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Dialysis patients are more vulnerable and susceptible to the severe coronavirus disease 2019 (COVID-19) infection due to multiple comorbidities. Since Taiwan has the highest incidence and prevalence of treated end-stage kidney disease world-wide, it is crucial to act in advance to prevent a potential disaster. In the face of the COVID-19 pandemic, we implement proactive infection control measures to prevent it from spreading without sacrificing the dialysis care quality. In this article, we focused on hemodialysis vascular access (HVA) care in particular. As a life-line of hemodialysis (HD) patients, HVA care has a profound impact on the patient’s quality of dialysis and life. Specifically, in our facility, the working and office areas of the HD units are separated to reduce cross-infection. All elective procedures for HVA are postponed, and operating rooms equipped with a negative-pressure anteroom are used for the suspected or confirmed COVID-19 patients. Herein, we share how we modified our HVA care policy not only to prevent our patients from COVID-19 infection but also to maintain the quality of HVA care. [ABSTRACT FROM AUTHOR]

Oncology Nurse Navigation is a professional service that integrates complex medical care procedures and promotes patient awareness of the major nursing problems. Using pre-assessment strategies and the integration of medical care information, Nurse Navigators help patients and their families gain comprehensive medical information and nursing care guidance from their initial post-diagnosis visit to their follow-up visits after remission. This article describes the author's experience with a 53-year- old married overseas Chinese woman who had been diagnosed with a rare tumor, PEComa, and who had traveled to Taiwan for treatment. During the outpatient care period with tumor progression, in addition to disease-related psychological and physical discomfort and pain, the prolonged uncertainty regarding treatment had induced adjustment difficulties and psychological symptoms in the patient. The patient's husband continued to work at his job in order to support the family's finances and was not able to maintain a close understanding of his wife's situation. He developed emotional stress when he saw his wife's disease relapse. The authors used Oncology Nurse Navigation approaches to actively assess the needs of the patient and her spouse, to explore their psychological state using emotional assessment scales, to understand the impact of recurrence on the family, to provide available resources and information, to help the couple learn to cope with psychological adjustment symptoms, to enhance their cognitive understanding of the disease, and to learn useful measures that helped them regain physical control, control over the treatment process, and effectively adapt to the disease and its effects. The authors' experience using Oncology Nurse Navigation with this patient may serve as a reference for healthcare professionals to facilitate the proactive assessment of patient needs at different stages of outpatient care, to remove barriers to seeking medical care through early interventions, and to implement a comprehensive and patient-centered approach to cancer treatment that may improve cancer treatment efficacy and quality of care. [ABSTRACT FROM AUTHOR]

Inter-facility transfer of patients with type A aortic dissection (AD) requires timely and efficient medical care. However, the quality of care provided during the transfer remains largely unknown. This study aimed to evaluate the quality of care of patients with type A AD who underwent inter-facility transfer at a single medical center in Taiwan. This retrospective cohort study enrolled all patients with type A AD who underwent interfacility transfer between January 2017 and December 2019. Patients with complete transfer records and electronic medical charts in the emergency department (ED) were included. Patients who experienced a cardiac arrest episode before transfer were excluded due to poor outcomes. Patients were divided into two groups based on their hemodynamic status: the ideal group with values within the desirable range heart rate (HR) <60 bpm and systolic blood pressure (SBP): 100-120 mmHg and the control group with values out of range (HR >60 bpm or SBP <100 or >120 mmHg) before the transfer. We conducted an analysis of variations of hemodynamic status after the transfer. Among the 378 patients transferred with type A AD, 36 (31.9%) in the ideal group and 255 (96.2%) in the control group experienced hemodynamic deterioration after the transfer. In the ideal group and control group, the presence of nurses and emergency physicians assisting in the transfer accounted for only 6.2% and 7.95%, respectively. The ideal group had a significantly better survival outcome (adjusted OR (aOR): 1.25, 95% confidence interval (CI): 1.12-2.45) compared to the control group. The quality of interfacility transfer in patients with type A AD is inadequate. Hemodynamic deterioration should be managed by ambulance crews during the transfer. [ABSTRACT FROM AUTHOR]

