1
|
Lin SY, Huang HY, Chang LL, Wang YL, Chen TC, Chang K, Tu HP, Lu PL. The impact of the fluconazole trailing effect on the persistence of Candida albicans bloodstream infection when treated with fluconazole. Clin Microbiol Infect 2024:S1198-743X(24)00154-X. [PMID: 38527614 DOI: 10.1016/j.cmi.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 03/10/2024] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVES The trailing effect of Candida species is a phenomenon characterized by reduced but persistent growth at antifungal concentrations above the MIC. We assessed the impact of trailing growth on the persistence of Candida albicans candidemia in patients receiving fluconazole (FLC) therapy. METHODS We retrospectively investigated candidemia isolates at three hospitals in southern Taiwan between 2013 and 2020. Patients treated with FLC for FLC-susceptible C. albicans candidemia were enrolled. The degree of trailing was determined as the average growth above the MIC divided by the measured growth at the lowest drug concentration using the EUCAST method and classified into four categories: residual (0.1-5%), slight (6-10%), moderate (11-15%), and heavy trailers (>15%). RESULTS Among isolates from 190 patients, the proportions of heavy trailers at 24 hours, 48 hours, and 72 hours were 63.7% (121/190), 63.2% (120/190), and 74.7% (142/190), respectively. Persistent candidemia was observed in 17 (8.9 %) patients. The proportion of persistent C. albicans candidemia in heavy trailing isolates at 48 hours was higher than in isolates without heavy trailing (13.3% [16/120] vs. 1.4% [1/70], p = 0.007). A multivariate analysis showed that immunosuppression (OR = 7.92; 95% CI: 2.38-26.39, p = 0.001), hospitalization days after the index date of C. albicans identification (OR = 1.03; 95% CI: 1.01-1.05, p = 0.011), and heavy trailing isolates at 48 hours (OR = 10.04; 95% CI: 1.27-79.88, p = 0.029) were independent factors for persistent candidemia. DISCUSSION The current study revealed that heavy trailing in C. albicans isolates is associated with persistent candidemia in patients receiving FLC treatment.
Collapse
Affiliation(s)
- Shang-Yi Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ho-Yin Huang
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Lin-Li Chang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Microbiology and Immunology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ya-Ling Wang
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tun-Chieh Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ko Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
2
|
Dong HM, Liang HP, Tao ZH, Duan YF, Milošević MV, Chang K. Interface thermal conductivities induced by van der Waals interactions. Phys Chem Chem Phys 2024; 26:4047-4051. [PMID: 38224156 DOI: 10.1039/d3cp05377f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The interface heat transfer of two layers induced by van der Waals (vdW) contacts is theoretically investigated, based on first-principles calculations at low temperatures. The results suggest that out-of-plane acoustic phonons with low frequencies dominate the interface thermal transport due to the vdW interaction. The interface thermal conductivity is proportional to the cubic of temperature at very low temperatures, but becomes linearly proportional to temperature as temperature increases. We show that manipulating the strain alters vdW coupling, leading to increased interfacial thermal conductivity at the interface. Our findings provide valuable insights into the interface heat transport in vdW heterostructures and support further design and optimization of electronic and optoelectronic nanodevices based on vdW contacts.
Collapse
Affiliation(s)
- H M Dong
- School of Materials Science and Physics, China University of Mining and Technology, Xuzhou 221116, China.
| | - H P Liang
- Beijing Computational Science Research Center, Beijing, 100193, China
| | - Z H Tao
- Department of Physics and NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
| | - Y F Duan
- School of Materials Science and Physics, China University of Mining and Technology, Xuzhou 221116, China.
| | - M V Milošević
- Department of Physics and NANOlab Center of Excellence, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso 78060-900, Brazil
| | - K Chang
- School of Physics, Zhejiang University, Hangzhou 310027, P. R. China.
| |
Collapse
|
3
|
Tsai JJ, Chang K, Chen CH, Liao CL, Chen LJ, Tsai YY, Tsai CY, Lin PC, Hsu MC, Liu LT. Dengue virus serotype did not contribute to clinical severity or mortality in Taiwan's largest dengue outbreak in 2015. Eur J Med Res 2023; 28:482. [PMID: 37932817 PMCID: PMC10626727 DOI: 10.1186/s40001-023-01454-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Dengue virus serotype 2 (DENV-2) was the major serotype in the 2015 dengue outbreak in Taiwan, while DENV-1 and DENV-3 were dominant between 2005 and 2014. We aimed to investigate whether DENV-2 contributed to disease severity and mortality in the outbreak in Kaohsiung city, Taiwan. METHODS We collected serum samples from dengue patients to detect the presence of DENV and determine the serotypes by using quantitative reverse transcription-polymerase chain reaction. Our cohorts comprised 105 DENV-1-infected cases and 1,550 DENV-2-infected cases. Demographic data, DENV serotype, and comorbidities were covariates for univariate and multivariate analyses to explore the association with severity and mortality. RESULTS The results suggested that DENV-1 persisted and circulated, while DENV-2 was dominant during the dengue outbreak that occurred between September and December 2015. However, DENV-2 did not directly contribute to either severity or mortality. Aged patients and patients with diabetes mellitus (DM) or moderate to severe chronic kidney disease (CKD) had a higher risk of developing severe dengue. The mortality of dengue patients was related to a higher Charlson comorbidity index score and severe dengue. Among DENV-2-infected patients and older patients, preexisting anti-dengue IgG, DM, and moderate to severe CKD were associated with severe dengue. Moreover, female sex and severe dengue were associated with a significantly higher risk of death. CONCLUSIONS Our findings highlight the importance of timely serological testing in elderly patients to identify potential secondary infections and focus on the meticulous management of elderly patients with DM or moderate to severe CKD to reduce dengue-related death.
Collapse
Affiliation(s)
- Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Ching-Len Liao
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Liang-Jen Chen
- Department of Family Medicine, Pingtung Christian Hospital, Pingtung, Taiwan
| | - Yan-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Miao-Chen Hsu
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Li-Teh Liu
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan.
| |
Collapse
|
4
|
Abstract
We study non-trivial spin textures, nanoscale magnetic skyrmions and skyrmioniums, in two-dimensional (2D) Janus magnets, such as MnSTe and MnSeTe, based on the micromagnetism approach and Landau-Lifshitz-Gilbert (LLG) equation. It is found that the Janus magnetic structures can host stable Néel nano-skyrmions with sub-10 nm diameters, and skyrmioniums with zero topological charge. The skyrmion size can be squeezed by external magnetic fields, and even the topological charge can be changed. The diameters of the skyrmioniums are about twice the size of the skyrmions. Moreover, the switching of the topological charge Q = ±1 can be realized by changing the direction of the external magnetic fields. Our results clearly show that magnetic skyrmions in Janus magnets can be used to construct new types of efficient spintronic nanodevices.
Collapse
Affiliation(s)
- H M Dong
- School of Materials Science and Physics, China University of Mining and Technology, Xuzhou 221116, China.
| | - P P Fu
- School of Materials Science and Physics, China University of Mining and Technology, Xuzhou 221116, China.
| | - Y F Duan
- School of Materials Science and Physics, China University of Mining and Technology, Xuzhou 221116, China.
| | - K Chang
- SKLSM, Institute of Semiconductors, Chinese Academy of Sciences, P.O. Box 912, Beijing 100083, China.
| |
Collapse
|
5
|
Lee IK, Lee NY, Huang WC, Hsu JC, Tai CH, Yang CH, Huang CH, Lin CY, Chang K, Chen YH. In-hospital mortality predictors among hospitalized adults and those with chronic kidney disease with dengue. J Microbiol Immunol Infect 2023; 56:996-1006. [PMID: 37604758 DOI: 10.1016/j.jmii.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Accurately identifying risk factors that predict fatality in dengue is crucial for patient triage and clinical management. Our objective was to identify predictors of death associated with dengue and investigate the clinical characteristics and risk factors among patients with chronic kidney disease (CKD) who died from dengue. METHODS A multicenter longitudinal observation study conducted from 2008 to 2019. RESULTS A total of 1272 patients (113 who died and 1186 who recovered) diagnosed with dengue were included. Old age, CKD, and an elevated white blood cell count at hospital presentation were identified as independent predictors of in-hospital mortality among individuals infected with the dengue virus. In a subgroup analysis of 138 patients with CKD infected with dengue virus, 64 (46.3%) patients died, with 46 (33.3%) patients dying within 7 days after symptom onset. Among 64 fatal dengue patients with CKD, 34.4% were in stages 2 and 3 of kidney disease, 51.5% were in stages 4 and 5, and 14.1% had end stage renal disease as per the classification by Kidney Disease Improving Global Outcomes. Multivariate analysis revealed that initial altered consciousness, pulmonary edema, and leukocytosis during hospitalization were independently associated with in-hospital mortality in CKD patients infected with the dengue virus. Leukocytosis during hospitalization and severe hepatitis were independent risk factors for death within 7 days after dengue illness onset in CKD patients. CONCLUSIONS This study offers valuable insights into predictors linked to fatality in dengue and reinforces the importance of optimizing patient triage to improve the quality of care.
Collapse
Affiliation(s)
- Ing-Kit Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Nan-Yao Lee
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Wen-Chi Huang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jui-Chi Hsu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chien-Hsiang Tai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheng Hsun Yang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chung-Hao Huang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Yu Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Center for Tropical Medicine and Infectious Disease Research, School of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan; College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
| |
Collapse
|
6
|
Liu LT, Tsai JJ, Chang K, Chen CH, Lin PC, Tsai CY, Tsai YY, Hsu MC, Chuang WL, Chang JM, Hwang SJ, Chong IW. Corrigendum: Identification and analysis of SARS-CoV-2 alpha variants in the largest Taiwan COVID-19 outbreak in 2021. Front Med (Lausanne) 2023; 10:1211944. [PMID: 37265482 PMCID: PMC10231225 DOI: 10.3389/fmed.2023.1211944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 06/03/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fmed.2022.869818.].
