Chien-Ling Su

Objective: Obstructive sleep apnea (OSA) is associated with metabolic dysregulation, potentially affecting ketone body metabolism. However, relationships between OSA and ketone body metabolism require further investigation. Thus, in this study, we investigated relationships between breath acetone levels and OSA manifestations (e.g., hypoxia and arousal events). Methods: Baseline characteristics were collected from 66 eligible participants, and breath acetone levels were measured before and after polysomnography (PSG). Participants were categorized into two groups using the apnea-hypopnea index (AHI): normal-to-mild (< 15 events/h) and moderate-to-severe (≥ 15 events/h) OSA groups. Differences in baseline characteristics, PSG parameters, and breath acetone levels between the two groups were analyzed. Next, correlations analyses and multivariable regression models adjusted for baseline characteristics were performed to examine relationships between alterations in breath acetone levels and various sleep parameters. Results: Significant differences were observed between the two groups in baseline characteristics, sleep quality indices and the overnight difference in acetone levels (all p < 0.01). Additionally, the overnight difference in acetone levels exhibited significant negative correlations ( p < 0.01) with the AHI, arousal index (ArI), and snoring index. In regression models adjusted for confounding factors, this overnight acetone difference remained significantly and negatively associated with both AHI and ArI values (both p < 0.05). Conclusions: The present observations provide insight into potential links between overnight breath acetone alterations and OSA manifestations.

Background Kidney disease is a chronic health burden that considerably impairs patients’ quality of life, necessitating a systematic evaluation of their holistic needs. This study employed the Taiwanese version of the Sheffield Profile for Assessment and Referral for Care (SPARC-T) questionnaire to identify unmet needs among patients with kidney disease. Methods In this prospective, cross-sectional study, the patients completed the SPARC-T questionnaire upon admission to the nephrology ward. Scores exceeding predefined thresholds in the psychological, depression, religious and spiritual, or social domains triggered referral to a psychiatry department, social works, or a discharge planning team. Demographic information and SPARC-T scores were analyzed using logistic regression. Results A total of 490 patients completed the questionnaire between January 2023 and June 2024. Of these, 47 patients (9.59%) had scores exceeding the threshold in at least one SPARC-T domain. The most frequently reported concerns were depression (6.94%) and spiritual distress (5.51%). Multivariate logistic regression revealed that female patients (odds ratio = 2.21, 95% confidence interval: 1.09 to 4.47) and individuals from low-income groups (odds ratio = 5.56, 95% confidence interval: 1.48 to 20.95) were significantly more likely to report higher distress scores. Conclusions Many patients with kidney disease, particularly women and those belonging to low-income groups, experienced unmet needs that extended beyond physical symptoms. Routine use of the SPARC-T is recommended to support patient-centered care by addressing psychological, spiritual, and social concerns alongside clinical management. Graphical Abstract

Air pollution is known to increase the risk of pneumonia. However, the effects of air pollution on the pleural effusion of patients with pneumonia are unclear. The objective of this study was to investigate alterations in inflammatory–immune biomarkers by air pollution in patients with pneumonia by analyzing their pleural effusion. Patients who had undergone thoracentesis to drain their pleural effusion in a hospital were recruited for this study. Patients with pneumonia and those with congestive heart failure respectively served as the case and control groups. We observed that an increase of 1 ppb in one-year NO₂ was associated with a decrease of 0.105 ng/mL in cluster of differentiation 62 (CD62) (95% confidence interval (CI) = −0.085, −0.004, p < 0.05) in the pleural effusion. Furthermore, we observed that an increase in one−year 1 ppb of NO₂ was associated with a decrease of 0.026 ng/mL in molybdenum (Mo) (95% CI = −0.138, −0.020, p < 0.05). An increase in one-year 1 ppb of SO₂ was associated with a decrease of 0.531 ng/mL in zinc (95% CI = −0.164, −0.006, p < 0.05). Also, an increase in one-year 1 ppb of O₃ was associated with a decrease of 0.025 ng/mL in Mo (95% CI = −0.372, −0.053, p < 0.05). In conclusion, air pollution exposure, especially gaseous pollution, may be associated with the regulation of immune responses and changes in metal levels in the pleural effusion of pneumonia patients.

We identified 78 imported chikungunya cases in Taiwan during 2006–2014. Sixty-six (84.6%) cases were initially suspected to be dengue, which indicates the necessity for laboratory diagnostics in differentiation between dengue and chikungunya. Results also emphasize the need for active surveillance of febrile illness at points of entry.