Stage In Taiwan Research Articles

Comparative effectiveness and stage-shift effect of endoscopic exam among newly diagnosed oral cancer patients with different stages in Taiwan.

Patients with oral cancer are at higher risk of developing second primary esophageal cancer (SPEC) and the consensus for screening strategies remains unclear. This study aimed to examine comparative effectiveness and the stage-shift effect of endoscopic exam among patients with oral cancer. A population-based longitudinal retrospective observational matched case and control cohort study with at least 5 years follow-up was conducted. We identified 45 457 newly diagnosed patients with oral cancer, 2004-2013, and the eligible patient with oral cancer was 39 401. Propensity score matching was used to match comparable groups, and the two groups (screening vs. nonscreening) was 5941, individually. The study primary endpoints were to compare detection of incident SPEC and the stage-shift effect of endoscopic screening between screened and nonscreened incident oral cancer patients. Cox proportional hazard and competing risk models were analyzed. Statistical analyses were conducted in 2020-2021. Detection of incident SPEC in the screened group was significantly higher than in the nonscreened group (hazard ratio: 2.92, 95% confidence interval [CI]: 2.29-3.72). The stage-shift effect from endoscopic screening was found overall in patients with oral cancer (odds ratio [OR]: 0.39, 95%CI: 0.21-0.70), in particular in advanced-stage patients (OR: 0.25, 95%CI: 0.11-0.61), but not in early-stage patients (OR: 0.60, 95%CI: 0.26-1.40). This study confirmed that endoscopic screening achieved early detection of SPEC among patients with oral cancer. To improve the screening stage-shift effect, patients with oral cancer are encouraged to undergo routine endoscopic screening.

Palliative inter-professional learning via cased based tele-videoconference: Experience from the hospice development stage in Taiwan and China.

Palliative care in rural areas can be difficult to assess and, often is of lower quality compared to more densely populated regions. A program of multicenter palliative care discussion forum via tele-videoconference may be a promising tool for exchanging valuable experience and constructing a comprehensive hospice care system in Taiwan and China.The multicenter palliative care discussion forum began 1997 and 2010 in Taiwan and China, respectively. In every forum, 1 to 2 cases were presented by multiple field specialists, and multi-dimensional problems were discussed. All of these case reports and reference materials from the forums were analyzed.The conference discussed 199 and 143 cases in Taiwan and China, including 172 and 143 cancer patients. The most common mentioned symptom was pain (66.3% in Taiwan, 96.95% in China). As time went on, the rate of discussion in pain management issues decreased, but the social and psycho-spiritual issues increased in Taiwan. After some major legal and social changes, the discussion of ethical issues increased rapidly. In China, the trends and ranking in discussion of nonpain management issues stabilized and showed most frequently in psycho-spiritual issues, followed by social, ethical and legal issues.Sharing palliative experience via tele-videoconferences is an effective tool to improve the quality of care, and also saves a significant amount of time and expense. Experts in different professions from different hospitals should discuss any palliative problems, share their valuable experience, and ponder a comprehensive hospice care.

Investigating Complimentary E-Marketing Strategy for Small- and Medium-Sized Enterprises at Growth Stage in Taiwan

Globally, 95% of enterprises are small and medium sized enterprises (SMEs). Social media has recently become a powerful marketing tool due to characteristics such as the ability to share digital information and interact with consumers instantly. In SMEs, limited budgets restrict the use of social media as marketing tools. Thus, complimentary use of social media may be an alternative method for SMEs to maximize their marketing strategies. This study identifies what marketing goals are important for SME growth and how complimentary social media are used for attaining marketing goals. The analytic hierarchy process (AHP) analysis was conducted to confirm the order of local weights and global weights for marketing goals and complimentary social media. We found that the order of local weights for marketing goals for SMEs in the growth phase is brand awareness > online purchase > sales potential. The order of global weights for complimentary social media to meet above marketing goals is Facebook > PIXNET > Twitter > Instagram > YouTube > LINE. Finally, we used an SME from Taiwan as a case study to ensure that the application of the above complimentary social media can meet above marketing goals and potentially increase the survival of SMEs at the growth phase in Taiwan.

