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An outbreak occurred in Wanhua District of Taipei City. It was traced to a cluster infection originating from a teahouse. To prevent further large-scaled community spread, the Taipei City Government established the first community rapid test screening station. This report describes the station's strategy and performance and key factors that contributed to its operation. The project involves collaboration among various departments of Taipei City Government, including the health, environmental, police, transportation, and fire departments. The station provides rapid screening, polymerase chain reaction (PCR) testing, and immediate isolation and follow-up medical services upon the detection of a positive case. These services are accessible to local residents and are intended to ease hospitals' burdens. In 36 days, a total of 8532 people were tested, and 419 confirmed cases were identified. Over the same period, the weekly number of positive cases in Wanhua District decreased from 356 to 40, and the PCR positive rate decreased from 21.7% to 1.2%. The policy of establishing rapid screening station, contact tracing and mask wearing policy are key strategies for interrupting chains of transmission of COVID-19. This intervention has become a model for preventing the spread of the epidemic and establishing community rapid screening stations in Taiwan. [ABSTRACT FROM AUTHOR]

Background/purpose: Malpractice claims place heavy economic and emotional burdens on both dentists and patients. Recently, medical malpractice lawsuits are decreasing in prevalence but increasing in severity. The percentage of dental malpractice payments is also growing among the health profession. The present study aimed to explore criminal convictions in dental malpractice litigation and to analyze the factors affecting the judgment in dental disputes in Taiwan.Methods: The keywords "dentist," "professional negligence," "medical malpractice," and "professional liability" were used to search Taiwan's Law and Regulations Retrieving System for criminal dental malpractice cases in all district courts from January 1, 2000 to June 30, 2021. The eligible judgments were summarized and analyzed.Results: Overall, 425 cases were identified, with 28 dental disputes included in the final analysis. The dentists lost in 10 cases (35.7%). The average claim time was 36.75 ± 16.34 months. Taipei and Taichung dealt with more lawsuit cases (n = 8). Local clinics were the most common institution of the defendants (75%) and had the highest number of convictions (n = 9). Implant dentistry was the most common specialty involved. Expert testimony of the Medical Review Committee (MRC) had a high K coefficient of agreement with court judgments regarding professional negligence (p < 0.001).Conclusion: The overall criminal conviction rate was 35.7%. Implant therapy and local clinics had the highest rate of lawsuits and a considerably higher conviction rate. All guilty dentists were fined or given probation. The court judgments were highly consistent with the expert testimony of the MRC. [ABSTRACT FROM AUTHOR]

From 0200 to 1000 LST 2 June 2017, the shallow, east–west-oriented mei-yu front (<1 km) cannot move over the Yang-Ming Mountains (with peaks ∼1120 m) when it first arrives. The postfrontal cold air at the surface is deflected by the Yang-Ming Mountains and moves through the Keelung River and Tamsui River valleys into the Taipei basin. The shallow northerly winds are anchored along the northern side of the Yang-Ming Mountains for 8 h. In addition, the southwesterly barrier jet with maximum winds in the 900–950-hPa layer brings in abundant moisture and converges with the northwesterly flow in the southwestern flank of the mei-yu frontal cyclone. Therefore, torrential rain (>600 mm) occurs over the northern side of the Yang-Ming Mountains. From 1100 to 1200 LST, with the gradual deepening of the postfrontal cold air, the front finally passes over the Yang-Ming Mountains and arrives at the Taipei basin, which results in an east–west-oriented rainband with the rainfall maxima over the northwestern coast and Taipei basin. From 1300 to 1400 LST, the frontal rainband continues to move southward with rainfall over the northwestern slopes of the Snow Mountains. In the prefrontal southwesterly flow, the orographic lifting of the moisture-laden low-level winds results in heavy rainfall on the southwestern slopes of the Snow Mountains and the Central Mountain Range. With the terrain of the Yang-Ming Mountains removed in the high-resolution model, the mei-yu front moves quickly southward without a rainfall maximum over the northern tip of Taiwan. [ABSTRACT FROM AUTHOR]

Background: Undiagnosed tuberculosis (TB) patients hospitalized because of comorbidities constitute a challenge to TB control in hospitals. We aimed to assess the impact of introducing highly sensitive fluorescent microscopy for examining sputum smear to replace conventional microscopy under a high TB risk setting. Methods: We measured the impact of switch to fluorescent microscopy on the smear detection rate of culture-confirmed pulmonary TB, timing of respiratory isolation, and total non-isolated infectious person-days in hospital at a high-caseload medical center (approximately 400 TB cases annually) in Taipei. Multivariable Cox regression was applied to adjust for effects of covariates. The effect attributable to the improved smear detection rate was determined using causal mediation analysis. Results: After switch to fluorescence microscopy, median non-isolated infectious duration decreased from 12.5 days to 3 days (P<0.001). Compared with conventional microscopy, fluorescence microscopy increased sputum smear detection rate by two-fold (for all patients: from 22.8% to 48.1%, P<0.001; for patients with cavitary lung lesion: from 43% to 82%, P = 0.029) and was associated with a 2-fold higher likelihood of prompt respiratory isolation (odds ratio mediated by the increase in sputum smear detection rate: 1.8, 95% CI 1.3–2.5). Total non-isolated infectious patient-days in hospital decreased by 69% (from 4,778 patient-days per year to 1,502 patient-days per year). Conclusions: In a high TB caseload setting, highly sensitive rapid diagnostic tools could substantially improve timing of respiratory isolation and reduce the risk of nosocomial TB transmission. [ABSTRACT FROM AUTHOR]

