Tenofovir Alafenamide for Chronic Hepatitis B Patients with Advanced Fibrosis and Partial Virologic Responses to Oral Nucleos(T)Ide Analogues- Interim Report

( Ming-lung Yu ),( Ming-lun Yeh ),( Chi-yi Chen ),( Pin-nan Cheng ),( Ming-jong Bair ),( Jyh-jou Chen ),( Ching-chu Lo ),( Chi-ming Tai ),( Ching-yang Tsai ),( Kuo-chih Tseng ),( Chien-hung Chen ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Insufficient data regarding the treatment strategy for partial response to nucleot(s)ide analogue (NUC) raised the aim of investigating tenofovir alafenamide (TAF) switching for chronic hepatitis B (CHB) patients with advanced fibrosis and partial response to other NUCs. Methods: CHB patients with advanced fibrosis (stage 3 or 4) and under NUC (except TAF) therapy with detectable hepatitis B virus (HBV) DNA for >52 weeks are enrolled to TAF 25 mg/day for 96 weeks. The objectives are viral suppression, alanine aminotransferase (ALT) normalization and safety. Results: From Feb. 2019, 34 patients, including 21 (61.8%) with entecavir, 10 (29.4%) TDF and 3 (8.8%) lamivudine or adefovir, were enrolled (15 [44.1%] male, median 53 years). The fibroscan demonstrated a mean of 10.5 kPa (7 [20.6%] cirrhotic). Sixteen (47.1%) patients were HBV e antigen positive, seven (20.6%) had YMDD mutation. The median HBV DNA level declined from 68.5 IU/mL at enrollment to 27.0 IU/mL at 4^th week, and undetectable at 12^th, 24^th, 36^th week, respectively, after TAF switching, with undetectable HBV DNA in 14/34 (41.2%), 17/33 (51.5%), 15/25 (60.0%), and 9/15 (60.0%) patients and rate of ALT normalization (≤40 U/L) of 85.3%, 85.3%, 84.8%, 92.0%, and 80.0%, respectively, after TAF switching. (figure 1) Two patients experienced transient virological breakthrough and another one developed at the final time follow up. Serum creatinine and eGFR levels were stable after TAF switching (figure 1). Two patients early terminated including one at 12^th week due to personal reason, and another one accidently died at 20^th week due to acute heart attack. Others suffered only mild degrees of adverse events which were considered unrelated to treatment. Conclusions: The preliminary results demonstrated the TAF switching is effective and safe in viral suppression for CHB patients with advanced fibrosis and partial virologic responses to other NUCs.

Sofosbuvir/Ledipasvir in the Treatment of Chronic Hepatitis C - A Subgroup Analysis from A Nationwide Real-World HCV Registry Program (TACR) in Taiwan

