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Combined Assessment of Serum Alpha-Synuclein and Rab35 is a Better Biomarker for Parkinson’s Disease
Hung-Li Wang,Chin-Song Lu,Tu-Hsueh Yeh,Yu-Ming Shen,Yi-Hsin Weng,Ying-Zu Huang,Rou-Shayn Chen,Yu-Chuan Liu,Yi-Chuan Cheng,Hsiu-Chen Chang,Ying-Ling Chen,Yu-Jie Chen,Yan-Wei Lin,Chia Chen Hsu,Huang-Li 대한신경과학회 2019 Journal of Clinical Neurology Vol.15 No.4
Background and Purpose It is essential to develop a reliable predictive serum biomarker for Parkinson’s disease (PD). Te accumulation of alpha-synuclein (αSyn) and up-regulated expression of Rab35 participate in the etiology of PD. Te purpose of this investigation was to determine whether the combined assessment of serum αSyn and Rab35 is a useful predictive biomarker for PD. Methods Serum levels of αSyn or Rab35 were determined in serum samples from 59 sporadic PD patients, 19 progressive supranuclear palsy (PSP) patients, 20 multiple system atrophy (MSA) patients, and 60 normal controls (NC). Receiver operating characteristics (ROC) curves were calculated to determine the diagnostic accuracy of αSyn or/and Rab35 in discriminating PD patients from NC or atypical parkinsonian patients. Results The levels of αSyn and Rab35 were increased in PD patients. The serum level of Rab35 was positively correlated with that of αSyn in PD patients. Compared to analyzing αSyn or Rab35 alone, the combined analysis of αSyn and Rab35 produced a larger area under the ROC curve and performed better in discriminating PD patients from NC, MSA patients, or PSP patients. When age was dichotomized at 55, 60, 65, or 70 years, the combined assessment of αSyn and Rab35 for classifying PD was better in the group below the cutof age than in the group above the cutof age. Conclusions Combined assessment of serum αSyn and Rab35 is a better biomarker for discriminating PD patients from NC or atypical parkinsonian patients, and is a useful predictive biomarker for younger sporadic PD patients.
Eunice Jia-Shiow Yuan,Shiau-Shian Huang,Chia-An Hsu,Jiing-Feng Lirng,Tzu-Hao Li,Chia-Chang Huang,Ying-Ying Yang,Chung-Pin Li,Chen-Huan Chen 한국보건의료인국가시험원 2023 보건의료교육평가 Vol.20 No.-
Purpose Coronavirus disease 2019 (COVID-19) has heavily impacted medical clinical education in Taiwan. Medical curricula have been altered to minimize exposure and limit transmission. This study investigated the effect of COVID-19 on Taiwanese medical students’ clinical performance using online standardized evaluation systems and explored the factors influencing medical education during the pandemic. Methods Medical students were scored from 0 to 100 based on their clinical performance from 1/1/2018 to 6/31/2021. The students were placed into pre-COVID-19 (before 2/1/2020) and midst-COVID-19 (on and after 2/1/2020) groups. Each group was further categorized into COVID-19-affected specialties (pulmonary, infectious, and emergency medicine) and other specialties. Generalized estimating equations (GEEs) were used to compare and examine the effects of relevant variables on student performance. Results In total, 16,944 clinical scores were obtained for COVID-19-affected specialties and other specialties. For the COVID-19-affected specialties, the midst-COVID-19 score (88.51–3.52) was significantly lower than the pre-COVID-19 score (90.14–3.55) (P<0.0001). For the other specialties, the midst-COVID-19 score (88.32–3.68) was also significantly lower than the pre-COVID-19 score (90.06–3.58) (P<0.0001). There were 1,322 students (837 males and 485 females). Male students had significantly lower scores than female students (89.33–3.68 vs. 89.99–3.66, P=0.0017). GEE analysis revealed that the COVID-19 pandemic (unstandardized beta coefficient=-1.99, standard error [SE]=0.13, P<0.0001), COVID-19-affected specialties (B=0.26, SE=0.11, P=0.0184), female students (B=1.10, SE=0.20, P<0.0001), and female attending physicians (B=-0.19, SE=0.08, P=0.0145) were independently associated with students’ scores. Conclusion COVID-19 negatively impacted medical students' clinical performance, regardless of their specialty. Female students outperformed male students, irrespective of the pandemic.
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.
혼합 코풀라 모형을 사용한 주식시장 내 기관투자가의 극단적 수익률 및 거래량 종속성 연구
황가흥 ( Chia Hsing Huang ),이건성 ( Chien Tsung Li ) 한국금융공학회 2012 금융공학연구 Vol.11 No.4
혼합 코풀라 모형은 대만 주식시장에서 외국계 기관투자가, 뮤추얼펀드 및 딜러의 극단수익률과 주식거래회전율 간의 관계를 연구하기 위해 사용되었다. 본 연구에서 는 극단적인 투자손실이 발생한 상황에서의 거래증가량을 연구하기 위한 변환된 함 수가 기재되었다. 실증결과 딜러는 극심한 손실 혹은 극심한 이익이 발생한 기간 모 두에서 가장 높은 거래량 증가를 나타내고 있다. 외국계 기관투자가와 비교했을 때, 뮤추얼펀드는 이익이 극대화되는 기간에 높은 거래량 증가 상태를 보였다. 이와 반 대로 뮤추얼펀드 비교했을 때 외국계 기관투자가는 극심한 투자손실이 발생되는 경 우에 높은 거래량 증가를 보였다. 극심한 주식수익률은 거래증가량에 비대칭적인 영 향을 끼치는 것을 확인할 수 있었다. Mixture copula models are used to study the relationships of extreme return and stock turnover rates of the foreign institutional investors, mutual funds and dealers in Taiwan. A transformation function is introduced in this paper to study the trading volume increment during extreme negative return condition. The results show that dealer has the highest trading volume increases both during extreme positive return and negative return periods. Comparing with foreign institutional investor, mutual fund has the higher trading increase during extreme positive return period. Comparing with mutual fund, foreign institutional investor has higher trading increase during extreme negative return period. The extreme stock market return has asymmetric impacts on the trading volume increment.
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.
Fang, Ting,Wang, Li-Yi,Lin, Tzu-Bin,Huang, Chia-Kai 서울대학교 교육연구소 2022 Asia Pacific Education Review Vol.23 No.2
The spread of English as a global language has contributed to the trend of recruiting native English-speaking teachers (NESTs) through government-funded schemes around the world, particularly in East Asia. In Taiwan, the NEST scheme has been recently expanded because of the national policy for a bilingual Taiwan in 2030. However, the NEST scheme in Taiwan has the strictest selection criteria and the least attractive incentives in the region. As these unfavorable conditions could affect the recruitment and effectiveness of the NEST scheme, this study explored the advantages and challenges perceived by NEST participants through in-depth interviews with 24 NESTs working in Taiwanese public schools to identify the factors that could influence their attrition and retention. It was found that most advantages were associated with the participants’ schools, such as the provision of resources and a sense of achievement, rather than from outside the schools. However, most of the perceived challenges also occurred inside the schools, such as the lack of collaboration with colleagues and class sizes. These findings suggested that the issues and agendas at the participating schools had the greatest influence on NEST decisions to stay or leave Taiwan. The implications for policymakers and school leaders are discussed and relevant suggestions are made.