Wayne H.-h. Sheu - Academia.edu (original) (raw)

Papers by Wayne H.-h. Sheu

International Journal of Environmental Research and Public Health

Background: Little has been done regarding the research on quality and quantity of patient suppor... more Background: Little has been done regarding the research on quality and quantity of patient support groups (PSGs) and how they can be improved. Here, we present three-year experiences of a quality improvement (QI) program of our PSGs. Methods: We launched earlier on a three-year project to improve our PSGs, including the number and quality of curricula. Data were collected on the number of PSGs, curricula, and participants. Results: In the first year, we organized relevant resources of our hospital and established a standard protocol for applying financial support and reporting the results. In the second year, we elected “the best patient” to promote sense of honor and better peer supports. In the third year, we surveyed through questionnaires participants’ health literacy to improve their feedback. Competitions and exhibitions of achievements were held each year to share results of every PSG. Finally, we had increased the volume of participation of patients and family over these thr...

$Research paper thumbnail of Shorter (GT)n repeats in the heme-oxygenase 1 gene promoter are associated with better mid-term survival in subjects with coronary artery disease and abnormal ejection fraction$

Biomarkers

BACKGROUND Heme oxygenase (HO)-1 is a rate-limiting enzyme for degrading heme into carbon monoxid... more BACKGROUND Heme oxygenase (HO)-1 is a rate-limiting enzyme for degrading heme into carbon monoxide. Subjects with longer GT repeats in the HO-1 gene (HMOX1) promoter are more likely to have coronary artery disease (CAD) and cardiovascular events. METHODS We retrospectively enrolled CAD subjects with an abnormal ejection fraction (EF) < 50% from our catheterization data (N = 670). Polymerase chain reactions were performed for amplifying the HMOX1 promoter GT repeating segment to determine the number of repeats. RESULTS In a median follow-up period of 40 months, 213 patients died. The distribution of genotype for HMOX1 promoter GT repeating segments SS, SL and LL were significantly different (p < 0.001) between the dead (44.6%, 36.2%, 19.2%, respectively) and the survived (53.8%, 37.4%, 8.8%, respectively)(S allele: ≤ 30 repeats, L allele:> 30 repeats). In Cox regression analysis, carrier of S allele (hazard ratio 0.665, p = 0.027), a higher EF (hazard ratio 0.037, p = 0.001) and revascularization with PCI were all negatively associated with all-cause death in subjects with CAD and abnormal EF. CONCLUSIONS Carrier of shorter (GT)n repeats of HMOX1 gene promoter was negatively correlated with death events in CAD patients with abnormal EF.

Genes

Background: Familial hypercholesterolemia (FH) has been associated with early coronary artery dis... more Background: Familial hypercholesterolemia (FH) has been associated with early coronary artery disease (CAD) and increased risk of atherosclerotic cardiovascular disease. However, the prevalence of FH and its long-term outcomes in a CAD-high-risk cohort, defined as patients with hypercholesteremia who underwent coronary angiography, remains unknown. Besides, studies regarding the impact of genetic variations in FH on long-term cardiovascular (CV) outcomes are scarce. Methods and Results: In total, 285 patients hospitalized for coronary angiography with blood low-density lipoprotein cholesterol (LDL-C) levels ≥ 160 mg/dL were sequenced to detect FH genetic variations in LDL receptors apolipoprotein B and proprotein convertase subtilisin/kexin type 9. Risk factors associated with long-term CV outcomes were evaluated. The prevalence of FH was high (14.4%). CAD and early CAD were significantly more prevalent among FH variation carriers than non-carriers, despite comparable blood LDL-C le...

Medicine

Supplemental Digital Content is available in the text Abstract A patient support group (PSG) can ... more Supplemental Digital Content is available in the text Abstract A patient support group (PSG) can serve the purposes of group therapy and education. However, how to evaluate outcome which can feedback to improve the PSG remains unclear. Health literacy, which is associated with patient outcome, has not been used in the evaluation of PSG. Since 2017, we had conducted a working group dedicated to the creation and improvement of PSG. We applied a questionnaire (Mandarin Multidimensional Health Literacy Questionnaire, MMHLQ) for PSGs of all kinds of diseases (5 types, 8 diseases). The outcome was evaluated by the MMHLQ (5 dimensions, 20 variables). We determined factors (age, 1st-time/non-1st-time participation, and patient/family participation) that were associated with all 20 health literacy. We finally obtained 458 questionnaires, with a response rate as high as 91.1% in 8 PSGs. Participants were 55.30 ± 16.39 y/o. The highest score was with the dimension of understanding (12.25 ± 1.85) and the lowest score was with the dimension of appraisal (10.66 ± 2.33). Participating patients (compared to family) were associated with a higher score with “obey the instruction of medical personnel to care disease” but lower score with “find health information from the network”. Moreover, older participants (age ≥65 years) had lower scores for all questions in MMHLQ, within which the dimension of appraisal received the lowest scores (P < .001). We found that the highest score is with the dimension of understanding, and the lowest score with the dimension of appraisal. The elderly participants showed lower abilities in health literacy, especially with the dimension of the appraisal. Results from MMHLQ can be used to adjust the PSG curriculum to improve the health literacy of participants.

