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Background: Acute respiratory distress syndrome (ARDS) is a common life-threatening condition in critically ill patients. Itis also an important public health issue because it can cause substantial mortality and health care burden worldwide. The objective of this study was to investigate therisk factors that impact ARDS mortality in a medical center in Taiwan. Methods: This was a single center, observational study thatretrospectively analyzed data from adults in 6 intensive care units (ICUs) at Taichung Veterans General Hospital in Taiwan from 1st October, 2018to30th September, 2019. Patients needing invasive mechanical ventilation and meeting the Berlin definition criteria were included for analysis. Results: A total of 1,778 subjects were screened in 6 adult ICUs and 370 patients fulfilled the criteria of ARDS in the first 24 hours of the ICU admission. Among these patients, the prevalenceof ARDS was 20.8% and the overall hospital mortality rate was 42.2%. The mortality rates of mild, moderate and severe ARDS were 35.9%, 43.9% and 46.5%, respectively. In a multivariate logistic regression model, combination of driving pressure (DP) > 14cmH2O and oxygenation (P/F ratio)≤150 was an independent predictor of mortality (OR2.497, 95% CI 1.201–5.191, p = 0.014). Patients with worse oxygenation and a higher driving pressure had the highest hospital mortality rate(p<0.0001). Conclusions: ARDS is common in ICUs and the mortality rate remains high. Combining oxygenation and respiratory mechanics may better predict the outcomes of these ARDS patients. [ABSTRACT FROM AUTHOR]

Objectives: We examined the association between anogenital human papillomavirus (HPV) infection and sexual networks in men who have sex with men (MSM). Methods: A total of 253 MSM, 20 years of age and older, were recruited from the community in Southern Taiwan in 2015–2016. At baseline and at each follow-up visit, MSM were screened for HPV to identify 37 HPV genotypes. At the six-month follow-up, MSM were asked to fill out an egocentric network assessment and to report the last five persons with whom they had sex regarding the characteristics of sexual behavior with each network member. Results: A total of 182 participants (71.9%) returned for the follow-up and one third had at least one HPV type detected. A higher level of bridging network position calculated by the level of constraints in the network was significantly less likely to have HPV detection at the anal site. A high level of concurrency was associated with penile HPV detection (AOR = 3.16, 95% CI = 1.01–9.86). Conclusions: Identifying network-related characteristics can advance our understanding of high-risk populations and for prioritizing HPV vaccine recommendations. [ABSTRACT FROM AUTHOR]

Mango (Mangifera indica) is a widely enjoyed tropical fruit that is rich in numerous nutrients, but it is also a common allergenic fruit that can induce anaphylactic shock in some mango-sensitized individuals. To protect allergic consumers, a TaqMan real-time PCR is developed herein by targeting the major mango allergen GAPDH gene to identify mango in foods. To prevent interference by other ingredients in the foods, an internal amplification control (IAC) is established and incorporated into the developed qPCR. Under the optimized assay conditions, the developed assay can detect mango genomic DNA down to 10 pg/μL and effectively differentiate mango from 21 other fruits and vegetables. In the incurred assay, the developed qPCR has a limit of detection (LOD) of 10 μg/g and 330 μg/g of mango powder in juice and cookie, respectively. The assay exhibits a board spectrum, successfully detecting six mango cultivars, and has good accuracy and precision as calculated intra- and inter-assay CV values < 10%. Forty commercial processed foods were simultaneously analyzed using the developed method and a qPCR method that is officially recognized by the Taiwan FDA. The sensitivity and specificity of this assay were estimated to be 85% and 100%, respectively, based on the ingredient labeling of these products. Hence, this developed qPCR is an effective method for screening mango in processed foods. [ABSTRACT FROM AUTHOR]

Previous studies have unanimously agreed that despite the challenges of postmodernism, militaries should not and cannot be governed using an occupational model. However, what the notion of the value type of a postmodern army is should be clarified. This study investigates the changing values of postmodern militaries caused by external economic factors. For this research, a questionnaire and long-term investigation method were adopted to collect 262 cadet samples from the Taiwanese military, navy, and air force. The results of a cluster analysis showed that the cadets primarily comprised 3 types, that is, the devotion (DE) type, socially competent (SC) type, and the comfortable (CO) type. This study shows that the socially competent type best satisfies the value demands of the military. In addition, the enlistment motivations of this type of cadet are generally to alleviate family financial burdens, non-economic-related reasons, self-actualization, and patriotism. [ABSTRACT FROM AUTHOR]

