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Article ; Online: Planning, implementing, and evaluating Hepatitis C virus elimination via collaborative community-based care cascade: age-period-cohort model for estimating demand from antecedent anti-HCV survey.

Lin, Ting-Yu / Jen, Hsiao-Hsuan / Hu, Tsung-Hui / Yao, Yu-Chin / Chen, Tony Hsiu-Hsi / Yen, Amy Ming-Fang / Yeh, Yen-Po

2023 Volume 18, Issue 2, Page(s) 476–485

Abstract: Background: Estimating the demand for HCV care cascade plays an important role in planning, monitoring, and assessing the performance of introducing a new community-based hepatitis C virus (HCV) elimination program but such an analytic and systematic ... ...

Abstract	Background: Estimating the demand for HCV care cascade plays an important role in planning, monitoring, and assessing the performance of introducing a new community-based hepatitis C virus (HCV) elimination program but such an analytic and systematic approach has been barley addressed. Methods: A new collaborative care program for HCV elimination in the Changhua Community of Taiwan has been offered to a total of 895,353 residents since 2018. To grasp the variation of demand for HCV care cascade across demographic and geographic features in the planning stage, we applied the age-period-cohort spatial model to the antecedent anti-HCV survey enrolling 123,617 participants aged 30 years or older between 2005 and 2018. Based on this precise denominator, we then employed a "before-and-after" study design to routinely evaluate whether the WHO criteria of 90% RNA positive diagnosis and 80% successful treatments could be reached. Results: The overall demand for HCV care cascade was 4.28% (HCV infection) of the underlying population but a declining trend was noted. The early cohort had a higher demand, whereas the demand of the young cohort decreased with each passing year. The demand also differed by township. The demand, allowing for these variations, for antiviral treatment was 22,362, yielding the WHO target of 12,880 for achieving HCV elimination. With 11,844 successful treatments, the effectiveness of elimination has already reached 92% (11,844/12,880) by the end of 2022. Conclusions: The demand for HCV care cascade allows health care decision-makers to timely and properly assess the performance of a novel community-based collaborative care program in achieving HCV elimination.
MeSH term(s)	Humans ; Hepacivirus/genetics ; Antiviral Agents/therapeutic use ; Hepatitis C/diagnosis ; Hepatitis C/epidemiology ; Hepatitis C/drug therapy ; RNA ; Taiwan/epidemiology ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology
Chemical Substances	Antiviral Agents ; RNA (63231-63-0)
Language	English
Publishing date	2023-11-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2270316-0
ISSN	1936-0541 ; 1936-0533
ISSN (online)	1936-0541
ISSN	1936-0533
DOI	10.1007/s12072-023-10605-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Identification and analysis of Nonlinear behaviors of vocal fold biomechanics during phonation to assess efficacy of surgery for benign laryngeal Diseases.

Tseng, Wen-Hsuan / Chiu, Hsiang-Ling / Hsiao, Tzu-Yu / Yang, Tsung-Lin / Shih, Po-Jen

Computers in biology and medicine

2024 Volume 169, Page(s) 107946

Abstract: Background: Current voice assessments focus on perceptive evaluation and acoustic analysis. The interaction of vocal tract pressure (P: Method: Healthy volunteers and patients with benign laryngeal lesions were recruited for this study. P: Results!# ...

Abstract	Background: Current voice assessments focus on perceptive evaluation and acoustic analysis. The interaction of vocal tract pressure (P Method: Healthy volunteers and patients with benign laryngeal lesions were recruited for this study. P Results: For healthy volunteers, nonlinearity was exhibited as an initial increase and then prompt decrease in vibrational frequency at the end of phonation, coinciding with P Conclusion: This novel method simultaneously monitors P
MeSH term(s)	Humans ; Vocal Cords/pathology ; Biomechanical Phenomena ; Phonation ; Laryngeal Diseases/pathology ; Acoustics ; Vibration
Language	English
Publishing date	2024-01-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2024.107946
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Article ; Online: A pre-symptomatic incubation model for precision strategies of screening, quarantine, and isolation based on imported COVID-19 cases in Taiwan

Grace Hsiao-Hsuan Jen / Amy Ming-Fang Yen / Chen-Yang Hsu / Sam Li-Sheng Chen / Tony Hsiu-Hsi Chen

Scientific Reports, Vol 12, Iss 1, Pp 1-

2022 Volume 11

Abstract: Abstract Facing the emerging COVID viral variants and the uneven distribution of vaccine worldwide, imported pre-symptomatic COVID-19 cases play a pivotal role in border control strategies. A stochastic disease process and computer simulation experiments ...

