Search

Introduction: Due to the high cost and complexity, the oral glucose tolerance test is not adopted as the screening method for identifying diabetes patients, which leads to the misdiagnosis of patients with isolated post‐challenge hyperglycemia (IPH), that is., patients with normal fasting plasma glucose (<7.0 mmoL/L) and abnormal 2‐h postprandial blood glucose (≥11.1 mmoL/L). We aimed to develop a model to differentiate individuals with IPH from the normal population. Methods: Data from 54301 eligible participants were obtained from the Risk Evaluation of Cancers in Chinese Diabetic Individuals: a longitudinal (REACTION) study in China. Data from 37740 participants were used to develop the diagnostic system. External validation was performed among 16561 participants. Three machine learning algorithms were used to create the predictive models, which were further evaluated by various classification algorithms to establish the best predictive model. Results: Ten features were selected to develop an IPH diagnosis system (IPHDS) based on an artificial neural network. In external validation, the AUC of the IPHDS was 0.823 (95% CI 0.811–0.836), which was significantly higher than the AUC of the Taiwan model [0.799 (0.786–0.813)] and that of the Chinese Diabetes Risk Score model [0.648 (0.635–0.662)]. The IPHDS model had a sensitivity of 75.6% and a specificity of 74.6%. This model outperformed the Taiwan and CDRS models in subgroup analyses. An online site with instant predictions was deployed at https://app‐iphds‐e1fc405c8a69.herokuapp.com/. Conclusions: The proposed IPHDS could be a convenient and user‐friendly screening tool for diabetes during health examinations in a large general population. [ABSTRACT FROM AUTHOR]

Aim: To evaluate real‐world abatacept retention and clinical outcomes in patients with rheumatoid arthritis in Taiwan. Methods: This prospective, observational study enrolled patients with rheumatoid arthritis aged ≥20 years who received abatacept in real‐world practice. The primary endpoint was the abatacept retention rate at 24 months. Patients were categorized into subgroups based on abatacept treatment status and previous biological disease‐modifying antirheumatic drug (bDMARD) therapy. Risk factors affecting abatacept retention were determined by regression analysis. Results: A total of 212 patients were enrolled. The overall abatacept retention rate at 24 months among all patients was 59.9% (95% confidence interval 53.0%–66.6%). Patients who were ongoing users of abatacept and bDMARD‐naïve had the highest retention rate (76.3%); of these, 31.6% achieved low disease activity or remission after 2 years. Previous treatment with bDMARDs was associated with an increased risk of abatacept discontinuation (hazard ratio 1.99; p =.002). The most common reasons for abatacept discontinuation were drug switch (11.3%) and loss to follow‐up (6.1%). Abatacept was well‐tolerated with no new safety signals. Conclusion: The 24‐month retention rate of abatacept was 59.9%; abatacept was associated with improved clinical outcomes and was well‐tolerated in the real‐world setting in Taiwan. [ABSTRACT FROM AUTHOR]

Biotic exchanges between Taiwan and Mainland China have shaped the biodiversity and ecosystems of both regions. Exchanges from Mainland China to Taiwan have received more attention, mainly studied in terrestrial vertebrates, while the reverse direction and invertebrates have largely been overlooked. Here, we explore the dispersal events between these two regions based on the moths of three species groups of Obeidia, including Taiwan taxa and its relatives from mainland. We conducted mixed methods and analysis, including reconstructing a phylogenetic tree, estimating associated divergence times and inferring ancestral areas and source regions, to explore the phylogeographical structure and genetic pattern of three groups based on eight genes. Our results revealed a structure of three clades and every clade included at least one Taiwanese taxa and its closest relatives of mainland of China, and also served Taiwan as an important source region of two mainland taxa. Our study revealed various origin pattern and dispersal models on the basis of three species groups of Obeidia. Bi‐directional biotic exchange via a land bridge were found: four Taiwanese taxa originated from mainland, and two of them migrated back to mainland. Both eastern Himalayas and south China are important origin areas for Taiwan biota, and the dominant source region may need multiple insect cases to confirm. Our study also provided evidences for disjunct distribution from the perspective of insecta molecular phylogeny. [ABSTRACT FROM AUTHOR]

Background: Studies on the correlation between high body mass index (BMI) and extended survival among patients receiving immune checkpoint inhibitors (ICIs) have been made, although findings have shown variability. Our research explored the phenomenon of the "obesity paradox" in patients with metastatic urothelial carcinoma (mUC) undergoing treatment with ICIs. Materials and Methods: We conducted a retrospective analysis of patients diagnosed with mUC who received a minimum of one cycle of ICI treatment at two medical centers in Taiwan from September 2015 to January 2023. Features of patients' clinicopathologic factors, including age, sex, primary or metastatic location, treatment line, and BMI were examined. The primary outcome were overall survival (OS) and progression‐free survival (PFS), which were assessed utilizing the Kaplan–Meier method. We employed the Cox‐regression model to adjust for multiple covariates. Results: A total of 215 patients were included, with 128 (59.5%) being male, and the median age was 70 years. In the obese group (BMI ≥25 kg/m2), patients demonstrated significantly better median OS compared to the non‐obese group (BMI <25 kg/m2) (21.9 vs. 8.3 months; p = 0.021). However, there was no significant difference in median PFS between the high and low BMI groups (4.7 vs. 2.8 months; p = 0.16). Post‐hoc subgroup revealed a survival benefit from ICI treatment in male patients within the BMI ≥25 kg/m2 group (HR 0.49, 95% CI 0.30–0.81, p = 0.005). Conclusion: Based on real‐world data from the Asia‐Pacific region, there appears to be a correlation between obesity and prolonged OS in patients receiving ICI treatment for mUC. [ABSTRACT FROM AUTHOR]

Background and Aim: Fecal microbiota transplantation (FMT) is used to treat recurrent or refractory Clostridioides difficile infection (CDI). In the past, screening of fecal donors required surveillance of personal behavior, medical history, and diseases that could be transmitted by the blood or fecal–oral route. In addition, the exclusion of multidrug‐resistant organisms (MDROs) has been recommended since 2018. This task has become more complicated in the era of the coronavirus disease‐2019 (COVID‐19) pandemic. To prevent fecal transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), it is crucial to commence screening for SARS‐CoV‐2, alongside other traditional tests. Our aim was to investigate whether hidden carriers of SARS‐CoV‐2 were enrolled for stool donation, and the status of the presence or incidence of MDRO during fecal donation in Taiwan. Methods: Fecal products collected from March 2019 to December 2022 were tested for MDRO and nucleic acid amplification tests for SARS‐CoV‐2 using the pooling method. The period of fecal product collection crossed the time before and during the COVID pandemic in Taiwan. Results: A total of 151 fecal samples were collected. The fecal products were tested using polymerase chain reaction (PCR) to detect SARS‐CoV‐2. The results were negative for all stocks. This was similar to the results of MDRO testing. The safety of FMT products has been guaranteed during the pandemic. Conclusion: Our FMT center produced MDRO‐free and COVID‐19‐free products before and during the COVID‐19 outbreak in Taiwan. Our protocol was effective for ensuring the safety of FMT products. [ABSTRACT FROM AUTHOR]

