Acromegaly determination using discriminant analysis of the three-dimensional facial classification in Taiwanese.

OBJECTIVES: The aim of this study was to assess the size, angles and positional characteristics of facial anthropometry between "acromegalic" patients and control subjects. We also identify possible facial soft tissue measurements for generating discriminant functions toward acromegaly determination in males and females for acromegaly early self-awareness. MATERIAL AND METHODS: This is a cross-sectional study. Subjects participating in this study included 70 patients diagnosed with acromegaly (35 females and 35 males) and 140 gender-matched control individuals. Three-dimensional facial images were collected via a camera system. Thirteen landmarks were selected. Eleven measurements from the three categories were selected and applied, including five frontal widths, three lateral depths and three lateral angular measurements. Descriptive analyses were conducted using means and standard deviations for each measurement. Univariate and multivariate discriminant function analyses were applied in order to calculate the accuracy of acromegaly detection. RESULTS: Patients with acromegaly exhibit soft-tissue facial enlargement and hypertrophy. Frontal widths as well as lateral depth and angle of facial changes were evident. The average accuracies of all functions for female patient detection ranged from 80.0-91.40%. The average accuracies of all functions for male patient detection were from 81.0-94.30%. The greatest anomaly observed was evidenced in the lateral angles, with greater enlargement of "nasofrontal" angles for females and greater "mentolabial" angles for males. Additionally, shapes of the lateral angles showed changes. The majority of the facial measurements proved dynamic for acromegaly patients; however, it is problematic to detect the disease with progressive body anthropometric changes. CONCLUSION: The discriminant functions of detection developed in this study could help patients, their families, medical practitioners and others to identify and track progressive facial change patterns before the possible patients go to the hospital, especially the lateral "angles" which can be calculated by relative point-to-point changes derived from 2D lateral imagery without the 3D anthropometric measurements. This study tries to provide a novel and easy method to detect acromegaly when the patients start to have awareness of abnormal appearance because of facial measurement changes, and it also suggests that undiagnosed patients be urged to go to the hospital as soon as possible for acromegaly early diagnosis.

Effect of Obesity and Metabolic Health Status on Metabolic-Associated Steatotic Liver Disease among Renal Transplant Recipients Using Hepatic Steatosis Index.

BACKGROUND/OBJECTIVES: Obesity and metabolic conditions increase the risk of metabolic-associated steatotic liver disease (MASLD). This study examined the risk of MASLD in 137 renal transplant recipients (RTRs) from a single-center hospital on the basis of their obesity and metabolic health status. METHODS: Participants were categorized into four groups: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically abnormal nonobese (MANO), and metabolically abnormal obese (MAO). MASLD was assessed using the hepatic steatosis index (HSI), calculated as 8 × (aspartate aminotransferase/alanine aminotransferase ratio) + body mass index + 2 (if diabetic) + 2 (if woman). The HSI scores were 29.50 ± 4.55, 38.08 ± 5.44, 33.61 ± 5.23, and 39.86 ± 4.13 in the MHNO, MHO, MANO, and MAO groups, respectively (p < 0.05). RESULTS: Overall, 25.55% of the participants (57.14% men) were classified as having MASLD (HSI > 36). A multivariate-adjusted regression analysis revealed significantly higher HSI scores in the MAO group than in the MHNO group. Both MHO and MANO groups also had significantly higher HSI scores. The odds ratios for more severe MASLD were 2.74 (95% CI: 0.88-8.52) for the MANO group and 74.59 (95% CI: 13.29-418.68) for the MAO group compared with the MHNO group. CONCLUSIONS: These findings suggest that RTRs with obesity have a higher risk of MASLD, but even those with a normal weight and metabolic abnormalities are at increased risk.

A novel method for synthesis of carbon dots and their applications in reactive oxygen species (ROS) and glucose detections.

