Use frequency of traditional Chinese medicine in Taiwan

BACKGROUND: Use of Traditional Chinese medicine (TCM), an important category of complementary and alternative medicine (CAM), has increased substantially in Western countries during the past decade. Use of TCM is also widespread in the Chinese population. However, few informative data have been obtained to date by large-scale investigations of TCM use in the Chinese population. This study was aimed at elucidating the demographics and patterns of TCM use in Taiwan. METHODS: We employed the complete datasets of TCM outpatient reimbursement claims from 1996 to 2001, including the use of Chinese herbal remedies, acupuncture and traumatology manipulative therapy, to analyse use frequencies, the characteristics of TCM users, and the disease categories that were treated by TCM in Taiwan. RESULTS: At the end of 2001, 6,142,829 (28.4%) among the 21,653,555 valid beneficiaries of the National Health Insurance in Taiwan had used TCM during the year. However, 13,536,266 subjects (62.5%) had used TCM at least once during the whole 6-year period from 1996 to 2001, with a total of 156,224,266 visits (mean 11.5 visits per user). The mean number of TCM users per annum was 5,733,602, with a mean increment of 1,671,476 (29.2%) of new users yearly. Among TCM users, female was higher than male (female:male = 1.13:1), and the age distribution displayed a peak at around the 30s, followed by the 20s and 40s. Chinese herbal remedies (85.9%) were the most common TCM modality used by this population, followed by acupuncture (11.0%) and traumatology manipulative therapies (3.1%). Private TCM clinics provided most of the TCM care (82.6%), followed by private TCM hospitals (12.0%). The top ten major disease categories for TCM visits were diseases of the respiratory system, musculoskeletal system and connective tissue; symptoms, signs and ill-defined conditions; injury and poisoning; diseases of the digestive system, genitourinary system, skin and subcutaneous tissue, nervous system and sense organs, circulatory and endocrine system; nutritional and metabolic diseases; and immunological disorders. CONCLUSION: TCM was popular among the Chinese population in Taiwan during the period studied. More than 60% of all subjects had used TCM during the 6-year interval. TCM was widely used by the Chinese population to treat problems and diseases of major human organ systems recognised by western medicine. This study provides information about the use frequencies of TCM and the disease categories treated by TCM, which should be useful for health policy makers and for those considering the integration of TCM and Western medicine

Overview of the interactive task in BioCreative V

Fully automated text mining (TM) systems promote efficient literature searching, retrieval, and review but are not sufficient to produce ready-to-consume curated documents. These systems are not meant to replace biocurators, but instead to assist them in one or more literature curation steps. To do so, the user interface is an important aspect that needs to be considered for tool adoption. The BioCreative Interactive task (IAT) is a track designed for exploring user-system interactions, promoting development of useful TM tools, and providing a communication channel between the biocuration and the TM communities. In BioCreative V, the IAT track followed a format similar to previous interactive tracks, where the utility and usability of TM tools, as well as the generation of use cases, have been the focal points. The proposed curation tasks are user-centric and formally evaluated by biocurators. In BioCreative V IAT, seven TM systems and 43 biocurators participated. Two levels of user participation were offered to broaden curator involvement and obtain more feedback on usability aspects. The full level participation involved training on the system, curation of a set of documents with and without TM assistance, tracking of time-on-task, and completion of a user survey. The partial level participation was designed to focus on usability aspects of the interface and not the performance per se. In this case, biocurators navigated the system by performing pre-designed tasks and then were asked whether they were able to achieve the task and the level of difficulty in completing the task. In this manuscript, we describe the development of the interactive task, from planning to execution and discuss major findings for the systems tested

Function-Structural Analysis of Lon Protease from hyperthermophilic archaeon Thermococcus kodakaraensis KOD1

