A Probabilistic Risk Analysis for Taipei Seismic Hazards: An Application of HAZ-Taiwan with its Pre-processor and Post-processor

This paper employs probabilistic risk analysis to estimate exceedance probability curves, average annual loss (AAL) and probable maximum loss (PML) for seismic hazards. It utilizes and event-driven loss estimation model, HAZ-Taiwan, and develops its pre-processing and post-processing software modules. First, the pre-processingmodule establishes a set of hazard-consistent scenarios. Then, the HAZ-Taiwan modelextimates hazards, vulnerabilities and economic losses for each scenario. Finally, the aggregate and occurrence exceedance probability curves for losses and theirconfidence intervals are simulated using the Monte Carlo simulation in thepost-processing module. The methodology is then applied to analyze seismic risks in Taipei. It is found that the exceedance probability of an aggregate loss of NT$40.398 billion is 0.001. This amount of loss is approximately 2.78$37.41-43.12 billion. The average annual loss of buildings in Taipei is NT$1.06 billion r approximately 0.07% of the total stock.probabilistic risk analysis, Hazard analysis, vulnerability analysis, exceedance probability curve, HAZ-Taiwan

Relationships between Connectedness, Performance Proficiency, Satisfaction, and Online Learning Continuance

Maintaining momentum is vital in terms of how soon students can complete a program, especially for those who are in the early stage of taking online courses. This study attempted to extend the existing literature by examining the influence of online students’ perceived sense of connectedness, performance proficiency, and satisfaction on their intentions to continue an online learning course. A quantitative survey approach was adopted to test our hypothesized structural model. Three hundred and sixty-nine students who had taken fewer than three fully online courses participated in this study. The results revealed that three out of four testing hypotheses were all supported at the 0.01 significance level, and one of the path coefficients indicated that online students’ confidence in their ability or competency to perform academic tasks did not directly influence their intention to take future online courses. Instead, the influence of performance proficiency on online learning continuance intention was mediated through the factor of satisfaction. In addition, satisfaction was found to have a significantly direct impact on online learning continuance intention, suggesting that when students taking online courses are satisfied with their online learning experience, the likelihood for them to continue taking other online courses is higher

Hospital treatment, mortality and healthcare costs in relation to socioeconomic status among people with bipolar affective disorder

BACKGROUND: Evidence regarding the relationships between the socioeconomic status and long-term outcomes of individuals with bipolar affective disorder (BPD) is lacking. AIMS: We aimed to estimate the effects of baseline socioeconomic status on longitudinal outcomes. METHOD: A national cohort of adult participants with newly diagnosed BPD was identified in 2008. The effects of personal and household socioeconomic status were explored on outcomes of hospital treatment, mortality and healthcare costs, over a 3-year follow-up period (2008–2011). RESULTS: A total of 7987 participants were recruited. The relative risks of hospital treatment and mortality were found elevated for the ones from low-income households who also had higher healthcare costs. Low premium levels did not correlate with future healthcare costs. CONCLUSIONS: Socioeconomic deprivation is associated with poorer outcome and higher healthcare costs in BPD patients. Special care should be given to those with lower socioeconomic status to improve outcomes with potential benefits of cost savings in the following years. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence

Let’s Play Cards: Multi-Component Cognitive Training With Social Engagement Enhances Executive Control in Older Adults

Cognitive training and social engagement are two of the routes that potentially improve cognitive functions in older adults. The former targets specific functions so that an intervention can trigger the plasticity and efficiency of the underpinning neural systems, and the latter also provides an environment supportive of social and emotional needs. We investigated whether an integration of the two routes could enhance cognitive functions related to executive control, because no prior research has adopted a theory-driven approach to design a group-based cognitive training program for executive control. Forty-six healthy and active older adults living in community settings were randomly assigned to a group-based training program or a group-based active control program. Twenty-three volunteers in a community center were recruited for the waitlist control group. A battery of card games was designed for the cognitive training program based on three theoretical models of executive functions. A set of commercial board games were run in the active control program. Using untrained tests as the outcome measures, we found significant improvement on executive control in the cognitive training group compared with the active and waitlist control groups while the two control groups did not differ in performance. The cognitive training group did not outperform the two groups on a test of reasoning or on a test of delayed episodic memory. The results support the idea that cognitive training with social interaction can improve performance on untrained tests that share overlapping cognitive processes. Despite the inability to adapt to each person’s performance, integrating the two routes is beneficial for improving cognitive functions in older adults

Modelling of pulse-like velocity ground motion during the 2018 M_w 6.3 Hualien earthquake, Taiwan

The 2018 February 6 M_w 6.3 Hualien earthquake caused severe localized damage in Hualien City, located 20 km away from the epicentre. The damage was due to strong (>70 cm s⁻¹) and sharp (duration ∼2.5 s) velocity pulses. The observed peak ground-motion velocity in Hualien City symmetrically decays with distance from the nearby Milun fault. Waveforms observed on the opposite sides of the fault show reversed polarity on the vertical and N–S components while the E–W component is almost identical. None of the published finite-fault slip models can explain the spatially highly localized large velocity pulses. In this study, we show that an M_w 5.9 strike-slip subevent on the Milun fault at 2.5 km depth, rupturing from north to south at ∼0.9Vs speed, combined with site effects caused by surficial layers with low S-wave speed, can explain the velocity pulses observed at the dense strong-motion network stations. This subevent contributes only 25 per cent of the total moment of the 2018 Hualien earthquake, suggesting that a small local slip patch near a metropolis can dominate the local hazard. Our result strongly suggests that seismic hazard assessments should consider large ground-motion variabilities caused by directivity and site effects, as observed in the 2018 Hualien earthquake

