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Article ; Online: Clinical presentations and prognosis of metformin-associated lactic acidosis patients in the intensive care unit: A 20-year survey.

Yang, Chun-Chieh / Weng, Shih-Feng / Tseng, Kuei-Ling / Ho, Chung-Han

2022 Volume 101, Issue 27, Page(s) e29918

Abstract: Methods: We retrospectively analyzed 82 adult patients with MALA admitted to the ICU over 20 years. The association between the clinical parameters and mortality post-MALA was estimated using logistic regression analysis.: Results: Patients with MALA ...

Abstract	Methods: We retrospectively analyzed 82 adult patients with MALA admitted to the ICU over 20 years. The association between the clinical parameters and mortality post-MALA was estimated using logistic regression analysis. Results: Patients with MALA admitted to the ICU presented with clinical symptoms mainly associated with the head (40.24%), chest (41.46%), and abdomen (35.37%). Additionally, the PLL distribution significantly varied with age, APACHE II = Acute Physiology and Chronic Health Evaluation II (APACHE II) score, various laboratory parameters like nadir arterial bicarbonate level, multiple treatment modalities such as renal replacement therapy, and mortality. The overall mortality rate was 17.07%. After adjustment of age and gender, the significant predictors of mortality were APACHE II score, PLL, vasoactive support, ventilator support, and cardiopulmonary resuscitation. Conclusions: Despite MALA being a rare event, it is necessary to evaluate its clinical characteristics, especially the associated PLL and mortality. In the current study, higher levels of APACHE II score and PLL show a greater likelihood of mortality in MALA patients.
MeSH term(s)	Acidosis, Lactic/chemically induced ; Acidosis, Lactic/therapy ; Adult ; Humans ; Intensive Care Units ; Metformin/adverse effects ; Prognosis ; Retrospective Studies
Chemical Substances	Metformin (9100L32L2N)
Language	English
Publishing date	2022-07-08
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.0000000000029918
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Article ; Online: Characteristics and outcomes for pulmonary aspergillosis in critically ill patients without influenza: A 3-year retrospective study.

Chao, Chien-Ming / Lai, Chih-Cheng / Chan, Khee-Siang / Yang, Chun-Chieh / Chen, Chin-Ming / Ho, Chung-Han / Ou, Hsuan-Fu / Yu, Wen-Liang

Journal of infection and public health

2023 Volume 16, Issue 12, Page(s) 2001–2009

Abstract: Background: Previous studies have revealed higher mortality rates in patients of severe influenza coinfected with invasive pulmonary aspergillosis (IPA) than in those without the coinfection; nonetheless, the clinical outcome of IPA in critically ill ... ...

Abstract	Background: Previous studies have revealed higher mortality rates in patients of severe influenza coinfected with invasive pulmonary aspergillosis (IPA) than in those without the coinfection; nonetheless, the clinical outcome of IPA in critically ill patients without influenza remains unclear. Patients and methods: This retrospective study was conducted in three institutes. From 2016-2018, all adult patients diagnosed with IPA in the intensive care units (ICUs) were identified. The logistic regression was used to identify the potential risk factors associated with in-hospital mortality in patients with non-influenza IPA. The stratified analysis of IPA patients with and without antifungal therapy was also performed. The final model was established using a forward approach, selecting variables with p-values less than 0.05. Results: Ninety patients were included during the study period, and 63 (70%) were men. The most common comorbidity was diabetes mellitus (n = 24, 27%), followed by solid cancers (n = 22, 24%). Antifungal therapy was administered to 50 (56%) patients, mostly voriconazole (n = 44). The in-hospital mortality rate was 49% (n = 44). Univariate analysis revealed that the risk factors for mortality included daily steroid dose, APACHE II score, SOFA score, C-reactive protein (CRP) level, carbapenem use, antifungal therapy, and caspofungin use. Multiple regression analysis identified four independent risk factors for mortality: age (Odds ratio [OR], 1.052, p = 0.013), daily steroid dose (OR, 1.057, p = 0.002), APACHE II score (OR, 1.094, p = 0.012), and CRP level (OR, 1.007, p = 0.008). Furthermore, the multivariable analysis identified that more physicians would initiate antifungal therapy for patients with prolonged steroid use (p = 0.001), lower white blood cell count (p = 0.021), and higher SOFA score (p = 0.048). Thus, under the selection bias, the independent risk factors for mortality in the antifungal treatment subgroup were daily steroid dose (OR, 1.046, p = 0.001) and CRP (OR, 1.006, p = 0.018), whereas the independent risk factor for mortality in the untreated group became APACHE II score (OR, 1.232, p = 0.007). Conclusions: Patients with IPA had a substantially high mortality. Overall, age, steroid use, APACHE II score, and CRP level were identified as the independent risk factors for mortality in patients in the ICU.
MeSH term(s)	Adult ; Male ; Humans ; Female ; Antifungal Agents/therapeutic use ; Influenza, Human/complications ; Influenza, Human/drug therapy ; Retrospective Studies ; Critical Illness ; Invasive Pulmonary Aspergillosis/drug therapy ; Intensive Care Units ; Steroids/therapeutic use
Chemical Substances	Antifungal Agents ; Steroids
Language	English
Publishing date	2023-09-28
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.2023.09.016
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Article ; Online: The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness.

