Acceptance of a Text Messaging Vaccination Reminder and Recall System in Malaysia's Healthcare Sector: Extending the Technology Acceptance Model.

Malaysian healthcare institutions still use ineffective paper-based vaccination systems to manage childhood immunization schedules. This may lead to missed appointments, incomplete vaccinations, and outbreaks of preventable diseases among infants. To address this issue, a text messaging vaccination reminder and recall system named Virtual Health Connect (VHC) was studied. VHC simplifies and accelerates immunization administration for nurses, which may result in improving the completion and timeliness of immunizations among infants. Considering the limited research on the acceptance of these systems in the healthcare sector, we examined the factors influencing nurses' attitudes and intentions to use VHC using the extended technology acceptance model (TAM). The novelty of the conceptual model is the incorporation of new predictors of attitude, namely, perceived compatibility and perceived privacy and security issues. We conducted a survey among 121 nurses in Malaysian government hospitals and clinics to test the model. We analyzed the collected data using partial least squares structural equation modeling (PLS-SEM) to examine the significant factors influencing nurses' attitudes and intentions to use VHC. Moreover, we applied an artificial neural network (ANN) to determine the most significant factors of acceptance with higher accuracy. Therefore, we could offer more accurate insights to decision-makers in the healthcare sector for the advancement of health services. Our results highlighted that the compatibility of VHC with the current work setting of nurses developed their positive perspectives on the system. Moreover, the nurses felt optimistic about the system when they considered it useful and easy to use in the workplace. Finally, their attitude toward using VHC played a pivotal role in increasing their intention to use it. Based on the ANN models, we also found that perceived compatibility was the most significant factor influencing nurses' attitudes towards using VHC, followed by perceived ease of use and perceived usefulness.

[In vitro study of non-thermal atmospheric plasma influencing the surface properties of dentin].

Objective: To study the influence of non-thermal atmospheric pressure plasma (NTAPP) on dentine surface temperature, wettability and morphology of collagen fibrils under different treatment condition. Methods: Helium was used as the operating gas at the flow rate of 3, 4, 5 L/min respectively. The plasma jet was operated at various input power of 8, 9, 10, 11 W. Thermal accumulation on human dentine surface (6 specimens per group, acquired from Department of Stomatology, The First Affiliated Hospital of Xi'an Medical University and Department of Stomatology, The Second Affiliated Hospital of Xi'an Medical University) of each group was measured continuously at 5 s intervals for 60 s by infrared thermography. Mean values were calculated and temperature curves were drawn. Dentine surface contact angles were measured after NTAPP treatment for 5, 10, 15, 20 s with gas flow rate and input power described above. The micro structure of the collagen fibrils of the negative control group (without NTAPP treatment) and NTAPP treatment groups (5 L/min gas flow rate, input power of 8, 9, 10, 11 W and treating time for 5, 10, 15, 20 s) was observed by field emission scanning electron microscopy (FE-SEM). All data were analyzed by SPSS 18.0. Results: Input power, gas flow and treatment time all showed significant influences on dentine surface temperature and wettability (P<0.01). Dentine temperature rose along with time. The greater input power was, the higher dentine temperature was. The greater gas flow rate was, the faster the temperature rose. Dentine surface temperature reached the highest point of (35.10±0.24) ℃ with NTAPP treatment for 60 s, at input power of 11 W and flow rate of 5 L/min. The contact angles of each experimental group decreased with time, and significant differences were found in the contact angles between the experimental groups and the negative control group (75.57°±1.45°). The contact angles showed a decreasing trend as the input power and the gas flow rate increased. The contact angles reached the lowest point of 13.19°±2.01° with NTAPP treatment for 20 s, at input power of 10 W and flow rate of 5 L/min. The FE-SEM results showed that, along with the increase of input power and extension of time, the demineralized collagen fibrils were destroyed in varying degrees. The collagen fibrils were curled, fractured, fused, and even disappeared. Conclusions: NTAPP could significantly increase the surface temperature, modify dentine wettability and alter the micro structure, which was significantly influenced by input power, gas flow rate and treating time.

Phylogeography of Bellamya (Mollusca: Gastropoda: Viviparidae) snails on different continents: contrasting patterns of diversification in China and East Africa.

