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This systematic review of research on adaptive learning used a strategic search process to synthesize research on adaptive learning based on publication trends, instructional context, research methodology components, research focus, adaptive strategies, and technologies. A total of 61 articles on adaptive learning were analyzed to describe the current state of research and identify gaps in the literature. Descriptive characteristics were recorded, including publication patterns, instructional context, and research methodology components. The count of adaptive learning articles published fluctuated across the decade and peaked in 2015. During this time, the largest concentration of adaptive learning articles appeared in Computers and Education. The majority of the studies occurred in higher education in Taiwan and the United States, with the highest concentration in the computer science discipline. The research focus, adaptive strategies, and adaptive technologies used in these studies were also reviewed. The research was aligned with various instructional design phases, with more studies examining design and development, and implementation and evaluation. For examining adaptive strategies, the authors examined both adaptive sources based on learner model and adaptive targets based on content and instructional model. Learning style was the most observed learner characteristic, while adaptive feedback and adaptive navigation were the most investigated adaptive targets. This study has implications for adaptive learning designers and future researchers regarding the gaps in adaptive learning research. Future studies might focus on the increasing availability and capacities of adaptive learning as a learning technology to assist individual learning and personalized growth. [ABSTRACT FROM AUTHOR]

Abstract: This study investigates the species of Cu and As (enargite) residues present in soils of the Chinkuashih area, northern Taiwan. Two pedons, on the shoulder and footslope along a toposequence, were examined for their metal partitioning and geochemical origins. The bulk soils were analyzed by sequential extraction combined with mineralogical analyses, including X-ray diffraction (XRD) and scanning electron microscopy ∕ energy dispersive spectrometer (SEM ∕ EDS) analyses. Soil pH ranged from 4.23 to 4.91 with low base saturation, and the soils can be classified as fine, mixed, thermic, Typic Kandiudults. Mineralogical study indicated that enargite and pyrite particles mainly coexisted in silt and sand fractions, particularly in lower soil horizons of the footslope, showing high contents of Cu and As. Kaolinite and illite were dominant minerals in clay fractions. The footslope accumulated more total Cu and As than that of shoulder pedon. The sequential extraction experiments resulted in high proportions of Cu remaining in residual fractions, while the most of As was bound in amorphous Fe and Al oxyhydroxide fraction. The risk analyses of Cu and As (enargite) contamination in soils of the Chinkuashih area merits further study. [Copyright &y& Elsevier]

Existing studies cannot evaluate the time-varying properties of frailty and polypharmacy despite raising concerns about their combined effects in older individuals. This study investigated the longitudinal association between different combined statuses of frailty and polypharmacy on risks of adverse outcomes. Retrospective cohort study. Subjects aged between 65 and 100 years (n = 100,000) were identified from Taiwan's National Health Insurance Research Database. Frailty was categorized into fit, mild, moderate, and severe frailty based on the multimorbidity frailty index. Concomitant use of 5 to 9 and ≥10 chronic medications was considered polypharmacy and excessive polypharmacy. We used generalized estimating equation models to examine the association among 12 groups of combined effects of frailty and polypharmacy and risks of all-cause mortality, all-cause hospitalization, and unplanned hospitalization. Age-stratified analyses were conducted for those aged 65 to 74, 75 to 84, and 85+ years. Compared with fit without polypharmacy, severe frailty with excess polypharmacy was associated with increased risks of adverse outcomes, particularly unplanned hospitalization (adjusted relative risk (aRR): 20.01 [95% confidence interval (CI)] 19.30–20.75). However, the combined effects varied in distinct groups. Within each polypharmacy category, there were dose-response associations between frailty category and adverse outcomes. For instance, within the polypharmacy group, the aRRs of mortality were 1.58 (1.52–1.64), 2.70 (2.60–2.80), 4.62 (4.44–4.82), and 6.81 (6.50–7.13) for the fit and mild, moderate, and severe frailty groups, respectively. By contrast, within each frailty category, the dose-response association between polypharmacy and adverse outcomes was limited to fit and mildly frail people. Age-stratified analyses yielded similar results. Both frailty and polypharmacy modified the risks of mortality and hospital admissions in older people, but the combined effects varied in distinct groups. This study thus highlights the potential to optimize care of older people by capturing the dynamic and combined changes related to frailty and polypharmacy. [ABSTRACT FROM AUTHOR]

