Kaohsiung Research Articles

Do meteorological variables impact air quality differently across urbanization gradients? A case study of Kaohsiung, Taiwan, China.

Air pollution has become a major challenge to global urban sustainable development, necessitating urgent solutions. Meteorological variables are key determinants of air quality; however, research on their impact across different urban gradients remains limited, and their mechanisms are largely unexplored. This study investigates the dynamic effects of meteorological variables on air quality under varying levels of urbanization using Kaohsiung City, Taiwan, as a case study. Meteorological and air pollutant data from monitoring stations in Kaohsiung, Taiwan, for the year 2023 were collected and analyzed. The Air Quality Index (AQI) was used to quantify air quality levels, and Granger causality tests and Vector Autoregression (VAR) models were employed to analyze the dynamic relationships between meteorological variables and AQI. The results revealed that: (1) Suburban areas exhibited significantly better air quality than urban and near-urban areas, with annual AQI values of 59.58 in Meinong (outskirts), 67.86 in Renwu (suburbs area), and 76.73 in Qianjin (urban area), showing a progressive improvement in air quality from urban to suburban areas, primarily due to lower levels of urbanization and abundant forest resources; (2) Temperature and relative humidity emerged as key meteorological variables influencing AQI, with Granger causality tests indicating that temperature significantly affects AQI, especially in urban areas. Impulse response analysis revealed that temperature had a notable positive and negative correlation effect on AQI over lagged periods, while wind speed showed a negative correlation with AQI in suburban areas, gradually shifting to a positive correlation over time; (3) Variance decomposition indicated that temperature had the largest impact on AQI in urban areas, particularly with cumulative lag effects, while wind speed was the main variables influencing air quality in suburban areas. This study provides scientific evidence for future urban planning and environmental management, supporting the development of more effective air quality improvement strategies to promote sustainable urban development.

Influences of service, reference groups and framing effects on the intentions of short-term rental users

ABSTRACT This study examines the influences of short-term rental services, reference groups, and information framing effects on consumers’ intentions to rent short-term rental properties. This study used a behavioural economics approach to analyze consumers’ intentions towards renting short-term rental properties. Using the concepts of reference groups and framing effects in addition to the three factors of location, price, and short-term rental services, this study proposes a conceptual framework model. Structural equation modelling was used for the parameter estimation. The study area included Kaohsiung City and Pingtung County. A total of 314 questionnaires were administered, from which 305 valid responses were obtained, indicating an effective response rate of 97.10%. The empirical results reveal that short-term rental services, reference groups, and framing effects had no direct significant influences on rental intentions. However, the three variables had indirect influences on rental intentions through the full mediator variable of attitudes. These findings highlight the importance of rental services, reference groups, and framing effects in analyzing consumers’ intentions towards short-term rental services.

Manifestation of Adult children of patients having Alzheimer’s dementia

AbstractBackgroundIndividuals with his parents having Alzheimer’s dementia (AD) have a 4 to 10 times higher risk of developing AD compared to those without family history. The increasing risks of developing AD may result from several underlying mechanisms to be clarified for further strategies of management. We are going to report the demographic and biological characteristics of adult children (AC) of AD parents cohort with its clinical significances in Taiwan.MethodAC of AD patients age from 50‐79 years old were recruited from the neurological outpatient department of Kaohsiung Municipal Ta‐Tung Hospital, Taiwan. The paired individuals, adult children with his/her parents were received annual following up in clinical, neuropsychological, and neuroimaging including PET/CT with 18F‐Florbetaben (FBB) imaging session, using DiscoveryTM MI DR PET/CT system (General Electric Medical Systems, Waukesha, Wisconsin, USA) examinations and assays of blood for genetic and protein analyses. This study was approved by Kaohsiung Medical University Hospital Institutional Review Board. Written informed consent was obtained from all participants before including in this study.Result63 AC with age 59.3 ± 5.8 years, female predominant (76.2%), baseline MMSE 28.3 ± 1.8, CASI 94.7 ± 3.4, and having at least one of APOE e4 allele 34.9%, have recruited. 19 voluntary participants (25.4%) completed 18F‐FBB PET. 9 of 19 (47.4%) were classified as amyloid‐positive based on visual assessment, rated by a senior board‐certificated nuclear medicine physician with experience in interpretation of 18F‐FBB PET who evaluated all images according to the guideline of 18F‐FBB PET interpretation, blind to all clinical information.ConclusionAC of AD patients have higher proportion of having APOE4 allele and higher proportion of having amyloid PET (+). It may imply AC does increase the risk of developing AD, and AC with amyloid PET (+) could be preclinical AD.

