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Kung PC, Huang HL, Hsu WC, Huang HL, Chang HJ, Shyu YIL. Coexisting with anomie: Experiences of persons living with early-stage dementia: A grounded theory study. Int J Ment Health Nurs 2024; 33:452-462. [PMID: 37985929 DOI: 10.1111/inm.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/19/2023] [Accepted: 11/05/2023] [Indexed: 11/22/2023]
Abstract
Individuals in the early stages of dementia often endure elevated levels of stress and anxiety, which can hinder their ability to adapt to the progression of dementia. To mitigate the negative impacts of dementia more effectively, it is necessary to explore the trajectory of the adaptation process of persons living with dementia. This study aimed to construct a theoretical framework for the adaptation process of individuals in the early stages of dementia. Participants were dyads of persons diagnosed with mild dementia or mild cognitive impairment (≥ 60 years of age) and their primary family caregivers. This longitudinal study used a grounded theory approach to explore the adaptation trajectory changes in persons with mild dementia over a 3-year period. Data were collected from dyads with face-to-face interviews. Analysis of the interview data revealed the core category was 'Coexisting with anomie: Progressive disappointment and striving', which was comprised of three categories: awareness of alienation, unsettled feelings, and restorative avoidance coping. Categories changed depending on levels of cognition and constituted progressive and cyclical dynamic processes. Four contextual factors positively or negatively influenced adaptation: level of insight about dementia, personal traits, caregiving style of the caregiver, and level of social interactions. These findings provide a new perspective about the mental health of persons in early-stage dementia. Understanding coexisting with anomie and related influencing factors could facilitate the development of support interventions by mental health nursing staff, which could improve emotional safety, promote psychological well-being, and increase quality of life for persons living with dementia.
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Affiliation(s)
- Pen-Chen Kung
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Huei-Ling Huang
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Wen-Chuin Hsu
- Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hong-Jer Chang
- National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Neurology, Dementia Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Bai YL, Shyu YIL, Huang HL, Chiu YC, Hsu WC. The enrichment process for family caregivers of persons living with dementia: A grounded theory approach. J Adv Nurs 2024; 80:252-263. [PMID: 37515365 DOI: 10.1111/jan.15809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/12/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
AIM Many persons living with dementia (PLWD) reside in the community and are cared for by family members. The aim of this qualitative study was to gain an understanding the enrichment process for family caregivers of PLWD in Taiwan. DESIGN A grounded theory approach with face-to-face semi-structured interviews was conducted with family caregivers of PLWD in Taiwan. METHODS Interview data from 30 family caregivers of PLWD recruited from dementia clinics or support groups in Taiwan were obtained from the first wave of a larger study conducted from January 2018 to September 2021. Glaser's grounded theory approach with theoretical sampling was used to understand the enrichment process of family caregivers of PLWD. RESULTS Analysis indicated the core category that characterized the process of enrichment was 'holding together'. Caregivers were able to maintain their connection to the person with dementia through activities that deepened their relationship and strengthened their bond. 'Holding together' included four components: maintaining continuity, creative interactions, interacting with humour and sharing pleasurable activities. Through these components, family caregivers generated positive interactions and relationships with the person living with dementia and sustained their motivation for caregiving. Three modifying elements facilitated or impeded the process of holding together: 'previous daily interactions', 'caregiving beliefs' and 'filial piety'. CONCLUSION Through the enrichment process of 'holding together', family caregivers used different strategies to conduct pleasurable and meaningful activities with the person living with dementia to maintain and improve their relationship and enhance their happiness in life. IMPACT To facilitate the enrichment process, health care providers should encourage activities between family caregivers and PLWD that promote continuity, increase interactions, provide humour and foster pleasurable activities. REPORTING METHOD This study adhered to the COREQ guideline checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Yu-Lin Bai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- NTU BioMedical Park Hospital Zhubei Campus, Zhubei, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Huei-Ling Huang
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yi-Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Huang HL, Liu XM, Zhang Y, Huang YS. [Comparison of formulas for intraocular lens power calculation after corneal refractive surgery]. Zhonghua Yan Ke Za Zhi 2023; 59:1012-1018. [PMID: 38061902 DOI: 10.3760/cma.j.cn112142-20231015-00143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objective: To evaluate the accuracy of five intraocular lens (IOL) power calculation formulas for calculating IOL power in patients with previous myopia-corrected corneal refractive surgery. Methods: In this case series study, a total of 30 eyes of 30 patients who had excimer laser corneal refractive surgery for myopia and subsequent cataract surgery in Qingdao Eye Hospital from April 2020 to October 2022 were included. The Pentacam anterior segment analysis system and IOLMaster were used to measure ocular parameters, including axial length, anterior chamber depth, keratometry, lens thickness, and mean true net power (mTNP). Five formulas were used for IOL power calculation: Shammas formula, Olsen formula, SRK/T (mTNP) formula, Haigis-L formula, and Barrett True-K formula. After cataract extraction, we obtained the actual postoperative refraction by measuring the objective refraction. The prediction error was determined as the difference between the actual postoperative refraction and the predicted refraction, and the absolute value of the prediction error was the absolute error. The differences in the calculation errors of the 5 formulas were compared. Results: Regarding the prediction errors, the results of the SRK/T (mTNP) and Olsen formulas were better than those of Shammas and Haigis-L, and the differences were statistically significant (all P<0.05). The proportion of eyes with an absolute error of 0.50 D for Barrett True-K was highest (70%, 21/30), followed by the SRK/T (mTNP) formula (67%, 20/30). The proportions of eyes with an absolute error within 1.00 D for Barrett True-K, SRK/T (mTNP), and Olsen were all over 80%, with 24 eyes, 24 eyes, and 25 eyes, respectively. Conclusions: The Barrett True-K formula showed high accuracy in predicting the refraction after cataract extraction in patients with a history of corneal refractive surgery for myopia. The calculation result of the Haigis-L formula was highly unstable.
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Affiliation(s)
- H L Huang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - X M Liu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - Y Zhang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - Y S Huang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
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Chen XH, Yang ZJ, Xu CJ, Chen YH, Huang HL, Li ZS, Lin T, Zhao ML, Chen T, Chen H, Liang YR, Zhu MS, Hu YF, Li GX, Yu J. [Application effect of the joint nasogastric tube for pairing overlap guiding tube (JNT) in esophagojejunostomy]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:986-989. [PMID: 37849270 DOI: 10.3760/cma.j.cn441530-20230105-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
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Lin PC, Huang CJ, Lu YM, Huang HL, Wu ZY, Chang CC, Chu FY. Diagnostic performance of GenBody COVID-19 rapid antigen test for laboratory and non-laboratory medical professionals in real practice: A retrospective study. Medicine (Baltimore) 2023; 102:e34927. [PMID: 37603502 PMCID: PMC10443765 DOI: 10.1097/md.0000000000034927] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023] Open
Abstract
Point-of-care tests for coronavirus disease 2019 (COVID-19) antigen detection have been widely used for rapid diagnosis in various settings. However, research on the diagnostic performance of the COVID-19 antigen test performed by non-laboratory personnel is limited. In this study, we aimed to elucidate the diagnostic performance of GenBody COVID-19 rapid antigen between laboratory professionals and non-laboratory staff. We retrospectively analyzed the data of patients who underwent both GenBody COVID-19 rapid antigen testing and reverse transcription polymerase chain reaction (RT-PCR) between November 01, 2021, and June 30, 2022. The diagnostic performance of the antigen test was compared between laboratory and non-laboratory operators, using RT-PCR as the gold standard. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, positive predictive value, negative predictive value, and accuracy were calculated and sensitivity analysis was performed based on the PCR cycle threshold (Ct) value. Of the 11,963 patients, 1273 (10.6%) tested positive using real-time RT-PCR. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, positive predictive value, negative predictive value, and accuracy of the GenBody COVID-19 rapid antigen test with 95% confidence interval were 79.92% (77.26%-82.39%), 99.23% (98.73%-99.57%), 103.25 (62.31-171.11), 0.2 (0.18-0.23), 510.18 (299.81-868.18), 98.11% (96.91%-98.85%), 90.75% (89.64%-91.75%) and 92.76% (91.76%-93.67%), respectively, for non-laboratory staff and 79.80% (74.78%-84.22%), 99.99% (99.94%-100.00%), 6983.92 (983.03-49617.00), 0.2 (0.16-0.25), 34566.45 (4770.30-250474.46) 99.58% (97.09%-99.94%), 99.32% (99.15%-99.46%), and 99.33% (99.13%-99.48%), respectively, for laboratory staff. Notably, when the PCR Ct value exceeded 25, the sensitivity of both the groups decreased to < 40%. The diagnostic performance of GenBody COVID-19 rapid antigen performed by non-laboratory staff was comparable to that of laboratory professionals. However, it should be noted that the sensitivity of the antigen tests decreased when the PCR Ct value exceeded 25. Overall, the GenBody COVID-19 antigen test is a viable option for non-laboratory staff during an epidemic.
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Affiliation(s)
- Pei-Chin Lin
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chun-Jung Huang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Yen-Ming Lu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Huei-Ling Huang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Zong-Ying Wu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chih-Chun Chang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan, Taiwan
| | - Fang-Yeh Chu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu City, Taiwan
- School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei City, Taiwan
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Kung PC, Huang HL, Che HL, Chou YF, Chi SF, Tseng SM. Effectiveness of clinical mentorship program for students of long-term aged care: A mixed-methods study. Nurse Educ Today 2023; 125:105781. [PMID: 36933372 DOI: 10.1016/j.nedt.2023.105781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/22/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Internationally, the population is rapidly aging with a strong demand for aged care services. In Taiwan, both recruiting and retaining staff to aged care poses difficulties. Good clinical role models can positively impact students' confidence and professional development and influence their willingness to enter the long-term aged care workforce. OBJECTIVES To clarify clinical mentors' roles and competencies and assess the effectiveness of a mentorship program for improving students' professional commitment and self-efficacy in long-term aged care. DESIGN A mixed-methods study with a quasi-experimental research design and qualitative interviews. SETTINGS Purposive sampling was used to recruit long-term aged care professional clinical mentors with preceptor qualifications and nursing and aged care students enrolled in a two-year technical program in a Taiwanese university's gerontology care department. PARTICIPANTS Fourteen mentors and 48 students participated. The student control group received regular education; the experimental group received mentorship guidance. METHODS This study included three phases. Phase one involved qualitative interviews to identify clinical mentors' roles and competencies. Phase two involved expert panel meetings to establish the clinical mentorship program's content and implementation. Phase three involved the program's evaluation. Quantitative questionnaires were administered before the program and subsequently at 6, 12, and 18 months to assess mentors' effectiveness and students' professional commitment and self-efficacy in long-term aged care. Qualitative focus groups solicited participants' feelings and suggestions for the program. RESULTS Clinical mentors' roles and competencies centered on two themes: professional role model and establishing good rapport. Quantitative analysis showed that mentoring effectiveness initially recorded a decline, followed by a subsequent increase. Both groups' professional self-efficacy and commitment followed an increasing trend. While the experimental group's professional commitment score was significantly higher than the control groups, their professional self-efficacy scores did not differ significantly. CONCLUSIONS The clinical mentorship program improved students' long-term aged care professional commitment and self-efficacy.
