Analyzing the incidence of silicosis across various industries in Taiwan: a study of occupational disease surveillance by linking national-based workers' and medicoadministrative databases.

OBJECTIVES: This study aimed to establish an occupational disease surveillance system by identifying high-risk industries for silicosis in Taiwan using a national database linkage approach. METHODS: The study was based on a comprehensive analysis of benefit claims from the National Labor Insurance Research Database and medical records from the National Health Insurance Research Database between 2004 and 2020, providing coverage for more than 88.5% of the workforce and 99.9% of citizens. Silicosis was defined as having received compensation for labor insurance benefits or having received a diagnosis of silicosis (International Classification of Diseases, 10th Revision: J62 or International Classification of Diseases, Ninth Revision: 502). The study used the International Standard Industrial Classification of All Economic Activities for industry-specific classification. Cox proportional hazard models were used to compare the silicosis incidence and risk among each industry and identify high-risk industries for silicosis. RESULTS: This study analyzed 1466 cases of silicosis between 2004 and 2020 and found that 28 industries had incidence rates of over 40 cases per 100,000 workers, indicating more than double the risk of developing silicosis. Of these industries, 14 were considered high risk (relative risk of over four times). Among these, this study identified industries rarely mentioned in the past, such as wholesale of brick, sand, cement, and products, artistic creation, landscape construction, and materials recovery. Stratification by years of work experience reveals those industries such as quarrying of stone, sand, clay, and other mining, construction of buildings, landscape construction, site preparation, foundation and structure construction, building completion and finishing, manufacture of ships, boats, and floating structures, and plumbing, heat, and air conditioning installation display higher hazard ratios for individuals with <10 years of work experience. CONCLUSIONS: The current surveillance system has identified certain industries that are at a higher risk of developing silicosis, which could be used for future occupational epidemiological surveys and targeted preventive measures in these sectors.

Dementia predicted one-year mortality for patients with first hip fracture: a population-based study.

Aims: We aimed to determine the effect of dementia and Parkinson's disease on one, three and 12-month mortality following surgery for fracture of the hip in elderly patients from an Asian population. Patients and Methods: Using a random sample of patients taken from the Taiwan National Health Insurance Research Database, this retrospective cohort study analyzed the data on 6626 elderly patients who sustained a fracture of the hip between 1997 and 2012 who had ICD-9 codes within the general range of hip fracture (820.xx). We used Cox regression to estimate the risk of death associated with dementia, Parkinson's disease or both, adjusting for demographic, clinical, treatment, and provider factors. Results: Among 6626 hip fracture patients, 10.20% had dementia alone, 5.60% had Parkinson's disease alone, and 2.67% had both. Corresponding one-year mortality rates were 15.53%, 11.59%, and 15.82%, compared with 9.22% for those without neurological illness. Adjusted hazard ratio for one-year mortality was 1.45 (95% confidence intervals (CI) 1.17 to 1.79) for those with dementia, and 1.57 (95% CI 1.07 to 2.30) with both dementia and Parkinson's disease versus patients with neither. There was no significant association with death for Parkinson's disease alone. Age, male gender and comorbidities were also associated with a higher risk of mortality. Conclusion: Dementia, with or without Parkinson's disease, is an independent predictor of mortality following surgery for fractures of the hip. Age, male gender and comorbidities also increase the risk of death. Parkinson's disease alone has no significant effect. Cite this article: Bone Joint J 2018;100-B:1220-6.

Clinical trial of electrical acupuncture on hemiplegic stroke patients.

To assess the efficacy of electrical acupuncture in the rehabilitation of patients with hemiplegia in stroke, we randomized 128 patients within 2 wk of stroke onset to receive either comprehensive rehabilitation plus electrical acupuncture (n = 59) or comprehensive rehabilitation only (n = 59). Electrical acupuncture was administered by electrical stimulation of acupuncture points through adhesive surface electrodes five times per week. Neurological status (Brunnstrom's stage) and the Chinese version of the Functional Independence Measure were assessed before treatment and at discharge. Patients treated with electrical acupuncture had a shorter duration of hospital stay for rehabilitation and better neurological and functional outcomes than the control group had, with a significant difference in scores for self-care and locomotion (P = 0.02). This result did not postulate the previous study that acupuncture therapy for stroke patients should depend on needle manual and "de qi" response. We suggest that electrical acupuncture through adhesive surface electrodes in conjunction with current optimal rehabilitation programs is a convenient and effective therapy for stroke patients.

[Analysis of the protein/polypeptide in Culex pipiens pallens (Diptera:Culicidae) during hibernation by two-dimensional gel electrophoresis].

Analysis on the protein/polypeptide in Culex pipiens pallens (Diptera: Culicidae) caught from the resting or overwintering places during the 3rd ten-day of September, the 2nd ten-day of December and the 1st ten-day of March in next year in Zhengzhou (34 degrees 43' N, 113 degrees 39' E) during hibernation by two-dimensional gel electrophoresis indicated that there were 153, 118 and 169 protein/polypeptide spots in unoverwintering, overwintering and recovering mosquitoes respectively. The molecular weight (MW) of most of the spots was less than 43.0 kDa, with isoelectric points (pI) between 5.65-7.34. The comparisons between each two types of mosquitoes during hibernation revealed that the variant rate of protein/polypeptide spots between overwintering and recovering mosquitoes (31.01%) was significantly higher than that between unoverwintering and recovering females (21.12%) (P < 0.05). The variant spots were 13 in unoverwintering, 7 in overwintering and 27 in recovering mosquitoes respectively. The comparisons among three types of mosquitoes during hibernation showed that the variant rate was significantly higher in recovering females (15.98%) than in unoverwintering (8.50%) (P < 0.05) and overwintering females (5.93%) (P < 0.01). The total variant rate of protein/polypeptide spots of all these three types of mosquitoes was 10.68%. Because the blood meal of all the mosquitoes used for homogenization was at Sella 1 (empty), and the ovary development was under Christophers II (resting stage), the experimental results were not affected by blood meal and the later ovary development (Christophers II-V).

[Variations of free amino acids in hemolymph of Culex pipiens pallens during overwintering period].

An analysis of the amino acids present in the hemolymph of Culex pipiens pallens caught from resting or overwintering places (blood meal: Sella 1, i.e. empty; ovary stage: under Christophers IIb) in Zhengzhou (34 degrees 43'N, 113 degrees 39E) indicated that 19, 18 and 18 kinds of free amino acids (FAAs) were detected during stages of preoverwintering, overwintering and postoverwintering respectively. Comparison of hemolymph amino acids between overwintering and preoverwintering stages revealed that the concentrations of the total FAAs and FAAs reduced significantly in overwintering except cystine and proline. The concentrations of cystine and proline during preoverwintering were 0.1563 +/- 0.0021 nmol/microliter and 22.2467 +/- 1.3537 nmol/microliter, but 0.2067 +/- 0.0058 nmol/microliter and 36.5467 +/- 0.4654 nmol/microliters during overwintering respectively. Comparison of hemolymph amino acids between postoverwintering and overwintering stages showed that the concentrations of all FAAs and total FAAs increased significantly during postoverwintering stage, and the concentrations of aspartic acid, glumatic acid, alanine, cystine, proline and total FAAs even exceeded those during preoverwintering stage respectively.