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      • KCI등재

        Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

        I Chun Ma,Kao Chin Chen,Wei Tseng Chen,Hsin Chun Tsai,Chien-Chou Su,Ru-Band Lu,Po See Chen,Wei Hung Chang,Yen Kuang Yang 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.4

        Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson’s comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities (CCI≥3) or older patients (≥65 years). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

      • Metformin Inhibits Nuclear Receptor TR4–Mediated Hepatic Stearoyl-CoA Desaturase 1 Gene Expression With Altered Insulin Sensitivity

        Kim, Eungseok,Liu, Ning-Chun,Yu, I-Chen,Lin, Hung-Yun,Lee, Yi-Fen,Sparks, Janet D.,Chen, Lu-Min,Chang, Chawnshang American Diabetes Association 2011 Diabetes Vol.60 No.5

        <P><B>OBJECTIVE</B></P><P>TR4 is a nuclear receptor without clear pathophysiological roles. We investigated the roles of hepatic TR4 in the regulation of lipogenesis and insulin sensitivity in vivo and in vitro.</P><P><B>RESEARCH DESIGN AND METHODS</B></P><P>TR4 activity and phosphorylation assays were carried out using hepatocytes and various TR4 wild-type and mutant constructs. Liver tissues from TR4 knockout, C57BL/6, and <I>db/db</I> mice were examined to investigate TR4 target gene stearoyl-CoA desaturase (<I>SCD</I>) 1 regulation.</P><P><B>RESULTS</B></P><P>TR4 transactivation is inhibited via phosphorylation by metformin-induced AMP-activated protein kinase (AMPK) at the amino acid serine 351, which results in the suppression of SCD1 gene expression. Additional mechanistic dissection finds TR4-transactivated <I>SCD1</I> promoter activity via direct binding to the TR4-responsive element located at −243 to −255 on the promoter region. The pathophysiological consequences of the metformin→AMPK→TR4→SCD1 pathway are examined via TR4 knockout mice and primary hepatocytes with either knockdown or overexpression of TR4. The results show that the suppression of <I>SCD1</I> via loss of TR4 resulted in reduced fat mass and increased insulin sensitivity with increased β-oxidation and decreased lipogenic gene expression.</P><P><B>CONCLUSIONS</B></P><P>The pathway from metformin→AMPK→TR4→SCD1→insulin sensitivity suggests that TR4 may function as an important modulator to control lipid metabolism, which sheds light on the use of small molecules to modulate TR4 activity as a new alternative approach to battle the metabolic syndrome.</P>

      • KCI등재

        The tyrosine kinase inhibitor nintedanib activates SHP-1 and induces apoptosis in triple-negative breast cancer cells

        Chun-Yu Liu,Tzu-Ting Huang,Pei-Yi Chu,Chun-Teng Huang,Chia-Han Lee,Wan-Lun Wang,Ka-Yi Lau,Wen-Chun Tsai,Tzu-I Chao,Jung-Chen Su,Ming-Huang Chen,Chung-Wai Shiau,Ling-Ming Tseng,Kuen-Feng Chen 생화학분자생물학회 2017 Experimental and molecular medicine Vol.49 No.-

        Triple-negative breast cancer (TNBC) remains difficult to treat and urgently needs new therapeutic options. Nintedanib, a multikinase inhibitor, has exhibited efficacy in early clinical trials for HER2-negative breast cancer. In this study, we examined a new molecular mechanism of nintedanib in TNBC. The results demonstrated that nintedanib enhanced TNBC cell apoptosis, which was accompanied by a reduction of p-STAT3 and its downstream proteins. STAT3 overexpression suppressed nintedanib-mediated apoptosis and further increased the activity of purified SHP-1 protein. Moreover, treatment with either a specific inhibitor of SHP-1 or SHP-1-targeted siRNA reduced the apoptotic effects of nintedanib, which validates the role of SHP-1 in nintedanib-mediated apoptosis. Furthermore, nintedanib-induced apoptosis was attenuated in TNBC cells expressing SHP-1 mutants with constantly open conformations, suggesting that the autoinhibitory mechanism of SHP-1 attenuated the effects of nintedanib. Importantly, nintedanib significantly inhibited tumor growth via the SHP-1/p-STAT3 pathway. Clinically, SHP-1 levels were downregulated, whereas p-STAT3 was upregulated in tumor tissues, and SHP-1 transcripts were associated with improved disease-free survival in TNBC patients. Our findings revealed that nintedanib induces TNBC apoptosis by acting as a SHP-1 agonist, suggesting that targeting STAT3 by enhancing SHP-1 expression could be a viable therapeutic strategy against TNBC.

