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An 8-month-old intact female shorthair domestic cat was referred to the National Chung Hsing University Veterinary Medical Teaching Hospital for uncontrolled chronic otitis in both ears. The affected ears revealed purulent discharge, erosion with bleeding and brownish-black proliferative tissue in the opening of both ear canals. Cytological examination of the discharge revealed the presence of gram-positive coccoid bacteria. We carried out histopathological examinations of biopsies obtained from friable and proliferative tissues of both ears. Based on the clinical and histopathological characteristics, proliferative and necrotizing otitis externa (PNOE) was diagnosed. Treatment was initiated with a combination of twice-daily application of 0.1% tacrolimus ointment and a once-daily otic lotion containing hydrocortisone aceponate, miconazole nitrate and gentamicin sulfate following the administration of once-daily anti-bacterial flush which contains tromethamine, edetate disodium dehydrate (EDTA) buffered to pH 8 with tromethamine hydrochloride and deionized water. The antibiotic ear lotion was withdrawn in the absence of purulent discharge in both ears after 11 weeks. Most proliferative lesions resolved after 17 weeks, and we tapered the dosage of 0.1% tacrolimus from once daily to once weekly during the year follow-up period. However, in our case, partial remission of PNOE was observed with the application of a combination of 0.1% tacrolimus ointment and a commercial ear lotion. The cat was healthy and had a good quality of life. To our knowledge, this is the first report of PNOE in a cat in Taiwan. [ABSTRACT FROM AUTHOR]

Background: A burn scar is a type of hypertrophic scar that can cause significant clinical symptoms, discomfort, and post-burn scar (PBS) syndrome in up to 77% of patients with burn injuries. Medication and rehabilitation are rarely effective at managing patient discomfort, and both laser and surgical interventions are postponed until the scar stabilizes and discomfort is tolerable. Objectives: The present study was conducted to investigate the effectiveness of auricular acupuncture among burn victims from the Formosa Color Dust Explosion in Taiwan. Methods: We enrolled 31 victims of the 2016 Formosa Color Dust Explosion who met the study inclusion criteria. The intervention involved placement of magnetic beads over the auricular Shenmen and Subcortex acupoints on one ear. Patients performed selfmassage five times per day, and both magnet beads were removed between the fifth and seventh days during the sessions. Several evaluation tools were used to assess clinical symptoms: the visual analogue scale for pain assessment, Burn Man Itch Scale for perceived patient itchiness, 5-D Pruritus Scale for sleep quality, and heart rate variability (HRV) for effects on the autonomic nervous system. Results: The clinical symptoms were significantly decreased following the intervention, but the effect did not endure. The normal-to-normal heart rate interval, heart rate analysis abnormalities, and very low frequency heart rate were significantly decreased among patients with abnormal HRV (SD < 40) following treatment. Conclusion: Stimulation of the auricular Shenmen and Subcortex acupoints may effectively reduce pain, itchiness, and sleep disturbances among patients with PBS syndrome. [ABSTRACT FROM AUTHOR]

