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Objectives: This retrospective case-controlled study aimed to evaluate the association between the severity of fall-related injuries and fall-risk-increasing drugs (FRIDs) in hospitalized patients. Methods: Data were collected from Changhua Christian Hospital, Taiwan, of all adult inpatients who experienced falls between January 2017 and December 2021, and were divided into two groups based on whether they sustained severe fall-related injuries. Retrospective data that may affect the severity of fall-related injuries and the use of FRIDs were investigated. Results: Among 1231 documented cases of falls, 26 patients sustained severe fall-related injuries. Older patients and those with osteoporosis were more susceptible to more severe injuries from a fall. The use of mobility aids and osteoporosis medications showed protective effects against fall injuries. No significant association was observed between fall-related injuries and comorbidities or FRIDs. Multivariate analysis confirmed the inverse correlation between the use of mobility aids, osteoporosis medications, and fall severity. Patients with osteoporosis exhibited significantly higher odds of sustaining more severe injuries with a fall (odds ratio = 3.02, 95% confidence interval: 1.21–7.53). Conclusions: This study highlights the importance of addressing risk factors associated with fall severity among hospitalized patients. Providing mobility aids to persons at greater risk. [ABSTRACT FROM AUTHOR]

Background Intradialytic hypotension (IDH) is a common hemodialysis complication causing adverse outcomes. Despite the well-documented associations of ambient temperatures with fluid removal and pre-dialysis blood pressure (BP), the relationship between ambient temperature and IDH has not been adequately studied. Methods We conducted a cohort study at a tertiary hospital in southern Taiwan between 1 January 2016 and 31 October 2021. The 24-h pre-hemodialysis mean ambient temperature was determined using hourly readings from the weather station closest to each patient's residence. IDH was defined using Fall40 [systolic BP (SBP) drop of ≥40 mmHg] or Nadir90/100 (SBP <100 if pre-dialysis SBP was ≥160, or SBP <90 mmHg). Multivariate logistic regression with generalizing estimating equations and mediation analysis were utilized. Results The study examined 110 400 hemodialysis sessions from 182 patients, finding an IDH prevalence of 11.8% and 10.4% as per the Fall40 and Nadir90/100 criteria, respectively. It revealed a reverse J-shaped relationship between ambient temperature and IDH, with a turning point around 27°C. For temperatures under 27°C, a 4°C drop significantly increased the odds ratio of IDH to 1.292 [95% confidence interval (CI) 1.228 to 1.358] and 1.207 (95% CI 1.149 to 1.268) under the Fall40 and Nadir90/100 definitions, respectively. Lower ambient temperatures correlated with higher ultrafiltration, accounting for about 23% of the increased IDH risk. Stratified seasonal analysis indicated that this relationship was consistent in spring, autumn and winter. Conclusion Lower ambient temperature is significantly associated with an increased risk of IDH below the threshold of 27°C, irrespective of the IDH definition. This study provides further insight into environmental risk factors for IDH in patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

