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This research explores the relationships between self-directed learning readiness and transformative learning theory (TLT) reflected by the Constructivist Internet-based Learning Environment Scale (CILES). A questionnaire survey about adult learner's perceptions of Internet-based learning was administered to adults enrolled in classes in community colleges in Taiwan. A total of 593 valid questionnaires were used for the structural equation modeling analysis. The findings confirmed a second-order hierarchical factor relationship of TLT (technical, dialectical and emancipatory learning interests) from CILES. Moreover, the three domains of learning interests of transformative learning were proved to have a developmental relationship, moderated by the readiness of self-directed learning for adult learners in Internet-based learning.

Purpose: This study aims to develop a regionalized characterization model of water consumption that can delineate what the potential damage receptors are and where they will be. In order to improve local water resources management, assessment results with more accurate spatial information are needed. This model could be used to derive regionalized life cycle assessment (LCA) results, especially for evaluations within a country. Methods: We developed a regionalized characterization model using a watershed-affected matrix and related factors. To construct the watershed-affected matrix, a watershed-affected area (WAA) describing the geographical boundary that will be affected by insufficient water supply from the watershed was proposed as a spatial scale to evaluate the impacts of local water consumption. The model could be performed with input water consumption inventory data carrying watershed scale attributes, and with output damage results carrying local administrative scale attributes. The area of concern (AoC) concept was applied to the model so that water consumption users, such as domestic, agricultural, and industrial sectors, could be used as damage receptor to reveal societal concern about which sector will be influenced due to water depletion. Results and discussion: This regionalized characterization model was tested on the three main watersheds in Taiwan, each representing typical, but different, water-usage features. Sector-wise WAAs of each watershed were constructed, and endpoint characterization factors (CFs) of local water consumption were calculated. The visualization results show the damage distribution of water consumption among the damage receptors, which used to be a single average value at the watershed or national scale. Conclusions: The model with the AoC concept is sufficiently flexible for choosing representative affected users and outcome indicators according to stakeholder preferences. Spatial differentiation and comparable results can also support LCA interpretation with detailed information. This model is expected to be further applied to the development of damage prevention strategies. [ABSTRACT FROM AUTHOR]

• Dynamic WDIs were proposed with consideration of water status under climate change. • Derivation of the monthly WDI with spatial and temporal improvement was displayed. • TaiWAP and SWAT were used for modeling local future weather and streamflow. • The importance of applying dynamic WDIs in the impact assessment was discussed. Understanding the environmental impacts associated with water-related adaptation measures plays an important role in decision making, as some adaptation measures may not offer environmental benefits compared to traditional water systems. The water depletion index (WDI) is one water stress indicator used to estimate the impacts of water consumption. A dynamic WDI was constructed and employed in this study under climate change scenarios with weather and streamflow modeling. To demonstrate whether adaptation measures can reduce water depletion and to demonstrate how dynamic WDI affects assessment results, Taipei, a highly developed and populated city in Taiwan, was selected as a case study site. Decreased WDI from July to August and increased WDI from September to October were simulated under climate change. This approach implied that when measuring water consumption impacts, the WDI should be applied according to the corresponding time period. Additionally, by substituting 70% of potable water with rainwater in a four-story building, 17.9–159.3 m3 of the freshwater depletion risk might be reduced every month. As adaptation measures can be long-term strategies and long-lasting infrastructures, a dynamic WDI could provide policy makers with a method to accurately and effectively assess the impacts of applying water-related adaptation measures in response to climate change. [ABSTRACT FROM AUTHOR]

This study aims at determining the level of depression and suicidal status of adult HIV test-seekers. Of the total enrolled 850 males, almost 50% reported some risk behaviors, 38.9% experienced depression, and 7.2% had suicidal ideation. Subjects with risky sexual behaviors in terms of repeated HIV test, had a history of sexually transmitted disease, engaged in one-night stands, or did not use condoms all the time with causal sexual partners were more likely to have depression. Furthermore, subjects who were bisexual/homosexual, engaged in Internet sex, engaged in one-night stands, or used addictive drugs within the past 6 months were more likely to experience suicidal ideation. The HIV testers are at risk of experiencing depression and suicidal ideation; each is associated with different types of risky sexual behaviors. It is essential for the health authority to further provide mental health services for HIV testers and to draw up an effective strategy in reducing unprotected sexual behaviors. [ABSTRACT FROM AUTHOR]

