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Systemic sclerosis (SSc) is a systemic autoimmune disease affecting multiple organs, including the kidneys. There is a lack of long-term renal prognosis studies on patients with SSc. The aim of this study was to assess the risk of end-stage renal disease (ESRD) in patients with SSc. We designed a prospective cohort study based on the National Health Insurance Research Database of Taiwan. Patients with SSc and a non-SSc control group were selected from 1 January 2000 to 31 December 2013. The SSc cohort and control group were matched on the propensity score in a 1:2 ratio. The primary outcome was development of ESRD. Cox proportional hazard regression was performed to assess the effects of SSc on ESRD. After propensity score matching, we enrolled 2012 patients in the SSc group and 4024 patients in the control group. During a mean follow-up of 6.5 years, 86 individuals [SSc group, n = 41 (2.04%); control group, n = 45 (1.12%)] had developed ESRD. The risk of ESRD in the SSc group was approximately two times higher than that in the control group [hazard ratio (HR) = 2.12, 95% confidence interval (CI) 1.39–3.24]. Subgroup analysis revealed that the higher risk of ESRD was predominantly in males (HR = 4.14, 95% CI 1.97–8.71) and the younger population (HR = 7.09, 95% CI 2.31–21.80). There was a significantly higher risk of ESRD among SSc patients than among the general population, with males and younger generations being the most vulnerable groups. [ABSTRACT FROM AUTHOR]

1. The following study provides the first data on the detection and types of Listeria monocytogenes isolated from broiler chickens during processing and from six Taiwanese abattoir environments. 2. Listeria monocytogenes was not detected in any cloacal (n = 120) or environmental (n = 256) samples collected before and during processing, indicating that faecal material and the environment of abattoirs were not important sources of L. monocytogenes for poultry carcases. However, 28 of 246 (11.4%; 95% CI: 7.7–16.0) rinse samples collected from carcases post-evisceration from three abattoirs were positive for L. monocytogenes. 3. The only serotypes detected were 1/2a (82.1%; 95% CI: 63.1–93.9) and 1/2b (14.3%; 95% CI: 4.0–32.7), with 3.6% (95% CI: 0.1–18.3) non-typable isolates. 4. Characterisation by Pulsed Field Gel Electrophoresis (PFGE) identified five PFGE types, confirming cross-contamination with L. monocytogenes during evisceration, chilling and post-chilling. 5. These findings highlight the potential for cross-contamination to occur through direct contact between carcases, especially whilst in chilling tanks. [ABSTRACT FROM AUTHOR]

Objectives: Few studies on tumour necrosis factor (TNF) inhibitor-associated tuberculosis (TB) and hepatic events have been performed in regions where these risks are elevated. This study aimed to provide a direct comparison between adalimumab and etanercept in a high-risk population and to address the implications for physicians working with patients in such an environment.Method: Data collected from the National Health Insurance Research Database (NHIRD) in Taiwan between 2007 and 2011 were analysed retrospectively for incidences of eight adverse events associated with TNF-α inhibitors. Hazard ratios (HRs) of adalimumab vs. etanercept were calculated using a Cox proportional hazards model.Results: During this 5-year period, 86 events of TB were reported after 5317 person-years of exposure to adalimumab (1.62 events per 100 person-years), compared to 44 events after 7690 person-years of exposure to etanercept (0.57 events per 100 person-years). For serious hepatic events that led to hospitalization, 0.75 events were reported per 100 person-years of exposure to adalimumab compared to 0.39 events per 100 person-years of exposure to etanercept. Adjusted HRs for TB [aHR 3.06, 95% confidence interval (CI) 2.09-4.49, p < 0.0001], hospitalization due to a hepatic event (aHR 2.05, 95% CI 1.27-3.30, p = 0.0035), and serious infection (aHR 1.48, 95% CI 1.19-1.84, p = 0.0005) attained significance.Conclusions: TNF-α-targeting therapies with the monoclonal antibody adalimumab confers significant added risk of TB and serious hepatic events compared to therapies with the soluble fusion protein etanercept. Tailored strategies to attenuate these risks are warranted in high-risk regions such as Taiwan. [ABSTRACT FROM AUTHOR]

