Taiwanese Populations Research Articles

Soft tissue sarcoma incidences and clinical characteristics are significantly different in France and Taiwan.

The incidence of different soft tissue sarcoma (STS) histotypes among ethnic and geographic populations has not been comprehensively investigated. Data from 2013 to 2016 were obtained from national cancer registry databases in France and Taiwan. Liposarcoma (LPS), leiomyosarcoma (LMS), angiosarcoma (AS), synovial sarcoma (SS), and malignant peripheral nerve sheath tumor (MPNST) were selected as index STSs to estimate the age-standardized incidence rates (ASRs) and other clinical features between patients. In total, 9398 patients (7148 from France and 2250 from Taiwan) were included. The ASRs of AS (5.4 vs. 2.8) and MPNST (2.0 vs. 1.0) were significantly higher in Taiwan; France had significantly higher ASRs for LPS (12.0 vs. 10.0), LMS (9.7 vs. 7.6), and SS (1.7 vs. 1.2). Patients in Taiwan with LMS or LPS were younger than their French counterparts. With regard to the distribution according to primary anatomic site, French patients had higher odds for extremity and truncal LMS (odds ratio [OR], 2.84; p < .001), AS (OR, 2.67; p < .001), MPNST (OR, 1.55; p=.027), and LPS (OR, 1.38; p < .001) and for breast AS (OR, 10.58; p < .001). Taiwanese patients had higher odds for liver AS (OR, 10.72; p < .001) and uterine LMS (OR, 3.21; p < .001). SS age and distribution according to primary anatomic site did not differ significantly between the French and Taiwanese populations. Significant differences in the incidence and clinical characteristics of index STS suggested that geographic (environmental) and ethnicity factors likely play a vital role in the pathogenesis of STS.

Global DNA methylation mediates the association between serum perfluorooctane sulfonate and carotid intima-media thickness in young and middle-aged Taiwanese populations

PurposePerfluoroalkyl and polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals used in the manufacture of many everyday products. Previous reports have shown PFAS exposure may contribute to cardiovascular diseases (CVD). Recent studies have also identified a critical role for DNA methylation, a model of epigenetic regulation, in the pathogenesis of CVD. Additionally, PFAS has been shown to affect DNA methylation. Our previous study reported the positive association between serum perfluorooctane sulfonate (PFOS) levels and mean carotid intima-media thickness (CIMT), a biomarker of arteriosclerosis, in a cohort composed of adolescent and young adult Taiwanese. However, the contribution of DNA methylation in the mechanism of PFOS-induced arteriosclerosis has never been explored in previous literature. Approach and resultsIn this cross-sectional study, we included 1425 young and middle-aged Taiwanese individuals (12–63 years) to investigate the correlation between serum PFOS levels, 5mdC/dG (a global DNA methylation marker) and the mean CIMT. We showed that the positive association between serum PFOS levels, 5mdC/dG, and mean CIMT. The regression coefficients of mean CIMT with a one-unit increase in ln-PFOS concentration were higher when the levels of 5mdC/dG were above the 50th percentile in the multiple regression analysis. In the structural equation model (SEM), the results showed that serum PFOS levels were directly correlated with mean CIMT and indirectly correlated with CIMT through 5mdC/dG. ConclusionsOur results showed that PFOS exposure has direct associations on arteriosclerosis and indirect direct associations on arteriosclerosis through DNA methylation. The results suggest that DNA methylation might regulate the relationship between PFOS and arteriosclerosis in the study subjects. Additional works are required to understand the causal inference between PFOS, DNA methylation, and arteriosclerosis.

The Most Common Location of Schools with Viral Upper Respiratory Tract Infection Clusters in Taiwan, 2011-2019.

