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1.
Nanotechnology ; 33(15)2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-34965523

RESUMO

Cu with nanotwin (NT) possesses great electrical, mechanical, and thermal properties and has potential for electronic applications. Various studies have reported the effect of NT orientation on Cu mechanical properties. However, its effect on Cu stress-relaxation behavior has not been clarified, particularly in nano-scale. In this study, Cu nanopillars with various orientations were examined by a picoindenter under constant strain and observed byin situTEM. The angles between the twin plane and the loading direction in the examined nanopillars were 0°, 60°, to 90°, and a benchmark pillar of single-crystal Cu without NT was examined. The stress drops were respectively 10%, 80%, 4%, and 50%. Owing to the interaction by NT, the dislocation behavior in nanopillars was different from that in bulk or in thin film samples. Especially, the rapid slip path of dislocations to go to the free surface of the nanopillar induced a dislocation-free zone in the 0° nanopillar, which led to work-softening. On the contrary, a high dislocation density was observed in the 90° nanopillar, which was generated by dislocation interaction and obstruction of dislocation slip by twin planes, and it led to work-hardening. The findings reveal the NT orientation in Cu nanopillars affected stress relaxation significantly.

2.
Clin Radiol ; 76(8): 626.e23-626.e32, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34023068

RESUMO

AIM: To compare the performance and reading time of different readers using automatic artificial intelligence (AI)-powered computer-aided detection (CAD) to detect lung nodules in different reading modes. MATERIALS AND METHODS: One hundred and fifty multidetector computed tomography (CT) datasets containing 340 nodules ≤10 mm in diameter were collected retrospectively. A CAD with vessel-suppressed function was used to interpret the images. Three junior and three senior readers were assigned to read (1) CT images without CAD, (2) second-read using CAD in which CAD was applied only after initial unassisted assessment, and (3) a concurrent read with CAD in which CAD was applied at the start of assessment. Diagnostic performances and reading times were compared using analysis of variance. RESULTS: For all readers, the mean sensitivity improved from 64% (95% confidence interval [CI]: 62%, 66%) for the without-CAD mode to 82% (95% CI: 80%, 84%) for the second-reading mode and to 80% (95% CI: 79%, 82%) for the concurrent-reading mode (p<0.001). There was no significant difference between the two modes in terms of the mean sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for both junior and senior readers and all readers (p>0.05). The reading time of all readers was significantly shorter for the concurrent-reading mode (124 ± 25 seconds) compared to without CAD (156 ± 34 seconds; p<0.001) and the second-reading mode (197 ± 46 seconds; p<0.001). CONCLUSION: In CAD for lung nodules at CT, the second-reading mode and concurrent-reading mode may improve detection performance for all readers in both screening and clinical routine practice. Concurrent use of CAD is more efficient for both junior and senior readers.


Assuntos
Inteligência Artificial , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Tempo
3.
Sci Rep ; 10(1): 16566, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024166

RESUMO

Fine grained and nanotwinned Au has many excellent properties and is widely used in electronic devices. We have fabricated [Formula: see text] preferred-oriented Au thin films by DC plating at 5 mA/cm2. Microstructure analysis of the films show a unique fine grain structure with a twin formation. Hardness tests performed on electroplated [Formula: see text] Au films show a hardness 47% greater than random and untwinned Au. We then achieved direct bonding between two Au [Formula: see text] surfaces operating at 200 °C for an hour in a vacuum oven. The highly-oriented [Formula: see text] nanotwinned Au films could be an ideal material in many gold products.

