Chung Shan Medical University Hospital is affiliated with the university..
Objectives This study aimed to investigate the associations of parental SA recorded within 3 years before childbirth and parental SA recorded during pregnancy with the odds of autism in offspring. Methods We conducted a nationwide nested case-control study using Taiwan’s 2006–2015 national birth cohort linked to multigenerational health records from 2003 to 2017. The study included 14,961 children with autism and 59,844 controls individually matched by birth year and sex. Conditional logistic regression with inverse probability of treatment weighting (IPTW) was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results Paternal SA recorded within 3 years before childbirth was associated with higher odds of offspring autism in the IPTW model (aOR of 2.208, 95% CI = 1.542–3.163). SA recorded during pregnancy was also associated with higher odds of offspring autism, with an aOR of 2.055 (95% CI = 1.021–4.136) for maternal SA and 1.653 (95% CI = 1.311–2.084) for paternal SA. Conclusion Paternal SA recorded within 3 years before childbirth and parental SA recorded during pregnancy were associated with higher odds of autism in offspring. Further studies are needed to clarify the underlying mechanisms.
To evaluate the efficiency, predictability, and residual astigmatism between first- and second-generation keratorefractive lenticule extraction (KLEx) surgeries in a prominent astigmatism population. A retrospective cohort study was conducted, and individuals who underwent first- and second-generation KLEx surgeries were enrolled. A total of 31 and 35 eyes were categorized into first and second KLEx groups, respectively. Visual acuity, refraction, topographic parameters, and surgical indices were recorded. Independent t tests were used to compare the postoperative uncorrected distance visual acuity (UDVA), spherical equivalent (SE), and residual astigmatism between the two groups. The difference in UDVA was not significant three months after KLEx surgery (P = 0.509), and the SEs three months after surgery also presented similar values between the two groups (P = 0.552). The first KLEx group demonstrated greater residual astigmatism than did the second KLEx group throughout the three-month follow-up period (all P < 0.05). The values of surgically induced astigmatism (SIA), difference vector (DV), magnitude of error (ME) and correction index (CoI) were significantly better in the second KLEx group via vector analysis (all P < 0.05). Old age, high steep keratometry (K), high topographic cylinder, large angle kappa, and a small optic zone were correlated with greater residual astigmatism in the first KLEx group (all P < 0.05), whereas only a small optic zone was significantly correlated with greater residual astigmatism in the second KLEx group (P = 0.047). The second-generation KLEx is correlated with a lower risk of residual astigmatism.
PURPOSE:This study investigates the psychological determinants of healthcare professionals' support for green hospital transitions by integrating the values-attitude-behavior (VAB) framework with the Theory of Planned Behavior. DESIGN/METHODOLOGY/APPROACH:A survey of 300 Taiwanese healthcare employees was conducted, and the data were analyzed using Covariance-Based Structural Equation Modeling. FINDINGS:Green values (GV) had a significant positive influence on attitudes, subjective norms (SN), and perceived behavioral control (PBC). However, GV did not directly influence behavioral intention. Among the theory constructs, only PBC had a significant positive effect on behavioral intentions (BI). Attitudes and SN did not have significant impacts. Furthermore, government policy (GP) demonstrated a significant positive direct effect on BI, however, analysis found no significant moderating effects on the relationships between attitude, subjective norm, PBC and intention. RESEARCH LIMITATIONS/IMPLICATIONS:The study focused on healthcare workers in Taiwan, future research should include more diverse populations or conduct comparative studies across various regions. PRACTICAL IMPLICATIONS:Hospital managers should prioritize training and resource provision to enhance staff control over environmental practices, while policymakers should maintain clear regulations and incentives to accelerate progress toward carbon-neutral healthcare. SOCIAL IMPLICATIONS:The findings of this study have significant implications for the development of sustainable healthcare practices and the achievement of sustainable development goals. ORIGINALITY/VALUE:Originality lies in the study's integrated VAB-TPB framework, which is uniquely applied to the high-constraint healthcare environment, offering a more nuanced model than prior single-theory applications. This study differs by demonstrating the primacy of PBC over attitudes and norms in a professional context and identifying GP as a direct driver rather than a moderator of intention. Focusing on Taiwan provides a distinctive case study of a high-performing healthcare system facing an urgent, policy-driven sustainability transition, strengthening the study's contribution to the green healthcare field.
