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Machine learning-based comparison of factors influencing estimated glomerular filtration rate in Chinese women with or without nonalcoholic fatty liver

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World Journal of Clinical Cases 2024年第15期12卷 2506-2521页

作者： I-chien Chen Lin-Ju chou Shih-Chen Huang Ta-Wei Chu Shang-Sen Lee Department of Nursing Kaohsiung Armed Forces General HospitalKaohsiung 802Taiwan Department of Obstetrics and Gynecology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Chief Executive Officer's Office MJ Health Research FoundationTaipei 114Taiwan Department of Urology Taichung Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTaichung 427Taiwan School of Medicine Tzu Chi UniversityHualian 970Taiwan Department of Urology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND The prevalence of non-alcoholic fatty liver(NAFLD)has increased recently.Subjects with NAFLD are known to have higher chance for renal function impairment.Many past studies used traditional multiple linear regression(MLR)to identify risk factors for decreased estimated glomerular filtration rate(eGFR).However,medical research is increasingly relying on emerging machine learning(Mach-L)methods.The present study enrolled healthy women to identify factors affecting eGFR in subjects with and without NAFLD(NAFLD+,NAFLD-)and to rank their importance.AIM To uses three different Mach-L methods to identify key impact factors for eGFR in healthy women with and without NAFLD.METHODS A total of 65535 healthy female study participants were enrolled from the Taiwan MJ cohort,accounting for 32 independent variables including demographic,biochemistry and lifestyle parameters(independent variables),while eGFR was used as the dependent variable.Aside from MLR,three Mach-L methods were applied,including stochastic gradient boosting,eXtreme gradient boosting and elastic net.Errors of estimation were used to define method accuracy,where smaller degree of error indicated better model performance.RESULTS Income,albumin,eGFR,High density lipoprotein-Cholesterol,phosphorus,forced expiratory volume in one second(FEV1),and sleep time were all lower in the NAFLD+group,while other factors were all significantly higher except for smoking area.Mach-L had lower estimation errors,thus outperforming MLR.In Model 1,age,uric acid(UA),FEV1,plasma calcium level(Ca),plasma albumin level(Alb)and T-bilirubin were the most important factors in the NAFLD+group,as opposed to age,UA,FEV1,Alb,lactic dehydrogenase(LDH)and Ca for the NAFLD-group.Given the importance percentage was much higher than the 2nd important factor,we built Model 2 by removing age.CONCLUSION The eGFR were lower in the NAFLD+group compared to the NAFLD-group,with age being was the most important impact factor in both groups of healthy Chinese women,followed by LDH,UA,FEV1 and

关键词： Non-alcoholic fatty liver Estimated glomerular filtration rate Machine learning Chinese women

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Two-Stage Production Planning Under Stochastic Demand:Case Study of Fertilizer Manufacturing

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Computers, Materials & Continua 2022年第1期70卷 1195-1207页

作者： Chia-Nan Wang Shao-Dong Syu chien-chang chou Viet Tinh Nguyen Dang Van Thuy Cuc Department of Industrial Engineering and Management National Kaohsiung University of Science and TechnologyKaohsiung80778Taiwan Sunline NP Telecommunications Co.Ltd Kaohsiung80778Taiwan Department of Shipping Technology National Kaohsiung University of Science and TechnologyKaohsiung80778Taiwan Faculty of Commerce Van Lang UniversityHo Chi Minh City70000Vietnam Faculty of Industrial Engineering and Management International UniversityHo Chi Minh City70000Vietnam

Agriculture is a key facilitator of economic prosperity and nourishes the huge global population.To achieve sustainable agriculture,several factors should be considered,such as increasing nutrient and water efficiency and/or improving soil health and quality.Using fertilizer is one of the fastest and easiest ways to improve the quality of nutrients inland and increase the effectiveness of crop yields.Fertilizer supplies most of the necessary nutrients for plants,and it is estimated that at least 30%-50%of crop yields is attributable to commercial fertilizer nutrient inputs.Fertilizer is always a major concern in achieving sustainable and efficient agriculture.Applying reasonable and customized fertilizerswill require a significant increase in the number of formulae,involving increasing costs and the accurate forecasting of the right time to apply the suitable formulae.An alternative solution is given by two-stage production planning under stochastic demand,which divides a planning schedule into two stages.The primary stage has non-existing demand information,the inputs of which are the proportion of raw materials needed for producing fertilizer products,the cost for purchasing materials,and the production cost.The total quantity of purchased material and produced products to be used in the blending process must be defined to meet as small as possible a paid cost.At the second stage,demand appears under multiple scenarios and their respective possibilities.This stage will provide a solution for each occurring scenario to achieve the best profit.The two-stage approach is presented in this paper,the mathematical model of which is based on linear integer programming.Considering the diversity of fertilizer types,themathematicalmodel can advise manufacturers about which products will generate as much as profit as possible.Specifically,two objectives are taken into account.First,the paper’s thesis focuses on minimizing overall system costs,e.g.,including inventory cost,purchasing cost,unit cost,and ordering cost at Stag

