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Simple Summary: The study examined the relationship between Human Papillomavirus (HPV) and various types of skin cancer, including squamous cell carcinoma, basal cell carcinoma, and melanoma. It aimed to assess how HPV influenced the likelihood of developing these cancers, considering factors such as age, gender, urbanization, and existing health conditions. Through statistical models, the research quantified the risk of skin cancer in individuals with HPV compared to those without, underscoring how behaviors related to sun exposure and protection practices could alter these risks. The findings were crucial for guiding prevention and treatment strategies and were of significant interest to medical professionals and public health policymakers. Overall, the study enhanced our understanding of the risks associated with HPV, potentially leading to more effective health interventions. Human papillomavirus (HPV) has been implicated in various cancers, including those affecting the skin. The study assessed the long-term risk of skin cancer associated with HPV infection in Taiwan region, using data from the National Health Insurance Research Database between 2007 and 2015. Our analysis revealed a significant increase in skin cancer risk among those with HPV, particularly for squamous cell carcinoma (SCC), the subtype with the highest observed adjusted hazard ratio (aHR) = 5.97, 95% CI: 4.96–7.19). The overall aHR for HPV-related skin cancer was 5.22 (95% CI: 4.70–5.80), indicating a notably higher risk in the HPV-positive group. The risk of skin cancer was further stratified by type, with basal cell carcinoma (aHR = 4.88, 95% CI: 4.14–5.74), and melanoma (aHR = 4.36, 95% CI: 2.76–6.89) also showing significant associations with HPV. The study also highlighted regional variations, with increased risks in southern Taiwan and the Kaohsiung-Pingtung area. Key findings emphasize the importance of sun protection, particularly in regions of high UV exposure and among individuals in high-risk occupations. This research contributes to a better understanding of the complex interactions between HPV and skin cancer risk, reinforcing the importance of preventive strategies in public health. [ABSTRACT FROM AUTHOR]

This paper complicates the classic security dilemma by considering the notions of ontological security and relational deterrence. It studies how the ontological security dilemma has emerged between the US, China, and Taiwan from the relational perspective and how these spiral chains will further develop in the future. The paper incurs the literature on relational analysis to expound on how different ontological security concerns allude to relational deterrence between the three actors. Taiwan's separatism is more of a threat to China's relational self than to physical security because the separatist does not belong to any already agreed relationship. A geometric model and a few simulations yield three unconventional findings. 1) The less advantaged the US military is over China, the less likely armed unification will occur. 2) The US anti-Chinese tendency is irrelevant in determining the probability of armed unification. 3) What may escalate the spiral are China's anti-Taiwan independence and Taiwan's anti-unification. Case sensitivity indicates the ontological sensibilities of a security dilemma. [ABSTRACT FROM AUTHOR]

Individuals with shoulder impingement syndrome (SIS) exhibit changes in corticospinal excitability, scapular kinematics, and scapular muscle-activation patterns. To restore the scapular kinematics and muscle-activation patterns in individuals with SIS, treatment protocols usually include scapula-focused exercises, such as scapular-orientation and strength training. To investigate whether scapular-orientation and strength training can reverse the altered corticospinal excitability of recreational overhead athletes with SIS. Randomized controlled clinical trial. University laboratory. Forty-one recreational overhead athletes with SIS: 20 in the scapular-orientation group (age = 26.45 ± 4.13 years, height = 171.85 ± 7.88 cm, mass = 66.70 ± 10.68 kg) and 21 in the strengthening group (age = 26.43 ± 5.55 years, height = 171.62 ± 5.87 cm, mass = 68.67 ± 10.18 kg). Both groups performed a 30-minute training protocol consisting of 3 exercises to strengthen the lower trapezius (LT) and serratus anterior muscles without overactivating the upper trapezius muscles. Participants in the scapular-orientation group were instructed to consciously activate their scapular muscles with electromyographic biofeedback and cues, whereas the strengthening group did not receive biofeedback or cues for scapular motion. Corticospinal excitability was assessed using transcranial magnetic stimulation. Scapular kinematics and muscle activation during arm elevation were also measured. After training, both groups demonstrated an increase in motor-evoked potentials in the LT (P =.004) and increases in scapular upward rotation (P =.03), LT activation (P <.001), and serratus anterior activation (P <.001) during arm elevation. Moreover, the scapular-orientation group showed higher LT activation levels during arm elevation after training than the strengthening group (P =.03). With or without biofeedback and cues, scapula-focused exercises improved scapular control and increased corticospinal excitability. Adding biofeedback and cues for scapular control during exercise helped facilitate greater LT activation, so feedback and cues are recommended during scapula-focused training. [ABSTRACT FROM AUTHOR]

Simple Summary: Trismus is a common complication in oral cancer patients that may influence surgical outcomes. This retrospective matched cohort analysis examined the influence of preoperative trismus on survival outcomes in 40 male Taiwanese oral cancer patients undergoing transoral robotic surgery (TORS). Through 1:1 propensity score matching, 20 trismus patients were compared to 20 non-trismus controls. TORS demonstrated comparable short-term surgical outcomes in trismus patients compared to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Analysis of long-term oncological outcomes demonstrated similar 5-year disease-free survival between groups, indicating comparable tumor control. However, trismus patients experienced significantly poorer 5-year overall survival. After adjusting for confounders, trismus independently conferred a 13-fold higher long-term mortality risk. Ultimately, this study highlights preoperative trismus as a harbinger of non-inferior short-term surgical outcomes, but diminished long-term survival in oral cancer patients treated robotically, even among those with equivalent tumor persistence following surgery. Further research should explore mechanisms linking trismus to mortality and approaches to improve outcomes in this population. Trismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed to investigate the associations between trismus and surgical outcomes in Taiwanese male oral cancer patients treated with TORS. We conducted a retrospective propensity score-matched cohort study of 40 Taiwanese male oral cancer patients who underwent TORS between 2016 and 2022. Overall, 20 patients with trismus were matched to 20 patients without trismus. TORS achieved similar operative and short-term clinical outcomes in trismus patients to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Kaplan–Meier and Cox proportional hazard regression analyses were performed to compare overall survival (OS) and disease-free survival (DFS) between the two groups. The overall survival (OS) rate at three years was significantly lower in patients with trismus than those without trismus (27.1% vs. 95.0%, log-rank p = 0.02). However, there was no significant difference in disease-free survival (DFS) rates between the trismus and non-trismus groups (36.6% vs. 62.7%, log-rank p = 0.87). After adjusting for confounders, trismus was independently associated with a 13-fold increased risk of mortality (adjusted HR 12.87, 95% CI 1.55–106.50, p < 0.05). In conclusion, trismus appears to be an independent prognostic factor for reduced long-term OS in Taiwanese male oral cancer patients undergoing TORS, though short-term surgical outcomes were non-inferior in the trismus patients. Further research is warranted to clarify the mechanisms linking trismus and survival in this population. [ABSTRACT FROM AUTHOR]

This study tested a cross-level moderated mediation model depicting the dynamism of individual resource loss through sickness presenteeism precipitated by long working hours and resource gain from group-level team support and the consequent effect on turnover intention over time. Employing a two-wave survey with 4 months in between, data were obtained from 294 nurses (37 teams) working in 12 hospitals across Taiwan. The hierarchical linear modeling analyses revealed that presenteeism partially mediated the effects of working long hours on later turnover intention. Moreover, group-level team support moderated the presenteeism-turnover linkage. Specifically, the damaging effect of working while ill on heightenedturnover intention was drastically attenuated for those with high team support. Our cross-level moderated mediation model has thus identified team support as a viable resource that can alleviate the damages of working in precarious conditions and help hospitals to retain nurses. We discussed the theoretical and managerial implications of our findings in the context of resource loss and gain, especially when stress and burnout are highly prevalent for the health care professions in the postpandemic era. [ABSTRACT FROM AUTHOR]

