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Driving decision-making among older adults with dementia in Taiwan: A longitudinal study
No full text[[abstract]]Background
Driving is a complex skill that requires the integration of cognition and motor functions. However, these functions are all impacted by dementia.
Aim
We investigated the driving status among persons with dementia and the effects of a Dementia and Driving Decision Aid (DDDA) on changes in driving decisions, depressive symptoms and anxiety.
Methods
A longitudinal study with a 6-month observation was undertaken. Participants were clients in an Integrated Dementia Care Center (IDCC) who were diagnosed with a mild dementia. The primary outcome was changes in driving decisions; secondary outcomes included depressive symptoms, anxiety, and views on the booklet. Data were collected at four time points: baseline (T0), and 1 month (T1), 3 months (T2), 6 months (T3) after implementing DDDA. A logistic regression was used to examine changes in driving decisions, and a repeated-measures ANOVA was adopted to compare changes in secondary outcomes across time.
Findings
The number of participants who decided to continue driving significantly decreased (p < 0.001), while those who decided to drive less significantly increased (p < 0.001). A significant improvement in depressive symptoms was found in participants over time (F = 9.192; p < 0.001), the mean scores at all post-test time points were lower compared to the baseline measure.
Discussion
We report successful implementation of a DDDA booklet in an IDCC in Taiwan. In addition, participants’ satisfaction level toward the booklet was high.
Conclusion
We suggest the DDDA booklet can be widely utilised in community-based dementia care centres
臺灣青年 COVID 19 期間電子煙使用易感之調查與防制
No full text[[abstract]]現階段臺灣正處疫情期間，我們對於臺灣青年的電子菸使用動機及易感知之甚少。透過社會學習理論與結果預期模型文獻，本研究假設疫情期間社群媒體菸品曝光度（媒體影響、社群影響）、正向結果預期（社交誘因、情感誘因、感官誘因）、負向結果預期（健康疑慮與成癮疑慮）與紙菸使用經驗對臺灣青年電子菸使用易感可能存在影響。本研究共蒐集到266位臺灣青年的有效樣本數據，並以結構方程模型檢驗數據有效性及驗證研究假設。結果顯示，僅有情感誘因、感官誘因與使用經驗會影響臺灣青年使用電子菸的易感程度。本研究實證結果將有助於政府菸害防制相關單位，針對臺灣青年未來吸食電子菸的重要影響因素對症下藥，以降低菸害防制成本並確保臺灣青年健康。[[abstract]]While the COVID-19 pandemic prevention, increasingly isolation may result in psychosocial stress, which is a risk factor for e-cigarettes. There is sparse evidence for the intention behind using e-cigarette among young Taiwanese. Based to social learning theory and outcome expectancy, this study provides empirical support for a motivation behind using e-cigarettes by testing the impacted variables derived from the integrated model of smoking on social media (social media and social effect), positive outcome expectation (social, emotion, sensation), negative out-come expectation (harm for health and addiction), and experience with conventional cigarettes. A cross-sectional e-survey was conducted among Taiwanese youths. A total of 266 smokers aged 19-25 years were recruited through an access panel. Findings indicated that in the COVID-19 context, the influences of emotional, sensational stimulations, and experience with conventional cigarettes positively predicts the level of intention for using e-cigarettes. The current study identified the psychosocial mechanisms of intention of e-cigarettes Taiwanese's user during the COVID-19 pandemic, which could be used as an empirical basis for the development of interventions to prevent tobacco. These efforts can help health promotion and reduce the costs of tobacco harm actually outweigh any financial benefits
Assessing the e cacy and safety of Juan Bi Tang for dialysis-related myofascial pain in the fistula arm: Study protocol for a randomized cross-over trial
No full text[[abstract]]Background: Dialysis-related myofascial pain in hemodialysis (HD) patients is an important issue that is associated with many other psychosomatic problems. Effective interventions are required to alleviate pain in this group. Chinese herbal medicine (CHM) may be a potential therapeutic treatment for reducing pain. The aim of this study is to evaluate the effects of a classic CHM formula intervention on pain intensity, daily function, quality of life (QOL), and safety in patients receiving HD in a dialysis center within the context of southern Taiwan.
Methods: This will be a randomized, open label, cross-over trial with two parallel groups in a pre- and post-test study. Forty patients reporting myofascial pain related to the arteriovenous (AV) fistula in the arm during regular HD sessions will be recruited. Participants will receive 4 weeks of treatment with Juan Bi Tang (JBT) and 4 weeks of no treatment in a random order, separated by a washout period of 2 weeks. Treatment doses (3 g JBT) will be consumed thrice daily. The primary outcome measure will be the Kidney Disease Quality of Life 36-Item Short-Form Survey. Secondary outcomes will include the Fugl-Meyer Assessment-arm, Visual Analogue Scale (VAS) of pain, and grip strength. Outcomes will be collected before and after each intervention, for a total of four times per participant. The safety evaluation will focus on adverse events (AEs).
