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    Sex differences in the trajectories of and factors related to extracurricular sport participation and exercise: a cohort study spanning 13 years
    (2020-11-02) Wu, Wen-Chi; Chang, Ling-Yin; Luh, Dih-Ling; Wu, Chi-Chen; Stanaway, Fiona; Yen, Lee-Lan; Chang, Hsing-Yi
    Abstract Background Extracurricular sport participation and exercise (ESPE) refers to regular exercise/sport participation in addition to the physical education in school among a school-aged population. Rather than general physical activity, ESPE is typically deliberately initiated and presents an efficient target for interventions. However, compared to physical activity, relatively few studies have investigated sex differences in the development of and factors associated with ESPE using a person-centered approach. This study aimed to examine the latent trajectories of ESPE from childhood to emerging adulthood across sexes, and to identify the associated sex-specific individual (i.e., body mass index, body dissatisfaction, stress, and screen behavior) and parental (i.e., parental exercise and parental screen behavior) factors. Methods This study used data from part of the Child and Adolescent Behavior in Long-term Evolution (CABLE) project, which comprised 2072 fourth graders (aged 9 years) in Northern Taiwan followed annually from 2001 to 2013 (13 waves). Repeated-measures latent class analysis was used to identify the trajectories of ESPE for males and females, respectively. Multinomial logistic regression was further used to identify sex-specific factors related to ESPE. Results Four trajectories of ESPE were identified for males and females. For males, these trajectories were Rarely-to-Never (20%), Often-to-Rarely (32%), Always-to-Never (21%), and Always (27%). For females, these trajectories were Rarely-to-Never (34%), Rarely (23%), Always-to-Rarely (33%), and Always (10%). We observed that the developmental patterns of ESPE varied by sex such that there was an earlier decline in the trajectories of ESPE in females than in males and that, compared with males, fewer females maintained exercise habits in young adulthood. Furthermore, we found several sex-specific factors related to ESPE, namely, stress, BMI, and parental exercise. Body dissatisfaction and individual screen behavior were associated with trajectories of ESPE for both sexes. Conclusions We found distinct trajectories of ESPE from childhood to emerging adulthood for both sexes. The trajectories of ESPE for males and females, however, differ in terms of patterns and associated factors. Our findings suggest that efforts to increase ESPE should be initiated early, and may be made more effective by considering sex differences.
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    Prison sentencing increases the risk of unemployment among illegal heroin users in Taiwan
    (2020-10-12) Lee, Charles T; Huang, Chiu-Mieh; Chang, Li-Chun; Wang, Shih-Wen; Hsu, Hsiao-Pei; Liao, Jung-Yu; Guo, Jong-Long
    Abstract Background Previous studies have rarely explored the effect of type of sentencing on employment status among illegal heroin users, therefore, we aims to examine the association of the sentencing types and employment outcomes among illegal heroin users in Taiwan. Methods Participants with illegal heroin use were identified through the national prison register system and deferred prosecution system: 2406 with deferred prosecutions, 4741 with observation and rehabilitation, 15 compulsory rehabilitation and 1958 sentenced to prison in calendar 2011. Logistic regression models were built to estimate the effect of sentencing type on unemployment status at 2 years after release. Stratification analysis was conducted to determine the effect of sentencing type based on the offender’s employment status before sentencing. Results Illegal heroin users receiving a prison sentence were more than twice as likely to be unemployed 2 years later than those receiving deferred prosecution. The unemployment rate was also higher for those with observation and rehabilitation and compulsory rehabilitation than deferred prosecution in the 2 years following sentencing. Males, older users, without a job before sentencing, divorced or widowed and higher prior drug use criminal records were also higher risk of unemployment. Subgroup analysis by prior employment status revealed that being sentenced to prison, observation and rehabilitation and compulsory rehabilitation affected the subsequent employment status only for those heroin users with a job before sentencing. The strength of associations showed dose-dependent relationship between different sentencing types (sentenced to prison> compulsory rehabilitation> observation and rehabilitation) and employment outcomes. Conclusions Illegal heroin users who receive a prison sentence have a much higher risk of unemployment than those who receive deferred prosecution after controlling potential confounders, especially those who had a job before sentencing. The implication is the stronger freedom of punishment, the higher risk of unemployment outcomes. Our study support that illegal heroin user is legally regarded as a patient before being regarded as a criminal, so giving priority to quit addition rather than imprisonment.
