Gender differences in ankylosing spondylitis-associated cumulative healthcare utilization: a population-based cohort study

BACKGROUND: Ankylosing spondylitis (AS) is one of the most common rheumatic diseases with gender differences in prevalence and clinical presentation. This study aimed to examine whether such gender differences are correlated with cumulative healthcare utilization in Taiwan. METHODS: The National Health Insurance Research Database supplied claim records of one million individuals from 1996 to 2007. Selected cases included patients aged >16 years. Certified rheumatologists diagnosed the patients in three or more visits and gave prescriptions for AS. Multivariate adjusted logistic regression analyses were used to calculate the influence of gender on cumulative healthcare utilization associated with AS. RESULTS: The study included 228 women and 636 men. After adjustment for potential confounding factors, men had more cumulative outpatient visits associated with AS (odds ratio, 1.59; 95% confidence interval, 1.13 -2.23; p = 0.008). Men also exhibited a trend for higher frequency of AS-related hospitalization (p = 0.054). CONCLUSION: Men are more likely to have high cumulative AS-associated healthcare utilization than women. Further investigation of the causal factors is warranted

A 3D unstructured grid nearshore hydrodynamic model based on the vortex force formalism

Acknowledgments This work was partly supported by joint Engineering and Physical Science Research Council (EPSRC) UK and Technology Foundation STW Netherlands funded SINBAD (EP/J005541/1) project. P. Zheng was supported by the China Scholarship Council during his four-year PhD study at the University of Liverpool. We would like to thank Prof. C.S. Chen of the University of Massachusetts-Dartmouth for providing the source code of FVCOM and also the SWAN developers for developing and providing this open source code. We would also like to thank the staff and personnel involved in collecting and maintaining the DUCK’94 experiment dataset and the anonymous reviewers for their constructive comments and suggestions. Computational support was provided by the Chadwick High Performance Computer at University of Liverpool and also the facilities of N8 HPC Centre of Excellence, provided and funded by the N8 consortium and EPSRC (EP/K000225/1).Peer reviewedPublisher PD

The Relationship between Knowledge and Medication Compliance Behavior among Patients with Tuberculosis

Tuberculosis (TB) remains the highest priority among infectious diseases in the world today with increasing morbidity and mortality every year. Adherence to treatment plays an important role in the success of therapy among TB patients. This study aims to explore the relationship between demographic characteristics, knowledge, and medication compliance behavior among patients with tuberculosis in Indonesia. This study was descriptive correlational and cross-sectional design with the total sample was 150 tuberculosis confirmed in Medan Pulmonary Hospital, Indonesia. In this study found that there is a significant relationship between ethnicity and medication adherence (continues variable) with p = 0.01. Meanwhile when medication compliance behavior was treated as categorical variables, a significant relationship was found between medication compliance behavior and medical history (p = 0.03), smoking (p = 0.005), and alcohol (p = 0.03) among tuberculosis patients in Indonesia. In the multivariate analysis, multiple linear regression was performed which surprisingly shows that education was significantly associated with knowledge of TB (p = 0,02), and ethnicity (0.04)

The Artificial Neural Networks Applied to Servo Control Systems

This chapter utilizes the direct neural control (DNC) based on back propagation neural networks (BPN) with specialized learning architecture applied to the speed control of DC servo motor. The proposed neural controller can be treated as a speed regulator to keep the motor in constant speed, and be applied to DC servo motor speed control. The proposed neural control applied to position control for hydraulic servo system is also studied for some modern robotic applications. A tangent hyperbolic function is used as the activation function, and the back propagation error is approximated by a linear combination of error and error!s differential. The simulation and experiment results reveal that the proposed neural controller is available to DC servo control system and hydraulic servo system with high convergent speed, and enhances the adaptability of the control system

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: A case report

AbstractRemitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare form of paraneoplastic tenosynovitis, which is more prone to occur in elderly males. A 78-year-old male had a past history of gastric cancer 23 years ago and underwent subtotal gastrectomy then. He led a fair life after the surgery. However, fever, edema in four extremities, gait disturbance, and liver function impairment bothered him for 5 months, which caused significant physical functional decline. Despite of extensive laboratory and imaging examinations, no definite diagnosis and treatment were provided. He was referred to Kyoto University hospital and RS3PE was diagnosed. After the diagnosis of RS3PE syndrome was made, systemic steroid was given and fever, edema and liver function impairment improved dramatically within 7 days. The patient was well managed by oral prednisolone 30mg per day after discharge. RS3PE should be considered when an elderly man with aforementioned presentations in order to prevent significant functional decline in daily living

Predictors of psychiatric readmissions in the short- and long-term: a population-based study in taiwan

OBJECTIVES: To explore the risks and rates of readmission and their predictors 14 days, one year, and five years after discharge for the psychiatric population in Taiwan. METHODS: This was a prospective study based on claims from 44,237 first-time hospitalized psychiatric patients discharged in 2000, who were followed for up to five years after discharge. The cumulative incidence and incidence density of readmission were calculated for various follow-up periods after discharge, and Cox proportional hazard models were generated to identify the significant predictors for psychiatric readmission. RESULTS: The less than 14-day, one-year, and five-year cumulative incidences were estimated at 6.1%, 22.3%, and 37.8%, respectively. The corresponding figures for incidence density were 4.58, 1.04, and 0.69 per 1,000 person-days, respectively. Certain factors were significantly associated with increased risk of readmission irrespective of the length of follow-up, including male gender, length of hospital stay >15 days, economic poverty, a leading discharge diagnosis of schizophrenia/affective disorders, and residence in less-urbanized regions. Compared to children/adolescents, young adults (20-39 years) were significantly associated with increased risks of <one-year and <five-year readmissions, but not <14-day readmission. Additionally, hospital characteristics were significantly associated with increased risk of <14-day and <one-year readmission, but not with risk of <five-year readmission. CONCLUSIONS: This study found that the significant predictors for psychiatric readmission 14 days to five years after discharge were essentially the same except for patient's age and hospital accreditation level. This study also highlighted the importance of socioeconomic factors in the prediction of readmission