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Previous studies have reported that sleep duration may increase the risk of hypertension and hyperuricemia. However, the results are contradictory. We investigated whether sleep duration was independently associated with hypertension and hyperuricemia. We aimed to assess the association between sleep duration, hypertension, and hyperuricemia in a population-based cross-sectional study. MJ Health Examination Center Database was used to obtain a large, representative sample of Taiwan population. This study revealed that short sleep duration is associated with an increased risk of hyperuricemia and hypertension. Patients who sleep ≤ 4 hours have a higher risk of hypertension than those who sleep 7 hours (Male: AOR = 1.131, 95% CI = 1.073-1.192; Female: AOR = 1.257, 95% CI = 1.190 -1.327). The risk of hyperuricemia in patients who sleep ≤ 4 hours is higher than those who sleep 7 hours (Male: AOR = 1.657, 95% CI = 1.213-5.768; Female: AOR = 1.583, 95% CI = 1.050-3.660). Besides, the risk of hyperuricemia in females who slept for more than 8 hours was 1.019 times that of those who slept for 7 hours. Participants aged < 50 years who sleep less than 4 hours a day have a higher risk of hypertension and hyperuricemia than those of the ages of 50-75 and >75 years. There were excellent response rates to sleep duration associated with hypertension and hyperuricemia questions and measurements representative sample of Taiwan population. &nbsp

To master the technology of reprogramming mouse somatic cells to induced pluripotent stem cells (iPSCs), which will lay a good foundation for setting up a technology platform on reprogramming human cancer cells into iPSCs. Mouse iPSCs (i.e., Oct4-GFP miPSCs) was successfully generated from mouse embryonic fibroblasts (MEFs) harboring Oct4-EGFP transgene by introducing four factors, Oct4, Sox2, c-Myc and Klf4, under mESC (Murine embryonic stem cells) culture conditions. Oct4-GFP miPSCs were similar to mESCs in morphology, proliferation, mESC-specific surface antigens and gene expression. Additionally, Oct4-GFP miPSCs could be cultured in suspension to form embryoid bodies (EBs) and differentiate into cell types of the three germ layers

Office workers often work overtime, stay up late, lack of sleep, and have poor sleep quality, resulting in a high liver index. Abnormal liver function is the main risk factor for modern social civilization diseases and chronic diseases. The purpose of this study was to explore the relationship between sleep time, sleep quality, and liver function, and analyze the collected data from the Taiwan MJ Health Examination Center from 2001 to 2010. This study mainly found that participants with extremely poor sleep had 1.128 times the chance of developing abnormal liver function compared with participants with good sleep. At the same time, it was found that the average daily sleep time of fewer than 4 hours, compared with people who sleep for 7-8 hours, the probability of abnormal liver function is 1.206 times. Therefore, good sleep quality and proper sleep time will reduce the occurrence of abnormal liver function.

Botulinum toxin is produced by Clostridium botulinum, a gram-positive anaerobic bacterium. This study aimed to examine the epidemiological characteristics, including sex, age, season in which infection occurred, place of residence, and epidemiological trends, of confirmed botulism cases in Taiwan from 2003 to 2020. This study examined the annual summary data on reported botulism in Taiwan' s Center for Disease Control from 2003 to 2020 available to the public on the internet. We found that there were 50 confirmed domestic cases of botulism. The incidence of botulism ranged from 0 to 0.48 per 1000,000 from 2003 to 2020 and peaked in 2008 and 2010. During the 18-year investigation period in which 6-year intervals were used, the study results showed a decreasing trend (2003-2008, 2009-14, and 2015-2020, had 22, 19, 9 cases each). In terms of patients' gender, age, and place of residence, most of the patients were females (56%), were aged ≥ 50 years (48%), and resided in Taipei and northern Taiwan (44%). The number of botulism cases in Taiwan from 2012 to 2020 compared with other years (from 2003 to 2011) found that there were significant differences among patients within an age group of20 years (P = .003, odds ratio = 18.500, and 95% confidence interval = 3.287-104.111), and there were significant differences among patients whose place of residence was Taipei metropolitan area (P = .025, odds ratio = 5.667, and 95% confidence interval = 1.248-25.734). During 2003 to 2009, there was no case of botulism among those aged20 years. Over the last 10 years, botulism in children showed an increasing trend. A total of 9 children were found to have botulism during 2010 to 2020; most of these children were male (66.7%) and were infected during spring and summer (66.7%). This study is the first to report the number of confirmed domestic cases with botulism from surveillance data from Taiwan's Center for Disease Control during 2003 to 2020. This study also found that the place of residence and age were associated with an increased risk of botulism in Taiwan. This information may be useful for policymakers and clinical experts to direct prevention- and control-based activities regarding botulism that result in the most severe illness and the greatest burden on Taiwanese.

