Taiwan Society Research Articles

Investigating online social media users’ behaviors for social commerce recommendations

Online social media create virtual communities and network platforms that people use to create, share, and exchange opinions, views and experiences. With social networks, social commerce not only relies on commerce, but online social media can also promote the sale of goods or services online. Many online operators have begun to use recommendation systems to analyze customer purchase history and identify individual products that customers may purchase. This enables the company to send product information to consumers to attract their attention. In addition, consumers have a higher purchase rate for recommended products based on consumer data. Based on a survey in Taiwan society, this study uses the questionnaire survey method to collect data on a relational database. This study investigates Taiwan online social media users’ behaviors using data mining methods, including clustering analysis and association rules. Clustering analysis is to investigate possible profiles of users and association rules are to find knowledge patterns and rules of user profiles, online social media usage motivation/preferences and social commerce behavior in order to generate social commerce recommendations in terms of social technology development in the modern society.

Profiles of Hospitalized Patients with Angiographic Coronary Heart Disease in Taiwan during 2014-2016: Report of a Tertiary Hospital.

The Taiwan Society of Cardiology (TSOC) has established multicenter registries for coronary artery disease (CAD) to investigate clinical characteristics, management and risks for mortality. However, the impacts of newly-emerged evidence-based therapies, including the use of drug-eluting stents (DESs), on patients with CAD in Taiwan remain unclear. The Tri-Service General Hospital-Coronary Heart Disease (TSGH-CHD) registry is a single-center, prospective, longitudinal registry in Taiwan containing data from 2014-2016. Individuals who were admitted for coronary angiography were enrolled. Patient profiles, management and in-hospital outcome data were collected. We included 3352 patients: 2349 with stable angina and 1003 with acute coronary syndrome (ACS). In the stable angina group, both patients receiving stenting and those receiving medical treatment had a 0.7% mortality rate; DESs were used in 70.4% of the patients receiving stenting. In the ACS group, the patients receiving stenting and those receiving medical treatment had a 4.9% and 10.7% mortality rate, respectively; DESs were used in 63.1% of the patients receiving stenting. In the 2008-2010 Taiwan ACS registry, DESs were used in only 28% of all stenting procedures, and the estimated hospital mortality rate was 1.8%. Multivariate analysis indicated that older age, prior stroke, and cardiogenic shock on admission were associated with an increased risk of in-hospital mortality in the ACS group. Compared with the Taiwan ACS cohort, the TSGH-CHD registry revealed increased DES use and increased disease complexity and severity after 2010. Although unlikely to significantly improve survival, interventionists seemed to perform high-risk procedures for complex CAD more often in the new DES era.

Differential Impact of Conditioning Intensity on Post-Transplant Outcome of FLT3 -Mutated and FLT3 Wild Type AML in First Remission, a Report from Taiwan Bone Marrow Transplant Registry (TBMTR)

