Shih-bin Su - Academia.edu (original) (raw)

Papers by Shih-bin Su

Research paper thumbnail of Prevalence of Urinary Tract Infections and Related Factors Among Female Pregnant Workers in the Electronic Industry

Research paper thumbnail of Open Access

Web-based computer adaptive assessment of individual perceptions of job satisfaction for hospital... more Web-based computer adaptive assessment of individual perceptions of job satisfaction for hospital workplace employees

Research paper thumbnail of Long-Term Prognosis of Patients with Carbon Monoxide Poisoning: A Nationwide Cohort Study

PLoS ONE, 2014

Background: Carbon monoxide poisoning (COP) often produces severe complications and can be fatal.... more Background: Carbon monoxide poisoning (COP) often produces severe complications and can be fatal. Because this topic has not been well delineated, we investigated long-term prognoses of patients with COP (COP [+]). Methods: In this retrospective nationwide cohort study, 441 COP [+] patients and 8820 COP [2] controls (120) from 1999 to 2010 were selected from Taiwan's National Health Insurance Research Database. Results: Thirty-seven (8.39%) COP [+] patients and 142 (1.61%) controls died (P,0.0001) during follow-up. Incidence rate ratios (IRR) of death were 5.24 times higher in COP [+] patients than in controls (P,0.0001). The risk of death was particularly high in the first month after COP (IRR: 308.78; 95% confidence interval [CI]: 40.79-2337.56), 1 to 6 months after (IRR: 18.92; 95% CI: 7.69-46.56), and 6-12 months after (IRR: 4.73; 95% CI: 1.02-21.90). After adjusting for age, gender, and selected comorbidities, the hazard ratio of death for COP [+] patients was still 4.097 times higher than for controls. Moreover, older age ($30 years old), male gender, diabetes mellitus, hypertension, and low income were also independent mortality predictors. Conclusions: COP significantly increases the risk for long-term mortality. Early follow-up and secondary prevention of death are needed for patients with COP.

Research paper thumbnail of A Stabilization Device That Promotes the Efficiency of Cardiopulmonary Resuscitation during Ambulance Transportation to the Level as under Non-Moving Conditions

PLoS ONE, 2014

Background: The survival rate of patients with out-of-hospital cardiac arrest is low, and measure... more Background: The survival rate of patients with out-of-hospital cardiac arrest is low, and measures to improve the quality of cardiopulmonary resuscitation (CPR) during ambulance transportation are desirable. We designed a stabilization device, and in a randomized crossover trial we found performing CPR in a moving ambulance with the device (MD) could achieve better efficiency than that without the device (MND), but the efficiency was lower than that in a non-moving ambulance (NM). Purpose: To evaluate whether a modified version of the stabilization device, can promote further the quality of CPR during ambulance transportation. Methods: Participants of the previous study were recruited, and they performed CPR for 10 minutes in a moving ambulance with the modified version of the stabilization device (MVSD). The primary outcomes were effective chest compressions and no-flow fraction recorded by a skill-reporter manikin. The secondary outcomes included back pain, physiological parameters, and the participants' rating about the device after performing CPR. Results: The overall effective compressions in 10 minutes were 86.4617.5% for NM, 60.9614.6% for MND, 69.7622.4% for MD, and 86.6%613.2% for MVSD (p,0.001). Whereas changes in back pain severity and physiology parameters were similar under all conditions, MVSD had the lowest no-flow fraction. Differences in effective compressions and the no-flow fraction between MVSD and NM did not reach statistical significance. Conclusions: The use of the modified device can improve quality of CPR in a moving ambulance to a level similar to that in a non-moving condition without increasing the severity of back pain.

Research paper thumbnail of A stabilization device to improve the quality of cardiopulmonary resuscitation during ambulance transportation: A randomized crossover trial

Resuscitation, 2013

Background: The quality of cardiopulmonary resuscitation (CPR) during ambulance transportation is... more Background: The quality of cardiopulmonary resuscitation (CPR) during ambulance transportation is suboptimal, and therefore measures that can improve the quality are desirable. Purpose: To evaluate whether the use of a stabilization device can improve the quality of CPR during ambulance transportation. Methods: This randomized controlled crossover trial enrolled 22 experienced ambulance officers. Each participant performed CPR in an ambulance under three conditions with 72 h apart, each condition for 10 min: non-moving (NM), moving without device (MND), and moving with device (MD). The sequences of conditions were randomized. The primary outcomes were effective chest compressions recorded by the Laerdal Resusci-Anne Skill-reporter manikin. The secondary outcomes included the severity of back pain scored using the Brief Pain Inventory short-form, the physiology parameter before and after CPR, and the changes in postural stability which was represented by the sway index (SI) of lower back measured using a goniometer. Results: The overall effective compressions in 10 min were 87.0 ± 17% for NM, 59.0 ± 19% for MND, and 69.0 ± 23% for MD (p < 0.001). Compared to MND, MD had a lower no-flow fraction while driving on curved sections (0.04 vs. 0.29, p < 0.001). Whereas the pain severity and social interference scores were similar under all conditions, MND had a higher SI than MD and NM. Conclusions: The use of a stabilization device can improve the quality of CPR and posture stability during ambulance transportation, although the effects on the severity of back pain were not significant.

