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  • SAGE Publications  (13)
  • 2020-2024  (13)
  • 1
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    Online Resource
    The relative importance of predictive factors for single first-generation EGFR-TKI use for more than 5 years in patients with advanced non-small cell lung cancer: Taiwan multicenter TIPS-5 study
    SAGE Publications ; 2021
    In:  Therapeutic Advances in Medical Oncology Vol. 13 ( 2021-01), p. 175883592110180-
    Details
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 13 ( 2021-01), p. 175883592110180-
    Abstract: The relative importance of predictive factors for advanced non-small cell lung cancer (NSCLC) patients on epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment remains unclear. Materials and methods: We retrospectively enrolled advanced NSCLC patients with single first-generation EGFR-TKI treatment for ⩾5 years (Y) in Taiwan. Clinical data was collected and compared with those of another cohort with single first-line EGFR-TKI treatment for 〈 5 Y. Plasma cell-free DNA (cfDNA) samples were collected from patient subsets, pre- and post-TKI, in the 〉 5 Y group. Results: Overall, 128 and 278 patients were enrolled in the ⩾5 Y and 〈 5 Y groups, respectively. Significant factors in the multivariate analysis of patients’ characteristics including Eastern Cooperative Oncology Group performance status 0–1, postoperative recurrence, without brain metastasis, oligometastasis (each score of 2), female sex, erlotinib use, and without bone metastasis (each score of 1), were incorporated into a risk scoring system. The area under the receiver operating characteristic curve was 0.82 [95% confidence interval (CI): 0.78–0.86]. Of the plasma cfDNA samples from 33 patients in the ⩾5 Y group, only 1 had a T790M in 25 patients without progressive disease. In 27 patients with single agent use for ⩾96 months, 22 (81.5%) received local treatment (surgery or radiotherapy) for the primary lung tumor before and during TKI treatment. Conclusion: For NSCLC patients with single first-generation EGFR-TKI use for ⩾5 Y, factors with different relative importance exist and the risk-scoring model is feasible with modest accuracy. The role of local treatment for primary tumors in patients with long-term TKI use requires further investigation.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    URL: Article
    DOI: 10.1177/17588359211018022
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2503443-1
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  • 2
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    Artificial intelligence-enabled electrocardiogram screens low left ventricular ejection fraction with a degree of confidence
    SAGE Publications ; 2022
    In:  DIGITAL HEALTH Vol. 8 ( 2022-01), p. 205520762211432-
    Details
    In: DIGITAL HEALTH, SAGE Publications, Vol. 8 ( 2022-01), p. 205520762211432-
    Abstract: Artificial intelligence-enabled electrocardiogram has become a substitute tool for echocardiography in left ventricular ejection fraction estimation. However, the direct use of artificial intelligence-enabled electrocardiogram may be not trustable due to the uncertainty of the prediction. Objective The study aimed to establish an artificial intelligence-enabled electrocardiogram with a degree of confidence to identify left ventricular dysfunction. Methods The study collected 76,081 and 11,771 electrocardiograms from an academic medical center and a community hospital to establish and validate the deep learning model, respectively. The proposed deep learning model provided the point estimation of the actual ejection fraction and its standard deviation derived from the maximum probability density function of a normal distribution. The primary analysis focused on the accuracy of identifying patients with left ventricular dysfunction (ejection fraction ≤ 40%). Since the standard deviation was an uncertainty indicator in a normal distribution, we used it as a degree of confidence in the artificial intelligence-enabled electrocardiogram. We further explored the clinical application of estimated standard deviation and followed up on the new-onset left ventricular dysfunction in patients with initially normal ejection fraction. Results The area under receiver operating characteristic curves (AUC) of detecting left ventricular dysfunction were 0.9549 and 0.9365 in internal and external validation sets. After excluding the cases with a lower degree of confidence, the artificial intelligence-enabled electrocardiogram performed better in the remaining cases in internal (AUC = 0.9759) and external (AUC = 0.9653) validation sets. For the application of future left ventricular dysfunction risk stratification in patients with initially normal ejection fraction, a 4.57-fold risk of future left ventricular dysfunction when the artificial intelligence-enabled electrocardiogram is positive in the internal validation set. The hazard ratio was increased to 8.67 after excluding the cases with a lower degree of confidence. This trend was also validated in the external validation set. Conclusion The deep learning model with a degree of confidence can provide advanced improvements in identifying left ventricular dysfunction and serve as a decision support and management-guided screening tool for prognosis.