Chao, Chien-Ming / Lai, Chih-Cheng / Ou, Hsuan-Fu / Ho, Chung-Han / Chan, Khee-Siang / Yang, Chun-Chieh / Chen, Chin-Ming / Yu, Wen-Liang

Journal of fungi (Basel, Switzerland)

2021 Volume 7, Issue 11

Abstract: Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and ... ...

Abstract	Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and risk factors for mortality in critically ill influenza patients remains undefined. The study was retrospectively conducted in three institutes. From 2016 through 2018, all adult patients with severe influenza admitted to an intensive care unit (ICU) were identified. All patients were classified as group 1, patients with concomitant severe influenza and IPA; group 2, severe influenza patients without IPA; and group 3, severe influenza patients without testing for IPA. Overall, there were 201 patients enrolled, including group 1 (
Language	English
Publishing date	2021-10-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2784229-0
ISSN	2309-608X ; 2309-608X
ISSN (online)	2309-608X
ISSN	2309-608X
DOI	10.3390/jof7110922
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Article ; Online: Prognosis of alcohol-associated lactic acidosis in critically ill patients: an 8-year study.

Yang, Chun-Chieh / Chan, Khee-Siang / Tseng, Kuei-Ling / Weng, Shih-Feng

Scientific reports

2016 Volume 6, Page(s) 35368

Abstract: Lactic acidosis is common in critical care; by contrast, a subtype called alcohol-associated lactic acidosis (AALA) is rarely encountered. The primary purpose of this study was to determine the prognosis of AALA in critically ill patients and the second ... ...

Abstract	Lactic acidosis is common in critical care; by contrast, a subtype called alcohol-associated lactic acidosis (AALA) is rarely encountered. The primary purpose of this study was to determine the prognosis of AALA in critically ill patients and the second aim was to determine whether the survival was associated to the peak blood lactate concentration. An 8-year retrospective analysis of adult patients admitted to the intensive care unit (ICU) with AALA between January 2007 and December 2014 was considered in a tertiary care hospital. In total, 23 patients were analyzed and the median peak blood lactate level was 15.9 mmol/L. Only 2 patients (8.7%) presented peak blood lactate levels <10 mmol/L. In this study, 21 patients survived from ICU and hospital, the mortality rate was 8.7%. The result indicted the survival of AALA was not associated with peak blood lactate concentration although survivors still had a better lactate clearance rate per hour than non-survivors. Moreover, AALA patients with coexisting sepsis presenting higher lactate clearance rate and shorter lactate clearance time than those of AALA patients with solely sepsis-related lactic acidosis.
Language	English
Publishing date	2016-10-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/srep35368
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Article ; Online: Aspergillosis related to severe influenza: A worldwide phenomenon?