This study aims to compare the clay mineralogy and whole-soil major chemistry of elements in late Miocene soil sediments and early Quaternary red paleosols in the Penghu Islands, (Pescadores), Taiwan, and Zhangpu Volcanic Park, Fujian. There were the late Miocene Chu Wan (CWI and CWII), Shiao Men Yu (SMY) and two intergrade red soils, Chu Wan (CW(irs)) and Shiao Men Yu (SMY(irs)), with three distinctive zones of different dominating kaolins in the profiles of the Penghu Islands. A Tong Wei (TW) paleosol of early Quaternary basaltic eruptions in the Penghu Islands was collected. The Anzei (AZ), Si Yu (HY) and Chianmei (CM) paleosols were sampled from the Penghu Islands and Yulinshi (YLS) paleosols near the Zhangpu Volcanic Park for this study. The CW and SMY paleosols erupted in the late Miocene, and the other paleosols erupted on the Penghu Islands. These paleosols were fractionated into clay fractions and subjected to soil physical and chemical analyses. Kaolin minerals were dominant in the CW(irs) and SMY(irs) paleosols. The top layer (layer one) in the CW(irs) was 7 Å-halloysite, and order/disordered kaolinites were present in layers two and three. The CW(irs) and SMY(irs) hexagonal-like, platy kaolinites (0.1–0.2 µm in diameter), spheroidal and hollow 7 Å-halloysite (layer 1) was determined with transmission electron microscopic (TEM) investigations. The early Quaternary red soil of TW consisted of kaolinite, illite, vermiculite and smectite clay assemblages. Late Miocene paleosols were classified as fine, kaolinite, hyperthermic and Typic Rhodic Paleudults, and the early Quaternary red paleosols were classified as fine, mixed, hyperthermic and Typic Rodistalf, respectively. Late Miocene paleosols contained more clays, lower SiO2/Al2O3 and higher chemical index of weathering (CIW) than early Quaternary paleosols. The kaolin, illite, smectite and vermiculite mineralogy, physical and chemical properties of paleosols and landscapes in the Zhangpu YLS, Fujian, were similar to those of late Miocene sediments and early Quaternary red paleosols in the Penghu Islands. [ABSTRACT FROM AUTHOR]

Background/Aims Diagnosis of isolated laryngopharyngeal reflux symptoms (ILPRS), ie, without concomitant typical reflux symptoms (CTRS), remains difficult. Mean nocturnal baseline impedance (MNBI) reflects impaired mucosal integrity. We determined whether esophageal MNBI could predict pathological esophagopharyngeal reflux (pH+) in patients with ILPRS. Methods In this cross-sectional study conducted in Taiwan, non-erosive or low-grade esophagitis patients with predominant laryngopharyngeal reflux symptoms underwent combined hypopharyngeal multichannel intraluminal impedance-pH monitoring when off acid suppressants. Participants were divided into the ILPRS (n = 94) and CTRS (n = 63) groups. Asymptomatic subjects without esophagitis (n = 25) served as healthy controls. The MNBI values at 3 cm and 5 cm above the lower esophageal sphincter (LES) and the proximal esophagus were measured. Results Distal but not proximal esophageal median MNBI values were significantly lower in patients with pH+ than in those with pH– (ILPRS in pH+ vs pH–: 1607 Ω vs 2709 Ω and 1885 Ω vs 2563 Ω at 3 cm and 5 cm above LES, respectively; CTRS in pH+ vs pH–: 1476 vs 2307 Ω and 1500 vs 2301 Ω at 3 cm and 5 cm above LES, respectively, P < 0.05 for all). No significant differences of any MNBI exist between any pH– subgroups and healthy controls. The areas under the receiver operating characteristic curve in the ILPRS group were 0.75 and 0.80, compared to the pH– subgroup and healthy controls (P < 0.001 for both), respectively. Interobserver reproducibility was good (Spearman correlation 0.93, P < 0.0001). Conclusion Distal esophageal MNBI predicts pathological reflux in patients with ILPRS. [ABSTRACT FROM AUTHOR]

Shallow bathymetry is important for ocean exploration, and the development of high-precision bathymetry inversion methods, especially for shallow waters with poor quality, is a major research aim. Synthetic aperture radar (SAR) image data benefit from a wide coverage, high measurement density, rapidity, and low consumption but are limited by low accuracy. Alternatively, multibeam data have low coverage and are difficult to obtain but have a high measurement accuracy. In this paper, taking advantage of the complementary properties, we use SAR image data as the content map and multibeam images as the migrated style map, applying the VGG19 neural network (optimizing the loss function formula) for bathymetric inversion. The model was universal and highly accurate for bathymetric inversion of shallow marine areas, such as turbid water in Taiwan. There was a strong correlation between bathymetric inversion data and measured data (R2 = 0.8822; RMSE = 1.86 m). The relative error was refined by 9.22% over those of previous studies. Values for different bathymetric regions were extremely correlated in the region of 20–40 m. The newly developed approach is highly accurate over 20 m in the open ocean, providing an efficient, precise shallow bathymetry inversion method for complex hydrographic conditions. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This cohort study investigated the correlation between Parkinson's disease (PD) risk and chronic obstructive pulmonary disease (COPD) risk under particulate matter with an aerodynamic diameter =2.5 µm (PM2.5) exposure. METHODS: Data from the National Health Research Institutes of Taiwan were used in this study. The Environmental Protection Administration of Taiwan established an air quality monitoring network for monitoring Taiwan's general air quality. COPD was indicated by at least 3 outpatient records and 1 hospitalization for COPD. After the implementation of age, sex, and endpoint matching at a 1:4 ratio, 137 patients and 548 patients were included in the case group and control group, respectively. Based on the 2005 World Health Organization (WHO) standards, monthly air particle concentration data were classified into the following 4 groups in analyses of exposure-response relationships: normal level, and 1.0, 1.5, and 2.0 times the WHO level ([concentration =2]×25 µg/m3×number of exposure months). RESULTS: A multivariate logistic regression revealed that the 1.0 and 1.5 WHO level groups did not significantly differ from the normal level group, but the 2.0 WHO level did (odds ratio, 4.091; 95% confidence interval, 1.180 to 14.188; p=0.038). CONCLUSIONS: Elevated PM2.5 concentrations were significantly correlated with an increased risk of PD among patients with COPD. Furthermore, exposure to high PM2.5 levels can further increase the risk of PD. [ABSTRACT FROM AUTHOR]

Simple Summary: Unlike other head and neck cancers, nasopharyngeal carcinoma (NPC) with long-latent recurrence (>five years) is not rare. This study aims to investigate the clinical characteristics and outcomes of long-latent recurrent NPC. We found that 8.1% recurrence occurred after five years. About two thirds of these patients' primary cancer belonged to the early stages, and almost half of the recurrence was a local recurrence. The five-year overall survival and disease-specific survival rate of long-latent recurrence was 19.7% and 24.5%, respectively. Most long-latent local recurrence was found in unresectable rT3 or rT4 cases, while one-third could not be detected by endoscopy due to recurrence in the skull base. A higher percentage of patients who died after long-latent recurrence were symptomatic with a follow-up interval more than six months, reflecting that delayed detection of recurrence may have a great impact on survival outcome. A long-term follow-up is necessary for early detection of NPC recurrence even after five years of disease-free interval. Purpose: To investigate the clinical characteristics, risk factors, and clinical outcomes of long-latent recurrence (>five years) of nasopharyngeal carcinoma (NPC). Methods: This retrospective study enrolled newly diagnosed NPC patients from the Chang Gung Research Database between January 2007 and December 2019. We analyzed the patients' characteristics and survival outcomes after recurrence. Results: A total of 2599 NPC patients were enrolled. The overall recurrence rate was 20.5%, while 8.1% of patients had long-latent recurrence (>five years). These patients had a higher percentage of initial AJCC (The American Joint Committee on Cancer) stage I/II (60.5%, p = 0.001) and local recurrence (46.5%, p < 0.001). Unresectable rT3 and rT4 were found in 60% of patients when recurrence and 30% of local recurrence occurred in the skull base, which could not be detected by the regular endoscopy. The five-year overall survival rate of long-latent recurrence was 19.7%. Alive patients tended to be asymptomatic but have regular follow-ups with the interval less than six months. Multivariate analysis showed age and initial advanced AJCC stages were independent risk factors of death after recurrence. In contrast, patients with recurrence between two and five years, salvage surgeries, and regional recurrence had favorable survival outcomes. Conclusion: Long-latent NPC recurrence is not rare, and the survival outcome is poor. Regular follow-up for early detection of NPC recurrence is necessary even after five years of disease-free period. [ABSTRACT FROM AUTHOR]

