Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 40.146
Filtrar
2.
Medicina (Kaunas) ; 57(6)2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34198775

RESUMO

Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients' data were collected with a mean age of 32.9. Among them, those who had CD4 positive cell number less than 350/mL were eligible to have highly active antiretroviral therapy (HAART). Patients were divided into group-1 that contains 45 treatment-naïve participants, and group-2 that includes 155 HAART treatment-experienced participants. MetS prevalence between group-1 and group-2 was 18% and 31%, respectively. The Framingham Risk Score (FRS) for the naïve and experienced groups were 4.7 ± 4.2 and 3.87 ± 5.92, respectively. High triglyceride (TG > 150 mg/dL) in group-1 and group-2 were 15.6% and 36.6% (p < 0.05), whereas, lower high-density lipoprotein (HDL < 39 mg/dL) in group-1 and group-2 presented as 76.7% versus 51% (p < 0.05), respectively. In group-2, treatment with protease inhibitors (PIs) resulted in higher TG levels when compared with non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (InSTIs). The prevalence of MetS in the treatment-naïve group was lower than that of the treatment-experienced group; high TG level resulted in higher MetS prevalence in the treatment-experienced group. In contrast, the cardiovascular risk of FRS in the treatment-naïve group was higher than that of the treatment-experienced group, which may result from the low HDL level. Although group-1 participants have a higher risk of developing CVDs, in group-2, an increasing TG level in PIs user indicated higher CVDs risk. TG and HDL are two significant biofactors that required regular evaluation in HIV-positive individuals.


Assuntos
Doenças Cardiovasculares , Infecções por HIV , Síndrome Metabólica , Estudos Transversais , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Prevalência , Fatores de Risco , Taiwan
3.
Molecules ; 26(13)2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34203213

RESUMO

In the present investigation, we compared the radical-scavenging activities and phenolic contents of seven Taiwanese Cirsium species with a spectrophotometric method. We further analyzed their phytochemical profiles with high-performance liquid chromatography-photodiode array detection (HPLC-DAD). We found that the flower part of Cirsium japonicum var. australe (CJF) showed the best radical-scavenging activities against 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and the hypochlorite ion, for which the equivalents were 6.44 ± 0.17 mg catechin/g, 54.85 ± 0.66 mmol Trolox/g and 418.69 ± 10.52 mmol Trolox/g respectively. CJF also had the highest contents of total phenolics (5.23 ± 0.20 mg catechin/g) and phenylpropanoids (29.73 ± 0.72 mg verbascoside/g). According to the Pearson's correlation coefficient, there was a positive correlation between the total phenylpropanoid content and ABTS radical-scavenging activities (r = 0.979). The radical-scavenging activities of the phenylpropanoids are closely related to their reducing power (r = 0.986). HPLC chromatograms obtained in validated HPLC conditions confirm that they have different phytochemical profiles by which they can be distinguished. Only CJF contained silicristin (0.66 ± 0.03 mg/g) and silydianin (9.13 ± 0.30 mg/g). CJF contained the highest contents of apigenin (5.56 ± 0.09 mg/g) and diosmetin (2.82 ± 0.10 mg/g). Among the major constituents, silicristin had the best radical-scavenging activities against DPPH (71.68 ± 0.66 mg catechin/g) and ABTS (3.01 ± 0.01 mmol Trolox/g). However, diosmetin had the best reducing power and radical-scavenging activity against the hypochlorite anion (41.57 ± 1.14 mg mmol Trolox/g). Finally, we found that flavonolignans (especial silicristin and silydianin) and diosmetin acted synergistically in scavenging radicals.


