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Background/Objectives The purpose of this study was to present an association between the treatment response of diabetic macular edema (DME) to intravitreal ranibizumab (IVR) injections and different morphology patterns using spectral domain optical coherence tomography (SD-OCT). Subjects/Methods This retrospective study included 216 eyes of 142 subjects who received IVR for DME and were observed for at least 2 years. Medical charts and SD-OCT images of consecutive patients were reviewed at baseline, 1, 3, 6, 12, and 24 months after first IVR treatment. The OCT patterns were characterized as diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD), and vitreomacular interface abnormalities (VMIAs). All patients were classified into four groups based on the OCT findings. Results For a total of 216 eyes, 36 eyes were classified into the DRT group, 76 in the CME group, 42 in the SRD group, and 62 in the VMIA group. There were significant central macula thickness (CMT) improvements in all groups at the 1st month and the 2nd year, except for the DRT group at the 2nd year. Patients with OCT findings of hyperreflective dots (HRDs), metabolic parameters of hyperlipidemia, and coronary artery disease (CAD) had significantly less improvements in CMT at 2-year follow-up (P=0.029, 0.007

This study applied trait-state-occasion (TSO) modelling to investigate the extent to which inter-individual differences in personality were accounted for by time-invariant and time-varying factors during adolescence. The participants were 753 high school students, and only 661 students were followed for 4 years. The mean age in the first year was 15.23 years and 52.8% were females. The results showed that the full TSO model had the best representation of adolescent personality, and the means of the proportions of variance explained by trait factors for the Big Five ranged between 56% and 83%, suggesting that inter-individual differences in personality are mainly accounted for by stable trait variance over the course of adolescence. Furthermore, the five dimensions of personality differed not only in the amounts of trait variance but also in the stability of time-varying factors. These findings have significant implications for personality research.

Objective Radiotherapy (RT) for head and neck cancer (HNC) within 7 days of tooth extraction is contraindicated because it may increase the risk of osteoradionecrosis of the jaw (ORNJ). However, delayed RT could compromise survival in patients with HNC. By using a national health care database, we reviewed the contraindications and analysed other risk factors for ORNJ. Design A retrospective cohort study. Setting By using Taiwan's National Health Insurance Research Database, 5,062 HNC patients with at least one tooth extraction 1-21 days before the first RT day (index day) and without any extractions during or after RT from 2000 to 2013 were included. The patients were divided into two groups according to the time of tooth extraction before the index day: 1-7 days and 8-21 days. Participants Taiwanese patients with head and neck cancer. Main outcomes measure Univariate and multivariate Cox proportional hazard regression models were used to evaluate the risk factors of ORNJ. Results The overall incidence of ORNJ in the included patients was 1.03% (mean follow-up duration, 4.07 ± 3.01 years; range, 1.00-13.99 years). Tooth extraction within 7 days before RT was not associated with increased ORNJ risk (hazard ratio [HR] = 0.734; p = 0.312). Significant risk factors for ORNJ included oral cancer (adjusted HR = 3.961), tumour excision surgery within 3 months before RT (adjusted HR = 3.488), and mandibulectomy within 3 months before RT (adjusted HR = 5.985; all p Conclusion In a mean follow-up of 4 years, tooth extraction within 7 days before RT for HNC treatment did not increase the ORNJ risk compared with tooth extraction 7-21 days before RT.

Deep cement mixed (DCM) soil columns have been widely utilized to improve soft soil to support embankments or seawalls. However, the influence of the time-dependent behavior of the soft soil on the performance of DCM column-supported embankments is not well understood. In this study, the finite element (FE) model was established to investigate the creep effects on settlements and load transfer mechanisms of the soft soil improved by DCM columns under embankment load. Comparisons were conducted for the cases of the soft soil with or without creep. The parametric analysis demonstrated that the area replacement ratio and Young's modulus of the DCM column can largely influence the long-term behaviors of the DCM column-improved composite ground. The numerical results were also compared with the results calculated by German design method (EBGEO) and British design method (BS 8006). Regarding the vertical stress taken by the DCM column, EBGEO method provides a lower limit while BS 8006 method provides an upper limit.

This study analyzed early childhood preservice teachers’ specific components of self-efficacy to provide a more exhaustive comprehension of the relationships among STEM self-efficacy, pedagogical belief, and the self-reported need for professional development (PD). The participants were undergraduate or graduate preservice teachers recruited from the early childhood education department of a university in Taiwan. The research used instruments including the Teacher STEM Self-efficacy Scale, Teacher STEM Pedagogical Belief Scale, and Need for PD Scale to collect the data. In total, 150 preservice preschool teachers completed the survey. MANOVA and structural equation modeling were used to analyze the data. The results revealed that preservice teachers’ scores on STEM self-efficacy and the three components of self-efficacy were positively correlated with their STEM pedagogical beliefs and self-reported need for PD. Furthermore, affective attitude predicted teachers’ need for PD directly or indirectly through STEM pedagogical belief. In addition, the result indicated that STEM pedagogical belief acted as an intermediary in the association between the two components of self-efficacy (“cognitive concept” and “affective attitude”) and the self-reported need for PD. However, STEM pedagogical belief cannot mediate the relationship between the “equipped skill” component of self-efficacy and the self-reported need for PD. Preservice preschool teachers who had STEM teaching experience, reported interests in STEM, or participated in STEM-related activities had higher levels of STEM self-efficacy in terms of cognitive concept, affective attitude, and equipped skill. Based on these findings, the researchers provide suggestions for future research and practical implications in teacher development program.

In this paper, a new simplified method (de-coupled method) is presented for calculating consolidation settlements of a soft soil layer with creep under multi-staged loadings. All equations of this ...

