Background
The use of masks is an effective measure to prevent severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection; however, mask reuse is not recommended. Studies examining the ...factors associated with mask reuse during the coronavirus disease (COVID-19) pandemic are limited. This nationwide survey aimed to determine the prevalence and factors associated with mask reuse among Taiwanese citizens during the pandemic.
Methods
From May 18 through May 31, 2020, a computer-assisted telephone interview system was used to randomly select Taiwanese citizens who were interviewed for COVID-19 preventive behaviors and knowledge on the usage of masks. Multivariate logistic regression was used to identify factors associated with mask reuse during the COVID-19 pandemic. Moreover, generalized estimating equations (GEE) were used to analyze the rate of mask reuse among participants before and during the pandemic.
Results
For a total of 1,075 participants, the overall mean age was 57.4 years, and 82.2% of participants reported mask reuse during the COVID-19 pandemic. After controlling for other covariates, participants who had a greater knowledge on mask usage or had a high supply of masks were less likely to reuse masks during the pandemic. GEE analysis showed that compared with the participants' mask wearing behaviors before the COVID-19 pandemic, they were more likely to reuse masks during the pandemic.
Conclusions
The rate of mask reuse among the general population during the pandemic was significantly higher than that before the pandemic. Individuals were less likely to reuse masks if they had adequate knowledge on mask usage or had a high supply of masks. Since mask reuse is associated with a higher risk of COVID-19 due to the possibility of wearing SAS-CoV-2-contaminated masks, it is imperative to educate people on the correct usage of masks. Further, the government should provide sufficient masks to the general population to decrease the reuse of masks.
Key messages
Mask reuse increased during the COVID-19 pandemic due to the shortage in supply.
It is imperative to educate people about the correct usage of masks.
Objectives: There have been few nationwide population studies of systemic sclerosis (SSc). We describe the epidemiological features of SSc in Taiwan.
Methods: The catastrophic illness registry of the ...Taiwan National Health Insurance Research Dataset (NHIRD) and the National Death Registry of Taiwan were used to calculate estimates of the incidence, prevalence, and mortality of SSc.
Results: A total of 1479 persons (325 males, 1154 females) with incident SSc were enrolled in the study. The annual incidence of SSc in Taiwan was found to be 10.9 cases (4.7 males, 17.4 females) per million population. During 2002-2007, the mean prevalence was 56.3 cases per million population. There were 204 deaths (70 males, 134 females) during the study period; 1-, 2-, and 5-year survival rates were 94.9, 92.0, and 83.2%, respectively. SSc patients had a standardized mortality ratio (SMR) of 3.24 95% confidence interval (CI) 2.82-3.71 for all-cause mortality, as compared with the national population in 2002. There was excess mortality from neoplasms (SMR 1.50, 95% CI 1.03-2.11), cardiovascular diseases (2.23, 1.52-3.16), kidney disease (4.67, 2.66-7.64), gastrointestinal diseases (2.50, 1.27-4.46), and pulmonary diseases (3.20, 1.89-5.09). In addition to male sex and older age, cancer and end-stage renal disease (ESRD) diagnosis were risk factors for death, with hazard ratios (HRs) of 2.71 (95% CI 1.27-5.76) and 2.59 (1.14-5.90), respectively.
Conclusion: SSc patients had a threefold greater risk of all-cause mortality than the general population of Taiwan. Male sex, older age, diagnosis of cancer, and ESRD were risk factors for death.
Good-optical-quality, thick InxGa1−xN films with high In content were grown using a homemade two-heater metal-organic chemical vapor deposition system. By varying the growth temperature, it was found ...that the In composition of the InGaN epilayer varied from 18 to 59% as the substrate temperature decreased from 750 to 625°C. Our results show that the optical properties in terms of the emission peak wavelength and linewidth are uniformly distributed throughout the entire 2in. wafer for the x=0.40 InGaN sample. The resultant mean peak wavelength and FWHM are 808±6nm and 229±18meV, respectively, at 18K. In addition, for the InGaN film grown at 625°C, a noticeable decrease in the In composition occurred when the ceiling temperature was >800°C, indicative of the occurrence of parasitic reactions in the gas phase.
