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Background and Aims: Besides hospital size, clinical diagnosis and severity of patient cases determine the total platelet usage. Therefore, the appropriateness of platelet usage could not be compared simply with the total units of platelet usage in each hospital. This study aimed to objectively monitor and analyze platelet usage after implementing a single‐unit issuing policy for each platelet transfusion in our hospital in October 2020. Materials and Methods: We used three objective indices, X, Y, and Z, to monitor platelet usage and compared it with other hospitals. Three indices were generated by dividing the annual total units of platelet usage by the total annual reimbursement, total number of admissions, and average total reimbursement per admission for each hospital. Results: The new indices X and Y alleviated hospital size–dependent differences. Index Y was preferred over X because its value fluctuated less during the COVID‐19 pandemic. The Z index was adjusted for the average total reimbursement per admission, and the results showed that more patients with higher disease complexity did not have increased platelet usage during the COVID‐19 pandemic. In our hospital (H1), index Z decreased from 2019 to 2021 due to a policy of issuing a single unit for each platelet transfusion. Conclusion: These three objective indices are suitable for peer comparison and monitoring platelet usage in hospitals, irrespective of their size. They could be applied to promote patient blood management and provide an early response to the gradual shortage of blood resources owing to the aging population and declining birth rate in Taiwan. [ABSTRACT FROM AUTHOR]

According to statistics, the number of patients with kidney dialysis is increasing every year, especially in Taiwan. The high content of antibiotics in kidney dialysis wastewater can create an environmental burden if not properly treated. Therefore, in this study, a new design for a flower-like ZnO catalyst that can effectively treat norfloxacin (NF) in dialysis wastewater is presented and its NF treatment efficiency is investigated under different operating parameters (including different dosages, pH, ambient temperatures, and pollutant concentrations). Scanning electron microscope results indicate that the ZnO sample consists of flower-like nanostructures with diameters of about 4.97 μm. The surface area, pore volume, and pore size of the flower-like ZnO were estimated to be 46.45 m2g−1, 0.132 cm3g−1, and 19.50 nm, respectively. The total removal efficiency increased with the increase in the initial pH value of NF, when the initial pH value of NF increased from 3.5 (38.1%) to 7.5 (82.5%). However, the total removal efficiency decreased with an increase in the initial pH value of NF, when the initial pH value of NF increased from 9.5 (79.5%) to 11.5 (32.9%). The second-order kinetic simulation results show that the linear relationship is better than that of the first-order kinetic, and the Rc2 values are all above 0.9. [ABSTRACT FROM AUTHOR]

Objective: Chinese herbal products (CHPs) are widely used for atrial fibrillation (AF) in Taiwan. We investigated the effect of adjuvant CHPs in preventing ischemic stroke in patients with AF. Methods: Taiwanese patients in the Health Insurance Database newly diagnosed with AF during 2000–2011 were enrolled. Medication treatment with/without CHPs was administered within 7 days after the AF diagnosis. The clinical endpoint was an ischemic stroke. The Chi-square test, Fisher’s exact test, and Student t test were used to examine differences between the traditional Chinese medicine (TCM) and non-TCM cohorts. Cox proportional hazard regression was used to assess the risk for ischemic stroke between two cohorts. Results: Three hundred and eleven patients underwent TCM treatment and 1715 patients did not. Compared to non-TCM users, TCM users had a lower incidence of stroke (12.59% vs. 1.93%, respectively) and lower risk of stroke [CHA2DS2-VASc score = 0–2 (hazard ratio = 0.20; 95% confidence interval = 0.06–0.65)]. Compared to non-TCM users, the stroke risk was significantly lower in TCM users with AF who were female or younger than 65 years, but not in males, people more than 65 years old, or people with comorbidities. Compared to TCM users, non-TCM users who received conventional treatment had a higher ischemic stroke risk. The risk for AF-related hospitalization was significantly lower in TCM users (0.64%) than in non-TCM users (38.1%). Conclusions: Users of TCM with AF have a lower risk of new-onset ischemic stroke. Therefore, adjuvant CHP therapy may have a protective effect and may be used in AF patients to prevent ischemic stroke. [ABSTRACT FROM AUTHOR]