Background: Stereotactic ablative radiotherapy (SABR) is now the standard of care for patients with inoperable early‐stage lung cancer. Many of these patients are elderly. EGFR (epidermal growth factor receptor) mutation is also common in the Asian population. Methods: To evaluate the effects of old age and EGFR mutation on treatment outcomes and toxicity, we reviewed the medical records of 71 consecutive patients with inoperable early‐stage non‐small cell lung cancer (NSCLC) who received SABR at Taipei Veterans General Hospital between 2015 and 2021. Results: The study revealed that median age, follow‐up, Charlson comorbidity index, and ECOG score were 80 years, 2.48 years, 3, and 1, respectively. Of these patients, 37 (52.1%) were 80 years or older, and 50 (70.4%) and 21 (29.6%) had T1 and T2 diseases, respectively. EGFR mutation status was available for 33 (46.5%) patients, of whom 16 (51.5%) had a mutation. The overall survival rates at 1, 3, and 5 years were 97.2, 74.9, and 58.3%, respectively. The local control rate at 1, 3, and 5 years was 97.1, 92.5, and 92.5%, respectively. Using Cox proportional hazards regression we found that male sex was a risk factor for overall survival (p = 0.036, 95% CI: 1.118–26.188). Two patients had grade 2 pneumonitis, but no other grade 2 or higher toxicity was observed. We did not find any significant differences in treatment outcomes or toxicity between patients aged 80 or older and those with EGFR mutations in this cohort. Conclusion: These findings indicate that age and EGFR mutation status do not significantly affect the effectiveness or toxicity of SABR for patients with inoperable early‐stage NSCLC. [ABSTRACT FROM AUTHOR]

The total electron content (TEC) profiles from the FORMOsa SATellite mission‐3/Constellation Observing System for the Meteorology, Ionosphere, and Climate (COSMIC) and the Fengyun‐3C (FY‐3C) radio occultation (RO) missions during 2006 and 2019 are used to establish the models for deriving the ionospheric sporadic E (Es) critical frequency (foEs). Smax is derived as the maximum vertical gradient of TEC disturbance, which is extracted from a RO TEC profile using the singular spectrum analysis method. Three candidate conversion models are obtained by fitting Smax with foEs observed by collocated ionosondes, and the one with the best performance, the COSMIC&FY‐3C (CF) model, is applied for deriving foEs (foEsCF) from the TEC data of the two missions jointly. For comparison, the C model, which is of similar form as the CF model while being established without using the FY‐3C data, is applied for deriving foEs (foEsC) from the COSMIC TEC data only. The validations over four independent ionosonde stations demonstrate that mean improvements of 0.11 MHz (32%) in the absolute bias and 0.24 MHz (17%) in the root mean square error are obtained by foEsCF compared with foEsC. The spatiotemporal distributions of Es intensity during 2015 and 2019, presented respectively by foEsCF and foEsC, are further compared. The CF model provides more abundant and more detailed information about Es intensity distribution, which is most distinct at high latitudes where the contribution of FY‐3C RO TEC data is significant. Our results reveal that with the aging of the COSMIC satellites, FY‐3C TEC data is a valuable supplementary RO data source for Es‐related studies. Plain Language Summary: Ionospheric sporadic E (Es) layers have significant impacts on radio communication and the propagation of global navigation satellite system signals, and the degrees of the impacts are closed related to the distributions and the intensity of Es layers. The radio occultation (RO) total electron content (TEC) profiles can be used for detecting the existence and the intensity of Es layers due to that the Es layers can bring to sudden enhancements of TEC values. In this study, based on the TEC data from FORMOsa SATellite mission‐3/Constellation Observing System for the Meteorology, Ionosphere, and Climate (COSMIC) and Fengyun‐3C (FY‐3C) RO missions and the collocated ionosonde observations during 2006 and 2019, an optimal model for deriving the Es intensity is promoted, and is compared with another model established using the same method but without using the FY‐3C data. The model using the FY‐3C data shows a better performance for deriving the Es intensity and provides more abundant and more detailed information about Es intensity distributions, especially in high‐latitude regions. The results contribute to understanding the value of FY‐3C RO TEC data for Es layer‐related studies, which is most significant during the last years of COSMIC mission lifespan, when the aging of the satellites brings to the decline in the COSMIC RO data volume. Key Points: The COSMIC&FY‐3C (CF) model, a model for deriving the sporadic E (Es) critical frequency from radio occultation (RO) total electron content data, is promoted by using the Constellation Observing System for the Meteorology, Ionosphere, and Climate (COSMIC) and the Fengyun‐3C (FY‐3C) data jointlyImprovements in the absolute bias and root mean square error of Es critical frequency are obtained by the CF model due to the contribution of FY‐3C RO dataDuring 2015 and 2019, the integrity of Es intensity distribution is improved by using the RO data from the two missions jointly [ABSTRACT FROM AUTHOR]

Aim: Rapid global warming is threatening global biodiversity, and it will likely lead to varying degrees of local adaptation, particularly amongst plant species. Besides, rising temperatures frequently result in upslope distribution shifts towards climatic optima (i.e. the escalator effect) within a limited dispersal space, such as in insular environments. Here, we integrated ecological and genetic approaches to investigate how climate change will impact the genetic compositions and spatial distributions of Taiwan's endemic maple Acer caudatifolium. Location: Taiwan. Methods: We estimate the distribution range shifts of A. caudatifolium under climate change through species distribution modelling (SDM). We also use 368 genotyped samples to infer dispersal and genetic hotspots and quantify the contributions of geography/environments to genetic variations. We further assess the potential risk to A. caudatifolium under different climate warming scenarios. Results: We detected three genetic diversity hotspots near mountainous glacial refugia and two dispersal hotspots in northern Taiwan and the central‐to‐southern Central Mountain Range. Overall range reductions and an altitudinal upslope shift were observed in SDM. Using both linear and nonlinear regression approaches, we found that genetic variation was significantly associated with geographic distance and elevation‐related climatic variables. The potential risk analysis revealed that the northernmost summit‐dwelling populations were the most vulnerable. Furthermore, the major risk factor differed amongst populations: for central populations, temperature and precipitation jointly determined the potential risk, whereas precipitation was the only risk factor for northern and southern populations. Main conclusions: This case study demonstrates how various climate factors, mountain height and the availability of corridors jointly determine the demographic fates and sustainability of island maples in the face of climate change. This study also provided estimates of the implications of global warming, which can be conducive to developing appropriate conservation strategies. [ABSTRACT FROM AUTHOR]