Effects of Media Literacy Intervention on Weight-Control Products Digital Marketing Targeting Adolescents.

This study aimed to evaluate the effects of a media literacy education intervention on adolescents' responses to digital marketing of weight-control products, focusing on media literacy, persuasion resistance efficacy, and purchase intention. Using a quasi-experimental design, the study involved 326 11th-grade students from a municipal high school in Kaohsiung City, Taiwan, with 189 students in the intervention group and 137 in the comparison group. Conducted in 2023, the intervention group participated in baseline and follow-up assessments and attended four 50 min media literacy sessions, while the comparison group completed only baseline and follow-up assessments with standard instruction. The results indicated that the media literacy intervention had positive effects on adolescents' conceptual, attitudinal, and critical media literacy, as well as their persuasion resistance efficacy in relation to digital marketing of weight-control products. However, no significant effect was observed on purchase intention. In conclusion, media literacy interventions can effectively enhance adolescents' media literacy and their ability to resist persuasion.

The Practice of Gifted Education in Rural Areas: A Case Study of Kaohsiung City’s Cross-School Blended Teaching Program

The Practice of Gifted Education in Rural Areas: A Case Study of Kaohsiung City’s Cross-School Blended Teaching Program

The epidemiology and phylogenetic trends of Omicron subvariants from BA.5 to XBB.1 in Taiwan

BackgroundOmicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, entered Taiwan at the end of 2021. The Taiwanese government ended its "zero-COVID" policy in March 2022. Multiple coronavirus disease 2019 (COVID-19) outbreaks began in April 2022. We monitored the replacement of Omicron subvariants after BA.1/BA.2 and analyzed their correlation with COVID-19 outbreaks. MethodsWe collected SARS-CoV-2 real-time qRTPCR-positive nasopharyngeal swabs from Kaohsiung Medical University Hospital (KMUH), Kaohsiung City, Taiwan, and performed sequencing for specimens exhibiting a cytopathic effect in Vero E6 cells to determine their clades and lineages. We analyzed the medical records of COVID-19 patients and identified hospitalization risk factor(s). We retrieved SARS-CoV-2 sequences identified in Taiwan from GISAID and analyzed their correlation with COVID-19 data from the Taiwan Centers for Disease Control. ResultsWe analyzed the phylogenesis of KMUH-47 to KMUH-104 (SARS-CoV-2 isolates identified herein) and all of the Omicron subvariants from BA.5 to XBB.1 (n = 1930). Age and comorbidities were hospitalization risk factors. Men generally exhibited a greater fatality rate than women. COVID-19-related deaths predominantly occurred in individuals over 70 years old. The COVID-19-related case fatality rate increased as nucleotide (NT) and amino acid (AA) substitutions increased. The number of COVID-19-related cases and deaths progressively decreased with each outbreak between August 2022 and October 2023. ConclusionHospitalization was associated with age and the presence of comorbidities. COVID-19-related fatality was linked to sex, age, and the accumulation of NT and AA substitutions in emerging Omicron subvariants.

A Study on the Spatial Layout of Newly Built Townhouses in Kaohsiung City

Due to their independent structure, piping, and access, townhouses offer great flexibility in floor plan changes and high spatial autonomy, making them the mainstream housing type in Taiwan. This study focuses on row houses and examines 2022 completion cases in Kaohsiung City. It collects floor plans from 14 newly constructed buildings, totaling 227 units, and analyzes spatial dimensions including the facade width, depth, habitable room, staircases, bathrooms, and total floor area for each case. The objective of this study is to examine the spatial layout of row houses in Kaohsiung City, with the aim of providing a reference for the future planning and design of such structures. The study results showed that 81.8% of the row houses analyzed have a total floor area per unit ranging from 136 to 192 m2, a facade width between 4.1 and 6.38 m, and a building depth from 7.67 to 12.68 m. In addition, they showed a low negative correlation between the facade width and total floor area, a high positive correlation between the building depth and total floor area, and a moderate negative correlation between the facade width and building depth. The spatial distribution within these houses includes 78% allocated to habitable room, 13.1% to staircases, and 8.7% to bathrooms. The total area of habitable rooms and bathrooms increases with the total floor area of the building. However, the total area of staircases remains almost constant as the area of habitable rooms increases. Furthermore, the most common location for staircase planning is the rear-right (RB) position, while the least common is the rear-left (LB) position. Among various staircase types, the C-shaped staircase has the largest average area per floor and the highest average proportion. Conversely, the I-shaped staircase has the smallest average area and the lowest average proportion. The U-shaped staircase is the most frequently planned, whereas the C-shaped staircase is the least frequently used. This means that planning of staircase location and type significantly affects the size and layout of habitable rooms and bathrooms in townhouses.