Research paper thumbnail of Intermediate bioelectrolyte changes after phospho-soda or polyethylene glycol precolonoscopic laxatives in a population undergoing health examinations

Nephrology Dialysis Transplantation, 2011

Background. Colonoscopy is a common procedure for diagnosing and screening colon cancer and other... more Background. Colonoscopy is a common procedure for diagnosing and screening colon cancer and other bowelrelated diseases. Many studies have pointed out that using phospho-soda as a bowel preparation can cause obvious electrolyte abnormalities or acute kidney injury. Nonetheless, there are few studies related to its prevalence and risk factors in the population undergoing health examinations. Our aim was to compare the biochemical and electrolyte changes after using two commonly used bowel preparation regimens in this population. Methods. In this retrospective study, we collected data about participants who, before a screening colonoscopy, used oral phospho-soda laxatives in 2006, and those who used polyethylene glycol-based laxatives in 2005. Several serum biochemical and electrolyte profiles were compared between the two groups. Additional risk factors of hyperphosphatemia, a well-known side effect of phospho-soda, were also derived. Results. We enrolled a total of 2270 participants (1321 in 2005; 1449 in 2006). The basic demographic data of the two groups were not statistically different. Nonetheless, between the two groups, some serum biochemical and electrolytic data differed significantly: in those using oral phospho-soda laxatives, we found a higher prevalence of hyperuricemia, hypocalcemia, hypokalemia, hypernatremia and hyperphosphatemia. Further analyses showed that using oral phosphosoda laxatives was a risk factor for hyperphosphatemia; conversely, being male was a protective factor. Conclusions. Oral phospho-soda laxatives indeed influence the biochemical and electrolyte profiles of persons undergoing health examinations. One should be careful when interpreting bioelectrolytic data while using phospho-soda as a bowel preparation.

Research paper thumbnail of Eradication of Amebiasis in a Large Institution for Adults With Mental Retardation in Taiwan

Infection Control & Hospital Epidemiology, 2007

Objective.Investigation of a program to eradicate amebiasis using consecutive intensive mass scre... more Objective.Investigation of a program to eradicate amebiasis using consecutive intensive mass screenings followed by medication in a large institute for adults with mental retardation in Taiwan.Design.Prospective cohort study, with 3 years of follow-up.Setting.A large, 450-bed institution for adults with mental retardation located in southern Taiwan.Participants.All 443 adults with mental retardation in the institution, who have various motor and/or mental handicaps, were included in this study.Interventions. A total of 7 consecutive intensive mass screenings for amebiasis for all residents (performed in March, August and November 2001, March and August 2002, January 2003, and May 2004). Infected patients were treated using the standard protocol of the Center for Disease Control of Taiwan.Results.Enzyme immunoassay testing was used for the amebiasis screening, with the rapid detection of the specific antigen for Entamoeba histolytica in human fecal specimens confirmed by microscopic ...

Research paper thumbnail of Decrease in seroprevalence of Hepatitis A after the implementation of nationwide disposable tableware use in Taiwan

BMC Public Health, 2010

Background Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmit... more Background Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use. Methods We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies. Results The overall sero-positive rate was 22.0% in the 11,777 part...

Research paper thumbnail of Screening for pulmonary tuberculosis using chest radiography in new employees in an industrial park in Taiwan

American Journal of Infection Control, 2007

Background: Pulmonary tuberculosis (TB) is prevalent in Taiwan, but it is suspected that its occu... more Background: Pulmonary tuberculosis (TB) is prevalent in Taiwan, but it is suspected that its occurrence has been underestimated by the National TB Surveillance Program. A pre-employment health examination is mandated by law in Taiwan, providing a mechanism to assess the occurrence of TB more accurately. Methods: A pre-employment TB screening program of an industrial park was used to evaluate the performance of the National TB Surveillance Program in Taiwan. The yields of the pre-employment TB screening, using chest radiography from July 2004 to June 2005, were compared with corresponding results of the National TB Surveillance Program. Results: A total of 17,105 new employees with an even gender distribution (men:women ratio, 50.2%:49.8%) underwent screening during the study period. Among the participants, 22 (128.6 per 100,000) new patients with pulmonary TB were diagnosed, and 7 (31.8%) of the patients had positive bacteriology findings. Compared with the results of the National TB Surveillance Program, the pre-employment screening had a much higher yield (128 vs. 47 per 100,000, P , .001). Conclusion: The yield of the active surveillance program through mandatory screening was much higher than that of the National TB Surveillance Program, which is a passive reporting system. The results of this study highlight the need for more active TB surveillance efforts in endemic areas like Taiwan.

