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Wang Z, Yang S, Lawson SB, Doddapaneni VVK, Albert M, Sutton B, Chang CH, Pasebani S, Xu D. Atomic Diffusivities of Yttrium, Titanium and Oxygen Calculated by Ab Initio Molecular Dynamics in Molten 316L Oxide-Dispersion-Strengthened Steel Fabricated via Additive Manufacturing. Materials (Basel) 2024; 17:1543. [PMID: 38612060 PMCID: PMC11012943 DOI: 10.3390/ma17071543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
Oxide-dispersion-strengthened (ODS) steels have long been viewed as a prime solution for harsh environments. However, conventional manufacturing of ODS steels limits the final product geometry, is difficult to scale up to large components, and is expensive due to multiple highly involved, solid-state processing steps required. Additive manufacturing (AM) can directly incorporate dispersion elements (e.g., Y, Ti and O) during component fabrication, thus bypassing the need for an ODS steel supply chain, the scale-up challenges of powder processing routes, the buoyancy challenges associated with casting ODS steels, and the joining issues for net-shape component fabrication. In the AM process, the diffusion of the dispersion elements in the molten steel plays a key role in the precipitation of the oxide particles, thereby influencing the microstructure, thermal stability and high-temperature mechanical properties of the resulting ODS steels. In this work, the atomic diffusivities of Y, Ti, and O in molten 316L stainless steel (SS) as functions of temperature are determined by ab initio molecular dynamics simulations. The latest Vienna Ab initio Simulation Package (VASP) package that incorporates an on-the-fly machine learning force field for accelerated computation is used. At a constant temperature, the time-dependent coordinates of the target atoms in the molten 316L SS were analyzed in the form of mean square displacement in order to obtain diffusivity. The values of the diffusivity at multiple temperatures are then fitted to the Arrhenius form to determine the activation energy and the pre-exponential factor. Given the challenges in experimental measurement of atomic diffusivity at such high temperatures and correspondingly the lack of experimental data, this study provides important physical parameters for future modeling of the oxide precipitation kinetics during AM process.
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Affiliation(s)
- Zhengming Wang
- Materials Science Program, Oregon State University, Corvallis, OR 97331, USA; (Z.W.); (C.-H.C.)
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (S.Y.); (S.B.L.); (S.P.)
| | - Seongun Yang
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (S.Y.); (S.B.L.); (S.P.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA;
| | - Stephanie B. Lawson
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (S.Y.); (S.B.L.); (S.P.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA;
| | - V. Vinay K. Doddapaneni
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA;
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, OR 97331, USA
| | - Marc Albert
- Electric Power Research Institute (EPRI), Charlotte, NC 28262, USA; (M.A.); (B.S.)
| | - Benjamin Sutton
- Electric Power Research Institute (EPRI), Charlotte, NC 28262, USA; (M.A.); (B.S.)
| | - Chih-Hung Chang
- Materials Science Program, Oregon State University, Corvallis, OR 97331, USA; (Z.W.); (C.-H.C.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA;
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, OR 97331, USA
| | - Somayeh Pasebani
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (S.Y.); (S.B.L.); (S.P.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA;
| | - Donghua Xu
- Materials Science Program, Oregon State University, Corvallis, OR 97331, USA; (Z.W.); (C.-H.C.)
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (S.Y.); (S.B.L.); (S.P.)
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Chen SY, Chen YL, Li PC, Cheng TS, Chu YS, Shen YS, Chen HT, Tsai WN, Huang CL, Sieber M, Yeh YC, Liu HS, Chiang CL, Chang CH, Lee AS, Tseng YH, Lee LJ, Liao HJ, Yip HK, Huang CYF. Engineered extracellular vesicles carrying let-7a-5p for alleviating inflammation in acute lung injury. J Biomed Sci 2024; 31:30. [PMID: 38500170 PMCID: PMC10949767 DOI: 10.1186/s12929-024-01019-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Acute lung injury (ALI) is a life-threatening respiratory condition characterized by severe inflammation and lung tissue damage, frequently causing rapid respiratory failure and long-term complications. The microRNA let-7a-5p is involved in the progression of lung injury, inflammation, and fibrosis by regulating immune cell activation and cytokine production. This study aims to use an innovative cellular electroporation platform to generate extracellular vesicles (EVs) carring let-7a-5p (EV-let-7a-5p) derived from transfected Wharton's jelly-mesenchymal stem cells (WJ-MSCs) as a potential gene therapy for ALI. METHODS A cellular nanoporation (CNP) method was used to induce the production and release of EV-let-7a-5p from WJ-MSCs transfected with the relevant plasmid DNA. EV-let-7a-5p in the conditioned medium were isolated using a tangential flow filtration (TFF) system. EV characterization followed the minimal consensus guidelines outlined by the International Society for Extracellular Vesicles. We conducted a thorough set of therapeutic assessments, including the antifibrotic effects using a transforming growth factor beta (TGF-β)-induced cell model, the modulation effects on macrophage polarization, and the influence of EV-let-7a-5p in a rat model of hyperoxia-induced ALI. RESULTS The CNP platform significantly increased EV secretion from transfected WJ-MSCs, and the encapsulated let-7a-5p in engineered EVs was markedly higher than that in untreated WJ-MSCs. These EV-let-7a-5p did not influence cell proliferation and effectively mitigated the TGF-β-induced fibrotic phenotype by downregulating SMAD2/3 phosphorylation in LL29 cells. Furthermore, EV-let-7a-5p regulated M2-like macrophage activation in an inflammatory microenvironment and significantly induced interleukin (IL)-10 secretion, demonstrating their modulatory effect on inflammation. Administering EVs from untreated WJ-MSCs slightly improved lung function and increased let-7a-5p expression in plasma in the hyperoxia-induced ALI rat model. In comparison, EV-let-7a-5p significantly reduced macrophage infiltration and collagen deposition while increasing IL-10 expression, causing a substantial improvement in lung function. CONCLUSION This study reveals that the use of the CNP platform to stimulate and transfect WJ-MSCs could generate an abundance of let-7a-5p-enriched EVs, which underscores the therapeutic potential in countering inflammatory responses, fibrotic activation, and hyperoxia-induced lung injury. These results provide potential avenues for developing innovative therapeutic approaches for more effective interventions in ALI.
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Affiliation(s)
- Sin-Yu Chen
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Yi-Ling Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833401, Taiwan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 833401, Taiwan
| | - Po-Chen Li
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Tai-Shan Cheng
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, 220216, Taiwan
| | - Yeh-Shiu Chu
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Yi-Shan Shen
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, 220216, Taiwan
- Department of Biomedical Engineering, National Taiwan University, Taipei, 106319, Taiwan
| | - Hsin-Tung Chen
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Wei-Ni Tsai
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Chien-Ling Huang
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | | | - Yuan-Chieh Yeh
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung, 204201, Taiwan
- Program in Molecular Medicine, College of Life Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Hsiao-Sheng Liu
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
- Center for Cancer Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan
- Teaching and Research Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 812015, Taiwan
| | - Chi-Ling Chiang
- Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, 43210, USA
- Comprehensive Cancer Center, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, 220216, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, 320315, Taiwan
| | | | - Yen-Han Tseng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, 112201, Taiwan
| | - Ly James Lee
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan.
- Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, 43210, USA.
- Spot Biosystems Ltd., Palo Alto, CA, 94305, USA.
| | - Hsiu-Jung Liao
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan.
- Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City, 220216, Taiwan.
| | - Hon-Kan Yip
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833401, Taiwan.
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 833401, Taiwan.
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 833401, Taiwan.
- Department of Nursing, Asia University, Taichung, 413305, Taiwan.
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404328, Taiwan.
| | - Chi-Ying F Huang
- Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan.
- Department of Biochemistry, School of Medicine, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan.
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Nguyen TM, Wu PY, Chang CH, Huang LF. High-yield BMP2 expression in rice cells via CRISPR and endogenous αAmy3 promoter. Appl Microbiol Biotechnol 2024; 108:206. [PMID: 38353738 PMCID: PMC10867061 DOI: 10.1007/s00253-024-13054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
Plant cells serve as versatile platforms for the production of high-value recombinant proteins. This study explored the efficacy of utilizing an endogenous αAmy3 promoter for the expression of a bioactive pharmaceutical protein, specifically the mature region of human bone morphogenetic protein 2 (hBMP2m). Utilizing a refined CRISPR/Cas9-mediated intron-targeting insertion technique, which incorporates an artificial 3' splicing site upstream of the target gene, we achieved a transformation efficiency of 13.5% in rice calli that carried the rice-codon optimized mature region of hBMP2 cDNA (rhBMP2m) in the αAmy3 intron 1. Both homozygous and heterozygous rhBMP2m knock-in rice suspension cell lines were generated. These lines demonstrated the endogenous αAmy3 promoter regulated rhBMP2m mRNA and rhBMP2m recombinant protein expression, with strongly upregulation in respond to sugar depletion. The homozygous rhBMP2m knock-in cell line yielded an impressive 21.5 μg/mL of rhBMP2m recombinant protein, accounting for 1.03% of the total soluble protein. The high-yield expression was stably maintained across two generations, indicating the genetic stability of rhBMP2m gene knock-in at the αAmy3 intron 1 locus. Additionally, the rice cell-derived rhBMP2m proteins were found to be glycosylated, capable of dimer formation, and bioactive. Our results indicate that the endogenous rice αAmy3 promoter-signal peptide-based expression system is an effective strategy for producing bioactive pharmaceutical proteins. KEY POINTS: • The endogenous αAmy3 promoter-based expression system enhanced the yield of BMP2 • The increased yield of BMP2 accounted for 1.03% of the total rice-soluble proteins • The rice-produced BMP2 showed glycosylation modifications, dimer formation, and bioactivity.
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Affiliation(s)
- Thi Mai Nguyen
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, 320, Taiwan, Republic of China
- Department of Life Sciences, National Central University, Taoyuan City, 320, Taiwan, Republic of China
| | - Pei-Yi Wu
- Department of Life Sciences, National Central University, Taoyuan City, 320, Taiwan, Republic of China
| | - Chih-Hung Chang
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, 320, Taiwan, Republic of China
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan, Republic of China
| | - Li-Fen Huang
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, 320, Taiwan, Republic of China.
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Lan TY, Chen CW, Huang YH, Lin SM, Liang CT, Chang CH, Rwei SP. Biobased polyester versus synthetic fiberglass casts for treating stable upper limb fractures in children: a randomized controlled trial. BMC Musculoskelet Disord 2024; 25:23. [PMID: 38166834 PMCID: PMC10759437 DOI: 10.1186/s12891-023-07138-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Stable upper limb fractures, such as radius, ulna, or distal humerus fractures, are common pediatric orthopedic traumas that are traditionally managed with cast immobilization. The commonly used synthetic fiberglass cast is light and water resistant but may promote skin itchiness during casting, which is a common complaint of patients. In addition, these diisocyanate-based casts have been proven to be toxic and may cause asthma. Herein, we introduce a novel biobased polyester cast to compare its clinical outcomes and patient satisfaction with conventional synthetic fiberglass casts. METHODS From Feb 2022 to Nov 2022, we undertook a single-center prospective randomized trial involving 100 children with cast-immobilized stable upper limb fractures. These patients were randomized into either biobased polyester or synthetic fiberglass groups. All patients were regularly followed up till the cast removal which occurred approximately 3-4 weeks after immobilizing. Objective clinical findings and subjective patient questionnaire were all collected and analyzed. RESULTS According to the radiographs taken on the day of cast removal, there was no loss of reduction in both groups. The incidence of skin problems was 3.4 times higher in the synthetic fiberglass group than in the biobased polyester group. For the subjective questionnaire, the biobased polyester cast was preferred in every sub-item. CONCLUSIONS Our study strongly suggested that the novel biobased polyester cast provides matching stability to conventional fiberglass casts and improves patient satisfaction in an eco-friendlier and safer way. TRIAL REGISTRATION ClinicalTrials.gov Protocol Registration and Results System ( https://www. CLINICALTRIALS gov/ ; ID: NCT06102603; Date: 26/10/2023).
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Affiliation(s)
- Tsung-Yu Lan
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd, New Taipei City, 220, Taiwan (R.O.C.)
- Department of Materials and Textiles, Asia Eastern University of Science and Technology, No.58, Sec.2, Sihchuan Rd, New Taipei City, 220, Taiwan (R.O.C.)
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd, Taipei, 10608, Taiwan (R.O.C.)
| | - Chin-Wen Chen
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd, Taipei, 10608, Taiwan (R.O.C.).
