Different Regions Of Taiwan Research Articles

Valuation of customers’ service quality, affective, sensory experience and entertainment to behavioral intention

This study explores the impact of distinct characteristics of theme restaurants on service quality and behavioral intentions. As the unique attributes of themed restaurants continue to gain in popularity, this study gathered data from a face-to-face survey of 776 diners who visited various themed restaurants across different regions of Taiwan. The study validated the evaluation of customers’ service quality, affective experience, sensory experience, and entertainment in relation to behavioral intention within a proposed conceptual model, which was then tested using covariance-based structural equation modeling (CB-SEM) analysis. The findings reveal that affective experiences, the perception of entertainment and the sensory experience mediate between service quality and behavioral intention. Furthermore, the study underscores that the perception of a servicescape acts as a moderating factor influencing the associations between service quality and sensory experience, thereby reinforcing the links between affective experience and behavioral intentions. The study's robustness is confirmed by implementing alternative models. The final section of the study discusses both theoretical and managerial implications derived from these outcomes.

Exploring the genetic makeup of Xanthomonas species causing bacterial spot in Taiwan: evidence of population shift and local adaptation

The introduction of plant pathogens can quickly reshape disease dynamics in island agro-ecologies, representing a continuous challenge for local crop management strategies. Xanthomonas pathogens causing tomato bacterial spot were probably introduced in Taiwan several decades ago, creating a unique opportunity to study the genetic makeup and adaptive response of this alien population. We examined the phenotypic and genotypic identity of 669 pathogen entries collected across different regions of Taiwan in the last three decades. The analysis detected a major population shift, where X. euvesicatoria and X. vesicatoria races T1 and T2 were replaced by new races of X. perforans. After its introduction, race T4 quickly became dominant in all tomato-growing areas of the island. The genomic analysis of 317 global genomes indicates that the Xanthomonas population in Taiwan has a narrow genetic background, most likely resulting from a small number of colonization events. However, despite the apparent genetic uniformity, X. perforans race T4 shows multiple phenotypic responses in tomato lines. Additionally, an in-depth analysis of effector composition suggests diversification in response to local adaptation. These include unique mutations on avrXv3 which might allow the pathogen to overcome Xv3/Rx4 resistance gene. The findings underscore the dynamic evolution of a pathogen when introduced in a semi-isolated environment and provide insights into the potential management strategies for this important disease of tomato.

Assessing the impact of specific PM2.5-Bound metallic elements on asthma emergency department visits: A case-crossover study in Taiwan

ObjectivesThis study aims to assess the specific PM2.5-bound metallic elements that contribute to asthma emergency department visits by using a case-crossover study design. MethodsThis study analyzed data from 11,410 asthma emergency department visits as case group and 22,820 non-asthma onset dates occurring one week and two weeks preceding the case day as controls from 2017 to 2020. PM2.5 monitoring data and 35 PM.2.5-bound metallic elements from six different regions in Taiwan were collected. Conditional logistic regression models were used to assess the relationship between asthma and PM2.5-bound metallic elements. ResultsOur investigation revealed a statistically significant risk of asthma emergency department visits associated with PM2.5 exposure at lag 0, 1, 2, and 3 during autumn. Additionally, PM2.5-bound hafnium (Hf), thallium (Tl), rubidium (Rb), and aluminum (Al) exhibited a consistently significant positive correlation with asthma emergency department visits at lags 1, 2, and 3. In stratified analyses by area, age, and sex, PM2.5-bound Hf showed a significant and consistent correlation. ConclusionsThis study provides evidence of PM2.5-bound metallic elements effects in asthma exacerbations, particularly for Hf. It emphasizes the importance of understanding the origins of these metallic elements and pursuing emission reductions to mitigate regional health risks.

