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Chen KW, Chen YR, Yang LY, Cheng YW, Chou SC, Chen YH, Chen YT, Hsieh ST, Kuo MF, Wang KC. Microcirculatory Impairment and Cerebral Injury in Hydrocephalus and the Effects of Cerebrospinal Fluid Diversion. Neurosurgery 2024:00006123-990000000-01097. [PMID: 38511941 DOI: 10.1227/neu.0000000000002908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/22/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Hydrocephalus is characterized by progressive enlargement of cerebral ventricles, resulting in impaired microvasculature and cerebral hypoperfusion. This study aimed to demonstrate the microvascular changes in hydrocephalic rats and the effects of cerebrospinal fluid (CSF) release on cerebral blood flow (CBF). METHODS On postnatal day 21 (P21), male Wistar rats were intracisternally injected with either a kaolin suspension or saline. On P47, Evan's ratio (ER) was measured using MRI. On P49, the arteriolar diameter and vascular density of the pia were quantified using a capillary video microscope. The CBF was measured using laser Doppler flowmetry. The expressions of NeuN and glial fibrillary acidic protein determined by immunochemical staining were correlated with the ER. The CBF and rotarod test performance were recorded before and after CSF release. The expressions of 4-hydroxynonenal (4-HNE) and c-caspase-3 were studied on P56. RESULTS Ventriculomegaly was induced to varying degrees, resulting in the stretching and abnormal narrowing of pial arterioles, which regressed with increasing ER. Quantitative analysis revealed significant decreases in the arteriolar diameter and vascular density in the hydrocephalic group compared with those in the control group. In addition, the CBF in the hydrocephalic group decreased to 30%-50% of that in the control group. In hydrocephalus, the neurons appear distorted, and the expression of 4-HNE and reactive astrogliosis increase in the cortex. After CSF was released, improvements in the CBF and rotarod test performance were inversely associated with the ER. In addition, the levels of 4-HNE and c-caspase-3 were further elevated. CONCLUSION Rapid ventricular dilatation is associated with severe microvascular distortion, vascular regression, cortical hypoperfusion, and cellular changes that impair the recovery of CBF and motor function after CSF release. Moreover, CSF release may induce reperfusion injury. This pathophysiology should be taken into account when treating hydrocephalus.
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Affiliation(s)
- Kuo-Wei Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Master Degree of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yong-Ren Chen
- Non-invasive Cancer Therapy Research Institute, Taipei, Taiwan
| | - Ling-Yu Yang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Wen Cheng
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sheng-Che Chou
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Traumatology, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan
| | - Yi-Hsing Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Tzu Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Tsang Hsieh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Meng-Fai Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuo-Chuan Wang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Yang LY, Tang SC, Lee JE, Chen YR, Chen YT, Chen KW, Hsieh ST, Wang KC. Recombinant soluble form of receptor for advanced glycation end products ameliorates microcirculation impairment and neuroinflammation after subarachnoid hemorrhage. Neurotherapeutics 2024; 21:e00312. [PMID: 38177024 DOI: 10.1016/j.neurot.2023.e00312] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
Impaired cerebral microcirculation after subarachnoid hemorrhage (SAH) has been shown to be related to delayed ischemic neurological deficits (DIND). We previously demonstrated the involvement of the receptor for advanced glycation end products (RAGE) in the pathogenesis of SAH related neuronal death. In the present study, we aimed to investigate the therapeutic effects of a recombinant soluble form of RAGE (sRAGE) on microcirculation impairment following SAH. Intrathecal injection of autologous blood in rats, mixed primary astrocyte and microglia cultures exposed to hemolysates and endothelial cells (ECs) from human brain microvascular exposed to glia-conditioned medium or SAH patient's CSF were used as experimental SAH models in vivo and in vitro. The results indicated that intrathecal administration of recombinant sRAGE significantly ameliorated the vasoconstriction of cortical arterioles and associated perfusion impairment, brain edema, reduced cell death, endothelial dysfunction, and improved motor performance at 24 and 48 h after SAH induction in rats. The in vitro results further showed that recombinant sRAGE significantly reduced astrocyte swelling and microglia activation, in parallel with decreased mRNA expression levels of pro-inflammatory cytokines including interleukin-6 (IL-6) and interleukin-1β (IL-1β) in vitro. Moreover, the in vitro model of SAH-induced p-eNOS and eNOS suppression, along with stress fiber formation in brain microvascular ECs, was effectively reversed by sRAGE treatment and led to a decrease in cleaved-caspase 3 expression. In summary, recombinant sRAGE effectively lessened microcirculation impairment and vascular injury after SAH via the mechanism of anti-inflammation, which may provide a potential therapeutic strategy for SAH.
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Affiliation(s)
- Ling-Yu Yang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Chun Tang
- Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jing-Er Lee
- Department of Neurology, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan
| | - Yong-Ren Chen
- Non-invasive Cancer Therapy Research Institute, Taipei, Taiwan; Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan
| | - Yi-Tzu Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuo-Wei Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Tsang Hsieh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuo-Chuan Wang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Chang JW, Kuo FC, Lin TC, Chin TW, Yang LY, Chen HH, Fan YH, Yang HH, Liu CS, Tsai HL. Long-term complications and outcomes of augmentation cystoplasty in children with neurogenic bladder. Sci Rep 2024; 14:4214. [PMID: 38378755 PMCID: PMC10879155 DOI: 10.1038/s41598-024-54431-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/13/2024] [Indexed: 02/22/2024] Open
Abstract
Augmentation cystoplasty (AC) is an effective surgical procedure for patients with neurogenic bladder whenever conservative treatments have failed. The present study aimed to determine the risks of metabolic complications, malignancy, long-term outcomes and histopathologic changes of native bladder and the augmented intestine after AC in children with neurogenic bladder. Pediatric patients < 18 years who underwent AC between 2000 and 2020 were enrolled. Early postoperative complications, long-term outcomes and histopathologic changes in mucosal biopsies of native bladder and the augmented intestine after AC were reviewed. Twenty-two patients with a mean age of 7.6 ± 4.4 years were included. The ileum was used in 19 patients and the sigmoid colon in 3 patients. The length of hospital stay was 14.8 ± 6.8 days. Post-operatively, the urinary continence rate improved from 22.7 to 81.8% (p < 0.001). Hydronephrosis resolved in 17 of 19 patients. Vesicoureteral reflux resolved in 16 (64.0%) of the refluxing ureter units and was downgraded in 7 (28.0%). Grades of hydronephrosis and reflux significantly improved following AC (p < 0.001). The estimated glomerular filtration rate also significantly increased (p = 0.012). Formation of urinary tract stones was the most frequent late complication (in 8 patients, 36.4%). Life-threatening spontaneous bladder perforation occurred in 1 patient. After a mean follow-up of 13.4 ± 5.9 years, there were no cases of mortality, new-onset symptomatic metabolic acidosis, or changes in serum electrolytes. Of the 17 patients who were followed for > 10 years, no cases of malignancy or metaplastic changes were identified in the native bladder or augmented bowel epithelium. AC is a safe and effective procedure with low surgical and metabolic complication rates. In addition, AC provides a satisfactory continence rate and long-term protection of renal function, increases functional capacity, and regresses reflux and hydronephrosis. Individualized surveillance is recommended for the early identification of urolithiasis and metabolic disturbances.
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Affiliation(s)
- Jei-Wen Chang
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fang-Cheng Kuo
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Bei-Tou District, Taipei, Taiwan
| | - Tzu-Ching Lin
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tai-Wai Chin
- Department of Pediatric Surgery, Changhua Christian Children Hospital, Changhua, Taiwan
| | - Ling-Yu Yang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Hung Chen
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Hua Fan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui-Hsin Yang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Bei-Tou District, Taipei, Taiwan
| | - Chin-Su Liu
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Bei-Tou District, Taipei, Taiwan
| | - Hsin-Lin Tsai
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Bei-Tou District, Taipei, Taiwan.
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Chen YX, Wu LL, Wu XX, Yang LY, Xu JQ, Wang L, Jiang ZY, Yao JN, Yang DN, Sun N, Zhang J, Zhang YW, Hu RW, Lin Y, Huang K, Li B, Niu JM. [Overview of design and construction of hypertensive disorders of a pregnancy-cohort in Shenzhen]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1858-1863. [PMID: 38129139 DOI: 10.3760/cma.j.cn112338-20230518-00308] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.
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Affiliation(s)
- Y X Chen
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - L L Wu
- Department of Obstetrics and Gynecology, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China
| | - X X Wu
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - L Y Yang
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - J Q Xu
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - L Wang
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - Z Y Jiang
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - J N Yao
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - D N Yang
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - N Sun
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - J Zhang
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - Y W Zhang
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - R W Hu
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - Y Lin
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - K Huang
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - B Li
- Department of Obstetrics, Shenzhen Maternity & Child Healthcare Hospital, the First School of Clinical Medicine, Southern Medical University, Shenzhen 518028, China
| | - J M Niu
- Department of Obstetrics and Gynecology, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China
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Zuo XN, Yang LY, Sun L, Guo LG, Gao ZF. [EB virus positive intravascular large B-cell lymphoma: a case report]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:867-868. [PMID: 38049344 PMCID: PMC10694079 DOI: 10.3760/cma.j.issn.0253-2727.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Indexed: 12/06/2023]
Affiliation(s)
- X N Zuo
- Department of Pathology, Beijing GoBroad Boren Hospital, Beijing 100071, China
| | - L Y Yang
- Department of Pathology, Beijing GoBroad Boren Hospital, Beijing 100071, China
| | - L Sun
- Department of Pathology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - L G Guo
- Department of Pathology, Beijing GoBroad Boren Hospital, Beijing 100071, China
| | - Z F Gao
- Department of Pathology, Beijing GoBroad Boren Hospital, Beijing 100071, China Department of Pathology, Peking University Third Hospital, Beijing 100191, China
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Yang LY, Chen YR, Lee JE, Chen KW, Luh HT, Chen YT, Wang KC, Hsieh ST. Dental Pulp Stem Cell-Derived Conditioned Medium Alleviates Subarachnoid Hemorrhage-Induced Microcirculation Impairment by Promoting M2 Microglia Polarization and Reducing Astrocyte Swelling. Transl Stroke Res 2023; 14:688-703. [PMID: 36181630 PMCID: PMC10444696 DOI: 10.1007/s12975-022-01083-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 03/03/2022] [Revised: 07/23/2022] [Accepted: 09/12/2022] [Indexed: 10/07/2022]
Abstract
Aneurysmal subarachnoid hemorrhage (SAH) can cause severe neurological deficits and high mortality. Early brain edema following SAH contributes to the initiation of microcirculation impairment and may further lead to delayed ischemic neurologic deficit (DIND). This study aimed to investigate whether dental pulp stem cell conditioned medium (DPSC-CM) ameliorates SAH-induced microcirculation impairment and the underlying mechanisms. SAH was induced via intrathecal injection of fresh autologous blood in Wistar male adult rat. DPSC-CM or DPSC-CM + insulin growth factor-1 (IGF-1) antibody was randomly administered by intrathecal route 5 min after SAH induction. To evaluate the underlying mechanisms of DPSC-CM in the treatment of SAH, primary rat astrocyte and microglia co-cultures were challenged with hemolysate or SAH-patient CSF in the presence or absence of DPSC-CM. The results showed that in vivo, DPSC-CM treatment decreased the brain water content, improved microcirculation impairment and enhanced functional recovery at 24 h post-SAH. DPSC-CM treatment also alleviated the expressions of water channel protein aquaporin-4 (AQP4) and pro-inflammatory cytokines, and enhanced the expressions of anti-inflammatory factors in the cortical region. However, all the beneficial effects of DPSC-CM were abrogated after treatment with IGF-1 neutralizing antibody. The in vitro results further showed that DPSC-CM treatment reduced hemolysate/SAH-patient CSF-induced astrocyte swelling and promoted M2 microglia polarization, partially through IGF-1/AKT signaling. The data suggested that DPSC-CM significantly reduced brain edema and rescued microcirculation impairment with concomitant anti-inflammatory benefits after SAH, and may potentially be developed into a novel therapeutic strategy for SAH.
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Affiliation(s)
- Ling-Yu Yang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yong-Ren Chen
- Non-Invasive Cancer Therapy Research Institute, Taipei, Taiwan
| | - Jing-Er Lee
- Department of Neurology, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan
| | - Kuo-Wei Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui-Tzung Luh
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Tzu Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuo-Chuan Wang
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
| | - Sung-Tsang Hsieh
- Department of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
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Yang LY, Chen H, Zhao Y. [Treatment strategy of lateral canals during root canal therapy]. Zhonghua Kou Qiang Yi Xue Za Zhi 2023; 58:958-963. [PMID: 37659856 DOI: 10.3760/cma.j.cn112144-20230113-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/04/2023]
Abstract
Lateral canals are small branches from the main root canal, usually extending from the dentin and cementum into the periodontal ligament, mostly located at the lower 1/3 of the apical portion. Due to the complex and varied anatomical morphology as well as the high incidence, it becomes an important factor affecting the effect of root canal therapy and a difficult point in this process. It is of great clinical significance to master the treatment strategy of lateral canals during root canal therapy. This article reviews the anatomical characteristics of lateral canals, as well as the clinical identification, treatment strategy and the laboratory detection methods of lateral canals in the process of root canal preparation, disinfection, and obturation.
