Diabetes risk in patients with chronic obstructive pulmonary disease: a retrospective cohort study

( Yi-chun Chou ),( Ta-liang Chen ),( Chien-chang Liao ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: The relationship between chronic obstructive pulmonary disease (COPD) and diabetes remains incompletely understood. This study evaluated the risk of diabetes in COPD patients with and without exacerbations. Methods: We identified 4671 adults newly diagnosed with COPD exacerbations and 9342 adults newly diagnosed with COPD without exacerbations during 2000-2008 using Taiwan’s National Health Insurance Research Database. A comparison cohort of 18684 adults without COPD, matched by age and sex, was randomly selected from the same dataset for the control group. Diabetes events during 2000-2013 were ascertained from medical claims during the follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of diabetes associated with COPD with or without exacerbations were calculated. Results: During the follow-up period, the incidences of diabetes for patients without COPD and for patients with COPD without or with exacerbations were 3.4, 4.1 and 7.4 per 1000 person-years, respectively (P < 0.0001). Increased risk of diabetes for patients with COPD without exacerbations (HR 1.09, 95% CI 1.02-1.17) and COPD with exacerbations (HR 2.18, 95% CI 1.88-2.52) was noted. The associaiton between COPD and diabetes risk was significant in various subgroups. Conclusion: Prevention and intervention strategies for diabetes risk is needed for this susceptible population.

Risk and Outcome of Stroke in Patients with Liver Cirrhosis: Two Nationwide Studies

( Yi-chun Chou ),( Chien-chang Liao ),( Chun-chuan Shih ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: The association between liver cirrhosis (LC) and stroke was not completely understood. The purpose of this study is to evaluate stroke risk and post-stroke outcomes in patients with LC. Methods: Using the Taiwan National Health Insurance Research Database, we identified 6944 adults aged ≥20 years diagnosed with LC in 2000-2005. Non-LC cohort consisted of 27776 adults randomly selected and matched by age and sex (case-control ratio=1:4). Incident events of stroke occurring after LC from January 1, 2000, through the end of 2009 were identified in the follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke associated with LC were calculated. We conducted another nested cohort study consisted of 21267 patients with hospitalization due to stroke between January 1, 2004, and December 31, 2010. We calculated the adjusted odds ratios (ORs) and 95% CIs of 30-day mortality after stroke in patients with and without LC during admission. Results: The incidences of stroke for people with and without LC were 7.5 and 4.9 per1000 person-years, respectively (P<0.0001). Compared to people without LC, patients with LC had increased risk of stroke (HR 1.75, 95% CI 1.52-2.01). The association was significant in both sexes. In the nested cohort study, LC was associated with post-hemorrhage mortality (OR 1.83, 95% CI 1.63-2.05) and epilepsy (OR 1.30, 95% CI 1.09-1.56). Conclusions: Patients with LC showed higher risks of stroke and post-stroke mortality. Our findings suggest the urgency of preventing and managing LC by a multidisciplinary medical team for this specific population.

Outcomes after Admission of Liver Disease in Patients with Influenza Vaccination: A Nationwide Study

( Yi-chun Chou ),( Chien-chang Liao ),( Ta-liang Chen ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: The influences of influenza vaccination (IV) on outcomes of admission of liver disease are unclear. The purpose of this study is to investigate IV’s effects on pneumonia and mortality after liver disease in geriatric patients. Methods: Using Taiwan’s National Health Insurance Research Database reimbursement claims data from 2008 to 2013, we conducted a retrospective cohort study of 21385 patients aged more than 66 years who admitted to hospitalization due to liver disease (included viral hepatitis, cancer, necrosis of liver, and chronic liver disease) and 21035 had IV before the admission within one year. Multivariate logistic regressions were used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of post-admission pneumonia and in-hospital mortality associated with IV. Results: Patients receiving IV showed less pneumonia after liver disease (OR 0.51, 95% CI 0.35-0.75). But there was no significant association between IV and in-hospital mortality (OR 0.85, 95% CI 0.46-1.56) compared with unvaccinated patients. Conclusions: Vaccinated geriatric patients showed lower risks of pneumonia compared with unvaccinated patients undergoing similar admission of liver disease. Further studies are needed to explain how IV improves the outcomes of liver disease.

