Delay of Surgery for Spinal Metastasis due to the COVID-19 Outbreak Affected Patient Outcomes

Chia-Jung Hsieh,Chun-Yu Wu,Yen-Heng Lin,Yu-Cheng Huang,Wen-Chi Yang,Tom Wei-Wu Chen,Wei-Li Ma,Wei-Hsin Lin,Feng-Ming Hsu,Furen Xiao,Shih-Hung Yang,Dar-Ming Lai,Chang-Mu Chen,Shin-Yi Chao,Fon-Yih Tsuan 대한척추신경외과학회 2023 Neurospine Vol.20 No.4

Objective: The present study is to analyze the effects of the coronavirus disease 2019 (COVID 2019) outbreak and the subsequent lockdown on the outcomes of spinal metastasis patients. Methods: The study was a retrospective analysis of data from a prospective cohort study. All patients underwent surgical intervention for spinal metastases between January 2019 and December 2021 and had at least 3 months of postoperative follow-up. The primary outcome was overall mortality during the 4 different stages (pre-COVID-19 era, COVID-19 pandemic except in Taiwan, national lockdown, lifting of the lockdown). The secondary outcomes were the oncological severity scores, medical/surgical accessibility, and patient functional outcome during the 4 periods as well as survival/mortality. Results: A total of 233 patients were included. The overall mortality rate was 41.20%. During the Taiwan lockdown, more patients received palliative surgery than other surgical methods, and no total en bloc spondylectomy was performed. The time from surgeon visit to operation was approximately doubled after the COVID-19 outbreak in Taiwan (75.97, 86.63, 168.79, and 166.91 hours in the 4 periods, respectively). The estimated survival probability was highest after the national lockdown was lifted and lowest during the lockdown. In the multivariate analysis, increased risk of mortality was observed with delay of surgery, with emergency surgery having a higher risk with delays above 33 hours, urgent surgery (below 59 and above 111 hours), and elective surgery (above 332 hours). Conclusion: The COVID-19 pandemic and related policies have altered daily clinical practice and negatively impacted the survival of patients with spinal metastases.

Deubiquitination and Stabilization of PD-L1 by CSN5

Lim, Seung-Oe,Li, Chia-Wei,Xia, Weiya,Cha, Jong-Ho,Chan, Li-Chuan,Wu, Yun,Chang, Shih-Shin,Lin, Wan-Chi,Hsu, Jung-Mao,Hsu, Yi-Hsin,Kim, Taewan,Chang, Wei-Chao,Hsu, Jennifer L.,Yamaguchi, Hirohito,Ding Elsevier 2016 Cancer cell Vol.30 No.6

<P><B>Summary</B></P> <P>Pro-inflammatory cytokines produced in the tumor microenvironment lead to eradication of anti-tumor immunity and enhanced tumor cell survival. In the current study, we identified tumor necrosis factor alpha (TNF-α) as a major factor triggering cancer cell immunosuppression against T cell surveillance via stabilization of programmed cell death-ligand 1 (PD-L1). We demonstrated that COP9 signalosome 5 (CSN5), induced by NF-κB p65, is required for TNF-α-mediated PD-L1 stabilization in cancer cells. CSN5 inhibits the ubiquitination and degradation of PD-L1. Inhibition of CSN5 by curcumin diminished cancer cell PD-L1 expression and sensitized cancer cells to anti-CTLA4 therapy.</P> <P><B>Highlights</B></P> <P> <UL> <LI> TNF-α stabilizes cancer cell PD-L1 in response to chronic inflammation </LI> <LI> Activation of NF-κB by TNF-α induces CSN5 expression leading to PD-L1 stabilization </LI> <LI> CSN5 enzyme activity controls T cell suppression via PD-L1 deubiquitination </LI> <LI> Destabilization of PD-L1 by CSN5 inhibitor curcumin benefits anti-CTLA4 therapy </LI> </UL> </P> <P><B>Graphical Abstract</B></P> <P>[DISPLAY OMISSION]</P>

Impacts of label quality on performance of steel fatigue crack recognition using deep learning-based image segmentation

Chia-Ming Chang,Shun-Hsiang Hsu,Ting-Wei Chang 국제구조공학회 2022 Smart Structures and Systems, An International Jou Vol.29 No.1

Structural health monitoring (SHM) plays a vital role in the maintenance and operation of constructions. In recent years, autonomous inspection has received considerable attention because conventional monitoring methods are inefficient and expensive to some extent. To develop autonomous inspection, a potential approach of crack identification is needed to locate defects. Therefore, this study exploits two deep learning-based segmentation models, DeepLabv3+ and Mask R-CNN, for crack segmentation because these two segmentation models can outperform other similar models on public datasets. Additionally, impacts of label quality on model performance are explored to obtain an empirical guideline on the preparation of image datasets. The influence of image cropping and label refining are also investigated, and different strategies are applied to the dataset, resulting in six alternated datasets. By conducting experiments with these datasets, the highest mean Intersection-over-Union (mIoU), 75%, is achieved by Mask R-CNN. The rise in the percentage of annotations by image cropping improves model performance while the label refining has opposite effects on the two models. As the label refining results in fewer error annotations of cracks, this modification enhances the performance of DeepLabv3+. Instead, the performance of Mask R-CNN decreases because fragmented annotations may mistake an instance as multiple instances. To sum up, both DeepLabv3+ and Mask R-CNN are capable of crack identification, and an empirical guideline on the data preparation is presented to strengthen identification successfulness via image cropping and label refining.

