2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

Wei-Che Lin,Wen-Chieh Chen,Pei-Wen Wang,Yi-Chia Chan,Yen-Hsiang Chang,Harn-Shen Chen,Szu-Tah Chen,Wei-Chih Chen,Kai-Lun Cheng,Shun-Yu Chi,Pi-Ling Chiang,Chen-Kai Chou,Feng-Fu Chou,Shun-Chen Huang,Feng 대한초음파의학회 2023 ULTRASONOGRAPHY Vol.42 No.3

Radiofrequency ablation (RFA) is a minimally invasive management strategy that has been widely applied for benign and recurrent malignant thyroid lesions as an alternative to surgery in Taiwan. Members of academic societies for specialists in interventional radiology, endocrinology, and endocrine surgery collaborated to develop the first consensus regarding thyroid RFA in Taiwan. The modified Delphi method was used to reach a consensus. Based on a comprehensive review of recent and valuable literature and expert opinions, the recommendations included indications, pre-procedural evaluations, procedural techniques, post-procedural monitoring, efficacy, and safety, providing a comprehensive review of the application of RFA. The consensus effectively consolidates advice regarding thyroid RFA in clinical practice for local experts.

Ethanol and Water Atomization of Like- and Unlike-Doublet Impinging Jets

( Wei Hsiang Lai ),( Shun Jie Yang ),( Wen Non Huang ) 한국액체미립화학회 2005 한국액체미립화학회 학술강연회 논문집 Vol.2005 No.-

The objective of the present study is to further investigate the general influence of the physical properties and environment effects on the mean drop size generated by like- and unlike-doublet impinging jets with 95% ethanol and purified water. The orifice of the injector element are 0.3, 0.5, and 0.7 mm in diameter, with depth-to-diameter ratio of 10, the impinging angle is set to be 60°, 90° and 120° respectively. In order to measure the mean drop size, the jet velocity is varied from 2 m/s to 30 m/s, the environment pressure is designated as 1, 2, 5 and 9 bar. Results show that in liquid shape mode, the larger impinging angle, the lower jet velocity threshold of mode transition is observed. Regarding the liquid film size, an empirical equation can be used to calculate the ψ angle, and the equation induced by Ibrahim et al.(1991) can figure out the film length by multiply a constant, which is related to the viscosity. The SMD of unlike-doublet impinging is highly influenced by the surface tension. High ambient pressure has no effect on film size, but it causes the liquid shape change mode in lower jet velocity.

Can Elderly Patients with Severe Mitral Regurgitation Benefit from Trans-catheter Mitral Valve Repair?

Ching-Wei Lee,Shih-Hsien Sung,Wei-Ming Huang,Yi-Lin Tsai,Hsiang-Yao Chen,Chiao-Po Hsu,Chun-Che Shih,Kuo-Piao Chung 대한심장학회 2019 Korean Circulation Journal Vol.49 No.6

Background and ObjectivesAge is a traditional risk factor for open-heart surgery. The efficacy and safety of transcatheter edge-to-edge mitral valve repair, using MitraClip (Abbott Vascular), has been demonstrated in patients with severe mitral regurgitation (MR). Since octogenarians or older patients are usually deferred to receive open-heart surgery, the main interest of this study is to elucidate the procedural safety and long-term clinical impact of MitraClip in elderly patients. MethodsPatients with symptomatic severe MR were evaluated by the heart team. For those with high or prohibitive surgical risks, transcatheter mitral valve repair was performed in hybrid operation room. Transthoracic echocardiography (TTE), blood tests, and six-minute walk test (6MWT) were performed before, 1-month, 6-months, and 1 year after index procedure. ResultsA total of 46 consecutive patients receiving MitraClip procedure were enrolled. Nineteen patients (84.2±4.0 years) were over 80-year-old and 27 (73.4±11.1 years) were younger than 80. Compare to baseline, the significant reduction in MR severity was achieved after the procedure and sustained. All the patients benefited from significant improvement in New York Heart Association functional class. The 6-minute walk test (6MWT) increased from 259±114 to 319±92 meters (p=0.03) at 1 year. The overall 1-year survival rate was 80% in the elderly and 88% in those <80 years, p=0.590. Baseline 6MWT was a predictor for all-cause mortality (odds ratio, 0.99; 95% confidence interval, 0.982–0.999; p=0.026) after the MitraClip procedure. ConclusionsTrans-catheter edge-to-edge mitral valve repairs are safe and have positive clinical impact in subjects with severe MR, even in advanced age.

