Taiwan Research Articles

Clinical care guidance in patients with diabetes and metabolic dysfunction-associated steatotic liver disease: A joint consensus.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide, affecting >30% of the global population. Metabolic dysregulation, particularly insulin resistance and its subsequent manifestation as type 2 diabetes mellitus, serves as the fundamental pathogenesis of metabolic liver disease. Clinical evidence of the recent nomenclature evolution is accumulating. The interaction and impacts are bidirectional between MASLD and diabetes in terms of disease course, risk, and prognosis. Therefore, there is an urgent need to highlight the multifaceted links between MASLD and diabetes for both hepatologists and diabetologists. The surveillance strategy, risk stratification of management, and current therapeutic achievements of metabolic liver disease remain the major pillars in a clinical care setting. Therefore, the Taiwan Association for the Study of the Liver (TASL), Taiwanese Association of Diabetes Educators, and Diabetes Association of the Republic of China (Taiwan) collaboratively completed the first guidance in patients with diabetes and MASLD, which provides practical recommendations for patient care.

Text analysis and optimization strategy of an app’s privacy policy from the perspective of dual perception: taking Chinese shopping apps as an example

Purpose This paper aims to conduct an in-depth analysis of the shortcomings of apps’ privacy policies and to propose improvement and optimization strategies, which are of great significance for establishing a transparent and responsible privacy protection framework that ensures compliant collection and use of users’ information and effective protection of their privacy. Design/methodology/approach This paper obtained privacy policy texts for 100 shopping apps through Web crawlers and manual downloads. Based on the perspective of perceived usefulness, thematic analysis is conducted through the latent Dirichlet allocation topic model and comparison with existing policies. Based on the perspective of perceived ease of use, readability analysis is conducted through content analysis and formula calculation. Findings The apps privacy policies can be divided into seven themes. The authors benchmark these seven topics with the Personal Information Protection Law of the People’s Republic of China, the E-Commerce Law of the People’s Republic of China and the General Data Protection Regulation. It is found that there are omissions in the information collection and use and juvenile protection of the existing apps. Through the indicators’ readability analysis and calculation, it is found that the existing apps privacy policies have good performance in the readability indicators such as naming method, frame directory and so on. However, text personalization and text readability need to be improved and optimized. Originality/value At the theoretical level, this paper constructs a model from the dual perception perspectives of perceived usefulness and perceived ease of use and analyses the apps’ privacy policy texts at a fine-grained level. At the practical level, based on large-scale apps’ privacy policy text data, this paper conducts multi-dimensional research from theme analysis, authoritative law benchmarking analysis, content analysis and text readability calculation and analysis. At the same time, this paper identifies the current problems of apps’ privacy policies and puts forward countermeasure suggestions for their content improvement and optimization.

The KMT versus the CCP: Dueling Chinese Nationalisms and the Politics of Colonial Rule During Hong Kong’s 1956 Riots

During October 10–12, 1956, British Hong Kong was engulfed in a downward spiral of violence that pitted Kuomintang (KMT) supporters against men and women affiliated with the Chinese Communist Party (CCP), forcing the People’s Republic of China (PRC), the Republic of China (ROC), and Great Britain to engage in a series of tense diplomatic exchanges that could have escalated into a wider geopolitical conflict. The actions of KMT supporters precipitated the 1956 riots, thereby granting opportunities to the PRC to repeatedly and strongly criticize the colonial government for allegedly failing to protect Chinese who were loyal to Beijing. While the PRC did not intervene militarily to protect its supporters, the 1956 riots revealed to London the precarious nature of colonial rule and underscored the fact that the colony’s very existence was dependent upon the acquiescence of Beijing.