To investigate whether previous exposure to obstructive sleep apnea (OSA) increases the risk of obesity in obese and nonobese patients. We identified 24,363 obese patients diagnosed between January 1, 2000, and December 31, 2015, in the Taiwan Longitudinal Health Insurance Database (LHID) 2005 National Health Insurance Research Database; 97,452 sex-, age- and index date-matched nonobese patients were identified from the same database. This study is based on the ninth edition of the International Classification of Sleep Disorders. Multiple logistic regression was used to analyze the previous exposure of obese patients to OSA. P .05 was considered significant. The average age of 121,815 patients was 44.30 ± 15.64 years old; 42.77% were males, and 57.23% were females. Obese patients were more likely to be exposed to OSA than nonobese patients (adjusted odds ratio [AOR] = 2.927, 95% CI = 1.878-4.194, P .001), and the more recent the exposure period was, the more severely obese the patient, with a dose-response effect (OSA exposure 1 year, AOR = 3.895; OSA exposure 1 year,5 years, AOR = 2.933; OSA exposure 5 years, AOR = 2.486). The probability of OSA exposure in obese patients was 2.927 times that in nonobese patients, and the longer the exposure duration was, the more severe the obesity situation, with a dose-response effect (OSA exposure 1 year, AOR = 2.251; OSA exposure 1 year,5 years, AOR = 2.986; OSA exposure 5 years, AOR = 3.452). The risk of obesity in subjects with OSA was found to be significantly higher in this nested case-control study; in particular, a longer exposure to OSA was associated with a higher likelihood of obesity, with a dose-response effect.

Esophageal squamous cell carcinoma (ESCC) is a highly malignant gastrointestinal cancer with a high recurrence rate and poor prognosis. Although N6-methyladenosine (m6A), the most abundant epitranscriptomic modification of mRNAs, has been implicated in several cancers, little is known about its participation in ESCC progression. We found reduced expression of ALKBH5, an m6A demethylase, in ESCC tissue specimens with a more pronounced effect in T3-T4, N1-N3, clinical stages III-IV, and histological grade III tumors, suggesting its involvement in advanced stages of ESCC. Exogenous expression of ALKBH5 inhibited the in vitro proliferation of ESCC cells, whereas depletion of endogenous ALKBH5 markedly enhanced ESCC cell proliferation in vitro. This suggests ALKBH5 exerts anti-proliferative effects on ESCC growth. Furthermore, ALKBH5 overexpression suppressed tumor growth of Eca-109 cells in nude mice; conversely, depletion of endogenous ALKBH5 accelerated tumor growth of TE-13 cells in vivo. The growth-inhibitory effects of ALKBH5 overexpression are partly attributed to a G1-phase arrest. In addition, ALKBH5 overexpression reduced the in vitro migration and invasion of ESCC cells. Altogether, our findings demonstrate that the loss of ALKBH5 expression contributes to ESCC malignancy.

Objective: to investigate whether persistent depressive disorder (PDD) affects sleep disorders (SDs) and increased suicide risk. Methods: in this study, we used the National Health Insurance Research Database (NHIRD) to select 117,033 SD patients, of whom 137 died by suicide, and 468,132 non-SD patients, of whom 118 died by suicide, and analyzed gender, age, and co-existing diseases. Hazard ratios (HRs) and 95% confidence intervals (CI) were calculated using a multivariate Cox proportional hazards model. Results: the hazard ratio of suicide in SD patients was 1.429 times that of non-SD patients. The hazard ratio of suicide in female patients was 1.297 times higher than in males. Compared with people without PDD, people with PDD had a 7.195 times higher hazard ratio for suicide than those without PDD. PDD patients with SDs had a 2.05 times higher hazard ratio for suicide than those with no SDs. Conclusions: suicide risk was increased in SD patients, and the maximum suicide risk was greater in SD patients with PDD than in non-PDD patients. PDD affected SDs and increased suicide risk. Clinicians should be aware of the possibility that PDD affects patients with SDs and contributes to suicide risk.

