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Simple Summary: This study reviews the development of the cetacean stranding response program in Taiwan from 1994 to 2018, and examines 1320 stranding events involving 1698 animals across at least 27 species. The stranding rates have increased significantly over the years, with a notable rise in annual events from 16 to over 90. Seasonal variation demonstrates higher stranding rates during the northeastern monsoon season. The study highlights the spatial distribution of strandings, with the highest frequency in northern Taiwan and mass strandings predominantly in the southwest. Additionally, live strandings accounted for 29.5% of events and 38.9% of animals. The rescue and rehabilitation of some individuals have been conducted, and 15 individuals have been released since 2000. The findings underscore the diversity and stranding patterns of cetaceans around Taiwanese waters, and provide valuable information for developing conservation strategies in the western Pacific. A national cetacean stranding response program in Taiwan has evolved significantly in the past three decades. Initially co-ordinated by National Taiwan University from 1994, the program transitioned to the Taiwan Cetacean Society in 1999, and local governments took on a more prominent role after 2009. A comprehensive stranding database (1994–2018) has been maintained, which documented 1320 stranding events involving 1698 animals from at least 27 species. The most commonly stranded species include finless porpoises, bottlenose dolphins, Kogia spp., and Risso's dolphins. The stranding rates varied annually and seasonally, with increases noted from an average of 16 events per year for the first 3 years to 44–58 events per year between 1997 and 2015, and a sharp rise to over 90 events per year for the period of the last three years. Seasonal variations were also significant, with higher stranding rates during the northeastern monsoon (NEM, October to next April) than that during southwestern monsoon (SWM, May to September). From the aspect of distribution, more frequent and even strandings occurred along the coast of northern Taiwan, while mass strandings were concentrated in the southwestern counties during NEM. Among all strandings, 390 events (29.5%) and 660 animals (38.9%) were live ones. Under great effort in rescuing and rehabilitating 52 cases, 15 cetacean individuals have been released since 2000. Additionally, there have been 56 mass strandings involving at least 11 species since 1994, predominated by pygmy killer whales, particularly during the NEM season along the southwest coast. This study not only contributes to our understanding of the stranding patterns and diversity of the cetaceans in Taiwan, but also provides valuable insights for future conservation strategies on cetaceans in the western Pacific. [ABSTRACT FROM AUTHOR]

Background: Glofitamab is a bispecific antibody with promise for treating relapsed/refractory B‐cell lymphoma according to a phase 1/2 clinical trial. This study examined its real‐world effectiveness. Methods: This was an investigator‐initiated, multicenter retrospective study including 34 patients who had relapsed/refractory B‐cell lymphomas after at least three prior lines of therapy and received glofitamab monotherapy in a compassionate use program in Taiwan between January 2021 and October 2022. Results: At a median follow‐up of 15.9 months, 56% of patients responded to glofitamab and 23% achieved complete remission. Response to the previous line of therapy significantly correlated with response to glofitamab (p =.020). Most responses were durable; only five out of the 19 responders had documented disease recurrence at the data cutoff date. The estimated progression‐free survival (PFS) was 3.2 months, and the estimated 1‐year PFS was 33% for the entire cohort. PFS was better for responders than nonresponders (median PFS, 16.9 vs. 1.8 months; 1‐year PFS, 60% vs. 0%). Forty‐three cytokine release syndrome (CRS) events were observed, three of which were grade 3; all were manageable without glofitamab discontinuation. No immune effector cell–associated neurotoxicity was reported. Among seven hepatitis B virus (HBV) carriers (six had antiviral prophylaxis) and 14 patients with remote HBV (four had antiviral prophylaxis), no HBV reactivation was observed. Conclusions: In this real‐world cohort, glofitamab exhibited effectiveness comparable to trial results without excessive CRS or new safety issues. With appropriate prophylaxis, glofitamab‐treated patients with chronic or remote HBV infection are unlikely to experience virus reactivation. [ABSTRACT FROM AUTHOR]

The Ministry of Ecology and Environment of the People ' s Republic of China formulated the " Differentiated Response Requirement Based on Performance Grading" measures for heavy air pollution alerts in July 2019 to promote air quality improvement and economic development. Eleven alerts (four yellow, six orange, and one red alert) in Langfang were classified into 8 pollution processes. The results showed that the mean concentration of PM2.5 was 41.4~129.0 µg/m³. The pollution processes were classified according to the backward trajectory analysis surface meteorological field changes, including southwest air masses, southeast air masses, northwest air masses and local air masses. The back of high pressure, bottom of low pressure, and weak pressure system might lead to the transport from southern regions. Moreover, uniform and weak pressure fields were the major meteorological fields in the northwest direction and during local pollution episodes. The mean and peak concentrations of PM2.5 in the southwest and local pollution processes were higher than those in the southeast and northwest, indicating that when these two types of pollution occur, the air quality is even worse. In addition, based on the emission reduction ratios of pollutants at various warning levels, the WRF-CMAQ model was used to evaluate the effectiveness of the differentiated response requirements based on performance grading during the 11 warning periods. The warning period, the mean concentration of PM2.5 during the warning period decreased by 2.6% to 5.9%, and the peak concentration of PM2.5 decreased by 0.7% to 7.7%. Overall, implementing emergency measures effectively improved the air quality and played a role in "peak shaving". [ABSTRACT FROM AUTHOR]

Phthalates (PAEs) and alkylphenols (APs), known as endocrine-disrupting compounds (EDCs), are ubiquitous in aquatic environments worldwide and may be harmful to aquatic ecosystems. This study is the first to comprehensively assess the occurrence and potential ecological risks of 12 EDCs in the surface sediments of seven major harbors in Taiwan. In addition, a correlation model was established between the concentration levels of individual PAEs and APs in the sediments and their production. The total PAEs concentrations in the sediments ranged between 129–1894 ng/g dw (mean: 558 ± 479 ng/g dw). Total APs concentrations ranged between<0.2–913 ng/g dw with a mean of 52 ± 178 ng/g dw. Among the 12 EDCs, bis(2-ethylhexyl) phthalate (55.1%) and diisononyl phthalate (31.6%) were the predominant PAEs, while 4-nonylphenol (93.2%) was the main AP. The occurrence and concentrations of PAEs and APs in the sediments were significantly correlated with their production (r = 0.989, p <.01), reflecting the status and degree of anthropogenic pollution. The concentrations of PAEs and APs in the sediments of Taiwanese harbors showed a potential decreasing trend over time, which should be related to strengthened regulations and changes in the industrial market. The estimated total risk quotient (TRQ) of algae exposed to the concentrations of 12 EDCs in sediments suggests moderate to high potential risks (TRQ = 0.74–2.18), while crustaceans (TRQ = 0.02–0.27) and fish (TRQ = 0.03–0.10) may have low to moderate potential risks. The main compounds responsible for these risks are dibutyl phthalate, dioctyl phthalate, and 4-nonylphenols. The results show that the pollution degree of surface sediments in the harbor could reflect anthropogenic pollution. Therefore, it is necessary to monitor the pollution of surface sediments in harbors, grasp the pollution situation, and evaluate the regulatory effect. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) and its risk factors seem to be linked with deteriorated graft function and persists as the major cause of mortality in kidney transplant recipients (KTRs). Diet quality is associated with CVD prevention in the healthy population, however, less study focuses on KTRs. The study aimed to determine the association between diet quality indices and lipid profile abnormalities as risk factors for CVD in KTRs. This prospective study enrolled 106 KTRs who had functioning allografts from September 2016. Lipid profiles included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) and were based on the National Cholesterol Education Program Adult Treatment Panel III recommendations. Three-day dietary data were collected by a well-trained registered dietitian. The Alternative Healthy Eating Index-Taiwan (AHEI-Taiwan), Alternative Healthy Eating Index-2010 (AHEI-2010), and Healthy Eating Index-2015 (HEI-2015) scores were calculated and divided into quartiles and compared accordingly. KTRs' mean LDL-C, HDL-C, TC, and TG levels were 119.8 ± 36.6 mg/dL, 52.0 ± 17.9 mg/dL, 205.8 ± 43.9 mg/dL, and 160.2 ± 121.6 mg/dL, respectively. Compared with the lowest quartile, only the highest quartile of AHEI-Taiwan had lower TC and LDL-C levels. After adjustment for age, gender, energy, Charlson comorbidity index, transplant duration, and dialysis duration, logistic regression analysis revealed that the highest quartile of AHEI-Taiwan had 82% (odds ratio [OR], 0.18; 95% confidence interval [CI] 0.04–0.72, p < 0.05) lower odds of high TC and 88% (OR 0.12; 95% CI 0.03–0.58, p < 0.05) lower odds of high LDL-C, and the highest quartile of HEI-2015 had 77% (OR 0.23; 95% CI 0.05–0.95, p < 0.05) lower odds of high LDL-C. Higher adherence to a healthy diet as per AHEI-Taiwan and HEI-2015 guidelines associated with lower risk of lipid profile abnormalities in KTRs. [ABSTRACT FROM AUTHOR]

