Total cholesterol affects the outcome of patients with anterior cerebral artery-occluded acute ischemic stroke treated with thrombolysis.

OBJECTIVE: In this study, we investigated whether certain types of lipid profiles are major contributors of acute ischemic stroke (AIS). PATIENTS AND METHODS: We screened 13,285 hospitalized patients in two stroke medical centers treated with thrombolysis, thrombectomy, or conventional care for anterior cerebral artery-occluded AIS, and found 266 patients. We examined their plasma lipid profiles using the cutoff values from a receiver operating characteristic (ROC) curve. We applied a multivariate logistic regression or Fisher's exact test to compare their outcomes and risk factors. We used the modified Rankin scale (mRS) score to assess the major clinical outcome of the patients 3 months after disease onset. Mortality and symptomatic intracranial hemorrhage (sICH) were both evaluated as risk factors. We analyzed symptoms' improvements at discharge as a disease outcome measure. RESULTS: In the patients with anterior cerebral artery-occluded AIS (NIHSS ≥ 10) treated by intravenous (IV) thrombolysis, a total cholesterol (TC) level greater than 5.07 mmol/L predicted a poor outcome (OR 3.55, 95% CI 1.21,10.46, p=0.021). CONCLUSIONS: In patients with anterior cerebral artery-occluded AIS, the TC level is a promising prognosis marker for the IV thrombolysis outcome.

Assessing equity: a way to improve sanitation service delivery in South African informal settlements.

This paper discusses the need to incorporate equity assessment into the planning and monitoring of sanitation service delivery to South African informal settlements. Equity assessment criteria were drawn from literature and a study of sanitation service delivery to informal settlements in three South African municipalities (Cape Town, Johannesburg and eThekwini) over the period 2012-2015. Three key dimensions of equity - resource allocation, access and stakeholder perceptions - were identified. These had eight associated criteria: (1) funds allocated for basic sanitation, (2) number of staff allocated to informal settlements, (3) disparities in access, (4) proportion of functioning sanitation facilities, (5) menstrual hygiene management (MHM) inclusion, (6) access to information, (7) meets users' notions of dignity, and (8) integration of the perspectives of key stakeholders. Key findings of the study indicate that the current focus on reducing service backlogs largely ignores equity and there is a need to better address this through the incorporation of: equity assessments, improving access to information, and the inclusion of marginalised communities in the planning of sanitation services.

Phosphocreatine attenuates angiotensin II-induced cardiac fibrosis in rat cardiomyocytes through modulation of MAPK and NF-κB pathway.

OBJECTIVE: Transforming growth factor ß (TGF-ß) plays crucial roles in Ang II-induced cardiac fibrosis (CF). Phosphocreatine (PCr), one of the important players involved in cellular energy metabolism, is widely used in the treatment of clinical heart failure. However, whether it participates in CF is still unclear. This study aimed to identify the mechanisms involved in PCr and CF. MATERIALS AND METHODS: Rat cardiomyocytes (H9C2) were induced by Ang II followed by treatment of PCr. ERK1 siRNA, ERK2 siRNA and NF-κB siRNA were applied to identify the molecular mechanism. Then CF-related proteins were analyzed by western blot and real-time PCR to confirm the influence of the mechanisms involved in PCr. RESULTS: PCr did protect cardiomyocytes from Ang II-induced fibrosis. Meanwhile, PCr suppressed Ang II-induced up-regulation of TGF-ß. By detecting TGFß-mediated or MAPK pathway associated proteins, PCr inhibited MAPK and NF-κB pathway, thus suppressed Ang II-induced cardiac fibrosis, which was further confirmed by siRNA transfection. CONCLUSIONS: Our study determined that PCr protected cardiomyocytes from Ang II-induced CF through inhibition of MAPK and NF-κB pathway.

Intention to comply with post-exposure management among nurses exposed to blood and body fluids in Taiwan: application of the theory of planned behaviour.

