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2. Feasibility and Accessibility of Human-Centered AI-Based Simulation System for Improving the Occupational Safety of Clinical Workplace

Author

Wang, Pin-Hsuan, Huang, Anna YuQing, Huang, Yen-Hsun, Yang, Ying-Ying, Lirng, JiingFeng, Li, Tzu-Hao, Hou, Ming-Chih, Chen, Chen-Huan, Yang, Albert ChihChieh, Lin, Chi-Hung, and Sheu, Wayne Huey-Herng

Abstract

Medical personnel need to learn occupational safety knowledge in clinical workplaces, not only to ensure their own safety, but also to further ensure patients safety. Based on Human-centered artificial intelligence (HAI) technology, this study will provide HAI-based occupational safety training system for two training topics, Needle Stick/Sharps Injury (NSSI) prevention and appropriate Clinical Waste Management (CWM). From April 2018 to December 2021, this clinical occupational safety HAI training is used by 342 medical personnel (doctors and non-doctors). This study aims to investigate the learning performance and effectiveness including decreasing anxiety and increasing mastering level of users. This study shows that, for the first-time and feel-friendly users of this HAI training system, not only can they achieve significant learning improvement, but they can also effectively decrease their anxiety and increase their mastery level of clinical work safety knowledge and skill. In terms of learning performance and effectiveness, this study found that doctors are significantly benefited by the HAI training system in contrast to non-doctors.

Published
2023

3. Precision subclassification of type 2 diabetes: a systematic review

Author

Misra, Shivani, Wagner, Robert, Ozkan, Bige, Schön, Martin, Sevilla-Gonzalez, Magdalena, Prystupa, Katsiaryna, Wang, Caroline C., Kreienkamp, Raymond J., Cromer, Sara J., Rooney, Mary R., Duan, Daisy, Thuesen, Anne Cathrine Baun, Wallace, Amelia S., Leong, Aaron, Deutsch, Aaron J., Andersen, Mette K., Billings, Liana K., Eckel, Robert H., Sheu, Wayne Huey-Herng, Hansen, Torben, Stefan, Norbert, Goodarzi, Mark O., Ray, Debashree, Selvin, Elizabeth, Florez, Jose C., Meigs, James B., and Udler, Miriam S.

Published
2023
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10. Defining patient-reported outcomes in diabetes, obesity, cardiovascular disease, and chronic kidney disease for clinical practice guidelines - perspectives of the taskforce of the Guideline Workshop.

Author

Barnard-Kelly, Katharine, Battelino, Tadej, Brosius, Frank C., Ceriello, Antonio, Cosentino, Francesco, Gavin III, James R., Giorgino, Francesco, Green, Jennifer, Ji, Linong, Kellerer, Monika, Koob, Sue, Kosiborod, Mikhail, Lalic, Nebojsa, Marx, Nikolaus, Nedungadi, Prashant, Parkin, Christopher G., Rodbard, Helena W., Rötzer, René D., Rydén, Lars, and Sheu, Wayne Huey-Herng

Subjects
CHRONIC kidney failure, QUALITY of life, MEDICAL sciences, CARDIOVASCULAR diseases, PUBLIC health
Abstract

Recent clinical practice guidelines for diabetes, obesity, cardiovascular disease (CVD) and chronic kidney disease (CKD) emphasise a holistic, person-centred approach to care. However, they do not include recommendations for the assessment of patient-reported outcomes (PROs), which would – dependent on the topic of guideline – be important for improving shared decision-making, patients' concordance with guideline recommendations, clinical outcomes and health-related quality of life (HRQoL). The Taskforce of the Guideline Workshop discussed PROs in diabetes, obesity, CVD and CKD as well as the relevance of their inclusion in clinical practice guidelines for the management of these conditions. Highlights: Patient engagement in disease management is a topic that is becoming increasingly important, also in terms of improving clinical outcomes Person-reported outcome measures (PROMs) are tools to assess person-reported outcomes (PROs) in an efficient and standardized manner Validated disease-specific measures for diabetes, obesity, CVD, and CKD as well as generic measures are available Currently underutilised in the routine care of cardio-renal-metabolic diseases, the integration of recommendations on PROs and PROMs into clinical practice guidelines may help to overcome the barriers to their implementation [ABSTRACT FROM AUTHOR]

Published
2025
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17. Optimizing lipid control in Taiwanese diabetic patients: A collaborative consensus by the Diabetes Association of the Republic of China (Taiwan) and the Taiwanese Association of Diabetes Educators.

