Different Regions Of Taiwan Research Articles

Factors associated with parental smoking in the presence of school-aged children: a cross-sectional study

BackgroundIn 2009, the Tobacco Hazards Prevention Act (Taiwan) was amended to more effectively restrict smoking in indoor public places and workplaces in Taiwan. However, the lack of prohibitions for smoking in private homes may place family members at increased risk for exposure to environmental tobacco smoke (ETS). The aim of our study was to determine the factors associated with parental smoking in the presence of children at home.MethodsIn 2010, we performed a cross-sectional study of factors associated with parental smoking in the presence of children at home in Taiwan using self-administered questionnaires. Quota sampling was used to select five primary schools from four different regions of Taiwan. Parents were surveyed to identify parental smokers and 307 parental smokers were selected for participation in our study. Questionnaire data regarding parental smoking in the presence of children at home and related interactions among family members were analyzed. Hierarchical logistic regression was used to determine the best-fit model for examining the relationships among the variables related to parental smoking in the presence of children at home.ResultsTwo-thirds of parents who smoked reported smoking in the presence of their children. The results of the hierarchical logistic regression analysis identified the smokers’ compliance with their family’s antismoking responses, mutual agreement with smoking bans, daily smoking, smoking more than 20 cigarettes per day, the education level of the parental smoker, and the annual family income as determinants of smoking in the presence of children at home.ConclusionsHouseholds with smoking parents should be targeted for interventions to encourage the adoption and enforcement of home smoking bans. Educational interventions that promote smoke-free homes for children and provide support to help parents stop smoking are critical factors in reducing the frequency of children’s ETS exposure in the home.

Survey of aflatoxin contamination in peanut products in Taiwan from 1997 to 2011

Aflatoxins are toxic, mutagenic, and carcinogenic compounds that contaminate various types of foods and feedstuffs. The aflatoxin levels in various kinds of peanut products in Taiwan were surveyed during the recent decade. A total of 1827 commercial peanut products were collected from different regions of Taiwan from 1997 to 2011. The samples were cleaned by immunoaffinity columns and analyzed for aflatoxins B1, B2, G1, and G2 by high-performance liquid chromatography with fluorescence detection. Aflatoxins were detected in 32.7% of samples with levels ranging from 0.2 μg/kg to 513.4 μg/kg. Peanut butter had the highest aflatoxin-positive incidence, followed by peanut flour, peanut candy, rice syrup, and peanuts. In addition, 6.8% of the samples had total aflatoxin concentrations (i.e., the sum of B1 + B2 + G1 + G2) that were higher than the Taiwan regulatory limit of 15 μg/kg. Among the aflatoxin-positive samples, aflatoxin B1 had the highest frequency of detection, followed by aflatoxin B2, aflatoxin G2, and aflatoxin G1. This longterm survey provides valuable information on aflatoxin contamination in peanut products marketed in Taiwan.

Acrothoracican barnacles (Lithoglyptida) in Taiwan, including the taxonomic status of Balanodytes taiwanus Utinomi, 1950 and cryptic diversity of Auritoglyptes bicornis (Aurivillius, 1892).

We list five acrothoracican barnacles of the order Lithoglyptida currently found in Taiwanese waters, including two new records, Trypetesa habei Utinomi, 1962 and Berndtiapurpurea Utinomi, 1950 and a new undescribed species of the genus Lithoglyptes. We also investigate the morphology and molecular genetics of Balanodytes taiwanus Utinomi, from its type locality, Taiwan. The original description of B. taiwanus in Utinomi (1950a) reported the absence of caudal appendages. Re-examination of the somatic body of one of the syntype specimens (the other syntype only having an opercular bar remaining) of B. taiwanus deposited in the Seto Marine Laboratory in Japan, revealed the presence of caudal appendages. The morphology of our specimens collected in various locations in Taiwan fits the description in Utinomi (1950a) and all have caudal appendages. The diagnosis of Balanodytes Utinomi, 1950 is revised herein. The genus Armatoglyptes Kolbasov & Newman, 2005 is a nomen nudum and ajunior synonym of Balanodytes. Our results also show that the widespread species Lithoglyptes habei Tomlinson, 1963 is a junior synonym of B. taiwanensis. The molecular sequence divergencse of the 16S RNA and COI genes were studied for samples of another monotypic genus Auritoglyptes (A. bicornis) from different regions of Taiwan. It was shown that there are at least three phylogenetic clades in Taiwan, suggesting that Auritoglyptes represents a cryptic species complex.

