Ping-Yi Lin

Background: Parkinson’s disease (PD) is a rapidly growing neurodegenerative disorder associated with gait impairment, functional decline, and increased fall risk. Conventional clinical assessments rely heavily on brief observational scales and are limited by subjectivity and environmental bias. There is a pressing need for objective, quantitative, and scalable digital assessment tools to support precision management of PD. Objective: This study aimed to develop and validate a smartphone-video-based gait assessment system aligned with a clinically meaningful pathway encompassing PD screening, functional evaluation, and fall risk classification. Methods: In this cross-sectional observational study, patients with mild-to-moderate PD and age-matched healthy controls were recruited following Institutional Review Board approval. Gait videos were recorded using smartphone cameras and processed through a silhouette extraction pipeline. Spatiotemporal gait features were subsequently extracted using a MoviNet-based deep learning framework. A multi-task framework was developed to perform PD screening, activities of daily living functional grading based on the Schwab and England Activities of Daily Living (S&E ADL) scale, and fall risk classification. Model performance and generalizability were evaluated using subject-independent data partitioning and independent cross-site validation. Results: A total of 40 participants were recruited. For PD screening, the model achieved an accuracy of 95.7%, a sensitivity of 96.6%, a specificity of 92.2%, and an AUC of 0.994 on the independent test set. For S&E ADL functional grading, the model achieved an overall accuracy of 88.5% across three functional categories (80, 90, and 100%). For fall risk classification, the model achieved an accuracy of 91.1%, a sensitivity of 68.4%, a specificity of 98.3%, and an AUC of 0.909. Overall, the framework demonstrated robust performance across PD screening, functional stratification, and fall risk classification tasks. Conclusion: This study developed a smartphone-video-based gait assessment framework using computer vision and deep learning. The proposed framework demonstrated strong performance in PD identification, severity estimation, and fall risk classification. Future work will expand validation across diverse populations and disease stages, while advancing toward multimodal integration and long-term home monitoring.

Objectives: Targeted temperature management (TTM) has been a fundamental component of post-resuscitation care for patients experiencing cardiac arrest for many years. This study aims to investigate the association between TTM and clinical outcomes in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR). Methods: This retrospective cohort study was conducted at a single tertiary medical center in Taiwan. A total of 360 patients were screened between January 2015 and May 2023, with 148 excluded. After selection, 212 patients were included in the final analysis, with 79 receiving TTM and 133 not receiving TTM. Findings: Patients in the TTM group had a higher rate of successful weaning from extracorporeal membrane oxygenation (64.6% vs. 42.1%, p = 0.002), survival to discharge (58.2% vs. 38.3%, p = 0.005) and lower cerebral performance category (CPC) scores at discharge (3.6 vs. 4.2, p = 0.001). A higher proportion of patients in the TTM group had a CPC score of 1–2 points at discharge, indicative of a favorable neurologic outcome (29.1% vs. 10.5%, p < 0.001). After adjusting for potential confounders, TTM was significantly associated with reduced odds of in-hospital death (adjusted odds ratio [OR] 0.34, 95% confidence interval [CI] 0.15–0.72, p = 0.006) and poor neurological outcomes (CPC 3–5; adjusted OR 0.30, 95% CI 0.12–0.72, p = 0.008). Conclusions: Among patients receiving ECPR, the use of TTM is associated with improved neurological outcomes and increased survival to hospital discharge. Future randomized controlled trials are needed to elucidate the pathophysiology and clinical impact of combining TTM with ECPR.