Author

Shen, Feng‐Chih, Chu, Chih‐Hsun, Chen, Jung‐Fu, Kuo, Chin‐Sung, Hsu, Chih‐Yao, Lin, Ching‐Han, Sheen, Yi‐Jing, Su, Sheng‐Chiang, Tien, Kai‐Jen, Lu, Chieh‐Hua, Lee, Chun‐Chuan, Yang, Yi‐Sun, Tu, Shih‐Te, Chen, Po‐Tsang, Chen, Ching‐Chu, Chien, Ming‐Nan, Li, Hung‐Yuan, Sheu, Wayne Huey‐Herng, Huang, Chien‐Ning, and Wang, Chih‐Yuan

Subjects
CONSENSUS (Social sciences), GLYCEMIC control, DIABETES, PEOPLE with diabetes, HYPERLIPIDEMIA
Abstract

We present an in‐depth analysis of dyslipidemia management strategies for patients with diabetes mellitus in Taiwan. It critically examines the disparity between established guideline recommendations and actual clinical practices, particularly in the context of evolving policies affecting statin prescriptions. The focus is on synthesizing the most recent findings concerning lipid management in patients with diabetes mellitus, with a special emphasis on establishing consensus regarding low‐density lipoprotein cholesterol treatment targets. The article culminates in providing comprehensive, evidence‐based recommendations tailored to the unique needs of those living with diabetes mellitus in Taiwan. It underscores the criticality of personalized care approaches, which incorporate multifaceted factors, and the integration of novel therapeutic options to enhance cardiovascular health outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Associations of Mitochondrial and Nuclear Mitochondrial Variants and Genes with Seven Metabolic Traits

Author

Kraja, Aldi T., Liu, Chunyu, Fetterman, Jessica L., Graff, Mariaelisa, Have, Christian Theil, Gu, Charles, Yanek, Lisa R., Feitosa, Mary F., Arking, Dan E., Chasman, Daniel I., Young, Kristin, Ligthart, Symen, Hill, W. David, Weiss, Stefan, Luan, Jian’an, Giulianini, Franco, Li-Gao, Ruifang, Hartwig, Fernando P., Lin, Shiow J., Wang, Lihua, Richardson, Tom G., Yao, Jie, Fernandez, Eliana P., Ghanbari, Mohsen, Wojczynski, Mary K., Lee, Wen-Jane, Argos, Maria, Armasu, Sebastian M., Barve, Ruteja A., Ryan, Kathleen A., An, Ping, Baranski, Thomas J., Bielinski, Suzette J., Bowden, Donald W., Broeckel, Ulrich, Christensen, Kaare, Chu, Audrey Y., Corley, Janie, Cox, Simon R., Uitterlinden, Andre G., Rivadeneira, Fernando, Cropp, Cheryl D., Daw, E. Warwick, van Heemst, Diana, de las Fuentes, Lisa, Gao, He, Tzoulaki, Ioanna, Ahluwalia, Tarunveer S., de Mutsert, Renée, Emery, Leslie S., Erzurumluoglu, A. Mesut, Perry, James A., Fu, Mao, Forouhi, Nita G., Gu, Zhenglong, Hai, Yang, Harris, Sarah E., Hemani, Gibran, Hunt, Steven C., Irvin, Marguerite R., Jonsson, Anna E., Justice, Anne E., Kerrison, Nicola D., Larson, Nicholas B., Lin, Keng-Hung, Love-Gregory, Latisha D., Mathias, Rasika A., Lee, Joseph H., Nauck, Matthias, Noordam, Raymond, Ong, Ken K., Pankow, James, Patki, Amit, Pattie, Alison, Petersmann, Astrid, Qi, Qibin, Ribel-Madsen, Rasmus, Rohde, Rebecca, Sandow, Kevin, Schnurr, Theresia M., Sofer, Tamar, Starr, John M., Taylor, Adele M., Teumer, Alexander, Timpson, Nicholas J., de Haan, Hugoline G., Wang, Yujie, Weeke, Peter E., Williams, Christine, Wu, Hongsheng, Yang, Wei, Zeng, Donglin, Witte, Daniel R., Weir, Bruce S., Wareham, Nicholas J., Vestergaard, Henrik, Turner, Stephen T., Torp-Pedersen, Christian, Stergiakouli, Evie, Sheu, Wayne Huey-Herng, Rosendaal, Frits R., Ikram, M. Arfan, Franco, Oscar H., Ridker, Paul M., Perls, Thomas T., Pedersen, Oluf, Nohr, Ellen A., Newman, Anne B., Linneberg, Allan, Langenberg, Claudia, Kilpeläinen, Tuomas O., Kardia, Sharon L.R., Jørgensen, Marit E., Jørgensen, Torben, Sørensen, Thorkild I.A., Homuth, Georg, Hansen, Torben, Goodarzi, Mark O., Deary, Ian J., Christensen, Cramer, Chen, Yii-Der Ida, Chakravarti, Aravinda, Brandslund, Ivan, Bonnelykke, Klaus, Taylor, Kent D., Wilson, James G., Rodriguez, Santiago, Davies, Gail, Horta, Bernardo L., Thyagarajan, Bharat, Rao, D.C., Grarup, Niels, Davila-Roman, Victor G., Hudson, Gavin, Guo, Xiuqing, Arnett, Donna K., Hayward, Caroline, Vaidya, Dhananjay, Mook-Kanamori, Dennis O., Tiwari, Hemant K., Levy, Daniel, Loos, Ruth J.F., Dehghan, Abbas, Elliott, Paul, Malik, Afshan N., Scott, Robert A., Becker, Diane M., de Andrade, Mariza, Province, Michael A., Meigs, James B., Rotter, Jerome I., and North, Kari E.

