Gender differences in oral health among prisoners: a cross-sectional study from Taiwan.

BACKGROUND: The prevalence of oral diseases among Taiwanese prisoners has rarely been investigated. This study aimed to estimate the gender-specific prevalence of oral disease in a sample of Taiwanese prisoners. METHODS: We included 83,048 participants from the National Health Insurance (NHI) Program. Outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision (ICD-9-CM). For prevalence, we provide absolute values and percentages. We also performed a χ2 test to assess sex and age group differences in the percentage of disease in the oral cavity, salivary glands, and jaw. RESULTS: The prevalence rate of oral diseases was 25.90%, which was higher than that of the general population. The prevalence of oral diseases in female prisoners was higher than that in male prisoners (p < 0.001), and the prevalence of oral diseases in prisoners aged ≤ 40 was higher than that of prisoners aged > 40. Among all cases of diagnosed oral diseases, the top three diseases were dental hard tissue diseases (13.28%), other cellulitis and abscesses (9.79%), and pruritus and related conditions (2.88%), respectively. The prevalence of various oral diseases in female prisoners was significantly higher than that in male prisoners. CONCLUSION: Oral disease is common among Taiwanese prisoners. Female prisoners had a higher prevalence of oral, salivary gland, and jaw diseases than male prisoners. Therefore, early prevention and appropriate treatment are required and also a need for gender-specific oral disease products given the differences in the prevalence of oral disease among male and female prisoners.

Adult abuse and poor prognosis in Taiwan, 2000-2015: a cohort study.

BACKGROUND: To investigate the risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, self-inflicted injury, and mortality after adult violence from 2000 to 2015 in Taiwan. METHODS: This study used data from National Health Insurance Research Database (NHIRD) on outpatient, emergency, and inpatient visits for two million people enrolled in the National Health Insurance (NHI) from 2000 to 2015. The case study defined ICD-9 diagnosis code N code 995.8 (abused adult) or E code E960-E969 (homicide and intentional injury of another). It analyzed first-time violence in adults aged 18-64 years (study group). 1:4 ratio was matched with injury and non-violent patients (control group). The paired variables were sex, age (± 1 year), pre-exposure to the Charlson comorbidity index, and year of medical treatment. Statistical analysis was conducted using SAS 9.4 and Cox regression for data analysis. RESULTS: In total, 8,726 individuals experienced violence (case group) while34,904 did not experienced violence (control group) over 15 years. The prevalence of poor prognosis among victims of violence was 25.4/104, 31.3/104, 10.5/10,4 and 104.6/104 for schizophrenic disorders, psychotic disorders, suicide or self-inflicted injury and mortality, respectively. Among adults, the risks of suicide or self-inflicted injury, schizophrenic disorders, psychotic disorders, and mortality after exposure to violence (average 9 years) were 6.87-, 5.63-, 4.10-, and 2.50-times (p < 0.01), respectively, compared with those without violence. Among males, the risks were 5.66-, 3.85-, 3.59- and 2.51-times higher, respectively, than those without violence (p < 0.01), and they were 21.93-, 5.57-, 4.60- and 2.46-times higher than those without violence (p < 0.01) among females. CONCLUSION: The risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, or self-inflicted injury and mortality after adult violence was higher than in those who have not experienced a violent injury. Adults at the highest risk for violent suicide or self-inflicted injuries due to exposure to violent injuries -males were at risk for schizophrenia and females were at risk for suicide or self-inflicted injuries. Therefore, it is necessary for social workers and medical personnel to pay attention to the psychological status of victims of violence.

Cloning, expression and characterization of two S-ribosylhomocysteine lyases from Lactobacillus plantarum YM-4-3: Implication of conserved and divergent roles in quorum sensing.

