Comparison of domiciliary oxygen using liquid oxygen and concentrator in northern Taiwan

Background/PurposeLong-term oxygen therapy has become standard treatment for patients with chronic respiratory insufficiency. However, patterns of long-term home oxygen therapy have not been well studied in Taiwan. Oxygen concentrator systems are commonly used in Taiwan, but liquid oxygen delivery systems are portable and may provide advantages over the concentrator system. This study compared oxygen usage between patients from a liquid oxygen group (LOG) and an oxygen concentrator group (OCG). The authors also assessed the physiologic responses of patients with chronic obstructive pulmonary disease (COPD) to ambulatory oxygen use at home.MethodsThe study used a retrospective, cross-sectional, observational survey design. The LOG comprised 42 patients, and the OCG comprised 102 patients. We recruited participants in northern Taiwan from July 2009 to April 2010. The questionnaire instruments that were used to collect data consisted of three parts: demographic characteristics, devices used in respiratory care, and activity status with portable oxygen. Two-minute walking tests were performed on COPD patients in their homes.ResultsCOPD was the most common diagnosis in our study, with more than 50% of patients who received oxygen long term in both groups having received this diagnosis. The LOG used oxygen for an average of 21.7 hours per day, whereas OCG averaged 15.2 hours per day (p<0.001). In the OCG, 92.2% of patients used a concentrator alone, whereas 23.8% of the LOG used liquid oxygen alone (p<0.001). The LOG patients were involved in significantly more outdoors activities (p=0.002) and reported traveling with oxygen more often (p<0.001) than the OCG patients. For patients with the same dyspnea level of COPD severity, those using liquid oxygen had a lower increase in pulse rate after the walking test, in comparison with the concentrator users.ConclusionPatients in the LOG used oxygen for longer hours, went on more outings, and were more likely to travel with oxygen than patients in the OCG. Being ambulatory with liquid oxygen might enable patients with COPD to walk more effectively

Is clopidogrel better than aspirin following breakthrough strokes while on aspirin? A retrospective cohort study.

ObjectiveThere is insufficient evidence on which to base a recommendation for optimal antiplatelet therapy following a stroke while on aspirin. The objective was to compare clopidogrel initiation vs aspirin reinitiation for vascular risk reduction among patients with ischaemic stroke on aspirin at the time of their index stroke.DesignRetrospective.SettingWe conducted a nationwide cohort study by retrieving all hospitalised patients (≥18 years) with a primary diagnosis of ischaemic stroke between 2003 and 2009 from Taiwan National Health Insurance Research Database.ParticipantsAmong 3862 patients receiving aspirin before the index ischaemic stroke and receiving either aspirin or clopidogrel after index stroke during follow-up period, 1623 were excluded due to a medication possession ratio &lt;80%. Also, 355 were excluded due to history of atrial fibrillation, valvular heart disease or coagulopathy. Therefore, 1884 patients were included in our final analysis.InterventionsPatients were categorised into two groups based on whether clopidogrel or aspirin was prescribed during the follow-up period. Follow-up was from time of the index stroke to admission for recurrent stroke or myocardial infarction, death or the end of 2010.Primary and secondary outcome measuresThe primary end point was hospitalisation due to a new-onset major adverse cardiovascular event (MACE: composite of any stroke or myocardial infarction). The leading secondary end point was any recurrent stroke.ResultsCompared to aspirin, clopidogrel was associated with a lower occurrence of future MACE (HR=0.54, 95% CI 0.43 to 0.68, p&lt;0.001, number needed to treat: 8) and recurrent stroke (HR=0.54, 95% CI 0.42 to 0.69, p&lt;0.001, number needed to treat: 9) after adjustment of relevant covariates.ConclusionsAmong patients with an ischaemic stroke while taking aspirin, clopidogrel initiation was associated with fewer recurrent vascular events than aspirin reinitiation

AN EXPLORATORY STUDY ON INTERFERENCE ERRORS FROM MALAY LANGUAGE TRASNFER TO MANDARIN LEXICON LEARNING

Language transfer is one of the main factors affecting foreign language learner from learning a target language well. In Malaysia, the number of non-Chinese students learning Mandarin is increasing. However, differences in their language and cultures could impose more difficulties to the non-Chinese students when learning the language. The present study explored the interference errors from Malay language to Mandarin learning of non-Chinese students in terms of lexicon. To this end, learner corpus containing collection of the students’ compositions, dialogues and examination scripts was compiled and analyzed in the study. Four types of lexicon interference errors were focused on, namely (1) improper usage of words (2) word orders error (3) improper usage of collocation and (4) improper usage of culture images. The findings reveal the highest interference error occurs in improper usages of words followed by word order errors, improper usages of collocation and improper usages of culture images. The finding calls for a more effective teaching to be incorporated to raise the students’ awareness on the negative transfer of their native language into Mandarin lexicon learning

