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Abstract Background This cohort study determines the predictors for cause-specific and timing of deaths in patients with COVID-19 in Taiwan. Methods Patients with laboratory-confirmed COVID-19 admitted to Taipei City Hospital from January 1 to July 31, 2022, were recruited in this cohort. All patients were followed up until death, discharge from the hospital, or August 31, 2022. Early deaths within the first 2 weeks were recorded, and the cause of death was confirmed by the death certificate database of Taiwan. Predictors of cause-specific and timing of deaths of patients with COVID-19 were determined using multinomial Cox proportional hazards regression analysis. Results Of the 195 (8.0%) patients who died during hospitalization, 147 (84.0%) had COVID-19-specific deaths. Moreover, 54.9% of the deceased patients had early death. After controlling for other covariates, patients aged ≥ 65 years had a higher risk of COVID-19-specific, non-COVID-19-specific, early, and late deaths [adjusted hazards ratio (AHR): 3.85, 6.45, 3.33, and 6.57; 95% confidence interval (CI): 1.91–7.78, 1.17–35.68, 1.51–7.36, and 2.18–19.76, respectively]. Fully vaccinated patients had a lower risk of COVID-19-specific (AHR: 0.68; 95% CI: 0.47–0.98) and early deaths (AHR: 0.54; 95% CI: 0.35–0.84), whereas comorbid patients with chronic obstructive pulmonary disease had a higher risk of non-COVID-19-specific deaths (AHR: 5.43; 95% CI: 1.73–17.03). Conclusions This study suggests that prioritizing COVID-19 vaccination and carefully monitoring comorbid patients during hospitalization can reduce the risk of COVID-19-specific and early deaths and non-COVID-19-specific mortalities, respectively.