- Research and Development Center for Smart Textile Technology, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd, Taipei, 10608, Taiwan (R.O.C.).
- Department of Molecular Science and Engineering, Institute of Organic and Polymeric Materials, Research and Development Center of Smart Textile Technology, National Taipei University of Technology, No. 1, Sec. 3, Chung-Hsiao East Road, Taipei, 106, Taiwan (R.O.C.).
| | - Yu-Hao Huang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd, New Taipei City, 220, Taiwan (R.O.C.)
| | - Shang-Ming Lin
- Department of Materials and Textiles, Asia Eastern University of Science and Technology, No.58, Sec.2, Sihchuan Rd, New Taipei City, 220, Taiwan (R.O.C.)
| | - Ching-Ting Liang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd, New Taipei City, 220, Taiwan (R.O.C.)
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd, New Taipei City, 220, Taiwan (R.O.C.)
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.)
| | - Syang-Peng Rwei
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd, Taipei, 10608, Taiwan (R.O.C.).
- Research and Development Center for Smart Textile Technology, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd, Taipei, 10608, Taiwan (R.O.C.).
- Department of Molecular Science and Engineering, Institute of Organic and Polymeric Materials, Research and Development Center of Smart Textile Technology, National Taipei University of Technology, No. 1, Sec. 3, Chung-Hsiao East Road, Taipei, 106, Taiwan (R.O.C.).
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Chen IC, Chuang IC, Chang KC, Chang CH, Wu CY. Dual task measures in older adults with and without cognitive impairment: response to simultaneous cognitive-exercise training and minimal clinically important difference estimates. BMC Geriatr 2023; 23:663. [PMID: 37845603 PMCID: PMC10580601 DOI: 10.1186/s12877-023-04390-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment. METHODS A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment ≥ 26) and cognitively impaired (Montreal Cognitive Assessment < 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET. RESULTS In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18-0.29; standardized response mean = 0.25-0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09-2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77-5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47-2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13-7.62. CONCLUSIONS Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment. TRIAL REGISTRATION NCT04689776, 30/12/2020.
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Affiliation(s)
- I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan.
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Ku-Chou Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Hung Chang
- Program in Occupational Therapy, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Medicine, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Orthopedic Surgery, School of Medicine, Washington University , St. Louis, MO, USA
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Newman-Griffis DR, Desmet B, Zirikly A, Tamang S, Chang CH. Editorial: Artificial intelligence for human function and disability. Front Digit Health 2023; 5:1282287. [PMID: 37744682 PMCID: PMC10515276 DOI: 10.3389/fdgth.2023.1282287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Affiliation(s)
- Denis R. Newman-Griffis
- Information School, University of Sheffield, Sheffield, United Kingdom
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Bart Desmet
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Ayah Zirikly
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
- Center for Speech and Language Processing, Johns Hopkins University, Baltimore, MD, United States
| | - Suzanne Tamang
- Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, United States
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, United States
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Chen HW, Huang CH, Huang CYF, Chang CH, Liao HJ. Distinct subsets of synovial fibroblasts control cartilage destruction in joint diseases. Clin Exp Rheumatol 2023:20013. [PMID: 37706287 DOI: 10.55563/clinexprheumatol/txl9rm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023]
Abstract
Inflammation-induced bone destruction is the main cause of progressive joint damage in rheumatoid arthritis (RA) and osteoarthritis (OA). In addition, depending on the tissue microenvironment stimulators, the synovium transforms into a hyperplastic invasive tissue. The synovium includes two specific subsets of fibroblasts surrounding the joints: lining and sublining synovial fibroblasts (SFs). These SFs grow and interact with immune cells invading the bone and cartilage; specifically, SFs, which are the major mesenchymal cells in the joints, develop an aggressive phenotype, thereby producing cytokines and proteases involved in arthritis pathogeneses. Transcriptomic differences in the heterogeneity of SFs reflect the joint-specific origins of the SFs interacting with immune cells. To understand the subsets of SFs that lead to joint damage in arthritis, clarifying the distinct phenotypes and properties of SFs and understanding how they influence bone cells, such as osteoclasts and chondrocytes, is crucial. This review provides an overview of the advancements in the understanding of SF subsets and features, which may aid in identifying newer therapeutic targets.
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Affiliation(s)
- Hung-Wei Chen
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chi-Hsiang Huang
- Department of Orthopaedics, Chu Shang Show Chwan Hospital, Nantou County, Taiwan
| | - Chi-Ying F Huang
- Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming Chiao Tung University, Taipei, and Institute of Biopharmaceutical Sciences, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Hung Chang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, and Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Hsiu-Jung Liao
- Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
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Chang CH, Yen KT, Li AL, Li YR, Su KW. LED-pumped eye-safe pulse laser with an extracavity optical parametric oscillator. Opt Lett 2023; 48:3877-3880. [PMID: 37527072 DOI: 10.1364/ol.496161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
An LED-side-pumped Nd:YAG/Cr4+:YAG passively Q-switched (PQS) laser containing an extracavity optical parametric oscillator (EOPO) is demonstrated. As far as we know, it is the first LED-pumped eye-safe laser. The Nd:YAG pump module is optimized to increase the PQS pulse energy to 24 mJ at 1064 nm. By using a single-pass EOPO design, the output energy of the signal pulse at 1573 nm is 7.44 mJ with a pulse width of 16 ns, the peak power is 434 kW, and the pump-to-signal conversion efficiency is 31%. For double-pass EOPO operation, the pump-to-signal conversion efficiency increases to 45.8%, the output energy of signal pulse is up to 10.98 mJ with a pulse width of 23.5 ns, and the peak power is 459 kW.
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Wang Y, Zheng J, Schneberk T, Ke Y, Chan A, Hu T, Lam J, Gutierrez M, Portillo I, Wu D, Chang CH, Qu Y, Brown L, Nichol MB. What quantifies good primary care in the United States? A review of algorithms and metrics using real-world data. BMC Prim Care 2023; 24:130. [PMID: 37355573 PMCID: PMC10290298 DOI: 10.1186/s12875-023-02080-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/09/2023] [Indexed: 06/26/2023]
Abstract
Primary care physicians (PCPs) play an indispensable role in providing comprehensive care and referring patients for specialty care and other medical services. As the COVID-19 outbreak disrupts patient access to care, understanding the quality of primary care is critical at this unprecedented moment to support patients with complex medical needs in the primary care setting and inform policymakers to redesign our primary care system. The traditional way of collecting information from patient surveys is time-consuming and costly, and novel data collection and analysis methods are needed. In this review paper, we describe the existing algorithms and metrics that use the real-world data to qualify and quantify primary care, including the identification of an individual's likely PCP (identification of plurality provider and major provider), assessment of process quality (for example, appropriate-care-model composite measures), and continuity and regularity of care index (including the interval index, variance index and relative variance index), and highlight the strength and limitation of real world data from electronic health records (EHRs) and claims data in determining the quality of PCP care. The EHR audits facilitate assessing the quality of the workflow process and clinical appropriateness of primary care practices. With extensive and diverse records, administrative claims data can provide reliable information as it assesses primary care quality through coded information from different providers or networks. The use of EHRs and administrative claims data may be a cost-effective analytic strategy for evaluating the quality of primary care.
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Affiliation(s)
- Yun Wang
- School of Pharmacy, Chapman University, Irvine, US.
| | | | - Todd Schneberk
- Gehr Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, Los Angeles, US
| | - Yu Ke
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, US
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, US
| | - Tao Hu
- Department of Geography, Oklahoma State University, Stillwater, US
| | - Jerika Lam
- School of Pharmacy, Chapman University, Irvine, US
| | | | | | - Dan Wu
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London, School of Hygiene and Tropical Medicine, London, UK
| | - Chih-Hung Chang
- Program in Occupational Therapy, Department of Medicine, and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, US
| | - Yang Qu
- School of Pharmacy, Chapman University, Irvine, US
| | | | - Michael B Nichol
- Sol Price School of Public Policy, University of Southern California, Los Angeles, US
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Wang CT, Huang B, Thogiti N, Zhu WX, Chang CH, Pao JL, Lai F. Successful real-world application of an osteoarthritis classification deep-learning model using 9210 knees-An orthopedic surgeon's view. J Orthop Res 2023; 41:737-746. [PMID: 35822355 DOI: 10.1002/jor.25415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/23/2022] [Accepted: 07/07/2022] [Indexed: 02/04/2023]
Abstract
This study aimed to evaluate the performance of a deep-learning model to evaluate knee osteoarthritis using Kellgren-Lawrence grading in real-life knee radiographs. A deep convolutional neural network model was trained using 8964 knee radiographs from the osteoarthritis initiative (OAI), including 962 testing set images. Another 246 knee radiographs from the Far Eastern Memorial Hospital were used for external validation. The OAI testing set and external validation images were evaluated by experienced specialists, two orthopedic surgeons, and a musculoskeletal radiologist. The accuracy, interobserver agreement, F1 score, precision, recall, specificity, and ability to identify surgical candidates were used to compare the performances of the model and specialists. Attention maps illustrated the interpretability of the model classification. The model had a 78% accuracy and consistent interobserver agreement for the OAI (model-surgeon 1 К = 0.80, model-surgeon 2 К = 0.84, model-radiologist К = 0.86) and external validation (model-surgeon 1 К = 0.81, model-surgeon 2 К = 0.82, model-radiologist К = 0.83) images. A lower interobserver agreement was found in the images misclassified by the model (model-surgeon 1 К = 0.57, model-surgeon 2 К = 0.47, model-radiologist К = 0.65). The model performed better than specialists in identifying surgical candidates (Kellgren-Lawrence Stages 3 and 4) with an F1 score of 0.923. Our model not only had comparable results with specialists with respect to the ability to identify surgical candidates but also performed consistently with open database and real-life radiographs. We believe the controversy of the misclassified knee osteoarthritis images was based on a significantly lower interobserver agreement.
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Affiliation(s)
- Cheng-Tzu Wang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Graduate Institute of Networking and Multimedia, National Taiwan University, Taipei, Taiwan
| | - Brady Huang
- Department of Computer Science, New York University, New York, New York, USA
| | - Nagaraju Thogiti
- Department of Mathematics, University of Southern California, Los Angeles, California, USA
| | - Wan-Xuan Zhu
- Graduate Institute of Networking and Multimedia, National Taiwan University, Taipei, Taiwan
| | - Chih-Hung Chang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Jwo-Luen Pao
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,General Education Center, Lunghwa University of Technology, Taoyuan, Taiwan
| | - Feipei Lai
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
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Lau SCL, Baum CM, Connor LT, Chang CH. Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) scale in stroke survivors. Top Stroke Rehabil 2023; 30:253-262. [PMID: 35037591 DOI: 10.1080/10749357.2022.2026280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE This study aimed to evaluate the psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) scale in adults with stroke. METHODS A secondary analysis of the Stroke Recovery in Underserved Populations Cohort Study. The CES-D was administrated to 828 stroke patients at discharge from inpatient rehabilitation facilities and at 3- and 12-month follow-ups. Data were analyzed using classical test theory (CTT) and Rasch measurement model. RESULTS Confirmatory factor analyses of the CES-D items showed excellent fit of a four-factor model (CFI = 0.98; TLI = 0.98; RMSEA = 0.05). CTT analyses revealed satisfactory reliability and validity. Rasch analyses also supported the unidimensionality of each factor (subscale). Wright maps indicated a floor effect and item gaps. A few items displayed differential item functioning: 3 items (1 depressed affect and 2 somatic symptoms) across gender, 1 item (depressed affect) across time of assessment and all # somatic symptom items across time of assessment. CONCLUSION The four-factor structure of the CES-D was confirmed and its psychometric properties were validated, supporting the use of four subscales to characterize depressive symptomatology in adults with stroke. Supplementary assessments are needed for evaluating and comparing somatic symptoms over time. A refinement of the CES-D was recommended to better differentiate stroke survivors with subtle depressive symptoms.
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Affiliation(s)
- Stephen C L Lau
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Carolyn M Baum
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Lisa Tabor Connor
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.,Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA
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12
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Lai CC, Fang HW, Chang CH, Pao JL, Chang CC, Chen YJ. Unusual capitate fracture with dorsal shearing pattern and concomitant carpometacarpal dislocation with a 6-year follow-up: A case report. World J Clin Cases 2023; 11:2060-2066. [PMID: 36998955 PMCID: PMC10044964 DOI: 10.12998/wjcc.v11.i9.2060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Isolated capitate fractures are rare carpal fractures. Following high-energy injuries, capitate fractures are usually associated with other carpal fractures or ligament injuries. The management of capitate fractures depends on the fracture pattern. Here, we report an unusual capitate fracture with a dorsal shearing pattern and concomitant carpometacarpal dislocation, with a 6-year follow-up. To the best of our knowledge, this fracture pattern and surgical management have not been previously reported.