Nurses are at significant risk from occupationally acquired bloodborne virus infections following a needlestick and sharps injury. This study aimed to apply the theory of planned behaviour (TPB) to predict nurses' intention to comply with occupational post-exposure management. A cross-sectional survey was applied to select registered nurses who worked in human immunodeficiency virus (HIV)-designated hospitals. An anonymous, self-administered questionnaire based on the TPB was distributed to 1630 nurses and 1134 (69.5%) questionnaires were returned. From these, a total of 802 nurses (71%) reported blood and body fluid exposure incidents during 2003-2005 and this group was used for analysis. Only 44.6% of the 121 exposed nurses who were prescribed post-exposure prophylaxis (PEP) by infectious disease doctors returned to the clinic for interim monitoring, and only 56.6% of exposed nurses confirmed their final serology status. Structural equation modelling was used to test the TPB indicating perceived behavioural control (the perception of the difficulty or ease of PEP management, ß=0.58), subjective norm (the perception of social pressure to adhere to PEP, ß=0.15), and attitudes (ß=0.12) were significant direct effects on nurses' intention to comply with post-exposure management. The hypothesised model test indicated that the model fitted with the expected relationships and directions of theoretical constructs [χ(2) (14, N=802)=23.14, P=0.057, GFI=0.987, RMSEA=0.039]. The TPB model constructs accounted for 54% of the variance in nurses' intention to comply with post-exposure management. The TPB is an appropriate model for predicting nurses' intention to comply with post-exposure management. Healthcare facilities should have policies to decrease the inconvenience of follow-up to encourage nurses to comply with post-exposure management.

(137)Cs, (239+240)Pu concentrations and the (240)Pu/(239)Pu atom ratio in a sediment core from the sub-aqueous delta of Yangtze River estuary.

A sediment core collected from the sub-aqueous delta of the Yangtze River estuary was subjected to analyses of (137)Cs and plutonium (Pu) isotopes. The (137)Cs was measured using γ-spectrometry at the laboratories at the Nanjing University and Pu isotopes were determined with Accelerator Mass Spectrometry (AMS), measurements made at the Australian National University. The results show considerable structure in the depth concentration profiles of the (137)Cs and (239+240)Pu. The shape of the vertical (137)Cs distribution in the sediment core was similar to that of the Pu. The maximum (137)Cs and (239+240)Pu concentrations were 16.21 ± 0.95 mBq/g and 0.716 ± 0.030 mBq/g, respectively, and appear at same depth. The average (240)Pu/(239)Pu atom ratio was 0.238 ± 0.007 in the sediment core, slightly higher than the average global fallout value. The changes in the (240)Pu/(239)Pu atom ratios in the sediment core indicate the presence of at least two different Pu sources, i.e., global fallout and another source, most likely close-in fallout from the Pacific Proving Grounds (PPG) in the Marshall Islands, and suggest the possibility that Pu isotopes are useful as a geochronological tool for coastal sediment studies. The (137)Cs and (239+240)Pu inventories were estimated to be 7100 ± 1200 Bq/m(2) and 407 ± 27 Bq/m(2), respectively. Approximately 40% of the (239+240)Pu inventory originated from the PPG close-in fallout and about 50% has derived from land-origin global fallout transported to the estuary by the river. This study confirms that AMS is a useful tool to measure (240)Pu/(239)Pu atom ratio and can provide valuable information on sedimentary processes in the coastal environment.

The influence of professional commitment on turnover intention.

This study investigated the influence of professional commitment on turnover intentions of nurses. The study also examined the relationships between demographic data, work-related variables and the professional commitment. The self-administered questionnaires were distributed to one fifth of Southern Taiwan's population of nurses (n = 4,000). A total of 2,543 subjects completed the questionnaires with a 63.6% response rate. The nurses exhibited a medium-high degree of overall professional commitment. Age, salary, years in profession and years in organization were correlated significantly with professional commitment by Pearson's correlation. There were significant correlations between professional commitment and marital status, educational level, status of the youngest child, level of position, and family support in Spearman's correlations. Family support, age, level of position and status of hospital were the significant predictors in the final regression analysis model. The discriminant analysis showed that 45.4% of nursing professional commitment was correctly classified in predicting intention to leave the profession and 33.1% in predicting the intention to leave the organization. The study recommended that nursing professional commitment is an important moderator to affect the turnover intention of staff nurses.

Expression and characterization of monocot rice cytosolic CuZnSOD protein in dicot Arabidopsis.