Discussion: This study will be the first to use CHM to treat patients receiving HD with dialysis-related myofascial pain in their fistula arm and to perform a complete assessment of the treatment, including records of QOL, arm function and muscle power, severity of pain, and safety. The results of the study will provide convincing evidence on the use of JBT as an adjuvant treatment for dialysis-related myofascial pain
Associating Violence With Schizophrenia-Risks and Biases
No full text[[abstract]]To the Editor Whiting et al1 conducted a systematic review and meta-analysis investigating the association between schizophrenia spectrum disorder and violence, including subgroup analysis by sex. They found that schizophrenia spectrum disorder was associated with a significant increase in risk of perpetrating violence compared with control, especially among women (odds ratio [OR], 10.2). We appreciate the authors’ effort to emphasize the importance of preventing violence perpetration in clinical services and routinely monitoring violence risk in future studies. However, we would like to discuss 2 statistical issues in their meta-analysis
Blood D-Amino Acid Oxidase Levels Increased With Cognitive Decline Among People With Mild Cognitive Impairment: A Two-Year Prospective Study
No full text[[abstract]]Background: Dysregulation of N-methyl-D-aspartate receptor (NMDAR) neurotransmission has been reported to be implicated in the pathogenesis of Alzheimer's disease (AD). D-amino acid oxidase (DAO), responsible for degradation of NMDAR-related D-amino acids such as D-serine, regulates NMDAR function. A cross-section study found that serum DAO levels were positively related with the severity of cognitive aging among elderly individuals. This 2-year prospective study aimed to explore the role of DAO levels in predicting the outcome of patients with very early-phase AD, such as mild cognitive impairment (MCI).
Methods: Fifty-one patients with MCI and 21 healthy individuals were recruited. Serum DAO levels and cognitive function, measured by the AD assessment scale-cognitive subscale and the Mini-Mental Status Examination, were monitored every 6 months. We employed multiple regressions to examine the role of DAO concentration in cognitive decline in the 2-year period.
Results: From baseline to endpoint (24 months), serum DAO levels increased significantly, and cognitive ability declined according to both cognitive tests in the MCI patients. Among the healthy individuals, DAO concentrations also increased and Mini-Mental Status Examination scores declined; however, AD assessment scale-cognitive subscale scores did not significantly change. Further, DAO levels at both months 12 and 18 were predictive of cognitive impairment at month 24 among the MCI patients.
Conclusions: To our knowledge, this is the first study to demonstrate that blood DAO levels increased with cognitive deterioration among the MCI patients in a prospective manner. If replicated by future studies, blood DAO concentration may be regarded as a biomarker for monitoring cognitive change in the patients with MCI
Chinese Herbal Medicine Reduces the Risk of Heart Failure in Hypertensive Patients: A Nationwide, Retrospective, Cohort Study
No full text[[abstract]]Background: Hypertension (HTN) is the leading preventable risk factor for cardiovascular disease worldwide. Patients with HTN are at higher risk for heart failure (HF). The currently available therapeutic approaches for HTN do not always optimally control blood pressure or are not suitable for hypertensive patients who have a higher number of comorbidities. This study aimed to determine whether Chinese herbal medicine (CMH)-based interventions could reduce the risk of HF in hypertensive patients.
Methods: This retrospective study randomly selected 2 million enrollees from the National Health Insurance Research Database and identified 507,608 patients who were newly diagnosed with HTN in 2000-2017. After 1:1 frequency-matching by age, sex, index year, income, urbanization, duration of HTN, comorbidities and antihypertensive medications, we selected 8,912 eligible patients in each group. During 16 years of follow-up, 380 CHM users and 426 CHM non-users developed HF, representing incidence rates of 6.29 and 7.43 per 1,000 person-years, respectively.
Results: CHM users had significantly lower HF risk compared with CHM non-users (adjusted HR = 0.85, 95% CI 0.74-0.98). The markedly predominant effect was observed in those receiving CHM products for more than 180 days (adjusted HR = 0.65). The frequently prescribed formula, Jia-Wei-Xiao-Yao-San, and the single herbs Ge Gen, Huang Qi, Du Zhong, Huang Qin, and Chuan Xiong were significantly associated with lower risk of HF.