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Affiliation(s)
- Pen-Chen Kung
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Huei-Ling Huang
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Hui-Lian Che
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Yen-Fang Chou
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Shu-Fen Chi
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Su-Mei Tseng
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Zhong WS, Xu Z, Cui J, Chen WX, Huang HL, Tan HL, Zhang PQ, Tan L, Xie L. [Application of lateral upper arm free flap in the repair of postoperative defects of oral cancer]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1219-1224. [PMID: 36319128 DOI: 10.3760/cma.j.cn115330-20220406-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To explore the clinical application and efficacy of lateral upper arm free flap (LUAFF) for one-stage repairing of soft tissue defect after oral cancer surgery. Methods: This article was a retrospective analysis of clinical data of 46 patients receiving treatment of one-stage repairing of soft tissue defect with LUAFF after oral cancer surgery in Hunan Cancer Hospital, from June 2019 to June 2021. Among these cases, 40 were males, and 6 were females. The patients' ages were from 23 to 64 years old. The clinical data of patients were reviewed and outcomes were evaluated. SPSS 23.0 software was used for statistical analysis. Results: In the LUAFF of 46 patients, flap area ranged from 5.0 cm×3.5 cm to 15.0 cm×7.0 cm; the mean pedicle length was 8.15±1.42 cm; the mean artery diameter was 1.20±0.41 mm (range, 1.5 to 2.5 mm); the mean diameter of the largest veins was 2.15±0.52 mm; and the median number of perforators was 2.6 (range, 1 to 4). All donor sites were closed primarily. Two cases had arterial anastomosis thrombosis, but their flaps were successfully saved with urgent re-anastomosis of the vessels. The overall flap survival rate was 93.5%(43/46), with flap necroses after operation in three cases. No patient received tracheotomy. The average hospital stay time of patients after operation was 9.4 days. The follow-up time was 6-24 months, elbow and wrist movements on the operative side were normal, and the upper limb muscle strength was not affected. Conclusions: LUAFF is a suitable choice for the repairs of small-moderate tissue defects in oral cancer surgery, with consistent perforators in the flap, simple harvest method, concealed donor-site scar, and high survival rate.
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Affiliation(s)
- W S Zhong
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Z Xu
- Department of Head and Neck Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - J Cui
- Department of Head and Neck Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
| | - W X Chen
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - H L Huang
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - H L Tan
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - P Q Zhang
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - L Tan
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
| | - Li Xie
- Department of Head and Neck Surgery, Hunan Cancer Hospital,The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China
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Huang HL, Lu WR, Huang HL, Liu CL. The effect of a family-centered advance care planning intervention for persons with cognitive impairment and their family caregivers on end-of-life care discussions and decisions. PLoS One 2022; 17:e0274096. [PMID: 36067182 PMCID: PMC9447906 DOI: 10.1371/journal.pone.0274096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/21/2022] [Indexed: 11/19/2022] Open
Abstract
Advanced care planning (ACP) includes advance directives (AD), which can specify provisions for palliative care and types of life-sustaining treatments for an individual requiring end-of-life (EoL) care. ACP for persons in the early stages of cognitive decline can decrease anxiety and conflict for family members needing to make decisions about EoL-care, which is especially critical for family caregivers (FCGs) if they play a role as a surrogate regarding healthcare decisions. However, ACP for persons with cognitive impairment (PWCIs) is often overlooked. This study explored the effects of a family-centered ACP intervention on decisions about EoL-care, life-sustaining treatment decisions, and discussions of related topics among PWCIs and FCGs. The study was conducted in outpatient clinics of regional teaching hospitals in northern Taiwan. Participants were dyads consisting of persons diagnosed with mild cognitive impairment or mild dementia and their FCGs. The family-centered ACP intervention was provided by an ACP-trained senior registered nurse. A one-group, pretest–posttest design was used to evaluate the effect of the intervention on 44 dyads. Four structured questionnaires collected data regarding familiarity with ACP, intention to engage in ACP, participation in personal discussions between the dyads about ACP, and consistency between PWCIs and FCGs for decisions about life-sustaining treatments at EoL. Paired t, Kappa, and McNemar tests were used to compare differences between pre-intervention data (pretest) and post-intervention data (posttest). There were significant increases in familiarity with ACP, components of ACP, and the number of topics PWCIs and FCGs personally discussed surrounding EoL-care decisions. There was no change for either group in wanting to have a formal ACP consultation and only modest increases in consistency between PWCIs and FCGs for life-sustaining treatment decisions after completion of the family-centered ACP intervention. Clinicians caring for PWCIs should incorporate family-centered ACP interventions and support ongoing discussions about life-sustaining medical treatments to ensure their preferences regarding EoL-care are respected. The accessibility and availability of consultations about ACP should also be provided.
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Affiliation(s)
- Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
| | - Wei-Ru Lu
- Department of Nursing, Sijhih Cathay General Hospital, New Taipei City, Taiwan
| | - Huei-Ling Huang
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chien-Liang Liu
- Dementia Center, Department of Internal Medicine, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
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Sung YL, Huang HL, Lin CC, Kröger T, Hsu WC, Hsu JL, Lin YE, Shyu YIL. Experiences of family caregivers of persons living with dementia with and without a smart- clothes assisted home nursing program during the heightened COVID-19 alert. BMC Geriatr 2022; 22:697. [PMID: 35996089 PMCID: PMC9395831 DOI: 10.1186/s12877-022-03379-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/29/2022] [Indexed: 11/12/2022] Open
Abstract
Background The COVID-19 pandemic has required restrictions of daily activities, which has been found to impact the lives of persons living with dementia (PLWDs) and their family caregivers, who have multiple care demands. The lack of relevant studies in Taiwan emphasized the need to explore the experiences of family caregivers of older PLWDs faced with the intensified restrictions to control the spread of COVID-19, and the impact of the availability of a smart-clothes home nursing program. Methods This qualitative study used semi-structured interviews with family caregivers of older PLWDs. Participants were recruited from dementia clinics of a medical center in northern Taiwan from a subset of a sample from a larger study on smart-clothes assisted home nursing care. A total of 12 family caregivers who participated in the original study were interviewed during the follow-up period; seven family caregivers of a PLWD wearing a smart-vest, which transmitted information to a home care nurse; five caregivers of a PLWD not wearing a smart-vest. Interviews were conducted by telephone because the conditions of the pandemic prevented face-to-face interviews. Recorded interviews were transcribed and analyzed using content analysis. Results Interview data showed family caregivers’ felt the care recipient’s health was compromised and functional conditions intensified as Covid-19-related pandemic restrictions increased. Specific concerns included a lack social interactions, decreased daily activity levels, loss of interest and lack of motivation for activities, increased mood and behavioral problems, a decline in physical function and an increase in health problems. Family caregivers were also impacted by these restrictions, with significant increases in severity of caregiver role strain, including feeling trapped, a lack of in-home support, profound powerlessness, and worries about the PLWD contracting the coronavirus. The smart-clothes assisted home nursing care program offered supplementary support to family caregivers by providing on-time interactions, helping them manage health problems, enhancing predictability of the care recipient’s behaviors, and providing caregivers with emotional support. Conclusions The findings of this study support alternative care such as implementation of technology-assisted home health services to meet caregiver needs to facilitate family caregiving of PLWDs during the necessary restrictions in activities implemented during the COVID-19 pandemic. Trial registration ClinicalTrials.gov Protocol Record NCT05063045.
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Affiliation(s)
- Ya-Li Sung
- School of Nursing, Change Gung University, Guishan District, 259 Wenhua 1st Road, Taoyuan, 33302, Taiwan, ROC
| | - Huei-Ling Huang
- Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, ROC.,Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan, ROC.,Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Chung-Chih Lin
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Teppo Kröger
- Department of Social Sciences and Philosophy, University of Jyväskylä, Jyväskylä, Finland.,Centre for Care Research West, Western Norway University of Applied Sciences, Bergen, Norway
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Jung-Lung Hsu
- Department of Neurology, New Taipei Municipal Tu Cheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei City, Taiwan, ROC.,Graduate Institute of Humanities in Medicine and Research Center for Brain and Consciousness, Taipei Medical University Shuang Ho Hospital, Taipei, Taiwan, ROC
| | - Yueh-E Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Yea-Ing L Shyu
- School of Nursing, Change Gung University, Guishan District, 259 Wenhua 1st Road, Taoyuan, 33302, Taiwan, ROC. .,Department of Gerontology and Health Care Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, ROC. .,Dementia Center, Department of Neurology, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC. .,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, ROC. .,Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC.
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Hou YJ, Zeng SY, Lin CC, Yang CT, Huang HL, Chen MC, Tsai HH, Liang J, Shyu YIL. Smart clothes-assisted home-nursing care program for family caregivers of older persons with dementia and hip fracture: a mixed-methods study. BMC Geriatr 2022; 22:104. [PMID: 35123399 PMCID: PMC8818174 DOI: 10.1186/s12877-022-02789-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The purpose of this preliminary study was to explore whether a smart clothes-assisted home-nursing care program could benefit family caregivers and their care recipients.
Methods
Family caregivers in charge of a care recipient’s living situation participated in this convergent parallel, mixed methods study. We recruited older persons with dementia (n = 7) and those discharged following hip-fracture surgery (n = 6) from neurological clinics and surgical wards of a medical center, respectively, along with their family caregivers: three spouses, eight sons, one daughter, and one daughter-in-law. Care recipients were asked to wear a smart vest at least 4 days/week for 6 months, which contained a coin-size monitor hidden in an inner pocket. Sensors installed in bedrooms and living areas received signals from the smart clothing, which were transmitted to a mobile phone app of homecare nurses, who provided caregivers with transmitted information regarding activities, emergency situations and suggestions for caregiving activities. Outcomes included changes from baseline in caregivers’ preparedness and depressive symptoms collected at 1- and 3-months, which were analyzed with Friedman’s non-parametric test of repeated measures with post-hoc analysis. Transcripts of face-to-face semi-structured interview data about caregivers’ experiences were analyzed to identify descriptive, interpretative, and pattern codes.
Results
Preparedness did not change from baseline at either 1- or 3-months for family caregivers of persons with dementia. However, depressive symptoms decreased significantly at 1-month and 3-months compared with baseline, but not between 1-months and 3-months. Analysis of the interview data revealed the smart clothes program increased family caregivers’ knowledge of the care recipient’s situation and condition, informed healthcare providers of the care recipient’s physical health and cognitive status, helped homecare nurses provide timely interventions, balanced the care recipient’s exercise and safety, motivated recipients to exercise, helped family caregivers balance work and caregiving, and provided guidance for caregiving activities.
Conclusions
Experiences with the smart clothes-assisted home-nursing care program directly benefited family caregivers, which provided indirect benefits to the care recipients due to the timely interventions and caregiving guidance from homecare nurses. These benefits suggest a smart-clothes-assisted program might be beneficial for all family caregivers.