From Tourism to Propaganda Tactics: Unveiling the PRC’s Influence on Palau’s Electoral Landscape

This article argues that the People’s Republic of China (PRC) is leveraging a combination of economic influence, political coercion, and disinformation tactics to sway the outcome of Palau’s 2024 presidential election. With the currently favored candidate reportedly being tied to Chinese Communist Party (CCP)-linked individuals and publicly promoting PRC narratives, it is critical to highlight the PRC’s influence tactics—such as propaganda, censorship, international partnerships, and financial pressures—that are being employed to achieve its goals. The article first offers a brief overview of the PRC’s actions and aims in the Indo-Pacific region, highlighting Palau’s significance to the PRC and the United States. Next, the author summarizes the PRC’s multiple forms of economic influence in the region, such as monopolizing tourism, buying land, engaging in bribery, encouraging illegal activities, and exploiting U.S. missteps. Then, after introducing Palau’s presidential candidates, the article delves into PRC information operations and tactics. It also examines key findings of PRC interference in other recent regional elections, such as in Taiwan and the Philippines, and analyzes what tactics were used, if they were effective, and how these tactics could be adapted to be successfully implemented in Palau. The article concludes with predictive analysis of the PRC’s potential actions in Palau, such as information operations, including amplifying local conflicts, using local media as proxies, and creating artificial intelligence (AI)-generated content, as well as listing potential countermeasures that could be implemented in Palau to combat PRC information advances, such as education programs for students and journalists, misinformation debunking campaigns, and implementing legislation to counter misinformation campaigns.

Higher Precision Is Not Always Better: Search Algorithm and Consumer Engagement

On decentralized e-commerce platforms, search algorithms play a critical role in matching buyers and sellers. A typical search algorithm routinely refines and improves its catalog of data to increase search precision, but the effects of a more precise search are little known. We evaluate such effects via a 2019 quasiexperiment on a world-leading e-commerce platform in which the search algorithm refined some product categories into finer subgroups to allocate consumer queries to more relevant product listings. Our data cover millions of consumers’ search and purchase behaviors over six months across multiple search sessions and product categories, enabling us to investigate trade-offs over time and across categories. We find that a more precise search algorithm improves consumers’ click-through and purchase rates drastically and instantaneously, but it comes at the cost of a significant decrease in consumer engagement and unplanned purchases over a longer time horizon. On average, consumers who used to spend more time searching now conduct 5.5% fewer searches, spend 4.1% less time on the platform, and decrease their spending on related categories by 2.2% in the week after the search precision increases. Our examination of the mechanisms behind these consequences calls for more careful search algorithm designs that account for not only instant conversion based on search precision but also consumer engagement and sellers’ strategic responses in the longer horizon. This paper was accepted by Anindya Ghose, information systems. Funding: This work was supported by the Key Program of the National Natural Science Foundation of China [Grants 72141305 and 72192803] and the Ministry of Education, People’s Republic of China (Fundamental Research Funds for the Central Universities), both to L. Fang. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.00478 .

Skin decontamination with and without water irrigation.

Rinsing only with water or washing with soap and water are common methods of skin decontamination for skin contaminated during a chemical hazard release. The null hypothesis was that a 15-minute water irrigation (decontamination method 1) would not be superior to decontamination using a microfiber towel, followed by a wet wipe (Signature Select Softly Flushable Tissue Better Living Brands LLC, Pleasanton, CA), followed by using another microfiber towel (decontamination method 2). A simulated contaminant (Magic Fluorescent Glow Paint for Face and Body, iLC Shenzhen Fulimei Technology Co. LTD, Shenzhen, the People's Republic of China) was applied to the dorsal skin of each subject's forearms. Then, photographs of these subject's skin were taken before and after decontamination of the simulated contaminant by using either decontamination method 1 or 2. Each of the subjects underwent both decontamination methods in separate trials, with each subject using one forearm for decontamination method 1 and their other forearm for decontamination method 2. Discrete points of contamination were quantified on the photographs that were taken with the skin illuminated by ambient visible light or ultraviolet light (395nm, Roceei ultraviolet flashlight, China). Under visible light, no residual contamination was seen by inspecting photographs taken after decontaminating with either method. Under ultraviolet light, less visible contamination was seen by inspecting photographs taken after decontaminating with method 1 than after decontaminating with method 2. In this study, skin decontamination with water irrigation was superior to skin decontamination without water irrigation.

