Search results for: Taiwan

Authors: Yu-Wen Huang, Yi-Cheng Chiang

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With urban development, lots of buildings are built around the city. The buildings always affect the urban wind environment. The accelerative situation of wind caused of buildings often makes pedestrians uncomfortable, even causes the accidents and dangers. Factors influencing pedestrian level wind including atmospheric boundary layer, wind direction, wind velocity, planting, building volume, geometric shape of the buildings and adjacent interference effects, etc. Planting has many functions including scraping and slowing urban heat island effect, creating a good visual landscape, increasing urban green area and improve pedestrian level wind. On the other hand, urban square is an important space element supporting the entrance to buildings, city landmarks, and activity collections, etc. The appropriateness of urban square environment usually dominates its success. This research focuses on the effect of tree-planting on the wind environment of urban square. This research studied the square belt of Taichung City Hall. Taichung City Hall is a cuboid building with a large mass opening. The square belt connects the front square, the central opening and the back square. There is often wind draft on the square belt. This phenomenon decreases the activities on the squares. This research applies tree-planting to improve the wind environment and evaluate the effects of two types of planting configuration. The Computational Fluid Dynamics (CFD) simulation analysis and extensive field measurements are applied to explore the improve efficiency of planting configuration on wind environment. This research compares efficiencies of different kinds of planting configuration, including the clustering array configuration and the dispersion, and evaluates the efficiencies by the SET*.

Keywords: micro-climate, wind environment, planting configuration, comfortableness, computational fluid dynamics (CFD)

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Authors: Bing-Qing Lu, Hui-Tzu Min

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Recent research, supported by sociocultural theory, has shown that collaborative writing in the second language (L2) contexts afford students opportunities to interact with each other to co-construct knowledge during the co-composing process. To date, much research on pair interaction in L2 collaborative writing settings has centered on intermediate and advanced learners by using static categorization of pair interaction patterns. Little is known about the fluid nature of pair interaction during collaborative writing, especially among low-proficiency learners. This study, thus, is aimed to explore the interaction dynamics of low-proficiency L2 learners during collaborative writing via examining the interaction pattern, focus of interaction, and the language related episodes (LREs) of 5 low-proficiency L2 writers from Taiwan. Employing a micro-level functional analytical method to capture the changing nature of pair interaction dynamics, the researchers calculated the number of characters/words produced by each pair member during CW and then classified their utterances into four task related-aspects--content, organization, language use, and task management--to determine each pair member's relative contribution to different dimensions of the evolving text. The LREs were also identified and examined. The results show that, of the five pairs, three pairs changed their interaction patterns when discussing different aspects of writing. Regarding the focus of their interaction, all five pairs paid attention to content most, followed by language use, task management, and organization. They were able to successfully resolve the majority of language issues (75.2%) in LREs and use the correct forms in their writing. These findings lend support to the fluid nature of pairs’ interactions and the changing roles of L2 learners in collaborative writing and highlighted the necessity of examining learners’ interaction patterns from a micro-level perspective. These findings also support previous research that low-proficiency pairs are able to correctly revolve 2/3 of their produced LREs, suggesting that collaborative writing may also be suitable for L2 low-proficiency learners.

Keywords: collaborative writing, low-proficiency L2 learners, micro-level functional analysis, pair interaction pattern

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Authors: Chih-Wen Fan

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Backgrounds/ Research goals : School improvement requires change leadership, which often means discomfort. Principals are the key people that determine the effectiveness of schools. In an era of organization’s pursuit of speed and effectiveness, school administration has to be accountable and innovative. Effective principals work to improve achievement by focusing on the administrative and teaching quality of improvement. However, there is a lack of literature addressing the relevant case studies on school change leadership. This article explores how principals can use change leadership to drive school change. It analyze the driving factors of principal changes in the case school, the beliefs of change leadership, specific methods, and what impact they have. Methods: This study applies the case study research method to the selected primary school located in an urban area for case study, which has achieved excellent performance after reform and innovation. The researchers selected an older primary school located in an urban area that was transformed into a high-performance primary school after changes were enacted by the principal. The selected case was recommended by three supervisors of the Education Department. The case school underwent leadership change by the new principal during his term, and won an award from the Ministry of Education. Total of 8 teachers are interviewed. The data encoding includes interviews and documents. Expected results/ conclusions: The conclusions of the study are, as follows: (1) The influence for Principal Lin's change leadership is from internal and external environmental development and change pressures. (2) The principal's belief in change leadership is to recognize the sense of crisis, and to create a climate of change and demand for change. (3) The principal's specific actions are intended to identify key members, resolve resistance, use innovative thinking, and promote organizational learning. (4) Principal Lin's change leadership can enhance the professional functions of all employees through appropriate authorization. (5) The effectiveness of change leadership lies in teachers' participation in decision-making; the school's reputation has been enhanced through featured courses.

Keywords: change leadership, empowerment, crisis awareness, case study

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Authors: Hsiao-Yung Wang

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This essay aims to examine how the transgender imagery has been constructed in the Taiwanese news media and its evolution from 1953 to 2016. It also explores the discourse patterns and rhetorical strategies in the transgender-related issues which contributed to levels of evaluation in forming ‘social deviance.’ Samples for analysis were selected from mainstream newspapers, including China Times, United Daily and Apple Daily. The time frame for sample selection is from August 1953 (when the first transgender case was reported in Taiwan) to June 2016. To enhance understanding of media representation as nominalistic-based, the author refers to the representative of critical rhetoric Raymie McKerrow for his study on remembrance and forgetfulness in public discourse (especially in his model of ‘critique of domination’); thereby categorizing the 64 years of transgender discourse into five periods: (1) transgender as ‘intersex’ of surgical-reparative medical treatment; (2) transgender as ‘freak gender-bender’ with criminal behaviors; (3) transgender as ‘ladyboy’ (‘katoey in a Thai term) of bar girls or sex workers; (4) transgender as ‘cross dresser’ of transvestite performance; and (5) transgender as ‘life-style or human right’ of spontaneous gender identification. Based on the research findings, this essay argues that the characterization of transgender reporting as a site for the production of compulsory sexism and gender stereotype by the specific forms of name-calling. Besides, the evolution of word-image addressing to transgender issues also pinpoints media as a reflection of fashion of the day. While the transgender imagery might be crystallized as ‘still social problems’ or ‘gender transgression’ in insidious rhetoric; and while the so-called ‘phobia’ persistently embodies in media discourse to exercise name-calling in an ambiguous (rather than in a bullying) way or under the cover of humanist-liberalist rationales, these emergent rhetorical dilemma should be resolved without any delay.