( Ming-Lung Yu ),( Chi-Yi Chen ),( Kuo-Chih Tseng ),( Ching-Chu Lo ),( Pin-Nan Cheng ),( Cheng-Yuan Peng ),( Ming-Jong Bair ),( Chih-Lang Lin ),( Chi-Ming Tai ),( Chi-Chieh Yang ),( Chih-Wen Lin ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: TASL HCV Registry (TACR) is a nationwide registry program organized and supervised by Taiwan Association for the Study of the Liver (TASL), which aims to setup the database and biobank of patients with chronic hepatitis C (CHC) in Taiwan. The present study aimed to evaluate the treatment outcome of sofosbuvir (SOF)/ledipasvir (LDV) in Taiwanese CHC patients in TACR. Methods: By May 2020, 19 tertiary hospitals, 23 community hospitals and one primary care clinic join the TACR program. The baseline characteristics, prior liver and non-liver related medical history, DAA regimens, laboratory results, treatment course and outcome were recorded. The primary objective was sustained virological response, defined as undetectable HCV RNA 3 months after end-of-treatment (SVR12). Results: A total of 4742 SOF/LDV+ ribavirin treated CHC patients with available SVR12 data from 39 sites were enrolled in the current analysis. The mean age was 61.3 years, and female accounted for 54.8% of the population. The dominant viral genotypes were GT1b (52.6%) and GT2 (35.6%). 1354 (28.6%) patients had liver cirrhosis, including 156 (3.3%) with liver decompensation, 552 (11.6%) had preexisting hepatocellular carcinoma (HCC) before DAAs treatment and 413 (8.7%) had hepatitis B virus dual infections. The overall SVR12 rate was 98.5%, with 98.5%, 98.2%, 99.7% and 98.6% in treatment- naïve non-cirrhotics, treatment-naïve cirrhotics, treatment- experienced non-cirrhotics and treatment-experienced cirrhotics patients, respectively. While patients were stratified by HCV genotype, the SVR12 was 98.5%, 98.4% and 98.5% among those with GT1, GT2 and GT6 infection, respectively. The strongest factor independent associated with treatment failure was DAA adherence < 60% (odds ratio [OR]/95% confidence intervals [CI]: 125.4/25.7-612.4, P<0.0001), followed by active HCC (OR/CI: 6.20/2.57-14.97, P<0.0001), HIV co-infection (OR/CI: 3.01/1.14-7.92, P=0.026), and male gender (OR/ CI: 1.85/1.09-3.13, P=0.023). The eGFR decreased significantly at the end of treatment (EOT) (89.3 ml/min/1.73㎡ vs. 93.2 ml/min/1.73㎡, P< 0.001) and remained stable 3 months after EOT (89.3 ml/min/1.73㎡). However, the decreased eGFR was observed only in patients whose baseline eGFR > 90 ml/ min/1.73㎡. Instead, patients with chronic kidney diseases whose pretreatment eGFR < 60 ml/min/1.73㎡ had improved eGFR after SOF/LDV. Conclusions: SOF/LDV is highly effective in treating CHC patients in real-world setting of Taiwan. The satisfactory result could be explicitly generalized to patients with different viral genotypes and liver disease severities.

Type 2 Diabetes Mellitus Increases Peritonsillar Abscess Susceptibility: Real-World Evidence

Ching-Lung Wu,Ming-Shao Tsai,Ta-Jen Lee,Yun-Ting Wang,Chia-Yen Liu,Yao-Hsu Yang,Yao-Te Tsai,Cheng-Ming Hsu,Ching-Yuan Wu,Pey-Jium Chang,Geng-He Chang 대한이비인후과학회 2021 Clinical and Experimental Otorhinolaryngology Vol.14 No.3

Objectives. Type 2 diabetes mellitus (T2DM) is a risk factor for deep neck infection (DNI) and leads to complications and poor outcomes. Our study aimed to investigate the risk, prognosis, and complications of peritonsillar abscess (PTA) in patients with T2DM. Methods. We extracted data of patients newly diagnosed as having T2DM between January 2000 and December 2011 from Taiwan’s National Health Insurance Research Database. These patients were matched with patients without T2DM, and PTA incidence was compared between both cohorts. Results. In total, 67,852 patients with and 135,704 patients without T2DM were enrolled. PTA incidence was significantly higher in patients with T2DM (incidence rate ratio, 1.91; P<0.001); moreover, PTA incidence was higher at 1 to 5 years after T2DM diagnosis than at <1 and >5 years after T2DM diagnosis. Cox regression analysis showed that patients with T2DM had an approximately 2-fold higher PTA risk (adjusted hazard ratio [aHR]: 1.89, P<0.001). Patients with a higher adapted Diabetes Complications Severity Index (aDCSI) had higher PTA risk than those with a lower aDCSI (aHRs: 2.17 for aDCSI ≥1, P=0.006 and 1.81 for aDCSI=0, P=0.002). T2DM patients with a high aDCSI (≥1) had a nonsignificantly longer hospitalization duration and a higher rate of DNI complications than did those with a low aDCSI (=0). Conclusion. In patients with T2DM, PTA incidence was relatively high, and it increased with T2DM severity. Moreover, T2DM patients should be particularly careful about PTA within 1 to 5 years after the diagnosis, and physicians should keep in mind that the prognosis of PTA was correlated with T2DM severity.