Objectives: This paper explores the factors influencing the involvement of health-promoting Taiwanese elementary schools in school-family partnership. Methods: The study design was cross-sectional. A stratified random sample was used, according to the size of the districts and individual schools, to select participants from 2,675 primary schools in Taiwan. A total of 584 participants were recruited and the response rate was 67% (n=391). Structured questionnaires including items on demographics, predisposing factors, reinforcing factors, enabling factors, and involvement in school-family partnership, were used to collect data. The data were analyzed using descriptive statistics and hierarchy regression, and p < .05 was considered statistically significant. The research framework was based on the PRECEDE-PROCEED model. Results: The demographics, predisposing factors, reinforcing factors, and enabling factors were the major factors affecting school involvement in school-family partnership, accounting for 46.4% of the total variance for involvement in school-family partnership. The demographics, predisposing factors, reinforcing factors, and enabling factors can divided for 4.4%, 13.2%, 20.3% & 8.6% of the total variances. Conclusions: The availability of helpful resources, supportive policymaking, supportive principal, colleagues, and perceived efficacy of school-family partnership, can successfully enhanced school involvement in school-family partnership. [ABSTRACT FROM AUTHOR]

Objectives: Atopic dermatitis (AD) is a common allergy that causes the skin to be dry and itchy. It appears at an early age, and is closely associated with asthma and allergic rhinitis. Thus, AD is an indicator that other allergies may occur later. Literatures indicate that the molecular basis of patients with AD is different from that of healthy individuals. According to the classics of Traditional Chinese Medicine, the body constitution of patients with AD is also different. The purpose of this study is to determine the differences in pulse spectrum analysis between patients with AD and nonatopic healthy individuals. Methods: A total of 60 children (30 AD and 30 non-AD) were recruited for this study. A pulse spectrum analyzer (SKYLARK PDS-2000 Pulse Analysis System) was used to measure radial arterial pulse waves of subjects. Original data were then transformed to frequency spectrum by Fourier transformation. The relative strength of each harmonic wave was calculated. Moreover, the differences of harmonic values between patients with AD and non-atopic healthy individuals were compared and contrasted. Results: This study showed that harmonic values and harmonic percentage of C3 (Spleen Meridian, according to Wang's hypothesis) were significantly different. Conclusions: These results demonstrate that C3 (Spleen Meridian) is a good index for the determination of atopic dermatitis. Furthermore, this study demonstrates that the pulse spectrum analyzer is a valuable auxiliary tool to distinguish a patient who has probable tendency to have AD and/or other allergic diseases. [ABSTRACT FROM AUTHOR]

Background: Real-time surveillance of COVID-19 in large-scale community outbreaks presents challenges. Simple counts of the daily confirmed cases can be misleading due to constraints from bottlenecks in access to care or laboratory testing. This study aimed to investigate the role of the SARS-CoV-2 antigen rapid diagnostic test (Ag-RDT) in addressing these challenges for real-time COVID-19 surveillance., Methods: This study included the results of 86,933 SARS-CoV-2 Ag-RDT and real-time reverse transcription polymerase chain reaction (RT-PCR) tests. These were conducted at four community testing stations within the Taipei metropolitan area during a community COVID-19 outbreak spanning from May 17, 2021, to August 9, 2021. We examined the correlation between the positive rates of Ag-RDT tests and the epidemic curve of laboratory-confirmed COVID-19 cases by onset date to examine its role in real-time surveillance., Results: During the 85-day study period, the trend of Ag-RDT test positive rates paralleled that of the epidemic curve. The correlation between the Ag-RDT positive rate and the number of cases (Pearson correlation coefficient: 0.968) is comparable to that of the RT-PCR positive rate (Pearson correlation coefficient: 0.964). The Ag-RDT positive rate exhibited a more advanced leading trend, with Ag-RDT leading by 3 days in comparison to the 2-day lead for RT-PCR., Conclusion: The positive rate of SARS-CoV-2 Ag-RDT tests at community testing stations serves as a good surrogate for assessing virus activity within the community and a useful tool for real-time COVID-19 surveillance. It is a robust indicator of the outbreak trend and near-term numbers of cases. This finding may facilitate the management of subsequent outbreaks of emerging infectious diseases., Competing Interests: Conflict of interest disclosure All authors have no competing interest to disclose., (Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Background: Infection is the most common predisposing factor for diabetic ketoacidosis (DKA); however, studies are rare that have investigated the clinical outcomes of septic patients with infection-precipitated DKA., Methods: A retrospective cohort study was conducted at a tertiary hospital from 2004 to 2013. Patients with DKA in whom the presence of a predisposing infection was confirmed were enrolled. Characteristics at initial presentation, primary infection sources, and causative microorganisms were compared between the nonacute kidney injury (non-AKI) group and acute kidney injury (AKI) group at each stage. Risk factors for the development of failure-stage AKI and its outcomes were also analyzed., Results: One hundred and sixty DKA episodes were assessed. The most common infection sites were the urinary and respiratory tracts. The leading causative microorganism was Escherichia coli, followed by Klebsiella pneumoniae. A complicated/severe infection state [odds ratio (OR), 15.27; p < 0.001] and a high level of C-reactive protein (OR, 1.012; p < 0.001) were independently associated with bacteremia. Corrected sodium (Na; OR, 1.062; p = 0.039), initial plasma glucose (OR, 1.003; p = 0.041), severe grade of DKA (OR, 13.41; p = 0.045), and the Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.08; p = 0.033) were identified as independent risk factors for the development of failure-stage AKI among septic patients with infection-precipitated DKA. Patients with failure-stage AKI had a higher frequency of incomplete recovery of renal function (20.4% of patients in failure vs. 5.9% of patients in risk and injury, p = 0.009). Bacteremia independently predicted the absence of complete recovery of renal function (OR, 5.86; p = 0.038)., Conclusion: For patients with infection-precipitated DKA, the clinician should aggressively monitor renal function if a patient presents with risk factors associated with failure-stage AKI. Furthermore, bacteremia predicts a poor renal prognosis., (Copyright © 2014. Published by Elsevier B.V.)

