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"Hsu Lin, Amy"
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Splat the Cat : blow, snow, blow
Splat the Cat can't wait for enough snow to fall, so he decides he will make it snow somehow.
Book
Changes in risk habits and influencing factors in the Taiwan oral cancer screening program
This study examines changes in oral risk habits and identifies factors influencing these changes among participants in a population-based oral cancer screening program to support effective public health interventions. The study included 2,569,920 individuals aged 30 and older who participated in Taiwan’s Oral Cancer Screening Program at least twice between 2010 and 2021. Changes in cigarette smoking and betel quid chewing were assessed between the first and last screenings and categorized as improved, unchanged, or worsened. A logistic regression model evaluated factors associated with habit improvement, including baseline oral habits, sex, age, education, screening adherence, and oral potentially malignant disorder (OPMD) findings. Among participants, 25.3% improved their oral habits. Baseline habits influenced how OPMD screening results affected behavior change. Among smokers, a positive screening result increased the likelihood of quitting or reducing smoking (adjusted odds ratio [aOR] = 1.18, 95% CI 1.16–1.20). However, among betel quid chewers, whether or not they smoked, a positive screening result was negatively associated with improved habits (aOR 0.79–0.88). Being female, older, college-educated, and regularly attending screenings were positively linked to behavior improvement. The program led to habit improvements in about one-quarter of participants, particularly older individuals, those with higher education, and frequent attendees. However, a diagnosis of OPMD motivated change only among smokers, not those engaging in both smoking and betel quid chewing, highlighting a lack of awareness in high-risk groups. Strengthening collaboration between health organizations and the screening program could enhance public awareness, improve program effectiveness, reduce oral cancer incidence, and lower long-term healthcare costs.
Journal Article
The name of the game
Looking forward to a fun-filled playdate with his friends Spike and Plank, Splat the Cat is dismayed when things start going wrong, from his fall during a game to his inability to find a good hide-and-seek spot.
Book
Performance measures of 8,169,869 examinations in the National Breast Cancer Screening Program in Taiwan, 2004–2020
Background
The benefits of mammographic screening have been shown to include a decrease in mortality due to breast cancer. Taiwan’s Breast Cancer Screening Program is a national screening program that has offered biennial mammographic breast cancer screening for women aged 50–69 years since 2004 and for those aged 45–69 years since 2009, with the implementation of mobile units in 2010. The purpose of this study was to compare the performance results of the program with changes in the previous (2004–2009) and latter (2010–2020) periods.
Methods
A cohort of 3,665,078 women who underwent biennial breast cancer mammography screenings from 2004 to 2020 was conducted, and data were obtained from the Health Promotion Administration, Ministry of Health and Welfare of Taiwan. We compared the participation of screened women and survival rates from breast cancer in the earlier and latter periods across national breast cancer screening programs.
Results
Among 3,665,078 women who underwent 8,169,869 examinations in the study population, the screened population increased from 3.9% in 2004 to 40% in 2019. The mean cancer detection rate was 4.76 and 4.08 cancers per 1000 screening mammograms in the earlier (2004–2009) and latter (2010–2020) periods, respectively. The 10-year survival rate increased from 89.68% in the early period to 97.33% in the latter period. The mean recall rate was 9.90% (95% CI: 9.83–9.97%) in the early period and decreased to 8.15% (95%CI, 8.13–8.17%) in the latter period.
Conclusions
The evolution of breast cancer screening in Taiwan has yielded favorable outcomes by increasing the screening population, increasing the 10-year survival rate, and reducing the recall rate through the participation of young women, the implementation of a mobile unit service and quality assurance program, thereby providing historical evidence to policy makers to plan future needs.
Journal Article
The rain is a pain
Splat the Cat can't wait to try out his new roller skates, but must stay inside because it's raining.
Book
Development of an Empathy-Centric Counseling Chatbot System Capable of Sentimental Dialogue Analysis
College students encounter various types of stresses in school due to schoolwork, personal relationships, health issues, and future career concerns. Some students are susceptible to the strikes of failures and are inexperienced with or fearful of dealing with setbacks. When these negative emotions gradually accumulate without resolution, they can cause long-term negative effects on students’ physical and mental health. Some potential health problems include depression, anxiety, and disorders such as eating disorders. Universities commonly offer counseling services; however, the demand often exceeds the counseling capacities due to limited numbers of counsellors/psychologists. Thus, students may not receive immediate counseling or treatments. If students are not treated, some repercussions may lead to severe abnormal behavior and even suicide. In this study, combining immersive virtual reality (VR) technique with psychological knowledge base, we developed a VR empathy-centric counseling chatbot (VRECC) that can complementarily support troubled students when counsellors cannot provide immediate support. Through multi-turn (verbal or text) conversations with the chatbot, the system can demonstrate empathy and give therapist-like responses to the users. During the study, more than 120 students were required to complete a questionnaire and 34 subjects with an above-median stress level were randomly drawn for the VRECC experiment. We observed decreasing average stress level and psychological sensitivity scores among subjects after the experiment. Although the system did not yield improvement in life-impact scores (e.g., behavioral and physical impacts), the significant outcomes of lowering stress level and psychological sensitivity have given us a very positive outlook for continuing to integrate VR, AI sentimental natural language process, and counseling chatbot for advanced VRECC research in helping students improve their psychological well-being and life quality at schools.
