The utilization and barriers of Pap smear among women with visual impairment.

BACKGROUND: Many evidences illustrate that the Pap smear screening successfully reduces if the cervical cancer could be detected and treated sufficiently early. People with disability were higher comorbidity prevalence, and less likely to use preventive health care and health promotion activities. There were also to demonstrate that people with visual impairment has less access to appropriate healthcare services and is less likely to receive screening examinations. In Taiwan, there was no study to explore utilization of Pap smear, associated factors and use barriers about Pap smear screening test among women with visual impairment. The purpose is to explore the utilization and barriers of using Pap smear for women with visual impairment in Taiwan. To identify the barriers of women with visual from process of receiving Pap smear screening test. METHODS: The cross-sectional study was conducted and the totally 316 participators were selected by stratified proportional and random sampling from 15 to 64 year old women with visual impairment who lived in Taipei County during December 2009 to January 2010. The data was been collected by phone interview and the interviewers were well trained before interview. RESULTS: The mean age was 47.1 years old and the highest percentage of disabled severity was mile (40.2 %). Totally, 66.5 % of participators were ever using Pap smear and 38.9 % used it during pass 1 year. Their first time to accept Pap smear was 38.8 year old. There was near 50 % of them not to be explained by professionals before accepting the Pap smear. For non-using cases, the top two percentage of barriers were "feel still younger" (22.3 %), the second was "there's no sexual experience" (21.4 %). We found the gynecology experiences was key factor for women with visual impairment to use Pap smear, especially the experiences was during 1 year (OR = 4). CONCLUSIONS: Associated factors and barriers to receive Pap smear screening test for women with visual impairment can be addressed through interventions aimed at improving on cognitions and attitudes for cervical cancer risk factors. Our study would be as a reference resource for erasing the barriers and inequality among the visually disabled women.

Simultaneous Double Eyelid Blepharoplasty and Ptosis Correction with a Single-Knot, Continuous, Nonincisional Technique: A Five-Year Review.

BACKGROUND: Double eyelid blepharoplasty is one of the most popular facial cosmetic surgeries performed in patients with Asian eyelids. Although most patients choose to undergo blepharoplasty for cosmetic purposes, rather than functional reasons, these patients frequently present with concomitant mild-to-moderate blepharoptosis. OBJECTIVES: Performing nonincisional double eyelid surgery without correcting the ptosis tends to lead to unsatisfactory results. The authors introduce our new method for simultaneous correction of blepharoptosis during double eyelid blepharoplasty. METHODS: For 5 years, the authors have performed a single-knot continuous nonincisional technique for simultaneous correction of blepharoptosis during double eyelid blepharoplasty. The medical charts of 127 patients (254 eyelids) were retrospectively reviewed. Müller muscle tagging suture was utilized to achieve the accurate amount of Müller tucking during the surgery. RESULTS: There was a statistically significant difference between pretreatment MRD1 (1.62 ± 0.57 mm), and postoperative MRD1 (3.97 ± 0.81 mm; P < .001, Wilcoxon signed rank test, nonparametric paired comparison). The mean duration of surgery for both eyelids was 14.8 minutes (range, 14.1-19.7 minutes), and the mean extent of Müller muscle tucking was 7.8 mm (range, 6.0-10.0 mm). The majority of patients showed favorable results during long-term follow-up, with minimal complications. CONCLUSIONS: There are no previously published articles documenting simultaneous double eyelid blepharoplasty and ptosis correction, using a single-knot continuous nonincisional technique. The authors suggest our simple and effective method is a good option for double eyelid blepharoplasty in cases with mild-to-moderate blepharoptosis.' LEVEL OF EVIDENCE 4: Therapeutic.

In situ TEM and energy dispersion spectrometer analysis of chemical composition change in ZnO nanowire resistive memories.

Resistive random-access memory (ReRAM) has been of wide interest for its potential to replace flash memory in the next-generation nonvolatile memory roadmap. In this study, we have fabricated the Au/ZnO-nanowire/Au nanomemory device by electron beam lithography and, subsequently, utilized in situ transmission electron microscopy (TEM) to observe the atomic structure evolution from the initial state to the low-resistance state (LRS) in the ZnO nanowire. The element mapping of LRS showing that the nanowire was zinc dominant indicating that the oxygen vacancies were introduced after resistance switching. The results provided direct evidence, suggesting that the resistance change resulted from oxygen migration.

White blood cell count and psychomotor cognitive performance in the elderly.

