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Article ; Online: Effects of a simulation-based blended training model on nurses’ treatment decision-related knowledge about oral cancer in Taiwan: a pilot survey.

Huang, Chia-Chang / Huang, Shiau-Shian / Yang, Ying-Ying / Kao, Shou-Yen

Journal of educational evaluation for health professions

2021 Volume 18, Page(s) 10

Abstract: The present study aimed to evaluate the effects of virtual reality (VR) simulations combined with bedside assignments on nurses’ self-efficacy in providing pre-treatment educational services. Between March 2019 and November 2020, we conducted a study of ... ...

Abstract	The present study aimed to evaluate the effects of virtual reality (VR) simulations combined with bedside assignments on nurses’ self-efficacy in providing pre-treatment educational services. Between March 2019 and November 2020, we conducted a study of VR educational materials that were developed to cover information about the treatment of oral cancers. The effects of the VR simulation, the thinking-path tracking map method, and bedside assignments on the nurses’ treatment decision-related knowledge were evaluated in a ward for oral cancer patients at Taipei Veterans General Hospital, Taipei, Taiwan. The blended training model significantly increased nurses’ familiarity (P<0.01) and confidence (P<0.03) regarding their knowledge of treatments and treatment decision-related knowledge. This model also significantly increased their confidence in their skills in bedside pre-treatment education for admitted oral cancer patients (P<0.002). Oral cancer-specific VR materials enhanced the effectiveness of skills training among nurses in the oral cancer ward.
MeSH term(s)	Clinical Competence ; Humans ; Mouth Neoplasms/therapy ; Nurses ; Simulation Training ; Surveys and Questionnaires ; Taiwan
Language	English
Publishing date	2021-05-25
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2586380-0
ISSN	1975-5937 ; 1975-5937
ISSN (online)	1975-5937
ISSN	1975-5937
DOI	10.3352/jeehp.2021.18.10
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cancer stem cell theory: Are we moving past the mist?

Hung, Kai-Feng / Yang, Ting / Kao, Shou-Yen

Journal of the Chinese Medical Association : JCMA

2019 Volume 82, Issue 11, Page(s) 814–818

Abstract: Cancer stem cells (CSC) are a subpopulation of tumor cells that have superior capacities of self-renewal, metastatic dissemination, and chemoresistance. These characteristics resemble, to some extent, the outcome of certain biological processes, ... ...

Abstract	Cancer stem cells (CSC) are a subpopulation of tumor cells that have superior capacities of self-renewal, metastatic dissemination, and chemoresistance. These characteristics resemble, to some extent, the outcome of certain biological processes, including epithelial-mesenchymal transition (EMT), autophagy, and cellular stress response. Indeed, it has been shown that the stimuli that induce these processes and CSC are overlapping, and CSC and tumor cells that underwent EMT or autophagy are much alike. However, as the cross talk between CSC, EMT, autophagy, and cellular stress is further explored, these processes are also found to have an opposing role in CSC, depending on the condition and status of cells. This contextual effect is likely due to overwhelming reliance on CSC markers for their identification, and/or discrepancies in recognition of CSC as a particular cell population or cellular state. In this review, we summarize how EMT, autophagy, and cellular stress response are tied or unwound with CSC. We also discuss the current view of CSC theory evolved from the emphasis of heterogenicity and plasticity of CSC.
MeSH term(s)	Animals ; Autophagy/physiology ; Cell Plasticity ; Epithelial-Mesenchymal Transition ; Humans ; Neoplastic Stem Cells/physiology ; Stress, Physiological/physiology
Language	English
Publishing date	2019-08-29
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2107283-8
ISSN	1728-7731 ; 1726-4901
ISSN (online)	1728-7731
ISSN	1726-4901
DOI	10.1097/JCMA.0000000000000186
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Article: An overview of detection and screening of oral cancer in Taiwan.

Kao, Shou Yen / Lim, Elva

The Chinese journal of dental research : the official journal of the Scientific Section of the Chinese Stomatological Association (CSA)

2015 Volume 18, Issue 1, Page(s) 7–12

Abstract: Oral cancer is a fatal disease, which accounts for the fourth highest incidence of malignancy in males and the seventh highest in the general population of Taiwan. About 95% of oral cancer is oral squamous cell carcinoma (OSCC). The relatively high ... ...

