Strategic highlights of Taiwan's people-centered New Southbound Policy

For more about the East-West Center, see http://www.eastwestcenter.org/Alan H. Yang and Jeremy Chiang, Executive Director and Managing Editor at the Taiwan-Asia Exchange Foundation, respectively, explain that "While the "Go South" policies concentrated on economic cooperation and state-owned-enterprise (SOE) investments, the NSP seeks deeper socio-economic connectivity between Taiwan and its neighboring communities.

The Taiwan ECDFS Near-Infrared Survey: Ultra-deep J and Ks Imaging in the Extended Chandra Deep Field-South

We present ultra-deep J and Ks imaging observations covering a 30' * 30' area of the Extended Chandra Deep Field-South (ECDFS) carried out by our Taiwan ECDFS Near-Infrared Survey (TENIS). The median 5-sigma limiting magnitudes for all detected objects in the ECDFS reach 24.5 and 23.9 mag (AB) for J and Ks, respectively. In the inner 400 arcmin^2 region where the sensitivity is more uniform, objects as faint as 25.6 and 25.0 mag are detected at 5-sigma. So this is by far the deepest J and Ks datasets available for the ECDFS. To combine the TENIS with the Spitzer IRAC data for obtaining better spectral energy distributions of high-redshift objects, we developed a novel deconvolution technique (IRACLEAN) to accurately estimate the IRAC fluxes. IRACLEAN can minimize the effect of blending in the IRAC images caused by the large point-spread functions and reduce the confusion noise. We applied IRACLEAN to the images from the Spitzer IRAC/MUSYC Public Legacy in the ECDFS survey (SIMPLE) and generated a J+Ks selected multi-wavelength catalog including the photometry of both the TENIS near-infrared and the SIMPLE IRAC data. We publicly release the data products derived from this work, including the J and Ks images and the J+Ks selected multiwavelength catalog.Comment: 25 pages, 25 figures, ApJS in pres

In-vivo corneal confocal microscopy in chemotherapy-induced peripheral neuropathy

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating condition affecting up to 80% of treated patients with severe impact on their quality of life. While some patients experience improvement in signs and symptoms after dose reduction or cessation of treatment, many develop chronic neuropathy which can last for years leading to high economic and disease burden. Assessment of CIPN currently relies on crude severity grading by clinicians, subjective patient questionnaires and nerve conduction studies limited to large nerve fibre assessment. Unfortunately, there is still an absence of reliable and efficient methods which can provide sensitive endpoint measures particularly with small nerve fibre assessments. While ocular surface neural changes have been well established as potential diagnostic and prognostic markers in other aetiologies of peripheral neuropathy particularly diabetes, there have been limited studies in CIPN. Hence, the overall aim of this thesis was to investigate whether neural changes on the ocular surface occurred with neurotoxic chemotherapy along with CIPN development. This was explored across several studies primarily with in-vivo corneal confocal microscopy (CCM). The first series, comprised of five cross-sectional studies, assessed patients who have already completed neurotoxic chemotherapy treatment for cancer and may have persistent CIPN. Neurotoxic chemotherapeutic drugs including taxanes or platinum compounds were the focus as these were the most commonly associated with CIPN. Chapter 2 analysed the reproducibility of corneal nerve image selection and analysis outcomes from the central cornea and inferior whorl region, a distinct landmark of the sub-basal nerve plexus. Analysis of both regions produced reliable and reproducible findings, although the inferior whorl region had slightly higher variability compared to the central cornea. This study also demonstrated that complex inferior whorl patterns, more commonly found in patients with CIPN compared to healthy individuals, may reduce reproducibility of image selection and analysis. Chapter 3 assessed whether corneal nerve damage occurred in patients who have already completed treatment with neurotoxic chemotherapy prior to assessment. This study established that there was corneal nerve reduction particularly in patients treated with paclitaxel who still had peripheral neuropathy post-treatment cessation, and this reduction was associated with worse fine hand dexterity. Chapter 4 then investigated whether the loss of nerves described in the previous study contributed to ocular surface discomfort associated with dry eye disease, which is a widespread and overlooked condition severely impacting quality of life analogous to CIPN. In this study, paclitaxel-treated patients with CIPN who had more severe corneal nerve fibre reduction, also had higher risk of suffering from ocular surface discomfort and worse visual function compared to patients without neuropathy and healthy controls. The study highlighted the need for eye care clinicians and medical oncologists to be aware of such ocular surface symptoms even in those who have completed neurotoxic chemotherapy treatment. Chapter 5 investigated corneal dendritic cells which are antigen-presenting cells and potent initiators of inflammatory responses residing in the sub-basal corneal nerve plexus. This study was conducted as these immune cells can also be observed with CCM, and neuroinflammation and immune cell infiltration have been implicated in the pathophysiology of CIPN. The findings indicated that there was an elevated presence of immature dendritic cell density in oxaliplatin-treated patients well after treatment cessation, but not in paclitaxel-treated patients. Chapter 6 evaluated the concentration of substance P, a sensory neuropeptide primarily expressed by small nerve fibres in the cornea and essential for maintenance of ocular surface health, in the tears. While the previous study demonstrated elevated dendritic cell density in oxaliplatin-treated patients, this study showed reduced substance P concentration in paclitaxel-treated patients instead. These two studies further emphasise potential differences in pathophysiological mechanisms underlying CIPN associated with these two drugs. Chapter 7 involved a longitudinal study which observed ocular surface and peripheral neuropathic changes during the treatment period, and monitoring patients up to twelve months post-treatment cessation. The study found a progressive loss in corneal nerve parameters with increasing cumulative dose from baseline to end of treatment particularly with taxane treatment, while other ocular surface measures including corneal dendritic cells and tear film substance P levels did not have significant changes. The findings indicated a potential mixed pattern of small and large nerve fibre involvement with taxane treatment, while oxaliplatin affects predominantly large nerve fibres. Corneal nerve fibre length measured during the treatment period was also lower in patients who continued to have persistent CIPN after treatment cessation compared to patients who did not, indicating the potential for early detection of corneal nerve fibre loss as an indicator of CIPN progression. Future studies investigating corneal nerve changes at multiple timepoints in larger studies involving taxane-treated patients may provide greater insight into the diagnostic and predictive utility of CCM in CIPN. Improvements in CCM instrumentation and methodology may also contribute to better assessment of the state of the sub-basal corneal nerve plexus. The discussion section further explores these issues in relation to the clinical applicability or scalability of CCM and potential solutions to improve imaging capabilities in the future

