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This study explored mathematics teachers' reasoning regarding their instructional design for technology use in teaching mathematics. Various types of qualitative data were obtained and analysed from a sample of 19 secondary and 28 primary preservice teachers. The findings showed that the purposes of technology use, teachers' conceptions of mathematics and its learning, their learning experience and knowledge of student thinking as well as mathematical cognition, and empirical inquiry were the main sources of teacher reasoning. Three levels of teacher reasoning were identified: descriptive, explanatory, and justifying. Our findings contributed to research on teacher professional development by identifying four types of technology use with a variety of pedagogical purposes, and formulating two main dimensions to characterise the three levels of teacher reasoning.

In this paper we report the results of a study in which we investigated how formal education and shadow education in Taiwan provide students opportunities to learn mathematics. Based on the conceptual framework of Opportunity to Learn (OTL), aspects specific to formal education, including mathematics curriculum, mathematics textbooks, and teachers' competence, and their teaching, were reviewed. Two national projects identified under shadow education were examined. The results revealed significant features of the mathematics curriculum, textbook design, and the quality of mathematics teachers in Taiwan that constitute a lived space where teachers with their knowledge and beliefs, curriculum, textbooks, and school settings, can generate cognitive and affective learning outcomes in students. Further analyses of the two above-mentioned projects showed how Taiwan extended learning opportunities to motivate students to learn and understand school mathematics. Based on the review, challenges were also identified.

Geometry theorem proving involves skills that are difficult to learn. Instead of working with abstract and complicated representations, students might start with concrete, graphical representations. A proof tree is a graphical representation of a formal proof, with each node representing a proposition or given conditions. A computer-assisted learning environment called MR Geo is proposed to help students in learning to do theorem proving, with the help of multiple representations including problem description, static figure, dynamic geometry figure, formal proof and proof tree. Empirical results indicated that medium-achievement students enjoyed most in interacting with these representations and found them most helpful in learning geometry proofs while low-achievement students changed their attitudes of hating geometry theorem proving. (Contains 4 figures and 4 tables.)

Background: Abiraterone and enzalutamide are widely used as first-line treatment for metastatic castration-resistant prostate cancer (mCRPC); however, their efficacy in mCRPC has been inconsistently demonstrated in other outcome studies from real-world databases. The aim of our study was to assess the comparative effectiveness of abiraterone and enzalutamide in patients with mCRPC using real-world data from Taiwan. Methods: This retrospective cohort population-based study included patients identified in the Taiwan National Health Insurance Research Database who had been diagnosed with mCRPC and who had taken abiraterone or enzalutamide between December 2014 and August 2017. The study's outcome evaluated the differences in overall survival (OS) and time to treatment failure (TTF) between abiraterone and enzalutamide over a 15-month follow-up period. The patients were followed from the index date to when the outcome occurred, to December 31, 2018, or to the patients' withdrawal from the National Health Insurance program. The estimated relative treatment effects of abiraterone and enzalutamide on OS and TTF were adjusted by the inverse probability of treatment weighting (IPTW) using the Kaplan–Meier method and a Cox proportional hazards model. Results: The abiraterone and enzalutamide groups consisted of 1,046 and 118 patients, respectively. After IPTW adjustment, 1,164 patients in the abiraterone group and 1,158 in the enzalutamide group underwent an outcome evaluation. Enzalutamide showed a similar OS rate to that of abiraterone (57.58% vs. 49.51%, p = 0.095 by log-rank test). Enzalutamide significantly reduced the risk of death for mCRPC when compared with abiraterone [adjusted hazard ratio (aHR), 0.828; 95% CI 0.731–0.938]. However, similar results were not observed in the TTF outcomes (63.84% vs. 67.79%, p = 0.2651 by log-rank test; aHR, 0.902; 95% CI 0.812–1.002). Conclusion: In conclusion, enzalutamide was associated with better OS for mCRPC than abiraterone in the Taiwan population. Our study showed that there was no statistically significant difference in TTF between enzalutamide and abiraterone. Studies with longer surveillance of enzalutamide and abiraterone using real-world databases are needed. [ABSTRACT FROM AUTHOR]