Collapse
Affiliation(s)
- Li-Teh Liu
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Miao-Chen Hsu
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Hepatobiliary and Pancreatic, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jer-Ming Chang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Inn-Wen Chong
- Department of Internal Medicine and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pulmonary Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
7
|
Chi CY, Sung TC, Chang K, Chien YW, Hsu HC, Tu YF, Huang YT, Shih HI. Development and Utility of Practical Indicators of Critical Outcomes in Dengue Patients Presenting to Hospital: A Retrospective Cross-Sectional Study. Trop Med Infect Dis 2023; 8:tropicalmed8040188. [PMID: 37104314 PMCID: PMC10142425 DOI: 10.3390/tropicalmed8040188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/21/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Global travel and climate change have drastically increased the number of countries with endemic or epidemic dengue. The largest dengue outbreak in Taiwan, with 43,419 cases and 228 deaths, occurred in 2015. Practical and cost-effective tools for early prediction of clinical outcomes in dengue patients, especially the elderly, are limited. This study identified the clinical profile and prognostic indicators of critical outcomes in dengue patients on the basis of clinical parameters and comorbidities. A retrospective cross-sectional study was conducted in a tertiary hospital from 1 July 2015 to 30 November 2015. Patients diagnosed with dengue were enrolled, and the initial clinical presentations, diagnostic laboratory data, details of the underlying comorbidities, and initial management recommendations based on 2009 World Health Organization (WHO) guidelines were used to evaluate prognostic indicators of critical outcomes in dengue patients. Dengue patients from another regional hospital were used to evaluate accuracy. A group B (4 points) classification, temperature < 38.5 °C (1 point), lower diastolic blood pressure (1 point), prolonged activated partial thromboplastin time (aPTT) (2 points), and elevated liver enzymes (1 point) were included in the scoring system. The area under the receiver operating characteristic curve of the clinical model was 0.933 (95% confidence interval [CI]: 0.905–0.960). The tool had good predictive value and clinical applicability for identifying patients with critical outcomes.
Collapse
Affiliation(s)
- Chia-Yu Chi
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Miaoli County 35053, Taiwan
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County 35053, Taiwan
- Department of Microbiology & Immunology, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Tzu-Ching Sung
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 840203, Taiwan
| | - Ko Chang
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 81267, Taiwan
| | - Yu-Wen Chien
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Hsiang-Chin Hsu
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Yi-Fang Tu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Yi-Ting Huang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
| | - Hsin-I Shih
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, Taiwan
- Correspondence: ; Tel.: +886-6-235-3535 (ext. 2237)
| |
Collapse
|
8
|
Lin CY, Chang K, Chang CJ. Questionnaire-Based Analysis of Adverse Events and Compliance with Malaria Chemoprophylaxis in Taiwan. J Pers Med 2023; 13:jpm13020179. [PMID: 36836413 PMCID: PMC9967687 DOI: 10.3390/jpm13020179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
Malaria was eradicated in Taiwan in 1952; however, imported malaria cases are reported every year. The subtropical climate in Taiwan permits mosquito propagation and possible outbreaks of mosquito-borne diseases. The aim of this study was to investigate travelers' compliance and side effects of malaria prophylaxis to prevent a malaria outbreak in Taiwan. In this prospective study, we enrolled travelers who visited our travel clinic before going to malarious areas. A total of 161 questionnaires were collected and analyzed. Associations between the occurrence of side effects and compliance with antimalarial drugs were analyzed. Adjusted odds ratios were calculated after adjusting for potential risk factors in multiple logistic regression analysis. Of the 161 enrolled travelers, 58 (36.0%) reported side effects. Insomnia, somnolence, irritability, nausea, and anorexia were associated with poor compliance. Mefloquine was not associated with more neuropsychological side effects than doxycycline. Multiple logistic regression analysis showed that chemoprophylaxis compliance was affected by a younger age, visiting friends and relatives, visiting the travel clinic more than 1 week before the trip, and preferring to use the same antimalarial regimen on the next trip. Our findings could provide information to travelers besides labeled side effects to improve compliance with malaria prophylaxis and consequently help to prevent malaria outbreaks in Taiwan.
Collapse
Affiliation(s)
- Ching-Yun Lin
- Department of Family Medicine, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung 812, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chai-Jan Chang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Department of Family Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence:
| |
Collapse
|
9
|
Tang JK, Wang YX, Chang K, Zhang DB. Polarization due to emergent polarity in elemental semiconductor thinfilms under bending. J Phys Condens Matter 2022; 51:015501. [PMID: 36301713 DOI: 10.1088/1361-648x/ac9dd8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Polarization via strain engineering provides a facial way to functionalize materials. We investigate the origin of electronic polarization in the bent elemental semiconductor thinfilms by combining analytical modeling with quantum mechanical simulation. A bond orbital model reveals a polarity of covalent bonds induced by strain gradient such that polarization along the strain gradient dimension can be induced, giving rise to the flexoelectric effect. At strain gradient1/R=0.01 nm-1, the net charge differences between the two sides are5×10-4e,2.5×10-3eand7.2×10-3efor C, Si and Ge films respectively. On the other hand, due to the emergent bond polarity, the polarization can be effectively tuned by normal strain applied to the bent film, mimicking the piezoelectric effect. Simulations using the generalized Bloch theorem strongly support this revelation. Findings have important implications for delineating the formation of polarization and related phenomena in semiconductors.
Collapse
Affiliation(s)
- J-K Tang
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875, People's Republic of China
| | - Y-X Wang
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875, People's Republic of China
| | - K Chang
- SKLSM, Institute of Semiconductors, Chinese Academy of Sciences, PO Box 912, Beijing 100083, People's Republic of China
- CAS Center for Excellence in Topological Quantum Computation, University of Chinese Academy of Sciences, Beijing 100190, People's Republic of China
- Beijing Academy of Quantum Information Sciences, Beijing 100193, People's Republic of China
| | - D-B Zhang
- College of Nuclear Science and Technology, Beijing Normal University, Beijing 100875, People's Republic of China
- Beijing Computational Science Research Center, Beijing 100193, People's Republic of China
| |
Collapse
|
10
|
Yi X, Chen Y, Chang K, Zheng Y, Li X. Laparoscopic-Assisted Transanal Total Mesorectal Excision for a Patient with Bowel Endometriosis. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Ruan J, Tian Q, Wang Y, Chang K, Yi X. 8659 Interleukin-33 Promotes Endometriosis Fibrosis by Inducing Fibroblast to Myofibroblast Transformation. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
12
|
Tian Q, Zheng Y, Chang K, Yi X. 8795 Impact of Surgical Procedures on Intestinal Function and Quality of Life in Patients with Deep Endometriosis: A Prospective Study. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Parnham JC, Chang K, Rauber F, Levy RB, von Hinke S, Laverty AA, Millett C, Vamos EP. The ultra-processed food content of school meals and packed lunches in the United Kingdom (2008-2017). Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
British children have the highest ultra-processed food (UPF) intake in Europe, which is linked to adverse health outcomes. Schools are posited as a setting for dietary intervention, yet the level of UPFs consumed at schools is currently unknown. This study aimed to describe the UPF content of school food in the UK, explore the UPF content of school meals and packed lunches (food from home) and examine whether UPF differs by children's household income.
Methods
A pooled cross-sectional analysis of primary (4-11 years, n = 1,895) and secondary schoolchildren (11-18 years, n = 1,408) from the UK's National Diet and Nutrition Survey (2008-2017) was conducted. Food diaries recorded student's meal-type (school meal/packed lunch). UPF intake was defined using the NOVA food classification system. Quantile regression models assessed the association between meal-type and lunchtime UPF intake (%kcal and % grams). Models were stratified by school phase (primary/secondary) and interacted meal-type with income.
Results
Schoolchildren consumed most of their lunch as UPF, with higher median intakes in secondary schoolchildren than primary schoolchildren (77.8 %kcal vs 72.6 %kcal). School meals were associated with lower median UPF intake (%kcal) in both primary (-20 percentage-points[pp] [95% CI -22.2, -17.4]) and secondary schoolchildren (-11pp [-16.0,-7.0]) compared with packed lunches. Results were similar when UPF %g was analysed. Overall, income was inversely associated with UPF content. However, in primary schoolchildren there was no significant income gradient in the UPF(%g) content of school meals.
Conclusions
In the first nationally representative study, we showed that on average UPF intake was high in all UK schoolchildren. Higher UPF intakes were observed in packed lunch consumers, secondary schoolchildren, and those with a lower income. Procurement policies must be revaluated to protect children from high UPF intake.
Funders: NIHR School for Public Health Research
Key messages
• In the first study of ultra-processed food content of UK school food, we show that children consumed around three quarters of their energy as ultra-processed food at lunch.
• Children who were older, took food from home or were from a low-income household were more likely to consume higher levels of ultra-processed food. Regulation is needed to protect these children.
Collapse
Affiliation(s)
- JC Parnham
- Public Health Policy Evaluation Unit, Imperial College London , London, UK
| | - K Chang
- Public Health Policy Evaluation Unit, Imperial College London , London, UK
| | - F Rauber
- Department of Nutrition, University of São Paulo , São Paulo, Brazil
- Department of Preventive Medicine, University of São Paulo , São Paulo, Brazil
| | - RB Levy
- Department of Nutrition, University of São Paulo , São Paulo, Brazil
- Department of Preventive Medicine, University of São Paulo , São Paulo, Brazil
| | - S von Hinke
- School of Economics, University of Bristol , Bristol, UK
| | - AA Laverty
- Public Health Policy Evaluation Unit, Imperial College London , London, UK
| | - C Millett
- Public Health Policy Evaluation Unit, Imperial College London , London, UK
| | - EP Vamos
- Public Health Policy Evaluation Unit, Imperial College London , London, UK
| |
Collapse
|
14
|
Kyriakos CN, Qi D, Chang K, Laverty AA, Filippidis FT. Global market trends of flavour capsule and menthol cigarettes in 78 countries, 2010-2020. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Flavoured tobacco products, including innovative flavour capsule cigarettes (FCCs) and menthol cigarettes, can increase appeal and encourage smoking initiation and use. Global epidemiological data on these products are scarce.
Methods
This study examined market trends of FCCs and menthol (non-capsule) cigarettes across 78 countries from 2010 to 2020 and assessed ecological-level factors associated with market shares of these products. Market share and retail volume data came from Euromonitor Passport and country-specific sociodemographic data come from the WHO and World Bank. Adjusted linear fixed effects panel regression analyses were used to evaluate the relationship between predictors variables and market outcomes.
Results
Global total retail volume of FCCs increased over time (0.2% in 2010 to 4.5% in 2020) and market share was associated with year and unemployment rate and inversely associated with % urban population and smoking prevalence (p < 0.001). In contrast, menthol retail volume decreased over time (5.0% to 3.8%) and market share was associated with % urban population (p = 0.001) and inversely associated with year (p = 0.004) and unemployment rate (p = 0.017). The greatest market increase of FCCs was observed in the Americas region and among upper-middle income countries. In Europe, there was a decrease of 0.64 percentage points from 2019 to 2020.
