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  1. Article ; Online: Increased antimicrobial resistance during the COVID-19 pandemic.

    Lai, Chih-Cheng / Chen, Shey-Ying / Ko, Wen-Chien / Hsueh, Po-Ren

    International journal of antimicrobial agents

    2021  Volume 57, Issue 4, Page(s) 106324

    Abstract: In addition to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection itself, an increase in the incidence of antimicrobial resistance poses collateral damage to the current status of the COVID-19 (coronavirus disease 2019) pandemic. ... ...

    Abstract In addition to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection itself, an increase in the incidence of antimicrobial resistance poses collateral damage to the current status of the COVID-19 (coronavirus disease 2019) pandemic. There has been a rapid increase in multidrug-resistant organisms (MDROs), including extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae, carbapenem-resistant New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales, Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus (MRSA), pan-echinocandin-resistant Candida glabrata and multi-triazole-resistant Aspergillus fumigatus. The cause is multifactorial and is particularly related to high rates of antimicrobial agent utilisation in COVID-19 patients with a relatively low rate of co- or secondary infection. Appropriate prescription and optimised use of antimicrobials according to the principles of antimicrobial stewardship as well as quality diagnosis and aggressive infection control measures may help prevent the occurrence of MDROs during this pandemic.
    MeSH term(s) Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Antimicrobial Stewardship ; Bacteria/drug effects ; Bacterial Infections/complications ; Bacterial Infections/drug therapy ; Bacterial Infections/epidemiology ; COVID-19/complications ; COVID-19/epidemiology ; Coinfection/drug therapy ; Coinfection/epidemiology ; Drug Resistance, Microbial ; Drug Utilization ; Fungi/drug effects ; Humans ; Incidence ; Mycoses/complications ; Mycoses/drug therapy ; Mycoses/epidemiology ; Pandemics
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-03-19
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 1093977-5
    ISSN 1872-7913 ; 0924-8579
    ISSN (online) 1872-7913
    ISSN 0924-8579
    DOI 10.1016/j.ijantimicag.2021.106324
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  2. Article ; Online: Temporal changes in biomarkers of neutrophil extracellular traps and NET-promoting autoantibodies following adenovirus-vectored, mRNA, and recombinant protein COVID-19 vaccination.

    Kuo, Yu-Min / Kang, Chun-Min / Lai, Zhi-Yun / Huang, Ting-Yu / Tzeng, Shiang-Jong / Hsu, Chih-Chieh / Chen, Shey-Ying / Hsieh, Song-Chou / Chia, Jean-San / Jung, Chiau-Jing / Hsueh, Po-Ren

    Journal of medical virology

    2024  Volume 96, Issue 3, Page(s) e29556

    Abstract: Neutrophil extracellular traps (NETs) play a role in innate pathogen defense and also trigger B-cell response by providing antigens. NETs have been linked to vaccine-induced thrombotic thrombocytopenia. We postulated a potential link between NET ... ...