The influence of physician specialty on the outcomes of kidney diseases (KDs) remains underexplored. We aimed to compare the complications and mortality of patients with admissions for KD who received care by nephrologists and non-nephrologist (NN) physicians. We used health insurance research data in Taiwan to conduct a propensity-score matched study that included 17,055 patients with admissions for KD who received care by nephrologists and 17,055 patients with admissions for KD who received care by NN physicians. Multivariable logistic regressions were conducted to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for 30-day mortality and major complications associated with physician specialty. Compared with NN physicians, care by nephrologists was associated with a reduced risk of 30-day mortality (OR 0.29, 95% CI 0.25–0.35), pneumonia (OR 0.82, 95% CI 0.76–0.89), acute myocardial infarction (OR 0.68, 95% CI 0.54–0.87), and intensive care unit stay (OR 0.78, 95% CI 0.73–0.84). The association between nephrologist care and reduced admission adverse events was significant in every age category, for both sexes and various subgroups. Patients with admissions for KD who received care by nephrologists had fewer adverse events than those who received care by NN physicians. We suggest that regular nephrologist consultations or referrals may improve medical care and clinical outcomes in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background Previous studies have demonstrated that multidisciplinary pre-dialysis education and team care may slow the decline in renal function for chronic kidney disease (CKD). Our study compared clinical outcomes of CKD patients between multidisciplinary care (MDC) and usual care in Taiwan. Methods In this 3-year prospective cohort study from 2008 to 2010, we recruited 1056 CKD subjects, aged 20–80 years, from five hospitals, who received either MDC or usual care, had an estimated glomerular filtration rate (eGFR) <60 mL/min, were matched one to one with the propensity score including gender, age, eGFR and co-morbidity diseases. The MDC team was under-cared based on NKF K/DOQI clinical practice guidelines and the Taiwanese pre-end-stage renal disease (ESRD) care program. The incidence of progression to ESRD (initiation of dialysis) and mortality was compared between two groups. We also monitored blood pressure control, the rate of renal function decline, lipid profile, hematocrit and mineral bone disease control. Results Participants were prone to be male (64.8%) with a mean age of 65.1 years and 33.1 months of mean follow-up. The MDC group had higher prescription rates of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB), phosphate binder, vitamin D3, uric acid lower agents and erythropoietin-stimulating therapy and better control in secondary hyperparathyroidism. The decline of renal function in advanced stage CKD IV and V was also slower in the MDC group (−5.1 versus −7.3 mL/min, P = 0.01). The use of temporary dialysis catheter was higher in the usual care group, and CKD patients under MDC intervention exhibited a greater willingness to choose peritoneal dialysis modality. A Cox regression revealed that the MDC group was associated with a 40% reduction in the risk of hospitalization due to infection, and a 51% reduction in patient mortality, but a 68% increase in the risk of initiation dialysis when compared with the usual care group. Conclusions MDC patients were found to have more effective medication prescription according to K/DOQI guidelines and slower renal function declines in advanced/late-stage CKD. After MDC intervention, CKD patients had a better survival rate and were more likely to initiate renal replacement therapy (RRT) instead of mortality. [ABSTRACT FROM PUBLISHER]

Endometriosis is a common systemic chronic inflammatory disease. Inflammation is the key mechanism responsible for the development of endothelial dysfunction and atherosclerosis. We aimed to investigate the risk of coronary artery disease (CAD) among Asian women with endometriosis. This retrospective population-based cohort study included patients with endometriosis diagnosed from 2000 to 2012 and registered in the Longitudinal Health Insurance Database, Taiwan. The comparison cohort (those without endometriosis) were selected (1:4) by matching the age frequency and the index year. We followed up the patients until the diagnosis of CAD (ICD-9-CM codes: 410–414, A270, and A279), withdrawal from the National Health Insurance system, death, or the end of the study. We used a multivariable-adjusted Cox proportional hazard model for evaluating the risk of CAD. We included 19,454 patients with endometriosis and 77,816 women as a comparison group. The mean age of the women at the diagnosis of endometriosis was 37.4 years. A total of 3245 women developed CAD in both groups during a median follow-up of 7 years. The incidence of CAD was higher in women with endometriosis than in those without (5.96 vs. 4.38 per 10,000 person-years; adjusted hazard ratio [95% confidence interval], 1.34 [1.22–1.47]). In conclusion, Asian women with endometriosis had a significantly higher risk of CAD. Further large-scale studies are needed to elucidate the cause-effect relationship between endometriosis and CAD. [ABSTRACT FROM AUTHOR]

Atmospheric polychlorinated-dibenzo-dioxins/dibenzo-furans (PCDD/Fs) remains an important environmental health concern. Although the total emission inventories of PCDD/Fs in Taiwan decreased from 320 to 52.1 g-I-TEQ/year during 2002–2016, the resulting concentrations of atmospheric PCDD/F and distributions in Taiwan are unknown. We, therefore, conducted a comprehensive investigation of spatial and seasonal variations and apportioned potential sources of ambient PCDD/F concentrations in Taiwan-based on 11-year observation data. A total of 1,008 atmospheric PCDD/F samples were collected from 25 air monitoring stations (from seven areas) and 1 background station for 2006–2016. Linear regression was used to model changes in PCDD/F concentrations. Principal component analysis (PCA) and positive matrix factorization (PMF) were used to identify potential contributors. PCDD/F concentrations in the ambient air gradually decreased during the study period, with a median concentration of 28.2 fg I-TEQ/m3 over 11 years. The highest median PCDD/F concentrations were found in the highly industrialized regions of western Taiwan (38.0–43.4 fg I-TEQ/m3). Lower concentrations were found in eastern Taiwan (∼10 fg I-TEQ/m3). Background stations reported the lowest concentrations of PCDD/Fs, with a median concentration of 1.47 fg I-TEQ/m3. Overall, the concentrations of atmospheric PCDD/Fs in Taiwan were higher in winter (13.4–86.7 fg I-TEQ/m3) than in summer (9.65–27.2 fg I-TEQ/m3). The PCA results indicated that PCDD/F profiles varied by both region (industrialized, urbanized, and background areas) and season. The PMF model for the overall data revealed that the major sources of PCDD/Fs were industrial activities (71.2%). However, in less industrialized areas, traffic activities, long-range transport, and open burning were dominant. • Atmospheric PCDD/Fs widely ranged from 0.97 to 255 fg I-TEQ/m3. • Annual median of ambient PCDD/Fs dropped from 43.9 to 18.2 fg I-TEQ/m3 in 11 years. • Highest level of PCDD/Fs were in western Taiwan spatially and in winter seasonally. • PMF showed major sources to be industry (71.2%), LRT (28.6%), and traffic (2.2%). [ABSTRACT FROM AUTHOR]

