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To assess the trend in prevalence and socioeconomic correlates of diabetes in pregnancy (DIP) in Taiwan from 2007 to 2014.In all, 1 606 344 pregnancies, including 199 383 DIP (1693 with pre-pregnancy type 1 diabetes [T1DM], 17 171 with pre-pregnancy type 2 diabetes [T2DM], and 180 519 with gestational diabetes mellitus [GDM]) were investigated. Logistic regression models were performed to identify the covariates significantly associating with DIP.Over the study period, the prevalence of pre-pregnancy T2DM increased by 568.44%; the prevalence of T1DM and GDM also increased but with a smaller magnitude. However, only the prevalence of pre-pregnancy T2DM showed an increase after socioeconomic variables were considered. Compared with immigrant mothers, native-born mothers had a significantly higher adjusted odds ratio of DIP, particularly pre-pregnancy T1DM (3.33, 95% confidence interval 1.57-7.05). Additionally, indigenous mothers and those from rural areas had a higher prevalence of pre-pregnancy T2DM but lower prevalence of GDM. Lower maternal education and income were associated with higher prevalence of pre-pregnancy T1DM but lower prevalence of pre-pregnancy T2DM and GDM.Socioeconomic variables largely accounted for the increased secular trend in pre-pregnancy T1DM and GDM, but the prevalence of pre-pregnancy T2DM still doubled, which was independent of socioeconomic covariates.

The role of adjuvant concurrent chemoradiotherapy (ACCRT) is unclear for patients with esophageal squamous cell carcinoma (ESCC) who receive esophagectomy with clean margins. We compared the survival of the ACCRT versus observation groups for these patients staged with positron emission tomography (PET) via a population-based approach.Eligible patients with locally advanced ESCC diagnosed between 2011 and 2017 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratios (HR) of death and incidence of esophageal cancer mortality (IECM) were compared between the ACCRT and observation groups. We also evaluated overall survival (OS) in subgroups of either with or without lymph node metastases.Our primary analysis consisted of 105 patients in whom the covariates were well balanced after PS weighting. The HR for death when ACCRT was compared with observation was 0.58 (95% confidence interval 0.28-1.21, p = 0.15). The results were also not significantly different for IECM or in the subgroup analyses.We found that for patients with PET-staged ESCC who received esophagectomy with clean margins, the survival was not statistically different between ACCRT and observation. Further studies (randomized or larger sample size) are needed to clarify this issue.

Fatigue is an inevitable hazard in the provision of air traffic services and it has the potential to degrade human performance leading to occurrences. The International Civil Aviation Organization (ICAO) requires air navigation services which providers establish fatigue risk management systems (FRMS) based on scientific principles for the purpose of managing fatigue. To develop effective FRMSs, it is important to investigate the relationship between traffic volume, air traffic management occurrences, and fatigue. Fifty‐seven qualified ATCOs from a European Air Navigation Services provider participated in this research by providing data indicating their alertness levels over the course of a 24‐hour period. ATCOs’ fatigue data were compared against the total of 153 occurrences and 962,328 air traffic volumes from the Eurocontrol TOKAI incident database in 2019. The result demonstrated that ATCO fatigue levels are not the main contributory factor associated with air traffic management occurrences, although fatigue did impact ATCOs’ performance. High traffic volume increases ATCO cognitive task load that can surpass available attention resources leading to occurrences. Furthermore, human resilience drives ATCOs to maintain operational safety though they suffer from circadian fatigue. Consequently, FRMS appropriately implemented can be used to mitigate the effects of fatigue. First‐line countermeasure strategies should focus on enough rest breaks and roster schedule optimization; secondary strategies should focus on monitoring ATCOs’ task loads that may induce fatigue. It is vital to consider traffic volume and ATCOs’ alertness levels when implementing effective fatigue risk management protocols.

