Databases in the Asia-Pacific Region: The Potential for a Distributed Network Approach

Background: This study describes the availability and characteristics of databases in Asian-Pacific countries and assesses the feasibility of a distributed network approach in the region. Methods: A web-based survey was conducted among investigators using healthcare databases in the Asia-Pacific countries. Potential survey participants were identified through the Asian Pharmacoepidemiology Network. Results: Investigators from a total of 11 databases participated in the survey. Database sources included four nationwide claims databases from Japan, South Korea, and Taiwan; two nationwide electronic health records from Hong Kong and Singapore; a regional electronic health record from western China; two electronic health records from Thailand; and cancer and stroke registries from Taiwan. Conclusions: We identified 11 databases with capabilities for distributed network approaches. Many country-specific coding systems and terminologies have been already converted to international coding systems. The harmonization of health expenditure data is a major obstacle for future investigations attempting to evaluate issues related to medical costs.postprin

Control of Silverleaf Whitefly, Cotton Aphid and Kanzawa Spider Mite with Oil and Extracts from Seeds of Sugar Apple

[[abstract]]Development of alternative methods for pest management is needed with the increased concern for adverse effects of pesticides for human health and the environment. The main goal of Our Study was to test the oil from seeds Of Sugar apple (Annona squamosa), all edible tropical fruit for pest control. The oil pressed Out of seeds was as effective in controlling the silverleaf whitefly, Bemisia argentifolii Bellows & Perring (Homoptera: Aleyrodidae), infesting leaves of tomato plants in greenhouse conditions as the recommended insecticide, with the advantage of not being phytotoxic. When observed with a scanning electron microscope, the seed oil caused whitefly nymphs to shrink and detach from the leaf surface. Sugar apple seed oil was also very effective in controlling the cotton aphid, Aphis gossypii Glover (Homoptera: Aphididae), on melon leaves and the Kanzawa spider mite, Tetranychus kanzawai Kishida (Acari: Tetranychidae), oil soybean leaves. The study revealed the possibility of developing the oil from sugar apple seeds, all agricultural waste, into a broad spectrum product friendly to the environment and human health for crop pest management

Evaluating the process of a genetic algorithm to improve the back-propagation network: A Monte Carlo study

[[abstract]]Many studies have mapped a bit-string genotype using a genetic algorithm to represent network architectures to improve performance of back-propagation networks (BPN). But the limitations of gradient search techniques applied to complex nonlinear optimization problems have often resulted in inconsistent and unpredictable performance. This study focuses oil how to collect and re-evaluate the weight matrices of a BPN while the genetic algorithm operations are processing in each generation to optimize the weight matrices. In this wily, overfitting. a drawback of BPNs that usually occurs during the later stage of neural network training with descending training error and ascending prediction error, can also be avoided. This study extends the parameters and topology of the neural network to enhance the feasibility of the solution space for complex nonlinear problems, The value of the proposed model is compared with previous studies Using a Monte Carlo study oil in-sample, interpolation, and extrapolation data for six test functions. (c) 2007 Elsevier Ltd. All rights reserved

Ligand-Based Dual Target Drug Design for H1N1: Swine Flu- A Preliminary First Study

[[abstract]]In March and April, 2009, an outbreak of H1N1 influenza in Mexico had led to hundreds of confirmed cases and the death toll had risen to 160. The worldwide spread of H1N1 has been attracting global attention and arising an overwhelming fear. So far, the vaccine and remedy has been in urgent need. In this Study, a QSAR model and pharmacophore map of neuraminidase (NA) type 1 (N1) contained two hydrogen bond acceptor features, one hydrogen bond donor feature, and one positive ionizable feature. NCI database was employed in virtual screen by the N1 pharmacophore map features. After screening, compounds were obtained and then docked into haemagglutinin type 1 (H1) to find out the candidate drugs for dual target of both N1 and H1. The candidate, NCI0353858, selected via virtual screening and docking, might be functional to this worldwide disease; consequently, further clinical investigations and scientific application are urgently demanded. We realize the proposed ligand does not have much validity without conducting a study on the stability of the protein-ligand complex by MD simulations and binding free energy, and such a study is underway and will be reported later in this journal. Nevertheless, the present study is clear, consistent and could give a rational explanation for the binding mode of the best selected ligand

