Dean Li helps TMU lead in infotech apps for health

Vol. 4, No. 1, 2013
Special issue: Connecting with research
Inside
Dean Li helps TMU lead in infotech apps for health
E Message from President Yen
E Alumni magazine debuts
E Student research takes
on life-saving topics
E Electronic records and hospital information systems in China
E Which hormones influence polycystic ovarian syndrome?
EEAhead of the pack: Recent bioinformatics publications
E Research speeds HIV test results to save lives
E Is the missing decade of aboriginal lifespan due to diet?
E Applying new concepts of resilience to patient safety
E ‘Mother of cancer research’ in Taiwan speaks
E Malawi must protect people from catastrophic medical spending
E Sage advice after a TMU year: prefer action over perfection
E Mastering the menu: Eating well in 50 Chinese words or less
E We care without distance
E Table tennis helps TMU
faculty put pressures aside
E 53rd anniversary celebration and sports day
<Editor’s note: In May, Dean YuChuan (Jack) Li of the College of
Medical Sciences and Technology
took time to walk TMU Outwards
through the university’s history from
the perspective of computerization.
Dean Li was recently appointed as
Editor-in-Chief of the SCI journal
Computer Methods and Programs
in Biomedicine (more often called
by its acronym, CMPB). This marks
the first time the journal has been
led from Asia in its 40-year history.
CMPB is in the top 14% of its peer
journals, and it receives more than
700 papers each year, of which only
20% can be published. The journal
remains based in Europe, but during
the five years that Dean Li was
Asia-Pacific Associate Editor, its Asian
contributions increased 100%.
Dean Li has been awarded as
Academician by American College
of Medical Informatics since 2010.
He practices dermatology as well as
leading TMU’s internationally noted
Biomedical Informatics graduate
studies program. Here are his
reflections on where informatics
research will lead in TMU’s future.>
In the beginning of 1995, it
became time to invest in a fiber
optic network system to connect
the campus and the hospital. We
went with an IBM system and we
established the first website for
medical university in Taiwan on
the August of 1995 I assumed the
position of IT director of both the
university and the hospitals for
the next 12 years.
(Continued on page 4)
Message from President Yen
TMU student research takes on life-saving topics
Greetings to all of the readers of TMU’s
English magazine. This special issue on
research helps to tell TMU’s most important
story: its mission to focus on translating
research to useful clinical practice.
For example, we have established a biobank
to help our scientists and collaborators
prove their concepts. We also are completing
work on a “value added” database using
National Health Insurance information.
This vast repository of information can be
a source of answers about treatments, risk
factors and medication use. “Big data” is
also the resource behind our brand-new
biostatistics center, which makes biomedical
information translatable from bench to
bedside.
We are also working hard to optimize a joint
Institutional Review Board and clinical trial
procedures to make it easier for clinicians
to perform research. They can conduct trials
to test hypotheses as well as to develop new
treatments and medical devices.
We are expanding our research and
clinical faculty to find useful and applicable
knowledge. Serendipitously, we are moving
on to help our community and our country
in partnership with businesses. These
Electronic records and hospital information systems in China
James Andrew Worley, Biomedical Informatics, United States
My master’s thesis
partnerships allow faster progress, and also
faster transfer of these good ideas into
practice.
Our challenge is often a matter of space, but
we have bold new plans to expand the TMU
campus as well. Stay tuned, because TMU will
continue to get bigger and better. n
“Clinical and
(Text by TMU Office of Public Affairs; translation by Jin Lin)
initial issue of TMU Alumni in January, with
the next issue due in July. This publication
allows alumni to keep in touch with TMU
and to stay informed about what their old
friends are doing.
This issue features a special interview with
Taitung’s Daren Township health center
director, Dr. Chao-Bing Hsu. But the biggest
news is the start of a new alumni association
and each department’s outreach to our
alumni. This issue discusses the mission
of this alumni association, as well as our
alumni’s reflections upon their schools. The
dean and chair of each department and
every TMU hospital introduce the many
2
Which hormones influence polycystic ovarian syndrome?
Ala’a Kutkut, Medical School, Jordan
TMU alumni magazine debuts
The Office of Public Affairs published the
research will focus on
China’s
implementation of
electronic hospital
information systems
(HIS) and electronic
medical records
(EMRs). This research
will document the
progress China has
made in incorporating
effective HIS, including EMRs, within its
national hospitals. I would like to determine
at what standardized levels China has these
health IT platforms in current operation. If
necessary, this research may involve a
standardization assessment system to
uniformly sort and analyze this data. I will
review distinctive regional and national
milestones in relation to current trends in
biomedical informatics, as these important
factors are relevant to this topic. Individual
patient records have been handled in various
ways by the administrators tasked with
keeping these records accessible and up-todate. I will explore these records-handling
procedures in detail because it is not
logically appropriate to keep such lab
records and body scans in printed-out
media. I will use a theoretical model to plot
and rate hospital units accordingly. n
new research centers and discuss biomedical
industry breakthroughs and the new era
of medical education, such as the six-year
clinical pharmacy degree that was recently
approved.
The magazine also discusses TMU’s rise in
international rankings to Taiwan’s number
two in medical and science education
(following only National Taiwan University).
In addition, there are some romantic stories
about our students who met their mates in
various TMU departments and student clubs.