Five funnel-web spiders in the genus Macrothele are widely distributed to Taiwan. We herein reported the severe case of a woman bitten by a male Macrothele gigas who present with autonomic (i.e., profuse sweating and piloerection), cardiovascular (hypertension and tachycardia), and neurologic effects (perioral numbness) in addition to local tissue swelling and regional limb pain. Morphine and ampicillin/sulbactam were administered. Her cardiovascular, neurologic, and local symptoms gradually improved, and thus was discharged 24 h post-bite. However, persistent diaphoresis and piloerection lasted for at least 3 days, and pre-renal azotemia was suspected. Due to the risk of severity and death reported for the Australian funnel web spider bites, we suggest patients bitten by an Asian funnel-web spider be carefully monitored and resuscitation performed as indicated. • Information on the diagnosis and management of the Asian funnel-web spiders' bites remains limited. • The patient bitten by Macrothele gigas (Asian funnel-web spider) developed cardiovascular, neurologic, and autonomic effects. • Specific antivenom is unavailable in Taiwan. • Immediately applying pressure immobilization and transporting the patient to the emergency department are recommended. [ABSTRACT FROM AUTHOR]

Lung cancers are life-threatening malignancies that cause great healthcare burdens in Taiwan and worldwide. The 5-year survival rate for Taiwanese patients with lung cancer is approximately 29%, an unsatisfactorily low number that remains to be improved. We first reviewed the molecular epidemiology derived from a deep proteogenomic resource in Taiwan. The nuclear factor erythroid 2-related factor 2 (NRF2)antioxidant mechanism was discovered to mediate the oncogenesis and tumor progression of lung adenocarcinoma. Additionally, DNA replication, glycolysis and stress response are positively associated with tumor stages, while cell-to-cell communication, signaling, integrin, G protein coupled receptors, ion channels and adaptive immunity are negatively associated with tumor stages. Three patient subgroups were discovered based on the clustering analysis of protein abundance in tumors. The first subgroup is associated with more advanced cancer stages and visceral pleural invasion, as well as higher mutation burdens. The second subgroup is associated with EGFR L858R mutations. The third subgroup is associated with PI3K/AKT pathways and cell cycles. Both EGFR and PI3K/AKT signaling pathways have been shown to induce NRF2 activation and tumor cell proliferation. We also reviewed the clinical evidence of patient outcomes in Taiwan given various approved targeted therapies, such as EGFR-tyrosine kinase inhibitors and anaplastic lymphoma kinase (ALK)inhibitors, in accordance with the patients' characteristics. Somatic mutations occurred in EGFR, KRAS, HER2 and BRAF genes, and these mutations have been detected in 55.7%, 5.2%, 2.0% and 0.7% patients, respectively. The EGFR mutation is the most prevalent targetable mutation in Taiwan. EML4-ALK translocations have been found in 9.8% of patients with wild-type EGFR. The molecular profiling of advanced NSCLC is critical to optimal therapeutic decision-making. The patient characteristics, such as mutation profiles, protein expression profiles, drug-resistance profiles, molecular oncogenic mechanisms and patient subgroup systems together offer new strategies for personalized treatments and patient care. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioners (NPs) play an important role in addressing growing health care needs. Among NPs, organizational empowerment is positively associated with overall practice outcomes. Therefore, efforts to promote organizational empowerment in practice are necessary to increase job satisfaction among NPs as well as decrease the stress and intention to leave. Purpose: This study investigated the relationships of organizational empowerment and practice outcomes of job satisfaction, work stress, and intention to leave in acute care practices. Methodological orientation: This study was conducted as a cross-sectional design with a national survey of 946 acute care NPs. Questionnaires contained demographic and practice characteristics, Misener Nurse Practitioner Job Satisfaction Scale, Condition for Work Effectiveness Questionnaire II, and the work stress VAS scale. Hierarchical Linear Model (HLM) was used to investigate individual NP-level or organization-level effects on job satisfaction. The factors associated with job satisfaction were examined by stepwise multiple regression. Results: The organizational empowerment was low, work stress was moderately high, and job satisfaction was between slightly unsatisfied and slightly satisfied. The HLM results indicated that organization-level effects did not affect the job satisfaction of NPs. Nurse practitioners with greater formal power, resources, and informal power had higher job satisfaction. Conversely, NPs with an intention to leave and a higher level of stress showed lower job satisfaction. Conclusions: Organizational empowerment, intention to leave, and stress affect job satisfaction of acute care NPs in Taiwan. Implications for practic: To enhance the job satisfaction of NPs, health care administrators should empower NPs by providing access to opportunity, support, information, and resources in the health care delivery system. [ABSTRACT FROM AUTHOR]

Biotic exchanges between Taiwan and Mainland China have shaped the biodiversity and ecosystems of both regions. Exchanges from Mainland China to Taiwan have received more attention, mainly studied in terrestrial vertebrates, while the reverse direction and invertebrates have largely been overlooked. Here, we explore the dispersal events between these two regions based on the moths of three species groups of Obeidia, including Taiwan taxa and its relatives from mainland. We conducted mixed methods and analysis, including reconstructing a phylogenetic tree, estimating associated divergence times and inferring ancestral areas and source regions, to explore the phylogeographical structure and genetic pattern of three groups based on eight genes. Our results revealed a structure of three clades and every clade included at least one Taiwanese taxa and its closest relatives of mainland of China, and also served Taiwan as an important source region of two mainland taxa. Our study revealed various origin pattern and dispersal models on the basis of three species groups of Obeidia. Bi‐directional biotic exchange via a land bridge were found: four Taiwanese taxa originated from mainland, and two of them migrated back to mainland. Both eastern Himalayas and south China are important origin areas for Taiwan biota, and the dominant source region may need multiple insect cases to confirm. Our study also provided evidences for disjunct distribution from the perspective of insecta molecular phylogeny. [ABSTRACT FROM AUTHOR]

Aim: The Massenerhebung effect (Mass elevation effect) refers to heat‐ or wind‐driven altitudinal distribution patterns of temperature‐dependent parameters among massifs with narrower range and lower elevation around peripheral and isolated mountains compared to core and continuous ones. Although common in ecology, this effect is rarely discussed in population genetics. Here, we use genetic markers to reveal population genetic patterns and also test the mountain‐ and sky‐barrier hypotheses relevant to the Massenerhebung distribution pattern of Acer morrisonense in Taiwan's rugged topography and varied local climates. Location: The alpine and cloud forest of Taiwan. Taxon: Acer morrisonense Hayata. Methods: Two chloroplast DNA (cpDNA) fragments and 17 expressed sequence tag‐simple sequence repeat (EST‐SSR) loci, respectively, from 200 to 286 individuals were used to elucidate the phylogeographic pattern of pollen and seed dispersal of A. morrisonense. These data were combined with ecological niche modeling (ENM) to infer distribution range shifts and refugia. We also correlated the genetic‐divergence indices with spatial factors to clarify latitudinal and altitudinal effects on genetic diversity. Results: The incongruent phylogeographic patterns of genetic distributions between nuclear and cpDNA markers indicate unhindered pollen flow but spatially constrained seed dispersal. Taken together with ENM, the genetic pattern further reflects historical colonization from central‐mountain refugia to edges since the Holocene. The Massenerhebung reduces the gene flow by the surrounding mountains and also causes lower genetic diversity compared to central alpine populations. Main conclusions: This study is the first to reveal the influence of Massenerhebung effect on cpDNA genetic structure of montane trees and reflect the spatial trends of seed dispersal. This population genetic pattern can also be attributed to the demography‐related range shifts with paleoclimate fluctuations under complex mountain topography, supporting the mountain‐barrier hypothesis. The results have important implications for conserving the genetic diversity of species with a wide altitudinal distribution range. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incidence of cancer among patients with ankylosing spondylitis (AS) and compare this risk with that of the general population. Method: We obtained data from Taiwan's National Health Insurance database on 19 289 patients with a first diagnosis of AS registered between 2000 and 2012 with no history of cancer before the diagnosis of AS. Standardized incidence ratios (SIRs) for all cancers and for site-specific cancers were used to assess whether AS was associated with an increased risk of cancer. Results: During the follow-up period, 485 patients developed cancer. The incidence rate was therefore 256.3 per 100 000 person-years. Compared with the general population, patients with AS had an increased risk of cancer [SIR 1.33, 95% confidence interval (CI) 1.20–1.47]. The SIR of cancer was higher in older patients; the risk increased from 8 years after initial diagnosis. Among solid tumours, the risk of melanoma was the highest (SIR 4.64, 95% CI 1.93–11.15), followed by prostate (SIR 2.53, 95% CI 2.01–3.19), thyroid (SIR 2.09, 95% CI 1.45–3.00), and bone cancer (SIR 2.00, 95% CI 1.01–3.99). Among haematological cancers, the risk of leukaemia was the highest (SIR 1.94, 95% CI 1.21–3.12). By contrast, the risks of oesophageal and oral cancers decreased in patients with AS. Conclusion: This nationwide population-based cohort study demonstrated that patients with AS in Taiwan are at an increased risk of cancer, particularly melanoma; prostate, thyroid, and bone cancers; and haematological malignancies. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Dual antibody-aided mesoporous nanoreactor for H2O2 self-supplying chemodynamic therapy and checkpoint blockade immunotherapy in triple-negative breast cancer" published in the Journal of Nanobiotechnology. The correction addresses an error in the funding information section, clarifying that the research was financially supported by the National Science and Technology Council, the National Health Research Institutes, and the Kaohsiung Armed Forces General Hospital in Taiwan. The original article has been corrected. The publisher, Springer Nature, maintains a neutral stance on jurisdictional claims and institutional affiliations. [Extracted from the article]

