Climatic factors associated with amyotrophic lateral sclerosis: a spatial analysis from

Taiwa

The utilization of hospice care among patients with motor neuron diseases: The experience in Taiwan from 2005 to 2010

AbstractBackgroundThe nature and extent of how patients with motor neuron diseases (MNDs) utilize hospice care in Taiwan remains unclear. This study aims to investigate the use of hospice care in Taiwan by patients with MND, and those factors that affect the extent, the cost, and the quality of their hospice treatment and care.MethodsWe analyzed data from hospice care inpatient claims of MNDs, using the National Health Insurance Research Database of Taiwan during 2005–2010.ResultsThirty patients and 58 related discharges were enrolled into our study, which consisted of 13 males and 17 females, with a mean age 58.3 years. Of that total, 27 of them (90%) had amyotrophic lateral sclerosis, and four (13.3%) had comorbid cancers; 17 died during hospice care. Acute low respiratory conditions (31.0%) accounted for the most common acute comorbidity. Noninvasive ventilation care was performed in only 13 (22.4%) of the discharges. In contrast to nasogastric intubation (40 discharges, 69.0%), no gastrostomy/jejunostomy was noted. These procedures bore no relationship to results observed in the discharges. Family physicians provided most inpatient hospice services (74.1%). Respiratory problems were the major causes of death (70.6% of decedents). The mean inpatient costs of hospice care were noticeably reduced from previously established nationwide mean costs.ConclusionHospice care can save costs for patients with terminal MNDs, and family physicians play a valuable role in caring for these patients. However, respiratory and feeding problems are prevalent, yet there are proven benefits when noninvasive ventilation care and gastrostomy/jejunostomy are promoted

Second-Order Time-Dependent Mild-Slope Equation for Wave Transformation

This study is to propose a wave model with both wave dispersivity and nonlinearity for the wave field without water depth restriction. A narrow-banded sea state centred around a certain dominant wave frequency is considered for applications in coastal engineering. A system of fully nonlinear governing equations is first derived by depth integration of the incompressible Navier-Stokes equation in conservative form. A set of second-order nonlinear time-dependent mild-slope equations is then developed by a perturbation scheme. The present nonlinear equations can be simplified to the linear time-dependent mild-slope equation, nonlinear long wave equation, and traditional Boussinesq wave equation, respectively. A finite volume method with the fourth-order Adams-Moulton predictor-corrector numerical scheme is adopted to directly compute the wave transformation. The validity of the present model is demonstrated by the simulation of the Stokes wave, cnoidal wave, and solitary wave on uniform depth, nonlinear wave shoaling on a sloping beach, and wave propagation over an elliptic shoal. The nearshore wave transformation across the surf zone is simulated for 1D wave on a uniform slope and on a composite bar profile and 2D wave field around a jetty. These computed wave height distributions show very good agreement with the experimental results available

A novel mutation in the WFS1 gene identified in a Taiwanese family with low-frequency hearing impairment

<p>Abstract</p> <p>Background</p> <p>Wolfram syndrome gene 1 (<it>WFS1</it>) accounts for most of the familial nonsyndromic low-frequency sensorineural hearing loss (LFSNHL) which is characterized by sensorineural hearing losses equal to and below 2000 Hz. The current study aimed to contribute to our understanding of the molecular basis of LFSNHL in an affected Taiwanese family.</p> <p>Methods</p> <p>The Taiwanese family with LFSNHL was phenotypically characterized using audiologic examination and pedigree analysis. Genetic characterization was performed by direct sequencing of <it>WFS1 </it>and mutation analysis.</p> <p>Results</p> <p>Pure tone audiometry confirmed that the family members affected with LFSNHL had a bilateral sensorineural hearing loss equal to or below 2000 Hz. The hearing loss threshold of the affected members showed no progression, a characteristic that was consistent with a mutation in the <it>WFS1 </it>gene located in the DFNA6/14/38 locus. Pedigree analysis showed a hereditarily autosomal dominant pattern characterized by a full penetrance. Among several polymorphisms, a missense mutation Y669H (2005T>C) in exon 8 of <it>WFS1 </it>was identified in members of a Taiwanese family diagnosed with LFSNHL but not in any of the control subjects.</p> <p>Conclusion</p> <p>We discovered a novel heterozygous missense mutation in exon 8 of <it>WFS1 </it>(i.e., Y669H) which is likely responsible for the LFSNHL phenotype in this particular Taiwanese family.</p

The utilization of hospice care among patients with motor neuron diseases: The experience in Taiwan from 2005 to 2010