Radon levels and dose assessment at the basement workplaces of hospitals in different regions of Taiwan

The basements of large hospitals in Taiwan are usually working areas for image radiometry, radiation therapy, and nuclear medicine, where the radon concentration can be accumulated. This study investigated radon concentrations in the basement working environments of 30 hospitals in different regions with various geology of Taiwan, aiming to explore the relationship between geological conditions and radon concentrations and estimate the radiation dose received by the working staff. Portable MR107+ semiconductor radon detectors calibrated with a radon chamber were used for radon measurement at the hospital basement working areas according to the protocol of MAH-2019 instrument placement recommendations from the US EPA. The excess lung cancer risk (ELCR) as well as the lung cancer cases per million persons (LCC) were further derived from the radiation dose.The basement working areas investigated are located on the first to sixth underground floors of hospitals in Taiwan mainland and islands, Penghu and Kinmen. The 222Rn concentration higher than 100 Bq/m3 was observed at CH-1 (122.1 Bq/m3) in Changhua City and CY-1 (114.7 Bq/m3) in Chiayi City. This is attributed to that the central air conditioning systems of these hospitals were turned off during off-duty hours. The radon concentrations of all hospitals were lower than the action level, 150 Bq/m3, regulated by the US EPA. No significant relationship was found between radon concentration and the geological characteristics of the measured sites. That is, the ventilation of the basement working areas in hospitals is more important than local geological characteristics on indoor radon concentration, and therefore proper ventilation is crucial for reducing radon gas concentration in the hospital basements. Estimated annual effective dose from 222Rn for the hospital staff was higher than 1 mSv/y at YL (1.24 mSv/y), CH-1 (1.64 mSv/y), CY-1 (1.54 mSv/y), CY-2 (1.34 mSv/y), and PH-2 (1.14 mSv/y), and that for the rest sites was <1 mSv/y. The maximum mean ELCR was found to be 0.63% at CH-1, and the related LCC was estimated to be 29.5 per million persons.

Discovery brand authentic and sensory experience influencing word of mouth with mediation and moderation setting

ABSTRACTThe purpose of the current study is to explore the direct, indirect and moderating roles of local food consumption and behaviour analysis. Although previous studies have highlighted the importance of local food and cultural experience, there is a lack of incorporation among different mechanism analyses. The current study therefore integrates a multiple mediation-moderation model using 670 participants from different regions in Taiwan. The results show that brand authenticity is a critical foundational attribute of indirect influence word of mouth (WOM) through sensory experience and cultural involvement. Furthermore, this study also confirmed the critical moderating attribute of behavioural intention and information quality in the strength of the above relationship among brand authenticity, WOM, sensory experience and cultural involvement.

Genetic surveillance and outcomes of pyrazinamide and fluoroquinolones-resistant tuberculosis in Taiwan

BackgroundPyrazinamide (PZA) and fluoroquinolone (FQ), particularly moxifloxacin (MXF), are essential drugs in the World Health Organization (WHO) recommended short-course regimen to treat drug-susceptible tuberculosis (TB). MethodsTo understand the extent of PZA and MXF susceptibility in general TB cases in Taiwan, we conducted retrospective analyses of 385 conservative Mycobacterium tuberculosis complex (MTBC) isolates identified from 4 TB laboratories in different regions of Taiwan. The case information was obtained from the TB registry. Genotypic drug susceptibility testing (DST) was performed by sequencing drug-resistance associated genes, PZA (pncA) and FQ (gyrA, and gyrB). Phenotypic DST was determined using the Bactec MGIT 960 system or the agar proportion method. Genotyping was carried out using spacer oligonucleotide typing. ResultsIn this study, 4.7% (18/385) cases' isolates harbored pncA mutations and 7.0% (27/385) cases’ isolates harbored gyrA or gyrB mutation. Notably, pncA mutation was associated with Beijing family genotypes (P = 0.028), East African-Indian (EAI) genotypes (P = 0.047) and MDR-TB (P < 0.001). Whereas, gyrA or gyrB mutation was associated with EAI genotypes (P = 0.020) and MDR-TB (P = 0.006). In addition, a statistically significant difference was found between the favorable outcomes using active and inactive PZA (P = 0.009) in 38 case isolates with any pncA, gyrA, or gyrB mutation. ConclusionWe concluded that routine PZA and FQ susceptibility tests are recommended for guiding the treatment of TB.

Emergency Medical Services in Taiwan: Past, Present, and Future.

