International Journal of Environmental Research and Public Health, 2019
Health of the metal industrial workers should be a noteworthy issue due to the hazard ofchronic e... more Health of the metal industrial workers should be a noteworthy issue due to the hazard ofchronic exposure to metals or toxic elements. The interactions among multiple elements aresophisticated and may differ from person to person. Tumor necrosis factor-α (TNF-α) genepolymorphisms were supposed to be involved with the interactions because TNF-α plays animportant role in inflammation, a mechanism by which toxic elements cause threats to humanhealth. This research aimed to analyze the influence of TNF-α gene polymorphisms and multielementson serum TNF-α level. Blood multi-elements concentrations (lead, cadmium, arsenic,selenium, cobalt, copper, and zinc), serum TNF-α level, and TNF-α single nucleotidepolymorphisms (SNPs), including −238G > A (rs361525), −308G > A (rs1800629), −857C > T(rs1799724), −863C > A (rs1800630), and −1031T > C (rs1799964), were measured in 462 metalindustrial workers. We applied mixed-effect models to analyze the interactions among multielementsan...
Illegal drug use has caused considerable health and social costs. Access to medical treatment has... more Illegal drug use has caused considerable health and social costs. Access to medical treatment has been one of the most cost‐effective interventions to reduce problematic drug use. Accessibility to treatment, which can be analyzed by the spatial approach such as geographic information system (GIS), has thus been utilized as a measure of the proportion of population that reaches appropriate health services. In this study, the association of accessibility coverage to medical facilities and socioeconomic status with human immunodeficiency virus (HIV) risk for heroin users was evaluated by GIS analysis in Kaohsiung, Taiwan. Data of 7890 heroin users were collected from 2011 to 2015 and categorized into five risk groups according to their income and distance to treatment settings. The results of this GIS‐based analysis show that the areas with over 50% accessibility coverage rate had less amounts of HIV cases with statistical significance. Inconvenient access to medical facilities could r...
Thirty paediatric patients with acute lower respiratory tract infections (ALRI) caused by simulta... more Thirty paediatric patients with acute lower respiratory tract infections (ALRI) caused by simultaneous multiple viral infections (SMV) in a 3»year interval were reviewed. Twenty patients were infected with two viruses simultaneously; nine patients with three viruses; and one patient with four viruses. The frequency of individual viruses were: adenovirus, 18 (60 per cent); respiratory syncytial virus, 7 (23 per cent); influenza virus type A, 6 (20 per cent); influenza virus type B, 15 (50 per cent); parainfluenza virus type 1, 11 (37 per cent); parainfluenza virus type 3, 13 (43 per cent). There was no difference between the clinical presentations of ALRI with SMV and those of ALRI with a single virus. In conclusion, SMV was not uncommon in children with ALRI; the clinical presentations of multiple viral infection were similar to those of single viral infection.
Most of the patients in this study with spinal muscular atrophy were found to have tremors of the... more Most of the patients in this study with spinal muscular atrophy were found to have tremors of the isoelectric line in the electrocardiogram (ECG) tracings. There were a total of 47 cases of SMA (mean age 40.8 months). All three types of SMA had a similar incidence (about 80%) of tremors in the tracings (p=0.885). In 7 cases the ECG tremors had an intermittent pattern. ECG tremors were commonly found in the majority of SMA patients and this finding, though non-specific, may suggest a possible SMA diagnosis.
Background: The study's purpose was to examine the effectiveness of different reminder strategies... more Background: The study's purpose was to examine the effectiveness of different reminder strategies on first-time free mammography screening among middle-aged women in Taiwan. Methods: A quasi-experimental design with random assignment was adopted to divide the participants into three Reminder Strategies groups (mail reminder, telephone reminder, and combined mail and telephone reminders) and one control group. This study recruited 240 eligible middle-aged women, and 205 of them completed the study. Upon the completion of data collection, mail reminders were provided to women of the first group; telephone reminders were provided to the second group; mail followed by telephone reminders were provided to the third group, and the usual postcards were provided to the control group 1 month after the interventions. Two follow-up assessments were conducted 1 and 3 months after the intervention to collect mammography-screening behaviors from all groups. Results: The findings showed that, compared to the control group, more participants in the intervention groups underwent mammography screening after receiving reminder interventions. Telephone contact as reminder was found to have the most significant influence among the interventions (OR = 5.0556; 95% CI = 2.0422-13.5722). Conclusions: Government and healthcare providers are recommended to consider adopting the telephone reminder strategy to encourage women to undergo their first-time mammography screening.