关键词： Two-stage stochastic programming demand uncertainty planning blending fertilizer

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Optimization Model for Selecting Temporary Hospital Locations During COVID-19 Pandemic

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Computers, Materials & Continua 2022年第1期70卷 397-412页

作者： Chia-Nan Wang chien-chang chou Hsien-Pin Hsu Van Thanh Nguyen Viet Tinh Nguyen Department of Industrial Engineering and Management National Kaohsiung University of Science and TechnologyKaohsiung80778Taiwan Department of Shipping Technology National Kaohsiung University of Science and TechnologyKaohsiung80778Taiwan Department of Supply Chain Management National Kaohsiung University of Science and TechnologyKaohsiung80778Taiwan Faculty of Commerce Van Lang UniversityHo Chi Minh City70000Vietnam

The two main approaches that countries are using to ease the strain on healthcare infrastructure is building temporary hospitals that are specialized in treating COVID-19 patients and promoting preventive measures.As such,the selection of the optimal location for a temporary hospital and the calculation of the prioritization of preventive measures are two of the most critical decisions during the pandemic,especially in densely populated areas where the risk of transmission of the virus is highest.If the location selection process or the prioritization of measures is poor,healthcare workers and patients can be harmed,and unnecessary costs may come into play.In this study,a decision support framework using a fuzzy analytic hierarchy process(FAHP)and a weighted aggregated sum product assessment model are proposed for selecting the location of a temporary hospital,and a FAHP model is proposed for calculating the prioritization of preventive measures against COVID-19.A case study is performed for Ho Chi Minh City using the proposed decision-making framework.The contribution of this work is to propose a multiple criteria decision-making model in a fuzzy environment for ranking potential locations for building temporary hospitals during the COVID-19 pandemic.The results of the study can be used to assist decisionmakers,such as government authorities and infectious disease experts,in dealing with the current pandemic as well as other diseases in the future.With the entire world facing the global pandemic of COVID-19,many scientists have applied research achievements in practice to help decision-makers make accurate decisions to prevent the pandemic.As the number of cases increases exponentially,it is crucial that government authorities and infectious disease experts make optimal decisions while considering multiple quantitative and qualitative criteria.As such,the proposed approach can also be applied to support complex decision-making processes in a fuzzy environment in different countries.

关键词： COVID-19 WHO MCDM preventive measures fuzzy theory FAHP WASPAS

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Spilled gallstone mimicking intra-abdominal seeding of gallbladder adenocarcinoma: A case report

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 622-627页

作者： Cheng-Ken Huang Ruey-Hwa Lu chien-Cheng Chen Po-Chun Chen Wen-chang Hsu Meng-Jui Tsai Chin-Tsung Ting Division of Gastrointestinal Surgery Department of SurgeryRen-Ai BranchTaipei City HospitalTaipei 106TaiwanChina Division of General Surgery Department of SurgeryZhongxing BranchTaipei City HospitalTaipei 103TaiwanChina School of Medicine Institute of Traditional MedicineNational Yang-Ming UniversityTaipei 112TaiwanChina Department of Health and Welfare University of TaipeTaipe 104TaiwanChina