Research paper thumbnail of Seroprevalence of rubella among women of childbearing age in Switzerland

European Journal of Clinical Microbiology & Infectious Diseases, 1995

A seroepidemiological study was carried out in Switzerland to define the population susceptible t... more A seroepidemiological study was carried out in Switzerland to define the population susceptible to rubella among women of childbearing age. IgG antibodies to rubella virus were determined in 9,046 women giving birth between 1 August 1990 and 30 September 1991 in 23 of 26 Swiss cantons. These sera represented 10-20% of the yearly total number of births in each Swiss canton. Anti-rubella IgG was measured by an automated enzyme-linked fluorescent assay for use with a commercial system (Vidas Rub IgG, bio-Mérieux, France). Before the study population was screened, the commercial system was compared to the traditional hemagglutination-inhibition (HAI) test using 500 consecutive samples from parturient women. The sensitivity was 97.7%, the specificity was 100%, and agreement between the two tests was 97.8%. The discrepancies corresponded to very low titres of antibodies as measured by HAI. The seroprevalence of rubella nationwide in women of childbearing age in Switzerland was 94.3%. The seroprevalence was higher (96.5%) in the 5,677 women of Swiss nationality than in the 3,090 women of a different nationality (90.4%) (p &lt; 0.001). In Swiss women the seroprevalence of rubella did not increase significantly with age and was identical in primiparous and in multiparous women, thus indicating that women of childbearing age are probably not sufficiently immunised.

Research paper thumbnail of Improving Urinary Tract Infections Among Female Clean Room Workers Through Intensive Health Education and Behaviour Modification

Research paper thumbnail of An app to classify a 5-year survival in patients with breast cancer using the convolutional neural networks (CNN) in Microsoft Excel

Research paper thumbnail of BMC Medical Research Methodology

Research article KIDMAP, a web based system for gathering patients ' feedback on their doctors

Research paper thumbnail of Validation of the Sleep Quality Scale and its Application on Internet

Objectives: In order to effectively help persons examine their insomnia, we planed to assess psyc... more Objectives: In order to effectively help persons examine their insomnia, we planed to assess psychometric properties of sleep quality for Taiwanese version on (1) validation, (2) determination of cut-off point to identify insomnia, and (3)KIDMAP to disclose self-assessing sleep quality. Methods: We adopted Rasch analysis with Winsteps computer software to build up a norm-reference of the self-assessing insomnia on internet for further medical consultation. Results: The measurement of the sleep quality scale for Taiwanese version had an overall reliability coefficient of 0.79 for all subjects. A summed score of greater than 6 was yielded by k-means procedure of cluster analysis. KIDMAP diagnosis could provide examinees with an objective and sufficient diagram to identify their quality of sleep at an early stage. Conclusions: A newly-innovated KIDMAP diagram of self-assessment medical scales for quality-of-sleep diagnosis may be an effective screening approach used as an e-commerce to...

Research paper thumbnail of Using Structure Holes for Determining Key Factors: An Illustration of Reporting Eradication of Amoebiasis

Background: Many researches aim to determine key factors affecting their concerns of interest usi... more Background: Many researches aim to determine key factors affecting their concerns of interest using traditional statistical techniques, such as logistical or linear regressions. Social network analysis (SNA) is a newly novel way determining key roles through the use of network and graph theories recently. An example of commonly visualized through SNA is the disease transmission path of Middle East respiratory syndrome (MERS). Purpose: To determine key roles using structure holes of SNA for further improvement, and to show the SNA advantage over traditional classic test theory. Methods: Data were records regarding 443 adult mentally retarded residents who were infected with amoebiasis and distributed in 10 houses in past 10 years. A series of intensive mass screenings and treatment interventions were conducted. Structure holes were applied to verify the efficacy of determining key roles and strong associations for the domains of interest in a network and compared with the result obta...

Research paper thumbnail of Using the Kano model to associate the number of confirmed cases of COVID-19 in a population of 100,000 with case fatality rates: an observational study

Background: One of the key factors to understand the spread of COVID-19 is the case fatality rate... more Background: One of the key factors to understand the spread of COVID-19 is the case fatality rate(CFR) rates for counties/regions. However, many merely reported those CFRs on the basis of total confirmed cases(TCC) instead of per population of 100, 000. As such, the disparate definitions of CFR yield inconsistent results in COVID-19 situations. Whether both incident rate and the CFR can be indicators to identify a country/region hit by COVID-19 under(or out of) control is still unclear. This study aims to (1) develop a diagram to disperse both TCC and CFR on a population base of 100,000(namely TCC100 and CFR100, respectively) using the Kano model, (2)discuss selected countries/regions with success on preventative measures to keep COVID-19 under control(i.e., relatively lower TCC100 and CFR100 or CFR), and (3) design an app to display both TCC100 and CFR100 or CFR for all infected countries/regions. Methods: We downloaded the COVID-19 data of confirmed cases and deaths in countries/r...