面對世界變革及教育系統之需求，本研究重新從認識論與方法論建立課程評鑑之基礎，並擴大視野，跨越邊界，透過朝向問題化的設計思考，規劃能喚起個體在群體中及對系統的覺知，反思課程實踐，建立具價值與意義之課程評鑑引導設計。本研究主要運用團體討論法，經過8次，每次1-2小時的團體討論，進行「意義驅動與展化的課程評鑑工作坊」之引導設計， 並以關鍵字分析和提問類型進行資料分析，再以參與工作坊學員之意見調查與備課文件作為語料分析之佐證。本研究發現包括：一、融入展化學習及U型理論之問題化的設計思考可生成課程新的理解；二、透過提問展開課程評鑑之選擇觀點、建立理解與策略之路徑值得探詢；三、問題化過程關注真實問題與脈絡、意向與思考性語言不可或缺、運用社群運作，能有意 義地連結個體的思維與集體共創的課程；四、多樣提問類型扮演不同功能，可豐實並活化問題化思考過程。最後，根據研究發現提出相關建議。 Motivation and Purpose As Taiwan enters the third decade of the twenty-first century, its educational systems must be well-equipped for the future. However, Taiwan’s seemingly rigorous and concrete curriculum evaluations as evidenced by past experience, have shown its limitations. Without a solid foundation in the needs and challenges of educators and the educated, curriculum evaluations become mere formalities incapable of driving self-reflection and improvement. Additionally, such evaluations must prompt critical inquiry into the following questions: “Why do we need curriculum evaluations?” “Why adopt one system of curriculum evaluation over another?” and “What do curriculum evaluations mean to us?” This study sought to utilize methodological and epistemological insights to ground curriculum evaluations in the context of the problems they seek to address; this allows us to expand our horizons, cross boundaries, and, through problem-oriented design thinking, make educators more aware of the systems and groups of which they are a part. Such reflection on curriculum evaluations prompted the creation of a series of meaningful curriculum evaluation measures and courses. Literature Review Epistemological reflections informed the present study’s multidisciplinary approach to curriculum evaluation; problem-oriented design thinking served as the engine for this study’s guiding design; and expansive learning and U-theory provided reference strategies, tools, and learning environment support. Research Questions The research questions this study sought to answer are as follows: 1. How does the problematization process influence the design of meaning-driven curriculum evaluations? 2. What key themes emerge during the problematization process within teams conducting meaning-driven curriculum evaluations? 3. How do various types of questioning facilitate design thinking in problematization for meaning-driven curriculum evaluation? 4. Through the lens of problematization in design thinking, what innovative guiding designs are developed for conducting meaning-driven curriculum evaluations? Method This study employed eight focus group sessions, each lasting 1-2 hours, to guide the design of a “Meaning-driven and Expansive Curriculum Evaluation Workshop.” Keywords and question types from the session transcripts were analyzed and coded; they were supplemented by opinion surveys of the workshop participants and their lesson preparation materials. Results and Discussion 1. Problematization— which is the process of identifying problems to be addressed and their solutions— is clearly discernible in the chronological evolution of the group discussions, which moved from clarifying key points of curriculum evaluation to designing a workshop on guiding evaluation design. In chronological order, the key questions of the problematization process were as follows. Early-stage questions were posed to clarify the problems surrounding curriculum evaluation in Taiwan and its relationship to educators. Beginning with the problems inherent in the current traditional evaluation system, participants questioned the meaning and value of curriculum evaluation, forming the workshop’s goals. Late-stage questions were designed to transform the meaning and goals that emerged during the discussions and incorporate them into the design of the workshop courses. The subsequent process of problematization emphasized creative collaboration and explored more fundamental problems, such as: “How can curriculum evaluation help educators improve their motivation and skills?” and “What must be done next?” 2. Multiple themes emerged from keyword analysis of problematization content, specifically: (1) The problematization process involves real problems/needs in the context of the curriculum: All the questions from the group discussion process were imported into a keyword analysis software. “What,” “how,” and “why” ranked as the top three keywords. The high frequency of these question words indicates that the group discussion focused on inquiry and exploration, which are basic functions of the problematization process. The team evaluated problems in the context of the curriculum, using questions to suggest avenues for experimental improvements. (2) Reflective and intentional language is essential to the design thinking process: Hypothetical questions typically inspire an epistemological approach of inquiry and verification, or evaluative thinking; this requires the use of reflective language. The keywords, the context of the educators’ questions, and the language used demonstrate that the participants focused their thinking and decision-making on the usability, appropriateness, and improvability of the proposed curriculum and were thus continually optimizing and evaluating ideas. The discussion leaders emphasized the participants’ intentions in curriculum evaluation during the discussion process. Additionally, the keyword “want” occurred frequently (17 times), underscoring the participants’ focus on changing their behaviors and responding to needs. (3) A learning community is the operational basis for the problematization process: The fourth-highest ranked keyword was “we,” whereas “they” was ranked 10th, indicating that the educators were focused on solving problems as a community. This community focus is consistent with U-theory’s approach of creating a social field that enables a team to generate collective wisdom and a sense of direction through exploration and reflection. The questions guided participants to consider the relationship between individuals and the team. (4) Members know that their ultimate goal is benefiting students, prompting critical reflection on and engagement with the evaluation process: The goal of any curriculum is to educate students. Curriculum evaluation is a crucial component of curriculum development that requires educators to remain flexible. Because the educators did not use traditional terms such as “evaluation” and “performance” in their questions, their meaning-driven curriculum evaluation emphasized the context of education itself, focusing on teachers and students and responding to their needs in the process of meeting the evaluation objectives. 3. Questions serve several functions in guiding the design thinking underpinning the problematization process: Through question analysis, 258 questions were categorized into 5 types: (1) Value-oriented questions concerning feelings, relationships, and meanings; (2) assessment-oriented questions using logical explorations in the context of a particular problem to reach a solution; (3) strategy-oriented questions focusing on perceiving problems and developing time-sensitive strategies to address them; (4) empathy-oriented questions promoting collaboration and dialogue; (5) task-oriented questions involving action planning, reflective evaluation, and collaboration. 4. The meaning-driven curriculum evaluation guiding design was generated, and a meaning-driven curriculum evaluation was proposed: The eight group discussions resulted in a 2-day meaning-driven curriculum evaluation guiding design workshop. The design philosophy emphasized participation and cocreation, where learning evolved continually through questioning and the cultivation of shared learning spaces. The process clarified participants’ perspectives on curriculum evaluation, starting from real problems/needs and moving through individual experiences to community dialogue and cocreation. The workshop was based on participants’ questions and encouraged individual reflection, group collaboration, and team cocreation. The guiding design was dynamic, emphasizing participant interaction and responses, with real-time adjustments made as new problems were identified. Conclusion 1. The themes and types of questions generated from keyword analysis indicate the feasibility of integrating expansive learning and U-theory to guide understanding in problematization thinking and planning. 2. The act of questioning reveals perspectives and options through mutual understanding and shared strategic vision to create a curriculum evaluation that is sensitive to the real needs of teachers and students. 3. The problematization process focuses on real problems/needs in context. Reflective and intentional language is indispensable to the problematization process. Moreover, a group approach to designing a curriculum evaluation establishes meaningful connections between educators’ thoughts and needs and the curriculum they deliver. 4. A diversity of question types enriches and animates the problematization process. Recommendations 1. Educators must be encouraged to engage in discourse with an open mind, maintain flexibility, and embrace uncertainty. 2. Design thinking must be integrated into curriculum evaluations. 3. A diversity of questions and opinions must be encouraged in curriculum evaluation.

