4,958 results on '"C. Chung"'
Search Results
252. Orbital angular momentum densities in the astigmatic transformation of Lissajous geometric laser modes
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Y. F. Chen, W. C. Chung, X. L. Zheng, M. X. Hsieh, J. C. Tung, and H. C. Liang
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Atomic and Molecular Physics, and Optics - Abstract
Orbital angular momentum densities in the astigmatic transformation of Lissajous geometric laser modes are originally and systematically investigated. The quantum theory of the coherent state is exploited to derive an analytical wave representation for the transformed output beams. The derived wave function is further employed to numerically analyze the propagation dependent orbital angular momentum densities. The parts of the negative and positive regions in the orbital angular momentum density are found to rapidly change in the Rayleigh range behind the transformation.
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- 2023
253. Comparison of Distal Radius Fracture Outcomes in Older Adults Stratified by Chronologic vs Physiologic Age Managed With Casting vs Surgery
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Mayank Jayaram, Hao Wu, Alfred P. Yoon, Robert L. Kane, Lu Wang, and Kevin C. Chung
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General Medicine - Abstract
ImportanceCasting is recommended for adults older than 65 years with distal radius fractures (DRFs) because similar long-term outcomes are achieved regardless of treatment. However, physiologically younger adults could benefit from operative DRF management despite advanced chronologic age.ObjectiveTo examine how chronologic age compares with measures of physiologic age in DRF treatment recovery.Design, Setting, and ParticipantsThis retrospective secondary analysis of the Wrist and Radius Injury Surgical Trial (WRIST) was performed from May 1 to August 31, 2022. WRIST was a 24-center randomized clinical trial that enrolled participants older than 60 years with unstable DRFs from April 1, 2012, to December 31, 2016.InterventionsParticipants selected casting or surgery. Patients who selected surgery were randomly assigned to volar lock plating, percutaneous pinning, or external fixation. Participants were stratified by chronologic age, number of comorbidities, and activity status.Main Outcomes and MeasuresThe primary outcome was Michigan Hand Outcomes Questionnaire (MHQ) score assessed at 6 weeks, 3 months, 6 months, and 1 year. Partial correlation (PC) analysis adjusted for confounding.ResultsThe final cohort consisted of 293 participants (mean [SD] age, 71.1 [8.89] years; 255 [87%] female; 247 [85%] White), with 109 receiving casting and 184 receiving surgery. Increased chronologic age was associated with increased MHQ scores in the surgery group at all time points but decreased MHQ scores in the casting group at 12 months (mean [SD] score, −0.46 [0.21]; P = .03). High activity was associated with improved MHQ scores in the surgical cohort at 6 weeks (mean [SD] score, 12.21 [5.18]; PC = 0.27; P = .02) and 12 months (mean [SD] score, 13.25 [5.77]; PC = 0.17; P = .02). Comorbidities were associated with decreased MHQ scores at all time points in the casting group. Clinically significant differences in MHQ scores were associated with low physical activity, 4 or more comorbidities, or increased age by 15 years.Conclusions and RelevanceIn this retrospective secondary analysis of WRIST, chronologic age was not associated with functional demand. These findings suggest that physicians should counsel active older adults with few comorbidities on earlier return to daily activities after surgery compared with casting.Trial RegistrationClinicalTrials.gov Identifier: NCT01589692
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- 2023
254. Diversity, Equity, and Inclusion in Hand Surgery
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Michael G. Galvez and Kevin C. Chung
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Orthopedics and Sports Medicine ,Surgery - Published
- 2023
255. Incidence and natural history of gastric high-grade dysplasia in patients with familial adenomatous polyposis syndrome
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Marisa, DelSignore, Tiffany, Jeong, Grant, Denmark, Dan, Feldman, Angela, Shih, Lawrence, Zukerberg, and Daniel C, Chung
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Adenoma ,Hyperplasia ,Adenomatous Polyposis Coli ,Stomach Neoplasms ,Incidence ,Gastroenterology ,Humans ,Radiology, Nuclear Medicine and imaging ,Retrospective Studies - Abstract
Familial adenomatous polyposis (FAP) is characterized by high risks of colonic and extracolonic tumors. Recent studies have suggested a rising risk for gastric cancer (GC). We sought to define the spectrum of premalignant gastric polyps in FAP, focusing on high-grade dysplasia (HGD).The gastric phenotypes of 118 patients diagnosed with FAP or attenuated FAP in our Hereditary Gastrointestinal Cancer Registry were retrospectively reviewed. To analyze the clinical features associated with the diagnosis of HGD, we established an age- and sex-matched control group of FAP patients from our cohort without gastric HGD in a 4:1 ratio.The spectrum and frequency of gastric polyps in individuals with FAP included fundic gland polyps (67.9%), hyperplastic polyps/foveolar hyperplasia (19.6%), tubular adenomas (15.2%), foveolar adenomas (10.7%), and pyloric gland adenomas (6.3%). Ten patients (8.9%) exhibited gastric HGD at a mean age of 55 ± 13 years, and HGD was seen in all polyp types. When compared with control subjects, HGD was associated with a high diversity of gastric polyp histology, prior low-grade dysplasia, severe gastric polyposis, and prior Whipple surgery (P = 2.0E-5, .003, .024, and .04, respectively). Two patients (1.7%) with HGD were diagnosed with GC. However, the remaining 8 patients with HGD have been under surveillance for an average of 5.8 ± 4.5 years without progression to GC.Gastric HGD in FAP may be more common than previously appreciated. The natural history of HGD is variable, and most patients with HGD do not appear to progress to GC.
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- 2023
256. Economic Value of Celebrity Endorsements: Tiger Woods' Impact on Sales of Nike Golf Balls.
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Kevin Y. C. Chung, Timothy P. Derdenger, and Kannan Srinivasan
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- 2013
- Full Text
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257. Wireless Applications for SMES: A Case Study.
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Karina Yuen and Walter W. C. Chung
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- 2002
258. Medical Students’ Reflections on the Recent Changes to the USMLE Step Exams
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Torin P Thielhelm, Nicholas D Camarda, Peter Cangialosi, Brian C Chung, and Dylan Eiger
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Matching (statistics) ,Students, Medical ,020205 medical informatics ,education ,MEDLINE ,02 engineering and technology ,Article ,Education ,Clinical knowledge ,03 medical and health sciences ,0302 clinical medicine ,Stakeholder Participation ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,030212 general & internal medicine ,Schools, Medical ,Protocol (science) ,Medical education ,Stakeholder ,Internship and Residency ,General Medicine ,Residency program ,Licensure, Medical ,United States Medical Licensing Examination ,United States ,Medicine ,Clinical Competence ,Educational Measurement ,Psychology ,Clinical skills ,Education, Medical, Undergraduate - Abstract
The United States Medical Licensing Examination (USMLE) consists of Step 1, Step 2 Clinical Knowledge, Step 2 Clinical Skills, and Step 3. To be licensed to practice medicine in the United States, medical students must pass all parts of the USMLE. However, in addition to that pass/fail grade, students are currently given a numerical score for Step 1, Step 2 Clinical Knowledge, and Step 3. Residency program directors have come to use the Step 1 score to efficiently screen a growing number of residency applicants. As a result, a deleterious environment in undergraduate medical education has been created, given the importance of Step 1 to medical students matching to their preferred residency program. It was announced in February 2020 that the score-reporting protocol for Step 1 would be changed from a 3-digit numerical score to pass/fail only, beginning no earlier than January 1, 2022. This decision will undoubtedly impact medical students, medical schools, and residency program directors. Here, the authors discuss the impact that the change to Step 1 scoring will have on these key stakeholder groups, from their perspective as students at MD-granting medical schools in the United States. They also call attention to outstanding issues with the USMLE that must be addressed to improve undergraduate medical education for all stakeholders, and they offer advice for further improvements to the residency application process.
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- 2020
259. Instability in the Setting of Distal Radius Fractures
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Kevin C. Chung and Phillip R. Ross
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Orthodontics ,030222 orthopedics ,business.industry ,medicine.medical_treatment ,Druj ,030230 surgery ,Wrist ,Osteotomy ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Forearm ,Ligament ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Displacement (orthopedic surgery) ,Malunion ,business ,Triangular Fibrocartilage Complex - Abstract
Distal radius fractures with severe displacement or concomitant triangular fibrocartilage complex tears may be accompanied by distal radioulnar joint instability. Clinicians should examine the distal radioulnar joint closely when managing wrist fractures and treat coexisting instability appropriately. Chronic instability from distal radius malunion may require osteotomy or radioulnar ligament reconstruction. With proper management, most patients recover forearm stability and rotational motion after distal radius fracture.