Conclusions
Overall, FCCs experienced substantial global growth in the recent decade, with the exception of Europe whose slight decrease may be attributable to the European Union ban on flavours in cigarettes. Findings indicate that there is a need for increased efforts to address flavours and innovative features used in tobacco products, which are known to appeal to youth.
Key messages
• This study contributes to global monitoring of tobacco products.
• Findings can be used by advocates and policy makers to support countries in adopting measures to ban flavoured tobacco products.
Collapse
Affiliation(s)
- CN Kyriakos
- Department of Primary Care and Public Health, Imperial College London , London, UK
| | - D Qi
- Department of Primary Care and Public Health, Imperial College London , London, UK
| | - K Chang
- Department of Primary Care and Public Health, Imperial College London , London, UK
| | - AA Laverty
- Department of Primary Care and Public Health, Imperial College London , London, UK
| | - FT Filippidis
- Department of Primary Care and Public Health, Imperial College London , London, UK
| |
Collapse
|
15
|
Hou ZF, Yuan ZH, Chang K, Cao YH, Guan FX, Gao Y. NLRP3 rs1539019 is significantly associated with chronic obstructive pulmonary disease in a Chinese Han population: a case-control study. Eur Rev Med Pharmacol Sci 2022; 26:5821-5828. [PMID: 36066157 DOI: 10.26355/eurrev_202208_29521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE COPD is a complex respiratory disease characterized by chronic airway inflammation and the airflow limitations are not fully reversible due to the combination of genetic and environmental factors. Genetic factors such as polymorphisms, may affect the susceptibility of COPD. In the present study, we examined the association between the polymorphisms of three genes and COPD risk in a Chinese Han population. PATIENTS AND METHODS A total of 375 COPD patients and 284 control subjects were recruited from November 2018 to June 2021. Data on demographic basic information, smoking status, history of coal dust exposure, and peripheral blood were collected from subjects of two groups. Three polymorphisms (NLRP3 rs1539019, LAMB1 rs4320486, IL-6 rs1800796) were analyzed. Logistic analysis was used to evaluate the genetic contribution of selected SNPs to COPD susceptibility. RESULTS The AC genotype of NLRP3 rs1539019 significantly decreased COPD risk compared with CC genotype (adjusted OR = 0.508, 95% CI 0.336-0.767). In the stratification analyses, the AC genotype significantly decreased the risk of COPD in subjects aged 60 and over (p=0.005; adjusted OR = 0.553; 95% CI 0.366-0.835) with current smoking status (p=0.002; adjusted OR = 0.419; 95% CI 0.240-0.732) when compared with AA+CC genotype. Moreover, a significantly decreased risk for GOLD III COPD was found in genotype AC of NLRP3 rs1539019 (p=0.006; adjusted OR = 0.502; 95% CI 0.306-0.822). CONCLUSIONS Our present study revealed that the genotype AC of NLRP3 rs1539019 is related to a decreased risk of COPD in a Chinese Han population, a large-sample, multi-center, multi-ethnic study is needed to further confirm our study.
Collapse
Affiliation(s)
- Z-F Hou
- Department of Pulmonary and Critical Care Medicine, Sinopharm Tongmei General Hospital, Datong, China.
| | | | | | | | | | | |
Collapse
|
16
|
Liu LT, Tsai JJ, Chang K, Chen CH, Lin PC, Tsai CY, Tsai YY, Hsu MC, Chuang WL, Chang JM, Hwang SJ, Chong IW. Identification and Analysis of SARS-CoV-2 Alpha Variants in the Largest Taiwan COVID-19 Outbreak in 2021. Front Med (Lausanne) 2022; 9:869818. [PMID: 35547225 PMCID: PMC9081839 DOI: 10.3389/fmed.2022.869818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/23/2022] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is believed to have originated in Wuhan City, Hubei Province, China, in December 2019. Infection with this highly dangerous human-infecting coronavirus via inhalation of respiratory droplets from SARS-CoV-2 carriers results in coronavirus disease 2019 (COVID-19), which features clinical symptoms such as fever, dry cough, shortness of breath, and life-threatening pneumonia. Several COVID-19 waves arose in Taiwan from January 2020 to March 2021, with the largest outbreak ever having a high case fatality rate (CFR) (5.95%) between May and June 2021. In this study, we identified five 20I (alpha, V1)/B.1.1.7/GR SARS-CoV-2 (KMUH-3 to 7) lineage viruses from COVID-19 patients in this largest COVID-19 outbreak. Sequence placement analysis using the existing SARS-CoV-2 phylogenetic tree revealed that KMUH-3 originated from Japan and that KMUH-4 to KMUH-7 possibly originated via local transmission. Spike mutations M1237I and D614G were identified in KMUH-4 to KMUH-7 as well as in 43 other alpha/B.1.1.7 sequences of 48 alpha/B.1.1.7 sequences deposited in GISAID derived from clinical samples collected in Taiwan between 20 April and July. However, M1237I mutation was not observed in the other 12 alpha/B.1.1.7 sequences collected between 26 December 2020, and 12 April 2021. We conclude that the largest COVID-19 outbreak in Taiwan between May and June 2021 was initially caused by the alpha/B.1.1.7 variant harboring spike D614G + M1237I mutations, which was introduced to Taiwan by China Airlines cargo crew members. To our knowledge, this is the first documented COVID-19 outbreak caused by alpha/B.1.1.7 variant harboring spike M1237I mutation thus far. The largest COVID-19 outbreak in Taiwan resulted in 13,795 cases and 820 deaths, with a high CFR, at 5.95%, accounting for 80.90% of all cases and 96.47% of all deaths during the first 2 years. The high CFR caused by SARS-CoV-2 alpha variants in Taiwan can be attributable to comorbidities and low herd immunity. We also suggest that timely SARS-CoV-2 isolation and/or sequencing are of importance in real-time epidemiological investigations and in epidemic prevention. The impact of G614G + M1237I mutations in the spike gene on the SARS-CoV-2 virus spreading as well as on high CFR remains to be elucidated.
Collapse
Affiliation(s)
- Li-Teh Liu
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hong Chen
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Zhunan, Taiwan.,National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Ping-Chang Lin
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ching-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Yi Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Miao-Chen Hsu
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Hepatobiliary and Pancreatic, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jer-Ming Chang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shang-Jyh Hwang
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Inn-Wen Chong
- Department of Internal Medicine and Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pulmonary Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
17
|
Lin CY, Lo SH, Pan CY, Chang K. Dengue prevention and control strategies for overseas immigration in Kaohsiung City. Kaohsiung J Med Sci 2022; 38:810-811. [PMID: 35503505 DOI: 10.1002/kjm2.12553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Chun-Yu Lin
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan
| | - Shih-Hao Lo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Chao-Ying Pan
- Bureau of Public Health, Kaohsiung City Government, Kaohsiung, Taiwan
| | - Ko Chang
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| |
Collapse
|
18
|
George E, Flagg E, Chang K, Bai HX, Aerts HJ, Vallières M, Reardon DA, Huang RY. Radiomics-Based Machine Learning for Outcome Prediction in a Multicenter Phase II Study of Programmed Death-Ligand 1 Inhibition Immunotherapy for Glioblastoma. AJNR Am J Neuroradiol 2022; 43:675-681. [PMID: 35483906 PMCID: PMC9089247 DOI: 10.3174/ajnr.a7488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/17/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Imaging assessment of an immunotherapy response in glioblastoma is challenging due to overlap in the appearance of treatment-related changes with tumor progression. Our purpose was to determine whether MR imaging radiomics-based machine learning can predict progression-free survival and overall survival in patients with glioblastoma on programmed death-ligand 1 inhibition immunotherapy. MATERIALS AND METHODS Post hoc analysis was performed of a multicenter trial on the efficacy of durvalumab in glioblastoma (n = 113). Radiomics tumor features on pretreatment and first on-treatment time point MR imaging were extracted. The random survival forest algorithm was applied to clinical and radiomics features from pretreatment and first on-treatment MR imaging from a subset of trial sites (n = 60-74) to train a model to predict long overall survival and progression-free survival and was tested externally on data from the remaining sites (n = 29-43). Model performance was assessed using the concordance index and dynamic area under the curve from different time points. RESULTS The mean age was 55.2 (SD, 11.5) years, and 69% of patients were male. Pretreatment MR imaging features had a poor predictive value for overall survival and progression-free survival (concordance index = 0.472-0.524). First on-treatment MR imaging features had high predictive value for overall survival (concordance index = 0.692-0.750) and progression-free survival (concordance index = 0.680-0.715). CONCLUSIONS A radiomics-based machine learning model from first on-treatment MR imaging predicts survival in patients with glioblastoma on programmed death-ligand 1 inhibition immunotherapy.
Collapse
Affiliation(s)
- E George
- From the Department of Radiology and Biomedical Imaging (E.G.), University of California San Francisco, San Francisco, California
| | - E Flagg
- Department of Radiology (E.F., R.Y.H.), Brigham and Women's Hospital, Boston, Massachusetts
| | - K Chang
- Massachusetts Institute of Technology (K.C.), Cambridge, Massachusetts
| | - H X Bai
- Department of Diagnostic Imaging (H.X.B.), Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - H J Aerts
- Artificial Intelligence in Medicine Program (H.J.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Departments of Radiation Oncology and Radiology (H.J.A.), Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - M Vallières
- Department of Computer Science (M.V.), Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - D A Reardon
- Center for Neuro Oncology (D.A.R.), Dana-Farber Cancer Institute, Boston, Massachusetts
| | - R Y Huang
- Department of Radiology (E.F., R.Y.H.), Brigham and Women's Hospital, Boston, Massachusetts
| |
Collapse
|
19
|
Strand N, Wie C, Peck J, Maita M, Singh N, Dumbroff J, Tieppo Francio V, Murphy M, Chang K, Dickerson DM, Maloney J. Correction to: Small Fiber Neuropathy. Curr Pain Headache Rep 2022; 26:439. [PMID: 35460493 DOI: 10.1007/s11916-022-01050-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- N Strand
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA.
| | - C Wie
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - J Peck
- Performing Arts Medicine Department, Shenandoah University, Winchester, USA
| | - M Maita
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - N Singh
- OrthoAlabama Spine and Sports, Birmingham, AL, USA
| | - J Dumbroff
- Mount Sinai Morningside and West Department of Anesthiology, New York, NY, USA
| | - V Tieppo Francio
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - M Murphy
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - K Chang
- Department of Anesthiology and Critical Care, Emory University, Atlanta, GA, USA
| | - D M Dickerson
- NorthShore University Healthsystem, Evanston, IL, USA
- University of Chicago Medicine, Chicago, IL, USA
| | - J Maloney
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA
| |
Collapse
|
20
|
Strand N, Wie C, Peck J, Maita M, Singh N, Dumbroff J, Tieppo Francio V, Murphy M, Chang K, Dickerson DM, Maloney J. Small Fiber Neuropathy. Curr Pain Headache Rep 2022; 26:429-438. [PMID: 35384587 DOI: 10.1007/s11916-022-01044-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW This narrative review aims to summarize advances in the field of small fiber neuropathy made over the last decade, with emphasis on novel research highlighting the distinctive features of SFN. RECENT FINDINGS While the management of SFNs is ideally aimed at treating the underlying cause, most patients will require pain control via multiple, concurrent therapies. Herein, we highlight the most up-to-date information for diagnosis, medication management, interventional management, and novel therapies on the horizon. Despite the prevalence of small fiber neuropathies, there is no clear consensus on guidelines specific for the treatment of SFN. Despite the lack of specific guidelines for SFN treatment, the most recent general neuropathic pain guidelines are based on Cochrane studies and randomized controlled trials (RCTs) which have individually examined therapies used for the more commonly studied SFNs, such as painful diabetic neuropathy and HIV neuropathy. The recommendations from current guidelines are based on variables such as number needed to treat (NNT), safety, ease of use, and effect on quality of life.
