State Differences in the Reporting of Diabetes-Related Incorrect Cause-of-Death Causal Sequences on Death Certificates

OBJECTIVE To examine state differences in the reporting of diabetes-related incorrect cause-of-death (COD) causal sequences on death certificates in the U.S. RESEARCH DESIGN AND METHODS We conducted a cross-sectional descriptive study to determine the prevalence of two types of incorrect COD causal sequences with data from the Multiple Cause Mortality File of the year 2004. RESULTS Among deaths in which diabetes was reported as the first diagnosis on line a, b, c, or d in Part I of the death certificate in the U.S., 21% had below diabetes placement error (ranged from 30% in Maryland to 7% in Hawaii) and 11% had above diabetes placement error (ranged from 18% in Kentucky to 5% in California). The net effects of the two types of error ranged from −0.7% in Nevada to 19.6% in the District of Columbia. CONCLUSIONS Because the rates of incorrect reporting of diabetes-related COD causal sequence varied across states, the comparability of the diabetes death rate between states may have been compromised

Quality of cause-of-death reporting using ICD-10 drowning codes: a descriptive study of 69 countries

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Social inequality in motorcycle helmet use: when a reduction in inequality is not necessarily good news

Background: We sought to examine changes in the magnitude of social inequality in motorcycle helmet use in Taiwan between 2001 and 2009. Methods: Using data from the 2001 and 2009 Taiwan National Health Interview Surveys, we calculated absolute (the slope index of inequality, SII) and relative (relative index of inequality, RII) measures of inequality in helmet use by three indicators of socioeconomic position. Results: The rate of motorcycle helmet use was 92% (14 801/16 100) in 2001 and decreased to 89% (15 748/17 948) in 2009. We noted a significant decrease in social inequality in helmet use in RII according to urbanisation level, a significant decrease in SII and RII according to income level, and a significant increase in SII according to education level. The reduction in RII according to urbanisation level was more prominent than that based on income level, from 1.73 (95% CI 1.63 to 1.84) in 2001 to 1.33 (95% CI 1.27 to 1.39) in 2009. The decline in helmet use was most prominent for motorcycle users who live in suburban areas, from 94% in 2001 to 88% in 2009. Conclusions: The significant reduction of social inequality in helmet use according to urbanisation level and income is not a public health success story. Rather, it is a warning sign of slackening law enforcement in Taiwan

Identification of essential genes in human lymphopoiesis

Objective. Pesticide self-poisoning accounts for one-third of suicides worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a commonly used method. We investigated trends in pesticide suicide, and factors associated with such trends, in Taiwan, a rapidly developing East Asian country. Methods. We conducted an ecological study using graphical approaches and Spearman's correlation coefficients to examine trends in pesticide suicide (19872010) in Taiwan in relation to pesticide sales, bans on selected pesticides, the proportion of the workforce involved in agriculture and unemployment. We compared pesticide products banned by the Taiwanese government with products that remained on the market and pesticides that accounted for the most poisoning deaths in Taiwan. Results. Age-standardised rates of pesticide suicide showed a 67% reduction from 7.7 per 100,000 (42% of all suicides) in 1987 to 2.5 per 100,000 (12% of all suicides) in 2010, in contrast to a 69% increase in suicide rates by other methods. Pesticide poisoning was the most commonly used method of suicide in 1987 but had become the third most common method by 2010. The reduction was paralleled by a 66% fall in the workforce involved in agriculture but there was no strong evidence for its association with trends in pesticide sales, bans on selected pesticide products or unemployment. The bans mostly post-dated the decline in pesticide suicides; furthermore, they did not include products (e.g. paraquat) that accounted for most deaths and were mainly restricted to selected high-strength formulated products whilst their equivalent low-strength products were not banned. Conclusions. Access to pesticides, indicated by the size of agricultural workforce, appears to influence trends in pesticide suicide in Taiwan. Targeted bans on pesticides should focus on those products that account for most deaths. © 2012 Informa Healthcare USA, Inc.postprin

