582 research outputs found
Activation of ubiquitin-proteasome pathway is involved in skeletal muscle wasting in a rat model with biliary cirrhosis: potential role of TNF-α
No full textFull responsibility with partial citizenship: Immigrant wives in Taiwan
No full text[[abstract]]The interrelationship between increased ageing and declining fertility is facing many developed countries with challenges, risks and policy debates around care, reproduction and women's rights. This article demonstrates the special case of cross-border marriages and the lives of immigrant wives in Taiwan, with a view to identifying their social needs and hence their prospects for social inclusion. It considers the extent to which these immigrant wives have managed to fulfil the dreams of their own native families and/or satisfy the reproductive demands of their 'in-law' families. Issues of women's social and reproductive role, gender discrimination and the unfulfilled rights and 'partial citizenship' of immigrant wives are discussed. The author argues that immigrant wives carry full responsibility but possess only partial citizenship. The ideology of the spousal sponsorship regime, which makes the application for naturalization extremely difficult, not only increases the vulnerability of immigrant women but violates their human fights.[[note]]SSC
Stimulated resistin expression in white adipose of rats with bile duct ligation-induced liver cirrhosis: relationship to cirrhotic hyperinsulinemia and increased tumor necrosis factor-alpha
No full textResistin, an adipose-derived polypeptide hormone, is proposed as a candidate of insulin resistance, although its roles in inhibiting adipogenesis & in inflammation have also been suggested. Liver cirrhosis is characterized by elevated circulating proinflammatory cytokines, including tumor necrosis factor- (TNF-), hyperinsulinemia & insulin resistance. The study aimed to examine resistin expression & its association with insulin & TNF- in a cirrhotic rat model using bile duct ligation (BDL). The BDL-induced cirrhotic rats showed significantly lower fat mass, insulin sensitivity & elevated plasma insulin & TNF- compared to sham animals. In addition, epididymal TNF- & resistin mRNA & protein levels were higher in cirrhotic rats. In normal control rats, in vivo insulin infusion & ex vivo administration of TNF- to cultured fat pads increased resistin gene expression significantly. These results implied that hyperinsulinemia & increased TNF- levels might upregulate adipose resistin gene in BDL-induced liver cirrhosis. Further study is necessary to document the role of resistin in metabolic abnormalities of liver cirrhosis
Mirrorlabs - Creating accessible Digital Twins of robotic production environment with Mixed Reality
No full textHow to visualize recorded production data in Virtual Reality? How to use state of the art Augmented Reality displays that can show robot data? This paper introduces an opensource ICT framework approach for combining Unity-based Mixed Reality applications with robotic production equipment using ROS Industrial. This publication gives details on the implementation and demonstrates the use as a data analysis tool in the context of scientific exchange within the area of Mixed Reality enabled human-robot co-production. Accepted Author ManuscriptMechatronic DesignTechnical SupportInternet of Thing
Using Virtual Reality for scenario-based Responsible Research and Innovation approach for Human Robot Co-production
No full textThis paper proposes to use Virtual Reality scenarios to explore the reaction of stakeholders within an innovation process in the context of the introduction of robots working in close collaboration with users. The goal is to design the system upfront in such a way, that it is not perceived as a threat to the worker or his/her job. Within the responsible research and innovation approach, the introduction of new technology needs to be accompanied by a careful investigation of the thoughts and feelings of all stakeholders. Especially workers who are currently not working with robots but their workspace is currently undergoing an Industry 4.0 driven transformation, experience fear, that this new technology will make their jobs redundant. On the other hand, it can be observed, that successful robot interaction processes, on the one hand, increase the overall productivity, but also can enhance human well-being. The feeling of 'teamwork' with the artificial intelligence entity can develop to be equally positive and motivating. To be able to design future workspaces which will result in a 'teamwork' perception instead of the 'fear' perception, the use of VR can be applied. Accepted Author ManuscriptMechatronic DesignInternet of ThingsEconomics of Technology and Innovatio
Initial Serum Glucose Level as a Prognostic Factor in the First Acute Myocardial Infarction
No full text[[alternative]]The Study of Alcohol Using Behavior During Working Time and Relating Factors of Construction Workers.
No full text[[abstract]]The main purpose of this study was to investigate the current alcohol using behavior of construction workers, and to examine the relationships between alcohol using behavior, background factors, drinking culture of workplace, colleague’s support, alcohol knowledge, and experience. By using a purposive sampling method, 162 respondents (58.1% response rate) was selected to participate in the survey. The data were collected with a self-administrated questionnaire from Mar. to Apr. 2006. One-way ANOVA, Pearson’s product-monent correlation and Multiple regression were used to analyze the data. Overall, the results indicated that:
(1) Among the subjects 70.4% have experience of drinking during working time. The average amount of alcohol drinking in a week is 356.58 grams, and the wine they drunk usually is beer.