CASE SUMMARY A 28-year-old man presented with left-hand volar tenderness and decreased grip strength that persisted for one month after a traffic accident. Radiography showed a distal capitate fracture with carpometacarpal joint incongruence. Computed tomography (CT) revealed a distal capitate fracture with carpometacarpal joint dislocation. The distal fragment was rotated by 90° in the sagittal plane, and an oblique shearing fracture pattern was noted. Open reduction and internal fixation (ORIF) with a locking plate were performed using the dorsal approach. The imaging studies performed 3 mo and 6 years following surgery revealed a healed fracture, and the Disabilities of the Arm, Shoulder, and Hand and visual analog scale scores were significantly improved.
CONCLUSION CT can detect capitate fractures with dorsal shearing pattern and concomitant carpometacarpal dislocation. ORIF using a locking plate are possible.
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Affiliation(s)
- Chien-Cheng Lai
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, Taiwan
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan 320, Taiwan
| | - Jwo-Luen Pao
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Chun-Chien Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Yeong-Jang Chen
- Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan
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13
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Dagli C, Chang CH, Hattori R, Wubie M, Connor LT. Abstract P257: Self-Perception of Mental and Physical Health Are Significant Predictors of Activities of Daily Living. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Background:
Stroke is a leading cause of long-term disability and death worldwide. Stroke results in impaired physical, psychological, and social functions. This study examined the extent to which self-perception of physical and mental health, conditions manageable by behavioral intervention (MBI), and medical conditions contribute to activities of daily living (ADL) performance post-stroke among adults aged 65 and above.
Methods:
Data from the 2017 Medicare Health Outcomes Survey Cohort 19 were analyzed. The outcome variable was defined as, being able to independently perform basic ADL such as bathing, dressing, eating, getting in and out of the chair, walking, and using the toilet. Stepwise binary logistic regression was used to identify risk factors that predict overall ADL performance.
Results:
A total of 9,531 older adults with stroke were included in the study, 56.97% of whom were females. Overall, 58.6% had some difficulty or were unable to perform ADLs post-stroke. In the final model, self-perception of physical (OR=0.89, 95% CI=0.883, 0.896) and mental (OR=0.961, 95% CI=0.954, 0.968) health and older (74+) age (OR=1.7, 95% CI=1.452,1.895) were associated with difficulty in self-perception of ADL. A 12.2% increase in explained variance after adding medical conditions such as diabetes, hypertension, cancer, etc. to demographic factors; a 13.6% increment in explained variance after adding conditions MBI such as obesity, smoking, pain, etc.; and a 10.5% increment after adding self-perception of mental and physical health was obtained. The final model explained 39.4% of the total variance in the self-perception of ADL.
Conclusion:
Not only conditions manageable by behavior interventions, and medical conditions predict performance, but self-perceptions of mental and physical health have an impact on ADL. The significant association between self-perception and ADL found in this study signals the need for new avenues for interventions for persons with stroke with respect to their ability to perform self-care activities. These findings can inform future work that identifies and addresses psychosocial and behavioral risk factors that contribute to ADL.
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Keleman AA, Chang CH, Bollinger RM, Lingler JH, Gabel M, Stark SL. Psychometric Evaluation of the Perceived Research Burden Assessment (PeRBA) in Longitudinal Studies of Alzheimer Disease Using Rasch Analysis. Alzheimer Dis Assoc Disord 2023; 37:28-34. [PMID: 36251929 PMCID: PMC9974570 DOI: 10.1097/wad.0000000000000532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The Perceived Research Burden Assessment (PeRBA) was developed to measure participant perceptions of burden in research studies. This study aimed to examine the psychometric properties of this assessment using Rasch analysis in participants in the longitudinal studies of the Alzheimer disease (AD) and their family members. METHODS PeRBA was administered to 443 participants in studies of AD and 212 family members across 4 Alzheimer Disease Research Centers. We used Rasch analysis to examine PeRBA's psychometric properties, and data-model fit both at item and scale levels. RESULTS PeRBA demonstrated good reliability and item and person fit for participants and family members. A few items did not fit the model for participants or family members. Areas of content redundancy were found in items assessing similar amounts of perceived research burden. Areas of content gaps were also found, with no items assessing certain levels of perceived research burden. CONCLUSION Analysis results support the good overall psychometric properties of PeRBA among research participants in studies of AD and their family members. Recommendations have been provided to improve the assessment, including rewording items and adding items that could account for a broader range of perceived research burden.
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Affiliation(s)
- Audrey A. Keleman
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
- Institute for Informatics, Washington University School of Medicine, St. Louis, MO
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Rebecca M. Bollinger
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
| | - Jennifer H. Lingler
- School of Nursing, Department of Health and Community Systems University of Pittsburgh, Pittsburgh, PA
| | - Matthew Gabel
- Department of Political Science, Washington University in St. Louis, St. Louis, MO
| | - Susan L. Stark
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
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15
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Chuang IC, Chiau HY, Liao WW, Wu YR, Chang CH, Wu CY. Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: A four-arm randomized controlled trial. Digit Health 2023; 9:20552076231203633. [PMID: 37744745 PMCID: PMC10515553 DOI: 10.1177/20552076231203633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on cognitive functions and instrumental ADL (IADL) in older adults with cognitive impairment. Methods A cluster randomized controlled trial was conducted. Eighty older adults with cognitive impairment were randomly assigned to COG, PHY, SEQ or SIMUL training groups. The intervention consisted of 90-min training sessions, totaling 36 sessions. Outcome measures were the Montreal Cognitive Assessment, three subtests of the Wechsler Memory Scale (WMS) and the Lawton IADL scale. Results Significant interaction effects between group and time were found in WMS-spatial span (p = 0.04) and WMS-word lists (p = 0.041). For WMS-spatial span, the SIMUL group showed outperformed the COG (p = 0.039), PHY (p = 0.010) and SEQ groups (p = 0.017). For WMS-word lists, the SEQ group improve more than COG (p = 0.013), PHY (p = 0.030) and SIMUL (p = 0.019) groups. No significant differences were found in IADL performance among four groups (p = 0.645). Conclusions Our study showed SEQ and SIMUL motor-cognitive training led to more pronounced improvements in visuospatial working memory or verbal memory compared with isolated COG or PHY training for community-based older adults with cognitive impairment. For enhancing effects on IADL, we suggest the use of sensitive measurement tools and context-enriched cognitive training involving real-life task demands.
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Affiliation(s)
- I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan
| | - Hui-Yan Chiau
- Institute of Cognitive Neuroscience, National Central University, Taoyuan
| | - Wan-Wen Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei City
| | - Yih-Ru Wu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan
- College of Medicine, Chang Gung University, Taoyuan
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University in St Louis School of Medicine, St Louis, MO, USA
- Department of Medicine, Washington University in St Louis School of Medicine, St Louis, MO, USA
- Department of Orthopaedic Surgery, Washington University in St Louis School of Medicine, St Louis, MO, USA
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
- Healthy Aging Research Center, Chang Gung University, Taoyuan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan
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Ak M, Gumus S, Aghayev A, Chang CH, Fu B, Roberts MS, Woodard PK, Bae KT. The Resolution Rate of Pulmonary Embolism on CT Pulmonary Angiography: a Prospective Study. Eur J Radiol 2022; 155:110466. [PMID: 35986988 DOI: 10.1016/j.ejrad.2022.110466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/25/2022] [Accepted: 08/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To prospectively assess the rate of clot resolution from CT pulmonary angiography (CTPA) in patients with acute pulmonary embolism (PE). MATERIALS AND METHODS This prospective cohort study included 290 patients (136 men, 154 women; mean age, 51.9 years) with acute PE. All patients had a CTPA at the presentation and had at least one follow-up within 6 months (mean 72.7 days). Sixty-four percent of patients had follow-up scans for research purposes within a pre-determined period (between 28 and 184 days; mean, 78.27 days) and 36 % had (between 2 and 184 days; mean, 62.78 days) for a clinical indication. The volume of each clot was measured using a semi-automated quantification program. The resolution rate was evaluated by interval-censored analysis. RESULTS The overall estimated probability of complete resolution was 42 % at 7 days, 56 % at 10 days, and 71 % at 45 days. Achieving complete resolution was significantly faster in patients with peripheral clots (HR: 1.78; CI: 1.05-3.03, p = 0.032) but slower in patients with consolidation and history of venous thromboembolism (VTE), (HR: 0.37; CI: 0.18-0.79, p = 0.01 and HR: 0.57; CI: 0.35-0.91, p = 0.019, respectively). Although the patients with cancer showed a faster resolution rate (HR: 1.67; CI: 1.05-2.68, p = 0.032), the mortality rate was significantly higher than non-cancer patients. CONCLUSION The resolution rate of clot burden in acute PE was associated with patients' clinical presentation variables and CTPA imaging biomarkers. This information may be incorporated into designing a prediction rule and determining the appropriate duration of anticoagulation therapy in patients with acute PE.
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Affiliation(s)
- M Ak
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - S Gumus
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
| | - A Aghayev
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - C H Chang
- Department of Medicine, School of Medicine, Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - B Fu
- Data and Statistical Sciences, Abbvie, Inc., Lake Bluff, IL, United States
| | - M S Roberts
- Department of Medicine, School of Medicine, Department of Biomedical Informatics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - P K Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, United States
| | - K T Bae
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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Chen YH, Liao HJ, Lin SM, Chang CH, Rwei SP, Lan TY. Radiographic outcomes of the treatment of complex femoral shaft fractures (AO/OTA 32-C) with intramedullary nailing: a retrospective analysis of different techniques. J Int Med Res 2022; 50:3000605221103974. [PMID: 35676773 PMCID: PMC9189532 DOI: 10.1177/03000605221103974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To assess the results of open versus closed reduction in intramedullary nailing (IMN) for complex femoral fractures (Arbeitsgemeinschaft für Osteosynthesefragen Foundation/Orthopaedic Trauma Association [AO/OTA]: 32-C) and to determine the factors involved in bone healing. METHODS This retrospective study involved 47 consecutive patients with complex femoral diaphyseal fractures who underwent reduction and fixation. RESULTS All open-reduction and 12 closed-reduction patients (52.17%) had an anatomical-to-small gap. The closed-small group had the highest bone union rate (100%), followed by the open-reduction (79.17%) and closed-large groups (72.73%); intergroup differences were significant. The closed-small group had the shortest mean union time (7.31 months), followed by the open-reduction group (7.58 months). The closed-large group had a significantly longer union time (9.75 months) than those in the closed-small and open-reduction groups. Femoral radiographic union scores in the closed-small and open-reduction groups were similar at three timepoints; scores were higher than those in the closed-large group, with a significant difference 6 and 9 months post-operatively. CONCLUSION IMN with closed reduction for complex femoral shaft fractures had better outcomes and fewer complications versus open reduction. For unsatisfactory closed reduction outcomes (i.e., residual gap >10 mm), minimally invasive techniques or open reduction with minimal stripping should be considered.
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Affiliation(s)
- Yu-Hung Chen
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City
| | - Hsiu-Jung Liao
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City
| | - Shang Ming Lin
- Department of Materials and Textiles, Asia Eastern University of Science and Technology, No. 58, Sec. 2, Sihchuan Rd., New Taipei City
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City
| | - Syang-Peng Rwei
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei.,Research and Development Center for Smart Textile Technology, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei
| | - Tsung-Yu Lan
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City.,Department of Materials and Textiles, Asia Eastern University of Science and Technology, No. 58, Sec. 2, Sihchuan Rd., New Taipei City.,Institute of Organic and Polymeric Materials, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei
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18
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Tsai YH, Yan YJ, Li YS, Chang CH, Haung CC, Chen TC, Lin SG, Ou-Yang M. Development and verification of the coaxial heterogeneous hyperspectral imaging system. Rev Sci Instrum 2022; 93:063105. [PMID: 35778029 DOI: 10.1063/5.0088474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
A hyperspectral imaging system (HIS) is a helpful tool that acquires spatial and spectral information from a target. This study developed a coaxial heterogeneous HIS (CHHIS) to collect spectral images with wavelengths ranging from 400 to 1700 nm. In this system, a visible (VIS) spectrometer and a short-wave infrared (SWIR) spectrometer are combined with a coaxial optical path to share the same field of view. This structure reduces the complexity of spatial registration and maintains the scanning duration of two spectrometers as that of a single spectrometer. The spectrometers are also replaceable for extending the detecting spectral range of the system. The calibration methodologies, including spatial correction, spectral calibration, and reflectance calibration, were developed for this system. The signal-to-noise ratio of VIS and SWIR spectrometers in the CHHIS was up to 40 and 60 dB when the exposure time of the VIS and SWIR imaging sensors was 1000 and 10 ms, respectively. When the target distance was at 600 mm, the spatial error of VIS and SWIR images in the scanning direction was less than 1 pixel; these results proved that the system was stable.
