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Article ; Online: Splenic aneurysm presented as gastric subepithelial lesion

Sheng‐Fu Wang / Chia‐Jung Kuo / Chun‐Jung Lin / Cheng‐Tang Chiu

Kaohsiung Journal of Medical Sciences, Vol 37, Iss 11, Pp 1016-

2021 Volume 1017

Keywords	Medicine (General) ; R5-920
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Early prediction of survival at different time intervals in sepsis patients

Shih-Hong Chen / Yi-Chia Wang / Anne Chao / Chih-Min Liu / Ching-Tang Chiu / Ming-Jiuh Wang / Yu-Chang Yeh

Tzu-Chi Medical Journal, Vol 34, Iss 1, Pp 55-

A visualized prediction model with nomogram and observation study

2022 Volume 61

Abstract: Objectives: Sepsis is a major cause of death around the world. Complicated scoring systems require time to have data to predict short-term survival. Intensivists need a tool to predict survival in sepsis patients easily and quickly. Materials and Methods: ...

Abstract	Objectives: Sepsis is a major cause of death around the world. Complicated scoring systems require time to have data to predict short-term survival. Intensivists need a tool to predict survival in sepsis patients easily and quickly. Materials and Methods: This retrospective study reviewed the medical records of adult patients admitted to the surgical intensive care units between January 2009 and December 2011 in National Taiwan University Hospital. For this study, 739 patients were enrolled. We recorded the demographic and clinical variables of patients diagnosed with sepsis. A Cox proportional hazard model was used to analyze the survival data and determine significant risk factors to develop a prediction model. This model was used to create a nomogram for predicting the survival rate of sepsis patients up to 3 months. Results: The observed 28-day, 60-day, and 90-day survival rates were 71.43%, 52.53%, and 46.88%, respectively. The principal risk factors for survival prediction included age; history of dementia; Glasgow Coma Scale score; and lactate, creatinine, and platelet levels. Our model showed more favorable prediction than did Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment at sepsis onset (concordance index: 0.65 vs. 0.54 and 0.59). This model was used to create the nomogram for predicting the mortality at the onset of sepsis. Conclusion: We suggest that developing a nomogram with several principal risk factors can provide a quick and easy tool to early predict the survival rate at different intervals in sepsis patients.
Keywords	cox proportion hazard model ; nomogram ; sepsis ; survival ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Perspiration promotes the effect of sulphite on the shielding response of rodent skin

Po-Ju Lai / Fen-Pi Chou / Ting-Shuan Yu / Huei-Jane Lee / Chun-Tang Chiu

Heliyon, Vol 7, Iss 8, Pp e07839- (2021)

2021

Abstract: Perspiration and environmental chemicals, such as air pollutants, are two of the complicating factors of skin disease. It has not been studied how perspiration affect the skin responding to air pollutants. We applied topically artificial eccrine ... ...

Abstract	Perspiration and environmental chemicals, such as air pollutants, are two of the complicating factors of skin disease. It has not been studied how perspiration affect the skin responding to air pollutants. We applied topically artificial eccrine perspiration, sulphite or both to the mouse skin for one and two weeks to examine the influence of both factors on the shielding ability of healthy skin. Morphological examination showed apparent thickening of the epidermal layer in the skin samples with combined treatment at 1 week, and in the sections applied with sulphite and combined treatment at 2 weeks without significant difference in the extent of epidermal hyperplasia between two groups. The outcomes of immunohistochemical (IHC) analysis showed elevated percentages of dermal fibroblasts expressing interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), tumor necrosis factor β (TNF-β) and cyclooxygenase-2 (Cox-2). Results of two-way repeated measured analysis of variance (two-way RMANOVA) showed that both perspiration and sulphite, but not the interaction between them, were significant factors affecting the expression of proinflammatory cytokines. The evidences indicated that perspiration induced cytokines expressions in the dermal fibroblasts and promoted the effect of sulphite on the shielding response of the skin by inducing epidermis hyperplasia.
Keywords	Epidermal hyperplasia ; Proinflammatory cytokines ; TNF-α ; Cox-2 ; IL-6 ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	616
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Fecal microbiota transplantation for treatment of refractory or recurrent Clostridioides difficile infection in Taiwan