Beneficial effect of sodium-glucose cotransporter-2 inhibitors on mortality among patients with cancer and diabetes mellitus.

The work attempts to describe mortality outcomes of sodium-glucose cotransporter-2 inhibitor (SGLT2I) in patients with diabetes mellitus (DM) and cancer. Using Taiwan's National Health Insurance Research Database to analyze the prognosis of cancer patients with coexisting DM, comparing those receiving SGLT2I with those who do not. After index-year and matching (age, sex, some comorbidities and medications), weobtain two groups of 20,339 patients. After further adjustment for age, sex and comorbidities, those with SGLT2I had a lower adjusted hazard ratio of mortality (aHR: 0.64 [95% CI: 0.60-0.68]). We conclude that SGLT2I medication should be considered first choice in patients suffering from DM and cancer.

The Geopolitics of Water Infrastructure on the Kinmen Islands

ABSTRACT This paper examines the bordering and debordering deployment of water infrastructures on the Islands of Kinmen. Located less than 5 km off the coast of China, yet 200 km from their governing authority, Taiwan, Kinmen holds a critical position in cross-strait relations, and its water infrastructures have carried opposite political intentions. The 2018 Fujian-Kinmen water transfer pipeline serves as a debordering tool as it showcases that the People’s Republic of China could offer benefits to the people on the islands. In contrast, Kinmen’s existing water infrastructure, established during the Cold War, served as part of the bordering campaign to counter Communist China, as it represented progress and modern living under the government of the Republic of China (Taiwan). However, rather than assuming the successful deployment of infrastructure or a passive role of the islands, this paper highlights that the planning and construction of Kinmen’s water infrastructures were influenced by conditions of militarisation, shifting cross-strait relations, the islands’ socio-material constraints and their relationships with Taiwan and China. The case of Kinmen illustrates the capacity of water infrastructure to serve bordering and debordering purposes, as well as how other factors disrupt or facilitate these processes.

New trends of export of vocational education from China within «One Belt, One Road» initiative

Introduction. Over the past few years, the authorities of the People's Republic of China have begun to pay more and more attention to the development of vocational secondary and higher education. In addition to the growth and development of this area within the country, gradually with the increase in China’s presence on the world stage, the PRC is beginning to export its educational services abroad.Purpose setting. The purpose of the study was to identify the features of China's promotion of its education abroad. The task is to examine the main forms of export of Chinese vocational education to foreign countries.Methodology and methods of the study. Using general methods of scientific knowledge and using a large array of factual data and sources in Chinese, consider the trends in the spread of Chinese vocational education in the world.Results. China has opened a new page in the development of vocational education both within the country and by experimenting with new formats of international cooperation in this segment of education. An example of such projects is the opening of the so-called Lu Ban Workshops, created in honor of the famous Chinese philosopher, engineer and artisan of the 5th century BC, which train modern specialists with technical skills. In total, China has launched over 40 similar workshops abroad with 70 different modern specialties, where more than 11 thousand people have already been trained. After the successful launch of Lu Ban Workshops, various Chinese professional institutions began to open their own specialized workshops, including those for the development of automobile transport, maritime economy, printing, etc.Conclusion. Such projects, which today cover both the SCO countries and the participants of the «One Belt, One Road» initiative, create a new platform for international exchange and cooperation in the field of vocational education and help promote humanitarian exchanges between China and other countries of the world.