Published
2019
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21. 2018 consensus of the Taiwan Society of Cardiology and the Diabetes Association of Republic of China (Taiwan) on the pharmacological management of patients with type 2 diabetes and cardiovascular diseases

Author

Chiang, Chern-En, Lin, Shih-Yi, Lin, Tsung-Hsien, Wang, Tzung-Dau, Yeh, Hung-I, Chen, Jung-Fu, Tsai, Chia-Ti, Hung, Yi-Jen, Li, Yi-Heng, Liu, Ping-Yen, Chang, Kuan-Cheng, Wang, Kang-Ling, Chao, Ting-Hsing, Shyu, Kou-Gi, Yang, Wei-Shiung, Ueng, Kwo-Chang, Chu, Pao-Hsien, Yin, Wei-Hsian, Wu, Yen-Wen, Cheng, Hao-Min, Shin, Shyi-Jang, Huang, Chien-Ning, Chuang, Lee-Ming, Lin, Shing-Jong, Yeh, San-Jou, Sheu, Wayne Huey-Herng, and Lin, Jiunn-Lee

Published
2018
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24. Use of Facebook by Academic Medical Centers in Taiwan During the COVID-19 Pandemic: Observational Study

Author

Chu, Wei-Min, Shieh, Gow-Jen, Wu, Shi-Liang, and Sheu, Wayne Huey-Herng

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundThe battle against COVID-19 remains ongoing, and social media has played an important role during the crisis for both communication and health promotion, particularly for health care organizations. Taiwan’s success during the COVID-19 outbreak is well known and the use of social media is one of the key contributing factors to that success. ObjectiveThis nationwide observational study in Taiwan aimed to explore the use of Facebook by academic medical centers during the COVID-19 pandemic. MethodsWe conducted a nationwide observational study of all Facebook fan page posts culled from the official accounts of all medical centers in Taiwan from December 2019 to April 2020. All Facebook posts were categorized into either COVID-19–related posts or non–COVID-19–related posts. COVID-19–related posts were split into 4 categories: policy of Taiwan’s Center for Disease Control (TCDC), gratitude notes, news and regulations from hospitals, and education. Data from each post was also recorded as follows: date of post, headline, number of “likes,” number of messages left, number of shares, video or non-video post, and date of search. ResultsThe Facebook fan pages of 13 academic medical centers, with a total of 1816 posts, were analyzed. From January 2020, the percentage of COVID-19 posts increased rapidly, from 21% (January 2020) to 56.3% (April 2020). The trends of cumulative COVID-19 posts and reported confirmed cases were significantly related (Pearson correlation coefficient=0.93, P

Published
2020
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35. Data from network meta-analyses can inform clinical practice guidelines and decision-making in diabetes management: perspectives of the taskforce of the guideline workshop.