Keywords: critical rhetoric, media representation, McKerrow, nominalistic, social deviance, transgender

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Authors: S. C. Lin, W. F. Hung, W. W. Cheng

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Teacher empowerment was regarded as investing teachers with the right to participate in the determination of school goals and policies and to exercise professional judgment about what and how to teach. Professional commitment was considered as a person’s belief in and acceptance of the values of his or her chosen occupation or line of work, and a willingness to maintain membership in that occupation. An effective school has been defined as one in which students’ progress further than might be expected from consideration of its intake. An effective school thus adds extra value to its students' outcomes, in comparison with other schools serving similar intakes. A number of literature from various countries explored that teacher empowerment and professional commitment significantly influenced school effectiveness. However, there lacked more empirical studies to examine the relationships among them. Hence, this study was to explore the relationships among teacher empowerment, professional commitment and school effectiveness in junior high schools in Taiwan. Samples were seven hundred and five junior high school teachers selected from Taichung City, Changhua County and Nantou County. Questionnaire was applied to collect data. Data were analyzed by using descriptive statistics, t-test, one-way ANOVA, Pearson’s product-moment correlation, and multiple regression analysis. The findings of this study were as follows: First, the overall performances of teachers’ perceptions of teacher empowerment, teacher professional commitment and school effectiveness were above average. Second, the teachers’ perceptions of teacher empowerment were significant different in gender, designated duty, and school size. Third, the teachers’ perceptions of teacher professional commitment were significant different in gender, designated duty, and school size. Fourth, the teachers’ perceptions of school effectiveness were significant different in designated duty. Fifth, teacher empowerment was mid-positively correlation by teacher professional commitment. Sixth, there was mid-positively correlation between teacher empowerment and school effectiveness. Seventh, there was mid-positively correlation between teacher professional commitment and school effectiveness. Eighth, Teacher empowerment and professional commitment could significantly predict school effectiveness. Based on the findings of this study, the study proposed some suggestions for educational authorities, schools, teachers, and future studies as well.

Keywords: junior high school teacher, teacher empowerment, teacher professional commitment, school effectiveness

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Authors: Panagodage Janaka Sampath Fernando

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Brain circulation has become a buzzword in the skilled migration literature. However, promoting brain circulation; returning of skilled migrants is challenging. Success stories in Asia, for instances, Taiwan, and China, are results of rigorous policy interventions of the respective governments. Nonetheless, the same policy mix has failed in other countries making it skeptical to attribute the success of brain circulation to the policy interventions per se. The paper seeks to answer whether the success of brain circulation within the Knowledge Services Industry (KSI) in Sri Lanka is a policy driven or a market driven process. Mixed method approach, which is a combination of case study and survey methods, was employed. Qualitative data derived from ten case studies of returned entrepreneurs whereas quantitative data generated from a self-administered survey of 205 returned skilled migrants (returned skilled employees and entrepreneurs) within KSI. The pull factors have driven the current flow of brain circulation within KSI but to a lesser extent, push factors also have influenced. The founding stone of the industry has been laid by a group of returned entrepreneurs, and the subsequent growth of the industry has attracted returning skilled employees. Sri Lankan government has not actively implemented the reverse brain drain model, however, has played a passive role by creating a peaceful and healthy environment for the industry. Therefore, in contrast to the other stories, brain circulation within KSI has emerged as a market driven process with minimal government interventions. Entrepreneurs play the main role in a market-driven process of brain circulation, and it is free from the inherent limitations of the reverse brain drain model such as discriminating non-migrants and generating a sudden flow of low-skilled migrants. Thus, to experience a successful brain circulation, developing countries should promote returned entrepreneurs by creating opportunities in knowledge-based industries.

Keywords: brain circulation, knowledge services industry, return migration, Sri Lanka

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Authors: Shang-Hsin Ou, Yang-Chun Lin, Ke-Hao Cheng

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The year 2021 marked a historic drought in Taiwan, posing unprecedented challenges due to record-low rainfall and inadequate reservoir storage. The central region experienced water scarcity, leading to the implementation of "Groundwater Utilization at Construction Sites" for drought-resilient livelihood water supply. This study focuses on the establishment process of temporary groundwater treatment plants at construction sites in Taichung City, serving as a reference for future emergency response and the utilization of construction site groundwater. To identify suitable sites for groundwater reuse projects, site selection operations were carried out based on relevant water quality regulations and assessment principles. Subsequently, the planning and design of temporary water treatment plants were conducted, considering the water quality, quantity, and on-site conditions of groundwater wells associated with construction projects. The study consolidates the major water treatment facilities at each site and addresses encountered challenges during the establishment process. Practical insights gained from operating temporary groundwater treatment plants are presented, including improvements related to stable water quality, water quantity, equipment operation, and hydraulic control. In light of possible future droughts, this study provides an outlook and recommendations to expedite and improve the setup of groundwater treatment plants at construction sites. This includes considering on-site water abstraction, treatment, and distribution conditions. The study's results aim to offer practical guidelines for effectively establishing and managing such treatment plants, while offering experiences and recommendations for other regions facing similar emergencies, water shortages, and drought situations. These endeavors contribute to ensuring sustainable water supply for drought-resilient livelihoods and maintaining societal stability.