The effects of creative personality and psychological influences on imagination

Film production involves numerous imaginative tasks. These tasks are closely associated to seeing the film-that-is-to-come through what is currently completed and what can be creatively added. The present study was aimed at examining the effects of both creative personality and psychological variables on the imagination of film majors. The mediator effects of inspiration through action and intrinsic motivation were also tested. A survey (N = 865) was administered at eight universities across different regions of Taiwan. The results of this study verified factor structures of both imaginative capabilities and psychological influences. The hypothesis of the study – that the variables of both inspiration through action and intrinsic motivation function mediator roles on imagination – was partially supported. The structural model also showed that creative personality and psychological variables had both direct and indirect effects on imagination. Limitations of the study were acknowledged, and future inquiries were discussed.

Personality and psychological factors predict imagination: Evidence from Taiwan

Little research has been done to determine whether psychological factors and personality traits make independent contributions to creativity or whether they interact with one another to affect an individual's creative behavior. The present study thus aimed at analyzing the effects of both personality and psychological factors on student imagination as one main characteristic of creative behavior. A survey (N=891) was administered at nine universities across different regions of Taiwan. The hypothesis of the study—that the variable of intrinsic motivation mediates the effects of personality/psychological variables and both types of imagination—was partially supported. The structural model also showed that most personality traits had direct effects on imagination, while most psychological variables had indirect effects. In addition, the trait of openness was identified as the most influential variable on both types of imagination, while conscientiousness had a distinctive role in evoking reproductive imagination. Furthermore, this study also sheds light on the variables of inspiration through action and self-efficacy which can greatly trigger student imagination.

Sertoli–Leydig cell tumors of the ovary: A Taiwanese Gynecologic Oncology Group study

ObjectiveTo report the natural history and prognosis of the uncommon Sertoli–Leydig cell tumor (SLCT) of the ovary. Materials and MethodsA 20-year retrospective review was conducted by the Taiwanese Gynecologic Oncology Group (TGOG), including nine tertiary medical centers from different regions in Taiwan. The medical records for 40 cases of ovarian SLCT were collected. Pathology reviews were carried out by a panel of expert pathologists. ResultsAfter pathological review, 17 patients were subsequently excluded because the pathology slides were unavailable in five cases, and discrepant results from the initial diagnosis were found in 12 cases (34%). For the remaining 23 patients, the median age was 41 years. The most common symptom was irregular vaginal bleeding followed by an abdominal mass or amenorrhea. Most of the tumors were unilateral and confined to the right ovary, with an average size of 8.2 cm. Preoperative serum markers were available for 12 patients and were elevated for three patients. All patients underwent primary surgery. Six patients accepted adjuvant chemotherapy, and bleomycin, etoposide, and cisplatin were used in four of them. Clinical follow-up information was available in 21 patients with a median of 19 months. Eighty-two percent of patients were alive and free of disease up to the date of the last follow-up. Two patients died of the disease. ConclusionThis study demonstrates the extreme rarity of ovarian SLCT in Taiwan. Histological discordance between the diagnosis and central review proves the need for expertise review before treatment. For an improved understanding of the biological behavior and treatment strategy for this unique tumor, international collaboration is imperative.