Yao-Ching Huang,1 Wu-Chien Chien,2– 5,* Chi-Hsiang Chung,2– 4 Hsin-An Chang,6,7 Yu-Chen Kao,6,8 Fang-Jung Wan,6 Shi-Hao Huang,1 Ren-Jei Chung,1,* Richard S Wang,9 Bing-Long Wang,2,* Nian-Sheng Tzeng,7,8,* Chien-An Sun10,11 1Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan; 2School of Public Health, National Defense Medical Center, Taipei, Taiwan; 3Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 4Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan; 5Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; 6Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; 7Student Counseling Center, National Defense Medical Center, Taipei, Taiwan; 8Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan; 9Program of Data Analytic and Business Computing, Stern School of Business, New York University, USA; 10Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan; 11Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan*These authors contributed equally to this workCorrespondence: Nian-Sheng TzengDepartment of Psychiatry, School of Medicine, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Gung Road, Nei-Hu District, Taipei, Taiwan, Republic of ChinaTel +886-2-87923311 Ext 17484Fax +886-2-87927221Email pierrens@mail.ndmctsgh.edu.twBing-Long WangDepartment of Public Health, National Defense Medical Center, 116, Section 6, Minchuan E. Road, Nei-Hu District, Taipei, Taiwan, Republic of ChinaTel +886-980-794951Email billwang1203@gmail.comBackground: Multiple sclerosis (MS) is a demyelinating disease that can damage neurons in the brain and spinal cord and is associated with several psychiatric disorders. However, few studies have evaluated the risk of psychiatric disorders in patients with MS by using a nationwide database. This study investigated the association between MS and the risk of psychiatric disorders.Methods: Using data from the Taiwan National Health Insurance Research Database from 2000 to 2015, we identified 1066 patients with MS. After adjustment for confounding factors, Fine and Gray’s competing risk model was used to compare the risk of psychiatric disorders during 15 years of follow-up.Results: Of the patients with MS, 531 (4622.86 per 105 person years) developed psychiatric disorders; by contrast, 891 of the 3198 controls (2485.31 per 105 person years) developed psychiatric disorders. Fine and Gray’s competing risk model revealed an adjusted hazard ratio (HR) of 5.044 (95% confidence interval = 4.448– 5.870, p < 0.001) after adjustment for all the covariates. MS was associated with depression, anxiety, bipolar disorder, sleep disorders, schizophrenia, schizophreniform disorder, and other psychotic disorders (adjusted HR: 12.464, 4.650, 6.987, 9.103, 2.552, 2.600, 2.441, and 2.574, respectively; all p < 0.001). Some disease-modifying drugs were associated with a lower risk of anxiety or depression.Conclusion: Patients with MS were determined to have a higher risk of developing a wide range of psychiatric disorders.Keywords: multiple sclerosis, psychiatric disorders, depression, anxiety

Background: This research focused on the association between physical activity and fruit-vegetable intake and the risk of depression in middle aged and older Taiwanese adults. Methods: Data were obtained from the 1999 to 2015 datasets of the Taiwan Longitudinal Survey on Aging (TLSA), and 4400 participants were included in 1999 (aged ≥53 years). Descriptive statistics provided all of the basic characteristic variables. A chi-square test analyzed the association between sex, age, years of education, marriage, hypertension, drinking, smoking, and the incidence of depression. Logistic regression analysis was used to determine significant associations between physical activity and fruit-vegetable intake, and the presence or absence of depression after 16 years. Results: Combined high physical activity and fruit-vegetable intake reduced the risk of depression by 80% (OR = 0.20, 95% CI = 0.10–0.45, p = 0.001) compared to low physical activity and fruit-vegetable intake; high physical activity and moderate or low fruit-vegetable intake caused a 70% reduction (OR = 0.30, 95% CI = 0.15–0.63, p = 0.005). High fruit-vegetable intake and low physical activity caused a 65% reduction (OR = 0.35, 95% CI = 0.15–0.63, p = 0.005), compared to low physical activity and low fruit-vegetable intake. High physical activity alone caused a 40% reduction, which is the same as by high fruit-vegetable intake alone. Conclusions: Fruit-vegetable intake combined with physical activity was negatively correlated with the risk of depression. More fruit-vegetable intake and physical activity might reduce this risk. The results highlight the importance of physical activity and fruit-vegetable consumption for middle-aged and older adults to prevent depression.

This study explored whether atrial fibrillation (AF)’s influence on short sleep duration (SD) increases the subsequent risk of fatness in management executives. This study included 25,953 healthy individuals working as management executives with ages ranging from 35 to 65 years (19,100 men and 6853 women) who participated in a qualifying physical filter program from 2006 to 2017 in Taiwan. Men and women who slept < 4 h had a 4.35-fold and 5.26-fold higher risk of developing AF than those who slept 7–8 h normally. Men and women who slept < 4 h had a 6.44-fold and 9.62-fold higher risk of fatness than those who slept 7–8 h. Men and women with AF had a 4.52-fold and 6.25-fold higher risk of fatness than those without AF. It showed that AF induced by short SD increases the risk of fatness. A short SD can predict an increased risk of fatness among management executives in Taiwan.

