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Yu PC, Hsin HT, Huang YC, Chung RJ, Lin IJ, Wang BL, Chen CF, Sun CA, Tang SE, Huang SH, Chien WC, Chiang CH. Standardized rate of hospitalization for violent injuries among different generations in counties and cities in Taiwan from 2000 to 2015. Medicine (Baltimore) 2023; 102:e33172. [PMID: 36897711 PMCID: PMC9997829 DOI: 10.1097/md.0000000000033172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
This study aimed to understand the distribution of the standardized rate of hospitalization for violent injuries in counties and cities in Taiwan. The ICD-9 diagnosis code N-codes 995.5 (abused child) and 995.8 (abused adult) or E-code E960-E969 (homicide and intentional injury by others) were defined as research cases. The study analyzed the standardized medical treatment rate of children and adolescents aged 0 to 17, adults aged 18 to 64, and older adults over 65 years old suffering from violence for the first time. During the 15-year period, the counties and cities with the highest rate of medical treatment for violent injuries among children (unit: per 105 people) were Pingtung County (33.1 males, 22.9 females), Lienchiang County (8.8 males, 9.8 females), and New Taipei City (8.2 males, 8.8 females). For adults, Pingtung County (73.2 males, 36.8 females), New Taipei City (26.0 males, 14.3 females), and Yunlin County (19.7 males, 7.7 females) registered the highest rates. For older adults, Pingtung County (33.6 persons), New Taipei City (12.5 persons), Yun Lin County (11.2 persons), and Taichung City (9.2 persons) registered the highest rates. The highest rates of older female adults receiving treatment were recorded in Pingtung County (15.1 persons), Yunlin County (9.0 persons), Taichung City (5.5 persons), and New Taipei City (5.1 persons). With the Poisson regression model, the relative risk ratio of seeking medical care owing to violence in Pingtung County (reference: Taipei City) was 25.1 times for children, 20.1 times for adults, and 11.7 times for older adults. The counties and cities with higher rates of violent medical treatment for adults and older adults during the 15-year period were Pingtung County, New Taipei City, and Yunlin County. For children and adolescents, Pingtung County, Lienchiang County, and New Taipei City recorded the highest rates. Pingtung County had the highest risk of sexual violence. These results may be related to the local industrial structure, demographic composition, and other characteristics explained in the text.
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Affiliation(s)
- Pi-Ching Yu
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate Institute of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ho-Tsung Hsin
- Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yao-Ching Huang
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Ren-Jei Chung
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
| | - Iau-Jin Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chin-Fu Chen
- Amed Advanced Medication Co., Ltd., New Taipei City, Taiwan
- Center for Technology Transfer and Resources Integration, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Big Data Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Shih-En Tang
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Shi-Hao Huang
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei, Taiwan
| | - Chun-Hsien Chiang
- Department of Cardiovascular Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan
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Chung CH, Lin IJ, Huang YC, Sun CA, Chien WC, Tzeng NS. The association between abused adults and substance abuse in Taiwan, 2000-2015. BMC Psychiatry 2023; 23:123. [PMID: 36823534 PMCID: PMC9951533 DOI: 10.1186/s12888-023-04608-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE To investigate whether adults suffering from violence were at risk of substance abuse and provides insight into the relationship between male and female abusers and substance abuse from 2000 to 2015 in Taiwan. METHODS This study used data on outpatient, emergency, and inpatient visits for 2 million people enrolled in universal health insurance from 2000 to 2015. ICD-9 diagnosis codes 995.8 (abused adult) and E960-E969 (homicide and injury purposely inflicted by other persons) were defined in this case study, analyzing first-time violence in adults aged 18-64 (study group). Non-abused patients (control group) were matched in a 1:4 ratio, and the paired variables were gender, age (± 1 year), pre-exposure Charlson Comorbidity Index, and year of medical treatment. SAS 9.4 and Cox regression were used for data analysis. RESULTS A total of 8,726 people suffered violence (control group: 34,904 people) over 15 years. The prevalence of substance abuse among victims of violence was 78.3/104, 61.9/104, and 51.5/104 for tobacco use disorder, alcoholism, and alcohol abuse, respectively. The risk (adults, overall) of drug abuse, drug dependence, and alcoholism after exposure to violence (average 9 years) was 7.47, 7.15, and 6.86 times (p < 0.01), respectively, compared with those without violence. The risk (adults, males) of drug abuse, drug dependence, and alcohol abuse after exposure to violence (average 9 years) was 6.85, 6.27, and 6.07 times, respectively, higher than those without violence (p < 0.01). Risks of drug dependence, alcohol abuse and alcoholism (adults, females) after exposure to violence (average 9 years) were 14.92, 12.26, and 11.55 times, respectively, higher than non-abused ones (p < 0.01). CONCLUSION The risks of substance abuse, after adult violence, are higher than in those who have not suffered violent injuries.