Abstract	Oral cancer is a fatal disease, which accounts for the fourth highest incidence of malignancy in males and the seventh highest in the general population of Taiwan. About 95% of oral cancer is oral squamous cell carcinoma (OSCC). The relatively high prevalence of OSCC in Taiwan is mainly because a high-risk group of the population exists, made up of 2.5 million people and who exhibit habits of betel nut chewing as well as cigarette smoking. Unfortunately, about 50% of the new OSCC cases found in medical centers presented with TNM stage III or IV cancer lesions leading to a low 5-year survival. Therefore, it is generally accepted that the prevention and screening of OSCC at early stages or premalignant levels in the high-risk group of the population is as equally important as treatment. In this review article, we describe the current status of OSCC in Taiwan regarding epidemiology. Furthermore we research and highlight the importance of various conventional and novel methods in the detection of this disease.
MeSH term(s)	Carcinoma, Squamous Cell/diagnosis ; Carcinoma, Squamous Cell/epidemiology ; Humans ; Mass Screening ; Mouth Neoplasms/diagnosis ; Mouth Neoplasms/epidemiology ; Prevalence ; Professional-Patient Relations ; Risk Factors ; Taiwan/epidemiology
Language	English
Publishing date	2015-03-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2129164-0
ISSN	1462-6446
ISSN	1462-6446
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Zs.A 5843: Show issues

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Article ; Online: Evaluation of factors associated with the risk stratification of survivorship for stage IV squamous cell carcinoma of the oral cavity: A 10-year retrospective study.

Cheng, Han-Chieh / Yang, Cheng-Chieh / Kao, Shou-Yen / Wu, Tzu-Ying / Wu, Cheng-Hsien

Journal of the Chinese Medical Association : JCMA

2020 Volume 83, Issue 5, Page(s) 491–499

Abstract: Background: Oral squamous cell carcinoma (OSCC) leads to thousands of deaths every year in Taiwan. Nearly 40% of OSCC patients are diagnosed with stage IV disease, which has a poor prognosis. Multimodality treatments including surgery and adjuvant ... ...

Abstract	Background: Oral squamous cell carcinoma (OSCC) leads to thousands of deaths every year in Taiwan. Nearly 40% of OSCC patients are diagnosed with stage IV disease, which has a poor prognosis. Multimodality treatments including surgery and adjuvant therapy have been utilized, but their treatment outcomes are generally poor. In this study, we sought to identify possible clinical impact factors that may contribute to the survival of stage IV OSCC. Methods: Data for patients with malignant neoplasms of the oral cavity registered in the Cancer Registry Database of Taipei Veterans General Hospital between 2002 and 2011 were retrieved. The study patients consisted of OSCC patients with clinical stage IV disease who had undergone a surgery and adjuvant therapy. The primary endpoints were the 5-year disease-free survival (DFS) and overall survival (OS) rates. The clinicopathological characteristics of the patients were also stratified and compared. Results: A total of 191 OSCC patients were included for retrospective analysis. The different subgroups of stage IV disease presented different treatment outcomes. The 5-year OS versus DFS rates of each subgroup were as follows: T4N0: 70.9% versus 52.6%; T1-3N23: 66.1% versus 49.8%; T4N1: 49.6% versus 31.6%; and T4N23: 40.9% versus 31.0% (p < 0.01). Patients with diabetes, moderate or poor cell differentiation, perineural invasion, and extracapsular spread presented lower 5-year OS rates (hazard ratio [HR] = 1.87, 1.65, 2.42, and 2.14, respectively), and patients with perineural invasion, positive cut margin, and extracapsular spread presented lower 5-year DFS rates (HR = 1.57, 1.62, and 1.71, respectively). Conclusion: In this study, we elucidated the different survival rates of different subgroups of stage IV OSCC following the same treatment scheme. The results of the study provide clinical physicians with references by which to evaluate prognosis and determine post-operative disease monitoring timetables based upon different characteristics.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Middle Aged ; Mouth Neoplasms/mortality ; Mouth Neoplasms/pathology ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Risk ; Squamous Cell Carcinoma of Head and Neck/mortality ; Squamous Cell Carcinoma of Head and Neck/pathology ; Survivorship
Language	English
Publishing date	2020-03-06
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2107283-8
ISSN	1728-7731 ; 1726-4901
ISSN (online)	1728-7731
ISSN	1726-4901
DOI	10.1097/JCMA.0000000000000292
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Article ; Online: Enhancing the learning and transfer of preprocedural communication skills during clerkship using audio-visual material: a prospective case-controlled study over 2 years.

