The impact of photobiomodulation on sleep and life quality in hemodialysis patients: A randomized controlled trial.

The quality of life (QoL) and sleep quality are closely linked to the physical and psychological health of end-stage renal disease (ESRD) patients, especially those underwent hemodialysis (HD) therapy. This study aims to investigate the impact of 830 nm laser treatment on improving QoL and sleep quality in HD patients. Forty ESRD patients participated in this study. 830 nm laser was used to radiate on the palm (at dose of 256.10 J/cm2), ST 36 and KI 1 acupoints (at dose of 109.76 J/cm2) of HD patients, and QoL and sleep quality questionnaires were utilized to assess changes following the treatment. After 830 nm laser radiation, lower global Pittsburgh Sleep Quality Index and Athens Insomnia Scale scores were observed, accompanied by higher physical and mental component summary scores in MOS 36-item short-form health survey version 2 and a global World Health Organization Quality of Life Brief Version score. The laser group also showed significant improvements in QoL and sleep quality indicators. Additionally, pain levels decreased on the third day and after one month according to visual analogue scale. This study revealed the positive effects of 830 nm laser on palm, KI 1 and ST 36 acupoints for improving the QoL and sleep quality in ESRD patients underwent HD treatment. The results suggest that 830 nm laser applied to specific targets could be used as a complementary and alternative approach to increase the QoL and sleep quality in ESRD patients.

Albusin B, mass-produced by the Saccharomyces cerevisiae suppression system, enhances lipid utilisation and antioxidant capacity in mice.

BACKGROUND: Albusin B (bacteriocin), isolated from Ruminococcus albus 7 and mass-produced by the Saccharomyces cerevisiae expression system, has previously been shown to have a beneficial effect on lipid metabolism in broiler chickens. The present study was focused on the effect of albusin B on lipid metabolism in mice and the potential of albusin B-expressing yeast product (albusin B) as a food supplement. Forty-five BALB/c male mice at 6 weeks of age were each orally administered normal saline (control), yeast (0.125 mg kg(-1) ) or albusin B (0.125 mg kg(-1) ) for 14 days and then euthanised. RESULTS: Compared with the control group, albusin B-fed mice exhibited decreased body weight and plasma levels of triglycerides and free fatty acids but increased plasma high-density lipoprotein. Albusin B-fed mice showed higher mRNA expression of fatty acid oxidation in the ileum, heart and liver than control mice. Compared with the control treatment, both yeast and albusin B treatments caused a decrease in mRNA expression of fatty acid synthesis in the heart and liver. Moreover, albusin B suppressed mRNA levels of lipogenesis in the ileum and liver. Albusin B-fed mice exhibited more favourable adenosine triphosphate production and antioxidant capacity in the heart and liver. Albusin B treatment led to a significantly lower respiratory quotient than that of the control, whereas yeast treatment did not. CONCLUSION: This study demonstrated a beneficial effect of albusin B on lipid utilisation and anti-atherosclerotic and antioxidant capacities in mice. However, more comprehensive studies are required to elucidate the exact mechanism behind the effect of albusin B.

Albusin B modulates lipid metabolism and increases antioxidant defense in broiler chickens by a proteomic approach.

BACKGROUND: The present study was designed to investigate the effect of albusin B on lipid metabolism and antioxidant defense in broiler chickens by a proteomic approach. The bacteriocin, albusin B of Ruminococcus albus 7, expressed by yeast was applied in this study. Three dietary treatments, consisting of the basal diet (control), basal diet + albusin B (2.5 g kg⁻¹), and basal diet + nosiheptide (2.5 mg kg⁻¹) were randomly fed to 90 broiler chickens from 1 to 35 days of age, respectively. After 35 days of supplementation, the growth performance, lipid metabolism and antioxidant proteins in the jejunum and liver, intestinal protein profile, and plasma lipid profile were analyzed. RESULTS: Broilers with albusin B supplementation had greater body weight than the control broilers. Compared with the control broilers, lower triglyceride and higher high-density lipoprotein concentration in the blood were observed in both broilers with albusin B and nosiheptide supplementation. In addition, albusin B suppressed the mRNA expression of fatty acid binding protein 2 and ATP binding cassette transporter G 5 in the jejunum. In the jejunal protein profiles, four antioxidant proteins were upregulated by albusin B and nosiheptide treatments. The jejunal antioxidant gene expression had a concordant pattern. Hepatic genes related to lipid metabolism, 3-hydroxy-3-methyl-glutaryl CoA reductase, and superoxide dismutase were upregulated by albusin B supplementation. CONCLUSION: Albusin B supplementation modulated lipid metabolism and activated systemic antioxidant defense, which might partially contribute to the performance of broiler chickens.

