The adverse effects of the COVID-19 vaccine have been discovered as the rapid application of the vaccines continues. Neurological complications such as transverse myelitis raise concerns as cases were observed in clinical trials. Transverse myelitis is a rare immune-mediated disease with spinal cord neural injury, resulting in neurological deficits in the motor, sensory, and autonomic system. Vaccine-related transverse myelitis is even rarer. We present a case of acute transverse myelitis after vaccination against COVID-19 with the ChAdOx1 nCOV-19 vaccine (AZD1222), which was the first case reported in Taiwan. Although it rarely occurs, post-vaccination neurological complications should not be ignored. As the pandemic of SARS-COV-2 continues to spread and concern about vaccination efficacy and safety rises, heterologous vaccination were implemented in health public policy in several countries. A literature review of several clinical trials shows promising effects of mix-and-match vaccination. Further study on different combinations of vaccines can be expected.

High-quality cardiopulmonary resuscitation (CPR) is a key element in out-of-hospital cardiac arrest (OHCA) resuscitation. Mechanical CPR devices have been developed to provide uninterrupted and high-quality CPR. Although human studies have shown controversial results in favor of mechanical CPR devices, their application in pre-hospital settings continues to increase. There remains scant data on the pre-hospital use of mechanical CPR devices in Asia. Therefore, we conducted a retrospective cohort study between September 2018 and August 2020 in an urban city of Taiwan to analyze the effects of mechanical CPR devices on the outcomes of OHCA; the primary outcome was attainment of return of spontaneous circulation (ROSC). Of 552 patients with OHCA, 279 received mechanical CPR and 273 received manual CPR, before being transferred to the hospital. After multivariate adjustment for the influencing factors, mechanical CPR was independently associated with achievement of any ROSC (OR = 1.871; 95%CI:1.195–2.930) and sustained (≥24 h) ROSC (OR = 2.353; 95%CI:1.427–3.879). Subgroup analyses demonstrated that mechanical CPR is beneficial in shorter emergency medical service response time (≤4 min), witnessed cardiac arrest, and non-shockable cardiac rhythm. These findings support the importance of early EMS activation and high-quality CPR in OHCA resuscitation.

The recruitment of an annelid community was examined on 2 tidal elevations in 2 kinds of sedirnents along an inclined intertidal mud flat In an estuary in northern Taiwan. Recruitment onto defaunated and ambient intact sediments (control) in both low and high tidal zones was followed weekly from 3 April to 1 May 1996. The overall density of recruits in the defaunated sediments reached the level of the control sediments within 3 wk in the low tidal zone, whereas in the high tidal zone the density of recruits did not reach the control level during the study period. Two polychaete species and 1 oligochaete species were the major recruits, and each exhibited a different recruitment mode and rate. The spionid Prionospio japonica and the oligochaete Doliodrilus tener were among the most rapid recruits. P japonica simultai~eously exhibited 2 recruitment modes, larval settlement and postlarval transportation, and its recruit density in the defaunated sediments in the low t~d a l zone reached the level of the control w~thin 1 wk. D. tener recruited predomnately by means of juvenile migration. In general, recruitment by settling larvae occurred at discrete intervals, whereas that by postlarvae or juveniles appeared to be continuous. The densities of P. japonica and of D. tener exhibited a zonation pattern whereln density increased along a down-shore gradient. The sedimentary characteristics also exhibited a similar zonation pattern, wherein the sediment particles became smaller and silt/clay content increased in the low tidal zone. This coupled phenomenon suggests that tidal action has a strong influence on the recruitment of P. japonica and D. tener. These recruits are passively entrapped in the low tidal zone due to the depositional conditions created by slow flows. However, the tidal zonation of the capitellid Capitella sp. showed an opposite trend, with greater recruitment in the high tidal zone, indicating that the recruitment of CapiteUa sp. possessed an active component. D. tener recruited mostly into the low tidal zone, but a small, significant proportion of the recruitment occurred in the high tidal zone. Cap~tella sp. and D. tener are subsurface burrowers, and thus, to some extent, their recruitment is less controlled by tidal action. Overall, the recru~tment of this annelid community is influenced by both physical and biological controls.

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Introduction. Disaster medical assistance team (DMAT) and urban search and rescue team (USAR) need to cooperate seamlessly to save lives in disasters, but related research is limited. Objectives. To estimate the disaster preparedness of the DMAT and the barriers affecting interagency cooperation between the DMAT and the USAR team. Methods. This was an observational study of a full-scale exercise conducted in Taiwan from November 16 to 18, 2018. The exercise scenario simulated a magnitude 7 earthquake in Tainan City. DMATs from other counties were deployed and cooperated with local USAR teams to carry out disaster relief. Our study invited 7 experts to evaluate DMATs on disaster preparedness capabilities and the interagency collaboration between DMATs and USAR. Results. A total of eight DMATs, consisting of 30 physicians, 65 nurses, 74 logisticians, 5 health bureau personnel, and 85 USAR teams, participated in this exercise. During the mission, 176 patients were treated. The capabilities of each team were generally consistent with the basic technical standards for type I emergency medical teams, but the compliance rates for basic local anesthesia, cold chain equipment for medication, rapid blood test tools, and sterilization devices were only 50%, 12.5%, 12.5%, and 9%, respectively. In addition, 53% of participants reported abnormal vital signs, indicating that it was a high-stress situation. Moreover, the main barriers to interagency collaboration were differing perspectives and poor mutual understanding. Conclusion. A full-scale exercise carried out jointly with DMATs and USAR teams was valuable for disaster preparedness, particularly in terms of understanding the weaknesses of those teams and the barriers to interagency collaboration.