Effectiveness of Implementing Modified Early Warning System and Rapid Response Team for General Ward Inpatients.

This retrospective study assessed the effectiveness and impact of implementing a Modified Early Warning System (MEWS) and Rapid Response Team (RRT) for inpatients admitted to the general ward (GW) of a medical center. This study included all inpatients who stayed in GWs from Jan. 2017 to Feb. 2022. We divided inpatients into GWnon-MEWS and GWMEWS groups according to MEWS and RRT implementation in Aug. 2019. The primary outcome, unexpected deterioration, was defined by unplanned admission to intensive care units. We defined the detection performance and effectiveness of MEWS according to if a warning occurred within 24 h before the unplanned ICU admission. There were 129,039 inpatients included in this study, comprising 58,106 GWnon-MEWS and 71,023 GWMEWS. The numbers of inpatients who underwent an unplanned ICU admission in GWnon-MEWS and GWMEWS were 488 (.84%) and 468 (.66%), respectively, indicating that the implementation significantly reduced unexpected deterioration (p < .0001). Besides, 1,551,525 times MEWS assessments were executed for the GWMEWS. The sensitivity, specificity, positive predicted value, and negative predicted value of the MEWS were 29.9%, 98.7%, 7.09%, and 99.76%, respectively. A total of 1,568 warning signs accurately occurred within the 24 h before an unplanned ICU admission. Among them, 428 (27.3%) met the criteria for automatically calling RRT, and 1,140 signs necessitated the nursing staff to decide if they needed to call RRT. Implementing MEWS and RRT increases nursing staff's monitoring and interventions and reduces unplanned ICU admissions.

Which are the vital factors of mobile personal health records applications that promote continued usage? A perspective on technology fit and social capital.

Introduction: With the widespread use of mobile devices and the rapid development of mobile networks, connecting mobile personal health record (mPHR) apps to wearable devices to collect personal health data for analysis and community activities has become a trend for health promotion. Therefore, the present study aims to explore the vital factors that impact the sustained usage of mPHR apps. Objective: In this study, we identified social lock-in as a major research gap in the current era of social media and the Internet. Therefore, to explore the effects of mPHR apps on continued app usage intention, we combined technology fit (individual-technology, synchronicity-technology, and task-technology fit) and social capital (structural, relational, and cognitive capital) to develop a novel study model. Methods: The purpose of this research is to investigate the willingness to participate in the mPHR apps. It collected 565 valid users' responses through the online questionnaire with a structural equation modeling approach. Results: That technology and social lock-in significantly affected the willingness of users to continue using mPHR apps (ß = 0.38, P < 0.001) and that the effects of social lock-in (ß = 0.38, P < 0.001) were more pronounced than those of technology lock-in (ß = 0.22, P < 0.001). Conclusions: The technology and social lock-in generated by technology fit and social capital had positive effects on continued app usage and the effects of both types of lock-in on continued app usage varied among different participant groups.

Low Seroprevalence of Aichi Virus Infection in Taiwan.

Aichi virus (AiV) belongs to the genus Kobuvirus of the family Picornaviridae; it is a single-stranded positive-sense RNA virus without an envelope. AiV causes acute gastroenteritis, abdominal pain, nausea, vomiting, and fever. Low incidence and high seroprevalence of AiV infections have been reported in several regions of the world; however, little was known on the prevalence of AiV infections in Taiwan. This study described the first two cases of AiV infection and analyzed AiV seroprevalence in Taiwan. A total of 700 sera were collected from a single hospital in southern Taiwan. The neutralization assay was employed to assess AiV neutralization antibodies in the serum. The test identified 48 positive cases, with a seroprevalence of 6.86%. Results also showed a gradual increase in AiV seroprevalence rate with age. Compared with other countries, Taiwan had a relatively low AiV seroprevalence, suggesting a low incidence of or sporadic AiV infections.

Evaluating the E-Health Cloud Computing Systems Adoption in Taiwan's Healthcare Industry.

