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Taiwan and Philippine (TWPH) (117°E-129°E, 5°N-26°N) is a region with most frequent and intense tropical cyclone (TC) influence in the world. This paper documents the climatology and variability of TWPH TC activity with specific attention to the difference in the TCs formed over the western North Pacific (WNP) and over the South China Sea (SCS). The spatial characteristics of TWPH TCs are analyzed based on the accumulated cyclone kinetic energy (ACE) in four sub-areas where distinctly different TC seasonality and variability is found. Different from over the broad Northwest Pacific Basin (0°-60°N, 100°E-180°) where the WNP-born TC frequency dropped sharply in late-1990s and the SCS-born TC frequency slightly increased in mid-1990s, over TWPH three distinct epochs are identified. A weakvariability epoch occurred during 1979-1996, a persistent low-ACE epoch during 1997-2002, and a more variable epoch during 2003-2018. The second epoch is most noteworthy. The unusually weak TC activity during this period in particular over the Philippines was associated with anomalously strong anticyclone over the SCS and the Philippine Sea during the East Asian summer monsoon season. The strong anticyclonic circulation appeared as a descending leg of the enhanced East Asian summer monsoon during summer (July-September). During autumn and early winter (September-December) the Philippine Sea anticyclone was interpreted as the descending Rossby wave response to the suppressed convection over tropical western Pacific. The anomalous anticyclone strengthened the low-level confluent flow and convection over the SCS. The findings are useful to real-time TWPH TC activity monitoring and analysis. [ABSTRACT FROM AUTHOR]

Background: Soft tissue artifacts (STAs) are a source of error in marker-based gait analysis in dogs. While some studies have revealed the existence of STAs in the canine hindlimb, STAs and their influence on kinematic gait analysis remain unclear. Methods: Thirteen healthy Taiwan dogs affixed with twenty skin markers on the thigh and crus were recruited. Soft tissue artifacts and their influence on the determination of segment poses and stifle angles were assessed by simultaneously measuring marker trajectories and kinematics of the underlying bones via a model-based fluoroscopic analysis method. Results: Markers on the thigh showed higher STAs than those on the crus, with root-mean-square amplitudes up to 15.5 mm. None of the tested marker clusters were able to accurately reproduce the skeletal poses, in which the maximum rootmean- square deviations ranged from 3.4° to 8.1°. The use of markers resulted in overestimated stifle flexion during 40-60% of the gait cycle and underestimated stifle flexion during 80-90% of the gait cycle. Conclusions: Considerable magnitudes and effects of STAs on the marker-based 3D gait analysis of dogs were demonstrated. The results indicate that the development of error-compensation techniques based on knowledge regarding STAs is warranted for more accurate gait analysis. [ABSTRACT FROM AUTHOR]

This study develops several chemical and physical methods to evaluate the quality of a traditional Chinese formulation, Jia-Wei-Xiao-Yao-San. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) coupled with electrospray ionization was used to measure the herbal biomarkers of saikosaponin A, saikosaponin D, ferulic acid, and paeoniflorin from this herbal formula. A scanning electron microscope (SEM) and light microscopy photographs with Congo red staining were used to identify the cellulose fibers if raw herbal powder had been added to the herbal pharmaceutical product. Moreover, water solubility and crude fiber content examination were used to inspect for potential herbal additives to the herbal pharmaceutical products. The results demonstrate that the contents of the herbal ingredients of saikosaponin A, saikosaponin D, ferulic acid, and paeoniflorin were around 0.351 ± 0.017, 0.136 ± 0.010, 0.140 ± 0.005, and 2.281 ± 0.406mg/g, respectively, for this herbal pharmaceutical product. The physical examination data demonstrate that the rawherbal powder had rough, irregular, lumpy, filamentous, and elongated shapes, as well as strong Congo red staining. In addition, water solubility and crude fiber content were not consistent in the herbal pharmaceutical products. [ABSTRACT FROM AUTHOR]

Background: Prolonged mechanical ventilation (PMV) is increasingly common worldwide, consuming enormous healthcare resources. Factors that modify PMV outcome are still obscure. Methods: We selected patients without preceding mechanical ventilation within the one past year and who developed PMV during index admission in Taiwan's National Health Insurance (NHI) system during 1998-2007 for comparison of mortality and resource use. They were divided into three groups: (1) patients with end-stage renal diseases (ESRD) before the index admission for PMV onset; (2) patients with dialysis-requiring acute kidney injury (AKI-dialysis) during the hospitalization course; and (3) patients without AKI or with non dialysis-requiring AKI during the hospitalization course (non-AKI). We used a random-effects logistic regression model to identify factors associated with mortality. Results: Compared with the other two groups, patients with AKI-dialysis had significantly longer mechanical ventilation, more frequent use of vasopressors, longer intensive care unit/hospital stay and higher inpatient expenditures during the index admission. Relative to non-AKI patients, patients with AKI-dialysis had an elevated mortality hazard; the adjusted relative risk ratios were 1.51 (95% confidence interval [CI]:1.46-1.56), 1.27 (95% CI: 1.23-1.32), and 1.10 (95% CI: 1.08-1.12) for mortality rates at discharge, 3 months, and 4 years after PMV, respectively. Patients with AKI-dialysis also consumed significantly higher total in-patient expenditure than the other two patient groups (p<0.001). Conclusions: Among patients that need PMV care during an admission, the presence of de novo AKI requiring dialysis significantly increased short and long term mortality, and demand for health care resources. [ABSTRACT FROM AUTHOR]