      • Research on Near Infrared Spectroscopy Application for Aflatoxin Testing on Rice

        ( I-chun Tung ),( Tsung-hsin Wu ),( Han-chun Hsu ),( Suming Chen ),( Chao-yin Tsai ),( Yung-kun Chuang ) 한국농업기계학회 2018 한국농업기계학회 학술발표논문집 Vol.23 No.1

        Rice is one of the most important staple food in the world. In many countries, environments with high temperature/humidity may provide favorable conditions for fungal propagation and production of aflatoxins during rice storage. Aflatoxin B<sub>1</sub> (AFB<sub>1</sub>), one of the secondary metabolites produced by Aspergillus flavus and Aspergillus parasiticus, is particularly carcinogenic to humans. People might very likely cause severe illness once rice is contaminated by aflatoxins. Therefore, the objective of this study is to develop a nondestructive method for rapid and accurate detection of the AFB<sub>1</sub> content in rice. In the present study, evaluation of AFB<sub>1</sub> contaminated rice were conducted by using near infrared spectroscopy (NIRS) technique with chemometrics. NIR Spectra and the AFB<sub>1</sub> contents of the artificially contaminated rice samples were measured by FOSS NIRS 6500 spectrometer and LC-MS/MS, respectively. Modified partial least square regression (MPLSR), a commonly used multivariate analysis method was then used to build calibration models. In summary, NIRS associated with chemometrics could provide a useful tool for rapid and accurate detection of AFB<sub>1</sub> content in rice.

      • KCI등재

        The Presence of Borrelia valaisiana-Related Genospecies in Ticks and a Rodent in Taiwan

        Chun-Man Huang,Hsi-Chieh Wang,Ying-Chun Lin,Shih-Hui Chiu,Ying-Shun Kao,Pei-Lung Lee,Hsiu-I Wang,Ruei-Chen Hung,Huang-I Chan,Ho-Sheng Wu,Chuen-Sheue Chiang,Jung-Jung Mu 한국미생물학회 2010 The journal of microbiology Vol.48 No.6

        A field survey was conducted to investigate the presence of Borrelia burgdorferi sensu lato (s.l.) in six counties of Taiwan. Spirochetes were successfully isolated from one rodent ear sample out of 485 rodent ears and 53live, fed tick (Ixodes granulatus) samples. The spirochetes were confirmed to be B. burgdorferi s.l. by real-time PCR. In addition, 23 of 113 tick samples were tested positive for Borrelia DNA according to real-time PCR. The Borrelia isolate from the rodent and the 23 Borrelia DNA samples from the ticks were identified as B. valaisiana-related genospecies by phylogenetic analysis based on flagellin gene sequences. These findings suggest that the Borrelia valaisiana-related strains are maintained in a zoonotic cycle between tick vectors and reservoir hosts in Taiwan.

      • SCOPUSKCI등재
      • KCI등재

        A Study on the Perception and Preference of the Wuxing Image Integrated into the Lucky Charm

        TSAI I-CHEN,Chen, Chun-Chih,Chia-Hui Huang 한국일러스트레이션학회 2021 일러스트레이션 포럼 Vol.22 No.66

        Lucky charms are mainly derived from people's wish to bring good luck or get rid of misfortune through the power of faith. Confronted by obstacles and disappointments, modern people would turn to traditional cultural beliefs to help them get over difficulties. Consumers in Taiwan are showing growing interests in lucky charms, while manufacturers are working hard to develop various types of lucky charms to meet the diverse needs of consumers. In recent years, most of the lucky charms are based on tangible or intangible images from religions, geomantic omen, folklore, etc. Also, in response to consumers' aesthetic needs, more aesthetic elements are incorporated into the design. Besides fundamental elements of religion, geomantic omen, folklore and other beliefs, manufacturers also need to understand consumers' perception and preferences to better meet their needs. The study aimed to explore the perception and preference of consumers for Wuxing lucky charms, and analyze consumers’ preferences of the geomantic omen images. This paper collected data through literature review and questionnaire survey of 79 people based on their identity and preference to identify important factors that influence consumers' preference so as to facilitate the design of lucky charms. The study analyzed the respondents' preferences of typical Wuxing lucky charms through the questionnaire survey, and found consumers prefer traditional, refined and delicate design. Also, they like products that could bring them good luck, revealing consumers' preference for geomantic omen image. This study will help manufacturers determine the focus of design, and provide references in this regard. From the study, we found that products with explicit colors can arouse more resonance from consumers. Therefore, it is suggested that when designing the Wuxing products, we can increase the use of Wuxing colors to highlight its characteristics and charms, and better meet the needs of consumers.