Kai-Yen Lan / Puo-Hsien Le / Cheng-Tang Chiu / Chien-Chang Chen / Yuan-Ming Yeh / Hao-Tsai Cheng / Chia-Jung Kuo / Chyi-Liang Chen / Yi-Ching Chen / Pai-Jui Yeh / Cheng-Hsun Chiu / Chee-Jen Chang

Frontiers in Medicine, Vol

a cost-effectiveness analysis

2023 Volume 10

Abstract: BackgroundCompared to antibiotic treatment, fecal microbiota transplantation (FMT) is a more effective treatment for refractory or recurrent CDI (rCDI). Patients with inflammatory bowel disease (IBD) have a higher incidence of CDI and worse outcomes. ... ...

Abstract	BackgroundCompared to antibiotic treatment, fecal microbiota transplantation (FMT) is a more effective treatment for refractory or recurrent CDI (rCDI). Patients with inflammatory bowel disease (IBD) have a higher incidence of CDI and worse outcomes. There has been no study from Asia to evaluate the cost-effectiveness of FMT for overall rCDI patients and rCDI patients with IBD.MethodsWe applied a Markov model with deterministic and probabilistic sensitivity analyses to evaluate the cost and effectiveness of different treatments for rCDI patients with a time horizon of 1 year from the payer's perspective. We compared the cost and clinical outcomes of FMT through colonoscopy to two antibiotics (vancomycin and fidaxomicin) using data from Chang Gung Memorial Hospital, Taoyuan, Taiwan.ResultsCompared to vancomycin, FMT was cost-effective in overall rCDI patients as well as IBD patients with rCDI [USD 39356 (NT$1,101,971.98)/quality-adjusted life year (QALY) gained in overall patients; USD65490 (NT$1,833,719.14)/QALY gained in IBD patients]. Compared to fidaxomicin, FMT was only cost-effective in overall rCDI patients [USD20255 (NT$567,133.45)/QALY gained] but slightly increased QALY (0.0018 QALY gained) in IBD patients with rCDI.ConclusionFMT is cost-effective, compared to vancomycin or fidaxomicin, for the treatment of rCDI in most scenarios from the payers' perspective in Taiwan.
Keywords	Clostridioides difficile ; inflammatory bowel disease ; cost-effectiveness analysis ; economic evaluation ; fecal microbiota transplantation ; vancomycin ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Enantiospecificity in achiral zeolites for asymmetric catalysis.

Chen, Tianxiang / Wun, Ching Kit Tommy / Day, Sarah J / Tang, Chiu C / Lo, Tsz Woon Benedict

Physical chemistry chemical physics : PCCP

2020 Volume 22, Issue 34, Page(s) 18757–18764

Abstract: This article highlights the recent fundamental study in using achiral and chiral porous materials for the potential applications in asymmetric catalysis. Thanks to the new-generation synchrotron X-ray powder diffraction (SXRD) facilities, we reveal the ... ...

Abstract	This article highlights the recent fundamental study in using achiral and chiral porous materials for the potential applications in asymmetric catalysis. Thanks to the new-generation synchrotron X-ray powder diffraction (SXRD) facilities, we reveal the presence of the unique 'chiral region' in achiral zeolites with the MFI topology. Both the inherent site-isolation effect of the active sites and internal confinement restraints in zeolites are critical for creating 'chiral regions' that can aid the design of more enantioselective catalytic reactions. We also offer an outlook on the challenges and opportunities of this research area.
Language	English
Publishing date	2020-03-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1476244-4
ISSN	1463-9084 ; 1463-9076
ISSN (online)	1463-9084
ISSN	1463-9076
DOI	10.1039/d0cp00262c
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: In situ probing of the thermal treatment of h-BN towards exfoliation.