    Type of Medium: Online Resource
    ISSN: 2055-2076 , 2055-2076
    URL: Article
    DOI: 10.1177/20552076221143249
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2819396-9
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  • 3
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    Comparison of Locking-Loop Suture Bridge Repair and Single-Row Suture Anchor Repair in Small to Medium Rotator Cuff Tears: A Prospective Cohort Study With Clinical and Ultrasound Evaluations
    SAGE Publications ; 2023
    In:  Orthopaedic Journal of Sports Medicine Vol. 11, No. 1 ( 2023-01-01), p. 232596712211422-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 11, No. 1 ( 2023-01-01), p. 232596712211422-
    Abstract: Single-row (SR) and double-row repair techniques have been described to treat rotator cuff tears. We present a novel surgical strategy of arthroscopic-assisted mini-open repair in which a locking-loop suture bridge (LLSB) is used. Purpose: To compare the functional outcomes and repair integrity of LLSB technique to the SR technique for arthroscopic-assisted mini-open repair of small to medium rotator cuff tears. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 39 patients who underwent LLSB repair (LLSB group) and 44 patients who underwent SR suture anchor repair (SR group) from 2015 to 2018. We evaluated all patients preoperatively and at 3, 6, 12, and 24 months postoperatively using the visual analog scale (VAS) for pain, Oxford Shoulder Score (OSS), and American Shoulder and Elbow Surgeons (ASES) score. Also, shoulder sonography was performed at 12 months postoperatively to evaluate repair integrity using the Sugaya classification system. The independent-sample t test was used to analyze functional outcomes (VAS, OSS, and ASES scores), and the Fisher exact test was used to analyze postoperative sonography results. Results: Patients in both the LLSB and SR groups saw a significant improvement on all 3 outcome measures from preoperatively to 24 months postoperatively ( P 〈 .001 for all). However, when comparing scores between groups, only the scores at 3 months postoperatively differed significantly (VAS: P = .002; OSS: P 〈 .001; ASES: P = .005). Shoulder sonography at 12 months postoperatively revealed no significant difference in repair integrity between the LLSB and SR groups (retear rate: 10.26% and 6.82%, respectively; P = .892). Conclusion: Better outcome scores were seen at 3-month follow-up in the LLSB group, with no difference in retear rates compared with the SR group at 12 months postoperatively. The LLSB technique was found to be a reliable technique for rotator cuff repair of small- to medium-sized tears.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/23259671221142242
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2706251-X
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  • 4
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    Transtubular potassium gradient predicts kidney function impairment after adrenalectomy in primary aldosteronism
    SAGE Publications ; 2020
    In:  Therapeutic Advances in Chronic Disease Vol. 11 ( 2020-01), p. 204062232094479-
    Details
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 11 ( 2020-01), p. 204062232094479-
    Abstract: In primary aldosteronism (PA), kidney function impairment could be concealed by relative hyperfiltration and emerge after adrenalectomy. We hypothesized transtubular gradient potassium gradient (TTKG), a kidney aldosterone bioactivity indicator, could correlate to end organ damage and forecast kidney function impairment after adrenalectomy. Methods: In the present prospective study, we enrolled lateralized PA patients who underwent adrenalectomy and were followed up 12 months after operation in the Taiwan Primary Aldosteronism Investigation (TAIPAI) registry from 2010 to 2018. The clinical outcome was kidney function impairment, defined as estimated glomerular filtration rate (eGFR) 〈 60 ml/min/1.73 m 2 at 12 months after adrenalectomy. End organ damage is determined by microalbuminuria and left ventricular mass. Results: In total, 323 patients [mean, 50.8 ± 10.9 years old; female 178 (55.1%)] were enrolled. Comparing pre-operation and post-operation data, systolic blood pressure, serum aldosterone, urinary albumin to creatinine ratio and eGFR decreased. TTKG ⩾ 4.9 correlated with pre-operative urinary albumin to creatinine ratio 〉 50 mg/g [odds ratio (OR) = 2.42; p = 0.034] and left ventricular mass (B = 20.10; p = 0.018). Multivariate logistic regression analysis demonstrated that TTKG ⩾ 4.9 could predict concealed chronic kidney disease (OR = 5.42; p = 0.011) and clinical success (OR = 2.90, p = 0.017) at 12 months after adrenalectomy. Conclusions: TTKG could predict concealed kidney function impairment and cure of hypertension in PA patients after adrenalectomy. TTKG more than 4.9 as an adverse surrogate of aldosterone and hypokalaemia correlated with pre-operative end organ damage in terms of high proteinuria and cardiac hypertrophy.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    URL: Article
    DOI: 10.1177/2040622320944792
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2554816-5
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  • 5
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    Risk factor analysis of nosocomial lower respiratory tract infection in influenza-related acute respiratory distress syndrome
    SAGE Publications ; 2020
    In:  Therapeutic Advances in Respiratory Disease Vol. 14 ( 2020-01), p. 175346662094241-
    Details
    In: Therapeutic Advances in Respiratory Disease, SAGE Publications, Vol. 14 ( 2020-01), p. 175346662094241-
