Taiwanese Ethnicity Research Articles

Sex-Specific Left Ventricular and Aorta Size Cut-Off Values for Hemodynamically Significant Chronic Aortic Regurgitation - Implications for Treatment in Asian Populations.

There are no sex-specific guidelines for chronic aortic regurgitation (AR). This retrospective study examined sex-specific differences and propose treatment criteria from an Asian AR cohort.Methods and Results: Consecutive 1,305 patients with moderate-severe AR or greater at 3 tertiary centers in Taiwan and Japan (2008-2022) were identified. Study endpoints were aortic valve surgery (AVS), all-cause death (ACD), and cardiovascular death (CVD). The median follow up was 3.9 years (interquartile range 1.3-7.1 years). Compared with men (n=968), women (n=337) were older, had more advanced symptoms, more comorbidities, larger indexed aorta size (iAortamax) and indexed left ventricular (LV) end-systolic dimension (LVESDi; P<0.001 for all). Symptomatic status was poorly correlated with the degree of LV remodeling in women (P≥0.18). Women received fewer AVS (P≤0.001) and men had better overall 10-year survival (P<0.01). Ten-year post-AVS survival (P=0.9) and the progression of LV remodeling were similar between sexes (P≥0.16). Multivariable determinants of ACD and CVD were age, advanced symptoms, iAortamax, LV ejection fraction (LVEF), LVESDi, LV end-systolic volume index (LVESVi), and Taiwanese ethnicity (all P<0.05), but not female sex (P≥0.05). AVS was associated with better survival (P<0.01). Adjusted LVEF, LVESDi, LVESVi, and iAortamaxcut-off values for ACD were 53%, 24.8 mm/m2, 44 mL/m2, and 25.5 mm/m2, respectively, in women and 52%, 23.4 mm/m2, 52 mL/m2, and 23.2 mm/m2, respectively, in men. Early detection and intervention using sex-specific cut-off values may improve survival in women with AR.

Association of Statin Therapy With Major Adverse Cardiovascular and Limb Outcomes in Patients With End-stage Kidney Disease and Peripheral Artery Disease Receiving Maintenance Dialysis

Controversy exists regarding whether statin therapy has benefits for patients with kidney failure, and the consequences of statin therapy for patients with kidney failure and concomitant peripheral artery disease (PAD) are particularly uncertain. To evaluate the association of statin therapy with cardiovascular (CV) and limb outcomes among patients with kidney failure and concomitant PAD and dyslipidemia who are receiving long-term maintenance dialysis. This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. A total of 20 731 patients with kidney failure receiving long-term maintenance dialysis who were diagnosed with PAD and dyslipidemia between January 1, 2001, and December 31, 2013, were identified, and 10 767 patients met study criteria. Data were analyzed from June 8, 2021, to June 2, 2022. Primary outcomes were all-cause death and the composite of endovascular therapy (EVT) and amputation. Other outcomes of interest included CV events (CV death, acute myocardial infarction, ischemic stroke, and hospitalization for heart failure), major adverse limb events (new-onset claudication, new-onset critical limb ischemia, EVT, and nontraumatic amputation), and all-cause readmission. All outcomes were examined at 1 year and 3 years of follow-up. To minimize selection bias, propensity score matching on a 1:1 ratio was performed among patients receiving statin therapy (statin group) and patients not receiving statin therapy (nonstatin group). A defined daily dose (DDD) approach was used to evaluate whether the association of statin therapy with the risk of primary outcomes was dose dependent. Among 20 731 patients with kidney failure and concomitant PAD and dyslipidemia receiving long-term maintenance dialysis, 10 767 patients (5593 women [51.9%]; mean [SD] age, 68.5 [11.5] years; all of Taiwanese ethnicity) met the predetermined study criteria; of those, 3597 patients were receiving statin therapy, and 7170 were not. A total of 6470 patients (mean [SD] age, 66.4 [11.3] years; 3359 women [51.9%]) were included in the 1:1 propensity score-matched cohort, with 3235 patients in each group (statin and nonstatin). The incidence and risk of CV and all-cause death were significantly lower in the statin group vs the nonstatin group at 3 years of follow-up (CV death: 611 patients [18.9%] vs 685 patients [21.2%]; hazard ratio [HR], 0.86 [95% CI, 0.77-0.96]; P = .008; all-cause death: 1078 patients [33.3%] vs 1138 patients [35.2%]; HR, 0.92 [95% CI, 0.84-0.996]; P = .04). Statin use was also associated with a significantly lower incidence and risk of the composite adverse limb outcome of EVT and amputation at 3 years of follow-up (314 patients [9.7%] vs 361 patients [11.2%]; subdistribution HR, 0.85 [95% CI, 0.73-0.99]; P = .04). Results of subgroup analyses were consistent with those of the primary analysis across all subgroup variables. In the adjusted dose-response analysis, the risk reduction associated with statin use increased in a dose-dependent manner for both all-cause death (HR: 0.95 for DDD <0.50, 0.92 for DDD 0.50-0.99, 0.85 for DDD 1.00-1.49, and 0.79 for DDD ≥1.50; P = .002 for trend) and the composite outcome of EVT and amputation (subdistribution HR: 0.79 for DDD <0.50, 0.78 for DDD 0.50-0.99, 0.82 for DDD 1.00-1.49, and 0.58 for DDD ≥1.50; P = .002 for trend) compared with no statin therapy; however, not all findings in the DDD analysis were statistically significant. In this cohort study, statin therapy was associated with reductions in the risk of all-cause death, CV death, and the composite adverse limb outcome of EVT and amputation. These findings suggest that statin therapy may have protective CV and limb benefits for patients with kidney failure and concomitant PAD who are receiving long-term maintenance dialysis.