Background. Archery exercise exerts a rehabilitative effect on patients with paraplegia and might potentially serve as complementary physiotherapy for patients with Parkinson's disease. Objective. This study aimed to examine the rehabilitative effects of an archery intervention. Methods. A randomized controlled trial of a 12-week intervention was performed in patients with idiopathic Parkinson's disease. Thirty-one of the 39 eligible patients recruited from a medical center in Taiwan participated in the trial, of whom 16 were in the experimental group practicing archery exercises and 15 were in the control group at the beginning; twenty-nine completed the whole process. The Purdue pegboard test (PPT), the Unified Parkinson's Disease Rating Scale I to III (UPDRS I to III), physical fitness test, and timed up and go test (TUG) were used to assess the intervention effects of archery exercise. Results. Compared to the control group, the outcome differences between the posthoc and baseline tests in PPT, UPDRS I to III, lower extremity muscular strength, and TUG in the experimental group (between-group difference in difference's mean: 2.07, 1.59, 1.36, −2.25, −3.81, −9.10, 3.57, and −1.51, respectively) did show positive changes and their effect sizes examined from Mann–Whitney U tests (η: 0.631, 0.544, 0.555, 0.372, 0.411, 0.470, 0.601, and 0.381, respectively; Ps < 0.05) were medium to large, indicating that the archery intervention exerted promising effects on improving hand flexibility and finger dexterity, activity functions in motor movement, lower extremity muscular strength, and gait and balance ability. Conclusions. Traditional archery exercise was suggested to have a rehabilitative effect for mild to moderate Parkinson's disease and could be a form of physiotherapy. Nevertheless, studies with larger sample sizes and extended intervention periods are needed to ascertain the long-term effects of archery exercise. [ABSTRACT FROM AUTHOR]

In this study, we explored the willingness to pay (WTP) for broilers raised under the high welfare system. The interval data model and the ordered probit model were used to investigate the factors that affect consumers' WTP for broiler meat produced by farm animal welfare (FAW), practice. Our results from both methods suggest that socioeconomic characteristics such as education level, income level, gender, and age significantly affect consumers' WTP. The food safety concerns of consumers and perceived consumer effectiveness also influence consumers' WTP. Using the interval data method, we computed the mean and median of the estimated WTP from our survey sample. The mean was 46.7745 New Taiwanese dollar per kilogram. The marginal effects of the different variables are also presented. Simple Summary: In Taiwan, the development of farm animal welfare practice is in its beginning stage. Consumers' attitude toward farm animal welfare products is important for the development of this practice. The main goal of this research is to explore the consumers' willingness to pay for broilers' welfare improvement and to identify the factors that affect this willingness to pay. The results of this study showed that consumers' food safety concerns combined with farm animal welfare can influence consumers' willingness to pay. The more consumers believed that they could make a difference in the improvement of animal welfare, the more they were willing to pay. Consumers who felt that farm animal welfare was the producers' responsibility were less willing to pay. The results of this study can be used to evaluate whether or not farm animal welfare practice is market viable. Moreover, the results can be used to develop marketing strategies for high welfare broilers. [ABSTRACT FROM AUTHOR]