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Affiliation(s)
- Chi-Hsiang Chung
- grid.260565.20000 0004 0634 0356School of Public Health, National Defense Medical Center, 11490 Taipei, Taiwan ,grid.278244.f0000 0004 0638 9360Department of Medical Research, Tri-Service General Hospital, 11490 Taipei, Taiwan ,Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), 11490 Taipei, Taiwan
| | - Iau-Jin Lin
- grid.278244.f0000 0004 0638 9360Department of Medical Research, Tri-Service General Hospital, 11490 Taipei, Taiwan
| | - Yao-Ching Huang
- grid.260565.20000 0004 0634 0356School of Public Health, National Defense Medical Center, 11490 Taipei, Taiwan ,grid.278244.f0000 0004 0638 9360Department of Medical Research, Tri-Service General Hospital, 11490 Taipei, Taiwan ,grid.412087.80000 0001 0001 3889Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), 10608 Taipei, Taiwan
| | - Chien-An Sun
- grid.256105.50000 0004 1937 1063Department of Public Health, College of Medicine, Fu-Jen Catholic University, 242062 New Taipei City, Taiwan ,grid.256105.50000 0004 1937 1063Big Data Center, College of Medicine, Fu-Jen Catholic University, 242062 New Taipei City, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, 11490, Taipei, Taiwan. .,Department of Medical Research, Tri-Service General Hospital, 11490, Taipei, Taiwan. .,Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), 11490, Taipei, Taiwan. .,Graduate Institute of Life Sciences, National Defense Medical Center, 11490, Taipei, Taiwan.
| | - Nian-Sheng Tzeng
- Student Counseling Center, National Defense Medical Center, 11490, Taipei, Taiwan. .,Department of Psychiatry, Tri-Service General Hospital, 11490, Taipei, Taiwan.
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Hsiao SH, Cheng CC, Lin IJ, Yu CP, Huang YC, Huang SH, Sun CA, Fann LY, Sheu MY, Chien WC. Persistent Depressive Disorder-Related Effect of Sleep Disorder on the Highest Risk of Suicide in Taiwan, 2000-2015. Int J Environ Res Public Health 2022; 19:13169. [PMID: 36293761 PMCID: PMC9603005 DOI: 10.3390/ijerph192013169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Sheng-Huang Hsiao
- Department of Neurosurgery, Taipei City Hospital, Ren-Ai Branch, Taipei 10629, Taiwan
- Department of Psychology, National Chengchi University, Taipei 11605, Taiwan
| | - Chih-Chien Cheng
- Department of Mechanical Engineering, National Central University, Jhongli 32001, Taiwan
- Department of Obstetrics/Gynecology, Taipei City Hospital, Taipei 10341, Taiwan
- School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - Iau-Jin Lin
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chia-Peng Yu
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yao-Ching Huang
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan
| | - Shi-Hao Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
- Big Data Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - Li-Yun Fann
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Nursing, Taipei City Hospital, Taipei 10684, Taiwan
- Department of Nurse-Midwifery and Women Health, National Taipei University of Nursing and Health Sciences, Taipei 11220, Taiwan
| | - Miin-Yea Sheu
- Department of Nursing, Taipei City Hospital, Taipei 10684, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei 11490, Taiwan
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Yu CP, Lin IJ, Wang BL, Tsao CH, Huang SH, Huang YC, Sun CA, Chung CH, Hu JM, Chien WC. Intestinal infectious diseases increase the risk of psychiatric disorders: A nationwide population-based cohort study. Medicine (Baltimore) 2022; 101:e30959. [PMID: 36221435 PMCID: PMC9543017 DOI: 10.1097/md.0000000000030959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Chia-Peng Yu
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Iau-Jin Lin
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Huei Tsao
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Microbiology & Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Shi-Hao Huang
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Yao-Ching Huang
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Je-Ming Hu
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Wu-Chien Chien, Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan and Je-Ming Hu, Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan (e-mail: (W-CC) and (J-MH))
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Wu-Chien Chien, Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan and Je-Ming Hu, Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan (e-mail: (W-CC) and (J-MH))