Philadelphia chromosome-like (Ph-like) acute lymphoblastic leukaemia (ALL), a high-risk subtype characterised by genomic alterations that activate cytokine receptor and kinase signalling, is associated with inferior outcomes in most childhood ALL clinical trials. Half of the patients with Ph-like ALL have kinase rearrangements or fusions. We examined the frequency and spectrum of these fusions using a retrospective cohort of 212 newly diagnosed patients with childhood B-cell ALL. Samples without known chromosomal alterations were subject to multiplex reverse transcription polymerase chain reaction to identify known Ph-like kinase fusions. Immunoglobulin heavy chain locus (IGH) capture and kinase capture were applied to samples without known kinase fusions. We detected known kinase fusions in five of 212 patients, comprising EBF1-PDGFRB, ETV6-ABL1, ZC3HAV1-ABL2, EPOR-IGH, and CNTRL-ABL1. Two patients with P2RY8-CRLF2 were identified. Patients with non-Ph kinase fusions had inferior 5-year event-free survival and overall survival compared with patients with other common genetic alterations. The prevalence of non-Ph kinase fusions in our Taiwanese cohort was lower than that reported in Caucasian populations. Future clinical trials with tyrosine kinase inhibitors may be indicated in Taiwan because of the inferior outcomes for B-cell ALL with kinase fusions. [ABSTRACT FROM AUTHOR]

• This study characterized the complete genome of an ST338 CA-MRSA strain isolated from a patient in China. • ST59 and ST338 MRSA are closely related in both phenotype and genotype, revealing a limitation of MLST in identifying similarities among isolates having different sequence types. • ST59 and ST338 MRSA may be transmitted among the communities of Taiwan and the Chinese mainland. To determine the molecular characteristics of a sequence type 338 community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strain and the relationship among MRSA strains from various lineages and areas. Whole-genome sequencing, genomic comparison, antimicrobial susceptibility testing, and hemolysis analysis were performed to identify the resistance determinants and virulence factors of strain ZY05 and the relationships among CC59 clones. MRSA strain ZY05 was resistant to tetracycline, erythromycin, and clindamycin, and the resistance genes erm (B) and tet (K) were detected in the genome. ZY05 harbors the genomic islands νSaα, νSaβ, νSaγ, and ΦSa2, the pathogenicity island νSa1, and virulence factors such as Panton–Valentine leukocidin, phenol-soluble modulins, alpha-hemolysin, enterotoxin B, enterotoxin K, and enterotoxin Q, which are the same as those present in ST59 strains. In addition, the virulence potential of ST338 did not differ from that of ST59. This strain contains the staphylococcal cassette chromosome mec (SCC mec) type V T , a distinct SCC mec type previously reported from Taiwan. The results of core genome multilocus sequence typing (cgMLST) analysis showed that the gene distances between ST59 and ST338 were close among CC59 isolates, while strains from Taiwan were identical to isolates from the Chinese mainland with respect to these two sequence types. The ST338 strain ZY05, which has a close genetic relationship to ST59 strains, is multidrug-resistant and highly virulent. Strains of two identical lineages, ST59 and ST338, from Taiwan and the Chinese mainland may have the same genetic background. [ABSTRACT FROM AUTHOR]

The study aimed to develop a real-time electromyography (EMG) signal acquiring and processing device that can acquire signal during electrical stimulation. Since electrical stimulation output can affect EMG signal acquisition, to integrate the two elements into one system, EMG signal transmitting and processing method has to be modified. The whole system was designed in a user-friendly and flexible manner. For EMG signal processing, the system applied Altera Field Programmable Gate Array (FPGA) as the core to instantly process real-time hybrid EMG signal and output the isolated signal in a highly efficient way. The system used the power spectral density to evaluate the accuracy of signal processing, and the cross correlation showed that the delay of real-time processing was only 250 μs. [ABSTRACT FROM AUTHOR]

Abstract: This study presents the efforts in archiving Chinese architecture using a long-range 3D laser scanner. A historical architecture, the main hall of the Pao-An Temple, was preserved in a digital format with the architectural shapes retrieved more accurate than traditional manual measurements did. The difficulties in measuring as-built free forms and curves up to the size of a building were encountered and solved to enable the display of the hidden inter-relationship between outdoor and indoor profiles through sections. This research identified the most error-prone measurements done by traditional approach by comparing original drawings with the final models which registered 1958 scans and sub-scans. To represent the special characteristics of as-built 3D temple form, the study includes the application of metadata in architecture, the information management of digital data, and the Internet display of large 3D data sets. [Copyright &y& Elsevier]

