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Article ; Online: Effectiveness of a nursing board games in psychiatric nursing course for undergraduate nursing students: An experimental design.

Wu, Chia-Shan / Chen, Mei-Fang / Hwang, Huei-Lih / Lee, Bih-O

2023 Volume 70, Page(s) 103657

Abstract: Aim: To examine the effectiveness of a psychiatric nursing board game in an undergraduate psychiatric nursing course.: Background: Didactic teaching fails to assist students in deepening their understanding of abstract concepts in psychiatric nursing. ...

Abstract	Aim: To examine the effectiveness of a psychiatric nursing board game in an undergraduate psychiatric nursing course. Background: Didactic teaching fails to assist students in deepening their understanding of abstract concepts in psychiatric nursing. The game-based learning of professional courses can address the demands of digital-age students, which may improve their learning outcomes. Design: A parallel two-arm experimental design was adopted in a nursing college in southern Taiwan. Methods: The participants were fourth-year students enroled in a college nursing programme in southern Taiwan. Simple random sampling was used to divide the class into intervention and control groups. The former participated in an eight-week game-based intervention course, while the latter continued to receive traditional instruction. In addition to collecting the students' demographic data, three structural questionnaires were developed to examine the variation in students' nursing knowledge and attitudes toward psychiatric nursing, as well as their learning satisfaction before and after the intervention. Results: There were a total of 106 participants, with 53 in each group. After the intervention, the two groups were significantly different in terms of their psychiatric nursing knowledge, attitudes and self-reported learning satisfaction. The intervention group's scores were significantly higher than those of the control group across all three dimensions. This suggests the positive effects of the board game intervention on students' learning outcomes. Conclusion: The research outcome can be applied in formative and undergraduate nursing education in teaching psychiatric nursing globally. The game-based learning materials developed can be used to train psychiatric nursing teachers. Future studies should recruit a larger sample and increase the follow-up time for assessing students' learning outcomes, as well as examine the similarities and differences in the learning outcomes of students from different educational systems.
MeSH term(s)	Humans ; Education, Nursing, Baccalaureate/methods ; Students, Nursing/psychology ; Research Design ; Psychiatric Nursing ; Learning
Language	English
Publishing date	2023-05-09
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2058575-5
ISSN	1873-5223 ; 1471-5953
ISSN (online)	1873-5223
ISSN	1471-5953
DOI	10.1016/j.nepr.2023.103657
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Article ; Online: Correction to: Staged surgery for tandem cervical and lumbar spinal stenosis: Which should be treated first?

Luo, Chi-An / Kaliya-Perumal, Arun-Kumar / Lu, Meng-Ling / Chen, Lih-Huei / Chen, Wen-Jer / Niu, Chi-Chien

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2020 Volume 29, Issue 4, Page(s) 923

Abstract: The authors would like to acknowledge the following funding information that was missing in. ...

Abstract	The authors would like to acknowledge the following funding information that was missing in.
Language	English
Publishing date	2020-01-31
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-020-06296-9
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Article ; Online: Biomechanical comparison of pedicle screw fixation strength in synthetic bones

Mu-Yi Liu / Tsung-Ting Tsai / Po-Liang Lai / Ming-Kai Hsieh / Lih-Huei Chen / Ching-Lung Tai

PLoS ONE, Vol 15, Iss 2, p e

Effects of screw shape, core/thread profile and cement augmentation.

2020 Volume 0229328

Abstract: Pedicle screw loosening resulting from insufficient bone-screw interfacial holding power is not uncommon. The screw shape and thread profile are considered important factors of the screw fixation strength. This work investigated the difference in pullout ...

