Medication Beliefs in Patients Following Percutaneous Coronary Intervention: A Cross-sectional Study

Patients post percutaneous coronary intervention need to take medication for their health. Beliefs about medication influence patients’ adherence in taking their medication regimens. Therefore, the study aimed to identify medication beliefs in patients following percutaneous coronary intervention in Indonesia. This research used a cross-sectional study with the convenience sampling method. A total of 132 adult patients following Percutaneous Coronary Intervention participated in this study. This study used The Beliefs about Medicines Questionnaire to identify patients’ beliefs about medication. The majority of respondents were male (85.6%) with a mean age of 60 years. Beliefs about general overuse were found to be the highest among other categories; specific-necessity, specific concern, and general harm. Elucidating patients’ beliefs about the medication will provide health care providers with a better understanding of patient medication behaviors after percutaneous coronary intervention. Recognition of patients’ beliefs may aid in targeting specific intervention programs to improve patients’ adherence to medication following Percutaneous Coronary Intervention procedure. Keywords: medication beliefs, percutaneous coronary intervention (PCI) Abstrak  Keyakinan Pengobatan pada Pasien yang Menjalani Intervensi Coronary Percutaneous: A Cross-Sectional Study. Pasien pasca intervensi koroner perkutan atau percutaneous coronary intervention (PCI) perlu minum obat untuk kesehatannya. Keyakinan terhadap pengobatan berpengaruh pada kepatuhan pasien dalam menjalani rejimen pengobatan. Penelitian ini bertujuan untuk mengidentifikasi keyakinan pengobatan pada pasien yang mengikuti PCI di Indonesia. Penelitian ini menggunakan studi cross-sectional dengan metode convenience sampling. Sebanyak 132 pasien dewasa yang menjalani prosedur PCI berpartisipasi dalam penelitian ini. Penelitian ini menggunakan The Beliefs about Medicines Questionnaire untuk mengidentifikasi keyakinan pasien tentang pengobatan. Mayoritas responden adalah laki-laki (85,6%) dengan usia rata-rata 60 tahun. Keyakinan tentang penggunaan berlebihan secara umum ditemukan sebagai yang tertinggi di antara kategori lainnya yaitu kebutuhan-spesifik, perhatian khusus, dan bahaya umum. Informasi mengenai keyakinan pasien tentang pengobatan akan memberikan pemahaman yang lebih baik bagi penyedia layanan kesehatan tentang perilaku pengobatan pasien setelah prosedur PCI. Pengakuan keyakinan pasien dapat membantu dalam menargetkan program intervensi khusus untuk meningkatkan kepatuhan pasien terhadap pengobatan setelah prosedur PCI. Kata Kunci: keyakinan pengobatan, percutaneous coronary intervention (PCI

Aspirin prevents resistin-induced endothelial dysfunction by modulating AMPK, ROS, and Akt/eNOS signaling

BackgroundResistin, an adipocytokine, plays a potential role in cardiovascular disease and may contribute to increased atherosclerotic risk by modulating the activity of endothelial cells. A growing body of evidence suggests that aspirin is a potent antioxidant. We investigated whether aspirin mitigates resistin-induced endothelial dysfunction via modulation of reactive oxygen species (ROS) generation and explored the role that AMP-activated protein kinase (AMPK), a negative regulator of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, plays in the suppressive effects of aspirin on resistin-induced endothelial dysfunction.MethodsHuman umbilical vein endothelial cells (HUVECs) were pretreated with various doses of aspirin (10-500 μg/mL) for 2 hours and then incubated with resistin (100 ng/mL) for an additional 48 hours. Fluorescence produced by the oxidation of dihydroethidium (DHE) was used to quantify the production of superoxide in situ; superoxide dismutase (SOD) and catalase activities were determined by an enzymatic assay; and protein levels of AMPK-mediated downstream signaling were investigated by Western blot.ResultsTreatment of HUVECs with resistin for 48 hours resulted in a 2.9-fold increase in superoxide production; however, pretreatment with aspirin resulted in a dose-dependent decrease in production of superoxide (10-500 μg/mL; n = 3 experiments; all P < .05). Resistin also suppressed the activity of superoxide dismutase and catalase by nearly 50%; that result, however, was not observed in HUVECs that had been pretreated with aspirin at a concentration of 500 μg/mL. The membrane translocation assay showed that the levels of NADPH oxidase subunits p47phoxand Rac-1 in membrane fractions of HUVECs were threefold to fourfold higher in cells that had been treated with resistin for 1 hour than in untreated cells; however, pretreatment with aspirin markedly inhibited resistin-induced membrane assembly of NADPH oxidase via modulating AMPK-suppressed PKC-α activation. Application of AMPKα1-specific siRNA resulted in increased activation of PKC-α and p47phox. In addition, resistin significantly decreased AMPK-mediated downstream Akt/endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling and induced the phosphorylation of p38 mitogen-activated protein kinases, which in turn activated NF-κB-mediated inflammatory responses such as the release of interleukin (IL)-6 and IL-8, the overexpression of adhesion molecules, and stimulation of monocytic THP-1 cell attachment to HUVECs (2.5-fold vs control; n = 3 experiments). Furthermore, resistin downregulated eNOS and upregulated inducible NO synthase (iNOS) expression, thereby augmenting the formation of NO and protein nitrosylation. Pretreatment with aspirin, however, exerted significant cytoprotective effects in a dose-dependent manner (P < .05).ConclusionsOur findings suggest a direct connection between adipocytokines and endothelial dysfunction and provide further insight into the protective effects of aspirin in obese individuals with endothelial dysfunction.Clinical RelevanceResistin has been reported to involve in the inflammatory process, which is a common feature in metabolic syndrome, insulin resistance status, and vascular diseases. This study underscores the potential clinical benefits and application of aspirin in prevention of obese-associated vascular dysfunction

