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An online system leveraging self-explanation was developed. The theoretical basis and design principles guiding the development of the system were explicated. Four evaluation studies were conducted to assess the student-generated explanations component accompanying student-generated questions (SQG) and the embedded designs. The analyzed data revealed several important findings. First, SGQ complemented by student-generated explanations (as compared to SGQ alone) was regarded as promoting learning better by a sizeable majority of the participants, and its facilitating effects on cognitive and affective aspects were noted. Second, the fact that the exact same set of cognitive and affective gains and similar patterns in the spread of responses were found from the explanation-generation for self- and peer-generated questions provided preliminary evidence supporting the "manageable versatility" design principle. Third, the result indicating that a predominant percent of the participants supported online practice on SGQ complemented by student-generated explanations substantiated the "manageable integration" guiding principle. Finally, the finding that a significantly greater percentage of the participants felt multimedia-equipped explanations to be better for SGQ (as compared to text-based explanations), both cognitively and affectively, provided preliminary evidence supporting the effectiveness of the multimedia design in terms of attaining the multiple feedback functions.

This study examined whether different identity revelation conditions result in different online targeting behavior among peer-assessors through a pretest and posttest quasi-experimental research design. Students from six fifth-grade classes (N = 196) participated in online learning tasks where they generated and selected peer-generated questions to review and assess in their respective identity revelation modes--real-name, nickname, and anonymity. Several findings were obtained. First, there was a high redundancy rate for both high- and low-targeted assessees under the pre-treatment (control) and treatment conditions for all three identity revelation modes. Second, the non-significant results of the chi-square tests indicated that the identity revelation modes and assessee redundancy were neither considerably related for the high- nor low-targeted assessees groups. Third, the results from the ANCOVA on the number of peer-feedback messages each student received showed no significant differences among the three identity revelation treatments. Fourth, the Wilcoxon tests confirmed that there were no significant differences in the assessee rankings in terms of the number of times their generated questions were assessed between the pre-treatment and treatment conditions for all different identity revelation modes. Finally, the results from participants' responses to the checkbox question revealed almost the same ranking pattern regarding factors dominating their targeting behavior (with the question-author ranked last among all factors), despite the various different identity revelation modes. In sum, identity revelation modes were not found to affect peer-assessors' targeting behavior in an online peer-assessment activity.

An online learning system in support of active learning and formative evaluation via a teaching-by-questioning strategy in classrooms was developed. Following a design-based research paradigm, the theoretical base, design principles, and associated spaces for the system were explicated. Its learning potential in terms of perceived usefulness, ease of use, and relative advantage was evaluated in an undergraduate engineering class by mixed methods research. Quantitative data from an end-of-semester questionnaire supported the learning usefulness of teaching-by-questioning on the developed system for the promotion of various cognitive and higher-order thinking processes regarded as important in active classrooms as well as its ease of use. Moreover, the results of the chi-square test indicated that substantially more participants supported the developed system over Facebook for promoting learning, and explanatory data further highlighted the developed system's distinct feature of deferring display of participants' responses to stimulate independent thinking and support meaningful formative evaluation.

The research objectives of this study were to examine the individual and combined predictive effects of the quality of online peer-feedback provided and received on primary school students' quality of question-generation. A correlational study was adopted, and performance data from 213 fifth-grade students engaged in online question-generation and peer assessment for six weeks were analysed using hierarchical multiple regression, with the dependent variable of scores on question-generation and independent variables of scores on peer-feedback provided and received. The results from the two-step hierarchical regression analysis indicated that the quality of peer-feedback provided and received, respectively, predicted students' quality of question-generation. Furthermore, the results from the three-step hierarchical regression analysis showed that the quality of peer-feedback provided and received in combination also predicted students' quality of question-generation. Details of the significance of this study are provided, as well as suggestions for instructional implementations.

This study examined the effects of identity revelation and concealment on the number of times students' work was assessed in an online peer assessment context. It also examined the underlying reasons guiding the assessor's targeting behavior. Two fifth-grade classes participated. The one-group pretest-posttest experimental research design coupled with qualitative research method was adopted. The results from social network analysis (SNA) showed a high redundancy rate for both high- and low-targeted assessees in identity-revealed and identity-concealed conditions for both classes. Moreover, the density metrics indicated that all sociograms were similarly sparse. The Wilcoxon tests further confirmed that there were no significant differences in the assessees' ranking in the two conditions for both classes. Finally, analysis of students' self-reflective data revealed that the features/content of the work to be assessed, rather than who the question-author was, was the determining factor when it came to deciding the target for online peer assessment.

