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To compare nurses' non-optimal eating behaviours across different shifts, to examine whether non-day shifts were related to deviation from optimal dietary behaviours compared with day shifts and whether such deviation was related to non-optimal macronutrient intake.This is a 4-day intensive longitudinal study.A convenience sample of hospital nurses was recruited in Taiwan. From September 2018 through January 2019, 120 participants completed 4-days of 24-h dietary recalls. One-way ANOVA and Kruskal-Wallis H test were used to compare differences in energy and macronutrient intake and frequency of meals and snacking, respectively. Generalized linear regressions examined (1) the associations between shiftwork schedules and non-optimal eating behaviours and (2) associations between non-optimal eating and high energy contribution of non-optimal macronutrients.Nurses consumed less energy on evening and night shifts compared with day shifts. However, energy intake from snacking was higher on evening and night shifts relative to day shifts. Nurses consumed less meals but had higher snacking frequency on non-day shifts. In addition, high energy intake from snacking was positively associated with high energy intake from saturated fat.Nurses were more likely to have non-optimal eating behaviours on non-day shifts, which may contribute to an increased intake of saturated fat; thus, increasing their risk of chronic diseases. Strategies to improve non-day shift nurses' non-optimal eating behaviours may be beneficial to their health.Shiftwork is known to affect nurses' eating behaviours; however, which shift is associated with unhealthy eating remains inconclusive. Despite lower energy intakes, nurses had higher intake by snacking on evening and night shifts. High snacking intake was associated with a high intake of saturated fat. Hospitals can increase the availability of healthy foods on evening or night shifts, which may improve non-day shift nurses' non-optimal eating behaviours.

Metabolic syndrome (MetS), a major contributor to cardiovascular and metabolic diseases, has been linked with exposure to air pollution. However, the relationship between air pollutants and the five components of MetS [abdominal obesity, elevated triglyceride, decreased high-density lipoprotein cholesterol (HDL-C), elevated blood pressure, and elevated fasting blood glucose levels], has not been clearly described.We examined the association between long-term exposure to air pollutants and the occurrence of MetS and its components by using a longitudinal cohort in Taiwan.The MJ Health Research Foundation is a medical institute that conducts regular physical examinations. The development of MetS, based on a health examination and the medical history of an MJ cohort of 93,771 participants who were enrolled between 2006 and 2016 and had two or more examinations, was compared with estimated exposure to air pollutants in the year prior to health examination. The exposure levels to fine particulate matter [PM with an aerodynamic diameter ofDuring the average follow-up period of 3.4 y, the incidence of MetS was 38.1/1,000 person-years. After mutual adjustment and adjustments for potential covariates, the results indicated that everyOur findings suggest that in apparently healthy adults undergoing physical examination, exposure to

Crossmodal correspondences refer to when specific domains of features in different sensory modalities are mapped. We investigated how vowels and lexical tones drive sound–shape (rounded or angular) and sound–size (large or small) mappings among native Mandarin Chinese speakers. We used three vowels (/i/, /u/, and /a/), and each vowel was articulated in four lexical tones. In the sound–shape matching, the tendency to match the rounded shape was decreased in the following order: /u/, /i/, and /a/. Tone 2 was more likely to be matched to the rounded pattern, whereas Tone 4 was more likely to be matched to the angular pattern. In the sound–size matching, /a/ was matched to the larger object more than /u/ and /i/, and Tone 2 and Tone 4 correspond to the large–small contrast. The results demonstrated that both vowels and tones play prominent roles in crossmodal correspondences, and sound–shape and sound–size mappings are heterogeneous phenomena.

Background Insulin resistance (IR) was reported to be associated with renal function impairment, but little is known about the gender difference. Hence, our study aimed to investigate the relationship between IR (estimated by the homeostasis model assessment of IR (HOMA-IR) index) and chronic kidney disease (CKD) in a Chinese population with metabolic syndrome (MetS) and discern whether there was any gender disparity or not. Methods This retrospective cross-sectional study enrolled 13,638 men and 10,450 women who received health examinations from 2013 to 2016 at Xiamen Chang Gung Hospital. Among the participants, 3,253 men (64.3%) and 1,808 women (35.7%) who had MetS and met the inclusion criteria were included for analysis. Spearman’s correlation was conducted to analyze the relationship between HOMA-IR and cardio-metabolic risk factors. Multivariable linear regression was analyzed to explore the relationship between HOMA-IR and cardio-metabolic variables. Logistic regression analysis was performed to assess the association between HOMA-IR and CKD. Results The median HOMA-IR and prevalence of CKD was 2.2 and 11.31%, respectively, for men and 2.09 and 15.93%, respectively, for women. In multivariable linear regression analysis, HOMA-IR was significant associated with estimated GFR, albumin/creatinine ratio in men. Multivariable logistic regression revealed a significant difference between HOMA-IR value and the prevalence of CKD in men but not in women (odds ratio in male = 1.21; 95% CI 1.14–1.28, p ≤ 0.001; odds ratio in female = 1.01; 95% CI 0.99–1.02, p = 0.38). Conclusions HOMA-IR was independently associated with CKD among men with MetS but not in women.

In hospitals, safety climate refers to the safety policies and regulations established by medical institutions and the measures taken to ensure medical personnel feel safe while working at these institutions. Safety climate can directly affect the overall work performance of medical personnel and indirectly affect patient care quality, which in turn impacts the rate of occupational hazards. Common occupational hazards in the medical workplace include contracting infectious diseases, overwork, irregular circadian rhythm due to working shifts, changes in sleep patterns and dietary habits, musculoskeletal discomfort, workplace violence, workplace stress, and needlestick injuries. This paper was developed to explore the history of promoting needlestick prevention in Taiwan, and discusses how to use the results of empirical research as scientific evidence and critical proofs to advocate for needlestick prevention and to establish related policies. In addition, the process of how improvements to the hospital safety climate and the prevention of occupational hazard incidents mutually influence and complement each other was examined. Future studies are encouraged to explore this topic to further elucidate the sources of workplace stress and to devise methods to ameliorate their influence on workplace stress in medical institutions. The results of these studies may be referenced by relevant government agencies and medical institutions when developing policies promoting safe environments in hospitals that improve the safe-work perceptions of nursing personnel and create comfortable and friendly medical environments.醫院安全風氣：由科學到政策—臺灣針扎防治歷程.醫療機構所建立相關的安全政策與制度，讓醫療人員感受到組織安全的相關作為，即是醫院安全風氣，其可以直接影響醫療人員整體工作表現，及間接地影響病人的照護品質，並進一步影響職業危害的發生狀況。醫療職場常見的職業危害，包含傳染性疾病、過勞高風險、輪班造成的晝夜節律、睡眠型態與飲食習慣改變、肌肉骨骼不適、職場暴力、職場壓力及針扎等；本文即是分享臺灣在針扎防治的推動歷程，如何運用實證研究結果的科學證據，倡議及提供政策制定的重要佐證及說帖，進而提升醫院安全風氣與職業危害事件降低之互相影響與改善的過程；未來應鼓勵透過更多的科學研究投入，針對職場壓力源的了解與改善，提供政府主管部門及醫療機構制定政策之參考，以創造安全風氣高的護理執業環境及提升護理人員對執業環境安全的整體知覺，共創合宜、友善的醫療執業環境。.