As information technology continues to evolve rapidly, programming skills become increasingly crucial. To be able to construct superb programming skills, the training must begin before college or even senior high school. However, when developing comprehensive training programmers, the learning and teaching processes must be considered. In order to improve the students' learning outcome and engagement in programming course, this study applied learning analytics into the proposed massive online open courses (MOOCs) enabled collaborative programming course. Through the proposed learning activity, instructors receive a monthly report that explains which students are at risk and in need of timely intervention. This study conducted an experiment to evaluate the effectiveness of the proposed learning activity. Students in the experimental group received learning interventions from an instructor according to the result of learning analytics, and students in the control group received interventions according to the instructor's observation. The data for this study were collected over 10 weeks at a university in Taiwan. The result indicated that the proposed programming course with learning analytics improved students' learning outcomes and levels of engagement. [ABSTRACT FROM PUBLISHER]

A cross-sectional cohort study was conducted to investigate whether ghrelin level in obese women predicts the quality of life (QOL). A total of 307 subjects fulfilled the criteria: (1) age between 20 and 65 years old, (2) body mass index ≥27 kg/m2(3) waist circumference ≥80 cm were enrolled in the study. All subjects were assigned to one of the plasma ghrelin level categories according to the quartiles. The median of age and BMI of the 307 obese women were 45 ± 18 years and 29.9 ± 4.1 kg/m2, respectively. The main outcome evaluated is the associations of plasma ghrelin level and QOL, which were evaluated using multiple linear regression analysis. Results of linear trend test show significant statistical difference in plasma lipoproteins (triglyceride, cholesterol, HDL-cholestero and LDL-cholesterol = and levels of obesity-related hormone peptides, including leptin, adiponectin, insulin among quartiles of ghrelin. Multiple liner regression analysis of serum obesity-related hormone peptide level and QOL using stepwise method shows ghrelin concentration was the only predictor of QOL, including PCS-12 level (β = −0.18,p = 0.001), MCS-12 level (β = −0.14,p = 0.009), WHOQOL-BREF scores: physical (β = −0.13,p = 0.03), psychological (β = −0.16,p = 0.007), social (β = −0.21,p =  < 0.001), and environmental (β = −0.22,p =  <0.001), after adjusting other factors for obese female subjects. This study demonstrated that ghrelin concentration is strongly associated with QOL level among obese women. Hence, ghrelin concentration might be a valuable marker to be monitored in obese women. [ABSTRACT FROM PUBLISHER]

The aim in this research is to develop a model that will assist in the reassignment of flights to common-use check-in counters following airport incidents. The model is formulated as a zero-one integer program. To develop a solution method that will efficiently solve the large problems that occur in the real world, we employ a decomposition technique, where a series of two relaxations of the original model are solved repeatedly. Numerical tests are performed based on a hypothetical incident that is mainly based on data from a Taiwan airport. The obtained results show that the model and the solution method could be useful for the airport authority in actual operations. [ABSTRACT FROM AUTHOR]

In this paper, we study rain attenuation at Ka-band in northern Taiwan from long-term experimental measurements using a Ka-band (28.35 GHz) CW system at vertical polarization, optical rain gauge, and 2D optical distrometer that measures the rain drop size distribution (DSD). The DSD were measured and analyzed for different seasons under various rain rates. The variability of DSD in both space and time was clearly shown even in the not so large area of Northern Taiwan. It follows that a relationship between rain rate and DSD was established. From statistical regress, it was also found that the DSD follows the Gamma distribution best in most cases. Making use of the Gamma-distribution for DSD along with a two-year set of continuously measured data (2002–2003), a semi-empirical rain attenuation model was then developed. To validate the model, we compared it with the measured data. The results show that the proposed model matched very well with in-situ measurement from a two-year data set. [ABSTRACT FROM AUTHOR]

A large proportion of materials cost that constituted a major proportion of expenses are used in Intensive Care Unit. The fundamental infrastructure of a well-organized material management information system within a healthcare organization must be effective, has financial and procurement management and be able to control warehouse inventory, enhancing operation efficiency and cost reduction is paramount in its mission. This empirical study application with the decision support system for material management in ICU of healthcare organizations in Taiwan. Therefore, the research framework is based on technology acceptance model and management support, communication, and computer self-efficacy are involved to survey the staff's behavior intention on using materials management information system in ICU. The result showed that PU and PEOU have a positive effect on attitude; supervisor support will have a positive effect on PU and PEOU; communication and coordination is important between users and the system providers and it can positively influence PEOU, computer self-efficacy is the same. The predictive power of behavior Intention is 69.1%. It indicated that the model could be used to predict the materials management staff's behavior on using materials management information system in ICU. [ABSTRACT FROM PUBLISHER]