Background: To examine the association of postpartum depression (PPD) with maternal suicide in the Taiwanese population. Methods: We examined the medical records of women aged 18–50 years who experienced childbirth and had PPD (the study cohort, n = 2882), who experienced childbirth but did not have PPD (comparison cohort 1, n = 5764), and who neither experienced childbirth nor had PPD (comparison cohort 2, n = 5764) between 2000 and 2015. The patients were followed up until suicide, withdrawal from the National Health Insurance program, or 31 December 2015. Results: The rates of anxiety and depression symptoms, as well as the cumulative risk of suicide, were significantly higher in the study cohort. PPD was significantly correlated with an increased risk of maternal suicide and was associated with a greater risk of developing comorbidities such as hypertension, diabetes mellitus, hyperlipidemia, and stroke. The comparison cohorts did not differ significantly in terms of suicide risk. Conclusion: PPD was associated with a significantly higher rate of suicide and a shorter time to suicide after childbirth. Younger age, winter, and subclinical depression and anxiety positively predicted suicide in the study cohort. To prevent maternal suicide, clinicians should be observant of subclinical depression and anxiety symptoms among patients.

Objective: To identify the differential patient characteristics, injury types, and treatment outcomes between hospitalized child abuse and non-child abuse injuries in Taiwan. Methods: Using the data from the National Health Insurance Research Database, we selected a total of 1525 patients under the age of 18 that were diagnosed with child abuse, as well as an additional 6100 patients as a comparison group. Chi-square test, Fisher exact test, and independent samples t-test were used to compare the differences between the abused children and the non-abuse-related injured children. The multivariate conditional logistic regression was performed to measure the risk factor of child maltreatment in injured children. Results: Intracranial injury was more frequent in the child abuse group than it was in the non-child abuse group (35.0% vs. 8.2%; p < 0.001). Children in the child abuse group tended to stay longer in the hospital and incur higher medical expenses (8.91 days vs. 4.41 days and USD 2564 vs. USD 880, respectively). In multivariate analysis, the Adjusted Odds Ratio (Adjusted OR) of abuse resulting in an injury for children in low-income families is 1.965 times higher than those in non-low-income families (p < 0.001). Children living in high urbanization areas had a significantly higher probability of being abused than those living in low urbanization areas (p < 0.001). Conclusion: Children under the age of 1 who were hospitalized with severe intracranial injuries are highly at risk for child maltreatment. Moreover, numerous high-risk environmental factors were observed in child abuse cases, including living in urban areas, families with low income, and seasonality, as child maltreatment cases occur more frequently in autumn.

This study aims to understand the trend distribution of violent injuries in Taiwan from 2000 to 2015. It used the data of outpatient, emergency, and hospitalization of 2 million people in the National Health Insurance sample from 2000 to 2015. We analyzed children and adolescents (hereinafter referred to as children, 0–17 years old), adults (18–64 years old), and The Elderly (over 65 years old) who suffered for the first time. The standardized rate of medical treatment for violent injuries was compared annually using the Poisson regression method. A total of 11,077 victims (7163 men, 3914 women) suffered violence during the 15 years, and the standardized rate of medical treatment for violence in adults dropped from 6.01 (1/104) in 2001 to 2.58 (1/104) in 2015. The standardized rate of medical treatment in adults over the years was higher than that in children (2.962001, 1.232015) and The Elderly (3.522001, 1.622015). The medical treatment rate of the adult generation is higher than that of the children and the elderly. The relative hazard ratio (RR) decreased from 2.38 in 2001 to 1.13 in 2014 (but the RR in 2014 was not significant). Furthermore, the rate of adult violence treatment has been decreasing every year, which shows that the government has achieved remarkable results in general violence prevention. With the accelerated aging of Taiwan’s population, it is expected that older adults exposed to the risk of violence will also increase and become more serious. Therefore, the government should continue to pay attention to this issue.

In Taiwan, the national research on homicide is rare, mostly discussing the issue of child abuse. We sought to better understand the characteristics and risk factors of homicide through a retrospective cohort study from 1998 to 2015. “Child battering and other maltreatment” ranked first for the 0–4 age group and second for the 5–14 age group. The hospital mortality was 511 deaths. We found that the 25–44 age group had the highest risk and accounted for 44.76% of hospitalization. The most common causes were “fight, brawl, and rape” (49.12%), “cutting and piercing instruments,” (13.16%) and “child battering and other forms of maltreatment” (4.72%). Additionally, the percentages of “fight, brawl, and rape,” “firearms and explosives,” and “cutting and piercing instruments” were significantly higher among males than among females. The percentages of “hanging and strangulation,” “corrosive or caustic substance,” “child battering and other maltreatment,” “submersion,” and “poisoning” were significantly higher among females than males. Factors associated with homicide in-hospital mortality included gender, age, low income, catastrophic disease, Charlson comorbidity index score, urbanization level, hospital level, classification of hospitalization, and surgery. Overall, the trend of hospitalization rates due to homicide decreased both by gender and age group, except for the 0–4 age group: cause of homicide first, hanging and strangulation second, firearms and explosives third; type of injury, hospitalized patients with “vascular injuries” first, joint and muscle sprain, and intracranial, chest, and abdominal pelvic injuries second, and “burns” third with a higher risk of death. Homicide reduction requires a comprehensive strategy beyond specific victim groups. Interagency collaboration should be strengthened, especially between law enforcement/criminal justice and public health.