Background: Many gamification applications (apps) have been designed to motivate students to learn particular content. Based on the brain activation approach, the present study adapted an app, named Shaking‐On, which requires students to shake their mobile devices to send their answers to multiple‐choice questions to the teacher. Students then learn from their performance. Objectives: To understand how this approach can stimulate participants' emotions when achieving their learning goals, the present study compared Shaking‐On to Kahoot! by checking participants' gameplay anxiety, learning interest, perceived learning value, and learning achievement while learning the Taiwanese language. Methods: The students were divided into two groups to play with one of the two apps, Shaking‐On or Kahoot!, as part of a quasi‐experimental study in which they used the assigned app six times in 6 weeks. Moreover, a questionnaire was distributed to participants and 151 useful responses from the Shaking‐On group, and 148 from the Kahoot! group were returned. Results and Conclusions: After statistical analysis, the results of this study revealed that besides no difference in gameplay anxiety when comparing the two groups of students, there were significant differences in game interest, flow experience, perceived learning value, and learning achievement, further indicating that Shaking‐On with hands‐on shaking outperformed Kahoot!. Lay Description: What is already known about this topic: The adoption of technology in learning pedagogies should enable students to interact with their technological devices in a fun way and there needs to be interested during the learning process.Different designs of e‐learning platforms have different functions for students to interact that promote in them different psychological outcomes, by shaping their learning behaviours and enhancing their motivation and engagement. What this paper adds: The present study adapted an app, named Shaking‐On, which requires students to shake their mobile devices to send their answers to multiple‐choice questions to the teacher, students will then learn from their performance.To understand how this approach can stimulate participants' emotions in achieving learning goals, the present study compared Shaking‐On to Kahoot! by checking participants' gameplay anxiety, learning interest, perceived learning value, and learning achievement when learning the Taiwanese language. Implications for practice and/or policy: The research on the application of CATML to education is increasing, but there has been less research in the field of Taiwanese languages.The studies related to digital game‐based learning, there are few studies that compare games with different operation movements. Therefore, this study can be used as a reference for the application of cognitive and affective theories of multimedia learning to study the field of learning other native and disappearing languages. [ABSTRACT FROM AUTHOR]

Aim: The Massenerhebung effect (Mass elevation effect) refers to heat‐ or wind‐driven altitudinal distribution patterns of temperature‐dependent parameters among massifs with narrower range and lower elevation around peripheral and isolated mountains compared to core and continuous ones. Although common in ecology, this effect is rarely discussed in population genetics. Here, we use genetic markers to reveal population genetic patterns and also test the mountain‐ and sky‐barrier hypotheses relevant to the Massenerhebung distribution pattern of Acer morrisonense in Taiwan's rugged topography and varied local climates. Location: The alpine and cloud forest of Taiwan. Taxon: Acer morrisonense Hayata. Methods: Two chloroplast DNA (cpDNA) fragments and 17 expressed sequence tag‐simple sequence repeat (EST‐SSR) loci, respectively, from 200 to 286 individuals were used to elucidate the phylogeographic pattern of pollen and seed dispersal of A. morrisonense. These data were combined with ecological niche modeling (ENM) to infer distribution range shifts and refugia. We also correlated the genetic‐divergence indices with spatial factors to clarify latitudinal and altitudinal effects on genetic diversity. Results: The incongruent phylogeographic patterns of genetic distributions between nuclear and cpDNA markers indicate unhindered pollen flow but spatially constrained seed dispersal. Taken together with ENM, the genetic pattern further reflects historical colonization from central‐mountain refugia to edges since the Holocene. The Massenerhebung reduces the gene flow by the surrounding mountains and also causes lower genetic diversity compared to central alpine populations. Main conclusions: This study is the first to reveal the influence of Massenerhebung effect on cpDNA genetic structure of montane trees and reflect the spatial trends of seed dispersal. This population genetic pattern can also be attributed to the demography‐related range shifts with paleoclimate fluctuations under complex mountain topography, supporting the mountain‐barrier hypothesis. The results have important implications for conserving the genetic diversity of species with a wide altitudinal distribution range. [ABSTRACT FROM AUTHOR]

The level of dentition asymmetry in snail‐eating snakes may reflect their prey choice and feeding efficiency on asymmetric land snails. The three species of Pareas snakes (Squamata: Pareidae) in Taiwan, which form partially sympatric distribution on the island, provide a potential case to test the hypothesis of niche partitioning and character displacement with regard to dentition asymmetry and specialisation in feeding behaviour.In this study, behavioural experiments confirmed that P. formosensis feeds exclusively on slugs, whereas P. atayal and P. komaii consumed both. However, P. atayal more efficiently preys on land snails than P. komaii, exhibiting a shorter handling time and fewer mandibular retractions.Micro‐CT and ancestral character reconstruction demonstrated the lowest asymmetry in P. formosensis (the slug specialist), the highest dentition asymmetry in P. atayal (the land snail specialist) and flexibility in P. komaii (the niche switcher): increased dentition asymmetry when sympatrically distributed with the slug eater (character displacement), and decreased asymmetry when living alone (ecological niche release).Ecological niche modelling showed that the distribution of P. formosensis is associated with the presence of slugs, while that of P. atayal could be explained by the land snails.Combining the results from morphology, phylogeny, behavioural experiments and ecological niche modelling, we showed that competition in the sympatric region might have facilitated character displacement among congeners, while the absence of competition in allopatric region has led to ecological niche release. [ABSTRACT FROM AUTHOR]

Dust particles are effective ice nuclei and are known to affect precipitation. Here, the possible impacts of mineral dust on summertime cloud and precipitation over the Taiwan region are investigated through analysis of 25 years (1989–2013) of multiple observational and modeling data sets. Due to the unique mechanism, typhoon precipitations are excluded from this study. Statistical methods (partial correlation and stratification) are used to untangle the influences of dust from the covarying meteorological conditions (water vapor, horizontal wind, sea surface temperature, and moisture flux). The results suggest a statistically significant positive correlation between nontyphoon precipitation and the number concentration of dust particles larger than 0.5 μm (Nd) in July and August in the regions with heavy precipitation. From clean (Nd = ~0.008 cm−3) to dusty days (Nd = ~0.2 cm−3), averaged ice (liquid) water paths and precipitation increase by ~25% (~20%) and ~70% over the orographic region, and vertically, ~30% more cloud ice content is generated at ~350 hPa (T = ~ −20°C), enhancing the development of the mixed‐phase cloud and precipitation. The results also indicate the critical role of the atmospheric water vapor in the responses of precipitation to Nd, with precipitation increasing more significantly with Nd in higher water vapor circumstances. Key Points: Long‐term multiple observational and modeling data sets are used to study the correlation between mineral dust and summertime precipitationThe analysis suggests a positive correlation between dust number concentration and precipitation in the orographic regionThe impact of mineral dust on precipitation is more significant in environments with higher water vapor concentrations [ABSTRACT FROM AUTHOR]

