Incidence and relative risk factors in posttransplant diabetes mellitus patients: a retrospective cohort study

Ching-Yao Cheng,Yu-Tung Feng,Hue-Yu Wang 대한이식학회 2020 Korean Journal of Transplantation Vol.34 No.4

Background: Posttransplant diabetes mellitus (PTDM) has a long-term impact on kidney transplantation outcomes, such as graft and patient survival. The incidence and risk factors of PTDM are well studied, but long-term follow-up results remain unavailable. We examined the long-term incidence and relative risk factors of PTDM. Methods: A hospital information system database for kidney transplant recipients (KTRs) for a transplantation center between 1983 and 2018 was used to perform this retrospective cohort study. KTRs with DM diagnosis and continuous use of hypoglycemic agents for more than 3 months were defined as having PTDM. Demographics and comorbidities before transplantation were also collected. Kaplan-Meier analyses were used to determine the cumulative incidence and relative risk factors. Results: A total of 296 PTDM cases were confirmed (28.46%) in this study. An increased cumulative incidence associated with age was noted, which was significantly increased in those aged ≥40 years. Male sex, hypertension, hyperlipidemia before transplantation, cytomegalovirus (CMV) infection, and tacrolimus-based regimens were also risk factors. No significant correlation was found between the development of PTDM and the increase of human leukocyte antigen mismatches, the primary causes of end-stage renal disease, and acute rejection. Conclusions: PTDM incidence was high in this cohort study. Characteristics such as age ≥40 years, tacrolimus use, comorbidity of hypertension and hyperlipidemia before transplantation, and CMV infection were associated with a high risk of PTDM. Monitoring and adjusting preventable risk factors such as CMV infection might be useful to prevent PTDM.

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.

Comedications and potential drug-drug interactions with direct-acting antivirals in hepatitis C patients on hemodialysis

( Po-yao Hsu ),( Yu-ju Wei ),( Jia-jung Lee ),( Sheng-wen Niu ),( Jiun-chi Huang ),( Cheng-ting Hsu ),( Tyng-yuan Jang ),( Ming-lun Yeh ),( Ching-i Huang ),( Po-cheng Liang ),( Yi-hung Lin ),( Ming-ye 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1

Background/Aims: Direct-acting antivirals (DAAs) have been approved for hepatitis C virus (HCV) treatment in patients with end-stage renal disease (ESRD) on hemodialysis. Nevertheless, the complicated comedications and their potential drug-drug interactions (DDIs) with DAAs might limit clinical practice in this special population. Methods: The number, class, and characteristics of comedications and their potential DDIs with five DAA regimens were analyzed among HCV-viremic patients from 23 hemodialysis centers in Taiwan. Results: Of 2,015 hemodialysis patients screened in 2019, 169 patients seropositive for HCV RNA were enrolled (mean age, 65.6 years; median duration of hemodialysis, 5.8 years). All patients received at least one comedication (median number, 6; mean class number, 3.4). The most common comedication classes were ESRD-associated medications (94.1%), cardiovascular drugs (69.8%) and antidiabetic drugs (43.2%). ESRD-associated medications were excluded from DDI analysis. Sofosbuvir/velpatasvir/voxilaprevir had the highest frequency of potential contraindicated DDIs (red, 5.6%), followed by glecaprevir/pibrentasvir (4.0%), sofosbuvir/ledipasvir (1.3%), sofosbuvir/velpatasvir (1.3%), and elbasvir/grazoprevir (0.3%). For potentially significant DDIs (orange, requiring close monitoring or dose adjustments), sofosbuvir/velpatasvir/voxilaprevir had the highest frequency (19.9%), followed by sofosbuvir/ledipasvir (18.2%), glecaprevir/pibrentasvir (12.6%), sofosbuvir/velpatasvir (12.6%), and elbasvir/grazoprevir (7.3%). Overall, lipid-lowering agents were the most common comedication class with red-category DDIs to all DAA regimens (n=62), followed by cardiovascular agents (n=15), and central nervous system agents (n=10). Conclusions: HCV-viremic patients on hemodialysis had a very high prevalence of comedications with a broad spectrum, which had varied DDIs with currently available DAA regimens. Elbasvir/grazoprevir had the fewest potential DDIs, and sofosbuvir/velpatasvir/voxilaprevir had the most potential DDIs. (Clin Mol Hepatol 2021;27:186-196)

Fabrication and Study of Novel Piezoresistive Polymer Composites Sensor for 3D Printing Applications

( Yu-yen Chen ),( Cheng-chun Huang ),( Ching-yuan Su ),( Yao-chuan Tsai ) 한국농업기계학회 2018 한국농업기계학회 학술발표논문집 Vol.23 No.1