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Fann LY, Lin IJ, Huang SH, Wang BL, Huang YC, Yu CP, Cheng CC, Sun CA, Hsu CW, Chien WC, Lu CH. Adults Suffering from Violence Are at Risk of Poor Prognosis in Taiwan, 2000-2015. Healthcare (Basel) 2022; 10:healthcare10081470. [PMID: 36011125 PMCID: PMC9407952 DOI: 10.3390/healthcare10081470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Li-Yun Fann
- Department of Nursing, Taipei City Hospital, Taipei 10341, Taiwan
- Department of Nurse-Midwifery and Women Health, National Taipei University of Nursing and Health Sciences, Taipei 11220, Taiwan
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Iau-Jin Lin
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Shi-Hao Huang
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yao-Ching Huang
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan
| | - Chia-Peng Yu
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chih-Chien Cheng
- Department of Mechanical Engineering, National Central University, Jhongli 32001, Taiwan
- Department of Obstetrics/Gynecology, Taipei City Hospital, Taipei 10341, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
- Big Data Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - Cheng-Wei Hsu
- Department of Nursing, Taipei City Hospital, Taipei 10341, Taiwan
- Correspondence: (C.-W.H.); (W.-C.C.); (C.-H.L.)
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei 11490, Taiwan
- Correspondence: (C.-W.H.); (W.-C.C.); (C.-H.L.)
| | - Chieh-Hua Lu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: (C.-W.H.); (W.-C.C.); (C.-H.L.)
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Chwo MJ, Huang SH, Huang YC, Lin IJ, Yu CP, Chung CH, Chien WC, Sun CA, Wu GJ. Sexual Assault Is the Biggest Risk Factor for Violence against Women in Taiwan-A Nationwide Population Cohort Study from 2000 to 2015. Int J Environ Res Public Health 2022; 19:ijerph19063473. [PMID: 35329159 PMCID: PMC8949986 DOI: 10.3390/ijerph19063473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 02/04/2023]
Abstract
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 <0.05 was considered significant. Results: The proportion of women (12−17.9 years old) who were sexually assaulted was 2.71 times that of women under the age of 12, and the risk of sexual assault for girls and adult women was 100 times that of men. Girls who were insured as labor insurance, farmers, members of water conservancy and fishery associations, low-income households, and community insured population (public insurance as the reference group) were significantly more likely to seek medical treatment from sexual assault than adult women. Among them, the risk was greatest for girls from low-income households (odds ratio = 10.74). Conclusion: Women are at higher risk of sexual assault than men regardless of whether they are children or adults, and the highest risk is for women in senior high schools, especially for girls from low-income households. Therefore, the protection of women’s personal autonomy is the direction that the government and people from all walks of life need to continue to strive for. Especially for high school students from low-income households, protection must be strengthened through education, social work, and police administration.
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Affiliation(s)
- Miao-Ju Chwo
- Department of Nursing, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan;
| | - Shi-Hao Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan; (S.-H.H.); (Y.-C.H.)
| | - Yao-Ching Huang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), Taipei 10608, Taiwan; (S.-H.H.); (Y.-C.H.)
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan; (I.-J.L.); (C.-H.C.)
| | - Iau-Jin Lin
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan; (I.-J.L.); (C.-H.C.)
| | - Chia-Peng Yu
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan; (I.-J.L.); (C.-H.C.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan; (I.-J.L.); (C.-H.C.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (G.-J.W.)
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan;
- Big Data Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - Gwo-Jang Wu
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan; (I.-J.L.); (C.-H.C.)
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, Taipei 11490, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: (W.-C.C.); (G.-J.W.)