Oral cancer is a fatal disease, and its incidence in Taiwan is increasing. Thyroid hormone as L-thyroxine (T4) stimulates cancer cell proliferation via a receptor on integrin αvβ3 of plasma membranes. It also induces the expression of programmed death-ligand 1 (PD-L1) and cell proliferation in cancer cells. Thyroid hormone also activates β-catenin-dependent cell proliferation in cancer cells. However, the relationship between PD-L1 and cancer proliferation is not fully understood. In the current study, we investigated the role of inducible thyroid hormone-induced PD-L1-regulated gene expression and proliferation in oral cancer cells. Thyroxine bound to integrin αvβ3 to induce PD-L1 expressions via activation of ERK1/2 and signal transducer and activator of transcription 3 (STAT3). Inactivated STAT3 inhibited PD-L1 expression and nuclear PD-L1 accumulation. Inhibition of PD-L1 expression reduced β-catenin accumulation. Furthermore, nuclear PD-L1 formed a complex with nuclear proteins such as p300. Suppression PD-L1 expression by shRNA blocked not only expression of PD-L1 and β-catenin but also signal transduction, proliferative gene expressions, and cancer cell growth. In summary, thyroxine via integrin αvβ3 activated ERK1/2 and STAT3 to stimulate the PD-L1-dependent and β-catenin-related growth in oral cancer cells. [ABSTRACT FROM AUTHOR]

Locating and calculating the number of asbestos-cement corrugated roofing tiles is the first step in the demolition process. In this work, archived image cubes of Taiwan served as the fundamental data source used via machine learning approach to identify the existence of asbestos-cement corrugated roofing tiles with more than 85% accuracy. An adequate quantity of ground-truth data covering all the types of roofs via aerial hyperspectral scan was the key to success for this study. Twenty randomly picked samples from the ground-truth group were examined by X-ray refraction detection to ensure correct identification of asbestos-cement corrugated roofing tiles with remote sensing. To improve the classifying accuracy ratio, two different machine learning algorithms were applied to gather the target layers individually using the same universal training model established from 400 ground-truth samples. The agreement portions within the overlapping layers of these two approaches were labeled as the potential targets, and the pixel growth technique was performed to detect the roofing boundary and create the polygon layer with size information. Exacting images from aerial photos within the chosen polygon were compared to up-to-date Sentinel-1 images to find the temporal disagreements and remove the mismatched buildings, identified as non-asbestos roofs, from the database to reflect the actual condition of present data. This automatic matching could be easily performed by machine learning to resolve the information lag while using archived data, which is an essential issue when detecting targets with non-simultaneous acquired images over a large area. To meet the 85% kappa accuracy requirement, the recurring processes were applied to find the optimal parameters of the machine learning model. Meanwhile, this study found that the support vector machine method was easier to handle, and the convolution neuro network method offered better accuracy in automatic classification with a universal training model for vast areas. This work demonstrated a feasible approach using low-cost and low-resolution archived images to automatically detect the existence of asbestos-cement corrugated roofing tiles over large regions. The entire work was completed within 16 months for an area of 36,000 km2, and the detected number of asbestos-cement corrugated roofing tiles was more than three times the initial estimation by statistics method from two small-area field surveys. [ABSTRACT FROM AUTHOR]

Acanthamoeba spp. are opportunistic human pathogens that cause granulomatous amoebic encephalitis and keratitis, and their accurate detection and enumeration in environmental samples is a challenge. In addition, information regarding the genotyping of Acanthamoeba spp. using various PCR methods is equally critical. Therefore, considering the diverse niches of habitats, it is necessary to develop an even more efficient genotyping method for Acanthamoeba spp. detection. This study improved the sensitivity of detection to avoid underestimation of Acanthamoeba spp. occurrence in aquatic environmental samples, and to accurately define the pathogenic risk by developing an efficient PCR method. In this study, a new nested genotyping method was established and compared with various PCR-based methods using in silico, lab, and empirical tests. The in silico test showed that many PCR-based methods could not successfully align specific genotypes of Acanthamoeba, except for the newly designed nested PCR and real-time PCR method. Furthermore, 52 water samples from rivers, reservoirs, and a river basin in Taiwan were analysed by six different PCR methods and compared for genotyping and detection efficiency of Acanthamoeba. The newly developed nested-PCR-based method of genotyping was found to be significantly sensitive as it could effectively detect the occurrence of Acanthamoeba spp., which was underestimated by the JDP-PCR method. Additionally, the present results are consistent with previous studies indicating that the high prevalence of Acanthamoeba in the aquatic environment of Taiwan is attributed to the commonly found T4 genotype. Ultimately, we report the development of a small volume procedure, which is a combination of recent genotyping PCR and conventional real-time PCR for enumeration of aquatic Acanthamoeba and acquirement of biologically meaningful genotyping information. We anticipate that the newly developed detection method will contribute to the precise estimation, evaluation, and reduction of the contamination risk of pathogenic Acanthamoeba spp., which is regularly found in the water resources utilised for domestic purposes. [ABSTRACT FROM AUTHOR]