Through development, multisensory systems reach a balance between stability and flexibility: the systems integrate optimally cross-modal signals from the same events, while remaining adaptive to environmental changes. Is continuous intersensory recalibration required to shape optimal integration mechanisms, or does multisensory integration develop prior to recalibration? Here, we examined the development of multisensory integration and rapid recalibration in the temporal domain by re-analyzing published datasets for audio–visual, audio–tactile, and visual–tactile combinations. Results showed that children reach an adult level of precision in audio–visual simultaneity perception and show the first sign of rapid recalibration at 9 years of age. In contrast, there was very weak rapid recalibration for other cross-modal combinations at all ages, even when adult levels of temporal precision had developed. Thus, the development of audio–visual rapid recalibration appears to require the maturation of temporal precision. It may serve to accommodate distance-dependent travel time differences between light and sound.

Vision is typically dominant over audition or touch in human adults. One classic example is the Colavita visual dominance effect: The presentation of a tone sometimes goes undetected when it is paired with a flash even though it is well detected when presented alone. We investigated whether the Colavita visual dominance effect is modulated by stimulus uncertainty in the temporal and spatial domains. In a simple discrimination task, participants were asked to press a predesignated key when detecting a flash, another key when detecting a tone, and both keys when detecting both a flash and a tone. Temporal uncertainty was increased by introducing temporal jitter between trials (Experiment 1), and spatial uncertainty was increased by shifting the flash to different locations (Experiment 2). The Colavita visual dominance effect was reduced when temporal uncertainty was increased, while it remained similar when spatial uncertainty was increased. We therefore demonstrate a novel consideration, where increasing temporal uncertainty balances the competition between vision and audition, suggesting that people's degree of sensory dominance is malleable. Our result therefore highlights the concept that intersensory competition is susceptible to the temporal predictability of the stimulus, which provides critical insights into the design of effective warning systems in the field of ergonomics.

Background Current American Heart Association Pediatric Life Support (PLS) guidelines do not recommend the routine use of sodium bicarbonate (SB) during cardiac arrest in pediatric patients. However, SB administration during pediatric resuscitation is still common in clinical practice. The objective of this study was to assess the impact of SB on mortality and neurological outcomes in pediatric patients with in-hospital cardiac arrest. Methods We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials from inception to January 2021. We included studies of pediatric patients that had two treatment arms (treated with SB or not treated with SB) during in-hospital cardiac arrest (IHCA). Risk of bias was assessed using the Newcastle-Ottawa Scale and the certainty of evidence was assessed using GRADE system. Results We included 7 observational studies with a total of 4877 pediatric in-hospital cardiac arrest patients. Meta-analysis showed that SB administration during pediatric cardiac resuscitation was associated with a significantly decreased rate of survival to hospital discharge (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.25–0.63, p value = 0.0003). There were insufficient studies for 24-h survival and neurologic outcomes analysis. The subgroup analysis showed a significantly decreased rate of survival to hospital discharge in both the “before 2010” subgroup (OR 0.47; 95% CI 0.30–0.73; p value = 0.006) and the “after 2010” subgroup (OR 0.46; 95% CI 0.25–0.87; p value = 0.02). The certainty of evidence ranged from very low to low. Conclusions This meta-analysis of non-randomized studies supported current PLS guideline that routine administration of SB is not recommended in pediatric cardiac arrest except in special resuscitation situations. Trial registration The protocol was registered with PROSPERO on 8 August 2020 (registration number: CRD42020197837).

Background The 2010 Advanced Cardiac Life Support guidelines stated that routine sodium bicarbonate (SB) use for cardiac arrest patients was not recommended. However, SB administration during resuscitation is still common. Objectives To evaluate the effect of SB on return of spontaneous circulation (ROSC) and survival-to-discharge rates in adult cardiac arrest patients. Methods We searched Medline, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to December 2019. We included trials on nontraumatic adult patients after cardiac resuscitation and SB treatment vs. controls. Results A meta-analysis was performed with six observational studies, including 18,406 adult cardiac arrest patients. There were no significant differences in the ROSC rate (odds ratio [OR] 1.185; 95% confidence interval [CI] 0.680–2.065) and survival-to-discharge rate (OR 0.296; 95% CI 0.066–1.323) between the SB and no-SB groups. In the subgroup analysis based on the year factor, there were no significant differences in the mortality rate in the After-2010 group. In the subgroup analysis based on the continent, the ROSC rate (OR 0.521; 95% CI 0.432–0.628) and survival-to-discharge rate (OR 0.102; 95% CI 0.066–0.156) were significantly lower in the North American group. Conclusions SB use was not associated with improvement in ROSC or survival-to-discharge rates in cardiac resuscitation. In addition, mortality was significantly increased in the North American group with SB administration.

We examined whether firefighters in Taiwan have a sleep problem and investigated the related factors of poor sleep quality.In this cross-sectional study, 2123 male shift firefighters in the Greater Taipei area were invited, and 37.7% of them satisfactorily completed the questionnaire online. The Chinese version of Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality. Multiple logistic and linear regression analyses were used to determine the associations among demographic characteristics, work-related characteristics, and poor sleep quality.As revealed by 801 valid questionnaires, 77.2% were poor sleepers (PSQI cutoff score 6), and 61.2% reported incomplete off-duty in the past month. Moreover, 42.6% of incomplete off-duty workers reported extended overtime of more than 5 h on off-duty days in the past month. Poor sleep quality was associated with the following factors: (1) demographic characteristics: age, working tenure, having children, and chronotype and (2) work-related characteristics: shift schedule and incomplete off-duty. The final model for poor sleep quality as per PSQI included age, chronotype, shift schedule, and incomplete off-duty hours in the past month. Longer hours of incomplete off-duty work were associated with increased risks of overall poor sleep quality and of poor subjective sleep quality, long sleep latency, sleep disturbances, and daytime dysfunction.Firefighters are advised to have a complete off-duty day to avoid poor sleep quality, long sleep latency, short sleep duration, sleep disturbances, and daytime dysfunction. Our results confirm the need for implementing appropriate shift schedules to ensure adequate rest time for firefighters.