Skin and soft-tissue infections (SSTIs) caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) have emerged as major health problems throughout the world. Most SSTI CA-MRSA strains produce Panton-Valentine leukocidin (PVL), but its contribution to CA-MRSA pathogenesis is poorly defined. Here, we used an endemic PVL-positive SSTI-causing CA-MRSA strain from Taiwan, together with an isogenic PVL-knockout mutant (Δpvl) and complemented PVL-positive derivative, to evaluate the role of PVL in the pathogenesis of CA-MRSA in the RHEK-1 human keratinocyte cell line and a rabbit skin infection model. We found that both PVL-positive CA-MRSA and isogenic Δpvl strains attached and were engulfed into endosomes of RHEK-1 cells within 1 hour following infection. However, by 2 hours after infection PVL-positive CA-MRSA more effectively disrupted endosomes, escaped into the cytoplasm, and replicated intracellularly. By 6 hours after infection, the PVL-positive strain caused significantly more caspase-dependent keratinocyte apoptosis than the isogenic Δpvl mutant. In the rabbit infection model, 1 week following infection the wild-type strain produced significantly more widespread lesions and cell apoptosis than the isogenic Δpvl mutant. These findings indicate that PVL is an important virulence factor that enables CA-MRSA to produce necrotizing skin infections by allowing the bacteria to escape from endosomes, replicate intracellularly, and induce apoptosis.

Lactobacillus pobuzihii is a novel species which has been previously found in pobuzihi (fermented cummingcordia), a traditional fermented food in Taiwan. However, the lactic acid bacteria (LAB) microflora in pobuzihi has not been studied in detail. In this study, LAB from pobuzihi were isolated, identified, and characterized. A total of 196 LAB were isolated; 79 cultures were isolated from the sample collected from a manufacturing factory, 38 from pobuzihi samples collected from 4 different markets, and 79 from 2 fresh cummingcordia samples. These isolates were characterized phenotypically and then divided into eight groups (A to H) by restriction fragment length polymorphism analysis and sequencing of 16S ribosomal DNA. Lactobacillus plantarum was the most abundant LAB found in most samples during the fermentation of pobuzihi. On the other hand, Enterococcus casseliflavus and Weissella cibaria were, respectively, the major species found in the two fresh cummingcordia samples. A potential novel species or subspecies of lactococcal strain was found. In addition, seven L. plantarum and five W. cibaria strains showed inhibitory activity against the indicator strain Lactobacillus sakei JCM 1157(T). This is the first report describing the distribution and varieties of LAB existing in the pobuzihi during its fermentation process and the final product on the market.

A novel pandemic influenza H1N1 (pH1N1) virus spread rapidly across the world in 2009. Due to the important role of antibody-mediated immunity in protection against influenza infection, we used an enzyme-linked immunosorbent assay-based microneutralization test to investigate cross-reactive neutralizing antibodies against the 2009 pH1N1 virus in 229 stored sera from donors born between 1917 and 2008 in Taiwan. The peak of cumulative geometric mean titers occurred in donors more than 90 years old and declined sharply with decreasing age. Sixteen of 27 subjects (59%) more than 80 years old had cross-reactive antibody titers of 160 or more against the 2009 pH1N1 virus, whereas none of the donors from age 9 to 49 had an antibody titer of 160 or more. Interestingly, 2 of 51 children (4%) from 6 months to 9 years old had an antibody titer of 40. We further tested the antibody responses in 9 of the 51 pediatric sera to three endemic seasonal influenza viruses isolated in 2006 and 2008 in Taiwan, and the results showed that only the 2 sera from children with antibody responses to the 2009 pH1N1 virus had high titers of neutralizing antibody against recent seasonal influenza virus strains. Our study shows the presence of some level of cross-reactive antibody in Taiwanese persons 50 years old or older, and the elderly subjects who may already have been exposed to the 1918 virus had high titers of neutralizing antibody to the 2009 pH1N1 virus. Our data also indicate that natural infection with the Taiwan 2006 and 2008 seasonal H1N1 viruses may induce a cross-reactive antibody response to the 2009 pH1N1 virus.

Background: This study was designed to determine the clinical characteristics of children infected with different strains of influenza B viruses isolated in southern Taiwan. The clinical features were compared with influenza A infection occurring in the same period., Methods: All children enrolled in the study had laboratory-confirmed infection with influenza A or B viruses. Influenza B speciation was performed by RNA extraction, cDNA synthesis, and amplification by polymerase chain reaction and sequencing. Demographic data, clinical findings, diagnoses, and outcomes were obtained., Results: During the study period, 163 strains of influenza A and 118 strains of influenza B were isolated. The Yamagata-like strains were most prevalent in 2001. New reassortant strains were identified since 2002 and became predominant in 2005 and 2006. Children with influenza B were more likely than those with influenza A to be diagnosed as upper respiratory tract infection, myositis, and gastroenteritis (P < 0.05). Children infected with Yamagata-like strains were more likely to develop lower respiratory tract infection (P < 0.05) and accounted for all cases of invasive disease. Children infected with the Victoria-like group had the longest hospital stays associated with severe bacterial superinfection., Conclusions: Currently new reassortant influenza B viruses are the predominant strains circulating in southern Taiwan. There is considerable similarity of clinical features between influenza A and B in children. The Yamagata-like strains were associated with more invasive infections. Continuous influenza virus surveillance is essential particularly in Taiwan where pandemic strains tend to appear earlier than in other countries.