Due to the increasing prominence of social network services, political communication has experienced a paradigm shift. To communicate with internet users, politicians, candidates, and political organizations create fan pages. Initially, they provide text-only material on their pages; later, to increase engagement, they include photos, images, and videos. This paper investigates image-based political images in Taiwan for the first time during a nationwide referendum. Unlike an election, a referendum is a policy-based vote. We evaluate over 2000 Facebook images shared by the two most prominent political parties in order to comprehend the aspects of images and the tactics of political organizations. In addition, we examine the textual content, objects, and colors of the collected data. We find that the characteristics of propaganda materials vary between political groups. Nonetheless, the color strategies employed by both sides are equivalent, with each side utilizing its own representative colors for consolidation and the opponent's colors for attacking. [ABSTRACT FROM AUTHOR]

The rising incidence rate of prostate cancer (PCa) worldwide has become a public health concern. PCa has a multifactorial etiology, and the link between human papillomavirus (HPV) and PCa has been widely investigated by numerous case–control studies. This age-matched, case–control study included 143 PCa patients and 135 benign prostatic hyperplasia (BPH) patients, with prostatic specimens testing negative for malignancy, as control. Study participants were recruited from four major hospitals in Taoyuan City, Taiwan, period 2018–2020, looking into HPV infection and other PCa risk factors, including dietary habits, family history, personal lifestyle, and sexual behavior. Multiple logistic regression analysis and forward stepwise selection analysis were conducted to identify potential risk factors for PCa. HPV DNA was found in 10 of the 143 PCa cases (7%) and 2 of the 135 BPH controls (1.5%) (OR = 6.02, 95% CI = 1.03–30.3, p = 0.046). This association was slightly significant, and furthermore, high risk HPV was not found to be associated with PCa. Higher body mass index (BMI) (OR = 1.15, 95% CI = 1.05–1.27, p = 0.003), more total meat consumption (OR = 2.74, 95% CI = 1.26–5.94, p = 0.011), exhibited association to PCa. However, PCa family history only presented a statistically significant difference by forward stepwise analysis (OR = 3.91, 95% CI = 1.17–13.12, p = 0.027). While much focus has been on the association between HPV and PCa, the results of this study indicate that more efforts should be directed towards investigating dietary habits, personal lifestyle and family history as factors for PCa. These results could serve as a basis for designing PCa prevention strategies. [ABSTRACT FROM AUTHOR]

Background: Long-term behaviour change in type 2 diabetic patients may provide effective glycemic control. Purpose: To investigate the key factors that promote behaviour change in diabetic subjects using the transtheoretical model. Methods: Subjects were selected by purposive sampling from type 2 diabetes outpatients. Self-administered questionnaires were used to collect the data related to the stages of behavioural change. HbA1C values were measured to evaluate glycemic control. Data were analyzed with analysis of variance (ANOVA), multiple regression and multinomial logistic regression. Results: Routine management of diabetes was a key factor in behaviour change, which correlated indirectly with HbA1C values through compliance and was positively affected by social support. Undermining from family or friends was directly associated with HbA1C. Conclusions: Based on factors influencing stages of behaviour change in diabetic subjects, tailoring a programme to help patients balancing life-style with diabetes, strengthening the patients' perceived confidence in routine management, and establishing a patient-friendly environment as well as support systems may show promise for changing the behaviours in all diabetic patients. (Contains 5 tables, 1 figure, and 1 note.)

The concentrations level and distribution of 16 US EPA polycyclic aromatic hydrocarbon (PAHs) from the water treatment plant (WTP), sewage treatment plant (STP), and industrial water treatment plant (ITP) sludge in Taiwan were determined and then assessed the sources, and potential toxicity (carcinogenic polycyclic aromatic hydrocarbons [CPAHs] and toxic BaP equivalent [TEQ]). Results indicated that the total concentrations of PAHs ranged between 58 and 16,436 μg/kg dw. Among the 17 samples, the 2-4 ring of total PAHs were the predominant compound in three kinds of treatment plant (> 60%). Especially, ITP1 owns 95.8% of 2-4 ring of total PAHs and ITP3 owns 54% of five- and six-ring of total PAHs. The molecular indices and principal component analysis (PCA) were used to determine the source contributions, with the results showing that the contributions of combustion/grass, coal or wood combustion and combustion/ liquid (oil) fossil fuel combustion. A PAH toxicity indicated by TEQ was 2.5–506 μg TEQ/g dw. Although, the results indicated that these were not recommended for land applications, but analyses are beneficial to develop effective management strategies for controlling PAH discharge in treatment plants and establishing strategies for its reuse in managing pollutants. [ABSTRACT FROM AUTHOR]

Background: Daratumumab (DARA) introduced in the multiple myeloma (MM) treatment strategy, producing a direct antitumor activity and immunomodulatory effects in phase I-II trial GEN501. In the POLLUX trial, the combination of DARA with lenalidomide and dexamethasone (DRd) reported impressive response rates. In Taiwan, the Dara-based regimen was supported by National Health Insurance recently, but there were no real-world data in Taiwan. Materials and Methods: We described a heavily pretreated group of 31 patients with MM who had received one or more lines of therapy to receive DRd therapy after Taiwan Food and Drug Administration approval. The primary end point was progression-free survival (PFS). Results: After a median follow-up of 22.87 (95% confidence interval [CI]: 16–29.73) months, the median time to first response was 59 days (95% CI: 24.8–81.6). Median PFS was 24.082 months (95% CI: 14–33) in patients who received DRd therapy. Twelve-month PFS showed 80.7% in the DRd group. Patients who achieved at least very good partial response (VGPR) had longer median PFS (39.8 months) than those who achieved partial response (7.35 months). The complete response rate and VGPR were 35.5% and 29%, respectively. About 22.6% of patients had a partial response. The average treatment duration was 11.48 ± 7 months. Patient experienced biological relapse at 5.88 months after discontinuing DRd treatment. Conclusion: After DRd treatment for 11.48 months, most of the patients showed biological relapse at 5.88 months, suggesting the good efficacy; however, the need of a longer maintenance treatment of DARA. The median PFS in real-world setting was consistent with the POLLUX trial regardless of more patients with high cytogenetic risks. Patient who could achieve deep response above VGPR had better PFS than those who did not. [ABSTRACT FROM AUTHOR]