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    Phloretin ameliorates hepatic steatosis through regulation of lipogenesis and Sirt1/AMPK signaling in obese mice
    (2020-09-29) Liou, Chian-Jiun; Wu, Shu-Ju; Shen, Szu-Chuan; Chen, Li-Chen; Chen, Ya-Ling; Huang, Wen-Chung
    Abstract Background Phloretin is isolated from apple trees and could increase lipolysis in 3T3-L1 adipocytes. Previous studies have found that phloretin could prevent obesity in mice. In this study, we investigated whether phloretin ameliorates non-alcoholic fatty liver disease (NAFLD) in high-fat diet (HFD)-induced obese mice, and evaluated the regulation of lipid metabolism in hepatocytes. Methods HepG2 cells were treated with 0.5 mM oleic acid to induce lipid accumulation, and then treated with phloretin to evaluate the molecular mechanism of lipogenesis. In another experiment, male C57BL/6 mice were fed normal diet or HFD (60% fat, w/w) for 16 weeks. After the fourth week, mice were treated with or without phloretin by intraperitoneal injection for 12 weeks. Results Phloretin significantly reduced excessive lipid accumulation and decreased sterol regulatory element-binding protein 1c, blocking the expression of fatty acid synthase in oleic acid-induced HepG2 cells. Phloretin increased Sirt1, and phosphorylation of AMP activated protein kinase to suppress acetyl-CoA carboxylase expression, reducing fatty acid synthesis in hepatocytes. Phloretin also reduced body weight and fat weight compared to untreated HFD-fed mice. Phloretin also reduced liver weight and liver lipid accumulation and improved hepatocyte steatosis in obese mice. In liver tissue from obese mice, phloretin suppressed transcription factors of lipogenesis and fatty acid synthase, and increased lipolysis and fatty acid β-oxidation. Furthermore, phloretin regulated serum leptin, adiponectin, triglyceride, low-density lipoprotein, and free fatty acid levels in obese mice. Conclusions These findings suggest that phloretin improves hepatic steatosis by regulating lipogenesis and the Sirt-1/AMPK pathway in the liver.
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    Psychometric properties and measurement invariance of the 7-item game addiction scale (GAS) among Chinese college students
    (2020-10-02) Liu, Yujie; Wang, Qian; Jou, Min; Wang, Baohong; An, Yang; Li, Zifan
    Abstract Background The 7-item Gaming Addiction Scale (GAS) has been used as a screening tool for addictive game use worldwide, and this study aimed to examine its psychometric properties and measurement invariance among college students in China. Methods Full-time students from multiple colleges in China were recruited. A total of 1040 completed questionnaires were used in the final analysis. Reliability of the GAS was assessed by internal consistency and split-half reliability. Validity of the GAS was assessed by structural validity, convergent validity, discriminant validity, and concurrent validity. A series of Multigroup Confirmatory Factor Analysis (MG-CFA) were conducted to test and establish measurement invariance across gender, class standing, family income and parental educational level. Results Exploratory factor analysis revealed a unidimensional structure of the GAS. The GAS exhibited excellent internal consistency (Cronbach’s α = 0.951, theta coefficient = 0.953, omega coefficient = 0.959) and structural validity (χ2 /df = 0.877 (p < 0.05), CFI = 0.999, TIL = 0.996, RMSEA =0.000). Concurrent validity of the GAS was confirmed by its correlation with problematic internet use, sleep quality, nine dimensions of psychiatric symptoms, and substance use. The GAS also demonstrated measurement invariance across father’s educational level (Δχ2 (df) = 19.128 (12), ΔCFI = − 0.009, ΔRMSEA = 0.010 for weak factorial model; Δχ2 (df) = 50.109 (42), ΔCFI = − 0.010, ΔRMSEA = 0.007 for strict factorial model.) and mother’s educational level (Δχ2 (df) = 6.679 (12), ΔCFI = 0.007, ΔRMSEA = − 0.010 for weak factorial model; Δχ2 (df) =49.131 (42), ΔCFI = − 0.009, ΔRMSEA = − 0.004 for strict factorial model), as well as partial measurement invariance across gender (except for item 2), class standing (except for item 7) and family income (except for item 5). Conclusions The Chinese version of the 7-item GAS can be an adequate assessment tool to assess internet gaming disorder among the college student population in China.