Assuntos
Cirsium/química , Sequestradores de Radicais Livres/química , Compostos Fitoquímicos/química , Extratos Vegetais/química , Taiwan
4.
Sensors (Basel) ; 21(13)2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34283134

RESUMO

Smartwatches are being increasingly used in research to monitor heart rate (HR). However, it is debatable whether the data from smartwatches are of high enough quality to be applied in assessing the health impacts of air pollutants. The objective of this study was to assess whether smartwatches are useful complements to certified medical devices for assessing PM2.5 health impacts. Smartwatches and medical devices were used to measure HR for 7 and 2 days consecutively, respectively, for 49 subjects in 2020 in Taiwan. Their associations with PM2.5 from low-cost sensing devices were assessed. Good correlations in HR were found between smartwatches and certified medical devices (rs > 0.6, except for exercise, commuting, and worshipping). The health damage coefficients obtained from smartwatches (0.282% increase per 10 µg/m3 increase in PM2.5) showed the same direction, with a difference of only 8.74% in magnitude compared to those obtained from certified medical devices. Additionally, with large sample sizes, the health impacts during high-intensity activities were assessed. Our work demonstrates that smartwatches are useful complements to certified medical devices in PM2.5 health assessment, which can be replicated in developing countries.


Assuntos
Poluentes Atmosféricos , Avaliação do Impacto na Saúde , Poluentes Atmosféricos/análise , Frequência Cardíaca , Humanos , Material Particulado/análise , Taiwan
5.
Artigo em Inglês | MEDLINE | ID: mdl-34205325

RESUMO

Patients might be willing to pay more to obtain better quality medical services when they recognize that high-level hospitals have better quality. However, published papers have not found solid empirical evidence to support this possibility. Therefore, the purpose of this study is to empirically investigate patients' willingness to pay (WTP) for an outpatient copayment. The study aims to analyze the difference between the two WTP values: to implement a hierarchy of medical care and to improve the quality of medical services. This study administered a questionnaire using the contingent valuation method with a quasi-bidding game for patients' WTP and the SERVQUAL scale for medical service quality. The Wilcoxon signed-rank test was employed to test the difference between the two WTP values, notably to implement a hierarchy of medical care and to improve the quality of medical services. Both of the WTP values are higher than the academic medical centre's current copayment NT$420 (approximately US$14); the percentage of respondents willing to pay a higher copayment declined when the outpatient copayment was increased, and the patients' WTP to have better medical service quality was significantly higher than that to implement a hierarchy of medical care. Patients' desire to receive better medical services from higher-level hospitals might be stronger than their desire to implement hierarchical medical care. This study reported the relationship between the respondents' perceived medical service quality and WTP for having better service quality by using regression models. The respondents' perceptions of medical service quality, especially for "reliability" and "assurance," would positively affect their WTP. Policy makers should focus on improving the quality of medical services.


Assuntos
Financiamento Pessoal , Pacientes Ambulatoriais , Serviços de Saúde , Humanos , Inquéritos e Questionários , Taiwan
6.
Artigo em Inglês | MEDLINE | ID: mdl-34205439

RESUMO

(1) Background: Trace metal (TM) contamination of farmland soil in Taiwan occurs because factories dump wastewater into irrigation ditches. Since vermicompost affects the bioavailability of TMs, the objective of this study was to evaluate its effects on the accumulation of growth of TMs in leafy vegetables. (2) Methods: Two TM-contaminated soils and different types of pak choi and lettuce were used and amended with vermicompost. Besides soil properties, the study assessed vermicompost's influence on the growth, accumulation, and chemical forms of TMs and on the health risks posed by oral intake. (3) Results: Vermicompost could increase the content of soil organic matter, available phosphorus, exchangeable magnesium, and exchangeable potassium, thus promoting the growth of leafy vegetables. The accumulation of four TMs in crops under vermicompost was reduced compared to the control, especially for the concentration of cadmium, which decreased by 60-75%. The vermicompost's influence on changing the chemical form of TMs depended on the TM concentrations, type of TM, and crop species; moreover, blanching effectively reduced the concentrations of TMs in high-mobility chemical forms. Although vermicompost mostly reduced the amount of cadmium consumed via oral intake, cadmium still posed the highest health risk compared to the other three TMs.