4.
QJM ; 112(10): 787-792, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31250012

RESUMO

BACKGROUND: The role of Helicobacter pylori (H. pylori) infection in the development of colorectal neoplasia has been a matter of scientific debate with controversial findings. AIMS: This study examined the association between H. pylori infection and colorectal cancer (CRC) in a nationwide population-based Chinese cohort study. METHODS: A total of approximately 3936 individuals with newly diagnosed H. pylori infection (the H. pylori-infected cohort) and 15 744 age- and sex-matched patients with diagnoses absence of H. pylori infection (the comparison cohort) from 2000 to 2005 were identified from Taiwan's National Health Insurance Research Database. The Kaplan-Meier method was used for measuring the cumulative incidence of CRC in each cohort. Cox proportional hazards models were used to compute hazard ratios (HRs) and accompanying 95% confidence intervals (CIs) for the estimation of the association between H. pylori infection and CRC. RESULTS: The cumulative incidence of CRC was higher in H. pylori-infected cohort than that in the comparison cohort (log-rank test, P < 0.001). After adjustment for potential confounders, H. pylori infection was associated with a significantly increased risk of CRC (adjusted HR 1.87; 95% CI 1.37-2.57). In addition, the HR of CRC appeared to increase with increasing frequency of clinical visits for H. pylori infection. CONCLUSIONS: Our study demonstrated that H. pylori infection was associated with an increased risk of CRC, which warrants confirmation and exploration of the underlying biologic mechanisms by future studies.


Assuntos
Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/microbiologia , Infecções por Helicobacter/complicações , Adulto , Distribuição por Idade , Idoso , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia , Adulto Jovem
5.
J Intellect Disabil Res ; 63(9): 1125-1136, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31016807

RESUMO

BACKGROUND: To promote sexual health in adults with an intellectual disability (ID) in Taiwan, sexual health programmes were provided to adults with ID, their parents and service workers. This study evaluates the impact of these programmes that involved the parents and service workers. METHODS: Intervention and participatory research paradigms were applied to develop, implement and evaluate programmes that address the challenges that relate to the sexual rights of adults with ID. Additionally, the programmes fostered open dialogue among the participants concerning the sexual health of people with ID. In total, 57 parents and 164 service workers were involved in the programmes. A quasi-experimental design and standardised questionnaires (Attitudes to Sexuality Questionnaire - Individuals with an Intellectual Disability), as well as in-depth interviews, were used to collect both quantitative and qualitative data on the programmes' effectiveness and participants' experiences between April 2012 and July 2015. RESULTS: The findings revealed that after the programmes were implemented, attitudes towards the sexual rights of people with ID were significantly more positive among both the parents and service workers. Participation in the sexual health programmes facilitated constructive dialogue by revealing hidden concerns and by transforming the perspectives of the parents and service workers from viewing sexuality as a social problem to understanding the sexual rights of adults with ID. CONCLUSIONS: Both the quantitative and qualitative results demonstrate that the programmes had a positive impact on the parents and service workers in terms of their attitudes towards the sexual rights of people with ID. Open dialogue and reciprocal interaction strategies caused transformations in the perspectives of parents and service workers on sexual health.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Direitos Humanos , Deficiência Intelectual , Pais , Pessoas com Deficiência Mental , Avaliação de Programas e Projetos de Saúde , Saúde Sexual , Sexualidade , Adulto , Idoso , Feminino , Pessoal de Saúde , Direitos Humanos/legislação & jurisprudência , Humanos , Masculino , Pessoa de Meia-Idade , Pessoas com Deficiência Mental/legislação & jurisprudência , Pesquisa Qualitativa , Saúde Sexual/legislação & jurisprudência , Taiwan
6.
QJM ; 112(4): 269-274, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30629254

RESUMO

BACKGROUND: The association between Parkinson's disease (PD) and stroke remains completely understood. AIM: We aimed to investigate stroke risk and post-stroke outcomes in patients with PD. DESIGN: The retrospective cohort study included 1303 patients aged ≥ 40 years with new-diagnosed PD and 5212 non-PD adults were selected by frequency matching with age and sex in 2000-05. Both two groups were followed up until the end of 2013. Another nested stroke cohort study of 17 678 patients with stroke hospitalization in 2002-09 was conducted to compare the admission outcome in patients with and without PD history. METHODS: We collected patients' characteristics and medical conditions in the present two studies from claims data of Taiwan's National Health Insurance. Incidences and risks of stroke in people with and without PD during the follow-up period were calculated by adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) in the Cox proportional hazard model. Complications and mortality during the stroke admission associated with PD were analysed by calculating adjusted odds ratios (ORs) and 95% CIs in the logistic regressions. RESULTS: Incidences of stroke for people with and without PD were 19.8 and 9.93 per 1000 person-years, respectively, with corresponding HR of 1.96 (95% CI 1.67-2.30). History of PD was associated with post-stroke gastrointestinal bleeding (OR 1.25, 95% CI 1.05-1.49), epilepsy (OR 1.64, 95% CI 1.32-2.04), pneumonia (OR 1.34, 95% CI 1.20-1.49), urinary tract infection (OR 1.33, 95% CI 1.21-1.45) and mortality (OR 1.35, 95% CI 1.13-1.62). CONCLUSION: PD increases stroke risk and influences post-stroke outcomes.