Comparison of 8- versus 12-weeks of glecaprevir/pibrentasvir for Taiwanese patients with hepatitis C and compensated cirrhosis in a real-world setting.

Real-world data on the effectiveness of glecaprevir/pibrentasvir (GLE/PIB) for patients with HCV infection and compensated cirrhosis is limited, especially for the 8-week regimen and in an Asian population. This retrospective study enrolled 159 consecutive patients with HCV and compensated cirrhosis who were treated with GLE/PIB at a single center in Taiwan. Sustained virological response (SVR) and adverse events (AEs) were evaluated. Among the 159 patients, 91 and 68 were treated with GLE/PIB for 8 and 12 weeks, respectively. In the per protocol analysis, both the 8- and 12-week groups achieved 100% SVR (87/87 vs. 64/64); and in the evaluable population analysis, 95.6% (87/91) of the 8-week group and 94.1% (64/68) of the 12-week group achieved SVR. The most commonly reported AEs, which included pruritus (15.4% vs. 26.5%), abdominal discomfort (9.9% vs. 5.9%), and skin rash (5.5% vs. 5.9%), were mild for the 8- and 12-week groups. Two patients in the 8-week group exhibited total bilirubin elevation over three times the upper normal limit. One of these two patients discontinued GLE/PIB treatment after 2 weeks but still achieved SVR. Both 8- and 12-week GLE/PIB treatments are safe and effective for patients of Taiwanese ethnicity with HCV and compensated cirrhosis.

Ethnic Ties, Organized Opposition and Voter Defection in Authoritarian Elections

AbstractExisting studies of ethnic voting mainly focus on democratic elections. In electoral autocracies, politically subordinate ethnicity can help citizens coordinate against the incumbent. However, we argue that collective action will be constrained when the group grows large, as it becomes costly for its members to form common behavioural norms and carry out effective sanctions through shared ethnic ties under authoritarian repression. Drawing on unique historical surveys in Taiwan, we study how Taiwanese ethnicity and local ethnic demography jointly induced voters' defection against the hegemonic KMT regime. We find that the pro-defection or anti-incumbent effect of Taiwanese ethnicity fell as the share of Taiwanese citizens in a township increased. However, the relative size of the Taiwanese group no longer undermined pro-defection ethnic voting after the KMT lifted the ban on opposition parties. Our results illustrate that formal organizations play a critical role in sustaining the informational salience of ethnicity in the elections.