The Big Three Perfectionism Scale (BTPS) is one of commonly used measures for assessing individuals' perfectionism. The main purpose of this current study was to assess the psychometric properties of the Big Three Perfectionism Scale (BTPS) within the framework of the Rasch model. The sample consisted of 502 adolescents (53% males and 47% females). This study revealed were several important findings. First, adolescents interpreted the categories of the rating scales of the BTPS as intended and items demonstrated good targeting with the operating ranges from - 4.79 to 4.47 logits for rigid perfectionism, from - 3.84 to 3.76 logits for self-critical perfectionism and from - 4.04 to 3.92 logits for narcissistic perfectionism. Second, rigid perfectionism, self-critical perfectionism and narcissistic perfectionism exhibited unidimensionally, providing justification for the use of summed scores for each scale. Third, the average item difficulty of facets was different within each scale, with the facets of self-worth contingencies, socially prescribed perfectionism and other-oriented perfectionism being more difficult to endorse in their belonging scale. Fourth, there were no DIF items across sex, suggesting that items in three scales functioned equally across boys and girls. Fifth, rigid perfectionism (r = 0.15) and self-critical perfectionism (r = 0.55) were positively associated with neuroticism, but self-critical perfectionism (r = - 0.24) and narcissistic perfectionism (r = - 0.29) were negatively related with agreeableness. Finally, sex moderated the associations between rigid perfectionism and neuroticism. In sum, the findings in this study enhance psychometric properties of the BTPS.

Geosynthetics and deep cement mixed (DCM) soil columns have been widely used to improve soft soil grounds in many countries and regions. This paper presents an experimental study on a geosynthetic-reinforced sand fill over marine clay with or without DCM columns under different loadings. Two tests were conducted on the sand fill reinforced with fixed-end and free-end geosynthetics over marine clay under three-stage local loading to investigate the effects of the boundary conditions of geosynthetic reinforcement on reducing settlements. It is observed that the fixed-end geosynthetic sheet is more effective in reducing settlements than the free-end condition under identical local loading. Another test was conducted on the fixed-end geosynthetic-reinforced sand fill over the marine clay improved by DCM columns under single-stage uniform loading. The vertical stresses on the marine clay and on the DCM columns, as well as the tensile strains of the geosynthetic sheet in the overlying sand fill, were measured. The results revealed that the stress concentration ratio increases with an increase in consolidation settlements, and the maximum tensile strain of the geosynthetic sheet occurs near the edge rather than at the center of the top surface of the DCM columns. Keywords: Settlement, Geosynthetic, Reinforcement, Deep cement mixed soil columns

The Brillouin optical time domain analysis (BOTDA) technology is gaining immense popularity and increasingly being utilised to measure strains in geotechnical structures. The deformations are usually determined by recording strains of selected points, from which the precaution and early warning of instability can be obtained. The errors of the measured strains using BOTDA are related to uncertainties in different connection methods and accumulated errors of the network in the monitoring zone. In this study, a network theory was derived first to measure the deformations of a geotechnical structure in two-dimensional (2D) condition. Next, two physical models (one with four nodes and the other with eight nodes) were established. The performance of the calculated deformations using the network theory based on the measured strains from BOTDA was examined and analysed by comparing the preset displacements from micrometres. From the test results, it is found that the stress concentration at the connection, which has a direct impact on the measured data, can be effectively reduced when using the rubber gasket. There is a good agreement between the calculated deformations and the preset displacements. The accumulated errors are less than 6% for three groups of relative stable nodes, which demonstrates that the proposed network theory can be well utilised in various fields and practical applications that require high precision.

BackgroundInfluenza is a major contributor to global disease burden. Vaccination recommendations specifically target populations at increased risk of serious influenza sequelae. The aim of this study is to conduct a systematic review and meta-analysis to evaluate the effectiveness of different quality improvement interventions to increase vaccination rates in high-risk populations.MethodsRandomized and nonrandomized studies with concurrent control groups will be identified. Interventions to increase vaccination rates will be categorized by strategy type. Overall intervention effects will be calculated using random effects models. Study quality will be assessed using a modified Cochrane Risk of Bias tool.

(1) Background: To investigate the correlation between therapeutic outcome and morphologic changes for diabetic macular edema (DME) after intravitreal injection of ranibizumab (IVIR). (2) Methods: This retrospective study included 228 eyes received IVIR for DME. Each participant was traced for two years after the initial IVIR, while the data of ophthalmic examination, optical coherence tomography (OCT) image, and systemic diseases were collected. The study population was categorized into different subgroups according to the existence of OCT morphologic change and the initial OCT morphologic pattern, including diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD), and vitreomacular interface abnormalities (VMIAs). The primary outcomes were the baseline best-corrected visual acuity (BCVA) and central macular thickness (CMT) during a two-year study period. The distribution of OCT morphologic change and its relation to primary outcome were analyzed. (3) Results: Comparing the 42 eyes (18.4%) with OCT morphological changes to another 186 eyes (81.6%) without such alteration, the former showed a poorer baseline BCVA (0.84 ± 0.39 vs. 0.71 ± 0.36, p = 0.035), worse final BCVA (0.99 ± 0.44 vs. 0.67 ± 0.30, p = 0.001), and thicker final CMT (354.21 ± 89.02 vs. 305.33 ± 83.05, p = 0.001). Moreover, the VMIA developed in 14.9% of all DME patients presenting the most common morphologic change among DRT, CME, and SRD. Besides, the presence of stroke was independently correlated to the morphologic change (adjusted odds ratio [aOR]: 6.381, 95% confidence interval (CI): 1.112–36.623, p = 0.038). (4) Conclusions: The change of OCT morphology in DME patients receiving IVIR was correlated to worse structural and visual outcome while the formation of VMIA most commonly occurred after initial treatment.

The anti-melanogenic activity of essential oils of Alpinia nantoensis and their bioactive ingredients were investigated in vitro. Treatment with leaf (LEO) and rhizome (REO) essential oils of A. nantoensis, significantly reduced forskolin-induced melanin production followed by down-regulation of tyrosinase (TYR) and tyrosinase related protein-1 (TRP-1) expression at both transcriptional and translational levels. Further studies revealed that down-regulation TYR and TRP-1 were caused by LEO/REO-mediated suppression of Microphthalmia-associated transcription factor (MITF), as evidenced by reduced nuclear translocation of MITF. Also, we found that LEO/REO induce the sustained activation of ERK1/2, which facilitate subsequent proteasomal degradation of MITF, as confirmed by that LEO/REO failed to inhibits MITF activity in ERK1/2 inhibitor treated cells. In addition, a significant increase of ubiquitinated MITF was observed after treatment with LEO and REO. Furthermore, the chemical composition of LEO and REO were characterized by gas chromatography-mass spectrometry (GC-MS) resulted that camphor, camphene, α-pinene, β-pinene, isoborneol and D-limonene were the major compounds in both LEO and REO. Further studies revealed that α-pinene and D-limonene were the active components responsible for the anti-melanogenic properties of LEO and REO. Based on the results, this study provided a strong evidence that LEO and REO could be promising natural sources for the development of novel skin-whitening agents for the cosmetic purposes.

