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This paper presents a deep neural network (DNN)‐based model to recognize fishing vessels. In Taiwan, the vast majority of small fishing vessels are not equipped with an automatic identification system (AIS). As a consequence, the staff in a fishing port administration become heavily loaded when monitoring and managing the fishing vessels accessing a port. The workload is expected to be eased using this work. For the first time in the literature, a captured fishing vessel image was converted to a 128‐dimensional embedding for recognition purposes. The presented model gave a false positive rate (FPR) as low as 1.13% and an accuracy up to 99.47% at threshold = 0.772379. Finally, all the performance metrics, namely, the true positive rate (TPR), the FPR, precision and accuracy, are actually functions of the threshold which can be specified by users to meet specific requirements. © 2022 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Objective: To determine the risk and time trends of heart failure (HF) leading to hospitalization in individuals newly diagnosed as having polymyositis/dermatomyositis (PM/DM) relative to non‐PM/DM controls at the general population level. Methods: A retrospective cohort study was conducted using data from a nationwide insurance database in Taiwan. Patients with incident PM/DM and without a history of HF were selected between 2000 and 2013. Unmatched and propensity score–matched cohorts were established separately. A multivariable Cox proportional hazards regression model was used to estimate the adjusted hazard ratio (HR) for the risk of HF in the unmatched cohort. In the propensity score–matched cohort, general population controls were selected and matched at a 1:1 ratio to the patients with PM/DM based on propensity scores, which accounted for the confounding factors of age, sex, index date (year) of first diagnosis, comorbidities, and medication usage. The cumulative incidence of HF was estimated using the Kaplan‐Meier method. A stratified Cox proportional hazards model was used to calculate the HR for the risk of HF events at different follow‐up time points among patients with PM/DM compared with non‐PM/DM controls in the propensity score–matched cohort. Results: In the unmatched cohort, the study assessed 2,025 patients with PM/DM and 196,109 general population controls. Results of multivariable Cox regression analysis, adjusted for age, sex, comorbidities, and medication usage, revealed a greater risk of HF leading to hospitalization in the PM/DM group than in the control group (adjusted HR 3.29, 95% confidence interval [95% CI] 2.60–4.18). After matching based on propensity score, a total of 1,997 pairs of PM/DM patients and general population controls were identified. In this propensity score–matched cohort, the cumulative incidence of HF in patients with PM/DM at 3 years, 5 years, and 10 years was 3.3%, 4.4%, and 7.4%, respectively. The absolute difference in HF risk in the PM/DM group compared with the control group was 1.8% at 3 years, 2.1% at 5 years, and 3.0% at 10 years. Compared with general population controls, patients with PM/DM exhibited an augmented risk of HF (HR 2.06, 95% CI 1.36–3.12). Analyses stratified according to follow‐up time point revealed that the increased risk of HF persisted for up to 10 years after the PM/DM diagnosis. Conclusion: These results indicate that the risk of HF leading to hospitalization was increased in patients with PM/DM throughout the study period, supporting the need for greater vigilance in the monitoring of patients with PM/DM for the development of this potentially lethal complication. [ABSTRACT FROM AUTHOR]

