PERCEPTION OF EARLY INTERVENTION FAMILY OUTCOME: INSIDE CHINESE-AMERICAN FAMILIES HAVING CHILDREN WITH DISABILITIES

This study seeks to determine whether Chinese-American Families having a child with disabilities experience different needs and expected early intervention family outcomes from families from the mainstream culture. The Researcher used different qualitative research techniques to examine Chinese-American Families who have children with disabilities. Participants shared their perceptions of many different issues around their young children with disabilities and the early intervention services that they had or have been receiving during the time of the interview. The results show parents from Chinese Cultures expect the same type of family outcomes as do mainstream parents; however, the data indicated that cultural differences and unfamiliarity with early intervention and special education systems have created a difference between the extent to which the Chinese cultures avail themselves of the available services which assist parents in dealing effectively with needs of the disabled children.In the general discussion the researcher will discuss the culture related themes which have caused this underutilization of relevant services. The future research implications and limitations of this study are provided in the last chapter

Survey of methadone-drug interactions among patients of methadone maintenance treatment program in Taiwan

<p>Abstract</p> <p>Background</p> <p>Although methadone has been used for the maintenance treatment of opioid dependence for decades, it was not introduced in China or Taiwan until 2000s. Methadone-drug interactions (MDIs) have been shown to cause many adverse effects. However, such effects have not been scrutinized in the ethnic Chinese community.</p> <p>Methods</p> <p>The study was performed in two major hospitals in southern Taiwan. A total of 178 non-HIV patients aged ≥ 20 years who had participated in the Methadone Maintenance Treatment Program (MMTP) ≥ 1 month were recruited. An MDI is defined as concurrent use of drug(s) with methadone that may result in an increase or decrease of effectiveness and/or adverse effect of methadone. To determine the prevalence and clinical characteristics of MDIs, credible data sources, including the National Health Insurance (NHI) database, face-to-face interviews, medical records, and methadone computer databases, were linked for analysis. Socio-demographic and clinical factors associated with MDIs and co-medications were also examined.</p> <p>Results</p> <p>128 (72%) MMTP patients took at least one medication. Clinically significant MDIs included withdrawal symptoms, which were found among MMTP patients co-administered with buprenorphine or tramadol; severe QTc prolongation effect, which might be associated with use of haloperidol or droperidol; and additive CNS and respiratory depression, which could result from use of methadone in combination with chlorpromazine or thioridazine. Past amphetamine use, co-infection with hepatitis C, and a longer retention in the MMTP were associated with increased odds of co-medication. Among patients with co-medication use, significant correlates of MDIs included the male gender and length of co-medication in the MMTP.</p> <p>Conclusions</p> <p>The results demonstrate clinical evidence of significant MDIs among MMTP patients. Clinicians should check the past medical history of MMTP clients carefully before prescribing medicines. Because combinations of methadone with other psychotropic or opioid medications can affect treatment outcomes or precipitate withdrawal symptoms, clinicians should be cautious when prescribing these medications to MMTP patients and monitor the therapeutic effects and adverse drug reactions. Although it is difficult to interconnect medical data from different sources for the sake of privacy protection, the incumbent agency should develop pharmacovigilant measures to prevent the MDIs from occurring. Physicians are also advised to check more carefully on the medication history of their MMTP patients.</p

QED and relativistic nuclear recoil corrections to the 413 nm tune-out wavelength for the 2\,^3S_1 state of helium

Comparison of high accuracy calculations with precision measurement of the 413 nm tune-out wavelength of the He(2\,^3S_1) state provides a unique test of quantum electro-dynamic (QED). We perform large-scale relativistic-configuration-interaction (RCI) calculations of the tune-out wavelength, that include the mass-shift operator, and fully account for leading relativistic nuclear recoil terms in the Dirac-Coulomb-Breit (DCB) Hamiltonian. We obtain the QED correction to the tune-out wavelength using perturbation theory, and the effect of finite nuclear size is also evaluated. The resulting tune-out wavelengths for the 2\,^3S_1(M_J=0) and 2\,^3S_1(M_J=\pm 1) states are 413.084 26(4) nm and 413.090 15(4) nm, respectively. Compared with the only current experimental value of 413.0938(9stat)(20syst) nm for the 2\,^3S_1(M_J=\pm 1) state, there is 1.8$\sigma$ discrepancy between present theoretical work and experiment, which stimulates further theoretical and higher-precision experimental investigations on the 413 nm tune-out wavelength. In addition, we also determine the QED correction for the static dipole polarizability of the He(2\,^3S_1) state to be 22.5 ppm, which may enable a new test of QED in the future.Comment: 6 pages; 2 figure