Quorum sensing (QS) is a means of cell-to-cell communication that regulates, via small signalling molecules, expression of a series of genes and controls multicellular behaviour in many bacterial species. The enzyme S-ribosylhomocysteine lyase (LuxS) transforms S-ribosylhomocysteine (SRH) into 4, 5-dihydroxy-2, 3-pentanedione (DPD), the precursor of the interspecies QS signalling molecule autoinducer-2 (AI-2). In this study, two LuxS-coding genes, luxS1 and luxS2, with 70% sequence identity were isolated from Lactobacillus plantarum YM-4-3, and overexpressed in Escherichia coli BL21 (DE3), and the protein products were purified successfully. After incubation of LuxS1 or LuxS2 with SRH, the reaction products were able to induce Vibrio harveyi BB170 bioluminescence, clearly demonstrating that both LuxS1 and LuxS2 synthesize AI-2 from SRH in vitro. Ellman's assay results revealed optimal temperatures for LuxS1 and LuxS2 of 45 and 37 °C, respectively, and their activities were stimulated or inhibited by several metal ions and chemical reagents. In addition, enzyme kinetics data showed that Km, Vmax and Kcat value of LuxS1 for the substrate (SRH) were higher than that of LuxS2. These results suggest that LuxS1 and LuxS2 mediate QS in a temperature-dependent manner and may play conserved roles in AI-2 synthesis but exhibit different activities in response to external environmental stress. To our knowledge, this paper is the first report of two luxS genes present in one bacterial genome and the subsequent comparative elucidation of their functions in AI-2 production. Collectively, our study provides a solid basis for future research concerning the AI-2/LuxS QS system in L. plantarum YM-4-3.

Association between XPG polymorphisms and stomach cancer susceptibility in a Chinese population.

Xeroderma pigmentosum group G (XPG) protein plays an important role in the DNA repair process by cutting the damaged DNA at the 3' terminus. Previous studies have indicated some polymorphisms in the XPG gene are associated with stomach cancer susceptibility. We performed this hospital-based case-control study to evaluate the association of four potentially functional XPG polymorphisms (rs2094258 C>T, rs751402 C>T, rs2296147 T>C and rs873601G>A) with stomach cancer susceptibility. The four single nucleotide polymorphisms (SNPs) were genotyped in 692 stomach cancer cases and 771 healthy controls. Logistic regression analysis was conducted, and odds ratios (ORs) and 95% confidence intervals (CIs) were used to assess the association of interest. Of the studied SNPs, XPG rs873601G>A polymorphism was found to significantly associate with stomach cancer susceptibility (AA versus GG/AG: OR = 1.31, 95% CI = 1.03-1.66, P = 0.027). Combined analysis of all SNPs revealed that the individuals with two of risk genotypes had a significantly increased stomach cancer risk (OR = 1.52, 95% CI = 1.13-2.06). In the stratification analysis, the association between the rs873601AA genotype and stomach cancer risk was observed in older group (>59 year), as well as patients with non-cardia stomach cancer. Further combined analysis indicated men, smokers, or non-drinkers more than one risk genotypes had a significantly increased stomach cancer risk. Our results indicate that XPG rs873601G>A polymorphism may be associated with the risk of stomach cancer. Further prospective studies with different ethnicities and large sample sizes are needed to validate our findings.

Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta-analysis.

We aim to systematically review and meta-analyze the effectiveness and safety of psychedelics [psilocybin, ayahuasca (active component DMT), LSD and MDMA] in treating symptoms of various mental disorders. Web of Science, Embase, EBSCO, and PubMed were searched up to February 2024 and 126 articles were finally included. Results showed that psilocybin has the largest number of articles on treating mood disorders (N = 28), followed by ayahuasca (N = 7) and LSD (N = 6). Overall, psychedelics have therapeutic effects on mental disorders such as depression and anxiety. Specifically, psilocybin (Hedges' g = -1.49, 95% CI [-1.67, -1.30]) showed the strongest therapeutic effect among four psychedelics, followed by ayahuasca (Hedges' g = -1.34, 95% CI [-1.86, -0.82]), MDMA (Hedges' g = -0.83, 95% CI [-1.33, -0.32]), and LSD (Hedges' g = -0.65, 95% CI [-1.03, -0.27]). A small amount of evidence also supports psychedelics improving tobacco addiction, eating disorders, sleep disorders, borderline personality disorder, obsessive-compulsive disorder, and body dysmorphic disorder. The most common adverse event with psychedelics was headache. Nearly a third of the articles reported that no participants reported lasting adverse effects. Our analyses suggest that psychedelics reduce negative mood, and have potential efficacy in other mental disorders, such as substance-use disorders and PTSD.

