Effectiveness of Exercise Interventions on Body Composition, Exercise Capacity, Fatigue, and Quality of Life in Patients with Liver Cirrhosis: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Diminished muscle protein synthesis in cirrhosis leads to reduced strength and mass, impacting daily activities and overall quality of life. AIMS: This study aimed to examine the effectiveness of exercise intervention in body composition, exercise capacity, fatigue, and quality of life in patients with liver cirrhosis. METHODS: A systematic search of medical databases, including PubMed, Embase, Cochrane, and CINAHL, was executed from their inception to November 2022. The inclusion criteria were randomized controlled trials comparing exercise interventions with a control group that did not receive exercise interventions. RESULTS: From the initially identified 2,565 articles, eight studies with a total of 220 patients were eligible for inclusion in this meta-analysis. According to the meta-analysis, exercise significantly improved the six-minute walk distance (6MWD) by 68.93 m (95% CI 14.29-123.57) compared to the control group. Furthermore, the subgroup analysis revealed that combing exercise with amino acid supplementation had a greater positive effect on the 6MWD (MD = 144.72, 95% CI 87.44-202.01). Exercise also significantly increased thigh circumference (MD = 1.26, 95% CI 0.12-2.39) and the thigh ultrasound average compression index (MD = 0.07, 95% CI 0.00-0.14). Moreover, exercise significantly decreased fatigue levels by 0.7 points in patients with liver cirrhosis (95% CI 0.38-1.03). However, no significant effects were observed on body mass index (BMI), fat mass, fat-free mass, and quality of life. CONCLUSIONS: Exercise can improve exercise capacity, thigh muscle thickness, and fatigue in patients with cirrhosis, but it does not have a significant impact on fat mass, BMI, or quality of life.

A Performance Improvement for Indoor Positioning Systems Using Earth's Magnetic Field.

Although most indoor positioning systems use radio waves, such as Wi-Fi, Bluetooth, or RFID, for application in department stores, exhibition halls, stations, and airports, the accuracy of such technology is easily affected by human shadowing and multipath propagation delay. This study combines the earth's magnetic field strength and Wi-Fi signals to obtain the indoor positioning information with high availability. Wi-Fi signals are first used to identify the user's area under several kinds of environment partitioning methods. Then, the signal pattern comparison is used for positioning calculations using the strength change in the earth's magnetic field among the east-west, north-south, and vertical directions at indoor area. Finally, the k-nearest neighbors (KNN) method and fingerprinting algorithm are used to calculate the fine-grained indoor positioning information. The experiment results show that the average positioning error is 0.57 m in 12-area partitioning, which is almost a 90% improvement in relation to that of one area partitioning. This study also considers the positioning error if the device is held at different angles by hand. A rotation matrix is used to convert the magnetic sensor coordinates from a mobile phone related coordinates into the geographic coordinates. The average positioning error is decreased by 68%, compared to the original coordinates in 12-area partitioning with a 30-degree pitch. In the offline procedure, only the northern direction data are used, which is reduced by 75%, to give an average positioning error of 1.38 m. If the number of reference points is collected every 2 m for reducing 50% of the database requirement, the average positioning error is 1.77 m.

Relationships between stroke prevalence, health literacy, and oral health-related quality of life in middle-aged and older adults: a national survey study.