Sofosbuvir/velpatasvir is an effective treatment for patients with hepatitis C and advanced fibrosis or cirrhosis in a real-world setting in Taiwan

IntroductionReal-world data regarding the impact of hepatic fibrosis on the effectiveness of sofosbuvir/velpatasvir (SOF/VEL) treatment is limited in the Asian population.MethodsWe analyzed data for all 823 patients with hepatitis C virus treated with SOF/VEL from June 2019 to September 2020 at Chang Gung Memorial Hospital in Chiayi, Taiwan. The degree of fibrosis was determined using the fibrosis-4 (FIB-4) index, with advanced fibrosis or cirrhosis defined as a FIB-4 score of > 3.25. The primary treatment outcome was the rate of sustained virologic response 12 weeks after treatment cessation (SVR). Adverse events (AEs) were also evaluated.ResultsSVR rates did not significantly differ (p > 0.05) between patients with FIB-4 scores of ≤ 3.25 and those with scores of > 3.25. In the per protocol analysis, 99.2% (593/598) of the FIB-4 ≤ 3.25 group and 100% (172/172) of the FIB-4 > 3.25 group achieved SVR; in the evaluable population analysis, 93.4% (593/635) of the FIB-4 ≤ 3.25 group and 91.5% (172/188) of the FIB-4 > 3.25 group achieved SVR. Five patients with FIB-4 scores of ≤ 3.25 did not attain SVR: two relapsed and three had no response. The most common AEs were comparable (p > 0.05) for the FIB-4 ≤ 3.25 group and the FIB-4 > 3.25 group and included abdominal discomfort (4.4% vs. 5.9%), fatigue (4.1% vs. 5.9%), and skin itching (3.6% vs. 3.2%). Laboratory abnormalities were more common in the FIB-4 > 3.25 group (p < 0.001). Six patients with FIB-4 scores of > 3.25 had total bilirubin elevation > 3 × the upper normal limit (UNL). Alanine transaminase elevation > 5 × the UNL was observed in two patients with FIB-4 scores of ≤ 3.25 and one patient with a FIB-4 score of > 3.25. No AEs resulted in treatment discontinuation.ConclusionsSOF/VEL treatment is well tolerated and achieves high SVR rates for patients of Taiwanese ethnicity with HCV, regardless of cirrhosis status.

Lifestyle Risk Factors in Esophageal Cancer: An Integrative Review.

Esophageal cancer (EC) is a prevalent type of cancer, affecting more than 16 000 people annually in the United States. Being a high-burden disease, the comprehensive management of EC is challenging, particularly for older adults. In addition, Asian countries have some of the highest age-standardized incidence rates of EC in the world. Epidemiologic studies have revealed that cigarette and cigar smoking, alcohol drinking, obesity, being overweight, and areca chewing increase the risk of EC. This integrative review aims to elucidate the association between lifestyle factors such dietary habits, smoking, and alcohol consumption and EC among the Asian populations with Chinese, Japanese, and Taiwanese ethnicity. The synthesis of the literature found that environmental factors play an important role in the risk of EC occurrence. Although most of the risk factors showed a positive relationship in increasing the risk, studies included in this review reported inconclusive results on whether tea and coffee are risk factors. The consumption of very hot beverages and low intake of green vegetable are associated with EC. Smoking, alcohol intake, and their interaction with diets were found to be the biggest factor in the development of EC. Registered nurses can educate about esophageal thermal injury among persons who have preference for drinking burning-hot beverages and those with multiple risk factors, such as those who smoke and drink excess alcohol, as well as promoting health behaviors and serving as patient advocates.

Racial difference in bioavailability of oral ibandronate between Caucasian and Taiwanese postmenopausal women.