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Affiliation(s)
- L Y Yang
- Department of Endodontics, School and Hospital of Stomatology, Lanzhou University & Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing, Lanzhou 730000, China
| | - H Chen
- Department of Endodontics, School and Hospital of Stomatology, Lanzhou University & Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing, Lanzhou 730000, China
| | - Y Zhao
- Department of Endodontics, School and Hospital of Stomatology, Lanzhou University & Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing, Lanzhou 730000, China
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Yang LY, Lou XL, Wang Y, Hou YQ. [miR-148b inhibits M2 polarization of LPS-stimulated macrophages by targeting DcR3]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1231-1237. [PMID: 37574317 DOI: 10.3760/cma.j.cn112150-20220808-00794] [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] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Objective: To investigate the effect of microRNA (miR-148b) targeting decoy receptor 3 (DcR3) on macrophage polarization in sepsis. Methods: Experimental study. From December 2019 to December 2022, serum microRNA expression was detected in 3 patients with sepsis and 3 healthy controls in the clinical laboratory of Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Phorbol 12-myristate 13-acetate (PMA) was used to induce the differentiation of human acute monocytic leukemia cells THP-1 into macrophages, and then lipopolysaccharide (LPS) was added to stimulate the establishment of a sepsis cell model, and the expression changes of miR-148b and DcR3 were detected by RT-PCR and Western blot. Overexpression of DcR3 was used to detect the expression levels of TNF-α, CD163 and IL-10 in macrophages stimulated by LPS (100 ng/ml). Overexpression of miR-148b was used to observe the changes of molecular markers of macrophage polarization. The targeting regulation effect of miR-148b on DcR3 was determined by dual-luciferase reporter assay. t test was used to analyze whether there were statistical differences among the groups. Results: The expression of miR-148b was down-regulated (P<0.05) and the expression of DcR3 was up-regulated (P<0.01) in THP-1 macrophages stimulated by LPS. Overexpression of DcR3 inhibited the expression of TNF-α (P<0.05) and promoted the expression of CD163 (P<0.01) and IL-10 (P<0.01). When miR-148b mimics was added, the opposite effect was observed. The dual-luciferase reporter assay confirmed that miR-148b targets and binds to DcR3, inhibiting its transcription and expression. The results of flow cytometry showed that DcR3 could reverse the promoting effect of miR-148b on the CD86/CD163 ratio of macrophages (P<0.05). Conclusion: miR-148b inhibits the expression of DcR3, thereby inhibiting M2 polarization in LPS-stimulated macrophage cells.
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Affiliation(s)
- L Y Yang
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Preparatory stage), Shanghai 201600, China
| | - X L Lou
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Preparatory stage), Shanghai 201600, China
| | - Y Wang
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Preparatory stage), Shanghai 201600, China
| | - Y Q Hou
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Preparatory stage), Shanghai 201600, China
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Luh HT, Chen KW, Yang LY, Chen YT, Lin SH, Wang KC, Lai DM, Hsieh ST. Does a negative correlation of heme oxygenase-1 with hematoma thickness in chronic subdural hematomas affect neovascularization and microvascular leakage? A retrospective study with preliminary validation. J Neurosurg 2023; 139:536-543. [PMID: 36609367 DOI: 10.3171/2022.11.jns221790] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Chronic subdural hematoma (CSDH) is a common neurological disease among elderly adults. The progression of CSDH is an angiogenic process, involving inflammatory mediators that affect vascular permeability, microvascular leakage, and hematoma thickness. The authors aimed to identify biomarkers associated with angiogenesis and vascular permeability that might influence midline shift and hematoma thickness. METHODS Medical records and laboratory data of consecutive patients who underwent surgery for CSDH were analyzed. Collected data were basic demographic data, CSDH classification, CSDH thickness, midline shift, heme oxygenase-1 (HO-1) levels in hematomas, and common laboratory markers. Linear regression analysis was used to evaluate the relationship of CSDH thickness with characteristic variables. The chick chorioallantoic membrane (CAM) assay was used to test the angiogenic potency of identified variables in ex ovo culture of chick embryos. RESULTS In total, 93 patients with CSDH (71.0% male) with a mean age of 71.0 years were included. The mean CSDH thickness and midline shift were 19.7 and 9.8 mm, respectively. The mean levels of HO-1, ferritin, total bilirubin, white blood cells, segmented neutrophils, lymphocytes, platelets, international normalized ratio, and partial thromboplastin time were 36 ng/mL, 14.8 μg/mL, 10.5 mg/dL, 10.3 × 103 cells/μL, 69%, 21.7%, 221.1 × 109 cells/μL, 1.0, and 27.8 seconds, respectively. Pearson correlation analysis revealed that CSDH thickness was positively correlated with midline shift distance (r = 0.218, p < 0.05) but negatively correlated with HO-1 concentration (r = -0.364, p < 0.01) and ferritin level (r = -0.222, p < 0.05). Multivariate linear regression analysis revealed that HO-1 was an independent predictor of CSDH thickness (β = -0.084, p = 0.006). The angiogenic potency of HO-1 in hematoma fluid was tested with the chick CAM assay; topical addition of CSDH fluid with low HO-1 levels promoted neovascularization and microvascular leakage. Addition of HO-1 in a rescue experiment inhibited CSDH fluid-mediated angiogenesis and microvascular leakage. CONCLUSIONS HO-1 is an independent risk factor in CSDH hematomas and is negatively correlated with CSDH thickness. HO-1 may play a role in the pathophysiology and development of CSDH, possibly by preventing neovascularization and reducing capillary fragility and hyperpermeability.
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Affiliation(s)
- Hui-Tzung Luh
- 1Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- 2Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Kuo-Wei Chen
- 1Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- 2Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Ling-Yu Yang
- 3Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Tzu Chen
- 3Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Hsuan Lin
- 4Institute of Statistics, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan
| | - Kuo-Chuan Wang
- 3Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Dar-Ming Lai
- 3Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Tsang Hsieh
- 5Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; and
- 6Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
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10
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Guo RP, Yang LY, Zhao JF, Su J. [Advance on cyclin D1 and CDK4 in cutaneous melanoma]. Zhonghua Bing Li Xue Za Zhi 2023; 52:767-770. [PMID: 37408419 DOI: 10.3760/cma.j.cn112151-20221230-01090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- R P Guo
- Department of Pathology, School of Basic Medical Sciences, Peking University Third Hospital, Beijing 100191, China
| | - L Y Yang
- Department of Pathology, School of Basic Medical Sciences, Peking University Third Hospital, Beijing 100191, China
| | - J F Zhao
- Department of Pathology, Yan'an Branch of Peking University Third Hospital, Yan'an Traditional Chinese Medicine Hospital, Yan'an 716000,China
| | - J Su
- Department of Pathology, School of Basic Medical Sciences, Peking University Third Hospital, Beijing 100191, China Department of Pathology, Yan'an Branch of Peking University Third Hospital, Yan'an Traditional Chinese Medicine Hospital, Yan'an 716000,China
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11
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Lou XL, Yang LY, Wang Y, Hou YQ. [Research progress on the relationship between COVID-19 and autoimmune diseases]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:785-792. [PMID: 37165828 DOI: 10.3760/cma.j.cn112150-20220810-00804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Different autoantibodies can be detected in patients with coronavirus disease 2019 (COVID-19). It is reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection could induce autoimmune diseases (AID), including children's multisystem inflammatory syndrome (MIS-C), Guillain Barre syndrome (GBS), Autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP) and thyroid autoimmune diseases. This article mainly reviews the similarities between COVID-19 and AID, the possibility of COVID-19 inducing AID, the risk of AID patients infected or vaccinated against COVID-19. The purpose is to provide strategies for the prevention, management and treatment of AID during the epidemic.
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Affiliation(s)
- X L Lou
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - L Y Yang
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - Y Wang
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
| | - Y Q Hou
- Department of Clinical Laboratory, Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201600, China
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Li Z, Peng WH, Liu WJ, Yang LY, Naeem A, Feng Y, Ming LS, Zhu WF. Advances in numerical simulation of unit operations for tablet preparation. Int J Pharm 2023; 634:122638. [PMID: 36702386 DOI: 10.1016/j.ijpharm.2023.122638] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
Recently, there has been an increase in the use of numerical simulation technology in pharmaceutical preparation processes. Numerical simulation can contribute to a better understanding of processes, reduce experimental costs, optimize preparation processes, and improve product quality. The intermediate material of most dosage forms is powder or granules, especially in the case of solid preparations. The macroscopic behavior of particle materials is controlled by the interactions of individual particles with each other and surrounding fluids. Therefore, it is very important to analyze and control the microscopic details of the preparation process for solid preparations. Since tablets are one of the most widely used oral solid preparations, and the preparation process is relatively complex and involves numerous units of operation, it is especially important to analyze and control the tablet production process. The present paper discusses recent advances in numerical simulation technology for the preparation of tablets, including drying, mixing, granulation, tableting, and coating. It covers computational fluid dynamics (CFD), discrete element method (DEM), population balance model (PBM), finite element method (FEM), Lattice-Boltzmann model (LBM), and Monte Carlo model (MC). The application and deficiencies of these models in tablet preparation unit operations are discussed. Furthermore, the paper provides a systematic reference for the control and analysis of the tablet preparation process and provides insight into the future direction of numerical simulation technology in the pharmaceutical industry.
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Affiliation(s)
- Zhe Li
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang 330004, PR China
| | - Wang-Hai Peng
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang 330004, PR China
| | - Wen-Jun Liu
- Jiangzhong Pharmaceutical Co. Ltd., Nanchang 330049, PR China
| | - Ling-Yu Yang
- Jiangzhong Pharmaceutical Co. Ltd., Nanchang 330049, PR China
| | - Abid Naeem
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang 330004, PR China
| | - Yi Feng
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang 330004, PR China; Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China
| | - Liang-Shan Ming
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang 330004, PR China.
| | - Wei-Feng Zhu
- Key Laboratory of Modern Preparation of TCM, Ministry of Education, Institute for Advanced Study, Jiangxi University of Chinese Medicine, Nanchang 330004, PR China.
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Wang KC, Yang LY, Lee JE, Wu V, Chen TF, Hsieh ST, Kuo MF. Combination of indirect revascularization and endothelial progenitor cell transplantation improved cerebral perfusion and ameliorated tauopathy in a rat model of bilateral ICA ligation. Stem Cell Res Ther 2022; 13:516. [PMID: 36371197 PMCID: PMC9652785 DOI: 10.1186/s13287-022-03196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/23/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective
Endothelial progenitor cells (EPCs) contribute to the recovery of neurological function after ischemic stroke. Indirect revascularization has exhibited promising effects in the treatment of cerebral ischemia related to moyamoya disease and intracranial atherosclerotic disease. The role of EPCs in augmenting the revascularization effect is not clear. In this study, we investigated the therapeutic effects of indirect revascularization combined with EPC transplantation in rats with chronic cerebral ischemia.
Methods
Chronic cerebral ischemia was induced by bilateral internal carotid artery ligation (BICAL) in rats, and indirect revascularization by encephalo-myo-synangiosis (EMS) was performed 1 week later. During the EMS procedure, intramuscular injection of EPCs and the addition of stromal cell-derived factor 1 (SDF-1), and AMD3100, an SDF-1 inhibitor, were undertaken, respectively, to investigate their effects on indirect revascularization. Two weeks later, the cortical microcirculation, neuronal damage, and functional outcome were evaluated according to the microvasculature density and partial pressure of brain tissue oxygen (PbtO2), regional blood flow, expression of phosphorylated Tau (pTau), TUNEL staining and the rotarod performance test, respectively.
Results
The cortical microcirculation, according to PbtO2 and regional blood flow, was impaired 3 weeks after BICAL. These impairments were improved by the EMS procedure. The regional blood flow was further increased by the addition of SDF-1 and decreased by the addition of AMD3100. Intramuscular injection of EPCs further increased the regional blood flow as compared with the EMS group. The rotarod test results showed that the functional outcome was best in the EMS combined with EPC injection group. Western blot analysis showed that the EMS combined with EPC treatment group had significantly decreased expressions of phosphorylated Tau and phosphorylated glycogen synthase kinase 3 beta (Y216 of GSK-3β). pTau and TUNEL-positive cells were markedly increased at 3 weeks after BICAL induction. Furthermore, the groups treated with EMS combined with SDF-1 or EPCs exhibited marked decreases in the pTau expression and TUNEL-positive cells, whereas AMD3100 treatment increased TUNEL-positive cells.
Conclusion
The results of this study suggested that indirect revascularization ameliorated the cerebral ischemic changes. EPCs played a key role in augmenting the effect of indirect revascularization in the treatment of chronic cerebral ischemia.
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Hu HY, Zhang B, Yang LY, Zhou L, Wang Y, Wang F. [PAHs exposure and its association with oxidative stress and neurotransmitter levels in coal miners]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:727-732. [PMID: 36348551 DOI: 10.3760/cma.j.cn121094-20210315-00150] [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: 06/16/2023]
Abstract
Objective: To learn the investigate of polycyclic aromatic hydrocarbons (PAHs) and to explore the association between PAHs exposure and oxidative stress' neurotransmitter levels in coal miners. Methods: A cross-sectional survey was conducted in 652 coal miners (239 in the underground first line group, 280 in the underground auxiliary group and 133 in the surface group) from April to June 2017. The levels of urinary monohydroxy PAHs metabolites (OH-PAHs) , oxidative stress and neurotransmitters in blood were determined. A linear regression model was used to evaluate the correlation between OH-PAHs and oxidative stress' neurotransmitter levels. The mediating role of oxidative stress between urinary OH-PAHs and neurotransmitters change was assessed by mediation analysis. Results: The levels of 2-hydroxynaphthalene (2-NAP) 、2-hydroxy uorene (2-FLU) 、1-hydroxypyrene (1-OHP) in urine OH-PAHs of coal miners in different workplaces were significantly different (H=33.64, 9.63, 26.82, P<0.01, =0.008, <0.01) . The levels of neurotransmitters [5-hydroxytryptamine (5-HT) , norepinephrine (NE) , epinephrine (E) , dopamine (DA) , acetylcholine (Ach) , acetylcholinesterase (AChE) ] and oxidative stress [malondialdehyde (MDA) (F=36.81, 15.58, 79.16, 179.58, 33.48, 67.63, 4.96, P<0.01) ] in the blood of three groups of coal miners were significantly different. After controlling the potential confounding factors, NE content was negatively correlated with 2-FLU level, and AChE activity was also negatively correlated with 1-OHP level (β=-134.99, 95% CI: -250.74~-19.23, P=0.02; β=-0.80, 95%CI: -1.54~-0.05, P=0.036) . Positive correlation was found between Ach content and 9-hydroxyphenanthrene (9-PHE) level, AChE activity was also positively correlated with 2-NAP level and 9-PHE level (β=0.96, 95%CI: 0.26~1.64, P=0.007; β=1.78, 95%CI: 0.75~2.82, P=0.001; β=0.77, 95%CI: 0.07~1.47, P=0.031) . In addition, superoxide dismutase activity was correlated with 1-OHP level and AChE activity (β=0.32, 95%CI: 0.02~0.62, P=0.034; β=-0.23, 95%CI: -0.43~-0.02, P=0.032) . Mediation analysis indicated that 1-OHP level may directly affect AChE activity (P<0.05) . Conclusion: The level of PAHs in underground coal miners is relatively higher, and may lead to changes of neurotransmitter levels. The mediating effect of oxidative stress has not been observed.
