This study investigated how creative personality, psychological empowerment, and job stress affect creative self‐efficacy and innovative behavior in hospitality employees. A hypothesized moderating ...role of knowledge‐sharing role in the relationship between creative self‐efficacy and innovative behavior was also tested. Three hundred and thirty‐nine employees and 89 supervisors employed by International Tourist Hotels in Taiwan participated in the study. A structural equation modeling analysis indicated that creative self‐efficacy significantly mediates the effects of creative personality and psychological empowerment on innovative behavior in the hospitality industry. The positive effect of creative self‐efficacy on innovative behavior was larger in high knowledge‐sharing work environments than in low knowledge‐sharing work environments. Theoretical and practical implications are further discussed.
Background. Very few nationwide studies have focused on the variations in the incidence and prevalence of dementia and Alzheimer’s disease (AD) in Asian countries. This study aims to describe the ...gender and age differences in the incidence and prevalence of dementia and AD in Taiwan. Methods. The data on dementia and AD were acquired from the Taiwan National Health Insurance Research Database from 2004 to 2010. The sex and age-specific rates were standardized, and the differences of gender and age on dementia or AD were assessed using Poisson regression analysis. Results. Over seven years, the prevalence of dementia and AD significantly increased from 4.7 to 7.6 per hundred people (β = 0.0784, p<0.0001) and 2.3 to 3.5 per hundred people (β = 0.0696, p<0.0001), respectively. However, the incidence of both dementia and AD decreased but not significantly from 10.9 to 10.7 and 4.9 to 4.6 per thousand person-years, respectively. Noticeably, both incidence and prevalence increased with age and were higher in women than in men. Conclusions. The standardized incidence rates of dementia and AD are much lower than the data reported in some studies from Europe, the US, and Japan. Further studies are warranted to explore which factors are associated with the differences in the incidence of dementia and AD in Taiwan.
Physical and social environments may influence cognition health in older adults. However, evidence regarding physical and social environments linked to dementia is lacking, especially in Asia. This ...study aims to explore the influence of physical and social environments on the incidence of dementia through a population-based case-control design in Taiwan.
We identified 26,206 incident cases with dementia aged≧65 years in 2010, with the same no. of controls from National Health Insurance claims. Environmental measures were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CI) of the association between dementia incidence and the environmental measures at the township level.
We observed a significant reduction of 12% in the odds ratios of dementia in areas with higher availability of playgrounds and sport venues (OR 0.88, 95% CI 0.81-0.95), after controlling for individual and other environmental characteristics. Community center availability was also significantly associated with an 8% decreased odds for dementia (OR 0.92, 95% CI 0.87-0.99), but the association was not significant after further consideration of individual-level characteristics. Although higher odds of dementia were found in areas with high median annual family income (OR 1.14, 95% CI 1.04-1.25), such a significant relationship did not appear in the full model.
Our study suggests that specific physical and social environmental features have different influences on the risk of dementia. Public health interventions may consider these environmental aspects for preventing dementia incidence.
Little is known about the association between environmental features and the risk of Alzheimer's dementia (AD). This study aims to investigate the association of physical and social environments with ...the incidence of AD. We identified 12,401 newly diagnosed AD cases aged ≥65 years in 2010, with the same no. of matched controls from National Health Insurance claims in Taiwan. Environmental data were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was conducted to calculate the odds ratios (OR) of AD in association with environmental features at the township level. Results showed that living in the areas with higher availability of playgrounds and sport venues was associated with a 3% decreased odds of AD (95% CI = 0.96-0.99), while higher density of elderly living alone was associated with a 5% increased odds of AD (95% CI = 1.01-1.11), after controlling for individual and other environmental factors. In further examination by urbanization level, the above relationships were found only in rural areas but not in urban areas. This study provides evidence that specific physical and social environmental features have different impacts on the risk of AD.
CO2 has been reported to be absorbed from the bowel more rapidly than air, resulting in a discomfort reduction after colonoscopy. Its role in deeply sedated patients is limited. This study was ...designed to investigate the efficacy and safety of CO2 insufflation during colonoscopy in patients deeply sedated with propofol.