BACKGROUND: White blood cell (WBC) count is associated with many inflammatory diseases such as cardiovascular disease, diabetes and hypertension. Research on the relationship of WBC count and cognition in the elderly is relatively sparse. This study examined the association between WBC count and cognitive performance in older adults. METHODS: Data from the National Health and Nutrition Examination Survey (1999-2002) containing 1670 older adults were analysed. Every subject completed a household interview, examination of digit symbol substitution test (DSST) scores, WBC count measurement and a questionnaire regarding personal health. WBC count was restricted to the normal range and divided into quartiles, using a multiple hierarchical regression model to estimate the relationship between WBC counts and DSST scores. Quartile-based analysis with an extended-model approach was used for further covariates adjustment. Trends test examining the associations across increasing quartiles of WBC counts and DSST scores were also conducted. RESULTS: In the multiple hierarchical regression model, the ß coefficient, representing the change of DSST scores for each 1000 cells uL(-1) increase in WBC count, was -0·097 (R(2) = 0·343, P < 0·001). After additional competent covariates adjustment, the negative correlation remained (all P < 0·001). In quartile-based multiple linear regression, the negative trends between DSST scores and WBC count quartiles in the stratified comparison with extended-model approach were all statistically significant (P for trends <0·001). CONCLUSIONS: Higher WBC counts, even within the normal range, were associated with poor psychomotor cognitive performance in the elderly.

Effectiveness of a stress-relief initiative for primary caregivers of adolescents with intellectual disability.

BACKGROUND: This study provides a perspective on the mental health status and analyses the effectiveness of a stress-relief program for primary caregivers of adolescents with intellectual disability (ID). METHOD: Seventy-seven primary caregivers of people with ID were recruited (intervention group, n = 31; non-intervention group, n = 46) to the study, which involved participation in one stress management workshop (intervention group only) and both groups reading an education booklet on stress management. RESULTS: We found that 22.1% of caregivers in the study were at high risk of depressive stress and in need of mental health consultation; this prevalence was nearly six times that of the general population. The effectiveness of mental health initiatives resulted in a significant reduction in depressive stress for the intervention group. CONCLUSIONS: The study highlights that a "face-to-face" workshop is an effective way to decrease levels of depressive stress.

A nanopatterned cell-seeded cardiac patch prevents electro-uncoupling and improves the therapeutic efficacy of cardiac repair.

The heart is an extremely sophisticated organ with nanoscale anisotropic structure, contractility and electro-conductivity; however, few studies have addressed the influence of cardiac anisotropy on cell transplantation for myocardial repair. Here, we hypothesized that a graft's anisotropy of myofiber orientation determines the mechano-electrical characteristics and the therapeutic efficacy. We developed aligned- and random-orientated nanofibrous electrospun patches (aEP and rEP, respectively) with or without seeding of cardiomyocytes (CMs) and endothelial cells (ECs) to test this hypothesis. Atomic force microscopy showed a better beating frequency and amplitude of CMs when cultured on aEP than that from cells cultured on rEP. For the in vivo test, a total of 66 rats were divided into six groups: sham, myocardial infarction (MI), MI + aEP, MI + rEP, MI + CM-EC/aEP and MI + CM-EC/rEP (n ≥ 10 for each group). Implantation of aEP or rEP provided mechanical support and thus retarded functional aggravation at 56 days after MI. Importantly, CM-EC/aEP implantation further improved therapeutic outcomes, while cardiac deterioration occurred on the CM-EC/rEP group. Similar results were shown by hemodynamic and infarct size examination. Another independent in vivo study was performed and electrocardiography and optical mapping demonstrated that there were more ectopic activities and defective electro-coupling after CM-EC/rEP implantation, which worsened cardiac functions. Together these results provide comprehensive functional characterizations and demonstrate the therapeutic efficacy of a nanopatterned anisotropic cardiac patch. Importantly, the study confirms the significance of cardiac anisotropy recapitulation in myocardial tissue engineering, which is valuable for the future development of translational nanomedicine.

A biomimetic tongue by photoluminescent metal-organic frameworks.

