DOCSLIB.ORG

Concurrent Proton-Pump Inhibitors Increase Risk of Death for Lung Cancer Patients Receiving 1St-Line Gefitinib Treatment - a Nationwide Population-Based Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Concurrent Proton-Pump Inhibitors Increase Risk of Death for Lung Cancer Patients Receiving 1St-Line Gefitinib Treatment - a Nationwide Population-Based Study Cancer Management and Research Dovepress open access to scientific and medical research Open Access Full Text Article ORIGINAL RESEARCH Concurrent proton-pump inhibitors increase risk of death for lung cancer patients receiving 1st-line gefitinib treatment - a nationwide population-based study This article was published in the following Dove Press journal: Cancer Management and Research Yu-Hung Fang 1 Purpose: Concurrent proton pump inhibitor (PPI) use might reduce the plasma concentra- – Yao-Hsu Yang 2 5 tion of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). Clinically, Meng-Jer Hsieh 6,7 the adverse effect of PPIs on patients with non-small cell lung cancer (NSCLC) treated with Ming-Szu Hung8,9 first-line EGFR TKIs remains controversial. This study was conducted to evaluate whether Yu-Ching Lin 1,8 the combined use of gefitinib with PPIs affected NSCLC outcomes. 1Division of Thoracic Oncology, Department of Patients and methods: We performed a nationwide cohort study of patients newly Pulmonary and Critical Care Medicine, Chang diagnosed with NSCLC between 1997 and 2013 using the Taiwan Cancer Registry and Gung Memorial Hospital, Chiayi Branch, Puzi For personal use only. fi City, Chiayi County, Taiwan, R.O.C; Taiwan National Health Insurance databases. We identi ed patients who were treated with 2Department of Traditional Chinese Medicine, first-line EGFR TKIs and analyzed the association between use of PPIs and TKI treatment Chang Gung Memorial Hospital, Chiayi Branch, fi Puzi City, Chiayi County, Taiwan, R.O.C; outcome. We de ned the coverage ratio of PPIs as duration of PPI treatment in days divided 3Center of Excellence for Chang Gung by duration of TKIs in days. Patients who exhibited an overlap of >20% between PPI and Research Datalink, Chang Gung Memorial fi Hospital, Chiayi Branch, Puzi City, Chiayi TKI usage days were de ned as having a high coverage ratio. County, Taiwan, R.O.C; 4Institute of Results: A total of 1278 patients were treated with first-line gefitinib, 309 of which took Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public PPIs at the same time and 145 had a high PPI coverage ratio. Patients had similar time to 5 Health, Taipei City, Taiwan, R.O.C; School of failure regardless of their PPI coverage ratio during gefitinib treatment. However, higher PPI Traditional Chinese Medicine, College of Medicine, Chang Gung University, Guishan coverage ratio significantly decreased overall survival (OS) compared with that of patients Township, Taoyuan County, Taiwan, R.O.C; with a lower PPI coverage ratio or no PPI treatment in univariate analysis (median OS, 13.5, 6Department of Respiratory Therapy, College of Medicine, Chang Gung University, Guishan 16.7, and 21.8 months, respectively, p<0.01) and multivariate analyses (high coverage ratio Township, Taoyuan County, Taiwan, R.O.C; HR: 1.67; low coverage ratio HR: 1.29). Exposure to PPIs during first line gefitinib treatment 7Division of Pulmonary Infection and Critical Cancer Management and Research downloaded from https://www.dovepress.com/ by 54.70.40.11 on 21-Oct-2019 Care Medicine, Department of Pulmonary and significantly decreased overall survival of patients with NSCLC. Critical Care Medicine, Chang Gung Memorial Concurrent use of PPIs was associated with lower overall survival in patients Hospital, Chiayi Branch, Puzi City, Chiayi Conclusion: County, Taiwan, R.O.C; 8Department of with EGFR-mutant NSCLC under first-line gefitinib treatment. Respiratory Care, Chang Gung University of Science and Technology, Chiayi Campus, Puzi Keywords: proton pump