本研究旨在探究1980～2020年國際師資培育研究的知識結構與趨勢，運用文獻計量法，分析高頻率出現作者、文獻知識聚類及突現詞探尋研究趨勢，以瞭解師資培育研究在不同時間序列中所關注的熱點，描繪40年來師資培育研究在政策、制度與實務的變革及挑戰，並展望未來研究趨勢。本研究採用VOSviewer和CiteSpace文獻計量工具，從Web of Science資料庫中選取1,779篇師資培育研究期刊論文，分析結果共有五聚類：教學實踐與反思、師資培育學程設計、教師信念與質性研究、教師知識與自我效能、教師認同。除此之外，師資培育研究趨勢為：一、巨觀層次的師資培育政策發展研究，由研究政策對師資培育的影響，逐漸轉為落實教育公平與社會正義之探討；二、中程層次的培養機構，轉變為與學校合作培養師資生，再擴及到情境脈絡對師資培育過程之影響分析；三、微觀層次的師資生學習，則從關注師資生在行動中反思以獲得知識與技能，逐步擴展至師資生學習成為教師中各面向的改變。最後，本研究提出師資培育研究未來展望，包括有效的師資培育政策、系統設計師資培育、師資生學習，以供參考。 1. Context and Research Questions Trends in teacher education research reflect changes in policies, systems, and practices as well as the challenges and strategies involved in addressing them. A thorough understanding of these trends is required to propose effective changes to policies and systems and improve teacher education practices (Darling-Hammond, 2016). However, a thorough review of the relevant literature is necessary to determine the factors influencing these trends. To identify issues and knowledge structures in teacher education and examine how these issues are studied, analyzed, and interpreted, researchers must understand how trends in teacher education research have shifted over time and how these trends have influenced teacher education practices. Therefore, we used bibliometric tools to explore the past, present, and future of teacher education research as well as the knowledge clusters and trends in international research on teacher education that are hidden in co-occurrences and burst terms. 2. Literature Review 2.1 Research Scope We examined teacher education during the preservice and induction periods. The terms preservice teacher, teacher student, prospective teacher, and teacher candidate are used to denote individuals that have not yet become regular (in-service) teachers and were the key terms searched for in this study. 2.2 Approaches to Teacher Education Research Teacher education research is greatly influenced by political and professional developments; thus, contemporary historical and political contexts, the positioning of teacher education, definitions of teacher education issues, and research methods influence the body of research (Cochran-Smith & Fries, 2005). Teacher education research considers both the teaching profession and policy implications (Darling-Hammond, 2016). Research on the teaching profession considers the knowledge and competencies of effective teaching strategies for school education, and various theoretical perspectives (e.g., teacher belief, teacher identity) have been used to explore the influencing factors of preservice teachers’ learning experiences (Cochran-Smith, 2016; Popkewitz et al., 1979). 2.3 Types of Teacher Education Research Frameworks Teacher education research has been categorized into handbooks and literature reviews. Both have their own characteristics, advantages, and limitations. For example, teacher education research handbooks are limited by the editors’ judgments and choices of the author or editor. Moreover, they primarily discuss current issues and are thus not wholly reflective of the overarching knowledge structure of teacher education research. By contrast, literature reviews often collect and analyze literature on the basis of a specific perspective or concept but lost others (Houston, 2008). The evolution of perspectives, methodologies, and approaches has increased the discourse and diversity within teacher education research (Cochran-Smith & Fries, 2005; Shulman, 1986). 3. Methods To investigated development of teacher education research, academic articles from 1980 to 2020 that double-blind peer reviews were retrieved from the Web of Science. After filtering for relevance, 1,779 articles were shortlisted. Next, the bibliometric tools, VOSviewer and CiteSpace, were used to understand the focus of teacher education research during different periods, to describe the changes and challenges of teacher education policies, systems, and practices over the past 40 years, and to identify future research trends. 4. Results and Discussion We identified five clusters of teacher education research: teaching practice and reflection, teacher education program design, teacher beliefs and qualitative research, teacher knowledge and self-efficacy, and teacher identity. By analyzing keywords and burst terms, we discovered 44 burst terms that evolved over time. In addition, the research hotspots have varied over the past 40 years, with each trend lasting only a short period. During 1980-2010, teacher education research was dominated by teacher education policy, including training and reform. After 2010, the focus of research alternated between teaching practices and noncognitive learning. Between 2015 and 2020, mathematics, content knowledge, and pedagogical content knowledge were the focus of research, indicating the importance of teacher knowledge and mathematics. Finally, through the literature review and a big data analysis, we discovered the following trends in teacher education research: (1) At the macro level, the focus of teacher training policies has gradually shifted from teacher education to the implementation of educational equity and social justice. (2) On a more specific level, the how institutions cooperate with schools for teacher education and how they analyze the impacts of certain contexts on teacher education process have changed. (3) On the micro level, teacher education has been gradually extended to include changes in various aspects of preservice teachers’ learning. 5. Suggestions Research on teacher education policy is based on multiple standpoints—and in some cases, opposition. Future policy research should employ empirical, scientific evidence to improve policy and debate the effectiveness of teacher education. Teacher education research is deeply influenced by political, social, and cultural factors and should be conducted by teams that test, collect, and analyze data on preservice teachers’ learning environments to identify influential contextual factors. By so doing, a strong foundation can be established for the systematic design of teacher education programs and acquisition of supporting resources. The cognitive and noncognitive learning of preservice teachers is influenced by their personalities and preparation. How changes occur and how preservice teachers can be internally motivated should continue to be explored. Going forward, researchers should consider philosophical, historical, and sociological insights to assess global developments and identify new research goals by reflecting on the academic discourse with peers and across boundaries.