    Abstract: Patients with severe influenza-related acute respiratory distress syndrome (ARDS) have high morbidity and mortality. Moreover, nosocomial lower respiratory tract infection (NLRTI) complicates their clinical management and possibly worsens their outcomes. This study aimed to explore the clinical features and impact of NLRTI in patients with severe influenza-related ARDS. Methods: This was an institutional review board approved, retrospective, observational study conducted in eight medical centers in Taiwan. From January 1 to March 31 in 2016, subjects were enrolled from intensive care units (ICUs) with virology-proven influenza pneumonia, while all of those patients with ARDS requiring invasive mechanical ventilation and without bacterial community-acquired pneumonia (CAP) were analyzed. Baseline characteristics, critical-illness data and clinical outcomes were recorded. Results: Among the 316 screened patients with severe influenza pneumonia, 250 with acute respiratory failure requiring intubation met the criteria of ARDS, without having bacterial CAP. Among them, 72 patients developed NLRTI. The independent risk factors for NLRTI included immunosuppressant use before influenza infection [odds ratio (OR), 5.669; 95% confidence interval (CI), 1.770–18.154], extracorporeal membrane oxygenation (ECMO) use after ARDS (OR, 2.440; 95% CI, 1.214–4.904) and larger corticosteroid dosage after ARDS (OR, 1.209; 95% CI, 1.038–1.407). Patients with NLRTI had higher in-hospital mortality and longer ICU stay, hospitalization and duration on mechanical ventilation. Conclusion: We found that immunosuppressant use before influenza infection, ECMO use, and larger steroid dosage after ARDS independently predict NLRTI in influenza-related ARDS. Moreover, NLRTI results in poorer outcomes in patients with severe influenza. The reviews of this paper are available via the supplemental material section.
    Type of Medium: Online Resource
    ISSN: 1753-4666 , 1753-4666
    URL: Article
    DOI: 10.1177/1753466620942417
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2387506-9
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  • 6
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    Dimensional accuracy in quick plastic forming of aluminum alloy using demolding mechanism
    SAGE Publications ; 2021
    In:  Advances in Mechanical Engineering Vol. 13, No. 6 ( 2021-06), p. 168781402110217-
    Details
    In: Advances in Mechanical Engineering, SAGE Publications, Vol. 13, No. 6 ( 2021-06), p. 168781402110217-
    Abstract: This study focuses on quick plastic forming (QPF), product dimensional tolerances, and removal methods. The traditional curled metal shell mold in QFP, has limitations such as long process time and unstable quality. Therefore, this investigation designed a demolding mechanism, in order to improve the process efficiency and dimensional accuracy of QPF, in the manufacture of metal casings. The research results show that the proposed mechanism can significantly decrease the process time, because it replaces most of the operations of specimens movement after forming completely. The shorter process time reduce the die temperature loss during operation, thus also improving the efficiency by eliminating the need to wait for the die to return to its operation temperature. In terms of dimensional tolerance, the tolerance grade of QPF process was determined using the standard deviation, and found to be between IT10 and IT14. This range covers the scope of CNC cutting and stamping processing, indicating that the process has commercial value in the production of metal casings, because the current mainstream manufacturing process of metal casings comprises casting, stamping and CNC machining.
    Type of Medium: Online Resource
    ISSN: 1687-8140 , 1687-8140
    URL: Article
    DOI: 10.1177/16878140211021731
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2501620-9
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  • 7
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    A novel model-based unbalance monitoring and prognostics for rotor-bearing systems
    SAGE Publications ; 2023
    In:  Advances in Mechanical Engineering Vol. 15, No. 1 ( 2023-01), p. 168781322211480-
    Details
    In: Advances in Mechanical Engineering, SAGE Publications, Vol. 15, No. 1 ( 2023-01), p. 168781322211480-
    Abstract: A novel model-based unbalance monitoring and prognostics for rotor-bearing systems is introduced in the paper. An analytical method is first applied for rotor modeling and the calculated first natural frequency is validated by an FEM model. The rotor-bearing model with the identified bearing parameters is next validated with an operational 3-stage turbine-bearing’s machine on the first critical speed. The novelty of the approach is that the unbalance proceeding with optimization schemes is evaluated in two phases. In phase I, the bearing parameters and the initial unbalances are simultaneously evaluated based on the operational data soon after an overhaul. In phase II, the unbalance deterioration with time is identified through every day’s measured vibration at two bearings. A set of operational data over 16 months, provided by a local company, are used to test the approach. The evaluated unbalance deterioration trend is verified by the collaborated company from two consecutive overhauls. Five optimization algorithms are also tested and the results prove the robustness of the derived approach. Finally, the unbalance forecasting capability extrapolating from historical unbalance curve is demonstrated and that can work as prognostics in a condition-based maintenance strategy.