Background Image‐guided radiotherapy (IGRT) is an advanced radiotherapy technique to improve the precision and accuracy of treatment delivery. A recent randomized controlled trial (RCT) for prostate cancer patients treated with radiotherapy via either IGRT or routine care reported statistically significantly worse overall survival (OS) for those patients treated with IGRT. This raised the concern regarding the effectiveness of IGRT in definitive concurrent chemoradiotherapy (dCCRT) for locally advanced lung cancer (LALC). Methods Eligible LALC patients diagnosed between 2011 and 2016 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratio (HR) of death and other outcomes were compared between IGRT and non‐IGRT. We also evaluated OS in various subgroups. Results Our primary analysis consisted of 797 patients in whom covariates were well balanced after PS weighing. The HR for death when IGRT was compared with non‐IGRT was 0.96 (95% confidence interval 0.79–1.15, P = 0.65). There were also no significant differences for most of the other outcomes or subgroup analyses. Conclusions In this updated nonrandomized study, we found that OS of LALC patients treated with dCCRT was not statistically different between those treated with IGRT versus non‐IGRT. The results should be interpreted with caution given the nonrandomized design. Studies regarding toxicity, local control, or designed as RCT are needed to clarify the role of IGRT. Key points Significant findings of the study The OS of LALC patients treated with dCCRT was not statistically different between those treated with IGRT versus those without IGRT, although the observed HR for death was less than unity (ie, in favor of IGRT). What this study adds In this updated nonrandomized study using real world data with additional potential confounders, our study provided a reasonable tentative evidence in the lack of RCT as suggested in the literature., In this updated nonrandomized study, we found that overall survival of locally advanced lung cancer patients treated with definitive concurrent chemoradiotherapy was not statistically different between those treated with IGRT versus non‐IGRT. The results should be interpreted with caution given the nonrandomized design. Randomized controlled trials are needed to clarify this finding.

The nature of the current rotating roster, providing 24-h air traffic services over five irregular shifts, leads to accumulated fatigue which impairs air traffic controllers’ cognitive function and task performance. It is imperative to develop an effective fatigue risk management system to improve aviation safety based upon scientific approaches. Two empirical studies were conducted to address this issue. Study 1 investigated the mixed effect of circadian rhythm disorders and resource depletion on controllers’ accumulated fatigue. Then, study 2 proposed a potential biofeedback solution of quick coherence technique which can mitigate air traffic controllers’ (ATCOs’) fatigue while on controller working position and improve ATCOs’ mental/physical health. The current two-studies demonstrated a scientific approach to fatigue analysis and fatigue risk mitigation in the air traffic services domain. This research offers insights into the fluctuation of ATCO fatigue levels and the influence of a numbers of factors related to circadian rhythm and resource depletion impact on fatigue levels on study 1; and provides psychophysiological coherence training to increase ATCOs’ fatigue resilience to mitigate negative impacts of fatigue on study 2. Based on these two studies, the authors recommended that an extra short break for air traffic controllers to permit practicing the quick coherence breathing technique for 5 min at the sixth working hour could substantially recharge cognitive resources and increase fatigue resilience. Application: Present studies highlight an effective fatigue intervention based on objective biofeedback to moderate controllers’ accumulated fatigue as a result of rotating shift work. Accordingly, air navigation services providers and regulators can develop fatigue risk management systems based on scientific approaches to improve aviation safety and air traffic controller's wellbeing. Higher Education Innovation Fund (HEIF 2017-2018)

The innovative concept of multiple remote tower operations (MRTO) can maximize cost savings by applying video panorama‐based remote tower working positions, which can facilitate fewer air traffic controllers (ATCO) to provide the air traffic services (ATS) function for more airports. Five subject‐matter experts, qualified remote tower ATCOs, participated in this research work by applying the human error template (HET) and comparing workload between physical tower operations and MRTO using NASA‐TLX (Task Load Index). The results demonstrate that augmented visualization provided sufficient technical support for a single ATCO to perform tasks originally designed to be performed by four ATCOs, however, the demands of the associated multiple tasks induced significant workload. There were significant differences in ATCOs’ mental demand, temporal demand, effort, and frustration between MRTO and physical tower operations. This innovative technology may induce human–computer interaction (HCI) issues that impact ATCO's perceived workload. This creates a need for further research on how to manage ATCO's workload in a multiple remote tower environment. This research work provided scientific evidence that MRTO can achieve the objectives of Single European Sky Air Traffic Management Research program. The findings can be applied to both ATCO training design and remote tower system design.

Ovarian cancer is the most lethal cancer of the female reproductive system. In that regard, several epidemiological studies suggest that long‐term exposure to estrogen could increase ovarian cancer risk, although its precise role remains controversial. To decipher a mechanism for this, we previously generated a mathematical model of how estrogen‐mediated upregulation of the transcription factor, E2F6, upregulates the ovarian cancer stem/initiating cell marker, c‐Kit, by epigenetic silencing the tumor suppressor miR‐193a, and a competing endogenous (ceRNA) mechanism. In this study, we tested that previous mathematical model, showing that estrogen treatment of immortalized ovarian surface epithelial cells upregulated both E2F6 and c‐KIT, but downregulated miR‐193a. Luciferase assays further confirmed that microRNA‐193a targets both E2F6 and c‐Kit. Interestingly, ChIP‐PCR and bisulphite pyrosequencing showed that E2F6 also epigenetically suppresses miR‐193a, through recruitment of EZH2, and by a complex ceRNA mechanism in ovarian cancer cell lines. Importantly, cell line and animal experiments both confirmed that E2F6 promotes ovarian cancer stemness, whereas E2F6 or EZH2 depletion derepressed miR‐193a, which opposes cancer stemness, by alleviating DNA methylation and repressive chromatin. Finally, 118 ovarian cancer patients with miR‐193a promoter hypermethylation had poorer survival than those without hypermethylation. These results suggest that an estrogen‐mediated E2F6 ceRNA network epigenetically and competitively inhibits microRNA‐193a activity, promoting ovarian cancer stemness and tumorigenesis.