Liu, Wei-Lun / Yu, Wen-Liang / Chan, Khee-Siang / Yang, Chun-Chieh / Wauters, Joost / Verweij, Paul E

The clinical respiratory journal

2019 Volume 13, Issue 8, Page(s) 540–542

MeSH term(s)	Antifungal Agents/standards ; Antifungal Agents/therapeutic use ; Cohort Studies ; Global Health/statistics & numerical data ; Hospitalization ; Humans ; Incidence ; Influenza A virus ; Influenza, Human/epidemiology ; Influenza, Human/etiology ; Influenza, Human/mortality ; Intensive Care Units/statistics & numerical data ; Invasive Pulmonary Aspergillosis/complications ; Invasive Pulmonary Aspergillosis/epidemiology ; Invasive Pulmonary Aspergillosis/mortality ; Invasive Pulmonary Aspergillosis/prevention & control ; Mortality ; Risk Assessment
Chemical Substances	Antifungal Agents
Language	English
Publishing date	2019-05-26
Publishing country	England
Document type	Comparative Study ; Letter
ZDB-ID	2442214-9
ISSN	1752-699X ; 1752-6981
ISSN (online)	1752-699X
ISSN	1752-6981
DOI	10.1111/crj.13036
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Article ; Online: High-level ambient particulate matter before influenza attack with increased incidence of Aspergillus antigenemia in Southern Taiwan, 2016.

Yu, Wen-Liang / Liu, Wei-Lun / Chan, Khee-Siang / Yang, Chun-Chieh / Tan, Che-Kim / Tsai, Chi-Lun / Chen, Chin-Ming / Chuang, Yin-Ching

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

2018 Volume 51, Issue 1, Page(s) 141–147

Abstract: We found significant correlation between the incidence of severe influenza and Aspergillus antigenemia among medical intensive care unit patients for 7-month observation (coefficient γ=0.976, p<0.001). High-level ambient pollution was noticed for 2 ... ...

Abstract	We found significant correlation between the incidence of severe influenza and Aspergillus antigenemia among medical intensive care unit patients for 7-month observation (coefficient γ=0.976, p<0.001). High-level ambient pollution was noticed for 2 months before the epidemic, highlighting that influenza patients might coinfect with aspergillosis in the community.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Air Pollution ; Antigens, Fungal/blood ; Aspergillosis/blood ; Aspergillosis/complications ; Aspergillosis/epidemiology ; Aspergillosis/immunology ; Aspergillus/immunology ; Aspergillus/pathogenicity ; Coinfection ; Female ; Humans ; Incidence ; Influenza, Human/complications ; Influenza, Human/epidemiology ; Male ; Mannans/blood ; Middle Aged ; Particulate Matter/adverse effects ; Risk Factors ; Taiwan/epidemiology
Chemical Substances	Antigens, Fungal ; Mannans ; Particulate Matter ; galactomannan (11078-30-1)
Language	English
Publishing date	2018-02
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.2016.09.001
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Zs.B 2083: Show issues

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Article: LINE-SCAN SPECTRAL IMAGING SYSTEM FOR ONLINE POULTRY CARCASS INSPECTION

CHAO, KUANGLIN / YANG, CHUN-CHIEH / KIM, MOON S

Journal of food process engineering. 2011 Feb., v. 34, no. 1

2011

Abstract: ABSTRACT: A line-scan spectral imaging system was developed for online identification of wholesome and unwholesome freshly slaughtered chicken carcasses on commercial processing lines. Hyperspectral images acquired by the imaging system for 5,549 ... ...

Abstract	ABSTRACT: A line-scan spectral imaging system was developed for online identification of wholesome and unwholesome freshly slaughtered chicken carcasses on commercial processing lines. Hyperspectral images acquired by the imaging system for 5,549 wholesome and 93 unwholesome chicken carcasses on a 140 bird per minute (bpm) processing line were analyzed to optimize region of interest size and location and determine key wavebands by which to implement online multispectral inspection based on single-waveband intensity and a two-waveband ratio. Multispectral inspection algorithms were developed for real-time online chicken inspection. The imaging system inspected over 100,000 chickens on the processing line during continuous operation and accurately identified over 99% of wholesome and over 96% of unwholesome chickens. A system of this type can perform food safety inspection tasks accurately and consistently on high-speed processing lines (e.g., at least 140 bpm), to help poultry processors improve production efficiency and satisfy increasing consumer demand for poultry products. PRACTICAL APPLICATIONS: The line-scan spectral imaging system was designed as a tool to assist poultry processors in meeting the requirements of the HACCP-Based Inspection Models Project as implemented by Food Safety and Inspection Service (FSIS). The system is particularly well suited for presorting poultry carcasses on high-speed processing lines by removing systemically diseased birds prior to the inspection stations. This can increase efficiency and reduce cross-contamination risks by minimizing the presence and unnecessary processing of unwholesome birds on the processing line. Real-time data collection and prompt removal of unwholesome poultry carcasses can enhance the ability of FSIS to certify U.S. poultry products for both domestic and export markets. In addition, the spectral imaging methodology of this system has the potential for easy adaptation to other high-speed food processing tasks, particularly those involving automated inspection for quality indicators.
Keywords	Food Safety and Inspection Service ; adaptation ; algorithms ; chicken carcasses ; chickens ; consumer demand ; cross contamination ; data collection ; exports ; food inspection ; food processing ; hyperspectral imagery ; image analysis ; markets ; models ; poultry products ; risk ; United States
Language	English
Dates of publication	2011-02
Size	p. 125-143.
Publishing place	Blackwell Publishing Inc
Document type	Article
ZDB-ID	752358-0
ISSN	0145-8876
ISSN	0145-8876
DOI	10.1111/j.1745-4530.2008.00341.x
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Risk of Diabetes Mellitus after First-Attack Acute Pancreatitis: A National Population-Based Study.

