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1

Ritchie, Nigel. "Marat “L’’Ami du peuple”Jean-Paul Marat, l’Ami du peuple. Une tradition politique à redécouvrir." French History 33, no. 1 (March 2019): 133–36. http://dx.doi.org/10.1093/fh/crz023.

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2

Yip, Winnie, Matthew Polisson, Ying Chun Li, Yiing Jenq Chou, and William Hsiao. "Treatments, outcomes, and costs for AMI patients in Taiwan." International Journal of Healthcare Technology and Management 10, no. 3 (2009): 169. http://dx.doi.org/10.1504/ijhtm.2009.025820.

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3

Tai, Ying-Hsuan, Ming-Long Chang, Pao-Hsien Chu, Chun-Chieh Yeh, Yih-Giun Cherng, Ta-Liang Chen, and Chien-Chang Liao. "Risk of Acute Myocardial Infarction in Patients with Gastroenteritis: A Nationwide Case-Control Study." Journal of Clinical Medicine 11, no. 5 (February 28, 2022): 1341. http://dx.doi.org/10.3390/jcm11051341.

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Gastroenteritis promotes the development of systemic inflammation and a hypercoagulable state. There are limited data regarding the association between gastroenteritis and acute myocardial infarction (AMI). We aimed to evaluate the risk of AMI after an episode of gastroenteritis. In this nested case-control study, we selected patients who were hospitalized for AMI (N = 103,584) as a case group during 2010–2017 and performed propensity score matching (case-control ratio 1:1) to select eligible controls from insurance research data in Taiwan. We applied multivariable logistic regressions to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of AMI associated with recent gastroenteritis within 14 days before AMI. We also compared the outcomes after AMI in patients with or without gastroenteritis. A total of 1381 patients (1.3%) with AMI had a prior episode of gastroenteritis compared to 829 (0.8%) among the controls. Gastroenteritis was significantly associated with a subsequent risk of AMI (adjusted OR: 1.68, 95% CI: 1.54–1.83), which was augmented in hospitalizations for gastroenteritis (adjusted OR: 2.50, 95% CI: 1.20–5.21). The outcomes after AMI were worse in patients with gastroenteritis than in those without gastroenteritis, including increased 30-day in-hospital mortality (adjusted OR: 1.28, 95% CI: 1.08–1.52), medical expenditure, and length of hospital stay. Gastroenteritis may act as a trigger for AMI and correlates with worse post-AMI outcomes. Strategies of aggressive hydration and/or increased antithrombotic therapies for this susceptible population should be further developed.
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4

Huang, Chia-Luen, Tai-Wen Wang, Yong-Chen Chen, Je-Ming Hu, Po-Ming Ku, Chang-Hsun Hsieh, Chien-Hsing Lee, et al. "Gout as a risk factor for acute myocardial infarction: evidence from competing risk model analysis." Journal of Investigative Medicine 69, no. 6 (May 17, 2021): 1161–67. http://dx.doi.org/10.1136/jim-2020-001714.

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Chronic inflammation, a hallmark of gout, is implicated in the pathogenesis of atherosclerosis. Thus, in theory, gout can be expected to increase the risk of acute myocardial infarction (AMI). Yet, results from several epidemiological studies have been inconclusive. A retrospective cohort study was conducted using the National Health Insurance Research Database of Taiwan dated from 2000 to 2013. The study cohort comprised 3581 patients with gout (the gout cohort) and 14,324 patients without gout (the non-gout cohort). The primary outcome was the incidence of AMI. To estimate the effect of gout on the risk of AMI, the Lunn-McNeil competing risk model was fitted to estimate cause-specific hazard ratios (HRs) and their 95% confidence intervals (CIs). The cumulative incidence of AMI was significantly higher in the gout cohort than in the non-gout cohort, resulting in an adjusted HR of 1.36 (95% CI 1.04 to 2.76). Further, HRs of gout with incident AMI were higher in patients without hypertension, diabetes mellitus, or hyperlipidemia (ranging from 1.63 to 2.09) than in those with each of these comorbidities (ranging from 0.95 to 1.13). The results of this study suggest that patients with gout have an increased risk of AMI. The AMI risk associated with gout was conditional on patients’ cardiovascular risk profile. Future work is needed to confirm these findings.
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5

Wu, Victor Chien-Chia, Tien-Hsing Chen, Michael Wu, Shao-Wei Chen, Chih-Hsiang Chang, Chun-Wei Chang, Ching-Chang Chen, et al. "Outcomes of patients with hypertrophic cardiomyopathy and acute myocardial infarction: a propensity score-matched, 15-year nationwide population-based study in Asia." BMJ Open 8, no. 8 (August 2018): e019741. http://dx.doi.org/10.1136/bmjopen-2017-019741.

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ObjectivesHypertrophic cardiomyopathy (HCM) entails thickening of the myocardium and an increased risk of ischaemia. However, the prognosis of patients with HCM with acute myocardial infarction (AMI) is incompletely understood.MethodsMedical information was retrieved from the Taiwan National Health Insurance Research Database in 1997–2011. The exclusion criteria were patients <18 years old, and history of AMI, coronary intervention, aortic valve disease, disease of the pericardium, heart surgery, device implantation, venous thromboembolism, cardiac transplant, congenital heart disease and end-stage renal disease on dialysis. Patients with HCM with AMI were compared with propensity score (PS)-matched patients with AMI without HCM. The primary endpoints were in-hospital and 1-year cardiovascular events.ResultsIn total, 201 166 patients were admitted for AMI. There were 177 058 patients with new-onset AMI, 257 with HCM and 176 801 without HCM after exclusion criteria. Using 1:4 PS matching, the study population consisted of patients with AMI, 257 with HCM and 1028 without HCM. Patients with AMI with HCM received significantly less coronary intervention (OR=0.46; 95% CI 0.32 to 0.65; p<0.001), coronary intervention with stenting (OR=0.33; 95% CI 0.20 to 0.57; p<0.001) and coronary artery bypass graft surgery (OR=0.22; 95% CI 0.05 to 0.90; p=0.036), and fewer episodes of shock (OR=0.64; 95% CI 0.48 to 0.86; p=0.003) and in-hospital death (OR=0.46; 95% CI 0.30 to 0.70; p<0.001), compared with patients with AMI without HCM. Specifically, for patients with HCM with AMI, AMI occurred predominantly (82.5%) in the form of ischaemia without requiring coronary stenting. Patients with AMI with HCM had significantly better survival than patients without HCM (HR=0.66; 95% CI 0.51 to 0.85; p=0.001) during the 1-year follow-up.ConclusionsThis is the first PS-matched study to compare the prognosis of patients with AMI with and without HCM. Compared with patients with AMI without HCM, patients with HCM had significantly better in-hospital and within 1-year outcomes.
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6

Wang, Wen-Hwa, Guang-Yuan Mar, Kai-Che Wei, Chin-Chang Cheng, and Wei-Chun Huang. "Risk Factors and Outcomes of Heart Failure Following First-Episode of Acute Myocardial Infarction—A Case Series Study of 161,384 Cases." Healthcare 9, no. 10 (October 16, 2021): 1382. http://dx.doi.org/10.3390/healthcare9101382.

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Background: Heart failure (HF) is one of the important complications of acute myocardial infarction (AMI), but the epidemiology, associated risks and outcomes have not been well investigated in the era of broad use of fluoroscopy-guided angiographic intervention. Methods: We analysed 161,384 subjects who had experienced the first episode of AMI during 1 January 2000 and 31 December 2012 using the Taiwan National Health Insurance Research Database. Results: During the index AMI hospitalization, 23.6% of cases developed HF. Female, ≥65 years-old, non-ST-segment elevation type of MI, diabetes mellitus (DM), peripheral vascular occlusion disease (PAOD), chronic obstructive pulmonary disease (COPD), atrial fibrillation, and ventricular tachycardia/fibrillation (VT/VF) were associated with higher risks of developing HF. HF cases had inferior survival outcomes compared to non-HF cases in both the short and long term. Among those HF patients, ≥65 years, DM, PAOD, and VT/VF were associated with worse outcomes. On the contrary, coronary reperfusion intervention and treat-to-target pharmacologic treatment were associated with favourable survival outcomes. Conclusions: HF remains common in the modern age and poses negative impacts in survival of AMI patients. It highlights that prudent prevention and early treatment of HF during AMI hospitalization is an important medical issue.
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Shih, Chiao-Yu, Min-Liang Chu, Tsung-Cheng Hsieh, Han-Lin Chen, and Chih-Wei Lee. "Acute Myocardial Infarction among Young Adult Men in a Region with Warm Climate: Clinical Characteristics and Seasonal Distribution." International Journal of Environmental Research and Public Health 17, no. 17 (August 24, 2020): 6140. http://dx.doi.org/10.3390/ijerph17176140.

