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Ling-Chun Lee,1,* Pi-Shan Hsu,2,3,* Kuen-Chang Hsieh,4– 6 Yu-Yawn Chen,7 Lee-Ping Chu,8 Hsueh-Kuan Lu,9 Yen-Chen Chiu,10 Lin Li,11 Chung-Liang Lai12,13 1Department of Physical Education, Chinese Culture University, Taipei, Taiwan; 2Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; 3Graduate Institute of Microbiology and Public Health, National Chung-Hsing University, Taichung, Taiwan; 4Fundamental Education Center, National Chin-Yi University of Technology, Taichung, Taiwan; 5Big Data Center, National Chung-Hsing University, Taichung, Taiwan; 6Office of Physical Education, Fu Jen Catholic University, New Taipei, Taiwan; 7Division of Food Nutrition, National Taitung Junior College, Taitung, Taiwan; 8Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan; 9General Education Center, National Taiwan University of Sport, Taichung, Taiwan; 10Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan; 11Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 12Department of Physical Medicine and Rehabilitation, Puzi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan; 13Department of Occupational Therapy, Asia University, Taichung, Taiwan*These authors contributed equally to this workCorrespondence: Chung-Liang LaiDepartment of Physical Medicine and Rehabilitation, Puzi Hospital, Ministry of Health and Welfare, No. 42– 50, YungHo Vil., Puzi City, Chiayi County, 61347, TaiwanTel +886-5-379-0600Email laipeter57@yahoo.com.twPurpose: To investigate the potential of standing 8-electrode bioelectrical impedance analysis (BIA) for assessing visceral fat area (VFA) and body fat mass (BFM) in athletes.Materials and Methods: A total of 95 subjects (50 males and 45 females) were recruited. VFA and BFM measurements were obtained using three standing 8-electrode BIA devices, InBody230, InBody770, and IOI353. These acquired VFA and BFM were expressed as VFAIOI353, VFAInBody230, VFAInBody770 V, BFMIOI353, BFMInBody230, and BFMInBody770, respectively. As reference measurement, the VFA acquired from computer tomography (CT) was expressed as VFACT, and the BFM measured by dual-energy X-ray absorptiometry (DXA) was denoted as BFMDXA.Results: The coefficient of determination (r2) in regression analysis between the measurements by VFAIOI353, VFAInBody230, VFAInBody770 and VFACT were 0.425, 0.492, and 0.473, respectively. Also, the limits of agreement (LOA) obtained from Bland–Altman analysis were − 25.18 to 56.62, − 29.74 to 62.44, and − 32.96 to 71.93 cm2. For BFM, r2 in regression analysis between the measurements by BFMIOI353, BFMInBody230, BFMInBody770 and BMFDXA were 0.894, 0.950, and 0.955, respectively; LOA were − 7.21 to 5.75, − 4.70 to 4.05, and − 5.48 to 3.05 kg, respectively.Conclusion: The results showed when assessing BFM, these instruments delivered comparable measurements, and the degree of agreement ranged from excellent to moderate compared with the reference method. However, when assessing VFA, the agreements were weak. Therefore, the application of standing 8-electrode BIA devices for assessing athletes’ VFA still needs improvement.Keywords: bioelectrical impedance analysis, body fat mass, visceral fat area

Pi-Shan Hsu,1,2 Ie-Bin Lian,3,4 Day-Yu Chao2 1Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 2Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan; 3Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua, Taiwan; 4Department of Applied Math, National Chung-Hsing University, Taichung, TaiwanCorrespondence: Day-Yu ChaoGraduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, Taichung 401, TaiwanTel +886-4-22840694Fax +886-4-22852186Email dychao@nchu.edu.twIe-Bin Lian Tel +886-4-7232105 ext. 3222Fax +886-4-7211192Email maiblian@cc.ncue.edu.twBackground: Influenza is a major cause of morbidity and mortality in the elderly worldwide. Influenza vaccination can prevent morbidity/mortality from influenza infection. A gap of 1– 2 years, before an epidemic strain is recommended by the World Health Organization (WHO) to be the vaccine strain in Southeast Asia, has been reported; this results in a high rate of vaccine mismatch and excess influenza-associated morbidity. The aim of the current study was to evaluate the effect of repeated vaccination on vaccine effectiveness (VE) among the elderly in Taiwan, during years with and without early appearance of antigenically drifted strains.Methods: A historical cohort study was conducted to evaluate the impact of repeated vaccination on the reduction of influenza-associated hospitalization among persons older than 64 years over two influenza seasons: 2007– 08, with all circulating virus strains mismatched, and 2008– 09, with all virus strains matched with the vaccine strains, considering four exposure effects, namely current vaccine effect, sequential vaccination effect, residual protection effect and no vaccination effect. Propensity score matching on vaccination status was performed to ensure similar baseline characteristics between the groups that received and did not receive vaccination.Results: Only current-year vaccination in combination with prior history of annual revaccination significantly reduced the risk of hospitalization, with adjusted hazard ratios of 0.68 (95% CI: 0.54, 0.85) and 0.74 (95% CI: 0.57, 0.95) during the 2007– 08 and 2008– 09 influenza seasons, respectively. Further stratification showed that even during the 2007– 08 influenza season, when all vaccinations were mismatched with the circulating strains, sequential vaccinations still significantly reduced influenza-associated hospitalization in the female population aged 68– 74 and 75– 84 years, with adjusted VE of 25.2% (95% CI: − 9.6, 49.0%) and 36.9% (95% CI: 17.1, 52.0%), respectively.Conclusion: Our study supports the recommendation of annual revaccination against influenza in the elderly, even though the circulating strain of influenza virus was antigenically mismatched with the vaccine strains.Keywords: vaccine effectiveness, trivalent influenza vaccine, elderly, prior vaccination history, repeated vaccination, propensity score matching