BACKGROUND: Species diversity is determined by both local environmental conditions that control differentiation and extinction and the outcome of large-scale processes that affect migration. The latter primarily comprises climatic change and dynamic landscape alteration. In the past few million years, both Southeast Asia and Eastern Africa experienced drastic climatic and geological oscillations: in Southeast Asia, especially in China, the Tibetan Plateau significantly rose up, and the flow of the Yangtze River was reversed. In East Africa, lakes and rivers experienced frequent range expansions and regressions due to the African mega-droughts. To test how such climatic and geological histories of both regions relate to their respective regional species and genetic diversity, a large scale comparative phylogeographic study is essential. Bellamya, a species rich freshwater snail genus that is widely distributed across China and East Africa, represents a suitable model system to address this question. We sequenced mitochondrial and nuclear DNA for members of the genus from China and used published sequences from Africa and some other locations in Asia to investigate their phylogeny and distribution of genetic diversity. RESULTS: Our phylogenetic analysis revealed two monophyletic groups, one in China and one in East Africa. Within the Chinese group, Bellamya species show little genetic differentiation. In contrast, we observe fairly deep divergence among the East African lakes with almost every lake possessing its unique clade. Our results show that strong divergence does not necessarily depend on intrinsic characteristics of a species, but rather is related to the landscape dynamics of a region. CONCLUSION: Our phylogenetic results suggest that the Bellamya in China and East Africa are independent phylogenetic clades with different evolutionary trajectories. The different climate and geological histories likely contributed to the diverging evolutionary patterns. Repeated range expansions and regressions of lakes likely contributed to the great divergence of Bellamya in East Africa, while reversal of the river courses and intermingling of different lineages had an opposite effect on Bellamya diversification in China.

Phosphorylation of CHIP at Ser20 by Cdk5 promotes tAIF-mediated neuronal death.

Cyclin-dependent kinase 5 (Cdk5) is a proline-directed serine/threonine kinase and its dysregulation is implicated in neurodegenerative diseases. Likewise, C-terminus of Hsc70-interacting protein (CHIP) is linked to neurological disorders, serving as an E3 ubiquitin ligase for targeting damaged or toxic proteins for proteasomal degradation. Here, we demonstrate that CHIP is a novel substrate for Cdk5. Cdk5 phosphorylates CHIP at Ser20 via direct binding to a highly charged domain of CHIP. Co-immunoprecipitation and ubiquitination assays reveal that Cdk5-mediated phosphorylation disrupts the interaction between CHIP and truncated apoptosis-inducing factor (tAIF) without affecting CHIP's E3 ligase activity, resulting in the inhibition of CHIP-mediated degradation of tAIF. Lentiviral transduction assay shows that knockdown of Cdk5 or overexpression of CHIP(S20A), but not CHIP(WT), attenuates tAIF-mediated neuronal cell death induced by hydrogen peroxide. Thus, we conclude that Cdk5-mediated phosphorylation of CHIP negatively regulates its neuroprotective function, thereby contributing to neuronal cell death progression following neurotoxic stimuli.

Loss of presenilin 2 is associated with increased iPLA2 activity and lung tumor development.

Presenilins are the enzymatic components of γ-secretase complex that cleaves amyloid precursor protein, Notch and ß-catenin, which has critical roles in the development of Alzheimer's disease and cancer cell growth. Therefore, in the present study, we studied the effects and mechanisms of PS2 knockout on lung cancer development and possible mechanisms as a key regulator of lung tumor development. We compared carcinogen-induced tumor growth between PS2 knockout mice and wild-type mice. PS2 knockout mice showed increased urethane (1 mg/g)-induced lung tumor incidence when compared with that of wild-type mice with decreased activity of γ-secretase in the lung tumor tissues. Consequently, iPLA2 activities in lung tumor tissues of PS2 knockout mice were much higher than in tumor tissues of wild-type mice. Furthermore, knockdown of PS2 using PS2 siRNA decreased γ-secretase activity with increased iPLA2 activity in the lung cancer cells (A549 and NCI-H460), leading to increased lung cancer cell growth. PS2 knockout mice and PS2 knockdown lung cancer cells showed increased DNA-binding activities of nuclear factor kappa-beta, signal transducer and activator of transcription 3 (STAT3) and AP-1 which are critical transcriptional factors of iPLA2 than those of PS2 wild-type mice and control lung cancer cells. Taken together, these results suggest that the loss of PS2 could have a critical role in lung tumor development through the upregulation of iPLA2 activity by reducing γ-secretase.

