Northern Part Of Taiwan Research Articles

Linking Taiwan to the Cathaysia Block during the Cenozoic: Evidence from Pb isotopes in detrital K-feldspar

The Cenozoic sedimentary rocks on the island of Taiwan hold significant implications for understanding tectonic and drainage evolutions in SE China, but the provenance of these rocks remains controversial. Here we derived Pb isotopes in detrital K-feldspars from the drainage systems in western Taiwan to evaluate the provenance of sediments and reveal the evolution of Cenozoic sedimentary. Our findings indicate that the fluvial sediments eroded from the Cenozoic sedimentary rocks were primarily derived from the eastern Cathaysia Block (91%), with minor contributions from the Yangtze River catchment. Spatially, the northern part of Taiwan contains more sediments derived from the Yangtze River catchment than the southern part. The Cathaysia Block has been crucial in supplying detritus to Taiwan since the Eocene, whereas the contribution of the Yangtze Block varies greatly at different sedimentary periods. Two major shifts in provenance occur at the boundaries between Eocene, Oligocene, and Miocene, which may be related to the changes in drainage systems and landscapes in eastern China.

Preliminary Study on the Duration of High-Frequency Seismic Waves in Northern Taiwan from Deep Regional Earthquakes

The high-frequency seismic waves are usually generated by shallow earthquakes and is observed at a location near the earthquake source. Seismic energy tends to attenuate as it propagates through the Earth’s surface and interior; however, this is not the case at the subduction zone. A regional earthquake that occurred within the subducting slab was observed to have high-frequency energy, although it is from the deep (i.e. > 100 km) and with moderate magnitude (i.e. Mw 5). This phenomenon resulted from the slab effect on focusing the earthquake signal or known as the guided wave. Taiwan has a complicated tectonic feature, where Taipei city, its capital, sits above the oblique subduction of Philippine Sea Plate (PSP), i.e. the southern Ryukyu subduction zone, enhancing its exposure to strong shaking resulting from the deep regional earthquakes. In this study, we use six regional earthquakes at the southern Ryukyu subduction zone recorded by the Formosa Array (FM Array). The FM Array is a dense seismic network with a total of 140 stations located in the northern part of Taiwan, with the distance between stations approximately 5 kilometers. With high-resolution data, we could identify the distribution of the guided wave phenomenon through body wave dispersion of deep regional earthquake signals, where only stations above 10 – 20 km from the plate interface showed dispersion. An Hp/Lp ratio with a 5-second moving window is applied to the dispersed signal. The results indicate that the high-frequency signal has a longer duration at stations that sit 10 to 20 km above the plate interface. This study suggests that the slab effect will produce an anomalous seismic intensity at the subduction region and should be considered in the Ground Motion Prediction Equation (GMPE) so that the damaged to buildings resulting from strong shaking could be reduced.

Co-occurrence probability of typhoon surges affecting multiple estuaries in the northern coastal region of Taiwan

Taiwan lies on the northwest Pacific and is usually invaded by typhoons in summers and autumns. When typhoons strike the coast, surges usually occur. In addition, if a typhoon surge occurs during a high-tide period, the water level starts to rise. As a result, largely urbanized and highly populated regions around the estuaries may be devastated by catastrophic damage owing to floodwater elevation rising and unable to drain off floodwater. Therefore, in order to allocate regional resources reasonably and prevent and reduce coastal disasters effectively, it is necessary to estimate the co-occurrence probability of typhoon surges in multiple estuaries. In this study, total 36 typhoon processes are applied to calculate the simultaneous-occurrence probability of typhoon surges in three estuaries in Nan-Kan River, Huang River, and Lan-Yang River in the northern part of Taiwan. We first use certain extreme-value distribution models to fit the simulated peak values of a typhoon surge. These univariate statistical distributions include the Pearson type III, Weibull, generalized extreme value, and lognormal distributions. Through hypothesis and goodness-of-fit tests, the Pearson type III distribution is chosen as the optimal curve to fit the typhoon surges in these three estuaries. Then, according to the dependence of the typhoon surges in these three estuaries, a three-dimensional compound probability distribution model P-GH-TriP3 is constructed, and the joint return periods are calculated. The results indicate the simultaneous-occurrence probability of disasters in these three estuaries is small, which can provide some reasonable proposal for coastal typhoon disaster prevention and reduction and ocean engineering design.

