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  • 1
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 14 ( 2023-01), p. 204062232211432-
    Abstract: Primary aldosteronism (PA) is the leading cause of secondary hypertension globally and is associated with adverse cardiovascular outcomes. However, the cardiac impact of concomitant albuminuria remains unknown. Objective: To compare anatomical and functional remodeling of left ventricle (LV) in PA patients with or without albuminuria. Design: Prospective cohort study. Methods: The cohort was separated into two arms according to the presence or absence of albuminuria ( 〉 30 mg/g of morning spot urine). Propensity score matching with age, sex, systolic blood pressure, and diabetes mellitus was performed. Multivariate analysis was conducted with adjustments for age, sex, body mass index, systolic blood pressure, duration of hypertension, smoking, diabetes mellitus, number of antihypertensive agents, and aldosterone level. A local-linear model with bandwidth of 2.07 was used to study correlations. Results: A total of 519 individuals with PA were enrolled in the study, of whom 152 had albuminuria. After matching, the albuminuria group had a higher creatinine level, at baseline. With regard to LV remodeling, albuminuria was independently associated with a significantly higher interventricular septum (1.22  〉  1.17 cm, p = 0.030), LV posterior wall thickness (1.16  〉  1.10 cm, p = 0.011), LV mass index (125  〉  116 g/m 2 , p = 0.023), and medial E/e′ ratio (13.61  〉  12.30, p = 0.032), and a lower medial early diastolic peak velocity (5.70  〈  6.36 cm/s, p = 0.016). Multivariate analysis further revealed that albuminuria was an independent risk factor for elevated LV mass index ( p  〈  0.001) and medial E/e′ ratio ( p = 0.010). Non-parametric kernel regression also demonstrated that the level of albuminuria was positively correlated with LV mass index. The remodeling of LV mass and diastolic function under the presence of albuminuria distinctly improved after PA treatment. Conclusion: The presence of concomitant albuminuria in patients with PA was associated with pronounced LV hypertrophy and compromised LV diastolic function. These alterations were reversible after treatment for PA. Plain language summary Cardiac Impact of Primary Aldosteronism and Albuminuria Primary aldosteronism and albuminuria has been, respectively, demonstrated to bring about left ventricular remodeling, but the aggregative effect was unknown. We constructed a prospective single-center cohort study in Taiwan. We proposed the presence of concomitant albuminuria was associated with left ventricular hypertrophy and compromised diastolic function. Intriguingly, management of primary aldosteronism was able to restore these alterations. Our study delineated the cardiorenal crosstalk in the setting of secondary hypertension and the role of albuminuria for left ventricular remodeling. Future interrogations toward the underlying pathophysiology as well as therapeutics will facilitate the improvement of holistic care for such population.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
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  • 2
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 14 ( 2023-01), p. 204062232211432-
    Abstract: Elevated arterial stiffness in patients with primary aldosteronism (PA) can be reversed after adrenalectomy; however, the effect of medical treatment with mineralocorticoid receptor antagonist (MRAs) is unknown. Objectives: The aim of this study was to evaluate the effect of MRAs and compare both treatment strategies on arterial stiffness in PA patients. Design: Prospective cohort study. Methods: We prospectively enrolled PA patients from 2006 to 2019 who received either adrenalectomy or MRA treatment (spironolactone). We compared their baseline and 1-year post-treatment biochemistry characteristics and arterial pulse wave velocity (PWV) to verify the effects of treatment and related determinant factors. Results: A total 459 PA patients were enrolled. After 1:1 propensity score matching for age, sex and blood pressure (BP), each group had 176 patients. The major determinant factors of baseline PWV were age and baseline BP. The adrenalectomy group had greater improvements in BP, serum potassium level, plasma aldosterone concentration, and aldosterone-to-renin ratio. The MRA group had a significant improvement in PWV after 1 year of treatment (1706.2 ± 340.05 to 1613.6 ± 349.51 cm/s, p  〈  0.001). There were no significant differences in post-treatment PWV ( p = 0.173) and improvement in PWV ( p = 0.579) between the adrenalectomy and MRA groups. The determinant factors for an improvement in PWV after treatment were hypertension duration, baseline PWV, and the decrease in BP. Conclusion: The PA patients who received medical treatment with MRAs had a significant improvement in arterial stiffness. There was no significant difference in the improvement in arterial stiffness between the two treatment strategies.