Sinicizing China’s World Muslim City: Spatial Politics, National Narratives, and Ethnoreligious Assimilation in the PRC

Abstract The nation-state is as much a narrative and ideational project as it is a spatial-territorial one. In the People’s Republic of China, Xi Jinping’s calls to “revitalize” China’s traditional culture, “Sinicize” religions, and “rejuvenate” the Chinese nation reflect a broader effort to reframe the national narrative and strengthen Communist Party control. This article examines the implications of Xi’s revisionist nationalism for China’s fifty-five minority nationalities, in particular the Hui, one of ten Muslim minority groups. It does so by analyzing the rise and demise of World Muslim City (WMC), a development project in western China that mobilized Hui identity and traditions for economic and diplomatic purposes. WMC was facilitated by a multicultural national narrative and by a fragmented authoritarian political system that for many years fostered policy improvisation, and deviation, at the local level. Its suspension underscores the increasingly anti-Muslim, anti-religious tenor of PRC policy, as evidenced by the Sinicization campaign that was a proximate cause of WMC’s demise. Its demise also highlights ongoing efforts to reassert CCP control over government, business, and the Party’s own rank-and-file. The fate of WMC furthermore reveals the spatial dimensions of Sinicization, and of Chinese cultural governance past and present. To paraphrase theorist Henri Lefebvre, Sinicization entails “spatial practices” that impose Xi-ist “representations of space” on lived “representational spaces,” from mosques and businesses to theme parks and luxury resorts.

STATE REGULATION OF THE EXTRACTION OF CRITICAL MINERALS AS A DOMINANT COMPONENT OF ACHIEVING THE GOALS OF SUSTAINABLE DEVELOPMENT AND STRENGTHENING THE ECONOMIC SECURITY OF THE STATE

The article states that the climate crisis and measures to mitigate it in recent years have significantly changed the energy landscape of the countries of the world and the configuration of the investment portfolio. Long-term investments in fossil fuels have been replaced by investments in environmentally friendly technologies, renewable sources of electricity, and smart systems for its distribution and storage. It is emphasized that even with full support of investments, plans for the decarburization of the electric power industry may remain unattainable, as the global reserves of «critical minerals», which are absolutely necessary for the transition to ecologically clean electric power, are noticeably decreasing and the demand continues to grow relentlessly. The scenarios developed by the International Energy Agency for the further transformation of the electric power sector to a low-carbon economy model were reviewed and briefly characterized: the scenario of declared policy (STEPS), the scenario of declared obligations (APS), and the scenario of net zero emissions by 2050 (NZE). The main aspects of each of the scenarios are outlined: the volume of demand for «critical minerals» their geographical concentration of extraction, and processing. It is emphasized that the world leader in the extraction and processing of «critical minerals» is the PRC, which dictates the «rules of the game» to the majority of the world's countries. Therefore, the issue of supplies of “critical minerals” is quite painful. It was emphasized that critical minerals market participants hope to reduce total dependence through new mining projects in different geographical regions, facilitating cross-investment opportunities between partner countries, and strengthening cooperation through initiatives such as the Mineral Security Partnership and the implementation of financial instruments. The potential of Ukraine's «critical minerals» and its ability to reduce the dependence of EU countries on the People's Republic of China are characterized. The main challenges of the development of the extractive industry in Ukraine are identified, and the main vectors of the Roadmap of the partnership between Ukraine and the EU regarding critical raw materials for 2023-2024 are outlined. It was emphasized that in order for Ukraine not to become only a supplier of raw materials, it is necessary to develop the processing of raw materials and the production of products with added value. It is emphasized that such localization requires much wider efforts of the government than the list of measures in the field of regulating the extraction of «critical minerals» defined by the latest legislative acts. The author emphasizes the need to develop a comprehensive system of incentives and introduce new opportunities for stabilization and sustainable development of Ukraine's economy in order to ensure sustainability and progress towards sustainable resource management and optimization of supply chains for critical raw materials. Proposals have been developed for climate-smart mining of «critical minerals» in Ukraine in the near future.

