Search results for: Hung Vo Thanh

Authors: Li-Ching Hung

Abstract:

The lack of empirical research on portfolio assessment in aboriginal EFL English classes of junior high schools in Taiwan may inhibit EFL teachers from appreciating the utility of this alternative assessment approach. This study addressed the following research questions: 1) understand how aboriginal EFL students and instructors of junior high schools in Taiwan perceive portfolio assessment, and 2) how portfolio assessment affects Taiwanese aboriginal EFL students’ learning outcomes. Ten classes of five junior high schools in Taiwan (from different regions of Taiwan) participated in this study. Two classes from each school joined the study, and each class was randomly assigned as a control group, and one was the experimental group. These five junior high schools consisted of at least 50% of aboriginal students. A mixed research design was utilized. The instructor of each class implemented a portfolio assessment for 15 weeks of the 2015 Fall Semester. At the beginning of the semester, all participants took a GEPT test (pretest), and in the 15th week, all participants took the same level of GEPT test (post-test). Scores of students’ GEPT tests were checked by the researcher as supplemental data in order to understand each student’s performance. In addition, each instructor was interviewed to provide qualitative data concerning students’ general learning performance and their perception of implementing portfolio assessments in their English classes. The results of this study were used to provide suggestions for EFL instructors while modifying their lesson plans regarding assessment. In addition, the empirical data were used as references for EFL instructors implementing portfolio assessments in their classes effectively.

Keywords: assessment, portfolio assessment, qualitative design, aboriginal ESL students

Procedia PDF Downloads 109

Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

Abstract:

Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

Procedia PDF Downloads 341

Authors: Hung Ton

Abstract:

The Vietnamese community in Toronto, Ontario, Canada, is a minority group with an estimated less than 1% of the population. They have been in Canada since the 1970s, therefore, many funding sources are considering them as a long-time residential group. However, their limitation of resources cannot give them equal opportunities to successfully gain support from many levels of government in Canada, compared to other long-time settled and large groups. In 2020 and 2021, they have zero financial support for addressing problem gambling in the Vietnamese community. In contrast, casinos never forget this community. The gambling industry has been targeting the Vietnamese community as one of their major clientele groups. There are always in-equal battles between low-budget educational workshops by this underserved community group and expensive variety music shows by casinos. In the very same target group, five single lines of free ads by a community project cannot get more attention than a full-page colorful poster by casinos. An outreach worker is running back and forth to talk to a group of 10 or 15 persons in an ESL or Tai Chi class held in a basement of an old community center while fifty thousand dollars variety music shows can attract five thousand audience in their luxury facilities. Five-dollar vouchers for those who attend the problem gambling awareness session are incomparable to two hundred dollar free tickets for people to attend the show in casinos and then exit the gambling area after the show ends. There is only one problem gambling counselor who speaks the Vietnamese language in the Ontario province and in Canada at large. However, there are 70 casinos in Ontario and more than 200 licensed gambling facilities in Canada. He has been lonely in all in-equal "battles" for the last almost 25 years. He exists, fighting over there with or without funding support for the program, he fights still.

Keywords: Canadian Vietnamese, gambling addiction, gambling treatment, community awareness

Procedia PDF Downloads 30

Authors: Hung-Shuo Wu, Huan-Chieh Chiu, Xiang-Yao Zheng, Yu-Cheng Yang, Chien-Hao Wang, Jen-Cheng Wang, Chwan-Lu Tseng, Joe-Air Jiang

Abstract:

Dynamic Thermal Rating (DTR) provides crucial information by estimating the ampacity of transmission lines to improve power dispatching efficiency. To perform the DTR, it is necessary to install on-line thermal sensors to monitor conductor temperature and weather variables. A simple and intuitive strategy is to allocate a thermal sensor to every span of transmission lines, but the cost of sensors might be too high to bear. To deal with the cost issue, a thermal sensor placement problem must be solved. This research proposes and implements a hybrid algorithm which combines proper orthogonal decomposition (POD) with particle swarm optimization (PSO) methods. The proposed hybrid algorithm solves a multi-objective optimization problem that concludes the minimum number of sensors and the minimum error on conductor temperature, and the optimal sensor placement is determined simultaneously. The data of 345 kV transmission lines and the hourly weather data from the Taiwan Power Company and Central Weather Bureau (CWB), respectively, are used by the proposed method. The simulated results indicate that the number of sensors could be reduced using the optimal placement method proposed by the study and an acceptable error on conductor temperature could be achieved. This study provides power companies with a reliable reference for efficiently monitoring and managing their power grids.

Keywords: dynamic thermal rating, proper orthogonal decomposition, particle swarm optimization, sensor placement, smart grid

Procedia PDF Downloads 402

Authors: Sheam-Chyun Lin, Wei-Kai Chen, Hung-Cheng Yen, Yung-Jen Cheng, Yu-Cheng Chen

Abstract:

Result from the constant dwindle in natural resources, the alternative way to reduce the costs in our daily life would be urgent to be found in the near future. As the ancient technique based on the theory of solar chimney since roman times, the double-skin façade are simply composed of two large glass panels in purpose of daylighting and also natural ventilation in the daytime. Double-skin façade is generally installed on the exterior side of buildings as function as the window, so there’s always a huge amount of passive solar energy the façade would receive to induce the airflow every sunny day. Therefore this article imposes a domestic double-skin window for residential usage and attempts to improve the volume flow rate inside the cavity between the panels by the frame geometry design, the installation of outlet guide plate and the solar energy collection system. Note that the numerical analyses are applied to investigate the characteristics of flow field, and the boundary conditions in the simulation are totally based on the practical experiment of the original prototype. Then we redesign the prototype from the knowledge of the numerical results and fluid dynamic theory, and later the experiments of modified prototype will be conducted to verify the simulation results. The velocities at the inlet of each case are increase by 5%, 45% and 15% from the experimental data, and also the numerical simulation results reported 20% improvement in volume flow rate both for the frame geometry design and installation of outlet guide plate.