ThermomiR-377-3p-induced suppression of Cirbp expression is required for effective elimination of cancer cells and cancer stem-like cells by hyperthermia.

BACKGROUND: In recent years, the development of adjunctive therapeutic hyperthermia for cancer therapy has received considerable attention. However, the mechanisms underlying hyperthermia resistance are still poorly understood. In this study, we investigated the roles of cold­inducible RNA binding protein (Cirbp) in regulating hyperthermia resistance and underlying mechanisms in nasopharyngeal carcinoma (NPC). METHODS: CCK-8 assay, colony formation assay, tumor sphere formation assay, qRT-PCR, Western blot were employed to examine the effects of hyperthermia (HT), HT + oridonin(Ori) or HT + radiotherapy (RT) on the proliferation and stemness of NPC cells. RNA sequencing was applied to gain differentially expressed genes upon hyperthermia. Gain-of-function and loss-of-function experiments were used to evaluate the effects of RNAi-mediated Cirbp silencing or Cirbp overexpression on the sensitivity or resistance of NPC cells and cancer stem-like cells to hyperthermia by CCK-8 assay, colony formation assay, tumorsphere formation assay and apoptosis assay, and in subcutaneous xenograft animal model. miRNA transient transfection and luciferase reporter assay were used to demonstrate that Cirbp is a direct target of miR-377-3p. The phosphorylation levels of key members in ATM-Chk2 and ATR-Chk1 pathways were detected by Western blot. RESULTS: Our results firstly revealed that hyperthermia significantly attenuated the stemness of NPC cells, while combination treatment of hyperthermia and oridonin dramatically increased the killing effect on NPC cells and cancer stem cell (CSC)­like population. Moreover, hyperthermia substantially improved the sensitivity of radiation­resistant NPC cells and CSC­like cells to radiotherapy. Hyperthermia noticeably suppressed Cirbp expression in NPC cells and xenograft tumor tissues. Furthermore, Cirbp inhibition remarkably boosted anti­tumor­killing activity of hyperthermia against NPC cells and CSC­like cells, whereas ectopic expression of Cirbp compromised tumor­killing effect of hyperthermia on these cells, indicating that Cirbp overexpression induces hyperthermia resistance. ThermomiR-377-3p improved the sensitivity of NPC cells and CSC­like cells to hyperthermia in vitro by directly suppressing Cirbp expression. More importantly, our results displayed the significantly boosted sensitization of tumor xenografts to hyperthermia by Cirbp silencing in vivo, but ectopic expression of Cirbp almost completely counteracted hyperthermia-mediated tumor cell-killing effect against tumor xenografts in vivo. Mechanistically, Cirbp silencing-induced inhibition of DNA damage repair by inactivating ATM-Chk2 and ATR-Chk1 pathways, decrease in stemness and increase in cell death contributed to hyperthermic sensitization; conversely, Cirbp overexpression-induced promotion of DNA damage repair, increase in stemness and decrease in cell apoptosis contributed to hyperthermia resistance. CONCLUSION: Taken together, these findings reveal a previously unrecognized role for Cirbp in positively regulating hyperthermia resistance and suggest that thermomiR-377-3p and its target gene Cirbp represent promising targets for therapeutic hyperthermia.

The benefit of vegetarian diets for reducing blood pressure in Taiwan: a historically prospective cohort study.