In this study, we synthesized (E)-N'-(4-methoxybenzylidene)-2-((5-phenyl-1H-pyrazol-3-yl)oxy)acetohydrazide (MBPA), a novel compound exhibiting significant inhibitory activity against alpha-amylase and alpha-glucosidase enzymes. The target compound was obtained through a condensation reaction between 2-((5-phenyl-1H-pyrazol-3-yl)oxy)acetohydrazide and 4-methoxybenzaldehyde. Structural confirmation was achieved using comprehensive spectroscopic techniques, including 1H NMR, 13C NMR, FT-IR, and HRMS-ESI. Additionally, single-crystal X-ray diffraction (XRD) analysis was performed to elucidate the molecular structure. The molecular geometry, electronic properties, and reactivity descriptors of the compound were investigated using density functional theory (DFT) at the B3LYP/6-311++G(d,p) level. Key analyses included MEP, NBO, QTAIM, and NCI. Additionally, Hirshfeld surface analysis was employed to characterize intermolecular interactions within the MBPA crystal structure, utilizing normalized contact distance (dnorm) surfaces and 2D fingerprint plots. MBPA was evaluated for its antihyperglycemic potential through in vitro assays. The compound demonstrated significant inhibitory effects against both alpha-glucosidase (IC50 = 68.99 +/- 0.85 mu M) and alpha-amylase (IC50 = 174.1 +/- 1.85 mu M), outperforming the standard drug acarbose (IC50 values of 98.12 +/- 2.10 mu M and 126.5 +/- 2.10 mu M, respectively). In addition, molecular docking studies were performed to investigate the interaction between the ligand (MBPA) and receptor proteins, alpha-glucosidase (PDB code: 3W37) and alpha-amylase (PDB code: 3CPU).
BACKGROUND:Knee osteoarthritis (OA) affects approximately 10% of the general population. Of these, nearly 20% of patients undergo total knee arthroplasty (TKA). A proportion subsequently develops long-term opioid use, yet comprehensive evaluations of perioperative risk factors remain limited. METHODS:A total of 15,051 patients with knee OA who underwent TKA between 2002 and 2018 were included. Our primary analysis used a Least Absolute Shrinkage and Selection Operator (LASSO)-Elastic Net logistic regression model with a 70/30 training-validation split to identify predictors of long-term opioid use and to estimate model performance using the area under the receiver operating characteristic curve (AUC) and calibration. As supplementary analyses, hierarchical logistic regression models progressively incorporated demographic, preoperative, in-hospital, and early post-discharge variables. RESULTS:Overall, 1029 patients were identified as long-term opioid users. The LASSO-Elastic Net model achieved an AUC of 0.8213 (95% CI: 0.8080-0.8347). The AUCs of the hierarchical logistic models were 0.7523 (95% CI: 0.7364-0.7681) for demographic and preoperative factors (Model 1), 0.7682 (95% CI: 0.7534-0.7829) with added hospitalisation factors (Model 2), and 0.8251 (95% CI: 0.8119-0.8383) after further including post-discharge variables (Model 3). CONCLUSION:This study systematically identifies risk factors for long-term opioid use across different phases of TKA care. A predictive model based on LASSO-Elastic analysis demonstrated an AUC of 0.8213, highlighting its potential for early identification of high-risk patients. SIGNIFICANCE STATEMENT:Using a population-based analysis, this study identifies risk factors for prolonged opioid use following TKA, aiding clinicians in early recognition and targeted preventive strategies.
