Analysis of clinical associated factors of vertical root fracture cases found in endodontic surgery.

BACKGROUND/PURPOSE: Early diagnosis of vertical root fracture (VRF) has been a great challenge. Since there is no single specific etiology identified, prevention of VRFs in endodontically treated teeth is quite difficult. The study aimed to evaluate the clinical associated factors of VRFs. MATERIALS AND METHODS: A retrospective observational study of medical charts was conducted in the Department of Endodontics of Taipei Medical University Hospital in Taiwan from January 2012 to July 2018. Logistic regression model was performed to determine the association between VRF and its clinical associated factors, inclusive of the tooth characteristics (age, gender and tooth type) and iatrogenic risk factors (history of root canal treatment, restoration and post). RESULTS: A total of 359 teeth were included in the study. The prevalence of VRF on a tooth basis was 18.7%. The result showed that age of more than 50 years (adjusted OR = 3.20, 95% CI: 1.81-5.64, p < 0.001) had significant higher risk of VRFs than those of less than 50 years. The subjects of molars (adjusted OR = 4.31; 95%CI = 2.24-8.27; P value < 0.001) and premolars (adjusted OR = 2.61; 95%CI = 1.16-5.86; P value = 0.021) had significant higher risk of VRFs than those of incisors. However, other variables such as gender, history of root canal treatment, restoration and post had no significant association with the VRF. CONCLUSION: Age and tooth type are significant clinical associated factors of VRF. In the presence of these factors as well as predominant diagnostic factors, clinical practitioners should be aware of the possible diagnosis of VRFs.

The association between clinical diagnostic factors and the prevalence of vertical root fracture in endodontic surgery.

BACKGROUND/PURPOSE: Diagnosis of vertical root fractures (VRFs) can often be challenging due to the similarity of signs and symptoms with other common dental infectious diseases. This study was aimed at evaluating the potential relationship between VRFs and commonly used clinical diagnostic factors. METHODS: 330 root-filled teeth with endodontic failures were subjected to endodontic microsurgery over a six-year period. VRFs were identified in 61 teeth. A randomly age- and sex-matched retrospective case-control study was conducted on a subset of 59 root-filled teeth with VRFs (cases) and 177 root-filled teeth without VRFs (controls). The strength of association between preoperative signs and radiographic findings and VRFs was evaluated using logistic regression model. RESULTS: Sinus tract, periodontal pocket depth ≥5 mm, periodontal swelling or abscess, and radiological image of J-shaped or "halo" radiolucency were significantly more frequent in cases than in controls (p < 0.05). With regard to logistic regression analysis, J-shaped or "halo" radiolucency demonstrated the greatest association with VRF, followed by periodontal pocket depth ≥5 mm, sinus tract, and periodontal swelling or abscess. Approximately 70% of cases manifested themselves as combinations of at least two of these factors. Teeth having two and three or four of these factors had 3.14 times and 11.64 times higher risks for the presentations of VRFs, respectively (p < 0.001). CONCLUSION: The major risk for VRFs was represented by those presenting radiological image of J-shaped or "halo" radiolucency, periodontal pocket depth ≥5 mm, sinus tract, and periodontal swelling or abscess simultaneously.

30 years follow-up and increased risks of breast cancer and leukaemia after long-term low-dose-rate radiation exposure.

BACKGROUND: The current study followed-up site-specific cancer risks in an unique cohort with 30 years' follow-up after long-term low-dose-rate radiation exposure in Taiwan. METHODS: Six thousand two hundred and forty two Taiwanese people received extra exposure in residential and school buildings constructed with Co-60-contaminated steel from 1982 until informed and relocated in early 1990s. The additional doses received have been estimated. During 1983-2012, 300 cancer cases were identified through the national cancer registry in Taiwan, 247 cases with minimum latent periods from initial exposure. The hazard ratios (HR) of site-specific cancers were estimated with additional cumulative exposure estimated individually. RESULTS: Dose-dependent risks were statistically significantly increased for leukaemia excluding chronic lymphocytic leukaemia (HR100mSv 1.18; 90% CI 1.04-1.28), breast cancers (HR100mSv 1.11; 90% CI 1.05-1.20), and all cancers (HR100mSv 1.05; 90% CI 1.0-1.08, P=0.04). Women with an initial age of exposure lower than 20 were shown with dose response increase in breast cancers risks (HR100mSv 1.38; 90% CI 1.14-1.60; P=0.0008). CONCLUSIONS: Radiation exposure before age 20 was associated with a significantly increased risk of breast cancer at much lower radiation exposure than observed previously.

Perceived environmental and health risks of nuclear energy in Taiwan after Fukushima nuclear disaster.