The People’s Republic of China’s Strategy in The Three Sea Domain: The East China Sea, South China Sea, Indian Ocean, and The US’s Struggle for Presence in This Region

The People’s Republic of China’s Strategy in The Three Sea Domain: The East China Sea, South China Sea, Indian Ocean, and The US’s Struggle for Presence in This Region

The visual construction of the people’s country and the Chinese nation: political aesthetics in the Ethno-documentaries of New China

This paper discusses the political positioning of the people and the cultural image of the Chinese nation through the lens of the Social-historical Scientific Documentary Films of China’s ethnic minorities (hereafter referred to as “the Ethno-documentaries”) by restoring the problem to the site of the investigation of humanities and social sciences and the General Surveys on (Folk) Arts in the early years of the establishment of the People’s Republic of China in the 1950s. Through detailed analysis of specific Ethno-documentary films, this paper explores how the social sciences conducted its “Social and Historical Investigation of China’s Ethnic Minorities” via the medium of film to convey the advanced social concepts and ideological work of the new regime through the historical narrative of art and politics. This study highlights three key points. First, the “Chinese nation” as a modern political concept dates its origins back to the 1920s with the emergence of the “National Heritage Reorganization Movement” and the “Doubting Antiquity School.” However, it was only through the medium of the Ethno-documentaries that this concept was visually and aurally represented in films for the first time, which draws our attention to the fact that the entry point for understanding modern China lies in discerning the relationship between culture and politics. Second, when discussing the relationship between culture and politics, this study juxtaposes the Ethno-documentaries and “art for workers-peasants-soldiers,” which developed during the same period. These two forms of art focus respectively on national history and the suffering of the lower classes of society, and it is this intertextual nature of the historical narrative that jointly anchors the cultural and historical view of New China. Lastly, historical view is the core of the humanities, social sciences, and art disciplines in New China. Previous studies have mainly attributed certain phenomena to the “politicization” or “pan-politicization” of a particular historical period due to disciplinary barriers and cultural trauma and have stopped discussing such topics in depth. In contrast, the significance of the political aesthetics in the Ethno-documentaries is to have transformed classical Chinese artistic language into a modern one to represent the Chinese people and the Chinese nation. It also raises a question of re-sinicization of many modern political issues that have persisted until now: How do today’s Chinese art works vividly depict the prosperity of this country and its hardworking and courageous people?

Hydrochlorothiazide Use and Risk of Skin Cancer: A Population-Based Retrospective Cohort Study.

Hydrochlorothiazide (HCTZ) exposure has been linked to increased skin cancer in Caucasian (white) populations, especially squamous cell carcinoma (SCC), but not basal cell carcinoma (BCC). This study aimed to evaluate and compare skin cancer risks associated with HCTZ- and other antihypertensives use. This retrospective cohort study utilized Taiwan's National Health Insurance Research Database. We identified patients aged 20 years and older, newly receiving antihypertensive medications between 2004 and 2015. We calculated the medication possession ratio (MPR) for the first 2 years of treatment to determine patient eligibility and treatment classification, whereby only patients with MPR above 80% were included. These were subsequently categorized by the type of antihypertensives they received, namely HCTZ, other thiazide diuretics, non-thiazide diuretics or non-diuretic antihypertensives. Cox proportional hazards model was used to evaluate skin cancer risks, and these were then classified as SCC or BCC. Our study included 41 086, 27 402, 19 613, and 856 782 patients receiving HCTZ, other thiazide diuretics, non-thiazide diuretics, and non-diuretic antihypertensives, respectively. We found BCC risks were similar when comparing HCTZ with other thiazides (adjusted hazard ratio: 0.84; 95% CI: 0.54-1.33), non-thiazide diuretics (0.93; 0.51-1.67), and non-diuretic antihypertensives (0.91; 0.66-1.26). We observed a higher SCC risk in the HCTZ group, compared to other thiazides (1.24; 0.74-2.08), non-thiazide diuretics (1.32; 0.70-2.51), and non-diuretic antihypertensives (1.23; 0.87-1.73), although the confidence intervals (CIs) were wide and crossed the null. We concluded that skin cancer need not be of major concern to physicians when prescribing antihypertensives for an Asian population.

