Study areas, population densities, and distributions of out-of-hospital cardiac arrests (OHCA) cases and hospitals in Kaohsiung, 2011–2013.

<p>Purple points indicate that patients with OHCA were transported to the closest emergency hospital while green points represent bypassing it.</p

Interpolation of the interval from the call to hospital admission by using the Kriging method.

<p>Areas marked with red indicate a prolonged interval of an out-of-hospital cardiac arrest (OHCA) case from the call to hospital admission, while areas marked with green show a short interval (<30 min). Uncolored areas are locations without sufficient interpolation information (sparse OHCA event points).</p

Flow chart of the study design.

<p>Abbreviations: CPR: cardiopulmonary resuscitation; AED: automated external defibrillator; LMA: laryngeal mask airway.</p

Survival percentages of out-of-hospital cardiac arrests (OHCA) by district in areas with high (> = 5,000 persons/km²) and low (< 5,000 persons/km²) population densities of Kaohsiung City, 2011–2013.

<p>Survival percentages of out-of-hospital cardiac arrests (OHCA) by district in areas with high (> = 5,000 persons/km²) and low (< 5,000 persons/km²) population densities of Kaohsiung City, 2011–2013.</p

Scatter plot of Body weight and age both labelled by OSTA undex.

<p>The scatter plot displayed no significant correlation between body weight and age in our study cohort. (Pearson’s r = -0.064, <i>p</i> = 0.515). The size of the symbol indicates the OSTA value.</p

A histogram of patient LINE-1 methylation levels.

<p>A histogram of patient LINE-1 methylation levels.</p

Kaplan-Meier disease-free survival curves.

<p>The curves depicting the effects on postoperative recurrence of LINE-1 methylation when divided into patients with “low” versus “high” methylation.</p

LINE-1 Methylation Status Correlates Significantly to Post-Therapeutic Recurrence in Stage III Colon Cancer Patients Receiving FOLFOX-4 Adjuvant Chemotherapy

<div><p>Background</p><p>Methylation levels of long interspersed nucleotide elements (LINE-1) are representative of genome-wide methylation status and crucial in maintaining genomic stability and expression. Their prognostic impact on colon cancer patients receiving adjuvant chemotherapy has not been well established. We evaluated the association between LINE-1 methylation status and clinicopathologic features and postoperative oncological outcomes in stage III colon cancer patients.</p><p>Materials and Methods</p><p>129 UICC stage III colon cancer patients who had received radical resection and FOLFOX adjuvant chemotherapy were enrolled. Global methylation was estimated by analyzing tumor LINE-1 methylation status using bisulfite-polymerase chain reaction (PCR) and pyrosequencing assay. Demographics, clinicopathological data, and postoperative outcomes were recorded by trained abstractors. Outcome measurements included postoperative recurrence and disease-free survival. Univariate, multivariate, and survival analyses were conducted to identify prognostic factors of oncological outcomes.</p><p>Results</p><p>The LINE-1 methylation of all 129 patients was measured on a 0–100 scale (mean 63.3; median 63.7, standard deviation 7.1), LINE-1 hypomethylation was more common in patients aged 65 years and above (61.7%±7.6% vs. 64.6±6.4, <i>p</i>=0.019) and those with post-therapeutic recurrence (61.7±7.4 vs 64.3±6.7, <i>p</i>=0.041). Considering risk adjustment, LINE-1 hypomethylation was found to be an independent risk factor of post-therapeutic recurrence (Adjusted OR=14.1, <i>p</i>=0.012). Kaplan-Meier analysis indicated that patients in the low methylation group had shorter period of disease free survival (<i>p</i>=0.01). In a stratified analysis that included 48 patients with post-therapeutic recurrence, it was found that those who experienced shorter period of disease free survival (≦6 months) appeared to have lower LINE-1 methylation levels than patients who reported of recurrence after 6 months (56.68±15.75 vs. 63.55±7.57, <i>p</i>=0.041)</p><p>Conclusion</p><p>There was a significantly greater risk of early postoperative recurrence and a shorter period of disease-free survival in Stage III colon cancer patients exhibiting LINE-1 hypomethylation status after being treated with radical resection and FOLFOX chemotherapy.</p></div

Independent factors for secondary outcome (complications) in the multivariate analyses.

<p>*Adjusted for gender, age, body weight, OSTA index, GCS, ISS, NISS, AIS-H and exposure of neurosurgery.</p><p>Independent factors for secondary outcome (complications) in the multivariate analyses.</p

Osteoporosis Self-Assessment Tool for Asians Can Predict Neurologic Prognosis in Patients with Isolated Moderate Traumatic Brain Injury

<div><p>Objectives</p><p>Osteoporosis Self-Assessment Tool for Asians (OSTA) has been proved to be a simple and effective tool for recognizing osteoporosis risk. Our previous study has demonstrated that the preoperative OSTA index was a good prognostic predictor for stage II and III colon cancer patients after surgery. We aim to evaluate the value of OSTA index in prognostication of isolated traumatic brain injury with moderate severity (GCS 9-13).</p><p>Methods</p><p>We retrospectively reviewed all patients visiting Kaohsiung Medical University Hospital emergency department due to isolated moderate traumatic brain injury from Jan. 2010 to Dec. 2012. Background data (including the OSTA index), clinical presentations, management and outcomes (ICU admission days, total admission days, complications, Glasgow outcome score (GOS) at discharge, mortality) of the patients were recorded for further analysis. Our major outcome was good neurologic recovery defined as GOS of 5. Pearson chi-square test and the Mann-Whitney U test were used to compare demographic features. Multiple logistic regression was used to identify independent risk factors.</p><p>Results</p><p>107 isolated moderate TBI patients were studied. 40 patients (37.4%) showed good recovery and 10 (9.3%) died at discharge. The univariate analysis revealed that younger age, higher OSTA index, lower ISS, lower AIS-H, and avoidance to neurosurgery were associated with better neurologic outcome for all moderate TBI patients. Multivariate analysis revealed that lower ISS, higher OSTA, and the avoidance of neurosurgery were independent risk factors predicting good neurologic recovery.</p><p>Conclusion</p><p>Higher ISS, lower OSTA index and exposure to neurosurgery were the independent risk factors for poorer recovery from isolated moderate TBI. In addition to labeling the cohort harboring osteoporotic risk, OSTA index could predict neurologic prognosis in patients with isolated moderate traumatic brain injury.</p></div