Detection of Feline Coronavirus in Feline Effusions by Immunofluorescence Staining and Reverse Transcription Polymerase Chain Reaction

Feline coronavirus (FCoV), the pathogen for feline infectious peritonitis, is a lethal infectious agent that can cause effusions in the pleural and abdominal cavities in domestic cats. To study the epidemiology of FCoV in Taiwan, 81 FIP-suspected sick cats with effusive specimens were recruited to test for FCoV infection using immunofluorescence staining and reverse transcription-polymerase chain reaction as detection methods, and viral RNAs were recovered from the specimens to conduct genotyping and phylogenetic analysis based on the spike (S) protein gene. The results revealed that a total of 47 (47/81, 58%) of the sick cats were positive for FCoV in the effusion samples, of which 39 were successfully sequenced and comprised of 21 type I strains, 9 type II strains, and 9 co-infections. The signalment analysis of these sick cats revealed that only the sex of cats showed a significant association (odds ratio = 2.74, 95% confidence interval = 1.06–7.07, p = 0.03) with the infection of FCoV, while age and breed showed no association. FCoV-positive cats demonstrated a significantly lower albumin to globulin ratio than negative individuals (p = 0.0004). The partial S gene-based phylogenetic analysis revealed that the type I strains demonstrated genetic diversity forming several clades, while the type II strains were more conserved. This study demonstrates the latest epidemiological status of FCoV infection in the northern part of Taiwan among sick cats and presents comparisons of Taiwan and other countries.

Effects of social media and design thinking on corporate identity design course in Taiwan

The present study aimed at exploring the effects of integrating social media (instant messaging through Line App and Facebook) and design thinking into a vocational education course on corporate identity design in Taiwan. Corporate identity helps organizations achieve competitive advantage. This benefit is even more pronounced in Taiwan, where visual communication is esteemed. The present study recruited two groups of 11th graders (N = 60) from a vocational high school in the northern part of Taiwan as its participants. One group was designated as the experimental group and the other as the control group. The experimental group received creative instruction through the use of Facebook and Line App with design thinking integrated into the pedagogy, whereas the control group did not. Both qualitative and quantitative approaches were used to obtain feedback on the teaching and learning process. The results of the analyses indicated that students who were allocated to the experimental group demonstrated better quality design products than their counterparts in the control group.

Imbalance in the geographical distribution of practicing dentists in postgraduate dental training institutions in Taiwan

Background/purposePostgraduate year training program for dentists (PGYD) in Taiwan started since 2010. This study tried to assess the geographical distribution of practicing dentists in postgraduate dental training institutions in Taiwan. Materials and methodsThis study utilized the secondary data analysis to measure and compare the numbers of practicing dentists in each type of dental training institution and the numbers of overall practicing dentists among different cities and counties in Taiwan. ResultsOur results found that the practicing dentists in each type of dental training institution showed a significantly greater imbalance in geographical distribution than the overall practicing dentists. It meant that the practicing dentists in postgraduate dental training institutions were more concentrated in northern part of Taiwan than in other parts of Taiwan, compared to the number of overall practicing dentists in different cities or counties in Taiwan. However, the disparities in the number of practicing dentists in dental training institutions could be compensated by cross-regional collaborating institutions under the joint training group system. ConclusionBecause continuation of the current PGYD system may accelerate the imbalance in geographical distribution of practicing dentists in dental training institutions in Taiwan. To prevent this, further studies on yearly changes in the geographical distribution of dentists in postgraduate dental training institutions by city or county should be taken to monitor whether we should further modify the currently used PGYD system toward a better one to solve the problem of imbalance in the geographical distribution of dentists in postgraduate dental training institutions in Taiwan.

Genome Analysis of a Novel Tembusu Virus in Taiwan.