(2) Age, race, level of education, and seniority of working is correlated significantly with alcohol using behavior of construction workers.
(3) Attitude about drinking during working time and previous positive alcohol experience is correlated significantly with alcohol using behavior of construction workers.
(4) The amount of variance explained by the five independent variables mentioned above is 30%. The variables that had significant explanatory power on alcohol using behavior are positive alcohol experience, the drinking norms of company, age , and drinking history of family.
At the end of this study, suggestions for health educations and future research are made. The author recommended that the health educational program of workplace should pay attention to the influence of drinking culture of workplace and positive alcohol experience of construction workers.
High triglyceride-to-HDL cholesterol ratio associated with albuminuria in type 2 diabetic subjects
No full textObjective: Emerging evidence indicates that metabolic syndrome (MetS) predisposes diabetic subjects to nephropathy. Aside from hypertension and hyperglycemia, it is unclear which component of MetS also contributes to increased urinary albumin excretion (UAE). We compared the MetS profiles of subjects divided into two groups based on their UAE.
Methods: The Asia Pacific Real-Life Effectiveness and Care Patterns of Diabetes Management (AP RECAP-DM) study is a cross-sectional survey in which type 2 diabetic subjects using oral anti-hyperglycemic drugs were enrolled. We analyzed the data of 162 type 2 diabetic subjects with normotension or taking antihypertensive medications.
Results: There were 123 subjects with normal UAE (<30 mg/g) and 39 with abnormal UAE (>= 30 mg/g). MetS was more prevalent in the abnormal UAE group (79.5%) than in the normal UAE group (58.5%) (P=0.018). Hypertriglyceridemia (odds ratio = 8.65, P<0.001) and reduced high-density lipoprotein (HDL) cholesterol (odds ratio = 3.27, P=0.022) were both independently associated with abnormal UAE. Using 3.4 as a cut-off value, a high triglyceride-to-HDL cholesterol ratio was a useful marker (odds ratio = 15.05, P<0.001) for abnormal UAE.
Conclusions: A high triglyceride-to-HDL cholesterol ratio was found to be an important risk factor for nephropathy in type 2 diabetic subjects. (C) 2013 Elsevier Inc. All rights reserved
Mortality and Predictors of Mortality from Discharged Hospitalized Diabetic Patients in a Medical Center
No full text背景：糖尿病已位居國人十大死亡原因第四位，但由於國內目前尚無針對糖尿病住院病患出院後的長期追蹤其死因之研究報告，因此我們收集糖尿病住院病患的臨床相關資料加以統計分析，以瞭解我國糖尿病住院病患出院後之死亡率及找出可能之危險因子。
目標:針對台灣某醫學中心的糖尿病住院病患，探討其出院後之死亡率、死亡原因、標準化死亡比(standardized mortality ratio，SMR)，及嘗試找出預測死亡之可能因子。
研究設計及方法：本研究是採前瞻性的世代研究（cohort study），收集西元1996年至2002年期間某醫學中心新陳代謝科的糖尿病住院後之出院病患，總計1792位。我們將此糖尿病患之名單連結至全國之死因檔，找出出院後在2002年12月31日前死亡之患者。其死亡證書上的死因是依據國際疾病分類碼第九版(ICD-9)而來，而標準化死亡比（SMR）則是以台灣一般人口當做參考組。以Kaplan-Meier方法作存活曲線並使用Cox的之單變量及多變量分析來探討可能因子對死亡風險之預測性。
結果：在1792位糖尿病住院病患中，男性為999位，女性為793位。平均年齡為62.4±15.0歲。全體總追蹤的人年數為4,399.2，男性患者的追蹤人年數為 2,404.8，女性為1,994.4。平均追蹤時間為29.5±21.0個月，中位數為27.0個月（2〜67個月），追蹤期間之死亡人數共有410位，男性為250位，女性160位，粗死亡率為93.2/1000人年。死亡率隨著年齡之增加而升高，糖尿病男性患者的死亡風險雖高於女性，但在各年齡層間無統計上之差異性。全體的標準化死亡比（SMR)為2.98（2.71〜3.28），其中男性為2.58（2.28-2.92），女性為3.80（3.25- 4.43），被歸類為糖尿病的標準化死亡比為14.92（12.76〜17.46），心血管疾病的標準化死亡比為1.97（1.57〜2.49）。糖尿病患的原死因百分比依序為：糖尿病、惡性腫瘤、心肺疾病、感染、中風、消化道疾病、腎病變、事故傷害、自殺、動脈小動脈和微血管的疾病，各個的死因比率分別為38.0，13.2，9.5，7.8，7.6，6.8，5.1，2.0，0.5，以及0.2%。從 Cox proportional hazard regression models的多變量分析發現糖尿病住院病患的年齡較長、高血壓罹病時間愈長、肌酸酐清除率較低、24小時蛋白尿較高者，是導致糖尿病住院病患後續死亡的獨立預測因子。
結論:糖尿病住院病患的後續死亡率約是台灣一般人口的3倍,增加住院糖尿病患者死亡之獨立預測因子為年齡高、高血壓罹病時間愈長、24小時蛋白尿增加、較低的肌酸酐清除率。Background: Diabetes mellitus has been the fourth leading causes of death in Taiwan. Currently, there is no long term follow-up report with regarding to diabetic inpatients in Taiwan. In order to understand the mortality rate of diabetic inpatients after discharge from hospital and to find the possible predictors, we collected the clinical data and following causes of death in a group of diabetic inpatients.