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2554816-5
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  • 3
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 13 ( 2022-01), p. 204062232110667-
    Abstract: Aldosterone excess in primary aldosteronism (PA) has been linked to insulin resistance, and diabetes mellitus has been associated with increased arterial stiffness and worse cardiovascular outcomes. However, the impact of diabetes on baseline and post-treatment arterial stiffness in patients with PA is unknown. Methods: This study prospectively enrolled 1071 PA patients, of whom 177 had diabetes and 894 did not. Clinical, biochemical, and brachial-ankle pulse wave velocity (baPWV) data were analyzed at baseline and 1 year after PA-specific treatment. After propensity score matching of age, sex, body mass index, systolic and diastolic blood pressure, hypertension duration, and number of antihypertensive medications, 144 patients with diabetes and 320 without diabetes were included for further analysis. Results: After propensity score matching, the baseline characteristics were balanced between the diabetes and nondiabetes groups except for fasting glucose, HbA1c, and lipid profiles. The patients with diabetes had significantly worse baseline baPWV compared with those without diabetes. After multivariable linear regression, the presence of diabetes mellitus remained a significant predictor of worse baseline mean baPWV (β: 46.3, 95% confidence interval: 2.9–89.7, p = 0.037). After 1 year of PA-specific treatment, only the nondiabetes group had significant recovery of mean baPWV (1661.8 ± 332.3 to 1565.0 ± 329.2 cm/s, p  〈  0.001; Δ = −96.8 ± 254.6 cm/s). In contrast, the diabetes group had less improvement (1771.2 ± 353.8 cm/s to 1742.0 ± 377.2 cm/s, p = 0.259; Δ = −29.2 ± 263.2 cm/s) even though the systolic and diastolic blood pressure significantly improved in both groups. Conclusion: The presence of diabetes mellitus in PA patients was associated with worse baseline and less post-treatment recovery of arterial stiffness.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 4
    Online Resource
    Online Resource
    SAGE Publications ; 2020
    In:  Journal of International Medical Research Vol. 48, No. 7 ( 2020-07), p. 030006052091505-
    In: Journal of International Medical Research, SAGE Publications, Vol. 48, No. 7 ( 2020-07), p. 030006052091505-
    Abstract: To analyse the epidemiology of mandibular fractures and the correlation between combined fractures during a 10-year period in central Taiwan. Methods This retrospective study analysed data collected from the medical records of patients that had mandibular fractures between January 2007 and October 2017. Data on age, sex, cause of injury, anatomical site of fracture, treatment and complications were obtained and analysed. Results A total of 265 patients who received treatment were included in the study. The mean ± SD age was 30.08 ± 13.47 years (range, 6–70 years) and the 21–30 years age group showed the highest incidence of mandibular fractures. The male-to-female ratio was 1.25:1. Road traffic accidents were the most common cause of fracture (206 of 265; 77.74%). The symphysis and parasymphysis area was the most common fracture site (169 of 420; 39.29%). Single-site fracture represented slightly more than 50% of the total 420 fractures. The most frequent combination of two fractures was an angle fracture combined with a symphysis and parasymphysis fracture (29 of 106 double fracture patients [27.36%]). There was a weak positive association between several combinations of fractures. Conclusions A better understanding of the influence of age and sex on the mechanism of injury is of great clinical importance in the assessment and diagnosis of fractures.
