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Whether altered white matter microstructural property of autistic people also exists in non-autistic siblings is uncertain. The microstructures of a neural tract may not be consistent throughout the whole track. We assessed 38 cognitive-able autistic males (aged 15.8 ± 4.4 years), 39 non-autistic siblings (16.5 ± 5.7 years), and 78 age- and sex-matched non-autistic comparison people (14.4 ± 5.3 years) using tract-based automatic analysis of diffusion spectrum imaging and threshold-free cluster-weighted method. First, we identified segments within the right frontal aslant tract, frontostriatal tract, and thalamic radiation to precentral areas in both autistic people and non-autistic siblings that differed from those in non-autistic comparison people. Second, segments within bilateral cingulate gyri and callosal fibers connecting superior temporal lobes differed between autistic people and non-autistic comparison people but not between siblings and non-autistic comparison people. Third, segments within the left inferior longitudinal fasciculus and callosal fibers connecting precuneus showed increased generalized fractional anisotropy in non-autistic siblings. Our findings suggest microstructural properties of some potential neural segments that were similar between autistic people and their non-autistic siblings may serve as intermediate phenotypes of autism, facilitating further etiological searching for autism. Meanwhile, increased microstructural properties in unaffected siblings alone might indicate compensatory processes in the light of genetic predisposition for autism.

Objective: The stigma and prejudice of the public regarding psychiatric disorders are a long‐standing social problem. However, health professionals are more likely to have negative attitudes and label people with mental health conditions. This study aimed to investigate how self‐rated familiarity and literacy about schizophrenia are related to social distancing towards schizophrenia patients among health professionals in Taiwan. Method: This study used a cross‐sectional questionnaire survey and invited respondents to complete the survey either electronically or in a pencil/paper format. Respondents included health professionals in different disciplines and students under medical placements. The survey instrument consists of three parts: sociodemographic information, the 18‐item Social Distance Scale for schizophrenia, and the 19‐item Schizophrenia Experience and Knowledge Questionnaires. Data were analyzed using linear regression models to explore sociodemographic factors, self‐rated familiarity, and literacy total scores about social distance, attitude, and opinions towards schizophrenia. Result: In total, 420 health professionals completed the questionnaire, of which 24.5% were physicians, 36.0% nurses, 6.7% pharmacists, and 28.6% interns. The majority of respondents (n = 360, 85.7%) had contact experience with schizophrenia patients, and approximately 60% rated their experience as a positive impression. Although 62.9% of respondents had received psychiatric education or training, 86% believed that such education/training was insufficient. Moreover, over half of the respondents did not have confidence in their knowledge of schizophrenia. Older age, being married, and having more working experience were associated with high social distance, a negative attitude, and high prejudice. More familiarity with schizophrenia was associated with low social distance, a positive attitude, and less prejudice. A high literacy score was associated with a positive attitude and less prejudice, but no significant correlation was observed with social distance (β ± SE = −0.26 ± 0.14, p =.057). Among respondents who rated their past contact experiences as negative, neither familiarity nor literacy was associated with social distance. Conclusion: High levels of self‐rated familiarity and high literacy about schizophrenia were associated with low social distance, a positive attitude, and less prejudice towards schizophrenia among health professionals. Therefore, sufficient education and training are imperative to increase familiarity and knowledge of schizophrenia. Appropriate education could be implemented from different perspectives, including communication skills, resources of social support, and topics to reduce stigma and prejudice. [ABSTRACT FROM AUTHOR]

Background: There have been no reports regarding clinical features and molecular characteristics of childhood methicillin-susceptible Staphylococcus aureus (MSSA) infections in Taiwan.Methods: We prospectively collected clinical S. aureus isolates from patients aged < 18 years in a university-affiliated hospital in 2015. Only the first isolate from each patient was included. Medical records were retrospectively reviewed. Patients were classified as community-associated (CA) or healthcare-associated (HA) by the epidemiologic criteria. All MSSA isolates were molecularly characterized.Results: A total of 495 S. aureus isolates were identified, and 178 (36.0%) were MSSA. Among the 131 MSSA-infected patients enrolled, 94 (71.8%) were community-associated and 60 (45.8%) were inpatients. Patients with HA infections was significantly younger than those with CA infections (median, 15 vs. 67.5 months). The most common specimen of MSSA identified was pus or wound (73.3%). Compared to HA-MSSA, CA-MSSA isolates were significantly less frequently from sputum (6.4% vs. 27%, p = 0.001). Nineteen pulsotypes were identified. Four pulsotypes accounted for 60% of the isolates. Isolates of ST15/pulsotype F were more frequently seen in CA than in HA (p = 0.064) while isolates of ST188/pulsotype AX frequently seen in HA (p = 0.049). PVL genes were identified in 11 isolates (8.4%), nine of which were characterized as ST59/pulsotype D, same as the local endemic CA-MRSA clone.Conclusions: MSSA accounted for around one-third of childhood S. aureus infections in northern Taiwan. SSTI was the most common manifestation. The molecular characteristics of these clinical MSSA isolates were relatively diverse and had certain significant differences between CA and HA isolates. [ABSTRACT FROM AUTHOR]