Chiang, Dung-Hung / Chen, Chung-Ting / Wang, Tse-Yao / Yang, Ying-Ying / Huang, Chia-Chang / Li, Tzu-Hao / Huang, Shiau-Shian / Kao, Shou-Yen / Chen, Chen-Huan / Hou, Ming-Chih / Sheu, Wayne Huey-Herng

BMJ open

2022 Volume 12, Issue 1, Page(s) e055953

Abstract: Objective/design/setting: This study aims to develop preprocedural communication-specific framework that emphasises the use of audiovisual materials and compares its acceptability by trainees with a regular module.: Trainees: Between October 2018 and ...

Abstract	Objective/design/setting: This study aims to develop preprocedural communication-specific framework that emphasises the use of audiovisual materials and compares its acceptability by trainees with a regular module. Trainees: Between October 2018 and July 2021, 96 medical clerks were enrolled and randomly divided into regular and intervention groups. Another 48 trainees whose did not join the framework-based training but complete self-assessments were enrolled as the control group. Interventions: In the intervention training module, the key steps of preprocedural communication-specific skills were structuralised into a framework using the acronym of OSCAR. Primary and secondary outcome measures: This study compared the acceptability of trainees for two modules by measuring the degree of increase in the end-of-rotation and follow up (4 weeks later) competency from baseline by trainees' self-assessments and physician assessments after serial trainings. Results: In comparison with regular group trainees, greater degree of improvements (framework-1 statement: 111%±13% vs 27%±5%, p<0.001; framework-2 statement: 77%±9% vs 48%±2%, p<0.05; skill-1 statement: 105%±9% vs 48%±3%, p<0.001); skill-2 statement: 71%±11% vs 50%±9%, p<0.05) were noted in the framework-related and skill-related statement 1-2 (the familiarity and confidence to use the framework and skills) than those of intervention group. At the end-of-rotation stage, the trainees ability to use the ' Conclusions: The OSCAR framework-based intervention module is well accepted by medical clerks and motivates them to integrate the acquired skills in clinical practice, which leads to trainees' primary care patients being satisfied with their preprocedural communication.
MeSH term(s)	Clinical Competence ; Communication ; Communications Media ; Humans ; Learning ; Self-Assessment
Language	English
Publishing date	2022-01-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-055953
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Article ; Online: Immersive virtual reality (VR) training increases the self-efficacy of in-hospital healthcare providers and patient families regarding tracheostomy-related knowledge and care skills: A prospective pre-post study.

Chiang, Dung-Hung / Huang, Chia-Chang / Cheng, Shu-Chuan / Cheng, Jui-Chun / Wu, Cheng-Hsien / Huang, Shiau-Shian / Yang, Ying-Ying / Yang, Ling-Yu / Kao, Shou-Yen / Chen, Chen-Huan / Shulruf, Boaz / Lee, Fa-Yauh

Medicine

2022 Volume 101, Issue 2, Page(s) e28570

Abstract: Background: Virtual reality (VR)-based simulation in hospital settings facilitates the acquisition of skills without compromising patient safety. Despite regular text-based training, a baseline survey of randomly selected healthcare providers revealed ... ...

Abstract	Background: Virtual reality (VR)-based simulation in hospital settings facilitates the acquisition of skills without compromising patient safety. Despite regular text-based training, a baseline survey of randomly selected healthcare providers revealed deficiencies in their knowledge, confidence, comfort, and care skills regarding tracheostomy. This prospective pre-post study compared the effectiveness of regular text- and VR-based intervention modules in training healthcare providers' self-efficacy in tracheostomy care skills. Methods: Between January 2018 and January 2020, 60 healthcare providers, including physicians, nurses, and respiratory therapists, were enrolled. For the intervention, a newly developed head-mounted display (HMD) and web VR materials were implemented in training and clinical services. Subsequently, in-hospital healthcare providers were trained using either text or head-mounted display virtual reality (HMD-VR) materials in the regular and intervention modules, respectively. For tracheostomy care skills, preceptors directly audited the performance of trainees and provided feedback. Results: At baseline, the degree of trainees' agreement with the self-efficacy-related statements, including the aspects of familiarity, confidence, and anxiety about tracheostomy-related knowledge and care skills, were not different between the control and intervention groups. At follow-up stage, compared with the regular group, a higher percentage of intervention group' trainees reported that they are "strongly agree" or "somewhat agree" that the HMD-VR simulation increases their self-efficacy, including the aspects of familiarity and confidence, and reduced their anxiety about tracheostomy-related knowledge and care skills. After implementation, a higher degree of trainees' average satisfaction with VR-based training and VR materials was observed in the intervention group than in the regular group. Most reported that VR materials enabled accurate messaging and decreased anxiety. The increasing trend of the average written test and hands-on tracheostomy care skills scores among the intervention group trainees was significant compared to those in the regular group. The benefits of HMD-VR simulations and web-VR material-based clinical services for in-hospital healthcare providers and patient families persisted until 3 to 4 weeks later. Conclusion: The current study suggests that VR materials significantly enhance trainees' self-efficacy (increased familiarity, increased confidence, and reduced anxiety) and their satisfaction with the training, while motivating them to use acquired knowledge and skills in clinical practice.
MeSH term(s)	Health Personnel/education ; Hospitals ; Humans ; Prospective Studies ; Self Efficacy ; Tracheostomy/education ; Virtual Reality
Language	English
Publishing date	2022-01-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000028570
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Article ; Online: Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study

