Search

Purpose: Vitamin D supplementation positively impacts anemia, but the relationship between a ferritin-related dietary pattern, iron parameters, and vitamin D in anemia is unclear. Methods: This cross-sectional study analyzed data from the 2017–2019 National Nutrition and Health Survey, including 1423 pregnant women over 15 years old. Dietary intake was assessed using a semi-quantitative food frequency questionnaire and a 24-hour dietary recall. The FrDP was identified using reduced rank regression with blood parameters as response variables and 32 food groups as predictors. Linear and binomial logistic regression analyses evaluated the associations between the FrDP and serum biomarkers, adjusting for demographic and dietary variables. Risk associations between the FrDP and vitamin D concentrations were also assessed. Results: The FrDP explained 18.5% of the variation in 6 response variables and was characterized by high consumption of fish, soy, gluten pasta, nuts, organ meat, pickled vegetables, and marine plants. The FrDP correlated positively with serum hemoglobin (r = 0.76), iron (r = 0.52), ferritin (r = 0.79), folate (r = 0.86), and vitamin B12 (r = 0.86). Linear regression revealed a positive association between the FrDP and serum iron. Women in the highest FrDP tertile were less likely to have low serum iron (OR = 0.65, 95% CI 0.50–0.85) but more likely to have low 25(OH) vitamin D concentrations (OR = 1.79, 95% CI 1.32–2.43). Conclusions: The FrDP was positively associated with serum iron but negatively associated with serum 25(OH) vitamin D in pregnant women. [ABSTRACT FROM AUTHOR]

Patients at risk of chronic kidney disease (CKD) must be identified early and precisely in order to prevent complications, save lives, and limit expenditures for patients and health systems. This study aimed to develop a simple, high-precision machine learning model to identify individuals at risk of developing CKD in the near future, using a novel metabolic index with or without creatinine. This retrospective cohort study used data from the MJ medical record database collected between 2001 and 2015 in Taiwan. We used Cox hazard regression to identify potential predictors, including the novel metabolic index, for use as variables in the models. To develop a machine learning-based CKD risk model with fewer variables, we performed several experimental analyses to combine interacting variables into subsets. Those subsets were used to train three models, random forest, logistic regression, and XGBoost, with or without adding creatinine. The study included 12,189 participants, 20% with and 80% without CKD. The most important conventional predictors of CKD are age and gender. The novel metabolic index, TyG-Index, TG/HDL-ratio and VAI, had stronger predictive power than the conventional risk factors. Without including creatinine data, the XGBoost provided the best predictive performance. After adding creatinine, the performance of all the models was excellent, outperforming both conventional indicators and existing clinical algorithms for CKD. Using novel metabolic index in machine learning-based CKD risk prediction can accurately identify individuals at risk of diagnosis with CKD in the next year, with or without including creatinine. [ABSTRACT FROM AUTHOR]

Unhealthy diet and inappropriate lifestyle contribute to an imbalance in cardiometabolic profiles among postmenopausal women. This research aimed to analyze the association between dietary pattern and changes in cardiovascular risk factors among postmenopausal Taiwanese women using binary logistic regression. This cross-sectional study involved 5689 postmenopausal Taiwanese women aged 45 years and above, and the data were obtained from Mei Jau Health Management Institution database between 2001 and 2015. The cardiovascular risk dietary pattern characterized by high intakes of processed food, rice/flour products, organ meat, and sauce was derived by reduced rank regression. Participants in the highest quartile of the cardiovascular risk dietary pattern were more likely to have high levels of systolic blood pressure (OR = 1.29, 95% CI 1.08–1.53), diastolic blood pressure (OR = 1.28, 95% CI 1.01–1.62), atherogenic index of plasma (OR = 1.26, 95% CI 1.06–1.49), triglycerides (OR = 1.38, 95% CI 1.17–1.62), and fasting blood glucose (Q3: OR = 1.45, 95% CI 1.07–1.97). However, this dietary pattern was not correlated with total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and C-reactive protein. Therefore, adherence to the cardiovascular risk dietary pattern increases the risk of having higher levels of blood pressure, triglycerides, fasting blood glucose in postmenopausal Taiwanese women. [ABSTRACT FROM AUTHOR]

(1) Background: Nutritional intake is fundamental to human growth and health, and the intake of different types of nutrients and micronutrients can affect health. The content of the diet affects the occurrence of disease, with the incidence of many diseases increasing each year while the age group at which they occur is gradually decreasing. (2) Methods: An artificial intelligence model for precision nutritional analysis allows the user to enter the name and serving size of a dish to assess a total of 24 nutrients. A total of two AI models, including semantic and nutritional analysis models, were integrated into the Precision Nutritional Analysis. A total of five different algorithms were used to identify the most similar recipes and to determine differences in text using cosine similarity. (3) Results: This study developed two models to form a precision nutrient analysis model. The 2013–2016 Taiwan National Nutrition Health Status Change Survey (NNHS) was used for model verification. The model's accuracy was determined by comparing the results of the model with the NNHS. The results show that the AI model has very little error and can significantly improve the efficiency of the analysis. (4) Conclusions: This study proposed an Intelligence Precision Nutrient Analysis Model based on a digital data collection framework, where the nutrient intake was analyzed by entering dietary recall data. The AI model can be used as a reference for nutrition surveys and personal nutrition analysis. [ABSTRACT FROM AUTHOR]