Background: Hepatitis B virus (HBV) infection is a major health problem. HBV genotypes may be associated with progression of liver disease. The distribution and clinical implications of HBV genotypes in southern Taiwan are evaluated. Methods: We used a polymerase chain reaction-restriction fragment length polymorphism genotyping method to determine HBV genotypes. Results: The genotype distribution for 265 patients with chronic HBV infection was as follows: A, 3 (1%); B, 158 (60%); C, 90 (34%); D, 7 (2.5%); E, 0; F, 0; and unclassified, 7 (2.5%). Compared with genotype B patients, genotype C patients had a higher hepatitis B e antigen positive rate and higher fibrosis score. There was no significant difference in the mean age between genotype B and genotype C patients with hepatocellular carcinoma (HCC). However, when patients were stratified by age, the prevalence of genotype C was significantly higher in young HCC patients (<50 years of age) than in age-matched asymptomatic carders (40% versus 10%, P < 0.001). Using multivariate analysis, the significant risk factors for advanced liver disease (cirrhosis or HCC) for patients with chronic HBV infection were old age, male gender and genotype C. Conclusions: These results suggest that genotype C is associated with more severe liver diseases than the B variant. [ABSTRACT FROM AUTHOR]

Wind power has had a striking development in recent years. However, advanced materials and technology for manufacturing wind turbines are necessary but usually unavailable in a developing country like Taiwan. In such a case, the consumption of transportation energy, especially an international one, cannot be ignored while the energy efficiency of wind power systems is surveyed. Based on our analysis, three demonstration wind systems in Taiwan, Mailiao, Jhongtun, and Chunfong, were analyzed to examine how the consumption of transportation energy affects the energy return on investment (EROI) and CO2emission for wind energy. We have found the EROI loss increases while the transportation energy consumption is considered. Notably, the transportation of mega wind turbines leads to more CO2emission. Moreover, wind turbines in small load capacities have less transportation energy ratio, while mega turbines consume disproportionately more transportation energy. [ABSTRACT FROM AUTHOR]

Energy consumption growth has recently been higher than economic growth in Taiwan, worsening energy efficiency. This article utilizes the momentum-threshold autoregressive cointegration method to examine the long-run equilibrium relationship between economic growth and energy consumption growth, particularly focusing on the most energy-consuming sectors in Taiwan. Allowing for a threshold effect sheds new light on the explanation of the non-linear characteristics of the energy-growth link. The results indicate that economic growth is non-linearly cointegrated with energy consumption when the asymmetric adjusting behavior is confirmed. Specifically, we find that the deviations adjust persistently toward equilibrium in a relative energy efficiency regime for the aggregate-level, while for the sector level in a relative energy inefficiency regime. The government authority should conduct effective energy demand-side management to improve energy efficiency. [ABSTRACT FROM AUTHOR]

This study uses the hybrid DEA model, in which the proportionate inputs are evaluated with a radial measure and the non-proportionate inputs are evaluated with a non-radial measure in order to evaluate the impact of marketing expense on the efficiency of Taiwan's international, tourist hotels. We further introduce the hybrid DEA into the technology gap measurement to evaluate the technology gaps of marketing expense utilization between different operating types. The empirical results indicate that the inefficiency caused from excess marketing expense is the main reason for lower efficiency in many tourist hotels, especially to chain-operated hotels and hotels that cater to domestic clients. Through the hybrid technology gap measurement, we find that the utilization of marketing resources is more effective for independent, city type hotels, as well as those that cater to international clients. [ABSTRACT FROM AUTHOR]

This study applies data envelopment analysis (DEA) to compute the efficient energy-saving ratios for 23 administrative regions in Taiwan from 1999–2005. One output (total income) and seven inputs (local government expenditure, employment, processed trash, household and commercial electricity consumption, industrial electricity consumption, gasoline sales volume, and diesel sales volume) are considered in the DEA models. It is found that most of the 23 administrative regions do not efficiently use household and commercial electricity, industrial electricity, gasoline, and diesel, even with respect to Taiwan's own efficiency frontier. Our results suggest that improving energy efficiency in household and commercial electricity use is a priority for non-metropolitan regions. There is still much room to improve the efficiency of electricity use for industries, especially for regions where manufacturing and high-tech industries concentrate, by means of cleaner production, energy-saving technology and equipment, etc. Motor vehicle energy efficiency is the key factor for saving gasoline. The energy efficiency of farming machines and carrying equipment should be continuously improved, especially for rural regions. [ABSTRACT FROM PUBLISHER]