We identified and isolated a novel Tembusu virus (TMUV) strain TP1906 (TMUV-TP1906) from a Culex annulus mosquito pool collected from the northern part of Taiwan in 2019. The TMUV-TP1906 genome is a 10,990-nucleotide-long, positive-sense, single-stranded RNA, consisting of a single open reading frame (ORF) encoding a polyprotein of 3425 amino acids, with 5′ and 3′ untranslated regions (UTRs) of 94 and 618 nucleotides, respectively. The nucleotide sequence of the TMUV-TP1906 of ORF exhibited 93.71% and 91.27% similarity with Sitiawan virus (STWV) and the TMUV prototype strain MM1775, respectively. The 3′-UTR variable region of TMUV-TP1906 showed nucleotide sequence divergence with other TMUV strains. Phylogenetic analysis of the complete ORF and polyprotein sequences revealed that TMUV-TP1906 is most closely related to STWV which causes encephalitis and retarded growth in chickens. We found that the TMUV-TP1906 caused a cytopathic effect (CPE) in the DF-1 chicken fibroblast cell line, while no apparent CPE was observed in Vero and C6/36 cells. In this study, we first identified and isolated a novel TMUV strain in Taiwan. In addition, to our knowledge, it is the first time that the TMUV strain was isolated from the Cx. annulus mosquitoes. Further study is warranted to investigate the host range and virulence of TMUV-TP1906.

Short-term exposure to particulate matters is associated with septic emboli in infective endocarditis.

This survey was to investigate the short-term effect of particulate matters (PMs) exposure on clinical and microbiological variables, especially septic emboli, in infective endocarditis (IE). The study analyzed 138 IE patients in Far Eastern Memorial Hospital from 2005 to 2015 and clinical variables were retrospectively requested. The data of air quality were recorded and collected by a network of 26 monitoring stations spreading in Northern part of Taiwan. We found that IE patients with septic emboli were found to be exposed to a significantly higher level of PM2.5 (32.01 ± 15.89 vs. 21.70 ± 13.05 μg/m3, P < .001) and PM10 (54.57 ± 24.43 vs 40.98 ± 24.81 μg/m3, P = .002) on lag 0 day when compared to those without. Furthermore, multivariate regression analysis revealed that that ambient exposure to PM2.5 (odds ratio: 3.87, 95% confidence interval: 1.31–8.31; P = .001) and PM10 (odds ratio: 4.58, 95% confidence interval: 2.03–10.32; P < .001) significantly increased risk of septic emboli in IE patients. To our knowledge, this is the first study demonstrating that short-term exposure to PMs was associated with septic emboli in IE.

Socioeconomic Inequality in One-Year Mortality of Elderly People with Hip Fracture in Taiwan.

Hip fracture commonly results in considerable consequences in terms of disability, mortality, long-term institutional care and cost. Taiwan launched its universal health insurance coverage in 1995, which largely removes financial barriers to health care. This study aims to investigate whether socioeconomic inequality in one-year mortality exists among Taiwanese elderly people. This population-based cohort study included 193,158 elderly patients (≥65 years) admitted for hip fracture between 2000 and 2012. With over a one-year follow-up, 10.52% of the participants died from all causes. The mortality rate was low in the northern part of Taiwan and in urban and high-family-income areas. Multiple Poisson regression models further suggested that the level of >Q1–Q3 and >Q3–Max showed significantly reduced odds ratio of one-year mortality at 0.90 (95% confidence interval (CI), 0.87–0.93) and 0.77 (95% CI, 0.74–0.81), respectively, compared with that of the lowest family income level (i.e., Min.–Q1). Despite a monotonic decline in overall one-year mortality during the study period, socioeconomic inequality in one-year mortality rate remained evident. The annual percentage change in one-year mortality was higher (−2.86) in elderly people from families with high income (>Q3–Max.) than that for elderly patients from family with low income (Min.–Q1, −1.94). Accessibility, rather than affordability, to health care for hip fracture is probably responsible for the observed socioeconomic inequality.

The Affection of Student Ratings of Instruction toward EFL Instructors

Student ratings of instruction can be a valuable indicator of teaching because the quality measurement of instruction identifies areas where improvement is needed. Student ratings of instruction are expected to evaluate and enhance the teaching strategies. Evaluation of teaching effectiveness has been officially implemented in Taiwanese higher education since 2005. Therefore, this research investigated Taiwanese EFL university instructors’ perceptions toward student ratings of instruction and the impact of student ratings of instruction on EFL instructors’ classroom teaching. The data of this quantitative study was collected by 21 questionnaires. 32 qualified participants were selected from ten universities in the northern part of Taiwan. The results indicate those EFL instructors’ perceptions and experiences toward student ratings of instruction affects their approach to teaching, but EFL instructors do not prepare lessons based on the results of student ratings of instruction.