Three methods for ethics instruction are used in Taiwanese military education: the ‘bag-of-virtues’, value-clarification and virtue-ethics methods. This article explains, analyzes and discusses each of these, thereby giving an introduction to how military ethics is taught – and thought of – within the Taiwanese military system. Recommendations are given for how to improve the parts of the system that do not seem to live up to the stated intentions. [ABSTRACT FROM PUBLISHER]

In this study, I examined what channels of socialization influence the moral behavior of cadets. We conducted a regression analysis of the effects of parents' attitudes to moral education, the standard and potential curriculum of schools, peer groups, and communication media on individual ethics and discipline using 399 sample participants. The participants were recruited through a questionnaire survey on cadets from academy of military, naval, and air force, and four-year based students from R.O.C. National Defense University. The analysis results showed that the cultivation of morality among cadets was directly influenced by the school's potential curriculum (i.e., intern cadres and officers in company) and their parents' attitudes to moral education during early childhood. The results also indicated that the influence of teaching by example was more significant than that of teaching by precept. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Betel quid (BQ) components induce the secretion of tumour necrosis factor-alpha (TNF-α) in oral keratinocytes, which promotes oral mucosal inflammation and oral cancer. This study was carried out to evaluate the association of TNFA genetic variants (−308G>A and −238G>A) with the risk and prognosis of BQ-related oral and pharyngeal squamous cell carcinoma (OPSCC). Design: A total of 403 subjects (205 cancer cases and 198 healthy controls) who habitually chewed BQ were recruited. The genotypes were determined by TaqMan real-time assays. Results: G allele and G/G genotype at TNFA −308 were associated with a 1.95-fold (95%CI: 1.16–3.28, p corrected =0.024) and 2.28-fold (95%CI: 1.30–4.00, p corrected =0.008) increased risk of cancer as compared to those with A allele or A/A+A/G genotypes, respectively. In addition, G allele (p =0.080) and G/G genotype (p =0.076) at TNFA −238 were associated with a borderline but statistically significant increased risk of OPSCC. The combined G/G+G/G genotype at both loci had a 2.37-fold increased risk of OPSCC as compared to those with other combined genotypes (95%CI: 1.41–4.00, p =0.001). Interactions between combined genotypes and smoking status were also found to contribute to risk of BQ-related OPSCC. There was no association of TNFA genotypes with clinicopathologic findings or the survival of OPSCC patients. Conclusions: BQ-chewers who carry the G allele or G/G genotype in TNFA −308 may have an increased risk of OPSCC. The intensity of cigarette smoking modulates the effect of the combined TNFA genotypes on risk of BQ-related OPSCC. [Copyright &y& Elsevier]

Aim of the study: Antrodia camphorata (niu-chang-chih) is a fungus native to Taiwan which is believed to be effective in preventing diseases. Recent reports demonstrate that Antrodia camphorata products induce the apoptosis of various kinds of tumor cells. In this study we determined the inhibitory effects of alcohol extract and individual fractions of alcohol extract on the proliferation of human non-small cell lung carcinoma A549 cell and clarified the mechanism underlying the anti-cancer activities. Materials and methods: Alcohol extracts of Antrodia camphorata mycelia were prepared by the serial extraction with the solvents with increasing polarity and fractionated using HPLC. Cell viability was determined by MTT assay. Apoptosis detection was carried out by subG1 analysis and annexin V/propidium iodide staining using flow cytometry. The impacts of HPLC fractions on the expression levels of apoptosis- and cancer-related proteins were evaluated by western blotting. Results: Three HPLC fractions, fractions 5–7, had robust inhibition of human A549 cells and among them fraction 6 (Fr-6) possessed the most potent effectiveness. Apoptotic assay showed that Fr-6-induced human A549 cell apoptosis by triggering the mitochondrial pathway and endothelium reticulum (ER) stress. Immunoblotting results demonstrated that Fr-6 possibly activated ER stress by lowering the expression level of calpain 1/2 small subunit and Fr-6-mediated decrease in cell proliferation might attribute to the suppressive effect on the Erk 1/2 pathway, which arose from Fr-6-derived low galectin-1 expression. Furthermore Fr-6 could diminish Rho GDP dissociation inhibitor α (RhoGDI-α) expression and subsequently activated c-Jun NH2-terminal kinase (JNK) pathway, which is linked to cell apoptosis. Fr-6 also could decrease the production level of eukaryotic translation initiation factor 5A, which is a potential cancer intervention target. Conclusion: These results suggested that the anti-cancer activity of Antrodia camphorata might be due to multiple active metabolites, which work together to induce cell apoptosis via various pathways. [Copyright &y& Elsevier]