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Affiliation(s)
- Y H Tsai
- Institute of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Y J Yan
- Institute of Electrical and Control Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Y S Li
- Institute of Electrical and Control Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - C H Chang
- Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - C C Haung
- Department of Tropical Fruit Trees (Fengshan Tropical Horticultural Experiment Branch), Taiwan Agricultural Research Institute, Kaohsiung 30010, Taiwan
| | - T C Chen
- Department of Aerospace and Systems Engineering, Feng Chia University, Taichung 30010, Taiwan
| | - S G Lin
- Department of Communication, Navigation and Control Engineering, National Taiwan Ocean University, Keelung, Taiwan
| | - M Ou-Yang
- Institute of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
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Chang CH, Lin CY, Chang CH, Liu FH, Huang YT, Liao YS. Enhanced biomedical applicability of ZrO 2-SiO 2 ceramic composites in 3D printed bone scaffolds. Sci Rep 2022; 12:6845. [PMID: 35477956 PMCID: PMC9046279 DOI: 10.1038/s41598-022-10731-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/29/2022] [Indexed: 11/25/2022] Open
Abstract
Zirconia (ZrO2) has been widely used in clinical applications, such as bone and dental implantation, because of its favorable mechanical properties and resistance to fracture. However, the poor cell affinity of ZrO2 for bone regeneration and tissue binding, as well as its shrinkage due to crystal phase transformation during heat treatment, limits its clinical use and processing plasticity. This study aims to investigate an appropriate ZrO2–SiO2 composite recipe for ceramic 3D printing processes that can strike a balance between the mechanical properties and cell affinity needed in clinical applications. Specimens with different ZrO2–SiO2 composite recipes were fabricated by a selective laser gelling method and sintered at temperatures ranging from 900 to 1500 °C. The S5Z5 composite, which consists of 50 wt% ZrO2, 35 wt% SiO2 and 15 wt% SiO2 sol, showed an appropriate compressive strength and bending strength of 82.56 MPa and 55.98 MPa, respectively, at a sintering temperature of 1300 °C. The shrinkage rate of the S5Z5 composite was approximately 5% when the sintering temperature was increased from 900 to 1500 °C. All composites exhibited no cytotoxicity after 144 h of MG63 cell incubation, and the S5Z5 composite exhibited the most obvious cell affinity among the composite recipes. From these results, compared with other composites, the S5Z5 composite was shown to possess mechanical properties and a cell affinity more comparable to those of natural human bone.
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Affiliation(s)
- Chih-Hao Chang
- Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, 100225, Taiwan, ROC. .,National Taiwan University Hospital Jin-Shan Branch, No.7, Yulu Rd., Wuhu Village, Jinshan Dist., New Taipei, 20844, Taiwan, ROC.
| | - Chih-Yang Lin
- Department of Mechanical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan, ROC
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei, 22000, Taiwan, ROC.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, No.135, Yuan-Tung Road, Zhongli Dist., Taoyuan, 32003, Taiwan, ROC
| | - Fwu-Hsing Liu
- Department of Mechanical Engineering, LungHwa University of Science and Technology, No.300, Sec.1, Wanshou Rd., Guishan Dist., Taoyuan, 333326, Taiwan, ROC
| | - Yu-Tzu Huang
- College of Medicine, Fu Jen Catholic University, No.300, Sec.1, Wanshou Rd., Guishan Dist., Taoyuan, 333326, Taiwan, ROC
| | - Yunn-Shiuan Liao
- Department of Mechanical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei, 10617, Taiwan, ROC.
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20
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Chen YC, Liao HJ, Hsu YM, Shen YS, Chang CH. Delivery of Mesenchymal Stem Cell in Dialdehyde Methylcellulose-Succinyl-Chitosan Hydrogel Promotes Chondrogenesis in a Porcine Model. Polymers (Basel) 2022; 14:polym14071474. [PMID: 35406348 PMCID: PMC9002496 DOI: 10.3390/polym14071474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 02/04/2023] Open
Abstract
Due to the limitation in the current treatment modalities, such as secondary surgery in ACI and fibrocartilage formation in microfracture surgery, various scaffolds or hydrogels have been developed for cartilage regeneration. In the present study, we used sodium periodate to oxidize methylcellulose and formed dialdehyde methylcellulose (DAC) after dialysis and freeze-drying process, DAC was further mixed with succinyl-chitosan (SUC) to form an DAC-SUC in situ forming hydrogel. The hydrogel is a stiffness, elastic-like and porous hydrogel according to the observation of SEM and rheological analysis. DAC-SUC13 hydrogel possess well cell-compatibility as well as biodegradability. Most bone marrow mesenchymal stem cells (BM-pMSCs) were alive in the hydrogel and possess chondrogenesis potential. According to the results of animal study, we found DAC-SUC13 hydrogel can function as a stem cell carrier to promote glycosaminoglycans and type II collagen synthesis in the osteochondral defects of porcine knee. These findings suggested that DAC-SUC13 hydrogel combined with stem cell is a potential treatment for cartilage defects repair in the future.
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Affiliation(s)
- Yu-Chun Chen
- Department of Chemical Engineering, National United University, Miaoli 360302, Taiwan;
| | - Hsiu-Jung Liao
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (H.-J.L.); (Y.-M.H.); (Y.-S.S.)
| | - Yuan-Ming Hsu
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (H.-J.L.); (Y.-M.H.); (Y.-S.S.)
| | - Yi-Shan Shen
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (H.-J.L.); (Y.-M.H.); (Y.-S.S.)
- Department of Biomedical Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan; (H.-J.L.); (Y.-M.H.); (Y.-S.S.)
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City 320315, Taiwan
- Correspondence:
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21
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Wu CL, Liu SF, Yu TL, Shih SJ, Chang CH, Yang Mao SF, Li YS, Chen HJ, Chen CC, Chao WC. Deep Learning-Based Pain Classifier Based on the Facial Expression in Critically Ill Patients. Front Med (Lausanne) 2022; 9:851690. [PMID: 35372435 PMCID: PMC8968070 DOI: 10.3389/fmed.2022.851690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivePain assessment based on facial expressions is an essential issue in critically ill patients, but an automated assessment tool is still lacking. We conducted this prospective study to establish the deep learning-based pain classifier based on facial expressions.MethodsWe enrolled critically ill patients during 2020–2021 at a tertiary hospital in central Taiwan and recorded video clips with labeled pain scores based on facial expressions, such as relaxed (0), tense (1), and grimacing (2). We established both image- and video-based pain classifiers through using convolutional neural network (CNN) models, such as Resnet34, VGG16, and InceptionV1 and bidirectional long short-term memory networks (BiLSTM). The performance of classifiers in the test dataset was determined by accuracy, sensitivity, and F1-score.ResultsA total of 63 participants with 746 video clips were eligible for analysis. The accuracy of using Resnet34 in the polychromous image-based classifier for pain scores 0, 1, 2 was merely 0.5589, and the accuracy of dichotomous pain classifiers between 0 vs. 1/2 and 0 vs. 2 were 0.7668 and 0.8593, respectively. Similar accuracy of image-based pain classifier was found using VGG16 and InceptionV1. The accuracy of the video-based pain classifier to classify 0 vs. 1/2 and 0 vs. 2 was approximately 0.81 and 0.88, respectively. We further tested the performance of established classifiers without reference, mimicking clinical scenarios with a new patient, and found the performance remained high.ConclusionsThe present study demonstrates the practical application of deep learning-based automated pain assessment in critically ill patients, and more studies are warranted to validate our findings.
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Affiliation(s)
- Chieh-Liang Wu
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan
- Artificial Intelligence Studio, Taichung Veterans General Hospital, Taichung, Taiwan
- Colledge of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Shu-Fang Liu
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tian-Li Yu
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Sou-Jen Shih
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Hung Chang
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Shih-Fang Yang Mao
- Electronic and Optoelectronic System Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Yueh-Se Li
- Electronic and Optoelectronic System Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Hui-Jiun Chen
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Chen Chen
- Electronic and Optoelectronic System Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
- *Correspondence: Chia-Chen Chen
| | - Wen-Cheng Chao
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Colledge of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
- Big Data Center, National Chung Hsing University, Taichung, Taiwan
- Wen-Cheng Chao
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22
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Liao HJ, Chang CH, Huang CYF, Chen HT. Potential of Using Infrapatellar–Fat–Pad–Derived Mesenchymal Stem Cells for Therapy in Degenerative Arthritis: Chondrogenesis, Exosomes, and Transcription Regulation. Biomolecules 2022; 12:biom12030386. [PMID: 35327578 PMCID: PMC8945217 DOI: 10.3390/biom12030386] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
Infrapatellar fat pad–derived mesenchymal stem cells (IPFP-MSCs) are a type of adipose-derived stem cell (ADSC). They potentially contribute to cartilage regeneration and modulation of the immune microenvironment in patients with osteoarthritis (OA). The ability of IPFP-MSCs to increase chondrogenic capacity has been reported to be greater, less age dependent, and less affected by inflammatory changes than that of other MSCs. Transcription-regulatory factors strictly regulate the cartilage differentiation of MSCs. However, few studies have explored the effect of transcriptional factors on IPFP-MSC-based neocartilage formation, cartilage engineering, and tissue functionality during and after chondrogenesis. Instead of intact MSCs, MSC-derived extracellular vesicles could be used for the treatment of OA. Furthermore, exosomes are increasingly being considered the principal therapeutic agent in MSC secretions that is responsible for the regenerative and immunomodulatory functions of MSCs in cartilage repair. The present study provides an overview of advancements in enhancement strategies for IPFP-MSC chondrogenic differentiation, including the effects of transcriptional factors, the modulation of released exosomes, delivery mechanisms for MSCs, and ethical and regulatory points concerning the development of MSC products. This review will contribute to the understanding of the IPFP-MSC chondrogenic differentiation process and enable the improvement of IPFP-MSC-based cartilage tissue engineering.
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Affiliation(s)
- Hsiu-Jung Liao
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan;
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan;
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City 320315, Taiwan
- Correspondence: (C.-H.C.); (H.-T.C.)
| | - Chi-Ying F. Huang
- Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
- Institute of Biopharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Hui-Ting Chen
- Department of Pharmacy, School of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Correspondence: (C.-H.C.); (H.-T.C.)
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23
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Hays RD, Chang CH. 2022 Update to state of the journal of patient-reported outcomes. J Patient Rep Outcomes 2022; 6:4. [PMID: 35020063 PMCID: PMC8755859 DOI: 10.1186/s41687-022-00412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Ron D Hays
- University of California, Los Angeles, USA.
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24
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Chang CH, Chang CH, Yang YW, Chen HY, Yang SJ, Yao WC, Chao CY. Quaternized Amphiphilic Block Copolymers as Antimicrobial Agents. Polymers (Basel) 2022; 14:250. [PMID: 35054658 PMCID: PMC8781064 DOI: 10.3390/polym14020250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/22/2021] [Accepted: 01/04/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, a novel polystyrene-block-quaternized polyisoprene amphipathic block copolymer (PS-b-PIN) is derived from anionic polymerization. Quaternized polymers are prepared through post-quaternization on a functionalized polymer side chain. Moreover, the antibacterial activity of quaternized polymers without red blood cell (RBCs) hemolysis can be controlled by block composition, side chain length, and polymer morphology. The solvent environment is highly related to the polymer morphology, forming micelles or other structures. The polymersome formation would decrease the hemolysis and increase the electron density or quaternized groups density as previous research and our experiment revealed. Herein, the PS-b-PIN with N,N-dimethyldodecylamine as side chain would form a polymersome structure in the aqueous solution to display the best inhibiting bacterial growth efficiency without hemolytic effect. Therefore, the different single-chain quaternized groups play an important role in the antibacterial action, and act as a controllable factor.