Summary: Background: This research applied bioelectrical impedance analysis (BIA) and Dual-Energy X-ray AbsorptioMetry (DXA) to measure the body composition of Taiwan elderly. We developed the new mathematical estimation model for fat free mass of multiple segments. Methods: The modified BIA instrument with 8 electrodes (BIA8) at 50 kHz and 0.4 mA was used to measure the bioelectrical impedance of whole body and all limb segments of 33 male elderly in Taiwan. The criterion fat free mass (FFM) values in whole body and all limb segments were determined by DXA. After analyzing by linear regression, we obtained the FFM estimation equation for limb segments. The Bland-Altmen analysis were used to evaluate the differences existed between the estimation FFM from equation by BIA and from by DXA. Result: The correlation efficient (R) with standard deviation (SD) of FFM measured by DXA v.s. estimated by BIA in whole body, lower limbs, upper limbs and trunk were 0.942 with 2.660 kg, 0.859 with 0.713 kg, 0.922 with 0.265 kg and 0.884 with 1.917 kg, respectively. The relative high in the weight coefficients of h2/Z for estimation equation implied the critical role played by height and BIA values. Conclusion: In summary, the multiple segments FFM estimated by BIA were highly relative to that of determined by DXA for elderly in Taiwan. It is feasible to apply in monitoring the body composition in elderly by fast, non-invasive and convenient way. [ABSTRACT FROM AUTHOR]

Goals: This paper aims to explore characteristics of demoralization syndrome as well as the relationship between demoralization syndrome and psychosocial issues as seen through examinations of cancer outpatients in Taiwan. Materials and methods: Outpatients with different cancer types were enrolled in this study. The Demoralization Scale Mandarin Version (DS-MV), Patient Health Questionnaire, Beck Hopelessness Scale, and McGill Quality of Life Questionnaire-Taiwan Version were used as instruments. All data were analyzed using SPSS 18.0. Results: Among the 234 patients studied (97 men and 223 women), the majority had cervical cancer (29.1%), followed by breast cancer (26.5%) and head and neck cancer (24.3%). The mean score of DS-MV was 31.05 (SD 14.87). The results of ANOVA analysis showed a significant effect of occupation F(4.209) = 7.145 ( p < 0.001), cancer diagnosis F(7.206) = 3.795 ( p < 0.001), and treatment F(8.206) = 3.553 ( p < 0.001) on DS-MV. Conclusions: Demoralization syndrome was found to be related to psychosocial issues, different cancer types, and treatments. Further studies are recommended to better understand causes and impacts of demoralization in the quality of life and care of cancer patients. [ABSTRACT FROM AUTHOR]