Collapse
Affiliation(s)
- N Strand
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA.
| | - C Wie
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - J Peck
- Performing Arts Medicine Department, Shenandoah University, Winchester, USA
| | - M Maita
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - N Singh
- OrthoAlabama Spine and Sports, Birmingham, AL, USA
| | - J Dumbroff
- Mount Sinai Morningside and West Department of Anesthesiology, New York, NY, USA
| | - V Tieppo Francio
- Department of Rehabilitation on Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - M Murphy
- Department of Rehabilitation on Medicine, The University of Kansas Medical Center, Kansas City, KS, USA
| | - K Chang
- Department of Anesthesiology and Critical Care, Emory University, Atlanta, GA, USA
| | - D M Dickerson
- NorthShore University HealthSystem, Evanston, IL, USA
- University of Chicago Medicine, Chicago,, IL, USA
| | - J Maloney
- Division of Pain Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA
| |
Collapse
|
21
|
Lee CH, Chang K, Chen YM, Tsai JT, Chen YJ, Ho WH. Epidemic prediction of dengue fever based on vector compartment model and Markov chain Monte Carlo method. BMC Bioinformatics 2021; 22:118. [PMID: 34749630 PMCID: PMC8576924 DOI: 10.1186/s12859-021-04059-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/02/2021] [Indexed: 11/15/2022] Open
Abstract
Background Dengue epidemics is affected by vector-human interactive dynamics. Infectious disease prevention and control emphasize the timing intervention at the right diffusion phase. In such a way, control measures can be cost-effective, and epidemic incidents can be controlled before devastated consequence occurs. However, timing relations between a measurable signal and the onset of the pandemic are complex to be discovered, and the typical lag period regression is difficult to capture in these complex relations. This study investigates the dynamic diffusion pattern of the disease in terms of a probability distribution. We estimate the parameters of an epidemic compartment model with the cross-infection of patients and mosquitoes in various infection cycles. We comprehensively study the incorporated meteorological and mosquito factors that may affect the epidemic of dengue fever to predict dengue fever epidemics. Results We develop a dual-parameter estimation algorithm for a composite model of the partial differential equations for vector-susceptible-infectious-recovered with exogeneity compartment model, Markov chain Montel Carlo method, and boundary element method to evaluate the epidemic periodicity under the effect of environmental factors of dengue fever, given the time series data of 2000–2016 from three cities with a population of 4.7 million. The established computer model of “energy accumulation-delayed diffusion-epidemics” is proven to be effective to predict the future trend of reported and unreported infected incidents. Our artificial intelligent algorithm can inform the authority to cease the larvae at the highest vector infection time. We find that the estimated dengue report rate is about 20%, which is close to the number of official announcements, and the percentage of infected vectors increases exponentially yearly. We suggest that the executive authorities should seriously consider the accumulated effect among infected populations. This established epidemic prediction model of dengue fever can be used to simulate and evaluate the best time to prevent and control dengue fever. Conclusions Given our developed model, government epidemic prevention teams can apply this platform before they physically carry out the prevention work. The optimal suggestions from these models can be promptly accommodated when real-time data have been continuously corrected from clinics and related agents.
Collapse
Affiliation(s)
- Chien-Hung Lee
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Office of Institutional Research and Planning Section, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko Chang
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yao-Mei Chen
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Superintendent Office, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jinn-Tsong Tsai
- Department of Computer Science, National Pingtung University, Pingtung, Taiwan.,Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yenming J Chen
- Management School, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.
| | - Wen-Hsien Ho
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
22
|
Ramirez R, Earland N, Harris P, Gerndt S, Wahle B, Chang K, Chaudhuri A, Jose Z. Surgical Drain Fluid as a Novel Liquid Biopsy Analyte to Measure Postoperative Minimal Residual Disease in HPV+ Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Chang K, Khandpur N, Neri D, Touvier M, Huybrechts I, Millett C, Vamos EP. Childhood consumption of ultra-processed foods and adiposity trajectories: a UK birth cohort study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Worldwide consumption of ultra-processed foods (UPFs) is continued to rise. Growing evidence has linked higher consumption with elevated risks of obesity and non-communicable diseases in adults. However, the influence of UPFs on long-term adiposity trajectories have not been evaluated in children.
Methods
Prospective birth cohort data were obtained from the Avon Longitudinal Study of Parents and Children. English children with baseline dietary intakes from 3-day food diaries and repeated adiposity measures were followed up from ages 7-24 years. Outcomes included body mass index (BMI), weight, waist circumference (WC), fat mass index (FMI) and body fat percentage. UPFs were identified using the NOVA food classification. Child's consumption of UPFs was derived as a percentage of its weight contribution (gram per day) in the total diet and categorised into quintiles. Longitudinal associations were assessed using linear growth curve models and adjusted for study covariates.
Results
Of the 9025 children followed up over a median (IQR) of 10.2 (5.2-16.4) years. Trajectories of BMI, FMI, weight and WC increased by an additional 0.06 (95% CI, 0.04-0.08) kg/m2, 0.03 (0.01-0.05) kg/m2, 0.20 (0.11-0.28) kg and 0.17 (0.11-0.22) cm per year among those in the highest (vs. lowest) quintile of UPF consumption. Evidence of dose-response relationships were consistently observed with those in the two highest quintiles of UPF consumption showing significantly more rapid progression of BMI, weight, and WC.
Conclusions
Radical and effective public health actions that reduce children's exposure and consumption of UPFs are urgently needed to address the obesity epidemic in England and internationally.
Funding: CM and EV are funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Grant Reference Number PD-SPH-2015. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Key messages
Children with highest (vs. lowest) quintile of ultra-processed food consumption had more rapid regression of BMI, FMI, weight and waist circumference from ages 7-24 years. Dose-response relationships were consistently observed in the two highest quintile of ultra-processed food consumption showing more rapid progression of BMI, weight and waist circumference.
Collapse
Affiliation(s)
- K Chang
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - N Khandpur
- Department of Nutrition, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - D Neri
- Department of Nutrition, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - M Touvier
- Sorbonne Paris Nord University, Inserm U1153, Paris, France
| | - I Huybrechts
- Nutrition and Metabolism Branch, IARC, Lyon, France
| | - C Millett
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - EP Vamos
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| |
Collapse
|
24
|
Yang L, Darasavath C, Chang K, Vilay V, Sengduangphachanh A, Adsamouth A, Vongsouvath M, Keolouangkhot V, Robinson MT. Cluster of Angiostrongyliasis Cases Following Consumption of Raw Monitor Lizard in the Lao People's Democratic Republic and Review of the Literature. Trop Med Infect Dis 2021; 6:tropicalmed6030107. [PMID: 34206193 PMCID: PMC8293387 DOI: 10.3390/tropicalmed6030107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022] Open
Abstract
Angiostrongyliasis in humans causes a range of symptoms from mild headache and myalgia to neurological complications, coma and death. Infection is caused by the consumption of raw or undercooked intermediate or paratenic hosts infected with Angiostrongylus cantonensis or via contaminated vegetables or water. We describe a cluster of cases involved in the shared meal of wild raw monitor lizard in the Lao PDR. Seven males, aged 22–36 years, reported headaches, abdominal pain, arthralgia, myalgia, nausea/vomiting, diarrhea, neurological effects and loss of appetite. Five were admitted to hospital. The final diagnosis was made by clinical presentation and case history, and positive A. cantonensis PCR for two cases. All hospitalized patients recovered fully following supportive treatment. The remaining two individuals sought local home remedies and made full recovery. Whilst most published reports concern infections via consumption of molluscs, few detailed reports exist on infections that result from the consumption of reptiles and there exists little awareness in Lao PDR. This case cluster, which originates from a single meal, highlights the potential public health risk of the consumption of raw and wild-caught meat in Lao PDR and the Southeast Asia region. Without specific diagnostics, clinical history and the consideration of recent food consumption are important when evaluating patients.