ATP-dependent Lon蛋白酶是維持蛋白質功能與結構之衡定的重要成員之一，普遍分布在各種生物體中。在功能方面，Lon能夠分解細胞內不正常累積的蛋白質以及特定的調節蛋白。Lon蛋白酶可大致分為兩種亞型，LonA和LonB。相較於LonB，LonA已廣泛的被學者們研究。先前的研究已經指出極端嗜熱古生菌(Thermococcus kodakaraensis KOD1)的Lon蛋白酶由N端ATP水解酶功能區及C端蛋白水解酶功能區所組成，在宿主體內是以膜蛋白的形式存在，屬於LonB。在本論文中，藉由刪去TK-Lon的穿膜區域，我們設計了1個TK-Lon的突變株蛋白質(TK-LonΔTM)，並探討此突變株蛋白質的功能與結構特性。在大量表現並純化出TK-LonΔTM後，實驗證明此突變株蛋白酶具有ATP水解酶與蛋白水解酶活性。利用電泳凝膠位移測定(EMSA)，我們發現TK-LonΔTM具有DNA-binding的活性。在伴護功能活性測定實驗中，我們觀察到不論是在加熱誘導或是利用化學試劑破壞使蛋白質不規則聚集的情況下，TK-LonΔTM都能預防變性蛋白質的不規則聚集。在熱穩定性的研究中，利用示差掃描熱分析儀(DSC)可觀察到TK-LonΔTM的熔點(Tm)為98.9℃，我們認為TK-LonΔTM仍然保留原來的極端熱穩定性。在結構方面，遠紫外光圓二色偏光光譜圖顯示TK-LonΔTM以α螺旋為主要二級結構；近紫外光圓二色偏光光譜圖顯示TK-LonΔTM擁有完整的三級結構。進一步利用凝膠過濾層析法、分析級超高速離心儀以及穿透式電子顯微鏡分析TK-LonΔTM的四級結構，我們的結果都顯示TK-LonΔTM會聚集形成六聚體(hexamer)，我們認為此突變株與野生型的結構極為相似。這些實驗結果都可以證明Lon蛋白酶的功能與結構特性不只存在於LonA中，也高度保留在LonB中。ATP-dependent Lon proteases degrade specific short-lived regulatory proteins and are key components of the protein quality control systems in the cell, which are universally distributed in all kingdoms of life. Lon protease can be divided into two subfamilies, LonA and LonB. LonA is well-studied as compared with LonB. Previous studies have shown that Lon protease from Thermococcus kodakaraensis KOD1 (TK-Lon) which belong to LonB is composed of an N-terminal ATPase domain and a C-terminal protease domain and is a membrane-bound protein in its native host. In this study, we designed a TK-Lon mutant protein (TK-LonΔTM) with a deletion of the membrane-anchoring region and characterized its function and structure. TK-LonΔTM was overexpressed in E.coli and purified from soluble fraction displaying ATPase and proteolytic activity. Electrophoresis mobility shift assay showed that TK-LonΔTM has DNA-binding activity. Chaperone activity assay indicated that TK-LonΔTM can prevent aggregation of denature proteins under thermal stress or chemical stress. The melting temperature of TK-LonΔTM was observed at 98.9 ℃ by differential scanning calorimetry, suggesting the extreme thermostable of TK-LonΔTM. Far-UV CD and near-UV CD measurements revealed that TK-LonΔTM consists of α-helices as the major secondary structure and possesses well-defined three-dimensional structure, respectively. Our gel-filtration chromatography assay, analytical ultracentrifugation and transmission electron microscopy all displayed that TK-LonΔTM assembles into hexameric rings that likely mimic the oligomerization state of the holoenzyme. These findings showed that function and structure of Lon protease are conserved in the LonA and LonB subfamilies

Linear disjointness preservers of operator algebras and related structures

We survey some recent studies of linear zero product or orthogonality preservers between C /W∗ -algebras, their dual or predual spaces, and holomorphic disjointness preservers of C -algebras. Such maps are expected to provide algebra or linear Jordan (∗-) homomorphisms between the underlying operator algebras. We also study orthogonality preservers between Hilbert C -modules and Fourier algebras. A few open problems are stated

