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Search Results: 1 - 10 of 4449 matches for " Juey-Jen Hwang "
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Efficacy, safety and tolerability of ongoing statin plus ezetimibe versus doubling the ongoing statin dose in hypercholesterolemic Taiwanese patients: an open-label, randomized clinical trial
Chih-Chieh Yu, Wen-Ter Lai, Kuang-Chung Shih, Tsung-Hsien Lin, Chieh-Hua Lu, Hung-Jen Lai, Mary E Hanson, Juey-Jen Hwang
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-251
Abstract: This was a randomized, open-label, parallel-group comparison study of ezetimibe 10 mg added to ongoing statin compared with doubling the dose of ongoing statin. Adult Taiwanese hypercholesterolemic patients not at optimal LDL-C levels with previous statin treatment were randomized (N = 83) to ongoing statin + ezetimibe (simvastatin, atorvastatin or pravastatin + ezetimibe at doses of 20/10, 10/10 or 20/10 mg) or doubling the dose of ongoing statin (simvastatin 40 mg, atorvastatin 20 mg or pravastatin 40 mg) for 8 weeks. Percent change in total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C) and triglycerides, and specified safety parameters were assessed at 4 and 8 weeks.At 8 weeks, patients treated with statin + ezetimibe experienced significantly greater reductions compared with doubling the statin dose in LDL-C (26.2% vs 17.9%, p = 0.0026) and total cholesterol (20.8% vs 12.2%, p = 0.0003). Percentage of patients achieving treatment goal was greater for statin + ezetimibe (58.6%) vs doubling statin (41.2%), but the difference was not statistically significant (p = 0.1675). The safety and tolerability profiles were similar between treatments.Ezetimibe added to ongoing statin therapy resulted in significantly greater lipid-lowering compared with doubling the dose of statin in Taiwanese patients with hypercholesterolemia. Studies to assess clinical outcome benefit are ongoing.Registered at ClinicalTrials.gov: NCT00652327Chinese populations are perceived to have lower low-density lipoprotein cholesterol (LDL-C) levels and coronary heart disease (CHD) risk than Caucasians [1]. However, as life expectancy and the standard of living improve in Asian countries, an increased risk for cardiovascular disease, high blood pressure, diabetes and dyslipidemia have become more prevalent and are predicted to continue to rise as the population ages [2]. LDL-C is the primary target of cholesterol-lowering therapy. Reducing serum levels of LDL-C is associated with a
Association of Lower Extremity Arterial Calcification with Amputation and Mortality in Patients with Symptomatic Peripheral Artery Disease
Chi-Lun Huang, I-Hui Wu, Yen-Wen Wu, Juey-Jen Hwang, Shoei-Shen Wang, Wen-Jone Chen, Wen-Jeng Lee, Wei-Shiung Yang
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0090201
Abstract: Objective The clinical implication of the coronary artery calcium score (CS) is well demonstrated. However, little is known about the association between lower extremity arterial calcification and clinical outcomes. Methods and Results Eighty-two patients with symptomatic peripheral artery disease (age 61.0±12.4 years) were followed for 21±11 months. CSs, ranging from the common iliac artery bifurcation to the ankle area, were analyzed through noncontrast multidetector computed tomography images retrospectively. The primary endpoints of this study were amputation and mortality. Old age, diabetes, hyperlipidemia, and end-stage renal disease were associated with higher CSs. Patients with more advanced Fontaine stages also tended to have significantly higher CSs (p = 0.03). During the follow-up period (21±11 months), 29 (35%) patients underwent amputation, and 24 (29%) patients died. Among the patients who underwent amputation, there were no significant differences in CSs between the amputated legs and the non-amputated legs. In the Cox proportional hazard model with CS divided into quartiles, patients with CS in the highest quartile had a 2.88-fold (95% confidence interval [CI] 1.18–12.72, p = 0.03) and a 5.16-fold (95% CI 1.13–21.61, p = 0.04) higher risk for amputation and all-cause mortality, respectively, than those with CS in the lowest quartile. These predictive effects remained after conventional risk factor adjustment. Conclusion Lower extremity arterial CSs are associated with disease severity and outcomes, including amputation and all-cause mortality, in patients with symptomatic peripheral artery disease. However, the independent predictive value needs further investigation in large scale, prospective studies.
