Ren-Hao Pan

Epidemiology of appendicitis and appendectomy for the low-income population in Taiwan, 2003–2011

BackgroundAlthough numerous epidemiological studies on appendicitis have been conducted worldwide, only a few studies have paid attention to the effect of socioeconomic status on appendicitis, particularly studies focusing on the low-income population (LIP).MethodsWe analyzed the epidemiological features of appendicitis in Taiwan using data from the National Health Insurance Research Database from 2003 to 2011. All cases diagnosed as appendicitis were enrolled.ResultsBetween 2003 and 2011, 2,916 patients from the LIP and 209,206 patients from the normal population (NP) were diagnosed with appendicitis. Our finding revealed that the ratios of comorbidities, complicated appendicitis, and readmissions in LIP patients were slightly higher than those of NP patients. LIP patients were more likely to live in suburban and rural areas, and hence a higher proportion of them were hospitalized in a district or regional hospital compared with NP patients. The crucially finding was that the overall incidence ratios of appendicitis, acute appendicitis, and perforated appendicitis in the LIP were substantially higher than those in the NP (36.25%, 35.33%, and 37.28%, respectively). The mean LOS in LIP patients was longer than that of NP patients. The overall case-fatality ratio of appendectomy in the LIP was higher when compared with the NP (0.41% versus 0.12%, p < 0.05). We also observed that appendicitis was occurred frequently in male patients, with a higher incidence for those aged 15–29 years in both the LIP and NP. The incidences of incidental appendectomy showed a decreasing trend in both the LIP and NP. Finally, a valuable discovery was that the total hospital cost was comparable between the laparoscopic appendectomy (LA) and open appendectomy (OA) (1,178 ± 13 USD versus 1,191 ± 19 USD, p < 0.05) in LIP patients because they saved more hospitalization costs than NP patients when the previous one chose the LA.ConclusionThis study confirmed that a lower socioeconomic status has significantly negative impact on the occurrence and treatment of appendicitis and appendectomy. In terms of hospital costs and LOS, LIP patients benefit more from the LA approach than they do from the OA approach in the treatment of appendicitis.

Epidemiology of Orthopedic Fractures and Other Injuries among Inpatients Admitted due to Traffic Accidents: A 10-Year Nationwide Survey in Taiwan

To investigate the major injury patterns associated with traffic accidents and evaluate the risk factors of the main injury, a survey of Taiwans national insurance admission data between 2002 and 2011 was performed. The incidence of traffic-accidents-related hospitalization was between 9.17% and 11.54% and the average mortality rate of the inpatients admitted due to traffic accidents was 0.68%. Of all inpatients due to road traffic accidents in Taiwan, orthopedic fractures were the most common injuries that accounted for 29.36% of them. There were a total of 391,197 cases of three orthopedic fracture groups that were divided into (1) fracture of upper limb, (2) fracture of lower limb, and (3) fracture of spine and trunk. An increase in national medical cost used for inpatients with orthopedic fractures was noted and ranged from US

Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data

45.6 million to US

Differences in Spontaneous Intracerebral Hemorrhage Cases between Urban and Rural Regions of Taiwan: Big Data Analytics of Government Open Data

86 million annually. These orthopedic fracture patterns were frequently associated with other injuries especially head injuries (ranged from 14% to 26%). A significant relation to male gender, older age, low income, and admission to high-level hospital to the observed fracture patterns was observed.

Does the Short-Term Effect of Air Pollution Influence the Incidence of Spontaneous Intracerebral Hemorrhage in Different Patient Groups? Big Data Analysis in Taiwan

Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM2.5, PM10, O3, SO2, and NO2) in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O3 in spring in Taipei. In children aged 0–6 years, asthma was associated with O3 in Taipei and SO2 in Kaohsiung, after controlling for the daily mean temperature and relative humidity.