Clusters of acute upper respiratory tract infections are mainly caused by type A or B influenza virus. Numerous factors modify the risk of upper respiratory tract infection (URTI) cluster transmission. The purpose of this study was to investigate the epidemiological characteristics, differences, and epidemic trends in influenza viruses and in non-influenza respiratory pathogens, and the distribution of the sites of URTI cluster events in Taiwan from 2011 to 2019. We examined the publicly available annual summary data on 1864 confirmed URTI clusters in the Taiwan Centers for Disease Control (Taiwan CDC) from 2011 to 2019. URTI clusters were mainly divided into 1295 clusters of influenza virus infections, 149 clusters of non-influenza respiratory pathogen infections, 341 clusters of pathogens not detected by routine tests, and 79 clusters of unchecked samples. There were statistically significant differences (p < 0.001) in the event numbers of URTI clusters among influenza and non-influenza respiratory pathogens between 2011 and 2019. There were statistically significant differences (p = 0.01) in instances of URTI clusters among non-influenza respiratory pathogens between 2011 and 2019. There were also statistically significant differences (p < 0.001) in instances of URTI clusters in different locations between 2011 and 2019. In all the pathogens of URTI clusters (odds ratio (OR) = 1.89–2.25, p = 0.002–0.004), most single infections were influenza A viruses (64.9%, 937/1444). Respiratory syncytial virus single infections were most numerous (43.0%, 64/149) among the non-influenza respiratory pathogens of URTI clusters. Of the institutions where URTI clusters occurred, schools had the most cases (50.1%, 933/1864) (OR = 1.41–3.02, p < 0.001–0.04). After the categorization of isolated virus strains by gene sequencing, it was found that, of the seasonal influenza A viruses, the H1N1 subtype viruses were predominantly A/California/07/2009, A/Michigan/45/2015, and A/Brisbane/02/2018, and the H3N2 subtype viruses were predominantly A/Hong Kong/4801/2014, A/Singapore/INFIMH-16–0019/2016, and A/Switzerland/8060/2017, during 2017–2019. Of the influenza B viruses, B/Brisbane/60/2008 (B/Vic) was the dominant type, and some were B/Massachusetts/02/2012 (B/Yam) and B/PHUKET/3073/2013 (B/Yam). This study is the first report of confirmed events of URTI clusters from surveillance data provided by the Taiwan CDC (2011–2019). This study highlights the importance of long-term, geographically extended studies, particularly for highly fluctuating pathogens, for understanding the implications of the transmission of URTI clusters in Taiwanese populations. Knowledge gaps and important data have been identified to inform future surveillance and research efforts in Taiwan.

Cost‐effectiveness of sodium‐glucose cotransporter‐2 inhibitors versus dipeptidyl peptidase‐4 inhibitors among patients with type 2 diabetes with and without established cardiovascular diseases: A model‐based simulation analysis using 10‐year real‐world data and targeted literature review

We conducted a model-based economic analysis of sodium-glucose cotransporter-2 inhibitors (SGLT2is) versus dipeptidyl peptidase-4 inhibitors (DPP4is) in patients with type 2 diabetes (T2D), with and without established cardiovascular diseases (CVDs), using 10-year real-world data. A Markov model was utilized to estimate healthcare costs and quality-adjusted life-years (QALYs) over a 10-year simulation time horizon from a healthcare sector perspective, with both costs and QALYs discounted at 3% annually. Model inputs were derived from analyses of Taiwan's National Health Insurance Research Database or published studies of Taiwanese populations. The primary outcome measure was the incremental cost-effectiveness ratios (ICERs). Incorporated with our study findings, a targeted literature review was conducted to synthesize updated evidence on the cost-effectiveness of SGLT2is versus DPP4is. Over 10 years, use of SGLT2is versus DPP4is yielded ICERs of $3244 and $4186 per QALY gained for patients with T2D, with and without established CVDs, respectively. Results were robust across a series of sensitivity and scenario analyses, showing ICERs between $-1074 (cost-saving) and $8467 per QALY gained for patients with T2D with established CVDsand between $369 and $37 122 per QALY gained for patients with T2D without established CVDs. Use of SGLT2is versus DPP4is was highly cost-effective for patients with T2D regardless of their CVD history in real-world clinical practice. Our results extend current evidence by showing SGLT2is as an economically rational alternative over DPP4is for T2D treatment in routine care. Future research is warranted to explore the heterogeneous economic benefits of SGLT2is given diverse patient characteristics in clinical settings.

Association of SNP rs5069 in APOA1 with Benign Breast Diseases in a Mexican Population.

