BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remain...BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.展开更多
BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific r...BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific region.Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.AIM To investigate the care cascade of incident HCV infections among PLWH in Taiwan.METHODS PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and 2018.All PLWH with incident HCV infections were followed until December 31,2019.The care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response achieved.Those who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed separately.The duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were estimated.RESULTS During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood samples.Of the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV RNA.Of those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieved viral clearance.Compared with that in the IFN era,the median interval from HCV seroconversion by retrospective testing to detection of HCV seropositivity by HIV-treating physicians was significantly shorter in the DAA era{179 d[interquartile range(IQR)87-434]vs 92 d(IQR 57-173);P<0.001}.The incidence rate of STIs in the DAA vs the IFN era was 50.5 per 100 person-years of follow-up(PYFU)and 38.5 per 100 PYFU,respectively,with an incidence rate ratio of 1.31(95%confidence interval 0.96-1.77),while the duration of HCV viremia was 380 d(IQR 274-554)and 735 d(IQR 391-1447)(P<0.001),respectively.CONCLUSION While anti-HCV therapies are effective in achieving viral clearance,our study suggests more efforts are needed to expedite the linkage of PLWH diagnosed with incident HCV infections to HCV treatment.展开更多
AIM: To examine the epidemiology of hepatitis B virus carrier status (HBVC) and sonographic fatty liver (SFL) in Taiwan Residents adults, and to evaluate their possible interaction in inducing liver damage (LD). From ...AIM: To examine the epidemiology of hepatitis B virus carrier status (HBVC) and sonographic fatty liver (SFL) in Taiwan Residents adults, and to evaluate their possible interaction in inducing liver damage (LD). From an epidemiological viewpoint, we analyzed previous studies which indicated that fatty liver sensitizes host immune response to HBV infection and enhances liver damage.METHODS: A cross-sectional retrospective analysis of health records including medical history, physical examination, abdominal sonogram, blood biochemistry and hepatic virological tests. We utilized the Student's t-test, chi-square, multivariate logistic regression and synergy index to assess risks for LD.RESULTS: Among a total of 5406 Taiwan Residents adults (mean age 46.2 years, 51.5% males), the prevalence of LD, HBVC and SFL were 12.3%, 15.1% and 33.4%, respectively; 5.1% of participants had SFL plus HBVC. Multivariate logistic regression analysis demonstrated that male gender (odds ratio (OR) = 2.8, 95% confidence interval (CI): 2.3-3.5), overweight state (OR = 1.6, 95% CI: 1.3-2.0), HBVC (OR = 2.5, 95% CI: 2.0-3.1) and SFL (OR = 4.2, 95% CI: 2.2-5.3) were independently associated with LD. Synergism analysis showed that the adjusted OR for LD in adults with HBVC-alone was 3.3 (95% CI: 2.4-4.6), SFL-alone, 4.7 (95% CI: 3.7-6.1) and combined HBVC and SFL, 9.5 (95% CI: 6.8-13.3); the synergy index was 1.4 (95% CI: 1.001-2.0).CONCLUSION: In Taiwan Residents adults, SFL plus HBVC have a significant synergistic association with LD.展开更多
AIM： To examine whether peanut consumption is associated with a reduced risk of colorectal cancer in a prospective cohort with a 10-year follow-up. METHODS： In 1990-1992, residents （12026 men and 11917 women aged 3...AIM： To examine whether peanut consumption is associated with a reduced risk of colorectal cancer in a prospective cohort with a 10-year follow-up. METHODS： In 1990-1992, residents （12026 men and 11917 women aged 30 to 65 years） in 7 townships, Taiwan, were interviewed and recruited into a cancerscreening cohort and annually followed up. Colorectal cancer cases in this cohort were identified from cancer registry and death certificates. Incidence rates of this disease by the end of 2001 were calculated by gender for the primary study variable and covariates. The dietary intake was assessed by means of weekly food frequency measures, including frequently consumed food groups and folk dishes including sweet potato, bean products, peanut products, pickled foodstuffs, nitrated or smoked foodstuffs. RESULTS： During the study period, 107 new colorectal cancer cases （68 men and 39 women） were confirmed. The multivariate Cox＇s proportional hazard model showed that the relative risk （RR） of peanut consumption was 0.73 [95% confidence interval （CI） = 0.44-1.21] for men and 0.42 （95% CI = 0.21-0.84） for women. However, frequent intake of pickled foodstuffs was harmful for women （RR= 2.15, 95% CI=0.99-4.65）. The risk of colorectal cancer was also elevated among cigarette smokers but not significant （P〈 0.05）.CONCLUSION： This study suggests that frequent intake of peanut and its products may reduce colorectal cancer risk in women, demonstrating the anti-proliferating effect of peanut intake.展开更多
The cored sediments sampled by R/V Marion Dufrense in the active margin off southwestern Taiwan on the east side of the Manila Trench are mostly muds consisting mainly of quartz, feldspar, illite, chlorite ＋ kaolinit...The cored sediments sampled by R/V Marion Dufrense in the active margin off southwestern Taiwan on the east side of the Manila Trench are mostly muds consisting mainly of quartz, feldspar, illite, chlorite ＋ kaolinite with a trace amount of montmorillonite. The cored sediments have higher Fe, Ti, Cr, Cs, Li, Ni, and V but lower Ca, Na, Mn, Hf, Nb, Sr, Ta, U and Zr contents when compared with the upper continental crust（UCC, Taylor and McLennan, 1985）. The Eu/Eu＊ ratios of the sediments averaging 0.69 indicate that the recycling effect on the Eu anomaly may be minor and the contribution of mafic source rock was unimportant, which can also be depicted in the La-Th-Sc plot（Cullers, 1994） showing a ＂mixed origin＂ close to the felsic end member. The chemistry of the cored sediment can be explained by a mixing model designed by Ho and Chen（1996） with four end members i.e., greywacke, shale, quartzite and limestone, which are widely distributed in the Cenozoic formations of southern Taiwan with greywacke as the dominant contributor followed by shale.展开更多