Deep proteogenomic investigations elucidate the NRF2 antioxidant mechanism as a major driving mechanism of lung adenocarcinoma in Asia.

Lung adenocarcinoma is a global leading cause of death. Despite modern therapeutic interventions, undesirable outcomes such as drug resistances and disease recurrence still occur. Therefore, continued investigations of disease driving mechanisms and counteracting strategies are urgently needed. We re-visited two deep-proteogenomic resources of lung adenocarcinoma published recently. These resources were derived from patient cohorts with decent sizes in Taiwan and China. The gene set enrichment analysis (GSEA) was performed. A heatmap was produced by the generalized association plot (GAP). Among 189 common oncogenic pathways investigated, the nuclear factor erythroid 2-related factor 2 (NRF2) downstream antioxidant mechanism was uncovered for the first time the leading oncogenic mechanism of lung adenocarcinoma in Taiwan. The gene levels of NRF2 (also known as NFE2L2) is negatively correlated with those of KEAP1 (Pearson's correlation = -0.275, p = 0.009) in patients' tumor tissues. Furthermore, the protein levels of EIF2S2 and PGD are higher in patients with more advanced stages in the Taiwan cohort (p = 0.001 and 0.05, respectively), and are indicative of poorer progression-free survival (PFS) and overall survival (OS) in the China cohort (all Cox-regression p < 0.05). On the other hand, EPHX1 is higher in patients with earlier stages in Taiwan (p = 0.003), and are indicative of better PFS and OS in China (both Cox-regression p < 0.05). When the patients were stratified using the median protein abundances for Kaplan-Meier visualizations, patient strata with higher EIF2S2, PGD, and EPHX1 have significantly poorer PFS (log-rank p = 0.041); poorer OS (p = 0.006), and better PFS and OS (p = 0.001 and 0.030), respectively. The NRF2 downstream antioxidant mechanism is one major driving mechanism of lung adenocarcinoma in Asia, and represents important directions for future therapeutic interventions. Major downstream proteins such as EIF2S2, PGD, and EPHX1 are indicative of cancer stages and prognosis.

Students' conceptions of health: A cross educational stage survey

The purpose of the study was to reveal participants' health concepts via a cross- sectional survey examining students at different educational stages. Four dimensions of health are integrated within an overall health concept, as drawn from relevant literature: the physical, mental, social, and cultural dimensions. An open questionnaire was administered to 551 students in three educational stages in Taiwan: junior high (13 ± 0.6yrs), senior high (16 ± 0.6yrs), and college (19 ± 0.6yrs). The results indicated that the total participants' major health concerns were situated within the physical dimension, followed by the social and mental dimensions. No participants mentioned a cultural dimension of health. Senior high school students were relatively more concerned with the mental rather than the physical dimension when compared to responses from the other two stages. Moreover, a gender difference was found in that female participants were more concerned with physical aspects while male participants focused more on the social dimension. Different concerns were obvious across the three educational stages; accordingly, an educational approach was suggested to address these findings.

Severity and prevalence of behavioral and psychological symptoms among patients of different dementia stages in Taiwan

Abstract Background To better understand the trends of behavioral and psychological symptoms of dementia (BPSD) over the disease progression is important to provide psychoeducation for dementia caregivers. Objective This study examined the severity and occurrence of BPSD across the various degrees of the disease. Methods This study was a cross-sectional design. Patients (N = 276) who had dementia from July 2001 to October 2008 were surveyed and assessed for dementia stage, using the clinical dementia rating scale (CDR). BPSD was evaluated using the Neuropsychiatric Inventory (NPI). We examined the differences between the severities and occurrence of the individual’s BPSD among various CDR stages with the Kruskal-Wallis test and Chi-square test. Results Delusion (p = 0.01), agitation/aggression (p = 0.033), apathy/indifference (p = 0.009), aberrant motor behavior (p < 0.001), nighttime behavior disturbances (p < 0.001), and eating abnormalities (p = 0.001) were significantly different among stages of dementia. The severity of BPSD became exacerbated over the course of the disease, and was highest in moderate (CDR = 2) or severe (CDR = 3) dementia. The occurrence of BPSD was highest when the CDR equaled 2 (97.5%). Discussion The association of global (or certain) BPSD, across different stages of dementia, is a non-linear relationship. These findings suggest the importance of taking into account clinical dementia stage for managing BPSD.