To prevent transmission of the coronavirus, we established the campus protection measures for coronavirus disease 2019 (COVID-19) (CPMCV-19) and analyzed the effectiveness and cost in practice. This project was set in Taiwan. We organized an anti-epidemic task force team from multidisciplinary co-workers to establish the CPMCV-19. The essential components were as follows: no close contact communication, sterilization, temperature control, social distancing, activity restrictions, personal hygiene control, and situational awareness. During 100 days of operation, the mean time spent for frontal temperature measuring was 2.7 ± 0.3 s per person. The mean on-duty time for individual personnel to control the gate and measure temperature was 3.5 h per day. In total, 31 persons with loss of taste/smell or fever were detected on campus and sent to hospital for screening within 1 h. A total of 6 persons were instructed to observe self-health management due to possible contact or travel history, and none were diagnosed with COVID-19 infection. A total budget of USD 27,100 was used for CMPCV-19 in this period. The established campus protection measures for COVID-19 were practical and might be effective. They can be used as reference for schools in a pandemic, such as COVID-19. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019, known as a widespread, aerosol spreading disease, has affected >549 000 000 people since 2019. During the lockdown period, dramatic reduction of elective endoscopic procedures, including endoscopic retrograde cholangiopancreatography, had been reported worldwide, leading to delayed diagnosis and treatment. Nevertheless, whether patients' hospital stays and complication rate of endoscopic retrograde cholangiopancreatography (ERCP) during the lockdown period were influenced by the pandemic still remains controversial., Methods: Patients who diagnosed with obstructive jaundice and acute cholangitis in the lockdown period, May 16 to July 26, 2021, were compared to the same prepandemic period in 2019., Results: A total of 204 patients in 2019 and 168 patients in 2021 were diagnosed with acute biliary cholangitis or obstructive jaundice, and 82 of the patients in 2019 and 77 patients in 2021 underwent ERCP ( p = 0.274). Patients whose quick Sequential Organ Failure Assessment (qSOFA) score was ≥ 2 occurred more during the lockdown period than during the normal period (24/77, 31.1% vs 12/82, 14.6%; p = 0.013). The initial laboratory data, including, total bilirubin (4.12 in 2021 vs 3.08 mg/dL in 2019; p = 0.014), gamma-glutamyl transferase (378 in 2021 vs 261 U/L in 2019; p = 0.009), and alkaline phosphatase (254 in 2021 vs 174 U/L in 2019; p = 0.002) were higher during the lockdown period compared to 2019. Hospital stay was statistically significant longer in the lockdown period (11 days [7.00-22.00] in 2021 vs 8 days in 2019 [6.00-12.00]; p value = 0.02). Multivariate analysis showed that qSOFA ≥ 2 (hazard ratio [HR] = 3.837, 95% confidence interval [CI] = 1.471-10.003; p = 0.006), and malignant etiology (HR = 2.932, 95% CI = 1.271-6.765; p = 0.012) were the statistically significant factors for a prolonged hospital stay, which was defined as hospital stay >21 days. ERCP-related complications and mortality rate were not statistically different between the two periods., Conclusion: Patients from May 16 to July 26, 2021, the lockdown period, had longer hospital stays and higher biliary tract enzyme levels, which indicated more severe disease. Nevertheless, ERCP could be safely and successfully performed even during the medical level 3 alert lockdown period without causing an increase in procedure-related complications and mortality., Competing Interests: Conflicts of interest: Dr. Ming-Chih Hou, Dr. Yi-Hsiang Huang, and Dr. Fa-Yuah Lee, editorial board members at Journal of the Chinese Medical Association, have no roles in the peer-review process of or decision to publish this article. The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article., (Copyright © 2022, the Chinese Medical Association.)

We reported two cases with community-acquired pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who returned from Wuhan, China in January, 2020. The reported cases highlight non-specific clinical presentations of 2019 novel coronavirus disease (COVID-19) as well as the importance of rapid laboratory-based diagnosis., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2020. Published by Elsevier B.V.)

Background: Although previous research showed that telehealth services can reduce the misuse of resources and urban-rural disparities, most healthcare insurers do not include telehealth services in their health insurance schemes. Therefore, no target variable exists for the classification approaches to learn from or train with. The problem of identifying the potential recipients of telehealth services when introducing telehealth services into health welfare or health insurance schemes becomes an unsupervised classification problem without a target variable., Methods: We propose a HDTTCA approach, which is a systematic approach (the main process of HDTTCA involves (1) data set preprocessing, (2) decision tree model building, and (3) predicting and explaining of the most important attributes in the data set for patients who qualify for telehealth service) to identify those who are eligible for telehealth services., Results: This work uses data from the NHIRD provided by the NHIA in Taiwan in 2012 as our research scope, which consist of 55,389 distinct hospitals and 653,209 distinct patients with 15,882,153 outpatient and 135,775 inpatient records. After HDTTCA produces the final version of the decision tree, the rules can be used to assign the values of the target variables in the entire NHIRD. Our data indicate that 3.56% (23,262 out of 653,209) of the patients are eligible for telehealth services in 2012. This study verifies the efficiency and validity of HDTTCA by using a large data set from the NHI of Taiwan., Conclusion: This study conducts a series of experiments 30 times to compare the HDTTCA results with the logistic regression findings by measuring their average performance and determining which model addresses the telehealth patient classification problem better. Four important metrics are used to compare the results. In terms of sensitivity, the decision trees generated by HDTTCA and the logistic regression model are on equal grounds. In terms of accuracy, specificity, and precision, the decision tree generated by HDTTCA provides a better performance than that of the logistic regression model. When HDTTCA is applied, the decision tree model generates a competitive performance and provides clear, easily understandable rules. Therefore, HDTTCA is a suitable choice in solving telehealth service classification problems.