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    A network approach to investigating the key microbes and stability of gut microbial communities in a mouse neuropathic pain model
    (2020-09-30) Brandon-Mong, Guo-Jie; Shaw, Grace T; Chen, Wei-Hsin; Chen, Chien-Chang; Wang, Daryi
    Abstract Background Neuropathic pain is an abnormally increased sensitivity to pain, especially from mechanical or thermal stimuli. To date, the current pharmacological treatments for neuropathic pain are still unsatisfactory. The gut microbiota reportedly plays important roles in inducing neuropathic pain, so probiotics have also been used to treat it. However, the underlying questions around the interactions in and stability of the gut microbiota in a spared nerve injury-induced neuropathic pain model and the key microbes (i.e., the microbes that play critical roles) involved have not been answered. We collected 66 fecal samples over 2 weeks (three mice and 11 time points in spared nerve injury-induced neuropathic pain and Sham groups). The 16S rRNA gene was polymerase chain reaction amplified, sequenced on a MiSeq platform, and analyzed using a MOTHUR- UPARSE pipeline. Results Here we show that spared nerve injury-induced neuropathic pain alters gut microbial diversity in mice. We successfully constructed reliable microbial interaction networks using the Metagenomic Microbial Interaction Simulator (MetaMIS) and analyzed these networks based on 177,147 simulations. Interestingly, at a higher resolution, our results showed that spared nerve injury-induced neuropathic pain altered both the stability of the microbial community and the key microbes in a gut micro-ecosystem. Oscillospira, which was classified as a low-abundance and core microbe, was identified as the key microbe in the Sham group, whereas Staphylococcus, classified as a rare and non-core microbe, was identified as the key microbe in the spared nerve injury-induced neuropathic pain group. Conclusions In summary, our results provide novel experimental evidence that spared nerve injury-induced neuropathic pain reshapes gut microbial diversity, and alters the stability and key microbes in the gut.
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    Bigger doesn’t mean bolder: behavioral variation of four wild rodent species to novelty and predation risk following a fast-slow continuum
    (2020-09-21) Best, Ian N; Shaner, Pei-Jen L; Lo, Hsuan-Yi; Pei, Kurtis J; Kuo, Chi-Chien
    Abstract Background Understanding how wild species respond to novel situations with associated risk can provide valuable insights for inter-specific behavioral variation and associations with pace-of-life (POL). Rodents, a globally distributed and diverse taxonomic group, have been the subjects of countless studies emulating risky situations. Controlled laboratory experiments with a focus on wild-caught species provide the opportunity to test fine-scale behavioral responses to contexts of risk with ecological implications. For example, assessing the importance of predator cues eliciting antipredator responses, as well as whether wild rodents embody behavioral plasticity and repertoires, illustrated by habituation and variation in behavioral traits, respectively. Results In this comparative study, we examined multiple behavioral responses of four rodent species in eastern Taiwan (three native species Mus caroli, Apodemus agrarius, Rattus losea, and one invasive, Rattus exulans) exposed to an unfamiliar microenvironment and novel cue from an allopatric predator, the leopard cat (Prionailurus bengalensis). All wild-caught animals were subjected to two consecutive nights of experimental trials in a laboratory setting. Behavioral responses to a novel situation during the first trial differed between species; smaller species investing more time in non-defensive behaviors compared to the larger species. More specifically, the smaller species M. caroli and A. agrarius allocated more time to exploration and foraging, whereas the larger rat species R. exulans and R. losea spent more time motionless or concealing. During the second trial, the addition of leopard cat cues did not elicit antipredator behaviors, but rather, rodents were found to exhibit increased non-defensive behaviors, specifically foraging efforts. Conclusions Our results suggest that these four species do largely follow a behavioral fast-slow continuum with the two smaller mice species demonstrating increased boldness in a novel context compared to the larger rat species. Also, the wild populations of rodents in eastern Taiwan may be naïve to leopard cats. Finally, the rodents in our study demonstrated habituation to the microenvironment, indicating they possess adaptive capacity.
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    Anxiety symptoms and preventive measures during the COVID-19 outbreak in Taiwan
    (2020-07-16) Wong, Li P; Hung, Chia-Chun; Alias, Haridah; Lee, Tony S
    Abstract Background It is hypothesized that anxiety and behavioral responses are intense at the beginning of an epidemic. The objective of this study was to investigate anxiety symptoms and use of preventive measures against COVID-19. The study also compared the association between preventive measures and anxiety symptoms during the week immediately preceding the study and those symptoms and measures at the beginning of the outbreak. Methods A cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan ages 20 to 70 years. The 6-item state version of the State–Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Multivariable logistic regression was used to determine the factors influencing an increase in the preventive measures scores. Results Of a total of 3555 completed responses, a total of 52.1% (95% confidence interval [CI] 50.4–53.7) of the respondents reported moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2–50.5) reported moderate to severe anxiety symptoms at the beginning of the outbreak. With a higher score indicating greater anxiety, the median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [interquartile range] 36.7–53.3) and 43.3 (IQR 36.7–53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0–30.0) and 24.0 (IQR 19.0–28.0), respectively, out of a maximum score of 36. In the multivariable analysis, an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28–8.66) was a strongly significant determinant of an increased preventive measures score in the past week compared with the score at the beginning of the outbreak. Conclusions Anxiety and preventive measures scores were high and increased with the epidemic rate. Higher anxiety was associated with an increased use of preventive measures against COVID-19.