Yan, Zhengyu / Abdelkader, Amor / Day, Sarah / Tang, Chiu / Casiraghi, Cinzia / Mirihanage, Wajira

Nanotechnology

2020 Volume 32, Issue 10, Page(s) 105704

Abstract: Two-dimensional (2D) hexagonal boron nitride (h-BN) is becoming increasingly interesting for wider engineering applications. Thermal exfoliation is being suggested as a facile technology to produce large quantities of 2D h-BN. Further optimization of the ...

Abstract	Two-dimensional (2D) hexagonal boron nitride (h-BN) is becoming increasingly interesting for wider engineering applications. Thermal exfoliation is being suggested as a facile technology to produce large quantities of 2D h-BN. Further optimization of the process requires fundamental understanding of the exfoliation mechanism, which is hardly realized by ex situ techniques. In this study, in situ synchrotron x-ray powder diffraction experiments are conducted while heat treating bulk h-BN up to 1273 K. During the heating process, linear expansion of c-axis is observed and the contraction of a-axis up to around 750 K is consistent with previous research. However, a changing behavior from contraction to expansion in a-axis direction is newly observed when heating over 750 K. With the consideration of previous thermally oxidation studies, a hypothesis of thermal assisted exfoliation with oxygen interstitial and substitution of nitrogen at high temperature is proposed.
Language	English
Publishing date	2020-11-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1362365-5
ISSN	1361-6528 ; 0957-4484
ISSN (online)	1361-6528
ISSN	0957-4484
DOI	10.1088/1361-6528/abce2e
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Effects of perioperative dexmedetomidine infusion on renal function and microcirculation in kidney transplant recipients

Yin-Chin Wang / Ming-Jiuh Wang / Chih-Yuan Lee / Chien-Chia Chen / Ching-Tang Chiu / Anne Chao / Wing-Sum Chan / Meng-Kun Tsai / Yu-Chang Yeh

Annals of Medicine, Vol 54, Iss 1, Pp 1233-

a randomised controlled trial

2022 Volume 1243

Abstract: Objective Ischemia-reperfusion injury affects postoperative transplanted kidney function in kidney transplant recipients. Dexmedetomidine was reported to attenuate ischemia-reperfusion injury and improve microcirculation, but its propensity to cause ... ...

Abstract	Objective Ischemia-reperfusion injury affects postoperative transplanted kidney function in kidney transplant recipients. Dexmedetomidine was reported to attenuate ischemia-reperfusion injury and improve microcirculation, but its propensity to cause bradycardia and hypotension may adversely affect microcirculation. This study investigated the effect of dexmedetomidine on postoperative renal function and sublingual microcirculation in kidney recipients.Methods The enrolled kidney transplant recipients were randomly allocated to the control group or dexmedetomidine group. After anaesthesia induction, patients in the dexmedetomidine group received dexmedetomidine infusion until 2 h after surgery. Sublingual microcirculation was recorded using an incident dark-field video microscope and analysed. The primary outcomes were the creatinine level on a postoperative day 2 and total vessel density at 2 h after surgery.Results A total of 60 kidney recipients were analysed, and the creatinine levels on postoperative day 2 were significantly lower in the dexmedetomidine group than in the control group (1.5 (1.1–2.4) vs. 2.2 (1.7–3.0) mg/dL, median difference −0.6 (95% CI, −0.7 to −0.5) mg/dL, p = .018). On a postoperative day 7, the creatinine levels did not differ significantly between the two groups. Total vessel density at 2 h after surgery did not differ significantly between the two groups.Conclusion We found that early postoperative renal function was better in kidney transplant recipients receiving dexmedetomidine infusion, but total vessel density was not significantly different between the intervention and control groups. Key messagesIschemia-reperfusion injury affects postoperative transplanted kidney function, and dexmedetomidine was reported to attenuate ischemia-reperfusion injury and improve microcirculation in other clinical conditions.This study showed that early postoperative renal function was better in kidney transplant recipients receiving dexmedetomidine.Dexmedetomidine’s side effect of bradycardia and hypotension may affect microcirculation, our results revealed that the perioperative sublingual microcirculation did not differ significantly in kidney transplant recipients receiving dexmedetomidine.
Keywords	Kidney ; transplant ; dexmedetomidine ; microcirculation ; Medicine ; R
Subject code	630
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Risk Factors, Clinical and Endoscopic Features, and Clinical Outcomes in Patients with Cytomegalovirus Esophagitis