inhibitor, epidermal growth factor receptor, non-small cell lung City, Chiayi County, Taiwan, R.O.C; 9School of cancer, gefitinib, tyrosine kinase inhibitor, National Health Insurance Research Database Medicine, College of Medicine, Chang Gung University, Guishan Township, Taoyuan County, Taiwan, R.O.C Introduction 1 Correspondence: Yu-Ching Lin Lung cancer is the leading cause of cancer-related mortality worldwide. Over the Division of Thoracic Oncology, last decade, one of the most important advances for the therapy of non-small cell lung Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial cancer (NSCLC) was the development of epidermal growth factor receptor (EGFR) Hospital, Chiayi Branch, No.6, W. Sec., tyrosine kinase inhibitors (TKIs).2,3 EGFR mutations are detected in more than 50% Jiapu Road, Puzi City, Chiayi County 4,5 61363, Taiwan, R.O.C of patients with the histological subtype of adenocarcinoma in East Asia. Among Tel +886 5 362 1000 Ext 2762 patients harboring an activating EGFR mutation, EGFR-TKIs significantly improve Fax +886 5 362 3005 6 7–9 Email [email protected] not only the patient’s quality of life, but also progression-free survival (PFS) and submit your manuscript | www.dovepress.com Cancer Management and Research 2019:11 8539–8546 8539 DovePress © 2019 Fang et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work http://doi.org/10.2147/CMAR.S222278 you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Powered by TCPDF (www.tcpdf.org) 1 / 1 Fang et al Dovepress overall survival (OS)10 compared with platinum-based the Bureau of NHI. The institutional review board of doublet chemotherapy. Nevertheless, almost all patients Chang Gung Memorial Hospital proved that patient con- who initially respond to EGFR-TKIs eventually show dis- sent was not required to review their medical records in ease progression. Many studies have aimed to extend the this retrospective database study (201700257B1). Patients’ effective period of EGFR-TKIs.11 However, identifying anonymity and confidentiality were ensured throughout the potential drug-drug interactions that may reduce the effi- study. cacy of EGFR-TKIs is equally important. There are two widely available first-generation EGFR- Definition of lung cancer TKIs, gefitinib and erlotinib, and most studies have focused Using the NHIRD, we identified patients older than 18 years on erlotinib.12 The recommended dose of gefitinib (250 mg/ of age with lung cancer according to the 9th Revision day) for NSCLC is around only one-third of its maximum International Classification of Disease, Clinical Modification tolerated dose, but the recommended dose used for erlotinib [ICD-9-CM] code 162 from the Registry of Catastrophic (150 mg/day) is its maximum tolerated dose.13 Besides, Illness Patients Database. The Registry of Catastrophic compared with gefitinib, exposure to erlotinib results in Illness Patients Database is a subset of NHIRD, and patholo- both higher maximum plasma concentration (Cmax) and gical confirmation of lung cancer is required to apply this the area under the serum concentration versus time curve registry. (AUC) at standard dosing.14 Therefore, we assume that the effects of gefitinib are more likely to be affected by con- Definition of first-line EGFR-TKI current drug treatments than the effects of erlotinib would. Among patients with ICD-9-CM code 162 between 1997 Proton pump inhibitors (PPIs), the major treatment for and 2013, we used Anatomical Therapeutic Chemical patients with reflux esophagitis or peptic ulcers, are one of (ATC) code to identify patients with NSCLC who were the most widely used classes of drugs in the world. In treated with gefitinib between Jun 2011 and Jun 2013. This timeline was chosen because NHI has reimbursed EGFR- For personal use only. healthy volunteers, PPI use may decrease the AUC and peak plasma concentration of first-generation EGFR- TKIs as a first-line therapy for late-stage EGFR-mutant TKIs.15 However, the