Abstract	Abstract Facing the emerging COVID viral variants and the uneven distribution of vaccine worldwide, imported pre-symptomatic COVID-19 cases play a pivotal role in border control strategies. A stochastic disease process and computer simulation experiments with Bayesian underpinning was therefore developed to model pre-symptomatic disease progression during incubation period on which we were based to provide precision strategies for containing the resultant epidemic caused by imported COVID-19 cases. We then applied the proposed model to data on 1051 imported COVID-19 cases among inbound passengers to Taiwan between March 2020 and April 2021. The overall daily rate (per 100,000) of pre-symptomatic COVID-19 cases was estimated as 106 (95% credible interval (CrI): 95–117) in March–June 2020, fell to 37 (95% CrI: 28–47) in July–September 2020 (p < 0.0001), resurged to 141 (95% CrI: 118–164) in October–December 2020 (p < 0.0001), and declined to 90 (95% CrI: 73–108) in January–April 2021 (p = 0.0004). Given the median dwelling time, over 82% cases would progress from pre-symptomatic to symptomatic phase in 5-day quarantine. The time required for quarantine given two real-time polymerase chain reaction (RT-PCR) tests depends on the risk of departing countries, testing and quarantine strategies, and whether the passengers have vaccine jabs. Our proposed four-compartment stochastic process and computer simulation experiments design underpinning Bayesian MCMC algorithm facilitated the development of precision strategies for imported COVID-19 cases.
Keywords	Medicine ; R ; Science ; Q
Subject code	006
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
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Article ; Online: A new approach to modeling pre-symptomatic incidence and transmission time of imported COVID-19 cases evolving with SARS-CoV-2 variants

Chen, Sam Li-Sheng / Jen, Grace Hsiao-Hsuan / Hsu, Chen-Yang / Yen, Amy Ming-Fang / Lai, Chao-Chih / Yeh, Yen-Po / Chen, Tony Hsiu-Hsi

Stoch Environ Res Risk Assess. 2023 Jan., v. 37, no. 1 p.441-452

2023

Abstract: There is paucity of the statistical model that is specified for data on imported COVID-19 cases with the unique global information on infectious properties of SARS-CoV-2 variant different from local outbreak data used for estimating transmission and ... ...

Abstract	There is paucity of the statistical model that is specified for data on imported COVID-19 cases with the unique global information on infectious properties of SARS-CoV-2 variant different from local outbreak data used for estimating transmission and infectiousness parameters via the established epidemic models. To this end, a new approach with a four-state stochastic model was proposed to formulate these well-established infectious parameters with three new parameters, including the pre-symptomatic incidence rate, the median of pre-symptomatic transmission time (MPTT) to symptomatic state, and the incidence (proportion) of asymptomatic cases using imported COVID-19 data. We fitted the proposed stochastic model to empirical data on imported COVID-19 cases from D614G to Omicron with the corresponding calendar periods according to the classification GISAID information on the evolution of SARS-CoV-2 variant between March 2020 and Jan 2022 in Taiwan. The pre-symptomatic incidence rate was the highest for Omicron followed by Alpha, Delta, and D614G. The MPTT (in days) increased from 3.45 (first period) ~ 4.02 (second period) of D614G until 3.94–4.65 of VOC Alpha but dropped to 3.93–3.49 of Delta and 2 days (only first period) of Omicron. The proportion of asymptomatic cases increased from 29% of D-614G period to 59.2% of Omicron. Modeling data on imported cases across strains of SARS-CoV-2 not only bridges the link between the underlying natural infectious properties elucidated in the previous epidemic models and different disease phenotypes of COVID-19 but also provides precision quarantine and isolation policy for border control in the face of various emerging SRAS-CoV-2 variants globally.
Keywords	COVID-19 infection ; Severe acute respiratory syndrome coronavirus 2 ; issues and policy ; quarantine ; risk ; statistical models ; stochastic processes ; Taiwan
Language	English
Dates of publication	2023-01
Size	p. 441-452.
Publishing place	Springer Berlin Heidelberg
Document type	Article ; Online
ZDB-ID	1481263-0
ISSN	1436-3259 ; 1435-151X ; 1436-3240 ; 0931-1955
ISSN (online)	1436-3259 ; 1435-151X
ISSN	1436-3240 ; 0931-1955
DOI	10.1007/s00477-022-02305-z
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Article ; Online: A pre-symptomatic incubation model for precision strategies of screening, quarantine, and isolation based on imported COVID-19 cases in Taiwan.