The editors invite all alumni to submit
writing for publication. In this way everyone
can help the garden of TMU’s influence bear
new blossoms. n
Biochemical
Presentations of
Hyperandrogenism”
discusses which of
the four abnormally
elevated androgen
groups (total
testosterone [TT],
androstenedione [A],
free androgen index
[FAI], or dehydroepiandrosterone [DHEAS])
present with an unfavorable metabolic and
hormonal profile that is more insulin-resistant
and poses additional cardiovascular risk.
My results show that subjects with excess
FAI are obese and face the highest metabolic
syndrome risk, adipocytokine alterations,
insulin resistance and cardiovascular risk.
The excess TT group presents with higher
gonadotropin dysfunction and marginal
insulin resistance risk. The excess A
group has the highest AMH, which may
counterbalance obesity; this group and
the excess DHEAS group have a favorable
association with insulin resistance.
Hyperandrogenism is a predominant
criterion in polycystic ovary syndrome
(PCOS) according to Androgen Excess
and PCOS (AE-PCOS) Society diagnostic
criteria. While differences between PCOS
phenotypes have been reported, no research
until this study has examined independent
abnormally elevated androgen measures to
observe differences in metabolic endocrine
features and insulin resistance.
Thus I conducted a retrospective
study in 121 Taiwanese women with
hyperandrogenism and 142 women without
hyperandrogenism, with medical records
reviewed from June 1, 2009, through July
21, 2012 classified women into four groups
according to abnormally elevated androgen
measures each above its cut-off value, and
the groups were compared with each other
and with controls.
It is important to understand the roles
of different androgens contributing to
hyperandrogenism and to offer appropriate
treatment to those facing the greatest health
risks; this research gives an evidence base to
those decisions. n
3
Ahead of the pack
Recent TMU
bioinformatics
publications
1. M-health (use of mobile phone
technologies for health applications)
Wen-Shan Jian, Min-Huei Hsu, Hosea
Sukati et al. (2012). LabPush: A Pilot
Study of Providing Remote Clinics with
Laboratory Results via Short Message
Service (SMS) in Swaziland, Africa. PLoS
One (7):e44462
Syed-Abdul S, Scholl J, Chen CC et
al. (2012).Telemedicine Utilization to
Support the Management of Burns
Treatment Involving Patient Pathways
in Both Developed and Developing
Countries: A Case Study. Journal of Burn
Care Research 2012 Jul;33(4):e207-12
2. EMR/PHR (electronic medical
record systems and portable personal
health records)
Wen-Shan Jian, Shabbir Syed-Abdul,
Sanjay P Sood et al. (2012). Factors
influencing consumer adoption of
USB-based personal health records in
Taiwan. BMC Health Services Research
(12):277
Li YC, Detmer DE, Shabbir SA et al.
(2011) A global travelers’ electronic
health record template standard
for personal health records. JAMIA
(Journal of the American Medical
Informatics Association). doi:10.1136/
amiajnl-2011-000323
3. Social network applications
for health
Shabbir SA, Lin CW, Scholl J et al.
(2011) Facebook use leads to healthcare reform in Taiwan. Lancet, June 18.
377(9783):2083-4
Special issue: Connecting with research
(Continued from page 1)
In 1997, with the opening of the new Wan Fang Hospital, we
adopted a new health information system that covered both our
TMU hospital and Wan Fang. However, what happened over time
was that the hospitals evolved into separate systems. In a way
they were competing with each other, which is not all bad.
Twelve years later, I decided to make a job change from
managing the hospitals’ IT operations, which had grown
essentially from a staff of two people to almost one hundred
between the campus and the hospitals. It had been a position of
incredible pressure – even banks’ IT isn’t as critical as hospitals’
data operations. After all, banks close every night but we operate
24 hours, constantly collecting and managing patient data. And
with banks it’s only money – with hospitals, lives are at stake!
So in 2006, I accepted an offer from National Yang Ming
University to chair their newly reformed Department of
Biomedical Informatics. Here I saw the academic side of
biomedical informatics in a department with sixty graduate
students.Yang Ming is a national university, so it has both space
and funding, things that TMU has to work very hard for on its
own. So I had three years to focus on pure research.
But in 2009, Wen-Ta Chiu, then TMU’s president, again asked me
to return to TMU. He knew how to convince me; he said “We
need you more than they do.” He called every now and then to
ask me to return to TMU. I took the job because he has been a
friend, a mentor and a father-like influence for me. I gave up the
life-time benefits of being a government employee and returned
to start a project to reintegrate the three hospital information
systems.
Our teaching hospitals work on a military-style model, with
a strict hierarchy – the Superintendent has final say over
absolutely everything. The university is more democratic, so it
took several years to integrate these different systems. In fact, it
was only several months ago that we finally announced that we
have integrated the three hospitals’ information systems. Prof.
Ray-Jade Chen of the Management and Development Office,
who coordinates the three-hospital system, manages this now.
(Continued on page 12)
4. Medical decision support for
physicians
Hsieh CH, Lu RH, Lee NH et al.