Keywords: drought resilience, groundwater treatment, construction site, water supply

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Authors: Jian-Heng Wu, Bor-Shen Lin

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The temperature-salinity relationship is one of the most important characteristics used for identifying water masses in marine research. Temperature-salinity characteristics, however, may change dynamically with respect to the geographic location and is quite sensitive to the depth at the same location. When depth is taken into consideration, however, it is not easy to compare the characteristics of different water masses efficiently for a wide range of areas of the ocean. In this paper, the Gaussian mixture model was proposed to analyze the temperature-salinity-depth characteristics of water masses, based on which comparison between water masses may be conducted. Gaussian mixture model could model the distribution of a random vector and is formulated as the weighting sum for a set of multivariate normal distributions. The temperature-salinity-depth data for different locations are first used to train a set of Gaussian mixture models individually. The distance between two Gaussian mixture models can then be defined as the weighting sum of pairwise Bhattacharyya distances among the Gaussian distributions. Consequently, the distance between two water masses may be measured fast, which allows the automatic and efficient comparison of the water masses for a wide range area. The proposed approach not only can approximate the distribution of temperature, salinity, and depth directly without the prior knowledge for assuming the regression family, but may restrict the complexity by controlling the number of mixtures when the amounts of samples are unevenly distributed. In addition, it is critical for knowledge discovery in marine research to represent, manage and share the temperature-salinity-depth characteristics flexibly and responsively. The proposed approach has been applied to a real-time visualization system of ocean data, which may facilitate the comparison of water masses by aggregating the data without degrading the discriminating capabilities. This system provides an interface for querying geographic locations with similar temperature-salinity-depth characteristics interactively and for tracking specific patterns of water masses, such as the Kuroshio near Taiwan or those in the South China Sea.

Keywords: water mass, Gaussian mixture model, data visualization, system framework

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Authors: Jyun-Huei Huang, Ting-I Lee

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Urban heat island effect is derived from the reduction of vegetative cover by urban development. Because plants can improve air quality and microclimate, green walls have been applied as a sustainable design approach to cool building temperature. By using plants to green vertical surfaces, they decrease room temperature and, as a result, decrease the energy use for air conditioning. Based on their structures, green walls can be divided into two categories, green façades and living walls. A green façade uses the climbing ability of a plant itself, while a living wall assembles planter modules. The latter one is widely adopted in public space, as it is time-effective and less limited. Although a living wall saves energy spent on cooling, it is not necessarily cost-effective from the perspective of a lifecycle analysis. The Italian study shows that the overall benefit of a living wall is only greater than its costs after 47 years of its establishment. In Taiwan, urban greening policies encourage establishment of green walls by referring to their benefits of energy saving while neglecting their low performance on cost-effectiveness. Thus, this research aims at understanding the perception of appliers and consumers on the cost-effectiveness of their living wall products from the lifecycle viewpoint. It adopts semi-structured interviews and field observations on the maintenance of the products. By comparing the two results, it generates insights for sustainable urban greening policies. The preliminary finding shows that stakeholders do not have a holistic sense of lifecycle or cost-effectiveness. Most importantly, a living wall well maintained is often with high input due to the availability of its maintenance budget, and thus less sustainable. In conclusion, without a comprehensive sense of cost-effectiveness throughout a product’s lifecycle, it is very difficult for suppliers and consumers to maintain a living wall system while achieve sustainability.

Keywords: case study, maintenance, post-occupancy evaluation, vertical greening

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Authors: Pei Chi Fang, Wei Chen Lin

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Trichomonas tenax is a microaerophilic oral protozoan found in patients with poor oral hygiene. It participates in the inflammatory process of periodontal disease and can potentially be aspirated into the lungs, giving rise to pulmonary trichomoniasis. However, the precise roles of T. tenax in the pulmonary system remain largely unexplored and warrant comprehensive epidemiological investigation. To assess the prevalence of T. tenax infection, we collected bronchoalveolar lavage fluid (BALF) samples from hospitalized patients with lung diseases. A specific nested PCR approach was employed to determine prevalence rates, yielding 21 positive cases out of 61 samples from Ditmanson Medical Foundation Chia-Yi Christian Hospital, and 11 positive cases out of 55 samples from National Cheng Kung University Hospital. Furthermore, there is a critical need for comprehensive data regarding the presence of T. tenax in environmental surface watersheds. In this context, we present findings from investigations in the Yanshuei and Donggang river basins in southern Taiwan, which are crucial sources for public drinking water in the region. In order to elucidate potential implications on pulmonary virus infections, we conducted an analysis of gene expression level changes in H292 cell line after exposure to T. tenax. Our findings revealed significant regulation of multiple virus-related genes, including IFI44L and IFITM3. Ongoing research endeavors are focused on identifying the key components within T. tenax responsible for these observed effects. Crucially, this study lays the groundwork for a preliminary understanding of T. tenax prevalence in patients with pulmonary diseases. It also seeks to establish a meaningful correlation between lung infections and oral hygiene practices, with the ultimate aim of informing distinct treatment and prevention strategies.

Keywords: parasitology, genes, virus, human health, infection, lung

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Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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Authors: Renee Yi-Mond Yuan

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The fast development of tourism industries around the world, has largely contributed to many cities, and countries economical and social progress. Past year Taiwan in particular was ranked among one of fastest raise growth country. Thanks to the prominent importance of this phenomenon; seasonal mobility or multipurpose trips have reached more than 1 Billion tourists crossing International borders and more than 4 billion intramural travelers that have nourished the economy and employment in the service sector in most attractive regions, representing about one tenth of World GDP amount, including trade, research, cultural or journalistic purposes. Then the increased activities are giving pressure to the consumption of energy, water, resources, and Greenhouse Gas emissions. The further concentration of tourists in most beautiful sites of the World with consistent supply and reduced pollutions and means for waste control and risks management are challenging the preservation and protection of the natural original environment, including species and their ecosystems, ethnics and their cultures or languages, protection of inherited landscapes and monuments for the future generations to come. In this article, few projects will be analyzed, methods and directions in the EU sustainable development scheme giving way to economical and social activities and preserve rural areas and remote countryside as well as smarter cities development. EU ETS forecasting escalation in the next few decades for road and air, and will reconsider investments and reliance on Biobased alternatives that may turn out solutions and contributions to sustain popularization of tourism development. Study of Examples of Stakeholders practices and Governments efforts, consumer’s attitude to bring new forms of more responsible holidays models: ecotourism, eco-certification, partnerships, investment in technologies and facilities, and possibly create greener perceptions and less impacting demands for the longer term through association, organizations and awards.