The aim of this study was twofold: first, to examine the lasting effects of working hours on later job performance and well‐being (i.e. emotional exhaustion and work engagement); second, to delineate the protective role of psychological detachment in the highly demanding Chinese work setting featuring long working hours. We employed a panel design in which all variables were measured twice, with six months in between the waves. Data were obtained from 323 Chinese employees working in diverse industries in Taiwan. Analysing the panel data with structural equation modelling (SEM) techniques, we found that working hours were positively associated with emotional exhaustion and negatively associated with work engagement and job performance, measured six months later. Detachment moderated the effects of working hours on later work engagement and job performance. Specifically, detachment attenuated the negative relationships between working hours and work engagement and job performance. The present study extends the recovery research in the West by demonstrating the protective role of detachment in the East Asian societies with important managerial implications. [ABSTRACT FROM AUTHOR]

The aim of this longitudinal study was to explore reciprocal relationships between work/family pressure, work/family interference, and work/family satisfaction among Taiwanese employees (N = 310). All study variables were assessed three times. We found that within the work domain, earlier work pressure caused later work-to-family conflict (WFC), while earlier WFC reduced later job satisfaction. We also found that earlier WFC caused later work pressure, while earlier job satisfaction reduced later WFC. Similarly, we found that within the family domain, earlier family pressure caused later family-to-work conflict (FWC), while earlier FWC reduced later family satisfaction. We also found that earlier FWC caused later family pressure. In addition, family pressure and family satisfaction had reciprocal relationships over time. Together these longitudinal and reciprocal relations strongly support our hypothesized feedback loops linking pressure, work and family conflict, and role satisfaction, within each of the work and family domains. We made specific suggestions on breaking these vicious cycles to effectively manage both the work and family roles. [ABSTRACT FROM AUTHOR]

Objectives: To carry out a comparison of upper urinary tract urothelial carcinoma characteristics and behavior between patients in Taiwan and Japan. Methods: A Taiwan urinary tract urothelial carcinoma cohort was obtained from Kaohsiung Chang Gung Memorial Hospital, and a Japan urinary tract urothelial carcinoma cohort from Hirosaki University Hospital. The inclusion criteria were urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy. Those who received perioperative chemotherapy were excluded. Finally, 765 patients in the Taiwan cohort and 325 in the Japan cohort were analyzed. The end‐point of this study was to study the natural course of urinary tract urothelial carcinoma within 5 years between these two groups. Results: The main finding was that urinary tract urothelial carcinoma patients in Taiwan were younger (P < 0.001), more were women (P < 0.001), with low‐stage disease (P < 0.001), with more chronic kidney disease (P < 0.001), with less smoking history (P < 0.001), with more bladder cancer history (P = 0.002), with more multifocal (P < 0.001) and less high‐grade disease (P = 0.015), as well as less lymphovascular invasion (P < 0.001) and more squamous differentiation (P < 0.001). However, the multivariate Cox regression analysis showed no racial difference in oncologic outcome, such as intravesical recurrence, systemic recurrence or cancer‐specific death in primary and propensity‐matched cohorts. Bladder cancer history was found to be the most important factor predicting intravesical recurrences, whereas stage was strongly associated with systemic recurrence and cancer specific mortality. Conclusions: The clinical characteristics of urinary tract urothelial carcinoma in Taiwan are significantly different from those of urinary tract urothelial carcinoma in Japan. However, there is no racial difference in stage‐specific oncologic outcome after standard nephroureterectomy. [ABSTRACT FROM AUTHOR]

Aim: To establish guidelines for the clinical management of axial spondyloarthritis that take into account local issues and clinical practice concerns for Taiwan. Method: Overarching principles and recommendations were established by consensus among a panel of rheumatology and rehabilitation experts, based on analysis of the most up‐to‐date clinical evidence and the clinical experience of panelists. All Overarching Principles and Recommendations were graded according to the standards developed by the Oxford Centre for Evidence Based Medicine, and further evaluated and modified using the Delphi method. Results: The guidelines specifically address issues such as local medical considerations, National Health Insurance reimbursement, and management of extra‐articular manifestations. Conclusion: It is hoped that this will help to optimize clinical management outcomes for axial spondyloarthritis in Taiwan. [ABSTRACT FROM AUTHOR]

The aim of this research was to explore relations between work and family demands and resources, work-to-family conflict (WFC), and work and family outcomes in a cross-cultural comparative context involving Taiwanese and British employees. Two-hundred and sixty-four Taiwanese employees and 137 British employees were surveyed using structured questionnaires. For both Taiwanese and British employees, work and family demands were positively related to WFC, whereas work resources were negatively related to WFC. Furthermore, WFC was negatively related to family satisfaction. More importantly, we found that nation moderated relationships between work resources and WFC, WFC and work, and family satisfaction. Specifically, work resources had a stronger protective effect for Taiwanese than British in reducing WFC, whereas WFC had a stronger detrimental effect on role satisfaction for British than Taiwanese. It is recommended that both culture-general and culture-specific effects should be taken into consideration in designing future WFC research and familyfriendly managerial practices. © 2010 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

In conventional multistage data envelopment analysis (DEA) studies, different hotel types are mostly assumed to be in a single technology set. However, the assumption that a single technology can have multiple operating types has been criticized by researchers in the past. To overcome this shortcoming, the main propose of this study is to establish a combination of the models of Tone and Chen and Zhu in order to assess the efficiencies of two hotel types. We first provide evidence that there is an existing defect arising from the direct combination of the two models. The nonhomogeneous two-stage model is established to evaluate the operational and expense utilization efficiencies for the Taiwanese international tourist hotels. The results verify that the defect from the direct combination of these models can be corrected by the new model. Empirical evaluation reveals that independent hotels have higher expense utilization efficiency and chain hotels have higher operational efficiency. The evaluation also indicates that tourist hotels can achieve best practices through a mutual learning strategy. [ABSTRACT FROM AUTHOR]

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

The purpose of this study was to examine an integrated model of the work-family interface ( WFI) linking work-family demands (workload and family conflict), resources (supervisory support and family support) and role satisfaction in a Chinese context. The four-factor structure of WFI comprises direction of influence (work to family vs family to work) and types of effect (work-family conflict vs work-family enrichment). A longitudinal design was used to collect data from 409 Chinese employees at three time points, separating measures of antecedents ( T1), WFI ( T2) and outcomes ( T3) in time. The results based on structural equation modelling ( SEM) reveal that: (1) the direction and types of effect were two underlying dimensions of the WFI, supporting the four-factor structure; (2) demands were more strongly related to conflict, while resources were more strongly related to enrichment; (3) work-family conflict and enrichment were related to role satisfaction, regardless of the direction of influence. [ABSTRACT FROM AUTHOR]

