Browsing by Author "Chen, Jen-Yin"

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A Novel Smart Assistance System for Blood Vessel Approaching: A Technical Report Based on Oximetry
(2020-04-01)
Lee, Chien-Ching
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Chuang, Chia-Chun
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Lai, Bo-Cheng
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Huang, Yi-Chia
;
Chen, Jen-Yin
In clinical practice, the catheter has to be placed at an accurate position during anesthesia administration. However, effectively guiding the catheter to the accurate position in deeper tissues can be difficult for an inexperienced practitioner. We aimed to address the current issues associated with catheter placement using a novel smart assistance system for blood vessel catheter placement. We used a hollow introducer needle embedded with dual wavelength (690 and 850 nm) optical fibers to advance the tip into the subclavian vessels in anesthetized piglets. The results showed average optical density changes, and the difference between the absorption spectra and hemoglobin concentrations of different tissue components effectively identified different tissues (p < 0.05). The radial basis function neural network (RBFNN) technique was applied to distinguish tissue components (the F-measure value and accuracy were 93.02% and 94%, respectively). Finally, animal experiments were designed to validate the performance of the proposed system. Using this system based on oximetry, we easily navigated the needle tip to the target vessel. Based on the experimental results, the proposed system could effectively distinguish different tissue layers of the animals.
An innovative nonpharmacological intervention combined with intravenous patient-controlled analgesia increased patient global improvement in pain and satisfaction after major surgery
(2017-01-01)
Chuang, Chia-Chun
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Lee, Chien-Ching
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Wang, Li-Kai
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Lin, Bor-Shyh
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Wu, Wen-Ju
Purpose: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit) into standard operating procedure (SOP) in acute pain service (APS) improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA). Patients and methods: This was a nonrandomized before-after study. Adult patients (aged between 20 and 80 years) who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients' characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0-10). A score of NRS. 4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent). Patients were separated into "before" and "after" CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement) and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA. Results: The response rate was 55.3%, with 187 usable questionnaires. CICARE effectively improved patient global impression of improvement in pain, patient satisfaction, communication skills and accessibility/availability of IV-PCA. No significant differences were noted in instrument proficiency, morphine dosage, delivery/demand ratios, rates of inadequately treated pain at rest and side effects of IV-PCA between groups. Paradoxical findings were noted between the rates of inadequately treated pain/side effects and PGI-Improvement in pain/patient satisfaction, which were affected by psychological factors. Conclusion: Nonpharmacological interventions carried out by implementing CICARE into SOP for APS effectively improved patient satisfaction and postoperative pain management quality, but this did not affect actual pain.
Enhancing Bowel Sounds by Using a Higher Order Statistics-Based Radial Basis Function Network
(2013-05-01)
Lin, Bor-Shyh
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Sheu, Ming-Jen
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Chuang, Ching-Chin
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Tseng, Kuan-Chih
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Chen, Jen-Yin
Auscultation of bowel sounds provides a noninvasive method to the diagnosis of gastrointestinal motility diseases. However, bowel sounds can be easily contaminated by background noises, and the frequency band of bowel sounds is easily overlapped with background noise. Therefore, it is difficult to enhance the noisy bowel sounds by using precise digital filters. In this study, a higher order statistics (HOS)-based radial basis function (RBF) network was proposed to enhance noisy bowel sounds. An HOS technique provides the ability of suppressing Gaussian noises and symmetrically distributed non-Gaussian noises due to their natural tolerance. Therefore, the influence of additional noises on the HOS-based learning algorithm can be reduced effectively. The simulated and experimental results show that the HOS-based RBF can exactly provide better performance for enhancing bowel sounds under stationary and nonstationary Gaussian noises. Therefore, the HOS-based RBF can be considered as a good approach for enhancing noisy bowel sounds.
Higher-Order-Statistics-Based Fractal Dimension for Noisy Bowel Sound Detection
(2015-07-01)
Sheu, Ming-Jen
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Lin, Ping-Yi
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Chen, Jen-Yin
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Lee, Chien-Ching
;
Lin, Bor-Shyh
Bowel sounds is an important physiological parameter of distinguishing the gastrointestinal motility dysfunction. Auscultation of bowel sounds provides a noninvasive way for clinical diagnosis, but it is also easily affected by environmental noise. In this study, a novel higher-order-statistics (HOS)-based fractal dimension algorithm was proposed for detecting noisy bowel sounds. By using the nature of preserving non-Gaussianity for higher order statistics technique, the proposed method can effectively detect bowel sounds under different noise conditions, and its performance is insensitive to the change of noise type and noise level.
Less postoperative pain in patients receiving trans-oral vestibular endoscopic thyroidectomy: a plausible finding?
(2017-08-01)
Lan, Kuo-Mao
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Chen, Chia-Ming
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Chuang, Chia-Chun
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Lee, Chien-Ching
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Wang, Li-Kai