Author

Ceriello, Antonio, Rodbard, Helena W., Battelino, Tadej, Brosius, Frank, Cosentino, Francesco, Green, Jennifer, Ji, Linong, Kellerer, Monika, Koob, Susan, Kosiborod, Mikhail, Lalic, Nebojsa, Marx, Nikolaus, Nedungadi, T. Prashant, Parkin, Christopher G., Rydén, Lars, Sheu, Wayne Huey-Herng, Standl, Eberhard, Vandvik, Per Olav, and Schnell, Oliver

Subjects
TYPE 2 diabetes, MINERALOCORTICOID receptors, GLUCAGON-like peptide-1 receptor, DIABETES, GLUCAGON-like peptide-1 agonists, HYPERGLYCEMIA
Abstract

In recent years, several novel agents have become available to treat individuals with type 2 diabetes (T2D), such as sodium-glucose cotransporter-2 inhibitors (SGLT-2i), tirzepatide, which is a dual glucose-dependent insulinotropic polypeptide receptor agonist (GIP RA)/glucagon-like peptide-1 receptor agonist (GLP-1 RA), and finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA) that confers significant renal and cardiovascular benefits in individuals with (CKD). New medications have the potential to improve the lives of individuals with diabetes. However, clinicians are challenged to understand the benefits and potential risks associated with these new and emerging treatment options. In this article, we discuss how use of network meta-analyses (NMA) can fill this need. [ABSTRACT FROM AUTHOR]

Published
2023
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45. Influence of Diabetic Retinopathy on the Relationship Between Body Mass Index and Mortality in Patients with Poorly Controlled Type 2 Diabetes

Author

Li, Yu-Hsuan, Sheu, Wayne Huey-Herng, and Lee, I-Te

Subjects
obesity, paradox, retrospective, overweight, cohort, Targets and Therapy [Diabetes, Metabolic Syndrome and Obesity], inpatient, Original Research
Abstract

Yu-Hsuan Li,1,2 Wayne Huey-Herng Sheu,1,3,4 I-Te Lee1,3,5,6 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; 2Graduate Institute of Data Science, Taipei Medical University, Taipei 11031, Taiwan; 3School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan; 4Rong Hsing Research Center for Translational Medicine, College of Life Sciences, National Chung Hsing University, Taichung 40227, Taiwan; 5School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; 6College of Science, Tunghai University, Taichung 40704, TaiwanCorrespondence: I-Te LeeDivision of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sect. 4, Taichung 40705, TaiwanTel +886-4-23741300Fax +886-4-23593662Email itlee@vghtc.gov.twPurpose: An “obesity paradox” has been observed in patients with type 2 diabetes. However, the optimal body mass index (BMI) for survival may be influenced by the stage of diabetes. We examined the relationship between BMI and mortality in patients with type 2 diabetes and the influence of diabetic retinopathy (DR).Patients and Methods: This is a retrospective cohort composing patients with type 2 diabetes who wereadmitted due to poor glucose control. Presence of DR was confirmed by ophthalmologists. The primary outcome was all-cause mortality. The association between BMI and mortality was assessed using a Cox proportional hazards model with adjustment for age, sex, and traditional risk factors.Results: A total of 2053 patients were enrolled. Over median follow-up of 6.7 years, there were 1060 deaths. Patients were classified into five categories based on admission BMI (kg/m2): < 18.5, 18.5‒23, 23‒25, 25‒27 (reference), 25‒30 and > 30. Mortality risk was significantly higher in the < 18.5 kg/m2, 18.5– 23 kg/m2, and 23– 25 kg/m2 categories than in the reference category (P < 0.001). The similar obesity paradox was observed in the subgroup of patients without DR. However, in patients with DR, only patients with BMI < 18.5 kg/m2 had significantly increased mortality than those in the reference category. The presence of DR significantly modified the shape of the association between BMI and mortality (P = 0.019).Conclusion: The obesity paradox exists in patients with poorly controlled type 2 diabetes. The presence of DR appears to significantly influence the shape of the association between BMI and mortality.Keywords: cohort, inpatient, obesity, paradox, overweight, retrospective

