Nationwide epidemiological study of severe gallstone disease in Taiwan

<p>Abstract</p> <p>Background</p> <p>Our study aimed to assess the nationwide trends in the incidence of severe gallstone disease in Taiwan among adults aged ≥20.</p> <p>Methods</p> <p>A retrospective longitudinal study was conducted using Taiwan National Health Insurance Research Database collected during 1997–2005. Patients with incident severe gallstone disease (acute cholecystitis, biliary pancreatitis, acute cholangitis) and gallstone-related procedures (elective and non-elective cholecystectomy, endoscopic retrograde cholangiopancreatography [ERCP]) that led to hospital admission were identified using ICD-9-CM diagnostic and procedure codes. Annual incidence rates of gallstone-related complications and procedures were calculated and their 95% confidence intervals (CI) were estimated assuming a Poisson distribution.</p> <p>Results</p> <p>The hospital admission rate for severe gallstone disease increased with advancing age and the age-standardized rate (95% CI) per 1000 population was 0.60 (0.59–0.60) for men and 0.59 (0.59–0.60) for women. Men had a higher rate of acute cholecystitis, probably due to the substantially lower rate of elective cholecystectomy among men than women. For those aged 20–39, hospital admissions for all gallstone-related complications and procedures increased significantly. For those aged ≥60, incidences of biliary pancreatitis, acute cholangitis, and hospital admission for gallstone receiving ERCP increased significantly without substantial change in the incidence of acute cholecystitis and despite a decreased rate of elective cholecystectomy.</p> <p>Conclusion</p> <p>This population-based study found a substantial increase in the rate of admission for severe gallstone disease among those aged 20–39. Concurrently, the incidences of biliary pancreatitis and acute cholangitis have risen among those aged ≥60.</p

Oncologic impact of delay between diagnosis and radical nephroureterectomy

PurposeThis study aimed to evaluate the oncological outcome of delayed surgical wait time from the diagnosis of upper tract urothelial carcinoma (UTUC) to radical nephroureterectomy (RNU).MethodsIn this multicenter retrospective study, medical records were collected between 1988 and 2021 from 18 participating Taiwanese hospitals under the Taiwan UTUC Collaboration Group. Patients were dichotomized into the early (≤90 days) and late (&gt;90 days) surgical wait-time groups. Overall survival, disease-free survival, and bladder recurrence-free survival were calculated using the Kaplan–Meier method and multivariate Cox regression analysis. Multivariate analysis was performed using stepwise linear regression.ResultsOf the 1251 patients, 1181 (94.4%) were classifed into the early surgical wait-time group and 70 (5.6%) into the late surgical wait-time group. The median surgical wait time was 21 days, and the median follow-up was 59.5 months. Our study showed delay-time more than 90 days appeared to be associated with worse overall survival (hazard ratio [HR] 1.974, 95% confidence interval [CI] 1.166−3.343, p = 0.011), and disease-free survival (HR 1.997, 95% CI 1.137−3.507, p = 0.016). This remained as an independent prognostic factor after other confounding factors were adjusted. Age, ECOG performance status, Charlson Comorbidity Index (CCI), surgical margin, tumor location and adjuvant systemic therapy were independent prognostic factors for overall survival. Tumor location and adjuvant systemic therapy were also independent prognostic factors for disease-free survival.ConclusionsFor patients with UTUC undergoing RNU, the surgical wait time should be minimized to less than 90 days. Prolonged delay times may be associated with poor overall and disease-free survival

A Review on Constitutionalism and State Contingency: A Synthetic Overview of Contemporary National Emergency Powers,Especially Focusing on the Implementation of the ROC’S and the ROK’S Practices and Theroies