Background: The commitment of nursing preceptors to their role is an important driving force that supports their clinical teaching and affects teaching quality. Role commitment undergoes dynamic development and thus changes over time. Existing studies have utilized only cross-sectional study designs and have not analyzed the changes in commitment trajectories with related factors. Purpose: This study aimed to investigate the development trajectories of the commitment of preceptors and to examine the predictors between the trajectories of role commitment among nursing preceptors. Methods: A single-group, repeated-measures design was adopted, and 59 participants completed the Commitment to the Preceptor Role Scale and the Preceptor_s Perception of Support Scale. The latent class growth analysis method was used to estimate the trajectory class patterns. The Wilcoxon rank-sum test, a nonparametric method, was used to compare the differences in demographic characteristics between the trajectories of commitment among nursing preceptors. Predictorswere examined using binary logistic regression analysis. Results: The two-class model was the best-fitting model to describe the trajectories of nursing preceptor commitment. The two classes in this model were "low commitment," which accounted for 90.3% of all the participants, and "high commitment," which accounted for 9.7%. A significant difference was found between the two classes in terms of motivation for being a preceptor (p = .048). Neither demographic characteristics nor organizational support had a predictive effect on the trajectories of commitment development. Conclusions/Implications for Practice: This study found a low level of role commitment among new preceptors. Moreover, internal motivation was found to be a significant factor affecting the trajectories of this commitment. Therefore, institutions should foster an appropriate environment to enhance the role identity of preceptors as well as cultivate and stimulate their commitment to this role. [ABSTRACT FROM AUTHOR]

Objective: To investigate factors influencing commitment to human papilloma virus (HPV) vaccination and prior vaccination among female college students in northern Taiwan. Methods: A quota sample of 400 female college students was recruited from nine colleges in northern Taiwan during March 2013. Of these, 398 completed the self administered questionnaire which was designed based on the health promotion model. Results: The results showed that factors associated with prior vaccination behavior were family history of gynecologic malignancy, ever being advised to get HPV vaccination, perceived barriers of action and perceived self-efficacy. Predictors for commitment to HPV vaccination in the next 6 months were the cost of vaccination, ever being advised to get HPV vaccination, perceived self-efficacy and situational influences. Perceived self-efficacy was significantly influenced by relationship status, past receipt of a recommendation for HPV vaccination and level of knowledge about HPV. Conclusion: When formulating vaccination policies, governmental or medical institutions should include these factors to promote vaccination. [ABSTRACT FROM AUTHOR]

Atopic dermatitis is a chronic inflammatory skin disease. Multiple genetic and environmental factors are thought to be responsible for susceptibility to AD. In this study, we collected 2,478 DNA samples including 209 AD patients and 729 control subjects from Taiwanese population and 513 AD patients and 1027 control subject from Japanese population for sequencing and genotyping ORAI1. A total of 14 genetic variants including 3 novel single-nucleotide polymorphisms (SNPs) in the ORAI1 gene were identified. Our results indicated that a non-synonymous SNP (rs3741596, Ser218Gly) associated with the susceptibility of AD in the Japanese population but not in the Taiwanese population. However, there is another SNP of ORAI1 (rs3741595) associated with the risk of AD in the Taiwanese population but not in the Japanese population. Taken together, our results indicated that genetic polymorphisms of ORAI1 are very likely to be involved in the susceptibility of AD. [ABSTRACT FROM AUTHOR]

The article discusses research on the zooplankton distribution patterns along the riverine, estuarine and marine parts of the Danshuei ecosystem in Northern Taiwan. It references a study by Jiang-Shiou Hwang at the National Taiwan Ocean University Institute of Marine Biology, and his colleagues, published in an issue of "Zoological Studies." The researchers examined the abundance and spatiotemporal distributions of mesozooplankton diversity as well as the estimated levels of ammonia to indicate water quality at five different stations in Taipei City. They conclude that marine zooplankton contributes significantly to the estuarine portion of the ecosystem in Danshuei.