Background: Most studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving on injury outcomes among VRUs (vulnerable road users) in developing countries. This study aims to evaluate the effect of drunk driving on fatal injuries among VRUs (pedestrians, cyclists, or motorcyclists). Methods: The data were extracted from the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. Crashes involving one motorized vehicle and one VRU were considered. This study examines the effect of drunk driving by estimating multivariate logistic regression models of fatal injuries among VRUs after controlling for other variables. Results: Among 1,416,168 casualties, the fatality rate of VRUs involved in drunk driving was higher than that of general road users (2.1% vs. 0.6%). Drunk driving was a significant risk factor for fatal injuries among VRUs. Other risk factors for fatal injuries among VRUs included VRU age ≥ 65 years (adjusted odds ratio [AOR]: 5.24, 95% confidence interval [CI]: 5.53–6.07), a nighttime accident (AOR: 4.52, 95% CI: 4.22–4.84), and being hit by a heavy-duty vehicle (AOR: 2.83, 95% CI: 2.26–3.55). Subgroup analyses revealed a linear relationship between driver blood alcohol concentration (BAC) and the risk of fatal injury among motorcyclists. Motorcyclists exhibited the highest fatality rate when they had a BAC ≤ 0.03% (AOR: 3.54, 95% CI: 3.08–4.08). Conclusion: Drunk driving was associated with a higher risk of fatality for all VRUs. The risk of fatal injury among motorcyclists was linearly related to the BAC of the drunk drivers. Injuries were more severe for intoxicated motorcyclists, even those with BAC ≤ 0.03%, which is within the legal limit. [ABSTRACT FROM AUTHOR]

In response to relatively little evidence on the determinants of the financial distress in cooperative financial institutions (e.g., Credit Unions), this paper proposes a distress indicator of Merton Distance to default (Merton DD), which was constructed with a z-score, possessed improved predictive capability, but reducing equity volatility. This model possesses the advantages of both hazard and modified Merton DD model, which could timely reflect market volatility and predict when distress would occur. As a demonstration, we applied this model to forecast the financial distress of credit unions in Taiwan. The results can provide more information to researchers. [ABSTRACT FROM AUTHOR]

Rationale and Objective: Gut microbiota have been targeted by alternative therapies for non-communicable diseases. We examined the gut microbiota of a healthy Taiwanese population, identified various bacterial drivers in different demographics, and compared them with dialysis patients to associate kidney disease progression with changes in gut microbiota. Study Design: This was a cross-sectional cohort study. Settings and Participants: Fecal samples were obtained from 119 healthy Taiwanese volunteers, and 16S rRNA sequencing was done on the V3-V4 regions to identify the bacterial enterotypes. Twenty-six samples from the above cohort were compared with fecal samples from 22 peritoneal dialysis and 16 hemodialysis patients to identify species-level bacterial biomarkers in the dysbiotic gut of chronic kidney disease (CKD) patients. Results: Specific bacterial species were identified pertaining to different demographics such as gender, age, BMI, physical activity, and sleeping habits. Dialysis patients had a significant difference in gut microbiome composition compared to healthy controls. The most abundant genus identified in CKD patients was Bacteroides , and at the species level hemodialysis patients showed significant abundance in B. ovatus , B. caccae, B. uniformis , and peritoneal dialysis patients showed higher abundance in Blautia producta (p ≤ 0.05) than the control group. Pathways pertaining to the production of uremic toxins were enriched in CKD patients. The abundance of the bacterial species depended on the type of dialysis treatment. Conclusion: This study characterizes the healthy gut microbiome of a Taiwanese population in terms of various demographics. In a case-control examination, the results showed the alteration in gut microbiota in CKD patients corresponding to different dialysis treatments. Also, this study identified the bacterial species abundant in CKD patients and their possible role in complicating the patients' condition. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine whether disability acceptance, hope, and resilience mediate the relationship between functional disability and life satisfaction in people with a lived experience of an infectious viral disease (i.e., polio and postpolio syndrome [PPS]). Participants consisted of 157 individuals diagnosed with polio or PPS who were recruited from two community support organizations in Taiwan. Participants completed self-report questionnaires. Data were analyzed with a simultaneous regression analysis. The tri-mediation model indicated that disability acceptance, hope, and resilience were associated with life satisfaction, accounting for a large effect size of 46% of the variance in the life satisfaction scores. The direct effect of functional disability on life satisfaction became insignificant when the mediators were controlled for in the model. Hope, disability acceptance, and resilience were found to fully explain the association between functional disability and life satisfaction. This study demonstrated that positive psychosocial factors might help to buffer the indirect and direct negative effects of functional disability on life satisfaction. Implications of these findings for future research and clinical practice when supporting individuals with a lived experience of an infectious viral disease, including COVID-19, are discussed. [ABSTRACT FROM AUTHOR]

Routine maintenance of fishing vessels and wastewater discharges are primary sources of heavy metals in fishing ports. Sediment pollution assessment is necessary in fishing port management, including sediment dredging and disposal, sewage treatment facility construction, and pollution source control. In this study, sediment heavy metal contents in Qianzhen Fishing Port, the largest pelagic fishery port in Taiwan, were investigated to assess the contamination levels and related potential ecological risks using multiple sediment pollution indices. Normalization methods were applied to identify the potential sources of heavy metals in fishing port sediments. Results showed that Cu, Zn, Pb, and Cr contents in the sediments of the inner fishing port (averages of 276, 742, 113, and 221 mg/kg, respectively) were 3–5 times greater compared to those along the port entrance and outside, indicating the strong impacts of anthropogenic pollution (EFCu: 5.6–12.5; EFZn: 2.8–4.3; EFPb: 2.4–5.4; EFCr: 1.1–3.2). Copper pollution was more severe, with high maxima contamination factor (CFCu: 15.1–24.8), probably contributed by copper-based antifouling paints used in fishing vessels. The sediments in the inner fishing port are categorized as having considerable ecological risk and toxicity (mERMq: 0.61–0.91; ΣTU: 7.5–11.7) that can potentially cause adverse effects on benthic organisms. Qianzhen Fishing Port sediments can be characterized as high Cu/Fe and Pb/Fe, moderate Zn/Fe, and high total grease content, indicating that the potential sources of heavy metals are primarily antifouling paints and oil spills from the fishing vessels. This study provides valuable data for pollution control, remediation, and environmental management of fishing ports. [ABSTRACT FROM AUTHOR]

Background: The incidence of follicular lymphoma (FL) in Taiwan has not been well investigated since its inclusion as a histological subtype in the Taiwan Cancer Registry in 2008. The purpose of this study was to describe the incidence patterns of FL in Taiwan and compare the trends with those in other racial groups in the United States. Materials and methods: We conducted an epidemiological study using population-based data from the Taiwan Cancer Registry, Ministry of Health and Welfare, and the 18 Surveillance, Epidemiology, and End Results (SEER) registries to evaluate the FL incidence from 2008 to 2017. We calculated the annual percent change (APC) to describe the trends in the incidence of FL in subpopulations defined by race and sex over time. Results: The annual age-adjusted incidence rate of FL in Taiwan increased significantly from 0.59 per 100,000 persons in 2008 to 0.82 per 100,000 persons in 2017, with an APC of 3.2. By contrast, the incidence rate in whites in the United States during the same period decreased from 3.42 to 2.74 per 100,000 persons, with an APC of −2.1. We found no significant change for the blacks (APC, −1.5%), Hispanics (APC, −0.7%), and Asians or Pacific Islanders (APC, +0.7%). The temporal trend was similar between the males and females. The relative frequency of FL among the incident non-Hodgkin lymphoma (NHL) cases also increased significantly in Taiwan from 7.64% in 2008 to 11.11% in 2017 (APC = 3.8). The relative frequency of FL among the incident NHL cases in the whites decreased from 2008 to 2012 (APC, −3.8%) and then stabilized after 2012 (APC, −0.2%). By contrast, little change in relative frequency of FL among the incident NHL cases was observed in the blacks, Hispanics, and APIs between 2008 and 2017. Conclusion: We found increases in the incidence of FL and the relative frequency of FL among the incident NHL cases in both males and females in Taiwan from 2008 to 2017. The FL incidence rates were unchanged for all races and sex groups in the United States, except for the decreases in the whites. [ABSTRACT FROM AUTHOR]