BACKGROUND: Stroke may cause debilitating neurological deficiencies that result in motor, sensory, and cognitive deficits and poorer psychosocial functioning. Prior studies have provided some initial evidence for the significant roles of health literacy and poor oral health for old people. However, few studies have focused on the health literacy of individuals who had a stroke; therefore, the relationships between the health literacy and oral health-related quality of life (OHRQoL) among middle-aged and older adults who had a stroke are unknown. We aimed to assess the relationships between stroke prevalence, health literacy status, and OHRQoL in middle-aged and older adults. METHODS: We retrieved the data from The Taiwan Longitudinal Study on Aging, a population-based survey. For each eligible subject, we gathered data in 2015 on age, sex, level of education, marital status, health literacy, the activity daily living (ADL), stroke history and OHRQoL. We evaluated the respondents' health literacy by using a nine-item health literacy scale and categorized their health literacy level as low, medium, or high. OHRQoL was identified based on the Taiwan version of the Oral Health Impact Profile (OHIP-7T). RESULTS: The final study contained 7702 community-based dwelling elderly people (3630 male and 4072 female) were analysis in our study. Stroke history was reported in 4.3% of participants, 25.3% reported low health literacy, and 41.9% had at least one ADL disability. Furthermore, 11.3% of participants had depression, 8.3% had cognitive impairment, and 3.4% had poor OHRQoL. Age, health literacy, ADL disability, stroke history, and depression status were significantly associated with poor OHRQoL after sex and marital status was adjusted. Medium (odds ratio [OR] = 1.784, 95% confidence interval [CI] = 1.177, 2.702) to low health literacy (OR = 2.496, 95% CI = 1.628, 3.828) was significantly associated with poor OHRQoL. CONCLUSIONS: Base our study results, people with stroke history had poor OHRQoL. Lower health literacy and ADL disability were associated with worse QHRQoL. Further studies are necessary to define practical strategies for reducing the risk of stroke and oral health with constantly lower health literacy, thereby improving the quality of life and providing health care of older people.

Socially Assistive Robots for People Living with Dementia in Long-Term Facilities: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND AND OBJECTIVE: The purpose of our study was to explore the immediate and long-term effects of socially assistive robots (SARs) on neuropsychiatric symptoms (NPSs), behavioral and psychological symptoms of dementia (BPSD), positive emotional experiences, and social interaction in older people living with dementia. METHODS: We set keywords and used Boolean operators to search the CINAHL, Cochrane Library, EMBASE, IEEE Digital Library, MEDLINE, PsycINFO, PubMed, Web of Science, Scopus, and Chinese Electronic Periodical Service from inception to February 2022 for randomized controlled trials. The Cochrane Collaboration bias assessment tool was used to assess article quality, and RevMan 5.4.1 software was used to conduct the meta-analysis. RESULTS: A total of 14 studies were included in the meta-analysis. SARs can help people living with dementia reduce their NPS of depression and anxiety, provide happiness from positive emotional experiences, and improve their social interaction through conversation. However, there was no significant improvement in agitation behavior, overall BPSD, or quality of life in people living with dementia. In follow-up, it was found that the effect of SRT was limited. CONCLUSION: SARs can reduce depression and increase positive emotions in people living with dementia. They may also reduce the burden on healthcare workers during the COVID-19 pandemic. This research was registered on PROSPERO CRD42020169340.

Factors Related to Nurse Satisfaction with Supervisor Leadership.

The satisfaction of nurses with the leadership of their supervisors exerts a positive association with their job satisfaction. This study identified factors associated with nurse satisfaction with supervisor leadership and developed a model of causal relationships based on social exchange theory. A satisfaction scale was developed to measure how nurses felt about the leadership of their supervisor, which also assessed the validity and reliability using a cross-sectional descriptive survey questionnaire administered to nurses working in a teaching hospital in northern Taiwan. A total of 607 valid questionnaires were returned. Structural equation modeling was used to test the theoretical model of this study. Only questions that were scored above 3 were included in the scale. A total of 30 questions were placed under seven constructs of this scale upon the assessment of content validity. The results indicate that satisfaction with shift schedules, educational training, and internal communication exerted direct, significant, and positive associations with satisfaction with the supervisor leadership. Furthermore, satisfaction with policies and guidelines exerted direct, significant, and positive associations with satisfaction with internal communication and exerted indirect associations with satisfaction with supervisor leadership through internal communication. In particular, satisfaction with shift schedules and internal communication were most significantly associated with satisfaction with supervisor leadership. The results of this study offer a reference for hospital management and emphasize focusing on the arrangement of nurse shifts in all departments. The establishment of diverse communication channels can enhance the degree of nurse satisfaction with supervisor leadership.

Enhancing bladder management for intrapartum/postpartum women at a maternity hospital in Taiwan: a best practice implementation project.

