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Article: Consistency in End-of-Life Care Preferences Between Hospitalized Elderly Patients and Their Primary Family Caregivers.

Chuang, I-Fei / Shyu, Yea-Ing Lotus / Weng, Li-Chueh / Huang, Hsiu-Li

2020 Volume 14, Page(s) 2377–2387

Abstract: Purpose: This study explored the consistency between preferences for end-of-life care for elderly hospitalized patients and their primary caregivers and predictors of consistency.: Patients and methods: This cross-sectional correlational study ... ...

Abstract	Purpose: This study explored the consistency between preferences for end-of-life care for elderly hospitalized patients and their primary caregivers and predictors of consistency. Patients and methods: This cross-sectional correlational study recruited 100 dyads of elderly hospitalized patients and their primary caregivers from a medical center in Central Taiwan. A structural questionnaire about preferences for seven end-of-life medical treatment options involved cardiopulmonary resuscitation, intravenous therapy, nasogastric tube feeding, intensive care unit, blood transfusion, tracheotomy, and hemodialysis. Results: The consistency was 42.28% for preferences of end-of-life medical care between patients and caregivers. The Kappa values for seven life-sustaining medical treatments ranged from 0.001 to 0.155. Logistic regression showed that the predictors of consistency for preferences of treatment were: a patient with a signed living will (odds ratio [OR] = 6.20, p<0.01) and a male family caregiver (OR= 0.23, p<0.01) for cardiopulmonary resuscitation; a patient who visited relatives in the intensive care unit (OR= 2.94, p< 0.05) and a spouse caregiver (OR= 3.07, p< 0.05) for nasogastric tube feeding; a spouse caregiver (OR=3.12, p<0.05) and a caregiver who visited the intensive care unit (OR= 5.50, p<0.01) for tracheotomy; and a spouse caregiver (OR= 2.76, p<0.05) and a caregiver who visited the intensive care unit (OR= 4.42, p<0.05) for hemodialysis. Conclusion: End-of-life medical treatment preferences were inconsistent between patients and family caregivers, which might be influenced by Asian culture, the nature of the relationship and individual experiences. Implementation of advance care planning that respects the patient's autonomy and preferences about end-of-life care is recommended.
Language	English
Publishing date	2020-12-03
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2455848-5
ISSN	1177-889X
ISSN	1177-889X
DOI	10.2147/PPA.S283923
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Article ; Online: Prevalence and household risk factors for fecal carriage of ESBL-producing, sequence type 131, and extraintestinal pathogenic Escherichia coli among children in southern Taiwan.

Cheng, Ming-Fang / Ho, Pei-Yu / Wang, Jiun-Ling / Tseng, Fan-Chen / Chang, Jenn-Tzong / Huang, I-Fei / Hung, Chih-Hsin

Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

2022 Volume 55, Issue 4, Page(s) 695–707

Abstract: Background: The rapidly increasing prevalence of antimicrobial-resistant Escherichia coli (E. coli) is a global concern. This study determined the prevalence and risk factors for the fecal carriage of drug-resistant E. coli and extraintestinal ... ...

Abstract	Background: The rapidly increasing prevalence of antimicrobial-resistant Escherichia coli (E. coli) is a global concern. This study determined the prevalence and risk factors for the fecal carriage of drug-resistant E. coli and extraintestinal pathogenic E. coli (ExPEC) among children. Materials and methods: In this prospective study, stool samples from children aged 0-18 years were obtained within three days of hospitalization between April 2016 and March 2019. E. coli were selected and tested for extended-spectrum β-lactamase (ESBL)-production and antimicrobial susceptibility. Multilocus sequence typing, blaCTX-M gene groups and ExPEC were determined using polymerase chain reactions. Questionnaires were recorded for risk factor analysis. Results: Among 179 E. coli isolates, 44.1% were multi-drug resistant, 20.7% produced ESBL, and 50.3% were ExPEC. Children carrying ESBL-producing E. coli were younger than those carrying non-ESBL strains. Several anthropogenic factors, including drinking water process, pork consumption, pets and household density might be associated with ESBL-producing E. coli, sequence type (ST) 131 E. coli, or ExPEC fecal carriage. Compared with families who live in less crowded houses, participants with pets had a similar trend of higher risks of ESBL-producing E. coli, ST131 E. coli, and ExPEC fecal carriage among those living in houses accommodating relatively more people. Conclusions: Children accounted for a large proportion of instances of feces carrying ESBL E. coli. In addition to antimicrobial control for people and livestocks, avenues of exposure, such as drinking water, food, pets, household density, and socioeconomic deprivation might present potentially novel opportunities to reduce the burden of nonsusceptible E. coli and ExPEC.
MeSH term(s)	Anti-Bacterial Agents ; Child ; Drinking Water ; Escherichia coli ; Escherichia coli Infections ; Extraintestinal Pathogenic Escherichia coli ; Feces ; Humans ; Multilocus Sequence Typing ; Prevalence ; Prospective Studies ; Risk Factors ; Taiwan ; beta-Lactamases
Chemical Substances	Anti-Bacterial Agents ; Drinking Water ; beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2022-04-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1497590-7
ISSN	1995-9133 ; 1684-1182 ; 0253-2662
ISSN (online)	1995-9133
ISSN	1684-1182 ; 0253-2662
DOI	10.1016/j.jmii.2022.04.001
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Book: Yu su chiao fei ch'i wu chih tsao tu jang kai lian chi ping yen chiu ch'i li yung hsiao kuo