A simple and novel method is proposed for preparation of water-soluble fluorescent carbon dots (C-dots), which have potential to be applied in detecting reactive oxygen species (ROS). The C-dots with high fluorescence quantum yield were created by hydrothermal methods with lactose as the carbon source and tris(hydroxylmethyl)aminomethane (Tris) as the surface passivation reagent. The C-dots have some unique characteristics such as excellent biocompatibility with a broad pH working range of 5-11 and high fluorescence, which makes them especially useful in the bio-detection field. The optical properties, surface groups, and element components of the prepared C-dots have been systematically studied by fluorescence spectroscopy. This facile approach is efficient and environmentally friendly and allows large-scale production of the C-dots without any further post-treatment. The C-dots have been adopted as probes for fluorescence turn-off detection owing to their high sensitivity to the hydroxyl radical. The detection limit can reach ∼0.1 µM under optimized conditions when using hydrogen peroxide as the source for generating ROS. Moreover, when paired with glucose oxidase, these C-dots can track glucose concentrations in samples. This adaptability suggests their potential in detecting various metabolites, paving the way for practical uses in disease detection.

High diet quality indices associated with lower risk of lipid profile abnormalities in Taiwanese kidney transplant recipients.

Cardiovascular disease (CVD) and its risk factors seem to be linked with deteriorated graft function and persists as the major cause of mortality in kidney transplant recipients (KTRs). Diet quality is associated with CVD prevention in the healthy population, however, less study focuses on KTRs. The study aimed to determine the association between diet quality indices and lipid profile abnormalities as risk factors for CVD in KTRs. This prospective study enrolled 106 KTRs who had functioning allografts from September 2016. Lipid profiles included low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) and were based on the National Cholesterol Education Program Adult Treatment Panel III recommendations. Three-day dietary data were collected by a well-trained registered dietitian. The Alternative Healthy Eating Index-Taiwan (AHEI-Taiwan), Alternative Healthy Eating Index-2010 (AHEI-2010), and Healthy Eating Index-2015 (HEI-2015) scores were calculated and divided into quartiles and compared accordingly. KTRs' mean LDL-C, HDL-C, TC, and TG levels were 119.8 ± 36.6 mg/dL, 52.0 ± 17.9 mg/dL, 205.8 ± 43.9 mg/dL, and 160.2 ± 121.6 mg/dL, respectively. Compared with the lowest quartile, only the highest quartile of AHEI-Taiwan had lower TC and LDL-C levels. After adjustment for age, gender, energy, Charlson comorbidity index, transplant duration, and dialysis duration, logistic regression analysis revealed that the highest quartile of AHEI-Taiwan had 82% (odds ratio [OR], 0.18; 95% confidence interval [CI] 0.04-0.72, p < 0.05) lower odds of high TC and 88% (OR 0.12; 95% CI 0.03-0.58, p < 0.05) lower odds of high LDL-C, and the highest quartile of HEI-2015 had 77% (OR 0.23; 95% CI 0.05-0.95, p < 0.05) lower odds of high LDL-C. Higher adherence to a healthy diet as per AHEI-Taiwan and HEI-2015 guidelines associated with lower risk of lipid profile abnormalities in KTRs.

Association of Three Different Dietary Approaches to Stop Hypertension Diet Indices with Renal Function in Renal Transplant Recipients.

Several dietary indices assess the impacts of the Dietary Approaches to Stop Hypertension (DASH) diet on health outcomes. We explored DASH adherence and renal function among 85 Taiwanese renal transplant recipients (RTRs) in a cross-sectional study. Data collection included demographics, routine laboratory data, and 3-day dietary records. Three separate DASH indices, that defined by Camões (based on nine nutrients), that defined by Fung (using seven food groups and sodium), and that modified by Fung (as above but separated for men and women) were used. Renal function was ascertained through the estimated glomerular filtration rate (eGFR) from patients' medical records. Participants' mean age was 49.7 ± 12.6 years and eGFR was 54.71 ± 21.48 mL/min/1.73 m2. The three established DASH diet indices displayed significant correlations (r = 0.50-0.91) and indicated the nutritional adequacy of the diet. Multiple linear regressions indicated a significant positive association between higher DASH scores for each index and increased eGFR. In addition, RTRs in the highest DASH score tertile had higher eGFR rates than those in the lowest tertile, regardless of confounding variables. Adherence to a DASH-style diet correlated with better renal function among RTRs. Educating RTRs about the DASH diet may prevent graft function deterioration.

