Taiwanese Women Research Articles

Regarding: "The Association Between Smartphone Use and Breast Cancer Risk Among Taiwanese Women: A Case-Control Study" [Letter

Regarding: "The Association Between Smartphone Use and Breast Cancer Risk Among Taiwanese Women: A Case-Control Study" [Letter

Gender Politics in Question: A Comparative Study of Edna O’Brien and Li Ang

ABSTRACT For centuries women have been subordinated, repressed, and intimidated in different ways. However, women in the contemporary world are trying to reclaim their natural rights. Ireland is a complex case, because in the wake of nationalism, Catholicism, and some other socio-historical conventions, Irish women’s movements were forced into the background until the last decades of the 20th century. Accordingly, Irish women have been constrained and daunted by the male discourses of nation, religion, and gender. Intriguingly, women in Taiwan have also been overburdened with pressures related to its unique political, social, and cultural legacies over the past few centuries. However, an increasing number of Taiwanese women have attempted to undo the patriarchy-driven phobia imposed on them to secure and consolidate their female identity. The traditions and transformations of women in both countries are well represented in works by Edna O’Brien and Li Ang. This paper is a comparative study of women in O’Brien’s and Li’s fiction. The focus is on investigating the ways in which women are subordinated in different historical and socio-cultural milieus, exploring how women react and fight against patriarchal discourses, and discussing the meanings and implications relevant to both writers and their fiction.

Interactive associations of sex and hyperlipidemia with calcific tendinitis of the shoulder in Taiwanese adults.

Calcific tendinitis (CT) of the shoulder is a painful disorder usually identified in individuals aged 40 and 60 years. The estimated global prevalence of CT is 2.7% to 36%. We examined the association of hyperlipidemia and sex with CT of the shoulder using Taiwan Biobank (TWB) and the National Health Insurance Research Database (NHIRD).Data were available for 9903 TWB participants who were recruited between 2008 and 2015. We used multiple logistic regression analysis to estimate the odds ratios (OR) and 95% confidence intervals (CI) for CT of the shoulder.Overall, 1564 women, and 1491 men were identified with hyperlipidemia. Women, compared to men, had higher odds of CT of the shoulder (OR, 1.53; 95% CI, 1.08–2.16). Hyperlipidemia, compared to no hyperlipidemia, was associated with an increased risk of CT (OR, 1.40; 95% CI, 1.02–1.93). The test for interaction was significant for sex and hyperlipidemia (P = .006). After stratification, the odds ratio for CT was 1.95 (95% CI, 1.30–2.92) in women and 0.82 (95% CI, 0.48–1.39) in men, respectively. Compared to men with no hyperlipidemia, the odds ratio was 0.86 (95% CI, 0.53–1.38) for men with hyperlipidemia and 2.00 (95% CI, 1.29–3.10) for women with hyperlipidemia.Importantly, our findings indicated that the risk for CT of the shoulder was higher among Taiwanese women with hyperlipidemia. However, CT risk among their male counterparts with hyperlipidemia was not significant.

Internalized homophobia, self-esteem, social support and depressive symptoms among sexual and gender minority women in Taiwan: An online survey.

WHAT IS KNOWN ON THE SUBJECT?: Sexual minority individuals are more likely to experience depressive disorders than heterosexual individuals. Factors associated with depressive symptoms among sexual minority individuals have been explored and examined; however, there is a limited evidence to understand the factors among sexual minority women in non-western countries. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: To the best our knowledge, this is the first study examining internalized homophobia, self-esteem, social support and depressive symptoms among sexual minority women in Taiwan. Sexual minority women at risk of having depressive symptoms had a higher level of internalized homophobia, lower self-esteem and fewer support from partners, friends, and families. Specifically, being single, being a student and having a higher personal income increased the risk of having depressive symptoms among sexual minority women. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health practitioners and nurses should be aware of and assess sexual minority women's level of internalized homophobia, self-esteem, and received social support to reduce the risk of depressive symptoms and thus help prevent suicidal ideation. LGBT sex education and government involvement are essential to buffer the negative influences of a homophobic society on the mental health of sexual minority women. ABSTRACT: Introduction Sexual minority women are more likely to report depressive symptoms than sexual minority men. However, there is a lack of evidence to understand factors associated with depressive symptoms among sexual minority women in non-western countries. Aim This study examined internalized homophobia, self-esteem, social support and depressive symptoms among Taiwanese sexual minority women. Method A total of 581 Taiwanese sexual minority women (Age range 20-48years old, Mean 26.96, SD 5.718) completed an online survey. Results Taiwanese sexual minority women at risk of having depressive symptoms had a higher level of internalized homophobia and lower self-esteem. Perceived support from participants' partners, friends and families was related to lower risk of depressive symptoms. Being single, being a student and having a higher personal income were also found to increase the risk of having depressive symptoms among the women. Discussion Mental health interventions are essential for sexual minority women with internalized homophobia and low self-esteem. Implications for Practice Mental health practitioners and nurses should be aware of and assess the concerns that sexual minority women have regarding healthcare services and provide culturally competent care to reduce the risk of depressive symptoms.