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The aim of this cross sectional study was to investigate the influence of the seasons on acute myocardial infarction (AMI) among young adult among young adults aged <45 years compared to old adults aged ≥45 years. The seasonal distribution of AMI hospital admissions among young adult men in eastern Taiwan was assessed. Data were extracted from 1413 male AMI patients from January 1994 to December 2015, including onset date, the average temperature (Tave) on the date of AMI hospitalization (AMI-Tave), and conventional risk factors, notably smoking, diabetes, hypertension, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and body mass index (BMI). The 1413 cases were divided into two groups: the young group (n = 138, <45 y/o) and the older group (n = 1275, ≥45 y/o). The differences between groups were examined. Logistic regression analyses were used to evaluate the associations between the seasons and the AMI hospitalization among the young group. The young group showed significantly higher percentage of smokers, BMI, total cholesterol levels, and triglycerides levels but lower percentage of diabetes and hypertension than the older group (p < 0.05). AMI hospitalization in winter was significantly greater compared to the other seasons among the young group (p < 0.05). Winter hospitalization was significantly associated with the young group relative to the older group (adjusted OR 1.750; 95% CI 1.151 to 2.259), while winter AMI-Tave in the young group was similar to that in the older group. Young adult men diagnosed with AMI are more likely than older adult men to be smokers, obese, and show an onset dependent on winter but not low-temperature in a region with a warm climate.
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Ko, Yao-Ping, Pei-Yun Chen, Chung Y. Hsu, Renin Chang, Kai-Chieh Hu, Lu-Ting Chiu, Yao-Min Hung, and Guang-Yuan Mar. "Scabies Infestation and Risk of Acute Myocardial Infarction: A Population-Based Cohort Study." Journal of Personalized Medicine 12, no. 2 (February 7, 2022): 229. http://dx.doi.org/10.3390/jpm12020229.

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Background: Scabies is an infectious inflammatory skin disease. Cytokine-mediated inflammatory responses may be one of the pathological mechanisms underlying myocardial infarction. Objective: We explore the association between scabies and subsequent acute myocardial infarction (AMI) and all-cause mortality; Methods: We conducted a nationwide population-based study using data from the National Health Insurance Research Database (NHIRD) in Taiwan. Patients with scabies (n = 30,184) and 120,739 controls without scabies were included. The primary outcomes were incidental AMI and all-cause mortality. Using Cox proportional-hazards regression analysis, we estimated the risk of acute myocardial infarction for the study cohort; Results: The mean age of the study cohort was 51.81 ± 19.89 years. The adjusted sub-distribution hazard ratios (aSHRs) of AMI were 1.214 (95% CI, 1.068–1.381) after adjusting for demographic characteristics, income, OPD utility frequency, days in hospital, co-morbidities, and medication. The adjusted hazard ratio (aHR) of all-cause mortality after adjusting for age, gender, income, OPD utility frequency, days in hospital, co-morbidities, co-medication, and urbanization was 1.612 (95% CI, 1.557–1.669). Conclusions: Our study showed that patients with scabies infestations were at higher risk for subsequent AMI and all-cause mortality.
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Huang, Hsiu-Ju, Chih-Wei Lee, Tse-Hsi Li, and Tsung-Cheng Hsieh. "Different Patterns in Ranking of Risk Factors for the Onset Age of Acute Myocardial Infarction between Urban and Rural Areas in Eastern Taiwan." International Journal of Environmental Research and Public Health 18, no. 11 (May 22, 2021): 5558. http://dx.doi.org/10.3390/ijerph18115558.

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This cross-sectional study aimed to investigate the difference in ranking of risk factors of onset age of acute myocardial infarction (AMI) between urban and rural areas in Eastern Taiwan. Data from 2013 initial onset of AMI patients living in the urban areas (n = 1060) and rural areas (n = 953) from January 2000 to December 2015, including onset age, and conventional risk factors including sex, smoking, diabetes, hypertension, dyslipidemia, and body mass index (BMI). The results of multiple linear regressions analysis showed smoking, obesity, and dyslipidemia were early-onset reversible risk factors of AMI in both areas. The ranking of impacts of them on the age from high to low was obesity (β = −6.7), smoking (β = −6.1), and dyslipidemia (β = −4.8) in the urban areas, while it was smoking (β = −8.5), obesity (β= −7.8), and dyslipidemia (β = −5.1) in the rural areas. Furthermore, the average onset ages for the patients who smoke, are obese, and have dyslipidemia simultaneously was significantly earlier than for patients with none of these comorbidities in both urban (13.6 years) and rural (14.9 years) areas. The findings of this study suggest that the different prevention strategies for AMI should be implemented in urban and rural areas.
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10

MIYAZAKI, Hideo, and Tadamichi TAKEHARA. "Dental health in Taiwan aboriginal adults. Bunun, Paiwan, Rukai and Ami tribes." JOURNAL OF DENTAL HEALTH 38, no. 5 (1988): 682–86. http://dx.doi.org/10.5834/jdh.38.682.

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11

Chen, Yu-Yen, Yun-Ju Lai, Yung-Feng Yen, Hsin-Hua Chen, and Pesus Chou. "Uveitis as a potential predictor of acute myocardial infarction in patients with Behcet’s disease: a population-based cohort study." BMJ Open 11, no. 1 (January 2021): e042201. http://dx.doi.org/10.1136/bmjopen-2020-042201.

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ObjectivesTo investigate whether uveitis is a predictor of acute myocardial infarction (AMI) among patients with Behcet’s disease (BD).DesignRetrospective cohort study.SettingPatients with BD were retrieved from the whole population of the Taiwan National Health Insurance Research Database from 1 January 2001 to 31 December 2013.ParticipantsAmong the 6508 patients with BD, 2517 (38.7%) were in the uveitis group and 3991 were in the non-uveitis group.Primary and secondary outcome measuresKaplan-Meier curves were generated to compare the cumulative hazard of AMI in the uveitis and non-uveitis groups. Multivariate Cox regression analysis was used to estimate the adjusted HRs and 95% CI of AMI, and was adjusted for age, gender, systemic comorbidities (eg, hypertension, diabetes, hyperlipidaemia, smoking) and clinical manifestation of BD (eg, oral ulcers, genital ulcers, skin lesions, arthritis and gastrointestinal involvement).ResultsThe mean age of the BD cohort was 38.1±15.1 years. Compared with non-uveitis patients, uveitis patients were significantly younger and male predominant. There was no significant difference between the two groups for most proportions of systemic comorbidities and clinical manifestations. The Kaplan-Meier method with the log-rank test showed that the uveitis group had a significantly higher cumulative hazard for patients with AMI compared with the non-uveitis group (p<0.0001). In the multivariable Cox regression after adjustment for confounding factors, patients with uveitis had a significantly higher risk of AMI (adjusted HR 1.87; 95% CI 1.52 to 2.29). Other significant risk factors for AMI were age, hypertension, smoking, and skin lesions.ConclusionsStatistical analyses from the nationwide database demonstrated that uveitis is a potential predictor of AMI in patients with BD.
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Chen, Yen-ting, Chien-Cheng Huang, Shih-Feng Weng, Chien-Chin Hsu, Jhi-Joung Wang, Hung-Jung Lin, Shih-Bin Su, How-Ran Guo, and Chi-Wen Juan. "Acute Myocardial Infarction: A Comparison of the Risk between Physicians and the General Population." BioMed Research International 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/904328.

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Physicians in Taiwan have a heavy workload and a stressful workplace, both of which may contribute to cardiovascular disease. However, the risk of acute myocardial infarction (AMI) in physicians is not clear. This population-based cohort study used Taiwan’s National Health Insurance Research Database. We identified 28,062 physicians as the case group and randomly selected 84,186 nonmedical staff patients as the control group. We used a conditional logistic regression to compare the AMI risk between physicians and controls. Subgroup analyses of physician specialty, age, gender, comorbidities, area, and hospital level were also done. Physicians have a higher prevalence of HTN (23.59% versus 19.06%, P<0.0001) and hyperlipidemia (21.36% versus 12.93%, P<0.0001) but a lower risk of AMI than did the controls (adjusted odds ratio (AOR): 0.57; 95% confidence interval (CI): 0.46–0.72) after adjusting for DM, HTN, hyperlipidemia, and area. Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant. Medical center physicians had a lower risk (AOR: 0.42; 95% CI: 0.20–0.85) than did local clinic physicians. Taiwan’s physicians had higher prevalences of HTN and hyperlipidemia, but a lower risk of AMI than did the general population. Medical center physicians had a lower risk than did local clinic physicians. Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.
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Lee, An-Sheng, Chung-Lieh Hung, Thung-Shen Lai, and Ching-Hu Chung. "Investigation of the Therapeutic Potential of Organic Nitrates in Mortality Reduction Following Acute Myocardial Infarction in Hyperlipidemia Patients: A Population-Based Cohort Study." Journal of Personalized Medicine 14, no. 1 (January 22, 2024): 124. http://dx.doi.org/10.3390/jpm14010124.

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Background: Dyslipidemia is a known risk factor for cardiac dysfunction, and lipid-lowering therapy with statins reduces symptoms and reduces hospitalization related to left ventricular heart failure. Acute myocardial infarction (AMI) is a cause of morbidity and mortality worldwide. In this study, we aimed to determine the real-world AMI treatment drug combination used in Taiwan by using the NHI database to understand the treatment outcomes of current clinical medications prescribed for hyperlipidemia patients with AMI. Methods: Using the NHI Research Database (NHIRD), we conducted a retrospective cohort study that compared different treatments for AMI in hyperlipidemia patients in the period from 2016 to 2018. We compared the survival outcomes between those treated with and without organic nitrates in this cohort. Results: We determined that most hyperlipidemia patients were aged 61–70 y (29.95–31.46% from 2016 to 2018), and the annual AMI risk in these patients was <1% (0.42–0.68% from 2016 to 2018). The majority of hyperlipidemia patients with AMI were women, and 25.64% were aged 61–70 y. Receiving organic nitrates was associated with lower all-cause mortality rates (HR, 95% CI, p-value = 0.714, 0.674–0.756, p < 0.0001). After multivariate analysis, the overall survival in four groups (beta-blockers, beta-blocker + diuretics, diuretics, and others) receiving an organic nitrate treatment was significantly higher than in the groups that were not treated with organic nitrates (beta-blockers HR = 0.536, beta-blocker + diuretics HR = 0.620, diuretics HR = 0.715, and others HR = 0.690). Conclusions: The survival benefit was significantly greater in patients treated with organic nitrates than in those treated without organic nitrates, especially when combined with diuretics. A combination of organic nitrates could be a better treatment option for hyperlipidemia patients with AMI.
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Tseng, Shih-Ting, Ming-Chang Lee, Yi-Ting Tsai, Mei-Chun Lu, Su-Chen Yu, I.-Ju Tsai, I.-Te Lee, and Yuan-Horng Yan. "Risks after Gestational Diabetes Mellitus in Taiwanese Women: A Nationwide Retrospective Cohort Study." Biomedicines 11, no. 8 (July 27, 2023): 2120. http://dx.doi.org/10.3390/biomedicines11082120.