Interethnic differences in the pharmacokinetics of oral ibandronate for osteoporosis are unknown. We compared the disposition of oral ibandronate between Caucasian and Taiwanese postmenopausal women. Ibandronate 150mg was administered to 35 Caucasian and 16 Taiwanese postmenopausal women in two separate phase 1 studies. Interethnic comparisons were performed to assess pharmacokinetic properties, including the area under the concentration-time curve (AUC), peak concentration (Cmax), elimination half-life, urinary drug recovery (Ae%), renal clearance (CLr), apparent total clearance (CL/F), and apparent volume of distribution (Vd/F). The mean AUC, Cmax, and Ae% were 2.41-, 1.69-, and 2.95-fold greater in the Taiwanese than in the Caucasian subjects, and the average CL/F and Vd/F were 2.48- and 2.46-fold smaller. There were no significant differences in mean CLr and half-life between both groups. As bisphosphonates are not biotransformed but are mainly excreted in the urine, the total body clearance is close to the CLr. These results suggested a larger bioavailability in the Taiwanese group which resulted in the differences in the CL/F and Vd/F. Multiple linear regression analysis demonstrated ethnicity influences of the pharmacokinetic properties after adjusting for the other variables. Bioavailability was largely responsible for the interethnic pharmacokinetic differences following oral administration of 150mg ibandronate and seemed greater in the Taiwanese compared with the Caucasian subjects. Further dose-ranging studies are warranted to determine the optimal dosages of oral ibandronate in patients of Asian or Taiwanese ethnicity.

A semiotic approach to ‘ethnicity’. An example from Taiwanese ‘Chineseness’

ABSTRACTFor a few decades, socio-cultural as well as linguistic anthropologists have worked hard to construct a reliable semiotic paradigm to study linguistic, cultural and social interactions. These subfields – linguistic, cultural and social – are often analytically tackled asunder, though they are intimately interconnected, intertwined and overlapping. The semiotic theory of culture is not a novel discovery in itself, but it can also be applied to the study of society and ethnicity. Culture, society and ethnicity are systems of communication, that is systems of signs; society is a system of signs whose meaning emerges from social interactions and ethnicity a system of signs whose meaning is strategically imposed by a specific society through a specific culture. Moreover, those three systems of communication, of signs, are interconnected in various ways. This essay will analyze ‘Taiwanese Ethnicity’ in its semiotic dimension, and explore how society, culture and ethnicity interact in constructing an ethnic identification.

Deduced probable human leukocyte antigen haplotypes associated with human leukocyte antigen DRB1*04:36 identified by case analysis of Taiwanese individuals.

Objective:Human leukocyte antigen (HLA) DRB1*04:36 is a low-frequency HLA-DRB1 allele. The aim here is to report the ethnicity of DRB1*04:36 and its associated HLA haplotypes among Taiwanese individuals.Materials and Methods:A sequence-based typing method was employed to confirm this low incidence allele. Polymerase chain reaction was performed to amplify exons 2 and 3 of the HLA-A and HLA-B loci and exon 2 of the HLA-DRB1 locus using group-specific primer sets. The amplicons were sequenced in both directions using BigDye Terminator Cycle Sequencing Ready Reaction kits and the manufacturer's protocols. One group of unrelated blood donors used in this study consists of randomized individuals with Taiwanese ethnicity who participate in the Tzu Chi Bone Marrow Donor Registry and the other group are randomized unrelated individuals from mainland China. The family members in the family part of the study are volunteer blood donors.Results:In exon 2, the DNA sequence of DRB1*04:36 is identical to DRB1*04:03:01 except for a nucleotide segment from residue 286 to residue 308. The nucleotide segment from residue 286 to residue 308, incidentally, is identical to that of DRB1*11:01:01:01. These observations suggest that DRB1*04:36 may have been derived through a gene recombination event involving DRB1*04:03:01 and DRB1*11:01:01:01. Our family study indicated that the HLA haplotype in association with DRB1*04:36 can be deduced to be A*24:02-B*39:01-DRB1*04:36. A randomized population study using Taiwanese suggests that additional DRB1*04:36 associated HLA haplotypes seem to exist.Conclusion:The information on the ethnicity of the DRB1**04:36 allele, and the deduced probable HLA haplotypes associated with the low incidence DRB1*04:36 allele that we report here, is of value to HLA testing laboratories for reference purposes. In addition, they can be used by stem cell transplantation donor search coordinators to aid the creation of strategy for finding compatible donors who are part of unrelated bone marrow donor registries when a patient carries this uncommon HLA allele.

Deduced probable human leukocyte antigen haplotypes associated with HLA-A*11:256Q and HLA-A*02:621 identified by case analyses of Taiwanese individuals.

