[Short-term efficacy and safety of cardiac contractility modulation in patients with heart failure]

Objective: To investigate the short-term efficacy and safety of cardiac contractility modulation (CCM) in patients with heart failure. Methods: This was a cross-sectional study of patients with heart failure who underwent CCM placement at the First Affiliated Hospital of Xinjiang Medical University from February to June 2022. With a follow-up of 3 months, CCM sensation, impedance, percent output, and work time were monitored, and patients were compared with pre-and 3-month postoperative left ventricular ejection fraction (LVEF) values, and 6-minute walk test distance and New York Heart Association (NYHA) cardiac function classification, and the occurrence of complications was recorded. Results: CCM was successfully implanted in all 9 patients. Seven(7/9) of them were male, aged (56±14) years, 3 patients had ischaemic cardiomyopathy and 6 patients had dilated cardiomyopathy. At 3-month postoperative follow-up, threshold was stable, sense was significantly lower at follow-up than before (right ventricle: (16.3±7.0) mV vs. (8.2±1.1) mV, P<0.05; local sense: (15.7±4.9) mV vs. (6.7±2.5) mV, P<0.05), and impedance was significantly lower at follow-up than before (right ventricle (846±179) Ω vs. (470±65) Ω, P<0.05, local sense: (832±246) Ω vs. (464±63) Ω, P<0.05). The CCM output percentage was (86.9±10.7) %, the output amplitude was (6.7±0.4) V, and the daily operating time was (8.6±1.0) h. LVEF was elevated compared to preoperative ((29.4±5.2) % vs. (38.3±4.3) %, P<0.05), the 6-minute walk test was significantly longer than before ((96.8±66.7)m vs. (289.3±121.7)m, P<0.05). No significant increase in the number of NYHA Class Ⅲ-Ⅳ patients was seen (7/9 vs. 2/9, P>0.05). The patient was not re-hospitalised for worsening heart failure symptoms, had no malignant arrhythmic events and experienced significant relief of symptoms such as chest tightness and shortness of breath. No postoperative complications related to pocket hematoma, pocket infection and rupture, electrode detachment, valve function impairment, pericardial effusion, or cardiac perforation were found. Conclusions: CCM has better short-term safety and efficacy in patients with heart failure.

[Effects of adjuvant trastuzumab on long-term survival of T1N0M0 stage human epidermal growth factor receptor 2 positive breast cancer: a real-world study]

Objective: To investigate the prognosis impact of adjuvant trastuzumab treatment on human epidermal growth factor receptor 2 (HER-2) positive early breast cancer patients. Methods: A retrospective study was conducted, HER-2-positive T1N0M0 stage breast cancer patients who underwent surgery in the Affiliated Tumor Hospital of Xinjiang Medical University from January 2010 to December 2019 were divided into treatment group and control group according to whether they were treated with trastuzumab or not. Propensity score matching (PSM) was used to balance the confounding bias caused by differences in baseline characteristics between the two groups. Cox proportional hazards model was used to analyze the risk factors affecting disease-free survival (DFS). The Kaplan-Meier method was used to estimate the 3- and 5-year DFS and overall survival (OS) rates of the two groups before and after PSM. Results: There were 291 patients with HER-2 positive T1N0M0 stage breast cancer, including 21 cases in T1a (7.2%), 61 cases in T1b (21.0%), and 209 cases in T1c (71.8%). Before PSM, there were 132 cases in the treatment group and 159 cases in the control group, the 5-year DFS rate was 88.5%, and the 5-year OS rate was 91.5%. After PSM, there were 103 cases in the treatment group and 103 cases in the control group, the 5-year DFS rate was 86.0%, and the 5-year OS rate was 88.5%. Before PSM, there were significant differences in tumor size, histological grade, vascular invasion, Ki-67 index, postoperative chemotherapy or not and radiotherapy between the treatment group and the control group (P<0.05). After PSM, there were no significant difference in clinicopathological features between the treatment group and the control group (P>0.05). Multivariate analysis showed that histological grade (HR=2.927, 95 CI: 1.476, 5.805; P=0.002), vascular invasion (HR=3.410, 95 CI: 1.170, 9.940; P=0.025), menstrual status (HR=3.692, 95 CI: 1.021, 13.344, P=0.046), and chemotherapy (HR=0.238, 95 CI: 0.079, 0.720; P=0.011) were independent factors affecting DFS. After PSM, the 5-year DFS rate of the treatment group was 89.2%, while that of the control group was 83.5%(P=0.237). The 5-year OS rate of the treatment group was 96.1%, while that of the control group was 84.7%(P=0.036). Conclusion: Postoperative targeted therapy with trastuzumab can reduce the risk of recurrence and metastasis in patients with HER-2-positive T1N0M0 stage breast cancer.

Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial

BACKGROUND

Chronic Sciatica is a disabling condition causing considerable medical, social and financial implications. Currently, there is no recognised long-term effective treatment to alleviate sciatica. Acupuncture has been widely used for treating chronic pains with persistent analgesic effects. We aim to evaluate the efficacy and safety of acupuncture for chronic sciatica with follow-up in 52 weeks.

METHODS AND ANALYSIS

This is a multicenter randomised sham-controlled trial. A total of 216 patients with chronic sciatica will be enrolled and randomly assigned to the acupuncture or sham acupuncture group. There will be 10 treatment sessions applied in 4 weeks with frequency decreased over time. Patients will complete follow-ups during 52 weeks. The primary outcomes are changes in leg pain intensity and disability from baseline to week 4. Secondary outcomes include back pain intensity, frequency and bothersomeness, quality of life, and global perceived effect. Adverse events will be recorded in detail.

ETHICS AND DISSEMINATION

Ethical approval of this trial was granted from the ethics committee of Beijing University of Chinese Medicine and all study centres (No. 2020BZYLL0803). Written informed consent will be obtained from enrolled patients. Trial results will be disseminated in peer-reviewed publications.

TRIAL REGISTRATION NUMBER

ChiCTR2100044585 (Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 24 March 2021); preresults.

Low temperature H2S removal with 3-D structural mesoporous molecular sieves supported ZnO from gas stream

A series of 3-dimensional (3-D) structural mesoporous silica materials, SBA-16, MCM-48 and KIT-6, was synthesized and supported with different ZnO loadings (10, 20, 30, and 40 wt%) by the incipient wetness method to evaluate the performances on H2S removal at room temperature. These materials were characterized by N2 adsorption, XRD, and TEM to investigate their textural properties. All the ZnO-loaded adsorbents exhibited the H2S removal capacity of bellow 0.1 ppmv. With the best ZnO loading percentage of 30 wt% on MCM-48 and KIT-6, 20 wt% on SBA-16 according to the results of breakthrough test, further increasing ZnO loading caused the decrease of the adsorption capacity due to the agglomeration of ZnO. Besides, the H2S adsorption capacities of the supports materials varied in the order of KIT-6>MCM-48>SBA-16, which was influenced primarily by their pore volume and pore size. With the largest pores in these 3-D arrangement materials, KIT-6 showed the best performance of supported material for ZnO, due to its retained superior physical properties as well as large pore diameter to allow faster gas-solid interaction and huge pore volume to disperse ZnO on the surface of it.

Beyond family planning: incentives in taiwan

Two large-scale, long-term research projects to test the feasibility of using positive and non-coercive incentives to encourage having fewer children and spacing were carried out in Taiwan during the 1970s. The results of these long-term projects are presented. The Educational Savings Plan, begun in 1971, provided financing for the secondary school education of children whose parents had limited family size to no more than three children. The Spacing Incentive Plan, begun in 1975, encouraged prolonging the interval between first and second births to at least three years by providing free birth delivery of the second child. Although both were less successful than anticipated, much was learned about the social, economic, and practical difficulties of program implementation.

Family composition preferences in a developing culture: The case of Taiwan, 1973

Abstract As fertility comes increasingly under voluntary control in a developing society, it can be argued that individual desires or preferences about children will become more salient and more significant for eventual fertility. Hence, the study of preferences is increasingly important as contraceptive use is extended and results in decreasing the number of unwanted births.(1) Further changes in fertility then depend on changes in preferences. The assumption is that people will at least try to achieve the families they want, if the means to do so are available. The fact that contraception is used at all is some evidence of the soundness of this assumption, although it should be recognized that family size desires operate in a complex of preferences, under varying degrees of conflict and control. To expect a one-to-one relationship between attitudes or preferences and overt behaviour would be simplistic.