The effectiveness of different health education strategies in people with pre-diabetes: A randomized controlled trial

Background. People with pre-diabetes often lack knowledge of their risks of developing diabetes. In one of our previous study, Multi-Approach Health Education was shown evidence to be effective on health behavior of reducing risks of developing diabetes. However, which one approach is really effective and efficient need further investigation. Purpose. To examine the effects of different intervention strategies on diabetes prevention knowledge, exercise, dietary behavior, and physiological indicators for people with pre-diabetes. Methods. This was a randomly controlled trial. People who received health examination and were found fasting blood glucose higher than normal, between 100 - 125 mg/dl in 2011 were recruited. Three types of intervention were randomly assigned to 3 groups respectively. The control group (n=51) received a health education lecture. One experimental group (n=48) received the identical lecture plus telephone encouragement. The second experimental group (n=41) received the identical lecture plus a health reminder poster in their daily life. The outcomes were evaluated for the change in knowledge of diabetes prevention, exercise behavior, dietary behavior, and physiological outcomes at 6 and 12 weeks after the lecture of three groups, respectively. Results. Three intervention strategies were equally efficacious at inducing positive behavioral changes but overall the magnitudes of physiological changes were the same. In general, the maximum change in parameters was achieved after 6 weeks and maintained in the second 6 weeks of the study. Conclusions. Educating people with pre-diabetes about their condition can have a positive effect upon their health behaviors. However, education lecture coupled with a telephone follow up or plus educational posters were found no more effective than lecture alone. The lecture alone of health education may be enough for people with pre-diabetes, but the long term effect needs further investigation

Functional decline and mortality in long-term care settings: Static and dynamic approach

AbstractBackground/PurposeFunctional impairment is known to be associated with higher mortality risk and adverse health outcomes. However, little is known about whether functional decline could predict mortality among the elderly in the long-term care setting.MethodsThis is a prospective cohort study in two veteran homes in northern Taiwan with active use of the minimum data set (MDS). Evaluation tools retrieved from the MDS, including MDS Resource Utilization Group-III for Activities of Daily Living (RUG-III ADL), MDS Cognitive Scale, MDS Social engagement, triggers for resident assessment protocol (RAP) and Pain scale, were utilized for the analysis.ResultsA total of 1125 male participants were included in this study. The mean age of the participants was 83.1 ± 5.1 years, and 65 (5.8%) developed physical functional decline within a 6-month period. Participants with functional decline [odds ratio (OR) 2.305, 95% confidence interval (CI) 1.002–5.303], poor baseline functional status (OR 1.116, 95% CI 1.002–1.242), positive RAP triggers for dehydration (OR 13.857, 95% CI 3.07–62.543), and underlying chronic lung diseases (OR 2.279, 95% CI 1.149–4.522), depression (OR 2.994, 95% CI 1.161–7.721), and cancer (OR 3.23, 95% CI 1.078–9.682) were more likely to have an additional 12-month mortality. By contrast, Parkinsonism (OR 3.875, 95% CI 1.169–12.841), increase in sum of RAP triggers (OR 6.096, 95% CI 2.741–13.562), and positive RAP triggers for cognitive loss (OR 3.164, 95% CI 1.612–6.212) and mood (OR 2.894, 95% CI 1.466–5.71) are strong predictors for functional decline within 6 months.ConclusionPhysical function decline within 6 months predicted the subsequent 1-year mortality, whereas increased sum of RAP triggers and positive trigger for cognitive loss and mood were associated with functional decline

High expression FUT1 and B3GALT5 is an independent predictor of postoperative recurrence and survival in hepatocellular carcinoma.

Cancer may arise from dedifferentiation of mature cells or maturation-arrested stem cells. Previously we reported that definitive endoderm from which liver was derived, expressed Globo H, SSEA-3 and SSEA-4. In this study, we examined the expression of their biosynthetic enzymes, FUT1, FUT2, B3GALT5 and ST3GAL2, in 135 hepatocellular carcinoma (HCC) tissues by qRT-PCR. High expression of either FUT1 or B3GALT5 was significantly associated with advanced stages and poor outcome. Kaplan Meier survival analysis showed significantly shorter relapse-free survival (RFS) for those with high expression of either FUT1 or B3GALT5 (P = 0.024 and 0.001, respectively) and shorter overall survival (OS) for those with high expression of B3GALT5 (P = 0.017). Combination of FUT1 and B3GALT5 revealed that high expression of both genes had poorer RFS and OS than the others (P < 0.001). Moreover, multivariable Cox regression analysis identified the combination of B3GALT5 and FUT1 as an independent predictor for RFS (HR: 2.370, 95% CI: 1.505-3.731, P < 0.001) and OS (HR: 2.153, 95% CI: 1.188-3.902, P = 0.012) in HCC. In addition, the presence of Globo H, SSEA-3 and SSEA-4 in some HCC tissues and their absence in normal liver was established by immunohistochemistry staining and mass spectrometric analysis

Persistent surgical wound bleeding: A rare condition related to acquired hemophilia A

SummaryAcquired hemophilia A (AHA) is a rare condition that predisposes affected patients to a bleeding tendency, even after a trivial physical insult. We present our experience with a 45-year-old male patient who was referred to our institute because of persistent bleeding from a left forearm surgical wound after fasciotomy. He was diagnosed as having AHA. Surgical treatment in combination with recombinant activated factor VII (rFVIIa) led to a satisfactory result. Clinical awareness and multidisciplinary professional connections are necessary in the treatment of AHA. Acquired hemophilia should be considered in the differential diagnosis of patients with uncontrolled bleeding episodes