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Affiliation(s)
- H Y Hu
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - B Zhang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - L Y Yang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - L Zhou
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Y Wang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - F Wang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
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Chen FC, Liu WJ, Zhu WF, Yang LY, Zhang JW, Feng Y, Ming LS, Li Z. Surface Modifiers on Composite Particles for Direct Compaction. Pharmaceutics 2022; 14:pharmaceutics14102217. [PMID: 36297653 PMCID: PMC9612340 DOI: 10.3390/pharmaceutics14102217] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Direct compaction (DC) is considered to be the most effective method of tablet production. However, only a small number of the active pharmaceutical ingredients (APIs) can be successfully manufactured into tablets using DC since most APIs lack adequate functional properties to meet DC requirements. The use of suitable modifiers and appropriate co-processing technologies can provide a promising approach for the preparation of composite particles with high functional properties. The purpose of this review is to provide an overview and classification of different modifiers and their multiple combinations that may improve API tableting properties or prepare composite excipients with appropriate co-processed technology, as well as discuss the corresponding modification mechanism. Moreover, it provides solutions for selecting appropriate modifiers and co-processing technologies to prepare composite particles with improved properties.
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Affiliation(s)
- Fu-Cai Chen
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
| | - Wen-Jun Liu
- Jiangzhong Pharmaceutical Co., Ltd., Nanchang 330049, China
| | - Wei-Feng Zhu
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
| | - Ling-Yu Yang
- Jiangzhong Pharmaceutical Co., Ltd., Nanchang 330049, China
| | - Ji-Wen Zhang
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Yi Feng
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Engineering Research Center of Modern Preparation Technology of TCM of Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Liang-Shan Ming
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Correspondence: (L.-S.M.); (Z.L.); Tel.: +86-791-8711-9027 (L.-S.M. & Z.L.)
| | - Zhe Li
- Key Laboratory of Preparation of Modern TCM, Ministry of Education, Jiangxi University of Chinese Medicine, Nanchang 330004, China
- Correspondence: (L.-S.M.); (Z.L.); Tel.: +86-791-8711-9027 (L.-S.M. & Z.L.)
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Yang YY, Huang PH, Yang LY, Huang CC, Liu CW, Huang SS, Chen CH, Lee FY, Kao SY, Shulruf B. Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study. J Educ Eval Health Prof 2022; 19:27. [PMID: 36252990 PMCID: PMC9764018 DOI: 10.3352/jeehp.2022.19.27] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative for the commonly used Angoff and Hofstee methods and their variants. The current study aims to estimate the minimum number of panelists required for obtaining acceptable and reliable cut scores using the EZ method. METHODS The primary data were extracted from 31 panelists who used the EZ method for setting cut scores for a 12-station of medical school’s final objective structured clinical examination (OSCE) in Taiwan. For this study, a new data set composed of 1,000 random samples of different panel sizes, ranging from 5 to 25 panelists, was established and analyzed. Analysis of variance was performed to measure the differences in the cut scores set by the sampled groups, across all sizes within each station. RESULTS On average, a panel of 10 experts or more yielded cut scores with confidence more than or equal to 90% and 15 experts yielded cut scores with confidence more than or equal to 95%. No significant differences in cut scores associated with panel size were identified for panels of 5 or more experts. CONCLUSION The EZ method was found to be valid and feasible. Less than an hour was required for 12 panelists to assess 12 OSCE stations. Calculating the cut scores required only basic statistical skills.
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Affiliation(s)
- Ying-Ying Yang
- Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
| | - Pin-Hsiang Huang
- National Yang-Ming University, Taipei, Taiwan
- University of New South Wales, Sydney, Australia
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ling-Yu Yang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Chang Huang
- Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
| | - Chih-Wei Liu
- Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
| | - Shiau-Shian Huang
- Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
| | - Chen-Huan Chen
- National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shou-Yen Kao
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Boaz Shulruf
- University of New South Wales, Sydney, Australia
- University of Auckland, Auckland, New Zealand
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Zhou J, Yang LY, Jia CL, Shi WG, Deng SR, Luo ZB. Identification and Functional Prediction of Poplar Root circRNAs Involved in Treatment With Different Forms of Nitrogen. Front Plant Sci 2022; 13:941380. [PMID: 35874008 PMCID: PMC9305699 DOI: 10.3389/fpls.2022.941380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
Circular RNAs (circRNAs) are a class of noncoding RNA molecules with ring structures formed by covalent bonds and are commonly present in organisms, playing an important regulatory role in plant growth and development. However, the mechanism of circRNAs in poplar root responses to different forms of nitrogen (N) is still unclear. In this study, high-throughput sequencing was used to identify and predict the function of circRNAs in the roots of poplar exposed to three N forms [1 mM NO3 - (T1), 0.5 mM NH4NO3 (T2, control) and 1 mM NH4 + (T3)]. A total of 2,193 circRNAs were identified, and 37, 24 and 45 differentially expressed circRNAs (DECs) were screened in the T1-T2, T3-T2 and T1-T3 comparisons, respectively. In addition, 30 DECs could act as miRNA sponges, and several of them could bind miRNA family members that play key roles in response to different N forms, indicating their important functions in response to N and plant growth and development. Furthermore, we generated a competing endogenous RNA (ceRNA) regulatory network in poplar roots treated with three N forms. DECs could participate in responses to N in poplar roots through the ceRNA regulatory network, which mainly included N metabolism, amino acid metabolism and synthesis, response to NO3 - or NH4 + and remobilization of N. Together, these results provide new insights into the potential role of circRNAs in poplar root responses to different N forms.
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Yang H, Chen SH, Yang LY, Ma LG, Cao LY, Wu SL. [Correlation of nonalcoholic fatty liver disease at different ages of onset with new-onset diabetes mellitus]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:631-636. [PMID: 36038325 DOI: 10.3760/cma.j.cn501113-20200804-00434] [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: 06/15/2023]
Abstract
Objective: To investigate the effect of nonalcoholic fatty liver (NAFLD) at different ages of onset with new-onset diabetes mellitus. Methods: The cohort study was conducted in Kailuan Group Company. Active and retired employees were used as study subjects. After excluding NAFLD diagnosed at baseline, previous history of diabetes mellitus, and long-term history of heavy drinking, 43 317 cases were finally included in the cohort. The study subjects were divided into five groups according to age (<30 years old as group 1, 30-39 years old as group 2, 40-49 years as group 3, 50-59 years as group 4, and ≥60 years as group 5). The prevalence and incidence density of new-onset diabetes mellitus were compared between each NAFLD and non-fatty liver population group. The effect of NAFLD at different ages of onset with new-onset diabetes mellitus was analyzed by multivariate Cox's regression model. Statistical analysis was performed using one-way ANOVA, χ2 test or multivariate Cox's regression model. Results: The prevalence and incidence density of diabetes mellitus was significantly higher in NAFLD than non-fatty liver population. The prevalence of diabetes mellitus in different age groups were 6.45%, 6.88%, 9.94%, 10.83%, and 11.43%, respectively. The incidence density of each age group was 9.21/1 000 person-years, 11.10/1 000 person-years, 16.17/1 000 person-years, 18.72/1 000 person-years, and 22.13/1 000 person-years, and the differences were statistically significant (P<0.001). Multivariate Cox's regression model result showed that after adjusting for confounding factors such as gender, systolic blood pressure, and fasting blood glucose, the HRs (95%CI) for diabetes mellitus in each age group were 3.992 (1.897, 8.400), 2.321 (1.589, 3.392), 2.041 (1.667, 2.500), 2.007 (1.708, 2.360), and 1.908 (1.570, 2.319), and the differences were statistically significant (P<0.001). Conclusion: Newly developed NAFLD is an independent risk factor for new-onset diabetes mellitus. Early exposure to NAFLD increases the risk of developing diabetes mellitus compared with the same age group. Younger age of onset of NAFLD should be given attention and active treatment.
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Affiliation(s)
- H Yang
- Oncology Department of Kailuan General Hospital, Tangshan 063000, China
| | - S H Chen
- Internal Medicine-Cardiovascular Department of Kailuan General Hospital, Tangshan 063000, China
| | - L Y Yang
- Oncology Department of Kailuan General Hospital, Tangshan 063000, China
| | - L G Ma
- Oncology Department of Kailuan General Hospital, Tangshan 063000, China
| | - L Y Cao
- Hepatobiliary Surgery Department of Kailuan General Hospital, Tangshan 063000, China
| | - S L Wu
- Internal Medicine-Cardiovascular Department of Kailuan General Hospital, Tangshan 063000, China
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Zhou Q, Tan YL, How CH, Yang LY. Breastfeeding woes: a family physician’s approach. Singapore Med J 2022; 63:68-73. [DOI: 10.11622/smedj.2022036] [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: 11/18/2022]
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Chiang DH, Huang CC, Cheng SC, Cheng JC, Wu CH, Huang SS, Yang YY, Yang LY, Kao SY, Chen CH, Shulruf B, Lee FY. Immersive virtual reality (VR) training increases the self-efficacy of in-hospital healthcare providers and patient families regarding tracheostomy-related knowledge and care skills: A prospective pre-post study. Medicine (Baltimore) 2022; 101:e28570. [PMID: 35029229 PMCID: PMC8757958 DOI: 10.1097/md.0000000000028570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Virtual reality (VR)-based simulation in hospital settings facilitates the acquisition of skills without compromising patient safety. Despite regular text-based training, a baseline survey of randomly selected healthcare providers revealed deficiencies in their knowledge, confidence, comfort, and care skills regarding tracheostomy. This prospective pre-post study compared the effectiveness of regular text- and VR-based intervention modules in training healthcare providers' self-efficacy in tracheostomy care skills. METHODS Between January 2018 and January 2020, 60 healthcare providers, including physicians, nurses, and respiratory therapists, were enrolled. For the intervention, a newly developed head-mounted display (HMD) and web VR materials were implemented in training and clinical services. Subsequently, in-hospital healthcare providers were trained using either text or head-mounted display virtual reality (HMD-VR) materials in the regular and intervention modules, respectively. For tracheostomy care skills, preceptors directly audited the performance of trainees and provided feedback. RESULTS At baseline, the degree of trainees' agreement with the self-efficacy-related statements, including the aspects of familiarity, confidence, and anxiety about tracheostomy-related knowledge and care skills, were not different between the control and intervention groups. At follow-up stage, compared with the regular group, a higher percentage of intervention group' trainees reported that they are "strongly agree" or "somewhat agree" that the HMD-VR simulation increases their self-efficacy, including the aspects of familiarity and confidence, and reduced their anxiety about tracheostomy-related knowledge and care skills. After implementation, a higher degree of trainees' average satisfaction with VR-based training and VR materials was observed in the intervention group than in the regular group. Most reported that VR materials enabled accurate messaging and decreased anxiety. The increasing trend of the average written test and hands-on tracheostomy care skills scores among the intervention group trainees was significant compared to those in the regular group. The benefits of HMD-VR simulations and web-VR material-based clinical services for in-hospital healthcare providers and patient families persisted until 3 to 4 weeks later. CONCLUSION The current study suggests that VR materials significantly enhance trainees' self-efficacy (increased familiarity, increased confidence, and reduced anxiety) and their satisfaction with the training, while motivating them to use acquired knowledge and skills in clinical practice.