Measurement of real-ear-to-coupler differentials (RECDs) is a critical part of the hearing aid (HA) verification process. This study examines the validity of reference RECD values preset by the HA analyzer, Audioscan RM500, for deaf-and-hard-of-hearing (DHH) children in Taiwan. RECD measurements were performed on 658 ears of DHH children. A linear mixed model was used to analyze the reference and measured RECD values. The findings revealed slight disparities between normative RECD values from North America and those observed in Taiwanese DHH children. While generally small (less than 5 dB), these differences imply potential challenges in achieving optimal HA fitting in specific scenarios. Therefore, we recommend individualized RECD/REM measurements for cases of poor auditory performance, certain frequency ranges, or notable variations in ear canal volume. From a clinical perspective, while broadly applicable, the use of North American RECD normative data in Taiwan requires cautious consideration of potential minor variations. This study contributes to current knowledge by affirming the use of a Western RECD database for Taiwanese DHH children. However, we underscore the ongoing importance of individualized HA fitting strategies, particularly for cases with stagnant intervention progress. While built-in RECD reference values can offer preliminary fitting guidance, especially in busy clinical settings, our study sheds light on the circumstances where caution is essential. Audiologists can efficiently allocate their time and effort by focusing on personalized RECD measurements for cases exhibiting suboptimal intervention outcomes, thereby effectively optimizing HA gain settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Lin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background/purpose: This study performed a population-based analysis in the managements of adult ear, nose, and throat FBs in Taiwan.Methods: The Taiwan Longitudinal Health Insurance Database 2000 were used, which comprises 1,000,000 beneficiaries randomly sampled in 2000 with a follow-up period from 2000 to 2013. Patients aged >18 years with ear, nose, or throat FB were identified according to the International Codes of Diseases.Results: In total, 94,312 adults with ear (n = 21,786), nose (n = 1007), throat (n = 62,986), airway (n = 419), or esophageal (n = 8114) FB were identified. Emergency department visits were most common among patients with esophageal or airway FB (33.3% and 25.1%, respectively). X-rays were most commonly performed for patients with esophageal FB (44.8%), and computed tomography (CT) was most commonly used for those with airway FB (4.3%). Hospitalization rate was the highest among patients with airway FB (7.4%), followed by those with esophageal (3.0%) and nose (0.7%) FB. Patients with airway FBs corresponded with the highest rate of intensive care unit stay (58.1%), longest hospital stay (10.5 days), and highest in-hospital mortality rate (25.8%). A multiple logistic regression model indicated that old age, medical comorbidities, undergoing CT, and airway or esophageal FB were associated with hospitalization among adults with FB.Conclusion: Disparities were identified in the treatment of ear, nose, and throat FB in adults. This study provides population-based data that may serve as a reference for otolaryngologists in clinical FB management. [ABSTRACT FROM AUTHOR]

Sleep disturbance is a significant problem affecting around 50% of cancer patients. Non‐pharmacological interventions can be used to improve sleep quality in cancer patients, but little is known about the feasibility, acceptability, and effectiveness of auricular point acupressure (APA) to reduce sleep disturbance in women with ovarian cancer undergoing chemotherapy. A pilot randomized controlled trial was conducted at a publicly funded hospital in southern Taiwan. Fifty‐five eligible women were approached and 47 women participated. Women randomly assigned to the control group (n = 24) received sleep hygiene practices alone. Women in the intervention group (n = 23) received sleep hygiene practices and APA treatment which involved gentle fingertip pressure at acupoints on the external ear. The Pittsburgh Sleep Quality Index (PSQI) was completed at four time points. Forty women completed the trial giving a retention rate of 85%. Women receiving the intervention reported a 65% reduction in sleep disturbance according to PSQI global scores from Time 1 (mean = 13.2) to Time 2 (mean = 4.65) after 4 weeks of APA treatment. There was a further 10% decrease in PSQI scores at Time 3 (mean = 4.21) after 6 weeks of APA treatment. Compared to controls, women receiving APA had significantly lower PSQI mean global scores at both Time 2 and Time 3 (p < .001). APA treatment for women with ovarian cancer produced significantly improved sleep. Participants found the procedure easy to perform. Pilot findings support the feasibility of a longitudinal study with a larger, representative sample. [ABSTRACT FROM AUTHOR]