Building Spiritual Care in Nursing: An Overview of Ku's Spiritual Studies in Taiwan.

This paper describes the overview of Ku's spiritual literature on nursing through five stages in Taiwan: the development of a spiritual framework, a scale of spiritual distress, a spiritual care model, a spiritual nursing course, and a spiritual care book in nursing. The article demonstrates the process of building spiritual care in nursing from constructing theoretical frameworks, measurements, and applying to education. The integrative overview of Ku's spiritual studies developed in this article could be an example in clinical and education fields for nurse administrators to develop spiritual capabilities.

Epidemiologic features of Kawasaki disease in acute stages in Taiwan, 1997–2010: Effect of different case definitions in claims data analysis

BackgroundKawasaki disease is the leading cause of pediatric acquired cardiac disease in many industrialized countries. The aim of this study was to estimate the incidence of Kawasaki disease in acute stages in Taiwan, by linking the diagnosis code to medication and comparing the differences in epidemiological features with those of previous reports that used the diagnosis code alone. MethodsWe searched the National Health Insurance Research Database from 1997 to 2010. For the International Classification of Diseases, Ninth Revision (ICD-9) set, all inpatients with a main diagnosis of Kawasaki disease (ICD-9, 446.1) were retrieved. For the ICD-9 + intravenous immunoglobulin (IVIG) set, Kawasaki disease in acute stages was defined as the disease stages requiring IVIG. The epidemiologic features were calculated and compared by both methods. ResultsThe incidence rates for children under 5 years ranged from 21.5 to 68.5 per 100,000 person-years (average 49.1) for the ICD-9 + IVIG set and from 48.5 to 82.8 per 100,000 person-years (average 74.9) for the ICD-9 set. Significant discrepancy in peak season estimation occurred in summer. The 5-year recurrence rate was 1.1% for the ICD-9 + IVIG set and 4.5% for the ICD-9 set. The coronary complication rates were around 7.24% (ICD-9 + IVIG) and 6.48% (ICD-9). ConclusionDiscrepancies occurred when different case definitions were used in claims data analysis. Previous reports might have overestimated the incidence, recurrence rate, and complication rate in older children. The new method might slightly underestimate them. The true incidence might lie in between.

A Walk-In Screening of Dementia in the General Population in Taiwan

Alzheimer's disease (AD) has increased in its prevalence due to the increasing aged population. Currently there is no updated data on the prevalence of dementia including its very mild stage in Taiwan. Under the extensive coverage of Mentality Protection Center (MPC), Fo Guang Shan, Taiwan, the volunteers of MPC have conducted the medicine-related services and the screening of dementia by AD8 (ascertainment of dementia 8) that can screen the dementia even at its very mild stage in general population in all Taiwan. From 2011 to 2013, in total, 2,171 participants, 368 in the northern, 549 in the central, 877 in the southern, and 377 in the eastern part, were recruited with the mean age being 66.9 ± 10.2 years old. The ratio of suspected dementia patients, AD8 score greater than or equal to 2, was 13.6% of all recruited participants with their mean AD8 score being 2.9 ± 1.3, mean age being 69.4 ± 10.8 years old, and female predominance being 73.0%. Although this is a screening study, it has extensive coverage of all Taiwan and the use of AD8 is capable of screening very mild dementia. A further study with a randomized sampling to examine the prevalence and incidence of dementia including its very mild stage is encouraged.

