Frequent consumption of vegetables predicts lower risk of depression in older Taiwanese – results of a prospective population-based study.

[[abstract]]Objective The study evaluated the association between consumption frequencies of the major food categories and the risk of new depression four years later in older Taiwanese. Design A prospective cohort study with multistage random sampling. Logistic regression analysis evaluated the significance of the longitudinal associations of intake frequencies of the major food categories with future (4 years later) risk of new depression, controlled for possible confounding factors with or without adjustment for cognitive status. Setting Population-based free-living elderly. Subjects Men and women (n 1609) ≥65 years of age. Results In a regression model that controlled for demographic, socio-economic, lifestyle and disease/health-related variables but not cognitive status, both fruits (OR = 0·66, 95 % CI 0·45, 0·98, P = 0·038) and vegetables (OR = 0·38, 95 % CI 0·17, 0·86, P = 0·021) were protective against depressive symptoms 4 years later. However, when the same regression model was also adjusted for cognitive status, only vegetables (OR = 0·40, 95 % CI 0·17, 0·95, P = 0·039) were protective against depressive symptoms. Higher consumption of eggs was close to being significant in both regression models (P = 0·087 and 0·069, respectively). Other food categories including meat/poultry, fish, seafood, dairy, legumes, grains and tea showed no significant associations. Conclusions Results suggest that although confounding factors cannot be totally ruled out, more frequent consumption of vegetables seems to be protective against depressive symptoms in the elderly. Further studies are needed to elucidate the causal role and the mechanism of the association

Validation of population-specific Mini-Nutritional Assessment with its long-term mortality-predicting ability--results of a population-based longitudinal 4-year study in Taiwan.

[[abstract]]Nutrition is a key element in geriatric health, and nutritional screening/assessment is a key component of comprehensive geriatric evaluation. The study aimed to validate the Mini Nutritional Assessment Taiwan version-1 (MNA-T1) which adopted population-specific anthropometric cut-points, and version-2 (MNA-T2) which replaced BMI with mid-arm and calf circumferences in the scale for predicting the nutritional status of elderly Taiwanese. Using data of a population-representative longitudinal study of 2802 Taiwanese aged 65 years or older, the study graded the nutritional status of each subject with the original and both modified versions at baseline, analysed their hospital length of stay, the Activities of Daily Living (ADL), the Center for Epidemiologic Studies Depression Scale (CES-D) and life-satisfaction scores at baseline and end of 4 years, and tracked their survival during the period. Results showed that both modified versions had superior predictive abilities compared with the original MNA, and their graded scores correlated better with hospital length of stay, and ADL, CES-D and life-satisfaction scores. Both modified versions were effective in predicting follow-up mortality risk. The relative mortality risk was about 7 times for those rated malnourished and 2·5 times for those rated at risk of malnutrition compared with those who were rated normal at baseline by the two modified versions. These results suggest that both of the modified versions are effective in predicting the nutrition and health statuses of Taiwanese elderly and would serve to validate the predictive ability of the two modified versions. The MNA-T2, which requires no BMI, can make routine nutritional screening/assessment an easier task

Sex and ethnic disparities in weight and height among children of transnational couple, aborigines, and Han Chinese in Taiwan.

[[abstract]]In this study, we examined sex and ethnic disparities in growth and body mass index (BMI) status among schoolchildren of transnational families, the aborigines and Han Taiwanese in Nantou, Taiwan. We tested the hypothesis that cultural and social factors of the transnational couples could impact the growth status of their children. The study also determined the factors associated with the growth status of schoolchildren. A total of 1674 school age children in the county were cluster sampled, and their weight and height data were statistically analyzed by 1-way analysis of variance, χ2 test, and linear regression analysis according to sex, ethnicity, and residential locations. The institutional review board of Asia University, Taiwan, ROC, approved the study protocol. Results showed that aboriginal boys were significantly shorter in stature than sons of the transnational couples and Han Taiwanese. However, weight and BMI were not different among the 3 groups. Daughters of the transnational couples were significantly shorter and lighter, whereas the aboriginal girls were shorter but not lighter and had significantly greater BMI compared with their Han Taiwanese counterparts. Regression analysis revealed significant associations of weight and BMI with sex and ethnicity. Results suggest that culture plays a role in sex disparity. Ethnic and sex disparities in growth status exist in Taiwan. Aboriginal boys and girls are shorter but not lighter compared with their Han Taiwanese counterparts, whereas daughters but not sons of transnational couples are shorter and lighter compared with Han Taiwanese counterparts. These findings are useful information for the educators and healthcare policy makers for improving diet and health

Modified Mininutritional Assessment Can Effectively Assess the Nutritional Status of Patients on Hemodialysis.

