Needs for providing overseas organ transplant medical function and information with eHealth telecare systems-instrument development for health professionals in Taiwan.

BACKGROUND: The use of eHealth systems for facilitating overseas organ transplantation (OOT) between 2 medical parties has been discussed. Nevertheless, little information is available about organ transplant health professionals' (OTHPs') needs in using the eHealth telecare systems (eHTSs) for providing OOT medical service. This project attempted to answer this question. METHODS: A purposive sample including OT surgeons (OTSs), registered nurses (RNs), and organ transplant coordinating nurses (OTCNs) was obtained from 5 hospitals in Taiwan. A Delphi research method was used in this research. The subjects were invited to respond to a sequence of surveys to learn their appraisal of the needs in using eHTSs for providing OOT medical service. RESULTS: Twenty-two subjects including surgeons (n = 10), RNs (n = 9), and OTCNs (n = 3) participated in this research. Their years working in the field ranged from 3 to 45 (mean 15.77) years. To learn OTHPs' appraisals of their needs in using eHTSs for providing OOT medical service, system function requirements (SFR) and system information requirements (SIR) for telecare were produced. SFR were identified to encompass the following 9 aspects: (a) safety in the supervisor mechanism for protection of privacy including account, password, and unediting mode of medical prescriptions; (b) unlimited to particular software or hardware; (c) options of related medical term language in English and traditional and simplified Chinese; (d) available any time and anywhere; (e) being able to save print and export medical records by E-mail systems under authorization; (f) friendly operation; (g) real-time and accurate information; (h) tape-recording functions (OTHPs may convey important medical information to others); and (i) online mutual communications between OTHPs and their clients. SIR included: (a) a comprehensive preoperative medical profile before departure for another country; (b) a comprehensive medical profile of OOT performed in another country; (c) a comprehensive postoperative treatment profile after return to original country; and (d) physiologic health indicators of long-term recovery in the community. CONCLUSIONS: In this project, OTHPs addressed their tangible needs for operating an eHTS to facilitate OOT. These findings would serve as a valuable reference for eHTS experts to continue to work with OTHPs to move to the next development stage.

Screening and characterization of LAB-produced bacteriocin-like substances from the intestine of grey mullet (Mugil cephalus L.) as potential biocontrol agents in aquaculture.

AIM: To isolate and characterize bacteriocin-like inhibitory substance (BLIS)-producing lactic acid bacteria from the intestine of grey mullet. METHODS AND RESULTS: Inhibitory activity against at least one or more indicator strains was observed in one Enterococcus thailandicus, one Enterococcus faecium and two Lactococcus garvieae strains. Enterococcus faecium B3-8 and Ent. thailandicus B3-22 showed the greatest inhibitory activities against Listeria monocytogenes ATCC 19111 and were therefore further characterized. The results suggested that the inhibitory substances from the two strains showed similar characteristics with respect to sensitivity to heat and proteolytic enzymes. BLIS from Ent. thailandicus B3-22 was characterized by a broader inhibitory spectrum than that from Ent. faecium B3-8. SDS-PAGE revealed that the molecular size of partially purified BLISs from Ent. faecium B3-8 and Ent. thailandicus B3-22 was c. 5 and 3 kDa, respectively. The molecular mass of purified bacteriocin from Ent. thailandicus B3-22 was further determined to be 6319 Da by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). The results indicated that BLIS from Ent. thailandicus B3-22 can effectively inhibit the growth of all tested L. garvieae strains. CONCLUSIONS: The findings obtained in this study suggest the potential use of Ent. thailandicus B3-22 as a biocontrol agent against pathogenic L. garvieae in the aquaculture. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report describing the characteristics of BLIS from Ent. thailandicus that showed potential for use as a biocontrol agent in the aquaculture.

The dilemma of "to be or not to be": developing electronically e-health & cloud computing documents for overseas transplant patients from Taiwan organ transplant health professionals' perspective.

AIMS: The development of mutually accessible e-health documents (ehD) and cloud computing (CC) for overseas organ transplant health professionals (OTHP) in two medical parties (domestic and overseas) would ensure better quality of care. This project attempted to compare pro and con arguments from the perspective of Taiwan's OTHP. METHODS: A sample was obtained from three leading medical centers in Taiwan. RESULTS: Eighty subjects including transplant surgeons (n = 20), registered nurses (RN; n = 30), coordinating nurses (OTCN; n = 15), and e-health information and communication technologies experts (ehICTs; n = 15) participated in this research. The pros of developing ehD were: (1) better and continuous care through communication and cooperation in two parties (78%); (2) better collaborative efforts between health professionals, information technology experts in two medical parties is (74%); (3) easier retrieval and communication of personal health documents with the trustworthy OTHP in the different countries (71%); and (4) CC may help develop transplant patients medical cloud based on the collaboration between medical systems in political parties of Taiwan and mainland China (69%). The cons of developing ehD and CC included: (1) inadequate knowledge of benefits and manuals of developing ehD and CC (75%); (2) no reliable communication avenues in developing ehD and CC (73%); (3) increased workload in direct care and documentation in developing new ehD and CC (70%); (4) lack of coaching and accreditation systems in medical, electronic, and law aspects to settle discrepancies in medical diagnosis and treatment protocols between two parties (68%); and (5) lacking systematic ehD and CC plans developed by interdisciplinary teams in two parties (60%). CONCLUSION: In this initial phase, the establishment of an interdisciplinary team including transplant leaders, transplant surgeon, RN, OTCN, ehICTs, and law experts from two parties might be helpful in working out developing plans with careful monitoring mechanisms.