AML with FLT3 -internal tandem duplication mutation (FLT3-ITD) has a very high relapse rate when patients were treated with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation (HSCT) as soon as possible once remission is achieved is generally recommended. Nevertheless, the best conditioning regimen, specifically the myeloablative (MAC) or reduced intensity conditioning (RIC), for FLT3-ITD AML remains unknown. Of the two largest series reported so far, vast majority of the patients received myeloablative regimen (100% in EBMT report, 87% in CIBMTR report). In this study, we utilize the Taiwan Bone Marrow Transplant Registry (TBMTR) database to analyze the impact of conditioning intensity on the post-transplant outcome of FLT3 -mutated and FLT3 wild type AML.TBMTR is a research collaboration affiliated to the Taiwan Society of Blood and Bone Marrow Transplantation. It comprises all the 14 transplantation centers in Taiwan that contribute detailed information on HSCT. In this study, only adults aged ≥ 18 years with a diagnosis of de novo AML who received allogeneic peripheral blood stem cell transplantation (PBSCT) at the first complete remission (CR1) and with known FLT-ITD mutation status in the registry were included. Patient characteristics and transplant outcome following MAC or RIC allogeneic PBSCT were compared. Kaplan-Meier estimates were used to calculate the probability of LFS and overall survival (OS). Cumulative incidence of relapse and non-relapse mortality (NRM) was calculated from the time of transplant to the time of event. NRM was considered a competing risk for relapse and vice versa. Multivariable analyses for LFS and OS were performed using Cox proportional hazards model.146 patients who met the eligibility criteria were enrolled for analysis. The median follow-up of survivors was 21 months (range, 1-73 months). Of the 146 patients, 49 (33.6%) were positive and 97 (66.4%) were negative for FLT3-ITD mutation. 32.7% and 35.1% of FLT3-ITD mutated and FLT3 WT AML received RIC regimen respectively. FLT3-ITD mutated patients had significantly higher WBC count (51.7 x 109/L) and more normal (64.9%) karyotype at diagnosis comparing to patients without FLT3 mutation (11.8 x 109/L WBC count and 42% normal karyotype). Patients who received RIC regimen were significantly older than patients who received MAC regimen (53.196±12.107 vs 38.327±11.788, p<0.001, for FLT3-ITD mutated AML; 52.084±12.533 vs 39.181±10.704, p<0.001, for FLT3 WT AML).In multivariable analysis, FLT3 mutation status did not negatively impact the transplant outcome in term of both overall survival (OS) and leukemia free survival (LFS). However, RIC regimen is associated with a significant poor LFS (HR 1.754, p=0.0476) and higher relapse rate (HR 2.184, p=0.015). The impact of conditioning intensity is even more prominent in patients of FLT3 WT AML (Figure 1, left, p=0.0468 for LFS, log rank test). For FLT3-ITD mutated AML, the LFS and relapse rate were almost the same after either MAC or RIC conditioning (Figure 1, right, p=0.768 for LFS, log rank test). For NRM and cumulative incidence of acute and chronic GVHD, the differential impact of conditioning intensity was not seen in FLT3-ITD mutated AML and FLT3 WT AML.In conclusion, conditioning intensity has a differential impact on post-transplant outcome of FLT3-ITD mutated AML and FLT3 WT AML. Reduced intensity conditioning is associated with a lower LFS and higher relapse rate for FLT3 WT AML. For patients of FLT3-ITD mutated AML, RIC is just as good as MAC, even though patients who received RIC were almost 15 years older than patients who received MAC. RIC allogeneic HSCT should be a viable option for elderly or unfit AML with FLT3-ITD mutation. [Display omitted] DisclosuresYao:Celgene International Sàrl: Research Funding. Tang:Celgene International Sàrl: Research Funding.

Based on AHP to Discuss Critical Factors in Open Government Data

The expansion of the government has the role definition and administrative category become more complicated. Meanwhile, the government controls the capacity and power to collect huge domestic national data, whose quantity and quality possessed by the government far exceed those controlled by private enterprises, organizations, and individuals. Along with the boom of digital technology and Internet, the emerging brand-new service depends on huge open government data. The questionnaire for this study is randomly distributed to the mass society in southern Taiwan to understand the weights of factors in the mass society. Total 300 copies of questionnaire are distributed, and 271 valid copies are retrieved, with the retrieval rate 90%. The research results reveal that political and social is mostly emphasized among dimensions in Hierarchy, followed by technical and economic and top five indicators, among 15, are ordered public license, single entry, governance transparency, data resolution, and data reuse. According to the results, discussion and suggestions are proposed, expecting to help the government further legislates for simplifying the openness process, reduce costs or commercial data use, and promote domestic competitiveness.

P425 Real-world evidence on effectiveness and safety of vedolizumab therapy for inflammatory bowel disease in Taiwan: Results from the TSIBD registry (VIOLET Study)