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11
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Huang HL, Wang KD, Sun XH. [Relative factors analysis of visual field defect in advanced primary glaucoma]. Zhonghua Yan Ke Za Zhi 2022; 58:22-27. [PMID: 34979789 DOI: 10.3760/cma.j.cn112142-20210608-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the relative factors of visual field defect in advanced primary glaucoma. Methods: A retrospective case-control study. The data of patients with primary advanced glaucoma who had the central 5 to 10 degrees of the visual field or the temporal peripheral field and were treated at Eye & ENT Hospital of Fudan University from January 2014 to December 2019 were reviewed. The patients were divded into the central visual field group and the temporal peripheral field group according to the type of visual field defect. Statistical analyses of single-factor (Chi square test or independent sample t test) and multivariate logistic regression were performed to analyze the correlation between the remaining visual field and the risk factors including age, gender, left/right eye, type of glaucoma, baseline glaucoma stage, peak intraocular pressure (IOP), mean IOP, number of operations, family history, high myopia, diabetes, hypertension, hypotension and migraine. Results: A total of 287 patients (287 eyes) were included. There were 101 patients [mean age, (61±15) years; 48 males, 53 females] with the central 5 to 10 degrees of the visual field and 186 patients [mean age, (59±17) years; 107 males, 79 females] with the temporal peripheral field. There was no statistically significant difference between the two groups with respect to age, gender, left/right eye, age of onset, number of operations, family history and history of combined systemic diseases (all P>0.05). Primary open-angle glaucoma, chronic primary angle-closure glaucoma (CPACG) and acute primary angle-closure glaucoma were found in 26, 34 and 41 patients, respectively, in the central visual field group, and in 61, 78 and 47 patients, respectively, in the temporal peripheral field group. The baseline glaucoma was in the moderate stage in 30 and 32 patients, and in the advanced stage in 71 and 154 patients, respectively, in the two groups. The peak IOP was (31.94±4.11) mmHg (1 mmHg=0.133 kPa) and (34.58±6.47) mmHg, and the mean IOP was (22.48±3.99) mmHg and (24.01±4.30) mmHg, respectively, in the two groups. High myopia occurred in 5 and 28 patients, respectively, in the two groups. The differences in the type of glaucoma (χ²=7.24), baseline glaucoma stage (χ²=6.04), peak IOP (t=4.22), mean IOP (t=2.96) and high myopia (χ²=6.57) between the two groups were statistically significant (all P<0.05). In the multivariable model, CPACG (OR=2.021, 95%CI: 1.020 to 4.001), higher peak IOP (OR=1.128, 95%CI: 1.038 to 1.226) and high myopia (OR=5.090, 95%CI: 1.556 to 16.651) increased the risks for the progression to the temporal peripheral field. Conclusion: CPACG, higher peak IOP and concurrent high myopia are all relative factors for the progression to the temporal peripheral field in advanced primary glaucoma.
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Affiliation(s)
- H L Huang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - K D Wang
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - X H Sun
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
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12
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Leong KI, Ho CY, Tsai YH, Chang CC, Huang HL, Tan NC, Chen WC. The role of pleural fluid lactate dehydrogenase-to-adenosine deaminase ratio in differentiating the etiology of pleural effusions. CHINESE J PHYSIOL 2022; 65:105-108. [DOI: 10.4103/cjp.cjp_104_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Li JK, Huang HL, Zhu YH, Lei JQ. [Research progress of cirrhotic portal hypertension in diagnostic imaging methods]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:1224-1228. [PMID: 35045646 DOI: 10.3760/cma.j.cn501113-20200116-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hepatic venous pressure gradient measurement via jugular vein catheterization is still currently the gold standard for evaluating portal hypertension. However, how to accurately and reproducibly assess whether there is portal hypertension has always been a concern in patients with liver cirrhosis. In recent years, imaging methods have made significant progress in the non-invasive diagnosis of portal hypertension. This paper reviews the current different diagnostic value of imaging methods and related research progress in an attempt to evaluate patients with cirrhotic portal hypertension.
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Affiliation(s)
- J K Li
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
| | - H L Huang
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
| | - Y H Zhu
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
| | - J Q Lei
- Department of Radiology, the First Hospital of Lanzhou University & Intelligent Imaging Medical Engineering Research Center of Gansu Province & Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou 73000, China
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14
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Hsiung TL, Wei LW, Huang HL, Wang HP. In situ X-ray absorption spectroscopic studies of TiO 2 photocatalytic active sites for degradation of trace CHCl 3 in drinking water. J Synchrotron Radiat 2021; 28:1839-1844. [PMID: 34738937 DOI: 10.1107/s1600577521008973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
Toxic disinfection byproducts such as trihalomethanes (e.g. CHCl3) are often found after chlorination of drinking water. It has been found that photocatalytic degradation of trace CHCl3 in drinking water generally lacks an expected relationship with the crystalline phase, band-gap energy or the particle sizes of the TiO2-based photocatalysts used such as nano TiO2 on SBA-15 (Santa Barbara amorphous-15), TiO2 clusters (TiO2-SiO2) and atomic dispersed Ti [Ti-MCM-41 (Mobil Composition of Matter)]. To engineer capable TiO2 photocatalysts, a better understanding of their photoactive sites is of great importance and interest. Using in situ X-ray absorption near-edge structure (XANES) spectroscopy, the A1 (4969 eV), A2 (4971 eV) and A3 (4972 eV) sites in TiO2 can be distinguished as four-, five- and six- coordinated Ti species, respectively. Notably, the A2 Ti sites that are the main photocatalytic species of TiO2 are shown to be accountable for about 95% of the photocatalytic degradation of trace CHCl3 in drinking water (7.2 p.p.m. CHCl3 gTiO2-1 h-1). This work reveals that the A2 Ti species of a TiO2-based photocatalyst are mainly responsible for the photocatalytic reactivity, especially in photocatalytic degradation of CHCl3 in drinking water.
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Affiliation(s)
- T L Hsiung
- Department of Environmental Engineering, National Cheng Kung University, Tainan, 70101, Taiwan
| | - L W Wei
- Department of Environmental Engineering, National Cheng Kung University, Tainan, 70101, Taiwan
| | - H L Huang
- Department of Safety, Health and Environmental Engineering, National United University, Miaoli 36063, Taiwan
| | - H Paul Wang
- Department of Environmental Engineering, National Cheng Kung University, Tainan, 70101, Taiwan
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15
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Huang CY, Tsai HW, Liu CY, Liu TH, Huang HL, Chang CC, Chen WC, Sun JT. The predictive and prognostic role of hematologic and biochemical parameters in the emergency department among coronavirus disease 2019 patients. CHINESE J PHYSIOL 2021; 64:306-311. [PMID: 34975124 DOI: 10.4103/cjp.cjp_77_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) had caused a worldwide pandemic with public health emergencies since 2020. For the symptomatic patients, high mortality rate was observed if without timely and optimized management. In this study, we aimed to investigate the predictive and prognostic roles of hematologic and biochemical parameters obtained in the emergency department (ED) for COVID-19 patients. We conducted a retrospective study in a dedicated COVID-19 medical center, recruiting a total of 228 COVID-19 patients with 86 severe and 142 non-severe cases. Both the hematologic and biochemical parameters obtained in the ED upon arrival were analyzed to evaluate the association of the biomarkers with disease severity and prognosis among COVID-19 patients. Among these parameters, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, and D-dimer were significantly higher in the severe group than the non-severe one, whereas the platelet count and lymphocyte-to-monocyte ratio were significantly lower. Receiver operating characteristic curve analysis revealed that the areas under curve of CRP, PCT, LDH, ferritin, D-dimer, and NLR for differentiating the severity of COVID-19 were 0.713, 0.755, 0.763, 0.741, 0.733, and 0.683, respectively, whereas the areas under curve of CRP, PCT, LDH, ferritin, D-dimer, and NLR for differentiating the mortality of COVID-19 were 0.678, 0.744, 0.680, 0.676, 0.755, and 0.572, respectively. Logistic regression analysis revealed that CRP, PCT, LDH, ferritin, D-dimer, and NLR were independent indicators for prediction of severe COVID-19, and LDH and ferritin were independent factors associated with the mortality in COVID-19. In conclusion, higher CRP, PCT, LDH, ferritin, D-dimer, and NLR were associated with severe COVID-19, whereas higher LDH and ferritin were associated with the mortality in COVID-19. These findings could help early risk stratification in the ED and contribute to optimized patient management.
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Affiliation(s)
- Chun-Yen Huang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Huang-Wen Tsai
- Division of Pediatric Surgery, Department of Surgery; Division of Trauma, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chia-Ying Liu
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tse-Hsuan Liu
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Huei-Ling Huang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chih-Chun Chang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City; Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan, Taiwan
| | - Wei-Chi Chen
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Yilan; Public Health Bureau, New Taipei City, Taiwan
| | - Jen-Tang Sun
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City; School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
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16
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Huang HL, Cai MY, Lin N, Wang Y, Xu LP. [Analysis of genetic abnormalities and clinical outcome of fetus with ultrasonic nonstructural abnormality]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1094-1099. [PMID: 34619927 DOI: 10.3760/cma.j.cn112150-20210326-00307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analysis the incidence of abnormal genetics and the clinical outcome of fetuses with ultrasonic nonstructural abnormality. Methods: This study was conducted retrospectively. 631 pregnant women were enrolled in the Prenatal Diagnostic Center of Fujian Maternal and Child Health Hospital due to ultrasonic nonstructural abnormality from January 2016 to January 2019. According to different gestational weeks, amniotic fluid or umbilical cord blood samples were collected for chromosome karyotype analysis and SNP-array. According to the number of nostructural abnormalities, they were divided into 1 nostructural abnormality group, 2 nostructural abnormalities group, and ≥3 nostructural abnormalities group. Chi-square test was used for comparison between groups. Results: Of the 631 cases, 34 cases (5.4%, 34/631) had abnormal karyotypes, including 20 cases with abnormal chromosome number and 14 cases with abnormal chromosome structure. In results of SNP-array, there were 53 abnormal results (8.4%, 53/631), including 32 cases of pathogenic copy number variations (CNV) and 21 cases of variations of uncertain clinical significance (VOUS). The rates of pathogenic CNV were 4.57% (21/260), 4.76% (7/147) and 16.67% (4/24) in the group of 1, 2 and ≥3 nostructural abnormalities, respectively. The rate of the three groups showed a linear trend, and the difference was statistically significant (χ²=7.419,P<0.05). In the single nostructural abnormality group, the rate of pathogenic CNV of nasal bone dysplasia, fetal growth restriction (FGR) and thickened nuchal translucency (NT) were 8.11% (3/37), 7.04% (5/71) and 5.60% (7/125), respectively. Conclusions: Compared with the karyotype analysis, SNP-array can significantly improve the detection rate of genetic abnormalities in ultrasonic nonstructural abnormality. When multiple ultrasonic nonstructural abnormality were combined, the risk of genetic abnormalities showed an upward trend.
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Affiliation(s)
- H L Huang
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - M Y Cai
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - N Lin
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - Y Wang
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
| | - L P Xu
- Fujian Maternity and Child Health Hospital, Fujian Maternity and Child Health Hospital Affiliated to Fujian Medical University, Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
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17
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Hsiung TL, Wei LW, Huang HL, Tuan YJ, Wang HP. In situ X-ray absorption spectroscopic studies of photocatalytic oxidation of As(III) to less toxic As(V) by TiO 2 nanotubes. J Synchrotron Radiat 2021; 28:849-853. [PMID: 33949992 DOI: 10.1107/s1600577521003076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
Arsenic in groundwater caused the black-foot disease (BFD) in many countries in the 1950-1960s. It is of great importance to develop a feasible method for removal of arsenic from contaminated groundwater in BFD endemic areas. Photocatalytic oxidation of As(III) to less toxic As(V) is, therefore, of significance for preventing any arsenic-related disease that may occur. By in situ synchrotron X-ray absorption spectroscopy, the formation of As(V) is related to the expense of As(III) disappearance during photocatalysis by TiO2 nanotubes (TNTs). Under UV/Vis light irradiation, the apparent first-order rate constant for the photocatalytic oxidation of As(III) to As(V) is 0.0148 min-1. It seems that As(III) can be oxidized with photo-excited holes while the not-recombined electrons may be scavenged with O2 in the channels of the well defined TNTs (an opening of 7 nm in diameter). In the absence of O2, on the contrary, As(III) can be reduced to As(0), to some extent. Cu(II) (CuO), as an electron acceptor, was impregnated on the TNTs surfaces in order to gain a better understanding of electron transfer during photocatalysis. It appears that As(III) can be oxidized to As(V) while Cu(II) is reduced to Cu(I) and Cu(0). The molecular-scale data are very useful in revealing the oxidation states and interconversions of arsenic during the photocatalytic reactions. This work has implications in that the toxicity of arsenic in contaminated groundwater or wastewater can be effectively decreased via solar-driven photocatalysis, which may facilitate further treatments by coagulation.