Background Sexual problems are common in male lung cancer survivors. However, the development of erectile dysfunction (ED) in lung cancer patients after surgery has been rarely explored. In this study, we aimed to explore the incidence and risk factors of ED after lung cancer surgery. Methods From 2000 to 2012, 6025 and 24,100 male patients were included in each matched cohort of lung cancer and non-lung cancer patients, respectively. Poisson regression analysis was used to calculate the incidence rate ratio (IRR) and 95% confidence interval (CI). Results The incidence of ED was higher in the lung cancer cohort compared to the non-lung cancer cohort (38.47 vs 28.28 per 10,000 person-years) with an adjusted IRR (aIRR) of 1.34 (95% CI: 1.06-1.70, p=0.014) after the confounders were adjusted for. An increased incidence of ED was observed in the lung cancer cohort aged 40-54 years (aIRR: 5.44, 95% CI: 2.25-13.15, p

Objectives Perceiving simultaneity of a visual and an auditory signal is critical for humans to integrate these multisensory inputs effectively and respond properly. We examined age-related changes in audiovisual simultaneity perception, and the relationships between this perception and working memory performances with aging. Methods Audiovisual simultaneity perception of young, middle-aged, and older adults was measured using a simultaneity judgment (SJ) task, in which a flash and a beep were presented at 1 of 11 stimulus-onset asynchronies (SOAs). Participants judged whether these two stimuli were perceived simultaneously. Precision of simultaneity perception, the SOA corresponding to the point of subjective simultaneity (PSS), and response errors at each SOA were estimated using model fitting. The precision and PSS are associated with multisensory perception per se, whereas the response error reflects executive ability when performing the SJ task. Visual working memory of the same middle-aged and older adults was measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB) beforehand. Results Compared to young adults’ performances, middle-aged and older adults showed a decreased precision, a shift of PSS toward the visual-leading SOAs, and increased response errors at the visual-leading SOAs. Among these changes, only the increased response errors correlated with worse spatial recognition memory in middle-aged and older adults. Discussion Age-related decrements in audiovisual simultaneity perception start from middle age and are manifested in both perceptual and executive parameters. Furthermore, higher-order executive ability is plausibly a common cause for age-related degenerations in the audiovisual simultaneity perception and visual working memory.

Dipeptidyl peptidase-4, a transmembrane glycoprotein expressed in various cell types, serves as a co-stimulator molecule to influence immune response. This study aimed to investigate associations between DPP-4 inhibitors and risk of autoimmune disorders in patients with type 2 diabetes mellitus in Taiwan. This retrospective cohort study used the nationwide data from the diabetes subsection of Taiwan National Health Insurance Research Database between January 1, 2009, and December 31, 2013. Cox proportional hazards models were developed to compare the risk of autoimmune disorders and the subgroup analyses between the DPP-4i and DPP-4i-naive groups. A total of 774,198 type 2 diabetic patients were identified. The adjusted HR of the incidence for composite autoimmune disorders in DPP-4i group was 0.56 (95% CI 0.53–0.60; P

PURPOSE: To identify factors responsible for hospital health care workers' intention to leave their job during the COVID-19 pandemic. DESIGN: A cross-sectional study was performed. METHODS: A self-administered questionnaire was delivered to solicit hospital health care workers' demographics, intention to leave, workplace environment, and changes related to COVID-19 from July to November 2020 in Taiwan. Principal component analysis was performed to compare group-related factors. Multiple logistic regression was used to determine the risk factors for the intention of health care workers to leave their job. FINDINGS: Among the 1209 health care workers (mean age, 36.3 years) who participated in the study, intention to leave the job was found to be related to factors relating to COVID-19, including perceived risk, affected social relationships, and increased workload and job stress, after adjustment for demographic and work factors. Supportive administration/management were protective factors against leaving the job. These results were supported by sensitivity analyses. CONCLUSIONS: Our findings suggest that the intention of health care workers to leave their job during a pandemic is related to potentially modifiable factors relating to the infection itself and work environment. CLINICAL RELEVANCE: High perceived risk of COVID-19, affected social relationaops, and increased workload and job stress were positively associated with the intention of health care workers to leave their job, whereas supportive administration and management were protective factors against leaving the job. Development of workplace strategies is important to help mitigate these above factors, improve psychological wellbeing, and promote workforce stability.

Crossmodal correspondences refer to the fact that certain domains of features in different sensory modalities are associated with each other. Here, we investigated the crossmodal correspondences between speech sounds and visual shapes. Specifically, we tested whether the classification dimensions of English vowels (front–central–back) and consonants (voiced–voiceless, sonorant–obstruent, and stop–continuant) correspond to visual shapes along a bipolar rounded–angular dimension. We adapted eighteen meaningless pseudowords from a previous study that corresponded to either the round or the sharp concept. On each trial, the participants heard one of the pseudowords and saw a rounded shape and an angular shape presented side-by-side on the monitor. Participants judged which shape provided a better match to the spoken pseudoword. A logistic regression was conducted in order to elucidate the effectiveness of classification dimensions of phonemes when predicting variations in the sound–shape matchings. The results demonstrated that the sound–shape matchings were predictable using front–central–back dimensions of vowels, and voiced–voiceless and stop–continuant dimensions of consonants. Hence, we verified that sound–shape matching is underpinned by contrasting dimensions in both vowels and consonants, therefore demonstrating crossmodal correspondences at the phonetic level.

Necrotizing fasciitis is a severe soft-tissue infection with a high mortality rate. There is little literature on the relationship between the ultrasonographic finding of fluid accumulation along the deep fascia and the diagnosis and prognosis of necrotizing fasciitis. This retrospective study showed that when fluid accumulation was present along the deep fascia, patients with clinically suspected necrotizing fasciitis had a higher probability of having necrotizing fasciitis. The ultrasonographic finding of fluid accumulation with a cutoff point of more than 2 mm of depth had the best accuracy (72.7%) for diagnosing necrotizing fasciitis. In regard to the prognosis of necrotizing fasciitis, when fluid accumulation was present along the deep fascia, patients with necrotizing fasciitis had a longer length of hospital stay and were at risk of amputation or mortality. Ultrasonography is a point-of-care imaging tool that facilitates the diagnosis and prognosis of necrotizing fasciitis.

