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Objective To study the risks of mortality and cancer incidence in physicians of traditional Chinese medicine (TCM) who had frequent exposure to herbal medicine. Methods A population-based cohort design was conducted in which a total of 7675 certified physicians of TCM who ever practised between 1985 and 2005 were compared with the age-, sex- and calendar year-specific mortalities and cancer incidence rates of the general population of Taiwan. The age-, sex- and calendar year-standardised mortality ratio (SMR) and standardised cancer incidence ratio (SIR) were calculated to estimate the relative risks of all causes and site-specific mortality and cancer incidence. Results Over an up to 20-year observational period, 796 (10.4%) physicians of TCM died, and 279 (3.6%) developed cancer. The study cohort showed a significantly reduced SMR for all-causes mortality (68, 95% CI 63 to 73), and for deaths from infectious (SMR=64), circulatory (SMR=68), respiratory (SMR=64) and digestive (SMR=56) disease. The study cohort also had a significantly reduced SIR (80, 95% CI 71 to 90) for all cancers, and for neoplasm of rectum, rectosigmoid junction, and anus (SIR=45), female breast (SIR=30) and cervix uteri (SIR=10). On the other hand, we noted that physicians of TCM suffered from a significantly increased SIR for neoplasm of liver and intrahepatic bile ducts (SIR=151, 95% CI 116 to 192) and of bladder cancer (SIR=259, 95% CI 167 to 382). Conclusion Like other healthcare workers, we noted that physicians of TCM had significantly reduced risks of all-causes mortality and cancer incidence. Nonetheless, reasons truly responsible for significantly increased risks of liver and bladder neoplasm among physicians of TCM warrant further investigations. [ABSTRACT FROM AUTHOR]

The article presents information on a study conducted to determine the risk of cardiovascular diseases in the healthcare workers of Taiwan by collecting their blood samples for laboratory testing and physical examinations. It mentions that the cardiovascular factors which were measured for each worker include blood biochemical parameters, body mass index (BMI) and blood pressure.

Airway sensitization requires the expression of prostanoid DP receptor in mice. Recent studies reported that polymorphisms in the gene encoding prostanoid DP receptor ( PTGDR) were associated with asthma in White people and Black people, but this association could not be replicated among Latinos and Koreans. This study investigated the association between asthma-related traits and six single nucleotide polymorphisms (SNPs) of PTGDR in Chinese children, consisted of 308 asthmatics and 368 non-allergic controls. Plasma total and aeroallergen-specific immunoglobulin E were measured by immunoassays. PTGDR SNPs were determined by multiplex SNaPshot™ genotyping. All polymorphic markers followed Hardy–Weinberg equilibrium except G1044A in the controls (p = 0.021). The linkage disequilibrium (LD) scores for these SNPs were moderate to high, and in particular, T-549C and C-441T were in strong LD. Significant interethnic variations in PTGDR alleles and haplotypes (up to 41%) were found in our subjects when compared with White people or Latinos. Asthma diagnosis, atopy and aeroallergen sensitization did not differ among children with different PTGDR genotypes (p > 0.15 for all). Linear regression showed weakly significant associations between T-197C and G1044A of PTGDR and spirometric variables. PTGDR haplotypes were not associated with asthma and atopy phenotypes (p > 0.09 for all). Our results do not support PTGDR to be a major candidate gene for asthma traits in Chinese children. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is an important risk factor for stroke, but whether there is differential gender-specific risk has not been fully elucidated. We aimed to explore the impact of gender on incidence and relative risks of hemorrhagic and ischemic stroke among the diabetic population in Taiwan. Methods: In this study, 500,868 diabetic patients and 500,248 age matched and-sex-matched nondiabetic individuals were linked to inpatient claims (1997–2002) to identify hospitalizations for nontraumatic hemorrhagic and ischemic stroke. Incidence density was calculated with the Poisson assumption, and Kaplan-Meier analysis was used to assess the cumulative incidence over a 6-year follow-up period. We also evaluated the relative hazards of stroke in relation to diabetes with the Cox proportional hazard model, adjusted with demographics and geographic regions. Results: The incidence of hemorrhagic stroke in diabetic women was less than that in diabetic men except in those aged ≥85, but the difference between male and female diabetic patients was less pronounced with ischemic stroke. The hazard ratios (HRs) of hemorrhagic and ischemic stroke among diabetic women were increased by a magnitude of 1.2 and 1.32, respectively, which were significantly higher than those of diabetic men. Further age-stratified analysis indicated that young and middle-aged diabetic women tended to have higher HRs and that diabetic women aged <35 suffered from particularly high HRs (HR 7.69, 95% confidence interval [CI] 1.81-32.75 for hemorrhagic stroke, and HR = 8.46, 95% CI 4.28-16.75 for ischemic stroke). Conclusions: There was a significant gender-diabetes interactive effect on the incidence of hemorrhagic and ischemic stroke. Additionally, young Taiwanese diabetic patients were most vulnerable to an increased relative risk of hemorrhagic and ischemic stroke. Comprehensive diabetic care with stroke prevention measures should be emphasized in young diabetic people in order to prevent premature disability. [ABSTRACT FROM AUTHOR]

We previously reported on the effects of a lactobacilli probiotic (SynForU-HerCare; two capsules/day of 9.5 log CFU/capsule) in improving symptoms of vaginal irritation, discharge and burning in pregnant women with vaginal candidiasis upon administration for 8 weeks, accompanied by improved emotional and social quality of life parameters. Thus, the present study aimed to analyse vaginal microbiota and inflammatory changes in hope to better understand the improved clinical symptoms as observed previously. Patients in the probiotic group showed a decreased abundance of Candida glabrata after 8 weeks (p = 0.009) in the lower vaginal region, while patients in the placebo group did not show any changes over time. In the higher vaginal and cervicovaginal regions, patients in the placebo group showed a decreased abundance of Candida albicans only within 4 weeks (p < 0.05) but no changes in abundance of C. glabrata over time, while patients in the probiotic group showed a continuous decreased abundance of C. albicans and C. glabrata over 8 weeks (p < 0.05). Patients in the placebo group also had a decreased abundance of Lactobacillus crispatus over 4 weeks (p = 0.023) in the lower vaginal region and a decreased abundance of L. jensenii over 8 weeks in the cervicovaginal region (p = 0.001). Meanwhile, patients in the probiotic group had an increased abundance of L. crispatus in the lower vaginal region after 8 weeks (p = 0.012) and Lactobacillus jensenii over 4 weeks in the cervicovaginal region (p < 0.001). Inflammation may have occurred in both low and high vaginal regions, predominantly observed by the increased concentration of pro-inflammatory cytokine TNF-alpha in patients from the placebo group (p < 0.05), while the administration of probiotics has shortened the period of inflammation as observed from the reduced need for anti-inflammatory cytokine IL-4 and IL-10 over time (p < 0.05). Taken together, our present new data further support previous findings that probiotic SynForU-HerCare had a beneficial effect against vaginal candidiasis in pregnant women via modulation of the vaginal microbiota and microenvironment. [ABSTRACT FROM AUTHOR]