廿一世紀，全球政經局勢與安全秩序依然紛擾、動盪，1999年臺灣發生921地震、2001年美國發生911恐怖攻擊事件、2002年中國爆發SARS危機事件、2008年發生四川省汶川大地震，2009年墨西哥爆發首例H1N1新型流感隱然有疫情擴散的風險、2010年海地島發生大地震，這些災害事變、恐怖事件乃至於癘疫的緊急應變措施，足讓我們思索並檢討分析法治國家緊急應變體制的過去、現在與未來。 面對「危機連續」的時代，如何鞏固國權並保障民權，本文主張先將研究聚焦於「憲政獨裁、法治國原則與人權保障」的歷史回顧，就中研究可確知，在維護憲法秩序方面，古典的國家緊急權之運作最不易處理，容易發生濫用、誤用。尤其，當國家行政部門以維護「國家安全」或「反共、反革命、戡亂」等意識型態符碼為名，長年持續國家緊急權體制之運作，極易戕害民主憲政的發展，甚至使國政轉趨消極，由常態憲政體制轉變成為獨裁專制政治或演變成為軍事政權及軍事政變惡性循環之憲政變體。 另外，隨著時空的推移變化，當代新興國家緊急權的內涵，已與以往古典的國家緊急權內涵有所不同。本論文研究前半部以古典國家緊急權制度（憲政獨裁）為主，集中探討一次戰後威瑪德國、二次戰後韓國與臺灣憲政獨裁的比較研究，從歷史回顧發展與規範設計兩大主軸進行（國際）政治現實面、歷史面、規範面及外國法制比較四向度研究；研究時空背景及區域以戰後第二波（從威瑪德國到盟軍占領德國）及第三波民主國家（戰後韓國與臺灣）為主軸，期更深入了解古典國家緊急權制度其歷史因果脈絡；此外，在新興國家緊急權領域，鑑於新興的緊急權相關外國文獻探討已多，而國內相關專書引介仍較少見，國內相關文獻著墨偏重於就災害防救法者較多；本論文研究後半部各章乃匯集探討在緊急憲法、緊急立法領域，我國乃至各國家災害防救法、反恐措施的規範研究與分析，期能正確掌握國家緊急權之演進、發展及變化，設計出適合可行的緊急規範。Most Modern States turn swiftly to law in an emergency.The Global response to the September 11, 2001 terrorist attacks on the United States was no exception and the wave of legislative responses is well documented. Yet there is an ever-present danger , borne out of historical and contemporary events(such as 1999 Chi-Chi earthquake in Taiwan , 2003 SARS Crisis in Hong Kong , 2008 Sichuan Earthquake In China , 2009 H1N1 pandemic flu contigency in Mexico , 2010 Haiti Earthquake and so on) , that even the most well-meaning executive , armed with emergency powers,will abuse them . And this inevitably leads to another common tendency in an emergency , to invoke law not only to empower the state,but also in a bid to constrain it. Is the rule of law optional for liberal democratic societies ? It is hardly a new claim that in a time of emergency even liberal democracies have to suspend the rights which those subject to the law enjoy in ordinary times in order to preserve themselves. All that is new is the prevalence of the same only claim that this emergency has no foreseeable end and so is permanent , we frequently fall into. Can law constrain the emergency state or must the state at times act outside the law when its existence is threatened? If it must act outside the law,is such conduct necessarily fatal to aspirations of legality? This thesis standing at the intersection of legal,political and social theory and practice explores law’s capacity to constrain state power in times of crisis. While there are so many eminent contigencies needed to tackle with , in face of ”consecutive crisis era” , the best solution to rebuild and consolidate state sovereignty and protect civil and political rights is to launch further probe into the problems of ambiguities for on the topic of ” Constitutional dictatorship , human rights protection and legality in a time of emergency ”. In the first and middle part of my thesis , using well known examples from the cold war confrontations to &quot; terrorism, insurgency , extremism and cyber espionage on so forth.” show that we need to look more closely at the kinds of conditions in which a suspension of ordinary legal regulation might occur . In addition , many questions have been asked about a state’s legal response to an emergency. Are new laws strictly necessary to cope with state contigencies? Do the state’s counter-terrorism measures strike the right balance between national security and human rights? What specific legal limits should be placed on the state’s response and which rights , if any , are non-derogatory even in times of emergency? These are important and contentious questions about which will be discussed in the last part of my thesis. I will set out my conception about rule of law which must aspire to realize principle like Harold J.Berman and William R.Greiner’s idea that legal order must aspire to realize principles of an “ inner morality of law ” . My thesis maintain that Constitutionism(the commonality of the rule-of-law) shows it as inter-dependent and inter-connected as a joint project, it requires cooperation between and among institutions more than the pure hypothesis of President or Supreme Court as a sole guardian of the Constitution. To sum up , The realization of the rule of law dependent on legislative and executive commitment and judicial guardianship

DO STATUS-SEEKING MOTIVES ENHANCE ECONOMIC GROWTH? A SMALL OPEN GROWTH MODEL

This paper explores the growth effects of both consumption- and wealth-induced social comparisons in a unified small open endogenous growth model. We analytically show that in an open economy not only do these two distinct status-seeking motives have very different growth effects, but these growth effects are also quite different from the conventional wisdom based on a closed economy. Status-seeking behavior need not favor economic growth. The asset portfolios of households and the imperfection of the international asset market both play an important role and jointly govern the growth effects of social status seeking. We also perform a quantitative experiment, showing that our analytical findings are robust and empirically plausible. Our analysis provides novel implications for social comparisons and new insights into the literature.</jats:p

Evaluation of Magnetic Nanoparticle-Labeled Chondrocytes Cultivated on a Type II Collagen–Chitosan/Poly(Lactic-co-Glycolic) Acid Biphasic Scaffold

Chondral or osteochondral defects are still controversial problems in orthopedics. Here, chondrocytes labeled with magnetic nanoparticles were cultivated on a biphasic, type II collagen–chitosan/poly(lactic-co-glycolic acid) scaffold in an attempt to develop cultures with trackable cells exhibiting growth, differentiation, and regeneration. Rabbit chondrocytes were labeled with magnetic nanoparticles and characterized by scanning electron microscopy (SEM), transmission electron (TEM) microscopy, and gene and protein expression analyses. The experimental results showed that the magnetic nanoparticles did not affect the phenotype of chondrocytes after cell labeling, nor were protein and gene expression affected. The biphasic type II collagen–chitosan/poly(lactic-co-glycolic) acid scaffold was characterized by SEM, and labeled chondrocytes showed a homogeneous distribution throughout the scaffold after cultivation onto the polymer. Cellular phenotype remained unaltered but with increased gene expression of type II collagen and aggrecan, as indicated by cell staining, indicating chondrogenesis. Decreased SRY-related high mobility group-box gene (Sox-9) levels of cultured chondrocytes indicated that differentiation was associated with osteogenesis. These results are encouraging for the development of techniques for trackable cartilage regeneration and osteochondral defect repair which may be applied in vivo and, eventually, in clinical trials