This paper aims to conduct and evaluate an educational intervention on preventing cervical cancer... more This paper aims to conduct and evaluate an educational intervention on preventing cervical cancer among married immigrant women of Vietnamese origin. The study design was a quasi-experimental method with two groups. In total, 260 married immigrant women of Vietnamese origin with national health insurance at least 30 years of age were recruited from November 2013 to January 2015 in southern Taiwan. The effects of the educational intervention, including cervical cancer and Papanicolaou test knowledge, attitudes towards cervical cancer, fatalism, barriers to receiving Papanicolaou tests, intention for receiving Papanicolaou tests within the next year, and intention for receiving Papanicolaou tests within the next 3 years, were evaluated. Repeated measures analyses of variance showed significant interactions between the intervention group and time for cervical cancer knowledge, knowledge of Papanicolaou test, attitudes towards cervical cancer, and intention for receiving a Papanicolaou test within the next 3 years; in addition, 71.4 % reported being satisfied or very satisfied with the intervention. The results of this study can provide information for governments to make appropriate health policies for screening behavior of cervical cancer, increase healthcare professionals' competencies towards Vietnamese women, and increase Papanicolaou test screening rates to decrease cervical cancer mortality. Effective interventions may require particular consideration of married immigrant women.
This study retrospectively reviewed those pediatric patients of acute lower respiratory tract inf... more This study retrospectively reviewed those pediatric patients of acute lower respiratory tract infection with positive virus identification by direct immunofluorescence assay (Direct IF) from Jan, 1992 to Dec, 1993. One hundred and eighteen patients with 133 positive Direct IF results (107 cases with single virus identified, and 11 cases with more than one) were included. The sex ratio was 1.6:1 with males predominant; age, 22.1 (1 approximately 154.8) (months); duration of admission, 5.7 (1 approximately 69) (days); peripheral white blood cell count, 10,600 +/- 3,800/mm3; C-reactive protein, 17.0 (0 approximately 163.3) mu/ml; body temperature, 37.1 +/- 1.1 degrees C in those cases with single virus. The symptoms were cough 105 cases (98.1%), rhinorrhea 46 cases (43.0%), dyspnea and/or tachypnea 43 cases (40.2%) and diarrhea 15 cases (14.0%). The viruses identified were: Adenovirus (52 cases, 39.1%). Influenza B (45 cases, 33.8%), Parainfluenza 1 (28 cases, 20.1%), Parainfluenza 3 (19 cases 14.3%), Respiratory Syncytial virus (17 cases, 12.8%), and Influenza A (9 cases, 6.8%). The seasonal incidence rates were spring (49 cases, 36.8%), summer (46 cases, 34.6%), autumn (23 cases, 17.3%), and winter (15 cases, 11.3%). The results showed much similarity with others, except the commonest viral type (Adenovirus in this study; Respiratory Syncytial virus in others) and the seasonal incidence rate (higher in spring and summer in this study but not in others). In conclusion, most children with acute viral lower respiratory tract infection had an uneventful course and Direct IF is a reliable method for viral detection in that disease.
Changes in the demographic structure in Taiwan have increased the need for long-term care (LTC). ... more Changes in the demographic structure in Taiwan have increased the need for long-term care (LTC). Person-centered and community-based care is being advocated. The need to address the specific LTC needs of Taiwan`s indigenous peoples has been a part of national LTC policy since National Long-term Care Plan 2.0 was adopted in 2015. The provision of LTC services and the deployment of related resources in indigenous areas generally lag behind Taiwan`s other areas. Potential reasons for this disparity include lack of in-charge, dedicated units; exclusive use of normative service models in indigenous areas; and conflict between talent cultivation and rooted development. Future policy should focus more on providing cultural care in indigenous areas and on offering more flexible and diversified development possibilities. The implementation of these policies may promote the development of LTC and the successful deployment of LTC resources in Taiwan`s indigenous regions.