To investigate the association between serum albumin levels and cause-specific mortality among community-dwelling older adults. This cohort study was based on data obtained from the government-sponsored Annual Geriatric Health Examination Program for the older adults in Taipei City between 2006 and 2010. The study sample consisted of 77,531 community-dwelling Taipei citizens (≥65 years old). Mortality was determined by matching the participants' medical records with national death files. Serum albumin levels were categorized into <3.6, 3.6-3.7, 3.8-3.9, 4.0-4.1, 4.2-4.3, and ≥4.4 g/dL. Cox proportional hazards regression models were used to evaluate the association between albumin levels and cause-specific mortality. Spline regression was used to calculate the risk of mortality associated with albumin levels, modeled as continuous variables. Community-dwelling older adults had a mean albumin level of 4.3 g/dL, which significantly reduced by age. Compared to albumin levels ≥4.4 g/dL, mildly low albumin levels (4.2-4.3 g/dL) were associated with an increased mortality risk (hazard ratio [HR]: 1.16, 95% confidence interval [CI]: 1.05-1.28 for all-cause mortality), and albumin levels <4.2 g/dL were associated with significantly higher rates of all-cause, cancer, cardiovascular, and respiratory mortalities. In the spline regression, the curve of mortality risk was relatively flat at an albumin level ≥4.4 g/dL, and the mortality risk gradually increased as the albumin level declined. Albumin levels ≥4.4 g/dL were associated with better survival among community-dwelling older adults, and mortality risk increased as the albumin level decreased. [ABSTRACT FROM AUTHOR]

Seasonal and spatial distributions of total mercury (THg) in the Danshuei Estuary and adjacent coastal areas near the ocean outfall of Taipei, Taiwan, have been successfully investigated from May 2003 to January 2005. We found spatio-temporal variation in THg levels in the Danshuei coastal area was the result of sources and supplies of Hg. High THg concentrations in sediments and seawater were particularly found near the effluent outfall. Average THg levels (avg.: 9–22 ng L−1) were much higher than those in surrounding coastal seawaters (avg.:1–2 ng L−1). Organic carbon contents then played vital roles in controlling water and sedimentary Hg concentrations and occurrences. Hg enrichment factor (EF) as an index of contamination status in surface sediments of the Danshuei coastal area averaged 2.0 ± 0.8 (EFs > 1), indicating an extra non-crustal source from anthropogenic loadings. It implies the Dansheui coastal environment nearby the sewer outfall is facing Hg pollution. • The coastal Hg pollution with source attribution was successfully explored by a portable flow injection mercury analyzer. • A non-conservative Hg behavior suggests active removal processes within Danshuei Estuary, Northern Taiwan. • Organic carbon contents play vital roles in controlling water and sedimentary Hg distributions and occurrences. • High Hg concentrations and enrichment factors in sediments and seawaters were found near the ocean outfall area. • It implies the Dansheui coastal environment is facing observable Hg contamination. [ABSTRACT FROM AUTHOR]

Vertical extinction profiles and columnar optical properties (optical depth, Angstrom exponent, lidar ratio, and particle depolarization) of aerosols were obtained by simultaneous measurements with a depolarization lidar and a sunphotometer at Taipei, Taiwan from February 2004 to January 2006. Columnar optical depths are high in Feb¿Apr (0.61¿0.75) by sunphotometer measurements. Lidar measurements show the contribution of aerosols in the free atmosphere on columnar optical depths are about 44¿50% in Feb¿Apr and about 26¿37% in other months. Back-trajectory analyses and depolarization measurements show almost all of non-spherical aerosols originated from Northwest China which indicate Asian dusts frequently transported to Taipei from dust source regions in the free atmosphere. Aerosols with depolarization lower than 5% are found mostly originated from South China or Southeast Asia. Good correlations between columnar lidar ratio, particle depolarization, and Angstrom exponent are found for cases that columnar water vapor less than 1.5 cm. The effect of water vapor on particle depolarization is briefly discussed. [Copyright &y& Elsevier]

