[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.

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.

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.

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.

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.

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.

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.

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.

PIP: 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 4 centers located in 3 countries (2 in Yugoslavia and 1 each in Taiwan and Bangladesh). The sponge was associated with more insertion and retention problems than the tablet, especially in the 2 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 6 months of use were also consistently higher among sponge users than Neo Sampoon users in the 4 centers. Life-table pregnancy rates at 12 months of use ranged from 3.8 to 18.2/100 sponge users and 6.2 to 29.9/100 Neo Sampoon users, based on data from the 2 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.

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.

[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.

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.

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.

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.

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.

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.

Promotion of a family planning program: the Taiwan model.

PIP: Taiwan has been able to reduce its total fertility rate (TFR) from 4.7 (1966) to 1.9 (1985). Demographers have estimated that Taiwan will achieve zero population growth (ZPG) in 70 years if the TFR remains the same, and if the TFR continues to decline, ZPG may be achieved in 40-50 years. Taiwan's 25 year strong family planning program has contributed greatly to this progress. So successful has it been that many family planning researchers and policy makers from around the world have studied the program over its 25 years and it serves as a model for other developing countries. Actual family planning activities include family planning education and promotion to motivate the public to understand the meaning and importance of family planning and subsequently to practice family planning, and the provision of contraceptives to the motivated. Education/promotion consists of home visits, sending congratulatory and informative letters to postpartum parents, establishing a telephone hotline, group education, and using the mass media. The Taiwan program finds that good supervision is a key to a successful program because it links the policy making units to the field and it contributes to maintaining quality fieldwork. Due to a good record system of program inputs, e.g., number of home visits, and outputs, e.g., fertility data, the program can quantitatively evaluate its goals defined in 3-5 year plans. For example, for over 2 decades, it has motivated approximately 90% of fecund women or their husbands to accept at least 1 contraceptive. Researchers hope to soon be able to further evaluate this program by measuring the quality of the program.^ieng

Future research directions on factors related to fertility decline in Taiwan, ROC.

PIP: Taiwan's crude birth rate declined from over 40/1000 in 1958 to 23/1000 in 1975 and 19.6/1000 in 1984. The contribution of the proportion married has been consistently negative. The largest part of the fertility decline of recent decades has been due to couples' efforts to regulate their fertility. Contraceptive prevalence rates increased from 24% in 1965 to 44% in 1975 and 70% in 1980. Motivation to control fertility is conceptualized as a net balance of the demand and supply of children. The costs of fertility regulation must be lower than the motivation to control fertility before action is taken to regulate fertility. As family planning programs expand, more contraceptive methods and service points become available and social and psychological costs are lowered as well. The family planning program's emphasis on small family size, spacing, and equal importance of daughters and sons has led many couples to lower their family size preferences. Preferred family size among wives 22-39 years of age declined from 4 in 1965 to 2.8 in 1980. On the supply side, the national program's emphasis on breastfeeding and delayed age at marriage has affected natural fertility. This relatively high natural fertility and the reductions in child mortality have caused the supply of children to exceed the demand, thereby creating motivation to control fertility. Despite recent declines in fertility, the total fertility rate must be reduced even further--to 2.1--to achieve zero population growth in 50 years. Research is needed to identify those policies and strategies that motivate people to prefer fewer children. More information is also needed on how to encourage breastfeeding, promote sterilization, raise further the age at marriage, reduce adolescent fertility, and increase contraceptive effectiveness.^ieng

An intensive effort to reduce fertility in Taoyuan County, Taiwan: 1973 intermediate report.

PIP: From 1951 to 1973, the crude birthrate in Taiwan declined more than 50%; there is still work to be done to reduce the annual growth rate to less than 1%. This reduction was due to a change in the age composition of the population, an increase in the age at marriage, and reduced marital fertility (contraception and induced abortion). Further reductions will rely mainly on further reductions in marital fertility. An intensive family planning program, reaching 60% of eligible couples and concentrating on the pill, loop, and condom methods, has been active since 1964. Fertility will decline when the ideal family size lowers and when son preference is eliminated. 2 high fertility counties, Taipei and Taoyuan, were selected for intensified activity in 1972. Imp roved activities included: 1) systematic home visits and use of a control card system, 2) strengthened supervision of workers, 3) improved training and publicity programs, 4) use of incentives for loop referrals, and 5) encouragement of word-of-mouth publicity by satisfied contraceptors. Schedules and targets were met or exceeded. The long-range results cannot be measured yet. Reasons for the greater success of the project in Taoyuan than in Taipei are examined. Lessons learned from the project are enumerated. It can be seen that intensive local government operations can be successful, particularly when more and better paid workers are used.^ieng

Planning, starting, and operating an educational incentives project.

PIP: The article presents a summary of activities in an educational savings project in Taiwan. The project rewards couples who limit their family size. The reward is in the form of funds which enable the couples to send their children to secondary schools or universities. According to a 1970 survey in Taiwan the ideal number of children remained at 4. Consistent with traditional Chinese values, Taiwanese expect their children to take care of them in their old-age. They also place a strong emphasis on education and when surveyed 40% cited education costs as a reason for saving money. A rural township, Changua county, was selected for the pilot project. The project offers to couples with 0, 1, or 2 children an annual deposit in a savings account for each year that they do not exceed 2 living children. If a couple has a third child the value of the savings account is reduced by 50%. If they have a fourth child the account is cancelled and all funds are returned to the bank. In this particular study it was decided to include couples who already had 3 children. The account can be closed by a 1 time withdrawal from 10-14 years after enrollment. After 10 years it is worth US $267.50. After 14 years its value is US $384.60. 961 married women less than 30 years old with 3 or fewer children were contacted to join the project. Village leaders and administrators were invited to a meeting to gain their support before registration took place. After mailing and meetings, 727 or 69% of those eligible joined the project. By September 1973 the investigators hoped to be able to measure the effect of the program on family size ideals, number of additional children wanted, and practice of contraception. By September 1975 they hope to begin to measure the program effect on fertility.^ieng