Studies on the physicians’ health have paid less attention on the Chinese medicine than on the western medicine professionals. Like western medicine professionals, Chinese medicine physicians’ health condition is critical to the quality of care and patients’ safety. They also cared a large number of patients in many Asia societies. However, no data have been reported regarding the health problems associated with Chinese medicine physicians. The aim of this study was to examine the mortality patterns of a cohort consisting of 6109 male physicians of Chinese medicine who were followed from 1991 through 2003 in Taiwan. The analyses of female subjects were not included due to small sample size. We calculated the overall and cause-specific standardized mortality ratios (SMRs) and life expectancy of the study cohort using the death rates of some 11 millions of Taiwanese male population as reference. We found out that physicians of Chinese medicine experienced significantly lower death rate of mortality from all causes (SMR = 0.63, 95% > CI: 0.57, 0.69), from malignant neoplasms (SMR = 0.69, 95% CI: 0.57, 0.82) and from cerebrovascular disease (SMR = 0.53, 95% CI: 0.38, 0.72). Additionally, they have longer life expectancy (ranged from 3 years to approximately 15 years). Our study is crucial to evaluate potential health risks associated with Chinese medicine physicians. Although this study did not reveal elevated death rate among Chinese medicine physicians, researchers and policy makers should not overlook other heath problems that Chinese medicine physicians might have experienced. ──── Chinese medicine Physicians; standardized mortality ratio; life expectancy; mortality rate; occupational epidemiology. [ABSTRACT FROM AUTHOR]

A large number of hospitalized patients have an indwelling urinary tract catheter (IUC) placed at some time during their hospital stay and may suffer from catheter-associated urinary tract infections, the leading cause of nosocomial infections. Here we investigated the prevalence of uropathogens associated with catheter-associated urinary tract infections and assessed the resistances of these pathogens to commonly prescribed antibiotics. In total, 2,997 urine samples were examined at a regional hospital in Taipei, Taiwan in 2004: 1,948 (65%) samples from hospitalized patients and 1,049 (35%) samples from outpatients. Patients with IUCs accounted for 1,381 samples (46%). Stratified analyses were used to calculate the age- and gender-adjusted odds ratio (OR) of antimicrobial resistance associated with the use of IUCs. Compared to the urine specimens of the patients without IUCs, those isolated from catheterized patients had a lower prevalence rate of Escherichia (E.) coli (23.4% vs 36.8%) and higher rates of resistant strains including Pseudomonas species (16.4% vs 8.6%) and rare gram-negative bacilli (5.8% vs 4.5%). Additionally, IUCs significantly increased the antimicrobial resistance of E. coli (OR 2.41-3.07), other species of Enterobacteriaceae (OR 1.57-2.38), and rare gram-negative bacilli (OR 2.41-5.21) to nearly all antibiotics tested, such as trimethoprim/sulfamethoxazole. Thus, IUCs increased the prevalence of urinary tract infections caused by some highly resistant pathogens. Moreover, IUCs were associated with the increased risk of concurrent resistance of Enterobacteriaceae. Clinicians are advised to exercise better management of urinary catheter in order to further reduce and control catheter-associated urinary tract infections in hospitals. [ABSTRACT FROM AUTHOR]

Family caregivers in East Asian countries are known to have a strong sense of filial piety and a traditional caregiving ideology. They are generally presumed to be protected from psychological distress arising from caregiving. However, there is scant information regarding the impact of caregiving on Chinese/Taiwanese families. The purpose of this study was aimed at identifying those family caregivers of Taiwanese terminally ill cancer patients who are at risk of experiencing depressive distress from the following three categories of predisposing factors: 1) contextual factors; 2) stressors; and 3) appraisal of the caregiving situation. Of the 170 Taiwanese family caregivers of terminally ill cancer patients that participated in this survey, 129 (75.9%) were at an extraordinarily high risk of being distressed because of depressive symptoms (CES-D>15). Results indicated that family caregivers were vulnerable to clinically depressive distress if they were the patient's spouse (adjusted odds ratio (AOR): 2.89; 95% confidence interval (CI): 1.19-7.01), or evaluated caregiving as imposing a greater negative impact on their own health (AOR: 1.27; 95% CI: 1.09-1.47). In contrast, if family caregivers felt very confident in their knowledge of how to take care of the patient at home (AOR: 0.35; 95% CI: 0.15-0.81), or were sufficiently aware of the patient's thoughts and feelings about disease experiences and symptoms (AOR: 0.47; 95% CI: 0.25-0.88), they were less likely to suffer from depressive distress. These finding have significant clinical implications when they are put into the context of Confucian cultures which place great emphasis on filial piety and familism. Interventions and policy should be developed to target spousal caregivers to enhance their confidence in caregiving and understanding of the patient's disease experiences. This will reduce the negative caregiving impact on the caregiver's health, which in turn may prevent the development of depressive distress among family caregivers. [ABSTRACT FROM AUTHOR]

Between February and April 2003, a total of 80 single-dwelling households close (<70 m) to high-tension (161 or 345 kV) power lines in a northern community of Taiwan received measurements of indoor extremely low-frequency (ELF) magnetic field for 72 h. Measurements were performed with EMDEX II™ meter at a sampling rate of every 300 s, yielding some 860 readings of ELF magnetic field for each household. In addition to the 72-h mean ELF magnetic field, we also calculated arithmetic means of the first 2, 6, 12, and 288 readings taken in each household to represent the information on spot, 30-min, 60-min, and 24-h exposures, respectively. The mean 72-h exposure to ELF magnetic field for the 80 study households was estimated at 0.80 micro-Tesla (μT) with a standard deviation (SD) of 1.13 μT. The mean for pot, 30-min, 60-min, and 24-h exposure was 0.88 (SD 1.38), 0.90 (SD 1.40), 0.9 (SD 1.17), and 0.83 (SD 1.17) μT, respectively. There were high agreements, indicated by a nearly perfect intra-class correlation coefficient, between 72-h mean exposure and those short-term exposure measures. Additionally, the sensitivity and specificity of various short-term exposures in the prediction of 72-h exposure greater than 0.4 μT were similar at values of 0.82–0.87 and 0.93–0.95, respectively. This study indicates that short-term measurements of indoor ELF magnetic field seem adequate to represent the mean 72-h exposure, but tended to overpredict 72-h exposure greater than 0.4 μT. Further investigation is needed to assess whether these findings can be replicated in households far away from high-tension power lines.Journal of Exposure Science and Environmental Epidemiology (2007) 17, 69–75. doi:10.1038/sj.jes.7500522; published online 23 August 2006 [ABSTRACT FROM AUTHOR]

