PATIENTS’ ACCEPTANCE AND RESISTANCE TOWARD THE HEALTH CLOUD: AN INTEGRATION OF TECHNOLOGY ACCEPTANCE AND STATUS QUO BIAS PERSPECTIVES

The latest technological trends such as health cloud provide a strong infrastructure and offer a true enabler for healthcare services over the Internet. Despite its great potential, there are gaps in our understanding of how users evaluate change related to the health cloud and decide to resist it. According to the technology acceptance and status quo bias perspectives, this study develops an integrated model to explain patients’ intention to use and resistance to health cloud services. A field survey was conducted in Taiwan to collect data from patients. The structural equation model was used to examine the data. The results showed that patient resistance to use was caused by inertia, perceived value, and transition costs. Perceived usefulness (PU) and perceived ease of use (PEOU) have positive and direct effects on behavioral intention to use, and PEOU appears to have a positive direct effect on PU. The results also indicated that the relationship between intention to use and resistance to use had a significant negative effect. Our study illustrates the importance of incorporating user resistance in technology acceptance studies in general and health technology usage studies in particular, grounds for a resistance model of resistance that can serve as the starting point for future research in this relatively unexplored yet potentially fertile area of research

Effects of Rhythmic Auditory Stimulation During Hemiplegic Arm Reaching in Individuals with Stroke: An Exploratory Study

SummaryObjective/BackgroundThis study investigated the effects of rhythmic auditory stimulation (RAS) on muscle activity and elbow motion during arm reaching with hemiplegic arm in participants with stroke.MethodsSixteen adults with stroke who resided in a community were recruited in this study. The RAS consisted of sound emitted from a digital metronome. While sitting upright in a chair, participants reached their arms towards a target (a switch on a table) both with and without RAS. The three-dimensional motion analysis system and surface electromyography system were used for measurements during the reaching tasks.ResultsWe found that RAS elicited better performance in reaching movements than those movements performed without RAS. RAS shortened the movement time (p = .002), reduced the change in acceleration (p = .001), increased the elbow extension range of motion (p = .001), increased muscle activation of the triceps brachii (p = .024), and reduced the co-contraction ratio (p = .015) of the affected arm.ConclusionRAS might be a useful technique to facilitate improvements in motor function of the affected arm in patients with stroke

Newly designed coil tube for bowel decompression in patients with small bowel obstructions

AbstractBackgroundThe purpose of this study was to clinically evaluate a coil tube that we recently designed for bowel decompression in patients with a small bowel obstruction.MethodsThe coil tube was composed of a stainless steel coil, a polyolefin tube, and a rubber adaptor. The tube was inserted under fluoroscopic guidance in 14 consecutive patients with small bowel obstructions. Technical success was defined as insertion of the distal end of the tube into at least the proximal jejunum, and clinical success was defined as intestinal decompression and relief of obstructive symptoms.ResultsThe technical success rate was 100%. Clinical success was achieved in 12 patients (86%). The clinical failures were a patient with peritoneal carcinomatosis and an ileocolic fistula, and a patient with bezoars following intestinal hemorrhage. No coil-related complications occurred.ConclusionOur newly designed coil tube was safe and effective in patients with bowel decompression associated with a small bowel obstruction. In addition, our tube has several advantages over other currently used tube types

Clinical Features and Prognosis of Henoch-Schönlein Purpura in Children and Adults: A 13-Year Retrospective Study at a Single Centre

Purpose To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-Schönlein purpura (HSP). Methods A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. Results The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5 %), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. Conclusion In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome

Immunoglobulin G Subclass Deficiency is the Major Phenotype of Primary Immunodeficiency in a Korean Adult Cohort

Primary immunodeficiency disease (PID) is a rare disorder in adults. Most often, serious forms are detected during infancy or childhood. However, mild forms of PID may not be diagnosed until later in life, and some types of humoral immunodeficiency may occur in adulthood. The purpose of this study was to identify clinical features of PID in Korean adults. A retrospective study was performed on 55 adult patients who were diagnosed as PID between January 1998 and January 2009 at a single tertiary medical center in Korea. IgG subclass deficiency was the most common phenotype (67%, 37/55), followed by total IgG deficiency (20%, 11/55), IgM deficiency (7%, 4/55), common variable immunodeficiency (2%, 1/55), and X-linked agammaglobulinemia (2%, 1/55). IgG3 and IgG4 were the most affected subclasses. Upper and lower respiratory tract infections (76%) were the most frequently observed symptoms, followed by multiple site infection (11%), urinary tract infection, and colitis. Bronchial asthma, rhinitis, and several autoimmune diseases were common associated diseases. IgG and IgG subclass deficiency should be considered in adult patients presenting with recurrent upper and lower respiratory infections, particularly in those with respiratory allergies or autoimmune diseases

