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Search Results: 1 - 10 of 84138 matches for " Jou-Wei Lin "
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Cigarette smoking, cadmium exposure, and zinc intake on obstructive lung disorder
Yu-Sheng Lin, James L Caffrey, Man-Huei Chang, Nicole Dowling, Jou-Wei Lin
Respiratory Research , 2010, DOI: 10.1186/1465-9921-11-53
Abstract: Data were obtained from a sample of 6,726 subjects aged 40+ from the Third National Health and Nutrition Examination Survey. The forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured using spirometry. Gender-, ethnicity-, and age-specific equations were used to calculate the lower limit of normal (LLN) to define obstructive lung disorder as: observed FEV1/FVC ratio and FEV1 below respective LLN. Zinc intake was assessed by questionnaire. Logistic regression analysis was applied to investigate the associations of interest.The analyses showed that an increased prevalence of obstructive lung disorder was observed among individuals with low zinc intake regardless of smoking status. The adjusted odds of lung disorder are approximately 1.9 times greater for subjects in the lowest zinc-intake tertile than those in the highest tertile (odds ratio = 1.89, 95% confidence interval = 1.22-2.93). The effect of smoking on lung function decreased considerably after adjusting for urinary cadmium. Protective association between the zinc-to-cadmium ratio (log-transformed) and respiratory risk suggests that zinc may play a role in smoking-associated lung disorder by modifying the influence of cadmium.While zinc intake is associated with lower risk of obstructive lung disorder, the role of smoking cession and/or prevention are likely to be more important given their far greater effect on respiratory risk. Future research is warranted to explore the mechanisms by which zinc could modify smoking-associated lung disease.Obstructive lung disorders including chronic obstructive pulmonary disease (COPD) are characterized by chronic airway inflammation and ensuing airflow limitation. Although cigarette smoking is the most important risk factor for obstructive lung disease, the underlying mechanisms are still not completely understood. For instance, it has been suggested that COPD results from smoking-associated inflammation and oxidative damage to key enzym
Association of Serum C-Peptide Concentrations with Cancer Mortality Risk in Pre-Diabetes or Undiagnosed Diabetes
Chih-Neng Hsu, Chia-Hsuin Chang, Yu-Sheng Lin, Jou-Wei Lin, James L. Caffrey
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0055625
Abstract: Background Known associations between diabetes and cancer could logically be attributed to hyperglycemia, hypersecretion of insulin, and/or insulin resistance. This study examined the relationship between initial glycemic biomarkers among men and women with impaired fasting glucose or undiagnosed diabetes and cancer mortality during follow up. Methods The cohort included subjects aged 40 years and above from the Third National Health and Nutrition Examination Survey (NHANES III) with fasted serum glucose >100 mg/dl without the aid of pharmaceutical intervention (insulin or oral hypoglycemics). Cancer mortality was obtained from the NHANES III-linked follow-up database (up to December 31, 2006). A Cox regression model was applied to test for the associations between cancer mortality and fasting serum glucose, insulin, glycosylated hemoglobin (HbA1c), C-peptide, insulin like growth factor (IGF-1), IGF binding protein 3 (IGFBP3) and estimated insulin resistance. Results A total of 158 and 100 cancer deaths were recorded respectively from 1,348 men and 1,161 women during the mean 134-month follow-up. After adjusting for the effect of age and smoking in women, all-cause cancer deaths (HR: 1.96 per pmol/ml, 95% CI: 1.02–3.77) and lung cancer deaths (HR: 2.65 per pmol/ml, 95% CI: 1.31–5.36) were specifically associated with serum C-peptide concentrations. Similar associations in men were not statistically significant. Serum glucose, HbA1c, IGF-1, IGFBP3 and HOMA were not independently related to long-term cancer mortality. Conclusion C-peptide analyses suggest a modest association with both all-cause and lung cancer mortality in women but not in men. Further studies will be required to explore the mechanisms.