Recognizing the potential of online student question-generation to engage language learners in communicative activities and use the target language in a personally meaningful way for language and learning motivation development, an experimental study examining the English learning effects of this approach, in comparison to an online drill-and-practice strategy, was conducted. A quasi-experimental research design was adopted. Four sixth-grade classes (N = 106) participated in this study and were randomly assigned to different treatment groups. An online learning system supporting the various learning activities was adopted. The results of analysis of covariance (ANCOVAs) showed that students in the online student question-generation group performed significantly better in English assessments and exhibited higher learning motivation than those in the contrast group. The significance of this study and suggestions for instructional implementation and future works are also presented.

Although research has found that student-constructed tests (SCT) have some potential for promoting cognitive elaboration, as yet there are no systems available to support the associated activities. This study designed and developed an SCT learning system guided by the ideology of contribution-based pedagogies, accentuating the principles of adaptability and flexibility. To assess its learning potential, a group of 54 student teachers used the system, and data on their perceptions, generated work, and online log files were collected and analysed. The constant comparative method, descriptive and inferential statistics, and content analysis were employed in the data analysis. Several important findings were obtained. First, a global and macro view accentuating the integration and inter-connectedness of the study material was obtained by the participants based on the SCT activity. Second, a significant proportion of the participants considered SCT as their preferred assessment and learning approach, highlighting its affective and cognitive potential, in comparison to the traditional teacher-constructed tests. Third, SCT encouraged a majority of students to generate questions involving cross-chapter topics and engage in question revision behaviour to different extents, indicative of knowledge integration and elaboration. Significance of this study and suggestions for instructional implementations, online system development, and future study are provided.

Traditional incinerators achieve the thermal requirements through heat transfer and heat radiation. However, the early recovery of flue gas preheats the air and yields nitrogen oxide (NOx) to rise in the combustion of overoxygen. The operation of an incinerator inevitably implies the release of greenhouse gases and emissions of NOx harmful to the human health. The administrator of one laboratory incinerator in Taiwan sought to optimize the operation conditions such as temperature or oxygen level of the combustion products within the combustion chamber to minimize the release of pollutants and maximize the efficiency of combustion. In this phase, air-fuel ratio control and air volume control are regarded as the first priority. A numerical model of the laboratory-scale plant in southern Taiwan is established by using enhanced wall treatment and coupling the thermochemical conversion of volatile waste to the gaseous combustion of the released syngas. The model allows users to characterize the temperature and retention time of the combustion products for the verification of the fulfillment of the existing regulation for NOx and oxygen level in incineration plants. It shows trade-off relationship between combustion efficiency of fuel and emissions (NOx and CO) in surveying cases of air-fuel ratio (AFR) ranges from 1.5∶1 to 14.4∶1 according to numerical results. Increasing the air volume enhances this trend. In this study, it shows the lowest emissions of NOx in case of AFR=1.5∶1 , but worse combustion efficiency. Meanwhile, to increase the air volume by 1.15 times suppress most CO and about 28% NOx, but increases by 6% the residual fuel. The averaged distribution of retention time of particles in this study ranged from 30 to 50 s, and is provided for further improvement of geometry in the next phase. [ABSTRACT FROM AUTHOR]

The focus of this study was to investigate the effects of student-question generation with online prompts on student academic achievement, question-generation performance, learning satisfaction and learning anxiety. This study adopted a quasi-experimental research design. Two classes of eighth grade students (N = 64) from one middle school participated in weekly 45-minute online question-generation learning sessions for 6 consecutive weeks. Data analyzed using ANCOVA indicated statistically significant differences between the two groups in regard to academic performance and question-generation performance with students assigned to the online prompts group performing significantly better than their counterparts assigned to the without prompts group. However, there were no statistically significant differences between the two groups in the areas of learning satisfaction and anxiety. Empirical and pedagogical significance of this study together with its implications for instructional implementation, system development, and future studies are provided.

This study examined the individual and combined predictive effects of two types of feedback (i.e., quantitative ratings and descriptive comments) in online peer-assessment learning systems on the quality of produced work. A total of 233 students participated in the study for six weeks. An online learning system that allows students to contribute to and benefit from the process of question-generation and peer-assessment was adopted. The regression results indicated that quantitative ratings and descriptive comments significantly predicted the quality of produced work (i.e., question-generation performance) both individually and collectively, and descriptive feedback explained more variance in quality of produced work than did quantitative ratings. The empirical significance of this study and suggestions for online learning system development, instructional implementation and future studies are discussed.

This study examined the effects of online procedural scaffolds (in the form of generic question-stems with context-specific examples) and the timing of scaffolding provision (immediate versus delayed) on supporting the online student question-generation learning process in a science class. A total of 78 fifth-grade Taiwanese students participated in eight online question-generation sessions. An online learning system equipped with a customizable scaffolding design in terms of content and timing of access was used. The results of ANOVAs on the students' week-by-week question-generation performance showed the immediate positive effects of immediate procedural scaffolding. However, the delayed procedural scaffolds group did not statistically distinguish themselves from the no-scaffolds group in any of the eight question-generation performances, nor did the delayed approach engender productive failure, as postulated by some researchers. The significance of this study is discussed, along with suggestions for related instructional implementations, online systems and future research.

