Clinical Outcomes and Cost-Effectiveness of Osteoporosis Screening With Dual-Energy X-ray Absorptiometry

Hsu Chiao-Lin,Wu Pin-Chieh,Yin Chun-Hao,Chen Chung-Hwan,Lee King-Teh,Lin Chih-Lung,Shi Hon-Yi 대한영상의학회 2023 Korean Journal of Radiology Vol.24 No.12

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan’s per capita gross domestic product). The ICER after stratifying by ages of 50–59, 60–69, 70–79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

Construction of a Wireless Sensor Networking Platform with Vibration Sensing and GPS Positioning

Chau-Chung Song,Yin-Chieh Hsu,Chen-Fu Feng,Yu-Kai Chen 제어로봇시스템학회 2009 제어로봇시스템학회 국제학술대회 논문집 Vol.2009 No.8

In this paper, the networking architectures and information middleware of wireless sensor networks are developed to construct the heterogeneous information system platform for the real-time structural health monitoring application. The design and implementation of sensor firmware and networking middleware are the key study topics for WSN-based intelligent system platform. The networking gateway of system platform must be developed the independent and highly interoperability to integrate the heterogeneous networks. The application study combined with vibration sensing and GPS positioning is used to demonstrate the feasibility of the developed system platform. The middleware technology is implemented to filter and pre-process the received data from the Zigbee sensor node and extract the available information to transfer to and record in the system database. Moreover, the GPRS and GSM modules are used to be responsible for the long-distance and alarm message transmission on the information network, respectively. Furthermore, the integration system platform is constructed by integrating Zigbee sensor network, GPRS/GSM communication and LAN internet to illustrate and evaluate the feasibility and performance of the proposed architecture for wireless sensor systems. In conclusion, the intelligent system platform of WSN-based monitoring system is developed and integrated to demonstrate and speed up the practical applications of wireless sensor networks in this paper.

The International Development Strategy of Les Enphants Roots in China Market

Huang, Shu-Tzu,Cho, Hsin-Ying,Hsu, Yin-Chieh The Korean Society of Costume 2014 International journal of costume and fashion Vol.14 No.1

Facing a mature domestic market and the challenges of the global consumer market, retailers in Taiwan are in pursuit of international development strategies for increasing its market opportunities as one of its key growth strategies. In the global market, the Chinese market becomes Taiwan retailers' main international development milestone due to its similarity of language, culture and historical background with China. Therefore, this research uses case study method based on Eclectic paradigm (Dunning 1981) to explore the various advantages of a Taiwanese children's clothing retailer Les Enphants, which include ownership advantage, internalization advantage, and location advantage. These advantages in turn demonstrate rationales behind Les Enphants' internationalization necessity (Why to Go), selecting China as an expansion target (Where to Go), and management and operation strategies implemented in China (How to Go). Our study highlights a successful entry and expansion model of the Taiwanese children clothing retailer, and may have solid contribution to the practical application of internationalization strategy theory.

The International Development Strategy of Les Enphants Roots in China Market

Shu Tzu Huang,Hsin Ying Cho,Yin Chieh Hsu 한국복식학회 2014 International journal of costume and fashion Vol.14 No.1

Facing a mature domestic market and the challenges of the global consumer market, retailers in Taiwan are in pursuit of international development strategies for increasing its market opportunities as one of its key growth strategies. In the global market, the Chinese market becomes Taiwan retailers’ main international development milestone due to its similarity of language, culture and historical background with China. Therefore, this research uses case study method based on Eclectic paradigm (Dunning 1981) to explore the various advantages of a Taiwanese children’s clothing retailer Les Enphants, which include ownership advantage, internalization advantage, and location advantage. These advantages in turn demonstrate rationales behind Les Enphants’ internationalization necessity (Why to Go), selecting China as an expansion target (Where to Go), and management and operation strategies implemented in China (How to Go). Our study highlights a successful entry and expansion model of the Taiwanese children clothing retailer, and may have solid contribution to the practical application of internationalization strategy theory.

Treatment outcomes of patients with stage II pure endometrioid-type endometrial cancer: a Taiwanese Gynecologic Oncology Group (TGOG-2006) retrospective cohort study

Hung-Chun Fu,Jen-Ruei Chen,Min-Yu Chen,Keng-Fu Hsu,Wen-Fang Cheng,An Jen Chiang,Yu-Min Ke,Yu-Chieh Chen,Yin-Yi Chang,Chia-Yen Huang,Chieh-Yi Kang,Yuan-Yee Kan,Sheng-Mou Hsiao,Ming-Shyen Yen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5

Objective: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. Methods: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. Results: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p<0.001), recurrent urinary tract infections (p=0.013), and leg lymphedema (p=0.038). Age over 50-year (HR=9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR=7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR=5.13; 95% CI, 1.38–19.1) and DSS (HR=5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p=0.046), but no impact on survival. Conclusion: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.