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    Pregnant women’s attitudes and decision-making regarding prenatal Down syndrome screening and diagnosis: scale development and validation
    (2020-07-14) Huang, Wei-Hsiang; Shih, Shu-Fang; Lin, Chen-Li; Liu, Chieh-Hsing
    Abstract Background Down syndrome is a common chromosomal abnormality and prenatal screening can inform parents of the risk of their baby having Down syndrome. Little research has examined how decisions regarding both Down syndrome screening as well as diagnosis are made among women who are currently pregnant and how their decisions are influenced by their social contexts, specifically family and social media, using mixed methods. The study was to test the validity and reliability of a scale that measures pregnant women’s attitudes and decision-making concerning prenatal Down syndrome screening and diagnosis in urban areas of Taiwan. Methods We developed an item pool based on a literature review and in-depth interviews with 30 pregnant women recruited at two district hospitals in urban areas. The item pool was reviewed by a panel of experts and then administered to 300 women who had been pregnant for less than 24 weeks and had not received the Down syndrome screening tests. We used item analysis and exploratory factor analysis to validate the scale and test its reliability. Results The initial item pool had 54 items. After the expert review, three items were deleted. After the item analysis, 16 additional items were deleted. Exploratory factor analysis of the remaining items revealed four factors labeled – “Attitudes towards Down syndrome and Screening Tests,” “Important others’ Attitudes towards Down Syndrome,” “Influence of Important Others on Decision-Making,” and “Influence of Social Media on Decision-Making” – and 16 of the remaining items had satisfactory loadings on those factors, explaining 72.0% of the total variance. The Cronbach’s α values of the dimensions ranged between 0.75 and 0.90, demonstrating satisfactory internal reliability. Conclusions The scale has satisfactory validity and reliability, and can be used to understand pregnant women’s attitudes and decision-making regarding Down syndrome screening and diagnosis, and to help design tailored consultations for pregnant women in clinical settings.
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    Evidence of STEM enactment effectiveness in Asian student learning outcomes
    (2020-07-10) Wahono, Bevo; Lin, Pei-Ling; Chang, Chun-Yen
    Abstract This study used a systematic review and meta-analysis as a method to investigate whether STEM enactment in Asia effectively enhances students’ learning outcomes. Verifiable examples of science, technology, engineering, and mathematics (STEM) education, effectively being applied in Asia, are presented in this study. The study involved 4768 students from 54 studies. Learning outcomes focused on the students’ academic learning achievement, higher-order thinking skills (HOTS), and motivation. The analysis results of effect sizes showed that the STEM enactments in Asia were effective at a moderate level (0.69 [0.58, 0.81 of 95% CI]) of improving students’ learning outcomes. Sequentially, the effectiveness of STEM enactment starts from students’ higher-order thinking skills, moves to students’ academic learning achievement, and ends with the motivation. In addition, STEM enactments in Asia were carried out with several variations where STEM integrated with project-based learning was preferred. The recommendations of this study include a combination of the learning approach, learning orientation, and duration of instruction, all of which contribute to the STEM enactment effectiveness and maximize results in STEM education. Some practical implications, such as the central role of the teacher during the STEM enactment, are extensively discussed. This study supports that STEM education is a universally crucial tool which effectively prepares students from various national and cultural backgrounds, across Asia, toward improved learning outcomes.
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    Adherence among HIV-positive injection drug users undergoing methadone treatment in Taiwan
    (2020-07-02) Chao, En; Hung, Chia-Chun; Lin, Ching-Po; Ku, Yi-Chien J; Ain, Qurat U; Metzger, David S; Lee, Tony S
    Abstract Aims The study aims were to investigate adherence to methadone maintenance treatment (MMT) and to identify associated clinical factors in patients who inject drugs diagnosed with human immunodeficiency virus (HIV) infection in Taiwan. Methods Data were from the National Health Surveillance System on HIV and the National Drug Treatment System on MMT. HIV-positive people who inject drugs (HIVPWID) were defined as the study population. Information obtained included age, sex, education, marital status, employment, methadone dose, and date of diagnosis of HIV infection. Adherence was defined as taking methadone for the past 90, 180 and 365 days, then categorized as high (> 90%), moderate (51 to 90%), or low (<=50%) adherent respectively. Results Of 1641 HIVPWID registered in the datasets from 2007 to 2012, 961 (58.56%) had received MMT. For HIVPWID evaluated at 90 days (n = 951), 271 (28.5%), 382 (40.2%), and 298 (31.3%) were classified as high, moderate, and low adherent respectively. For HIVPWID evaluated at 180 days (n = 936), 190 (20.3%), 349 (37.3%), and 397 (42.4%) were classified as high, moderate, and low adherent respectively. For HIVPWID evaluated at 365 days (n = 919), 133 (14.5%), 271 (29.5%), and 515 (56.0%) were classified as high, moderate, and low adherent respectively. After controlling for sociodemographics, results showed that methadone dose, location of MMT clinic, and date of HIV diagnosis were significantly associated with MMT adherence. Conclusions Study findings underscore the importance to MMT adherence of methadone dosage, early diagnosis of patient’s HIV infection, and area of patient residence.