Objective:HLA-A*11:256Q and HLA-A*02:621 are two low-frequency HLA-A alleles. The aim here is to report the ethnicity of A*11:256Q and A*02:621 and associated human leukocyte antigen (HLA) haplotypes among Taiwanese individuals.Materials and Methods:HLA data from randomized Taiwanese registered in the Tzu Chi Stem Cells Centre and China Shanghai Tissuebank Diagnostics were analyzed. HLA typing of the donors was carried out using a sequence-based typing method to confirm the two low-incidence alleles. Polymerase chain reaction was performed to amplify exons 2 and 3 of the HLA-A and HLA-B loci and exon 2 of the HLA-DRB1 locus using group-specific primer sets. The amplicons were sequenced in both directions using BigDye Terminator Cycle Sequencing Ready Reaction kits and the manufacturer's protocols. Exon 1 and exons 4-8 of the A*11:256Q allele were also sequenced and analyzed.Results:The Taiwanese ethnicity for both A*11:256Q and A*02:621 alleles was confirmed in this study. Further, the DNA sequence of A* 11:256Q was confirmed to be identical to A*11:02:01from exon 1 to exon 8 except for the residues from 409 to 417 where a segment of nine nucleotides (TACCGGCAG) is deleted in A*11:256Q. The HLA haplotype associated with A*11:256Q was deduced as A*11:256Q-B*27-DRB1*12. In exons 2 and 3, the DNA sequence of A*02:621 is identical to A*02:01:01:01 except at residue 169 where T of A*02:01:01:01 is replaced by C in A*02:621 (at codon 33; TTC->CTC). The HLA haplotype in association with A*02:621 was deduced as A*02:621-B*15:18-DRB1*12:02.Conclusion:The information on the ethnicity of the A*11:256Q and A*02:621 alleles and the deduced probable HLA haplotypes associated with the two low-incidence alleles reported here are valuable to HLA testing laboratories for reference purposes. In addition, they can be used by stem cell transplantation donor search coordinators to aid in finding compatible donors in unrelated bone marrow donor registries when a patient carries these uncommon HLA alleles.

Deduced probable HLA haplotypes associated with HLA-C*04:82 found by case analysis of Taiwanese individuals

ObjectiveHLA-C*04:82 is a low incidence HLA-C allele. The aim here is to report the ethnicity of C*04:82 and its associated HLA haplotypes among Taiwanese individuals. Materials and MethodsA sequence-based typing method was used to confirm this low incidence allele. Polymerase chain reaction was performed to amplify exons 2 and 3 of the HLA-A, HLA-B, and HLA-C loci and exon 2 of the HLA-DRB1 locus using group-specific primer sets. The amplicons were sequenced in both directions using Terminator Cycle Sequencing Ready Reaction kits and the manufacturer’s protocols. The potential unrelated bone marrow stem cell donors in this study were randomized individuals with Taiwanese ethnicity who participated in the Tzu Chi Bone Marrow Donor Registry. The family members in the family part of the study were volunteer blood donors. ResultsThe DNA sequence of C*04:82 was identical to C*04:01:01:01 in exons 2, 3, and 4. It differed from C*04:01:01:01 in exon 5 where a segment of nucleotides (CTAGCTGTC) was inserted between residues 969 and 970 of C*04:01:01:01. The insertion of these nucleotides caused a 35 amino acid alteration to the protein sequence of C*04:01:01:01. Three probable HLA haplotypes that were associated with C*04:82 among Taiwanese individuals were deduced. Confirmation of the DNA and protein sequences of C*04:82 and its Taiwanese ethnicity were established in this study. ConclusionThe ethnicity of the C*04:82 allele and the deduced probable HLA haplotypes associated with the low-incidence C*04:82 allele are of value for reference purposes for HLA testing laboratories. In addition, they can be used by search coordinators to aid the creation of a strategy for finding compatible stem cell donors for patients who carry this uncommon HLA allele.