Different Influences on Tacrolimus Pharmacokinetics by Coadministrations of Zhi Ke and Zhi Shi in Rats

Tacrolimus, an immunosuppressant with narrow therapeutic window, has been used widely in transplant patients. Grapefruit juice and pomelo have been reported to increase the blood levels of tacrolimus. Zhi Ke and Zhi Shi, the ripe peels and unripe fruits of Citrus aurantium which is chemotaxonomically related to grapefruit and pomelo, are in wide use in clinical Chinese medicine. To investigate the possible interaction of these two Citrus herbs with tacrolimus, male Sprague-Dawley rats were orally given tacrolimus (1.5 mg/kg) with and without Zhi Ke and Zhi Shi decoctions in a cross-over design. Blood samples were withdrawn via cardiopuncture at specific time and quantitated by a microparticle enzyme immunoassay. In addition, to explore the mechanism of interaction, LS 180 cell line was used for the transport study of rhodamine 123, a typical substrate of P-glycoprotein (P-gp). The results showed that Zhi Shi significantly decreased the Cmax and AUC0−t of tacrolimus by 72.4% and 72.0%, respectively, whereas Zhi Ke did not affect tacrolimus pharmacokinetics. LS 180 cell line study indicated that Zhi Shi increased the efflux activity of P-gp, enabling us to explain the decreased oral bioavailability of tacrolimus caused by Zhi Shi. Hence, we suggest that Zhi Shi be contraindicated for transplant patients treated with tacrolimus to reduce the risk of allograft rejection

Wear Behavior of a Heat-Treatable Al-3.5Cu-1.5Mg-1Si Alloy Manufactured by Selective Laser Melting

In this study, the wear behavior of a heat-treatable Al-7Si-0.5Mg-0.5Cu alloy fabricated by selective laser melting was investigated systematically. Compared with the commercial homogenized AA2024 alloy, the fine secondary phase of the SLM Al-Cu-Mg-Si alloy leads to a low specific wear rate (1.8 ± 0.11 × 10-4 mm3(Nm)-1) and a low average coefficient of friction (0.40 ± 0.01). After the T6 heat treatment, the SLM Al-Cu-Mg-Si alloy exhibits a lower specific wear rate (1.48 ± 0.02 × 10-4 mm3(Nm)-1), but a similar average coefficient of friction (0.34 ± 0.01) as the heat-treated AA2024 alloy. Altogether, the SLM Al-3.5Cu-1.5Mg-1Si alloy is suitable for the achievement of not only superior mechanical performance, but also improved tribological properties

The Incremental Diagnostic Performance of Coronary Computed Tomography Angiography Added to Myocardial Perfusion Imaging in Patients with Intermediate-to-High Cardiovascular Risk

Purpose: Several studies have suggested that a combined approach of stress myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CCTA) can provide diagnostic results with excellent accuracy. We aimed to explore whether the addition of CCTA to stress MPI provides incremental diagnostic value in intermediate-to-high cardiovascular risk patients. Methods: A total of 106 consecutive patients (93 male, 65 ± 10.4 years) underwent coronary artery calcium scoring (CACS), CCTA and 201 Thallium stress MPI before coronary angiography was reviewed. Thirty-seven patients (34.9%) had a history of proven coronary artery disease (CAD) or revascularization procedures, and four had documented non-significant CAD (3.8%). The remaining patients consisted of 17 (16.0%) classified as intermediate, and 48 (45.3%) as the high-risk groups. Results: Obstructive CAD was diagnosed by invasive coronary angiography in 88 patients with 161 vessels. The sensitivity and specificity in a patient-based analysis for obstructive CAD were 99% and 17% for CCTA, 80% and 50% for MPI and 91% and 67% for the combined method, respectively. The per-vessel diagnostic sensitivity and specificity were 95% and 54% for CCTA, 59% and 75% for MPI and 84% and 76% for the combined method. There were significant differences (p &lt; 0.05) when comparing the combined method with MPI or CCTA by areas under the curve in a patient-or vessel-based analysis. However, CACS of 400 or more could not further stratify the patients with obstructive CAD. Conclusions: CCTA, not CACS, provided additional diagnostic values to stress MPI in patients with intermediateto-high cardiovascular risk