Background The standard of care for fit locally advanced non-small cell lung cancer (NSCLC) patients is concurrent chemoradiotherapy (CCRT). However, in a subset of patients with lung adenocarcinoma with mutant EGFR (LA-mEGFR), the role of EGFR-tyrosine kinase inhibitors (TKIs) is not clear. We compared CCRT versus TKIs for the treatment of stage IIIb LA-mEGFR in a Taiwanese population. Methods We identified patients from the Taiwan Cancer Registry with good performance status at clinical stage IIIb LA-mEGFR, diagnosed from June 2011 to December 2015 and treated with either TKIs or CCRT. Clinical covariables and survival status were also collected. The Cox regression method was used in the primary analyses and several propensity score methods and alternative study cohort definitions were used in additional analyses. Results We compared the data of 177 TKI and 22 CCRT patients and found no statistically significant difference in overall (adjusted hazard ratio of death 0.71, 95% confidence interval 0.34-1.47) or lung cancer-specific survival (hazard ratio 0.65, 95% confidence interval 0.31-1.35). The results of most additional analyses were insignificant. Conclusion In this population-based study from Taiwan with limited case numbers, no statistical difference in the survival outcomes of patients with clinical stage IIIb LA-mEGFR treated with either EGFR-TKIs or CCRT was determined. Further prospective studies are needed to clarify our findings.

Background: Antimicrobial therapy for intra-abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. Methods: Quantitative: A retrospective audit of patients with complicated intra-abdominal infection before and after a multifaceted persuasive intervention was performed. Qualitative: Semi-structured interviews were performed to evaluate which elements of the intervention were perceived to be effective. Results: An intervention including collaborative inter-specialty and inter-professional educational meetings, and education of all professional streams was undertaken. Quantitative: Twenty-three patients before and 22 patients after the intervention were included. The total duration of antibiotics decreased significantly following the intervention (9.2 versus 6.6 days P = 0.02). The duration of intravenous antibiotics did not change significantly (5.4 versus 4.5 days, P = 0.06). Qualitative: Eighteen health-care professionals participated. Thematic analysis indicated that a collaborative approach between senior surgical and infectious disease specialists in the pre-intervention stage led to perceived ownership and leadership of the intervention by the surgical team, which was thought critical to the success of the intervention. Conversely, the ability of nurses and pharmacists to influence antibiotic practice was considered limited and a poster promoting the intervention was perceived as ineffective. Conclusion: Consultant leadership and specialty ownership of the process were perceived to be critical in the success of the intervention. Antibiotic stewardship programs which address social factors may have greater efficacy to optimize antimicrobial prescribing.

Food adulteration has a long history in human society, and it still occurs in modern times. Because children are relatively vulnerable to food adulterants, studying the health impacts of food adulteration on children is important. This article provides an overview of the child health impacts of food adulterants in two recent food adulteration incidents in the Greater China Region: (1) a plasticizer incident in Taiwan and (2) a 2,4,6-triamino-1,3,5-triazine (melamine)-tainted milk incident in China. The involved food adulterants, di-(2-ethylhexyl) phthalate (DEHP), diisononyl phthalate (DiNP) and melamine, are harmful to the hippocampus, kidneys, reproductive organs and immune system of children, and they also increase the risk of cancer. To detect food adulteration and to avoid further harm caused by food adulteration, simple screening methods have been developed, and they have recently emerged as a new focus area for research. This article also summarizes the simple screening methods used to analyse the aforementioned food adulterants and reports how governments reacted to the recent food incidents. © 2017 Society of Chemical Industry.

The fundamental approach to improve pilots’ situation awareness would be to reorganise and restructure the presentation of information to fit pilot’s cognitive model on the flight deck. This would facilitate pilots’ perception, understanding, and projection hence making it easier to find the relevant targets. Sixty pilots (30 B-737 pilots; 30 B-777 pilots) participated in this research to investigate pilots’ situation awareness while interacting with digital displays and moving pointed needle displays on cabin pressurization system. The results have shown significant differences on pilots’ perception, understanding and overall situation awareness between digital display and pointed display on the flight deck. Pilots significantly preferred the digital design Cabin Pressurization System which is consistent with the proximity compatibility principle, and the position of the display on the centre instrument panel is easily accessible to both pilots and does not require large head movements. There are some recommendations on the cabin pressurization design including the size of outflow valve position indicator which should be significantly increased to provided saliency of information; colour coding should be used on cabin altitude and differential pressure indicator to mark critical cabin altitude; and standard operating procedures shall include cabin altitude and differential pressure reading by pilot monitoring. The final and completed solution to the issues on the cabin pressurization system is to redesign the scattered pointed displays as integrated digital displays to fit the human-centred principle.