A new marine ciliate, Metaurostylopsis antarctica nov. spec. (Ciliophora, Urostylida) from the Antarctic Ocean

In this study, a new marine urostylid ciliate, Metaurostylopsis antarctica nov. spec. collected from the Antarctic Ocean was investigated using morphological, morphometrical, and molecular methods. Metaurostylopsis antarctica nov. spec. is characterized as follows: slender to ellipsoid form in body shape; two types of cortical granules, ellipsoid large one (type I, yellow-green, 1.5 × 1 μm) in rows along dorsal kineties and cirri, circular small one (type II, colourless, 0.3 μm in diameter) scattered throughout whole body; 19–24 adoral membranelles, 4 frontal cirri, 2–5 frontoterminal cirri, 1 buccal and 2 transverse cirri; 3–5 midventral pairs, 10–15 cirri of midventral row; 1 right and 2 left marginal rows; 3 dorsal kineties; about 43 macronuclear nodules. This new species mainly differs from the congeners by the number of marginal rows (1 vs. 3 or more on right side; 2 vs. 3 or more on left side). In addition, proter’s oral primordium  developed on the right side of the oral cavity (vs. in center of oral cavity), and the rightmost anlage splits into two parts, nam ely, the frontoterminal cirri and a transverse cirrus (vs. only frontoterminal cirri). Inter-specific dissimilarities of the SSU rRNA gene between the congeners range from 3.3 to 4.4%

New Sensitization to House Dust Mites in Cefteram-Induced Occupational Asthma: A Case Report

Occupational asthma (OA) can improve after cessation of exposure; however, some patients suffer from persistence or aggravation of their asthmatic symptoms. Here we report a case of a new sensitization to house dust mites during the follow-up period in a 37-year-old female patient with OA induced by cefteram pivoxil powder (cefteram powder). She was previously diagnosed with OA caused by inhalation of cefteram powder. Consequently, she left her job and had been well for 9 subsequent years. She began to experience aggravation of her rhinitis and asthmatic symptoms again several months prior to presentation. Her skin-prick test results had converted to strongly positive responses to two types of house dust mites. The serum levels of eosinophil cationic protein (ECP) and the total and specific immunoglobulin (Ig)E levels against the two types of house dust mites were elevated. An inhalation challenge test with Dermatophagoides farinae was performed, and significant bronchoconstriction (21.1% reduction in the forced expiratory volume in the first second) with asthma symptoms was observed at 10 minutes. To our knowledge, this is the first case demonstrating a new sensitization to house dust mites in a patient with OA caused by cefteram powder. Regular monitoring, including skin-prick tests and measurement of specific serum IgE/ECP levels, may help to screen potential cases

Acute Urticaria Induced by Oral Methylprednisolone

Although corticosteroids have immunosuppressive, anti-inflammatory, and anti-allergic effects, allergic reactions are rare. We report a case involving a 52-year-old-female with acute urticaria caused by oral methylprednisolone. The patient had experienced aspirin-exacerbated respiratory disease (AERD) for 13 years with frequent asthma exacerbations. Symptoms of asthma exacerbations improved with short-term treatments of systemic steroids, including methylprednisolone or deflazacort, which had been well tolerated. However, the current admission was prompted by the development of acute generalized urticaria following the oral ingestion of methylprednisolone (8 mg) for relief of symptoms. An oral provocation test with 4 mg oral methylprednisolone led to generalized urticaria 20 minutes later, confirming the causal association. This is the first report of acute urticaria caused by oral methylprednisolone in a patient with AERD

Interleukin-2 induces the in vitro maturation of human pluripotent stem cell-derived intestinal organoids.

Human pluripotent stem cell (hPSC)-derived intestinal organoids (hIOs) form 3D structures organized into crypt and villus domains, making them an excellent in vitro model system for studying human intestinal development and disease. However, hPSC-derived hIOs still require in vivo maturation to fully recapitulate adult intestine, with the mechanism of maturation remaining elusive. Here, we show that the co-culture with human T lymphocytes induce the in vitro maturation of hIOs, and identify STAT3-activating interleukin-2 (IL-2) as the major factor inducing maturation. hIOs exposed to IL-2 closely mimic the adult intestinal epithelium and have comparable expression levels of mature intestinal markers, as well as increased intestine-specific functional activities. Even after in vivo engraftment, in vitro-matured hIOs retain their maturation status. The results of our study demonstrate that STAT3 signaling can induce the maturation of hIOs in vitro, thereby circumventing the need for animal models and in vivo maturation