Abstract	Pedicle screw loosening resulting from insufficient bone-screw interfacial holding power is not uncommon. The screw shape and thread profile are considered important factors of the screw fixation strength. This work investigated the difference in pullout strength between conical and cylindrical screws with three different thread designs. The effects of the thread profiles on the screw fixation strength of cannulated screws with or without cement augmentation in osteoporotic bone were also evaluated. Commercially available artificial standard L4 vertebrae and low-density polyurethane foam blocks were used as substitutes for healthy vertebrae and osteoporotic bones, respectively. The screw pullout strengths of nine screw systems were investigated (six in each). These systems included the combination of three different screw shapes (solid/cylindrical, solid/conical and cannulated/cylindrical) with three different thread profiles (fine-thread, coarse-thread and dual-core/dual-thread). Solid screws were designed for the cementless screw fixation of vertebrae using the standard samples, whereas cannulated screws were designed for the cemented screw fixation of osteoporotic bone using low-density test blocks. Following specimen preparation, a screw pullout test was conducted using a material test machine, and the maximal screw pullout strength was compared among the groups. This study demonstrated that, in healthy vertebrae, both the conical and dual-core/dual-thread designs can improve pullout strength. A combination of the conical and dual-core/dual-thread designs may achieve optimal postoperative screw stability. However, in osteoporotic bone, the thread profile have little impact on the screw fixation strength when pedicle screws are fixed with cement augmentation. Cement augmentation is the most important factor contributing to screw pullout fixation strength as compared to screw designs.
Keywords	Medicine ; R ; Science ; Q
Subject code	620
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
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Article ; Online: Cardenolide glycosides sensitize gefitinib-induced apoptosis in non-small cell lung cancer: inhibition of Na

Du, Chi-Min / Leu, Wohn-Jenn / Jiang, Yi-Huei / Chan, She-Hung / Chen, Ih-Sheng / Chang, Hsun-Shuo / Hsu, Lih-Ching / Hsu, Jui-Ling / Guh, Jih-Hwa

Naunyn-Schmiedeberg's archives of pharmacology

2024

Abstract: The treatment of non-small cell lung cancer (NSCLC) is known as a significant level of unmet medical need in spite of the progress in targeted therapy and personalized therapy. Overexpression of the ... ...

Abstract	The treatment of non-small cell lung cancer (NSCLC) is known as a significant level of unmet medical need in spite of the progress in targeted therapy and personalized therapy. Overexpression of the Na
Language	English
Publishing date	2024-03-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	121471-8
ISSN	1432-1912 ; 0028-1298
ISSN (online)	1432-1912
ISSN	0028-1298
DOI	10.1007/s00210-024-03031-9
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Article ; Online: The correlations between the anchor density and the curve correction of adolescent idiopathic scoliosis surgery.

Yeh, Yu-Cheng / Niu, Chi-Chien / Chen, Lih-Huei / Chen, Wen-Jer / Lai, Po-Liang

BMC musculoskeletal disorders

2019 Volume 20, Issue 1, Page(s) 497

Abstract: Background: The optimal anchor density in adolescent idiopathic scoliosis (AIS) surgery to achieve good curve correction remains unclear. The purpose of the study is to analyze the correlations between three-dimensional curve correction and anchor ... ...

Abstract	Background: The optimal anchor density in adolescent idiopathic scoliosis (AIS) surgery to achieve good curve correction remains unclear. The purpose of the study is to analyze the correlations between three-dimensional curve correction and anchor density in the pedicle screw-based posterior fusion of AIS. Methods: One hundred and twenty-seven AIS patients receiving primary posterior fusion with pedicle screw instrumentation were retrospectively reviewed. Anchor density (AD) was defined as the screws number per fused spinal segment. The correlations between three-dimensional curve correction radiographic parameters and anchor density were analyzed with subgroup analysis based on different curve types, curve magnitudes, and curve flexibilities. The differences of curve correction parameters between the low-density (AD ≤1.4), middle-density (1.4 < AD ≤1.7) and high-density (AD > 1.7) groups were also calculated. Independent t-test, analysis of variance (ANOVA), and Pearson's correlation coefficient were used for statistical analysis. Results: There were no correlations between the anchor density and the coronal curve correction or apical vertebral rotation (AVR) correction. In the sagittal plane, mild positive correlations existed between anchor density and thoracic kyphosis correction in all patients (r = 0.27, p = 0.002). Subgroup analysis revealed similar mild positive correlations in Lenke 1 (r = 0.31, p = 0.02), Lenke 1-3 (r = 0.27, p = 0.01), small curves (40°-60°, r = 0.38, p < 0.001), and flexible curves (flexibility > 40%, r = 0.34, p = 0.01). There were no differences between low-density (mean 1.31), middle-density (mean 1.55), and high-density (mean 1.83) in terms of coronal or axial curve correction parameters. Low-density group has longer fused level (mean difference 2.14, p = 0.001) and smaller thoracic kyphosis correction (mean difference 9.25°, p = 0.004) than high-density group. Conclusion: In our study, the anchor density was not related to coronal or axial curve corrections. Mild positive correlations with anchor density were found in thoracic kyphosis correction, especially in patients with smaller and flexible curves. Low anchor density with longer fusion level achieves similar curve corrections with middle or high anchor density in adolescent idiopathic scoliosis surgery.
MeSH term(s)	Adolescent ; Child ; Female ; Humans ; Imaging, Three-Dimensional ; Kyphosis/diagnostic imaging ; Kyphosis/surgery ; Male ; Pedicle Screws ; Radiography ; Retrospective Studies ; Scoliosis/diagnostic imaging ; Scoliosis/surgery ; Spinal Fusion/instrumentation ; Spinal Fusion/methods ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/surgery ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2019-10-27
Publishing country	England
Document type	Journal Article
ISSN	1471-2474
ISSN (online)	1471-2474
DOI	10.1186/s12891-019-2844-1
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Article ; Online: Degenerative cervical myelopathy presenting as subjective lower limb weakness could be a trap towards misdiagnosis.

