Predictors for psychological distress of young burn survivors across three years: A cohort study of a burn disaster in Taiwan.

PURPOSE: The study aims to investigate long-term psychological distress and its risk factors in the burn survivors. DESIGN: A longitudinal study with follow-up interviews was conducted from November 2015-June 2018. A post-burn baseline interview was conducted 6 months after the event, followed by annual surveys for three years. METHODS: The burn survivors received structured assessment through telephone in the four-wave interviews, including the five-item Brief Symptom Rating Scale (BSRS-5); two-item Patient Health Questionnaire (PHQ-2); four-item Startle, Physiological Arousal, Anger, and Numbness Scale (SPAN-4); and six-item Impact of Event Scale (IES-6) alongside demographic data and other health-related assessment. FINDINGS: A total of 180 respondents with the mean age of 23 years old completed the four waves of interview. Using the BSRS-5 as the outcome, each variable had different input in psychological distress during the follow-up years. The main finding was that the SPAN-4 score could predict more than 62% of psychological distress between 6 months and 3 years after the disaster. The generalized estimating equation demonstrated that SPAN-4, IES-6, family functioning impairment, hypnotics use, adaptation to the event, and PHQ-2 could predict psychological distress. However, the variable of follow-up year did not exemplify significant estimation in the model. CONCLUSIONS: The results indicated that different factors had various influences on psychological distress across the four follow-up stages. PTSD-like symptoms, depression, and anxiety were the most common psychological problems experienced by the young burn cohort in the longitudinal post-traumatic period. CLINICAL RELEVANCE: Healthcare providers should be aware of psychological consequences of traumatic events within up to a 3-year post-burn period, particularly post-traumatic stress, depression, and anxiety symptoms.

A longitudinal study on psychological reactions and resilience among young survivors of a burn disaster in Taiwan 2015-2018.

AIM: To investigate the long-term psychological reactions and resilient process of the young survivors after a large-scale burn disaster of the Formosa Color Dust Explosion in Taiwan. DESIGN: Longitudinal study with follow-up interviews using standardized questionnaire during November 2015-June 2018. METHODS: The burn survivors received structured assessment in the four-wave interviews including the five-item Brief Symptom Rating Scale, nine-item Concise Mental Health Checklist, and two-item Patient Health Questionnaire for depressive symptoms and suicide risk assessment. Post-traumatic psychological symptoms were assessed through the four-item Startle, Physiological Arousal, Anger, and Numbness Scale, and six-item Impact of Event Scale. FINDINGS: The response rates were 65.1%, 74.2%, 76.9%, and 78.5% across the four-wave interviews among 484 burn survivors. The participants were mean-aged 23.1 years with just over half having 40% or more burn wounds in total body surface area. The respondents at each wave were similar in gender, age, and per cent of total body surface area burned. In the first 2 years of recovery, the respondents showed resilience in coping with stress of trauma under family and social support. While there was a decreasing trend of psychological symptoms over the first 2 years, hypnotic use and alcohol consumption remained at about 10% in the final interview, which were accompanied by psychological symptom recurrence. CONCLUSION: Young burn survivors recovered both psychologically and physically under supportive care and personal resilience in 2 years after the burn event, yet post-traumatic mental distress and coping efforts after 2 years during community reintegration should be detected and managed. Early prevention and detection of mental health deterioration is needed even after 2 years of burn disasters. IMPACT: The study demonstrated post-burn longitudinal changes on psychological reactions. Nursing staffs may help young burn survivors identify mental distress and stress management needs in the long-term psychological adaptation process.

Changes in sugar composition during baking and their effects on sensory attributes of baked sweet potatoes.

The objective of this study was to evaluate the influence of sugar composition on the sensory attributes of seven baked sweet potatoes. The sugar composition was analyzed using high performance liquid chromatography. Results showed that the total sugar content of baked sweet potatoes increased significantly because of the formation of maltose. The maltose content dramatically increased after baking, and became the major sugar component of baked sweet potatoes. On the other hand, baked sweet potatoes were evaluated on a 7-point hedonic scale for sensory analysis. Overall acceptability results showed that the panelists preferred baked CYY95-26 and TNG66 over the other baked varieties. Because the correlation between overall acceptability and sweetness was the highest (r = 0.69, p < 0.01), sweetness was determined as the most important factor determining the overall acceptability of baked sweet potatoes. Although sugar composition changed on baking, the overall acceptability of baked sweet potatoes was highly associated with the sucrose content.

A knowledge elicitation approach to traffic accident analysis in open data: comparing periods before and after the Covid-19 outbreak.

Extracting knowledge from open data of traffic accidents has been attracting increasing attention to policymakers responsible for road safety. This article presents a knowledge elicitation approach to exploring the determinants of traffic accidents from open government data of an urban area in Taiwan. The collected open dataset contains 34 decisional attributes and one predictive attribute (i.e., type of injury, including head, breast, leg), and 47,974 cases. Prediction models using a classification-oriented mechanism and generated rules that considered datasets from before (B-dataset; 30,116 cases) and after (A-dataset; 17,868 cases) beginning to combat the Covid-19 pandemic in an urban area of Taiwan were compared. The findings showed that prediction accuracy was acceptable but not high, at 70.73% for B-dataset and 74.77% for A-dataset. Determinants in the human and vehicle categories revealed higher classification ranks than those in the temporal and environment categories. Traffic accidents involving motorcycles were 5.13% higher in A-dataset, whereas those involving cars were 4.11% lower. Injury on leg or foot was 3.46% higher in A-dataset, whereas other types of injury were up to 1.00% lower. The average support for rules in the A-dataset rule base and the simplicity of the A-dataset decision tree were higher than those of B-dataset. The research demonstrates the value of open government data in prediction model development and knowledge elicitation to support policymaking in the traffic safety domain.