Keywords: solar energy, double-skin façades, thermal buoyancy, fluid machinery

Procedia PDF Downloads 463

Authors: Samar Mousa, Rebecca Shirley

Abstract:

Injuries to the hand account for 20% of all emergency department attendances, with an estimated annual treatment cost of over £100 million in the UK. Functional impairments as a result of hand injuries often necessitate absence from employment, resulting in reduced productivity estimated to incur an additional £600m loss to the UK economy. Appropriate and early management is vital to preserve anatomy, prevent stiffness and allow function. The initial assessment and management of hand injuries are usually undertaken by junior staff, many of whom have little or no training or experience in splinting hand fractures. In our plastic surgery department at Stoke Mandeville hospital Buckinghamshire trust, we carried out an audit project to detect errors in hand splinting in the period between April 2022 and July 2022 and find out measures to support junior doctors, nurses and hand therapists in providing the best possible care for hand trauma patients. Our standards were The British Society for Surgery of the Hand (BSSH) standard of care in hand trauma, AO surgery reference and Stoke Mandeville hospital hand therapy mini protocol Feb 2022 During the period of 4 months, 5 cases were identified. Two cases of wrong splint choice, two cases of early removal of the splint and one tight splint that required change. In order to avoid those mistakes, a training program was given to junior doctors and nurses in collaboration with the hand therapy team regarding ways of splinting the hand in different injuries like fractures, tendons injuries, muscle injuries and ligamentous injuries. In addition to, a poster hung in the examination rooms and theatres to help junior doctors reach the correct decision.

Keywords: splinting, hand trauma, plastic surgery, tendon injury, hand fracrture

Procedia PDF Downloads 62

Authors: Sa`ad M. Ismail, Hung-Hsun Yen, Christina M. Murray, Helen M. S. Davies

Abstract:

The lumbosacral junction (where the 7th lumbar vertebra (L7) articulates with the sacrum) is a clinically important area in the dog. The 7th lumbar vertebra (L7) is normally shorter than other lumbar vertebrae, and it has been reported that variations in the L7 length may be associated with other abnormal anatomical findings. These variations included the reduction or absence of the portion of the median sacral crest. In this study, 53 greyhound cadavers were placed in right lateral recumbency, and two lateral radiographs were taken of the lumbosacral region for each greyhound. The length of the 6th lumbar (L6) vertebra and L7 were measured using radiographic measurement software and was defined to be the mean of three lines drawn from the caudal to the cranial edge of the L6 and L7 vertebrae (a dorsal, middle, and ventral line) between specific landmarks. Sacrocaudal fusion was found in 41.5% of the greyhounds. The mean values of the length of L6, L7, and the ratio of the L6/L7 length of the greyhounds with sacrocaudal fusion were all greater than those with standard sacrums (three sacral vertebrae). There was a significant difference (P < 0.05) in the mean values of the length of L7 between the greyhounds without sacrocaudal fusion (mean = 29.64, SD ± 2.07) and those with sacrocaudal fusion (mean = 30.86, SD ± 1.80), but, there was no significant difference in the mean value of the length of the L6 measurement. Among different types of sacrocaudal fusion, the longest L7 was found in greyhounds with sacrum type D, intermediate length in those with sacrum type B, and the shortest was found in those with sacrums type C, and the mean values of the ratio of the L6/L7 were 1.11 (SD ± 0.043), 1.15, (SD ± 0.025), and 1.15 (SD ± 0.011) for the types B, C, and D respectively. No significant differences in the mean values of the length of L6 or L7 were found among the different types of sacrocaudal fusion. The occurrence of sacrocaudal fusion might affect direct anatomically connected structures such as the L7. The variation in the length of L7 between greyhounds with sacrocaudal fusion and those without may reflect the possible sequences of the process of fusion. Variations in the length of the L7 vertebra in greyhounds may be associated with the occurrence of sacrocaudal fusion. The variation in the vertebral length may affect the alignment and biomechanical properties of the sacrum and may alter the loading. We concluded that any variations in the sacrum anatomical features might change the function of the sacrum or the surrounding anatomical structures.

Keywords: biomechanics, Greyhound, sacrocaudal fusion, locomotion, 6th Lumbar (L6) Vertebra, 7th Lumbar (L7) Vertebra, ratio of the L6/L7 length

Procedia PDF Downloads 331

Authors: Ju May Wen, Chun Hung Lin, Eric Zhi Feng Liu

Abstract:

Flow theory implies that people are persuaded by happiness. By focusing on an activity, people turn a blind eye to external factors. This study explores the influence of educational board games and fundamental Chinese language teaching on students’ learning motivation and flow experience. Fifty-three students studying Chinese language fundamental courses were used in the study. These students were divided into three groups: (1) flash card teaching group; (2) educational original board game teaching group; and (3) educational Chinese board game teaching group. Chinese language teaching was integrated with the educational board game titled ‘Transportation GO.’ The students were observed playing this game as the teacher collected quantitative and qualitative data. Quantitative data was collected from the learning motivation scale and flow experience scale. Qualitative data was collected through observing, recording, and visiting. The first result found that the three groups integrated with Chinese language teaching could maintain students’ high learning motivation and high flow experience. Second, there was no significant difference between the flow experience of the flash card group and the educational original board game group. Third, there was a significant difference in the flow experience and learning motivation of the educational Chinese board game group vs. the other groups. This study suggests that the experimental model can be applied to advanced Chinese language teaching. Apart from oral and literacy skills, the study of educational board games integrated with Chinese language teaching to enforce student writing skills will be continued.