Empirical studies have found that participation in international service increases learners' intercultural competence, language skills, appreciation of cultural differences, and tolerance for ambiguity. While previous studies suggest that international service experience is potentially transformative in nature, the present study examined international service experience and explored the factors that encourage transformation. Based on transformative learning and social psychology, the theoretical framework of the present study included three perspectives: environment-person interaction, schema adjustment, and the Johari Window. Data were obtained from 10 international service participants by observation, semistructured interviews, and written documents. Analysis of the data identified three components that enhanced transformation through environment-person interaction in cross-cultural settings: exploring the unknown world, relearning from the basic levels, and the unknown self revealed. (Contains 2 figures.)

This study examined the effects of different levels of identity revelation in relation to aspects most relevant to engaged online learning activities. An online learning system supporting question-generation and peer-assessment was adopted. Three 7th grade classes (N=101) were assigned to three identity revelation modes (real-name, nickname and anonymity) and observed for six weeks. A pretest-posttest quasi-experimental research design was adopted. Findings did not confirm that different levels of identity revelation affected participants' academic performance, nor led participants to view the peer-assessment strategy, the interacting parties, interaction processes, or engaged activities in different ways. Implications for generalizability of research findings and suggestions for teaching practices are offered. (Contains 2 tables and 3 figures.)

A web-based learning system has been developed to facilitate question-posing, peer-assessing, item-viewing and drill-and-practice learning activities. In this paper, the pedagogical basis underlying the design and development of the system is explained in the light of information-processing theory, social construction of knowledge theory and social modelling theory. A preliminary study to evaluate the instructional potential of the system has been conducted; this has also identified the factors that influence students' use of the system. Results taken from questionnaires and open-ended questions revealed that by enabling students to play various roles such as composers, critics and adapters, the system was perceived as a cognition-enhancing and motivational learning tool by the participants. Data analysis further indicated that various factors worked together to influence the performance of question-posing.

Since past studies showing that competition has negative effects on group process were primarily conducted in traditional classrooms involving face-to-face situations, this study extends past research by investigating whether the negative effects associated with face-to-face team competition can be mitigated with the support of networking technologies where opponents' identity or proximity can be manipulated and concealed. Three fourth-grade classes were randomly assigned to three different treatment conditions to participate in the study. A synchronous competitive learning system, named "Joyce," was devised to have pairs of students compete by answering questions with another randomly assigned pair of opponents over three instructional sessions. Results from the study indicated that students in the face-to-face team competition condition rated significantly less favorably on inner-group processing than those in the decreased proximity and anonymity conditions at 0.009 level, and 0.067 level, respectively. Data analysis on students' perceptions toward classroom climate revealed that students in the anonymity condition rated significantly more favorably on classroom climate than those in the other two conditions (0.000 level). The results of this study suggest that to promote effective interactions within learning groups and to cultivate a more regulated classroom learning atmosphere, networked team competition where opponents are not identified may be the preferred instructional strategy to adopt, as compared to face-to-face team competition. The findings also suggest that designers of competitive game-based learning systems should include the feature of anonymity in their system to support student learning. The following are appended: (1) Student Perceptual Impressions of In-Group Processing; and (2) Student Perceptual Impressions of Classroom Climate. (Contains 1 figure and 1 table.)

Describes a study of Taiwan university students that investigated the impacts of incorporating email into the classroom on student achievement and attitudes using a posttest-only control-group design. Results showed a statistically significant difference in academic performance but not in student attitudes toward computers. (Author/LRW)

Describes a study conducted at a university in Taiwan that explored the effectiveness of electronic mail as a supplementary aid to instruction and as a communication link between students and between students and instructors in fostering interpersonal relationships. Examines student attitudes toward the instructor, group-mates, and other classmates. (Author/LRW)

Describes a study of fifth-grade Taiwanese students that examined the instructional effects of two grouping methods, cooperation with or without inter-group competition, on student academic achievement and pro-social behaviors in a computer-based science learning environment. Discusses implications for cooperative learning. (Author/LRW)

Examines the effects and implications of embedding the element of competition in computer-assisted cooperative learning situations on student cognitive, affective, and social outcomes. Results of statistical analyses of Taiwanese fifth graders show that cooperation without inter-group competition engendered better attitudes and promoted more positive inter-personal relationships. (Contains 50 references.) (Author/LRW)