Cerebrospinal Fluid Lactate Levels as a Prognostic Indicator in Patients With Cryptococcal Meningitis Who Are HIV Negative: A Retrospective Cohort Study.

Cryptococcal meningitis (CM) is a severe central nervous system infection. In patients with HIV infections and coexisting CM, elevated baseline cerebrospinal fluid (CSF) lactate levels can predict increased mortality. However, the CSF lactate level's significance in patients with CM who are HIV negative remains unclear, necessitating further investigation to elucidate the potential distinctions and enhance patient management. This study investigated the significance of CSF lactate levels in patients with CM who were HIV negative. This retrospective study utilized data from the clinical databases of patients who underwent lumbar punctures at a medical center in Kaohsiung City, southern Taiwan. Demographic data, CSF lactate levels, routine CSF analyses, and hematologic and neurologic findings were evaluated. The optimal CSF lactate threshold value was determined by the Youden index. This retrospective study included 70 patients with CM, among whom 44 (63%) and 26 (37%) tested negative and positive for HIV, respectively. The group without HIV exhibited higher CSF lactate levels, with an optimal CSF lactate cutoff point of 7.935 mmol/L for predicting 90-day mortality, resulting in significant predictive accuracies (area under the curve, 0.755; sensitivity, 57.1%; specificity, 100%); this value was an independent mortality predictor in patients who were HIV negative. In patients with CM who were HIV negative, CSF lactate levels ≥7.935 mmol/L correlated with higher mortality rates but without statistical significance. All patients with CM who were HIV negative and had CSF lactate levels ≥7.935 mmol/L died within 3 months of admission. Patients with CM who were HIV negative had elevated CSF lactate levels that correlated with adverse outcomes, enabling early identification of high-risk individuals.

Complete genome sequence of aquaculture pond isolate, Bacillus velezensis M4019.

Bacillus velezensis is commonly found in soil and has various antibacterial activities against animal and plant pathogens. Here, we present the complete genome sequence of Bacillus velezensis strain M4019, isolated from a euryhaline aquaculture pond water in Yong-An, Kaohsiung City, Taiwan. This pond-water-derived isolate, unlike common soil-derived isolates, may provide potentially different adaptations and antimicrobial cues for future research.

Laparoscopic training workshop to assess medical students’ skill acquisition and interest in surgical careers

BackgroundWith its minimally invasive approach, laparoscopic surgery has transformed the medical landscape. As the demand for these procedures escalates, there is a pressing need for adept surgeons trained in laparoscopic techniques. However, current training often falls short of catering to medical school education. This study evaluates the impact of a custom-designed laparoscopic training workshop on medical students’ surgical skills and career aspirations.MethodsThis prospective experimental study was conducted at the E-Da hospital in Kaohsiung City, Taiwan. Medical students from Taiwanese medical schools undergoing Clerk 5, Clerk 6, and Postgraduate Year 1 and 2 were invited to participate. Medical students (n = 44) underwent an endoscopic skill training workshop consisting of lectures, box training, and live tissue training. The trainees performed multiple tasks before and after training using our objective evaluation system. The primary outcome was assessed before and after training through a questionnaire assessing the influence of training on students’ interest in surgery as a career. The secondary outcome measured improvement in skill acquisition, comparing the task completion time pre- and post-workshop. For the primary outcome, descriptive statistics were used to summarize the questionnaire responses, and paired t-tests were performed to determine significant changes in interest levels post-workshop. For the secondary outcome, paired t-tests were used to compare the time recorded pre- and post-training.ResultsPost-training, participants exhibited significant proficiency gains, with task completion times reducing notably: 97 s (p = 0.0015) for Precision Beads Placement, 88.5 s (p < 0.0001) for Beads Transfer Exercise, 95 s (p < 0.0001) for Precision Balloon Cutting, and 137.8 s (p < 0.0001) for Intracorporeal Suture. The primary outcome showcased an increased mean score from 8.15 pre-workshop to 9.3 post-workshop, indicating a bolstered interest in surgery as a career. Additionally, post-training sentiment analysis underscored a predominant inclination toward surgery among 88% of participants.ConclusionThe custom-designed laparoscopic workshop significantly improved technical skills and positively influenced students’ career aspirations toward surgery. Such hands-on training workshops can play a crucial role in medical education, bridging the gap between theoretical knowledge and practical skills and potentially shaping the future of budding medical professionals.