This article presents a Bayesian approach for simultaneously calibrating models and soil parameters using field data on wall deflections and ground surface settlement from braced excavations. This approach is developed based on the Metropolis–Hastings algorithm, the Gibbs algorithm, and hybrid Markov chain Monte Carlo simulation. The Formosa excavation case history is adopted to demonstrate this approach. The predictions are made by using both calibrated models and soil parameters, and the predicted excavation-induced responses from the models are shown to have greater accuracy and less variability than the responses obtained when updating the soil parameters only. This Bayesian approach is effective given the availability of reasonably estimated prior distributions and field observation data with good quality. [ABSTRACT FROM AUTHOR]

The aim of this study was twofold: first, to examine the lasting effects of working hours on later job performance and well‐being (i.e. emotional exhaustion and work engagement); second, to delineate the protective role of psychological detachment in the highly demanding Chinese work setting featuring long working hours. We employed a panel design in which all variables were measured twice, with six months in between the waves. Data were obtained from 323 Chinese employees working in diverse industries in Taiwan. Analysing the panel data with structural equation modelling (SEM) techniques, we found that working hours were positively associated with emotional exhaustion and negatively associated with work engagement and job performance, measured six months later. Detachment moderated the effects of working hours on later work engagement and job performance. Specifically, detachment attenuated the negative relationships between working hours and work engagement and job performance. The present study extends the recovery research in the West by demonstrating the protective role of detachment in the East Asian societies with important managerial implications. [ABSTRACT FROM AUTHOR]

Background: Climate change is expected to alter the factors that drive changes in adaptive variation. This is especially true for species with long life spans and limited dispersal capabilities. Rapid climate changes may disrupt the migration of beneficial genetic variations, making it challenging for them to keep up with changing environments. Understanding adaptive genetic variations in tree species is crucial for conservation and effective forest management. Our study used landscape genomic analyses and phenotypic traits from a thorough sampling across the entire range of Quercus longinux, an oak species native to Taiwan, to investigate the signals of adaptation within this species. Results: Using ecological data, phenotypic traits, and 1,933 single-nucleotide polymorphisms (SNPs) from 205 individuals, we classified three genetic groups, which were also phenotypically and ecologically divergent. Thirty-five genes related to drought and freeze resistance displayed signatures of natural selection. The adaptive variation was driven by diverse environmental pressures such as low spring precipitation, low annual temperature, and soil grid sizes. Using linear-regression-based methods, we identified isolation by environment (IBE) as the optimal model for adaptive SNPs. Redundancy analysis (RDA) further revealed a substantial joint influence of demography, geology, and environments, suggesting a covariation between environmental gradients and colonization history. Lastly, we utilized adaptive signals to estimate the genetic offset for each individual under diverse climate change scenarios. The required genetic changes and migration distance are larger in severe climates. Our prediction also reveals potential threats to edge populations in northern and southeastern Taiwan due to escalating temperatures and precipitation reallocation. Conclusions: We demonstrate the intricate influence of ecological heterogeneity on genetic and phenotypic adaptation of an oak species. The adaptation is also driven by some rarely studied environmental factors, including wind speed and soil features. Furthermore, the genetic offset analysis predicted that the edge populations of Q. longinux in lower elevations might face higher risks of local extinctions under climate change. [ABSTRACT FROM AUTHOR]

Research on structural stigma has associated the poor mental health status among lesbian, gay, and bisexual (LGB) people with discriminatory institutions. Yet, less is known about the role of LGB adults' perceptions of social attitudes toward LGB issues. Moreover, the psychological mediation framework posits LGB people's self-acceptance as a mediator between a stigmatizing environment and individual mental health. This study investigated: (a) how perceived attitudes toward LGB issues from different social realms (society, heterosexual friends, and family members) were associated with LGB people's mental health; and (b) whether self-acceptance mediated the effects of perceived attitudes. In this cross-sectional study, 1527 Taiwanese LGB adults (812 men; 715 women) aged between 20 and 62 years were recruited via Facebook to complete an online survey. The majority of respondents self-identified as homosexual (1129) and 399 as bisexual. The survey consisted of assessment of respondents' mental health and questions to rate individual self-acceptance and perceptions of social attitudes. Path analysis showed that self-acceptance partially mediated the association between mental health and perceived societal acceptance of homosexuality and fully mediated the effect of perceptions of friends' acceptance of homosexuality on mental health. Self-acceptance fully mediated the effects of perceived support for same-sex marriage from friends and families. This research yielded evidence about the interplay between perceived social stigma, self-acceptance, and mental health, particularly in the context of public debate about same-sex marriage. The effects of public discourse about sexual diversity and marriage equality on LGB adults' mental health should be addressed by affirmative policies and practices. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) and tuberculosis (TB) are major public health and economic burdens. DM increases Mycobacterium tuberculosis (M.tb) infection rates and treatment durations. This study evaluated the relationship between five classes of oral DM medications and TB infection risk in DM patients. We used longitudinal records from the Taiwan Longitudinal Health Insurance Research Database. DM patients were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 250 and A code A181. TB patients were identified using ICD-9-CM code 010.x-017.x. Oral DM medications were divided into five classes: sulfonylureas, biguanides, meglitinides, α-glucosidase inhibitors (AGIs), and thiazolidinediones. Users were classified as nonusers, low-concentration users, and high-concentration users. The incidence rate ratio (IRR) was derived using multivariate Poisson regression to calculate the relative risk of TB infection. DM patients using low- and high-concentration AGIs had significantly lower TB infection risks compared with nonusers. The IRRs of the sulfonylureas and AGI users were [CI] 0.693–0.948) and (95% CI 0.651–0.995), respectively. The other four classes of medications exhibited no significant effect on TB infection risk in DM patients. Furthermore, DM patients using high-concentration AGIs had a significantly lower TB infection risk compared with those using low-concentration AGIs (IRR 0.918, 95% CI: 0.854–0.987). We noted a dose-response relationship in the effects of DM medications on TB risk. Accordingly, we suggest that DM patients use AGIs to benefit from their protective effect on TB infection risk. [ABSTRACT FROM AUTHOR]

Quantitative trading is a crucial aspect of money management; however, conventional trading strategies are based on indicators and signals, despite the fact that position sizing is arguably the most important issue. In this study, we present a stock evaluation function that outputs the size of the stock in each fixed period as well as the consequences of increasing or decreasing the size of one's position. The difficulties involved in using machine learning to adjust stock weighting can be attributed to difficulties in obtaining definite answers via supervised learning. We therefore train our evaluation function using reinforcement learning via CNN within the EIIE network architecture and have the agent adjust the size of the position with the purpose of maximizing profits. Back testing was performed using the top 50 stocks in Taiwan, based on market capitalization. In experiments, most of the stock returns outperformed conventional strategies in terms of cumulative stock value. [ABSTRACT FROM AUTHOR]