Explores the relative effects of cooperation with and without inter-group competition on Taiwanese students' academic achievement in science and their attitudes toward science in a computer-assisted instruction environment. Contains 23 references. (Author/ASK)

Objective: To explore the economic burdens of hip fracture surgery in patients referred to lower-level medical institutions and to evaluate how referral systems affect costs and outcomes of hip fracture surgery.Design: A nationwide population-based retrospective cohort study.Setting: All hospitals in Taiwan.Participants: A total of 7500 patients who had received hip fracture surgery (International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic codes 820.0 ∼ 820.9 and procedure codes 79.15, 79.35, 81.52, 81.53) performed in 1997 to 2013.Main Outcome Measures: Total costs including outpatient costs, inpatient costs and total medical costs and medical outcomes including 30-day readmission, 90-day readmission, infection, dislocation, revision and mortality.Results: The patients were referred to a lower medical institution after hip fracture surgery (downward referral group) and 3034 patients continued treatment at the same medical institution (non-referral group). Demographic characteristics, clinical characteristics and institutional characteristics were significantly associated with postoperative costs and outcomes (P < 0.05). On average, the annual healthcare cost was New Taiwan Dollars (NT$)2262 per patient lower in the downward referral group compared with the non-referral group. The annual economic burdens of the downward referral group approximated NT$241 million (2019 exchange rate, NT$30.5 = US$1).Conclusions: Postoperative costs and outcomes of hip fracture surgery are related not only to demographic and clinical characteristics, but also to institutional characteristics. The advantages of downward referral after hip fracture surgery can save huge medical costs and provide a useful reference for healthcare authorities when drafting policies for the referral system. [ABSTRACT FROM AUTHOR]

Taiwanese tonal alternation is realized in a circular chain shift fashion for both smooth and checked syllables. Debate regarding the processes of less productive Taiwanese tonal alternation has centered on whether a surface tone is derived from an underlying tone, or whether a surface tone is selected without undergoing any derivation. The current study investigates this controversial issue by examining Taiwanese checked tone and smooth tone sandhi neutralization in production. In particular, we analyzed whether checked citation and sandhi tone 53 (C21→C53), checked citation and sandhi tone 21 (C53→C21), smooth citation and sandhi tone 55 (S51→S55), and smooth citation and sandhi tone 21 (S33→S21) are acoustically completely neutralized in fundamental frequency (F0) height, contour, and duration. A non-sandhi exception was also included to evaluate the effect of position-in-word on F0 height and duration given that citation tones always appear in phrase-final position. Any trace of influence from the underlying representation would indicate a computational mechanism, whereas the absence of any trace would suggest a lexical mechanism for the production of Taiwanese tonal alternation. Results did not show any influence of F0 height, F0 contour, or tone duration from the underlying representation for both checked and smooth tones, supporting a lexical mechanism in speech production for less productive tonal alternations. [ABSTRACT FROM AUTHOR]

Residents' work overload is a rising issue in Taiwan. Duty hours of the residents in the United States have been limited by the Accreditation Council for Graduate Medical Education Common Program Requirements since 2003; similar standards were not implemented in Taiwan until 2013. Taiwanese duty hour standards are the work hour limits adopted as part of the required teaching hospital accreditation status. In January 2015, the Ministry of Health and Welfare conducted a national survey for all house officers in Taiwan. We collected data including those on demographics and perceptions of residents regarding duty hour limits. Most respondents reported positive perceptions of the duty hour standards. They felt that these limits will improve resident education, quality of life, and patient safety. The strong incentive to follow the regulations (through teaching hospital accreditation) could help protect residents (and patients) from unsafe working conditions. However, further studies on the influence of shortened duty hour on professional development are necessary for future improvement. [ABSTRACT FROM AUTHOR]

Isothiocyanates (ITCs) occur in many cruciferous vegetables. These compounds, which have significant anticancer actions, can induce apoptosis in different human cancer cell lines. In the present study, we investigated if allyl isothiocyanate (AITC) would induce toxicity in human breast cancer MCF-7 (estrogen receptor positive) and MDA-MB-231 (estrogen receptor negative) cells. We found that AITC stimulated reactive oxygen species and Ca production, and decreased the mitochondrial membrane potential. Activity of caspase-8, -9 and -3 was increased by AITC in both cell lines. AITC also induced mitochondrial-mediated apoptosis, as shown by cytochrome c, AIF and Endo G release from mitochondria, activation of caspase-9 and caspase-3, and formation of DAPI-positive cells. There was a significant reduction in the levels of the anti-apoptotic protein Bcl-2 along with a marked increase in the pro-apoptotic protein Bax in both cell lines. AITC induced apoptosis in human breast cancer MCF-7 cells via AIF and Endo G signaling pathways, but in MDA-MB-231 cells apoptosis occurred via the GADD153 pathway. This study has revealed novel anti-cancer mechanisms of AITC, a compound that is ordinarily present in human diets and may have potential therapeutic effects in various cancers. [ABSTRACT FROM AUTHOR]