Protective Effects of Influenza Vaccination on the Admission Outcomes of Liver Cancer: A Nationwide Matched Study

( Yi-chun Chou ),( Ta-liang Chen ),( Chien-chang Liao ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: Limited information is available on the association between influenza vaccination (IV) and cancer outcomes. The purpose of this study is to evaluate the effects of IV on the out comes of liver cancer. Methods: Using reimbursement claims data of National Health Insurance in Taiwan in 2008-2013, we conducted a matched cohort study including 32330 patients aged ≥20 years underwent inpatient care of liver cancer and 5841 of them received IV within previous one year. Using propensity score matching procedure, we selected 5621 patients with IV and 5621 patients without IV for comparison. Logistic regressions were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) of IV associated with complications and in-hospital mortality during admission of liver cancer. Results: Patients with liver cancer receiving IV showed less pneumonia (P<0.0001), septicemia (P<0.0001), urinary tract infection (P<0.0001), and in-hospital mortality (P<0.0001) compared with unvaccinated patients with liver cancer. IV was associated with decreased risk of in-hospital mortality during the cancer admission (OR, 0.60; 95% CI, 0.47-0.76) after adjustment. Vaccinated patients with liver cancer also had shorter length of hospital stay (P<0.0001) and lower medical expenditure (P<0.0001) than non-vaccinated patients. Conclusions: Among patients with admission of liver cancer, vaccinated patients showed lower risks of complications and in-hospital mortality compared with unvaccinated patients. Further studies are needed to explain how IV improves outcomes of liver cancer.

Improving Guidance Accuracy of Two-year Postgraduate Nurses for the Administering of Home Parenteral Nutrition

Yi-Shan Chou,Wan-Chun Liao,Pi-Ling Chou,Yu-Yin Wang,Mei-Chu Yang 한국간호과학회 2019 한국간호과학회 학술대회 Vol.2019 No.10

Poster Session : PS 1007 ; GI Motility : Gastrointestinal Hemorrhage and Post-Hemorrhage Mortality in Patients with ITP: Two Cohort Studies

( Yi Chun Chou ),( Chien Chang Lia ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The relationship between immune thrombocytopenia (ITP) and gastrointestinal hemorrhage is not determined. This study evaluated the risk of gastrointestinalhemorrhage and post-hemorrhage mortality in patients with ITP. Methods: Using the Taiwan National Health Insurance Research Database, we identifi ed 1033 adults aged =18 years diagnosed with ITP in 2000-2003. Non-ITP cohort consisted of 10330 adults were randomly selected and matched by age and sex from the same dataset. Events of gastrointestinal hemorrhage in 2000-2008 were ascertained from medical claims. Adjusted hazard ratios (HR) and 95% confi dence interval (CI) of gastrointestinal hemorrhage associated with ITP was calculated. Another nested cohort study consisted of 27369 patients with hospitalization due to gastrointestinal hemorrhage between 2004 and 2010. We calculated the adjusted odds ratios (ORs) and 95% CIs of 30-day mortality after gastrointestinal hemorrhage in patients with and without ITP during admission. Results: During 78,073 person-years of follow-up, the incidences of gastrointestinal hemorrhage for people with and without ITP were 14.5 and 5.07 per 1000 person- years, respectively (p<0.0001). Compared to people without ITP, patients with ITP had increased risk of gastrointestinal hemorrhage (HR 2.61, 95% CI 2.05-3.32). In the nested cohort study, ITP was associated with post-hemorrhage mortality (OR 1.98, 95% CI 1.09-3.59). Conclusions: Our two nationwide retrospective cohort studies investigated the increased gastrointestinal hemorrhage and post-hemorrhage mortality in patients with ITP.

