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Chien-Tai Hong,Lung Chan,Chaur-Jong Hu,Chien-Min Lin,Chien-Yeh Hsu,Ming-Chin Lin 한국유방암학회 2017 Journal of breast cancer Vol.20 No.4
Purpose: Whether tamoxifen affects the risk of neurodegenerative disease is controversial. This nationwide population-based study investigated the risk of Parkinson’s disease (PD) associated with tamoxifen treatment in female patients with breast cancer using Taiwan’s National Health Insurance Research Database. Methods: A total of 5,185 and 5,592 female patients with breast cancer who did and did not, respectively, receive tamoxifen treatment between 2000 and 2009 were included in the study. Patients who subsequently developed PD were identified. A Cox proportional hazards model was used to compare the risk of PD between the aforementioned groups. Results: Tamoxifen did not significantly increase the crude rate of developing PD in female patients with breast cancer (tamoxifen group, 16/5,169; non-tamoxifen group, 11/5,581; p=0.246). Tamoxifen did not significantly increase the adjusted hazard ratio (aHR) for subsequently developing PD (aHR, 1.310; 95% confidence interval [CI], 0.605–2.837; p= 0.494). However, tamoxifen significantly increased the risk of PD among patients followed up for more than 6 years (aHR, 2.435; 95% CI, 1.008–5.882; p=0.048). Conclusion: Tamoxifen treatment may increase the risk of PD in Taiwanese female patients with breast cancer more than 6 years after the initiation of treatment.
( Chien-lung Hsu ),( Han-yu Lin ) 한국인터넷정보학회 2013 KSII Transactions on Internet and Information Syst Vol.7 No.11
Key exposure is a major threat to secure cryptosystems. To mitigate the impact caused by key-compromise attacks, a key-insulated cryptographic mechanism is a better alternative. For securing the large message communication in peer-to-peer networks, in this paper, we propose the first novel identity-based key-insulated encryption (IB-KIE) scheme with message linkages. Our scheme has the properties of unbounded time periods and random-access key-updates. In the proposed scheme, each client can periodically update his private key while the corresponding public one remains unchanged. The essential security assumption of our proposed scheme is based on the well-known bilinear Diffie-Hellman problem (BDHP). To ensure the practical feasibility, we also formally prove that the proposed scheme achieves the security requirement of confidentiality against indistinguishability under adaptive chosen-ciphertext attacks (IND-CCA2) in the random oracle model.
Chien-Chun Kung,Feng-Lung Chiang 제어로봇시스템학회 2015 제어로봇시스템학회 국제학술대회 논문집 Vol.2015 No.10
In this paper, the processes for establishing the missile maximum capture area and the fighter minimum evasive range are proposed for negotiation team air combat. The architecture of multi-fighter air combat simulation system is constructed by game theory with a utilitarian solution to solve the optimal pursuit /evasion strategies of the two rival sides. This paper assesses the effectiveness of PN and PGN missile guidance laws to establish the missile maximum capture areas and the fighter minimum evasive ranges for a negotiation team air combat. The optimal distance to launch missile and the last chance to escape from missile can be predicted with the information.