Conclusions: This population-based study revealed decreased HF risk in hypertensive patients with CHM use. These findings may provide a reference for HF prevention strategies and support the integration of CHM into clinical intervention programs that provide a favorable prognosis for hypertensive patients
The Tyndall Effect in High-Resolution Computed Tomography of Semicircular Canalolithiasis with Benign Paroxysmal Positional Vertigo
No full text[[abstract]]To date, along with the progress of new technology and computer program development, the high-resolution computed tomography (HRCT) had been applied in different clinical application, such as HRCT for coronary angiography. In the current neuroimaging reports, we present HRCT images of the head/neck of two cases, in which one had a diagnosis of benign paroxysmal positional vertigo (BPPV) and the other did not, to represent the Tyndall effect, which describes the scattering of light by particles (i.e., semicircular canalolithiasis) in the path of light and enables clinicians to see a specific signal on the HRCT images. On the HRCT image of the patient with canalolithiasis with BPPV, we could obviously see the scattering effect (i.e., Tyndall effect) in the horizontal/posterior semicircular canal; however, on the HRCT image of the other without canalolithiasis, we could not see such findings. Therefore, through the assistance of technological progress, HRCT might be beneficial in the diagnosis of semicircular canalolithiasis, which has the advantage of being noninvasive and having a low risk of complications. However, because of the disadvantages of expense and risk of radiation exposure, HRCT should be reserved for patients who are difficult to diagnose
Understanding willingness to communicate in L2 between Korean and Taiwanese students
No full text[[abstract]]This study examined Korean (n = 143) and Taiwanese (n = 261) EFL students’ willingness to communicate in a second language (L2 WTC) in in-class, out-of-class, and digital settings. Follow-up interviews (n = 20) were also conducted to identify factors that might have influenced their L2 WTC. Results showed that Korean and Taiwanese participants scored lowest on L2 WTC inside the classroom. The qualitative data suggest that L2 speaking anxiety might have equally influenced both groups’ L2 WTC. Additionally, while Korean students scored higher on L2 WTC outside the classroom than Taiwanese students, the Taiwanese scored higher on L2 WTC in digital settings than did the Koreans. The qualitative data revealed that these discrepancies might have been influenced by English environment and teaching practice. These findings suggest that East Asian learners of English as a foreign language (EFL) can become more willing to communicate when sufficient opportunities for English use are provided through instructional and institutional support
2,3,5,40 -Tetrahydroxystilbene-2-O-β-glucoside Attenuates Reactive Oxygen Species-Dependent Inflammation and Apoptosis in Porphyromonas gingivalis-Infected Brain Endothelial Cells
No full text[[abstract]]Porphyromonas gingivalis, a periodontal pathogen, has been proposed to cause blood vessel injury leading to cerebrovascular diseases such as stroke. Brain endothelial cells compose the blood-brain barrier that protects homeostasis of the central nervous system. However, whether P. gingivalis causes the death of endothelial cells and the underlying mechanisms remain unclear. This study aimed to investigate the impact and regulatory mechanisms of P. gingivalis infection in brain endothelial cells. We used bEnd.3 cells and primary mouse endothelial cells to assess the effects of P. gingivalis on endothelial cells. Our results showed that infection with live P. gingivalis, unlike heat-killed P. gingivalis, triggers brain endothelial cell death by inducing cell apoptosis. Moreover, P. gingivalis infection increased intracellular reactive oxygen species (ROS) production, activated NF-κB, and up-regulated the expression of IL-1β and TNF-α. Furthermore, N-acetyl-L-cysteine (NAC), a most frequently used antioxidant, treatment significantly reduced P. gingivalis-induced cell apoptosis and brain endothelial cell death. The enhancement of ROS production, NF-κB p65 activation, and proinflammatory cytokine expression was also attenuated by NAC treatment. The impact of P. gingivalis on brain endothelial cells was also confirmed using adult primary mouse brain endothelial cells (MBECs). In summary, our results showed that P. gingivalis up-regulates IL-1β and TNF-α protein expression, which consequently causes cell death of brain endothelial cells through the ROS/NF-κB pathway. Our results, together with the results of previous case-control studies and epidemiologic reports, strongly support the hypothesis that periodontal infection increases the risk of developing cerebrovascular diseas
An IoT and Machine Learning-Based Routing Protocol for Reconfigurable Engineering Application
No full text[[abstract]]With new telecommunications engineering applications, the cognitive radio (CR) network-based internet of things (IoT) resolves the bandwidth problem and spectrum problem. However, the CR-IoT routing method sometimes presents issues in terms of road finding, spectrum resource diversity and mobility. This study presents an upgradable cross-layer routing protocol based on CR-IoT to improve routing efficiency and optimize data transmission in a reconfigurable network. In this context, the system is developing a distributed controller which is designed with multiple activities, including load balancing, neighbourhood sensing and machine-learning path construction. The proposed approach is based on network traffic and load and various other network metrics including energy efficiency, network capacity and interference, on an average of 2 bps/Hz/W. The trials are carried out with conventional models, demonstrating the residual energy and resource scalability and robustness of the reconfigurable CR-IoT