With the technology development, the technique of 3D printing has gradually matured. The characteristic of 3D printing is that it can print the product directly without another complex process. If the 3D printing could be applied to manufacturing sensor elements, it could be quicker and cheaper for the sensor element fabrication and the sensor forms will be applicable. Piezoresistive effect is a common sensor sensing principle which is through the deformation of the material to cause the resistance changes. In this study, a piezoresistive polymer composites material was developed, which can be manufactured by the photo-curable 3D printing. The different amount of the conductive carbon black (CB) nanoparticles was employed and added into photo-curable resin for obtaining the conductive percolation threshold of the polymer composites and measuring the piezoresistivity of the polymer composites. The conductive percolation threshold is around 1.0~1.5wt%, and the gauge factor of 1.5wt% is 9~17. The gauge factor was found which would decrease with the increasing strains. This study can be applied on fabricating the piezoresistive pressure and tactile sensors which can be used to the agricultural, industrial and various industries.

Potential of a combination of entomopathogenic fungal strains and a non-ionic surfactant to control the fall armyworm (Spodoptera frugiperda)

Wu Sing-Shan,Tseng Ching-Tzu,Yang Yu-Hung,Liu Yao-Chia,Chang Ju-Chun,Gyawali Purushottam,Li Yi-Hsuan,Yang Tzu-Hao,Tsai Yi-Fang,Tang Li-Cheng,Nai Yu-Shin 한국응용곤충학회 2022 Journal of Asia-Pacific Entomology Vol.25 No.4

The fall armyworm, Spodoptera frugiperda, is an emerging invasive pest in Taiwan that feeds on a wide range of crops and causes serious damage. Herein, an entomopathogenic fungal library (EFLib) was constructed to identify potential microbes to control FAW. Twenty-eight indigenous entomopathogenic fungi (EPF) were iso lated and investigated for their potential pathogenicity, with Metarhizium pinghaense (Mp-NCHU-124) and Beauveria bassiana (Bb-NCHU-157) exerting dose-dependent effects on the 4th instar FAW larvae. The non-ionic surfactant Silwet L-77 rapidly killed FAW larvae after spraying at a concentration of 300 mg/kg and the toxic effect of Silwet L-77 on FAW larvae was dose-dependent. When the EPF isolates (10 6 conidia/mL) were applied to FAW larvae in combination with the non-ionic surfactant Silwet L-77 (30–90 mg/kg), the mortality rate dramatically increased and the LT 50 reduced, with increased fungal mycosis (Mp-NCHU-124: 38% to 72% and Bb-NCHU-157: 20 to 62%), indicating the high compatibility of EPF with the non-ionic surfactant. Thus, the Silwet L-77+EPF combined formulation has potential for practical field application for FAW pest control and sustainable agriculture in the future.

High Power Density Asymmetrical Full-Bridge Soft-Switching Inverter

Pei-Chin Chi,Cheng-Yen Chou,Marojahan Tampubolon,Yao-Ching Hsieh,Jing-Yuan Lin,Huang-Jen Chiu 전력전자학회 2015 ICPE(ISPE)논문집 Vol.2015 No.6

This paper presents a Zero-Voltage-Switching (ZVS) technique eliminating the switching loss on a proposed single phase bi-directional full-bridge Buck inverter in which asymmetrical filter topology and control scheme are for each arm. Here Metal-Oxide-Field-Effect- Transistor(MOSFET) is chosen as the switching device, an L₁-C₁ filter is connected across the full-bridge, an L₂ filter is connected in series to load or grid. While the arm connecting with the C₁ is controlled by the polarity of 50Hz sinusoid reference command and the arm connecting with the L₁ is controlled by a Pulse-Width-Modulation(PWM) signal modulated by sinusoid, the L₁-C₁ then operates as an output filter of Buck, and the succeeding L₂ filter further attenuates ripple current flowing to load or grid. The ZVS technique sets the L₁ inductance such low that its current flows bi-directionally within a switching period, then the bidirectional current with sufficiently high peaks in turn charge and discharge the output capacitance Coss of MOSFETs of the switching arm within floating time, defined as the duration when both MOSFETs of an arm are off, to let the MOSFETs D-S channels be turned on or off at the state that Coss are fully discharged to zero voltage, so ZVS of MOSFET is achieved. Under the ZVS operation without frequency proportional switching loss, the switching frequency is possible to be raised to high to compact the sizes of passive components and heat sink of the inverter for achieving high power density. Simulation and experiment have been carried out to verify the ZVS operation.