Endotoxin and CD14 in the progression of biliary atresia

<p>Abstract</p> <p>Background</p> <p>Biliary atresia (BA) is a typical cholestatic neonatal disease, characterized by obliteration of intra- and/or extra-hepatic bile ducts. However, the mechanisms contributing to the pathogenesis of BA remain uncertain. Because of decreased bile flow, infectious complications and damaging endotoxemia occur frequently in patients with BA. The aim of this study was to investigate endotoxin levels in patients with BA and the relation of these levels with the expression of the endotoxin receptor, CD14.</p> <p>Methods</p> <p>The plasma levels of endotoxin and soluble CD14 were measured with a pyrochrome Limulus amebocyte lysate assay and enzyme-linked immunosorbent assay in patients with early-stage BA when they received the Kasai procedure (KP), in patients who were jaundice-free post-KP and followed-up at the outpatient department, in patients with late-stage BA when they received liver transplantation, and in patients with choledochal cysts. The correlation of CD14 expression with endotoxin levels in rats following common bile duct ligation was investigated.</p> <p>Results</p> <p>The results demonstrated a significantly higher hepatic CD14 mRNA and soluble CD14 plasma levels in patients with early-stage BA relative to those with late-stage BA. However, plasma endotoxin levels were significantly higher in both the early and late stages of BA relative to controls. In rat model, the results demonstrated that both endotoxin and CD14 levels were significantly increased in liver tissues of rats following bile duct ligation.</p> <p>Conclusions</p> <p>The significant increase in plasma endotoxin and soluble CD14 levels during BA implies a possible involvement of endotoxin stimulated CD14 production by hepatocytes in the early stage of BA for removal of endotoxin; whereas, endotoxin signaling likely induced liver injury and impaired soluble CD14 synthesis in the late stages of BA.</p

New Ventures, Internationalization, and Asymmetric Grin Curve: Analysis of Taiwan’s Big Data

Under globalization, small and medium enterprises (SMEs) that predominate Taiwan’s economy have been primarily original equipment manufacturers (OEMs) continuing to adjust operating strategies in order to extend supply chains and enhance competitiveness. This paper adopts the big data composed of 104,377 Taiwanese manufacturers from the 2011 Industry, Commerce, and Service Census to assess impact of the business life cycle, brand revenue, R&amp;D spending, and internationalization on value creation. Major findings are as follows. First, the link of the firm’s operating years with value creation is characterized by a quadratic U-shaped curve where the minimum point corresponds to 15 years of operation, suggesting a cost of lower value added for new ventures at the early stage of development. Second, a reversed U-shaped curve of value creation is found as regards brand revenue and R&amp;D spending, with the greater impact of the latter. Third, the impact of overseas investment and export expansion is also captured by a reversed U-shaped curve, with greater impact for the former. Fourth, an asymmetric grin curve rather than a smile curve is found in Taiwan’s manufacturers, whose value creation can be strengthened by strategies that focus on the learning curve, internationalization, internet, operating scale, and capital intensity

Short-term glutamine supplementation decreases lung inflammation and the receptor for advanced glycation end-products expression in direct acute lung injury in mice

BACKGROUND: Glutamine (GLN) has been reported to improve clinical and experimental sepsis outcomes. However, the mechanisms underlying the actions of GLN remain unclear, and may depend upon the route of GLN administration and the model of acute lung injury (ALI) used. The aim of this study was to investigate whether short-term GLN supplementation had an ameliorative effect on the inflammation induced by direct acid and lipopolysaccharide (LPS) challenge in mice. METHODS: Female BALB/c mice were divided into two groups, a control group and a GLN group (4.17% GLN supplementation). After a 10-day feeding period, ALI was induced by intratracheal administration of hydrochloric acid (pH 1.0; 2 mL/kg of body weight [BW]) and LPS (5 mg/kg BW). Mice were sacrificed 3 h after ALI challenge. In this early phase of ALI, serum, lungs, and bronchoalveolar lavage fluid (BALF) from the mice were collected for further analysis. RESULTS: The results of this study showed that ALI-challenged mice had a significant increase in myeloperoxidase activity and expression of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in the lung compared with unchallenged mice. Compared with the control group, GLN pretreatment in ALI-challenged mice reduced the levels of receptor for advanced glycation end-products (RAGE) and IL-1β production in BALF, with a corresponding decrease in their mRNA expression. The GLN group also had markedly lower in mRNA expression of cyclooxygenase-2 and NADPH oxidase-1. CONCLUSIONS: These results suggest that the benefit of dietary GLN may be partly contributed to an inhibitory effect on RAGE expression and pro-inflammatory cytokines production at an early stage in direct acid and LPS-induced ALI in mice