Breast cancer (BCa) is the most common type of cancer affecting women worldwide. Some histological subtypes of benign breast disease (BBD) are considered risk factors for developing BCa. Single nucleotide polymorphisms (SNPs) in the genes encoding apolipoproteins A-I (APOA1) and B (APOB) have been associated with BCa in Tunisian, Chinese, and Taiwanese populations. The objective of this pilot study is to evaluate the possible contribution of APOA1 and APOB polymorphisms to BCa and BBD in the Mexican population. We analyzed the association of 4 SNPs in genes encoding apolipoproteins: rs670 and rs5069 in the APOA1 gene, and rs693 and rs1042031 in the APOB gene, by performing PCR-RFLP with DNA extracted from the biopsy tissue of Mexican women with BCa or BBD and whole blood samples obtained from the general population (GP). Our results showed an association between the CT + TT genotypes of the SNP rs5069 and BBD (p = 0.03201). In the A-T haplotype, the frequency of the SNPs rs670 and rs5069 differed significantly between the BBD group and the GP and BCa groups (p = 0.004111; p = 0.01303). In conclusion, the SNP rs5069 is associated with BBD but not with BCa in the Mexican population.

Association between serum per- and polyfluoroalkyl substances and thrombograms in young and middle-aged Taiwanese populations

PurposePer- and polyfluoroalkyl substances (PFAS) are a class of man-made chemicals used in many products. Recent in vitro and epidemiological reports have found that PFAS exposure can modify the function of platelets. Platelet size has been shown to affect platelet activity, and thrombograms are a simple method of indirect assessment of platelet function. However, there has been no large-scale research investigating the association between PFAS levels and complete thrombograms in humans. Approach and resultsIn the current cross-sectional study, we enrolled 1779 Taiwanese subjects (aged between 12 and 63 years) to study the associations between serum PFAS concentrations and thrombograms. There were 1175 men and 604 women with a mean age of 34.5 years. When all four PFAS were fitted by the multiple linear models at the same time, platelet counts decreased significantly with increasing quartiles of perfluorooctanoate acid (PFOA) and perfluorooctane sulfonate (PFOS), while platelet distribution width (PDW), mean platelet volume (MPV), and platelet-large cell ratio (PLCR) also increased significantly with increasing quartiles of PFOS. The mean platelet count was the lowest (264.02 k/µL [95% CI 256.00–272.04]; P < 0.001) when both PFOA and PFOS concentrations were above the 50th percentile. ConclusionsWe report that serum PFAS levels were correlated with thrombograms. If the association is etiologic, PFOA/PFOS may decrease the number of platelets, while PFOS may also increase the variation and the average size of platelets in the subjects of the study. Interestingly, PFOA and PFOS may have synergistic effects on the decrease in platelet counts. Further research is needed to study the effect of PFAS on platelets in humans.

Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S): Evidence of Measurement Invariance Across Five Countries.

PurposeThe percentage of individuals who were fully vaccinated against COVID-19 was 53% worldwide, 62% in Asia, and 11% in Africa at the time of writing (February 9, 2022). In addition to administrative issues, vaccine hesitancy is an important factor contributing to the relatively low rate of vaccination. The Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) was developed to assess COVID-19 vaccination acceptance levels. However, it has only been tested among Taiwanese, mainland Chinese, and Ghanaian populations (Chen et al, 2021; Fan et al, 2021; Yeh et al, 2021). Therefore, the present study examined the construct validity and measurement invariance of the MoVac-COVID19S among individuals from five countries (ie, Taiwan, mainland China, India, Ghana, and Afghanistan).Participants and MethodsA cross-sectional survey study recruited 6053 participants across five countries who completed the survey between January and March 2021. Confirmatory factor analysis (CFA) fit indices were used to examine factor structure and measurement invariance across the five countries.ResultsThe fit indices of the CFA were relatively good across the countries except for the root mean square error of approximation (RMSEA). Moreover, the four-factor structure (either nine or 12 items) had a better fit than the one-factor structure. However, the four-factor model using nine MoVac-COVID19S items was the only model that had measurement invariance support for both factor loadings and item intercepts across the five countries.ConclusionThe present study confirmed that the MoVac-COVID19S has acceptable psychometric properties and can be used to assess an individual’s willingness to get COVID-19 vaccination.

