Viral load and clinical features in children infected with seasonal influenza B in 2006/2007

Background/PurposeIn influenza B infection, viral load is believed to be related to the severity of clinical illness. The correlation between viral load and symptoms is not known. We conducted a study to assess the relationship between virus load and clinical features in children infected with influenza B, in the hope that clinical features could be used as surrogate markers of viral load to guide treatment.MethodsBetween December 2006 and February 2007, 228 patients with fever and respiratory symptoms were prospectively enrolled in our tertiary hospital-based study. Real-time reverse transcription polymerase chain reaction (RT-PCR) was performed to determine viral load.ResultsReal-time RT-PCR was positive for influenza B in 76 patients. Using virus culture as the gold standard, the sensitivity and specificity were 95% and 87%, respectively. Influenza culture positive rate significantly correlated with viral load (p = 0.03). The median copy number of influenza B virus in the 76 RT-PCR positive patients was 9735 copies/ml (range 4.8×101–2.0×106 copies/ml). Samples obtained later in the clinical course tended to have lower viral load (p = 0.7), while patient age (p = 0.72) and fever duration (p = 0.96) positively related to viral load. In patients >3 years of age, myalgia was related to statistically lower viral loads (14300 vs. 1180; p = 0.025). Patients with chills tended to have higher viral loads (72450 vs. 7640; p = 0.1). Patients with abdominal pain tended to have lower viral loads (1998 vs. 12550; p = 0.06).ConclusionCulture rate positively correlated with viral load. Patients with myalgia had a lower viral load

Purchase Intention of Made-in-China Medical Devices among Malaysians: Does COO Effect Work?

Made-in-China products are getting popular around the world. Overcoming the ‘low quality’ perception or unfavorable country of origin (COO) effect is imperative not only for China marketers but also for any related business in other markets. Despite their huge popularity, understanding of market responses and perceptions towards China products remain unclear, especially in the technology-advanced healthcare sector. Based on the Theory of Reasoned Action (TRA) and COO effect, this study examined how subjective norms, self-image congruence and stereotype affected Malaysian consumers’ attitude and purchase intention of Made-in-China medical devices. 200 questionnaires in total were distributed among buyers in Malaysian public and private hospitals. A total of 178 valid responses were collected adopting purposive sampling technique. Findings indicated a significant impact of consumer attitude on purchase intention and attitude was found to be driven by subjective norms and stereotypes (warmth and competence), but not self-image congruency. The study also showed significant mediating effects of consumer attitude on the relationship between subjective norms and stereotype (competence) on purchase intention. The findings provide valuable insights to assist marketers in tapping into the Made-in-China medical device market as well as helping healthcare agencies plan and implement effective policy and marketing communication strategies

Purchase Intention of Made-in-China Medical Devices among Malaysians: Does COO Effect Work?

Made-in-China products are getting popular around the world. Overcoming the ‘low quality’ perception or unfavorable country of origin (COO) effect is imperative not only for China marketers but also for any related business in other markets. Despite their huge popularity, understanding of market responses and perceptions towards China products remain unclear, especially in the technology-advanced healthcare sector. Based on the Theory of Reasoned Action (TRA) and COO effect, this study examined how subjective norms, self-image congruence and stereotype affected Malaysian consumers’ attitude and purchase intention of Made-in-China medical devices. 200 questionnaires in total were distributed among buyers in Malaysian public and private hospitals. A total of 178 valid responses were collected adopting purposive sampling technique. Findings indicated a significant impact of consumer attitude on purchase intention and attitude was found to be driven by subjective norms and stereotypes (warmth and competence), but not self-image congruency. The study also showed significant mediating effects of consumer attitude on the relationship between subjective norms and stereotype (competence) on purchase intention. The findings provide valuable insights to assist marketers in tapping into the Made-in-China medical device market as well as helping healthcare agencies plan and implement effective policy and marketing communication strategies.