This study aimed to assess the impact of diabetic retinopathy (DR) severity on the incidence of major adverse cardiac events (MACE) and end-stage renal disease (ESRD) in T1D patients. Patients diagnosed with T1D between 1999 and 2013 were identified from patient-level data of Taiwan's National Health Insurance Research database. A total of 1135 patients were included and classified into mild DR (n = 454), severe DR (n = 227), or non-DR (n = 454) by using propensity score matching. Multi-state model analyses, an extension of competing risk models with adjustment for transition-specific covariates for prediction of subsequent MACE and ESRD, were performed. MACE and ESRD risks were significantly higher in the severe DR patients; a 2.97-fold (1.73, 5.07) and 12.29-fold (6.50, 23.23) increase in the MACE risk among the severe DR patients compared to the mild DR and DR-free patients, respectively; and, a 5.91-fold (3.50, 9.99) and 82.31-fold (29.07, 233.04) greater ESRD risk of severe DR patients than that of the mild DR and DR-free groups, respectively (p < 0.001). Severity of DR was significantly associated with the late diabetes-related vascular events (i.e., MACE, ESRD) among T1D patients. [ABSTRACT FROM AUTHOR]

Background/purpose: Myeloma jaw lesions are not uncommon. The study aimed to investigate the status of jaw lesions and medication-related osteonecrosis of jaw (MRONJ) in multiple myeloma (MM) patients.Methods: One hundred and twenty-two consecutive newly-diagnosed MM patients seeking dental care at a hospital of southern Taiwan was examined according to jaw lesions with complete follow-up data.Results: Median age of the patients was 67.8 years, and 88.5% of patients were of DS stage III and 41.0% were of ISS stage III at diagnosis. Median survival was 37.9 months for 43 (35.2%) patients with jaw lesions and 57.4 months for 79 patients without jaw lesions. 1-year, 5-year and >7-year overall survival rates for patients with jaw lesions versus patients without jaw lesions were 94.9%, 67.2%, 56.7% vs 83.7%, 51.8%, 26.8% respectively. Patients with jaw lesions had the worse survival (P = 0.03). Neither age nor stage affected survival. Jaw lesions involved the mandible more often than the maxilla and stopped progressing during remission, but did not repair. Jaw lesions were the first evidence or recurrent sign of MM in six (4.9%) patients. Long-term monthly antiresorptive therapy changed the radiographic patterns of jawbones and induced MRONJ developing in 16.7% (8/48) of patients. Five (62.5%) MRONJ sites spontaneously occurred without local risk factors.Conclusion: Nearly one-third of MM patients develop osteolytic jaw lesions that seem to be associated with poorer survival. Jaw lesion is an independent prognostic predictor of survival in myeloma. Antiresorptive drugs at less frequent dosing regimen are crucial to minimize spontaneous MRONJ. [ABSTRACT FROM AUTHOR]

Complete disease journey and risk factors for poor outcomes are needed to facilitate effectiveness evaluations of new therapies and clinical decision-making in B-cell Non-Hodgkin lymphoma (B-NHL), particularly in Asia where such data are lacking. This retrospective cohort study used electronic medical records from a regional medical centre in southern Taiwan to follow-up 441 patients newly diagnosed with common B-NHL subtypes: Diffuse Large B-cell Lymphoma (DLBCL), Follicular Lymphoma (FL), Chronic Lymphocytic Leukaemia/Small Lymphocytic Lymphoma (CLL/SLL), Marginal Zone Lymphoma (MZL), Mantle Cell Lymphoma (MCL), and Waldenström macroglobulinemia (WM), between 01-Jan-2008 and 31-Dec-2013, until 31-Dec-2017. Treatment pathways were modelled using a Markov approach. Stage III/IV disease at diagnosis was frequent for patients with DLBCL, FL, MCL and WM. Hepatitis B surface antigen/hepatitis C virus seropositivity was 18.6%/12.3%. Clinical responses to 1st-line treatment were observed in 76.0% (DLBCL), 87.3% (FL), 86.0% (MZL), 60.0% (MCL), and 42.9% (WM) of patients. For DLBCL, disease control was achieved by ~ 50% after 1st-line, ~ 24% after 2nd-line, ~ 17% after 3rd-line. Patients with Stage III/IV DLBCL or age > 65 years at diagnosis had lower rates of active treatment, poorer disease control and higher mortality than patients with early stage disease or age ≤ 65 years. Disease flare < 6 months after 1st-line treatment was significantly associated with mortality. Despite good clinical response rates for some sub-types, survival remains poor. New treatments are needed to improve the outcome of B-NHL. [ABSTRACT FROM AUTHOR]

Background: Pharmaceutical care provided by well‐educated clinical pharmacists improves the safety and effectiveness of health care, especially regarding medication use, and can thus save costs. Aims: The aim of this study is to illustrate the implementation of the reimbursement policy of National Health Insurance for pharmaceutical care in Taiwan, to determine its influences on current health care practices, and to evaluate the quantity of pharmacy interventions. Materials & Methods: The inclusion criteria for this study were qualified pharmacists working in intensive care units (ICUs) at medical centers and regional hospitals or in clinics at district hospitals who provided pharmaceutical care services. Details of the pharmaceutical care they provided—including pharmacy notes (in the subjective, objective, assessment, and plan sequence), intervention type, and acceptance by physicians—were uploaded and documented via an online virtual private network platform, from which data were later collected and analyzed. Results: During the first quarter of 2019, a total of 260 pharmacists were included in the analysis, 109 of whom were from medical centers, 94 from regional hospitals, and 57 from district hospitals. The total person‐days of pharmaceutical care during the study period was 12 158 for medical centers, 7090 for regional hospitals, and 757 for district hospitals. The acceptance rates of the doctors were 98.3%, 89.5%, and 90.5% for medical centers, regional hospitals, and district hospitals, respectively. Discussion: The cost savings of pharmaceutical care was estimated by adverse drug events (ADEs) avoidance based on an average prolonged ICU stay of 2 days per ADE. Pharmaceutical care in ICUs resulted in a savings of 57 931 710 New Taiwan Dollars during the study period, with a cost‐benefit ratio of 13.7. Conculsion: Based on the cost effectiveness of pharmaceutical care in early 2019, the program should be reserved and expanded to different settings, and it will hopefully become an essential service provided by pharmacists in Taiwan. [ABSTRACT FROM AUTHOR]

This study evaluated the level of the contaminant of the heavy metals in sludge from different sources and the ecological risk criteria associated with it was also analyzed to establish its reuse in agriculture. The sludge samples were collected from the water plant (WTP), wastewater treatment plant (WWTP), and industrial water treatment plant (IPT) in Taiwan. The inductively coupled plasma mass spectrometry was used to measure the trace metals in sludge. The pollution level and ecological risk criteria for heavy metals in sludge were also used to evaluate its reuse in agriculture. The result shows the average concentrations of trace metals in sludge for three groups (WTP, WWTP, and ITP). Significant correlations were found between concentrations of Zn-Ag (p < 0.001). The higher values of Igeo showed in ITP, indicated Hg to be a major pollutant. In Taiwan, the regulations did not establish the reuse of sludge in agriculture. However, the concentration level of trace metals in sludge was particularly lower than the regular levels in most groups, like WTP and WWTP groups. The industrial sludge was not recommended for the use in agriculture. The results of this study can be used for regular monitoring to establish a reference for sludge management and application to agriculture. [ABSTRACT FROM AUTHOR]

This study investigates the existence of quarterly accrual anomalies in Taiwan's stock market. Our empirical results indicate that the arbitrage portfolios formed by the accounting accruals of the fourth‐quarter financial reports could result in abnormal returns, and thus, inferred that quarterly accrual anomalies exist. We further examined the causes of the accrual anomalies and determined that the manager conduct earnings management behavior during the fourth quarter. Managers execute discretionary accruals for management earnings forecast to meet previously issued financial forecasts, which leads to the fourth‐quarter accrual anomalies. The portfolios formed by using discretionary accruals and management earnings forecasts produce arbitrage portfolios with optimal return. [ABSTRACT FROM AUTHOR]