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Affiliation(s)
- Dung-Hung Chiang
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, Taipei, Taiwan
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Chia-Chang Huang
- Faculty of Medicine, Taipei, Taiwan
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Medical Innovation Research Office, Clinical Innovation Center, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shu-Chuan Cheng
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Division of Respiratory Therapy, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jui-Chun Cheng
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Division of Respiratory Therapy, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Hsien Wu
- Faculty of Medicine, Taipei, Taiwan
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shiau-Shian Huang
- Faculty of Medicine, Taipei, Taiwan
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Medical Innovation Research Office, Clinical Innovation Center, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ying-Ying Yang
- Faculty of Medicine, Taipei, Taiwan
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Medical Innovation Research Office, Clinical Innovation Center, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ling-Yu Yang
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shou-Yen Kao
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chen-Huan Chen
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Fa-Yauh Lee
- National Yang-Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
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21
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Wu JW, Cheng HM, Huang SS, Liang JF, Huang CC, Yang LY, Shulruf B, Yang YY, Chen CH, Hou MC, Sheu WHH. Comparison of OSCE performance between 6- and 7-year medical school curricula in Taiwan. BMC Med Educ 2022; 22:15. [PMID: 34983486 PMCID: PMC8725566 DOI: 10.1186/s12909-021-03088-7] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The year 2013 marks a watershed in the history of medical education in Taiwan. Following Taiwan's Taskforce of Medical School Curriculum Reform recommendations, the medical school curriculum was reduced from 7 to 6 years. This study aimed to analyze the impact of medical school curriculum reform on medical students' performance in objective structured clinical examinations (OSCEs). METHODS We retrospectively analyzed the OSCE records at Taipei Veterans General Hospital (Taipei VGH), one of Taiwan's largest tertiary medical centers, between November 2016 and July 2020. The eligibility criteria were medical students receiving a full one-year clinical sub-internship training at Taipei VGH and in their last year of medical school. All medical students received a mock OSCE-1 at the beginning of their sub-internship, a mock OSCE-2 after six months of training, and a national OSCE at the end of their sub-internship. The parameters for performance in OSCEs included "percentage of scores above the qualification standard" and "percentage of qualified stations." RESULTS Between November 2016 and July 2020, 361 undergraduates underwent clinical sub-internship training at Taipei VGH. Among them, 218 were taught under the 7-year curriculum, and 143 were instructed under the 6-year curriculum. Based on baseline-adjusted ANCOVA results, medical students under the 7-year curriculum had a higher percentage of scores above the qualification standard than those under the 6-year curriculum at the mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 33.8% [95% CI 32.0-35.7] vs. 28.2% [95% CI 25.9-30.4], p < 0.001), and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4-91.4] vs. 84.0% [95% CI 81.5-86.4], p = 0.001). Moreover, medical students in the 7-year curriculum had a higher percentage of qualified stations in mock OSCE-1 (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 87.4-91.4] vs. 84.0% [95% CI 81.5-86.4], p = 0.001) and mock OSCE-2 (7-year curriculum vs. 6-year curriculum: 91.9% [95% CI 90.1-93.8] vs. 86.1% [95% CI 83.8-88.3], p = 0.001). After clinical sub-internship training, there were no differences in the percentage of scores above the qualification standard (7-year curriculum vs. 6-year curriculum: 33.5% [95% CI 32.2-34.9] vs. 34.6 [95% CI 32.9-36.3], p = 0.328) and percentage of qualified stations (7-year curriculum vs. 6-year curriculum: 89.4% [95% CI 88.1-90.7] vs. 90.2% [95% CI 88.6-91.8], p = 0.492). CONCLUSIONS At the beginning of the sub-internship, medical students under the 7-year curriculum had better OSCE performance than those under the 6-year curriculum. After the clinical sub-internship training in Taipei VGH, there was no difference in the national OSCE score between the 6- and 7-year curricula. Our study suggests that clinical sub-internship is crucial for the development of clinical skills and performance in the national OSCE.
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Affiliation(s)
- Jr-Wei Wu
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hao-Min Cheng
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shiau-Shian Huang
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jen-Feng Liang
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chia-Chang Huang
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ling-Yu Yang
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Boaz Shulruf
- University of New South Wales, Sydney, Australia
| | - Ying-Ying Yang
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan.
- Division of Clinical Skills Training Center, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Chen-Huan Chen
- Department of Medical Education, Taipei Veterans General Hospital and College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Chih Hou
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wayne Huey-Herng Sheu
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Medical Technology, College of Life Science, National Chung-Hsing University, Taichung, Taiwan
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22
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Zhou J, Yang LY, Chen X, Shi WG, Deng SR, Luo ZB. Genome-Wide Identification and Characterization of Long Noncoding RNAs in Populus × canescens Roots Treated With Different Nitrogen Fertilizers. Front Plant Sci 2022; 13:890453. [PMID: 35646010 PMCID: PMC9135444 DOI: 10.3389/fpls.2022.890453] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/19/2022] [Indexed: 05/14/2023]
Abstract
Nitrate (NO3 -) and ammonium (NH4 +) are the primary forms of inorganic nitrogen acquired by plant roots. LncRNAs, as key regulators of gene expression, are a class of non-coding RNAs larger than 200 bp. However, knowledge about the regulatory role of lncRNAs in response to different nitrogen forms remains limited, particularly in woody plants. Here, we performed strand-specific RNA-sequencing of P. × canescens roots under three different nitrogen fertilization treatments. In total, 324 lncRNAs and 6,112 mRNAs were identified as showing significantly differential expression between the NO3 - and NH4NO3 treatments. Moreover, 333 lncRNAs and 6,007 mRNAs showed significantly differential expression between the NH4 + and NH4NO3 treatments. Further analysis suggested that these lncRNAs and mRNAs have different response mechanisms for different nitrogen forms. In addition, functional annotation of cis and trans target mRNAs of differentially expressed lncRNAs indicated that 60 lncRNAs corresponding to 49 differentially expressed cis and trans target mRNAs were involved in plant nitrogen metabolism and amino acid biosynthesis and metabolism. Furthermore, 42 lncRNAs were identified as putative precursors of 63 miRNAs, and 28 differentially expressed lncRNAs were potential endogenous target mimics targeted by 96 miRNAs. Moreover, ceRNA regulation networks were constructed. MSTRG.6097.1, MSTRG.13550.1, MSTRG.2693.1, and MSTRG.12899.1, as hub lncRNAs in the ceRNA networks, are potential candidate lncRNAs for studying the regulatory mechanism in poplar roots under different nitrogen fertilization treatments. The results provide a basis for obtaining insight into the molecular mechanisms of lncRNA responses to different nitrogen forms in woody plants.
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Chang SL, Kuo MJ, Lin YJ, Chen SA, Chen CT, Yang YY, Yang LY, Kao SY, Shulruf B, Lee FY. Virtual reality-based preprocedural education increases preparedness and satisfaction of patients about the catheter ablation of atrial fibrillation. J Chin Med Assoc 2021; 84:690-697. [PMID: 34029219 DOI: 10.1097/jcma.0000000000000555] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A recent study suggested to develop and implement more interacted material for preprocedural education to decrease patients' anxiety about the atrial fibrillation (AF) ablation. This study compared the effectiveness of using either newly developed virtual reality (VR) materials (VR group) or paper-based materials (paper group) on giving AF preprocedural education. METHODS This study consequentially enrolled 33 AF patients preparing for ablation from November 2019 to October 2020. After enrollment, patients were randomized as either paper (n = 22) or VR (n = 11) groups. RESULTS In comparison with the baseline stage, at the posteducation stage, the degree of improvement in patients' self-assessed self-efficacy on AF ablation knowledge was higher among VR group patients than those in the paper group. At the posteducation stage, the patients' satisfaction to preprocedural education and used materials were higher among the VR group than that among the paper group. In addition to meet their needs and give accurate medical information, VR group patients reported that VR materials increased the effectiveness of education, increased their preparedness for AF catheter ablation, achieved paperless purposes, and willing to recommend VR materials to others. Operators subjectively reported that the periprocedure cooperation was increased both among paper and VR group patients after preprocedural education for the details of procedure. Better preparedness of VR group patients was supported by less periprocedure pain, anxiety, and impatience than those among paper group patients. CONCLUSION Interactive VR-based materials are superior to the paper-based materials to provide patients immerse and imagine the journey and detail knowledge of AF catheter ablation before the procedure and better prepared patients for the procedure.
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Affiliation(s)
- Shih-Lin Chang
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Jen Kuo
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yenn-Jiang Lin
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shih-Ann Chen
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Chung-Ting Chen
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Ying Yang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | | | - Fa-Yauh Lee
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Chen SC, Yang LY, Adeel M, Lai CH, Peng CW. Transcranial electrostimulation with special waveforms enhances upper-limb motor function in patients with chronic stroke: a pilot randomized controlled trial. J Neuroeng Rehabil 2021; 18:106. [PMID: 34193179 PMCID: PMC8244182 DOI: 10.1186/s12984-021-00901-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 04/08/2021] [Accepted: 06/23/2021] [Indexed: 12/04/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) and intermittent theta burst stimulation (iTBS) were both demonstrated to have therapeutic potentials to rapidly induce neuroplastic effects in various rehabilitation training regimens. Recently, we developed a novel transcranial electrostimulation device that can flexibly output an electrical current with combined tDCS and iTBS waveforms. However, limited studies have determined the therapeutic effects of this special waveform combination on clinical rehabilitation. Herein, we investigated brain stimulation effects of tDCS-iTBS on upper-limb motor function in chronic stroke patients. Methods Twenty-four subjects with a chronic stroke were randomly assigned to a real non-invasive brain stimulation (NIBS; who received the real tDCS + iTBS output) group or a sham NIBS (who received sham tDCS + iTBS output) group. All subjects underwent 18 treatment sessions of 1 h of a conventional rehabilitation program (3 days a week for 6 weeks), where a 20-min NIBS intervention was simultaneously applied during conventional rehabilitation. Outcome measures were assessed before and immediately after the intervention period: Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Jebsen-Taylor Hand Function Test (JTT), and Finger-to-Nose Test (FNT). Results Both groups showed improvements in FMA-UE, JTT, and FNT scores after the 6-week rehabilitation program. Notably, the real NIBS group had greater improvements in the JTT (p = 0. 016) and FNT (p = 0. 037) scores than the sham NIBS group, as determined by the Mann–Whitney rank-sum test. Conclusions Patients who underwent the combined ipsilesional tDCS-iTBS stimulation with conventional rehabilitation exhibited greater impacts than did patients who underwent sham stimulation-conventional rehabilitation in statistically significant clinical responses of the total JTT time and FNT after the stroke. Preliminary results of upper-limb functional recovery suggest that tDCS-iTBS combined with a conventional rehabilitation intervention may be a promising strategy to enhance therapeutic benefits in future clinical settings. Trial registration: ClinicalTrials.gov Identifier: NCT04369235. Registered on 30 April 2020.
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Affiliation(s)
- Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ling-Yu Yang
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Muhammad Adeel
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.,International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Chien-Hung Lai
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan. .,International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan. .,School of Gerontology Health Management, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan.
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Zhang Y, Ma ZZ, Wu BW, Dou Y, Zhang Q, Yang LY, Chen EZ. [Establishment of a risk prediction model for bloodstream infection and analysis of its predictive value in patients with extremely severe burns]. Zhonghua Shao Shang Za Zhi 2021; 37:530-537. [PMID: 34139830 DOI: 10.3760/cma.j.cn501120-20210114-00021] [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 establish a prediction model for bloodstream infection in patients with extremely severe burns based on the screened independent risk factors, and to analyze its predictive value. Methods: A retrospective case-control study was conducted. From January 1, 2010 to December 31, 2019, 307 patients with extremely severe burns were admitted to the Department of Burns and Plastic Surgery of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medcine, including 251 males and 56 females, aged from 33 to 55 years. According to the occurrence of bloodstream infection, the patients were divided into non-bloodstream infection group (221 cases) and bloodstream infection group (86 cases). The gender, age, body mass index, outcome, length of hospital stay of patients were compared between the two groups, and the detection of bacteria in blood microbial culture of patients was analyzed in bloodstream infection group. The included 307 patients were divided into modeling group (219 cases) and validation group (88 cases) according to the random number table with the ratio of about 7∶3. The gender, age, body mass index, total burn area, full-thickness burn area, combination of inhalation injury, implementation of mechanical ventilation, days of mechanical ventilation, days of intensive care unit (ICU) stay, outcome, length of hospital stay, complication of bloodstream infection of patients were compared between the two groups. The patients in modeling group were divided into bloodstream infection subgroup and non-bloodstream infection subgroup. The total burn area, full-thickness burn area, combination of inhalation injury, implementation of mechanical ventilation, days of mechanical ventilation, and days of ICU stay of patients were compared between the two subgroups. The above-mentioned data between two groups were statistically analyzed with independent sample t test, chi-square test, and Mann-Whitney U test to screen out the factors with statistical significant differences in the subgroup univariate analysis of modeling group. The factors were used as variables, and binary multivariate logistic regression analysis was used to screen out the risk factors of bloodstream infection in patients with extremely severe burns, based on which the prediction model for bloodstream infection in patients with extremely severe burns of modeling group was established. The receiver operating characteristic (ROC) curve of the prediction model predicting the risk of bloodstream infection of patients in modeling group was drawn, and the area under the ROC curve was calculated. The sensitivity, specificity, and the best prediction probability were calculated according to the Youden index. The patients in validation group were divided into bloodstream infection subgroup (21 cases) and non-bloodstream infection subgroup (67 cases). The prediction probability>the best prediction probability of model was used as the judgment standard of bloodstream infection. The prediction model was used to predict the occurrence of bloodstream infection of patients in the two subgroups of validation group, and the incidence, specificity, and sensitivity of bloodstream infection were calculated, In addition, the ROC curve of the prediction model predicting the risk of bloodstream infection of patients in validation group was drawn, and the area under the ROC curve was calculated. Results: Compared with those of non-bloodstream infection group, the mortality of patients in bloodstream infection group was significantly higher (χ2=8.485, P<0.01), the length of hospital stay was significantly increased (Z=-3.003, P<0.01), but there was no significant change in gender, age, or body mass index (P>0.05). In bloodstream infection group, 110 strains of bacteria were detected in blood microbial culture, among which Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii were the top three bacteria, accounting for 35.45% (39/110), 26.36% (29/110), and 13.64% (15/110) respectively. Gender, age, body mass index, total burn area, full-thickness burn area, proportion of combination of inhalation injury, proportion of implementation of mechanical ventilation, days of mechanical ventilation, days of ICU stay, outcome, length of hospital stay, and proportion of complication of bloodstream infection of patients were similar between modeling group and validation group (P>0.05). Compared with those of non-bloodstream infection subgroup in modeling group, the total burn area, full-thickness burn area, proportion of combination of inhalation injury, proportion of implementation of mechanical ventilation, days of mechanical ventilation, and days of ICU stay of patients in bloodstream infection subgroup were significantly increased (Z=-4.429, t=-4.045, χ2=7.845, 8.845, Z=-3.904, -4.134, P<0.01). Binary multivariate logistic regression analysis showed that total burn area, days of ICU stay, and combination of inhalation injury were the independent risk factors for bloodstream infection of patients in modeling group (odds ratio=1.031, 1.018, 2.871, 95% confidence interval=1.004-1.059, 1.006-1.030, 1.345-6.128, P<0.05 or P<0.01). In modeling group, the area under the ROC curve was 0.773 (95% confidence interval=0.708-0.838); the sensitivity was 64.6%, the specificity was 77.9%, and the best prediction probability was 0.335 when the Youden index was 0.425. The bloodstream infection incidence of patients predicted by the prediction model in validation group was 27.27% (24/88), with specificity of 82.09% (55/67) and sensitivity of 57.14% (12/21). The area under the ROC curve in validation group was 0.759 (95% confidence interval=0.637-0.882). Conclusions: The total burn area, days of ICU stay, and combination of inhalation injury are the risk factors of bloodstream infection in patients with extremely severe burns. The prediction model for bloodstream infection risk in patients with extremely severe burns based on these factors has certain predictive value for burn centers with relatively stable treatment methods and bacterial epidemiology.
