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1.
Oncogene ; 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31831835

RESUMO

The original version of this Article omitted the following from the Acknowledgements: Professor Stebbing sits on SABs for Celltrion, Singapore Biotech, Vor Biopharma, TLC Biopharmaceuticals and Benevolent AI, has consulted with Lansdowne partners, Vitruvian and Social Impact Capital and Chairs the Board of Directors for BB Biotech Healthcare Trust and Xerion Healthcare. This has now been corrected in both the PDF and HTML versions of the Article.

2.
Cancer Manag Res ; 11: 9049-9055, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31749631

RESUMO

Purpose: To compare the efficacy of chemoradiotherapy or surgery for limited-stage small cell lung cancer (SCLC). Patients and methods: A retrospective analysis was performed on 138 patients with limited-stage SCLC who received surgery (69 patients) or chemoradiotherapy (69 patients) between January 2000 and September 2016 in Zhejiang Cancer Hospital. Patients of the chemoradiotherapy group were selected by using "pair-matched case-control" methodology from a cohort of 503 patients who received chemoradiotherapy. Results: The major prognostic factors, including T, N stage, treatment duration, age, gender, and whether or not they received prophylactic cranial irradiation were well balanced between two groups. The median overall survival (OS) time and 5-year OS rate were 37.1 months and 45.0% in the surgical group vs 45.0 months and 45.0% in the chemoradiotherapy group (P=0.846). The median progression-free survival (PFS) time and 5-year PFS rate were 27.1 months and 37.8% vs 36.2 months and 40.0%, respectively, in the two groups (P=0.610). The 5-year OS rate (62.3% vs 40.1%, P=0.038) and 5-year PFS rate (80.1% vs 40.1%, P=0.048) in the surgical group were significantly higher than those of the chemoradiotherapy group in patients with stage I disease. The 5-year OS rate (41.2% vs 50.6%, P=0.946) and 5-year PFS rate (64.7% vs 42.1%, P=0.280) of surgery for stage II SCLC were comparable to chemoradiotherapy. As for stage III SCLC, compared with the surgical group, the chemoradiotherapy group had a better 5-year OS trend (25.1% vs 47.6%, P=0.220), but the difference did not reach statistical significance. Conclusion: Surgery could confer survival benefits in patients with p-stage I disease, but not in patients with p-stage II and III disease.

3.
Oncogene ; 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31754213

RESUMO

EGFR-mutant non-small-cell lung cancer (NSCLC) patients inevitably develop drug resistance when treated with EGFR tyrosine kinase inhibitors (TKIs). Systematic genetic analysis is important to understand drug-resistant mechanisms; however, the clinical significance of co-occurring genetic alterations at baseline, co-acquired mutations at progressive disease (PD), and the clonal evolution remain underinvestigated. We performed targeted sequencing of pre-treatment and PD tumor samples from 54 EGFR-mutant NSCLC patients. Ten additional patients were sequenced using whole-exome sequencing to infer the clonal evolution patterns. We observed a domain-dependent effect of PIK3CA mutation at baseline on patient progression-free survival (PFS). In addition, at baseline, 9q34.3/19p13.3 (NOTCH1/STK11/GNA11) showed a co-deletion pattern, which was associated with a significantly worse PFS (p = 0.00079). T790M-postive patients with other concurrent acquired oncogenic mutations had a significantly shorter PFS (p = 0.005). Besides acquired T790M mutation, chromosomal instability (CIN) related genes, including AURKA and TP53 alterations, were the most frequently acquired events. CIN significantly increased during TKI treatment in T790M-negative patients and is a candidate resistance mechanism to the first-generation TKIs. Clonal evolution analyses suggest that the composition and relationship among resistant subclones, particularly relationship with T790M subclone, affect patients' outcomes. Overall, our findings of novel co-occurring alterations and clonal evolution patterns can be served as predictive biomarkers to stratify patients and help to better understand the drug-resistant mechanism to TKIs.