Mannose-binding lectin (MBL), a member of the innate immune system, initiates complement deposition on microbial surfaces. MBL deficiency is associated with severe respiratory infections. Polymorphisms in the MBL gene ( mbl2) were associated with the susceptibility and severity of autoimmune diseases. This study investigated whether mbl2 polymorphisms at positions -550 and -221 and at codon-54 are associated with asthma phenotypes in Chinese children. Asthmatics aged 5–18 yr and non-allergic controls were eligible, and their plasma total and allergen-specific immunoglobulin E (IgE) concentrations were measured by micro-particle immunoassay and fluorescent enzyme immunoassay. mbl2 polymorphisms were genotyped by restriction fragment length polymorphism. Three hundred and seventeen asthmatic children and 140 controls were recruited, with their mean (s.d.) log-transformed plasma total IgE being 2.61 (0.61) and 1.77 (0.77), respectively (p < 0.0001). Polymorphisms at -550 and codon-54 (p < 0.0001 for both) but not at -221 (p = 0.534) of mbl2 were significantly associated with plasma MBL concentrations. mbl2 genotypes were not associated with asthma, atopy, sensitization to individual aeroallergens or spirometric variable. Subjects with LYB haplotype had the lowest plasma MBL concentrations (p < 0.0001), but two- and three-loci mbl2 haplotypes were also not associated with asthma diagnosis. However, patients with LY and LYB haplotypes were less likely to be atopic (p = 0.006 and 0.031). Subjects with LY and LYA were also less likely to be sensitized to cockroach (p = 0.035 and 0.047). The latter three associations became insignificant when adjusted for multiple comparisons. Despite the importance of MBL in innate immunity, our mbl2 polymorphisms only show weak association with asthma and atopy in children. [ABSTRACT FROM AUTHOR]

Background: Vascular endothelial growth factor (VEGF), AA isoform of platelet-derived growth factor (PDGF-AA), and epidermal growth factor (EGF) are involved in the pathogenesis of airway inflammation in asthma. These molecules are closely associated with cytokines such as tumor necrosis factor-α (TNF-α) and interleukin (IL)-4. This study investigates the relation between childhood asthma and levels of these mediators in exhaled breath condensate (EBC). Methods: EBC was collected from asthmatic children and controls using a disposable collection kit, and the concentrations of VEGF, PDGF-AA, EGF, TNF-α and IL-4 in EBC were measured using sandwich enzyme immunoassays. Exhaled nitric oxide concentration was measured by a chemiluminescence analyzer. Results: Thirty-five asthmatic patients aged between 7 and 18 years and 11 controls were recruited. Sixteen patients had intermittent asthma (IA) whereas 19 of them suffered from persistent asthma (PA). A significant correlation was found between IL-4 and TNF-α in EBC (ρ = 0.374, p = 0.010). PDGF-AA levels in EBC were higher in subjects with diminished FEV1 (p = 0.023) whereas IL-4 concentrations were increased in asthmatics (p = 0.007) as well as subjects with increased plasma total IgE (p = 0.033). Patients with PA receiving high-dose inhaled corticosteroid (ICS) had higher EBC IL-4 concentration than those on low-dose ICS (p = 0.007). Linear regression revealed that PDGF-AA levels in EBC were negatively associated with FEV1 percentage (β = –0.459, p = 0.006) among the asthmatic patients. Conclusions: IL-4 in EBC is increased in childhood asthma, and growth factors are detectable in a significant proportion of these children. Increased PDGF-AA is found in asthmatics with more severe airflow limitation. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article presents a study on the association of petrochemical air pollution with the increased risks of term low-birth-weight(LBW) infants. The study involved infants from Kaohsiung, a petrochemical industrial city, and Taipei, a non-petrochemical industrial city. The prevalence of low birth weight infants were found to be higher in Kaohsiung than in Taipei. Multivariate logistic regression analysis showed that low-birth-weight risk in Kaohsiung was higher by 13 percent compared to the those in Taipei.

Leung TF, Li CY, Lam CWK, Au CSS, Yung E, Chan IHS, Wong GWK, Fok TF. The relation between obesity and asthmatic airway inflammation. Pediatr Allergy Immunol 2004: 15: 344–350. © 2004 Blackwell Munksgaard Epidemiologic studies suggest increased asthma prevalence in obese subjects. However, the relation between obesity and airway inflammation remains unclear. This cross-sectional study aims to investigate the relation between obesity indices and exhaled nitric oxide (ENO) and leukotriene B4 (LTB4) in children with asthma. Asthmatic patients aged 7–18 yr old were recruited. Weight-for-height Z score was calculated from anthropometry. ENO was measured by online single-breath method using a chemiluminescence analyzer, whereas LTB4 concentrations in exhaled breath condensate (EBC) were quantified using competitive enzyme immunoassay. Ninety-two asthmatics and 23 controls were recruited. The mean ENO and LTB4 concentrations in EBC were higher in asthmatic patients (87 p.p.b. and 40.5 pg/ml) than controls (25 p.p.b. and 18.7 pg/ml) (p < 0.0001 for both). Obesity, as defined by weight >120% median weight-for-height, was not associated with any alteration in ENO or LTB4 concentrations in patients with asthma. Besides, these inflammatory markers did not differ between asthmatics in the highest and lowest quartiles of weight-for-height Z score. On multivariate analysis, ENO showed significant correlation with age ( β = 0.511, p < 0.0001), peripheral blood eosinophil count ( β = 0.222, p = 0.019), plasma total IgE concentration ( β = 0.187, p = 0.050) and forced expiratory volume in 1-s (FEV1; β = −0.221, p = 0.014). None of the factors was associated with LTB4 concentration in EBC. In conclusion, ENO and LTB4 concentration in EBC are increased in childhood asthma. However, these inflammatory markers did not differ between obese and non-obese children with asthma. [ABSTRACT FROM AUTHOR]

The purposes of this research were to develop and lest a self-care scale for dysmenorrhic adolescents. A focus group was employed to obtain information on dysmenorrhic self-care behavior of adolescents. A convenience sample of 361 adolescent girls aged 13-18 were employed who had experienced cramping pain in the lower abdomen during their menstrual periods at least two times within the 6 months prior to the study. Cronbach's alpha of the scale was found to be 0.89 and both content and construct validity were addressed by a contrast-groups approach and confirmatory factor analysis. It was concluded that the resulting scale was both reliable and valid. [ABSTRACT FROM AUTHOR]

Presents a study which assessed the relationship between exposure to power-frequency electromagnetic fields and the risk for cognitive impairment, an indication of certain neurological disease such as Alzheimer's disease. Methods; Results; Discussion.