Chiang, Ching Tsun / Huang, Li-chen

The utilization and preparation of soil conditioner from plastic waste materials

(T'ai-wan fei liao ku fen yu hsien kung ssŭ. Yen chiu chuan pao ; no. 54)

1977

Author's details	Chiang Ching-ts'un, Huang Li-chên. --
Series title	T'ai-wan fei liao ku fen yu hsien kung ssŭ. Yen chiu chuan pao ; no. 54
Language	Chinese
Size	19 p. :, ill., col. plates ;, 26 cm. --
Publisher	T'ai-wan fei liao ku fen yu hsien kung ssŭ
Publishing place	T'ai-pei, T'ai-wan
Document type	Book
Note	English summary. ; Cover title.
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Geographic distribution of the major clone of extended-spectrum beta-lactamase-producing Escherichia coli infection in a pediatric community in southern Taiwan.

Chen, Wan-Ling / Cheng, Ming-Fang / Tseng, Fan-Chen / Wu, Pin-Chien / Huang, I-Fei / Chen, Yun-Wen / Chiou, Yee-Hsuan / Chen, Yao-Shen / Lee, Susan Shin-Jung / Hung, Wan-Yu / Wang, Jiun-Ling / Hung, Chih-Hsin

Journal of infection and public health

2023 Volume 16, Issue 6, Page(s) 853–858

Abstract: Background: The geographic distribution of the major clone of sequence type 131 (ST131) in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) infections is not known. We analyzed the clinical features, resistance mechanisms, ... ...

Abstract	Background: The geographic distribution of the major clone of sequence type 131 (ST131) in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) infections is not known. We analyzed the clinical features, resistance mechanisms, and geographic distribution of ESBL-producing E. coli clones in 120 children. Methods: We studied the 120 ESBL-producing E. coli strains from children younger than 18 years. A VITEK 2 automated system was used to determine bacterial identification and ESBL production. Sequence type was determined by multi-locus sequence typing (MLST). The genetic relationship of the ESBL-producing strains was studied using pulsed-field gel electrophoresis (PFGE). Phylogenetic group and blaCTX-M group was performed using polymerase chain reaction (PCR). Multiplex PCR for detecting the common group 9 variant, CTX-M-14, and group 1 variant, CTX-M-15, was also performed. The addresses of the 120 children were collected, and plotted on the Taiwan map. Results: The groups in the center of Kaohsiung City lived mainly in urban areas with a population density of over 10,000 people per square kilometer, and the majority of the Kaohsiung groups on the outskirts of the city center lived in suburban areas with a population density of under 6000 people per square kilometer. There was no statistically significant difference between the city center and outskirt groups in terms of clinical presentation, laboratory, and imaging data. However, more ST131 clones, major pulsotype groups, and phylogenetic group B2 strains were found in the center of Kaohsiung than on the outskirts. Conclusion: ESBL-producing E. coli clones may be more challenging to treat clinically. Most infections were community-acquired, and there appeared to be major pulsotype clones, mainly in urban areas. This reinforces the necessity of environmental surveillance and sanitary procedures for ESBL-producing E. coli.
MeSH term(s)	Humans ; Child ; Escherichia coli/genetics ; Escherichia coli Infections/epidemiology ; Escherichia coli Infections/microbiology ; Multilocus Sequence Typing ; Phylogeny ; Taiwan/epidemiology ; beta-Lactamases/genetics ; Multiplex Polymerase Chain Reaction ; Electrophoresis, Gel, Pulsed-Field
Chemical Substances	beta-Lactamases (EC 3.5.2.6)
Language	English
Publishing date	2023-03-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.03.017
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Article ; Online: Factors affecting fecal excretion time in pediatric nontyphoid Salmonella infection.