Molecular genetic diversity of the Saccharomyces yeasts in Taiwan: Saccharomyces arboricola, Saccharomyces cerevisiae and Saccharomyces kudriavzevii

Genetic hybridization, sequence and karyotypic analyses of natural Saccharomyces yeasts isolated in different regions of Taiwan revealed three biological species: Saccharomyces arboricola, Saccharomyces cerevisiae and Saccharomyces kudriavzevii. Intraspecies variability of the D1/D2 and ITS1 rDNA sequences was detected among S. cerevisiae and S. kudriavzevii isolates. According to molecular and genetic analyses, the cosmopolitan species S. cerevisiae and S. kudriavzevii contain local divergent populations in Taiwan, Malaysia and Japan. Six of the seven known Saccharomyces species are documented in East Asia: S. arboricola, S. bayanus, S. cerevisiae, S. kudriavzevii, S. mikatae, and S. paradoxus.

Polybrominated Diphenyl Ethers in Foodstuffs from Taiwan: Level and Human Dietary Exposure Assessment

Polybrominated diphenyl ethers (PBDEs) may contaminate food through bioconcentration and biomagnification. PBDEs often exist in the food chain and are consumed by humans. This study aims to determine the concentrations of PBDEs in food intake and to estimate the daily exposure of Taiwanese citizens to PBDEs. One hundred and eight food samples from nine types of commonly consumed foodstuffs were collected from northern, central, southern, and eastern regions of Taiwan. The samples were analyzed for PBDE level by gas chromatography mass spectrometry. Also, a daily dietary intake survey was conducted of 466 adults (153 men, 313 women) in these four regions of Taiwan. Taiwanese daily dietary intake of PBDE is calculated by means of food PBDEs level and daily dietary intake. The result of this study showed the highest concentration of ΣPBDE was found in butter (890.3±309.0pg/g wet weight), followed by egg and pork (553.0±185.0pg/g wet weight and 545.4±181.0pg/g wet weight). Deca-BDE was found the highest concentration among eight kinds PBDEs. The average daily intake of PBDEs for the 466 subjects was 67.95±23.01ng/day. There was a significant difference between the daily intake of ΣPBDE in different regions of Taiwan (p<0.05). The highest daily intake of ΣPBDE was in northern Taiwan, which is also the most urbanized area.

Use of Rubber Dams During Root Canal Treatment in Taiwan

Isolation of teeth with rubber dams is an important procedure for infection control in dentistry, especially in endodontic treatment. This study surveyed the prevalence of rubber dam usage in nonsurgical root canal treatment (RCT) by dentists under the National Health Insurance system in Taiwan. A total of 1,332 completed RCT cases were randomly selected from a large database from the Bureau of National Health Insurance in Taiwan in 2004. The radiographs and dental charts of the selected cases were evaluated for the prevalence of rubber dam usage in RCT. The frequencies of rubber dam usage for RCT by dentists were compared between hospitals and private dental clinics and among six different regions in Taiwan. The overall prevalence of rubber dam usage for RCT by dentists under the National Health Insurance system in Taiwan was 16.5%. The frequency of rubber dam usage for RCT by dentists in hospitals (32.8%) was significantly higher than that (10.3%) in private dental clinics (p < 0.0001). However, there was no significant difference in the frequency of rubber dam usage for RCT by dentists among six different geographic regions in Taiwan. The prevalence of rubber dam usage for RCT by dentists in Taiwan is relatively low. Because rubber dam isolation of an endodontically-treated tooth can provide better infection control, increase patient protection, and improve treatment efficiency, there is an urgent need to advise dentists in Taiwan to use rubber dams for every RCT case.

Is the development of a diabetes care system important for quality care? An analysis in Taiwan.