    Abstract Neutrophil extracellular traps (NETs) play a role in innate pathogen defense and also trigger B-cell response by providing antigens. NETs have been linked to vaccine-induced thrombotic thrombocytopenia. We postulated a potential link between NET biomarkers, NET-promoting autoantibodies, and adverse events (AEs) after COVID-19 vaccine boosters. Healthy donors (HDs) who received ChAdOx1-S (A), mRNA-1273 (M), or recombinant protein (MVC-COV1901) vaccines at the National Taiwan University Hospital between 2021 and 2022 were recruited. We measured serial NET-associated biomarkers, citrullinated-histone3 (citH3), and myeloperoxidase (MPO)-DNA. Serum citH3 and MPO-DNA were significantly or numerically higher in HDs who reported AEs (n = 100, booster Day 0/Day 30, p = 0.01/p = 0.03 and p = 0.30/p = 0.35, respectively). We also observed a positive correlation between rash occurrence in online diaries and elevated citH3. A linear mixed model also revealed significantly higher citH3 levels in mRNA-1273/ChAdOx1-S recipients than MVC-COV1901 recipients. Significant positive correlations were observed between the ratios of anti-heparin platelet factor 4 and citH3 levels on Booster Day 0 and naïve and between the ratios of anti-NET IgM and citH3 on Booster Day 30/Day 0 in the AA-M and MM-M group, respectively. The increased levels of citH3/MPO-DNA accompanied by NET-promoting autoantibodies suggest a potential connection between mRNA-1273/ChAdOx1-S vaccines and cardiovascular complications. These findings provide insights for risk assessments of future vaccines.
    MeSH term(s) Humans ; Extracellular Traps/metabolism ; COVID-19 Vaccines/adverse effects ; Autoantibodies ; 2019-nCoV Vaccine mRNA-1273 ; RNA, Messenger/genetics ; RNA, Messenger/metabolism ; COVID-19/prevention & control ; COVID-19/metabolism ; Biomarkers ; ChAdOx1 nCoV-19 ; Vaccination ; DNA/metabolism ; Adenoviridae
    Chemical Substances COVID-19 Vaccines ; Autoantibodies ; 2019-nCoV Vaccine mRNA-1273 (EPK39PL4R4) ; RNA, Messenger ; Biomarkers ; ChAdOx1 nCoV-19 (B5S3K2V0G8) ; DNA (9007-49-2)
    Language English
    Publishing date 2024-03-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 752392-0
    ISSN 1096-9071 ; 0146-6615
    ISSN (online) 1096-9071
    ISSN 0146-6615
    DOI 10.1002/jmv.29556
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  3. Article: Increased antimicrobial resistance during the COVID-19 pandemic

    Lai, Chih-Cheng / Chen, Shey-Ying / Ko, Wen-Chien / Hsueh, Po-Ren

    International journal of antimicrobial agents. 2021 Apr., v. 57, no. 4

    2021  

    Abstract: In addition to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection itself, an increase in the incidence of antimicrobial resistance poses collateral damage to the current status of the COVID-19 (coronavirus disease 2019) pandemic. ... ...

    Abstract In addition to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection itself, an increase in the incidence of antimicrobial resistance poses collateral damage to the current status of the COVID-19 (coronavirus disease 2019) pandemic. There has been a rapid increase in multidrug-resistant organisms (MDROs), including extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae, carbapenem-resistant New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales, Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus (MRSA), pan-echinocandin-resistant Candida glabrata and multi-triazole-resistant Aspergillus fumigatus. The cause is multifactorial and is particularly related to high rates of antimicrobial agent utilisation in COVID-19 patients with a relatively low rate of co- or secondary infection. Appropriate prescription and optimised use of antimicrobials according to the principles of antimicrobial stewardship as well as quality diagnosis and aggressive infection control measures may help prevent the occurrence of MDROs during this pandemic.
    Keywords Acinetobacter baumannii ; Aspergillus fumigatus ; COVID-19 infection ; Candida glabrata ; Klebsiella pneumoniae ; Severe acute respiratory syndrome coronavirus 2 ; antibiotic resistance ; disease control ; methicillin-resistant Staphylococcus aureus ; multiple drug resistance ; pandemic ; secondary infection
    Language English
    Dates of publication 2021-04
    Publishing place Elsevier Ltd
    Document type Article
    Note NAL-light
    ZDB-ID 1093977-5
    ISSN 1872-7913 ; 0924-8579
    ISSN (online) 1872-7913
    ISSN 0924-8579
    DOI 10.1016/j.ijantimicag.2021.106324
    Database NAL-Catalogue (AGRICOLA)

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  4. Article ; Online: Resuscitation teamwork during the COVID-19 pandemic in the emergency department: Challenges and solutions.

