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The assessment of daily living activities could provide information about daily functions and participation restrictions to develop intervention strategies. The purposes of this study were to assess the scores of the Barthel Index (BI) and Lawton Instrumental Activities of Daily Living (IADL) scale in older adults with cognitive impairment and to explore the different effects that levels of cognitive functions have on changes in IADL functions. We recruited 31 participants with dementia, 36 with mild cognitive impairment (MCI), and 35 normal controls (NCs) from the neurology outpatient department of a regional hospital. The results of the demographic and clinical characteristics through the Lawton IADL scale, BI, Quick Mild Cognitive Impairment (Qmci) screen, Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE), were collected on the same day and compared with the Kruskal-Wallis test, Wilcoxon rank-sum test, Fisher's exact test, and a multiple linear regression analysis, as appropriate. In the BI, bathing was the most discriminating activity to differentiate patients with MCI and dementia; in the Lawton IADL scale, medication responsibility and shopping were the most discriminating activities to differentiate NCs and patients with MCI, and patients with MCI and dementia, respectively. In addition, the predictors of changes in Lawton IADL scale scores were the problem-solving score of the Clinical Dementia Rating scale, a Qmci score of > 20.4 and an age of ≤ 81.2 years, a MoCA score of < 9.4 and an age of > 81.2 years, and the MMSE score and an age of > 81.2 years. This study adds to the evidence that the description of basic and instrumental daily activities is integrated in older adults with cognitive impairment. Notably, the Qmci is the most significant predictor of changes in IADL function for \"young\" older adults, as are the MoCA and MMSE for \"old\" older adults.

The health benefits of leisure-time physical activity are well known, but whether less exercise than the recommended 150 min a week can have life expectancy benefits is unclear. We assessed the health benefits of a range of volumes of physical activity in a Taiwanese population. In this prospective cohort study, 416 175 individuals (199 265 men and 216 910 women) participated in a standard medical screening programme in Taiwan between 1996 and 2008, with an average follow-up of 8·05 years (SD 4·21). On the basis of the amount of weekly exercise indicated in a self-administered questionnaire, participants were placed into one of five categories of exercise volumes: inactive, or low, medium, high, or very high activity. We calculated hazard ratios (HR) for mortality risks for every group compared with the inactive group, and calculated life expectancy for every group. Compared with individuals in the inactive group, those in the low-volume activity group, who exercised for an average of 92 min per week (95% CI 71–112) or 15 min a day (SD 1·8), had a 14% reduced risk of all-cause mortality (0·86, 0·81–0·91), and had a 3 year longer life expectancy. Every additional 15 min of daily exercise beyond the minimum amount of 15 min a day further reduced all-cause mortality by 4% (95% CI 2·5–7·0) and all-cancer mortality by 1% (0·3–4·5). These benefits were applicable to all age groups and both sexes, and to those with cardiovascular disease risks. Individuals who were inactive had a 17% (HR 1·17, 95% CI 1·10–1·24) increased risk of mortality compared with individuals in the low-volume group. 15 min a day or 90 min a week of moderate-intensity exercise might be of benefit, even for individuals at risk of cardiovascular disease. Taiwan Department of Health Clinical Trial and Research Center of Excellence and National Health Research Institutes.

Halide perovskites exhibit unique slow hot-carrier cooling properties capable of unlocking disruptive perovskite photon–electron conversion technologies (e.g., high-efficiency hot-carrier photovoltaics, photo-catalysis, and photodetectors). Presently, the origins and mechanisms of this retardation remain highly contentious (e.g., large polarons, hot-phonon bottleneck, acoustical–optical phonon upconversion etc.). Here, we investigate the fluence-dependent hot-carrier dynamics in methylammonium lead triiodide using transient absorption spectroscopy, and correlate with theoretical modeling and first-principles calculations. At moderate carrier concentrations (around 10 18  cm −3 ), carrier cooling is mediated by polar Fröhlich electron–phonon interactions through zone-center delayed longitudinal optical phonon emissions (i.e., with phonon lifetime τ LO around 0.6 ± 0.1 ps) induced by the hot-phonon bottleneck. The hot-phonon effect arises from the suppression of the Klemens relaxation pathway essential for longitudinal optical phonon decay. At high carrier concentrations (around 10 19  cm −3 ), Auger heating further reduces the cooling rates. Our study unravels the intricate interplay between the hot-phonon bottleneck and Auger heating effects on carrier cooling, which will resolve the existing controversy. Harvesting excess energy from above-bandgap photons can break solar cells’ conventional efficiency limits. Using transient spectroscopy, modelling and ab-initio calculations, Fu et al., unravel the interplay between hot phonon bottleneck and Auger heating effects on hot-carrier cooling in halide perovskites.