Aim The effects of image-guided radiotherapy (IGRT, an advanced RT technology) have been debated in the literature. We compared the outcomes of locally advanced rectal cancer (LARC) patients treated with neoadjuvant concurrent chemoradiotherapy (NCCRT; with vs without IGRT) in a large population-based propensity score (PS)-matched analysis. Methods We identified LARC patients diagnosed between 2007 and 2015 via the Taiwan cancer registry (TCR) and constructed a PS-matched cohort to balance observable potential confounders. Outcomes (R0 resection, overall survival, incidence of local regional recurrence [ILRR], rectal cancer mortality [IRCM], other cancer mortality [IOCM] and cardiovascular mortality [ICVM]) were obtained from TCR and the national death registry. We compared the hazard ratio (HR) of death and other endpoints between IGRT and non-IGRT groups. We performed supplementary analysis (SA) to evaluate the robustness of these results in a subgroup, taking an additional potential confounder into account. Results Our study population comprised of 586 patients that were balanced with regard to observed covariables. There was no significant difference in HR for death (0.99; 95% confidence interval 0.70-1.39; P = 0.94) between IGRT and non-IGRT groups. There were also no significant differences in R0 resection, ILRR, IRCM, IOCM or ICVM. The results of our SA were consistent with these findings. Conclusion For LARC patients treated with NCCRT, the treatment outcome was not significantly different among patients treated with and without IGRT. Further study is needed to clarify these results with consideration to additional potential confounding factors and toxicity profiles at endpoints.

An ion-moderated partition high-performance liquid chromatography method was developed for the separation and identification of common organic carbonates. The separation of organic carbonates was achieved on an ion exclusion column with an exchangeable hydrogen ion. An isocratic, aqueous mobile phase was used for elution and detection was performed with a refractive index detector. The developed method was validated for specificity, linearity, limits of detection and quantification, precision and accuracy. All calibration curves showed excellent linear regression (R2 > 0.9990) within the testing range. The limits of detection were 3.8-30.8 ppm for the analyzed carbonates. Improvements in the peak resolution of the chromatograms were achieved by decreasing the column temperature. Addition of the organic modifier, acetonitrile, to the eluent was found to have insignificant effects on the peak resolution. The developed method was demonstrated for analyzing organic carbonate components in the electrolyte system of a commercial lithium ion battery.

Background Screening for colorectal cancers outside the recommended guidelines presents a considerable burden to resource management in many public hospitals. The aim of this study is to evaluate the frequency, indications and outcomes for repeat colonoscopy performed within 5 years of a negative colonoscopy. Methods A retrospective review of all colonoscopies at Nambour Hospital in 2008 was performed to identify those with a negative colonoscopy. The charts of patients undergoing repeat colonoscopy at the same institution within 5 years of a negative colonoscopy were examined further, and data obtained regarding indications and outcomes of subsequent colonoscopies. Results A total of 616 colonoscopies were identified, 427 (69.3%) were negative for adenoma and carcinoma. Of these patients, 74 (17.3%) underwent a repeat colonoscopy at Nambour Hospital within 5 years. Eighteen out of 74 (24.3%) were outside guideline recommendation. Overall, one patient (1.4%) had cancer and 11 patients (14.9%) had polyps detected at repeat colonoscopy. Most of the polyps detected had low-risk features and were detected in the fourth and fifth years of the study period. Conclusion The yield of a second colonoscopy within 5 years of a good-quality negative colonoscopy is low but not zero. In the absence of new concerning symptoms or other risk factors, patients can be reassured and guidelines adhered to.

Cullin 4A (Cul4A) has been observed to be overexpressed in various cancers. In this study, the role of Cul4A in the growth and chemosensitivity in lung cancer cells were studied. We showed that Cul4A is overexpressed in lung cancer cells and tissues. Knockdown of the Cul4A expression by shRNA in lung cancer cells resulted in decreased cellular proliferation and growth in lung cancer cells. Increased sensitivity to gemcitabine, a chemotherapy drug, was also noted in those Cul4A knockdown lung cancer cells. Moreover, increased expression of p21, transforming growth factor (TGF)‐β inducible early gene‐1 (TIEG1) and TGF beta‐induced (TGFBI) was observed in lung cancer cells after Cul4A knockdown, which may be partially related to increased chemosensitivity to gemcitabine. G0/G1 cell cycle arrest was also noted after Cul4A knockdown. Notably, decreased tumour growth and increased chemosensitivity to gemcitabine were also noted after Cul4A knockdown in lung cancer xenograft nude mice models. In summary, our study showed that targeting Cul4A with RNAi or other techniques may provide a possible insight to the development of lung cancer therapy in the future.