Experiential learning of HIV self-test among student nurses: A qualitative study

Background: There is increasing demand for HIV self-tests, and nurses play an important role in counselling and assisting in the testing process. Traditional lecture-based nursing education has not typically focused on self-testing procedures, and there is little understanding of clients' experiences of self-testing. Objectives: To understand the experiential learning (EL)of student nurses during the process of self-testing for HIV. Design: This study used a qualitative design. Settings: A college in northern Taiwan. Participants: We recruited a purposive sample of 30 nursing students. Methods: The OraQuick self-test was used as the self-testing tool in this study. After participants used the OraQuick self-test, they underwent a semi-structured interview during the post-test counselling period. All interview data were subjected to line-by-line content analysis. Results: We extracted nine themes of nursing students' experiences during experiential learning of HIV self-test. In the pre-test stage, they recalled possible risk behaviors for HIV infection, decided to complete the self-test alone or asked for significant others to accompany them, and endured emotional fluctuations immediately prior to the test. When waiting for the test results, they felt isolated from the outside world. Some participants also began questioning the accuracy and safety of the test, and either viewed the results immediately or later on. In the post-test stage, some participants reported being uncertain about the results. Participants reported a greater understanding of the personal impact of testing and revealed their needs for support. Some identified a sense of loss and linked this to the rapid and direct delivery of test results. Conclusions: Our results can be used to guide HIV-related education courses and prevention programs. Experiential learning has the potential to improve HIV pre and post-test counselling, as nurses develop both clinical knowledge and personal insight of the testing process

Women's preference for cesarean delivery and differences between Taiwanese women undergoing different modes of delivery

<p>Abstract</p> <p>Background</p> <p>The rate of cesarean delivery was 35% in 2007 in Taiwan. It is unclear how many of the cesarean deliveries were without medical indications. Women's preference for cesarean delivery during their course of pregnancy has rarely been studied and therefore our objectives were to examine rate of cesarean deliveries without medical indications, to explore women's preference for cesarean delivery as their gestation advances, and to compare background and perinatal factors among women who underwent different modes of delivery in Taiwan.</p> <p>Methods</p> <p>This prospective study applied a longitudinal design. The study participants were 473 women who received prenatal care at four hospitals in Taipei and answered structured questionnaires at 20 to 24 weeks of pregnancy, 34 to 36 weeks of pregnancy, and 5 to 7 weeks after delivery.</p> <p>Results</p> <p>Of the 151 women (31.9%) who had cesarean deliveries, 19.9% were without medical indication. Three indications: malpresentation, prior cesarean section, and dysfunctional labor together accounted for 82.6% of cesarean section with medical indications. The prevalence of maternal preference for cesarean delivery was found to be 12.5% and 17.5% during the second and third trimester, respectively. Of the women who preferred cesarean delivery during the second trimester, 93.2% eventually had a cesarean delivery. Women who were older, with older spouses, and who had health problems before or during pregnancy were more likely to have cesarean deliveries.</p> <p>Conclusions</p> <p>About 20% of cesarean deliveries were without medical indications. Women's preference for cesarean delivery during the second trimester predicts subsequent cesarean delivery. Counseling regarding mode of delivery should be offered early in pregnancy, especially for women who are older or with older spouses, have health problems, or had a prior cesarean section.</p

Inter-Allelic Prion Propagation Reveals Conformational Relationships among a Multitude of [PSI] Strains