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Objective: An increasing trend in the prevalence of gestational diabetes mellitus (GDM) has been reported in Taiwan. GDM has been linked to various adverse maternal outcomes over a long period, including cardiovascular disease (CVD) and chronic kidney disease (CKD). However, evidence implies that the effects of GDM on the mid-term surrogate risk factors for these diseases are limited. Furthermore, data from nationwide cohort studies are limited. The primary aim of this study was to investigate the risk of developing type 2 diabetes mellitus (T2DM), arterial hypertension (aHTN), and hyperlipidemia (HL) through a 5-year follow-up post-delivery of women with GDM in a nationwide cohort study in Taiwan. The second objective was to investigate the risk of developing insulin resistance syndrome (IRS)-related diseases, including CVD, acute myocardial infarction (AMI), peripheral artery occlusive disease (PAOD), non-alcoholic fatty liver diseases (NAFLD), and CKD. Methods: This was a retrospective, population-based nationwide cohort study. The data source comprises a merge of the Birth Certificate Application Database (BCA) and the National Health Insurance Research Database in Taiwan. Women aged between 15 and 45 years who gave birth in Taiwan between 2004 and 2011 were included. Women who were enrolled and had a GDM diagnosis were assigned to the exposure group. Women who were enrolled without a GDM diagnosis were assigned to the comparison group. The relative risk of developing T2DM, aHTN, HL, and IRS-related diseases, including CVD, AMI, PAOD, NAFLD, and CKD, were analyzed and presented as hazard ratio (HR) through Cox regression and log-rank regression analyses. Results: A total of 1,180,477 women were identified through the BCA database between 2004 and 2011. Of those, 71,611 GDM-diagnosed women and 286,444 women without GDM were included in the final analysis. After adjusting for age, pre-existing cancer, and parity, developing T2DM, aHTN, and HL were still significantly increased in the GDM group (HR and interquartile range (IQR): 2.83 (2.59, 3.08), 1.09 (1.01, 1.06), and 1.29 (1.20, 1.38), accordingly). CVD, NAFLD, and CKD had a very low incidence and showed insignificant results. Conclusion: Our findings provide nationwide cohort data showing that GDM increased the risk of developing T2DM, aHTN, and HL 5 years after delivery within the same group. The GDM complications and risk of CVD, AMI, PAOD, NAFLD, and CKD need further investigation.
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Lin, Hugo, Yu-Han Chang, Yu-Tsang Wang, Peir-In Liang, Chi-Chih Hung, Jer-Ming Chang, Dao-Fu Dai, Chang-Shen Lin, and Kai-Ting Chang. "Thiazide and thiazide-like diuretics associated with improved cardiovascular and renal outcomes for chronic kidney disease patients." Annals of the Academy of Medicine, Singapore 52, no. 10 (October 30, 2023): 510–21. http://dx.doi.org/10.47102/annals-acadmedsg.v52n10p510.

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Taiwan Introduction: Hypervolemia is a prevalent comorbidity of chronic kidney disease (CKD) patients. Thiazide diuretics (THZ) are the most common treatment for volume overload and hypertension (HTN). This study examines the association between THZ usage and clinical outcomes among CKD patients in a nationwide cohort. Method: The total number of patients in the study was 24,312. After matching with one non-user randomly selected from the CKD population, we identified 8501 patients in the THZ and the comparison cohorts. Cox proportional hazards regression analysis was conducted to estimate the associations of THZ on the incidence of all-cause mortality, end-stage renal disease (ESRD), congestive heart failure (CHF), acute myocardial infarction (AMI), peripheral arterial occlusive disease (PAOD), and stroke. Results: The all-cause mortality rate was significantly lower in THZ users than in non-users (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.60–0.71). The THZ usage was associated with a lower incidence of ESRD, AMI, PAOD, and stroke (P<0.05). In subgroup analysis, some significant clinical outcomes were related with CKD stages 3 and 4 (P<0.05); however, there were no clinical associations in CKD stage 5. In further THZ subtype analysis, there were clinical associations with fewer deaths, ESRD, AMI, and PAOD accompanying chlorthalidone treatment. Moreover, the indapamide prescription was linked to lower mortality, ESRD, AMI, and PAOD prevalence. However, there were significantly greater incidences of ESRD, CHF, and AMI in the metolazone users. Conclusion: THZ usage is associated with lower mortality and incidence of ESRD, AMI, PAOD, and stroke s in patients with CKD stages 3 and 4.
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Fan, P. C., W. C. Chung, C. Y. Lin, and C. H. Chan. "Clinical manifestations of taeniasis in Taiwan aborigines." Journal of Helminthology 66, no. 2 (June 1992): 118–23. http://dx.doi.org/10.1017/s0022149x00012694.

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ABSTRACTFrom 1974 to 1989, a total of 24 500 aborigines at 67 villages in ten mountainous districts/towns in Taiwan were examined for the TaiwanTaeniainfection and 12% were found to be infected. In order to define the clinical manifestations of taeniasis caused by the TaiwanTaenia, 1661 aborigines in ten mountainous districts were surveyed. The overall clinical rate was 76%. The clinical rate was highest among Atayal aborigines (81%), followed by Bunun (66%) and Yami (61%) aborgines and lowest among Ami aborigines (40%). Among 1153 infected people, 10% had passed gravid segments in the faeces for less than 1 year, 24% for 1–3 years, 17% for 4–5 years. 23% for 6–10 years, 16% for 11–20 years, 7% for 21–30 years, and 3% over 30 years. Twenty-six occurrences of gastrointestinal and neurological symptoms were reported by 1258 infected persons. Passing proglottides in the faeces (95%) was the most frequent sign, followed by pruritis ani (77%), nausea (46%), abdominal pain (45%), dizziness (42%), increased appetite (30%), headache (26%). etc.
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Miyazaki, Hideo, Yoshiko Yamaguchi, and Tadamichi Takehara. "Dental arch and palate in Taiwan aboriginals—Ami, Bunun, Paiwan and Rukai tribes." Archives of Oral Biology 38, no. 9 (September 1993): 729–35. http://dx.doi.org/10.1016/0003-9969(93)90067-v.

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Chu, C. C., H. L. Lee, J. Trejaut, H. L. Chang, and M. Lin. "HLA-A, -B, -Cw and -DRB1 allele frequencies in an Ami population from Taiwan." Human Immunology 65, no. 9-10 (September 2004): 1102–7. http://dx.doi.org/10.1016/j.humimm.2004.08.134.

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Hsu, Hsin-Hui, Chew-Teng Kor, Yao-Peng Hsieh, and Ping-Fang Chiu. "Effects of Prevalent and Incident Atrial Fibrillation on Renal Outcome, Cardiovascular Events, and Mortality in Patients with Chronic Kidney Disease." Journal of Clinical Medicine 8, no. 9 (September 3, 2019): 1378. http://dx.doi.org/10.3390/jcm8091378.

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Background: Little is known about how incident atrial fibrillation (AF) affects the clinical outcomes in chronic kidney disease (CKD) patients and whether there is a different influence between pre-existing and incident AF. Methods: Incident CKD patients from 2000 to 2013 were retrieved from the National Health Insurance Research Database (NHIRD) of Taiwan and they were classified as non-AF (n = 15,251), prevalent AF (n = 612), and incident AF (n = 588). The outcomes of interest were end-stage renal disease (ESRD) requiring dialysis, all-cause mortality, cardiovascular (CV) mortality, acute myocardial infarction (AMI), stroke or systemic thromboembolism. Results: Compared with CKD patients without AF, those with prevalent or incident AF were associated with higher adjusted rates of ESRD (hazard ratio (HR), 1.40; 95% confidence interval (CI), 1.32–1.48; HR, 2.91; 95% CI, 2.74–3.09, respectively), stroke or systemic thromboembolism (HR, 1.89; 95% CI, 1.77–2.03; HR, 1.67; 95% CI, 1.54–1.81, respectively), AMI (HR, 1.24; 95% CI, 1.09–1.41; HR, 1.99; 95% CI, 1.75–2.27, respectively), all-cause mortality (HR, 1.64; 95% CI, 1.56–1.72; HR, 2.17; 95% CI, 2.06–2.29, respectively), and CV mortality (HR, 2.95; 95% CI, 2.62–3.32; HR, 4.61; 95% CI, 4.09–5.20, respectively). Intriguingly, CKD patients with prevalent AF were associated with lower adjusted rates of ESRD, AMI, all-cause mortality, and CV mortality compared with those with incident AF. Conclusion: Both incident and prevalent AF were independently associated with greater risks of AMI, all-cause mortality, CV mortality, ESRD, and stroke or systemic thromboembolism. Our findings are novel in that, compared with prevalent AF, incident AF possessed an even higher risk of some clinical consequences, including ESRD, all-cause mortality, CV mortality, and AMI.
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Tsai, Pei-Fang (Jennifer), Po-Chia Chen, Yen-You Chen, Hao-Yuan Song, Hsiu-Mei Lin, Fu-Man Lin, and Qiou-Pieng Huang. "Length of Hospital Stay Prediction at the Admission Stage for Cardiology Patients Using Artificial Neural Network." Journal of Healthcare Engineering 2016 (2016): 1–11. http://dx.doi.org/10.1155/2016/7035463.