INTRODUCTION AND AIMS: Voiding dysfunction is a common perinatal condition. Appropriate bladder management and monitoring during labor and postpartum improves bladder function and reduces the incidence of infections and complications. This project aimed to promote evidence-based bladder management strategies for perinatal women at a maternity hospital in Taiwan. METHODS: The project was implemented using the JBI framework and the JBI Practical Application of Clinical Evidence System. Implementation audits were conducted by examining nurses and intrapartum and postpartum women. Ten criteria were applied in the baseline audit, and two follow-up audits were conducted to assess actual compliance with best-practice recommendations. Through a Getting Research into Practice analysis, we identified three barriers to changing practice. RESULTS: A comparison of the audit outcomes revealed that all criteria had improved by the second follow-up audit cycle. Specifically, the compliance rate increased from 37% and 50% to 100% for criteria 1 and 2, respectively; from 0% to 100% for criteria 3, 5, and 10; and from 7%, 28%, 50%, and 17% to 100%, 100%, 97%, and 100% for criteria 4, 6, 8, and 9, respectively. Following implementation, the frequency of intrapartum intermittent catheterization (53.44-38.30%) and the postpartum incidence of urinary retention (9.09-8.51%) decreased. The time to first voiding after vaginal delivery and between the first and the second voiding decreased from 5.51 and 4.01 h to 2.32 and 2.29 h, respectively. CONCLUSIONS: This evidence-based implementation project achieved substantial improvements in bladder management. Relational leadership theory, which integrates empowerment, purposefulness, ethical behaviors, and process orientation, underpinned the project.

Scale-Mark-Based Gauge Reading for Gauge Sensors in Real Environments with Light and Perspective Distortions.

Nowadays, many old analog gauges still require the use of manual gauge reading. It is a time-consuming, expensive, and error-prone process. A cost-effective solution for automatic gauge reading has become a very important research topic. Traditionally, different types of gauges have their own specific methods for gauge reading. This paper presents a systematized solution called SGR (Scale-mark-based Gauge Reading) to automatically read gauge values from different types of gauges. Since most gauges have scale marks (circular or in an arc), our SGR algorithm utilizes PCA (principal components analysis) to find the primary eigenvector of each scale mark. The intersection of these eigenvectors is extracted as the gauge center to ascertain the scale marks. Then, the endpoint of the gauge pointer is found to calculate the corresponding angles to the gauge's center. Using OCR (optical character recognition), the corresponding dial values can be extracted to match with their scale marks. Finally, the gauge reading value is obtained by using the linear interpolation of these angles. Our experiments use four videos in real environments with light and perspective distortions. The gauges in the video are first detected by YOLOv4 and the detected regions are clipped as the input images. The obtained results show that SGR can automatically and successfully read gauge values. The average error of SGR is nearly 0.1% for the normal environment. When the environment becomes abnormal with respect to light and perspective distortions, the average error of SGR is still less than 0.5%.

Institutional factors associated with the incidence rates of central line-associated bloodstream infection in California community hospitals.

Central line-associated bloodstream infections are frequent, deadly, costly, and preventable. The study aimed to explore how some hospital-related characteristics were associated with incidence rates of central line-associated bloodstream infections reported by community hospitals in California from January to December 2019. This retrospective, cross-sectional study used combined data from records submitted to the California Department of Public Health, California Open Data Portal, the California Health and Human Services Open Data Portal, and the American Hospital Directory by community hospitals in California with central line-associated bloodstream infections in 2019. Results showed that CLABSIs are significantly associated with bed capacity, health care system affiliation, ownership, and hospital accreditation status (p < 0.0001). CLABSI remains a relevant threat to patient safety and quality of care, even more so in the community hospital setting. Understanding if a relationship exists between institutional factors and CLABSI rates might better prepare leaders in healthcare organizations to reduce HAIs.

Effects of personalized music intervention on nurse burnout: A feasibility randomized controlled trial.

Burnout is highly prevalent among nurses; however, the effect of personalized music intervention on burnout remains unclear on nurses. We aimed to investigate the effects of personalized music intervention in relieving burnout among nurses. Forty-two eligible nurses were recruited for an assessor-blinded, two-arm parallel randomized controlled trial. The participants were randomly assigned to the following two groups: The personalized music group (n = 21), which listened to music of their choice for 30 min per session three times per week for 5 weeks; and the wait-list control group (n = 21), which did not listen to any music for relaxation. At baseline, nurses in the personalized music group had worse emotional exhaustion and greater depression compared with the wait-list control group. Results from an analysis of covariance using baseline emotional exhaustion and depression as covariates indicated that nurses who received personalized music intervention experienced less emotional exhaustion than the nurses in the wait-list control experienced. Personalized music intervention can be used for nurses as an adjuvant approach to reduce emotional exhaustion and then improve their well-being.