BACKGROUND Gallbladder rupture is common in laparoscopic cholecystectomy because the gallbladder is usually in acute or chronic inflammation status.The gallstones may sometime be spilled into the peritoneal cavity,resulting in intra-abdominal ab-scess if the gallstones were not retrieved.The diagnosis of intra-abdominal ab-scess caused by unretrieved gallstone can usually be correctly identified in the routine imaging studies,such as abdominal ultrasonography or computed tomo-graphy(CT).Here we present a case of abscess formation from unretrieved gall-stone following laparoscopic cholecystectomy,which mimics the imaging findings of metastatic gallbladder ade-nocarcinoma.CASE SUMMARY This case described a 78-year-old man who received laparoscopic cholecystectomy and gallbladder adenocarcinoma was diagnosed after surgery.After adjuvant chemotherapy,the following up abdominal CT showed several small nodules at right upper abdomen and peritoneal carcinomatosis is considered.Repeated laparoscopic surgery for the excision of seeding tumor was conducted and the pathological diagnosis of the nodules and mass was inflammatory tissues and gallbladder stone.CONCLUSION Spilled gallstones are a common complication during laparoscopic cholecystectomy and some gallstones fail to be retrieved due to the size or the restricted view of laparoscopic surgery.For spilled gall bladder stones,surgeons may consider regular computerized tomography follow-up,and if necessary,laparoscopic examination can be used as a means of confirming the diagnostic and treatment.

关键词： Laparoscopic cholecystectomy Gallstone spillage Gallbladder cancer Mimicked cancerous Case report

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Assessment and Visualization of Ki67 Heterogeneity in Breast Cancers through Digital Image Analysis

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Advances in Breast Cancer Research 2024年第2期13卷 11-26页

作者： chien-Hui Wu Min-Hsiang chang Hsin-Hsiu Tsai Yi-Ting Peng Department of Anatomical Pathology Far Eastern Memorial Hospital New Taipei AI Lab Quanta Computer Inc. Taoyuan

The Ki67 index (KI) is a standard clinical marker for tumor proliferation;however, its application is hindered by intratumoral heterogeneity. In this study, we used digital image analysis to comprehensively analyze Ki67 heterogeneity and distribution patterns in breast carcinoma. Using Smart Pathology software, we digitized and analyzed 42 excised breast carcinoma Ki67 slides. Boxplots, histograms, and heat maps were generated to illustrate the KI distribution. We found that 30% of cases (13/42) exhibited discrepancies between global and hotspot KI when using a 14% KI threshold for classification. Patients with higher global or hotspot KI values displayed greater heterogenicity. Ki67 distribution patterns were categorized as randomly distributed (52%, 22/42), peripheral (43%, 18/42), and centered (5%, 2/42). Our sampling simulator indicated analyzing more than 10 high-power fields was typically required to accurately estimate global KI, with sampling size being correlated with heterogeneity. In conclusion, using digital image analysis in whole-slide images allows for comprehensive Ki67 profile assessment, shedding light on heterogeneity and distribution patterns. This spatial information can facilitate KI surveys of breast cancer and other malignancies.

关键词： Ki67 Heterogeneity Breast Cancer Digital Image Analysis

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Re-evaluating the role of pelvic radiation in the age of modern precision medicine and systemic therapy

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World Journal of Clinical Oncology 2024年第1期15卷 1-4页

作者： Tao-Wei Ke Yu-Min Liao Sheng-Chi chang Che-Hung Lin William Tzu-Liang Chen Ji-An Liang Chun-Ru chien Department of Colorectal Surgery China Medical University HospitalTaichung 40402Taiwan School of Chinese Medicine College of Chinese MedicineChina Medical UniversityTaichung 40402Taiwan Division of Hematology and Oncology Department of Internal MedicineChina Medical University HospitalTaichung 40402Taiwan Department of Colorectal Surgery China Medical University Hsinchu HospitalHsinchu 30272Taiwan School of Medicine College of MedicineChina Medical UniversityTaichung 40402Taiwan Department of Radiation Oncology China Medical University HospitalTaichung 40402Taiwan

The efficacy of pelvic radiation in the management of locally advanced stage rectal cancer has come under scrutiny in the context of modern precision medicine and systemic therapy as evidenced by recent clinical trials such as FOWARC(J Clin Oncol 2019;37:3223-3233),NCT04165772(N Engl J Med 2022;386:2363-2376),and PROSPECT(N Engl J Med 2023;389:322-334).In this review,we comprehensively assess these pivotal trials and offer additional insights into the evolving role of pelvic radiation in contemporary oncology.