Background: We aimed to explore the efficacy and safety profile of preoperative neoadjuvant chemo... more Background: We aimed to explore the efficacy and safety profile of preoperative neoadjuvant chemoradiation (NACRT) in locally advanced rectal cancer (LARC) in upper rectum versus middle/lower rectum. Methods: The study included 173 patients with stage II or III (T2-4b, N0-2b) LARC who underwent NACRT followed by total mesorectal excision (TME) between January 2011 and October 2016. Cox regression, log-rank test, and Kaplan-Meier curves were calculated. Results: Among the 173 patients, 58 had lesions in the upper rectum and 115 patients had lesions in middle/lower rectum. In a median follow-up of 35 months (range, 6-73 months), the 5-year disease-free survival (DFS) and overall survival (OS) were 84% and 88% for the patients with upper rectal cancer and 77% and 68% for those with middle/lower rectal cancer (P = 0.251 and P = 0.058, respectively). The 5-year DFS (P = 0.012) and OS (P = 0.003) were better in the NACRT responders [tumor regression grade (TRG) 0 or 1] compared with nonresponders (TRG 2 or 3). The independent prognostic factor of favorable response to NACRT was the FOLFOX regimen (P = 0.004). Conclusions: Patients with LARC in the upper rectum who underwent NACRT followed by TME had similar DFS and a trend toward longer OS, compared with those who had middle/lower rectal lesions. Furthermore, FOLFOX may yield superior results than fluoropyrimidine based regimen during NACRT. NACRT might be an alternative option for patients with LARC in the upper rectum as it has a favorable pathological complete response rate and comparable clinical outcomes when compared with patients with LARC in middle/lower rectum.
Colorectal cancer (CRC) is a major public health problem. Early CRC detection, pretherapeutic res... more Colorectal cancer (CRC) is a major public health problem. Early CRC detection, pretherapeutic responsiveness prediction, and postoperative micrometastasis monitoring are the hallmarks for successful CRC treatment. Here, the methodologies used for detecting circulating tumor cells (CTCs) from CRC are reviewed. In addition to the traditional CRC biomarkers, the persistent presence of posttherapeutic CTCs indicates resistance to adjuvant chemotherapy and/or radiotherapy; hence, CTCs also play a decisive role in the subsequent relapse of CRC. Moreover, the genetic and phenotypic profiling of CTCs often differs from that of the primary tumor; this difference can be used to select the most effective targeted therapy. Consequently, studying CTCs can potentially individualize treatment strategies for patients with CRC. Therefore, CTC detection and characterization may be valuable tools for refining prognosis, and CTCs can be used in a real-time tumor biopsy for designing individually tailored therapy against CRC.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for... more Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for patients with advanced-stage oral squamous cell carcinoma (OSCC) remains poor. The present study investigated the prognostic value of three DNA repair genes, namely excision repair cross-complementing group 1 (ERCC1), ERCC2 and X-ray repair cross-complementing group 1 (XRCC1) in OSCC. The protein expression levels of XRCC1, ERCC1 and ERCC2 in oral cell lines were analyzed via western blotting and immunohistochemistry using samples from 98 patients with biopsy-proven OSCC, while the χ 2 test was used to analyze the clinicopathological association. Kaplan-Meier estimates were used to determine the prognostic value of XRCC1, ERCC1 and ERCC2 for overall survival, and the log-rank test was used to evaluate the significance of differences. Multivariate analysis revealed a positive association between ERCC2 expression and OSCC recurrence (19.64-fold; 95% CI, 5.00-77.1; P<0.001). In addition, the high protein expression levels of XRCC1, ERCC1 and ERCC2 were associated with poor disease-free and overall survival rates. Therefore, the present study suggested that high ERCC2 expression may be a risk factor for OSCC recurrence.