The best cochlear–neural delay model for designing a chirp that can produce the largest auditory brainstem response (ABR) has not been established. This study comprised two experiments. Experiment I aimed to estimate the delay model by measuring derived-band ABR latencies at different levels. The results demonstrated that, as the level decreased, the delay between the center frequencies of 0.7 and 5.7 kHz increased. The aim of experiment II was to compare ABRs generated by three stimuli: (1) a level-dependent derived-band (DB)-Chirp, designed based on the model in experiment I; (2) a level-dependent level specific (LS)-Chirp from Kristensen and Elberling [(2012). J. Am. Acad. Audiol. 23, 712–721]; and (3) a click. The results demonstrated that the DB-Chirp produced significantly larger wave V than the LS-Chirp at 45 dB normal hearing level (nHL); however, no differences were observed at other levels. The wave I generated by the DB-Chirp and LS-Chirp were significantly larger than those evoked by the click at 45 and 60 dB nHL and at 30 and 45 dB nHL, respectively; however, at all levels, no differences between these two chirps were observed. The DB-Chirp may be a valuable stimulus for producing ABRs for clinical applications such as assessing cochlear synaptopathy and estimating hearing sensitivity. [ABSTRACT FROM AUTHOR]

Patients with chronic obstructive pulmonary disease (COPD) are at higher risk of stroke. This study aimed to investigate the clinical factors of stroke risk in COPD and allied conditions patients and associations between medications for treating COPD and allied conditions. The population-based study cohort comprised 24,173 patients diagnosed with COPD and allied conditions between 2000 and 2013, and 24,170 selected matched patients without COPD comprised the comparison cohort from a nationwide database. Cox-proportional hazard regression was performed to determine the impact of medical therapies, comorbidities, and other clinical factors on stroke risk. Of the 48,343 included patients, 1394 (2.9%) experienced stroke during follow-up, with a significant difference between COPD and allied conditions cohort (1003/4.2%) and comparison cohort (391/1.6%) (adjusted hazard ratio [aHR]: 2.72, p < 0.001). Cox-regression analysis revealed that COPD and allied conditions patients who were older (>65 years) (HR: 1.06); male (HR: 1.39); with hypertension (HR: 1.46), diabetes mellitus (HR: 1.33) and atrial fibrillation (HR: 1.63) had increased stroke risk. Mucolytics (HR: 0.44) and combination therapy with inhaled corticosteroids (ICS) and long-acting β2-agonists (LABA) (HR: 0.75) were associated with decreased stroke risk in COPD and allied conditions patients. Among COPD and allied conditions patients, major comorbidities increase risk of stroke. Therapy with mucolytic agents and combination ICS/LABA is associated with risk reduction. [ABSTRACT FROM AUTHOR]

Background: Anemia and electrolyte disturbances are adverse outcomes of chronic kidney disease (CKD). This study explored the association between metabolic parameters with anemia and electrolyte and mineral disorders among CKD patients in Taiwan.Methods: This cross-sectional study with a total of 2176 CKD stages 3-5 patients were collected from the Department of Nephrology at Shuang Ho Hospital, Taipei Medical University through the "Chronic Kidney Disease Common Care Network" database from December 2008 to April 2019. A multivariable-adjusted logistic regression expressed as odd ratios (OR) was performed to assess the association of metabolic parameters with anemia and electrolyte and mineral disorders.Results: Elevated diastolic blood pressure, fasting blood glucose, and glycated hemoglobin A1c (HbA1c) were associated with presence of anemia. Similarly, elevated fasting blood glucose and HbA1c were associated with hyponatremia (OR = 1.59 and 1.58, P for both < 0.01) and hypercalcemia (OR = 1.38 and 1.33, P for both < 0.05). There was no significant association in serum lipid levels with presence of anemia. However, total triglycerides, total cholesterol and low-density lipoprotein-cholesterol were only associated with presence of hypercalcemia (OR = 1.43, 1.95 and 3.08, respectively, P for all < 0.05).Conclusions: Elevated diastolic blood pressure, fasting blood glucose, HbA1c and blood lipids are associated with anemia or electrolyte and mineral disorders in CKD patients. [ABSTRACT FROM AUTHOR]