Background: Adrenoleukodystrophy (ALD) is an X-linked peroxisomal disorder caused by mutations in the ABCD1 gene. The clinical manifestations of ALD vary widely with some patients presenting with adrenomyeloneuropathy (AMN) that resembles the phenotype of hereditary spastic paraplegia (HSP). The aim of this study is to investigate the frequency, spectrum, and clinical features of ABCD1 mutations in Taiwanese patients with HSP phenotype.Methods: Mutational analysis of the ABCD1 gene was performed in 230 unrelated Taiwanese patients with clinically suspected HSP by targeted resequencing. Clinical, electrophysiological, and neuroimaging features of the patients carrying an ABCD1 pathogenic mutation were characterized.Results: Ten different ABCD1 mutations were identified in eleven patients, including two novel mutations (p.Q177Pfs*17 and p.Y357*) and eight ever reported in ALD cases of other ethnicities. All patients were male and exhibited slowly progressive spastic paraparesis with onset ages ranging from 21 to 50 years. Most of them had additional non-motor symptoms, including autonomic dysfunction in nine patients, sensory deficits in seven, premature baldness in seven, skin hyperpigmentation in five, psychiatric symptoms in one and cerebellar ataxia in one. Seven of the ten patients who ever received nerve conduction studies showed axonal polyneuropathy. Magnetic resonance imaging (MRI) revealed diffuse spinal cord atrophy in seven patients, cerebral white matter hyperintensity in one patient, and cerebellar involvement in one patient.Conclusions: ABCD1 mutations account for 4.8% (11/230) of the cases with HSP phenotype in Taiwan. This study highlights the importance to consider ABCD1 mutations in patients with clinically suspected HSP of unknown genetic causes. [ABSTRACT FROM AUTHOR]

Flexible and transparent applications have become an emerging technology and have shifted to the forefront of materials science research in recent years. Transparent conductive oxide films have been applied for flat panel displays, solar cells, and transparent glass coatings. However, none of them can fulfill the requirements for advanced transparent flexible devices, such as high-frequency applications. Here, we present a promising technique for transparent flexible conducting oxide heteroepitaxial films: the direct fabrication of epitaxial molybdenum-doped indium oxide (IMO) thin films on a transparent flexible muscovite substrate. An n-type epitaxial IMO film is demonstrated with a mobility of 109 cm2 V−1 s−1, a figure of merit of 0.0976 Ω−1, a resistivity of 4.5 × 10−5 Ω cm and an average optical transmittance of 81.8% in the visible regime. This heteroepitaxial system not only exhibits excellent electrical and optical performance but also shows excellent mechanical durability. Our results illustrate that this is an outstanding way to fabricate transparent and flexible conducting elements for the evolution and expansion of next-generation smart devices. Optoelectronic materials: A flexible transparent conductor A thin, flexible material that is transparent and can conduct an electrical current has been developed by scientists in Taiwan. Materials with flexibility, transparency and conductivity are useful for wearable optoelectronics, but are rare. Indium tin oxide is a widely used transparent conductor, but when used in thin layers its electrical properties are not good enough for efficient thin-film transistors, thin-film solar cells and high-frequency devices. Ying-Hao Chu and co-workers from the National Chiao Tung University in Hsinchu used a technique called radio-frequency magnetron sputtering to deposit a thin film of indium oxide containing small amounts of molybdenum on a substrate. Measurements showed that the films had high charge mobility at room temperature, low electrical resistivity, and optical transparency, indicating that the material could be used in the next generation of smart devices. We present a promising technique for transparent flexible conducting oxide heteroepitaxial films: the direct fabrication of epitaxial molybdenum-doped indium oxide (IMO) thin films on a transparent flexible muscovite substrate. An n-type epitaxial IMO film is demonstrated with a mobility of 109 cm2 V−1 s−1, a figure of merit of 0.0976 Ω−1, a resistivity of 4.5 × 10−5 Ω cm and an average optical transmittance of 81.8% in the visible regime. IMO heterostructure not only exhibits excellent performance but also shows excellent mechanical durability. This study demonstrated an extraordinary achievement for the evolution and expansion of next-generation smart devices. [ABSTRACT FROM AUTHOR]