Dengue fever is a vector-borne disease that has become a serious global public health problem ove... more Dengue fever is a vector-borne disease that has become a serious global public health problem over the past decade. An essential aspect of controlling and preventing mosquito-borne diseases is reduction of mosquito density. Through the process of urbanization, sewers (ditches) have become easy breeding sources of vector mosquitoes. In this study, we, for the first time, used unmanned ground vehicle systems (UGVs) to enter ditches in urban areas to observe vector mosquito ecology. We found traces of vector mosquitoes in ~20.7% of inspected ditches, suggesting that these constitute viable breeding sources of vector mosquitoes in urban areas. We also analyzed the average gravitrap catch of five administrative districts in Kaohsiung city from May to August 2018. The gravitrap indices of Nanzi and Fengshan districts were above the expected average (3.26), indicating that the vector mosquitoes density in these areas is high. Using the UGVs to detect positive ditches within the five districts followed by insecticide application generally yielded good control results. Further improving the high-resolution digital camera and spraying system of the UGVs may be able to effectively and instantly monitor vector mosquitoes and implement spraying controls. This approach may be suitable to solve the complex and difficult task of detecting mosquito breeding sources in urban ditches.
to explore the effects of a group health education programme on the childbearing knowledge, attit... more to explore the effects of a group health education programme on the childbearing knowledge, attitude, and behaviours among Southeast Asian immigrant women in Taiwan. a quasi-experimental design with convenience sampling was used. participants living in Kaohsiung County, Taiwan, were randomly divided by districts into either the experimental group or the control group. one hundred Southeast Asian immigrant women were recruited as research participants. Among the 100 participants, 50 were in the experimental group and 50 were in the control group. A total of 99 participants completed the entire research procedure. a structured interview was used to evaluate the effects of a group health education programme. the interview consisted of four measurements: the Demographic Inventory Scale, the Childbearing Knowledge Scale, the Childbearing Attitude Scale, and the Childbearing Planning Scale. after employing the group health education intervention, statistically significant changes from the pre-test to the post-test were found in the experimental group&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s scores for the Childbearing Knowledge Scale (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001), the Childbearing Attitude Scale (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), and the Childbearing Planning Scale (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001). The study&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s results indicated that providing education through group learning with guidance and support in childbearing health significantly improved Southeast Asian immigrant women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s childbearing health knowledge, attitudes, and behaviours. an appropriate, community-based group health education programme can create awareness for childbearing health among Southeast Asian immigrant women in Taiwan and improve their childbearing attitudes and behaviours.
Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for... more Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for patients with advanced-stage oral squamous cell carcinoma (OSCC) remains poor. The present study investigated the prognostic value of three DNA repair genes, namely excision repair cross-complementing group 1 (ERCC1), ERCC2 and X-ray repair cross-complementing group 1 (XRCC1) in OSCC. The protein expression levels of XRCC1, ERCC1 and ERCC2 in oral cell lines were analyzed via western blotting and immunohistochemistry using samples from 98 patients with biopsy-proven OSCC, while the χ 2 test was used to analyze the clinicopathological association. Kaplan-Meier estimates were used to determine the prognostic value of XRCC1, ERCC1 and ERCC2 for overall survival, and the log-rank test was used to evaluate the significance of differences. Multivariate analysis revealed a positive association between ERCC2 expression and OSCC recurrence (19.64-fold; 95% CI, 5.00-77.1; P<0.001). In addition, the high protein expression levels of XRCC1, ERCC1 and ERCC2 were associated with poor disease-free and overall survival rates. Therefore, the present study suggested that high ERCC2 expression may be a risk factor for OSCC recurrence.
Little is known about the effects of seamless hospital discharge planning on long-term care (LTC)... more Little is known about the effects of seamless hospital discharge planning on long-term care (LTC) costs and effectiveness. This study evaluates the cost and effectiveness of the recently implemented policy from hospital to LTC between patients discharged under seamless transition and standard transition. A total of 49 elderly patients in the standard transition cohort and 119 in the seamless transition cohort were recruited from November 2016 to February 2018. Data collected from medical records included the Multimorbidity Frailty Index, Activities of Daily Living Scale, and Malnutrition Universal Screening Tool during hospitalization. Multiple linear regression and Cox regression models were used to explore risk factors for medical resource utilization and medical outcomes. After adjustment for effective predictors, the seamless cohort had lower direct medical costs, a shorter length of stay, a higher survival rate, and a lower unplanned readmission rate compared to the standard co...