Abstract Background The biting midge, Forcipomyia taiwana, is one of the most annoying blood-sucking pests in Taiwan. Current chemical control methods only target the adult, not the immature stages (egg to pupa), of F. taiwana. Discovering new or alternative tactics to enhance or replace existing methods are urgently needed to improve the effectiveness of F. taiwana control. The egg is the least understood life stage in this pest species but may offer a novel point of control as addition of NaCl to the egg environment inhibits development. Thus, the objective of this study was to use RNA profiling to better understand the developmental differences between wild-type melanized (black) and NaCl-induced un-melanized (pink), infertile F. taiwana eggs. Results After de novo assembly with Trinity, 87,415 non-redundant transcripts (Ft-nr) with an N50 of 1099 were obtained. Of these, 26,247 (30%) transcripts were predicted to have long open reading frames (ORFs, defined here as ≥300 nt) and 15,270 (17.5%) transcripts have at least one predicted functional domain. A comparison between two biological replicates each of black and pink egg samples, although limited in sample size, revealed 5898 differentially expressed genes (DEGs; 40.9% of the transcripts with long ORFs) with ≥2-fold difference. Of these, 2030 were annotated to a Gene Ontology biological process and along with gene expression patterns can be separated into 5 clusters. KEGG pathway analysis revealed that 1589 transcripts could be assigned to 18 significantly enriched pathways in 2 main categories (metabolism and environmental information processing). As expected, most (88.32%) of these DEGs were down-regulated in the pink eggs. Surprisingly, the majority of genes associated with the pigmentation GO term were up-regulated in the pink egg samples. However, the two key terminal genes of the melanin synthesis pathway, laccase2 and DCE/yellow, were significantly down-regulated, and further verified by qRT-PCR. Conclusion We have assembled and annotated the first egg transcriptome for F. taiwana, a biting midge. Our results suggest that down-regulation of the laccase2 and DCE/yellow genes might be the mechanism responsible for the NaCl-induced inhibition of melanization of F. taiwana eggs.

This study aims to describe and offer recommendations for curriculum development and curriculum leadership. It first analyses the change from 2001 to the present. Secondly, it probes into the expectations of two school leaders and twenty-six primary teachers about the New National Curriculum (NNC). Through using 2 interviews with different primary school curriculum leaders and literature analysis, this study found that the starting points of curriculum leadership in both schools were different due to their different school cultures. However, both schools encouraged teachers to become learners, in order to better understanding the learning process, to motivate the students better, and to provide appropriate materials. The objective was to maintain flexibility, and to embrace diversified voices. In terms of the school-based curriculum, while both schools had their respective characteristics, both observed the changes in the environment and everyday school life. Teachers returned to the cultivation of student quality, gradually adjusting teaching methods based on their existing experiences, and, collaborating with each other, they were able to implement reform curriculum.