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- 2020
260. Patient-reported outcomes after digit replantation and revision amputation: when is maximum recovery attained?
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Alfred P. Yoon, Lu Wang, Yibo Wang, and Kevin C. Chung
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medicine.medical_specialty ,business.industry ,General surgery ,medicine.medical_treatment ,MEDLINE ,Amputation, Surgical ,Revision amputation ,Numerical digit ,Amputation, Traumatic ,Replantation ,Finger Injuries ,medicine ,Humans ,Surgery ,Patient Reported Outcome Measures ,business - Published
- 2020
261. Effect of Low-dose and Standard-dose Aspirin on PGE2 Biosynthesis Among Individuals with Colorectal Adenomas: A Randomized Clinical Trial
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John J. Garber, James M. Richter, David A. Drew, Manish Gala, Marina V. Magicheva-Gupta, Madeline M. Schuck, Dylan C. Zerjav, Patrick Miller, Joseph C. Yarze, Francis Colizzo, Hamed Khalili, Kyle Staller, Peter J. Carolan, Ginger L. Milne, Andrew T. Chan, Oliver Takacsi-Nagy, Norman S. Nishioka, Katheleen O. Stewart, Giovanna Petrucci, Wenjie Ma, Carlo Patrono, Samantha M. Chin, Amit Joshi, Lawrence R. Zukerberg, Dana Meixell, Daniel C. Chung, Jennifer Mackinnon Krems, Katherine K. Gilpin, Melanie P. Parziale, Emily N. Pond, Molin Wang, and Bianca Rocca
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Adenoma ,Adult ,Male ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Adolescent ,Settore BIO/14 - FARMACOLOGIA ,aspirin ,Colorectal cancer ,Urinary system ,Urine ,platelet, aspirin, colon cancer, thromboxane, pge1 ,Gastroenterology ,Article ,Dinoprostone ,law.invention ,Excretion ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,Aged ,Aged, 80 and over ,platelet ,Creatinine ,Aspirin ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,pge1 ,Middle Aged ,medicine.disease ,030104 developmental biology ,colon cancer ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Female ,Colorectal Neoplasms ,business ,thromboxane ,medicine.drug - Abstract
Low-dose aspirin is recommended by the U.S. Preventive Services Task Force for primary prevention of colorectal cancer in certain individuals. However, broader implementation will require improved precision prevention approaches to identify those most likely to benefit. The major urinary metabolite of PGE2, 11α-hydroxy-9,15-dioxo-2,3,4,5-tetranor-prostane-1,20-dioic acid (PGE-M), is a biomarker for colorectal cancer risk, but it is unknown whether PGE-M is modifiable by aspirin in individuals at risk for colorectal cancer. Adults (N = 180) who recently underwent adenoma resection and did not regularly use aspirin or NSAIDs were recruited to a double-blind, placebo-controlled, randomized trial of aspirin at 81 or 325 mg/day for 8–12 weeks. The primary outcome was postintervention change in urinary PGE-M as measured by LC/MS. A total of 169 participants provided paired urine samples for analysis. Baseline PGE-M excretion was 15.9 ± 14.6 (mean ± S.D, ng/mg creatinine). Aspirin significantly reduced PGE-M excretion (−4.7 ± 14.8) compared with no decrease (0.8 ± 11.8) in the placebo group (P = 0.015; mean duration of treatment = 68.9 days). Aspirin significantly reduced PGE-M levels in participants receiving either 81 (−15%; P = 0.018) or 325 mg/day (−28%; P < 0.0001) compared with placebo. In 40% and 50% of the individuals randomized to 81 or 325 mg/day aspirin, respectively, PGE-M reduction reached a threshold expected to prevent recurrence in 10% of individuals. These results support that aspirin significantly reduces elevated levels of PGE-M in those at increased colorectal cancer risk to levels consistent with lower risk for recurrent neoplasia and underscore the potential utility of PGE-M as a precision chemoprevention biomarker. The ASPIRED trial is registered as NCT02394769.
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- 2020
262. Observation: Setting the Foundation for Creativity and Innovation
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Natalie B. Baxter, William T. Chung, and Kevin C. Chung
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Creativity ,Humans ,Surgery ,Organizational Innovation - Published
- 2022
263. Interobserver and Intraobserver Reliability of the Sirveaux Classification of Scapular Notching After Reverse Total Shoulder Arthroplasty
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Nathanael D. Heckmann, Braden McKnight, Xiao T. Chen, Brian C. Chung, J. Ryan Hill, Lakshmanan Sivasundaram, Reza Omid, and George F. Hatch
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Observer Variation ,Radiography ,Scapula ,Arthroplasty, Replacement, Shoulder ,Humans ,Reproducibility of Results ,Orthopedics and Sports Medicine ,Surgery ,Arthroplasty - Abstract
The Sirveaux classification characterizes the severity of scapular notching after reverse total shoulder arthroplasty (rTSA). However, its reliability has not been validated. The goal of the current study was to determine the interobserver and intraobserver reliability of the Sirveaux classification. An online survey was sent to the American Shoulder and Elbow Surgeons (ASES), containing 10 radiographs showing a range of scapular notching. Members were asked to grade the degree of scapular notching with the Sirveaux classification system. Then ASES members from our institution regraded the images a second time after a minimum of 6 weeks. Fleiss' and Cohen kappa coefficients were calculated to determine the degree of interobserver and intraobserver reliability, respectively. A total of 50 ASES members graded the radiographs and 3 regraded images after more than 6 weeks. Fleiss' kappa coefficient was 0.2437, indicating fair interobserver agreement. Surgeons who perform more than 20 rTSA procedures per year (n=34) had a Fleiss' kappa of 0.2864. The mean Cohen kappa coefficient was 0.4763, indicating moderate intraobserver reliability. The Sirveaux classification system has fair interobserver and moderate intraobserver reliability. Surgeons should use additional means to describe the severity of notching, particularly when communicating with other physicians or publishing research. [ Orthopedics . 2022;45(4):239–243.]
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- 2022
264. Monthly Column: Editor's Perspective
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Kevin C. Chung
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Surgery - Published
- 2022
265. Breast, Colorectal, Lung, Prostate, and Cervical Cancer Screening Prevalence in a Large Commercial and Medicare Advantage Plan, 2008-2020
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Ashley Kim, Matthew Gitlin, Ela Fadli, November McGarvey, Ze Cong, and Karen C. Chung
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Epidemiology ,Public Health, Environmental and Occupational Health - Abstract
This study aimed to comprehensively assess breast, colorectal, cervical, lung, and prostate cancer screening rates and trends in the United States over time among individuals for whom screening is recommended by the United States Preventive Services Task Force (USPSTF). This retrospective study was conducted in two-year intervals from January 1, 2008 to February 29, 2020, using Optum's de-identified Clinformatics® Data Mart Database, which includes Medicare Advantage and commercially insured members. Screening-eligible individuals, who had not previously had the cancer being screened and met USPSTF criteria for screening, were identified at various time points within the study timeframe for relevant screening tests within five cancer types: breast, colorectal, cervical, lung, and prostate. In the 2020 analysis period, patients who were eligible for cancer screening included: breast: 1,620,588; colorectal: 2,763,736; cervical: 1,371,506; lung: 1,491,594; prostate: 1,126,249. Breast and cervical cancer screening prevalence rates were highest (64.4% and 63.8%, respectively), followed by colorectal (29.5%), prostate (11.7%), and lung (3.8%). Black/African American individuals and Hispanics had moderately low screening rates for cervical (58.6%) and breast (61.8%) cancer, respectively; Hispanics had the lowest screening rates for prostate cancer (6.1%). Those residing in the West had lower screening rates for breast (58.9%), cervical (62.1%), and prostate (5.6%) cancer. Screening rates remained stable over time for breast, colorectal, and lung cancer, and changed significantly for cervical (-9.5%, 2012-2020) and prostate (+7.3%, 2008-2020) cancer. Real-world cancer screening rates remain suboptimal and low, and efforts to increase screening uptake and reduce cancer health disparities remain critical.