Objectives: This study used a case control Study to compare whether obstructive sleep apnea (OSA) or central sleep apnea (CSA) are related with an increased risk of obesity.Materials and Methods: We used 2005 Longitudinal Health Insurance Database (LHID2005), which is part of the Taiwan National Health Insurance Research Database (NHIRD) to identified 24 363 obese patients; 97 452 patients without obesity were identified also, from the same database from January 1, 2000, to December 31, 2015. Age, sex, and index date were matched. Multiple logistic regression was used to analyze the previous exposure risk of OSA or CSA with obesity and. A p value of Results: Obesity patients have higher risk to be exposed to OSA than did those with CSA (OSA adjusted OR [AOR] = 2.927, 95% CI = 1.878-4.194, p < .001; CSA adjusted OR [AOR] = 2.234, 95% CI = 1.483-4.380, p < .001). Furthermore, the closeness of the exposure period to the index time was positively associated with the severity of obesity, with a dose–response effect (OSA exposure Conclusions: OSA patients have significantly higher risk of Obesity than that of CSA in this study. Longer exposure to OSA or CSA was related with a higher likelihood of obesity, with a dose-response effect.

Objective: To investigate whether children with maltreatment exposure were associated with the risk of psychiatric disorders, suicide, and death. Methods: A retrospective cohort study was conducted, with 1592 child maltreatment cases and 6368 comparison cohort (1:4) matched for gender, age, and index year, from the Longitudinal Generation Tracking Database (LGTD2000) sampled from Taiwan National Health Insurance Research Database (NHIRD) in 2000, backtracking between 2000–2015 in Taiwan. The stratified Cox regression model was used to compare the risk of developing a mental illness and poor prognosis during the 15 years of follow-up. Results: There were 473 in the cohort with child maltreatment (675.10 cases per 100,000 person years) and 1289 in the comparison cohort (453.82 cases per 100,000 person years) that developed mental illness and poor prognosis. The stratified Cox regression model revealed that the adjusted hazard ratio (HR) was 1.91 to 11.76 (p < 0.05) after adjusting for monthly income level, occupation, and CCI after violence. Conclusion: Exposure to child maltreatment is associated with the risk of psychiatric disorders, but not suicide or death. This finding could be a reminder for clinicians about the mental health problems in patients with child maltreatment.

Objective: To investigate the association between various injuries and attention-deficit hyperactivity disorder (ADHD) and distinguish ADHD from non-ADHD with regards to risk of various injuries among children in Taiwan. Method: Using the data from the National Health Insurance Research Database, we selected a total of 1802 subjects under the age of 18 who were diagnosed with ADHD as well as an additional 7208 subjects as a comparison group. Results: Compared with children who were not diagnosed with ADHD, children diagnosed with ADHD were more likely to intentionally injure themselves. During the school year, ADHD children were injured less frequently than were non-ADHD children on traffic-related incidents. The adjusted hazard ratio of injury for the ADHD children was 2.493 times higher than that of comparison subjects. The ADHD children had a greater length of stay and medical cost when compared to those of the non-ADHD children. Age showed a significant inverse relationship with injury. Among the ADHD children, the injury rate was evidently higher for the low-income group than for the non-low-income group. Conclusions: Age, cause of injuries, low-income household status, and school season all have a significant connection to the risk of injury for ADHD children.

Objective: To understand the main types of risk of violence against women in Taiwan. Materials and methods: This study used the outpatient, emergency, and hospitalization data of 2 million people in the National Health Insurance sample from 2000 to 2015. The International Classification of Diseases, Ninth Revision diagnostic N-codes 995.5 (child abuse) and 995.8 (adult abuse) or E-codes E960–E969 (homicide and intentional injury by others) were defined as the case study for this study, and the risks of first violent injury for boys and girls (0–17 years old), adults (18–64 years old), and elders (over 65 years old) were analyzed. Logistic regression analysis was used for risk comparison. A p value of

Objective: To investigate whether central sleep apnea (CSA) is associated with an increased risk of obesity. Materials and methods: From 1 January 2000 to 31 December 2015, we screened 24,363 obese patients from the 2005 longitudinal health insurance database, which is part of the Taiwan National Health Insurance Research Database. From the same database, 97,452 non-obese patients were also screened out. Age, gender, and index dates were matched. Multiple logistic regression was used to analyze the previous exposure risk of obese and CSA patients. A p-value of