Keywords: tourism, sustainability, protection, risks management, change in rural/urban environment

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Authors: Chia-Hsun Chang

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Background: Combination of drug treatment, dietary management, and regular exercise can effectively control type II diabetes mellitus (T2DM). Performing daily physical activities other than structured exercise is much easier and whether daily physical activities including work, walking, housework, gardening, leisure exercise, or transportation have a similar effect on diabetes control is not well studied.Aims and Objectives: This study aims to determine whether daily physical activity undertaken by patients with T2DM is associated with their diabetes control. Design: A correlation study with prospective design. Methods: Purposive sampling of 206 patients with T2DM was recruited from a medical center in Central Taiwan. The International Physical Activity Questionnaire was used to assess daily levels of physical activities, and the Diabetes Compliance Questionnaire was used to assess medication and dietary compliance. Data of diabetes control (hemoglobin A1c, HbA1c)were followed up every three months for one year after recruitment. Results: In this study, the average age of the participants was 62.5 years (±10.4 years), and the average duration of diabetes since diagnosis was 13.2 years (±7.8), 112 of the participants were women (54.4%) and 94 of the participants were men (45.6%). The mean HbA1c level was 7.8% (±1.4), and 78.2% of the participants presented with unsatisfactory diabetes control. Because the participants were distributed across a wide age range, and their physical health, activity levels, and comorbidities might have varied with age, the participants were divided into two groups: 121 participants who were younger than 65 years (58.7%) and 85 participants who were older than 65 years (41.3%). Both younger (< 65 years) and older (> 65 years) patients with diabetes engaged in more moderate and low levels of physical activity (89.3% and 87%, respectively). Results showed that the levels of daily physical activity were not significantly associated with diabetes control after adjustment for medication and dietary compliance in both groups. Conclusion: Performing daily physical activity is not significantly correlated with diabetes control. Daily physical activity cannot completely replace exercise. Relevance to Clinical Practice: Health personnel must encourage patients to engage in exercise that is planned, structured, and repetitive for improving diabetes control.

Keywords: daily physical activity, diabetes control, international physical activity questionnaire (IPAQ), type II diabetes mellitus (T2DM)

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Authors: Kung-Jen Tu, Danny Vernatha

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To assist individual departments within universities in their energy management tasks, this study explores the application of Building Information Modeling in establishing the ‘BIM based Energy Management Support System’ (BIM-EMSS). The BIM-EMSS consists of six components: (1) sensors installed for each occupant and each equipment, (2) electricity sub-meters (constantly logging lighting, HVAC, and socket electricity consumptions of each room), (3) BIM models of all rooms within individual departments’ facilities, (4) data warehouse (for storing occupancy status and logged electricity consumption data), (5) building energy management system that provides energy managers with various energy management functions, and (6) energy simulation tool (such as eQuest) that generates real time 'standard energy consumptions' data against which 'actual energy consumptions' data are compared and energy efficiency evaluated. Through the building energy management system, the energy manager is able to (a) have 3D visualization (BIM model) of each room, in which the occupancy and equipment status detected by the sensors and the electricity consumptions data logged are displayed constantly; (b) perform real time energy consumption analysis to compare the actual and standard energy consumption profiles of a space; (c) obtain energy consumption anomaly detection warnings on certain rooms so that energy management corrective actions can be further taken (data mining technique is employed to analyze the relation between space occupancy pattern with current space equipment setting to indicate an anomaly, such as when appliances turn on without occupancy); and (d) perform historical energy consumption analysis to review monthly and annually energy consumption profiles and compare them against historical energy profiles. The BIM-EMSS was further implemented in a research lab in the Department of Architecture of NTUST in Taiwan and implementation results presented to illustrate how it can be used to assist individual departments within universities in their energy management tasks.

Keywords: database, electricity sub-meters, energy anomaly detection, sensor

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Authors: Wan-I Lee, Nelio Mendoza Figueredo

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The impact of COVID-19 has a significant effect on all sectors of society globally. Health information technology (HIT) has become an effective health strategy in this age of distancing. In this regard, Mobile Health (mHealth) plays a critical role in managing patient and provider workflows during the COVID-19 pandemic. Therefore, the users' perception of service quality about mHealth services plays a significant role in shaping confidence and subsequent behaviors regarding the mHealth users' intention of use. This study's objective was to explore levels of user attributes analyzed by a qualitative method of how health practitioners and patients are satisfied or dissatisfied with using mHealth services; and analyzed the users' intention in the context of Taiwan during the COVID-19 pandemic. This research explores the experienced usability of a mHealth services during the Covid-19 pandemic. This study uses qualitative methods that include in-depth and semi-structured interviews that investigate participants' perceptions and experiences and the meanings they attribute to them. The five cases consisted of health practitioners, clinic staff, and patients' experiences using mHealth services. This study encourages participants to discuss issues related to the research question by asking open-ended questions, usually in one-to-one interviews. The findings show the positive and negative attributes of mHealth service quality. Hence, the significant importance of patients' and health practitioners' issues on several dimensions of perceived service quality is system quality, information quality, and interaction quality. A concept map for perceptions regards to emergency uses' intention of mHealth services process is depicted. The findings revealed that users pay more attention to "Medical care", "ease of use" and "utilitarian benefits" and have less importance for "Admissions and Convenience" and "Social influence". To improve mHealth services, the mHealth providers and health practitioners should better manage users' experiences to enhance mHealth services. This research contributes to the understanding of service quality issues in mHealth services during the COVID-19 pandemic.

Keywords: COVID-19, mobile health, service quality, use intention

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Authors: Yu-Mei Tseng, Chih-Chun Wu

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As information and communication technology (ICT) has become a part of people’s lives, most teenagers born after the 1980s and grew up in internet generation are called digital natives. Meanwhile, those teenagers’ parents are called digital immigrants. They need to keep learning new skills of ICT. This study investigated that high school students helped their parents set up social network services (SNS) and taught them how to use ICT. This study applied paper and pencil anonymous questionnaires that asked the ICT learning and ICT products using in high school students’ parents. The sample size was 2,621 high school students, including 1,360 (51.9%) males and 1,261 (48.1%) females. The sample was from 12 high school and vocational high school in central Taiwan. Results from paired sample t-tests demonstrated regardless genders, both male and female high school students help mothers set up Facebook and LINE more often than fathers. In addition, both male and female high school students taught mothers to use ICT more often than fathers. Meanwhile, both male and female high school students teach mothers to use SNS more often than fathers. The results showed that intergenerational ICT teaching occurred more often between mothers and her children than fathers. It could imply that mothers play a more important role in family ICT learning than fathers, or it could be that mothers need more help regarding ICT than fathers. As for gender differences, results from the independent t-tests showed that female high school students were more likely than male ones to help their parents setup Facebook and LINE. In addition, compared to male high school students, female ones were more likely to teach their parents to use smartphone, Facebook and LINE. However, no gender differences were detected in teaching mothers. The gender differences results suggested that female teenagers offer more helps to their parents regarding ICT learning than their male counterparts. As for area differences, results from the independent t-tests showed that the high school in remote area students were more likely than metropolitan ones to teach parents to use computer, search engine and download files of audio and video. The area differences results might indicate that remote area students were more likely to teach their parents how to use ICT. The results from this study encourage children to help and teach their parents with ICT products.