clinical impact of PPIs on the treat- primary lung cancer since Jun 2011. ment outcome of EGFR-TKIs remains controversial.12,16–18 According to the NHI policy, physicians must seek There have been few large, multi-center studies focused on approval every 3 months when prescribing first-line patients receiving first-line EGFR-TKIs, and all the studies EGFR-TKIs with initial pathological diagnosis, EGFR fi enrolled patients being treated with other antacid agents, not mutation type analysis, and image evidence con rming PPIs only. Therefore, we used nationwide data from the advanced lung cancer in patients, and re-apply every Taiwan National Health Insurance Research Database to 3 months according to the tumor response as evaluated evaluate the impact of PPIs on first-line EGFR-TKIs treat- by image studies with chest computer tomography, bone ment outcomes. scans, and brain magnetic resonance imaging, which must be peer reviewed. NHI policy states that EGFR-TKI use is Cancer Management and Research downloaded from https://www.dovepress.com/ by 54.70.40.11 on 21-Oct-2019 not allowed beyond radiological progression. Materials and methods To exclude patients who were not taking first-line Data source EGFR-TKIs, we identified patients who had received In Taiwan, the National Health Insurance (NHI) is a sin- prior chemotherapy using ATC codes including: gle-payer mandatory national health insurance system that L01XA01 (Cisplatin); L01XA02 (Carboplatin); L01BA04 covers more than 99% of citizens and provides compre- (Pemetrexed); L01CA04 (Vinorelbine); L01CD01 (Paclit- hensive medical care.19 The National Health Insurance axel); L01CD02 (Docetaxel); and L01BC05 (Gemcit- Research Database (NHIRD), established by the National abine). Health Research Institutes (NHRI) of the Taiwanese gov- Thus, according to the NHI policy, patients taking first- ernment, is one of the largest and most complete health- line EGFR-TKIs without previous chemotherapy must care databases in the world, and has been used to have late-stage EGFR-mutant primary lung cancer.
Load more

Recommended publications
  • An Expert-Based Assessment Model for Evaluating Habitat Suitability of Pond-Breeding Amphibians
    sustainability Article An Expert-Based Assessment Model for Evaluating Habitat Suitability of Pond-Breeding Amphibians Shin-Ruoh Juang 1, Szu-Hung Chen 2 and Chen-Fa Wu 1,* 1 Department of Horticulture, National Chung Hsing University, Taichung City 402, Taiwan; [email protected] 2 Department of Ecosystem Science & Management, Texas A&M University, College Station, TX 77843, USA; [email protected] * Correspondence: [email protected]; Tel./Fax: +886-4-2285-9125 Academic Editor: Iain Gordon Received: 8 November 2016; Accepted: 10 February 2017; Published: 16 February 2017 Abstract: Farm ponds are important habitats for amphibians, birds, and other wildlife. In Taiwan, artificial ponds were originally created on farmlands for irrigation purposes and the needs of the domestic water supply. Although pond creation is a typical farming practice, it also provides habitats for pond-breeding amphibians. Thus, it is essential to understand the current status of habitats and their vulnerability regarding urgent conservation needs for target species. Günther’s frog (Hylarana guentheri), a pond-breeding amphibian, has a high sensitivity towards surrounding environmental changes, and can be used as an indicator species to assess habitat suitability. The purpose of this study is to establish a systematic framework to assess the habitat suitability of pond-breeding amphibians by using Günther’s frog as a pilot-study species. First, we collected frog survey data from Chiayi, Taiwan, from winter 2013 to spring 2015, and investigated the present status of the environmental conditions around the ponds. Next, expert questionnaires and the fuzzy Delphi method were applied to establish the hierarchical evaluation criteria regarding the habitat suitability assessment.
