Browsing by Author "Yu, Cheng-Sheng"

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Dynamic change of surface microbiota with different environmental cleaning methods between two wards in a hospital
(2017-01)
Chen, Chang-Hua
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Tu, Chi-Chao
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Kuo, Han-Yueh
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Zeng, Rong-Fong
;
Yu, Cheng-Sheng
Terminal disinfection and daily cleaning have been performed in hospitals in Taiwan for many years to reduce the risks of healthcare-associated infections. However, the effectiveness of these cleaning approaches and dynamic changes of surface microbiota upon cleaning remain unclear. Here, we report the surface changes of bacterial communities with terminal disinfection and daily cleaning in a medical intensive care unit (MICU) and only terminal disinfection in a respiratory care center (RCC) using 16s ribosomal RNA (rRNA) metagenomics. A total of 36 samples, including 9 samples per sampling time, from each ward were analysed. The clinical isolates were recorded during the sampling time. A large amount of microbial diversity was detected, and human skin microbiota (HSM) was predominant in both wards. In addition, the colonization rate of the HSM in the MICU was higher than that in the RCC, especially for Moraxellaceae. A higher alpha-diversity (p = 0.005519) and a lower UniFrac distance was shown in the RCC due to the lack of daily cleaning. Moreover, a significantly higher abundance among Acinetobacter sp., Streptococcus sp. and Pseudomonas sp. was shown in the RCC compared to the MICU using the paired t test. We concluded that cleaning changes might contribute to the difference in diversity between two wards.
First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
(2016-01-01)
Lin, Chih-Ming
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Chang, Yu-Jun
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Liu, Chi-Kuang
;
Yu, Cheng-Sheng
;
Lu, Henry Horng-Shing
Age is an important risk factor for stroke, and carotid artery stenosis is the primary cause of first-ever ischemic stroke. Timely intervention with stenting procedures can effectively prevent secondary stroke; however, the impact of stenting on various periprocedural physical functionalities has never been thoroughly investigated. The primary aim of this study was to investigate whether prestenting characteristics were associated with long-term functional outcomes in patients presenting with first-ever ischemic stroke. The secondary aim was to investigate whether patient age was an important factor in outcomes following stenting, measured by the modified Rankin scale (mRS). In total, 144 consecutive patients with first-ever ischemic stroke who underwent carotid artery stenting from January 2010 to November 2014 were included. Clinical data were obtained by review of medical records. The Barthel index (BI) and mRS were used to assess disability before stenting and at 12-month follow-up. In total, 72/144 patients showed improvement (mRS[+]), 71 showed stationary and one showed deterioration in condition (mRS[-]). The prestenting parameters, ratio of cerebral blood volume (1.41 vs 1.2 for mRS[-] vs mRS[+]), BI ( 75 vs 85), and high-sensitivity C-reactive protein (hsCRP 5.0 vs 3.99), differed significantly between the two outcome groups (P<0.05). The internal carotid artery/common carotid artery ratio (P=0.011), BI (P=0.019), ipsilateral internal carotid artery resistance index (P=0.003), and HbA1c (P=0.039) were all factors significantly associated with patient age group. There was no significant association between age and poststenting outcome measured by mRS with 57% of patients in the >= 75 years age group showing mRS(-) and 43% showing mRS(+) (P=0.371). Our findings indicate that in our elderly patient series, carotid artery stenting may benefit a significant proportion of carotid stenotic patients regardless of age. Ratio of cerebral blood volume, BI, and admission hsCRP could serve as important predictors of mRS improvement and may facilitate differentiation of patients at baseline.
Impact of baseline characteristics on outcomes of carotid artery stenting in acute ischemic stroke patients
(2016-01-01)
Yu, Cheng-Sheng
;
Lin, Chih-Ming
;
Liu, Chi-Kuang
;
Lu, Henry Horng-Shing
;
生物科技學院
Carotid artery stenting is an effective treatment for ischemic stroke patients with moderate-to-severe carotid artery stenosis. However, the midterm outcome for patients undergoing this procedure varies considerably with baseline characteristics. To determine the impact of baseline characteristics on outcomes following carotid artery stenting, data from 107 eligible patients with a first episode of ischemic stroke were collected by retrospective chart review. A modified Rankin Scale (mRS) was used to divide patients into two baseline groups, mRS <= 2 and mRS >2. A three-step decision-tree statistical analysis was conducted. After weighting the decision-tree parameters, the following impact hierarchy was obtained: admission low-density lipoprotein, gouty arthritis, chronic kidney disease, ipsilateral common carotid artery resistance index, contralateral ophthalmic artery resistance index, sex, and dyslipidemia. The finite-state machine model demonstrated that, in patients with baseline mRS <= 2, 46% had an improved mRS score at follow-up, whereas 54% had a stable mRS score. In patients with baseline mRS > 2, a stable mRS score was observed in 75%, improved score in 23%, and a poorer score in 2%. Admission low-density lipoprotein was the strongest predictive factor influencing poststenting outcome. In addition, our study provides further evidence that carotid artery stenting can be of benefit in first-time ischemic stroke patients with baseline mRS scores > 2.
Optimal design of resonant piezoelectric buzzer from a perspective of vibration-absorber theory
(2007-09-01)
Bai, Mingsian R.
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Chen, Rong-Liang
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Chuang, Chung-Yuan
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Yu, Cheng-Sheng
;
Hsieh, Huey-Lin
In this paper, an optimization technique is presented for the design of piezoelectric buzzers. This design technique aims at finding the optimal configuration of the coupled cavity and diaphragm structure to maximize the sound pressure output. Instead of measuring the material constants of the piezoelectric ceramic and the metal diaphragm, an "added-mass method" is developed to estimate the equivalent electromechanical parameters of the system on which an analogous circuit can be established. The electrical impedance and on-axis sound pressure level of the piezoelectric buzzer can be simulated by solving the loop equations of the electromechanoacoustical analogous circuit. An interesting finding of this research is that the nature of the piezoelectric buzzer bears remarkable resemblance to that in the dynamic vibration absorber theory. Much physical insight can be gained by exploiting this resemblance in search of the optimal configuration. According to the system characteristic equation, a design chart was devised to "lock" the critical frequency at which the system delivers the maximal output. On the basis of the analogous circuit and the vibration absorber theory, an optimal design was found with constrained optimization formalism. Experiments were conducted to justify the optimal design. The results showed that the performance was significantly improved using the optimal design over the original design. Design guidelines for the piezoelectric buzzers are summarized. (c) 2007 Acoustical Society of America.
Role of Extracranial Carotid Duplex and Computed Tomography Perfusion Scanning in Evaluating Perfusion Status of Pericarotid Stenting
(2016-01-01)
Lin, Chih-Ming
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Chang, Yu-Jun
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Liu, Chi-Kuang
;
Yu, Cheng-Sheng
;
Lu, Henry Horng-Shing
Carotid stenting is an effective treatment of choice in terms of treating ischemic stroke patients with concomitant carotid stenosis. Though computed tomography perfusion scan has been recognized as a standard tool to monitor/ follow up this group of patients, not everyone could endure due to underlyingmedical illness. In contrast, carotid duplex is a noninvasive assessment tool and could track patient clinical condition in real time. In this studywe found that "resistance index" of the carotid ultrasound could detect flow changes before and after the stenting procedure, thus having great capacity to replace the role of computed tomography perfusion exam.