Activation of the pre-supplementary motor area but not inferior prefrontal cortex in association with short stop signal reaction time – an intra-subject analysis

Abstract Background Our previous work described the neural processes of motor response inhibition during a stop signal task (SST). Employing the race model, we computed the stop signal reaction time (SSRT) to index individuals' ability in inhibitory control. The pre-supplementary motor area (preSMA), which shows greater activity in individuals with short as compared to those with long SSRT, plays a role in mediating response inhibition. In contrast, the right inferior prefrontal cortex (rIFC) showed greater activity during stop success as compared to stop error. Here we further pursued this functional differentiation of preSMA and rIFC on the basis of an intra-subject approach. Results Of 65 subjects who participated in four sessions of the SST, we identified 30 individuals who showed a difference in SSRT but were identical in other aspects of stop signal performance between the first ("early") and last two ("late") sessions. By comparing regional brain activation between the two sessions, we confirmed greater preSMA but not rIFC activity during short as compared to long SSRT session within individuals. Furthermore, putamen, anterior cerebellum and middle/posterior cingulate cortex also showed greater activity in association with short SSRT. Conclusion These results are consistent with a role of medial prefrontal cortex in controlled action and inferior frontal cortex in orienting attention. We discussed these findings with respect to the process of attentional monitoring and inhibitory motor control during stop signal inhibition.</p

The impact of dry eye disease on corneal nerve parameters::A systematic review and meta‐analysis

Purpose: Dry eye disease (DED) is a growing global health problem with a significant impact on the quality of life of patients. While neurosensory abnormalities have been recognised as a contributor to DED pathophysiology, the potential role of in vivo corneal confocal microscopy in detecting nerve loss or damage remains unclear. This systematic review with meta‐analysis (PROSPERO registered CRD42022381861) investigated whether DED has an impact on sub‐basal corneal nerve parameters. Methods: PubMed, Embase and Web of Science Core Collection databases were searched from inception to 9 December 2022. Studies using laser scanning confocal microscopy to compare corneal nerve parameters of DED with healthy eyes were included. Study selection process and data extraction were performed by two independent members of the review team. Results: Twenty‐two studies with 916 participants with DED and 491 healthy controls were included, with 21 of these studies included in subsequent meta‐analyses. There was a decrease in total corneal nerve length (−3.85 mm/mm2; 95% CI −5.16, −2.55), corneal main nerve trunk density (−4.81 number/mm2; 95% CI −7.94, −1.68) and corneal nerve branch density (−15.52 number/mm2; 95% CI −27.20, −3.84) in DED eyes compared with healthy eyes, with subgroup analysis demonstrating that these differences were more evident in studies using NeuronJ software, a semi‐automated procedure. While this review found evidence of loss of corneal nerve parameters in eyes with DED compared with healthy controls, particularly with the use of a semi‐automated image analysis method, it is evident that there is substantial heterogeneity between studies in terms of corneal nerve imaging methodology. Conclusions: Standardisation is required in terms of terminology and analysis, with more research needed to potentially improve the clinical applicability and practicality of corneal nerve imaging. Further investigation is also required to confirm the diagnostic accuracy of this imaging modality and its potential for monitoring DED treatment efficacy