Changes in Dietary Nutrient Intake and Estimated Glomerular Filtration Rate over a 5-Year Period in Renal Transplant Recipients.

The scarcity of dietary guidance for renal transplant recipients (RTRs) raises concerns regarding obesity and associated comorbidities, including impaired renal function. This two-stage cross-sectional study examined longitudinal changes in dietary nutrient intake in the same individuals over a 5-year interval. This study involved two stages: T1 (September 2016 to June 2018) and T2 (July 2022 to August 2023). The average duration between the two data collection stages was 6.17 ± 0.42 (range 5.20-6.87) years. The study included 227 RTRs with an average age and time since transplant of 49.97 ± 12.39 and 9.22 ± 7.91 years, respectively. Of the 35 patients who participated in both phases, fewer than half met the recommended intakes for energy, dietary fiber, and most vitamins and minerals, as set in the Dietary Reference Intakes (DRIs) or by the Dietitian Association Australia (DAA). Over half exceeded the DRI recommended intake for total protein, and more than 80% of the protein consumed per kilogram of body weight exceeded the DAA's recommendations. In the T2 stage, the RTRs had a significantly higher blood urea nitrogen level, lower albumin level, and estimated glomerular filtration rate. These findings indicate that deteriorating dietary intake in RTRs can adversely affect their nutritional status and transplanted kidney function over a 5-year period.

A Pilot Study of Interactive-Video Games in People with Mild Cognitive Impairment.

Early preventive strategies for improving cognitive function are crucial for people with mild cognitive impairment (MCI). Cognitive training exercises may improve cognitive functioning. However, there was limited evidence from training programs that combined cognitive-specific and physical activities, particularly in using interactive video games as interventions. This study aimed to evaluate the feasibility and effects of the interactive-video games on cognitive function, physical function, mood status and quality of life in community-dwelling people with MCI. A quasi-experimental study was undertaken. Participants in the intervention group received 60 min group-based training program once per week for 12 weeks. A generalised estimating equation (GEE) was used to examine the main effect, interactions and changes in outcomes over time. Sixteen participants completed the trial with eight in the intervention group and eight in the comparison group. The tolerable acceptance rate, perfect attendance rate, high satisfaction with the training content, and no injuries or falls demonstrated the feasibility of this program. The scores of cognitive function increased in both groups and the interaction between time and groups were significant over 12 weeks of training (p < 0.05). As the result, we determined that interactive-video games can be a safe, feasible, enjoyable intervention and user-friendly among people with MCI in community settings.

The relationship between serum uric acid level and metabolic syndrome: differences by sex and age in Taiwanese.

BACKGROUND: Metabolic syndrome (MetS) and hyperuricemia are important risk factors for cardiovascular disease. However, findings regarding the relationship between serum uric acid (UA) level and components of MetS have been inconsistent. This study was performed to explore the potential value of UA level as a marker of MetS among male and female Chinese of different ages. METHODS: A total of 5896 subjects (2960 females and 2936 males) were recruited from the Department of Health Management at the Chang Gung Medical Center. Hyperuricemia was defined as a serum UA value >7.0 mg/dL for males or >6.0 mg/dL for females. MetS was defined according to the criteria of the Adult Treatment Panel III, as modified for Chinese subjects. Serum UA was used to differentiate MetS and to calculate epidemiological indices by means of discriminate analysis and logistic regression. RESULTS: The sensitivity and specificity of serum UA concentration as a marker of MetS ranged from 55.2% to 61.4% and 61.9% to 68.4%, respectively. Subjects with high UA had a higher risk of MetS, with odds ratios ranging from 1.23 to 1.82 (P < 0.01). A positive correlation between serum UA and MetS was observed in both sexes. Serum UA and the occurrence of MetS rose with increasing age in females; in males, however, UA values did not vary with age. CONCLUSIONS: Serum UA is more closely associated with MetS in females than in males. High UA among middle-aged women may predict the development of MetS.

Using the OVAKO working posture analysis system in cleaning occupations.