Psilocybin for End-of-Life Anxiety Symptoms: A Systematic Review and Meta-Analysis

Chia-Ling Yu,Fu-Chi Yang,Szu-Nian Yang,Ping-Tao Tseng,Brendon Stubbs,Ta-Chuan Yeh,Chih-Wei Hsu,Dian-Jeng Li,Chih-Sung Liang 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.10

Objective To systematically examine the effectiveness and tolerability of psilocybin for treating end-of-life anxiety symptoms. Methods The Medline, Embase, CENTRAL, and PsycINFO databases were searched up to November 25, 2020. We enrolled clinical trials investigating psilocybin for treating end-of-life anxiety symptoms. Meta-analysis was conducted using random-effects model. Results Overall, five studies were included, revealing that psilocybin was superior to the placebo in treating state anxiety at 1 day (Hedges’ g, -0.70; 95% confidence interval, -1.01 to -0.39) and 2 weeks (-1.03; -1.47 to -0.60) after treatment. Psilocybin was more effective than placebo in treating trait anxiety at 1 day (-0.71; -1.15 to -0.26), 2 weeks (-1.08; -1.80 to -0.36), and 6 months (-0.84; -1.37 to -0.30) after treatment. Psilocybin was associated with transient elevation in systolic (19.00; 13.58-24.41 mm Hg) and diastolic (8.66; 5.18-12.15 mm Hg) blood pressure compared with placebo. The differences between psilocybin and placebo groups with regard to allcause discontinuation, serious adverse events, and heart rates were nonsignificant. Conclusion Psilocybin-assisted therapy could ameliorate end-of-life anxiety symptoms without serious adverse events. Because of the small sample sizes of the included studies and high heterogeneity on long-term outcomes, future randomized controlled trials with large sample sizes are needed.

IPv6 DoS Attacks Detection Using Machine Learning Enhanced IDS in SDN/NFV Environment

Chia-Wei Tseng,Li-Fan Wu,Shih-Chun Hsu,Sheng Wang Yu 한국통신학회 2020 한국통신학회 APNOMS Vol.2020 No.09

The rapid growth of IPv6 traffic makes security issues become more important. This paper proposes an IPv6 network security system that integrates signature-based Intrusion Detection Systems (IDS) and machine learning classification technologies to improve the accuracy of IPv6 denial-of-service (DoS) attacks detection. In addition, this paper has also enhanced IPv6 network security defense capabilities through software-defined networking (SDN) and network function virtualization (NFV) technologies. The experimental results prove that the detection and defense mechanisms proposed in this paper can effectively strengthen IPv6 network security.

A New Joint Echo Cancellation and Decision Feedback Equalization for Digital Subscriber Loops

Cheng Chia Hsu,Che Ho Wei 대한전자공학회 1997 TENCON 87 - Computers and Communications Technolog Vol.- No.-

An R package UnifiedDoseFinding for continuous and ordinal outcomes in Phase I dose-finding trials

Rongji Mu,Chia Wei Hsu,Shouhao Zhou,Haitao Pan 한국통계학회 2022 Communications for statistical applications and me Vol.29 No.4

Phase I dose-finding trials are essential in drug development. By finding the maximum tolerated dose (MTD) of a new drug or treatment, a Phase I trial establishes the recommended doses for later-phase testing. The primary toxicity endpoint of interest is often a binary variable, which describes an event of a patient who experiences dose-limiting toxicity. However, there is a growing interest in dose-finding studies regarding non-binary outcomes, defined by either the weighted sum of rates of various toxicity grades or a continuous outcome. Although several novel methods have been proposed in the literature, accessible software is still lacking to implement these methods. This study introduces a newly developed R package, UnifiedDoseFinding, which implements three phase I dose-finding methods with non-binary outcomes (Quasi- and Robust Quasi-CRM designs by Yuan it et al. (2007) and Pan it et al. (2014), gBOIN design by Mu it et al.(2019), and by a method by Ivanova and Kim (2009)). For each of the methods, UnifiedDoseFinding provides corresponding functions that begin with next_ that determines the dose for the next cohort of patients, select\_, which selects the MTD defined by the non-binary toxicity endpoint when the trial is completed, and get_oc, which obtains the operating characteristics. Three real examples are provided to help practitioners use these methods. The R package UnifiedDoseFinding, which is accessible in R CRAN, provides a user-friendly tool to facilitate the implementation of innovative dose-finding studies with nonbinary outcomes.