The strategies of the extrapolation adjusted by model prediction (ExAMP) blending scheme, which trusts the field pattern predicted by extrapolation and allows the field intensity to be adjusted by numerical weather prediction (NWP), for rainfall nowcasting are analyzed in this study. The McGill algorithm for precipitation nowcasting by Lagrangian extrapolation (MAPLE) and the Weather Research and Forecasting (WRF) model serve as the extrapolation and NWP models, respectively. Seven 150-min rainfall nowcasting experiments with different strategies are carried out for 37 sampled periods from seven heavy rainfall events in Taiwan in 2019. The results of the overall statistics indicate that, for the extrapolation component, extrapolating the current rainfall rate estimated from the lowest dual-polarimetric radar observations is a superior strategy. The ExAMP scheme that blends the MAPLE and WRF forecasts can surpass both components in 150-min rainfall nowcasting, and an empirical limitation on the innovation of intensity during the blending procedure is found unnecessary in this study. Moreover, the spatial performance for two contrasting events reveals the ability of ExAMP in grasping the rainfall strengthening and weakening in different areas. The skill statistics separately at rainfall strengthening gauges and weakening gauges further prove the effectiveness of ExAMP even though it is effective in intensity correction instead of pattern correction. [ABSTRACT FROM AUTHOR]

Released thyroid cancer patients treated with 131I may cause a radiation risk to their family members. However, no current regulations exist in Taiwan to limit the radiation dose among patients released post-treatment. This study assessed radiation exposure to caregivers of thyroid cancer patients treated with 131I to verify whether their doses exceed the 5-mSv limit per treatment session. The study population comprised 63 patients from four hospitals and their caregivers. Dose rates at a 1-m distance from patients were quantified before their release. Dosimetry data of caregivers were obtained using personalized thermoluminescent dosimetry badges. Upon the release of patients treated with 131I, Dose rates at a 1-m distance from the patients were 3.9–55 μSv/h. The radiation doses to caregivers ranged from 0.21 to 1.7 mSv after the patients released. When the 1-m dose rate of patients upon hospital release was 50 μSv/h, the highest possible radiation dose was assessed of 4.76 mSv for caregivers. In conclusion, as the dose rates at a 1-m distance from patients upon release were <50 μSv/h, the radiation dose received by their caregivers would be in accordance with the 5-mSv limit recommended by the International Atomic Energy Agency series 40, International Commission on Radiological Protection publication 94, and National Council on Radiation Protection and Measurements Report no. 155. • Dose to caregivers of the patients with I-131 treated were measured by dosimeters. • The 63 population data were collected from 4 hospitals in Taiwan. • Current management practices were verified to be safe to caregivers in Taiwan. • The 50 μSv/h criteria to release the patients was recommended. [ABSTRACT FROM AUTHOR]