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For hospitals’ admission management, the ability to predict length of stay (LOS) as early as in the preadmission stage might be helpful to monitor the quality of inpatient care. This study is to develop artificial neural network (ANN) models to predict LOS for inpatients with one of the three primary diagnoses: coronary atherosclerosis (CAS), heart failure (HF), and acute myocardial infarction (AMI) in a cardiovascular unit in a Christian hospital in Taipei, Taiwan. A total of 2,377 cardiology patients discharged between October 1, 2010, and December 31, 2011, were analyzed. Using ANN or linear regression model was able to predict correctly for 88.07% to 89.95% CAS patients at the predischarge stage and for 88.31% to 91.53% at the preadmission stage. For AMI or HF patients, the accuracy ranged from 64.12% to 66.78% at the predischarge stage and 63.69% to 67.47% at the preadmission stage when a tolerance of 2 days was allowed.
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Chen, Chih-Wei, Chun-Wei Chang, Yi-Cheng Lin, Wan-Ting Chen, Li-Nien Chien, and Chun-Yao Huang. "Comparison of clinical outcomes of angiotensin receptor blockers with angiotensin-converting enzyme inhibitors in patients with acute myocardial infarction." PLOS ONE 18, no. 9 (September 14, 2023): e0290251. http://dx.doi.org/10.1371/journal.pone.0290251.

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Background Angiotensin receptor blockers (ARBs) are considered an alternative to angiotensin-converting enzyme inhibitors (ACEIs) in patients with acute myocardial infarction (AMI), but in the era of extensive use of preventive therapies and percutaneous coronary intervention, this has not been adequately evaluated in Asians. Methods This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. In total, 52,620 patients initially hospitalized due to AMI between 2002 and 2015 were assessed. Results After propensity score matching, 14,993 patients each were assigned to ACEI and ARB groups. Patients who received ARBs had significantly lower all-cause mortality (adjusted hazard ratio [aHR]: 0.82; 95% confidence interval [CI]: 0.75–0.90) and hospitalization for heart failure (aHR: 0.92; 95% CI: 0.85–0.99) compared with those who received ACEIs at 18 month follow-up. No significant difference was observed between the two groups in terms of major adverse cardiovascular events (aHR: 098; 95% CI: 0.90–1.07), cardiovascular death (aHR: 0.82; 95% CI: 0.68–1.00), ischemia stroke (aHR: 0.93; 95% CI: 0.77–1.11), and nonfatal myocardial infarction (aHR: 1.04; 95% CI: 0.93–1.17). ARBs showed benefits in many subgroups in terms of all-cause mortality and cardiovascular death. Conclusions Real-world data demonstrate that ARBs might be associated with lower all-cause mortality and hospitalization for heart failure compared with ACEIs among patients with AMI.
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Miyazaki, H., and T. Takehara. "Prevalence of dental caries in Taiwan Aboriginal children - Bunun, Paiwan, Rukai, Ami, and Yami Tribes." Australian Dental Journal 33, no. 3 (June 1988): 226–30. http://dx.doi.org/10.1111/j.1834-7819.1988.tb01319.x.

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Yang, Nien-Che, Yan-Lin Zeng, and Tsai-Hsiang Chen. "Assessment of Voltage Imbalance Improvement and Power Loss Reduction in Residential Distribution Systems in Taiwan." Mathematics 9, no. 24 (December 15, 2021): 3254. http://dx.doi.org/10.3390/math9243254.

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In this study, the non-dominated sorting genetic algorithm II (NSGA-II) is used to optimize the annual phase arrangement of distribution transformers connected to primary feeders to improve three-phase imbalance and reduce power loss. Based on the data of advanced metering infrastructure (AMI), a quasi-real-time ZIP load model and typical sample distribution systems in Taiwan are constructed. The equivalent circuit models and solution algorithms for typical distribution systems in Taiwan are built using the commercial software package MATLAB. A series of simulations, analyses, comparisons, and explorations is executed. Finally, the quantitative evaluation results for improving the voltage imbalance and reducing the power loss are summarized. For the series of studies, the percentage reductions in (1) total power imbalance TSI, (2) total line loss TLL, (3) average voltage drop AVD, (4) total voltage imbalance factors for zero/negative sequences Td0/Td2, and (5) neutral current of the main transformer ILCO are up to 45.48%, 4.06%, 16.61%, 63.99%, 21.33%, and 88.01%, respectively. The results obtained in this study can be applied for energy saving and can aid the authorities to implement sustainable development policies in Taiwan.
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Cheng, Tai Ann, and Mutsu Hsu. "Sex differences in minor psychiatric morbidity among three aboriginal groups in Taiwan: the effects of lineage." Psychological Medicine 23, no. 4 (November 1993): 949–56. http://dx.doi.org/10.1017/s0033291700026416.

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SynopsisSex differences in minor psychiatric morbidity (MPM) have been investigated among three aboriginal groups in Taiwan. The study included both ethnographic observation and a sample survey (N = 733) using a modified Clinical Interview Schedule. The findings lend support to the hypothesis that although a female excess of MPM will be found among the patrilineal group (the Bunun), the reverse will be observed in the matrilineal group (the Ami); no such difference will be found in the bilateral group (the Atayal). Further analysis revealed sex differences in the mean duration of MPM and similar incidence ratios between two sexes in these three groups. Possible sociocultural explanations are proposed.
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Chen, Wan-Lin, Hon-Ping Ma, Chih-Hsiung Wu, Hung-Yi Chiou, Yun Yen, Wen-Ta Chiu, and Shin-Han Tsai. "Clinical Research of Mortality in Emergency Air Medical Transport." BioMed Research International 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/767402.

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Introduction.EAMT in Taiwan has experienced increasing demand in the past few years. The objective is to analyze the trend of EAMT in the past six years and mortality rate within three days of patients undergoing interfacility transport in Taiwan.Material and Method.We conducted a retrospective review of patients who were airlifted from remote islands to main island between 2006 and 2011. Main outcome measures are EAMT number (EAMT-N), EAMT per thousand population (EAMT frequency, EAMT-F), number of mortality (Mor-N), and mortality rate within three days after EAMT (Mor-R).Results and Discussion.Overall mortality rate is 7.54% in 1684 airlifted patients. Acute myocardial infarction (AMI, 26.3%) and traumatic brain injury (TBI, 25.8%) comprise the majority in diagnosis (52.1%). However, Mor-Rin these two categories is significantly low in AMI (3.5%) and TBI (5.1%).Conclusion.The present study demonstrates that physician density is not related to EAMT-Nbut to physician number. As general population ages (10%), the average age of patient who underwent EAMT doubled (21%). This study also leaves room for discussion regarding futile medical care. The results can be used as a reference for increasing utilization of EAMT in current National Health Care Scheme.
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Tätte, Kai, Ene Metspalu, Helen Post, Leire Palencia-Madrid, Javier Rodríguez Luis, Maere Reidla, Anneliis Rea, et al. "The Ami and Yami aborigines of Taiwan and their genetic relationship to East Asian and Pacific populations." European Journal of Human Genetics 29, no. 7 (March 23, 2021): 1092–102. http://dx.doi.org/10.1038/s41431-021-00837-6.

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Ma, Jen-Wen, Sung-Yuan Hu, Ming-Shun Hsieh, Yi-Chen Lee, Shih-Che Huang, Kuan-Ju Chen, Yan-Zin Chang, and Yi-Chun Tsai. "PEAL Score to Predict the Mortality Risk of Cardiogenic Shock in the Emergency Department: An Observational Study." Journal of Personalized Medicine 13, no. 11 (November 16, 2023): 1614. http://dx.doi.org/10.3390/jpm13111614.

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Background: The in-hospital mortality of cardiogenic shock (CS) remains high (28% to 45%). As a result, several studies developed prediction models to assess the mortality risk and provide guidance on treatment, including CardShock and IABP-SHOCK II scores, which performed modestly in external validation studies, reflecting the heterogeneity of the CS populations. Few articles established predictive scores of CS based on Asian people with a higher burden of comorbidities than Caucasians. We aimed to describe the clinical characteristics of a contemporary Asian population with CS, identify risk factors, and develop a predictive scoring model. Methods: A retrospective observational study was conducted between 2014 and 2019 to collect the patients who presented with all-cause CS in the emergency department of a single medical center in Taiwan. We divided patients into subgroups of CS related to acute myocardial infarction (AMI-CS) or heart failure (HF-CS). The outcome was all-cause 30-day mortality. We built the prediction model based on the hazard ratio of significant variables, and the cutoff point of each predictor was determined using the Youden index. We also assessed the discrimination ability of the risk score using the area under a receiver operating characteristic curve. Results: We enrolled 225 patients with CS. One hundred and seven patients (47.6%) were due to AMI-CS, and ninety-eight patients among them received reperfusion therapy. Forty-nine patients (21.8%) eventually died within 30 days. Fifty-three patients (23.55%) presented with platelet counts < 155 × 103/μL, which were negatively associated with a 30-day mortality of CS in the restrictive cubic spline plot, even within the normal range of platelet counts. We identified four predictors: platelet counts < 200 × 103/μL (HR 2.574, 95% CI 1.379–4.805, p = 0.003), left ventricular ejection fraction (LVEF) < 40% (HR 2.613, 95% CI 1.020–6.692, p = 0.045), age > 71 years (HR 2.452, 95% CI 1.327–4.531, p = 0.004), and lactate > 2.7 mmol/L (HR 1.967, 95% CI 1.069–3.620, p = 0.030). The risk score ended with a maximum of 5 points and showed an AUC (95% CI) of 0.774 (0.705–0.843) for all patients, 0.781 (0.678–0.883), and 0.759 (0.662–0.855) for AMI-CS and HF-CS sub-groups, respectively, all p < 0.001. Conclusions: Based on four parameters, platelet counts, LVEF, age, and lactate (PEAL), this model showed a good predictive performance for all-cause mortality at 30 days in the all patients, AMI-CS, and HF-CS subgroups. The restrictive cubic spline plot showed a significantly negative correlation between initial platelet counts and 30-day mortality risk in the AMI-CS and HF-CS subgroups.
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Chimed, Surenjav, and Batmyagmar Khuyag. "Prognostic Relevance of Intra-aortic Balloon Pump in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock: Nationwide Population Study in Taiwan." Central Asian Journal of Medical Sciences 2, no. 1 (June 25, 2016): 69–75. http://dx.doi.org/10.24079/cajms.2016.01.011.