Ser-634 and Ser-636 of Kaposi’s Sarcoma-Associated Herpesvirus RTA are Involved in Transactivation and are Potential Cdk9 Phosphorylation Sites

The replication and transcription activator (RTA) of Kaposi’s sarcoma-associated herpesvirus (KSHV), K-RTA, is a lytic switch protein that moderates the reactivation process of KSHV latency. By mass spectrometric analysis of affinity purified K-RTA, we showed that Thr-513 or Thr-514 was the primary in vivo phosphorylation site. Thr-513 and Thr-514 are proximal to the nuclear localization signal (527KKRK530) and were previously hypothesized to be target sites of Ser/Thr kinase hKFC. However, substitutions of Thr with Ala at 513 and 514 had no effect on K-RTA subcellular localization or transactivation activity. By contrast, replacement of Ser with Ala at Ser-634 and Ser-636 located in a Ser/Pro-rich region of K-RTA, designated as S634A/S636A, produced a polypeptide with ∼10 kDa shorter in molecular weight and reduced transactivation in a luciferase reporter assay relative to the wild type. In contrast to prediction, the decrease in molecular weight was not due to lack of phosphorylation because the overall Ser and Thr phosphorylation state in K-RTA and S634A/S636A were similar, excluding that Ser-634 or Ser-636 motif served as docking sites for consecutive phosphorylation. Interestingly, S634A/S636A lost ∼30% immuno-reactivity to MPM2, an antibody specific to pSer/pThr-Pro motif, indicating that 634SPSP637 motif was in vivo phosphorylated. By in vitro kinase assay, we showed that K-RTA is a substrate of CDK9, a Pro-directed Ser/Thr kinase central to transcriptional regulation. Importantly, the capability of K-RTA in associating with endogenous CDK9 was reduced in S634A/S636A, which suggested that Ser-634 and Ser-636 may be involved in CDK9 recruitment. In agreement, S634A/S636A mutant exhibited ∼25% reduction in KSHV lytic cycle reactivation relative to that by the wild type K-RTA. Taken together, our data propose that Ser-634 and Ser-636 of K-RTA are phosphorylated by host transcriptional kinase CDK9 and such a process contributes to a full transcriptional potency of K-RTA

Volcanism, redox conditions, and microbialite growth linked with the end-Permian mass extinction: Evidence from the Xiajiacao section (western Hubei Province), South China

© 2017. A new Permian-Triassic boundary microbialite (PTBM) is described from the Xiajiacao section of western Hubei Province, South China. The new microbialite, 3.16. m thick, comprises a thin layer of stromatolite and a thick thrombolite unit. An irregular contact separates the uppermost Permian skeletal packstone from the post-extinction stromatolite, but it is not yet possible to discriminate whether it was formed by submarine solution in the wake of ocean acidification or subaerial exposure due to regional regression, or a combination of both. The stromatolite shows "cabbage-like" morphology, and the thrombolite is characterized by centimetric clotted texture. Abundant columns of the microproblematica structure Gakhumella, coccoid-like spheroids, bacterial clump-like spheroids, and hollow spheroids are recognized in both stromatolites and thrombolites and may have played an important role in accretion of the microbialites. Pyrite framboid analysis indicates that microbialites may have been affected by lower dysoxic to upper dysoxic conditions in the immediate aftermath of the Permian-Triassic extinction. Stratigraphic abundance of both high-temperature grains (β-quartz and glassy balls) peaked ~. 20. cm below the biotic extinction horizon, implying that either intensive volcanic eruption occurred only just prior to biotic extinction, or volcanism was still intensive during biotic extinction, but volcanic grains were not deposited in the Xiajiacao locality, likely due to the shallow, agitated environment caused by the regional regression. Overall, microbial bloom, indicated by the widespread PTBMs, seems to have been little affected by the contemporaneous volcanism.We thank both anonymous reviewers and editor Thomas Algeo for critical comments and constructive suggestions, which have greatly improved the quality of the paper. This study is partly supported by the 111 Program of China (B08030), two NSFC grants (41572091, 41402089), and one research grant from the State Key Laboratory of Biogeology and Environmental Geology (BGEG), China University of Geosciences (GBL11206). It is a contribution to the IGCP 630 “Permian–Triassic climatic and environmental extremes and biotic response”