Keywords: adult ICT learning, family ICT learning, ICT learning, urban-rural gap

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Chun Chen Yea, Wen Huei Chou

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Many chemical changes in the atmosphere and the ocean are invisible to the naked eye, but they have profound impacts. These changes not only confirm the phenomenon of global carbon pollution, but also forewarn that more changes are coming. The carbon dioxide gases emitted from the burning of fossil fuels dissolve into the ocean and chemically react with seawater to form carbonic acid, which increases the acidity of the originally alkaline seawater. This gradual acidification is occurring at an unprecedented rate and will affect the effective formation of carapace of some marine organisms such as corals and crustaceans, which are almost entirely composed of calcium carbonate. The carapace of these organisms will become more dissoluble. Acidified seawater not only threatens the survival of marine life, but also negatively impacts the global ecosystem via the food chain. Faced with the threat of ocean acidification, all humans are duty-bound. The industrial sector outputs the highest level of carbon dioxide emissions in Taiwan, and the petrochemical industry is the major contributor. Ever since the construction of Formosa Plastics Group's No. 6 Naphtha Cracker Plant in Yunlin County, there have been many environmental concerns such as air pollution and carbon dioxide emission. The marine life along the coast of Yunlin is directly affected by ocean acidification arising from the carbon emissions. Societal change demands our willingness to act, which is what social advocacy promotes. This study uses digital storytelling for social advocacy and ocean acidification as the subject of a visual narrative in visualization to demonstrate the subsequent promotion of social advocacy. Storytelling can transform dull knowledge into an engaging narrative of the crisis faced by marine life. Digital dissemination is an effective social-work practice. The visualization promoting awareness on ocean acidification disseminated via social media platforms, such as Facebook and Instagram. Social media enables users to compose their own messages and share information across different platforms, which helps disseminate the core message of social advocacy.

Keywords: digital storytelling, visualization, ocean acidification, social advocacy

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Authors: Kung-Jen Tu

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Many public housing properties developed by local governments in Taiwan in the 1980s have deteriorated severely as these rental apartment buildings aged. The lack of building maintainability considerations during project design phase as well as insufficient maintenance funds have made it difficult and costly for local governments to maintain and keep public housing properties in good shape. In order to assist the local governments in achieving and delivering sustainable public housing, this paper intends to present a developed design evaluation method to be used to evaluate the presented design schemes from property management and financial feasibility perspectives during project design phase of public housing projects. The design evaluation results, i.e. the property management and financial implications of presented design schemes that could occur later during the building operation and maintenance phase, will be reported to the client (the government) and design schemes revised consequently. It is proposed that the design evaluation be performed from two main perspectives: (1) Operation and property management perspective: Three criteria such as spatial appropriateness, people and vehicle circulation and control, property management working spaces are used to evaluate the ‘operation and PM effectiveness’ of a design scheme. (2) Financial feasibility perspective: Four types of financial analyses are performed to assess the long term financial feasibility of a presented design scheme, such as operational and rental income analysis, management fund analysis, regular operational and property management service expense analysis, capital expense analysis. The ongoing Chung-Li Public Housing Project developed by the Taoyuan City Government will be used as a case to demonstrate how the presented design evaluation method is implemented. The results of property management assessment as well as the annual operational and capital expenses of a proposed design scheme are presented.

Keywords: design evaluation method, management fund, operational and capital expenses, rental apartment buildings

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Authors: Ya-Hui Lee, Ching-Yi Lu, Chien Hung, Hsieh

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The purpose of this study is to explore the difference between state-owned-enterprise employees and the civil servants regarding their future-oriented thinking and retirement planning. The researchers investigated 687 middle age and older adults (345 state-owned-enterprise employees and 342 civil servants) through survey research, to understand the relevance between and the prediction of their future-oriented thinking and retirement planning. The findings of this study are: 1.There are significant differences between these two professions regarding future-oriented thinking but not retirement planning. The results of the future-oriented thinking of civil servants are overall higher than that of the state-owned-enterprise employees. 2. There are significant differences both in the aspects of future-oriented thinking and retirement planning among civil servants of different ages. The future-oriented thinking and retirement planning of ages 55 and above are more significant than those of ages 45 or under. For the state-owned-enterprise employees, however, there is no significance found in their future-oriented thinking, but in their retirement planning. Moreover, retirement planning is higher at ages 55 or above than at other ages. 3. With regard to education, there is no correlation to future-oriented thinking or retirement planning for civil servants. For state-owned-enterprise employees, however, their levels of education directly affect their future-oriented thinking. Those with a master degree or above have greater future-oriented thinking than those with other educational degrees. As for retirement planning, there is no correlation. 4. Self-assessment of economic status significantly affects the future-oriented thinking and retirement planning of both civil servants and state-owned-enterprise employees. Those who assess themselves more affluently are more inclined to future-oriented thinking and retirement planning. 5. For civil servants, there are significant differences between their monthly income and retirement planning, but none with future-oriented thinking. As for state-owned-enterprise employees, there are significant differences between their monthly income and retirement planning as well as future-oriented thinking. State-owned-enterprise employees who have significantly higher monthly incomes (1,960 euros and above) have more significant future-oriented thinking and retirement planning than those with lower monthly incomes (1,469 euros and below). 6. The middle age and older adults of both professions have positive correlations with future-oriented thinking and retirement planning. Through stepwise multiple regression analysis, the results indicate that future-oriented thinking and retirement planning have positive predictions. The authors then present the findings of this study for state-owned-enterprises, public authorities, and older adult educational program designs in Taiwan as references.