International Journal of Environmental Research and Public Health, 2019
Health of the metal industrial workers should be a noteworthy issue due to the hazard ofchronic e... more Health of the metal industrial workers should be a noteworthy issue due to the hazard ofchronic exposure to metals or toxic elements. The interactions among multiple elements aresophisticated and may differ from person to person. Tumor necrosis factor-α (TNF-α) genepolymorphisms were supposed to be involved with the interactions because TNF-α plays animportant role in inflammation, a mechanism by which toxic elements cause threats to humanhealth. This research aimed to analyze the influence of TNF-α gene polymorphisms and multielementson serum TNF-α level. Blood multi-elements concentrations (lead, cadmium, arsenic,selenium, cobalt, copper, and zinc), serum TNF-α level, and TNF-α single nucleotidepolymorphisms (SNPs), including −238G > A (rs361525), −308G > A (rs1800629), −857C > T(rs1799724), −863C > A (rs1800630), and −1031T > C (rs1799964), were measured in 462 metalindustrial workers. We applied mixed-effect models to analyze the interactions among multielementsan...
Illegal drug use has caused considerable health and social costs. Access to medical treatment has... more Illegal drug use has caused considerable health and social costs. Access to medical treatment has been one of the most cost‐effective interventions to reduce problematic drug use. Accessibility to treatment, which can be analyzed by the spatial approach such as geographic information system (GIS), has thus been utilized as a measure of the proportion of population that reaches appropriate health services. In this study, the association of accessibility coverage to medical facilities and socioeconomic status with human immunodeficiency virus (HIV) risk for heroin users was evaluated by GIS analysis in Kaohsiung, Taiwan. Data of 7890 heroin users were collected from 2011 to 2015 and categorized into five risk groups according to their income and distance to treatment settings. The results of this GIS‐based analysis show that the areas with over 50% accessibility coverage rate had less amounts of HIV cases with statistical significance. Inconvenient access to medical facilities could r...
Thirty paediatric patients with acute lower respiratory tract infections (ALRI) caused by simulta... more Thirty paediatric patients with acute lower respiratory tract infections (ALRI) caused by simultaneous multiple viral infections (SMV) in a 3»year interval were reviewed. Twenty patients were infected with two viruses simultaneously; nine patients with three viruses; and one patient with four viruses. The frequency of individual viruses were: adenovirus, 18 (60 per cent); respiratory syncytial virus, 7 (23 per cent); influenza virus type A, 6 (20 per cent); influenza virus type B, 15 (50 per cent); parainfluenza virus type 1, 11 (37 per cent); parainfluenza virus type 3, 13 (43 per cent). There was no difference between the clinical presentations of ALRI with SMV and those of ALRI with a single virus. In conclusion, SMV was not uncommon in children with ALRI; the clinical presentations of multiple viral infection were similar to those of single viral infection.
Most of the patients in this study with spinal muscular atrophy were found to have tremors of the... more Most of the patients in this study with spinal muscular atrophy were found to have tremors of the isoelectric line in the electrocardiogram (ECG) tracings. There were a total of 47 cases of SMA (mean age 40.8 months). All three types of SMA had a similar incidence (about 80%) of tremors in the tracings (p=0.885). In 7 cases the ECG tremors had an intermittent pattern. ECG tremors were commonly found in the majority of SMA patients and this finding, though non-specific, may suggest a possible SMA diagnosis.
Background: The study's purpose was to examine the effectiveness of different reminder strategies... more Background: The study's purpose was to examine the effectiveness of different reminder strategies on first-time free mammography screening among middle-aged women in Taiwan. Methods: A quasi-experimental design with random assignment was adopted to divide the participants into three Reminder Strategies groups (mail reminder, telephone reminder, and combined mail and telephone reminders) and one control group. This study recruited 240 eligible middle-aged women, and 205 of them completed the study. Upon the completion of data collection, mail reminders were provided to women of the first group; telephone reminders were provided to the second group; mail followed by telephone reminders were provided to the third group, and the usual postcards were provided to the control group 1 month after the interventions. Two follow-up assessments were conducted 1 and 3 months after the intervention to collect mammography-screening behaviors from all groups. Results: The findings showed that, compared to the control group, more participants in the intervention groups underwent mammography screening after receiving reminder interventions. Telephone contact as reminder was found to have the most significant influence among the interventions (OR = 5.0556; 95% CI = 2.0422-13.5722). Conclusions: Government and healthcare providers are recommended to consider adopting the telephone reminder strategy to encourage women to undergo their first-time mammography screening.