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- 2022
266. The Art of a Scientific Presentation: Tips from Steve Jobs
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Sakura Horiuchi, Jacob S. Nasser, and Kevin C. Chung
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Teaching Materials ,Communication ,Teaching ,Humans ,Surgery ,Surgery, Plastic ,Schools, Medical - Published
- 2022
267. Computer-Aided Detection Improves Adenomas per Colonoscopy for Screening and Surveillance Colonoscopy: A Randomized Trial
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Aasma Shaukat, David R. Lichtenstein, Samuel C. Somers, Daniel C. Chung, David G. Perdue, Murali Gopal, Daniel R. Colucci, Sloane A. Phillips, Nicholas A. Marka, Timothy R. Church, William R. Brugge, Robert Thompson, Robert Chehade, Burr Loew, Jackie Downing, James Vermillion, Lawrence Borges, Ruma Rajbhandari, Theodore Schafer, Sahin Coban, James Richter, Peter Carolan, Francis Colizzo, Tiffany Jeong, Marisa DelSignore, Shreya Asher, Robert McCabe, Daniel Van Handel, Birtukan Cinnor, Benjamin Mitlyng, Cynthia Sherman, S. David Feldshon, Amy Lounsbury, Ana Thompson, Anusha Duggirala, Irena Davies, Christopher Huang, Charles Bliss, Arpan Mohanty, Oltion Sina, Jean Mendez, Allison Iwan, Jennifer Stromberg, Jonathan Ng, Lavi Erisson, Polina Golland, Daniel Wang, Evan Wlodkowski, Joseph Carlin, Perikumar Javia, Neelima Chavali, Austin Wang, Janine Little, and Cara Hunsberger
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Adenoma ,Hepatology ,Computers ,Gastroenterology ,Colonic Polyps ,Humans ,Colonoscopy ,Colorectal Neoplasms ,Early Detection of Cancer - Abstract
Colonoscopy for colorectal cancer screening is endoscopist dependent, and colonoscopy quality improvement programs aim to improve efficacy. This study evaluated the clinical benefit and safety of using a computer-aided detection (CADe) device in colonoscopy procedures.This randomized study prospectively evaluated the use of a CADe device at 5 academic and community centers by US board-certified gastroenterologists (n = 22). Participants aged ≥40 scheduled for screening or surveillance (≥3 years) colonoscopy were included; exclusion criteria included incomplete procedure, diagnostic indication, inflammatory bowel disease, and familial adenomatous polyposis. Patients were randomized by endoscopist to the standard or CADe colonoscopy arm using computer-generated, random-block method. The 2 primary endpoints were adenomas per colonoscopy (APC), the total number of adenomas resected divided by the total number of colonoscopies; and true histology rate (THR), the proportion of resections with clinically significant histology divided by the total number of polyp resections. The primary analysis used a modified intention-to-treat approach.Between January and September 2021, 1440 participants were enrolled to be randomized. After exclusion of participants who did not meet the eligibility criteria, 677 in the standard arm and 682 in the CADe arm were included in a modified intention-to-treat analysis. APC increased significantly with use of the CADe device (standard vs CADe: 0.83 vs 1.05, P = .002; total number of adenomas, 562 vs 719). There was no decrease in THR with use of the CADe device (standard vs CADe: 71.7% vs 67.4%, P for noninferiority.001; total number of non-neoplastic lesions, 284 vs 375). Adenoma detection rate was 43.9% and 47.8% in the standard and CADe arms, respectively (P = .065).For experienced endoscopists performing screening and surveillance colonoscopies in the United States, the CADe device statistically improved overall adenoma detection (APC) without a concomitant increase in resection of non-neoplastic lesions (THR).gov registration: NCT04754347.
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- 2022
268. Time to Stop Routinely Prescribing Opiates after Carpal Tunnel Release
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Donald H. Lalonde, Janice F. Lalonde, Joy C. MacDermid, Kevin C. Chung, Bing Siang Gan, Cassandra Mierisch, Robert E. Van Demark, and Mario Luc
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Adult ,Male ,Canada ,Pain, Postoperative ,Ibuprofen ,Analgesics, Non-Narcotic ,Middle Aged ,Carpal Tunnel Syndrome ,United States ,Analgesics, Opioid ,Young Adult ,Double-Blind Method ,Humans ,Surgery ,Female ,Hydrocodone ,Prospective Studies ,Practice Patterns, Physicians' ,Acetaminophen ,Aged ,Pain Measurement - Abstract
North American surgeons continue to routinely order narcotic medication for postoperative pain relief after carpal tunnel surgery. For some patients, this instigates persistent use. This double-blind, multicenter trial investigated whether over-the-counter medications were inferior to opioid pain control after carpal tunnel release.Patients undergoing carpal tunnel release in five centers in Canada and the United States (n = 347) were randomly assigned to postoperative pain control with (opioid) hydrocodone/acetaminophen 5/325 mg versus over-the-counter ibuprofen/acetaminophen 600/325 mg. The two primary outcome measures were the Numeric Pain Rating Scale (0 to 10) and the six-item Patient-Reported Outcome Measurement Information System Pain Interference T-score. Secondary outcome measures were total medication used and overall satisfaction with pain medication management.The authors found no significant differences between opioid and over-the-counter patients in the Numeric Pain Rating Scale scores, Pain Interference T-scores, number of doses of medication, or patient satisfaction. The highest Numeric Pain Rating Scale group difference was the night of surgery, when opiate patients had 0.9/10 more pain than over-the-counter patients. The highest group difference in Pain Interference T-scores (2.1) was on the day of surgery, when the opiate patients had more pain interference than the over-the-counter group. Patient nationality or sex did not generate significant pain score differences.Pain management is not inferior for patients managed with over-the-counter acetaminophen/ibuprofen versus opioids. This study provides high-quality evidence that U.S. and Canadian surgeons should stop the routine prescription of narcotics after carpal tunnel surgery for patients who are not taking pain medicines daily before surgery.Therapeutic, II.
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- 2022
269. Reconstructive Plastic Surgery
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Catherine de Blacam, Morad Askari, Steven M. Sultan, Brian Le, Jeremy A. Goss, Austin Michael Beason, Anthony J. Archual, David W. Chang, Paul S. Cederna, Amr Reda Mabrouk, Zubin J. Panthaki, Sigrid Blome-Eberwein, Ryan W. Schmucker, Hinne A. Rakhorst, Thomas D. Samson, Giovanni Montealegre Gómez, Jason Yoo, David A. Sterling, Patricia A. Eadie, Harris Gellman, Megan P. Lundgren, Nelson Piccolo, Marilyn Ng, Kant Y.K. Lin, Randolph Wojcik, Robert X. Murphy, Ian C. Sando, Rebecca M. Garza, Michael Grimaldi, Mamtha S. Raj, Sean J. Wallace, Wrood Kassira, Edward I. Chang, Seth R. Thaller, Chetan Satish Nayak, Jonathan Yun Lee, Kevin C. Chung, Melissa Mueller, Julio Daniel Kirschbaum Fridman, Michael W. Neumeister, Arin K. Greene, Mimis Cohen, Husain AlQattan, Waseem Mohiuddin, Robert M. Teixeira, Billy Lane O'Neill, Ricardo Galán, Liann Casey, Leela S. Mundra, Randy M. Hauck, Emily Grace Clark, Joon Pio Hong, Jong-Woo Choi, Morgan Brgoch, Chrisfouad R. Alabiad, Sarah A. Cazorla, Daniel Josef Kedar, Steven Michael Koehler, Erez Dayan, Jarom Gilstrap, Cindy Siaw Lin Goh, Sabrina Gallego-Gónima, Paul R. Weiss, Carlos Eduardo Torres Fuentes, Nathan F. Miller, Charles P. Melone, Terence Lin Hon Goh, John D. Potochny, Rodney Cooter, Mark R. Sultan, Kriya Gishen, Alex Schmucker, Douglas S. Wagner, Bharat Ranganath, Logan W. Carr, Donald R. Mackay, M. Shuja Shafqat, Joseph E. Losee, Guillermo Echeverria, Rei Ogawa, Ellyn McNamara, Ajul Shah, Lucie Lessard, Emily Nicole Perez, Sivan Zissman, Timothy Shane Johnson, Rachel Georgopoulos, David Chiu, Hernando Laverde-Gutierrez, Karen Kaplan, John M. Roberts, David Leshem, James Nolan Winters, Joshua Michael Adkinson, Eric I-Yun Chang, Brian Mailey, Kavita T. Vakharia, Sameer A. Patel, Christopher Edward Fundakowski, Wooshik Jeong, Graeme Perks, Paymon Rahgozar, Seán Carroll, Patrick J. Greaney, Hyunsuk Peter Suh, Charles K. Herman, Eyal Gur, Geoffrey Konopka, Gregory R.D. Evans, William Y. Hoffman, Jessica Billig, Michael Ku Hung Hsieh, Stefania de Fazio, and Rogerio I. Neves