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Affiliation(s)
- Y Zhang
- Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai 200025, China
| | - Z Z Ma
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200020, China
| | - B W Wu
- Nursing Department, Ruijin Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai 200025, China
| | - Y Dou
- Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai 200025, China
| | - Q Zhang
- Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai 200025, China
| | - L Y Yang
- Department of Critical Care, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China
| | - E Z Chen
- Emergency Department, Ruijin Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai 200025, China
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Li SX, Li X, Chen XH, Wu XF, Huang JC, Lai XP, Yang LY, Huang ZZ, Zhang GH, Chang LH. [The expression of Notch pathway in nasal polyps and its correlation with the decreased Treg percentage and eosinophil infiltration]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:124-132. [PMID: 33548941 DOI: 10.3760/cma.j.cn115330-20200814-00675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the correlation between Notch pathway expression in nasal polyps and Treg percentage and Eos infiltration. Methods: Patients with chronic sinusitis and simple nasal septum deviation who received nasal endoscopic surgery in the Third Affiliated Hospital of Sun Yat-Sen University between November 2012 and August 2018 were selected and enrolled in CRS group and control group respectively. Nasal mucosa tissues were collected from 30 CRSsNP patients (14 males and 16 females aged from 18 to 63), 58 CRSwNP patients (38 males and 20 females aged from 18 to 65) and 29 patients (19 males and 10 females aged from 20 to 57), who underwent nasal endoscopic surgery for correction of simple nasal septum deviation. Hematoxylin-eosin(HE) staining was used to observe the infiltration of eosinophilic granulocytes in the tissues and to classify chronic sinusitis with polyps (CRSwNP) into eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP)and non-eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of Notch pathway receptors (Notch-l, 2, 3, 4) and their ligands (Jagded-l, Jagded-2, Delta-l, Delta-3and Delta-4) in the nasal mucosa of each group, as well as the expression of Th2 cytokines (IL-4, IL-5, IL-13), eosinophilic cationic protein (ECP)and the key transcription factor Foxp3 in Treg cells. Finally, flow cytometry was used to detect CD4+CD25+Foxp3+ Treg cells in nasal mucosa of each group. Results: Compared with controls, the expression of Th2 cytokines (IL-4, IL-5, IL-13) in CRSsNP and non-Eos-CRSwNP patients was the highest in Eos-CRSwNP (F=16.930,9.197,9.116, all P<0.05). Foxp3 had the lowest expression in Eos-CRSwNP patients and was lower than non-Eos-CRSwNP patients (F=2.780,P<0.05), and was negatively correlated with ECP (r=-0.326,P<0.05). Compared with controls, Eos-CRSwNP patients in CRSsNP patients and non-Eos-CRSwNP patients exhibited a significantly lower frequency of CD4+CD25+Foxp3+Treg cells (F=13.140, all P<0.01). The expression of Notch-l and Jagged-l in Eos-CRSwNP was significantly higher than that of the controls, CRSsNP patients and non-Eos-CRSwNP patients (F=5.953/F=6.380, P<0.05). In the nasal polyp group, the expression of Notch-l and Jagged-l showed significantly negative correlation with Foxp3 (r=-0.611/-0.346, all P<0.05), and positive correlation with Th2 cytokines (IL-4, IL-5, IL-13) and ECP, respectively (r=0.781/0.459,0.621/0.601,0.605/0.490,0.464/0.668, all P<0.05). There was no significant difference in the expression of receptor and ligand of the other Notch pathway among the groups. Conclusion: Abnormal activation of Notch-l/Jagged-l pathway may be involved in decreasing Treg ratio in Eos-CRSwNP, thereby promoting Th2 inflammatory response and Eosinophil infiltration.
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Affiliation(s)
- S X Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X H Chen
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X F Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - J C Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - X P Lai
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - L Y Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Z Z Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - G H Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - L H Chang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
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Long LN, Zhang HH, Wang F, Yin YX, Yang LY, Chen JS. Research Note: Effects of polysaccharide-enriched Acanthopanax senticosus extract on growth performance, immune function, antioxidation, and ileal microbial populations in broiler chickens. Poult Sci 2021; 100:101028. [PMID: 33647719 PMCID: PMC7921867 DOI: 10.1016/j.psj.2021.101028] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/16/2020] [Accepted: 01/01/2021] [Indexed: 11/22/2022] Open
Abstract
Acanthopanax senticosus (AS) is a well-known, highly effective traditional Chinese herbal medicine. Polysaccharides extracted from AS (ASPS) have multiple pharmacologic and biological activities with potential use as additives in broiler chicken feed. This trial evaluated the effects of dietary ASPS on growth performance, immune function, antioxidation, and ileal microbial populations in broiler chickens. A total of 240 1-day-old Arbor Acres male broiler chicks were randomly divided into 4 groups, with 10 replicates of 6 chicks and fed a corn- and soybean-based diet supplemented with 0, 1, 2, or 4 g/kg ASPS. Compared with the control group, supplementation with 1 g/kg ASPS increased ADG and ADFI in the finisher and overall periods and decreased the feed conversion ratio in the finisher period (both P < 0.05). Serum IgA and IgM were significantly increased by supplementation with 1 and 2 g/kg of ASPS (P < 0.05). Superoxide dismutase and glutathione peroxidase activities were increased and malondialdehyde concentration was decreased in birds fed ASPS-supplemented diets compared with those in the control group (P < 0.05). Polysaccharides extracted from AS supplementation increased Lactobacillus and decreased Escherichia coli and Salmonella counts in the ileal contents compared with the control diet (both P < 0.05). The results show that dietary ASPS improved growth performance, immune status, and antioxidant capacity and stimulated the growth of beneficial gut bacteria in broiler chickens. In conclusion, ASPS was effective as a natural additive in broiler chicken feed; 1 g/kg can be considered as the optimum dosage.
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Affiliation(s)
- L N Long
- School of Life Science and Engineering, Foshan University, Foshan 528231, China; Animal Nutritional Genome and Germplasm Innovation Research Center, College of Animal Science and Technology, Hunan Agricultural University, Changsha, Hunan 410128, China
| | - H H Zhang
- School of Life Science and Engineering, Foshan University, Foshan 528231, China
| | - F Wang
- Animal Nutritional Genome and Germplasm Innovation Research Center, College of Animal Science and Technology, Hunan Agricultural University, Changsha, Hunan 410128, China
| | - Y X Yin
- Animal Nutritional Genome and Germplasm Innovation Research Center, College of Animal Science and Technology, Hunan Agricultural University, Changsha, Hunan 410128, China
| | - L Y Yang
- Animal Nutritional Genome and Germplasm Innovation Research Center, College of Animal Science and Technology, Hunan Agricultural University, Changsha, Hunan 410128, China
| | - J S Chen
- Animal Nutritional Genome and Germplasm Innovation Research Center, College of Animal Science and Technology, Hunan Agricultural University, Changsha, Hunan 410128, China; CAS Key Laboratory of Agro ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Changsha 410125, China.
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28
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Qiao G, Tan FX, Yang LY, Yang XF, Liu YS. Correction: Largely enhanced thermoelectric effect and pure spin current in silicene-based devices under hydrogen modification. Nanoscale 2021; 13:1364. [PMID: 33406180 DOI: 10.1039/d0nr90290j] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Correction for 'Largely enhanced thermoelectric effect and pure spin current in silicene-based devices under hydrogen modification' by G. Qiao et al., Nanoscale, 2020, 12, 277-288, DOI: 10.1039/C9NR07541K.
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Affiliation(s)
- G Qiao
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China.
| | - F X Tan
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China. and School of Materials Science and Engineering, China University of Mining and Technology, Xuzhou 221116, China
| | - L Y Yang
- School of Mechanical Engineering, Changshu Institute of Technology, Changshu 215500, China.
| | - X F Yang
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China.
| | - Y S Liu
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China.
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Chang SL, Kuo MJ, Lin YJ, Chen SA, Yang YY, Cheng HM, Yang LY, Kao SY, Lee FY. Virtual reality informative aids increase residents' atrial fibrillation ablation procedures-related knowledge and patients' satisfaction. J Chin Med Assoc 2021; 84:25-32. [PMID: 33230060 DOI: 10.1097/jcma.0000000000000464] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia, and increasing numbers of patients receive AF ablation nowadays. Therefore, in the cardiology division, residents need to be familiar with the AF ablation procedure-related knowledge for primary care. This study evaluated the baseline residents and patients' self-efficacy to the AF ablation procedure-related knowledge, developed the specific virtual reality (VR) informative aids, and evaluated the effects of VR training and resident-led VR aids-based patient education on their self-efficacy, in the aspects of familiarity, confidence and anxiety, and satisfaction. METHODS From 2019, April to 2020, April, this 1-year prospective prestudy and poststudy was undergone in the cardiology division. Between 2019, April and 2019, December, the experienced physicians were invited to develop VR informative aids for AF ablation procedure-related knowledge. Between January 2020 and April 2020, newly developed VR informative aids were implemented in the educational program of training rotated residents for giving patient education. RESULT A total of 20 residents and 32 patients were enrolled. The baseline self-reported self-efficacy and knowledge scores were relatively low among rotated residents and their patients. In addition to the high level of satisfaction, self-efficacy and knowledge scores of residents and their patients were increased after VR aids-based training and resident-led patient education. Higher degree of improvement in self-efficacy was noted among patients with depression/anxiety history than those without history. The follow-up assessments among residents showed that the positive effects of VR aids were sustained until 2 weeks later. CONCLUSION Overall, residents and patients reported that the VR aids increase the effectiveness of patient education, achieve the purpose of a paperless environment, and motivate them to recommend it to others. The implementation of resident-to-patient education has a positive impact on trainees and patients understanding about AF ablation procedures-related knowledge.
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Affiliation(s)
- Shih-Lin Chang
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ming-Jen Kuo
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yenn-Jiang Lin
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shih-Ann Chen
- Vice Superintendent, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Ying Yang
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hao-Min Cheng
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Vice Superintendent, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fa-Yauh Lee
- Vice Superintendent, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Wu CH, Huang YC, Chiang DH, Yang YY, Yang LY, Kao SY, Chen CH, Lee FY. A quality improvement pilot project of training nurses to use VR educational aids to increase oral cancer patients' pretreatment knowledge and satisfaction. Eur J Oncol Nurs 2020; 49:101858. [PMID: 33130425 DOI: 10.1016/j.ejon.2020.101858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/05/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Cheng-Hsien Wu
- Division of Family Dentistry, Department of Stomatollgy, Taipei Veteran General Hospital, Taipei, Taiwan; School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Chen Huang
- Department of Nursing, Taipei Veteran General Hospital, Taiwan; School of Nursing, National Yang-Ming University, Taipei, Taiwan.
| | - Dung-Hung Chiang
- Department of Critical Care Medicine, Taipei Veteran General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Ying-Ying Yang
- Division of Clinical Skills Training Center, Department of Medical Education, Taipei Veteran General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Ling-Yu Yang
- Department of Medical Education, Taiwan; Faculty of Medicine, Taiwan.
| | - Shou-Yen Kao
- Division of Family Dentistry, Department of Stomatology, Taiwan; School of Dentistry, Taiwan; National Yang-Ming University, Taipei, Taiwan.
| | - Chen-Huan Chen
- Department of Medical Education, Taiwan; Faculty of Medicine, Taiwan; National Yang-Ming University, Taipei, Taiwan.
| | - Fa-Yauh Lee
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University, Taipei, Taiwan.
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Abstract
RATIONALE Corpus callosum syndrome is a rare consequence of traumatic brain injuries. We provide a case of a patient with typical corpus callosum syndrome following a traumatic brain injury, and demonstrate neural reorganization and significant neural regeneration after comprehensive rehabilitation, using diffusion tensor imaging fiber bundle tracking. PATIENT CONCERNS We found typical clinical manifestations of damage to the corpus callosum. DIAGNOSES, INTERVENTIONS, AND OUTCOMES We diagnosed a Traumatic Brain Injury (diffuse axonal injury and rupture of corpus callosum). The patient underwent a comprehensive multifaceted rehabilitation program including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, transcranial magnetic stimulation, and hyperbaric oxygen therapy. This rehabilitation program resulted in greatly improved physical and communication ability. LESSONS Comprehensive rehabilitation can significantly improve the function of patients with corpus callosum syndrome and may cause neural remodeling, as seen on diffusion tensor imaging.
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Affiliation(s)
- Xiao-Li Wu
- Department of Neurorehabilitation, Rehabilitation Medicine of Capital Medical University, China Rehabilitation Research Centre, Beijing, China
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Lin CT, Lecca D, Yang LY, Luo W, Scerba MT, Tweedie D, Huang PS, Jung YJ, Kim DS, Yang CH, Hoffer BJ, Wang JY, Greig NH. 3,6'-dithiopomalidomide reduces neural loss, inflammation, behavioral deficits in brain injury and microglial activation. eLife 2020; 9:e54726. [PMID: 32589144 PMCID: PMC7375814 DOI: 10.7554/elife.54726] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/12/2020] [Indexed: 12/19/2022] Open
Abstract
Traumatic brain injury (TBI) causes mortality and disability worldwide. It can initiate acute cell death followed by secondary injury induced by microglial activation, oxidative stress, inflammation and autophagy in brain tissue, resulting in cognitive and behavioral deficits. We evaluated a new pomalidomide (Pom) analog, 3,6'-dithioPom (DP), and Pom as immunomodulatory agents to mitigate TBI-induced cell death, neuroinflammation, astrogliosis and behavioral impairments in rats challenged with controlled cortical impact TBI. Both agents significantly reduced the injury contusion volume and degenerating neuron number evaluated histochemically and by MRI at 24 hr and 7 days, with a therapeutic window of 5 hr post-injury. TBI-induced upregulated markers of microglial activation, astrogliosis and the expression of pro-inflammatory cytokines, iNOS, COX-2, and autophagy-associated proteins were suppressed, leading to an amelioration of behavioral deficits with DP providing greater efficacy. Complementary animal and cellular studies demonstrated DP and Pom mediated reductions in markers of neuroinflammation and α-synuclein-induced toxicity.