The ability to control the morphology of fluorite-structured cerium oxide nanomaterials is an important step in the design of cerium oxide-based catalysts. Herein, we report an additive-free synthesis of cerium oxide nanorods with highly tunable aspect ratios from ~6:1 to 40:1. The use of a microwave hydrothermal method allows for both rapid synthesis and temperature control. The ability to control the length of the nanorods from 1.7 μm by varying only the reaction temperature was demonstrated over a temperature range of 80°C to 200°C. The formation of the resulting nanorods was investigated using selected-area electron-diffraction and high-resolution transmission electron microscopy. The surface area of nanorod products was found to decrease from 117 to 22 m2/g as the reaction temperature increased from 80°C to 200°C, complementing the general trend of the increasing aspect ratios of these products.

Paddy soil and rice (Oryza sativa L.) in the Wanshan mining area in Guizhou Province, China, have been contaminated by toxic trace metals such as cadmium (Cd) and mercury (Hg). The present study examined correlations between the types and physicochemical parameters of the soil and the contents of trace metals and the different forms of Hg in rice. The health risks of consuming contaminated rice from the Wanshan mining area were also assessed. Sequential extraction procedures were used to investigate the chemical behavior of Hg in the soil. The results showed that Hg and Cd were the most abundant trace metals in the Wanshan mining area. The toxic methylmercury (MeHg) content was substantial in brown rice, and the total amounts of total Hg (THg), diethylenetriaminepentaacetic acid-Hg, and water-soluble Hg varied in the rhizosphere and non-rhizosphere soils. An antagonistic interaction between Mn in brown rice, straw, and husk and MeHg in brown rice was also shown. An analysis of calculated dietary intake, target hazard quotients, and hazard indexes showed a potential risk of transferring Hg, MeHg, and Cd to humans when rice from the Wanshan mining area is consumed. Therefore, it must be concluded that consuming contaminated rice near the Wanshan mining area is a potential threat to human health.

Foodborne diseases are an important public health problem in the world. The bacterial resistance against presently used antibiotics is becoming a public health issue; hence, the discovery of new antimicrobial agents from natural sources attracts a lot of attention. Antibacterial activities of oligogalacturonide from commercial microbial pectic enzyme (CPE) treated citrus pectin, which exhibits antioxidant and antitumor activities, against 4 foodborne pathogens including Salmonella Typhimurium, Staphylococcus aureus, Listeria monocytogenes, and Pseudomonas aeruginosa was assessed. Pectin hydrolysates from CPE hydrolysis exhibited antibacterial activities. However, no antibacterial activity of pectin was observed. Citrus oligogalacturonide from 24-h hydrolysis exhibited bactericidal effect against all selected foodborne pathogens and displayed minimal inhibitory concentration at 37.5 μg/mL for P. aeruginosa, L. monocytogenes, and S. Typhimurium, and at 150.0 μg/mL for S. aureus.

A copolymerization strategy is developed to utilize porphyrin as a complementary light-harvesting unit (LHU) in D-A polymers. For polymer solar cells (PSCs), the presence of LHUs increases the short-circuit current density (Jsc ) without sacrificing the open-circuit voltage (Voc ) and fill factor (FF). Up to 8.0% power conversion efficiency (PCE) is delivered by PPor-2:PC71 BM single-junction PSCs. A PCE of 8.6% is achieved when a C-PCBSD cathodic interlayer is introduced.

Aims To report the annual incidence rate and the socio-demographic and clinical characteristics of childhood Type 1 diabetes in Taiwan in the period 2003–2008. Methods A total of 1306 incident cases of childhood (0–14 years) Type 1 diabetes were identified from Taiwan's National Health Insurance claim datasets from the period 2003–2008. The temporal trend of the incidence rate of Type 1 diabetes and the features of hospitalizations in the first year after diagnosis were investigated. The associations of patient characteristics, child population density and the urbanization level of the residential areas with the risk of Type 1 diabetes were assessed using Poisson regression analysis. Results The annual incidence rate was stable, irrespective of age and gender, with a mean annual incidence rate of 5.3 per 100 000 children. Girls were more likely than boys to develop Type 1 diabetes (6.0 vs 4.7 per 100 000 children) and the incidence rate increased with age. There was no apparent geographic variation in the incidence rates. Despite the 60% decrease in the rate of admission (from 11.0 to 5.8%) over the study period, ketoacidosis remained the major diabetes complication leading to admission for childhood Type 1 diabetes. The multivariate analysis suggested that female gender and older age were significant predictors of the incidence of Type 1 diabetes, whereas the population density of children and the urbanization levels of the residential areas were not. Conclusions Girls and older children should receive particular attention when formulating preventive strategies targeting Type 1 diabetes. Additionally, clinicians should still carefully optimize the management of children with Type 1 diabetes to further reduce the occurrence of ketoacidosis.

