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Background: To identify the gastric cancer burden in Indigenous Taiwanese peoples and conduct a project to evaluate how to reduce the disparities most effectively in Indigenous communities. Methods: First, we quantified the gastric cancer burden for Indigenous peoples using data from Taiwan Cancer and Mortality Registries. Risk factor analyses were carried out based on literature review and data from ongoing mass screening for other cancers. Second, we identified parameters that might be associated with Helicobacter pylori infection or help identify a good eradication strategy. Findings: Gastric cancer incidence (24·4 vs. 12·3 per 100,000 person-years) and mortality rates (15·8 vs. 6·8 per 100,000 person-years) were higher in Indigenous peoples than in non-Indigenous, with 2·19-fold (95% Confidence Interval [CI]: 2·06-2·33) and 2·47-fold (2·28-2·67) increased risk, respectively. Despite similar cancer stage at diagnosis, the survival rate in Indigenous peoples was 9·6% (0·1-20·1%) lower. Helicobacter pylori infection is a well-documented risk factor and smoking for >10 years increased the risk by 26·3% (7·9-47·8%). In Indigenous communities, both H. pylori infection (56·1%, 95% CI: 53·6-58·6%) and smoking (28·4%, 95% CI: 25·7-31·0%) were prevalent. Program eradication rates using clarithromycin-based triple therapy were suboptimal (73·7%, 95% CI: 70·0-77·4%); the habits of smoking (1·49-fold, 95% CI: 1·10-2·02) and betel nut chewing (1·40-fold, 95% CI: 1·03-1·89) were associated with the higher risk of treatment failure. Interpretation: Gastric cancer burden is higher in Indigenous Taiwanese than in their non-Indigenous counterparts. Eliminating risk factors, including H. pylori eradication and smoking cessation, is a top priority to reduce this health disparity. Funding: Health Promotion Administration, Ministry of Health and Welfare, Taiwan. Declaration of Interest: The authors report no conflicts of interest. Ethical Approval: The Research Ethics Committee of National Taiwan University Hospital (201804108RINB) and the Council of Indigenous Peoples in Taiwan (1070056368) approved the protocol for this program. The informed consent has been obtained from each participant.

Background Without intervention, renal function deteriorates in patients with chronic kidney disease (CKD). Aim This pilot study aimed to develop a self-management education program based on self-regulation theory and to evaluate its effects on self-efficacy, self-management behavior, and CKD progression among patients with early-stage CKD. Methods In this single-group, pretest–posttest, repeated-measures, longitudinal study, participants underwent baseline pretesting (T 0 ) and posttesting at 3 (T 1 ), 6 (T 2 ), and 12 (T 3 ) months after a 5-week group-session self-management program. Results Self-efficacy increased significantly at T 2 ( χ 2 =8.97, p =.02) and T 3 ( χ 2 =10.71, p =.01) compared with T 0 , but self-management behavior did not. A marginally significant decrease in serum creatinine levels was observed from T 0 to T 3 ( χ 2 =6.29, p =.07) but estimated glomerular filtration rates remained stable throughout the 12-month period. Conclusions The results of this empirical study suggest that the theory-based intervention is feasible and has potential efficacy in retarding CKD progression.

“When should we trigger a transfusion?” is always a critical question between the patient’s benefits and risks in red blood cell (RBC) transfusion. A computerized transfusion decision support system (CTDSS) has been used since September 2004 in an academic medical center with 1400 beds. In this study, the factors affecting RBC transfusion were investigated. In total 20,551 RBC-transfusion episodes between January and December 2008 were reviewed. The nearest hemoglobin concentration before transfusion is defined as the transfusion trigger. The physician compliance, the factors associated with the transfusion triggers and posttransfusion hemoglobin increment were investigated. The physician compliance is 83.1%. The transfusion trigger is 8.32±1.84 (mean±standard deviation) g/dL. The transfusion triggers are statistically significant in terms of both different order sources and disease types (p

It has been proven that extracellular matrix turnover is involved in the pathogenesis of various renal fibrosis diseases. Matrix metalloproteinase-2 and -9 (MMP-2 and -9) are the extracellular matrix degrading enzymes that are believed to play important roles in renal diseases. However, the relationship of circulating levels of MMP-2, -9 and serum creatinine in the patients of chronic kidney disease (CKD) has not yet been investigated.Gelatin zymography and ELISA were employed to measure MMP-2 and MMP-9 activities in the plasma samples of 60 CKD patients and 40 control subjects.Serum creatinine concentrations and MMP-2 activities were significantly higher (p0.001) while MMP-9 activity and creatinine clearance (CCr) were significantly lower (p0.05 and p0.001, respectively) in CKD patients, as compared with those of control subjects. In addition, serum creatinine concentrations correlated with MMP-2 activity (R=0.288, p0.05) and inversely correlated with that of MMP-9 (R=0.344, p0.01).This study demonstrated a correlation between MMP-2, -9 and serum creatinine in CKD patients to suggest that MMP-2 and MMP-9 might contribute in the pathogenesis of CKD.