A good community‐based or hospital‐based program involving physicians and nurses is deemed useful for the management of chronic illnesses, such as diabetes, as this program would reduce health‐care costs, admission rates and emergency room visits1. Therefore, establishment of a health‐care system for the management of diabetes in a highly cost‐effective way is important from the viewpoint of public health. In 1990, the first government‐subsidized diabetes center with educators in Taiwan was founded at the National Taiwan University Hospital, wherein an integrated clinic for screening diabetic complications (retinopathy, microalbuminuria, peripheral neuropathy and ankle‐brachial index) was set up to monitor the outcomes of individuals with diabetes. Because of the increasing rate of diabetes prevalence and its associated chronic complications, the Department of Health commissioned the Diabetes Association of the Republic of China to help set up more diabetes centers in 1991, and 2 years later, the name was changed to Center for Health Promotion of Persons with Diabetes. As smaller units were set up in the regional hospitals and clinics, they were called Classroom for Health Promotion of Persons with Diabetes, and Clinic for Health Promotion of Persons with Diabetes, respectively. To date, 167 small and large units of Health Promotion of Persons with Diabetes have been set up with aid from the Taiwanese Association of Diabetes Educators (TADE), which was established in 1996 to train health professionals. The Bureau of National Health Insurance (BNHI) offers free Health Check‐Up for Adults every 3 years for persons aged over 40 years, and every year for persons aged over 65 years. To improve the quality of care for diabetic patients, a pilot program called Improvement Plan for Diabetes Medical Benefits was launched in November 2001. The pilot program was replaced by a formal program with introduction of a pay‐for‐performance (P4P)2 scheme in 2007. For the first time in the history of diabetes education in Taiwan, the program reimbursed the cost of patient education by a certified nurse and dietitian included in the case management fee, in addition to the usual physician’s fees and the medication fees. To be eligible for this program, the patients must undergo a baseline assessment, and an annual check‐up for a complete biochemical examination and screening for complications. The data of these assessments have to be uploaded to the BNHI website. To date, approximately 30% of diabetic patients in Taiwan have been covered by the improvement program.

THE DEVELOPMENT OF A COMPETENCE SCALE FOR LEARNING SCIENCE: INQUIRY AND COMMUNICATION

The objective of this study was to develop an instrument to measure school students’ competence in learning science as part of a large research project in Taiwan. The instrument consisted of 29 self-report, Likert-type items divided into 2 scales: Competence in Scientific Inquiry and Competence in Communication. The Competence in Scientific Inquiry scale contained 4 subscales: presenting questions and hypothesis, planning, experimenting and data gathering, and data analyzing, interpreting, and concluding. The Competence in Communication scale contained 4 subscales: expressing, evaluating, responding, and negotiating. Students were recruited randomly from primary, junior, and senior high schools in different regions of Taiwan to validate the instrument and establish its reliability and validity. The results of the analyses indicate that the instrument, scales, and subscales have reasonable internal consistency; that the theoretical structure was supported by empirical data; and that the subscales are homogeneous. These results indicate that it is an appropriate tool for measuring students’ competence in learning science. Implications and suggestions for further studies are included.

The Association Between Arsenic Exposure and Cerebrovascular Disease-A Study in the Blackfoot Disease Endemic Area in Taiwan

ISEE-0480 Background and Objective: Epidemiological studies have demonstrated that chronic arsenic exposure may cause various health effects, but previous studies on the association between arsenic exposure from drinking water and cerebrovascular diseases (CVD) in different regions in Taiwan yielded inconsistent results. The objective of this study is to evaluate the possible association between arsenic exposure and mortality of CVD in Taiwan with the data from the whole country, trying to solve the problem with a more complete database. Methods: We analyzed the national death registry data of Taiwan from 1971 to 2005. Two areas were defined as the exposed group: one is the blackfoot disease (BFD) endemic area, and the other is the Lan-Yang Basin (LYB) area. The arsenic levels in the drinking water in the BFD area were generally higher than those in the LYB area. Standardized mortality ratios (SMRs) adjusted for gender and age were calculated using the whole population in Taiwan and the population in the Chiayi-Tainan area as the reference populations respectively. Results: The standardized mortality rate of CVD in Taiwan decreased from 2.46/103 in 1971 to 0.63/103 in 2005. Women had lower rates than men, with SMR = 0.80. The exposure group had higher SMRs of CVD in comparison with the reference populations, with SMRs from 1.06 to 1.09 in men and 1.12 to 1.14 in women. The BFD endemic area had higher mortality rates of CVD than the LYB area, with SMR = 1.05 in men and SMR = 1.04 in women. Conclusion: In Taiwan, women had lower mortality rates of CVD, and the rate has been constantly decreasing in both genders from 1971 to 2005. Exposure to arsenic in drinking water is associated with a higher risk of CVD.

