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Background Previous population-based studies in western countries had revealed increased skin cancer risk among transplant recipients compared to the general population. However, population-based studies in Asia on skin cancer among recipients of different transplanted organs were lacking in the literature. Aims This study aims to estimate skin cancer risk among recipients in Taiwan, examine the association between each specific type of skin cancer and each type of transplanted organ, and compare skin cancer risk between different immunosuppressive regimens. Methods This population-based retrospective cohort study identified 7550 patients with heart, lung, kidney or liver transplantation and 30,200 controls matched for gender, age and comorbidity index from the National Health Insurance Research Database in Taiwan between 2000 and 2015. Using multivariable Cox proportional hazard models, we estimated the hazard ratios and 95% confidence intervals for the correlation of skin cancer with organ transplantation as well as immunosuppressive regimen. Results Organ transplant recipients in Taiwan had an increased risk of skin cancer with adjusted hazard ratios of 4.327 (95% confidence intervals 2.740-6.837, P < 0.001), with the greatest risk, observed among heart recipients (adjusted hazard ratios 6.348, 95% confidence intervals 3.080-13.088, P < 0.001). The risk of non-melanoma skin cancer and melanoma was 4.473 (95% confidence intervals 2.568-7.783, P < 0.001) and 3.324 (95% confidence intervals 1.300-8.172, P < 0.001), respectively. When comparing immunosuppressants, those with calcineurin inhibitors carried the highest risk of skin cancer (adjusted hazard ratios 4.789, 95% confidence intervals 3.033-7.569, P < 0.001), followed by those with antimetabolites (adjusted hazard ratios 4.771, 95% confidence intervals 3.025-7.541, P < 0.001). Limitations We could not evaluate confounding behavioural risk factors of skin cancers that were not documented in the database, nor could we recognize patients’ compliance with immunosuppressants. Conclusion Organ recipients have a greater risk of skin cancer. Clinicians should inform recipients of the importance of photoprotection and regular dermatologic follow-up.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening adverse reactions to drugs and psychological sequelae are also observed to follow the trauma of widespread epidermal necrolysis. To delineate the association between SJS and TEN, and psychiatric disorders, we conducted a retrospective population-based cohort study by including 212 patients diagnosed with first-time SJS or TEN in Taiwan between 2000 and 2013 and 669 population controls. Adjusted hazard ratios were calculated after adjusting for sex, age, comorbidity in the form of Charlson comorbidity index, and facility level of care. Overall, SJS or TEN was associated with an increased risk of developing psychiatric disorders including schizophrenia, major depressive disorder, mania, anxiety, and bipolar with an adjusted hazard ratio of 1.392 (95% CI, 1.192-1.625; p 0.001). Particularly, the adjusted hazard ratios of psychiatric disorders were 1.290 (95% CI, 1.105-1.506; p 0.001) for SJS and 1.855 (95% CI, 1.587-2.167; p 0.001) for TEN.

Due to the impact of COVID-19, a large number of employees of organizations around the world have been forced to work remotely from home starting in 2020. As a result, leaders and followers face new communication and interaction challenges. If an enterprise is to be successful in the new wave of economic development, it must embrace the role of employee followers. However, there is currently no relevant research. Therefore, the purpose of this study is to analyze the interaction between organic leadership and implicit followers from the perspective of followers who are working remotely and further analyze their relationship with trust in their supervisor, organizational citizenship behavior, and active followership. Using the method of questionnaire measurement, multigroup analysis and ANCOVA and PLS-SEM analysis found the following. First, difference in leadership styles (IV) and implicit followers (IV) had significant effects on employees’ trust in supervisor (DV), organizational citizenship behavior (DV), and active followers (DV). Secondly, the influence of the leaders’ styles (IV) on employees’ trust in supervisor (DV), organizational citizenship behavior (DV), and active followership (DV) was significantly affected only when IFTs were anti-prototypical traits. Finally, organizational citizenship behavior (Med) had an indirect effect between trust in supervisor (DV) and active followership (DV). This article not only fills the gaps in the literature related to leaders and followers, but also provides analytical evidence and new thinking which will enable companies to propose management strategies more effectively for employees working remotely in the face of the impact of the epidemic.