    Lin, Chien-Hao / Lin, Hao-Yang / Tseng, Wen-Pin / Ma, Matthew Huei-Ming / Tsai, Min-Shan / Chen, Shey-Ying / Huang, Chien-Hua

    Resuscitation

    2021  Volume 160, Page(s) 18–19

    MeSH term(s) COVID-19 ; Emergency Service, Hospital ; Humans ; Pandemics ; Resuscitation ; SARS-CoV-2
    Language English
    Publishing date 2021-01-16
    Publishing country Ireland
    Document type Letter ; Comment
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2021.01.004
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    Zs.A 1048: Show issues Location:
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  5. Article: Monitoring the performance of a dedicated weaning unit using risk-adjusted control charts for the weaning rate in prolonged mechanical ventilation.

    Huang, Hsiao-Fang / Jerng, Jih-Shuin / Hsu, Pei-Jung / Lin, Nai-Hua / Lin, Li-Min / Hung, Shu-Min / Kuo, Yao-Wen / Ku, Shih-Chi / Chuang, Pao-Yu / Chen, Shey-Ying

    Journal of the Formosan Medical Association = Taiwan yi zhi

    2023  Volume 122, Issue 9, Page(s) 880–889

    Abstract: Background: Weaning rate is an important quality indicator of care for patients with prolonged mechanical ventilation (PMV). However, diverse clinical characteristics often affect the measured rate. A risk-adjusted control chart may be beneficial for ... ...

    Abstract Background: Weaning rate is an important quality indicator of care for patients with prolonged mechanical ventilation (PMV). However, diverse clinical characteristics often affect the measured rate. A risk-adjusted control chart may be beneficial for assessing the quality of care.
    Methods: We analyzed patients with PMV who were discharged between 2018 and 2020 from a dedicated weaning unit at a medical center. We generated a formula to estimate monthly weaning rates using multivariate logistic regression for the clinical, laboratory, and physiologic characteristics upon weaning unit admission in the first two years (Phase I). We then applied both multiplicative and additive models for adjusted p-charts, displayed in both non-segmented and segmented formats, to assess whether special cause variation existed.
    Results: A total of 737 patients were analyzed, including 503 in Phase I and 234 in Phase II, with average weaning rates of 59.4% and 60.3%, respectively. The p-chart of crude weaning rates did not show special cause variation. Ten variables from the regression analysis were selected for the formula to predict individual weaning probability and generate estimated weaning rates in Phases I and II. For risk-adjusted p-charts, both multiplicative and additive models showed similar findings and no special cause variation.
    Conclusion: Risk-adjusted control charts generated using a combination of multivariate logistic regression and control chart-adjustment models may provide a feasible method to assess the quality of care in the setting of PMV with standard care protocols.
    MeSH term(s) Humans ; Respiration, Artificial ; Ventilator Weaning ; Intensive Care Units ; Patient Discharge ; Logistic Models
    Language English
    Publishing date 2023-05-05
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 2096659-3
    ISSN 1876-0821 ; 0929-6646
    ISSN (online) 1876-0821
    ISSN 0929-6646
    DOI 10.1016/j.jfma.2023.04.021
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  6. 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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  7. Article ; Online: Improving the Process of Shared Decision-Making by Integrating Online Structured Information and Self-Assessment Tools

    Pei-Jung Hsu / Chia-Ying Wu / Lu-Cheng Kuo / Ming-Yuan Chen / Yu-Ling Chen / Szu-Fen Huang / Pao-Yu Chuang / Jih-Shuin Jerng / Shey-Ying Chen

    Journal of Personalized Medicine, Vol 12, Iss 256, p

    2022  Volume 256

    Abstract: The integration of face-to-face communication and online processes to provide access to information and self-assessment tools may improve shared decision-making (SDM) processes. We aimed to assess the effectiveness of implementing an online SDM process ... ...