Objectives: Substantially increased funding for health care services occurred in Taiwan after the implementation of a national health insurance plan in 1995. This study attempts to examine the impact of this national health insurance plan on the utilization of prenatal and intrapartum care services. Methods: Nationally representative surveys of all pregnant women in Taiwan in 1989 (1,662 participants) and in 1996 (3,626 participants) were included in the analysis. We first compared the distribution of birth characteristics between the two surveys. We then calculated the rate of utilization of various prenatal and intrapartum care services in the two surveys in the overall sample and in subsamples, stratified by maternal education, age, and parity. Results: The utilization of most prenatal and intrapartum care services, especially the complicated laboratory tests, increased in 1996 compared to 1989. For example, the proportion of women who received amniocentesis increased from 1.62% in 1989 to 5.60% in 1996 and German measles testing increased from 5.96% to 27.11%. By contrast, the proportion of women who received consultation services was stable over time, or for family planning, consultation declined from 33.21% to 27.00%. These changes in utilization over time were consistently observed across different maternal education, age, and parity groups. Conclusions: The utilization of prenatal and intrapartum care services, especially for the more expensive services, has substantially increased in Taiwan since the implementation of the national health insurance. For countries considering similar national health insurance plan, it may be helpful to consider cost-containing measures before the implementation of such a plan. [ABSTRACT FROM AUTHOR]

Examines the association between the longest held occupation in a lifetime and risk of disability in activities of daily living (ADL) among elderly people in northern Taiwan. Collection of occupational data through interviews; High risk of ADL disability among unskilled blue collar workers.

Abstract Background Sarcopenia, gait disturbance, and intradialytic hypotension are among the various factors that contribute to fall risk. This study aimed to investigate the relationship between risk of sarcopenia, hemodialysis (HD) session, and long-term fall risk in older end-stage kidney disease (ESKD) patients by analyzing their spatiotemporal gait characteristics. Methods We recruited 22 non-demented patients aged ≥ 65 years who were undergoing maintenance HD. Participants were divided into two groups based on their SARC-F score (

Abstract The integration of fiber-optical wireless convergence with fifth generation new radio is crucial in building high-performance access networks. This approach not only provides high-transmission-rates but also ensures broad coverage, which is vital for future networks. Here we report fifth generation new radio fiber-wireless converged systems by injection locking multi-optical carrier into directly-modulated lasers. Data rates of 10 Gb/s, 20 Gb/s, and 40 Gb/s are achieved by direct modulation on directly-modulated lasers using 16-quadrature amplitude modulation-orthogonal frequency-division multiplexing signal. Through 25-km single-mode fiber, 1.5-km optical wireless, and 12-/22-/33-m millimeter-wave/sub-terahertz wireless integrated-media, 10-Gb/s/20-GHz, 20-Gb/s/60-GHz, and 40-Gb/s/100-GHz signals are transmitted with acceptably low bit error rates and error vector magnitudes, as well as distinct constellations. The successful transport of fifth generation new radio millimeter-wave and sub-terahertz signals at different carrier frequencies through fiber-wireless convergence demonstrates the potential of the system to meet the evolving requirement of next-generation communications.

Objectives: To reassess the risk of leukaemia associated with residential exposure near high voltage transmission electric lines of 49 kV and above in view of the recent publications.Methods: Through a review of papers considering the risk of leukaemia among people living near high voltage transmission lines, the combined risks of leukaemia were calculated for distances < or = 50 m and < or = 25 m and for exposures at 2 mG, 3 mG, 4 mG, and 10 mG.Results: The combined analysis of the contributive studies indicated an estimate of risk (odds ratio (OR)) for exposure > or = 2 mG of 1.3, 95% confidence interval (95%CI) 1.0 to 1.7. The ORs increased with exposures at 3 mG, 4 mG, and 10 mG. The risks were also increased for distances of 50 and 25 m from the lines.Conclusions: This meta-analysis tends to confirm the presence of an association between exposure to magnetic fields and leukaemia among people who reside in the vicinity of high voltage transmission electric lines of > or = 49 kV. There is consistency across studies. Measures of exposure used in the studies were either distance from the lines or calculated fields estimated from pertinent line features. The results apply to adults as well as to children. [ABSTRACT FROM AUTHOR]

OBJECTIVE--We prospectively assessed the age- and sex-specific incidence and relative risk of malignant neoplasm of the pancreas in Taiwan's diabetic population. RESEARCH DESIGN AND METHODS--A total of 615,532 diabetic patients and 614,871 age- and sex-matched control subjects were linked to inpatient claims (2000-2006) to identify the admissions for malignant neoplasm of the pancreas (ICD-9: 157). The Cox proportional hazards regression model was used to estimate the age- and sex-specific relative risk of pancreatic neoplasm. RESULTS--Compared with the control group, the diabetic patients had a significantly increased risk of pancreatic cancer (hazard ratio [HR] 1.54 [95% CI 1.39-1.71]). The higher and significant age-specific HRs were observed in diabetic men (1.91) and women (1.80) aged 45-65 years. CONCLUSIONS--Middle-aged diabetic men and women were associated with the most increased risk of malignant neoplasm of the pancreas. [ABSTRACT FROM AUTHOR]

Abstract Few studies included objective blood pressure (BP) to construct the predictive model of severe obstructive sleep apnea (OSA). This study used binary logistic regression model (BLRM) and the decision tree method (DTM) to constructed the predictive models for identifying severe OSA, and to compare the prediction capability between the two methods. Totally 499 adult patients with severe OSA and 1421 non‐severe OSA controls examined at the Sleep Medicine Center of a tertiary hospital in southern Taiwan between October 2016 and April 2019 were enrolled. OSA was diagnosed through polysomnography. Data on BP, demographic characteristics, anthropometric measurements, comorbidity histories, and sleep questionnaires were collected. BLRM and DTM were separately applied to identify predictors of severe OSA. The performance of risk scores was assessed by area under the receiver operating characteristic curves (AUCs). In BLRM, body mass index (BMI) ≥27 kg/m2, and Snore Outcomes Survey score ≤55 were significant predictors of severe OSA (AUC 0.623). In DTM, mean SpO2