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Affiliation(s)
- Chih-Tung Lin
- Graduate Institute of Medical Sciences, Taipei Medical UniversityTaipeiTaiwan
| | - Daniela Lecca
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIHBaltimoreUnited States
| | - Ling-Yu Yang
- Graduate Institute of Medical Sciences, Taipei Medical UniversityTaipeiTaiwan
| | - Weiming Luo
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIHBaltimoreUnited States
| | - Michael T Scerba
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIHBaltimoreUnited States
| | - David Tweedie
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIHBaltimoreUnited States
| | - Pen-Sen Huang
- Graduate Institute of Medical Sciences, Taipei Medical UniversityTaipeiTaiwan
| | - Yoo-Jin Jung
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIHBaltimoreUnited States
| | - Dong Seok Kim
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIHBaltimoreUnited States
- AevisBio IncGaithersburgUnited States
- AevisBio IncDaejeonRepublic of Korea
| | - Chih-Hao Yang
- Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical UniversityTaipeiTaiwan
| | - Barry J Hoffer
- Department of Neurological Surgery, Case Western Reserve UniversityClevelandUnited States
| | - Jia-Yi Wang
- Graduate Institute of Medical Sciences, Taipei Medical UniversityTaipeiTaiwan
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical UniversityTaipeiTaiwan
- Neuroscience Research Center, Taipei Medical UniversityTaipeiTaiwan
| | - Nigel H Greig
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIHBaltimoreUnited States
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Shulruf B, Yang YY, Huang PH, Yang LY, Huang CC, Huang CC, Liu CW, Huang SS, Chen CH, Lee FY, Kao SY. Standard setting made easy: validating the Equal Z-score (EZ) method for setting cut-score for clinical examinations. BMC Med Educ 2020; 20:167. [PMID: 32450878 PMCID: PMC7249316 DOI: 10.1186/s12909-020-02080-x] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND This study aims to assess the feasibility, reliability and validity of the panel-based Equal Z-score (EZ) method applied to objective structural clinical examination (OSCE) of Chinese medical students and undertaking a comparison with the statistical techniques-based Borderline Regression Method (BRM). METHODS Data received from two cohorts of 6th and 7th year medical students in Taiwan who set the mock OSCE as a formative assessment. Traditionally this medical school uses BRM to set the pass/fail cut-score. For the current study, 31 OSCE panellists volunteered to participate in the EZ method in parallel to the BRM. RESULTS In the conduct of this study, each panel completed this task for an OSCE exam comprising 12 stations within less than 60 min. Moreover, none of the 31 panellists, whose are busy clinicians, had indicated that the task was too difficult or too time-consuming. Although EZ method yielded higher cut-scores than the BRM it was found reliable. Intraclass correlation (ICC) measuring absolute agreement, across the three groups of panellists was .893 and .937 for the first and second rounds respectively, demonstrating high level of agreement across groups with the EZ method and the alignment between the BRM and the EZ method was visually observed. The paired t-test results identified smaller differences between the cut-scores within methods than across methods. CONCLUSIONS Overall this study suggests that the EZ method is a feasible, reliable and valid standard setting method. The EZ method requires relatively little resources (takes about an hour to assess a 12 station OSCE); the calculation of the cut-score is simple and requires basic statistical skills; it is highly reliable even when only 10 panellists participate in the process; and its validity is supported by comparison to BRM. This study suggests that the EZ method is a feasible, reliable and valid standard setting method.
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Affiliation(s)
- Boaz Shulruf
- University of New South Wales, Sydney, Australia.
| | - Ying-Ying Yang
- National Yang-Ming University, Taipei, Taiwan.
- Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Pin-Hsiang Huang
- University of New South Wales, Sydney, Australia
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | | | | | - Chih-Wei Liu
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Chen-Huan Chen
- National Yang-Ming University, Taipei, Taiwan
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shou-Yen Kao
- Taipei Veterans General Hospital, Taipei, Taiwan
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Wu SH, Yang YY, Huang CC, Liu CW, Yang LY, Chen CH, Kao SY, Lee FY. Virtual reality simulation increases Chinese physicians’ and lab technicians’ familiarity and confidence regarding proper clinical wastes segregation/disposal: a 2-year pilot study. BMJ Simul Technol Enhanc Learn 2020; 7:38-40. [PMID: 35521086 PMCID: PMC8936531 DOI: 10.1136/bmjstel-2019-000554] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/26/2019] [Accepted: 05/01/2020] [Indexed: 11/16/2022]
Abstract
Although they receive regular training, the survey we administered to our junior physicians and lab technicians revealed that they lack familiarity and confidence regarding the proper segregation/disposal of clinical wastes. In this pilot prospective study, carried out between September 2017 and September 2019, we developed a virtual reality (VR) simulation and integrated it into the steps of Gangen’s training flow. Next, we analysed objective performance, recorded by the App in the VR system as well as the subjective self-assessments of 96 junior physicians and lab technicians after two practices of VR games. Before receiving training, lab technicians' self-assessed familiarity and confidence regarding proper clinical wastes segregation/disposal were higher than among physicians. Compared with the first VR game, we noted greater improvement in accuracy as well as a higher percentage of shortened time to complete 10 actions of segregation/disposal of VR clinical wastes, among junior physicians/male trainees, that of junior lab technicians/female trainees in the second VR game. Most of the trainees (81%–88%) reported that they found the VR game-based training to be useful, in contrast to poster-mass media-based training. Our initial positive results indicated the possibility of applying this VR game-based simulation system to regular institution-wide staff education in future.
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Affiliation(s)
- Szu-Hsien Wu
- Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Ying Yang
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Chang Huang
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Wei Liu
- Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ling-Yu Yang
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chen-Huan Chen
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Clinical Skills Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shou-Yen Kao
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- Taipei Veterans General Hospital, Taipei, Taiwan
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Lee FY, Yang YY, Huang CC, Huang LJ, Chang CC, Liang JF, Huang SS, Lee WS, Lu DY, Chuang CL, Yang LY, Huang HC, Shulruf B, Chen CH, Kao SY. Sustained effects of faculty leadership development modules for clinical instructors of core competences education in Taiwan: a four-year explanatory case study. BMC Med Educ 2020; 20:155. [PMID: 32414406 PMCID: PMC7226719 DOI: 10.1186/s12909-020-02065-w] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The Accreditation Council for Graduate Medical Education (ACGME) core competencies (CC) in general medicine-based primary care are essential for junior medical trainees. In this country, a regular faculty development (FD) program aimed at training faculty in instructing (teaching and assessing) these CC had operated. However, leadership was not emphasized. In a new intervention module, the roles and associated responsibilities of clinical instructors to conduct, design, and lead CC-based education were emphasis. AIMS This follow-up explanatory case study compares the effectiveness of intervention module with that of the previous regular module. METHODS The regular group (n = 28) comprised clinical instructors who participated in the FD module during the 2013-2014 year while the intervention group (n = 28) was composed of 2015-2016 participants. Prior to the formal (hands-on) training, participants in the intervention group were asked to study the online materials of the regular module. These participants then received a 30-h hands-on training in conducting, designing, and leading skills. Finally, they prepared a 10-h reflective end-of-module presentation of their real-world practices. RESULTS Following the training, a higher degree improvement in participants self-reported familiarity with CC education, self-confidence in their ability to deliver CC education and sustained involve CC education were noted among the intervention FD group, compared with the regular FD group. In the intervention group, senior academicians (associate and full professor) are more substantially involved in designing and leading CC-based courses than junior academicians (lecturers and assistant professors). Among non-teaching award winners of in the intervention FD group, the follow-up degree of sustained involvement in delivering, designing and leading CC-based courses was significantly higher than that of the regular group. CONCLUSIONS Our study demonstrated that leadership training in the intervention FD modules substantially motivated clinical instructors to become leaders in CC education.
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Affiliation(s)
- Fa-Yauh Lee
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
| | - Ying-Ying Yang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan.
- Division of Clinical Skills Training Center, Taipei Veteran General Hospital , Taipei, Taiwan.
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
- Department of Medicine, Taipei Veteran General Hospital , Taipei, Taiwan.
| | - Chia-Chang Huang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Division of Clinical Skills Training Center, Taipei Veteran General Hospital , Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ling-Ju Huang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Chih Chang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Feng Liang
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
| | - Shiau-Shian Huang
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Bali Psychiatric Center, Ministry of Health and Welfare, Bali, Taiwan
| | - Wei-Shin Lee
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Dai-Yin Lu
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chiao-Lin Chuang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ling-Yu Yang
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
| | - Hui-Chun Huang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Boaz Shulruf
- New South Wales Sydney University, Sydney, Australia
| | - Chen-Huan Chen
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
| | - Shou-Yen Kao
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
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Tsai HL, Chang JW, Chen MH, Jeng MJ, Yang LY, Wu KG. Associations Between Psychiatric Disorders and Enuresis in Taiwanese Children: A National Population-Based Study. Clin Epidemiol 2020; 12:163-171. [PMID: 32110107 PMCID: PMC7035896 DOI: 10.2147/clep.s230537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 09/10/2019] [Accepted: 12/07/2019] [Indexed: 11/23/2022] Open
Abstract
Background Psychiatric disorders such as attention-deficit/hyperactivity disorder may negatively impact drug compliance and the prognosis of enuresis. However, existing studies regarding associations between lifetime psychiatric disorders and childhood enuresis are primarily from Western countries, and studies from Taiwan are lacking. Methods We conducted a population-based retrospective cohort analysis using the Taiwan Longitudinal Health Insurance Database 2010. A total of 1,146 children with enuresis (ICD-9-CM code: 307.6) and 4,584 randomly selected sex- and age-matched controls were identified between January 1, 1997 and December 31, 2011. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the development of psychiatric disorders in the children with enuresis. Results Enuresis was more common in the younger children, and the rate was significantly higher in boys (58.7%) than in girls (41.3%). A total of 171 patients (14.9%) in the enuresis group had at least one psychiatric diagnosis vs 259 (5.7%) in the control group (p<0.001). Multivariate analysis showed that the presence of enuresis increased the odds of developing major depressive/dysthymic disorder (OR=2.841, 95% CI: 1.619, 4.987), attention-deficit/hyperactivity disorder (OR=3.156, 95% CI: 2.446, 4.073), autism spectrum disorder (OR=2.468, 95% CI: 1.264, 4.822), anxiety disorders (OR=3.113, 95% CI: 2.063, 4.699), intelligence disability (OR=3.989, 95% CI: 2.476, 6.426), disruptive behavior disorders (OR=3.749, 95% CI: 1.756, 8.004), and tic disorder (OR=2.660, 95% CI: 1.642, 4.308). Conclusion Children with enuresis are likely to have psychiatric disorders, and physicians should consider this during their evaluation.
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Affiliation(s)
- Hsin-Lin Tsai
- Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jei-Wen Chang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mei-Jy Jeng
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ling-Yu Yang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Keh-Gong Wu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
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Abstract
Large hepatocellular carcinoma (HCC) is one of the most common malignancies and was mistaked as "advanced and unresectable" . Liver resection is still the best curable treatment for HCC.The resection of large HCC is very difficult, which seriously restrict the progress of liver surgery.Our study proved that solitary large HCC (SLHCC) has unique clinicopathological and molecular biological characteristics.No matter how big the tumor size is, it belongs to early stage if there is no vascular invasion.Liver resection should be aggressively recommended for the patients with SLHCC, in which they can obtain good outcome, with 40% 5-year survival rate.We has also defined the borderline resectable hepatocellular carcinoma, and suggested that strictly master and correctly judge the surgical indications, syntheticly evaluate the surgical safety and patient's tolerability for liver resection.After that, with hands of experienced surgeons, liver resection for SLHCC can be safely and reliablely performed.
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Affiliation(s)
- L Y Yang
- Department of Surgery, Xiang Ya Hospital, Central South University, Changsha 410008, China
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Qiao Q, Tan FX, Yang LY, Yang XF, Liu YS. Largely enhanced thermoelectric effect and pure spin current in silicene-based devices under hydrogen modification. Nanoscale 2020; 12:277-288. [PMID: 31825044 DOI: 10.1039/c9nr07541k] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Based on the density functional theory and nonequilibrium Green's function methods, we launch a systematic study of the magnetic properties and thermoelectric effects in silicene-based devices constructed by using zigzag silicene nanoribbons (ZSiNRs). By modulating the adsorption site, it is found that the ground state of ZSiNRs varies from an antiferromagnetic state to a ferromagnetic state. Meanwhile, a spin-degenerate semiconductor evolves into a spin semiconductor. The spin and charge thermoelectric figure of merits have an almost equal value of about 60 in the narrow device, which originates from the spin-dependent conductance dips and high spin-filtering effects. Moreover, a thermally-driven pure spin current in the silicene-based devices is obtained in the absence of the gate voltage, and its magnitude is effectively enhanced as the device width increases. Our results suggest that the silicene-based devices have very good prospects for spin caloritronics.
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Affiliation(s)
- Q Qiao
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China.
| | - F X Tan
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China. and School of Materials Science and Engineering, China University of Mining and Technology, Xuzhou 221116, China
| | - L Y Yang
- School of Mechanical Engineering, Changshu Institute of Technology, Changshu 215500, China.
| | - X F Yang
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China.
| | - Y S Liu
- School of Physics and Electronic Engineering, Changshu Institute of Technology, Changshu 215500, China.