OBJECTIVE: Past vegetarians research has often found that they have lower blood pressure (BP). Effects may include their lower BMI and higher intake levels of fruit and vegetables. Besides, the study pursues to extend this evidence in a diverse population containing vegans, lacto-ovo vegetarians and omnivores. DESIGN: The study analyzed data on five hundred vigorous individuals aged 20 years or older from a standard medical screening program and provided validated questionnaire. Criteria were established for vegan, lacto-ovo vegetarian, partial vegetarian and omnivorous dietary patterns. SETTING: Health screening programs were conducted at a standard medical screening program in Taiwan between 2006 and 2017. Dietary data were gathered by self-administered questionnaire. SUBJECTS: Five hundred Taiwanese subjects representing the cohort. RESULTS: Multiple regression analyses confirmed that the vegan vegetarians had lower systolic and diastolic BP (mmHg) than omnivorous Taiwanese (ß = - 6.8, p < 0.05 and ß = - 6.9, p < 0.001). Findings for lacto-ovo vegetarians (ß = - 9.1, p < 0.001 and ß = - 5.8, p < 0.001) were similar. The vegetarians were also less likely to be using antihypertensive medications. Defining hypertension as systolic BP > 139 mmHg or diastolic BP > 89 mmHg or routine of antihypertensive medications, the odds ratio of hypertension compared with omnivores was 0.37 (95% CI = 0.19-0.74), 0.57 (95% CI = 0.36-0.92) and 0.92 (95% CI = 0.50-1.70), respectively, for vegans, lacto-ovo vegetarians and partial vegetarians. Results were reduced after adjustment for BMI. CONCLUSIONS: The study concludes from this relatively large study that vegetarians, especially vegans, with otherwise diverse characteristics but stable diets, do have lower systolic and diastolic BP and less hypertension than omnivores.

Standardized rate of hospitalization for violent injuries among different generations in counties and cities in Taiwan from 2000 to 2015.

This study aimed to understand the distribution of the standardized rate of hospitalization for violent injuries in counties and cities in Taiwan. The ICD-9 diagnosis code N-codes 995.5 (abused child) and 995.8 (abused adult) or E-code E960-E969 (homicide and intentional injury by others) were defined as research cases. The study analyzed the standardized medical treatment rate of children and adolescents aged 0 to 17, adults aged 18 to 64, and older adults over 65 years old suffering from violence for the first time. During the 15-year period, the counties and cities with the highest rate of medical treatment for violent injuries among children (unit: per 105 people) were Pingtung County (33.1 males, 22.9 females), Lienchiang County (8.8 males, 9.8 females), and New Taipei City (8.2 males, 8.8 females). For adults, Pingtung County (73.2 males, 36.8 females), New Taipei City (26.0 males, 14.3 females), and Yunlin County (19.7 males, 7.7 females) registered the highest rates. For older adults, Pingtung County (33.6 persons), New Taipei City (12.5 persons), Yun Lin County (11.2 persons), and Taichung City (9.2 persons) registered the highest rates. The highest rates of older female adults receiving treatment were recorded in Pingtung County (15.1 persons), Yunlin County (9.0 persons), Taichung City (5.5 persons), and New Taipei City (5.1 persons). With the Poisson regression model, the relative risk ratio of seeking medical care owing to violence in Pingtung County (reference: Taipei City) was 25.1 times for children, 20.1 times for adults, and 11.7 times for older adults. The counties and cities with higher rates of violent medical treatment for adults and older adults during the 15-year period were Pingtung County, New Taipei City, and Yunlin County. For children and adolescents, Pingtung County, Lienchiang County, and New Taipei City recorded the highest rates. Pingtung County had the highest risk of sexual violence. These results may be related to the local industrial structure, demographic composition, and other characteristics explained in the text.

Effect of far-infrared radiation on inhibition of colonies on packaging during storage of sterilised surgical instruments.