Research paper thumbnail of Comparison of the risk for dementia between physicians and the general population: a nationwide population-based cohort study

Aging Clinical and Experimental Research

Background Physicians have better medical knowledge, which may decrease the risk of dementia; how... more Background Physicians have better medical knowledge, which may decrease the risk of dementia; however, this issue remains unclear. This study was performed to clarify it. Methods We conducted a nationwide population-based study that recruited 29,388 physicians, 50,000 participants from the general population, and 30,446 other healthcare professionals (HCPs; excluding physicians) for this study. The prevalence of dementia was compared among the three groups and physician subgroups by tracing their medical histories from 2006 to 2012. Results Physicians had a lower prevalence of dementia than the general population after adjusting for age, sex, head trauma, hypothyroidism, hypertension, diabetes mellitus, stroke, vascular disease, atrial fibrillation, hypercholesterolemia, depression, and alcoholism [adjusted odds ratio (AOR) 0.56; 95% confidence interval (CI) 0.47–0.67]. Other HCPs also had a lower prevalence for dementia than the general population (AOR 0.46; 95% CI 0.36–0.60). Compared with other HCPs, physicians had no difference in the prevalence for dementia (AOR 0.98 95% CI 0.71–1.36). Physicians who were older, specialized in pediatrics and worked at local hospitals and clinics had a higher prevalence for dementia than their counterparts did. Conclusions Physicians had a lower prevalence for dementia than the general population. The prevalence for dementia in specific subgroups of physicians was higher, which needs to be clarified by further studies.

Research paper thumbnail of Exposure Duration and History of Hypertension Predicted Neurological Sequelae in Patients with Carbon Monoxide Poisoning

Epidemiology

BACKGROUND Carbon monoxide poisoning (COP) accounts for a large number of emergency department vi... more BACKGROUND Carbon monoxide poisoning (COP) accounts for a large number of emergency department visits worldwide and is fatal in many cases. In surviving patients, neurological sequelae (NS) attributable to cerebral hypoxia are the most devastating outcome, but reliable predictors are limited. Therefore, we conducted a study to identify predictors of NS in patients with COP and evaluate their effects. METHODS In this retrospective case-control study, we identified patients with COP in a medical center in Southern Taiwan between January 2005 and December 2014. Cases were patients with NS, and controls were patients without NS. We obtained information on potential predictors of NS from medical records and evaluated their association with NS, including demographic characteristics, exposure source, suicide attempts, duration of exposure (by tertile), histories, symptoms, signs, laboratory data, treatment, and the length of hospital stay. RESULTS We included 371 patients with COP. Of them, 93 developed NS, and their mean ages (41.4 ± 14.7 years vs. 39.7 ± 14.2 years) and proportions of males (59.1% vs. 58.6%) were similar to those in the 298 controls. Multivariate logistic regression showed that a history of hypertension (adjusted odds ratio = 2.1; 95% confidence interval = 1.0, 4.5) and a longer duration of carbon monoxide exposure (adjusted odds ratio = 1.7; 95% confidence interval = 1.1, 2.8; the longest tertile [>5 hours] vs. the other two tertiles [≤5 hours]) were independent predictors for NS, but not the level of carboxyhemoglobin. CONCLUSIONS This study identified two independent predictors for NS that may be useful for public healthcare workers and physicians in predicting outcomes and deciding on treatment strategies for COP patients.

Research paper thumbnail of Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution

The oncologic merits of laparoscopic technique for colorectal cancer surgery remain debatable. El... more The oncologic merits of laparoscopic technique for colorectal cancer surgery remain debatable. Eligible patients with non-metastatic colorectal cancer who were scheduled for an elective resection by only one surgeon in a medical institution were randomized to either laparoscopic or open treatment. During this period, total 188 patients received laparoscopic surgery and other 163 patients to open approach. The primary endpoint was cancer-free 5-year survival after operative treatment and secondary endpoint was the tumor recurrence incidence. We found there was no statistically significant difference between open and laparoscopic groups regarding average number of lymph nodes dissected, overall mortality rate, cancer recurrence rate or cancer-free 5-year survival. Nevertheless, laparoscopic approach was more effective for colorectal cancer treatment with shorter hospital stay and less blood loss despite operation time was significantly longer. Meanwhile fewer patients receiving laparo...

Research paper thumbnail of Risk for cervical herniated intervertebral disc in dentists: a nationwide population-based study

BMC Musculoskeletal Disorders

Background: Prolonged static postures (PSPs) may predispose dentists to develop cervical herniate... more Background: Prolonged static postures (PSPs) may predispose dentists to develop cervical herniated intervertebral disc (C-HIVD); however, there is limited evidence supporting this in the literature thus far. We conducted this study to fit the data gap. Methods: We conducted a retrospective nationwide population-based study using the Taiwan National Health Insurance Research Database to identify 10,930 dentists, an identical number of age-and sex-matched participants from the general population, and 73,718 other health care providers (HCPs, non-dentists). Comparisons for the risk of developing C-HIVD between dentists and the general population, and between dentists and other HCPs were performed by tracing their medical histories between 2007 and 2011. Results: Dentists had a cumulative incidence rate of 1.1% for C-HIVD during the 5-year follow-up period. Overall, there was no difference of the risk for C-HIVD between dentists and the general population after adjusting for hypertension, hyperlipidemia, liver disease, mental disorders, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy, stroke, and renal disease (adjusted odds ratio [AOR]: 1.2, 95% confidence interval [CI]: 0.9-1.6). However, stratified analysis showed that younger dentists (≤ 34 years) had a trend of higher risk for C-HIVD than members of the younger general population (AOR: 1.9, 95% CI: 0.9-4.1). There was no difference found between dentists and other HCPs (AOR: 0.9, 95% CI: 0.8-1.1). Conclusion: Younger dentists had a trend of higher risk of developing C-HIVD than members of the general population.

