One plus one more than two : university-community partnerships for elderly : an interdisciplinary service-learning project

Faculties at Taipei Medical University developed an interdisciplinary courses cluster which consists of Chinese History, Nutrition, Elderly Activity Design, and Physical Examination. In this course cluster, faculties, students, teaching assistant, and NPO/community members serve the same elderly over two years by providing health related care in accordance with the courses objectives. In this project, not only students\u27 soft abilities, such as problem-solving skills, team work abilities, and communication abilities, are improved, but also develop some pilot devices for the elderly, such as remote health examination and instant soft meal. The paper will describe this model of interdisciplinary service-learning in health professions education, explores common experiences and themes across courses, and identifies key components for success

Evidence of potential bias in a comparison of beta blockers and calcium channel blockers in patients with chronic obstructive pulmonary disease and acute coronary syndrome: results of a multinational study

OBJECTIVES: A number of observational studies have reported that, in patients with chronic obstructive pulmonary disease (COPD), beta blockers (BBs) decrease risk of mortality and COPD exacerbations. To address important methodological concerns of these studies, we compared the effectiveness and safety of cardioselective BBs versus non-dihydropyridine calcium channel blockers (non-DHP CCBs) in patients with COPD and acute coronary syndromes (ACS) using a propensity score (PS)-matched, active comparator, new user design. We also assessed for potential unmeasured confounding by examining a short-term COPD hospitalisation outcome. SETTING AND PARTICIPANTS: We identified 22 985 patients with COPD and ACS starting cardioselective BBs or non-DHP CCBs across 5 claims databases from the USA, Italy and Taiwan. PRIMARY AND SECONDARY OUTCOME MEASURES: Stratified Cox regression models were used to estimate HRs for mortality, cardiovascular (CV) hospitalisations and COPD hospitalisations in each database after variable-ratio PS matching. Results were combined with random-effects meta-analyses. RESULTS: Cardioselective BBs were not associated with reduced risk of mortality (HR, 0.90; 95% CI 0.78 to 1.02) or CV hospitalisations (HR, 1.06; 95% CI 0.91 to 1.23), although statistical heterogeneity was observed across databases. In contrast, a consistent, inverse association for COPD hospitalisations was identified across databases (HR, 0.54; 95% CI 0.47 to 0.61), which persisted even within the first 30 days of follow-up (HR, 0.55; 95% CI 0.37 to 0.82). Results were similar across a variety of sensitivity analyses, including PS trimming, high dimensional-PS matching and restricting to high-risk patients. CONCLUSIONS: This multinational study found a large inverse association between cardioselective BBs and short-term COPD hospitalisations. The persistence of this bias despite state-of-the-art pharmacoepidemiologic methods calls into question the ability of claims data to address confounding in studies of BBs in patients with COPD

Location-based Data Analysis of Visitor Structure for Recreational Area Management

This work presents a location-based data analysis framework for profiling visitors structures. In terms of recreational area management, understanding visitors’ structure and popularity is important. Traditionally, visitors monitoring with automatic counting devices has drawbacks of inaccurate visitors counting. In this work, compared to automatic counting devices, we use Wi-Fi tracking as the main method to count visitors, which provides a fairly precise picture of visitor structures. Moreover, we deliver rich analytic functions in this framework and we present the functionality with visitor data collected from Guanyinshan Visitor Center. This framework not only standardizes visitor counting process but also facilitates a profound analysis of visitor structures. Key Words: Guanyinshan Visitor Center, Wi-Fi trackin

Induction of Antinuclear Antibodies by De Novo Autoimmune Hepatitis Regulates Alloimmune Responses in Rat Liver Transplantation

Concanavalin A (Con A) is a lectin originating from the jack-bean and well known for its ability to stimulate T cells and induce autoimmune hepatitis. We previously demonstrated the induction of immunosuppressive antinuclear autoantibody in the course of Con A-induced transient autoimmune hepatitis. This study aimed to clarify the effects of Con A-induced hepatitis on liver allograft rejection and acceptance. In this study, we observed the unique phenomenon that the induction of transient de novo autoimmune hepatitis by Con A injection paradoxically overcomes the rejection without any immunosuppressive drug and exhibits significantly prolonged survival after orthotopic liver transplantation (OLT). Significantly increased titers of anti-nuclear Abs against histone H1 and high-mobility group box 1 (HMGB1) and reduced donor specific alloantibody response were observed in Con A-injected recipients. Induction of Foxp3 and IL-10 in OLT livers of Con A-injected recipients suggested the involvement of regulatory T cells in this unique phenomenon. Our present data suggest the significance of autoimmune responses against nuclear histone H1 and HMGB1 for competing allogeneic immune responses, resulting in the acceptance of liver allografts in experimental liver transplantation

Determination of band alignment in the single layer MoS2/WSe2 heterojunction

The emergence of transition metal dichalcogenides (TMDs) as 2D electronic materials has stimulated proposals of novel electronic and photonic devices based on TMD heterostructures. Here we report the determination of band offsets in TMD heterostructures by using microbeam X-ray photoelectron spectroscopy ({\mu}-XPS) and scanning tunneling microscopy/spectroscopy (STM/S). We determine a type-II alignment between $\textrm{MoS}_2$ and $\textrm{WSe}_2$ with a valence band offset (VBO) value of 0.83 eV and a conduction band offset (CBO) of 0.76 eV. First-principles calculations show that in this heterostructure with dissimilar chalcogen atoms, the electronic structures of $\textrm{WSe}_2$ and $\textrm{MoS}_2$ are well retained in their respective layers due to a weak interlayer coupling. Moreover, a VBO of 0.94 eV is obtained from density functional theory (DFT), consistent with the experimental determination.Comment: ^ These authors contributed equally. *Corresponding author E-mail: [email protected], [email protected] 20 pages, 4 figures in main tex

Variability in Estimated Glomerular Filtration Rate by Area under the Curve Predicts Renal Outcomes in Chronic Kidney Disease

Greater variability in renal function is associated with mortality in patients with chronic kidney disease (CKD). However, few studies have demonstrated the predictive value of renal function variability in relation to renal outcomes. This study investigates the predictive ability of different methods of determining estimated glomerular filtration rate (eGFR) variability for progression to renal replacement therapy (RRT) in CKD patients. This was a prospective observational study, which enrolled 1,862 CKD patients. The renal end point was defined as commencement of RRT. The variability in eGFR was measured by the area under the eGFR curve (AUC)%. A significant improvement in model prediction was based on the −2 log likelihood ratio statistic. During a median 28.7-month follow-up, there were 564 (30.3%) patients receiving RRT. In an adjusted Cox model, a smaller initial eGFR AUC%_12M (P<0.001), a smaller peak eGFR AUC%_12M (P<0.001), and a larger negative eGFR slope_12M (P<0.001) were associated with a higher risk of renal end point. Two calculated formulas: initial eGFR AUC%_12M and eGFR slope_12M were the best predictors. Our results demonstrate that the greater eGFR variability by AUC% is associated with the higher risk of progression to RRT