AIM:To investigate the etiology of esophageal cancer among Taiwan Residents women.METHODS:This is a multi-center,hospital-based,case-control study.Case patients consisted of women who were newly diagnosed and patholog...AIM:To investigate the etiology of esophageal cancer among Taiwan Residents women.METHODS:This is a multi-center,hospital-based,case-control study.Case patients consisted of women who were newly diagnosed and pathology-proven to have esophageal squamous cell carcinoma(ESCC) from three large medical centers(one from Northern and two from Southern Taiwan,respectively)between August 2000 and December 2008.Each ESCC patient was matched with 4 healthy women based on age(within 3 years)and hospital of origin,from the Department of Preventive Medicine in each hospital.A total of 51 case patients and 204 controls,all women,were studied.RESULTS:Frequencies of smokers and drinkers among ESCC patients were 19.6%and 21.6%,respectively,which were significantly higher than smokers(4.4%) and drinkers(4.4%)among controls(OR=4.07,95%CI:1.36-12.16,P=0.01;OR=3.55,95%CI:1.03-12.27,P=0.04).Women who drank an amount of alcohol more than 158 g per week had a 20.58-fold greater risk(95%CI:1.72-245.62,P=0.02)of ESCC than those who never drank alcohol after adjusting for other covariates,although the sample size was small.CONCLUSION:Cigarette smoking and alcohol drinking,especially heavy drinking,are the major risks for developing ESCC in Taiwan Residents women.展开更多
Academics in Taiwan have been working on geo-conservation for 20 years.Numerous studies focus on investigation,assessment,monitoring and education of special scientific important geoheritages. However,few researches h...Academics in Taiwan have been working on geo-conservation for 20 years.Numerous studies focus on investigation,assessment,monitoring and education of special scientific important geoheritages. However,few researches have been done on the issues of local stakeholder participation and community development.The authors choose one of the national-level geoheritages,the Lichi Badland展开更多
Ozone sensitivity was investigated using CAMx simulations and photochemical indicator ratios at three sites （Pingtung City, Chao-Chou Town, and Kenting Town） in Pingtung County in southern Taiwan during 2003 and 200...Ozone sensitivity was investigated using CAMx simulations and photochemical indicator ratios at three sites （Pingtung City, Chao-Chou Town, and Kenting Town） in Pingtung County in southern Taiwan during 2003 and 2004. The CAMx simulations compared fairly well with the hourly concentrations of ozone. Simulation results also showed that Pingtung City was mainly a volatile organic compounds （VOC）-sensitive regime, while Chao-Chou Town was either a VOC-sensitive or a NOx-sensitive regime, depending on the seasons. Measurements of three photochemical indicators （H202, HNO3, and NOy） were conducted, and simulated three transition ranges of H202/HNO3 （0.5-0.8）, O3/HNO3 （10.3-16.2） and O3/NOy （5.7-10.8） were adopted to assess the ozone sensitive regime at the three sites. The results indicated that the three transition ranges yield consistent results with CAMx simulations at most times at Pingtung City. However, both VOC-sensitive and NOx-sensitive regimes were important at the rural site Chao-Chou Town. Kenting Town, a touring site at the southern end of Taiwan, was predominated by a NOx-sensitive regime in four seasons.展开更多
OBJECTIVE: To examine and describe the use of Western and Chinese Medicine for pregnancy preparation among women with breast cancer after cancer-related treatment in Taiwan.METHODS: Women of reproductive age(20-49year...OBJECTIVE: To examine and describe the use of Western and Chinese Medicine for pregnancy preparation among women with breast cancer after cancer-related treatment in Taiwan.METHODS: Women of reproductive age(20-49years) women who were treated for breast cancer from January 2011 through June 2015 in a Taiwan Residents city participated in the study. Of 306 eligible study participants, interviews were completed in197(64%). Participants were asked about sociodemographic variables, disease and treatment characteristics, their desire for fertility, and their use of Western or Chinese Medicine.RESULTS: The proportions of women who planned to use Western or Chinese Medicine to help achieve pregnancy were 17.3% and 14.7%, respectively. The result of binary logistic regression showed that current employment and lack of children were factors predictive of the use of Western Medicine. Younger age and the use of Chinese Medicine before treatment were predictors of using Chinese Medicine. While the desire for fertility preservation was related to the use of Western Medicine,the desire for pregnancy was related to the use of Chinese Medicine.CONCLUSION: Various characteristics guided the women's decisions to use Western or Chinese Medicine. Health care providers should learn patients' preferences for fertility preservation and provide appropriate advice, referring them to safe providers of their desired method of fertility treatment.展开更多
AIM: To determine if gene-specific DNA methylation in prospectively collected blood samples is associated with later development of hepatocellular carcinoma(HCC).METHODS: Comparing genome-wide DNA methylation profiles...AIM: To determine if gene-specific DNA methylation in prospectively collected blood samples is associated with later development of hepatocellular carcinoma(HCC).METHODS: Comparing genome-wide DNA methylation profiles using Illumina Human methylation 450 K arrays, we previously identified a list of loci that were differentially methylated between tumor and adjacent nontumor tissues. To examine if dysregulation of DNAmethylation patterns observed in tumor tissues can be detected in white blood cell(WBC) DNA, we conducted a prospective case-control study nested within a community-based cancer screening cohort in Taiwan with 16 years of follow up. We measured methylation levels in ninety-six loci that were aberrant in DNA methylation in HCC tumor tissues compared to adjacent tissues. Baseline WBC DNA from 159 HCC cases and 312 matched controls were bisulfite treated and assayed by Illumina Bead Array. We used the χ2 test for categorical variables and student's t-test for continuous variables to assess the difference in selected characteristics between cases and controls. To estimate associations with HCC risk, we used conditional logistic regression models stratified on the matching factors to calculate odds ratios(OR) and 95%CI. RESULTS: We found that high methylation level in cg10272601 in WNK2 was associated with increased risk of HCC, with an OR of 1.91(95%CI: 1.27-2.86). High methylation levels in both cg12680131 in TPO and cg22511877 in MYT1 L, however, were associated with decreased risk. The ORs(95%CI) were 0.59(0.39-0.87) and 0.50(0.33-0.77), respectively, for those with methylation levels of cg12680131 and cg22511877 above the median compared with those with levels below the median. These associations were still statistically significant in multivariable conditional logistic regression models after adjusting for hepatitis B virus infection and alcohol consumption. CONCLUSION: These findings support the measurement of methylation markers in WBC DNA as biomarkers of HCC susceptibility but should be replicated in additional prospective studies.展开更多