4.
Sci Rep ; 9(1): 10561, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31332217

RESUMO

Upward shifts of alpine treelines and shrub expansion are occurring under climate change, and Abies faxoniana (AF) and Rhododendron lapponicum (RL) may become distributed at higher altitudes. How do abiotic factors and litter quality modulate the effects of soil fauna on carbon release in this context? A field decomposition experiment involving the foliar litter of AF and RL was conducted along an elevation gradient encompassing coniferous forest, alpine shrubland and alpine meadow by using litterbags with different mesh sizes (3 and 0.04 mm). The objective was to determine the influences of soil fauna, litter quality and abiotic factors on species-specific carbon release and their contributions during litter decomposition. Our findings demonstrated that higher soil fauna abundance and diversity facilitated litter carbon release. The contribution rates of soil fauna to carbon release (Cfau) decreased with elevation increasing and decomposition time. Cfau are influenced by soil faunal diversity, dominant fauna groups (Collembola, Oribatida, Mesostigmata), and abiotic factors (temperature). Soil fauna significantly and directly regulated carbon release, abiotic factors indirectly regulated carbon release via altering soil fauna community composition and litter quality. This study improve our understanding in the mechanisms of decomposer contributions to carbon cycling in the context of global climate change.

5.
BMC Geriatr ; 19(1): 159, 2019 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174477

RESUMO

BACKGROUND: Taiwan, one of the fastest-aging countries in the world, started implementing version 1.0 of its long-term care (LTC) plan in 2008. In 2017, LTC Plan 2.0 began a new era with its goal to integrate Taiwan's fragmented LTC service system. LTC Plan 2.0 also aims to establish an integrated community-based LTC system incorporating both health care and disability prevention. This three-tier model consists of the following: two LTC services with a day-care center as their base and case management (Tier A), a day-care center and a single LTC service (Tier B), and LTC stations that provide primary prevention services and respite services for frail community-dwelling older adults to prevent further disabilities (Tier C). A defined cluster of agencies in a local area works together as a Tier ABC team. LTC Plan 2.0 is a new policy for Taiwan, and hence it is important to understand the agencies' initial difficulties with implementation and identify future challenges to help further policy development. METHODS: This preliminary study explored the challenges to implementing LTC 2.0 through in-depth interviews based on Evashwick's integration mechanisms with representatives from three service teams. We interviewed three chief executive officers and three case managers. RESULTS: We found that the LTC Plan 2.0 mechanisms for service integration have been insufficiently implemented. Recommendations include (1) Build up the trust between agencies and government, avoid duplication of LTC services within Tier ABC team, and encourage agencies within a team to create a shared administrative system with the same mission and vision. (2) Clarify the roles and responsibilities of government care managers and agency case managers. (3) Provide an integrated information system and create an official platform for sharing client records across different agencies and caregivers. (4) Establish a tool and platform to track the budget and payment across different levels of service as soon as possible. CONCLUSION: There is an increased demand for LTC services in Taiwan because of its rapidly aging population. Our findings shed some light on the challenges to developing integrated LTC services and thus may help both policymakers and service providers find ways to overcome these challenges.

6.
J Aging Health ; : 898264319841524, 2019 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-30964384

RESUMO

OBJECTIVE: The objective of this study was to adapt and validate the Vietnamese version of Active Aging Index (AAI). METHOD: We conducted an expert panel, focus groups, test-retest and examination of internal consistency, and construct and concurrent validity among 804 older Vietnamese adults. RESULTS: Scale content validity index (CVI) was 0.98. Test-retest coefficients ranged from 0.70 to 1.00. The Cronbach's alphas of well-being, voluntary, affordability, and politics were 0.94, 0.70, 0.65, and 0.16, respectively. Voluntary and well-being had good construct validity. Regarding politics, only one of four items had good test-retest reliability (Kappa 0.84), while other three had low variance in both test-retest and field study. In exploratory factor analysis, items assessing affordability loaded on three components. AAI was positively associated with perceived health, life satisfaction, and quality of life; it was negatively associated with falls, loneliness, and frailty. DISCUSSION: In adapting AAI, researchers should consider cultural sensitivity. Key modifications, findings, explanations, and suggestions are presented here.