Shen, Hsiu-Nien / Yang, Chun-Chieh / Chang, Ya-Hui / Lu, Chin-Li / Li, Chung-Yi

The American journal of gastroenterology

2015 Volume 110, Issue 12, Page(s) 1698–1706

Abstract: Objectives: Population-based data on the risk of diabetes mellitus onset after acute pancreatitis (AP) are lacking. We assessed the incidence of diabetes in AP survivors compared with matched controls.: Methods: The study cohort, drawn from Taiwan ... ...

Abstract	Objectives: Population-based data on the risk of diabetes mellitus onset after acute pancreatitis (AP) are lacking. We assessed the incidence of diabetes in AP survivors compared with matched controls. Methods: The study cohort, drawn from Taiwan National Health Insurance claims data, included 2,966 first-attack AP patients and 11,864 non-AP general controls individually matched on age and sex, with an AP/non-AP ratio of 1:4. Incidence rate was estimated under Poisson assumption. Relative risks of diabetes were indicated by hazard ratios (HRs) estimated from Cox proportional hazard regression models with a partitioning of time at 3 months to account for proportionality. Results: In the first partition of time (<3 months), the incidences of diabetes were 60.8 and 8.0 per 1,000 person-years in AP and control groups, respectively; representing a covariate-adjusted HR of 5.90 (95% confidence interval (CI) 3.37-10.34). In the second partition (≥3 months), the incidences of diabetes were 22.5 and 6.7 per 1,000 person-years in AP and control groups, respectively (adjusted HR 2.54, 95% CI 2.13-3.04). In the second partition, the risk of diabetes was greater in men than in women (HR 3.21 vs. 1.58, P=0.0004). When the analyses were stratified by severity of AP, the results for mild AP were similar to those for all AP. Conclusions: The risk of diabetes increases by twofold after AP; therefore, a long-term screening is necessary to evaluate diabetes after an attack regardless of severity. Further research should be conducted to develop cost-effective follow-up strategies, and to elucidate the underlying mechanisms of the relationship between diabetes and AP.
MeSH term(s)	Acute Disease ; Adult ; Aged ; Case-Control Studies ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/etiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Pancreatitis/complications ; Poisson Distribution ; Proportional Hazards Models ; Risk ; Severity of Illness Index ; Taiwan/epidemiology
Language	English
Publishing date	2015-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.1038/ajg.2015.356
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Ui V Zs.36: Show issues

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Article: Higher mortality of severe influenza patients with probable aspergillosis than those with and without other coinfections.

Ku, Yee-Huang / Chan, Khee-Siang / Yang, Chun-Chieh / Tan, Che-Kim / Chuang, Yin-Ching / Yu, Wen-Liang

Journal of the Formosan Medical Association = Taiwan yi zhi

2017 Volume 116, Issue 9, Page(s) 660–670

Abstract: Background/purpose: Aspergillus-associated infection might comprise up to 23-29% of severe influenza patients from the community throughout stay in an intensive care unit (ICU). In Taiwan, cases of severe influenza with aspergillosis are increasingly ... ...

