Treatment Retention Rates of 3-monthly Paliperidone Palmitate and Risk Factors Associated with Discontinuation: A Population-based Cohort Study

Chien-Heng Lin,Huang-Li Lin,Chih-Lin Chiang,Yi-Wen Chen,Yan-Fang Liu,Yen Kuang Yang,Chao-Hsiun Tang 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.3

Objective: Limited evidence exists regarding real-world 3-monthly paliperidone palmitate (PP3M) treatment retention and associated factors. Methods: We conducted a retrospective, nationwide cohort study using the Taiwan National Health Insurance Research Database between October 2017 and December 2019. Adult patients with schizophrenia initiated on PP3M were enrolled. The primary outcomes were time to PP3M discontinuation, time to psychiatric hospitalization, and the proportions of patients receiving the next PP3M dose within 120 days among first-, second-, and third-dose completers. Key covariates included prior PP1M duration and adequate PP3M initiation. Results: The PP3M treatment retention rates were 79.7%, 66.3%, and 52.5% after 6, 12, and 24 months, respectively, with 86.4%, 90.6%, and 90.0% of respective first-, second-, and third-dose completers receiving the next PP3M dose. Adequate PP3M initiation and prior PP1M treatment duration > 180 days were associated with favorable PP3M treatment retention. In multivariate analyses, PP1M durations of 180−360 days (adjusted relative risk [aRR], 1.76) or < 180 days (aRR, 2.79) were associated with PP3M discontinuation at the second dose. Inadequate PP3M initiation was associated with discontinuation at the third dose (aRR, 2.18). Patients fully adherent to PP3M treatment in the first year had a higher probability of being free from psychiatric hospitalization (86.7% at 2 years), compared with those partially adherent or non-adherent to PP3M in the first year. Conclusion: Prior PP1M duration and adequate PP3M initiation are major factors affecting PP3M treatment retention. Higher PP3M treatment retention is associated with a lower risk of psychiatric hospitalization.

Common Neurological Disorders Involving Inpatient Liaisons at a Secondary Referral Hospital in Taiwan: A Retrospective Cross-Sectional Study

Chih-Yang Liu,Han-Lin Chiang,Ser-Chen Fu,Yu-Chin Su,Cheng-Lun Hsiao,Fu-Yi Yang,Shinn-Kuang Lin 대한신경과학회 2016 Journal of Clinical Neurology Vol.12 No.1

Background and Purpose Te requirement for neurology liaison is increasing in accordance with the growing health care demands associated with aging populations. Te aim of this study was to characterize the nature of neurological inpatient liaisons (NILs) to help plan for the appropriate use of neurology resources. Methods Tis was a retrospective cross-sectional study of NILs in a secondary referral hospital over a 12-month period. Results Tere were 853 neurological consultations with a liaison rate of 3% per admission case. Chest medicine, gastroenterology, and infectious disease were the three most frequent specialties requesting liaison, and altered consciousness, seizure, and stroke were the three most frequent disorders for which a NIL was requested. Infection was the most common cause of altered consciousness. Epilepsy, infection, and previous stroke were common causes of seizure disorders. Acute stroke accounted for 44% of all stroke disorders. Electroencephalography was the most recommended study, and was also the most frequently performed. Ninety-fve percent of emergency consultations were completed within 2 hours, and 85% of regular consultations were completed within 24 hours. Te consult-to-visit times for emergency and regular consultations were 44±47 minutes (mean±standard deviation) and 730±768 minutes, respectively, and were shorter for regular consultations at intensive care units (p=0.0151) and for seizure and stroke disorders (p=0.0032). Conclusions Altered consciousness, seizure, and stroke were the most common reasons for NILs. Half of the patients had acute neurological diseases warranting immediate diagnosis and treatment by the consulting neurologists. Balancing increasing neurologist workloads and appropriate health-care resources remains a challenge.