Luo, Chi-An / Lu, Meng-Ling / Kaliya-Perumal, Arun-Kumar / Chen, Lih-Huei / Chen, Wen-Jer / Niu, Chi-Chien

Scientific reports

2020 Volume 10, Issue 1, Page(s) 21188

Abstract: When patients presenting with subjective lower limb weakness (SLLW) are encountered, it is natural to suspect a lumbar pathology and proceed with related clinical examination, investigations and management. However, SLLW could be a sign of degenerative ... ...

Abstract	When patients presenting with subjective lower limb weakness (SLLW) are encountered, it is natural to suspect a lumbar pathology and proceed with related clinical examination, investigations and management. However, SLLW could be a sign of degenerative cervical myelopathy (DCM) due to an evolving cord compression. In such circumstances, if symptoms are not correlated to myelopathy at the earliest, there could be potential complications over time. In this study, we intend to analyse the outcomes after surgical management of the cervical or thoracic cord compression in patients with SLLW. Retrospectively, patients who presented to our center during the years 2010-2016 with sole complaint of bilateral SLLW but radiologically diagnosed to have a solitary cervical or thoracic stenosis, or tandem spinal stenosis and underwent surgical decompression procedures were selected. Their clinical presentation was categorised into three types, myelopathy was graded using Nurick's grading and JOA scoring; in addition, their lower limb functional status was assessed using the lower extremity functional scale (LEFS). Functional recovery following surgery was assessed at 6 weeks, 3 months, 6 months, one year, and two years. Selected patients (n = 24; Age, 56.4 ± 10.1 years; range 32-78 years) had SLLW for a period of 6.4 ± 3.2 months (range 2-13 months). Their preoperative JOA score was 11.3 ± 1.8 (range 7-15), and LEFS was 34.4 ± 7.7 (range 20-46). Radiological evidence of a solitary cervical lesion and tandem spinal stenosis was found in 6 and 18 patients respectively. Patients gradually recovered after surgical decompression with LEFS 59.8 ± 2.7 (range 56-65) at 1 year and JOA score 13.6 ± 2.7 (range - 17 to 100) at 2 years. The recovery rate at final follow up was 47.5%. Our results indicate the importance of clinically suspecting SLLW as an early non-specific sign of DCM to avoid misdiagnosis, especially in patients without conventional upper motor neuron signs. In such cases, surgical management of the cord compression resulted in significant functional recovery and halted the progression towards permanent disability.
MeSH term(s)	Adult ; Cervical Vertebrae/pathology ; Diagnostic Errors ; Female ; Humans ; Lower Extremity/pathology ; Male ; Middle Aged ; Muscle Weakness/diagnosis ; Muscle Weakness/pathology ; Retrospective Studies ; Spinal Cord Compression/diagnostic imaging ; Spinal Cord Diseases/diagnosis
Language	English
Publishing date	2020-12-03
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/s41598-020-78139-y
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Article ; Online: Biomechanical comparison of pedicle screw fixation strength in synthetic bones: Effects of screw shape, core/thread profile and cement augmentation.

