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Hui Yu Liang,Fu In Tang,Tze Fang Wang,Shu Yu 한국간호과학회 2021 Asian Nursing Research Vol.15 No.1
Purpose: Nurse practitioners (NPs) are increasingly important in healthcare as they play a key role in leading advanced nursing practices. Assessing their professional competence is essential. The aim of this study was to evaluate NPs' professional competencies based on at a collaborative model around NP self and compare different methods of assessment. Methods: This is a cross-sectional study, and a purposive sample of 211 participants in the teaching hospital was used. Methods used were self-assessment (nurse practitioners), peer assessment (physicians and nurses) and supervisor assessment (head nurses). Results: The competence of nurse practitioners was rated as moderate (mean score = 3.45 of a possible 5; SD = 0.59). However, each method resulted in differences in competence for total scores and dimensions. The highest competence was in direct patient care (mean = 3.55, SD = 0.53), and the lowest score was in monitoring the quality of patient care (mean = 3.30, SD = 0.82). post hoc analysis shown that supervisor assessment rated professional competence significantly lower than the method of selfassessment and peer assessment (F = 10.07, p < .001). Conclusion: NPs require an increased effort to continuous learning for enhancing professional competencies. Moreover, using multiple methods for assessment to obtain a more comprehensive and accurate evaluation of NPs’ professional competence.
Chuah Tyng Yu,Lim Chun Yee,Tan Rui Zhen,Pratumvinit Busadee,Loh Tze Ping,Vasikaran Samuel,Markus Corey 대한진단검사의학회 2023 Annals of Laboratory Medicine Vol.43 No.5
Functional reference limits describe key changes in the physiological relationship between a pair of physiologically related components. Statistically, this can be represented by a significant change in the curvature of a mathematical function or curve (e.g., an observed plateau). The point at which the statistical relationship changes significantly is the point of curvature inflection and can be mathematically modeled from the relationship between the interrelated biomarkers. Conceptually, they reside between reference intervals, which describe the statistical boundaries of a single biomarker within the reference population, and clinical decision limits that are often linked to the risk of morbidity or mortality and set as thresholds. Functional reference limits provide important physiological and pathophysiological insights that can aid laboratory result interpretation. Laboratory professionals are in a unique position to harness data from laboratory information systems to derive clinically relevant values. Increasing research on and reporting of functional reference limits in the literature will enhance their contribution to laboratory medicine and widen the evidence base used in clinical decision limits, which are currently almost exclusively contributed to by clinical trials. Their inclusion in laboratory reports will enhance the intellectual value of laboratory professionals in clinical care beyond the statistical boundaries of a healthy reference population and pave the way to them being considered in shaping clinical decision limits. This review provides an overview of the concepts related to functional reference limits, clinical examples of their use, and the impetus to include them in laboratory reports.
The assessment of host and bacterial proteins in sputum from active pulmonary tuberculosis
Hsin-Chih Lai,Yu-Tze Horng,Pen-Fang Yeh,Jann-Yuan Wang,Chin-Chung Shu,Chia-Chen Lu,Jang-Jih Lu,Jen-Jyh Lee,Po-Chi Soo 한국미생물학회 2016 The journal of microbiology Vol.54 No.11
Pulmonary tuberculosis (TB) is caused by Mycobacterium tuberculosis. The protein composition of sputum may reflect the immune status of the lung. This study aimed to evaluate the protein profiles in spontaneous sputum samples from patients with active pulmonary TB. Sputum samples were collected from patients with pulmonary TB and healthy controls. Western blotting was used to analyze the amount of interleukin 10 (IL-10), interferon-gamma (IFN-γ), IL-25, IL- 17, perforin-1, urease, albumin, transferrin, lactoferrin, adenosine deaminase (also known as adenosine aminohydrolase, or ADA), ADA-2, granzyme B, granulysin, and caspase- 1 in sputum. Results of detection of IL-10, IFN-γ, perforin- 1, urease, ADA2, and caspase-1, showed relatively high specificity in distinguishing patients with TB from healthy controls, although sensitivities varied from 13.3% to 66.1%. By defining a positive result as the detection of any two proteins in sputum samples, combined use of transferrin and urease as markers increased sensitivity to 73.2% and specificity to 71.1%. Furthermore, we observed that the concentration of transferrin was proportional to the number of acidfast bacilli detected in sputum specimens. Detection of sputum transferrin and urease was highly associated with pulmonary TB infection. In addition, a high concentration of transferrin detected in sputum might correlate with active TB infection. This data on sputum proteins in patients with TB may aid in the development of biomarkers to assess the severity of pulmonary TB.
Fa-Po Chung,Chin-Yu Lin,Yenn-Jiang Lin,Shih-Lin Chang,Li-Wei Lo,Yu-Feng Hu,Ta-Chuan Tuan,Tze-Fan Chao,Jo-Nan Liao,Ting-Yung Chang,Shih-Ann Chen 대한심장학회 2018 Korean Circulation Journal Vol.48 No.10
Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is predominantly an inherited cardiomyopathy with typical histopathological characteristics of fibro-fatty infiltration mainly involving the right ventricular (RV) inflow tract, RV outflow tract, and RV apex in the majority of patients. The above pathologic evolution frequently brings patients with ARVD/C to medical attention owing to the manifestation of syncope, sudden cardiac death (SCD), ventricular arrhythmogenesis, or heart failure. To prevent future or recurrent SCD, an implantable cardiac defibrillator (ICD) is highly desirable in patients with ARVD/C who had experienced unexplained syncope, hemodynamically intolerable ventricular tachycardia (VT), ventricular fibrillation, and/or aborted SCD. Notably, the management of frequent ventricular tachyarrhythmias in ARVD/C is challenging, and the use of antiarrhythmic drugs could be unsatisfactory or limited by the unfavorable side effects. Therefore, radiofrequency catheter ablation (RFCA) has been implemented to treat the drug-refractory VT in ARVD/C for decades. However, the initial understanding of the link between fibro-fatty pathogenesis and ventricular arrhythmogenesis in ARVD/C is scarce, the efficacy and prognosis of endocardial RFCA alone were limited and disappointing. The electrophysiologists had broken through this frontier after better illustration of epicardial substrates and broadly application of epicardial approaches in ARVD/C. In recent works of literature, the application of epicardial ablation also successfully results in higher procedural success and decreases VT recurrences in patients with ARVD/C who are refractory to the endocardial approach during long-term follow-up. In this article, we review the important evolution on the delineation of arrhythmogenic substrates, ablation strategies, and ablation outcome of VT in patients with ARVD/C.