Collapse
Affiliation(s)
- Leeyounjera Yang
- Adult Infectious Disease Ward, Mahosot Hospital, Vientiane 01000, Laos; (L.Y.); (C.D.); (K.C.); (V.K.)
| | - Chirapha Darasavath
- Adult Infectious Disease Ward, Mahosot Hospital, Vientiane 01000, Laos; (L.Y.); (C.D.); (K.C.); (V.K.)
| | - Ko Chang
- Adult Infectious Disease Ward, Mahosot Hospital, Vientiane 01000, Laos; (L.Y.); (C.D.); (K.C.); (V.K.)
| | - Vilayvanh Vilay
- Infectious Disease Ward, 103 Military Hospital, Vientiane 01000, Laos;
| | | | - Aphaphone Adsamouth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane 01000, Laos;
| | - Manivanh Vongsouvath
- Microbiology Laboratory, Mahosot Hospital, Vientiane 01000, Laos; (A.S.); (M.V.)
| | - Valy Keolouangkhot
- Adult Infectious Disease Ward, Mahosot Hospital, Vientiane 01000, Laos; (L.Y.); (C.D.); (K.C.); (V.K.)
| | - Matthew T. Robinson
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane 01000, Laos;
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK
- Correspondence:
| |
Collapse
|
25
|
Xin JF, Sun YG, Xia S, Chang K, Zhu Y, Liu X, An R, Su WC, Shen WB. [Clinical features of primary isolated chylopericardium: a retrospective review study]. Zhonghua Wai Ke Za Zhi 2021; 59:507-512. [PMID: 34102736 DOI: 10.3760/cma.j.cn112139-20200724-00577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine the clinical characteristics and abnormal reflux branches of primary isolated chylopericardium. Methods: Totally 43 patients with primary isolated chylopericardium at Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital,Capital Medical University from June 2007 to January 2018 were recruited in this study. There were 21 males and 22 females, aging (23.0±15.9) years (range: 2 to 57 years). The levels of triglyceride, total cholesterol, total protein and albumin in pericardial effusion and blood were compared by paired-t test, and the characteristics of lymphatic system in direct lymphangiography and postoperative CT were analyzed. Results: Pericardial effusion was mainly milky white and monocytes, and 95.3%(41/43) were positive for Rivalta test. The level of triglyceride in pericardial effusion was significantly higher than that of blood ((9.67±5.11) mmol/L vs. (1.28±0.89) mmol/L, t=10.557, P<0.01), and the levels of total cholesterol ((2.19±0.52) mmol/L vs. (4.12±1.06) mmol/L, t=-3.732, P<0.01), total protein ((61.25±16.17) g/L vs. (68.26±8.30) g/L, t=-2.958, P=0.005) and albumin ((36.63±7.06) g/L vs. (42.32±4.73) g/L, t=-5.747, P<0.01) were significantly lower than that of blood. In the direct lymphangiography, the imaging of iliac and retroperitoneal lymphatics showed dilated or tortuous in 90.7% (39/43), the thoracoabdominal segment of thoracic duct showed dilation in 46.5% (20/43), and cervical thoracic duct imaging showed dilation in 44.2% (19/43) and stenosis in 55.8% (24/43). The image of lipiodol flowing into the vein showed obstruction at the venous angle. There were 60.5%(26/43) of the patients with lipiodol reflux through the bronchomediastinal trunk (type Ⅰ), 11.6%(5/43) with lipiodol diffusion to the pericardium through the abnormal pathway from the thoracic segment of the thoracic duct (type Ⅱ), while no communication pathway between the thoracic duct and the pericardial cavity (type Ⅲ) found in 27.9%(12/43). CT images obtained after the direct lymphangiography showed 34.9%(15/43) had abnormal distribution of lipiodol in pericardium, mediastinal lymph nodes and lung hilar lymph nodes, 46.5%(20/43) in mediastinal lymph nodes and lung hilar lymph nodes, 14.0%(6/43) only mediastinal lymph nodes, 4.6%(2/43) had no lipiodol in the above areas. Conclusions: Pericardial effusion compared with same period blood, has higher triglyceride, lower total cholesterol, total protein and albumin. The obstruction of the cervical segment of the thoracic duct and the formation of abnormal reflux branches would be corelative to primary isolated chylopericardium.
Collapse
Affiliation(s)
- J F Xin
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y G Sun
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - S Xia
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - K Chang
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Y Zhu
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - X Liu
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - R An
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - W C Su
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - W B Shen
- Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
26
|
Lu Y, Hong C, Chang K, Lee C. 618 Glucose transporter 1 enhances glycolysis, oxidative stress, and fibroblast proliferation in keloid. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
27
|
Chang K, Huang CH, Chen TC, Lin CY, Lu PL, Chen YH. Clinical characteristics and risk factors for intracranial hemorrhage or infarction in patients with dengue. J Microbiol Immunol Infect 2021; 54:885-892. [PMID: 33840603 DOI: 10.1016/j.jmii.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 02/15/2021] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Intracranial hemorrhage (ICH) or infarction in dengue cases is rare but very challenging for clinicians. We report these uncommon complications of dengue patients and focused on the significant factors associated with ICH or infarction in dengue patients. METHODS This investigation was a retrospective study of 182 adult dengue patients who received brain computed tomography at three Taiwan hospitals during the 2014 and 2015 dengue outbreaks. This included 13 hemorrhage cases, 26 infarction cases and 143 cases without brain infarction or hemorrhage. RESULTS Among them, 13 (7.14%) suffered from ICH (6 had subdural hemorrhage, 3 had subarachnoid hemorrhage, 1 had subdural and subarachnoid hemorrhage, and 3 had intracerebral hemorrhage) and 26 (14.3%) had brain infarction. The overall mortality rate was 4/13 (30.8%) in the ICH group and 3/26 (11.5%) in the infarction group. The significant variables from the univariate analysis, including difference between 2014 and 2015, age, history of cerebrovascular accident, bone pain, arthralgia, dizziness, altered consciousness, and a higher Charlson comorbidity score. Multivariate analysis revealed that significant risk factors for ICH/infarction in dengue cases were the year of occurrence, 2014 vs. 2015 (p < 0.0001, OR = 25.027, 95% CI = 8.205-76.336), Charlson score >4 (p = 0.01, OR = 3.764, 95% CI = 1.364-10.386) and altered consciousness (p < 0.0001, OR = 6.3, 95% CI = 2.242-17.7). The factors physicians should notice in dengue endemic regions for brain infarction or ICH include altered consciousness and a Charlson score >4, especially in the year that a higher frequency of infarction/ICH was observed.
Collapse
Affiliation(s)
- Ko Chang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chung-Hao Huang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| | - Tun-Chieh Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chun-Yu Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yen-Hsu Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, Graduate Institute of Medicine, Sepsis Research Institute, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
| |
Collapse
|
28
|
Mayxay M, Douangdala P, Vilayhong C, Phommasone K, Chansamouth V, Vongsouvath M, Rattanavong S, Chang K, Sengvilaipaseuth O, Chanthongthip A, Thongpaseuth S, Newton PN, Dubot-Pérès A. Outcome of Japanese Encephalitis Virus (JEV) Infection in Pediatric and Adult Patients at Mahosot Hospital, Vientiane, Lao PDR. Am J Trop Med Hyg 2020; 104:567-575. [PMID: 33350379 PMCID: PMC7866311 DOI: 10.4269/ajtmh.20-0581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/17/2020] [Indexed: 11/07/2022] Open
Abstract
Although Japanese encephalitis virus (JEV) infection is an important cause of acute febrile illness in Lao PDR (Laos), patient outcome has not been evaluated. We prospectively followed up 123 JEV-infected patients (70 children ≤ 15 years and 53 adults ≥ 15 years) admitted at Mahosot Hospital, Vientiane, from 2003 to 2013. Japanese encephalitis virus infection was diagnosed by the detection of anti-JEV IgM in cerebrospinal fluid and/or IgM seroconversion. Neurological sequelae were assessed using the Liverpool Outcome Score (LOS), total (maximum score = 75), and final (maximum score = 5). The median (interquartile range [IQR]) age of the patients was 12.0 (7.5-18.8) years, and 57% were male. The median (IQR) duration of patients' follow-up was 4.5 (3.2-7.3) years. Of all patients, 10/123 (8.1%) died during hospitalization, and 13/123 (10.6%) died at home after discharge, giving a mortality of 18.7% (23/123) (33 [26.8%] patients were lost to follow-up). The frequency of neurological sequelae at the last follow-up was 61.2% (48.4% in adults and 69.4% in children, P = 0.135). The proportion of patients with severe and moderate functional impairment at the last follow-up was significantly higher in children (25%) than adults (6.5%), P = 0.042. Half of the patients who were still alive at the last follow-up (67) and for whom LOS data were available (22) had improvements in their total and final LOS between discharge and the last follow-up. The total and final LOS at discharge were not significantly different between children and adults, but total LOS at the last follow-up was significantly higher in adults than children (median [IQR]: 74.5 [73-75] versus 73.0 [73-75], P = 0.019).
Collapse
Affiliation(s)
- Mayfong Mayxay
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Laos.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | | | - Chanthala Vilayhong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Koukeo Phommasone
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Vilada Chansamouth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Sayaphet Rattanavong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Ko Chang
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Onanong Sengvilaipaseuth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Anisone Chanthongthip
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Soulignasack Thongpaseuth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Paul N Newton
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Audrey Dubot-Pérès
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| |
Collapse
|
29
|
Li MD, Lang M, Deng F, Chang K, Buch K, Rincon S, Mehan WA, Leslie-Mazwi TM, Kalpathy-Cramer J. Analysis of Stroke Detection during the COVID-19 Pandemic Using Natural Language Processing of Radiology Reports. AJNR Am J Neuroradiol 2020; 42:429-434. [PMID: 33334851 DOI: 10.3174/ajnr.a6961] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has led to decreases in neuroimaging volume. Our aim was to quantify the change in acute or subacute ischemic strokes detected on CT or MR imaging during the pandemic using natural language processing of radiology reports. MATERIALS AND METHODS We retrospectively analyzed 32,555 radiology reports from brain CTs and MRIs from a comprehensive stroke center, performed from March 1 to April 30 each year from 2017 to 2020, involving 20,414 unique patients. To detect acute or subacute ischemic stroke in free-text reports, we trained a random forest natural language processing classifier using 1987 randomly sampled radiology reports with manual annotation. Natural language processing classifier generalizability was evaluated using 1974 imaging reports from an external dataset. RESULTS The natural language processing classifier achieved a 5-fold cross-validation classification accuracy of 0.97 and an F1 score of 0.74, with a slight underestimation (-5%) of actual numbers of acute or subacute ischemic strokes in cross-validation. Importantly, cross-validation performance stratified by year was similar. Applying the classifier to the complete study cohort, we found an estimated 24% decrease in patients with acute or subacute ischemic strokes reported on CT or MR imaging from March to April 2020 compared with the average from those months in 2017-2019. Among patients with stroke-related order indications, the estimated proportion who underwent neuroimaging with acute or subacute ischemic stroke detection significantly increased from 16% during 2017-2019 to 21% in 2020 (P = .01). The natural language processing classifier performed worse on external data. CONCLUSIONS Acute or subacute ischemic stroke cases detected by neuroimaging decreased during the COVID-19 pandemic, though a higher proportion of studies ordered for stroke were positive for acute or subacute ischemic strokes. Natural language processing approaches can help automatically track acute or subacute ischemic stroke numbers for epidemiologic studies, though local classifier training is important due to radiologist reporting style differences.