A near field communication-enabled e-learning environment for context-aware mobile Japanese conversation learning

In this study, we utilised near field communication-enabled smartphones with context-aware technology to propose a context-aware mobile Japanese conversation learning system (CAMJAL) for Taiwanese students. Our proposed CAMJAL system was implemented to record students' learning behaviours between peers in a context-aware computing environment. This system extend perceived convenience as external variable to technology acceptance model (TAM) to analyse its explanatory power and examine antecedent factors that affect acceptance of CAMJAL. Participants were 86 university students with advanced Japanese abilities from the northern part of Taiwan. After conducting CAMJAL with near field communication-enabled smartphones, data was collected by questionnaires. Our experimental results revealed that a) perceived convenience, perceived ease of use, and perceived usefulness were antecedent factors that affect acceptance of CAMJAL; b) perceived ease of use had a significantly positive effect on perceived convenience; c) perceived convenience had a significantly positive effect on perceived usefulness; d) perceived ease of use and perceived usefulness had a significantly positive effect on attitude towards use; and e) perceived ease of use, perceived usefulness, and attitude towards use had a significantly positive effect on behaviour intentions to learning. Overall, the extended TAM was effective in predicting and explaining the acceptance of CAMJAL.

A Near Field Communication-enabled E-Learning Environment for Context-Aware Mobile Japanese Conversation Learning

In this study, we utilised near field communication-enabled smartphones with context-aware technology to propose a context-aware mobile Japanese conversation learning system (CAMJAL) for Taiwanese students. Our proposed CAMJAL system was implemented to record students' learning behaviours between peers in a context-aware computing environment. This system extend perceived convenience as external variable to technology acceptance model (TAM) to analyse its explanatory power and examine antecedent factors that affect acceptance of CAMJAL. Participants were 86 university students with advanced Japanese abilities from the northern part of Taiwan. After conducting CAMJAL with near field communication-enabled smartphones, data was collected by questionnaires. Our experimental results revealed that a) perceived convenience, perceived ease of use, and perceived usefulness were antecedent factors that affect acceptance of CAMJAL; b) perceived ease of use had a significantly positive effect on perceived convenience; c) perceived convenience had a significantly positive effect on perceived usefulness; d) perceived ease of use and perceived usefulness had a significantly positive effect on attitude towards use; and e) perceived ease of use, perceived usefulness, and attitude towards use had a significantly positive effect on behaviour intentions to learning. Overall, the extended TAM was effective in predicting and explaining the acceptance of CAMJAL.

The Effectiveness of Hydrogen Water Chemistry on Corrosion Mitigation in an Advanced Boiling Water Reactor

For further improvements on thermal efficiency and operation safety, reactor internal pumps, instead of conventional recirculation systems, are adopted in an advanced boiling water reactor (ABWR). With the novel design of internal circulation, the traveling path and pattern of the recirculated liquid coolant in an ABWR is actually different from that of the coolant in a conventional boiling water reactor. To ensure operation safety, optimization of the coolant chemistry in the primary coolant circuit (PCC) of a nuclear reactor is essential no matter what type or generation the reactor belongs to. For a better understanding of the water chemistry in an ABWR, such as the one being constructed in the northern part of Taiwan, and for safer operation of this ABWR, in this study we conducted a proactive, thorough water chemistry analysis prior to the completion of this reactor. A well-developed computer code was used to investigate the effectiveness of hydrogen water chemistry (HWC) on the redox species concentrations and electrochemical corrosion potential (ECP) behavior of components in the PCC of the Lungmen ABWR in Taiwan. Our analyses indicated that the effective oxidant concentrations at the top of the downcomer location would be expected to be >100 ppb at 0.5 ppm [H2]FW at the original rated power. While an effective ECP reduction at 0.4 ppm [H2]FW was observed at the downcomer outlet, a 2.0 ppm [H2]FW was not enough to reduce the ECP below the Ecrit at the upper plenum outlet. In summary, the effectiveness of HWC in the PCC of an ABWR is expected to vary from location to location and eventually from plant to plant due to different degrees of radiolysis and physical dimensions in different ABWRs.

Effects of 100-km ultramarathon on acute kidney injury.