Integrated postdischarge transitional care in a hospitalist system to improve discharge outcome: an experimental study
Chin-Chung Shu, Nin-Chieh Hsu, Yu-Feng Lin, Jann-Yuan Wang, Jou-Wei Lin, Wen-Je Ko
BMC Medicine , 2011, DOI: 10.1186/1741-7015-9-96
Abstract: From December 2009 to May 2010, patients admitted to the hospitalist ward of a medical center in Taiwan and later discharged alive to home care were included. Efforts to improve the quality of interventions in the PDTC program, including a disease-specific care plan, telephone monitoring, hotline counseling and referral to a hospitalist-run clinic, were implemented in the latter four months in the intervention group, while the control group was recruited during the first two months of the study period. The primary end point was unplanned readmission or death within 30 days after discharge.There were 94 and 219 patients in the control and intervention groups, respectively. Both groups had similar characteristics at the time of admission and at discharge. In the intervention group, 18 patients with worsening disease-specific indicators recorded during telephone monitoring and 21 patients with new or worsening symptoms recorded during hotline counseling had higher rates of unplanned readmission than those without worsening disease-specific indicators (P = 0.031) and worsening symptoms (P = 0.019), respectively. Patients who received PDTC had lower rates of readmission and death than the control group within 30 days after discharge (15% vs. 25%; P = 0.021). Nonuse of a hospitalist-run clinic and presence of underlying malignancy were other independent risk factors for readmission and death within 30 days after discharge.Integrated PDTC using disease-specific care, telephone monitoring, hotline counseling and a hospitalist-run clinic can reduce rates of postdischarge readmission and death.The hospitalist system has grown worldwide in recent decades [1-3], even though its pros and cons are still a matter of debate. While the hospitalist system may lessen hospitalization costs, interruption of patient care provided by the primary care physician is a major concern [4]. In fact, short-term postdischarge readmission rates are very high in the elderly, approaching 20% within o
Antihypertensive Agents and Risk of Parkinson's Disease: A Nationwide Cohort Study
Yen-Chieh Lee, Chin-Hsien Lin, Ruey-Meei Wu, Jou-Wei Lin, Chia-Hsuin Chang, Mei-Shu Lai
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098961
Abstract: Background and Purpose Hypertension has been associated with Parkinson's disease (PD), but data on antihypertensive drugs and PD are inconclusive. We aim to evaluate antihypertensive drugs for an association with PD in hypertensive patients. Methods Hypertensive patients who were free of PD, dementia and stroke were recruited from 2005–2006 using Taiwan National Health Insurance Database. We examined the association between the use of calcium channel blockers (CCBs), angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) and the incidence of PD using beta-blockers as the reference. Cox regression model with time-varying medication use was applied. Results Among 65,001 hypertensive patients with a mean follow-up period of 4.6 years, use of dihydropyridine CCBs, but not non-dihydropyridine CCBs, was associated with a reduced risk of PD (adjusted hazard ratio [aHR] = 0.71; 95% CI, 0.57–0.90). Additionally, use of central-acting CCBs, rather than peripheral-acting ones, was associated with a decreased risk of PD (aHR = .69 [55–0.87]. Further decreased association was observed for higher cumulative doses of felodipine (aHR = 0.54 [0.36–0.80]) and amlodipine (aHR = 0.60 [0.45–0.79]). There was no association between the use of ACEIs (aHR = 0.80 [0.64–1.00]) or ARBs (aHR = 0.86 [0.69–1.08]) with PD. A potentially decreased association was only found for higher cumulative use of ACEIs (HR = 0.52 [0.34–0.80]) and ARBs (HR = 0.52 [0.33–0.80]). Conclusions Our study suggests centrally-acting dihydropyridine CCB use and high cumulative doses of ACEIs and ARBs may associate with a decreased incidence of PD in hypertensive patients. Further long-term follow-up studies are needed to confirm the potential beneficial effects of antihypertensive agents in PD.