Validation of Type 2 Diabetes Risk Variants Identified by Genome-Wide Association Studies in Han Chinese Population: A Replication Study and Meta-Analysis
Yi-Cheng Chang, Pi-Hua Liu, Yu-Hsiang Yu, Shan-Shan Kuo, Tien-Jyun Chang, Yi-Der Jiang, Jiun-Yi Nong, Juey-Jen Hwang, Lee-Ming Chuang
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0095045
Abstract: Background Several genome-wide association studies (GWAS) involving European populations have successfully identified risk genetic variants associated with type 2 diabetes mellitus (T2DM). However, the effects conferred by these variants in Han Chinese population have not yet been fully elucidated. Methods We analyzed the effects of 24 risk genetic variants with reported associations from European GWAS in 3,040 Han Chinese subjects in Taiwan (including 1,520 T2DM cases and 1,520 controls). The discriminative power of the prediction models with and without genotype scores was compared. We further meta-analyzed the association of these variants with T2DM by pooling all candidate-gene association studies conducted in Han Chinese. Results Five risk variants in IGF2BP2 (rs4402960, rs1470579), CDKAL1 (rs10946398), SLC30A8 (rs13266634), and HHEX (rs1111875) genes were nominally associated with T2DM in our samples. The odds ratio was 2.22 (95% confidence interval, 1.81-2.73, P<0.0001) for subjects with the highest genetic score quartile (score>34) as compared with subjects with the lowest quartile (score<29). The incoporation of genotype score into the predictive model increased the C-statistics from 0.627 to 0.657 (P<0.0001). These estimates are very close to those observed in European populations. Gene-environment interaction analysis showed a significant interaction between rs13266634 in SLC30A8 gene and age on T2DM risk (P<0.0001). Further meta-analysis pooling 20 studies in Han Chinese confirmed the association of 10 genetic variants in IGF2BP2, CDKAL1, JAZF1, SCL30A8, HHEX, TCF7L2, EXT2, and FTO genes with T2DM. The effect sizes conferred by these risk variants in Han Chinese were similar to those observed in Europeans but the allele frequencies differ substantially between two populations. Conclusion We confirmed the association of 10 variants identified by European GWAS with T2DM in Han Chinese population. The incorporation of genotype scores into the prediction model led to a small but significant improvement in T2DM prediction.
Genetic Variation in the NOC Gene Is Associated with Body Mass Index in Chinese Subjects
Yi-Cheng Chang, Yen-Feng Chiu, Pi-Hua Liu, Siow Wei Hee, Tien-Jyun Chang, Yi-Der Jiang, Wei-Jei Lee, Po-Chu Lee, Hui-Yi Kao, Juey-Jen Hwang, Lee-Ming Chuang
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0069622
Abstract: Circadian clock genes are critical regulators of energy homeostasis and metabolism. However, whether variation in the circadian genes is associated with metabolic phenotypes in humans remains to be explored. In this study, we systemically genotyped 20 tag single nucleotide polymorphisms (SNPs) in 8 candidate genes involved in circadian clock, including CLOCK, BMAL1(ARNTL), PER1, PER2, CRY1, CRY2, CSNK1E,, and NOC(CCRN4L) in 1,510 non-diabetic Chinese subjects in Taipei and Yunlin populations in Taiwan. Their associations with metabolic phenotypes were analyzed. We found that genetic variation in the NOC gene, rs9684900 was associated with body mass index (BMI) (P = 0.0016, Bonferroni corrected P = 0.032). Another variant, rs135764 in the CSNK1E gene was associated with fasting glucose (P = 0.0023, Bonferroni corrected P = 0.046). These associations were consistent in both Taipei and Yunlin populations. Significant epistatic and joint effects between SNPs on BMI and related phenotypes were observed. Furthermore, NOC mRNA levels in human abdominal adipose tissue were significantly increased in obese subjects compared to non-obese controls. Conclusion Genetic variation in the NOC gene is associated with BMI in Chinese subjects.