The effect of thickness on the texture and magnetic properties of single-layered FePt films by rapid thermal annealing

The single-layered FePt films with thickness in the range of 5 to 50 nm are deposited directly on Si(100) substrate without underlayer, then post annealed at 700 degrees C by rapid thermal annealing (RTA) technique. As the film thickness of FePt is over 20 nm, the L1(0) FePt(111) preferred orientation is presented and tended to in-plane magnetic anisotropy. However, the L1(0) FePt(001) texture is obtained and exhibited perpendicular magnetic anisotropy as the film thickness is decreased to 10 nm. Its perpendicular coercivity (Hc(perpendicular)), saturation magnetization (Ms) and perpendicular squareness (S(perpendicular)) are 14.8 kOe, 795 emu/cm3 and 0.79, respectively. On the other hand, both the grain size and domain size of FePt film decrease with decreasing the film thickness of FePt. The grain size for 10-nm FePt film is as small as 9.7 nm with domain size of 123 nm, which reveal its significant potential as perpendicular magnetic recording media for ultra high-density recording.

Effect of amended soil and hydraulic load on enhanced biological nitrogen removal in lab-scale SWIS

To characterize the effect of amended soil on nitrogen removal in subsurface wastewater infiltration system (SWIS), culture, grass carbon, and zeolite were mixed to produce microbial inoculums, and then the optimal microbial inoculums, nutrient substance, cinder, and original soil were mixed to produce the soils through bioaugmentation. Results indicate that the microbial inoculums (culture+50% grass carbon+50% zeolite) and the amended soil (12.5% microbial inoculums+25% nutrient substrate+12.5% cinder+50% original soil) have the optimal biogenic stimulating properties, and the adsorption capacity of the amended soil are 1.216 mg-Pg(-1) and 0.495 mg-Ng(-1). The laboratory soil column experiment indicates that the efficient mode of nitrogen removal in lab-scale SWIS is adsorption-nitrification-denitrification and the nitrification/denitrification can be enhanced by the application of the amended soil. On average, the SWIS filled with amended soil converts 85% of ammonia nitrogen (NH(4)(+)-N) to NO(x)(-)-N and removes 49.8-60.6% of total nitrogen (TN), while the system filled with original soil removes 80% of NH(4)(+)-N and 31.3-43.2% of TN at 4-8 cm day(-1). Two systems are overloads at 10 cm day(-1). It is concluded that the microbial activities and nitrogen removal efficiencies are improved in SWIS after bioaugmentation.

Anaerobic baffled reactor (ABR) for treating heavy oil produced water with high concentrations of salt and poor nutrient

The start-up and operational performance (total 212 days, including the start-up of 164 days) of an anaerobic baffled reactor (ABR), which is used to treat heavy oil produced water, was studied without the temperature control. Inoculums were mixtures of acclimated sediment taken from a heavy oil produced water treatment plant and digested sludge from a sewage wastewater treatment plant. The rod-shaped and spherical granules with colors of henna and black, in which Clostridia, Methanosarcina and Methanothrx sp. were main populations, were observed in each compartment of ABR after the reactor's successful start-up (day 164). Rhodopseudomonas with the activity of lipase and halotolerant, as a kind of photosynthetic bacteria, was also observed in the first five compartments. X-ray diffraction (XRD) showed that the spherical granule sludge was compact and contained a large amount of organics, amorphous materials, and crystals of Fe(2)O(3), FeS, and CaCO(3), whereas the rod-shaped granule sludge was incompact without crystals of Fe(2)O(3), FeS, and CaCO(3). Scanning electron microscope (SEM) showed that the skeleton construction of this rod-shaped granule was filamentous bacteria and amount of extracellular polymeric substances (EPS). The ABR, after successful start up, can achieve high average chemical oxygen demand (COD) and oil removals of 65% and 88% for heavy oil produced water with poor nutrient (COD:TN:TP, 1200:15:1) and high salt concentration (1.15-1.46%), respectively. Furthermore, ABR kept stable during 2.5 times the COD level shock load (0.50 kg COD m-3 d-1) for four days.

Taiwan's population and family planning efforts: an historical perspective

The unprecedented decline of Taiwan's natural population increase rate from 3% in 1963 to 1.9% in 1973, attributed primarily to an increasing use of contraception, brought universal attention to one of the first and most successful national family planning programs, at a time when successes were few. Taiwan met its goal of decreasing its natural increase rate despite its young population, increasing numbers of women of childbearing ages, a strong preference for sons and a per capita income at the outset in 1963 of less than U.S.$200. Recognition of this achievement brought thousands of professionals, particularly from developing countries, to study the program firsthand: more than 3,000 during 1970--73 alone. This was matched by an avalanche of publications about the program that appeared around the world, written by practitioners, academics and others. This article tells the story of this success.