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Objectives: Intra-aortic balloon pump (IABP) is the most widely-used form of mechanical hemodynamic support in patients with cardiogenic shock. However, usefulness of IABP in the high-risk patient population is conflicting. We examined whether the patient prognosis in Taiwan forthose treated with IABP has improved in recent years. Methods: We used Taiwan's National Health Insurance Research Database to retrospectively review 3145 (2358 men, 75% of cases) cardiogenic shock patients who were treated with primary percutaneous coronary intervention (PCI) due to acute myocardial infarction (AMI) between 2000 and 2012. The primary outcome was all-cause mortality and secondary outcome was heart failure. Results: A total of 1417 patients who received IABP therapy and 1728 patients who did not receive non-IABP were selected in this study. During the follow-up period, the adjusted hazard ratio for overall mortality was 1.22 (Cl 95%: 1.10-1.35, p<0.0001) and for overall heart failure was 1.24 (Cl 95%: 1.08-1.41, p <0.001). Risk factors for all-cause mortality were previous heart failure, diabetes, chronic kidney disease and hypertension. Conclusion: In this nationwide, population-based, retrospective cohort study in Taiwan, we found that mortality rate and heart failure rate did not decline in cardiogenic shock patients who underwent primary PCI plus IABP therapy.
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Lee, Chien-Hsing, Phuong Nguyen Thanh, Chao-Tsung Yeh, and Ming-Yuan Cho. "Three-Phase Load Prediction-Based Hybrid Convolution Neural Network Combined Bidirectional Long Short-Term Memory in Solar Power Plant." International Transactions on Electrical Energy Systems 2022 (September 16, 2022): 1–15. http://dx.doi.org/10.1155/2022/2870668.

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The economic renewable energy generations have been rapidly developed because of the sharp reduction in the costs of solar panels. It is imperative to forecast the three-phase load power for more effective energy planning and optimization in a smart solar microgrid installed on a building in the Linyuan District, Taiwan. To alleviate this problem, this article proposes a convolution neural network bidirectional long short-term memory (CNN-Bi-LSTM) to accurately predict the short-term three-phase load power in building the energy management system in the smart solar microgrid with the collected data from advanced metering infrastructure (AMI), which have not been investigated before. The three-phase load-predicting methodology is developed using weather parameters and different collected data from AMI. The project evaluates the performance of the CNN-Bi-LSTM model by utilizing hyper-parameter optimization to attain the optimum parameters. The prediction models are trained based on hourly historical input features, selected based on the Pearson correlation coefficient. The performances’ optimal structure CNN-Bi-LSTM are validated and compared with the bidirectional LSTM (Bi-LSTM), LSTM, the Gated Recurrent Unit (GRU), and the recurrent neural network (RNN) models. The obtained optimized structure of CNN-Bi-LSTM demonstrates the effectiveness of the proposed models in the short-term prediction of three-phase load power in a smart solar microgrid for building with a maximum enhancement of 68.36% and 8.81% average MSE, and 30.26% and 36.36% average MAE during the testing and validating operations.
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Wu, Li-Kung, Chung-Shan Hung, Yen-Lun Kung, Zhong-Kui Chen, Shinn-Zong Lin, Jaung-Geng Lin, and Tsung-Jung Ho. "Efficacy of Acupuncture Treatment for Incidence of Poststroke Comorbidities: A Systematic Review and Meta-Analysis of Nationalized Cohort Studies." Evidence-Based Complementary and Alternative Medicine 2022 (February 1, 2022): 1–12. http://dx.doi.org/10.1155/2022/3919866.

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Acupuncture has been applied as a complementary therapy in stroke survivors worldwide and approved to be beneficial to stroke recovery. However, there is little medical evidence regarding the association between acupuncture and the risk of poststroke comorbidities. We reviewed big data studies from the Taiwan National Health Insurance Research Database to investigate the risk of poststroke comorbidities after acupuncture treatment in a real-world situation. Ten English (PubMed, Embase, Medline, Cochrane, Alt HealthWatch, CINAHL, Health Source, PsycINFO, PsycARTICLES, and Psychology and Behavioral Sciences Collection) and two Chinese (AiritiLibray and Visualizing Health Data) electronic databases were searched from inception until December 2020 for nationalized cohort studies comparing the effects of acupuncture treatment with a nonacupuncture control group among stroke patients. Eight nationalized cohort studies were included. Six of eight studies showed a moderate overall risk of bias, while two studies showed a serious overall risk of bias. Included studies have investigated the effect of acupuncture in reducing the risk of seven medical conditions after stroke, including stroke recurrence, new-onset acute myocardial infarction (AMI), pneumonia, dementia, epilepsy, urinary tract infection (UTI), and depression. The meta-analysis showed clinically significant reductions in the risk of poststroke comorbidities in the acupuncture group compared to the nonacupuncture group (HR, 0.776; 95% CI, 0.719–0.838; p < 0.0001 ). In this systematic review and meta-analysis of nationalized cohort studies, acupuncture showed clinically relevant benefits in reducing the incidence of poststroke comorbidities, such as stroke recurrence, new-onset acute myocardial infarction (AMI), pneumonia, dementia, epilepsy, and UTI.
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Wei, Kai-Che, Cheng-Len Sy, Wen-Hwa Wang, Chia-Ling Wu, Shang-Hung Chang, and Yu-Tung Huang. "Major acute cardiovascular events after dengue infection–A population-based observational study." PLOS Neglected Tropical Diseases 16, no. 2 (February 7, 2022): e0010134. http://dx.doi.org/10.1371/journal.pntd.0010134.

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Background Dengue virus (DENV) infection may be associated with increased risks of major adverse cardiovascular effect (MACE), but a large-scale study evaluating the association between DENV infection and MACEs is still lacking. Methods and findings All laboratory confirmed dengue cases in Taiwan during 2009 and 2015 were included by CDC notifiable database. The self-controlled case-series design was used to evaluate the association between DENV infection and MACE (including acute myocardial infarction [AMI], heart failure and stroke). The "risk interval" was defined as the first 7 days after the diagnosis of DENV infection and the "control interval" as 1 year before and 1 year after the risk interval. The incidence rate ratio (IRR) and 95% confidence interval (CI) for MACE were estimated by conditional Poisson regression. Finally, the primary outcome of the incidence of MACEs within one year of dengue was observed in 1,247 patients. The IRR of MACEs was 17.9 (95% CI 15.80–20.37) during the first week after the onset of DENV infection observed from 1,244 eligible patients. IRR were significantly higher for hemorrhagic stroke (10.9, 95% CI 6.80–17.49), ischemic stroke (15.56, 95% CI 12.44–19.47), AMI (13.53, 95% CI 10.13–18.06), and heart failure (27.24, 95% CI 22.67–32.73). No increased IRR was observed after day 14. Conclusions The risks for MACEs are significantly higher in the immediate time period after dengue infection. Since dengue infection is potentially preventable by early recognition and vaccination, the dengue-associated MACE should be taken into consideration when making public health management policies.
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Feuchtwang, Stephan. "Religion in Modern Taiwan: Tradition and Innovation in a Changing Society. Edited by Philip Clart and Charles B. Jones. [Honolulu: University of Hawai‘i Press, 2003. x+333 pp. $49.00. ISBN 0-8248-2564-0.]." China Quarterly 179 (September 2004): 833–35. http://dx.doi.org/10.1017/s0305741004350605.

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Religion is profuse in Taiwan, and this is reflected in publications. In the last chapter of this collection, Randall Nadeau and Chang Hsun point out that Taiwanese academic publications on religion in Taiwan have increased hugely in the last two decades. Taiwanese anthropologists have probably been most prominent in this study. But this book contains only one chapter by an anthropologist writing as such. He is Huang Shiu-wey. Typical of an old anthropological habit, now that Chinese, according to Nadeau and Chang, are more studied than aboriginal inhabitants (yuanzhumin) by Taiwanese anthropologists, Huang's chapter is on the Ami. It stands awkwardly among the others, which are by historians and teachers in religious studies departments, with its use of anthropological concepts of culture and identity and its concentration on ritual and avoidance of a discrete concept of religion. One other chapter is about “religious culture.” It is by Julian Pas, the justly renowned editor of the Journal of Chinese Religions, who died before he could polish his chapter. The book is dedicated to him. But honouring his efforts to enrich the study of religion in China and Taiwan and sympathy for his state of health at the time will not prevent a reader from noticing how short and thin his chapter is, precisely because he misses so much that anthropologists have written. The book as a whole shares this failing. The introduction does not make the conceptual and informative links to provide a social analysis of the remarkable cultural and religious changes that each chapter describes within its own narrow remit. The editors simply state that religion is dynamic, that modernization includes the fact that traditions change, and that the aim of the book is to chart those changes. They introduce each chapter without linking it to the others.
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Wang, Kuang-Te, Chun-Yen Chen, Charles Jia-Yin Hou, Cheng-Ho Tsai, and Hung-I. Yeh. "O9-05 Comparison of clinical characteristics of acute myocardial infarction (AMI) in aborigines and non-aborigines in Taitung area of Taiwan." International Journal of Cardiology 97 (January 2004): S35. http://dx.doi.org/10.1016/s0167-5273(04)80116-5.