Normal tension glaucoma (NTG) has similar optic neuropathy as primary open-angle glaucoma (POAG), but intraocular pressure (IOP) is within the normal range. Compared with high-pressure POAG, the development of NTG is possibly a consequence of a complex interaction of several ocular and systemic factors. Recent data have shown higher translaminar pressure gradient due to impaired cerebrospinal fluid dynamics may account for the pathogenic mechanism. Insufficient blood supply and vascular dysregulation may also be the cause of the disease. In clinical evaluation, NTG is a diagnosis by excluding other nonglaucomatous optic neuropathies. NTG is characterized by larger and deeper optic-disc cupping, more central visual field defects and a higher incidence of disc hemorrhage compared with POAG. In clinical practice, controlling IOP as low as possible (with medication, laser trabeculoplasty, or surgery) is the key to manage NTG patients. In addition to IOP reduction, the control of systemic risk factors or improving ocular perfusion may be beneficial therapies. NTG is more prevalent in Asia than in the Western countries. Due to increasing old population and underdiagnoses in the clinical settings, NTG became a great challenge for ophthalmologist in Asia. Therefore, the aim of this article is to focus on the epidemiology, to update pathogenesis, diagnosis, and management for NTG.

Abstract Background To evaluate the diagnostic ability of macular ganglion cell asymmetry to diagnose preperimetric glaucoma (PPG), using Cirrus spectral domain optical coherence tomography (OCT). Methods This prospective study included 67 eyes of 67 patients with PPG and 67 eyes of 67 age- and refractive error-matched controls. We measured circumpapillary RNFL (cpRNFL) thickness, macular ganglion cell-inner plexiform layer (GCIPL) thickness and optic nerve head (ONH) parameters using OCT. Macular ganglion cell asymmetries were expressed as absolute difference and ratios between inferior hemisphere and superior hemisphere, inferotemporal (IT) and superotemporal (ST), IT and superonasal (SN), IT and inferonasal (IN), ST and IN as well as temporal and nasal. An asymmetry index was assigned by taking the absolute value of log10 of the ratio. The area under the receiver operating characteristics curve (AUROC), partial AUROC (pAUROC) ≥ specificities 90 and 95%, cutoff values and sensitivities at specificities 90 and 95% was analyzed. Results Parameters with largest AUROCs were IT GCIPL thickness (0.784), average RNFL thickness (0.767), and average C/D (0.746). For macular asymmetry parameters, log IT/SN index had the largest AUROC (0.734), followed by log IT/IN index (0.725), and absolute difference of IT−SN GCIPL thickness (0.715). Performance was comparable between the best measures of asymmetry analysis (log IT/SN index) and those of cpRNFL, GCIPL, and ONH parameters (all P > 0.05). The IT/SN asymmetry index not only had the largest pAUROC based on the pAUROCs ≥90 and 95% specificity (0.044 and 0.019) but also had the highest diagnostic sensitivity at 90 and 95% specificities (52.2 and 46.3%). Conclusions GCIPL asymmetry measurements have diagnostic ability comparable to cpRNFL, GCIPL, and ONH analysis for PPG. The best macular ganglion cell asymmetry parameter was IT/SN asymmetry index, which could be a new parameter to detect early structural changes in PPG.

PURPOSE:To evaluate ways to improve the generalizability of a deep learning algorithm for identifying glaucomatous optic neuropathy (GON) using a limited number of fundus photographs, as well as the key features being used for classification. METHODS:A total of 944 fundus images from Taipei Veterans General Hospital (TVGH) were retrospectively collected. Clinical and demographic characteristics, including structural and functional measurements of the images with GON, were recorded. Transfer learning based on VGGNet was used to construct a convolutional neural network (CNN) to identify GON. To avoid missing cases with advanced GON, an ensemble model was adopted in which a support vector machine classifier would make final classification based on cup-to-disc ratio if the CNN classifier had low-confidence score. The CNN classifier was first established using TVGH dataset, and then fine-tuned by combining the training images of TVGH and Drishti-GS datasets. Class activation map (CAM) was used to identify key features used for CNN classification. Performance of each classifier was determined through area under receiver operating characteristic curve (AUC) and compared with the ensemble model by diagnostic accuracy. RESULTS:In 187 TVGH test images, the accuracy, sensitivity, and specificity of the CNN classifier were 95.0%, 95.7%, and 94.2%, respectively, and the AUC was 0.992 compared to the 92.8% accuracy rate of the ensemble model. For the Drishti-GS test images, the accuracy of the CNN, the fine-tuned CNN and ensemble model was 33.3%, 80.3%, and 80.3%, respectively. The CNN classifier did not misclassify images with moderate to severe diseases. Class-discriminative regions revealed by CAM co-localized with known characteristics of GON. CONCLUSIONS:The ensemble model or a fine-tuned CNN classifier may be potential designs to build a generalizable deep learning model for glaucoma detection when large image databases are not available.