Metabolic genotypes of 5,10-methylenetetrahydrofolate reductase (MTHFR) and folate status on oxidative DNA lesions in hepatocellular carcinoma (HCC) has not been elucidated. The aims of the study were to investigate the folate-polymorphic interactions on genetic oxidative damage in association with advanced HCC malignancy and prognosis.The study included 232 HCC patients with folate nutrition, MTHFR C677T polymorphic, p53 genetic and tumour pathological data collected and analyzed for their survivals after a 7.8-years following up. By adjustment for oxidative risk factors of HCC, the compound CT and TT genotypes in relative to the CC wild-type were associated with 83% reduced lymphocytic p53 oxidative lesions of HCC patients with RBC folate lower than 688 ng/mL (OR: 0.17, 95%CI: 0.07-0.43). Such genetic protective effects by the CT/TT genotypes were 2-fold enhanced among those with high RBC folate (OR: 0.08, 95% CI: 0.03-0.21, P for interaction0.001). For those with non-folate-deficient status, the compound CT and TT vs. CC genotypes were associated with 80% reduced risks of advanced HCC stages (IIIIV) (OR: 0.2, 95%CI: 0.08-0.56). Such protection was negated either by adjustment of lymphocytic p53 oxidative lesions or by 3-fold increased risks among those with high RBC status (OR: 0.6, 95%CI; 0.31-1.41, P for interaction = 0.009). Multivariate Cox proportional hazards analysis showed that the CT/TT genotypes vs. CC wild-type were the independent predictable factor for better survival outcome of HCC patients (HR: 0.48, CI = 0.30-0.79). For CC homozygote, the second vs. the bottom tertile levels of RBC status were associated with 2-fold increased mortality rate of HCC patients (HR: 2.05, CI = 1.0-4.1).Our data demonstrated that reduced MTHFR activities associated with the MTHFR T allele may interact with RBC folate as the risk modifiers of lymphocytic p53 oxidative lesions of HCC patients. The CT/TT genotypes correlated with lower risks of late-stage HCC and a favorable survival of HCC patients, depending on p53 oxidative lesions or RBC folate status.

Aims To investigate t(14;18)/IGH–BCL2 in follicular lymphoma (FL) cases from Taiwan. Methods and results We retrospectively studied 93 consecutive cases, using immunohistochemistry and fluorescence in-situ hybridization (FISH). Fifty-nine (63%) tumours were low-grade (LG) and 34 (37%) were high-grade (HG; 24% FL3A and 13% FL3B). FISH showed IGH, BCL2 and BCL6 rearrangements in 59%, 47% and 11% of cases, respectively, and MYC rearrangement in 5% of FL3A tumours and 25% of FL3B tumours. The translocation partner of all BCL2 rearrangements was IGH, with IGH–BCL2 fusion in 63% of LG tumours and 18% of HG tumours. LG tumours were enriched with a CD10+/bcl-2+/MUM1- phenotype, and were frequently associated with BCL2 rearrangement but less commonly with BCL6 rearrangement. FL3A tumours were more closely related to FL3B tumours than to LG tumours in immunophenotype and genetic aberrations. There was no statistically significant difference between grade 1 and two tumours, between FL3A and FL3B tumours or between nodal and extranodal tumours in immunophenotypic or FISH findings. The cumulative survival rate was higher in LG FL patients with IGH–BCL2 translocation than in those without rearrangement. Conclusions In Taiwan, FL3A tumours were more closely related to FL3B tumours than to LG tumours, and a literature review showed that the frequency of t(14;18)/IGH–BCL2 in FL in Taiwan is among the lowest in the world.