Cytosolic CuZnSOD removes deleterious superoxides from plant cells. In order to understand its function better, we sought to express a monocot CuZnSOD gene in transgenic Arabidopsis. We constructed a transgene using the CaMV 35S promoter to express a rice cytosolic CuZnSOD gene in Arabidopsis and generated over 200 transformants. A 16 kD polypeptide, the same size as the native rice CuZnSOD polypeptide, was detected in the transgenic Arabidopsis. Interestingly, two forms of rice CuZnSOD, rSODI and rSODII, having the same dimeric size, were detected in the transgenic plants. rSODII protein was relatively abundant but had low specific activity. In contrast, rSODI protein was relatively rare and had high specific activity. Inter-conversion of rSODI and rSODII could be achieved by the addition and removal of copper ions into the purified recombinant SOD and to the leaf extract of transgenic plants. Our analysis indicates that rSODI most likely corresponds to native rice CuZnSOD that has incorporated the Cu and Zn ions required for full activity, whereas the less active rSODII form may not have properly incorporated the necessary copper ions.

Prevalence and correlates of substance use among clinical nurses in Kaohsiung city.

Though substance abuse and its deleterious health sequelae are a serious problem in Taiwan, licit and illicit substance use patterns among nurses are understudied. The purpose of this study was to investigate the prevalence of substance use and to identify its related factors among clinical nurses. A total of 907 registered nurses were recruited for this study via stratified-random sampling from hospitals in Kaohsiung city. Each participant was requested to reply to a structured questionnaire anonymously and a 98.1% response rate was achieved. Prevalence of substance use during the past year was estimated as follows: alcohol drinking (regular use-3.8%); coffee drinking (regular use-44.7%); cigarette smoking (regular use-0.2%); regular use of analgesics 21.1%; regular use of benzodiazepines 1.8%; use of narcotics (ever use-0.7%). Significant factors related to substance use were analyzed by logistic regression. This revealed that for regular alcohol use, the significant factor was a positive attitude toward substance use; for BZD drug use, they were poor mental health, positive attitude toward substance use, being unmarried, and used analgesics; for regular analgesics use, they were work in non-critical care unit, self-perceived poor health status, and BZD drug use. Results generated from this study may act as reference for nursing administration to develop an effective health promotion program of physical and mental health for the clinical nurses.

The stress- and abscisic acid-induced barley gene HVA22: developmental regulation and homologues in diverse organisms.

Abscisic acid (ABA) induces the expression of a battery of genes in mediating plant responses to environmental stresses. Here we report one of the early ABA-inducible genes in barley (Hordeum vulgare L.), HVA22, which shares little homology with other ABA-responsive genes such as LEA (late embryogenesis-abundant) and RAB (responsive to ABA) genes. In grains, the expression of HVA22 gene appears to be correlated with the dormancy status. The level of HVA22 mRNA increases during grain development, and declines to an undetectable level within 12 h after imbibition of non-dormant grains. In contrast, the HVA22 mRNA level remains high in dormant grains even after five days of imbibition. Treatment of dormant grains with gibberellin (GA) effectively breaks dormancy with a concomitant decline of the level of HVA22 mRNA. The expression of HVA22 appears to be tissue-specific with the level of its mRNA readily detectable in aleurone layers and embryos, yet undetectable in the starchy endosperm. The expression of HVA22 in vegetative tissues can be induced by ABA and environmental stresses, such as cold and drought. Apparent homologues of this barley gene are found in phylogenetically divergent eukaryotic organisms, including cereals, Arabidopsis, Caenorhabditis elegans, man, mouse and yeast, but not in any prokaryotes. Interestingly, similar to barley HVA22, the yeast homologue is also stress-inducible. These observations suggest that the HVA22 and its homologues encode a highly conserved stress-inducible protein which may play an important role in protecting cells from damage under stress conditions in many eukaryotic organisms.

Floral spray transformation can efficiently generate Arabidopsis transgenic plants.

In this study, floral spray and floral dip were used to replace the vacuum step in the Agrobacterium-mediated transformation of a superoxide dismutase (SOD) gene into Arabidopsis. The transgene was constructed by using a CaMV 35S promoter to drive a rice cytosolic CuZnSOD coding sequence in Arabidopsis. The transgene construct was developed in binary vectors and mobilized into Agrobacterium. When Arabidopsis plants started to initiate flower buds, the primary inflorescence shoots were removed and then transformed by floral spray or floral dip. More than 300 transgenic plants were generated to assess the feasibility of floral spray used in the in planta transformation. The result indicates that the floral spray method of Agrobacterium can achieve rates of in planta transformation comparable to the vacuum-infiltration and floral dip methods. The floral spray method opens up the possibility of in planta transformation of plant species which are too large for dipping or vacuum infiltration.