Keywords: Chinese language instruction, educational board game, learning motivation, flow experience

Procedia PDF Downloads 148

Authors: Yah-Ling Hung

Abstract:

eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Keywords: eHealth, health intervention, health literacy, usability evaluation

Procedia PDF Downloads 109

Authors: Saem Lee, Thanh Nguyen, Hio-Jung Shin, Thomas Koellner

Abstract:

Land-use management has an influence on the provision of ecosystem service in dynamic, agricultural landscapes. Agricultural land use is important for maintaining the productivity and sustainability of agricultural ecosystems. However, in Korea, intensive farming activities in this highland agricultural zone, the upper stream of Soyang has led to contaminated soil caused by over-use pesticides and fertilizers. This has led to decrease in water and soil quality, which has consequences for ecosystem services and human wellbeing. Conventional farming has still high percentage in this area and there is no special measure to prevent low water quality caused by farming activities. Therefore, the adoption of environmentally friendly farming has been considered one of the alternatives that lead to improved water quality and increase in biomass production. Concurrently, farm households with environmentally friendly farming have occupied still low rates. Therefore, our research involved a farm household survey spanning conventional farming, the farm in transition and organic farming in Soyang watershed. Another purpose of our research was to compare economic advantage of the farmers adopting environmentally friendly farming and non-adaptors and to investigate the different factors by logistic regression analysis with socio-economic and benefit-cost ratio variables. The results found that farmers with environmentally friendly farming tended to be younger than conventional farming and farmer in transition. They are similar in terms of gender which was predominately male. Farmers with environmentally friendly farming were more educated and had less farming experience than conventional farming and farmer in transition. Based on the benefit-cost analysis, total costs that farm in transition farmers spent for one year are about two times as much as the sum of costs in environmentally friendly farming. The benefit of organic farmers was assessed with 2,800 KRW per household per year. In logistic regression, the factors having statistical significance are subsidy and district, residence period and benefit-cost ratio. And district and residence period have the negative impact on the practice of environmentally friendly farming techniques. The results of our research make a valuable contribution to provide important information to describe Korean policy-making for agricultural and water management and to consider potential approaches to policy that would substantiate ways beneficial for sustainable resource management.

Keywords: organic farming, logistic regression, profitability, agricultural land-use

Procedia PDF Downloads 368

Authors: Yi-Lin Chen, Sheng-Jou Hung, Tsunglin Liu

Abstract:

Adaptive immune system recognizes a wide range of antigens via expressing a large number of structurally distinct T cell and B cell receptor genes. The distinct receptor genes arise from complex rearrangements called V(D)J recombination, and constitute the immune repertoire. A common method of profiling immune repertoire is via amplifying recombined receptor genes using multiple primers and high-throughput sequencing. This multiplex-PCR approach is efficient; however, the resulting repertoire can be distorted because of primer bias. To eliminate primer bias, 5’ RACE is an alternative amplification approach. However, the application of RACE approach is limited by its low efficiency (i.e., the majority of data are non-regular receptor sequences, e.g., containing intronic segments) and lack of the convenient tool for analysis. We propose a computational tool that can correctly identify non-regular receptor sequences in RACE data via aligning receptor sequences against the whole gene instead of only the exon regions as done in all other tools. Using our tool, the remaining regular data allow for an accurate profiling of immune repertoire. In addition, a RACE approach is improved to yield a higher fraction of regular T-cell receptor sequences. Finally, we quantify the degree of primer bias of a multiplex-PCR approach via comparing it to the RACE approach. The results reveal significant differences in frequency of VJ combination by the two approaches. Together, we provide a new experimental and computation pipeline for an unbiased profiling of immune repertoire. As immune repertoire profiling has many applications, e.g., tracing bacterial and viral infection, detection of T cell lymphoma and minimal residual disease, monitoring cancer immunotherapy, etc., our work should benefit scientists who are interested in the applications.

Keywords: immune repertoire, T-cell receptor, 5' RACE, high-throughput sequencing, sequence alignment

Procedia PDF Downloads 162

Authors: Hung Tran

Abstract:

This interpretive qualitative study employed three theoretical lenses: Bronfenbrenner’s (1979) Ecological System of Human Development, Vygotsky’s (1978) Sociocultural Theory of Development, and Knowles’s (1970) Adult Learning Theory as the theoretical framework in connection with the constructivist research paradigm to investigate into positive and negative aspects of the extant English as a Foreign Language (EFL) faculty mentoring programs at four higher education institutions (HEIs) in the Mekong River Delta (MRD) of Vietnam. Four apprentice faculty members (mentees), four experienced faculty members (mentors), and two associate deans (administrators) from these HEIs participated in two tape-recorded individual interviews in the Vietnamese language. Twenty interviews were transcribed verbatim and translated into English with verification. The initial analysis of data reveals that the mentoring program, which is mandated by Vietnam’s Ministry of Education and Training, has been implemented differently at these HEIs due to a lack of officially-documented mentoring guidance. Other general themes emerging from the data include essentials of the mentoring program, approaches of the mentoring practice, the mentee – mentor relationship, and lifelong learning beyond the mentoring program. Practically, this study offers stakeholders in the mentoring cycle description of benefits and best practices of tertiary EFL mentorship and a suggested mentoring program that is metaphorically depicted as “a lifebuoy” for its current and potential administrators and mentors to help their mentees survive in the first years of teaching. Theoretically, this study contributes to the world’s growing knowledge of post-secondary mentorship by enriching the modest literature on Asian tertiary EFL mentorship.