7.
Arch Gerontol Geriatr ; 82: 161-166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30802840

RESUMO

OBJECTIVES: To understand whether disability trajectories mediated the association between sociodemographic characteristics and later health care and long-term care services use. METHODS: Data were from the Taiwan Longitudinal Study on Aging Survey, 1996-2007 (N =3429). Latent class growth curves modeling and structural equation modeling were applied to examine the effect of disability trajectory as mediator on sociodemographic characteristics and on later services use. RESULTS: Respondents were identified in three trajectories: maintained disability (1.92%), progressive disability (10.56%), and functional independence trajectories (87.52%). The progressive disability trajectory partially and fully mediated the effects of age on later use of health care and long-term care services (the partially mediating effect on age and long-term care service use: ß = 0.047, p < 0.001, for example). With the progressive disability trajectory in the model, higher education had a direct effect on greater use of long-term care services (ß = 0.020, p =0.020), but through the mediating effect of the disability trajectory, education had an indirect effect on lower use of long-term care services(ß = -0.025, p < 0.001). Education had fully mediating effects on the later use of inpatient (ß = -0.016, p < 0.001) and emergency services (ß= -0.012, p < 0.001). CONCLUSIONS: Preventing older adults from developing a fast-growing disability trajectory could be an effective way to decrease use of health care and long-term care services and related expenditures in late life.

8.
Percept Mot Skills ; 126(3): 389-409, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30803309

RESUMO

This randomized controlled trial explored the effects of a Ving Tsun (VT) Chinese martial art training program on reactive standing balance performance, postural muscle reflex contraction latency, leg muscle performance, balance confidence and falls in community-dwelling older adults. We randomly assigned 33 healthy older adults to either a VT group (mean age = 67.5 years) or a control group (mean age = 72.1 years). The VT group received two 1-hour VT training sessions per week for three months (24 sessions). Primary outcome measures collected before and after the intervention period were electromyographic muscle activation onset latencies of the hamstring and gastrocnemius and the center of pressure path, length and movement velocity in standing (reactive balance performance). Secondary outcome measures included isometric peak force and time to isometric peak force of the knee extensors and flexors, the Activities-Specific Balance Confidence Scale score, and fall history. Results revealed that the mean gastrocnemius muscle activation onset latency was significantly longer (22.53 ms) in the VT group after the intervention. The peak force of the knee flexors significantly increased (by 1.58 kg) in the control group over time but not in the VT group. The time to reach peak force in the knee flexors was significantly longer (by 0.51 s) in the control group (but not the VT group) at posttest compared with the pretest value. No other significant group, time, or group-by-time interaction effects were noted. We discussed possible reasons for the failure of three months of martial art training to benefit fall risks among these older adults.


Assuntos
Acidentes por Quedas/prevenção & controle , Envelhecimento/fisiologia , Terapia por Exercício/métodos , Perna (Membro)/fisiologia , Artes Marciais , Músculo Esquelético/fisiologia , Equilíbrio Postural/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Falha de Tratamento
9.
Sci Rep ; 8(1): 14998, 2018 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-30301949

RESUMO

Plant litter decomposition is an important biogeochemical process in terrestrial ecosystems. Although climate and substrate quality controls over litter decomposition are reasonably well understood, their impacts on lignocellulose degradation and lignocellulolytic enzymes remain elusive. Here, the decomposition of three leaf litters derived from Salix paraplesia (SP), Deyeuxia scabrescens (DS), and Ajuga ovalifolia (AO), was studied across an alpine forest-tundra ecotone during one snow-covered season with the objective of distinguishing between the effects of microclimate and litter quality on litter decomposition rates and lignocellulolytic enzymes. The results showed that both microclimate and litter quality affected lignocellulose degradation rates and lignocellulolytic enzyme activities; however, microclimate factors had the greater effects. Interestingly, freeze-thaw cycles and moisture were the predominant factors explaining the variations in decomposition rate and enzyme activities. Higher cellulose degradation rates were associated with higher cellulose concentrations. Cellulolytic enzymes had a greater effect on litter decomposition than did ligninolytic enzymes at the early decomposition stage. Litter decomposition and enzyme activities should be given more attention under global climate change, as the direction and magnitude of changes in microclimate factors and litter quality could strongly influence the nutrient cycling and energy fluxes of alpine ecosystems.