Journal Article
A whale of a tale
\"Splat's family is going to the beach--and Splat can't wait to find a shell with the sound of the sea inside! But when all he finds are broken shells, can a friend in the ocean help save the day?\"-- Provided by the publisher.
Book
Genetically programmed alternative splicing of NEMO mediates an autoinflammatory disease phenotype
Host defense and inflammation are regulated by the NF-κB essential modulator (NEMO), a scaffolding protein with a broad immune cell and tissue expression profile. Hypomorphic mutations in inhibitor of NF-κB kinase regulatory subunit gamma (IKBKG) encoding NEMO typically present with immunodeficiency. Here, we characterized a pediatric autoinflammatory syndrome in 3 unrelated male patients with distinct X-linked IKBKG germline mutations that led to overexpression of a NEMO protein isoform lacking the domain encoded by exon 5 (NEMO-Δex5). This isoform failed to associate with TANK binding kinase 1 (TBK1), and dermal fibroblasts from affected patients activated NF-κB in response to TNF but not TLR3 or RIG-I-like receptor (RLR) stimulation when isoform levels were high. By contrast, T cells, monocytes, and macrophages that expressed NEMO-Δex5 exhibited increased NF-κB activation and IFN production, and blood cells from these patients expressed a strong IFN and NF-κB transcriptional signature. Immune cells and TNF-stimulated dermal fibroblasts upregulated the inducible IKK protein (IKKi) that was stabilized by NEMO-Δex5, promoting type I IFN induction and antiviral responses. These data revealed how IKBKG mutations that lead to alternative splicing of skipping exon 5 cause a clinical phenotype we have named NEMO deleted exon 5 autoinflammatory syndrome (NDAS), distinct from the immune deficiency syndrome resulting from loss-of-function IKBKG mutations.
Journal Article
Splat the Cat : up in the air at the fair
\"Splat and his friends are going to the fair, but Kitten can't come. They want to bring her back a get-well gift. Will they find the perfect present?\"--Page [4] of cover.
Book
Evaluating correlates of protection for mix-match vaccine against COVID-19 VOCs with potential of evading immunity
In the face of rapid emerging variants of concern (VOCs) with potential of evading immunity from Beta to Omicron and uneven distribution of different vaccine brands, a mix-match strategy has been considered to enhance immunity. However, whether increasing immunogenicity using such a mix-match can lead to high clinical efficacy, particularly when facing Omicron pandemic, still remains elusive without using the traditional phase 3 trial. The aim of this study is to demonstrate how to evaluate correlates of protection (CoP) of the mix-match vaccination.
Data on neutralizing antibody (NtAb) titers and clinical efficacy against Wuhan or D614G strains of homologous ChAdOx1 nCov-19 or mRNA-1273 and heterologous vaccination were extracted from previous studies for demonstration. The reductions in NtAb titers of homologous vaccination against Beta, Delta, and Omicron variants were obtained from literatures. A Bayesian inversion method was used to derive CoP from homologous to mix-match vaccine.
Findings
The predicted efficacy of ChAdOx1 nCov-19 and mRNA-1273 for Wuhan or D614G strains was 93 % (89 %-97 %). Given 8 ∼ 11-fold, 2 ∼ 5.5-fold, and 32.5 ∼ 36-fold reduction of NtAb for Beta, Delta, and Omicron variants compared with D614G, the corresponding predictive efficacy of the mix-match ranged from 75.63 % to 73.87 %, 84.87 % to 81.25 %, and 0.067 % to 0.059 %, respectively.
Interpretations
While ChAdOx1 nCov-19 and mRNA-1273 used for demonstrating how to timely evaluate CoP for the mix-match vaccine still provides clinical efficacy against Beta and Delta VOCs but it appears ineffective for Omicron variants, which highlights the urgent need for next generation vaccine against Omicron variant.
Journal Article