FREQUENCIES OF PREDICTED MIA ANTIGEN AMONG SOUTHERN THAI BLOOD DONORS

Background: The Mia antigen (MNS7) of the MNS blood group system is clinically important in Asian populations. Anti-Mia has been implicated in hemolytic transfusion reactions and hemolytic disease of the fetus and newborn in Thai populations. However, data of this antigen frequency among southern Thais remains unknown.&#x0D; Objective: This study aimed to determine and predict Mia antigen frequencies among southern Thai blood donors and to estimate the risk of alloimmunization among Thais.&#x0D; Methods: A cross-sectional study was conducted. Altogether, 400 southern and 500 central Thai blood samples were genotyped for GYP(B-A-B) and GYP(A-B-A) MNS hybrids using polymerase chain reaction with sequence-specific primer (PCR-SSP).&#x0D; Results: Among them, 19 of 400 (4.45%), and 28 of 500 (9.33%) were positive with the set of GP. Hut, GP.HF, GP.Mur, GP.Hop, and GP.Bun. No GP.Vw phenotype was found among southern and central Thais. The predicted Mi(a+)frequency among southern Thais was significantly lower than among central and northern Thais (p&lt;0.05). Its frequency was similar to Vietnamese, Taiwanese, and Southern Han Chinese populations (p&gt;0.05) but significantly differed from Indonesian, Filipino, and Chinese (Guangzhou) populations (p&lt;0.05). The risk of Mia alloimmunization among southern Thais was significantly lower than among both Thai groups (p&lt;0.05).&#x0D; Conclusion: This constitutes the first study to report Mi(a+) frequencies among southern Thais, supporting the estimation risk of alloimmunization and providing transfusion safety among Thai populations.

Global DNA Methylation Mediates the Association Between Serum Perfluorooctane Sulfonate and Carotid Intima-Media Thickness in Young and Middle-Aged Taiwanese Populations

Global DNA Methylation Mediates the Association Between Serum Perfluorooctane Sulfonate and Carotid Intima-Media Thickness in Young and Middle-Aged Taiwanese Populations

Cultural adaptation and validation of the Addenbrooke’s Cognitive Examination III in a Taiwanese population (T‐ACE‐III) presenting to hospital with suspected dementia

AbstractBackgroundThe Addenbrooke’s Cognitive Examination III (ACE‐III) is an effective cognitive test for detecting dementia in many countries and covers a wide range of cognitive domains. However, there has been no study about the usefulness of the ACE‐III in patients with suspected dementia in Taiwan where patients use Traditional Chinese, unlike mainland China. We therefore aimed to culturally adapt and find the sensitivity and specificity of the ACE‐III for investigating people with possible dementia presenting to hospital in Taiwan.MethodWe used the guideline for cross‐cultural adaptation process to culturally adapt the simplified Chinese version (C‐ACE‐III) for Taiwanese populations (T‐ACE‐III). We recruited consenting patients who had presented to clinics with suspected dementia in Northern Taiwan and had been through the diagnostic process. We timed the interviews and conducted receiver operating characteristic (ROC) curve analysis to test the ability of the T‐ACE‐III to differentiate between dementia and non‐dementia using clinical diagnosis as the gold standard. We used linear regression to find significant predictors of ACE‐T score entering age, education, sex, language group, and dementia status as possible predictors.Result110 participants were invited, of whom 91 Chinese/ Hokkien‐speaking individuals aged 49 to 93 years consented to take part and ninety completed the test: 24 males and 33 females with dementia and 12 males and 21 females without. It took on average 16.3 and 24.0 minutes to administer in non‐dementia and dementia group, respectively. The T‐ACE‐III demonstrated a sensitivity of 100.0% and a specificity of 78.8%, for distinguishing dementia from non‐dementia with a cut‐off value of 86/87, a sensitivity of 89.5% and a specificity of 100.0%, with a cut‐off value of 73/74. The area under the curve (AUC) = 0.99 in T‐ACE‐III. The diagnosis of dementia, and language used were significant predictors accounting for 68.1% of the variance in T‐ACE‐III scores.ConclusionThe culturally adapted T‐ACE‐III is a brief, reliable, and acceptable tool for discriminating dementia from non‐dementia cases in a Taiwanese population in a memory clinic setting.

Validation of the Taiwanese Version of ACE-III (T-ACE-III) to Detect Dementia in a Memory Clinic.