Severe preeclampsia is associated with a higher relative abundance of Prevotella bivia in the vaginal microbiota

We sought to compare the vaginal microbiota profiles of Taiwanese women with severe preeclampsia (SPE) and normotensive control pregnancies. In a discovery cohort, vaginal swab samples and paired blood specimens were simultaneously obtained at the time of caesarean delivery from 30 women with SPE and 30 controls. The composition of vaginal microbiota was characterised by 16S ribosomal RNA gene sequencing of the V3–V4 region. Results were subsequently validated by real-time qPCR. We sought confirmation of our findings in an expanded cohort consisting of 58 women with SPE and 55 controls. In both the discovery and confirmation cohorts, women with SPE had higher relative abundance of Prevotella bivia in their vaginal microbial community (P = 0.006 and 0.011, respectively). Plasma levels of tumour necrosis factor alpha (TNF-α) were higher when compared with controls (P = 0.031) in the confirmation cohort. Three variables (vaginal Prevotella bivia, plasma TNF-α, and body mass index [BMI]) were included in a prediction panel for SPE. Of these, BMI was the most predictive variable. The area under the curve (AUC) of predicted probability values for the three-variable panel revealed that it can discriminate between SPE and normotensive pregnancies with good accuracy (AUC = 0.797, P < 0.001). We conclude that enrichment of Prevotella bivia in vaginal microbiota, which is tightly regulated by BMI, may be involved in the pathogenesis of SPE.

Risk of major adverse cardiovascular and cerebrovascular events in Taiwanese women with endometriosis

Endometriosis (EM) is linked to cardiovascular disease (CVD). However, whether this finding can be applied to the Taiwanese population remained unanswered. To investigate the association between EM and major adverse cardiovascular and cerebrovascular events (MACCE) and the therapeutic effect on the risk of MACCE in Asian women with EM. A retrospective population-based cohort study was performed. A total of 17 543 patients with EM aged between 18 and 50 years were identified from a general population of 1 million Taiwanese after excluding diagnoses of major CVD and cerebrovascular accident (CVA) prior to EM. The comparison group (n=70 172) without EM was selected by matching the study cohort with age, sex, and income and urbanization levels in a 4:1 ratio. During a median follow-up period of 9.2 years, Taiwanese women with EM had a significantly higher frequency of comorbidities, medical and surgical treatment, and MACCE than did their non-EM counterparts (2.76% vs 2.18%, P<.0001). After adjustment for comorbidities, patients with EM had an approximately 1.2-fold increased risk of MACCE (95% CI 1.05-1.29; P=.0053) and a higher cumulative incidence of MACCE compared with the normal population. Neither medical nor surgical treatment increased the risk of MACCE. Furthermore, medical treatment for EM appeared to be protective against MACCE. Taiwanese women with EM not only had a substantially higher frequency of comorbidities but also an increased risk of MACCE compared with the general population.