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    Sequence analysis and protein interactions of Arabidopsis CIA2 and CIL proteins
    (2020-06-18) Yang, Chun-Yen; Sun, Chih-Wen
    Abstract Background A previous screening of Arabidopsis thaliana for mutants exhibiting dysfunctional chloroplast protein transport identified the chloroplast import apparatus (cia) gene. The cia2 mutant has a pale green phenotype and reduced rate of protein import into chloroplasts, but leaf shape and size are similar to wild-type plants of the same developmental stage. Microarray analysis showed that nuclear CIA2 protein enhances expression of the Toc75, Toc33, CPN10 and cpRPs genes, thereby up-regulating protein import and synthesis efficiency in chloroplasts. CIA2-like (CIL) shares 65% sequence identity to CIA2, suggesting that CIL and CIA2 are homologous proteins in Arabidopsis. Here, we further assess the protein interactions and sequence features of CIA2 and CIL. Results Subcellular localizations of truncated CIA2 protein fragments in our onion transient assay demonstrate that CIA2 contains two nuclear localization signals (NLS) located at amino acids (aa) 62-65 and 291-308, whereas CIL has only one NLS at aa 47-50. We screened a yeast two-hybrid (Y2H) Arabidopsis cDNA library to search for putative CIA2-interacting proteins and identified 12 nuclear proteins, including itself, CIL, and flowering-control proteins (such as CO, NF-YB1, NF-YC1, NF-YC9 and ABI3). Additional Y2H experiments demonstrate that CIA2 and CIL mainly interact with flowering-control proteins via their N-termini, but preferentially form homo- or hetero-dimers through their C-termini. Moreover, sequence alignment showed that the N-terminal sequences of CIA2, CIL and NF-YA are highly conserved. Therefore, NF-YA in the NF-Y complex could be substituted by CIA2 or CIL. Conclusions We show that Arabidopsis CIA2 and CIL can interact with CO and NF-Y complex, so not only may they contribute to regulate chloroplast function but also to modulate flower development.
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    The origin and underlying driving forces of the SARS-CoV-2 outbreak
    (2020-06-07) Chaw, Shu-Miaw; Tai, Jui-Hung; Chen, Shi-Lun; Hsieh, Chia-Hung; Chang, Sui-Yuan; Yeh, Shiou-Hwei; Yang, Wei-Shiung; Chen, Pei-Jer; Wang, Hurng-Yi
    Abstract Background SARS-CoV-2 began spreading in December 2019 and has since become a pandemic that has impacted many aspects of human society. Several issues concerning the origin, time of introduction to humans, evolutionary patterns, and underlying force driving the SARS-CoV-2 outbreak remain unclear. Method Genetic variation in 137 SARS-CoV-2 genomes and related coronaviruses as of 2/23/2020 was analyzed. Result After correcting for mutational bias, the excess of low frequency mutations on both synonymous and nonsynonymous sites was revealed which is consistent with the recent outbreak of the virus. In contrast to adaptive evolution previously reported for SARS-CoV during its brief epidemic in 2003, our analysis of SARS-CoV-2 genomes shows signs of relaxation. The sequence similarity in the spike receptor binding domain between SARS-CoV-2 and a sequence from pangolin is probably due to an ancient intergenomic introgression that occurred approximately 40 years ago. The current outbreak of SARS-CoV-2 was estimated to have originated on 12/11/2019 (95% HPD 11/13/2019–12/23/2019). The effective population size of the virus showed an approximately 20-fold increase from the onset of the outbreak to the lockdown of Wuhan (1/23/2020) and ceased to increase afterwards, demonstrating the effectiveness of social distancing in preventing its spread. Two mutations, 84S in orf8 protein and 251 V in orf3 protein, occurred coincidentally with human intervention. The former first appeared on 1/5/2020 and plateaued around 1/23/2020. The latter rapidly increased in frequency after 1/23/2020. Thus, the roles of these mutations on infectivity need to be elucidated. Genetic diversity of SARS-CoV-2 collected from China is two times higher than those derived from the rest of the world. A network analysis found that haplotypes collected from Wuhan were interior and had more mutational connections, both of which are consistent with the observation that the SARS-CoV-2 outbreak originated in China. Conclusion SARS-CoV-2 might have cryptically circulated within humans for years before being discovered. Data from the early outbreak and hospital archives are needed to trace its evolutionary path and determine the critical steps required for effective spreading.