Keywords: state-owned-enterprise employees, civil servants, future-oriented thinking, retirement planning

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Authors: Hans Tjio, Wee Meng Seng

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The interaction of contract and property has always been a concern in corporate and commercial law, where there are internal structures created that may not match the externally perceived image generated by the labels attached to those structures. We will focus, in particular, on the priority structures created by affirmative asset partitioning, which have increasingly come under challenge by those attempting to negotiate around them. The most prominent has been the AT1 bonds issued by Credit Suisse which were wiped out before its equity when the troubled bank was acquired by UBS. However, this should not have come as a surprise to those whose “bonds” had similarly been “redeemed” upon the occurrence of certain reference events in countries like Singapore, Hong Kong and Taiwan during their Minibond crisis linked to US sub-prime defaults. These were derivatives classified as debentures and sold as such. At the same time, we are again witnessing “liabilities” seemingly ranking higher up the balance sheet ladder, finding themselves lowered in events of default. We will examine the mechanisms holders of perpetual securities or preference shares have tried to use to protect themselves. This is happening against a backdrop that sees a rise in the strength of private credit and inter-creditor conflicts. The restructuring regime of the hybrid scheme in Singapore now, while adopting the absolute priority rule in Chapter 11 as the quid pro quo for creditor cramdown, does not apply to shareholders and so exempts them from cramdown. Complicating the picture further, shareholders are not exempted from cramdown in the Dutch scheme, but it adopts a relative priority rule. At the same time, the important UK Supreme Court decision in BTI 2014 LLC v Sequana [2022] UKSC 25 has held that directors’ duties to take account of creditor interests are activated only when a company is almost insolvent. All this has been complicated by digital assets created by businesses. Investors are quite happy to have them classified as property (like a thing) when it comes to their transferability, but then when the issuer defaults to have them seen as a claim on the business (as a choice in action), that puts them at the level of a creditor. But these hidden interests will not show themselves on an issuer’s balance sheet until it is too late to be considered and yet if accepted, may also prevent any meaningful restructuring.

Keywords: asset partitioning, creditor priority, restructuring, BTI v Sequana, digital assets

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Authors: Chih-Yang Liao

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Baseball is usually played outdoors in the warmest months of the year. Therefore, baseball players are susceptible to the influence of the hot environment. It has been shown that hitting performance is increased in games played in warm weather, compared to in cold weather, in Major League Baseball. Intermittent cooling during sporting events can prevent the risk of hyperthermia and increase endurance performance. However, the effects of cooling during baseball games played in a hot environment are unclear. This study adopted a cross-over design. Ten Division I collegiate male baseball players in Taiwan volunteered to participate in this study. Each player played two simulated baseball games, with one day in between. Five of the players received intermittent cooling during the first simulated game, while the other five players received intermittent cooling during the second simulated game. The participants were covered in neck and forehand regions for 6 min with towels that were soaked in icy salt water 3 to 4 times during the games. The participants received the cooling treatment in the dugout when they were not on the field for defense or hitting. During the 2 simulated games, the temperature was 31.1-34.1°C and humidity was 58.2-61.8%, with no difference between the two games. Ratings of perceived exertion, thermal sensation, tympanic and forehead skin temperature immediately after each defensive half-inning and after cooling treatments were recorded. Ratings of perceived exertion were measured using the Borg 10-point scale. The thermal sensation was measured with a 6-point scale. The tympanic and skin temperature was measured with infrared thermometers. The data were analyzed with a two-way analysis of variance with repeated measurement. The results showed that intermitted cooling significantly reduced ratings of perceived exertion and thermal sensation. Forehead skin temperature was also significantly decreased after cooling treatments. However, the tympanic temperature was not significantly different between the two trials. In conclusion, intermittent cooling in the neck and forehead regions was effective in alleviating the perceived exertion and heat sensation. However, this cooling intervention did not affect the core temperature. Whether intermittent cooling has any impact on hitting or pitching performance in baseball players warrants further investigation.

Keywords: baseball, cooling, ratings of perceived exertion, thermal sensation

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Authors: Amadou Wurry Jallow, Adama N. S. Bah, Karamo Bah, Shih-Ye Wang, Kuo-Chung Chu, Chien-Yeh Hsu

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Chronic kidney disease (CKD) is a major public health challenge with high prevalence, rising incidence, and serious adverse consequences. Developing effective risk prediction models is a cost-effective approach to predicting and preventing complications of chronic kidney disease (CKD). This study aimed to develop an accurate machine learning model that can dynamically identify individuals at risk of CKD using various kinds of diagnostic data, with or without laboratory data, at different follow-up points. Creatinine is a key component used to predict CKD. These models will enable affordable and effective screening for CKD even with incomplete patient data, such as the absence of creatinine testing. This retrospective cohort study included data on 19,429 adults provided by a private research institute and screening laboratory in Taiwan, gathered between 2001 and 2015. Univariate Cox proportional hazard regression analyses were performed to determine the variables with high prognostic values for predicting CKD. We then identified interacting variables and grouped them according to diagnostic data categories. Our models used three types of data gathered at three points in time: non-laboratory, laboratory, and metabolic indices data. Next, we used subgroups of variables within each category to train two machine learning models (Random Forest and XGBoost). Our machine learning models can dynamically discriminate individuals at risk for developing CKD. All the models performed well using all three kinds of data, with or without laboratory data. Using only non-laboratory-based data (such as age, sex, body mass index (BMI), and waist circumference), both models predict chronic kidney disease as accurately as models using laboratory and metabolic indices data. Our machine learning models have demonstrated the use of different categories of diagnostic data for CKD prediction, with or without laboratory data. The machine learning models are simple to use and flexible because they work even with incomplete data and can be applied in any clinical setting, including settings where laboratory data is difficult to obtain.