Assessment and determinants of global outcomes among 445 mass-casualty burn survivors: A 2-year retrospective cohort study in Taiwan.

PURPOSE: To study outcomes among survivors of the mass-casualty powder explosion on 27 June 2015, at Formosa Fun Coast Waterpark, New Taipei City, Taiwan. METHODS: Using retrospective data on Taiwanese survivors, we analyzed prehospital management, burns assessment and prognosis, functional recovery, and medical costs, followed-up through 30 June 2017. We related outcomes to burn extent, categorized according to the percentages of total body surface area with second/third-degree burns (%TBSA) or autologous split-thickness skin grafts (%STSG), and an investigational scale: f{SASG} = (%TBSA + %STSG)/2, stratified by %STSG. Analyses included casualty dispersal, comparisons between %TBSA, %STSG and f{SASG}, and their relationships with length of hospitalization, times to rehabilitation and social/school re-entry, physical/mental disability, and medical costs. We also investigated how burn scars restricting joint mobility affected rehabilitation duration. RESULTS: 445 hospitalized casualties (excluding 16 foreigners, 23 with 0% TBSA and 15 fatalities) aged 12-38 years, had mean TBSA of 41.1%. Hospitalization and functional recovery durations correlated with %TBSA, %STSG and f{SASG} - mean length of stay per %TBSA was 1.5 days; more numerous burn scar contractures prolonged rehabilitation. Females had worse burns than males, longer hospitalization and rehabilitation, and later school/social re-entry; at follow-up, 62.3% versus 37.7% had disabilities and 57.7% versus 42.3% suffered mental trauma (all p ≤ 0.001). Disabilities affecting 225/227 people were skin-related; 34 were severely disabled but 193 had mild/moderate impairments. The prevalence of stress-related and mood disorders increased with burn extent. Treatment costs (mean USD-equivalents ∼$48,977/patient, ∼$1192/%TBSA) increased with burn severity; however, the highest %TBSA, %STSG and f{SASG} categories accounted for <10% of total costs, whereas TBSA 41-80% accounted for 73.2%. CONCLUSIONS: Besides %TBSA, skin-graft requirements and burn scar contractures are complementary determinants of medium/long-term outcomes. We recommend further elucidation of factors that influence burn survivors' recovery, long-term physical and mental well-being, and quality of life.

Multiplex PCR detection of enterotoxin genes in Aeromonas spp. from suspect food samples in northern Taiwan.

Aeromonads possess an array of virulence factors and are causative agents of a number of human infections. Among them, genes of one cytotoxic (Act) and two cytotonic (Alt, Ast) enterotoxins are implicated in a human diarrheal disease. A rapid, specific, simultaneous detection of these enterotoxin genes in suspected food poisoning samples is not yet reported. Hence, a multiplex PCR assay was designed to amplify the cytotoxic (act), heat-labile cytotonic (alt), and heat-stable cytotonic (ast) enterotoxin genes of aeromonads. The PCR assay was tested with 133 Aeromonas spp. isolated from suspect food poisoning samples and retail samples of poultry and fish from wet markets in and around Taipei, Northern Taiwan. The Aeromonas spp. isolates were divided into six genotypes based on absence or presence of one or more enterotoxin genes. Of these 133 isolates, Aeromonas caviae (52.5%) and Aeromonas hydrophila (43.4%) were the most frequently isolated species from food poisoning samples and retail samples, respectively. Among the species, A. hydrophila had a significantly higher proportion for harboring three enterotoxin genes than had the others, whereas Aeromonas encheleia, considered a nonpathogen, was found harboring three enterotoxin genes. The multiplex PCR assays are rapid and specific, and provide a useful tool for the detection and genotyping of enterotoxin genes of aeromonads.

Open data mining for Taiwan's dengue epidemic.

By using a quantitative approach, this study examines the applicability of data mining technique to discover knowledge from open data related to Taiwan's dengue epidemic. We compare results when Google trend data are included or excluded. Data sources are government open data, climate data, and Google trend data. Research findings from analysis of 70,914 cases are obtained. Location and time (month) in open data show the highest classification power followed by climate variables (temperature and humidity), whereas gender and age show the lowest values. Both prediction accuracy and simplicity decrease when Google trends are considered (respectively 0.94 and 0.37, compared to 0.96 and 0.46). The article demonstrates the value of open data mining in the context of public health care.

Identification of phostensin, a PP1 F-actin cytoskeleton targeting subunit.

We have identified a novel protein, protein phosphatase 1 F-actin cytoskeleton targeting subunit (phostensin). This protein is encoded by KIAA1949 and was found to associate with protein phosphatase 1 (PP1) in the yeast two-hybrid assay, co-immunoprecipitation, and GST pull-down assay. Northern blot analysis revealed that phostensin mRNA was predominantly distributed in leukocytes and spleen, and phostensin protein was present in crude extracts of human peripheral leukocytes. Immunofluorescence microscopic analysis revealed that the phostensin/PP1 complex was conspicuously localized with the actin cytoskeleton at the cell periphery in Madin-Darby canine kidney (MDCK) epithelial cells. Taken together, our data shows that phostensin targets PP1 to F-actin cytoskeleton. The phostensin/PP1 complex may play a vital role in modulation of actin rearrangements.