• Carbapenem-resistant A. baumannii (CRAB) is associated with high mortality rates. • Sequence types ST455 and ST787 CRAB belonging to CC455 are widespread in Taiwan. • Novel contact-dependent growth inhibition CDI TYTH1 was found in CC455. • CDI TYTH1 appears to be a functional epidemic genetic marker for CRAB. The aim of the study was to evaluate the distribution and function of contact-dependent growth inhibition (CDI) systems associated with carbapenem-resistant Acinetobacter baumannii (CRAB) isolates. Isolates were examined by multilocus sequence typing (MLST) and polymerase chain reaction (PCR) for the presence of CDI genes in CRAB and carbapenem-susceptible A. baumannii (CSAB) from patients with invasive disease in a medical center in Taiwan. Inter-bacterial competition assays were performed to characterize the in vitro function of the CDI system. A total of 89 (61.0%) CSAB and 57 (39.0%) CRAB isolates were collected and examined. ST787 (20/57; 35.1%) was the predominant sequence type among CRAB, followed by ST455 (10/57; 17.5%). More than half the CRAB (56.1%, 32/57) belonged to CC455 and more than one third (38.6%, 22/57) to CC92. A novel CDI system, cdi TYTH1 , was found in 87.7% (50/57) of the CRAB but in only 1.1% (1/89) of the CSAB isolates (P <0.00001). The cdi TYTH1 was also identified in 94.4% (17/18) of previously genome-sequenced CRAB isolates and only one CSAB isolate from Taiwan. Two other previously reported CDI (cdi 19606-1 and cdi 19606-2) were not found in these isolates, except both were found in one CSAB. All six CRAB without cdi TYTH1 showed growth inhibition by a CSAB carrying cdi TYTH1 in vitro. All clinical CRAB isolates belonging to the predominant CC455 carried the newly identified cdi TYTH1. This CDI system was widespread in CRAB clinical isolates and appeared to be an epidemic genetic marker for CRAB in Taiwan. The cdi TYTH1 was functional in vitro in bacterial competition assay. [ABSTRACT FROM AUTHOR]

Background. To determine the risk factors and prevalence of asymptomatic gastric polyps in the general population of Taiwan. Methods. Consecutive asymptomatic individuals completing a health examination during October 2015–March 2016 were enrolled in the study and subjected to upper GI endoscopy. Their demographic data and medical history were collected, and the prevalence of gastric polyps was calculated. The risk factors of gastric polyps were identified by analyzing these data through univariate and multivariate logistic regression. Results. Gastric polyp prevalence in the study population was 29.8%. Age range of 45–60 years, current smoking, and lack of regular exercise were found to be significantly associated with gastric polyps, whereas age range of 45–60 years (relative risk [RR], 1.59; 95% confidence interval [CI], 1.06–2.40) and current smoking (RR, 1.63; 95% CI, 1.04–2.55) were found to be independent predictors for gastric polyps. Conclusions. In Taiwan, asymptomatic gastric polyps have a prevalence of 29.8%. Age range of 45–60 years and current smoking may increase the risk of asymptomatic gastric polyps. [ABSTRACT FROM AUTHOR]

The incidence of nasopharyngeal carcinoma (NPC) in Southeast Asia and Taiwan is high due to epidemiological factors. Cisplatin-based chemoradiotherapy is an important treatment strategy with excellent outcomes for patients with NPC. However, the outcomes for patients who are refractory to cisplatin-based therapy are poor. Methods for risk stratification of patients with NPC undergoing cisplatin-based chemoradiotherapy require to be investigated. A previous study indicated that ubiquitin-conjugating enzyme E2 B (UBE2B) was able to regulate alkylating drug sensitivity in NPC cells. In the present study, the clinical significance of UBE2B expression in patients with NPC was analyzed. Analysis of the two available NPC datasets containing the UBE2B expression profile (GSE12452 and GSE68799) was performed to evaluate the UBE2B expression levels in NPC tissues compared with nasopharyngeal mucosal epithelial tissues. Furthermore, immunohistochemical staining was performed using anti-UBE2B antibodies on samples from 124 patients with NPC who underwent cisplatin-based chemoradiotherapy. Disease-specific survival (DSS), distant metastatic-free survival (DMeFS) and local recurrence-free survival (LRFS) of patients with high and low UBE2B expression was analyzed. Furthermore, the associations between UBE2B expression and the biological behavior of NPC cells were investigated in vitro. Using public NPC datasets and in vitro studies, it was identified that UBE2B expression levels were increased in NPC tumor tissues compared with those in mucosal epithelial tissues. The cell proliferation ability was decreased in UBE2B-deficient NPC cells as compared with that in UBE2B-proficient cells. Immunohistochemical analysis of 124 NPC tissues from patients who underwent cisplatin-based chemoradiotherapy indicated that high UBE2B expression levels were associated with poor DSS, DMeFS and LRFS. Multivariate regression analysis of factors influencing survival also confirmed that high UBE2B expression levels were a statistically significant independent risk factor for poor clinical outcomes in terms of DSS [hazard ratio (HR), 1.955; 95% CI 1.164-3.282], DMeFS (HR, 2.141; 95% CI 1.206-3.801) and LRFS (HR, 2.557; 95 CI 1.313-4.981). In vitro analysis indicated that O6-methylguanine-DNA methyltransferase attenuated cisplatin sensitivity induced by knockdown of UBE2B in NPC cells. In conclusion, the present study demonstrated that high UBE2B expression is associated with poor clinical outcomes for patients with NPC treated with cisplatin-based chemoradiotherapy. [ABSTRACT FROM AUTHOR]