This study draws on Relevance Theory (Sperber and Wilson, 1986/1995), Conversation Analysis (Sacks et al., 1974), and Politeness Theory (Brown and Levinson, 1987) in investigating a full range of discourse functions for hao and dui with reference to recurrent patterns, distributions, and forms of organization in a large corpus of talk. Special emphasis is placed on a comparison of hao and dui in combination with a small subset of discourse particles: in particular hao/hao le/hao la/hao a/hao ba and dui/dui a/dui le in spoken discourse. We find that both of the markers signal special sequential relatedness in talk and carry information which is relevant in determining the boundaries of conversational exchange. However, in interaction hao is used for expressing acceptance of the other speaker's move or act, whereas dui conveys acknowledgment of the propositional content of the utterance produced by the other speaker. [ABSTRACT FROM AUTHOR]

Although osteoporosis prevention has been identified as a critical issue for women and the elderly population, some health professionals still misunderstand osteoporosis. Public health nurses (PHNs) are responsible for health promotion and disease prevention in community populations. The objective of this study was to investigate PHNs’ knowledge of osteoporosis and its related factors. A cross-sectional research design was used: 678 subjects from 3,300 PHNs who worked at health centers in Taiwan during 2000 were selected by cluster random sampling to participate in this study; 539 of them returned the questionnaire. On average, the PHNs’ knowledge was found to be 0.68 (ranging from 0 to 1). The highest and lowest scores were found in the areas of disease prevention and the detection of the symptoms/signs of osteoporosis. By using one-way ANOVA, our study found that participants who had studied osteoporosis at school, had graduated from university, were RNs or LPNs and had studied osteoporosis as part of continuing education (CE) had higher knowledge scores. This study recommends that CE and nursing education about osteoporosis need to be highly valued. Nursing educators should reassess and reconstruct nursing curricula. Health administrators should evaluate learning needs and provide CE via multiple channels. Symptoms/signs, diagnosis/treatment and prevention issues are suggested as the core components of designing nursing curricula and CE. [ABSTRACT FROM AUTHOR]

Road dust contributes a large percentage of the atmosphere's suspended particles in Taiwan. Three road dust samples were collected from downtown, electrical park, and freeway tunnel areas. A mechanical sieve separated the road dust in the initial stage. Particles >100 µm were 75%,70%, and 60% (wt/wt), respectively, of the samples. Those particles <37 µm were resuspended in another mixing chamber and then collected by a Moudi particle sampler. The largest mass fraction of resuspended road dust was in the range of 1-10 µm. Ultrafine particles (<1 µm) composed 33.7, 17, and 7.4% of the particle samples (downtown, electrical park, and freeway tunnel, respectively). The road dust compositions were analyzed by inductively coupled plasma (ICP)-atomic emissions spectroscopy and ICP-mass spectrometry. The highest concentration fraction contained more aluminum (Al), iron (Fe), calcium (Ca), and potassium than other elements in the road dust particle samples. Additionally, the sulfur (S) content in the road dust from the electrical park and freeway tunnel areas was 2.1 and 3.4 times the downtown area sample, respectively. The sulfur originated from the vehicle and boiler oil combustion and industrial manufacturing processes. Furthermore, zinc (Zn) concentration in the tunnel dust was 2.6 times that of the downtown and electrical park samples, which can be attributed to vehicle tire wear and tear. Resuspended road dusts (<10 µm) from the downtown and freeway tunnel areas were principally 2.5-10 µm Al, barium (Ba), Ca, copper (Cu), Fe, magnesium (Mg), sodium (Na), antimony (Sb), and Zn, whereas arsenic (As), chromium (Cr), and nickel (Ni) were predominant in the ultra fine particle samples (<1 µm). Al, Ba, and Ca are the typical soil elements in coarse particles; and As, and Cr and Ni are the typical fingerprint of oil combustion and vehicle engine abrasion in ultra fine particles. There was a special characteristic of resuspension road dust at electrical park, that is, many elements, including As, Ba, Ca, cadmium, Cr, Cu, Fe, manganese (Mn), Ni, lead (Pb), S, vanadium (V), and Zn, were major in ultra fine particles. These elements should be attributed to the special manufacturing processes of electric products. [ABSTRACT FROM AUTHOR]