Background Traditional Chinese medicine (TCM) has become more popular as a therapy for symptom relief among menopause-aged women. The aim of this study was to analyze the utilization of TCM for climacteric women in Taiwan. Methods The study analyzed frequency distributions among 19 379 women aged 45–55 years, recruited from a random-sampled cohort of 200 000 people from the National Health Insurance database. Data mining was conducted to explore the co-prescription patterns for finished herbal products (FHP). Result There were 19 379 women aged 45–55 years in the sample; of these, 12 572 (64.9%) utilized TCM services at least once. A total of 4078 (21.0%) of the 19 379 climacteric women utilized 145 200 (79.2%) TCM visits. Of these, 39 802 (21.7%) visits were because of diseases of the musculoskeletal system and connective tissue, of which more than half were treated with acupuncture and traumatology manipulative therapies. There were 28 154 visits with FHP prescriptions because of non-specific symptoms and ill-defined conditions, and Jia-wei-xiao-yao-san was the most frequent formula. Nearly two-thirds of FHP contained more than two herbal formulae. Conclusions Women of climacteric age in Taiwan utilized TCM more often than other age groups. To deal with multiple symptoms and/or diseases among climacteric women, new prescription patterns of combining two or more herbal formulae have evolved. Studies on safety issues and drug–herb interactions are warranted for future research. [ABSTRACT FROM AUTHOR]

Night markets have become the most popular tourism attraction for international tourists in Taiwan since 2003. They offer tourists a chance to experience new things and visit different environments when visiting the island. Japan has long been the leading generator of international tourism for Taiwan in terms of numbers and expenditures. Thus, the objective of this research is to profile Japanese tourists based on their novelty- seeking motives in visiting night markets. The 320 Japanese tourists are segmented into three groups: conservative tourists, moderate novelty- seekers, and well-planned explorers. Based on the results, implications and recommendations are provided to the tourism authorities, and future research possibilities are also noted. [ABSTRACT FROM AUTHOR]

Epidemiological studies have demonstrated an association between long-term exposure to inorganic arsenic and the related adverse effects such as cancers, skin lesions, and vascular diseases. Although several hypotheses have been proposed for the mechanism of arsenic-induced pathogenesis, it remains imperfectly understood. Recent studies have suggested that alterations in growth signal transduction pathways, particularly involving transforming growth factor-alpha (TGF-alpha), may be important. Immunoassays were used to determine the plasma levels of TGF-alpha and epidermal growth factor receptor (EGFR), which is the receptor for TGF-alpha, in residents of an arseniasis area of Taiwan in relation to their estimated cumulative arsenic exposure from drinking water. No relationship between arsenic exposure and EGFR was found. However, among the high cumulative exposure group (>6 ppm-years), levels of plasma TGF-alpha (25.5±38.2 pg ml-1) and the proportion of individuals with TGF-alpha over-expression (29.4%) were significantly higher (p<0.05) than normal, healthy unexposed controls (8.1±5.6 pg ml-1, 8.6%, respectively). There was a significant linear trend between cumulative arsenic exposure and the prevalence of plasma TGF-alpha over-expression after adjusting for age and sex (p = 0.019). The results suggest that plasma TGF-alpha expression may be a useful biomarker when detecting adverse effects on arsenic exposed population. [ABSTRACT FROM AUTHOR]

Objective: To investigate the role of the killer cell immunoglobulin‐like receptor (KIR) gene's repertoire in the pathogenesis of rheumatoid arthritis (RA) in Taiwan. Methods: KIR genotypes were determined in 122 patients with RA and 96 healthy controls by the sequence‐specific primer polymerase chain reaction (SSP‐PCR) method. Human leucocyte antigen (HLA)‐C genotyping was also performed simultaneously in 72 patients and 66 controls by the SSP‐PCR method. Results: The total carriage frequency of KIR 2DS4 regardless of corresponding HLA‐Cw4 was significantly increased in RA patients compared with controls [p<0.001, odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.1–3.4, Pc<0.01]. The total carriage frequency of KIR 2DL1 regardless of corresponding HLA‐C also tended to be increased in RA patients (p<0.02, OR = 2.1, 95% CI = 1.2–3.9, Pc = not significant). The frequency of KIR 2DS4 with corresponding HLA‐Cw4 was increased in RA patients in comparison with controls (p = 0.02, OR = 3.2, 95% CI = 1.1–9.4). Moreover, the association of RA with KIR 2DS4 depended on the presence of the corresponding HLA‐Cw4. Conclusions: KIR 2DS4 may be a risk factor for susceptibility to RA in Taiwan. [ABSTRACT FROM AUTHOR]