The sterilisation of surgical instruments is a major factor in infection control in the operating room (OR). All items used in the OR must be sterile for patient safety. Therefore, the present study evaluated the effect of far-infrared radiation (FIR) on the inhibition of colonies on packaging surface during the long-term storage of sterilised surgical instruments. From September 2021 to July 2022, 68.2% of 85 packages without FIR treatment showed microbial growth after incubation at 35 °C for 30 days and at room temperature for 5 days. A total of 34 bacterial species were identified, with the number of colonies increasing over time. In total, 130 colony-forming units were observed. The main microorganisms detected were Staphylococcus spp. (35%) and Bacillus spp. (21%) , Kocuria marina and Lactobacillus spp. (14%), and mould (5%). No colonies were found in 72 packages treated with FIR in the OR. Even after sterilisation, microbial growth can occur due to movement of the packages by staff, sweeping of floors, lack of high-efficiency particulate air filtration, high humidity, and inadequate hand hygiene. Thus, safe and simple far-infrared devices that allow continuous disinfection for storage spaces, as well as temperature and humidity control, help to reduce microorganisms in the OR.

Hairy gene homolog increases nasopharyngeal carcinoma cell stemness by upregulating Bmi-1.

B-cell-specific Moloney murine leukemia virus integration site 1 (Bmi-1) is overexpressed in various cancer types. We found that Bmi-1 mRNA levels were elevated in nasopharyngeal carcinoma (NPC) cell lines. In immunohistochemical analyses, high Bmi-1 levels were observed in not only 5 of 38 non-cancerous nasopharyngeal squamous epithelial biopsies, but also in 66 of 98 NPC specimens (67.3%). High Bmi-1 levels were detected more frequently in T3-T4, N2-N3 and stage III-IV NPC biopsies than in T1-T2, N0-N1 and stage I-II NPC samples, indicating that Bmi-1 is upregulated in advanced NPC. In 5-8F and SUNE1 NPC cells, stable depletion of Bmi-1 using lentiviral RNA interference greatly suppressed cell proliferation, induced G1-phase cell cycle arrest, reduced cell stemness and suppressed cell migration and invasion. Likewise, knocking down Bmi-1 inhibited NPC cell growth in nude mice. Both chromatin immunoprecipitation and Western blotting assays demonstrated that Hairy gene homolog (HRY) upregulated Bmi-1 by binding to its promoter, thereby increasing the stemness of NPC cells. Immunohistochemistry and quantitative real-time PCR analyses revealed that HRY expression correlated positively with Bmi-1 expression in a cohort of NPC biopsies. These findings suggested that HRY promotes NPC cell stemness by upregulating Bmi-1, and that silencing Bmi-1 can suppress NPC progression.

A multicenter prospective study on the management of hepatoblastoma in children: a report from the Chinese Children's Cancer Group.

BACKGROUND: This study aimed to identify survival risk factors in Chinese children with hepatoblastoma (HB) and assess the effectiveness of the new treatment protocol proposed by the Chinese Children's Cancer Group (CCCG) in 2016. METHODS: A multicenter, prospective study that included 399 patients with HB from January 2015 to June 2020 was conducted. Patient demographics, treatment protocols, and other related information were collected. Cox regression models and Kaplan-Meier curve methods were used. RESULTS: The 4-year event-free survival (EFS) and overall survival (OS) were 76.9 and 93.5%, respectively. The 4-year EFS rates for the very-low-risk, low-risk, intermediate-risk, and high-risk groups were 100%, 91.6%, 81.7%, and 51.0%, respectively. The 4-year OS was 100%, 97.3%, 94.4%, and 86.8%, respectively. Cox regression analysis found that age, tumor rupture (R +), and extrahepatic tumor extension (E +) were independent prognostic factors. A total of 299 patients had complete remission, and 19 relapsed. Patients with declining alpha-fetoprotein (AFP) > 75% after the first two cycles of neoadjuvant chemotherapy had a better EFS and OS than those ≤ 75%. CONCLUSIONS: The survival outcome of HB children has dramatically improved since the implementation of CCCG-HB-2016 therapy. Age ≥ 8 years, R + , and E + were independent risk factors for prognosis. Patients with a declining AFP > 75% after the first two cycles of neoadjuvant chemotherapy had better EFS and OS.