Typhoon-induced storm surges are catastrophic disasters in coastal areas worldwide, although typhoon surges are not extremely high in Taiwan. However, the rising water level around an estuary could be a block that obstructs the flow of water away from the estuary and indirectly forms an overflow in the middle or lower reaches of a river if the occurrence of the highest storm surge (HSS) coincides with the highest astronomical tide (HAT). Therefore, assessing the highest storm tide (HST, a combination of the HSS and HAT) hazard level along the coast of Taiwan is particularly important to an early warning of riverine inundation. This study hindcasted the storm surges of 122 historical typhoon events from 1979 to 2018 using a high-resolution, unstructured-grid, surge-wave fully coupled model and a hybrid typhoon wind model. The long-term recording measurements at 28 tide-measuring stations around Taiwan were used to analyze the HAT characteristics. The hindcasted HSSs of each typhoon category (the Central Weather Bureau of Taiwan classified typhoon events into nine categories according to the typhoon's track) were extracted and superposed on the HATs to produce the individual potential HST hazard maps. Each map was classified into six hazard levels (I to VI). Finally, a comprehensive potential HST hazard map was created based on the superposition of the HSSs from 122 typhoon events and HATs. [ABSTRACT FROM AUTHOR]

The strategies of the extrapolation adjusted by model prediction (ExAMP) blending scheme, which trusts the field pattern predicted by extrapolation and allows the field intensity to be adjusted by numerical weather prediction (NWP), for rainfall nowcasting are analyzed in this study. The McGill algorithm for precipitation nowcasting by Lagrangian extrapolation (MAPLE) and the Weather Research and Forecasting (WRF) model serve as the extrapolation and NWP models, respectively. Seven 150-min rainfall nowcasting experiments with different strategies are carried out for 37 sampled periods from seven heavy rainfall events in Taiwan in 2019. The results of the overall statistics indicate that, for the extrapolation component, extrapolating the current rainfall rate estimated from the lowest dual-polarimetric radar observations is a superior strategy. The ExAMP scheme that blends the MAPLE and WRF forecasts can surpass both components in 150-min rainfall nowcasting, and an empirical limitation on the innovation of intensity during the blending procedure is found unnecessary in this study. Moreover, the spatial performance for two contrasting events reveals the ability of ExAMP in grasping the rainfall strengthening and weakening in different areas. The skill statistics separately at rainfall strengthening gauges and weakening gauges further prove the effectiveness of ExAMP even though it is effective in intensity correction instead of pattern correction. [ABSTRACT FROM AUTHOR]

Taiwan's most significant natural hazards are caused by hydrological extremes resulting from excessive precipitation. The threat of extreme precipitation is posed by several different types of weather patterns that affect Taiwan. This study examined the bi‐decadal changes in rainfall by defining an extreme precipitation occurrence (EPO) for a range of event durations from 1 to 24 hr. Three major weather types affecting EPO in Taiwan were identified from 1993 to 2015: the front type consisting of either a frontal zone or convective systems developing with an apparent Meiyu cloudband, diurnal rainfall events when no apparent synoptic features are present, and a tropical cyclone (TC) type according to the maximum sustained wind radius of a TC. Results show that TC‐type events have the greatest overall contribution to EPO at longer (>6 hr) durations. Diurnal/afternoon convection events contribute most to the shorter (<3 hr) duration EPO, while frontal/Meiyu systems prevail in the medium (3–6 hr) duration. EPO of almost all durations have experienced an increase, with the 3‐ and 12‐hr EPO having increased by 4.6 days each over the 23 years. However, apparent decadal‐scale variability exists in these EPO associated with the decreasing tendency of EPO after the mid‐2000s, particularly the longer duration (>6 hr) EPO associated with the TC‐type events in summer. The distinction between EPO trends for the entire island of Taiwan and for the Taipei metropolitan area alone (northern Taiwan, population of 7 million) were compared, and an intriguing interannual variation is reported in the TC‐type EPO associated with the TC season 1 year to a year and half just before an El Niño–Southern Oscillation event. The analysis here provides refined statistical distributions of extreme rainfall, and these can contribute to the revision of governmental definitions for weather disasters that are used in mitigation and response strategies. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to determine if the triceps-reflecting anconeus pedicle (TRAP) approach combined with the precontoured locking plate can provide acceptable clinical outcomes in the treatment of comminuted distal humerus fracture.Methods: Between August 2008 and June 2014, 48 patients with Orthopaedic Trauma Association type C (21 with C2, 27 with C3) distal humerus fractures underwent open reduction and internal fixation with orthogonal precontoured locking plate fixation using the TRAP approach. Occurrences of bony union, implant failure, posttraumatic arthrosis, and heterotopic ossification were detected with radiography. Clinical assessment included evaluation of range of motion and determination of the pain score, Mayo Elbow Performance Index (MEPI) score, and Disability of the Arm Shoulder and Hand (DASH) score.Results: The fractures healed within 3 months in 25 patients (53%) and within 6 months in 23 patients (47%). The 12-month assessment revealed improved elbow movement, with the mean arc of flexion-extension of 121° (range, 100°-140°), mean arc of supination-pronation of 163° (range, 150°-180°), and mean flexion contracture of 8° (range, 0°-30°). The mean MEPI score was 81 and the mean DASH score was 11.7.Conclusions: By retaining the intact olecranon by the TRAP approach, orthopedic surgeon can get adequate surgical exposure for fracture fixation and can use olecranon as a three-dimensional template to restore the articular fragments. The promising results in this study obtain because that precise identification of the triceps muscle allowed the determination of a proper length-tension relationship for triceps reattachment. The combination of triceps tendon repair and anconeous muscle repair ensured the strength of the extensor mechanism. Therefore, the TRAP approach in combination with the usage of the precontoured locking plate can be recommended as the optimal surgical approach for the treatment of comminuted distal humerus fracture. [ABSTRACT FROM AUTHOR]