Dissemination of transposon Tn6001 in carbapenem-non-susceptible and extensively drug-resistant Pseudomonas aeruginosa in Taiwan

ObjectivesTo investigate the prevalence of metallo-β-lactamases (MBLs) and Tn6001 in carbapenem-non-susceptible Pseudomonas aeruginosa (CNSPA). The CNSPA included extensively drug-resistant P. aeruginosa (XDRPA) and non-XDRPA isolates in Taiwan.MethodsA total of 308 CNSPA isolates collected at a medical centre from 2000 to 2005 and 26 XDRPA collected from six medical centres in different regions of Taiwan in 2003 were included. MBL genes and Tn6001 were detected by PCR. Clonal relatedness was determined by PFGE.ResultsOf the 308 CNSPA isolates, 30 (10%) were XDRPA, including 27 (9%) colistin-only-susceptible (COS) and 3 (1%) colistin-only-intermediate (COI) P. aeruginosa. blaVIM-3 was found in 16 (53%) isolates of the XDRPA (n = 30), whereas only 72 (26%) of the non-XDRPA (n = 278) carried the gene. In450 was higher in COS P. aeruginosa (12/27; 44%) than in non-XDRPA isolates (53/278; 19%). Tn6001 was highest in COS P. aeruginosa (11/27; 41%), followed by COI P. aeruginosa (1/3; 33%), and lowest in non-XDRPA (46/278; 17%). Of 26 XDRPA from six medical centres, higher prevalences of blaVIM-3 (16/26; 62%), In450 (16/26; 62%) and Tn6001 (12/26; 46%) were found. Genotyping by PFGE revealed 60 pulsotypes. Hybridization of a blaVIM-3-specific probe following PFGE suggested that the mobile element Tn6001 might have transferred horizontally.ConclusionsTn6001 and In450 play an important role in the dissemination of CNSPA and XDRPA. The prevalence of these genetic constituents was higher in XDRPA than in non-XDRPA isolates, suggesting that the mobile element Tn6001 might have transferred horizontally.

Strength and durability of concrete in hot spring environments

In this paper an experimental study of the influence of hot springs curing upon concrete properties was carried out. The primary variables of the investigation include water-to-binder ratio (W/B), pozzolanic material content and curing condition. Three types of hot springs, in the range 40-90oC, derived from different regions in Taiwan were adopted for laboratory testing of concrete curing. In addition, to compare with the laboratory results, compressive strength and durability of practical concrete were conducted in a tunnel construction site. The experimental results indicate that when concrete comprising pozzolanic materials was cured by a hot spring with high temperature, its compressive strength increased rapidly in the early ages due to high temperature and chloride ions. In the later ages, the trend of strength development decreased obviously and the strength was even lower than that of the standard cured one. The results of durability test show that concrete containing 30-40% Portland cement replacement by pozzolanic materials and with W/B lower than 0.5 was cured in a hot spring environment, then it had sufficient durability to prevent steel corrosion. Similar to the laboratory results, the cast-inplace concrete in a hot spring had a compressive strength growing rapidly at the earlier age and slowly at the later age. The results of electric resistance and permeability tests also show that concrete in a hot spring had higher durability than those cured in air. In addition, there was no neutralization reaction being observed after the 360-day neutralization test. This study demonstrates that the concrete with enough compressive strength and durability is suitable for the cast-in-place structure being used in hot spring areas.