The design for the deployment of artistic statues in an exhibition area comes from the designer's experience, and whether such a design is adequate having no simple applicable criterion. The proposed model, deploying statues (DSs) model, not only applies the fractal dimension to measure the spatial complexity as its objective but also considers the traffic flow zone, the number of DSs, the average diameter of the statue, and the minimum allowable distance of adjacent artistic statues to arrange the spatial configuration in an exhibition area. The minimal complexity (fractal dimension) is mainly focused on because exhibiting designers deem that the spatial simplicity of an exhibition area leads to comfortable vision for a visitor. Indeed, this paper describes an applicable aspect of fractals. A computational intelligence written in Fortran Program to perform the spatial arrangement of artistic statues in an exhibition area is provided, and its adaptability has been explored by pilot tests of benchmark cases. Then, a case study through visual reality deployment for the Hosanna Museum at Chiayi Taiwan is followed. This study indeed provides a valuable tool in conducting the pre-stage of thinking process for exhibiting designers in deploying exhibits. [ABSTRACT FROM AUTHOR]

Objective: To investigate the associations of cytochrome p450 1A1 (CYP1A1) gene polymorphisms with susceptibility to psoriatic arthritis in Taiwan.Methods: CYP1A1 gene polymorphisms were determined in 52 patients with psoriatic arthritis and in 90 healthy controls by polymerase chain reaction/restriction fragment length polymorphism.Results: The genotype frequency of CYP1A1 4889A/G was significantly increased in patients with psoriatic arthritis in comparison with healthy controls. The phenotype frequency of CYP1A1 4889G was also significantly increased in patients with psoriatic arthritis. The genotype frequency of CYP1A1 4887C/A was significantly higher in patients with psoriatic arthritis than in controls. The allele and phenotype frequencies of 4887A were also significantly increased in patients with psoriatic arthritis. We also found that the association of CYP1A1 4887A with psoriatic arthritis was independent of 4889G but a synergistic effect was present between CYP1A1 4887A and 4889G. The CYP1A1 4889A/G and 4887C/A polymorphisms were not associated with the manifestations and severity of psoriatic arthritis.Conclusion: CYP1A1 4887A and 4889G may be precipitating factors for susceptibility to psoriatic arthritis in Taiwan. An additive effect was found between CYP1A1 4887A and 4889G. [ABSTRACT FROM AUTHOR]

There are three grandparent farms for three different chicken breeds in Taiwan. One of these farms, populated by breast meat yield chickens (yield type), suffered from a severe subgroup J avian leukosis virus (ALV-J) infection in mid-1997. The affected flocks at that farm had a weekly mortality of more than 1% and a 15% drop in egg production. The broilers from that breed had a 10% condemnation rate during the first week of age, and 5% of the remaining broilers were stunted afterwards. Some chickens had myeloid leukosis lesions at 6 weeks old. Their survivability was about 85%. However, chickens at the other two grandparent farms, populated with non-yield chickens (regular type), were also infected by ALV-J and showed myeloid leukosis. However, chickens at these farms produced progeny whose survivability reached more than 95%. ALV-J caused greater economic loss in yield type chickens than in regular type chickens in Taiwan. [ABSTRACT FROM AUTHOR]

In this paper, the pressing problem of unemployment in the contemporary developing world is studied from an historical perspective of transition growth, i.e. the process representing the termination of economic colonialism and the initiation of modern growth. This problem is investigated for a particular type of LDC, namely, the open dualistic labour surplus economy. The post-war (1950-70) experience of Taiwan and Korea were analyzed from this viewpoint-emphasizing the fine differences as well as the family resemblance among these countries. As ex-Japanese colonies, both these countries shared a relatively strong agricultural infrastructure and the open dualistic and labour surplus characteristic at the beginning of the transition in the 1950s. However, as we show, Taiwan had an initially more favourable set of institutional and economic conditions in agriculture. [ABSTRACT FROM AUTHOR]