The Epidemiology and Cost of Hospital-Treated Traumatic Brain Injuries: a 10-Year Nationwide Survey in Taiwan

This study evaluated the differences in spontaneous intracerebral hemorrhage (sICH) between rural and urban areas of Taiwan with big data analysis. We used big data analytics and visualization tools to examine government open data, which included the residents’ health medical administrative data, economic status, educational status, and relevant information. The study subjects included sICH patients of Taipei region (29,741 cases) and Eastern Taiwan (4565 cases). The incidence of sICH per 100,000 population per year in Eastern Taiwan (71.3 cases) was significantly higher than that of the Taipei region (42.3 cases). The mean coverage area per hospital in Eastern Taiwan (452.4 km2) was significantly larger than the Taipei region (24 km2). The residents educational level in the Taipei region was significantly higher than that in Eastern Taiwan. The mean hospital length of stay in the Taipei region (17.9 days) was significantly greater than that in Eastern Taiwan (16.3 days) (p < 0.001). There were no significant differences in other medical profiles between two areas. Distance and educational barriers were two possible reasons for the higher incidence of sICH in the rural area of Eastern Taiwan. Further studies are necessary in order to understand these phenomena in greater depth.

A Study of the Effects of Daily Physical Activity on Memory and Attention Capacities in College Students

Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that the occurrence of sICH is related to air pollution. This study used big data analysis to explore the impact of air pollution on the risk of sICH in patients of differing age and geographic location. 39,053 cases were included in this study; 14,041 in the Taipei region (Taipei City and New Taipei City), 5537 in Taoyuan City, 7654 in Taichung City, 4739 in Tainan City, and 7082 in Kaohsiung City. The results of correlation analysis indicated that there were two pollutants groups, the CO and NO2 group and the PM2.5 and PM10 group. Furthermore, variations in the correlations of sICH with air pollutants were identified in different age groups. The co-factors of the influence of air pollutants in the different age groups were explored using regression analysis. This study integrated Taiwan National Health Insurance data and air pollution data to explore the risk factors of sICH using big data analytics. We found that PM2.5 and PM10 are very important risk factors for sICH, and age is an important modulating factor that allows air pollutants to influence the incidence of sICH.

A survey of ambulatory-treated asthma and correlation with weather and air pollution conditions within Taiwan during 2001–2010

Background: Traumatic brain injury (TBI) is one of the most common types of injury, especially among young adults. Methods: This study used the Taiwan National Health Insurance Research Database to evaluate the incidence and medical cost of TBI in Taiwan. Multi-level logistic regression models were used to assess the correlations between factors. Results: A total of 290,114 subjects were included from 2002 to 2011. The incidence of head injury was around 126.1 cases per 100,000 population per year. Around 1/3 of TBIs were caused by traffic accidents, and the mortality rate was lower than 4%. The incidences of TBI in males were significantly higher than those in females in all age groups. The average length of stay was 11.53 days. The average total medical cost was

Design of an NGS MicroRNA predictor using multilayer hierarchical MapReduce framework

USD 2809.24. The incidence of TBI was significantly higher in subjects aged 25 to 44 years (25.58%) and those aged 45 to 64 years (24.95%). Conclusion: The incidences of TBI vary in hospitals of different levels and in different regions. Acute subdural hematoma (SDH), traumatic subarachnoid hemorrhage (SAH) and traumatic intracranial hemorrhage (ICH) have higher severities than other TBIs, especially at the older ages. The male TBI subjects had both a higher incidence and a higher mortality rate than the female subjects in all age groups and TBI groups, with the exception of SAH.

Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study

This study evaluated the relationship between daily physical activity (DPA) and memory capacity, as well as the association between daily activity and attention capacity, in college students in Taiwan. Participants (mean age = 20.79) wore wearable trackers for 106 days in order to collect DPA. These data were analyzed in association with their memory and attention capacities, as assessed using the spatial span test (SST) and the trail making test (TMT). The study showed significant negative correlations between memory capacity, time spent on the attention test (TSAT), calories burnt, and very active time duration (VATD) on the day before testing (r = −0.272, r = −0.176, r = 0.289, r = 0.254, resp.) and during the week prior to testing (r = −0.364, r = −0.395, r = 0.268, r = 0.241, resp.). The calories burnt and the VATD per day thresholds, which at best discriminated between normal-to-good and low attention capacity, were ≥2283 calories day−1, ≥20 minutes day−1 of very high activity (VHA) on the day before testing, or ≥13,640 calories week−1, ≥76 minutes week−1 of VHA during the week prior to testing. Findings indicated the short-term effects that VATD and calories burnt on the day before or during the week before testing significantly and negatively associated with memory and attention capacities of college students.