This paper uses the theory of social construction of reality deriving from the writings of Max Weber, Alfred Schutz, Thomas Luckmann and Peter Berger to explain the origin of national identity and hence the emergence of a nation. It argues that social construction of national reality originates from everyday life experience taken for granted during the process of socialization. Individuals make sense out of the external world. Experiences taken for granted become actor's stock of knowledge. A common scheme of knowledge shared by the community serves to differentiate in-group (nationals) and out-group (foreigners). Collective consciousness thus defines national identity and hence a nation. Unless people (both in-group and out-group) interact with and learn from each other, different stocks of knowledge taken for granted will create political tension. This theory will be applied to understand the tensions in Tibet and along the Taiwan Strait. The paper further argues that Taiwan can hardly separate from mainland China in the future, while strong Tibetan consciousness continues to defy against powerful Chineseness, resulting in endless upheavals in the region. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is, primarily, to investigate the relationships of the project leader's competencies with job satisfaction, and their impact on project performance. The second objective is to determine whether job satisfaction plays a mediating role in the relationship between leadership competency and project performance. The third objective is to examine the moderating role of project type in the relationship between job satisfaction and project performance. Design/methodology/approach – To address the primary aims, a questionnaire-based survey was used to measure the project leader's competency, the job satisfaction of team members, and the performance of projects in the Taiwanese police departments. The structural equation modeling (SEM) approach was used to validate the research model. Findings – The results show that job satisfaction mediates the effects of leadership competency on project performance. Furthermore, these results prove that complexity, workload, method, and project duration have a moderating effect on the relationship between job satisfaction and project schedule success. Research limitations/implications – The research was limited to inspecting projects in the Taiwanese police departments. The data analyzed in this study are project-specific. Practical implications – This paper reports on the findings about leadership benefits and provides recommendations for improving police project performance. Originality/value – This research is the first to provide empirical evidence that supports the expectation of improving police project performance by developing leadership competencies. Findings from this study are helpful to project leaders in deciding whether to develop certain competencies. [ABSTRACT FROM AUTHOR]

It is a great fortune to live in Taiwan, because even though it's status as "a country" is still under contention, we have already enjoyed the recognition of a pluralistic democracy, race and culture. Although the Taiwanese have inherited the rich Chinese culture, there are indeed differences still between people across straits, because a sensitive and tense political climate has influenced indirectly their social customs, beliefs, values and thinking. As Chinese, it seems that we are responsible for and are obliged to illustrate clearly the aesthetic differences between both sides of the straits that result from the regional and cultural discrepancy. Based on this ideology, this essay was written with the aim of analyzing two internationally acclaimed directors, from the perspective of aesthetics in Movie Design-taking the works of Hou Hsiao-Hsien and Zhang Yi-Mou (A City of Sadness(1990) and Hero(2003) respectively) as examples. These two movies possess superlative art achievements that act as the symbolic indicators of the epoch and the political consciousness of the people. This research made use of two methods: The comparative method is used to examine the following image analysis procedures, such as compositional interpretation (i.e. shots, narration and custom code analysis), and discourse analysis (seeing it from the audience's perspective, and interpreting the culture and ideology from a personal point of view). The preliminary research shows: 1. Hsiao-Hsien's A City of Sadness (1990) is full of regional characteristics (e.g. Tai Ke culture, long shots displaying the common people's life, and portions of the script that criticizes the political situation at that time). 2. Zhang Yi-Mou's Hero (2003) applies long shots to present Chinese grant territory, and angle shots to display the power and army of the king, with much praise and little criticism towards the political situation. 3. Unique regional images are used in these two movies (e.g. Chinese hero and Taiwanese Tai Ke are from different eras. The influence onto Tai Ke from the colonization era is presented through the costumes and stage setting). [ABSTRACT FROM AUTHOR]

This study applies the concept of coordinating entrepreneurship to explain the emergence of global production network. More specifically, this study explains and illustrates how Taiwan-born technopreneurs move between Silicon Valley and Taiwan's Hsinchu, thereby promoting Taiwan's computer and information technology (IT) industries. With their entrepreneurial spirit and social network, Taiwan-born technopreneurs even turn Dongguan, a farming village in south China, into a modern IT industrial city. This paper concludes that as a result of the coordinating efforts of these entrepreneurs, electronics and computer plants scattered around the globe are integrated into a global production network, as illustrated by IT firms in Silicon Valley, Hsinchu and Dongguan. [ABSTRACT FROM AUTHOR]