Assuntos
Metais Pesados , Poluentes do Solo , Cádmio/análise , Metais Pesados/análise , Solo , Poluentes do Solo/análise , Taiwan , Verduras
7.
Artigo em Inglês | MEDLINE | ID: mdl-34207241

RESUMO

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.


Assuntos
Diabetes Mellitus , Hipertensão , Acidentes , Estudos de Casos e Controles , Humanos , Razão de Chances , Taiwan/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34207812

RESUMO

We examined multidimensional factors within four systems (individual, family, school, and community) that influence internet addiction across time among children through adolescence in Taiwan. We hypothesize that internet addiction increases from childhood to adolescence and that resilience, child neglect, positive school experiences, and community violence are significant predictors at baseline and of the rate of change across time. Based on stratified random sampling, a valid sample size of 6233 Taiwanese children participated in our study, which we began in 2014 and then followed this sample in 2016 and 2018 using repeated measures. We used hierarchical linear modeling to model changes in internet addiction across time (with equal two-year intervals between assessments) and the associations between the predictors and internet addiction over time. The results show that internet addiction increases from childhood to adolescence. After controlling for gender, we found that resilience and positive school experiences predict less internet addiction, whereas neglect and community violence predict greater internet addiction. Over time, greater resilience predicts a decreasing trajectory of internet addiction, whereas greater neglect and community violence predict a slower increasing trajectory and positive school experiences predict a faster-increasing trajectory. A holistic approach can help children cope with internet addiction.


Assuntos
Comportamento Aditivo , Maus-Tratos Infantis , Adolescente , Comportamento Aditivo/epidemiologia , Criança , Humanos , Internet , Transtorno de Adição à Internet , Estudos Longitudinais , Taiwan/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-34208074

RESUMO

During pregnancy, a woman's enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be "Decreased then Increased" (56.8%). Other noticeable patterns were "Continuously Increased" (28.4%), "Increased then Decreased" (10.5%) and "Continuously Decreased" (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants' major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the "moderately distressful" level. This study provides evidence that could be used to predict women's pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.


Assuntos
Parto , Gestantes , Adulto , Feminino , Humanos , Estudos Longitudinais , Projetos Piloto , Gravidez , Taiwan/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-34208194

RESUMO

In 2020, Taiwan's healthcare system faced a notable burden imposed by the coronavirus disease (COVID-19) pandemic. Emergency department (ED) is a high-risk area for severe acute respiratory syndrome coronavirus 2 transmission. The effect of COVID-19 on the utilization of ED services among frequent ED users remains unknown. This cohort study determined the impact of the COVID-19 pandemic on healthcare-seeking behaviors among frequent ED users at Taipei City Hospital, Taiwan. We included ED users aged ≥ 18 years admitted to Taipei City Hospital during February 2019-January 2020 (before the pandemic) and February 2020-January 2021 (during the pandemic). Frequent ED users were patients with four or more ED visits per year. Stepwise logistic regression was performed to identify predictors of frequent ED use during the COVID-19 pandemic. Frequent ED users had shorter hospital stays in the ED during the pandemic. After adjusting for sociodemographic factors and other covariates, patients with a triage status of level 4-5, pneumonia diagnosis, giddiness, or dyspnea were more likely frequent ED visitors during the COVID-19 pandemic. To reduce the risk of acquiring COVID-19, it is important to utilize territorial healthcare or telehealth to avoid inappropriate ED visits for patients with a low level of risk or chronic disease.