Background: Dietary patterns were associated with the risk of chronic disease development and outcome-related diseases. In this study, we aimed to compare the correlation between dietary patterns and metabolic syndrome (MetS) using two methods for identifying dietary patterns.Methods: The participants (n = 25,569) aged ≥40 years with impaired kidney function were retrieved from Mei Jau (MJ) Health Screening database from 2008 to 2010. Dietary patterns were identified by principal component analysis (PCA) and reduced rank regression (RRR) from twenty-two food groups using PROC FACTOR and PROC PLS functions.Results: We identified two similar dietary pattern characteristics (high intakes of deep fried foods, preserved or processed foods, dipping sauce, meat, sugary drinks, organ meats, jam/honey, fried rice/flour products, instant noodles and eggs) derived by PCA and RRR. Logistic regression analysis revealed that RRR-derived dietary pattern scores were positively associated with an odds ratio (OR = 1.70, 95% CI: 1.56, 1.86) of having MetS than PCA-derived dietary pattern scores (OR = 1.38, 95% CI: 1.27, 1.51). The correlations between RRR-derived dietary pattern scores and elevated systolic and diastolic blood pressure (OR = 1.30 for both) or low high density lipoprotein cholesterol in women (OR = 1.32) were statistically significant but not significant in PCA-derived dietary pattern scores.Conclusions: Our findings suggest that RRR gives better results when studying behavior related dietary patterns in association with MetS. RRR may be more preferable to provide dietary information for developing dietary guidelines among people with MetS. Further studies with prospective measurements are needed to verify whether RRR is a useful analytic tool for the association between dietary patterns and other chronic diseases. [ABSTRACT FROM AUTHOR]

Cancer is the leading cause of death in Taiwan, according to the Ministry of Health and Welfare (2017), with cancers of the trachea, bronchus, and lung being the most prevalent. Thus, it is critically important to study this disease. By using Taiwan's National Health Insurance Research Database (NHIRDB), which covers 99.9% of residents, we are capable of analyzing comorbidities and predicting the outcomes of the clinical therapy. This study focuses on non-small cell lung cancer. We first obtain cancer registration indexes from two million individual patient records in NHIRDB by screening patients of having a clinical diagnosis of ICD C33-34 (trachea, bronchus and lung cancer). Then, we used these cancer registration indexes to find all the therapies and comorbidity of the patients and used them as input parameters to establish a predictive model of survival probability for lung cancer. Linear and nonlinear data mining methods were employed to build prediction models to study the effects of different therapies on the 3-year survival probability of lung cancer patients. We found that the artificial neural network (ANN) model performs better than the logistic regression (LR) model. It comes out that the best point of the ANN model on the ROC curve is at sensitivity = 77.6%, specificity = 76.8% and AUROC = 83%. [ABSTRACT FROM AUTHOR]

Background: Hypokalemia is a common clinical problem. The association between urinary tract infection (UTI) and hypokalemia is not clear. Hypokalemia is common in patients with UTI in clinical observation. The aim of the study is to determine if UTI is associated with hypokalemia.Methods: Patients hospitalized with UTI and the control group were retrieved from the Longitudinal Health Insurance Database 2005. The control group was patients hospitalized with other reasons and were matched for the confoundings of UTI and hypokalemia. We analyze the risk of hypokalemia using logistic regression and calculate the odds ratio (OR) and 95% confidence interval (CI) of OR.Results: We analyzed 43,719 UTI patients and control patients. Hypokalemia was found in 4540 (10.4%) patients with UTI and 1842 (4.2%) control patients. The percentage of patients with hypokalemia was higher in UTI patients (chi-square, p < 0.001). UTI was associated with hypokalemia and the odds ratio (OR) was 2.27 [95% confidence interval (CI): 2.17-2.41]. Cerebrovascular accident, chronic obstructive pulmonary disease, hypertension, congestive heart failure, diarrhea, medications including thiazides, sulfonamides, xanthines, and laxatives were independently associated with hypokalemia. Recurrent UTI was associated with hypokalemia in UTI patients (OR: 1.13, 95% CI: 1.05-1.23, p < 0.001).Conclusions: Urinary tract infection is associated with hypokalemia among inpatients. The association is independent of patients' comorbidities and medications. Recurrent UTI is associated with increased hypokalemia in UTI patients. [ABSTRACT FROM AUTHOR]