Published
2020

48. Toward better diabetes care: Exploration and implementation.

Author

Sheu, Wayne Huey‐Herng

Subjects
*TECHNOLOGICAL innovations, *ELECTRONIC health records, *DIABETES, *PATIENT readmissions, *INDIVIDUALIZED medicine
Abstract

Approximately 40 years ago, I was fortunate enough to step into the field of diabetes. When I had my fellowship training in the USA, I learned how to ask a good scientific question and conduct clinical research. With collaboration with my mentors, Prof. Gerald R Reaven and Prof. Ida Chen, we participated in many clinical trials. We established the Taiwan Diabetes Registry (TDR) to track long‐term changes in diabetes profiles. The ultimate purpose of medical research is to provide benefits to patients. Using electronic medical records and point‐of‐care glucometers, we reduced inpatients' hyperglycemia and hypoglycemia greatly, which was also reflected by the reduction in hospital stays and readmission rates. With the advent of new technology and medications, we have to ponder where we are on the journey toward better diabetes care. We rigorously advocate diabetes care, hold many symposia and publish updated guidelines. We successfully hosted the congress of the 11th International Diabetes Federation Western Pacific Region & 8th Asian Association for the Study of Diabetes Scientific Meeting 2016 at Taipei, Taiwan. As the era of precision medicine is coming, Taiwan could be considered as one of the best places to run precision medicine. The Taiwan Precision Medicine Initiative has enrolled more than half a million residents, and is currently conducting genotyping and data analysis. In conclusion. I witnessed the early days of simple and few choices for diabetes management to the current various modalities in diabetes care. As these new technologies have become available, patients will always remain at the center of the care model with warmth and humility. In this review, I had addressed the issues how to advance better diabetes care via exploration and implementation, both of which I had spend my efforts in past 4 decades. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Association of Major Adverse Cardiac Events and Beta-Blockers in Patients with and without Atherosclerotic Cardiovascular Disease: Long-Term Follow-Up Results of the T-SPARCLE and T-PPARCLE Registry in Taiwan.

Author

Liu, Patrick Yan-Tyng, Lin, Fang-Ju, Yeh, Chih-Fan, Hsiao, Yu-Chung, Hsuan, Chin-Feng, Chang, Wei-Tien, Kao, Hsien-Li, Jeng, Jiann-Shing, Wu, Yen-Wen, Hsieh, I-Chang, Fang, Ching-Chang, Wang, Kuo-Yang, Chang, Kuan-Cheng, Lin, Tsung-Hsien, Sheu, Wayne Huey-Herng, Li, Yi-Heng, Yin, Wei-Hsian, Yeh, Hung-I, Chen, Jaw-Wen, and Wu, Chau-Chung

Subjects
MAJOR adverse cardiovascular events, CARDIOVASCULAR diseases, TAIWANESE people, ADRENERGIC beta blockers
Abstract

Beta-blockers are widely used, but the benefit is now challenged in patients at risk of atherosclerotic cardiovascular disease (ASCVD) in the present coronary reperfusion era. We aimed to identify the risk factors of a major adverse cardiac event (MACE) and the long-term effect of beta-blockers in two large cohorts in Taiwan. Two prospective observational cohorts, including patients with known atherosclerosis cardiovascular disease (T-SPARCLE) and patients with at least one risk factor of ASCVD but without clinically evident ASCVD (T-PPARCLE), were conducted in Taiwan. The primary endpoint is the time of first occurrence of a MACE (cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, and cardiac arrest with resuscitation). Between December 2009 and November 2014, with a median 2.4 years follow-up, 11,747 eligible patients (6921 and 4826 in T-SPARCLE and T-PPARCLE, respectively) were enrolled. Among them, 273 patients (2.3%) met the primary endpoint. With multivariate Cox PH model analysis, usage of beta-blocker was lower in patients with MACE (42.9% vs. 52.4%, p < 0.01). In patients with ASCVD, beta-blocker usage was associated with lower MACEs (hazard ratio 0.72; p < 0.001), but not in patients without ASCVD. The event-free survival of beta-blocker users remained higher during the follow-up period (p < 0.005) of ASCVD patients. In conclusion, in ASCVD patients, reduced MACE was associated with beta-blocker usage, and the effect was maintained during a six-year follow-up. Prescribing beta-blockers as secondary prevention is reasonable in the Taiwanese population. [ABSTRACT FROM AUTHOR]

Published
2023
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