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.

Successful Treatment of Infantile Fibrosarcoma Spinal Metastasis by Chemotherapy and Stereotactic Hypofractionated Radiotherapy

Lo, Cheng-Hsiang,Cheng, Shin-Nan,Lin, Kuen-Tze,Jen, Yee-Min The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.54 No.6

We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife$^{(R)}$ stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.

Simple but Organized Neurology Residency Training Improves the Quality of Acute Stroke Care: From the Outset to Long-Term Effect

Yu-Ming Chang,Chun-Min Wang,Po-Yu Lin,Pi-Shan Sung,Sheng-Hsiang Lin,Chih-Hung Chen 대한뇌졸중학회 2021 Journal of stroke Vol.23 No.2

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Operating Performance Following Acquisitions: Evidence from Taiwan’s IT Industry

Hsu-Huei Huang,Min-Lee Chan,I-Hsiang Huang,Kuo-Hsing Wu 한국증권학회 2014 Asia-Pacific Journal of Financial Studies Vol.43 No.5

This paper examines the performance of Taiwanese firms following acquisitions and findsthat, when contrasted with the acquisitions that take place in the U.S., Taiwanese acquirersexhibit negative industry-adjusted accounting performance. The negative performance ismostly driven by firms with low growth opportunities, but is mitigated under more concen-trated shareholdings and better board structures. These findings suggest that while weak cor-porate governance at the country-level may adversely affect the overall effectiveness of thetakeover market in Taiwan, there is substantial cross-sectional variation in corporate gover-nance at the firm-level. The evidence also shows that the announcement of an acquisition isaccompanied by a positive announcement effect, and the poor operating performance mightbe related to the decreased assets turnover and sales growth rate.

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.

An optimal design algorithm for centrifugal fans: Theoretical and experimental studies

Cheng-Hung Huang,Min-Hsiang Hung 대한기계학회 2013 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.27 No.3

This study examines the inverse design problem (IDP) of determining the optimal three-dimensional shape of a centrifugal-flow fan based on a desired airflow rate. The desired volume airflow rate can be obtained by multiplying the airflow rate of an existing fan by a constant greater than unity. The geometry of the redesigned fan is generated using several design variables, which enables the shape of the fan to be constructed completely; thus, the parameter estimation technique used in inverse design problems can be used. Finally, prototypes of the original and optimized centrifugal fans are fabricated, and the fan performance is tested based on the AMCA-210-85 standard, which uses calibrated nozzles and pressure taps within a standardized test chamber, to verify the validity of this work. The experimental results demonstrate that by using the fabricated optimal fan, the airflow rate can be increased by 11.8 % and the fan noise can be reduced by 3.5 %; as a result, the performance of optimal fan is greatly improved.

A smart pipet tip: Triboelectricity and thermoelectricity assisted <i>in situ</i> evaluation of electrolyte concentration

Choi, Dongwhi,Tsao, Yu-Hsiang,Chiu, Che-Min,Yoo, Donghyeon,Lin, Zong-Hong,Kim, Dong Sung unknown 2017 Nano energy Vol.38 No.-

<P><B>Abstract</B></P> <P>Pipet tips are commonly utilized laboratory tools to transfer adjustable volume of liquid in various fields of chemistry, biology and physics. Recently, we have reported that the ordinary pipetting procedure always involves spontaneous liquid-solid contact electrification, resulting in generation of net electrical charges on the dispensed solution and the inner surface of the polymeric pipet tip. In this study, a concept of a smart pipet tip is proposed to evaluate the electrolyte concentration of the dispensed solution by use of spontaneously generated electric signals during the ordinary pipetting procedure. The smart pipet tip possessing triboelectricity and thermoelectricity detecting modules is advantageous as it performs <I>in situ</I> evaluation of solution characteristics without any subsidiary solution handling process. The spontaneously generated electric signals are intensively investigated with the theoretical analyses. The proof-of-concept demonstration of the present smart pipet tip is shown for <I>in situ</I> prediction of morphology of nanoparticles during their synthetic reaction, which critically determines their catalytic activity.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The present smart pipet tip enables <I>in situ</I> evaluation of solution characteristics. </LI> <LI> Firstly, the electrical charges inside the pipet tip is advantageously utilized. </LI> <LI> Multi-parametric effect on liquid-solid triboelectricity is effectively separated. </LI> <LI> The morphology of nanoparticles can be <I>in situ</I> predicted by using the smart pipet tip. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>We demonstrate that the developed smart pipet tip composed of triboelectricity and thermoelectricity detecting modules is useful for the evaluation of solution characteristics and chemical reactions.</P> <P>[DISPLAY OMISSION]</P>

Experiences of Family of Patient with Newly Diagnosed Advanced Terminal Stage Hepatocellular Cancer

Shih, Whei-Mei Jean,Hsiao, Ping-Ju,Chen, Min-Li,Lin, Mei-Hsiang Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.8

Background: Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of cancer-related death worldwide due to its generally poor prognosis. Caregiver burden for liver cancer cases is higher than with other cancer and needs especial attention. Methods: To explore the experiences of families of patients with newly diagnosed advanced terminal stage hepatocellular cancer by interview. Results: Nine participants were recruited in this study. Content analysis of the interviews revealed four themes: blaming oneself, disrupting the pace of life, searching all possible regimens, and not letting go. Conclusions: This study provides new insight into the needs and support of family members especially when they are facing loved ones with newly diagnosed advanced terminal stage HCC. These results will inform future supportive care service development and intervention research aimed at providing assistance in reducing unmet supportive care needs and psychological distress of these family members.