本研究探討「差異化教學法」對國中八年級學生數學學習成效的影響，採用準實驗研究法，並採取不等組前－後測設計。研究對象為某國中八年級兩班共 50 位學生，以其中一班為實驗組，進行「差異化教學法」，另一班為對照組，進行「講述教學法」。教學內 容為「等差數列」與「等差級數」兩個單元，實驗教學結束後，研究者蒐集相關資料進行量化的分析比較，以探討兩組學生數學學習成效的改變，並透過教學回饋單及晤談資料來了解學生對於「差異化教學法」的態度及接受程度。研究發現，實施差異化教學可 以顯著提高學生數學學習成效，以中分群學生之學習成效差距最大。 The study discusses the impact of “differentiated instruction” on the learning of math for 8th graders in junior high school. The quasi-experimental research method was adopted, using the pretest-posttest design with unequal groups. The subjects were 50 students from two 8th grade classes in one junior high school. One class was assigned as the experimental group to receive “differentiated instruction”, while the other one was the control group to receive “didactic instruction”. The instruction contents were two units of the curriculum: “arithmetic sequence” and “arithmetic series”. After the entire experimental teaching was over, the researcher collected relevant data to proceed with quantitative analysis and comparison, as well as to investigate the changes of math learning outcomes for the two groups of students. Students' attitudes and degree of acceptance toward “differentiated instruction” were examined through data collected from students' feedback sheets and interviews. Findings from this study indicate that the implementation of differentiated instruction can significantly promote student's learning outcomes in math; the effect is particularly noteworthy for the average-grade student group.

Abstract Background A considerable number of studies have identified the risk factors attributable to job-related stress among nurses. However, studies investigating psychological symptoms among hospital nurses is still lacking, especially in Taiwan, where the average patient to nurse ratio is among the highest in the world. This study aimed to investigate the potential role of self-rated health status, self-reported diseases, and utilization of occupational health checks in psychological symptoms among Taiwanese nurses. Methods A cross-sectional design was conducted from September through December 2013. Data were collected through online self-administered questionnaire among 697 registered nurses in seven regional hospitals governed by the Taipei City Government. Results Nurses with fair or poor self-rated health, lower education,

Background To investigate the incidence of and risk factors for bleb-related infection (BRI) in patients who underwent mitomycin C-augmented primary trabeculectomy. Methods We reviewed the medical charts of consecutive patients who had received primary trabeculectomy in Taipei Veterans General Hospital. We recorded the demographic and clinical characteristics of patients before, during and after surgery. Furthermore, we recorded the time interval between surgery and infection onset, clinical manifestations and visual outcomes of patients with BRI. The cumulative incidence of BRI was estimated using the Kaplan-Meier method. A Cox proportional hazards model was used to explore factors associated with BRI. Results In total, 1663 eyes were postoperatively followed up for 94.57±65.23 months. The cumulative incidence of BRI was 1.86 per 1000 person-years during the 28-year follow-up period: 24 (1.44%) patients developed BRI and 6 (0.36%) patients additionally developed endophthalmitis. A multivariate analysis revealed a significant association of BRI with wound manipulation, high myopia and hyperlipidaemia. Patients younger than 60 years were more likely to receive wound manipulation than their elderly counterparts (<0.001). One year after BRI, the best corrected visual acuity of the eyes with blebitis did not change significantly, whereas that of the eyes with endophthalmitis worsened significantly. Conclusion Risk factors for BRI after trabeculectomy include wound manipulation, high myopia and hyperlipidaemia. Considering myopia is highly prevalent throughout the world and is a risk factor for glaucoma, the lifelong risk of BRI after trabeculectomy in eyes with high myopia warrants the attention of ophthalmologists. [ABSTRACT FROM AUTHOR]