Economic development and foreign trade: a сomparative analysis of the United States and China

The article presents a comparative analysis of socio-economic and foreign trade relationships between the United States and the People's Republic of China, two leading countries of the world economy, which exert maximum influence on global processes in economics and politicsas well as in world trade, investment activities and scientific and technical sphere. Today, the rivalry between the two powers has also intensified in the monetary and financial aspect due to the growing importance and share of the yuan in international settlements and government reserves of many countries. This situation continues to worsen smoothly, often having a negative impact on other countries, including the Russian Federation. The purpose of the article is to explore the current state of the demographic situation, the dynamics of GDP and trade turnover of the two countries, to characterize the current situation and identify trends in its development in the medium term, which will make it possible to form the positions and policies of other subjects of the world economy to ensure their stability and balance their actions. The article concludes that both countries are currently experiencing a period of socio-economic and foreign trade turbulence, and its range has not yet shown a tendency to decrease. It is often the United States that acts as the source of this turbulence, trying to overcome the negative processes in its own economy. Therefore, it is important for third countries, for example, Russia, to take consistent measures to ensure national, including foreign economic, security. The methodological basis of the research is statistical, comparative, graphical analysis, the study of reports and archives, calculations based on data from open international statistical databases and official websites of international economic organizations, the main purpose of which is to study the economic indicators of the United States and the People's Republic of China. The study period covers 2012–2023.

Reaffirming Loyalty and Legitimacy: Representations of Hui Multi-Layered Identity in Bai Lian’s “Mountain Pass”

In the People’s Republic of China (PRC), the Cultural Revolution (1966–1976) left many writers severed from their cultural roots. Starting in the 1980s, literary authors sought to address this disconnection by turning their attention to rural communities. This tendency is exemplified by the emergence of two significant trends: root-seeking literature and new fiction from Tibet. Root-seeking authors focused on local customs, marginalized cultures, and minority groups to reinvigorate Chinese literature and fill the perceived cultural void. Around the same time, new fiction from Tibet featured diverse responses to post-Mao changes, with some idealizing Tibet as a repository of “authentic” traditions, while others criticized its perceived backwardness. Both trends have been interpreted in scholarship as responses, often critical, to state policies. The short story “Mountain Pass” (1985) by Hui writer Bai Lian intersects with these movements temporally and thematically. However, unlike them, Bai Lian’s portrayal of rural communities emphasizes the Hui’s historical role in resisting the Qing empire, pivotal to the emergence of the PRC, while also highlighting the group’s Arab and Persian origins. This three-layered identification with the local, national, and transnational enriches our understanding of the 1980s literary landscape, challenging the notion that this era was solely characterized by resistance to the central state.

Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, in patients from China mainland, Taiwan, and South Korea with moderate to severe plaque psoriasis: a phase 3 randomized clinical trial.

Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, is approved in the United States, European Union, Japan, South Korea, China, and other countries for treatment of moderate-to-severe plaque psoriasis. To evaluate the efficacy and safety of deucravacitinib in Asian patients with moderate to severe plaque psoriasis. In the 52-week, blinded, phase 3 POETYK PSO-3 trial (NCT04167462), patients were randomized 1 : 2 to placebo (n = 74) or deucravacitinib 6 mg once daily (n = 146) for 16 weeks followed by deucravacitinib alone. Coprimary endpoints were achievement of ≥ 75% reduction from baseline in Psoriasis Area and Severity Index (PASI 75) and static Physician Global Assessment score of 0 (clear) or 1 (almost clear) (sPGA 0/1) at Week 16. Efficacy and safety were evaluated throughout. At Week 16, significantly higher proportions of patients receiving deucravacitinib versus placebo achieved PASI 75 (68.8% vs. 8.1%; P < 0.0001) and sPGA 0/1 (55.6% vs. 6.8%; P < 0.0001). Response rates with deucravacitinib were maintained through Week 52. Common adverse events included upper respiratory tract infection and nasopharyngitis. Serious adverse event and discontinuation rates were low. Deucravacitinib was efficacious and well tolerated in Asian patients with moderate to severe plaque psoriasis.