Objective: To investigate the mortality rate, causes of death, and standardized mortality ratio (SMR), and further to identify the significant predicting factors of mortality from discharged hospitalized diabetic patients in a medical center at Taiwan.
Research design and methods: A prospective cohort study was carried out with 1792 discharged diabetic inpatients in a medical center during the years 1996-2002. These 1792 subjects were linked to the national mortality database to ascertain the diabetic subjects who died before Dec. 31, 2002. Underlying causes of death were determined from death certificates coded according to the 9th revision of the International Classification of Diseases. Excess mortality in this cohort study was evaluated by calculating standardized mortality ratios (SMRs) in relation to those of the general population. Predictors of mortality were assessed by Kaplan-Meier survival curves and by uni- and multivariate Cox survival analyses.
Results: A total of 1792 patients were studied, with 999 male and 793 female. The mean age was 62.415.0 years. The total follow-up person-years were 4,399.2 (2,404.8 for males, 1,994.4 for females), The mean follow-up period was 29.521.0 months, and the median was 27.0 months (ranged 2-67 months). During this period 410 patients died (250 in males, 160 in females) with the crude mortality rate was 93.2/1,000 person-years. The overall SMR was 2.98 (2.71-3.28), with 2.58(2.28- 2.92) in men and 3.80(3.25-4.43) in women. SMR caused by diabetes was 14.92(12.76-17.46), by cardiovascular SMR was 1.97(1.57-2.49). The percentage of causes of death ascribed to diabetes, cancer, cardiopulmonary disease, infection, stroke, digestive diseases, nephropathy, accidents, suicide, and disease of arteries, arterioles, and capillaries were 38.0, 13.2, 9.5, 7.8, 7.6, 6.8, 5.1, 2.0, 0.5, and 0.2 %, respectively. The independent predictors of mortality were older age, longer duration hypertension, increased 24h proteinuria, and decreased creatinine clearance, which were obtained by multivariate Cox proportional hazard regression models.
Conclusions: In general discharged hospitalized diabetic patients had about threefold excess mortality than the general population. The predictors of mortality included older age, longer duration hypertension, increased 24h proteinuria, and decreased creatinine clearance.目 錄
口試委員會審定 …………………………………………………………… i
博碩士論文授權書………………………………………………………… ii
誌謝 …………………………………………………………………………iii
目錄………………………………………………………………………… iv
表目錄 ………………………………………………………………………vii
圖目錄………………………………………………………………………ix
中文摘要 ……………………………………………………………………1
英文摘要 ……………………………………………………………………3
第一章 緒論
第一節 研究動機……………………………………………………………5
第二節 研究目的……………………………………………………………9
第三節 研究假設 …………………………………………………………10
第四節 名詞界定 …………………………………………………………11
第二章 文獻考證
第一節 糖尿病之流行病學 ………………………………………………20
第二節 糖尿病之併發症 …………………………………………………23
第三節 糖尿病患之過剩死亡率 …………………………………………28
第三章 研究方法
第一節 研究對象與場所 …………………………………………………31
第二節 研究方法 …………………………………………………………32
第三節 研究數據之定義 …………………………………………………36
第四節 資料之統計分析 …………………………………………………41
第五節 倫理考量 …………………………………………………………42
第四章 研究結果
第一節 研究對象之特性描述 ……………………………………………43
第二節 不同年齡別及性別之死亡率及標準化死亡比之分析 …………46
第三節 糖尿病患之死因百分比及年齡標準化死亡比之分析 …………48
第四節 存活者與死亡者檢驗值之比較分析 ……………………………50
第五節 依性別區分存活者與死亡者檢驗值之比較分析 ………………52