Research paper thumbnail of Prevalence of Urinary Tract Infections and Related Factors Among Female Pregnant Workers in the Electronic Industry

Research paper thumbnail of Open Access

Web-based computer adaptive assessment of individual perceptions of job satisfaction for hospital... more Web-based computer adaptive assessment of individual perceptions of job satisfaction for hospital workplace employees

Research paper thumbnail of Long-Term Prognosis of Patients with Carbon Monoxide Poisoning: A Nationwide Cohort Study

PLoS ONE, 2014

Background: Carbon monoxide poisoning (COP) often produces severe complications and can be fatal.... more Background: Carbon monoxide poisoning (COP) often produces severe complications and can be fatal. Because this topic has not been well delineated, we investigated long-term prognoses of patients with COP (COP [+]). Methods: In this retrospective nationwide cohort study, 441 COP [+] patients and 8820 COP [2] controls (120) from 1999 to 2010 were selected from Taiwan's National Health Insurance Research Database. Results: Thirty-seven (8.39%) COP [+] patients and 142 (1.61%) controls died (P,0.0001) during follow-up. Incidence rate ratios (IRR) of death were 5.24 times higher in COP [+] patients than in controls (P,0.0001). The risk of death was particularly high in the first month after COP (IRR: 308.78; 95% confidence interval [CI]: 40.79-2337.56), 1 to 6 months after (IRR: 18.92; 95% CI: 7.69-46.56), and 6-12 months after (IRR: 4.73; 95% CI: 1.02-21.90). After adjusting for age, gender, and selected comorbidities, the hazard ratio of death for COP [+] patients was still 4.097 times higher than for controls. Moreover, older age ($30 years old), male gender, diabetes mellitus, hypertension, and low income were also independent mortality predictors. Conclusions: COP significantly increases the risk for long-term mortality. Early follow-up and secondary prevention of death are needed for patients with COP.

Research paper thumbnail of A Stabilization Device That Promotes the Efficiency of Cardiopulmonary Resuscitation during Ambulance Transportation to the Level as under Non-Moving Conditions

PLoS ONE, 2014

Background: The survival rate of patients with out-of-hospital cardiac arrest is low, and measure... more Background: The survival rate of patients with out-of-hospital cardiac arrest is low, and measures to improve the quality of cardiopulmonary resuscitation (CPR) during ambulance transportation are desirable. We designed a stabilization device, and in a randomized crossover trial we found performing CPR in a moving ambulance with the device (MD) could achieve better efficiency than that without the device (MND), but the efficiency was lower than that in a non-moving ambulance (NM). Purpose: To evaluate whether a modified version of the stabilization device, can promote further the quality of CPR during ambulance transportation. Methods: Participants of the previous study were recruited, and they performed CPR for 10 minutes in a moving ambulance with the modified version of the stabilization device (MVSD). The primary outcomes were effective chest compressions and no-flow fraction recorded by a skill-reporter manikin. The secondary outcomes included back pain, physiological parameters, and the participants' rating about the device after performing CPR. Results: The overall effective compressions in 10 minutes were 86.4617.5% for NM, 60.9614.6% for MND, 69.7622.4% for MD, and 86.6%613.2% for MVSD (p,0.001). Whereas changes in back pain severity and physiology parameters were similar under all conditions, MVSD had the lowest no-flow fraction. Differences in effective compressions and the no-flow fraction between MVSD and NM did not reach statistical significance. Conclusions: The use of the modified device can improve quality of CPR in a moving ambulance to a level similar to that in a non-moving condition without increasing the severity of back pain.

Research paper thumbnail of A stabilization device to improve the quality of cardiopulmonary resuscitation during ambulance transportation: A randomized crossover trial

Resuscitation, 2013

Background: The quality of cardiopulmonary resuscitation (CPR) during ambulance transportation is... more Background: The quality of cardiopulmonary resuscitation (CPR) during ambulance transportation is suboptimal, and therefore measures that can improve the quality are desirable. Purpose: To evaluate whether the use of a stabilization device can improve the quality of CPR during ambulance transportation. Methods: This randomized controlled crossover trial enrolled 22 experienced ambulance officers. Each participant performed CPR in an ambulance under three conditions with 72 h apart, each condition for 10 min: non-moving (NM), moving without device (MND), and moving with device (MD). The sequences of conditions were randomized. The primary outcomes were effective chest compressions recorded by the Laerdal Resusci-Anne Skill-reporter manikin. The secondary outcomes included the severity of back pain scored using the Brief Pain Inventory short-form, the physiology parameter before and after CPR, and the changes in postural stability which was represented by the sway index (SI) of lower back measured using a goniometer. Results: The overall effective compressions in 10 min were 87.0 ± 17% for NM, 59.0 ± 19% for MND, and 69.0 ± 23% for MD (p < 0.001). Compared to MND, MD had a lower no-flow fraction while driving on curved sections (0.04 vs. 0.29, p < 0.001). Whereas the pain severity and social interference scores were similar under all conditions, MND had a higher SI than MD and NM. Conclusions: The use of a stabilization device can improve the quality of CPR and posture stability during ambulance transportation, although the effects on the severity of back pain were not significant.

