Abrupt Decline in Estimated Glomerular Filtration Rate after Initiating Sodium-Glucose Cotransporter 2 Inhibitors Predicts Clinical Outcomes: A Systematic Review and Meta-Analysis

Min-Hsiang Chuang,Yu-Shuo Tang,Jui-Yi Chen,Heng-Chih Pan,Hung-Wei Liao,Wen-Kai Chu,Chung-Yi Cheng,Vin-Cent Wu,Michael Heung 대한당뇨병학회 2024 Diabetes and Metabolism Journal Vol.48 No.2

Background: The initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) typically leads to a reversible initial dip in estimated glomerular filtration rate (eGFR). The implications of this phenomenon on clinical outcomes are not well-defined.Methods: We searched MEDLINE, Embase, and Cochrane Library from inception to March 23, 2023 to identify randomized controlled trials and cohort studies comparing kidney and cardiovascular outcomes in patients with and without initial eGFR dip after initiating SGLT2i. Pooled estimates were calculated using random-effect meta-analysis.Results: We included seven studies in our analysis, which revealed that an initial eGFR dip following the initiation of SGLT2i was associated with less annual eGFR decline (mean difference, 0.64; 95% confidence interval [CI], 0.437 to 0.843) regardless of baseline eGFR. The risk of major adverse kidney events was similar between the non-dipping and dipping groups but reduced in patients with a ≤10% eGFR dip (hazard ratio [HR], 0.915; 95% CI, 0.865 to 0.967). No significant differences were observed in the composite of hospitalized heart failure and cardiovascular death (HR, 0.824; 95% CI, 0.633 to 1.074), hospitalized heart failure (HR, 1.059; 95% CI, 0.574 to 1.952), or all-cause mortality (HR, 0.83; 95% CI, 0.589 to 1.170). The risk of serious adverse events (AEs), discontinuation of SGLT2i due to AEs, kidney-related AEs, and volume depletion were similar between the two groups. Patients with >10% eGFR dip had increased risk of hyperkalemia compared to the non-dipping group.Conclusion: Initial eGFR dip after initiating SGLT2i might be associated with less annual eGFR decline. There were no significant disparities in the risks of adverse cardiovascular outcomes between the dipping and non-dipping groups.

Effect of under-bump-metallization structure on electromigration of Sn-Ag solder joints

Chen, Hsiao-Yun,Ku, Min-Feng,Chen, Chih Techno-Press 2012 Advances in materials research Vol.1 No.1

The effect of under-bump-metallization (UBM) on electromigration was investigated at temperatures ranging from $135^{\circ}C$ to $165^{\circ}C$. The UBM structures were examined: 5-${\mu}m$-Cu/3-${\mu}m$-Ni and $5{\mu}m$ Cu. Experimental results show that the solder joint with the Cu/Ni UBM has a longer electromigration lifetime than the solder joint with the Cu UBM. Three important parameters were analyzed to explain the difference in failure time, including maximum current density, hot-spot temperature, and electromigration activation energy. The simulation and experimental results illustrate that the addition 3-${\mu}m$-Ni layer is able to reduce the maximum current density and hot-spot temperature in solder, resulting in a longer electromigration lifetime. In addition, the Ni layer changes the electromigration failure mode. With the $5{\mu}m$ Cu UBM, dissolution of Cu layer and formation of $Cu_6Sn_5$ intermetallic compounds are responsible for the electromigration failure in the joint. Yet, the failure mode changes to void formation in the interface of $Ni_3Sn_4$ and the solder for the joint with the Cu/Ni UBM. The measured activation energy is 0.85 eV and 1.06 eV for the joint with the Cu/Ni and the Cu UBM, respectively.

The Incremental Cost Matrix Procedure for Locating Repair Service Centers in Multinational Reverse Logistics

Chen, Hsin Min,Hsieh, Chih Kuang,Wu, Ming Cheng,Luo, Shin Wei Korean Institute of Industrial Engineers 2009 Industrial Engineeering & Management Systems Vol.8 No.3