ObjectiveThe Addenbrooke’s Cognitive Examination III (ACE-III) is a 100-points cognitive test used in detecting dementia in many countries. There has been no validation study of the ACE-III in patients with suspected dementia in a Taiwanese population, where the language is traditional Chinese. We aimed to culturally adapt and validate the ACE-III as a cognitive assessment tool for differentiating between people with and without dementia presenting to healthcare professionals in Taiwan with possible dementia.MethodsWe culturally adapted the ACE-III for Taiwan (T-ACE-III) and tested it with consenting patients with suspected dementia in northern Taiwan who had been through the diagnostic process. We calculated receiver operating characteristic (ROC) curves to test the ability of the T-ACE-III to differentiate between dementia and non-dementia cases using clinician diagnosis as the gold standard. We generated the Youden Index to determine the best cut-off score.ResultsWe recruited 90 Taiwanese individuals aged 49–93 years: 24 males and 33 females had dementia and 12 males and 21 females did not. The area under the ROC curve was 0.99 for distinguishing dementia from non-dementia. The T-ACE-III had a sensitivity of 100% and specificity of 78.8% when the cut-off score was 86/87. With a cut-off value of 73/74, the specificity was 100.0%, and sensitivity 89.5%. The highest Youden Index was 0.895, indicating the best overall cut-off point to be 73/74.ConclusionsThe T-ACE-III is an acceptable cognitive test with excellent psychometric properties for discriminating dementia from non-dementia in Taiwanese populations in memory clinic settings.

Leucostegia amplissima, the Third Species of the Genus (Hypodematiaceae)

Abstract— Leucostegia has been long recognized as a small fern genus with only two species, L. immersa and L. pallida. Here we elevate a variety of L. immersa to species level and make the new combination Leucostegia amplissima based on morphological and molecular phylogenetic evidence. Morphologically, Leucostegia amplissima differs from L. immersa by having larger evergreen fronds, smaller indusia, and glandular hairs on the basal stipes. The study of Taiwanese populations further suggested an ecological divergence between L. immersa and L. amplissima.

Association between the total plasma isomers of per- and polyfluoroalkyl substances and erythrograms in young and middle-aged Taiwanese populations

PurposePer- and polyfluoroalkyl substances (PFAS) are human-made chemicals used in daily use products. Recent studies have shown that different perfluorooctanoic acid (PFOA) and/or perfluorooctane sulfonate (PFOS) isomers may have different biological effects. In vitro studies have also reported that PFAS exposure can alter the structure of hemoglobin (Hb). In epidemiology, however, few studies have investigated the relationship between PFAS exposure and erythrocytes. Additionally, the correlation between PFOA/PFOS isomers and full erythrograms has never been explored. Approach and resultsIn cohorts comprising young and middle-aged Taiwanese populations, we enrolled 1483 participants (aged between 12 and 63 years) to analyze the correlations between the plasma levels of PFOA/PFOS isomers and whole-blood erythrograms. The study comprised 868 men and 615 women with a mean age of 31.2 years. When all PFOA/PFOS isomers were entered into the multiple linear regression model, the linear PFOA (L-PFOA) levels were positively correlated with the Hb, hematocrit (HCT), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) levels while the branched PFOS (B-PFOS) levels were positively associated with the Hb, HCT, and mean corpuscular hemoglobin concentration (MCHC). The mean value of Hb was the highest (14.66 mg/dL (95% CI =14.52–14.80); P for trend <0.001) when both the L-PFOA and B-PFOS levels were above the 50th percentile. ConclusionsThe results imply that PFOA/PFOS isomers may increase the weight and volume of Hb/RBC and that L-PFOA/B-PFOS may have an additive effect on the Hb levels. However, it is also possible PFAS detected at a higher concentration may due to its binding to higher levels of Hb. Further studies are needed to investigate the effects of PFOA/PFOS isomers on RBCs in humans.

Phylogeography of the wide-host range panglobal plant pathogen Phytophthora cinnamomi.