Atrial Fibrillation's Influence on Short Sleep Duration Increases the Risk of Fatness in Management Executives.

This study explored whether atrial fibrillation (AF)'s influence on short sleep duration (SD) increases the subsequent risk of fatness in management executives. This study included 25,953 healthy individuals working as management executives with ages ranging from 35 to 65 years (19,100 men and 6853 women) who participated in a qualifying physical filter program from 2006 to 2017 in Taiwan. Men and women who slept < 4 h had a 4.35-fold and 5.26-fold higher risk of developing AF than those who slept 7−8 h normally. Men and women who slept < 4 h had a 6.44-fold and 9.62-fold higher risk of fatness than those who slept 7−8 h. Men and women with AF had a 4.52-fold and 6.25-fold higher risk of fatness than those without AF. It showed that AF induced by short SD increases the risk of fatness. A short SD can predict an increased risk of fatness among management executives in Taiwan.

Segregating Suspected Child Maltreatment from Non-Child Maltreatment Injuries: A Population-Based Case-Control Study in Taiwan.

Objective: To identify the differential patient characteristics, injury types, and treatment outcomes between hospitalized child abuse and non-child abuse injuries in Taiwan. Methods: Using the data from the National Health Insurance Research Database, we selected a total of 1525 patients under the age of 18 that were diagnosed with child abuse, as well as an additional 6100 patients as a comparison group. Chi-square test, Fisher exact test, and independent samples t-test were used to compare the differences between the abused children and the non-abuse-related injured children. The multivariate conditional logistic regression was performed to measure the risk factor of child maltreatment in injured children. Results: Intracranial injury was more frequent in the child abuse group than it was in the non-child abuse group (35.0% vs. 8.2%; p < 0.001). Children in the child abuse group tended to stay longer in the hospital and incur higher medical expenses (8.91 days vs. 4.41 days and USD 2564 vs. USD 880, respectively). In multivariate analysis, the Adjusted Odds Ratio (Adjusted OR) of abuse resulting in an injury for children in low-income families is 1.965 times higher than those in non-low-income families (p < 0.001). Children living in high urbanization areas had a significantly higher probability of being abused than those living in low urbanization areas (p < 0.001). Conclusion: Children under the age of 1 who were hospitalized with severe intracranial injuries are highly at risk for child maltreatment. Moreover, numerous high-risk environmental factors were observed in child abuse cases, including living in urban areas, families with low income, and seasonality, as child maltreatment cases occur more frequently in autumn.

Exposure of Child Maltreatment Leads to a Risk of Mental Illness and Poor Prognosis in Taiwan: A Nationwide Cohort Study from 2000 to 2015.

Objective: To investigate whether children with maltreatment exposure were associated with the risk of psychiatric disorders, suicide, and death. Methods: A retrospective cohort study was conducted, with 1592 child maltreatment cases and 6368 comparison cohort (1:4) matched for gender, age, and index year, from the Longitudinal Generation Tracking Database (LGTD2000) sampled from Taiwan National Health Insurance Research Database (NHIRD) in 2000, backtracking between 2000−2015 in Taiwan. The stratified Cox regression model was used to compare the risk of developing a mental illness and poor prognosis during the 15 years of follow-up. Results: There were 473 in the cohort with child maltreatment (675.10 cases per 100,000 person years) and 1289 in the comparison cohort (453.82 cases per 100,000 person years) that developed mental illness and poor prognosis. The stratified Cox regression model revealed that the adjusted hazard ratio (HR) was 1.91 to 11.76 (p < 0.05) after adjusting for monthly income level, occupation, and CCI after violence. Conclusion: Exposure to child maltreatment is associated with the risk of psychiatric disorders, but not suicide or death. This finding could be a reminder for clinicians about the mental health problems in patients with child maltreatment.

Males with low income and catastrophic illnesses are important risk factors for in-hospital homicide-related deaths in Taiwan from 1998 to 2015: A cross-sectional study.