Research paper thumbnail of Intermediate bioelectrolyte changes after phospho-soda or polyethylene glycol precolonoscopic laxatives in a population undergoing health examinations

Nephrology Dialysis Transplantation, 2011

Background. Colonoscopy is a common procedure for diagnosing and screening colon cancer and other... more Background. Colonoscopy is a common procedure for diagnosing and screening colon cancer and other bowelrelated diseases. Many studies have pointed out that using phospho-soda as a bowel preparation can cause obvious electrolyte abnormalities or acute kidney injury. Nonetheless, there are few studies related to its prevalence and risk factors in the population undergoing health examinations. Our aim was to compare the biochemical and electrolyte changes after using two commonly used bowel preparation regimens in this population. Methods. In this retrospective study, we collected data about participants who, before a screening colonoscopy, used oral phospho-soda laxatives in 2006, and those who used polyethylene glycol-based laxatives in 2005. Several serum biochemical and electrolyte profiles were compared between the two groups. Additional risk factors of hyperphosphatemia, a well-known side effect of phospho-soda, were also derived. Results. We enrolled a total of 2270 participants (1321 in 2005; 1449 in 2006). The basic demographic data of the two groups were not statistically different. Nonetheless, between the two groups, some serum biochemical and electrolytic data differed significantly: in those using oral phospho-soda laxatives, we found a higher prevalence of hyperuricemia, hypocalcemia, hypokalemia, hypernatremia and hyperphosphatemia. Further analyses showed that using oral phosphosoda laxatives was a risk factor for hyperphosphatemia; conversely, being male was a protective factor. Conclusions. Oral phospho-soda laxatives indeed influence the biochemical and electrolyte profiles of persons undergoing health examinations. One should be careful when interpreting bioelectrolytic data while using phospho-soda as a bowel preparation.

Research paper thumbnail of Eradication of Amebiasis in a Large Institution for Adults With Mental Retardation in Taiwan

Infection Control & Hospital Epidemiology, 2007

Objective.Investigation of a program to eradicate amebiasis using consecutive intensive mass scre... more Objective.Investigation of a program to eradicate amebiasis using consecutive intensive mass screenings followed by medication in a large institute for adults with mental retardation in Taiwan.Design.Prospective cohort study, with 3 years of follow-up.Setting.A large, 450-bed institution for adults with mental retardation located in southern Taiwan.Participants.All 443 adults with mental retardation in the institution, who have various motor and/or mental handicaps, were included in this study.Interventions. A total of 7 consecutive intensive mass screenings for amebiasis for all residents (performed in March, August and November 2001, March and August 2002, January 2003, and May 2004). Infected patients were treated using the standard protocol of the Center for Disease Control of Taiwan.Results.Enzyme immunoassay testing was used for the amebiasis screening, with the rapid detection of the specific antigen for Entamoeba histolytica in human fecal specimens confirmed by microscopic ...

Research paper thumbnail of Decrease in seroprevalence of Hepatitis A after the implementation of nationwide disposable tableware use in Taiwan

BMC Public Health, 2010

Background Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmit... more Background Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use. Methods We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies. Results The overall sero-positive rate was 22.0% in the 11,777 part...

Research paper thumbnail of Screening for pulmonary tuberculosis using chest radiography in new employees in an industrial park in Taiwan

American Journal of Infection Control, 2007

Background: Pulmonary tuberculosis (TB) is prevalent in Taiwan, but it is suspected that its occu... more Background: Pulmonary tuberculosis (TB) is prevalent in Taiwan, but it is suspected that its occurrence has been underestimated by the National TB Surveillance Program. A pre-employment health examination is mandated by law in Taiwan, providing a mechanism to assess the occurrence of TB more accurately. Methods: A pre-employment TB screening program of an industrial park was used to evaluate the performance of the National TB Surveillance Program in Taiwan. The yields of the pre-employment TB screening, using chest radiography from July 2004 to June 2005, were compared with corresponding results of the National TB Surveillance Program. Results: A total of 17,105 new employees with an even gender distribution (men:women ratio, 50.2%:49.8%) underwent screening during the study period. Among the participants, 22 (128.6 per 100,000) new patients with pulmonary TB were diagnosed, and 7 (31.8%) of the patients had positive bacteriology findings. Compared with the results of the National TB Surveillance Program, the pre-employment screening had a much higher yield (128 vs. 47 per 100,000, P , .001). Conclusion: The yield of the active surveillance program through mandatory screening was much higher than that of the National TB Surveillance Program, which is a passive reporting system. The results of this study highlight the need for more active TB surveillance efforts in endemic areas like Taiwan.