Because of the increasing adoption and use of technology in primary health care (PHC), public health informatics competencies (PHIC) are becoming essential for public health workers. Unfortunately, no studies have measured PHIC in resource-limited setting. This paper describes the process of developing and validating Public Health Informatics Competencies for Primary Health Care (PHIC4PHC), an instrument for measuring PHC workers' competencies in public health informatics. Method: This study developed a questionnaire that had three stages: the Delphi technique, a pretest, and field test. Eleven academicians from a university and 13 PHC workers joined 2 rounds of group discussion in the first stage. The second stage comprised two pilot studies with 75 PHC workers in Semarang Municipality. The third stage involved validating the questionnaire with 462 PHC workers in Kendal District. This study used Pearson's product-moment correlation for the validity check and Cronbach's alpha coefficient for determining the internal consistency. This study used the K-means algorithm for clustering the results of the PHIC4PHC questionnaire. Results and Conclusion: PHIC4PHC is the first comprehensive PHIC questionnaire administered in a resource-limited setting, consisting of 11 indicators and 42 measurement items concerning knowledge of health information systems, skills required for health data management, ethical aspects of data sharing and health information literacy. The final results of PHIC4PHC were clustered into three classes based on the K-means algorithm. Overall, 45.7% PHC workers achieved medium competency, whereas 25.6% and 27.7% achieved low and high competency, respectively. Men had higher competency than women. The higher the worker's level of education, the higher the PHIC level; the longer the worker's work experience, the lower the PHIC score; and the greater the worker's age, the lower the PHIC score. Measuring and monitoring PHIC is vital to support successful health IT adoption in PHC. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of obesity has become a pandemic problem, and dietary patterns are one of the important factors causing obesity. Although the correlation between dietary patterns and obesity has been well explored, the gender difference on the association between dietary patterns and obesity remains unclear. The objective of this study examined whether gender difference existed in the relationship of dietary patterns with metabolic parameters and specific indices of adiposity among young and middle-aged adults with dyslipidemia and abnormal fasting plasma glucose (FPG) in Taiwan.Methods: A total of 14,087 subjects aged between 20 and 50 years with dyslipidemia and abnormal FPG were recruited in Taiwan between 2001 and 2010 for a cross-sectional study. Dyslipidemia was defined primarily according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with minor modification. Abnormal FPG level was defined by the American Diabetes Association. Principal component analysis was conducted to identify dietary patterns. Multivariate logistic regression analysis was performed to evaluate the association of dietary patterns and metabolic parameters with different indices of adiposity including general obesity, central obesity, and high body fat, stratified by gender.Results: Two dietary patterns derived from principal component analysis were the prudent dietary pattern and the western dietary pattern. Both men and women in the highest quartile of the western dietary pattern had a significantly increased odds ratio of general obesity, central obesity, and high body fat. However, only male subjects in the higher quartiles of the prudent dietary pattern had a significantly decreased odds ratio of all indices of obesity. Both men and women with higher high-density lipoprotein cholesterol and total cholesterol levels had a significantly reduced odds ratio of general and central obesity, while those with higher triglycerides and FPG levels had a significantly increased odds ratio of general and central obesity. Higher low-density lipoprotein cholesterol level was significantly associated with an elevated odds ratio of high body fat, while higher total cholesterol level was significantly correlated with a reduced odds ratio of high body fat only in women.Conclusions: Gender difference exists in the association of dietary patterns and metabolic parameters with obesity and body fat in young and middle-aged adults with dyslipidemia and abnormal FPG in Taiwan. [ABSTRACT FROM AUTHOR]

Low adherence to leprosy treatment is the main challenge in Indonesia. This is a quasi-experimental observational study in a real setting of a leprosy control program in Indonesia. The study is aimed at evaluating an e-leprosy framework in increasing the rate of on-time attendance at primary health care and on-time completion of treatment of leprosy patients. This study has implemented an e-leprosy framework for primary health care at Pekalongan District. The intervention was conducted for 19 months to observe a 1-episode long-term treatment of leprosy patients. The study collected data of 391 registered patients from June 2012 to March 2016. Based on the inclusion and exclusion criteria, this study selected 188 patients. The SMS (short message service) reminders proved to be effective in increasing on-time completion and on-time attendance rates by 21% and 14.6%, respectively. There is a trend for late collections of the drugs at the 3rd, 8th, and 11th multidrug therapy drug collections. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effectiveness of home telehealth care combined with case management by public health nurses, in improving blood pressure control in patients with hypertension.Methods: This cohort study examined the data of patients with hypertension obtained from a telehealth service centre database, between July 2011- June 2012. Eligible patients were adults (≥40 years old) with both prehypertension and hypertension, living alone or in the remote suburbs of metropolitan areas. Demographic data were collected from 12 district public health centre in Taipei, Taiwan. Following enrolment, patients received an appropriate and validated home telehealth device kit for automatic blood pressure monitoring and automated modem via a telephone line or a desktop computer with Internet connection to enable data transmission between the patient's home and telehealth service centre. Patients were instructed to upload the measured data immediately every day. The study outcomes included blood pressure and home telehealth service utilisation.Results: Of the 432 patients recruited, 408 (94%) completed data collection. Linear regression analysis found an average 22.1 mm Hg reduction in systolic blood pressure after one year. The mean slope of systolic blood pressure was classified as decreased or non-decreased. An systolic blood pressure decreasing trend was observed in 52.2% patients, while 47.8% patients showed an increasing systolic blood pressure trend. Patients in the decreased systolic blood pressure group tended to be older ( p = 0. 0001), with a greater proportion of hypertension alarms ( p = 0. 001), improved self-blood pressure monitoring behaviour ( p = 0.009) and higher self-measured blood pressure monitoring frequency ( p = 0. 010). Patients in the decreased systolic blood pressure group had a higher self-measured blood pressure monitoring frequency (odds ratio = 0.95, 95% confidence interval, 0.91-0.99, p = 0. 013) than their counterparts.Conclusions: Home telehealth care combined with care management by public health nurses based in public health care centre was feasible and effective for improving blood pressure control among patients with hypertension. Further studies should conduct a thorough analysis of the cost-effectiveness of this intervention. A randomised controlled trial with a longer follow-up period is required to examine the effects of the improved home telehealth device kit on the care of patients with hypertension. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the association of thiazolidinedione and its dose effect with the risk of Parkinson’s disease (PD) in patients with diabetes mellitus (DM). Methods: This study enrolled 38,521 patients with newly-diagnosed DM, between 2001 and 2013, and compared them to the matched subjects without DM. The hazard ratios (HRs) for PD were compared between the thiazolidinedione-treated and non-thiazolidinedione-treated groups of the study cohort, and between subgroups who received different cumulative dosages of thiazolidinedione. Results: We observed that 544 (1.4%) patients developed PD during the follow-up median duration of 6.2 years in patients with newly-diagnosed DM or had a higher risk for PD than patients without DM (HR = 1.150). In the study cohort, the risk of PD was significantly lower in the thiazolidinedione-treated group (HR = 0.399) compared to the non-thiazolidinedione-treated group. Thiazolidinedione reduced the risk of PD in a dose-dependent manner, with HRs ranging from 0.613 to 0.081 with defined daily doses of 0-90 to >720, respectively. Conclusions: Thiazolidinedione use was associated with a significantly reduced risk of PD in patients with newly-diagnosed DM. Further studies to elucidate the common mechanism of PD and DM may provide novel therapies for these two diseases. Key messages: Newly-diagnosed diabetes mellitus slightly increases the risk for Parkinson’s disease. Thiazolidinedione is associated with a lower risk of Parkinson's disease in a dose-dependent manner in patients with newly-diagnosed diabetes mellitus. [ABSTRACT FROM AUTHOR]