PCR amplification and sequence analysis of the major capsid protein gene of megalocytiviruses isolated in Taiwan

Viruses belonging to the genus Megalocytivirus in the family Iridoviridae are one of the major agents causing mass mortalities in marine and freshwater fish in Asian countries. Outbreaks of iridovirus disease have been reported among various fish species in Taiwan. However, the genotypes of these iridoviruses have not yet been determined. In this study, seven megalocytivirus isolates from four fish species: king grouper, Epinephelus lanceolatus (Bloch), barramundi perch, Lates calcarifer (Bloch), silver sea bream, Rhabdosargus sarba (Forsskal), and common ponyfish, Leiognathus equulus (Forsskal), cultured in three different regions of Taiwan were collected. The full open reading frame encoding the viral major capsid protein gene was amplified using PCR. The PCR products of approximately 1581 bp were cloned and the nucleotide sequences were phylogenetically analysed. Results showed that all seven PCR products contained a unique open reading frame with 1362 nucleotides and encoded a structural protein with 453 amino acids. Even though the nucleotide sequences were not identical, these seven megalocytiviruses were classified into one cluster and showed very high homology with red sea bream iridovirus (RSIV) with more than 97% identity. Thus, the seven iridovirus strains isolated from cultured marine fish in Taiwan were closer to the RSIV genotype than the infectious spleen and kidney necrosis virus genotype.

Dissemination of multidrug-resistant, class 1 integron-carrying Acinetobacter baumannii isolates in Taiwan

In this study, 283 multidrug-resistant Acinetobacter baumannii (MDR-AB) bloodstream isolates were collected between 1996 and 2004, from three teaching hospitals located in different regions of Taiwan. Susceptibility data showed that strains carrying class 1 integrons were significantly more resistant (p <0.01) to all tested antibiotics (except aztreonam and chloramphenicol) than strains lacking integrons, Seven types of gene cassette were identified among these strains, including two that have not been previously reported. The vast majority of the cassettes encoded aminoglycoside resistance genes, including aacA4, aacC1, aac(6')-II, aadA1, aadA2, aadA4 and aadDA1. Sixteen distinct ribotypes were identified in MDR-AB isolates carrying class 1 integrons. Only one strain was found to produce an extended-spectrum beta-lactamase, i.e. VEB-3. In the 18 imipenem-resistant strains, two carbapenenmase genes, bla(VIM-11) and bla(OXA-58), were found concomitantly in one isolate. An island-wide epidemic clone and an endemic clone from a hospital located in the northern region were identified by ribotyping. On the basis of the susceptibility data among the different ribogroups, the epidemic clone was associated more significantly with resistance to cefepime and ampicillin-sulbactam than was the endemic clone. In conclusion, the presence of class 1 integrons was significantly associated with resistance in MDR-AB, and the epidemic, class 1 integron-carrying MDR-AB clone was found to be widespread in Taiwan.