Cooperative learning has many pedagogical benefits. However, if the cooperative learning teams become ineffective, these benefits are lost. Accordingly, this study developed a computer-aided assessment method for identifying ineffective teams at their early stage of dysfunction by using the Mahalanobis distance metric to examine the difference between the sequential test scores of the unknown team and the test scores of a reference group of functioning teams. The effectiveness of the proposed method was verified by conducting field experiments over an 18-week engineering course in Taiwan. Forty-eight students were randomly assigned to cooperative learning teams. The students' learning performance was evaluated by means of unit tests and homework tests. The functioning of the cooperative teams was examined at seven different points during the course of the study. The ineffective teams were identified with quantified type I errors. It was found that some teams failed persistently. Such teams require some form of external intervention to remedy the group dynamics. The results also showed that teams can become ineffective at any stage of the cooperative learning process. Thus, continuous monitoring is required to ensure that appropriate remedial actions are taken in a timely manner. [ABSTRACT FROM AUTHOR]

Background The risk factors for gastrointestinal bleeding (GIB) in clopidogrel users have not been identified. Aim To clarify whether clopidogrel use is a risk factor for upper GIB (UGIB) and lower GIB (LGIB) and identify the risk factors in clopidogrel users. Methods Using the National Health Insurance Research Database of Taiwan, 3238 clopidogrel users and 12 952 age-, sex-, and enrolment time-matched controls in a 1:4 ratio were extracted for comparison from a cohort dataset of 1 000 000 randomly sampled subjects. Cox proportional hazard regression models were used to identify the independent risk factors for UGIB and LGIB in all enrollees and clopidogrel users after adjustments for age, gender, comorbidity [i.e., coronary artery disease, hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease (CKD), cirrhosis, uncomplicated peptic ulcer disease, and peptic ulcer bleeding (PUB)], and medications [e.g., nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 inhibitors, aspirin, steroids, selective serotonin reuptake inhibitors (SSRIs), warfarin and alendronate]. Results Cox proportional hazard regression analysis showed that use of clopidogrel increased the risk of UGIB [hazard ratio (HR): 3.66; 95% confidence interval (CI): 2.96-4.51] and LGIB [HR: 3.52, 95% CI: 2.74-4.52]. Age, CKD, PUB history, use of aspirin and NSAIDs were independent risk factors for UGIB in the clopidogrel users. Age, CKD, PUB history, use of aspirin and SSRIs were independent risk factors for LGIB. Conclusions In clopidogrel users, age, CKD, PUB history, use of aspirin and NSAIDs are independent risk factors for UGIB; age, CKD, PUB history, use of aspirin and SSRIs are independent risk factors for LGIB. [ABSTRACT FROM AUTHOR]

Aim We sought to reconstruct the spatio-temporal genetic diversification in goldfish of the Carassius auratus complex, which is widely distributed in Eurasia, to test whether vicariance events or human-mediated translocations best explained lineage divergence and genogeographical history. Location East Asia and the Oriental islands including Japan, the Ryukyus and Taiwan, and Europe, including Russia and the Czech Republic. Methods We reconstructed the matrilineal history of Eurasian goldfish using 1876 sequences from the partial mitochondrial DNA control region (426 bp) and 191 complete sequences of cytochrome b (1140 bp) from 67 localities representing most of the range of the species. Divergence times were estimated using a Bayesian Markov chain Monte Carlo approach based either on molecular clock data or on the fossil record. Genetic structure and the historical demography of populations were analysed using partial correlation tests and analyses of molecular variance. Results Three lineages had high levels of regional specificity. Lineages A and B from the main islands of Japan differed greatly from lineage C, which occurred on the mainland, Taiwan and the Ryukyus. Lineages A and B had late Pliocene origins. Six geographically constrained sublineages within lineage C had near-simultaneous mid-Pleistocene divergences. Main conclusions Genetic structure in the C. auratus complex appears to have been driven by palaeoenvironmental perturbations rather than human translocations. The disappearance of a land bridge in the Tsushima Strait around 3.0 Ma is responsible for the separation of Japanese and continental lineages; the estimated divergence time is 2.75-2.32 Ma. Fujian, China and Vietnam appear to have provided important refugia for the C. auratus complex during glaciation. After warm, moist summer monsoons intensified during the mid-Pleistocene, goldfish are likely to have dispersed north-eastwards to recolonize the Ryukyus via Taiwan and northwards to recolonize mainland China. [ABSTRACT FROM AUTHOR]

Background Few large population-based studies have compared the occurrence of peptic ulcer bleeding ( PUB) in cirrhotic and noncirrhotic patients. Aims To investigate if cirrhotic patients have higher risk of PUB than the general population and to identify possible risk factors of PUB in cirrhotic patients. Methods Using the National Health Insurance Research Database, a nationwide population-based dataset in Taiwan and matching age, gender, comorbidities and ulcerogenic medication by propensity score, 4013 cirrhotic patients, 8013 chronic hepatitis patients and 7793 normal controls were compared. The log-rank test was used to analyse differences in accumulated PUB-free survival rates between the groups. Cox proportional hazard regressions were performed to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in cirrhotic patients. Results During the 7-year follow-up, cirrhotic patients had significantly higher incidences of PUB than chronic hepatitis patients and controls, respectively ( P < 0.001 by log-rank test). By Cox proportional hazard regression analysis, cirrhosis was independently associated with increased risk of PUB (hazard ratio: 4.22; 95% CI 3.37-5.29, P < 0.001) after adjusting for age, gender, economic status, underlying comorbidities and ulcerogenic medication. Age, male, diabetes, chronic renal disease, history of gastro-oesophageal variceal bleeding and use of nonsteroidal anti-inflammatory drugs were risk factors for PUB in cirrhotic patients. Conclusion Cirrhotic patients have a significantly higher risk of peptic ulcer bleeding after adjustments for possible confounding factors like age, gender, economic status, underlying comorbidities and ulcerogenic medication. [ABSTRACT FROM AUTHOR]

Background Src protein overexpression correlates with progression and prognosis of a variety of human cancers. Methods This study used immunohistochemistry to examine the expression of Src protein in 93 specimens of oral squamous cell carcinoma (OSCC). Results We found a significant association of high expression of Src protein (labeling indices >50%) with larger tumor size ( p = .017), positive lymph node metastasis ( p = .030), more advanced clinical stages ( p = .007), and recurrence ( p < .001) of OSCC. High expression of Src protein was identified as an independent unfavorable prognosis factor by multivariate Cox regression analysis. The Kaplan-Meier curve showed that patients with OSCC with high expression of Src protein had a significantly poorer cumulative survival than those with low expression of Src protein (log-rank test, p = .00267). Conclusion The expression of Src protein is significantly associated with the progression, recurrence, and prognosis of OSCCs in Taiwan. © 2011 Wiley Periodicals, Inc. Head Neck, 2012 [ABSTRACT FROM AUTHOR]

