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Expression of cytokines and growth factors have been shown to be highly correlated with the prognosis of esophageal squamous cell carcinoma (ESCC), a deadly disease with poor prognosis. The suppressor of cytokine signaling (SOCS) family of proteins are key factors in regulating cytokines and growth factors. Yet the role of the SOCS proteins in ESCC is hardly investigated. We currently investigated the prognostic role of SOCS5 in ESCC. We analyzed the prognostic effects of 16 single nucleotide polymorphisms (SNPs) within the SOCS genes in 632 ESCC patients. We repeatedly observed that the 3 SNPs in SOCS5, SOCS5:rs3814039, SOCS5:rs3738890, and SOCS5: rs3768720, were significantly correlated with both overall (OS) and progression-free survival (PFS) of ESCC patients (rs3814039, p=0.032 for OS and p=0.009 for PFS; rs3738890, p=0.016 for OS, and p=0.008 for PFS; rs3768720, p=0.005 for OS and p=0.002 for PFS). SOCS5: rs3768720 was also significantly associated with distant metastasis (Ptrend=0.028). The luciferase assay revealed that SOCS5:rs3814039 and SOCS5: rs3768720 might influence the prognosis by regulating SOCS5 expression. Functional analysis demonstrated SOCS5 was able to regulate epidermal growth factor receptor (EGFR) expression and migration activity of ESCC cells. Furthermore, Patients with strong SOCS5 in normal tissues exhibited significantly better PFS (P=0.049) and reduced risk of distant metastasis (P=0.004) compared to those with weak SOCS5 expression. Overall, our study demonstrates the novel function of SOCS5 in ESCC prognosis. The genetic polymorphisms and expression of SOCS5 could serve as a novel therapeutic biomarker for improving the prognosis of ESCC.

Differences in sociodemographic variables, health beliefs, and a healthy lifestyle all contribute to the varied prevalence of metabolic syndrome (MetS). We investigated the associations among MetS-related risk factors and performed a cross-sectional study, recruiting 1741 Taiwanese residents aged ≥30 years, between August 2014 and August 2015. Data were obtained on sociodemographic factors, health beliefs, and health-promoting lifestyle profiles using questionnaires. Multivariate analysis revealed that age ≥65 years (odds ratio [OR] = 2.17), low educational level (OR = 1.46), body mass index ≥24 kg/m2 (OR = 9.00), more health responsibility (OR = 1.08), and less exercise (OR = 0.924) were independent risk factors for MetS development. A correlation existed between health beliefs and health-promoting lifestyle profiles, suggesting that the establishment of an effective health-promoting program should consider participants’ health beliefs.

Background Previous literatures showed no evidence that wearing an external breast prosthesis may prevent changes in body posture in women who underwent mastectomy. Objective To determine whether the weight of an external breast prosthesis can contribute to posture changes in women post mastectomy. Methods Fifty-one women with unilateral mastectomy (age 58 ± 11.39 years) were divided into 2 subgroups by their operation side. Asymmetry of body posture was evaluated by using the electromyography activity of erector spinae muscles with four different weights of breast prosthesis. Results Despite the operation side, the erector spinae muscle activities on the operation side and non-operation side were significantly different. Overall, for patients who had operation on the left side, their erector spinae muscle activity imbalance will be smaller, compared to the imbalance among patients with right operation side. The weight of the external breast prosthesis did not influence the differences of erector spinae muscle activities on the operation side and non-operation side. Conclusions The weight of an external breast prosthesis for women after mastectomy may not be crucial when choosing a proper prosthesis.

The purpose of this study is to analyze the independent clinical, laboratory, dialysis factors between a disease-specific score for cardiac risk stratification and the Quality of life (QOL) application in hemodialysis (HD) patients. A total of 43 end-stage renal disease patients (female 17 and male 26) on regular HD were included. They were clinically stable with a mean Kt/V (Daugirdas) 1.76±0.41 and mean dialysis 7.4±0.94 years. Patients answered the Kidney Disease Quality of Life questionnaire short form (KDQOL-SF) which includes the physical and mental health component (PHC, MHC). Application of a previously validated cardiac risk score (CRS) using cardiac history (A), dialysis duration (B), body mass index (C) and serum phosphate (D) multiplied by various hazards ratio (HR) was also investigated retrospectively. CRS (A+B+C+D)< 50 allocated low risk, and CRS≥50 stands for high risk of future cardiac events. The impact of various factors on CRS and KDQOL-SF was estimated by multivariate analysis using SPSS 10.0 depending on variables characteristics. Most of the KDQOL-SF scores specific for dialysis significantly correlated with Hct, albumin, electrolytes, age, dose of HD and social support (P