This paper aims to conduct and evaluate an educational intervention on preventing cervical cancer... more This paper aims to conduct and evaluate an educational intervention on preventing cervical cancer among married immigrant women of Vietnamese origin. The study design was a quasi-experimental method with two groups. In total, 260 married immigrant women of Vietnamese origin with national health insurance at least 30 years of age were recruited from November 2013 to January 2015 in southern Taiwan. The effects of the educational intervention, including cervical cancer and Papanicolaou test knowledge, attitudes towards cervical cancer, fatalism, barriers to receiving Papanicolaou tests, intention for receiving Papanicolaou tests within the next year, and intention for receiving Papanicolaou tests within the next 3 years, were evaluated. Repeated measures analyses of variance showed significant interactions between the intervention group and time for cervical cancer knowledge, knowledge of Papanicolaou test, attitudes towards cervical cancer, and intention for receiving a Papanicolaou test within the next 3 years; in addition, 71.4 % reported being satisfied or very satisfied with the intervention. The results of this study can provide information for governments to make appropriate health policies for screening behavior of cervical cancer, increase healthcare professionals&amp;amp;#39; competencies towards Vietnamese women, and increase Papanicolaou test screening rates to decrease cervical cancer mortality. Effective interventions may require particular consideration of married immigrant women.
This study retrospectively reviewed those pediatric patients of acute lower respiratory tract inf... more This study retrospectively reviewed those pediatric patients of acute lower respiratory tract infection with positive virus identification by direct immunofluorescence assay (Direct IF) from Jan, 1992 to Dec, 1993. One hundred and eighteen patients with 133 positive Direct IF results (107 cases with single virus identified, and 11 cases with more than one) were included. The sex ratio was 1.6:1 with males predominant; age, 22.1 (1 approximately 154.8) (months); duration of admission, 5.7 (1 approximately 69) (days); peripheral white blood cell count, 10,600 +/- 3,800/mm3; C-reactive protein, 17.0 (0 approximately 163.3) mu/ml; body temperature, 37.1 +/- 1.1 degrees C in those cases with single virus. The symptoms were cough 105 cases (98.1%), rhinorrhea 46 cases (43.0%), dyspnea and/or tachypnea 43 cases (40.2%) and diarrhea 15 cases (14.0%). The viruses identified were: Adenovirus (52 cases, 39.1%). Influenza B (45 cases, 33.8%), Parainfluenza 1 (28 cases, 20.1%), Parainfluenza 3 (19 cases 14.3%), Respiratory Syncytial virus (17 cases, 12.8%), and Influenza A (9 cases, 6.8%). The seasonal incidence rates were spring (49 cases, 36.8%), summer (46 cases, 34.6%), autumn (23 cases, 17.3%), and winter (15 cases, 11.3%). The results showed much similarity with others, except the commonest viral type (Adenovirus in this study; Respiratory Syncytial virus in others) and the seasonal incidence rate (higher in spring and summer in this study but not in others). In conclusion, most children with acute viral lower respiratory tract infection had an uneventful course and Direct IF is a reliable method for viral detection in that disease.
Changes in the demographic structure in Taiwan have increased the need for long-term care (LTC). ... more Changes in the demographic structure in Taiwan have increased the need for long-term care (LTC). Person-centered and community-based care is being advocated. The need to address the specific LTC needs of Taiwan`s indigenous peoples has been a part of national LTC policy since National Long-term Care Plan 2.0 was adopted in 2015. The provision of LTC services and the deployment of related resources in indigenous areas generally lag behind Taiwan`s other areas. Potential reasons for this disparity include lack of in-charge, dedicated units; exclusive use of normative service models in indigenous areas; and conflict between talent cultivation and rooted development. Future policy should focus more on providing cultural care in indigenous areas and on offering more flexible and diversified development possibilities. The implementation of these policies may promote the development of LTC and the successful deployment of LTC resources in Taiwan`s indigenous regions.