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LEE, C. S., J. C. CHANG, and A. T. A. CHENG. "Acculturation and suicide: a case–control psychological autopsy study." Psychological Medicine 32, no. 1 (January 2002): 133–41. http://dx.doi.org/10.1017/s0033291701004895.

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Background. The relationships between acculturation and suicide were investigated in East Taiwan.Methods. Psychological autopsy interviews were conducted for consecutive suicides from two native Taiwanese groups (Atayal and Ami) (N = 30 for each group); each of them was matched with two controls for age, sex and area of residence. The Taiwan Aboriginal Acculturation Scale was used to measure the extent of acculturation.Results. A lower degree of social assimilation was significantly associated with a higher risk of suicide in the Atayal and the male groups. In multivariable regression analysis, a significant effect of low social assimilation on the risk of suicide was found in Atayal and in men, even after controlling for the effects of ICD-10 depressive episode and emotionally unstable personality disorder. Meanwhile, there was a significant trend across low, moderate and high social assimilation on suicide risk in Atayal and in men.Conclusions. For the native Taiwanese, the stress from rapid acculturation into the main Chinese society is crucial to their mental health. It might be reduced through targeted social and educational programmes.
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Huang, Nicole, Yiing-Jenq Chou, Hsiao-Yun Hu, and Cheng-Hua Lee. "Gender disparities in AMI management and outcomes among health professionals, their relatives, and non-health professionals in Taiwan from 1997 to 2007." Social Science & Medicine 77 (January 2013): 70–74. http://dx.doi.org/10.1016/j.socscimed.2012.11.006.

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Liu, I. C., S. F. Liao, W. C. Lee, C. Y. Kao, R. Jenkins, and A. T. A. Cheng. "A cross-ethnic comparison on incidence of suicide." Psychological Medicine 41, no. 6 (September 22, 2010): 1213–21. http://dx.doi.org/10.1017/s0033291710001807.

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BackgroundSuicide rates vary widely across nations and ethnic groups. This study aims to explore potential factors contributing to inter-ethnic differences in suicide rates.MethodStudy subjects came from a case-control psychological autopsy study conducted in Taiwan, including 116 consecutive suicides from two aboriginal groups and Taiwanese Han; 113 of them each matched with two living controls. Gender-, age- and method-specific suicide rates, population attributable fraction (PAF) of suicide for five major risk factors, help-seeking before suicide and emergency medical aid after suicide were compared between the three ethnic groups.ResultsOne aboriginal group (the Atayal) had significantly higher adjusted rate ratios (RR) of suicide than the other aboriginal group (the Ami) [RR 0.20, 95% confidence intervals (CI) 0.12–0.34] and the Han (RR 0.26, 95% CI 0.16–0.40). Such differences can be explained by higher PAFs of suicide for three major risk factors (substance dependence, PAF 47.6%, 95% CI 25.5–64.2; emotionally unstable personality disorder, PAF 52.7%, 95% CI 32.8–69.0; family history of suicidal behaviour, PAF 43.5%, 95% CI 23.2–60.2) in this group than in the other two groups. This higher suicide rate was substantially reduced from 68.2/100 000 per year to 9.1/100 000 per year, comparable with the other two groups, after stepwise removal of the effects of these three risk factors. Suicide rates by self-poisoning were also significantly higher in this group than in the other two groups.ConclusionsHigher rates of specific risk factors and use of highly lethal pesticides for suicide contributed to the higher suicide rate in one ethnic group in Taiwan. These findings have implications for developing ethnicity-relevant suicide prevention strategies.
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Mirabal, Sheyla, Kristian J. Herrera, Tenzin Gayden, Maria Regueiro, Peter A. Underhill, Ralph L. Garcia-Bertrand, and Rene J. Herrera. "Increased Y-chromosome resolution of haplogroup O suggests genetic ties between the Ami aborigines of Taiwan and the Polynesian Islands of Samoa and Tonga." Gene 492, no. 2 (January 2012): 339–48. http://dx.doi.org/10.1016/j.gene.2011.10.042.

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Zadora, Anna. "Revue des livres A.A. Tikhomirov, « Lučšij drug nemeckogo Naroda » : Kul’t Stalina v Vostočnoj Germanii (1945-1961) [Le meilleur ami du peuple allemand: le culte de Staline en Allemagne de l’Est], Moskva : ROSSPEN, 2014." Revue d’études comparatives Est-Ouest 46, no. 01 (March 2015): 229–35. http://dx.doi.org/10.4074/s0338059915001126.

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Lee, Tsong-Hai, Yu-Sheng Lin, Chia-Wei Liou, Jiann-Der Lee, Tsung-I. Peng, and Chi-Hung Liu. "Comparison of long-term efficacy and safety between cilostazol and clopidogrel in chronic ischemic stroke: a nationwide cohort study." Therapeutic Advances in Chronic Disease 11 (January 2020): 204062232093641. http://dx.doi.org/10.1177/2040622320936418.

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Background: Previous clinical trials showed a significant difference in efficacy and safety among antiplatelets in acute ischemic stroke (IS). The present study wished to compare the efficacy and safety head-to-head between cilostazol and clopidogrel in chronic IS. Methods: This open prospective cohort study recruited chronic IS patients with an index hospitalization between 2001 and 2013 from Taiwan National Health Insurance Research Database. In the 504,191 hospitalized patients, patients who had missing information and history of atrial fibrillation or rheumatic heart disease, received mechanical valve replacement or anticoagulants, expired during the index hospitalization, received follow-up ⩽6 months, or had recurrent stroke within 6 months after index stroke were excluded. Results: Among the 15,968 eligible patients, 502 patients who consistently received either cilostazol or clopidogrel from the 7th month after the index stroke were included for analysis after propensity score matching. The 3-year primary outcomes showed similar frequency of recurrent IS, all-cause mortality, and acute myocardial infarction (AMI), and similar frequency of intracerebral hemorrhage, gastrointestinal bleeding, and major bleeding between the cilostazol and clopidogrel groups. Subgroup analysis revealed that patients with a history of hypertension or gastrointestinal bleeding had a trend of having lower frequency of recurrent IS or major bleeding, respectively, in the cilostazol group. Conclusion: The present real-world study demonstrated no significant difference in efficacy and safety between cilostazol and clopidogrel in chronic IS. However, cilostazol might be better than clopidogrel in patients with a history of hypertension or gastrointestinal bleeding.
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Che Kamarludin, Siti Norsyarahah, Sandra Ubong, Nadzeerah Idris, Intan Suhada Azmi, Muhammad Syafiq Jainal, Rafidah Jalil, Wan Siti Atikah Wan Omar, Tengku Elida Tengku Zainal Mulok, Nor Sharliza Mohd Safaai, and Amizon Azizan. "Imidazolium-Based Ionic Liquid Dissolution Influence on Crystallinity of Oil Palm Frond, Oil Palm Trunk and Elephant Grass Lignocellulosic Biomass." Advanced Materials Research 911 (March 2014): 307–13. http://dx.doi.org/10.4028/www.scientific.net/amr.911.307.

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Ionic liquid (IL) has been shown to affect cellulose crystalline structure in lignocellulosic biomass (LB) during pretreatment. This research was carried out with two different experimental design involving IL to observe the effect of dissolution in IL on: (A) the crystallinity of cellulose and (B) the dissolution efficiency of LB. For experiment A, the types of IL used in this research were 1-ethyl-3-methylimidazolium Acetate [EMI[A, 1-allyl-3-methylimidazolium Chloride [AMI[C, 1-butyl-3-methylimidazolium Chloride [BMI[C and 1-ethyl-3-methylimidazolium Chloride [EMI[C. The crystallinity degree of LB was investigated before and after pretreatment with IL. The microcrystalline cellulose (MCC) was used as the simulated LB (cellulose content) was dissolved in IL and the crystallinity after the dissolution was analyzed. The temperature (70°C, 80°C, 90°C, 99°C) and concentration ratio of IL with volume/volume (v/v: 10%, 25%, 50%) were varied while the dissolution time remained constant. The crystallinity was analyzed by using Fourier Transform Infrared Spectroscopy (FTIR). The results showed that the dissolution temperature and IL concentration ratio affects the intensity of the FTIR peaks. In experiment B, the dissolution of LB with 1-butyl-3-methylimidazolium Chloride [BMI[C and 1-Ethyl-3-methylimidazolium Chloride [EMI[C as ILs were investigated. Four types of LB involved were Elaeis guineensis species of Oil Palm Trunk (OPT) and Oil Palm Frond (OPF) and Pennisetum purpureum species (elephant grass) originated from Taiwan and India. From the results obtained, the [BMI[C gave better dissolution to biomass.
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Zakharova, Larissa. "ALEXEI TIKHOMIROV, « Лучший друг немецкого народа » : культ Сталина в Восточной Германии (1945-1961 гг.) [ « Le meilleur ami du peuple allemand ». Le culte de Staline en Allemagne de l’Est (1945-1961)], Moscou, ROSSPEN, 2014, 310 p., ISBN 978-5-8243-1861-6." Revue d’histoire moderne & contemporaine 65-2, no. 2 (2018): 211. http://dx.doi.org/10.3917/rhmc.652.0211.