Shear Mode Piezoelectric Ceramic Printhead Array Design

( Shih Wun Huang ),( Yeoung Jen Wu ),( Wei Hsiang Lai ) 한국액체미립화학회 2005 한국액체미립화학회 학술강연회 논문집 Vol.2005 No.-

This paper starts with an overview of different kind of piezoelectric drop-on-demand inkjet printhead, then focus on particular Xaar-type piezoelectric shear mode inkjet printhead which have higher density of print channel than other piezoelectric printhead types. Detail fabrication processes are described and the simulation of the operation condition is also carried out. The ink channels formed by MEMS wafer-cutting technology and the electrodes are coated on both upper half side of the actuator walls. Finite element analysis software ANSYS is used to simulate the strain, stress dispersion under different boundary condition when the external voltage is applied. The results show that there is a linear relationship between the applied voltage and the wall cross section area changes. In the simulation of the relationship between electrodes cover length and the cross section area change of ink channel, it is found that the quantity of ink channel cross section area change increases significantly as the electrode cover length is over 55%-60% height of actuator wall.

Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study

Ying-Ying Yang,Pin-Hsiang Huang,Ling-Yu Yang,Chia-Chang Huang,Chih-Wei Liu,Shiau-Shian Huang,Chen-Huan Chen,Fa-Yauh Lee,Shou-Yen Kao,Boaz Shulruf 한국보건의료인국가시험원 2022 보건의료교육평가 Vol.19 No.-

Purpose Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative for the commonly used Angoff and Hofstee methods and their variants. The current study aims to estimate the minimum number of panelists required for obtaining acceptable and reliable cut scores using the EZ method. Methods The primary data were extracted from 31 panelists who used the EZ method for setting cut scores for a 12-station of medical school’s final objective structured clinical examination (OSCE) in Taiwan. For this study, a new data set composed of 1,000 random samples of different panel sizes, ranging from 5 to 25 panelists, was established and analyzed. Analysis of variance was performed to measure the differences in the cut scores set by the sampled groups, across all sizes within each station. Results On average, a panel of 10 experts or more yielded cut scores with confidence more than or equal to 90% and 15 experts yielded cut scores with confidence more than or equal to 95%. No significant differences in cut scores associated with panel size were identified for panels of 5 or more experts. Conclusion The EZ method was found to be valid and feasible. Less than an hour was required for 12 panelists to assess 12 OSCE stations. Calculating the cut scores required only basic statistical skills.

An Economic-Statistical Design of Moving Average Control Charts

Yu, Fong-Jung,Chin, Hsiang,Huang, Hsiao Wei The Korean Society for Quality Management 2006 The Asian Journal on Quality Vol.7 No.3

Control charts are important tools of statistical quality control. In 1956, Duncan first proposed the economic design of $\bar{x}-control$ charts to control normal process means and insure that the economic design control chart actually has a lower cost, compared with a Shewhart control chart. An moving average (MA) control chart is more effective than a Shewhart control chart in detecting small process shifts and is considered by some to be simpler to implement than the CUSUM. An economic design of MA control chart has also been proposed in 2005. The weaknesses to only the economic design are poor statistics because it dose not consider type I or type II errors and average time to signal when selecting design parameters for control chart. This paper provides a construction of an economic-statistical model to determine the optimal parameters of an MA control chart to improve economic design. A numerical example is employed to demonstrate the model's working and its sensitivity analysis is also provided.