AIM To examine the accuracy of machine learning to relate particulate matter(PM) 2.5 and PM10 concentrations to upper respiratory tract infections(URIs).METHODS Daily nationwide and regional outdoor PM2.5 and PM10 con...AIM To examine the accuracy of machine learning to relate particulate matter(PM) 2.5 and PM10 concentrations to upper respiratory tract infections(URIs).METHODS Daily nationwide and regional outdoor PM2.5 and PM10 concentrations collected over 30 consecutive days obtained from the Taiwan Environment Protection Administration were the inputs for machine learning, using multilayer perceptron(MLP), to relate to the subsequent one-week outpatient visits for URIs. TheURI data were obtained from the Centers for Disease Control datasets in Taiwan between 2009 and 2016. The testing used the middle month dataset of each season(January, April, July and October), and the training used the other months' datasets. The weekly URI cases were classified by tertile as high, moderate, and low volumes.RESULTS Both PM concentrations and URI cases peak in winter and spring. In the nationwide data analysis, MLP machine learning can accurately relate the URI volumes of the elderly(89.05% and 88.32%, respectively) and the overall population(81.75% and 83.21%, respectively) with the PM2.5 and PM10 concentrations. In the regional data analyses, greater accuracy is found for PM2.5 than for PM10 for the elderly, particularly in the Central region(78.10% and 74.45%, respectively), whereas greater accuracy is found for PM10 than for PM2.5 for the overall population, particularly in the Northern region(73.19% and 63.04%, respectively).CONCLUSION Short-term PM2.5 and PM10 concentrations were accurately related to the subsequent occurrence of URIs by using machine learning. Our findings suggested that the effects of PM2.5 and PM10 on URI may differ by age, and the mechanism needs further evaluation.展开更多
Purpose: To investigate the correlation of various corneal hysteresis(CH) factors in Chinese adults.Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the ...Purpose: To investigate the correlation of various corneal hysteresis(CH) factors in Chinese adults.Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study. Goldmann-correlated intraocular pressure(IOPG) and CH were measured using an ocular response analyzer(ORA).Central corneal thickness was measured using the ORA's integrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values.The Pearson correlation coefficient was used to test correlations between CH and quantitative factors. The chi-square test was used to detect differences in categorical values.Results: Longer axial length(P =0.0001), lower IOPG(P =0.03), older age(P=0.003),and thinner central corneal thickness(P=0.0001) were significantly associated with lower CH.The anterior chamber depth(P=0.34), gender(P =0.23), and corneal curvature(P=0.18) had no relationship to CH.Conclusion: Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measurement of corneal biomechanical properties in Chinese adults.But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.展开更多
AIM: To examine the associations between objective health indicators and high need for recovery (NFR) after work, one of the subjective presentations of work related-fatigue, among apparently healthy workers in modern...AIM: To examine the associations between objective health indicators and high need for recovery (NFR) after work, one of the subjective presentations of work related-fatigue, among apparently healthy workers in modern workplaces. METHODS: From October to December, 2007, an annual health examination was performed for the workers from an electronics manufacturing factory in Taiwan. Health records of 1216 workers with a relatively homogeneous socioeconomic status were used for analysis. The health checkups included personal and NFR scale questionnaires, physical examinations, blood tests for biochemistry and hematology. The workers within the top tertile NFR score were defi ned as high-NFR workers. RESULTS: After adjusted for potential confounders, the workers with elevated alanine aminotransferase (ALT) and central obesity had a significantly higher NFR after work, with increased risks of 1.4-fold [95% confi dence interval (CI) = 1.01-2.0] and 1.8-fold (95% CI = 1.2-2.7), respectively. Shiftworkers had a 2.0-fold (95% CI = 1.5-2.6) increased risk for high-NFR. The associations between high-NFR and lipid profi les, blood sugar, hematology indexes or blood pressure were insignifi cant after controlling for confounders.CONCLUSION: For apparently healthy workers, high NFR after work is not simply a subjective experience. Objective health measures, such as elevated ALT and increased waist circumference, should be carefully evaluated for the apparently healthy workers having a higher NFR after work.展开更多
In this study,Bayesian probability method and machine learning model are used to study the real occurrence probability of earthquake-induced landslide risk in Taiwan region.The analyses were based on the 1999 Taiwan C...In this study,Bayesian probability method and machine learning model are used to study the real occurrence probability of earthquake-induced landslide risk in Taiwan region.The analyses were based on the 1999 Taiwan Chi-Chi Earthquake,the largest earthquake in the history in this Region in a hundred years,thus can provide better control on the prediction accuracy of the model.This seismic event has detailed and complete seismic landslide inventories identified by polygons,including 9272 seismic landslide records.Taking into account the real earthquake landslide occurrence area,the difference in landslide area and the non-sliding/sliding sample ratios and other factors,a total of 13,656,000 model training samples were selected.We also considered other seismic landslide influencing factors,including elevation,slope,aspect,topographic wetness index,lithology,distance to fault,peak ground acceleration and rainfall.Bayesian probability method and machine learning model were combined to establish the multi-factor influence of earthquake landslide occurrence model.The model is then applied to the whole Taiwan region using different ground motion peak accelerations(from 0.1 g to 1.0 g with 0.1 g intervals)as a triggering factor to complete the real probability of earthquake landslide map in Taiwan under different peak ground accelerations,and the functional relationship between different Peak Ground Acceleration and their predicted area is obtained.展开更多