A total of 125 continuous patients were randomly assigned to receive either CO2 (n = 63) or air (n = 62) insufflation during propofol-sedated colonoscopy. Postcolonoscopy abdominal pain, distention, and satisfaction were assessed at 1, 3, and 24 h after the procedure, and the proportions of pain-free and distention-free patients were compared. Residual bowel gas in the colon and small bowel was evaluated at 1 h after colonoscopy. End-tidal CO2 and O2 saturation was measured for safety analysis.
There was a significant difference between the two groups regarding the postcolonoscopy abdominal pain, distention, and subjective satisfaction at 1 h (P < 0.001) and 3 h (P < 0.01) after the procedure. Patients' pain and distention at 1 and 3 h after the procedure were significantly lower in the CO2 group (P < 0.01). Residual bowel gas in the colon and small bowel was significantly less in the CO2 group (P < 0.001). There was no significant difference in end-tidal CO2 levels between two groups before, during, and after the procedure.
Compared with air, CO2 insufflation during colonoscopy reduced postcolonoscopy abdominal discomfort and improved patients' satisfaction. It was safe to use CO2 insufflation in deeply sedated colonoscopy.
Sorafenib is currently a targeted agent widely used in the treatment of advanced hepatocellular carcinoma (aHCC). However, to date there is still a lack of a reliable marker capable of predicting ...sorafenib therapeutic responses. Here, we conducted a genome-wide association study (GWAS) to identify candidate single-nucleotide polymorphism outcome predictors in aHCC patients. A total of 74 real-world sorafenib-treated aHCC patients were enrolled for GWAS and outcome analysis. GWAS showed that rs1010816 (
= 2.2 × 10
) was associated with sorafenib therapeutic response in aHCC patients. Kaplan-Meier analysis indicated that the "TT" genotype was significantly associated with a favorable therapeutic response but not significantly associated with overall survival (OS). Univariate followed by multivariate Cox proportional hazard analysis showed that ascites, main portal vein thrombosis, lower platelet count, lower total sorafenib doses, higher PALBI score in model A and higher ALBI grade in model B were significantly associated with a shorter OS. Subgroup analysis showed that only in alcoholic aHCC patients treated by sorafenib, rs1010816 "TT" genotype was significantly associated with longer OS (
= 0.021). Sorafenib had a favorable therapeutic outcome in alcoholic aHCC patients carrying rs1010816 "TT" genotype.
Globus pallidus necrosis (GPN) is one of typical neurological imaging features in patients with carbon monoxide (CO) poisoning. Current clinical guideline recommends neurological imaging examination ...for CO-intoxicated patients with conscious disturbance rather than routine screening, which may lead to undiagnosed GPN. We aimed to develop an artificial intelligence algorithm for predicting GPN in CO intoxication patients. We included CO intoxication patients with neurological images between 2000 and 2019 in Chang Gung Memorial Hospital. We collected 41 clinical and laboratory parameters on the first day of admission for algorithm development. We used fivefold cross validation and applied several machine learning algorithms. Random forest classifier (RFC) provided the best predictive performance in our cohort. Among the 261 patients with CO intoxication, 52 patients presented with GPN. The artificial intelligence algorithm using the RFC-based AI model achieved an accuracy = 79.2 ± 2.6%, sensitivity = 77.7%, precision score = 81.9 ± 3.4%, and F1 score = 73.2 ± 1.8%. The area under receiver operating characteristic was approximately 0.64. Top five weighted variables were Platelet count, carboxyhemoglobin, Glasgow Coma scale, creatinine, and hemoglobin. Our RFC-based algorithm is the first to predict GPN in patients with CO intoxication and provides fair predictive ability. Further studies are needed to validate our findings.