Interleaved DC-DC Converters with Partial Ripple Current Cancellation

Lin, Bor-Ren,Chiang, Huann-Keng,Cheng, Chih-Yuan The Korean Institute of Power Electronics 2012 JOURNAL OF POWER ELECTRONICS Vol.12 No.2

An interleaved PWM converter is proposed to implement the features of zero voltage switching (ZVS), load current sharing and ripple current reduction. The proposed converter includes two ZVS converters with a common clamp capacitor. With the shared capacitor, the charge balance of the two interleaved parts is automatically regulated under input voltage and load variations. The active-clamping circuit is used to realize the ZVS turn-on so that the switching losses on the power switches are reduced. The ZVS turn-on of all of the switching devices is achieved during the transition interval. The interleaved pulse-width modulation (PWM) operation will reduce the ripple current and the size of the input and output capacitors. The current double rectifier (CDR) is adopted in the secondary side to reduce output ripple current so that the sizes of the output chokes and capacitor are reduced. The circuit configuration, operation principles and design considerations are presented. Finally experimental results based on a 408W (24V/17A) prototype are provided to verify the effectiveness of the proposed converter.

Cloning and Gene Expression Analysis of Sponge Gourd Ascorbate Peroxidase Gene and Winter Squash Superoxide Dismutase Gene under Respective Flooding and Chilling Stresses

Chih Ming Chiang,Wen Shuo Kuo,Kuan-Hung Lin 한국원예학회 2014 Horticulture, Environment, and Biotechnology Vol.55 No.2

Previously, we reported that increased ascorbate peroxidase (APX) and superoxide dismutase (SOD) activitiesprovide sponge gourd (SG) and winter squash (WS) plants with increased waterlogging and chilling stress tolerance,respectively. The objectives of this work were to clone the APX gene from SG and the SOD gene from WS, andmeasure the regulation of APX and SOD gene expressions under flooding and chilling stress, respectively. The fulllengths of APX and SOD cDNA were found to be 761 and 703 bp, respectively. Different tissues from bitter melon(BM) and SG displayed wide variations in their expression profiles, and the highest level of APX transcripts weredetected in roots of SG at 72 hours of flooding treatment. Additionally, the differential SOD expressions of BM andWS were directly associated with chilling stress responses. A phylogenetic analysis of APX and SOD indicated thatplant APXs and SODs diverged into two major clusters.

Smart monitoring system with multi-criteria decision using a feature based computer vision technique

Chih-Wei Lin,Wen-Ko Hsu,Dung-Jiang Chiou,Cheng-Wu Chen,Wei-Ling Chiang 국제구조공학회 2015 Smart Structures and Systems, An International Jou Vol.15 No.6

When natural disasters occur, including earthquakes, tsunamis, and debris flows, they are often accompanied by various types of damages such as the collapse of buildings, broken bridges and roads, and the destruction of natural scenery. Natural disaster detection and warning is an important issue which could help to reduce the incidence of serious damage to life and property as well as provide information for search and rescue afterwards. In this study, we propose a novel computer vision technique for debris flow detection which is feature-based that can be used to construct a debris flow event warning system. The landscape is composed of various elements, including trees, rocks, and buildings which are characterized by their features, shapes, positions, and colors. Unlike the traditional methods, our analysis relies on changes in the natural scenery which influence changes to the features. The “background module” and “monitoring module” procedures are designed and used to detect debris flows and construct an event warning system. The multi-criteria decision-making method used to construct an event warring system includes gradient information and the percentage of variation of the features. To prove the feasibility of the proposed method for detecting debris flows, some real cases of debris flows are analyzed. The natural environment is simulated and an event warning system is constructed to warn of debris flows. Debris flows are successfully detected using these two procedures, by analyzing the variation in the detected features and the matched feature. The feasibility of the event warning system is proven using the simulation method. Therefore, the feature based method is found to be useful for detecting debris flows and the event warning system is triggered when debris flows occur.

Exploring the Influential Factors of Manufacturers’ Initial Intention in Applying for the Green Mark EcoLabel in Taiwan

Shu-Chiang Lin,Satria Fadil Persada,Reny Nadlifatin,Hsiang-Yu Tsai,Chih-Hsing Chu 한국정밀공학회 2015 International Journal of Precision Engineering and Vol.2 No.4

The Green Mark eco-label constitutes an essential program introduced by Taiwan’s Environmental Protection Administration to support environmental protection. In the manufacturing industry, the Green Mark eco-label is intended to enable differentiating between manufacturers that apply green processes and those that do not. This paper presents an assessment model for identifying manufacturers’ initial intention to apply the Green Mark eco-label. The model was derived from the certification process flow. A total of 200 structured questionnaires were distributed to manufacturers in Taiwan, and 172 responses were retrieved. The model was analyzed by applying structural equation modeling, and the correlation of review process and end certification process exhibited the strongest correlation. Improving the document verification stage is highly likely to increase the overall initial intention ofmanufacturers to participate in the Green Mark eco-label program. The overall certification process contributed 16% to the total initial intention of manufacturers to apply the Green Mark eco-label to their products.