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Plastic surgery ,medicine.medical_specialty ,business.industry ,medicine ,business ,Surgery - Published
- 2022
270. Movement of forest-dependent dung beetles through riparian buffers in Bornean oil palm plantations
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Eleanor M. Slade, Arthur Y. C. Chung, Ross E. J. Gray, Owen T. Lewis, Luisa F. Rodriguez, Otso Ovaskainen, Organismal and Evolutionary Biology Research Programme, Biosciences, and Otso Ovaskainen / Principal Investigator
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0106 biological sciences ,tropical forest ,Riparian buffer ,Biodiversity ,habitaatti ,Generalist and specialist species ,010603 evolutionary biology ,01 natural sciences ,lantakuoriaiset ,Bayesian Joint Species Movement Modelling ,Deforestation ,movement corridor ,insects ,dispersal ,Riparian zone ,Dung beetle ,geography ,geography.geographical_feature_category ,Ecology ,biology ,viljelymetsät ,Agroforestry ,bayesilainen menetelmä ,010604 marine biology & hydrobiology ,riparian reserves ,trooppinen vyöhyke ,puupellot ,Malaysia ,Dispersal ,15. Life on land ,biology.organism_classification ,Bayesian joint species movement modelling ,Insects ,Habitat ,1181 Ecology, evolutionary biology ,hyönteiset ,mark-release-recapture ,Environmental science ,Biological dispersal ,leviäminen - Abstract
1. Fragmentation of tropical forests is increasing globally, with negative impacts for biodiversity. In Southeast Asia, expansion of oil palm agriculture has caused widespread deforestation, forest degradation and fragmentation. 2. Persistence of forest-dependent species within these fragmented landscapes is likely to depend on the capacity of individuals to move between forest patches. In oil palm landscapes, riparian buffers along streams and rivers are potential movement corridors, but their use by moving animals is poorly studied. 3. We examined how six dung beetle species traversed riparian buffers connected to a continuous forest reserve area within an oil palm plantation in Sabah, Malaysian Borneo. We used a mark–release–recapture study and a new Bayesian Joint Species Movement Modelling (JSMM) approach, extended to a continuous capture process model. 4. Dung beetle species were fairly generalist in their habitat use, but two species showed a statistically supported preference for riparian buffer forest over oil palm, and one species showed a strong preference for forest reserve over riparian buffer, indicating the importance of forested areas within oil palm landscapes for some species. 5. A land-use change simulation indicated that the loss of riparian buffers in oil palm will result in reduced movement by forest-dependent species. 6. Synthesis and applications. Our results provide evidence for the use of riparian buffers in oil palm plantations for forest-dependent dung beetle species, strengthening the case for their retention, restoration and re-establishment. Furthermore, our study demonstrates the wider applicability of the Joint Species Movement Modelling (JSMM) framework to assess movement behaviour of species in fragmented landscapes, a vital tool for future forest and landscape management and conservation prioritisation exercises.
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- 2022
271. Local-scale temperature gradients driven by human disturbance shape the physiological and morphological traits of dung beetle communities in a Bornean oil palm–forest mosaic
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Joseph Williamson, Enoch Teh, Tommaso Jucker, Matilda Brindle, Emma Bush, Arthur Y. C. Chung, Jonathan Parrett, Owen T. Lewis, Stephen J. Rossiter, Eleanor M. Slade, and Asian School of the Environment
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Functional Traits ,Biological sciences [Science] ,Ecology, Evolution, Behavior and Systematics ,Ctmax - Abstract
Temperature change is an often-assumed, but rarely tested, mechanism by which sensitive species may decline in forest landscapes following habitat degradation, fragmentation and destruction. Traits mediate how species respond to environmental change, with physiological, morphological and behavioural traits key to determining the response of ectotherms to temperature. We collected data on traits linked to thermal sensitivity (critical thermal maxima, body size, cuticle lightness and pilosity) for 46 dung beetle species (Scarabaeinae) in a forest–oil palm mosaic in Malaysian Borneo. By combining these data with a large-scale community sampling campaign (>59,000 individuals sampled from >600 traps) and an airborne Light Detection and Ranging-derived thermal map, we investigated how traits mediate species- and community-level responses to temperature. Using hierarchical models, we found that critical thermal maxima predicted how species respond to maximum temperatures. These results were mirrored in community-level analyses alongside similar patterns in other thermal traits. Increased body size and decreased pilosity were associated with higher temperatures, while cuticle lightness showed a complex relationship with temperature across the disturbance gradient. Our findings highlight the potential mechanisms by whichforest specialists decline in human-modified landscapes, resulting in changes to community patterns and processes. Published version This work was funded by the Natural Environment Research Council (NERC) through the Human Modified Tropical Forests programme (NE/K016261/1; NE/K016377/1) and the Newton-Ungku Omar Fund via the British Council and Malaysian Industry Government Group for High Technology (216433953). NERC funded the PhD studentship for JW (NE/L002485/1) and research fellowship of TJ (NE/S01537X/1). EMS acknowledges funding from a BES Small Ecological Project Grant, No.: 3256/4035, and the Varley-Gradwell Travelling Fellowship in Insect Ecology. David Coomes was instrumental in the generation of the airborne LiDAR-derived thermal projections.
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- 2022
272. Cost of cancer management by stage at diagnosis among Medicare beneficiaries
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Sheila R. Reddy, Michael S. Broder, Eunice Chang, Caleb Paydar, Karen C. Chung, and Anuraag R. Kansal
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Male ,Databases, Factual ,Neoplasms ,Humans ,Health Care Costs ,General Medicine ,Medicare ,United States ,health care economics and organizations ,Aged ,Retrospective Studies ,SEER Program - Abstract
Estimate the annual cost of care in the 5 years following a cancer diagnosis for 17 invasive cancer types, by stage at diagnosis. We used 2012–2016 data from the Surveillance, Epidemiology, and End Results (SEER) registry-Medicare claims database to examine cost of care among Medicare beneficiaries with a confirmed cancer diagnosis based on International Classification of Diseases for Oncology, Third Edition histology codes reported in SEER. Beneficiaries contributed to the annual cost calculations (Years 1–5) using their observed time after diagnosis. Beneficiaries were continuously enrolled in fee-for-service Medicare Parts A/B and Part D during follow-up. Total, inpatient, outpatient, and pharmacy cancer-related service costs were calculated. From 2012 to 2016, we identified 597,778 Medicare beneficiaries with incident cancer diagnosis within 5 years (Stage I, II, III, and IV: 32.6%, 33.4%, 15.9%, and 18.0%, respectively). In Year 1, mean (standard deviation) total costs for Stage I diagnoses varied from $7640 ($17,378) (prostate) to $94,636 ($117,636) (pancreas). Total costs increased by stage and reached $58,783 ($92,344) (prostate) to $156,982 ($175,009) (stomach) for Stage IV diagnoses in Year 1. Costs in Year 1 were significantly higher for Stage IV diagnoses than for earlier stages across all cancer types. In Years 2–5, total costs were lower than in Year 1 but continued to increase by stage. Beneficiaries diagnosed at later stages of cancer have higher costs of care (up to 7 times as much) than those diagnosed at earlier stages. Earlier cancer diagnosis may lead to more efficient treatment and decreased management cost.