Collapse
Affiliation(s)
- M D Li
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| | - M Lang
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| | - F Deng
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| | - K Chang
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| | - K Buch
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| | - S Rincon
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| | - W A Mehan
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| | - T M Leslie-Mazwi
- Neurology and Neurosurgery (T.M.L.-M.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - J Kalpathy-Cramer
- From the Departments of Radiology (M.D.L., M.L., F.D., K.C., K.B., S.R., W.A.M., J.K.-C.)
| |
Collapse
|
30
|
Kudsi OY, Chang K, Bou-Ayash N. Robotic approach to delayed anastomotic leakage after ileocaecectomy for a neuroendocrine tumour - a video vignette. Colorectal Dis 2020; 22:1470. [PMID: 32372480 DOI: 10.1111/codi.15108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/19/2020] [Indexed: 02/08/2023]
Affiliation(s)
- O Y Kudsi
- Good Samaritan Medical Center, Brockton, Massachusetts, USA.,Tufts University School of Medicine, Brockton, Massachusetts, USA
| | - K Chang
- Good Samaritan Medical Center, Brockton, Massachusetts, USA
| | - N Bou-Ayash
- Good Samaritan Medical Center, Brockton, Massachusetts, USA
| |
Collapse
|
31
|
Chang K, Chen H, Chen S, Kuo C. Infection control strategies of patient diversion in response to
COVID
‐19. Kaohsiung J Med Sci 2020; 36:765-767. [PMID: 32649789 PMCID: PMC7405221 DOI: 10.1002/kjm2.12270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ko Chang
- Department of Internal Medicine Kaohsiung Municipal Siaogang Hospital Kaohsiung Taiwan
- Faculty of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
| | - Huang‐Chi Chen
- Department of Internal Medicine Kaohsiung Municipal Siaogang Hospital Kaohsiung Taiwan
| | - Szu‐Chia Chen
- Department of Internal Medicine Kaohsiung Municipal Siaogang Hospital Kaohsiung Taiwan
- Faculty of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
| | - Chao‐Hung Kuo
- Department of Internal Medicine Kaohsiung Municipal Siaogang Hospital Kaohsiung Taiwan
- Faculty of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
| |
Collapse
|
32
|
Parnham J, Millett C, Chang K, von Hinke S, Pearson-Stuttard J, Vamos EP. The Healthy Start scheme and its association with food expenditure in low-income families in the UK. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Healthy Start programme is a statutory benefit-in-kind in the United Kingdom (UK) which aims to enable low-income families to purchase fruit, vegetables, cow's milk and infant formula through the provision of vouchers. The scheme was introduced in 2006, however, the effect on food purchasing in participating households has not been evaluated within an eligible population. This study aimed to determine whether participation in the Healthy Start (HS) scheme is associated with differences in food purchasing in a representative sample of households in the United Kingdom.
Methods
Cross-sectional analysis of the Living Costs and Food Survey dataset (2010-2017). All households with a child (0-3 years) or pregnant woman were included in the analysis (n = 4,869). Multivariable quantile regression was used to compare the expenditure and quantity of fruit and vegetable, infant formula and total food purchases between Healthy Start participating, eligible non-participating, nearly-eligible and ineligible households.
Results
54% (n = 475) of eligible households participated in Healthy Start. After accounting for covariates, no significant difference was found in the quantity or expenditure of fruit and vegetable purchases between Healthy Start participating and non-participating households. Fruit and vegetable expenditure (£/week) was found to be higher in nearly eligible (β1.60; 95% CI 0.79, 2.41) and ineligible households (β2.56; 95% CI 1.77, 3.35) compared to Healthy Start eligible households.
Conclusions
The present study did not demonstrate significant differences in the fruit and vegetable expenditure of HS participating and non-participating households. The analysis demonstrates that inequalities in fruit and vegetable purchasing persists in the UK. Improved participation and increased voucher value may be needed to promote well-being and counteract the harmful effect of poverty on fruit and vegetables purchasing.
Key messages
The study found no evidence of different food purchases between Healthy Start participating and non-participating households. Increased voucher value may be needed to counteract food-price inflation. The paper reflected persistent socioeconomic inequalities in the UK, indicating the Healthy Start scheme does not sufficiently counteract the harmful effects of poverty on food purchasing.
Collapse
Affiliation(s)
- J Parnham
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - C Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - K Chang
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - S von Hinke
- Department of Economics, University of Bristol, Bristol, UK
- Erasmus University, Rotterdam, Netherlands
- Institute for Fiscal Studies, London, UK
| | - J Pearson-Stuttard
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - E P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
33
|
Kudsi OY, Chang K, Bou‐Ayash N. Robotic low anterior resection for a distal sigmoid colon cancer during the COVID-19 pandemic- a video vignette. Colorectal Dis 2020; 22:1031. [PMID: 32790219 PMCID: PMC7436878 DOI: 10.1111/codi.15310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/23/2020] [Indexed: 02/08/2023]
Affiliation(s)
- O. Y. Kudsi
- Good Samaritan Medical CenterBrocktonMassachusettsUSA,Tufts University School of MedicineBostonMassachusettsUSA
| | - K. Chang
- Good Samaritan Medical CenterBrocktonMassachusettsUSA
| | - N. Bou‐Ayash
- Good Samaritan Medical CenterBrocktonMassachusettsUSA
| |
Collapse
|
34
|
Chang K, Pan C, Lu P. Sentinel surveillance at airports: Experience of dengue and COVID-19 prevention in Taiwan. Kaohsiung J Med Sci 2020; 36:665-666. [PMID: 32668030 PMCID: PMC7404355 DOI: 10.1002/kjm2.12265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ko Chang
- Department of Internal MedicineKaohsiung Municipal Siaogang HospitalKaohsiungTaiwan
- College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
| | - Chao‐Ying Pan
- Bureau of Public HealthKaohsiung City GovernmentKaohsiungTaiwan
| | - Po‐Liang Lu
- College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
- Department of Internal MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
| |
Collapse
|
35
|
Liang PC, Chen KY, Huang CH, Chang K, Lu PL, Yeh ML, Huang CF, Huang CI, Hsieh MH, Dai CY, Lin ZY, Chen SC, Chuang WL, Chen YH, Huang JF, Yu ML. Viral Interference Between Dengue Virus and Hepatitis C Virus Infections. Open Forum Infect Dis 2020; 7:ofaa272. [PMID: 32875000 PMCID: PMC7452371 DOI: 10.1093/ofid/ofaa272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/26/2020] [Indexed: 12/03/2022] Open
Abstract
Both dengue virus (DENV) and hepatitis C virus (HCV) belong to the Flaviviridae family and could induce hepatitis. We aimed to investigate the interference between them. In total, 515 patients confirmed with dengue fever (DF) were enrolled. Thirty-two patients (6.21%) were seropositive for anti-HCV; 12 of 32 anti-HCV-positive patients had detectable HCV-RNA at presentation of DF. The proportion of dengue hemorrhagic fever was comparable between patients with or without anti-HCV and between those with or without HCV-RNA. Eleven of 32 patients received HCV-RNA testing during a median interval of 23 months after DF, which revealed significantly increased HCV-RNA levels (5.43 ± 0.77 vs 3.09 ± 1.24 log IU/mL, follow-up vs acute-DF phase; P = .003). Four of 11 patients with baseline HCV-RNA values before DF demonstrated a nadir viremia during acute DF. We also included age-, sex-, and follow-up duration–matched HCV-monoinfected patients as controls; higher delta HCV-RNA changes were demonstrated in patients with DF than in controls during the follow-up period (2.34 ± 1.15 vs –0.27 ± 0.76 log IU/mL; P < .001). Further in vitro experiments showed that HCV nonstructural protein 5A was downregulated in Con1 HCV replicon cells infected by DENV1. These clinical and experimental findings suggested possible viral interference in DENV/HCV. However, HCV viremia did not affect the disease outcomes of DF.
Collapse
Affiliation(s)
- Po-Cheng Liang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kuan-Yu Chen
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Hao Huang
- Infectious Diseases Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ko Chang
- Infectious Diseases Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Infectious Diseases Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-I Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng-Hsuan Hsieh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Zu-Yau Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shinn-Chern Chen
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsu Chen
- Infectious Diseases Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Centre for Liquid Biopsy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Internal Medicine and Hepatitis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Center For Intelligent Drug Systems and Smart Bio-devices (IDS2B) and Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan
| |
Collapse
|
36
|
Lee CY, Wu PH, Tsai JJ, Chen TC, Chang K, Lu PL. Cascade Analysis of Anonymous Voluntary HIV Counseling and Testing Among Patients with HIV Infection in Taiwan. AIDS Patient Care STDS 2020; 34:303-315. [PMID: 32639210 DOI: 10.1089/apc.2020.0044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Despite successful implementation of anonymous voluntary human immunodeficiency virus (HIV) counseling and testing (aVCT) in Taiwan, the trend of late HIV presentation in sexually active populations has remained unchanged in Taiwan over the past decade. We evaluated the effect and acceptance of an aVCT cascade program among Taiwanese individuals by surveying 572 participants (mean age: 29.6 years; 99.3% men; and 79.5% same-sex sexual contact) diagnosed with HIV/acquired immune deficiency syndrome (AIDS) from 2015 to 2019. We designed a five-stage continuum based on acceptance of the program before HIV diagnosis: at high risk of HIV infection (Stage 1), heard of aVCT (Stage 2), wants to receive aVCT (Stage 3), has received aVCT (Stage 4), and regularly receives aVCT (Stage 5). Four domains established from exploratory factor analysis described reasons for inability to reach the next aVCT stage: low perceived HIV risk, fear of testing positive because of discrimination/stigmatization, and structural barriers to aVCT. Regular aVCT (vs. never receiving aVCT) protected against AIDS on diagnosis (p < 0.001). There were no significant differences in program acceptance across 2015-2019. However, uptake reduced markedly across the program; the largest reduction (37.4.0-61.0%) occurred from Stage 4 to Stage 5. Fear of testing positive because of discrimination/stigmatization was the main reason for not proceeding to the next aVCT stage. Although the findings indicate the benefits of regular aVCT for early HIV diagnosis, additional strategies to reduce fear of negative social consequences of HIV infection are prioritized to optimize aVCT in Taiwan.