[[abstract]]"Objective: We sought to determine whether the MNA (Mininutritional Assessment) would be an effective tool for assessing the nutritional status of patients undergoing hemodialysis. Design: Purposive sampling. Setting: Two hospital-managed hemodialysis centers in central Taiwan. Patients:Subjects were 95 ambulatory patients older than 40 years without acute diseases or infections who had received hemodialysis treatment at the center for longer than 30 days. Methods: Each subject was interviewed with a structured questionnaire to elicit basic personal data and healthand lifestyle-related information and answered questions on the Council on Nutrition Appetite Questionnaire and MNA. Serum biochemical data were obtained from their routine measurement. The nutritional status of each subject was graded with two modified MNA versions. MNA-TI adopted population-specific anthropometric cut-points, and MNA-TII further had the body mass index question deleted from the scale and question scores adjusted but maintained the same 30 total points. Results:Based on the strength of correlation with the key nutrition-related parameters including appetite status, serum creatinine, percent weight loss, hospital length of stay, number of prescribed drugs, and hemodialysis time, both modified MNA versions reflected the nutritional status of Taiwanese hemodialysis patients better than the Council on Nutrition Appetite Questionnaire. Serum albumin did not reflect nutritional status well in these hemodialysis patients. MNA-TI predicted 26.4% and MNA-TII predicted 29.5% of hemodialysis patients were either malnourished or at risk of malnutrition. Conclusions: Both versions of the modified MNA are effective in assessing the nutritional status of hemodialysis patients. MNA-TII without body mass index is a significant improvement for hemodialysis patients because body weights fluctuate significantly between dialysis sessions

Population-specific modifications of the short-form Mini Nutritional Assessment and Malnutrition Universal Screening Tool for elderly Taiwanese.

[[abstract]]"Background The Mini Nutritional Assessment (MNA) and the Malnutrition Universal Screening Tool (MUST) are two widely used malnutrition screening scales. Objective The study was to compare the grading ability of the two scales, and to determine whether adoption of population-specific anthropometric cut-points could improve the grading ability of these tools and whether calf circumference (CC) could be an acceptable alternative to BMI in these scales. Design Purposive sampling. Settings Outpatients receiving annual physical examination at an area hospital. Participants Community-living elderly who were 65 years or older, able to communicate orally, without acute health conditions and willing to sign a study-consent. Methods Subjects were measured for anthropometrics and blood biochemical indicators, and interviewed for personal data and answers to the MNA and MUST. The risk of malnutrition was evaluated with the short-form MNA (MNA-SF) and the MUST, each in three versions (the original, Taiwan version-1 (T1) which adopted population-specific anthropometric cut-points, and Taiwan version-2 (T2) which replaced BMI with CC). Long-form (LF) MNA versions served as references. Results Results showed that (a) in both scales, patterns of nutritional status rated with the original versions were different from those rated with respective modified versions but ratings made with two modified versions were the same, (b) the T2 versions showed the best grading ability based on agreement with the reference (MNA-LF), and (c) MNA-SF versions rated greater proportions of subjects at risk of malnutrition than the respective MUST versions. Conclusions (a) Adoption of population-specific anthropometric cut-points improves the grading ability of the MNA-SF and the MUST in community-living Taiwanese, (b) CC is an acceptable alternative to BMI for both MNA-SF and MUST, and (c) nutritional assessment tools should be as much population or ethnically specific as possible to account for cultural and anthropometric differences across populations.

Integral manifold of weak non-linear differential equations and its application to optimal regulator problems

Article信州大学工学部紀要 71: 1-16 (1992)departmental bulletin pape

Clinical application of a new fibrin adhesive (Tisseel) in urologic surgery

接着, 縫合部補強, 止血を目的として, 21回使用した.有用性は100%と考える.副作用としては, 1例で術後長期にわたる肝障害を示したが, Tisseelによるものとは判定できなかった.局所の組織反応は, かなり強いが接着力は強く止血効果も優れているOur experience with the use of a new biological tissue adhesive (Tisseel) consisting of highly concentrated human fibrinogen, thrombin and factor XIII in urologic surgery is reported. In 21 operations (18 patients), Tisseel was used for the purpose of tissue adhesion and reduction of sutures of the renal parenchymal wound in nephrolithotomy, water tight sealing in suture part of expanded pyelolithtomy and vasovasostomy, and local hemostasis of oozing in prostatectomized fossa. Tisseel was not responsible for the two unsuccessful trials; and, undesirable complications due to this adhesive were few. Our results revealed that this new fibrin adhesive will be useful for urologic surgery