Hydration of DCPD over sulfonic acid-functionalized SBA-15 catalyst

Yu-Cheng Lin,Yu-Wei Huang,Ku-Hsiang Sung,Tsung-Han Lin,Soofin Cheng 한국공업화학회 2016 Journal of Industrial and Engineering Chemistry Vol.44 No.-

Sulfonic acid-functionalized SBA-15 materials (SA-SBA-15) with ordered channeling pores weresynthesized by one-pot co-condensation and used to catalyze the hydration of dicyclopentadiene(DCPD). The target product, cydecanol (DCPD-OH) has been used as a modifier for polyester or alkydresin. Propylsulfonic acid functionalized SBA-15 was found to be more efficient than the silica gelcounterpart or arylsulfonic acid functionalized material in catalyzing DCPD hydration to yield DCPD-OH. The DCPD conversion and DCPD-OH yield increased with the decrease in H2O/DCPD ratio. Optimal DCPDconversion and DCPD-OH selectivity were obtained with the molar composition of DCPD:H2O:H+[1TD$DIF]-catalyst = 1:30:0.1.

An Economic-Statistical Design of Moving Average Control Charts

( Fong Jung Yu ),( Hsiang Chin ),( Hsiao Wei Huang ) 한국품질경영학회 2006 The Asian Journal on Quality Vol.7 No.3

Multi-Response Optimization and Investigations of Al-Steel Lap-Joint Performance Using a Novel MIG Weld-Brazing Technique

Hsuan-Liang Lin,Wei-Hsiang Huang 한국정밀공학회 2022 International Journal of Precision Engineering and Vol.23 No.9

The multiple quality characteristics (QCs) of aluminum (Al) alloy to galvanized (GA) steel lap-joint specimens were optimized in a novel metal inert gas (MIG) weld-brazing process, which using the hybrid shielding gas involve helium (He) and argon (Ar). The MIG weld-brazing technique offer a great potential for dissimilar metal joining such as Al and steel, which combines the advantages of fusion welding and brazing process. The grey-based Taguchi method was employed to solve the multi-response optimization problems in this study, which integrated the grey relational analysis and Taguchi method. It obtains the optimal parameters that considered with multiple QCs such as wettability and tensile strength of Al-steel lap-joint specimens. The experimental results demonstrated that the amount of pores of specimens that produced by adding 3% He gas to Ar-based gas is less than other hybrid shielding gas. Confirmation experiments revealed that the tensile strength of Al-steel lap-joint specimens was up to 208.2 MPa. The experimental procedure proposed by the authors improved the wettability and tensile strength of Al-steel lap-joint specimens simultaneously. The average thickness of intermetallic compounds layer between the Al fusion zone and GA steel surface that used optimal MIG weld-brazing parameters is 6.27 μm proximately.

Risk factors in progression from endometriosis to ovarian cancer: a cohort study based on medical insurance data

An Jen Chiang,Chung Chang,Chi-Hsiang Huang,Wei-Chun Huang,,Yuen-Yee Kan,Jiabin Chen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.3

Objective: The objective was to identify risk factors that were associated with the progression from endometriosis to ovarian cancer based on medical insurance data. Methods: The study was performed on a dataset obtained from the National Health Insurance Research Database, which covered all the inpatient claim data from 2000 to 2013 in Taiwan. The International Classification of Diseases (ICD) code 617 was used to screen the dataset for the patients who were admitted to hospital due to endometriosis. They were then tracked for subsequent diagnosis of ovarian cancer, and available biological, socioeconomic and clinical information was also collected. Univariate and multivariate analyses were then performed based on the Cox regression model to identify risk factors. C-index was calculated and cross validated. Results: A total of 229,617 patients who were admitted to hospital due to endometriosis from 2000 to 2013 were included in the study, out of whom 1,473 developed ovarian cancer by the end of 2013. A variety of factors, including age, residence, hospital stratification, premium range, and various comorbidities had significant impact on the progression (p<0.05). Among them, age, urbanization of residence, hospital stratification, premium range, post-endometriosis childbearing, pelvic inflammation, and depression all had independent, significant impact (p<0.05). The validated C-index was 0.69. Conclusion: For a woman diagnosed with endometriosis, increased age, residing in a highly urbanized area, low or high income, depression, pelvic inflammation, and absence of childbearing post-endometriosis all put her at high-risk to develop ovarian cancer. The findings may be of help to gynecologists to identify high-risk patients.