Keywords: faculty mentorship, mentees, mentors, administrator, the MRD, Vietnam

Procedia PDF Downloads 102

Authors: Huan-Chieh Chiu, Hung-Shuo Wu, Chien-Hao Wang, Yu-Cheng Yang, Ching-Ya Tseng, Joe-Air Jiang

Abstract:

Power failure resulting from tower collapse due to violent seismic events might bring enormous and inestimable losses. The Chi-Chi earthquake, for example, strongly struck Taiwan and caused huge damage to the power system on September 21, 1999. Nearly 10% of extra high voltage (EHV) transmission towers were damaged in the earthquake. Therefore, seismic hazards of EHV transmission towers should be monitored and evaluated. The ultimate goal of this study is to establish a damage level assessment model for EHV transmission towers. The data of earthquakes provided by Taiwan Central Weather Bureau serve as a reference and then lay the foundation for earthquake simulations and analyses afterward. Some parameters related to the damage level of each point of an EHV tower are simulated and analyzed by the data from monitoring stations once an earthquake occurs. Through the Fourier transform, the seismic wave is then analyzed and transformed into different wave frequencies, and the data would be shown through a response spectrum. With this method, the seismic frequency which damages EHV towers the most is clearly identified. An estimation model is built to determine the damage level caused by a future seismic event. Finally, instead of relying on visual observation done by inspectors, the proposed model can provide a power company with the damage information of a transmission tower. Using the model, manpower required by visual observation can be reduced, and the accuracy of the damage level estimation can be substantially improved. Such a model is greatly useful for health and construction monitoring because of the advantages of long-term evaluation of structural characteristics and long-term damage detection.

Keywords: damage level monitoring, drift ratio, fragility curve, smart grid, transmission tower

Procedia PDF Downloads 274

Authors: Kai Pei Huang, Ting Chung Hung, Li Ching Wu

Abstract:

Amyloidosis refers to a variety of conditions wherein amyloid proteins are abnormally deposited in organ or tissues and cause harm. Among the several forms of amyloidosis, the principal types of that in inpatient medical services are the AL amyloidosis (primary) and AA amyloidois (secondary). AL Amyloidois is due to deposition of protein derived from overproduction of immunoglobulin light chain in plasma cell myeloma. Furthermore, it is a systemic disorder that can present with a variety of symptoms, including heavy proteinemia and edema, heptosplenomegaly, otherwise unexplained heart failure. We reported a 78-year-old female presenting dysuria, oliguria and leg edema for several months. Laboratory data showed proteinuria (UPCR:1679.8), leukocytosis (WBC:16.2 x 10^3/uL), results of serum urea nitrogen (39mg/dL), creatinine (0.76 mg/dL), IgG (748 mg/dL.), IgA (635 mg/dL), IgM (63 mg/dL), kappa light chain(18.8 mg/dL), lambda light chain (110.0 mg/dL) and kappa/lambda ratio (0.17). Renal biopsy found amyloid fibrils in glomerular mesangial area, and Congo red stain highlights amyloid deposition in glomeruli. Additional lab studies included serum protein electrophoresis, which shows a major monoclonal peak in β region and minor small peak in gamma region, and the immunotyping studies for serum showed two IgA/λ type. We treated sample with beta-mercaptoethanol which reducing the polymerized immunoglobulin to clarify two IgA/λ are secreted from the same plasma cell clone in bone marrow. Later examination confirmed it existed plasma cell infiltration in bone marrow, and the immunohistochemical staining showed monotypic for λ light chain and are positive for IgA. All findings mentioned above reveal it is a case of plasma cell myeloma with λ Light Chain Amyloidosis.

Keywords: amyloidosis, immunoglobulin light chain, plasma cell myeloma, serum protein electrophoresis

Procedia PDF Downloads 190

Authors: Yu-Chieh Chen, Li-Yun Wang, Chi-Chih Chen, Huy Hùng Đào, Ya-Mei Chen, Ming-Chu Cheng, Wen-Bin Chung, Hso-Chi Chaung, Guan-Ming Ke

Abstract:

Many recent researches have demonstrated that CD154, a protein primarily expressed on activated T cell molecules, has potentially acted as a molecular adjuvant to improve the immunogenicity of subunit vaccines against viral infections. Classical swine fever (CSF) affects the swine industry worldwide that is one of the most devastating and highly contagious pig diseases. It is listed by the World Organization for Animal Health (OIE) as an infectious animal disease that must be reported. Although pigs vaccinated with subunit vaccines can be differentially diagnosed from those infected animals, subunit vaccines usually need adjuvants to enhance and elicit immune responses. In this study, CD154 was linked with CSFV E2 sequences and then expressed in CHO cells to produce the fusion protein as E2-CD154. The porcine specific CpG adjuvant was also used in one of the formulations. The specific pathogen-free pigs (SPF) at the age of 4-week-old were randomly separated into four groups, vaccinated with E2-CpG, E2-CD154, E2-CD154-CpG or the commercial Bayovac® CSF-E2 vaccine and boosted two weeks after primary vaccination. The results showed that the percentages of CD4+ and CD4+IL2+ in peripheral blood mononuclear cells (PBMC) in E2-CD154 vaccinated piglets seven days after primary vaccination were gained by 1-5% relative to the control group. In addition, the percentages of CD4+IFNγ+ T cells had slightly edged up 0.1-0.3% compared with the control group. Also, increased E2-specific IFNγ levels had edged up CD4+CD8+ T cells found in E2-CD154 and E2-CD154-CpG groups, particularly in the E2-CD154-CpG group. These results implicate that CD154 may enhance cellular immunity and synergistically act with species-specific CpG adjuvant as a dual-phase adjuvant. Therefore, the CD154 may be beneficial as a promising adjuvant in subunit vaccines.

