Association of TNF-α gene with spontaneous deep intracerebral hemorrhage in the Taiwan population: a case control study

<p>Abstract</p> <p>Background</p> <p>Genetic factors may play a role in susceptibility to spontaneous deep intracerebral hemorrhage (SDICH). Previous studies have shown that <it>TNF-α </it>gene variation was associated with risks of subarachnoid hemorrhage in multiple ethnicities. The present case-control study tested the hypothesis that genetic variations of the <it>TNF-α </it>gene may affect the risk of Taiwanese SDICH. We examined the association of SDICH risks with four single nucleotide polymorphisms (SNPs) within the <it>TNF-α </it>gene promoter, namely T-1031C, C-863A, C-857T, and G-308A.</p> <p>Methods</p> <p>Genotyping was determined by PCR-based restriction and electrophoresis assay for 260 SDICH patients and 368 controls. Associations were tested by logistic regression or general linear models with adjusting for multiple covariables in each gender group, and then in combined. Multiplicative terms of gender and each of the four SNPs were applied to detect the interaction effects on SDICH risks. To account for the multiple testing, permutation testing of 1,000 replicates was performed for empirical estimates.</p> <p>Results</p> <p>In an additive model, SDICH risks were positively associated with the minor alleles -1031C and -308A in men (OR = 1.9, 95% CI 1.1 to 3.4, p = 0.03 and OR = 2.6, 95% CI 1.3 to 5.3, p = 0.005, respectively) but inversely associated with -863A in females (OR = 0.5, 95% CI 0.2 to 0.9, p = 0.03). There were significant interaction effects between gender and SNP on SDICH risks regarding SNPs T-1031C, C-863A, and G-308A (p = 0.005, 0.005, and 0.007, respectively). Hemorrhage size was inversely associated with -857T in males (p = 0.04).</p> <p>Conclusions</p> <p>In the Taiwan population, the associations of genetic variations in the <it>TNF-α </it>gene promoter with SDICH risks are gender-dependent.</p

Validation of a Chinese version of disease specific quality of life scale (HFS-36) for hemifacial spasm in Taiwan

<p>Abstract</p> <p>Background and object</p> <p>There was no Chinese questionnaire to evaluate the health-related quality of life (HRQoL) in patients with hemifacial spasm (HFS). In this study, we aimed to validate a new disease-specific HRQoL scale for HFS (HFS-36) in Chinese version, and compared it to SF-36, a generic HRQoL scale.</p> <p>Patients and Methods</p> <p>The HFS-36 Chinese version was modified from English version of HFS-30, including subscales of mobility, activities of daily living (ADL), emotional well-being, stigma, social support, cognition, bodily discomfort, and communication. All the items were scored on the 5-point scales, ranging from 0(never) to 4(always). Patients with HFS were asked to answer HFS-36 and SF-36 questionnaires on the same day before and 6-8 weeks after Botulinum toxin (BTX) injections, respectively. The reliability and validity of HFS-36 scale were evaluated statistically.</p> <p>Results</p> <p>Totally, 103 patients (68 females; 35 males) were recruited in this study, with a mean age of 57.6 ± 11.5 years and a mean duration of HFS for 7.6 ± 5.8 years. The intra-class correlation (ICC) and Cronbach's α were over 0.7 in the majority of items. HFS-36 showed a good correlation to HFS severity before BTX treatment and a significant improvement of subscale scoring after BTX treatment. HFS-36 also had a significant correlation to the mental health of SF-36.</p> <p>Conclusions</p> <p>The Chinese version of HFS-36 demonstrated a good reliability and validity in subscales of motility, ADL, emotion well-being, stigma and bodily discomfort. The HRQoL was significantly improved after BTX treatment assessed by HFS-36 or SF-36. Compared to SF-36, HFS-36 scale was more sensitive and specific to evaluate the HRQoL in HFS.</p

A Numerical Solution for Broadband PLC Splitter with Variable Splitting Ratio Based on Asymmetric Three Waveguide Structures