Plantation forests play a critical role in forest management due to their high productivity and large contribution to carbon sequestration (CSE). The purpose of this study was to assess the CSE of plantations containing four important conifer species distributed across Taiwan, namely, the China fir (Cunninghamia lanceolata), Japanese cedar (Cryptomeria japonica), Taiwania (Taiwania cryptomerioides) and Taiwan red cypress (Chamaecyparis formosensis). Data regarding the plantations were obtained from a survey of permanent sample plots (PSPs). We used these data to calculate the CSE in each PSP and adopted CSEmean and CSEperiod as indicators to assess the CSE of the four conifers. According to the CSEmean obtained from analysis of variance and the least significant difference method, two groups were identified among these four conifers: the Japanese cedar (4.03 Mg ha−1 yr−1) and Taiwania (3.52 Mg ha−1 yr−1) yielded higher CSEmean values and the China fir (1.79 Mg ha−1 yr−1) and Taiwan red cypress (2.36 Mg ha−1 yr−1) yielded lower CSEmean values. The same patterns were observed in the CSEperiod values; however, no significant difference in CSEperiod was observed between Taiwan red cypress and either of the two groups. Therefore, Japanese cedar and Taiwania have high CSE potential among conifers. [ABSTRACT FROM AUTHOR]

Objectives: To carry out a comparison of upper urinary tract urothelial carcinoma characteristics and behavior between patients in Taiwan and Japan. Methods: A Taiwan urinary tract urothelial carcinoma cohort was obtained from Kaohsiung Chang Gung Memorial Hospital, and a Japan urinary tract urothelial carcinoma cohort from Hirosaki University Hospital. The inclusion criteria were urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy. Those who received perioperative chemotherapy were excluded. Finally, 765 patients in the Taiwan cohort and 325 in the Japan cohort were analyzed. The end‐point of this study was to study the natural course of urinary tract urothelial carcinoma within 5 years between these two groups. Results: The main finding was that urinary tract urothelial carcinoma patients in Taiwan were younger (P < 0.001), more were women (P < 0.001), with low‐stage disease (P < 0.001), with more chronic kidney disease (P < 0.001), with less smoking history (P < 0.001), with more bladder cancer history (P = 0.002), with more multifocal (P < 0.001) and less high‐grade disease (P = 0.015), as well as less lymphovascular invasion (P < 0.001) and more squamous differentiation (P < 0.001). However, the multivariate Cox regression analysis showed no racial difference in oncologic outcome, such as intravesical recurrence, systemic recurrence or cancer‐specific death in primary and propensity‐matched cohorts. Bladder cancer history was found to be the most important factor predicting intravesical recurrences, whereas stage was strongly associated with systemic recurrence and cancer specific mortality. Conclusions: The clinical characteristics of urinary tract urothelial carcinoma in Taiwan are significantly different from those of urinary tract urothelial carcinoma in Japan. However, there is no racial difference in stage‐specific oncologic outcome after standard nephroureterectomy. [ABSTRACT FROM AUTHOR]

Background Prescribing opioids for chronic noncancer pain (CNCP) has been strictly regulated in Taiwan. This study was undertaken to survey pain and non-pain related physicians' knowledge, attitudes, and practices regarding prescribing opioids for CNCP. Methods A questionnaire survey was conducted in this comparison study. All 66 physicians who were treating officially registered CNCP outpatients were visited and completed anonymous questionnaires. The other physicians (anesthesiologists, oncologists, and non-pain physicians) were surveyed by a mailed questionnaire. Results A total of 266 (75%) questionnaires were received from 355 board-certified physicians. More CNCP physicians (81.8%) and anesthesiologists (69.7%) had received prior CNCP-related training courses than had oncologists (21.2%) and non-pain physicians (10.3%). Varied proportions of physicians by type were unfamiliar with the Taiwan opioid regulations (16.7–86.8%) and would accordingly skip or reduce dosage of opioid prescriptions (27.3–73.5%). In addition, non-pain physicians had a significantly lower knowledge level, more negative attitudes, and greater hesitation about prescribing opioids compared to the pain-related physicians (P  < 0.001). CNCP physicians who had received CNCP-related training courses had a higher knowledge score than did those not receiving training (P  = 0.002). Overall, the leading barriers for prescribing opioids were inadequate knowledge of pain management (76%), physician reluctance (73%), and family reluctance (78%). Conclusion There are substantial knowledge gaps, negative attitudes, and hesitation toward prescribing long-term opioids for CNCP patients by physicians in Taiwan, suggesting that efforts are needed to improve postgraduate education regarding adequate opioid management for CNCP. [ABSTRACT FROM AUTHOR]

Adaptive trait divergence is usually episodic rather than universal in a phylogeny. To determine whether trait divergence reaches an extreme level (i.e. deviation from neutrality), the evolutionary rate of the species and intraspecific variation must be taken into account. Accordingly, we attempt to explore the trend of trait divergence over divergence times conditioned on the genetic distance. The Brownian motion (BM) model, a commonly used random-walk process for describing the neutral evolution of traits, is used to simulate the distribution of trait divergence under neutrality. The observed trait divergences are then compared to the BM expectations to detect outliers, which are considered to be selected. We assessed the ability of this method to characterize trait divergence under selection among 14 Lithocarpus species in Taiwan. The results are consistent with the previous inference of phylogenetic constraint based on tests of the phylogenetic signal, but further signals of adaptive and conserved trait divergences are detected between some lineages derived from particular nodes (common ancestors), indicating differential investments in growth rate and chemical defense among some endemic species in Taiwan. These results show that the adaptive divergence of environmentrelated traits is transient, episodic, and punctuated. Under strong selection pressure, the trait divergence after standard deviation correction will be more significant because the trait variance within the population decreases. However, it tends to be an overestimation of conservative evolution in older common ancestors due to the larger standard deviation produced from diverse descendants. Nevertheless, this study still provides a simple approach to detect adaptive divergence in a phylogenetic framework. [ABSTRACT FROM AUTHOR]

Species delimitation may be difficult for recently divergent species, particularly those with few distinguishable morphological characteristics. Zingiber kawagoii and Z. shuanglongensis are two recently divergent species endemic to Taiwan whose extremely similar vegetative characteristics hinder their distinction during non-flowering seasons. Given their recent divergence, the speciation process and introgressions between these two gingers warrant exploration. However, such studies are hampered by the absence of appropriate molecular markers. To solve this dilemma, we developed 20 transferable expressed sequence tag-simple sequence repeat loci (EST-SSR). Seven highly differentiated loci were further identified for rapid species delimitation. A preliminary test using discriminant analysis of principal components (DAPC) validated the effective discrimination of these EST-SSR loci, while Bayesian clustering analysis (BCA) revealed obvious introgression events between species, particularly on positive-outlier loci. These results imply adaptive introgressions between these species. However, more sampling and further experiments are necessary to validate this inference and resolve questions regarding the introgression and speciation mechanisms. The development of genetic markers in this study provides appropriate experimental conditions and a basis for further research. [ABSTRACT FROM AUTHOR]

We used a positive psychology perspective to explore the relationships among university students' social support, belonging, self-esteem, hope, and learning outcomes. Participants, comprising 739 students enrolled at a science and technology university in Taiwan, completed written questionnaires assessing the focal variables. The results showed that students' perception of social support influenced learning outcomes through self-esteem and belonging, which then influenced their hope. In addition, social support given by teachers versus that given by peers had different influences on students' hope. Teacher support effectively predicted the goal orientation, pathways thinking, and agency thinking dimensions of students' hope, whereas peer support effectively predicted students' pathways thinking and agency thinking but not goal orientation. Practical implications and recommendations for future research are presented. [ABSTRACT FROM AUTHOR]