Abstract Background GEMINI trials and real-world studies in Western population have demonstrated the effectiveness and safety of vedolizumab (VDZ) for IBD. However, long-term real-world evidence of VDZ in Asian populations remains limited. This study aimed to investigate the effectiveness and safety of VDZ in Taiwan CD and UC patients, and the IBD relapse after VDZ discontinuation. Methods Data were prospectively collected (January 2018-May 2020) from the Taiwan Society of IBD (TSIBD) registry, one of the largest real-world Asian IBD cohorts. Patients (&amp;gt;18 years old) receiving ≥1 dose of VDZ with up to a 1-year follow-up period were analyzed. Effectiveness at 6 month and 1 year including clinical response (CRS), clinical remission (CRM), steroid-free remission (SRM) and mucosal healing (MH);and safety outcome were analyzed descriptively. IBD relapse after VDZ treatment discontinuation was assessed since the reimbursement period in Taiwan is limited due to drug holiday required by government. Results A total of 274 patients (CD:127, UC:147) were included. At VDZ initiation, average [SD] age (year): 33.4 [14.6] in CD and 42.4 [14.3] in UC; median disease duration (years): 3.1 in CD and 3.9 in UC; 50.4% of CD and 70.7% of UC patients were biologics (bio)-naïve. Treatment effectiveness was analyzed (Figure 1-4). At 6 months, effectiveness in the CD bio-naïve group was significantly higher than the bio-exposed patients in CRS (67.4% vs 43.9%, p=0.047), CRM (62.8% vs 39.0%, p=0.025), and SRM (43.3% vs 4.3%, p=0.001), respectively. At 1 year, the CD bio-naïve group had higher CRS (82.1% vs 60.7%, p=0.026) than the bio-exposed group. There was no difference in effectiveness between bio-naïve and bio-exposed groups in UC at both 6 months and 1 year. Three patients (1.1%) reported serious infections (respiratory infection, intractable infection with underlying myelodysplastic syndrome and intestinal perforation due to endoscopy) and two (0.7%) had infusion-related reactions. No malignancies or hepatic injuries were reported. After limited treatment up to one year due to reimbursement, 58% (54/93) of patients had IBD relapse (CD: 27 [62.8%], UC: 27 [54%]). After cessation of VDZ, the mean [SD] time to IBD relapse was 5.5 [4.0] months in CD, and 5.8 [5.7] months for UC. Conclusion This study has shown the effectiveness and safety of VDZ therapy for Taiwan IBD patients. Better outcomes were observed in bio-naïve CD patients, whereas bio-naïve and bio-exposed UC patients have comparable outcomes. After a limited VDZ treatment duration, over one-half of patients had IBD relapse, with the majority occurring within 5 months of VDZ discontinuation. These data suggest that continued VDZ therapy would benefit the majority of IBD patients in Taiwan.

Laparoscopic Revision for Gastric Clipping: a Single Center Experience and Taiwan Database Review.

Laparoscopic gastric clipping (LGC) is a relatively novel restrictive bariatric surgery wherein a horizontal metallic clip is applied to the gastric fundus. Its intraoperative complications or the difficulties associated with the applied gastric clip (GC) during revisional procedures have seldom been mentioned. Herein, the experience of revisional procedures after initial gastric clipping is reported. A retrospective cohort review of LGC based on the Taiwan Bariatric Registry of Taiwan Society Metabolic and Bariatric Surgery was performed. Six patients with severe obesity presented for revisional surgery after initial LGC by other surgeons. Patients' characteristics, indications, and details of revisional surgery were recorded. Between 2012 and 2019, 39 patients who underwent pure LGC and six patients with previous LGC history were referred for revisional surgery. Their mean age and the mean body mass index were 34.7 ± 9.5 years and 38.4 ± 10.5 kg/m2, respectively. Three, two, and one patient underwent revisional surgery for insufficient weight loss, weight recidivism, and intractable belching, respectively. The mean interval between initial LGC and revisional surgery was 40.5 ± 22.4 months. Laparoscopic removal of the GC with concomitant revisional surgeries were collected, including a revision to sleeve gastrectomy (n = 5) and revision to Roux-en-Y gastric bypass (n = 1). Moreover, the mean operative time was 286.8 ± 78.2 min. All patients had uneventful recovery postoperatively but experienced significant adhesion around the GC and the left liver. Laparoscopic revisional surgery with concomitant GC removal for patients with severe obesity after gastric clipping could be feasibly conducted by experienced bariatric surgeons.

2021 Advocacy Statements for the Role of 99mTc-Pyrophosphate Scintigraphy in the Diagnosis of Transthyretin Cardiac Amyloidosis: A Report of the Taiwan Society of Cardiology and the Society of Nuclear Medicine of the Republic of China.