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    A reappraisal of lymph node dissection in colorectal cancer during primary surgical resection
    (2020-05-17) Chen, Yen-Jen; Yeh, Shin-Ting; Kao, Ping-Sheng; Ou, Liang-Hung; Lin, Chen-Sung
    Abstract Purpose Controversy exists regarding the extent to which lymph node dissection (LND) should be performed for operable colorectal cancers (CRCs) during primary surgical resection. We reappraised the role of LND in CRCs. Methods Seventy-three CRC patients (mean age, 65.3 years; 43 males) undergoing primary surgical resection at Taipei Hospital, Ministry of Health and Welfare, Taiwan, within a 3-year period were retrospectively analyzed. Their pathological T/N/M statuses and cancer stages were defined according to the American Joint Committee on Cancer (AJCC) 8th edition staging system. The numbers of total dissected lymph nodes (TDLNs), positive dissected lymph nodes (PDLNs), and negative dissected lymph nodes (NDLNs) for each CRC patient were recorded in detail (TDLNs = PDLNs + NDLNs). Possible prognostic variables were evaluated. Results An advanced N status (N1/N2 vs. N0; HR, 5.749/17.677 vs. 1.000; p = 0.056/0.009) and M1 status (M1 vs. M0; HR, 7.517 vs. 1.000; p = 0.010) were independent variables for a poor prognosis. For all 73 CRC patients (p = 0.030), as well as T2 CRC patients (p = 0.061), those with > 15 TDLNs tended to have more PDLNs than those with ≤ 15 TDLNs. For 42 N(+) CRC patients (p = 0.007), as well as N2 CRC patients (p = 0.011), those with > 21 TDLNs tended to have more PDLNs than those with ≤ 21 TDLNs. Conclusion For CRC patients undergoing primary surgical resection, the number of TDLNs influences the accuracy of nodal staging. A minimum of 15 TDLNs is necessary for positive lymph nodes to be identified in CRC patients, and 21 TDLNs is sufficient for the severity of the N(+) status to be distinguished in N(+) CRC patients.
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    The mediating effect of dietary patterns on the association between mother’s education level and the physical aggression of five-year-old children: a population-based cohort study
    (2020-05-15) Wu, Wen-Chi; Lin, Ching-I; Li, Yi-Fan; Chang, Ling-Yin; Chiang, Tung-liang
    Abstract Background Relatively few studies have investigated the effects of diet on behavior problems among preschoolers, particularly, physical aggression. In addition, children raised by poorly educated mothers usually have a higher probability of developing negative outcomes. Additionally, highly educated mothers have a higher probability of providing more healthy foods for their children. Thus, mothers providing healthy foods might mitigate children’s behavior problems. The study aims to examine whether preschoolers’ dietary pattern, as a manipulable factor, mediates the association between maternal education level and physical aggression. Methods Data came from the Taiwan Birth Cohort Study (TBCS), a nationally representative population-based cohort study, which included 18,513 five-year-old Taiwanese children. Mothers and primary caregivers reported the information on preschoolers’ physical aggression and food consumption at age 5 and maternal education level at age 6 months. Two dietary patterns, namely a healthy diet and a high-fat-sugar-salt (HFSS) diet, were retrieved by exploratory factor analysis. Mediation hypotheses were tested by a series of multiple regression models conducted using the PROCESS macro of SAS 9.4. All models were adjusted for children’s sex, parental marital status, household income, mental distress at age 5 and children’s physical aggression at age 3. Results Maternal education positively linked to healthy dietary patterns (B = 0.014, p = 0.002) which was negatively associated with preschoolers’ physical aggression (B = -0.096, p = 0.013), and it is negatively related to the HFSS dietary pattern (B = -0.042, p = 0.002) which was directly positively associated with preschoolers’ physical aggression (B = 0.123, p = 0.008). The association between maternal education and preschoolers’ physical aggression was partially mediated by preschoolers’ healthy (B = -0.001, p < .001) and HFSS (B = -0.005, p = <.001) dietary patterns, respectively. The R-square of the mediation model is 0.178. Conclusions Preschoolers’ dietary patterns directly associate with their physical aggression. In addition, mothers with poor education may provide less healthy foods and more unhealthy foods to their children, which may increase the level of physical aggression. The results imply partial mediating effects of dietary patterns between maternal education and physical aggression. It is suggested that a parent-based nutritional education program focusing on healthy meal preparation for poor educated mothers might be beneficial for preschoolers’ healthy development.