This study aims to examine the characteristics of Taiwanese children with chronic kidney disease (CKD) and delineate the factors that lead to disease progression in this population. Methods: We reviewed the records of the Taiwan Pediatric Renal Collaborative Study, a multicenter database of Taiwanese children with CKD. Multivariate regression analysis was used to identify the main factors associated with disease progression. Results: A total of 382 children aged 1–18 years were included in the study (median age was 10.6 years; interquartile range: 6.4–13.8). There were 197 males (51.6%) and 185 females. CKD Stage 1 was diagnosed in 159 children (41.6%), Stage 2 in 160 (41.9%), Stage 3 in 51 (13.4%), and Stage 4 in 12 (3.1%). Fifty-six children (14.7%) experienced CKD progression. A multivariate analysis for all patients indicated that the risk for disease progression was increased in children with CKD secondary to a structural abnormality, genetic disease, anemia, elevated diastolic blood pressure, or elevated blood urea nitrogen. Compared with children with Stage 1 CKD, those with Stage 2 and Stage 4 CKD had decreased risk for CKD progression in this short-term cohort follow-up. Conclusion: CKD etiology affects disease progression. Careful monitoring and treatment of anemia and elevated blood pressure in children with CKD may slow disease progression.

課程改革的大旗揮舞了多年，究竟兒童對課程知覺為何？兒童在學校如何過生活？從早上八點到下午四點，孩子如何經驗課程？如何覺知課堂？課堂是孩子在學校生活中停留最久的地方，兒童在課堂的身影與心理的狀態，很少主動告訴成人，而成人也鮮少進行理解。本研究透過訪談四所小學96位學生，了解兒童所知覺的課 程及其所經驗的課堂生活。研究發現，兒童對不同學科有既定的刻板印象，而教師的教學流程，兒童也都心知肚明；兒童的上課生活充滿著被控制與無奈，他們能做的是勉強自己去面對；少部分的課堂生活則有著好奇與探索，引領孩子更寬廣的學習。兒童對課程的喜好，除了內容因素，也和學習的方式有關。而在課堂生活方 面，常常是喜悅與恐懼參半，有意義的學習與填充式學習並存。從本研究所得也讓我們看見，即使課程政策推動強調學生中心與主動學習已經行之多年，但是，實際的教育現場還是有一大段努力的路要走。 How have the several-year curriculum reform added to children’s understanding of courses? How do they spend school days? What is their classroom experience? Classrooms are the main venue for their school lives, but children’s physical and mental status in classrooms remains a mystery that earns flagging attention from adults. This study aims to provide a glimpse of children’s learning and their classroom experience. After interviewing 96 subjects from 4 elementary schools, it shows that subjects, as well as teaching style, are stereotyped. Furthermore, being controlled and helpless in classes, they cannot do anything but accept it. Content of the curriculum factors and ways of learning are the factors for Children's preferences on curriculum. In the classroom life, joy and fear are often mixed; meaningful learning and filling learning coexist. The findings also drive us to the significant difference among the real practices inside classrooms, the student-centered approaches and active learning that has been promoted by policies for years.

To investigate the different impacts on patient-reported vision-related quality of life (pVRQOL) outcomes in patients with primary angle-closure glaucoma(PACG) and primary open-angle glaucoma(POAG).Prospective cross-sectional study. PACG and POAG patients who had a best-corrected visual acuity(BCVA) in the better eye equal to or better than 20/60, intraocular pressure controlled at or below 25 mmHg and reliable visual field test were invited to participate. The control group included patients with BCVA in the better eye equal to or better than 20/60 and who did not have major eye disease. A validated Taiwanese version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25(T)) was performed to assess pVRQOL. The association between each domain of NEI VFQ-25(T) among 3 groups was determined using multivariable linear regression analysis.A total of 106 PACG, 186 POAG, and 95 controls were enrolled. In multivariable regression analysis of all three groups(PACG/POAG/controls), compared to POAG, PACG showed a weakly positive association with social functioning (R2 = 0.13, β = 0.22, P = 0.04). PACG showed no significantly negative impact on pVRQOL compared to controls. Taking only glaucoma patients into consideration, PACG patients had a higher score on social functioning compared to POAG (R2 = 0.16, β = 0.27, P = 0.01). The results of other domains of NEI VFQ-25(T) between the two groups did not differ significantly(p>0.05).In patients with controlled disease, the impact of PACG and POAG on most domains of NEI VFQ-25(T) were similar, except for better social functioning in PACG compared to POAG.