    Type of Medium: Online Resource
    ISSN: 0300-0605 , 1473-2300
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 5
    In: Therapeutic Advances in Chronic Disease, SAGE Publications, Vol. 13 ( 2022-01), p. 204062232210780-
    Abstract: To establish a FRAX®-based prediction model for rheumatoid arthritis (RA)-associated fragility fracture. Methods: This study is a longitudinal, real-world, registry cohort study. Patients with RA were registered to start in September 2014. The baseline demographics, bone mineral density (BMD), and risk factors of osteoporosis or fragility fracture were recorded. Subsequent fragility fractures during the 3-year observation period were also recorded. We developed a fixed intervention threshold (FITD) to identify fractures by choosing an optimal cut-off point on the receiver operating characteristic (ROC) curve and FRAX®. Several models for intervention thresholds (IT), including fixed intervention threshold (Taiwan) (FITT), age-specific individual intervention threshold (IIT), and hybrid intervention threshold (HIT), were compared to evaluate which IT model will have better discriminative power. Results: As of December 2020, a total of 493 RA participants have completed the 3-year observation study. The mean age of the participants was 59.3 ± 8.7, and 116 (23.5%) new fragility fractures were observed during the study period. In terms of pairwise comparisons of area under the curve ( n, 95% confidence interval) in the ROC curve, the FITD (0.669, 0.610–0.727, p  〈  0.001) with a value of 22% in major osteoporotic fracture and FITT (0.640, 0.582–0.699, p  〈  0.001) is significantly better than reference, but not for IIT (0.543, 0.485–0.601, p = 0.165) and HIT (0.543, 0.485–0.601, p = 0.165). Conclusion: An optimal FIT is established for intervention decisions in RA-associated fragility fractures. This model can offer an easy and simple guide to aid RA caregivers to provide interventions to prevent fragility fractures in patients with RA.
    Type of Medium: Online Resource
    ISSN: 2040-6223 , 2040-6231
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 6
    In: Cell Transplantation, SAGE Publications, Vol. 24, No. 12 ( 2015-12), p. 2463-2478
    Abstract: Cardiovascular disease is the leading cause of death globally, and stem cell therapy remains one of the most promising strategies for regeneration or repair of the damaged heart. We report that human placenta-derived multipotent cells (hPDMCs) can modulate cardiac injury in small and large animal models of myocardial ischemia (MI) and elucidate the mechanisms involved. We found that hPDMCs can undergo in vitro cardiomyogenic differentiation when cocultured with mouse neonatal cardiomyocytes. Moreover, hPDMCs exert strong proangiogenic responses in vitro toward human endothelial cells mediated by secretion of hepatocyte growth factor, growth-regulated oncogene-α, and interleukin-8. To test the in vivo relevance of these results, small and large animal models of acute MI were induced in mice and minipigs, respectively, by permanent left anterior descending (LAD) artery ligation, followed by hPDMC or culture medium-only implantation with follow-up for up to 8 weeks. Transplantation of hPDMCs into mouse heart post-acute MI induction improved left ventricular function, with significantly enhanced vascularity in the cell-treated group. Furthermore, in minipigs post-acute MI induction, hPDMC transplantation significantly improved myocardial contractility compared to the control group ( p=0.016) at 8 weeks postinjury. In addition, tissue analysis confirmed that hPDMC transplantation induced increased vascularity, cardiomyogenic differentiation, and antiapoptotic effects. Our findings offer evidence that hPDMCs can modulate cardiac injury in both small and large animal models, possibly through proangiogenesis, cardiomyogenesis, and suppression of cardiomyocyte apoptosis. Our study offers mechanistic insights and preclinical evidence on using hPDMCs as a therapeutic strategy to treat severe cardiovascular diseases.