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Affiliation(s)
- T L Hsiung
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
| | - L W Wei
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
| | - H L Huang
- Department of Safety, Health and Environmental Engineering, National United University, Miaoli 36003, Taiwan
| | - Y J Tuan
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
| | - H Paul Wang
- Department of Environmental Engineering, National Cheng Kung University, Tainan 70101, Taiwan
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18
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Kung PC, Huang HL, Hsu WC, Hsu JL, Tang LY, Shyu YIL. Fluctuating interpretations: Striving to maintain a sense of self in early dementia. Geriatr Nurs 2021; 42:484-490. [PMID: 33721655 DOI: 10.1016/j.gerinurse.2021.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022]
Abstract
This study aimed to develop a conceptual framework of the experience of persons living with the early stages of dementia. A grounded theory approach examined the experience from the perspective of the patient. Data were collected from dyads of persons with mild dementia and their family caregivers (N = 17) using face-to-face interviews at three timepoints over a one-year period. Transcribed interviews were analyzed with constant comparative analysis. The core category was "Fluctuating interpretations: striving to maintain one's sense of self." Interpretations were comprised of three subcategories: being a stranger to oneself, sense-making, and strategies for coexistence. Different situations influenced the process and affected individuals' attitudes and behaviors. Interpretations were a protective vehicle and stabilizing force that enabled persons with dementia to coexist with disease changes. Perspectives of persons with dementia during the early stages should be considered when designing intervention strategies for patient-centered care.
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Affiliation(s)
- Pen-Chen Kung
- PhD student, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Lecturer, Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Huei-Ling Huang
- Associate Professor, Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Associate Researcher, Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Chuin Hsu
- Associate Professor & Visiting Staff, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Director, Dementia Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jung-Lung Hsu
- Associate professor, Attending, Department of Neurology, New Taipei Municipal Tu Cheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei City, Taiwan; Adjunct Associate Professor, Taipei Medical University Shuang Ho Hospital, Graduate Institute of Humanities in Medicine and Research Center for Brain and Consciousness, Taipei, Taiwan
| | - Li-Yu Tang
- Secretary General, Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Yea-Ing L Shyu
- Lambda Beta Chapter-At-Large, Distinguished Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Professor and Group Project Leader, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Professor, Department of Gerontology and Health Care Management Chang Gung University of Science and Technology.
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Huang HL, Gnanasegaran G, Paez D, Fanti S, Hacker M, Sathekge M, Bom HS, Cerci JJ, Chiti A, Lan X, Herrmann K, Scott AM, Vinjamuri S, Dorbala S, Estrada E, Pellet O, Orellana P, El-Haj N, Giammarile F, Abdel-Wahab M, Bomanji J. Nuclear medicine services after COVID-19: gearing up back to normality. Eur J Nucl Med Mol Imaging 2020; 47:2048-2053. [PMID: 32367256 PMCID: PMC7197920 DOI: 10.1007/s00259-020-04848-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- H L Huang
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.,Department of Nuclear Medicine and Molecular Imaging, Division of Radiological Sciences, Singapore General Hospita, Bukit Merah, Singapore
| | | | - D Paez
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - S Fanti
- Department of Oncology, Division of Nuclear Medicine, University of Bologna, Bologna, Italy
| | - M Hacker
- Department of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Sathekge
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - H S Bom
- Department of Nuclear Medicine, Chonnam National University, Seoul, South Korea
| | - J J Cerci
- PET/CT Department at Quanta Diagnostics and Therapy, Curitiba, Brazil
| | - A Chiti
- Humanitas University and Humanitas Research Centre, Milan, Italy
| | - X Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - S Vinjamuri
- Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - S Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - E Estrada
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - O Pellet
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - P Orellana
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - N El-Haj
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - F Giammarile
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - M Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.
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Shyu YI, Hou YJ, Zeng SY, Lin CC, Yang CT, Huang HL, Chen MC, Tsai HH, Liang J, Hsu JL, Hsu WC. A Smart Technology-Assisted Home-Nursing Care Program for Family Caregivers of Older Persons with Dementia and Hip Fracture: A Mixed-Methods Study (Preprint). JMIR Aging 2020. [DOI: 10.2196/22300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Huang HL, Gnanasegaran G, Paez D, Fanti S, Hacker M, Sathekge M, Bom HS, Cerci JJ, Chiti A, Lan X, Herrmann K, Scott AM, Vinjamuri S, Dorbala S, Estrada E, Pellet O, Orellana P, El-Haj N, Giammarile F, Abdel-Wahab M, Bomanji J. Correction to: Nuclear medicine services after COVID-19: gearing up back to normality. Eur J Nucl Med Mol Imaging 2020; 47:2220. [PMID: 32462399 PMCID: PMC7252414 DOI: 10.1007/s00259-020-04884-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors P. Orellana and N. El-Haj were inadvertently deleted in the original paper.
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Affiliation(s)
- H L Huang
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK
- Department of Nuclear Medicine and Molecular Imaging, Division of Radiological Sciences, Singapore General Hospital, Bukit Merah, Singapore
| | | | - D Paez
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - S Fanti
- Department of Oncology, Division of Nuclear Medicine, University of Bologna, Bologna, Italy
| | - M Hacker
- Department of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Sathekge
- NuclearMedicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - H S Bom
- Department of Nuclear Medicine, Chonnam National University, Seoul, South Korea
| | - J J Cerci
- PET/CT Department at Quanta Diagnostics and Therapy, Curitiba, Brazil
| | - A Chiti
- Humanitas University and Humanitas Research Centre, Milan, Italy
| | - X Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - S Vinjamuri
- Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - S Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - E Estrada
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - O Pellet
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - P Orellana
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - N El-Haj
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - F Giammarile
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - M Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.
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Shen MH, Yang CT, Wu CC, Huang HL, Lin YE, Shyu YIL, Chung SC. Resuming Normal Life as a Family Caregiver During Drip-Like Recovery of Older Persons With Cognitive Impairment Recovering From Hip Surgery: A Grounded Theory. J Nurs Scholarsh 2020; 52:250-260. [PMID: 32246742 DOI: 10.1111/jnu.12554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE This study was undertaken to develop a theoretical framework explaining family caregiving processes for older persons with cognitive impairment recovering from hip fracture surgery. DESIGN AND METHODS In this grounded theory study, data were collected in audio-recorded face-to-face interviews with 21 family caregivers. Among these caregivers, 14 cared for hip-fractured persons with cognitive impairment, and seven cared for those without cognitive impairment. Caregivers were interviewed five times after patients' discharge: at 1 week and at 1, 3, 6, and 12 months. Data were analyzed by constant comparative analysis. FINDINGS The core category explaining the family caregiving process for hip-fractured persons with cognitive impairment was "resuming normal life during drip-like recovery." This category captures the slowness of the recovery process, as slow as dripping water. During the early postoperative period, caregivers attempted to gain control of the postoperative situation, using various maintenance and improvement strategies to deal with the chaos in individuals and the family and to protect hip-fractured persons with cognitive impairment from further harm. The goal of recovery was to get back to their original life. CONCLUSIONS Family caregivers of hip-fractured older persons with cognitive impairment needed to deal with more complex chaotic situations, exerted more efforts to administer safety measures, and required more time to achieve a stable life pattern. CLINICAL RELEVANCE Since postoperative recovery was perceived as extremely slow, family caregivers of hip-fractured older persons with cognitive impairment should be patient regarding recovery and be informed before hospital discharge of different strategies to resume normal life during postoperative recovery.
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Affiliation(s)
- Mei-Hsing Shen
- Research Assistant, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Tzu Yang
- Lambda Beta Chapter-At-Large, Assistant Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chuan Wu
- Professor and Deputy Director, Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Huei-Ling Huang
- Associate Professor, Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yueh-E Lin
- Supervisor, Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- Lambda Beta Chapter-At-Large, Distinguished Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Professor and Group Project Leader, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Research Fellow, Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Consultant, Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Professor, Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Shih-Chi Chung
- Assistant Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Shang Q, Wu P, Huang HL, Zhang SL, Tang XD, Guo XJ. Inhibition of heat shock protein 90 suppresses Bombyx mori nucleopolyhedrovirus replication in B. mori. Insect Mol Biol 2020; 29:205-213. [PMID: 31621968 DOI: 10.1111/imb.12625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/02/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
Heat shock protein 90 (Hsp90) plays a very important role in facilitating the replication of many viruses. Until now, little has been known about the role of Hsp90 in Bombyx mori virus infection. In this study, we explored the role of BmHsp90 in B. mori nucleopolyhedrovirus (BmNPV) replication. We found that BmHsp90 inhibition by geldanamycin (GA) significantly reduced the BmNPV titre, the protein expression level of BmNPV nucleocapsid protein 39 (VP39) and the transcript level of BmNPV genes. Silencing the hsp90 gene in BmN cells by small interfering RNA suppressed BmNPV replication whereas overexpression of hsp90 promoted the replication of BmNPV. After inhibition of Hsp90, the expression of three key genes [signal transducing activator of transcription (stat), suppressor of cytokine signalling protein 2 (socs2), socs6] involved in the Janus kinase/STAT pathway significantly changed, with up-regulation of stat and down-regulation of socs2 and socs6. In addition, the expression of two antiapoptosis genes, BmNPV inhibitor of apoptosis protein1 (BmNPV-iap1) and Bmiap2, was greatly decreased in GA-treated cells, whereas their expression was significantly increased in hsp90-overexpressed silkworm larvae. Our results indicated that inhibition of Hsp90 can suppress BmNPV proliferation in B. mori. Our findings may provide new clues to elucidate the molecular mechanisms of silkworm-virus interactions.