•Effects of growth temperature on the physical properties of InGaN epilayer were examined using two-heater MOCVD reactor.•High optical-quality InGaN films were realized with emission wavelengths up to 793 nm at 14K.•Good PL uniformity were observed for an x=0.40 InxGa1-xN sample at 18 K over the entire 2 in. wafer.
Thyroid hormones regulate the rate of metabolism and affect the differentiation and growth of many tissues in the body. We investigated the association between hyperthyroidism and cancer risk in ...Taiwan.
A random sample of 1 000 000 individuals from Taiwan's National Health Insurance database was enrolled. We found 17 033 patients to have newly diagnosed hyperthyroidism between 2000 and 2005. These patients were recruited along with a match cohort of 34 066 patients without hyperthyroidism. Starting from index date, we followed up all patients for 4 years to identify those who developed cancer.
During the 4-year follow-up study, cancer was diagnosed in 1.23% of patients with hyperthyroidism and 1.02% of the member of the comparison cohort. Regression analysis showed that patients with hyperthyroidism were at greater risk of cancer incidence, especially thyroid cancer, compared the comparison cohort (HR: 1.213; 95% CI: 1.022-1.440; p<0.05 and HR: 7.355; 95% CI: 3.885-13.92; p<0.05, respectively). After adjusting for age, gender, diabetes mellitus, hypertension, hyperlipidemia, gout, geographic region, and income, patients with hyperthyroidism remained at increased risk of cancer incidence and thyroid cancer (Adjusted HR: 1.206; 95% CI: 1.015-1.433 and 6.803; 95% CI: 3.584-12.91, respectively) (both p<0.05). The longer the duration of hyperthyroidism, the greater the risk of thyroid cancer.
This 4-year follow up study suggests that patients with hyperthyroidism are at increased risk of cancer, especially thyroid cancer.
Significant heterogenity of stage IB (sixth edition of the TNM staging system) nonsmall cell lung cancer (NSCLC) has been identified, and further subclassification according to tumour size has been ...proposed. The aim of this study is to evaluate the prognostic factors in patients with resected stage IB NSCLC > 3 cm. From January 1980 to December 2000, 525 patients underwent surgical resection for stage IB NSCLC > 3 cm at Taipei Veterans General Hospital, Taipei, Taiwan. The clinicopathological characteristics of these patients were retrospectively reviewed. The 5- and 10-yr overall survival rates were 44.9% and 27.3%, respectively. Age (p < 0.001), tumour size (p = 0.002), extent of pulmonary resection (p = 0.002), histological type (p = 0.005) and number of mediastinal lymph nodes dissected/sampled (p = 0.004) were significant predictors for overall survival in multivariate analysis. Patients with tumour size >7 cm, or > 5 to ≤ 7 cm, had a worse survival than those with tumour size > 3 to ≤ 5 cm. However, visceral pleural invasion did not influence overall survival. Stage IB NSCLC with a diameter > 3 cm may be subclassified according to tumour size regardless of visceral pleural invasion.
•Effects of FA and memantine against Aβ-induced cytotoxicity are dose-dependent.•The combo treatments counteract Aβ-induced mitochondrial death signals.•FA and memantine ameliorate Aβ-induced ...apoptosis and necrosis of neuronal cells.