This study provides a heuristic algorithm to solve the locating problem of repair service centers (RSCs). To enhance the customer service level with more satisfaction and quicker responsiveness, the locating problem of RSCs has become one of the important issues in reverse supply chain management. This problem is formulated as a zero-one mixed integer programming in which an exiting distributor will be considered to be an un-capacitated repair service center for the objective of cost-minimizing. Since logistical costs are highly interrelated with the multinational location of distributors and RSCs, the fixed cost for setting a repair service center, variable cost, transportation cost, and exchange rates are considered in this study. Recognizing the selection of un-capacitated RSCs' locations is a combinatorial optimization problem and is a zero-one mixed integer programming with NP-hard complexity, we provide a heuristic algorithm named as incremental cost matrix procedure (ICMP) to simplify the solving procedure. By using the concise and structural cost matrix, ICMP can efficiently screen the potential location with cost advantage and effectively decide which distributor should be a RSC. Results obtained from the numerical experiments conducted in small scale problem have shown the fact that ICMP is an effective and efficient heuristic algorithm for solving the RSCs locating problem. In the future, using the extended ICMP to solve problems with larger industrial scale or problems with congestion effects caused by the variation of customer demand and the restriction of the RSC capacity is worth a further investigation.

REVIEW : Intestinal Stricture in Crohn`s Disease

( Chen Wang Chang ),( Jau Min Wong ),( Chien Chih Tung ),( I Lun Shih ),( Horng Yuan Wang ),( Shu Chen Wei ) 대한장연구학회 2015 Intestinal Research Vol.13 No.1

Crohn`s disease (CD) is a disease with chronic inflammation of unknown etiology involving any part of the gastrointestinal tract. The incidence and prevalence of CD are increasing recently in Asia. Half of the CD patients will have intestinal complica-tions, such as strictures or fistulas, within 20 years after diagnosis. Twenty-five percentage of CD patients have had at least one small bowel stricture and 10% have had at least one colonic stricture and lead to significant complications. Most of these pa-tients will require at least one surgery during their lifetime. Early diagnosis and evaluation with adequate managements for the patients can prevent disability and mortality of these patient. Here, we reviewed the current incidence of CD with stricture, the etiology of stricture, and how to diagnose and manage the stricture. (Intest Res 2015;13:19-26)

Effects of the addition of minute amounts of alumina on the microstructure and sintering behavior of yttria stabilized tetragonal zirconia polycrystals ceramic via a co-precipitation process

Chih-Cheng Chen,Chang-Min Zhou,Hsing-I Hsiang 한양대학교 세라믹연구소 2008 Journal of Ceramic Processing Research Vol.9 No.3

It is feasible to add homogeneously minute amounts (0.25 wt%) of Al₂O₃ into 3 mol% yttria stabilized tetragonal zirconia polycrystals using a co-precipitation procedure to produce precursory gel nano-powders. X-ray diffraction, scanning electron microscopy, high-angle annular dark-field-field emission gun transmission electron microscopy, relative density determination, shrinkage, and resistivity measurements using impedance spectroscopy were combined to elucidate the microstructure and sintering behavior of zirconia ceramics produced using 0.25 wt% added Al₂O₃, possibly the limit of solubility of Al₂O₃ in the ZrO₂ structure. Two modes of sintering behavior may be described as: (I) The total solid solution of Al₂O₃ in the solid solution of ZrO₂ structure via a precursory co-precipitation procedure; calcining at 800 oC and sintering at 1275 oC can be shown to indicate the viable solubility of Al₂O₃ in the ZrO₂ structure, designated as stage I of the thermal treatment; and (II) At the higher sintering temperature, above 1275 oC, the segregation of Al₂O₃ at triple junction occurs. Higher bulk and grain boundary resistivity values are found for the sample sintered at 1275 oC, which probably resulted from the dissolution of Al₂O₃ in the ZrO₂ structure. It is feasible to add homogeneously minute amounts (0.25 wt%) of Al₂O₃ into 3 mol% yttria stabilized tetragonal zirconia polycrystals using a co-precipitation procedure to produce precursory gel nano-powders. X-ray diffraction, scanning electron microscopy, high-angle annular dark-field-field emission gun transmission electron microscopy, relative density determination, shrinkage, and resistivity measurements using impedance spectroscopy were combined to elucidate the microstructure and sintering behavior of zirconia ceramics produced using 0.25 wt% added Al₂O₃, possibly the limit of solubility of Al₂O₃ in the ZrO₂ structure. Two modes of sintering behavior may be described as: (I) The total solid solution of Al₂O₃ in the solid solution of ZrO₂ structure via a precursory co-precipitation procedure; calcining at 800 oC and sintering at 1275 oC can be shown to indicate the viable solubility of Al₂O₃ in the ZrO₂ structure, designated as stage I of the thermal treatment; and (II) At the higher sintering temperature, above 1275 oC, the segregation of Al₂O₃ at triple junction occurs. Higher bulk and grain boundary resistivity values are found for the sample sintered at 1275 oC, which probably resulted from the dissolution of Al₂O₃ in the ZrO₂ structure.