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Affiliation(s)
- Chih-Hao Chang
- Department of Orthopedics, National Taiwan University Hospital Jin-Shan Branch, No. 7, Yulu Rd., Wuhu Village, Jinshan Dist., New Taipei City 20844, Taiwan
- Department of Orthopedics, National Taiwan University College of Medicine, National Taiwan University Hospital, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan;
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banciao Dist., New Taipei City 220, Taiwan;
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, No. 135, Yuan-Tung Road, Chuang-Li Dist., Taoyuan 320, Taiwan
| | - Ya-Wen Yang
- Department of Surgery, National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Taipei 10002, Taiwan;
| | - Hsuan-Yu Chen
- Department of Orthopedics, National Taiwan University College of Medicine, National Taiwan University Hospital, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan;
| | - Shu-Jyuan Yang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei 100, Taiwan;
| | - Wei-Cheng Yao
- Department of Anesthesiology and Pain Medicine, Min-Sheng General Hospital, No. 168, Ching-Kuo Rd., Taoyuan 330, Taiwan;
| | - Chi-Yang Chao
- Department of Materials Science and Engineering, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei 10617, Taiwan
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25
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Lai CC, Wang TM, Chang CH, Pao JL, Fang HW, Chang CC, Lin SM, Lan TY. Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents. BMC Musculoskelet Disord 2021; 22:977. [PMID: 34814872 PMCID: PMC8609868 DOI: 10.1186/s12891-021-04855-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background Evans calcaneal lengthening osteotomy is used to treat symptomatic flexible flatfoot when conservative treatment fails. Grafts such as autologous iliac bone grafts, allografts, and xenografts are implanted at the osteotomy site to lengthen the lateral column of the hindfoot. This study aimed to present the outcomes of an autologous mid-fibula bone graft used for calcaneal lengthening in symptomatic pes valgus in adolescents. Methods We retrospectively examined 23 ft of 13 adolescents who underwent surgery between July 2014 and January 2018. The radiological and clinical outcomes (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale scores) were assessed during a mean follow-up of 49.7 (range, 30.9–73.4) months. The mean distance of the lengthening site was measured to evaluate graft sinking or collapse. The Goldberg scoring system was used to determine the degree of union at the donor and recipient sites. Results The calcaneal pitch and the anteroposterior and lateral talo-first metatarsal (Meary) angles showed significant correction, from 14.4 to 19.6 (p < 0.001), and from 14.5 to 4.6 (p < 0.001) and 13.5 to 8.5 (p < 0.001), respectively. The mean distance of the lengthening site showed no significant change (p = 0.203), suggesting no graft sinking or postoperative collapse. The lateral distal tibial angle showed no significant difference (p = 0.398), suggesting no postoperative ankle valgus changes. Healing of the recipient and donor sites occurred in 23 and 21 ft, respectively. The American Orthopaedic Foot and Ankle Society ankle-hindfoot scores improved significantly, from 68.0 to 98.5 (p < 0.001). Conclusions Evans calcaneal lengthening using an ipsilateral mid-fibula bone autograft resulted in significant improvement in clinical and radiological outcomes without ankle valgus deformity. Hence, it could be a treatment option for lateral column calcaneal lengthening in adolescents.
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Affiliation(s)
- Chien-Cheng Lai
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City, 220, Taiwan.,Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Ting-Ming Wang
- Department of Orthopedic Surgery, School of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City, 220, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Jwo-Luen Pao
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City, 220, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Chun-Chien Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City, 220, Taiwan
| | - Shang-Ming Lin
- Department of Materials and Textiles, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
| | - Tsung-Yu Lan
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., New Taipei City, 220, Taiwan. .,Department of Orthopedic Surgery, School of Medicine, National Taiwan University Hospital, Taipei, Taiwan. .,Department of Materials and Textiles, Asia Eastern University of Science and Technology, New Taipei City, Taiwan.
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26
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Chen HH, Chen YC, Yu SN, Lai WL, Shen YS, Shen PC, Lin SH, Chang CH, Lee SM. Infrapatellar fat pad-derived mesenchymal stromal cell product for treatment of knee osteoarthritis: a first-in-human study with evaluation of the potency marker. Cytotherapy 2021; 24:72-85. [PMID: 34696962 DOI: 10.1016/j.jcyt.2021.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 08/16/2021] [Accepted: 08/22/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND AIMS Infrapatellar fat pad-derived mesenchymal stromal cells (IFP-MSCs) have not yet been used in a human clinical trial. In this open-label phase 1 study, patients with knee osteoarthritis (OA) received a single intra-articular injection of autologous IFP-MSCs. Safety was assessed through physical examination of the knee joint, vital signs, laboratory tests and adverse events. Efficacy was evaluated with regard to pain and function using questionnaires, x-ray and magnetic resonance imaging (MRI). Indoleamine-2,3-dioxygenase (IDO) expression in IFP-MSCs primed with interferon gamma was used as an in vitro potency measurement in investigating the correlations of clinical outcomes. METHODS Twelve patients with symptomatic knee OA were recruited. IFP adipose tissue was harvested from each patient's knee through surgical excision for IFP-MSC manufacturing. Cryopreserved IFP-MSCs (5 × 107 cells) were injected into the knee joint immediately after thawing. RESULTS No significant adverse events were observed. Patients who received IFP-MSCs exhibited clinically significant pain and functional improvement at 48-week follow-up. The MRI Osteoarthritis Knee Score average was also significantly reduced from 100.2 before injection to 85.0 at 48 weeks after injection. The IDO expression of the primed IFP-MSCs of the 12 patients was correlated with clinical outcomes after injection. CONCLUSIONS A single intra-articular injection of IFP-MSCs appears to be a safe therapy for treating knee OA and may improve disease symptoms. IDO measurement of primed IFP-MSCs has potential as a potency marker of MSC products for immunomodulatory therapy.
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Affiliation(s)
- Hung-Hsuan Chen
- Research and Development Department, EMO Biomedicine Corporation, New Taipei City, Taiwan
| | - Yu-Chun Chen
- Department of Chemical Engineering, National United University, Miaoli City, Taiwan
| | - San-Ni Yu
- Research and Development Department, EMO Biomedicine Corporation, New Taipei City, Taiwan
| | - Wan-Ling Lai
- Research and Development Department, EMO Biomedicine Corporation, New Taipei City, Taiwan
| | - Yi-Shan Shen
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei City, Taiwan
| | - Pei-Chun Shen
- Research and Development Department, EMO Biomedicine Corporation, New Taipei City, Taiwan
| | - Siao-Han Lin
- Research and Development Department, EMO Biomedicine Corporation, New Taipei City, Taiwan
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Shing-Mou Lee
- Research and Development Department, EMO Biomedicine Corporation, New Taipei City, Taiwan.
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27
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Chen YT, Liu WS, Su KY, Hsu YH, Chang CH. Acute heart failure with dilated cardiomyopathy as the first manifestation of eosinophilic granulomatosis with polyangiitis. J Eur Acad Dermatol Venereol 2021; 36:e125-e128. [PMID: 34553425 DOI: 10.1111/jdv.17693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/26/2021] [Accepted: 09/16/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Y T Chen
- Department of Dermatology, Skin Institute, Hualian Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - W S Liu
- Department of Cardiovascular Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - K Y Su
- Division of Allergy, Immunology and Rheumatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Y H Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - C H Chang
- Department of Dermatology, Skin Institute, Hualian Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.,Doctoral Degree Program in Translational Medicine, Tzu Chi University and Academia Sinica, Hualien, Taiwan
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28
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Liu YL, Yen CC, Liu TST, Chang CH, Shih TTF, Wang JH, Yang MC, Lin FH, Liu HC. Safety and Efficacy of Kartigen ® in Treating Cartilage Defects: A Randomized, Controlled, Phase I Trial. Polymers (Basel) 2021; 13:polym13183029. [PMID: 34577930 PMCID: PMC8466236 DOI: 10.3390/polym13183029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 01/18/2023] Open
Abstract
Here, we aimed to investigate the safety and preliminary efficacy of Kartigen®, a matrix with autologous bone marrow mesenchymal stem cell-derived chondrocyte precursors embedded in atelocollagen. As a surgical graft, Kartigen® was implanted onto the cartilage defects at the weight-bearing site of the medial femoral condyle of the knee. Fifteen patients were enrolled and stratified into two groups, undergoing either Kartigen® implantation (n = 10) or microfracture (control group, n = 5). The primary endpoint was to evaluate the safety of Kartigen® by monitoring the occurrence of adverse events through physician queries, physical examinations, laboratory tests, and radiological analyses for 2 years. There were no infections, inflammations, adhesions, loose body, or tumor formations in the Kartigen®-implanted knees. The preliminary efficacy was assessed using the International Knee Documentation Committee (IKDC) score, visual analog scale, and second-look arthroscopy. The postoperative IKDC scores of the Kartigen® group significantly improved in the 16th week (IKDC = 62.1 ± 12.8, p = 0.025), kept increasing in the first year (IKDC = 78.2 ± 15.4, p < 0.005), and remained satisfactory in the second year (IKDC = 73.6 ± 13.8, p < 0.005), compared to the preoperative condition (IKDC = 47.1 ± 17.0), while the postoperative IKDC scores of the control group also achieved significant improvement in the 28th week (IKDC = 68.5 ± 6.1, p = 0.032) versus preoperative state (IKDC = 54.0 ± 9.1). However, the IKDC scores decreased in the first year (IKDC = 63.5 ± 11.6) as well as in the second year (IKDC = 52.6 ± 16.4). Thirteen patients underwent second-look arthroscopy and biopsy one year after the operation. The Kartigen® group exhibited integration between Kartigen® and host tissue with a smooth appearance at the recipient site, whereas the microfracture group showed fibrillated surfaces. The histological and immunohistochemical analyses of biopsy specimens demonstrated the columnar structure of articular cartilage and existence of collagen type II and glycosaminoglycan mimic hyaline cartilage. This study indicates that Kartigen® is safe and effective in treating cartilage defects.
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Affiliation(s)
- Yen-Liang Liu
- Master Program for Biomedical Engineering, College of Biomedical Engineering, China Medical University, Taichung 406040, Taiwan;
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 406040, Taiwan
| | - Chun-Che Yen
- Kartigen Biomedical Inc., Taipei 100047, Taiwan;
| | | | - Chih-Hung Chang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei 220216, Taiwan;
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan 320315, Taiwan
| | - Tiffany Ting-Fang Shih
- Department of Medical Imaging and Radiology, National Taiwan University Hospital, Taipei 100225, Taiwan;
| | - Jyh-Horng Wang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei 100225, Taiwan;
| | - Ming-Chia Yang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 310401, Taiwan;
| | - Feng-Huei Lin
- Department of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei 106319, Taiwan;
| | - Hwa-Chang Liu
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei 100225, Taiwan;
- Department of Orthopaedic Surgery, Taiwan Adventist Hospital, Taipei 105404, Taiwan
- Correspondence:
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Doddapaneni VVK, Lee K, Colbert TT, Mirzababaei S, Paul BK, Pasebani S, Chang CH. A Scalable Solution Route to Porous Networks of Nanostructured Black Tungsten. Nanomaterials (Basel) 2021; 11:nano11092304. [PMID: 34578620 PMCID: PMC8465037 DOI: 10.3390/nano11092304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/29/2021] [Accepted: 08/31/2021] [Indexed: 11/25/2022]
Abstract
This paper studied the feasibility of a new solution-processed method to manufacture black tungsten nanostructures by laser conversion of tungsten hexacarbonyl precursor on the Inconel 625 substrate under argon atmosphere at ambient pressure. The results show that sublimation of the precursor can be prevented if the decomposition temperature (>170 °C) is achieved using the laser heating method. Three different laser powers from 60–400 W were used to investigate the role of laser parameters on the conversion. It was found that lower laser power of 60 W resulted in a mixture of unconverted precursor and converted tungsten. Higher laser powers >200 W resulted in α-W (BCC) in one step without further heat treatment. Different oxygen concentrations from 0.5 ppm to 21 vol% were used in the laser canister to investigate the effect of oxygen concentration on the conversion. It was found that the hard vacuum (>10−4 torr) or hydrogen is not necessary to obtain α-W (BCC). The solar absorptance varied from 63–97%, depending on the amount of precursor deposited on the substrate and oxygen content in the laser canister. This solution-based laser conversion of tungsten precursor is a scalable method to manufacture tungsten coatings for high-temperature applications.