关键词： Radiotherapy Locally advanced stage rectal cancer Precision medicine Systemic therapy Clinical trial

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Heuristic Scheduling of Job Orders in a Build-to-Order Manufacturing System

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Computer Systems Science & Engineering 2022年第3期40卷 1059-1072页

作者： Chia-Nan Wang chien-chang chou Yu-Chi Chung Nguyen Ky Phuc Phan VanThanh Nguyen Viet Tinh Nguyen Department of Industrial Engineering and Management National Kaohsiung University of Science and TechnologyKaohsiung80778Taiwan Department of Shipping Technology National Kaohsiung University of Science and TechnologyKaohsiung80778Taiwan Faculty of Industrial Engineering and Management International UniversityHo Chi Minh City70000Vietnam Faculty of Commerce Van Lang UniversityHo Chi Minh City70000Vietnam

With the continuous development of technology,traditional manual work has been becoming more and more automated.Most large or medium-sized companies have applied Enterprise Resource Planning(ERP)software into their business and production activities.However,since many small firms cannot afford ERP because of its expensive cost,they often still employ manual work for the same tasks this software resolves,especially for scheduling.This paper aims to provide a possible solution for small businesses to try automated scheduling and discover whether it can help much.There are two main ways to make this determination:a mathematical model and a heuristic model,which are suitable for assessing low-and medium-sized workloads,respectively.This case study was carried out in a small domestic interior furniture company,particularly in scheduling for their customized products in two-stage flow shop.Normally,they produce according to the sequence of customers’orders.However,when we applied these supportive tools with batch-processing machines,they experienced enhanced production performance due to diminishing setup time for distinctive items and a more streamlined arrangement of job sequences.These changes were implemented for some small companies that do not use many production stages and have a suitable number of jobs and customers.If this method were applied to larger demands,it would need further improvement and development to become a complete tool that can perform like a part of an ERP system.

关键词： scheduling mathematical heuristic flow shop batch-processing

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Can rifaximin for hepatic encephalopathy be discontinued during broad-spectrum antibiotic treatment?

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World Journal of Hepatology 2024年第2期16卷 115-119页

作者： chien-Hao Huang Piero Amodio Division of Hepatology Department of Gastroenterology and HepatologyChang-Gung Memorial HospitalLinkou Medical CenterTaoyuan 333Taiwan Department of Clinical and Experimental Medicine University of PaduaPadova 35122Italy

Hepatic encephalopathy(HE)is a formidable complication in patients with decompensated cirrhosis,often necessitating the administration of rifaximin(RFX)for effective management.RFX,is a gut-restricted,poorly-absorbable oral rifamycin derived antibiotic that can be used in addition to lactulose for the secondary prophylaxis of HE.It has shown notable reductions in infection,hospital readmission,duration of hospital stay,and mortality.However,limited data exist about the concurrent use of RFX with broad-spectrum antibiotics,because the patients are typically excluded from studies assessing RFX efficacy in HE.A pharmacist-driven quasi-experimental pilot study was done to address this gap.They argue against the necessity of RFX in HE during broad-spectrum antibiotic treatment,particularly in critically ill patients in intensive care unit(ICU).The potential for safe RFX discontinuation without adverse effects is clearly illuminated and valuable insight into the optimization of therapeutic strategies is offered.The findings also indicate that RFX discontinuation during broadspectrum antibiotic therapy was not associated with higher rates of delirium or coma,and this result remained robust after adjustment in multivariate analysis.Furthermore,rates of other secondary clinical and safety outcomes,including ICU mortality and 48-hour changes in vasopressor requirements,were comparable.However,since the activity of RFX is mainly confined to the modulation of gut microbiota,its potential utility in patients undergoing extensive systemic antibiotic therapy is debatable,given the overlapping antibiotic activity.Further,this suggests that the action of RFX on HE is class-specific(related to its activity on gut microbiota),rather than drug-specific.A recent double-blind randomized controlled(ARiE)trial provided further evidence-based support for RFX withdrawal in critically ill cirrhotic ICU patients receiving broad-spectrum antibiotics.Both studies prompt further discussion about optimal therapeutic strategy for patients facing

关键词： Rifaximin discontinuation Hepatic encephalopathy Broad-spectrum antibiotics Crit-ically ill Medical intensive care unit Pharmacist-driven protocol

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基于MaxEnt模型的核桃炭疽病适生性分析

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林业科学研究 2024年第3期37卷 68-78页

作者：薄淑文喻红稠韩长志西南林业大学林学院云南昆明650224 云南省森林灾害预警与控制重点实验室云南昆明650224

[目的]根据核桃炭疽病的已知分布情况,对它在中国范围内和云南省范围内的适生区分别进行预测分析,明确核桃炭疽病在我国潜在的分布区范围,有助于生产上采取科学高效的监测和预防措施,降低潜在的生态和经济损失。[方法]利用MaxEnt物种分... 详细信息