Ho, Pei-Yu / Chen, Wan-Ling / Cheng, Ming-Fang / Shen, Ying-Tso / Hu, Hong-Hsiang / Sheu, Sheng-Kai / Huang, I-Fei

Pediatrics and neonatology

2021 Volume 62, Issue 4, Page(s) 387–393

Abstract: Background: This study investigated whether the appropriate antibiotics therapy affects the fecal excretion time in pediatric salmonellosis of different severities and explored the factors associated with the fecal excretion time of nontyphoid ... ...

Abstract	Background: This study investigated whether the appropriate antibiotics therapy affects the fecal excretion time in pediatric salmonellosis of different severities and explored the factors associated with the fecal excretion time of nontyphoid Salmonella. Methods: Between 2012 and 2017, admitted children with nontyphoid salmonellosis who consented to receive consecutive stool cultures every 4-7 days until 2 consecutive negative results were obtained were enrolled. Patients were stratified into no, appropriate (bacteremia or severe patients receiving antibiotics active in vitro), and inappropriate antibiotics (patients with mild or moderate severity receiving antibiotics or severe receiving antibiotics resistant in vitro) therapy groups. A previously proposed severity score was used to classify the patients into severe, moderate, and mild severity classes. The demographics, clinical manifestations, laboratory data and severity were compared among the groups. To explore the factors associated with the fecal excretion time of nontyphoid Salmonella, univariate and multivariate analyses were performed using linear regression analysis. Results: This study enrolled 126 children with nontyphoid salmonellosis; 58 and 18 in the mild and severe classes, respectively. The no, appropriate and inappropriate antibiotics therapy groups comprised 69, 24 and 33 patients, respectively. The mean fecal excretion time was 12.17 days. The appropriate antibiotics therapy group had comparable fecal excretion time with that of no antibiotics group. Age <1 year, increased white blood cell count, decreased hemoglobin, and inappropriate antibiotics therapy significantly prolonged fecal excretion time in univariate analysis (p < 0.05). The multivariate analysis showed that inappropriate antibiotics therapy and decreased hemoglobin significantly prolonged the fecal excretion time. Conclusion: Inappropriate antibiotics therapy and decreased hemoglobin prolong the fecal excretion time of nontyphoid Salmonella, whereas appropriate antibiotics therapy does not. Continuous monitoring of antibiotic resistance and judicious use of antibiotics in children with nontyphoid salmonellosis are necessary.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy ; Child ; Humans ; Salmonella ; Salmonella Infections/diagnosis ; Salmonella Infections/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2021-04-09
Publishing country	Singapore
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2441816-X
ISSN	2212-1692 ; 1875-9572
ISSN (online)	2212-1692
ISSN	1875-9572
DOI	10.1016/j.pedneo.2021.03.016
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Article ; Online: Geographic distribution of the major clone of extended-spectrum beta-lactamase-producing Escherichia coli infection in a pediatric community in southern Taiwan

Wan-Ling Chen / Ming-Fang Cheng / Fan-Chen Tseng / Pin-Chien Wu / I-Fei Huang / Yun-Wen Chen / Yee-Hsuan Chiou / Yao-Shen Chen / Susan Shin-Jung Lee / Wan-Yu Hung / Jiun-Ling Wang / Chih-Hsin Hung

Journal of Infection and Public Health, Vol 16, Iss 6, Pp 853-

2023 Volume 858

Abstract	Background: The geographic distribution of the major clone of sequence type 131 (ST131) in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) infections is not known. We analyzed the clinical features, resistance mechanisms, and geographic distribution of ESBL-producing E. coli clones in 120 children. Methods: We studied the 120 ESBL-producing E. coli strains from children younger than 18 years. A VITEK 2 automated system was used to determine bacterial identification and ESBL production. Sequence type was determined by multi-locus sequence typing (MLST). The genetic relationship of the ESBL-producing strains was studied using pulsed-field gel electrophoresis (PFGE). Phylogenetic group and blaCTX-M group was performed using polymerase chain reaction (PCR). Multiplex PCR for detecting the common group 9 variant, CTX-M-14, and group 1 variant, CTX-M-15, was also performed. The addresses of the 120 children were collected, and plotted on the Taiwan map. Results: The groups in the center of Kaohsiung City lived mainly in urban areas with a population density of over 10,000 people per square kilometer, and the majority of the Kaohsiung groups on the outskirts of the city center lived in suburban areas with a population density of under 6000 people per square kilometer. There was no statistically significant difference between the city center and outskirt groups in terms of clinical presentation, laboratory, and imaging data. However, more ST131 clones, major pulsotype groups, and phylogenetic group B2 strains were found in the center of Kaohsiung than on the outskirts. Conclusion: ESBL-producing E. coli clones may be more challenging to treat clinically. Most infections were community-acquired, and there appeared to be major pulsotype clones, mainly in urban areas. This reinforces the necessity of environmental surveillance and sanitary procedures for ESBL-producing E. coli.
Keywords	Escherichia coli ; Extended‐spectrum β‐lactamases ; ST131 ; CTX-M ; Phylogenetic group ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	630
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Lactobacillus acidophilus attenuates Salmonella-induced intestinal inflammation via TGF-β signaling.