Various hypotheses have been proposed regarding the origin of the plant pathogen Phytophthora cinnamomi. P.cinnamomi is a devastating, highly invasive soilborne pathogen associated with epidemics of agricultural, horticultural and forest plantations and native ecosystems worldwide. We conducted a phylogeographic analysis of populations of this pathogen sampled in Asia, Australia, Europe, southern and northern Africa, South America, and North America. Based on genotyping-by-sequencing, we observed the highest genotypic diversity in Taiwan and Vietnam, followed by Australia and South Africa. Mating type ratios were in equal proportions in Asia as expected for a sexual population. Simulations based on the index of association suggest a partially sexual, semi-clonal mode of reproduction for the Taiwanese and Vietnamese populations while populations outside of Asia are clonal. Ancestral area reconstruction provides new evidence supporting Taiwan as the ancestral area, given our sample, indicating that this region might be near or at the centre of origin for this pathogen as speculated previously. The Australian and South African populations appear to be a secondary centre of diversity following migration from Taiwan or Vietnam. Our work also identified two panglobal, clonal lineages PcG1-A2 and PcG2-A2 of A2mating type found on all continents. Further surveys of natural forests across Southeast Asia are needed to definitively locate the actual centre of origin of this important plant pathogen.

Association between Hydroxychloroquine and bacterial pneumonia in rheumatic patients: A population-based propensity score matching cohort study.

Whether hydroxychloroquine (HCQ) use could reduce lesser risk of bacterial infections is unknown. We aimed to conduct a retrospective cohort propensity-matching study to investigate the association between HCQ use and the incidence of bacterial pneumonia in rheumatic patients. The Longitudinal Health Insurance Database (LHID) from Taiwan National Health Insurance Research Database (NHIRD) of 23million Taiwanese populations was used. We included patients who were newly diagnosed with rheumatic and immune disease (ICD-9-CM codes 696.0, 710, 714) within 2000-2012. HCQ users and non-users were then matched according to age, sex, urbanisation level, monthly income, comorbidities and medications in the ratio of 1:1 by the propensity score matching. Cox proportional hazard model was used to evaluate the risk of bacterial pneumonia in rheumatic patients who used HCQ and who did not use HCQ. There were total 3285 patients with rheumatic and immune disease enrolled. The cumulative incidence curve of patients with the use of HCQ sulphate had no difference to that of patient without the use of HCQ sulphate in propensity score-matched cohort, (Log-rank test: P=.5). However, patients who used HCQ sulphate for more than 1400 average use days had a lesser risk of bacterial pneumonia (adjusted HR=0.55, 95% CI=0.35, 0.89) in the cohort matched, with regarding HCQ non-users as a reference. Rheumatic patients taking HCQ had no overall significant differences of bacterial pneumonia incidences compared with rheumatic patients not taking HCQ. HCQ used more than >1400days or lupus patients using HCQ was associated with lower risk of bacterial pneumonia.

Origin and Potential Expansion of the Invasive Longan Lanternfly, Pyrops candelaria (Hemiptera: Fulgoridae) in Taiwan.

Simple SummaryThe longan lanternfly Pyrops candelaria (Linnaeus), which feeds on longan trees, has invaded the main island of Taiwan. Thus, this study aimed to (1) trace the origin of invasion, (2) predict habitat suitability and (3) study the risk of lanternfly spread into crop cultivation areas. We reconstructed the longan lanternfly phylogeny to compare haplotypes among different regions. In addition, we predicted the habitat suitability for the species based on MaxEnt and then matched it with longan and pomelo cultivation areas. Our results indicated that the Taiwanese populations of longan lanternfly might originate from the Kinmen Islands and the plain areas of Taiwan are considered to have high habitat suitability.The longan lanternfly Pyrops candelaria is a new invasive species on the main island of Taiwan. The introduction of an invasive species may negatively influence the native fauna, flora and environment. Thus, this study aimed to infer the invasion history, predict habitat suitability and potential expansion and assess the risk to crop cultivation areas in Taiwan. Genetic structures of P. candelaria from the main island of Taiwan and related regions were analyzed based on partial COI and ND2 sequences. Additionally, machine learning MaxEnt was utilized to study habitat suitability. The results suggested that the Taiwanese populations may originate from the Kinmen Islands and the plain areas of Taiwan are considered to have high habitat suitability. Furthermore, most of the cultivation areas of longan and pomelo crops showed high habitat suitability.

BRCA1 and BRCA2 Variation in Taiwanese General Population and the Cancer Cohort.