Jen, Grace Hsiao-Hsuan / Yen, Amy Ming-Fang / Hsu, Chen-Yang / Chen, Sam Li-Sheng / Chen, Tony Hsiu-Hsi

Scientific reports

2022 Volume 12, Issue 1, Page(s) 6053

Abstract: Facing the emerging COVID viral variants and the uneven distribution of vaccine worldwide, imported pre-symptomatic COVID-19 cases play a pivotal role in border control strategies. A stochastic disease process and computer simulation experiments with ... ...

Abstract	Facing the emerging COVID viral variants and the uneven distribution of vaccine worldwide, imported pre-symptomatic COVID-19 cases play a pivotal role in border control strategies. A stochastic disease process and computer simulation experiments with Bayesian underpinning was therefore developed to model pre-symptomatic disease progression during incubation period on which we were based to provide precision strategies for containing the resultant epidemic caused by imported COVID-19 cases. We then applied the proposed model to data on 1051 imported COVID-19 cases among inbound passengers to Taiwan between March 2020 and April 2021. The overall daily rate (per 100,000) of pre-symptomatic COVID-19 cases was estimated as 106 (95% credible interval (CrI): 95-117) in March-June 2020, fell to 37 (95% CrI: 28-47) in July-September 2020 (p < 0.0001), resurged to 141 (95% CrI: 118-164) in October-December 2020 (p < 0.0001), and declined to 90 (95% CrI: 73-108) in January-April 2021 (p = 0.0004). Given the median dwelling time, over 82% cases would progress from pre-symptomatic to symptomatic phase in 5-day quarantine. The time required for quarantine given two real-time polymerase chain reaction (RT-PCR) tests depends on the risk of departing countries, testing and quarantine strategies, and whether the passengers have vaccine jabs. Our proposed four-compartment stochastic process and computer simulation experiments design underpinning Bayesian MCMC algorithm facilitated the development of precision strategies for imported COVID-19 cases.
MeSH term(s)	Bayes Theorem ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/prevention & control ; Computer Simulation ; Humans ; Quarantine ; SARS-CoV-2 ; Taiwan/epidemiology
Language	English
Publishing date	2022-04-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-09863-w
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Article: A new approach to modeling pre-symptomatic incidence and transmission time of imported COVID-19 cases evolving with SARS-CoV-2 variants.

Chen, Sam Li-Sheng / Jen, Grace Hsiao-Hsuan / Hsu, Chen-Yang / Yen, Amy Ming-Fang / Lai, Chao-Chih / Yeh, Yen-Po / Chen, Tony Hsiu-Hsi

Stochastic environmental research and risk assessment : research journal

2022 , Page(s) 1–12

Abstract	There is paucity of the statistical model that is specified for data on imported COVID-19 cases with the unique global information on infectious properties of SARS-CoV-2 variant different from local outbreak data used for estimating transmission and infectiousness parameters via the established epidemic models. To this end, a new approach with a four-state stochastic model was proposed to formulate these well-established infectious parameters with three new parameters, including the pre-symptomatic incidence rate, the median of pre-symptomatic transmission time (MPTT) to symptomatic state, and the incidence (proportion) of asymptomatic cases using imported COVID-19 data. We fitted the proposed stochastic model to empirical data on imported COVID-19 cases from D614G to Omicron with the corresponding calendar periods according to the classification GISAID information on the evolution of SARS-CoV-2 variant between March 2020 and Jan 2022 in Taiwan. The pre-symptomatic incidence rate was the highest for Omicron followed by Alpha, Delta, and D614G. The MPTT (in days) increased from 3.45 (first period) ~ 4.02 (second period) of D614G until 3.94-4.65 of VOC Alpha but dropped to 3.93-3.49 of Delta and 2 days (only first period) of Omicron. The proportion of asymptomatic cases increased from 29% of D-614G period to 59.2% of Omicron. Modeling data on imported cases across strains of SARS-CoV-2 not only bridges the link between the underlying natural infectious properties elucidated in the previous epidemic models and different disease phenotypes of COVID-19 but also provides precision quarantine and isolation policy for border control in the face of various emerging SRAS-CoV-2 variants globally.
Language	English
Publishing date	2022-09-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1481263-0
ISSN	1436-3259 ; 1435-151X ; 1436-3240 ; 0931-1955
ISSN (online)	1436-3259 ; 1435-151X
ISSN	1436-3240 ; 0931-1955
DOI	10.1007/s00477-022-02305-z
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Article: The Bayesian Susceptible-Exposed-Infected-Recovered model for the outbreak of COVID-19 on the Diamond Princess Cruise Ship.