To evaluate the prevalence and characteristics of acute kidney injury (AKI) in 100-km ultramarathon runners. Prospective observational study. The 2011 Soochow University ultramarathon, in which each athlete ran for 100 km. All Taiwanese entrants who participated in the 100-km race and lived in the northern part of Taiwan were invited to participate in the study. Acute kidney injury was defined using the Acute Kidney Injury Network criteria. Blood and urine samples were collected 1 week before, immediately after, and 1 day after the race. Immediately after the race, 85% (22) of the 26 subjects were diagnosed with AKI, 65% (16) with moderate dehydration, 23% (6) with muscle cramps, and 12% (3) with hematuria. Body weight was significantly decreased from prerace to all postrace measurements. Plasma levels of potassium ion, creatinine, renin, and aldosterone were significantly elevated immediately after the race and then significantly reduced 1 day after the race. Changes in plasma levels of sodium, creatine kinase, and creatine kinase-MB, as well as urine potassium and creatinine, were indicative of AKI. Transient AKI and muscle cramps are very common in 100-km ultramarathon runners. All transient ultra-runners who developed AKI in this study recovered their renal function 1 day later. Ultramarathon running is associated with a wide range of significant changes in hematological parameters, several of which can be associated with potentially serious renal and physiological abnormalities.

Kuroshio 해류의 흐름장에 부유하는 해양 폐기물의 변동 특성

Abstract This study is to analyze the variability of floating marine debris(FMD) on the Kuroshio Current Area(KCA). A sighting survey was conducted from July 5th to July 16th, 2013 while navigating on KCA from Keelung, Taiwan to Tokyo, Japan using T/V KAYA of Pukyong National University. The sampled zones were divided into 6 transects and observed FMD during daytime in each transect. And also specified with 56 segments by defined one hour tracking distance as one segment on the survey routes. The results are as follows: 1. Hourly deviation of FMD’s quality in each transect goes up to 10 times at NT, HS and SK. The others 3 times or so.2. During the surveys, the largest amounts of it were found as total mean of 31.0 num(ea)/km² at NT transect in the northern part of Taiwan. So it is estimated because this area has gotten out of KCA.3. And also quality of it on KCA was not directly related to Kuroshio Current’s strong or weak. In conclusion, For the more detailed results on KCA are required of much more surveys. Key words : Variability, Floating marine debris, Kuroshio Current Area, DeviationCorresponding author : 051-629-5993, kimjh@pknu.ac.kr (2014 ) .

A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study

BackgroundThe incidence of fungal healthcare-associated infection (HAI) has increased in a major teaching hospital in the northern part of Taiwan over the past decade, especially in the intensive care units (ICUs). The purpose of this study was to determine the factors that were responsible for the outbreak and trend in the ICU.MethodsSurveillance fungal cultures were obtained from “sterile” objects, antiseptic solutions, environment of infected patients and hands of medical personnel. Risk factors for comparison included age, gender, admission service, and total length of stay in the ICU, Acute Physiology and Chronic Health Evaluation (APACHE) II scores at admission to the ICU, main diagnosis on ICU admission, use of invasive devices, receipt of hemodialysis, total parenteral nutrition (TPN) use, history of antibiotic therapy before HAI or during ICU stay in no HAI group, and ICU discharge status (ie, dead or alive). Univariable analysis followed by multiple logistic regression analysis was performed to identify the independent risk factors for ICU fungal HAIs and ICU mortality.ResultsThere was a significant trend in ICU fungal HAIs from 1998 to 2009 (P < 0.001). A total of 516 episodes of ICU fungal HAIs were identified; the rates of various infections were urinary tract infection (UTI) (54.8%), blood stream infection (BSI) (30.6%), surgical site infection (SSI) (6.6%), pneumonia (4.5%), other sites (3.5%). The fungi identified were: yeasts (54.8%), Candida albicans (27.3%), Candida tropicalis (6.6%), Candida glabrata (6.6%), Candida parapsilosis (1.9%), Candida species (0.8%), and other fungi (1.9%). Candida albicans accounted for 63% of all Candida species. Yeasts were found in the environment of more heavily infected patients. The independent risk factors (P < 0.05) of developing ICU fungal HAIs from all sites were TPN use, sepsis, surgical patients, mechanical ventilation and an indwelling urinary catheter. The independent risk factors for ICU fungal UTI included TPN use, mechanical ventilation and an indwelling urinary catheter. The independent risk factors for ICU fungal BSI included TPN use, sepsis, and higher APACHE II score. The independent risk factors for ICU fungal pneumonia included TPN use, surgical patients. The independent risk factors for ICU fungal SSI included surgical patients, and TPN use. The odds ratios of TPN use in various infection types ranged from 3.51 to 8.82. The risk of mortality in patients with ICU fungal HAIs was over 2 times that of patients without ICU HAIs in the multiple logistic regression analysis (P < 0.001).ConclusionsThere was a secular trend of an increasing number of fungal HAIs in our ICU over the past decade. Patients with ICU fungal HAIs had a significantly higher mortality rate than did patients without ICU HAIs. Total parenteral nutrition was a significant risk factor for all types of ICU fungal HAIs, and its use should be monitored closely.