The Incremental Cost Matrix Procedure for Locating Repair Service Centers in Multinational Reverse Logistics

Hsin Min Chen,Chih Kuang Hsieh,Ming Cheng Wu,Shin Wei Luo 대한산업공학회 2009 Industrial Engineeering & Management Systems Vol.8 No.3

This study provides a heuristic algorithm to solve the locating problem of repair service centers (RSCs). To enhance the customer service level with more satisfaction and quicker responsiveness, the locating problem of RSCs has become one of the important issues in reverse supply chain management. This problem is formulated as a zero-one mixed integer programming in which an exiting distributor will be considered to be an un-capacitated repair service center for the objective of cost-minimizing. Since logistical costs are highly interrelated with the multinational location of distributors and RSCs, the fixed cost for setting a repair service center, variable cost, transportation cost, and exchange rates are considered in this study. Recognizing the selection of un-capacitated RSCs’ locations is a combinatorial optimization problem and is a zero-one mixed integer programming with NP-hard complexity, we provide a heuristic algorithm named as incremental cost matrix procedure (ICMP) to simplify the solving procedure. By using the concise and structural cost matrix, ICMP can efficiently screen the potential location with cost advantage and effectively decide which distributor should be a RSC. Results obtained from the numerical experiments conducted in small scale problem have shown the fact that ICMP is an effective and efficient heuristic algorithm for solving the RSCs locating problem. In the future, using the extended ICMP to solve problems with larger industrial scale or problems with congestion effects caused by the variation of customer demand and the restriction of the RSC capacity is worth a further investigation.

Experience of patients with inflammatory bowel disease in using a home fecal calprotectin test as an objective reported outcome for self-monitoring

( Shu-chen Wei ),( Chien-chih Tung ),( Meng-tzu Weng ),( Jau-min Wong ) 대한장연구학회 2018 Intestinal Research Vol.16 No.4

Background/Aims: Fecal calprotectin (fC) level is a predictive marker of mucosal healing for patients with inflammatory bowel disease (IBD). Home fC tests are now available. We evaluated the performance of the smartphone-based IBDoc home testing system in patients with IBD and obtained their feedback as an objective patient-reported outcome. Methods: This prospective study enrolled consecutive patients with IBD in clinical remission. fC in the same stool sample was assessed by using both the laboratory test (Quantum Blue calprotectin test) and home test (IBDoc). The correlation between the 2 tests was analyzed using the Pearson method. In addition, the patients were asked to fill a questionnaire based on their experience. Results: Fifty-one patients with IBD (68 tests and 49 questionnaires) were included. The correlation between Quantum Blue test and IBDoc was good (r=0.776, P< 0.0001). After the test, 56% patients found IBDoc easy to perform, and 96% were satisfied with it. Thirty-nine patients (80%) had a strong ( >70%) probability to use it for future monitoring if the price was acceptable. By using 250 μg/g as the cutoff, the agreement between home test and laboratory results was 80%, and by using 600 μg/g as the cutoff, the agreement increased to 92%. Conclusions: The correlation between the laboratory and home tests was good. Most patients found the home test to be feasible and easy to use and preferred it over laboratory test and endoscopy for monitoring. Therefore, the home test could be used as an objective patient-reported outcome. (Intest Res 2018;16:546-553)

Effect of line and floor type on growth performance and feather characterization during the growth period of White Roman geese

Lin Min Jung,Chang Shen Chang,Chen Tzu Jou,Lin Wei Chih,Peng Shao Yu,Lee Tzu Tai 아세아·태평양축산학회 2020 Animal Bioscience Vol.33 No.9