This study examined the correlation of dietary patterns with components of metabolic syndrome (MetS) and inflammation among middle-aged and older adults with MetS in Taiwan. This cross-sectional study used data from the Mei Jau International Health Management Institution in Taiwan between 2004 and 2013. A total of 26,016 subjects aged 35 years and above were selected for analysis. MetS was defined according to the International Diabetes Federation. Three dietary patterns were identified by principal component analysis. High intake of a meat-instant food dietary pattern (rich in animal protein, saturated fat, sweets, sodium, and food additives) was positively associated with components of MetS and C-reactive protein (CRP), while high intake of a vege-seafood dietary pattern (rich in dietary fiber, vitamins, minerals, and unsaturated fat) or a cereal-dairy dietary pattern (rich in dietary fiber, antioxidants, phytochemicals, complex carbohydrate, prebiotics, and probiotics) was inversely associated with components of MetS and CRP. Our findings suggested that intake of a vege-seafood dietary pattern or a cereal-dairy dietary pattern decreased the risk of developing MetS and inflammation among middle-aged and older adults with MetS. [ABSTRACT FROM AUTHOR]

Background: Diet has been associated with differences in weight and nutritional status of an individual. The prevalence of overweight and obesity increased among adults in Taiwan. Hence, we examined the relationship between dietary patterns and weight status by gender among middle-aged and older adults in Taiwan.Methods: The cross-sectional data of 62,965 participants aged ≥40 years were retrieved from the Mei Jau health screening institutions' database collected from 2001 and 2010. Diet information was evaluated using a food frequency questionnaire, while the dietary patterns were derived using principal component analysis before summing up and dividing into quintiles of consumption. The association between dietary patterns and weight status among adult men and women was explored using multinomial logistic regression models. Three models were analyzed before stratifying data by gender.Results: Two dietary patterns were derived with one reflecting a high consumption of vegetables and fruits (vegetable-fruit dietary pattern) and the other a high consumption of meat and processed foods (meat-processed dietary pattern). After adjustment, highest consumption of vegetables and fruits (Q5) reduced the likelihood of being overweight (OR = 0.91; 95% CI, 0.85-0.97) or obese (OR = 0.85; 95% CI, 0.78-0.92), while highest consumption of meat and processed foods increased the likelihood of being overweight (OR = 1.50; 95% CI, 1.40-1.59) or obese (OR = 1.94; 95% CI, 1.79-2.10). Women were less likely to be overweight or obese with the highest intake of fruits and vegetables (Q5) while both genders were more likely to be overweight or obese with high consumption of meat and processed foods.Conclusions: High intake of vegetables and fruits is associated with lower odds of being overweight or obese, especially among women. But, high intake of meat and processed foods is associated with higher odds of overweight and obesity in both genders. [ABSTRACT FROM AUTHOR]

Objective: To assess the factors associated with malnutrition among children <5 years in Burkina Faso.Design: This study was based on secondary analysis of cross-sectional population-based data from Burkina-Faso Demographic Health Surveys 2010.Setting: This study was carried out in Burkina Faso, West Africa.Participants: The participants were 6337 children <5 years and their mothers.Main Outcome Measures: Demographic characteristics, child nutrition and health status, and maternal and household information were collected. Survey-specific SAS procedures for weighting, clustering and stratification in the survey design were used. The distribution of different nutritional status, such as underweight, stunting and wasting and the effects of risk factors on malnutrition was analyzed.Results: Out of 6337 children <5 years, 51.0% of children were male and 57.8% of children had an average size at birth. There were 15.6, 21.5 and 10.6% of children who recently suffered from diarrhea, fever and acute respiratory infection, respectively. Child sex, age, size at birth, child morbidity, mother's education and body mass index and household wealth index were significantly associated with undernutrition among children <5 years in Burkina Faso.Conclusions: In addition to the improvement of household wealth index, more health and nutritional education for mothers should be implemented by the government to improve health and nutritional status of children <5 years in Burkina Faso. [ABSTRACT FROM AUTHOR]