Urothelial carcinoma is the most common cancer following kidney transplantation (KT) in Taiwan. Unusual presentation of upper urinary tract urothelial carcinoma (UTUC) is noted in Taiwan and China. As the post-KT-UTUC oncological course is not fully understood, the aim of this study is to identify postulated significant differences for the clinical cancer course of UTUC among end-stage renal disease (ESRD) patients with and without KT. From 2005 January to 2016 March, 194 ESRD patients underwent radical nephroureterectomy due to UTUC in our hospital. The parameters were obtained from the chart record and pathology report. SPSS version 21 software was used for all statistical analyses. Unequal matching created study groups wherein a 0.2 caliper width was performed for adjusting these confounding pathological factors. Propensity score-matching cohort was performed for each population first, and then for all the study patients. We observed that the average age of UTUC in ESRD patients after KT was younger than in those without KT. The pathological factors such as stage, bladder cancer history, papillary structure, lymphovascular invasion, and variant histology were equal in these two groups. However, younger onset (p<0.001), more multifocal tumors, and carcinomas in situ were observed in post-KT UTUC (p<0.001 and 0.006, respectively). After adjustment of pathological factors by propensity score-matched analysis, the 5-year systemic UTUC recurrence was significantly more in ESRD after KT compared with ESRD without KT (p=0.03). No obvious difference in 5-year cancer related death could be observed between these two groups (p=0.314). Post-kidney transplantation upper urinary tract urothelial carcinoma in Taiwan is relatively common, has younger onset, and is associated with aggressive pathological features. The oncologic outcome of UTUC after KT is poor in our observation, even after propensity scored-matched analysis. It indicates the immunosuppression status is still associated with more malignant UTUC behavior. [ABSTRACT FROM AUTHOR]

This case study presents the effect of spatial variability of soft clays on the geotechnical serviceability assessment of braced excavations. Finite element modeling is performed to predict the excavation-induced wall and ground movement. The spatial variations in two key soil parameters are modeled as two correlated lognormal random fields. The system reliability-based serviceability assessment conducted in this case study shows that the system probability of serviceability failure is greater than or equal to that for each single failure mode, indicating that serviceability assessment considering an individual failure mode can result in unsafe predictions. [ABSTRACT FROM AUTHOR]

Objective. To investigate the subsequent risks of urinary tract cancers among individuals with bladder pain syndrome/interstitial cystitis (BPS/IC), and gender differences, as well as the effect of associated comorbidity using a population-based administrative database in Taiwan. Patients and Methods. BPS/IC subjects (10192) and their age- and sex-matched non-BPS/IC control subjects (30576), who had no previous upper urinary tract cancer (UUC), bladder cancer (BC), and prostate cancer (PC), subsequently developed these disorders from the recruited date between 2002 and 2008 and the end of follow-up 2011. A Cox proportional hazards regression model was constructed to estimate the risk of subsequent UUC, BC, and PC following a diagnosis of IC/BPS. The effect of associated comorbidities was measured by Charlson Comorbidity Index (CCI). The risk of outcomes was assessed with Kaplan-Meier curves. Results. In the BPS/IC subjects, 37 (0.36%) received a diagnosis of BC, and 22 (0.22%) received a diagnosis of UUC; both were significantly higher than the control group, 19 (0.06%) for BC and 30 (0.10%) for UUC. Cox proportional analysis revealed that the adjusted HR for BC and UUC during the follow-up period for patients with IC/BPS was 5.44 (95% CI: 3.10-9.54) and 1.97 (95% CI: 1.13-3.45) than that of comparison subjects. The HRs went up to 5.66 (95% CI: 3.21-9.99) and 2.01 (95% CI: 1.14-3.55) after adjusted by Comorbidity Index (CCI). The male BPS/IC patients have a higher adjusted HR for BC; however, female patients have a higher adjusted HR for both BC and UUC. The adjusted HR for PC has no difference between BPS/IC and control group. Conclusion. Patients with BPS/IC are at risk of developing BC in both males and females, and UUC in females. This result reminds physicians to evaluate the potential risk of subsequent development of BC and UUC among individuals with BPS/IC. [ABSTRACT FROM AUTHOR]

Based on regional spatial structure theory, this paper analyzed the mechanism of further regional economic cooperation between Fujian and Taiwan under the Belt and Road background. Then countermeasures and suggestions were put forward, including cooperation on agriculture, infrastructure, talent and industrial between Fujian and Taiwan. [ABSTRACT FROM AUTHOR]

New approach methodologies in toxicology, such as in vitro high-throughput screening (HTS), can minimize the use of experimental animals and allow mechanism-based predictions of in vivo toxicity. HTS data has been increasingly used in the regulatory context; however, only a few studies integrated dietary exposure and HTS data to foster chemical prioritization in food. Additionally, the endocrine-associated risk of veterinary drug residues in food is yet to be fully characterized. This study aims to systematically compare the translated HTS data with the acceptable daily intake (ADI) values and prioritize the pesticides and veterinary drug residues (n = 294) in food using the exposure-activity ratio (EAR) and Toxicological Prioritization index (ToxPi). The dietary exposure assessment was accomplished using a stochastic human exposure and dose simulation high-throughput model (SHEDS-HT). We selected 76 HTS assays from 12 nuclear receptors to represent the molecular initiating event (MIE) of endocrine-disrupting phenotypes. Chemical prioritization was achieved using 4 methods (i.e., EAR-OED, EAR-ADI, ToxPi-exposure + ADI, and ToxPi-exposure + endocrine score), where the consensus prioritized chemicals were fipronil, furazolidone, oxolinic acid, and oxytetracycline for the Taiwanese population. This case study demonstrates the utility of HTS data in fostering regulatory decisions on chemicals, especially for those lacking comprehensive toxicity data. • Characterize the aggregate exposure of pesticides and veterinary drugs in Taiwan. • Review the high-throughput screening data to assess the endocrine-active potentials. • Compare the in vitro point of departure data with the acceptable daily intake. • Combine exposure and in vitro HTS data to foster chemical prioritization. • A prioritization framework for endocrine-active chemicals was proposed. [ABSTRACT FROM AUTHOR]

Aspidistra Ker Gawl. is one of the the most diverse and fastest-growing genera of angiosperm. Most Aspidistra species have been discovered in a limited area or a single site through morphological comparison. Because of the lack of population studies, morphological variation within species and the boundaries of some species remain unclear. In recent years, combining genetic and morphological markers has become a powerful approach for species delimitation. In this study, we performed population sampling and integrated morphometrics and microsatellite genetic diversity analyses to determine the species diversity of Aspidistra in Taiwan. We identified three species, namely Aspidistra attenuata Hayata; A. daibuensis Hayata var. daibuensis; A. mushaensis Hayata var. mushaensis; and reduced A. longiconnectiva C.T.Lu, K.C.Chuang & J.C. Wang to the variety level, and described a new variety, A. daibuensis Hayata var. longkiauensis. The description, diagnosis, distribution, and photographs of this new variety as well as a key to the known Taiwanese Aspidistra are provided. [ABSTRACT FROM AUTHOR]

Background: Enterovirus 71 (EV71) belongs to picornavirus family and could be classified phylogenetically into three major genogroups (A, B and C) including 11 genotypes (A, B1-B5 and C1-C5). Since 1997, EV71 has caused large-scale of epidemics with neurological complications in Asian children. In Taiwan, nationwide EV71 epidemics with different predominant genotypes have occurred cyclically since 1998. A nationwide EV71 epidemic occurred again in 2012. We conducted genetic and antigenic characterizations of the 2012 epidemic. Methods: Chang Gung Memorial Hospital (CGMH) is a medical center in northern Taiwan. In CGMH, specimens were collected from pediatric inpatients with suspected enterovirus infections for virus isolation. Enterovirus isolates were serotyped and genotyped and sera from EV71 inpatients were collected for measuring neutralizing antibody titers. Results: There were 10, 16 and 99 EV71 inpatients identified in 2010, 2011 and 2012, respectively. There were 82 EV71 isolates genotyped, which identified 17 genotype C4a viruses and 65 genotype B5 viruses. The genotype B5 viruses were not detected until November 2011 and caused epidemics in 2012. Interestingly, the B5-2011 viruses were genetically distinguishable from the B5 viruses causing the 2008 epidemic and are likely introduced from China or Southeastern Asia. Based on antigenic analysis, minor antigenic variations were detected among the B5-2008, B5-2011, C4a-2008 and C4a-2012 viruses but these viruses antigenically differed from genotype A. Conclusions: Genotype B5 and C4a viruses antigenically differ from genotype A viruses which have disappeared globally for 30 years but have been detected in China since 2008. Enterovirus surveillance should monitor genetic and antigenic variations of EV71. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine an integrated model of the work-family interface ( WFI) linking work-family demands (workload and family conflict), resources (supervisory support and family support) and role satisfaction in a Chinese context. The four-factor structure of WFI comprises direction of influence (work to family vs family to work) and types of effect (work-family conflict vs work-family enrichment). A longitudinal design was used to collect data from 409 Chinese employees at three time points, separating measures of antecedents ( T1), WFI ( T2) and outcomes ( T3) in time. The results based on structural equation modelling ( SEM) reveal that: (1) the direction and types of effect were two underlying dimensions of the WFI, supporting the four-factor structure; (2) demands were more strongly related to conflict, while resources were more strongly related to enrichment; (3) work-family conflict and enrichment were related to role satisfaction, regardless of the direction of influence. [ABSTRACT FROM AUTHOR]