Background: This study investigated one-stop breast screening combining magnetic resonance imaging (MRI) and ultrasound (US) in asymptomatic Asian women., Methods: 3,586 asymptomatic women (mean age, 45.3 years) were retrospectively analyzed by breast MRI followed by US. US-guided biopsy was performed when the MRI-detected lesion was confirmed by US. When the lesion was not detected on the initial US, a second-look US guided by MRI findings was performed. Then biopsy was done. MRI-positive and US-negative patients were followed up according to MRI lesion size, MRI lesion morphology, and mammographic diagnosis., Results: In total, 115 subjects had suspicious malignant lesions and received US-guided biopsy, and 47 malignant lesions, including 35 invasive cancers and 12 carcinoma in situ (CIS) lesions, were diagnosed. More than half (22/35, 63%) of the women with invasive cancer were <50 years of age, and 27 (57.4%) of the 47 cancer cases had early breast cancers. Two invasive cancers (5.7%) and 7 CIS lesions (58.3%) were found at the second-look US. The overall cancer incidence was 1.31% (47/3,586) and increased to 2.2% (78/3,586) if precancerous lesions were included. Subjects aged 41-50 years had the highest incidence of cancer detection (1.97%). Five MRI and US-negative cases had cancers found 1 year after the screening., Conclusions: The results from the one-stop breast screening in this study showed that combining MRI and US is an efficient multimodality tool for screening asymptomatic Asian women in a metropolitan area of Taiwan who had concerns about the diagnosis and radiation of mammography., (Copyright © 2012 S. Karger AG, Basel.)

Background: Recent refinements of lung MRI techniques have reduced the examination time and improved diagnostic sensitivity and specificity. We conducted a study to assess the feasibility of MRI for the detection of primary lung cancer in asymptomatic individuals., Methods: A retrospective chart review was performed on images of lung parenchyma, which were extracted from whole-body MRI examinations between October 2000 and December 2007. 11,766 consecutive healthy individuals (mean age, 50.4 years; 56.8% male) were scanned using one of two 1.5-T scanners (Sonata and Sonata Maestro, Siemens Medical Solutions, Erlangen, Germany). The standard protocol included a quick whole-lung survey with T2-weighted 2-dimensional half Fourier acquisition single shot turbo spin echo (HASTE) and 3-dimensional volumetric interpolated breath-hold examination (VIBE). Total examination time was less than 10 minutes, and scanning time was only 5 minutes. Prompt referrals and follow-ups were arranged in cases of suspicious lung nodules., Results: A total of 559 individuals (4.8%) had suspicious lung nodules. A total of 49 primary lung cancers were diagnosed in 46 individuals: 41 prevalence cancers and 8 incidence cancers. The overall detection rate of primary lung cancers was 0.4%. For smokers aged 51 to 70 years, the detection rate was 1.4%. TNM stage I disease accounted for 37 (75.5%). The mean size of detected lung cancers was 1.98 cm (median, 1.5 cm; range, 0.5-8.2 cm). The most histological types were adenocarcinoma in 38 (77.6%)., Conclusion: Rapid zero-dose MRI can be used for lung cancer detection in a healthy population.