Lai, Chao-Chih / Hsu, Chen-Yang / Jen, Hsiao-Hsuan / Yen, Amy Ming-Fang / Chan, Chang-Chuan / Chen, Hsiu-Hsi

Stochastic environmental research and risk assessment : research journal

2021 Volume 35, Issue 7, Page(s) 1319–1333

Abstract: The outbreak of COVID-19 on the Diamond Princess Cruise Ship provides an unprecedented opportunity to estimate its original transmissibility with basic reproductive number (R: Supplementary information: The online version contains supplementary ... ...

Abstract	The outbreak of COVID-19 on the Diamond Princess Cruise Ship provides an unprecedented opportunity to estimate its original transmissibility with basic reproductive number (R Supplementary information: The online version contains supplementary material available at (10.1007/s00477-020-01968-w).
Language	English
Publishing date	2021-01-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1481263-0
ISSN	1436-3259 ; 1435-151X ; 1436-3240 ; 0931-1955
ISSN (online)	1436-3259 ; 1435-151X
ISSN	1436-3240 ; 0931-1955
DOI	10.1007/s00477-020-01968-w
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Article ; Online: Evaluating medical capacity for hospitalization and intensive care unit of COVID-19

Grace Hsiao-Hsuan Jen / Shey-Ying Chen / Wei-Jung Chang / Chiung-Nien Chen / Amy Ming-Fang Yen / Ray-E Chang

Journal of the Formosan Medical Association, Vol 120, Iss , Pp S86-S

A queue model approach

2021 Volume 94

Abstract: Background: The surge of COVID-19 pandemic has caused severe respiratory conditions and a large number of deaths due to the shortage of intensive care unit (ICU) in many countries. Methods: We developed a compartment queue model to describe the process ... ...

Abstract	Background: The surge of COVID-19 pandemic has caused severe respiratory conditions and a large number of deaths due to the shortage of intensive care unit (ICU) in many countries. Methods: We developed a compartment queue model to describe the process from case confirmation, home-based isolation, hospitalization, ICU, recovery, and death. By using public assessed data in Lombardy, Italy, we estimated two congestion indices for isolation wards and ICU. The excess ICU needs were estimated in Lombardy, Italy, and other countries when data were available, including France, Spain, Belgium, New York State in the USA, South Korea, and Japan. Results: In Lombardy, Italy, the congestion of isolation beds had increased from 2.2 to the peak of 6.0 in March and started to decline to 3.9 as of 9th May, whereas the demand for ICU during the same period has not decreased yet with an increasing trend from 2.9 to 8.0. The results showed the unmet ICU need from the second week in March as of 9th May. The same situation was shown in France, Spain, Belgium, and New York State, USA but not for South Korea and Japan. The results with data until December 2020 for Lombardy, Italy were also estimated to reflect the demand for hospitalization and ICU after the occurrence of viral variants. Conclusion: Two congestion indices for isolation wards and ICU beds using open assessed tabulated data with a compartment queue model underpinning were developed to monitor the clinical capacity in hospitals in response to the COVID-19 pandemic.
Keywords	Capacity ; Compartment model ; COVID-19 ; Intensive care unit ; Queue model ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Evaluating Clinical Efficacy of Antiviral Therapy for COVID-19: A Surrogate Endpoint Approach.