Surface flow constructed wetland for heavy oil-produced water treatment

Heavy oil-produced water from China' Liaohe Oilfield was purified in a surface flow constructed wetland (SFCW) during a 3-yr field experiment. Treatment showed high mean removal efficiencies of 80%, 93%, 88% and 86% for COD, oil, BOD and TKN, respectively for reed bed #1 and 71%, 92%, 77%, and 81% for COD, oil, BOD and TKN, respectively for reed bed #2. The results also showed that in the third year of the system's operation, the oil-produced water had mainly positive impacts on the reed's health parameters. Thus, reed can be used as a feasible wetland macrophyte for treating such wastewater, and this SFCW system can operate for a long time.

Genotoxicity assessment of soils from wastewater irrigation areas and bioremediation sites using the Vicia faba root tip micronucleus assay

Genotoxicity potential of soils taken from wastewater irrigation areas and bioremediation sites was assessed using the Vicia faba root tip micronucleus assay. Twenty five soils were tested, of which 8 were uncontaminated soils and taken as the control to examine the influence of soil properties; 6 soils were obtained from paddy rice fields with a history of long-term wastewater irrigation; 6 soils were obtained from bioremediation sites to examine effects of bioremediation; and 5 PAH-contaminated soils were used to examine methodological effects between direct soil exposure and exposure to aqueous soil extracts on micronuclei (MN) frequency ( per thousand) in the V. faba root tips. Results indicate that soil properties had no significant influences on MN frequencies (p > 0.05) when soil pH varied between 3.4 to 7.6 and organic carbon between 0.4% and 18.6%. The MN frequency measured in these control soils ranged from 1.6 per thousand to 5.8 per thousand. MN frequencies in soils from wastewater irrigation areas showed 2- to 48-fold increase as compared with the control. Soils from bioremediation sites showed a mixed picture: MN frequencies in some soils decreased after bioremediation, possibly due to detoxification; whereas in other cases remediated soils induced higher MN frequencies, suggesting that genotoxic substances might be produced during bioremediation. Exposure to aqueous soil extracts gave a higher MN frequency than direct exposure in 3 soils. However, the opposite was observed in the other two soils, suggesting that both exposure routes should be tested in case of negative results from one route. Data obtained from this study indicate that the MN assay is a sensitive assay suitable for evaluating genotoxicity of soils.

Earthworm cytochrome P450 determination and application as a biomarker for diagnosing PAH exposure

We developed a new microsome purification method and used the Omura and Sato method to measure the total content of cytochrome (Cyt) P450 in earthworm (Eisenia fetida) microsomes. In method development, two different pretreatments, i.e. solubilization or manual separation were used to purify worm microsomes. Solubilization was more effective than manual separation and difference spectra showed a peak at 450 +/- 1 nm in microsomes received solubilization pretreatment. We conducted a 48 h contact test by exposing worms on pyrene (Py) and benzo[a]pyrene (BaP) spiked filter paper. A dose-response relationship was established between total P450 content and the concentration of Py or BaP ranging from 10(-6) mg mL(-1) to 10(-2) mg mL(-1). Results show that total Cyt P450 content in earthworms is a promising biomarker for diagnosing PAHs exposure at sublethal dose ranges.

DNA changes in barley (Hordeum vulgare) seedlings induced by cadmium pollution using RAPD analysis

In recent years, several plant species have been used as bioindicators, and several tests have been developed to evaluate the toxicity of environmental contaminants on vegetal organisms. In this study, barley (Hordeum vulgare L) seedling was used as bioindicator of cadmium (Cd) pollution in the range of 30-120 mgl(-1). Inhibition of root growth and reduction of total soluble protein content in root tips of barley seedlings were observed with the increase of Cd concentrations. The changes occurring in random amplified polymorphic DNA (RAPD) profiles of root tips following Cd treatment included variation in band intensity, loss of normal bands and appearance of new bands compared with the normal seedlings. Additionally, we found that the effect of changes was dose-dependent. These results indicated that genomic template stability (a qualitative measure reflecting changes in RAPD profiles) was significantly affected at the above Cd concentration. Thus, DNA polymorphisms detected by RAPD analysis could be used as an investigation tool for environmental toxicology and as a useful biomarker assay for the detection of genotoxic effects of Cd pollution on plants.