Research paper thumbnail of Seroprevalence of rubella among women of childbearing age in Switzerland

European Journal of Clinical Microbiology & Infectious Diseases, 1995

A seroepidemiological study was carried out in Switzerland to define the population susceptible t... more A seroepidemiological study was carried out in Switzerland to define the population susceptible to rubella among women of childbearing age. IgG antibodies to rubella virus were determined in 9,046 women giving birth between 1 August 1990 and 30 September 1991 in 23 of 26 Swiss cantons. These sera represented 10-20% of the yearly total number of births in each Swiss canton. Anti-rubella IgG was measured by an automated enzyme-linked fluorescent assay for use with a commercial system (Vidas Rub IgG, bio-Mérieux, France). Before the study population was screened, the commercial system was compared to the traditional hemagglutination-inhibition (HAI) test using 500 consecutive samples from parturient women. The sensitivity was 97.7%, the specificity was 100%, and agreement between the two tests was 97.8%. The discrepancies corresponded to very low titres of antibodies as measured by HAI. The seroprevalence of rubella nationwide in women of childbearing age in Switzerland was 94.3%. The seroprevalence was higher (96.5%) in the 5,677 women of Swiss nationality than in the 3,090 women of a different nationality (90.4%) (p &lt; 0.001). In Swiss women the seroprevalence of rubella did not increase significantly with age and was identical in primiparous and in multiparous women, thus indicating that women of childbearing age are probably not sufficiently immunised.

Research paper thumbnail of Improving Urinary Tract Infections Among Female Clean Room Workers Through Intensive Health Education and Behaviour Modification

Research paper thumbnail of An app to classify a 5-year survival in patients with breast cancer using the convolutional neural networks (CNN) in Microsoft Excel

Research paper thumbnail of BMC Medical Research Methodology

Research article KIDMAP, a web based system for gathering patients ' feedback on their doctors

Research paper thumbnail of Validation of the Sleep Quality Scale and its Application on Internet

Objectives: In order to effectively help persons examine their insomnia, we planed to assess psyc... more Objectives: In order to effectively help persons examine their insomnia, we planed to assess psychometric properties of sleep quality for Taiwanese version on (1) validation, (2) determination of cut-off point to identify insomnia, and (3)KIDMAP to disclose self-assessing sleep quality. Methods: We adopted Rasch analysis with Winsteps computer software to build up a norm-reference of the self-assessing insomnia on internet for further medical consultation. Results: The measurement of the sleep quality scale for Taiwanese version had an overall reliability coefficient of 0.79 for all subjects. A summed score of greater than 6 was yielded by k-means procedure of cluster analysis. KIDMAP diagnosis could provide examinees with an objective and sufficient diagram to identify their quality of sleep at an early stage. Conclusions: A newly-innovated KIDMAP diagram of self-assessment medical scales for quality-of-sleep diagnosis may be an effective screening approach used as an e-commerce to...

Research paper thumbnail of Using Structure Holes for Determining Key Factors: An Illustration of Reporting Eradication of Amoebiasis

Background: Many researches aim to determine key factors affecting their concerns of interest usi... more Background: Many researches aim to determine key factors affecting their concerns of interest using traditional statistical techniques, such as logistical or linear regressions. Social network analysis (SNA) is a newly novel way determining key roles through the use of network and graph theories recently. An example of commonly visualized through SNA is the disease transmission path of Middle East respiratory syndrome (MERS). Purpose: To determine key roles using structure holes of SNA for further improvement, and to show the SNA advantage over traditional classic test theory. Methods: Data were records regarding 443 adult mentally retarded residents who were infected with amoebiasis and distributed in 10 houses in past 10 years. A series of intensive mass screenings and treatment interventions were conducted. Structure holes were applied to verify the efficacy of determining key roles and strong associations for the domains of interest in a network and compared with the result obta...

Research paper thumbnail of Using the Kano model to associate the number of confirmed cases of COVID-19 in a population of 100,000 with case fatality rates: an observational study

Background: One of the key factors to understand the spread of COVID-19 is the case fatality rate... more Background: One of the key factors to understand the spread of COVID-19 is the case fatality rate(CFR) rates for counties/regions. However, many merely reported those CFRs on the basis of total confirmed cases(TCC) instead of per population of 100, 000. As such, the disparate definitions of CFR yield inconsistent results in COVID-19 situations. Whether both incident rate and the CFR can be indicators to identify a country/region hit by COVID-19 under(or out of) control is still unclear. This study aims to (1) develop a diagram to disperse both TCC and CFR on a population base of 100,000(namely TCC100 and CFR100, respectively) using the Kano model, (2)discuss selected countries/regions with success on preventative measures to keep COVID-19 under control(i.e., relatively lower TCC100 and CFR100 or CFR), and (3) design an app to display both TCC100 and CFR100 or CFR for all infected countries/regions. Methods: We downloaded the COVID-19 data of confirmed cases and deaths in countries/r...

