Ching-Wen Chien

This study aimed to assess the association between sedentary behavior (SB) and dementia among the general adult population. We queried PubMed, Web of Science, Embase, and Cochrane Library from their inception to November 3, 2024. Two authors independently extracted the data from included studies, including hazard ratios (HRs) and their 95% confidence intervals (CIs), to assess the risk of dementia among individuals with SB. The quality of included studies was assessed using the Newcastle–Ottawa Scale. We used a random effects model if I2 > 50% and p < 0.10; otherwise, a fixed-effect model was used. In addition, we assessed publication bias by funnel plot, and performed leave-one-out sensitivity analysis. We included ten cohort studies, nine of which were of high quality. Our analysis demonstrated an increased risk of dementia among individuals with SB (pooled HRs, 1.17; 95% CIs, 1.06–1.29). Individuals with high sedentary time (ST), defined by TV viewing, demonstrated a 31% increased risk of dementia compared to those with low ST (pooled HRs, 1.31; 95% CIs, 1.25–1.37). No significantly increased risk for dementia was observed among individuals with high computer usage time (pooled HRs, 0.89; 95% CIs, 0.73–1.09). However, when SB was defined by other methods, individuals with high ST demonstrated a 33% increased risk of dementia compared to those with low ST (pooled HRs, 1.33; 95% CIs, 1.25–1.42). SB increases the risk of dementia, but SB defined by computer usage time has not shown this association. CRD42023493109.

The prison population has been increasing globally, and prisoner health is an important issue of global health. However, it has not received sufficient attention, especially in developing countries and regions. Among all the prisoners, the health status of older prisoners requires special attention due to their declining health and energy. This study aims to assess the prevalence of digestive diseases among older prisoners in Taiwan. Data on older prisoners from the National Health Insurance Research Database from January 1 to December 31, 2013, were used in this study. Digestive diseases were assessed in 2,215 older prisoners using the International Classification of Diseases, 9th revision Clinical Modification (ICD-9-CM). We identified the most common digestive diseases and explored any sex-specific differences in their prevalence. The estimated prevalence of digestive system diseases among the prisoners was 51.56%. Older women prisoners had a higher prevalence (62.68%) compared to men prisoners in general (50.80%). Diseases with a prevalence > 10% include esophageal, gastric, and duodenal diseases; diseases of the oral cavity, salivary glands, and jaws; and other intestinal and peritoneal diseases. Women prisoners showed a significantly higher prevalence of diseases of the oral cavity, salivary glands, jaws, esophagus, stomach, duodenum, non-infectious enteritis, and colitis. Our findings indicate that a considerable number of older prisoners in Taiwan experienced digestive diseases, which may be attributable to general deterioration of physical function and poor resistance. Early detection and treatment are crucial for these conditions, and it is important to maintain human rights and justice in prison systems.

To identify the key risk factors for venous thromboembolism (VTE) in urological inpatients based on the Caprini scale using an interpretable machine learning method. VTE risk data of urological inpatients were obtained based on the Caprini scale in the case hospital. Based on the data, the Boruta method was used to further select the key variables from the 37 variables in the Caprini scale. Furthermore, decision rules corresponding to each risk level were generated using the rough set (RS) method. Finally, random forest (RF), support vector machine (SVM), and backpropagation artificial neural network (BPANN) were used to verify the data accuracy and were compared with the RS method. Following the screening, the key risk factors for VTE in urology were “(C1) Age,” “(C2) Minor Surgery planned,” “(C3) Obesity (BMI > 25),” “(C8) Varicose veins,” “(C9) Sepsis (< 1 month),” (C10) “Serious lung disease incl. pneumonia (< 1month) ” (C11) COPD,” “(C16) Other risk,” “(C18) Major surgery (> 45 min),” “(C19) Laparoscopic surgery (> 45 min),” “(C20) Patient confined to bed (> 72 h),” “(C18) Malignancy (present or previous),” “(C23) Central venous access,” “(C31) History of DVT/PE,” “(C32) Other congenital or acquired thrombophilia,” and “(C34) Stroke (< 1 month.” According to the decision rules of different risk levels obtained using the RS method, “(C1) Age,” “(C18) Major surgery (> 45 minutes),” and “(C21) Malignancy (present or previous)” were the main factors influencing mid- and high-risk levels, and some suggestions on VTE prevention were indicated based on these three factors. The average accuracies of the RS, RF, SVM, and BPANN models were 79.5%, 87.9%, 92.6%, and 97.2%, respectively. In addition, BPANN had the highest accuracy, recall, F1-score, and precision. The RS model achieved poorer accuracy than the other three common machine learning models. However, the RS model provides strong interpretability and allows for the identification of high-risk factors and decision rules influencing high-risk assessments of VTE in urology. This transparency is very important for clinicians in the risk assessment process.