Evaluation of the effect of laser acupuncture and cupping with ryodoraku and visual analog scale on low back pain.

The purpose of this study was to evaluate the effect of laser acupuncture (LA) and soft cupping on low back pain. In this study, the subjects were randomly assigned to two groups: active group (real LA and soft cupping) and placebo group (sham laser and soft cupping). Visual analog scale (VAS) and Ryodoraku were used to evaluate the effect of treatment on low back pain in this trial. Laser, 40 mW, wavelength 808 nm, pulse rate 20 Hz, was used to irradiate Weizhong (BL40) and Ashi acupoints for 10 minutes. And the Ryodoraku values were measured 2 times, that is, before and 15 minutes after treatment. The results show that there were significant difference between the first day baseline and the fifth day treatment in VAS in the two groups. Therefore, LA combined with soft cupping or only soft cupping was effective on low back pain. However, the Ryodoraku values of Bladder Meridian of the placebo group have been decreased apparently, and didn't come back to their original values. It means that "cupping" plays the role of "leak or purge" in traditional Chinese medicine (TCM). On the other hand, the Ryodoraku values of Bladder Meridian of the active group have been turned back to almost their original values; "mend or reinforcing" effect is attributed to the laser radiation.

Effects of albusin B (a bacteriocin) of Ruminococcus albus 7 expressed by yeast on growth performance and intestinal absorption of broiler chickens--its potential role as an alternative to feed antibiotics.

BACKGROUND: Bacteriocins with antimicrobial activity are considered as potential alternatives to antibiotics. The aim of this study was to investigate the effect of albusin B (bacteriocin) of Ruminococcus albus 7 expressed by yeast on the growth performance of broiler chickens. Ninety 1-day-old healthy broiler chickens were randomly divided into three groups: control, albusin B (2.5 g kg(-1)) and nosiheptide (2.5 mg kg(-1), antibiotic control). Growth performance and intestinal functions were measured at 5 weeks of age. RESULTS: Albusin B-supplemented broilers showed increased body weight gain compared with control broilers (54.7 ± 5.3 vs 48.5 ± 6.1 g day(-1) per bird, P < 0.05). Broilers supplemented with nosiheptide had a less developed mucosal layer than broilers in the other two groups. Compared with the control group, broilers supplemented with albusin B or nosiheptide showed increased mRNA expression of sGLT1, GLUT2 and PEPT1 in the jejunum (P < 0.05). The faecal Lactobacillus count was higher in the albusin B group than in the other two groups (P < 0.05). CONCLUSION: Albusin B supplementation increased intestinal absorption and elevated the faecal Lactobacillus count, thereby promoting the growth performance of broiler chickens. These improvements resulting from albusin B supplementation provide evidence of potential alternatives to antibiotics in broiler chicken feed.

Determination of free and total levels of phenytoin in human plasma from patients with epilepsy by MEKC: an adequate alternative to HPLC.

Phenytoin is a widely used anti-seizure agent, and a good correlation is observed between its concentration in plasma and the clinical effect. We developed a selective CE with UV detection at 200 nm for analysis of free and total levels of phenytoin in human plasma based on MEKC. A sample pretreatment by liquid-liquid extraction with ethyl acetate for determination of total level of phenytoin and serum ultrafiltrate was prepared by ultrafiltration technique (ultrafiltration membrane 30 kDa; 2000 g, 10 min) for determination of free level of phenytoin and subsequent quantification by MEKC was used. MEKC was performed in Tris buffer (25 mM; pH 10.5) containing SDS (180 mM) and EG (13%) as BGE. Hydrodynamic injection for phenytoin determination (0.5 psi 5 s for total level, 2 psi 5 s for free level) was used to introduce samples. The separation voltage was set at 20 kV. Data obtained by MEKC were compared with the results by a validated HPLC method. The MEKC assay of phenytoin exhibited a very good correlation with respect to HPLC by Bland-Altman method. The equations for the Passing-Bablok regression line were as follows: for total level: MEKC=1.0143 x HPLC+0.0976, r(2)=1; for free level: MEKC=1.0013 x HPLC-0.0016, r(2)=1. The proposed method was applied successfully to monitor free and total levels of phentoin in 20 patients with seizures.

Simultaneous determination of galantamine, rivastigmine and NAP 226-90 in plasma by MEKC and its application in Alzheimer's disease.