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    Life satisfaction of Taiwanese dental graduates received residencies in the U.S.: a cross-sectional study
    (2020-04-28) Fu, Martin M; Chen, Rebecca Y; Kao, Huan-Chen; Wang, Chi-Hsien; Chan, Hsun-Liang; Fu, Earl; Lee, Tony S
    Abstract Background Each year, more than 200 international dental graduates start U.S. specialty trainings to become specialists. It is unknown if their life satisfaction is associated with any dental career-related factor before residencies (e.g. dental school class rank, research experience, or private practice experience) and after residencies (e.g. staying in the U.S., teaching status, workplace, or board certification). This cross-sectional study aimed to identify these potential factors by surveying Taiwanese dental graduates who pursued U.S. residencies. Methods Life satisfaction was measured with a structured questionnaire, Satisfaction With Life Scale (SWLS), which includes five statements on a 5-point Likert scale. Online surveys were sent out to 290 Taiwanese dental graduates who were known to pursue U.S. residencies. T-test, one way analysis of variance, and multivariable adjusted generalized linear model (GLM) were used to assess the differences of mean SWLS scores from different variables. Results Surveys were completed by 158 dentists. Mean SWLS score of 125 specialists was higher (p = 0.0007) than the score of 33 residents. For the 125 specialists, multivariable adjusted GLM demonstrated better life satisfaction was positively associated with multiple independent factors, such as having research experience, being ranked in the top 26 ~ 50% of the class in dental school, starting U.S. residency within 4 years after dental school, starting residency before year 1996, and specializing in endodontics (vs. periodontics). Life satisfaction was not associated with any factors after residency (e.g. staying in the U.S. afterwards, teaching status, or workplace), but better mean life satisfaction score was significantly associated with being American specialty board certified (p < 0.001) for the specialists in the 26 ~ 75% of their class in dental school. For the 33 residents, better mean life satisfaction score was associated with better dental school class rank in both bivariate (p = 0.020) and multivariable adjusted GLM (p = 0.004) analyses. Conclusions The life satisfaction of Taiwanese dental graduates pursuing U.S. residencies might be associated with some professional factors, such as research experience, dental school class rank, residency timing, specialty type, and specialty board certification. We hope our results may provide some objective information on making career decisions for international dental graduates/students who are preparing for U.S. residency.
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    IDC theory: interest and the interest loop
    (2020-01-30) Wong, Lung-Hsiang; Chan, Tak-Wai; Chen, Wenli; Looi, Chee-Kit; Chen, Zhi-Hong; Liao, Calvin C Y; King, Ronnel B; Wong, Su L
    Abstract Numerous studies have shown that learning is enhanced when students show interest in the subject matter. However, educators continue to grapple with the challenges, or simply do not recognize their potential roles, in the development of students’ academic interest and interest in learning in general. This conceptual paper is written under the auspices of the interest-driven creator (IDC) initiative, a theoretical synthesis effort carried out by a group of educational researchers in Asia. The intention is to co-construct a holistic developmental/design framework to guide the students in fostering their learning interests, capabilities in creation, and learning habits—the three anchored concepts of IDC theory. This paper focuses on delineating a three-component “interest loop” to guide the design of a coherent learning process that encompasses a series of learning tasks. The three components are triggering interest, immersing interest, and extending interest. Underpinned by the rich literature on interest development, we will propose suitable design strategies for each of the three components, namely, curiosity, flow, and meaningfulness, respectively. We will then explicate their respective design considerations/principles to maximize the intended effects.
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    Intelligent video interview agent used to predict communication skill and perceived personality traits
    (2020-01-08) Suen, Hung-Yue; Hung, Kuo-En; Lin, Chien-Liang
    Abstract The prediction of individual interpersonal communication skills and personality traits is a critical issue in both industrial and organizational psychology and affective computing. In this study, we invited 114 participants, including 57 interviewers and 57 interviewees, to collect the ground truth of interviewees’ communication skills and personality traits as perceived by real human interviewers in a structured behavioral interview setting. We develop an asynchronous video interview (AVI) platform with an artificial intelligence (AI) decision agent based on a TensorFlow convolutional neural network (CNN), called AVI-AI, that can be used to partially displace human raters’ work in the initial stage of employment screening and to successfully predict a job candidate’s communication skills and personality traits. The experimental results show that AVI-AI can predict not only a candidate’s interpersonal communication skills but also his or her openness, agreeableness, and neuroticism, as perceived by experienced human resource professionals. The interrater reliability values were all acceptable to support the ground truth assumption. However, our AVI-AI could not predict the conscientiousness and extraversion as perceived by the real human raters in this study.