Cancer Risk Associated with Insulin Glargine among Adult Type 2 Diabetes Patients – A Nationwide Cohort Study
Chia-Hsuin Chang, Sengwee Toh, Jou-Wei Lin, Shu-Ting Chen, Chuei-Wen Kuo, Lee-Ming Chuang, Mei-Shu Lai
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0021368
Abstract: Background Preclinical and observational studies raise the concern about the safety of insulin glargine in terms of cancer initiation and promotion. This study is designed to examine cancer incidence associated with use of insulin glargine vs. intermediate/long-acting human insulin (HI). Methodology A retrospective cohort study using the Taiwan National Health Insurance claims database was conducted to identify adult patients with type 2 diabetes mellitus and without a history of cancer who initiated insulin glargine (n = 10,190) or intermediate/long-acting HI (n = 49,253) during 2004–2007. Exclusive users were followed from the date of insulin initiation to the earliest of cancer diagnosis, death, disenrollment, or December 31 2007. We estimated adjusted hazard ratios and 95% confidence intervals (CIs) with Cox proportional hazards models adjusting for baseline propensity score. Findings The incidence rate of all cancer per 1,000 person-years was 13.8 for insulin glargine initiators (179 cases) and 16.0 for intermediate/long-acting HI initiators (1,445 cases) during an average follow-up of 2 years. No significant difference in overall cancer risk between insulin glargine initiators and HI initiators was found. For men, however, the adjusted hazard ratio of insulin glargine use as compared with intermediate/long-acting HI was 2.15 (95% CI 1.01–4.59) for pancreatic cancer, and 2.42 (95% CI 1.50–8.40) for prostate cancer. The increased risk was not observed among women. Conclusions Insulin glargine use did not increase the risk of overall cancer incidence as compared with HI. The positive associations with pancreatic and prostate cancer need further evaluation and validation.
Nationwide epidemiological study of severe gallstone disease in Taiwan
John Huang, Chia-Hsuin Chang, Juin-Ling Wang, Hsu-Ko Kuo, Jou-Wei Lin, Wen-Yi Shau, Po-Huang Lee
BMC Gastroenterology , 2009, DOI: 10.1186/1471-230x-9-63
Abstract: A retrospective longitudinal study was conducted using Taiwan National Health Insurance Research Database collected during 1997–2005. Patients with incident severe gallstone disease (acute cholecystitis, biliary pancreatitis, acute cholangitis) and gallstone-related procedures (elective and non-elective cholecystectomy, endoscopic retrograde cholangiopancreatography [ERCP]) that led to hospital admission were identified using ICD-9-CM diagnostic and procedure codes. Annual incidence rates of gallstone-related complications and procedures were calculated and their 95% confidence intervals (CI) were estimated assuming a Poisson distribution.The hospital admission rate for severe gallstone disease increased with advancing age and the age-standardized rate (95% CI) per 1000 population was 0.60 (0.59–0.60) for men and 0.59 (0.59–0.60) for women. Men had a higher rate of acute cholecystitis, probably due to the substantially lower rate of elective cholecystectomy among men than women. For those aged 20–39, hospital admissions for all gallstone-related complications and procedures increased significantly. For those aged ≥60, incidences of biliary pancreatitis, acute cholangitis, and hospital admission for gallstone receiving ERCP increased significantly without substantial change in the incidence of acute cholecystitis and despite a decreased rate of elective cholecystectomy.This population-based study found a substantial increase in the rate of admission for severe gallstone disease among those aged 20–39. Concurrently, the incidences of biliary pancreatitis and acute cholangitis have risen among those aged ≥60.Gallstone disease was once considered a disease of the West [1]. In the US, it is estimated to affect 20 – 25 million adults (i.e., 10–15% of the population) [2,3]. Of the approximately one third of individuals with gallstones who develop symptoms, 80% experience biliary colic [4]. Gallstone disease and its complications (cholecystitis, pancreatitis, and cholangiti