Assuntos
Doença de Parkinson/complicações , Acidente Vascular Cerebral/etiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/epidemiologia , Medição de Risco/métodos , Distribuição por Sexo , Fatores Socioeconômicos , Acidente Vascular Cerebral/epidemiologia , Taiwan/epidemiologia
7.
Clin Microbiol Infect ; 25(4): 512.e1-512.e6, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29906589

RESUMO

OBJECTIVES: Tigecycline non-susceptible Acinetobacter nosocomialis (TNAN) has been discovered in clinical isolates. The resistance-nodulation-cell division (RND)-type efflux system plays a major role in tigecycline non-susceptible Acinetobacter baumannii, but the mechanism in A. nosocomialis remains unknown. Our aim was to analyse the contribution of efflux-based tigecycline resistance in clinical A. nosocomialis isolates collected from multiple medical centres in Taiwan. METHODS: A total of 57 A. nosocomialis isolates, including 46 TNAN and 11 tigecycline-susceptible A. nosocomialis (TSAN) isolates, were analysed. Of these, 46 TNAN isolates were clustered to ST410 (43 isolates) and ST68 (three isolates) by multi-locus sequence typing. RESULTS: The relationship between the RND efflux pump and tigecycline resistance was indirectly verified by successfully reducing tigecycline resistance with NMP, an efflux pump inhibitor. The three RND efflux systems (AdeABC, AdeIJK and AdeFGH) were detected in all clinical isolates. The transcript level of adeB gene increased significantly and was correlated with tigecycline resistance. Moreover, the AdeRS two-component system was further classified into four different types of AdeRS patterns considering the amino acid sequence. Further analysis showed that tigecycline resistance was related to the transcript level of adeB gene and the AdeRS pattern. CONCLUSION: This study showed that the dissemination of TNAN isolates in Taiwan is attributable mainly to the spread of ST410. The AdeABC efflux pump appeared to play an important role in the tigecycline resistance of A. nosocomialis.


Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Acinetobacter/efeitos dos fármacos , Acinetobacter/isolamento & purificação , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/fisiologia , Proteínas de Membrana Transportadoras/metabolismo , Tigeciclina/uso terapêutico , Acinetobacter/genética , Acinetobacter/metabolismo , Infecções por Acinetobacter/microbiologia , Sequência de Aminoácidos/genética , Farmacorresistência Bacteriana/genética , Humanos , Proteínas de Membrana Transportadoras/biossíntese , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Taiwan
8.
Med Vet Entomol ; 33(2): 195-202, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30488454

RESUMO

In current sampling approaches, there exists a divergence between the surveillance of arthropod-borne and that of non-arthropod-borne viruses. It is commonly held that the collection of vector specimens applies only to arbovirus surveillance and that the surveillance of non-arboviruses must rely on traditional methods that involve the sampling of blood, faeces or saliva, or other examinations. The vector-based approach is a sampling method that has the ability to survey both arboviruses and non-arboviruses by distinguishing engorged vector specimens from entire vector samples. Accordingly, five arboviruses and three non-arboviruses were detected in a study using a vector-based approach conducted during 2012-2015. Hence, this report provides the first description of the Taiwanese vector species for the bovine arboviruses detected. The present investigations demonstrate that the vector-based approach applies not only to the surveillance of arboviruses, but also has potential as a possible tool for monitoring non-arboviruses on livestock farms in the future.