Aim: To compare efficacy between total gastrectomy (TG) and proximal gastrectomy (PG) for upper-third gastric cancer. Materials & methods: PubMed, Embase and Cochrane library were searched to select suitable researches. Stata was used for meta-analysis including 5-year overall survival rate, recurrence rate, complication morbidities and serum nutritional levels. Results: Ten retrospective English researches were contained. Our study showed no significant difference of 5-year overall survival rate, recurrence rate, reflux symptoms and anastomotic leakage. TG experienced longer operation time, more lymph nodes-retrieved number, more estimated blood loss and higher ileus, but less anastomotic stricture. PG showed advantages over TG in terms of serum nutritional levels. Conclusion: PG is more preferable to TG for treatment of upper-third gastric cancer.

Background: Massive transfusion in patients with upper gastrointestinal bleeding (UGIB) was not investigated. We developed a new scoring system to predict massive transfusion and to enhance care and early resource mobilization. Methods: Massive transfusion was defined as transfusion with ≥10 units of red blood cells within the first 24 h. Data were extracted from a 10-year, six-hospital database. Logistic regression was applied to derive a risk score for massive transfusion using data from 2006 to 2010, in 24,736 patients (developmental cohort). The score was then validated using data from 2011 to 2015 in 27,449 patients (validation cohort). Area under the receiver operating characteristic (AUROC) curve was performed to assess prediction accuracy. Results: Five characteristics were independently associated (p 0), international normalized ratio (INR) >1.5, pulse >100 beats per minute or systolic blood pressure Conclusions: The new scoring system predicts massive transfusion requirement in patients with UGIB well.Key messagesMassive transfusion is a life-saving management in massive upper gastrointestinal bleeding. How to identify patients requiring massive transfusion in upper gastrointestinal bleeding is poorly documented.Approximately 3.9% of upper gastrointestinal bleeding patients require massive transfusion.A new scoring system is developed to identify patients requiring massive transfusion with high accuracy. Massive transfusion is a life-saving management in massive upper gastrointestinal bleeding. How to identify patients requiring massive transfusion in upper gastrointestinal bleeding is poorly documented. Approximately 3.9% of upper gastrointestinal bleeding patients require massive transfusion. A new scoring system is developed to identify patients requiring massive transfusion with high accuracy.

Simple Summary Annexin A1 (ANXA1) is associated with the growth and resistance to chemotherapy drugs in lung cancer cells. In this study, the association of ANXA1 with chemosensitivity to Osimertinib, a third generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) was studied. The knockdown of ANXA1 increased chemosensitivity to Osimertinib and decreased tumorigenesis, invasion and migration of lung cancer cells with EGFR mutations. The study showed that ANXA1 plays critical roles in chemosensitivity to Osimertinib in lung cancer cells with EGFR mutations. Abstract Annexin A1 (ANXA1) has been reported to promote tumor growth and resistance to chemotherapy drugs in lung cancer cells. In this study, we focused on the association of ANXA1 and chemosensitivity with a third generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), Osimertinib, in lung cancer cells with EGFR mutations. The overexpression of ANXA1 was observed in the lung cancer cells studied. The downregulation of ANXA1 with small interference RNA (siRNA) decreased the growth of lung cancer cells. In lung cancer cells with EGFR mutations, the knockdown of ANXA1 increased the chemosensitivity to Osimertinib, and decreased the tumorigenesis, invasion and migration of lung cancer cells. Further study showed that the knockdown of ANXA1 inhibited the phosphorylation of EGFR and down-stream Akt pathways and promoted apoptosis in lung cancer cells treated with Osimertinib. A mice xenograft lung cancer model was established in our study and showed that ANXA1 siRNA enhanced the effects of Osimertinib in vivo. Our study results showed that ANXA1 plays critical roles in chemosensitivity to EGFR-TKI in lung cancer cells with the EGFR mutation. Our efforts may be used in the development of lung cancer treatment strategies in the future.

Cullin 4A (Cul4A) reportedly has oncogenic roles in several cancer types by regulating tumor suppressors through the ubiquitination and proteolysis of the tumor suppressor. In addition, Cul4A is associated with chemosensitivity to chemotherapy drugs. This study investigated the association between Cul4A and lung cancer cell chemosensitivity to paclitaxel, particularly with respect to the role of the p33 inhibitor of the growth 1 (p33ING1b) tumor suppressor. The results showed that the Cul4A knockdown upregulated the p33ING1b expression in lung cancer cells and increased the lung cancer cell and mice tumor xenograft chemosensitivity to paclitaxel. The Cul4A knockdown also inhibited the growth and increased the apoptosis in the tumor xenografts treated with paclitaxel. Notably, the p33ING1b overexpression increased the lung cancer cell chemosensitivity to paclitaxel, but the p33ING1b knockdown reduced the chemosensitivity. A further analysis demonstrated that Cul4A regulates the expression of p33ING1b through protein-protein interactions, ubiquitination, and protein degradation. In conclusion, the present findings suggest that Cul4A mediates the chemosensitivity of lung cancer cells to paclitaxel by regulating p33ING1b. These findings may offer novel insights into future therapeutic strategies for lung cancer that target Cul4A.

Background/purpose Superspreading events (SSEs) are pivotal in the spread of SARS-CoV-2. This study aimed to investigate an SSE of COVID-19 in a hospital and explore the transmission dynamics and heterogeneity of SSE. Methods We performed contact tracing for all close contacts in a cluster. We did nasopharyngeal or throat swabbing for SARS-CoV-2 by real-time RT-PCR. Environmental survey was performed. The epidemiological and clinical characteristics of the SSE were studied. Results Patient 1 with congestive heart failure and cellulitis, who had onset of COVID-19 two weeks after hospitalization, was the index case. Patient 1 led to 8 confirmed cases, including four health care workers (HCW). Persons tested positive for SARS-CoV-2 were HCW (n = 4), patient 1's family (n = 2), an accompanying person of an un-infected in-patient (n = 1), and an in-patient admitted before the SSE (n = 1). The attack rate among the HCW was 3.2 % (4/127). Environmental survey confirmed contamination at the bed rails, mattresses, and sink in the room patient 1 stayed, suggesting fomite transmission. The index case's sputum remained positive on illness day 35. Except one asymptomatic patient, at least three patients acquired the infection from the index case at the pre-symptomatic period. The effective reproduction number (Rt) was 0.9 (8/9). Conclusion The host factor (heart failure, longer viral shedding), transmissibility of SARS-CoV-2 (Rt, pre-symptomatic transmission), and possible multiple modes of transmission altogether contributed to the SSE. Rapid response and advance deployment of multi-level protection in hospitals could mitigate COVID-19 transmission to one generation, thereby reducing its impact on the healthcare system.