Huang, I-Fei / Lin, I-Chun / Liu, Pei-Feng / Cheng, Ming-Fang / Liu, Yen-Chen / Hsieh, Yao-Dung / Chen, Jih-Jung / Chen, Chun-Lin / Chang, Hsueh-Wei / Shu, Chih-Wen

BMC microbiology

2015 Volume 15, Page(s) 203

Abstract: Background: Salmonella is a common intestinal pathogen that causes acute and chronic inflammatory response. Probiotics reduce inflammatory cytokine production and serve as beneficial commensal microorganisms in the human gastrointestinal tract. TGF-β ( ... ...

Abstract	Background: Salmonella is a common intestinal pathogen that causes acute and chronic inflammatory response. Probiotics reduce inflammatory cytokine production and serve as beneficial commensal microorganisms in the human gastrointestinal tract. TGF-β (transforming growth factor β)/SMAD and NF-κB signaling play important roles in inflammation in intestinal cells. However, the involvement of the signaling in regulating inflammation between Salmonella and probiotics is not fully understood. Methods: L. acidophilus and prebiotic inulin were used to treat human intestinal Caco-2 cells prior to infection with Salmonella. The cells were harvested to examine the cytokines and MIR21 expression with immunoblotting and real-time PCR. NF-κB and SMAD3/4 reporter vectors were transfected into cells to monitor inflammation and TGF-β1 signaling, respectively. Results: In this study, we showed that the probiotic L. acidophilus decreased Salmonella-induced NF-κB activation in human intestinal Caco-2 cells. Expression of the inflammatory cytokines, TNF-α and IL-8, in L. acidophilus-pretreated cells was also significantly lower than that in cells infected with Salmonella alone. Moreover, TGF-β1 and MIR21 expression was elevated in cells pretreated with L. acidophilus or synbiotic, a combination of inulin and L. acidophilus, compared to that in untreated cells or cells infected with S. typhimurium alone. By contrast, expression of SMAD7, a target of MIR21, was accordingly reduced in cells treated with L. acidophilus or synbiotics. Consistent with TGF-β1/MIR21 and SMAD7 expression, SMAD3/4 transcriptional activity was significantly higher in the cells treated with L. acidophilus or synbiotics. Furthermore, TGF-β1 antibody antagonized the SMAD3/4 and NF-κB transcriptional activity modulated by L. acidophilus in intestinal cells. Conclusion: Our results suggest that the TGF-β1/MIR21 signaling pathway may be involved in the suppressive effects of L. acidophilus on inflammation caused by S. typhimurium in intestinal Caco-2 cells.
MeSH term(s)	Caco-2 Cells ; Cytokines/biosynthesis ; Gene Expression Profiling ; Humans ; Immunosuppressive Agents ; Inflammation/pathology ; Inulin/metabolism ; Lactobacillus acidophilus/growth & development ; Models, Biological ; NF-kappa B/metabolism ; Probiotics ; Real-Time Polymerase Chain Reaction ; Salmonella Infections/pathology ; Signal Transduction ; Smad3 Protein/biosynthesis ; Smad4 Protein/biosynthesis ; Transforming Growth Factor beta/metabolism
Chemical Substances	Cytokines ; Immunosuppressive Agents ; NF-kappa B ; SMAD3 protein, human ; SMAD4 protein, human ; Smad3 Protein ; Smad4 Protein ; Transforming Growth Factor beta ; Inulin (9005-80-5)
Language	English
Publishing date	2015-10-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1471-2180
ISSN (online)	1471-2180
DOI	10.1186/s12866-015-0546-x
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Article ; Online: A spatiotemporal barrier formed by Follistatin is required for left-right patterning.