Cooperative learning has many pedagogical benefits. However, if the cooperative learning teams become ineffective, these benefits are lost. Accordingly, this study developed a computer-aided assessment method for identifying ineffective teams at their early stage of dysfunction by using the Mahalanobis distance metric to examine the difference between the sequential test scores of the unknown team and the test scores of a reference group of functioning teams. The effectiveness of the proposed method was verified by conducting field experiments over an 18-week engineering course in Taiwan. Forty-eight students were randomly assigned to cooperative learning teams. The students' learning performance was evaluated by means of unit tests and homework tests. The functioning of the cooperative teams was examined at seven different points during the course of the study. The ineffective teams were identified with quantified type I errors. It was found that some teams failed persistently. Such teams require some form of external intervention to remedy the group dynamics. The results also showed that teams can become ineffective at any stage of the cooperative learning process. Thus, continuous monitoring is required to ensure that appropriate remedial actions are taken in a timely manner. [ABSTRACT FROM AUTHOR]

The aim of this study was two-fold: first, to examine both the immediate and the lasting effects of presenteeism on health; second, to explore the moderating effect of self-efficacy on the presenteeism-health relationship in a Chinese context. We employed a two-wave study design in which presenteeism, health (i.e. physical health, mental health and exhaustion), and self-efficacy were assessed at Time 1; health was measured again at Time 2 three months later. We surveyed a diverse sample of 345 full-time Chinese employees working in Taiwan and mainland China. Hierarchical regression analyses showed that presenteeism over the previous six months was negatively related to employees' physical health, mental health and exhaustion at Time 1. However, we found no association between presenteeism and health at Time 2, after controlling for the baseline level of health, indicating that presenteeism may not have a lasting effect. Self-efficacy was found to moderate the relationships between presenteeism and all three aspects of health at Time 2, suggesting that for some individuals presenteeism may not on balance be a bad thing. The study sheds light on the association between presenteeism and health. The findings on self-efficacy also extend the literature to incorporate individual characteristics in the presenteeism context. [ABSTRACT FROM PUBLISHER]

Lung cancer is the leading cause of death from cancer in Taiwan and throughout the world. Immunotherapy has revealed promising and significant efficacy in NSCLC, through immune checkpoint inhibition by blocking programmed cell death protein (PD)-1/PD-1 ligand (PD-L1) signaling pathway to restore patients' T-cell immunity. One novel type of long, non-coding RNAs, circular RNAs (circRNAs), are endogenous, stable, and widely expressed in tissues, saliva, blood, urine, and exosomes. Our previous results revealed that the plasma level of hsa_circ_0000190 can be monitored by liquid-biopsy-based droplet digital PCR and may serve as a valuable blood-based biomarker to monitor the disease progression and the efficacy of immunotherapy. In this study, hsa_circ_0000190 was shown to increase the PD-L1 mRNA-mediated soluble PD-L1 (sPD-L1) expression, consequently interfering with the efficacy of anti-PD-L1 antibody and T-cell activation, which may result in immunotherapy resistance and poor outcome. Our results unraveled that hsa_circ_0000190 facilitated the tumorigenesis and immune evasion of NSCLC by upregulating sPD-L1 expression, potentially developing a different aspect in elucidating the molecular immunopathogenesis of NSCLC. Hsa_circ_0000190 upregulation can be an effective indicator for the progression of NSCLC, and hsa_circ_0000190 downregulation may possess a potential therapeutic value for the treatment of NSCLC in combination with immunotherapy. [ABSTRACT FROM AUTHOR]

Acinetobacter baumannii is the main cause of nosocomial infections, which are increasingly difficult to treat due to the emergence of carbapenem resistance. This study focused on major carbapenemase genes and explored the association between carbapenemase genes, sequence types (ST types), and capsular types (K types). A total of 98 carbapenem-resistant A. baumannii (CRAB) strains were collected from two hospitals, the Chang Gung Memorial Hospital-Lin Kou branch (LCGMH) in northern Taiwan and the CGMH-Kaohsiung branch (KCGMH) in southern Taiwan, from 2015 to 2017. Major carbapenemase genes of class A, B, and D β-lactamases were detected by polymerase chain reaction. All strains except 1 were positive for bla OXA-51-like , 76 strains (77.6%) carried bla OXA-23-like , and 25 strains (25.5%) carried bla OXA-24-like. The regional distribution showed that bla OXA-23-like was more common than bla OXA-24-like in both hospitals (85.3% and 60% in LCGMH and KCGMH, respectively); however, the percentage of bla OXA-24-like was much higher in KCGMH (46.7%) than in LCGMH (16.2%). Oxford multilocus sequence typing and global optimal eBURST analysis were conducted for 59 strains. The results of this study showed the association between bla OXA gene patterns, ST types, and K types and demonstrated that four major K types, KL2, KL10, KL22, and KL52, which were associated with specific ST types, were mainly clustered into clonal complexes CC208 and CC549 (a unique clonal complex found in Taiwan). These findings provide important information for monitoring the epidemiology and dissemination of this pathogen. [ABSTRACT FROM AUTHOR]

Background: Thrombosis with thrombocytopenia syndrome (TTS) is a very rare prothrombotic disorder that is a safety concern for some COVID-19 vaccines. We aimed to devise a case definition to estimate the incidence of thrombosis with thrombocytopenia as a proxy for TTS in a national insurance claims database. Methods: We conducted a retrospective observational study using the National Health Insurance Research Database (NHIRD) in Taiwan over the three-year period prior to the SARS-COV-2 pandemic (2017–2019). Our case definition was all patients with newly diagnosed thrombosis co-occurring with a diagnosis of thrombocytopenia within seven days before or after the thrombosis diagnosis. Cases were identified using International Classification of Disease-10 codes. Findings: We identified 2010 patients with newly diagnosed thrombosis co-occurring with thrombocytopenia during the study period. The mean age was 64.71 years; female:male ratio 1:1.45. The most frequent thrombotic events were coronary artery disease (18.81%), cerebral infarction (16.87%), and disseminated intravascular coagulation (13.13%). Cerebral venous sinus thrombosis was rare (<0.1%). The average annual incidence rate of co-occurring new diagnoses of thrombosis and thrombocytopenia was 2.84 per 100 000 population. Incidence rates were higher in men than women, except in 20–39 year-olds (higher in females). 20.6% of patients died within the first month after diagnosis. Interpretation: We observed that the demographic and clinical characteristics of thrombosis with co-occurring thrombocytopenia using our case definition is different from that of TTS. Further research is needed to refine the case definition of TTS in the post-COVID-19 vaccination period. [ABSTRACT FROM AUTHOR]

The article discusses the use of ultrafast photoemission spectroscopy and photon engineering techniques in the study of quantum materials. These techniques allow scientists to observe the development of electronic band structures and their occupancy over time, providing insights into non-equilibrium characteristics. The National Synchrotron Radiation Research Center in Taiwan is working on enhancing time-resolved spectroscopic methodologies, including the development of a time-resolved photoemission spectroscopy system and a time-resolved angle-resolved photoemission spectroscopy system. These systems aim to deepen our understanding of the electronic and dynamic characteristics of substances and their relationship with fundamental physical attributes. The article highlights the design and specifications of the Tr-ARPES setup, including the laser source, optics, and photon flux generation. The system offers high energy and temporal resolution, making it a powerful tool for studying quantum materials and driving innovation in various scientific and technological fields. [Extracted from the article]