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- 2022
- Full Text
- View/download PDF
273. List of contributors
- Author
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Michael C. Chung, Haiming Dai, Juan Guan, Jia Jia, Rui Kang, Scott H. Kaufmann, Mary E. Law, Brian K. Law, Daiqing Liao, X. Wei Meng, Gautam Sethi, Muthu K. Shanmugam, Xiaokun Shu, Daolin Tang, Tsz-Leung To, Mengxiong Wang, and Kaiqin Ye
- Published
- 2022
274. Protein phase separation in cell death and survival
- Author
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Juan Guan, Michael C. Chung, and Daiqing Liao
- Subjects
Chemistry ,Cell biology - Published
- 2022
275. Effective fuzzy c-means clustering algorithms for data clustering problems.
- Author
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S. R. Kannan, S. Ramathilagam, and P. C. Chung
- Published
- 2012
- Full Text
- View/download PDF
276. Personal Mobility and Manipulation Appliance - Design, Development, and Initial Testing.
- Author
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Rory A. Cooper, Garrett Grindle, Juan Jose Vazquez Lopez, Jijie Xu, Hongwu Wang, Jorge L. Candiotti, C. Chung, Ben Salatin, Elaine Houston, Annmarie Kelleher, Rosemarie Cooper, Emily Teodorski, and S. Beach
- Published
- 2012
- Full Text
- View/download PDF
277. Memory Allocation with Lazy Fits.
- Author
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Yoo C. Chung and Soo-Mook Moon
- Published
- 2000
- Full Text
- View/download PDF
278. Reducing Sweep Time for a Nearly Empty Heap.
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Yoo C. Chung, Soo-Mook Moon, Kemal Ebcioglu, and Dan Sahlin
- Published
- 2000
- Full Text
- View/download PDF
279. A new territory of multi-user variable remote control for interactive TV.
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Shu-Ching Wang, T. C. Chung, and Kua-Qin Yan
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- 2011
- Full Text
- View/download PDF
280. LaTTe: A Java VM Just-In-Time Compiler with Fast and Efficient Register Allocation.
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Byung-Sun Yang, Soo-Mook Moon, Seongbae Park, Junpyo Lee, SeungIl Lee, Jinpyo Park, Yoo C. Chung, Suhyun Kim, Kemal Ebcioglu, and Erik R. Altman
- Published
- 1999
- Full Text
- View/download PDF
281. Application of deep learning: detection of obsolete scaphoid fractures with artificial neural networks
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Alfred P. Yoon and Kevin C. Chung
- Subjects
Scaphoid Bone ,Artificial neural network ,business.industry ,Deep learning ,MEDLINE ,Wrist Injuries ,Machine learning ,computer.software_genre ,Fractures, Bone ,Deep Learning ,Humans ,Medicine ,Surgery ,Neural Networks, Computer ,Artificial intelligence ,business ,computer - Published
- 2021
282. Promoting Health Policy Research in Plastic Surgery
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Kevin C. Chung, Rod J. Rohrich, and Natalie B. Baxter
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Plastic surgery ,medicine.medical_specialty ,Medical education ,business.industry ,Health Policy ,Research ,medicine ,Surgery ,Surgery, Plastic ,business ,Health policy - Published
- 2021
283. Efficacy of Nonoperative Treatments for Lateral Epicondylitis: A Systematic Review and Meta-Analysis
- Author
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Lan Y. Yang, Alfred P. Yoon, Julia C. Howard, Shannon M. Wood, You J. Kim, and Kevin C. Chung
- Subjects
medicine.medical_specialty ,Population ,Pain ,Electric Stimulation Therapy ,030230 surgery ,Conservative Treatment ,Placebo ,Injections ,law.invention ,03 medical and health sciences ,Grip strength ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Tennis elbow ,Humans ,Pain Management ,Adverse effect ,education ,Pain Measurement ,Randomized Controlled Trials as Topic ,education.field_of_study ,business.industry ,Epicondylitis ,Tennis Elbow ,medicine.disease ,Exercise Therapy ,Treatment Outcome ,030220 oncology & carcinogenesis ,Meta-analysis ,Physical therapy ,Surgery ,business - Abstract
BACKGROUND Lateral epicondylitis is a common overuse injury affecting approximately 1 to 3 percent of the population. Although symptoms may disappear spontaneously within 1 year, the clinical guidelines for conservative treatment are not clear. The authors' objective was to examine the outcomes of nonsurgical treatments for lateral epicondylitis through a meta-analysis and provide a treatment recommendation using the available evidence. METHODS The authors searched the PubMed, EMBASE, Scopus, and Web of Science databases to identify primary research articles studying conservative treatments (electrophysiotherapy, physical therapy, and injections) for lateral epicondylitis. The authors included randomized controlled trials published in peer-reviewed journals. Data related to outcomes (pain, grip strength, Patient-Rated Tennis Elbow Evaluation score, and Disabilities of the Arm, Shoulder and Hand score) and complications were extracted. RESULTS Fifty-eight randomized controlled trials were included in the meta-analysis. Electrophysiotherapy was effective in improving pain [mean difference, -10.0 (95 percent CI, -13.8 to -6.1)], Patient-Rated Tennis Elbow Evaluation score [mean difference, -10.7 (95 percent CI, -16.3 to -5.0)], and Disabilities of the Arm, Shoulder and Hand score [mean difference, -11.9 (95 percent CI, -15.8 to -7.9)]; and physical therapy improved pain [mean difference, -6.0 (95 percent CI, -9.7 to -2.3)] and Patient-Rated Tennis Elbow Evaluation scores [mean difference, -7.5 (95 percent CI, -11.8 to -3.2)] compared to placebo. Injections did not improve any outcome measures. Patients who received electrophysiotherapy and injections reported higher adverse effects than physical therapy patients. CONCLUSIONS Patients who received electrophysiotherapy and physical therapy reported statistically and clinically improved scores in pain and function compared to placebo. Injections may put patients at higher risk for adverse effects compared to other conservative treatments. When managing lateral epicondylitis conservatively, electrophysiotherapy and physical therapy should be prioritized before other interventions. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, I.
- Published
- 2020
284. Hand Infections
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Kevin C. Chung, Ben K. Gundlach, and Sarah E. Sasor
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030222 orthopedics ,medicine.medical_specialty ,Intravenous drug ,medicine.drug_class ,business.industry ,Minor surgical procedure ,Public health ,Antibiotics ,Human immunodeficiency virus (HIV) ,030230 surgery ,medicine.disease ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Epidemiology ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Intensive care medicine ,business - Abstract
Upper extremity infections are common. Most infections can be effectively treated with minor surgical procedures and/or oral antibiotics; however, inappropriate or delayed care can result in significant, long-term morbidity. The basic principles of treating hand infections were described more than a century ago and most remain relevant today. Immunosuppressant medications, chronic health conditions such as diabetes and human immunodeficiency virus, and public health problems like intravenous drug use, have changed the landscape of hand infections and provide new challenges in treatment.
- Published
- 2020
285. Trigger Finger Treatment: Identifying Predictors of Nonadherence and Cost
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Kelly A. Speth, Lu Wang, Jessica I. Billig, Jacob S. Nasser, and Kevin C. Chung
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Male ,medicine.medical_specialty ,Steroid injection ,Total cost ,Population ,MEDLINE ,Injections, Intralesional ,030230 surgery ,Odds ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Diabetes Mellitus ,medicine ,Humans ,Orthopedic Procedures ,education ,Glucocorticoids ,Economic consequences ,Aged ,education.field_of_study ,Evidence-Based Medicine ,business.industry ,Health Care Costs ,Evidence-based medicine ,Middle Aged ,medicine.disease ,Treatment Outcome ,Trigger Finger Disorder ,030220 oncology & carcinogenesis ,Costs and Cost Analysis ,Patient Compliance ,Female ,Surgery ,Trigger finger ,business ,Follow-Up Studies - Abstract
BACKGROUND Evidence-based practices in medicine are linked with a higher quality of care and lower health care cost. For trigger finger, identifying patient factors associated with nonadherence to evidence-based practices will aid physicians in treatment decisions. The objectives were to (1) determine patient factors associated with treatment nonadherence, (2) examine the success rates of steroid injections, and (3) evaluate the economic consequences of nonadherence to treatment recommendations. METHODS The authors used data from the Clinformatics DataMart database from 2010 to 2017 to conduct a population-based analysis of patients with single-digit trigger finger. The authors calculated rates of steroid injection success and examined associations between injection success and patient factors using chi-square tests. In addition, the authors analyzed differences in the cost to the insurer, the cost to the patient, and total cost. RESULTS A total of 29,722 patients were included in this analysis. Injection success rates were similar for diabetic (72 percent) and nondiabetic patients (73 percent), women (73 percent), and men (73 percent). Nonetheless, diabetics (OR, 1.4; 95 percent CI, 1.4 to 1.5; p < 0.001) and women (OR, 1.2; 95 percent CI, 1.1 to 1.2; p < 0.001) were significantly more likely to receive nonadherent treatment. In total, $23 million (U.S. dollars) were spent on nonadherent trigger finger care. CONCLUSIONS Diabetics and women have increased odds of having surgery without a prior steroid injection, despite similar success rates of steroid injections compared to nondiabetics and men. Because performing surgical release before any steroid injections may represent a higher cost treatment option, providers should provide steroid injections before surgery for all patients regardless of diabetes status or sex to minimize overtreatment. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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- 2020
286. The Increasing Financial Burden of Outpatient Elective Surgery for the Privately Insured
- Author
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Wen-Ching Lan, Erika D. Sears, Chang-Fu Kuo, Kevin C. Chung, and Jessica I. Billig
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Outpatient surgery ,Article ,Insurance Coverage ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Outpatients ,Humans ,Medicine ,health care economics and organizations ,Health policy ,Aged ,Retrospective Studies ,media_common ,Finance ,Insurance, Health ,Health economics ,business.industry ,Health Policy ,Retrospective cohort study ,Health Care Costs ,Middle Aged ,Surgical procedures ,Payment ,United States ,Surgery ,Ambulatory Surgical Procedures ,030220 oncology & carcinogenesis ,Ambulatory ,Outpatient elective ,Female ,030211 gastroenterology & hepatology ,Health Expenditures ,business ,Follow-Up Studies - Abstract
OBJECTIVE: To examine temporal trends of out-of-pocket (OOP) expenses, total payments, facility fees, and professional fees for outpatient surgery. SUMMARY BACKGROUND DATA: Approximately 48 million outpatient surgeries are performed annually with a limited financial understanding of these procedures. High OOP expenses may influence treatment decisions, delay care, and cause financial burden for patients. METHODS: We conducted a retrospective cohort study of patients with employer-sponsored insurance undergoing common outpatient surgical procedures (cholecystectomy, cataract surgery, meniscectomy, muscle/tendon procedures, and joint procedures) from 2011-2017. Total payments for surgical encounters paid by the insurer/employer and patient OOP expenses were calculated. We used multivariable linear regression to predict total payments and OOP expenses, with costs adjusted to the 2017 U.S. dollar. RESULTS: We evaluated 5,261,295 outpatient surgeries (2011-2017). Total payments increased by 29%, with a 53% increase in facility fees and no change in professional fees. OOP expenses grew by 50%. After controlling for procedure type, procedures performed in ambulatory surgery centers conferred an additional $2,019 in predicted total payments (95%CI:$2,002-$2,036) and $324 in OOP expenses (95%CI:$319-$328) compared to predicted cost for office-based procedures. Hospital-based procedures cost an additional $2,649 in predicted total payments (95%CI:$2,632-$2,667) and $302 in predicted OOP expenses (95%CI:$297-$306) compared to office procedures. CONCLUSION: Increases in outpatient surgery total payments were driven primarily by facility fees and OOP expenses. OOP expenses are rising faster than total payments, highlighting the transition of costs to patients. Healthcare cost reduction policies should consider the largest areas of spending growth such as facility fees and OOP expenses to minimize the financial burden placed on patients.