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Affiliation(s)
- V. Vinay K. Doddapaneni
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, OR 97331, USA; (V.V.K.D.); (T.T.C.)
| | - Kijoon Lee
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (K.L.); (S.M.); (B.K.P.); (S.P.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA
| | - Tyler T. Colbert
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, OR 97331, USA; (V.V.K.D.); (T.T.C.)
| | - Saereh Mirzababaei
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (K.L.); (S.M.); (B.K.P.); (S.P.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA
| | - Brian K. Paul
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (K.L.); (S.M.); (B.K.P.); (S.P.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA
| | - Somayeh Pasebani
- School of Mechanical, Industrial and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331, USA; (K.L.); (S.M.); (B.K.P.); (S.P.)
- Advanced Technology and Manufacturing Institute (ATAMI), Corvallis, OR 97330, USA
| | - Chih-Hung Chang
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, OR 97331, USA; (V.V.K.D.); (T.T.C.)
- Correspondence: ; Tel.: +1-541-737-8548
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Hoyt CR, L’Hotta AJ, Bauer AH, Chang CH, Varughese TE, Abel RA, King A. Activity Engagement Among Infants and Toddlers With Developmental Disabilities: Rasch Analysis of the Infant Toddler Activity Card Sort (ITACS). Am J Occup Ther 2021. [DOI: 10.5014/ajot.2021.75s2-rp3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Date Presented 04/9/21
Development in the first years of life is often characterized by a child’s aptitude to complete discrete tasks, such as walking or stacking blocks. True participation requires the child to incorporate skills into everyday activities. This presentation will provide an overview of the Infant Toddler Activity Card Sort, the initial psychometrics, and a Rasch analysis.
Primary Author and Speaker: Catherine R. Hoyt
Contributing Authors: Ching-Fan Sheu
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Affiliation(s)
| | | | - Anna H. Bauer
- Washington University in St. Louis, Saint Louis, MO, USA
| | | | | | - Regina A. Abel
- Washington University in St. Louis, Saint Louis, MO, USA
| | - Allison King
- Washington University in St. Louis, Saint Louis, MO, USA
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Hsu TL, Li TC, Lai FP, Ouhyoung M, Chang CH, Wang CT. Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report. J Int Med Res 2021; 49:3000605211028415. [PMID: 34282643 PMCID: PMC8295961 DOI: 10.1177/03000605211028415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/08/2021] [Indexed: 11/19/2022] Open
Abstract
Fat embolism syndrome (FES) is a complication of long bone fractures that often occurs within 72 hours of injury. Early-onset isolated cerebral fat embolism is catastrophic and rarely reported. We herein present a rare case of delayed-onset isolated cerebral FES that developed 10 days after definite fixation of a left tibial plateau fracture. A 70-year-old woman was injured in a traffic accident and diagnosed with a left tibial plateau fracture. However, she developed sudden loss of consciousness (E4V1M1) and quadriplegia 10 days after fracture fixation. Her vital signs showed no respiratory distress. Diagnosis of isolated cerebral FES was made based on magnetic resonance imaging of the brain, the findings of which were compatible with the clinical neurological findings. After supportive care and rehabilitation, her consciousness became clear on the second day of admission, and her consciousness changed to E4V5M6. She gradually regained strength in her right limbs but had residual left limb paraplegia. Isolated cerebral FES should always be considered for patients who develop a change in consciousness, even beyond 72 hours after injury. Imaging may not initially show definitive abnormalities. Repeated magnetic resonance imaging should be considered if the initial clinical presentation does not fully meet Gurd's criteria.
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Affiliation(s)
- Ta-Li Hsu
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City
| | - Tien-Chi Li
- Department of Radiology, Far Eastern Memorial Hospital, New Taipei City
| | - Fei-Pi Lai
- Graduate Institute of Networking and Multimedia, National Taiwan University, New Taipei City
| | - Ming Ouhyoung
- Graduate Institute of Networking and Multimedia, National Taiwan University, New Taipei City
| | - Chih-Hung Chang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City
| | - Cheng-Tzu Wang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City
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Liang ZC, Chong MSY, Liu GKP, Valle AGD, Wang D, Lyu X, Chang CH, Cho TJ, Haas SB, Fisher D, Murphy D, Hui JHP. COVID-19 and Elective Surgery: 7 Practical Tips for a Safe, Successful, and Sustainable Reboot. Ann Surg 2021; 273:e39-e40. [PMID: 32433295 PMCID: PMC7268862 DOI: 10.1097/sla.0000000000004091] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Zhen Chang Liang
- Department of Orthopaedic Surgery, National University of Singapore, National University Health System, Singapore
| | - Mark Seng Ye Chong
- Department of Orthopaedic Surgery, National University of Singapore, National University Health System, Singapore
| | - Gabriel Ka Po Liu
- Department of Orthopaedic Surgery, National University of Singapore, National University Health System, Singapore
| | | | - Dahui Wang
- National Children's Medical Center & Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xuemin Lyu
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Xicheng, People's Republic of China
| | - Chih-Hung Chang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
- Division of Infectious Disease, National University Hospital, Singapore
| | - Tae-Joon Cho
- Division of Paediatric Orthopaedics, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Korea
| | | | - Dale Fisher
- Division of Infectious Disease, National University Hospital, Singapore
- Division of Paediatric Orthopaedics, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Korea
| | - Diarmuid Murphy
- Department of Orthopaedic Surgery, National University of Singapore, National University Health System, Singapore
| | - James Hoi Po Hui
- Department of Orthopaedic Surgery, National University of Singapore, National University Health System, Singapore
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Wu K, Chen YC, Lin SM, Chang CH. In vitro and in vivo effectiveness of a novel injectable calcitonin-loaded collagen/ceramic bone substitute. J Biomater Appl 2021; 35:1355-1365. [PMID: 33522363 DOI: 10.1177/0885328221989984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study aimed to evaluate the effectiveness of a novel calcitonin-loaded calcium phosphate composite bone cement in vitro and in vivo. The novel composite bone cements were composed of NuROs injectable bone graft substitute, type I collagen, and/or salmon calcitonin. The setting time, porosity, wettability, compressive strength, compressive modulus, and crystallographic structures of cement specimens were determined. Degradation rate, calcitonin release rate, and osteoinductivity were assessed in vitro. In addition, osteogenic effect was examined in a rabbit model of femoral defect. The results revealed that addition of collagen/calcitonin did not substantially alter physical properties and degradation rate of bone cement specimens. Calcitonin was released into culture medium in a two-phase manner. Osteogenic effect of conditioned medium derived from calcitonin containing bone cement was observed. Finally, de novo bone growth and bone mineralization across the bone defect area were observed in rabbits after implantation of composite bone cement specimens. In conclusion, this novel calcitonin-loaded composite calcium phosphate bone cement exhibits biocompatibility, bioresorbability, osteoinductivity, and osteoconductivity, which may be suitable for clinical use.
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Affiliation(s)
- Karl Wu
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Materials and Textiles, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Yu-Chun Chen
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,College of General Studies, Yuan Ze University, Taoyuan City, Taiwan
| | - Shang M Lin
- Department of Materials and Textiles, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, Taiwan
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34
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Hoyt CR, L'Hotta AJ, Bauer AH, Chang CH, Varughese TE, Abel RA, King AA. Activity competence among infants and toddlers with developmental disabilities: Rasch analysis of the Infant Toddler Activity Card Sort (ITACS). J Patient Rep Outcomes 2021; 5:14. [PMID: 33475869 PMCID: PMC7818375 DOI: 10.1186/s41687-021-00287-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Development is rapid in the first years of life. Developmental delays appearing during this critical period have the potential to persist throughout the child’s life. Available standardized assessments for this age record a child’s ability to successfully complete discrete skills but fail to capture whether the child incorporates those skills into daily routines that are meaningful to the child and family. The Infant Toddler Activity Card Sort (ITACS) is a newly developed photograph-based early intervention tool to measure the participation-related concept of activity competence using caregiver report. The purpose of the present study was to use Rasch analysis to determine if ITACS items comprehensively measure the construct of child activity competence. Results A total of 60 child/caregiver dyads participated. The dichotomous caregiver-reported responses (present vs. absent) on the 40 individual ITACS items were used in Rasch analysis, and three iterations of the model were completed. The final model included 51 child/caregiver dyads and 67 ITACS assessments with a good spread of individual ability measure (6.47 logits). All items demonstrated adequate infit except for “sleeping” (range 0.68–1.54). Five items (sleeping, eating at restaurants, brushing teeth, crawling, and interact with pets) demonstrated high Mean Square (MNSQ) outfit statistics and one (take a bath) demonstrated low MNSQ outfit. ITACS items demonstrated a good spread of item difficulty measures (6.27 logits), and a clear ceiling was observed. Three activity items (smiling, breastfeeding, and playing with adults) were rarely endorsed as concerns. The activities most likely to be reported as challenging were “crying/communicating” and “going to school”. Person and item reliability statistics were adequate (0.79 and 0.80, respectively). The separation between individuals and between items were adequate to good (1.96 and 1.99, respectively). Conclusions Findings indicate that ITACS items are measuring a unidimensional construct--activity competence in early childhood. The Rasch analysis of caregiver responses suggest that some activities are more likely to be considered challenging and may be important targets for intervention. These results provide evidence to further validate the ITACS as a caregiver report measure and support its use in the early intervention setting to facilitate caregiver driven goal development.
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Affiliation(s)
- Catherine R Hoyt
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA.
| | - Allison J L'Hotta
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA
| | - Anna H Bauer
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA.,Institute of Informatics, Washington University School of Medicine, St. Louis, MO, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Taniya E Varughese
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA
| | - Regina A Abel
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Allison A King
- Program in Occupational Therapy, Washington University School of Medicine, 4444 Forest Park Blvd, MSC 8505-66-1, MO, 63108, St. Louis, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.,Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA.,Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Institute of Public Health, Washington University School of Medicine, St. Louis, MO, USA
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Hays RD, Chang CH. State of the Journal of Patient-Reported Outcomes. J Patient Rep Outcomes 2021; 5:11. [PMID: 33471203 PMCID: PMC7817729 DOI: 10.1186/s41687-021-00284-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Ron D Hays
- University of California, Los Angeles, USA.
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36
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Li Y, Xiong C, Aschenbrenner AJ, Chang CH, Weiner MW, Nosheny RL, Mungas D, Bateman RJ, Hassenstab J, Moulder KL, Morris JC. Item response theory analysis of the Clinical Dementia Rating. Alzheimers Dement 2020; 17:534-542. [PMID: 33215873 DOI: 10.1002/alz.12210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/10/2020] [Accepted: 09/18/2020] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The Clinical Dementia Rating (CDR) is widely used in Alzheimer's disease research studies and has well established reliability and validity. To facilitate the development of an online, electronic CDR (eCDR) for more efficient clinical applications, this study aims to produce a shortened version of the CDR, and to develop the statistical model for automatic scoring. METHODS Item response theory (IRT) was used for item evaluation and model development. An automatic scoring algorithm was validated using existing CDR global and domain box scores as the reference standard. RESULTS Most CDR items discriminate well at mild and very mild levels of cognitive impairment. The bi-factor IRT model fits best and the shortened CDR still demonstrates very high classification accuracy (81%∼92%). DISCUSSION The shortened version of the CDR and the automatic scoring algorithm has established a good foundation for developing an eCDR and will ultimately improve the efficiency of cognitive assessment.
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Affiliation(s)
- Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andrew J Aschenbrenner
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chih-Hung Chang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA.,Institute for Informatics, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael W Weiner
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,San Francisco Veteran's Administration Medical Center, San Francisco, California, USA
| | - Rachel L Nosheny
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
| | - Dan Mungas
- Department of Neurology, University of California, Davis, Davis, California, USA
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Krista L Moulder
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
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Kim KI, Guo Q, Tang L, Zhu L, Pan C, Chang CH, Razink J, Lerner MM, Fang C, Ji X. Reversible Insertion of Mg-Cl Superhalides in Graphite as a Cathode for Aqueous Dual-Ion Batteries. Angew Chem Int Ed Engl 2020; 59:19924-19928. [PMID: 32710468 DOI: 10.1002/anie.202009172] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Indexed: 11/08/2022]
Abstract
Oxidative anion insertion into graphite in an aqueous environment represents a significant challenge in the construction of aqueous dual-ion batteries. In dilute aqueous electrolytes, the oxygen evolution reaction (OER) dominates the anodic current before anions can be inserted into the graphite gallery. Herein, we report that the reversible insertion of Mg-Cl superhalides in graphite delivers a record-high reversible capacity of 150 mAh g-1 from an aqueous deep eutectic solvent comprising magnesium chloride and choline chloride. The insertion of Mg-Cl superhalides in graphite does not form staged graphite intercalation compounds; instead, the insertion of Mg-Cl superhalides makes the graphite partially turbostratic.