Investigating social behaviors and brain structural alterations in unaffected siblings of individuals with autism spectrum disorder (ASD) may help identify intermediate phenotypes of social communication deficits in ASD. This study hypothesized that such intermediate phenotypes could be identified in white matter tracts of the social communication model that exhibited reduced tract integrity and associations with social communication deficits. Boys with ASD (N = 30), unaffected male siblings (N = 27), and typically developing (TD) boys (N = 30) underwent clinical evaluation and MRI scanning. Group differences in generalized fractional anisotropy (GFA) values, a white matter integrity index derived from diffusion MRI data, and the relationships of GFA with the Social Responsiveness Scale (SRS) scores and the Child Behavior Checklist (CBCL/4-18) scores were investigated. Significant differences were found in the GFA values of the frontal aslant tract (FAT) among the three groups, with the decreasing order of GFA from TD to siblings to ASD. The GFA values of the FAT were associated with the social communication scores (on the SRS) in the sibling group, and those of the superior longitudinal fasciculus III were associated with the social problems scores (on the CBCL/4-18) in the boys with ASD. Due to the altered tract integrity and association with social communication deficits in the unaffected siblings of individuals with ASD, the FAT might be a heritable neural basis for social communication deficits of ASD. Autism Res 2019, 12: 225-238 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Autism spectrum disorder (ASD) is a group of highly heritable disorders with social communication deficits as one of the core symptoms. This study aimed to identify a neural trait of social communication deficits in individuals with ASD. We investigated brain structural alterations and their associations with social communication scores in unaffected siblings of individuals with ASD. The siblings' frontal aslant tract was found to be impaired, and this tract showed a significant association with the social communication scores. Our findings support that the frontal aslant tract might be a potential neural trait of social communication deficits in ASD., (© 2018 International Society for Autism Research, Wiley Periodicals, Inc.)