(2011) Novel solutions for an old
disease: diagnosis of acute appendicitis
with random forest, support vector
machines, and artificial neural
networks. Surgery 149(1):87-93
Chang YJ,Yeh ML, Li YC et al. (2011)
Predicting Hospital-Acquired Infections
by Scoring System with Simple
Parameters. PLoS One 6(8): e23137.
doi:10.1371/journal.pone.0023137 n
4
Minister of Health Wen-Ta Chiu (fifth from left) joined a press conference to
note an M-Health research milestone at TMU.
Research speeds HIV test results to save lives:
African study of M-health app cuts test times by 75%
The respected biomedical
journal PLOS One has
published TMU’s LabPush
study about the effectiveness
of providing remote clinics
in Swaziland with laboratory
results via SMS (short
message service). To mark
this occasion, TMU held an
inspiring multimedia press
conference to discuss the
background of this historic
study. A TMU student
from Swaziland, Sharoon
Hlatshwayo, performed
music and dozens of
reporters gathered to hear
Minister of Health Wen-Ta
Chiu speak in praise of the
project.
“Although other
projects use SMS for
health applications at
remote African clinics,
no studies have been
published that measure
their effectiveness.”
Dean Jack Li designed a
service to return test results
by SMS, hoping to reduce
the turnaround time from
a month to a few days. This
has the potential to lead to
better service, fewer patients
lost to treatment and more
appropriate dosing.
The TMU team thus set
out to both develop such
a service and measure its
effectiveness to support
evidence-based development
of the Swazi health care
system. The study shows that
SMS delivery of lab reports
can reduce turnaround times
by up to 75% for remote
clinics.
The TMU team learned
The problem addressed
additional lessons relevant
by the project was that
to other M-health projects
lab results for HIV tests
in Africa. For example, the
often took a month to be
process of getting hostreturned to Swazi patients
government approval was
because delivery motorbikes
expected to be short, but
travel infrequently between
it took 18 months due to
clinics and central labs. Bad
inter-agency delays. Paying
roads and limited public
staff to log each test time
transport meant that Swazis
was expected to increase
who travelled hours to be
reliability, but in fact this was
tested often returned via the
a recurring issue because
same difficult routes -- only
of noncompliance and
to find that their test results
Swazi student Sharoon Hlatshwayo
inaccurate recording by lab
have not arrived. Delays in
joined Dean Jack Li at the LabPush
and
clinic staff.
test results can also lead to
event to sing for television reporters.
suboptimal medication dosing,
The study and the
since by the time a test result
lessons learned can help
returns, the patient’s T-cell count is already a
future efforts to use this powerful and
month out of date and requires a new test.
widespread technology. The Swazi study
This makes the overall clinical situation for
also provides evidence that Taiwan is
processing blood tests difficult for patients.
spreading its technologies internationally
It was this situation that troubled the
Taiwan Medical Mission operated by TMU.
As the university was already using mobile
phones for health via the SANA project of
the Massachusetts Institute of Technology,
College of Medical Sciences and Technology
to enhance health services in developing
countries. The full paper can be read
at: http://www.plosone.org/article/
info%3Adoi%2F10.1371%2Fjournal.
pone.0044462 n
5
Is the missing decade of aboriginal lifespan due to diet?
Special issue: Connecting with research
Trista Di Genova, Public Health and Nutrition, United States
Many great advances in
medicine over the past 50
years have translated to
a 10-year plus increase in
average life expectancy in
Taiwan. However, scholars
point out the continued
existence of a persistent
gap in life expectancy
– Aborigines lives on
average 10 years less than
the general population. A
great part of indigenous
deaths can be attributed to
preventable causes related
to ‘lifestyle choices’ such as
traffic accidents, cirrhosis,
or cancers related to betel
chewing, smoking and
alcohol.
Aboriginal children eating junk food:
photos by Trista di Genova
how their diet is changing
over time by conducting a
cross-generational 24-hour
food recall survey.
‘Mother of cancer research’ in Taiwan speaks
This remote, picturesque
mountain area (pop. 4500,
primarily Atayal tribal
people) could be considered
a fruit basket of Taiwan.
Residents here usually
grow their own fruits and
vegetables, and this industry
has in recent years become
a bigger piece of the local
economy so that some earn
a good living selling their
small-scale farming produce.
Editor’s note: Dr. Jacqueline Whang-Peng
has been nicknamed “the Mother of Cancer
Research in Taiwan” due to her pioneering
efforts in cancer research. An Academic Sinica
scholar, she currently works at Wan Fang
Medical Center and Taipei Medical University
Hospital’s International Cancer Institute. She
spent thirty years as the first woman on the
medical staff at the United States National
Institutes of Health (1960 to 1990) and
continues to maintain close ties with her US
colleagues. Professor Whang-Peng was both the
first female surgeon in Taiwan and also the first
non-US-born female recipient of the Arthur S.
Flemming Award. We had a chance to talk with
her about the future of cancer treatment at her
Wan Fang office.
My fieldwork feels exciting
for its relevance because
I study what the Atayal
grow for themselves to eat
– quite literally measuring
what’s in their gardens. They
also are teaching me how
they work with the land,
their views toward nature
and the environment, and
about Atayal culture and
Yet some Aboriginal
populations experience less
incidence of certain diseases
than the general population.
