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Yen-Yue Lin,Chin-Wang Hsu,Wayne Huey-Herng Sheu,Shi-Jye Chu,Chin-Pyng Wu,Shih-Hung Tsai 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.3
Purpose: Severe hypoglycemia can result in neural damage, impaired cognitive function, coma, seizures, or death. The decision to admit diabetic patients after initial treatment in the emergency department remains unclear. Our purpose is to identify risk factors for developing recurrent hypoglycemia in diabetic patients admitted for severe hypoglycemia. Materials and Methods: We reviewed the records of 233 subjects (92 males, 141 females; mean age, 74.1 ± 9.8 years) with type 2 diabetes treated at a tertiary care teaching hospital and hospitalized for severe hypoglycemia. Results: Seventy-four (31.8%) patients were categorized with recurrent hypoglycemia and 159(68.2%) with non-recurrent. Multivariate logistic regression analysis revealed that patients with loss of a recent meal, coronary artery disease, infection, and poor renal function (lower estimated glomerular filtration rate) were at risk for recurrent hypoglycemia. The use of calcium-channel blockers appeared to be a protective factor for the development of recurrent hypoglycemia. Conclusion: There may be a subset of patients with severe hypoglycemia and certain risk factors for recurrent hypoglycemia that should be admitted.
Hung-Yen Chin,Chin-Jung Wang,Eileen Changchien,Mei-Fung Lin,Chi-Hsin Chiang 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.4
Purpose: The aim of this study is to explore non-steroid anti-inflammation drugs (NSAIDs) potency for pelvic floor muscle pain by measuring local concentration in a rat model. Materials and Methods: We used nine NSAIDs, including nabumetone,naproxen, ibuprofen, meloxicam, piroxicam, diclofenac potassium, etodolac, indomethacin, and sulindac, and 9 groups of female Wister rats. Each group of rats was fed with one kind of NSAID (2 mg/mL) for three consecutive days. Thereafter, one mL of blood and one gram of pelvic floor muscle were taken to measure drug pharmacokinetics, including partition coefficient, lipophilicity, elimination of half-life (T1/2) and muscle/plasma converting ratio (Css, muscle/Css, plasma). Results: Diclofenacpotassium had the lowest T1/2 and the highest mean Css, muscle/Css, plasma (1.9 hours and 0.85±0.53, respectively). The mean Css, muscle/Css, plasma of sulindac, naproxen and ibuprofen were lower than other experimental NSAIDs. Conclusion: Diclofenac potassium had the highest disposition in pelvic floor muscle in a rat model. The finding implies that diclofenac potassium might be the choice for pain relief in pelvicmuscle.
Li-Chin Chen,Chun-Chih Lin,Chin-Yen Han,Chun-Lan Hsieh,Chiung-Jung (Jo) Wu,Hwey-Fang Liang 한국간호과학회 2018 Asian Nursing Research Vol.12 No.1
Purpose: This study aims to gain in-depth understanding of nurses' perspectives of working in an overcrowded emergency. Methods: Symbolic interactionism and Charmaz’s construction of grounded theory were used. Purposive sampling at the start of the study and a further theoretical sampling by snowball technique were used to recruit 40 registered nurses (RN) to participate in in-depth, semi-structured interviews betweenMay and November, 2014. Data analysis included analytic techniques of initial, focused and theoretical coding. Results: Study findings showed searching for work role is derived by the themes of Finding the role of positioning in Emergency Department (ED), Recognizing causes of ED overcrowding, and Confined working environment. Nurses' work experience which represents the RNs not gained control over their work, as care actions influenced by the problematic overcrowded circumstance of the ED environment. Conclusion: The findings fill a gap in knowledge about how RNs experience their work role in the context of an overcrowded Emergency Department in Taiwan. Arising from the study result include taking account of nurses' perspectives when planning staff/patient ratios, strategies to reduce waiting time and ensure that clients receive appropriate care.
THE EFFECT OF RESTAURANT INNOVATIVENESS ON CUSTOMER ADVOCACY
Chang-Hua Yen,Hui-Hsuan Yen,Shu-Chin Wu,Ko-Yu Chang 글로벌지식마케팅경영학회 2023 Global Marketing Conference Vol.2023 No.07
This study supplements the literature by determining how restaurant innovativeness is linked to customer advocacy as well as considering self-image congruity as mediator of this relationship. A questionnaire survey of 385 restaurant customers was conducted in Taiwan. The results indicated that restaurant innovativeness is positively related to customers’ self-image congruity and customer advocacy. Customers’ self-image congruity is positively associated with customer advocacy. In addition, self-image congruity mediates the relationship between restaurant innovativeness and customer advocacy. The research contributes to literature by extend the relationships between restaurant innovativeness, self-image congruity, and customer advocacy. Restaurant managers should adopt approaches (e.g. innovativeness-related activities) for enhancing self-image congruity in customers.