Abstract: Citrus tristeza virus (CTV), the causal agent of tristeza disease, causes the devastating diseases worldwide. In Taiwan, complex cultivars and long‐term infection by CTV result in more than 90% of infected citrus trees, but local strain identification and classification are still incomplete. Here, six CTV strains were categorized by grafting onto eight citrus cultivars and the pathological characteristics of the stem‐pitting mild strains were identified. After 6 months of inoculation, the pummelo stem‐pitting severe strain (CTV‐Pum/SP/T1) only caused severe symptoms in Wentan pummelo (WP) and the mild strain (CTV‐Pum/M/T5) was symptomless in every cultivar; the sweet orange (SO) stem‐pitting severe strain (CTV‐SwO/SP/T7) affected SO, WP and Ponkan mandarin (PM), and the mild strain (CTV‐SwO/M/T51) caused no symptoms in SO except for WP; the mandarin stem‐pitting severe strain (CTV‐Man/SP/T46) caused severe impacts in PM, WP and Eureka lemon, whereas the mild strain (CTV‐Man/M/T2) only caused severe stem‐pitting in WP. The full‐length sequencing of both pummelo stem‐pitting strains and phylogenetic analysis revealed that CTV‐Pum/SP/T1 and CTV‐Pum/M/T5 were related to the HA18‐9 and HA16‐5 strains from Hawaii, respectively. Moreover, recombination analysis revealed that TCT repeat sequences existed at open reading frame 1a in both the CTV‐Pum/SP/T1 and the T36 strains from the United States, indicating that the possible evolution relationship between two regions. Furthermore, improved universal and specific primer pairs were designed for more specific, sensitive detection to meet the needs for quarantine and early prevention. The understanding of strain pathogenicity and genomic analysis provided further characterization of each strain and enabled practical challenge inoculation against CTV disease. [ABSTRACT FROM AUTHOR]

This article considers the efficacy of educational computer and video games in improving student motivation and achievement. It is stated that prior research has suggested that educational games provide positive opportunities for active learning and help develop learning skills. A content analysis approach is used to analyze 196 different games that are popular in Taiwan. A Delphi survey is given to six educational technology experts, six educational psychology experts, six game design experts, six students each from elementary, junior, and high schools, and six teachers in an attempt to reach a consensus on educational games.

Purpose: The aim of this study was to examine the association between obstructive sleep apnea (OSA) diagnosis and diverse types of injuries. Design: This population‐based retrospective cohort study compared records from 2000 to 2013 in the Taiwan National Health Insurance Research Database. Methods: 3025 patients identified with OSA were compared against the control cohort consisting of 12,100 age‐ and sex‐matched patients. Cox proportional hazards regression analysis was performed to estimate the effects of OSA on injury risk. Findings: Patients with OSA exhibited a significantly higher overall incidence of injury of 2599 per 100,000 person‐years compared to the control cohort (2248 per 100,000 person‐years). After the confounding factors were considered, subjects with OSA showed a higher risk of injury than subjects in the control group (adjusted hazard ratio [HR] = 1.78, 95% confidence interval [CI] = 1.64–1.93). The risk of unintentional injury (traffic, poisoning, falls) and intentional injury (suicide) in the group of patients with OSA was higher than that in the controls. Conclusions: Our study strongly supports the conclusion that adults with OSA are at increased risk of injury. Clinical relevance: The present results indicate the significance of OSA as a predictor of injury risk, which will provide valuable information for clinical practice and injury prevention. [ABSTRACT FROM AUTHOR]

Purpose: To understand how emergency nurses develop resilience in the context of workplace violence. Design: This study employed grounded theory methodology. Thirty nurses from three hospital emergency departments in Taiwan were interviewed between August and December 2018. Methods: Semistructured interviews were used to collect data. Interviews were audio‐recorded and transcribed verbatim. Findings: The process through which emergency nurses who had experienced workplace violence developed resilience took place in three stages: the release of emotions after the assault; the interpretation of conflicting thoughts and actions; and the establishment of strategies to cope with workplace violence in the future. The core theme was the motivating role of professional commitment to emergency patient care. Conclusions: The results of this study can inform the development of support systems to enhance the resilience of nurses experiencing workplace violence by alerting healthcare administrators and governing institutions to their needs. Clinical Relevance: Emergency nurses viewed professional growth and professional commitment as an invisible motivator in the development of resilience following an encounter with workplace violence. [ABSTRACT FROM AUTHOR]