Objective: The purpose of this study was to investigate whether goose growth and feather characteristics are influenced by their line and feeding surroundings, inclusive of floor materials and types, since there are no reports regarding these factors. Methods: The 240 White Roman geese which were hatched and sex identified came from 3 commercial goose farms. They were randomly distributed to 24 pens depending on a completely random design. The study continued for 13 weeks and included 3 lines of commercial geese and 2 floor types (cement strip floor [CSF] or cement floor [CF]). Results: The day one gosling weight from A farm was lower than other two farms (96 g vs 107 and 115 g; p<0.001). Afterwards, the body weight, back length, keel length, chest girth and main wing feather length among 3 farms showed no significance difference prior to 12 weeks. The CF group showed heavier body weight, shorter back length, longer keel length, shorter chest girth and shorter main wing feather length than the CSF group prior to 12 weeks. The down weight in the CF was heavier than the CSF group (57.1 g vs 41.8 g; p<0.01) prior to 13 weeks. Conclusion: The body weight showed the positive relations for dry feather weight (r = 0.59), down weight (r = 0.69), percent of the down weight of live body weight prior to 13 weeks (r = 0.61).

Haloperidol and Other Antipsychotics Exposure before Endometrial Cancer Diagnosis: A Population-based Case-control Study

Wei-Ling Chen,Srinivasan Nithiyanantham,Yan-Chiao Mao,Chih-Hsin Muo,Chih-Pin Chuu,Shih-Ping Liu,Min-Wei Huang,Kuan-Pin Su 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.3

Objective: Endometrial cancer is the most common malignancy of the female genital tract worldwide, and the associated relationship between endometrial cancer formation and various antipsychotics need to be confirmed. Methods: We conducted a case-control study by using data from Taiwan National Health Insurance Research Database to compare individual antipsychotic exposure between females with and without endometrial cancer. Among 14,079,089 females in the 12-year population-based national dataset, 9,502 females with endometrial cancer were identified. Their medical records of exposure to antipsychotics, including quetiapine, haloperidol, risperidone, olanzapine, amisulpride, clozapine, and aripiprazole, for up to 3 years before endometrial cancer diagnosis were reviewed. Daily dosage and cumulative exposure days were analyzed in the risky antipsychotic users. Additionally, the subsequent 5-year mortality rate of endometrial cancer among users of the risky antipsychotic were also analyzed. Results: Among endometrial cancer patients, the proportion of those who have used haloperidol before being diagnosed with endometrial cancer is significantly higher than other antipsychotic users. The significant odds ratio (OR) and a 95% confidence interval of 1.75 (1.31−2.34) were noted. Furthermore, haloperidol users were associated with a significantly higher 5-year mortality rate after getting endometrial cancer than non-users. Conclusion: There is a high correlation between the use of haloperidol and endometrial cancer formation. However, the underlying pathological biomechanisms require additional investigations.

Malignant transformation of ovarian mature cystic teratoma into squamous cell carcinoma: a Taiwanese Gynecologic Oncology Group (TGOG) study

An Jen Chiang,Min-Yu Chen,Chia-Sui Weng,Hao Lin,Chien-Hsing Lu,Peng-Hui Wang,Yu-Fang Huang,Ying-Cheng Chiang,Mu-Hsien Yu,Chih-Long Chang 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.5

Objective: The malignant transformation (MT) of ovarian mature cystic teratoma (MCT)to squamous cell carcinoma (SCC) is very rare. This study analyzed cases from multiplemedical centers in Taiwan to investigate the clinicopathologic characteristics, treatment, andprognostic factors of this disease and reviewed related literature. Methods: Pathological reports of 16,001 patients with primary ovarian cancer who weretreated at Taiwan medical centers from 1990 to 2011 were reviewed. In total, 52 patients withMT of MCT to SCC were identified. Results: Among all ovarian MCTs, the incidence of MT to SCC is 0.2%. The median age ofpatients was 52 years (range, 29–89 years), and the mean tumor size was 10.5 cm (range, 1–40cm). We analyzed the patients in our study and those in the literature and determined thatearly identification and complete surgical resection of the tumor are essential for long-termsurvival. In addition, adjuvant chemotherapy or concurrent chemoradiotherapy can be usedto treat this malignancy. Old age, large tumor size (≥15.0 cm), and solid components in MCTsare suitable indicators predicting the risk of MT of MCT to SCC. Conclusion: Similar to general epithelial ovarian cancers, the early detection of MT of MCTto SCC is critical to long-term survival. Therefore, older patients with a large tumor or those with a tumor containing a solid component in a clinically diagnosed MCT should beevaluated to exclude potential MT to SCC.