Aims and objectives This study examined the effects of auricular acupressure therapy on women with postpartum insomnia. Background Postpartum women generally have poor sleep quality because of frequent night-time breastfeeding during the first month after giving birth. Design A one-group pretest/post-test quasi-experiment was conducted. Methods A convenience sampling method was used to recruit participants at a postpartum centre (doing-the-month centre) in Northern Taiwan, from January 2014-July 2014. Thirty women with postpartum insomnia received auricular acupressure therapy on one auricular point (Shenmen point pressing) four times a day for 14 days. The Chinese version of the Pittsburgh Sleep Quality Index was used to assess sleep quality before and after the 14-day treatment. Results After the 14-day auricular acupressure treatment, the Pittsburgh Sleep Quality Index total scores of the women decreased from 8·7 (pretest) to 5·57 (post-test, 36% reduction). Scores on the subscales of the Pittsburgh Sleep Quality Index, including sleep quality, sleep latency, sleep duration and sleep disturbance, also statistically improved ( p < 0·05). Conclusions Hormone changes and frequent breastfeeding were identified as characteristics that may exacerbate poor sleep quality of postpartum women, for whom the auricular acupressure intervention may effectively improve sleep quality. Relevance to clinical practice Auricular acupressure can be an alternative complementary therapy to aid postpartum women with insomnia in improving sleep quality. [ABSTRACT FROM AUTHOR]

Background Anxiety and fatigue adversely affect women's postpartum recovery, but few effective non-pharmacological interventions are known to relieve these two common and unpleasant symptoms. Objectives To examine the efficacy of an auricular acupressure intervention provided during early postpartum in reducing anxiety, fatigue levels, cortisol levels, blood pressure, and heart rate. Design A single-blind, randomised controlled trial. Setting A 40-bed postpartum unit. Participants Women who underwent caesarean section were randomly allocated to two groups: intervention (auricular pressure, n = 40), and control (usual care, n = 40). Methods The intervention group received auricular acupressure on the shenmen acupoint twice a day (9 AM and 5 PM), and the control group received usual postpartum care. Serum cortisol levels were assessed by immunochemiluminescence, with blood pressure and heart rate assessed by electric sphygmomanometer. Anxiety and fatigue symptoms were assessed using the State Anxiety subscale of the State-Trait Anxiety Inventory and the Fatigue Continuum Form, respectively. Results Of the 76 women who completed the study, those who received auricular acupressure had significantly lower mean cortisol levels (mean difference = 4 μg/dl, p < 0.05), heart rate (mean difference = 9.2 beats/min, p < 0.001), anxiety symptoms (mean difference = 3.8, p < 0.01), and fatigue symptoms (mean difference = 7.1, p < 0.01) than women in the control group at 5 days postpartum. Conclusions Auricular acupressure is an effective non-pharmacological method for reducing cortisol levels, heart rate, anxiety, and fatigue in early postpartum after caesarean section. [ABSTRACT FROM AUTHOR]

Auricular acupoint stimulation has become a popular weight loss method. However, its efficacy for obesity treatment has not been fully studied. This study aimed to investigate the effect of a 10-week intervention of auricular electrical stimulation combined with auricular acupressure on weight reduction in obese outpatients. In this single-blind randomized sham-controlled study, 134 participants were randomly assigned to an experimental group receiving stimulation at true acupoints, or a sham group receiving stimulation delivered in the same manner but at sham acupoints. Each participant received nutrition counseling by a nutritionist weekly. The results showed significant differences in body mass index, blood pressure, total cholesterol, triglyceride, and leptin or adiponectin over time within the group, but not between the groups. This study could not exclude the effect of placebo and dietary consultation. Further study that adds a control group receiving no treatment is therefore needed to confirm the effects of auricular acupressure. [ABSTRACT FROM AUTHOR]