Keywords: chronic kidney disease, glomerular filtration rate, creatinine, novel metabolic indices, machine learning, risk prediction

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Authors: Liang Cheng Chang, Wei Ju Huang, You Cheng Chen

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Investigation and research are keys for conjunctive use of surface and groundwater resources. The hydrogeological structure is an important base for groundwater analysis and simulation. Traditionally, the hydrogeological structure is artificially determined based on geological drill logs, the structure of wells, groundwater levels, and so on. In Taiwan, groundwater observation network has been built and a large amount of groundwater-level observation data are available. The groundwater level is the state variable of the groundwater system, which reflects the system response combining hydrogeological structure, groundwater injection, and extraction. This study applies analytical tools to the observation database to develop a methodology for the identification of confined and unconfined aquifers. These tools include frequency analysis, cross-correlation analysis between rainfall and groundwater level, groundwater regression curve analysis, and decision tree. The developed methodology is then applied to groundwater layer identification of two groundwater systems: Zhuoshui River alluvial fan and Pingtung Plain. The abovementioned frequency analysis uses Fourier Transform processing time-series groundwater level observation data and analyzing daily frequency amplitude of groundwater level caused by artificial groundwater extraction. The cross-correlation analysis between rainfall and groundwater level is used to obtain the groundwater replenishment time between infiltration and the peak groundwater level during wet seasons. The groundwater regression curve, the average rate of groundwater regression, is used to analyze the internal flux in the groundwater system and the flux caused by artificial behaviors. The decision tree uses the information obtained from the above mentioned analytical tools and optimizes the best estimation of the hydrogeological structure. The developed method reaches training accuracy of 92.31% and verification accuracy 93.75% on Zhuoshui River alluvial fan and training accuracy 95.55%, and verification accuracy 100% on Pingtung Plain. This extraordinary accuracy indicates that the developed methodology is a great tool for identifying hydrogeological structures.

Keywords: aquifer identification, decision tree, groundwater, Fourier transform

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Authors: A. Yu-Chen Chien, B. Ying-Ju Su

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Greenway is a type of linear park which links the planar parklands and connects the open spaces. In the urban environment, except for providing open spaces with recreational function as well as effectively improve the appearance of the surrounding environment, greenway and parkland also creates benefits to the social and psychological aspects of human. In 2014, the statistics of The Ministry of Home Affairs show that citizens in Taichung enjoy the green area at an average of 4.27 square kilometers per person. How to use the existing green space system effectively and enhance the quality of leisure life thus become the major issues today. The study here points out that greenway and parkland and other open spaces are closely related to the daily life of urban residents. Whether the operation could be executed in accordance with the design is our major concern. To explore the issue, we implemented the Post-Occupancy Evaluation of Taiyuan Greenway in Taichung City. In 1956, Taichung city carried out the urban plan according to Howard’s concept about “Garden City” and built the Taiyuan greenway to restrain the urban expansion. 50-year past, due to the population growth and new demands, the government started to reconstruct the program. It is a three stage modification project of “The Townspace Renaissance project in Taiwan” since 2009, of which the greenway construction is the main point. In this research, we mainly focus on the third stage of this program to investigate the user’s preference and degree of satisfaction based on the Post-Occupancy Evaluation about the finished, unfinished, and undergoing construction sectors as well as facilities. We collected and analyzed the data based on the questionnaires and explored the possible facts that might have affected the degree of satisfaction about the greenway modification project based on the chi-square test. We hope to inspect the purpose of the demonstration projects and provide reference to the Taichung government for the modification planning and the greenway design in the future.

Keywords: greenway, landscape greenway, post-occupancy evaluation, Taichung city

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Authors: Palaniyandi Karuppaiya, Hsin Sheng Tsay, Fang Chen

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Medicinal herbs do represent a huge and noteworthy reservoir for novel anticancer drugs discovery. Dysosma pleiantha (Hance) Woodson (Berberidaceae), one of the oldest traditional Chinese medicinal herb, highly prized by the mountain tribes of Taiwan and China for its medicinal properties contained pharmaceutically important antitumor compounds podophyllotoxin, quercetin and kaempferol. Among lignans, podophyllotoxin is an active antitumor compound and has now been modified to produce clinically useful drugs etoposide and teniposide. In recent years, natural populations of D. peliantha have declined considerably due to anthropogenic activities such as habitat destruction and commercial exploitation for medicinal applications. As to its overall conservation status, D. pleiantha has been ranked as threatened on the China Species Red List. In the present study, an efficient in vitro callus culture system of D. pleiantha was established on Gamborg’s medium with various combinations and concentrations of different auxins and cytokinins under dark condition. Best callus induction was recorded in 2 mg/L 2, 4 - Dichlorophenoxyacetic acid (2,4-D) along with 0.2 mg/L kinetin and the maximum callus proliferation was achieved at 1 mg/L 2,4-D. Among the explants tested, maximum callus induction (86 %) was achieved from tender leaves. Hence, in subsequent experiments, leaf callus was further investigated for suitable callus biomass and production level of anticancer compounds under the influence of different additives. A maximum fresh callus biomass (8.765 g) was recorded in callus proliferation medium contained 500 mg/L casein hydrolysate. High performance liquid chromatography results revealed that the addition of different concentrations of peptone (1, 2 and 4 g/L) in callus proliferation medium enhanced podophyllotoxin (16 fold), quercetin (12 fold) and kaempferol (5 fold) accumulation than control. Thus, the established in vitro callus culture under the influence of different additives may offer an alternative source of enhanced production of podophyllotoxin, kaempferol and quecertin without harming natural plant population.

Keywords: dysosma pleiantha, kaempferol, podophyllotoxin, quercetin

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Authors: Wen-Bin Chiou, Hsiao-Chiao Weng

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Social networking sites (SNS) such as Facebook and Twitter are low-cost tools that can promote the creation of social connections by providing a convenient platform that can be accessed at any time. In the current research, a laboratory experiment was conducted test the hypothesis that reminders of losing SNS would alter the impact of social events, especially those involving social exclusion. Specifically, this study explored whether losing SNS would intensify perceived social distress induced by exclusionary bogus feedback. Eighty-eight Facebook users (46 females, 42 males; mean age = 22.6 years, SD = 3.1 years) were recruited via campus posters and flyers at a national university in southern Taiwan. After participants provided consent, they were randomly assigned to a 2 (SNS non-use vs. neutral) between-subjects experiment. Participants completed an ostensible survey about online social networking in which we included an item about the time spent on SNS per day. The last question was used to manipulate thoughts about losing SNS access. Participants under the non-use condition were asked to record three conditions that would render them unable to use SNS (e.g., a network adaptor problem, malfunctioning cable modem, or problems with Internet service providers); participants under the neutral condition recorded three conditions that would render them unable to log onto the college website (e.g., server maintenance, local network or firewall problems). Later, this experiment employed a bogus-feedback paradigm to induce social exclusion. Participants then rated their social distress on a four-item scale, identical to that of Experiment 1 (α = .84). The results showed that thoughts of losing SNS intensified distress caused by social exclusion, suggesting that the loss of SNS has a similar effect to the loss of a primary source for social reconnections. Moreover, the priming effects of SNS on perceived distress were more prominent for heavy users. The demonstrated link between the idea of losing SNS use and increased pain of social exclusion manifests the importance of SNS as a crucial gateway for acquiring and rebuilding social connections. Use of online social networking appears to be a two-edged sword for coping with social exclusion in human lives in the e-society.