Backgrounds: Oral cancer is the 4th leading cause of cancer death for males and the top cancer in young adult males in Taiwan. Tongue squamous cell carcinoma (TSCC) is a common oral cancer and generally associated with poor prognosis. Global DNA hypomethylation at the 5 position of cytosine (5mC) is a well-known epigenetic feature of cancer. Therefore, the purpose of this study was to investigate the relationship of the global 5mC content with the tumorigenesis and prognosis of patients with TSCC.Methods: The levels of global 5mC were evaluated by immunohistochemistry using tissue microarray slides of 248 surgically resected TSCC and 202 corresponding tumor adjacent normal (TAN) tissues.Results: We found that the level of 5mC in TSCC (P < 0.001) was significantly decreased as compared to TAN. Among TSCC tissues, decreased levels of 5mC were associated with female gender (P = 0.036). In addition, the global hypomethylation was associated with the poor disease-specific survival in TSCC patients (adjusted hazard ratio: 1.55, P = 0.043), especially for patients in older age group (> 50 years, P = 0.013), with moderate or poor cell differentiation (P = 0.044), early stage of disease (I-II, P = 0.046), small tumor size (T1-T2, P = 0.005), without lymph node involvement (P = 0.041), and ever received postoperative radiotherapy (P = 0.009).Conclusions: Global hypomethylation was an independent biomarker for the development and poor prognosis of TSCC. [ABSTRACT FROM AUTHOR]

In this study, an ensemble typhoon quantitative precipitation forecast (ETQPF) model was developed to provide typhoon rainfall forecasts for Taiwan. The ETQPF rainfall forecast is obtained by averaging the pick-out cases, which are screened using certain criterion based on given typhoon tracks from an ensemble prediction system (EPS). Therefore, the ETQPF model resembles a climatology model. However, the ETQPF model uses the quantitative precipitation forecasts (QPFs) from an EPS instead of historical rainfall observations. Two typhoon cases, Fanapi (2010) and Megi (2010), are used to evaluate the ETQPF model performance. The results show that the rainfall forecast from the ETQPF model, which is qualitatively compared and quantitatively verified, provides reasonable typhoon rainfall forecasts and is valuable for real-time operational applications. By applying the forecast track to the ETQPF model, better track forecasts lead to better ETQPF rainfall forecasts. Moreover, the ETQPF model provides the 'scenario' of the typhoon QPFs according to the uncertainty of the forecast tracks. Such a scenario analysis can provide valuable information for risk assessment and decision making in disaster prevention and reduction. Deficiencies of the ETQPF model are also presented, including that the average over the pick-out case usually offsets the extremes and reduces the maximum ETQPF rainfall, the underprediction is especially noticeable for weak phase-locked rainfall systems, and the ETQPF rainfall error is related to the model bias. Therefore, reducing model bias is an important issue in further improving the ETQPF model performance. [ABSTRACT FROM AUTHOR]