Intestinal infectious diseases (IIDs) are among the most common diseases and are prevalent worldwide. IIDs are also one of the major disease groups with the highest incidence worldwide, especially among children and older adults. We observed a higher probability of IIDs in patients from the psychiatric department of Tri-Service General Hospital. Therefore, our objective was to investigate if there is an association between IIDs and the risk of developing psychiatric disorders. This nationwide population-based study used the database of the National Health Insurance (NHI) program in Taiwan. The study included 150,995 patients from 2000 to 2015, comprising 30,199 patients with IIDs as the study group and 120,796 patients without IIDs as the control group. Cox proportional hazards regression analysis was performed to calculate the hazard ratio of psychiatric disorders during the 16-year follow-up. Of the patients with IIDs, 4022 (13.32%) developed psychiatric disorders compared to 8119 (6.72%) who did not (P .001). The adjusted hazard ratio (aHR) for overall psychiatric disorders in the study group was 2.724 (95% confidence interval [CI]: 2.482-2.976; P .001). More specifically, the study group had a higher risk of developing a psychiatric disorder, including sleep disorders, depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD)/acute stress disorder (ASD), schizophrenia, mental retardation (MR), substance abuse, and other psychiatric disorders. Furthermore, refractory IIDs (seeking medical attention for IIDs 3 or more times) increased the risk (aHR: 3.918; 95% CI: 3.569-4.280; P .001) of developing psychiatric disorders. There was an association between IIDs and the increased risk of developing psychiatric disorders. The novel role of etiological factors in the development of psychiatric disorders deserves more attention, and the control of pathogens that cause IIDs is of urgent public health importance.

Objective: To understand the risk of developing a poor prognosis in adulthood after violent injury in Taiwan. Methods: This study used the data of outpatients, from emergency departments, and from hospitalization of 2 million people under National Health Insurance from 2000 to 2015. The ICD-9 diagnostic code N-code was defined as the case of this study and was 995.8 (abused adult) or E-code was E960-E969 (homicide and intentional injury by others) The first violent injury of 18–64-year-old adults (the study group) was analyzed. Patients who had not suffered violent abuse were the control group. The groups were matched in a 1:4 ratio, and the paired variables were gender, age ±1 year, Charlson Comorbidity index (CCI) before exposure, and year of medical treatment. SAS 9.4 statistical software was used, and the Cox regression method was used for data analysis. Results: During the 15-year period, a total of 8726 people suffered from violence (34,904 controls). The incidences of common poor prognoses among the victims of violence were sleep disorder, anxiety, and depression, in 33.9%, 21.6%, and 13.2% of people, respectively. The risk (Adults, Overall) of developing Post-Traumatic Stress Disorder (PTSD), bipolar disorder, and manic disorder after being violently injured (average 9 years) was 34.86, 4.4, and 4.1 times higher than those who had not suffered violence (all p values < 0.01). The risk (Adults, Males) of developing PTSD, bipolar disorder, and manic disorder after being violently injured (average 9 years) was 30.0, 3.81, and 2.85 times higher, respectively, than those who had not suffered violence (all p values < 0.01). The risk (Adults, Females) of developing PTSD, manic disorder, and bipolar disorder after being violently injured (average 9 years) was 36.8, 6.71, and 5.65 times higher, respectively, than of those who had not suffered violence (all p values < 0.01). Conclusion: The risks of poor prognosis are higher in adults who have suffered violent abuse than in those who have not. Therefore, police, social workers, and medical personnel should pay attention to the mental state of victims of violence. They should aim to support prompt treatment, to avoid PTSD, bipolar disorder, manic disorder, etc.

This study aimed to investigate not only the differences in in-hospital deaths between male and female homicides in Taiwan from 1998 to 2015, but also the epidemiological characteristics and long-term trend analysis. We collected data on 76,125 hospitalized patients injured in attempted homicides from January 1, 1998, to December 31, 2015, from the National Health Insurance Research Database (NHIRD), identifying 59,161 male and 16,694 female patients. Age, gender, and index date match. Multiple logistic regression was used to analyze the risks of gender differences in terms of homicide. The death risk of male patients was 1.673 times that of female patients and the mortality risk of low-income male patients was 3.447 times greater than that of non-low-income male patients. Moreover, the in-hospital death risk was 23.584 and 5.064 times higher for male and female patients with catastrophic illness, respectively, compared to patients with noncritical diseases. There is a higher trend of male than female patients hospitalized after an attempted homicide. Gender differences are significantly related to homicide, with males having a higher risk of death risk from homicide than females, especially in terms of low-income and catastrophic illness.