Abstract A two-way fifth-generation (5G) new radio (NR) free-space optical (FSO)-hollow-core fibre (HCF)-underwater wireless optical communication (UWOC) converged systems with a red/green/blue (R/G/B) 3-wavelengths and spatial light modulator (SLM)-based beam-tracking scheme is practically built. It is the first to practically build a two-way FSO-HCF-UWOC converged system with high-speed and long-distance optical wireless-wired-underwater wireless communication characteristics. It shows a 5G NR FSO-HCF-UWOC convergence from drone or buildings to undersea, using R/G/B 3-wavelengths and an SLM as a demonstration. The R/G/B 3-wavelengths are used to enhance the downstream and upstream aggregate transmission rates. An SLM with electrical comparator is used to adjust the laser beam and mitigate laser beam misalignment caused by drone movement or ocean flow. Over a hybrid of 1-km FSO, 10-m HCF, and 10.44-m ocean water-air-ocean water medium, downstream/upstream 5G-millimeter-wave (MMW) 9.1-Gb/s/24-GHz signals are transmitted with satisfactorily low bit error rates and error vector magnitudes, as well as distinct constellations. This demonstrated that the 5G NR FSO-HCF-UWOC converged system exhibits promising potential as it advances the scenario implemented by the 5G-MMW signals over FSO, HCF, and UWOC convergence, paving the way for high-speed and long-distance communications across diverse media.

Objective: Whether pregnancy is associated with severe injuries from motor vehicle crashes (MVCs) remains unclear. This study aimed to investigate the potential relationship between pregnancy and severity of injuries from MVCs. Methods: We identified a total of 23,559 pregnant women victims who encountered MVCs during pregnancy as well as 94,236 age- and calendar year-at MVC matched non-pregnant women victims that are also involved in MVCs. Injury severity was assessed using the Maximum Abbreviated Injury Scale (MAIS) based on the diagnosis of medical claims after MVCs. Multinomial logistic regression models were used to estimate the odds ratio and corresponding 95 % CI of injury severity levels associated with pregnancy. Results: Pregnant women had a significantly higher risk of both severe (adjusted odds ratio, aOR = 1.79, 95 % CI = 1.54–2.08) and mild injuries (aOR = 8.63, 95 % CI = 8.21–9.07) following MVCs as compared to non-pregnant women victims. Particularly, pregnant women who were riding scooters had an increased risk of severe injury (aOR = 4.25, 95 % CI = 3.58–5.04). In addition, pregnant women who experienced MVC but without any injury were more likely to visit a clinic than non-pregnant MVC victims. Conclusion: Pregnant women victims, particularly those who were riding scooters involved in MVCs suffered from a higher risk of severe injury as compared to their non-pregnant counterparts. Our findings suggest that women should consider avoiding riding a scooter and must use restrictive devices during pregnancy, which would help reduce the severity of injuries sustained following an MVC.

Background/purpose: The optimal timing of vascular access (VA) creation for hemodialysis (HD) and whether this timing affects mortality and health-care utilization after HD initiation remain unclear. Thus, we conducted a population-based study to explore their association. Methods: We used Taiwan's National Health Insurance Research Database to analyze health-care outcomes and utilization in a cohort initiating HD during 2003–2013. We stratified patients by the following VA creation time points: >180, 91–180, 31–90, and ≤30 days before and ≤30 days after HD initiation and examined all-cause mortality, ambulatory care utilization/costs, hospital admission/costs, and total expenditure within 2 years after HD. Cox regression, Poisson regression, and general linear regression were used to analyze mortality, health-care utilization, and costs respectively. Results: We identified 77,205 patients who started HD during 2003–2013. Compared with the patients undergoing VA surgery >180 days before HD initiation, those undergoing VA surgery ≤30 days before HD initiation had the highest mortality—15.92 deaths per 100-person-years, crude hazard ratio (HR) 1.56, and adjusted HR 1.28, the highest hospital admissions rates— 2.72 admission per person-year, crude rate ratio (RR) 1.48 and adjusted RR 1.32, and thus the highest health-care costs— US$31,390 per person-year, 7% increase of costs and 6% increase with adjustment within the 2-year follow-up after HD initiation. Conclusion: Late VA creation for HD can increase all-cause mortality, hospitalization, and health-care costs within 2 years after HD initiation. Early preparation of VA has the potential to reduce post-HD mortality and healthcare expenses for the ESKD patients.

Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV2, first detected in China in 2019. This disease causes respiratory infections and significantly impacts global health. Purpose: This study aims to analyze the risk factors for mortality in COVID-19 patients at Universitas Airlangga Hospital in 2021. Methods: This observational analytical study uses a case-control design, including 168 samples with 64 cases and 64 controls. Secondary data from patient medical records at Universitas Airlangga Hospital, including age, gender, education, comorbidities, oxygen saturation, and length of stay. Chi-square tests analyzed the data with a 95% confidence level (a=5%). Results: The analysis revealed significant associations between COVID-19 mortality and several factors. Age (p=0.01; OR=3.24; 95%CI=1.57-6.65), gender (p=0.01; OR=2.2; 95%CI=1.17-4.02), education (p=0.00; OR=2.40; 95%CI=1.11-5.40), comorbidities (p=0.08; OR=2.50; 95%CI=1.26-4.91), and oxygen saturation (p=0.00; OR=5.40; 95%CI=117.10-2490.06) were significantly associated with COVID-19 mortality. Oxygen saturation was the most influential factor (p=0.00; OR=901.73; 95%CI=120.75-6733.48) associated with mortality. Conclusion: Age, gender, education, comorbidities, and oxygen saturation significantly affect COVID-19 mortality rates. This study highlights the importance of monitoring and managing these risk factors in managing COVID-19 at Universitas Airlangga Hospital. [ABSTRACT FROM AUTHOR]