Authorized Tracking and Tracing for RFID

Ming-Yang Chen,Ching-Nung Yang,Chi-Sung Laih 보안공학연구지원센터 2007 International Journal of Security and Its Applicat Vol.1 No.1

Radio Frequency Identification (RFID) systems have become popular for identifying not only objects but also persons. For example, in supply chain applications, the company can constantly track the movements of goods. Also, for Body Area Network or Personal Area Work, the tag is usually used for identifying a person. However, the movements and current locations of goods and a person’s activity profiles are the sensitive information and should be kept secret. This paper develops the interaction protocols between readers and tags to address this privacy issue of protecting tagged objects from tracking and tracing by unauthorized readers.

New Isolated Single-Phase AC-DC Converter for Universal Input Voltage

Ming-Rong Lee,Lung-Sheng Yang,Chia-Ching Lin 전력전자학회 2013 JOURNAL OF POWER ELECTRONICS Vol.13 No.4

This paper investigates a new isolated single-phase AC-DC converter, which integrates a modified AC-DC buck-boost converter with a DC-DC forward converter. The front semi-stage is operated in discontinuous conduction mode (DCM) to achieve an almost unity power factor and a low total harmonic distortion of the input current. The rear semi-stage is used for step-down voltage conversion and electrical isolation. The front semi-stage uses a coupled inductor with the same winding-turn in the primary and secondary sides, which is charged in series during the switch-on period and is discharged in parallel during the switch-off period. The discharging time can be shortened. In other words, the duty ratio can be extended. This semi-stage can be operated in a larger duty-ratio range than the conventional AC-DC buck-boost converter for DCM operation. Therefore, the proposed converter is suitable for universal input voltage (90~264 Vrms) and a wide output-power range. Moreover, the voltage stress on the DC-link capacitor is low. Finally, a prototype circuit is implemented to verify the performance of the proposed converter.

Micromagnetic Simulation for Spin-transfer Switching with a Tilted Spin Polarizer

Ching-Ming Lee,Jyh-Shinn Yang,Te-ho Wu 한국자기학회 2010 한국자기학회 학술연구발표회 논문개요집 Vol.2010 No.12

The Root Extract of Gentiana macrophylla Pall. Alleviates B19-NS1-Exacerbated Liver Injuries in NZB/W F1 Mice

Ming-Jen Sheu,Chun-Ching Chiu,Deng-Jye Yang,Tsai-Ching Hsu,Bor-Show Tzang 한국식품영양과학회 2017 Journal of medicinal food Vol.20 No.1

The nonstructural protein NS1 of human parvovirus B19 (B19) is known to exacerbate disease activity in systemic lupus erythematosus (SLE). However, no specific medicine for B19 infection is available. The roots of Gentiana macrophylla Pall. (GM), the traditional Chinese medicine “Qinjiao,” have been used for centuries to treat rheumatic disease, including SLE. Herein, we aimed to investigate the effects of GM root extract (100 and 300 mg/kg body weight) on B19-NS1-exacerbated liver injury in NZB/W F1 mice; liver tissues were assessed by hematoxylin–eosin staining and immunoblotting. The GM root extract significantly decreased B19-NS1-exacerbated liver inflammation by suppressing the expressions of hepatic inducible nitric oxide synthase, cyclooxygenase type 2 (COX-2), interleukin (IL)-1β proteins, values of serum asparate transaminase (AST) and alanine transaminase (ALT), and lymphocyte infiltration (P < .05). It also significantly reduced the B19-NS1-exacerbated hepatic matrix metalloproteinase-9 (MMP-9) and urokinase plasminogen activator (uPA) expressions by downregulating tumor necrosis factor (TNF)-α/NF-κB (p65) signaling. These findings suggest a therapeutic potential of GM root extract against B19-NS1-exacerbated liver inflammation in SLE.