Background: Leukocytosis is a common laboratory finding in emergency departments worldwide. Various infectious diseases are common causes of leukocytosis in hospitalized adult patients. Most emergency physicians have a high awareness of sepsis or severe infection, which requires empirical antibiotics. However, there are many other etiologies for leukocytosis. The outcome of prescribing broad-spectrum antibiotics in the emergency department for leukocytosis patients is not well-understood. Objectives: Our objectives were to determine whether prescribing antibiotics in the emergency department affect outcome for hospitalized adult patients with leukocytosis. Methods: A retrospective cohort study of hospitalized adult emergency department patients with leukocytosis was conducted in a tertiary hospital in Taiwan between June 2016 and June 2017. Patients with leukocytosis (white blood cell count >11,000 cells per μL) who were admitted via the emergency department at the Kaohsiung Veterans General Hospital, from June 2016 to June 2017 were enrolled. Patients aged ⩽18 years, pregnant women, those who received prophylactic antibiotics prior to operation, and those with a final diagnosis of hematologic malignancy were excluded from this study. The primary outcome measure was hospital stay, and the secondary outcome measure was mortality. All collected data were statistically analyzed. Results: A total of 8054 hospitalized adult patients with leukocytosis were included (the exclusion criteria included patients aged ⩽18 years, pregnant women, those who received prophylactic antibiotics prior to surgery, and those with a final diagnosis of hematologic malignancy); all patients were admitted via the emergency department. In all, 4486 patients received initial antibiotic treatment in the emergency department, whereas 3568 patients did not receive antibiotics in the emergency department and ward/intensive care unit within 3 days. There was no statistically significant difference in hospital days (p = 0.239) or mortality (p = 0.345) between those who received and did not receive antibiotics in the emergency department. Conclusion: Hospitalized adult patients with leukocytosis did not necessarily require antibiotics in the emergency department except when they had a differential diagnosis that requires antibiotic treatment. [ABSTRACT FROM AUTHOR]

Background and Aim: It is currently unknown how hepatitis C virus (HCV) eradication with pegylated interferon and ribavirin (PR) therapy affects the incidence of new‐onset liver cirrhosis (LC) in patients without cirrhosis and the incidence of decompensated liver disease (DLD) or hepatocellular carcinoma (HCC) in patients with cirrhosis. Methods: Taiwanese chronic hepatitis C cohort (T‐COACH) is a nationwide HCV registry cohort from 23 hospitals in Taiwan recruited between 2003 and 2015. This study enrolled 10 693 patients with chronic hepatitis C (CHC), linked to the Taiwan National Health Insurance Research Database, receiving PR therapy for at least 4 weeks for new‐onset LC and liver‐related complications (DLD or HCC). Results: Of the 10 693 patients, 1372 (12.8%) patients had LC, and the mean age was 54.0 ± 11.4 years. The mean follow‐up duration was 4.38 ± 2.79 years, with overall 46 798 person‐years. The 10‐year cumulative incidence rates of new‐onset LC were 5.0% (95% confidence interval [CI]: 3.2–7.7) in patients without cirrhosis with a sustained virologic response (SVR) and 21.9% (95% CI: 13.4–32.4) in those without SVR (hazard ratio [HR]: 0.22, P < 0.001). The 10‐year cumulative incidence rates of liver‐related complications were 21.4% (95% CI: 11.1–37.2) in patients with cirrhosis with SVR and 47.0% (95% CI: 11.1–86.0) in those without SVR after adjustment for age, sex, and competing mortality (HR: 0.52, P < 0.001). Conclusions: Hepatitis C virus eradication with PR therapy decreased the incidence of new‐onset LC in noncirrhotic patients and the incidence of liver‐related complications in cirrhotic patients with CHC. [ABSTRACT FROM AUTHOR]