Abstract	Background/purpose: Aspergillus-associated infection might comprise up to 23-29% of severe influenza patients from the community throughout stay in an intensive care unit (ICU). In Taiwan, cases of severe influenza with aspergillosis are increasingly reported. Therefore, we describe the relative risk of mortality among severe influenza patients with aspergillosis and other coinfections compared to severe influenza patients without Aspergillus coinfections. Methods: We retrospectively reviewed 124 adult patients with severe influenza in a tertiary medical center in southern Taiwan from January 2015 through March 2016. The definition of probable aspergillosis required abnormal radiological findings and positive Aspergillus galactomannan (GM) antigen and/or Aspergillus isolation. Results: Probable aspergillosis (detected throughout the whole course) and other coinfections (only community-acquired) were diagnosed in 21 (17%) and 38 (31%) of all patients respectively. Klebsiella pneumoniae (36.8%), Pseudomonas aeruginosa (31.6%) and Staphylococcus aureus (31.6%) were the most frequent isolates of other coinfections. In-ICU mortality of Aspergillus group (66.7%) was significantly higher than other coinfections (23.7%, p = 0.001) or control group without coinfections (15.4%, p < 0.001), with significant odds ratios after adjusting for important variables. The factor of GM index ≥0.6 had a 19.82 (95% CI, 4.91 to 80.07, p < 0.0001) odds of expiring in an ICU among the Aspergillus group. Conclusion: Dual Aspergillus and influenza infection is emerging in southern Taiwan. Meanwhile, community-acquired P. aeruginosa should be listed in the common copathogens with severe influenza. The 67% mortality linked to aspergillosis highlights the need for physicians to focus attention on patients with GM ≥ 0.6.
Language	English
Publishing date	2017-09
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.2017.06.002
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Article ; Online: Role of the Diphosphine Chelate in Emissive, Charge-Neutral Iridium(III) Complexes.

Liao, Jia-Ling / Devereux, Leon / Fox, Mark A / Yang, Chun-Chieh / Chiang, Yu-Cheng / Chang, Chih-Hao / Lee, Gene-Hsiang / Chi, Yun

Chemistry (Weinheim an der Bergstrasse, Germany)

2017

Abstract: A class of neutral tris-bidentate Ir(III) metal complexes incorporating a diphosphine as a chelate is prepared and characterized here for the first time. Treatment of [Ir(dppb)(tht)Cl3] (1) with fppzH afforded the dichloride complexes, trans-(Cl,Cl)[Ir( ... ...

Abstract	A class of neutral tris-bidentate Ir(III) metal complexes incorporating a diphosphine as a chelate is prepared and characterized here for the first time. Treatment of [Ir(dppb)(tht)Cl3] (1) with fppzH afforded the dichloride complexes, trans-(Cl,Cl)[Ir(dppb)(fppz)Cl2] (2) and cis-(Cl,Cl)[Ir(dppb)(fppz)Cl2] (3). The reaction of 3 with the dianionic chelate precursor bipzH2 or mepzH2, in DMF gave the complex [Ir(dppb)(fppz)(bipz)] (4) or [Ir(dppb)(fppz)(mepz)] (5), respectively. In contrast, a hydride complex [Ir(dppb)(fppz)(bipzH)H] (6) was isolated instead of 4 in protic solvent, namely: DGME. All complexes 2 - 6 are luminescent in powder forms and thin films where the dichlorides (2, 3) emit with maxima at 590-627 nm (orange) and quantum yields (Q.Y.s) up to 90% whereas the tris-bidentate (4, 5) and hydride (6) complexes emit at 455-458 nm (blue) with Q.Y.s up to 70%. Hybrid TD-DFT calculations showed considerable MLCT contribution to the orange-emitting 2 and 3 but substantial ligand-centered 3ππ* transition character in the blue-emitting 4 - 6. The dppb does not participate to these radiative transitions in 4 - 6, but it provides the rigidity and steric bulk needed to promote the luminescence by suppressing the self-quenching in the solid state. Fabrication of an OLED with dopant 5 gave a deep blue CIE chromaticity of (0.16, 0.15). Superior blue emitters, which are vital in OLED applications, may be found in other neutral Ir(III) complexes containing phosphine chelates.
Language	English
Publishing date	2017-10-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1478547-x
ISSN	1521-3765 ; 0947-6539
ISSN (online)	1521-3765
ISSN	0947-6539
DOI	10.1002/chem.201703482
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