Background/purpose: The age at menarche reflects a pubertal girl's physiologic maturity. The aims of this study were to evaluate the relationship between the age at menarche and skeletal maturation in female orthodontic patients.Methods: Hand-wrist radiographs and lateral cephalometric radiographs from 304 adolescent female subjects (age, 8-18.9 years) were selected from the files of the Department of Orthodontics, National Taiwan University Hospital (NTUH). Hand-wrist bone maturation stages were assessed using the NTUH Skeletal Maturation Index (NTUH-SMI). Cervical vertebral maturation stages (CVMS) were determined using the latest CVMS Index. Menarcheal ages were self-reported by the patients and verified by the patients' mothers. The relationships between the NTUH-SMI or CVM stages and menarcheal status were investigated.Results: More than 90% of the 148 subjects who had already attained menstruation had skeletal maturation beyond the NTUH-SMI stage four or CVMS III. However, the subjects who had never experienced menarche mostly had skeletal maturation before NTUH-SMI stage five or CVMS IV. During the period of orthodontic treatment, 19 females experienced their menarche. The mean age at menarche for the 167 female patients in total was 11.97 years. In average, menarche occurred between NTUH-SMI stages four and five or between CVM stages III and IV. The percentage of girls with menses increased from 1.2% at age 9 to 6.6% at age 10, 39.5% at age 11, 81.4% at age 12, 97% at age 13, and 100% at age 14. Compared with the results obtained 20 years previously, we found a downward shift of 0.47 years per decade for the mean age at menarche in female orthodontic patients.Conclusion: The majority of female orthodontic patients have passed the pubertal growth spurt when they experience their menarche. Menarche usually follows the pubertal growth spurt by about 1 year and occurs after NTUH-SMI stage four or CVMS III. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the prevalence of long-term urinary catheter (UC) indwelling and potentially inappropriate urinary catheterization among residents of long-term care facilities (LTCFs) in Taiwan. Method From January to March of 2007, residents with long-term urethral UC indwelling of LTCFs in northern Taipei were invited for study and were enrolled when the informed consent was obtained. For every subject, UC was removed by home care nurses, and self-voiding (SV) status was determined after a 4-hour observation period. Residual volume (RV) was measured when the UC was re-indwelled. Potentially inappropriate UC indwelling was defined by the concomitant presence of SV and the RV less than 150 mL. Results In total, 252 residents from eight LTCFs were screened and 45 out of 62 residents with long-term UC indwelling were enrolled (mean age = 80.4 ± 8.9 years, 40% were males, 95.6% were severely disabled). SV was noted in 86.7% (39/45) of study subjects, and 71.8% (28/39) self-voided subjects had their RV less than 150 mL. By definition, the prevalence of potentially inappropriate UC indwelling in this study was 62.2%. The mean RV was significantly lower in subjects with SV (101.3 ± 66.1 vs. 221.7 ± 154.1 mL, P = 0.002) and subjects with SV were more prone to have the RV less than 150 mL ( P = 0.018). Conclusion The prevalence of long-term UC indwelling among Taiwanese LTCF residents was high and a high proportion of their UC may be removable. A national audit and introducing a practice guideline for continence care in LTCFs may help to promote quality of care for institutionalized older people in Taiwan. [ABSTRACT FROM AUTHOR]

Introduction: Although an array of maternal and child-centered risks have been researched, considerably less is known about the effects of paternal influences on child's birth outcomes and early development. This longitudinal study thus examined the effects of paternal influences (parental stress, partner support, childcare and nursing, and father-child interaction) from early pregnancy to 2 years postpartum on pregnancy outcomes and toddlerhood development, with a simultaneous consideration of maternal depression.Methods: Pregnant women together with their partners were recruited from 2011 to 2016 at five selected hospitals in Taipei, Taiwan. In total, 440 families completed seven assessments from early pregnancy to 2 years postpartum. Self-reported data were analyzed using logistic regression and generalized estimating equation models.Results: The increment in parental stress from early to late pregnancy was independently and significantly associated with higher risks of low birthweight (adjusted odds ratio [aOR] = 5.3, 95% confidence interval [CI] = 1.0-27.7). In the postpartum years, paternal poorer childcare and nursing (aOR = 1.7, 95% CI = 1.0-3.0) and father-child interaction (aOR = 1.8, 95% CI = 1.2-2.9) were significantly associated with increased risks of child's suspected developmental delay up to 2 years postpartum, particularly among children of nondepressed mothers' children.Limitations: Selecting both parents in metropolitan areas with higher socioeconomic status may compromise the generalizability of the study.Conclusions: We suggested the essential role of longitudinal paternal influences from early pregnancy on birth outcomes and child's development during infancy and toddlerhood. Maternal depression remains critical to concern. [ABSTRACT FROM AUTHOR]