Is income still an obstacle that influences health in Taiwan, the National Health Insurance system was instituted in 1995? After collecting injured inpatient data from the health insurance information of nearly the whole population, we categorized the cases as either low-income or nonlow-income and tried to determine the correlation between poverty and injury. Chi-square tests, Fisher’s exact tests, an independent-samples t-test, and percentages were used to identify differences in demographics, causes for hospitalization, and other hospital care variables. Between 1998 and 2015, there were 74,337 inpatients with low-income injuries, which represented 1.6% of all inpatients with injury events. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the nonlow-income group. Furthermore, the average length of hospital stay (9.9 days), average medical expenses (1681 USD), and mortality rate (3.6%) values for the low-income inpatients were higher than those of the nonlow-income group (7.6 days, 1573 USD, and 2.1%, respectively). Among the injury causes, the percentages of “fall,” “suicide,” and “homicide” incidences were higher for the low-income group than for the nonlow-income group. These findings support our hypothesis that there is a correlation between poverty and injury level, which results in health inequality. Achieving healthcare equality may require collaboration between the government and private and nonprofit organizations to increase the awareness of this phenomenon.

Background : Embryonic gene Cripto-1 (CR-1) is not detected or expressed at low levels in normal adult tissues, however, is re-expressed in numerous tumors, including hepatocellular carcinoma (HCC) and CR-1 transgene overexpression led to mammary epithelial hyperplasia and adenocarcinoma, which prompted us to investigate whether hepatocyte-specific overexpression of CR-1 in transgenic mice can initiate hepatocarcinogenesis. Methods : Semi-quantitative RT-PCR, qRT-PCR, Western blotting or immunohistochemical staining were employed to detected CR-1 mRNA transcript or CR-1 expression in HCC tissue specimens. Combined use of CR-1 transgenic mice, microarray, 2/3 partial hepatectomy (PHx), and TCGA and GEO database examined the functions of CR-1 in initiate hepatocelluar carcinogenesis. Results: Here we firstly provided the direct evidence that a truncated 1.7-kb mRNA transcript from CR-1 geneis dominantly expressed in HCC specimens, suggesting the importance of short CR-1 mRNA form in HCC progression.We found that CR-1 is frequently upregulated in HCC specimens. Hepatocyte-specific overexpression of CR-1 in transgenic mice promoted hepatocyte proliferation after 2/3 PHx, CR-1 positively regulated HCC cell proliferation and invasion in vitro, and CR-1 overexpression promoted tumour growth of HCC cells in nude mice. In this study, we demonstrated that CR-1 transgenic overexpression in transgenic liver abnormally activated downstream pathways (i.e., AKT, Wnt/b-catenin, Stat3, MAPK/ERK, JNK, TGF-b and Notch) and led to the deregulated expression profile of genes, including up-regulated genes (i.e., CD5L, S100A8, S100A9, Timd4, Orm2, Orm3, Saa1, Saa3, Itih3, Itih4, Ly6e, IGHG1, IGHG2B and Vnn3) and down-regulated genes (i.e.,PDK4, DMBT1, G0S2, Plk2, Plk3, Gsta1 and Gsta2), all of which are key regulators of cellular proliferation, inflammation response, cellular malignant transformation, hepatocarcinogenesis or HCC progression, however, there were no histological signs of precancerous lesions, hepatocyte dysplasia and HCC formation in livers samples from 3-, 6- or 8-month-old RCLG/Alb-Cre transgenic mice, suggesting that the constitutive expression of CR-1 alone is not sufficient to promote hepatocarcinogenesis, unless other factors, i.e., a second hit, is present. Conclusions: Taken together, we provide the first in vivo genetic evidence that CR-1 overexpression in transgenic mouse liver promotes hepatocyte proliferation after 2/3 PHx, and causes the deregulated molecular alterations involved in HCC oncogenesis, however, these abnormally molecular alterations are not sufficient to initiate hepatocarcinogenesis in mice. Keywords : Cripto-1 (CR-1), hepatocellular carcinoma (HCC), transgenic mice, hepatocarcinogenesis

Objectives: To investigate whether chronic obstructive pulmonary disease (COPD) affects nonapnea sleep disorder (NASD) on the risk of obesity. Materials and Methods: From 1 January 2000 to 31 December 2015, a total of 24,363 patients with obesity from the 2005 Longitudinal Health Insurance Database were identified; 97,452 patients without obesity were also identified from the same database. Multiple logistic regression was used to analyze the previous exposure risk of patients with obesity and NASD. A p value of

Objective: This study used a long-term trend analysis to investigate whether gender differences were related to the risk of injury and epidemiological characteristics in Taiwan from 1998 to 2015. Materials and methods: Data on 4,647,259 hospitalized patients that were injured from 1 January 1998, to 31 December 2015 were collected from the National Health Insurance Research Database (NHIRD). Among the injured patients, 2,721,612 males and 1,925,446 females were identified. Patients were age-, gender-, and index date-matched. Multiple logistic regression was used to analyze the risks of injury via gender differences. A p-value < 0.05 was considered significant. Results: The injury risk of the male patients was 1.4 times higher than that of female patients (AOR = 1.427, 95% CI = 1.40–1.44). The rising trend of male injured hospitalized patients was also greater than that of female injured hospitalized patients. Conclusion: Males were more at risk of injury than females. Gender differences were related to the increased risk of epidemiological characteristics of injury.