Background The factors that predict the progression of Mycoplasma pneumoniae infection remain inconclusive. Therefore, we investigated macrolide resistance prevalence, M pneumoniae genotype, and clinical characteristics of childhood M pneumoniae respiratory tract infections in Taiwan. Methods A total of 295 children hospitalized with respiratory tract infections with positive serological M pneumoniae immunoglobulin M test results were enrolled in this 3-year prospective study. Oropharyngeal swabs were obtained for M pneumoniae cultures and polymerase chain reaction tests. All M pneumoniae specimens were further characterized by P1 typing, multilocus variable-number tandem-repeat analysis (MLVA), and macrolide resistance genotyping. The clinical characteristics and blood cytokine profiles were analyzed accordingly. Results Of 138 M pneumoniae specimens, type I P1 was the predominant (136 of 138, 98.6%). The MLVA type P (4-4-5-7-2) was the leading strain (42 of 138, 30.4%), followed by type J, U, A, and X. The overall macrolide-resistant rate was 38.4% (53 of 138); the resistance rate increased dramatically yearly: 10.6% in 2017, 47.5% in 2018, and 62.5% in 2019 (P  < .001). All macrolide-resistant M pneumoniae (MRMP) harbored the A2063G mutation and were MLVA type 4-5-7-2 (49 of 53, 92.5%), especially type U and X. No significant differences in clinical symptoms, duration of hospital stay, and radiographic findings were identified among patients between MRMP and macrolide-sensitive M pneumoniae (MSMP) groups. Patients with MRMP infection had more febrile days before and during hospitalization and higher interleukin (IL)-13 and IL-33 levels than patients with MSMP infection (P  < .05). Conclusions Macrolide-resistant M pneumoniae surged in Taiwan throughout the study period, but macrolide resistance was not a determinant factor of clinical severity. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the risk of osteoporosis or bone fractures (vertebrae, hip and others) in hysterectomized women in Taiwan. Materials and methods: This is a retrospective population-based cohort study from 2000 to 2013. Women aged ≥30 years who underwent hysterectomy between 2000 and 2012 were included in this study. The comparison group was randomly selected from the database with a 1:4 matching with age and index year. Incidence rate and hazard ratios of osteoporosis and bone fracture between hysterectomized women and the comparison group were calculated. Cox proportional hazard regressions were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: We identified 9,189 hysterectomized women and 33,942 age-matched women without a hysterectomy. All women were followed for a median time of about 7 years. The adjusted hazard ratio (aHR) of subsequent osteoporosis or bone fracture was higher in the hysterectomy women (2.26, 95% confidence interval [CI] = 2.09–2.44) than in the comparison group. In the subgroup analysis, oophorectomy and estrogen therapy increase the risk of osteoporosis or fracture in both groups. Regarding the fracture site, the aHR of vertebral fracture (4.92, 95% CI = 3.78–6.40) was higher in the hysterectomized women than in the comparison group. As follow-up time increasing, the aHR of vertebral fracture in hysterectomized women were 4.33 (95% CI = 2.99–6.28), 3.89 (95% CI = 2.60–5.82) and 5.42 (95% CI = 2.66–11.01) for <5, 5–9 and ≥9 years of follow-up, respectively. Conclusions: In conclusion, we found that hysterectomized women might be associated with increased risks of developing osteoporosis or bone fracture. [ABSTRACT FROM AUTHOR]