第六節 不同死因別間臨床特徵之分析 …………………………………55
第七節 糖尿病住院病患之單變項分析 …………………………………58
第八節 糖尿病住院病患之死亡預測因子 ………………………………60
第五章 討論
第一節 糖尿病之死亡率 …………………………………………………62
第二節 糖尿病患之死亡原因 ……………………………………………66
第三節 糖尿病患死亡率之相關危險因子 ………………………………71
第六章 結論……………………………………………………………… 75
參考資料 …………………………………………………………………99
表目錄
表一.糖尿病住院病患男性和女性之臨床特徵分析(連續變項）…………… 77
表二.糖尿病住院病患男性和女性之臨床特徵分析（類別變項） ………… 78
表三. 糖尿病住院病患每1000人年之年齡別性別死亡率和標準化死亡比
(SMR)及性別死亡率比………………………………………………………… 79
表四.糖尿病住院病患之死因別百分比和年齡標準化死亡比 ……………… 80
表五.糖尿病住院病患存活者和死亡者之臨床特徵分析(連續變項)…………81
表六.糖尿病住院病患存活者和死亡者之臨床特徵分析(類別變項)…………82
表七.男性糖尿病住院病患存活者和死亡者之臨床特徵分析(連續變項)……83
表八.男性糖尿病住院病患存活者和死亡者之臨床特徵分析(類別變項)……84
表九.女性糖尿病住院病患存活者和死亡者之臨床特徵分析(連續變項)……85
表十.女性糖尿病住院病患存活者和死亡者之臨床特徵分析(類別變項)……86
表十一.糖尿病住院病患死因別為糖尿病和非糖尿病之臨床特徵分析(連續變項) ……………………………………………………………………87
表十二.糖尿病住院病患死因別為糖尿病和非糖尿病之臨床特徵分析(類別變項)…………………………………………………………………… 88
表十三.糖尿病住院病患以死因別為糖尿病、心血管疾病和其他疾病之臨床特徵分析(連續變項) …………………………………………………89
表十四.糖尿病住院病患死因別為糖尿病、心血管疾病和其他疾病之臨床特徵分析(類別變項) ……………………………………………………90
表十五.糖尿病住院病患之單變項Cox存活分析 …………………………………………………………………………………………………………91
表十六.Cox proportional hazards model分析糖尿病住院病患存活有關的預測因子 ………………………………………………………………… 92
表十七.Cox proportional hazards model分析糖尿病住院病患存活有關的預測因子（男） ………………………………………………………… 93
表十八.Cox proportional hazards model分析糖尿病住院病患存活有關的預測因子（女） ………………………………………………………… 94
圖目錄
〈圖一〉糖尿病住院病患年長者的Kaplan-Meier存活曲線…………………95
〈圖二〉糖尿病住院病患高血壓罹病時間長的Kaplan-Meier存活曲線……96
〈圖三〉糖尿病住院病患肌酸酐清除率較低的Kaplan-Meier存活曲線……97
〈圖四〉糖尿病住院病患24小時蛋白尿增加的Kaplan-Meier存活曲線……9
Toward better diabetes care: Exploration and implementation
No full text[[abstract]]Approximately 40 years ago, I was fortunate enough to step into the field of diabetes. When I had my fellowship training in the USA, I learned how to ask a good scientific question and conduct clinical research. With collaboration with my mentors, Prof. Gerald R Reaven and Prof. Ida Chen, we participated in many clinical trials. We established the Taiwan Diabetes Registry (TDR) to track long-term changes in diabetes profiles. The ultimate purpose of medical research is to provide benefits to patients. Using electronic medical records and point-of-care glucometers, we reduced inpatients’ hyperglycemia and hypoglycemia greatly, which was also reflected by the reduction in hospital stays and readmission rates. With the advent of new technology and medications, we have to ponder where we are on the journey toward better diabetes care. We rigorously advocate diabetes care, hold many symposia and publish updated guidelines. We successfully hosted the congress of the 11th International Diabetes Federation Western Pacific Region & 8th Asian Association for the Study of Diabetes Scientific Meeting 2016 at Taipei, Taiwan. As the era of precision medicine is coming, Taiwan could be considered as one of the best places to run precision medicine. The Taiwan Precision Medicine Initiative has enrolled more than half a million residents, and is currently conducting genotyping and data analysis. In conclusion. I witnessed the early days of simple and few choices for diabetes management to the current various modalities in diabetes care. As these new technologies have become available, patients will always remain at the center of the care model with warmth and humility
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