Information about the raindrop size distribution (RSD) is vital for comprehending the precipitation microphysics, improving the rainfall estimation algorithms, and appraising the rainfall erosivity. Previous research has revealed that the RSD exhibits diversity with geographical location and weather type, which leads to the assessment of the region and weather-specific RSDs. Based on long-term (2004 to 2016) disdrometer measurements in northern Taiwan, this study attempts to demonstrate the RSD aspects of summer seasons that were bifurcated into two weather conditions, namely typhoon (TY) and non-typhoon (NTY) rainfall. The results show a higher concentration of small drops and a lower concentration of large-sized drops in TY compared to NTY rainfall, and this behavior persisted even after characterizing the RSDs into different rainfall rate classes. RSDs expressed in gamma parameters show higher mass-weighted mean diameter (Dm) and lower normalized intercept parameter (Nw) values in NTY than TY rainfall. Moreover, sorting these two weather conditions (TY and NTY rainfall) into stratiform and convective regimes revealed a larger Dm in NTY than in TY rainfall. The RSD empirical relations used in the valuation of rainfall rate (Z–R, Dm–R, and Nw–R) and rainfall kinetic energy (KE–R and KE–Dm) were enumerated for TY and NTY rainfall, and they exhibited profound diversity between these two weather conditions. Attributions of RSD variability between the TY and NTY rainfall to the thermodynamical and microphysical processes are elucidated with the aid of reanalysis, remote sensing, and ground-based data sets.

Background It remains unclear whether sepsis-related cardiovascular complications have an adverse impact on survival independent of pre-existing comorbidities. To investigate the survival impact of post-sepsis cardiovascular complications among sepsis survivors, we conducted a population-based study using the National Health Insurance Database of Taiwan. Methods We identified sepsis patients from the National Health Insurance Research Database of Taiwan using ICD-9-CM codes involving infection and organ dysfunction between 2000 and 2011. Post-sepsis incident myocardial infarction (MI) and stroke were ascertained by ICD-9-CM codes and antiplatelet treatment. We constructed a non-sepsis comparison cohort using propensity score matching to ascertain the association between sepsis and cardiovascular complications. Furthermore, we compared the 180-day mortality and 365-day mortality between patients surviving sepsis with or without post-sepsis MI or stroke within 70 days of hospital discharge. We constructed Cox regression models adjusting for pre-existing comorbidities to evaluate the independent survival impact of post-sepsis MI or stroke among sepsis survivors. Results We identified 42,316 patients hospitalized for sepsis, from which we matched 42,151 patients 1:1 with 42,151 patients hospitalized without sepsis. Compared to patients hospitalized without sepsis, patients hospitalized with sepsis had an increased risk of MI or stroke (adjusted odds ratio 1.72, 95% CI 1.60–1.85). Among 42,316 patients hospitalized for sepsis, 486 (1.15%) patients developed incident stroke and 108 (0.26%) developed incident MI within 70 days of hospital discharge. Compared to sepsis survivors without cardiovascular complications, sepsis survivors with incident MI or stroke had a higher mortality rate at 180 days (11.68% vs. 4.44%, P  = 0.003) and at 365 days (16.75% vs. 7.11%, P  = 0.005). Adjusting for age, sex, and comorbidities, post-sepsis MI or stroke was independently associated with increased 180-day (adjusted hazard ratio [HR] 2.16, 95% CI 1.69–2.76) and 365-day (adjusted HR 1.90, 95% CI 1.54–2.32) mortality. Conclusions Compared to sepsis patients without incident MI or stroke, sepsis patients with incident MI or stroke following hospital discharge had an increased risk of mortality for up to 365 days of follow-up. This increased risk cannot be explained by pre-sepsis comorbidities.

The rise of marine recreational activities has led to a growing use of marine recreational powered platforms, raising safety concerns related to navigation. In Taiwan, the current regulatory system for such platforms remains fragmented and under debate. This study aims to support policy development by identifying key safety management priorities. This study utilized the four core components of the SHELL model, which include Software, Hardware, Environment, and Liveware, as the analytical foundation and identified 20 preliminary safety criteria through an extensive review of relevant literature. A Modified Delphi Method and DEMATEL analysis were applied to gather expert insights and prioritize 10 representative indicators. The resulting Influence Network Relation Map revealed that “Comprehensive Management Regulations” had the highest causal influence across all dimensions. Additionally, “Basic Navigation Concepts” and “Emergency Response and Safety Knowledge” were found to be the most central elements. Based on these findings, the study recommends targeted measures including enhanced regulation, improved training, radar monitoring, and spatial planning to reduce navigation risks and promote safer marine recreation. Building on the above findings, this study confirms the effectiveness of an innovative integration of the SHELL model and the DEMATEL method, which provides a structured and adaptive framework capable of systematically identifying systemic navigational risks in marine recreational activities.