Prevalence of symptoms and associated factors across menopause status in Taiwanese women

To investigate the prevalence of symptoms and associated factors in Taiwanese women calling a menopause hotline. A cross-sectional, descriptive, epidemiological study was performed on 20,882 women aged 40 to 89 years registered in the menopause consultation database of the nationwide toll-free consultation hotline for menopause-related issues from January 2006 to December 2016. The data included demography, sources of menopausal health care, and menopause/midlife symptoms scale. The mean menopausal age was 49.6 ± 4 years. The prevalence of the symptoms increased with the progress of the menopausal stages, and the differences between stages were significant. The top five symptoms reported on a menopause hot line were memory loss (66.9%), fatigue (66.5%), insomnia (59.6%), depressed mood (58.5%), and back pain (58.2%). Of the women, 23.5% did visit a medical facility for menopausal problems mainly the department of gynecology. More than half of the women (56.4%) opted for medical personnel as the preferred channel for obtaining information concerning menopause. Women who had a higher education level, were single, had no children, were not experiencing the empty-nest phenomenon, were employed, had no chronic disease, were premenopausal, had never received hormone therapy, and had not visited medical facilities scored the lowest in menopause/midlife symptoms. Compared with premenopausal and perimenopausal women, postmenopausal women experience the most severe symptoms. Therefore, establishing a menopause consultation hotline answered by medical personnel and implementing support for postmenopausal women to obtain strategies to alleviate symptoms are required and necessary.

The TMPRSS6 variant (SNP rs855791) affects iron metabolism and oral iron absorption - a stable iron isotope study in Taiwanese women.

Genome wide studies have associated TMPRSS6 rs855791 (2321 C>T) with iron status and hepcidin. It is unclear whether this polymorphism affects iron absorption. We administered standardized ricebased test meals containing 4 mg of labeled 57Fe or 58Fe as FeSO4 on alternate days in non-anemic Taiwanese women (n=79, 44 TT variant, 35 CC variant). Fractional iron absorption was measured by erythrocyte incorporation of the tracers 14 days after administration. Compared to the CC variant, iron and transferrin saturation were lower (P=0.001; P<0.001, respectively) and serum hepcidin/transferrin saturation and serum hepcidin/serum iron ratios were higher (P=0.042; P=0.088, respectively) in the TT variant. Serum hepcidin did not differ between the groups (P=0.862). Geometric mean (95% Confidence Interval [CI]) fractional iron absorption, corrected to a serum ferritin of 15 μg/L, was 26.6% (95% CI: 24.0-29.5) in the CC variant and 18.5% (95% CI: 16.2-21.1) in the TT variant (P=0.002). Overall, predictors of iron absorption were: serum ferritin (P<0.001); genetic variant (P=0.032); and hepcidin (P<0.001). In the models by variant, in the CC variant the model explained 67-71% of variability in absorption and serum ferritin was the only significant predictor (P<0.001); while in the TT variant, the model explained only 35-43% of variability, and hemoglobin (P=0.032), soluble transferrin receptor (P=0.004) and hepcidin (P<0.001) were significant predictors. Women with the TMPRSS6 rs855791 (2321 C>T) polymorphism show altered iron homeostasis which affects oral iron absorption and may increase their risk for iron deficiency. The trial was registered as clinicaltrials gov. Identifier: NCT03317873, and funded by the Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan, (grant CMRPG8F0721) and ETH Zurich, Switzerland.

The Association Between Smartphone Use and Breast Cancer Risk Among Taiwanese Women: A Case-Control Study.

IntroductionBreast cancer is a common malignancy worldwide. Smartphones have gradually become indispensable to our modern lives and have already changed lifestyles of human beings. To our best knowledge, no study has investigated the relationship between smartphone use and breast cancer. This case-control study purposely investigated the relationship between smartphone use and breast cancer risk.Materials and MethodsThis was a case-control study comprising 894 healthy controls and 211 patients with breast cancer. All participants were asked to respond to standard questionnaires to collect information on sleep quality, smartphone addiction, and smartphone use.ResultsParticipants with smartphone addiction had a significantly higher 1.43-fold risk of breast cancer. Individuals with the habitual behavior of smartphone use >4.5 minutes before bedtime had a significantly increased 5.27-fold risk of breast cancer compared to those who used a smartphone for ≤4.5 minutes before bedtime. Additionally, a closer distance between the smartphone and the breasts when using the smartphone exhibited a significantly increased 1.59-fold risk. Participants who carried their smartphone near their chest or waist-abdomen area had significantly increased 5.03-fold and 4.06-fold risks of breast cancer, respectively, compared to those who carried the smartphone below the waist. Moreover, there was a synergistic effect of smartphone addiction and smartphone use of >4.5 minutes before bedtime which increased the breast cancer risk.ConclusionExcessive smartphone use significantly increased the risk of breast cancer, particularly for participants with smartphone addiction, a close distance between the breasts and smartphone, and the habit of smartphone use before bedtime.