Transthyretin cardiac amyloidosis (ATTR-CM) is an increasingly recognized cause of heart failure with preserved ejection fraction. Favorable prognosis depends on early diagnosis and correct treatment strategy. Among patients for whom there is a high clinical suspicion of cardiac amyloidosis, 99mTc-labeled bone avid scintigraphy including 99mTc-pyrophosphate (PYP) scintigraphy may be of diagnostic and prognostic importance. Various international guidelines support the non-biopsy diagnosis of ATTR-CM using 99mTc-PYP scintigraphy, yet emphasize the gap in standardization of acquisition and imaging analysis protocols, as well as the appropriateness of its clinical use. Therefore, a joint expert consensus has been reached by the Taiwan Society of Cardiology and the Society of Nuclear Medicine of the Republic of China, to advocate for the application of 99mTc-PYP scintigraphy in the diagnosis of ATTR-CM. This article aims to highlight the recommendations on image acquisition, qualitative and quantitative assessments of cardiac 99mTc-PYP uptake, and diagnostic algorithms. We hope the implementation of these recommendations in Taiwan will facilitate the process and enhance the diagnostic rate of ATTR-CM.

COVID-19 crisis and challenges for graduate employment in Taiwan, Mainland China and East Asia: a critical review of skills preparing students for uncertain futures

ABSTRACT Graduate employment and unemployment or underemployment are becoming increasingly important issues confronting not only global higher education research but also social and political debates in contemporary societies. In addition to the rapid social and economic changes resulting from the exponential technologies, the outbreak of the COVID-19pandemic has further intensified unemployment resulted from the serious global economic downturn. As the leading article for the present Special Issue examining the complex issues of graduate employment before the COVID-19 crisis,this article reviews some key issues related to youth transition from education to work, specifically addressing graduate employment issues confronting the societies in Mainland China, Taiwan, Hong Kong, and other East Asian societies. To prepare students to be adaptive to rapid social and economic changes generated from the unprecedented global COVID-19 crisis, higher education institutions must search for a more flexible approach to prepare them to manage uncertain futures. More research should be conducted to better understand not only graduate employment but also broader issues concerning university governance in the post-COVID-19 era.

Biopsychosocial Needs of Elderly Individuals in Prolonged Social Isolation During the COVID-19 Outbreak: A Qualitative Study

Background: As countries are affected by COVID-19, the elderly population will be told to self-isolate for very long time in Turkey and a lot of countries. The aim of study was to evaluate the biopsychosocial needs of elderly individuals in the COVID-19 outbreak. Methods: In this qualitative research in-depth interviewwas used. A total of 20 participants aged 65 and over were interviewed. The interviews went on until no new data was obtained. All interviews were recorded digitally and the records were transcribed and coded by two independent researchers, who identified major themes by relevance. Results: According to the in-depth interviews with elderly: all elderly people were exposed to fear and anxiety in this process and elderly living in rural areas were found to be less biopsychosocially affected by the pandemic process and it was observed that most elderly people were afraid to apply to health centers during pandemic even if they have a disease condition. The majority of the participants stated that they did not meet anyone outside the home during this period. Conclusion: It is of great importance to evaluate these people within the framework of the biopsychosocial approach. Our study confirmed this need with in-depth interviews with the elderly. We are concerned about the effects of the curfew on elderly people appropriate;effective campaigns should be done to promote healthy life behaviors and physiological needs of them. Copyright (C) 2021, Taiwan Society of Geriatric Emergency & Critical Care Medicine.

2020 Guideline for Prehospital Management, Emergency Evaluation and Treatment of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the Taiwan Society of Emergency Medicine and Taiwan Stroke Society.

To improve the clinical outcomes of patients with acute ischemic stroke, the public, pre-hospital care system, and hospitals should cooperate to achieve quick assessment and management for such patients and to start treatment as soon as possible. To reach the goal, the Consensus Group, including emergency physicians and neurologists in the Taiwan Society of Emergency Medicine and Taiwan Stroke Society, performed an updated review and discussion for the local guidelines. The guidelines consist of 12 parts, including public education program, evaluation and management in the emergency medical system, emergency medical system, assessment of stroke care capability of the hospital by independent parties, stroke team of the hospital, telemedicine, organization, and multifaceted integration, improvement of quality of care process of stroke system, initial clinical and imaging evaluations after arriving at the hospital, imaging evaluation for indications of intravenous thrombolysis, imaging evaluation for indications of endovascular thrombectomy, and other diagnostics. For detailed contents in Chinese, please refer to the Taiwan Stroke Society Guideline and Taiwan Emergency Medicine Bulletin.