Assuntos
COVID-19 , Telemedicina , Estudos de Coortes , Serviço Hospitalar de Emergência , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Taiwan/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34198623

RESUMO

This study investigated the influences of nursing assistants' job competency on their intrinsic and extrinsic satisfaction and intention to stay in the profession of long-term care institutions. Understanding the relationship between job competency and job satisfaction, both intrinsic and extrinsic, would enable institutions to strengthen service workers' intention to stay and to retain essential personnel. This study was a cross-sectional study in which nursing assistants from 26 nursing homes and 15 elderly welfare institutions in Taiwan. The relationship between job competency and intention to stay was discovered to be significantly mediated by intrinsic and extrinsic job satisfaction. Given the staff shortages and difficulty retaining staff in long-term care environments, organizations must be able to strengthen employees' intention to stay; one suggestion is to improve the employees' competency, because higher competency results in higher quality of care and greater extrinsic job satisfaction. Furthermore, greater job competency is more likely to result in affirmation and accomplishment, both of which increase intrinsic job satisfaction and thus positively influence intention to stay.


Assuntos
Satisfação no Emprego , Assistentes de Enfermagem , Idoso , Estudos Transversais , Humanos , Intenção , Reorganização de Recursos Humanos , Inquéritos e Questionários , Taiwan
12.
Artigo em Inglês | MEDLINE | ID: mdl-34200552

RESUMO

Prior studies on adverse outcomes of parental corporal punishment on children have focused on examining one of two broad domains of parental corporal punishment: parental beliefs or actual use. Recently, researchers have argued that parental belief and actual use of corporal punishment should work jointly to contribute to children's depression and involvement in school violence. Yet, studies supporting this proposition are lacking. This study examined the indirect link from parental attitudes towards corporal punishment to children's depression and school violence involvement through actual use of corporal punishment. Four hundred and thirty-three elementary school students and their parents in Taiwan participated in this study. The results indicate that positive parental attitudes towards corporal punishment do not predict children's depression and involvement in school violence. However, parental attitudes towards corporal punishment had significant indirect relationships with depression and involvement in school violence through the actual use of corporal punishment. These findings applied to both genders. This study supports the proposition that parental attitudes and the actual use of corporal punishment could work together to predict children's depression and school violence. Future intervention programs for decreasing children's depressive symptoms and involvement in school violence might need to tackle corporal punishment in the family.


Assuntos
Bullying , Maus-Tratos Infantis , Adolescente , Criança , Depressão/epidemiologia , Feminino , Humanos , Masculino , Punição , Instituições Acadêmicas , Taiwan/epidemiologia , Violência
13.
Molecules ; 26(12)2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34204654

RESUMO

Vanilla (Vanilla planifolia) is a precious natural flavoring that is commonly used throughout the world. In the past, all vanilla used in Taiwan was imported; however, recent breakthroughs in cultivation and processing technology have allowed Taiwan to produce its own supply of vanilla. In this study, headspace solid-phase microextraction (HS-SPME) combined with GC-FID and GC-MS was used to analyze the volatile components of vanilla from different origins produced in Taiwan under different cultivation and processing conditions. The results of our study revealed that when comparing different harvest maturities, the composition diversity and total volatile content were both higher when the pods were matured for more than 38 weeks. When comparing different killing conditions, we observed that the highest vanillin percentage was present after vanilla pods were killed three times in 65 °C treatments for 1 min each. From the experiment examining the addition of different strains, the PCA results revealed that the volatiles of vanilla that was processed with Dekkera bruxellensis and Bacillus subtilis was clearly distinguished from which obtained by processing with the other strains. Vanilla processed with B. subtilis contained 2-ethyl-1-hexanol, and this was not detected in other vanillas. Finally, when comparing the vanillin percentage from seven different regions in Taiwan, vanilla percentage from Taitung and Taoyuan Longtan were the highest.


Assuntos
Vanilla/química , Vanilla/metabolismo , Compostos Orgânicos Voláteis/química , Agricultura/métodos , Benzaldeídos/química , Benzaldeídos/isolamento & purificação , Cromatografia Gasosa/métodos , Aromatizantes/análise , Cromatografia Gasosa-Espectrometria de Massas/métodos , Extratos Vegetais/análise , Microextração em Fase Sólida/métodos , Taiwan , Compostos Orgânicos Voláteis/análise
14.
Artigo em Inglês | MEDLINE | ID: mdl-34280979