[Molecular coherent radiation in VUV/XUV regions and the determination of rotational temperature of molecule]

The investigation of spectroscopy of vacuum ultraviolet (VUV, 100-200 nm) and extreme ultraviolet (XUV, 10-100 nm) regions has attracted the attention of many researchers in recent years because of its promising applications in such areas as spectroscopy of highly excited states of atoms and molecules, life science, plasma physics and material science. In this paper we report the study of molecular coherent spectrum in the VUV and XUV regions through nonlinear optical processes and the determination of the rotational temperature of molecules. Because molecular gases have abundant energy levels, it can provide resonant levels to enhance the generated radiation and a wide tunibility of the spectrum in VUV and XUV regions. The determination of the rotational temperature of molecules will be very useful for the study of molecular spectroscopy and the nonlinear optical process in VUV/XUV regions.

Loading of doxorubicin into liposomes by forming Mn2+-drug complexes

A new procedure for loading doxorubicin into large unilamellar vesicles (LUVs) is characterized. It is shown that doxorubicin can be loaded into LUVs composed of sphingomyelin/cholesterol (55:45 mole/mole) in response to a transmembrane MnSO4 gradient in the absence of a transmembrane pH gradient. Complex formation between doxorubicin and Mn2+ is found to be a driving force for doxorubicin uptake. Uptake levels approaching 100% can be achieved up to a drug-to-lipid molar ratio of 0.5 utilizing an encapsulated MnSO4 concentration of 0.30 M. In vitro leakage assays show excellent retention properties over a 24 h period. The possible advantages of a liposomal formulation of doxorubicin loaded in response to entrapped MnSO4 are discussed.

A highly active microsomal glutathione transferase from frog (Xenopus laevis) liver that is not activated by N-ethylmaleimide

Microsomal glutathione transferase has hitherto only been purified from mammalian species. N-ethylmaleimide and trypsin activation (discriminating features of this enzyme) has only been observed in microsomes from mammals. In this paper we describe the first isolation and characterization of a non-mammalian microsomal glutathione transferase from frog (Xenopus laevis) liver. This protein has a molecular weight similar to that of the mammalian enzyme (approximately 17 kDa), but cannot be activated by N-ethylmaleimide or trypsin. In fact the enzyme is rapidly inactivated by this sulfhydryl reagent and protease. It thus appears that N-ethylmaleimide activation is not an obligatory property of microsomal glutathione transferase. The frog liver microsomal glutathione transferase has one of the highest specific activities towards the second substrate 1-chloro-2,4-dinitrobenzene (CDNB) (200 mumol/min mg) obtained with any glutathione transferase and accounts for the high activity found in frog liver microsomes. The kcat/K(m) for glutathione and CDNB are 0.017 and 1.1 x 10(6) M-1 s-1, respectively. The enzyme also functions as a glutathione peroxidase (dilinoleoyl phosphatidylcholine hydroperoxide is reduced (5.2 mumol/min mg)). It is now evident that a highly active microsomal glutathione transferase, with a molecular weight similar to that of the mammalian enzymes also exists in a non-mammal species.

Binding of glutathione and an inhibitor to microsomal glutathione transferase

Microsomal glutathione transferase is an abundant liver protein that can be activated by thiol reagents. It is not known whether the activation is associated with changed binding properties of the enzyme. Therefore the binding of GSH and an inhibitor to rat liver microsomal glutathione transferase was studied by use of equilibrium dialysis and equilibrium partition in a two-phase system. The radioactive substrate glutathione and an inhibitor (glutathione sulphonate) give hyperbolic binding isotherms with a stoichiometry of 1 mol per mol of enzyme (i.e. 1 molecule per homotrimer). Glutathione had an equilibrium binding constant of 18 microM. Competition experiments involving glutathione sulphonate showed that it could effectively displace GSH. These and kinetic studies showed that the Kd and Ki for glutathione sulphonic acid are close to 10 microM. No change in these parameters was obtained after N-ethylmaleimide activation of the enzyme. Thus activation does not result from changes in binding affinity to GSH.