Considerations When Managing Heart Failure during the COVID-19 Pandemic-Consensus from the Taiwan Society of Cardiology.

Coronavirus disease 2019 (COVID-19) has spread rapidly around the world since December 2019. Acute heart failure has accounted for 23-24% of the initial presentations in patients with COVID-19 infection. Furthermore, COVID-19 might increase metabolic demand and cause acute decompensation of pre-existing stable heart failure. These patients are thus more susceptible to the evolution of more serious clinical symptoms and a higher mortality rate. Given the lack of knowledge about this new disease, this review provides recommendations for the management of heart failure during the COVID-19 pandemic in Taiwan.

Introduction of 2021 Journal of Taiwan Society of Plastic Surgery for Annals of Plastic Surgery Supplement.

Wang, Hsian-Jenn MD, MMM; Chuang, Chwei-Chin MD; Chen, Shyi-Gen MD; Cheng, Nai-Chen MD; Chen, Chieh-Feng MD Author Information

The Social Network and Adjustment of Indian Women in Taiwan: a Qualitative Study

Social networking is recognized as one of the major supplies in human life progression. This social form significantly influences the altercation of needs as well as supports. There are various types of social networks that vary as the function of respect to the mass of networking members, contact frequency, geographical vicinity, and subsequent arrangements. Herein, the present analysis examines mainly the workplace influences on the social networking structures within the prosperous immigrants, the types of support (i.e., social, emotional, or instrumental) they get from their co-workers, and the various approaches of women to create and maintain the social relationships. Therefore, the main targets of the present research are the following: highlighting their important strategies for life adaptation in Taiwan and their methodology to create daily life social networking. Herein, around ten women were selected randomly, and their detailed in-depth interview had been taken. As for analysis, the researchers inductively analyzed various essential parameters, such as identifying categories, themes, and outlines, which are mainly appeared from the data. In this course, six relevant and understandable wide themes are mainly appeared via analyzing the interviews. These six themes related to the social networking of Indian women staying in Taiwan are as follows: communication, thinking about Taiwan society, the similarity between India and Taiwan society, differences between India and Taiwan society, social life, and women autonomy and working culture. A major issue for respondents is some have difficulties in communicating their own view and their idea related to the matter because of language problems. However, this place is safe and local people are kind and very helpful in nature. The status of Indian women is excellent, and they feel comfortable, safe, and happy to stay and work in Taiwan.

Teachers’ perspectives on cultural and national values in school music education between multiculturalism and nationalism in Taiwan

ABSTRACT This empirical study attempted to examine cultural and national values in relation to the teaching of musical multiculturalism, which is defined as music from regions around the world, as well as Taiwanese nationalism (i.e., a desinicized version of national identity based on Taiwan’s localization movement) in school music education. Data were drawn from questionnaires completed by 70 in-service and 40 pre-service teachers between February and October 2018. Two major questions will be explored in this paper in response to the changing society of Taiwan: (1) how do teachers feel about music teaching related to diverse music cultures; and (2) how have they reacted to Taiwanese nationalism in school music education? The findings indicated a significantly higher preference for teaching traditional Western music versus that of other cultures among all the teachers. In addition, the participants with more experience exhibited a significantly greater preference for teaching traditional Chinese music and national education compared to their less experienced counterparts. Based on the survey data, this paper will argue that there is a cultural gap between teaching traditional Chinese music, Taiwanese local music, and other music cultures alongside the question of nationalism in contemporary music education in Taiwan.

Real world experience on angiotensin receptor and neprilysin inhibition in reduced ejection fraction heart failure patients with advanced chronic kidney disease