Pai-Jui Yeh / Ren-Chin Wu / Chien-Ming Chen / Cheng-Tang Chiu / Ming-Wei Lai / Chien-Chang Chen / Chia-Jung Kuo / Jun-Te Hsu / Ming-Yao Su / Puo-Hsien Le

Journal of Clinical Medicine, Vol 11, Iss 1583, p

2022 Volume 1583

Abstract: Cytomegalovirus (CMV) esophagitis is the second most common CMV disease of the gastrointestinal tract. This study aims to comprehensively analyze risk factors, clinical characteristics, endoscopic features, outcomes, and prognostic factors of CMV ... ...

Abstract	Cytomegalovirus (CMV) esophagitis is the second most common CMV disease of the gastrointestinal tract. This study aims to comprehensively analyze risk factors, clinical characteristics, endoscopic features, outcomes, and prognostic factors of CMV esophagitis. We retrospectively collected data of patients who underwent esophageal CMV immunohistochemistry (IHC) staining between January 2003 and April 2021 from the pathology database at the Chang Gung Memorial Hospital. Patients were divided into the CMV and non-CMV groups according to the IHC staining results. We enrolled 148 patients (44 CMV and 104 non-CMV patients). The risk factors for CMV esophagitis were male sex, immunocompromised status, and critical illness. The major clinical presentations of CMV esophagitis included epigastric pain (40.9%), fever (36.4%), odynophagia (31.8%), dysphagia (29.5%), and gastrointestinal bleeding (29.5%). Multiple diffuse variable esophageal ulcers were the most common endoscopic feature. The CMV group had a significantly higher in-hospital mortality rate (18.2% vs. 0%; p < 0.001), higher overall mortality rate (52.3% vs. 14.4%; p < 0.001), and longer admission duration (median, 24 days (interquartile range (IQR), 11–47 days) vs. 14 days (IQR, 7–24 days); p = 0.015) than the non-CMV group. Acute kidney injury (odds ratio (OR), 174.15; 95% confidence interval (CI), 1.27–23,836.21; p = 0.040) and intensive care unit admission (OR, 26.53; 95% CI 1.06–665.08; p = 0.046) were predictors of in-hospital mortality. In conclusion, the mortality rate of patients with CMV esophagitis was high. Physicians should be aware of the clinical and endoscopic characteristics of CMV esophagitis in high-risk patients for early diagnosis and treatment.
Keywords	acute kidney injury ; cytomegalovirus ; endoscopy ; esophagitis ; prognostic factor ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementation of fecal microbiota transplantation in a medical center for recurrent or refractory Clostridioides difficile infection and report of preliminary outcome

Yuan-Ming Yeh / Hao-Tsai Cheng / Puo-Hsien Le / Chien-Chang Chen / Chia-Jung Kuo / Chyi-Liang Chen / Cheng-Tang Chiu / Cheng-Hsun Chiu

Biomedical Journal, Vol 45, Iss 3, Pp 504-

2022 Volume 511

Abstract: Background: Fecal microbiota transplantation (FMT) has been shown to highly effective in the treatment of recurrent or refractory Clostridioides difficile infection (rCDI) in many countries of the world. Not until 2018, Ministry of Health and Welfare, ... ...