BACKGROUND Bariatric surgery is one of most effective long-term treatments for morbid obesity.However,post-bariatric surgery anemia is identified as a common adverse effect and remains a challenge nowadays.AIM To esti...BACKGROUND Bariatric surgery is one of most effective long-term treatments for morbid obesity.However,post-bariatric surgery anemia is identified as a common adverse effect and remains a challenge nowadays.AIM To estimate the risk of post-bariatric surgery anemia and to stratify the association between age,gender,and types of surgery.METHODS This study is a population-based cohort study.We conducted this nationwide study using claims data from National Health Insurance Research Database in Taiwan.There were 4373 morbidly obese patients in this study cohort.RESULTS Among patients who were diagnosed with morbid obesity,2864 received bariatric surgery.All obesity-associated comorbidities decreased in the surgical group.Increasing risk of post-bariatric surgery anemia among obese patients was found by Cox proportional hazards regression[adjusted hazard ratio(HR):2.36].Also,we found significantly increasing cumulative incidence rate of anemia among patients receiving bariatric surgery by log-rank test.After adjusting for age and gender,the increasing incidence of post-bariatric surgery anemia was found among women(adjusted HR:2.48),patients in the 20–29-year-old group(adjusted HR:3.83),and patients in the 30-64-year-old group(adjusted HR:2.37).Moreover,malabsorptive and restrictive procedures had significantly higher adjusted HRs,3.18 and 1.55,respectively.CONCLUSION Bariatric surgery give rise to anemia risk among obese patients,specifically in women,young-and middle-aged patients,and patients undergoing malabsorptive procedures in our population-based cohort study in Taiwan.展开更多
Screening for elders at risk for depression is crucial for promoting mental health in later life. The present study investigates the cutoff score of a short form of the CES-D for screening of depressive symptoms in th...Screening for elders at risk for depression is crucial for promoting mental health in later life. The present study investigates the cutoff score of a short form of the CES-D for screening of depressive symptoms in the elderly population of Taiwan. This particular short form of CES-D is repeatedly used in the Taiwan Longitudinal Study on Aging (TLSA), a national survey of representative older adults in Taiwan, and is therefore referred to as the TLSA form. Data collected from five waves of TLSA were analyzed in this study. Participant responses repeatedly measured in 1989 and 1993 were used to identify a cutoff for the TLSA form of the CES-D with sensitivity and specificity using the cutoff of 4 on the Boston form of the CES-D as the criterion. Longitudinal data from the years 1996, 1999, and 2003 were used to validate the proposed cutoff by comparing the prevalence rates for depressive symptoms among older Taiwan Residents estimated from the identified cutoff and reported in previous studies. The score of 10 on the TLSA form of the CES-D was suggested, yielding a specificity of 0.93 and a sensitivity of approximately 0.96. The estimated prevalence rates for depressive symptoms among Taiwan Residents elders based on the suggested cutoff were between 18.9% and 23.7%, which are similar to previously reported rates. The cutoff score of 10 on the TLSA form of the CES-D is therefore recommended for screening depressive symptoms among older adults in Taiwan.展开更多
BACKGROUND Major societies provide differing guidance on management of Barrett’s esophagus(BE),making standardization challenging.AIM To evaluate the preferred diagnosis and management practices of BE among Asian end...BACKGROUND Major societies provide differing guidance on management of Barrett’s esophagus(BE),making standardization challenging.AIM To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists.METHODS Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis,surveillance and management of BE.RESULTS Five hundred sixty-nine of 1016(56.0%)respondents completed the survey,with most respondents from Japan(n=310,54.5%)and China(n=129,22.7%).Overall,the preferred endoscopic landmark of the esophagogastric junction was squamocolumnar junction(42.0%).Distal palisade vessels was preferred in Japan(59.0%vs 10.0%,P<0.001)while outside Japan,squamo-columnar junction was preferred(59.5%vs 27.4%,P<0.001).Only 16.3%of respondents used Prague C and M criteria all the time.It was never used by 46.1%of Japanese,whereas 84.2%outside Japan,endoscopists used it to varying extents(P<0.001).Most Asian endoscopists(70.8%)would survey long-segment BE without dysplasia every two years.Adherence to Seattle protocol was poor with only 6.3%always performing it.73.2%of Japanese never did it,compared to 19.3%outside Japan(P<0.001).The most preferred(74.0%)treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had esophagitis.For BE with low-grade dysplasia,6-monthly surveillance was preferred in 61.9%within Japan vs 47.9%outside Japan(P<0.001).CONCLUSION Diagnosis and management of BE varied within Asia,with stark contrast between Japan and outside Japan.Most Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction,which is incorrect.Most also did not consistently use Prague criteria,and Seattle protocol.Lack of standardization,education and research are possible reasons.展开更多
BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric c...BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric cancer incidence according to age,sex,and Helicobacter pylori(H.pylori)treatment in Taiwan.METHODS In this population-based study,we used the national Taiwan Cancer Registry database.Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan.Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H.pylori infection.RESULTS The annual percent changes showed continuously decreasing rates of gastric cancer among both males and females.However,the decreasing trends differed by sex,with an annual percent change of-2.58%in males and-2.14%in females.The age-specific incidence rates increased with age.Within the same age group,more recent time periods showed lower incidence rates than greater time periods.Similarly,the sex ratio was lower in later birth cohorts than in earlier birth cohorts.Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H.pylori infection during 2005 to 2016(r=0.72).CONCLUSION We observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan.These results support H.pylori eradication programs in Taiwan.展开更多
基金Supported by National Science and Technology Council,Taiwan,No.MOST 111-2629-H-227-001-MY2.