Negotiating The Maze: Confronting Dysphagia Together With My Stroke-Afflicted Family Member

Aim: To generate a descriptive theory grounded in the responses of family caregivers caring for their family stroke survivors with dysphagia during hospitalization. Design and Method: A qualitative study employing the grounded theory method was used. Fifteen family caregivers participated in comprehensive interviews. The interview data were analyzed using the constant comparative method. Findings: ‘Negotiating the maze: Confronting dysphagia with my stroke-afflicted family member’ was the core category guiding the care process for dysphagia family members among caregivers. After surviving stroke, the caregivers felt ‘more confusion less rejoicing’ as the antecedent condition. The following three interaction categories were identified: (1) ‘being overwhelmed by nasogastric (NG) tube issues’; (2) ‘searching for the right helper and information’; and (3) ‘food culture conflicts with the formula diet administered through the NG tube’. Additionally, ‘Maintaining positivity’ described the consequence of this process. Conclusions: This study highlights the critical perspective of family members who care for dysphagia stroke survivors in the hospital. Participants were under tremendous pressure during the disease treatment process. However, all attempted to maintain a positive attitude and treasured the chance to accompany their family members. Clinical Relevance: These findings can assist health professionals in charting the effects of dysphagia and in understanding the problems and needs according to the subjective perspectives of family caregivers. They can also provide a necessary foundation for comprehensive care interventions for family caregivers of stroke survivors with dysphagia

Tuberculosis in Children and Adolescents, Taiwan, 1996–2003

Analysis of data from Taiwan’s National Tuberculosis (TB) Registry showed that incidence of TB in persons <20 years of age was 9.61/100,000 person-years, biphasic, and age-relevant, with a major peak in persons slightly >12 years. Aboriginal children were 8.1–17.4× more likely to have TB than non-Aboriginal children

Joint relationship between renal function and proteinuria on mortality of patients with type 2 diabetes: The Taichung Diabetes Study

Abstract Background Estimated glomerular filtration rate (eGFR) is a powerful predictor of mortality in diabetic patients with limited proteinuria data. In this study, we tested whether concomitant proteinuria increases the risk of mortality among patients with type 2 diabetes. Methods Participants included 6523 patients > 30 years with type 2 diabetes who were enrolled in a management program of a medical center before 2007. Renal function was assessed by eGFR according to the Modification of Diet in Renal Disease Study equation for Chinese. Proteinuria was assessed by urine dipstick. Results A total of 573 patients (8.8%) died over a median follow-up time of 4.91 years (ranging from 0.01 year to 6.42 years). The adjusted expanded cardiovascular disease (CVD)-related mortality rates among patients with proteinuria were more than three folds higher for those with an eGFR of 60 mL/min/1.73 m2 or less compared with those with an eGFR of 90 mL/min/1.73 m2 or greater [hazard ratio, HR, 3.15 (95% confidence interval, CI, 2.0–5.1)]. The magnitude of adjusted HR was smaller in patients without proteinuria [1.98 (95% CI, 1.1–3.7)]. An eGFR of 60 mL/min/1.73 m2 to 89 mL/min/1.73 m2 significantly affected all-cause mortality and mortality from expanded CVD-related causes only in patients with proteinuria. Similarly, proteinuria affected all outcomes only in patients with an eGFR of <60 mL/min/1.73 m2. Conclusion The risks of all-cause mortality, as well as expanded and non-expanded mortality from CVD-related causes associated with proteinuria or an eGFR of 90 mL/min/1.73 m2 or greater are independently increased. Therefore, the use of proteinuria measurements with eGFR increases the precision of risk stratification for mortality.http://deepblue.lib.umich.edu/bitstream/2027.42/112804/1/12933_2012_Article_558.pd

Metabolic syndrome in a Taiwanese metropolitan adult population

<p>Abstract</p> <p>Background</p> <p>Metabolic syndrome (MS) is a combination of medical disorders that increase one's risk for cardiovascular disease and diabetes. Little information exists on the prevalence of MS in a general adult population in Taiwan.</p> <p>Methods</p> <p>We did a cross-sectional survey in a representative sample of 2,359 Chinese adults aged 40 years and over who lived in a metropolitan city, Taiwan in 2004–05. MS was defined by Adult Treatment Panel III criteria modified for Asians.</p> <p>Results</p> <p>The prevalence of MetS was 35.32% and 43.23% in men aged 40–64 years and 65 years and over, respectively, and 24.19% and 51.82% in women aged 40–64 years and 65 years and over. Older age, postmenopausal status, higher body mass index, current smoking, low education attainment, low household income, no alcohol consumption, lower level of occupation physical activity, and a family history of diabetes were associated with increased odds of MetS.</p> <p>Conclusion</p> <p>MetS was present in more than 30% of the Taiwan adult population aged 40 years and over in a metropolitan area; there were substantial variations by age and body mass index groups.</p