RESUMO

The present study aimed to identify the distinct classes of motivations to get vaccinated and to adopt preventive behaviors against the coronavirus disease 2019 (COVID-19) among people in Taiwan and to examine the roles of Protection Motivation Theory (PMT) cognitive constructs in these unique classes of motivations to get vaccinated and to adopt preventive behaviors. We recruited 1047 participants by using a Facebook advertisement. Participants' motivations to get vaccinated and to adopt preventive behaviors against COVID-19, PMT constructs of threat appraisal (perceived severity and perceived vulnerability), and PMT constructs of coping appraisal (self-efficacy, response efficacy, response cost, knowledge, and previous vaccination for seasonal influenza) were determined. We analyzed participants' motivations to get vaccinated and to adopt preventive behaviors against COVID-19 by using latent profile analysis. The present study identified three latent classes, including the participants with high motivation for vaccination and preventive behaviors (the class of Both High), those with low motivation for vaccination and preventive behaviors (the class of Both Low), and those with high motivation for vaccination but low motivation for preventive behaviors (the class of High Vaccination but Low Preventive Behaviors). Compared with the participants in the class of Both High, participants in the class of Both Low had lower levels of perceived vulnerability, perceived severity, self-efficacy to have vaccination, response efficacy of vaccination, knowledge about vaccination, and previous vaccination for seasonal influenza; participants in the class of High Vaccination but Low Preventive Behaviors had lower levels of perceived vulnerability and perceived severity but higher levels of response cost of vaccination. We concluded that varieties of motivations, threat, and coping appraisals should be considered in intervention programs aiming to increase motivation to adopt recommended protective behaviors against COVID-19.


Assuntos
COVID-19 , Motivação , Estudos Transversais , Humanos , SARS-CoV-2 , Inquéritos e Questionários , Taiwan , Vacinação
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(7): 910-915, 2021 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-34304431

RESUMO

Objective: To understand the employment situation of graduates of public health-related majors and explore the associated factors of turnover intention among public health practitioners in China. Methods: In April 2020, the convenient sampling method was used to recruit public health related graduates from 98 universities with public health-related majors from 31 provinces in China (excluding Hong Kong, Macao and Taiwan) and from Chinese Center for Disease Control and Prevention (only including working or unemployed status, no requirement for graduation years). A total of 1 322 questionnaires were collected, of which 1 165 (88.1%) were valid. Through the network questionnaire survey, the information of public health graduates' work situation, job satisfaction and turnover intention were collected. Multivariate logistic regression model was used to analyze the associated factors of turnover intention, and structural equation model was constructed to explore the correlation between turnover intention and job satisfaction. Results: The age of 1 165 graduates was (28.1±4.8) years. Among them, 719 (61.7%) were female and 856 (73.5%) graduates were engaged in public health-related work after graduation. The results of multivariate logistic regression analysis showed that compared with those over 30 years old, graduates under 30 years old had higher turnover intention (OR=2.531, 95%CI: 1.549-4.155). Compared with those with junior or no title, graduates with senior title had higher turnover intention (OR=2.310, 95%CI: 1.047-5.162). The results of structural equation model analysis showed that the four factors of job satisfaction, 'salary and welfare', 'promotion development', 'work itself', and 'internal and external environment', were negatively correlated with turnover intention. The internal and external environment had the greatest impact on turnover intention (total effect =-0.539). Conclusion: Most graduates of public health-related majors are engaged in public health-related work in China. Age, professional title and job satisfaction are the associated factors of turnover intention.


