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.

Validation of a Palliative Prognostic Index to Predict Life Expectancy for Terminally Ill Cancer Patients in a Hospice Consultation Setting in Taiwan

Cheng, Wei-Hong,Kao, Chen-Yi,Hung, Yu-Shin,Su, Po-Jung,Hsieh, Chia-Hsun,Chen, Jen-Shi,Wang, Hung-Ming,Chou, Wen-Chi Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.6

Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan. Methods: In total, 623 terminal cancer patients under hospice consultation care from one medical center in northern Taiwan were enrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultation and patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzed retrospectively to determine significance of between-group differences. Results: By PPI sum score, 37.2% of patients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poor prognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days, respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versus good prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group. The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.

EVOLUTION OF THE TIMES WHEN THE TRADITIONAL MATERIALS ENCOUNTER INTERACTIVE TECHNOLOGY

Chen-Wei Chiang,Min-Shiue Wu,Meng-Te Hsieh,Chia-Yu Kao,Chun-Yan Liu 한국디자인학회 2015 한국디자인학회 학술발표대회 논문집 Vol.2015 No.10

The Reflection of Bamboo combines traditional materials with interactive technology, analyzing what the characteristics of the old and new materials are, as well as how to apply technology to the integration of these materials. Through this installation, we reconsider the possibility of integrating traditional materials with modern technology. Adopting bamboo as the main material, this installation raises the spirit of traditional techniques in a unique way and employs bamboo’s special tenacity. Viewers can interact with this installation and experience the strength, esthetics and variation in the demonstrated shadow.

Enhanced Allergic Inflammation of Der p 2 Affected by Polymorphisms of MD-2 Promoter

En-Chih Liao,Chia-Wei Hsieh,Ching-Yun Chang,Sheng-Jie Yu,Meei-Ling Sheu,Sheng-Mao Wu,Jaw-Ji Tsai 대한천식알레르기학회 2015 Allergy, Asthma & Immunology Research Vol.7 No.5

Purpose: Myeloid differentiation-2 (MD-2) has been associated with endotoxin and inflammatory disorders because it can recognize lipopolysaccharide (LPS) binding and attenuate Toll-like receptor 4 (TLR4)-mediated signaling. However, its role in allergic inflammation has yet to be clarified. We examined whether single nucleotide polymorphisms (SNPs) in MD-2 promoter can affect MD-2 expression and aimed to clarify the relationship between Der p 2 allergy and SNPs of MD-2 promoter. Methods: The function of SNPs of MD-2 promoter and the effects of cytokines and immunoglobulin on the secretion and mRNA expression were investigated in 73 allergic subjects with different MD-2 gene promoter variants. Peripheral blood mononuclear cells were cultured with or without LPS in the presence of Dermatophagoides pteronyssinus group 2 allergen (Der p 2), followed by mRNA extraction and cytokine expression analysis. The culture supernatants were collected for cytokine measurement. Results: Patients with the MD-2 promoter SNPs (rs1809441/rs1809442) had increased mRNA expressions of MD-2, ε heavy chain of IgE (Cε), and interleukin (IL)-8; however, only MD-2 and IL-8 were further up-regulated after Der p 2 stimulation. Patients with SNPs of MD-2 promoter tended to have high levels of IL- 1β, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α after Der p 2 and LPS stimulation. Increased secretions of IL-6, IL-8, and IL-10 were found to be up-regulated by Der p 2 stimulation, and an increased secretion of IFN-γ and decreased secretion of IL-4 were noted after LPS stimulation. Conclusions: The high levels of proinflammatory cytokines secreted by Der p 2 were predetermined by MD-2 promoter SNPs (rs1809441/rs1809442). Through cytokine secretion by Der p 2 and LPS, these SNPs may serve as an indicator of the pathological phenotype of Der p 2-induced allergic inflammation.

The back contact modification in high-efficiency Cu₂ZnSn(S,Se)₄ solar cells by a thin MoO₃ layer

Septia KHOLIMATUSSADIAH,Cheng-Ying CHEN,Wei-Chao CHEN,Yi-Rung LIN,Shao-Hung LU,Meng-Chia HSIEH,Jan-Kai CHANG,Chih-I WU,Ruei-San CHEN,Kuei-Hsien CHEN,Li-Chyong CHEN 한국진공학회 2016 한국진공학회 학술발표회초록집 Vol.2016 No.8

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.

Health Care Utilization and Expenditures of Patients with Diabetes Comorbid with Depression Disorder: A National Population-Based Cohort Study

Chun-Jen Huang,Hui-Min Hsieh,Herng-Chia Chiu,Peng-Wei Wang,Mei-Hsuan Lee,Chih-Yi Li,Ching-Hua Lin 대한신경정신의학회 2017 PSYCHIATRY INVESTIGATION Vol.14 No.6

Objective: The study investigated to compare health care utilization and expenditures between diabetic patients with and without depression in Taiwan. Methods: Health care utilization and expenditure among diabetic patients with and without depression disorder during 2000 and 2004 were examined using Taiwan’s population-based National Health Insurance claims database. Health care utilization included outpatient visits and the use of inpatient services, and health expenditures were outpatient, inpatient, and total medical expenditures. Moreover, general estimation equation models were used for analyzing the factors associated with outpatient visits and expenditures. Multiple logistic regression analysis was applied for identifying the factors associated with hospitalization. Results: The average annual outpatient visits and annual total medical expenditures in the study period were 44.23–52.20; NT$87,496–133,077 and 30.75–32.92; NT$64,411–80,955 for diabetic patients with and without depression. After adjustment for covariates, our results revealed that gender and complication were associated with out-patient visits. Moreover, the time factor was associated with the total medical expenditure, and residential urbanization and complication factors were associated with hospitalization. Conclusion: Health care utilization and expenditures for diabetic patients with depression were significantly higher than those without depression. Sex, complications, time, and urbanization are the factors associated with health care utilization and expenditures.