Rapid Built-up of PM10 in the Ambient Air of the Leeward Side Resulting from Strong Pressure Gradient Force Associated with Density Current

Meteorological factors can result in air pollution. Some studies have indicated that the leeward side effect’s weak flow and subsidence play major roles in inducing high PM10 (particulate matter with a diameter of ≤ 10 µm) in southern Taiwan during winter due to topographic blocking. However, the results of this research showed that the rapid build-up of high PM10 in Kaohsiung city (KHC) during evenings is not completely explained by weak flow and subsidence. In northern Taiwan, topographic blocking on northwesterly enhances a significant pressure gradient force (PGF) induced strong winds. According to the Froude number (above 0.5), the flow in northern Taiwan can pass the terrain, producing subsidence warming in central Taiwan, which is located at the leeward side of the northeastern Central Mountain Range (CMR). In addition, strong winds blew river dusts in the middle of Taiwan under a stable atmosphere and stimulated density current, transporting PM10 to southern Taiwan. A large horizontal pressure gradient was still formed in central western Taiwan between the cold flow originating from northern Taiwan and the warm flow by subsidence warming. The strong PGF and the interaction between the flow and the terrain in northern Taiwan should favor the density current. After PM10 was transported into KHC efficiently in a short time by the density current, the local effect of weak rear flow and subsidence in KHC enhanced and maintained PM even more than it did in central Taiwan.

Establishment and analysis of online energy baseline for water purification plants: A case study in Kaohsiung city, Taiwan

Water and energy are closely linked and are crucial for national security and economic development. Most water providers prioritise the stability of water supply and aim to reduce energy consumption under the premise of a stable supply. The average energy required to supply water in Taiwan in one of the lowest worldwide. In the Kaohsiung area, the average energy used by a water purification plant to provide 1 m3 of water is 0.32 kWh/m3, lower than the world average of 0.37 kWh/m3. However, the most energy-consuming plant (Weng Park water purification plant) uses eight times as much energy as the least energy-consuming plant (Pingding water purification plant). Most studies focus on the energy required to provide 1 m3 of water. This study combined attributes of four plants, such as the amount of energy consumed, quantity of water supplied, purified, and collected, and weather data. These data were used to model energy baselines for water providers. Artificial intelligence was imported into Microsoft Azure machine learning to train the model, which was verified using another Kaohsiung plant and one overseas to establish an online energy baseline modelling system that can be applied in various water purification plants.

Field study on the integration of a hydrogen-producing microbiome in restoring Phellinus noxius-affected rhizosphere

At National Kaohsiung University of Science and Technology (NKUST), a mesophilic anaerobic bioreactor system produces a hydrogen-producing microbiome (HMb) containing beneficial bacteria such as Bacillus sp. This HMb, known for degrading cellulose and remediating soil, is being tested in Kaohsiung City, Taiwan, to treat tree root rot caused by Phellinus noxius (P. noxius). The study aims to evaluate HMb's effectiveness in restoring the rhizosphere, enhancing soil health, and increasing tree resistance by assessing soil bioactivity and microbial diversity.Field experiments showed that HMb treatment improved tree health by 24 % at the highest health level but reduced it by 20 % at the next level. Post-treatment soil organic matter (SOM) and total Kjeldahl nitrogen (TKN) levels remained stable, indicating minimal impact on soil fertility. HMb also lowered soil pH in some plots, potentially suppressing pathogens and enhancing nutrient absorption. The study found that HMb increased microbial diversity in the rhizosphere, particularly Acidobacteria and Proteobacteria, which inhibited fungal growth. However, HMb had no significant impact on P. noxius populations. Overall, HMb treatment shows promise in enhancing plant health by improving microbial diversity and soil conditions, but further research is needed to understand its full impact on pathogen suppression and soil health restoration.