Background/aims: Direct‐acting antivirals (DAAs) are highly effective in treating chronic hepatitis C virus (HCV)‐infected patients. The real‐world treatment outcome in Taiwanese patients on a nationwide basis is elusive. Methods: The Taiwan HCV Registry (TACR) programme is a nationwide registry platform including 48 study sites, which is organized and supervised by the Taiwan Association for the Study of the Liver. The primary endpoint was sustained virological response (SVR12, undetectable HCV RNA 12 weeks after end‐of‐treatment). Results: A total of 13 951 registered patients with SVR12 data available were analysed (mean age, 63.0 years; female, 55.9%; HCV genotype‐1 [GT1], 57.9%; cirrhosis, 38.4%; preexisting hepatocellular carcinoma [HCC], 10.6%; and hepatitis B virus coinfection, 7.7%). The overall SVR12 rate was 98.3%, with 98.7%, 98.0%, 98.4% and 97.4% in treatment‐naïve noncirrhotic, treatment‐naïve cirrhotic, treatment‐experienced noncirrhotic and treatment‐experienced cirrhotic patients, respectively. The SVR12 rate was > 95% across all subgroups except treatment‐experienced cirrhotic patients who received sofosbuvir/ribavirin (88.7%), treatment‐naïve noncirrhotic patients (94.8%) and treatment‐experienced cirrhotic (94.8%) patients who received daclatasvir/asunaprevir. The most important factor associated with treatment failure was DAA adherence < 60% (adjusted odds ratio [aOR]/95% confidence interval [CI]: 117.1/52.4‐261.3, P <.001), followed by GT3/GT2 (aOR/CI: 5.78/2.25‐14.9, P =.0003 and aOR/CI: 1.55/1.05‐2.29, P =.03, compared with GT1), active hepatocellular carcinoma (aOR/CI: 4.29/2.57‐7.16, P <.001), the use of sofosbuvir/ribavirin (aOR/CI: 2.51/1.67‐3.77, P <.001) and daclatasvir/asunaprevir (aOR/CI: 3.29/1.94‐5.58, P <.001), decompensated liver cirrhosis (aOR/CI: 2.50/1.20‐5.22, P =.02) and high HCV viral loads (aOR/CI: 2.16/1.57‐2.97, P <.001). Conclusions: DAAs are highly effective in treating Taiwanese HCV patients in the real‐world setting. Maintaining DAA adherence and selecting highly efficacious regimens are keys to ensure treatment success. [ABSTRACT FROM AUTHOR]

Aim Multidisciplinary care ( MDC) for patients with chronic kidney disease ( CKD) may help to optimize disease care and improve clinical outcomes. Our study aimed to evaluate the effectiveness of pre-end-stage renal disease ( ESRD) patients under MDC and usual care in Taiwan. Method In this 3-year retrospective observational study, we recruited 822 ESRD subjects, aged 18 years and older, initiating maintenance dialysis more than 3 months from five cooperating hospitals. The MDC ( n = 391) group was cared for by a nephrologists-based team and the usual care group ( n = 431) was cared for by sub-specialists or nephrologists alone more than 90 days before dialysis initiation. Patient characteristics, dialysis modality, hospital utilization, hospitalization at dialysis initiation, mortality and medical cost were evaluated. Medical costs were further divided into in-hospital, emergency services and outpatient visits. Results The MDC group had a better prevalence in peritoneal dialysis ( PD) selection, less temporary catheter use, a lower hospitalization rate at dialysis initiation and 15% reduction in the risk of hospitalization ( P < 0.05). After adjusting for gender, age and Charlson Comorbidity Index score, there were lower in-hospital and higher outpatient costs in the MDC group during 3 months before dialysis initiation ( P < 0.05). In contrast, medical costs ( NT$ 146 038 vs 79 022) and hospitalization days (22.4 vs 15.5 days) at dialysis initiation were higher in the usual care group. Estimated medical costs during 3 months before dialysis till dialysis initiation, the MDC group yielded a reduction of NT$ 59 251 for each patient ( P < 0.001). Patient mortality was not significantly different. Conclusion Multidisciplinary care intervention for pre- ESRD patients could not only significantly improve the quality of disease care and clinical outcome, but also reduce medical costs. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to several research studies on the clinical presentation and prognosis of ulcerative colitis in elderly adults, and it mentions proctitis, inflammatory bowel disease, and the risk of death in older people.