Deduced probable HLA-C*07:359-associated human leukocyte antigen haplotypes found by case analysis of Taiwanese unrelated bone marrow hematopoietic stem cell donors

ObjectivesHLA-C*07:359 is a low-incidence allele in the human leukocyte antigen (HLA)-C locus. The objective of this study is to report the ethnicity and haplotypes of HLA-C*07:359 that were found during an analysis of Taiwanese unrelated bone marrow hematopoietic stem cell donors. Materials and methodsA sequence-based typing method was employed to confirm low-incidence alleles. Polymerase chain reaction was performed to amplify exon 2 and exon 3 of the HLA-A, HLA-B, and HLA-C loci, as well as exon 2 of the HLA-DRB1 locus, using group-specific primer sets. The amplicons were sequenced in both directions using BigDye Terminator Cycle Sequencing Ready Reaction kits, according to the manufacturer's protocols. The potential unrelated bone marrow stem cell donors investigated here are individuals with Taiwanese ethnicity who are participating in the Tzu Chi Bone Marrow Donor Registry. ResultsThe DNA sequence of C*07:359 is identical to that of C*07:02:01:01 in exons 2, 3, and 4 except at residue 862, where the G of C*07:02:01:01 is substituted by the A of C*07:359. The nucleotide exchange leads to an amino acid replacement at codon 264, where the glutamic acid of C*07:02:01:01 is replaced by the lysine of C*07:359. We deduced a probable HLA-B and HLA-C haplotype that is associated with C*07:359 in Taiwanese, namely B*39-C*07:359. ConclusionInformation on the ethnicity of the C*07:359 allele and its deduced probable HLA haplotypes that are associated with the low-incidence C*07:359 allele reported here are of value to HLA testing laboratories for reference purposes. In addition, they can be used by stem cell transplantation donor search coordinators to determine a strategy for finding compatible donors using unrelated bone marrow donor registries when patients carry this uncommon HLA allele.

Recognition of HLA-A*11:01-B*51:01-C*14:02-DRB1*11:01-DQB1*03:13 and HLA-A*02-B*40-C*03:77-DRB1*14 haplotypes restricted to Taiwanese

ObjectiveIn the Tzu Chi Taiwanese Bone Marrow Donor Registry individuals carrying the human leukocyte antigen (HLA)-C*03:77 allele and -DQB1*03:13 allele were registered. Here we report the confirmed DNA sequences of C*03:77 and DQB1*03:13 and the probable HLA haplotypes deduced in association with C*03:77 (i.e., HLA-A*02-B*40-C*03:77) and DQB1*03:13 (i.e., HLA-A*11:01-B*51:01-C*14:02-DRB1*11:01-DQB1*03:13) in Taiwanese. Materials and MethodsA sequence-based typing (SBT) method was used to confirm the low incidence alleles observed. Polymerase chain reaction was carried out to amplify exons 2 and 3 of the HLA-C locus with group-specific primer sets. For HLA-DQB1 allelic typing, six group-specific primer sets were used in the SBT procedure. Amplicons were sequenced using the Big Dye Terminator Cycle Sequencing Ready Reaction Kit (versions 3.1; Applied Biosystems, Foster City, CA, USA) in both directions according to the manufacturer's protocols. ResultsWe confirmed the DNA sequence of C*03:77, which is identical to the sequence of C*03:04:01:01 in exons 2 and 3 except for the nucleotide at position 527 (A→T). The nucleotide substitution caused an amino acid replacement at residue (codon) 152 (E→V). Similarly, our SBT confirmed that the DNA sequence of DQB1*03:13 is analogous to the sequence of DQB1*03:01:01:01 in exons 2 and 3, except for the nucleotide at residue 296 (T→A). The nucleotide variation caused one amino acid exchange at residue (codon) 67 (V→D). ConclusionsThe Taiwanese ethnicity of our donors identified in this study completes the ethnicity background for C*03:77 and DQB1*03:13 alleles listed on the IMGT/HLA Database and provides a strategy for marrow donor registry search coordinators to screen for unrelated HLA matched hematopoietic stem cell donors for blood disease patients bearing C*03:77 or DQB1*03:13.

Discovery of the novel HLA-DRB1*04:05:14 allele in a Taiwanese unrelated haematopoietic stem cell donor by a sequence-based typing method

We report here a de novo HLA-DRB1*04 allele, DRB1*04:05:14, discovered in a Taiwanese unrelated volunteer bone marrow stem cell donor by a sequence-based typing method. In exon 2, the DNA sequence of DRB1*04:05:14 is identical to the sequence of DRB1*04:05:01 except the nucleotide at positions 321 where C is replaced by T (at codon 78; TAC→TAT). Due to the silent mutation, the nucleotide substitution produced no amino acid variation in comparison with DRB1*04:05:01. We assume DRB1*04:05:14 was derived from DRB1*04:05:01 via a point mutation. The probable HLA-A, -B and -DRB1 haplotype in association with DRB1*04:05:14 may be deduced as A*11-B*55-DRB1*04:05:14. We here report the Taiwanese ethnicity of DRB1*04:05:14.