Assuntos
Mudança Climática , Ecossistema , Microclima , Tundra , Florestas , Folhas de Planta/crescimento & desenvolvimento , Estações do Ano , Neve , Solo , Temperatura Ambiente
10.
PLoS One ; 13(10): e0203757, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30281590

RESUMO

OBJECTIVES: The aims of this study were to investigate (1) whether and (2) the extent to which Taiwanese older adults' leisure time activity (LTA) trajectories mediated the potential association between their sociodemographic factors and their functional disability trajectories. METHODS: Longitudinal data from four waves of the Taiwan Longitudinal Study on Aging (TLSA), collected between 1996 and 2007, were used for analysis (N = 3,429). Parallel-process latent growth curve modeling was adopted to evaluate the process by which LTA mediated between sociodemographic factors (age, gender, education, self-rated health, comorbidities, and depression) and the outcome process of functional disabilities. RESULTS: When mediated by baseline level of LTA, five sociodemographic factors-age, gender, education level, self-rated health, and number of comorbidities-had significant and negative mediating effects on baseline or change in functional disability, thus improving disability outcomes. However, four of the sociodemographic factors (age, education level, and number of comorbidities), when mediated through the rate of change in LTA, were found to have significant and positive mediating effects, which increased disability levels. The proportion of effects mediated by the LTA trajectory ranged from 0% to 194%. DISCUSSION: The large proportion of effects mediated through the LTA process underlines the importance of LTA to public health policy and health programs for older adults. The study's findings shed light on how to better target populations of older adults to promote an active lifestyle and achieve more successful aging in late life in Asian countries.


Assuntos
Envelhecimento/psicologia , Pessoas com Deficiência/psicologia , Progressão da Doença , Atividades de Lazer/psicologia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Ásia , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Taiwan
11.
Genomics Proteomics Bioinformatics ; 16(4): 262-268, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30208340

RESUMO

Esophageal squamous-cell carcinoma (ESCC) is one of the most lethal malignancies in the world and occurs at particularly higher frequency in China. While several genome-wide association studies (GWAS) of germline variants and whole-genome or whole-exome sequencing studies of somatic mutations in ESCC have been published, there is no comprehensive database publically available for this cancer. Here, we developed the Chinese Cancer Genomic Database-Esophageal Squamous Cell Carcinoma (CCGD-ESCC) database, which contains the associations of 69,593 single nucleotide polymorphisms (SNPs) with ESCC risk in 2022 cases and 2039 controls, survival time of 1006 ESCC patients (survival GWAS) and gene expression (expression quantitative trait loci, eQTL) in 94 ESCC patients. Moreover, this database also provides the associations between 8833 somatic mutations and survival time in 675 ESCC patients. Our user-friendly database is a resource useful for biologists and oncologists not only in identifying the associations of genetic variants or somatic mutations with the development and progression of ESCC but also in studying the underlying mechanisms for tumorigenesis of the cancer. CCGD-ESCC is freely accessible at http://db.cbi.pku.edu.cn/ccgd/ESCCdb.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Bases de Dados Genéticas , Carcinoma de Células Escamosas do Esôfago/genética , Variação Genética , Estudo de Associação Genômica Ampla , Idoso , China/epidemiologia , Feminino , Predisposição Genética para Doença , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único/genética , Interface Usuário-Computador
12.
Sci Rep ; 8(1): 10029, 2018 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-29968739

RESUMO

Cellulose and lignin are the main polymeric components of the forest litter horizon. We monitored microbial community composition using phospholipid fatty acid (PLFA) analysis and investigated the ligninolytic and cellulolytic enzyme activities of the litter horizon across an alpine treeline ecotone in the eastern Tibetan Plateau. The activities of ligninolytic and cellulolytic enzymes and the biomass of microbial PLFAs were higher in the initial stage of litter decomposition than in the latter stage in the three vegetation types (coniferous forest, alpine shrubland and alpine meadow). Soil microbial community structure varied significantly over the course of litter decomposition in the three vegetation types. Furthermore, the BIOENV procedure revealed that the carbon to nitrogen (C:N) ratio, carbon to phosphorus (C:P) ratio and moisture content (MC) were the most important determinants of microbial community structure in the initial stage of litter decomposition, whereas pH and the lignin concentration were the major factors influencing the microbial community structure in the later stage of litter decomposition. These findings indicate that litter quality drives the differentiation of microbial communities in the litter horizon across an alpine treeline ecotone in the eastern Tibetan Plateau.