With the rapid growth of social network services, a paradigm shift in communication between media organizations and the audience has occurred. Numerous mass media agencies established fan pages on social platforms, such as Facebook, Twitter and Instagram, to disseminate breaking news, promote reports and interact with their audience. In this study, we leverage the reaction emojis delivered from users to media fan pages on Facebook to investigate how users react to media organizations and the implications of selective exposure. Using a 1-year-long observation of user activities on mass media pages, we perform a series of quantitative approaches to locate media agencies, measure the distances between them and cluster organizations into groups. A total of 30 fan pages of mass media organizations in Taiwan are investigated. The outcomes suggest that the report genres and topics are key factors to categorize media groups through reaction emojis from the online audience. [ABSTRACT FROM AUTHOR]

Background. Out-of-hospital cardiac arrest (OHCA) remains a big issue of critical care. It is well known that bystander cardiopulmonary resuscitation (CPR) with an automated external defibrillator (AED) used did improve the survival rate. Therefore, CPR education including basic life support (BLS) and AED has been advocated for years. It showed significant improvement of knowledge and willingness to perform CPR through adolescents after the course. However, little is known regarding the ability and learning effectiveness of school students who attend such courses. Therefore, this study aimed to evaluate the CPR effectiveness of both adolescents (12 years old) and adults who undergo the same course of BLS and AED. Methods. This is a retrospective study. Sixth-grade elementary school students in Northern Taiwan were selected to compare with the adult group. Both took 90 minutes of the BLS and AED course by the doctor with BLS instructor qualification. The primary outcomes were CPR quality and passing or failing the skill examination parameters. The secondary outcome was the posttraining written test and questionnaire of CPR willingness. Results. In the written test, there was a statistical difference in the pretest score except AED knowledge, but no difference was revealed in the posttest score. No statistical difference in CPR quality was noted. In the skill examination, only checking breathing status had statistical difference (elementary group (71%) vs. adult group (86%) (p = 0.003)). Conclusion. We revealed that sixth-grade elementary students' performance in CPR and AED was similar to that of adults after completing the current 90-minute course. Therefore, we strongly advocate offering CPR and AED courses to 12-year-old children, and these courses should emphasize checking the victim's breathing status. [ABSTRACT FROM AUTHOR]

A baseline study was undertaken on polycyclic aromatic hydrocarbons (PAHs) in phytoplankton. Plankton samples from six stations (duplicates) in Kaohsiung Harbor (KH), Taiwan along with a phytoplankton control sample afar from the harbor, were collected. We applied size-fractionation to isolate phytoplankton (55–120 μm), followed by sedimentation and centrifugation to remove abiogenic particulates. The phytoplankton was freeze-dried, extracted with acetone: n -hexane (1:1, v/v), and analyzed using GC–MS. ΣPAHs in phytoplankton ranged between 5204 and 28,903 ng/g dry weight (mean: 12,150 ng/g). The ΣPAHs in KH were >7 times than the control site (C1: 3972 ng/g). Cluster analysis showed spatial gradients (northern < southern KH). Accumulated PAHs in phytoplankton were from petrogenic (fishing ports and ships) and pyrogenic (river outflows), dominated by lower-ring PAHs, likely due to their higher bioavailability in the dissolved phase. We present a practical phytoplankton isolation technique for more accurate phytoplankton PAH concentrations with insights into their distribution and sources. [Display omitted] • First report on PAHs in size-fractionated marine harbor phytoplankton • Use of simple pre-treatment to isolate and study PAHs in phytoplankton • PAHs accumulated in phytoplankton are from pyrogenic and petrogenic sources. • Fishing ports and rivers are major PAH sources in phytoplankton from study area. [ABSTRACT FROM AUTHOR]

Purpose: Environmental turbulence represents a double-edged sword, simultaneously fueling and hindering a firm's entrepreneurial orientation (EO). Drawing on the theories of EO and network relationships, this study aims to develop and test a conceptual model that provides a nuanced account of the relationship between environmental turbulence and firm EO. Design/methodology/approach: Data for this study were collected using a survey of high-technology firms in Hsinchu Science Park (HSP) in Taiwan. Questionnaires were mailed to 297 high-technology firms in the semiconductor, photoelectric and communication industries within HSP. Completed questionnaires were received from 94 firms, which included responses from 94 research and development managers and 462 employees. Findings: The results reveal that the degree of environmental turbulence exhibits an inverted U-shaped relationship with a firm's EO. Moreover, this relationship is positively moderated by network relationships between firms, but negatively moderated by organizational inertia. Originality/value: The empirical and conceptual findings have important implications for understanding EO, because the findings explain causal relationships that transform a firm's interactive and inner control capabilities into firm-level results. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis patients have a high risk of mortality. The most common causes of death are cardiovascular disease and infection. The potential hazard or benefit associated with vitamin D use and cardiovascular or infection outcome is poorly characterized.Methods: We conducted a retrospective observational cohort study by recruiting 52,757 patients older than 20 years from Taiwan National Health Insurance Research Database (NHIRD) who initiated maintenance hemodialysis between 2001 and 2009. Patients who were prescribed activated vitamin D before the 360th day from hemodialysis initiation were defined as vitamin D users. The primary outcome of interest includes occurrence of acute myocardial infarction (AMI), ischemic stroke, lower limb amputation, and hospitalization for infection, respectively, while death events are treated as competing events. We conducted competing risk analysis using subdistribution hazard regression model to estimate subdistribution hazard ratios (SHRs) in relation to various outcomes.Results: During the median follow-up of 1019 days, the vitamin D users had a lower crude mortality rate, lower incidences of AMI, ischemic stroke, amputation, and hospitalization for infection compared with non-users. Taking into consideration competing events of death, vitamin D users were associated with a lower hazard of lower limb amputation (SHR 0.84 [95% CI, 0.74-0.96]) and hospitalization for infection (SHR 0.90 [95% CI, 0.87-0.94]), but not AMI or ischemic stroke, after adjustment for potential confounders. Subgroup analyses and dose response evaluation both showed a consistent association of activated vitamin D treatment with decreased risk of amputation and infection.Conclusion: The findings suggest that therapeutic activated vitamin D use in hemodialysis patients may be beneficial for decreasing infection events and amputation, of which the latter is a complication of peripheral vascular disease, rather than reducing major atherosclerotic cardiovascular events such as AMI or ischemic stroke. [ABSTRACT FROM AUTHOR]

Teng, Y.-M.; Wu, K.-S., and Wang, M.-J., 2020. Using the analytic hierarchy process (AHP) and Delphi analysis to evaluate key factors in the development of the Taiwan cruise tourism industry. Journal of Coastal Research, 36(4), 828–833. Coconut Creek (Florida), ISSN 0749-0208. In recent years, the cruise tourism industry in Asia has developed rapidly. Taiwan is surrounded by the sea and has four ports, namely, Keelung, Taichung, Kaohsiung, and Hualien Ports, which is an ideal place for the development of cruise tourism. Analyzing the key factors for the sustainable development of the cruise tourism industry in Taiwan is necessary due to the increasing demand for cruise tourism in Taiwan. Thus, the Delphi and analytic hierarchy process methods are used to evaluate the key factors in the development of the cruise tourism industry in Taiwan. Results reveal the influencing factors and provide reference for the government and cruise operators. [ABSTRACT FROM AUTHOR]

Rodent parvovirus infection is one of the common viral problems in laboratory rodent colonies. In this study, two new parvoviruses were identified in naturally-infected rats from two different research colonies in Taiwan. The genomic nucleotide sequences and the predicted amino acid sequences of proteins for these two viruses were compared to the previously characterized rodent parvoviruses. The two newly identified viruses were most closely related to each other, also closely related to two variants of rat minute virus (RMV; RMV-1 and RMV-2), and distinct from but closely related to Kilham rat virus and H-1 virus. These two viruses were significantly different from variants of rat parvovirus (RPV; RPV-1 and RPV-NTU1). Phylogenetic data also supported that these two new viruses are variants of the RMV species. These two newly identified viruses were designated RMV type National Taiwan University 1 (RMV-NTU1) and RMV type National Taiwan University 2 (RMV-NTU2). RMV-NTUs are the first molecularly characterized RMV variants identified in Asia. [ABSTRACT FROM AUTHOR]