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Praveen Rajneesh C, Hsieh TH, Chen SC, Lai CH, Yang LY, Chin HY, Peng CW. Deep Brain Stimulation of the Pedunculopontine Tegmental Nucleus Renders Neuroprotection through the Suppression of Hippocampal Apoptosis: An Experimental Animal Study. Brain Sci 2020; 10:brainsci10010025. [PMID: 31906559 PMCID: PMC7016688 DOI: 10.3390/brainsci10010025] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 11/26/2022] Open
Abstract
The core objective of this study was to determine the neuroprotective properties of deep brain stimulation of the pedunculopontine tegmental nucleus on the apoptosis of the hippocampus. The pedunculopontine tegmental nucleus is a prime target for Parkinson′s disease and is a crucial component in a feedback loop connected with the hippocampus. Deep brain stimulation was employed as a potential tool to evaluate the neuroprotective properties of hippocampal apoptosis. Deep brain stimulation was applied to the experimental animals for an hour. Henceforth, the activity of Caspase-3, myelin basic protein, Bcl-2, BAX level, lipid peroxidation, interleukin-6 levels, and brain-derived neurotrophic factor levels were evaluated at hours 1, 3 and 6 and compared with the sham group of animals. Herein, decreased levels of caspases activity and elevated levels of Bcl-2 expressions and inhibited BAX expressions were observed in experimental animals at the aforementioned time intervals. Furthermore, the ratio of Bcl-2/BAX was increased, and interleukin -6, lipid peroxidation levels were not affected by deep brain stimulation in the experimental animals. These affirmative results have explained the neuroprotection rendered by hippocampus apoptosis as a result of deep brain stimulation. Deep brain stimulation is widely used to manage neuro-motor disorders. Nevertheless, this novel study will be a revelation for a better understanding of neuromodulatory management and encourage further research with new dimensions in the field of neuroscience.
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Affiliation(s)
- Chellappan Praveen Rajneesh
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan; (C.P.R.); (L.-Y.Y.)
| | - Tsung-Hsun Hsieh
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (S.-C.C.); (C.-H.L.)
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Chien-Hung Lai
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (S.-C.C.); (C.-H.L.)
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Ling-Yu Yang
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan; (C.P.R.); (L.-Y.Y.)
| | - Hung-Yen Chin
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei 11031, Taiwan;
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei-11031, Taiwan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan; (C.P.R.); (L.-Y.Y.)
- Research Center of Biomedical Device, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel./Fax: +886-2-2736-1661 (ext. 3070)
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Yang LY, Greig NH, Tweedie D, Jung YJ, Chiang YH, Hoffer BJ, Miller JP, Chang KH, Wang JY. The p53 inactivators pifithrin-μ and pifithrin-α mitigate TBI-induced neuronal damage through regulation of oxidative stress, neuroinflammation, autophagy and mitophagy. Exp Neurol 2019; 324:113135. [PMID: 31778663 DOI: 10.1016/j.expneurol.2019.113135] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 06/30/2019] [Revised: 10/20/2019] [Accepted: 11/24/2019] [Indexed: 01/06/2023]
Abstract
Traumatic brain injury (TBI) is one of the most common causes of death and disability worldwide. We investigated whether inhibition of p53 using pifithrin (PFT)-α or PFT-μ provides neuroprotective effects via p53 transcriptional dependent or -independent mechanisms, respectively. Sprague Dawley rats were subjected to controlled cortical impact TBI followed by the administration of PFTα or PFT-μ (2 mg/kg, i.v.) at 5 h after TBI. Brain contusion volume, as well as sensory and motor functions were evaluated at 24 h after TBI. TBI-induced impairments were mitigated by both PFT-α and PFT-μ. Fluoro-Jade C staining was used to label degenerating neurons within the TBI-induced cortical contusion region that, together with Annexin V positive neurons, were reduced by PFT-μ. Double immunofluorescence staining similarly demonstrated that PFT-μ significantly increased HO-1 positive neurons and mRNA expression in the cortical contusion region as well as decreased numbers of 4-hydroxynonenal (4HNE)-positive cells. Levels of mRNA encoding for p53, autophagy, mitophagy, anti-oxidant, anti-inflammatory related genes and proteins were measured by RT-qPCR and immunohistochemical staining, respectively. PFT-α, but not PFT-μ, significantly lowered p53 mRNA expression. Both PFT-α and PFT-μ lowered TBI-induced pro-inflammatory cytokines (IL-1β and IL-6) mRNA levels as well as TBI-induced autophagic marker localization (LC3 and p62). Finally, treatment with PFT-μ mitigated TBI-induced declines in mRNA levels of PINK-1 and SOD2. Our data suggest that both PFT-μ and PFT-α provide neuroprotective actions through regulation of oxidative stress, neuroinflammation, autophagy, and mitophagy mechanisms, and that PFT-μ, in particular, holds promise as a TBI treatment strategy.
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Affiliation(s)
- Ling-Yu Yang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Nigel H Greig
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - David Tweedie
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Yoo Jin Jung
- Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program National Institute on Aging, NIH, Baltimore, MD 21224, USA
| | - Yung-Hsiao Chiang
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei 110, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei 110, Taiwan
| | - Barry J Hoffer
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Jonathan P Miller
- Department of Neurological Surgery, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Ke-Hui Chang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Jia-Yi Wang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan; Department of Neurosurgery, Taipei Medical University Hospital, Taipei 110, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei 110, Taiwan.
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Praveen Rajneesh C, Yang LY, Chen SC, Hsieh TH, Chin HY, Peng CW. Cystometric Measurements in Rats with an Experimentally Induced Traumatic Brain Injury and Voiding Dysfunction: A Time-Course Study. Brain Sci 2019; 9:brainsci9110325. [PMID: 31739594 PMCID: PMC6895874 DOI: 10.3390/brainsci9110325] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Received: 10/25/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injuries (TBIs) are a serious public health issue worldwide with increased mortality as well as severe disabilities and injuries caused by falls and road accidents. Unfortunately, there is no approved therapy for TBIs, and bladder dysfunction is a striking symptom. Accordingly, we attempted to analyze bladder dysfunction and voiding efficiency in rats with a TBI at different time-course intervals. Time-dependent analyses were scheduled from the next day until four weeks after a TBI. Experimental animals were grouped and analyzed under the above conditions. Cystometric measurements were used for this analysis and were further elaborated as external urethral sphincter electromyographic (EUS-EMG) activity and cystometrogram (CMG) measurements. Moreover, magnetic resonance imaging (MRI) studies were conducted to investigate secondary injury progression in TBI rats, and results were compared to normal control (NC) rats. Results of EUS-EMG revealed that the burst period, active period, and silent period in TBI rats were drastically reduced compared to NC rats, but they increased later and reached a stagnant phase. Likewise, in CMG measurements, bladder function, the voided volume, and voiding efficiency decreased immediately after the TBI, and other parameters like the volume threshold, inter-contraction interval, and residual volume drastically increased. Later, those levels changed, and all observed results were compared to NC rats. MRI results revealed the prevalence of cerebral edema and the progression of secondary injury. All of the above-stated results of the experiments were extensively substantiated. Thus, these innovative findings of our study model will surely pave the way for new therapeutic interventions for TBI treatment and prominently highlight their applications in the field of neuroscience in the future.
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Affiliation(s)
- Chellappan Praveen Rajneesh
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei-11031, Taiwan
| | - Ling-Yu Yang
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei-11031, Taiwan
| | - Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei-11031, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei-11031, Taiwan
| | - Tsung-Hsun Hsieh
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan-33302, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou-33305, Taiwan
| | - Hung-Yen Chin
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei-11031, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei-11031, Taiwan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei-11031, Taiwan
- Research Center of Biomedical Device, Taipei Medical University, Taipei-11031, Taiwan
- Correspondence: ; Tel./Fax: +886-2-2736-1661 (ext. 3070)
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Shiao TH, Yang YY, Wu CY, Yang LY, Hwang SJ, Huang CC, Liang JF, Kao SY, Lee FY. Creation of nurse-specific integrated interprofessional collaboration and team-efficiency scenario/video improves trainees' attitudes and performances. J Chin Med Assoc 2019; 82:546-553. [PMID: 31274786 DOI: 10.1097/jcma.0000000000000116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND It is importance to train the interprofessional collaboration (IPC) and team-efficiency (TE) of medical trainees. This prospective study evaluates whether implementation of scenario/video-created workshops in integrated IPC and TE (IIT) program provides additional benefits for IPC-TE skills of nursing trainees. METHODS Mock simulation with two IIT scenarios was held as preintervention IPC-TE assessment. Basic and advanced workshops were arranged for teams of intervention groups for creation of discipline-specific scenario and video. Thirty-six nursing trainees were randomized into teams of five members (three nursing students, one standardized medical student, and one standardized trainees of other profession) in either intervention (scenario plus video and scenario) or control groups. After intervention, all groups received the formal simulation-based assessment using another two IIT scenario. In addition to instructors-based assessment of team' performance in mock and formal IIT simulation using interprofessional team collaboration scale (AITCS), self-assessment of attitudes and program-value score were completed by each trainee, using attitudes toward interprofessional health care teams scale (ATIHCTS) at all stages. RESULTS Nursing trainees in intervention group gave high satisfaction score to this IIT intervention. In comparison with control group, greater increase in instructor-assessed team performance in the "partnership," "cooperation," and "shared decision making" domains of AITCS and the self-assessed "quality of care delivery" and TE domains of ATIHCTS were noted in the intervention groups. The overall improvement was greater in the scenario plus video group than those in the scenario group. Further, these improvements among nursing trainees persisted until follow-up stage at 4-weeks later. CONCLUSION For nursing trainees, our study suggested that implementation of a scenario creation-based training resulted in additional improvement in trainee' IPC and TE behaviors and attitudes. Additionally, making video of newly created nurse-specific scenario enhances partnership and cooperation among nursing trainees and their interprofessional team members.
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Affiliation(s)
- Tsu-Hui Shiao
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Ying Yang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chen-Yi Wu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shinn-Jang Hwang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chia-Chang Huang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Jen-Feng Liang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fa-Yauh Lee
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Chang CC, Lirng JF, Wang PN, Wang SJ, Chen CH, Yang LY, Huang WJ, Huang HC. A pilot study of integrating standardized patients in problem-based learning tutorial in Taiwan. J Chin Med Assoc 2019; 82:464-468. [PMID: 31008811 DOI: 10.1097/jcma.0000000000000109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Problem-based learning (PBL) has been widely adopted in medical education; however, its application has been questioned due to the lack of interaction with a real patient. Standardized patients (SPs) might solve this problem. Herein, we tested the impact of integrating SPs in a PBL tutorial. METHODS In 2017, a total of 313 students, 66 facilitators, and 36 SPs were enrolled at National Yang-Ming University, Taiwan. The SPs presented the symptoms/signs of the cases then the students interviewed them to obtain the detail history. All students, facilitators, and SPs were invited to complete the questionnaires before and after this program. RESULTS Most SPs considered that both the second-year dental medical student and third-year medical students participated actively and were competent enough but students and facilitators considered that the fourth-year medical students might be more prepared. Overall, the students thought highly of the interactions with the SPs. Only about one-fifth felt that this design caused unnecessary pressure among the students and facilitators. They agreed that this program significantly inspired the student's learning motivation (pre- vs post-course: 4.1 ± 0.7 vs 4.3 ± 0.7, p < 0.001), increased their confidence level in interviewing patients (4.0 ± 0.8 vs 4.2 ± 0.7, p < 0.001), and encouraging critical thinking (4.0 ± 0.7 vs 4.2 ± 0.7, p < 0.001). CONCLUSION The SPs, facilitators, and students had different viewpoints with regards to integrating SPs in the PBL tutorial. However, a majority agreed that this design enhanced the motivation of students and supported such an application in PBL tutorials.
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Affiliation(s)
- Ching-Chih Chang
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
| | - Jiing-Feng Lirng
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Pei-Ning Wang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shuu-Jiun Wang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
- Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chen-Huan Chen
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - William J Huang
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hui-Chun Huang
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
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Su CJ, Pan SW, Huang LJ, Yang LY, Yang YY, Hwang SJ, Chuang CL, Chang CC, Huang HC, Kao SY, Lee FY. Trios-OSCE-based simulation course enhances the subcompetency of emergency-stabilization for postgraduate year-1 residents. J Chin Med Assoc 2019; 82:407-412. [PMID: 31058714 DOI: 10.1097/jcma.0000000000000089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND For patient safety, this study aims to evaluate the effectiveness of additional objective structured clinical examination (OSCE)-based medical simulation courses to establish the "emergency-stabilization" subcompetency of postgraduate first year (PGY-1) residents. METHODS In the simulation course, trainees were randomly divided into three groups: intervention, regular, and control group as Trios-OSCE trainees, Single-OSCE trainees, or OSCE observers (feedback-givers) after attending the pre-OSCE common simulation workshop. Three PGY-1 residents rotated through the Trios OSCE long-station together, while single PGY-1 residents rotated through regular OSCE alone and the control group gave feedback after observation of their peers' OSCE performance. Using Queen's simulation assessment tool, either in Trios-OSCE or Single-OSCE, performance levels were rated as either inferior, novice, competent, advanced or superior in the "therapeutic actions" and "communication" domains. The "overall performances" of all trainees were graded by qualified assessors, experienced facilitators, and standardized senior nurse. RESULTS The proportion of "overall performance" of trainee's, rated by an experienced facilitator as "above competent level," was significantly higher in intervention group A than in regular group B. After training, the degree of increase in self-efficacy scores was higher among the intervention group than the regular and control groups. In the follow-up stage, a trend of increasing self-efficacy scores was noted in both the interventional and regular groups. For all trainees among the three groups, high postcourse value scores confirm that the new Trios-OSCE model meets the needs of trainees and also motivates the self-directed learning and self-reflection of trainees. CONCLUSION Our results provide initial evidence that the new emergency-stabilization-enhanced Trios-OSCE-based medical simulation course including the additional training capacity offered by adding an observer group had positive effects on PGY-1 residents' self-efficacy and clinical transfer.