A high-speed and power-efficient heterogeneous octa-core CPU complex is realized in a 7nm FinFET process. On-chip sensors that handle guard band in terms of process $(V_{PGB})$, voltage, temperature $(V_{TGB})$, and aging $(V_{AGB})$ are designed for power enhancement in dynamic frequency and voltage scaling (DVFS). A process sensor (P-sensor) is used to determine per-die V PGB for Smartphone operation voltage $(V_{sov})$ with machine learning (ML). A temperature sensor (T-sensor) senses run-time local thermal and temperature inversion (T-inversion) to scale V TGB in DVFS. An aging sensor (A-sensor) converts cell degradation to corresponding V AGB for aging compensation. Lastly, a voltage sensor (V-sensor) sustains system stability against supply noise. With sensor assistance, the CPU performs up to 2.8GHz speed with 13% power improvement in a fully integrated 5G multi-mode Smartphone SoC that supports the sub-6GHz band with 2.6Gbps upload and 4.7Gbps download speeds.

The Bouba/Kiki effect constitutes a classic sound-shape correspondence, with the meaningless sounds "Bouba" and "Kiki" being mapped onto smooth and spiky patterns, respectively. While it is commonly believed that the Bouba/Kiki effect is driven by the local rounded and angular features of a pattern, here we investigated the importance of an alternative level of visual processing-namely the global contours. We adopted compound radial frequency (RF) patterns and segmented them into convexities (outward curves) or concavities (inward curves). Note that convexities are more informative in terms of inferring the global contour than concavities. When the perceptual grouping of segments was facilitated by increasing their length, the grouping of convexities was more efficient than that of concavities as manifested by the closer matching judgments to the compound RF patterns. When we interfered with the perceptual grouping of segments by rotating each segment by 180°, the matching consensus of convexities was higher when they were presented in the original than in the reversed orientation. Hence, the Bouba/Kiki effect was susceptible to the factors modulating the perceptual grouping process going from segments to the global contour, suggesting that the Bouba/Kiki effect may occur at the global level of shape perception. Sound-shape correspondences would therefore seem to be expressed at multiple levels of information processing, furthering our understanding of the development, underpinning neural mechanisms, and applications of crossmodal correspondences. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background: Emergency transfusion strategies for patients with upper gastrointestinal bleeding (UGIB) have not been well developed. The BISHE is a recently developed scoring system for prediction of patients likely to require massive transfusion but has not been validated. In this study, we evaluated the predictive ability of the BISHE score and that of a revised scoring system in an effort to improve care for patients with UGIB and allow better resource allocation. Methods: This prospective observational cohort study included patients who were admitted to our hospital between July 1, 2016 and June 30, 2019 and required massive transfusion (defined as receiving three units of red blood cells over one hour) in the emergency department. The predictive accuracy of the BISHE score and that of the revised scoring system were compared using area under the receiver-operating characteristic (AUROC) curve analysis. Results: Liver cirrhosis, an international normalized ratio >1.5, and hemoglobin Conclusions: Compared with the BISHE score, the revised scoring system was better able to identify patients likely to require massive transfusion.

Purpose Nurses are exposed to a poor psychological work environment; this may cause poor mental health, which is a risk factor for suicidal ideation. We investigated the association between psychological work environment and suicidal ideation among hospital nurses in Taiwan. Design We conducted a cross-sectional survey in Taiwan female nurses using stratified sampling by region (north, central, south, and east) to select representative centers for this study. Methods A self-report questionnaire including items on demographic data, the psychological work environment, and suicidal ideation was sent to nurses working in hospitals. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of the psychological work environment on suicidal ideation. Findings A total of 2,734 eligible questionnaires (76.8%) were returned. The prevalence of suicidal ideation was 18.3%, and higher risk was found to be associated with the educational level of junior college or below, higher personal burnout, higher client-related burnout, and always feeling stressed at work. Estimation of population attributable risk showed that higher personal burnout, client-related burnout, and always feeling stressed at work were the most crucial factors among nurses, accounting for 19.4%, 8.6%, and 10.5% of suicidal ideation, respectively. Conclusions A considerable proportion of nurses developed suicidal ideation. A poor psychological work environment was a relevant factor for suicidal ideation. Clinical evidence This study provides relevant knowledge for nursing management levels in preventing the development of suicidal ideation among nurses. Not only for nurses' mental health, but for patient safety and care quality, further studies in improving nurses' psychological work environment are warranted.

We report two experiments designed to extend the well-known Bouba/Kiki effect to the case of an unusual set of commercially produced plateware, and further to assess the influences of these plates on the expected taste of a dessert based on the theory of crossmodal correspondences. The results demonstrate that plates having a smoother circumference are more likely to be matched to ‘Bouba’, while those with a pointier circumference are more likely to be matched to ‘Kiki’ instead, thus demonstrating the typical Bouba/Kiki effect. Importantly, the shape and colour of the plates modulated people’s ratings of the expected taste and liking of the ice cream/sorbet displayed on them. Specifically, the colour of the plate induced a general effect on the expected tastes that were consistent with the white-sweet and black-bitter associations, and the higher expected liking of the ice cream/sorbet was attributed to the higher colour contrast between the food and plate. The shape of the plate modulated ratings of expected liking for the chocolate ice cream and the expected sweetness of the lemon sorbet. Finally, colour and shape conjointly modulated how sour the lemon sorbet was expected to taste. These results provide relevant insights for those chefs, restaurateurs and Instagrammers wishing to optimize the plateware for specific dishes.

BACKGROUND/AIMS Increased risk of bacterial infection is common in cirrhotic patients with upper gastrointestinal bleeding (UGIB). Our study aimed to explore the association of the bacteremia with in-hospital mortality and risk factors of bacteremia in these patients. MATERIALS AND METHODS In our retrospective cohort study, we collected data for cirrhotic patients with UGIB admitted to our hospital between August 2010 and December 2010. The primary outcome was in-hospital mortality. The secondary outcome was bacteremia. A multivariate logistic regression analysis was performed to determine risk factors for mortality and bacteremia. RESULTS A total of 202 patients with cirrhosis presenting with UGIB at the emergency department (ED) were enrolled. Bacteremia was associated with a higher mortality rate (adjusted odds ratio [OR]: 9.7; 95% confidence interval [CI]: 1.9-50.6, p=0.007), whereas shock (systolic blood pressure 0% immature neutrophils of band form) were associated with bacteremia in cirrhotic patients with UGIB (adjusted OR: 5.3; 95% CI: 2.3-12.7, p