Pulmonary fibrosis (PF) is a major public health problem with limited therapeutic options. There is a clear need to identify novel mediators of PF to develop effective therapeutics. Here we show that an ER protein disulfide isomerase, thioredoxin domain containing 5 (TXNDC5), is highly upregulated in the lung tissues from both patients with idiopathic pulmonary fibrosis and a mouse model of bleomycin (BLM)-induced PF. Global deletion of Txndc5 markedly reduces the extent of PF and preserves lung function in mice following BLM treatment. Mechanistic investigations demonstrate that TXNDC5 promotes fibrogenesis by enhancing TGFβ1 signaling through direct binding with and stabilization of TGFBR1 in lung fibroblasts. Moreover, TGFβ1 stimulation is shown to upregulate TXNDC5 via ER stress/ATF6-dependent transcriptional control in lung fibroblasts. Inducing fibroblast-specific deletion of Txndc5 mitigates the progression of BLM-induced PF and lung function deterioration. Targeting TXNDC5, therefore, could be a novel therapeutic approach against PF., Pulmonary fibrosis is a major public health problem with unclear mechanism and limited therapeutic options. Here the authors show that a fibroblast-enriched endoplasmic reticulum protein, TXNDC5, promotes pulmonary fibrosis by stabilizing TGFBR1 and show the potential of TXNDC5 as a therapeutic target against pulmonary fibrosis.

Background and Aims To evaluate the association of osteoporosis medications and outcomes of patients at risk of CKD. Method We included patients with stage 3-5 CKD from three Taipei Medical University-affiliated hospitals between January 1, 2011 and August 31, 2016. Patients were divided into two groups based on whether they received osteoporosis medications (bisphosphonates, raloxifene, teriparatide, or denosumab) and then matched at a 1:1 ratio by using propensity scores. The outcomes of interest were bone fractures, cardiovascular (CV) events, and all-cause mortality. Cox proportional hazard regression models were applied to identify the risk factors. Results A total of 39128 patients with CKD were included. After propensity score matching, 763 patients were in the study and control groups, respectively. The mean age of patients was 71.9 ± 12.5 years, and 34.4% of patients were men. After a median follow-up of 2.9 years, the incidence rates of bone fracture, CV events, and all-cause mortality were 10.4%, 7.5%, and 7.5%, respectively. Multivariate analysis results indicated that osteoporosis treatment was note associated with reduced risks of bone fracture (HR 0.85; 95% CI 0.43–1.68; P = 0.65), CV events (HR 0.82; 95% CI 0.56–1.20; P = 0.30), and all-cause mortality (HR 0.74; 95% CI 0.51–1.08; P = 0.12). Subgroup analysis demonstrated only patients with CKD stage 3 who received osteoporosis medications associated with better survival. Conclusion Osteoporosis medications did not reduce bone fractures, CV events or mortality in patients with CKD. Improved overall survival was observed in patients with CKD stage 3.

The authors consecutively assessed various arterial pulse‐wave velocity (PWV) indices and ankle‐brachial index (ABI) by an automatic device (VP2000, OMRON Health Care Co. Ltd., Kyota, Japan) in outpatients with ≥ 1 cardiovascular risk. PAD was defined as ABI ≤ 0.9. Among 2309 outpatients (mean age 62.4 years), worse renal function was associated with higher brachial‐ankle PWV, heart‐carotid PWV, heart‐femoral PWV (hf‐PWV), and lower ABI (all P

// Chih-Jen Wu 1, 2, 3 , Cheng-Yi Chen 1, 8, 11 , Thung-S. Lai 4 , Pei-Chen Wu 1 , Chih-Kuang Chuang 5, 6, 7 , Fang-Ju Sun 8, 9 , Hsuan-Liang Liu 5 , Han-Hsiang Chen 1, 8 , Hung-I. Yeh 10 , Chih-Sheng Lin 11 and Cheng-Jui Lin 1, 5, 8 1 Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medical College ,Taipei, Taiwan 2 Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan 3 Graduate Institute of Medical Sciences and Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan 4 Graduate Institute of Biomedical Science, Mackay Medical College, New Taipei City, Taiwan 5 Institute of Biotechnology, National Taipei University of Technology, Taipei, Taiwan 6 Division of Genetics and Metabolism, Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan 7 College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan 8 Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan 9 Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan 10 Department of Medicine, Mackay Medical College, New Taipei City, Taiwan 11 Department of Biological Science and Technology, National Chaio Tung University, Hsinchu, Taiwan Correspondence to: Cheng-Jui Lin, email: lincj@mmh.org.tw Keywords: indoxyl sulfate, chronic kidney disease, erythropoietin, renal anemia Received: April 27, 2017 Accepted: May 29, 2017 Published: June 28, 2017 ABSTRACT Renal anemia is a common complication in patients with advanced chronic kidney disease. In vitro studies have shown that indoxyl sulfate decreases erythropoietin production. Whether this effect is seen in vivo remains unclear. Our goal was to explore the role of indoxyl sulfate in renal anemia. We found serum indoxyl sulfate levels are significantly and negatively associated with erythropoietin levels in human. A multiple stepwise linear regression analyses after adjustment for other independent parameters revealed that free indoxyl sulfate, and total indoxyl sulfate were significantly associated with erythropoietin levels. In animal studies, erythropoietin gene and protein expression were markedly inhibited in rats with chronic kidney disease; however, this effect was significantly reversed by lowering serum indoxyl sulfate with AST-120. Indoxyl sulfate may also inhibit erythropoietin expression in animal models with chronic kidney disease. These findings further support the role of indoxyl sulfate in the development of renal anemia.