Aims We prospectively assessed the age- and sex-specific incidence rates and relative risks of overall and severe acute pancreatitis in Taiwanese with diabetes. Methods The study cohort included age- and-sex-matched groups of patients with (n = 547 554) and without (n = 584 373) diabetes. Incidence rate was estimated under Poisson assumption and relative risks of acute pancreatitis and severe acute pancreatitis, based on modified Atlanta criteria, were indicated by hazard ratios estimated from Cox proportional hazard regression models. Results Over an 8-year follow-up period, the incidence of acute pancreatitis was 2.98 and 1.68 per 1000 person-years for patients with and without diabetes, respectively, representing a covariate adjusted hazard ratio of 1.53 (95% confidence interval 1.49–1.58). Diabetes was associated with a significantly elevated risk of acute pancreatitis in all sex and age stratifications, with the highest hazard ratio noted for study subjects aged

Background and objective: Population-based data on pleural infections are limited. This study describes the temporal trends in the incidence, management and outcomes of pleural infections in Taiwan. Methods: The Taiwan National Health Insurance Research Database was used to analyse data on 26 385 patients with a first episode of pleural infection between 1997 and 2008. Results: During the study period, the median age of the patients increased from 60 to 65 years. The majority of patients were men (75%); this proportion remained constant over time. The standardized annual incidence of pleural infection increased from 5.2 per 100 000 in 1997 and reached a plateau of 8.4 to 9.6 per 100 000 between 2002 and 2008. Over time, there was an increase in the use of computed tomography (from 47.3% in 1997–1998 to 59.4% in 2007–2008), pigtail catheters (from 1.5% to 18.9%), fibrinolytics (from 0.9% to 9.3%) and surgery (from 27.7% to 33.6%), to treat pleural infections. Furthermore, the use of life-support resources, including haemodialysis, mechanical ventilation and intensive care, also increased by 3.1%, 11.0% and 12.8%, respectively. Median hospital charges per patient increased by 63.6% over the 12 years. Although the proportion of patients with organ dysfunction (i.e. severe sepsis) increased from 26.5% to 47.7%, 30-day mortality decreased from 15.0% to 13.1% (P-value for trend = 0.001). Conclusions: These findings suggest that advances in the management of pleural infections and subsequent severe sepsis may have led to a reduction in the risk of short-term mortality in Taiwan.

The existence and stability of erbium hexaboride (ErB6) has been a controversial topic in literature due to cited failures in reproducing previous synthetic results. Here, we report our proof of the existence of ErB6 by demonstrating the synthesis of a mixture of ErB6 nanowires and erbium tetraboride (ErB4) nanoplatelets via palladium nanoparticle-assisted chemical vapor deposition. High-resolution transmission electron microscopy and selected-area electron diffraction showed that both the ErB6 nanowires and ErB4 nanoplatelets were single crystalline with expected cubic and tetragonal crystal structures, respectively. The observed lattice constants compared well with the theoretical structures calculated using density functional theory.

Summary T cell and natural killer (NK)/T-cell neoplasms are rare and may occasionally present as leukaemia. We retrospectively searched T cell and NK/T-cell tumours in a single institution in Taiwan from January 2000 to December 2009 and identified 137 (19.1%) patients with T cell and NK/T-cell tumours among 718 patients with lymphoid neoplasms. Among these 137 patients, 18 (13.1%) presented with leukaemia including T-lymphoblastic lymphoma/leukaemia (T-LBL), T-cell prolymphocytic leukaemia, aggressive NK-cell leukaemia, adult T-cell lymphoma/leukaemia (ATLL), T-cell large granular lymphocytic (T-LGL) leukaemia and unspecified peripheral T-cell lymphoma. Cases with concurrent lymphoma, higher absolute leukaemic cell counts and elevated lactate dehydrogenase level carried a poorer prognosis. The survival was dichotomous, with a very poor prognosis for patients with T-LBL, T-cell prolymphocytic leukaemia, aggressive NK-cell leukaemia, ATLL in acute phase and unspecified peripheral T-cell lymphoma, while those with T-LGL leukaemia and ATLL in chronic phase had a favourable outcome.

Aims: To characterize the clinicopathological features of sporadic Burkitt lymphoma (BL). Methods and results: A retrospective study of 17 paediatric and 14 adult BLs with history and histopathology review, immunohistochemistry, Epstein–Barr virus (EBV) in situ hybridization (EBER) and fluorescence in situ hybridization. There was no statistically significant difference in gender, frequency of central nervous system (CNS) involvement and leukaemic change at presentation, or frequency of CD10+/Bcl-2−/Bcl-6+ (88% versus 86%), Ki67 labelling index, EBER (24% versus 21%), or C-MYC translocation (100% versus 92%) between paediatric and adult tumours. Correct pretreatment diagnoses were made in 13/17 (76%) paediatric and in 9/14 (64%) adult tumours. Twenty-eight patients received chemotherapy including 13/16 (81%) paediatric and 3/12 (25%) adult patients with appropriate regimens; 16 (57%) received CNS prophylaxis. The 1- and 5-year overall survival (OS) rates for paediatric patients were 80% and 50%, respectively, whereas 1-year OS for adults was 15%. Conclusions: Sporadic paediatric and adult BLs were phenotypically and genotypically similar. The significant prognosticators were age (P = 0.001), with or without CNS prophylaxis (P = 0.004), and CNS involvement (P = 0.008) and leukaemic change (P = 0.019) in disease course. The poor outcome in adult patients might be related to incorrect diagnosis and inappropriate treatment.