The predictors of long-term care service utilization among older Americans.

Long-term care for the elderly has recently become an area of great interest for practicing social workers because of the increasing number of aged persons and the important role of government in financing and regulating their care. Therefore, the purpose of this study was to provide a set of estimates on patterns in long-term care service use among older Americans over an eight-year period. This study applied multinomial logistic regression to analyzing the data from the National Long-Term Care Survey of 1982-1989 (NLTCS). The results of this study showed a number of differences from the results with cross-sectional studies. Of the 6,393 sample persons, more than half (56.5%) died over the eight years from 1982 to 1989. The rate of entering nursing homes (12.6%) was low. The rate of using community-based care services was fairly low. About 10.4 percent of the sample received care from helping professional personnel or paid helpers. As expected, the number receiving care from kin and other informal support was high. Long-term care services in the United States were distributed very unequally among various social groups. The indicator of need was not the only determinant of service utilization. Other variables such as number of household members, race, age and education were also important for service utilization. The predictors of deceased versus informal help were need, age, number of household member, gender and marital status. The predictors of nursing home care versus informal help were need, age, number of household members, education, attitude toward nursing home and race. The predictors of community-based help care versus informal help were need, number of household members, and education.

Novel selective quinazoline inhibitors of endothelin converting enzyme-1.

PD 069185 is a highly selective and structurally novel inhibitor of endothelin converting enzyme-1 (ECE-1). PD 069185 is a trisubstituted quinazoline with an IC50 value of 0.9 +/- 0.1 microns for inhibition of human ECE-1 from the solubilized membrane fraction of CHO cells stably transfected with human ECE-1 cDNA. Kinetic analysis revealed that PD 069185 is best fit with a competitive inhibition model with a Ki value of 1.1 +/- 0.1 microns and binds in a reversible manner. The closely related enzyme, ECE-2, is not inhibited at up to 100 microns PD 069185. In addition, PD 069185 at 200-300 microns has little effect on other metalloproteases, such as neutral endopeptidase 24.11, stromelysin, gelatinase A, and collagenase, showing a high ECE-1 specificity. Data are also presented to show that this series of inhibitors are effective in inhibiting ECE-1 in intact cells and in attenuating the increase in perfusion pressure induced by big ET-1 in isolated rat mesentery. These non-peptidic ECE-1 inhibitors should serve as a valuable tool to study the pathophysiological role of endothelin and the therapeutic potential of ECE-1 inhibitors.

Purification and characterization of manganese superoxide dismutase from Ganoderma microsporum.

Manganese superoxide dismutase (Mn-SOD) in the mycelium of Ganoderma microsporum was purified to homogeneity by heat treatment at 70 degrees C, ammonium sulfate fractionation, DEAE-52 anion-exchange chromatography, and Sephacryl SH-200 chromatography. The molecular mass of its native form was estimated to be 98 kD by size-exclusion chromatography. This enzyme is tetrameric composed of four subunits of equal size of 25 kD. The pI of this purified Mn-SOD was located at pH 6.34 and 5.06 by isoelectric focusing. Comparisons of 17 amino acids from the N-terminus of Mn-SOD subunit with the derived amino acid sequences from the reported Mn-SOD cDNA clones of other sources indicated a high degree of homology among the Ganoderma genus but the Mn-SOD from G. microsporum showed a high variation when compared with other organisms.

Characterization of endothelin converting enzyme from intact cells of a permanent human endothelial cell line, EA.hy926.

Endothelin converting enzyme (ECE) from intact cells of a permanent human endothelial cell line, EA.hy926, was studied by examining the effects of phosphoramidon, an endothelin converting enzyme inhibitor, on the levels of secreted endothelin-1 and big endothelin-1. The specific ECE activity was demonstrated by a phosphoramidon dose-dependent decrease in ET-1 level with a concomitant increase in big ET-1 level. By using a specific neutral endopeptidase 24.11 (NEP 24.11) inhibitor, thiorphan, it was also shown that the phosphoramidon-sensitive ET-1 degrading activity in this cell line is due to the NEP 24.11 activity. Other serine, acid, and cysteine protease inhibitors had no effect on the endogenous synthesis of ET-1 and big ET-1 supporting the evidence that ECE is insensitive to these protease inhibitors as has been demonstrated with the isolated enzyme.