Diabetes

In the article cited above, in the first paragraph of RESULTS, a link to the full set of results ... more In the article cited above, in the first paragraph of RESULTS, a link to the full set of results was given as https://www.ncbi.nlm.nih.gov/gap. Due to National Institutes of Health (NIH) administrative resource constraints and the absence of a requirement for dbGAP deposition of summary statistics, the NIH requested the authors deposit the data in an alternate public database. Therefore, the data were instead subsequently deposited in the Type 2 Diabetes Knowledge Portal (http://www.type2diabetesgenetics.org/).

Journal of the Formosan Medical Association

Summary paragraphThe Trans-Omics for Precision Medicine (TOPMed) program seeks to elucidate the g... more Summary paragraphThe Trans-Omics for Precision Medicine (TOPMed) program seeks to elucidate the genetic architecture and disease biology of heart, lung, blood, and sleep disorders, with the ultimate goal of improving diagnosis, treatment, and prevention. The initial phases of the program focus on whole genome sequencing of individuals with rich phenotypic data and diverse backgrounds. Here, we describe TOPMed goals and design as well as resources and early insights from the sequence data. The resources include a variant browser, a genotype imputation panel, and sharing of genomic and phenotypic data via dbGaP. In 53,581 TOPMed samples, >400 million single-nucleotide and insertion/deletion variants were detected by alignment with the reference genome. Additional novel variants are detectable through assembly of unmapped reads and customized analysis in highly variable loci. Among the >400 million variants detected, 97% have frequency <1% and 46% are singletons. These rare va...

Diabetes, Obesity and Metabolism

To assess the cardiovascular (CV) safety of oral semaglutide, the first tablet formulation of a g... more To assess the cardiovascular (CV) safety of oral semaglutide, the first tablet formulation of a glucagon-like peptide-1 receptor agonist. Materials and methods: PIONEER 6 is a multinational, randomized, placebo-controlled, double-blind trial in patients with type 2 diabetes at high risk of CV events (defined as being aged ≥50 years and having established CV disease [CVD] or moderate [stage 3] chronic kidney disease [CKD], or being aged ≥60 years with ≥1 other CV risk factor). Patients were randomized to once-daily oral semaglutide (up to 14 mg) or placebo added to standard of care. The primary composite endpoint is time to first occurrence of CV death or non-fatal myocardial infarction or non-fatal stroke. The primary hypothesis was to exclude an excess in CV risk with oral semaglutide by assessing non-inferiority versus placebo for the primary endpoint (noninferiority margin of 1.8 for the upper boundary of the 95% confidence interval of the hazard ratio). PIONEER 6 is event-driven, with follow-up continuing until accrual of at least 122 primary outcome events. There is no pre-defined minimal duration. Results: Overall, 3183 patients have been enrolled (mean age 66.1 years, 31.6% females) in 214 sites across 21 countries. At baseline, the mean duration of diabetes was 14.9 years, mean glycated haemoglobin concentration was 66 mmol/mol (8.2%), and 84.6% of patients had established CVD/moderate CKD. Conclusions: PIONEER 6 will provide evidence regarding the CV safety of oral semaglutide in patients with type 2 diabetes and high CV risk.

Journal of diabetes investigation, Jan 25, 2018

Biosimilar insulin may reduce treatment costs although its extent of usage is largely unknown. We... more Biosimilar insulin may reduce treatment costs although its extent of usage is largely unknown. We examined biosimilar insulin use and its associations with quality of glycemic control using the JADE (Joint Asia Diabetes Evaluation) Register. We conducted a cross-sectional analysis in 81,531 patients with type 1 and type 2 diabetes enrolled into the JADE Programme from 2007 to 2014. We extracted all insulin-related terms from the JADE portal and compared clinical profiles between biosimilar and originator insulin users. We performed multivariate analysis to assess the association of biosimilar insulin compared with originator insulin with dosage, HbA1c and hypoglycaemia events. Amongst 81,531 patients, 20.5% (n=16,738) were insulin-treated. In four countries with high usage of biosimilar insulin, 4.7% (n=719) of insulin users (n=10,197) were treated with biosimilar insulin [India (n=507, 70.3%), Philippines (n=90, 12.5%), China (n=62, 8.6%), Vietnam (n=60, 8.3%)]. Biosimilar insulin ...

Oncotarget

Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral anti-hyperglycemic drugs enabling effective gl... more Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral anti-hyperglycemic drugs enabling effective glycemic control in type 2 diabetes (T2D). Despite DPP-4 inhibitors' advantages, the patients' therapeutic response varies. In this retrospective cohort study, 171 Taiwanese patients with T2D were classified as sensitive or resistant to treatment based on the mean change in HbA1c levels. Using an assumption-free genome-wide association study, 45 single nucleotide polymorphisms (SNPs) involved in the therapeutic response to DPP-4 inhibitors (P < 1 × 10-4) were identified at or near PRKD1, CNTN3, ASK, and LOC10537792. A SNP located within the fourth intron of PRKD1 (rs57803087) was strongly associated with DPP-4 inhibitor response (P = 3.2 × 10-6). This is the first pharmacogenomics study on DPP-4 inhibitor treatment for diabetes in a Taiwanese population. Our data suggest that genes associated with β-cell function and apoptosis are involved in the therapeutic effect of DPP-4 inhibitors, even in the presence of additional oral anti-diabetic drugs. Our findings provide information on how genetic variants influence drug response and may benefit the development of personalized medicine.