Effects of Dantrolene on Arrhythmogenicity in Isolated Regional Ischemia-Reperfusion Rabbit Hearts with or without Pacing-Induced Heart Failure

Dantrolene was reported to suppress ventricular fibrillation (VF) in failing hearts with acute myocardial infarction, but its antiarrhythmic efficacy in regional ischemia-reperfusion (IR) hearts remains debatable. Heart failure (HF) was induced by right ventricular pacing. The IR rabbit model was created by coronary artery ligation for 30 min, followed by reperfusion for 15 min in vivo in both HF and non-HF groups (n = 9 in each group). Simultaneous voltage and intracellular Ca2+ (Cai) optical mapping was then performed in isolated Langendorff-perfused hearts. Electrophysiological studies were conducted and VF inducibility was evaluated by dynamic pacing. Dantrolene (10 μM) was administered after baseline studies. The HF group had a higher VF inducibility than the control group. Dantrolene had both antiarrhythmic (prolonged action potential duration (APD) and effective refractory period) and proarrhythmic effects (slowed conduction velocity, steepened APD restitution slope, and enhanced arrhythmogenic alternans induction) but had no significant effects on ventricular premature beat (VPB) suppression and VF inducibility in both groups. A higher VF conversion rate in the non-HF group was likely due to greater APD prolonging effects in smaller hearts compared to the HF group. The lack of significant effects on VPB suppression by dantrolene suggests that triggered activity might not be the dominant mechanism responsible for VPB induction in the IR model

Digital health interventions to promote healthy lifestyle in hemodialysis patients: an interventional pilot study

Abstract Low physical activity has been associated with poor prognosis in hemodialysis (HD) patients. Interventions to maintain healthy lifestyle in this population are important to reduce mortality. This study aimed to evaluate the effectiveness of digital health interventions (DHIs) for improving the physical activity and health-related quality of life (HRQoL) in HD patients. The 24-week prospective study enrolled 31 clinically stable HD patients. All participants were assigned home exercises and provided with wearable devices. Dietary and exercise information was uploaded to a health management platform. Suggestions about diet and exercise were provided, and a social media group was created. Physical performance testing was performed at baseline and during weeks 4, 8, 12, 16 and 24. HRQoL and nutritional status were evaluated. A total of 25 participants completed the study. After the interventions, the daily step count increased 1658 steps. The 10-time-repeated sit-to-stand test reduced by 4.4 s, the sit-to-stand transfers in 60 s increased 12 repetitions, the distance of six-minute walk test (6MWT) increased by 55.4 m. The mental health components and burden of kidney disease of the Kidney Disease Quality of Life survey, and subjective global assessment (SGA) scores improved. By Spearman correlation, the monthly step count correlated positively with 6MWT and SGA. DHIs that combined wearable devices, a health management platform, and social media could strengthen physical activity and improve the HRQoL and nutrition of maintenance HD patients. The results outline a new model to promote healthy lifestyle behaviors in HD patients

Role of sarcoplasmic reticulum calcium in development of secondary calcium rise and early afterdepolarizations in long QT syndrome rabbit model.