Liu, Mu-Yi / Tsai, Tsung-Ting / Lai, Po-Liang / Hsieh, Ming-Kai / Chen, Lih-Huei / Tai, Ching-Lung

PloS one

2020 Volume 15, Issue 2, Page(s) e0229328

Abstract	Pedicle screw loosening resulting from insufficient bone-screw interfacial holding power is not uncommon. The screw shape and thread profile are considered important factors of the screw fixation strength. This work investigated the difference in pullout strength between conical and cylindrical screws with three different thread designs. The effects of the thread profiles on the screw fixation strength of cannulated screws with or without cement augmentation in osteoporotic bone were also evaluated. Commercially available artificial standard L4 vertebrae and low-density polyurethane foam blocks were used as substitutes for healthy vertebrae and osteoporotic bones, respectively. The screw pullout strengths of nine screw systems were investigated (six in each). These systems included the combination of three different screw shapes (solid/cylindrical, solid/conical and cannulated/cylindrical) with three different thread profiles (fine-thread, coarse-thread and dual-core/dual-thread). Solid screws were designed for the cementless screw fixation of vertebrae using the standard samples, whereas cannulated screws were designed for the cemented screw fixation of osteoporotic bone using low-density test blocks. Following specimen preparation, a screw pullout test was conducted using a material test machine, and the maximal screw pullout strength was compared among the groups. This study demonstrated that, in healthy vertebrae, both the conical and dual-core/dual-thread designs can improve pullout strength. A combination of the conical and dual-core/dual-thread designs may achieve optimal postoperative screw stability. However, in osteoporotic bone, the thread profile have little impact on the screw fixation strength when pedicle screws are fixed with cement augmentation. Cement augmentation is the most important factor contributing to screw pullout fixation strength as compared to screw designs.
MeSH term(s)	Biomechanical Phenomena ; Bone Cements/chemistry ; Bone and Bones/physiology ; Bone and Bones/surgery ; Humans ; Lumbar Vertebrae/surgery ; Materials Testing ; Osteoporosis/surgery ; Pedicle Screws ; Spinal Fusion/instrumentation ; Spinal Fusion/methods
Chemical Substances	Bone Cements
Language	English
Publishing date	2020-02-21
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0229328
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Article ; Online: Risk factors of neurological deficit and pulmonary cement embolism after percutaneous vertebroplasty.

Hsieh, Ming-Kai / Kao, Fu-Cheng / Chiu, Ping-Yeh / Chen, Lih-Huei / Yu, Chia-Wei / Niu, Chi-Chien / Lai, Po-Liang / Tsai, Tsung-Ting

Journal of orthopaedic surgery and research

2019 Volume 14, Issue 1, Page(s) 406

Abstract: Background: The risk factors, incidence, and clinical management of pulmonary cement embolism and neurological deficit during percutaneous vertebroplasty (PVP) were evaluated.: Methods: Three thousand one hundred and seventy-five patients with ... ...

Abstract	Background: The risk factors, incidence, and clinical management of pulmonary cement embolism and neurological deficit during percutaneous vertebroplasty (PVP) were evaluated. Methods: Three thousand one hundred and seventy-five patients with symptomatic osteoporotic vertebral compression fractures (OVCFs) treated with PVP were retrospectively reviewed in a single institution. Clinical parameters such as age, gender, number of fractures, and time from fracture to vertebroplasty were recorded at the time of surgery. Image and surgical parameters including the amount of cement, the vertebral level, uni- or bipedicle surgical approach, and leakage pattern were recorded. Results: Type-C leakage, including paraspinal (25%), intradiscal (26%), and posterior (0.7%) leakage, was more common than type-B (11.4%) and type-S leaks (4.9%). Cement leakage into the spinal canal (type-C posterior) occurred in 26 patients (0.7%), and four patients needed surgical decompression. Three in nine patients with leakage into thoracic spine needed decompressive surgery, but only one of 17 patients into lumbar spine needed surgery (p < 0.01). Age, gender, number of fractures, and time from fracture to vertebroplasty were not risk factors of pulmonary cement embolism or neurological deficit. The risk factor of pulmonary cement embolism was higher volume of PMMA injected (p < 0.001) and risk factor of neurological deficit was type-C posterior cement leakage into thoracic spine. The incidence of pulmonary cement embolism was significantly high in the volume of PMMA injected (PMMA injection < 3.5 cc: 0%; 3.5-7.0 cc: 0.11%; > 7.0 cc: 0.9%; p < 0.01) which needed postoperative oxygen support. Conclusions: Cement leakage is relatively common but mostly of no clinical significance. Percutaneous vertebroplasty in thoracic spine and high amount of PMMA injected should be treated with caution in clinical practice.
MeSH term(s)	Aged ; Aged, 80 and over ; Bone Cements/adverse effects ; Female ; Fractures, Compression/surgery ; Humans ; Male ; Middle Aged ; Nervous System Diseases/epidemiology ; Nervous System Diseases/etiology ; Osteoporotic Fractures/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; Retrospective Studies ; Risk Factors ; Spinal Fractures/surgery ; Taiwan/epidemiology ; Vertebroplasty/adverse effects ; Vertebroplasty/methods
Chemical Substances	Bone Cements
Language	English
Publishing date	2019-11-29
Publishing country	England
Document type	Journal Article
ISSN	1749-799X
ISSN (online)	1749-799X
DOI	10.1186/s13018-019-1459-4
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Article ; Online: Current concepts of percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures: evidence-based review.