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Lin IJ, Tzeng NS, Chung CH, Chien WC. Psychiatric disorders in female psychosexual disorders-a nationwide, cohort study in Taiwan : Psychiatric disorders and female psychosexual disorders. BMC Psychiatry 2021; 21:63. [PMID: 33509146 PMCID: PMC7845000 DOI: 10.1186/s12888-021-03060-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 01/18/2021] [Indexed: 12/02/2022] Open
Abstract
We aimed to investigate whether females with psychosexual disorders were associated with the risk of affective and other psychiatric disorders. A total of 2240 enrolled individuals, with 560 patients with psychosexual disorders and 1680 subjects without psychosexual disorders (1:3) matched for age and index year, from the Longitudinal Health Insurance Database, retrieved from the National Health Insurance Research Database (NHIRD), between 2000 and 2015 in Taiwan. The multivariate Cox regression model was used to compare the risk of developing psychiatric disorders during the 15 years of follow-up. There were 98 in the cohort with psychosexual disorders (736.07 per 100,000 person-year) and 119 in the non-cohort without psychosexual disorders (736.07 per 100,000 person-year) that developed psychiatric disorders. The multivariate Cox regression model revealed that the adjusted hazard ratio (HR) was 9.848 (95% CI = 7.298 - 13.291, p < 0.001), after the adjustment of age, monthly income, urbanization level, geographic region, and comorbidities. Female patients with psychosexual disorders were associated with the risk of psychiatric disorders. This finding could be a reminder for clinicians about the mental health problems in patients with psychosexual disorders.
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Affiliation(s)
- Iau-Jin Lin
- grid.260565.20000 0004 0634 0356Graduate Institute of Life Sciences, National Defense Medical Center, 9314R, No.161, Section 6, Min-Chuan East Road, Neihu District, Taipei, 11490 Taiwan, Republic of China
| | - Nian-Sheng Tzeng
- grid.260565.20000 0004 0634 0356Department of Psychiatry, School of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China ,grid.260565.20000 0004 0634 0356Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chi-Hsiang Chung
- grid.260565.20000 0004 0634 0356Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Gung Road, Neihu District, Taipei, 11490 Taiwan, Republic of China ,grid.260565.20000 0004 0634 0356School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China ,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, 9314R, No.161, Section 6, Min-Chuan East Road, Neihu District, Taipei, 11490, Taiwan, Republic of China. .,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Gung Road, Neihu District, Taipei, 11490, Taiwan, Republic of China. .,School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China. .,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, Republic of China.
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Lin IJ, Chi CS, Chen CH, Wang TM. The follow-up on the training course of pediatric advanced life support. Acta Paediatr Taiwan 2000; 41:205-10. [PMID: 11021006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Two parts are included in this article. First, to improve the training course in pediatric advanced life support (PALS), we held a 2-day PALS training course on March 28 and 29, 1999. A pretest, posttest, and survey questionnaire were given to each participant. Of the 143 participating in the 2-day PALS course, 137 completed the study. The mean pretest score was 70.2 (SD = 11.5) and the mean posttest score was 86.9 (SD = 9.1). There was significant improvement noted after the 2-day PALS training course (p < 0.001). The 2-day PALS training course resulted in greater improvement in scores compared with the previous 1-day PALS training course in some certain groups of participants. The number of participants complaining that they were too rushed to get the best learning result declined from 71 of 106 (66.3%) taking the 1-day training course to 43 of 137 (31.4%) taking the 2-day training course. Second, a same written test was given to the 129 participants who had finished a 1-day PALS training course one year previously to evaluate the participants' retention of knowledge after 1 year. Of 82 responders who took the 1-year follow up test, 75 were from the medical center. The score of the follow-up test for these 75 participants showed a significant decline when compared with the posttest, except for those receiving another training course of advanced life support during the follow-up year. We conclude that the 2-day PALS training course is better than the 1-day PALS training course. Those who participate in the pediatric critical or emergent care had better receive the 2-day PALS training course. The participants receiving the 1-day PALS training showed a significant decline in their knowledge after 1 year, and they should reinforce their knowledge in the following years.