The taste sensing capabilities of a "biomimetic tongue" based on the photoluminescence (PL) responses of metal-organic frameworks (MOFs), [In(OH)(bdc)]n (bdc=1,4-benzenedicarboxylate), [Tb(btc)]n (MOF-76, btc=benzene-1,3,5-tricarboxylate), and [Ca3(btc)2(DMF)2(H2O)2]·3H2O are proven on aqueous solutions of five basic tastants: sucrose (sweet), caffeine (bitter), citric acid (sour), sodium chloride (salty) and monosodium glutamate (umami). For [In(OH)(bdc)]n, the tastant interacts stereochemically with poly(acrylic acid) (PAA) and alters its conformations. The frequency and magnitude of chelation between COO(-) pendant groups of PAA and In(3+) nodes of [In(OH)(bdc)]n framework influence the corresponding PL reponses. For MOF-76, the tastant interacts with incorporated water in MOF-76 through hydrogen bonding. The limitation of O-H bond stretching of water results in the enhancement of the PL intensity. For [Ca3(BTC)2(DMF)2(H2O)2]·3H2O, it is added as a third MOF component to increase the precision on taste discrimination. The significance of MOF-based "biomimetic tongue" includes: (1) PAA on [In(OH)(bdc)]n mimics the taste receptor cells (TRCs) for their structural flexibility, (2) the Weber-Fechner law of human sensing that sensation is proportional to the logarithm of the stimulus intensity is observed between the PL emission response of MOF-76 and the concentration of tastant, (3) the strength of taste is quantified by the τ scale and the PL emission intensity of MOF-76, which are dependent on the logarithmic tastant concentration, (4) the tastant is identified by the shape of the 3D principal component analysis contour map (i.e., pattern recognition method), and (5) the fabrication of [In(OH)(bdc)]n/PAA film by brushing is illustrated.

Copper silicide/silicon nanowire heterostructures: in situ TEM observation of growth behaviors and electron transport properties.

Copper silicide has been studied in the applications of electronic devices and catalysts. In this study, Cu3Si/Si nanowire heterostructures were fabricated through solid state reaction in an in situ transmission electron microscope (TEM). The dynamic diffusion of the copper atoms in the growth process and the formation mechanism are characterized. We found that two dimensional stacking faults (SF) may retard the growth of Cu3Si. Due to the evidence of the block of edge-nucleation (heterogeneous) by the surface oxide, center-nucleation (homogeneous) is suggested to dominate the silicidation. Furthermore, the electrical transport properties of various silicon channel length with Cu3Si/Si heterostructure interfaces and metallic Cu3Si NWs have been investigated. The observations not only provided an alternative pathway to explore the formation mechanisms and interface properties of Cu3Si/Si, but also suggested the potential application of Cu3Si at nanoscale for future processing in nanotechnology.

The effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution: six-month short-term effect.

Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities. The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution. There were 146 participants with intellectual disabilities (age 19-67 years) were recruited in the study. We collected information on disability condition (type and level), height, weight, BMI, and physical fitness status (includes V-shape sit and reach test, sit-up 30s, sit-up 60s, and shuttle run) at the beginning and 6 months later of the program intervention. The results show that there were statistical decreases in individual's weight, BMI score, BMI category, and positive improvement in V-shape sit and reach test, sit-up in 30s and 60s tests after 6-month interventions. However, the shuttle run test did not improve at the post-test among people with intellectual disabilities. The results also showed that the mild disability level group has the highest effectiveness on the healthy fitness program on decreasing body weight. Generally speaking, the preliminary study found the healthy exercise program has positive fitness effects on people with intellectual disabilities. To maximize the benefits of regular physical activity on people with ID, there is a need to evaluate the long-term effect of the intervention program and then to initiate the healthy exercise strategies in institution for this group of people.

Quality of life in caregivers of children and adolescents with intellectual disabilities: use of WHOQOL-BREF survey.

The present study based on World Health Organization quality of life (WHOQOL-BREF) scale to examine quality of life of the caregivers caring for their children/adolescents with intellectual disabilities in Taiwan, and the factors contributing to their quality of life. Structured interviews were conducted with 597 caregivers of children/adolescents with intellectual disabilities. The results found that the mean scores in each domain of WHOQOL-BREF of the caregivers as the followings: physical capacity (PC) was 13.71+/-2.35, psychological well-being (PW) was 12.21+/-2.55, social relationship (SR) was 12.99+/-2.43 and environment (EN) was 12.32+/-2.38. These mean scores were lower than the general population and slight higher than the caregivers of adults with intellectual disabilities in Taiwan. Finally, multiple stepwise regressions were conducted to examine the characteristics of caregiver and children/adolescents with intellectual disabilities will more likely explained the WHOQOL-BREF mean scores. The study found the following three factors: self-perceived health status, household income and stress from insufficient family support were significantly correlated to all four domains in multiple stepwise regression analyses. The results highlights that caregivers of children and adolescents with intellectual disabilities seem to display a lower WHOQOL-BREF mean score than the general population, probably for a combination of stress, health and household income factors. These finding must be taken into account in policy making to provide better and more specific supports and interventions for the caregivers of people with intellectual disabilities.