Upstream-facing convex surfaces: Bedrock bedforms produced by fluvial bedload abrasion

Bedrock bedforms are a common sight in many bedrock river channels but few process-form linkages have been established for the myriad of forms recognised in the literature. Direct observations from bedrock channels on rates and distributions of erosion involved in bedrock bedform development are rare because of difficulties in making observations in these high-energy environments. Upstream-facing convex surfaces (UFCS) are common in bedrock rivers and are partnered with downstream-facing surfaces. We have made observations of bedrock morphology, aspect, and surface texture of UFCSs in bedrock river channels exposed at low river stage in Taiwan. A distinct contrast in morphology and surface texture exists between upstream- and downstream-facing surfaces. On a millimetre scale of observation, UFCSs have a three-dimensional, brittle fracture-dominated, granular surface texture but on a decimetre to metre scale have an overall convex form. Downstream-facing surfaces, in contrast, have millimetre to micrometre scale rugosity characterised by smooth polished surfaces that on a centimetre to metre scale are concave or undulating with intricately sculpted features. A curvilinear topographic feature, or crest line, marks the change in slope, aspect, and surface textures between upstream- and downstream-facing surfaces and is orientated approximately perpendicular to the reach azimuth and therefore mean flow direction. We used a system of removable datums and terrestrial laser scanning to monitor the three-dimensional erosion of nine bedforms at sites in the Liwu River, Taiwan, over a period of one year (2007–2008). All sites had an asymmetric distribution of erosion with higher rates of erosion on upstream-facing surfaces and minor to undetectable erosion on downstream-facing surfaces, with local complexity. The crest line mapped the boundary between relatively high and low erosion rates between the upstream-facing and downstream-facing surfaces respectively. Observations from unscaled flume experiments show that bedload particles transit a flow obstacle by travelling up the upstream-facing surface, where erosion is focused, and hop over the top of the obstacle. Our field and flume observations indicate that UFCSs observed in natural rivers are produced by bedload abrasion, which by being decoupled from the flow can only impact the stoss surface to any significant extent. Micropitting found on polished downstream-facing surfaces indicate that they are dominantly formed by suspended load abrasion. The aspect of a surface, its position in a channel cross section, the topography of the channel upstream, and the local topography of the bedrock bedform are significant controls on the location and magnitude of abrasion by bedload and resultant surface textures because of their effect on steering a bedload particle stream. The high erosion rates observed indicate that abrasion by bedload is the controlling process in the formation of this variety of bedrock bedform and possibly the channel at large in this setting.

Dilemmas Across Different Overseas Liver Transplant Stages: Taiwan Transplant Recipient Families' Perspectives

AimsThis study aimed to explore the dilemmas of Taiwanese overseas liver transplant recipient families (OLTRF) across three overseas liver transplant (OLT) stages in Taiwan and Mainland China. Patients and methodsAn exploratory qualitative method was employed using a purposive sample of OLTRF, who received guided face-to-face, semistructured interviews. Data were subjected to content analysis. ResultsNineteen OLTRF (15 female, 4 male) aged between 29 and 71 years (mean 55.1) for 19 patients with end-stage liver diseases were interviewed. OLT stages including predeparture stage (first stage), stay in China stage (second stage), and reentry to Taiwan stage (third stage). Ten kinds of dilemmas were encountered: (1) unable to get transplantation immediately (first to second stages); (2) dilemma of choosing overseas transplantation (first to second stages); (3) uncertainty about the transplantation outcomes (second to third stages); (4) care pressure (second to third stages); (5) poor diet adaptation (second to third stages); (6) lack of trust in the medical care quality (second stage); (7) worry about not fulfilling family responsibilities (second stage); (8) lack of information (all stages); (9) financial pressure (all stages); and (10) frustration when seeking medical care (all stages). ConclusionsTaiwanese OLTRF's perspectives of their dilemmas through the OLT process were first revealed in this study. Both Western and Eastern health professionals might be empowered by better understanding of OLTRF's living experiences and concerns during the stages of overseas liver transplantation.