Summary Background Peptic ulcer bleeding remains a major healthcare problem despite decreasing prevalence of peptic ulcer disease. The role of chronic obstructive pulmonary disease ( COPD) in the risk of peptic ulcer bleeding has not yet been established. Aim To determine if COPD patients have a higher risk of peptic ulcer bleeding than the general population and to identify the risk factors of peptic ulcer bleeding in COPD patients. Methods From Taiwan's National Health Insurance research database, 62 876 patients, including 32 682 COPD and 30 194 age-gender-matched non- COPD controls, were recruited. Cox proportional hazard regression was performed to evaluate independent risk factors for ulcer bleeding in all patients and to identify risk factors in COPD patients. Results During the 8-year follow-up, COPD patients had a significant higher rate of peptic ulcer bleeding than the control group ( P < 0.001, by log-rank test). By Cox proportional hazard regression analysis, COPD [hazard ratio ( HR) 1.93, 95% CI 1.73-2.17] was an independent risk factor after adjusting for age, gender, underlying comorbidities and ulcerogenic medication. Age > 65 years, male, comorbidities of hypertension, diabetes, heart failure, history of peptic ulcer disease, and chronic renal disease and use of nonsteroidal anti-inflammatory drugs were risk factors of ulcer bleeding in COPD patients. Conclusion Patients with chronic obstructive pulmonary disease have a higher risk of peptic ulcer bleeding after adjustments for possible confounding factors like underlying comorbidities and ulcerogenic medication. [ABSTRACT FROM AUTHOR]

Objective. To determine the incidence of cervical cancer and the age-specific survival from small cell cervical carcinoma in Taiwan. Design. Retrospective study. Setting. Taiwan. Population. Women diagnosed with cervical cancer from 1991 to 2005. Methods. Analysis of data from the National Cancer Registration System and National Death Certification System. Main Outcome Measures. Incidence and age at diagnosis of cervical carcinoma and age-specific and overall survival from small cell cervical carcinoma. Results. During the study period, 36 122 women were diagnosed with cervical cancer, and 81.8% had squamous cell carcinoma (SCC). For the periods 1991-1995, 1996-2000 and 2001-2005, the mean age at diagnosis increased from 53.9±13.3 to 55.0±14.9 and then to 56.7±14.7 years, respectively. The incidence of SCC decreased from 1991 to 2005. During the same period, non-significant increases of adenocarcinoma and small cell carcinoma were noted. For SCC, occurrence peaked in 1991-1995 in patients 50-59 years of age. From 1996 to 2005, it peaked in patients 40-49 years of age. For cervical adenocarcinoma, occurrence peaked in patients 40-49 years of age, with a steady increase in this age group from 1991 to 2005. Occurrence of small cell cervical carcinoma peaked in the period 1991-1995 in patients 30-39 years of age. During the 15 years of the study, the overall mortality rate of the 198 patients with small cell cervical carcinoma was 65.7%. Conclusions. In Taiwan, the incidence of small cell cervical carcinoma and adenocarcinoma tended to increase, but the incidence of squamous cell cervical carcinoma significantly decreased during the period 1991-2005. [ABSTRACT FROM AUTHOR]

In this study, an intelligent learning style aware diagnosis agent for computer-supported cooperative learning is proposed. Learners are first assigned to heterogeneous groups based on their learning styles questionnaire given right before the beginning of learning activities on the e-learning platform. The proposed diagnosis agent then scrutinizes each learner's learning portfolio on e-learning platform and automatically issues feedback messages in case some learner's behavior that is unfitted to his/her learning styles or devious argument on discussion board or wiki is detected. The Moodle, an open-source software e-learning platform, is used to establish the cooperative learning environment for this study. The experimental results reveal that the proposed learning style aware diagnosis agent indeed boosts the performance of the learners. © 2009 Wiley Periodicals, Inc. Comput Appl Eng Educ 19: 739-746, 2011 [ABSTRACT FROM AUTHOR]

Objective Cytosolic phospholipase A2 (cPLA2) is a rate-limiting enzyme that plays a critical role in the biosynthesis of eicosanoids. The aim of this study was to investigate the mechanisms underlying interleukin-1β (IL-1β)-induced cPLA2 expression in human rheumatoid arthritis synovial fibroblasts (RASFs). Methods Synovial tissue was obtained from patients with RA who were undergoing joint replacement surgery. In a mouse model of IL-1β-mediated inflammatory arthritis, neutrophil infiltration, bone erosion, and cPLA2 expression in ankle synovium were analyzed by immunohistochemistry. IL-1β-induced cPLA2 expression was determined by Western blotting, real-time polymerase chain reaction, and gene promoter assay using pharmacologic inhibitors and transfection with short hairpin RNAs or small interfering RNAs. The recruitment of NF-κB and p300 to the cPLA2 promoter was determined by chromatin immunoprecipitation assay. Prostaglandin E2 (PGE2) biosynthesis was evaluated by enzyme-linked immunosorbent assay. Results IL-1β-induced cPLA2 expression and PGE2 release were mediated through a myeloid differentiation factor 88 (MyD88)/c-Src-dependent matrix metalloproteinase (MMP)/heparin-binding epidermal growth factor (HB-EGF) cascade linking to transactivation of the EGF receptor (EGFR)/phosphatidylinositol 3-kinase (PI 3-kinase)/Akt, p300, and NF-κB p65 pathways. IL-1β also stimulated Akt phosphorylation and nuclear translocation. Activation of Akt eventually led to the acetylation of histone residues by phosphorylation and recruitment of p300 and enhanced its histone acetyltransferase activity on the NF-κB elements of the cPLA2 promoter. IL-1β-induced NF-κB transcriptional activity was mediated through a PI 3-kinase/Akt-dependent cascade. Up-regulation of cPLA2 by IL-1β increased PGE2 biosynthesis in RASFs. Conclusion IL-1β-induced cPLA2 expression is mediated through activation of the MyD88/c-Src, MMP/HB-EGF, EGFR/PI 3-kinase/Akt, p300, and NF-κB pathways. These results provide insights into the mechanisms underlying IL-1β-enhanced joint inflammatory responses in RA and may inspire new targeted therapeutic approaches. [ABSTRACT FROM AUTHOR]

This study investigates whether physicians' levels of occupational stress may influence the likelihood of their prescribing hormone replacement therapy (HRT). One hundred and one physicians answered a cross-sectional, mailed, self-administered survey that measured occupational stress using Occupational Stress Indicator 2. Questions concerning HRT-including the possibility of recommending HRT to treat menopausal syndrome-were also asked. We found the likelihood of prescribing HRT for menopausal syndrome positively correlates with 'coping' ( p < 0.01) and 'other indications' ( p < 0.001). The likelihood of prescribing is also greater when the patient is a younger menopausal woman ( p < 0.0001) and if the physician is more experienced ( p < 0.05). Multiple regression analysis reveals that the 'coping' scale ( p < 0.05) is the most significant factor, whereas 'seeking support' is the significant subscale ( p < 0.0001). Our results indicate that 'seeking support' from the 'coping' scale is the most important factor that influences the prescribing of HRT. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background [ABSTRACT FROM AUTHOR]

