% CI: 1.37, 4.27), and those with the highest level of insured amount (reference, lowest level; OR, 0.53; 95% CI: 0.34, 0.83). Conclusion The population-based study identified risks for severe PAH in patients with SARDs, and these findings provide evidence for PAH risk stratification in patients with SARDs. [ABSTRACT FROM AUTHOR]

Pneumococcus is one of the major threat for senior citizens health worldwide. Pneumococcal Conjugate Vaccines (PCV7, PCV10, and PCV13) were gradually commenced in the national pediatric immunization programme in Taiwan since 2005 and polysaccharide pneumococcal vaccine (PPV23) was granted adult indication since 2015. However, in a most-recent nationwide long-term surveillance, the PCV13 serotypes have shifted to being dominated types in that of > = 65 years-old seniors. This study aims to evaluate the PCV13-introduction effectiveness based on a selected test city. Data of the national health insurance research database (NHIRD) between 2013 and 2018 were retrieved to collect data on yearly medical use of citizen aged 65-66 years and were linked to the death registry database for death-ascertainment. Compared to females, males had more hospitalization due to IPD (RR = 1.37, 95% CI: 1.04- 1.79) and due to pneumonia (1.69, 1.34-2.14). The introduction of PCV13 free-vaccination was associated with significant reductions of hospitalization by 40% for IPD (0.6, 0.51-0.71) and 36% for pneumonia (0.64, 0.58-0.7) in females. However, the effects were not significant in both sex combined and in males. As far as mortality is concerned, the introduction of the PCV13 free-vaccination had 33% lower risk of all cause death with IPD claimed within one month of death (0.67, 0.49- 0.91) and for pneumonia (0.77, 0.60-0.99). This was also observed in both sex combined (0.82, 0.68-0.98) for IPD, but not for pneumonia, or for both events in males. In conclusion, the policy of PCV13 vaccination for seniors aged 65 years was associated with all-cause mortality with IPD or pneumonia claims one month before death. The evidence was stronger in females than in males. The effectiveness for the associated reduced hospitalization has been demonstrated in females. Further analysis with individual vaccination history and extended years is needed. Funding: The current study was funded by Pfizer Limited (Taiwan). Key messages: The pneumococcal serotype shift has been found in elderly from PPV-23 vaccine-type to PCV vaccine-type and hence the preparedness of PCV13-introduction for elderly immunization programme is necessary. The findings of this pilot study included the effectiveness of PCV13-introduction in seniors aged 65 years and some implications to subgroup analyses needed for preparing a nationwide implementation. [ABSTRACT FROM AUTHOR]

The objectives of this study were to determine the relationship between exposure levels and respiratory abnormalities, to measure FVC and FEV11 changes per year based on work duties and to investigate the prevalence of and factors related to pneumoconiosis. A total of 583 male workers from 50 iron foundries in central Taiwan were investigated. First, workers' respiratory symptoms were categorized using a modified American Thoracic Society (ATS) questionnaire and then were verified by physician's examination. Next, pulmonary function tests were performed including: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and forced expiratory flow rate. A chest radiograph was used to diagnose pneumoconiosis according to ILO criteria. Furnace workers were found to have the highest prevalence of chronic phlegm, thoracic disorders and chronic bronchitis. In general, smokers had a higher prevalence of respiratory symptoms as compared with non-smokers. Pulmonary function abnormalities and pneumoconiosis were closely linked to smoking and work duration. After adjusting for age, height and smoking there was a significant decrease based on work duration in FVC and FEV1 for furnace and moulding workers compared with after-processing and administrative workers. The overall prevalence of pneumoconiosis was 8.8%, highest among furnace (16.3%) and after-processing workers (11.4%) and lowest among administrative workers (2.5%). Using multiple logistic regression, the risk of developing pneumoconiosis (as compared with the administrative workers) for furnace workers was highest (8.98 times greater risk), followed by after-processing workers (6.77 times greater risk) and moulding workers (5.41 times greater risk). Prolonged exposure to free silica, and smoking habits, can result in respiratory abnormalities among foundry workers. [ABSTRACT FROM PUBLISHER]