Fu, Xin-Xin / Zhuo, Ding-Hao / Zhang, Ying-Jie / Li, Yun-Fei / Liu, Xiang / Xing, Yan-Yi / Huang, Ying / Wang, Yi-Fan / Cheng, Tao / Wang, Dan / Chen, Si-Han / Chen, Yi-Jian / Jiang, Guan-Nan / Lu, Fu-I / Feng, Yu / Huang, Xiao / Ma, Jun / Liu, Wei / Bai, Ge /

Xu, Peng-Fei

Proceedings of the National Academy of Sciences of the United States of America

2023 Volume 120, Issue 24, Page(s) e2219649120

Abstract: How left-right (LR) asymmetry emerges in a patterning field along the anterior-posterior axis remains an unresolved problem in developmental biology. Left-biased Nodal emanating from the LR organizer propagates from posterior to anterior (PA) and ... ...

Abstract	How left-right (LR) asymmetry emerges in a patterning field along the anterior-posterior axis remains an unresolved problem in developmental biology. Left-biased Nodal emanating from the LR organizer propagates from posterior to anterior (PA) and establishes the LR pattern of the whole embryo. However, little is known about the regulatory mechanism of the PA spread of Nodal and its asymmetric activation in the forebrain. Here, we identify bilaterally expressed Follistatin (Fst) as a regulator blocking the propagation of the zebrafish Nodal ortholog Southpaw (Spaw) in the right lateral plate mesoderm (LPM), and restricting Spaw transmission in the left LPM to facilitate the establishment of a robust LR asymmetric Nodal patterning. In addition, Fst inhibits the Activin-Nodal signaling pathway in the forebrain thus preventing Nodal activation prior to the arrival, at a later time, of Spaw emanating from the left LPM. This contributes to the orderly propagation of asymmetric Nodal activation along the PA axis. The LR regulation function of Fst is further confirmed in chick and frog embryos. Overall, our results suggest that a robust LR patterning emerges by counteracting a Fst barrier formed along the PA axis.
MeSH term(s)	Animals ; Zebrafish/genetics ; Zebrafish/metabolism ; Zebrafish Proteins/genetics ; Zebrafish Proteins/metabolism ; Follistatin/genetics ; Follistatin/metabolism ; Body Patterning/genetics ; Transforming Growth Factor beta/metabolism ; Gene Expression Regulation, Developmental
Chemical Substances	Zebrafish Proteins ; Follistatin ; Transforming Growth Factor beta
Language	English
Publishing date	2023-06-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.2219649120
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Article: Recurrent lupus mesenteric vasculitis leading to gastrointestinal perforation and sepsis.

Wang, Ying-Shu / Huang, I-Fei / Feng, Wen-Bin / Chiou, Yee-Hsuan

The Kaohsiung journal of medical sciences

2015 Volume 31, Issue 8, Page(s) 440–441

MeSH term(s)	Adolescent ; Fatal Outcome ; Female ; Humans ; Intestinal Perforation/diagnostic imaging ; Intestinal Perforation/etiology ; Lupus Nephritis/complications ; Lupus Nephritis/diagnostic imaging ; Mesenteric Arteries/diagnostic imaging ; Mesenteric Arteries/pathology ; Radiography, Abdominal ; Recurrence ; Sepsis/diagnostic imaging ; Sepsis/etiology ; Vasculitis/complications ; Vasculitis/diagnostic imaging
Language	English
Publishing date	2015-08
Publishing country	China (Republic : 1949- )
Document type	Case Reports ; Letter
ZDB-ID	639302-0
ISSN	1607-551X ; 0257-5655
ISSN	1607-551X ; 0257-5655
DOI	10.1016/j.kjms.2015.04.007
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Article: Deep Learning-based Deformable Registration of Dynamic Contrast-Enhanced MR Images of the Kidney.

Huang, James / Guo, Junyu / Pedrosa, Ivan / Fei, Baowei

Proceedings of SPIE--the International Society for Optical Engineering

2022 Volume 12034

Abstract: Respiratory motion is a major contributor to bias in quantitative analysis of magnetic resonance imaging (MRI) acquisitions. Deformable registration of three-dimensional (3D) dynamic contrast-enhanced (DCE) MRI data improves estimation of kidney kinetic ... ...

Abstract	Respiratory motion is a major contributor to bias in quantitative analysis of magnetic resonance imaging (MRI) acquisitions. Deformable registration of three-dimensional (3D) dynamic contrast-enhanced (DCE) MRI data improves estimation of kidney kinetic parameters. In this study, we proposed a deep learning approach with two steps: a convolutional neural network (CNN) based affine registration network, followed by a U-Net trained for deformable registration between two MR images. The proposed registration method was applied successively across consecutive dynamic phases of the 3D DCE-MRI dataset to reduce motion effects in the different kidney compartments (
Language	English
Publishing date	2022-04-04
Publishing country	United States
Document type	Journal Article
ISSN	0277-786X
ISSN	0277-786X
DOI	10.1117/12.2611768
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