New Ventures, Internationalization, and Asymmetric Grin Curve: Analysis of Taiwan’s Big Data

Under globalization, small and medium enterprises (SMEs) that predominate Taiwan’s economy have been primarily original equipment manufacturers (OEMs) continuing to adjust operating strategies in order to extend supply chains and enhance competitiveness. This paper adopts the big data composed of 104,377 Taiwanese manufacturers from the 2011 Industry, Commerce, and Service Census to assess impact of the business life cycle, brand revenue, R&D spending, and internationalization on value creation. Major findings are as follows. First, the link of the firm’s operating years with value creation is characterized by a quadratic U-shaped curve where the minimum point corresponds to 15 years of operation, suggesting a cost of lower value added for new ventures at the early stage of development. Second, a reversed U-shaped curve of value creation is found as regards brand revenue and R&D spending, with the greater impact of the latter. Third, the impact of overseas investment and export expansion is also captured by a reversed U-shaped curve, with greater impact for the former. Fourth, an asymmetric grin curve rather than a smile curve is found in Taiwan’s manufacturers, whose value creation can be strengthened by strategies that focus on the learning curve, internationalization, internet, operating scale, and capital intensity

Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: a prospective randomized controlled trial

Abstract Background Health-related quality of life (HRQoL) has been used to assess subjects’ prognosis and recovery following hip fracture. However, evidence is mixed regarding the effectiveness of interventions to improve HRQoL of elders with hip fracture. The purposes of this study were to identify distinct HRQoL trajectories and to evaluate the effects of two care models on these trajectories over 12 months following hip-fracture surgery. Methods For this secondary analysis, data came from a randomized controlled trial of subjects with hip fracture receiving three treatment care models: interdisciplinary care (n = 97), comprehensive care (n = 91), and usual care (n = 93). Interdisciplinary care consisted of geriatric consultation, discharge planning, and 4 months of in-home rehabilitation. Comprehensive care consisted of interdisciplinary care plus management of malnutrition and depressive symptoms, fall prevention, and 12 months of in-home rehabilitation. Usual care included only in-hospital rehabilitation and occasional discharge planning, without geriatric consultation and in-home rehabilitation. Mental and physical HRQoL were measured at 1, 3, 6, and 12 months after discharge by the physical component summary scale (PCS) and mental component summary scale (MCS), respectively, of the Medical Outcomes Study Short Form 36, Taiwan version. Latent class growth modeling was used to identify PCS and MCS trajectories and to evaluate how they were affected by the interdisciplinary and comprehensive care models. Results We identified three quadratic PCS trajectories: poor PCS (n = 103, 36.6 %), moderate PCS (n = 96, 34.2 %), and good PCS (n = 82, 29.2 %). In contrast, we found three linear MCS trajectories: poor MCS (n = 39, 13.9 %), moderate MCS (n = 84, 29.9 %), and good MCS (n = 158, 56.2 %). Subjects in the comprehensive care and interdisciplinary care groups were more likely to experience a good PCS trajectory (b = 0.99, odds ratio [OR] = 2.69, confidence interval [CI] = 7.24–1.00, p = 0.049, and b = 1.32, OR = 3.75, CI = 10.53–1.33, p = 0.012, respectively) than those who received usual care. However, neither care model improved MCS. Conclusions The interdisciplinary and comprehensive care models improved recovery from hip fracture by increasing subjects’ odds for following a trajectory of good physical functioning after hospitalization. Trial registration ClinicalTrials.gov ( NCT01350557 )http://deepblue.lib.umich.edu/bitstream/2027.42/134528/1/12891_2016_Article_958.pd

EBV-encoded small RNA1 and nonresolving inflammation in rheumatoid arthritis

AbstractRheumatoid arthritis (RA) is a chronic autoimmune disease characterized by perpetuated inflammation in multiple joints. To date, there is no cure for RA, and the causal factor for non-resolving inflammation in RA remains unclear. In this study, we initially observed expression of Epstein–Barr virus-encoded small RNA1 (EBER1) in the synovial tissue of all five patients who showed nonresolving RA inflammation. By contrast, EBER1 was detected in the synovial tissue of only one out of seven patients with advanced osteoarthritis (OA; p < 0.01, Fisher’s exact test). To confirm this finding, we conducted a second study on synovial tissue samples taken from 23 patients with nonresolving RA inflammation and 13 patients with OA. All synovial samples from patients with nonresolving inflammation of RA showed positive expression of EBER1 (23/23, 100%), whereas none of the synovial samples from patients with OA showed expression of EBER1 (0/13, 0%; p < 0.001, by Fisher’s exact test). In vitro, transfection of RA synovial fibroblasts with EBER1 induced the production of interleukin-6. Taken together, these data strongly suggest that nonresolving RA inflammation is strongly related to the presence of EBER1, which might be, at least partially, responsible for synovial fibroblast interleukin-6 production