// Pei-Chen Wu 1,2,* , Vin-Cent Wu 3,* , Cheng-Jui Lin 1,4,5 , Chi-Feng Pan 1 , Chih-Yang Chen 1 , Tao-Min Huang 6 , Che-Hsiung Wu 7 , Likwang Chen 8 , Chih-Jen Wu 1,4,9,10 and The NRPB Kidney Consortium 11 1 Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan 2 Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan 3 Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan 4 Department of Medicine, Mackay Medical College, Taipei, Taiwan 5 Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan 6 Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou, Taiwan 7 Division of Nephrology, Taipei Buddhist Tzu Chi General Hospital, Buddhist Tzu Chi University, Taipei, Taiwan 8 Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan 9 Graduate Institute of Medical Sciences and Department of Pharmacology, College of Medicine, Taipei Medical University, Taipei, Taiwan 10 Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan 11 NRPB, National Research Program for Biopharmaceuticals, ROC, Taiwan * These authors have contributed equally to this work Correspondence to: Chih-Jen Wu, email: // Keywords : meglitinide, diabetes mellitus, hypoglycemia, chronic kidney disease, mortality Received : January 21, 2017 Accepted : April 14, 2017 Published : April 27, 2017 Abstract The safety of short-acting meglitinides in diabetic patients with advanced chronic kidney disease (CKD) has not been widely reported. Diabetic patients with advanced CKD who had a serum creatinine level of > 6 mg/dL a hematocrit level of ≦ 28% and received erythropoiesis-stimulating agent treatment between 2000 and 2010, were included in this nationwide study in Taiwan. The outcomes of interest were defined as hypoglycemia and long-term mortality. The risks of hypoglycemia and death were analyzed using Cox proportional hazards models, with end-stage renal disease and anti-diabetic drugs as time-dependent variables. Fresh users and matched non-users of meglitinides (both n = 2,793) were analyzed. The use of meglitinides increased the risk of hypoglycemia (HR, 1.94, p 62 and ≤ 33 years from the generalized additive model. This study suggests that the use of short-acting meglitinides could be associated with increased risk of hypoglycemia in diabetic patients with advanced CKD, especially in patients aged > 62 and ≤ 33 years. Meglitinide combined with insulin will increase hypoglycemia in patients with advanced CKD.

Objective We present molecular cytogenetic characterization of Jacobsen syndrome (11q23.3-q25 deletion) in a fetus associated with double outlet right ventricle (DORV), hypoplastic left heart syndrome (HLHS), and ductus venosus (DV) agenesis on prenatal ultrasound. Case Report A 26-year-old woman underwent prenatal ultrasound examination at 22 weeks of gestation, which revealed intrauterine growth restriction, short femurs, DORV, HLHS, DV agenesis, single umbilical artery, and curly fourth toe of the left foot. The parents elected to terminate the pregnancy, and a 500-g female fetus was delivered at 23 weeks of gestation with facial dysmorphism, bilateral camptodactyly, and hammertoes. The parental karyotypes were normal. Cytogenetic analysis of the cord blood and umbilical cord revealed a karyotype of 46,XX,del(11)(q23). Array comparative genomic hybridization analysis of the DNA extracted from the umbilical cord revealed a 14.38-Mb deletion of 11q23.3-q25 encompassing BSX , ETS1 , FLI1 , and ARHGAP32 . Metaphase fluorescence in situ hybridization analysis using the probes RP11-209L12 (11q25) and RP11-25M7 (11q11) showed a distal 11q deletion in the aberrant chromosome 11 in 17/17 cells examined. Conclusion Prenatal diagnosis of DORV, HLHS, DV agenesis associated with intrauterine growth restriction and short limbs should include a differential diagnosis of Jacobsen syndrome.

The growth of large-area epitaxial transition metal dichalgogenides (TMDCs) are of central importance for scalable integrated device applications. Different methods have been developed to achieve large-sized high quality films. However, reliable approaches for centimeter-sized or even wafer-level epitaxial growth of TMDCs are still lacking. Here we demonstrate a new method to grow inch-sized epitaxial WSe2 films on SiO2/Si substrates at a much lower temperature with high repeatability and scalability. High quality crystalline films are achieved through direct selenization of a tungsten film with platinum as the underlayer. The self-assembled PtSe2 buffer layer, formed during selenization, assists epitaxial growth of WSe2. Using fabricated WSe2 films, excellent performance memory devices are demonstrated. As a member of the TMDC family, our findings based on WSe2 may also be applied to other TMDC materials for large-scale production of high quality TMDC films for various applications.

BACKGROUND Cardiovascular (CV) events are the major cause of morbidity and mortality associated with blood pressure (BP) in hemodialysis (HD) patients. BP varies significantly during HD treatment, and the dramatic variation in BP is a well-recognized risk factor for increased mortality. It is important to develop an intellectual system capable of predicting BP profiles for real-time monitory. OBJECTIVE Our aim was to build a web-based system to predict the systolic blood pressure (SBP) change during hemodialysis process. METHODS This study was based on a large stream of HD parameters collected from a dialysis equipment connected to the Vital Info Portal gateway and linked with the demographic data stored in the hospital information system. The data set was divided into three groups - training, test and new patients. The training group was useful to build a multiple linear regression model, in which the SBP change was the dependent variable and the dialysis parameters and demographic data were the independent variables. We used the test and new patient groups to evaluate the model performance using coverage rates in different thresholds. A web-based interactive system based on the model was built for visualizing the prediction performance. RESULTS A total of 542,424 BP records were used in the model building. The accuracy was greater than 80% in the prediction error range of 15%, and 20mmHg of true SBP in the test and new patient groups for the SBP change model suggested a good performance of our prediction model. In the case of absolute SBP values (5, 10, 15, 20 and 25 mmHg), the accuracy of SBP prediction increased as the threshold value augmented. CONCLUSIONS This database supported the application of our prediction model in reducing the frequency of intradialytic SBP variability, and therefore, it could aid in the clinical decision when a new patient undertakes HD treatment. Whether the introduction of SBP prediction intelligent system can lower CV events in HD patients, it needs further investigations.