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Affiliation(s)
- Keun-Il Kim
- Department of Chemistry, Oregon State University, Corvallis, OR, 97331-4003, USA
| | - Qiubo Guo
- Department of Chemistry, Oregon State University, Corvallis, OR, 97331-4003, USA
| | - Longteng Tang
- Department of Chemistry, Oregon State University, Corvallis, OR, 97331-4003, USA
| | - Liangdong Zhu
- Department of Chemistry, Oregon State University, Corvallis, OR, 97331-4003, USA
| | - Changqing Pan
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, OR, 97331-4002, USA
| | - Chih-Hung Chang
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, OR, 97331-4002, USA
| | - Joshua Razink
- CAMCOR, University of Oregon, Eugene, OR, 97403-1241, USA
| | - Michael M Lerner
- Department of Chemistry, Oregon State University, Corvallis, OR, 97331-4003, USA
| | - Chong Fang
- Department of Chemistry, Oregon State University, Corvallis, OR, 97331-4003, USA
| | - Xiulei Ji
- Department of Chemistry, Oregon State University, Corvallis, OR, 97331-4003, USA
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L'Hotta AJ, Hoyt CR, Lindsey T, Abel RA, Chang CH, King AA. Validation of the fine motor subtest of the Bayley-III with children with sickle cell disease using Rasch analysis. Child Care Health Dev 2020; 46:576-584. [PMID: 32599661 DOI: 10.1111/cch.12795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 06/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children with sickle cell disease (SCD) are at risk for fine motor (FM) delays; however, screening for FM impairments is not common among young children with SCD. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) is the most commonly used performance-based developmental assessment. We aim to determine if the FM subtest of the Bayley-III is structured hierarchically in accordance with development and comprehensively evaluates FM development in children with SCD. METHODS Bayley-III assessments were completed between October 2009 and December 2013. The Bayley-III FM screening test, a shorter and more rapid method of assessing for FM impairments, was not directly administered to participants. Screening test scores were calculated from full Bayley-III scores. RESULTS Rasch analysis was performed using WINSTEPS. Sixty children with SCD were included in the final Rasch model. The Rasch-generated Wright map, which jointly positions items and persons on the same latent trait, illustrated that the FM items were slightly skewed towards more challenging items, indicating more difficult items may be overrepresented. High item separation values were reported (17.4), and item outfit statistics were less than 1.7. More than one third of items demonstrated overfit, indicating possible item redundancy. The FM subtest and the screening test, a shorter and faster method of assessing skills, were highly correlated (r = 0.993, p < 0.001). CONCLUSION The Bayley-III FM subtest is structured hierarchically, aligning with motor development, and comprehensively evaluates FM development in children with SCD. The test could be improved by reordering items, removing overfitting items and modifying screening test items to capture all ranges of development. The screening test is comprehensive and has high potential clinical utility among children with SCD.
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Affiliation(s)
| | | | - Terianne Lindsey
- School of Medicine, Washington University, St. Louis, Missouri.,Department of Hematology and Oncology, St. Louis Children's Hospital, St. Louis, Missouri
| | - Regina A Abel
- School of Medicine, Washington University, St. Louis, Missouri
| | - Chih-Hung Chang
- School of Medicine, Washington University, St. Louis, Missouri
| | - Allison A King
- School of Medicine, Washington University, St. Louis, Missouri.,Department of Hematology and Oncology, St. Louis Children's Hospital, St. Louis, Missouri
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Lin CR, Fan KH, Lin CY, Hung TM, Huang BS, Chen EYC, Kang CJ, Huang SF, Chang JTC, Chang CH. Development and evaluation of a computerized clinical outcome assessment tool for head and neck cancer patients. Medicine (Baltimore) 2020; 99:e20304. [PMID: 32846748 PMCID: PMC7447395 DOI: 10.1097/md.0000000000020304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Paper-based clinical outcome data collection methods have practical limitations when used in clinical settings, as the data are often not summarized in time to facilitate patient-physician communications and therefore cannot be used in clinical decision making. This study aimed to develop a computerized clinical outcome assessment tool (COAT) and evaluate its acceptability, feasibility, and potential clinical applications during clinical encounters for patients with head and neck cancer (HNC).The traditional Chinese (TChi) character version of the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) questionnaire was first transcribed and implemented into a touch-screen computerized administration and reporting system (COAT-HNC for short). Each HNC patient was invited to complete the COAT-HNC during their scheduled clinic visits as part of their clinical care. Upon completion, a structured summary report was generated, and subsequently used for treatment evaluation and planning.A cohort of 385 HNC patients were enrolled. Each scale of the computerized TChi FACT-H&N questionnaire demonstrated acceptable internal consistency, with Cronbach coefficient alpha ranging from 0.74 to 0.90. The touch-screen-based and audio-capable COAT-HNC was reported to be easy to use. Patients and physicians were able to utilize the summary report during their clinical encounters to discuss treatment progress and to plan care.It is practically feasible to design, develop, and implement the COAT-HNC system in routine HNC care. The COAT-HNC has the potential to become a valuable tool for data collection and management of clinical outcomes, and appears useful for HNC patients. However, larger studies to demonstrate its clinical usefulness are still needed.
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Affiliation(s)
- Ching-Rong Lin
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
| | - Kang-Hsing Fan
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
- Chang Gung University, Tao-Yuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
- Chang Gung University, Tao-Yuan, Taiwan
| | - Tsung-Min Hung
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
| | - Bing-Shen Huang
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
| | - Eric Yen-Chao Chen
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Chung-Jan Kang
- Department of E.N.T., Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
| | - Shiang-Fu Huang
- Department of E.N.T., Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
| | - Joseph Tung-Chieh Chang
- Department of Radiation Oncology, Chang Gung Memorial Hospital at Lin-Kou, Tao-Yuan, Taiwan
- Chang Gung University, Tao-Yuan, Taiwan
- Xiamen Chang Gung Memorial Hospital, Xiamen, Fujian, China
| | - Chih-Hung Chang
- Washington University School of Medicine, St. Louis, MO, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- China Medical University, Taichung, Taiwan
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Lin CJ, Huang YH, Huang KY, Wu SI, Chang YH, Yeh HM, Chang CH, Lin IC, Huang HC, Sun FJ, Berk M, Liu SI. A Randomized Controlled Trial of Transcultural Validation of Group-Based Psychosocial Intervention for Patients with Bipolar Disorder. Psychiatry Res 2020; 290:113139. [PMID: 32512353 DOI: 10.1016/j.psychres.2020.113139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/24/2020] [Accepted: 05/24/2020] [Indexed: 11/25/2022]
Abstract
Adjunctive psychosocial interventions are part of the preferred method to treat bipolar disorder (BD). This study aimed to conduct a randomized control and protocol-guided trial, in order to evaluate the feasibility and effectiveness of adjunctive group-based treatments for Chinese outpatients with BD. A single-blind trial in which 68 outpatients with BD were randomly assigned to either treatment as usual (TAU) or to an experimental group with 12 additional weekly sessions and 3 monthly booster sessions. Participants were assessed at baseline for mood condition, suicidal ideation, medication adherence, and quality of life (QoL), with follow-up assessments every 3 months over a 1-year period. The overall retention rate of this study was 89.7%. The results showed significant differences between groups for the variables evaluated, which included achieving euthymia, decrease of depression symptoms, and improvement of QoL. No improvements in medication adherence, reduction in manic symptoms, or suicidal ideation was observed. The results of this study support the transcultural validity and efficacy of group-based psychosocial intervention as anadjunct to TAU among Chinese outpatients with BD to promote improvements during the course of the illness including achieving euthymia, reducing depressive symptoms, and improving QoL.
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Affiliation(s)
- Chen-Ju Lin
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; Institute of Health and Welfare Policy, National Yang-Ming University
| | - Yu-Hsin Huang
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taipei, Taiwan
| | - Kuo-Yang Huang
- Department of Psychiatry, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Shu-I Wu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; Department of Audiology and Speech Language Pathology, MacKay Medical College, Taipei, Taiwan
| | - Yi-Hung Chang
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hsiao-Mei Yeh
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chih-Hung Chang
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taipei, Taiwan
| | - I-Chieh Lin
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hui-Chun Huang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Michael Berk
- School of Medicine, Deakin University, Victoria, Australia
| | - Shen-Ing Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.
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Chang CH, Lin CS, Ho CL. Isolated intracardiac recurrence of diffuse large B-cell lymphoma successfully treated with rituximab and bendamustine chemotherapy regimen. J Postgrad Med 2020; 66:176-177. [PMID: 32675458 PMCID: PMC7542051 DOI: 10.4103/jpgm.jpgm_683_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/02/2020] [Accepted: 04/23/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- CH Chang
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - CS Lin
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - CL Ho
- Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. E-mail:
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Abstract
Background Unilateral biportal endoscopic (UBE) decompression is a minimally invasive (MI) approach to treat degenerative lumbar canal stenosis (DLCS). Decompression can be performed in a clear and magnified surgical field with proper control of normal saline inflow and outflow. Methods Clinical and radiographic data of 81 consecutive patients of DLCS treated between July 2018 and Feb 2019 using UBE techniques were reviewed. They were 38 males and 43 females with an average age of 70.2. Sixty-nine had pure canal stenosis and 12 patients had associated spondylolisthesis. Bilateral decompression via unilateral laminotomy was performed from the side on patients with more severe neurological symptoms. This is a retrospective study from chart review and image analysis. Therefore, we don't have formal ethical information for this study, and it is not mandatory in our hospital. Results At the final follow-up, the mean VAS for low back pain was improved from 4.3±3.0 to 1.2±1.0 and the VAS for leg symptoms was improved from 7.3±2.2 to 0.9±0.7. The mean JOA score and ODI was significantly improved from 13.3±7.9 to 25.3±5.0 and from 54.6±16.9 to 14.6±12.6, respectively. Modified Macnab criteria were excellent in 47 patients (58.0%), good in 29 (35.8%), fair in 5 (6.2%). The average hospital stay was 3.6±2.4 days. MRI before and after the operation showed the cross-sectional dural area (CSDA) was significantly increased from 71.4±36.5 to 177.3±59.2 mm2, corresponding to a 201.9%±188.0% increase. The percentage of facet joint preservation was 84.2% on the approach side and 92.9% on the contralateral side. Complications included 4 dural tears, 1 transient motor weakness, 1 inadequate decompression, and 1 epidural hematoma. Conclusions With UBE techniques, decompression for DLCS can be performed safely and effectively. The soft tissue and facet joint destruction are minimized; therefore, it is possible to avoid spinal fusion as well as to preserve the segmental stability.
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Affiliation(s)
- Jwo-Luen Pao
- Department of Orthopedic Surgery, Far-Eastern Memorial Hospital, New Taipei
| | - Shang-Ming Lin
- Department of Materials and Textiles, Oriental Institute of Technology, New Taipei
| | - Wen-Chi Chen
- Department of Orthopedic Surgery, Far-Eastern Memorial Hospital, New Taipei
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far-Eastern Memorial Hospital, New Taipei
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He Y, Chen Z, Chang CH. Hydrothermal synthesis and site symmetry tuning of polycrystalline YVO 4:Eu nanoparticles via a continuous-flow microreactor. Nanotechnology 2020; 31:235603. [PMID: 32053797 DOI: 10.1088/1361-6528/ab7605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Yttrium orthovanadate (YVO4) has been widely used as a host material for low- and medium-power diode-pumped solid-state lasers due to its excellent thermal, mechanical, and optical properties. This work demonstrates the synthesis and site symmetry tunning of polycrystalline YVO4:Eu nanoparticles with uniform size and shape using a continuous-flow microreactor at high pressures. High-quality YVO4:Eu nanoparticles were created using a residence time of fewer than 20 s. Carefully controlling the heat flux and flow rate can produce the YVO4:Eu nanoparticles showing different crystallinity, crystal morphologies, site symmetry around Eu3+, and therefore optical emission. The site symmetry of YVO4:Eu is adjusted without any stoichiometric modification of the precursors by simply varying the flow rate and heat flux of the microreactor. The site symmetries of the as-synthesized YVO4:Eu nanoparticles are studied by investigating their photoluminescent emission spectra and computational model of first-principle density functional theory (DFT). The DFT model indicates that the oxygen vacancy influenced the V-O association and the overlap between Eu 4f and V 3d states which can contribute to different optical transitions and, therefore, distinct emission spectrum. The use of a continuous flow microreactor at high pressure provides better understandings of the hydrothermal syntheses of functional nanoparticles and enables scalable manufacturing concurrently.