PHYSIOLOGICAL AND ELECTROMYOGRAPHIC RESPONSES AT THREE LEVELS OF BICYCLE SEAT HEIGHT

Recently, bicycle riding has become one of the most popular exercises. As the use time increased, the risk of pedalling injury raised. Holmes (1994) indicated that inappropriate bicycle saddle height could result in lower limbs injuries. The motivation of this study was to find out the best riding position that could effectively use energy from the physiology and electromyography measures. The oxygen consumption (VO2), heart rate (HR), respiratory exchange ratio (RER) and the muscle activity (electromyography, EMG) from rectus femoris (RF) and biceps femoris (BF) of lower limb were collected during a 6 min cycling trail in three different heights of bicycle saddle. The purpose of this study was to compare the effects of three different types of bicycle seat heights and different perspectives of muscle activity and physiology’s parameters

Using Constructivism to explore students’ perspectives on learning Mandarin Lexical

Teaching lexical items plays an important role in second or foreign language classroom. There has been a dramatic increase in studies done on the importance of adopting the right methods to introduce the students with lexical items considering the central role that lexis plays in any languages. The purpose of this study is to investigate the students’ perspective on the Constructivist Learning Theory in learning Mandarin lexical more effectively. Nine types of teaching methods introduced in this study are: (1) compare and contrast, (2) word wall, (3) note taking and summarising, (4) recitation, (5) cues, question and activating prior knowledge, (6) role play, (7) non-linguistic representation, (8) homework and practice, and (9) analysis of students' work and discussion. Descriptive survey method which involves questionnaires was employed and 35 participants were selected for this study. The findings revealed that the students perceived note taking and summarising as well as homework and practice as the most helpful methods for learners to minimize the negative transfer of their mother tongue in Mandarin lexis learning. They also mentioned that note taking and summarising were the most interesting methods as compared to other methods whereas homework and practice was most effective for them. It is recommended that foreign language instructors in Malaysian higher education institution to keep updated on the current approach in introducing lexical items in an effective and interesting manner

Safety and efficacy of etomidate and propofol anesthesia in elderly patients undergoing gastroscopy: A double-blind randomized clinical study

The aim of the present study is to compare the safety, efficacy and cost effectiveness of anesthetic regimens by compound, using etomidate and propofol in elderly patients undergoing gastroscopy. A total of 200 volunteers (65–79 years of age) scheduled for gastroscopy under anesthesia were randomly divided into the following groups: P, propofol (1.5–2.0 mg/kg); E, etomidate (0.15-0.2 mg/kg); P+E, propofol (0.75–1 mg/kg) followed by etomidate (0.075-0.1 mg/kg); and E+P, etomidate (0.075-0.01 mg/kg) followed by propofol (0.75–1 mg/kg). Vital signs and bispectral index were monitored at different time points. Complications, induction and examination time, anesthesia duration, and recovery and discharge time were recorded. At the end of the procedure, the satisfaction of patients, endoscopists and the anesthetist were evaluated. The recovery (6.1±1.2 h) and discharge times (24.8±2.8 h) in group E were significantly longer compared with groups P, P+E and E+P (P<0.05). The occurrence of injection pain in group P+E was significantly higher compared with the other three groups (P<0.05). In addition, the incidence of myoclonus and post-operative nausea and vomiting were significantly higher in group P+E compared with the other three groups (P<0.05). There was no statistical difference among the four groups with regards to the patients' immediate, post-procedure satisfaction (P>0.05). Furthermore, there was no difference in the satisfaction of anesthesia, as evaluated by the anesthetist and endoscopist, among the four groups (P>0.05). The present study demonstrates that anesthesia for gastroscopy in elderly patients can be safely and effectively accomplished using a drug regimen that combines propofol with etomidate. The combined use of propofol and etomidate has unique characteristics which improve hemodynamic stability, cause minimal respiratory depression and less side effects, provide rapid return to full activity and result in high levels of satisfaction