This study aimed to investigate not only the differences in in-hospital deaths between male and female homicides in Taiwan from 1998 to 2015, but also the epidemiological characteristics and long-term trend analysis. We collected data on 76,125 hospitalized patients injured in attempted homicides from January 1, 1998, to December 31, 2015, from the National Health Insurance Research Database (NHIRD), identifying 59,161 male and 16,694 female patients. Age, gender, and index date match. Multiple logistic regression was used to analyze the risks of gender differences in terms of homicide. The death risk of male patients was 1.673 times that of female patients and the mortality risk of low-income male patients was 3.447 times greater than that of non-low-income male patients. Moreover, the in-hospital death risk was 23.584 and 5.064 times higher for male and female patients with catastrophic illness, respectively, compared to patients with noncritical diseases. There is a higher trend of male than female patients hospitalized after an attempted homicide. Gender differences are significantly related to homicide, with males having a higher risk of death risk from homicide than females, especially in terms of low-income and catastrophic illness.

Association of Postpartum Depression with Maternal Suicide: A Nationwide Population-Based Study.

BACKGROUND: To examine the association of postpartum depression (PPD) with maternal suicide in the Taiwanese population. METHODS: We examined the medical records of women aged 18-50 years who experienced childbirth and had PPD (the study cohort, n = 2882), who experienced childbirth but did not have PPD (comparison cohort 1, n = 5764), and who neither experienced childbirth nor had PPD (comparison cohort 2, n = 5764) between 2000 and 2015. The patients were followed up until suicide, withdrawal from the National Health Insurance program, or 31 December 2015. RESULTS: The rates of anxiety and depression symptoms, as well as the cumulative risk of suicide, were significantly higher in the study cohort. PPD was significantly correlated with an increased risk of maternal suicide and was associated with a greater risk of developing comorbidities such as hypertension, diabetes mellitus, hyperlipidemia, and stroke. The comparison cohorts did not differ significantly in terms of suicide risk. CONCLUSION: PPD was associated with a significantly higher rate of suicide and a shorter time to suicide after childbirth. Younger age, winter, and subclinical depression and anxiety positively predicted suicide in the study cohort. To prevent maternal suicide, clinicians should be observant of subclinical depression and anxiety symptoms among patients.

Relationship between Injuries and Attention-Deficit Hyperactivity Disorder: A Population-Based Study with Long-Term Follow-Up in Taiwan.

OBJECTIVE: To investigate the association between various injuries and attention-deficit hyperactivity disorder (ADHD) and distinguish ADHD from non-ADHD with regards to risk of various injuries among children in Taiwan. METHOD: Using the data from the National Health Insurance Research Database, we selected a total of 1802 subjects under the age of 18 who were diagnosed with ADHD as well as an additional 7208 subjects as a comparison group. RESULTS: Compared with children who were not diagnosed with ADHD, children diagnosed with ADHD were more likely to intentionally injure themselves. During the school year, ADHD children were injured less frequently than were non-ADHD children on traffic-related incidents. The adjusted hazard ratio of injury for the ADHD children was 2.493 times higher than that of comparison subjects. The ADHD children had a greater length of stay and medical cost when compared to those of the non-ADHD children. Age showed a significant inverse relationship with injury. Among the ADHD children, the injury rate was evidently higher for the low-income group than for the non-low-income group. CONCLUSIONS: Age, cause of injuries, low-income household status, and school season all have a significant connection to the risk of injury for ADHD children.

Chronic Obstructive Pulmonary Disease Effect of Nonapnea Sleep Disorder on the Risk of Obesity: A Nationwide Population-Based Case-Control Study.