Prototypic rat parvoviruses are among the most common infectious agents in laboratory rats worldwide. It is important to determine the infectious condition of rat parvoviruses in research colonies in Taiwan. In this study, virus species-specific PCR assays were applied to screen Kilham rat virus (KRV), Toolan's H-1 virus (H-1 virus), rat parvovirus (RPV) and rat minute virus (RMV) in 203 rats from five different research colonies in Taiwan. In this survey, the infection rate of rat parvoviruses was 19.2% (39/203), including KRV (12.3%; 25/203), RMV (8.9%; 18/203) and RPV (1.0%; 2/203). Dual infection of KRV and RMV were detected in 3.0% (6/203) of samples. No rats were positive for H-1 virus. The infectious rates of KRV and RMV detected in this study are much higher than those reported in USA and in Europe. Rat parvovirus PCR assays reported in this paper could be a useful tool for routine rat health monitoring program applied in laboratory rat facilities. [Chang YH, Liao YC, Wang KW, Hsieh SC, Wang MH, Fang BH, Chang CY, Chueh LL, Wan CH, PCR Surveillance of four prototypic rat parvoviruses in laboratory rat colonies in Taiwan, Taiwan Vet J 46(1): 1–7, 2020] [ABSTRACT FROM AUTHOR]

One of the most concerning emerging pollutants is microplastics (MPs), which can infiltrate soft tissues of organisms by ingestion, adhesion, and fusing and may even become embedded in biominerals. However, very little evidence is available about MPs in biominerals found in the wild. This study detected the abundance and characteristics of MPs in the shells of farmed oysters (Crassostrea angulata) off the coast of Taiwan and discussed the distribution, accumulation, and diversity in the oyster shells. The results showed that MPs were ubiquitous in oyster shells, with an average abundance of 0.70 ± 0.40 MPs/g. MPs abundance was significantly (p < 0.01) higher in small oyster shells (shell length < 6.5 cm, weight 5–10 g) and inorganic (CaCO 3) fraction (HCl digestion) than in large oyster shells (>6.5 cm, 10–25 g) and an organic fraction (H 2 O 2 digestion), respectively. However, there was no significant difference in MPs abundance between the top and bottom shells (p > 0.05). MPs with a size <2 mm accounted for 78.5 %, fibrous MPs for 93.7 %, and rayon for 89.5 %. The MPs diversity integrated index (MPDII) in oyster shells was low (0.27), and the small and fibrous MPs seemed more easily embedded in biominerals. The findings confirm the presence of MPs in oyster shells in coastal environments. In addition, oyster shells may contain higher amounts of MPs than soft tissues 4–5 times, which needs to be confirmed. Further revealing the distribution and accumulation of MPs in water/terrestrial biominerals will help to understand the fate of MPs in the environment. • Microplastics are found in the shells of coastal-farmed oysters. • Small size (<2 mm) and fibrous MPs are more likely to embed in oyster shells. • Rayon is the main polymer type, followed by PET, cellophane, and PP. • There is low diversity of MPs in oyster shells. [ABSTRACT FROM AUTHOR]

The present study applied the social-ecological framework to explore factors associated with adolescents' experiences in bullying victimization in Taiwanese middle schools. Data include a random sample of 1,262 students, ages 13–15, from 43 middle schools in Taiwan's New Taipei City. Hierarchical generalized linear modeling was utilized to analyze the data, which included hierarchical and nested structures, such as individual and area level variables. Descriptive statistics and basic inferential analysis were conducted to test the hypotheses that individual (delinquency), family (parental monitoring), school (teacher support and teacher/staff punishment), community (community environment), and area levels (poverty rate) were associated with bullying victimization. Findings reveal that individual (Grade 7, conduct problems), school (teacher/staff punishment), community environment, and criminal activities had significant effects on bullying victimization in Taiwan. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Early Cenozoic rift basins developed commonly on the Mesozoic basement along the SE Asia Continent. However, Eocene–Oligocene sequences were only exposed widely onshore Taiwan. We study benthic foraminifera and determine U–Pb geochronology of detrital zircon grains in the Early Cenozoic sequence onshore Taiwan for understanding if there was any significant change in faunal content and sediment provenance between the Eocene syn-rift sequences and the overlying Oligocene post-rift strata across the breakup unconformity. The Eocene syn-rift sequences are mostly of thick, cross-bedded sandstones of fluvial-deltaic depositions without marine fauna. Intensive study on the Eocene stratigraphy in more than ten sections all over the Taiwan mountain belt in the last three decades, shallow marine benthic foraminifera of Gaudryina hayasakai-Hanzawaia asterizana-Planularia okinoshimaensis-Heterolepa praecinta assemblage were found only in very limited exposures in the Western Foothills, central Taiwan. This study shows that the Eocene benthic foraminiferal assemblage is similar to the Shihtsaoan fauna in the overlying Oligocene post-rift marine strata. This indicates no significant faunal break across the breakup unconformity. As a consequence, Gaudryina hayasakai Zone of the Shihtsaoan age can extend downward to the Eocene and the Shihtsaoan Stage would be equivalent to the Hsuehshanian Stage established previously from northern Taiwan. The Taiwan Eocene marine sequences could be deposited in a normal-fault bounded narrow seaway or gulf connecting southeastward to the open Huatung Basin. U–Pb geochronology of detrital zircons in the Taiwan Eocene syn-rift sandstones shows a prominent age peak centered in Yenshanian (100–155 Ma) similar to the Paleocene–Oligocene fluvial-deltaic deposits in the East China Sea and is also comparable to the U–Pb zircon age spectrum of modern river sands of the Fujian Province, SE China. Petrographic study also suggests a prevailing sediment provenance of the Cathaysia granites and volcanics. These Cathaysia detritals were transported to the Taiwan Eocene grabens through some SE-flowing rivers. Structural reconstructions in previous study indicated that the mountain belt with the Eocene sequences in NE Taiwan had been shortened by imbricated thrusting westward for 160–200 km wide during the arc-continent collision in the last 6.5 Ma. Integrating paleontology and sedimentology evidence reveal that the Eocene coast was located along the modern shelf break of the East China Sea ~ 350–400 km east off the modern Chinese coast line. This implies that in the Eocene time (~ 40 Ma) there was no wide Asian epi-continental marginal seas off Chinese coast until the onset sedimentation of the Oligocene post-rift strata during opening of the South China Sea in the Early Oligocene time (~ 33 Ma). [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to evaluate the measurement structure of the Employers’ Stigmatizing Attitudes Toward Cancer Survivors Scale (ESATPD-Cancer Scale). Methods A quantitative descriptive design using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). One hundred and seventy-seven Taiwanese human resources (HR) professionals participated in this study. Results EFA revealed a one-factor measurement structure accounting for 50% of the total variance. We conducted a CFA to confirm the one-factor structure; after two pairs of error terms were correlated, the re-specified model was found to fit the data adequately: χ2/df = 1.69, GFI = 0.97, CFI = 0.98, and RMSEA = 0.06. Internal consistency reliability coefficient (Cronbach’s alpha) for the ESATPD-Cancer Scale was computed to be 0.80. In addition, stigmatizing attitudes were found to be negatively associated with HR professionals’ willingness to hire cancer survivors. Conclusions The results of this study support a one-factor measurement structure for the ESATPD-Cancer Scale in a sample of HR professionals in Taiwan. Findings also support a relationship between ESATPD-Cancer Scale scores and HR professionals’ willingness to hire cancer survivors, demonstrating support for the construct validity of the scale. [ABSTRACT FROM AUTHOR]