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Affiliation(s)
- Q Shang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
| | - P Wu
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
- The Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Research Institute, Chinese Academy of Agricultural Sciences, Zhenjiang, China
- Quality inspection center for sericultural products, Ministry of Agriculture and Rural Affairs, Zhenjiang, China
| | - H L Huang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
| | - S L Zhang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
| | - X D Tang
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
- The Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Research Institute, Chinese Academy of Agricultural Sciences, Zhenjiang, China
| | - X J Guo
- Sericultural Research Institute, Jiangsu University of Science and Technology, Zhenjiang, China
- The Key Laboratory of Silkworm and Mulberry Genetic Improvement, Ministry of Agriculture and Rural Affairs, Sericultural Research Institute, Chinese Academy of Agricultural Sciences, Zhenjiang, China
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Ge FF, Yang XQ, Chen YX, Huang HL, Shen XC, Li Y, Hu JM. Application of Eye Tracker in Lie Detection. Fa Yi Xue Za Zhi 2020; 36:229-232. [PMID: 32530172 DOI: 10.12116/j.issn.1004-5619.2020.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Indexed: 06/11/2023]
Abstract
Objective To investigate the application value of eye tracking in lie detection. Methods The 40 subjects were randomly divided into two groups. The pupil diameter, fixation duration, points of fixation and blink frequency of the subjects in the experimental group in observing target stimulation and non-target stimulation were recorded with eye tracker after they accomplished the mock crime. The eye movement parameters of subjects in the control group were directly collected. The differences in eye movement parameters of the experimental group and the control group in observing target stimulation and non-target stimulation were analyzed by t-test. Pearson coefficient analysis of correlation between eye movement parameters that had differences was conducted. The effectiveness of eye movement parameters to distinguish between the experimental group and the control group was calculated by the receiver operator characteristic (ROC) curve. Results Participants from the experimental group had shorter average pupil diameter, longer average fixation duration and fewer fixation points (P<0.05), but the differences in blink frequency had no statistical significance. The differences in the above indicators of the control group in observing target stimulation and non-target stimulation had no statistical significance. The average fixation duration showed a negative correlation with fixation points (r=-0.255, P<0.05); the average fixation duration showed a negative correlation with average pupil diameter (r=-0.218, P<0.05); the fixation points showed a positive correlation with average pupil diameter (r=0.09, P<0.05). The area under the curve of average pupil diameter, average fixation duration and fixation points was 0.603, 0.621 and 0.580, respectively. Conclusion The average pupil diameter, average fixation duration and fixation points obtained by the eye tracker under laboratory conditions can be used to detect lies.
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Affiliation(s)
- F F Ge
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
- West China School of Medicine, Sichuan University, Chengdu 610000, China
| | - X Q Yang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Y X Chen
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - H L Huang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - X C Shen
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - Y Li
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
| | - J M Hu
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610000, China
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25
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Huang HL, Ke YJ, Yang L, Yan Q, He BC, Zhou K, Chen ZR, Guo HM, Lu C, Liu J, Huang JS. [The mid-term outcomes of minimally invasive plasty for severe tricuspid regurgitation after cardiac surgery]. Zhonghua Wai Ke Za Zhi 2019; 57:902-907. [PMID: 31826593 DOI: 10.3760/cma.j.issn.0529-5815.2019.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: To evaluate the efficacy of minimally invasive surgery in patients with late severe tricuspid regurgitation after cardiac surgery, and to evaluate the role of leaflets augmentation technique in tricuspid valvuloplasty. Methods: From January 2015 to June 2019, 85 patients undergoing tricuspid valve repair procedure with minimally invasive approach at Department of Cardiovascular Surgery, Guangdong provincial People's Hospital were enrolled. There were 22 males and 63 females, aging of (53.6±12.4) years (range: 15 to 75 years). The interval between the prior and current operations was (16.0±7.3) years (range: 0.2 to 35.0 years). The diameter of right atrium and right ventricle was (77.3±17.2) mm and (61.0±8.4) mm, respectively. Tricuspid regurgitation was severe or extremely severe, the tricuspid regurgitation area was (19.0±10.3) cm(2). All patients underwent minimally invasive tricuspid valvuloplasty or tricuspid valve replacement on beating-heart with totally endoscopic technique and port-access approach through right chest wall. The operations included tricuspid valve replacement and tricuspid valvuloplasty, the technique of tricuspid valvuloplasty including leaflets augmentation with patch, ring implantation, chordae tendineaes reconstruction, release of papillary muscle, edge to edge method, etc. Postoperative hospitalization days, the time of ICU stay, blood transfusion rate, ventilator time and the results of echocardiography were recorded. Follow-up was completed regularly by WeChat, telephone and outpatient visit. Results: Sixty-five patients underwent tricuspid valve repair, and 20 patients underwent tricuspid valve replacement because of prosthetic failure and plasty failure. Five patients died during hospitalization, with mortality rate 5.9%. One patient was transferred to local hospital for anti-infection treatment, the other 79 patients were discharged from hospital in well condition and followed-up. The postoperative hospitalization time was 7.0 (5.5) days (M(Q(R))) days, the mean ventilator time was 18.0 (16.2) hours, and the mean ICU stay time was 68.0 (75.5) hours. There were 35 patients without blood conduction transfusion, the transfusion rate was only 58.9% (50/85). Four cases of severe, 9 cases of moderate and 67 cases of mild to zero tricuspid regurgitation were examined before being discharged, with tricuspid regurgitation area of (2.8±3.5) cm(2) (range: 0 to 19.1 cm(2)). The follow-up time was 1 to 38 months. Two patients died during follow-up, one patient died from infective endocarditis and mitral perivalvular leakage, the other one died of intractable right heart failure. One patient was implanted with permanent pacemaker due to Ⅲ atrioventricular block. Valvular re-replacement was performed in 2 patients who were re-admitted for the artificial valve infection and mechanical valve obstruction. No re-operation of tricuspid valve. Conclusions: Totally endoscopic minimally invasive technique provided satisfactory surgical outcomes for critically sick patients with severe tricuspid regurgitation following cardiac surgery. The application of leaflets augmentation technique achieved ideal repair effect for previously unrepairable lesions.
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Affiliation(s)
- H L Huang
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510100, China
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Liang JH, Luo HL, Long F, Li L, Huang HL, Huang M, Zhang X, Mao WD. [Expression and significance of Survivin and Bcl-2 in nasal aquamous cell carcinoma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 30:529-531. [PMID: 29871061 DOI: 10.13201/j.issn.1001-1781.2016.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the expression and it's clinical significance of Survivin and Bcl-2 in nasal squamous cell carcinoma (SNSCC). Method:The immunohistochemical Envision two step method was used to measure the expression of Survivin and Bcl-2 in 35 cases of SNSCC, 20 cases of normal inferior concha tissues. Result:The expression of Survivin in SNSCC was 88.6%, significantly higher than the normal inferior turbinate mucosal tissue expression of 0% (P<0.01). The expression of Bcl-2 in SNSCC was 71.4%, significantly higher than the normal inferior turbinate mucosal tissue expression of 25% (P<0.01). Expression of Bcl-2 was significantly higher in SNSCC than in normal tissue. The expression of Survivin was positively correlated with Bcl-2 expression (P<0.01). The higher the grade of tumor, the lower expressions of Survivin and Bcl-2. Conclusion:Survivin and Bcl-2 may play an promoting role in the development and progression process of SNSCC. Survivin may become a target spot of SNSCC gene therapy.
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Affiliation(s)
- J H Liang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - H L Luo
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - F Long
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - L Li
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - H L Huang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - M Huang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - X Zhang
- Department of Otolaryngology Head and Neck Surgery,Hanzhong Central Hospital,Hanzhong,723000,China
| | - W D Mao
- Department of Pathology,Hanzhong Central Hospital
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Abstract
Background/aims Limited research has been conducted on agitated behavior in Taiwan and dementia among community-dwelling elderly. Therefore, this study focused on community elderly with dementia and a factor analysis of an inventory of their agitated behaviors was conducted. Patients and methods Participants (N=221) completed the Chinese Cohen-Mansfield Agitation Inventory, community form. Item analysis and exploratory factor analysis assessed reliability, validity, and the underlying factor structure. Results Five factors were extracted and accounted for 44.53% of the total variance. This study classified agitated behaviors into 5 main subtypes: physically agitated behaviors, destructive behaviors, verbally agitated behaviors, handling things behavior, and aggressive behaviors. Conclusion The results indicate that differences in the agitated behavior of elderly with dementia exist with respect to cultural background and setting. This novel research and its findings serve as a reference for assessing the agitated behaviors of elderly with dementia living in their homes. Applications may exist for other countries with Chinese/Taiwanese populations.
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Affiliation(s)
- Huei-Ling Huang
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan, .,Nursing Department, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan, .,School of Nursing, College of Medicine & Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, .,Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, .,Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan,
| | - Wen-Chuin Hsu
- Chang Gung Dementia Center, Department of Neurology, Chang Gung University and Memorial Hospital, Taoyuan, Taiwan
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Wang N, Zhou H, Huang HL. Comparison of automatic and manual reposition treatment for horizontal semicircular canal benign paroxysmal positional vertigo. J BIOL REG HOMEOS AG 2018; 32:719-723. [PMID: 29921405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The purpose of this investigation was to compare the efficacy of automatic to manual reposition treatment for patients with horizontal semicircular canal paroxysmal positional vertigo (BPPV). Sixty patients diagnosed with BPPV were equally and randomly divided into either a manual reposition treatment group or an automatic reposition treatment group. The groups were compared regarding difference in pain [visual analog scale (VAS)], extent of vertigo disorder [dizziness handicap inventory (DHI)], quality of life (SF-36), and therapeutic effect. Improved VAS, DHI and SF-36 were observed in both groups, however the efficacious rate of the automatic reposition group (96.7%) was 13.4% higher than that of the manual reposition group, reaching a statistical significance (p less than 0.05). In conclusion, in the treatment of BPPV patients, automatic reposition is more effective than manual reposition and can improve the patients quality of life.
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Affiliation(s)
- N Wang
- Department of Neurology, Xuzhou First Peoples Hospital, Xuzhou, Jiangsu, PR China
| | - H Zhou
- Department of Neurology, Xuzhou First Peoples Hospital, Xuzhou, Jiangsu, PR China
| | - H L Huang
- Department of Neurology, Xuzhou First Peoples Hospital, Xuzhou, Jiangsu, PR China
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Kuo LM, Huang HL, Liang J, Kwok YT, Hsu WC, Liu CY, Shyu YIL. Trajectories of health-related quality of life among family caregivers of individuals with dementia: A home-based caregiver-training program matters. Geriatr Nurs 2017; 38:124-132. [DOI: 10.1016/j.gerinurse.2016.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/21/2016] [Accepted: 08/29/2016] [Indexed: 01/07/2023]
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Dong L, Shi YK, Xu JP, Zhang EY, Liu JC, Li YX, Ni YM, Yang Q, Han T, Fu B, Chen J, Ren L, Wei SL, Chen H, Liu KX, Yu FX, Liu JS, Xiao MD, Wu SM, Zhang KL, Huang HL, Jiang SL, Qiao CH, Wang CS, Xu ZY, Zhou XM, Wang DJ, Ni LX, Xiao YB, Jiang SL, Zhang GM, Liang GY, Yang SY, Bo P, Zhong QJ, Zhang JB, Zhang X, Zhu YB, Teng X, Zhu P, Huang F, Xiao YM, Cao GQ, Tian H, Xia LM, Lu FL, Liu YQ, Liu DX, Xu H, Yuan Y, Li M, Chang C, Wu XC, Xu Z, Guo P, Bai YJ, Xue WB, Jiang XY, Na ZH, Zeng QY, Cai H, Wang YL, Xiong R, Jin S, Zheng XM, Wu D. [The multicenter study on the registration and follow-up of low anticoagulation therapy for the heart valve operation in China]. Zhonghua Yi Xue Za Zhi 2017; 96:1489-94. [PMID: 27266493 DOI: 10.3760/cma.j.issn.0376-2491.2016.19.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the optimal anticoagulation methods and monitoring strategy for Chinese patients undergoing heart valve replacement, which is potentially quite different from western populations. METHODS In this multicenter prospective cohort study, the anticoagulation and monitoring strategy data was acquired from 25 773 in-hospital patients in 35 medical centers and 20 519 patients in outpatient clinic in 11 medical centers from January 1st, 2011 to December 31th, 2015. RESULTS As for in-hospital patients, mean age of study population was (48.6±11.2) years old; main etiology of valve pathology was rheumatic (87.5%) origin among study cohort; 94.8% of study population received mechanical valve implantation; international normalized ratio (INR) monitoring (in all the study centers) and low-intensity anticoagulation strategy (31 hospitals chose target INR range of 1.5-2.5, and actual values of INR among 89.2% of 100 069 in-hospital monitoring samples were 1.5-2.5), with mean actual INR values of 1.84±0.53, and warfarin dosage of (2.82±0.93) mg/d were widely adopted among the study centers; strategies of in-hospital warfarin administration were similar in all the study centers; complication rates of low-intensity anticoagulation strategy were low in severe hemorrhage (0.02%), thrombosis (0.05%), and thromboembolism (0.05%) events, without anticoagulation-related death.As for 18 974 outpatient clinic patients, the follow-up rate was 92.47%, with a total of 30 012 patient-years (Pty). Anticoagulation-related morbidity and mortality rates were 0.67% and 0.15% Pty; major hemorrhage morbidity and mortality rates were 0.25% and 0.13% Pty; thromboembolism morbidity and mortality rates were 0.45% and 0.03% Pty.The mean dosage of warfarin daily dosage was (2.85±1.23) mg/d and INR value was 1.82±0.57.No significant regional difference in the intensity of anticoagulation therapy was noted during the study. CONCLUSIONS INR can be used as a normalized indicator for intensity of anticoagulation therapy in China.The optimal anticoagulation intensity with INR range from 1.5 to 2.5 is safe and effective for Chinese patients with heart valve replacement, and there is no significant regional difference in the intensity of anticoagulation therapy.
