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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.
( Lai Wei ),( Yan Luo ),( Wang-long Chuang ),( Seung Woon Paik ),( Ming-lung Yu ),( Linda M Fredrick ),( Andrew Campbell ),( Roger Trinh ),( Jeffrey Enejosa ),( Nancy S Shulman ),( Jeong Heo ),( Nilou 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: ONYX-I and ONYX-II are Phase 3 studies exploring the PK, safety, and efficacy of the 3-DAA ± ribavirin regimen in a HCV GT1b-infected Asian population. Comparable PK exposures of the 3-DAA regimen between the Asian and predominantly Caucasian (thereafter referred to as “Western”) HCV GT1-infected patients in other studies have been published. Methods: We compared the safety/efficacy profiles of the 3-DAA regimen (+ ribavirin for patients with compensated cirrhosis) in Asian patients in ONYX-I and -II Phase 3 studies conducted in China, Taiwan, and South Korea with Western patients enrolled in PEARL-II (treatment-experienced), PEARL-III (treatment-naive), and TURQUOISE-II (compensated cirrhosis) Phase 3 studies conducted exclusively in North America, Europe, and Australia. Results: Among treatment-naive non-cirrhotic patients, sustained virologic response at post treatment week 12 (SVR12) was achieved by 99.5% (183/184; 95% CI 97.0-99.9) of Asian patients compared with 99.0% (207/209; 95% CI 97.7-100) of Western patients (GT1b). In non-cirrhotic treatment-experienced patients, SVR12 was achieved by 100% (141/141; 95% CI 97.4-100) of Asian patients and 100% (91/91; 95% CI 95.9-100) of Western patients (GT1b). Among cirrhotic patients, SVR12 was achieved by 100% (104/104; 95% CI 96.4-100) of Asian patients compared with 98.5% (67/68; 95% CI 95.3-100) of Western patients (GT1a and -1b-infected patients). The majority of Asian and Western patients with or without cirrhosis had at least 1 treatment-emergent adverse event (TEAE). A low percentage of Asian and Western patients (<4%) experienced serious TEAEs. TEAEs leading to treatment discontinuation, in both Asian and Western patients, were rare. No patients without cirrhosis and 1 subject with cirrhosis discontinued treatment due to a TEAE. Only 1 death occurred across the studies, which was not due to a TEAE. Conclusions: The safety/efficacy profiles were consistent between the Asian and Western HCV GT1b-infected patients treated with OBV+PTV/r + DSV.
Wei-Teh Li,Jau-Ming Chen,Ruo-Shan Tseng,Tzu-Ling Lai 한국기상학회 2022 Asia-Pacific Journal of Atmospheric Sciences Vol.58 No.1
September 2016 harbored record-breaking three tropical cyclones (TCs) affecting Taiwan within a month. Multiple modulating processes governing these three TC events and associated rainfall and intensification features are examined. September 2016 fell in a La Niña phase. For interannual variability, major warm sea surface temperature (SST) anomalies in September 2016 shifted eastward toward the tropical western North Pacific (WNP) compared to the Maritime Continent during other La Niña events. These SST anomalies induced strong convergence and convection anomalies facilitating TC formation. The TCs formed in the joint region between a northern anticyclonic anomaly over the northern WNP and a southern cyclonic anomaly extending from the tropical WNP toward Taiwan. They were steered by anomalous easterly/southeasterly flows northwestward toward an anomalous cyclonic center overlying Taiwan, leading to intensive TC activity affecting Taiwan. For intraseasonal variability, the three TCs of September 2016 were steered by anomalous easterly/southeasterly flows in the southern section of a 30–60-day anomalous anticyclone over the subtropical WNP northwestward toward a 30–60-day anomalous cyclone that lay over Taiwan. During these events, local rainfall in Taiwan was mainly affected by moisture convergence due to 3–10-day transient anomalies, rather than intraseasonal anomalies. For TC intensification processes, faster intensification was assisted by decreases in vertical wind shear and increases in upward motion, moisture convergence, upper-level divergence, and SST. Intensification processes were mainly affected by transient anomalies. Overall, interannual and intraseasonal anomalies modulated TC genesis and movement, while transient anomalies influenced local rainfall and intensification processes.