Predictors of Positive Bone Metastasis in Newly Diagnosed Prostate Cancer Patients
Chien, Tsu-Ming,Lu, Yen-Man,Geng, Jiun-Hung,Huang, Tsung-Yi,Ke, Hung-Lung,Huang, Chun-Nung,Li, Ching-Chia,Chou, Yii-Her,Wu, Wen-Jeng,Huang, Shu-Pin Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3
Background: The prevalence of prostate cancer (PCa) has been increasing in recent years. Treatment strategies are largely based on the results of bone scan screening. Therefore, our aim was to investigate predictors of positive bone metastasis in newly diagnosed PCa patients. Materials and Methods: After extensive review, 336 consecutive patients newly diagnosed with PCa between April 2010 and November 2013 at our institution were enlisted in the study. Patients were divided into two groups according to bone scan results. Univariate analyses (Chi-square test for discrete variables and independent t-test for continuous variables) were applied to determine the potentially significant risk factors associated with distant bone metastasis. Binary logistic regression analyses were used to further investigate the influence of these factors on bone metastasis. Results: The patient mean age was $71.9{\pm}8.6years$ (range: 48 to 94 years). The mean prostate specific antigen (PSA) level and biopsy Gleason score were $260.2{\pm}1107.8ng/mL$ and $7.4{\pm}1.5$, respectively. The body mass index (BMI) for the series was $24.5{\pm}3.4kg/m^2$. Sixty-four patients (19.0%) had a positive bone scan result. Patients with positive bone scan results had a significantly lower BMI ($23.3{\pm}3.5$ vs. $24.8{\pm}3.3$; p=0.003), a higher Gleason score ($8.5{\pm}1.1$ vs. $7.1{\pm}1.5$; p < 0.001), and a higher PSA level ($1071.3{\pm}2337.1$ vs. $69.4{\pm}235.5$; p < 0.001) than those without bone metastasis. Multivariate logistic regression analysis employing the above independent predictors demonstrated that a Gleason score of ${\geq}7$, clinical stage ${\geq}T3$, $BMI{\leq}22kg/m^2$, and an initial PSA level of ${\geq}20ng/mL$ were all independent predictors of bone metastasis. Conclusions: A bone scan might be necessary in newly diagnosed PCa patients with any of the following criteria: clinical stage T3 or higher, a Gleason score of 7 or higher, BMI equal to or less than 22, and a PSA level of 20 or higher.
Enhancing elderly long-term care service using Kinect exergame
Tien-Lung Sun,Ta-Min Hung,Chia-Hsuan Lee,Chien-Hua Huang,Chun Pei 대한인간공학회 2014 대한인간공학회 학술대회논문집 Vol.2014 No.5
Kinect based somatosensory exergame is useful to support long-term care as it can motivate chronic rehabilitation patients or elderly with decreasing motor ability to do physical exercise in a pleasant and interesting gaming environment. Dynamic game difficulty adjustment (DDA) technique is implemented in all games to keep players engaged and adhered to the game. For long-term care service, game difficulty has to be manually adjusted as players are not able to or not willing to adjust game settings by themselves. To support manually difficulty adjustment, it is important to conduct player experience study to understand the impact of different game settings or gaming parameters on game difficulty. This paper evaluates the difficulty of a Kinect exergame using objective player experiences derived from Kinect sensor and gameplay based player experience. Specifically, a Kinect exergame for upper arm exercise is developed and deployed to a nursing center at central Taiwan. The challenge (psychological difficulty) and intensity (physiological difficulty) of the game are analyzed using hand movement speed derived from Kinect sensor (objective player experience) and game score (gameplay based experience). The results show that the objective player experience derived from Kinect sensor can help understand the exergame intensity. With cross reference to game performance, subjects who are more engaged in the exergame can be identified. Specifically, analysis of the hand movement speed shows that the Kinect exergame considered in this work does not present enough physiological difficulty (intensity) to elderly with level-4 muscle power but does present difficulty to elderly with level-3 muscle power. Subjects with level-3 muscle power who are engaged in the game can be identified from their game scores. As the optimum difficulty level as well as other game settings varies from individual to individual, an important task in exergame design is to dynamically adjust its challenge and intensity so that elderly players can be engaged in and adhered to the game. The results of this paper show that player experiences derived from Kinect sensor and gameplay performance can help game developers better understand, and hence adjust, the game difficulty levels.
Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation
Huei-Lung Liang,Huay-Ben Pan,Yih-Huie Lin,Chiung-Yu Chen,Hsiao-Min Chung,Tung-Ho Wu,Kang-Ju Chou,Pin-Hong Lai,Chien-Fang Yang 대한영상의학회 2006 Korean Journal of Radiology Vol.7 No.2
Objective: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. Materials and Methods: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patients (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8 10mm in diameter and 40 80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. Results: No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates ( standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69% 9 and 88% 6, 41% 10 and 88% 6, 30% 10 and 77% 10, and 12% 8 and 61% 13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51% 16 and 86% 13 vs 45% 15 and 73% 13 at 6 months, and 25% 15 and 71% 17 vs 23% 17 and 73% 13 at 12 months (p = .346 and .224), respectively. Conclusion: Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.