Both the challenges faced by Taiwan's indigenous communities due to the COVID-19 pandemic and their experience in preventing the virus's spread are worthy of more discussion. Data include participant observation, archival data analysis, and the author's practical experience on the Tribal Culture and Health Station program. With theoretical insights from the literature on decolonization, sociology of disaster, and community development, this article analyzes three main aspects: the Taiwanese disease control model, Taiwanese indigenous peoples' response to the disease, and the coping experience of Tribal Culture and Health Station. This article thus highlights the importance of medical and public infrastructures, and concludes how social solidarity, public and private collaboration, and innovative technology utilization deeply shaped indigenous community development and the disease control work. The promotion of the Tribal Culture and Health Station in Taiwanese indigenous tribes and the National Health Insurance have become crucial factors to establish disease control centers in tribes and implement disease control policies from the government. What we need to further examine is the relationship between indigenous people and the state, as well as the potential of traditional indigenous medicine and a bottom-up tribal development model. It is the value of reciprocity and collective action from indigenous tribes that can be exemplified for the mainstream society under the pandemic. [ABSTRACT FROM AUTHOR]

Background: ABO subgroups would be considered when discrepancies in ABO grouping occur. Serological methods including adsorption-elution test, salivary ABH inhibition test, and anti-A1 (lectin) saline method could be used. However, these serological methods are laboring and obscure. Therefore, reliable and affordable method to assess the ABO subgroups is of particular interest.Methods: To solve this problem, the multiplex SNaPshot-based assays were designed to determine rare A and B subgroups. Primers used as probes for determination of rare ABO blood groups known in Taiwanese population were designed. Many ABO subtype samples were used to validate the accuracy and reproducibility of our SNaPshot panel.Results: A panel of primer probes were successfully designed in determining 8 SNP sites (261, 539, 838, 820, 745, 664, IVS6 +5, and 829 in exon 6 and 7) for A phenotype and 6 SNP sites (261, 796, IVS3 +5, 247, 523, and 502 in exon 2, 6 and 7 and intron 3) for B phenotype. SNaPshot analysis for defining blood group A alleles (A1, A2, A3, Am and Ael) and blood group B alleles (B1, B3, Bw and Bel) was therefore available.Conclusion: SNaPshot analysis could be used in reference laboratories for typing known rare subgroups of A and B without DNA cloning and traditional sequencing. Moreover, this method would help to construct databases of genotyped blood donors, and it potentially plays a role in determining fetal-maternal ABO incompatibility. [ABSTRACT FROM AUTHOR]

We observed transient elevations in creatinine levels among kidney recipients after three traditional holidays in Taiwan. This retrospective cohort study aimed to compare the changes in eGFR levels after Chinese New Year, Dragon Boat Festival, and Mid-Autumn Festival, all of which are associated with high-calorie and high-fat diets. We conducted a retrospective analysis of 364 kidney recipients with stable graft function who were following at Chang Gung Memorial Hospital Linkou from 2018 to 2020. The graft function before and after the festival was determined by calculating the eGFR level using the serum creatinine measured during clinic visits prior to and following the festival. The patients were then categorized into subgroups based on their sex, BMI, and co-morbidities. The eGFR levels before and after the festival were evaluated and compared within these subgroups. A total of 301 kidney recipients have been finally included in this retrospective cohort study. The analysis showed a significant decrease in overall eGFR levels after Chinese New Year (from 56.92 ± 29.70 to 55.14 ± 24.79, P =.006), Mid-Autumn Festival (from 54.03 ± 24.61 to 53.35 ± 24.33, P =.008), and Dragon Boat Festival only in 2020 (from 50.98 ± 24.35 to 49.99 ± 23.45, P =.018). The analysis of subgroups suggested a tendency of renal function decline after all 3 traditional holidays in patient groups with DM or hypertension or nonoverweight status. In this study, we observed a significant decline in renal function among kidney recipients following traditional holidays in Taiwan, particularly among recipients with hypertension or diabetes mellitus or those who were not overweight. [ABSTRACT FROM AUTHOR]