I-Mei Lin,Sheng-Yu Fan,Cheng-Fang Yen,Yi-Chun Yeh,Tze‐Chun Tang,Mei-Feng Huang,Tai-Ling Liu,Peng-Wei Wang,Huang-Chi Lin,Hsin-Yi Tsai,Yu-Che Tsai 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2
Objective: Autonomic imbalance is considered a psychopathological mechanism underlying major depressive disorder (MDD). Heart rate variability (HRV) is an index for autonomic activation. Poor sleep quality is common among patients with MDD. HRV biofeedback (BF) has been used for regulating autonomic balance among patients with physical illness and mental disorders. The purpose of present study was to examine the effects of HRV-BF on depressive symptoms, sleep quality, pre-sleep arousal, and HRV indices, in patients with MDD and insomnia. Methods: In this case-controlled study, patients with MDD and Pittsburgh Sleep Quality Index (PSQI) score higher than 6 were recruited. The HRV-BF group received weekly 60-minute protocol for 6 weeks, and the control group who have matched the age and sex received medical care only. All participants were assessed on Beck Depression Inventory-II, Back Anxiety Inventory, PSQI, and Pre-Sleep Arousal Scale. Breathing rates and electrocardiography were also performed under resting state at pre-testing, and post-testing conditions and for the HRV-BF group, also at 1-month follow-up. Results: In the HRV-BF group, symptoms of depression and anxiety, sleep quality, and pre-sleep arousal were significantly improved, and increased HRV indices, compared with the control group. Moreover, in the HRV-BF group, significantly improved symptoms of depression and anxiety, decreased breathing rates, and increased HRV indices were detected at post-testing and at 1-month follow-up, compared with pre-testing values. Conclusion: This study confirmed that HRV-BF is a useful psychosocial intervention for improving autonomic balance, baroreflex, and symptoms of depression and insomnia in MDD patients.
Chung-Che Chou,Gee‑Jin Yu,Kung‑Juin Wang,Wei‑Tze Chang,Chiun‑Lin Wu,Charlene Chin‑Jie Zhao,Chun‑Yao Yang,Ming‑Ti Chou 한국정밀공학회 2023 International Journal of Precision Engineering and Vol.24 No.9
This paper presents a study to investigate the feasibility of using robotic welding technologies to weld the continuity plate and the column flange plate during manufacturing steel built-up box columns in buildings. Specimens designed to emulate the key components in the steel beam-to-column moment connections for Special moment frame were fabricated and welded using a proposed automated procedure that performs multi-layer, multi-pass welding for thick steel plates. Effects of controlling parameters on robotic welding results that includes the manner of bead stacking, wire feed speed, travel speed, working angle, arc voltage, the path of the welding pass, and the methods to start and finish welding passes were investigated. The quality of the welded products was assessed by visual inspection and ultrasonic testing (UT). Further mechanical tests including tensile tests, bending tests, and cyclic loading tests were carried out on selected welded products that passed the UT examination. The test results indicated that the robotic welds showed no visible damage or cracks, met requirements specified in the AWS specification, and exhibited satisfactory strength and ductility.
Kuo-Feng Hua,A-Ching Chao,Ting-Yu Lin,Wan-Tze Chen,Yu-Chieh Lee,Wan-Han Hsu,Sheau-Long Lee,Hsin-Min Wang,Ding-I. Yang,Tz-Chuen Ju 고려인삼학회 2022 Journal of Ginseng Research Vol.46 No.4
Background: Huntington's disease (HD) is a neurodegenerative disorder caused by the expansion oftrinucleotide CAG repeat in the Huntingtin (Htt) gene. The major pathogenic pathways underlying HDinvolve the impairment of cellular energy homeostasis and DNA damage in the brain. The protein kinaseataxia-telangiectasia mutated (ATM) is an important regulator of the DNA damage response. ATM isinvolved in the phosphorylation of AMP-activated protein kinase (AMPK), suggesting that AMPK plays acritical role in response to DNA damage. Herein, we demonstrated that expression of polyQ-expandedmutant Htt (mHtt) enhanced the phosphorylation of ATM. Ginsenoside is the main and most effectivecomponent of Panax ginseng. However, the protective effect of a ginsenoside (compound K, CK) in HDremains unclear and warrants further investigation. Methods: This study used the R6/2 transgenic mouse model of HD and performed behavioral tests,survival rate, histological analyses, and immunoblot assays. Results: The systematic administration of CK into R6/2 mice suppressed the activation of ATM/AMPK andreduced neuronal toxicity and mHTT aggregation. Most importantly, CK increased neuronal density andlifespan and improved motor dysfunction in R6/2 mice. Conversely, CK enhanced the expression of Bcl2protected striatal cells from the toxicity induced by the overactivation of mHtt and AMPK. Conclusions: Thus, the oral administration of CK reduced the disease progression and markedlyenhanced lifespan in the transgenic mouse model (R6/2) of HD.