    [Show full text]
  • The History and Politics of Taiwan's February 28
    The History and Politics of Taiwan’s February 28 Incident, 1947- 2008 by Yen-Kuang Kuo BA, National Taiwan Univeristy, Taiwan, 1991 BA, University of Victoria, 2007 MA, University of Victoria, 2009 A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY in the Department of History © Yen-Kuang Kuo, 2020 University of Victoria All rights reserved. This dissertation may not be reproduced in whole or in part, by photocopy or other means, without the permission of the author. ii Supervisory Committee The History and Politics of Taiwan’s February 28 Incident, 1947- 2008 by Yen-Kuang Kuo BA, National Taiwan Univeristy, Taiwan, 1991 BA, University of Victoria, 2007 MA, University of Victoria, 2009 Supervisory Committee Dr. Zhongping Chen, Supervisor Department of History Dr. Gregory Blue, Departmental Member Department of History Dr. John Price, Departmental Member Department of History Dr. Andrew Marton, Outside Member Department of Pacific and Asian Studies iii Abstract Taiwan’s February 28 Incident happened in 1947 as a set of popular protests against the postwar policies of the Nationalist Party, and it then sparked militant actions and political struggles of Taiwanese but ended with military suppression and political persecution by the Nanjing government. The Nationalist Party first defined the Incident as a rebellion by pro-Japanese forces and communist saboteurs. As the enemy of the Nationalist Party in China’s Civil War (1946-1949), the Chinese Communist Party initially interpreted the Incident as a Taiwanese fight for political autonomy in the party’s wartime propaganda, and then reinterpreted the event as an anti-Nationalist uprising under its own leadership.
    [Show full text]
  • Atmospheric PM2.5 and Polychlorinated Dibenzo-P-Dioxins and Dibenzofurans in Taiwan
    Aerosol and Air Quality Research, 18: 762–779, 2018 Copyright © Taiwan Association for Aerosol Research ISSN: 1680-8584 print / 2071-1409 online doi: 10.4209/aaqr.2018.02.0050 Atmospheric PM2.5 and Polychlorinated Dibenzo-p-dioxins and Dibenzofurans in Taiwan Yen-Yi Lee 1, Lin-Chi Wang2*, Jinning Zhu 3**, Jhong-Lin Wu4***, Kuan-Lin Lee1 1 Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan 2 Department of Civil Engineering and Geomatics, Cheng Shiu University, Kaohsiung 83347, Taiwan 3 School of Resources and Environmental Engineering, Hefei University of Technology, Hefei 246011, China 4 Sustainable Environment Research Laboratories, National Cheng Kung University, Tainan 70101, Taiwan ABSTRACT In this study, the atmospheric PM2.5, increases/decreases of the PM2.5, the PM2.5/PM10 ratio, total PCDD/Fs-TEQ concentrations, PM2.5-bound total PCDD/Fs-TEQ content, and PCDD/F gas-particle partition in Taiwan were investigated for the period 2013 to 2017. In Taiwan, the annual average PM2.5 concentrations were found to be 28.9, 24.1, 21.4, 20.2, –3 and 19.9 µg m in 2013, 2014, 2015, 2016, and 2017, respectively, which indicated that the annual variations in PM2.5 levels were decreasing during the study period. The average increases (+)/decreases (–) of PM2.5 concentrations were –16.7%, –11.1%, –5.75%, and –1.73% from 2013 to 2014, from 2014 to 2015, from 2015 to 2016, and from 2016 to 2017, respectively. Based to the relationship between PM10 values and total PCDD/F concentrations obtained from previous studies, we estimated that in 2017, the annual average total PCDD/Fs-TEQ concentrations ranged between 0.0148 –3 –3 (Lienchiang County) and 0.0573 pg WHO2005-TEQ m (Keelung City), and averaged 0.0296 pg WHO2005-TEQ m , while –1 the PM2.5-bound total PCDD/Fs-TEQ content ranged from 0.302 (Kaohsiung City) to 0.911 ng WHO2005-TEQ g –1 (Keelung City), at an average of 0.572 ng WHO2005-TEQ g .