This review assessed the development of Taiwan's emergency medical services (EMS) and focused on the optimizing initiatives of the EMS systems, the current state of Taiwan's EMS system, EMS benchmarks in different regions of Taiwan, EMS response during the coronavirus disease 2019 (COVID-19) pandemic, and future design. In the past decade, there has been a noticeable increase in prehospital services, numerous optimizing initiatives to improve patient prognosis, and the medical oversight model. Taiwan's current EMS system, including the dispatch system, out-of-hospital cardiac arrest (OHCA) patient management, time-sensitive critical illness in prehospital settings, and disaster response, has undergone significant improvements. These improvements have been demonstrated to have a measurable impact on patient outcomes, as supported by medical literature. Each region in Taiwan has developed a unique EMS system with local characteristics, such as the implementation of the Global Resuscitation Alliance 10 steps for OHCA-related quality control, hearing automated external defibrillator program, a five-level prehospital triage system, an island-hopping strategy for patients with major trauma, dispatcher-assisted teamwork for OHCA resuscitation, and optimized prehospital care for acute coronary syndrome patients. In response to the COVID-19 pandemic from 2019 to 2023, Taiwan's EMS implemented measures to combat the outbreak such as interagency collaboration to obtain patient's personal information, to optimize prehospital management initiatives, and to provide financial compensation and personal insurance for emergency medical technicians. The areas that need focus include integrating prehospital and in-hospital information to build a national-level database (One-Stop Emergency Management), increasing public awareness of first responders and emergency casualty care, and evolving the EMS system by incorporating private EMS system, initiating school-based education of paramedicine, and legally recognizing paramedics as medical and health care personnel. By improving these areas, we can better prepare for the future and ensure that Taiwan's EMS system continues to provide high-quality care to those in need.

Impact of the COVID-19 pandemic on population-based cancer screening, a nationwide retrospective study in Taiwan

BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic has placed a great burden on Taiwan’s health care system. It has also had a great impact on other public health issues, including cancer screening. Delayed cancer screening was also noticed in the U.S. during the pandemic, which may have led to both delayed diagnosis and poor prognosis. In Taiwan, population-based cancer screening for breast cancer, oral cancer, colon cancer and cervical cancer has been executed and ongoing for years.MethodIn this study we have analyzed the change in screening numbers for cancer during the period of the 2019 to 2021 COVID-19 outbreak in Taiwan.ResultsThrough our results we found that total cancer screening numbers decreased from 307,547 to 103,289 (a 66% decrease) from the years 2020 to 2021. Specifically, a 63%, 79%, 65% and 71% decrease in screening cases was seen for colon cancer, oral cancer, cervical cancer and breast cancer, respectively, during that period. A similar condition was noticed when comparing 2019 to 2021 when the disclosed total cancer screening numbers decreased by 70% (2019–2021); 65%, 83%, 70% and 76% in colon cancer, oral cancer, cervical cancer and breast cancer, respectively. Among these various cancer screenings, oral cancer screening showed the greatest reduction rate (a drop of 83% compared to 2019 and 79% compared to 2020). We also compared the reduction rates taken from different regions in Taiwan. It was in Taipei, where most COVID-19 cases were noted, that the greatest reduction rate of cancer screening numbers occurred (a drop of76% compared to 2019 and 74% compared to 2020). A proportional decrease of screening cases was also noticed in all areas when confirmed COVID-19 cases rose.ConclusionsScreening for cancers dropped significantly due to the pandemic and its effect on long-term health needs to be evaluated. Additionally, efforts should be taken to address these cancer screening number deficits which have taken place during the COVID-19 pandemic.

Exploring assessment for learning: assessment tools and approaches in Taiwanese CLIL classes

ABSTRACT This study explores how the concept of Assessment for Learning (AfL) is practised in the CLIL contexts. It focuses on the assessment purpose of understanding and supporting students’ content and language learning. Ten CLIL teachers in the bilingual program of three different regions in Taiwan were involved in the study. Results from the class observations and semi-structured interviews indicated that four formative assessment approaches – questioning techniques, worksheets, peer and self-assessment, and formative use of summative tests – were frequently carried out in CLIL classes. A synergy of assessment tools was also found in the observed CLIL class, which provides students, teachers, and parents with a continuing stream of evidence of student progress and skill. Findings showed that the teachers were aware of AfL and promoted it through various formative assessment practices in their CLIL classes. This study provides insights into the development of alternative instruments that can be used to assess EFL more comprehensively in the CLIL classroom context of elementary education.