Objectives: To examine the effect of kettlebell training on body composition, muscle strength, pulmonary function, and chronic low-grade inflammatory markers among elderly people with sarcopenia., Design: Randomized controlled trial., Setting: Community center and research center., Participants: A total of 33 elderly women with sarcopenia (aged 65-75 years) were recruited., Intervention: The participants were randomly assigned to a kettlebell training (KT) group or a control (CON) group. The KT group received an 8-week training intervention involving 60-min sessions twice a week, whereas the CON group members continued their daily lifestyles without participating in any exercise training. Four weeks of detraining were organized to observe the retention effect of the training program on the KT group., Measurements: The participants' body composition, muscle strength, pulmonary function, and chronic low-grade inflammatory markers were measured and analyzed before training (at Week 0, W0), after 8 weeks of training (at Week 8, W8), and after 4 weeks of detraining (at Week 12, W12)., Results: In the KT group, appendicular skeletal muscle mass (ASM) and the sarcopenia index measured at W8 and W12 were significantly higher than those at W0(p = .004; p = .005). At W8 and W12, the sarcopenia index was significantly higher in the KT group than the CON group(p = .020; p = .019). In the CON group, the skeletal muscle mass levels measured at W8 and W12 were significantly lower than that at W0(p = .029; p = .005), and the ASM and the sarcopenia index measured at W8 were significantly lower than those at W0(p = .037; p = .036). Additionally, the measured left handgrip strength(p = .006), back strength(p = .011; p = .018), and peak expiratory flow (PEF) (p = .008; p = .006) were significantly higher in the KT group than the CON group at W8 and W12. At W8, the measured right handgrip strength was significantly higher in the KT group than the CON group(p = .043). In the KT group, the back strength and PEF levels measured at W8 and W12 were significantly higher than those at W0(p = .000; p = .004), and the left and right handgrip strength levels at W8 were significantly higher than those at W0(p = .004; p = .013). By contrast, in the CON group, the left(p = .004; p = .006)and right(p = .002; p = .004)handgrip strength levels and PEF(p = .018; p = .012) measured at W8 and W12 were significantly lower than those at W0. Moreover, compared with the high-sensitivity C-reactive protein (hs-CRP) levels measured at W0, those measured at W8 and W12 were significantly lower in the KT group(p = .006; p = .013)but significantly higher in the CON group(p = .005; p = .009). There was no significant difference in hs-CRP, IL-6, TNF-α between the KT and CON group., Conclusion: For elderly people with sarcopenia, participating in kettlebell training significantly increases the sarcopenia index, grip strength, back strength, and PEF. In addition, the retention effect of the training program continued after 4 weeks of detraining., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objectives: Experimental research has shown that herbal and traditional Chinese medicines (TCM) may serve as complements to Western medicine treatments in the control of blood glucose and cardiovascular complications, but population-based studies are limited. We investigated the association between TCM use and subsequent risk of stroke in older patients with diabetes., Study Design: The database used in this cohort study contained longitudinal medical claims for one million subjects randomly selected among beneficiaries of a universal health care program in Taiwan. We identified a cohort of patients with diabetes aged 65 years and older who initiated anti-diabetic medications from 2000 to 2012. Patients who had at least two TCM outpatient visits after their initiation of anti-diabetic medications were considered TCM users., Main Outcome Measures: The incidence of stroke was measured until 2013. Cox regression models with TCM use as a time-dependent variable were used to calculate the adjusted hazard ratios (HRs) comparing TCM use with no use., Results: Over the 13-year period, 17,015 patients were identified; 4912 (28.9%) of them were TCM users. The incidence of stroke during the follow-up (per 1000 person-years) was 22.8 in TCM users and 25.7 in non-users. TCM users had an adjusted HR of 0.93 for the incidence of ischemic stroke (95% confidence interval [CI] 0.83, 1.04) and of 0.89 for developing hemorrhagic stroke (95% CI 0.66, 1.19), compared with non-users., Conclusions: In this study, in older patients receiving Western medicine treatments for diabetes, TCM use was not associated with an increased risk of developing ischemic stroke and hemorrhagic stroke.

Background: AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated., Methods and Results: The study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow-up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all-cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all-cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38-1.60 and 1.48, 1.33-1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47-1.82) and HFpEF (1.34, 1.22-1.48). Moreover, when we calculated a new AHEAD-U score by considering uric acid (>8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all-cause and cardiovascular mortality, respectively., Conclusions: The AHEAD score was useful in predicting long-term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD-U score may further improve risk stratification., (© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Background: This study aims to improve accuracy of Bioelectrical Impedance Analysis (BIA) prediction equations for estimating fat free mass (FFM) of the elderly by using non-linear Back Propagation Artificial Neural Network (BP-ANN) model and to compare the predictive accuracy with the linear regression model by using energy dual X-ray absorptiometry (DXA) as reference method., Methods: A total of 88 Taiwanese elderly adults were recruited in this study as subjects. Linear regression equations and BP-ANN prediction equation were developed using impedances and other anthropometrics for predicting the reference FFM measured by DXA (FFMDXA) in 36 male and 26 female Taiwanese elderly adults. The FFM estimated by BIA prediction equations using traditional linear regression model (FFMLR) and BP-ANN model (FFMANN) were compared to the FFMDXA. The measuring results of an additional 26 elderly adults were used to validate than accuracy of the predictive models., Results: The results showed the significant predictors were impedance, gender, age, height and weight in developed FFMLR linear model (LR) for predicting FFM (coefficient of determination, r2 = 0.940; standard error of estimate (SEE) = 2.729 kg; root mean square error (RMSE) = 2.571kg, P < 0.001). The above predictors were set as the variables of the input layer by using five neurons in the BP-ANN model (r2 = 0.987 with a SD = 1.192 kg and relatively lower RMSE = 1.183 kg), which had greater (improved) accuracy for estimating FFM when compared with linear model. The results showed a better agreement existed between FFMANN and FFMDXA than that between FFMLR and FFMDXA., Conclusion: When compared the performance of developed prediction equations for estimating reference FFMDXA, the linear model has lower r2 with a larger SD in predictive results than that of BP-ANN model, which indicated ANN model is more suitable for estimating FFM.