Atherosclerosis Supplements

The aim of our study is to assess prevalence of MetS in patients with peripheral arterial disease... more The aim of our study is to assess prevalence of MetS in patients with peripheral arterial disease (PAD) and its correlation with localization of atherosclerosis, androgen profile and cardiovascular comorbidity. Methods: The presence of MetS was assessed in 98 PAD male patients. Mets was defined by the criteria of IDF (2005). All patients had undergone peripheral angiography. Level of total testosterone 11 nmol/L was considered normal. Results: The prevalence of the metabolic syndrome in the study population was 59.2%. The mean age of patients with MetS was 61.4±5.2 (mean±SD) years compared with 68.1±6.7 years for patients without MetS (P = 0.032). 26.5% of PAD patients presented total testosterone below normal. In patients with and without MetS, respectively, levels of plasma total testosterone were 8.2±0.7 versus 15.9±2.1 nmol/L (P < 0.05). A previous myocardial infarction was documented in 45.9% of patients with MetS and in 25.5% of those without MetS (P < 0.05). 27 (27.6%) patients with Mets had cerebrovascular accident in anamnesis (versus 17.3% in subjects without MetS, P < 0.05). Severe atherosclerosis of infrainguinal arteries was detected in 79.6% of patients with MetS (versus 35.7% in control, P < 0.05). In our study there were no patients with MetS with isolate occlusion of iliac arteries, but only in association with atherosclerosis of runoff vessels. Conclusion: MetS is present in >50% of PAD patients and strongly associated with hypoandrogenaemia, severe atherosclerosis of infrainguinal arteries and high cardiovascular comorbidity.

Diabetes Research and Clinical Practice

Medicine, 2017

The effect of glycemic control on the prognosis of nondiabetic patients after acute myocardial in... more The effect of glycemic control on the prognosis of nondiabetic patients after acute myocardial infarction (AMI) remains uncertain. We investigated whether glycated hemoglobin (HbA1c) is associated with adverse outcomes after AMI in nondiabetic patients. In this observational study, we enrolled nondiabetic patients with AMI in the emergency department of 2 medical centers from January 2011 to September 2014. All patients received primary percutaneous coronary intervention and were divided into 4 groups according to the interquartile range of average HbA1c level (Group I, ≤5.6%; Group II, 5.6%-5.8%; Group III, 5.8%-6.0%; and Group IV, >6.0%). Multivariate logistic analysis was performed to estimate the correlation of HbA1c with major adverse cardiac events (MACEs) after AMI. In total, 267 eligible patients were enrolled; 48 patients (18%) developed MACEs within a median follow-up of 178 days. Univariate analysis showed HbA1c > 6.0%, with a higher risk of MACEs in Group IV than i...

Diabetes Research and Clinical Practice, 2016

A double exposure technology, SPADE (Single Photo-resist And Double Exposure), utilizes the total... more A double exposure technology, SPADE (Single Photo-resist And Double Exposure), utilizes the total accumulation resist energy exposing by different masks for pattern development. This "SPADE" process is a double exposure procedure that including resist coating, baking, first mask exposure, and second mask exposure and developer. This paper examines the process condition affecting the performance of ROM codes. We found that the first exposure with pre-code dense pattern is one of most critical parameters to affect the performance of the CD bias and resolution. Additionally, the second mask for real code pattern developer was also investigated in different mask CD size split. The final ROM code CD behavior is determined by both of the two masks. The results of these studies are discussed in term of mask type, exposure dosage, mask sizing and overlay sensitivity. Experimental results indicate that the iso-dense CD bias is smaller than traditional method. The energy latitude (E.L.%) also shows double than that of traditional ones.

PloS one, 2016

Metabolic syndrome (MetS) is a complicated health problem that encompasses a variety of metabolic... more Metabolic syndrome (MetS) is a complicated health problem that encompasses a variety of metabolic disorders. In this study, we analyzed the relationship between the major biochemical parameters associated with MetS and circulating levels of microRNA (miR)-33, miR-103, and miR-155. We found that miRNA-33 levels were positively correlated with levels of fasting blood glucose, glycosylated hemoglobin A1c, total cholesterol, LDL-cholesterol, and triacylglycerol, but negatively correlated with HDL-cholesterol levels. In the cellular study, miR-33 levels were increased in macrophages treated with high glucose and cholesterol-lowering drugs atorvastatin and pitavastatin. miR-33 has been reported to play an essential role in cholesterol homeostasis through ATP-binding cassette transporter A1 (ABCA1) regulation and reverse cholesterol transport. However, the molecular mechanism underlying the linkage between miR-33 and statin treatment remains unclear. In the present study, we investigated w...