Abdominal obesity is an independent risk factor for cardiovascular disease and chronic kidney disease (CKD). Visceral adiposity index (VAI), a simple formula representing visceral adipose dysfunction, has already been proven to have a strong correlation with various cardiometabolic disorders. Limited studies are available regarding the relationship between VAI and renal function decline. Therefore, the purpose of this study was to evaluate the relationship between VAI and renal function and to estimate the risk of chronic kidney disease in a relatively healthy adult population in Taiwan.The design of the study is retrospective cross-sectional analysis.This study involved 23,570 subjects aged ≥18 years who underwent annual heath checkups between January and December 2013. A multivariate logistic regression model was used to assess the relationship between VAI and CKD. Receiver-operating characteristic curve and Youden index were developed to determine the discrimination power of VAI for metabolic syndrome and CKD.None, observational study.The main outcome measure of this study was CKD.In our study, the adjusted odds ratio (OR) of abnormal VAI for CKD was 1.5 (95% confidence interval [CI], 1.08-2.08; P = .016) in all subjects. A higher VAI was superior in association with CKD in men than women (OR, 1.62; 95% CI, 1.13-2.32; P = .009 vs. OR, 1.28; 95% CI, 0.66-2.47; P = .469, respectively). The area under the curve for VAI was 0.694 (95% CI, 0.660-0.729; P .001), and using a Youden index with a cut-off VAI value of 2.96 for CKD discrimination obtained a sensitivity of 67.7% and specificity of 65.1%.A higher VAI score was associated with increased risks of CKD. VAI would be an applicable tool for early detection of CKD in relatively healthy adults in Taiwan, especially men.

In this work, silver (Ag) precursors with different thicknesses were sputtered on the surfaces of CuIn alloys, and (AgCu)InSe2 (ACIS) films were formed after selenization at 550 °C under nitrogen condition using a rapid thermal process furnace. The structure and electrical properties of the ACIS films were investigated. The result showed that the distribution of Ag+ ion was more uniform with increasing the thickness of Ag precursor, and the surface of the thin-film became more homogeneous and denser. When Ag/Cu ratio ≥0.249, the small grain particles disappeared. The band gap can be rationally controlled by adjusting Ag content. When (Ag + Cu)/In ratio ≥ 1.15, the surface of the ACIS thin-film mainly exhibited n-type semiconductor. Through the photoelectrochemistry measurement, it was observed that the incorporation of Ag+ ions could improve photocurrent by adjusting the band gap. With the Ag precursor thickness increased, the dark current decreased at the more negative potential.

Asatone is an active component extracted from the Chinese herb Radix et Rhizoma Asari. Our preliminary studies have indicated that asatone has an anti-inflammatory effect on RAW 264.7 culture cells challenged with lipopolysaccharide (LPS). Acute lung injury (ALI) has high morbidity and mortality rates due to the onset of serious lung inflammation and edema. Whether asatone prevents ALI LPS-induced requires further investigation. In vitro studies revealed that asatone at concentrations of 2.5–20[Formula: see text][Formula: see text]g/mL drastically prevented cytotoxicity and concentration-dependently reduced NO production in the LPS-challenged macrophages. In an in vivo study, the intratracheal administration of LPS increased the lung wet/dry ratio, myeloperoxidase activity, total cell counts, white blood cell counts, NO, iNOS, COX, TNF-[Formula: see text], IL-1[Formula: see text], and IL-6 in the bronchoalveolar lavage fluid as well as mitogen-activated protein kinases in the lung tissues. Pretreatment with asatone could reverse all of these effects. Asatone markedly reduced the levels of TNF-[Formula: see text] and IL-6 in the lung and liver, but not in the kidney of mice. By contrast, LPS reduced anti-oxidative enzymes and inhibited NF-[Formula: see text]B activations, whereas asatone increased anti-oxidative enzymes in the bronchoalveolar lavage fluid and NF-[Formula: see text]B activations in the lung tissues. Conclusively, asatone can prevent ALI through various anti-inflammatory modalities, including the major anti-inflammatory pathways of NF-[Formula: see text]B and mitogen-activated protein kinases. These findings suggest that asatone can be applied in the treatment of ALI.

ObjectivesThe study aimed to investigate the association of insulin resistance (IR), which was estimated by the homoeostasis model assessment for IR (HOMA-IR), with albuminuria and renal function impairment in a general Chinese population.DesignA retrospective cross-sectional study.Setting and participantsA total of 13 742 adults (age: ≥18 years) who underwent a health check-up at a hospital in Southeast China during 2013–2014 were enrolled. 216 subjects were excluded due to lack of enough fasting time, be pregnant, have chronic diseases influencing metabolic functions or have glomerulonephritis, renal cancer, kidney transplant. Eventually, 7552 men and 5974 women were included for the present analysis.Primary outcome measuresThe association of HOMA-IR with albuminuria and renal function impairment were analysed. The HOMA-IR cut-off value for detecting albuminuria and renal function impairment were determined.ResultsAn increase in the HOMA-IR quartile was significantly associated with the prevalence of albuminuria and renal function impairment in all men and women aged >45 years. The multivariable logistic regression analyses revealed a significant association of the HOMA-IR with albuminuria and renal function impairment in subjects aged >45 years of the fourth quartiles compared with those of the first quartile after adjusting for potential confounders (albuminuria: men OR, 2.39; 95% CI 1.51 to 3.79, p=0.001; renal function impairment: men OR, 2.30; 95% CI 1.50 to 3.51; p45 years and 1.86 in women aged >45 years.ConclusionsOur study revealed that HOMA-IR was significantly associated with albuminuria and renal function impairment in individuals aged >45 years.

Background Obesity is associated with increased risk of cardiovascular disease and chronic kidney disease (CKD). Hyperhomocysteinaemia refers to increased oxidative stress and has been associated with the risk of CKD. Objectives We investigated the association among body mass index (BMI), homocysteine level and impaired renal function in a Taiwanese adult population. Methods This was a retrospective cross-sectional study involving 24826 subjects who underwent a health check-up from January 2013 to December 2015. A multivariate linear regression model was developed to analyse the relationship among BMI, serum homocysteine and estimated glomerular filtration rate (eGFR). A multivariate logistic regression model was used to assess the relationship among weight categories, hyperhomocysteinaemia and CKD. Results The prevalence of CKD in the quartile groups of homocysteine were 2.5%, 2.7%, 3.4% and 5.2% (P < 0.01). For every one-unit increase in BMI (kg/m2), the eGFR decreased by 0.50 ml/min/1.73 m2. Overweight/obese subjects with high homocysteine levels had a higher odds ratio (OR) for CKD, as compared with normal weight subjects (1.84 versus 1.38, respectively; P < 0.01 versus P = 0.02, respectively). Overweight/obese female subjects with hyperhomocysteinaemia had an OR of 3.40 [P < 0.01; 95% confidence interval (CI): 2.06-5.61] for CKD; in males, the OR was 1.66 (P < 0.01; 95% CI: 1.38-1.99). Conclusions Patients who are overweight/obese with higher homocysteine levels have an increased risk of CKD, especially females. Additional studies exploring whether the effect of weight loss or homocysteine-lowering therapies such as folic acid, vitamin B12 supplements that may prevent or slow the progression of declining renal function, is warranted.