    Type of Medium: Online Resource
    ISSN: 0963-6897 , 1555-3892
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
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  • 7
    Online Resource
    Online Resource
    SAGE Publications ; 2022
    In:  Journal of Applied Gerontology Vol. 41, No. 3 ( 2022-03), p. 736-743
    In: Journal of Applied Gerontology, SAGE Publications, Vol. 41, No. 3 ( 2022-03), p. 736-743
    Abstract: Home care (HC) services are the foundational service in Taiwan, such as personal care, housekeeping, showers, meal preparation, and so on. We used population-representative data to evaluate the effects of HC services use on the long-term functional performance of older adults. Method This longitudinal study used latent growth curve modeling, measured as trajectories in activities of daily living (ADL) ability. We retrieved data for 1,851 care recipients from the Long-Term Care Service Management System database. Results Continuous use of HC services had positive effects on functional performance over time of declining functional capacity (β = .075, p 〈 .05). While greater age was associated with slower increases in ADL scores, being female and living alone were associated with faster increases in ADL scores. Discussion Continuous use of the HC services provided has a significant impact on maintaining or improving functional performance among older adults in the early stage of declined functional capacity.
    Type of Medium: Online Resource
    ISSN: 0733-4648 , 1552-4523
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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    detail.hit.zdb_id: 155897-3
    SSG: 5,2
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  • 8
    Online Resource
    Online Resource
    SAGE Publications ; 2011
    In:  Concurrent Engineering Vol. 19, No. 3 ( 2011-09), p. 225-234
    In: Concurrent Engineering, SAGE Publications, Vol. 19, No. 3 ( 2011-09), p. 225-234
    Abstract: Advancing technologies and constantly changing market needs induce competition between organizations and force enterprises to adopt better management methods to improve operational performance to survive and make profits. Knowledge management has been widely recognized as one of the effective methods to achieve the above objective. Previous researches of knowledge management chiefly focused on qualitative approaches, and largely stressed key success factors of knowledge management, such as the infrastructure of information technology, the design of the knowledge management system, deployment of motivation schemes, and the like. Among them, the knowledge spiral of socialization, externalization, connection, and internalization are the core of researches and discussions. However, early studies only disclosed the necessary cyclical phenomenon of knowledge management. A quantitative method revealing how the existing knowledge can support the creation of new knowledge or upgrade current knowledge remains non-existent. To bridge this gap, this study proposes a mathematical model which can quantify the supporting effects of the existing knowledge on the creation of new knowledge. The model evaluates knowledge from the perspectives of complexity (knowledge type/knowledge area) and depth (knowledge level), and the results of the example illustrate that the proposed model can be an effective method of measuring the usefulness of the existing knowledge.
    Type of Medium: Online Resource
    ISSN: 1063-293X , 1531-2003
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
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    detail.hit.zdb_id: 1179349-1
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  • 9
    In: Australian & New Zealand Journal of Psychiatry, SAGE Publications, Vol. 43, No. 2 ( 2009-02), p. 158-166
    Abstract: Objective: There has been no large-scale survey of suicide-related behaviours including suicidal ideations, plans and attempts in China involving both rural and urban areas and using standardized assessment tools. The aim of the present study was to determine the lifetime prevalence of suicide-related behaviour and its relationship with sociodemographic factors and psychiatric disorders in the rural and urban regions of Beijing, China. Methods: A total of 5926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview. Basic sociodemographic and clinical data and data on suicide-related behaviour were also collected. Results: The overall lifetime prevalence estimates of suicidal ideation, plans and attempts were 2.3%, 1.4%, and 1.0%, respectively; the corresponding figures were 2.8%, 1.6%, and 1.3% in the rural sample, and 1.8%, 1.3%, and 0.9% in the urban sample. Age ( 〉 25years), female sex, unmarried status, lower education level, lower ( 〈 RMB500month −1 ) or higher ( 〉 RMB2000month −1 ) monthly income and presence of major medical disorders were significantly associated with increased risk of suicide-related behaviour. 36.2% of subjects with suicide-related behavior consulted a medical practitioner and 20.7% consulted a psychiatrist. Conclusions: The prevalence of lifetime suicide-related behaviour in Beijing is lower than in Western countries, but the low percentage of subjects treated for suicide-related behaviour indicates a major public health problem that should be addressed. National surveys are needed to further explore the prevalence of suicide-related behaviour in China.
