Acute generalized exanthematous pustulosis: A retrospective study of 51 cases in Taiwan

AbstractBackground/ObjectiveAcute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse drug reaction characterized by fever and numerous sterile non-follicular pustules. It is mainly attributed to drugs, although other factors have been implicated. The objective of this study was to evaluate the clinical and histological features of AGEP in a Taiwanese population.MethodsIn this retrospective study, we reviewed patients diagnosed with AGEP with a EuroSCAR (RegiSCAR) validation score more than 4 (>4, probable to definite cases), between 1992 and 2012 at the Chang Gung Memorial Hospital in Taiwan. Demographic, clinical and laboratory data, pathologic findings, and disease causality were analyzed.ResultsA total of 51 patients were included in this study, with 34 (66.7%) patients being diagnosed with AGEP with drug causality, and 17 (33.3%) patients being diagnosed with AGEP without drug causality. Cases of AGEP with drug causality showed an older average age, and a significantly higher rate of previous drug hypersensitivity history compared to cases of AGEP without drug causality (p = 0.0018). None of the patients had a history of psoriasis or had developed psoriasis at the 1-year follow-up. A total of 12 cases (23.5%) had systemic involvement, including liver and kidneys. Penicillin or aminopenicillin (17.6%) and cephalosporins (17.6%) were the most common causative drug groups related to AGEP. In AGEP patients without drug causality, three cases of pathogen infections were identified (1 case of mycoplasma, Coxsackie virus, and Epstein-Barr virus, respectively).ConclusionWe found that beta-lactam antibiotics were the major drug class responsible for inducing AGEP in a Taiwanese population, but that some infectious pathogens may also contribute to AGEP development

The Relationships among Trust, E-Satisfaction, E-Loyalty, and Customer Online Behaviors

Online shopping behaviors, different from traditional shopping behaviors, are related to information system and characterized with uncertainty, anonymity and potential opportunism. This paper is to conceptualize and analyze customer online behaviors, trust, customer satisfaction and customer loyalty based on Technology Acceptance Model (TAM). 1258 valid questionnaires are gathered from online customers having e-shopping experiences in Taiwan. Using structural equation modeling, the empirical results indicated that perceived use of use, perceived usefulness, and trust has the significant effects to facilitate customer satisfaction and customer loyalty, and further, effects customer’s intentions and behaviors toward online purchasing

Improving Concrete Durability by Using Optimized Aggregate Gradation and Reducing Cement Content

"This study evaluated the effects of (1) reducing the cementitious content, (2) the use of optimized aggregate gradation (OAG) technique, and (3) the use of Portland limestone cement (Type IL) in Florida Class I pavement and Class IV structural concrete. The potential performance of the pavement concrete mixes was also evaluated using critical stress analysis using a 3D FEM model. The compressive strength, modulus of rupture, modulus of elasticity, Poisson’s ratio, splitting tensile strength, coefficient of thermal expansion, rapid chloride permeability, and surface resistivity of the concrete mixes using normal Portland cement (Type I/II) and the concrete mixes using Type IL cement were similar to one another. The results of critical stress analysis indicated that the pavement concrete using Type IL cement had a predicted performance similar to concrete using Type I/II cement. The predicted performance of the pavement concrete was improved when the OAG technique was used. The main findings from this study are as follows: (1) The cementitious content of typical Florida pavement and structural concrete can be reduced by as much as 10 to 15% without loss in workability of the fresh concrete, and without decreasing the strength and durability of the hardened concrete. (2) Portlandlimestone cement (Type IL) can be used as a substitute for ordinary Portland cement (Type I/II). (3) The OAG technique can be used to efficiently reduce the cementitious content of the concrete mixes and to improve their performance.

The antecedent of citizen intention use of e-government service

The purpose of this study was to integrate citizen perceived value into an expectation- confirmation model (ECM) and to explain citizen intention use of e-government services. After reviewing both ECM and citizen perceived values, integrated models were designed. This study was compared to the basic ECM; this study revealed that the integration of ECM with citizen perceived value can provide a concerted solution to illustrate some factors and how it can influence citizen intention use for e-government services

A Comparative Study Of Ethical Work Climates Among Public And Private Sector Asian Accountants

The purpose of this study is to determine whether a significant difference exists in the ethical behavior between public and private sector accountants. Current research has either focused on one sector or the other, leaving scant data for comparative studies. The public sector’s focus on the intricacies of bureaucracy, emphasis on serving the public and sworn oaths to constitutions is bound and constrained by rules and law. The private sector, on the other, hand emphasizes entrepreneurship and risk-taking, encouraging creative approaches that challenge the parameters of the law, as well as answering to stake-holders. These differences toward decision-making influence their respective ethical choices. The 36-item revised version of Ethical Climate Questionnaire, developed by Bart Victor, John B. Cullen, (1987-1988), and James W. Bronson (1993), was the instrument used to evaluate the ethical perceptions of the accountants. Factor analysis results extracted seven dimensions and all of them originally identified from the based theory of Ethical Work Climate of Cullen, Victor, and Bronson (1993). They are Rules/Codes, Caring, Self-Interest, Social Responsibility, Efficiency, Instrumentalism, and Personal Morality. The results reflected the differences between the public and private sectors, emphasizing what is considered to be of optimum to each. The public sector showed a higher perception in rules/codes, caring, self-interests, social responsibility, and instrumentalism, while efficiency and personal morality were perceived higher in the private sector

Controlled Heterogeneous Nucleation and Growth of Germanium Quantum Dots on Nanopatterned Silicon Dioxide and Silicon Nitride Substrates

Controlled heterogeneous nucleation and growth of Ge quantum dots (QDs) are demonstrated on SiO_2/Si_3N_4 substrates by means of a novel fabrication process of thermally oxidizing nanopatterned SiGe layers. The otherwise random self-assembly process for QDs is shown to be strongly influenced by the nanopatterning in determining both the location and size of the QDs. Ostwald ripening processes are observed under further annealing at the oxidation temperature. Both nanopattern oxidation and Ostwald ripening offer additional mechanisms for lithography for controlling the size and placement of the QDs

Application of Novel Technology in Aquaculture

Aquaculture continues to be the fastest-growing food production field that has a lot of potential to meet the aqua-protein needs. The scientific and business communities are responding to the many challenges and opportunities inherent in the growing aquaculture field. Advancements in production and detection of harmful material systems and technologies are contributing to aquaculture industry’s expansion and sustainability. All of these production system technologies are benefitting from expanding information and communication systems, which are enabling advances in every stage of production. In the future, the new farming operation of friendly environment will focus on the use of nonecology destructive substances, no antibiotics, and the natural probiotics or novel immunomodulatory substances to match the physiological regulation of cultured organisms and the management of aquaculture. The future scientific-based innovation will contribute toward meeting increasing food demands, while improving social, environmental, and financial sustainability of the global aquaculture industry