Channel-Composition-Dependent Characteristics of -Doped InxAl1-xAs/InyGa1-yAs Metamorphic High Electron Mobility Transistors

Ching-Sung Lee,Chia-Jeng Chian,Wei-Chou Hsu,Ke-Hua Su,Su-Jen Yu 한국물리학회 2008 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.52 No.4

This work provides comprehensive comparisons of the device characteristics, including the voltage gain, power performance, linearity and noise characteristics, for InAlAs/InGaAs/GaAs metamorphic high electron mobility transistors with respect to different indium contents in the InGaAs channel. Though the device with a high In-ratio InGaAs channel usually demonstrated improved high-frequency characteristics, the kink effects in their narrow-gap channel materials were found to seriously degrade the device performance. On the other hand, the low In-ratio channel device had characteristics advantageous for high-gain and high-linearity applications while the device with a compromised channel composition design was suitable for high-power circuit applications. This work provides comprehensive comparisons of the device characteristics, including the voltage gain, power performance, linearity and noise characteristics, for InAlAs/InGaAs/GaAs metamorphic high electron mobility transistors with respect to different indium contents in the InGaAs channel. Though the device with a high In-ratio InGaAs channel usually demonstrated improved high-frequency characteristics, the kink effects in their narrow-gap channel materials were found to seriously degrade the device performance. On the other hand, the low In-ratio channel device had characteristics advantageous for high-gain and high-linearity applications while the device with a compromised channel composition design was suitable for high-power circuit applications.

Application of Data Quality Indicator of Carbon Footprint and Water Footprint

Tsai Chi Kuo,Miao-Ling Huang,Chia Wei Hsu,Chiuhsiang Joe Lin,Chih-Chun Hsieh,Chih-Hsing Chu 한국정밀공학회 2015 International Journal of Precision Engineering and Vol.2 No.1

To mitigate the impact of global warming on the environment, many governments, non-profit organizations, and enterprises have formulated relevant standards to assist enterprises in promoting carbon management, and to encourage the design and popularization of low-carbon products. These standards include: PAS 2050, ISO/TS 14067 and so on. Under these initiatives, enterprises try to disclose the carbon and water footprints of the products based on the life cycle. Some enterprises argue and debate that there exists uncertainty of the footprints calculation since the data collection is not systematically. To solve this problem, in this research, the calculation of carbon footprint and water footprint are evaluated with the data quality indicator (DQI) management system. The collected data is evaluated based on the footprint calculation methods. Also the pedigree matrix is constructed as an aide to solve the data uncertainty that included reliability, completeness, times, geography, and technologies differences. Through the DQI, the carbon footprint and water footprint are not only calculated simultaneously, but also correctly. The results could be the reference for products’ environmental improvement.

Flow-induced Orientations of Fibers and Their Influences on Warpage and Mechanical Property in Injection Fiber Reinforced Plastic (FRP) Parts

Chao-Tsai Huang,Jia-Hao Chu,Wei-Wen Fu,Chia Hsu,Sheng-Jye Hwang 한국정밀공학회 2021 International Journal of Precision Engineering and Vol.8 No.3

During the past two centuries, due to too fast growth of the human population, the pollution made by human has seriously impacts on our environment, particularly, for the CO2 emission. To diminish the CO2 emission problem, one of the effective solutions is applying lightweight material, such as the fiber-reinforced plastics (FRP), to replace metal in the manufacturing of transportation vehicles. However, since the reinforced function of the fibers inside plastic matrix is very complex, it is not easy to be visualized and managed. Specifically, the connection from microstructures of the fibers to the physical properties of the final product is far from our understanding. In this study, we have proposed a benchmark with three standard specimens based on ASTM D638 with different gate designs. This system is used to study the fiber microstructures and associated mechanical properties using numerical simulation and experimental studies. Results showed that the tensile properties (including tensile modulus and tensile stress) of all three ASTM standard specimens can be improved significantly in the appearance of the fibers. Moreover, the tensile properties variation of the finished parts associated with the microstructures of the short fibers based on the gate design have been also investigated. Specifically, the tensile modulus and the strength of the Model I are greater than that of Model II, while Model III is much less than others because of its double gate effect. The reason why the tensile modulus and the strength of the Model I is greater than that of Model II is due to some entrance effect. That entrance effect will further provide flow-induced fiber orientation to melt and then enhance the tensile properties of Model I. To confirm the observation, a series simulation and experimental studies have been performed. Specifically, the fiber orientation distribution is predicted using CAE, and verified using micro-CT scan and image analysis by Avizo software. Hence, the correlation from fiber microstructure feature (particularly in fiber orientation) to tensile modulus and tensile stress for fiber reinforced thermoplastic (FRP) in injection molding process can be validated.