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Affiliation(s)
- Yujuan He
- School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, Oregon, 97331, United States of America
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Lin JW, Chang CH, Caffrey JL. Examining the association between oral health status and dementia: A nationwide nested case-controlled study. Exp Biol Med (Maywood) 2020; 245:231-244. [PMID: 32039633 DOI: 10.1177/1535370220904924] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Alzheimer’s disease as a consequence of chronic brain inflammation mediated by infectious microbes including the oral microbiome continues to attract support. Taiwan’s National Insurance database was used to evaluate associations between dental health and Alzheimer’s disease; 209,112 new cases of Alzheimer’s disease were matched 1:4 with 836,448 dementia-free controls to test the hypothesis that better dental health would be associated with less occurrence of dementia. Ten year dental records and conditional logistic regression models were used to estimate the odds ratios associated with Alzheimer’s disease. Subgroup analyses compared vascular Alzheimer’s disease and sporadic Alzheimer’s disease. As the population aged, Alzheimer’s disease diagnoses were more frequent with a 10 fold upward inflection after 60. Nearly 56% of sporadic Alzheimer’s disease patients were women but less than 50% had vascular Alzheimer’s disease. Comorbidities were 10–20% higher in the Alzheimer’s disease patients than in controls, but stroke, chronic infection, and pneumonia were 40–45% more common in the vascular Alzheimer’s disease patients. Heart disease, hypertension, diabetes, stroke, peripheral artery disease, pneumonia, and herpetic disease (HSV) were all associated with higher odds of Alzheimer’s disease. HSV was not a factor in the vascular Alzheimer’s disease. Routine dental procedures tended to lower odds ratios. Root canals and extractions that restore oral homeostasis were associated with lower odds of dementia. However, when extractions exceeded four, the odds of Alzheimer’s disease rose. The fact that Alzheimer’s disease was not associated with periodontal procedures per se but with more frequent periodontal emergencies suggested again a chronic issue. Dental health costs suggest that good dental care was associated with lower odds of Alzheimer’s disease except for radiographic costs which were consistently associated with higher odds, independent of oral health. Common comorbid conditions were associated with higher odds of Alzheimer’s disease and oral health care was associated with lower odds, providing support for the hypothesis that the oral microbiome is a factor in the development of Alzheimer’s disease. Impact statement This study clearly demonstrates the power and value of a nationally applied digital medical record. Longitudinal studies of gradually developing pathologies like dementia have often been limited by sample size and narrow and incomplete medical histories. The Taiwan National Insurance database provides an unparalleled opportunity for detailed analyses of associations between current medical conditions and a spectrum of prior medical and dental events. The temporal impact of the database will only become more important as the past historical record progressively expands going forward. The inclusion of dental records in assessing the relationship with subsequent dementia is very important because this information is often unavailable or dependent on subject recall. This study clearly establishes associations between a variety of suspected cardiovascular and metabolic factors and the odds of dementia. A critical outcome should include the design of targeted interventions and the subsequent assessment of their efficacy.
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Affiliation(s)
- J W Lin
- Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Douliu City, Yunlin County 64051
| | - C H Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 10617
| | - J L Caffrey
- Physiology and Cardiovascular Research Institute, University of North Texas Health Science Center, TX 76107, USA
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Sturluson A, Sousa R, Zhang Y, Huynh MT, Laird C, York AHP, Silsby C, Chang CH, Simon CM. Curating Metal-Organic Frameworks To Compose Robust Gas Sensor Arrays in Dilute Conditions. ACS Appl Mater Interfaces 2020; 12:6546-6564. [PMID: 31918544 DOI: 10.1021/acsami.9b16561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Metal-organic frameworks (MOFs), tunable, nanoporous materials, are alluring recognition elements for gas sensing. Mimicking human olfaction, an array of cross-sensitive, MOF-based sensors could enable analyte detection in complex, variable gas mixtures containing confounding gas species. Herein, we address the question: given a set of MOF candidates and their adsorption properties, how do we select the optimal subset to compose a sensor array that accurately and robustly predicts the gas composition via monitoring the adsorbed mass in each MOF? We first mathematically formulate the MOF-based sensor array problem under dilute conditions. Instructively, the sensor array can be viewed as a linear map from gas composition space to sensor array response space defined by the matrix H of Henry coefficients of the gases in the MOFs. Characterizing this mapping, the singular value decomposition of H is a useful tool for evaluating MOF subsets for sensor arrays, as it determines the sensitivity of the predicted gas composition to measurement error, quantifies the magnitude of the response to changes in composition, and recovers which direction in gas composition space elicits the largest/smallest response. To illustrate, on the basis of experimental adsorption data, we curate MOFs for a sensor array with the objective of determining the concentration of CO2 and SO2 in the gas phase.
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Affiliation(s)
- Arni Sturluson
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Rachel Sousa
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Yujing Zhang
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Melanie T Huynh
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Caleb Laird
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Arthur H P York
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Carson Silsby
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Chih-Hung Chang
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
| | - Cory M Simon
- School of Chemical, Biological, and Environmental Engineering , Oregon State University , Corvallis , Oregon 97331 , United States
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Jun HY, Chang CH, Ahn KS, Ryu SO, Choi CH. Microfluidics-enabled rational design for Ag–ZnO nanocomposite films for enhanced photoelectrochemical performance. CrystEngComm 2020. [DOI: 10.1039/c9ce01316d] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A facile and rapid synthetic method to fabricate the Ag–ZnO nanocomposite films with controlled morphology is developed by using microreactor-assisted solution deposition (MASD) process for enhanced photoelectrochemical performance.
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Affiliation(s)
- Ho Young Jun
- Department of Chemical Engineering
- Yeungnam University
- Gyeongsan-si
- South Korea
| | - Chih-Hung Chang
- School of Chemical, Biological & Environmental Engineering
- Oregon State University
- Corvallis
- USA
| | - Kwang-Soon Ahn
- Department of Chemical Engineering
- Yeungnam University
- Gyeongsan-si
- South Korea
| | - Si Ok Ryu
- Department of Chemical Engineering
- Yeungnam University
- Gyeongsan-si
- South Korea
| | - Chang-Ho Choi
- Department of Chemical Engineering
- Gyeongsang National University
- Jinju-si
- South Korea
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Lee CH, Lin SM, Chang CH, Lan TY. Adult Idiopathic Bilateral Coxa Vara with Hip Osteoarthritis Treated with Bilateral Proximal Femur Osteotomy: A Case Report. JBJS Case Connect 2019; 9:e0383. [PMID: 31688053 DOI: 10.2106/jbjs.cc.18.00383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CASE We reported a case of a 25-year-old woman with idiopathic bilateral coxa vara who had initial presentation of hip osteoarthritis. She was later treated with bilateral subtrochanteric valgus osteotomy. A good functional outcome was recorded without nonunion or deformity recurrence. The arthritis of the hips also decelerated. CONCLUSIONS Coxa vara first diagnosed in adulthood was relatively uncommon, and the cause in this present case was uncertain. Subtrochanteric valgus osteotomy seemed to be a suitable treatment for this case.
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Affiliation(s)
- Cheng-Han Lee
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shang Ming Lin
- Department of Materials and Textiles, Oriental Institute of Technology, New Taipei City, Taiwan
| | - Chih-Hung Chang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tsung-Yu Lan
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Materials and Textiles, Oriental Institute of Technology, New Taipei City, Taiwan
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L'Hotta A, Hoyt C, Lindsey T, Abel R, King A, Chang CH. Validation of the Fine Motor Subtest of the Bayley-III Using Rasch Analysis. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.08.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Liao CH, Chen CS, Chen YC, Jiang NE, Farn CJ, Shen YS, Hsu ML, Chang CH. Vancomycin-loaded oxidized hyaluronic acid and adipic acid dihydrazide hydrogel: Bio-compatibility, drug release, antimicrobial activity, and biofilm model. J Microbiol Immunol Infect 2019; 53:525-531. [PMID: 31607570 DOI: 10.1016/j.jmii.2019.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Prosthesis infection is a difficult-to-treat situation. Hydrogel is a novel biomaterial, which can be applied by simply spraying or by coating on implants before surgery and can be easily mixed with antibiotics. METHODS In order to evaluate the potential use of antibiotic-loaded hydrogel, we incorporated vancomycin into oxidized hyaluronic acid (HA) and adipic acid dihydrazide and evaluated the drug release and antimicrobial activity against methicillin-resistant Staphylococcus aureus (ATCC 29213). RESULTS The average release percentage of vancomycin on day 3 was about 86%. The antibiotic-loaded gel was biocompatible with mesenchymal stem cell, MC3T3, and L929 cell lines. The in vitro inhibition zones of vancomycin-loaded hydrogel [500X minimal inhibition concentration (MIC), 50X MIC, 10X MIC, and blank hydrogel] were 21, 13, 9, and 5 mm, respectively. In the Ti6Al4V implant biofilm model, 0.01-1% vancomycin-loaded gel exhibited significant anti-biofilm activity, measured by the MTT assay. CONCLUSIONS Vancomycin could be loaded onto oxidized HA and adipic acid dihydrazide, which exhibited excellent drug release and in vitro antimicrobial activity with minimal cell toxicity.
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Affiliation(s)
- Chun-Hsing Liao
- Department of Medicine, Yang-Ming University, Taiwan; Division of Infectious Disease, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chiang Sang Chen
- Department of Material and Fiber, Oriental Institute of Technology, New Taipei City, Taiwan; Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yu-Chun Chen
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; College of General Studies, Yuan Ze University, Taoyuan City, Taiwan
| | - Ni-En Jiang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chui Jia Farn
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taiwan
| | - Yi-Shan Shen
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Ming-Lun Hsu
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan.
| | - Chih-Hung Chang
- Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
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Gagnon CM, Brewington DV, Scholten PM, Atchison J, Chang CH. Impact of Symptom Reporting Agreement on Interdisciplinary Pain Program Participation. Pain Pract 2019; 19:621-632. [PMID: 30891911 DOI: 10.1111/papr.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/25/2019] [Accepted: 03/05/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate whether physician-patient agreement of potential patient problem areas impacts subsequent patient enrollment in an interdisciplinary pain management program. DESIGN Retrospective chart review of 544 patients who underwent evaluation of their chronic pain. Physicians and their patients endorsed perceived patient problems during the evaluation. The potential problems included 7 clinical domains: pain, sleep, mood, physical functioning, ability to cope with pain, ability to manage pain flare-ups, and pain medication effectiveness. RESULTS Results indicated statistically significant levels of agreement among the physicians and their patients (free-marginal kappa range, 0.19 to 0.94, P's < 0.001). The highest agreement occurred for pain and the lowest for pain medication effectiveness. Patients who enrolled in a recommended program did not differ from those who did not enroll based on either levels of agreement or average number of physician-patient agreements for the 7 clinical domains (P's > 0.05). Patients recommended for higher-intensity programs were perceived by their evaluating physician to have a significantly greater number of problematic clinical domains than those recommended for less intense pain programs. CONCLUSION The level of physician-patient agreement regarding the patients' current difficulties did not appear to influence patients' decisions to participate in interdisciplinary pain management. Extraneous, nonclinical factors may have had a greater impact on participation in interdisciplinary pain management than physician-patient agreement. Future research should focus on identifying these factors and their impact. Also, studying the impact of physician-patient agreement beyond enrollment status (eg, on successful program completion) may be helpful in potentially enhancing patient outcomes.
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Affiliation(s)
- Christine M Gagnon
- Shirley Ryan AbilityLab, Chicago, Illinois, U.S.A.,Department of PM&R, Northwestern Feinberg School of Medicine, Chicago, Illinois, U.S.A
| | | | - Paul M Scholten
- Shirley Ryan AbilityLab, Chicago, Illinois, U.S.A.,Department of PM&R, Northwestern Feinberg School of Medicine, Chicago, Illinois, U.S.A
| | - James Atchison
- Shirley Ryan AbilityLab, Chicago, Illinois, U.S.A.,Department of PM&R, Northwestern Feinberg School of Medicine, Chicago, Illinois, U.S.A.,Department of PM&R, Mayo Clinic Jacksonville, Jacksonville, Florida, U.S.A
| | - Chih-Hung Chang
- Shirley Ryan AbilityLab, Chicago, Illinois, U.S.A.,Department of PM&R, Northwestern Feinberg School of Medicine, Chicago, Illinois, U.S.A.,Washington University School of Medicine, St. Louis, Missouri, U.S.A
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