Objectives: Mutation of the exon 3 of CTNNB1, the coding gene of β-catenin, is a crucial molecular mechanism leading to aberrant activation of the Wnt/β-catenin pathway, which is highly associated with the carcinogenesis of hepatocellular carcinoma (HCC). The prevalence and clinical significance of CTNNB1 mutations in advanced HCC remain unclear. Methods: Patients with advanced HCC and available pathologic tissues (either obtained when diagnosed at advanced or early stages) were enrolled in this study. Direct sequencing of exon 3 of CTNNB1 was performed to detect somatic mutations. The associations between CTNNB1 mutations and clinicopathologic features were analyzed. Results: A total of 115 patients were enrolled, among whom 78 (67.8%) had chronic hepatitis B virus infection. Twenty-one (18.3%) patients were found to have CTNNB1 mutations, all of which were missense mutations. The CTNNB1 mutation rates were similar among pathologic tissues obtained at advanced and early stages (17.5 and 20.0%, respectively). Patients aged over 60 years were more likely to have CTNNB1 mutations than patients younger than 60 years (32.6 vs. 8.7%, p = 0.001). The mutations were not associated with survival or other clinicopathologic features. Conclusion: In patients with advanced HCC, CTNNB1 mutations were not prognostically significant. No apparent increase of CTNNB1 mutations occurred during the progression of HCC. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background & Aims: No approved therapy is available for patients with advanced hepatocellular carcinoma (HCC) who fail first-line therapy. The prognosis of these patients, especially those eligible for clinical trials of second-line therapy, is unclear. Methods: All patients who participated in clinical trials of first-line systemic therapy for metastatic or locally advanced HCC in a referral center of Taiwan between 2005 and 2011 were included. Their clinicopathologic characteristics, when the first-line treatment failed, were analyzed and correlated with the overall survival (OS) from the date of first-line treatment failure. Results: A total of 192 patients were included. Before the start of the first-line therapy, all patients had Child-Pugh class A liver reserves and Cancer of the Liver Italian Program (CLIP) scores ⩽4. After the failure of the first-line therapy, the median OS of the entire group was 4.0months. Patients with Child-Pugh class A liver reserves, when the first-line treatment failed, had significantly better OS than patients with Child-Pugh class B or C liver reserves (median, A vs. B vs. C=7.5 vs. 1.3 vs. 1.0month, p <0.001). According to the key eligibility criteria of 3 published clinical trials for second-line therapy, 41%–56% of patients were potentially eligible. Compared to patients who were ineligible for clinical trials, potentially eligible patients had longer OS with a median of 7.8–8.6months. Conclusions: Patients with advanced HCC who failed first-line therapy could have substantially improved prognosis if they had Child-Pugh A liver reserves or were potentially eligible for clinical trials. [Copyright &y& Elsevier]

Operational monsoon moisture surveillance and severe weather prediction is essential for timely water resource management and disaster risk reduction. For these purposes, this study suggests a moisture indicator using the COSMIC-2/FORMOSAT-7 radio occultation (RO) observations and evaluates numerical model experiments with RO data assimilation. The RO data quality is validated by a comparison between sampled RO profiles and nearby radiosonde profiles around Taiwan prior to the experiments. The suggested moisture indicator accurately monitors daily moisture variations in the South China Sea and the Bay of Bengal throughout the 2020 monsoon rainy season. For the numerical model experiments, the statistics of 152 moisture and rainfall forecasts for the 2020 Meiyu season in Taiwan show a neutral to slightly positive impact brought by RO data assimilation. A forecast sample with the most significant improvement reveals that both thermodynamic and dynamic fields are appropriately adjusted by model integration posterior to data assimilation. The statistics of 17 track forecasts for typhoon Hagupit (2020) also show the positive effect of RO data assimilation. A forecast sample reveals that the member with RO data assimilation simulates better typhoon structure and intensity than the member without, and the effect can be larger and faster via multi-cycle RO data assimilation. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Transitional cell carcinoma of the urinary bladder is associated with occupational exposure to 4,4′-methylenebis(2-chloroaniline) (MBOCA). A program to monitor MBOCA levels in the work environment and to screen for bladder cancer was performed at four MBOCA manufacturing factories. Methods: The U.S. Occupational Safety and Health Administration analytic method No. 24 was adopted in this study to measure air MBOCA concentrations. A total of 70 MBOCA-exposed workers and another 92 nonexposed workers were recruited for screening. Urine occult blood tests, urine cytology, tests for the urine tumor marker nuclear matrix protein, and abdominal ultrasonography were performed in all patients. Intravenous urography and cystoscopy were used to confirm the presence of bladder cancer. Results: The air concentration of MBOCA was greatest in the purification area (0.23 to 0.41 mg/m3), followed by the washing area (less than 0.02 to 0.08 mg/m3) and neutralization area (less than 0.05 to 0.06 mg/m3). This study identified a current worker with proved bladder cancer. In addition, we also identified 1 worker with suspected malignant cells on urine cytology and 1 worker with atypical cytology combined with gross hematuria. Although the prevalence of atypical urinary cells and the nuclear matrix protein 22 tumor marker was not significantly different between the MBOCA-exposed workers and nonexposed workers as a whole or when grouped by sex, the prevalence of positive occult blood was marginally significantly (P = 0.055) greater in male exposed workers (18%) than in male nonexposed workers (7%). Conclusions: The findings of this study support the conclusions from other studies that MBOCA is potentially carcinogenic to humans. Control measures are needed to prevent overexposure from inhalation and skin absorption. [Copyright &y& Elsevier]