    Type of Medium: Online Resource
    ISSN: 0004-8674 , 1440-1614
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
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    detail.hit.zdb_id: 221140-3
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  • 10
    In: Molecular Imaging, SAGE Publications, Vol. 2021 ( 2021-01)
    Abstract: Background. Inducible nitric oxide synthase (iNOS) plays a crucial role in neuroinflammation, especially microglial activity, and may potentially represent a useful biomarker of neuroinflammation. In this study, we carefully defined a strategic plan to develop iNOS-targeted molecular PET imaging using (4[Formula: see text]-amino-5[Formula: see text] ,8[Formula: see text]-difluoro-1[Formula: see text] H-spiro[piperidine-4,2[Formula: see text]-quinazolin] -1-yl)(4-fluorophenyl)methanone ([ 18 F]FBAT) as a tracer in a mouse model of lipopolysaccharide- (LPS-) induced brain inflammation. Methods. An in vitro model, murine microglial BV2 cell line, was used to assess the uptake of [ 18 F]FBAT in response to iNOS induction at the cellular level. In vivo whole-body dynamic PET/MR imaging was acquired in LPS-treated (5 mg/kg) and control mice. Standard uptake value (SUV), total volume of distribution ([Formula: see text] ), and area under the curve (AUC) based on the [ 18 F]FBAT PET signals were determined. The expression of iNOS was confirmed by immunohistochemistry (IHC) of brain tissues. Results. At the end of synthesis, the yield of [ 18 F]FBAT was 2.2–3.1% (EOS), radiochemical purity was 〉 99%, and molar radioactivity was 125–137 GBq/ μmol. In vitro, [ 18 F]FBAT rapidly and progressively accumulated in murine microglial BV2 cells exposed to LPS; however, [ 18 F]FBAT accumulation was inhibited by aminoguanidine, a selective iNOS inhibitor. In vivo biodistribution studies of [ 18 F]FBAT showed a significant increase in the liver and kidney on LPS-treated mice. At 3 h postinjection of LPS, in vivo, the [ 18 F]FBAT accumulation ratios at 30 min post intravenous (i.v.) radiotracer injection for the whole brain, cortex, cerebellum, and brainstem were [Formula: see text] , [Formula: see text], [Formula: see text] , and [Formula: see text], respectively, compared to those of mice not injected with LPS. The mean area under the curve (AUC 0-30min ), total volume of distribution ([Formula: see text], mL/cm 3 ), and [Formula: see text] (influx rate) of [ 18 F]FBAT were [Formula: see text] - and [Formula: see text]-fold higher in the 3 h LPS group, respectively, than in the control group. In the pharmacokinetic two-compartment model, the whole brain [Formula: see text] of [ 18 F]FBAT was significantly higher in mice injected with LPS compared to the control group. Aminoguanidine, selective iNOS inhibitor, pretreatment significantly reduced the AUC 0-30min and [Formula: see text] values in LPS-induced mice. Quantitative analysis of immunohistochemically stained brain sections confirmed iNOS was preferentially upregulated in the cerebellum and cortex of mice injected with LPS. Conclusion. An automated robotic method was established for radiosynthesis of [ 18 F]FBAT, and the preliminary in vitro and in vivo results demonstrated the feasibility of detecting iNOS activity/expression in LPS-treated neuroinflammation by noninvasive imaging with [ 18 F]FBAT PET/MRI.
    Type of Medium: Online Resource
    ISSN: 1535-3508 , 1536-0121
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2137435-1
    detail.hit.zdb_id: 2069848-3
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