BACKGROUND: Bluetooth earphones can facilitate communications among workers engaged in manual(e.g., professional driver)or visual tasks (e.g., security guard). If workers remove their Bluetooth earphones due to poor fit, then communication effectiveness will decline, especially during manual or visual tasks. OBJECTIVES: (1) To identify which design properties of Bluetooth earphones can contribute to user comfort, and (2) to identify if person characteristics (i.e., gender and ear shapes in this study) are related to differences in comfort perception during earphone use. METHODS: 198 participants were recruited for this study.Individuals used four models of Bluetooth earphones in randomized order while performing computer tasks and then completed questionnaires on comfort perception specifically designed for this study. The 2 × 3 × 4 mixed design analysis of variance (ANOVA) was conducted to investigate the effects of gender, ear shape, and model condition. Results: The results indicated that there were significant differences in model on comfort perception. CONCLUSIONS: For earplugs, the shape of the earphone and the elasticity of material are important ergonomic concerns to improve the comfort perception. In addition, the adjustable tail length is an important ergonomic design property for the ear-hook. The information gained in this study should be useful in improving the ergonomic fitness of Bluetooth earphones. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the correlation of heart rate variability (HRV) and meridian electrical conductance among middle-aged women during an 8-week period of auricular acupressure (AA) treatment for weight reduction. Methods: Sixty (60) subjects were randomized either to a control group ( n=30) or to a treatment group with AA ( n=30). Anthropometric parameters, HRV indices, and meridian levels were measured before treatment, at the 5th week, and 1 week after the 8-week treatment period. Results: Although no significant changes were observed in body weight (BW) and body-mass index (BMI) from baseline to 1 week after AA treatment, a significant decrease in Waist Circumference (WC) was observed in the acupressure group. In contrast, the subjects' BW, BMI, and WC were significantly increased from baseline to the 9th week in the control group. With adjustment for baseline low frequencies (LF) of HRV, the LF at the 5th and 9th weeks in the acupressure groups was generally lower than that in the control group, with a p-value=0.027 using the mixed linear model. The meridian levels for Spleen, Bladder, and Gallbladder were significantly lower in the group subjected to acupressure than in the control group at the 5th week. Conclusions: The results of the present study indicate that AA tends to inactivate the sympathetic nervous activity demonstrated by both HRV and meridian electrical conductance changes. As a result, AA may modulate the autonomic nervous system to exert its physiological effect through the pathway of the meridian system. [ABSTRACT FROM AUTHOR]

The earlier one starts to smoke, the more likely it is that one's tobacco use will increase. Either auricular acupressure or multimedia education could improve physiological health status and reduce smoking for young smokers. This study aimed to evaluate the effects of a 10-week auricular acupressure (AA) and interactive multimedia (IM) on smoking cessation in college smokers. A pre and posttest control research design with two experiments (AA and IM) and one control was used. Thirty-two participants were in each of three groups. A significant difference from pretest to posttest among three groups was exhibited on carbonmonoxide (CO), cotinine, and nicotine dependence. Scheffe's post hoc test found significances on CO in the AA between the IM and the control and cotinine and nicotine dependence between the AA and the control. After controlling the covariates, the main effect of the group was no difference in all outcomes. The interventions, especially AA, may contribute to a decrease of CO, cotinine, and nicotine dependence along with the time change. An analysis without controlling influences may overestimate interventional effects. [ABSTRACT FROM AUTHOR]

Background: Environmental conditions can easily affect the body temperature of newborns because their central nervous system, which helps maintain body temperature, has not yet fully developed. Monitoring changes in newborn body temperature can help prevent harm caused by abnormally high and low body temperatures. Taking rectal temperature readings is the most reliable way to obtain core temperature. However, because inserting a thermometer into a newborn's rectum may cause discomfort and present health risks, this temperature-taking approach is no longer used in clinical settings. The axillary temperature readings now used, including ear and back temperature, have not been empirically verified to accurately reflect core body temperature. Convenient-to-use electronic thermometers have replaced traditional mercury thermometers in the clinic. However, nearly all research done until recent years has employed mercury thermometers for temperature measurement, there is a paucity of research employing electronic thermometers. Purpose: The purpose of this study was to investigate relationships among five temperature measurement sites (including tympanic temperature, rectal temperature, axillary temperature, and back temperature) in newborns. Method: This study used a descriptive-correlation design, employed convenience sampling, and collected data from August 2010 to February 2011 at a registered postpartum nursing home in Taipei. Thirty-three babies aged from 1 to 28 days old were recruited. MT-200 electronic thermometers were utilized to take back, axillary, and rectal temperature readings and an IRT4520 ear thermometer was used to take ear temperature readings. Collected data were analyzed using SPSS18.0 statistical software for descriptive statistics, Pearson correlation, generalized estimation equations (GEE), and intraclass correlation coefficient (ICC). Results: We identified the least difference between right tympanic temperature and rectal temperature' a significant relationship between left tympanic temperature and rectal temperature, and axillary temperature as the most stable of the 5 body-temperature reading methods, with no outliers. There were no gender differences among the five body temperatures. Results revealed the ICC of the five temperature measurement sites to be low during both morning and evening measurements. Conclusions / Implications for Practice: Current research suggests that tympanic temperature can replace rectal temperature readings. Findings may provide a reference to clinical nursing staffs and parents to measure newborn body temperature. [ABSTRACT FROM AUTHOR]

