Standardized maximim D-optimal designs for enzyme kineticinhibition models

Locally optimal designs for nonlinear models require a single set of nominal values for the unknown parameters.An alternative is the maximin approach that allows the user to specify a range of values for each parameter ofinterest. However, the maximin approach is difficult because we first have to determine the locally optimal designfor each set of nominal values before maximin types of optimal designs can be found via a nested optimizationprocess. We show that particle swarm optimization (PSO) techniques can solve such complex optimizationproblems effectively. We demonstrate numerical results from PSO can help find, for the first time, formulae forstandardized maximin D-optimal designs for nonlinear model with 3 or 4 parameters on the compact andnonnegative design space. Additionally, we show locally and standardized maximin D-optimal designs for inhibitionmodels are not necessarily supported at a minimum number of points. To facilitate use of such designs, wecreate a web-based tool for practitioners to find tailor-made locally and standardized maximin optimal designs

Using the Clinical Frailty Scale to Predict the Length of Stay in Otolaryngology Unit in Taiwan

Frailty was a common syndrome in geriatric clinic and general internal medical wards. Some authors had identified the Clinical Frailty Scale (CFS) as a predictor of length of stay in the acute medicine unit. However, the role of the Clinical Frailty Scale in the length of stay in otolaryngology unit had not been well studied. The objective of this study was to find out the correlation of the CFS in elderly patients admitted to otolaryngology unit and their length of stay. A retrospective medical chart review of 203 elderly patients admitted to the otolaryngology ward from January, 2014 to December, 2018 was performed. These patients were hospitalized for treating otorhinolaryngological (ENT) disease or for otorhinolaryngological surgery except for those of ENT related malignancies at Kaohsiung Municipal United Hospital (KMUH). Patients\u27 demographics, CFS scores, Charlson comorbidities Index (CCI), and length of stay (LOS) were recorded. All the participants were divided into three groups: non-frail (CFS 1- 4), mildtomoderately frail (CFS 5- 6), and severely frail (CFS7- 8). Severely frail group had longer lengths of stay (mean= 8.76±0.97 days), comparing to mild to moderate frail group (mean=6.25±0.72 days), and non-frail group (mean= 3.93±0.38 days, p=0.000). For the length of stay stratified by each individual CFS score, it was significant that patients with higher CFS scores had longer lengths of stay (p=.000). The group with higher CFS scores had higher CCI when compared with non-frail group (6.76±1.35 for severely frail, vs. 5.41±1.10 for mild to moderately frail vs. 3.02±0.95 for non-frail, p=0. 000). The use of the CFS for assessment of the elderly patients could help the otolaryngologist to predict the length of stay in otolaryngology unit in Taiwan

Preventive and therapeutic role of traditional Chinese herbal medicine in hepatocellular carcinoma

AbstractHepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide. The clinical management of HCC remains a substantial challenge. Although surgical resection of tumor tissues seems promising, a high recurrence and/or metastasis rate accounting for disease-related death has led to an urgent need for improved postsurgical preventive/therapeutic clinical intervention. Developing advanced target-therapy agents such as sorafenib appears to be the only effective clinical intervention for patients with HCC to date, but only limited trials have been conducted in this regard. Because of their enhanced preventive/therapeutic effects, traditional Chinese herbal medicine (CHM)-derived compounds are considered suitable agents for HCC treatment. The CHM-derived compounds also possess multilevel, multitarget, and coordinated intervention effects, making them ideal candidates for inhibition of tumor progression and HCC metastasis. This article reviews the anticancer activity of various CHMs with the hope of providing a better understanding of how to best use CHM for HCC treatment