- Published
- 2020
287. Fruit and vegetable consumption is associated with lower prevalence of asymptomatic diverticulosis: a cross-sectional colonoscopy-based study
- Author
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Hamed Khalili, Po Hong Liu, Jessica McGoldrick, Benjamin Maxner, Rocco Ricciardi, Joseph C. Yarze, Danielle Bellavance, Kyle Staller, Daniel C. Chung, and Ramnik J. Xavier
- Subjects
medicine.medical_specialty ,Colonoscopy ,Lower risk ,Asymptomatic ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Surveys and Questionnaires ,Internal medicine ,Vegetables ,Prevalence ,medicine ,Humans ,And epidemiology ,Longitudinal Studies ,Poisson regression ,lcsh:RC799-869 ,030304 developmental biology ,Diverticulosis ,0303 health sciences ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,General Medicine ,Middle Aged ,medicine.disease ,Confidence interval ,Diet ,Diverticulum ,Cross-Sectional Studies ,Fruit ,Lower prevalence ,symbols ,Population study ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,medicine.symptom ,Fruit and vegetables ,business ,Research Article - Abstract
Background Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis. Methods Our study population included participants in the Gastrointestinal Disease and Endoscopy Registry (GIDER), a colonoscopy-based longitudinal cohort at the Massachusetts General Hospital, who provided comprehensive information on dietary intake and lifestyle factors using validated questionnaires prior to colonoscopy. Information on presence and location of diverticula was obtained from the endoscopist at the end of each procedure. We used Poisson regression modeling to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs). Results Among 549 participants with a mean age of 61 years enrolled in GIDER, we confirmed diverticulosis in 245 (44.6%). The prevalence of diverticulosis appeared to decrease with higher consumption of fruit and vegetables (Ptrend = 0.007 for fruit and 0.008 for vegetables, respectively). Compared to participants with less than five servings of vegetables per week, the multivariable-adjusted PRs of diverticulosis were 0.84 (95% CI, 0.60–1.17) with five to seven servings per week and 0.62 (95% CI, 0.44–0.89) with greater than one serving per day. Similarly, compared to participants with less than five servings per week of fruit, the multivariable-adjusted PR of diverticulosis was 0.60 (95% CI, 0.41–0.87) with greater than one serving per day. These associations were not modified by age, BMI, smoking, or red meat intake (All Pinteraction > 0.055). Conclusion In a colonoscopy-based longitudinal cohort study, we show that higher consumption of fruit and vegetables is associated with lower risk of prevalent diverticulosis.
- Published
- 2020
288. Postoperative follow-up time and justification in prospective hand surgery research: a systematic review
- Author
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Rachel C. Hooper, Jacob S. Nasser, Kevin C. Chung, Shale J Mack, and Helen Huetteman
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Radiography ,Hand surgery ,Thumb ,Hand ,Carpal Tunnel Syndrome ,Arthroplasty ,Surgery ,Fracture Fixation, Internal ,medicine.anatomical_structure ,Carpometacarpal joint ,medicine ,Humans ,Internal fixation ,Carpal tunnel ,Prospective Studies ,business ,Prospective cohort study ,Follow-Up Studies - Abstract
We systematically reviewed prospective studies for five hand procedures to analyse postoperative follow-up time, clinical or radiographic plateau, and whether the authors provide justification for times used. Demographic data, outcomes and mean follow-up were analysed. A total of 188 articles met our inclusion criteria. The mean postoperative follow-up time among these studies were carpal tunnel release, 21 months (range 1.5–111); cubital tunnel release, 27 months (2.5–46); open reduction and internal fixation for the distal radius fracture, 24 months (3–120); thumb carpometacarpal joint arthroplasty, 64 months (8.5–228); and flexor tendon repair, 25 months (3–59). Authors provided justification for follow-up intervals in 10% of these reports. We conclude that most prospective clinical studies in hand surgery do not properly justify follow-up length. Clinically unnecessary follow-up is costly without much benefit. In prospective research, we believe justified postoperative follow-up is essential, based on expected time to detect clinical plateau, capture complications and determine the need for secondary surgery. Level of evidence: III
- Published
- 2020
289. The Wrist and Radius Injury Surgical Trial: 12-Month Outcomes from a Multicenter International Randomized Clinical Trial
- Author
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Melissa J. Shauver, H. Myra Kim, Kevin C. Chung, Sunitha Malay, and Wrist
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Population ,Bone Nails ,030230 surgery ,Wrist ,Conservative Treatment ,Article ,law.invention ,03 medical and health sciences ,External fixation ,0302 clinical medicine ,Randomized controlled trial ,Fracture Fixation ,law ,Multicenter trial ,medicine ,Humans ,Internal fixation ,Malunion ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Age Factors ,Middle Aged ,Wrist Injuries ,medicine.disease ,Surgery ,Casts, Surgical ,Percutaneous pinning ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Radius Fractures ,business ,Follow-Up Studies - Abstract
BACKGROUND: Optimal treatment for distal radius fractures (DRFs) in older adults remains uncertain. No randomized trials comparing the most frequently used treatments in this population have been conducted. Surgical treatment rates vary widely, though the sustained benefits of surgery are uncertain. METHODS: The Wrist and Radius Injury Surgical Trial (WRIST), randomized, multicenter trial, enrolled 304 adults age 60 years and older with isolated, unstable DRFs at 24 institutions. Patients who wanted surgery (n=187) were randomized to internal fixation with volar plate (VLPS), external fixation (EFP), or percutaneous pinning; patients who preferred conservative management (n=117) received casting. The primary outcome was the 12-month Michigan Hand Outcomes Questionnaire (MHQ) Summary score. Secondary outcomes included MHQ domain scores and radiographic parameters. RESULTS: At 12 months, there were no differences by treatment in primary or the majority of secondary outcomes. Twelve-month MHQ Summary scores differed between VLPS and EFP by 3 points (97.5% CL: −6.0, 11.5) and between VLPS and pinning by −0.14(−9.2,8.9). However, at 6 weeks, mean MHQ Summary score for VLPS was greater than EFP by 19(p
- Published
- 2020
290. Industry Funding and Self-Declared Conflict of Interest in Hand Surgery Publications
- Author
-
Phillip R. Ross, Shannon M. Wood, and Kevin C. Chung
- Subjects
Reconstructive surgery ,medicine.medical_specialty ,media_common.quotation_subject ,Disclosure ,030230 surgery ,Medicare ,Centers for Medicare and Medicaid Services, U.S ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Relevance (law) ,Orthopedics and Sports Medicine ,media_common ,030222 orthopedics ,Conflict of Interest ,business.industry ,Conflict of interest ,Hand surgery ,Hand ,Payment ,United States ,Academic integrity ,Family medicine ,Orthopedic surgery ,Surgery ,business ,Medicaid - Abstract