Central Obesity Predicts Non-Hodgkin's Lymphoma Mortality and Overall Obesity Predicts Leukemia Mortality in Adult Taiwanese

Objective: Obesity may increase the risk of neoplasia, including that of the lymphohematopoietic system. In a large Taiwanese cohort, we have evaluated whether body fat and its distribution is associated with non-Hodgkin's lymphoma (NHL) and leukemia mortalities.Methods: During 1997–2007 in Taiwan, 383,956 subjects aged 19–98 years without any cancer history were obtained through a health screening center and followed up for a median of 7.2 years. Unit records were linked to the national death registry; ICD-9 codes were used to identify 143 NHL and 73 leukemia deaths. Objectively, height, weight, and waist circumference data were measured to calculate body mass index (BMI) and central obesity status. Based on World Health Organization criteria modified for Asia and Taiwan, BMI was classified to <18.5, 18.5–23.9, 24–26.9, and ≥27 kg/m2. Waist circumference ≥90 cm in men and ≥80 cm in women was defined as central obesity. Cox proportional hazard regression models were adjusted for possible confounders including gender, age, education, smoking status, alcohol consumption, physical activity, and clinic location.Results: BMI was not associated with NHL deaths, although the trend was significant, but central obesity with adjustment was (hazard ratio [HR] = 1.87, 95% confidence interval [CI] = 1.27–2.75) compared with non–centrally obese subjects. BMI, but not central obesity, was associated with leukemia mortality (HR = 1.93, 95% CI = 1.00–3.75).Conclusions: An increased risk for NHL with increased abdominal fatness and more so with lower BMI is apparent in Taiwanese; this may indicate that metabolically localized and proinflammatory fat is important. For leukemia, where most is myeloid leukemia, increased general fatness is evidently a risk with Taiwanese ethnicity.

Computing Power and Sample Size for Case-Control Association Studies with Copy Number Polymorphism: Application of Mixture-Based Likelihood Ratio Test

Recent studies suggest that copy number polymorphisms (CNPs) may play an important role in disease susceptibility and onset. Currently, the detection of CNPs mainly depends on microarray technology. For case-control studies, conventionally, subjects are assigned to a specific CNP category based on the continuous quantitative measure produced by microarray experiments, and cases and controls are then compared using a chi-square test of independence. The purpose of this work is to specify the likelihood ratio test statistic (LRTS) for case-control sampling design based on the underlying continuous quantitative measurement, and to assess its power and relative efficiency (as compared to the chi-square test of independence on CNP counts). The sample size and power formulas of both methods are given. For the latter, the CNPs are classified using the Bayesian classification rule. The LRTS is more powerful than this chi-square test for the alternatives considered, especially alternatives in which the at-risk CNP categories have low frequencies. An example of the application of the LRTS is given for a comparison of CNP distributions in individuals of Caucasian or Taiwanese ethnicity, where the LRTS appears to be more powerful than the chi-square test, possibly due to misclassification of the most common CNP category into a less common category.

Risk factors associated with hepatitis C virus infection in Taiwanese government employees.

This study evaluated the roles of multiple factors in hepatitis C virus (HCV) infection, with emphasis on the modification of various individual characteristics on the risk associated with percutaneous exposure to blood. Serum samples taken from 4869 men in Taiwan within a cohort study were tested for HCV antibody. The overall positive rate of anti-HCV was 1.6%. In a logistic regression, factors positively associated with anti-HCV positivity were previous blood transfusion (odds ratio [OR] = 7.28: 95% confidence interval [CI] = 4.26-12.45), a history of surgery (OR = 2.06: 95% CI = 1 23-3.46), and lower educational levels (OR = 1.94; 95% CI = 1.14-3.32). The anti-HCV positive rate was significantly lower in hepatitis B surface antigen (HBsAg) carriers than in non-carriers (OR = 0.60; 95% CI = 0.37-0.95). Ageing, lower educational levels, O blood group, and Taiwanese ethnicity enhanced the likelihood of HCV infection through blood transfusion/surgery, whereasHBsAg status, cigarette smoking, and habitual alcohol drinking reduced it.