Immense diversity of prion strains is observed, but its underlying mechanism is less clear. Three [PSI] prion strains—named VH, VK, and VL—were previously isolated in the wild-type yeast genetic background. Here we report the generation and characterization of eight new [PSI] isolates, obtained by propagating the wild-type strains with Sup35 proteins containing single amino-acid alterations. The VH strain splits into two distinct strains when propagated in each of the three genetic backgrounds, harboring respectively single mutations of N21L, R28P, and Gi47 (i.e. insertion of a glycine residue at position 47) on the Sup35 N-terminal prion-forming segment. The six new strains exhibit complex inter-conversion patterns, and one of them continuously mutates into another. However, when they are introduced back into the wild-type background, all 6 strains revert to the VH strain. We obtain two more [PSI] isolates by propagating VK and VL with the Gi47 and N21L backgrounds, respectively. The two isolates do not transmit to other mutant backgrounds but revert to their parental strains in the wild-type background. Our data indicate that a large number of [PSI] strains can be built on three basic Sup35 amyloid structures. It is proposed that the three basic structures differ by chain folding topologies, and sub-strains with the same topology differ in distinct ways by local structural adjustments. This “large number of variations on a small number of basic themes” may also be operative in generating strain diversities in other prion elements. It thus suggests a possible general scheme to classify a multitude of prion strains

A transient homotypic interaction model for the influenza A virus NS1 protein effector domain

Influenza A virus NS1 protein is a multifunctional virulence factor consisting of an RNA binding domain (RBD), a short linker, an effector domain (ED), and a C-terminal 'tail'. Although poorly understood, NS1 multimerization may autoregulate its actions. While RBD dimerization seems functionally conserved, two possible apo ED dimers have been proposed (helix-helix and strand-strand). Here, we analyze all available RBD, ED, and full-length NS1 structures, including four novel crystal structures obtained using EDs from divergent human and avian viruses, as well as two forms of a monomeric ED mutant. The data reveal the helix-helix interface as the only strictly conserved ED homodimeric contact. Furthermore, a mutant NS1 unable to form the helix-helix dimer is compromised in its ability to bind dsRNA efficiently, implying that ED multimerization influences RBD activity. Our bioinformatical work also suggests that the helix-helix interface is variable and transient, thereby allowing two ED monomers to twist relative to one another and possibly separate. In this regard, we found a mAb that recognizes NS1 via a residue completely buried within the ED helix-helix interface, and which may help highlight potential different conformational populations of NS1 (putatively termed 'helix-closed' and 'helix-open') in virus-infected cells. 'Helix-closed' conformations appear to enhance dsRNA binding, and 'helix-open' conformations allow otherwise inaccessible interactions with host factors. Our data support a new model of NS1 regulation in which the RBD remains dimeric throughout infection, while the ED switches between several quaternary states in order to expand its functional space. Such a concept may be applicable to other small multifunctional proteins

Increased Risk of Vascular Events in Emergency Room Patients Discharged Home with Diagnosis of Dizziness or Vertigo: A 3-Year Follow-Up Study

BACKGROUND: Dizziness and vertigo symptoms are commonly seen in emergency room (ER). However, these patients are often discharged without a definite diagnosis. Conflicting data regarding the vascular event risk among the dizziness or vertigo patients have been reported. This study aims to determine the risk of developing stroke or cardiovascular events in ER patients discharged home with a diagnosis of dizziness or vertigo. METHODOLOGY: A total of 25,757 subjects with at least one ER visit in 2004 were identified. Of those, 1,118 patients were discharged home with a diagnosis of vertigo or dizziness. A Cox proportional hazard model was performed to compare the three-year vascular event-free survival rates between the dizziness/vertigo patients and those without dizziness/vertigo after adjusting for confounding and risk factors. RESULTS: We identified 52 (4.7%) vascular events in patients with dizziness/vertigo and 454 (1.8%) vascular events in patients without dizziness/vertigo. ER patients discharged home with a diagnosis of vertigo or dizziness had 2-fold (95% confidence interval [CI], 1.35-2.96; p<0.001) higher risk of stroke or cardiovascular events after adjusting for patient characteristics, co-morbidities, urbanization level of residence, individual socio-economic status, and initially taking medications after the onset of dizziness or vertigo during the first year. CONCLUSIONS: ER patients discharged home with a diagnosis of dizziness or vertigo were at a increased risk of developing subsequent vascular events than those without dizziness/vertigo after the onset of dizziness or vertigo. Further studies are warranted for developing better diagnostic and follow-up strategies in increased risk patients