Aging increases vulnerability to diseases, necessitating comprehensive strategies promoting healthy lifestyles. Posbindu PTM (Integrated Guidance Post for NCDs) is Indonesia’s community-based program which was aimed to mitigate the impact of NCDs through monitoring risk factors and empowering individuals for early intervention and lifestyle changes. This study examined the correlations between smoking status, and implementation of Posbindu PTM among Indonesia’s elderly population with morbidity rates. Data from 34 provinces were analyzed using Spearman’s correlation test (α=5%) to examine relationships between morbidity rates (dependent variable) from the 2022 Elderly Population Statistics data, smoking status (active smokers, ex-smokers, non-smokers), and the percentage of Posbindu PTM implementation (independent variables) from the data of the 2021 Indonesia Health Profile. Active smokers (p=0.007, r=0.455) and ex-smokers (p=0.003, r=0.497) showed positive correlations with morbidity, while non-smokers (p=0.002, r=-0.506) exhibited a negative correlation. Posbindu PTM implementation (66.4% average in 2021) was not significantly correlated with morbidity (p=0.367). High smoking rates among Indonesia’s elderly affect morbidity levels. Posbindu PTM, as an early detention and health promotion program, has not been well-implemented nationwide. Efforts and government commitment to prioritize health promotion and prevention at the grassroots level are essential for achieving a prosperous and effective aging society. [ABSTRACT FROM AUTHOR]

PURPOSE We undertook a study to investigate the relationship between duration of medication use and prevalence of impaired awareness of hypoglycemia (IAH) among patients with insulin-treated or sulfonylurea-treated type 2 diabetes in Taiwan. METHODS A total of 898 patients (41.0% insulin users, 65.1% sulfonylurea users; mean [SD] age = 59.9 [12.3] years, 50.7% female) were enrolled in pharmacies, clinics, and health bureaus of Tainan City, Taiwan. Presence of IAH was determined with Chinese versions of the Gold questionnaire (Gold-TW) and Clarke questionnaire (Clarke-TW). Sociodemographics, disease and treatment histories, diabetes-related medical care, and health status were collected. We used multiple logistic regression models to assess the relationship between duration of medication use and IAH. RESULTS Overall IAH prevalence was 41.0% (Gold-TW) and 28.2% (Clarke-TW) among insulin users, and 65.3% (Gold-TW) and 51.3% (Clarke-TW) among sulfonylurea users. Prevalence increased with the duration of sulfonylurea use, whereas it decreased with the duration of insulin use. After controlling for potential confounders, 5 or more years of sulfonylurea use was significantly associated with 3.50-fold (95% CI, 2.39-5.13) and 3.06-fold (95% CI, 2.11-4.44) increases in the odds of IAH based on the Gold-TW and Clarke-TW criteria, respectively. On the other hand, regular blood glucose testing and retinal examinations were associated with reduced odds in both insulin users and sulfonylurea users. CONCLUSIONS The prevalence of IAH was high among patients using sulfonylureas long term, but the odds of this complication were attenuated for those who received regular diabetes-related medical care. Our study suggests that long-term sulfonylurea use and irregular follow-up increase risk for IAH. Further prospective studies are needed to confirm the observed associations. [ABSTRACT FROM AUTHOR]

ABSTRACTColorectal cancer (CRC) long-term survivor is a rapid enlarging group. However, the effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPSV23) on this group is unknown. This nationwide population-based study in Taiwan was designed to examine the effect of PPSV23 on incidence rate ratio (IRR) of pneumonia hospitalization, cumulative incidence, and overall survival rate for these long-term CRC survivors. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2000–2017. After individual exact matching to covariates with 1:1 ratio, there were a total of 1,355 vaccinated and 1,355 unvaccinated survivors. After adjusted by multivariate Poisson regression model, vaccinated group had a non-significantly lower pneumonia hospitalization risk than unvaccinated, with an adjusted IRR of 0.879 (p = .391). Besides, vaccinated group had both lower cumulative incidence rate and higher overall survival time than unvaccinated.

Objectives: The World Health Organization’s Integrated Care for Older People (ICOPE) framework launched in 2019 is used to assess the intrinsic capacity of older individuals. Older women may face greater socioeconomic disadvantages, which can impact their physical and mental well-being. Therefore, we examined sex differences in intrinsic capacity and the influence of socioeconomic status. Methods: We conducted a cross-sectional study in Tainan, Taiwan, recruiting 1,268 adults aged 60 or older in 2022. The ICOPE screening assessed cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms. Intrinsic capacity scores ranged from 0 to 6 and were categorized as impairment (1 or higher) or no impairment (0). Binary logistic regression models were used to analyze sex differences in intrinsic capacity, adjusting sequentially for demographics, lifestyle, and socioeconomic factors. Results: The prevalence of intrinsic capacity impairment was 34 %. Women had significantly higher odds of intrinsic capacity impairment (women vs. men, odds ratio [OR] = 1.39, 95 % CI = 1.10–1.75). After sequentially adjusting for demographic characteristics, lifestyle, and socioeconomic factors, the ORs were 1.46 (95 % CI = 1.12–1.90), 1.69 (95 % CI = 1.23–2.31), and 1.24 (95 % CI = 0.88–1.73), respectively. Stratified analyses showed that higher odds of impairment in women than in men was evident only in the financially dependent group (P for interaction = 0.059). Conclusions: Older women in Taiwan have poorer intrinsic capacity than men, a disparity largely attributable to women’s lower socioeconomic status. Strategies to promote healthy aging among women from disadvantaged socioeconomic backgrounds may help mitigate this sex difference in intrinsic capacity.

Abstract Compared with previous generations, fifth-generation communications can provide faster download and upload speeds and support a greater number of connected devices. Integrating fifth-generation signals with optical wireless communication systems provides promising ways to afford higher transmission rates and faster wireless connectivity. Here we report a fifth-generation wavelength-division-multiplexing-based bidirectional optical wireless communication system with signal remodulation employing cascaded reflective semiconductor optical amplifiers to effectively remove the downstream data for uplink transmission. It shows a fifth-generation wavelength-division-multiplexing-based bidirectional optical wireless communication system using four wavelengths for communication. The uplink performance is substantially enhanced by using two reflective semiconductor optical amplifiers to remove the downstream data. The system achieves an aggregate transmission rate of 36.4 Gbit/s for both downlink and uplink transmissions over a 100-m optical wireless link. This demonstrated fifth-generation wavelength-division-multiplexing-based bidirectional optical wireless communication system employing cascaded reflective semiconductor optical amplifiers holds great potential for enhancing fifth-generation advanced communication capabilities.