A simple and sensitive MEKC with UV detection was developed and validated for the simultaneous determination of acetylcholinesterase inhibitors including galantamine, rivastigmine and major metabolite NAP 226-90 in plasma. A sample pretreatment by liquid-liquid extraction with diethylether and subsequent quantification by MEKC was used. The optimum separation for these analytes was achieved in <10 min at 25 degrees C with a fused-silica capillary column of 30.2 cm x 50 microm id (effective length 20 cm) and a run buffer containing 25 mM Tris buffer (pH 5.0) with 160 mM sodium octanesulfonate, 20% ACN and 0.01% PVP as a dynamic coating to reduce analytes' interaction with the capillary wall. For sensitivity consideration regarding the determination of linearity, LOD, quantitation and monitoring drugs concentration in patients, the detection wavelengths for galantamine or rivastigmine and NAP 226-90 were set at 214 or 200 nm, respectively. One male volunteer (26-year-old) was orally administered a single dose of 4.5 mg rivastigmine (Exelon, Novartis) in capsule, and blood samples were drawn over a 12 h period for concentration-time profile study. The method was also successfully applied for monitoring galantamine or rivastigmine and its metabolite NAP 226-90 in 11 Alzheimer's disease patients' plasma after oral administration of the commercial products Reminyl (8 mg galantamine/capsule) or Exelon (3 mg rivastigmine/capsule), respectively.

A Study on the Reporting Intention of Medical Incidents: A Nursing Perspective.

Medical incidents threaten patients' lives and health, increase medical costs, and can lead to medical disputes. A high proportion of medical incidents are not reported. The aim of this study was to explore the factors influencing nurses' reporting of medical incidents. The cross-sectional survey design used a self-administered 47-item questionnaire to survey 835 nurses in three hospitals in Taiwan between January and December 2014. The intention among nurses to report medical incidents was high (3.86/5); nurses' intention to report medical incidents was positively correlated ( r = .34, p < .0001) with their attitude about reporting, awareness of reporting ( r = .37, p < .0001), and support from interested parties ( r = .12, p = .001), and was negatively correlated with positive incentives ( r = -.14, p < .0001) and negative incentives ( r = .29, p < .0001). Nurses' awareness and a supportive work environment affect nurses' willingness to voluntarily report medical incidents; hence, they are critical considerations as Taiwan moves toward systems of mandatory reporting.

Enantioselective determination of aspartate and glutamate in biological samples by ultrasonic-assisted derivatization coupled with capillary electrophoresis and linked to Alzheimer's disease progression.

A simple cyclodextrin-mediated capillary zone electrophoresis method equipped with a laser-induced fluorescence detector was developed for chiral analysis of the excitatory amino acids aspartate (Asp) and glutamate (Glu). Plasma and cerebrospinal fluid (CSF) samples were pretreated with centrifugal filter devices before analysis to remove high-molecular-weight proteins (molecular weight cut-off: 3000) and then derivatized using 10 mM 6-carboxyfluorescein N-hydroxysuccinimide ester in DMSO under sonication at 25 °C for 2 h. After the derivatization reaction, reacted samples were diluted 100-fold with 5-([4,6-dichlorotriazin-2-yl]amino)fluorescein hydrochloride (DTAF) solution and then hydrodynamically subjected to capillary electrophoresis (0.5 psi for 5 s, injection volume 8.27 nL). The separation buffer consisted of 50 mM borate buffer (pH 9.0) with 6 mM γ-CD and 0.1% polyvinylpyrrolidone, and the separation voltage was set at 20 kV. In the linearity calculations for the determination of d/l-Asp and d/l-Glu in plasma and CSF, a standard addition method was utilized to spike solutions with 0-20.0 µg mL-1l-Glu and 0-2.0 µg mL-1d-Glu and d/l-Asp to construct calibration curves. Correlation coefficients were above 0.998 for every analyte. The limits of detection (S/N = 3) for d/l-Asp and d/l-Glu standard solutions were 0.85-0.96 µg mL-1. The proposed method was applied successfully to determine d/l-Asp and d/l-Glu concentrations in the plasma and CSF samples of 26 patients with Alzheimer's disease (AD), and the association between these concentrations and disease severity was investigated. Statistical analysis showed a moderately negative correlation (r = -0.158) between plasma l-Asp concentration and AD severity.

Study of Patients' Willingness to Pay for a Cure of Chronic Obstructive Pulmonary Disease in Taiwan.

OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) is one of the fastest growing causes of death worldwide. However, few studies, if any, have been conducted that have investigated patient profiles in Asia. This paper analyzes patient willingness to pay (WTP) as a function of patient disease severity, health-related quality of life (HRQL), and smoking behavior in Taiwan. STUDY DESIGN: A cross-sectional survey was conducted using in-person interviews with COPD patients. A hypothetical scenario was designed and presented to ascertain each subject's willingness to pay (WTP) for a cure for COPD. METHODS: A survey of subjects with COPD was performed in Taiwan. The contingent valuation method (CVM) was employed to measure patient financial burden, which was analyzed along with covariates that included various types of health-related quality of life (HRQL), severity level, and demographic background. Multivariate regression and simulation methods were employed for analysis. RESULTS: A total of 142 subjects were interviewed, with an average annual WTP of approximately $1422 USD (or 42,662.37 NTD, New Taiwan Dollars). The annual WTP for patients 55 years of age or younger, $5709.06, was the highest and equivalent to approximately one-third of Taiwan average annual personal income or quadruple the spending amount of the Taiwan National Bureau of Health Insurance (NBHI) for each COPD patient. Current cigarette smokers were willing to pay a substantially higher amount than former smokers and nonsmokers, which reflects a psychological desire for redemption in COPD patients. CONCLUSIONS: The results of this study provide directions for the relevant authorities regarding the alleviation of suffering as a result of COPD. Appropriate health promotion measures, such as measures to reduce tobacco usage, early diagnosis, and active treatment, may be necessary to contain the escalating costs related to COPD and to prevent this epidemic from worsening.

The Perceptions and Expectations Toward the Social Responsibility of Hospitals and Organizational Commitment of Nursing Staff.

BACKGROUND: The labor rights of medical workers in hospitals in Taiwan have been a key issue of discussion and controversy in recent years. Generally, poor work conditions and manpower shortages in hospitals have resulted in a vicious circle of severely overworked medical and healthcare staff and chronically low staffing and retention rates. PURPOSE: This study employed corporate social responsibility as the conceptual framework of the social responsibility of hospitals to examine the perceptions and expectations of nurses toward the social responsibility practices of the hospital where they serve and to explore the relationship between these perceptions and organizational commitment (OC). METHODS: The participants were all nurses who were employed by one medical group in southern Taiwan. Two hundred forty anonymous questionnaires, which included scales that were designed to measure the social responsibility of hospitals and OC, were distributed. Two hundred twenty-seven valid questionnaires were returned. Exploratory factor analysis was used to validate the dimension of the social responsibility of hospitals, and hierarchical multiregression analyses were used to verify the relationship between the perceptions of nurses with regard to the social responsibility practices of the hospital where nurses serve and OC. RESULTS: There were considerable differences between participants' perceptions and expectations toward the social responsibility of hospitals. The nurses with high perceptions toward the social responsibility practices of the hospital where they serve tended to have relatively high OC. Senior nurses who had high perceptions of the legal and rational, ethical, and economic dimensions of the social responsibility practices of the hospital where they serve exhibited relatively strong affective commitment. Nurses in junior positions who had high perceptions of the practices of ethical responsibilities exhibited relatively strong continuance commitment. Senior nurses who had high perceptions of the legal and rational, ethical, and discretionary dimensions of the social responsibility practices of the hospital where they serve exhibited relatively strong normative commitment. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: A friendly and humane work environment in hospital settings facilitates the implementation of social responsibility, which has been shown to foster higher levels of organizational identification and job performance among nurses and other hospital employees.

Simultaneous determination of celecoxib, meloxicam, and rofecoxib using capillary electrophoresis with surfactant and application in drug formulations.

A simple and selective CE using surfactant with UV detection is described for the simultaneous determination of selective cyclooxygenase-2 inhibitors, celecoxib, meloxicam, and rofecoxib. The simultaneous analysis of celecoxib, meloxicam, and rofecoxib was performed in Tris buffer (10 mM; pH 11) with 60 mM sodium octane-sulfonate and 20% ACN as an anionic surfactant and organic modifier, respectively. Under this condition, good separation with high efficiency and the required short analysis time is achieved. The linear ranges of the method for the determination of celecoxib, meloxicam, and rofecoxib were over 5-100 microg/mL; the detection limits at 200 nm (S/N = 3; injection 3.45 kPa, 5 s) were 2, 1, and 1 microg/mL, respectively. The small amount of sample required and the expeditiousness of the procedure allow content uniformity to be determined in individual pharmaceutical products.