    [Show full text]
  • Relationships Between Floods and Social Fragmentation: a Case Study of Chiayi, Taiwan
    Relationships between floods and social fragmentation: A case study of Chiayi, Taiwan • Yung-Jaan Lee • Chung-Hua Institution for Economic Research, Taiwan • Li-Pei Peng* • Ting-Jay Lee • National Taiwan University, Taiwan *Corresponding author Abstract Resumen Lee, Y.-J. Peng, L.-P., & Lee, T.-J. (March-April, 2017). Lee, Y.-J. Peng, L.-P., & Lee, T.-J. (marzo-abril, 2017). Las Relationships between floods and social fragmentation: A relaciones entre las inundaciones y la fragmentación social: un case study of Chiayi, Taiwan. Water Technology and Sciences estudio de caso de Chiayi, Taiwán. Tecnología y Ciencias del (in Spanish), 8(2), 5-18. Agua, 8(2), 5-18. The social vulnerability approach has been recognized El enfoque de la vulnerabilidad social ha sido reconocido como una de las as one of the most important tools for exploring contexts herramientas más importantes para explorar contextos y estrategias and coping strategies in relation to contemporary disasters. de afrontamiento en relación con los desastres contemporáneos. Sin However, social vulnerability is such a multi-faceted and embargo, la vulnerabilidad social es un constructo tan multifacético complex construct that scholars from different fields have not y complejo que estudiosos de diversas disciplinas no han llegado a un consenso sobre la mejor manera de medirlo y continúa el debate reached consensus on how best to measure it, and discussions 5 on this issue continue. Some scholars consider that this sobre dicha cuestión. Algunos estudiosos consideran que este enfoque puede manifestar el papel de la intervención humana. Sin approach can manifest the role of human agency. However, embargo, dada la falta de observaciones históricas, interpretar las given a lack of historical observations, interpreting the causes causas de los desastres a través de perspectivas basadas en eventos of disasters through event-based perspectives cannot easily no puede reflejar el mecanismo institucional detrás de tales eventos.
    [Show full text]
  • Recalcitrant Periprosthetic Joint Infection with Iliac Fossa Abscess After Total Hip Arthroplasty
    Recalcitrant Periprosthetic Joint Infection With Iliac Fossa Abscess After Total Hip Arthroplasty Kuo-Ti Peng ( [email protected] ) Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County Tsung-Yu Huang Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi Jiun-Liang Chen Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County Chiang-Wen Lee Department of Nursing, Division of Basic Medical Sciences, and Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Puzi City, Chiayi County Hsin-Nung Shih Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Linkou Research Article Keywords: total hip arthroplasty, periprosthetic joint infection, iliac fossa abscess, ilioinguinal incision, debridement Posted Date: January 21st, 2021 DOI: https://doi.org/10.21203/rs.3.rs-144908/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/14 Abstract Background: Total hip arthroplasty (THA) is a widely used and successfully performed orthopedic procedure for treating severe hip osteoarthritis, rheumatoid arthritis, and avascular necrosis. However, periprosthetic joint infection (PJI) after THA is a devastating complication for patients and orthopedic surgeons. Although surgical technology has been advanced and antibiotic-loaded cemented spacers or beads have developed, the treatment failure rate of one- or two-stage exchange arthroplasty for PJI is reported to be high, with >10% rate of incidence. Therefore, determining the possible pathogenesis and increasing the treatment success rate is a clinically important and urgent issue. Methods: A total of 256 patients with PJI who had undergone THA from 2005 to 2015 were included in this retrospective review.