We selected iOS in this study as the App operation system, Objective-C as the programming language, and Oracle as the database to develop an App to inspect controlled substances in patient care units. Using a web-enabled smartphone, pharmacist inspection can be performed on site and the inspection result can be directly recorded into HIS through the Internet, so human error of data translation can be minimized and the work efficiency and data processing can be improved. This system not only is fast and convenient compared to the conventional paperwork, but also provides data security and accuracy. In addition, there are several features to increase inspecting quality: (1) accuracy of drug appearance, (2) foolproof mechanism to avoid input errors or miss, (3) automatic data conversion without human judgments, (4) online alarm of expiry date, and (5) instant inspection result to show not meted items. This study has successfully turned paper-based medication inspection into inspection using a web-based mobile device. [ABSTRACT FROM AUTHOR]

The article discusses the development of "WebBio" which is a web-based system for managing and analyzing patient data of biological products in hospitals. Topics covered include the specific features of biological products, the computational methods and tools used in developing the "WebBio" system, and details relating to the system requirements and limitations of the "WebBio" system.

Background: Fat embolism syndrome (FES) is a potentially fatal complication of long bone fractures. There have been no reports of FES in long bone fractures in this decade in Taiwan. The purpose of this study was to review the FES experiences in a tertiary referral center between January 1997 and February 2008. Methods: Between January 1997 and February 2008, 13 patients with long bone fractures with documented FES in our institution were reviewed. FES was diagnosed clinically by at least 2 major criteria or 1 major with at least 4 minor signs of Gurd''s criteria. Results: The incidences of FES, less than those reported in the literature, were 0.15% in fracture of the tibia, 0.78% in fracture of the femur and 2.4% in multiple fractures. The mortality rate of FES, similar to other available results, was about 7.7%. All cases were less than 35 years old, except for 1 70-year-old male. Fat embolism occurred within an average of 48.5 hours after long bone fracture. Eleven presented with sudden drop in hemoglobin level, dropping 4.2 g/dL on average. Nine presented with thrombocytopenia, and 10 presented with sudden drop in platelet count, dropping 140,000/dL on average. Two had cerebral sequelae without recovery at the last 48-month follow-up. Conclusion: This 12-year interval retrospective study revealed modern epidemiologic results for FES in long bone fracture. Compared with the available literature in the recent decade, the incidence of FES in long bone fracture in our institution is less and the mortality rate is similar. [Copyright &y& Elsevier]

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In this article, we discuss the complexity of geometric proofs with respect to a theoretical analysis and empirical results from studies in Taiwan and Germany. Based on these findings in both countries, specific teachings experiments with junior high school students were developed, conducted, and evaluated. According to the different classroom and learning culture in East Asia and Western Europe, the interventions differed in their way of organizing the learning activities during regular mathematics lessons. The statistical analysis of the pre-post-test data indicated that both interventions were successful in fostering students' proof competence. [ABSTRACT FROM AUTHOR]