Taiwan has been referred to by the World Bank as one of the East Asia's "economic miracles". Many quantitative models on Taiwan's economic growth have been conducted by neo-classical mainstream economists. However, none of them investigates in detail the thinking of those policy-makers who work behind the economic success of Taiwan. Li Kuo-Ting is generally regarded as the architect of Taiwan's economic "miracle". In this paper, an evolutionary perspective has been used to understand the economic management of Li Kuo-Ting in particular and the learning government in Taiwan in general. It will be argued that a policy change is a matter of learning, experimenting, and a process of trial and error, involving subjective aspects such as the policy-makers' perception, vision and experiences, and objective factors such as environmental, geographical or international constraints. Furthermore, Taiwan has been able to succeed because its policy-makers are willing to learn and unlearn. Though the right policy has not always been adopted, Taiwan's policy-makers are willing to experiment with a new policy in a pragmatic way. Policies that did not work were either modified or abandoned. Policies that did work were adopted. This paper concludes that Taiwan's economic "miracle" has been the result of a long-term evolutionary process of entrepreneurial vision by the government, careful policy experimentation and market selection. [ABSTRACT FROM AUTHOR]

Abstract Background Recent studies have indicated that complementary and alternative medicine (CAM) has been gaining popularity around the world. Previous studies showed that CAM use was common among dermatology patients in Western nations. This study presents the prevalence and types of CAM use among a group of patients in a dermatology clinic in Taiwan. Methods A convenient sample of 198 patients was recruited from the dermatology clinic of Show Chwan Memorial Hospital in Changhua City, Taiwan. Each patient completed a standardized questionnaire. Chi-square tests were used to compare the demographic characteristics of those who did and did not use CAM. Logistic regression analyses were performed to determine the strength of association between correlate variables and CAM use. Results Forty-one per cent of subjects had used CAM to treat their dermatological conditions. Subjects in the younger (< 30 years) and older (> 50 years) age groups were more likely to use CAM than those in the 30–50-year age group. Those that participated in religious or social groups were more likely to use CAM. CAM users felt a more negative impact of their dermatological conditions on daily living, relationships, emotional well-being and physical health. Conclusions As in Western nations, CAM use is prevalent among dermatology patients in Taiwan: not only the traditionally popular Chinese CAM, but also Western CAM. With CAM being popular in the younger age group, dermatologists will likely encounter more CAM users in the future. Because some CAM may produce serious side-effects, dermatologists need to help and guide patients to assess the benefits and dangers of using CAM to treat dermatological conditions. [ABSTRACT FROM AUTHOR]

Toll collectors are potentially exposed to high concentrations of a variety of automotive emissions. The purpose of this study is to assess if there is an excess of adverse health outcomes among toll collectors. Self-reported chronic respiratory symptoms and acute irritative symptoms were assessed in a cross-sectional study among 363 toll collectors (exposure group) and 147 office workers (control group). The prevalence rates for chronic respiratory symptoms were not significantly different between the exposure group and the control group. This could be related to the short length of employment for the toll collectors. Another likely explanation for not detecting apparent respiratory effects might be that symptomatic workers drop out of this work a few years after starting the job. Acute irritative symptoms (nose, throat, nausea, and headache), however, were significantly more common among the toll collectors than among the controls. [ABSTRACT FROM AUTHOR]

Background: The survival of critically ill patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT) is highly dependent on their nutritional status., Objectives: The prognostic nutritional index (PNI) is an indicator used to assess nutritional status and is calculated as: PNI = (serum albumin in g/dL) × 10 + (total lymphocyte count in/mm 3 ) × 0.005. In this retrospective study, we investigated the correlation between this index and clinical outcomes in critically ill patients with AKI receiving CRRT., Methods: We analyzed data from 2076 critically ill patients admitted to the intensive care unit at Changhua Christian Hospital, a tertiary hospital in central Taiwan, between January 1, 2010, and April 30, 2021. All these patients met the inclusion criteria of the study. The relationship between PNI and renal replacement therapy-free survival (RRTFS) and mortality was examined using logistic regression models, Cox proportional hazard models, and propensity score matching. High utilization rate of parenteral nutrition (PN) was observed in our study. Subgroup analysis was performed to explore the interaction effect between PNI and PN on mortality., Results: Patients with higher PNI levels exhibited a greater likelihood of achieving RRTFS, with an adjusted odds ratio of 2.43 (95% confidence interval [CI]: 1.98-2.97, p -value < 0.001). Additionally, these patients demonstrated higher survival rates, with an adjusted hazard ratio of 0.84 (95% CI: 0.72-0.98) for 28-day mortality and 0.80 (95% CI: 0.69-0.92) for 90-day mortality (all p -values < 0.05), compared to those in the low PNI group. While a high utilization rate of parenteral nutrition (PN) was observed, with 78.86% of CRRT patients receiving PN, subgroup analysis showed that high PNI had an independent protective effect on mortality outcomes in AKI patients receiving CRRT, regardless of their PN status., Conclusions: PNI can serve as an easy, simple, and efficient measure of lymphocytes and albumin levels to predict RRTFS and mortality in AKI patients with require CRRT.