Objectives: To investigate whether chronic obstructive pulmonary disease (COPD) affects nonapnea sleep disorder (NASD) on the risk of obesity. Materials and Methods: From 1 January 2000 to 31 December 2015, a total of 24,363 patients with obesity from the 2005 Longitudinal Health Insurance Database were identified; 97,452 patients without obesity were also identified from the same database. Multiple logistic regression was used to analyze the previous exposure risk of patients with obesity and NASD. A p value of <0.05 was considered significant. Results: The risk of developing obesity in patients with COPD is 3.05 times higher than that in patients without COPD. Patients with COPD with NASD had a 1.606-fold higher risk of developing obesity than those without NASD. Patients with obesity were more likely to be exposed to NASD than did those without obesity (adjusted odds ratio, 1.693; 95% confidence interval, 1.575−1.821, p < 0.001). Furthermore, the closeness of the exposure period to the index time was positively associated with the severity of obesity, with a dose−response effect. The exposure duration of NASD in patients with obesity was 1.693 times than that in those without obesity. Longer exposure durations were associated with more severe obesity, also with a dose−response effect. Conclusions: The COPD effect of NASD increases the subsequent risk of obesity, and the risk of obesity was determined to be significantly higher in patients with NASD in this case−control study. Longer exposure to NASD was associated with a higher likelihood of obesity, also with a dose−response effect.

The Synergetic Impact of Physical Activity and Fruit and Vegetable Consumption on the Risk of Depression in Taiwanese Adults.

BACKGROUND: This research focused on the association between physical activity and fruit-vegetable intake and the risk of depression in middle aged and older Taiwanese adults. METHODS: Data were obtained from the 1999 to 2015 datasets of the Taiwan Longitudinal Survey on Aging (TLSA), and 4400 participants were included in 1999 (aged ≥53 years). Descriptive statistics provided all of the basic characteristic variables. A chi-square test analyzed the association between sex, age, years of education, marriage, hypertension, drinking, smoking, and the incidence of depression. Logistic regression analysis was used to determine significant associations between physical activity and fruit-vegetable intake, and the presence or absence of depression after 16 years. RESULTS: Combined high physical activity and fruit-vegetable intake reduced the risk of depression by 80% (OR = 0.20, 95% CI = 0.10-0.45, p = 0.001) compared to low physical activity and fruit-vegetable intake; high physical activity and moderate or low fruit-vegetable intake caused a 70% reduction (OR = 0.30, 95% CI = 0.15-0.63, p = 0.005). High fruit-vegetable intake and low physical activity caused a 65% reduction (OR = 0.35, 95% CI = 0.15-0.63, p = 0.005), compared to low physical activity and low fruit-vegetable intake. High physical activity alone caused a 40% reduction, which is the same as by high fruit-vegetable intake alone. CONCLUSIONS: Fruit-vegetable intake combined with physical activity was negatively correlated with the risk of depression. More fruit-vegetable intake and physical activity might reduce this risk. The results highlight the importance of physical activity and fruit-vegetable consumption for middle-aged and older adults to prevent depression.

Trend Distribution of Violent Injuries in Taiwan from 2000 to 2015.

This study aims to understand the trend distribution of violent injuries in Taiwan from 2000 to 2015. It used the data of outpatient, emergency, and hospitalization of 2 million people in the National Health Insurance sample from 2000 to 2015. We analyzed children and adolescents (hereinafter referred to as children, 0-17 years old), adults (18-64 years old), and The Elderly (over 65 years old) who suffered for the first time. The standardized rate of medical treatment for violent injuries was compared annually using the Poisson regression method. A total of 11,077 victims (7163 men, 3914 women) suffered violence during the 15 years, and the standardized rate of medical treatment for violence in adults dropped from 6.01 (1/104) in 2001 to 2.58 (1/104) in 2015. The standardized rate of medical treatment in adults over the years was higher than that in children (2.962001, 1.232015) and The Elderly (3.522001, 1.622015). The medical treatment rate of the adult generation is higher than that of the children and the elderly. The relative hazard ratio (RR) decreased from 2.38 in 2001 to 1.13 in 2014 (but the RR in 2014 was not significant). Furthermore, the rate of adult violence treatment has been decreasing every year, which shows that the government has achieved remarkable results in general violence prevention. With the accelerated aging of Taiwan's population, it is expected that older adults exposed to the risk of violence will also increase and become more serious. Therefore, the government should continue to pay attention to this issue.