Whether to report diabetes as the underlying cause-of-death? a survey of internists of different sub-specialties

<p>Abstract</p> <p>Background</p> <p>Cause-specific mortality is a commonly used endpoint of clinical trials or prospective studies. However, it is sometimes difficult for physician to determine the underlying-cause-of-death (UCD), especially for diabetic patients coexisted with cardiovascular diseases (CVD). The aim of this survey was to examine whether internists with different specialties have different opinions on the reporting of diabetes as the UCD.</p> <p>Methods</p> <p>A total of 549 physicians completed the questionnaire in Taiwan, which comprised seven hypothetical case scenarios, each indicating a different level of contribution of diabetes in initiating the chain of events leading to death.</p> <p>Results</p> <p>As a whole, endocrinologists were more likely than cardiologists and nephrologists to report diabetes as the UCD. The differences were more prominent when the diabetic patient had a coexisting CVD. In scenario 3 (a diabetic patient with hypertension who died from acute myocardial infarction), the percentage was 56% in endocrinologists, which was significantly higher than in cardiologists (42%) and nephrologists (41%). In scenario 4 (a diabetic patient with hypertension who died from cerebrovascular infarction), the percentage was 45% in endocrinologists, and only 31% in cardiologists and 36% in nephrologists.</p> <p>Conclusions</p> <p>Internists of different sub-specialties do have different opinions on the reporting of diabetes as the UCD, especially when the diabetic patient has a coexisting CVD.</p

Exploration of agr types, virulence−associated genes, and biofilm formation ability in Staphylococcus aureus isolates from hemodialysis patients with vascular access infections

IntroductionStaphylococcus aureus, is a pathogen commonly encountered in both community and hospital settings. Patients receiving hemodialysis treatment face an elevated risk of vascular access infections (VAIs) particularly Staphylococcus aureus, infection. This heightened risk is attributed to the characteristics of Staphylococcus aureus, , enabling it to adhere to suitable surfaces and form biofilms, thereby rendering it resistant to external interventions and complicating treatment efforts.MethodsTherefore this study utilized PCR and microtiter dish biofilm formation assay to determine the difference in the virulence genes and biofilm formation among in our study collected of 103 Staphylococcus aureus, isolates from hemodialysis patients utilizing arteriovenous grafts (AVGs), tunneled cuffed catheters (TCCs), and arteriovenous fistulas (AVFs) during November 2013 to December 2021.ResultsOur findings revealed that both MRSA and MSSA isolates exhibited strong biofilm production capabilities. Additionally, we confirmed the presence of agr types and virulence genes through PCR analysis. The majority of the collected isolates were identified as agr type I. However, agr type II isolates displayed a higher average number of virulence genes, with MRSA isolates exhibiting a variety of virulence genes. Notably, combinations of biofilm-associated genes, such as eno−clfA−clfB−fib−icaA−icaD and eno−clfA−clfB−fib−fnbB−icaA−icaD, were prevalent among Staphylococcus aureus, isolates obtained from vascular access infections.DiscussionThese insights contribute to a better understanding of the molecular characteristics associated with Staphylococcus aureus, infections in hemodialysis patients and provided more targeted and effective treatment approaches

Trends in solids/liquids poisoning suicide rates in Taiwan: a test of the substitution hypothesis