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Affiliation(s)
- L Dong
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Chen HF, Yao ZH, Yan XH, Zhao L, Wang S, Lin J, Huang HL. [Comparison and application of two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2017; 35:130-133. [PMID: 28355703 DOI: 10.3760/cma.j.issn.1001-9391.2017.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To apply and compare two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise. Methods: In April 2013, an occupational health survey was carried out in a lead-acid battery enterprise. Lead smoke and lead dust were tested in the workplace. The risk assessment index system for occupational chemical hazards that was established and optimized by the research group (referred to as "optimized index system" ) , as well as the Singapore semi-quantitative risk assessment model, was used for occupational lead exposure risk classification in the lead-acid battery enterprise. The two risk classification results were analyzed and compared. Results: In the lead smoke risk classification results, the optimized index system classified the raw material group and foundry group workshops as Class I hazardous and the assembling group workshop as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as high risk and foundry group and assembling group workshops as extremely high risk. In the lead dust risk classification results, the optimized index system classified the raw material group workshop as Class I hazardous, while the plate painting group, plate cutting group, and assembling group workshops were classified as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as medium risk, the plate painting group and plate cutting group workshops as high risk, and the assembling group workshop as extremely high risk. Conclusion: There are some differences in risk assessment of occupational lead exposure between the two risk assessment methods. The optimized index system is comparably more reasonable and feasible, and is highly operable.
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Affiliation(s)
- H F Chen
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong Provincial Key Laboratory of Occupational Diseases Prevention and Treatment, Guangzhou 510300, China
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Kuo LM, Huang HL, Liang J, Kwok YT, Hsu WC, Su PL, Shyu YIL. A randomized controlled trial of a home-based training programme to decrease depression in family caregivers of persons with dementia. J Adv Nurs 2016; 73:585-598. [PMID: 27653753 DOI: 10.1111/jan.13157] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2016] [Indexed: 12/22/2022]
Abstract
AIMS The aim of this study was to explore distinct trajectories of caregivers' depressive symptoms and the effects of a training programme on these trajectories over 18 months after the programme. BACKGROUND Overall effects of caregiver-training programmes on family caregivers' depressive symptoms have been reported, but few studies explored distinct courses of changes in caregivers' depressive symptoms and followed up intervention effects on these distinct courses. DESIGN Randomized clinical trial. METHODS Family caregivers (n = 116) were randomly assigned into experimental (n = 57) and control (n = 59) groups. The experimental group received the training programme with telephone consultation and the control group received written educational materials and social telephone follow-ups. Caregivers' depressive symptoms were assessed from June 2009 - March 2012 by self-completed questionnaires before, at 2 weeks and 3, 6, 12 and 18 months after the intervention. Groups of individual trajectories were distinguished using group-based trajectory modelling. RESULTS Caregivers' depressive symptoms fell into three stable trajectories: non-depressed, mildly blue and depressed. After controlling for covariates, caregivers who received the caregiver-training programme were less likely than those who did not experience persistent depressive symptoms (b = -1·92, odds ratio = 0·15, P < 0·05). CONCLUSION Depressive symptoms of family caregivers of persons with dementia were relatively stable and followed three distinct courses: non-depressed, mildly blue and depressed. Therefore, caregivers' depressive symptoms should be assessed as early as possible. Caregivers in the experimental group had a lower probability of persistent depressive symptoms than caregivers in the control group. Therefore, this training programme can be used by healthcare providers for persons with dementia and their caregivers. TRIAL REGISTRATION NUMBER NCT02667951.
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Affiliation(s)
- Li-Min Kuo
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Huei-Ling Huang
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Jersey Liang
- School of Public Health and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yam-Ting Kwok
- Division of Neurology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Wen-Chuin Hsu
- Dementia Center, Department of Neurology, Chang Gung University and Memorial Hospital, Taoyuan, Taiwan
| | - Pei-Ling Su
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Traumatological Division, Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Kuo LM, Huang HL, Hsu WC, Wang YT, Shyu YIL. Home-based caregiver training: Benefits differ by care receivers' dementia diagnosis. Geriatr Nurs 2016; 37:376-384. [DOI: 10.1016/j.gerinurse.2016.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/09/2016] [Accepted: 05/16/2016] [Indexed: 11/28/2022]
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Liu J, Guo HM, Gao Q, Chen B, Xie B, Huang HL, Liu J, Lu C, Chen JM, Zhuang J. [Clinical experience of 60 patients underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty]. Zhonghua Wai Ke Za Zhi 2016; 54:605-8. [PMID: 27502135 DOI: 10.3760/cma.j.issn.0529-5815.2016.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To summarize the clinical experience of 60 patients underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty. METHODS Sixty patients were enrolled retrospectively from March 2014 to January 2016 in Department of Cardiacvascular Surgery, Guangdong Cardiovascular Institute. They underwent three-dimensional video assisted thoracoscopic mitral valvuloplasty. There were 37 male and 23 female patients. The range of age was 15 to 78 years (the median age was 47 years). The techniques of mitral valvuloplasty included chordae tendineae transplantation (53 patients), annuloplasty (58 patients), posterior leaflet resection (13 patients), anterior leaflet resection (2 patients), commissure resection (1 patient). Their information from charts were collected. The follow-up time was lasting 3 to 25 months by telephone or outpatient department interview. The data was analyzed via paired t test or Wilcoxon signed-rank test. RESULTS Conversions to mitral valve replacement were performed for two patients. No patients underwent thoracotomy. The operation time was (213±37) minutes, cardiopulmonary bypass time was (129±31) minutes, aortic cross clamping time was (81±21) minutes. Postoperative hospital stay was (7±3) days. During follow-up period, there were no re-operation and no death. Mitral regurgitation level and New York Heart Association class were both improved (Z=-6.286, P=0.000, Z=-6.237, P=0.000), respectively. Besides, there was also no new atrial fibrillation patients. CONCLUSIONS Not only does three-dimensional video assisted thoracoscopic mitral valvuloplasty maintain the advantages of 2-Dimensional thoracoscopy, but also have the similar view of median thoracotomy. This technique showed promising clinical value in the future.
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Affiliation(s)
- J Liu
- Department of Cardiacvascular Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Lin N, Lin Y, Huang HL, Lin XL, He DQ, He SQ, Guo DH, Li Y, Xu LP. [Prenatal diagnosis of Thailand deletion of α-thalassemia 1 families]. Zhonghua Yi Xue Za Zhi 2016; 96:1919-22. [PMID: 27373361 DOI: 10.3760/cma.j.issn.0376-2491.2016.24.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To conduct analysis and prenatal diagnosis on 11 couples carrying Thailand deletion (--(THΑI)) α-thalassemia 1, so as to provide information for clinical genetic counseling on α-thalassemia 1. METHODS Altogether 11 Thailand deletion (--(THΑI)) α-thalassemia 1 families were collected from Fujian Maternal and Children Health Hospital from May 2009 to September 2015. Gap-polymerase chain reaction (gap-PCR) and reverse dot blot (RDB) technology were used to detect the thalassemia mutations in the couples and fetuses. RESULTS In one family, Thailand deletion α-thalassemia 1 was detected in both the pregnant woman and her husband. In 10 families, Thailand deletion α-thalassemia 1 was detected in either the pregnant women or the husband, while the spouses had α-thalassemia heterozygote (1 combined with β thalassemia heterozygote). Thailand deletion α-thalassemia 1 family members all had lower mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH). In prenatal diagnosis of the 12 fetuses, 4 fetuses were found with hemoglobin(Hb) Bart's hydrops fetalis syndrome, 5 were with α-thalassemia heterozygote, and 3 were normal. CONCLUSIONS For couples with positive hematological phenotype but normal results in routine genetic examination of α-thalassemia, attention should be paid especially for with a history of having babies of hydrops fetalis syndrome or hemoglobin H disease. It is necessary to consider the possibility of the rare Thailand deletion (--(THΑI)) α-thalassemia 1. Prenatal diagnosis for high-risk families plays an important role.
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Affiliation(s)
- N Lin
- Center of Prenatal Diagnosis, Fujian Matenal and Children Health Hospital, Fujian Medical University Teaching Hospital, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fuzhou 350001, China
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Kuo LM, Huang HL, Hsu WC, Shyu YIL. Health-related quality of life and self-efficacy of managing behavior problems for family caregivers of vascular dementia and Alzheimer's disease patients. Dement Geriatr Cogn Disord 2015; 38:310-20. [PMID: 25011490 DOI: 10.1159/000360414] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Little is known about the differences in patients' behavioral problems and health outcomes of family caregivers of patients with vascular dementia (VaD) and Alzheimer's disease (AD). METHODS A secondary analysis of baseline data on a subsample of caregiver-dementia patient dyads in a randomized clinical trial. RESULTS Family caregivers of VaD patients reported higher self-efficacy than caregivers of AD patients in handling verbally nonaggressive and verbally aggressive behaviors. Caregivers of VaD patients had poorer health-related quality of life (HRQoL) than caregivers of AD patients considering role disability due to physical health problems, bodily pain, social function, and physical component summary. Greater self-efficacy was associated with better mental health-related outcomes for family caregivers of VaD patients, and better self-care ability of VaD patients was associated with better caregiver mental health-related outcomes. Caring for a patient with more severe dementia predicted poor physical health-related outcomes in role disability due to physical health problems, but better overall mental health (mental component summary) for caregivers. CONCLUSION This study is the first to examine and compare the behavioral problems of AD and VaD patients in a Chinese population, along with their family caregivers' self-efficacy and health outcomes. Family caregivers of patients with VaD might warrant specific attention to their HRQoL, with interventions developed to enhance their self-efficacy.