Research paper thumbnail of Comparison of the risk for dementia between physicians and the general population: a nationwide population-based cohort study

Aging Clinical and Experimental Research

Background Physicians have better medical knowledge, which may decrease the risk of dementia; how... more Background Physicians have better medical knowledge, which may decrease the risk of dementia; however, this issue remains unclear. This study was performed to clarify it. Methods We conducted a nationwide population-based study that recruited 29,388 physicians, 50,000 participants from the general population, and 30,446 other healthcare professionals (HCPs; excluding physicians) for this study. The prevalence of dementia was compared among the three groups and physician subgroups by tracing their medical histories from 2006 to 2012. Results Physicians had a lower prevalence of dementia than the general population after adjusting for age, sex, head trauma, hypothyroidism, hypertension, diabetes mellitus, stroke, vascular disease, atrial fibrillation, hypercholesterolemia, depression, and alcoholism [adjusted odds ratio (AOR) 0.56; 95% confidence interval (CI) 0.47–0.67]. Other HCPs also had a lower prevalence for dementia than the general population (AOR 0.46; 95% CI 0.36–0.60). Compared with other HCPs, physicians had no difference in the prevalence for dementia (AOR 0.98 95% CI 0.71–1.36). Physicians who were older, specialized in pediatrics and worked at local hospitals and clinics had a higher prevalence for dementia than their counterparts did. Conclusions Physicians had a lower prevalence for dementia than the general population. The prevalence for dementia in specific subgroups of physicians was higher, which needs to be clarified by further studies.

Research paper thumbnail of Exposure Duration and History of Hypertension Predicted Neurological Sequelae in Patients with Carbon Monoxide Poisoning

Epidemiology

BACKGROUND Carbon monoxide poisoning (COP) accounts for a large number of emergency department vi... more BACKGROUND Carbon monoxide poisoning (COP) accounts for a large number of emergency department visits worldwide and is fatal in many cases. In surviving patients, neurological sequelae (NS) attributable to cerebral hypoxia are the most devastating outcome, but reliable predictors are limited. Therefore, we conducted a study to identify predictors of NS in patients with COP and evaluate their effects. METHODS In this retrospective case-control study, we identified patients with COP in a medical center in Southern Taiwan between January 2005 and December 2014. Cases were patients with NS, and controls were patients without NS. We obtained information on potential predictors of NS from medical records and evaluated their association with NS, including demographic characteristics, exposure source, suicide attempts, duration of exposure (by tertile), histories, symptoms, signs, laboratory data, treatment, and the length of hospital stay. RESULTS We included 371 patients with COP. Of them, 93 developed NS, and their mean ages (41.4 ± 14.7 years vs. 39.7 ± 14.2 years) and proportions of males (59.1% vs. 58.6%) were similar to those in the 298 controls. Multivariate logistic regression showed that a history of hypertension (adjusted odds ratio = 2.1; 95% confidence interval = 1.0, 4.5) and a longer duration of carbon monoxide exposure (adjusted odds ratio = 1.7; 95% confidence interval = 1.1, 2.8; the longest tertile [>5 hours] vs. the other two tertiles [≤5 hours]) were independent predictors for NS, but not the level of carboxyhemoglobin. CONCLUSIONS This study identified two independent predictors for NS that may be useful for public healthcare workers and physicians in predicting outcomes and deciding on treatment strategies for COP patients.

Research paper thumbnail of Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution

The oncologic merits of laparoscopic technique for colorectal cancer surgery remain debatable. El... more The oncologic merits of laparoscopic technique for colorectal cancer surgery remain debatable. Eligible patients with non-metastatic colorectal cancer who were scheduled for an elective resection by only one surgeon in a medical institution were randomized to either laparoscopic or open treatment. During this period, total 188 patients received laparoscopic surgery and other 163 patients to open approach. The primary endpoint was cancer-free 5-year survival after operative treatment and secondary endpoint was the tumor recurrence incidence. We found there was no statistically significant difference between open and laparoscopic groups regarding average number of lymph nodes dissected, overall mortality rate, cancer recurrence rate or cancer-free 5-year survival. Nevertheless, laparoscopic approach was more effective for colorectal cancer treatment with shorter hospital stay and less blood loss despite operation time was significantly longer. Meanwhile fewer patients receiving laparo...

Research paper thumbnail of Risk for cervical herniated intervertebral disc in dentists: a nationwide population-based study

BMC Musculoskeletal Disorders

Background: Prolonged static postures (PSPs) may predispose dentists to develop cervical herniate... more Background: Prolonged static postures (PSPs) may predispose dentists to develop cervical herniated intervertebral disc (C-HIVD); however, there is limited evidence supporting this in the literature thus far. We conducted this study to fit the data gap. Methods: We conducted a retrospective nationwide population-based study using the Taiwan National Health Insurance Research Database to identify 10,930 dentists, an identical number of age-and sex-matched participants from the general population, and 73,718 other health care providers (HCPs, non-dentists). Comparisons for the risk of developing C-HIVD between dentists and the general population, and between dentists and other HCPs were performed by tracing their medical histories between 2007 and 2011. Results: Dentists had a cumulative incidence rate of 1.1% for C-HIVD during the 5-year follow-up period. Overall, there was no difference of the risk for C-HIVD between dentists and the general population after adjusting for hypertension, hyperlipidemia, liver disease, mental disorders, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy, stroke, and renal disease (adjusted odds ratio [AOR]: 1.2, 95% confidence interval [CI]: 0.9-1.6). However, stratified analysis showed that younger dentists (≤ 34 years) had a trend of higher risk for C-HIVD than members of the younger general population (AOR: 1.9, 95% CI: 0.9-4.1). There was no difference found between dentists and other HCPs (AOR: 0.9, 95% CI: 0.8-1.1). Conclusion: Younger dentists had a trend of higher risk of developing C-HIVD than members of the general population.