There is a need for a screening tool with capacities of accurate detection of early mild cognitive impairment (MCI) and dementia and is suitable for use in a range of languages and cultural contexts. This research aims to evaluate the psychometric and diagnostic properties of the Taiwan version of Qmci (Qmci-TW) screen and to explore the discriminating ability of the Qmci-TW in differentiating among normal controls (NCs), MCI and dementia. Thirty-one participants with dementia and 36 with MCI and 35 NCs were recruited from a neurology department of regional hospital in Taiwan. Their results on the Qmci-TW, Taiwanese version of the Montreal Cognitive Assessment (MoCA), and Traditional Chinese version of the Mini-Mental State Examination (MMSE) were compared. For analysis, we used Cronbach's α, intraclass correlation coefficient, Spearman's ρ, Kruskal-Wallis test, receiver operating characteristic curve analysis, and multivariate analysis, as appropriate. The Qmci-TW exhibited satisfactory test-retest reliability, internal consistency, and interrater reliability as well as a strong positive correlation with results from the MoCA and MMSE. The optimal cut-off score on the Qmci-TW for differentiating MCI from NC was ≤ 51.5/100 and dementia from MCI was ≤ 31/100. The MoCA exhibited the highest accuracy in differentiating MCI from NC, followed by the Qmci-TW and then MMSE; whereas, the Qmci-TW and MMSE exhibited the same accuracy in differentiating dementia from MCI, followed by the MoCA. The Qmci-TW may be a useful clinical screening tool for a spectrum of cognitive impairments.

Somatic inactivating mutations of ARID1A , a SWI/SNF chromatin remodeling gene, are prevalent in human endometrium-related malignancies. To elucidate the mechanisms underlying how ARID1A deleterious mutation contributes to tumorigenesis, we establish genetically engineered murine models with Arid1a and/or Pten  conditional deletion in the endometrium. Transcriptomic analyses on endometrial cancers and precursors derived from these mouse models show a close resemblance to human uterine endometrioid carcinomas. We identify transcriptional networks that are controlled by Arid1a and have an impact on endometrial tumor development. To verify findings from the murine models, we analyze ARID1A WT and ARID1A KO human endometrial epithelial cells. Using a system biology approach and functional studies, we demonstrate that ARID1A -deficiency lead to loss of TGF-β tumor suppressive function and that inactivation of ARID1A/TGF-β axis promotes migration and invasion of PTEN -deleted endometrial tumor cells. These findings provide molecular insights into how ARID1A inactivation accelerates endometrial tumor progression and dissemination, the major causes of cancer mortality. ARID1A, which is often mutated in human endometrial cancer, is a component of the SWI/SNF chromatin remodelling complex. Here, the authors show that Arid1a mutations in the mouse endometrium and primary human endometrial epithelial cells cause widespread reprogramming of gene transcription and result in a loss of response to TGFβ.

This study explored the impact of message sensation value (MSV) and message appeal on viewers’ responses to anti-bullying videos on YouTube from various sources. Through quantitative content analysis, 1431 videos were coded by trained coders based on predefined coding schemes. The results revealed that anti-bullying videos employed relatively low MSV levels (mean = 4.33, score range: 0–15). Most videos utilized positive emotional appeal (70.6%), about half employed rational appeal (54.9% self-efficacy appeal, 49.1% response efficacy appeal), and less than half incorporated negative emotional appeal (45.1%). Significant variations were observed in MSV and message appeal across different sources. Videos by YouTubers, amateurs, and recreational channels exhibited higher MSV levels than those by governments, non-profit organizations, and news channels. Videos uploaded by YouTubers received the highest number of views, likes, and comments, higher than those uploaded by governments and other sources. Videos employing higher levels of MSV received significantly more views, while message appeal had no significant effects after sources, languages, and numbers of subscribers were considered. The findings suggest that combining YouTubers’ broad reach with the credibility of government sources may offer an optimal strategy for effectively delivering accurate anti-bullying messages to a broader audience.