Keywords: CD154, CpG adjuvant, cellular immunity, subunit vaccine, pig

Procedia PDF Downloads 23

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

Abstract:

Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

Procedia PDF Downloads 53

Authors: Sa'ad M. Ismail, Hung-Hsun Yen, Christina M. Murray, Helen M. S. Davies

Abstract:

In the dog, the median sacral crest is formed by the fusion of three sacral spinous processes. In greyhounds with standard sacrums, this fusion in the median sacral crest consists of the fusion of three sacral spinous processes while it consists of four in greyhounds with sacrocaudal fusion. In the present study, variations in the angulation of the first sacral spinous process in association with different types of sacrocaudal fusion in the greyhound were investigated. Sacrums were collected from 207 greyhounds (102 sacrums; type A (unfused) and 105 with different types of sacrocaudal fusion; types: B, C and D). Sacrums were cleaned by boiling and dried and then were placed on their ventral surface on a flat surface and photographed from the left side using a digital camera at a fixed distance. The first sacral spinous process angle (1st SPA) was defined as the angle formed between the cranial border of the cranial ridge of the first sacral spinous process and the line extending across the most dorsal surface points of the spinous processes of the S1, S2, and S3. Image-Pro Express Version 5.0 imaging software was used to draw and measure the angles. Two photographs were taken for each sacrum and two repeat measurements were also taken of each angle. The mean value of the 1st SPA in greyhounds with sacrocaudal fusion was less (98.99°, SD ± 11, n = 105) than those in greyhounds with standard sacrums (99.77°, SD ± 9.18, n = 102) but was not significantly different (P < 0.05). Among greyhounds with different types of sacrocaudal fusion the mean value of the 1st SPA was as follows: type B; 97.73°, SD ± 10.94, n = 39, type C: 101.42°, SD ± 10.51, n = 52, and type D: 94.22°, SD ± 11.30, n = 12. For all types of fusion these angles were significantly different from each other (P < 0.05). Comparing the mean value of the1st SPA in standard sacrums (Type A) with that for each type of fusion separately showed that the only significantly different angulation (P < 0.05) was between standard sacrums and sacrums with sacrocaudal fusion sacrum type D (only body fusion between the S1 and Ca1). Different types of sacrocaudal fusion were associated with variations in the angle of the first sacral spinous process. These variations may affect the alignment and biomechanics of the sacral area and the pattern of movement and/or the force produced by both hind limbs to the cranial parts of the body and may alter the loading of other parts of the body. We concluded that any variations in the sacrum anatomical features might change the function of the sacrum or surrounding anatomical structures during movement.

Keywords: angulation of first sacral spinous process, biomechanics, greyhound, locomotion, sacrocaudal fusion

Procedia PDF Downloads 280

Authors: Jhe-Hao Huang, Kun-Da Wu, Wei-Cheng Shih, Jui-Pin Hung

Abstract:

This study presented the investigation on the dynamic characteristics of a spindle tool system by experimental and finite element modeling approaches. As well known facts, the machining stability is greatly determined by the dynamic characteristics of the spindle tool system. Therefore, understanding the factors affecting dynamic behavior of a spindle tooling system is a prerequisite in dominating the final machining performance of machine tool system. To this purpose, a physical spindle unit was employed to assess the dynamic characteristics by vibration tests. Then, a three-dimensional finite element model of a high-speed spindle system integrated with tool holder was created to simulate the dynamic behaviors. For modeling the angular contact bearings, a series of spring elements were introduced between the inner and outer rings. The spring constant can be represented by the contact stiffness of the rolling bearing based on Hertz theory. The interface characteristic between spindle nose and tool holder taper can be quantified from the comparison of the measurements and predictions. According to the results obtained from experiments and finite element predictions, the vibration behavior of the spindle is dominated by the bending deformation of the spindle shaft in different modes, which is further determined by the stiffness of the bearings in spindle housing. Also, the spindle unit with tool holder shows a different dynamic behavior from that of spindle without tool holder. This indicates the interface property between tool holder and spindle nose plays an dominance on the dynamic characteristics the spindle tool system. Overall, the dynamic behaviors the spindle with and without tool holder can be successfully investigated through the finite element model proposed in this study. The prediction accuracy is determined by the modeling of the rolling interface of ball bearings in spindles and the interface characteristics between tool holder and spindle nose. Besides, identifications of the interface characteristics of a ball bearing and spindle tool holder are important for the refinement of the spindle tooling system to achieve the optimum machining performance.