Keywords: online social networking, perceived distress, social exclusion, SNS

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Authors: Pei-Chih Wu, Hsin-Chih Lai, Yung-Lung Lee, Yun-Yao Chi, Ching-Yi Horng, Hsien-Chang Wang

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The impact of climate change to health has always been well documented. Amongst them, water-borne infectious diseases, chronic adverse effects or cancer risks due to chemical contamination in flooding or drought events are especially important in river basin. This study therefore utilizes GIS and different models to integrate demographic, land use, disaster prevention, social-economic factors, and human health assessment in the Erren River basin. Therefore, through the collecting of climatic, demographic, health surveillance, water quality and other water monitoring data, potential risks associated with the Erren River Basin are established and to understand human exposure and vulnerability in response to climate extremes. This study assesses the temporal and spatial patterns of melioidosis (2000-2015) and various cancer incidents in Tainan and Kaohsiung cities. The next step is to analyze the spatial association between diseases incidences, climatic factors, land uses, and other demographic factors by using ArcMap and GeoDa. The study results show that amongst all melioidosis cases in Taiwan, 24% cases (115) residence occurred in the Erren River basin. The relationship between the cases and in Tainan and Kaohsiung cities are associated with population density, aging indicator, and residence in Erren River basin. Risks from flooding due to heavy rainfall and fish farms in spatial lag regression are also related. Through liver cancer, the preliminary analysis in temporal and spatial pattern shows an increases pattern in annual incidence without clusters in Erren River basin. Further analysis of potential cancers connected to heavy metal contamination from water pollution in Erren River is established. The final step is to develop an assessment tool for human exposure from water contamination and vulnerability in response to climate extremes for the second year.

Keywords: climate change, health impact, health adaptation, Erren River Basin

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Authors: Yueh Hsiu Giffen Cheng, Teng Jung Wang

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According to the study of British national advisory council on creative and cultural education（NACCCE, what the present and the future need awesome innovative and creative people from the perspective of commercial human resources. Therefore, we can know from above, creativity plays an important role in today’s enterprise indeed. Besides, many companies are aimed at developing team work as their main goal, so “creativity” and “teamwork” become more and more important factors to succeed and team creativity also turn into an important issue gradually. Then, the study takes in-depth interviews of design companies’ leaders and uses self-designed questionnaire regarding affecting team creativity to conduct cross-analysis. The results show that for those creative-oriented integrated design companies, their design strategies don’t begin until data collection and their scripts are usually the best way to inspire creativity. Besides, passing down a legacy of experiences are their common educational training. Most important of all, their organizational resources and leaders can assist all the team to learn and grow effectively and the good interaction between the leader and the member can also bring work flexibility and efficiency. In short, the leader’s expectation of members’ performance can cause them to encourage each other to progress. Moreover, the analysis of questionnaire indicates that members who are open-minded and leaders who have transformational leadership style can both help to establish a good team interaction. Furthermore, abundant resources and training system are also good approaches to establish a harmonious relationship. Finally, through integrating the outcomes of interviews and questionnaires, we can infer that those integrated design companies’ circumstances of design progress are mainly from their leaders’ guidance. In addition, the analysis of design problems are focused on their creative strategies and their scripts and sketches can also inspire their creativity. In sum, the feature of all team is influenced by 4 factors: leaders who have transformational leadership style, open-minded members, flexible working environment, resources and interactive relationship. Ultimately, the study hopes that the result above can apply to the design-related industries or help general companies elevate the team creativity.

Keywords: creativity, team creativity, integrated design companies, design process

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

Abstract:

Objectives: Obstructive sleep apnea syndrome (OSAS) is a popular problem in the modern society. It usually leads to sleep disorder, excessive daytime sleepiness and associated with cardiovascular diseases, cognitive dysfunction and even death. The nonsurgical therapies include continuous positive airway pressure (CPAP), diet and oral appliances. The surgical approaches have nasal surgery, tonsillectomy, adenoidectomy, uvulopalatopharyngoplasty (UPPP) and transoral robotic surgery (TORS).We compare the impact of surgical treatments on these kinds of patients. Methods: Between January 2018 to September 2022, We have enrolled 125 OSAS patients including 82 male and 43 female in Chi Mei Medical Center, Liouying, Taiwan. The age distribution from 6 to 71 years old (y/o) with mean age 36.1 y/o. The averaged body mass index (BMI) is 25 kg/m2 in male and 25.5 kg/m2 in female. In this cohort, we evaluated their upper airway obstruction sites with nasopharyngoscopy and scheduled a planned surgery. Some of cases received polysomnography (PSG) preoperatively, the averaged apnea-hypopnea index (AHI) is 37.7 events/hour. We have 68 patients received tonsillectomy, 9 received UPPP, 42 received UPPP and septomeatoplasty (SMP) and 6 received adenoidectomy and tonsillectomy (A and T). The subjective daytime sleepiness was evaluated with the Epworth sleepiness scale (ESS). Results: In the 68 tonsillectomy group, the averaged BMI is 24.9 kg/m2. In the UPPP group, the averaged BMI is 28.9 kg/m2. In UPPP and SMP group, the averaged BMI is 27.9 kg/m2. In the A and T group, the averaged BMI is 17.2 kg/m2. The reduction of AHI less than 20 is 58% postoperatively. The ESS reduced from 10.9 to 4.9 after surgery. Conclusion: Obstructive sleep apnea syndrome is a common upper airway disturbance in the general population. The prevalence rate is ranging high depending on different regions, age, sex and race. It leads to severe morbidity and mortality including car accident, stroke, nocturnal desaand sudden death and should be considered to be a major public health problem. The CPAP is effective to improve daytime sleepiness but the long-term compliance is low. The surgical treatment with different modalities can produce 50% decrease in AHI and ESS after surgery in the 6 to 12 months short-term period.

Keywords: apnea-hypopnea index, obstructive sleep apnea syndrome, polysomnography, uvulopalatopharyngoplasty

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