Jen, Hsiao-Hsuan / Chang, Wei-Jung / Lin, Ting-Yu / Hsu, Chen-Yang / Yen, Amy Ming-Fang / Lai, Chao-Chih / Chen, Tony Hsiu-Hsi

Infectious diseases and therapy

2021 Volume 10, Issue 2, Page(s) 815–825

Abstract: Introduction: Efficient evaluation with an early surrogate endpoint, taking into account the process of disease evolution, may not only clarify inconsistent or underpowered results but also provide a new insight into the exploration of a new antiviral ... ...

Abstract	Introduction: Efficient evaluation with an early surrogate endpoint, taking into account the process of disease evolution, may not only clarify inconsistent or underpowered results but also provide a new insight into the exploration of a new antiviral therapy for treating COVID-19 patients. Methods: We assessed the dynamics of COVID-19 disease spectrum, commencing from low-risk (no or low oxygen supplement), medium-risk (non-invasive ventilator or high oxygen supplement), and high-risk (extracorporeal membrane oxygenation or invasive ventilator) risk state on enrollment, and then the subsequent progression and regression of risk states until discharge or death. The efficacy of antiviral therapy in altering the dynamics was assessed by using the high-risk state as a surrogate endpoint based on the data retrieved from the two-arm Adaptive Covid-19 Treatment Trial. Results: Using the high-risk state as a surrogate endpoint, remdesivir treatment led to a decrease in the high-risk COVID-19 state by 34.8% (95% CI 26.7-42.0%) for a 14-day period and 29.3% (95% CI 28.8-29.8%) up to 28 days, which were consistent with a statistically significant reduction of death by 30.5% (95% CI 6.6, 50.9%) up to a 28-day period. The estimates of numbers needed to be treated were 100.9 (95% CI 88.1, 115.7) for using the high-risk COVID-19 state as a surrogate endpoint for a 14-day period and 133.3 (95% CI 112.5, 158.0) were required for averting one death from COVID-19 up to 28 days. Conclusions: We demonstrate the expedient use of the high-risk COVID-19 disease status as a surrogate endpoint for evaluating the primary outcome of the earliest death.
Language	English
Publishing date	2021-03-18
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2701611-0
ISSN	2193-6382 ; 2193-8229
ISSN (online)	2193-6382
ISSN	2193-8229
DOI	10.1007/s40121-021-00431-9
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Article ; Online: Mitigating the impact of COVID-19 on colorectal cancer screening: Organized service screening perspectives from the Asia-Pacific region.

Chiu, Han-Mo / Su, Chiu-Wen / Hsu, Weng-Feng / Jen, Grace Hsiao-Hsuan / Hsu, Chen-Yang / Chen, Sam Li-Sheng / Chen, Hsiu-Hsi

Preventive medicine

2021 Volume 151, Page(s) 106622

Abstract: Colorectal cancer(CRC) is one of the most prevalent malignancies in the Asia-Pacific region, and many countries in this region have launched population CRC service screening. In this study, CRC screening key indicators, including the FIT(fecal ... ...

Abstract	Colorectal cancer(CRC) is one of the most prevalent malignancies in the Asia-Pacific region, and many countries in this region have launched population CRC service screening. In this study, CRC screening key indicators, including the FIT(fecal immunochemical test) screening rate (or participation rate) and the rate of undergoing colonoscopy after positive FIT in 2019 and 2020, were surveyed in individual countries in the Asia-Pacific region. The impact of the pandemic on the effectiveness of CRC screening was simulated given different screening rates and colonoscopy rates and assuming the pandemic would persist or remain poorly controlled for a long period of time, using the empirical data from the Taiwanese program and the CRC natural history model. During the COVID-19 pandemic, most of the programs in this region were affected, but to different extents, which was largely influenced by the severity of the local pandemic. Most of the programs continued screening services in 2020, although a temporary pause occurred in some countries. The modeling study revealed that prolonged pauses of screening led to 6% lower effectiveness in reducing CRC mortality. Screening organizers should coordinate with health authorities to elaborate on addressing screening backlogs, setting priorities for screening, and applying modern technologies to overcome potential obstacles. Many novel approaches that were developed and applied during the COVID-19 pandemic, such as the risk-stratified approach that takes into account personal CRC risk and the local epidemic status, as well as new digital technologies, are expected to play important roles in CRC screening in the future.
MeSH term(s)	Asia ; COVID-19 ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Early Detection of Cancer ; Humans ; Mass Screening ; Occult Blood ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-05-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2021.106622
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