THE EFFECT OF RESTAURANT INNOVATIVENESS ON CUSTOMER ADVOCACY
Chang-Hua Yen,Hui-Hsuan Yen,Shu-Chin Wu,Ko-Yu Chang 글로벌지식마케팅경영학회 2023 Global Marketing Conference Vol.2023 No.07
This study supplements the literature by determining how restaurant innovativeness is linked to customer advocacy as well as considering self-image congruity as mediator of this relationship. A questionnaire survey of 385 restaurant customers was conducted in Taiwan. The results indicated that restaurant innovativeness is positively related to customers’ self-image congruity and customer advocacy. Customers’ self-image congruity is positively associated with customer advocacy. In addition, self-image congruity mediates the relationship between restaurant innovativeness and customer advocacy. The research contributes to literature by extend the relationships between restaurant innovativeness, self-image congruity, and customer advocacy. Restaurant managers should adopt approaches (e.g. innovativeness-related activities) for enhancing self-image congruity in customers.
Effect of Intra-layer Vs Fluctuation on Linear Seismic Site Response
Yen-Hsiang Chang,Chi-Chin Tsai,Chien-Chia Huang,박두희 대한토목학회 2021 KSCE JOURNAL OF CIVIL ENGINEERING Vol.25 No.10
Soil properties vary in space even within a soil layer. Nevertheless, site response analyses are typically conducted using a best-characterized shear wave velocity (Vs) profile without considering its fluctuation. In this study, the random field theory is adopted to model heterogeneous Vs profiles for a range of coefficient of variations (COVs) and correlation lengths (CLs). Linear 1D site responses are analyzed with the randomized profiles to quantify the influence of spatial Vs variation on the propagated ground motions. Results reveal that a higher COV of randomized Vs profiles leads to a lower mean ground response compared with a homogeneous Vs profile. The variation of CL does not significantly affect the surface response and peak ground acceleration profile, but is shown to influence the degree of fluctuation of the maximum shear strain profiles. For idealized profiles, the effect of heterogeneous Vs on ground response can be approximately predicted by using reduced Vs and enlarged small strain damping that are dependent on COV.
Design and simulation of self-tuning PI-type temperature control for an injection molding machine
Chin Sheng Chen,Yen Ting Chen 제어로봇시스템학회 2009 제어로봇시스템학회 국제학술대회 논문집 Vol.2009 No.8
A Proportional-Integral (PI) controller is a typical controller in industry application. For control engineer, it isimportant to find out the optimal PI parameters by observing system response when system model is difficult to identifycorrectly. However, this task is time consuming and boring. This paper proposes a self-tuning methodology with a Gradient Bisection Algorithm (GBA) to find the optimal PI parameters based on the cost function of integral absolute error (IAE) and the design indexes. The control plant for this paper is barrel temperature control of injection moldingmachine with uncertain model. Finally, the simulation results show that our proposed algorithms can dramaticallyreduce the tuning time and control response can achieve the specified performance.
Yen-Hsiang Huang,Kuo-Hsuan Hsu,Chun-Shih Chin,Jeng-Sen Tseng,Tsung-Ying Yang,Kun-Chieh Chen,Kang-Yi Su,Sung-Liang Yu,Jeremy J.W. Chen,Gee-Chen Chang 대한암학회 2022 Cancer Research and Treatment Vol.54 No.2
Purpose The aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced EGFR-mutant lung adenocarcinoma patients. Materials and Methods From August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis. Results A total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481). Conclusion Our research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced EGFR-mutant lung adenocarcinoma patients. PurposeThe aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced <i>EGFR</i>-mutant lung adenocarcinoma patients.Materials and MethodsFrom August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis.ResultsA total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481).ConclusionOur research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced <i>EGFR</i>-mutant lung adenocarcinoma patients.
Ching-Yen Kuo,Liang-Chin Yu,Hou-Chaung Chen,Chien-Lung Chan 대한의료정보학회 2018 Healthcare Informatics Research Vol.24 No.1
Objectives: The aims of this study were to compare the performance of machine learning methods for the prediction of themedical costs associated with spinal fusion in terms of profit or loss in Taiwan Diagnosis-Related Groups (Tw-DRGs) andto apply these methods to explore the important factors associated with the medical costs of spinal fusion. Methods: A dataset was obtained from a regional hospital in Taoyuan city in Taiwan, which contained data from 2010 to 2013 on patients ofTw-DRG49702 (posterior and other spinal fusion without complications or comorbidities). Naïve-Bayesian, support vectormachines, logistic regression, C4.5 decision tree, and random forest methods were employed for prediction using WEKA3.8.1. Results: Five hundred thirty-two cases were categorized as belonging to the Tw-DRG49702 group. The mean medicalcost was US $4,549.7, and the mean age of the patients was 62.4 years. The mean length of stay was 9.3 days. The lengthof stay was an important variable in terms of determining medical costs for patients undergoing spinal fusion. The randomforest method had the best predictive performance in comparison to the other methods, achieving an accuracy of 84.30%,a sensitivity of 71.4%, a specificity of 92.2%, and an AUC of 0.904. Conclusions: Our study demonstrated that the randomforest model can be employed to predict the medical costs of Tw-DRG49702, and could inform hospital strategy in terms ofincreasing the financial management efficiency of this operation.