Background A mass spectrometry-based assessment of methicillin resistance in Staphylococcus aureus would have huge potential in addressing fast and effective prediction of antibiotic resistance. Since delays in the traditional antibiotic susceptibility testing, methicillin-resistant S. aureus remains a serious threat to human health. Results Here, linking a 7 years of longitudinal study from two cohorts in the Taiwan area of over 20 000 individually resolved methicillin susceptibility testing results, we identify associations of methicillin resistance with the demographics and mass spectrometry data. When combined together, these connections allow for machine-learning-based predictions of methicillin resistance, with an area under the receiver operating characteristic curve of >0.85 in both the discovery [95% confidence interval (CI) 0.88–0.90] and replication (95% CI 0.84–0.86) populations. Conclusions Our predictive model facilitates early detection for methicillin resistance of patients with S. aureus infection. The large-scale antibiotic resistance study has unbiasedly highlighted putative candidates that could improve trials of treatment efficiency and inform on prescriptions. [ABSTRACT FROM AUTHOR]

Background: The role of smoking in nasopharyngeal carcinoma (NPC) remains uncertain, especially in endemic regions. We conducted an individual participant data (IPD) meta-analysis of prospective cohort studies to investigate the associations between smoking exposure and risk of NPC.Methods: We obtained individual participant data of 334 935 male participants from six eligible population-based cohorts in NPC-endemic regions, including two each in Guangzhou and Taiwan, and one each in Hong Kong and Singapore. We used one- and two-stage approaches IPD meta-analysis and Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of NPC for smoking exposure adjusting for age and drinking status.Results: During 2 961 315 person-years of follow-up, 399 NPC evens were ascertained. Risks of NPC were higher in ever versus never smokers (HRone-stage = 1.32, 95% CI = 1.07-1.63, P = 0.0088; HRtwo-stage = 1.27, 1.01-1.60, 0.04). These positive associations appeared to be stronger in ever smokers who consumed 16+ cigarettes/day (HRone-stage = 1.67, 95% CI = 1.29-2.16, P = 0.0001), and in those who started smoking at age younger than 16 (2.16, 1.33-3.50, 0.0103), with dose-response relationships (P-values for trend = 0.0028 and 0.0103, respectively). Quitting (versus daily smoking) showed a small reduced risk (stopped for 5+ years: HRone-stage = 0.91, 95% CI = 0.60-1.39, P = 0.66; for former smokers: HRtwo-stage = 0.84, 0.61-1.14, 0.26).Conclusions: This first IPD meta-analysis from six prospective cohorts in endemic regions has provided robust observational evidence that smoking increased NPC risk in men. NPC should be added to the 12-16 cancer sites known to be tobacco-related cancers. Strong tobacco control policies, preventing young individuals from smoking, would reduce NPC risk in endemic regions. [ABSTRACT FROM AUTHOR]

Recent studies have demonstrated that the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) could be used to detect superbugs, such as methicillin-resistant Staphylococcus aureus (MRSA). Due to an increasingly clinical need to classify between MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) efficiently and effectively, we were motivated to develop a systematic pipeline based on a large-scale dataset of MS spectra. However, the shifting problem of peaks in MS spectra induced a low effectiveness in the classification between MRSA and MSSA isolates. Unlike previous works emphasizing on specific peaks, this study employs a binning method to cluster MS shifting ions into several representative peaks. A variety of bin sizes were evaluated to coalesce drifted or shifted MS peaks to a well-defined structured data. Then, various machine learning methods were performed to carry out the classification between MRSA and MSSA samples. Totally 4858 MS spectra of unique S. aureus isolates, including 2500 MRSA and 2358 MSSA instances, were collected by Chang Gung Memorial Hospitals, at Linkou and Kaohsiung branches, Taiwan. Based on the evaluation of Pearson correlation coefficients and the strategy of forward feature selection, a total of 200 peaks (with the bin size of 10 Da) were identified as the marker attributes for the construction of predictive models. These selected peaks, such as bins 2410–2419, 2450–2459 and 6590–6599 Da, have indicated remarkable differences between MRSA and MSSA, which were effective in the prediction of MRSA. The independent testing has revealed that the random forest model can provide a promising prediction with the area under the receiver operating characteristic curve (AUC) at 0.8450. When comparing to previous works conducted with hundreds of MS spectra, the proposed scheme demonstrates that incorporating machine learning method with a large-scale dataset of clinical MS spectra may be a feasible means for clinical physicians on the administration of correct antibiotics in shorter turn-around-time, which could reduce mortality, avoid drug resistance and shorten length of stay in hospital in the future. [ABSTRACT FROM AUTHOR]