BACKGROUND: Cleaning workers experience severe musculoskeletal symptoms. OBJECTIVE: The objective of this paper was to examine musculoskeletal symptoms in cleaners of different heights to evaluate the effects of height on working postures in the work environment (schools). METHODS: We used a three-stage method including using the Nordic Musculoskeletal Questionnaire (NMQ) to evaluate musculoskeletal symptoms, a task analysis to confirm typical cleaning tasks, and the OVAKO Working Posture Assessment System (OWAS) for posture analysis. Multinomial logistic regression was performed to evaluate the adjusted effects of individual characteristics on painful body regions, using individuals without any pain as the reference category. RESULTS: This study found that the prevalence of musculoskeletal symptoms is very high for cleaners, especially in the shoulders, elbows, and lower back. Odds ratios for the accumulation of two or more risk factors were higher among men and were inversely associated with national economic indicators. The relatively high prevalence of musculoskeletal symptoms may stem from the multiple operations involved in cleaning tasks, such as trash collecting, floor mopping, toilet cleaning, and mirror polishing. Workers of different heights had differential work loadings for different tasks. CONCLUSIONS: This paper proposes recommendations for job adaptations and occupational safety training. Cleaners of different heights execute the typical tasks via different postures, and awkward postures often result in musculoskeletal symptoms. Cleaners should be provided with specific tools and training regarding working postures on the basis of height. These findings can be used as a reference for related operation designs and task improvements to ensure correct tool usage and safer working postures during cleaning.

The influence of body mass on foot dimensions during pregnancy.

In this study, a time-series approach was used to measure women's feet to accurately analyze changes in foot size and body mass during pregnancy. One-hundred women who were pregnant for the first time were asked to respond to questions on subjective complaints of foot discomfort listed in a questionnaire. Among these 100 women, a sample of 30 was obtained and used to measure the women's feet from the twentieth week of the gestation period until labor. The data (from 5 of the 30 women) were used to establish a prediction model for the influence of body mass on changes in foot size during pregnancy. The results indicate that the women subjectively complained that their shoes were too tight, resulting in foot discomfort. From the twentieth to the thirty-eighth week of pregnancy, the average increase in foot length, width, and back foot surface was 0.86 cm (3.6%), 0.25 cm (2.6%), and 18.36 cm(2) (11.9%), respectively. The height of the arch decreased by an average of 0.52 cm (-24.2%). Body mass accounted for more than 90% of the variation (R(2)) in foot dimensions during pregnancy and, thus indicated satisfactory predictive ability. The prediction model developed in this study can serve as a reference for clinical applications and shoe design to prevent women from experiencing extreme discomfort in their feet during pregnancy.

Surveying the comfort perception of the ergonomic design of bluetooth earphones.

BACKGROUND: Bluetooth earphones can facilitate communications among workers engaged in manual (e.g., professional driver)or visual tasks (e.g., security guard). If workers remove their Bluetooth earphones due to poor fit, then communication effectiveness will decline, especially during manual or visual tasks. OBJECTIVES: (1) To identify which design properties of Bluetooth earphones can contribute to user comfort, and (2) to identify if person characteristics (i.e., gender and ear shapes in this study) are related to differences in comfort perception during earphone use. METHODS: 198 participants were recruited for this study.Individuals used four models of Bluetooth earphones in randomized order while performing computer tasks and then completed questionnaires on comfort perception specifically designed for this study. The 2 × 3 × 4 mixed design analysis of variance (ANOVA) was conducted to investigate the effects of gender, ear shape, and model condition. RESULTS: The results indicated that there were significant differences in model on comfort perception. CONCLUSIONS: For earplugs, the shape of the earphone and the elasticity of material are important ergonomic concerns to improve the comfort perception. In addition, the adjustable tail length is an important ergonomic design property for the ear-hook. The information gained in this study should be useful in improving the ergonomic fitness of Bluetooth earphones.

Association of body weight with the risk for malignancies in hospitalized patients with or without diabetes mellitus in Taiwan.