A Quantitative Study on Attitudes of Web-Based Mathematic Competition in Different Learning Stages students in Taiwan

The study mainly investigates the studentsâ?? attitudes toward mathematic learning and web-based mathematic competition in different learning stages in Taiwan. This study was to conduct an online survey, which is driven by three issues: (1) What are the differences in mathematical learning attitudes with the web-based mathematics competition in the different learning stages (2) Is there any significant difference between studentsâ?? mathematical learning attitudes to take part in the web-based mathematics competition in the different learning stages? (3) Is there any correlation between studentsâ?? mathematical learning attitudes, the participatorsâ?? motivation and the attitudes of studentsâ?? took part in the web-based mathematics competition? The research targets of this study are 277 students, including 207(74.7%) boys and 70(25.3%) girls. The collected data of this study was analyzed by descriptive statistics, one-way ANOVA, Scheffeâ?? method and Pearsonâ??s product-moment correlation. Following are the results of the study: There is significant motivational difference between elementary school and junior high school students to participate the web-based mathematic competition and there are middle relationships between studentsâ?? mathematical learning attitudes, the participatorsâ?? motivation and the attitudes of studentsâ?? took part in the web-based mathematics competition.

Planning and Building a Taiwan Cyber Forensic Laboratory

The problems of safeguarding cybersecurity have gotten much worse in recent years. The risks in cybersecurity are increasing rapidly in our country. Because the cybersecurity defenses and computer crime investigation systems of our government and businesses have been threatened, the damage of cybercrime for national security and public security will become more critical, even more than violent crime and economic crime. The national cyber forensics mechanism and laboratory will play a crucial role in dealing with cybercrime. In 2003, our government conducted a research of digital evidence, the standard procedure of the operations and cyber forensic laboratory. It included the organization, training, technical capability, legislation, and operation procedures. In 2004, our government made a policy to build the first nationwide cyber security and forensic laboratory. It will be one of the major cybersecurity defense mechanisms in Taiwan. Our bureau (MJIB) made a plan and got the additional budget to build a cyber forensic lab this year. This study has four aspects: 1) The study of reliable cyber forensic software and hardware; 2) The standard of the operating procedures of cyber forensics; 3) Training courses for the examiner, including an internationally well-known certification system in cyber forensics; and 4) The study of certification for the cyber forensic laboratory. Cyber forensics is still in its early stages in Taiwan. More professional cyber forensic manpower is needed, as well as a certified cyber forensic mechanism. It is expected that cyber forensics will become increasingly important for cybersecurity policy and management in the future. Hence, building a certificated laboratory and establishing the SOP of cyber forensics from this study can be the basis to cultivate cyber forensic capabilities in our country. In this way, law enforcement will get more help from our laboratory. The laboratory, through its operation, also enhances the ability of Taiwan's cyber forensic professionals and provides more convincing digital evidence in court. Furthermore, it can consolidate cybersecurity systems and the e-Taiwan environment.

A comparative research on built-land changes between Fujian and Taiwan provinces

Comparative study of LUCC between Fujian and Taiwan provinces could be a good case for study because of their geographical proximities and historical, cultural similarities. Fujian and Taiwan had gone through and currently are in different economic development stages. Taiwan is in the stage of post-industrialization and Fujian is in the intermediate stage of industrialization. By using the official statistics, changes of built-land in Fujian and Taiwan were analyzed in details. The results showed that these two provinces seemed to have the same characteristics of built-land changes, i.e., accelerating development, and concentrated distribution on both sides of the Taiwan Straits, forming a pattern with the economic layout of two sides acting in cooperation with eath other. If comparing different industrialized areas in Fujian with industrialized stages in Taiwan, it is clear that these two provinces seemed to have the same characteristics of synthesized index of built-land change (Lc), i.e., which is from stabilization or comparative stabilization at the initial stages of industrialization to high expansion at the intermediate stages of industrialization, then followed by low consumption at later stages of industrialization, but the Lc of the initial and the later stages of industrialization in Taiwan were slightly higher than those in Fujian. The results from comparison on relevant indexes have shown: The industrial structure changing rate of Fujian is actually higher than that of built-land in Taiwan, but its using efficiency of regional built-land is also obviously lower than that in Taiwan in the intermediate and later stages of industrialization of Fujian. The major driving forces of the built-land changes in both provinces were analyzed in Causal Models of Path Analysis, and its result indicated that the difference in built-land changes of the two provinces is closely related to their economic development stages and industrial structure. Countermeasure for the realization of sustainable utilization of built-land in Fujian put forward in this article is to strengthen its intension and tap the latent power.