People with a chronic psychiatric disorder (CPD) have low employment rates worldwide. This multicenter retrospective cohort study examined the employment outcomes of an innovative in-house vocational training program for people with CPD in Taiwan and explored which program parameters significantly predicted outcomes. Data were retrieved from the records of 323 participants who completed the training program. Satisfactory employment rates were found at 1 (52.9%), 3 (60.4%), and 6 (65.6%) mo posttraining, and 38.7% of participants demonstrated high employment sustainability (employed throughout the first 6 mo posttraining). Three program parameters significantly predicted employment outcomes: (1) occupational therapists' pursuit of additional training or short-term apprenticeship pertinent to clients' job interests, (2) posttraining vocational counseling provided by community-based occupational therapists, and (3) the duration of 6 mo posttraining to allow clients to prepare for competitive employment. Occupational therapist--led in-house vocational training is a promising alternative to traditional vocational training for people with CPD. [ABSTRACT FROM AUTHOR]

Employment of migrant care workers (MCWs) is increasing, globalising, and is feminised, but the style, nature and extent of MCW policy in Taiwan is very different. This study explores the specific path for MCW policies amidst the globalisation of MCWs and analyses the intersection of the care, migration and employment regimes and compares these to South Korea’s and Japan’s migrant worker policies. This gives a deeper understanding of the formation and transition for Taiwan’s MCW policy. The similarities and uniqueness of Taiwan MCW policy are discussed in this study. [ABSTRACT FROM PUBLISHER]

Background/purpose: The incidence of multiple myeloma in Asia has risen in the past 30 years. Lenalidomide, an IMiD immunomodulatory agent, has improved the overall survival in patients with relapsed/refractory multiple myeloma (RRMM) when used with dexamethasone versus dexamethasone alone. This observational registry (T-CC-MM-009; NCT01752075) assessed the safety and efficacy of lenalidomide plus dexamethasone in a large Chinese population of patients with RRMM.Methods: This registry followed the first 100 patients treated with lenalidomide plus dexamethasone in Taiwan. Patients were ≥18 years old and had ≥1 prior treatment. The recommended starting dose for the first four 28-day cycles was 25 mg lenalidomide on days 1-21 and 40 mg dexamethasone on days 1-4, 9-12, and 17-20. Thereafter, dexamethasone was given on days 1-4 only. The primary objective was safety; secondary objectives were efficacy, lenalidomide dosage, and reasons for discontinuation.Results: The median duration of treatment was 34.6 weeks, and 75.5% completed ≥3 cycles. Most patients (82.7%) experienced ≥1 treatment-related adverse event; the most commonly reported were neutropenia (23.5%), thrombocytopenia (19.4%), anemia (16.3%), fatigue (16.3%), and hypoesthesia (15.3%). Bleeding events (25.5% of patients) were mostly grade 1/2 (80%). Three patients (3%) had venous thromboembolic events. Two invasive second primary malignancies were reported; however, time to onset was <1 year, suggesting they may not be related to lenalidomide. The overall response rate was 34.7%; median time to disease progression was 20.5 months.Conclusion: These data confirm the safety and efficacy of lenalidomide plus dexamethasone for patients with RRMM in Taiwan. [ABSTRACT FROM AUTHOR]

This study assesses the risk of fractures among children with Tourette syndrome (TS), and identifies the effects of comorbidities and antipsychotics. We randomly sampled the claims data of 1 million enrollees in the National Health Insurance program of Taiwan, and identified 1258 children with TS diagnosed between 2000 and 2010. Additionally, 12,580 children without TS who were frequency matched for sex, age, residential area, parental occupation, and index year were identified for comparison. The children's cases were followed until December 31, 2010, or censored to ascertain incident fractures cases and associations with comorbidities of attention-deficit/hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD) and treatments with antipsychotics, antidepressants, or clonidine. The TS cohort had a 1.27-fold higher incidence of fractures than did the comparison cohort (190.37 vs. 149.94 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.28 [95% confidence interval (CI) 1.06-1.55] based on multivariable Cox regression analysis. This increased risk of fractures was apparent for fractures of the skull, neck, and spine. Comorbid ADHD and OCD did not result in an additional risk of fractures. The children without both ADHD and OCD were also at a higher risk of fractures, indicating that TS alone increases the risk of fractures. The children taking antipsychotics had a reduced risk of fractures, and the adjusted HR decreased to 1.17 (95% CI 0.90-1.52). Children with TS have an increased risk of fractures. ADHD and OCD do not increase the risk further. [ABSTRACT FROM AUTHOR]

In this article, the authors intend to investigate the cross-strait economic integration and the dependence of stock markets between Mainland China and Taiwan. The authors first identify a sequence of important events that have loosened policy restrictions on transportation, commerce, and communication between mainland China and Taiwan. The authors employ various dependence functions to examine the degrees of dependence with symmetric and asymmetric structures to estimate the effects of economic integration on the tail dependence for the major industries. The authors find the market and industrial dependence has significantly increased as well as the market index due to the tendency of the cross-strait economic integration. [ABSTRACT FROM PUBLISHER]

Rehabilitation counselor skills, knowledge, and training are significant predictors of quality of employment outcome. In the past decade, vocational rehabilitation (VR) and placement-related work settings in Taiwan have gone through a tremendous amount of change to reflect changing policies, types of disabilities, and global factors. VR professionals’ competencies also need to be addressed to keep pace with this transformation. The purpose of this study was to validate the Taiwanese version of the Systems Approach to Placement: Self-Assessment for Students and Counselors (SAP-SASC), designed to identify critical areas of knowledge, skills, and competencies possessed by practicing VR professionals. A total of 116 participants completed the instrument. The participants represent (a) rehabilitation counseling master’s students from National Changhua University of Education, National Kaohsiung Normal University, and National Taiwan Normal University and (b) job coaches, VR case managers, and other VR professionals from the Council of Labor Affairs in Taichung, Changhua, Nantou, and Taipei counties. Multi-trait scaling analysis revealed eight components of VR professionals’ competence (client, health, education, family, social, employer, placement, and funding). The respondents expressed the highest level of competence in providing job seeking and social skills training, addressing job modification needs, performing job analysis, and referring clients of community-based support services. [ABSTRACT FROM AUTHOR]

The Kidney Disease Quality of Life–36 Questionnaire (KDQOL-36™), modified by RAND, has been widely used for measurement of quality of life among hemodialysis or peritoneal dialysis patients. The purpose of this study was to refine and evaluate, by using confirmatory factor analysis, the structure of the KDQOL-36™ when the questionnaire was used to evaluate chronic kidney disease patients in Stages 1 to 5 in Taiwan. The psychometric properties of the translated version were determined among Mandarin-speaking adults (N = 428). Because the sample data did not fit the hypothetical model, one item was deleted and nine error terms were estimated. After improving the model fit, the modified model was presented as follows: χ2 = 1390.903, χ2/df = 2.711, p < .001, goodness-of-fit index = .833, adjusted goodness-of-fit index = .806, root mean square error of approximation = .063. According to the study results, the researchers suggest that because of content overlap, some items may be deducted from the KDQOL-36™. [ABSTRACT FROM AUTHOR]

Phthalate esters (PAEs) are fat soluble synthetic chemicals, usually regarded as plasticizers for being added in numerous plastic products. Thus, environmental and health hazards of PAEs are associated with increasing plastic pollution. In this study, PAEs from sludge samples collected from water, sewage, and industrial treatment plants (N = 17) were analyzed using Gas Chromatography/Mass Spectrometry. Microplastics (MPs) were also quantified and correlated with PAEs. Results showed the highest average PAE concentrations in sewage treatment plants. The greatest ΣPAEs concentration were found in sewage treatment plant (STP4) with 32,414 μg/kg dw, while the lowest found in water treatment plant (WTP3) with 2062 μg/kg dw. Among different PAEs, di-(2-ethyl hexyl) phthalate (DEHP) contributes the highest. Similarly, DEHP, di-n-octyl phthalate (DnOP) and diisononyl phthalate (DiNP) significantly correlated with the total PAEs indicating their large contribution to sludge contamination. The abundance of microplastics in sludge ranged between 1 and 7 MP/g, highest at ITP6, but not detected in some stations. While microplastics may potentially increase PAEs, there was no significant relationship between ΣPAEs and MP abundance. The estimated human daily intake of DEHP and di-n-butyl phthalate (DnBP) when contaminated sludge be used showed low toxicological risks to exposed adults. This research presents the sludge characteristics, PAEs, and microplastic concentrations in different wastewater treatment plants in Taiwan. PAE contamination was highly contributed by domestic and industrial wastes shown by their significant amounts in STP and ITP. Results further provide evidence for potential sludge recycling (WTP sludge) and application to soil. [Display omitted] • The ΣPAEs concentration ranged between 2062 and 32,414 μg/kg in sludge samples. • DiNP, DnOP, DEHP contributed >94% of PAEs in sludge samples, except ITP2 and ITP6. • Low toxicological risk of WTP sludge shows possible disposal and soil application. [ABSTRACT FROM AUTHOR]