Human Tuberculosis Caused byMycobacterium bovis, Taiwan

To the Editor: Mycobacterium bovis is one of the causative agents of tuberculosis (TB) in humans and animals. Drinking unpasteurized milk, eating undercooked meat, and close contact with infected animals are the main sources of infection for humans. Currently, 119 M. bovis spoligotypes are contained in the fourth international spoligotyping database (SpolDB 4) and are categorized into 3 main sublineages corresponding to ST prototypes 482, 683, and 479 (1). Although an M. bovis surveillance program for farm animals has been implemented by the Taiwan Council of Agriculture, no surveillance system exists for human TB cases caused by M. bovis. To monitor the epidemiology of M. bovis in domestic animals, a regular tuberculin skin test (TST) is compulsory for cattle and sheep and optional for deer in Taiwan (2). In 2005, screening of Mycobacterium spp. infections by TST was performed for 111,412 cattle and 73,396 caprint and ovine herds, of which 188 (0.17%) and 148 (0.2%), respectively, were positive (2). We used spacer oligonucleotide typing (spoligotyping) and mycobacterial interspersed repetitive units–variable number tandem repeat (MIRU-VNTR) methods to investigate human TB caused by M. bovis in Taiwan. During 2004–2005, a total of 3,321 mycobacteria isolates from individual patients were sent to the reference laboratory for strain typing. Of the 3,321 patients, 2,427 (73.1%) were male, 903 (27.2%) were from eastern Taiwan, and 513 (15.4%) were aboriginal persons. The mean age of the patients was 58.7 years: 224 (6.7%) were 65 years of age. Isolates were screened by using a GenoType kit (3) and multiplex PCR (4). To differentiate between M. bovis and M. bovis BCG strains, presence or absence of region of difference 1 was analyzed (5). Spoligotyping was performed with a commercial kit (Isogen Bioscience BV, Maarssen, the Netherlands) following the manufacturer’s instructions (6). Spoligotyping profiles were analyzed by using Bionumerics software, version 4.51 (Applied Maths, Kortijk, Belgium). The resolved spoligotype was designated by comparing it to SpolDB4 (1). The MIRU-VNTR assay was performed by using a modified, high-throughput, 15-loci MIRU typing system that we developed (7). Of the 3,321 patient isolates, 3,306 (99.5%) were M. tuberculosis and only 15 (0.5%) were M. bovis. Mean age of the 15 M. bovis–infected patients was 62.2 years (Table). Twelve (80%) patients were male, and 3 (20%) were female. Of these 15 patients, 10 (66.7%) had newly diagnosed TB and 5 (33.3%) had been treated with anti-TB drugs. Most (11/15, 73%) of the patients were from eastern Taiwan, where the reporting rate for TB was highest among the 4 regions of Taiwan; 60% (9/15) were aboriginal persons. Of the 15 patients, 13 (86.7%) had pulmonary TB, 1 had both pulmonary and extrapulmonary TB, and 1 had extrapulmonary TB. Only 2 patients (cases 2 and 3) had known contact with farm animals. Univariate analysis showed that region (eastern region 1.2% vs. other region 0.2%; odds ratio [OR] 7.4, 95% confidence interval [CI] (2.4–23.4) and ethnicity (aboriginal 1.8% vs. nonaboriginal 0.2%; OR 8.3, 95% CI 3.0–23.5) were associated with M. bovis infection but not age and sex. The association between region and M. bovis disappeared after controlling for age and ethnicity. Aboriginal ethnicity was the only factor significantly associated with TB caused by M. bovis after controlling for age (adjusted OR 12.7, 95% CI 4.2–38.9). Table Characteristics of 15 patients with tuberculosis caused by Mycobacterium bovis, Taiwan, 2004–2005 Spoligotyping profiles of the 15 M. bovis isolates were typical of M. bovis with the absence of spacers 3, 6, 9, 16, 21, and 39–43 (8). Although 15 cases were reported separately from different regions of Taiwan, only 1 spoligotyping profile was identical to spoligotype ST 684 of the bovis sublineage. In addition, we identified 2 similar MIRU-VNTR profiles: 523–23232–42533–22 (13/14, 92.9%, cases 1–9, 11–13, and 15) and 523–22232–42523–22 (1/14, 7.1%, case 14). We were unable to obtain sufficient DNA from 1 strain (case 10) for MIRU-VNTR typing. Aboriginal persons in Taiwan were more likely to have TB caused by M. bovis and had a 5-fold higher reporting rate for TB (9) than nonaboriginal persons. Environmental and genetic factors may be associated with a higher reporting rate for TB among aboriginal populations (10), but the contribution of M. bovis infection needs to be investigated. Because only 1 major spoligotype and 2 similar MIRU patterns were found in this case series, spread of a predominant clone in Taiwan is likely. In addition, because of insufficient epidemiologic data, we were unable to determine the proportion of cases caused by reactivation of latent infection and those caused by recent transmission. In our study population, M. bovis infection in humans appeared to be predominately indigenous in Taiwan because no imported case was noted. We are now genotyping M. bovis strains isolated from farm animals to help elucidate the source of infection and transmission of M. bovis in Taiwan.

