J Formos Med Assoc
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The dysfunction of the ABO glycosyltransferase (GT) enzyme, which is caused by mutations in the ABO gene, can lead to weak ABO phenotypes. In this study, we have discovered a novel weak ABO subgroup allele and investigated the underlying mechanism to causing its Aweak phenotype. ⋯ One novel AW allele was identified and the SNP c.424A > G (p.M142V) can cause the Aweak phenotype through damaging the hydrogen bonds and reducing stability of the GTA.
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Drug-induced sleep endoscopy (DISE) is used for evaluating upper airway anatomy and determining airway obstruction patterns. It is typically performed with the patient in the supine position. Airway collapse severity is influenced by body position and level of consciousness; the resultant dynamic changes may vary across patients. In this study, we evaluated the severity of upper airway collapse through awake endoscopy and DISE and identified factors affecting the pattern of airway collapse severity. ⋯ In patients with obstructive sleep apnea, tongue strength may vary depending on body position. Our results should be interpreted with caution because of the limited sample size. Future studies should investigate the effect of oropharyngeal rehabilitation on tongue strength and collapse severity.
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During the COVID-19 pandemic, Taiwan's pediatric healthcare system faced its most severe shortage of pediatric residents in history. This review investigates the causes, consequences, and potential solutions to this shortage. Between 2020 and 2023, the recruitment rate of pediatric residents dropped by 27.3%, increasing workloads for attending pediatricians and may worsening health outcomes for pediatric patients. ⋯ Systemic recommendations include increasing health expenditure as a percentage of gross domestic production (GDP) and amending the NHI Act to eliminate the global budget payment system. Managing the resulting increase in financial responsibility could involve raising tax revenue as a percentage of GDP. Implementing these measures could strengthen the pediatric healthcare system and prevent a collapse of pediatric inpatient care.
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National Taiwan University Hospital (NTUH) has demonstrated exceptional resilience and adaptability in its response to the COVID-19 pandemic. Since the outbreak in early 2020, NTUH has been at the forefront of Taiwan's healthcare system, taking proactive measures to prepare for and manage the pandemic. The hospital swiftly established dedicated outpatient clinics and wards, which were crucial in isolating and treating COVID-19 patients. ⋯ NTUH also shared its pandemic prevention experience internationally, participating in video conferences to discuss its preventive measures and best practices. In caring for frontline healthcare workers, NTUH established interdisciplinary care teams to provide psychological support, assistance with basic daily needs, and effective social, psychological, and mental health support programs. In conclusion, NTUH demonstrated efficient response capabilities and care for healthcare workers during the COVID-19 pandemic, providing valuable insights for future challenges in dealing with emerging infectious diseases.
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The integrated home-based medical care (iHBMC) program has been implemented by the Taiwanese government since 2016. The pandemic of coronavirus disease 2019 (COVID-19) accelerated the shift from hospital-based to community-based healthcare, with a special focus on advanced home care for frail older adults. This study focuses on home-based advanced care, such as hospital at home (HaH), aiming to explore the feasibility and resilience of HaH within a home-based medical care model in a rural community in Taiwan. ⋯ Different forms of home healthcare enhance the resilience of medical care provision in rural areas. As Taiwan approaches a hyper-aged society by 2025, it is crucial that National Health Insurance policies support various home-based care models that address transportation issues and maintain high care standards in underserved rural areas.