The purpose of this paper is to show the similarities as well as the differences of fundamental fraction knowledge owned by preservice elementary teachers from the United States ( N= 89) and Taiwan ( N= 85). To this end, we examined and compared their performance on an instrument including 15 multiple-choice test items. The items were categorized into four different types of fundamental fraction constructs, including part-whole relationship, quotient, equivalence, and meanings of operations. Each item was embedded in the area, linear, or set model except for the items constructed out of the meaning of operations. Several items were featured with a pictorial illustration. Quantitative analysis showed that U.S. preservice teachers were significantly outperformed by their Taiwanese counterparts overall. The difference between the two groups was statistically significant on 12 of 15 items. Findings suggest that preservice elementary teachers from both countries need to be better prepared in their understanding of the meaning of fraction multiplication or division operations. Findings also suggest that U.S. preservice elementary teachers need to be more knowledgeable in dealing with fraction problems embedded in a linear model. Further research is suggested to study the issues raised from the findings. [ABSTRACT FROM AUTHOR]

Very few studies have addressed the magnitude of the effect of the condition of the patients and the surgical volume on possible cost savings in coronary artery bypass grafting (CABG). The objectives of this study were to analyse and compare the costs of the CABG operating room (OR) between two hospitals, and to examine the effect of surgical volume and severity of illness on the OR costs. The charts of patients who were diagnosed with coronary artery disease and who underwent CABG at two acute tertiary care hospitals in 2004 were reviewed retrospectively. Data on patient demographics, length of stay (LOS) and the American Society of Anesthesiologists Physical Status (ASAPS) score were extracted from the patient records. Cost information was obtained from detailed billing charges and from the financial accounting divisions of the hospitals. The high-volume hospital consumed fewer resources than the low-volume hospital (US$5411 vs. US$6407). The age of the patients, surgical volume, operating hours and LOS were associated with the OR cost. Patient age and ASAPS score, hospital, and surgical volume were associated with LOS. Patient age, the number of diseased vessels, doctor volume and pump used or not were positively associated with the operation time. The LOS and the operation time may be the mediators of the relationship between the ASAPS score and cost, and may moderate the association of volume with cost. This study supports the saying that 'practice makes perfect'. The knowledge and experience of the surgeons and the hospital management team are equally important in the supply of health services to patients with varying severity of illness, and are needed to maintain the competitive position of a hospital. [ABSTRACT FROM AUTHOR]

The article presents a study conducted at the National Synchrotron Radiation Research Center (NSRRC) in Taiwan for the design and development of a compact end-station of circular-dichroism spectra within the vacuum-ultraviolet region circular dichroism. The study used a linearly polarized light take from beamline BL04B. Results show that the beam light is suitable for measuring the protein samples, and that its radiation damage to protein is depending on the density of photon flux.

Background and Aim: The prevalence of Helicobacter pylori-negative duodenal ulcer (DU) is increasing in Western countries but is rare in Japan. We aimed to examine the prevalence of H. pylori infection and the characteristics in DU and gastro-duodenal ulcer (GDU) diseases in Taiwan. Study: All patients with an endoscopic diagnosis of DU or GDU from September 2003 to May 2004 at Taipei Veterans General Hospital were included. Rapid urease test was done for all patients, while urea breath test was carried out on those with negative rapid urease tests. A patient was considered infected if either test was positive. Results: The prevalence of H. pylori was 88.7% (555/626) in DU and 90.5% (95/105) in GDU patients. There was no difference in sex and prevalence of H. pylori between the two groups but age was higher in the GDU patients (60.1 ± 15.5 vs. 55.4 ± 15.5, P = 0.005). Of H. pylori-negative DU patients, 28.2% (20/71) reported using non-steroidal anti-inflammatory drugs (NSAIDs)/aspirin, which were used by all 10 H. pylori-negative GDU patients (100%) ( P < 0.001). There was no difference in sex and age between H. pylori-positive and negative DU patients. The prevalence rate of H. pylori in DU was not statistically different among outpatients, inpatients, and physical check-up subjects (86.8% vs. 93.3% vs. 90.7%, P = 0.163). Conclusion: The prevalence of H. pylori infection in DU appears to be decreasing in Taiwan. Thus, eradication therapy without confirming the presence of H. pylori in DU patients cannot be recommended. NSAIDs/aspirin is the major risk factor for H. pylori-negative DU patients, especially those with co-morbid gastric ulcer. [ABSTRACT FROM AUTHOR]

The interaction between killer-cell immunoglobulin-like receptors (KIRs) and human leukocyte antigen (HLA) molecules expressed on target cells is known to modulate the cytolytic activity of natural killer (NK) cells. To date, a wide range of KIR genotypes has been observed, which varies among different ethnic populations. We report here comparison of the KIR gene content and genotypic structure of KIRs in 106 individuals from Eastern mainland Chinese Han and 97 from Taiwanese Han. All 17 KIR genes were observed in the two populations. Framework genes 2DL4, 3DL2, 3DL3 and 3DP1 were present in all individuals. The two populations had very similar frequencies in most loci, however, significant differences were noted in the frequencies of KIR3DS1 and KIR2DS4D ( KIR2DS4 deletant variant). A total of 35 and 29 genotypes were identified in the individuals from the Eastern mainland Chinese and the Taiwanese Hans, respectively. Some pairs of KIRs showed significant positive and negative linkage disequilibrium (LD). Our data showed that there were minor distinctions in KIR gene frequencies, genotypes and LD between the two populations, which shed light on a possible geographic genetic demarcation among different Chinese communities. [ABSTRACT FROM AUTHOR]

When someone is criticized for some failure or deficiency, he or she is faced with a dilemma about whether or how to respond. To date, most research on responses to criticism has adopted a communication approach and has focused on general social complaints. The present study instead adopted the perspective of stress and coping and aimed to delineate possible responses to criticism pertaining to one's physical appearance. We investigated the efficacy of three coping styles, namely acceptance, avoidance, and retaliation in explaining emotional reactions towards such criticism, and we additionally controlled for personality characteristics... [ABSTRACT FROM AUTHOR]

The aim of the present secondary data analysis was to explore antecedents and consequences of family socialization values emphasizing independence or interdependence, using a Taiwanese national probability sample. Analysis of variance revealed that those who were male, older and less educated emphasized greater interdependence values. In contrast, those who were younger, with higher social status and urban residents emphasized greater independence values. Multiple regression analysis further revealed that valuing interdependence was related to preferring a greater number of offspring, a higher endorsement of filial piety, greater marital and life satisfaction. Finally, in this national sample, endorsement on independence and interdependence values was equivalent. [ABSTRACT FROM AUTHOR]