Abstract Background The World Health Organization (WHO) proposed the concept of intrinsic capacity (comprising composite physical and mental capacity) which aligns with their concepts of healthy aging and functional ability. Consequently, the WHO promotes the Integrated Care for Older People (ICOPE) framework as guidance for geriatric care. Consequently, each government should have a screening tool corresponding to ICOPE framework to promote geriatric care. The present study examined the initial psychometric properties of the Taiwan version of ICOPE (i.e., ICOPES-TW). Methods Older people (n = 1235; mean age = 72.63 years; 634 females [51.3%]) were approached by well-trained interviewers for participation. A number of measures were administered including the ICOPES-TW, WHOQOL-AGE (assessing quality of life [QoL]), Clinical Frailty Scale (assessing frailty), Barthel Index (assessing basic activity of daily living [BADL]), and Lawton Instrumental Activities of Daily Living Scale (assessing instrumental activity of daily living [IADL]). Results The ICOPES-TW had a two-factor structure (body functionality [eigenvalue = 1.932] and life adaptation [eigenvalue = 1.170]) as indicated by the results of exploratory factor analysis. Internal consistency of the ICOPES-TW was low (Cronbach’s α = 0.55 [entire ICOPES-TW], 0.45 (body functionality factor), and 0.52 (life adaptation factor). ICOPES-TW scores were significantly (i) positively correlated with age (r = 0.321), IADL (r = 0.313), and frailty (r = 0.601), and (ii) negatively correlated with QoL (r=–0.447), and BADL (r=–0.447), with all p-values

Background: Administering premixed drugs in commodity packets was first reported in Asia in 2015, but there continues to be a dearth of related population-based data. This study aimed at examining (1) the prevalence of drug-packet use in the population and (2) the sociodemographic profiles, particularly gender distribution, of drug-packet users. Methods: Data were derived from a survey of 18,626 Taiwanese civilians, aged 12–64 years, using stratified, multi-stage, random sampling in 2018. Participants anonymously completed a computer-assisted self-interview on tablet computers which covered the use and problematic use of illicit drugs/inhalants, prescription drugs, and other psychoactive substances. Results: Approximately 1.46% of respondents had a lifetime use of illicit drugs, with drugs in commodity packets (0.18%) being ranked the fifth-most commonly used illicit drugs, higher than nitrous oxide (0.14%) and heroin (0.09%). Ten formats of drug packets were endorsed by users. Approximately 81.6% of persons with drug packet use had lifetime use of other illicit drugs. The correlates of the use of drugs in commodity packets were different from those of the exclusive use of other drugs, particularly concerning the lack of gender differences in the former category in the whole sample and the subgroups of various sociodemographic characteristics and other substance use. Conclusion: Drugs in commodity packets have become a common way of administering illicit drugs in the population in Taiwan, and there were no gender differences among users. Our findings have implications for more efficient drug testing and culturally appropriate intervention for drug-packet use.

Objectives: Medication non-adherence among older adults with non-communicable diseases (NCDs) remains prevalent worldwide, which causes hospitalization and mortality. Our study aimed to examine the association of medication non-adherence with level of overall intrinsic capacity (IC), pattern of IC, and specific IC component among older adults with NCDs. Methods: A cross-sectional questionnaire-based survey of 1268 older adults aged 60 years and above was conducted in 2022 in southern Taiwan. Among them, 894 suffered from 1 more NCD were included in this study. The Integrated Care for Older People Screening Tool for Taiwanese and the Adherence to Refills and Medication Scale were used to assess IC and medication non-adherence, respectively. Latent class analysis (LCA) was used to identify patterns of IC impairment, and binary logistic regression was used to assess the association between medication non-adherence and IC. Results: Older adults in the moderate (score: 1–2) or low (score≧3) overall IC groups were more likely to experience medication non-adherence (moderate: adjusted odds ratio (aOR) 1.57 [95% CI: 1.05–2.36]; low: 2.26 [1.40–3.67]). The “physical and nutritional impairments accompanied by depressive symptoms” group was associated with statistically higher odds of medication non-adherence (aOR 1.66 [1.01–2.73]). Older adults with cognitive impairment, hearing loss, or depressive symptoms showed greater likelihood of medication non-adherence (cognitive impairment: aOR 1.53 [1.03–2.27]; hearing loss: aOR 1.57 [1.03–2.37]; depressive symptoms: aOR 1.81 [1.17–2.80]). Conclusions: Intervention for improving medication non-adherence among older adults with NCDs should consider IC.

Background: Long COVID, an emerging public health issue, is characterized by persistent symptoms following SARS-CoV-2 infection. This study aims to explore the relationship between post-COVID-19 symptomatology and patient distress employing Latent Class Analysis to uncover symptom co-occurrence patterns and their association with distress. Methods: A cross-sectional study was conducted using an online survey among 240 participants from a university and affiliated hospital of southern Taiwan. The survey quantified distress due to persistent symptoms and assessed the prevalence of Long COVID, symptom co-occurrence, and latent symptom classes. Latent Class Analysis (LCA) identified distinct symptom patterns, and multiple regression models evaluated associations between symptom patterns, distress, and demographic factors. Results: The study found that 80 % of participants experienced Long COVID, with symptoms persisting for over three months. Individuals with multiple COVID-19 infections showed a significant increase in general (β = 1.79), cardiovascular (β = 0.61), and neuropsychological symptoms (β = 2.18), and higher total distress scores (β = 6.35). Three distinct symptomatology classes were identified: ''Diverse'', ''Mild'', and ''Severe'' symptomatology. The ''Mild Symptomatology'' class was associated with lower distress (−10.61), while the ''Severe Symptomatology'' class showed a significantly higher distress due to symptoms (13.32). Conclusion: The study highlights the significant impact of Long COVID on individuals, with distinct patterns of symptomatology and associated distress. It emphasizes the cumulative effect of multiple COVID-19 infections on symptom severity and the importance of tailored care strategies.

Two-way wireless-over-fiber and free-space optical (FSO)-over-fiber communication systems, with an optical carrier transmission for a hybrid 10 Gbps baseband data stream, are proposed and practically demonstrated. 10 Gbps/50 GHz and 10 Gbps/100 GHz millimeter-wave data signal transmissions are also proposed and practically demonstrated. An optical carrier with a 10 Gbps baseband data stream is delivered via a 50 km single-mode fiber transportation to effectively lower dispersion-induced limitation due to fiber links and distortion produced by beating among multiple optical sidebands. To our understanding, this experiment is foremost in employing an optical carrier transmission approach to a two-way wireless-over-fiber and FSO-over-fiber communication system to suppress fiber dispersion and distortion effectively. Bit error rate performs well for downlink and uplink deliveries via a 50 km single-mode fiber transportation with a 100 m FSO link/5 m RF wireless delivery. The offered two-way wireless-over-fiber and FSO-over-fiber communication system with an optical carrier transmission is a promising option. It should be interesting for signifying the progress in the integration of long-haul fiber-based trunks and short-range RF/optical wireless link-based branches. [ABSTRACT FROM AUTHOR]

