Background
The increasing prevalence of diabetes and its significant impact on mortality and morbidity rates worldwide has led to a growing interest in understanding its common risk factors, ...particularly in relation to chronic kidney disease (CKD). This research article aims to investigate the shared risk factors between type 1 diabetes (T1D), type 2 diabetes (T2D), and CKD using a Mendelian randomization (MR) design.
Methods
The study utilized genome-wide association study (GWAS) datasets for T1D, T2D, and CKD from the FinnGen research project. GWAS summary statistics datasets for 118 exposure traits were obtained from the IEU OpenGWAS database. MR analyses were conducted to examine the causal relationships between exposure traits and each of the three outcomes. Multiple methods, including inverse-variance weighted, weighted median, and MR-Egger, were employed for the MR studies.
Results
Phenome-wide MR analyses revealed that eosinophil percentage exhibited a significant and suggestive causal association with T1D and CKD, respectively, suggesting its potential as a shared risk factor for T1D and CKD. For T2D, 34 traits demonstrated significant associations. Among these 34 traits, 14 were also significantly associated with CKD, indicating the presence of common risk factors between T2D and CKD, primarily related to obesity, height, blood lipids and sex hormone binding globulin, blood pressure, and walking pace.
Conclusion
This research has uncovered the eosinophil percentage as a potential common risk factor for both T1D and CKD, while also identifying several traits, such as obesity and blood lipids, as shared risk factors for T2D and CKD. This study contributes to the understanding of the common risk factors between diabetes and CKD, emphasizing the need for targeted interventions to reduce the risk of these diseases.
FMS‐like tyrosine kinase 3 (FLT3) is one of the most frequently mutated genes in hematological malignancies. FLT3 internal tandem duplication (FLT3‐ITD) mutations located in juxtamembrane domain ...(JMD) and tyrosine kinase domain 1 (TKD1) regions account for two‐thirds of all FLT3 mutations. The outcome of patients remains unsatisfactory, with low survival rates. It is not yet known whether the different mutations within the FLT3 gene are all associated with patient outcome. In addition, the cause of FLT3‐ITD in‐frame duplication events remains unknown. Although there are some published studies investigating the FLT3‐ITD mutation and its clinical implications in Chinese acute myeloid leukemia (AML) patients, sample sizes tend to be small and detailed molecular profiles of FLT3 mutations are lacking in these studies. In our study, 227 FLT3‐ITD sequences were analyzed from 227 Chinese de novo AML patients. ITD were next classified into 3 types based on molecular profiles of insertion DNA sequences: DNA complete duplication (type I), DNA partial duplication (type II) and complete random sequence (type III). From the 154 patients, we confirmed that high ITD allelic ratio (≥.5) and allogeneic stem cell transplant treatment under CR1 are independent prognostic factors. We also presented evidence that ITD integration sites in the hinge region or beta1‐sheet region are an unfavorable prognostic factor in adult AML patients with FLT3‐ITD mutations. These findings may help to decipher the mechanisms of FLT3‐ITD in‐frame duplication events and stratify patients when considering different therapeutic combinations.
A total of 227 FLT3‐ITD sequences were analyzed from 227 Chinese adult de novo acute myeloid leukemia (AML) patients. ITD could be classified into 3 types based on molecular profiles. ITD integration sites in the hinge region or beta1‐sheet region are an unfavorable prognostic factor in adult AML patients with FLT3‐ITD mutations.
Coronary artery disease (CAD) covers a wide spectrum from persons who are asymptomatic to those presenting with acute coronary syndromes (ACS) and sudden cardiac death. Coronary atherosclerotic ...disease is a chronic, progressive process that leads to atherosclerotic plaque development and progression within the epicardial coronary arteries. Being a dynamic process, CAD generally presents with a prolonged stable phase, which may then suddenly become unstable and lead to an acute coronary event. Thus, the concept of ＂stable CAD＂ may be misleading, as the risk for acute events continues to exist, despite the use of pharmacological therapies and revascularization. Many advances in coronary care have been made, and guidelines from other international societies have been updated. The 2023 guidelines of the Taiwan Society of Cardiology for CAD introduce a new concept that categorizes the disease entity according to its clinical presentation into acute or chronic coronary syndromes (ACS and CCS, respectively). Previously defined as stable CAD, CCS include a heterogeneous population with or without chest pain, with or without prior ACS, and with or without previous coronary revascularization procedures. As cardiologists, we now face the complexity of CAD, which involves not only the epicardial but also the microcirculatory domains of the coronary circulation and the myocardium. New findings about the development and progression of coronary atherosclerosis have changed the clinical landscape. After a nearly 50-year ischemia-centric paradigm of coronary stenosis, growing evidence indicates that coronary atherosclerosis and its features are both diagnostic and therapeutic targets beyond obstructive CAD. Taken together, these factors have shifted the clinicians' focus from the functional evaluation of coronary ischemia to the anatomic burden of disease. Research over the past decades has strengthened the case for prevention and optimal medical therapy as central interventions in patients with CCS. Even though functional capacity has clear prognostic implications, it does not include the evaluation of non-obstructive lesions, plaque burden or additional risk-modifying factors beyond epicardial coronary stenosis-driven ischemia. The recommended first-line diagnostic tests for CCS now include coronary computed tomographic angiography, an increasingly used anatomic imaging modality capable of detecting not only obstructive but also non-obstructive coronary plaques that may be missed with stress testing. This non-invasive anatomical modality improves risk assessment and potentially allows for the appropriate allocation of preventive therapies. Initial invasive strategies cannot improve mortality or the risk of myocardial infarction. Emphasis should be placed on optimizing the control of risk factors through preventive measures, and invasive strategies should be reserved for highly selected patients with refractory symptoms, high ischemic burden, high-risk anatomies, and hemodynamically significant lesions. These guidelines provide current evidence-based diagnosis and treatment recommendations. However, the guidelines are not mandatory, and members of the Task Force fully realize that the treatment of CCS should be individualized to address each patient's circumstances. Ultimately, the decision of healthcare professionals is most important in clinical practice.
