Sofosbuvir/Ledipasvir in the Treatment of Chronic Hepatitis C - A Subgroup Analysis from A Nationwide Real-World HCV Registry Program (TACR) in Taiwan

( Ming-Lung Yu ),( Chi-Yi Chen ),( Kuo-Chih Tseng ),( Ching-Chu Lo ),( Pin-Nan Cheng ),( Cheng-Yuan Peng ),( Ming-Jong Bair ),( Chih-Lang Lin ),( Chi-Ming Tai ),( Chi-Chieh Yang ),( Chih-Wen Lin ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: TASL HCV Registry (TACR) is a nationwide registry program organized and supervised by Taiwan Association for the Study of the Liver (TASL), which aims to setup the database and biobank of patients with chronic hepatitis C (CHC) in Taiwan. The present study aimed to evaluate the treatment outcome of sofosbuvir (SOF)/ledipasvir (LDV) in Taiwanese CHC patients in TACR. Methods: By May 2020, 19 tertiary hospitals, 23 community hospitals and one primary care clinic join the TACR program. The baseline characteristics, prior liver and non-liver related medical history, DAA regimens, laboratory results, treatment course and outcome were recorded. The primary objective was sustained virological response, defined as undetectable HCV RNA 3 months after end-of-treatment (SVR12). Results: A total of 4742 SOF/LDV+ ribavirin treated CHC patients with available SVR12 data from 39 sites were enrolled in the current analysis. The mean age was 61.3 years, and female accounted for 54.8% of the population. The dominant viral genotypes were GT1b (52.6%) and GT2 (35.6%). 1354 (28.6%) patients had liver cirrhosis, including 156 (3.3%) with liver decompensation, 552 (11.6%) had preexisting hepatocellular carcinoma (HCC) before DAAs treatment and 413 (8.7%) had hepatitis B virus dual infections. The overall SVR12 rate was 98.5%, with 98.5%, 98.2%, 99.7% and 98.6% in treatment- naïve non-cirrhotics, treatment-naïve cirrhotics, treatment- experienced non-cirrhotics and treatment-experienced cirrhotics patients, respectively. While patients were stratified by HCV genotype, the SVR12 was 98.5%, 98.4% and 98.5% among those with GT1, GT2 and GT6 infection, respectively. The strongest factor independent associated with treatment failure was DAA adherence < 60% (odds ratio [OR]/95% confidence intervals [CI]: 125.4/25.7-612.4, P<0.0001), followed by active HCC (OR/CI: 6.20/2.57-14.97, P<0.0001), HIV co-infection (OR/CI: 3.01/1.14-7.92, P=0.026), and male gender (OR/ CI: 1.85/1.09-3.13, P=0.023). The eGFR decreased significantly at the end of treatment (EOT) (89.3 ml/min/1.73㎡ vs. 93.2 ml/min/1.73㎡, P< 0.001) and remained stable 3 months after EOT (89.3 ml/min/1.73㎡). However, the decreased eGFR was observed only in patients whose baseline eGFR > 90 ml/ min/1.73㎡. Instead, patients with chronic kidney diseases whose pretreatment eGFR < 60 ml/min/1.73㎡ had improved eGFR after SOF/LDV. Conclusions: SOF/LDV is highly effective in treating CHC patients in real-world setting of Taiwan. The satisfactory result could be explicitly generalized to patients with different viral genotypes and liver disease severities.

Design and Modeling of Multistage Depressed Collectors by Using 3D Conformal Finite-difference Time-domain Particle-in-cell Simulations

Ming-Chieh Lin,Peter H. Stoltz,David N. Smithe,Hoyoung Song,김형종,최진주,김선주,Sung Hoon Jang 한국물리학회 2012 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.60 No.5

The feasibility of designing and modeling a multistage depressed collector (MDC) by using 3D conformal finite-difference time-domain (CFDTD) particle-in-cell (PIC) simulations as implemented in 3D PIC code, VORPAL has been studied. A simple circuit model employing feedback mechanisms has been implemented to provide stable time-dependent voltages for each stage of the depressed collector, and an arbitrary space-time dependent spent-beam distribution is given in our timedomain simulations. We demonstrate the design of a five-stage depressed collector recovering a triangular-like spent-beam distribution imported from a large signal simulation, achieving an energy recovery efficiency of 75%. The MDC after optimization can be integrated into the limited space of an S-band traveling wave tube for a compact microwave power module (MPM).