Indoor Robot Navigation Based on DWA

Yi-Chun Lin,Chih-Chung Chou,Feng-Li Lian 제어로봇시스템학회 2009 제어로봇시스템학회 국제학술대회 논문집 Vol.2009 No.8

Robot navigation methods can be divided into two classes: global path planning and local reactive methods. Global path planning methods find an optimal path to a specified goal, while local reactive methods compute proper control commands for the robot according to recent sensory information. In this paper, a new navigation method is presented, the new method integrates dynamic window approach (DWA) and best-first search (BFS), therefore, the robot can react to dynamic environments and the path optimality can be maintained.

Using Chlorophyll Fluorescence and Vegetation Indices to Predict the Timing of Nitrogen Demand in Pentas lanceolata

Chun-Wei Wu,Kuan-Hung Lin,Ming-Chih Lee,Yung-Liang Peng,Ting-Yi Chou,Yu-Sen Chang 한국원예학회 2015 원예과학기술지 Vol.33 No.6

The objective of this study was to predict the timing of nitrogen (N) demand through analyzing chlorophyll fluorescence (ChlF), soil-plant analysis development (SPAD), and normalized difference vegetation index (NDVI), which are positively correlated with foliar N concentration in star cluster (Pentas lanceolata). The plants were grown in potting soil under optimal conditions for 30 d, followed by weekly irrigation with five concentrations (0, 4, 8, 16, and 24 mM) of N for an additional 30 d. These five N application levels corresponded to leaf N concentrations of 2.62, 3.48, 4.00, 4.23, and 4.69%, respectively. We measured 13 morphological and physiological parameters, as well as the responses of these parameters to various N-fertilizer treatments. The general increases in Dickson’s quality index (DQI), above-ground dry weight (DW), total DW, flowering rate, △F/Fm’, and qP in response to t reatment with 0 to 8 mM N were similar to those of SPAD, NDVI, and Fv/Fm. Consistent and s trong correlations (R² = 0.60 to 0.85) were observed between leaf N concentration (%) and SPAD, NDVI, △F/Fm’, and above-ground DW. Validation of leaf S PAD, NDVI, and △F/Fm’ revealed that these vegetation indices are accurate predictors of leaf N concentration that can be used for non-destructive estimation of the proper timing for N-solution irrigation of P. lanceolata. Moreover, irrigation with 8 mM N-fertilizer i s recommended w hen leaf N concentration, SPAD, NVDI, and △F/Fm’ ratios are reduced from their saturation values of 4.00, 50.68, 0.64, and 0.137%, respectively.

Using Chlorophyll Fluorescence and Vegetation Indices to Predict the Timing of Nitrogen Demand in Pentas lanceolata

Wu, Chun-Wei,Lin, Kuan-Hung,Lee, Ming-Chih,Peng, Yung-Liang,Chou, Ting-Yi,Chang, Yu-Sen Korean Society of Horticultural Science 2015 원예과학기술지 Vol.33 No.6

The objective of this study was to predict the timing of nitrogen (N) demand through analyzing chlorophyll fluorescence (ChlF), soil-plant analysis development (SPAD), and normalized difference vegetation index (NDVI), which are positively correlated with foliar N concentration in star cluster (Pentas lanceolata). The plants were grown in potting soil under optimal conditions for 30 d, followed by weekly irrigation with five concentrations (0, 4, 8, 16, and 24 mM) of N for an additional 30 d. These five N application levels corresponded to leaf N concentrations of 2.62, 3.48, 4.00, 4.23, and 4.69%, respectively. We measured 13 morphological and physiological parameters, as well as the responses of these parameters to various N-fertilizer treatments. The general increases in Dickson's quality index (DQI), above-ground dry weight (DW), total DW, flowering rate, ${\Delta}F/Fm$', and qP in response to treatment with 0 to 8 mM N were similar to those of SPAD, NDVI, and Fv/Fm. Consistent and strong correlations ($R^2$= 0.60 to 0.85) were observed between leaf N concentration (%) and SPAD, NDVI, ${\Delta}F/Fm$', and above-ground DW. Validation of leaf S PAD, NDVI, and ${\Delta}F/Fm$' revealed that these vegetation indices are accurate predictors of leaf N concentration that can be used for non-destructive estimation of the proper timing for N-solution irrigation of P. lanceolata. Moreover, irrigation with 8 mM N-fertilizer i s recommended w hen leaf N concentration, SPAD, NVDI, and ${\Delta}F/Fm$' ratios are reduced from their saturation values of 4.00, 50.68, 0.64, and 0.137%, respectively.