Metabolic syndrome, a widespread condition in Taiwan, increases the risks of cardiovascular diseases. Cardiovascular disease is the second leading cause of death in Taiwan after cancer. Thus, this health problem is a priority issue of concern.To study the effects of active intervention of interdisciplinary health education on the prevalence of metabolic syndrome in community residents.This longitudinal study was conducted from 2014 to 2015 on 661 participants who were all over 30 years old and living in four towns in northern Taiwan. The data were collected into two steps. In the first step, participants completed a blood study, body measurement, and pretest questionnaires and participated in the entire course of metabolic syndrome health education. The results of the blood test and body measurement were blinded to the experienced metabolic physicians before and after the education courses. In the second step, one year after administering the interdisciplinary health education course, the participants repeated the blood study, body measurement, and posttest questionnaires.1. The participants had a higher incidence of metabolic syndrome. However, gender and marital status had no significant correlation with metabolic syndrome. Higher education levels were associated with a lower prevalence of metabolic syndrome. 2. The average scores for literacy rose from 2.30 pretest to 5.65 posttest. There were significant correlations (p.05) between pretest and posttest health education. 3. The diagnosis of metabolic syndrome in this study changed from 215 participants (32.5%) to 170 participants (25.7%) between pretest and posttest (p.05). 4. active health education had significant and positive effects on the cessation of smoking and chewing betel nut (p.05).The active interdisciplinary health education intervention used in this study significantly decreased the smoking and betel-nut chewing habits and decreased the overall risk of metabolic syndrome in participants. Therefore, providing active health education on metabolic syndrome holds the potential to significantly decrease the prevalence of metabolic syndrome in at-risk populations. In addition, healthcare providers should make appropriately targeted health education more accessible to elderly patients who are prone to metabolic syndrome. Finally, the cessation of chewing betel nut should be seen as a major factor in the prevention and alleviation of metabolic syndrome.跨領域健康教育介入對降低社區居民代謝症候群盛行率之成效探討—以北台灣四鄉鎮為例.代謝症候群是盛行於台灣地區的慢性疾病，易增加罹患心血管疾病的風險。由於心血管疾病已成為台灣十大死因之第二位，非常接近首位惡性腫瘤的死亡率，是值得被正視的健康問題。.探討跨領域代謝症候群健康教育方案介入措施對降低社區居民代謝症候群盛行率之成效。.以2014-2015年北台灣四鄉鎮30歲以上民眾為研究對象，採分層隨機抽樣，完成全程試驗共計661人。資料收集分二階段，第一階段：研究對象須接受採血、體位測量及填寫前測問卷，血液檢查與體位測量結果於上課前由醫師個別對研究對象說明；第二階段：經跨領域健康教育介入後，預約研究對象採血日期、體位測量與後測問卷填寫，前、後測間隔一年。.1.年齡越高者越容易發生代謝症候群，性別、婚姻狀況與代謝症候群盛行率並未具顯著相關，教育程度越高者代謝症候群盛行率越低。2.健康教育介入前、後研究對象的代謝症候群認知具有顯著差異性（p.05）。「前測」平均數由2.30分提升至「後測」平均數5.65分。3.研究對象診斷為代謝症候群者由215人（32.5%）減少至170人（25.7%），代謝症候群盛行率改善具顯著性（p.05）。4.健康教育介入與研究對象戒菸、戒食檳榔的相關性具顯著性（p.05）。.跨領域代謝症候群健康教育介入，能減少研究對象吸菸、嚼食檳榔比例，進而減少罹患代謝症候群危險因子，降低代謝症候群盛行率；因此，若能將代謝症候群健康教育積極在各社區推廣與落實，應能有效降低國人代謝症候群盛行率。此外，基於高齡者易發生代謝症候群，因此建議衛教策略宜注意淺顯易懂及生活化，而戒嚼檳榔也應列為代謝症候群防治工作的重點項目。.

Background Chemotherapy-related health care utilization by breast cancer patients can be expensive for payers and patients. This study evaluated the patient-centered medical home program Community Care of North Carolina (CCNC) in terms of its potential to reduce health care utilization associated with chemotherapy-related adverse events (AEs). Methods Early-stage breast cancer cases diagnosed during the 5-year period 2003-2007 were identified in the North Carolina Central Cancer Registry; these cases were then linked to North Carolina Medicaid claims data. We measured health care utilization associated with chemotherapy-related AEs by setting (inpatient, outpatient, or emergency department) during a 15-month postdiagnosis follow-up period. Descriptive and multivariate analyses were performed to examine associations between CCNC enrollment and health care utilization associated with chemotherapy-related AEs. Results A large proportion of breast cancer patients had at least 1 health care visit associated with a chemotherapy-related AE (n = 412 [72.3%]). The mean numbers of AE-related visits occurring in inpatient, outpatient, and emergency department settings were 0.30 (standard deviation [SD] = 0.83), 6.92 (SD = 10.94), and 0.46 (SD = 1.26), respectively. CCNC enrollment was associated with significantly fewer inpatient admissions (marginal effect, -0.1421; 95% confidence interval, -0.280 to -0.004). Limitations In this observational study, we were unable to draw conclusions about the causality of these associations. Conclusions Patients enrolled in CCNC had fewer inpatient health care visits associated with chemotherapy-related AEs. Future research should continue to explore the extent to which patient-centered medical homes can monitor and help manage the effects of cancer treatments.