( Ya-min Lai ),( Wei-yan Yao ),( Yao He ),( Xuan Jiang ),( Yu-bei Gu ),( Min-hu Chen ),( Yu-lan Liu ),( Yao-zong Yuan ),( Jia-ming Qian ) 대한소화기학회 2017 Gut and Liver Vol.11 No.2
Background/Aims: Patients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective deple-tion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy out-comes based on patients` baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders. Methods: This was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endo-scopic activity index and the Mayo score. Results: Thirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed. Conclusions: The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Addition-ally, GMA was well tolerated and had a good safety profile. (Gut Liver 2017;11:216-225)
Evaluation of Key Success Factors for Web Design in Taiwan’s Bike Case Study
I-Sung LAI,Yung-Fu HUANG,Jie-Hua SIANG,Ming-Wei WENG 한국유통과학회 2020 The Journal of Asian Finance, Economics and Busine Vol.7 No.11
Global warming awareness through energy conservation is growing due to the regulatory policies issued by governments and voluntary organization that established carbon emission limits. Transportation is one of the major contributors to carbon emissions. Bike will be simultaneously saving money, getting fit and helping to reduce global warming. Web design has been identified as a key factor for the acceptance and success of the websites and electronic commerce. The purpose of this research is to investigate the effective implementation of the proposed Analytic Hierarchy Process (AHP) technique on a bike case study whose company (Bike Company) is involved in web design for a critical component in the demonstration. Survey research used a variety of data collection methods, with the most common being questionnaires and interviews of some exporters. The research results reveal that the top five key success factors are Good reputation, Transaction security, Ease of use, Promotion, and Diversified choices, which provide the guidelines and directions for decision-makers to design effective websites in the current competitive business scenario. The major findings of this study are suggesting that Internet marketing channels are securing the company’s relevance, together with paving the way for methods to increase web traffic.
Chyong-Huey Lai,Elizabeth Vallikad,Hao Lin,Lan-Yan Yang,Shih-Ming Jung,Hsueh-Erh Liu,Yu-Che Ou,Hung-Hsueh Chou,Cheng-Tao Lin,Huei-Jean Huang,Kuan-Gen Huang,Jiantai Qiu,Yao-Ching Hung,Tzu-I Wu,Wei-Yang 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.1
Objectives: An Asian Gynecologic Oncology Group phase III randomized trial was conducted to determine whether maintenance chemotherapy could improve progression-free survival (PFS) in stages III/IV ovarian cancer. Methods: Between 2007 and 2014, 45 newly-diagnosed ovarian cancer patients were enrolled after complete remission and randomized (1:1) to arm A (4-weekly carboplatin area under the curve 4 and pegylated liposomal doxorubicin [PLD] 30 mg/m2, n=24) for 6 cycles or arm B (observation, n=21). The primary end-point was PFS. A post hoc translational study was conducted to deep sequence BRCA/homologous recombination deficiency (HRD) genes, because BRCA/HRD mutations (BRCA/HRDm) are known to be associated with better prognosis. Results: Enrollment was slow, accrual was closed when 7+ years had passed. With a median follow-up of 88.9 months, the median PFS was significantly better in arm A (55.5 months) than arm B (9.2 months) (hazard ratio [HR]=0.40; 95% confidence interval [CI]=0.19–0.87; p=0.020), yet the median overall survival was not significantly different in arm A (not reached) than arm B (95.1 months) (p=0.148). Overall grade 3/4 adverse events were more frequent in arm A than arm B (60.9% vs 0.0%) (p<0.001). Quality of life was generally not significantly different. Distribution of BRCA1/2m or BRCA/HRDm was not significantly biased between the two arms. Wild-type BRCA/non-HRD subgroup seemed to fare better with maintenance therapy (HR=0.35; 95% CI=0.11–1.18; p=0.091). Conclusions: Despite limitations in small sample size, it suggests that maintenance carboplatin-PLD chemotherapy could improve PFS in advanced ovarian cancer.