Background & aims: Irritable bowel syndrome (IBS) manifests as chronic abdominal pain. One pathophysiological theory states that the brain–gut axis is responsible for pain control in the intestine. Although several studies have discussed the structural changes in the brain of IBS patients, most of these studies have been conducted in Western populations. Different cultures and sexes experience different pain sensations and have different pain responses. Accordingly, we aimed to identify the specific changes in the cortical thickness of Asian women with IBS and to compare these data to those of non-Asian women with IBS. Methods: Thirty Asian female IBS patients (IBS group) and 39 healthy individuals (control group) were included in this study. Brain structural magnetic resonance imaging was performed. We used FreeSurfer to analyze the differences in the cortical thickness and their correlations with patient characteristics. Results: The left cuneus, left rostral middle frontal cortex, left supramarginal cortex, right caudal anterior cingulate cortex, and bilateral insula exhibited cortical thinning in the IBS group compared with those in the controls. Furthermore, the brain cortical thickness correlated negatively the severity as well as duration of abdominal pain. Conclusions: Some of our findings differ from those of Western studies. In our study, all of the significant brain regions in the IBS group exhibited cortical thinning compared with those in the controls. The differences in cortical thickness between the IBS patients and controls may provide useful information to facilitate regulating abdominal pain in IBS patients. These findings offer insights into the association of different cultures and sexes with differences in cortical thinning in patients with IBS. [ABSTRACT FROM AUTHOR]

Background: We hypothesize that autoantibodies are induced after the blood-brain barrier is damaged by stroke and the risk of bullous pemphigoid (BP) is increased after stroke. We assess the risk of BP after first-ever stroke in a nationwide population-based cohort of first-ever stroke patients. Methods: We extracted data from the Longitudinal Health Insurance Database 2005 and identified patients with first-ever stroke as well as control patients matched for age, gender, and year of enrollment. The risk of BP in first-ever stroke patients in comparison with that in control patients was analyzed using Cox regression. Results: Of 12,607 patients with first-ever stroke, 38 (0.3%) patients developed BP in a median of 3.5 years. In the control patients, 8 persons (0.06%) had BP in a median of 3.7 years. The crude hazard ratio (HR) of BP in first-ever stroke patients was 4.83 (95% CI 2.25-10.34, p < 0.001) compared to the control group. The adjusted HR was 4.20 (95% CI 1.94-9.08, p < 0.001) after adjustments for age, gender, hypertension, diabetes, dementia, epilepsy, Parkinson disease, furosemide, and neuroleptics for stroke patients. Conclusions: The risk of BP is increased in first-ever stroke patients in a nationwide population-based cohort and this association is independent of well-known confounders of BP. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective cohort study used a population-based dataset to test the risk for parkinsonism in patients receiving flunarizine and cinnarizine, compared with matched controls. Methods: Data were obtained from the National Health Insurance Research Dataset of Taiwan. Patients receiving flunarizine or cinnarizine for more than 1 month between 2000 and 2005 were enrolled. Exclusion criteria included receiving flunarizine, cinnarizine, or antipsychotics for more than 1 month during 1997-1999, a history of neurodegenerative diseases, and an age of less than 30 years. One matched control for each patient was selected. Each participant was followed for diagnosis of parkinsonism within a 3-year observation period. Stroke, diabetes mellitus, total prescription days, and doses of flunarizine or cinnarizine were recorded. Results: The study and control groups consisted of 9830 subjects. In the study group, 280 patients (2.9 %) were diagnosed with parkinsonism with a median observation period of 1.2 years, and 49 participants (0.5 %) were diagnosed in the control group with a median observation period of 1.9 years. The adjusted hazard ratio for parkinsonism among patients receiving flunarizine and cinnarizine was 5.117 (95 % CI = 3.758-6.967). Age, stroke, and diabetes mellitus were significant risk factors, but female sex and total doses of the study drugs were not. Conclusions: This study demonstrates that flunarizine and cinnarizine significantly increase the risk for parkinsonism. The treatment benefits of these two agents should be balanced with this adverse effect. Physicians must look carefully for early signs of parkinsonism in patients treated with flunarizine and cinnarizine. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is one of the leading causes of mortality and loss of disability-adjusted life years in developed countries. This study derived a dietary pattern using an a priori method and additionally derived dietary patterns using a posteriori methods, and assessed the relationship with CVD risk factors in Taiwanese middle-aged and elderly adults. Methods: Cross-sectional analyses of 62,965 subjects aged 40 years and above from the Mei Jau (MJ) database collected between 2003 and 2012 in Taiwan. Diet was assessed using a 22 item semi-quantitative food frequency questionnaire. Using this information, three dietary patterns were generated. The a priori diet was labeled the Taiwanese dietary pattern and was derived using hypothesized effect of 22 food groups, while two a posteriori dietary patterns, “vegi-fruits” and “meat-processed”, were derived using principal component analysis. The association between dietary patterns and a range of CVD risk factors (i.e. blood lipids, blood glucose and C-reactive protein) was evaluated using linear regression. Results: The results showed that high intake (Q5, quintile 5) of Taiwanese diet was negatively associated with CVD risk factors at (p < 0.001, model 3), but not with triacylglycerol. In addition, high intake of vegi-fruit dietary pattern (Q5) was negatively associated with CVD risk factors (p < 0.001), but not with high-density lipoprotein, while high consumption of meat-processed dietary pattern (Q5) was positively associated with CVD risk factors (p < 0.001), but negatively related with triacylglycerol in Q3 level and no association with C-reactive protein. Conclusion: A negative association was observed between Taiwanese or vegi-fruit dietary patterns and CVD risk factors, while a positive association was found between meat-processed dietary pattern and CVD risk factors. The findings suggested that a diet rich in vegetables and fruits has a beneficial effect in the management of CVD risk factors. [ABSTRACT FROM AUTHOR]