      • KCI등재

        Development of a Cycling Safety Services System and Its Deep Learning Bicycle Crash Model

        I-Hsuan Peng,Pei-Chun Lee,Chen-Kang Tien,Jyun-Sen Tong 한국통신학회 2022 Journal of communications and networks Vol.24 No.2

        This research developed an Internet of things (IoT)services system for cyclists to keep them safe when cycling –from terminal to back end – called the cycling safety servicessystem. The proposed system consists of wearable devices, aservice mobile app, and back-end services, primarily providingthree categories of services: (1) The cycling team services, (2)the physiological status services, and (3) the environmental informationservice, incorporating the technologies of deep learning,IoT end device development, mobile app programming, RESTfulAPI implementation, open data exploitation, etc. The proposedsystem aims at protecting the cyclists from being left out whencycling as a team, warning them when their physiological statusis going to be abnormal or when there is a possibility of a bicyclecrash, as well as proactively sending out urgent messages withlocation information when a crash occurs. Moreover, to enablethe mobile app to recognize crash events, this research traineda deep learning bicycle crash model of 87.8049% accuracy andimplemented a procedure in the mobile app based on this modelto detect bicycle crashes automatically. The proposed system alsoprovides a way for the cyclists to report any false crash alarm sothat the crash model can be re-trained to reduce its false alarmratio after the system is distributed to the consumers in thefuture. This research confirmed that the proposed system workswell, and suggests that the proposed system, the crash model, thedata collection method with its associated mobile apps, and theanonymous crash locations collected in the future can be valuableand contribute to the cycling society and relevant researchers ina positive way.

      • Ledipasvir/Sofosbuvir for 12 Weeks Is Safe and Effective in CHC and CHB Coinfection Patients: A Phase 3 Study in Taiwan

        ( Chun-Jen Liu ),( Wan-Long Chuang ),( I-Shyan Sheen ),( Horng-Yuan Wang ),( Chi-Yi Chen ),( Kuo-Chih Tseng ),( Ting-Tsung Chang ),( Benede tta Massetto ),( Jenny Yang ),( Gregory Camus ),( Fangqiu Zh 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

        Aims: Patients co-infected with HCV and HBV have more rapid progression and worse outcomes than mono-infected patients. Taiwan has among the highest prevalence of chronic HCV/HBV coinfection in Southeast Asia. This study evaluated the safety and efficacy of an all-oral treatment with ledipasvir(LDV)/sofosbuvir(SOF) for 12 weeks in chronic HCV and HBV coinfection. Methods: Patients with or without compensated cirrhosis chronic HCV GT1/GT2 and HBV (HBsAg+) treatment naïve were enrolled into open-label, receiving LDV 90 mg/SOF 400 mg(QD) for 12 weeks. The primary efficacy endpoint is SVR12. HBV DNA was monitored at all study visits and it will be monitored for 2 years post-treatment. Results: A total of 111 patients (68[61%] with GT1 and 43[39%] with GT2) were enrolled and treated. The majority were female(62%), treatment naive(67%), and non-cirrhotic(85%), with a mean age of 55 years and mean BMI of 24.5kg/m2. All but one was HBeAg negative. Mean baseline HBV DNA was 2.1 log10IU/mL. SVR4 was 100%(111/111). The mean change in HBV DNA ranged from -0.06 log10IU/mL at week 1 to +0.49 log10IU/mL at follow-up visit 4; HBV DNA kinetics are shown in Fig 1. 60(54%) patients had an increase in HBV DNA> 10 x BL or became HBV DNA > LLOQ. No patients had ALT ≥ 2 X baseline. No patients discontinued treatment due to adverse events (AEs). Three patients had serious AEs(optic neuritis, post procedural bleeding and duodenal ulcer bleeding; none was considered drug related). Conclusions: In chronic HCV/HBV infection patients, LDV/SOF for 12 weeks resulted in an SVR4 rate of 100%. Although most patients had an increase in HBV DNA during treatment, this was not associated with ALT elevations ≥2 X baseline, and no patients started HBV therapy to date. This all-oral, interferon-free regimen was well tolerated, supporting its potential as a treatment option for HCV/HBV co-infected patients.

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