Evaluating the Influence of Sustainable Urban Disaster Prevention Planning Satisfaction on Residents’ Living Willingness: A Structural Equation Modeling Approach in Kaohsiung City

Rapid urban development and increasing climate-related challenges underscore the need for effective urban disaster mitigation strategies. This study, conducted in Kaohsiung City, Taiwan, uses a Structural Equation Model to assess how satisfaction with urban disaster prevention planning influences residents’ intentions to stay there. We found that satisfaction with sustainable urban disaster prevention increases residents’ willingness to remain and acts as a key mediator between satisfaction with public facilities and residential intentions. The methodology provides practical insights for urban planners and policymakers, highlighting that improving public facilities and effective disaster planning significantly strengthens residents’ attachment to urban environments. These findings suggest a pragmatic way to enhance urban sustainability and resilience by incorporating disaster preparedness into urban development plans.

Relationship between transformational leadership, work engagement, and organisational citizenship behaviour: the moderating effect of work engagement

ABSTRACT We explored the relationship between teachers’ perceptions of transformational leadership and organisational citizenship behaviour (OCB) in Taiwan’s six-year high schools and whether work engagement moderated the relationship between the principal’s transformational leadership and teachers’ OCB. A total of 310 valid questionnaires were collected from teachers in Kaohsiung City, Taiwan. The six-year high school teachers’ perceptions of principals’ transformational leadership and work engagement were at the upper-middle level, with the sub-dimensions “inspiration and encouragement”, “focus”, and “dedication” ranking the highest. Their OCB was high and the sub-dimension, “active and helping behaviour”, ranked the highest. They felt that the principal’s transformational leadership, work engagement, and teachers’ OCB had a significant positive relationship and explanatory power. Their work engagement positively moderated principals’ transformational leadership and OCB. If the principal focused on transformational leadership and matched teachers with higher degrees of work engagement, a higher OCB of teachers would appear.

On the Reconstruction of Old Buildings in Kaohsiung City, Taiwan

On the Reconstruction of Old Buildings in Kaohsiung City, Taiwan

Epidemiology of Murine Typhus in Taiwan from 2013 to 2020.

Murine typhus is a flea-borne disease caused by Rickettsia typhi infection. The disease is a notifiable infectious disease in Taiwan. Specimens from suspected cases are required to be sent to the Taiwan Centers for Disease Control and Prevention for laboratory diagnosis. In this study, 204 cases of murine typhus were identified by bacterial isolation, real-time polymerase chain reaction, or indirect immunofluorescence assay between 2013 and 2020. The average incidence rate was 0.11/100,000 person-years (95% CI: 0.08-0.13). Murine typhus occurred throughout the year, but it was most prevalent in summer (May to August). The majority of patients were males (75%), residents of Kaohsiung city (31%), and worked in agriculture, forestry, fishing, and animal husbandry (27%). Fever was the most common symptom, present in 95.6% of patients, followed by headache (41%), myalgia (33%), and liver dysfunction (33%). Only 13% of patients had a rash. Up to 80% of cases were among hospitalized patients, and 43% of patients developed severe manifestations. Serological assays also indicated coinfection events. Seven patients showed a 4-fold increase in antibody titers against Orientia tsutsugamushi (N = 2), Coxiella burnetii (n = 2), and Leptospira (N = 3). In conclusion, murine typhus is an endemic and important zoonotic rickettsial disease in Taiwan that cannot be ignored. Further epidemiological surveillance and clinical characteristics should be continuously investigated to prevent and control murine typhus.