Highlights • The methicillin resistance rate of Staphylococcus aureus isolates was comparable in the new and old hospitals. • The molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) differed between the new and old hospitals. • The molecular epidemiology of MRSA in the hospitals changed over time. Abstract Objective To compare the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) isolates between an old, urban hospital and a new, rural hospital over the same time period. Methods The molecular characteristics of 398 MRSA bloodstream isolates collected between 2007 and 2013 from two hospitals in Taiwan were analyzed retrospectively; 202 isolates were from the old hospital and 196 from the new hospital (opened in 2007). Results The rate of resistance to multiple antibiotics was significantly higher in the old hospital (93%) than in the new hospital (81%) (p < 0.001). Genetic community-associated MRSA carrying staphylococcal cassette chromosome (SCC) type IV or V accounted for 58% of all MRSA isolates in the new hospital, significantly higher than the rate in the old hospital (p = 0.018). The rate of spa t037-SCC mec III MRSA was significantly lower in the new hospital than in the old hospital (p = 0.02). A significant decreasing trend in spa t002-SCC mec II MRSA isolates was observed in the old hospital (p = 0.006), while the proportion of spa t037-SCC mec III MRSA decreased significantly in the new hospital (41.7% to 26.1%, p = 0.022). Conclusions The rate of multiple antibiotic resistance and the molecular characteristics of MRSA differed significantly between the old and new hospitals and changed over time. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study has been to evaluate the occupational heat exposure of 12 workers at 5 plants in a subtropical country.Material and Methods: The heat stresses and strain on workers in 5 plants were assessed by the International Organization for Standardization (ISO) 7243 index (wet bulb globe temperature - WBGT) and the ISO 7933 index (maximum allowable exposure time - Dlim).Results: Results indicated that 42% of the subjects (5 workers) surpassed the WBGT limits. According to the Dlim, 42% of the subjects could not continue working in the hot environments. The relationships between the various heat stress indices and the WBGT index were also correlated. However, further studies from different heat environments and more subjects should be performed.Conclusions: The sensitive dependence of skin temperature on meteorological and physiological indices for each subject was clearly observed. Obviously, the heart rate response to metabolic rate was much greater than that caused by environmental heat alone. The exponential relationship between workers' duration-limited exposure time, predicted by various estimated criteria, and WBGT were also found. Int J Occup Med Environ Health 2017;30(3):379-395. [ABSTRACT FROM AUTHOR]

Study question During controlled ovarian stimulation (COS), does the duration of premature serum progesterone (P) elevation before administration of hCG affect the outcomes of IVF/ICSI embryo transfer (-ET) cycles? Summary answer The duration of the premature serum P elevation is inversely related to the clinical pregnancy rate of IVF/ICSI-ET cycles. What is known and what this paper adds The majority of the previous studies only considered a single serum P measurement made on the day of hCG administration and the results of attempts to relate this to IVF/ICSI-ET outcomes were controversial. However, the effect of the duration of premature serum P elevation before the hCG administration on the outcomes of IVF/ICSI-ET cycles has not been studied well. Here we demonstrate that the duration of premature serum P elevation has a more significant inverse correlation than the absolute serum P concentration on the day of hCG administration with IVF/ICSI-ET outcomes. Design It is a retrospective, single-centre cohort study. A total of 1784 IVF and/or ICSI-ET cycles were included from October 2005 to June 2011. Participants and setting A total of 1784 patients underwent their IVF and/or ICSI-ET cycles in a university hospital IVF unit. The inclusion criteria include (i) age between 20 and 42 years and (ii) eligible indications for COS before IVF/ICSI. Main results and the role of chance The duration of premature serum P elevation to >1 ng/ml is significantly inversely associated with the probability of clinical pregnancy (odds ratio = 0.773, 95% confidence interval: 0.660–0.891, P < 0.001), after adjustment for possible confounders with multivariate logistic regression analysis. However, the significance of inverse correlation between the absolute serum P concentration on the day of hCG administration with clinical pregnancy rate decreased after adjustment. Bias, confounding and other reasons for caution The cutoff value we chose to define premature serum P elevation (P > 1.0 ng/ml) might not be able to be applied to different immunoassay kits and study population. The retrospective nature of this study inevitably might be influenced by some selection bias. Generalizability to other populations Older patients (>42 years) are excluded from our study. Study funding/competing interest(s) This study was supported in part by grants from the National Science Council (100-2314-B-002-022-MY3) and National Taiwan University Hospital (NTUH 100-S1555), Taipei, Taiwan. No competing interests are declared. Trial registration number nil. [ABSTRACT FROM AUTHOR]

Abstract: Geotechnical reconnaissance of a recurrent liquefaction site at a Quaternary alluvial deposit in southern Taiwan was conducted to establish a comprehensive case history for liquefaction on silty fine sand with high fines content. The liquefaction occurred at a silty fine sand layer with D50 =0.09mm and fines content greater than 35% and was triggered by a Mw =6.4 earthquake on March 4, 2010, which induced maximum horizontal acceleration up to 0.189g at the site. In situ subsurface characterizations, including standard penetration test, cone penetration test, and shear wave velocity measurement, were performed as well as cyclic simple shear tests on undisturbed specimens retrieved by a modified hydraulic piston sampler. Comparisons of cyclic resistance ratios (CRRs) indicate that CPT sounding with standard penetration rate could overestimate the resistance ratio and drainage conditions during penetration should be considered for high fines content soil in the liquefaction analysis. Additionally, variations of CRRs from different in situ tests indicate that correlations among in situ tests and CRR could be soil specific and precautions should be taken when using these curves on silty fine sands. [Copyright &y& Elsevier]