Cost-Effective Fitting Model for Indoor Positioning Systems Based on Bluetooth Low Energy.

Bluetooth Low Energy (BLE) is a positioning technology that is commonly used in indoor positioning systems (IPS) such as shopping malls or underground parking lots, because of its low power consumption and the low cost of Bluetooth devices. It also maintains high positioning accuracy. Since the cost of BLE itself is low, it has now been used in larger environments such as parking lots or shopping malls for a long time. However, it is necessary to configure a large number of devices in the environment to obtain accurate positioning results. The most accurate method of using signal strength for positioning is the signal pattern-matching method. The positioning result is compared through a database with the overheads of time and labor costs, since the amount of data will be proportional to the size of the environment for BLE-IPS. A planar model that conforms to the signal strength in the environment was generated, wherein the database comparison method is replaced by an equation solution, to improve various costs but diminish the positioning accuracy. In this paper, we propose to further replace the planar model with a cost-effective fitting model to both save costs and improve positioning accuracy. The experimental results demonstrate that this model can effectively reduce the average positioning error in distance by 31%.

Comprehensive assessment of the impact of land use and hydrogeological properties on the groundwater quality in Taiwan using factor and cluster analyses.

This study aims at making a comprehensive assessment of the impact of land use and the hydrogeological properties on groundwater quality. First, factor analysis (FA) is applied to reveal the main pollutant sources and hydrogeological processes controlling the groundwater quality. FA identifies the four most important factors. Factor 1 (seawater salinization) is characterized by a medium loading of land use type of aquaculture. It is recognized that the high scores for factor 1 in coastal areas are due to over-pumping from aquafarms. Focused land use management is required to prevent saline-water intrusion in coastal aquifers. Factor 3 (nitrate pollution) shows high correlations with the land use type of fruit farming and the gravel thickness in unsaturated layers. High scores for factor 3 are also found in the proximal area of the Chuoshui River Alluvial Fan and the northeastern mountain area in the Pingtung Plain. Fruit farmers should be educated to reduce the application of fertilizers and promote the organic fruit farming. The impacts of land use and the hydrogeological properties on both Factor 2 (arsenic enrichment) and Factor 4 (reductive dissolution of Fe2+ and Mn2+) are negligible. Second, cluster analysis (CA) is performed on computed scores of the four main factors to separates 123 monitoring wells into cluster 1 (low polluted zone), cluster 2 (nitrate polluted zone) and cluster 3 (hybrid polluted zone). The results obtained from CA provide practical applications such as reduce agrichemical use in the areas of cluster 2 and enforce intensive monitoring in the prioritizing areas of cluster 3. This study successively uses the FA and CA to extract the meaningful information present by geographical visualization of scores for 4 main factors and 3 distinct clusters zones. The results are essential for formulating sound groundwater resource and land use management policies to ensure groundwater sustainability.

Health Literacy and Exercise to Treat Frailty in Community-Dwelling Older Adults: A National Survey Study.

Aging is a major challenge facing modern society and has attracted global attention. Studies have provided some initial evidence that health literacy plays a role in determining frailty; however, most of these studies have used small convenience samples of individuals recruited from geographically limited areas, thus limiting the generalizability of their findings. The present study explored the relationships among health literacy, exercise, and frailty in Taiwanese older adults by using the data of a national population-based survey. We retrieved data from the Taiwan Longitudinal Study on Aging, a population-based survey. We gathered the 2015 data on the age, sex, education level, marital status, exercise habits, and activities of daily living (ADLs) of each eligible respondent. We evaluated the respondents' health literacy by using a nine-item health literacy scale and categorized their health literacy level as low, medium, or high. Frailty was diagnosed according the Fried criteria. Our final sample consisted of 7702 community-dwelling older adults (3630 men and 4072 adults). Of these, 25.3% had low health literacy. The proportion of respondents who had two or more disabilities in terms of ADLs or instrumental ADLs was higher among the women (36.4% and 12.6%, respectively), and regular exercise was more common among the men (19.6%). Frailty was more prevalent among the women; the prevalence of frailty among the male and female respondents was 4.5% and 8.1%, respectively. High health literacy and regular exercise were protective factors for frailty. According to our results, poor health literacy is a risk factor for prefrailty and frailty, and regular exercise is significantly negatively associated with prefrailty and frailty. Additional studies are necessary to define practical strategies for reducing the risks of disability and death for older adults with low health literacy who do not exercise regularly, thereby improving their quality of life.