Increased dietary folic acid (FA) is associated with reduced risks of Alzheimer’s disease (AD). The AD drug memantine (Mn) has had limited therapeutic effects for the treatment of patients with moderate to severe AD. This study investigated whether and the underlying mechanisms by which the combination of Mn and FA may have synergistic or additive effects in protecting against amyloid-β(25–35) peptide (Aβ)-induced neurocytotoxicity. Aβ treatment of human neuroblastoma SH-SY5Y cells significantly induced a 6-fold increase of apoptotic cells compared with the Aβ-untreated group. Preincubation of Aβ-exposed cells with FA (500μM) or Mn (20μM) caused a 22% and 10% reduction of apoptotic cells, respectively, whereas the combo-treatments at such doses synergistically alleviated Aβ-induced apoptosis by 60% (P<0.05). The apoptotic protection by the combo-treatments coincided with attenuating Aβ-elicited mitochondrial (mt) membrane depolarization and abolishing Aβ-induced mt cytochrome c release to the cytosol. Increased levels of FA at 1000μM in combination with 20μM Mn exerted an additive protection against Aβ(25–35)-induced-apoptosis as compared to the isolate Mn group (P<0.05). The combo-treatments reversed Aβ-elicited mt membrane depolarization, attenuated Aβ-elicited mt cytochrome c release to the cytosol, and diminished Aβ-promoted superoxide generation. The apoptotic-protection by such combo-treatments was partially abolished by carbonyl cyanide 3-chlorophenylhydrazone (mt membrane potential uncoupler) and sodium azide (mt cytochrome c oxidase inhibitor). Taken together, the data demonstrated that dose-dependent FA and Mn synergistically or additively protected SH-SY5Y cells against Aβ-induced apoptosis, which was partially, if not completely, mediated by mt stress-associated death signals.
Taiwan's National Health Insurance Research Database (NHIRD) exemplifies a population-level data source for generating real-world evidence to support clinical decisions and health care policy-making. ...Like with all claims databases, there have been some validity concerns of studies using the NHIRD, such as the accuracy of diagnosis codes and issues around unmeasured confounders. Endeavors to validate diagnosed codes or to develop methodologic approaches to address unmeasured confounders have largely increased the reliability of NHIRD studies. Recently, Taiwan's Ministry of Health and Welfare (MOHW) established a Health and Welfare Data Center (HWDC), a data repository site that centralizes the NHIRD and about 70 other health-related databases for data management and analyses. To strengthen the protection of data privacy, investigators are required to conduct on-site analysis at an HWDC through remote connection to MOHW servers. Although the tight regulation of this on-site analysis has led to inconvenience for analysts and has increased time and costs required for research, the HWDC has created opportunities for enriched dimensions of study by linking across the NHIRD and other databases. In the near future, researchers will have greater opportunity to distill knowledge from the NHIRD linked to hospital-based electronic medical records databases containing unstructured patient-level information by using artificial intelligence techniques, including machine learning and natural language processes. We believe that NHIRD with multiple data sources could represent a powerful research engine with enriched dimensions and could serve as a guiding light for real-world evidence-based medicine in Taiwan.
Porcupine quills are composed of keratin proteins fabricated during quill growth into a cylindrical outer shell with an interior foam core. In the present research, the tensile and nanomechanical ...properties of quill shells from North American porcupine (Erethizon dorsatum) were tested in the axial and circumferential directions at relative humidities of 65% and 100%. At 65% relative humidity, the mean axial elastic modulus and strength of the shell were found to be significantly greater than the corresponding circumferential elastic modulus and strength. Increasing the relative humidity to 100% decreased the measured moduli and strengths and increased the fracture strains due to the plasticizing effects of the absorbed water molecules. Fracture morphologies after tensile testing revealed a three layer structure for the quill shells. The elastic modulus and hardness of the inner quill shell layer were found to be larger than the middle and outer layers by nanoindentation testing. An extensive amount of fibrous cortical cell structure was found aligned parallel to the growth direction of the quill and accounted for the higher moduli, strength and hardness measurements in the axial direction compared to the circumferential direction. Transmission electron microscopy revealed a fine structure of 3–4μm diameter cortical spindle cells composed of 7nm diameter intermediate filaments. The unfolding process of α-helices within the intermediate filaments was quantitatively measured by in-situ infrared spectroscopy technique.
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