Assuntos
Infecções por Arbovirus/veterinária , Arbovírus/isolamento & purificação , Doenças dos Bovinos/virologia , Ceratopogonidae/virologia , Culicidae/virologia , Insetos Vetores/virologia , Animais , Infecções por Arbovirus/virologia , Bovinos , Mosquitos Vetores/virologia , Taiwan
9.
Clin Radiol ; 74(2): 166.e1-166.e7, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30514584

RESUMO

AIM: To report positive predictive values (PPVs) of mammographic findings (MFs) of a screening cohort in Taiwan with a view to providing radiologists around the world with adequate information for assessing MFs before recommending biopsy for Asian women. MATERIALS AND METHODS: Between January 2014 and June 2017, 18,449 women received screening mammography at Tri-Service General Hospital (TSGH). Of these women, 1,622 exhibited specific MFs, namely mass (n=518), microcalcification (n=668), focal asymmetry (FA; n=462), and architectural distortion (AD; n=117). The distribution and PPVs of each MF were calculated after stratification based on cancer type, age, and breast density. RESULTS: The age group with the highest proportion of women was 50-59 years (48.1%), and most women presented with dense breasts (68.6%). The most common MF in the recalled women was microcalcification (41.2%) and the least common was AD (7.2%). AD was the most predictive MF for overall breast cancers, invasive carcinomas, and carcinomas in situ. Microcalcification was the second most predictive MF among recalled women for predicting overall breast cancers; however, it was less predictive than mass and FA in women who received a biopsy recommendation or underwent biopsy. CONCLUSION: AD can indicate the likelihood of breast cancer development in Asian women with abnormal screening results. Benign breast diseases are more likely to occur in women recommended for or receiving breast biopsy owing to microcalcification than to mass or FA.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma in Situ/diagnóstico por imagem , Mamografia/métodos , Adulto , Fatores Etários , Idoso , Ásia , Mama/diagnóstico por imagem , Doenças Mamárias/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Taiwan
11.
Eur J Surg Oncol ; 43(10): 1855-1861, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28756019

RESUMO

BACKGROUND: Recent publications have suggested that human epidermal growth factor receptor 2 (HER2)-negative breast cancers with "weak" estrogen receptor (ER)/progesterone receptor (PR) expression levels by immunohistochemical (IHC) analysis were considered as the triple-negative (TN) subtype. This study aimed to evaluate the overall survival (OS), disease-free survival rates (DFS), and disease-specific survival (DSS) based on ER and PR expression levels into one of three groups, ER and PR <1%, ER and PR 1%-20%, and ER or PR >20% by hormone therapy. METHODS: Medical records of 3353 breast cancer patients treated from 2006 to 2013 were retrospectively reviewed. Tumor characteristics, type of treatment, OS, DFS and DSS were evaluated among the three patient groups. RESULTS: Regarding OS, there were significant differences according to the received hormone therapy in the different groups: ER and PR <1% (P = 0.972), ER and PR 1%-20% (P = 0.264), and ER or PR >20% (P = 0.014). Regarding DFS and DSS, there were also significant differences in the different groups: ER and PR <1% (P = 0.611, 0.766), ER and PR 1%-20% (P = 0.847, 0.629), and ER or PR >20% (P = 0.031, 0.002). CONCLUSIONS: In HER2 negative breast cancer patient with hormone therapy, ER and PR expression level of 1%-20% has similar survival outcome to the ER and PR expression level of <1% by IHC analysis.


Assuntos
Receptor ErbB-2/metabolismo , Receptores de Estrogênio/biossíntese , Receptores de Progesterona/biossíntese , Neoplasias de Mama Triplo Negativas/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Intervalo Livre de Doença , Feminino , Seguimentos , Terapia de Reposição Hormonal/métodos , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Taiwan/epidemiologia , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/metabolismo , Adulto Jovem
12.
J Intellect Disabil Res ; 61(2): 144-154, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27189793