Professionals’ experiences and attitudes toward use of Traditional Chinese Medicine in hospice palliative inpatient care units: A multicenter survey in Taiwan

Yu-Jia Lin,Hsiao-Ting Chang,Ming-Hwai Lin,Ru-Yih Chen,Ping-Jen Chen,Wen-Yuan Lin,Jyh-Gang Hsieh,Ying-Wei Wang,Chung-Chieh Hu,Yi-Sheng Liou,Tai-Yuan Chiu,Chun-Yi Tu,Yi-Jen Wang,Bo-Ren Cheng,Tzeng-Ji Ch 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.2

Background: Medical staff may have difficulties in using conventional medicine to manage symptoms among terminally ill patients, including adverse effects of the treatment. Traditional Chinese medicine (TCM) is regarded as a complementary or alternative medicine, and has been increasingly used in the field of palliative medicine in recent years. This study aimed to investigate the experiences of and attitudes toward using TCM among palliative care professionals, and to provide preliminary information about its use in palliative care. Methods: This was a cross-sectional survey study conducted in eight inpatient hospice wards in Taiwan between December 2014 and February 2016. The questionnaire was self-administered, and was analyzed with descriptive statistics including Pearson’s Chi-square test and Fisher’s exact test. Results: A total of 251 palliative care professionals responded to the questionnaire, of whom 89.7% and 88.9% believed that the use of TCM could improve the physical symptoms and quality of life in terminally ill patients, respectively. Overall, 59.8%, of respondents suggested that TCM had rare side effects, and 58.2% were worried that TCM could affect the liver and kidney function of patients. In total, 89.7% and 88.0% of professionals agreed there were no suitable clinical practice guidelines and educational programs, respectively, for TCM use in palliative care. Conclusions: Most of the respondents agreed there was insufficient knowledge, skills-training, and continuing education on the use of TCM in terminally ill patients in Taiwan. These results show that to address patient safety considerations, guidelines about use of TCM in palliative care should be established.

Development of an Indoor Positioning System for Greenhouse Flying Robot

( Ming-jhe He ),( Suming Chen ),( Chao-yin Tsai ),( Chieh-yu Lin ) 한국농업기계학회 2018 한국농업기계학회 학술발표논문집 Vol.23 No.1

Precision cultivation is a new trend in agricultural production nowadays. The current greenhouse cultivation only uses a few of sensors to represent the overall state of the greenhouse. That couldn’t get the entire environmental conditions of greenhouse and make it difficult to implement precise cultivation in greenhouse. To utilize a quadrotor equipped with sensors to collect the environmental information in greenhouse; and locating the quadrotor is the primary task. Since the Global Positioning System cannot be used in the greenhouse, an indoor-positioning system to locate the quadrotor has to be studied. Lin (2017) has developed an indoor-positioning system which is based on UWB (Ultra-Wideband) technology but has not been able to extend to whole greenhouse. In this study, the number of anchors was increased by SPI (Serial Peripheral Interface bus) technology to extend the UWB indoor-positioning system to whole greenhouse. At present, the error of the absolute distance in the indoor positioning system is about 0.08 m. In the flight test, the quadrotor could fly on the scheduled paths and collect the environmental information.