BRCA1 and BRCA2 (BRCA) play essential roles in maintaining genome stability. Rapidly evolving human BRCA generates oncogenic variants causing high cancer risk. BRCA variation is ethnic-specific in reflecting adaptation and/or effects of genetic drift. Taiwanese population of 23.8 million is an admixture of multiple ethnic origins; Taiwan’s subtropical and tropical climate and geographically islandic location provide a unique natural environment. Therefore, Taiwanese population provides a unique model to study human BRCA variation. Through collecting, standardizing, annotating, and classifying publicly available BRCA variants derived from Taiwanese general population and the cancer cohort, we identified 335 BRCA variants, of which 164 were from 1,517 non-cancer individuals, 126 from 2,665 cancer individuals, and 45 from both types of individuals. We compared the variant data with those from other ethnic populations such as mainland Chinese, Macau Chinese, Japanese, Korean, Indian, and non-Asians. We observed that the sharing rates with other Asian ethnic populations were correlated with its genetic relationship. Over 60% of the 335 Taiwanese BRCA variants were VUS, unclassified variants, or novel variants, reflecting the ethnic-specific features of Taiwanese BRCA variation. While it remains challenging to classify these variants, our structural and in silico analyses predicted their enrichment of BRCA deleterious variants. We further determined the 3.8% prevalence of BRCA pathogenic variants in the Taiwanese breast cancer cohort, and determined 0.53% prevalence of the BRCA pathogenic variants in Taiwanese general population, with the estimated 126,140 BRCA pathogenic variant carriers. We identified BRCA2 c.5164_5165delAG at BRCA2 BRC6 motif as a potential founder mutation in Taiwanese population. Our study on BRCA variation in Taiwanese and other East Asian populations demonstrates that ethnic specificity is a common phenomenon for BRCA variation in East Asian population; the data generated from the study provide a reference for clinical applications in BRCA-related cancer in Taiwanese population.

Mutational landscape with a focus on KRAS mutations in non-small lung cancer in Taiwan.

e20513 Background: Lung cancer is the leading cause of cancer death in Taiwan. The poor prognosis of lung cancer patients with advanced disease and recent development of precision medicine motivates the investigation of molecular targets. The purpose of the study is to estimate the prevalence of KRAS gene mutations and 15 other gene targets among non-small cell lung cancer (NSCLC) patients in Taiwan. Methods: This retrospective study included 933 NSCLC patients diagnosed between January 1992 and July 2018 at six medical centers in Taiwan, including Taichung Veteran’s General Hospital, Chung San Medical University Hospital, China Medical University Hospital, Kaohsiung Veteran’s General Hospital, Tri-Service General Hospital and National Taiwan University Hospital. Patients ≥18 years, had primary histologically confirmed NSCLC diagnosis at time before any treatment, and availability of archival tumor tissue with &gt;30% tumor cellularity. Mutational Analysis: The Formalin-Fixed Paraffin-Embedded (FFPE) tumor blocks were analyzed for the prevalence of somatic mutations. The entire coding sequence of 16 genes was analyzed by next generation sequencing of macrodissected DNA from FFPE recut slides at a depth of greater than 300x and interrogated for somatic pathogenic variants. RNA was not available; hence this limits sensitivity to detect fusions. Results: The mean age at diagnosis was 62 years, 498/933 (53%) were women, 411/843 (49%) were smokers or former smokers, and 829/933 (89%) of adenocarcinoma histopathology. Stage was available for 723 patients with a distribution of 328/723 (45%) Stage I, 120/723 (17%) Stage II, 210/723 (29%) Stage III, and 65/723 (9%) Stage IV. EGFR mutations were identified in 327/933 (35.1%) and TP53 mutations in 179/933 (19.2%). KRAS mutations were identified in 72/933 (7.7%) patients, with KRAS G12C mutations observed in 23/933 (2.5%), KRAS G12D in 16/933 (1.7%), and KRAS G12V in 14/933 (1.5%) (Table). In addition, co-occurring mutations with KRAS were observed and are highlighted, including 14 TP53, 4 PIK3CA, 2 EGFR, 2 CTNNB1, 1 STK11, 1 BRAF and 1 PTEN. Conclusions: EGFR and TP53 were the most frequent mutations identified among all stage NSCLC in Taiwanese populations, followed by KRAS. KRAS G12C and KRAS G12D, the two most frequent KRAS mutations, were identified in 32% and 22% of the KRAS-mutant tumors. Although the prevalence of any KRAS mutation or KRAS G12C mutation is lower than typically seen in Western countries, it is similar to observations among Asian populations. These findings broaden the understanding of the mutational landscape of NSCLC patients in Taiwan to inform development of new therapeutic approaches. [Table: see text]