Such is the case of the
Atayal in Hsinchu County,
Farmers in Chingchuan, a mostly
where I’m conducting
aboriginal mountain village.
nutrition fieldwork. I’m
language.
investigating the dietary habits of the Atayal
because they retain many aspects of an
And if you think Taiwanese people are
age-old traditional diet. Compared to the
friendly, you should come and meet these
modern diet that is high in sugar, salt, fried
people – they’re ten times friendlier! This
foods and chemicals, this diet eaten in the
is one big reason why I’ve moved into the
mountains can be considered a model as it
mountains. I’m going to love this hands-on
is still full of fresh fruits, vegetables and lean
field experience, so thank you TMU for
meats hunted from the forest.
everything these past two years, for the
So I am looking into what aspects of the
traditional diet the Atayal are retaining and
Based on an interview with Heather Chen, Taiwan Tech Trek intern
What is happening in cancer research at Taipei
Medical University?
At TMU, we do have very good research on
breast cancer. We have found that breast
cancer also has a high amount of nicotine
receptors. That is what we want to target
on for breast cancer. Do you have any comment on the government
cancer prevention policies? Do you think they’re
effective? Do you recommend any changes?
scholarship and good times. Really, I couldn’t
have chosen a better place to study. n
Right now we have problems for prostate
cancer. That is the one important direction
for cancer research. Screening is not helpful
because prostate cancer only shows up
when it is at later stages. We have so many
things for women in breast, colorectal, and
cervical cancer. But nothing for cancer for
men. We need to emphasize on prostate
research. We need to use the digital PSA
(plastic specific antigen) to do very early
detection, especially for aggressive forms of
prostate cancer.
Applying new concepts of resilience to patient safety
Eliana Rubashkyn, Health Care Administration, Colombia
A decade ago, medical errors and adverse
6
events produced in hospitals were among
the top 10 leading causes of death in the
U.S., even above breast cancer and AIDS.
Recently TMU researchers Prof. Sheuwen
Chuang and Eliana Rubashkyn have been
working to apply the concepts of resilience
engineering and “safety II” in a model
intensive care unit in Taiwan.
Resilience engineering, according to Cook
and Woods, is a way that people at all levels
of an organization can try to anticipate paths
that might lead to failure, as well as to create
and sustain strategies resistant to failure,
and adjust tasks and activities to maintain
safety margins despite workplace pressures
to do more and to do it faster (“Nine steps
(Continued on page 9)
One of my priorities is that we do more
research on colorectal cancer. There are
people who say that it has something to
do with your diet. I remember an English
researcher went to Uganda and he noticed
that the foreigners had the colorectal cancer
whereas the native people did not. He went
to their home to see what they eat. Native
people eat vegetable roots because they
are poor. So, they have a lot of fiber rich
foods. The Taiwanese now have colorectal
cancer. Our economy is getting better and
people are getting richer. So a lot of people
don’t eat as many vegetables as before. (Continued on page 15)
Photo at US NIH, 1960s.
7
Special issue: Connecting with research
Malawi must protect people from catastrophic medical spending
Dominic Moyo, Malawi
(This article appeared in Malawi’s major
newspaper, the Nyasa Times)
Recent news reports of drug shortages
in public hospitals are unfortunately not
news. Far from being an isolated lapse, such
deadly shortfalls are a perennial problem.
Insufficient services, facilities, medical
supplies and human resources also have led
to a loss of trust in Malawi’s health system.
When I worked in the
public hospitals, many
patients came to these
facilities as their last resort,
in desperation because
they could not afford care
elsewhere and had to
settle for what little care
they could get from public
hospitals.Yet the technically
free care these facilities
offer poses different
economic challenges for the
poor that leave many unable
to complete treatment
or procure necessary
medications. In reality, this free care is
difficult to access and low in quality.
Less than 10% of the national budget goes to
health, in contrast to the WHO-sponsored
Abuja Declaration signed in 2001 by many
nations committing to spend at least 15%
on health. Malawi’s health budget allows
only about US$ 25 per person per year for
health services – just over half of the US$
44 specified as the lowest possible level to
provide essential services by the Taskforce
on Innovative International Financing. Thus
current financing can only provide half of
what might in the best case (with no waste
and good planning) be sufficient care.
Drug shortages at hospitals
8
Filling this financial gap to purchase health
care becomes a major challenge when
people have to spend money from their
pockets. This is especially worse for people
in rural areas, where medical services are
almost nonexistent.Very poor people must
first pay for transport to a health facility that
Sage advice after a TMU year: prefer action over perfection
Bamodu Oluwaseun, Nigeria
has erratic supplies of medications and other
medical necessities. So then they must find
drugs in pharmacies, and pay more.
Starting in 2001, global health initiatives
poured money into Malawi for more than
half a decade, with the Global Fund, World
Bank and PEPFAR among others initiating
vertical programs to reach vulnerable
people and reduce out-of-pocket health
costs. Then the economic crisis saw budget
cuts and withdrawal by
major bilateral donors. Now
a single illness or accident
can shift poor families
into crisis as health costs
continue to increase.
In 2000 WHO said health
systems should protect
people from catastrophic
health expenditures, defined
as when households
spend more than 40% of
disposable income on health
after subtracting subsistence
costs. Given the current
economic turmoil, Malawi is
failing utterly on this count: subsistence costs
are increasing while incomes are not.
Budget allocations to public hospitals have
not increased, leaving most to operate in
debt and lacking basic necessities. Many
people thus spend their disposable income
on medications and other medical expenses.