RESUMO

BACKGROUND: Self-determined behaviour is composed of multiple, interrelated component elements, and yet little empirical study has researched the self-determination components other than choice making and goal setting. Also, few theoretical relationships have been drawn between the component elements of self-determined behaviour and the impact of disability category. Therefore, this study examined profiles of the combination of three self-report measures of component elements of self-determined behaviour (autonomous functioning, problem solving and internal locus of control) between two groups (ID and learning disabilities/emotional disorders). METHOD: We analysed data from 96 middle school and high school students ages 13 through 22 years who completed three self-report instruments of the Autonomy - section 1 of The Arc's Self-determination Scale, the Problem Solving Survey and the Nowicki-Strickland Locus of Control Scale. A multivariate analysis of covariance was conducted to investigate the differences between the two groups after controlling for the developmental effects of age. A discriminant function analysis examined whether membership of the two groups could be predicted from the three component elements. RESULTS: Results showed that each group had different profiles within the combined three component elements of self-determination but groups were not different on any single measure of component elements of self-determined behaviour exclusively. The combination of three variables was useful in confirming the membership of two dichotomous groups. CONCLUSIONS: Score differences on the three component behaviour imply that the two groups have different instructional needs and therefore require differentiated instructional approaches. The three measures of the component elements of self-determined behaviour collectively separate the two groups, suggesting that the component elements should be considered in a combination as opposed to being treated as individual elements in the context of discussing self-determined behaviour.


Assuntos
Sintomas Afetivos/psicologia , Pessoas com Deficiência/psicologia , Deficiências da Aprendizagem/psicologia , Autonomia Pessoal , Estudantes/psicologia , Adolescente , Adulto , Educação Inclusiva , Feminino , Humanos , Masculino , Adulto Jovem
13.
Nat Mater ; 14(8): 820-5, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26168344

RESUMO

Nanowire growth by the vapour-liquid-solid (VLS) process enables a high level of control over nanowire composition, diameter, growth direction, branching and kinking, periodic twinning, and crystal structure. The tremendous impact of VLS-grown nanowires is due to this structural versatility, generating applications ranging from solid-state lighting and single-photon sources to thermoelectric devices. Here, we show that the morphology of these nanostructures can be further tailored by using the liquid droplets that catalyse nanowire growth as a 'mixing bowl', in which growth materials are sequentially supplied to nucleate new phases. Growing within the liquid, these phases adopt the shape of faceted nanocrystals that are then incorporated into the nanowires by further growth. We demonstrate this concept by epitaxially incorporating metal-silicide nanocrystals into Si nanowires with defect-free interfaces, and discuss how this process can be generalized to create complex nanowire-based heterostructures.

14.
Clin Otolaryngol ; 40(4): 355-62, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25639297

RESUMO

OBJECTIVE: Recent reports have identified hypercholesterolaemia as a significant risk factor for idiopathic sudden sensorineural hearing loss (ISSNHL). Therefore, we investigated whether lipid profiles and lipoprotein ratios are correlated with the prognosis of hearing recovery in ISSNHL patients. DESIGN: A retrospective cohort study. MAIN OUTCOME MEASURES: Patients with ISSNHL were classified into four groups (complete, partial, slight and no recovery) according to their degree of hearing recovery using Siegel's criteria and the Sudden Deafness Research Group (SDRG) criteria developed by the Japanese Ministry of Welfare. All patients' lipid profiles were analysed, including total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol and triglycerides. We calculated the ratios of TC/HDL-C and LDL-C/HDL-C and used statistical methods to evaluate correlations between lipid profiles and lipoprotein ratios and ISSNHL prognosis. RESULTS: Hearing recovery was observed in 103 (62.0%) of 166 cases using Siegel's criteria and in 114 (68.7%) of 166 cases using SDRG's criteria. Among the three recovery groups (i.e. excluding the no recovery group), the ratio of LDL-C/HDL-C was found to be associated with recovery outcome by showing the ratio on an upward trend from complete recovery to slight recovery group, and the difference is statistically significant (P = 0.016 by Siegel's criteria, P = 0.041 by SDRG's criteria). Multiple linear regression analysis further revealed a significantly higher LDL-C/HDL-C ratio in slight hearing recovery group compared with complete recovery group (P = 0.007 by Siegel's criteria, P = 0.031 by SDRG's criteria). CONCLUSION: We suggested that lipoprotein ratio of LDL-C/HDL-C may be a prognostic factor for hearing recovery in ISSNHL patients. Further studies should be conducted to determine whether hearing outcomes in ISSNHL can be improved by changing patients' lipid profiles via antilipidemic treatment.