NORMAL GAIT OF CHILDREN

The rapid development of gait analysis and its increasing application to pathological gait in children has created an urgent need for normative data. However, research on maturation of gait in children is just in the beginning stage in Taiwan. In order to care for the welfare of children, more data and knowledge in the field are mandatory. The first goal of this study is to offer some background data and basic studies to any other researchers who are interested in this topic. The second goal was to investigate the corresponding factors to gait parameters, such as body weight, height, angular deformities (genu varum and valgum) and torsional deformities (toe in and out). In this study, twenty-three children (five years old in average) were included and motion analysis and force plate system were applied to investigate the kinematics and kinetics of lower limbs. The results showed that body height and weight are both corresponding factors to gait development. Gait analyses revealed that there were no differences between boys and girls. Children with genu valgum attend to more gait stability using compensatory mechanism.

Correlation of human papillomavirus 16 and 18 with cervical neoplasia in histological typing and clinical stage in Taiwan: an in-situ polymerase chain reaction approach.

In situ polymerase chain reaction (ISPCR) promises to considerably enhance our ability to detect a few copies of target nucleic acid sequences in fixed tissues and cells. The aim of this study was to investigate cervical carcinoma to determine the human papillomavirus (HPV) types on paraffin-embedded tissue sections by ISPCR and standard in situ hybridization. The results will correlate the morphological characteristics of lesions with viral typing results. This study examined prevalence of HPV 16 and 18 DNA in biopsies from 85 cervical cancer patients by ISPCR, employing HPV 16, 18 consensus primers. There are 45 patients with squamous cell carcinomas, 13 with adenocarcinoma, 2 with adenosquamous carcinomas, 3 with small cell carcinomas, and 22 carcinoma in situ. The relation between the types of HPV detected, tumor type, and clinical stage were analyzed. Fifty-two of 85 biopsies were HPV 16- or 18-positive, HPV 16 being the most prevalent type. Squamous cell carcinoma had a high prevalence of HPV 16 and adenocarcinoma had a high prevalence of HPV 18. HPV 18 was the predominant type among high clinical stage (III-IV) cases while HPV 16 and mixed HPV 16 with HPV18 were significantly correlated with low clinical stage (0-I-II). Our results indicate that certain malignant cervical tumor phenotypes and stages correlate with specific HPV type, and that ISPCR is a sensitive and fast method to detect HPV in these patients.

AIDS in Asia: 3rd Taipei AIDS Meeting.

At the Third International Conference on AIDS, Taipei, Taiwan, gene therapy, HIV quasi species, and Asian epidemiology were the main issues. Various effectors for gene therapy such as ribozyme, thymidine kinase and PKR were tested. Though not clinically available in the near future, gene therapy will likely play an important role in the combat against HIV. That non-syncytia-inducing HIV-1s are capable of direct T lymphocyte killing was reported and provides a possible explanation for progression to AIDS in patients in whom no syncytia-inducing HIV-1 could be found. Epidemiological data concerning Asia were presented in this meeting; among them is a detailed description of the current status of HIV infections in Taiwan. The HIV epidemic is still in its early stage in Taiwan, but some ominous signs favoring disease spread have been found. Copyright 1995 S. Karger AG, Basel

Optimal Design of a Pilot OTEC Power Plant in Taiwan

In this paper, an optimal design concept has been utilized to find the best designs for a complex and large-scale ocean thermal energy conversion (OTEC) plant. The OTEC power plant under this study is divided into three major subsystems consisting of power subsystem, seawater pipe subsystem, and containment subsystem. The design optimization model for the entire OTEC plant is integrated from these subsystems under the considerations of their own various design criteria and constraints. The mathematical formulations of this optimization model for the entire OTEC plant are described. The design variables, objective function, and constraints for a pilot plant under the constraints of the feasible technologies at this stage in Taiwan have been carefully examined and selected. The numerical optimization method called Sequential Quadratic Programming (SQP) is selected to obtain the optimum results. The main purpose of this paper is to demonstrate the design procedure with the optimization techniques for engineering and economics in the OTEC plant so that anyone else can build upon their models according to their needs.