This out-of-pocket expenditure on health
is regressive (affecting the poor more than
the rich) and prevents people from accessing
desperately needed medical services, since
only those who can pay receive treatment.
Prepayment insurance
Prepayment of health services is the best
form of health financing; many countries
have implemented this form of revenue
collection and have excellent health systems.
Yet only private institutions like the Medical
Aid Society of Malawi provide this, and their
premium costs are prohibitive to an average
rural resident.
(Continued on page 14)
Nothing I had done in the past could have
adequately prepared me for a stress-less
first year in the Graduate Institute of Clinical
Medicine. So here are some wisdom nuggets
from a green-horn.
A lot of reading and learning is demanded,
but success requires a focused learning
precisely directed toward an eventual
publication/dissertation. By my second
semester, I learned that signing up for
non-required (elective) courses outside of
my area of interest was unnecessary. Like
many ill-advised pursuers after excellence in
graduate school, I went too far with relevant
project title search, read so much and
broadly about my intended research interest
that I almost never started any real benchwork. My advisors were beginning to lose
patience with their ‘eternal’ student, who
seem bitten by the ‘want to learn everything,
but do nothing’ bug of graduate school.
What was the goal? Making a contribution to
human knowledge. A graduate degree is not
a game of acquisition but of contribution.
It is not how much you know, but how
focused you are. The price I paid for this
enlightenment was a wasted first semester.
Not perfect, but it works!
Being a perfectionist, I kept looking for the
green light of approval from tutors and
advisors that I had a perfect research outline.
This kept me from starting on laboratory
work until that perfectionist in me died. To
those trailing after I say: however it looks,
start the work anyway.
Success never embraces the procrastinator.
Like my advisor always told me: ‘Don’t
think too much, just do it!’ Begin your
bench-work right away. Way into my second
semester I realized that the project topic
matters less than getting the degree. It does
not matter what I get my degree in; it is the
training that matters, not the topic. Once a
man has been taught to shoot, he can keep
shooting until he hits the bull’s eye. To make
a big impact in graduate school is like hitting
a bull’s eye at first shot. The degree is only a
starting point, not your final undertaking in
the world of science.
Madman chasing knowledge
Sanity is a relative perception; we classify
those different from and unlike us as mad.
But really, are they? In this pursuit, let not
your short-sightedness ruin the vision of a
bright tomorrow. Do not allow what you
know to hinder the reception, processing
and application of the knowledge of what
is not known. An open mind is a teachable
mind, a teachable mind is a brilliant mind, and
a brilliant mind is a winning mind. Welcome
to the world of professional thinkers. n
Resilience and patient safety
(Continued from page 6)
to move forward from error”; Cogn Technol
Work 2002; 2: 137-144).
is impossible to encapsulate a linear solution
for a dynamic threat.
Why is patient safety still not improving
much? In part because, as Leape and Berwick
concluded, “The more complex any system
is, the more chances it has to fail.” Safety
traditionally has been seen as a condition
where the number of adverse outcomes
is as low as possible and total safety
means that nothing was done wrong. This
perspective on safety intends to look at the
negative and tries to eliminate it. However
the nature of an adverse event is dynamic; it
Hollnagel and Chuang argue instead that
health systems are complex and adaptive
in the nature of a socio-technical system.
Compliance to standards is not always
possible due to human behavior factors,
as humans adapt their behavior according
with the current situation and environment.
Understanding and working with complexity
requires a shift in paradigm from linear
thinking to dynamic, holistic and systemic
thinking. n
9
Mastering the menu: Eating well in 50 Chinese words or less
By Dana Jensen, Health Care Administration, United States
Ordering from a
Chinese menu can be a
huge challenge -- even
for people who are
proficient in Chinese.
Menu items may have
confusing names that
don’t tell you much
about the ingredients or
preparation, and many
dishes might have very similar names.
Luckily, by knowing just a handful of words,
you can get a reasonable (if not exact) idea
of what you’re ordering. By leaving some
details of the order to chance, you get a
great chance to find new foods you might
never try otherwise, while still staying within
your comfort zone.
The basics
When we’re trying to pick a restaurant
for dinner, my Taiwanese roommates will
often ask me what kind of food I want:
street food, noodles, rice, or soup? While
it may seem strange at first, the majority of
Taiwanese/Chinese foods fall into one of
those categories. If you select a restaurant
at random and look at their menu, you’ll see
several words repeated over and over. Just
pick your favorite and you’ll at least have a
general idea of what you’re getting.
Fried rice is the way to go when you
want a classic, tasty, simple lunch.There
are several restaurants on “food street”
alone that serve it, with dozens of flavors
between them.The food translation list
should cover all the basics, so be sure to
try something you haven’t had before!
Noodles
麵
Miàn
Rice
飯
Fàn
Soup
湯
Tāng
Bread
包
Pancakes
餅
Bāo
Bing
Protein
The names of most meats are much easier
to learn in Chinese than in English. Instead
of beef/pork/mutton, the Chinese names
directly translate as “cow meat/pig meat/
sheep meat.” If you see the character for
an animal followed by the word for “meat,”
then you know what type of meat you’ll be
getting. If it’s just the word “meat” without
a specific animal listed, it’s going to be
pork. Unfortunately sea animals are named
differently, but they’re listed below. Soy-based
foods will include the character listed in a
number of different forms.
