BACKGROUND:The possible effect of pulmonary tuberculosis (TB) on subsequent lung cancer development has been suspected, but the evidence remains inconsistent. The purpose of this study was to perform a nationwide population-based cohort study to investigate the risk of lung cancer after pulmonary TB infection. METHODS: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database. In total, 5657 TB patients and 23,984 controls matched for age and sex were recruited for the study from 1997 to 2008. RESULTS: The incidence rate of lung cancer (269 of 100,000 person-years) was significantly higher in the pulmonary TB patients than that in controls (153 of 100,000 person-years) (incidence rate ratio [IRR], 1.76; 95% confidence interval [CI], 1.33-2.32; P < .001). Compared with the controls, the IRRs of lung cancer in the TB cohort were 1.98 at 2 to 4 years, 1.42 at 5 to 7 years, and 1.59 at 8 to 12 years after TB infections. The multivariate Cox proportional hazards model revealed pulmonary TB infections (hazard ratio [HR], 1.64; 95% CI, 1.24-2.15; P < .001) and chronic obstructive pulmonary disease (HR, 1.09; 95% CI, 1.03-1.14; P ¼ .002) to be independent risk factors for lung cancer. CONCLUSIONS: Pulmonary infection with TB is associated with an increased risk of lung cancer. Cancer 2011;117:618-24.

ObjectivesThe aim of the study was to investigate determinants of long-term care use and to clarify the differing characteristics of home/community-based and institution-based services users.DesignCross-sectional, population-based study.SettingUtilizing data from the 2005 National Health Interview Survey conducted in Taiwan.ParticipantsA national sample of 2,608 people (1,312 men, 1,296 women) aged 65 and older.MeasurementsThe utilization of long-term care services (both home/community- and institution-based services) was measured. A χ2 analysis tested differences in baseline characteristics between home/community-based and institution-based long-term care users. The multiple-logistic model was adopted with a hierarchical approach adding the Andersen model’s predisposing, enabling, and need factors sequentially. Multiple logistic models further stratified data by gender and age.ResultsCompared with users of home/community-based care, those using institution-based care had less education (p = 0.019), greater likelihood of being single (p = 0.001), fewer family members (p = 0.002), higher prevalence of stool incontinence (p = 0.011) and dementia (P = .025), and greater disability (p = 0.016). After adjustment, age (compared with 65–69 years; 75–79 years, odds ratio [OR] = 2.08, p = 0.044; age ≥80, OR = 3.30, p = 0.002), being single (OR = 2.16, p = 0.006), urban living (OR = 1.68, p = 0.037), stroke (OR = 2.08, p = 0.015), dementia (OR = 2.32, p = 0.007), 1–3 items of activities of daily living (ADL) disability (OR = 5.56, p<0.001), and 4–6 items of ADL disability (OR = 21.57, p<0.001) were significantly associated with long-term care use.ConclusionAge, single marital status, stroke, dementia, and ADL disability are predictive factors for long-term care use. The utilization was directly proportional to the level of disability.

Background and Purpose-A correlation has been found between periodontal disease (PD) and stroke. This study was conducted to investigate whether dental prophylaxis and periodontal treatment reduce the incidence rate (IR) of ischemic stroke. Methods-We identified 510 762 PD cases and 208 674 non-PD subjects from January 1, 2000, to December 31, 2010. The PD cases were divided into dental prophylaxis, intensive treatment, and no treatment groups. The stroke IRs were assessed among groups during follow-up. Cox regression analysis was used after adjustment for age, sex, and comorbidities to determine the relationship between periodontal treatment and incidence of ischemic stroke. Results-The stroke IR of the non-PD subjects was 0.32%/year. In the PD group, subjects who received dental prophylaxis had the lowest stroke IR (0.14%/year); subjects with intensive treatment or tooth extraction had a higher stroke IR (0.39%/year); and subjects without PD treatment had the highest stroke IR (0.48%/year; P<0.001). After adjustment for confounders, the dental prophylaxis and intensive treatment groups had a significant lower hazard ratios for stroke than the non-PD group (hazard ratio=0.78 and 0.95; 95% confidence interval=0.75-0.81 and 0.91-0.99, respectively), whereas the PD without treatment group had a significant higher hazard ratio for stroke (1.15; 95% confidence interval=1.07-1.24), especially among the youngest (20-44) age group (hazard ratio=2.17; 95% confidence interval=1.64-2.87) after stratifying for age. Conclusions-Maintaining periodontal health by receiving dental prophylaxis and PD treatment can help reduce the incidence of ischemic stroke.

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Subjects who had more severe PD or did not receive periodontal treatment were at greater risk of developing dementia.

ObjectivesTo evaluate the associations of body mass index (BMI) with all-cause, cardiovascular disease (CVD), and expanded CVD mortality in the elderly.DesignObservational cohort study.SettingAnnual physical examination program for the elderly from 2006 to 2010.ParticipantsWe included 77,541 Taipei residents aged ≥65 years (39,365 men and 38,176 women).MeasurementsBMI was categorized as underweight (BMI<18.5), normal weight (18.5≤BMI<25), overweight (25≤BMI<30), grade 1 obesity (30≤BMI<35), or grade 2–3 obesity (BMI≥35). Mortality was ascertained by national death files.ResultsUnderweight (hazard ratios [HRs] of all-cause, CVD, and expanded CVD mortality: 1.92, 1.74, and 1.77, respectively), grade 2–3 obesity (HRs: 1.59, 2.36, and 2.22, respectively), older age, male sex, smoking, and high fasting blood sugar were significant predictors of mortality. Meanwhile, being married/cohabitating, higher education, alcohol consumption, more regular exercise, and high total cholesterol were inversely associated with mortality. Multivariate stratified subgroup analyses verified smokers (HRs of all-cause, CVD, and expanded CVD mortality: 3.25, 10.71, and 7.86, respectively, for grade 2–3 obesity), the high triglyceride group (HRs: 5.82, 10.99, and 14.22, respectively for underweight), and patients with 3–4 factors related to metabolic syndrome (HRs: 4.86, 12.72, and 11.42, respectively, for underweight) were associated with mortality.ConclusionThe associations of BMI with all-cause, CVD, expanded CVD mortality in the elderly are represented by U-shaped curves, suggesting unilateral promotions or interventions in weight reduction in the elderly may be inappropriate. Heterogeneous effects of grades 1 and 2–3 obesity on mortality were observed and should be treated as different levels of obesity.

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In this paper, a fundamental frequency (F(0)) tracking algorithm is presented that is extremely robust for both high quality and telephone speech, at signal to noise ratios ranging from clean speech to very noisy speech. The algorithm is named "YAAPT," for "yet another algorithm for pitch tracking." The algorithm is based on a combination of time domain processing, using the normalized cross correlation, and frequency domain processing. Major steps include processing of the original acoustic signal and a nonlinearly processed version of the signal, the use of a new method for computing a modified autocorrelation function that incorporates information from multiple spectral harmonic peaks, peak picking to select multiple F(0) candidates and associated figures of merit, and extensive use of dynamic programming to find the "best" track among the multiple F(0) candidates. The algorithm was evaluated by using three databases and compared to three other published F(0) tracking algorithms by using both high quality and telephone speech for various noise conditions. For clean speech, the error rates obtained are comparable to those obtained with the best results reported for any other algorithm; for noisy telephone speech, the error rates obtained are lower than those obtained with other methods.