The purpose of this study is to understand factors that affect continuance intention of a popular hedonic information system, blogs. The expectation-confirmation theory (ECT) is adapted with perceived enjoyment, habit and user involvement. Data was collected via an online survey. A total of 430 valid responses were collected. The research model was assessed by structural equation modelling (SEM). The results show that continuance intention of blog use was predicted collectively by user involvement, satisfaction and perceived enjoyment. Habit, however, exhibited no strong relationship with satisfaction and use intention. Users' satisfaction with blog use was predicted primarily by perceived enjoyment, followed by users' confirmation of expectation and user involvement. Perceived enjoyment was predicted by users' involvement and users' confirmation of expectation. Blogging time significantly moderates the effect of habit on perceived enjoyment, but not on satisfaction and continuance intention. The integrated model explains 65% of the satisfaction and 57% of continuance intention. The results suggest that integrating perceived enjoyment and user involvement into the ECT provides better insights into continuous use in the blog context. [ABSTRACT FROM AUTHOR]

Abstract: Sun Moon Lake (SML) is located at 23°52′N, 120°55′E near the center of Taiwan Island. In 2009, deposition of polychlorinated dibenzo-p-dioxin and dibenzofuran (PCDD/F) in ambient air, water bodies and sediments were measured in SML in this study. The monthly atmospheric PCDD/F deposition ranged from 0.61 to 3.0pg I-TEQm−2 d−1 in the vicinity area of SML. Average PCDD/F concentrations (0.008–0.012pg I-TEQ L−1) in the surface water were uniform and sufficiently mixed at the center, outflow and south bay of SML. However, the PCDD/F content (2.42±0.5ng I-TEQ kg−1 d.w.) of surface sediments measured at the south bay of SML was significantly higher than the PCDD/F content at other sampling sites. To evaluate the anthropogenic pollution history in central Taiwan, PCDD/F concentrations were also analyzed at 1–2cm intervals in three dated sediment cores collected at different locations of SML. The year dating by the sediment cores at different depths was estimated from the sedimentation rate (0.47±0.13–1.35±0.22cmy−1) calculated by 210Pb and 137Cs analysis. Based on the results of isotope analysis of sediment cores collected from the center, outflow and south bay of SML, PCDD/F concentrations at different locations appeared to be quite similar. PCDD/F concentrations in sediment cores began to increase in 1964 and reached a peak (4.78ng I-TEQ kg−1 d.w.) in 1968. In addition, variation in PCDD/F content at different depth of the sediment cores appeared to correlate directly with the rate of organochlorine pesticides production in Taiwan. [Copyright &y& Elsevier]

There are few nationwide population studies on the epidemiology of rheumatoid arthritis (RA). Here, we present the epidemiologic features and mortality rates of RA in Taiwan. The catastrophic illness registry of the Taiwan National Health Insurance Research Database and the National Death Registry of Taiwan were used to estimate the incidence and prevalence of RA and its associated mortality rates. All-cause and cause-specific standardized mortality ratios (SMRs) were calculated and compared to the corresponding ratios of the general population in 2002. The study comprised 15,967 incident RA cases (3,562 men; 12,405 women) occurring from 2002 through 2007. The annual incidence of RA was 15.8 cases (men, 10.1; women, 41.0) per 100,000 population. The period prevalence was 97.5 cases (men, 37.4; women, 159.5) per 100,000 population. During 67,010 person-years of follow-up, 985 deaths (372 men; 613 women) were identified, and this corresponded to a crude mortality rate of 14.7 deaths (men, 25.0; women, 11.8) per 1,000 person-years. Compared to female patients, male patients had a higher risk for mortality (log-rank test, p < 0.001). RA patients had an SMR of 1.25 (95 % confidence interval [CI], 1.18-1.33) for all-cause mortality. Compared to the general population, RA patients of both genders in this cohort had a significantly higher risk of mortality from infection (SMR, 2.49) and gastrointestinal diseases (SMR, 1.76). RA incidence and prevalence were higher in women than in men. Mortality was higher in men than in women. Compared to the general population, RA patients had a higher risk of death, particularly from infection and gastrointestinal diseases. [ABSTRACT FROM AUTHOR]

The aim of this research was to explore the impact of independent and interdependent self-construals on relations between work and family demands (workload and family conflict) and work/family conflict (WFC and FWC). Three hundred and ten Taiwanese employees were surveyed at two times (6 weeks apart) using structured questionnaires. For Taiwanese employees, workload was positively related to WFC (r = .39), whereas family conflict was positively related to FWC (r = .24). Furthermore, independent self-construal exacerbated the positive relation between workload and WFC (the interaction effect accounted for an additional 1.7% of variance in WFC), but buffered the positive relation between family conflict and FWC (the interaction effect accounted for an additional 2.6% of variance in FWC). However, interdependent self-construal did not have a moderating effect on either the workload-WFC or family conflict-FWC relation. It is recommended that culture as construed at the individual level needs to be studied in order to understand its intricate effects on individuals' perceptions of work and family demands and conflict. [ABSTRACT FROM AUTHOR]

Background Few large population-based studies have compared the occurrence of peptic ulcer bleeding ( PUB) in cirrhotic and noncirrhotic patients. Aims To investigate if cirrhotic patients have higher risk of PUB than the general population and to identify possible risk factors of PUB in cirrhotic patients. Methods Using the National Health Insurance Research Database, a nationwide population-based dataset in Taiwan and matching age, gender, comorbidities and ulcerogenic medication by propensity score, 4013 cirrhotic patients, 8013 chronic hepatitis patients and 7793 normal controls were compared. The log-rank test was used to analyse differences in accumulated PUB-free survival rates between the groups. Cox proportional hazard regressions were performed to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in cirrhotic patients. Results During the 7-year follow-up, cirrhotic patients had significantly higher incidences of PUB than chronic hepatitis patients and controls, respectively ( P < 0.001 by log-rank test). By Cox proportional hazard regression analysis, cirrhosis was independently associated with increased risk of PUB (hazard ratio: 4.22; 95% CI 3.37-5.29, P < 0.001) after adjusting for age, gender, economic status, underlying comorbidities and ulcerogenic medication. Age, male, diabetes, chronic renal disease, history of gastro-oesophageal variceal bleeding and use of nonsteroidal anti-inflammatory drugs were risk factors for PUB in cirrhotic patients. Conclusion Cirrhotic patients have a significantly higher risk of peptic ulcer bleeding after adjustments for possible confounding factors like age, gender, economic status, underlying comorbidities and ulcerogenic medication. [ABSTRACT FROM AUTHOR]

Résumé: Objectifs: Peu d’études se sont intéressées à l’association entre goutte et cancer. Cette étude examine le risque relatif de cancers au sein d’une cohorte nationale. Méthodes: La base de données de l’assurance maladie nationale de Taïwan constituait la source de données primaires. Les données recueillies de 2000 à 2008 chez des sujets âgés de plus de 20ans et sans antécédent de cancer ont été inclues dans l’analyse. La définition des cas de la goutte correspondait aux dossiers mentionnant un diagnostic de goutte et les traitements adaptés (médicaments hypo-uricémiants, incluant allopurinol, benzbromarone, probénécide et sulfinpyrazone, ainsi que la colchicine). Un modèle de régression de Cox (modèle à risques proportionnels) a été utilisé pour estimer l’association entre goutte et cancer. Résultats: Un total de 694361 patients (355278hommes, 339083femmes) ont été inclus ; parmi eux, 25943présentaient un antécédent de goutte. L’âge moyen (±écart-type) était de 42,3±16,3ans. Pendant les 5471272années-patients de suivi, un cancer a été détecté chez 24088patients (1745 atteints de goutte et 22343 témoins). La plupart des cancers concernaient le foie, le poumon et le côlon. L’incidence globale du cancer était significativement plus élevée parmi les patients goutteux que parmi les témoins (8,7 vs 4,2 cas par 1000 années-patients, p <0,001). Après ajustement sur l’âge et le sexe, la goutte s’est révélée associée au cancer avec un « hazard ratio » (HR) (rapport des risques instantanés) de 1,15 (intervalle de confiance à 95 % [IC], 1,10–1,21 ; p <0,001). La goutte était associée dans la majeure partie des cas au cancer de la prostate, avec un HR ajusté sur l’âge et le sexe de 1,71 (1,45–2,02). D’un autre côté, la goutte tendait à une association inverse, bien que négligeable, avec le cancer du sein (HR ajusté, 0,81 ; IC 95 %, 0,63–1,04). Conclusion: La goutte était associée à un risque de cancer plus élevé, notamment celui de la prostate chez les hommes. [Copyright &y& Elsevier]