Bubble-Generating Carrier Systems for Localized Controlled Release

Chieh-Cheng Huang,Ming-Fan Chung,Ko-Jie Chen,Wei-Tso Chia,Kun-Ju Lin,Hsing-Wen Sung 한국고분자학회 2016 한국고분자학회 학술대회 연구논문 초록집 Vol.41 No.2

Hericium erinaceus Mycelium and Its Isolated Compound, Erinacine A, Ameliorate High-Fat High-Sucrose Diet-Induced Metabolic Dysfunction and Spatial Learning Deficits in Aging Mice

Yun-Chieh Tsai,Yu-Chen Lin,Chun-Chih Huang,Oliver B. Villaflores,Tzong-Yuan Wu,Shih-Ming Huang,Ting-Yu Chin 한국식품영양과학회 2019 Journal of medicinal food Vol.22 No.5

Aging and lifestyle factors, including high-sugar and high-fat diets, promote a systemic metabolic imbalance that promotes neurodegeneration. Hericium erinaceus has long been used in traditional Chinese medicine. Recently, its functional activities, such as antimetabolic dysfunction, antineuroinflammatory activities, and stimulation of nerve growth factor (NGF) synthesis, have been revealed. This study demonstrated that Hericium erinaceus mycelium (HEM) and an isolated diterpenoid derivative, erinacine A (EA), may reverse spatial learning disabilities in aging mice (15 months old) fed with a high-fat and high-sucrose diet (HFSD). Aging mice were randomly assigned to one of four treatment groups: (1) a chow diet (control), (2) an HFSD, and an HFSD supplemented with either (3) HEM or (4) EA for 18 weeks. The Morris water maze (MWM) and Y-maze were used for behavioral assessments. Both HEM- and EA-treated mice had shorter mean daily escape latencies than HFSD-treated mice in the MWM. In addition, HEM-treated mice had a slightly increased exploratory time and frequency in the novel arm in the Y-maze. Quantitative PCR revealed that both HEM- and EA-treated mice exhibited reduced messenger RNA (mRNA) expression of tumor necrosis factor-α, interleukin-1β, and HEM-treated mice exhibited increased mRNA expression of NGF and NeuN in the hippocampus. Moreover, HEM and EA also decreased body weight, abdominal fat, plasma glucose, serum and liver total cholesterol, and liver triacylglycerol. Thus, HEM may be a potential health-promoting supplement for minimizing the progression of aging and obesity-induced neurodegeneration by reducing metabolic abnormalities and neuroinflammatory cytokines and increasing neurogenesis factors.

A Micro Cutter Auto-Alignment System with On-Machine Positioning Error Measurement and Compensation Methods

Shih-Ming Wang,Ji-Jun Lin,Zhe-Zhi Ye,Shambaljamts Tsooj,Chun-Chieh Wang 한국정밀공학회 2014 International Journal of Precision Engineering and Vol. No.

To perform an accurate micro machining process, accurate alignment of the micro cutter with respect to the local coordinate frame for machining is essential. Due to the fragility of the micro tool, traditional cutter alignment method used in industry is no longer proper for micro machining. Utilizing machine vision technology with 2 CCDs, a micro tool positioning error measurement and auto-compensation method and system were proposed. In the measurement method, Power Law Method was first used to enhance the image taken by a CCD. Canny Edge Method and image projection method were then used to identify the contours of the cutter and the workpiece from the image. Finally, the position errors of the cutter were determined through calculating the number of pixels between the cutter and the workpiece. The proposed error compensation system can automatically generate NC codes which will accurately re-locate the cutter based on the measured position errors . Experiments were conducted on a micro machine tool, and the results have shown that the y-dir. positioning error of the cutter was significantly improved from -0.025 mm to 0.001 mm, and the total machining error was reduced from -0.02 mm to -0.001 mm.