This study investigated the effects of auricular acupuncture on athletes' recovery abilities after exercise. Subjects were selected from twenty-four male elite university basketball players, randomly divided into two groups: auricular acupuncture group (AAG), and normal control group (NCG), each group containing twelve subjects. Auricular acupuncture was experimented to each AAG athlete while no auricular acupuncture was conducted to each NCG athlete. Each subject in both groups performed a ride on the stationary bike until exhausted. The data of heart rate (HRmax), oxygen consumption (VO2 max), and blood lactic acid were measured at four points of time: during the rest period after warm-ups and at the 5th, 30th and 60th minutes post-exercise, respectively. One-way ANOVA and repeated Scheffé methods were used to test the differences of the data between these two groups. The results showed that both HRmax and blood lactic acid in AAG were significantly lower than those in NCG at the 30th and 60th minutes post-exercise. This suggests that auricular acupuncture can enhance athletes' recovery abilities after aggressive exercise. [ABSTRACT FROM AUTHOR]

Background: Women report a higher incidence of sleep problems than men. Few studies addressing the effect of gender on the efficacy of administering auricular acupressure (AA) at shenmen points (heart meridian 7 [HT7]) on sleep quality have been published. Purpose: The primary aim of this study was to investigate the effects of a 4-week AA intervention applied at the HT7 points on sleep quality, perceived physical health, and perceived mental health in community-dwelling individuals with poor self-reported sleep quality. Additional analyses were used to evaluate the gender-specific effects of this intervention. Methods: A cluster randomized controlled trial with repeated-measures design was used. One hundred seventy-nine eligible participants were randomly assigned to either the AA group (n = 88; 47 women, 41 men) or the sleep hygiene instruction (SHI) group (n = 91; 52 women, 39 men). The AA group self-administered acupressure at HT7 on both ears for a 4-week period, whereas the SHI group received an SHI information sheet. Outcome measures included the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form Health Survey-12 Version 2, with data collected at baseline and at 2, 4, and 8 weeks posttest. Results: Linear mixed-model analysis revealed that the participants in the AA group experienced significantly greater reductions in mean PSQI global score and the three indices of sleep latency, subjective sleep quality, and daytime dysfunction than the SHI group at 2 and 4 weeks posttest. The improvements in subjective sleep quality and daytime dysfunction remained at 4 weeks posttest in the AA group, but not in the SHI group. The PSQI global score decreased significantly more in men than women in the AA group between baseline and 4 weeks posttest. Conclusions/Implications for Practice: Four weeks of self-administered acupressure at HT7 on both ears is an effective intervention for community-dwelling poor sleepers who are over 45 years old. Moreover, the improvements in subjective sleep quality and daytime dysfunction persist for up to 4 weeks after the end of the intervention. This self-administered acupressure intervention is more effective in men than in women in terms of improving sleep quality. Gender bias is known to influence research results and may lead to inappropriate generalizations. Thus, future studies that are performed to build basic scientific evidence should include considerations of the effects of gender in the study design. [ABSTRACT FROM AUTHOR]