Hsieh, Ming-Kai / Chen, Lih-Huei / Chen, Wen-Jer

Biomedical journal

2013 Volume 36, Issue 4, Page(s) 154–161

Abstract: Vertebral compression fractures constitute a major health care problem, not only because of their high incidence but also due to both direct and indirect consequences on health-related quality of life and health care expenditures. The mainstay of ... ...

Abstract	Vertebral compression fractures constitute a major health care problem, not only because of their high incidence but also due to both direct and indirect consequences on health-related quality of life and health care expenditures. The mainstay of management for symptomatic vertebral compression fractures is targeted medical therapy, including analgesics, bed rest, external fixation, and rehabilitation. However, anti-inflammatory drugs and certain types of analgesics can be poorly tolerated by elderly patients, and surgical fixation often fails due to the poor quality of osteoporotic bone. Balloon kyphoplasty and vertebroplasty are two minimally invasive percutaneous surgical approaches that have recently been developed for the management of symptomatic vertebral compression fractures. The purpose of this study was to perform a comprehensive review of the literature and conduct a meta-analysis to compare clinical outcomes of pain relief and function, radiographic outcomes of the restoration of anterior vertebral height and kyphotic angles, and subsequent complications associated with these two techniques.
MeSH term(s)	Cost-Benefit Analysis ; Fractures, Compression/surgery ; Humans ; Kyphoplasty/adverse effects ; Kyphoplasty/economics ; Kyphoplasty/methods ; Osteoporotic Fractures/surgery ; Radiography ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/surgery ; Vertebroplasty
Language	English
Publishing date	2013-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2698541-X
ISSN	2320-2890 ; 2319-4170
ISSN (online)	2320-2890
ISSN	2319-4170
DOI	10.4103/2319-4170.112544
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Article ; Online: Current concepts of percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures

Ming-Kai Hsieh / Lih-Huei Chen / Wen-Jer Chen

Biomedical Journal, Vol 36, Iss 4, Pp 154-

Evidence-based review

2013 Volume 161

Abstract	Vertebral compression fractures constitute a major health care problem, not only because of their high incidence but also due to both direct and indirect consequences on health-related quality of life and health care expenditures. The mainstay of management for symptomatic vertebral compression fractures is targeted medical therapy, including analgesics, bed rest, external fixation, and rehabilitation. However, anti-inflammatory drugs and certain types of analgesics can be poorly tolerated by elderly patients, and surgical fixation often fails due to the poor quality of osteoporotic bone. Balloon kyphoplasty and vertebroplasty are two minimally invasive percutaneous surgical approaches that have recently been developed for the management of symptomatic vertebral compression fractures. The purpose of this study was to perform a comprehensive review of the literature and conduct a meta-analysis to compare clinical outcomes of pain relief and function, radiographic outcomes of the restoration of anterior vertebral height and kyphotic angles, and subsequent complications associated with these two techniques.
Keywords	balloon kyphoplasty ; osteoporosis ; vertebral compression fracture ; vertebroplasty ; Medicine (General) ; R5-920 ; Biology (General) ; QH301-705.5
Language	English
Publishing date	2013-08-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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