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Affiliation(s)
- Chia-Jui Su
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Sheng-Wei Pan
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ling-Ju Huang
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ying-Ying Yang
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shinn-Jang Hwang
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chiao-Lin Chuang
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ching-Chih Chang
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hui-Chun Huang
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Fa-Yauh Lee
- Department of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Li YT, Chen SC, Yang LY, Hsieh TH, Peng CW. Designing and Implementing a Novel Transcranial Electrostimulation System for Neuroplastic Applications: A Preliminary Study. IEEE Trans Neural Syst Rehabil Eng 2019; 27:805-813. [PMID: 30951469 DOI: 10.1109/tnsre.2019.2908674] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Recently, a specific repetitive transcranial magnetic stimulation (rTMS) waveform, namely, the theta burst stimulation (TBS) protocol, has been proposed for more efficiently inducing neuroplasticity for various clinic rehabilitation purposes. However, few studies have explored the feasibility of using the TBS combined with direct current (dc) waveform for brain neuromodulation; this waveform is transcranially delivered using electrical current power rather than magnetic power. This study implemented a prototype of a novel transcranial electrostimulation device that can flexibly output a waveform that combined dc and the TBS-like protocol and assessed the effects of the novel combinational waveform on neuroplasticity. An in vivo experiment was conducted first to validate the accuracy of the stimulator's current output at various impedance loads. Using this transcranial stimulator, a series of transcranial stimulation experiments was conducted on the brain cortex of rats, in which electrode-tissue impedance and motor evoked potentials (MEPs) were measured. These experiments were designed to assess the feasibility and efficacy of the new combinational waveforms for brain neuroplasticity. Our results indicated that the transcranial electrostimulation system exhibited satisfactory performance, as evidenced by the error percentage of less than 5% for current output. In the animal experiment, the dc combined with intermittent TBS-like protocol exerted a stronger neuroplastic effect than the conventional dc protocol. These results demonstrated that the combination of electrical dc and TBS-like protocols in our system can produce a new feasible therapeutic waveform for transcranially inducing a promising neuromodulatory effect on various diseases of the central nervous system.
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Wu SH, Yang YY, Shulruf B, Yang LY, Chen CH, Lee FY. Engaging trainees by actively giving feedback will increase their receptiveness to peer' feedback and motivate behavior-changes in holistic care: a pilot study. MedEdPublish 2019. [DOI: 10.15694/mep.2019.000049.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article was migrated. The article was not marked as recommended. Background: Continuous trainings of holistic-care behaviors, including teamwork and communication, are important for health professionals to ensure holistic care. In holistic-care simulation training, receiving feedback is a regular step to help trainees assess and rethink their practice. Initial acceptance of feedback by trained health professionals will motivate them in changing behaviors. So, it is importance to increase the trainee's initial receptiveness of in-training feedback. Objective: This study aims to evaluate whether engaging trainees by actively giving feedback will increase their receptiveness to peer' feedback and motivate behavior changes in holistic care. Methods: Health professionals without previous holistic-care training were enrolled, and randomly divided into feedback-giver groups including A (bi-directional feedback recipients and givers group) and C (unidirectional feedback givers group) groups, and non-feedback givers group B (regular feedback recipients group). In addition to immediate satisfaction and receptiveness to in-training peer-feedback, the percentages of health professionals who are willing to make immediate and continuous motivated type of behavior-change were compared between groups. Results: Higher satisfaction score and higher percentage of motivated type behavior changes were noted in feedback-giving-groups (A and C) than those in non-feedback-giving group (B). The feedback training's effectiveness was confirmed by high preceptor approval of trainee's feedback skills and trainees' good receptivity to their peers' feedback. Self- and mentor-assessments revealed that initial positive receptiveness (determined by high positivity and usefulness scores) to peer's feedback is associated with more motivated-type behavior changes in their clinical practice. Conclusion: Current study suggested that feedback-giving training is a feasible strategy to increase receptiveness of participants to peer's feedback and activate participants' motivation to make the immediate and continuous behavior-type changes on giving holistic-care behavior-specific peer-feedback.
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Shiao TH, Wu CY, Yang YY, Chang SC, Shulruf B, Yang LY, Chen CH, Lee FY. Pilot simulation-based research for evaluation, training and assessment of holistic nursing at four intensive care unit sites. MedEdPublish (2016) 2019; 8:40. [PMID: 38089255 PMCID: PMC10712602 DOI: 10.15694/mep.2019.000040.1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: Holistic nursing of intensive care unit (ICU) patients encompasses diverse challenges requiring regular in situ evaluation, training and assessment. Simulation has been adopted as a research and training tool in medicine; however, evidence for its use in enhancing holistic care at multi-sites is limited. Objective: This study aims to conduct a simulation-based research (SBR) at four ICU for standardized training of holistic nursing. Methods: There are stages of evaluating, training+in-training assessment and post-course assessment in this SBR. Specifically, the curriculum-mapped scenarios were developed according to the deficiency of each site after evaluating stage. At the training stage, the first simulation by team was defined as preparation step and the in-training assessment was undertaken at the second simulation. Results: From January 2017 to October 2018, sixty-four ICU nurses (16 teams, 4 teams in each site) at RCU, PICU, NICU and GYN ICU, attend 8 similar courses (2 courses at each site) over 20 months. In comparison with baseline performance, in-training assessments revealed the significant improvement of attendee's skills of holistic nursing. Attendees commented that simulation was a valuable training modality to enhance skills of holistic care including history taking, physical examination, communication and teamwork that are rarely taught among ICU nurses. Post-course workplace assessment by senior nurses revealed the high frequency of clinical application of holistic nursing by attendees. Additionally, post-course self assessment revealed a high attendee's confidence of holistic approaching in ICU. Conclusion: This pilot SBR demonstrated the feasibility of a standardized holistic care simulation program across four ICUs. In situ simulation and post-course workplace assessment affords situational learning without compromising patient safety and is an exciting and novel training of holistic nursing for ICU that could be integrated into regular intervention.
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Affiliation(s)
- Tsu-Hui Shiao
- High-fidelity Medical Simulation Center for Holistic Care and Inter-Professional Collaboration
| | - Chen-Yi Wu
- High-fidelity Medical Simulation Center for Holistic Care and Inter-Professional Collaboration
| | - Ying-Ying Yang
- High-fidelity Medical Simulation Center for Holistic Care and Inter-Professional Collaboration
| | | | | | - Ling-Yu Yang
- High-fidelity Medical Simulation Center for Holistic Care and Inter-Professional Collaboration
| | | | - Fa-Yauh Lee
- High-fidelity Medical Simulation Center for Holistic Care and Inter-Professional Collaboration
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Yang YY, Yang LY, Lee FY, Hwang SJ. DAA-based IIT simulation model enhances the interprofessional collaboration and team efficiency competency of health professionals. J Chin Med Assoc 2019; 82:169-171. [PMID: 30908410 DOI: 10.1097/jcma.0000000000000024] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
One of the ten recommendations of the commission on education of health professionals for the twenty-first century is the "promotion of interprofessional education that breaks down professional silos while enhancing collaborative relationships in effective teams." Continuously, the increasing prevalence of patients with complex chronic health issues challenges the staff's training strategy of healthcare institution. To ensure patient safety, the collaborative involvement of a team of health professional is necessary to delivery care to patients with complex health conditions and social disadvantage. Integrated interprofessional collaboration and team efficiency (IIT) is a competency that can optimize the multiple professional skills to provide well-coordinated, high-quality, and patient-centered care. IIT-based training is a way to improve team-based care through positive shared learning activities in a nonthreatening environment to respond to patient's needs. The describe, analysis, application (DAA) diamond is a debriefing method that provides different health professionals with valuable learning experiences through communication. Using advocacy-inquiry approach, DAA-based IIT simulation offers an effective platform for training IIT. Including all disciplines in the DAA-based IIT simulation process reinforces the unique role/contribution of each team member and provides a mechanism for the team to talk together for system improvements. Actually, good clinical care requires practitioner's ability to effectively resolve stress and conflict, improve job satisfaction/wellbeing, and enhance quality and safety of patient care. In our institution, regular DAA-based IIT simulation courses were held at various divisions and had been proved to improve the safety and quality of healthcare.
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Affiliation(s)
- Ying-Ying Yang
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fa-Yauh Lee
- Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Huang CC, Hsu HC, Yang LY, Chen CH, Yang YY, Chang CC, Chuang CL, Lee WS, Lee FY, Hwang SJ. Peer-assisted learning model enhances clinical clerk's procedural skills. J Chin Med Assoc 2018; 81:747-753. [PMID: 29779999 DOI: 10.1016/j.jcma.2017.06.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 01/20/2017] [Revised: 06/16/2017] [Accepted: 06/20/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Failure to transfer procedural skills learned in a laboratory to the bedside is commonly due to a lack of peer support/stimulation. A digital platform (Facebook) allows new clinical clerks to share experiences and tips that help augment their procedural skills in a peer-assisted learning/teaching method. This study aims to investigate the effectiveness of the innovation of using the digital platform to support the transfer of laboratory-trained procedural skills in the clinical units. METHODS Volunteer clinical clerks (n = 44) were enrolled into the peer-assisted learning (PAL) group, which was characterized by the peer-assisted learning of procedural skills during their final 3-month clinical clerkship block. Other clerks (n = 51) did not join the procedural skills-specific Facebook group and served as the self-directed learning regular group. The participants in both the PAL and regular groups completed pre- and post-intervention self-assessments for general self-assessed efficiency ratings (GSER) and skills specific self-assessed efficiency ratings (SSSER) for performing vein puncture, intravenous (IV) catheter and nasogastric (NG) tube insertion. Finally, all clerks received the post-intervention 3-station Objective Structured Clinical Skills Examination (OSCE) to test their proficiency for the abovementioned three procedural skills. RESULTS Higher cumulative numbers of vein punctures, IV catheter insertions and NG tube insertions at the bedside were carried out by the PAL group than the regular group. A greater improvement in GSERs and SSSERs for medical procedures was found in the PAL group than in the regular group. The PAL group obtained higher procedural skills scores in the post-intervention OSCEs than the regular group. CONCLUSION Our study suggested that the implementation of a procedural skill-specific digital platform effectively helps clerks to transfer laboratory-trained procedural skills into the clinical units. In comparison with the regular self-directed learning group, the peer-assisted learning characteristics of Facebook give additional benefits to the PAL group by enhancing their procedural skills.
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Affiliation(s)
- Chia-Chang Huang
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Hui-Chi Hsu
- Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Camillians Saint Mary's Hospital, Luodong, Yilan, Taiwan, ROC
| | - Ling-Yu Yang
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chen-Huan Chen
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ying-Ying Yang
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
| | - Ching-Chih Chang
- Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chiao-Lin Chuang
- Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Wei-Shin Lee
- Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Fa-Yauh Lee
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shinn-Jang Hwang
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Qin DL, Jin XN, Wang SJ, Wang JJ, Mamat N, Wang FJ, Wang Y, Shen ZA, Sheng LG, Forsman M, Yang LY, Wang S, Zhang ZB, He LH. [Research on the reliability and validity of postural workload assessment method and the relation to work-related musculoskeletal disorders of workers]. Beijing Da Xue Xue Bao Yi Xue Ban 2018; 50:488-494. [PMID: 29930418] [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: 06/08/2023]
Abstract
OBJECTIVE To form a new assessment method to evaluate postural workload comprehensively analyzing the dynamic and static postural workload for workers during their work process to analyze the reliability and validity, and to study the relation between workers' postural workload and work-related musculoskeletal disorders (WMSDs). METHODS In the study, 844 workers from electronic and railway vehicle manufacturing factories were selected as subjects investigated by using the China Musculoskeletal Questionnaire (CMQ) to form the postural workload comprehensive assessment method. The Cronbach's α, cluster analysis and factor analysis were used to assess the reliability and validity of the new assessment method. Non-conditional Logistic regression was used to analyze the relation between workers' postural workload and WMSDs. RESULTS Reliability of the assessment method for postural workload: internal consistency analysis results showed that Cronbach's α was 0.934 and the results of split-half reliability indicated that Spearman-Brown coefficient was 0.881 and the correlation coefficient between the first part and the second was 0.787. Validity of the assessment method for postural workload: the results of cluster analysis indicated that square Euclidean distance between dynamic and static postural workload assessment in the same part or work posture was the shortest. The results of factor analysis showed that 2 components were extracted and the cumulative percentage of variance achieved 65.604%. The postural workload score of the different occupational workers showed significant difference (P<0.05) by covariance analysis. The results of nonconditional Logistic regression indicated that alcohol intake (OR=2.141, 95%CI 1.337-3.428) and obesity (OR=3.408, 95%CI 1.629-7.130) were risk factors for WMSDs. The risk for WMSDs would rise as workers' postural workload rose (OR=1.035, 95%CI 1.022-1.048). There was significant different risk for WMSDs in the different groups of workers distinguished by work type, gender and age. Female workers exhibited a higher prevalence for WMSDs (OR=2.626, 95%CI 1.414-4.879) and workers between 30-40 years of age (OR=1.909, 95%CI 1.237-2.946) as compared with those under 30. CONCLUSION This method for comprehensively assessing postural workload is reliable and effective when used in assembling workers, and there is certain relation between the postural workload and WMSDs.
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Affiliation(s)
- D L Qin
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
| | - X N Jin
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
| | - S J Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
| | - J J Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
| | - N Mamat
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
| | - F J Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
| | - Y Wang
- CRRC Changchun Railway Vehicles CO., LTD., Changchun 130062, China
| | - Z A Shen
- CRRC Changchun Railway Vehicles CO., LTD., Changchun 130062, China
| | - L G Sheng
- CRRC Changchun Railway Vehicles CO., LTD., Changchun 130062, China
| | - M Forsman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm SE17177, Sweden
| | - L Y Yang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm SE17177, Sweden
| | - S Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
| | - Z B Zhang
- China Academy of Safety Science and Technology, Beijing 100029, China
| | - L H He
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, China
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