Stimulatory effect of Echinacea purpurea extract on the trafficking activity of mouse dendritic cells: revealed by genomic and proteomic analyses

<p>Abstract</p> <p>Background</p> <p>Several <it>Echinacea </it>species have been used as nutraceuticals or botanical drugs for "immunostimulation", but scientific evidence supporting their therapeutic use is still controversial. In this study, a phytocompound mixture extracted from the butanol fraction (BF) of a stem and leaf (S+L) extract of <it>E. purpurea </it>([BF/S+L/Ep]) containing stringently defined bioactive phytocompounds was obtained using standardized and published procedures. The transcriptomic and proteomic effects of this phytoextract on mouse bone marrow-derived dendritic cells (BMDCs) were analyzed using primary cultures.</p> <p>Results</p> <p>Treatment of BMDCs with [BF/S+L/Ep] did not significantly influence the phenotypic maturation activity of dendritic cells (DCs). Affymetrix DNA microarray and bioinformatics analyses of genes differentially expressed in DCs treated with [BF/S+L/Ep] for 4 or 12 h revealed that the majority of responsive genes were related to cell adhesion or motility (<it>Cdh10</it>, <it>Itga6</it>, <it>Cdh1</it>, <it>Gja1 </it>and <it>Mmp8</it>), or were chemokines (<it>Cxcl2, Cxcl7) </it>or signaling molecules (<it>Nrxn1, Pkce </it>and <it>Acss1</it>). TRANSPATH database analyses of gene expression and related signaling pathways in treated-DCs predicted the JNK, PP2C-α, AKT, ERK1/2 or MAPKAPK pathways as the putative targets of [BF/S+L/Ep]. In parallel, proteomic analysis showed that the expressions of metabolic-, cytoskeleton- or NF-κB signaling-related proteins were regulated by treatment with [BF/S+L/Ep]. <it>In vitro </it>flow cytometry analysis of chemotaxis-related receptors and <it>in vivo </it>cell trafficking assay further showed that DCs treated with [BF/S+L/Ep] were able to migrate more effectively to peripheral lymph node and spleen tissues than DCs treated as control groups.</p> <p>Conclusion</p> <p>Results from this study suggest that [BF/S+L/Ep] modulates DC mobility and related cellular physiology in the mouse immune system. Moreover, the signaling networks and molecules highlighted here are potential targets for nutritional or clinical application of <it>Echinacea </it>or other candidate medicinal plants.</p

Tissue-specific gene expression templates for accurate molecular characterization of the normal physiological states of multiple human tissues with implication in development and cancer studies

<p>Abstract</p> <p>Background</p> <p>To elucidate the molecular complications in many complex diseases, we argue for the priority to construct a model representing the normal physiological state of a cell/tissue.</p> <p>Results</p> <p>By analyzing three independent microarray datasets on normal human tissues, we established a quantitative molecular model GET, which consists of 24 tissue-specific <it>G</it>ene <it>E</it>xpression <it>T</it>emplates constructed from a set of 56 genes, for predicting 24 distinct tissue types under disease-free condition. 99.2% correctness was reached when a large-scale validation was performed on 61 new datasets to test the tissue-prediction power of GET. Network analysis based on molecular interactions suggests a potential role of these 56 genes in tissue differentiation and carcinogenesis.</p> <p>Applying GET to transcriptomic datasets produced from tissue development studies the results correlated well with developmental stages. Cancerous tissues and cell lines yielded significantly lower correlation with GET than the normal tissues. GET distinguished melanoma from normal skin tissue or benign skin tumor with 96% sensitivity and 89% specificity.</p> <p>Conclusions</p> <p>These results strongly suggest that a normal tissue or cell may uphold its normal functioning and morphology by maintaining specific chemical stoichiometry among genes. The state of stoichiometry can be depicted by a compact set of representative genes such as the 56 genes obtained here. A significant deviation from normal stoichiometry may result in malfunction or abnormal growth of the cells.</p