A numerical solution for the broadband planar-lightwave-circuit (PLC) splitter with a variable splitting ratio based on asymmetric three waveguides weighted by the Blackman weighting function is designed for passive optical network applications with wavelengths between 1.53 and 1.57 &#181;m. The performance of the proposed splitter is verified using the beam propagation method (BPM). It was found that a polynomial function of the splitting ratios accompanying a geometrical shift can be derived from the proposed splitter. The splitting ratio can be changed from 50:50 to 90:10 with this geometrical shift. The excess loss, crosstalk, polarization dependent loss, and splitting ratio variations against wavelength of the proposed splitter with wavelengths between 1.53 and 1.57 &#181;m are better than 0.139 dB, &#8722;22.75 dB, 0.006 dB, and 0.335%, respectively. Obviously, the proposed splitter with variable splitting ratio retains the advantages of the symmetric design, such as low excess loss, low crosstalk, polarization insensitivity, broadband, and wavelength insensitivity

A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers

Aims. To test the effectiveness of a discharge planning program for dyads of older stroke survivors and their family caregivers in Taiwan.----- Background. Family caregivers of stroke survivors often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. However, little information could be found on discharge planning programs for caregivers of stroke survivors in Asian families.----- Design. A randomised experimental design was used to explore the effects of a discharge planning program for 158 dyads of older stroke patients and their family caregivers.----- Methods. The control group (n = 86 dyads) received only routine hospital discharge planning services and the experimental group (n = 72 dyads) received routine hospital discharge planning services plus the caregiver-oriented discharge planning program. Outcome variables were measured at baseline, before discharge and one month after hospital discharge.----- Variables were measured by the Nurse Evaluation of Caregiver Preparation Scale, Preparedness for Caregiving Scale, Caregiver Discharge Needs Satisfaction Scale and Perception of Balance between Competing Needs Scale.----- Results. Caregivers in the experimental group had significantly better nurse evaluation and self-evaluation of preparation after the program than before, and greater satisfaction of discharge needs one month after discharge than before discharge. Caregivers in the experimental group had significantly better nurse evaluations and self-evaluations of preparation and better satisfaction of discharge needs after the program compared with the control group. However, no significant difference was found between caregiver groups in perceived balance of competing needs.----- Conclusions. This discharge planning program benefited family caregivers of older stroke patients during the transition from hospitalisation to one month after discharge. Relevance to clinical practice. This caregiver-oriented discharge planning program, with its emphasis on individualised health education and home visits following discharge may improve caregivers’ preparation and the satisfaction of their needs during the discharge transition

A clinical trial of an individualised intervention programme for family caregivers of older stroke victims in Taiwan

[[abstract]]d 86 in the control group) and their family caregivers. A caregiver‐oriented intervention programme was designed to increase caregiver preparedness, to enhance caregiver perception of balance between competing needs and to satisfy specific needs during the transition between hospitalisation and discharge. Long‐term outcomes were measured by caregiver’s health‐related quality of life, quality of care, stroke patient’s self‐care ability, patient’s health‐related quality of life and service utilisation. Longitudinal data were analysed by the generalised estimating equation approach. Results. During the 12 months following discharge of older patients with stroke, caregivers in the experimental group provided significantly better quality of care (β = 0·45; p = 0·03) than the control group. Between the sixth–twelfth months following discharge, patients in the control group were more likely to be institutionalised than those in the experimental group (χ2 = 5·11; p = 0·03). Conclusion. Using a sample from Taiwan, this intervention programme succeeded in improving quality of care provided by family caregivers to older patients with stroke and in decreasing the likelihood of their institutionalisation. Relevance to clinical practice. Older Chinese patients with stroke and their family caregivers can benefit from an individualised programme that prepares caregivers for patient discharge. Similar programmes may be applicable to other countries with Chinese populations

A home‐based training program improves Taiwanese family caregivers' quality of life and decreases their risk for depression: a randomized controlled trial

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97499/1/gps3853.pd