Spatiotemporal seismicity pattern of the Taiwan orogen

Abstract. We investigate the temporal and spatial seismicity patterns prior to eight M &gt; 6 events nucleating in different regions of Taiwan through a region–time–length algorithm and an analysis of a self-organizing spinodal model. Our results show that the spatiotemporal seismicity variations during the preparation process of impending earthquakes display distinctive patterns corresponding to tectonic settings. Q-type events occur in southern Taiwan and experience a seismic quiescence stage prior to the mainshock. A seismicity decrease of 2.5 &lt; M &lt; 4.5 events occurs around the relatively high b-value southern Central Range, which contributes to the accumulation of tectonic stress for preparing for the occurrence of the Q-type event. On the other hand, A-type events occur in central Taiwan and experience a seismic activation stage prior to the mainshock, which nucleates on the edge of the seismic activation area. We should pay attention when accelerating seismicity of 3 &lt; M &lt; 5 events appears within the low b-value area, which could promote the nucleation process of the A-type event.

National surveillance of antimicrobial susceptibilities to ceftaroline, dalbavancin, telavancin, tedizolid, eravacycline, omadacycline, and other comparator antibiotics, and genetic characteristics of bacteremic Staphylococcus aureus isolates in adults: Results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART) program in 2020.

Methicillin-resistant Staphylococcus aureus (MRSA) causes invasive infections and is associated with community-acquired infections (CAIs) and hospital-associated infections (HAIs). In 2020, 315 S. aureus isolates, including 145 methicillin-susceptible S. aureus (MSSA) and 170 MRSA, mainly associated with bacteremia and mostly CAIs, were collected from 16 hospitals in different regions of Taiwan. Minimum inhibitory concentrations (MICs) were determined using the Sensititre™ complete automated AST system. Staphylococcal cassette chromosome mec (SCCmec) types were analysed using multiplex polymerase chain reaction. The median age of patients infected with MRSA was significantly higher than that of patients infected with MSSA (72.5 years vs. 67.0 years, P=0.027). MIC50/MIC90 values of eravacycline and omadacycline were 0.06/0.12, and 0.25/0.5, respectively. Of the MRSA isolates, 4.1% presented susceptible dose-dependence to ceftaroline, most of which (85.7%) were HAI- and Panton-Valentine leukocidin (PVL)-negative. Among the MRSA isolates, 7.1% were not susceptible to telavancin and tedizolid (mainly type IV, PVL-negative, and CAI), 0.6% were not susceptible to daptomycin (type III, PVL-negative, and HAI), and 1.8% were not susceptible to quinupristin/dalfopristin (three isolates were type III, IV, and VT, respectively, and all were PVL-negative), but all were susceptible to dalbavancin. In conclusion, patients with bacteremia caused by MRSA were older than those with bacteremia caused by MSSA, SCCmec type IV was more predominant in CAI than in HAI, and MRSA isolates not susceptible to novel anti-MRSA antimicrobials belonged to types II, III, or IV. Further studies that include comprehensive demographics and more detailed descriptions of other antimicrobial-resistant genes are urgently needed.

Overview of dental professionally topical fluoride application in public health measure in Taiwan in 2021