Daily is a great Japanese-influenced
restaurant just south of school, with
wonderful chicken and pork cutlets,
omelette rice and other favorites! The
menu is partly in English.
Sweet Lemon, a Southeast Asian-influenced
restaurant in the main “food street” by
the hospital has dozens of popular rice
and noodle dishes, as well as huge drinks.
Their menu is bilingual, so you can use it to
practice using the food translation list!
Vegetables
Drinks
The all-purpose word for vegetables is
actually the same word that’s used for
“dishes” or “food,” so this can be a little tricky.
However, when you see this character as part
of a longer item, it pretty much guarantees
there will be a leafy green vegetable inside.
Other important additions are listed.
Often the menus are even larger at drink
shops than at restaurants! Luckily, they’re
usually fairly simple to understand if you
know what to look for. Combining the
words below yields dozens of possible
drinks. Remember that black tea translates
as “red tea” in Chinese. Also, if you want
your milk tea made with real milk instead of
powdered milk or non-dairy creamer, make
sure it says “fresh milk.” Often drink shops
are able to substitute fresh milk at a small
additional cost.
Meat
肉
Cow
牛
Niú
Pig
豬
Zhū
Sheep
羊Yáng
Chicken
雞
Duck
鴨
Yā
Fish
魚
Yú
Leafy greens
菜
Cài
瓜
Guā
Ròu
Jī
Crab
蟹
Xiè
Gourd / pumpkin
Shrimp
蝦
Xiā
Onion
洋蔥
Corn
玉米
Yángcōng
Yùmǐ
Oyster
牡蠣
Mǔlì
Clam
蛤
Há
Tomato
西紅柿
西蘭花
Xī lánhuā
竹
Soy
豆
Dòu
Broccoli
Egg
蛋
Dàn
Bamboo
Wonton. Lots of places around campus
serve wontons/餛飩/húntún, so try a bunch
and find your favorite! I like these “giant”
pork wontons from a shop at the north
end of Wuxing Market. One of the stalls
in TMU’s own cafeteria serves a fantastic
bowl of wonton noodle soup.
Chuang’s is a relaxing shop close to school
where you can get delicious drinks, very
nice pastas, and several tasty risottos.
There is no English menu, so be sure to
bring your translation list. It’s well worth
the extra work!
Xīhóngshì
Fresh
鮮
Xiān
Zhú
Tea
茶
Chá
紅
Hóng
Eggplant
茄子
Qiézi
Red
Cucumber
黃瓜
Huángguā
Green
綠
Sauces
Especially when you’re ordering pasta, it
helps to know what sauce you’re going to
get. There are far too many sauces to list, but
I’ve given several common ones.
Nǎiyóu
Cream
奶油
Curry
咖哩
Ketchup (tomato)
番茄醬
Fānqié jiàng
Garlic
大蒜
Dàsuàn
Wine
酒
Jiǔ
Gālí
Please note: Many words I’ve listed appear in their
“short form” as they would be used on menus, not as
they would appear alone. n
10
Just across from the TMU Hospital
emergency room, you’ll find the local
“food street.” Pretty much every shop in
this alley sells either food or drinks, all
at very reasonable prices.You can get a
meal for as little as 30NT, and prices don’t
get much higher than 150NT in these
restaurants.
Oolong
烏龍
Milk
奶
Tapioca pearls
珍珠
Winter melon
冬瓜
Juice
汁
Apple
蘋果
Orange
橙
Guava
番石榴
Lemon
檸檬
Watermelon
西瓜
Lǜ
Wū lóng
Nǎi
Zhēnzhū
Dōngguā
Zhī
Píngguǒ
Chéng
Fān shíliú
Níngméng
Xīguā
Mángguǒ
Mango
芒果
Strawberry
草莓
Cǎoméi
Grape
葡萄
Pútáo
Coffee
咖啡
Kāfēi
11
M-health apps provide decision support for patients, clinicians
(Continued from page 4)
Academic leadership
logic is different, this has been proven.
Since 2011 I have been the dean of this
college, a position which allows me more
time for research and clinical duties.
In the first year of studying in English,
students cannot dream in their new language
– but after that, their logic changes. For
one thing, in English the business being
communicated is up front, not the modifiers
and qualifiers and politeness. In Chinese,
those modifiers are equal in importance to
the subject itself.
“Technology
drives these
changes, we don’t
invent them. All
across the planet,
even the poorest
areas have
these affordable,
sophisticated
tools. It’s a shame
if we don’t use
them!”
And in fact from the first
day I came back to TMU in
the 1990s, I thought it was
an underrated area of the
university. I launched this young
department with a public
relations event – the first direct
real-time broadcast of surgery
from the operating theater
to a conference room where
reporters could ask questions
of the surgeon.
I felt that we should let people
know what we’re doing; we do
want to share these ideas with the public. So
you need simple words to explain complex
situations.
Student research ideas
We do not force students to research a
particular topic suggested by faculty. Instead we
give them six months to come up with their
own ideas, to explore different areas and see
where they would like to work on research.
We ask them to have three to five research
ideas to discuss, and we give them feedback
about the practical considerations, the value
and the chances of success of each research
idea. This has broadened our department;
over ten years our research profile has been
one of variety and diversity because over
50% of students came up with their own
ideas and pursued them.