Detecting acute ST-segment elevation myocardial infarction (STEMI) in the setting of left bundle branch block (LBBB) remains a challenge to clinicians. Several diagnostic and triage algorithms have been proposed to accurately identify LBBB patients with an acute culprit vessel. We aimed to validate the algorithm proposed by Cai et al., which uses patients' hemodynamic status and the modified Sgarbossa electrocardiography criteria to guide reperfusion therapy.This retrospective study was performed with a chart review in emergency departments (EDs) of 2 medical centers, 2 regional hospitals, and 1 local hospital. From January 2010 to December 2014, 2432 consecutive patients were diagnosed as having STEMI in the ED, including 65 patients with LBBB (2.6%).The patients with LBBB were older and more frequently presented with acute pulmonary edema (58.5% vs 22.1%, p 0.001), cardiogenic shock (16.9% vs 6.3% p = 0.006), and VT/VF episodes (7.7% vs 2.2%, p = 0.034) and had a higher 30-day mortality rate (20.0% vs 10.4% p = 0.032) than those without LBBB. We then tested the algorithm proposed by Cai et al. and noted a sensitivity of 93.8% in identifying a culprit lesion.The inconsistency of the guideline recommendations reflects the uncertainty of diagnostic and therapeutic strategies and the pressing need for tools to accurately identify the true acute myocardial infarction in patients presenting with chest pain and LBBB. The algorithm proposed by Cai et al. had good sensitivity and would allow emergency physicians to implement the timely treatment protocol for this high-risk population.

Perceiving simultaneity is critical in integrating visual and auditory signals that give rise to a unified perception. We examined whether background color modulates people's perception of audiovisual simultaneity. Two hypotheses were proposed and examined: (1) the red-impairment hypothesis: visual processing speed deteriorates when viewing a red background because the magnocellular system is inhibited by red light; and (2) the blue-enhancement hypothesis: the detection of both visual and auditory signals is enhanced when viewing a blue background because it stimulates the blue-light sensitive intrinsically photosensitive retinal ganglion cells (ipRGCs), which trigger a higher alert state. Participants were exposed to different backgrounds while performing an audiovisual simultaneity judgment (SJ) task: a flash and a beep were presented at pre-designated stimulus onset asynchronies (SOAs) and participants judged whether or not the two stimuli were presented simultaneously. Experiment 1 demonstrated a shift of the point of subjective simultaneity (PSS) toward the visual-leading condition in the red compared to the blue background when the flash was presented in the periphery. In Experiment 2, the stimulation of ipRGCs was specifically manipulated to test the blue-enhancement hypothesis. The results showed no support for this hypothesis, perhaps due to top-down cortical modulations. Taken together, the shift of PSS toward the visual-leading condition in the red background was attributed to impaired visual processing speed with respect to auditory processing speed, caused by the inhibition of the magnocellular system under red light.

Cullin 4A (Cul4A) is overexpressed in a number of cancers and has been established as an oncogene. This study aimed to elucidate the role of Cul4A in lung cancer invasion and metastasis. We observed that Cul4A was overexpressed in non-small cell lung cancer (NSCLC) tissues and the overexpression of Cul4A was associated with poor prognosis after surgical resection and it also decreased the expression of the tumor suppressor protein annexin A10 (ANXA10). The knockdown of Cul4A was associated with the upregulation of ANXA10, and the forced expression of Cul4A was associated with the downregulation of ANXA10 in lung cancer cells. Further studies showed that the knockdown of Cul4A inhibited the invasion and metastasis of lung cancer cells, which was reversed by the further knockdown of ANXA10. In addition, the knockdown of Cul4A inhibited lung tumor metastasis in mouse tail vein injection xenograft models. Notably, Cul4A regulated the degradation of ANXA10 through its interaction with ANXA10 and ubiquitination in lung cancer cells. Our findings suggest that Cul4A is a prognostic marker in NSCLC patients, and Cul4A plays important roles in lung cancer invasion and metastasis through the regulation of the ANXA10 tumor suppressor.

Objective: Being overweight is associated with an increased risk of diabetes mellitus, hypertension, and cardiovascular disease. Lipoprotein-associated phospholipase A2 (Lp-PLA2) can independently predict the risk of cardiovascular disease. This study is aimed to investigate whether Lp-PLA2 was associated with an overweight status. Methods: This was a cross-sectional study that enrolled 3760 Chinese adults (age, 18–50 years) who underwent medical examination department of Xiamen Chang-Gung Hospital (XCGH) from 2018 to 2020. To explore the distribution of overweight classifications in the Chinese population, we evaluated the correlation of the overweight status with Lp-PLA2, after correcting for possible influencing factors. Results: The Lp-PLA2 level was greater in male than in female subjects ( p < 0.001). Subjects with a central overweight status had a greater Lp-PLA2 level than those with normal weight and a peripheral overweight status, in both male and female cohorts. The Lp-PLA2 level was significantly greater in those with additional comorbidities (namely diabetes mellitus (DM), hypertension (HTN), overweight, and metabolic syndrome (MetS)). The age-adjusted and LDL-adjusted Lp-PLA2 level also was significantly higher in the DM (+) and HTN (−) subgroups than in the DM (−), HTN (−), DM (−), and HTN (+) subgroups. Conclusion: Lp-PLA2 is associated with sex, central overweight status, diabetes, hypertension, and MetS in adults aged < 50 years and the age-adjusted and LDL-adjusted Lp-PLA2 was significantly higher in the DM (+) and HTN (−) subgroups than in the DM (−) and HTN (−) and DM (−) and HTN (+) subgroups.