A bidirectional fiber-free-space optical (FSO)/wireless convergent system that uses dual-polarization and one optical sideband transmission schemes for hybrid vestigial sideband (VSB)–four-level pulse amplitude modulation (PAM4)/millimeter-wave signal transmission is proposed and demonstrated. Using a dual-polarization scheme, one optical sideband that is modulated by a 56 Gb s−1 VSB–PAM4 signal (x-polarization) and another optical sideband that is modulated by a 10 Gbps data stream (y-polarization) are separated and polarized orthogonally. One optical sideband modulated by a 10 Gbps data stream (y-polarization) is delivered to efficaciously suppress the dispersion-induced limitation due to a span of 40 km single-mode fiber (SMF) and the distortion due to the beating among multiple sidebands. The proposed bidirectional fiber-FSO/wireless convergent system is a prominent one for providing broadband integrated services, such as the Internet, telecommunication, and 5G mobile networks. [ABSTRACT FROM AUTHOR]

This study proves that an underwater wireless optical communication (UWOC) based on a 6 m/5.2 Gbps 68 nm vertical-cavity surface-emitting laser (VCSEL)-based system is superior to a 405 nm UWOC system. This UWOC application is the first to use a VCSEL at approximately 680 nm. The experiment also proved that a 680 nm VCSEL has the same transmission distance as that of an approximately 405 nm laser diode. The 680 nm VCSEL has a 5.2 Gbps high transmission rate and can transmit up to 6 m. Thus, the setup is the best alternative solution for high-speed UWOC applications. [ABSTRACT FROM AUTHOR]

Abstract Importance Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity. Compared with disease burden rates in 1990, significant reductions in Disability-Adjusted Life Years (DALYs) burden rates for CVD have been recorded. However, general DALYs rates have not changed in Indonesia in the past 30 years. Thus, assessing Indonesian CVD burdens will be an essential first step in determining primary disease interventions. Objective To determine the national and province-level burden of CVD from 1990 to 2019 in Indonesia. Design, Setting, and Participants A retrospective observational study was conducted using data from the Global Burden of Disease (GBD) 2019, provided by the Institute of Health Metrics and Evaluation (IHME), to analyze trends in the burden of CVD, including mortality, morbidity, and prevalence characteristics of 12 underlying CVDs. Exposures Residence in Indonesia. Main Outcomes and Measures Mortality, incidence, prevalence, death, and DALYs of CVD. Results All-age CVD deaths more than doubled from 292 thousand (95% UI: 246 to 339 thousand) in 1990 and increased to 659 thousand (95% UI: 542 to 747 thousand) in 2019. All CVDs recorded increased death rates, except for rheumatic heart disease (RHD) (− 69%) and congenital heart disease (CHD) (− 37%). Based on underlying diseases, stroke and ischemic heart disease (IHD) are still the leading causes of mortality and morbidity in Indonesia, whereas stroke and peripheral artery disease (PAD) are the most prevalent CVDs. Indonesia has the second worst CVD DALYs rates compared to ASEAN countries after Laos. At provincial levels, the highest CVD DALY rates were recorded in Bangka Belitung, South Kalimantan, and Yogyakarta. In terms of DALYs rate changes, they were recorded in West Nusa Tenggara (24%), South Kalimantan (18%), and Central Java (11%). Regarding sex, only RHD, and PAD burdens were dominated by females. Conclusions CVD mortality, morbidity, and prevalence rates increased in Indonesia from 1990 to 2019, especially for stroke and ischemic heart disease. The burden is exceptionally high, even when compared to other Southeast Asian countries and the global downward trend. GBD has many limitations. However, these data could provide policymakers with a broad view of CVD conditions in Indonesia.

Tunable optical band-pass filter (TOBPF) composed of a vertical-cavity surface-emitting laser (VCSEL) is proposed for multi-wavelength optical fiber transport systems. Experimental results prove that through properly adjusting VCSEL driving current, one of multiple injected lightwaves can properly flow through the proposed optical filter and others will be attenuated roughly 12 dB. Furthermore, by changing the VCSEL driving current, the pass-band window of the VCSEL-based TOBPF can be shifted to align with different designated injected lightwave and to block the others. By employing the TOBPF in multi-wavelength optical fiber transport systems, proper eye diagrams are experimentally observed for each dedicated optical signal. The proposed scheme is shown to be a practical and flexible component for multi-wavelength optical fiber transport systems. [ABSTRACT FROM AUTHOR]

Abstract Background Understanding demographic profiles is essential to the assessment of health burden imposed by motor vehicle crashes (MVCs) on pregnant women. However, Asian studies that have examined it are lacking. The study aimed to describe the demographic characteristics and prevalence of MVCs involving pregnant women in Taiwan. Methods A cross-sectional study conducted by the Taiwan Birth Notification dataset from 2008 to 2017 was linked with the police-reported traffic collision registry to identify pregnant women involved in MVCs. The pregnant women were categorized according to their gestational age, age at delivery, the role of road user (driver, passenger, or pedestrian), and vehicle types (car, two-wheeled motor vehicle, or others). A chi-square test was performed for the significance test. Results A total of 22,134 (1.13%) pregnant women were involved in MVCs in the study period. Two-wheeled motor vehicle (47.9%) and driver (81.4%) were the mainly reported vehicle type and road user at the crash scenes, respectively. The majority of MVCs occurred in pregnant women aged 28–34 years. The number of MVCs rapidly declined after 37 weeks of gestation, especially two-wheeled motor vehicle or car crashes. However, the number of pedestrian victims climbed up during the third trimester. Conclusion Pregnant women are susceptible to MVCs regardless of their gestational age, role of a road user, or type of vehicle. The findings of this study emphasize the need for increased awareness of traffic collision prevention among pregnant women aged 28–34. In addition, improving pedestrian safety is essential for the reduction of pregnant victims.

Abstract Fifth-generation (5G) communication provides a substantial increase in data transmission capacity because of more available bandwidth and advanced communication techniques. It opens the door to a range of new applications, such as 4K/8K video streaming, Internet of Things, autonomous vehicles, unmanned aerial vehicles, and more. However, atmospheric attenuation poses a technical challenge for 5G communication, especially at higher frequencies. Free-space optics (FSO)-based interface between fibre and 5G communication integrates fibre optics, FSO and 5G communications, achieving high-speed and long-distance transmission and providing an alternative for 5G signal transport. Here we report a two-way fibre-FSO-5G wireless communication employing polarisation-orthogonal modulation. After 25-km single-mode fibre, 1-km FSO, and 20-m (millimetre-wave)/10-m (sub-6 GHz) radio-frequency wireless transport, satisfactorily low bit error rates and error vector magnitudes are acquired, meeting the demands of 5G emerging applications.