    [Show full text]
  • Hemigobius Crassa (HERRE, 1945)
    86 Journal of Marine Science and Technology, Vol. 21, Suppl., pp. 86-93 (2013) DOI: 10.6119/JMST-013-1220-4 THE MOLECULAR PHYLOGENY OF GENUS Hemigobius (TELEOSTEI: GOBIIDAE), WITH THE CONFIRMATION OF VALIDITY OF Hemigobius crassa (HERRE, 1945) Shih-Pin Huang1, I-Shiung Chen1, and Kwang-Tsao Shao2 Key words: Hemigobius, mangrove, gobies, Taiwan. in Thailand, Singapore and Indonesia [20, 21]. There are two possible Hemigobius species have been de- scribed in southern China. The Vaimosa crassa Herre, 1945 ABSTRACT collected from Hong Kong, and Mugilogobius obliquifascia- The genus Hemigobius Bleeker, 1874 is has been regarded tus Wu and Ni, 1985 collected from Hainan Island, Goung- as only two valid species in previous study including H. dong and Fujian Province, southern China. Previous studies hoevenii (Bleeker, 1851) and H. mingi (Herre, 1936). Tradi- consider they should be considered that two species are the tionally, the both Vaimosa crassa Herre, 1945 and Mugilogo- junior synonyms of Hemigobius hoevenii [20, 21]. On the bius obliquifasciatus Wu and Ni, 1985 found from Chinese other hand, the Hemigobius bleekeri Koumans, 1953 [19] and Taiwanese waters had ever been regarded as the junior collected from Java and Sphenentogobius vanderbilti Fowler, synonyms of H. hoevenii. However, our present study have 1940 [12] collected from Sumatra also be regarded as syno- been confirm that H. crassa collected from Hong Kong and nym of H. mingi [20, 21]. So far, merely two species including Taiwan is a valid species. The H. crassa can be well distin- H. hoevenii and H. mingi would be regarded as valid member guished from H.
    [Show full text]
  • The Potential SARS-Cov-2 Entry Inhibitor
    bioRxiv preprint doi: https://doi.org/10.1101/2020.03.26.009803; this version posted March 26, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. The potential SARS-CoV-2 entry inhibitor Jrhau Lung1, Yu-Shih Lin2, Yao-Hsu Yang3,4,5, Yu-Lun Chou6, Geng-He Chang 7, 8, Ming-Shao Tsai 7, Cheng-Ming Hsu 7 , Reming-Albert Yeh 7,Li-Hsin Shu 3, Yu-Ching Cheng 3, Hung Te Liu 3, Ching-Yuan Wu 3, 5* 1 Department of Research and Development, Chiayi Chang Gung Memorial Hospital, Chiayi Branch, Putzu, Taiwan 2 Department of Pharmacy, Chiayi Chang Gung Memorial Hospital, Chiayi Branch, Putzu, Taiwan. 3 Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Putzu, Taiwan. 4 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi Branch, Putzu, Taiwan. 5 School of Chinese medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. 6 Department of surgery, Kaohsiung Chang Gung Memorial Hospital 7 Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi, Taiwan 8 Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan *Correspondence to: Ching-Yuan Wu, M.D., Ph. D. 1 bioRxiv preprint doi: https://doi.org/10.1101/2020.03.26.009803; this version posted March 26, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.
    [Show full text]
  • Promoted Human Oral Cancer Cells Metastatic Potential
    Surfactin from Bacillus subtilis attenuates ambient air particulate matter- promoted human oral cancer cells metastatic potential Thi Thuy Tien Vo1,#, Chiang-Wen Lee2,3,4,5,#, Ching-Zong Wu1, Ju-Fang Liu6, Wei- Ning Lin7, Yuh-Lien Chen8, Lee-Fen Hsu9,10, Ming-Horng Tsai11,12, I-Ta Lee1,* 1School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan 2Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County 61363, Taiwan 3Department of Nursing, Division of Basic Medical Sciences, and Chronic Diseases and Health Promotion Research Center, and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Puzi City, Chiayi County 61363, Taiwan 4Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City 24301, Taiwan 5College of Medicine, Chang Gung University, Guishan Dist., Taoyuan City 33303, Taiwan 6School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan 7Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City, Taiwan 8Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan 9Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi City, Chiayi County 613, Taiwan 10Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County 613, Taiwan 11Department of Pediatrics, Division of Pediatric Hematology/Oncology and Neonatology, Yunlin Chang Gung Memorial Hospital, Yunlin, Taiwan 12College of Medicine, Chang Gung University, Taoyuan, Taiwan #These authors contributed equally to this work Running Title: Inhibition of oral cancer cell invasion by surfactin *Corresponding Author: I-Ta Lee School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan 250 Wuxing St.