Background/purposeIn Taiwan, it has been 16 years since the policy of children's dental professionally topical fluoride application (PTFA) services was implemented. This study investigated the differences in the number of children's dental PTFA outpatient visits among cities and counties or different regions of Taiwan in 2021. Materials and methodsThe population data and medical records of the number of children's dental PTFA outpatient visits were obtained from the websites of Ministry of the Interior and Ministry of Health and Welfare, respectively. The secondary data were divided by cities and counties to analyze the urban-rural gap and regional differences in the number of children's dental PTFA outpatient visits in Taiwan in 2021. ResultsIn Taiwan, municipalities had the largest number of dental PTFA visits (721,338, 66.91% of the total dental PTFA visits), while remote and outlying island counties had the smallest number of dental PTFA visits (84,509, 7.84%). The northern region had the largest number of dental PTFA visits (466,728, 43.29%), while outlying islands had the smallest number of dental PTFA visits (25,055, 2.32%). Based on the children aged 3–5 years, municipalities had the lowest dental PTFA use rate (171.70%), while remote and outlying island counties had the highest dental PTFA use rate (482.96%). ConclusionIn Taiwan, there is a higher number of children's dental PTFA outpatient visits in municipalities than in non-municipalities or remote and outlying island counties as well as in northern region than in each of other four regions (central, southern, and eastern regions and outlying islands).

Geographic Transmission and Epidemic History of HIV-1 CRF01_AE, CRF07_BC, and HCV Subtype-6w among Taiwanese Persons Who Inject Drugs.

Persons who inject drugs (PWID) and their risk-related behaviors (e.g., unprotected sex and sharing needles/syringes/other injection equipment) have caused severe public health problems, especially in the rapid spread of HIV-1 and HCV. Here, we reconstructed the epidemic history of HIV-1 circulating recombinant form (CRF) 01_AE, CRF07_BC, and HCV subtype-6w among Taiwanese PWID. The timescales were estimated using phylogenetic and Bayesian coalescent analyses. The results revealed that CRF01_AE started to circulate in the Taiwanese PWID population in central Taiwan at 1992.5 (95% credible region: 1988.8–1995.9) and spread to other regions of Taiwan, while CRF07_BC was first identified in southern Taiwan at 2000.0 (95% CR: 1997.8–2002.2) and then spread northward to central-northern Taiwan. All HCV-6 strains were from Asia (that is, China, Myanmar, Taiwan, and Vietnam) and originated in 1928.1 (95% CR: 1890.2–1966.0). Furthermore, subtype-6w isolates from different regions of Taiwan appeared to share a common source that existed in the mid-1990s (95% CR: 1985.0–2001.8) or thereabouts. The routes of drug trafficking and the resulting high prevalence of HIV-1/HCV co-infections among PWID might have contributed to the virus transmission and promoted its spread worldwide. Long-term monitoring and policy implementation in at-risk populations would be useful for disease control.

Stimulation of GLUT4 Glucose Uptake by Anthocyanin-Rich Extract from Black Rice (Oryza sativa L.) via PI3K/Akt and AMPK/p38 MAPK Signaling in C2C12 Cells.

Anthocyanin from black rice was reported to have beneficial effects on diabetes, but the molecular mechanisms are still largely unknown. Black rice cultivated from different regions in Taiwan (Hualien and Changhua) were included in this study. Concentrations of anthocyanin were significantly higher using the ethanol extraction method than those using water; therefore, ethanol extracts from Hualien and Changhua black rice (HBRE and CBRE) were used for further investigation. 2-NBDG glucose uptake analysis revealed that both HBRE and CBRE promote glucose uptake in C2C12 myotubes. The membrane expression levels of GLUT4 and phosphorylation of IRS-1 also had been markedly increased by both HBRE and CBRE, which was in accordance with the glucose uptake results. CBRE did not affect the downstream of IRS-1 but significantly enhanced protein levels of p-AMPK/AMPK. In contrast, HBRE was shown to target various signaling participated in GLUT4 glucose uptake, including PI3K/Akt and the p38 MAPK/ERK. Overall, we demonstrated that anthocyanin-rich extracts from black rice stimulate GLUT4 glucose uptake via upregulation of PI3K/Akt and AMPK/p38 MAPK signaling in C2C12 myotubes. Our findings revealed that anthocyanin-rich black rice might be a promising functional food for the prevention and treatment of insulin resistance and diabetic hyperglycemia.