Background: Previous studies have presented an unclear association between major depressive disorder (MDD) and tinnitus. Therefore, in this study, we aimed to demonstrate the actual association between MDD and new-onset tinnitus using a large, population-based dataset in Taiwan., Method: This case-control study used the data from the National Health Insurance Database. In total, 18,365 patients with tinnitus were recruited as cases, and 18,365 propensity score-matched patients without tinnitus were identified as controls. Logistic regression models were constructed to calculate the odds ratios (ORs) and to estimate the association between prior MDD and tinnitus., Results: MDD was found in 396 (2.16%) patients with tinnitus and 228 (1.24%) controls without tinnitus. The logistic regression model indicated that prior MDD was associated with tinnitus (adjusted OR, 1.74; 95% CI, 1.47-2.05). Moreover, MDD was positively associated with tinnitus among most subgroups. Notably, a significant association between MDD and tinnitus was observed among patients with diabetes (adjusted OR, 2.05) and hyperlipidemia (adjusted OR, 1.94). Furthermore, sensitivity analyses consistently found a relationship between prior MDD and tinnitus., Limitations: The database used in this study does not provide information regarding the lifestyle and gene factors., Conclusions: Our results showed a positive association between prior MDD and tinnitus. In addition, MDD may be one of the risk factors for tinnitus onset. Therefore, we recommended that the clinicians should be alert about the tinnitus condition among patients with MDD and provide appropriate interventions for them., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2019. Published by Elsevier B.V.)

Background: Smoking plays a disease-related risk factor and is however the principal cause of preventable death. Many studies support the use of combined rather than single interventions to stop smoking., Objective: This study aimed to evaluate the effects of auricular acupressure combined with multimedia instruction in comparison with auricular acupressure alone on smoking cessation in young adults., Method: A quasi-experimental research design was used and participants were assigned to experimental groups according to their preference. Group 1 received the 10-week program with auricular acupressure plus multimedia instruction; Group 2 received auricular acupressure alone. Thirty-two participants were in each group were recruited from universities in Taiwan. The physical and psychological data were collected right before and after the program., Results: This study demonstrated the effects of smoking cessation on physical and psychological factors in each group. Statistical between-group differences existed in psychological factors of smoking cessation self-efficacy and nicotine dependence, but not in physical factors of carbon monoxide and cotinine., Conclusions: This study adds to the body of research on the benefits of using auricular acupressure combined with or without multimedia instruction for smoking cessation in adolescents. The combined intervention was more effective especially in increasing smoking cessation self-efficacy and decreasing nicotine dependence. Further study is suggested adding control groups such as placebo in order to understand a single effect of smoking cessation., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

Myopia is a major health problem, not only because of its high prevalence in Asia but also because it contributes to visual morbidity. This study aimed to evaluate the effect of ear acupressure for visual improvement on school children in Taiwan. Participants were fifth-grade school children with visual acuity between 6/37.5 and 6/9.6 in one eye. The experimental group (n = 35) received a 15-week ear acupressure intervention with seed embedding; the control group (n = 35) did not. Data for demographic factors, visual acuity, refractive error, and behavior toward visual health were collected before and after the intervention. The significant differences were observed between the two groups in visual acuity (p = 0.02), refractive error (p = 0.04), and behaviors toward visual health (p = 0.045). Performing ear acupressure may facilitate improved visual health for children. However, it requires more extended studies exploring its effects on elementary students in different grades. Longitudinal effects of this intervention also require further study.

Japanese, Taiwanese, and Koreans, after drinking amounts of alcohol that have no detectable effect on Caucasoids, respond with a marked facial flushing and mild to moderate symptoms of intoxication. Group differences are present at birth, and are probably related to variations in autonomic reactivity.