文摘BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.
基金Supported by National Taiwan University Hospital,Taipei,Taiwan,No.NTUH106-003347(to Sun HY).
文摘BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific region.Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.AIM To investigate the care cascade of incident HCV infections among PLWH in Taiwan.METHODS PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and 2018.All PLWH with incident HCV infections were followed until December 31,2019.The care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response achieved.Those who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed separately.The duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were estimated.RESULTS During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood samples.Of the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV RNA.Of those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieved viral clearance.Compared with that in the IFN era,the median interval from HCV seroconversion by retrospective testing to detection of HCV seropositivity by HIV-treating physicians was significantly shorter in the DAA era{179 d[interquartile range(IQR)87-434]vs 92 d(IQR 57-173);P<0.001}.The incidence rate of STIs in the DAA vs the IFN era was 50.5 per 100 person-years of follow-up(PYFU)and 38.5 per 100 PYFU,respectively,with an incidence rate ratio of 1.31(95%confidence interval 0.96-1.77),while the duration of HCV viremia was 380 d(IQR 274-554)and 735 d(IQR 391-1447)(P<0.001),respectively.CONCLUSION While anti-HCV therapies are effective in achieving viral clearance,our study suggests more efforts are needed to expedite the linkage of PLWH diagnosed with incident HCV infections to HCV treatment.
文摘AIM: To examine the epidemiology of hepatitis B virus carrier status (HBVC) and sonographic fatty liver (SFL) in Taiwan Residents adults, and to evaluate their possible interaction in inducing liver damage (LD). From an epidemiological viewpoint, we analyzed previous studies which indicated that fatty liver sensitizes host immune response to HBV infection and enhances liver damage.METHODS: A cross-sectional retrospective analysis of health records including medical history, physical examination, abdominal sonogram, blood biochemistry and hepatic virological tests. We utilized the Student's t-test, chi-square, multivariate logistic regression and synergy index to assess risks for LD.RESULTS: Among a total of 5406 Taiwan Residents adults (mean age 46.2 years, 51.5% males), the prevalence of LD, HBVC and SFL were 12.3%, 15.1% and 33.4%, respectively; 5.1% of participants had SFL plus HBVC. Multivariate logistic regression analysis demonstrated that male gender (odds ratio (OR) = 2.8, 95% confidence interval (CI): 2.3-3.5), overweight state (OR = 1.6, 95% CI: 1.3-2.0), HBVC (OR = 2.5, 95% CI: 2.0-3.1) and SFL (OR = 4.2, 95% CI: 2.2-5.3) were independently associated with LD. Synergism analysis showed that the adjusted OR for LD in adults with HBVC-alone was 3.3 (95% CI: 2.4-4.6), SFL-alone, 4.7 (95% CI: 3.7-6.1) and combined HBVC and SFL, 9.5 (95% CI: 6.8-13.3); the synergy index was 1.4 (95% CI: 1.001-2.0).CONCLUSION: In Taiwan Residents adults, SFL plus HBVC have a significant synergistic association with LD.
基金Supported by the Grant NSC 2000-2314-B-002-373, NSC 2001-2320-B-002-123 and NSC 2002-2320-B-002-121 from the National Science Council, Taipei, Taiwan, China
文摘AIM： To examine whether peanut consumption is associated with a reduced risk of colorectal cancer in a prospective cohort with a 10-year follow-up. METHODS： In 1990-1992, residents （12026 men and 11917 women aged 30 to 65 years） in 7 townships, Taiwan, were interviewed and recruited into a cancerscreening cohort and annually followed up. Colorectal cancer cases in this cohort were identified from cancer registry and death certificates. Incidence rates of this disease by the end of 2001 were calculated by gender for the primary study variable and covariates. The dietary intake was assessed by means of weekly food frequency measures, including frequently consumed food groups and folk dishes including sweet potato, bean products, peanut products, pickled foodstuffs, nitrated or smoked foodstuffs. RESULTS： During the study period, 107 new colorectal cancer cases （68 men and 39 women） were confirmed. The multivariate Cox＇s proportional hazard model showed that the relative risk （RR） of peanut consumption was 0.73 [95% confidence interval （CI） = 0.44-1.21] for men and 0.42 （95% CI = 0.21-0.84） for women. However, frequent intake of pickled foodstuffs was harmful for women （RR= 2.15, 95% CI=0.99-4.65）. The risk of colorectal cancer was also elevated among cigarette smokers but not significant （P〈 0.05）.CONCLUSION： This study suggests that frequent intake of peanut and its products may reduce colorectal cancer risk in women, demonstrating the anti-proliferating effect of peanut intake.
