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Palliative Care for Adult Patients Undergoing Hemodialysis in Asia: Challenges and Opportunities
Wei-Min Chu,Hung-Bin Tsai,Yu-Chi Chen,Kuan-Yu Hung,Shao-Yi Cheng,Cheng-Pei Lin 한국호스피스완화의료학회 2024 한국호스피스.완화의료학회지 Vol.27 No.1
This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.
Min-Hsiang Chuang,Yu-Shuo Tang,Jui-Yi Chen,Heng-Chih Pan,Hung-Wei Liao,Wen-Kai Chu,Chung-Yi Cheng,Vin-Cent Wu,Michael Heung 대한당뇨병학회 2024 Diabetes and Metabolism Journal Vol.48 No.2
Background: The initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) typically leads to a reversible initial dip in estimated glomerular filtration rate (eGFR). The implications of this phenomenon on clinical outcomes are not well-defined.Methods: We searched MEDLINE, Embase, and Cochrane Library from inception to March 23, 2023 to identify randomized controlled trials and cohort studies comparing kidney and cardiovascular outcomes in patients with and without initial eGFR dip after initiating SGLT2i. Pooled estimates were calculated using random-effect meta-analysis.Results: We included seven studies in our analysis, which revealed that an initial eGFR dip following the initiation of SGLT2i was associated with less annual eGFR decline (mean difference, 0.64; 95% confidence interval [CI], 0.437 to 0.843) regardless of baseline eGFR. The risk of major adverse kidney events was similar between the non-dipping and dipping groups but reduced in patients with a ≤10% eGFR dip (hazard ratio [HR], 0.915; 95% CI, 0.865 to 0.967). No significant differences were observed in the composite of hospitalized heart failure and cardiovascular death (HR, 0.824; 95% CI, 0.633 to 1.074), hospitalized heart failure (HR, 1.059; 95% CI, 0.574 to 1.952), or all-cause mortality (HR, 0.83; 95% CI, 0.589 to 1.170). The risk of serious adverse events (AEs), discontinuation of SGLT2i due to AEs, kidney-related AEs, and volume depletion were similar between the two groups. Patients with >10% eGFR dip had increased risk of hyperkalemia compared to the non-dipping group.Conclusion: Initial eGFR dip after initiating SGLT2i might be associated with less annual eGFR decline. There were no significant disparities in the risks of adverse cardiovascular outcomes between the dipping and non-dipping groups.
( Qing Wei ),( San Zhen Liu ),( Jian Feng Huang ),( Xue Ying Mao ),( Xiao Hui Chu ),( Yu Wang ),( Min Yan Qiu ),( Yu Min Mao ),( Yi Xie ),( Yao Li ) 생화학분자생물학회 2004 BMB Reports Vol.37 No.4
Double stranded targets on the cDNA microarray contain representatives of both the coding and noncoding strands, which will introduce hybridization competition with probes. Here, the effect of double and single strands of targets on the signal intensity and the ratios of Cy5/Cy3 within the same slide were compared. The results show that single stranded targets can increase the hybridization efficiency without changing the Cy5/Cy3 ratio. Based on these results, a new strategy was established by generating cDNA targets with asymmetric PCR, instead of conventional PCR, to increase the sensitivity of the cDNA microarray. Furthermore, the feasibility of this approach was validated. The results indicate that the cDNA microarray system based on asymmetric PCR is more sensitive, with no decrease in the reliability and reproducibility as compared with that based on conventional symmetric PCR.
Can-Tong Liu,Yi-Wei Xu,Hong Guo,Chao-Qun Hong,Xin-Yi Huang,Yu-Hao Luo,Shi-Han Yang,Ling-Yu Chu,En- Min Li,Yu-Hui Peng 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.6
Background/Aims: Esophagogastric junction adenocarcinoma (EJA) is a malignant tumor associated with high morbidity and has attracted increasing attention due to a rising incidence and low survival rate. Pathological biopsy is the gold standard for diagnosis, but noninvasive and effective tests are lacking, resulting in diagnoses at advanced stages. This study explored the diagnostic value of insulin-like growth factor binding protein 7 (IGFBP7) in EJA. Methods: A total of 120 EJA patients and 88 normal controls were recruited, and their serum levels of IGFBP7 were measured by enzymelinked immunosorbent assay. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic value, and Pearson chi-square analysis was used to evaluate the correlation between IGFBP7 and clinical parameters. Kaplan- Meier survival analysis was carried out to assess the effect of IGFBP7 on overall survival (OS). Results: The levels of IGFBP7 were higher in both early- and late-stage EJA patients than in normal controls (p<0.001). The area under the ROC curve for EJA patients was 0.794 (95% confidence interval [CI], 0.733 to 0.854), with a cutoff value of 2.716 ng/mL, a sensitivity of 63.3% (95% CI, 54.0% to 71.8%) and a specificity of 90.9% (95% CI, 82.4% to 95.7%). For the diagnosis of early-stage EJA, the same cutoff value and specificity were obtained, but the sensitivity of IGFBP7 was 54.3% (95% CI, 36.9% to 70.8%). Patients with low IGFBP7 protein expression had lower OS than those with high expression (p=0.034). The multivariate analysis showed that IGFBP7 is an independent prognostic factor for EJA (p=0.011). Conclusions: Serum IGFBP7 acts as a potential diagnostic and prognostic marker for EJA.
Innovative Design and Integrated Manufacturing Laboratory at Seoul National University
Sung-Hoon Ahn,Won-Shik Chu,Varsha Khare,Gil-Yong Lee,Wei Wang,Dong-Hyeon Kim,Sung-Ik Park,Min-Woo Han,Hyun-Taek Lee,Min-Cheol Kim,Jang-Yeob Lee,Hyung-Soo Kim,Min-Soo Kim,Kang-In Lee,Ying Jun Quan,Ji-H 한국생산제조학회 2016 한국생산제조시스템학회 학술발표대회 논문집 Vol.2016 No.10
Lee, Jong-Hee,Lee, Jeong-Ik,Lee, Joo-Won,Lee, Jun-Yeob,Kang, Dong-Min,Yuanc, Wei,Kwon, Soon-Ki,Chu, Hye-Yong The Korean Infomation Display Society 2009 Journal of information display Vol.10 No.2
Highly efficient blue and white phosphorescent organic light-emitting diodes (PHOLEDs) with an exciton-confining structure were investigated in this study. Effective charge confinement was achieved by stacking two emitting layers with different charge-transporting properties, and blue PHOLEDs with a maximum luminance efficiency of 47.9 lm/W were developed by using iridium(III) bis(4,6-(difluorophenyl) pyridinato-N,C2')picolinate (FIrpic) as an electrophosphorescent dopant. Moreover, when the optimized green and red emitting layers were sandwiched between the two stacked blue emitting layers, white PHOLEDs (WOLEDs) with peak external and luminance efficiencies of 19.0% coupling technique.and 54.0 lm/W, respectively, were obtained without the use of any out-coupling technique.