Distributions of dental freshmen and practicing dentists and their correlations in different regions of Taiwan in 2020

Background/purposeTaiwan is facing the problems of the surplus, the uneven distribution, and the urban-rural gap of dental students and practicing dentists. The main purpose of this study was to evaluate the distributions of dental freshmen and practicing dentists in different regions of Taiwan in 2020.Materials and methodsWe collected the numbers of dental freshmen and practicing dentists in different regions of Taiwan in 2020 for evaluation of their regional distributions in Taiwan and their relationship by the regression analysis.ResultsThe numbers of dental freshmen and of practicing dentists per 100,000 people in municipalities were higher than those in non-municipalities (P < 0.01 for practicing dentists only). These corresponding numbers in cities with dental schools were significantly higher than those in cities and counties without dental schools, respectively (all P-values < 0.05). In addition, the coefficients of correlation between the dentist index and the dental student index were R2 = 0.7521 (P < 0.05) for municipalities (n = 6), R2 = 0.6332 (P < 0.001) for non-municipalities (n = 15), R2 = 0.9334 (P < 0.05) for cities with dental schools (n = 4), R2 = 0.4925 (P < 0.01) for cities and counties without dental schools (n = 17), and R2 = 0.5025 (P < 0.001) for nationwide (n = 21).ConclusionThe dental freshmen and practicing dentists are still more concentrated in municipalities than in non-municipalities and in cities with dental schools than in cities and counties without dental schools in Taiwan in 2020.

New Insights on Volatile Components of Vanilla planifolia Cultivated in Taiwan.

Vanilla (Vanilla planifolia) is a precious natural flavoring that is commonly used throughout the world. In the past, all vanilla used in Taiwan was imported; however, recent breakthroughs in cultivation and processing technology have allowed Taiwan to produce its own supply of vanilla. In this study, headspace solid-phase microextraction (HS-SPME) combined with GC-FID and GC-MS was used to analyze the volatile components of vanilla from different origins produced in Taiwan under different cultivation and processing conditions. The results of our study revealed that when comparing different harvest maturities, the composition diversity and total volatile content were both higher when the pods were matured for more than 38 weeks. When comparing different killing conditions, we observed that the highest vanillin percentage was present after vanilla pods were killed three times in 65 °C treatments for 1 min each. From the experiment examining the addition of different strains, the PCA results revealed that the volatiles of vanilla that was processed with Dekkera bruxellensis and Bacillus subtilis was clearly distinguished from which obtained by processing with the other strains. Vanilla processed with B. subtilis contained 2-ethyl-1-hexanol, and this was not detected in other vanillas. Finally, when comparing the vanillin percentage from seven different regions in Taiwan, vanilla percentage from Taitung and Taoyuan Longtan were the highest.

Distributions of dental freshmen enrolled by northern, central, and southern dental schools in each city or county and different regions of Taiwan in 2020

Background/purposeIn Taiwan, the uneven distribution and the urban-rural gap of dentists are long-standing problems. Thus, the regional balance of domestic dental schools and their students are very important for the further distribution of practicing dentists. The main purpose of this study was to evaluate the distributions of dental freshmen enrolled by dental schools of general universities in each city or county and different regions of Taiwan in 2020. Materials and methodsThis study mainly collected the number of dental freshmen enrolled by the northern, central, and southern dental schools and further evaluated their distributions in each city or county and different regions of Taiwan in 2020. ResultsThe distribution of dental freshmen in Taiwan in 2020 did have a regional imbalance. These dental freshmen were mainly concentrated in municipalities, cities with dental schools, and the northern region of Taiwan. The enrolled dental freshmen tended to choose a dental school which was in the same location as they grew up. We also found that the dental freshmen enrolled by the northern, central, and southern dental schools mostly came from the northern, the northern, and the southern regions of Taiwan, respectively. ConclusionWe conclude that the dental freshmen are mainly concentrated in municipalities, cities with dental schools, and the northern region of Taiwan. Moreover, the dental freshmen enrolled by the northern or central dental schools mostly come from the northern region of Taiwan and those enrolled by the southern dental schools majorly come from the southern region of Taiwan.