基金supported by the Central Geological Survey of the Ministry of Economic Affairs under grant 5226902000-05-94-02, No. NRF-2012R1A1A2005044 and 5226902000-95-02
文摘The cored sediments sampled by R/V Marion Dufrense in the active margin off southwestern Taiwan on the east side of the Manila Trench are mostly muds consisting mainly of quartz, feldspar, illite, chlorite ＋ kaolinite with a trace amount of montmorillonite. The cored sediments have higher Fe, Ti, Cr, Cs, Li, Ni, and V but lower Ca, Na, Mn, Hf, Nb, Sr, Ta, U and Zr contents when compared with the upper continental crust（UCC, Taylor and McLennan, 1985）. The Eu/Eu＊ ratios of the sediments averaging 0.69 indicate that the recycling effect on the Eu anomaly may be minor and the contribution of mafic source rock was unimportant, which can also be depicted in the La-Th-Sc plot（Cullers, 1994） showing a ＂mixed origin＂ close to the felsic end member. The chemistry of the cored sediment can be explained by a mixing model designed by Ho and Chen（1996） with four end members i.e., greywacke, shale, quartzite and limestone, which are widely distributed in the Cenozoic formations of southern Taiwan with greywacke as the dominant contributor followed by shale.
基金Supported by Grants from Kaohsiung Medical University Hospital(KMUH96-6G04)National Science Council(NSC 98-2918-I-037-001 and NSC 97-2314-B-037-018-MY3)
文摘AIM:To investigate the etiology of esophageal cancer among Taiwan Residents women.METHODS:This is a multi-center,hospital-based,case-control study.Case patients consisted of women who were newly diagnosed and pathology-proven to have esophageal squamous cell carcinoma(ESCC) from three large medical centers(one from Northern and two from Southern Taiwan,respectively)between August 2000 and December 2008.Each ESCC patient was matched with 4 healthy women based on age(within 3 years)and hospital of origin,from the Department of Preventive Medicine in each hospital.A total of 51 case patients and 204 controls,all women,were studied.RESULTS:Frequencies of smokers and drinkers among ESCC patients were 19.6%and 21.6%,respectively,which were significantly higher than smokers(4.4%) and drinkers(4.4%)among controls(OR=4.07,95%CI:1.36-12.16,P=0.01;OR=3.55,95%CI:1.03-12.27,P=0.04).Women who drank an amount of alcohol more than 158 g per week had a 20.58-fold greater risk(95%CI:1.72-245.62,P=0.02)of ESCC than those who never drank alcohol after adjusting for other covariates,although the sample size was small.CONCLUSION:Cigarette smoking and alcohol drinking,especially heavy drinking,are the major risks for developing ESCC in Taiwan Residents women.
文摘Academics in Taiwan have been working on geo-conservation for 20 years.Numerous studies focus on investigation,assessment,monitoring and education of special scientific important geoheritages. However,few researches have been done on the issues of local stakeholder participation and community development.The authors choose one of the national-level geoheritages,the Lichi Badland
基金supported by the Environmental Protection Bureau,Government of Pingtung County,Taiwan,China
文摘Ozone sensitivity was investigated using CAMx simulations and photochemical indicator ratios at three sites （Pingtung City, Chao-Chou Town, and Kenting Town） in Pingtung County in southern Taiwan during 2003 and 2004. The CAMx simulations compared fairly well with the hourly concentrations of ozone. Simulation results also showed that Pingtung City was mainly a volatile organic compounds （VOC）-sensitive regime, while Chao-Chou Town was either a VOC-sensitive or a NOx-sensitive regime, depending on the seasons. Measurements of three photochemical indicators （H202, HNO3, and NOy） were conducted, and simulated three transition ranges of H202/HNO3 （0.5-0.8）, O3/HNO3 （10.3-16.2） and O3/NOy （5.7-10.8） were adopted to assess the ozone sensitive regime at the three sites. The results indicated that the three transition ranges yield consistent results with CAMx simulations at most times at Pingtung City. However, both VOC-sensitive and NOx-sensitive regimes were important at the rural site Chao-Chou Town. Kenting Town, a touring site at the southern end of Taiwan, was predominated by a NOx-sensitive regime in four seasons.
基金Support by the Ministry of Science and Technology,Taiwan(MOST 103-2314-B-715-005-MY3)Mackay Medical College,Taiwan China(No.105B06)
文摘OBJECTIVE: To examine and describe the use of Western and Chinese Medicine for pregnancy preparation among women with breast cancer after cancer-related treatment in Taiwan.METHODS: Women of reproductive age(20-49years) women who were treated for breast cancer from January 2011 through June 2015 in a Taiwan Residents city participated in the study. Of 306 eligible study participants, interviews were completed in197(64%). Participants were asked about sociodemographic variables, disease and treatment characteristics, their desire for fertility, and their use of Western or Chinese Medicine.RESULTS: The proportions of women who planned to use Western or Chinese Medicine to help achieve pregnancy were 17.3% and 14.7%, respectively. The result of binary logistic regression showed that current employment and lack of children were factors predictive of the use of Western Medicine. Younger age and the use of Chinese Medicine before treatment were predictors of using Chinese Medicine. While the desire for fertility preservation was related to the use of Western Medicine,the desire for pregnancy was related to the use of Chinese Medicine.CONCLUSION: Various characteristics guided the women's decisions to use Western or Chinese Medicine. Health care providers should learn patients' preferences for fertility preservation and provide appropriate advice, referring them to safe providers of their desired method of fertility treatment.