電子學習對香港小學生書寫漢字的影響

( Wai Yi Chou ),( Chun Man Sin ),( Wai Ip Lam ),( King Ping Chan ),( Ka Man Ma ) 한국한자한문교육학회 2014 漢字 漢文敎育 Vol.33 No.-

홍콩 교육당국은 90년대부터 적극적으로 정보통신기술을 이용한 학습을 추진 하였다. 그러나 전자학습이 소학교 학생들의 연필을 잡고 한자를 쓰는데 있어 어떤 영향을 미칠 것인가에 대해서는 여전히 많은 논쟁이 있다. 전자교재를 교육의 보조도구로 활용하는 방안은 이미 20년을 넘도록 추진되고 있으나, 오직 학자들만이 가끔씩 이 변화가 가져오는 이익과 손해에 대해서 관심을 가지고 있을 뿐이다. 본 연구는 두 개의 소학교에 있는 네 개 반의 5학년 학생 80명을 연구 대상으로 삼아, 녹화와 분석을 통해 학생들의 한자쓰기를 상하구조, 좌우구조, 전포위구조, 반포위구조 등으로 분류하고, 계량화하였다. 이 때 비교실험군(전자학습반)과 통제군(전통학습반)으로 나누고 학생들의 한자 쓰기 필순의 습관과 틀리게 쓰는 상황이 각기 다르게 나타는 상황과 한자 쓰기 퀴즈와 면담의 내용 까지도 실험 내용에 포함시켰다. 연구를 통해 우리는 대조군과 실험군에서 암묵적으로 사용하는 한자쓰기와 필순에 별다른 차이가 없음을 발견하였다. 하지만 실험조의 낮은 수준의 학생들은 암묵적 쓰기에 있어서 대조군의 낮은 수준의 학생에 비해 현격하게 낮은 결과를 나타내었다. 교사 심층 면담을 통해 전자학습이 학생들의 한자 쓰기에 부정적 영향을 미치고 있으며, 합리적인 하자교육의 운용과 평가, 학교 공부를 통해 이를 감소시키거나 없앨 수 있음을 알았다. 바대로 얘기하자면 보조적인 교수 학습 전략이 부족하다면 낮은 수준의 학생들은 한자를 학습하는데 부정적인 영향이 계속 될 가능성이 있으며, 학습에 부담을 증가시킬 수 있다는 것이다. 때문에 교사는 전자학습의 보조적인 전략을 운영할 때에도 많은 주의를 기울여야 한다. The Hong Kong Education Bureau has been actively promoting e-learning since the 90s. However, it is still debatable whether the use of electronic media for learning is of negative influence to primary students` handwriting for Chinese characters. Ever since the adoption of e-learning, few scholars have paid ample and close attention to the pros and cons derived from the change. This research is based on four classes of 80 primary five students in total as subjects, through video recording and analysis of the performance of students` handwriting specifically by approaches such as evaluation of top-bottom, left-right and whole-surrounded, semi-surrounded structure of Chinese characters. To measure and compare between the experimental group (learning Chinese characters through electronic materials) and the control group (learning Chinese characters through traditional materials), handwriting of Chinese characters including order of strokes and seriousness of characters mistakes, were studied to see the difference. The research data includes the interviews of the teachers and the results of the Chinese characters writing test. The findings of this research, generally speaking, is that the experimental group has no significant difference in dictation ability and stroke order compared to the control group. However, low-achieving students in the experimental group are found to have lower dictation abilities than that of the control group. The teachers interview show that if the strategies, assessments and assignments of the teaching of literacy are well coordinated, the negative effect of e-learning on writing Chinese characters may be diminished or even eliminated. On the contrary, the insufficiency of corresponding strategies and the subsequent workloads may cause negative effect of learning Chinese character for low-achieving students. Therefore, teachers have to be careful while using corresponding strategies for teaching Chinese characters.