Background: We aimed to explore the efficacy and safety profile of preoperative neoadjuvant chemo... more Background: We aimed to explore the efficacy and safety profile of preoperative neoadjuvant chemoradiation (NACRT) in locally advanced rectal cancer (LARC) in upper rectum versus middle/lower rectum. Methods: The study included 173 patients with stage II or III (T2-4b, N0-2b) LARC who underwent NACRT followed by total mesorectal excision (TME) between January 2011 and October 2016. Cox regression, log-rank test, and Kaplan-Meier curves were calculated. Results: Among the 173 patients, 58 had lesions in the upper rectum and 115 patients had lesions in middle/lower rectum. In a median follow-up of 35 months (range, 6-73 months), the 5-year disease-free survival (DFS) and overall survival (OS) were 84% and 88% for the patients with upper rectal cancer and 77% and 68% for those with middle/lower rectal cancer (P = 0.251 and P = 0.058, respectively). The 5-year DFS (P = 0.012) and OS (P = 0.003) were better in the NACRT responders [tumor regression grade (TRG) 0 or 1] compared with nonresponders (TRG 2 or 3). The independent prognostic factor of favorable response to NACRT was the FOLFOX regimen (P = 0.004). Conclusions: Patients with LARC in the upper rectum who underwent NACRT followed by TME had similar DFS and a trend toward longer OS, compared with those who had middle/lower rectal lesions. Furthermore, FOLFOX may yield superior results than fluoropyrimidine based regimen during NACRT. NACRT might be an alternative option for patients with LARC in the upper rectum as it has a favorable pathological complete response rate and comparable clinical outcomes when compared with patients with LARC in middle/lower rectum.
Colorectal cancer (CRC) is a major public health problem. Early CRC detection, pretherapeutic res... more Colorectal cancer (CRC) is a major public health problem. Early CRC detection, pretherapeutic responsiveness prediction, and postoperative micrometastasis monitoring are the hallmarks for successful CRC treatment. Here, the methodologies used for detecting circulating tumor cells (CTCs) from CRC are reviewed. In addition to the traditional CRC biomarkers, the persistent presence of posttherapeutic CTCs indicates resistance to adjuvant chemotherapy and/or radiotherapy; hence, CTCs also play a decisive role in the subsequent relapse of CRC. Moreover, the genetic and phenotypic profiling of CTCs often differs from that of the primary tumor; this difference can be used to select the most effective targeted therapy. Consequently, studying CTCs can potentially individualize treatment strategies for patients with CRC. Therefore, CTC detection and characterization may be valuable tools for refining prognosis, and CTCs can be used in a real-time tumor biopsy for designing individually tailored therapy against CRC.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for... more Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for patients with advanced-stage oral squamous cell carcinoma (OSCC) remains poor. The present study investigated the prognostic value of three DNA repair genes, namely excision repair cross-complementing group 1 (ERCC1), ERCC2 and X-ray repair cross-complementing group 1 (XRCC1) in OSCC. The protein expression levels of XRCC1, ERCC1 and ERCC2 in oral cell lines were analyzed via western blotting and immunohistochemistry using samples from 98 patients with biopsy-proven OSCC, while the χ 2 test was used to analyze the clinicopathological association. Kaplan-Meier estimates were used to determine the prognostic value of XRCC1, ERCC1 and ERCC2 for overall survival, and the log-rank test was used to evaluate the significance of differences. Multivariate analysis revealed a positive association between ERCC2 expression and OSCC recurrence (19.64-fold; 95% CI, 5.00-77.1; P<0.001). In addition, the high protein expression levels of XRCC1, ERCC1 and ERCC2 were associated with poor disease-free and overall survival rates. Therefore, the present study suggested that high ERCC2 expression may be a risk factor for OSCC recurrence.