Increased di-(2-ethylhexyl) phthalate exposure poses a differential risk for adult asthma clusters

BackgroundDEHP, a common plasticizer known for its hormone-disrupting properties, has been associated with asthma. However, a significant proportion of adult asthma cases are “non-atopic”, lacking a clear etiology.MethodsIn a case-control study conducted between 2011 and 2015, 365 individuals with current asthma and 235 healthy controls from Kaohsiung City were enrolled. The control group comprised individuals without asthma, Type 2 Diabetes Mellitus (T2DM), hypertension, or other respiratory/allergic conditions. The study leveraged asthma clusters (Clusters A to F) established in a prior investigation. Analysis involved the examination of urinary DEHP metabolites (MEHP and MEHHP), along with the assessment of oxidative stress, sphingolipid metabolites, and inflammatory biomarkers. Statistical analyses encompassed Spearman’s rank correlation coefficients, multiple logistic regression, and multinomial logistic regression.ResultsAsthma clusters (E, D, C, F, A) exhibited significantly higher ORs of MEHHP exposures compared to the control group. When considering asthma-related comorbidities (T2DM, hypertension, or both), patients without comorbidities demonstrated significantly higher ORs of the sum of primary and secondary metabolites (MEHP + MEHHP) and MEHHP compared to those with asthma comorbidities. A consistent positive correlation between urinary HEL and DEHP metabolites was observed, but a consistent negative correlation between DEHP metabolites and selected cytokines was identified.ConclusionThe current study reveals a heightened risk of MEHHP and MEHP + MEHHP exposure in specific asthma subgroups, emphasizing its complex relationship with asthma. The observed negative correlation with cytokines suggests a new avenue for research, warranting robust evidence from epidemiological and animal studies.

Application of cohesive soil flow limit and slope critical flow angle

To investigate the relationship between moisture content in cohesive soils during spontaneous liquefaction and their corresponding critical slope failure angles. This study modified the liquid limit test apparatus originally developed by A. Atterberg in 1911, adapting it into a liquid-flow limit test apparatus. On-site soils from three actual cases of slope failures in Xiaolin Village, Jiasian District, Kaohsiung City, as well as soils from slope failures along the banks of Meilong River and Zengwun River were used for experiments involving different soil moisture content and slope failure angles. Based on the experimental findings, the moisture content which cohesive soils undergo spontaneous liquefaction was designated as the Flow Limit (FL), corresponding to the downslope angle at which circular failure occurs. This value represents the critical sliding angle at which spontaneous liquefaction occurs as a results of soil saturation. It also represents the maximum slope angle for exposed mudrock or clay slopes, and establishes the critical slope angle for vegetated slopes. Beyond this critical FL angle, all vegetation is susceptible to loss due to soil liquefaction. Furthermore, this study conducted FL tests on soils from thirteen tree holes in Kaohsiung City, two mountain slopes in Fengshan District, and the silty clay responsible for property damage and injuries during a landslide in Yanchao District on September 29, 2016, as a means of validation. The consistent test results observed reaffirm that different soils exhibit similar spontaneous liquefaction angles and flow limit behavior. These FL test results demonstrate a consistent pattern, reinforcing the notion of distinct curve characteristics that can be replicated across diverse soil compositions.

Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma: The Effectiveness of Different Particle Sizes in Downstaging and Bridging in Living Donor Liver Transplantation

To compare the effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) with different particle sizes in bridging and downstaging in pretransplant hepatocellular carcinoma patients. Assess the recurrent and survival rates after living donor liver transplantation (LDLT). Retrospective review of 580 patients who underwent TACE using DEB from August 2012 to June 2020 at Taiwan Kaohsiung Chang Gung Memorial Hospital. Pre- and post-TACE computed tomography scan images of the liver were reviewed, and treatment responses were assessed using modified Response Evaluation Criteria in Solid Tumors criteria. Patients were divided by who met the criteria (n = 342) or beyond (n = 238) the University of California San Francisco criteria for successful bridging and downstaging rate evaluation. Each group was divided into subgroups according to DEB particle sizes (group A: <100μm, group B: 100-300 μm, group C: 300-500 μm, and group D: 500-700 μm) to compare objective response rate and post-LDLT survival rate. Overall successful bridging and downstaging rate is 97.1% and 58.4%, respectively, in the group of patients who meet the criteria (n = 332) and are beyond (n = 139) the University of California San Francisco criteria. Group B (100-300 μm) had a higher successful bridging rate (99.5%, P = .003) and downstaging rate (63.8%, P = .443). This subgroup also demonstrated a higher objective response rate in single (93.2%, P = .038) tumors, multiple (83.3%, P = .001) tumors, and tumors with size less than 5 cm (93.9%, P = .005). There are no significant differences in post-LDLT overall survival rate between different particle sizes. TACE with 100 to 300 μm DEB particles is associated with a better chance of bridging and downstaging hepatocellular carcinoma patients to LDLT.