BACKGROUND: The purpose of this study was to determine the risk for cancers in patients with and without type 2 diabetes mellitus (DM) stratified by body mass index (BMI). METHODS: Patients hospitalized from January 2000 to December 2010 with a diagnosis of malignant neoplasm (International Classification of Diseases, Ninth Revision, codes 140-208.91) were included. Diabetes mellitus was defined as a fasting blood glucose of 126 mg/dL or greater or a postprandial blood glucose of 200 mg/dL or greater. The patients were categorized according to BMI criteria for Asians: normal weight, BMI of less than 24 kg/m; overweight, BMI of greater than 24 kg/m; and obese, BMI of greater than 27 kg/m. RESULTS: A total of 42,229 patients were included, of which 24,884 (59%) were normal weight, 10,096 (24%) were overweight, and 7,249 (17%) were obese. There were 4,195 (16.9%), 2,056 (20.4%), and 1,625 (22.4%) patients with DM in the normal weight, overweight, and obese groups, respectively. Regardless of weight, the diabetic patients were more likely to have pancreas, liver, urinary tract, prostate, skin, hematological, lung, secondary, and gastric malignancies but were less likely to have cervical, oropharyngeal, nasopharyngeal, breast, or thyroid cancer. Regardless of sex or the presence or the absence of DM, the patients with more than 1 malignancy were more likely to die than were those with only 1 malignancy. Furthermore, the obese diabetic patients had higher mortality than did the obese nondiabetic patients with the same number of cancers. CONCLUSIONS: Regardless of weight category (normal, overweight, or obese), diabetic patients are more likely to have pancreas, liver, urinary tract, prostate, skin, hematological, lung, secondary, and gastric malignancies. Diabetic patients may benefit from increased surveillance for these cancers.

Significance and association of serum uric acid (UA) levels with components of metabolic syndrome (MS) in the elderly.

UNLABELLED: Information concerning the association of serum UA levels and the development of MS in the Chinese aging population is limited. The aims of this study were to investigate age-related metabolic disorders and analyze the relationship between serum UA levels and the components of MS in the elderly. This cross-sectional observational study was performed in subjects from the Department of Health Examination, including 1182 subjects aged ≧65 years; among these subjects, 528 were women (mean age, 70.7 ± 4.8 years) and 654 were men (mean age, 71.4 ± 5.3 years). All the subjects underwent three-dimensional (3-D) whole-body scanning for accurate anthropometric measurements. Data analyses were performed using SPSS software. RESULTS: MS, hyperuricemia, hypertension, and diabetes mellitus (DM) were present in 53.9%, 40.6%, 33.1%, and 30.1% of the subjects, respectively. Univariate statistical analysis showed that age, blood pressure, blood sugar levels, high-density lipoprotein levels, triglyceride levels, WBC count, and related anthropometric indices differed significantly in subjects categorized according to serum UA levels. In conclusion, our study showed that a high percentage of elderly subjects had hyperuricemia. The results showed an association between serum UA levels and cardiovascular risk factors, and this finding warrants concern with regard to the aging population.

To construct a forecasting model of the anthropometric chronic disease risk factor score.

BACKGROUND: Many health indices have a relationship with anthropometric indices. This research attempts to provide a new measurement: a chronic disease risk factor score built into the regression model. This new model will help people visualize their health status and get multiple information during the process of the healthy examination. METHODS: Data from 8,034 subjects were collected from the data bank of the Health Examination Center in Chang Gung Memorial Hospital. Related anthropometric indices and biochemical factors were selected and used to construct a regression model. The anthropometric indices used were body mass index, waist hip ratio, waist hip area ratio, health index, waist leg ratio and trunk leg ratio. Biochemical data included blood pressure, glucose, triglyceride, cholesterol and uric acid, combined to form an anthropometric chronic disease risk factor score. RESULTS: Subjects under 45 years of age had the highest chronic disease risk factor score, and were selected to construct a regression model. The R-square of this model is 0.355; its predictive error is near 12%. After verification with a testing group, the regression model could be used to predict health status. CONCLUSION: The purpose of this study was to develop a new anthropometric chronic disease risk factor score by combining anthropometric indices and biochemical data. A multiple regression model was used to illustrate health status via anthropometric chronic disease risk factor scores for the subjects participating in the health examination. The results show that the chronic disease risk factor score is useful for prescribing relevant medical treatment as well as for other research.