A study of hospital nurses' attitudes toward continuing education in Kaohsiung City, Taiwan.

The purpose of this study was to investigate hospital nurses' attitudes toward continuing education. Continuing education was defined as non-credit organized educational programs designed for nurses by hospitals, nursing institutions, or other related organizations to maintain or improve professional competence. It included "in-service education", "on-the-job training", and other synonymous educational activities. Six hundred and seventy-four randomly selected hospital nurses in Kaohsiung City participated in this study. The data was collected by delivering a 34-statement questionnaire through the directors of nursing. Cronbach's Alpha Coefficient was applied to determine the reliability with a value of 0.79. Factor analysis and a group of experts' suggestions were applied to determine the validity. Frequency distribution, Analysis of Variance, Scheffe' test, and Multiple Regression Analysis were conducted to analyze the research questions. The level of significance was set at 0.05 or less. The results indicated that the majority of nurses (92.65%) hold positive attitudes toward continuing education (M = 86.32). Nurses' attitudes toward continuing education were related to selected personal and professional characteristics, and hospital policies regarding continuing education. To maintain nurses' positive attitudes and to develop positive attitudes for those who hold negative attitudes, some strategies for continuing education should be considered by nursing administrators.

[A pilot study of nursing activities on the Chest Medicine Ward at KMCH].

The current study sought to establish a preliminary patient classification system by determining how much time nurses spend each shift on their various activities. In this way we hoped to determine the direct care needs of the patient. From August 11 through the 17, snap-shot observations on the Chest Medicine Ward of Kaohsiung Medical College Hospital were taken every five minutes throughout the day to evaluate nursing activities and health care needs of patients. After employing such statistical techniques as percentage comparison, One-way ANOVA on the collected data, we gained a preliminary understanding of the distribution, characteristics, extent and nature of nursing activities. The results demonstrated that the average working hours of the day shift and the evening shift are 8.13 and 8.05 hours respectively. The night shift may be as long as 8.52 hours. Our studies also revealed that the most demanding nursing activity is indirect care (50.73%), direct care (29.39%), individual time (13.73%) and related activities (6.15%) follow. In the direct care of patient, nurses devoted most of their time monitoring vital signs, administering medication, assisting in examination and treatment, caring for, and communicating with patients. On hygiene, physical movements and the clean up of body discharges were mostly devoted by patients and families.

China: acceptability and effect of three kinds of sexual publication.

A nationwide political movement named "sweeping away the yellow subjects" ("yellow" means erotic and pornographic as does "blue" in U.S.) was launched by the Communist Party and then enlarged by the government in China since the end of July 1989. Almost all of the written, audio, and visual publications were banned as long as they described any kind of sexual behavior. Publishers were punished by arrest. At least 20 persons were put to death for selling "the yellow subjects." The argument of the Party and the government for launching such a movement was that the yellow subjects result in readers and viewers becoming sexual offenders. Although we are unable to test directly with enough survey data, we studied two basic facts: (i) How many and what kind of persons accepted three kinds of publications on sexuality: scientific books, erotic literature, and visual materials? (ii) What kind of and how much influence was there on the readers' and viewers' attitudes towards other subjects which were not directly sexual? As the first research on this subject in China, we conducted a social survey with a questionnaire. What we found provided a basis for confirming one aspect of the hypothesis that a sex revolution appeared in China in 1988.

Starch Phosphorylase Inhibitor Is beta-Amylase.

The proteinaceous noncompetitive inhibitor of starch phosphorylase isolated from the root of sweet potato (Ipomoea batatas [L.] Lam.) (TC Chang, JC Su 1986 Plant Physiol 80: 534-538) has been identified as a beta-amylase. The starch phosphorylase inhibitor and beta-amylase activities copurified to give a protein indistinguishable from commercial beta-amylase by electrophoretic and immunological methods, and the two activities showed parallel responses in pH, temperature, and inhibitor sensitivity tests. The amylolytic pattern of the inhibitor corresponded to that of beta-amylase and its inhibitory effect toward starch phosphorylase was due to neither deprivation of starch, the primer for the phosphorylase assay, nor the inhibitory effect of amylolytic products.