Background Community Care of North Carolina (CCNC) initiated an innovative medical home program in the 1990 s to improve primary care in Medicaid-insured populations. CCNC has been successful in improving asthma, diabetes, and cardiovascular outcomes but has not been evaluated in the context of cancer care. We explored whether CCNC enrollment was associated with guideline-concordant follow-up care among breast cancer survivors. Methods Using state cancer registry records matched to Medicaid claims, we identified women 18 to 64 years old who were diagnosed with stage 0, I, II, or unstaged breast cancer from 2003 to 2007 and tracked their monthly CCNC enrollment. Using published American Society for Clinical Oncology guidelines to define our outcomes, we employed multivariate logistic regressions to examine, as a function of CCNC enrollment, receipt of mammogram and at least 2 physical examinations/history-taking visits within observational windows consistent with the guidelines. Results Of the 840 women, approximately half were enrolled into the CCNC for some time during the study period. Between 40% and 85% received follow-up mammogram in accordance with guidelines, with significant variation by CCNC status, and 95% of women received at least 2 physical examinations/history-taking visits. In multivariate models, increasing months of CCNC enrollment was significantly positively associated with receipt of follow-up mammogram but not with physical examinations/history-taking visits. Conclusions Results suggest that CCNC enrollment is associated with guideline-concordant follow-up care for Medicaid-insured survivors. Given the growing population of cancer survivors and increased emphasis on primary care medical homes, future studies should explore what factors are associated with medical home participation and whether similar findings are observed with extended follow-up.

In this article, we propose a multiple decision procedure to test the homogeneity of normal variances. If the null-hypothesis is rejected, our goal is to select a subset containing the population a...

Therapies that combine Chinese and western medicine is applied particularly often on patients in rehabilitation departments to reduce disease and illness recovery times. Acupuncture (fine needle piercing) is a widely applied traditional Chinese therapeutic approach. However, accidents including leaving needles in the patient's body and patient fainting due to carelessness or inadequate nursing training have raised concerns about the efficacy of acupuncture.This article was written to recommend ways to improve the safety of acupuncture applied to patients in rehabilitation departments.The authors developed standard operating procedures, nursing records, double-checking requirements, and on-the-job training courses.After implementation of recommended resolutions, nursing staff cognition rose from 9.6 (63.8%) to 14.5 points (96.6%); the Traditional Chinese Medicine (TCM) nursing skill accuracy rate rose from 93 (58.1%) to 144 points (90.0%); and accident incidents fell from 6 (0.9%; 2008.1-2009.1) to 0 (2009.4.1-4.30).Implementing resolution recommendations effectively enhance patient safety.

Traditional studies utilize data from financial statements to construct financial crisis alerting models by using statistical methods or artificial intelligence techniques. According to these models, researchers can evaluate the possibilities of bankruptcy. While these models can predict the future operational status with the aid of earlier financial data, they cannot consider the continuous classification signals which might be helpful to the prediction. Hence, according to priori studies, our study not only considers corporate factors and different sample matches but also uses financial ratios within different periods to construct Back-Propagation Neural Network models. Besides, we apply sequential pattern mining to signals of the best models, which we construct, in order to gain some prediction patterns, which we can utilize to predict a company's operational status of next term. The study shows that the combination of Back-Propagation Neural Network model (BPNN) and sequential pattern mining can forecast the operational status without any financial information of next term and its predicting result is similar to the classification result which is made by BPNN.

Prediction models provide investors preliminary information before bankruptcy. Prediction models based on classification technique distinguish a listed company between healthiness and bankruptcy in the most literature, but little attention has been paid to do the further discussion on the sequential analysis of classifications. To supplement this insufficiency, a mixture model of Support Vector Machine (SVM) and Binary Sequential Analysis (BSA) is presented. The BSA mines the predicting pattern from the SVM classification signals to predict next outcome of the company. The mixture modes can not only provide a company the contemporaneous classification but also the next prediction of failure status. Our experimental results of Taiwan stock market reported that the accuracy of BSA prediction is very close to the correctness of SVM classification, or the difference is less than 2%.

We characterize fault geometries for moderate and large earthquakes in and offshore southwest (SW) Taiwan. Stress orientation estimates suggest that the first shock of the Pingtung earthquake may be characterized by slab flexure. Aregion of predominately normal-faulting earthquakes is also defined. Using the maximum-likelihood Gutenberg-Richter relation, we find that the repeat times for magnitude, M _ 6.5 and M _ 7.0 earthquakes are approximately 30 and 80 years, respectively. By assuming a Gaussian probability distribution with a standard deviation of 0.4 the recurrence time, we estimate a 50% probability of an M _ 6.5 earthquake recurring in the next 30 years, while only a 20% probability of an M _ 7.0 in the next 50 years. To test the empirical relation that is currently being used to convert ML to seismic moment (M0), we test the well-defined energy to moment ratio (E/M0) for the region. We additionally utilize this method to identify the lack of slow-source earthquakes in several recent offshore events in Taiwan.

In this paper, we propose a multiple decision procedure for testing the homogeneity of normal means when the sample sizes and unknown variances are unequal. When there is a substantial departure from the null hypothesis we reject the null hypothesis and also identify the levels that contributed most towards the departure from homogeneity.