And our lab has always been in English –
even before we had foreign students in
the department. This was very unpopular
at the time; in fact they said it couldn’t be
done. But I did it because when I heard our
students give conference presentations, it
hurt my ears!
English for thinking
12
And we can’t switch back, because we
want our students to be comfortable and
competent in international conference
situations. Beyond that, students think
differently in English and in Chinese. The
And this is deadly in science writing. Don’t
hide your subject! This reflects the different
attitudes of Taiwanese and American cultures.
Phones for health
Now our research has grown from that
early gee-whiz PR event to help give
feedback to clinicians. This is one way that
marrying IT with medicine can have a big
impact on medical practice, and it is the
roots of M-health, or technologies that
use mobile phone systems to assist health
professionals and patients.
For one thing, M-health is a very practical
way of providing IT systems to underresourced areas.
For example, the SANA project that we are
partnering with MIT (Massachusetts Institute
of Technology this time, not Made In Taiwan)
is working in Pakistan to lower the very high
infant mortality rate by tracking all married
women so they can be informed about and
urged to access health services. M-health
is more concerned with applications
than research. HIT (health information
technologies) like this can amplify our efforts
with proper deployment.
But the more original research we’re doing is
in the area of medical decision-making. With
optimal use of computers and information,
we can use electronic records to help
clinicians as well as to handle automatic
follow-up with patients about appointments
and services.
Our holy grail is the second opinion,
providing more information for both doctors
and patients. For example, we can help with
decision support in the area of CT scans by
informing doctors about the risks of contrast
media when the kidney function of a patient
(Continued next page)
‘We care without distance’
By Prof. Val Crawford, TMU Outwards editor
As this issue’s theme is “Connecting with
research,” the other pages of this magazine
are full of TMU’s research and the many
ways our bench-to-bedside efforts translate
ideas into better practice.
So here I’d like to talk about connecting.
Our title, TMU Outwards, refers to the global
reach of this institution: the international
students, visiting scholars, partner
universities, outbound exchange students,
service groups going abroad, and our medical
missions that teach our students and staff
while helping others.
Still, when I looked up and saw “We Care
Without Distance” bannered across TMU
Hospital in huge letters, I was confused.
What does this mean?
Is it the quality of empathy that erases a
clinical professional’s cool remove from pain,
distress and death? Is it the home care, the
mammogram-mobile and other programs
that take our services to the community?
Is it the satellite links that enable real-time
medical exams for burn victims on the far
side of Africa?
I think the meaning is connection – because
connection is our primary business.
Education is connection, a message that
(Continued from page 12)
is impaired or unknown. We were able to
prevent 200 cases of contrast media-induced
kidney damage a year in one hospital.
Helping patients take meds
We can also provide decision support for
patients. We have completed a three-year
study of medication reminders for patients.
Compliance is a huge problem. Half of
all prescribed medication is not taken
properly. Sometimes even when I prescribe
for myself, I still miss times that I should
take it. And the effect of this is bad for
disease control, waste of resources and
pollution to the environment, because we
throw away these drugs and our rivers
bridges a gap and changes a learner. These
days that gap can be easily hurdled from
any distance, and at any time, by our Open
Course Ware (lab videos get heavy play at
midnight during midterm weeks).
Sometimes the greatest distance is invisible,
only an arm’s reach away behind a wall
of indifference. That’s what it feels like
when students are playing on Facebook
instead of engaging in classroom discussion
– a common enough problem that “We
Distantly Care” might be their slogan.
But when we connect, we educate and
help each other. With dozens of nations
represented at TMU, cultural distances and
differences are reliably unpredictable. Some
students dislike criticism and speaking up;
others learn best with competition and even
conflict, if resolved with the rhetorical tools
of civilized debate.
Connecting is not about the easiest habits of
conviviality, about reiterating what we know.
It’s tempting to shut down when we leave
our comfort zone. But becoming a scholar is
like going to a very long academic conference:
there are people to meet and ideas to
encounter, and a limited amount of time to
prove one’s worth, to justify the resources
spent in sending us across the planet. n
have been contaminated with sedatives and
other chemicals.
We know that compliance goes down with
increased prescriptions. It’s estimated at
80% with one drug, but it drops to 20% with
four meds. Taiwan’s average patient takes 4.4
medications, so 80% of these meds are taken
incorrectly or incompletely.
Yet in our trial of 1000 patients, reminders
delivered through mobile phone messages
cut the number of missed meds from 50% to
10%, and late or delayed dosages from 74%
to 20%. This would be one of the examples
that how appropriate use of simple IT
intervention can have dramatic effect on the
impact of healthcare. n
13
Table tennis helps TMU faculty put pressures aside
Story and photo by Trista di Genova, United States
A
few years ago, Prof. Jung-shan “Jack”
Chang created TMU’s Faculty and Staff Table
Tennis Club.The Graduate Institute of Medical
Sciences faculty member was recreating
the golden years of his youth as a graduate
student in the United
States, but he had higher
motives as well.
“I just want people
to be healthy,”
he said during a
recent Wednesday night
in the United Medical
Building basement. This
informal workout was
attended by TMU’s vice
president and other
academic notables.