Family Livelihood, Social Class and Mothers’ Self-cognition: The Transformation of “Mothering” in Japanese Colonial Taiwan (1895–1945)

Based on oral histories and diaries of women who lived in the Japanese colonial period, this article analyzes the role and transformation of “mothering” in Taiwan, examining how the Han Chinese patriarchal society in Taiwan responded to colonialization and modernization in the early twentieth century. It reveals that most Taiwanese women at that time married in their teens and began to take on the tasks of mothers before the age of twenty. Difference in social class served as a key element affecting mothering practices. Rural and lower-class mothers had no choice but to prioritize productive labor over physical childcare; women of the traditional upper class could afford nannies; the emerging group of “new women” hired lower-class women to help with household tasks and childcare while they developed their professional careers. In addition to the physical care of children, Taiwanese mothers put great emphasis on the education and future development of children, especially sons. However, as the custom of “daughters-in-law-to-be” was quite common, from an early age many girls faced only their “mothers-in-law-to-be” instead of their biological mothers. “Mothering” was thus absent in these women’s lives, complicating the meaning of “motherhood.”

Dietary exposure assessment of methylmercury and polyunsaturated fatty acids in saltwater fish and processed foods among Taiwanese women of child-bearing age and children: A novel core food-matching approach

Saltwater fish is rich in health-promoting polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Excessive fish intake may also cause health hazards due to methylmercury (MeHg). A novel dose estimation method was proposed in this study to improve the quality of food matching by considering the usage ratio of cooking and processing methods in sampling design. In total, 39 table-ready samples were specified according to 2–3 common cooking methods, and MeHg and total mercury (THg) were analyzed. The results showed that mercury was detected in 20 samples (LOD = 0.01 μg/g). High MeHg samples included fried-Spanish mackerel (1.23 μg/g), non-cooked shredded swordfish (0.325 μg/g), pan-fried Spanish mackerel (0.248 μg/g), and non-cooked shredded salmon (0.208 μg/g). Consumption data (n = 166,911) were obtained from 24-h recalls in the 2005–2008 Nutrition and Health Surveys in Taiwan (NAHSIT). The average whole-group estimated daily intake (EDI_WG) was 0.018 (7.9% tolerable daily intake, TDI) for women of child-bearing age and 0.031 μg/day per kg body weight (13.6% TDI) for children. However, 95th percentile values (P95) of 90.4% TDI and 185% TDI were estimated for the two consumer-only populations, which have raised public health concerns. The ratio of % TDI to % daily reference intake (% DRI) was used as a risk–benefit (R/B) indicator. The top 4 R/B foods were: tuna sashimi (0.089 and 0.14), non-cooked shredded swordfish (0.033 and 0.052), fried-Spanish mackerel (0.027 and 0.043) and deep-fried fish balls (0.022 and 0.035) in the two perspective populations.

Effectiveness of antiresorptive medications in women on long-term dialysis after hip fracture: A population-based cohort study.

There is no clear evidence how effective the antiresorptive (AR) drugs alendronate and raloxifene are at reducing risk of second hip fracture and mortality in dialysis populations. The purpose of this study was to compare the risk of hospitalization for second hip fracture and risk of mortality between AR user and non-user groups in Taiwanese women on long-term dialysis with hip fractures. We conducted a retrospective cohort study using Taiwan National Health Insurance Research Datasets. Long-term dialysis women older than 50 years with newly diagnosed hip fractures and new to AR therapy from 2005 to 2011 were recruited. The patients were divided into AR users and non-users and matched by propensity score. We used Cox Proportional Hazards models to assess association of AR with risks of second hip fracture and mortality. Totally, 1,079 dialysis patients were included, and after matching, we were left with 74 AR users and 74 non-users. AR users did not show a significant reduction in the incidence of second hip fracture compared with non-users (adjusted Hazard Ratio (HR): 0.91, 95% CI: 0.30-2.76), and alendronate users exhibited higher risk of second hip fracture compared with raloxifene users (adjusted HR: 2.80, 95% CI: 0.42-18.79). In addition, AR users were found to have significantly lower 1- and 2-year mortality rates than the non-users (1- year: adjusted HR 0.25, 95% CI, 0.07-0.90; 2-year: 0.35, 95%CI: 0.17-0.72). AR treatment did not significantly improve the risk of second hip fracture but significantly reduce mortality in older women on dialysis. Further clinical trials on effectiveness of AR medications for dialysis populations should be warranted.