<p>Abstract</p> <p>Background</p> <p>Several previous studies have illustrated that restricting access to lethal methods can reduce suicide rates. The most often cited example was Kreitman's study, showing a reduction not only in gas-specific suicide rates, but also in the overall suicide rates because of the lack of increase of other methods. However, method substitution is still a major concern in the application of the means restriction strategy to prevent suicide. The aim of the study was to investigate whether the reduction in the solids/liquids poisoning suicide rate in 1983-1993 after the launching of pesticide restriction interventions in Taiwan was accompanied with an increase in the suicide rate using other methods (method substitution).</p> <p>Methods</p> <p>Data on age-, sex- and method-specific suicide rates for 1971-1993 in Taiwan were obtained. Changes in solids/liquids poisoning suicide rates were compared with suicide rates by hanging and other methods between 1983 and 1993.</p> <p>Results</p> <p>No concomitant increase in suicide rates by hanging or other methods was noted from 1983 to 1993, during which the suicide rates by poisoning with solids/liquids (mainly pesticides) decreased markedly and steadily. The phenomenon of method substitution was also not found by sex and age groups.</p> <p>Conclusion</p> <p>In general, no method substitution was found along with the reduction in solids/liquids suicide rates in Taiwan. Our study results have also added the evidence that restricting access to methods maybe a promising strategy in preventing suicide, particularly in those countries where the "target method" has been found to contribute greatly to the suicide rates.</p

Development and characterization of a potential diagnostic monoclonal antibody against capsid protein VP1 of the chicken anemia virus

Chicken anemia virus (CAV) is an important viral pathogen that causes anemia and severe immunodeficiency syndrome in chickens worldwide. In this study, a potential diagnostic monoclonal antibody against the CAV VP1 protein was developed which can precisely recognize the CAV antigen for diagnostic and virus recovery purposes. The VP1 gene of CAV encoding the N-terminus-deleted VP1 protein, VP1Nd129, was cloned into an Escherichia (E.) coli expression vector. After isopropyl-β-D-thiogalactopyronoside induction, VP1Nd129 protein was shown to be successfully expressed in the E. coli. By performing an enzyme-linked immunoabsorbent assay using two coating antigens, purified VP1Nd129 and CAV-infected liver tissue lysate, E3 monoclonal antibody (mAb) was found to have higher reactivity against VP1 protein than the other positive clones according to the result of limiting dilution method from 64 clones. Using immunohistochemistry, the presence of the VP1-specific mAb, E3, was confirmed using CAV-infected liver and thymus tissues as positive-infected samples. Additionally, CAV particle purification was also performed using an immunoaffinity column containing E3 mAb. The monoclonal E3 mAb developed in this study will not only be very useful for detecting CAV infection and performing histopathology studies of infected chickens, but may also be used to purify CAV particles in the future

Suicide mortality trends by sex, age and method in Taiwan, 1971–2005

<p>Abstract</p> <p>Background</p> <p>Method-specific suicide trends varied across countries, and studies of the trends in different countries can contribute to the understanding of the epidemiology of suicide. The purpose of this study was to examine the changes in suicide trends by sex, age and method in the years 1971 to 2005 in Taiwan.</p> <p>Methods</p> <p>Mortality data files of suicide and undetermined deaths for the years 1971–2005 were obtained for analyses. Age-, sex- and method-specific suicide rates were calculated by four age groups (15–24, 25–44, 45–64 and 65 and above) and five suicide methods (solids/liquids poisoning, other gases poisoning, hanging, jumping, and others).</p> <p>Results</p> <p>Both sexes experienced downward trends from 1971 to 1993, and then an upward trend since 1993. People aged 65 years and above had the highest suicide rates throughout the study periods. However, males aged 25–64 years experienced the steepest increasing trends. As to suicide methods, an annual increase, since 1991, of people jumping from heights to commit suicide, and a marked increase, since 1998, of people completing suicide by poisoning with other gases (mainly charcoal-burning) were observed.</p> <p>Conclusion</p> <p>Suicide by means of charcoal-burning and jumping from heights has become a serious public health problem in Taiwan. Preventive measures to curb these increasing trends are urgently needed.</p

The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis

<p>Abstract</p> <p>Background</p> <p>Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan.</p> <p>Methods</p> <p>Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models.</p> <p>Results</p> <p>In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95).</p> <p>Conclusion</p> <p>Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.</p