Background: Tumor markers are used to screen tens of millions of individuals worldwide at annual health check-ups, especially in East Asia. Machine learning (ML)-based algorithms that improve the diagnostic accuracy and clinical utility of these tests can have substantial impact leading to the early diagnosis of cancer. Methods: ML-based algorithms, including a cancer screening algorithm and a secondary organ of origin algorithm, were developed and validated using a large real world dataset (RWD) from asymptomatic individuals undergoing routine cancer screening at a Taiwanese medical center between May 2001 and April 2015. External validation was performed using data from the same period from a separate medical center. The data set included tumor marker values, age, and gender from 27,938 individuals, including 342 subsequently confirmed cancer cases. Results: Separate gender-specific cancer screening algorithms were developed. For men, a logistic regression-based algorithm outperformed single-marker and other ML-based algorithms, with a mean area under the receiver operating characteristic curve (AUROC) of 0.7654 in internal and 0.8736 in external cross validation. For women, a random forest-based algorithm attained a mean AUROC of 0.6665 in internal and 0.6938 in external cross validation. The median time to cancer diagnosis (TTD) in men was 451.5, 204.5, and 28 days for the mild, moderate, and high-risk groups, respectively; for women, the median TTD was 229, 132, and 125 days for the mild, moderate, and high-risk groups. A second algorithm was developed to predict the most likely affected organ systems for at-risk individuals. The algorithm yielded 0.8120 sensitivity and 0.6490 specificity for men, and 0.8170 sensitivity and 0.6750 specificity for women. Conclusions: ML-derived algorithms, trained and validated by using a RWD, can significantly improve tumor marker-based screening for multiple types of early stage cancers, suggest the tissue of origin, and provide guidance for patient follow-up. [ABSTRACT FROM AUTHOR]

• Taiwan has the highest prevalence and incidence of end-stage renal disease. • Early-stage of kidney disease is usually asymptomatic, so patients must rely on routine urinalysis for detection. • Urinary ACR measured by Siemens Novus with Pro12 dipsticks was shown to be a reliable test for detection of microalbuminuria. Taiwan has the highest end-stage renal disease prevalence in the world, and the costs on the maintenance of dialysis imposes a great financial burden on National Health Insurance. Routine urinalysis provides an opportunity for the early detection of microalbuminuria. We evaluated the accuracy of semi-quantitative chemical methods from Siemens Novus Pro12 dipstick for albumin-creatinine ratio (ACR). We collected 1029 random urine samples and performed urinary analytic tests by Siemens Novus with Pro12 dipsticks and also calculated the urinary ACR. The reference method was performed by Hitachi LST008, a quantitative assay. The percentage of exact agreement in ACR was 81.9% between Siemens Novus and Hitachi LST008. The percentage of agreement within 1 level between the 2 methods was 98.5%. When ACR > 30 mg/g was defined as the threshold for positive results, the sensitivity, specificity, positive, and negative predictive values for microalbuminuria were 87.2%, 91.6%, 91.5%, and 87.3%, respectively. There were 778 cases with negative results of urinary protein, analyzed by conventional dipsticks. 149 of 778 (19.2%) cases were positive, measured by Pro12 dipsticks, and 111 of 149 (74.5%) cases were confirmed positive ACR by Hitachi LST008. Urinary ACR measured by Siemens Novus with Pro12 dipsticks was shown to be a reliable test for detection of microalbuminuria. [ABSTRACT FROM AUTHOR]

In conjunction with the international collaborative project of ESEMS (Experimental Scientific Education Micro Satellite) whose goal is to develop an experimental scientific-education microsatellite with science payloads, a team consisting of professors and students from the National Central University (NCU) has designed and fabricated a set of space flight instruments for space weather studies. The Block of Central University (BCU) made payload has been flown successfully on board Tatiana-2. To our knowledge, the BCU payload is the very first successful satellite payload which has been developed from design and component selection to the completion of the flight module mainly by students and faculty on the NCU campus in Taiwan. This paper describes some details of the engineering effort in building the BCU payload, including sensing devices (ETP and MRM), data processing unit, and power supply. Samples of flight data acquired by BCU are also presented to show that all units of the BCU system and payload-spacecraft interfaces functioned well as expected. The flight data provides direct evidence that the NCU team is capable of developing spaceflight quality instruments for future satellite missions. [ABSTRACT FROM AUTHOR]