The accumulation of pollutants in the semi-enclosed waters of ports has long been a concern. This study assessed the pollution status, sources, and toxicity risks of 16 polycyclic aromatic hydrocarbons (PAHs) in surface sediments of 7 major ports in Taiwan. Total PAHs concentrations in sediments ranged between 8.4 and 572.5 ng/g dw, with an average of 112.4 ± 136.5 ng/g dw. The 3- and 4-ring PAHs (63 %) were the major constituents of PAHs in the sediments. Diagnostic ratios and positive matrix factorization analyses indicated that PAHs in sediments were mainly contributed by biomass combustion (45.0 %), coal combustion (31.5 %), and vehicle emissions and related fossil fuels (23.5 %). The results of ecological risk assessment showed a low–medium risk of PAHs in the sediments outside the port, whereas most of the sediments within the port presented a medium–high risk. An assessment of the possible human health risks indicated that PAHs were present at acceptable levels. [Display omitted] • Significant accumulation of PAHs in sediments of commercial ports in Taiwan. • Biomass and coal combustion are the main sources of PAHs in sediments. • Coal-fired power plants near ports are a source of PAHs in sediments. • TEQ of PAHs in the port sediments may pose moderate–high ecological risk. [ABSTRACT FROM AUTHOR]

Prior studies found bendamustine is efficacious in patients with indolent B-cell non-Hodgkin lymphoma (NHL). To date, no studies have reported the efficacy of bendamustine in a Chinese population. This multicentre phase II trial evaluated the pharmacokinetics (PK), safety and efficacy of bendamustine monotherapy in Chinese patients in Taiwan with pretreated indolent B-cell NHL or mantle cell lymphoma (MCL). For PK assessments, patients were randomized (n = 16; 11 with indolent B-cell NHL and five with MCL) to 90 or 120 mg/m(2) of bendamustine for the first cycle. Plasma levels of bendamustine and its two metabolites were analyzed. For efficacy and safety evaluations, bendamustine 120 mg/m(2) was given to all patients every 3 weeks starting at cycle 2 for a minimum of a total of six cycles. The median age of patients was 61.7 years, and the majority were men (75%). The median number of prior treatments was 4 (range, 1-9 regimens), and all patients were previously treated with rituximab. Bendamustine plasma concentration peaked near the end of infusion and was rapidly eliminated with a mean elimination half-life (t(1/2)) of 0.67-0.8 h. Of the evaluable patients (n = 14), the overall response rate was 78.6%, including 7.2% of patients having a complete response. Mean progression-free survival was 27.5 weeks. The most common grade 3-4 adverse events were leucopenia (56.3%), neutropenia (56.3%) and thrombocytopenia (25%). In conclusion, bendamustine was efficacious and well tolerated in Taiwanese patients with indolent NHL and MCL with a similar PK profile to that of other populations. [ABSTRACT FROM AUTHOR]

In the recent years, great importance has been shown toward the cultural creativity in Taiwan. Cultural identification and determining how best to apply it to commercial products require investigating and compiling a vast amount of cultural information, along with the individual ideas of designers, to develop new cultural products. During the product development and design process, the color scheme is the final and most important element. It not only represents the first image of the product but also elicits the important first-sight impression of consumers. Consequently, color ranks first in cultural commodity development. By understanding the Taiwanese culture, as well as assessing, verifying, and internalizing it into the materials that can be used by the designers, this study uses an artificial neural network system and simplifies the collected pictures that are representative of the Taiwanese culture into groups of different matching colors to assist designers in developing cultural commodities with different features and according to different cultural styles. © 2014 Wiley Periodicals, Inc. Col Res Appl, 40, 341-351, 2015 [ABSTRACT FROM AUTHOR]

Patents are important knowledge assets that enable firms to compete successfully and earn returns. To control spending on patent renewal fees, firms carefully analyze the value of their patents to determine whether patent rights need to be maintained, thereby rendering renewal decisions an opportunity to examine patent values. This study incorporates social network analysis and traditional patent indicators to empirically investigate the determinants affecting patent valuation by firms and research institutes in the Taiwanese and South Korean biotechnology industries. Results indicate that firms and research institutes value their patents differently. Certain indicators derived from knowledge flow and traditional patent indicators significantly affect patent value. Based on the findings, this study provides suggestions for policy-making. [ABSTRACT FROM AUTHOR]

Elder abuse is a serious issue in Taiwan because of rapid growth among the aging population and the deterioration of traditional values. Understanding of elder abuse in Taiwan has been fragmented, as a bulk of studies have primarily focused on socio-demographic characteristics and past childhood abuse. Only a handful of studies have focused on the environmental contexts. To address this research gap, we systematically review the prevalence, socio-demographic characteristics, and risk factors associated with elder abuse in Taiwan by applying Bronfenbrenner's ecological framework. Twenty-nine research articles are reviewed to address this research gap. Practice and policy implications are also discussed. [ABSTRACT FROM AUTHOR]

Recent studies show that hospitality and services can, if attractively designed, elicit positive responses from guests or customers. Although responses are individual and highly subjective, Fuzzy Quality Function Deployment (FQFD) may provide a competitive advantage to those who are able to read and interpret customers’ responses and needs in terms of hospitality services. This study introduces an integrative framework of Kano's model and FQFD applied to Taiwanese Ban-Doh banquet services. Kano's model with fuzzy sets was used and integrated into the FQFD method to show the relation between service attributes and customer responses. Kano's model categorizes service attributes into three major groups: Must-be, One-dimensional and Attractive. The findings of a case study involving six senior Ban-Doh chefs and 80 guests who attended Ban-Doh banquets are presented. By focusing on the quality of service characteristics that satisfy customers, this study enables service providers and managers to determine the extent to which they can prioritize the improvement of service design in Ban-Doh banquet services to satisfy customer expectations. [ABSTRACT FROM AUTHOR]

Forest thinning is an important method for managing forests, changing forest structure, biological diversity and community. This study examined forest thinning effects on macrofungal diversity and the environmental factors affecting fruiting and community structure. Field surveys were conducted from 2006 to 2010 in 35-year-old Cryptomeria japonica plantations in central Taiwan. Thinning was completed in October 2007 and included control, 25% thinning, and 50% thinning treatments. Each treatment had four replications. Forest thinning and time affected macrofungal species richness observed but not abundance. Thinning influenced macrofungal community compositions; however, the difference between the two thinning intensities was not significant. The macrofungal community showed significant differences between communities of eastern and northern aspect. A redundancy analysis indicated that macrofungal communities in the C. japonica plantations were significantly affected by relative humidity, light, canopy cover, soil water content, soil temperature, soil pH value and soil texture. The fruiting of a dominant coral fungal species, Scytinopogon sp., was affected by thinning and light. The fruiting bodies of this species decreased in the 25% thinning plots and disappeared in 50% thinning plots in the first two years post-thinning, but were recorded in the third year post-thinning. After thinning, macrofungal species richness observed decreased, the community changed, and changes were associated with environmental conditions. Forest thinning decreased observable macrofungal diversity and changed the community structure, and these changes were associated with environmental variation after thinning. [ABSTRACT FROM AUTHOR]