Collapse
Affiliation(s)
- Chun-Yuan Lee
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung City, Taiwan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Pei-Hua Wu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Jih-Jin Tsai
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Tun-Chieh Chen
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Infection Control Office, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan
| | - Ko Chang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung City, Taiwan
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Po-Liang Lu
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| |
Collapse
|
37
|
Zhou H, Hu R, Tang O, Hu C, Tang L, Chang K, Shen Q, Wu J, Zou B, Xiao B, Boxerman J, Chen W, Huang RY, Yang L, Bai HX, Zhu C. Automatic Machine Learning to Differentiate Pediatric Posterior Fossa Tumors on Routine MR Imaging. AJNR Am J Neuroradiol 2020; 41:1279-1285. [PMID: 32661052 PMCID: PMC7357647 DOI: 10.3174/ajnr.a6621] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 04/30/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Differentiating the types of pediatric posterior fossa tumors on routine imaging may help in preoperative evaluation and guide surgical resection planning. However, qualitative radiologic MR imaging review has limited performance. This study aimed to compare different machine learning approaches to classify pediatric posterior fossa tumors on routine MR imaging. MATERIALS AND METHODS This retrospective study included preoperative MR imaging of 288 patients with pediatric posterior fossa tumors, including medulloblastoma (n = 111), ependymoma (n = 70), and pilocytic astrocytoma (n = 107). Radiomics features were extracted from T2-weighted images, contrast-enhanced T1-weighted images, and ADC maps. Models generated by standard manual optimization by a machine learning expert were compared with automatic machine learning via the Tree-Based Pipeline Optimization Tool for performance evaluation. RESULTS For 3-way classification, the radiomics model by automatic machine learning with the Tree-Based Pipeline Optimization Tool achieved a test micro-averaged area under the curve of 0.91 with an accuracy of 0.83, while the most optimized model based on the feature-selection method χ2 score and the Generalized Linear Model classifier achieved a test micro-averaged area under the curve of 0.92 with an accuracy of 0.74. Tree-Based Pipeline Optimization Tool models achieved significantly higher accuracy than average qualitative expert MR imaging review (0.83 versus 0.54, P < .001). For binary classification, Tree-Based Pipeline Optimization Tool models achieved an area under the curve of 0.94 with an accuracy of 0.85 for medulloblastoma versus nonmedulloblastoma, an area under the curve of 0.84 with an accuracy of 0.80 for ependymoma versus nonependymoma, and an area under the curve of 0.94 with an accuracy of 0.88 for pilocytic astrocytoma versus non-pilocytic astrocytoma. CONCLUSIONS Automatic machine learning based on routine MR imaging classified pediatric posterior fossa tumors with high accuracy compared with manual expert pipeline optimization and qualitative expert MR imaging review.
Collapse
Affiliation(s)
- H Zhou
- Department of Neurology (H.Z., L.T., B.X.), Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - R Hu
- From the School of Computer Science and Engineering (R.H., B.Z., C.Z.)
| | - O Tang
- Warren Alpert Medical School, Brown University (O.T.), Providence, Rhode Island
| | - C Hu
- Department of Neurology (C.H.), Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - L Tang
- Department of Neurology (H.Z., L.T., B.X.), Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - K Chang
- Department of Radiology (K.C.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Q Shen
- Radiology (Q.S., J.W.), Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - J Wu
- Radiology (Q.S., J.W.), Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - B Zou
- From the School of Computer Science and Engineering (R.H., B.Z., C.Z.)
| | - B Xiao
- Department of Neurology (H.Z., L.T., B.X.), Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - J Boxerman
- Department of Diagnostic Imaging (J.B., H.X.B.), Rhode Island Hospital
| | - W Chen
- Department of Pathology (W.C.), Hunan Children's Hospital, Changsha, Hunan, China
| | - R Y Huang
- Department of Radiology (R.Y.H.), Brigham and Women's Hospital, Boston, Massachusetts
| | - L Yang
- Departments of Neurology (L.Y.)
| | - H X Bai
- Department of Diagnostic Imaging (J.B., H.X.B.), Rhode Island Hospital
| | - C Zhu
- From the School of Computer Science and Engineering (R.H., B.Z., C.Z.)
- College of Literature and Journalism (C.Z.), Central South University, Changsha, Hunan, China
- Mobile Health Ministry of Education-China Mobile Joint Laboratory (C.Z.), China
| |
Collapse
|
38
|
Chang K, Rattanavong S, Mayxay M, Keoluangkhot V, Davong V, Vongsouvath M, Luangraj M, Simpson AJH, Newton PN, Dance DAB. Bacteremia Caused by Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Vientiane, Lao PDR: A 5-Year Study. Am J Trop Med Hyg 2020; 102:1137-1143. [PMID: 32157990 PMCID: PMC7204562 DOI: 10.4269/ajtmh.19-0304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Although there has been an increasing incidence of bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) across South East Asia, there are sparse data from the Lao PDR, where laboratory capacity for antimicrobial resistance surveillance is limited. We, therefore, retrospectively reviewed bacteremia caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae between 2010 and 2014 at Mahosot Hospital, Vientiane, Lao PDR. Clinical and laboratory data relating to all episodes of ESBL-E bacteremia were reviewed over the 5-year period and compared with non-ESBL-E bacteremia. Blood cultures positive for E. coli or K. pneumoniae were identified retrospectively from laboratory records. Clinical and laboratory data were extracted from research databases and case notes and analyzed using STATA. Between 2010 and 2014, we identified 360 patients with E. coli (n = 249) or K. pneumoniae (n = 111) bacteremia, representing 34.8% of all patients with clinically significant bacteremia. Seventy-two (20%) isolates produced ESBL; E. coli accounted for 15.3% (55/360) and K. pneumoniae for 4.7% (17/360), respectively. The incidence of ESBL-producing E. coli bacteremia rose during the study period. By multiple logistic analysis, reported antibiotic use in the previous week was significantly associated with ESBL positivity (P < 0.001, odds ratio 3.89). Although multiresistant, most ESBL-producing E. coli and K. pneumoniae remained susceptible to meropenem (65/65; 100%) and amikacin (64/65; 98.5%). We demonstrated an alarming increase in the incidence of ESBL-E as a cause of bacteremia in Vientiane during the study period. This has implications for empiric therapy of sepsis in Laos, and ongoing surveillance is essential.
Collapse
Affiliation(s)
- Ko Chang
- Adult Infectious Diseases Ward, Mahosot Hospital, Vientiane, Laos
| | - Sayaphet Rattanavong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Mayfong Mayxay
- Institute of Research and Education Development (IRED), University of Health Sciences, Vientiane, Laos.,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | | | - Viengmon Davong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Manophab Luangraj
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Andrew J H Simpson
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - Paul N Newton
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| | - David A B Dance
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
| |
Collapse
|
39
|
Chen HC, Chang K, Chen SC. Infection control strategies of medical institutions in response to COVID-19. Kaohsiung J Med Sci 2020; 36:565-567. [PMID: 32533625 PMCID: PMC7323432 DOI: 10.1002/kjm2.12244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 01/20/2023] Open
Affiliation(s)
- Huang-Chi Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Ko Chang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
40
|
Chen SC, Chang K, Kuo CH. Emergency department infection control strategies in response to COVID-19. Kaohsiung J Med Sci 2020; 36:568-569. [PMID: 32492263 PMCID: PMC7300690 DOI: 10.1002/kjm2.12243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko Chang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
41
|
Chiu HH, Juan HL, Lu PL, Chang K. A graveyard keeper with severe hyperbilirubinemia caused by leptospirosis. J Microbiol Immunol Infect 2020; 54:536-537. [PMID: 32518036 DOI: 10.1016/j.jmii.2020.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Huei-Hsuan Chiu
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Huai-Lei Juan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Po-Liang Lu
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| | - Ko Chang
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
| |
Collapse
|
42
|
Kudsi OY, Gokcal F, Bou-Ayash N, Crawford AS, Chung SK, Chang K, Litwin D. Learning curve in robotic transabdominal preperitoneal (rTAPP) ventral hernia repair: a cumulative sum (CUSUM) analysis. Hernia 2020; 25:755-764. [PMID: 32495055 PMCID: PMC7268975 DOI: 10.1007/s10029-020-02228-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/25/2020] [Indexed: 11/30/2022]
Abstract
Purpose rTAPP-VHR is a novel technique which may be added to a surgeon’s armamentarium. We aim to evaluate the robotic transabdominal preperitoneal ventral hernia repair (rTAPP-VHR) learning curve based on operative times while accounting for peritoneal flap integrity. Methods We performed a retrospective analysis of a database collected over a 7-year period. Patients with primary ventral hernias were included and a cumulative sum analysis(CUSUM) was used to create learning curves for three subsets of operative times. A risk-adjusted CUSUM (RA-CUSUM) accounted for repair quality based on peritoneal flap completeness. The flap was considered as incomplete when peritoneal gaps were unable to be closed. Results 105 patients undergoing rTAPP-VHR were included. Learning curves were created for skin-to-skin, console, and off-console times. Patients were divided into three phases. In terms of skin-to-skin times, both phase 2&3 had a mean 11 min shorter than that of phase 1 (p = 0.0498, p = 0.0245, respectively), with a steady decrease after forty-six cases. An incomplete peritoneal flap was noted in 25/36 patients in phase 1, as compared to 5/24 and 5/45 patients in phase 2&3, respectively. When risk-adjusted for peritoneal flap completeness, gradually decreasing skin-to-skin times were observed after sixty-one cases. In terms of off-console times, the mean across three phases was 14 min, with marked improvement after forty-three cases. Conclusions Forty-six cases were needed to achieve steadily decreasing operative times. We can assume that ensuring good-quality repairs, through maintenance of peritoneal flap integrity, was gradually improved after sixty-one cases. Moreover, familiarization with port placements and robotic docking was accomplished after forty-three cases.