As my own unfinished
thesis writing has me
nearly “bouncing off the
walls” as well, I often
join this two hours of
gleeful madness every
week.
In my case, at first being really rusty at
table tennis, the priority was getting some
hard action from the “ping-pong robot”
or ball-serving machine. This robot is a
glorious invention, since both the frequency
and position of these robo-serves can be
adjusted to wear down a player with a brisk
pace or allow leisurely lobs. And the robot
doesn’t mind if you prefer the ball to always
land in one spot, or if you want the challenge
of alternating right and left serves on this
miniature tennis court.
It’s a great workout. It makes you sweat and
uses all your upper body muscles.
“It also builds hand-eye coordination,” Prof.
Chang explained as he helped coach a new
member on a forehand
return. Under his guidance,
the faculty table tennis
club now numbers
thirty-plus members.
Students can play in the
same space (next to
the food court) at any
time during the rest of
the week, or even take
a class in table tennis to
learn the finer points
of the sport. This has
paid off, because TMU’s
players recently took a
national award at the
College Games in Ilan
last month.
When Prof. Chang was
studying plant pathology in the States, he
found the graduate student lifestyle afforded
him plenty of time to return to a childhood
interest in the art and sport of table tennis.
The apex of his career was to be twice
crowned champion of a New York-area
competition for Taiwanese scholars. Now
he just coaches for fun, but watch out if you
face him in a game; he’s tough! (After all, he
also keeps fit by riding his bike to TMU all
the way from Xindian every day.) n
Malawi must protect people from catastrophic medical spending
(Continued from page 8)
The recent enactment of a national
registration system provides a window of
opportunity to set up a national health
insurance system. This will ensure that the
people getting medical care are those who
most need it, unlike the current system
where anyone can receive treatment at no
cost. The insurance system will also establish
14
a sense of shared responsibility to ensure
hospitals respond to patients’ needs.
This initiative requires a coordinated effort
between public and private sectors to provide
checks and balances, but it has worked in
countries similar to Malawi – why can’t it
work for us? n
‘Mother of cancer research’ tells her story
(Continued from page 7)
What do you think is a reason why more men
are getting prostate cancer?
We don’t really know much about prostate
cancer, but we think it has something to do
with steroid intake. Also, one’s diet has a lot
to do with getting prostate cancer. In fact,
I think a lot of cancers are related to food
intake.
I know in the past, you had faced discrimination
in the science field for being a female. Has that
changed now?
For female scientists, they always say they
have some discrimination. I think for
example, even in America it is the same
thing. Also when female scientists have
a family, they need to have kids to think
about. I do not blame women for putting
family first. But I still think ability wise there
is no difference between men and women. I
think sometimes women are better because
they are more concentrated. In fact, to look at a current gender divide,
look at nursing. We have very few male
students. The male nurses all end up
going into the ER, ICU, and neonatal. If
you want to discriminate, look at the
nurses. A lot of male nurses are in ICU
because of the time they get to spend in the
department. However, overall, I think the
medical field does not discriminate between
genders.
Everywhere has unfairness. Even in a group
of females, there is still competition and
inequality. There is always a problem. I
never thought because I was a woman, I did
not get what I was supposed to get. A lot of
times, it is not because you are a woman. It
is because you do not speak up. If you go
there and display your passion, you will get
what you want.
Do you see any new developments in terms of
cancer treatment besides chemotherapy?
There is so much that has improved. Before,
we had treatment that killed not only
tumor cells but also healthy cells. Now we
target the drug so it only kills the tumor
cells. But it is an expensive drug. We also
have immunotherapy. Immunotherapy is
a preventive vaccine, such as the one for
HPV (human papillomavirus). It is not only
preventive but it can also kill tumor cell
because it uses antibodies.Your tumor has
a specific antigen that it presents so making
an antibody model makes immunotherapy
more effective. We hope that we can find a
unique antigen on every tumor so can use
the antibody to create vaccines so people
will not get cancer.
What do you think about the statistic that 70%
of doctors would decline treatment if they had
cancer?
You see this trend when doctors have
the end-stage cancer, not early stage. At
end stage, doctors know they cannot
stand chemotherapy. They cannot stand
to take medication. So they think of
taking alternative therapy, like Chinese
medicine. That therapy tries induce your
immune system so you don’t need medical
treatment. They try to activate your chi
[vital energy]. They use tai-chi, da-zhong,
meditation. Maybe they will use herbal drugs
or change your diet. How do you compare Taiwan’s health care to the
rest of the world?
For medical care, Taiwan is at the top. For
example, last time I was in America, my
husband was unable to get out of bed and
we thought it was a stroke. Of course, they
did all sorts of tests. But they did not find
anything and we stayed in the hospital for
three days. The bill from that was a shock.
Even with health insurance from working
at NIH, the bill cost a fortune. In Taiwan, I
broke my hip in a fall and another time I had
my gallbladder removed because of stomach
problems. Do you know how much I paid
for the care? Not even $20,000 NT, which is
not even $1000 USD. Amazing. n
15
53rd anniversary sports day on June 1
Taipei Medical University
250 Wuxing St., Taipei 11031 Taiwan
16
Website: www.tmu.edu.tw/English/main.php
Phone: +8862-2736-1661, ext. 2711
E-mail: [email protected]
Facebook: TMU Outwards n