Although the electronic health (e-health) cloud computing system is a promising innovation, its adoption in the healthcare industry has been slow. This study investigated the adoption of e-health cloud computing systems in the healthcare industry and considered security functions, management, cloud service delivery, and cloud software for e-health cloud computing systems. Although numerous studies have determined factors affecting e-health cloud computing systems, few comprehensive reviews of factors and their relations have been conducted. Therefore, this study investigated the relations between the factors affecting e-health cloud computing systems by using a multiple criteria decision-making technique, in which decision-making trial and evaluation laboratory (DEMATEL), DANP (DEMATEL-based Analytic Network Process), and modified VIKOR (VlseKriterijumska Optimizacija I Kompromisno Resenje) approaches were combined. The intended level of adoption of an e-health cloud computing system could be determined by using the proposed approach. The results of a case study performed on the Taiwanese healthcare industry indicated that the cloud management function must be primarily enhanced and that cost effectiveness is the most significant factor in the adoption of e-health cloud computing. This result is valuable for allocating resources to decrease performance gaps in the Taiwanese healthcare industry.

Comparison of diagnostic tools with multiplex polymerase chain reaction for pediatric lower respiratory tract infection: a single center study.

BACKGROUND/PURPOSE: Acute respiratory tract infections are a leading cause of morbidity and mortality in children worldwide. Most have a viral etiology, with pneumococcus as an important pathogen. This single-center study compared the use of conventional diagnostic tools and two multiplex polymerase chain reaction (PCR) examinations for determining pathogens in lower respiratory tract infections (LRTIs) among children aged <5 years. METHODS: From July to October 2010, 45 patients aged 2 months to 60 months and diagnosed as having LRTIs were enrolled. Their nasopharyngeal aspirates were evaluated through viral culture and two multiplex PCR examinations. The patients' clinical course, symptoms, signs, and laboratory findings were recorded and analyzed. RESULTS: Among the 45 patients, 38 (84.4%) had detectable pathogens. Conventional viral and blood cultures had 35.6% positive rate, which increased to 51.1% when the quick antigen tests (Influenza A+B test and respiratory syncytial virus) and urine pneumococcal antigen test were combined. The positive rate further increased to 84.4% when the two multiplex PCR methods were combined. Twelve patients had co-infection, including 10 detected by the multiplex PCR methods. The co-infection rate was 26.7% (12/45). CONCLUSION: Most LRTIs in children have a viral etiology. Multiplex PCR tests are rapid assays that can increase the diagnostic yield rate and detect slow-growing viruses and can detect more pathogens than conventional viral culture to enable, thereby helping clinicians to provide appropriate and timely treatment.

Detection and identification of human parechoviruses from clinical specimens.

Human parechovirus (HPeV) may cause various illnesses; however, technologists and clinicians often overlook it. This study, designed to detect HPeV in 3124 clinical specimens from 2849 patients between January and August 2007, presents the first report of HPeVs confirmed by RNA sequences in Taiwan. Reverse transcriptase polymerase chain reaction (RT-PCR) and phylogenetic tree analysis identified the isolates as HPeV1 (n = 5), HPeV3 (n = 1), and HPeV4 (n = 2) from 6 children. Although the prevalence is low, HPeVs do cause significant clinical manifestations in children. Phylogenetic analysis has separated the 8 HPeV1 strains as a new lineage from the prototype strain (L02971) in evolutionary transition. Clinicians and technologists should have a high index of suspicion and apply RT-PCR for identification when presented with slower Enterovirus-like cytopathic effect (CPE) in cell cultures and negative or equivocal results of staining with indirect immunofluorescence assay, particularly if the CPE is larger, smoother, and more refractive and relatively slow.

Use of a disposable water filter for prevention of false-positive results due to nontuberculosis mycobacteria in a clinical laboratory performing routine acid-fast staining for tuberculosis.

A point-of-use 0.2-microm filter was evaluated for elimination of nontuberculosis mycobacteria in laboratory water to reduce false-positive acid-fast bacillus staining results. Use of the point-of-use filter can significantly reduce the false-positive rate to 1.2% compared to samples treated with tap water (10.7%) and deionized water (8.7%).