The deep cement mixing (DCM) technique is an in-situ ground improvement method to stabilize and solidify soft clay ground. To facilitate the practical design of DCM, it is necessary to establish the relationship between the strength and stiffness of cement treated soil with governing factors first. In this study, the influence of different seawater and cement contents on the strength and stiffness of cement stabilized Hong Kong marine deposits (HKMD) was investigated by a series of unconfined/confined compression tests. According to the experimental results, an attempt was made to predict the unconfined compressive strength (UCS), qu, by using a simple empirical equation based on water/cement ratio (w/c). The correlation between the strength and secant modulus of improved HKMD was obtained. Importantly, a linear relationship between small-strain (e

In recent decades, conventional electric instruments have been widely adopted to monitor rupture failure of trees by measuring the longitudinal strains of tree trunks. However, the good measurement accuracy is compromised by the significant difference in stiffness of the sensing element and tree trunks. Besides, the reliability of electric instruments under harsh environments, especially extreme weathers, such as thunderstorms and typhoons, is also doubtful. In this study, a novel strain gauge based on fiber Bragg grating (FBG) sensing technology was developed specifically for measuring the strain distribution of tree trunks under static or dynamic loading. The main principle of the design of the strain gauges is presented in detail. The laboratory calibration proves that the FBG-based strain gauges in polyoxymethylene (POM) and polylactic acid (PLA) backings show a better performance than those made of metal. To test the performance of this novel FBG-based strain gauge, a set of transducers were installed at different heights of a Celtis sinensis. Firstly, a pull test on this tree trunk was conducted to validate the good performance of the novel strain gauge when the tree is subjected to static loading. Secondly, the good dynamic performance of the novel strain gauge is proved by successfully recording the dynamic motion of a tree trunk during a typhoon. Furthermore, a monitor system relied on the FBG-based strain gauges is conceived to assess the resilience of urban ecosystems formed by trees to extreme weather events.

Aim Acute kidney injury (AKI) carries an increasing incidence rate worldwide and increases the risk of developing end-stage renal disease (ESRD) as well as the medical expenses during the post-AKI course. The Taiwan Consortium for Acute Kidney Injury and Renal Diseases (CAKs) has thus launched a nationwide epidemiology and prognosis of dialysis-requiring acute kidney injury (NEP-AKI-D) study, which prospectively enrols critically ill patients with AKI. Through thoroughly evaluating the risk and prognostic factors of AKI, we hope to lower the incidence of AKI and ESRD from the perspective of AKI-ESRD interaction. Methods The CAKs includes 30 hospitals which distribute widely through the four geographical regions (north, middle, south, and east) of Taiwan, and have a 1:1 ratio of medical centres to regional hospitals in each region. The NEP-AKI-D study enrols intensive care unit-based AKI patients who receive dialysis in the four seasonal sampled months (October 2014, along with January, April, and July 2015) in the included hospitals. The collected data include demographic information, pertaining laboratory results, dialysis settings and patient outcomes. The data are uploaded in a centre website and will be audited by on-site principal investigators, computer logic gates, and the CAKs staffs. The outcomes of interest are in-hospital mortality, dialysis-dependency and readmission rate within 90 days after discharge. Conclusion The NEP-AKI-D study enrols a large number of representative AKI patients throughout Taiwan. The results of the current study are expected to provide more insight into the risk and prognostic factors of AKI and further attenuated further chronic kidney disease transition.

This study explored the longitudinal measurement invariance in the Beck Depression Inventory–II (BDI-II) in early adolescents (junior high school students). The participants were 730 early adolescents (330 boys and 400 girls), who were followed up over 3 years (in six waves). To reduce the size of longitudinal model and verify the stability of the findings, the Fall and Spring series data sets were analyzed separately. Each series includes three waves of data with about 1-year apart. It was found that the three-factor model (Negative Attitude, Performance Difficulty, and Somatic Elements) best fitted the data. Results of both data sets provided support for the longitudinal measurement invariance (threshold invariance) of the three-factor model, suggesting that the BDI-II measured the same construct over 3 years. The study also examined the category function of the BDI-II on the basis of the pattern of threshold estimates. Finally, the implications of the findings on the continuing use of the BDI-II are discussed.

Objective Patient-reported outcome measures are increasingly required as metrics for determining the efficacy of depression interventions. However, the scores obtained from self-reports over the course of treatment may be biased because respondents restructured the factors of the depression symptoms (reconceptualization), changed their values of the symptoms in reflecting depression (reprioritization), or adjusted their standards of assessing the levels of symptoms (recalibration). The aim of present study is to assess response shifts on the depression measure. Method This study uses the procedures for assessing longitudinal measurement invariance to evaluate response shift effects on the Beck Depression Inventory II (BDI-II) with 320 early adolescents suffering from depression (43.8% boys and 56.2% girls) over the course of their treatment in the school settings. Results The findings reveal clear signs of response shifts (recalibration) in the BDI-II for depressed students. Compared with the factor scores before treatment, the factor scores after treatment were underestimated, especially on the negative attitude and performance difficulty factors. Conclusions Estimates of treatment efficacy based on observed test scores appear to be confounded by response shifts.

Objective To report prenatal diagnosis of 22q11.2 deletion syndrome with right aortic arch (RAA), left ductus arteriosus, cardiomegaly, and pericardial effusion in the fetus. Case report A 35-year-old woman, gravida 2, para 1, was referred to the hospital at 31 weeks of gestation because of abnormal ultrasound findings and whole-genome array comparative genomic hybridization report. G-banding chromosome analysis revealed a karyotype of 46,XX. Level II ultrasound at 22 weeks of gestation revealed RAA with the presence of the aortic arch on the right side of trachea at three vessels and trachea view, left ductus arteriosus, and mild right side pyelectasis. Cardiomegaly and pericardial effusion were also found 2 months later. Array comparative genomic hybridization detected a 2.743-Mb deletion at 22q11.2 region. Multiplex ligation-dependent amplification detected deletion in the DiGeorge syndrome critical region of chromosome 22 low copy number repeat 22-A–C. Metaphase fluorescence in situ hybridization on lymphocyte in cord blood confirmed deletion in 22q11.2 region. Conclusion Chromosome abnormalities have been found in patients with RAA. Prenatal diagnosis of RAA with or without intracardiac or extracardiac anomalies should include a diagnosis of 22q11.2 deletion syndrome.

Background/Aims: Indoxyl sulfate (IS) is a protein-bound uremic toxin that accumulates in patients with chronic kidney disease (CKD). We explored the effect of IS on human early endothelial progenitor cells (EPCs) and analyzed the correlation between serum IS levels and parameters of vascular function, including endothelial function in a CKD-based cohort. Methods: A cross-sectional study with 128 stable CKD patients was conducted. Flow-mediated dilation (FMD), pulse wave velocity (PWV), ankle brachial index, serum IS and other biochemical parameters were measured and analyzed. In parallel, the activity of early EPCs was also evaluated after exposure to IS. Results: In human EPCs, a concentration-dependent inhibitory effect of IS on chemotactic motility and colony formation was observed. Additionally, serum IS levels were significantly correlated with CKD stages. The total IS (T-IS) and free IS (F-IS) were strongly associated with age, hypertension, cardiovascular disease, blood pressure, PWV, blood urea nitrogen, creatine and phosphate but negatively correlated with FMD, the estimated glomerular filtration rate (eGFR), hemoglobin, hematocrit, and calcium. A multivariate linear regression analysis also showed that FMD was significantly associated with IS after adjusting for other confounding factors. Conclusions: In humans, IS impairs early EPCs and was strongly correlated with vascular dysfunction. Thus, we speculate that this adverse effect of IS may partly result from the inhibition of early EPCs.