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    Long-term monitoring reveals invariant clutch size and unequal reproductive costs between sexes in a subtropical lacertid lizard
    (2020-01-06) Lin, Jhan-Wei; Chen, Ying-Rong; Li, Tsui-Wen; Shaner, Pei-Jen L; Lin, Si-Min
    Abstract Based on 20,000 records representing c. 11,000 individuals from an 8-year capture-mark-recapture (CMR) study, we tested and confirmed a new case of invariant clutch size (ICS) in a sexually dichromatic lacertid lizard, Takydromus viridipunctatus. In the grassland habitat of the early succession stage, females showed strictly low and invariant clutch size, multiple clutches in a breeding season, high reproductive potential, and annual breeding cycles that correspond to the emergence of male courtship coloration. The hatchlings mature quickly, and join the adult cohort for breeding within a few months, whereas adults show low survival rates and a short lifespan, such that most die within one year. Mortality increased in both sexes during the breeding season, especially in females, indicating an unequal cost of reproduction in survival. These life history characters may be explained by two non-exclusive hypotheses of ICS—arboreal hypothesis and predation hypothesis—within the ecological context of their habitat. Our study highlights a confirmed case of ICS, which adapts well to this r-selected grassland habitat that experiences seasonal fluctuation and frequent disturbance.
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    IDC theory: creation and the creation loop
    (2019-12-30) Chan, Tak-Wai; Looi, Chee-Kit; Chang, Ben; Chen, Wenli; Wong, Lung-Hsiang; Wong, Su L; Yu, Fu-Yun; Mason, Jon; Liu, Chen-Chung; Shih, Ju-Ling; Wu, Ying-Tien; Kong, Siu-Cheung; Wu, Longkai; Chien, Tzu-Chao; Liao, Calvin C Y; Cheng, Hercy; Chen, Zhi-Hong; Chou, Chih-Yueh
    Abstract The interest-driven creator (IDC) theory is being developed as a group endeavor by Asian researchers to articulate a holistic learning design theory for future education in Asia. The theory hypothesizes that students, driven by interest, can be engaged in the creation of knowledge (generating ideas and artifacts). By repeating this creation process in their daily learning routines, they will excel in learning performance, develop twenty-first-century competencies, and form creation habits. We hope that with such practices in education, our future generations will ultimately become lifelong interest-driven creators. In IDC Theory, there are three anchored concepts, namely, interest, creation, and habit. Each anchored concept comprises three component concepts which form a concept loop. For example, the creation loop consists of three component concepts—imitating, combining, and staging. Imitating is concerned with taking in (or inputting) an abundant amount of existing knowledge from the outside world to form one’s background knowledge. Combining refers to delivering (or outputting) new ideas or artifacts prolifically by synthesizing existing information encountered in the world and thoughts arising from the students’ background knowledge. Staging relates to frequently demonstrating the generated ideas or artifacts to the relevant communities and receiving feedback from these communities to improve the novelty and value of the demonstrated outcomes while gaining social recognition and nurturing positive social emotions. This paper focuses on describing the three components of the creation loop. We provide three case studies to illustrate the creation loop at work, as well as how it intertwines with both the interest and habit loops in supporting students to develop their creation capabilities. In presenting this iteration of the creation concept, an anchored concept in IDC theory, we acknowledge the roles played of imitation, combination, and staging in different learning and education contexts—indeed, there are multiple theories that inform and intersect with it.
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    Intelligent data cache based on content popularity and user location for Content Centric Networks
    (2019-12-26) Wu, Hsin-Te; Cho, Hsin-Hung; Wang, Sheng-Jie; Tseng, Fan-Hsun
    Abstract Content cache as well as data cache is vital to Content Centric Network (CCN). A sophisticated cache scheme is necessary but unsatisfied currently. Existing content cache scheme wastes router’s cache capacity due to redundant replica data in CCN routers. The paper presents an intelligent data cache scheme, viz content popularity and user location (CPUL) scheme. It tackles the cache problem of CCN routers for pursuing better hit rate and storage utilization. The proposed CPUL scheme not only considers the location where user sends request but also classifies data into popular and normal content with correspond to different cache policies. Simulation results showed that the CPUL scheme yields the highest cache hit rate and the lowest total size of cache data with compared to the original cache scheme in CCN and the Most Popular Content (MPC) scheme. The CPUL scheme is superior to both compared schemes in terms of around 8% to 13% higher hit rate and around 4% to 16% lower cache size. In addition, the CPUL scheme achieves more than 20% and 10% higher cache utilization when the released cache size increases and the categories of requested data increases, respectively.