Aim: This study examines the association between musculoskeletal disorders, job strain index, work‐related fatigue, and burnout among hospital nurses. Additionally, the mediating roles of work‐related fatigue and burnout in the correlation between job strain and musculoskeletal disorders were evaluated. Background: Musculoskeletal disorders often arise from high workloads and prolonged work hours among nurses. Despite extensive research, the definitive impact of psychological factors, work‐related fatigue, and burnout on musculoskeletal disorders remains inconclusive. Methods: A cross‐sectional study was conducted at a public hospital. The study adhered to STROBE guidelines and included 471 nurses who participated voluntarily and anonymously by completing a web‐based questionnaire. The data were collected from January to December 2022. The questionnaire covered demographics, job characteristics, the job control–demand–support model, work‐related fatigue, burnout, and other relevant factors. The mediating roles of work‐related fatigue and burnout in the relationship between job strain and musculoskeletal disorders were evaluated using Hayes Model 7. Results: Musculoskeletal disorders across nine body sites exhibited significant correlations with levels of job strain, work‐related fatigue, and burnout. Work‐related fatigue showed a significant association with burnout but did not directly associate with musculoskeletal disorders. Burnout, however, directly influenced the prevalence of musculoskeletal disorders. Notably, both work‐related fatigue and burnout served as mediators in the relationship between job strain and musculoskeletal disorders, with burnout being the primary contributor. Conclusion: Given that burnout is identified as the principal contributing factor to musculoskeletal disorders among nurses, it is recommended to implement empowerment initiatives within nursing departments. Prioritizing the reduction of work‐related fatigue and burnout through tailored prevention programs for nurses is essential. Implications for the Profession: The rising prevalence of musculoskeletal disorders calls for nurse managers to act promptly. They should implement intervention programs to reduce psychological stress and workload, enhance nursing management, and ensure an ergonomic workplace environment for nurses.

With rapid urbanization in Taiwan, the green space has become a key factor in modifiable cardiovascular disease (CVD) risks. We investigated the relationships between socioeconomic status (SES), green space, and cerebrovascular disease (CBD) at the township level in Taiwan, focusing on urban–rural disparities. Analyzing data from 358 townships (2011–2020), we examined SES indicators (e.g., low-income households, education levels, median tax payments), green space (Normalized Difference Vegetation Index—NDVI), and CBD mortality rates using the pooled ordinary least squares (OLS) and random-effect models (REM) in panel regression. Additionally, we explored the mediating role of the NDVI in the SES-CBD mortality association. CBD mortality decreased more in urban areas over the decade, with consistent NDVI patterns across regions. Rural areas experienced a decline in low-income households, contrasting with an increase in urban areas. SES variables, NDVI, and time significantly affected CBD mortality in rural areas but not urban ones. Notably, the NDVI had a stronger impact on CBD mortality in rural areas. Mediation analysis revealed the NDVI’s indirect effects, especially in rural areas. Despite overall declines in CBD mortality in Taiwan, urban–rural disparities in SES and green space persist. Addressing these disparities is critical for understanding and developing interventions to mitigate health inequalities.

Workplace violence (WPV) is on the rise in occupational settings across Taiwan, with civil servants being no exception to this concerning trend. This study seeks to explore gender disparities in WPV and assess its correlation with job characteristics. A total of 20,046 civil servants from 647 institutions participated in the study, revealing significant gender-based differences in the occurrence of four categories of violence. Upon adjusting for covariates, the findings indicate that female civil servants exhibit higher odds ratios (aORs) for experiencing psychological (aOR=1.62), verbal (aOR=1.43) and sexual harassment (aOR=1.40). Particularly noteworthy is the increased likelihood of WPV among female civil servants compared to their male counterparts, especially within specific demographics: those working in health services (aOR=2.24), local government (aOR=1.64), unmarried civil servants (aOR=1.88) and those in supervisory positions (aOR=1.64). These results hold significant implications for anticipating, preventing and intervening in incidents of WPV within governmental offices. There is a pressing need for enhanced training programmes addressing gender-based WPV, emphasizing the importance of preparedness and intervention strategies for civil servants, especially those identified as more vulnerable based on their demographic and occupational profiles.

We explored the trends and the diversity of the mortality and risk factors of age-standardized cardiovascular diseases (CVD) and cerebrovascular disease (CBD) from 2000 to 2020 in five advanced Asian countries, including China, Japan, Singapore, South Korea, and Taiwan. Data were obtained from the Global Burden of Disease (GBD) report. Overall, the CVD mortality rates decreased gradually in all five Asian countries. Singapore had the highest rates before 2011, but Taiwan replaced Singapore as the nation of the highest mortality rates after 2012. Additionally, South Korea had the highest CBD mortality rates before 2016, while Taiwan experienced a peak in 2011 and remained high thereafter. The absolute difference (AD) and relative difference (RD) for CVD mortality rates showed clear declining trends in all five countries, with South Korea and China displaying the highest reductions, respectively. It is noteworthy that overweight and obesity exhibited an increasing trend in all these five Asian countries, with China demonstrating the highest AD and RD. Except for Taiwan, where a negative association of r=-0.732 was observed, CVD mortality was positively associated with CBD, hypertension, and DM mortality in all other four countries, therefore, further investigation into these relationships are needed.