Traditional Chinese medicine (TCM) formulates treatment according to body constitution (BC) differentiation. Different constitutions have specific metabolic characteristics and different susceptibility to certain diseases. This study aimed to assess theYang-Xuconstitution using a body constitution questionnaire (BCQ) and clinical blood variables. A BCQ was employed to assess the clinical manifestation ofYang-Xu. The logistic regression model was conducted to explore the relationship between BC scores and biomarkers. Leave-one-out cross-validation (LOOCV) and K-fold cross-validation were performed to evaluate the accuracy of a predictive model in practice. Decision trees (DTs) were conducted to determine the possible relationships between blood biomarkers and BC scores. According to the BCQ analysis, 49% participants without any BC were classified as healthy subjects. Among them, 130 samples were selected for further analysis and divided into two groups. One group comprised healthy subjects without any BC (68%), while subjects of the other group, named as the sub-healthy group, had three BCs (32%). Six biomarkers, CRE, TSH, HB, MONO, RBC, and LH, were found to have the greatest impact on BCQ outcomes inYang-Xusubjects. This study indicated significant biochemical differences inYang-Xusubjects, which may provide a connection between blood variables and theYang-XuBC.

Generally, effective stresses of saturated soils are determined by subtracting the measured pore-water pressure from the total earth pressure. In this paper, a novel FBG-based effective stress cell (FBG-ESC) for directly measuring effective stress in saturated soils is fabricated. Because of the counteraction of pore-water pressures acting on the front and back surface, the deflection of sensing plate is induced by the average pressure of soil particles only and thus the effective stress is directly measured. The good performance of FBG-ESC in saturated CDG soil under a multi-stage loading has been validated by comparison with the calculated results. Moreover, the FBG-ESC has been applied in a physical model to monitor the evolution of effective stress in saturated clayey soil subjected to complex loadings. The results demonstrate that the FBG-ESC can be also utilized in marine environment.

In normal practice, a multi-stage surcharge loading is applied gradually to achieve a certain strength of soft soils, and thus it is important to study the settlement of soft soils under multi-stage ramp loading. In this study, a new simplified method is developed to calculate the settlement of multi-layer soft soils exhibiting creep subjected to the multi-stage loading under a one-dimensional straining condition. The Zhu and Yin method is utilized to obtain the average degree of consolidation for multi-layer soils under each loading stage. The effects of creep compression on excess pore water pressure and total settlement during consolidation stage are elaborated. Subsequently, two typical projects, Ska-Edeby with 46 years’ recorded settlement data and highway embankment in the Berthierville area, are selected as the typical multi-layer soil profiles. Cases with three different loadings and two different over consolidation ratio (OCR) values are analyzed using the finite element modeling, namely the new simplified method, and the Hypothesis A method. With the use of the results from finite element analysis as the reference, the new simplified method offers a good estimation of the settlement for all the cases and outperforms the Hypothesis A method in terms of accuracy.

Printing industries are ever-improving with new breakthroughs in related technologies to satisfy various marketing requirements. They are capable of providing various value-added services by updating their printing facilities. However, the rapid growth printing requirements are also concomitant environment impact. For example, many volatile organic compounds (VOCs) printing materials are the sources of air pollution. In this paper, an original toner-saving method based on the human perceptual features to curb the negative environmental impacts and decrease material wasting is proposed. In addition, the proposed method is designed for friendly use. By configuring only few parameters, users can select the desired printing quality for varying applications. Furthermore, the proposed method can be applied to cooperate with existing hardware-based toner-saving method to enlarge application scope.

Objectives Cancer of the oral cavity, a well-known global health concern, remains one of most common causes of cancer mortality. Continuity of care (COC), a measurement of the extent to which an individual patient receives care from a given provider over a specified period of time, can help cancer survivors process their experiences of dealing with the illness and recuperation; however, limited research has focused on the survival rate of working-age patients with oral cancer. Methods A total of 14,240 working-age patients (20 0.38) and non-high COC (COCI ≤ 0.38) groups. After propensity-score matching, the mortality risk in the low and intermediate COC groups was also found to be significantly higher than that in the high COC group (aHR = 1.178, 95% CI = 1.074–1.292, p < 0.001 and aHR = 1.189, 95% CI = 1.107–1.277, p = 0.001, respectively). Conclusions In Taiwan, COC and prior dental treatment before RT significantly affected the survival rate of working-age patients with oral cancer. This result merits policymakers’ attention.

Aims To interpret how the thickness of the peripapillary retinal nerve fiber layer (RNFL) changes with increasing age, axial length, or anterior chamber depth as measured by spectral domain optical coherence tomography (OCT) in the normal elderly population in Taiwan. Methods A total of 82 volunteers (143 eyes) were enrolled. Generalized estimating equations were used to evaluate the correlation. Results The RNFL was significantly thinner in the superonasal (p = 0.004), inferotemporal (p = 0.046), and temporolower (p = 0.009) segments with age. The same trend was also observed in the superotemporal (p = 0.330) segment, although it was not statistically significant. The global RNFL thickness decreased by 4.97 μm per decade (β = -0.497; p = 0.021), and thinning was significant in the superonasal (-9.90 μm per decade, p < 0.001) and temporolower (-6.78 μm per decade, p < 0.001) segments; the same trend showed borderline significance in the superotemporal (-6.96 μm per decade, p = 0.073) and inferotemporal (-7.23 μm per decade, p = 0.059) segments. In eyes with longer axial length, the RNFLs significantly decreased in the non-temporal segments. Global RNFL thickness decreased by 3.086 μm for each additional millimeter of axial length (β = -3.086; p < 0.001). Conclusions Changes in RNFL thickness were correlated with age in the superonasal, superotemporal, inferotemporal, and temporolower segments, and were correlated with axial length in the non-temporal segments. Anterior chamber depth was not correlated with RNFL thickness.