Yang, Ying-Ying / Huang, Pin-Hsiang / Yang, Ling-Yu / Huang, Chia-Chang / Liu, Chih-Wei / Huang, Shiau-Shian / Chen, Chen-Huan / Lee, Fa-Yauh / Kao, Shou-Yen / Shulruf, Boaz

Journal of educational evaluation for health professions

2022 Volume 19, Page(s) 27

Abstract: Purpose: Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative ...

Abstract	Purpose: Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative for the commonly used Angoff and Hofstee methods and their variants. The current study aims to estimate the minimum number of panelists required for obtaining acceptable and reliable cut scores using the EZ method. Methods: The primary data were extracted from 31 panelists who used the EZ method for setting cut scores for a 12-station of medical school’s final objective structured clinical examination (OSCE) in Taiwan. For this study, a new data set composed of 1,000 random samples of different panel sizes, ranging from 5 to 25 panelists, was established and analyzed. Analysis of variance was performed to measure the differences in the cut scores set by the sampled groups, across all sizes within each station. Results: On average, a panel of 10 experts or more yielded cut scores with confidence more than or equal to 90% and 15 experts yielded cut scores with confidence more than or equal to 95%. No significant differences in cut scores associated with panel size were identified for panels of 5 or more experts. Conclusion: The EZ method was found to be valid and feasible. Less than an hour was required for 12 panelists to assess 12 OSCE stations. Calculating the cut scores required only basic statistical skills.
MeSH term(s)	Clinical Competence ; Educational Measurement/methods ; Humans ; Reproducibility of Results ; Research Design ; Schools, Medical ; Taiwan
Language	English
Publishing date	2022-10-17
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2586380-0
ISSN	1975-5937 ; 1975-5937
ISSN (online)	1975-5937
ISSN	1975-5937
DOI	10.3352/jeehp.2022.19.27
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Article ; Online: Identification of plasma hsa_circ_0000190 and 0001649 as biomarkers for predicting the recurrence and treatment response of patients with oral squamous cell carcinoma.

Hung, Kai-Feng / Chen, Bing-Hong / Wang, Tsui-Ying / Yang, Yi-Ping / Chien, Yueh / Lo, Jeng-Fan / Yang, Lin / Peng, Bou-Yue / Kao, Shou-Yen / Wu, Cheng-Hsien

Journal of the Chinese Medical Association : JCMA

2022 Volume 85, Issue 4, Page(s) 431–437

Abstract: Background: Oral squamous cell carcinoma (OSCC) is a type of malignancy characterized by high relapse and recurrence rates in the late stage despite optimal surgical intervention and postoperative chemoradiotherapy. Because the management of relapse ... ...