Keywords: contact stiffness, dynamic characteristics, spindle, tool holder interface

Procedia PDF Downloads 265

Authors: Hsin-Yu Lin, Ching-Hsia Hung

Abstract:

Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

Procedia PDF Downloads 78

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

Abstract:

Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

Procedia PDF Downloads 48

Authors: Tz-Bang Du, Cheng-Han Hsieh, Li-Ping Ju, Hung-Jie Liou

Abstract:

Polyether amines synthesize by secondary hydroxyl polyether diol play an important role in epoxy hardener. The low molecular weight product is used in low viscosity and high transparent polyamine product for the logo, ground cover, especially for wind turbine blade, while the high molecular weight products are used in advanced agricultures such as a high-speed railway. High-pressure reductive amination process is required for producing these amines. In the condition of higher than 150 atm pressure and 200 degrees Celsius temperature, supercritical ammonia is used as a reactant and also a solvent. It would be a great challenge to select a catalyst support for such high-temperature alkaline circumstance. In this study, we have established a six-autoclave-type (SAT) high-pressure reactor for amination catalyst screening, which six experiment conditions with different temperature and pressure could be examined at the same time. We synthesized copper-nickel catalyst on different shaped alumina catalyst support and evaluated the catalyst activity for high-pressure reductive amination of polypropylene glycol (PPG) by SAT reactor. Ball type gamma alumina, ball type activated alumina and pellet type gamma alumina catalyst supports are evaluated in this study. Gamma alumina supports have shown better activity on PPG reductive amination than activated alumina support. In addition, the catalysts are evaluated in fixed bed reactor. The diamine product was successfully synthesized via this catalyst and the strength of the catalysts is measured. The crush strength of blank supports is about 13.5 lb for both gamma alumina and activated alumina. The strength increases to 20.3 lb after synthesized to be copper-nickel catalyst. After test in the fixed bed high-pressure reductive amination process for 100 hours, the crush strength of the used catalyst is 3.7 lb for activated alumina support, 12.0 lb for gamma alumina support. The gamma alumina is better than activated alumina to use as catalyst support in high-pressure reductive amination process.

Keywords: high pressure reductive amination, copper nickel catalyst, polyether amine, alumina

Procedia PDF Downloads 198

Authors: Wei-Ting Hung

Abstract:

Inbound tourist expenditure might not only have influenced by individual tourist characteristics but may also be affected by nationality characteristics. The cross national distance effects on tourist consumption behavior should be incorporated in the analytical framework. Additionally, the often used factor analysis, cluster analysis and regression analysis overlook the hierarchical tourist consumption data structure and may lead to misleading results. The objectives of the present study were twofold. First, we propose a multilevel model that takes individual and cross-national differences into account under a hierarchical framework. Second, we further sought to determine the types of cross-national differences affecting tourist expenditure. Thus, this study incorporates the individual tourist effects and cross national distance effects simultaneously, uses the data of 2010 Annual Survey Report on Visitors’ Expenditure and Trends in Taiwan to investigate the determinants of inbound tourist expenditure. Multilevel analysis was used to investigate the influence of individual tourist effects and cross national distance effects on inbound tourist expenditure. The empirical results show that cross national distance plays a crucial role in tourist consumption behavior. Our findings also indicate age and income have positive influence on tourism expenditure., whereas education and gender do not have significant impact. Regarding macro-level factors, geographic and cultural differences exhibited significant positive relationships on tourism expenditure, while economic differences did not. Based on the above empirical results, it is suggested that tour operators should take tourists’ individual attributes, particularly their income and age, into consideration when arranging tours. In addition, nationality holds sway over tourists’ consumption behavior, of which geographic and cultural differences are the two major factors at play. The empirical results of this study serve as practical suggestions for tourism marketing strategies and policy implications for government policies.

Keywords: cross national distance, inbound tourist, multilevel analysis, tourist expenditure

Procedia PDF Downloads 327

Authors: You-Lin Wu, Yi-Hsing Sung, Shih-Hung Lin, Jing-Jenn Lin

Abstract:

Performance improvement in optoelectronic devices such as solar cells and photodetectors has been reported when a polymer/ZnO nanorods stack is used. Resistance switching of polymer/ZnO nanocrystals (or nanorods) hybrid has also gained a lot of research interests recently. It has been reported that high- and low-resistance states of a metal/insulator/metal (MIM) structure diode with a polystyrene (PS) and ZnO hybrid as the insulator layer can be switched by applied bias after a high-voltage forming process, while the same device structure merely with a PS layer does not show any forming behavior. In this work, we investigated the current-voltage (I-V) characteristics of an MIM device with a PS/ZnO nanorods stack deposited on fluorine-doped tin oxide (FTO) glass substrate. The ZnO nanorods were grown by a hydrothermal method using a mixture of zinc nitrate, hexamethylenetetramine, and DI water. Following that, a PS layer was deposited by spin coating. Finally, the device with a structure of Ti/ PS/ZnO nanorods/FTO was completed by e-gun evaporated Ti layer on top of the PS layer. Semiconductor parameters analyzer Agilent 4156C was then used to measure the I-V characteristics of the device by applying linear ramp sweep voltage with sweep sequence of 0V → 4V → 0V → 3V → 0V → 2V → 0V → 1V → 0V in both positive and negative directions. It is interesting to find that the I-V characteristics are bias dependent and hysteretic, indicating that the device Ti/PS/ZnO nanorods/FTO structure has ferroelectricity. Our results also show that the maximum hysteresis loop height of the I-V characteristics as well as the voltage at which the maximum hysteresis loop height of each scan occurs increase with increasing maximum sweep voltage. It should be noticed that, although ferroelectricity has been found in ZnO at its melting temperature (1975℃) and in Li- or Co-doped ZnO, neither PS nor ZnO has ferroelectricity at room temperature. Using the same structure but with a PS or ZnO layer only as the insulator does not give and hysteretic I-V characteristics. It is believed that a charge polarization layer is induced near the PS/ZnO nanorods stack interface and thus causes the ferroelectricity in the device with Ti/PS/ZnO nanorods/FTO structure. Our results show that the PS/ZnO stack can find a potential application in a resistive switching memory device with MIM structure.