Increased prevalence of Parkinson's disease in soils with high arsenic levels

IntroductionExposure to arsenic (As)-containing pesticides was associated with an increased risk for Parkinson's disease (PD). Arsenic also induced in murine brains α-synuclein aggregates, a pathognomic feature of PD. ObjectivesPeople living on farms irrigated with high As water in Taiwan are likely exposed to increased As. We addressed whether increased farm soil As levels correlate with an increased PD risk. MethodsWe used the information from several national surveys (1983–1986) on soil metal contents to study the relationships between soil metal contents and PD prevalence in Taiwan. PD prevalence (2009–2013) was calculated with a database from Taiwan's compulsory national health insurance. A patient is defined by a PD diagnosis and prescriptions of Levodopa in three or more office visits in twelve months. We used regression models to study the correlation between PD prevalence and soil metal contents. ResultsThe PD prevalence ranged from 83 to 213 per one hundred thousand persons in different regions of Taiwan. Among the studied heavy metals, we found only As was significantly associated with the PD prevalence. The top three regions (Yunlin, Chiayi, Tainan) in the PD prevalence list correspond exactly with the top three in soil As levels. Soil As levels and PD prevalence had a strong correlation (r = 0.75). ConclusionPD prevalence is statistically correlated with farm soil As levels in Taiwan.

Epidemiology profile and outcomes of oral potentially malignant disorders among different geographic regions of Taiwan: A retrospective observational nationwide population database study

Background: The malignant transformation of oral potentially malignant disorders (OPMDs) is a potential cause of oral cancers. However, epidemiological studies on malignant transformation of OPMDs are lacking. The present study is aimed to investigate the percentage of OPMD in the oral mucosal screening database and the malignant transformation (%) across different regions of Taiwan. Methods: We determined the cases of malignant transformation of OPMD to oral cancers during the 2-year follow-up by the oral mucosal screening database and the cancer registry database contained in the National Health Insurance Research Database. Patients with oral cancer history before OPMD diagnosis were excluded from the study. We collected data including clinical diagnosis, biopsy result, follow-up, and place of residence of the patient. The most widely used definition from the Council for Economic Planning and Development in Taiwan was used in this study for the classification into Southern, Northern, Eastern, and Western Taiwan regions. Differences in the malignant transformation (%) and ranking between regions were evaluated using analysis of variance test. Results: Chiayi city located in Southern Taiwan has the highest percentage of OPMD in oral screening citizen. The percentage of OPMD in the oral mucosal screening database was highest in Southern Taiwan and lowest in Eastern Taiwan; however, the malignant transformation (%) was highest in the Eastern Taiwan and lowest in Northern Taiwan. Conclusion: Dentists and otolaryngologists in Southern Taiwan, especially Chiayi city, should be cautious when screening the patient because of the high percentage of OPMD in oral mucosal screening database. The percentage of OPMD in the oral mucosal screening database and the malignant transformation (%) are different among the different regions in Taiwan. Further research is needed to clarify the reasons for the different malignant transformation (%) between regions.

Does postgraduate year training program for dentists worsen the imbalance of geographical distribution of dentists in Taiwan?

Background/purposeTaiwan implemented the non-compulsory postgraduate year training program for dentists (PGYD) in 2010. Previous studies found that training institutions for dentists are mostly distributed in metropolitan areas. This study explored whether the PGYD system might worsen the imbalance of geographical distribution of dentists in Taiwan. Materials and methodsThis study collected the data of population, the number of practicing dentists from 2010 to 2018, and the number of practicing dentists in the training institutions in 2018 to draw the Lorenz curve and to calculate the Gini coefficient for evaluating whether the PGYD system might worsen the imbalance of geographical distribution of dentists in Taiwan. ResultsOur results showed that the uneven geographical distribution of overall practicing dentists did not deteriorate after the implementation of the PGYD system. However, the uneven geographical distribution of practicing dentists in training institutions was more serious than the uneven geographical distribution of overall practicing dentists. ConclusionBecause the PGYD system is not mandatory, dentists engage in training program and select training institutions as driven by the market factors. After completion of the PGYD training, dentists choose the practice location as driven by the market factors again and this in turn redistributes the dentists to different regions of Taiwan. In addition, major dentist policies may also result in the movement of dentists to various regions of Taiwan. Thus, the market-driven redistribution of dentists to different regions of Taiwan finally reduces the imbalance of geographical distribution of dentists in Taiwan caused by the PGYD system.