Harmful effects of MSG on function of hypothalamus-pituitary-target gland system

It has been demonstrated that neonatal administration of monosodium glutamate (MSG) results in a clearly defined lesion of the arcuate nucleus (AN) of the hypothalamus. The present study shows that fat was accumulated in the abdomen of male rats treated with MSG; weights of the body, pituitary and testis were lower; beta-EP content in hypothalamus decreased while L.EnK content increased; serum LH, FSH, TSH, GH and TS levels all decreased in varying degrees while serum PRL level significantly increased. The cAMP content lowered in pituitary, but nor in testes; clear histological changes occurred in testicular tissue; Se-GSH-Px activity in both testis and adrenal gland lowered while LPO level significantly increased. Both Se-GSH-Px activity and LPO level in liver increased. These results indicate that MSG is harmful to the function of the hypothalamus-pituitary-target system of neonatal rats.

Kinetic studies on rat liver microsomal glutathione transferase: consequences of activation

Rat liver microsomal glutathione transferase is activated by sulfhydryl reagents and proteolysis. This property varies, however, depending on the combination, concentration and reactivity of the substrates. Thus, a multi-dimensional diagram can be envisioned in which the parameters affecting enzyme activity and activation are visualized. In principle activation could stem from an alteration in enzyme mechanism, transition-state complementarity, product release rate or pH-rate behaviour. These studies appear to rule out these possibilities and an alternate hypothesis is suggested based on the following experiments: (i) alternate substrate diagnosis of the kinetic mechanism of microsomal glutathione transferase indicates a random sequential mechanism. Non-activated and activated enzyme follow the same mechanism by these criteria. (ii) The microsomal glutathione transferase stabilizes a Meisenheimer complex between 1,3,5-trinitrobenzene and glutathione. The formation constants were similar for the unactivated and activated enzyme ((15 +/- 1).10(3) and (14 +/- 1).10(3) M-1, respectively, at pH 8). Inasmuch as the Meisenheimer complex resembles the transition state there is no evidence for an increased stabilization upon activation. (iii) The catalytic rate constant kcat does not vary with the viscosity in the assay medium. Thus, product release is not rate limiting for the unactivated and activated microsomal glutathione transferase (with saturating 1-chloro-2,4-dinitrobenzene and varying GSH). (iv) The pH dependence of the Kf-values for Meisenheimer complex formation exhibited pKa values close to 6 for both the activated and unactivated microsomal glutathione transferase. The pH profile of kcat (with saturating 1-chloro-2,4-dinitrobenzene and variable GSH concentrations) showed apparent pKa values of 5.7 +/- 0.5 and 6.3 +/- 0.4 for the unactivated and activated enzyme, respectively, indicative of a very similar requirement for deprotonation of the enzyme-GSH-1-chloro-2,4-dinitrobenzene complex. (v) Examination of the kinetic parameters (obtained with GSH as the variable substrate against increasingly reactive electrophilic substrates) in Hammett plots shows that the activation mechanism entails a more efficient utilization of GSH. It is suggested that a higher rate of formation of the glutathione thiolate anion occurs in the activated enzyme.

Taiwan's transition from high fertility to below-replacement levels

This article compares the fertility experience of Taiwanese in the eight years since the total fertility rate reached 2.1 with that before fertility reached replacement levels. During the earlier period, two-thirds of the fertility decline resulted from falling marital fertility and one-third from higher age at marriage. The changing age distribution retarded this decline. Since 1983, the further decline to 1.7-1.8 has been entirely the result of the trend toward later marriage. Older age distributions now facilitate the decline. Births postponed by those marrying later make the conventional TFR misleading. Computation based on parity-progression ratios raise TFRs from 1.7 to 2.0, a number less alarming to policymakers. Contraceptive prevalence is at saturation levels in all major populations strata. The "KAP-GAP" has disappeared. What would have happened without Taiwan's effective family planning program is impossible to determine, but clearly, contraceptive services supplied by the program were the major proximate cause of Taiwan's fertility decline.