Acupuncture for ventilator-dependent patients at a hospital-based respiratory care center: A randomized controlled trial

Jia-Ming Chen,Wan-Li Chiang,Bin-Chuan Ji,Ruei-Jhe Jhang,Pei-Hsin Chen,Ya-Lun Li,Che-Ju Chang,Sung-Yen Huang,Tsung-Chieh Lee,Chia-Yun Chen,Ching-Hsiung Lin,Sheng-Hao Lin 한국한의학연구원 2023 Integrative Medicine Research Vol.12 No.4

Background: In intensive care units, mechanical ventilation is an important therapy to help patients with dysp- nea. However, long-term ventilator dependence would consume huge medical resources and increase the risk of morbidity and mortality. The aim of the study was to examine the efficacy of the acupuncture combined with western medical care on ventilator parameters in ventilator-dependent patients. Methods: In this clinical trial, 80 ventilator-dependent patients aged 20 to 80 years old were randomly assigned to acupuncture group and control group in the respiratory care center (RCC) of Changhua Christian Hospital. Besides regular medical care and therapy, participants in the acupuncture group received acupuncture therapy at the same 17 acu-points for 20 minutes once a day, a total of 12 sessions. The ventilator parameters were recorded to evaluate the respiratory efficiency for all participants. The primary outcome was rapid shallow breathing index (RSBI), and secondary outcomes were respiratory rate (RR), tidal volume (TV) and ventilation per minute (MV). Results: Though there was no significant difference in the parameter between the acupuncture group and the control group, we found the trend of decreasing RSBI in the acupuncture group. In subgroup analyses, the mean of RSBI significantly decreased 16.02 (with the SD in 60.84) in acupuncture group, while it increased 17.84 (with the SD in 39.38) in control group (p = 0.036) after 12 sessions. Conclusion: Acupuncture treatment can improve breathing ability of patients with respirator dependence in respiratory care center.

Max-throughput interference avoidance mechanism for indoor self-organizing small cell networks

Kuang-Hsun Lin,Cho-Hsin Tsai,Jen-Wei Chang,Yu-Chieh Chen,Hung-Yu Wei,Fu-Ming Yeh 한국통신학회 2017 ICT Express Vol.3 No.3

Since mobile traffic has been growing recently, the deployment of indoor small cells has become an attractive solution to enhance coverage. However, the increasing density of cells makes inter-cell interference more considerable. In this paper, we propose a max-throughput Interference Avoidance (MTIA) centralized algorithm to improve the system’s throughput. Based on signaling and reports, a central controller connected to each base station can properly turn off base stations that may induce a relatively strong interference, and thus increase SINR. We implemented the MTIA algorithm in an LTE TDD network simulation and showed that MTIA effectively reduces inter-cell interference and improves the system’s throughput.

Co-Culturing Cancer Cells and Normal Cells in a Biochip under Electrical Stimulation

Kin Fong Lei,Shao-Chieh Hsieh,Rei-Lin Kuo,Ngan-Ming Tsang 한국바이오칩학회 2018 BioChip Journal Vol.12 No.3

The ideal cancer therapeutic strategy is to inhibit the tumor with minimal influence on the normal tissue. Recently, applying an alternating electric field for inhibiting tumor was developed; but, it has not been adopted to be one of the regular therapeutic options. More basic scientific evidence is needed to clarify the efficacy and safety. In the current study, co-culturing cancer cells and normal cells under the electrical stimulation was conducted to provide evidence of this novel cancer therapy. A microfluidic cell culture biochip has been developed and consisted of nine culture chambers incorporating with stimulating electrodes. Cells cultured in the chamber received uniform electric field and cell viability was studied during the culture course. The electric field perturbs cell division and the correlation between cell proliferation rate and inhibition effect was studied among five cell lines, i.e., Huh7, HeLa, TW06, BM1, and HEL299. The results confirmed that cells with higher proliferation rate responded to a higher inhibition. In addition, co-culturing cancer cells and normal cells was conducted to mimic in vivo microenvironment that consists of both cancer and stromal cells. The cancer cells and normal cells were respectively transduced with green fluorescent protein and red fluorescent protein in order to differentiate the cells in a same culture chamber. During the culture course, the electric field was applied to the culture chamber and both cells simultaneously received the field. The results indicated that the growth of the cancer cells were inhibited while the normal cells were maintained. These results provided the evidence of the therapeutic efficacy and safety. Moreover, the microfluidic cell culture biochip could be used for the systematic and precise investigations of the cellular responses under the electrical stimulation.