Abstract: Many food safety issues have arisen in Taiwan during the past decade. Therefore, in 2016, the Taiwan government proposed the "five rings of food safety" policy to comprehensively protect consumer food supply. Among these policies, the "4-labels-1-Q" approach was adopted to ensure the selection of foods with traceable labels for retrospective study. Hence, this study investigated the association between the degree of familiarity with the 4-labels-1-Q food traceability system and risk perceptions and also investigated whether a consumer's purchase intention toward fresh foods with food labels changed after viewing an educational film on food labels. This study defined subjects as the main food purchasers for their families; 290 valid questionnaire interviews were administered and educational films shown in Tainan markets and stores. Results showed that knowledge about labels significantly affected risk perception for labeling. Age, educational level, and degree of risk perception influenced purchase intention. Results also showed that after viewing the video, subjects' label knowledge and purchase intention increased significantly. However, after adjustment for age, educational level, income, and purchase places, the effect of film education on risk perception was insignificant, especially for those who had lower educational levels, including those older than 65 years. Public trust can be boosted through label education among age groups using different channels and methods, and encouraging the sale of labeled foods in traditional markets would be a useful strategy. Age, educational level, income, and risk perception of participants significantly affected purchase intention. This study can be a reference for designing risk communication strategies and promoting traceable agricultural products., (Copyright ©, International Association for Food Protection.)

underlying representations play a crucial role in capturing predictable relations among different phonetic categories in phonological theory. Tone sandhi is a tonal alternation phenomenon in which a tone changes to a different tone in certain phonological environments. This study investigates whether Taiwanese listeners are more sensitive to the surface form of the tones or the underlying tonal representations of tone sandhi words. An auditory lexical decision experiment was conducted to examine priming effects between monosyllabic primes and disyllabic target words (tone sandhi T51 → T55 and sandhi T24 → T33). Each target was preceded by either a surface-tone prime (e.g., ping55-ping55tsun24; pue33-pue33jong51), an underlying-tone prime (e.g., ping51-ping55tsun24; pue24-pue33jong51), or an unrelated control (e.g., ping21-ping55tsun24; pue21-pue33jong51). Results showed significant differences in the natue of the priming effects across the two sandhi types, with productivity of the tone sandhi rule influencing how listeners' process and represent tone sandhi words.

Both periodontitis and osteoporosis have similar sign of bone resorption in nature. However, the relationship of the severity between these 2 bone-loss diseases is still uncertain.The aim of this study was to investigate the association between the severity of osteoporosis and periodontitis regarding the impact of oral hygiene maintenance. In total, 35,127 osteoporosis patients and 50,498 comparisons were derived from the Longitudinal Health Insurance Database of Taiwan between 2000 and 2010. The population was subdivided into groups according to the different level oral hygiene maintenance and the severity of periodontitis and osteoporosis. The association between osteoporosis and periodontitis was estimated by multinomial logistic regression and rank correlation by Kendall rank correlation test, presented by odds ratio (OR), and 5% confidence intervals (CIs).After controlling the age, sex, and comorbidities, variables in the good oral hygiene maintenance population, we found that periodontitis raised 1.29-fold risk of osteoporosis (95% CI = 1.12-1.49); the risk of osteoporosis was increased with the elevated severity of periodontitis from 1.27 (95% CI = 1.08-1.48) to 1.38 (95% CI = 1.01-1.89). There is a positive correlation between the severity of periodontitis and osteoporosis occurrence in this population (OR = 1.27-1.46; Kendall rank correlation test P = 0.0003). In the poor oral hygiene maintenance population, periodontitis patients had 6.02-fold risk of osteoporosis than those who without periodontitis (95% CI = 4.65-7.81); the risk of osteoporosis was increased with periodontitis severity from 5.96 (95% CI = 4.48-7.92) to 6.37 (95% CI = 3.36-12.1).This result indicated the periodontitis and osteoporosis are conjunctive. The sudden periodontal breakdown of those who with good oral hygiene maintenance might be an indicator for the risk of osteoporosis; if those who were diagnosed as osteoporosis must pay more attention to their periodontal health. Good oral hygiene maintenance might be a crucial factor for preventing the deterioration of osteoporosis progressing; the oral hygiene maintenance plays a significant influence on the association between periodontitis and osteoporosis.