After the nuclear disaster in Fukushima in Japan in 2011, a nation-wide survey using a standardized self-administered questionnaire was conducted in Taiwan, with a sample size of 2,742 individuals including the residents who live within and beyond 30 km from a nuclear power plant (NPP), to evaluate the participants' perceived nuclear risk in comparison with their perceived risks from selected environmental hazards and human behaviors. The three leading concerns of nuclear energy were "nuclear accidents (82.2%)," "radioactive nuclear waste disposal (76.9%)" and "potential health effects (73.3%)." Respondents (77.6%) perceived a higher relative risk of cancer incidence for those who live within 30 km from an NPP than those who live outside 30 km from an NPP. All the participants had a higher risk perception of death related to "nuclear power operation and nuclear waste" than cigarette smoking, motorcycling, food poisoning, plasticizer poisoning and traveling by air. Moreover, the residents in Gongliao where the planned fourth NPP is located had a significantly higher perceived risk ratio (PRR) of cancer incidence (adjusted odd ratio (aOR)=1.84, p value=0.017) and perceived risk of death (aOR=4.03, p value<0.001) related to nuclear energy. The other factors such as female gender (aOR/p value, 1.25/0.026 and 1.34/0.001 respectively), lower education levels (aOR/p value: 1.31/0.032; 2.03/<0.001) and the participants' concerns about nuclear accidents (aOR/p value: 1.33/0.022; 1.51/<0.001) and potential health effects (aOR/ p value: 2.95/ <0.001; 2.56/<0.001) were found to be commonly associated with the PRRs of "cancer incidence" and "perceived risk of death" related to nuclear energy, respectively. In addition, the respondents' concerns about nuclear waste disposal and possible eco-environmental damage made significant contributions (aOR/ p value: 1.39/ 0.001; 1.40/<0.001) to predict their perceived risk of death related to nuclear power. These factors are considered as important indicators and they can be used for suggesting future policy amendments and public referendum on the decision of the operation of the planned NPP.

Risk perception of nuclear power plants among university students in Northeast Asia after the Fukushima nuclear disaster.

To examine the perception of nuclear energy risks among Asian university students following the Fukushima nuclear disaster, a standardized questionnaire survey was conducted since July 2011 after the Fukushima disaster. A total of 1814 respondents from 18 universities in China, Japan, Korea, and Taiwan participated in this survey. It showed that students with the following characteristics had a higher preference for "a clear schedule to phase out nuclear power plant (NPP)": females (adjusted odds ratio [aOR] = 1.84, 95% confidence interval [CI] = 1.44-2.34), in Japan (aOR = 2.81, 95% CI = 2.02-3.90), in China (aOR = 1.48, 95% CI = 1.04-2.09), and with perceived relative risks of cancer incidence greaterthan 1 (aOR = 1.42, 95% CI = 1.07-1.88). "If nuclear energy were phased out," the opinions on potential electricity shortage were as follows: Japan, aOR = 0.53, 95% CI = 0.40-0.69; China, aOR = 2.46, 95% CI = 1.75-3.45; and associated with academic majors (science/technology, aOR = 0.43, 95% CI = 0.31-0.59; medicine/health science, aOR = 0.64, 95% CI = 0.49-0.84). The results carried essential messages for nuclear energy policy in East Asia.

Risk perception, trust, and factors related to a planned new nuclear power plant in Taiwan after the 2011 Fukushima disaster.

After the Fukushima nuclear disaster in March 2011, an international review of nuclear safety indicated that two of the three nuclear power plants (NPPs) operating in Taiwan were listed as the most dangerous in the world. To understand the perception of NPP risks by the public in Taiwan and their attitudes regarding a planned fourth NPP after the Fukushima nuclear incident in 2011, a study was conducted in August 2011. A sample of 2819 individuals responded to the survey, with 66% perceiving that Taiwan's safety management of NPPs was inferior to Japan's, while 40% perceived a higher possibility of nuclear accidents like that in Japan. On average, a 'safe' distance of 94 km from an NPP was expected. 56% opposed the planned fourth NPP, with females (adjusted odd ratios (aOR) 2.03; 95% confidence interval (CI) 1.71-2.41), residence near the planned fourth NPP (aOR/CI 13.90/7.79-24.80), distrust of safety management (aOR/CI 1.98/1.45-2.69) and emergency planning (aOR/CI 1.89/1.49-2.40) as the main determinants. Others included those who expected larger safe distances from an NPP (trend test, p < 0.001), perceived excess cancer risks of living within 30 km of an NPP (aOR/CI 2.74/2.02-3.71), and projection of no electric shortage without NPPs (aOR/CI 1.93/1.50-2.49). Given that Taiwan's large population lives close to the existing NPPs and long-term concerns about the safety of these nuclear plants, the Fukushima incident in Japan likely augmented public risk perceptions on nuclear power in general and on the planned fourth NPP.

Work-related fatigue among medical personnel in Taiwan.

BACKGROUND/PURPOSE: Work-related fatigue among medical personnel is a major concern for patient safety, however heavy on-call duty is common in many hospitals. The purpose of this study was to investigate the prevalence of self-reported work-related fatigue and its associated factors. METHODS: A cross-sectional survey of 1833 participants was conducted in two hospitals in Taipei City, Taiwan, using a self-administered questionnaire. Participants reported their demographic characteristics, health-related behavior, health status and symptoms, and work-related fatigue during the past 3 months. RESULTS: The prevalence of work-related fatigue among the 1833 participants was 30.9%. Younger participants (20-29 years old) were more likely to report work-related fatigue than older participants (40-65 years old) [adjusted odds ratio (aOR) = 1.55, 95% confidence interval (CI) = 1.18-2.01]. Physicians, nurses, and medical technicians were more likely to report work-related fatigue symptoms than administrative personnel (aOR = 2.30, 95% CI = 1.57-2.79; aOR = 2.83, 95% CI = 1.87-3.99; and aOR = 2.01, 95% CI = 1.12-3.06, respectively). Those who drank coffee more than five times a week were more likely to report work-related fatigue than those who did not drink coffee at all (aOR = 2.53, 95% CI = 1.25-1.93). Participants with poor and very poor self-reported health were more likely to report work-related fatigue (aOR = 1.80, 95% CI = 1.26-2.38) than those who reported that their health was fair, good, or very good. CONCLUSION: We identified factors associated with work-related fatigue among hospital workers in Taipei City. These findings can be applied toward on-the-job training and the development of preventive measures for occupational safety in general hospitals.