Heart disease is the leading cause of death worldwide. Therefore, assessing the risk of its occurrence is a crucial step in predicting serious cardiac events. Identifying heart disease risk factors and tracking their progression is a preliminary step in heart disease risk assessment. A large number of studies have reported the use of risk factor data collected prospectively. Electronic health record systems are a great resource of the required risk factor data. Unfortunately, most of the valuable information on risk factor data is buried in the form of unstructured clinical notes in electronic health records. In this study, we present an information extraction system to extract related information on heart disease risk factors from unstructured clinical notes using a hybrid approach. The hybrid approach employs both machine learning and rule-based clinical text mining techniques. The developed system achieved an overall microaveraged F-score of 0.8302. [ABSTRACT FROM AUTHOR]

Objective: To explore the associations between different dietary patterns and semen quality in a general Asian male population. Methods: Cross-sectional study. Healthy Taiwanese men aged 18 years or older who participated in a standard medical screening program from 2008-2013 run by a private firm were included in this study. Semen parameters including sperm concentration (SC), total sperm motility (TSM), progressive motility (PRM) and normal sperm morphology (NSM) were recorded. A dietary questionnaire was used to categorize the participants into 5 groups: “Healthy diet”, “Western diet”, “High-carbohydrate diet”, “High sweet snacks & sugar-sweetened drinks” and “High-sodium diet”. Results: A total of 7282 men completed the questionnaire regarding dietary pattern, and examination of anthropometric indexes was performed and laboratory data were obtained. A high intake of a “Western diet” resulted in statistically linear declines of SC and NSM (P < 0.001 and P < 0.001). Similarly, a greater intake of “High sweet snacks & sugar-sweetened drinks” was associated with a lower SC (P = 0.001). Increased intake of a “High-carbohydrate diet” was related to higher prevalences of abnormal TSM and PRM (P = 0.012 and P = 0.025). Similarly, a greater intake of a “High-sodium diet” was correlated with an elevated prevalence of abnormal NSM (P = 0.035). Conclusions: This study showed that a greater intake of a “Western diet” is associated with poorer SC and NSM, a “High sweet snacks and sugar-sweetened drinks” intake is correlated with a lower SC, and high-carbohydrate food is related to elevated prevalences of abnormal TSM and PRM. [ABSTRACT FROM AUTHOR]

This study aimed to explore the association between body mass index (BMI), other anthropometric indexes and semen quality in a general male population in Taiwan. In this cross-sectional cohort study, the study cohort consisted of 7941 healthy male individuals aged 18 years or older who participated in a standard medical screening program run by a private firm from January 2008 to May 2013. Semen parameters including sperm concentration (SC), total sperm motility (TSM), progressive motility (PRM), and normal sperm morphology (NSM) were recorded. Anthropometric indexes including BMI, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body fat percentage were measured. A total of 7630 men were enrolled for the final analysis, of whom 68.5% had a normal weight distribution and 31.4% were overweight or obese. Total sperm motility, progressive motility, normal sperm morphology and sperm concentration showed a statistically linear decline with increasing age (p < 0.001, p < 0.001, p < 0.001 and p = 0.004). Sperm concentration showed a significantly negatively linear association with BMI (p = 0.005), and normal sperm morphology showed an inverse association with BMI and waist-to-height ratio (p < 0.001 and p = 0.004). The prevalence of abnormal total sperm motility, progressive motility, normal sperm morphology and sperm concentration increased with increasing age (p = 0.011, p < 0.001, p < 0.001 and p = 0.002). Lower normal sperm morphology and sperm concentration were associated with increasing body adiposity (p<0.05). No relationship between obesity and sperm motility was identified. [ABSTRACT FROM AUTHOR]

Homocysteine level can lead to adverse effects on the brain white matter through endothelial dysfunction, microstructural inflammation, and neurotoxin effects. Despite previously observed associations between elevated homocysteine and macroscopic structural brain changes, it is still unknown whether microstructural associations of homocysteine on brain tissue properties can be observed in healthy subjects with routine MRI. To this end, we investigated potential relationships between homocysteine levels and microstructural measures computed with diffusion tensor imaging (DTI) in a cohort of 338 healthy participants. Significant positive correlations were observed between homocysteine levels and diffusivity measures in the bilateral temporal WM, the brainstem, and the bilateral cerebellar peduncle. This is the first study demonstrating that DTI is sufficiently sensitive to relate microstructural WM properties to homocysteine levels in healthy subjects. [ABSTRACT FROM AUTHOR]