Background and Aims: Little is currently known about the risk of developing bisphosphonate-related osteonecrosis of the jaw (BRONJ). This study sought to determine the incidence of BRONJ in osteoporotic patients. We also sought to identify the nature and types of risk factors of osteonecrosis of jaw (ONJ) related to the use of oral bisphosphonates (BPs)., Materials and Methods: Data from the National Health Insurance system of Taiwan. This cohort study included 19,399 adult osteoporosis patients received dental extraction in 2000-2010 (osteoporosis cohort) and 38,669 age and gender matched comparisons selected from dental extraction people without osteoporosis and osteonecrosis history (comparison cohort). All study subjects were followed from the date of their dental extraction (index date) to the development of ONJ and were included in the study up to 2011 or were lost to the study, whichever occurred first. Cox proportional hazard regression was used to estimate the hazard ratio and 95% confidence intervals for the two cohorts., Results: Patients with osteoporosis had a significantly higher risk to develop ONJ than healthy persons (adjusted HR, 2.05; 95% confidence interval, 1.58-2.65). The risk of ONJ increased with the severity of osteoporosis, no matter whether patient with cancer or not. A cumulative effect of dental extraction frequency may increase the risk of ONJ., Conclusions: We concluded that ONJ is caused by a number of factors. Osteoporosis and past dental history play the very important roles, while BPs play the synergistic effect.

Osteoporosis is an essential index of health and economics in every country. Recognizing asymptomatic elderly population with high risks of osteoporosis remains a difficult challenge. For this purpose, we developed and validated an artificial neural network (ANN) to identify the osteoporotic subjects in the elderly. The study population consisted of 1403 elderly adults (mean age 63.50 +/- 0.24 years ranged from 50 to 91 years old, 157 male and 1246 female) randomly selected into 3 sets, 703 participants in training set, 350 participants in selection set, and the remaining 350 participants in test set. The input variables included demographic characteristics, anthropometric measurements, and clinical data. The outcome variable was dichotomous, either non-osteoporotic (T-score of greater than -2.5) or osteoporotic (T-score of -2.5 or less) groups classified by the measurement from dual energy X-ray absorptiometry. ANN was constructed with data from training and selection sets and validated in test set whose outcome variable was unknown to the network. The performance of ANN was evaluated by discrimination and calibration simultaneously. After training processes, the final best ANN was a multilayer perceptron network which determined seven input variables (gender, age, weight, height, body mass index, postmenopausal status, and coffee consumption) as significant features. The discriminatory power of ANN for test set was excellent (area under receiver operating characteristics curve = 0.82 +/- 0.03). ANN also had statistically good fit represented by statistically insignificant Hosmer-Lemeshow statistic (p = 0.24). These results suggested that our final ANN concurrently had good discriminatory power and good-fit calibration. ANN can be used as a promising tool for the elderly to stratify high risk subjects into osteoporotic group.

Background: Both C-reactive protein (CRP) and ferritin have been reported to reflect the extent of oxidative stress and inflammation in individual patients and may be useful markers of disease activity and mortality risk. Exposure to oxidative stress has been reported to increase ferritin synthesis. We investigated the relationship between oxidative stress with CRP and ferritin concentrations in febrile emergency room patients to test the hypothesis whether the intensity of oxidative stress correlated with serum ferritin concentration., Methods: Six normal healthy volunteers and 59 emergency room, febrile patients with body temperature >38.3 we enrolled before receiving medical treatment. Baseline measurements included complete blood count, blood biochemistry, CRP and serum ferritin concentrations, and transferring saturation (TSAT). The intensity of lucigenin-enhanced chemiluminescence (LucCL), corresponding to the level of superoxide, was detected by luminometer., Results: In febrile patients, plasma LucCL intensity was higher than in normal healthy volunteers (P<0.05). The group with bacterial infection had higher serum ferritin (319.4+/-53.7 vs 102.0+/-21.2 ng/dL, P<0.05) and CRP concentrations (7.2+/-1.2 vs 2.2+/-0.6 mg/dL; P<0.05) than the group without bacterial infection. There were no differences in leukocytes (9790+/-606 vs 9577+/-656 /mm3) or plasma LucCL intensity (423.7+/-10.8 vs 409.5+/-6.9 relative light unit?RLU?;) between the two groups. LucCL intensity showed no correlation with serum ferritin concentration (r= -0.0599, P>0.05), TSAT(r= -0.0592, P>0.05), CRP(r= 0.1027, P>0.05) and absolute neutrophil counts (r= 0.1059; P >0.05)., Conclusion: In this sample of emergency room febrile patients, plasma LucCL intensity was higher than in normal healthy control volunteers. A single point measurement of oxidative stress, particularly plasma LucCL intensity, may not be sufficient to differentiate the origin of fever in febrile patients. These data demonstrate that patients with bacterial infection had increased levels of CRP and ferritin, but this was not associated with LucCL intensity.