Clinical acceptability, use-patterns and use-effectiveness of the vaginal contraceptive sponge and Neo Sampoon tablets--an international multi-center randomized clinical trial

This paper describes the results from a randomized clinical trial comparing the Collatex vaginal contraceptive sponge (a predecessor of the Today sponge) and Neo Sampoon foaming vaginal contraceptive tablets; the trial was conducted from 1979 to 1983 in four centers located in three countries (two in Yugoslavia and one each in Taiwan and Bangladesh). The sponge was associated with more insertion and retention problems than the tablet, especially in the two Asian centers. More Neo Sampoon users complained of a burning or stinging sensation. This complaint, however, seemed to be well-tolerated and was not a frequent reason for irregular use and/or discontinuation of use of the tablets. Clinically significant medical complications were rarely reported for either method. Sponge users were more likely to report irregular use than tablet users, primarily due to inconvenience of use. Rates of discontinuation at six months of use were also consistently higher among sponge users than Neo Sampoon users in the four centers. Life-table pregnancy rates at 12 months of use ranged from 3.8 to 18.2 per 100 sponge users and 6.2 to 29.9 per 100 Neo Sampoon users, based on data from the two Yugoslavian centers and the Taiwan center (data from the Bangladesh center were excluded from analysis of pregnancy rates). Practical implications of these findings are discussed.

Implications for adolescent sex education in Taiwan

This first Taiwan-wide sample survey of adolescent sexual awareness, knowledge, attitude, and behavior shows that secondary school students there: lack basic knowledge about contraception and reproduction, are often not being taught adequately about these subjects in school, have fairly permissive attitudes about sexual relationships, particularly males, are sexually active, particularly males and those in the private vocational high schools (although less so than their US counterparts), want to learn more about the nature of intimate relationships between males and females, and look to school and public health agencies to be more active sources of information and education.

Social and economic change, intergenerational relationships, and family formation in Taiwan

This paper examines the influence of social change and economic growth on intergenerational relationships and the formation of families in Taiwan. Using data from two island-wide surveys in 1973 and 1980, the analysis shows that, as expected, social change has been accompanied by rapid changes in family structure and relationships, including the spread of schooling, the employment of young people outside the family, increasing separation of the residences of parents and children before and after marriage, growing independence of young people, and increases in premarital sex and pregnancies. The position of a family in the social structure also influences the way young people interact with their parents and form their own families: women with educated fathers have more nonfamilial experiences than others, and farm origins tend to exert a traditional influence on the life course. Finally, experiences early in the life course have important ramifications for later behavior and transitions.

Valproic acid analysis in saliva and serum using selected ion monitoring (electron ionization) of the tert.-butyldimethylsilyl derivatives

A highly sensitive ion monitoring method for the determination of valproic acid in saliva and in serum has been developed based on the gas chromatographic--mass spectrometric analysis of the tert.-butyldimethylsilyl derivatives. Extraction methods are simple and the techniques for derivatization are rapid and convenient. Selected ion monitoring was carried out using electron ionization conditions and a common ion m/z 201 (M+--57) present in valproic acid and the internal standard octanoic acid. The lower limit of sensitivity that has acceptable precision for assay purposes is 0.1 mg/l based on a 200-microliter sample size. The ion monitoring method (derivatized) was compared to a gas chromatographic method (underivatized) for serum valproate assays and found to be essentially identical. The assay methodology was used in a kinetic study of valproic acid in two normal subjects. Saliva levels of drug were found to give reasonably good correlations with serum total and with serum free concentrations of drug in both individuals.U

Do intentions predict fertility? The experience in Taiwan, 1967-74

Are responses to survey questions about desire for additional children useful in predicting future fertility? Data from Taiwan covering the years 1967--74, a period of rapid fertility decline and increasing contraceptive practice, indicate that reproductive intentions and contraceptive use were very good predictors of subsequent fertility. Whether more children were wanted was itself the most important determinant of contraceptive use. Aggregate consistency between attitudes and behavior was higher than found in US surveys during the same period. Similar studies are needed to determine whether statements of intentions have predictive value in other settings as well.

Trends in fertility, family size preferences, and family planning practice: Taiwan, 1961-76

A series of six sample surveys and vital statistics are used to analyze major reproductive trends for 1961-76 in Taiwan. Fertility fell rapidly during 1961-70 as a result of adoption of contraception and rising age at marriage, while there was little change in preferred family size. Between 1970 and 1976 the practice of contraception reached high levels in all social strata, and preferred family size and fertility both declined rapidly. Practice of contraception for spacing births increased considerably after 1970. These changes occurred while many traditional familial values, including strong son preference, persisted. A continuation of the decline in fertility is predicted.