Female Transplant Surgeons in Taiwan

First kidney transplantation in Asia was performed in 1968 at our institution in Taiwan. We have good reputation and outcome of solid organ transplantation. In 44 yeas, there are only five qualified female transplant surgeons. Three general surgeons are involved in liver, pancreas, and kidney transplantation. One is a pediatric surgeon and performed the first intestine transplantation in Taiwan. The other one is an urologist and was involved in kidney transplantation. However, the liver transplant surgeon and the urologist have given up their transplant career because of their family life. Three active female transplant surgeons all work at Northern part of Taiwan. In Asia, surgical society is male-dominant. However, the numbers of female medical students and surgical trainees are increasing. To provide female mentors and create role models in the field of transplant surgeon is crucial for recruiting new blood. Herein we introduced current situation of female transplant surgeons in Taiwan and may create connection to other Asia countries and female transplant surgeons in the worlds.

Seismotectonics of northeastern Taiwan: Kinematics of the transition from waning collision to subduction and postcollisional extension

The northeastern region of Taiwan is one of the few places on Earth that experienced a transition from collision to subduction and back‐arc opening in a young orogenic belt. This provides us a rare opportunity to study the structural characteristics in such a transition. We attempt to analyze the seismicity and stress patterns in this transitional region using data obtained from a dense and high‐quality seismic network. Our results show that from south to north, fault types change from thrust to strike‐slip, then to normal faulting. The transitional domain between Ilan and Hualien is dominated by left‐lateral strike‐slip faulting with a NNW‐SSE minimum principal stress axis, consistent with the opening of the Okinawa Trough. To the north, the Ilan Plain is formed by structural activities of a series of normal fault systems. To the south, the spatial distribution of an earthquake cluster north of Taiwan's Coastal Range appears to parallel the subducting interface between the Philippine Sea and Eurasian plates. This implies the northern extension of the Coastal Range has subducted. Consequently, the opening of the Okinawa Trough becomes an important tectonic driving force in northeastern Taiwan. The westernmost Ryukyu arc is pushed by the opening Okinawa Trough, and moves southward. The northern part of Taiwan's Central Range moves with the arc to bend southeastward, and the Ilan Plain forms in the space north of the range. The bending of the Central Range belt results in bedding plane slip with left‐lateral strike‐slip earthquakes in the transitional domain to accommodate the deformation.

Glutathione S-Transferase genotype may be a modifier on urothelial cell cycle in dyestuff manufacturing workers

ObjectivesIn the past study, the latent period of bladder cancer caused by occupational exposure is 6 months to 40–8 years. Benzidine-based dyes have been produced and used in Taiwan until...

Performance evaluation of knowledge management among hospital employees

The purpose of this study is to investigate the cognition of knowledge management (KM) among hospital employees and the relationship between KM and the KM enabler activities (financial, customer, internal business processes, learning and growth) in a regional hospital in Taiwan. Both qualitative and quantitative research were used in this study. The instrument was conducted using in-depth interviews of three policy-makers as participants. The quantitative data were collected from a regional hospital in the Northern part of Taiwan with a 77 percent effective response rate (n=154). The findings in this paper indicate that the cognition and demand for KM in subordinates is close to the expectations of policy-makers. The policy-makers expect subordinates working in the hospital to be brave in taking on new responsibilities and complying with hospital operation norms. KM is emphasized as a powerful and positive asset. Moreover, understanding KM predicts good performance in an organization. The findings in this paper can be generalized to other regional hospitals. The findings may be applied to a wider population. This study can provide insights into the perceptions and cognitions of workers in a hospital about KM and the activities of KM enablers. The responses and perceptions observed in the interviews in this study, as well as the quantitative research results could be useful to other hospitals and individuals who engage KM as a new management trend. This study suggested KM guidelines for policy-makers who are experienced managers.