(1) Limited evidence has shown the mediating effects of work characteristics and sleep duration on obesity and type 2 diabetes mellitus (T2DM) among adults. The objective of this study is to assess the interaction effects between sleep duration and effort–reward imbalance (ERI) on the risk of obesity and T2DM among Taiwanese public servants aged 40–60. (2) A national survey for Taiwanese public servants was conducted by multistage stratified random cluster sampling based on proportional probabilistic sampling. A total of 11,875 participants aged 40–60 years old were collected; (3) 3.6% of participants had self-reporting T2DM diagnosed by a physician and the prevalence of overweight and obesity were 44.0% and 15.8%, respectively. There was a significant correlation between sleep hours for the workday and risk of T2DM in non-obese and obese groups (odds ratio, OR = 1.48 and 1.39, respectively), but this did not exist for the weekend/vacation group. Similar trends in the two groups by sleep hours on a workday, obesity and overweight were significantly associated with the risks of T2DM. Clearly, sleep duration and ERI were moderating factors on the association between BMI and on the prevalence of T2DM. (4) A short sleep duration and heavy job stress contributes to the risk of weight gain and T2DM development.

Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor with poor prognosis, largely due to resistance to current radiotherapy and Temozolomide chemotherapy. The constitutive activation of Signal Transducer and Activator of Transcription 3 (STAT3) is evidenced as a pivotal driver of GBM pathogenesis and therapy resistance, and hence, is a promising GBM drug target. 5-acetyloxy-6,7,8,4′-tetramethoxyflavone (5-AcTMF) is an acetylated derivative of Tangeretin which is known to exert anticancer effects on breast, colon, lung, and multiple myeloma; however, its effect on GBM remains elusive. Herein, we reported that 5-AcTMF suppressed the viability and clonogenicity along with inducing apoptosis in multiple human GBM cell lines. Mechanistic analyses further revealed that 5-AcTMF lowered the levels of Tyrosine 705-phosphorylated STAT3 (p-STAT3), a canonical marker of STAT3 activation, but also dampened p-STAT3 upregulation elicited by Interleukin-6. Notably, ectopic expression of dominant-active STAT3 impeded 5-AcTMF-induced suppression of viability and clonogenicity plus apoptosis induction in GBM cells, confirming the prerequisite of STAT3 blockage for the inhibitory action of 5-AcTMF on GBM cell survival and growth. Additionally, 5-AcTMF impaired the activation of STAT3 upstream kinase JAK2 but also downregulated antiapoptotic BCL-2 and BCL-xL in a STAT3-dependent manner. Moreover, the overexpression of either BCL-2 or BCL-xL abrogated 5-AcTMF-mediated viability reduction and apoptosis induction in GBM cells. Collectively, we, for the first time, revealed the anticancer effect of 5-AcTMF on GBM cells, which was executed via thwarting the JAK2-STAT3-BCL-2/BCL-xL signaling axis. Our findings further implicate the therapeutic potential of 5-AcTMF for GBM treatment.

Policemen and firefighters encounter numerous emergency events that frequently lead to high burnout and low job support, resulting in adverse health effects. A number of studies reported the correlation between job characteristics and the risk of peptic ulcer diseases (PUD) across various industries. However, there is very little research on evaluating the interaction effects of burnout and job support on the prevalence of PUD among firefighters and policemen. The objective of this study was to assess the interactional effects between burnout and job support on the prevalence of PUD among firefighters and policemen. This was a cross-sectional quantitative study. Registered, full-time police officers and firefighters in Taiwan were anonymously interviewed by a mail-delivered questionnaire. All female workers were excluded due to different job characteristics and a limited sample size. A total of 9328 firefighters and 42,798 policemen completed the questionnaire, with a response rate of 78.7%. Overall, prevalence rates of self-reported and self-reports of physician-diagnosed PUD were 8.3% and 6.5% for policemen and 7.1% and 5.5% for firefighters, respectively. There was a 22% reduced odds ratio of PUD as diagnosed by physicians for the group with low burnout and high job support, but an increased odds ratio of 53% for the group with high burnout and low job support, after adjusting for lifestyle and demographic variables. There must be an increase of job support and reduction of burnout through the modification of work structure and setting up of counseling services to reduce workplace stress and the prevalence of PUD among policemen and firefighters.