Quantitative PCR and in vivo efficacy of antibiotics in the treatment of Vibrio vulnificus infection in a mouse model.

The Centers for Disease Control and Prevention (CDC) recommend oral or intravenous doxycycline plus a third-generation cephalosporin or fluoroquinolone alone for the treatment of Vibrio vulnificus infections. Until now, no study has compared oral with parenteral administered doxycycline with respect to their in vivo efficacy. In the present work, ICR mice infected with a high dose of V. vulnificus were administered ciprofloxacin, ceftriaxone, and doxycycline. The bacterial DNA copy number in surviving and non-surviving mice was determined using quantitative polymerase chain reaction (qPCR). In this setting, ciprofloxacin was the most effective monotherapeutic drug, but a higher survival rate (50%) was achieved using the combination therapy of intraperitoneal doxycycline plus ceftriaxone. The blood of non-surviving mice at 12 h post-infection contained at least 10(4) DNA copies/µL, in contrast to 10(2) to 10(3) DNA copies/µL in surviving mice. Thus, in the treatment of V. vulnificus infections in humans, when the intravenous form of doxycycline is unavailable, ciprofloxacin might be a better option than oral doxycycline to lower mortality. In addition, our results demonstrate that qPCR can be a useful tool for identifying the V. vulnificus load in infected patients, with the DNA copy number providing a marker of either disease severity or mortality.

Effect of ribavirin on junin virus infection in guinea pigs.

Junin virus (JUNV) is the aetiological agent of Argentine haemorrhagic fever. The pathogenesis of the infection is not well understood, no licensed vaccines exist and no specific antiviral therapy is available. Previous studies have demonstrated the ability of ribavirin to delay and reduce JUNV disease and virus burden in guinea pigs without preventing death. Based on available data, we performed three different studies to determine the efficacy of ribavirin against JUNV in the guinea pig model with a focus on survival. Different doses and treatment schedules of ribavirin were tested in a lethal model of JUNV infection. Our results show that prolonged treatment with high doses of ribavirin significantly reduces the mortality in guinea pigs infected with JUNV. These results may be useful in future experimental studies or clinical testing.

A framework for cohesive healthcare coalition formation.

The mobilisation of cohesive and effective groups of healthcare human resource is important in ensuring the success of healthcare organisations. However, forming the right team or coalition in healthcare organisations is not always straightforward due to various human factors. Traditional coalition formation approaches have been perceived as 'materialistic' or focusing too much on competency or pay-off. Therefore, to put prominence on the human aspects of working together, we present a cohesiveness-focused healthcare coalition formation methodology and framework that explores the possibilities of social networks, i.e. the relationship between various healthcare human resources, and adaptive resonance theory.

Enhancement of lactate and succinate formation in adhE or pta-ackA mutants of NADH dehydrogenase-deficient Escherichia coli.

AIMS: The aim of the study is to investigate the effect of multiple mutations in redox or energy producing pathways of Escherichia coli on metabolic product distribution in anaerobic-rich media cultures. METHODS AND RESULTS: Various combinations of NADH dehydrogenase (NDH)-deficient, alcohol dehydrogenase (ADH), and phosphotransacetylase and acetate kinase (PTA-ACK) mutants were constructed. Anaerobic LB-glucose cultures of the strains were grown and extracellular metabolites were analysed and compared with those of the parental strain, E. coli MG1655. The profile of metabolites was examined in log phase and 24-h cultures. CONCLUSIONS: Inactivation of ndh and/or nuo gene leads to higher production of d-lactate, ethanol, formate and succinate in log phase. Inactivation of pta-ackA in NDH-I- or NDH-II-deficient strains lead to increased D-lactate formation and decreased ethanol formation. Removal of ethanol production by adhE gene inactivation generated higher production of succinate and D-lactate. D-lactate was the primary product in the ndh nuo adhE strain. SIGNIFICANCE AND IMPACT OF THE STUDY: The results show the effects of altering NADH utilization pathways on distribution of metabolic products. Such information improves our understanding of metabolic shifts and may find application in metabolic engineering of E. coli.