Home food making, belonging, and identity negotiation in Belgian Taiwanese immigrant women\u2019s everyday food practices

This article examines the experiences of (re)producing home food in the daily life and food practices of Belgian Taiwanese immigrant women. The research is based on ethnography—both online and offline—and qualitative semi-structured interviews with seventeen Taiwanese immigrant women/housewives in Belgium. Participants’ food practices involve buying, growing, making, and sharing food. Buying Taiwanese food ingredients presents a genuine challenge, as Chinese and Asian supermarkets in Belgium do not carry all Taiwanese food items. Consequently, many Taiwanese immigrant women and housewives in this study share similar experiences of growing specific foods in their home garden; moreover, by doing so, they also transform their gardens in their private homes into transnational social spaces, and thereby connect their previous lived experiences and homeland memories with their present living circumstances. Moreover, Taiwanese immigrant women like to prepare and cook food with their husband and children while imparting Taiwanese food and cultural values through personal stories. Furthermore, by organizing and regularly participating in activities involving sharing and eating food with other Taiwanese immigrant women, these food-sharing events and behaviors also become an important social networking strategy that allows them to make, expand, and cultivate friendships; in addition, food sharing activities also assist the participants to construct a collective social identity of being immigrant mothers/housewives in a foreign land. However, what is meant by “Taiwanese” food varies substantially between participants, as do the associated emotional and ethnic meanings. Several things were stated to account for the taste of Taiwanese food, such as using certain condiments or the Ta Tung rice cooker. Equally diverse is the personal attachment of ethnonational identity toward the notion of home food, as discussions of childhood memories, ethnonational identity negotiation, and cultural markers are accompanied by critical reflection on the social constructed nature of home/ethnic foods in the migration contexts.

The experience of menopausal women participating in weight management program: A pilot study

ObjectiveMenopause is the transitional period of women transforming from middle age to old age, and often associated with obesity. Adequate weight control (ideal body weight maintenance) is an important issue for women's health. However, little is known about the experience of Taiwanese women participating in weight management programs. Materials and methodsThe current weight management program referred to the participation and completion of a 10 h weight management program (the course of 5 weeks, 2 h per week) at a community hospital in 2016 entrusted by the government in Taiwan. Using the descriptive phenomenological research method, purposive sampling, and a semi-structured interview guide, to conduct one-on-one in-depth interviews with menopausal women, did analyses. ResultsBetween August and September 2016, there were 71 subjects entering into the current study, with a median age of 56 (51–60) years. The median weight reduction was 0.6 kg at the end of the course but all were satisfied with it. There were four experiences detectable in the current study, including initial benefits from weight management programs, the difficulty in facing changes, adjustments, and a better body image. ConclusionsBelief (for better health and body figure) and assistance (for change) were important issues in weight management programs, which can be used as reference for future designs of weight management program in overweight/obese menopausal women.

Understanding Taiwanese Women's Decisional Experiences Regarding Prenatal Screening Procedures And Diagnostics: A Phenomenological Study

This study sought to understand Taiwanese women's decisional experiences regarding prenatal screening procedures and diagnostics. A hermeneutic phenomenological design guided semistructured interviews with 33 women who were 36 weeks pregnant. Data were collected between February and October 2016. Verbatim transcripts were analyzed following hermeneutic circle to cocreate an understanding of Taiwanese women's decision-making in prenatal screening and diagnostics. Women's existential experiences were derived from their decision-making process on prenatal screening procedures and diagnostics for chromosomal aneuploidy. These decisional experiences were captured by four theme clusters and eight themes, which were inductively derived from 16 meaning units: (1) accessing health information; (2) considering what was best for my baby; (3) considering family finance; and (4) feeling anxiety posttest. Participants made informed choices on several prenatal screening procedures, ostensibly, based on their personal values and considerations. During the decision-making process, often-cited benefits of genetic screenings were emphasized, but test limitations were often unheeded. A fundamental need for supportive information in decision making was further identified with recommended strategies. Hence, a revision of traditional genetic counseling approaches is recommended. As genomics technologies are increasingly available during antenatal services, women should be sufficiently educated about them to support decision making.