Real-time, Economical Identification of Microplastics Using Impedance-based Interdigital Array Microelectrodes and k-Nearest Neighbor Model

Congo Tak Shing Ching,Pei-Yuan Lee,Nguyen Van Hieu,Hsin-Hung Chou,Fiona Yan-Dong Yao,Cheng Sha-Yen,Lin Yung-Kai,Thien Luan Phan 한국생물공학회 2023 Biotechnology and Bioprocess Engineering Vol.28 No.3

Microplastic, being a direct carrier of many pollutants, has caused grave concern and become a public issue. This gives rise to the need of a quick method for quantifying and identifying microplastics in the environment. This study uses impedance spectroscopy, particularly the imaginary part of impedance, for detection and identification of sample microplastics. Two type of common microplastic contaminants, Polyethylene and Polystyrene, diameter 20 m and 150 m, were chosen for this study. The results confirm accurate identification of microplastic material in question, by using self-normalized ratio between two characteristic frequencies of 7MHz and 8.9 MHz, Zf = 7 MHz / Zf = 8.9 MHz. 3-kNN classifier built with the ratio Zf = 7 MHz / Zf = 8.9 MHz, and Zf = 8 MHz /Zf = 8.9 MHz, demonstrates accuracy upto 90% for the identification of single or both microplastic types in samples. These results confirm impedance spectroscopy, permitting rapid identification of microplastic without labeling and skillful techniques, as a potential rapid sensor.

A Systematic Classification of the Congenital Bronchopulmonary Vascular Malformations: Dysmorphogeneses of the Primitive Foregut System and the Primitive Aortic Arch System

Meng-Luen Lee,Hung-Chi Lue,Ing-Sh Chiu,Han-Yao Chiu,Lon-Yen Tsao,Ching-Yuan Cheng,Albert D. Yang 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.1

Purpose: We reviewed the cases of 33 patients from our clinic and 142 patients from the literature with congenital bronchopulmonary vascular malformations (BPVM), systematically analyzed the bronchopulmonary airways, pulmonary arterial supplies, and pulmonary venous drainages, and classified these patients by pulmonary malinosculation (PM). Materials and Methods: From January 1990 to January 2007, a total of 33 patients (17 men or boys and 16 women or girls), aged 1 day to 24 years (median, 2.5 months), with congenital BPVM were included in this study. Profiles of clinical manifestations, chest radiographs, echocardiographs, esophagographs, computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), cardiac catheterizations with angiography, contrast bronchographs, bronchoscopies, chromosomal studies, surgeries, and autopsies of these patients were analyzed to confirm the diagnosis of congenital BPVM. A total of 142 cases from the literature were also reviewed and classified similarly. Results: The malformations of our 33 patients can be classified as type A isolated bronchial PM in 13 patients, type B isolated arterial PM in three, type C isolated venous PM in two, type D mixed bronchoarterial PM in five, type F mixed arteriovenous PM in one, and type G mixed bronchoarteriovenous PM in nine. Conclusion: Dysmorphogeneses of the primitive foregut system and the primitive aortic arch system may lead to haphazard malinosculations of the airways, arteries, and veins of the lung. A systematic classification of patients with congenital BPVM is clinically feasible by assessing the three basic bronchovascular systems of the lung independently.

Scaling up the in-hospital hepatitis C virus care cascade in Taiwan

( Chung-feng Huang ),( Pey-fang Wu ),( Ming-lun Yeh ),( Ching-i Huang ),( Po-cheng Liang ),( Cheng-ting Hsu ),( Po-yao Hsu ),( Hung-yin Liu ),( Ying-chou Huang ),( Zu-yau Lin ),( Shinn-cherng Chen ),( 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1

Background/Aims: Obstacles exist in facilitating hepatitis C virus (HCV) care cascade. To increase timely and accurate diagnosis, disease awareness and accessibility, in-hospital HCV reflex testing followed by automatic appointments and a late call-back strategy (R.N.A. model) was applied. We aimed to compare the HCV treatment rate of patients treated with this strategy compared to those without. Methods: One hundred and twenty-five anti-HCV seropositive patients who adopted the R.N.A. model in 2020 and another 1,396 controls treated in 2019 were enrolled to compare the gaps in accurate HCV RNA diagnosis to final treatment allocation. Results: The HCV RNA testing rate was significantly higher in patients who received reflex testing than in those without reflex testing (100% vs. 84.8%, P<0.001). When patients were stratified according to the referring outpatient department, a significant improvement in the HCV RNA testing rate was particularly noted in patients from non-hepatology departments (100% vs. 23.3%, P<0.001). The treatment rate in HCV RNA seropositive patients was 83% (83/100) after the adoption of the R.N.A. model, among whom 96.1% and 73.9% of patients were from the hepatology and non-hepatology departments, respectively. Compared to subjects without R.N.A. model application, a significant improvement in the treatment rate was observed for patients from non-hepatology departments (73.9% vs. 27.8%, P=0.001). The application of the R.N.A. model significantly increased the in-hospital HCV treatment uptake from 6.4% to 73.9% for patients from non-hepatology departments (P<0.001). Conclusions: The care cascade increased the treatment uptake and set up a model for enhancing in-hospital HCV elimination. (Clin Mol Hepatol 2021;27:136-143)

Maintenance of pegylated liposomal doxorubicin/carboplatin in patients with advanced ovarian cancer: randomized study of an Asian Gynecologic Oncology Group

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.