Challenging issues of overseas transplantation in mainland China: Taiwan organ transplant health professionals' perspective.

OBJECTIVE: As the source of organs is limited in Taiwan, and communication systems are becoming more open between Taiwan and mainland China, the call for overseas transplantation in mainland China is increasing in Taiwan. This study explored the perspectives of Taiwan organ transplant health professionals on the challenging issues related to transplantation procedures in mainland China, including health professionalism as well as collaborative systems for information and communication technologies (ICTs). METHODS: A purposive sample including overseas transplant surgeons (OTS), registered nurses (RN), overseas transplant coordinating nurses (OTCN), and e-health ICTs experts (eh-ICTs) was obtained from two medical centers in Taipei. Subjects underwent face-to-face interviews with data subjected to content analysis. RESULTS: The 70 subjects included OTS (n = 20), RN (n = 25), OTCN (n = 15), and eh-ICTs (n = 10). Their ages ranged from 23 to 63 years old (mean, 33.7 years). The current challenges were identified: (a) lack of workable collaborative systems for continuous medical care between two parties due to different medical recording systems in particular (86%, n = 60; OTS, n = 19; RN, n = 21; OTCN, n = 10; eh-ICTs, n = 10); (b) lack of mutual trustworthy relationships between medical delivery systems (84%, n = 59; OTS, n = 17; RN, n = 22; OTCN, n = 10; eh-ICTs, n = 10); (c) lack of accreditation systems to judge possible conflicts related to medical diagnosis and treatment protocols (79%, n = 55; OTS, n = 19; RN, n = 19; OTCN, n = 7; eh-ICTs, n = 10); (d) Taiwanese hesitation regarding the quality of transplant procedures in mainland China (71%, n = 50; OTS, n = 18; RN, n = 17; OTCN, n = 8; eh-ICTs, n = 7); and (e) stress from concerns of Taiwan medical societies about the benefits of collaboration with mainland China (64%, n = 45; OTS, n = 13; RN, n = 18; OTCN, n = 8; eh-ICTs n = 6). CONCLUSION: This discussion is still ongoing. Trapped by the limited organ source and confronted by multiple challenges revealed in this project, Taiwan societies have suggested to initiate interdisciplinary communication avenues. Starting with less culturally confounded issues such as establishing a reliable ICTs system (ie, e-health documents) may be more appreciated by the two parties in the near future.

Test-retest reliability and criterion validity of the Chinese version of CBCL, TRF, and YSR.

BACKGROUND: Psychometric properties of the Chinese version of CBCL, TRF, and YSR were understudied. This study aimed at examining their test-retest reliability and criterion validity. METHODS: Three Chinese community and clinic samples were recruited in Hong Kong. The parents, teachers, and youths respectively completed the CBCL, TRF, and YSR. RESULTS: The Chinese CBCL, TRF, and YSR were test-retest reliable and valid. However, there was score/case attenuation at retest. CBCL and TRF appeared to screen externalizing and ADHD problems better, while YSR screened internalizing problems better. CONCLUSIONS: Clinicians should be cautious about score/case attenuation at retest while using CBCL, TRF, and YSR to chart patients' progress. They should also recognize their different strengths in screening various disorders.

A strategy for identification and quantitation of phosphopeptides by liquid chromatography/tandem mass spectrometry.

Liquid chromatography/tandem mass spectrometry (LC/MS/MS) is a state-of-the-art method of structural analysis of peptides/proteins. Here, using activating transcription factor-2 (ATF2) as an example, we report how LC/MS/MS data were processed to generate selected ion tracings for identification of phosphorylated peptides based on their parallel elution behavior with their nonphosphorylated analogs. Via this approach, we verified that amino acid residues Thr-69, Thr-71, and Ser-90 of ATF2 were the in vitro targets for c-Jun kinase. Selected ion tracing method was also used to quantitatively determine phosphorylation states of peptides. We demonstrated that the phosphorylation of Thr-69/Thr-71 was increased in response to ultraviolet irradiation specifically in subconfluent but not in confluent cultures. About 24% of Thr-69/Thr-71-containing segment were singly phosphorylated in subconfluent cultures, while minimal phosphorylation occurred in confluent cultures. In contrast, Ser-112 phosphorylation remained unaffected by cell densities. This strategy could be applied to the studies of a variety of modifications seen in various regulated cellular processes.