Revision of the genera Xanthogaleruca Laboissière, 1932 and Pyrrhalta Joannis, 1865 (Coleoptera, Chrysomelidae, Galerucinae) of Taiwan, with type designation of Galerucella lineatipes Takei.

The taxonomic status of Pyrrhalta Joannis, 1865 and allied genera Tricholochmaea Laboissière, 1932 and Xanthogaleruca Laboissière, 1934 is discussed based on the study of Taiwanese species. Tentatively, Xanthogaleruca and Pyrrhalta are regarded as valid genera while Tricholochmaea is a synonym of Pyrrhalta. Fourteen species are recognized and redescribed, including P. gressitti Kimoto, 1969; P. taiwana Kimoto, 1969; P. viridipennis Kimoto, 1981; P. igai Kimoto, 1981; P. meifena Kimoto, 1976; P. maculata Gressitt & Kimoto, 1963; P. tsoui Bezděk & Lee, 2019; P. semifulva (Jacoby, 1885); P. discalis Gressitt & Kimoto, 1963; P. ishiharai Kimoto, 1994; P. shirozui Kimoto, 1969; P. kobayashii Kimoto, 1974; P. ohbayashii Kimoto, 1984; and P. takizawai Kimoto, 1996. Taiwanese populations identified as Xanthogaleruca aenescens (Fairmaire) were misidentified and those are described as a new species, X. yuaesp. nov.Xanthogaleruca aenescens is redescribed for comparison. Eight additional new species of Pyrrhalta are described: P. alishanensissp. nov., P. houjayisp. nov., P. formosanensissp. nov., P. jungchanisp. nov., P. luisp. nov., P. meihuaisp. nov., P. tahsiangisp. nov., and P. wulaiensissp. nov. Type specimens of Galerucella lineatipes Takei, 1916 were rediscovered and are designated as lectotype and paralectotype. Galerucella lineatipes is removed from synonymy with G. calmariensis (Linnaeus, 1767) and regarded as a senior synonym of P. humeralis (Chen, 1942), syn. nov. Most Pyrrhalta species can be classified into four species groups based on their morphological and genitalic similarity. host plants and other biological information are provided for almost all species.

Measurement Invariance of the Drivers of COVID-19 Vaccination Acceptance Scale: Comparison between Taiwanese and Mainland Chinese-Speaking Populations.

The impacts of novel coronavirus disease-2019 (COVID-19) on human life continue to be serious. To control the spread of COVID-19, the production of effective vaccines is likely to be one of the best solutions. However, vaccination hesitancy may decrease individuals’ willingness to get vaccinated. The Drivers of COVID-19 Vaccination Acceptance Scale (DrVac-COVID19S) was recently developed to help healthcare professionals and researchers better understand vaccination acceptance. The present study examined whether DrVac-COVID19S is measurement invariant across different subgroups (Taiwanese vs. mainland Chinese university students; males vs. females; and health-related program majors vs. non-health-related program majors). Taiwanese (n = 761; mean age = 25.51 years; standard deviation (SD) = 6.42; 63.5% females) and mainland Chinese university students (n = 3145; mean age = 20.72 years; SD = 2.06; 50.2% females) were recruited using an online survey between 5 January and 21 February 2021. Factor structure and measurement invariance of the two DrVac-COVID19S scales (nine-item and 12-item) were tested using confirmatory factor analysis (CFA). The findings indicated that the DrVac-COVID19S had a four-factor structure and was measurement invariant across the subgroups. The DrVac-COVID19S’s four-factor structure was supported by the CFA results is a practical and valid instrument to quickly capture university students’ willingness to get COVID-19 vaccination. Moreover, the DrVac-COVID19S can be used to compare university students’ underlying reasons to get COVID-19 vaccination among different subgroups.