Institution Type-Dependent High Prevalence of Dementia in Long-Term Care Units

Background/Aims: It is estimated that there are 90,000 patients with dementia in the 23 million habitants of Taiwan, with a few institutions specialized in dementia care. To assess the need of institutional care for dementia, we investigated the institution prevalence of dementia. Methods: We performed stratified randomized sampling of elder residents from different types of institutions in different regions of Taiwan. A 2-stage survey with screening and clinical confirmation was carried out in 2004. Results: In total, 1,525 residents aged 65 years and over in 60 institutions participated in the study in which 1,308 elders completed the 2-stage survey. Among these, 631 elders were diagnosed as having dementia. The dementia prevalence was 26.8% in the residential houses, 61.8% in the assisted living facilities and 64.5% in the nursing homes. Vascular dementia was the leading cause of dementia in the institutions. Old age, diabetes mellitus and family history of dementia increased risks for both Alzheimer’s disease and vascular dementia. Conclusion: The investigation showed that the prevalence of dementia in the long-term care units of Taiwan was much higher than those from community studies and the high prevalence in the institutions depended on the type of the long-term care unit.

P1344 Multidrug-resistant Acinetobacter baumannii susceptible only to colistin outbreak in a cardiac surgical intensive care unit

In this study, 283 multidrug-resistant Acinetobacter baumannii (MDR-AB) bloodstream isolates were collected between 1996 and 2004, from three teaching hospitals located in different regions of Taiwan. Susceptibility data showed that strains carrying class 1 integrons were significantly more resistant (p <0.01) to all tested antibiotics (except aztreonam and chloramphenicol) than strains lacking integrons, Seven types of gene cassette were identified among these strains, including two that have not been previously reported. The vast majority of the cassettes encoded aminoglycoside resistance genes, including aacA4, aacC1, aac(6′)-II, aadA1, aadA2, aadA4 and aadDA1. Sixteen distinct ribotypes were identified in MDR-AB isolates carrying class 1 integrons. Only one strain was found to produce an extended-spectrum β-lactamase, i.e. VEB-3. In the 18 imipenem-resistant strains, two carbapenenmase genes, blaVIM-11 and blaOXA-58, were found concomitantly in one isolate. An island-wide epidemic clone and an endemic clone from a hospital located in the northern region were identified by ribotyping. On the basis of the susceptibility data among the different ribogroups, the epidemic clone was associated more significantly with resistance to cefepime and ampicillin–sulbactam than was the endemic clone. In conclusion, the presence of class 1 integrons was significantly associated with resistance in MDR-AB, and the epidemic, class 1 integron-carrying MDR-AB clone was found to be widespread in Taiwan.

Gravity Terrain Effect of the Seafloor Topography in Taiwan

Gravity terrain correction is used to compensate for the gravitational effects of the topography residual to the Bouguer plate. The seafloor topography off the eastern offshore of Taiwan is extremely rugged, and the depth of the sea bottom could be greater than 5000 m. In order to evaluate the terrain effect caused by the seafloor topography, a modern computer algorithm is used to calculate the terrain correction based on the digital elevation model (DEM). Based on the results of this study, the terrain effect caused by the seafloor topography makes a significant contribution to the total terrain effect in every region of Taiwan. In the southern coastal area of Taiwan, the terrain effect caused by the seafloor topography is approximately six times that caused by land topography. Therefore, the terrain effect caused by the seafloor topography cannot be neglected in the reduction of gravity data measured on land. The terrain correction should be calculated from the DEM of both land topography and bathymetry. The optimum correction distance for different regions in Taiwan is different. In eastern and southern Taiwan, the proper correction distance is 300 km, while in western and central Taiwan, it is 100 and 200 km, respectively. The accuracy of terrain correction over the rugged topography of Taiwan can be improved by compensating for the gravitational effect caused by the seafloor topography. The complete Bouguer gravity map of eastern Taiwan is reproduced based on the total terrain correction introduced in this paper. The lineation of the gravity anomaly coincides with the known fault traces and provides the possible position of extension in those areas that are difficult to trace on the surface. In this paper, the southern extension of the Chihshang fault is well delineated in the vicinity of Luye from the gravity anomaly map and confirmed by a ground resistivity survey.