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Affiliation(s)
- I J Lin
- Department of Pediatrics, Chu-Tung Veterans Hospital, Taichung, Taiwan
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Lou YC, Lin IJ, Pai MT, Cheng JW. Solution structure of an N-capping peptide from the N-terminal leucine-repeat region of hepatitis delta antigen. Arch Biochem Biophys 2000; 377:219-27. [PMID: 10845697 DOI: 10.1006/abbi.2000.1797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hepatitis delta virus (HDV) is a satellite virus of the hepatitis B virus (HBV) which provides the surface antigen for the viral coat. The RNA genome of HDV encodes two proteins, the small delta antigen and the large delta antigen, which differ only with the latter having an additional 19 amino acids at the C-terminus. Previously, we have shown that dAg24-50, a synthetic peptide corresponding to residues 24-50 of the N-terminal leucine-repeat region of hepatitis delta antigen, binds to the viral RNA and forms an alpha-helical conformation in TFE-containing solution. However, it exhibited low alpha-helicity (less than 5%) in the absence of TFE. In order to obtain biologically active delta antigen peptides with higher structural stability in solution, an N-capping 21-residue polypeptide corresponding to residues 24-38 of hepatitis delta antigen (dAg(Cap24-38am)) was synthesized and, surprisingly, its solution structure was found to be a stable alpha-helix (64%) by circular dichroism and 1H NMR techniques. Moreover, the structure of the capping box shows the characteristic L-shaped bend perpendicular to the helix axis. This structural knowledge provides a molecular basis for understanding the role of the N-terminal leucine-repeat region of hepatitis delta antigen and has a significant potential for the development of diagnostic and therapeutic methods for HDV.
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Affiliation(s)
- Y C Lou
- Department of Life Science, National Tsing Hua University, Taiwan, Republic of China
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Lin IJ, Chen CH, Chen PY, Wang TM, Chi CS. Nosocomial infection in a neonatal intensive care unit--from a viewpoint of national health insurance. Acta Paediatr Taiwan 2000; 41:123-8. [PMID: 10920543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
In order to survey both the epidemiology of nosocomial infection in our neonatal intensive care unit (NICU) and the changing face of nosocomial infection after the introduction of National Health Insurance (NHI) in Taiwan, we retrospectively reviewed the nosocomial infections which occurred in our NICU from March 1, 1991, to February 28, 1999. We also compared the nosocomial infections from the viewpoint of NHI. The mean rate of nosocomial infections in our NICU during these 8 years was 13.6%, and it had significantly increased after the NHI plan was implemented (from 7.9% to 19.0%). The most common type of nosocomial infection was blood stream infection (53.8%, 120 of 223 infections). Coagulase-negative Staphylococci and fungi were the two most common pathogens of nosocomial blood stream infection in our NICU, accounting for 28.1% and 24.2% of the infections, respectively. The survival rate of very low birth weight (VLBW) infants increased from 76.3% to 78.4% after the implementation of NHI. However, the nosocomial infection rate of the VLBW infants had markedly increased from 22.6% to 41.9%. The total number of hospitalization days of the patients with nosocomial infection was significantly greater than that of those without nosocomial infections (p < 0.05), and the patients with the lower birth weights had longer hospital stays. The risk factors for nosocomial infection including invasive procedures, multiple and empirical antibiotics, and extremely low birth weight premature infants, remained the same, but the prevalence of nosocomial infection in the neonatal intensive care unit has changed markedly since the NHI plan began. Further investigation to determine strategies for preventing nosocomial infection in very low birth weight infants is warranted.
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Affiliation(s)
- I J Lin
- Department of Pediatrics, Chu-Tung Veterns Hospital, Taichung Veterans General Hospital, Taiwan
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Abstract
Hepatitis delta virus (HDV) is a satellite virus of the hepatitis B virus (HBV) which provides the surface antigen for the viral coat. The RNA genome of HDV encodes two proteins: the small delta antigen and the large delta antigen. The two proteins resemble each other except for the presence of an additional 19 amino acids at the C terminus of the latter species. We have found that the N-terminal leucine-repeat region of hepatitis delta antigen (HDAg) binds to the autolytic domain of HDV genomic RNA and attenuates its autolytic activity. A 27-residue polypeptide corresponding to residues 24-50 of HDAg, designated dAg(24-50), was synthesized, and its solution structure was found to be an alpha-helix by circular dichroism and (1)H-nuclear magnetic resonance (NMR) techniques. Binding affinity of dAg(24-50) with HDV genomic RNA was found to increase with its alpha-helical content, and it was further confirmed by modifying its N- and C-terminal groups. Furthermore, the absence of RNA binding activity in the mutant peptides, dAgM(24-50am) and dAgM(Ac24-50am), in which Lys38, Lys39, and Lys40 were changed to Glu, indicates a possible involvement of these residues in their binding activity. Structural knowledge of the N-terminal leucine-repeat region of HDAg thus provides a molecular basis for the understanding of its role in the interaction with RNA. Proteins 1999;37:121-129.