Assuntos
Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Súbita/etiologia , Hiperlipidemias/complicações , Feminino , Perda Auditiva Neurossensorial/classificação , Perda Auditiva Súbita/classificação , Humanos , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
15.
Osteoporos Int ; 26(6): 1723-32, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25672807

RESUMO

UNLABELLED: The association between Parkinson's disease and fracture was not completely understood. This nationwide study investigated increased risk of fracture in patients with Parkinson's disease. In the nested cohort study, Parkinson's disease was associated with pneumonia, septicemia, stroke, urinary tract infection, and mortality after fracture admission. INTRODUCTION: Falls are a common complication in people with Parkinson's disease (PD). This study evaluated fracture risk and post-fracture outcomes in patients with PD. METHODS: We identified 1,423 adults aged 40 years and older newly diagnosed with PD using the Taiwan National Health Insurance Research Database from 2000 to 2003. Comparison cohort consisted of 5,692 adults without PD randomly selected from the same dataset, frequency matched in age and sex. Followed-up events of fracture from January 1, 2000, until December 31, 2008, were ascertained from medical claims. Adjusted hazard ratios (HR) and 95 % confidence interval (CI) of fracture associated with PD were evaluated. Another nested cohort study of 397,766 hospitalized fracture patients analyzed for adjusted odds ratios (ORs) and 95 % CIs of adverse events after fracture among patients with and without PD between 2004 and 2010. RESULTS: The incidences of fracture for people with and without PD were 39.5 and 23.9 per 1,000 person-years, respectively (p < 0.0001). Compared with control, the adjusted HR of fracture was 2.25 (95 % CI 1.97-2.58) for PD patients. Previous PD was associated with risks of pneumonia (OR 1.44, 95 % CI 1.36-1.52), septicemia (OR 1.41, 95 % CI 1.33-1.49), stroke (OR 1.40, 95 % CI 1.32-1.50), urinary tract infection (OR 1.53, 95 % CI 1.46-1.61), and mortality (OR 1.25, 95 % CI 1.15-1.35) after fracture. CONCLUSIONS: PD was associated with higher risk of fracture. Patients with PD had more complications and mortality after fracture. Fracture prevention and attention to post-fracture adverse events are needed for this susceptible population.


Assuntos
Fraturas Ósseas/epidemiologia , Doença de Parkinson/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Fraturas Ósseas/etiologia , Mortalidade Hospitalar , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Prognóstico , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Taiwan/epidemiologia
16.
J Clin Pharm Ther ; 40(2): 240-4, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25487647

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Dosage adjustment of 500 mg ertapenem daily is recommended for patients with advanced kidney disease. 30% of ertapenem is cleared by a session of haemodialysis (HD). However, because most published carbapenems studies have excluded patients on dialysis, little is known about the dosing of ertapenem to avoid central nervous system (CNS) toxicity in regular HD patients. We report of four patients who developed CNS toxicity in such patients. CASE SUMMARY: The 4 HD patients developed unexplained CNS toxicity manifested as seizures, hallucination and cognitive dysfunction after receiving 3-7 consecutive recommended doses of ertapenem. Their symptoms of CNS toxicity were completely resolved within 8 days after discontinuation of ertapenem. In one of our presented cases, we demonstrated the very high level of plasma ertapenem accumulating with several consecutive doses. Cognitive function gradually recovered in line with a corresponding decline in blood level of ertapenem. WHAT IS NEW AND CONCLUSIONS: This is the first report of ertapenem-associated CNS toxicity in patients on regular HD and utilizing the plasma ertapenem concentration to demonstrate the causal relationship. The recommended dosage of 500 mg ertapenem daily may be still too high in regular HD patients, especially in Asians, owing to their relatively small body size. An increased awareness of ertapenem-associated CNS toxicity would avoid unnecessary examinations, hospitalization, and potentially catastrophic complications.