A vertical (laterally integrated) two-dimensional numerical model was applied to study the salt water intrusion in the Tanshui River estuarine system, Taiwan. The river system has experienced dramatic changes in the past half century because of human intervention. The construction of two reservoirs and water diversion in the upper reaches of the river system significantly reduces the freshwater inflow. The land subsidence within the Taipei basin and the enlargement of the river constriction at Kuan-Du have lowered the river bed. Both changes have contributed farther to the intrusion of tidal flow and salt water in the upstream direction. The model was reverified with the earliest available hydrographic data measured in 1977. The overall performance of the model is in reasonable agreement with the field data. The model was then used to investigate the change in salt water intrusion as a result of reservoir construction and bathymetric changes in the river system. The model simulation study reveals that significant salinity increases have resulted from the combined changes. It has been speculated by ecological researchers that the long-term increase in salinity might be the driving force altering the aquatic ecosystem structure in the lower reach of the estuary and the Kuan-Du mangrove swamp, particularly the enlargement of the mangrove area and the disappearance of freshwater marshes. However, concrete proof has not been available since no prototype salinity data were available prior to the reservoir construction. This case study offers the first quantitative estimate of the salinity changes due to human interference in this natural system. [ABSTRACT FROM AUTHOR]

Enterovirus A71 (EV-A71) can induce severe neurological complications and even fatal encephalitis in children, and it has caused several large outbreaks in Taiwan since 1998. We previously generated VP1 codon-deoptimized (VP1-CD) reverse genetics (rg) EV-A71 viruses (rgEV-A71s) that harbor a high-fidelity (HF) 3D polymerase. These VP1-CD-HF rgEV-A71s showed lower replication kinetics in vitro and decreased virulence in an Institute of Cancer Research (ICR) mouse model of EV-A71 infection, while still retaining their antigenicity in comparison to the wild-type virus. In this study, we aimed to further investigate the humoral and cellular immune responses elicited by VP1-CD-HF rgEV-A71s to assess the potential efficacy of these EV-A71 vaccine candidates. Following intraperitoneal (i.p.) injection of VP1-CD-HF rgEV-A71s in mice, we observed a robust induction of EV-A71-specific neutralizing IgG antibodies in the antisera after 21 days. Splenocytes isolated from VP1-CD-HF rgEV-A71s-immunized mice exhibited enhanced proliferative activities and cytokine production (IL-2, IFN-, IL-4, IL-6, and TNF-a) upon re-stimulation with VP1-CD-HF rgEV-A71, as compared to control mice treated with adjuvant only. Importantly, administration of antisera from VP1-CD-HF rgEV-A71s-immunized mice protected against lethal EV-A71 challenge in neonatal mice. These findings highlight that our generated VP1-CD-HF rgEV-A71 viruses are capable of inducing both cellular and humoral immune responses, supporting their potential as next-generation EV-A71 vaccines for combating EV-A71 infection. IMPORTANCE EV-A71 can cause severe neurological diseases and cause death in young children. Here, we report the development of synthetic rgEV-A71s with the combination of codon deoptimization and high-fidelity (HF) substitutions that generate genetically stable reverse genetics (rg) viruses as potential attenuated vaccine candidates. Our work provides insight into the development of low-virulence candidate vaccines through a series of viral genetic editing for maintaining antigenicity and genome stability and suggests a strategy for the development of an innovative next-generation vaccine against EV-A71. [ABSTRACT FROM AUTHOR]

The article provides information on the Taiwanese Dermatological Association and the Taiwanese Society for Investigative Dermatology in Taiwan. It accounts the establishment of the two organizations. The Taiwanese Dermatological Association has a prestigious award given annually to an outstanding foreign dermatologist. Both researchers and physicians interested in the study of skin biology and disease have been invited to participate in the Taiwanese Society for Investigative Dermatology.

Examines the interaction between functional polymorphism of alcohol-metabolism genes in protection against alcoholism in Taiwan. Investigations on the major enzymes of alcohol metabolism; Exhibition of functional polymorphism; Enumeration of combinatorial genotypes of the polymorphic ADH2 and ALDH2.