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Affiliation(s)
- I J Lin
- Department of Life Science, National Tsing Hua University, Hsinchu, Taiwan, ROC
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Lin IJ, Che MJ, Yeh A, Hwang JJ, Wei CY, Tsao WL, Lee CP. Comparison of the sensitivity and specificity of an automatic ligase chain reaction assay system with a one-step polymerase chain reaction assay in the diagnosis of Mycobacterium tuberculosis complex. Changgeng Yi Xue Za Zhi 1999; 22:204-11. [PMID: 10493024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
BACKGROUND Polymerase chain reaction (PCR) and ligase chain reaction (LCR) are two nucleic acid amplification-based molecular methods. The former has been used widely in the identification of Mycobacterium tuberculosis (M. tuberculosis). In contrast, the LCR assay which was recently introduced is not well known in our medical communities in Taiwan. To determine which method is more reliable and suitable for the identification of M. tuberculosis in our clinics, we compared the sensitivity and specificity of these two methods. METHODS An automatic LCR assay system and a manual one-step PCR assay were studied in a side by side comparison of their performance in detection of M. tuberculosis. The automatic LCR system uses the single copy antigen protein b (Pab) gene and the manual one-step PCR assay uses the multi-copy IS6110 insertion element as the target DNA; both target DNA sequences are found specifically in M. tuberculosis complex. RESULTS Both assays detected two of the M. tuberculosis complex strains, M. tuberculosis and M. bovis, but not other mycobacterial strains. In addition, both methods, which were based on different amplification principles, showed compatible sensitivity; as low as 10 and 100 copies of M. tuberculosis genomes were detected by the LCR and PCR assays, respectively. When the template DNA was less than 1000 copies, however, the automatic LCR assay system showed a lower reproducibility than that of the one-step PCR assay. CONCLUSION Our results suggest that in addition to the PCR assay, the LCR assay is a useful method for the molecular identification of M. tuberculosis complex strains.
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Affiliation(s)
- I J Lin
- Department of Medical Technology, Tzu Chi College of Medicine and Humanities, Abbott Laboratories, Taiwan, R.O.C
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Lin IJ, Chen CH, Wang TM, Fu LS, Chi CS. Infants of twin pregnancies with one twin demise in the uterus: a retrospective study. Acta Paediatr Taiwan 1999; 40:92-6. [PMID: 10910594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Many papers have reported that twin pregnancies with one twin demise in the uterus can cause complications in the surviving twin. We retrospectively reviewed charts from 1988 to 1997 at our hospital and found 17 of 302 twin deliveries with one twin intrauterine fetal death. The incidence of intrauterine death of a single twin was 5.7%. Six of the surviving twin (35.3%) had renal function impairment. One died due to acute renal failure. The other five patients recovered normal serum creatinine level. Five patients (29.4%) had abnormal brain imaging findings. One had multicystic encephalomalacia and microcephaly. Three of the five patients were complicated with cerebral palsy. After dividing the patients into complicated (n = 8, 47.1%) and non-complicated (n = 9, 52.9%) groups, we found that the patients with complication had lower Apgar score at 5 minutes and those with monochorionic diamniotic placenta had higher incidences of complication (62.5% vs 12.5%). We conclude that twin pregnancies with one fetal demise in the uterus do result in a higher incidence of complication in the surviving twin, especially if placentation type is monochorionic diamniotic. In managing the surviving twin of the monozygous twin pregnancies with one fetal demise in the uterus, we must be careful to monitor these patients. If complication was suspected, we should arrange the brain and kidney ultrasonography and manage these patients appropriately to decrease the complication risk.