The dielectric properties and microstructural characteristics in solid solutions of Ba1−xLax[Zn(1+x)/3Nb(2−x)/3]O3 (BLZN) are investigated by measuring and observing these properties, respectively, by means of transmission electron microscopy and Raman spectroscopy. The 1:1 ordered structure of BLZN can be explained by the random-site model for the distribution of B-site cations. The decrease in the tolerance factor (t) by lanthanum substitution causes the tilting of oxygen octahedra. It appears that the onset of antiphase and inphase tilting causes the variation in the temperature coefficient of resonant frequency (τf). In the untilted region where t≥1.01, the τf shows a linear increase with decreasing tolerance factor. The region of antiphase tilting, where 0.965≤t

If carrier women could be identified in time and take appropriate measures, fragile X syndrome (FXS) can be prevented. Wide screening of women to be or in their early pregnancy was considered a good approach to identify carriers without misdetection. Nevertheless, we argued against the cost-effectiveness of implementing such a screening program in Taiwan, due to the lower carrier rate found in our pilot study. To reliably estimate the prevalence of mutant FMR1 gene in Taiwan, we anonymously screened 10,046 newborn boys using bloodspot polymerase chain reaction (PCR). Among them, the sample from one boy, who was most likely had FXS, failed repeatedly in PCR amplification. The estimated prevalence of premutation (55–200 CGG repeats) and intermediate alleles (45–54 CGG repeats) was 1:1,674 (n = 6) and 1:143 (n = 70), respectively. All these estimates were constantly lower than that reported in Caucasian populations, with variable statistic significance. Furthermore, when comparing analyses of the distribution of alleles at the two most often investigated microsatellite loci, DXS548 and FRAXAC1, between 100 control and 28 unrelated fragile X chromosomes, we found no apparent founder haplotype prevalent among the fragile X patients. Because a few founder haplotypes were reportedly prevalent in two thirds of fragile X alleles in Caucasians and in Chinese from Central China, we thus suggested that lack of founder fragile X chromosomes might result in a relatively low prevalence of mutant FMR1 gene in a population, as observed in Taiwan. © 2005 Wiley-Liss, Inc.

Flexible polyurethane foam (PUF) is coated by layer-by-layer (LbL) assembly using branched polyethyleneimine (BPEI), poly(acrylic acid) (PAA), and two different charged nanoparticles, such as sodium montmorillonite (Na-MMT) and layered double hydroxide (LDH). Three different deposition strategies, that is, bilayer, trilayer, and quadlayer, exhibit different coating growth, morphology, and flammability properties. Changing the nanosheet from LDH to MMT dramatically alter the coating mass for the same number of layers. A five bilayer PAA/BPEI+LDH coating reduced the peak heat release rate by 40% and the average heat release rate by 70%, which is two times more effective than commercial fire retardants (FRs) and other LbL-FR coatings for PUF. MMT and LDH mixed multilayers resulted in effective flame-retardant coatings with less coating mass by manipulating the deposition strategy. This study manifests the flexibility of LbL to fine-tune flammability reduction by switching the coating weight gains, which is significant to accelerate the development of other LbL coating regardless of the intended applications. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015, 132, 41767.

Rituximab is a commonly utilized treatment agent for B-cell lymphoma. Late onset neutropenia (LON) has been identified as a complication associated with rituximab, primarily in conjunction with hematopoietic stem cell transplantation (HSCT). Scant data exists regarding rituximab-related LON outside the spectrum of HSCT, including newly-diagnosed lymphoma. We examined a large cohort of newly-diagnosed B-cell lymphoma patients treated with rituximab-based therapy. We identified patients with LON and analyzed the characteristics and outcomes. Furthermore, we utilized multiplex PCR for the detection of the FcgRIIIa 158 V/F polymorphism and correlated this with LON. Eighty consecutive B-cell lymphoma patients were examined. Nine of 80 (11.3%) patients developed LON. The clinical course of LON was generally self-limiting without adverse events. The onset of LON occurred at a mean of 66 days after the last course of treatment, while the mean duration of LON was 97 days. Moreover, the V/V and V/F polymorphisms were significantly associated with the occurrence of LON (P 5 0.046) yielding an odds ratio for the development of LON of1.47 (95% CI 1.21-1.78). We identified an incidence of LON following frontline rituximab-based treatment of 11.3%. The FcgRIIIa polymorphism was highly associated with development of LON.