[目的]根据核桃炭疽病的已知分布情况,对它在中国范围内和云南省范围内的适生区分别进行预测分析,明确核桃炭疽病在我国潜在的分布区范围,有助于生产上采取科学高效的监测和预防措施,降低潜在的生态和经济损失。[方法]利用MaxEnt物种分布模型,通过筛选生物气候变量和优化模型参数构建表现最佳的模型,进而应用于核桃炭疽病在中国和云南省范围内的适生区的预测。利用ArcGIS软件对预测结果进行可视化处理和面积统计,并利用模型的结果对影响核桃炭疽病的主要环境因素进行分析。[结果]MaxEnt模型预测结果显示:影响核桃炭疽病适生性的主导环境因子主要有年降雨量、最干月份降雨量、温度季节性、最冷季度平均温度、年平均温度、等温性、平均日较差和最暖季度平均降雨量等。核桃炭疽病在中国生态适宜区总面积约为317.12万平方公里,占国土总面积的33.03%,主要分布在我国华中、华东、华南的全部地区以及西南大部分地区和“三北”(西北、华北、东北)少部分地区;核桃炭疽病在云南的适生区主要集中在滇西地区,约为22.64万平方公里,占省总面积的57.44%。[结论]核桃炭疽病在中国有着较为广泛的适生区域,尤以云南省核桃炭疽病发生点数量最多和高度适生区分布区域最广泛,预测适生区与已经获取核桃炭疽病分布点结果相一致,未来应结合当地核桃炭疽病菌的生物学特征和实地分布情况进一步加强核桃炭疽病的预测和防治。

关键词：核桃炭疽病适生性 MaxEnt模型中国云南

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Nosocomial infection and spread of SARS-CoV-2 infection among hospital staff,patients and caregivers

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World Journal of Clinical Cases 2022年第34期10卷 12559-12565页

作者： Chih-chien Cheng Li-Yun Fann Yi-chang chou Chia-Chen Liu Hsiao-Yun Hu Dachen Chu Department of Education and Research Taipei City HospitalTaipei 116009Taiwan Department of Nursing Taipei City HospitalTaipei 106243Taiwan Department of Education and Research Taipei City HospitalTaipei 106109Taiwan School of Medicine College of MedicineFu Jen Catholic UniversityTaipei 106109Taiwan

BACKGROUND There are difficulties in diagnosing nosocomial transmission of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in hospital settings. Furthermore, mortality of cases of nosocomial infection(NI) with SARS-CoV-2 is higher than that of the general infected population. In the early stage of the pandemic in Taiwan, as patients were not tested for SARS-CoV-2 at admission, NIs often go undetected. Strictly applying the systematic polymerase chain reaction(PCR) screening, as a standard infection control measure was subsequently implemented to reduce NI incidence. However, evidence on risk factors for SARS-CoV-2 NIs among healthcare workers(HCWs) and caregivers is limited.AIM To assess NI incidence of SARS-CoV-2 among hospital staff, hospitalized patients, and caregivers, and the transmission routes of clusters of infection.METHODS This descriptive retrospective analysis at our hospital from May 15 to August 15, 2021 included data on 132 SARS-CoV-2 NIs cases among hospital staff, inpatients, and caregivers who previously tested negative but subsequently identified with a positive SARS-CoV-2 reverse transcriptase-PCR(RT-PCR) test results, or a hospital staff who tested positive following routine SARS-CoV-2 RT-PCR test. Chi-square tests were performed to compare the differences between hospital staff and private caregivers, and between clusters and sporadic infections.RESULTS Overall, 9149 patients and 2005 hospital staff members underwent routine SARS-CoV-2 RT-PCR testing, resulting in 12 confirmed cluster and 23 sporadic infections. Among the index cases of the clusters, three(25%) cases were among hospital staff and nine(75%) cases were among other contacts. Among sporadic infections, 21(91%) cases were among hospital staff and two(9%) cases were among other contacts(P < 0.001). There was an average of 8.08 infections per cluster. The secondary cases of cluster infection were inpatients(45%), hospital staff(30%), and caregivers(25%). Private caregivers constituted 27% and 4% of the cluste

关键词： COVID-19 SARS CoV-2 Cross infection Incidence Retrospective studies Infection control

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