Collapse
Affiliation(s)
- O Y Kudsi
- Department of Surgery, Good Samaritan Medical Center, Tufts University School of Medicine, One Pearl Street, Brockton, MA, 02301, USA.
| | - F Gokcal
- Department of Surgery, Good Samaritan Medical Center, Tufts University School of Medicine, One Pearl Street, Brockton, MA, 02301, USA
| | - N Bou-Ayash
- Department of Surgery, Good Samaritan Medical Center, Tufts University School of Medicine, One Pearl Street, Brockton, MA, 02301, USA
| | - A S Crawford
- Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - S K Chung
- Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - K Chang
- Department of Surgery, Good Samaritan Medical Center, Tufts University School of Medicine, One Pearl Street, Brockton, MA, 02301, USA
| | - D Litwin
- Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|
43
|
Hwang B, Kim J, Chang K, Ahn Y, Byun S, Kim H, Bu S. Impact of Anemia on Long-Term Clinical Outcome in Patients with Left Ventricular Systolic Dysfunction after Acute Myocardial Infarction. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
44
|
Wang R, Chang K, Zhou H, Wu J, Cohan G, Jayaraman M, Huang R, Boxerman J, Yang L, Hui F, Woo J, Bai H. Abstract No. 720 Identification of irreversibly damaged brain tissue on computed tomography perfusion using convolutional neural network to assist selection for mechanical thrombectomy in ischemic stroke patients. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
45
|
Daye D, Tabari A, Kim H, Chang K, Brito Orama S, Bai H, Kalva S, Gee M, Kalpathy-Cramer J, Wehrenberg-Klee E, Uppot R. 3:36 PM Abstract No. 36 Machine learning-based radiomic features on pre-ablation magnetic resonance imaging as predictors of pathologic response in patients with hepatocellular carcinoma listed for hepatic transplant. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
46
|
Huang HY, Lu PL, Wang YL, Chen TC, Chang K, Lin SY. Usefulness of EQUAL Candida Score for predicting outcomes in patients with candidaemia: a retrospective cohort study. Clin Microbiol Infect 2020; 26:1501-1506. [PMID: 32036049 DOI: 10.1016/j.cmi.2020.01.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 01/20/2020] [Accepted: 01/24/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The European Confederation of Medical Mycology (ECMM) Quality of Clinical Candidaemia Management (EQUAL) score is a tool designed by the ECMM to measure guideline adherence. The current study investigated the association between EQUAL scores and clinical outcomes. METHODS This retrospective study was conducted in three hospitals in Taiwan. Patients with candidaemia between January 2014 and July 2018 were enrolled. Guideline adherence was evaluated using EQUAL score indicators. Clinical outcomes and predictors of 30-day mortality were investigated. RESULTS A total of 384 patients were enrolled. The overall mean EQUAL score was 8.91 ± 3.42 (9.42 ± 3.60 in survivors vs. 8.10 ± 2.94 in non-survivors, p < 0.001). Higher scores were positively correlated with survival (p < 0.001). Scores of 16-22 indicated the highest survival rates (p for trend <0.001). The Kaplan-Meier plot revealed that patients with EQUAL scores ≥10 exhibited significantly higher survival rates (p < 0.001) than those with scores <10. Multivariable analysis revealed that EQUAL scores ≥10 (odds ratio (OR) 0.37, 95% confidence interval (CI) 0.19-0.74), advanced age (OR 1.02, 95% CI 1.00-1.04), septic shock (OR 4.42, 95% CI 2.09-9.36), high sequential organ failure assessment scores (OR 4.28, 95% CI 2.15-8.52), intravascular catheter-related source (OR 0.42, 95% CI 0.19-0.94) and central venous catheter retention (OR 5.41, 95% CI 2.06-14.24) were independent predictors of 30-day mortality. DISCUSSION Greater guideline adherence with a higher EQUAL score was significantly associated with survival. An EQUAL score cutoff point <10 predicted 30-day mortality.
Collapse
Affiliation(s)
- Ho-Yin Huang
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ya-Ling Wang
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tun-Chieh Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Yi Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| |
Collapse
|
47
|
Jakubek YA, Chang K, Sivakumar S, Yu Y, Giordano MR, Fowler J, Huff CD, Kadara H, Vilar E, Scheet P. Large-scale analysis of acquired chromosomal alterations in non-tumor samples from patients with cancer. Nat Biotechnol 2020; 38:90-96. [PMID: 31685958 PMCID: PMC8082517 DOI: 10.1038/s41587-019-0297-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 09/25/2019] [Indexed: 01/21/2023]
Abstract
Mosaicism, the presence of subpopulations of cells bearing somatic mutations, is associated with disease and aging and has been detected in diverse tissues, including apparently normal cells adjacent to tumors. To analyze mosaicism on a large scale, we surveyed haplotype-specific somatic copy number alterations (sCNAs) in 1,708 normal-appearing adjacent-to-tumor (NAT) tissue samples from 27 cancer sites and in 7,149 blood samples from The Cancer Genome Atlas. We find substantial variation across tissues in the rate, burden and types of sCNAs, including those spanning entire chromosome arms. We document matching sCNAs in the NAT tissue and the adjacent tumor, suggesting a shared clonal origin, as well as instances in which both NAT tissue and tumor tissue harbor a gain of the same oncogene arising in parallel from distinct parental haplotypes. These results shed light on pan-tissue mutations characteristic of field cancerization, the presence of oncogenic processes adjacent to cancer cells.
Collapse
Affiliation(s)
- Y A Jakubek
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - K Chang
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Sivakumar
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Y Yu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M R Giordano
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Fowler
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C D Huff
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - H Kadara
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - E Vilar
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Scheet
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
48
|
Fry J, Alarcon R, Baeßler S, Balascuta S, Palos LB, Bailey T, Bass K, Birge N, Blose A, Borissenko D, Bowman J, Broussard L, Bryant A, Byrne J, Calarco J, Caylor J, Chang K, Chupp T, Cianciolo T, Crawford C, Ding X, Doyle M, Fan W, Farrar W, Fomin N, Frlež E, Gericke M, Gervais M, Glück F, Greene G, Grzywacz R, Gudkov V, Hamblen J, Hayes C, Hendrus C, Ito T, Jezghani A, Li H, Makela M, Macsai N, Mammei J, Mammei R, Martinez M, Matthews D, McCrea M, McGaughey P, McLaughlin C, Mueller P, Petten DV, Penttilä S, Perryman D, Picker R, Pierce J, Počanić D, Qian Y, Ramsey J, Randall G, Riley G, Rykaczewski K, Salas-Bacci A, Samiei S, Scott E, Shelton T, Sjue S, Smith A, Smith E, Stevens E, Wexler J, Whitehead R, Wilburn W, Young A, Zeck B. The Nab experiment: A precision measurement of unpolarized neutron beta decay. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201921904002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Neutron beta decay is one of the most fundamental processes in nuclear physics and provides sensitive means to uncover the details of the weak interaction. Neutron beta decay can evaluate the ratio of axial-vector to vector coupling constants in the standard model, λ = gA/gV, through multiple decay correlations. The Nab experiment will carry out measurements of the electron-neutrino correlation parameter a with a precision of δa/a = 10−3 and the Fierz interference term b to δb = 3 × 10−3 in unpolarized free neutron beta decay. These results, along with a more precise measurement of the neutron lifetime, aim to deliver an independent determination of the ratio λ with a precision of δλ/λ = 0.03% that will allow an evaluation of Vud and sensitively test CKM unitarity, independent of nuclear models. Nab utilizes a novel, long asymmetric spectrometer that guides the decay electron and proton to two large area silicon detectors in order to precisely determine the electron energy and an estimation of the proton momentum from the proton time of flight. The Nab spectrometer is being commissioned at the Fundamental Neutron Physics Beamline at the Spallation Neutron Source at Oak Ridge National Lab. We present an overview of the Nab experiment and recent updates on the spectrometer, analysis, and systematic effects.
Collapse
|
49
|
Chen KH, Tam CWC, Chang K. Early Maladaptive Schemas, Depression Severity, and Risk Factors for Persistent Depressive Disorder: a Cross-sectional Study. East Asian Arch Psychiatry 2019; 29:112-117. [PMID: 31871307 DOI: 10.12809/eaap1821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate associations of the five early maladaptive schemas (EMS) domains with depression severity by comparing patients with persistent depressive disorder (PDD), patients with major depressive disorder (MDD), and controls with no psychiatric disorders. METHODS Patients with PDD (n = 30), patients with MDD (n = 24), and controls with no psychiatric disorders (n = 30) were recruited. Participants were assessed using the Mini-International Neuropsychiatric Interview 5.0 version (MINI), the Beck Depression Inventory-Second Edition (BDI-II), and the Young Schema Questionnaire-3rd Edition Short Form (YSQ-S3). RESULTS The five EMS domains (YSQ-S3 score) significantly correlated with depression severity (BDI-II score), with correlation coefficients ranging from 0.583 to 0.788. After controlling for age, education, and sex, the two best predictors of depression severity were domains 'over-vigilance and inhibition' and 'disconnection and rejection'. For domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition, the total YSQ-S3 score was significantly higher in the PDD group than both the MDD and control groups. For the domain of impaired limits, the total YSQ-S3 score was significantly higher in both the PDD and MDD groups than the control group. CONCLUSION All five EMS domains correlated significantly with depression severity. PDD and MDD differed in psychopathology. The EMS domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition may be specific risk factors for PDD.
Collapse
Affiliation(s)
- K H Chen
- Department of Clinical Psychology, Ten Chen Hospital (Chungli), Taoyuan City, Taiwan
| | - C W C Tam
- Department of Psychology, Chung Yuan Christian University, Chungli, Taoyuan City, Taiwan
| | - K Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan City, Taiwan
| |
Collapse
|
50
|
Lo SH, Tang HJ, Lee SSJ, Lee JC, Liu JW, Ko WC, Chang K, Lee CY, Chang YT, Lu PL. Determining the clinical characteristics and prognostic factors for the outcomes of Japanese encephalitis in adults: A multicenter study from southern Taiwan. J Microbiol Immunol Infect 2019; 52:893-901. [PMID: 31628089 DOI: 10.1016/j.jmii.2019.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND In Southeast Asia, Japanese encephalitis (JE) is an important cause of viral encephalitis which may cause severe neurological sequelae. JE affects mostly children; therefore, clinical presentations and prognosis of adult JE patients are seldom addressed. This study aimed to describe the clinical characteristics and prognostic factors for the outcome of adult JE patients. METHODS Medical records of adult JE patients with acute encephalitis syndrome during 2001-2018 from five medical centers in southern Taiwan were reviewed. Clinical characteristics, brain images, and prognostic factors for outcomes were analyzed. Patients were divided into the good outcome (GO) group and poor outcome (PO) group according to their Glasgow Coma Scale (GCS) scores (GCS >8 vs. ≤ 8) at discharge. RESULTS Sixty-eight patients (men, 61.8%; median age, 50 years) were included. Summer is the epidemic season, and the number of cases peaked in June. The most common symptoms at initial presentation were altered consciousness and fever (both 94.1%), followed by headache (51.4%). The most commonly involved brain regions were thalamus (55.7%) and basal ganglion (37.7%). The median GCS score at nadir was 8, and the median time from onset to nadir was five days. Fifty-two patients were included in the GO group, while 16 were included in the PO group. On multivariate analysis, flaccidity, rigidity, and elevated CSF protein level were identified as independent prognostic factors for PO. CONCLUSION Initial clinical presentations of abnormal muscle tone including flaccidity, rigidity and high CSF protein levels are independent prognostic factors for PO in adult JE patients.
Collapse
Affiliation(s)
- Shih-Hao Lo
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Hung-Jen Tang
- Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Susan Shin-Jung Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Jen-Chieh Lee
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jien-Wei Liu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital; Chang Gung University Medical College, Taoyuan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine and Center of Infection Control, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ko Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siao-Kang Hospital, Taiwan
| | - Chun-Yuan Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siao-Kang Hospital, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Ting Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan.
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|