Assuntos
Celulose/análise , Lignina/análise , Resíduos/efeitos adversos , Altitude , Biomassa , Carbono/análise , Monitorização de Parâmetros Ecológicos/métodos , Ecossistema , Ácidos Graxos/análise , Florestas , Concentração de Íons de Hidrogênio , Microbiota , Nitrogênio/análise , Fosfolipídeos/análise , Fósforo/análise , Folhas de Planta/química , Estações do Ano , Solo/química , Microbiologia do Solo , Temperatura Ambiente , Tibet , Traqueófitas
13.
Oncol Lett ; 15(6): 8703-8710, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29805608

RESUMO

Crizotinib is an anti-cancer drug with a substantial beneficial effect in advanced non-small-cell lung cancer (NSCLC) patients harboring anaplastic lymphoma kinase (ALK) rearrangement. However, the real-world data currently available on this drug are limited. Thus, the present study aimed to retrospectively examine the treatment patterns and survival outcome of 83 advanced NSCLC patients with ALK rearrangement in a single center in China. Of the 83 patients enrolled, 33 (39.8%) patients received crizotinib and the remaining 50 (60.2%) patients received chemotherapy as the initial therapy. The first-line use of crizotinib prolonged the PFS1 (progression-free survival to the first detection of subsequent disease progression) compared with chemotherapy (median, 18.5 vs. 4.9 months; P<0.001), however, it did not prolong the overall survival (OS; P=0.802). At the last follow up, 71 (85.5%) patients had received crizotinib and 12 (14.5%) patients were crizotinib-naive. Patients who had received crizotinib exhibited a significantly longer OS as compared with those who were crizotinib-naive [hazard ratio (HR) for mortality, 0.279; 95% confidence interval, 0.107-0.727; P<0.05). Among the 71 patients who had received crizotinib, this was administered as a first-line therapy in 33 (46.5%) cases, as a second-line therapy in 22 (31.0%) cases and after the second-line therapy in 16 (22.5%) cases. No significant difference in the OS among the three groups was observed (P=0.577). The Cox multivariate analysis identified the following independent negative prognostic factors for OS: Smoking history (HR=4.565), liver invasion at diagnosis (HR=4.294) and bone invasion at diagnosis (HR=2.587). In addition, the use of crizotinib (HR=0.319) was identified as a positive prognostic factor for OS. In conclusion, the present real-world study revealed that the use of crizotinib improved the long-term survival of patients with ALK-positive advanced NSCLC. There was no difference in survival outcome between patients with initial use of crizotinib and those with subsequent use of crizotinib after first-line therapy.

14.
J Appl Gerontol ; : 733464818774642, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29766761

RESUMO

We aimed to understand the relationships between care recipients' profiles and home- and community-based services (HCBS use patterns. Data were from the 2010 to 2013 Long-Term Care Service Management System in Taiwan ( N = 78,205). We used latent class analysis and multinomial logistic regression analyses. Three HCBS use patterns were found. Care recipients who lived alone, lived in less urbanized areas, and had instrumental activities of daily living disabilities were more likely to be in the home-based personal care group. Those in the home-based personal and medical care group were more likely than others to have a primary caregiver. Care recipients who had poorer abilities at basic activities of daily living and cognitive function, better household income, and lived in a more urbanized area were more likely to be in the non-personal care multiple services group. The findings suggest that policymakers alleviate barriers to accessing various patterns of HCBS should be encouraged.

15.
J Cardiovasc Pharmacol ; 72(1): 40-48, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29688911

RESUMO

Tranilast is clinically indicated for the treatment of allergic disorders and is also a nonselective blocker of the transient receptor potential vanilloid 2 (TRPV2) channel. Previous studies have found that it has protective effects in various animal models of cardiac disease. Our laboratory has found that genetic deletion of TRPV2 results in a blunted hypertrophic response to increased afterload; thus, this study tested the hypothesis that tranilast through cardiomyocyte TRPV2 blockade can inhibit the hypertrophic response to pressure overload in vivo through transverse aortic constriction and ex vivo through isolated myocyte studies. The in vivo studies demonstrated that tranilast blunted the fibrotic response to increased afterload and, to a lesser extent, the hypertrophic response. After 4 weeks, this blunting was associated with improved cardiac function, although at 8 weeks, the cardiac function deteriorated similarly to the control group. Finally, the in vitro studies demonstrated that tranilast was not inhibiting these responses at the cardiomyocyte level. In conclusion, we demonstrated that tranilast blunting of the fibrotic and hypertrophic response occurs independently of cardiac TRPV2 channels and may be cardioprotective in the short term but not after prolonged administration.