Assuntos
Intenção , Saúde Pública , Adulto , China , Estudos Transversais , Emprego , Feminino , Hong Kong , Humanos , Satisfação no Emprego , Macau , Inquéritos e Questionários , Taiwan , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-34202996

RESUMO

We aimed to evaluate factors influencing the outcomes of patients with platinum-sensitive recurrent epithelial ovarian carcinoma (EOC). Patients with advanced-stage EOC, who received debulking surgery and adjuvant chemotherapy for recurrence, were obtained from the National Health Insurance Research database of Taiwan between 2000 and 2013. A total of 1038 patients with recurrent advanced-stage EOC were recruited. The platinum + paclitaxel (PT) group had the best five-year overall survival (OS) compared with the other three groups (p < 0.001). The hazard ratios (HRs) of five-year OS for the platinum + liposomal doxorubicin (PD), topotecan (TOP), and pegylated liposomal doxorubicin (PLD) groups were 1.21 (p = 0.07), 1.35 (p = 0.016), and 1.80 (p < 0.001), respectively, compared with the PT group. The PT group also had lower hazard ratios of five-year OS for patients with platinum therapy-free interval (TFIp) between 6 and 12 months compared with the other three groups (p < 0.0001). However, the HRs of five-year OS did not differ between the PT and PD groups in patients with TFIp >12 months. Patients with TFIp >12 months had lower HRs of five-year OS compared with those with TFIp of 6-12 months, regardless of whether they were treated with platinum-based (p = 0.001) or non-platinum-based (p = 0.003) regimens. Chemotherapeutic regimens and TFIp influenced the outcomes of patients with recurrent EOC. For patients with TFIp of 6-12 months, the PT regimen is the first choice based on their best overall survival result. For patients with TFIp >12 months, either platinum-based or non-platinum regimens could be used because of their similar excellent overall survival.


Assuntos
Neoplasias Ovarianas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Epitelial do Ovário/tratamento farmacológico , Feminino , Humanos , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Estudos Retrospectivos , Taiwan/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-34204785

RESUMO

Although corticosteroids can serve as an effective anti-inflammatory adjuvant therapy, the role of adjunctive steroid therapy in pediatric bacterial meningitis in Taiwan remains under-investigated. Cases of acute bacterial meningitis, aged between 1 month and 20 years, were divided into a steroid group (empirical antibiotics with adjunctive steroid therapy) and a non-steroid group (empirical antibiotics only). Data were identified from the annual hospitalization discharge claims of the National Health Insurance Research Database using the International Classification of Diseases, Ninth Revision codes. Of the 8083 episodes enrolled in this study, 26% (2122/8083) and 74% (5961/8083) were divided into the steroid and non-steroid groups, respectively. The fatality rates were 7.9% in the steroid group and 1.7% in the non-steroid group during hospitalization (p < 0.0001). In the steroid and non-steroid groups, the median length of hospital stay was 13 and 6 days, respectively (p < 0.0001). Medical costs (median (interquartile range)) of hospitalization were 77,941 (26,647-237,540) and 26,653 (14,287-53,421) New Taiwan dollars in the steroid and non-steroid groups, respectively (p < 0.0001). The steroid group had a more fulminant course at baseline, a higher fatality rate, length of hospital stay, and medical cost of hospitalization. Therefore, the beneficial effects of the adjunctive use of corticosteroids in pediatric bacterial meningitis are inconclusive, and additional prospective multicenter investigations are required to clarify this issue.


Assuntos
Meningites Bacterianas , Anti-Inflamatórios/uso terapêutico , Criança , Humanos , Lactente , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/epidemiologia , Estudos Prospectivos , Esteroides/uso terapêutico , Taiwan/epidemiologia
18.
J Environ Manage ; 294: 112938, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34214943

RESUMO

The present study uses agent-based modeling (ABM) to examine the effectiveness of a nudge policy for improving recycling behavior. In our simulation, agents' recycling behavior is computed by components of the Theory of Planned Behaviour (i.e., attitudes, perceived behavioral control, social norms) and influenced by other agents as well as their surrounding (i.e., amount of waste in the area). The simulation, based on real data from a Taiwan community district, confirms realistic recycling trends and demonstrates the usefulness and reliability of ABM as a method to examine the effectiveness of waste management policies. An additional step in our simulation was to manipulate the amount of waste in the community to test the effect of a nudge policy based on social norms. Results showed that the policy increases recycling activity, but predominantly in low waste scenarios. This suggests that nudges, in the form of norm-based policies, can be an effective solution to enhancing people's recycling behavior under specific circumstances.