The extent to which attention modulates multisensory processing in a top-down fashion is still a subject of debate amongst researchers. Typically, cognitive psychologists interested in this question have manipulated the participants’ attention in terms of single/dual tasking or focal/divided attention between sensory modalities. Here, we suggest an alternative approach, one that builds on the extensive older literature highlighting hemispheric asymmetries in the distribution of spatial attention. Specifically, spatial attention in vision, audition, and touch is typically biased preferentially toward the right hemispace, especially under conditions of high perceptual load. Here, we review the evidence demonstrating such an attentional bias toward the right in extinction patients and healthy adults, and the evidence of such rightward-biased attention in multisensory experimental settings. We then evaluate those studies that have either demonstrated a more pronounced multisensory effect in the right than left hemispace, or else demonstrated similar effects in the two hemispaces. The results suggest that the influence of rightward-biased attention is more likely to be observed when the crossmodal signals interact at the later stages of information processing and under conditions of higher perceptual load – the conditions where attention is perhaps a compulsory enhancer in information processing. We therefore suggest that the spatial asymmetry in attention may provide a useful signature of top-down attentional modulation in multisensory processing.

To study whether the ethanol extract of Phellinus merrillii (EPM) has chemopreventive potential against liver carcinogenesis. Thirty male Spraque-Dawley rats were randomly divided into control group, EPM control group, hepatocarcinoma control group, low-dose EPM group and high-dose EPM group, 6 in each group. Using the Solt and Farber protocol in a rat model of hepatocarcinogenesis, the chemopreventive effect of EPM on diethylnitrosamine (DEN)-initiated, 2-acetylaminofluorene (2-AAF) and partial hepatectomy (PH)-promoted liver carcinogenesis in rats was evaluated. Basic pathophysiological and histological examinations, together with the serum levels of glutamic oxaloacetic transaminase (sGOT), glutamic pyruvic transaminase (sGPT) and gamma-glutamyl transpeptidase (γ-GT) were measured. Treatment of EPM at the concentration of 2 g/kg body weight in the diet for 8 weeks clearly prevented the development of carcinogenesis and reduced the levels of sGOT, sGPT, and serum γ-GT of rats as compared with the hepatocarcinoma control group (P

We measured the typical developmental trajectory of the window of audiovisual simultaneity by testing four age groups of children (5, 7, 9, and 11 years) and adults. We presented a visual flash and an auditory noise burst at various stimulus onset asynchronies (SOAs) and asked participants to report whether the two stimuli were presented at the same time. Compared with adults, children aged 5 and 7 years made more simultaneous responses when the SOAs were beyond ± 200 ms but made fewer simultaneous responses at the 0 ms SOA. The point of subjective simultaneity was located at the visual-leading side, as in adults, by 5 years of age, the youngest age tested. However, the window of audiovisual simultaneity became narrower and response errors decreased with age, reaching adult levels by 9 years of age. Experiment 2 ruled out the possibility that the adult-like performance of 9-year-old children was caused by the testing of a wide range of SOAs. Together, the results demonstrate that the adult-like precision of perceiving audiovisual simultaneity is developed by 9 years of age, the youngest age that has been reported to date.

We charted the developmental trajectory of the perception of audiotactile simultaneity by testing three groups of children (aged 7, 9, and 11 years) and one group of adults. A white noise burst and a tap to the index finger were presented at 1 of 13 stimulus onset asynchronies (SOAs), and the participants were asked to report whether the two stimuli were simultaneous. Compared with adults, 7-year-olds made significantly more simultaneous responses at 9 of the 13 SOAs, whereas 9-year-olds differed from adults at only 2 SOAs. The precision of simultaneity perception was lower, and response errors were higher, in younger children than in adults. The 11-year-olds were adult-like on all measures, thereby demonstrating that judgments about simultaneity for audiotactile stimuli are mature by 11 years. This developmental pattern is similar to that for simultaneity perception for visuotactile stimuli but later than that for audiovisual stimuli. The longer developmental trajectories of the perception of simultaneity between touch and vision and between touch and audition may arise from the need to coordinate and recalibrate between different reference frames and different neural transmission times in each sensory system during body growth; in addition, the ubiquity of audiovisual experience in everyday life may accelerate the development of that modality pairing.

Chronic kidney disease (CKD) is a risk factor for cardiovascular diseases and is associated with an increase in all-cause mortality. Studies regarding association among various body compositions in different inflamed states and the risk of CKD were rare. We aimed to evaluate the relationship among body composition, high-sensitivity C-reactive protein (hsCRP) level, and the risk of CKD. This was a retrospective cross-sectional study using annual health examination data from 2 medical centers in northern and southern Taiwan between January and December 2015. We performed a variance analysis of the estimated glomerular filtration rate (eGFR) distribution in groups based on hsCRP and body fat percentage (BFP), and a multivariate logistic regression model was used to assess the relationship among BFP, hsCRP levels, and CKD. A total of 10,267 subjects aged ≥18 years undergoing health examination were analyzed. In our study, overweight/obese patients were associated with increased risk of CKD. Nevertheless, in subjects with elevated hsCRP level, overweight/obese group with a higher BFP had a lower risk of CKD as compared with overweight/obese with normal BFP group (for BMI ≧ 23 kg/m2, high BFP/high hsCRP: odds ratio [OR] for CKD 1.86, 95% confidence interval [CI] = 1.10–3.17, P = .02; normal BFP/high hsCRP group: OR 2.32, 95% CI = 1.23–4.37, P = .01) after adjusting for various confounders. Our findings suggest that various body compositions in different inflamed states may interfere with the risk of CKD. These results provide an important method for the early detection of impaired renal function by identifying various body compositions and inflammation states to detect CKD at an earlier stage.

Background: High occupational stress has been associated with altered eating behaviors and obesity. Occupational stress is reported to be high in Asian countries. Furthermore, many Asian countries are increasingly consuming Western-type foods (e.g., incorporating drinks with meals) which collectively may also be contributing to obesity. Therefore, the aim of this study was to examine (a) associations between sugar-sweetened beverage (SSB) consumption as meal replacement and obesity and (b) associations between workload and substituting meals with SSB in nurses. Methods: A representative sample of 854 hospital-based nurses completed a structured questionnaire about SSB consumption, workload, and body mass index (BMI). Log binomial regression models were employed to test associations between SSBs and obesity rates and associations between workload and SSBs. Results: Most participants (57.6%) consumed SSBs as meal replacements during work. This was related to high workloads during shifts. Substituting SSBs for meals was significantly associated with increased likelihood of obesity (aPRR = 1.4, 95% CI (1.1, 1.7)). Workload was positively associated with SSB intake as meal substitutes (aPRR = 1.4, 95% CI (1.2, 1.6)). Conclusions: Our findings show that SSBs are used as meal substitutes and is due to the workload demands. Sugar-sweetened beverage consumption is also positively associated with the increased likelihood of obesity. Interventions that modify workloads and decrease SSB consumption may improve workers&rsquo, eating behaviors and health.