Assuntos
Hipertrofia Ventricular Esquerda/prevenção & controle , Miócitos Cardíacos/efeitos dos fármacos , Canais de Cátion TRPV/antagonistas & inibidores , Disfunção Ventricular Esquerda/prevenção & controle , Função Ventricular Esquerda/efeitos dos fármacos , Remodelação Ventricular/efeitos dos fármacos , ortoaminobenzoatos/farmacologia , Animais , Canais de Cálcio/genética , Canais de Cálcio/metabolismo , Modelos Animais de Doenças , Progressão da Doença , Fibrose , Hipertrofia Ventricular Esquerda/metabolismo , Hipertrofia Ventricular Esquerda/patologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Camundongos Knockout , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , Recuperação de Função Fisiológica , Transdução de Sinais/efeitos dos fármacos , Canais de Cátion TRPV/genética , Canais de Cátion TRPV/metabolismo , Fatores de Tempo , Fator de Crescimento Transformador beta1/metabolismo , Disfunção Ventricular Esquerda/metabolismo , Disfunção Ventricular Esquerda/fisiopatologia , ortoaminobenzoatos/toxicidade
16.
J Appl Gerontol ; 37(6): 706-727, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-27231245

RESUMO

We aimed to identify leisure activity (LA) trajectories and examined the association among baseline characteristics, LA trajectories, and the later disability among older Taiwanese adults. Data were from the Taiwan Longitudinal Study on Aging Survey for the years 1996-2007 ( N = 3,186). LA trajectories were identified by using latent class growth curve modeling. Regression analyses were applied to predict the relationships among baseline characteristics, LA trajectories, and disability. Four LA trajectories-consistent high, consistent low, increasing, and decreasing-were identified. Lower depressive symptom was related to consistently active in LAs. Younger age and fewer comorbidities were related to develop an increasing LA trajectory. Participants in the consistent-high or increasing LA trajectories were more likely to be functionally independent, but those in the decreasing LA subgroup were more at risk of developing disability. The findings suggested that long-term changes in LA over time have benefits on physical health in older population.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência/estatística & dados numéricos , Atividades de Lazer , Fatores Etários , Idoso , Comorbidade , Depressão/epidemiologia , Feminino , Humanos , Análise de Classes Latentes , Estudos Longitudinais , Masculino , Taiwan/epidemiologia
17.
Oncotarget ; 8(40): 67497-67505, 2017 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-28978048

RESUMO

The pathogenesis of food allergy (FA) is to be further investigated. Regulatory B cells (B10 cell) play a critical in the maintenance of the homeostasis in the intestine. Deregulation of B10 cell is associated with immune inflammation. Micro RNA (miR) 155 is involved in affecting immune cell function. This study tests a hypothesis that miR-155 affects the B10 cell function to facilitate the initiation of FA. In this study, BALB/c mice were sensitized to ovalbumin (OVA) to induce FA-like inflammation in the intestine. B cells were isolated from the intestine by magnetic cell sorting. The expression of miR-155 and IL-10 in B cells was assessed by real time RT-PCR. The results showed that mice sensitized to OVA showed FA-like inflammation and lower frequency of B10 cell in the intestine. B cells isolated from the intestine of FA mice showed higher levels of miR-155 and lower levels of IL-10. Although all the three T helper (Th)2 cytokines, including interleukin (IL)-4, IL-5 and IL-13, were higher in the serum, only IL-13 was positively correlated with the levels of miR-155 in the intestinal B cells. Exposure to IL-13 in the culture markedly increased the expression of miR-155 and suppressed the expression of IL-10 in B cells. Blocking miR-155 abolished the IL-13-induced IL-10 suppression in B cells and inhibited FA response in mice. In conclusion, miR-155 plays a critical role in the initiation of FA in mice. Blocking miR-155 has therapeutic potential in the treatment of FA.