Chronic treatment with the gamma-secretase inhibitor LY-411,575 inhibits beta-amyloid peptide production and alters lymphopoiesis and intestinal cell differentiation.

Inhibition of gamma-secretase, one of the enzymes responsible for the cleavage of the amyloid precursor protein (APP) to produce the pathogenic beta-amyloid (Abeta) peptides, is an attractive approach to the treatment of Alzheimer disease. In addition to APP, however, several other gamma-secretase substrates have been identified (e.g. Notch), and altered processing of these substrates by gamma-secretase inhibitors could lead to unintended biological consequences. To study the in vivo consequences of gamma-secretase inhibition, the gamma-secretase inhibitor LY-411,575 was administered to C57BL/6 and TgCRND8 APP transgenic mice for 15 days. Although most tissues were unaffected, doses of LY-411,575 that inhibited Abeta production had marked effects on lymphocyte development and on the intestine. LY-411,575 decreased overall thymic cellularity and impaired intrathymic differentiation at the CD4(-)CD8(-)CD44(+)CD25(+) precursor stage. No effects on peripheral T cell populations were noted following LY-411,575 treatment, but evidence for the altered maturation of peripheral B cells was observed. In the intestine, LY-411,575 treatment increased goblet cell number and drastically altered tissue morphology. These effects of LY-411,575 were not seen in mice that were administered LY-D, a diastereoisomer of LY-411,575, which is a very weak gamma-secretase inhibitor. These studies show that inhibition of gamma-secretase has the expected benefit of reducing Abeta in a murine model of Alzheimer disease but has potentially undesirable biological effects as well, most likely because of the inhibition of Notch processing.

Death due to hydrogen sulfide poisoning after drain cleansing in an apartment house / 대한법의학회지

A nine-year old boy was found unconscious by his father in his apartment house. He was transferred to the emergency unit immediately but resuscitation was failed. Drain cleansing was performed just before the deceased came home. The father stated that there was foul odor in the house when he opened the door. The autopsy finding showed only nonspecific findings including severe pulmonary edema. Significant amount of sulfide ion was detected from blood and brain tissue. The cause of death was concluded as hydrogen sulfide poisoning.

The Effect of IGF-1 on ALP Activity of MC3T3-E1 Cell / 대한치주과학회지

Polypeptide growth factors belong to a class of potent biologic mediators which regulate cell differentiation, proliferation, migration and metabolism. IGF-I is polypeptides secreted by skeletal cells and is considered as regulators of bone formation. The purpose of this study is to evaluate the effects of IGF-I on bone nodule formation and alkaline phosphatase activity of MC3T3-E1 cells. MC3T3-E1 cells were seeded at 1x10(4) cells/well, 1x10(5) cells/well in alpha-modified Eagle medium containing 10% fetal bovine serum, 10 mM beta-glycerophosphate and 50microgram/ml of ascorbic acid. Before 48 hours of indicated time, medium were changed with serum free medium. After 24 hours, 0.1, 1, 10 ng/ml IGF-I were added to the cells and cultured for 3, 7, 14, 21, 28 days. And histochemical analysis was done and ALP activity was measured and was expressed as nmol/min/mg of protein. The bone nodule formation in MC3T3-E1 cells of IGF-I was seen at 21, 28 days, but there were no difference between control group and experimental groups. The ALP activity decreased when it is compare to control 2 group except for 1 ng/ml, 10 ng/ml IGF-I of 21-day-groups and 1 ng/ml IGF-I of 28-day-groups. Dose response effects of IGF-I of ALP activity in MC3T3-E1 cells were seen the highest ALP activity at 1ng/ml until 21days and the highest ALP activity at 10 ng/ml of 28 daygroups. The peak times were seen at 7-day group, 14-day group on control group and experimental group respectively, and 1 ng/ml group was the highest ALP activity. From the above results, IGF-I was not seen notable effect on bone nodule formation and decreased ALP activity of MC3T3-E1 cells but the use of IGF-I to mediate biological stimulation of MC3T3-E1 cells shows promise for future therapeutic application.