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Rudolph, Michael. "Authenticating Performances." Archiv orientální 83, no. 2 (September 15, 2015): 343–74. http://dx.doi.org/10.47979/aror.j.83.2.343-374.

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Adherents of performance theory emphasise the constitutive and transformative potentia of rituals with respect to patterns of social organization and authority. For them, rituals “not only mean something, but also do something, particularly the way they construct and inscribe power relationships” (Bell 1997). This contribution focuses on the role of ritual in postcolonial identity constitution and the performative authentication of political power and social authority in Taiwan. Since the middle of the 1990s, traditionalist performances have been on the rise on the island. Generously subsidised by government bodies which have sought to demonstrate their nativist or multiculturalist orientations, aboriginal elites not only publicly worshipped ancestor gods and enacted animal sacrifices in so called “revitalised” public rituals, but also used these occasions to point to the primordial power of aborigines vis-à-vis their former colonisers, the Han Chinese. In many cases, however, the “revitalised” rituals described here conflicted with the interests of common people in aboriginal society, who wished public ritual to be compatible with their newly adopted Christian traditions. Taking a closer look at the contemporary rituals of the Taroko and Ami, which are characterised by the above mentioned dynamics, I argue that rituals publicly performed by aborigines today amalgamate different levels of meaning. While they articulate and negotiate the identity needs and social exigency of the respective social group or society (Turner 1969), they simultaneously carry those often elite-dominated mechanisms that are described by Hobsbawm and Ranger (1983) in their examinations of the processes of cultural invention for the needs of political and cultural entities, as well as by Paul Brass (1991) in his analyses of elite competition. In other words, while these rituals may in many cases have efficacy with regard to the constitution of society and identity, the traditionalist rituals in particular frequently serve the authentication exigencies of various elites. Finally, I suggest that if one wants to provide the culture of common people with greater opportunities for representation, one should not focus too much on the display of “authentic” old traditions in order to highlight Taiwanese subjectivity, but should also acknowledge those hybridised new traditions which aboriginal society has generated over the course of Taiwan’s more recent history and which may also contain new religious elements.
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43

Tung, Chueh-Chen, Yu-Shih Lin, Jian-Xiang Liao, Tzu-Hsuan Tu, James T. Liu, Li-Hung Lin, Pei-Ling Wang, and Chih-Lin Wei. "Contrasting carbon cycling in the benthic food webs between a river-fed, high-energy canyon and an upper continental slope." Biogeosciences 21, no. 7 (April 9, 2024): 1729–56. http://dx.doi.org/10.5194/bg-21-1729-2024.

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Abstract. The Gaoping Submarine Canyon (GPSC) off southwest Taiwan has been extensively studied due to its unique geology, its role in transferring terrestrial material to the deep sea, and its diverse biological communities. However, there is a lack of understanding of carbon cycling across the sediment–water interface in the canyon. This study aims to fill the gap by utilizing the field data collected between 2014 and 2020 and a linear inverse model (LIM) to reconstruct the benthic food web (i.e., carbon flows through different stocks) in the head of GPSC and the upper Gaoping slope (GS). The biotic and abiotic organic carbon (OC) stocks were significantly higher on the slope than in the canyon, except for the bacteria stock. The sediment oxygen utilization was similar between the two habitats, but the magnitude and distribution of the OC flow in the food web were distinctively different. Despite a significant input flux of ∼ 2020 mg C m−2 d−1 in the canyon, 84 % of the carbon flux exited the system, while 12 % was buried. On the slope, 84 % of the OC input (∼ 109 mg C m−2 d−1) was buried, and only 7 % exited the system. Bacteria processes play a major role in the carbon fluxes within the canyon. In contrast, the food web in the upper slope exhibited stronger interactions among metazoans, indicated by higher fluxes between meiofauna and macrofauna compartments. Network indices based on the LIM outputs showed that the canyon head had higher total system throughput (T..) and total system throughflow (TST), indicating greater energy flowing through the system. In contrast, the slope had a significantly higher Finn cycling index (FCI), average mutual information (AMI), and longer OC turnover time, suggesting a relatively more stable ecosystem with higher energy recycling. Due to sampling limitations, the present study only represents the benthic food web during the “dry” period. By integrating the field data into a food web model, this study provides valuable insight into the fates of OC cycling in an active submarine canyon, focusing on the often overlooked benthic communities. Future studies should include “wet” period sampling to reveal the effects of typhoons and monsoon rainfalls on OC cycling.
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Li, Chen-Yu, Po-Jui Wu, Chi-Jen Chang, Chien-Ho Lee, Wen-Jung Chung, Tien-Yu Chen, Chien-Hao Tseng, Chia-Chen Wu, and Cheng-I. Cheng. "Weather Impact on Acute Myocardial Infarction Hospital Admissions With a New Model for Prediction: A Nationwide Study." Frontiers in Cardiovascular Medicine 8 (December 14, 2021). http://dx.doi.org/10.3389/fcvm.2021.725419.

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Introduction: Cardiovascular disease is one of the leading causes of mortality worldwide. Acute myocardial infarction (AMI) is associated with weather change. The study aimed to investigate if weather change was among the risk factors of coronary artery disease to influence AMI occurrence in Taiwan and to generate a model to predict the probabilities of AMI in specific weather and clinical conditions.Method: This observational study utilized the National Health Insurance Research Database and daily weather reports from Taiwan Central Weather Bureau to evaluate the discharge records of patients diagnosed with AMI from various hospitals in Taiwan between January 1, 2008 and December 31, 2011. Generalized additive models (GAMs) were used to estimate the effective parameters on the trend of the AMI incidence rate with respect to the weather and health factors in the time-series data and to build a model for predicting AMI probabilities.Results: A total of 40,328 discharges were listed. The minimum temperature, maximum wind speed, and antiplatelet therapy were negatively related to the daily AMI incidence; however, a drop of 1° when the air temperature was below 15°C was associated with an increase of 1.6% of AMI incidence. By using the meaningful parameters including medical and weather factors, an estimated GAM was built. The model showed an adequate correlation in both internal and external validation.Conclusion: An increase in AMI occurrence in colder weather has been evidenced in the study, but the influence of wind speed remains uncertain. Our analysis demonstrated that the novel GAM model can predict daily onset rates of AMI in specific weather conditions.
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Liu, Sheng-Fu, Chao-Lun Lai, Raymond Nien-Chen Kuo, Ting-Chuan Wang, Ting-Tse Lin, and K. Arnold Chan. "Mortality among acute myocardial infarction patients admitted to hospitals on weekends as compared with weekdays in Taiwan." Scientific Reports 13, no. 1 (February 9, 2023). http://dx.doi.org/10.1038/s41598-022-25415-8.

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AbstractWeekend effect has been considered to be associated with poorer quality of care and patient’s survival. For acute myocardial infarction (AMI) patients, the question of whether patients admitted during off-hours have worse outcomes as compared with patients admitted during on-hours is still inconclusive. We conducted this study to explore the weekend effect in AMI patients, using a nationwide insurance database in Taiwan. Using Taiwan National Health Insurance (NHI) claims database, we designed a retrospective cohort study, and extracted 184,769 incident cases of AMI through the NHI claims database between January 2006 and December 2014. We divided the patients into weekend admission group and weekday admission group. Patients were stratified as ST elevation/non-ST elevation AMI and receiving/not receiving percutaneous coronary intervention (PCI). We used a logistic regression model to examine the relative risk of in-hospital mortality and 1-year mortality which were obtained from the Taiwan National Death Registry between study groups. We found no difference between weekend group and weekday group for risk of in-hospital mortality (15.8% vs 16.2%, standardized difference 0.0118) and risk of 1-year mortality (30.2% vs 30.9%, standardized difference 0.0164). There was no statistically significant difference among all the comparisons through the multivariate logistic regression analysis adjusting for all the covariates and stratifying by the subtypes of AMI and whether or not executing PCI during hospitalization. As for AMI patients in Taiwan, admission on weekends or weekdays did not have a significant impact on either in-hospital mortality or 1-year cumulative mortality.
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Chien, Shih-Chieh, Chien-Yi Hsu, Hung-Yi Liu, Chao-Feng Lin, Chung-Lieh Hung, Chun-Yao Huang, and Li-Nien Chien. "Cardiogenic shock in Taiwan from 2003 to 2017 (CSiT-15 study)." Critical Care 25, no. 1 (November 18, 2021). http://dx.doi.org/10.1186/s13054-021-03820-1.

