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Background and Objectives: Although statins are recommended for secondary prevention of acute ischemic stroke, some population-based studies and clinical evidence suggest that they might be used with an increased risk of intracranial hemorrhage. In this nested case–control study, we used Taiwan's nationwide universal health insurance database to investigate the possible association between statin therapy prescribed to acute ischemic stroke patients and their risk of subsequent intracerebral hemorrhage and all-cause mortality in Taiwan. Materials and Methods: All data were retrospectively obtained from Taiwan's National Health Insurance Research Database. Acute ischemic stroke patients were divided into a cohort receiving statin pharmacotherapy and a control cohort not receiving statin pharmacotherapy. A 1:1 matching for age, gender, and index day, and propensity score matching was conducted, producing 39,366 cases and 39,366 controls. The primary outcomes were long-term subsequent intracerebral hemorrhage and all-cause mortality. The competing risk between subsequent intracerebral hemorrhage and all-cause mortality was estimated using the Fine and Gray regression hazards model. Results: Patients receiving statin pharmacotherapy after an acute ischemic stroke had a significantly lower risk of subsequent intracerebral hemorrhage (p < 0.0001) and lower all-cause mortality rates (p < 0.0001). Low, moderate, and high dosages of statin were associated with significantly decreased risks for subsequent intracerebral hemorrhage (adjusted sHRs 0.82, 0.74, 0.53) and all-cause mortality (adjusted sHRs 0.75, 0.74, 0.74), respectively. Conclusions: Statin pharmacotherapy was found to safely and effectively reduce the risk of subsequent intracerebral hemorrhage and all-cause mortality in acute ischemic stroke patients in Taiwan. [ABSTRACT FROM AUTHOR]

Recent studies in the earthquake magnitude‐frequency relation (b‐value) found that the b‐value can decrease with time before large earthquakes in the source area. Such a decrease even coincided with a burst of foreshocks immediately before the earthquakes implying a preslip migrating toward the nucleation zone. We systematically survey the b‐value variations in space and time in the source area of 17 earthquakes with magnitudes greater than ML 6.0 in Taiwan. We relocated the earthquakes released by the Central Weather Administration of Taiwan since 2012 as timing can provide a sufficiently low completeness magnitude (MC) of 1.5. We carefully determine the spatiotemporal search criteria on seismicity in the source area of all targeted earthquakes. We surveyed the temporal b‐value systematically using moving time windows with a given number of earthquake events with the magnitudes greater than MC. We found the b‐value decreased clearly for 2 days before the 2018 ML 6.3 Hualien earthquake, coinciding with a burst of ML 5.8 earthquake and its aftershocks nearby as foreshocks. The foreshocks migrated updip toward the hypocenter of the 2018 ML 6.3 Hualien earthquake and revealed a second decrease in the b‐value 10 hours before it occurred. The b‐value precursor primarily comes from a rapid reduction of small earthquakes in the foreshocks and agrees with recent key findings of preslip. However, there is no strong correlation between the b‐value precursor and coseismic slip. Apart from this, the b‐values did not change significantly in most cases of earthquakes in Taiwan before and after they occurred. Plain Language Summary: Direct evidence for the precursor of a large earthquake is rare and difficult to be quantified accurately. Earthquake magnitude‐frequency relation (b‐value) is a classic observation implying stress accumulation on a seismogenic fault. Scientists found that the b‐value can decrease within a few days before an impending large earthquake in the source area. Taiwan is one of the regions undergoing frequent M ≥ 6.0 earthquakes and can map the b‐value in high resolution based on the relocated earthquakes. This study systematically surveyed the b‐value in the source area of seventeen ML ≥ 6.0 earthquakes in Taiwan, probing into b‐value precursor in the 8‐year time series. We found that the b‐value had a robust decrease 2 days before the 2018 ML 6.3 Hualien earthquake, coinciding with the initiation of foreshocks nearby and at a downdip of the hypocenter of the 2018 ML 6.3 Hualien earthquake. The foreshocks showed clear evidence of precursor as they migrated updip toward the hypocenter with a second decrease in the b‐value 10 hours before the earthquake occurred. We found no evidence of a b‐value precursor in most of the targeted earthquakes that agrees with the knowledge of precursor as happening episodically and unexpectedly. Key Points: We found a b‐value precursor that coincides with foreshocks for 2 days before the 2018 ML 6.3 Hualien earthquake in the source areaThe b‐value precursor correlates with foreshock distribution in the source area and is likely uncorrelated to the high coseismic slipThere is no significant change in the b‐value before M ≥ 6.0 earthquakes in Taiwan in a majority of the cases that we analyzed [ABSTRACT FROM AUTHOR]

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Background: Osteoporotic fractures are a significant cause of morbidity and mortality affecting population worldwide. All guidelines recommended vertebral fracture assessment by dual-energy X-ray absorptiometry (DXA). This study aimed at evaluation of any associated benefits of screening with DXA in patients who had received vertebroplasty in Taiwan. Methods: Data were obtained from the National Health Insurance Research Database (NHIRD) in Taiwan. We retrospectively compared the data of patients, who were admitted for vertebroplasty, whether they received DXA screening or not. The outcomes of interest were recurrence of spinal fracture and mortality during a follow-up period of 10 years. Results: From this Taiwan national database, the screening rate of osteoporosis in patient who received vertebroplasty was 11.7%. The mean age in the non-DXA screened cohort (n=32,986) was 74.03± 12.21 years (71.98% female). In the DXA screened cohort (n=4361), the mean age was 76.43± 9.19 years (79.91% female). During the 10-year follow-up period, after matching, non-DXA patients had significantly higher mortality rates than their DXA counterparts, which were 42.37% and 37.73% (p-value < 0.0001), respectively. The re-fracture rates between non-DXA and DXA patients were not significantly different at 17.26% and 16.89% (p-value = 0.1766), respectively. Conclusion: The rate of DXA screening before patients receiving vertebroplasty was extremely low, at 11.7%. Our results showed that DXA screening before vertebroplasty in spinal fractures patients had lower mortality. From this national retrospective cohort study, routine screening of osteoporosis in spinal fracture patients can lead to reduction in mortality. [ABSTRACT FROM AUTHOR]

Background: Statin treatment improves clinical outcomes in patients with ischemic strokes, although there is no evidence regarding the safety of statin therapy in patients with intracerebral hemorrhage (ICH). This study aimed at evaluating the effects of continuing statin treatment after ICH. Methods: Data were obtained from the National Health Insurance Research Database in Taiwan. We retrospectively compared the data of patients with and without statin exposure after ICH. The outcomes of interest were recurrence of hemorrhagic stroke and mortality during a follow-up period of 10 years. Results: During the 10-year follow-up period, the mortality rate was 32.73% in the statin group and 42.77% in the non-statin group. Statin therapy in patients with acute ICH with dyslipidemia can decrease mortality. Conclusion: Statin therapy reduced the risk of 10-year mortality in patients who experienced acute hemorrhagic stroke. [ABSTRACT FROM AUTHOR]