New Isolated Single-Phase AC-DC Converter for Universal Input Voltage

Lee, Ming-Rong,Yang, Lung-Sheng,Lin, Chia-Ching The Korean Institute of Power Electronics 2013 JOURNAL OF POWER ELECTRONICS Vol.13 No.4

This paper investigates a new isolated single-phase AC-DC converter, which integrates a modified AC-DC buck-boost converter with a DC-DC forward converter. The front semi-stage is operated in discontinuous conduction mode (DCM) to achieve an almost unity power factor and a low total harmonic distortion of the input current. The rear semi-stage is used for step-down voltage conversion and electrical isolation. The front semi-stage uses a coupled inductor with the same winding-turn in the primary and secondary sides, which is charged in series during the switch-on period and is discharged in parallel during the switch-off period. The discharging time can be shortened. In other words, the duty ratio can be extended. This semi-stage can be operated in a larger duty-ratio range than the conventional AC-DC buck-boost converter for DCM operation. Therefore, the proposed converter is suitable for universal input voltage (90~264 $V_{rms}$) and a wide output-power range. Moreover, the voltage stress on the DC-link capacitor is low. Finally, a prototype circuit is implemented to verify the performance of the proposed converter.

Morphological segmentation based on edge detection-II for automatic concrete crack measurement

Tung-Ching Su,Ming-Der Yang 사단법인 한국계산역학회 2018 Computers and Concrete, An International Journal Vol.21 No.6

Crack is the most common typical feature of concrete deterioration, so routine monitoring and health assessment become essential for identifying failures and to set up an appropriate rehabilitation strategy in order to extend the service life of concrete structures. At present, image segmentation algorithms have been applied to crack analysis based on inspection images of concrete structures. The results of crack segmentation offering crack information, including length, width, and area is helpful to assist inspectors in surface inspection of concrete structures. This study proposed an algorithm of image segmentation enhancement, named morphological segmentation based on edge detection-II (MSED-II), to concrete crack segmentation. Several concrete pavement and building surfaces were imaged as the study materials. In addition, morphological operations followed by cross-curvature evaluation (CCE), an image segmentation technique of linear patterns, were also tested to evaluate their performance in concrete crack segmentation. The result indicates that MSED-II compared to CCE can lead to better quality of concrete crack segmentation. The least area, length, and width measurement errors of the concrete cracks are 5.68%, 0.23%, and 0.00%, respectively, that proves MSED-II effective for automatic measurement of concrete cracks.

Evolution of Multi-temporal Landslides at Luhu, Miaoli County, Taiwan

( Che-ming Yang ),( Keng-hao Kang ),( Kuo-wei Li ),( Hui-jung Wang ),( Ching-ping Hsiao ),( Jyh-jong Liao ),( Yii-wen Pan ) 대한지질공학회 2019 대한지질공학회 학술발표회논문집 Vol.2019 No.2

A deep-seated landslide took place in Luhu, Miao-Li, Taiwan during intermittent rainfall in April 2018; initially, there were successive rock falls and gully erosion then leaded to a deep-seated landslide failure eventually. This study aims to understand the failure mechanism and the process of deep-seated failure. The study site is a steep anaclinal slope consisting of the Miocence Shihti Formation with thick sandstone, interbedded of sandstone and shale. We collected multi-temporal ortho-images and digital elevation (surface) models from 1980 to 2019 for geological investigation, geomorphological interpretation and numerical simulation. The images reveal several slope failures at 1998, 2003, 2005, 2009, 2015, 2017 and 2018 with various volume and failure types. The study area contains three sub-regions: the north, the northwest and the southwest slopes. The slope failure occurred repeatedly inside the north and the northwest slopes in the early stage. Gully erosion in the southwest slope progressed to a landslide on April 5, 2018 first and expanded to cover the deep-seated landslide failure in the northwest slope eventually; the slope failure resulted in a natural dam. After the landslide, several open cracks appeared near to the crown. The estimated maximum thickness, area and volume of the deep-seated landslide are ~60 m, 65,000 m2 and ~2 Mm3, respectively. Based on these results, we also performed a series of numerical simulation using the software RAMMS to interpret the run out and the deposition of this landslide case.