    [Show full text]
  • No. Area Post Office Name Zip Code Telephone No. Address Same Day
    Zip Same Day Flight No. Area Post Office Name Telephone No. Address Code Cutoff Time* 1 Tainan Chiayi Wunhua Rd. Post Office 60044 (05)2259-408(05)2227-881 No. 134, Wunhua Rd., East District, Chiayi 600-44, Taiwan (R.O.C.) Next-Day-Flight Service** 2 Tainan Chiayi Jhongshan Rd. Post Office 60041 (05)2785-145 No. 107, Jhongshan Rd., East District, Chiayi 600-41, Taiwan (R.O.C.) Next-Day-Flight Service** 3 Tainan Shueishang Nanjing Post Office 60859 (05)2682-035 No. 1, Sanjhen Rd., Sanjhen Village, Shueishang, Chiayi County 608-59, Taiwan (R.O.C.) Next-Day-Flight Service** 4 Tainan Shueishang Jhongjhuang Post Office 60857 (05)2890-344 No. 61-61, Jhongjhuang, Jhongjhuang Village, Shueishang, Chiayi County 608-57, Taiwan (R.O.C.) Next-Day-Flight Service** 5 Tainan Chiayi Railway Station Front Post Office 60042 (05)2242-021 No. 647, Jhongjheng Rd., West District, Chiayi 600-42, Taiwan (R.O.C.) Next-Day-Flight Service** 6 Tainan Chiayi Mincyuan Rd. Post Office 60044 (05)2273-547 No. 467, Mincyuan Rd., West District, Chiayi 600-44, Taiwan (R.O.C.) Next-Day-Flight Service** 7 Tainan Taibao Post Office 61250 (05)3711-040 No. 439-2, Houtan Village, Taibao, Chiayi County 612-50, Taiwan (R.O.C.) Next-Day-Flight Service** 8 Tainan Chiayi Jhongsiao Post Office 60044 (05)2783-079 No. 2(08)1, Mincyuan Rd., East District, Chiayi 600-44, Taiwan (R.O.C.) Next-Day-Flight Service** 9 Tainan Chiayi Beishe Post Office 60092 (05)2320-200 No. 245, Beising St., West District, Chiayi 600-92, Taiwan (R.O.C.) Next-Day-Flight Service** 10 Tainan Shueishang Post Office 60848 (05)2682-140 No.
    [Show full text]
  • Article Formatting Requirements
    APPLYING GEO-DATA TO EVALUATE THE APPROPRIATENESS OF BUS NETWORK Chih-Hung Chang1, Jau-Ming Su2, Chao-Neng Chang3,, Chih-Kang Lin4,Mei-Hui Shen5, and Chin-Tung Tsai6 1,2,3,4Chih-Hung Chang, Chung Hua University, Department of Transportation Technology and Logistics Management [email protected], [email protected], [email protected], [email protected] 5Chung Hua University, Department of Transportation Technology and Logistics Management, [email protected] 6Operation and Management Division, Institute of Transportation, Ministry of Transportation and Communications, [email protected] Abstract In recent years, a great deal of resources have been invested in public transportation development in Taiwan. Although the Ratio of the Users of Public Transport has increased significantly, the pace of growth has already started to slow down. As a result, all levels of the governments are attempting to boost the ratio of the users of public transport by planning new transit service routes with potential. Due to the limitations of forecasts derived from conventional transportation demand data, some local and foreign scholars and research organizations have employed the service population indicator to plan transit service routes. In this study, we utilize a variety of geospatial data, such as village and street number diagrams from the Taiwan Geospatial One-Stop Portal, created by the Information Center, Ministry of the Interior; the Household Registration Statistics database; the Bus Dynamic Information System implemented by the Directorate General of Highways, Ministry of Transportation and Communications (MOTC); and other big data sources such as income and land use data. This will enable government transportation agencies to assess the benefits of new transit routes using transportation demand data and the service population indicator.