Edge Computing of Online Bounded-Error Query for Energy-Efficient IoT Sensors.

Since the power of transmitting one-bit data is higher than that of computing one thousand lines of code in IoT (Internet of Things) applications, it is very important to reduce communication costs to save battery power and prolong system lifetime. In IoT sensors, the transformation of physical phenomena to data is usually with distortion (bounded-error tolerance). It introduces bounded-error data in IoT applications according to their required QoS2 (quality-of-sensor service) or QoD (quality-of-decision making). In our previous work, we proposed a bounded-error data compression scheme called BESDC (Bounded-Error-pruned Sensor Data Compression) to reduce the point-to-point communication cost of WSNs (wireless sensor networks). Based on BESDC, this paper proposes an online bounded-error query (OBEQ) scheme with edge computing to handle the entire online query process. We propose a query filter scheme to reduce the query commands, which will inform WSN to return unnecessary queried data. It not only satisfies the QoS2/QoD requirements, but also reduces the communication cost to request sensing data. Our experiments use real data of WSN to demonstrate the query performance. Results show that an OBEQ with a query filter can reduce up to 88% of the communication cost when compared with the traditional online query process.

Increased Risk of Major Depressive Disorder Following Tinnitus: A Population-Based Study.

Background and Purpose: In this study, we aimed to evaluate the relationship between tinnitus and a subsequent diagnosis of major depressive disorder (MDD) by studying the incidence of both entities. Design: A retrospective cohort study. Methods: Data for this observational follow-up study were retrieved from the Taiwan's National Health Insurance Dataset. A total of 375,272 patients with newly diagnosed tinnitus (study group) were retrieved. The date of first diagnosis of tinnitus was assigned as their index date. Comparison patients were selected by propensity score matching (one per case, n = 375,272 controls) from the same dataset, with their index date being the date of their first health service claim in the year of diagnosis of their matched index case. We tracked each patient's claims records for 1 year from the index date to identify those who received a diagnosis of MDD. Cox proportional hazards regression was performed to calculate the MDD hazard ratio for cases vs. controls. Results: We found that the overall incidence rate for MDD was 0.78 (95% CI = 0.76~0.80) per 100 person-years, being 1.17 (95% CI = 1.14~1.21) among the study cohorts and 0.38 (95% CI = 0.36~0.40) among the comparison cohorts. The log-rank test revealed that the patients in the study cohort had significantly lower one-year MDD-free survival when compared to the comparison cohort (p < 0.001). Cox proportional hazards analysis showed that the patients in the study cohort had a higher hazard of developing MDD than the patients in the comparison cohort (adjusted HR = 3.08, 95% CI = 2.90~3.27). Conclusions: In this study, we demonstrate that tinnitus is associated with an increased hazard of subsequent MDD in Taiwan.

Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts.