The Principle of Righteousness and the Chosŏn–Ming and ROK–ROC Security Commitments*

This study addresses the question of why some decision‐makers and political elites in Chosŏn and the Republic of Korea (ROK) remained committed to the Ming Dynasty and the Republic of China (ROC) when the latter had declined in power. Based on the social psychological literature on righteousness, we explore this relationship through the lens of spontaneous and binding mechanisms. The former refers to voluntary help after reciprocity has been internalized as a duty, and the latter suggests that although individuals are reluctant to help, the fear of violating righteousness motivates continued commitment. Using the most‐different case design, this study finds supporting evidence from both the Chosŏn and the ROK periods. Specifically, Chosŏn loyalist officials insisted on aiding the weakened Ming and dethroned the rationalist King, Gwanghaegun. Moreover, those Korean elites who lived through the Korean Independence Movement and the Korean War emphasized diplomatic ties with the ROC even after the ROC lost its UN seat in 1971. By integrating social psychology and constructivism literature, the findings illuminate how the norms of righteousness shape decision‐makers' foreign policy and alliance commitment preferences.

Intergenerational Storytelling in China: Teachings About Family, Life, and Society Amidst Cultural-Historical Change

SYNOPSIS Objective. Over the past century, nationwide political, social, and economic reforms in the People’s Republic of China have drastically changed the structure of Chinese society and family life. This study describes the content of intergenerational storytelling in mainland Chinese families. Design. 193 emerging adult grandchildren recalled in writing a memorable story shared with them by their closest grandparent. Qualitative content analysis addressed what types of memorable stories are told by Chinese grandparents to their grandchildren and the central lessons embedded within those stories. Results. Stories in four broad thematic areas were told: (1) sociohistorical context and events, (2) existential life matters, (3) family history and dynamics, and (4) career and education. Across these areas, several subthemes and lessons learned by grandchildren emerged. Conclusions. Storytelling has the potential to build a bridge between generations whose realities are seemingly ages apart.

Superior benefits of sodium-glucose co-transporter-2 inhibitors compared with dipeptidyl peptidase-4 inhibitors for diabetic kidney disease: A cohort study.

To compare cardiorenal outcomes of dipeptidyl peptidase-4 inhibitors (DPP-4is) and sodium-glucose co-transporter-2 inhibitors (SGLT-2is) in a national diabetic kidney disease (DKD) population. A cohort study was conducted using Taiwan's National Health Insurance Research Database and Laboratory Databases. Propensity score-matched prevalent new users of SGLT-2is (n = 1524) and DPP-4is (n = 6005) during 2017-2018 were selected from adults with DKD and an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73m2. Composite renal outcomes included sustained eGFR decrease, renal failure and renal mortality. Composite cardiovascular (CV) outcomes included acute myocardial infarction, stroke, hospitalization for heart failure and CV death. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Compared with DPP-4i users, SGLT-2i users had a reduced risk of composite renal endpoint (HR: 0.16; CI: 0.12-0.24), consistently for a prolonged time to 50% or higher eGFR decrease (HR 0.17; CI: 0.11-0.27), renal failure (HR: 0.14; CI: 0.08-0.23) and decreased renal death (HR: 0.10; CI: 0.01-0.70). SGLT-2i users had a better composite CV outcome than DPP-4i users (HR: 0.74; CI: 0.64-0.85), and lower risks of stroke (HR: 0.76; CI: 0.62-0.92) and hospitalization for heart failure (HR: 0.68; CI: 0.55-0.84). Findings were consistent in analyses stratified by concomitant antidiabetic agents or intervals between DKD diagnosis and study drug initiation. This study shows the superior cardiorenal benefits of SGLT-2is compared with DPP-4is in the DKD population, regardless of concomitant antidiabetic agents or time from DKD onset to study drug initiation. SGLT-2is should be prioritized in adult patients with DKD.