Keywords: ferroelectricity, hysteresis, polystyrene, resistance switching, ZnO nanorods

Procedia PDF Downloads 285

Authors: Hung-Sheng Lin, Cheng-Hsuan Li

Abstract:

Over the past few years, kernel-based algorithms have been widely used to extend some linear feature extraction methods such as principal component analysis (PCA), linear discriminate analysis (LDA), and nonparametric weighted feature extraction (NWFE) to their nonlinear versions, kernel principal component analysis (KPCA), generalized discriminate analysis (GDA), and kernel nonparametric weighted feature extraction (KNWFE), respectively. These nonlinear feature extraction methods can detect nonlinear directions with the largest nonlinear variance or the largest class separability based on the given kernel function. Moreover, they have been applied to improve the target detection or the image classification of hyperspectral images. The double nearest proportion feature extraction (DNP) can effectively reduce the overlap effect and have good performance in hyperspectral image classification. The DNP structure is an extension of the k-nearest neighbor technique. For each sample, there are two corresponding nearest proportions of samples, the self-class nearest proportion and the other-class nearest proportion. The term “nearest proportion” used here consider both the local information and other more global information. With these settings, the effect of the overlap between the sample distributions can be reduced. Usually, the maximum likelihood estimator and the related unbiased estimator are not ideal estimators in high dimensional inference problems, particularly in small data-size situation. Hence, an improved estimator by shrinkage estimation (regularization) is proposed. Based on the DNP structure, LDA is included as a special case. In this paper, the kernel method is applied to extend DNP to kernel-based DNP (KDNP). In addition to the advantages of DNP, KDNP surpasses DNP in the experimental results. According to the experiments on the real hyperspectral image data sets, the classification performance of KDNP is better than that of PCA, LDA, NWFE, and their kernel versions, KPCA, GDA, and KNWFE.

Keywords: feature extraction, kernel method, double nearest proportion feature extraction, kernel double nearest feature extraction

Procedia PDF Downloads 299

Authors: Angela T. H. Kwan, Wenjun Liang, Jack Wellington, Mohammad Mofatteh, Thanh N. Nguyen, Pingzhong Fu, Juanmei Chen, Zile Yan, Weijuan Wu, Yongting Zhou, Shuiquan Yang, Sijie Zhou, Yimin Chen

Abstract:

Background: Endovascular Therapy (EVT)—in the form of mechanical thrombectomy—following intravenous thrombolysis is the standard gold treatment for patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It is well established that an ASPECTS ≥ 7 is associated with an increased likelihood of positive post-EVT outcomes, as compared to an ASPECTS < 7. There is also prognostic utility in coupling posterior circulation ASPECTS (pc-ASPECTS) with magnetic resonance imaging for evaluating the post-EVT functional outcome. However, the value of pc-ASPECTS applied to CT must be explored further to determine its usefulness in predicting functional outcomes following EVT. Objective: In this study, we aimed to determine whether pc-ASPECTS on CT can predict post-EVT functional outcomes among patients with AIS due to LVO. Methods: A total of 247 consecutive patients aged 18 and over receiving EVT for LVO-related AIS were recruited into a prospective database. The data were retrospectively analyzed between March 2019 to February 2022 from two comprehensive tertiary care stroke centers: Foshan Sanshui District People’s Hospital and First People's Hospital of Foshan in China. Patient parameters included EVT within 24hrs of symptom onset, premorbid modified Rankin Scale (mRS) ≤ 2, presence of distal and terminal cerebral blood vessel occlusion, and subsequent 24–72-hour post-stroke onset CT scan. Univariate comparisons were performed using the Fisher exact test or χ2 test for categorical variables and the Mann–Whitney U test for continuous variables. A p-value of ≤ 0.05 was statistically significant. Results: A total of 247 patients met the inclusion criteria; however, 3 were excluded due to the absence of post-CTs and 8 for pre-EVT ASPECTS < 7. Overall, 236 individuals were examined: 196 anterior circulation ischemic strokes and 40 posterior strokes of basilar artery occlusion. We found that both baseline post- and pc-ASPECTS ≥ 7 serve as strong positive markers of favorable outcomes at 90 days post-EVT. Moreover, lower rates of inpatient mortality/hospice discharge, 90-day mortality, and 90-day poor outcome were observed. Moreover, patients in the post-ASPECTS ≥ 7 anterior circulation group had shorter door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), and last known normal-to-puncture-time (LKNPT). Conclusion: Patients of anterior and posterior circulation ischemic strokes with baseline post- and pc-ASPECTS ≥ 7 may benefit from EVT.

Keywords: endovascular therapy, thrombectomy, large vessel occlusion, cerebral ischemic stroke, ASPECTS

Procedia PDF Downloads 60

Authors: S. C. Lin, W. F. Hung, W. W. Cheng

Abstract:

Teacher empowerment was regarded as investing teachers with the right to participate in the determination of school goals and policies and to exercise professional judgment about what and how to teach. Professional commitment was considered as a person’s belief in and acceptance of the values of his or her chosen occupation or line of work, and a willingness to maintain membership in that occupation. An effective school has been defined as one in which students’ progress further than might be expected from consideration of its intake. An effective school thus adds extra value to its students' outcomes, in comparison with other schools serving similar intakes. A number of literature from various countries explored that teacher empowerment and professional commitment significantly influenced school effectiveness. However, there lacked more empirical studies to examine the relationships among them. Hence, this study was to explore the relationships among teacher empowerment, professional commitment and school effectiveness in junior high schools in Taiwan. Samples were seven hundred and five junior high school teachers selected from Taichung City, Changhua County and Nantou County. Questionnaire was applied to collect data. Data were analyzed by using descriptive statistics, t-test, one-way ANOVA, Pearson’s product-moment correlation, and multiple regression analysis. The findings of this study were as follows: First, the overall performances of teachers’ perceptions of teacher empowerment, teacher professional commitment and school effectiveness were above average. Second, the teachers’ perceptions of teacher empowerment were significant different in gender, designated duty, and school size. Third, the teachers’ perceptions of teacher professional commitment were significant different in gender, designated duty, and school size. Fourth, the teachers’ perceptions of school effectiveness were significant different in designated duty. Fifth, teacher empowerment was mid-positively correlation by teacher professional commitment. Sixth, there was mid-positively correlation between teacher empowerment and school effectiveness. Seventh, there was mid-positively correlation between teacher professional commitment and school effectiveness. Eighth, Teacher empowerment and professional commitment could significantly predict school effectiveness. Based on the findings of this study, the study proposed some suggestions for educational authorities, schools, teachers, and future studies as well.

Keywords: junior high school teacher, teacher empowerment, teacher professional commitment, school effectiveness

Procedia PDF Downloads 432

Authors: Yun-Chin Chung, Nileema Divate, Gen-Hung Chen, Pei-Ru Huang, Rupesh Divate

Abstract:

Many environmental factors, such as glucose concentration, ethanol, temperature, osmotic pressure and pH, decrease the production rate of ethanol using yeast as a starter. Fermentation starters with high tolerance to various stresses are always demanded for brewing industry. Trehalose, a storage carbohydrate in cell wall of yeast, plays an important role in tolerance of environmental stress by preserving integrity of plasma membrane and stabilizing proteins. Furan aldehydes are toxic to yeast and the growth rate of yeast is significantly reduced if furan aldehydes were present in the fermentation medium. In yeast, aldehyde reductase is involved in the detoxification of reactive aldehydes and consequently the growth of yeast is improved. The aims of this study were to construct a genetic recombinant Saccharomyces cerevisiae or Pichia pastoris with furfural and HMF degrading and high ethanol tolerance capacities. Yeast strains were engineered by genetic recombination for overexpression of trehalose-6-phosphate synthase gene (tps1) and aldehyde reductase gene (ari1). TPS1 gene was cloned from S. cerevisiae by reverse transcription-polymerase chain reaction (RT-PCR) and then ligated with pGAPZαC vector. The constructed vector, pGAPZC-tps1, was transformed to recombinant yeasts strain with overexpression of ari1. The transformants with pGAPZC-tps1-ari1 were generated called STA (S. cerevisiae) and PTA (P. pastoris) with overexpression of tps1, ari1. PCR with tps1-specific primers and western blot with his-tag confirmed the gene insertion and protein expression of tps1 in the transformants, respectively. The neutral trehalase gene (nth1) of STA was successfully deleted and the novel strain STAΔN will be used for further study, including the measurement of trehalose concentration and ethanol, furfural tolerance assay.

Keywords: genetic recombinant, yeast, ethanol tolerance, trehalase, aldehyde reductase

Procedia PDF Downloads 396

Authors: Yu-Wen Cheng, Jau-Der Ho, Liang-Huan Wu, Fan-Li Lin, Li-Huei Chen, Hung-Ming Chang, Yueh-Hsiung Kuo, George Hsiao

Abstract:

Retina glial activation and neuroinflammation have been confirmed to cause devastating responses in retinodegenerative diseases. The expression and activation of matrix metalloproteinase (MMP)-9 and inducible nitric oxide synthase (iNOS) could be exerted as the crucial pathological factors in glaucoma- and blue light-induced retinal injuries. The present study aimed to investigate the retinoprotective effects and mechanisms of fungal ingredient 3,4-dihydroxybenzalacetone (DBL) isolated from Phellinus linteus in the retinal glial activation and retinodegenerative animal models. According to the cellular studies, DBL significantly and concentration-dependently abrogated MMP-9 activation and expression in TNFα-stimulated retinal Müller (rMC-1) cells. We found the inhibitory activities of DBL were strongly through the STAT- and ERK-dependent pathways. Furthermore, DBL dramatically attenuated MMP-9 activation in the stimulated Müller cells exposed to conditioned media from LPS-stimulated microglia BV-2 cells. On the other hand, DBL strongly suppressed LPS-induced production of NO and ROS and expression of iNOS in microglia BV-2 cells. Consistently, the phosphorylation of STAT was substantially blocked by DBL in LPS-stimulated microglia BV-2 cells. In the evaluation of retinoprotective functions, the high IOP-induced scotopic electroretinographic (ERG) deficit and blue light-induced abnormal pupillary light response (PLR) were assessed. The deficit scotopic ERG responses markedly recovered by DBL in a rat model of glaucoma-like ischemia/reperfusion (I/R)-injury. DBL also reduced the aqueous gelatinolytic activity and retinal MMP-9 expression in high IOP-injured conditions. Additionally, DBL could restore the abnormal PLR and reduce retinal MMP-9 activation. In summary, DBL could ameliorate retinal neuroinflammation and MMP-9 activation by predominantly inhibiting STAT3 activation in the retinal Müller cells and microglia, which exhibits therapeutic potential for glaucoma and other retinal degenerative diseases.

Keywords: glaucoma, blue light, DBL, retinal Müller cell, MMP-9, STAT, Microglia, iNOS, ERG, PLR

Procedia PDF Downloads 110

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

Abstract:

Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

Procedia PDF Downloads 65

Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

Abstract:

Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

Procedia PDF Downloads 201