The Use of Sub-Mental Ultrasonography for Identifying Patients with Severe Obstructive Sleep Apnea
Chin-Chung Shu, Peilin Lee, Jou-Wei Lin, Chun-Ta Huang, Yeun-Chung Chang, Chong-Jen Yu, Hao-Chien Wang
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0062848
Abstract: Objective This study aimed to explore the association between obstructive sleep apnea (OSA) severity and pharyngeal parameters using sub-mental ultrasonography (US), and investigate the accuracy of US for identifying severe OSA patients. Methods One hundred and five consecutive referrals for suspected OSA were enrolled. The diameters of the retro-glossal (RG) and retro-palatal (RP) regions were measured via sub-mental US upon expiration during tidal breathing, forced inspiration, and Müller maneuver (MM). Independent factors associated with severe OSA identified from two-thirds of randomly-selected patients (model-development group) were used to construct a model for predicting severe OSA. The accuracy of the model was validated in the remaining one-third of patients (validation group). Results Fifty severe OSA patients, 30 with mild-moderate OSA, and 25 without OSA were enrolled. Compared to non-OSA and mild-moderate OSA patients, those with severe OSA had narrower RP diameter in all three maneuvers. Using the prediction model constructed with changes of RP diameters at MM and neck circumference, the independent predictors of severe OSA in the model-development group had 100% sensitivity and 65% specificity. Conclusion Sub-mental US can accurately discriminate the severity of OSA and be used to identify patients with severe OSA. Trial Registration ClinicalTrials.gov NCT00674076
Including Total EGFR Staining in Scoring Improves EGFR Mutations Detection by Mutation-Specific Antibodies and EGFR TKIs Response Prediction
Shang-Gin Wu,Yih-Leong Chang,Jou-Wei Lin,Chen-Tu Wu,Hsuan-Yu Chen,Meng-Feng Tsai,Yung-Chie Lee,Chong-Jen Yu,Jin-Yuan Shih
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0023303
Abstract: Epidermal growth factor receptor (EGFR) is a novel target for therapy in subsets of non-small cell lung cancer, especially adenocarcinoma. Tumors with EGFR mutations showed good response to EGFR tyrosine kinase inhibitors (TKIs). We aimed to identify the discriminating capacity of immunohistochemical (IHC) scoring to detect L858R and E746-A750 deletion mutation in lung adenocarcinoma patients and predict EGFR TKIs response. Patients with surgically resected lung adenocarcinoma were enrolled. EGFR mutation status was genotyped by PCR and direct sequencing. Mutation-specific antibodies for L858R and E746-A750 deletion were used for IHC staining. Receiver operating characteristic (ROC) curves were used to determine the capacity of IHC, including intensity and/or quickscore (Q score), in differentiating L858R and E746-A750 deletion. We enrolled 143 patients during September 2000 to May 2009. Logistic-regression-model-based scoring containing both L858R Q score and total EGFR expression Q score was able to obtain a maximal area under the curve (AUC: 0.891) to differentiate the patients with L858R. Predictive model based on IHC Q score of E746-A750 deletion and IHC intensity of total EGFR expression reached an AUC of 0.969. The predictive model of L858R had a significantly higher AUC than L858R intensity only (p = 0.036). Of the six patients harboring complex EGFR mutations with classical mutation patterns, five had positive IHC staining. For EGFR TKI treated cancer recurrence patients, those with positive mutation-specific antibody IHC staining had better EGFR TKI response (p = 0.008) and longer progression-free survival (p = 0.012) than those without. In conclusion, total EGFR expression should be included in the IHC interpretation of L858R. After adjusting for total EGFR expression, the scoring method decreased the false positive rate and increased diagnostic power. According to the scoring method, the IHC method is useful to predict the clinical outcome and refine personalized therapy.