Economies that experience rapid growth also experience major changes in their consumption patterns, particularly for consumer durables. This paper studies the diffusion of durables in Taiwan between 1977 and 1991. We focus on the link between household accumulation of durables and participation in informal financial institutions. While growth in per capita income in Taiwan has been great, many households still rely on traditional forms of finance. We test the idea that rotating savings and credit associations, which are found worldwide, exist to lower the con of saving for durables. Our analysis finds evidence of that link. [ABSTRACT FROM AUTHOR]

The article examines the importance of firms' own investments in technological capability, focusing on the case of Taiwan (China). Research on the nature and extent of technical change in developing countries indicates that firm-level efforts to obtain international knowledge may have higher payoffs when accompanies by investments in the development of in-house technological capabilities. Firms' technical efficiency were estimated using microdata from the 1986 Taiwanese census of manufactures.

Objectives: Occupational characteristics in the food and beverage service industry (FBSI) have been found to be associated with musculoskeletal disorders (MSDs). This study aimed to examine gender and site-specific incident risks of MSDs among FBSI workers in Taiwan using a national population-based database. Methods: We conducted a 15-year population-based cohort study among 224 506 FBSI workers in Taiwan using data from five large nationwide databases to estimate direct standardized incidence ratios (SIRs) for identifying specific MSDs related to overexertion and repetitiveness during work. Overall, MSDs risks were also investigated by gender, sub-industrial categories, and certificate types. Results: We found SIRs for overall MSDs for male and female workers of 1.706 (95% CI, 1.688-1.724) and 2.198 (95% CI, 2.177-2.219), respectively. Our findings indicate significantly increased WMSD risk for both men and women, including median/ulnar nerve disorders (ICD-9 354.0-354.2); spondylosis and allied disorders (ICD-9 721); intervertebral disc disorders (ICD-9 722); disorders of the back (ICD-9 724); peripheral enthesopathies and allied syndromes (ICD-9 726); synovium, tendon, and bursa disorders (ICD-9 727); and soft tissues of the peripheral system disorders (ICD-9 729). Food stall workers and workers with Chinese cuisine or baking licenses were at higher risk among sub-industrial categories and certificate types. Conclusion: This large-scale study revealed that FBSI workers were at higher risk for several MSDs than the general population. This information could help prioritize MSD problems and identify a high-risk population. Relevant policy and ergonomic improvements and interventions could be implemented for health promotion in this industry. [ABSTRACT FROM AUTHOR]

We investigate the coseismic and post-seismic deformation due to the 6 February 2018 M w 6.4 Hualien earthquake to gain improved insights into the fault geometries and complex regional tectonics in this structural transition zone. We generate coseismic deformation fields using ascending and descending Sentinel-1A/B InSAR data and GPS data. Analysis of the aftershocks and InSAR measurements reveal complex multifault rupture during this event. We compare two fault model joint inversions of SAR, GPS and teleseismic body waves data to illuminate the involved seismogenic faults, coseismic slip distributions and rupture processes. Our preferred fault model suggests that both well-known active faults, the dominantly left-lateral Milun and Lingding faults, and previously unrecognized oblique-reverse west-dipping and north-dipping detachment faults, ruptured during this event. The maximum slip of ∼1.6 m occurred on the Milun fault at a depth of ∼2–5 km. We compute post-seismic displacement time series using the persistent scatterer method. The post-seismic range-change fields reveal large surface displacements mainly in the near-field of the Milun fault. Kinematic inversions constrained by cumulative InSAR displacements along two tracks indicate that the afterslip occurred on the Milun and Lingding faults and the west-dipping fault just to the east. The maximum cumulative afterslip of 0.4–0.6 m occurred along the Milun fault within ∼7 months of the main shock. The main shock-induced static Coulomb stress changes may have played an important role in driving the afterslip adjacent to coseismic high-slip zones on the Milun, Lingding and west-dipping faults. [ABSTRACT FROM AUTHOR]