A new approach to forecasting regional and seasonal tropical cyclone (TC) frequency in the western North Pacific using the antecedent large-scale environmental conditions is proposed. This approach, based on TC track types, yields probabilistic forecasts and its utility to a smaller region in the western Pacific is demonstrated. Environmental variables used include the monthly mean of sea surface temperatures, sea level pressures, low-level relative vorticity, vertical wind shear, and precipitable water of the preceding May. The region considered is the vicinity of Taiwan, and typhoon season runs from June through October. Specifically, historical TC tracks are categorized through a fuzzy clustering method into seven distinct types. For each cluster, a Poisson or probit regression model cast in the Bayesian framework is applied individually to forecast the seasonal TC activity. With a noninformative prior assumption for the model parameters, and following Chu and Zhao for the Poisson regression model, a Bayesian inference for the probit regression model is derived. A Gibbs sampler based on the Markov chain Monte Carlo method is designed to integrate the posterior predictive distribution. Because cluster 5 is the most dominant type affecting Taiwan, a leave-one-out cross-validation procedure is applied to predict seasonal TC frequency for this type for the period of 1979--2006, and the correlation skill is found to be 0.76. [ABSTRACT FROM AUTHOR]

Background: This study investigated the incidence of potentially preventable hospitalisations in the first two years of life among children in the National Health Insurance (NHI) system of Taiwan. It also examined income disparities in potentially preventable hospitalisations across four economic categories: below a government-established poverty line and low-, middle-, and upper-income. Five major diseases causing potentially preventable hospitalisations were investigated: gastroenteritis and dehydration, asthma and chronic bronchitis, acute upper respiratory infections, lower respiratory infections, and acute injuries and poisonings. Methods: NHI data on enrolee registrations and use of ambulatory and hospital care by all children born between July 1, 2003 and June 30, 2004 (n = 218,158) was used for the study. The negative binomial regression method was used to identify factors associated with total inpatient care and the severity level for various types of potentially preventable hospitalisations during the first two years of life. Results: This study found high inpatient expenses for lower respiratory infections for children in all income categories. Furthermore, results from the multivariate analysis indicate that children in the lowest economic category used inpatient care to a much greater extent than better-off children for problems considered potentially avoidable through primary prevention or through timely outpatient care. This was especially true for acute injuries and poisonings and for lower respiratory infections. On average, and controlling for other variables, a child in poverty spent 6.1 times more days in inpatient care for acute injuries and poisonings (p < 0.01) and 2.7 times more days for lower respiratory infections (p < 0.01) before age two, compared with a similarly-aged high-income child. The results also suggest a connection between economic status and the severity of a condition causing a potentially avoidable hospital admission. On average, length of stay for each admission for gastroenteritis and dehydration for children in poverty was 1.3 times that for high-income children (p < 0.01). Both the ratios for lower respiratory infections and for acute upper respiratory infections were 1.2 (p < 0.01 for both). Conclusions: There were high hospital admission rates and lengths of stays for lower respiratory infections among young children in all income categories. Hospital care use of young children in the poorest category was significantly higher for acute injuries and poisonings as well as for lower respiratory infections, compared with those of better-off children. The findings suggest the need for increased attention to these two disease types. It particularly calls for more research on the causes of high hospital care use for lower respiratory infections and on the reasons for large economic disparities in hospital care use for acute injuries and poisonings. [ABSTRACT FROM AUTHOR]