Growth-arrest-specific 7 (GAS7) belongs to a group of adaptor proteins that coordinate the actin cytoskeleton. Among human GAS7 isoforms, only GAS7C possesses a Src homology 3 domain. We report here that GAS7C acts as a migration suppressor and can serve as a prognostic biomarker in lung cancer. GAS7C overexpression reduces lung cancer migration, whereas GAS7C knockdown enhances cancer cell migration. Importantly, ectopically overexpressed GAS7C binds tightly with N-WASP thus inactivates the fibronectin/integrin/FAK pathway, which in turn leads to the suppression of F-actin dynamics. In addition, overexpression of GAS7C sequesters hnRNP U and thus decreases the level of β-catenin protein via the β-TrCP ubiquitin-degradation pathway. The anti-metastatic effect of GAS7C overexpression was also confirmed using lung cancer xenografts. Our clinical data indicated that 23.6% (25/106) of lung cancer patients showed low expression of GAS7C mRNA which correlated with a poorer overall survival. In addition, low GAS7C mRNA expression was detected in 60.0% of metastatic lung cancer patients, indicating an association between low GAS7C expression and cancer progression. A significant inverse correlation between mRNA expression and promoter hypermethylation was also found, which suggests that the low level of GAS7C expression was partly due to promoter hypermethylation. Our results provide novel evidence that low GAS7C correlates with poor prognosis and promotes metastasis in lung cancer. Low GAS7C increases cancer cell motility by promoting N-WASP/FAK/F-actin cytoskeleton dynamics. It also enhances β-catenin stability via hnRNP U/β-TrCP complex formation. Therefore, GAS7C acts as a metastasis suppressor in lung cancer.

In a six-wave longitudinal study with two cohorts (660 adolescents and 630 young adults), this study investigated the longitudinal stability of the Beck Depression Inventory II (BDI-II) using the Trait-State-Occasion (TSO) model. The results revealed that the full TSO model was the best fitting representation of the depression measured by the BDI-II for both cohorts. It was found that the trait components explained more than 50% of the state variance of the BDI-II scores in both cohorts, and the occasion-specific factor explained about 7% to 12% of variances. The occasion-specific variance was more stable (occasion stability) and somewhat higher in the younger cohort. Implications regarding the longitudinal stability of the BDI-II measure are discussed.

Background Although the optimal timing of initiation of renal replacement therapy (RRT) in critically ill patients with acute kidney injury has been extensively studied in the past, it is still unclear. Methods In this systematic review, we searched all related randomized controlled trials (RCTs) that directly compared earlier and later RRT published prior to June 25, 2016, from PubMed, MEDLINE, and EMBASE. We extracted the study characteristics and outcomes of all-cause mortality, RRT dependence, and intensive care unit (ICU) and hospital length of stay (LOS). Results We identified 51 published relevant studies from 13,468 screened abstracts. Nine RCTs with 1627 participants were included in this meta-analysis. Earlier RRT was not associated with benefits in terms of mortality [relative risk (RR) 0.88, 95% confidence interval (CI) 0.68–1.14, p = 0.33] and RRT dependence (RR 0.81, 95% CI 0.46–1.42, p = 0.46). There were also no significant differences in the ICU and hospital LOS between patients who underwent earlier versus later RRT [standard means difference −0.08 (95% CI −0.26 to 0.09) and −0.11 (95% CI −0.37 to 0.16) day, respectively]. In subgroup analysis, earlier RRT was associated with a reduction in the in-hospital mortality among surgical patients (RR 0.78, 95% CI 0.64–0.96) and patients who underwent continuous renal replacement therapy (CRRT) (RR 0.80, 95% CI 0.67–0.96). Conclusions Compared with later RRT, earlier initiation of RRT did not show beneficial impacts on patient outcomes. However, a lower rate of death was observed among surgical patients and in those who underwent CRRT. The included literature is highly heterogeneous and, therefore, potentially subject to bias. Further high-quality RCT studies are warranted. Electronic supplementary material The online version of this article (doi:10.1186/s13613-017-0265-6) contains supplementary material, which is available to authorized users.

To investigate the effectiveness of a school-based program promoting outdoor activities in Taiwan for myopia prevention and to identify protective light intensities.Multi-area, cluster-randomized intervention controlled trial.A total 693 grade 1 schoolchildren in 16 schools participated. Two hundred sixty-seven schoolchildren were in the intervention group and 426 were in the control group.Initially, 24 schools were randomized into the intervention and control groups, but 5 and 3 schools in the intervention and control groups, respectively, withdrew before enrollment. A school-based Recess Outside Classroom Trial was implemented in the intervention group, in which schoolchildren were encouraged to go outdoors for up to 11 hours weekly. Data collection included eye examinations, cycloplegic refraction, noncontact axial length measurements, light meter recorders, diary logs, and questionnaires.Change in spherical equivalent and axial length after 1 year and the intensity and duration of outdoor light exposures.The intervention group showed significantly less myopic shift and axial elongation compared with the control group (0.35 diopter [D] vs. 0.47 D; 0.28 vs. 0.33 mm; P = 0.002 and P = 0.003) and a 54% lower risk of rapid myopia progression (odds ratio, 0.46; 95% confidence interval [CI], 0.28-0.77; P = 0.003). The myopic protective effects were significant in both nonmyopic and myopic children compared with controls. Regarding spending outdoor time of at least 11 hours weekly with exposure to 1000 lux or more of light, the intervention group had significantly more participants compared with the control group (49.79% vs. 22.73%; P0.001). Schoolchildren with longer outdoor time in school (≥200 minutes) showed significantly less myopic shift (measured by light meters; ≥1000 lux: 0.14 D; 95% CI, 0.02-0.27; P = 0.02; ≥3000 lux: 0.16 D; 95% CI, 0.002-0.32; P = 0.048).The school-based outdoor promotion program effectively reduced the myopia change in both nonmyopic and myopic children. Outdoor activities with strong sunlight exposure may not be necessary for myopia prevention. Relatively lower outdoor light intensity activity with longer time outdoors, such as in hallways or under trees, also can be considered.