A knowledge creation info-structure to acquire and crystallize the tacit knowledge of health-care experts.

Tacit knowledge of health-care experts is an important source of experiential know-how, yet due to various operational and technical reasons, such health-care knowledge is not entirely harnessed and put into professional practice. Emerging knowledge-management (KM) solutions suggest strategies to acquire the seemingly intractable and nonarticulated tacit knowledge of health-care experts. This paper presents a KM methodology, together with its computational implementation, to 1) acquire the tacit knowledge possessed by health-care experts; 2) represent the acquired tacit health-care knowledge in a computational formalism--i.e., clinical scenarios--that allows the reuse of stored knowledge to acquire tacit knowledge; and 3) crystallize the acquired tacit knowledge so that it is validated for health-care decision-support and medical education systems.

An approach to enrich online medical Problem-Based Learning with tacit healthcare knowledge.

Existing Problem-Based Learning (PBL) problems, though suitable in their own right for teaching purposes, are limited in their potential to evolve by themselves and to create new knowledge. Presently, they are based on textbook examples of past cases and/or cases that have been transcribed by a clinician. In this paper, we present (a) a tacit healthcare knowledge representation formalism called Healthcare Scenarios, (b) the relevance of healthcare scenarios in PBL in healthcare and medicine, (c) a novel PBL-Scenario-based tacit knowledge explication strategy and (d) an online PBL Problem Composer and Presenter (PBL-Online) to facilitate the acquisition and utilisation of expert-quality tacit healthcare knowledge to enrich online PBL. We employ a confluence of healthcare knowledge management tools and Internet technologies to bring tacit healthcare knowledge-enriched PBL to a global and yet more accessible level.

The genes for anabolic 2-oxoglutarate: ferredoxin oxidoreductase from Hydrogenobacter thermophilus TK-6.

2-Oxoglutarate: ferredoxin oxidoreductase (OGOR) of a thermophilic, chemolithoautotrophic hydrogen-oxidizing bacterium, Hydrogenobacter thermophilus TK-6, is involved in carbon dioxide fixation via a reductive TCA cycle. The enzyme is a heterodimer comprising subunits of 70 and 35 kDa. The structural genes for the subunits (korAB) were cloned with primers designed from N-terminal sequences of the purified enzyme. The korAB genes were followed by two open reading frames of unknown function (orf3 and orf4). KorA carried a binding motif for coenzyme A, and KorB carried binding motifs for Fe-S cluster and thiamine pyrophosphate. Active recombinant enzyme from korAB was produced in E. coli under the control of the lac promoter. orf3 and orf4 were not necessary for the expression of active enzyme in E. coli. The recombinant enzymes had high substrate specificity toward 2-oxoglutarate as in the case of the native enzyme purified from strain TK-6.

Urinary microalbumin and retinol-binding protein assay for verifying children's nephron development and maturation.

In order to further understanding of the development and maturation of the renal tubular reabsorption and glomerular permeability functions for the determination of the clinical pathological manifestation and treatment processing of renal diseases, random urine samples were collected from healthy subjects aged from birth to 60 years. All the samples were stored frozen at -70 degrees C for 4 months. The concentrations of the retinol-binding protein (RBP) and microalbumin (MALB) in urine were measured by enzyme-linked immunosorbent assay and at 492 nm with the microplate reader as a valuable marker of renal tubular and glomerular development and maturation The concentrations of RBP and MALB in urine gradually decrease with age. The level of RBP in urine is higher in children before 3 years than after 3 years (P < 0.01). The levels of MALB in urine is higher in children before 1 year of age than after 1 year (P < 0.01). Our results suggest that the development and maturation of the glomerular permeability functions and the renal tubular reabsorption are gradual and continuous processes from birth to adolescence but the key stage of their maturation may be at about 1 year and 3 years respectively: and that the rate of the tubular development may be slower than that of the glomerular development. Our results also extend existing data for normal ranges of RBP and MALB in urine from neonates to adults.

Studies on the constituents of Artemisia annua Part II.

The present paper is a continuation of our study on the Chinese traditional herb Artemisia annua L. [1-5], describing several additional constituents: quinghaosu IV and V (V, VII), quinghao acid (VIII) [6], chrysosplenol (VIa) [7] and a paraffinic alcohol; V, VII and VIII are compounds with unreported structures.