Quorum sensing (QS) is a means of cell-to-cell communication that regulates, via small signalling molecules, expression of a series of genes and controls multicellular behaviour in many bacterial species. The enzyme S-ribosylhomocysteine lyase (LuxS) transforms S-ribosylhomocysteine (SRH) into 4, 5-dihydroxy-2, 3-pentanedione (DPD), the precursor of the interspecies QS signalling molecule autoinducer-2 (AI-2). In this study, two LuxS-coding genes, luxS1 and luxS2, with 70% sequence identity were isolated from Lactobacillus plantarum YM-4-3, and overexpressed in Escherichia coli BL21 (DE3), and the protein products were purified successfully. After incubation of LuxS1 or LuxS2 with SRH, the reaction products were able to induce Vibrio harveyi BB170 bioluminescence, clearly demonstrating that both LuxS1 and LuxS2 synthesize AI-2 from SRH in vitro. Ellman's assay results revealed optimal temperatures for LuxS1 and LuxS2 of 45 and 37 °C, respectively, and their activities were stimulated or inhibited by several metal ions and chemical reagents. In addition, enzyme kinetics data showed that Km, Vmax and Kcat value of LuxS1 for the substrate (SRH) were higher than that of LuxS2. These results suggest that LuxS1 and LuxS2 mediate QS in a temperature-dependent manner and may play conserved roles in AI-2 synthesis but exhibit different activities in response to external environmental stress. To our knowledge, this paper is the first report of two luxS genes present in one bacterial genome and the subsequent comparative elucidation of their functions in AI-2 production. Collectively, our study provides a solid basis for future research concerning the AI-2/LuxS QS system in L. plantarum YM-4-3.

National Science Council of Taiwan [NSC 100-2112-M-011-001-MY3, NSC 100-2221-E-131-005-MY2]; National Basic Research Program of China [2012CB933503]; National Natural Science Foundation of China [61036003, 61176092]

Multi-channel, fully integrated CMOS optical receivers combining with spatially modulated photo detector (SMPD) array, transimpedance amplifiers, and limiting amplifiers are presented. It demonstrates scalable channel numbers with minimum area overhead and low cross talk of less than 0.1 dB. The receiver array is implemented in 0.18 μm CMOS and provides 20 Gbps throughput (5Gbps × 4). The conversion gain of each channel is 116 dB Ω, and the input sensitivity is about −11dBm for BER of less than 10−12. Besides, a 10 Gbps receiver with automatic gain control (AGC) for TIA is proposed. It tolerates 15 dB dynamic range, and the gain peaking can be improved by more than 3dB.

Optical coherence tomography (OCT) provides high resolution, cross-sectional image of internal microstructure of biological tissue. We use the Finite-Difference Time-Domain method (FDTD) to analyze the data acquired by OCT, which can help us reconstruct the refractive index of the biological tissue. We calculate the refractive index tomography and try to match the simulation with the data acquired by OCT. Specifically, we try to reconstruct the structure of melanin, which has complex refractive indices and is the key component of human pigment system. The results indicate that better reconstruction can be achieved for homogenous sample, whereas the reconstruction is degraded for samples with fine structure or with complex interface. Simulation reconstruction shows structures of the Melanin that may be useful for biomedical optics applications.

We report a detailed characterization of a Ge/Si0.16Ge0.84multiple quantum well (MQW) structure on Ge-on-Si virtual substrate (VS) grown by ultrahigh vacuum chemical vapor deposition by using temperature-dependent photoreflectance (PR) in the temperature range from 10 to 300 K. The PR spectra revealed a wide range of optical transitions from the MQW region as well as transitions corresponding to the light-hole and heavy-hole splitting energies of Ge-on-Si VS. A detailed comparison of PR spectral line shape fits and theoretical calculation led to the identification of various quantum-confined interband transitions. The temperature-dependent PR spectra of Ge/Si0.16Ge0.84MQW were analyzed using Varshni and Bose-Einstein expressions. The parameters that describe the temperature variations of various quantum-confined interband transition energies were evaluated and discussed.

Temperature dependent near band edge transitions in Ge epilayer on Si substrate with different thickness were studied by using photoreflectance (PR) and piezoreflectance (PzR) measurements. The identification of conduction to light-hole (LH) band and conduction to heavy-hole (HH) band transitions originated from the strain induced valence band splitting results from tensile strain have been achieved by comparing the relative intensities of PR and PzR spectra. The strain induced energy splitting between LH and HH can be reduced with a thinner substrate and can be accounted by the mismatch of thermal expansion coefficients between the Si substrate and Ge epilayer. We also studied temperature dependent energy splitting between LH and HH through theoretical calculations. The comparison of energy splitting between experiments and theoretical calculations were made and discussed.