Construing and Depression in Taiwanese Women

This research explores the association between depression and aspects of construing, assessed by repertory grid technique, in women in Taiwan. Women diagnosed as depressed exhibited tighter, more unidimensional construing than women not so diagnosed. In addition, various aspects of self-construing were associated with depression, including construing the self as dissimilar to the ideal self, the self in social roles, and the parents; and a discrepancy between the ideal self and the person’s view of how others would like her to be. There was no significant difference in the content of constructs elicited from women with and without depression, but the participants used fewer emotional and more value constructs than the Spanish sample from which the Classification System for Personal Constructs (CSPC) employed in the present study was developed. The findings concerning social roles and content of construing are considered from a cultural perspective.

Trapped and Resistant Body: Everyday Practices of Women in Taiwan in the Context of Intimate Partner Violence

The extensive literature on intimate partner violence (IPV) against women has focused on the single actors of forces imposed on women. Little is known about the intertwined relationships among the roles of multiple participants in the context of IPV. This study used Michel de Certeau’s concepts of strategies, tactics, and space to explore the power struggle between female survivors and IPV perpetrators, family members, and institutions. This study used data collected in semi-structured interviews between 2016 and 2018 with 24 women (30 to 54 years of age) in Taiwan who experienced IPV from their male partners. Thematic analysis was used to identify and organize themes based on the concepts of strategies, tactics, and spatial actions. Three coders analyzed the data based on the conceptual framework, and inter-rater reliability was evaluated to ensure the quality of the results. Six themes were identified and grouped into two dimensions. Female Taiwanese survivors of IPV confronted not only the strategies of their male partners and families but also strategic mechanisms from the police and nongovernmental organizations. Female survivors found tactical opportunities to evade or resist everyday forms of strategic power. Understanding the quotidian experiences of female survivors has important implications for their protection and support to help them increase their safety and well-being when they are involved in an IPV relationship in particular, and spatial power structures in general.

Aspirin associated with a decreased incidence of uterine cancer: A retrospective population-based cohort study.

Aspirin (ASA) exerts an anti-tumor effect via the COX pathway. Clinical studies on the chemopreventive effects of ASA on uterine cancer (UC) remain inconsistent. We used population-based retrospective cohort study to evaluate the UC in ASA users in Taiwanese women. From insurance claims data, we identified 23,342 women received ASA treatment between 2000 and 2010 and a comparison group of same sample size randomly selected from the same database matched by the propensity score. The incidence of UC in the ASA cohort was 10% of that in the comparison group (0.28 vs 2.73 per 10,000 person-years). The Poisson regression analysis estimated adjusted incidence rate ratio (IRR) was 0.10 (95% confidence interval (CI) = 0.09–0.11) for ASA users relatives to comparisons after controlling for covariates. The UC incidence in ASA users decreased with age, from 0.61 per 10,000 person-years in the 20 to 39 years old (adjusted IRR = 0.21, 95% CI = 0.15–0.29) to 0.21 per 10,000 person-years in the 65 to 80 years old (adjusted IRR = 0.15, 95% CI = 0.12–0.16). The incidence was higher in longer term users. Hormone therapy of estradiol was associated with the increase of UC risk in both cohorts, but less in ASA users than comparisons (1.34 vs 4.75 per 10,000 person-years). This study suggests that ASA use was associated with a decreased risk of UC. Further prospective randomized clinical trials are warranted to confirm the association.