Resistance, Chaos and Control in China: Taiping Rebels, Taiwanese Ghosts and Tiananmen (review)

Reviews 581 A few final comments. The quality oftranslation in Running Wildis generally very good, though some stories exhibit more than others the flare ofa skilled and literary hand. Jeanne Tai's translation of"One Kind ofReality," for example, brings out nicely the ironic effect ofrecounting atrocities in the language ofa "barren narration," and the translators of"Running Wild" evoke something ofSu Tong's exuberant use oflanguage. The collection contains quite a few typographical errors that careful editing should easily have detected. Finally, the quality of the stories themselves is rather uneven, or it may be that the styles represented vary so greatly that one is left with the impression of contemporary Chinese literature as an incoherent salmagundi. But this is no doubt precisely what David Wang and Jeanne Tai were interested in achieving, and the bad taste it leaves me with is perhaps a product ofmy own anachronistic desire for the comforting unity of some modernist metanarrative. Kirk A. Denton Ohio State University Robert P. Weiler. Resistance, Chaos and Control in China: TaipingRebels, Taiwanese Ghosts and Tiananmen. Seattle: University ofWashington Press, 1994. vii, 255 pp. Hardcover $49.50. Robert Weiler (associate professor of anthropology, Boston University) has produced a tour de force ofinterpretative scholarship that should go a long way toward educating general readers and China scholars alike about some ofthe ingrained biases in the field ofSinology. The core ofthis study is based on the author's original fieldwork in Taiwan in the 1980s, when he became interested in the phenomenon ofghost worship that was then peaking in the northern part of the island. The main interpretative point of the book, however, is to compare this craze to the Taiping movement of the nineteenth century and to the Tiananmen movement of 1989. Though claiming to admire and incorporate much from the schools ofthought he criticizes, Weller's critique oflarge bodies of scholarship on the right and left ofacademic politics is nonetheless incisive and even devastating. „ ,„~~ , rr ¦ To many readers it will be clear from the outset, long before Weiler states his© 1995 by University' ° ofHawai'iPresscase exPuciuym me conclusion, thathe is taking on the totalitarian model, a model too long dominant in the China field and still insufficiently challenged after the fall ofLeninist regimes around the world. Against those who claim that the 582 China Review International: Vol. 2, No. 2, Fall 1995 traditional Chinese autocratic state and its modern Leninist variant have maintained total control of society and managed to stifle all potentially heterodox ideas and movements, Weiler convincingly demonstrates that there are always areas of "free space" for ideas and movements outside official control that can potentially provide the basis for resistance. The prime example he cites is the Taiping rebellion of the nineteenth century, which developed out of the quasiChristian "God Worshipping Society" founded by Hong Xiuquan in Guangxi in the 1840s. Though the movement was at first "overloaded" with many possible meanings, once its leaders managed to impose an official interpretation of events and sorted out the various cases of spirit possession into the officially approved and discredited, the Taipings turned toward open rebellion, not just against the Manchu regime, but against the ideology and structure of the two-thousand-yearold Confucian bureaucratic empire. Despite the value of demonstrating the limits oftotalitarianism as applied to China, Weiler makes clear throughout his study that the Taiping case of open rebellion was extremely rare and, by its nature, self-defeating. Thus his interpretation is also aimed at correcting the view oftoo many neo-Marxist and/or poststructuralist scholars (perhaps dominant in his own field of anthropology), who tend to see resistance in almost every movement outside of direct government control. Early in this study, for example, in an account of a Taiwanese village ritual where pigs were fattened and then offered up whole to community gods, Weiler shows how at times, to paraphrase Freud on cigars, a pig is just a pig. Even while agreeing with earlier commentators that such rituals often seemed to imply an assertion ofnative Taiwanese ethnicity and "quiet political resistance" (p. 7) to the mainlander-dominated Nationalist Party government, Weiler faces up to the blatant contradiction to this interpretation that he saw firsthand...