Effects of Clopidogrel on Mortality, Cardiovascular and Bleeding Outcomes in Patients with Chronic Kidney Disease - Data from Taiwan Acute Coronary Syndrome Full Spectrum Registry
Tsung-Hsien Lin, Wen-Ter Lai, Ho-Tsung Hsin, Ai-Hsien Li, Chun-Li Wang, Chi-Tai Kuo, Juey-Jen Hwang, Fu-Tien Chiang, Shu-Chen Chang, on behalf of ACS Full Spectrum Registry Investigators
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0071917
Abstract: Background The efficacy of clopidogrel is inconclusive in the chronic kidney disease (CKD) population with acute coronary syndrome (ACS). Furthermore, CKD patients are prone to bleeding with antiplatelet therapy. We investigated the efficacy and safety of clopidogrel in patients with ACS and CKD. Methods In a Taiwan national-wide registry, 2819 ACS patients were enrolled. CKD is defined as an estimated glomerular filtration rate of less than 60 ml/min per 1.73 m2. The primary endpoints are the combined outcomes of death, non-fatal myocardial infarction and stroke at 12 months. Results Overall 949 (33.7%) patients had CKD and 2660 (94.36%) patients received clopidogrel treatment. CKD is associated with increased risk of the primary endpoint at 12 months (HR 2.39, 95% CI 1.82 to 3.15, p<0.01). Clopidogrel use is associated with reduced risk of the primary endpoint at 12 months (HR 0.42, 95% CI: 0.29–0.60, p<0.01). Cox regression analysis showed that clopidogrel reduced death and primary endpoints for CKD population (HR 0.35, 95% CI: 0.21–0.61 and HR 0.48, 95% CI: 0.30–0.77, respectively, both p<0.01). Patients with clopidogrel(?)/CKD(?), clopidogrel(+)/CKD(+) and clopidogrel(?)/CKD(+) have 2.4, 3.0 and 10.4 fold risk to have primary endpoints compared with those receiving clopidogrel treatment without CKD (all p<0.01). Clopidogrel treatment was not associated with increased in-hospital Thrombolysis In Myocardial Infarction (TIMI) bleeding in CKD population. Conclusion Clopidogrel could decrease mortality and improve cardiovascular outcomes without increasing risk of bleeding in ACS patients with CKD.
Spatial autocorrelation analysis of 13 leading malignant neoplasms in Taiwan: a comparison between the 1995-1998 and 2005-2008 periods  [PDF]
Pui-Jen Tsai, Cheng-Hwang Perng
Health (Health) , 2011, DOI: 10.4236/health.2011.312120
Abstract: Spatial autocorrelation methodologies, including Global Moran’s I and Local Indicators of Spatial Association statistic (LISA), were used to describe and map spatial clusters of 13 leading malignant neoplasms in Taiwan. A logistic regression fit model was also used to identify similar characteristics over time. Two time periods (1995-1998 and 2005-2008) were compared in an attempt to formulate common spatio-temporal risks. Spatial cluster patterns were identified using local spatial autocorrelation analysis. We found a significant spatio-temporal variation between the leading malignant neoplasms and well-documented spatial risk factors. For instance, in Taiwan, cancer of the oral cavity in males was found to be clustered in locations in central Taiwan, with distinct differences between the two time periods. Stomach cancer morbidity clustered in aboriginal townships, where the prevalence of Helicobacter pylori is high and even quite marked differences between the two time periods were found. A method which combines LISA statistics and logistic regression is an effective tool for the detection of space-time patterns with discontinuous data. Spatio-temporal mapping comparison helps to clarify issues such as the spatial aspects of both two time periods for leading malignant neoplasms. This helps planners to assess spatio-temporal risk factors, and to ascertain what would be the most advantageous types of health care policies for the planning and implementation of health care services. These issues can greatly affect the performance and effectiveness of health care services and also provide a clear outline for helping us to better understand the results in depth.
Field Survey on Human Thermal Comfort Reports in Air-Conditioned Offices in Taiwan
Ruey Lung Hwang and Ming-Jen Cheng
The Open Construction & Building Technology Journal , 2007, DOI: 10.2174/1874836800701010008]
Abstract: Field experiments, conducted in 29 air-conditioned offices, used survey questionnaires and physical measurements to investigate workers’ subjective thermal responses and comfort perception. A total of 650 individuals participated in the field study. The thermal neutrality and thermal preference of subjects occurred at 25.6°C and 24.1°C respectively. Responses from those subjects suggest a comfort temperature range is 23.8–27.5oC, that shifts to slightly warmer temperatures by about 0.5oC as comparing to comfort zone recommended in ASHRAE standard 55. Responses from subjects also indicate that people in Taiwan have a leniency toward the humidity guideline in ASHRAE standard 55, due to acclimate to the humid climate. The findings were compared with the similar studies in hot-humid climate.