AHRR cg05575921 methylation in relation to smoking and PM2.5 exposure among Taiwanese men and women

BackgroundPolycyclic aromatic hydrocarbon (PAH)-rich substances like cigarette smoke and PM2.5 induce aryl hydrocarbon receptor (AHR)-mediated aryl hydrocarbon receptor repressor (AHRR) methylation. AHRR cg05575921 and coagulation factor II (thrombin) receptor-like 3 (F2RL3) cg03636183 methylation patterns are well-established biomarkers for smoking. Even though AHRR cg05575921 methylation has recently been associated with PM2.5, the interaction between smoking and PM2.5 on AHRR methylation is yet to be fully explored. We evaluated AHRR and F2RL3 CpG sites to identify potential significant markers in relation to PM2.5 and smoking in Taiwanese adults.MethodsDNA methylation and smoking data of 948 participants aged 30–70 years were obtained from the Taiwan Biobank Database (2008–2015), while PM2.5 data were obtained from the Air Quality Monitoring Database (2006–2011).ResultsSmoking and PM2.5 were independently associated with hypomethylation (lower levels) of AHRR cg05575921, AHRR cg23576855, F2RL3 cg03636183, and F2LR3 cg21911711 after multiple-comparison correction (Bonferroni P < 0.00028409). Cg05575921 was the most hypomethylated AHRR CpG site, while cg03636183 was the most hypomethylated F2RL3 CpG site. Overall, cg05575921 was the most hypomethylated CpG site: β = − 0.03909, P < 0.0001; − 0.17536, P < 0.0001 for former and current smoking, respectively (P-trendsmoking < 0.0001) and − 0.00141, P < 0.0001 for PM2.5. After adjusting for F2RL3 cg03636183, smoking and PM2.5 remained significantly associated with cg05575921 hypomethylation: β − 0.02221, P < 0.0001; − 0.11578, P < 0.0001 for former and current smoking, respectively (P-trendsmoking < 0.0001) and − 0.0070, P = 0.0120 for PM2.5. After stratification by sex, smoking and PM2.5 remained associated (P < 0.05) with cg05575921 hypomethylation in both men (β = − 0.04274, − 0.17700, and − 0.00163 for former smoking, current smoking, and PM2.5, respectively) and women (β = − 0.01937, − 0.17255, and − 0.00105 for former smoking, current smoking, and PM2.5, respectively). After stratification by residential area, former and current smoking remained associated (P < 0.05) with cg05575921 hypomethylation: β = − 0.03918 and − 0.17536, respectively (P-trendsmoking < 0.0001). Living in the central and southern areas was also associated (P < 0.05) with cg05575921 hypomethylation: β = − 0.01356 and − 0.01970, respectively (P-trendarea < 0.0001).ConclusionSmoking and PM2.5 were independently associated with hypomethylation of cg05575921, cg23576855, cg03636183, and cg21911711. The most hypomethylated CpG site was cg05575921 and its association with smoking and PM2.5 was dose-dependent.

Risk of Breast Cancer in Women with Mastitis: A Retrospective Population-Based Cohort Study.

Background and objectives: Breast cancer is a common cancer in women and has been the fourth leading cause of death in Taiwanese women. Risk factors for breast cancer include family history of breast cancer, genetic factors, and not breastfeeding. Several studies have reported an association between repeated inflammation at a young age, especially among lactating women, and cancer; however, the number of studies about the association of mastitis and breast cancer in nonlactating women is still limited. Therefore, the aim of this study was to determine the relationship between mastitis in women aged ≥40 years and breast cancer. Materials and Methods: This was a retrospective cohort study design. The data source was the Longitudinal Health Insurance Database 2010 (LHID 2010), comprising data collected by Taiwan’s National Health Insurance program. Cases of newly diagnosed mastitis in women aged ≥40 years (ICD-9-CM code = 611.0) were selected from the years 2010 to 2012. Women not diagnosed with mastitis were selected as the control group, and their data for the years 2009 to 2013 were obtained through the database. In addition, the non-mastitis group was matched 1:10 by age. Results: A total of 8634 participants were selected from the LHID 2010, which included 734 cases with mastitis and 7900 cases without mastitis. After adjustment for age, hypertension, hyperlipidemia, diabetes, hypothyroidism, and autoimmune diseases, the Cox proportional hazard model showed that patients with mastitis had a higher risk of breast cancer (aHR = 3.71, 95% CI = 1.9–7.02) compared with the non-mastitis group. The Kaplan–Meier curve also showed that women with mastitis had a higher risk of developing breast cancer. Conclusions: This study confirmed that women with mastitis have a higher risk of developing breast cancer. Therefore, women aged ≥40 years could reduce breast cancer risk by taking precautions to prevent mammary gland infection and mastitis.