Abstract	Background: Fecal microbiota transplantation (FMT) has been shown to highly effective in the treatment of recurrent or refractory Clostridioides difficile infection (rCDI) in many countries of the world. Not until 2018, Ministry of Health and Welfare, Taiwan approved the application of FMT for rCDI under a special law. The study reported the first implementation of the technology in the medical center in Taiwan and the preliminary outcome. Methods: FMT was used to treat patients with rCDI in Chang Gung Memorial Hospital. FMT was delivered by gastroenterologists using colonoscope. Strict donor screening was performed according to the guidelines. We followed up the clinical course of patients after FMT. 16S rRNA sequencing of fecal samples for donor, and also recipient before and after FMT was carried out. Results: From September 2018 to June 2020, 39 patients with rCDI received FMT, with a successful rate of 89.7%. Two patients died due to causes unrelated to FMT, and two other cases showed no clinical improvement after the procedure. High school and college students showed the best pass rate during donor screening. The presence of multi-drug resistant pathogen was the most common cause for screening failure. We demonstrated in a case the use of rRNA sequencing as a biomarker indicating for the improvement of dysbiosis in a patient after FMT. Conclusions: FMT was successfully implemented in a medical center in Taiwan and showed a comparable successful rate in treating rCDI, compared to other countries. Safety remains the most important issue when applying FMT in the clinical setting.
Keywords	Fecal microbiota transplantation ; Clostridioides difficile infection ; Donor screening ; 16S rRNA sequencing ; Outcome ; Medicine (General) ; R5-920 ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence, risk factors, and optimized management of moderate-to-severe thirst in the post-anesthesia care unit

Chia-Wei Lee / Shih-Ting Liu / Ya-Jung Cheng / Ching-Tang Chiu / Yu-Fen Hsu / Anne Chao

Scientific Reports, Vol 10, Iss 1, Pp 1-

2020 Volume 10

Abstract: Abstract Post-operative thirst is common and may cause intense patient discomfort. The aims of this retrospective study conducted in a high-volume post-anesthesia care unit (PACU) were as follows: (1) to examine the prevalence of moderate-to-severe post- ... ...

Abstract	Abstract Post-operative thirst is common and may cause intense patient discomfort. The aims of this retrospective study conducted in a high-volume post-anesthesia care unit (PACU) were as follows: (1) to examine the prevalence of moderate-to-severe post-operative thirst—defined as a numerical rating scale (NRS) score of 4 or higher, (2) to identify the main risk factors for moderate-to-severe post-operative thirst, and (3) to maximize the efficacy and safety of thirst management through a quality improvement program. During a 1-month quality improvement program conducted in August 2018, a total of 1211 adult patients admitted to our PACU were examined. Moderate-to-severe thirst was identified in 675 cases (55.8%). The use of glycopyrrolate during anesthesia was associated with moderate-to-severe thirst (71.7% versus 66.4%, respectively, p = 0.047; adjusted odds ratio: 1.46, p = 0.013). Following a safety assessment, ice cubes, room temperature water, or an oral moisturizer were offered to patients. A generalized estimating equation model revealed that ice cubes were the most effective means for thirst management—resulting in an estimated thirst intensity reduction of 0.93 NRS points at each 15-min interval assessment (p < 0.001)—followed by room temperature water (− 0.92/time-point, p < 0.001) and the oral moisturizer (− 0.60/time-point; p < 0.001). Patient satisfaction (rated from 1 [definitely dissatisfied] to 5 [very satisfied]) followed a similar pattern (ice cubes: 4.22 ± 0.58; room temperature water: 4.08 ± 0.55; oral moisturizer: 3.90 ± 0.55, p < 0.001). The use of glycopyrrolate—an anticholinergic agent that reduces salivary secretion—was the main independent risk factor for moderate-to-severe post-operative thirst. Our findings may provide clues towards an optimized management of thirst in the immediate post-operative period.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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