Abstract	Background: Oral squamous cell carcinoma (OSCC) is a type of malignancy characterized by high relapse and recurrence rates in the late stage despite optimal surgical intervention and postoperative chemoradiotherapy. Because the management of relapse following definitive treatment is challenging, accurate risk stratification is of clinical significance to improve treatment outcomes. Circular RNAs (circRNAs) are noncoding RNAs featured with cell-type specificity and high stability, owing to their circular structure, making these molecules excellent biomarkers for a variety of diseases. Methods: The levels of hsa_circ_0000190 and 0001649 in plasma samples from 30 healthy controls and 66 OSCC patients were determined by droplet digital polymerase chain reaction. The same primer sets were used with PCR to examine the expression of these two circRNAs in cancerous and adjacent normal tissues. A receiver operating characteristics curve was generated to evaluate the diagnostic value. The Kaplan-Meier method with a log-rank test was used for survival analysis. Results: We identified two circRNAs as potential biomarkers for OSCC, showing that the plasma level of hsa_circ_0000190 was significantly decreased in the late stage and marginally correlated with the development of second primary OSCC. We also found that the decreased plasma hsa_circ_0001649 was correlated with the recurrence and poor prognosis of patients. Additionally, we found that high plasma hsa_circ_0000190, but not hsa_circ_0001649, possibly predicted a better response of patients to induction chemotherapy. Conclusion: Our study demonstrated the potential of biomarkers in plasma to inform not just the tumor but the entire oral cavity, thereby offering a prediction for early recurrence and second primary OSCC. The plasma circRNAs remain valuable for OSCC, albeit the easy accessibility to the oral cavity.
MeSH term(s)	Biomarkers ; Biomarkers, Tumor/genetics ; Carcinoma, Squamous Cell/genetics ; Carcinoma, Squamous Cell/therapy ; Head and Neck Neoplasms ; Humans ; Mouth Neoplasms/therapy ; Neoplasm Recurrence, Local ; RNA/metabolism ; Squamous Cell Carcinoma of Head and Neck
Chemical Substances	Biomarkers ; Biomarkers, Tumor ; RNA (63231-63-0)
Language	English
Publishing date	2022-01-27
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2107283-8
ISSN	1728-7731 ; 1726-4901
ISSN (online)	1728-7731
ISSN	1726-4901
DOI	10.1097/JCMA.0000000000000700
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Article ; Online: The Omicron variant wave: Where are we now and what are the prospects?

Wang, Mong-Lien / Lin, Yang / Hou, Ju-Fen / Yang, Yi-Ping / Chien, Yueh / Sun, Yi-Chen / Liang, Kung-Hao / Yang, De-Ming / Chang, Tai-Jay / Wu, Cheng-Hsien / Kao, Shou-Yen / Hung, Kai-Feng

Journal of the Chinese Medical Association : JCMA

2022 Volume 86, Issue 2, Page(s) 135–137

Abstract: The Omicron variant BA.2 is the dominant form of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in many countries, including those that have already implemented the strictest quarantine mandates that effectively contained the ... ...

Abstract	The Omicron variant BA.2 is the dominant form of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in many countries, including those that have already implemented the strictest quarantine mandates that effectively contained the spread of the previous variants. Although many individuals were partially or fully vaccinated, confirmed Omicron infections have far surpassed all other variants combined in just a couple of months since the Omicron variant emerged. The ChAdOx1-S (AstraZeneca), BNT162b2 (Pfizer-BioNTech), and mRNA-1273 (Moderna) vaccines offer protection against the severe illness of SARS-CoV-2 infection; however, these currently available vaccines are less effective in terms of preventing Omicron infections. As a result, a booster dose of BNT162b2 or mRNA-1273 is recommended for individuals >12 years old who had received their second dose of the approved vaccines for >5 months. Herein, we review the studies that assessed the clinical benefits of the booster dose of vaccines against Omicron infections. We also analyzed public data to address whether early booster vaccination effectively prevented the surge of the Omicron infections. Finally, we discuss the consideration of a fourth dose of vaccine as a way to prevent possible upcoming infections.
MeSH term(s)	Humans ; Child ; 2019-nCoV Vaccine mRNA-1273 ; BNT162 Vaccine ; COVID-19/prevention & control ; SARS-CoV-2
Chemical Substances	2019-nCoV Vaccine mRNA-1273 (EPK39PL4R4) ; BNT162 Vaccine
Language	English
Publishing date	2022-12-13
Publishing country	Netherlands
Document type	Review ; Journal Article
ZDB-ID	2107283-8
ISSN	1728-7731 ; 1726-4901
ISSN (online)	1728-7731
ISSN	1726-4901
DOI	10.1097/JCMA.0000000000000863
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Article ; Online: Virtual reality simulation increases Chinese physicians' and lab technicians' familiarity and confidence regarding proper clinical wastes segregation/disposal: a 2-year pilot study.

Wu, Szu-Hsien / Yang, Ying-Ying / Huang, Chia-Chang / Liu, Chih-Wei / Yang, Ling-Yu / Chen, Chen-Huan / Kao, Shou-Yen / Lee, Fa-Yauh

BMJ simulation & technology enhanced learning

2020 Volume 7, Issue 1, Page(s) 38–40

Abstract: Although they receive regular training, the survey we administered to our junior physicians and lab technicians revealed that they ... ...

Abstract	Although they receive regular training, the survey we administered to our junior physicians and lab technicians revealed that they lack
Language	English
Publishing date	2020-05-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2799014-X
ISSN	2056-6697 ; 2056-6697
ISSN (online)	2056-6697
ISSN	2056-6697
DOI	10.1136/bmjstel-2019-000554
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