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Affiliation(s)
- Li-Min Kuo
- School of Nursing, Hsin Sheng College of Medical Care and Management, Longtan, Taiwan, ROC
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Zhu P, Zhao MY, Li XH, Fu Q, Zhou ZF, Huang CF, Zhang XS, Huang HL, Tan Y, Li JX, Li JN, Huang S, Ashraf M, Lu C, Chen JM, Zhuang J, Guo HM. Effect of low temperatures on BAX and BCL2 proteins in rats with spinal cord ischemia reperfusion injury. Genet Mol Res 2015; 14:10490-9. [PMID: 26400280 DOI: 10.4238/2015.september.8.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We evaluated changes in BAX and BCL2 expression levels after spinal cord ischemia/reperfusion injury (SCII) and hypothermia during operations in rats. Eighty rats were divided into four groups: Group A (N = 20, 18°C); Group B (N = 20, 28°C); Group C (N = 20, room temperature); and Group D (N = 20, sham operation control). Spinal cord ischemia was induced for 90 min. Hypothermia was induced 15 min before, and maintained during ischemia, followed by heating to normothermia for 30 min after reperfusion. Motor function of the lower limbs was evaluated according to the Tarlov score at 72 and 168 h. For each rat, spinal cord samples were taken at 6, 24, 72 h, and 1 week to evaluate the histopathological changes, neuronal apoptosis, and BAX and BCL2 expression levels. Compared with normothermia, hypothermia significantly improved hind limb function; Group B achieved a higher score than Group A. Group D showed no neurologic deficiency, while the other groups showed various degrees. Group C exhibited greater neuronal apoptosis, higher BAX expression, but lower BCL2 expression than the other groups. Compared with Group A, BAX was expressed less and BCL2 more in Group B, and there was less apoptosis in Group B. Hypothermia preserves hind limb motor function and reduces neuronal death, thereby protecting rats from SCII. The spinal cord may be protected from SCII by inhibition of BAX and activation of BCL2. However, deep hypothermia may inhibit the expression of BCL2, resulting in a worse outcome than mild hypothermia.
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Affiliation(s)
- P Zhu
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - M Y Zhao
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - X H Li
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Q Fu
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Z F Zhou
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - C F Huang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - X S Zhang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - H L Huang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Y Tan
- Department of Pharmacology, UIC College of Medicine, Chicago, IL, USA
| | - J X Li
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J N Li
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - S Huang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - M Ashraf
- Department of Pharmacology, UIC College of Medicine, Chicago, IL, USA
| | - C Lu
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J M Chen
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J Zhuang
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - H M Guo
- Department of Cardiovascular Surgery, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
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Huang HL, Lu PH, Yang HC, Lee GD, Li HR, Liao KC. Fiber-optic triggered release of liposome in vivo: implication of personalized chemotherapy. Int J Nanomedicine 2015; 10:5171-84. [PMID: 26316748 PMCID: PMC4542555 DOI: 10.2147/ijn.s85915] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of this research is to provide proof of principle by applying the fiber-optic triggered release of photo-thermally responsive liposomes embedded with gold nanoparticles (AuNPs) using a 200 μm fiber with 65 mW and 532 nm excitation for topical release in vivo. The tunable delivery function can be paired with an apoptosis biosensor based on the same fiber-optic configuration for providing real-time evaluation of chemotherapy efficacy in vivo to perform as a personalized chemotherapy system. The pattern of topical release triggered by laser excitation conveyed through optical fibers was monitored by the increase in fluorescence resulting from the dilution of self-quenching (75 mM) fluorescein encapsulated in liposomes. In in vitro studies (in 37°C phosphate buffer saline), the AuNP-embedded liposomes showed a more efficient triggered release (74.53%±1.63% in 40 minutes) than traditional temperature-responsive liposomes without AuNPs (14.53%±3.17%) or AuNP-liposomes without excitation (21.92%±2.08%) by spectroscopic measurements. Using the mouse xenograft studies, we first demonstrated that the encapsulation of fluorescein in liposomes resulted in a more substantial content retention (81%) in the tumor than for free fluorophores (14%) at 120 minutes after administration from in vivo fluorescence imaging. Furthermore, the preliminary results also suggested the tunable release capability of the system by demonstrating consecutive triggered releases with fiber-optic guided laser excitation.
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Affiliation(s)
- Huei-Ling Huang
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan
| | - Pei-Hsuan Lu
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan
| | - Hung-Chih Yang
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan
| | - Gi-Da Lee
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan ; Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Han-Ru Li
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan
| | - Kuo-Chih Liao
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan
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Abstract
PURPOSE The purpose of this study was to explore family caregivers' role-implementation experiences at different stages of dementia. PATIENTS AND METHODS For this cross-sectional, exploratory study, 176 dyads of family caregivers and their community-dwelling elderly relatives with dementia were recruited from the neurological clinics of a medical center in Taiwan. The Family Caregiving Inventory was used to assess family caregivers for caregiving activities, role strain, role preparation, and help from others at different stages of care receivers' dementia. RESULTS Family caregivers' caregiving activities were related to patients' stages of dementia. For patients with mild dementia, caregivers provided more assistance in transportation and housekeeping. In addition to these two activities, family caregivers of patients with moderate dementia provided more assistance with mobility and protection. For patients with severe dementia, family caregivers provided more assistance with personal care, mobility and protection, transportation, and housekeeping. Overall, family caregivers reported having some preparation to provide care; the most difficult caregiving activity was identified as managing behavioral problems. CONCLUSION This study's results provide a knowledge base for designing dementia stage-specific interventions in clinical practice and developing community-based, long-term care systems for families of patients with dementia.
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Affiliation(s)
- Huei-Ling Huang
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan ; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Min-Chi Chen
- Department of Public Health and Biostatistics Consulting Center, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Chang Huang
- Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hung-Chou Kuo
- Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sien-Tsong Chen
- Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan ; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chuin Hsu
- School of Medicine, Chang Gung University, Taoyuan, Taiwan ; Chang Gung Dementia Center, Taoyuan, Taiwan
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Cui JJ, Tian Y, Liu Y, Huang HL, Jin Y. Proacrosin activation mechanisms in capacitated and frozen-thawed boar spermatozoa. Genet Mol Res 2014; 13:9915-20. [PMID: 25501202 DOI: 10.4238/2014.november.27.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The main objective of the current study was to explore the different activation mechanisms of capacitation and freeze-thawed spermatozoa. Using SDS-PAGE and Western blotting, the conversion process of boar proacrosin during freeze-thawing and capacitation of spermatozoa was analyzed. The results revealed that capacitated spermatozoa exhibited a greater fluorescence area than that of the freeze-thawed spermatozoa, which were smaller than those of the fresh group. Fresh spermatozoa displayed 45- and 35- kDa protein bands, while those of freeze-thawed andcapacitated spermatozoa displayed 45-, 35- and 28-kDa bands. In summary, these data indicate that proacrosin is activated, thus becoming α- and β-acrosins and a 28-kDa protein during capacitation and freeze-thawing.
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Affiliation(s)
- J J Cui
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - Y Tian
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - Y Liu
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - H L Huang
- Agricultural College of Yanbian University, Yanji, Jinlin, China
| | - Y Jin
- Agricultural College of Yanbian University, Yanji, Jinlin, China
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Liu HY, Wang YN, Huang HL, Hsu WC, Lin YE, Huang TH, Shyu YIL. Psychometric Properties of the Finding a Balance Scale for Family Caregivers of Elders with Dementia in Taiwan. Res Nurs Health 2014; 37:336-46. [DOI: 10.1002/nur.21603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Hsin-Yun Liu
- Postdoctoral Fellow, Healthy Aging Research Center; Chang Gung University; Taoyuan Taiwan
| | - Yu-Nu Wang
- Instructor, Department of Nursing; Chang Gung University of Science and Technology; Taoyuan Taiwan
| | - Huei-Ling Huang
- Associate Professor, Department of Gerontological Care and Management; Chang Gung University of Science and Technology; Taoyuan Taiwan
| | - Wen-Chuin Hsu
- Assistant Professor and Visiting Staff, Department of Neurology; Chang Gung University and Memorial Hospital; Taoyuan Taiwan
| | - Yueh-E Lin
- Supervisor, Department of Nursing; Linkou Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Tza-Hsin Huang
- Director, Department of Nursing; Taoyuan Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Yea-Ing L. Shyu
- Professor, School of Nursing; and Healthy Aging Research Center; Chang Gung University; 259 Wen-Hwa 1st Road, Kwei-Shan Taoyuan 33302 Taiwan
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Abstract
To explore the relationship between Myf5 gene polymorphisms and production performance traits in Songliao white geese, we used the chicken Myf5 sequence to design primers and amplified part of the exon 1 sequence of the Songliao white goose Myf5 gene. Results of single-strand conformation polymorphism polymerase chain reaction analysis revealed polymorphisms of the amplified fragment, including three genotypes (AA, AB, and BB). Three varieties were dominated by allele A and were mainly expressed in AA genotypes. We also identified that the Myf5 gene has one single nucleotide change (A→G) on exon 1 at locus 1344, and another (G→C) at locus 1410. Analysis of variance showed significant differences between genotypes before slaughter in live weight, carcass weight, eviscerated weight, leg muscle weight, weight of the wings, and slaughter rate. There were no significant differences with respect to other growth and carcass traits evaluated.
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Affiliation(s)
- J B Wu
- Agricultural College of Yanbian University, Yanji, China
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Huang HL, Kuo LM, Chen YS, Liang J, Huang HL, Chiu YC, Chen ST, Sun Y, Hsu WC, Shyu YIL. A home-based training program improves caregivers' skills and dementia patients' aggressive behaviors: a randomized controlled trial. Am J Geriatr Psychiatry 2013; 21:1060-70. [PMID: 23933422 DOI: 10.1016/j.jagp.2012.09.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 08/28/2012] [Accepted: 09/26/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the effects of an individualized, home-based caregiver-training program for caregivers of elderly patients with dementia and behavioral problems. METHODS Using a randomized clinical trial in the neurologic clinics of two hospitals and a community care management center in northern Taiwan, we tested an individualized home-based caregiver-training program for managing behavioral problems, with referrals to community services and telephone consultation. Participants were patients with dementia and their caregivers (N = 129): 63 in the intervention group and 66 in the control group. The control group received only written instructions and social telephone follow-ups. Behavioral problems of elderly dementia patients were assessed by the Chinese version of the Cohen-Mansfield Agitation Inventory, community form. Family caregivers' outcomes were measured by the Agitation Management Self-efficacy Scale and the Preparedness and Competence Scales. These instruments were administered before the program and 2 weeks, 3 months, and 6 months afterward. RESULTS Family caregivers who received the individualized home-based training program had better preparedness (t = 2.72, df = 127, p <0.01), competence (t = 4.77, df = 126, p <0.001), and overall self-efficacy (t = 3.81, df = 127, p <0.001) at 3 months than those in the control group. Moreover, the growth rate by treatment interaction effect was significant for caregiver competence (t = 2.25, df = 127, p <0.05) and overall self-efficacy for managing behavioral problems (t = 2.16, df = 127, p <0.05). The probability of physically aggressive behavior for patients in the intervention group decreased from 0.27 to 0.12. CONCLUSION Our individualized home-based caregiver-training program improved caregivers' preparedness, competence, and self-efficacy for managing problematic behaviors and decreased physical aggressiveness of elderly patients with dementia.