Purpose Accurate financial disclosure is essential to prevent bias in scientific reporting. We aimed (1) to document the extent of industry financial payments to hand surgery literature authors and (2) to uncover discrepancies in author self-declared conflict of interest (COI). Methods We screened all scientific and review articles published in 2017 from the American editions of 4 peer-reviewed journals (Journal of Hand Surgery [JHS], Journal of Bone and Joint Surgery [JBJS], Plastic and Reconstructive Surgery [PRS], and Journal of the American Academy of Orthopaedic Surgeons [JAAOS]) to identify authors of hand, wrist, elbow, and peripheral nerve topics. We compared self-reported disclosures with industry-reported payments on the Centers for Medicare and Medicaid Services’ Open Payments Database (OPD) for 3 years prior to publication or per journal policy. We individually examined each for relevance of the corporate payer to the article’s subject matter. Results We found 630 eligible authors from 395 articles. The total amount of industry-reported payments over 3 years prior to publication was $24,396,607.80. The median total payments per author per year was $118.40, with interquartile range from $0 to $1,364; 68% of authors received some industry payment; the most common being food and beverage (66% of authors). Senior authors received significantly more industry payments (median, $2,985.67/y) than first and middle authors ($70.27 and $113.17, respectively). Of all authors examined, 58% had undisclosed payments, but only 14% were relevant to the article subject matter. Authors in JAAOS & JBJS, senior authors, and those receiving more than $500,000 from industry were less likely to accurately report all payments. Conclusions Industry payments to hand surgery authors were lower than those reported to other orthopedic specialties and tended to be concentrated in a few authors receiving large amounts. Relevant COI disclosure inaccuracies are infrequent within hand surgery literature. Uniform policies of complete disclosure across journals may remove author judgment regarding payment relevance to published material and help eliminate remaining COI errors. Authors may reference the OPD prior to submitting disclosures to prevent potential discrepancies and identify errors within the database. Clinical relevance Relationships with industry offer opportunities for innovation, education, and research, but overlooking COI self-reporting may erode confidence in the academic integrity of the hand surgery literature.
- Published
- 2020
291. Access to Hand Therapy Following Surgery in the United States
- Author
-
Kevin C. Chung and Jasmine Krishnan
- Subjects
Service (business) ,030222 orthopedics ,Rehabilitation ,business.industry ,medicine.medical_treatment ,Hand therapy ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Health care ,medicine ,book.journal ,Orthopedics and Sports Medicine ,Surgery ,business ,book - Abstract
Hand therapy is a time-sensitive and essential postoperative service for patients undergoing reparative or corrective procedures in the hand and plays an important role in achieving best functional outcomes. In the United States, therapy is an independent service from a payer's standpoint. Access is affected by global and distinct factors in health care. This article presents views on certain aspects of health care that aide in and those that impede access to hand therapy for patients in the United States, and concludes with a brief glimpse into some ongoing efforts to improve access for patients.
- Published
- 2020
292. The Next Frontier of Outcomes Research: Collaborative Quality Initiatives
- Author
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Jessica I. Billig, Sandra V. Kotsis, Kevin C. Chung, and Michigan Collaborative Hand Initiative for Quality in Surgery
- Subjects
Michigan ,medicine.medical_specialty ,Quality management ,media_common.quotation_subject ,030230 surgery ,03 medical and health sciences ,Frontier ,0302 clinical medicine ,Outcome Assessment, Health Care ,medicine ,Quality (business) ,Operations management ,Surgery, Plastic ,Intersectoral Collaboration ,Quality Indicators, Health Care ,media_common ,Process Measures ,business.industry ,Hand surgery ,Quality Improvement ,Incentive ,030220 oncology & carcinogenesis ,Surgery ,Outcomes research ,business ,Health care quality - Abstract
Quality improvement efforts at the federal level have instituted both rewards and penalties as incentives to improve health care quality. However, neither of these methods has shown long-lasting improvements. Furthermore, many programs have focused on decreasing mortality or hospital readmissions, measurements that are not applicable to many surgical fields, including plastic surgery. One model that has been shown to be effective is a collaborative quality initiative that uses a pay-for-participation method whereby participants learn from one another and institute changes to improve patient care. Many of these changes are process measures that are easier to implement and quicker to show improvement than structural or outcome measures. Regional collaborative quality initiatives have been developed in other surgical specialties such as bariatric surgery and urology. Currently, the authors are establishing a new collaborative quality initiative for hand surgery: the Michigan Collaborative Hand Initiative for Quality in Surgery. It is a collaboration of nine sites with the goal of identifying areas that are in need of quality improvement in hand surgery and implementing measures to improve on them. The authors believe that collaborative quality initiatives will promote high-quality care and should be incorporated into the field of plastic surgery.
- Published
- 2020
293. Deriving Evidence from Secondary Data in Hand Surgery
- Author
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Kevin C. Chung and Lee Squitieri
- Subjects
medicine.medical_specialty ,Study quality ,business.industry ,media_common.quotation_subject ,Big data ,Health services research ,Hand surgery ,Secondary data ,Hand surgeons ,Risk analysis (engineering) ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Quality (business) ,business ,Health policy ,media_common - Abstract
Health services research using secondary data is a powerful tool for guiding quality/performance measure development, payment reform, and health policy. Patient preferences, physical examination findings, use of postoperative care, and other factors specific to hand surgery research are critical pieces of information required to study quality of care and improve patient outcomes. These data often are missing from data sets, causing limitations and challenges when performing secondary data analyses in hand surgery. As the role of secondary data in surgical research expands, hand surgeons must apply novel strategies and become involved in collaborative initiatives to overcome the limitations of existing resources.
- Published
- 2020
294. Establishment of a National Hand Surgery Data Registry
- Author
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Robert L. Kane, Kevin C. Chung, and Jacob S. Nasser
- Subjects
030222 orthopedics ,medicine.medical_specialty ,Quality management ,business.industry ,Outcome measures ,food and beverages ,Hand surgery ,Benchmarking ,030230 surgery ,Hand surgeons ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Operations management ,National registry ,Quality of care ,business ,Daily routine - Abstract
Considerable variation exists in the practice of hand surgery that may lead to wasteful spending and less than optimal quality of care. Hand surgeons can benefit from a centralized system that tracks process and outcome measures, delivers national benchmarking, and encourages the sharing of knowledge. A national registry can fulfill these needs for hand surgeons and incorporate quality improvement into their daily routine. Leaders in hand surgery should convene to appraise the organization of a national registry for their field and reach consensus on how the registry can be designed and funded.
- Published
- 2020
295. Using Evidence for Hand Surgery
- Author
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Kristine A. Huynh and Kevin C. Chung
- Subjects
030222 orthopedics ,Medical education ,medicine.medical_specialty ,Evidence-based practice ,Process (engineering) ,business.industry ,Individualized treatment ,Hand surgery ,Evidence-based medicine ,030230 surgery ,Patient care ,03 medical and health sciences ,Critical appraisal ,0302 clinical medicine ,medicine ,Orthopedics and Sports Medicine ,Surgery ,business ,Research question - Abstract
Each step of the evidence-based practice process is critical and requires clear understanding for accurate application. To practice evidence-based care, providers must acquire a specific skillset that facilitates translation of a patient problem into an answerable research question. Additional requirements are understanding of electronic databases, critical appraisal of the available evidence, and integration of the findings to generate a specific, individualized treatment plan. Although this process is demanding, evidence-based practice is essential in the delivery of optimal patient care.