Sodium Gill Potential as a Tool to Monitor Valve Closure Behavior in Freshwater Clam Corbicula fluminea in Response to Copper
Chung-Min Liao,Chieh-Ming Lin,Li-John Jou,Wei-Yu Chen
Sensors , 2008, DOI: 10.3390/s8095250
Abstract: Valve closure behavior in freshwater clam Corbicula fluminea is a biologically sensitive endpoint. The purpose of this paper was to derive an electrophysiological response model of C. fluminea to assess copper (Cu)-sodium (Na) interactions in gill membrane, whereby valve closure behavior and Cu toxicity could be monitored. The proposed model was based on the integration of Cu bioavailability, Na and Cu internalizations, and electrochemically-based gill potentials. Based on Na active transport under non-equilibrium conditions, predicted gill potential of -8.2 mV agreed reasonably well with published the measured transepithelial potential of -7 mV in C. fluminea. Our proposed framework captured the general features observed in model applications including: (i) 50% inhibitory Cu2+ activities for Na membrane potential (ENa) and uptake rate (JNa) were estimated to be 0.072 and 0.043 mM, respectively, with a stoichiometry of 3Cu2+: 1ENa and 1JNa; (ii) the external Cu2+-dependent internal Na concentration could be parsimoniously estimated, and (iii) the site-specific clam gill potentials could be monitored. Here we provided a new approach to monitor waterborne metal toxicity to reduce the nationwide economic losses due to bans on harvesting of contaminated clam and the potential risks to the health of clams.
Integrating the TRIZ and Taguchi's Method in the Optimization of Processes Parameters for SMT
Yung-Tsan Jou,Wen-Tsann Lin,Wei-Cheng Lee,Tsu-Ming Yeh
Advances in Materials Science and Engineering , 2013, DOI: 10.1155/2013/830891
Abstract: SMT is an assembly technology for core circuit board parts. Unless process parameters are effectively controlled, poor solderability may result in a decline in product quality. This study looks at an SMT manufacturing process in a multinational company. First, the TRIZ contradiction matrix is revised to investigate the association between the 39 parameters in the contradiction matrix and 13 parameters that influence the unevenness of solder paste in the solder paste printing process. Expert verification is then used to screen the key factors affecting the quality of SMT, which are then combined with Taguchi's method to identify the optimal parameter set influencing the thickness of SMT solder paste. Results. TRIZ identifies squeegee pressure, ejection speed, squeegee speed, and squeegee angle as the four parameters with the greatest influence on SMT solder paste thickness. Taguchi's method is used to identify the optimum levels set for the experimental factors and carry out confirmation experiments. The S/N ratio improved from 21.732?db to 26.632?db, while the mean also improved from the current 0.163?mm to 0.155?mm, close to the target value of 0.15?mm. The results show that applying TRIZ and Taguchi's method for the purpose of product improvement is feasible. 1. Introduction Today, product cycles are short and undergo rapid changes. Consumer electronic products, such as smart phones, notebook computers, and digital cameras, play an important role in our everyday lives. As consumers become more demanding, there is an increasing emphasis on lighter, thinner, high quality, and low-priced products that can be delivered to the consumer quickly. In addition, due to global competition, businesses are increasingly demanding rigorous quality standards to meet customer’s demand [1, 2]. To meet the demand for light, thin, short, and small electronic products, print circuit boards (PCB) have evolved from single-layer to multilayer boards, with a consequent reduction in their size. As a result, most traditional plated-through hole parts are gradually falling out of use. An effective solution to this is to attach electronic components onto the PCB, resulting in the development of surface mount technology (SMT). However, unless process parameters are effectively controlled, poor solderability may result in a decline in product quality. For example, if insufficient solder paste is deposited at the PCB printing stage, the strength of the solder joints may be inadequate or an empty solder phenomenon may occur. However, if too much solder paste is deposited, bridges may
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