Chung-Liang Lai,1,* Ming-Miau Tsai,1,* Jia-Yuan Luo,1 Wan-Chun Liao,1 Pi-Shan Hsu,2,3 Han-Yu Chen4 1Department of Physical Medicine and Rehabilitation, 2Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, 3Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung-Hsing University, 4Department of Physical Therapy, Hungkuang University, Taichung, Taiwan *These authors contributed equally to this work Background: Stroke often causes functional decline in patients. Therefore, after the acute phase, many patients require post-acute care (PAC) to maximize their functional progress, reduce disability, and make it possible for them to return to their home and community. PAC can be provided in different settings. Taiwan’s National Health Insurance (NHI) proposed a PAC pilot program, effective since 2014, for stroke patients that allowed patients with the potential for functional improvement to receive PAC rehabilitation in regional or community hospitals. The purpose of this study was to explore the initial achievements and clinical impact of this program in Taiwan. Methods: This was a retrospective cohort study that mainly analyzed basic hospitalization data and scores for function and quality of life, as recorded immediately after admission and before discharge, for stroke patients in the PAC program in a hospital in Taiwan. Results: This study collected complete data from a total of 168 patients. After an average of 43.57 days in the program, patients showed significant improvement in the Modified Rankin Scale (MRS), the Barthel Activity Daily Living Index (B-ADL), the Lawton–Brody Instrumental Activity Daily Living Scale (LB-IADL), the Functional Oral Intake Scale (FOIS), and the Mini Nutrition Assessment (MNA), in mobility, self-care, and usual activity, as well as on anxiety/depression in the EuroQol Five Dimensions Questionnaire (EQ-5D) and in the Mini Mental State Examination (MMSE). After discharge, 76.8% of the patients could return to their home and community. Conclusion: This study showed that the pilot PAC program significantly promoted recovery of function in stroke patients and helped them to return to their home and community. Patients with the potential for functional recovery should consider receiving PAC service in a hospital after discharge from acute stroke care. Keywords: post-acute care, rehabilitation, stroke

Chung-Liang Lai,1,2 Shiuan-Yu Tseng,1,2 Chung-Nan Chen,3 Wan-Chun Liao,2 Chun-Hou Wang,4 Meng-Chih Lee,1,5,* Pi-Shan Hsu5,* 1Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; 2Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 3Department of Radiology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 4School of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan; 5Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan*These authors contributed equally to this workBackground: The issue of osteoporosis-induced fractures has attracted the world's attention. Postmenopausal women are particularly at risk for this type of fracture. The nonmedicinal intervention for postmenopausal women is mainly exercise. Whole body vibration (WBV) is a simple and convenient exercise. There have been some studies investigating the effect of WBV on osteoporosis; however, the intervention models and results are different. This study mainly investigated the effect of high-frequency and high-magnitude WBV on the bone mineral density (BMD) of the lumbar spine in postmenopausal women.Methods: This study randomized 28 postmenopausal women into either the WBV group or the control group for a 6-month trial. The WBV group received an intervention of high-frequency (30 Hz) and high-magnitude (3.2 g) WBV in a natural full-standing posture for 5 minutes, three times per week, at a sports center. Dual-energy X-ray absorptiometry was used to measure the lumbar BMD of the two groups before and after the intervention.Results: Six months later, the BMD of the WBV group had significantly increased by 2.032% (P=0.047), while that of the control group had decreased by 0.046% (P=0.188). The comparison between the two groups showed that the BMD of the WBV group had increased significantly (P=0.016).Conclusion: This study found that 6 months of high-frequency and high-magnitude WBV yielded significant benefits to the BMD of the lumbar spine in postmenopausal women, and could therefore be provided as an alternative exercise.Keywords: whole body vibration, osteoporosis, postmenopausal women Corrigendum for this paper has been published

Lai CL, Tseng SY, Chen CN, et al. Clin Interv Aging. 2013;8:1603–1609. On page 1603, the author affiliations have been listed incorrectly. The correct author list is as follows:Chung-Liang Lai1,2,6Shiuan-Yu Tseng1,2Chung-Nan Chen3Wan-Chun Liao2Chun-Hou Wang4Meng-Chih Lee1,5,*Pi-Shan Hsu5,*1Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; 2Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 3Department of Radiology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 4School of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan; 5Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 6Central Taiwan University of Science and Technology, Taichung, TaiwanRead the original paper