    Abstract The integration of face-to-face communication and online processes to provide access to information and self-assessment tools may improve shared decision-making (SDM) processes. We aimed to assess the effectiveness of implementing an online SDM process with topics and content developed through a participatory design approach. We analyzed the triggered and completed SDM cases with responses from participants at a medical center in Taiwan. Data were retrieved from the Research Electronic Data Capture (REDCap) database of the hospital for analysis. Each team developed web-based patient decision aids (PDA) with empirical evidence in a multi-digitized manner, allowing patients to scan QR codes on a leaflet using their mobile phones and then read the PDA content online. From July 2019 to December 2020, 48 web-based SDM topics were implemented in the 24 clinical departments of this hospital. The results showed that using the REDCap system improved SDM efficiency and quality. Implementing an online SDM process integrated with face-to-face communication enhanced the practice and effectiveness of SDM, possibly through the flexibility of accessing information, self-assessment, and feedback evaluation.
    Keywords shared decision-making ; patient decision aids ; digital patient–provider communication tool ; Medicine ; R
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Spontaneous rupture of urinary bladder diverticulum with pseudo-acute renal failure.

    Sung, Chih-Wei / Chang, Chin-Chen / Chen, Shey-Ying / Tseng, Wen-Pin

    Internal and emergency medicine

    2018  Volume 13, Issue 4, Page(s) 619–622

    MeSH term(s) Acute Kidney Injury ; Adult ; Ascites/etiology ; Diverticulum/complications ; Diverticulum/diagnosis ; Diverticulum/diagnostic imaging ; Female ; Humans ; Rupture, Spontaneous/complications ; Rupture, Spontaneous/diagnosis ; Rupture, Spontaneous/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Urinary Bladder/abnormalities ; Urinary Bladder/diagnostic imaging ; Urinary Bladder/physiopathology
    Language English
    Publishing date 2018-01-30
    Publishing country Italy
    Document type Editorial
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-018-1796-z
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    Zs.A 6673: Show issues Location:
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  9. Article: Evaluating medical capacity for hospitalization and intensive care unit of COVID-19: A queue model approach.

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

    Journal of the Formosan Medical Association = Taiwan yi zhi

    2021  Volume 120 Suppl 1, Page(s) S86–S94

    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 ... ...

    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 9
    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.
    MeSH term(s) COVID-19/epidemiology ; Hospitalization ; Humans ; Intensive Care Units ; Italy/epidemiology ; Japan ; Models, Theoretical ; Pandemics ; Republic of Korea ; Surge Capacity
    Language English
    Publishing date 2021-05-09
    Publishing country Singapore
    Document type Journal Article
    ZDB-ID 2096659-3
    ISSN 1876-0821 ; 0929-6646
    ISSN (online) 1876-0821
    ISSN 0929-6646
    DOI 10.1016/j.jfma.2021.05.002
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  10. Article: Improving the Process of Shared Decision-Making by Integrating Online Structured Information and Self-Assessment Tools.

    Hsu, Pei-Jung / Wu, Chia-Ying / Kuo, Lu-Cheng / Chen, Ming-Yuan / Chen, Yu-Ling / Huang, Szu-Fen / Chuang, Pao-Yu / Jerng, Jih-Shuin / Chen, Shey-Ying

    Journal of personalized medicine

    2022  Volume 12, Issue 2

    Abstract: The integration of face-to-face communication and online processes to provide access to information and self-assessment tools may improve shared decision-making (SDM) processes. We aimed to assess the effectiveness of implementing an online SDM process ... ...

    Abstract The integration of face-to-face communication and online processes to provide access to information and self-assessment tools may improve shared decision-making (SDM) processes. We aimed to assess the effectiveness of implementing an online SDM process with topics and content developed through a participatory design approach. We analyzed the triggered and completed SDM cases with responses from participants at a medical center in Taiwan. Data were retrieved from the Research Electronic Data Capture (REDCap) database of the hospital for analysis. Each team developed web-based patient decision aids (PDA) with empirical evidence in a multi-digitized manner, allowing patients to scan QR codes on a leaflet using their mobile phones and then read the PDA content online. From July 2019 to December 2020, 48 web-based SDM topics were implemented in the 24 clinical departments of this hospital. The results showed that using the REDCap system improved SDM efficiency and quality. Implementing an online SDM process integrated with face-to-face communication enhanced the practice and effectiveness of SDM, possibly through the flexibility of accessing information, self-assessment, and feedback evaluation.
    Language English
    Publishing date 2022-02-10
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12020256
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