Assuntos
Reciclagem , Gerenciamento de Resíduos , Humanos , Políticas , Reprodutibilidade dos Testes , Análise de Sistemas , Taiwan
19.
J Med Microbiol ; 70(7)2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34236300

RESUMO

Introduction. Outbreaks of carbapenem-resistant A. baumannii and A. nosocomialis have occurred worldwide in healthcare settings. Rapid and reliable molecular typing of bacterial isolates is vital for the effective surveillance of institutional outbreaks. The Pan-PCR and OXA-PCR assays are two multiplex PCR-based assays for the molecular typing of Acinetobacter species.Gap statement. However, few studies have investigated the discriminatory power of two multiplex PCR assays in in the genotyping of Acinetobacter species.Aim. We aimed to evaluate the efficacies of the Pan-PCR and OXA-PCR assays for molecular typing of A. baumannii and A. nosocomialis.Methodology. A total of 105 carbapenem-resistant A. baumannii isolates (CRABs) and 93 carbapenem-resistant A. nosocomialis isolates (CRANs) obtained from blood cultures were used for molecular typing by the Pan-PCR and OXA-PCR assays and two multilocus sequence typing (MLST) schemes.Results. The isolates were individually divided into 12 and 21 different sequence types via the Pasteur and Oxford MLST schemes, respectively. Additionally, these isolates were distinguished into 18 different types by the Pan-PCR and OXA-PCR assays. The results of the Pan-PCR and OXA-PCR assays distinguished CRABs and CRANs with a sensitivity of 98.13 % and a specificity of 100 %.Conclusion. The Pan-PCR and OXA-PCR assays are promising alternative methods for rapid molecular typing of CRABs and CRANs in a routine laboratory setting.


Assuntos
Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/genética , Acinetobacter/efeitos dos fármacos , Acinetobacter/genética , Carbapenêmicos/farmacologia , Reação em Cadeia da Polimerase/métodos , Acinetobacter/classificação , Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/classificação , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Humanos , Taiwan/epidemiologia
20.
Aging (Albany NY) ; 13(13): 17237-17252, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34214049

RESUMO

Genetic background has been considered one of the important contributors to the rate of cognitive decline among patients with Alzheimer's disease (AD). We conducted a 4-year longitudinal follow-up study, recruited 255 AD and 44 mild cognitive impairment (MCI) patients, and used a data-driven trajectory analysis to examine the influence of selected AD risk genes on the age for and the rate of cognitive decline in Han Chinese population. Genotyping of selected single-nucleotide polymorphisms in the APOE, ABCA7, SORL1, BIN1, GAB2, and CD33 genes was conducted, and a Bayesian hierarchical model was fitted to analyze the trajectories of cognitive decline among different genotypes. After adjusting for sex and education years, the APOE ε4 allele was associated with an earlier mean change of -2.39 years in the age at midpoint of cognitive decline, the G allele in ABCA7 rs3764650 was associated with an earlier mean change of -1.75 years, and the T allele in SORL1 rs3737529 was associated with a later mean change of 2.6 years. Additionally, the rate of cognitive decline was associated with the APOE ε4 allele and SORL1 rs3737529. In summary, APOE and SORL1 might be the most important genetic factors related to cognitive decline in Han Chinese population.


Assuntos
Doença de Alzheimer/epidemiologia , Doença de Alzheimer/genética , Grupo com Ancestrais do Continente Asiático/genética , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/genética , Idoso , Idoso de 80 Anos ou mais , Apolipoproteínas E/genética , Feminino , Seguimentos , Genótipo , Humanos , Proteínas Relacionadas a Receptor de LDL/genética , Estudos Longitudinais , Masculino , Proteínas de Membrana Transportadoras/genética , Testes de Estado Mental e Demência , Polimorfismo de Nucleotídeo Único , Taiwan/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...