In the present paper, a preliminary statement on the traditional-modern bicultural self in contemporary Taiwan was proposed and our presentation was organized in four parts. First, a theoretical and conceptual analysis was attempted to describe the emergence and composition of the traditional-modern bicultural self of the contemporary Taiwanese people. The cultural and social roots of such a bicultural self were explored, and its constituting elements delineated and their interrelations analyzed. Second, relevant empirical evidence pertaining to this particular model of the Chinese bicultural self was reviewed. Third, our present model was related and compared against various existing bicultural self models. Finally, directions and issues for future research on the Chinese bicultural self were discussed. [ABSTRACT FROM AUTHOR]

>Background The epidemiology and impact of functional constipation on Asians remain unclear. >Aim To determine the prevalence of functional constipation, its social/medical impact, and its distinction from constipation-predominant irritable bowel syndrome (C-IBS) in Taiwan. >Methods A Rome II questionnaire was administered to an apparently healthy adult Chinese population ( n = 2865). >Results The prevalence of functional constipation was 8.5% and it was 2.7% for C-IBS. The functional constipation subjects were predominantly female and had excessive gastrointestinal-related doctor visits, absenteeism and sleep disturbance compared with controls ( P < 0.01). Among functional constipation subjects, approximately 40% were ‘consulters’ with excessive doctor consultations, absenteeism and sleep disturbance. Female gender, the presence of sleep difficulty and higher constipation symptom scores were predictive of their consultation behaviour ( P < 0.05). No differences existed in demographic variables, doctor consultations and absenteeism between 172 functional constipation and 54 C-IBS subjects. However, the C-IBS subjects experienced more severe constipation symptoms and sleep disturbance than functional constipation subjects. >Conclusions Functional constipation in Taiwan is comparable with that in other countries. The clinical presentation of constipation-predominant irritable bowel syndrome differ somewhat from that of functional constipation. [ABSTRACT FROM AUTHOR]

Background : Little is known about the social and medical burdens of heartburn in Asia. Aim : To assess the impact of heartburn in Taiwan. Methods : We applied a questionnaire to 2018 apparently healthy adult Chinese receiving a routine health maintenance programme. Costs of heartburn-related prescriptions were obtained from the Bureau of National Health Insurance of Taiwan. Results : Heartburn prevalence (>1 episode/week) was 7%. Smoking and increased body mass index were associated with heartburn occurrence. Heartburn sufferers reported more atypical gastro-oesophageal reflux disease symptoms, e.g. chest pain, dysphagia and globus. They were more likely to consult physicians, and have an increased frequency and number of days of absenteeism, irrespective of upper gastrointestinal or nongastrointestinal-related illnesses. They experienced sleep disturbances more frequently. The 62 heartburn consulters (48%) were more likely to have co-existing globus, visited physicians more, had more absenteeism, suffered from more sleep disturbances and had higher costs for antacids, proton pump inhibitors, hypnotic/sedatives, tranquilizers and antidepressants than nonconsulters. Conclusions : Heartburn prevalence in Taiwan is lower than in Western countries. Nevertheless, heartburn in Taiwanese creates a significant burden in terms of social impact, health resource utilization, sleep quality and pharmaceutical costs. The increased costs of psychoactive drugs in consulters suggest that anxiety/depression affects their health-seeking behaviour. [ABSTRACT FROM AUTHOR]

: Little is known about the gender effect on irritable bowel syndrome in Asia. : To assess the gender difference in Chinese subjects with irritable bowel syndrome meeting Rome II criteria. : Irritable bowel syndrome was identified from an apparently healthy adult population receiving a routine health maintenance program ( n = 2018). : Female gender is not a factor associated with irritable bowel syndrome or irritable bowel syndrome-related health care-seeking behaviour. Female irritable bowel syndrome subjects, irrespective of consulting behaviour for irritable bowel syndrome, are likely to have<3 bowel movements/week, hard/lumpy stools and abdominal fullness/bloating ( P < 0.05). Female irritable bowel syndrome subjects are prone to be absent from school/work with more days of absenteeism, irrespective of consultation status ( P < 0.05). Only female irritable bowel syndrome consulters have more absenteeism for their irritable bowel syndrome-related symptoms, reporting more sleep disturbances than their male counterparts ( P < 0.001). : In an apparent healthy adult population in Taiwan, gender difference is present in Rome II defined Chinese subjects with irritable bowel syndrome as regards bowel symptoms, social impact and sleep quality. Female predominance was not found in irritable bowel syndrome subjects and irritable bowel syndrome-related health care-seeking behaviour in the current population. Both irritable bowel syndrome non-consulters and consulters have similar gender difference profiles in presenting symptoms, suggesting that bowel symptoms per se may not be the only factor leading to health care-seeking behaviour. The gender differences in sleep problems were observed solely in irritable bowel syndrome consulter. [ABSTRACT FROM AUTHOR]

: Irritable bowel syndrome is a common condition seen in Western countries. In Asia, however, it is less known and even less studied. : To determine the prevalence and social impact of irritable bowel syndrome as well as the health-seeking behaviour of irritable bowel syndrome patients in Taiwan : Using the modified Rome II questionnaire, a survey was carried out in a population receiving physical check-up ( n = 2865). : The prevalence of irritable bowel syndrome in Taiwan was 22.1% and 17.5% (κ = 0.73) according to the Rome II and I criteria, respectively. No gender difference was found between subjects with and without irritable bowel syndrome symptoms. Irritable bowel syndrome subjects were likely to undertake an excessive number of physician-visits ( P < 0.01). Such subjects were often absent from work/school, with more days of absenteeism than irritable bowel syndrome-free subjects ( P < 0.01). They also suffered obvious sleep disturbance ( P < 0.01). Nearly half of the irritable bowel syndrome subjects were ‘consulters’, and they were more likely to have frequent physician-visits, suffer from work/school absenteeism, and endure sleep disturbance and bowel symptoms than irritable bowel syndrome nonconsulters ( P < 0.05). : Irritable bowel syndrome is common in a Chinese population of Taiwan. Similar to irritable bowel syndrome in the West, it also involves significant social and medical burdens. However, in the irritable bowel syndrome subjects of Taiwan there is no gender difference, and more irritable bowel syndrome subjects will seek physician consultations, which may be due to Taiwan's easily accessible and affordable heath care facilities. [ABSTRACT FROM AUTHOR]

This paper investigates theoretically a factor that impacts the institutional and structural environment of initiating small investments in Taiwan, namely personal relationship networks. A potential investor needs market opportunities in order to earn profit, business organization to exploit the opportunity, and capital to initiate the business. In Taiwan's network economy, the solidarity provided by “family” networks makes small initial business organizations possible. Subcontracting systems, both horizontal and vertical, make the entry-level investment low, and the decentralized production/marketing processes provide numerous market opportunities for small investments. Taiwanese entrepreneurs opt to start their business ventures primarily through the use of network financing, since bank loans fall under the dominion of government policies. [ABSTRACT FROM AUTHOR]