Abstract Background Angiotensin receptor and neprilysin inhibition (ARNI) reduces the risk of cardiovascular mortality among patients with heart failure with reduced ejection fraction (HFrEF) as compared with enalapril in the PARADIGM-HF trial. However, patients with glomerular filtration rate (GFR) less than 30 ml/min/1.73 m2 or systolic blood pressure less than 100 mmHg were excluded from the PARADIGM-HF trial. We assessed the potential beneficial effects of ARNI in HFrEF patients with advanced chronic kidney disease (GFR&amp;lt;30 ml/min/1.73 m2) by using a multicenter real-world data in Taiwan. Methods The TAROT-HF (Treatment with Angiotensin Receptor neprilysin inhibitor for Taiwan Heart Failure patients) study is a multicenter study which enrolled 1,694 HFrEF patients on ARNI treatment from 9 hospitals between March 2017 and December 2018. The data was compared to the outcome from the TSOC (the Taiwan Society of Cardiology)-HFrEF registry which enrolled 1,509 HFrEF patients from 21 hospitals between 2013 and 2014 prior to era of ARNI. After 1:1 propensity score matching, a total of 1,198 patients from the TAROT-HF study and 1,198 patients from the TSOC-HFrEF registry were included for analysis. Results During the 1 -year follow-up, the TAROT-HF cohort showed a significant superior prognosis on cardiovascular (CV) death (6.8% vs 10.6%, p&amp;lt;0.001) and all-cause death (8.5% vs 16.2, p&amp;lt;0.001) as compared with the TSOC-HFrEF study population. The patients were classified into 4 groups according to the renal function with eGFR values of &amp;lt;30, 30–59, 60–89, and ≥90 ml/min/1.73m2, and there was no significant interaction between matched cohorts and renal function. The beneficial effects of ARNI on CV death and all-cause death were consistent across four eGFR groups, including 387 patients with eGFR&amp;lt;30 ml/min/1.73m2 (16.2%). Conclusions Our study demonstrated the effectiveness of ARNI on HFrEF patients in real world experience, including those with advanced chronic kidney disease with eGFR&amp;lt;30 ml/min/1.73m2. Funding Acknowledgement Type of funding source: None

2020 Consensus Statement of the Taiwan Hypertension Society and the Taiwan Society of Cardiology on Home Blood Pressure Monitoring for the Management of Arterial Hypertension.

To facilitate the applications of home blood pressure (HBP) monitoring in clinical settings, the Taiwan Hypertension Society and the Taiwan Society of Cardiology jointly put forward the Consensus Statement on HBP monitoring according to up-to-date scientific evidence by convening a series of expert meetings and compiling opinions from the members of these two societies. In this Consensus Statement as well as recent international guidelines for management of arterial hypertension, HBP monitoring has been implemented in diagnostic confirmation of hypertension, identification of hypertension phenotypes, guidance of anti-hypertensive treatment, and detection of hypotensive events. HBP should be obtained by repetitive measurements based on the " 722 " principle, which is referred to duplicate blood pressure readings taken per occasion, twice daily, over seven consecutive days. The " 722" principle of HBP monitoring should be applied in clinical settings, including confirmation of hypertension diagnosis, 2 weeks after adjustment of antihypertensive medications, and at least every 3 months in well-controlled hypertensive patients. A good reproducibility of HBP monitoring could be achieved by individuals carefully following the instructions before and during HBP measurement, by using validated BP devices with an upper arm cuff. Corresponding to office BP thresholds of 140/90 and 130/80 mmHg, the thresholds (or targets) of HBP are 135/85 and 130/80 mmHg, respectively. HBP-based hypertension management strategies including bedtime dosing (for uncontrolled morning hypertension), shifting to drugs with longer-acting antihypertensive effect (for uncontrolled evening hypertension), and adding another antihypertensive drug (for uncontrolled morning and evening hypertension) should be considered. Only with the support from medical caregivers, paramedical team, or tele- monitoring, HBP monitoring could reliably improve the control of hypertension.

Predictive Power of In-Hospital and Long-Term Mortality of the GRACE, TIMI, Revised CADILLAC and PAMI Score in NSTEMI Patients with Diabetes - Data from TSOC ACS-DM Registry.

Risk score is widely used in non-ST segment elevation myocardial infarction (NSTEMI) patients to predict the in-hospital outcome for immediate coronary angiography decision and care of unit selection. This study compared the performances of the thrombolysis in myocardial infarction (TIMI), Global Registry of Acute Coronary Events (GRACE), Primary Angioplasty in Myocardial Infarction (PAMI), and Revised Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (Revised CADILLAC) risk scores in predicting in-hospital and long-term outcomes in diabetic NSTEMI patients. A total of 750 diabetic NSTEMI patients from 27 hospitals were enrolled between January 2013 and December 2015 in the nationwide registry initiated by the Taiwan Society of Cardiology. Four score systems were calculated with receiver operator characteristic analysis used to compare outcome discrimination performance. No studied risk scores reached acceptable discrimination per area under curve (AUC) in the prediction of in-hospital outcome except for the revised CADILLAC score which reached acceptable discrimination in new-onset cardiogenic shock (AUC = 0.7191) and acute renal failure (AUC = 0.7283). In long-term outcomes, only the revised CADILLAC score reached acceptable discrimination of mortality prediction at 6, 12 and 24 months (AUC = 0.7261 at 6 months, 0.7319 at 12 months, and 0.7256 at 24 months). Subgroup analysis based on the revised CADILLAC score risk class showed a significant difference in adjusted mortality rate between low-risk group/intermediate-risk group and high-risk group. Only the revised CADILLAC score showed acceptable accuracy to predict the long-term mortality outcome among the scores studied.