To analyze the key factors influencing the psychological resilience of intensive care unit (ICU) nurses during the COVID-19 pandemic and put forward suggestions promoting resilience based on key improvement factors and clinical experience. Data were collected from 35 ICU nurses in a hospital in Zhejiang Province, China, through a questionnaire survey conducted between January and February 2023. The Decision-Making Trial and Evaluation Laboratory (DEMATEL) method was then used to construct and visualize the relationship structure between the factors. The DEMATEL-based Analytical Network Process (DANP) was applied to determine the influential weights of all factors. Finally, the key improvement factors were identified using importance-performance analysis (IPA). Based on the cause-effect impact network diagram (CEIND), it was concluded that (C 11), (C 22), and (C 32) are the key factors that promote the improvement of psychological resilience among ICU nurses. Additionally, these factors were the key factors that influence psychological resilience. The confidence levels of these results and the gap were 99.6% and 0.4%, respectively, which exceed the threshold value of 95%, indicating good stability. Finally, for the case hospitals, (C 13) was identified as the key improvement factor. Hospital administrators should support ICU nurses in enhancing their psychological resilience during major epidemics by: (i) Providing training on comprehensive protective measures and nursing skills; (ii) Effectively managing the human resources of nurses in the hospital to reduce their workload; (iii) Increasing social and organizational support for nurses to alleviate anxiety caused by large-scale public health events and improve their psychological resilience.

Background: As older people have complex medical needs and still encounter challenges in accessing online health information, the relationship between Internet use and the choice of medical institution made by them is unclear, and we aimed to examine this relationship. Methods: Data from the newly released 2020 China Family Panel Survey database were used. Furthermore, we used descriptive statistics to analyze the background characteristics of the sample and a logistic regression model to estimate the impact of Internet use on the choice of medical institution made by older adults. We conducted a stratified analysis to explore the influence of different characteristics on the relationship between Internet use and the choice of medical institution. Results: Totally 4,948 older adults were included. Multivariate logistic regression showed that, compared to non-Internet users, Internet users were less likely to choose community health service centers over general hospitals (P < 0.001, OR = 0.667, 95CI%: 0.558–0.797). The subgroup analyses found that Internet use only had an impact on the choice of medical institution in older adults aged 65–69 years, those with partners, those with primary or secondary education, those residing in urban areas, those without medical insurance, those with a self-rated health status as average or healthy, those with unchanged or better health trend, and those without chronic disease. The effect of Internet use on the choice of medical institution did not differ by sex, satisfaction, or trust in doctors. Conclusion: Internet use may significantly affect older adults’ tendency to choose general hospitals to meet their daily medical needs. The subgroup analyses indicated that different characteristics of older people affected this association.

Background: Prisoner health is a topic of significant importance; however, it has received limited attention in epidemiological studies, likely because of challenges in obtaining relevant data. Specifically, research on ocular disorders among elderly prisoners is lacking. Thus, the aim of this study was to evaluate the prevalence of disorders of the eye and adnexa among elderly prisoners in Taiwan. Methods: We investigated the presence of eye and adnexal disorders in elderly prisoners in Taiwan using data from the Taiwan National Health Insurance Research Database. The ocular disorders were identified using the appropriate disease codes in the International Classification of Diseases, 9th revision Clinical Modification (codes 360–379). In addition, the most common types of eye and adnexal disorders among the prisoners were identified. Results: A total of 2215 elderly prisoners (age ≥ 65 years; 2073 men and 142 women) were examined. The prevalence of eye and adnexal disorders among the prisoners was 18.87%. The elderly female prisoners exhibited a higher prevalence of eye and adnexal disorders than the elderly male prisoners. The most common disorders were disorders of the conjunctiva, cataract, and disorders of the lacrimal system. Conclusions: A considerable proportion of elderly prisoners have disorders of the eye and adnexa. The overall quality of life of elderly prisoners can be improved by addressing their visual health, which contributes to the fulfillment of their basic human rights.

We conducted this umbrella review to review the current evidence on the relationship between COVID-19 and sexual health in both men and women. We conducted searches in Pubmed, Embase, and the Cochrane dataset for meta-analyses that met our pre-set inclusion criteria. We included studies with detailed information investigating the link between COVID-19 and sexual health in men/women. We did not limit the language. The results of the included studies frequently relied on the Female Sexual Function Index to assess sexual health in women. For men, the International Index of Male Function and hospital diagnoses were commonly used to assess sexual health. Currently, there is conflicting evidence regarding the impact of COVID-19 on sexual health. However, since most studies were observational in nature, additional study designs are necessary to draw definitive conclusions across different contexts. Our findings highlight the importance of sexual health among COVID-19 patients and people affected due to COVID-19. Further critical studies should investigate the mechanism underlying the association between COVID-19 and sexual health.