Abstract: Several studies have demonstrated that millions of people globally are potentially exposed to volcanic gases. Hydrogen sulfide is a typical gas in volcanic and geothermal areas. The gas is toxic at high concentrations that predominantly affects the nervous, cardiovascular, and respiratory systems. The WHO air quality guideline for hydrogen sulfide is 150μgm−3 (105ppb). The northwest part of Taipei is surrounded by sulfur-rich geothermal and hot springs. Active fumaroles and bubbling springs around the geothermal area emit acidic gases. In combination with automobile emissions, the pollution of acid aerosols is characteristic of the metropolis. This study considered sulfur-rich geothermal, suburban and downtown locations of this metropolis to evaluate geothermally emitted acid aerosol and H2S pollution. Acid aerosols were collected using a honeycomb denuder filter pack sampling system (HDS), and then analyzed by ion chromatography (IC). Results indicated that long-term geothermal emissions, automobile emissions and photochemical reactions have led to significant variations in air pollution among regions of metropolitan Taipei. The highest H2S concentration was 1705ppb in the geothermal area with low traffic density and the mean concentration was 404.06ppb, which was higher than WHO guideline and might cause eye irritation. The SO2 concentrations were relatively low (mean concentration was 3.9ppb) in this area. It may partially result from the chemical reduction reaction in the geothermal emission, which converted the SO2 gas into SO4 2− and H2S. Consequently, very high sulfate concentrations (mean concentration higher than 25.0μgm−3) were also observed in the area. The geothermal areas also emitted relatively high levels of aerosol acidity, Cl−, F−, PO4 3−, and N-containing aerosols. As a result, concentrations of HNO3, NO2 −, PO4 3−, and SO4 2− in metropolitan Taipei are significantly higher than those in other urban areas considered in other studies. These results provide evidence that geothermal emissions represent a significant source of acid aerosols in metropolitan Taipei. Therefore, in this metropolitan area, the combined health effects of air pollutants from automobiles and geothermal emissions should be particular concern. [Copyright &y& Elsevier]

Abstract: Metropolitan Taipei, which is located in the subtropical area, is characterized by high population and automobile densities. For convenience, most primary schools are located near major roads. This study explores the exposure of acid aerosols for schoolchildren in areas in Taipei with different traffic densities. Acid aerosols were collected by using a honeycomb denuder filter pack sampling system (HDS). Experimental results indicated that the air pollutants were significantly correlated with traffic densities. The ambient air NO2, SO2, HNO3, NO3 −, SO4 2−, and aerosol acidity concentrations were 31.3 ppb, 4.7 ppb, 1.3 ppb, 1.9 μg m−3, 18.5 μg m−3, and 49.5 nmol m−3 in high traffic density areas, and 6.1 ppb, 1.8 ppb, 0.9 ppb, 0.7 μg m−3, 8.8 μg m−3 and 14.7 nmol m−3 in low traffic density areas. The exposure levels of acid aerosols for schoolchildren would be higher than the measurements because the sampling height was 5 m above the ground. The SO2 levels were low (0.13–8.03 ppb) in the metropolitan Taipei. However, the SO4 2− concentrations were relatively high, and might be attributed to natural emissions of sulfur-rich geothermal sources. The seasonal variations of acid aerosol concentrations were also observed. The high levels of acidic particles in spring time may be attributed to the Asian dust storm and low height of the mixture layer. We conclude that automobile contributed not only the primary pollutants but also the secondary acid aerosols through the photochemical reaction. Schoolchildren were exposed to twice the acid aerosol concentrations in high traffic density areas compared to those in low traffic density areas. The incidence of allergic rhinitis of schoolchildren in the high traffic density areas was the highest in spring time. Accompanied by high temperature variation and high levels of air pollution in spring, the health risk of schoolchildren had been observed. [Copyright &y& Elsevier]

The optical properties (extinction-to-backscatter ratio, backscattering, depolarization, and backscatter-related Angstrom exponent) and height distribution of Asian dusts were measured using a two-wavelength Raman/depolarization lidar at Taipei, Taiwan, during the Asian dust seasons in 2004 and 2005. Dust layers were frequently observed in the free atmosphere (1–6km). Dust optical thickness ranged from 0.01 to 0.55; backscatter-related Angstrom exponents ranged from 0.42 to 1.47; and lidar ratios (extinction-to-backscatter ratio) for 355nm ranged from 32 to 72sr (steradian). The mean values of dust particle depolarization and extinction coefficient are and , respectively, which are close to the moderate dust depolarizations and extinctions observed in free atmosphere in China and Japan. Backscatter-related Angstrom exponents were found correlated positively with lidar ratio and negatively with particle depolarization, indicating that the dust optical characteristics are predominated by size distribution. Dusts were found to tend to exhibit unusual low depolarization properties under moist conditions (relative humidity ), and the possible explanations are discussed. [Copyright &y& Elsevier]