    Type of Medium: Online Resource
    ISSN: 1687-8132 , 1687-8140
    URL: Article
    DOI: 10.1177/16878132221148019
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
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  • 8
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    Effects of laser therapy on chronic low back pain: A systematic review and meta-analysis of randomized controlled trials
    SAGE Publications ; 2022
    In:  Clinical Rehabilitation Vol. 36, No. 3 ( 2022-03), p. 289-302
    Details
    In: Clinical Rehabilitation, SAGE Publications, Vol. 36, No. 3 ( 2022-03), p. 289-302
    Type of Medium: Online Resource
    ISSN: 0269-2155 , 1477-0873
    URL: Article
    DOI: 10.1177/02692155211057435
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2028323-4
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  • 9
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    Evaluating Different Strategies on the Blood Collection Counter Settings to Improve Patient Waiting Time in Outpatient Units
    SAGE Publications ; 2022
    In:  INQUIRY: The Journal of Health Care Organization, Provision, and Financing Vol. 59 ( 2022-01), p. 004695802210957-
    Details
    In: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, SAGE Publications, Vol. 59 ( 2022-01), p. 004695802210957-
    Abstract: Long patient waiting time is one of the major problems in the healthcare system and it would decrease patient satisfaction. Previous studies usually investigated how to improve the treatment flow in order to reduce patient waiting time or length of stay. The studies on blood collection counters have received less attention. Therefore, the objective of this study is to reduce the patient waiting time at outpatient clinics for metabolism and nephrology outpatients. A discrete-event simulation is used to analyze the four different strategies for blood collection counter resource allocation. Through analyzing four different strategic settings, the experimental results revealed that the maximum number of patients waiting before the outpatient clinics was reduced from 41 to 33 (20%); the maximum patient waiti-ng time at the outpatient clinics was decreased from 201.6 minutes to 83 minutes (59%). In this study, we found that adjusting the settings of blood collection counters would be beneficial. Assigning one exclusive blood collection counter from 8 to 10 am is the most suitable option with the least impact on the operational process for hospital staff. The results provide managerial insight regarding the cost-effective strategy selection for the hospital operational strategy.
    Type of Medium: Online Resource
    ISSN: 0046-9580 , 1945-7243
    URL: Article
    DOI: 10.1177/00469580221095797
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2147137-X
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  • 10
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    Midterm Outcomes After Revision Posterior Cruciate Ligament Reconstruction With a Single-Bundle Transtibial Autograft
    SAGE Publications ; 2022
    In:  Orthopaedic Journal of Sports Medicine Vol. 10, No. 8 ( 2022-08-01), p. 232596712211154-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 10, No. 8 ( 2022-08-01), p. 232596712211154-
    Abstract: There is a lack of consensus regarding the optimal technique for revision posterior cruciate ligament (PCL) reconstruction. Purpose: To evaluate midterm outcomes after revision PCL reconstruction using a single-bundle transtibial autograft. Study Design: Case series; Level of evidence, 4. Methods: We reviewed 17 patients who underwent revision PCL reconstruction performed in our medical center by a single surgeon from 2003 to 2016. The cohort included 12 male and 5 female patients with a mean age of 31.3 years (range, 17-48 years). All of the patients underwent single-bundle transtibial reconstruction using the same surgical technique and were reviewed at a minimum of 4 years postoperatively. Preoperative and postoperative posterior stress radiography was performed. The preoperative tibial slope and tibiofemoral angle were also measured. Preoperative and postoperative functional outcomes were evaluated using the International Knee Documentation Committee (IKDC) subjective and objective scores as well as the Lysholm score. Results: The most common factor that contributed to the failure of primary surgery was misplaced tunnels, especially on the femoral side. There were 2 patients who had grade 2 laxity preoperatively, and 15 patients had grade 3 laxity preoperatively. At the latest follow-up, all 17 patients had grade 1 laxity. On posterior stress radiography, posterior displacement improved from 10.8 ± 2.1 mm preoperatively to 2.9 ± 1.1 mm at the latest follow-up ( P 〈 .001). The IKDC subjective score improved from 34.9 ± 6.8 preoperatively to 75.3 ± 15.7 postoperatively ( P 〈 .001), and the Lysholm score improved from 38.1 ± 10.0 preoperatively to 88.5 ± 7.6 postoperatively ( P 〈 .001). All patients reached the minimal clinically important difference (MCID) for the Lysholm score, and 94% reached the MCID for the IKDC subjective score, with 65% reaching the Patient Acceptable Symptom State. Conclusion: According to the findings of this study, arthroscopic revision PCL reconstruction with a single-bundle transtibial autograft offered satisfactory outcomes at midterm follow-up.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/23259671221115423
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2706251-X
    SSG: 31
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