Association of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture Risk

Importance: Many prescription drugs increase fracture risk, which raises concern for patients receiving 2 or more such drugs concurrently. Logic suggests that risk will increase with each additional drug, but the risk of taking multiple fracture-associated drugs (FADs) is unknown. Objective: To estimate hip fracture risk associated with concurrent exposure to multiple FADs. Design, Setting, and Participants: This cohort study used a 20% random sample of Medicare fee-for-service administrative data for age-eligible Medicare beneficiaries from 2004 to 2014. Sex-stratified Cox regression models estimated hip fracture risk associated with current receipt of 1, 2, or 3 or more of 21 FADs and, separately, risk associated with each FAD and 2-way FAD combination vs no FADs. Models included sociodemographic characteristics, comorbidities, and use of non-FAD medications. Analyses began in November 2018 and were completed April 2019. Exposure: Receipt of prescription FADs. Main Outcomes and Measures: Hip fracture hospitalization. Results: A total of 11.3 million person-years were observed, reflecting 2,646,255 individuals (mean [SD] age, 77.2 [7.3] years, 1,615,613 [61.1%] women, 2,136,585 [80.7%] white, and 219 579 [8.3%] black). Overall, 2,827,284 person-years (25.1%) involved receipt of 1 FAD; 1,322,296 (11.7%), 2 FADs; and 954,506 (8.5%), 3 or more FADs. In fully adjusted, sex-stratified models, an increase in hip fracture risk among women was associated with the receipt of 1, 2, or 3 or more FADs (1 FAD: hazard ratio [HR], 2.04; 95% CI, 1.99-2.11; P\u3c.001; 2 FADs: HR, 2.86; 95% CI, 2.77-2.95; P\u3c.001; ≥3 FADs: HR, 4.50; 95% CI, 4.36-4.65; P\u3c.001). Relative risks for men were slightly higher (1 FAD: HR, 2.23; 95% CI, 2.11-2.36; P\u3c.001; 2 FADs: HR, 3.40; 95% CI, 3.20-3.61; P\u3c.001; ≥3 FADs: HR, 5.18; 95% CI, 4.87-5.52; P\u3c.001). Among women, 2 individual FADs were associated with HRs greater than 3.00; 80 pairs of FADs exceeded this threshold. Common, risky pairs among women included sedative hypnotics plus opioids (HR, 4.90; 95% CI, 3.98-6.02; P\u3c.001), serotonin reuptake inhibitors plus benzodiazepines (HR, 4.50; 95% CI, 3.76-5.38; P\u3c.001), and proton pump inhibitors plus opioids (HR, 4.00; 95% CI, 3.56-4.49; P\u3c.001). Receipt of 1, 2, or 3 or more non-FADs was associated with a small, significant reduction in fracture risk compared with receipt of no non-FADs among women (1 non-FAD: HR, 0.93; 95% CI, 0.90-0.96; P\u3c.001; 2 non-FADs: HR, 0.84; 95% CI, 0.81-0.87; P\u3c.001; ≥3 non-FADs: HR, 0.74; 95% CI, 0.72-0.77; P\u3c.001). Conclusions and Relevance: Among older adults, FADs are commonly used and commonly combined. In this cohort study, the addition of a second and third FAD was associated with a steep increase in fracture risk. Many risky pairs of FADs included potentially avoidable drugs (eg, sedatives and opioids). If confirmed, these findings suggest that fracture risk could be reduced through tighter adherence to long-established prescribing guidelines and recommendations

Association of Over-The-Counter Pharmaceutical Sales with Influenza-Like-Illnesses to Patient Volume in an Urgent Care Setting

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round. © 2013 Liu et al

Systematic nomenclature for the PLUNC/PSP/BSP30/SMGB proteins as a subfamily of the BPI fold-containing superfamily

We present the BPIFAn/BPIFBn systematic nomenclature for the PLUNC (palate lung and nasal epithelium clone)/PSP (parotid secretory protein)/BSP30 (bovine salivary protein 30)/SMGB (submandibular gland protein B) family of proteins, based on an adaptation of the SPLUNCn (short PLUNCn)/LPLUNCn (large PLUNCn) nomenclature. The nomenclature is applied to a set of 102 sequences which we believe represent the current reliable data for BPIFA/BPIFB proteins across all species, including marsupials and birds. The nomenclature will be implemented by the HGNC (HUGO Gene Nomenclature Committee)