- Published
- 2020
296. Navigating the Intersection of Evidence and Policy in Hand Surgery Practice
- Author
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Natalie B. Baxter and Kevin C. Chung
- Subjects
Safety Management ,medicine.medical_specialty ,Quality management ,030230 surgery ,Patient advocacy ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Insurance policy ,Health care ,medicine ,Humans ,Orthopedics and Sports Medicine ,Healthcare Disparities ,Health policy ,Quality of Health Care ,030222 orthopedics ,business.industry ,Health Policy ,Incidence ,Hand Injuries ,Hand surgery ,Evidence-based medicine ,Hand ,United States ,Orthopedics ,Surgery ,business ,Intersection (aeronautics) - Abstract
Collaboration with organizations beyond the clinical setting is necessary to identify safety hazards that contribute to the high incidence and severity of hand conditions. Hand surgeons are acutely aware of obstacles patients face while navigating the health care system. Advocacy efforts encourage the development of equitable insurance policies and improve health resource allocation so that hand surgeons can treat a larger patient population. Participation in quality initiatives supports the development of evidence-based clinical guidelines. Further evidence must be generated to ensure that surgeons remain proficient in the latest techniques and uphold high standards of care as hand surgery procedures evolve.
- Published
- 2020
297. Reduced benefits of ant occupation for ant-trees in oil palm compared with heavily logged forest
- Author
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Brigitte Fiala, H. Justin, Petra Kokorova, Arthur Y. C. Chung, Tom M. Fayle, Dan Leština, Heike Feldhaar, A. Salleh, and Mickal Houadria
- Subjects
0106 biological sciences ,0301 basic medicine ,Abiotic component ,Canopy ,Mutualism (biology) ,Herbivore ,Biology ,01 natural sciences ,Forest restoration ,03 medical and health sciences ,030104 developmental biology ,Agronomy ,Secondary forest ,Tree health ,General Agricultural and Biological Sciences ,Restoration ecology ,010606 plant biology & botany - Abstract
Understanding interactions between species in altered ecosystems is important, as they influence resilience and opportunities for restoration. Here we explore a multipartite interaction between an important early succession myrmecophytic tree in Borneo (Macaranga pearsonii), and its ant mutualists that provide protection from herbivores. We compare the mutualistic system between two highly degraded habitats that are candidates for future restoration: oil palm plantation and recently heavily-logged forest. For each tree we measured tree structure (height, diameter, number of branches), leaf biomass and herbivore damage. We also measured soil characteristics (phosphate and nitrate content, pH, density) and canopy openness as these may influence tree health. For each branch, we quantified number of ant workers, brood, alates and queens as well as number of coccids. The ants tend these symbiotic coccids for their sugar-rich exudate produced by sucking the tree’s sap. We demonstrate that herbivore damage was up to twice as high in oil palm plantation compared to heavily-logged forest. This herbivory increase was not related directly to changes in abiotic conditions or to higher herbivore pressure, but rather to the distribution of the ant workers within the trees. However, trees in oil palm were able to compensate for the increased herbivory by increasing leaf production. For similar ant abundance, fewer branches were occupied in oil palm plantation, and there were relatively more ants in the presence of coccids. Taken together, our findings indicate that although this mutualism has variation in its functioning, with reduced benefits for the tree of ant occupation in oil palm plantation, the mutualism persists in oil palm. Therefore Macaranga pearsonii is a viable candidate for forest restoration (just as in secondary forest) if these trees are allowed to grow in oil palm plantations.
- Published
- 2020
298. Management of the credit and collection policies of the MIPYMES for their financial sustainability, Asunción, 2017
- Author
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J. E. Chiriani-Cabello, C Chung, and M. Á. Alegre-Brítez
- Subjects
Finance ,alta dirección ,business.industry ,senior management ,políticas de crédito y cobranza ,bad debts ,credit and collection policies ,General Energy ,credit sales ,incobrables ,Financial sustainability ,MIPYMES ,ventas a crédito ,business ,MSMEs - Abstract
RESUMEN Las políticas de crédito son las reglas que la alta dirección diseña e implementa dentro de las organizaciones cuando las operaciones se realizan a crédito y las políticas de cobranzas son consideradas como reglas que establecen las empresas para la recuperación del crédito otorgado. El objetivo general de la investigación es analizar la gestión de las políticas de crédito y cobranza de las MIPYMES para su sustentabilidad financiera en Asunción. La metodología utilizada para este trabajo de investigación fue el enfoque cuantitativo, con un diseño no experimental de corte transversal y descriptiva. El tipo de muestro fue probabilístico, cuyo proceso de recolección de datos fue realizado a través de encuestas online durante los meses de agosto a octubre de 2017, mediante un cuestionario semiestructurado de 25 preguntas, a una muestra de 234 empresas categorizadas como MIPYMES. Las técnicas de procesamiento de datos consistieron en el uso del Microsoft Excel (2013) y estadística descriptiva. Las conclusiones más relevantes fueron: El 88% de las empresas comercializan sus ventas a crédito, el 56% de las empresas mercantiles no aplica las políticas de crédito y cobranzas y el 70% desconocen o no aplican los tipos de políticas crediticias. ABSTRACT Credit policies are the rules that senior management designs and implements within organizations when operations are carried out on credit and collection policies are considered as rules established by companies for the recovery of the credit granted. The general objective of the research is to analyze the management of the credit and collection policies of MSMEs for their financial sustainability in Asunción. The methodology used for this research work was the quantitative approach, with a non-experimental cross-sectional and descriptive design. The type of sampling was probabilistic, whose process of data collection was carried out through online surveys during the months of August to October 2017, through a semi-structured questionnaire of 25 questions, to a sample of 234 companies categorized as MSMEs. The data processing techniques consisted of the use of Microsoft Excel (2013) and descriptive statistics. The most relevant conclusions were: 88% of companies sell their sales on credit, 56% of commercial companies do not apply credit and collection policies and 70% do not know or do not apply the types of credit policies.
- Published
- 2020
299. Synthesis of Ag/Fe/CAC for colour and COD removal from methylene blue dye wastewater
- Author
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W. C. Chung, W. M. Fong, and A. C. Affam
- Subjects
Langmuir ,Environmental Engineering ,Materials science ,Central composite design ,Chemical oxygen demand ,010501 environmental sciences ,01 natural sciences ,chemistry.chemical_compound ,Adsorption ,chemistry ,Wastewater ,medicine ,Environmental Chemistry ,Response surface methodology ,General Agricultural and Biological Sciences ,Methylene blue ,0105 earth and related environmental sciences ,Activated carbon ,medicine.drug ,Nuclear chemistry - Abstract
This study investigated the performance of commercial activated carbon modified with Ag/Fe nanoparticles for colour removal and chemical oxygen demand reduction from methylene blue dye wastewater under visible light irradiation. Central composite design of the response surface methodology was used to optimize the operating conditions with a minimum number of experiments. There are three operating variables namely adsorbent dosage (g) (1.5–3.5 g), pH of dye wastewater (pH 4–10) and contact time (min) (60–120 min) via a total 20 of experiments were carried out to optimize the combination effects of the parameters. In the Ag/Fe/CAC study, under optimum operating conditions of 1.79 g/L, pH 5.75 and 115 min of contact time, chemical oxygen demand reduction and colour removal were 37 and 94%, respectively. The error differences between predicted and experimental data were
- Published
- 2020
300. Investigation of a copper–nickel alloy resistor using co-electrodeposition
- Author
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K. C. Chung and Wen-His Lee
- Subjects
Materials science ,Annealing (metallurgy) ,General Chemical Engineering ,Alloy ,Analytical chemistry ,02 engineering and technology ,Copper nickel alloy ,engineering.material ,010402 general chemistry ,021001 nanoscience & nanotechnology ,Electrochemistry ,01 natural sciences ,0104 chemical sciences ,law.invention ,Lattice constant ,law ,Materials Chemistry ,engineering ,Resistor ,0210 nano-technology ,Electroplating ,Single crystal - Abstract
Using this co-electrodeposition method, we successfully prepared a Cu–Ni alloy film at a low temperature. The results of this study showed that when Cu–Ni film is co-deposited at − 1.3 V (vs. Ag/AgCl) in a solution with a composition ratio of Ni to Cu ions of 90:10, the atomic percentage of Cu to Ni necessary to form the Cu–Ni alloy is approximately one. Electroplated for 20 min, the thickness of the Cu–Ni film grows to around 10 μm, and the resistance is approximately 103 mΩ. In this work, the samples were annealed at 700, 800, and 900 °C for 30 min, respectively. The resistance increased gradually with increases in the annealing temperature because of the increasing entropy of the Cu–Ni alloy. On the contrary, the TCR decreased gradually with increases in the annealing temperature. The sample annealed at 900 °C exhibited a single crystal FCC Cu–Ni alloy with a lattice constant of 3.62 A, corresponding to a very low TCR of around 50 ppm/ °C.
- Published
- 2020
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