Background: Self-esteem, a key construct of personality, influences thoughts, actions, and feelings. Adolescence is a critical stage to the development of self-esteem. Taiwan currently offers no self-esteem building curriculum in the public education system. Therefore, incorporating self-esteem-related teaching activities into the existing curriculum represents a feasible approach to enhance self-esteem in middle school students. Purpose: This study aimed to explore the effects on junior high school students' self-esteem of a self-esteem program incorporated into the general health and physical education curriculum. Methods: A quasi-experimental research design was used, and 184 seventh-grade students at two junior high schools in Taipei City were randomly selected and separated into two groups. The experimental group received one 32-week self-esteem program incorporated into their regular health and physical education curriculum, which was administered in three 45-minute-session classes each week. The control group received the regular health and physical education with no specially designed elements. During the week before the intervention began and the week after its conclusion, each participant's global and academic, physical, social, and family self-esteem was assessed. Data were analyzed using analysis of covariance. Results: For all participants, the experimental group was significantly superior to the control group in respect to physical self-esteem (p = .02). For girls, the experimental group was significantly superior to the control group in family self-esteem (p = .02). However, there was no significant difference between the two groups in terms of global self-esteem. Conclusions and Implications for Practice: This study provides preliminary evidence that incorporating self-esteem activities into the regular school health and physical education curriculum can result in minor effects in students' physical self-esteem and family self-esteem. Findings may provide teachers and school administrators with information to help them design programs to improve students' self-esteem. This study also reminds health professionals to focus on providing self-esteem-building programs when working with adolescent clients. [ABSTRACT FROM AUTHOR]

lin p-c&lu c-m (2005) Journal of Clinical Nursing14, 719–726Hip fracture: family caregivers’ burden and related factors for older people in TaiwanThe purpose of this study was to explore the burden experienced by caregivers during the transition from hospital to home.With a growing older population, home-based care has gradually gained more recognition. Most older people with hip fracture in Taiwan have to be discharged at a relatively early stage. Therefore, the caregiving tasks falls on the families.A total of 98 older people with hip fracture and their caregivers were interviewed. The sample was selected from three medical centres in Taipei, and questionnaires were collected at one week and one month following hospital discharge.(i) Family caregivers were usually women (63.3%) with spouses being the primary caregivers in most cases (30.6%). About one-third of caregivers took care of other family members on top of their responsibilities caring for the sick elders at home, and 77.6% shared the care tasks with others. (ii) The caregivers experienced moderate burdens. About 91.8% of caregivers reported‘I feel sad watching the elder's health deteriorating’, 84.9% reported‘I must keep an eye on the elder constantly’ and 56.7% reported‘Taking care of the sick elder at home makes me feel exhausted’. (iii) Caregiver burden and the functional level of older people were adversely correlated. (iv) Caregivers who were unable to access other resources for help and/or had provided care to the older person prior to the fracture resulting in hospitalization experienced a higher burden.These findings should be helpful in the formulation of evidence-based discharge planning and home health care services.Comprehensive discharge planning and developing social support systems for family caregivers to reduce caregivers burden are needed. [ABSTRACT FROM AUTHOR]

This study investigated the association between food insecurity and Taiwanese children's ambulatory medical care use for treating eighteen disease types linked to endocrine and metabolic disorders, nutrition, immunity, infections, asthma, mental health, injury, and poisoning. We used longitudinal data in the Taiwan National Health Insurance scheme (NHI) for 764,526 elementary children, and employed approximate NHI data to construct three indicators imputed to food insecurity: low birth weight status, economic stains (poverty versus nonpoverty), and time of year (summer break time versus semester time). We compared ambulatory care for these diseases between children with low birth weight and those not, and between children living in poverty and those not. A difference-in-differences method was adopted to examine the potential for a publicly- funded lunch program to reduce the harmful health effects of food insecurity on poor children. We found that children in poverty were significantly more likely to have ambulatory visits linked with diabetes, inherited disorders of metabolism, iron deficiency anemias, ill-defined symptoms concerning nutrition, metabolism and development, as well as mental disorders. Children with low birth weight also had a significantly higher likelihood of using care for other endocrine disorders and nutritional deficiencies, in addition to the above diseases. The study failed to find any significant effect of the semester school lunch program on alleviating the harmful health effects of food insecurity for poor children, suggesting that a more intensive food program or other program approaches might be required to help poor children overcome food insecurity and its related health outcomes. [ABSTRACT FROM AUTHOR]

In this study, a multivariate linear regression model is applied to predict the seasonal tropical cyclone (TC) count in the vicinity of Taiwan using large-scale climate variables available from the preceding May. Here the season encompasses the five-month period from June through October, when typhoons are most active in the study domain. The model is based on the least absolute deviation so that regression estimates are more resistant (i.e., not unduly influenced by outliers) than those derived from the ordinary least square method. Through lagged correlation analysis, five parameters (sea surface temperature, sea level pressure, precipitable water, low-level relative vorticity, and vertical wind shear) in key locations of the tropical western North Pacific are identified as predictor datasets. Results from cross-validation suggest that the statistical model is skillful in predicting TC activity, with a correlation coefficient of 0.63 for 1970 - 2003. If more recent data are included, the correlation coefficient reaches 0.69 for 1970 - 2006. Relative importance of each predictor variable is evaluated. For predicting higher than normal seasonal TC activity, warmer sea surface temperatures, a moist troposphere, and the presence of a low-level cyclonic circulation coupled with low-latitude westerlies in the Philippine Sea in the antecedent May appear to be important. [ABSTRACT FROM AUTHOR]