AIMS AND OBJECTIVES: To investigate whether the sleep quality and fatigue of female nurses working rotating shifts could be used to predict future turnover status. BACKGROUND: Female nurses working rotating shifts often suffer from sleep problems and fatigue, and the turnover rates of nurses are generally higher than those of other hospital personnel. DESIGN: A prospective study. METHODS: We recruited a total of 198 female nurses working rotating shifts from December 2017 to March 2019. The nurses completed the Checklist Individual Strength (CIS) scale and wore an actigraph for seven consecutive days in order to collect their sleep parameters. Their turnover status was tracked until 31 May 2021 at which time 55 participants (27.8%) had resigned. The Cox proportional hazard model was used to analyse the factors influencing turnover. In addition, the study adhered to the STROBE checklist. RESULTS: The results revealed significant differences between the nurses in the still-working group and the resigned group in terms of the sleep quality parameters sleep efficiency (SE) and wake after sleep onset (WASO) as well as CIS scores. WASO was significantly correlated with intensity of fatigue, and fatigue was common among all of the nurses working rotating shifts. As time progressed, the sleep quality parameter WASO and CIS scores could be used to predict turnover status after 2.4 years. CONCLUSION: The results of this study indicated more sleep fragmentation and poor sleep efficiency in the resigned group. Sleep fragmentation was highly correlated with fatigue, and sleep fragmentation and fatigue could be used to predict turnover status. RELEVANCE TO CLINICAL PRACTICE: We suggest that relevant hospital management pay more attention to the sleep conditions and fatigue of female nurses working rotating shifts when arranging personnel and schedules and offer them more understanding.

Influence of Obesity on Heart Rate Variability in Nurses with Age and Shift Type as Moderators.

Obesity is a risk factor of cardiovascular disease-related mortality and may be associated with changes in the autonomic nerve activity. Nurses working shifts and caring for patients are under great mental and physical pressure, and research has proven that these can negatively affect the body. The objective of this study was to examine the influence of obesity in nurses on their heart rate variability (HRV) and determine whether age or shift type moderates this influence. A questionnaire survey and HRV measurements were conducted on nurses at a hospital in Taiwan during a routine employee health checkup. HRV analysis was conducted using a noninvasive HRV monitor for five minutes. A total of 242 nurses with a mean age of 28.98 ± 6.56 years were enrolled in this study. An overly large waist circumference (WC) had a negative impact on high frequency (HF), low frequency (LF), and standard deviation of normal-to-normal interval (SDNN), while an overly high body mass index (BMI) had a negative impact on very low frequency (VLF) and SDNN. The interaction term "overly large WC × age" had a negative impact on HF (ß = -0.21, p = 0.010) and LF (ß = -0.18, p = 0.030), whereas the interaction term "overly high BMI×age" had a negative impact on HF (ß = -0.27, p = 0.001), LF (ß = -0.19, p = 0.023), and VLF (ß = -0.17, p = 0.045). The interaction terms "overly large WC × shift type" and "overly high BMI × shift type" did not influence any HRV parameters. As age increased, so did the degree to which the HF and LF of nurses with an overly large WC were lower than normal, and so did the degree to which the HF, LF, and VLF of nurses with an overly high BMI were lower than normal.

Bacterial Dynamics in the Accessory Nidamental Gland of Sepioteuthis lessoniana throughout Maturation.

The accessory nidamental gland (ANG) is part of the reproduction organ in the majority of female cephalopods, including the bigfin reef squid Sepioteuthis lessoniana, an economically important fishery product. Microbes in Alphaproteobacteria, Gammaproteobacteria, and Verrucomicrobia have been suggested to play a role in the maturation of the S. lessoniana ANG and are responsible for its color. However, the bacterial composition and dynamics of the different maturation stages of the ANG remain unclear. In the present study, we surveyed ANG-associated bacterial dynamics in wild-caught S. lessoniana at various developmental stages in different populations over 3 years. The results obtained showed that the ANG bacterial community shifted gradually and decreased in diversity throughout maturation. Verrucomicrobia occupied the ANG during the early stages in large numbers, and was replaced by Bacteroidia, Alphaproteobacteria, and Gammaproteobacteria in the later stages. Flavobacteriales and Alphaproteobacteria both appeared to contribute to pigmentation, while Bacteroidia, Alphaproteobacteria, and Gammaproteobacteria may be involved in enriching the heme biosynthesis pathway in the ANG with the maturation of S. lessoniana. The present results provide an open question of whether S. lessoniana actively selects the bacterial community in the ANG to adjust to its surrounding environment.

A Nationwide Population-Based Study on the Association between Land Transport Accident and Peripheral Vestibular Disorders.