18.
Int J Qual Health Care ; : 1-5, 2017 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-28637191

RESUMO

Objective: The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. Design: We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. Setting: A total of 33 senior health enterprises in Taiwan. Participants: Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. Intervention(s): None. Main Outcome Measure(s): Core values and vision, organization structure, quality services provided, strategies for quality services. Results: This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. Conclusions: The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service.

19.
Hu Li Za Zhi ; 64(2): 55-65, 2017 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-28393339

RESUMO

BACKGROUND: Hospitalized patients generally have elevated levels of emotional distress. Gaining a better under-standing of the problem of emotional distress among hospitalized patients is conducive to providing appropriate emotional care and promoting their recovery. PURPOSE: To analyze the scores for the "sixth vital sign" (i.e., emotional distress), diversification, and the health-related problems of hospitalized patients at a medical center in Taiwan. The results may offer an important reference for providing effective emotional care to hospitalized patients. METHODS: A retrospective descriptive research design was used. Data were collected from all of the 27,885 inpatients that were registered at the target hospital in 2013. Further, a total of 245,814 attendance records were assessed to extract the data that were relevant to emotional distress. RESULTS: The findings revealed that 58.3% of hospitalized patients had earned a sixth vital sign score ≥ 1 and that 0.8% of these patients had earned a score ≥ 4. On the whole, the sixth vital sign scores of hospitalized patients were found to decrease progressively with the number of hospitalization days except for hematology and oncology, neurosurgery, and plastic surgery patients. The highest emotional distress scores were found among family medicine, dermatology, and plastic surgery patients. Moreover, emotional distress scores were significantly higher in patients who had health problems that involved pain, anxiety, or sleep disorder. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The present study suggests that improving the emotional care of hematology, oncology, neurosurgery, family medicine, dermatology, and plastic surgery patients and of patients with health problems involving pain, anxiety, or sleep disorder may significantly improve the quality of inpatient holistic healthcare. Only 0.8% of the subjects in the present study had an emotional distress score ≥ 4, which is significantly lower than the level reported in other similar studies. Our findings suggest that related education and training for nursing staffs may improve their assessment and care practices in caring for patients with emotional distress. Furthermore, using more appropriate words, methods, and environments to evaluate the emotional distress of patients holds the potential to improve assessment and care for these patients.


Assuntos
Pacientes Internados/psicologia , Estresse Psicológico/epidemiologia , Sinais Vitais , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
Int J Qual Health Care ; 28(4): 497-501, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27301480

RESUMO

OBJECTIVE: With global population aging, great business opportunities are driven by the various needs that the elderly face in everyday living. Internet development makes information spread faster, also allows elderly and their caregivers to more easily access information and actively participate in value co-creation in the services. This study aims to investigate the designs of value co-creation by the supply and demand sides of the senior industry. DESIGN: This study investigated senior industry in Taiwan and analyzed bussiness models of 33 selected successful senior enterprises in 2013. We adopted series field observation, reviews of documentations, analysis of meeting records and in-depth interviews with 65 CEOs and managers. SETTING: Thirty-three quality enterprises in senior industry. PARTICIPANTS: Sixty-five CEOs and managers in 33 senior enterprises. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Value co-creation design, value co-creating process. RESULTS: We constructed a conceptual model that comprehensively describes essential aspects of value co-creation and categorized the value co-creation designs into four types applying for different business models: (i) interaction in experience spaces co-creation design, (ii) on-site interacting co-creation design, (iii) social networking platform co-creation design and (iv) empowering customers co-creation design. Through value co-creation platform design, the senior enterprises have converted the originally passive roles of the elderly and caregivers into active participants in the value co-creation process. CONCLUSIONS: The new paradigm of value co-creation designs not only promote innovative development during the interactive process, lead enterprises reveal and meet customers' needs but also increase markets and profits.


Assuntos
Enfermagem Geriátrica , Recursos em Saúde/organização & administração , Modelos Organizacionais , Aquisição Baseada em Valor , Idoso , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Taiwan
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