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Abstract Background This study investigated temporal trends in the treatment and mortality of patients with cardiogenic shock (CS) in Taiwan in relation to acute myocardial infarction (AMI) accreditation implemented in 2009 and the unavailability of percutaneous ventricular assist devices. Methods Data of patients diagnosed as having CS between January 2003 and December 2017 were collected from Taiwan’s National Health Insurance Research Database. Each case was followed from the date of emergency department arrival or hospital admission for the first incident associated with a CS diagnosis up to a 1-year interval. Measurements included demographics, comorbidities, treatment, mortality, and medical costs. Using an interrupted time-series (ITS) design with multi-level mixed-effects logistic regression model, we assessed the impact of AMI accreditation implementation on the mortality of patients with AMI and CS overall and stratified by the hospital levels. Results In total, 64 049 patients with CS (mean age:70 years; 62% men) were identified. The incidence rate per 105 person-years increased from 17 in 2003 to 25 in 2010 and plateaued thereafter. Average inpatient costs increased from 159 125 points in 2003 to 240 993 points in 2017, indicating a 1.5-fold increase. The intra-aortic balloon pump application rate was approximately 22–25% after 2010 (p = 0.093). Overall, in-hospital, 30-day, and 1-year mortality declined from 60.3%, 63.0%, and 69.3% in 2003 to 47.9%, 50.8% and 59.8% in 2017, respectively. The decline in mortality was more apparent in patients with AMI-CS than in patients with non-AMI-CS. The ITS estimation revealed a 2% lower in-hospital mortality in patients with AMI-CS treated in district hospitals after the AMI accreditation had been implemented for 2 years. Conclusions In Taiwan, the burden of CS has consistently increased due to high patient complexity, advanced therapies, and stable incidence. Mortality declined over time, particularly in patients with AMI-CS, which may be attributable to advancements in AMI therapies and this quality-improving policy.
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47

Chen, Yen-Ju, I.-Chieh Chen, Yi-Ming Chen, Tzu-Hung Hsiao, Chia-Yi Wei, Han-Ni Chuang, Wei-Wen Lin, and Ching-Heng Lin. "Prevalence of genetically defined familial hypercholesterolemia and the impact on acute myocardial infarction in Taiwanese population: A hospital-based study." Frontiers in Cardiovascular Medicine 9 (September 12, 2022). http://dx.doi.org/10.3389/fcvm.2022.994662.

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BackgroundFamilial hypercholesterolemia (FH) is a common genetic disorder with markedly increased risk of coronary artery diseases (CAD), especially acute myocardial infarction (AMI). However, genetic tests for FH are not always necessary in the current diagnostic criteria of FH, which might lead to underestimation of the prevalence of FH and a lack of awareness of FH-associated CAD and AMI. We aimed to explore the prevalence of genetically defined FH in the hospital-based population and to determine the impact of FH risk variants on CAD and AMI.MethodsThe study participants were recruited between June 24, 2019 and May 12, 2021, at a medical center in Taiwan, in cooperation with the Taiwan Precision Medicine Initiative (TPMI) project. The prevalence of FH was calculated and the effects of FH pathogenic variants on CAD and AMI were analyzed by logistic regression models and shown as ORs and 95% CI.ResultsThe prevalence of genetically defined FH was 1.13% in the hospital-based population in Taiwan. Highest LDL and total cholesterol levels were observed in patients with LDLR rs28942084 (LDL 219.4±55.2; total cholesterol 295.8±55.4). There was an approximately 4-fold increased risk of hyperlipidemia in subjects with the LDLR rs769446356 polymorphism (OR, 4.42; 95% CI, 1.92-10.19) and AMI in individuals with the LDLR rs730882109 polymorphism (OR, 3.79; 95% CI, 2.26-6.35), and a 2-fold increased risk of CAD in those with the LDLR rs749038326 polymorphism (OR, 2.14; 95% CI, 1.31-3.50), compared with the groups without pathogenic variants of FH.ConclusionsThe prevalence of genetically defined FH was 1.13% in the hospital-based population in Taiwan, which was higher than the rate observed in individuals with clinically defined FH. The risk of CAD and AMI was increased to varying degrees in subjects with different FH risk alleles. Close monitoring and risk stratification strategy are essential in high-risk patients with FH risk alleles to facilitate early detection and treatments.
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Lee, Cheng-Han, Yi-Heng Li, Ching-Lan Cheng, Jyh-Hong Chen, and Yea-Huei Kao Yang. "Abstract 11133: The Incidence and Predicting Factors of Heart Failure After First Acute Myocardial Infarction: A Population[[Unable to Display Character: ‐]]Based Study in Taiwan." Circulation 130, suppl_2 (November 25, 2014). http://dx.doi.org/10.1161/circ.130.suppl_2.11133.

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Background: Early coronary revascularization and medical therapy advancement improve the survival of patients (pts) with acute myocardial infarction (AMI). However, survivors of AMI are at heightened risk of developing heart failure (HF) and there is a paucity of information regarding this issue in Asian countries. This study described the temporal trends in the incidence of HF after the first AMI and the predicting factors of HF development in Taiwan. Methods: We conducted a nationwide population-based cohort study by using 1999 to 2009 National Health Insurance Research Database. Pts aged≧18 years, with no history of HF, who hospitalized with a first AMI between January 2002 and December 2008 were identified and followed up for one year. The primary outcome was HF. We evaluated the incidence of HF during the index hospitalization, 30 days, 6 months, and one year after the discharge. The predicting factors of HF were identified by Cox proportional hazard model. Results: Overall, 42,011 first AMI pts (mean age 64.4 ± 13.8 years; male 75.0%) from 2002 to 2008 were identified. The HF incidence during the index hospitalization was 14.8%. After exclusion of HF during the hospitalization, the overall HF prevalence at 30 days, 6 months, and 1 year was 9.6%, 14.2%, and 16.8%, respectively. The HF prevalence at 1 year declined from 17.9% to 14.9% (p<0.05) from 2002 to 2008. The independent predicting factors of HF after the first AMI were elder age (≧65 years) (adjusted HR 1.81, 95% CI 1.51-2.18), diabetes mellitus (adjusted HR 1.30, 95% CI 1.21-1.41), chronic kidney disease (adjusted HR 1.41, 95% CI 1.20-1.65), use of loop diuretics within 30 days after the discharge (adjusted HR 2.21, 95% CI 2.00-2.43), and recurrent AMI (adjusted HR 2.43, 2.16-2.74). Conclusions: Survivors of AMI without prior HF remain at risk of developing HF in Taiwan and most episodes occur within 6 months after AMI. Five important clinical factors of HF were identified that may help us for risk stratification.
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Liao, Chia-Te, Tung-Han Hsieh, Chia-Yin Shih, Ping-Yen Liu, and Jung-Der Wang. "Cost-effectiveness of percutaneous coronary intervention versus medical therapy in patients with acute myocardial infarction: real-world and lifetime-horizon data from Taiwan." Scientific Reports 11, no. 1 (March 10, 2021). http://dx.doi.org/10.1038/s41598-021-84853-y.

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AbstractAlthough some studies have assessed the cost-effectiveness of percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI), there has been a lack of nationwide real-world studies estimating life expectancy (LE), loss-of-LE, life-years saved, and lifetime medical costs. We evaluated the cost-effectiveness of PCI versus non-PCI therapy by integrating a survival function and mean-cost function over a lifelong horizon to obtain the estimations for AMI patients without major comorbidities. We constructed a longitudinal AMI cohort based on the claim database of Taiwan's National Health Insurance during 1999–2015. Taiwan's National Mortality Registry Database was linked to derive a survival function to estimate LE, loss-of-LE, life-years saved, and lifetime medical costs in both therapies. This study enrolled a total of 38,441 AMI patients; AMI patients receiving PCI showed a fewer loss-of-LE (3.6 versus 5.2 years), and more lifetime medical costs (US$ 49,112 versus US$ 43,532). The incremental cost-effectiveness ratio (ICER) was US$ 3488 per life-year saved. After stratification by age, the AMI patients aged 50–59 years receiving PCI was shown to be cost-saving. From the perspective of Taiwan's National Health Insurance, PCI is cost-effective in AMI patients without major comorbidities. Notably, for patients aged 50–59 years, PCI is cost-saving.
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Hsu, Chia-Ling, Sheng-Hui Hung, Dulmaa Munkhtogoo, and Pa-Chun Wang. "The impact of the COVID-19 Pandemic on Emergency Care of Acute Myocardial Infarction: Findings from the Taiwan Clinical Performance Indicator (TCPI)." International Journal for Quality in Health Care, May 27, 2023. http://dx.doi.org/10.1093/intqhc/mzad034.

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Abstract Background Acute myocardial infarction (AMI) treatment requires timely diagnosis and treatment for optimal health outcomes. The COVID-19 pandemic has caused changes in healthcare delivery and utilisation; therefore, our study explored the changes in emergency care quality indicators for patients with AMI before and during different periods of government response to the COVID-19 outbreak in Taiwan. Methods The Taiwan Clinical Performance Indicators (TCPI) database was used to evaluate the impact of COVID-19 on acute care quality indicators for patients with AMI during four periods: before the COVID-19 outbreak (Period I, 1 January to 31 December 2019) and during three periods in which the central government imposed different levels of epidemic prevention and response alerts (Period II, 1 January 2020, to 30 April 2021; Period III, 1 May to 31 July 2021; and Period IV, 1 August to 31 December 2021) . Results A 15.9% decrease in monthly emergency department admission for patients with AMI occurred during Period III. The hospital “door-to-electrocardiogram time being &lt;10 min” indicator attainment was significantly lower during Periods III and IV. The attainment of “dual antiplatelet therapy (DAPT) received within 6 hours of emergency department arrival” indicator improved in Period IV, whereas “the primary percutaneous coronary intervention (PCI) being received within 90 min of hospital arrival” indicator significantly decreased during Periods III and IV. The indicator “in-hospital mortality” was unchanged within our study duration. Conclusion Overall, the quality of care for patients with AMI was mildly influenced during the assessed pandemic periods, especially in terms of door-to- electrocardiogram times of &lt;10 min and primary PCI received within 90 min of hospital arrival (Period III). Using our study results, hospitals can develop strategies regarding care delivery for patients with AMI during a COVID-19 outbreak on the basis of central government alert levels, even during the height of the pandemic.
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