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Affiliation(s)
- I J Lin
- Department of Pediatrics, Taichung Veterans General Hospital, Taiwan
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Lin IJ, Chi CS, Shu SG. The preliminary result of the training course of pediatric advanced life support. Acta Paediatr Taiwan 1999; 40:5-8. [PMID: 10910576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
To improve the preparedness of health care providers in pediatric resuscitation and to evaluate the effectiveness of the Pediatric Advanced Life Support course, we followed the standard guidelines of American Heart Association to conduct the first 10-hour course of Pediatric Advanced Life Support course in our hospital and designed this study. A total of 160 doctors and nurses were enrolled in the providers course held on Jan. 11, 1998. A pretest, posttest and survey questionnaire were given to each participant. One hundred and twenty-nine completed these tests. The average scores were 73.1 for the pretest and 86.8 for the posttest. The average scores on the pretest and posttest among doctors (n = 57) and nurses (n = 72) are 72.6, 86.7 and 73.5, 86.8, respectively (p < 0.001). In the participants with pretest score of less than 80 (n = 92), the mean values of pretest and posttest scores were 69.0 and 86.4. The participants with pretest scores higher than or equal to 80 (n = 37) had pretest and posttest mean values of 83.3 and 87.7. The participants with less background knowledge (pretest < 80) had better increment scores after this course (p < 0.05). The mean posttest scores in those working in private clinics and having 20 years of working experience are 74.0 and 72.0 (lower than the criteria for successful completion of written examination). We conclude that this provider course did increase the knowledge and skill pertaining to pediatric resuscitation personnel, particularly in participants with less background knowledge. The participants from private clinics or with working experience more than 20 years need a repeatedly educational PALS training course.
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Affiliation(s)
- I J Lin
- Department of Pediatrics, Taichung Veterans General Hospital, Taiwan
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Cheng JW, Lin IJ, Lou YC, Pai MT, Wu HN. Local helix content and RNA-binding activity of the N-terminal leucine-repeat region of hepatitis delta antigen. J Biomol NMR 1998; 12:183-188. [PMID: 9729796 DOI: 10.1023/a:1008270202095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Hepatitis delta virus (HDV) is a satellite virus of the hepatitis B virus (HBV) which provides the surface antigen for the viral coat. Our results show that the N-terminal leucine-repeat region of hepatitis delta antigen (HDAg), encompassing residues 24-50, binds to the autolytic domain of HDV genomic RNA and attenuates its autolytic activity. The solution conformation of a synthetic peptide corresponding to residues 24-50 of HDAg as determined by two-dimensional 1H NMR and circular dichroism techniques is found to be an alpha-helix. The local helix content of this peptide was analyzed by NOEs and coupling constants. Mutagenesis studies indicate that Lys38, Lys39, and Lys40 within this alpha-helical peptide may be directly involved in RNA binding. A structural knowledge of the N-terminal leucine-repeat region of HDAg thus provides a molecular basis for understanding its role in the interaction with RNA.
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Affiliation(s)
- J W Cheng
- Department of Life Science, National Tsing Hua University, Taiwan, Republic of China
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Lin IJ, Shu SG, Chu HY, Chi CS. Primary intracranial germ-cell tumor in children. Zhonghua Yi Xue Za Zhi (Taipei) 1997; 60:259-64. [PMID: 9509681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Primary intracranial germ-cell tumors (GCTs) account for about 11.1% of all primary brain tumors of children in Taiwan. Because these tumors commonly involve the hypothalamus-pituitary gland regions and their biochemical secreting character, patients frequently display neuroendocrinological symptoms and signs. Endocrinopathy, if present, often occurs prior to other neurological or radiological manifestations. This article reviews experience here, with present results comparing them with previous reports. METHODS Twelve children who were diagnosed with primary intracranial germ-cell tumors between 1983 to 1995 were studied retrospectively. Their clinical presentations, laboratory results and treatment modalities as well as the current status were collected for presentation here. RESULTS There were seven boys and five girls. The age distribution was from 5 to 15 years old. The most common symptom was increased intracranial pressure (9/12), followed by diabetes insipidus (8/12), vision deficit (8/12) and sexual precocity in 3 boys. In 11 patients the tumors arose from the suprasellar or pineal regions. In two patients the tumors arose synchronously in the suprasellar and pineal regions. Pure germinoma was found in six patients. Only one had an elevated tumor marker. These six patients all received radiation with or without operation therapy, and all are still alive. Six patients, each with a non-germinomatous malignant germ-cell tumor, had a poorer prognosis. Although they received aggressive treatment, including operation, radiation and chemotherapy, three patients died, with a mean survival period of 3.3 years. CONCLUSIONS In cases of diabetes insipidus in children or sexual precocity in boys, a thorough investigation for intracranial germ-cell tumors is recommended. The treatment and outcome are different for germinomas and non-germinomatous malignant germ-cell tumors. A thorough pathological diagnosis is recommended for planning of treatment protocol in order to improve prognosis.
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Affiliation(s)
- I J Lin
- Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, R.O.C
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