Objective: This study evaluated the efficacy and safety of transdermal fentanyl in the outpatient treatment of head and neck cancer patients with pain caused by radiotherapy., Methods: Patients with a visual analogue scale score >or=4 were invited to participate in the study. The following variables were collected: visual analogue scale, the Brief Pain Inventory, concomitant pain medications and adverse effects. A total of 163 head and neck cancer patients were enrolled (148 males and 15 females; median age, 53 years; age range, 21-72 years). Seventy-two (44%) patients had a visual analogue scale score >6 at enrollment, despite the use of non-steroidal anti-inflammatory drugs or weak opioids. Ninety-four (57.7%) patients received concurrent chemotherapy., Results: A total of 88 patients completed the study, whereas 55 underwent a drop-out by side effects. The most frequently reported adverse events were vomiting (23.9%) and nausea (16.6%). Treatment with transdermal fentanyl resulted in a significant decrease in visual analogue scale and Brief Pain Inventory scores that persisted during treatment. In the overall efficacy evaluation, the pain-alleviating effect, the easiness of application and the overall impression of transdermal fentanyl were rated as good by 54.5%, 65.9% and 59.1% of the completers, respectively. Effects of transdermal fentanyl were rated as good by 64.8% of the investigators., Conclusions: Our data provide evidence that transdermal fentanyl is effective and relatively easy to use for outpatient treatment of pain control in head and neck cancer patients following radiotherapy in selected patients. Reduction of side effects and effective pain management need to be paramount in the management of head and neck cancer patients undergoing radiotherapy.

The aim of this study is to investigate cancer patients' response and side effects associated with transdermal therapeutic fentanyl (TTS-F), whose pain was hardly controlled by nonweak/weak opioids in Taiwan. From 2005 to 2006, 822 outpatients received TTS-F to collect pain assessment forms and diaries for 4 weeks. Most (78.7%) patients were initially prescribed 25 microg/h TTS-F. Doses were adjusted weekly at clinicians' discretion, according to pain assessment and side effects. Patients receiving 50 microg/h, 75 microg/h, and > 75 microg/h TTS-F had increased from 17.5% to 32.1%, 1.8% to 3.4%, and 1.9% to 2.2%, respectively, by week 2; further small increases were found in weeks 3 and 4. Pain palliation improved from 60.6% during week 1 to 78.6% at week 4. The common adverse effects were nausea/vomiting. Patient's compliance was >90%. This study found that the TTS-F is effective and well tolerated.

Objective: To validate the performance of current diabetes risk scores (DRSs) based on simple clinical information in detecting type 2 diabetes, metabolic syndrome (MetSyn), and chronic kidney disease (CKD)., Research Design and Methods: The performance of 10 DRSs was evaluated in a cross-sectional population screening of 2,759 Taiwanese subjects., Results: All DRSs significantly correlated with measures of insulin resistance, estimated glomerular filtration rate, and urine albumin excretion. The prevalence of screening-detected diabetes (SDM), MetSyn, and CKD increased with higher DRSs. For prediction of SDM, the Cambridge DRS by Griffin et al. and the Finnish DRS outperformed other DRSs in terms of discriminative power and model fit. For prediction of MetSyn and CKD, the Atherosclerosis Risk in Community Study score by Schmidt et al. outperformed other DRSs., Conclusions: Risk scores based on simple clinical information are useful to identify individuals at high risk for diabetes, MetSyn, and CKD in different ethnic populations.

MMH01 is a compound isolated from Antrodia cinnamomea. MMH01 markedly inhibited growth of human leukemia U937 and pancreatic cancer BxPC3 cells. It resulted in distinct patterns of cell cycle distribution in U937 (G2/M, sub-G1 and polyploidy) and BxPC3 cells (G0/G1 and sub-G1). The modes of cell death in U937 cells include apoptosis and mitotic catastrophe, whereas apoptosis-associated events or necrosis in BxPC3 cells. Neither mitochondrial membrane permeabilization nor caspase dependence was noted. Proteins involving mitotic catastrophe-associated cell death such as cyclin B1 and checkpoint kinase 2 were activated in U937 cells. Only slight to moderate viability inhibition was noted to human monocytes, the normal counterpart of these myeloid leukemic cells. In conclusion, MMH01 possesses cytotoxicity against human leukemia and pancreatic cancer cells.