基金Supported by National Institutes of Health grants,RO1ES005116(Santella RM)and P30ES009089(Santella RM)
文摘AIM: To determine if gene-specific DNA methylation in prospectively collected blood samples is associated with later development of hepatocellular carcinoma(HCC).METHODS: Comparing genome-wide DNA methylation profiles using Illumina Human methylation 450 K arrays, we previously identified a list of loci that were differentially methylated between tumor and adjacent nontumor tissues. To examine if dysregulation of DNAmethylation patterns observed in tumor tissues can be detected in white blood cell(WBC) DNA, we conducted a prospective case-control study nested within a community-based cancer screening cohort in Taiwan with 16 years of follow up. We measured methylation levels in ninety-six loci that were aberrant in DNA methylation in HCC tumor tissues compared to adjacent tissues. Baseline WBC DNA from 159 HCC cases and 312 matched controls were bisulfite treated and assayed by Illumina Bead Array. We used the χ2 test for categorical variables and student's t-test for continuous variables to assess the difference in selected characteristics between cases and controls. To estimate associations with HCC risk, we used conditional logistic regression models stratified on the matching factors to calculate odds ratios(OR) and 95%CI. RESULTS: We found that high methylation level in cg10272601 in WNK2 was associated with increased risk of HCC, with an OR of 1.91(95%CI: 1.27-2.86). High methylation levels in both cg12680131 in TPO and cg22511877 in MYT1 L, however, were associated with decreased risk. The ORs(95%CI) were 0.59(0.39-0.87) and 0.50(0.33-0.77), respectively, for those with methylation levels of cg12680131 and cg22511877 above the median compared with those with levels below the median. These associations were still statistically significant in multivariable conditional logistic regression models after adjusting for hepatitis B virus infection and alcohol consumption. CONCLUSION: These findings support the measurement of methylation markers in WBC DNA as biomarkers of HCC susceptibility but should be replicated in additional prospective studies.
基金Supported by Hualien Armed Forces General Hospital,No.805-C107-14Ministry of Science and Technology,Taiwan,R.O.C.,No.MOST 107-2221-E-899-002-MY3
文摘AIM To examine the accuracy of machine learning to relate particulate matter(PM) 2.5 and PM10 concentrations to upper respiratory tract infections(URIs).METHODS Daily nationwide and regional outdoor PM2.5 and PM10 concentrations collected over 30 consecutive days obtained from the Taiwan Environment Protection Administration were the inputs for machine learning, using multilayer perceptron(MLP), to relate to the subsequent one-week outpatient visits for URIs. TheURI data were obtained from the Centers for Disease Control datasets in Taiwan between 2009 and 2016. The testing used the middle month dataset of each season(January, April, July and October), and the training used the other months' datasets. The weekly URI cases were classified by tertile as high, moderate, and low volumes.RESULTS Both PM concentrations and URI cases peak in winter and spring. In the nationwide data analysis, MLP machine learning can accurately relate the URI volumes of the elderly(89.05% and 88.32%, respectively) and the overall population(81.75% and 83.21%, respectively) with the PM2.5 and PM10 concentrations. In the regional data analyses, greater accuracy is found for PM2.5 than for PM10 for the elderly, particularly in the Central region(78.10% and 74.45%, respectively), whereas greater accuracy is found for PM10 than for PM2.5 for the overall population, particularly in the Northern region(73.19% and 63.04%, respectively).CONCLUSION Short-term PM2.5 and PM10 concentrations were accurately related to the subsequent occurrence of URIs by using machine learning. Our findings suggested that the effects of PM2.5 and PM10 on URI may differ by age, and the mechanism needs further evaluation.
基金supported by grants of Far Eastern Memorial Hospital (FEMH-99-HHC-002), Taiwan, China
文摘Purpose: To investigate the correlation of various corneal hysteresis(CH) factors in Chinese adults.Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study. Goldmann-correlated intraocular pressure(IOPG) and CH were measured using an ocular response analyzer(ORA).Central corneal thickness was measured using the ORA's integrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values.The Pearson correlation coefficient was used to test correlations between CH and quantitative factors. The chi-square test was used to detect differences in categorical values.Results: Longer axial length(P =0.0001), lower IOPG(P =0.03), older age(P=0.003),and thinner central corneal thickness(P=0.0001) were significantly associated with lower CH.The anterior chamber depth(P=0.34), gender(P =0.23), and corneal curvature(P=0.18) had no relationship to CH.Conclusion: Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measurement of corneal biomechanical properties in Chinese adults.But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.
文摘AIM: To examine the associations between objective health indicators and high need for recovery (NFR) after work, one of the subjective presentations of work related-fatigue, among apparently healthy workers in modern workplaces. METHODS: From October to December, 2007, an annual health examination was performed for the workers from an electronics manufacturing factory in Taiwan. Health records of 1216 workers with a relatively homogeneous socioeconomic status were used for analysis. The health checkups included personal and NFR scale questionnaires, physical examinations, blood tests for biochemistry and hematology. The workers within the top tertile NFR score were defi ned as high-NFR workers. RESULTS: After adjusted for potential confounders, the workers with elevated alanine aminotransferase (ALT) and central obesity had a significantly higher NFR after work, with increased risks of 1.4-fold [95% confi dence interval (CI) = 1.01-2.0] and 1.8-fold (95% CI = 1.2-2.7), respectively. Shiftworkers had a 2.0-fold (95% CI = 1.5-2.6) increased risk for high-NFR. The associations between high-NFR and lipid profi les, blood sugar, hematology indexes or blood pressure were insignifi cant after controlling for confounders.CONCLUSION: For apparently healthy workers, high NFR after work is not simply a subjective experience. Objective health measures, such as elevated ALT and increased waist circumference, should be carefully evaluated for the apparently healthy workers having a higher NFR after work.
基金supported by the National Key Research and Development Program of China(2018YFC1504703)。
文摘In this study,Bayesian probability method and machine learning model are used to study the real occurrence probability of earthquake-induced landslide risk in Taiwan region.The analyses were based on the 1999 Taiwan Chi-Chi Earthquake,the largest earthquake in the history in this Region in a hundred years,thus can provide better control on the prediction accuracy of the model.This seismic event has detailed and complete seismic landslide inventories identified by polygons,including 9272 seismic landslide records.Taking into account the real earthquake landslide occurrence area,the difference in landslide area and the non-sliding/sliding sample ratios and other factors,a total of 13,656,000 model training samples were selected.We also considered other seismic landslide influencing factors,including elevation,slope,aspect,topographic wetness index,lithology,distance to fault,peak ground acceleration and rainfall.Bayesian probability method and machine learning model were combined to establish the multi-factor influence of earthquake landslide occurrence model.The model is then applied to the whole Taiwan region using different ground motion peak accelerations(from 0.1 g to 1.0 g with 0.1 g intervals)as a triggering factor to complete the real probability of earthquake landslide map in Taiwan under different peak ground accelerations,and the functional relationship between different Peak Ground Acceleration and their predicted area is obtained.