Lane-mark detection is one of the most important parts of the intelligent transportation system (ITS). Cameras mounted in front of automobiles are used to capture the road scene to detect lane-marks. This paper proposes a new lane-mark extraction algorithm that consists of six parts. We first determine the regions of interest (ROIs) of captured images and investigate their boundaries. Then, we divide the boundary image into subimages to calculate the local edge-orientation of each block and remove edges with abnormal orientations. After that, the multi-adaptive thresholding method is employed for each subimage so that the system can work efficiently for an image that has different contrasts to indicate sub-regions for lane-marks. We then verify these candidate lane-mark edges and fit the lane-marks using either straight or curved line models. A Kalman filter is also applied to track them. The proposed method is evaluated in several situations, including in bad weather conditions and in the presence of shadow effects, obstacles such as wipers, or road signs on the road. The results show that the proposed method can detect the lane-marks in real time for various complex environments.

β-catenin nuclear accumulation is frequently identified in human non-small cell lung cancer (NSCLC). The HMG-box transcription factor 1 (HBP1) is a known repressor of β-catenin transactivation. However, the role of HBP1 in relation to β-catenin nuclear accumulation has not been addressed in human cancer patients. In addition, the mechanism of HBP1 gene alteration in NSCLC remains unclear, although HBP1 mutation and gene deletion of HBP1 are reported in breast and colon cancers. Here, we demonstrate that HBP1 acts as a tumour suppressor and serves as a prognostic biomarker in NSCLC clinical and cell models. The immunohistochemistry data indicated that 30.5% (25/82) of tumours from NSCLC patients showed absence or low expression of HBP1 protein. A significant inverse correlation between mRNA/protein expression and promoter hypermethylation suggested that promoter hypermethylation is responsible for low expression of HBP1 in NSCLC patients. Reactivation of HBP1 expression by demethylation reagent or ectopic expression of HBP1 suppressed β-catenin transactivation. Conversely, HBP1 knockdown increased β-catenin transactivation. Importantly, preserved expression of HBP1 had a significantly protective effect on prognosis in patients with β-catenin nuclear accumulation, suggesting that low expression of HBP1 in NSCLC patients with β-catenin nuclear accumulation was one of the major determinants of prognosis. Our data from cellular and clinical models suggest that HBP1 is a suppressor of cancer progression, making it a potential prognostic predictor and therapeutic target to attenuate lung cancer progression.

Forimage retargeting, most approaches only use color information to tackle this problem. In this paper, we analyze both color and depth information captured by a RGB-D camera to maintain the structure and preserve important regions. Particularly, we present a content-aware image retargeting algorithm based on depth information. In addition, we introduce a depth-based importance map, such that deformation of the image is guided by this map. This depth-based importance map is produced automatically by combining gradient, salience, and depth-based measures. More specifically, the depth-based measure is a weight map, in which we analyze depth information and use the mean shift procedure to find the local peak as the central of the important objects, and apply Gaussian distribution to determine the weight. Consequently, this depth-based importance map is used as the input of the discontinuous seam carving algorithm, and the seam is processed by the dynamic programming method. Our experimental results demonstrate the effectiveness of using the depth-based importance map in the discontinuous seam carving algorithm that it can visually behave better in maintaining the structure and preserving important regions. The proposed method produces much better results than other approaches, that are the state-of-the-art in content-aware image resizing.

Objective We present perinatal imaging findings and molecular genetic analysis of thanatophoric dysplasia type I (TD1) in a fetus. Case Report A 28-year-old woman was referred for genetic counseling at 22 weeks of gestation because of abnormal prenatal ultrasound findings. Level II ultrasound examination revealed a narrow chest, shortened and curved long limbs, protrusion of the abdomen, and macrocephaly. A tentative diagnosis of TD1 was made. After genetic counseling, the pregnancy was terminated and a malformed fetus was delivered. Postnatal radiography findings were consistent with the diagnosis of TD1, with additional findings of short ribs, platyspondyly, and horizontal acetabular roofs. Molecular genetic analysis using umbilical cord tissue revealed a heterozygous mutation of c.2419T>G (p.Ter807Gly) (X807G) in the fibroblast growth factor receptor 3 gene (FGFR3) . Conclusion A second-trimester fetus with a heterozygous c.2419T>G mutation in FGFR3 may present characteristic ultrasound and X-ray findings of TD1.

Because of its high prevalence worldwide, osteoporosis is considered a serious public health concern. Many known risk factors for developing osteoporosis have been identified and are crucial if planning health care needs. Recently, an association between uric acid (UA) and bone fractures had been explored. Extracellular UA exhibits antioxidant properties by effectively scavenging free radicals in human plasma, but this benefit might be disturbed by the hydrophobic lipid layer of the cell membrane. In contrast, intracellular free oxygen radicals are produced during UA degradation, and superoxide is further enhanced by interacting with NADPH oxidase. This intracellular oxidative stress, together with inflammatory cytokines induced by UA, stimulates osteoclast bone resorption and inhibits osteoblast bone formation. UA also inhibits vitamin D production and thereby results in hyper-parathyroidism, which causes less UA excretion in the intestines and renal proximal tubules by inhibiting the urate transporter ATP-binding cassette subfamily G member 2 (ABCG2). At normal or high levels, UA is associated with a reduction in bone mineral density and protects against bone fracture. However, in hyperuricemia or gout arthritis, UA increases bone fracture risk because oxidative stress and inflammatory cytokines can increase bone resorption and decrease bone formation. Vitamin D deficiency, and consequent secondary hyperparathyroidism, can further increase bone resorption and aggravated bone loss in UA-induced osteoporosis.

Amid rapid global economic development and the threat of global warming, green transportation and related issues have risen to prominence in various countries. In Taiwan in_2009, Taichung was selected as a low-carbon demonstration city, in which energy conservation and carbon reduction would be actively promoted, with the wider aim of developing a green economy and lifestyle. This study explores the carbon-reduction benefits of the MRT elevated railway in the Taichung Metropolitan Area. The railway’s construction has been associated with intensive redevelopment of existing stations, but this process has been unbalanced due to railway physical. Five new stations will also be added, and belt-like spaces at ground level made available for housing and other non-railway-related purposes. Utilizing literature collection and the Analytical Hierarchy Process (AHP) research method to explore the factors affecting the efficiency of the MRT, this study reveals that the AHP weights of the main criteria for the escalation of MRT development in Taichung are 0.5833 for green transportation and 0.4167 for green environment; while in the overall ranking of the sub-criteria, the top three evaluation factors are mass transportation (0.31337), greenery planting (0.21832), and green building (0.19444).