BACKGROUND:L-type calcium current reactivation plays an important role in development of early afterdepolarizations (EADs) and torsades de pointes (TdP). Secondary intracellular calcium (Cai) rise is associated with initiation of EADs. OBJECTIVE:To test whether inhibition of sarcoplasmic reticulum (SR) Ca2+ cycling suppresses secondary Cai rise and genesis of EADs. METHODS:Langendorff perfusion and dual voltage and Cai optical mapping were conducted in 10 rabbit hearts. Atrioventricular block (AVB) was created by radiofrequency ablation. After baseline studies, E4031, SR Ca2+ cycling inhibitors (ryanodine plus thapsigargin) and nifedipine were then administrated subsequently, and the protocols were repeated. RESULTS:At baseline, there was no spontaneous or pacing-induced TdP. After E4031 administration, action potential duration (APD) was significantly prolonged and the amplitude of secondary Cai rise was enhanced, and 7 (70%) rabbits developed spontaneous or pacing-induced TdP. In the presence of ryanodine plus thapsigargin, TdP inducibility was significantly reduced (2 hearts, 20%, p = 0.03). Although APD was significantly prolonged (from 298 ± 30 ms to 457 ± 75 ms at pacing cycle length of 1000 m, p = 0.007) by ryanodine plus thapsigargin, the secondary Cai rise was suppressed (from 8.8 ± 2.6% to 1.2 ± 0.9%, p = 0.02). Nifedipine inhibited TdP inducibility in all rabbit hearts. CONCLUSION:In this AVB and long QT rabbit model, inhibition of SR Ca2+ cycyling reduces the inducibility of TdP. The mechanism might be suppression of secondary Cai rise and genesis of EADs

Features and Prognostic Factors for Elderly With Acute Poisoning in the Emergency Department

Elderly persons with acute poisoning in the emergency department (ED) and prognostic factors of outcomes have not been well addressed in previous research. This study aimed to investigate the characteristics of elderly patients with acute poisoning visiting the ED, and to identify the possible predictive factors of mortality. Methods: Patients aged ≥ 65 years with acute poisoning who visited the ED in Taipei Veterans General Hospital from January 1, 2006 through to September 30, 2008 were enrolled in the study. We collected demographic information on underlying diseases, initial presentations, causes and toxic substances, complications, dispositions, and outcomes. Analyses were conducted among different groups categorized according to age, suicide attempt, and outcome. Multiple logistic regression was applied to identify possible predictive clinical factors influencing mortality in the elderly with acute poisoning. Results: A total of 250 patients were enrolled in the study, with a mean age of 77 years and male predominance. The most common cause of intoxication was unintentional poisoning. Medication accounted for 57.6% of poisonous substances, of which benzodiazepine was the most common drug, followed by warfarin. The overall mortality rate was 9.6%. The average length of stay in the ED increased significantly in the old (65–74 years), very old (75–84 years) and extremely old (≥ 85 years) groups. Suicide attempt patients experienced more complications including respiratory failure, aspiration pneumonia, hypotension and mortality. Three clinical predictive factors of mortality were identified: herbicide poisoning, hypotension and respiratory failure upon presentation. Conclusion: Our results demonstrated that elderly patients with acute poisoning had a mortality rate of 9.6%. Suicide attempts resulted in more serious complications. The risk factors for mortality were herbicide intoxication, hypotension and respiratory failure

Permissible viewing times of educational projector and TV

Projectors have become one major medium in modern teaching, with large area-size displays emerging as an alternative. What concerns the general public is whether such eLearning would impose threat on eyes, by noting blue enriched white light to be hazardous to retina and else. Especially, little was known about their permissible viewing time under a certain viewing clarity. We had hence carried out a quantitative study with the use of a blue-hazard quantification spectrometer to determine the permissible viewing time when using a projector and a large size TV screen for displaying. Surprisingly, the large TV screen could permit a much longer viewing time, meaning which is more eye-friendly. It is plausibly because its resolution is much higher than that of the projector. Two dilemmas were observed in such eLearning; those sitting in the front would suffer a much higher illuminance, leading to a much shorter viewing time, while those sitting in the back would need a far much larger font size to see clearly. To ensure both viewing clarity and a sufficiently long permissible viewing time, orange text on black background is suggested to replace the defaulted black text on white background. The permissible viewing time could hence drastically increase from 1.3 to 83 h at 2 m by viewing a 30 pt font for the TV and from 0.4 to 54 h for the projection. At 6 m, the permissible viewing time was increased from 12 to 236 h for the TV and from 3 to 160 h for the projection, based on a viewable 94 pt font. These results may help educators and other e-display users to wisely apply the display tools with safety