基金Supported by the Yin Shu-Tien Foundation Taipei Veterans General Hospital-National Yang-Ming University Excellent Physician Scientists Cultivation Program,No.107-V-B-087.
文摘BACKGROUND Bariatric surgery is one of most effective long-term treatments for morbid obesity.However,post-bariatric surgery anemia is identified as a common adverse effect and remains a challenge nowadays.AIM To estimate the risk of post-bariatric surgery anemia and to stratify the association between age,gender,and types of surgery.METHODS This study is a population-based cohort study.We conducted this nationwide study using claims data from National Health Insurance Research Database in Taiwan.There were 4373 morbidly obese patients in this study cohort.RESULTS Among patients who were diagnosed with morbid obesity,2864 received bariatric surgery.All obesity-associated comorbidities decreased in the surgical group.Increasing risk of post-bariatric surgery anemia among obese patients was found by Cox proportional hazards regression[adjusted hazard ratio(HR):2.36].Also,we found significantly increasing cumulative incidence rate of anemia among patients receiving bariatric surgery by log-rank test.After adjusting for age and gender,the increasing incidence of post-bariatric surgery anemia was found among women(adjusted HR:2.48),patients in the 20–29-year-old group(adjusted HR:3.83),and patients in the 30-64-year-old group(adjusted HR:2.37).Moreover,malabsorptive and restrictive procedures had significantly higher adjusted HRs,3.18 and 1.55,respectively.CONCLUSION Bariatric surgery give rise to anemia risk among obese patients,specifically in women,young-and middle-aged patients,and patients undergoing malabsorptive procedures in our population-based cohort study in Taiwan.
文摘Screening for elders at risk for depression is crucial for promoting mental health in later life. The present study investigates the cutoff score of a short form of the CES-D for screening of depressive symptoms in the elderly population of Taiwan. This particular short form of CES-D is repeatedly used in the Taiwan Longitudinal Study on Aging (TLSA), a national survey of representative older adults in Taiwan, and is therefore referred to as the TLSA form. Data collected from five waves of TLSA were analyzed in this study. Participant responses repeatedly measured in 1989 and 1993 were used to identify a cutoff for the TLSA form of the CES-D with sensitivity and specificity using the cutoff of 4 on the Boston form of the CES-D as the criterion. Longitudinal data from the years 1996, 1999, and 2003 were used to validate the proposed cutoff by comparing the prevalence rates for depressive symptoms among older Taiwan Residents estimated from the identified cutoff and reported in previous studies. The score of 10 on the TLSA form of the CES-D was suggested, yielding a specificity of 0.93 and a sensitivity of approximately 0.96. The estimated prevalence rates for depressive symptoms among Taiwan Residents elders based on the suggested cutoff were between 18.9% and 23.7%, which are similar to previously reported rates. The cutoff score of 10 on the TLSA form of the CES-D is therefore recommended for screening depressive symptoms among older adults in Taiwan.
文摘BACKGROUND Major societies provide differing guidance on management of Barrett’s esophagus(BE),making standardization challenging.AIM To evaluate the preferred diagnosis and management practices of BE among Asian endoscopists.METHODS Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis,surveillance and management of BE.RESULTS Five hundred sixty-nine of 1016(56.0%)respondents completed the survey,with most respondents from Japan(n=310,54.5%)and China(n=129,22.7%).Overall,the preferred endoscopic landmark of the esophagogastric junction was squamocolumnar junction(42.0%).Distal palisade vessels was preferred in Japan(59.0%vs 10.0%,P<0.001)while outside Japan,squamo-columnar junction was preferred(59.5%vs 27.4%,P<0.001).Only 16.3%of respondents used Prague C and M criteria all the time.It was never used by 46.1%of Japanese,whereas 84.2%outside Japan,endoscopists used it to varying extents(P<0.001).Most Asian endoscopists(70.8%)would survey long-segment BE without dysplasia every two years.Adherence to Seattle protocol was poor with only 6.3%always performing it.73.2%of Japanese never did it,compared to 19.3%outside Japan(P<0.001).The most preferred(74.0%)treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had esophagitis.For BE with low-grade dysplasia,6-monthly surveillance was preferred in 61.9%within Japan vs 47.9%outside Japan(P<0.001).CONCLUSION Diagnosis and management of BE varied within Asia,with stark contrast between Japan and outside Japan.Most Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction,which is incorrect.Most also did not consistently use Prague criteria,and Seattle protocol.Lack of standardization,education and research are possible reasons.
文摘BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric cancer incidence according to age,sex,and Helicobacter pylori(H.pylori)treatment in Taiwan.METHODS In this population-based study,we used the national Taiwan Cancer Registry database.Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan.Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H.pylori infection.RESULTS The annual percent changes showed continuously decreasing rates of gastric cancer among both males and females.However,the decreasing trends differed by sex,with an annual percent change of-2.58%in males and-2.14%in females.The age-specific incidence rates increased with age.Within the same age group,more recent time periods showed lower incidence rates than greater time periods.Similarly,the sex ratio was lower in later birth cohorts than in earlier birth cohorts.Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H.pylori infection during 2005 to 2016(r=0.72).CONCLUSION We observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan.These results support H.pylori eradication programs in Taiwan.