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Affiliation(s)
- Huei-Ling Huang
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Kuo LM, Huang HL, Huang HL, Liang J, Chiu YC, Chen ST, Kwok YT, Hsu WC, Shyu YIL. A home-based training program improves Taiwanese family caregivers' quality of life and decreases their risk for depression: a randomized controlled trial. Int J Geriatr Psychiatry 2013; 28:504-13. [PMID: 22778053 DOI: 10.1002/gps.3853] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 06/08/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Little is known about the longitudinal effects of training programs on family caregivers' health-related quality of life (HRQoL) and depressive symptoms over time. Therefore, the purpose of this study was to examine the effects of a home-based caregiver training program on HRQoL and depressive symptoms for family caregivers of older persons with dementia. METHODS Outcomes (caregivers' HRQoL and depressive symptoms) were assessed before the training program (baseline), and at 2 weeks, 3 months, and 6 months afterwards. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Survey, Taiwan version. Depressive symptoms were measured using the Chinese version Center for Epidemiologic Studies Depression Scale. RESULTS Family caregivers who received the individualized home-based training program had better health outcomes in bodily pain (b = 12.37, p < 0.013), role disability due to emotional problems (b = 17.74, p < 0.013), vitality (b = 12.40, p < 0.001), better mental summary score (b = 5.14, p < 0.003), and decreased risk for depression (odds ratio = 0.15, confidence interval = 0.04-0.65, p < 0.013) than those in the control group during the 6 months following the training program. CONCLUSION Our home-based caregiver training program improved caregivers' HRQoL, especially role limitations due to emotional problems, and decreased their risk for depression.
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Affiliation(s)
- Li-Min Kuo
- School of Nursing, Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan
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Chang TC, Shyu YIL, Chen MC, Chiu YC, Huang HL. [Predictors of competence in family caregivers of dementia patients]. Hu Li Za Zhi 2012; 59:25-35. [PMID: 23212252 DOI: 10.6224/jn.59.6.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Differences in dementia symptoms at different dementia stages increase the burden of caregiving. The inability of family caregivers to meet patient needs not only influences the health of the patient, but also impacts negatively on their personal physical and mental health. PURPOSE This study explores predictors of competence in family caregivers of dementia patients. METHODS We designed a cross-sectional study to examine 123 participant groups. Each group included one individual diagnosed with dementia and one family caregiver. RESULTS Predictors of caregiver competence included few / no caregiver chronic diseases, relatively high level of caregiver education, and lack of comorbidities in the care recipient. These predictors explained 26.7% of total variance. CONCLUSION We recommend that nurses evaluate caregivers' care competency in order to provide appropriate health information and assistance. Guidance provided should take into consideration the caregivers' educational background. Apart from providing information related to dementia behavior, nurses should also provide caregiver guidance information related to the effects of comorbidities on dementia, as appropriate.
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Affiliation(s)
- Tzu-Chung Chang
- Department of Gerontological Care and Management, Chan Gung University of Science and Technology, Taiwan, ROC
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Abstract
BACKGROUND Returning to work has been recognized as an indicator of functional recovery. Few studies have aimed to explore whether one's type of work changes after transplantation. PURPOSE This study aims to describe the change in types of work in liver transplant patients. METHODS A retrospective and descriptive study was conducted at a medical center in northern Taiwan. The data were collected by a self-report questionnaire between July and September 2010. Descriptive statistics an correlational analysis were used to analyze the data. RESULTS A convenience sample of 111 adult liver transplant patients was included in this study. Of the sample, 20 patients remained unemployed, 44 had a change in status by becoming unemployed (n=42) or employed (n=2), and 47 patients remained employed after transplantation. At the time of data collection, 49 (44.1%) liver transplant patients were gainfully employed, a rate that was lower than that of the pretransplantation stage (n=89, 80.2%). The number of workers engaged in manual labor decreased from 40 to 18 between pre- and posttransplantation. Of the 47 still-employed patients, 6 (12.8%) changed their occupation after transplantation. CONCLUSION The rate of gainful employment after liver transplantation was low, and those patients who had done manual labor pretransplantation were no longer able to do this type of work and were unemployed. The still-employed patients who worked in management or were professionals did not change their type of work after transplantation; however, service and labor workers did change their type of work.
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Affiliation(s)
- L-C Weng
- School of Nursing, Chang Gung University, and Liver Research Center, Department of General Surgery, Chang Gung Medical Foundation-Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Abstract
Beta-blockers are recommended as first-line symptomatic treatment for stable angina. However, their impact on mortality outside the context of myocardial infarction is unknown. We performed a meta-analysis of all randomized trials of beta-blockers in stable angina. Medical databases and cardiology journals were searched for relevant randomized clinical trials. The primary outcome was cardiovascular mortality, separately considering trials of beta-blockers versus placebo and beta-blockers versus other antianginals. We conducted a subgroup analysis on cardioselective versus non-cardioselective beta-blockers and calcium channel antagonists versus nitrates. We calculated odds ratios (ORs) and confidence intervals (CIs) using Peto's method. We found no statistically significant evidence that beta-blockers impact on mortality when compared with placebo (OR, 0.42; CI, 0.15–1.21) or other antianginals (OR, 0.98; CI, 0.86–1.10), or all others (OR, 0.97; CI, 0.86–1.09). There was a trend for cardioselective beta-blockers to have a greater improvement in mortality when compared with placebo and to have greater impact than non-calcium channel antagonists. Beta-blockers do not have statistically significant impact on mortality versus placebo or versus other active comparators. The findings exclude a benefit of 15% or greater and a hazard of 10% or greater. The impact of cardioselectivity requires further study.
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Affiliation(s)
- H L Huang
- University of Edinburgh, Edinburgh, Scotland, UK
| | - K A A Fox
- President of British Cardiovascular Society, Professor of Cardiology, Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland, UK
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Li D, Tang GP, Li JZ, Kong Y, Huang HL, Min LJ, Zhou J, Shen FP, Wang QQ, Yu H. Dual-targeting non-viral vector based on polyethylenimine improves gene transfer efficiency. Journal of Biomaterials Science, Polymer Edition 2012; 18:545-60. [PMID: 17550658 DOI: 10.1163/156856207780852532] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Polyethylenimine (PEI) is the polymer most commonly used for transferring plasmids into eukaryotes, but its gene-transfer efficiency is lower compared to viral vectors. Receptors targeting PEI combined with ligands can enhance efficiency of gene transfer into the corresponding receptor-positive cells. Using the double-receptor-mediated pathway of viral infection, in this study we synthesized a novel non-viral vector based on PEI combined with two peptides recognizing FGF receptors (peptide YC25) and integrins (peptide CP9) on the cell surface. The dual targeting vector showed a physicochemical character similar to that of PEI, such as pDNA formation, particle size, zeta potential and lower toxicity. In vitro gene transfer showed that the dual-receptor targeted vector (YC25-PEI-CP9) exhibited a markedly higher transgene efficiency in cell lines with positive expression of FGF receptors and integrins, compared with single-peptide-modified PEI or unmodified PEI. In the cells with only integrin-positive expression, YC25-PEI-CP9 mediated a higher transgene expression than PEI but lower than CP9-PEI. The corresponding free peptides could inhibit the transgene efficiency of the peptide-coupled PEI. In vivo gene transfer in tumor-bearing nude mice also demonstrated that the dual-targeting vectors showed a significantly enhanced transfection efficiency in tumors with positive expression of FGF receptors and integrins. The synthesized polymer YC25-PEI-CP9 has the prospect to act as a novel kind of non-viral vector in gene therapy.
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Affiliation(s)
- D Li
- Institute of Immunology, Zhejiang University, 388 Yuhangtang Road, Hangzhou 310058, P. R. China
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Huang HL, Shyu YIL, Huang HL, Chen ST, Li HJ, Shiu MN, Pong MC. Factors associated with dementia care practices among community health nurses: results of a postal survey. Int J Nurs Stud 2012; 50:1219-28. [PMID: 22429473 DOI: 10.1016/j.ijnurstu.2012.02.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 01/09/2012] [Accepted: 02/02/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The incremental prevalence of dementia is making dementia management a worldwide issue. The role of community health nurses must grow along with the increasing aging population and the resulting increase in dementia cases. OBJECTIVES Explore the factors related to dementia care practices among the different types of community health nurses in Taiwan. DESIGN Cross-sectional study. SETTING Primary care centers or institutions in New Taipei City. PARTICIPANTS Community health nurses who work in health care centers (district nurses), long-term care centers (care managers), or home care institutions (home health care nurses). METHODS Self-completion questionnaires sent by mail. RESULTS A total of 195 participants returned the questionnaires (response rate 81.9%). Although 65.8% of participants had experience in case finding, just 34.6% of them reported using validated cognitive testing tools. Only 15% of participants provided case management following dementia case findings. The regression models showed that the different types of community health nurses, number of years working as a nurse, and their level of confidence was significantly related to their dementia care practice. District nurses identified significantly less suspected dementia cases and provided less nursing care to caregivers of dementia patients than care managers and home health care nurses. Among community health nurses, the care managers most often used formal cognitive instruments. District nurses provided the least amount of supportive resources information, had the most negative attitude and the lowest level of confidence toward dementia care than care managers and home health care nurses. CONCLUSIONS This study presented the profiles of dementia care practice in Taiwan. It showed the considerable variation in knowledge, attitude, confidence and dementia care practices among the different community health nurses. The professional roles regarding dementia care in Taiwan remain blurred. Future training must focus on promoting the level of confidence of community health nurses to identify and manage people with dementia and raise awareness about demented person's and their caregiver's need. The priority of the policy on dementia care in the community must be raised to high, and the professional responsibilities and roles of the different types of community health nurses for the ever increasing dementia population in Taiwan must be redefined and optimized.
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Affiliation(s)
- Hsiu-Li Huang
- School of Nursing, Health Aging Research Center, Chang Gung University, Taiwan.
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Chen WH, Li YJ, Wang MS, Kang ZC, Huang HL, Shaw HM. Elevation of tissue α-tocopherol levels by conjugated linoleic acid in C57BL/6J mice is not associated with changes in vitamin E absorption or α-carboxyethyl hydroxychroman production. Nutrition 2011; 28:59-66. [PMID: 21872434 DOI: 10.1016/j.nut.2011.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 03/28/2011] [Accepted: 04/21/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Conjugated linoleic acid (CLA) decreases adipose mass and increases vitamin E levels in the liver and adipose tissue in mice. The aim of the present study was to examine the mechanism by which CLA alters vitamin E levels in tissues and antioxidant activity in mice. METHODS C57BL/6J mice were divided into three groups and fed 5% lipid as soybean oil alone (control group), 4% soybean oil supplemented with 1% CLA (CLA group), or 5% lipid with a vitamin E supplement (VE group) for 4 wk. RESULTS The CLA and VE diets resulted in a significant increase in the α-tocopherol concentration in all tissues examined, i.e., the liver, kidney, testis, spleen, heart, lung, and adipose tissue (P < 0.05). Levels of thiobarbituric acid-reactive substances in the kidney, testis, heart, lung, and adipose tissue were lower in the CLA and VE groups than in the control group (P < 0.05). CLA did not alter the absorption rate of vitamin E or α-carboxyethyl hydroxychromans levels in the liver and plasma. The CLA diet induced a significant increase in α-tocopherol transfer protein and mRNA levels in the liver. CLA resulted in a decrease in catalase and glutathione peroxidase activities and peroxisome proliferator α mRNA levels but had no effect on levels of mRNAs for other nuclear transcription factors in the liver. CONCLUSION The increase in vitamin E status in CLA-fed mice is not due to altered absorption and metabolism of vitamin E but might be related to the induction of α-tocopherol transfer protein expression in the liver. The regulation of the activities of catalase and glutathione peroxidase by CLA is not mediated by vitamin E accumulation in the liver.
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Affiliation(s)
- Wan-Hsuan Chen
- Institute of Nutrition and Health Science, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
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