Abstract Background: The nature and extent of how patients with motor neuron diseases (MNDs) utilize hospice care in Taiwan remains unclear. This study aims to investigate the use of hospice care in Taiwan by patients with MND, and those factors that affect the extent, the cost, and the quality of their hospice treatment and care. Methods: We analyzed data from hospice care inpatient claims of MNDs, using the National Health Insurance Research Database of Taiwan during 2005e2010. Results: Thirty patients and 58 related discharges were enrolled into our study, which consisted of 13 males and 17 females, with a mean age 58.3 years. Of that total, 27 of them (90%) had amyotrophic lateral sclerosis, and four (13.3%) had comorbid cancers; 17 died during hospice care. Acute low respiratory conditions (31.0%) accounted for the most common acute comorbidity. Noninvasive ventilation care was performed in only 13 (22.4%) of the discharges. In contrast to nasogastric intubation (40 discharges, 69.0%), no gastrostomy/jejunostomy was noted. These procedures bore no relationship to results observed in the discharges. Family physicians provided most inpatient hospice services (74.1%). Respiratory problems were the major causes of death (70.6% of decedents). The mean inpatient costs of hospice care were noticeably reduced from previously established nationwide mean costs. Conclusion: Hospice care can save costs for patients with terminal MNDs, and family physicians play a valuable role in caring for these patients. However, respiratory and feeding problems are prevalent, yet there are proven benefits when noninvasive ventilation care and gastrostomy/ jejunostomy are promoted

OMAE2006-92088 WAVE TRANSFORMATION AND SOIL RESPONSE DUE TO SUBMERGED PERMEABLE BREAKWATER

ABSTRACT This study reports the experimental results of the wave transformation and the wave-induced soil response when the waves pass through the submerged permeable breakwater. The model of the submerged breakwater was built on a horizontal sandy bottom. The experimental results of the spectrum of the wave transformation and the wave-induced pore-pressure are first analyzed in this paper. It is found that the wave spectrum is similar to the condition of the impermeable bottom that the higher harmonic mode appears when the waves pass over the submerged structure. However, the higher harmonic mode is not found in the spectrum of the wave-induced pore pressure, showing that the nonlinearity of the pore pressure is damped by the porous bed. The influences of the geometry of the submerged breakwater to the transformation of the wave height and the pore-pressure are also investigated. Based on the experimental results, the regression formulas for the coefficients of the wave reflection, the wave transmission and the wave energy dissipation are obtained in the paper

Computations of nearshore wave transformation using finite-volume method

The accurate computation of nearshore wave transformation is a major aspect of the design of coastal structures and the prediction of nearshore currents and shoreline changes. This paper adopts the finitevolume method with adequate numerical algorithms for computing the wave transformation based on the hyperbolic time-dependent mild-slope equations involving wave breaking. Both the predictor–corrector scheme and the time-staggered leapfrog scheme were employed to discretize the governing equations; their results were first compared to the analytic solution for wave shoaling over a sloped beach to ascertain their accuracy. Results presented here using the time-staggered leapfrog scheme showed in better agreementwith the experimental results. The numerical predictions for wave transmission over an elliptic shoal are then conducted and compared with the other models, from which the results show that the present model is in better agreementwith the experimental results than the other numerical models. The successful simulations are also shown by practical examples including the waves around an offshore breakwater and around two offshore breakwaters with tombolo topography

Multiple sclerosis incidence associated with the soil lead and arsenic concentrations in Taiwan.

BACKGROUND: Few studies in the world have assessed the incidence of multiple sclerosis (MS) with soil heavy metal concentrations. We explored the association of soil heavy metal factors and the MS incidence in Taiwan. METHODS: There were 1240 new MS cases from the National Health Insurance Research Database and were verified with serious disabling disease certificates, 1997-2008. Soil heavy metal factors records included arsenic, mercury, cadmium, chromium, copper, nickel, lead and zinc in Taiwan from 1986 to 2002. Spatial regression was used to reveal the association of soil heavy metals and age- and gender-standardized incidence ratios for townships by controlling sunlight exposure hours, smoking prevalence and spatial autocorrelation. RESULTS: The lead (Pb) concentration in the soil positively correlated with the township incidence; on the other hand, the arsenic (As) concentration in soil negatively correlated with the township incidence and when found together controlled each other. The positive correlation of lead (Pb) predominated in males, whereas the negative correlation of arsenic (As) in soil predominated in females. CONCLUSIONS: We conclude that exposure to lead (Pb) in soil positive associated with incidence of MS in Taiwan, especially in males. Exposure to arsenic (As) in soil negative associated with MS in Taiwan, especially in females

OMAE2011-49896 Draft: Statistical Analysis on the Extreme Events of Big Waves under Wave Climate Change around Taiwan Waters

ABSTRACT This study aimed to analyze the statistical characteristics of wave heights, wave energy and wave steepness, in order to investigate the wave climate changes around Taiwa