Atrial fibrillation (AF) is prevalent in end-stage renal disease (ESRD) patients and negatively impacts patient outcomes. We explored the incidence and risk factors for new-onset AF among patients ...with ESRD undergoing renal replacement therapy, without a prior history of AF, retrieved from Taiwan’s National Health Insurance Research Database (NHIRD). For each of 134,901 patients with ESRD, one age- and gender-matched control and one similarly matched patient with chronic kidney disease (CKD), a total of 404,703 patients, were selected from the NHIRD. The study endpoint was the occurrence of new-onset AF and patients were followed an average of 5.1 years. The incidence rates of AF were 12.1, 7.3, and 5.0 per 1000 person-years for ESRD, CKD, and control patients, respectively. Among patients with ESRD, age, hypertension, heart failure, coronary artery disease, peripheral arterial occlusive disease, and chronic obstructive pulmonary disease were significant risk factors for new-onset AF. Thus, patients with ESRD had a significantly higher risk of new-onset AF. The presence of multiple risk factors was associated with a higher possibility of AF occurrence.
β-Galactosidase was immobilized on chitosan-coated magnetic Fe3O4 nanoparticles and was used to produce galactooligosaccharides (GOS) from lactose. Immobilized enzyme was prepared with or without the ...coupling agent, tris(hydroxymethyl)phosphine (THP). The two immobilized systems and the free enzyme achieved their maximum activity at pH 6.0 with an optimal temperature of 50 °C. The immobilized enzymes showed higher activities at a wider range of temperatures and pH. Furthermore, the immobilized enzyme coupled with THP showed higher thermal stability than that without THP. However, activity retention of batchwise reactions was similar for both immobilized systems. All the three enzyme systems produced GOS compound with similar concentration profiles, with a maximum GOS yield of 50.5% from 36% (w · v(-1)) lactose on a dry weight basis. The chitosan-coated magnetic Fe3O4 nanoparticles can be regenerated using a desorption/re-adsorption process described in this study.
The number of natural disasters induced by rainfall events in Taiwan has soared, with typhoons and torrential rains invariably inducing major landslides. In this study, data on major ...rainfall-generated landslides (605 in total) which occurred between 2006 and 2014 were used to classify landslides as types: shallow landslides (SL, 495), large landslides (LL, 34), and debris flows (DF, 76). LL were defined as landslides having an area, depth, and volume greater than 10 ha, 2 m and 2 × 10
5
m
3
, respectively. These were then analysed for their geometric form, geographic distribution, and scale and volume characteristics through a ternary diagram. A significant linear trend was found between the length (
L
) and volume (
V
) of SL, with the trend gradually moderating and converging with LL as length increased. The volume of LL displayed a significant increasing trend with depth (
H
), while SL and DF had less depth and average distribution. The median landslide length/width (
L
/
W
) ratios of SL and LL were quite close, and they had relatively similar morphologies; however, SL tended to occur near the slope toe, while large LL, due to their large volume, originated near the mountain ridges and extended to the nearest streams. The power law scaling components of
W
(
β
1
) and
L
(
β
2
) of SL were similar because of their (SL) small size, and they were highly concentrated at the centre of the developed ternary diagram. Through logistic regression, we further validated the exponents in classifying the landslides;
β
1
,
β
2
, and
β
3
(power law scaling component of
H
) are used in the ternary diagram. Overall,
β
1
was found to be the best model for classifying DF, SL, and LL having a correct rate of 0.955 and a lowest Akaike information criterion (AIC), 136.115, and Bayesian information criterion (BIC), 153.736.
β
3
, the depth index, though had a poor AIC, was 100% correct in classifying LL.