The Model for Prediction Across Scales (MPAS) is used to simulate the East Asian winter monsoon (EAWM) over the 2011–2020 winter. The 45 day hindcasts are made with 30 km horizontal resolution and constructed to a time-lagged ensemble system. The climatology, the major modes of EAWM variability, and the blocking activities are examined. The evaluation results reveal that MPAS can simulate the climatologic characteristics of EAWM reasonably, with a surface cold bias of 4% and a positive rainfall bias of 9% over East Asia. MPAS can perform skillfully in the forecasts of surface temperature probability of East Asia and is more reliable in detecting below normal and above normal events. The features that influence the EAWM variability are also analyzed. MPAS simulates reasonably in the occurrence frequency of blocking high in both locations and duration time. The empirical orthogonal function analysis also shows that MPAS can capture the two major modes of the surface temperature of EAWM. On the other hand, it is also found that a biased sea surface temperature may modify the circulations over the Western Pacific and affect the simulated occurrence frequency of cold events near Taiwan during winter. [ABSTRACT FROM AUTHOR]

The article describes a cyanide poisoning case in Taiwan involving a 32-year-old woman. The woman lost consciousness after drinking a non-alcoholic beverage and was transported to a hospital, where she was intubated. The blood gas measurements of the woman before and after intubation were cited. She was given intravenous hydroxocobalamine and she showed signs of improvement 2-3 minutes after. She was discharged from the hospital after 10 days.

Methicillin-resistant Staphylococcus aureus (MRSA) causes superficial infections such as cellulitis or invasive infections such as osteomyelitis; however, differences in MRSA isolates from cellulitis (CL-MRSA) and from osteomyelitis (OM-MRSA) at the same local area remain largely unknown. A total of 221 MRSA isolates including 106 CL-MRSA strains and 115 OM-MRSA strains were collected at Chang-Gung Memorial Hospital in Taiwan between 2016 and 2018, and their genotypic and phenotypic characteristics were compared. We found that OM-MRSA isolates significantly exhibited higher rates of resistance to multiple antibiotics than CL-MRSA isolates. Genotypically, OM-MRSA isolates had higher proportions of the SCCmec type III, the sequence type ST239, and the spa type t037 than CL-MRSA isolates. Besides the multidrug-resistant lineage ST239-t037-SCCmecIII more prevalent in OM-MRSA, higher antibiotic resistance rates were also observed in several other prevalent lineages in OM-MRSA as compared to the same lineages in CL-MRSA. Furthermore, when prosthetic joint infection (PJI) associated and non-PJI-associated MRSA strains in osteomyelitis were compared, no significant differences were observed in antibiotic resistance rates between the two groups, albeit more diverse genotypes were found in non-PJI-associated MRSA. Our findings therefore suggest that deep infections may allow MRSA to evade antibiotic attack and facilitate the convergent evolution and selection of multidrug-resistant lineages. [ABSTRACT FROM AUTHOR]