本研究旨在既有體系與正在建構的體系中進行理論的論述與實踐溝通。嘗試從理論與實踐現場的觀看與理解中找到可能性，並嘗試建構其可能的體系，更重要的是透過課程推展體系的建立，讓課程改革過程中的「人」，亦能得以開展，並將實踐歷程與智慧回饋至課程改革系統。為達成研究目的，本研究深入探討臺灣與國外當前的課程推展體系，並依據研究目的擬訂團體座談會討論題綱，根據當前困境、理想樣貌與具體配套措施三個層面與各個層級專家學者進行團體座談與諮詢會議，並佐以文獻與文件檔案分析，以瞭解課程推展體系中的組織與任務、組織間的關係與互動，以及策略配套與人才培育之內涵。歸納研究發現，提出以下結論與建議：一、課程推展不能僅限於課程推動自身，而是要與人發生關聯，課程推展的理念宣示溝通與發展人的核心關懷需要不斷提醒與落實，並與教育人員的成長共同思考實踐；二、課程改革推展體系中，其推展的關係並非單向，而是多向的生態體系，是相互連帶的，強調推展過程的溝通對話與互動；三、國家教育研究院是國家課程推動的大腦與引擎，需要進行組織內的調整，調用專業人員並需有專屬課程推展經費支持；四、將國家課程審議會設為常設性機制，能改善國家與民間課程改革缺乏共識之問題；五、透過實驗學校進行課程實驗與推展，以使課程改革內容更具可行性；六、師資培育機構為一協助單位，透過分區領導提供諮詢服務與進行人才培育；七、教師層級在課程推展體系中應發揮其主動性、主體性與更積極之功能；八、建立教師生涯發展階梯，營造一個教師間相互協力實踐與影響的環境。The purpose of this study is to theoretically describe and practically discuss curriculum promotion systems which are both in process and already in place. The study uses theory as well as practical observation to explore curriculum possibilities and look for other possible promotion systems as well. But most importantly, the study promotes the establishment of curriculum promotion systems to ensure the development of persons involved in the curriculum reform, and to ensure that practical experience and wisdom is integrated into the reform process. In order to achieve these aims, this paper thoroughly discusses current curriculum promotion systems in Taiwan and abroad. The study also employs seminars group discussions to investigate relevant issues, current problems, ideal models, and concrete measures. Specialist scholars at each of these three levels are invited to conduct seminars and advising sessions. The study will also thoroughly review relevant literature and documentation to adequately understand the organizational structure and responsibilities implicit in the curriculum promotion system, to understand the interactive nature of the organizational parts of the system, and to understand strategy and talent cultivation dimensions of the system. The Study’s conclusions and recommendations are as follows: (1) Curriculum promotion doesn’t limit in courses, but connects with person. The idea declaring, communication and core concern for staff development in curriculum promotion need to remind and implement constantly and developed amongst education workers. (2) In a curriculum promotion system, efforts are not uni-directional but rather multi-directional. The whole system can be thought of as its own ecosystem which is based on the mutual interaction of its members. As such, communication, dialogue and interaction are crucial for the development of the curriculum. (3) The National Academy for Educational Research is the nerve center and the main driving force behind the national curriculum. Adjustments need to be made to the organization, and specialized personnel and funding should support these projects. (4) The National Curriculum Review should act as a permanent mechanism which can promote a common understanding of curriculum reform at both government and citizen levels. (5) Experimental schools should be employed to experiment with and develop curriculum, making the contents of curriculum reform more feasible. (6) Teacher training institutions should play a supporting role administered through different districts, and should offer advising services and cultivate needed talent. (7) Teachers should play an active, central, positive role in the curriculum promotion system. (8) Build a life-long professional development system to cultivate a cooperation and practicing environment.

BACKGROUND AND PURPOSE: The aim was to identify the risk factors for renal scarring and deteriorating renal function in children with primary vesico-ureteral reflux (VUR). MATERIALS AND METHODS: Patients with primary VUR admitted to the National Cheng Kung University Hospital were retrospectively analyzed. The outcomes were renal scarring, assessed by technetium-99 m dimercaptosuccinic acid scanning, and renal function, assessed by estimated glomerular filtration rate. Univariate and multivariate models were applied to identify the corresponding independent predictors. RESULTS: A total of 173 patients with primary VUR were recruited. The median age of VUR diagnosis was 10.0 months (IQR: 4.0-43.0 months). After adjusting for confounding factors, it was found that older age of VUR diagnosis (≥5 years vs.