The use of data warehouses combined with online analytical processing (OLAP) platforms has become popular in Taiwan’s insurance market. However, most schools do not have an insurance data warehouse ...and OLAP platform for student learning in Taiwan. The researched courses are insurance information system courses for two university classes. Based on the teacher’s experience and innovativeness, those courses are integrated using the guided project-based learning approach. Students need to build a customer micro-database, analyze customer figures through pivot analysis charts, and plan marketing campaigns. The study finds a project-based learning approach is helpful to enhance students’ OLAP analysis abilities. Secondly, the research finds that the flexibility for students to choose the topic of their project is one of the key success factors. Thirdly, the evaluation share of the student’s learning scores is important for the completion of the project. Fourthly, the courses are accompanied with satisfaction questionnaires to monitor the learning results and analyze the learning satisfaction for students among course A, course B, and the college average. Those students in the two classes both have higher satisfaction scores than the college average, but there are still differences between the classes after the t-test.
ObjectivesNurses are at high risk of dysmenorrhoea while working with patients. The study objectives were to: (1) describe the demographic and menstruation characteristics of dysmenorrhoea, knowledge ...about dysmenorrhoea and menstrual attitudes towards menstruation among dysmenorrhoeal and non-dysmenorrhoeal hospital nurses; (2) identify significant differences between the groups; and (3) examine factors influencing dysmenorrhoea.MethodsThis cross-sectional survey used a structured questionnaire, administered at two hospitals in southern Taiwan. Participants included hospital nurses at least 18 years of age who agreed to participate. All participants were recruited through random sampling. The questionnaire included demographic data, the Dysmenorrhoea Knowledge Scale and Menstrual Attitude Scale (MAS).ResultsA total of 420 nurses completed the questionnaire. Among them, 297 (70.7%) had experienced dysmenorrhoea in the past 6 months and 123 (29.3%) had not. Significant differences in age (P<0.001), marital status (P<0.001), childbearing status (P<0.001), age at menarche (P<0.05) and rotating three shift ratio (P<0.05) were identified between the dysmenorrhoea and non-dysmenorrhoea groups. Analysis of the MAS results revealed significant differences between the groups regarding consideration of menstruation as a debilitating (P<0.001) or bothersome event (P<0.05), anticipation and prediction of menstruation onset (P<0.01) and denial of any effects from menstruation (P<0.001). Results of the multiple logistic regression showed that predictive factors included age <40 years (4.46 vs 1.00), working three shift rotations (2.07 vs 1.00), marital status (2.59 vs 1.00), acknowledging menstruation as a debilitating event (2.72 vs 1.00) and denial of effects from menstruation (2.59 vs 1.00).ConclusionsThese findings could help nursing managers to create a caring and friendly work environment for hospital nurses at risk of dysmenorrhoea.
Carbapenem-resistant Acinetobacter baumannii poses a significant threat to hospitalized patients, as few therapeutic options remain. Thus, we investigated the molecular epidemiology and mechanism of ...resistance of carbapenem-resistant A.baumannii isolates in Beijing, China.
Carbapenem-resistant A.baumannii isolates (n = 101) obtained between June 2009 and November 2014 were used. Multilocus sequence typing (MLST) and PCR assays for class C and D β-lactamase were performed on all isolates. S1 nuclease pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to identify the resistance gene location.
All 101 A.baumannii isolates were highly resistant to frequently used antimicrobials, and were considered multidrug resistant. A total of 12 sequence types (STs) were identified, including 10 reported STs and 2 novel STs. Eighty-seven isolates were classified to clonal complex 92 (CC92), among which ST191 and ST195 were the most common STs. The bla
gene was positive in most (n = 95) of the A.baumannii isolates. Using S1-nuclease digestion PFGE and Southern blot hybridization, 3 patterns of plasmids carrying bla
were confirmed. ST191 and ST195 (both harboring bla
) caused outbreaks during the study period, and this is the first report of outbreaks caused by ST191 and ST195 in north China.
bla
-producing A.baumannii ST191 and ST 195 isolates can disseminate in a hospital and are potential nosocomial outbreak strains. Surveillance of imipenem-resistant A.baumannii and antimicrobial stewardship should be strengthened.
Abstract Background This study aimed to examine whether long working hours and short sleep duration were associated with an increased risk of acute myocardial infarction (AMI) or severe coronary ...heart diseases (SCHD), independent of established psychosocial work-related factors. Methods A case–control study was conducted. Cases were 322 men, aged < 60 years and economically active, who were admitted to hospital with a first diagnosed AMI or SCHD during 2008–2011, of whom 134 were confirmed AMI and the other 188 were angiography-confirmed SCHD. Controls were 644 men who were drawn from a national survey and were matched to the cases on age, education and area of residence. Odds ratios of total CHD and confirmed AMI in relation to average weekly working hours and daily hours of sleep were calculated. Results Men with average working hours longer than 60 h/week were found to have significantly increased risks for total CHD (OR = 2.2) as compared to those with weekly working hours in 40–48 h, and those with daily hours of sleep fewer than 6 h were found to have increased risks for CHD (OR = 3.0) as compared to those with sleeping hours in 6–9 h. Restriction to confirmed AMI yielded a greater risk and these associations remained consistent with adjustment of smoking status, body mass index and psychosocial work factors including job demands, job control, workplace justice, job insecurity and shift work. Conclusion The results support the hypothesis that long working hours and short sleep duration contribute independently to the risk of cardiovascular diseases in men.
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