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.

Interleaved DC-DC Converters with Partial Ripple Current Cancellation

Bor-Ren Lin,Huann-Keng Chiang,Chih-Yuan Cheng 전력전자학회 2012 JOURNAL OF POWER ELECTRONICS Vol.12 No.2

An interleaved PWM converter is proposed to implement the features of zero voltage switching (ZVS), load current sharing and ripple current reduction. The proposed converter includes two ZVS converters with a common clamp capacitor. With the shared capacitor, the charge balance of the two interleaved parts is automatically regulated under input voltage and load variations. The active-clamping circuit is used to realize the ZVS turn-on so that the switching losses on the power switches are reduced. The ZVS turn-on of all of the switching devices is achieved during the transition interval. The interleaved pulse-width modulation (PWM) operation will reduce the ripple current and the size of the input and output capacitors. The current double rectifier (CDR) is adopted in the secondary side to reduce output ripple current so that the sizes of the output chokes and capacitor are reduced. The circuit configuration, operation principles and design considerations are presented. Finally experimental results based on a 408W (24V/17A) prototype are provided to verify the effectiveness of the proposed converter.

Trough Melatonin Levels Differ between Early and Late Phases of Alzheimer Disease

Chieh-Hsin Lin,Chih-Chiang Chiu,Hsien-Yuan Lane 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.1

Objective: Melatonin has been considered to have an essential role in the pathophysiology of Alzheimer’s disease (AD) for its regulatory function on circadian rhythm and interaction with glutamate for the modulation of learning and memory. Previous studies revealed that melatonin levels decreased in patients with AD. However, melatonin supplement didn’t show promising efficacy for AD. This study compared trough melatonin levels among elderly people with different severities of cognitive deficits. Methods: We enrolled 270 elder individuals (consisting four groups: healthy elderly, amnestic mild cognitive impairment [MCI], mild AD, and moderate-severe AD) in the learning cohort. Trough melatonin levels in plasma were measured using ELISA. Cognitive function was evaluated by Clinical Dementia Rating Scale (CDR) and Mini-Mental State Examination (MMSE). An independent testing cohort, also consisting of four groups, was enrolled for ascertainment. Results: In the learning cohort, trough melatonin levels decreased in the MCI group but elevated in the mild and moderate to severe AD groups. Trough melatonin levels were associated with CDR and MMSE in MCI or AD patients significantly. In the testing cohort, the results were similar to those in the learning cohort. Conclusion: This study demonstrated that trough melatonin levels in the peripheral blood were decreased in MCI but increased with the severity of AD. The finding supports the trials indicating that melatonin showed efficacy only in MCI but not in AD. Whether trough melatonin level has potential to be a treatment response biomarker for AD, especially its early phase needs further studies.

A Hybrid Grey Model to Forecast the Annual Maximum Daily Rainfall

Yong-Jun Lin,Pin-Chan Lee,Kuo-Chen Ma,Chih-Chiang Chiu 대한토목학회 2019 KSCE JOURNAL OF CIVIL ENGINEERING Vol.23 No.11

This study proposes a hybrid grey model for forecasting annual maximum daily rainfall in order to determine long-term hydrological system trends. The proposed model uses an integral form of background value to improve accuracy, and applies two residual operators, the Fourier series and the exponential smoothing technique, to correct periodic and stochastic errors. The annual maximum daily rainfall measured by 5 stations around Taiwan are used to validation the proposed model. The performance of the proposed hybrid grey model is compared with those of the autoregressive integrated moving average (ARIMA) and artificial neural network (ANN) models. By evaluation of different indicators, it is shown that the proposed model outperforms both compared models. With more precise information, the proposed model will allow government officials and civil engineering-related industries to better prepare for heavy rainfall, averting potential disasters.