Maintaining human health at the border of Taiwan.

Because international travel is now more frequent and convenient, communicable diseases that occur in one region can be transmitted to another area within a few hours. For this reason, many efforts have been undertaken in Taiwan to establish a comprehensive border quarantine system to protect against imported diseases that may threaten the health of the population. According to the International Health Regulations (2005), decades of development strategies for border quarantine have covered not only routine practices and specific measures for handling a pandemic but also have drawn attention to the development of core capacities at designated points of entry. However, as a result of the rapidly increasing number of points of entry, changes in transportation patterns, and the emergence of diseases, current border quarantine practice is being challenged to maintain human resources and the efficacy of entry screening. It is therefore critical to reexamine border quarantine strategies that will fit future needs and national conditions. This article reviews the current border health practices in Taiwan and discusses 5 key challenges to be further considered and improved. The findings can serve as a guide for further policy reform in Taiwan and other countries.

Building core capacities at the designated points of entry according to the International Health Regulations 2005: a review of the progress and prospects in Taiwan.

BACKGROUND: As designated points of entry (PoEs) play a critical role in preventing the transmission of international public health risks, huge efforts have been invested in Taiwan to improve the core capacities specified in the International Health Regulations 2005 (IHR 2005). This article reviews how Taiwan strengthened the core capacities at the Taoyuan International Airport (TIA) and the Port of Kaohsiung (PoK) by applying a new, practicable model. DESIGN: An IHR PoE program was initiated for implementing the IHR core capacities at designated PoEs. The main methods of this program were 1) identifying the designated PoEs according to the pre-determined criteria, 2) identifying the competent authority for each health measure, 3) building a close collaborative relationship between stakeholders from the central and PoE level, 4) designing three stages of systematic assessment using the assessment tool published by the World Health Organization (WHO), and 5) undertaking action plans targeting the gaps identified by the assessments. RESULTS: Results of the self-assessment, preliminary external assessment, and follow-up external assessment revealed a continuous progressive trend at the TIA (86, 91, and 100%, respectively), and at the PoK (77, 97, and 99.9%, respectively). The results of the follow-up external assessment indicated that both these designated PoEs already conformed to the IHR requirements. These achievements were highly associated with strong collaboration, continuous empowerment, efficient resource integration, and sustained commitments. CONCLUSIONS: Considering that many countries had requested for an extension on the deadline to fulfill the IHR 2005 core capacity requirements, Taiwan's experiences can be a source of learning for countries striving to fully implement these requirements. Further, in order to broaden the scope of public health protection into promoting global security, Taiwan will keep its commitments on multisectoral cooperation, human resource capacity building, and maintaining routine and emergency capacities.

Determination and kinetics of producing glucosamine using fungi.

This work used three fungi, Rhizopus oligosorus BCRC 31996, Monascus pilosus BCRC31527, and Aspergillus sp. BCRC31742, to produce glucosamine by using submerged fermentation and flask cultures. The reaction of glucosamine with 1-naphthyl isothiocyanate as derivatizing agent was carried out in pyridine at 50 degrees C for 1 h. The derivative was accurately analyzed and quantified by using high performance liquid chromatography. The relative standard deviation of glucosamine determined between experimental and real values were less than 2%. The kinetic and strategy of producing glucosamine in a flask culture was investigated to achieve an optimum yield of glucosamine under different conditions including three kinds of fungi, medium, and pH values. The descending ability of producing glucosamine for the three fungi was Aspergillus sp. BCRC31742 > Monascus pilosus BCRC31527 > Rhizopus oligosorus BCRC 31996 under the conditions studied. The experimental result shows that the glucosamine concentration had an optimum value and was 3430 mg/L by using Aspergillus sp. BCRC31742 culture in glucose and peptone (GP) medium, the yield of which was the best amount using wild-type microorganisms in the past. The generation culture of fungi and the pH control played important roles in enhancing the yield of glucosamine. The specific growth rate of the microorganism and the biomass, content, yield, and productivity of glucosamine were calculated as well.

The efficacy of brimonidine in preventing intraocular pressure elevation in the provocative test for primary angle-closure glaucoma.

The purpose of this study was to evaluate the efficacy of 0.2% brimonidine tartrate in preventing intraocular pressure (IOP) elevation in the dark-prone provocative test for primary angle-closure glaucoma (PACG). Twenty-two eyes from 22 patients with angle-closure glaucoma were enrolled in this study. Each of the selected eyes had previously tested positive in a recent dark-prone test. One drop of 0.2% brimonidine tartrate was then instilled in each eye 2 hours prior to a second dark-prone test. An IOP elevation of greater than 8 mmHg was regarded as a positive result. The IOP elevation in the first dark-prone test was 11.91 +/- 5.17 (range: 5.7 - 27.3) mmHg, while the IOP only increased 5.70 - 2.96 (range: 2.9 - 12.2) mmHg in the second dark-prone test that was pre-treated with 0.2% brimonidine tartrate (p < 0.001). A significant difference was also noted in the pre-test IOP (15.59 +/- 3.86 mmHg vs. 13.33 +/- 3.65 mmHg, p = 0.008) as well as in the post-test IOP (27.62 +/- 7.27 mmHg vs. 19.03 +/- 3.50 mmHg, p < 0.001) in the two sequential dark-prone tests. All but three of the initially positive dark-prone tests (86.46%) converted to negative tests after pre-treatment with brimonidine. There was a significant effect of 0.2% brimonidine tartrate in the prevention of IOP elevation in PACG patients previously found to test positive in the dark-prone provocative test.