New Opportunities for Healthcare Driven by Smart Technology

Taiwan officially entered the era of negative population growth in 2020, with the number of births falling below the number of deaths. Taiwan society is facing the severe problems of low birthrate and aging population, which will exacerbate the social gap in medical resources. Fortunately, rapid progress in developing smart technologies (Button et al., 2014) should bring new opportunities for healthcare. Therefore, the focus of and approach to healthcare should be adjusted (While & Dewsbury, 2011). On the one hand, applying smart technology in medical / nursing staff education offers myriad opportunities for improvement (Car et al., 2019), including using virtual reality in training, using mobile technology tools in education, and using Internet of Things technology to assist medical/nursing staff in the clinical-care process. Moreover, smart education technology will play an important, auxiliary role in the healthcare field in terms of mobile applications, robot practice, simulation experience, digital medicine, and telemedicine and influence the future of medical/nursing health care education (Bajpai et al., 2019). On the other hand, using smart technology to promote healthcare through various innovative healthcare design activities will help develop older-adult-friendly technology products, systems, services, and even living environments (Wang et al., 2015). These include remote home care systems, smart homes, rehabilitation systems, environment-assisted living, intelligent mobile assistance systems, communication platforms and social networks, accompanying robots, and interactive entertainment technology, among others. Smart technology will provide family members and professional medical staffs with more-convenient and efficient healthcare support, maximize the effectiveness of healthcare resources, and drive the development of related industries (Insel, 2017). The title of this column is interdisciplinary applications of healthcare and technology: education, research, and practice. In using smart technology to support healthcare, key research and practical issues will be how to apply related innovations to promote medical education, combine clinical research, and effectively integrate smart technology into healthcare.

Key Teacher Attitudes for Sustainable Development of Student Employability by Social Cognitive Career Theory: The Mediating Roles of Self-Efficacy and Problem-Based Learning.

Higher education policy and talent training are failing to meet the ever-changing expectations of employers and society in Taiwan, resulting in a gap between university education and employment. This study used social cognitive career theory (SCCT) to explore the relationships among self-efficacy, transformational leadership (TL), student employability (SE), and problem-based learning (PBL) in higher education institutions (HEIs). The analysis of 637 undergraduates from 16 Taiwanese HEIs using structural equation modeling (SEM) shows significant positive correlations among self-efficacy, PBL, TL, and SE, with PBL and self-efficacy as key mediators. Based on these findings, the researchers propose feasible suggestions for related issues and future research.

Family Livelihood, Social Class and Mothers’ Self-cognition: The Transformation of “Mothering” in Japanese Colonial Taiwan (1895–1945)

Based on oral histories and diaries of women who lived in the Japanese colonial period, this article analyzes the role and transformation of “mothering” in Taiwan, examining how the Han Chinese patriarchal society in Taiwan responded to colonialization and modernization in the early twentieth century. It reveals that most Taiwanese women at that time married in their teens and began to take on the tasks of mothers before the age of twenty. Difference in social class served as a key element affecting mothering practices. Rural and lower-class mothers had no choice but to prioritize productive labor over physical childcare; women of the traditional upper class could afford nannies; the emerging group of “new women” hired lower-class women to help with household tasks and childcare while they developed their professional careers. In addition to the physical care of children, Taiwanese mothers put great emphasis on the education and future development of children, especially sons. However, as the custom of “daughters-in-law-to-be” was quite common, from an early age many girls faced only their “mothers-in-law-to-be” instead of their biological mothers. “Mothering” was thus absent in these women’s lives, complicating the meaning of “motherhood.”