Light Enhancement of Solar Module  [PDF]
Hsin-Hsin Hsieh, Jen-Loong Hwang, Chia-Yu Lin, Jang-Hsing Hsieh
Energy and Power Engineering (EPE) , 2014, DOI: 10.4236/epe.2014.614044
Abstract: This paper presents sputtered-deposited Ag nanoparticles (NPs) on the encapsulant material (ethylene vinyl acetate, EVA) with the variation of annealing condition on crystalline silicon solar cell to enhance the light intensity, and a conventional solar cell is also performed for comparison. It was found that an increase in the transmittance at the wavelength of 500 - 800 nm was detected in the Ag nanoparticle solar cells. And red-light enhancement of around 2% was measured in the Ag-sputtered solar module under annealing condition of 700 for 3 min from incident photon to converted electron (IPCE) profile. The photovoltaic performance of solar modules was characterized by a flasher system in AAA class (temporal instability, spectral match, and irradiance non-uniformity). The IV curve showed a current enhancement with Ag-EVA sample, and thus a high power output around 0.250 W was observed. A high fill factor of 73.63% also implied a high performance in series and shunt resistance. Surface plasmonic resonance effects of Ag nanoparticles deposited on the surface of solar cell were examined and discussed. This paper not only illustrated the performance of the surface plasmonic resonance of a solar device but also verified the application in the industrial production.
Direct Activation of Bmi1 by Twist1: Implications in Cancer Stemness, Epithelial-Mesenchymal Transition, and Clinical Significance
Kou-Juey Wu
Chang Gung Medical Journal , 2011,
Abstract: Cancer stemness is a concept used to describe a minorpopulation of cells (cancer stem cells-CSCs) residing in atumor, which possess self-renewal properties and are resistantto chemo/radiation therapy. Epithelial-mesenchymal transition(EMT), a major mechanism of cancer metastasis, is a processwhich generates cells with stem-like properties. The relationship between cancer stemness and EMT is well documentedbut without detailed mechanistic explanation. Bmi1 belongs tothe polycomb repressive complex 1 (PRC1) which maintainsself-renewal and stemness. Recent results showed that Twist1,an EMT regulator, directly activates Bmi1 and these two molecules function together to mediate cancer stemness and EMT.These results provide a molecular explanation of the relationship between cancer stemness and EMT. Bmi1 is frequentlyoverexpressed in various types of human cancers and can confer drug resistance. Twist1 is also overexpressed in various human cancers with prognosticsignificance. The functional interdependence between Twist1 and Bmi1 provides a freshinsight into the molecular mechanism of EMT-induced cancer stemness. Further investigation of the mechanisms mediating EMT and cancer stemness will be helpful in the management and treatment of metastatic cancers
A Parametric Study of Solute Redistribution During Transient Liquid Phase Diffusion Bonding Process
Tien-Chien Jen,Yuning Jiao,Thomas Hwang
International Journal of Rotating Machinery , 2001, DOI: 10.1155/s1023621x01000331
Abstract: A parametric study is performed to investigate the solute redistribution during the transient liquid phase (TLP) diffusion bonding process. The macroscopic solute diffusion in the liquid and the solid phase, as well as the solid transformation to the liquid due to solute macrosegregation, are considered in this study. The effects of the following parameters are considered: ratio of solute diffusivity in liquid and solid state alloy (ξ=Dl/Ds), holding temperatures (θ), a combined parameter related to solidus and liquidus slopes in the phase diagram (ϕ), and the re-melting and re-solidification time (τ). The thickness of the pure liquid zone and the mushy zone of the TLP diffusion bonding process are demonstrated with respect to the above-mentioned parameters. It is shown numerically that the holding time, the holding temperature, and solute diffusivity ratio influence the solute distribution strongly, which in turn influences the liquid zone and mushy zone thickness significantly. It is concluded that for the TLP diffusion bonding process, the optimal technique parameters are high holding temperature, long holding time, and a large liquidus and solidus temperature slope ratio (ml/ms) of the interlayer material.
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