Dengue fever is a vector-borne disease that has become a serious global public health problem ove... more Dengue fever is a vector-borne disease that has become a serious global public health problem over the past decade. An essential aspect of controlling and preventing mosquito-borne diseases is reduction of mosquito density. Through the process of urbanization, sewers (ditches) have become easy breeding sources of vector mosquitoes. In this study, we, for the first time, used unmanned ground vehicle systems (UGVs) to enter ditches in urban areas to observe vector mosquito ecology. We found traces of vector mosquitoes in ~20.7% of inspected ditches, suggesting that these constitute viable breeding sources of vector mosquitoes in urban areas. We also analyzed the average gravitrap catch of five administrative districts in Kaohsiung city from May to August 2018. The gravitrap indices of Nanzi and Fengshan districts were above the expected average (3.26), indicating that the vector mosquitoes density in these areas is high. Using the UGVs to detect positive ditches within the five districts followed by insecticide application generally yielded good control results. Further improving the high-resolution digital camera and spraying system of the UGVs may be able to effectively and instantly monitor vector mosquitoes and implement spraying controls. This approach may be suitable to solve the complex and difficult task of detecting mosquito breeding sources in urban ditches.
to explore the effects of a group health education programme on the childbearing knowledge, attit... more to explore the effects of a group health education programme on the childbearing knowledge, attitude, and behaviours among Southeast Asian immigrant women in Taiwan. a quasi-experimental design with convenience sampling was used. participants living in Kaohsiung County, Taiwan, were randomly divided by districts into either the experimental group or the control group. one hundred Southeast Asian immigrant women were recruited as research participants. Among the 100 participants, 50 were in the experimental group and 50 were in the control group. A total of 99 participants completed the entire research procedure. a structured interview was used to evaluate the effects of a group health education programme. the interview consisted of four measurements: the Demographic Inventory Scale, the Childbearing Knowledge Scale, the Childbearing Attitude Scale, and the Childbearing Planning Scale. after employing the group health education intervention, statistically significant changes from the pre-test to the post-test were found in the experimental group&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s scores for the Childbearing Knowledge Scale (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001), the Childbearing Attitude Scale (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01), and the Childbearing Planning Scale (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001). The study&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s results indicated that providing education through group learning with guidance and support in childbearing health significantly improved Southeast Asian immigrant women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s childbearing health knowledge, attitudes, and behaviours. an appropriate, community-based group health education programme can create awareness for childbearing health among Southeast Asian immigrant women in Taiwan and improve their childbearing attitudes and behaviours.
Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for... more Oral cancer is the fourth most common type of cancer among males in Taiwan, and the prognosis for patients with advanced-stage oral squamous cell carcinoma (OSCC) remains poor. The present study investigated the prognostic value of three DNA repair genes, namely excision repair cross-complementing group 1 (ERCC1), ERCC2 and X-ray repair cross-complementing group 1 (XRCC1) in OSCC. The protein expression levels of XRCC1, ERCC1 and ERCC2 in oral cell lines were analyzed via western blotting and immunohistochemistry using samples from 98 patients with biopsy-proven OSCC, while the χ 2 test was used to analyze the clinicopathological association. Kaplan-Meier estimates were used to determine the prognostic value of XRCC1, ERCC1 and ERCC2 for overall survival, and the log-rank test was used to evaluate the significance of differences. Multivariate analysis revealed a positive association between ERCC2 expression and OSCC recurrence (19.64-fold; 95% CI, 5.00-77.1; P<0.001). In addition, the high protein expression levels of XRCC1, ERCC1 and ERCC2 were associated with poor disease-free and overall survival rates. Therefore, the present study suggested that high ERCC2 expression may be a risk factor for OSCC recurrence.
Little is known about the effects of seamless hospital discharge planning on long-term care (LTC)... more Little is known about the effects of seamless hospital discharge planning on long-term care (LTC) costs and effectiveness. This study evaluates the cost and effectiveness of the recently implemented policy from hospital to LTC between patients discharged under seamless transition and standard transition. A total of 49 elderly patients in the standard transition cohort and 119 in the seamless transition cohort were recruited from November 2016 to February 2018. Data collected from medical records included the Multimorbidity Frailty Index, Activities of Daily Living Scale, and Malnutrition Universal Screening Tool during hospitalization. Multiple linear regression and Cox regression models were used to explore risk factors for medical resource utilization and medical outcomes. After adjustment for effective predictors, the seamless cohort had lower direct medical costs, a shorter length of stay, a higher survival rate, and a lower unplanned readmission rate compared to the standard co...
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