    [Show full text]
  • Atmospheric Arsenic Deposition in Chiayi County in Southern Taiwan
    Aerosol and Air Quality Research, 13: 932–942, 2013 Copyright © Taiwan Association for Aerosol Research ISSN: 1680-8584 print / 2071-1409 online doi: 10.4209/aaqr.2012.11.0315 Atmospheric Arsenic Deposition in Chiayi County in Southern Taiwan Long-Full Lin1, Shu Hsien Wu2, Sheng-Lun Lin3,4*, John Kennedy Mwangi2, Yi-Ming Lin5, Chia-Wei Lin2, Lin-Chi Wang4,6, Guo-Ping Chang-Chien4,7 1 Department of Environmental Engineering, Kun Shan University, Yung Kang, Tainan City 71003, Taiwan 2 Department of Environmental Engineering, National Cheng Kung University, Tainan City 70101, Taiwan 3 Center of General Education, Cheng Shiu University, Kaohsiung City 83347, Taiwan 4 Super Micro Mass Research and Technology Center, Cheng Shiu University, Kaohsiung City 83347, Taiwan 5 College of Environmental Science and Engineering, South China University of Technology, Guangzhou 510640, China 6 Department of Civil Engineering and Engineering Informatics, Cheng Shiu University, Kaohsiung City 83347, Taiwan 7 Department of Cosmetic and Fashion Styling, Cheng Shiu University, Kaohsiung City 83347, Taiwan ABSTRACT Although arsenic contamination of underground water in southern Taiwan is well known, few studies examine atmospheric arsenic deposition in this area, which might be the major source of such pollution to the soil, water, and even underground water. This research focused on the atmospheric arsenic concentration, dry and wet depositions, and the As distribution around Chiayi County, located in the south of Taiwan. Eight sampling sites are used, both upwind and downwind of an area with heavy industrial and human activities. All samples were collected by a PS-1 high volume sampler at each site, pretreated by a digestion process, and further analyzed with an ICP-MS.
    [Show full text]
  • 2016Taiwan Health and Welfare Report
    ISSN-24092630 2016 Taiwan Health and Welfare Report Taiwan Health and 2016 Welfare Report Promote the health and well-being of all citizens Being the most trustworthy government agency Health Happiness Fairness Sustainability Ministry of Health and Welfare, R.O.C.(Taiwan) Ministry of Health and Welfare, ISSN 2409-2630 0 0 3 0 0 9 772409 263003 GPN : 2010302163 Price：NT$300 Advertisement Ministry of Health and Welfare, R.O.C. (Taiwan) Taiwan Health and Welfare Report 2016 Adhering to the Whole-Person Care Value, Achieving Holistic Health and Social Welfare Policies. Ministry of Health and Welfare, R.O.C.(Taiwan) Foreword The Ministry of Health and Welfare's responsibilities include health planning and promotion, prevention and control of disease, food safety, drug management, social insurance, and welfare, relief and protective services. Our mandate also includes biotechnology R&D, international health cooperation, and diverse other areas affecting public health and well-being far beyond Taiwan. To explain our agency's health and social administration initiatives, we publish this annual report outlining our major policies and their concrete results. Some important trends continue to develop. Taiwan has officially been an "aging society" since 1993, and the government has been building better living environments and a long-term care system for senior citizens. This system focuses on economic security, health care and maintenance, and living care. June 2015 saw the enactment of the Long-term Care Services Act, which will be implemented beginning in 2017. Our agency continues to formulate the Act's sub-statutes and ancillary measures, and to implement the plan's second phase.
    [Show full text]