Sex-related factors play an important role in the pathophysiology of heart failure (HF). However, trends in sex-related differences in hospital management for HF are not clear. We identified patients hospitalized for HF through a nationwide database (National Health Insurance in Taiwan), containing 722,272 subjects from 1999 to 2008. Higher incidences of diabetes mellitus (37 vs. 25 %, p < 0.001), thyroid dysfunction (2 vs. 0 %, p < 0.001), and transient cerebral ischemia (2 vs. 1 %, p < 0.05), as well as a lower incidence of chronic lung disease (14 vs. 22 %, p < 0.001) differentiated female HF patients from male HF patients. During this 10-year period, both percentage of HF hospitalization and age-adjusted HF rates significantly increased for total HF sample (1.92 vs. 2.49  ‰, p < 0.05, and 20.44 vs. 27.38/100,000, p < 0.05) and for female (1.76 vs. 2.86  ‰, p < 0.05, and 20.94 vs. 32.12/100,000, p < 0.05), but such changes did not occur among male patients (2.12 vs. 2.09  ‰, p > 0.05, and 19.93 vs. 22.51/100,000, p > 0.05). The age at the time of hospitalization and the length of the hospital stay increased significantly for all HF patients during the 10-year study period. However, the daily cost of hospitalization increased in males, but not in females. Compared to the survivors, patients who died were older and had a longer hospitalization and higher daily cost both in males and females. Through our analysis of the NHI database, we observed trends in factors related to hospitalization of HF patients in Taiwan that may be attributable to sex-related differences in the pathophysiology and treatment strategies for HF. [ABSTRACT FROM AUTHOR]

The present study investigated dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS). A total of forty-five women (aged 25–40 years) with PCOS and 161 control women (aged 25–43 years) with non-PCOS-related infertility were recruited. Anthropometry, glucose tolerance and sex hormones were determined and dietary intake was assessed. Women with PCOS had lower serum sex hormone-binding globulin and increased BMI, waist:hip ratio, luteinising hormone, ratio of luteinising hormone:follicle-stimulating hormone, testosterone and free androgen index (FAI). Postprandial glucose, fasting insulin and insulin resistance were elevated in women with PCOS. Women with PCOS had reduced energy and carbohydrate intake but higher fat intake. Serum sex hormone-binding globulin level was negatively associated with BMI in both groups and negatively correlated with macronutrient intake in the PCOS group with hyperandrogenism. However, FAI was positively correlated with BMI, waist circumference and glucose metabolic parameters in both groups. Therefore, women with PCOS consume lower energy and carbohydrate compared with those with non-PCOS-related infertility and macronutrient intake is only negatively associated with serum sex hormone-binding globulin level in the PCOS group with hyperandrogenism. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Adverse drug reactions increase morbidity and mortality, and potential drug interactions (DIs) increase the probability of adverse drug reactions. Objectives: To survey the potential DIs of dermatologic outpatient prescriptions from the National Health Insurance Research Database of Taiwan. Methods: All prescriptions written by dermatologists in 2000 were analyzed to identify potential DIs among drugs appearing on the same prescription sheet. Results: Of 150.6 million prescription sheets with 669.5 million prescriptions registered in the National Health Insurance Research Database of Taiwan, we identified 6.6 million (4.4%) dermatology prescription sheets with 19 million (2.8%) prescriptions. The findings of the study showed that 283,458 potential DIs were found in this category, accounting for 1.49% per prescription. The most common significance Level 1 interaction (1.1%) was between the less-sedative antihistamines (terfenadine/astemizole) and azole antifungal agents. Among the category of severity, the most common was terfenadine interacting with cimetidine and ketoconazole (4.4%), followed by astemizole interacting with cimetidine and ketoconazole (2.9%). The most common drug class interaction occurred between corticosteroids and antacids (48.5%). Overall, DI incidence in dermatologic patients was lower than that of the general patient population. Conclusions: Based on the study findings, we concluded that dermatologists need to be reminded of having possible potential DIs when prescribing medications. Introducing information technology into the computerized physician order entry system into the daily practice may reduce potential DIs. [Copyright &y& Elsevier]

This paper compares the interoperability approaches of three countries: Taiwan, Denmark and Canada. The work maps out how various countries have addressed the interoperability problems as well as what factors affect decisions and the result, and in what manner. The key findings are as follows: (1) The federal government's ability to mandate standards affects choice of interoperability strategy; (2) E-Health status influences choice of interoperability strategy; (3) Differences in geography, population, and demographics affect the selection of national strategies towards interoperability. [ABSTRACT FROM AUTHOR]

The article focuses on the BioIPMall, a Web-based platform for analyzing and trading biomedical Internet Protocol (IP) and developing strategies for application development. BioIPMall, an open information-sharing platform accessible to individuals and institutions, has features including platform management and security, membership application and management, and IP searching and portfolio analysis capabilities. A seven-step process allows the use of the platform to transfer technology from research institutes and industry.