Leading enterprises worldwide are proactively fulfilling environmental protection. This trend has elicited international attention. The corporate environmental responsibility (CER) framework was ...constructed based on the strategy these enterprises executed. This conceptual framework precisely determined current international advanced CER content. However, understanding the true intention of businesses that practice environmental management and protection through the CER framework is difficult, thereby making CER performance measurement indicators crucial. However, the lack of active CER performance measurement indicators resulted in the inability to reflect fully the effects of industry situation and business development on the living environment. Hence, this situation signals the urgency to construct CER performance measurement indicators that reflect fully industry situation and social needs. This study aims to address the deficiencies of CER performance measurement indicators in the academic circle, and construct a set of active CER performance measurement indicators that fully reflect the effects of industry situation and business development on the living environment. For this reason, this study employs content analysis method to establish CER performance measurement indicators based on the CER framework. This indicator provides an effective and applied CER performance measurement tool and offers the government with foresighted concepts of environmental protection.
•The Corporate Environmental Responsibility (CER) framework has been constructed.•Understanding the true intention of businesses is difficult.•CER performance measurement indicators are crucial.•This study provides an effective and applied CER performance measurement tool.•This study offers the government with foresighted concepts.
Background
Factors of metabolic syndrome such as obesity are well‐known risk factors for gallstone disease (GSD). There are different indicators of obesity, including weight, body mass index, waist ...circumference, and waist‐to‐height ratio. The predictive ability of different obesity indicators for GSD remains unclear.
Objective
To explore the most efficient predictor of GSD among the different anthropometric indicators of obesity.
Methods
This population‐based cross‐sectional study included 2263 participants who completed a questionnaire detailing their demographics, medical history, and lifestyle between 2014 and 2017 in Taiwan. Blood samples were collected and physical examinations, including anthropometric measurements, were performed. Gallstone disease was ascertained using ultrasonography. Multivariate analyses were performed to identify independent risk factors for GSD.
Results
The overall prevalence of GSD was 8.8%. According to the multivariate analysis, individuals with a waist‐to‐height ratio ≥0.5 (odds ratio|odds ratios (OR) = 1.65, 95% confidence interval (CI) = 1.10−2.48, p = 0.017) had an increased risk of GSD. Diabetes was the main risk factor for GSD in men (OR = 2.06, 95% CI = 1.17−3.65, p = 0.013). Among women, waist‐to‐height ratio >0.5 (OR = 1.76, 95% CI = 1.03−3.02, p = 0.040) and current hormone drug use (OR = 2.73, 95% CI = 1.09−6.84, p = 0.033) were significant risk factors for gallstones.
Conclusion
GSD was independently associated with central obesity and exogenous hormone intake in women. Among the anthropometric indicators used to assess central obesity, waist‐to‐height ratio was the most accurate predictor of GSD.
Obesity is a risk factor of gallstone disease. Among anthropometric indicators of obesity, waist–to–height ratio has the best predictability of gallstone disease in women.
Paraquat poisoning is characterized by multi-organ failure and pulmonary fibrosis with respiratory failure, resulting in high mortality and morbidity. The objective of this study was to identify ...predictors of mortality in cases of paraquat poisoning. Furthermore, we sought to determine the association between these parameters.
A total of 187 patients were referred for management of intentional paraquat ingestion between January 2000 and December 2010. Demographic, clinical, and laboratory data were recorded. Sequential organ failure assessment (SOFA) and acute kidney injury network (AKIN) scores were collected, and predictors of mortality were analyzed.
Overall hospital mortality for the entire population was 54% (101/187). Using a multivariate logistic regression model, it was found that age, time to hospitalization, blood paraquat level, estimated glomerular filtration rate at admission (eGFR( first day)), and the SOFA(48-h) score, but not the AKIN(48-h) score, were significant predictors of mortality. For predicting the in-hospital mortality, SOFA(48-h) scores displayed a good area under the receiver operating characteristic curve (AUROC) (0.795 ± 0.033, P<0.001). The cumulative survival rate differed significantly between patients with SOFA(48-h) scores <3 and those ≥ 3 (P<0.001). A modified SOFA (mSOFA) score was further developed by using the blood paraquat level, and this new score also demonstrated a better AUROC (0.848±0.029, P<0.001) than the original SOFA score. Finally, the cumulative survival rate also differed significantly between patients with mSOFA scores <4 and ≥4 (P<0.001).
The analytical data demonstrate that SOFA and mSOFA scores, which are based on the extent of organ function or rate of organ failure, help to predict mortality after intentional paraquat poisoning.
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