This case-control study aimed to investigate the association of peripheral vestibular disorders (PVD) with subsequent land transport accidents. Data for this study were obtained from Taiwan's National Health Insurance (NHI) dataset. We retrieved 8704 subjects who were newly found to have land transport accidents as cases. Their diagnosis date was used as their index date. Controls were identified by propensity score matching (one per case, n = 8704 controls) from the NHI dataset with their index date being the date of their first health service claim in 2017. Multiple logistic regressions were performed to calculate the prior PVD odds ratio of cases vs. controls. We found that 2.36% of the sampled patients had been diagnosed with PVD before the index date, 3.37% among cases and 1.36% among controls. Chi-square test revealed that there was a significant association between land transport accident and PVD (p < 0.001). Furthermore, multiple logistic regression analysis suggested that cases were more likely to have had a prior PVD diagnosis when compared to controls (OR = 2.533; 95% CI = 2.041-3.143; p < 0.001). After adjusting for age, gender, hypertension, diabetes, coronary heart disease, and hyperlipidemia, cases had a greater tendency to have a prior diagnosis of PVD than controls (OR = 3.001, 95% CI = 2.410-3.741, p < 0.001). We conclude that patients with PVD are at twofold higher odds for land transport accidents.

Natal origin and migration pathways of Mekong catfish (Pangasius krempfi) using strontium isotopes and trace element concentrations in environmental water and otoliths.

To improve our knowledge of the migration pathway of a highly threatened fish species along the Mekong River, strontium isotope ratios (87Sr/86Sr) and 18 trace element concentrations were measured in the water and in the otoliths of an anadromous catfish, Pangasius krempfi, to infer its natal origin and potential migration pathways. Water was sampled at 18 locations along the mainstream, tributaries and distributaries of the Mekong River. To check for accuracy and precision, measurements of the 87Sr/86Sr ratios and trace element concentrations were then compared in two laboratories that use different analytical methods. Differences in trace element concentrations between locations were not significant and could not, therefore, be used to discriminate between migration pathways. However, the Mekong mainstream, tributaries and distributaries could all be discriminated using Sr isotopes. The 87Sr/86Sr profiles recorded in P. krempfi otoliths showed that there were three contingents with obligate freshwater hatching and variable spawning sites along the Mekong mainstream, from Phnom Penh (Cambodia) to Nong Khai (Thailand) or further. After hatching, the fish migrated more or less rapidly to the Mekong Delta and then settled for most of their lifetime in brackish water. Spawning habitats and migration routes may be threatened by habitat shifts and the increasing number of hydropower dams along the river, especially the contingents born above Khone Falls (Laos). The conservation of P. krempfi, as well as other migratory fish in the Mekong River, requires agreements, common actions and management by all countries along the Mekong River. This study highlighted the importance of using both Sr/Ca and 87Sr/86Sr ratios to understand life history of anadromous fishes as the 87Sr/86Sr ratio in the water was shown to be less effective than the Sr/Ca ratio in identifying movements between different saline areas.

Increased Risk of Injury Following a Diagnosis of Vertigo: A Population-based Study.

BACKGROUND: This study aimed to evaluate whether peripheral vestibular disorders (PVD) are associated with subsequent injury. METHODS: Data for this follow-up study were retrieved from the Taiwan's National Health Insurance (NHI) Dataset. A total of 251,355 patients with newly diagnosed PVD during January 2015 to December 2016 was identified as the study cohort, the diagnosis date being their index date. Comparison patients were identified by propensity score-matching (one per case, n = 251,355 controls) from the remaining NHI beneficiaries in 2015 with their index date being the date of their first health service claim in 2015. We tracked each subject's claims history for 1 year from the index date to identify those who suffered an injury. Cox proportional hazards regressions were performed to calculate the injury hazard ratio of cases versus controls. RESULTS: The incidence of injury during 1-year follow-up was 128.6 (95% CI = 127.6-129.5) per 1,000 person-years, 158.2 (95% CI = 156.8-159.6) and 97.5 (95% CI = 96.3-98.7) among the study and comparison cohorts, respectively. After adjusting for demographic variables, the hazard ratio (HR) for injury during 1-year was 1.663 (95% CI: 1.636-1.690) for cases relative to controls. CONCLUSIONS: Patients with PVD were at a higher risk for a wide range of injuries, most of all, joint dislocation and sprain. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:1633-1638, 2021.