Assuntos
Antibacterianos/efeitos adversos , Antibacterianos/farmacocinética , Doenças do Sistema Nervoso Central/induzido quimicamente , Diálise Renal , beta-Lactamas/efeitos adversos , beta-Lactamas/farmacocinética , Idoso , Povo Asiático , Relação Dose-Resposta a Droga , Ertapenem , Feminino , Humanos , Masculino , Insuficiência Renal
17.
J Hum Hypertens ; 28(11): 689-93, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24430706

RESUMO

Limited evidence is available on the risk differences in the development of stroke subtypes in relation to particular clustering patterns of the metabolic syndrome (MetS) components. A follow-up study of a Chinese cohort involving 10,292 individuals was performed to assess the roles of cluster patterns of the MetS components in the prediction of incident stroke subtypes. During follow-up, there were 161 incident cases of ischemic strokes and 41 incident cases of hemorrhagic strokes. Among MetS components, only the hypertensive trait was associated with significantly elevated risks of both ischemic and hemorrhagic strokes. Furthermore, MetS with hypertension as components was associated with increased risk of ischemic and hemorrhagic strokes (adjusted hazards ratio (95% confidence interval) was 2.96 (1.94-4.50) and 2.93 (1.25-6.90), respectively) as compared with those who had neither hypertension nor MetS. Notably, as the number of the MetS components increased, the risk of ischemic stroke significantly and dose-dependently increased. This implies a cumulative effect of MetS components in elevating the risk of ischemic stroke. These findings suggest that MetS comprises heterogenous clusters with respect to the risk of developing the subtype of stroke.


Assuntos
Povo Asiático , Síndrome Metabólica/etnologia , Acidente Vascular Cerebral/etnologia , Adulto , Idoso , Análise por Conglomerados , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/diagnóstico , Taiwan/epidemiologia , Adulto Jovem
18.
Science ; 343(6168): 281-4, 2014 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-24436416

RESUMO

In the growth of nanoscale device structures, the ultimate goal is atomic-level precision. By growing III-V nanowires in a transmission electron microscope, we measured the local kinetics in situ as each atomic plane was added at the catalyst-nanowire growth interface by the vapor-liquid-solid process. During growth of gallium phosphide nanowires at typical V/III ratios, we found surprising fluctuations in growth rate, even under steady growth conditions. We correlated these fluctuations with the formation of twin defects in the nanowire, and found that these variations can be suppressed by switching to growth conditions with a low V/III ratio. We derive a growth model showing that this unexpected variation in local growth kinetics reflects the very different supply pathways of the V and III species. The model explains under which conditions the growth rate can be controlled precisely at the atomic level.

19.
J Intellect Disabil Res ; 55(9): 823-31, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21366754

RESUMO

BACKGROUND: The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family. METHODS: A one-group repeated-measures analysis was conducted for five interviews after the adults with intellectual disabilities entered the new environment. Forty-nine adults were initially studied (T1) and 29 adults remained in the homes until the end of the study (T5). RESULTS: This study found significant improvements over the 2 years in the residents' quality of life and family contact. The results also highlight a decrease in maladaptive behaviour among the residents moving from institution and an increase in choice making and family contact among the residents moving from family. No significant changes in adaptive behaviour and community inclusion were found. CONCLUSION: Results revealed that further policy changes and financial support including service quality assurance are required in order to improve service outcomes for adults living in the new residential scheme.


Assuntos
Deficiência Intelectual/psicologia , Deficiência Intelectual/terapia , Avaliação de Resultados em Cuidados de Saúde , Instituições Residenciais/organização & administração , Instituições Residenciais/normas , Adaptação Psicológica , Adulto , Saúde da Família , Feminino , Seguimentos , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Comportamento Social , Taiwan , Adulto Jovem
20.
J Intellect Disabil Res ; 55(6): 572-80, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21435068

RESUMO

BACKGROUND: In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire - Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. METHODS: People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. RESULTS: A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40-item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self-determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P<0.000, P<0.01 and P<0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α=0.79). CONCLUSIONS: Initial validity tests indicated that the Chinese Quality of Life Questionnaire - Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made.


Assuntos
Comparação Transcultural , Características Culturais , Deficiência Intelectual/etnologia , Deficiência Intelectual/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários , Atividades Cotidianas/classificação , Atividades Cotidianas/psicologia , Adolescente , Adulto , Idoso , Comorbidade , Educação de Pessoa com Deficiência Intelectual , Feminino , Hong Kong , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/reabilitação , Masculino , Pessoa de Meia-Idade , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Ajustamento Social , Adulto Jovem
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