172 research outputs found

    A Study of Conflict and Resistant Behaviors in the Implementation of the Ecosystem

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    The physical retail market of the J Company is impacted by up-and-coming virtual market channels, resulting in constantly shrinking business performance. Hence the J Company was compelled to launch an innovative ecosystem IT platform to re-capture market advantages through new technology application and new retail methods. However, the promotion of the new innovative platform was met with expected and unexpected resistance and conflict from within and outside the company. This paper explored ways to prevent and solve the problems confronted during the course of implementation to increase success in promoting the ecosystem platform

    Rdzeniowy zespół twarzowo-palcowy: częsty zespół w nietypowej lokalizacji

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    Background and purpose Cheiro-oral syndrome (COS) is an established neurological entity characterized by a sensory impairment confined to the mouth angle and ipsilateral finger(s)/ hand. The current understanding of localization is a concomitant involvement of the spinothalamic and trigeminothalamic tract between the cortex and pons. The cervical spinal cord has not been mentioned in this situation yet, and this unusual location may heretofore increase the risk of misdiagnosis. Material and methods Six patients who presented with unilateral COS due to cervical cord disorder are reported. Results All patients were women and their age ranged between 42 and 70 years. Their neurological deficits included unilateral paraesthesiae restricted to cheiro-oral distribution, positive radicular sign, and mild change of tendon reflex. Cervical spinal stenosis at middle/lower cervical spine with variable magnitude of cord compression and intrinsic cord damage was found. A diagnostic dilemma obviously arises from the lack of tangible neurological signs or typical pattern of myelopathy, in addition to the previous concept of cerebral involvement. A benign course ensued in all reported patients. Conclusions Cheiro-oral syndrome can be an early neurological sign for cervical cord disorder; it further suggests that it is a strong neurological but weak localizing sign. A reciprocal influence of multiple factors is considered to generate COS at the cervical cord. Therefore, an absence of brain pathology should lead to a thorough examination of the cervical cord in case of COS.Wstęp i cel pracy Zespół twarzowo-palcowy (ZTP) jest znanym zespołem neurologicznym, który cechuje się niedoczulicą ograniczoną do kącika ust i palców ręki lub ręki po tej samej stronie. Bieżący stan wiedzy dotyczący lokalizacji uszkodzenia w tym zespole wskazuje na jednoczesne zajęcie dróg rdzeniowo-wzgórzowej i trójdzielno-wzgórzowej pomiędzy mostem i korą mózgową. W tym kontekście nie wymieniano dotąd uszkodzenia rdzenia kręgowego w odcinku szyjnym, a taka nietypowa lokalizacja uszkodzenia może zwiększyć ryzyko błędnego rozpoznania miejsca uszkodzenia. Materiał i metody W pracy przedstawiono dane dotyczące 6 pacjentek z jednostronnym ZTP spowodowanym występowaniem nieprawidłowości w obrębie rdzenia kręgowego. Wyniki Zakres wieku pacjentek wynosił od 42 do 70 lat. Objawy neurologiczne obejmowały jednostronne parestezje ograniczone do obszaru twarzy i ręki, objaw korzeniowy i niewielkie nieprawidłowości w zakresie odruchów głębokich. Stwierdzono występowanie zwężenia kanału kręgowego w środkowej lub dolnej części odcinka szyjnego z uciskiem rdzenia kręgowego i uszkodzeniem wewnątrz rdzenia kręgowego. Wątpliwości diagnostyczne wynikały z braku typowych objawów neurologicznych mielopatii i stwierdzenia lokalizacji zmian nieodpowiadającej wcześniejszym opiniom na temat mózgowego pochodzenia zespołu. U wszystkich opisywanych pacjentek przebieg schorzenia był łagodny. Wnioski Zespół twarzowo-palcowy może być wczesnym objawem neurologicznym nieprawidłowości w obrębie rdzenia kręgowego. Stanowi istotny objaw neurologiczny, ale jego wartość lokalizacyjna jest niewielka. Powstawanie ZTP wskutek uszkodzenia rdzenia kręgowego wynika z wzajemnych oddziaływań wielu czynników. W razie braku uchwytnej patologii mózgu należy w przypadkach ZTP przeprowadzić szczegółowe badania rdzenia kręgowego w odcinku szyjnym

    Signs of outflow feedback from a nearby young stellar object on the protostellar envelope around HL Tau

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    HL Tau is a Class I-II protostar embedded in an infalling and rotating envelope and possibly associated with a planet forming disk, and it is co-located in a 0.1 pc molecular cloud with two nearby young stellar objects. Our ALMA observations revealed two arc-like structures on a 1000 au scale connected to the disk, and their kinematics could not be explained with any conventional model of infalling and rotational motions. In this work, we investigate the nature of these arc-like structures connected to the HL Tau disk. We conducted new observations in the 13CO and C18O (3-2; 2-1) lines with JCMT and IRAM 30m, and obtained the ACA data with the 7-m array. With the single-dish, ACA, and ALMA data, we analyzed the gas motions on both 0.1 pc and 1000 au scales in the HL Tau region. We constructed new kinematical models of an infalling and rotating envelope with the consideration of relative motion between HL Tau and the envelope. By including the relative motion between HL Tau and its protostellar envelope, our kinematical model can explain the observed velocity features in the arc-like structures. The morphologies of the arc-like structures can also be explained with an asymmetric initial density distribution in our model envelope. In addition, our single-dish results support that HL Tau is located at the edge of a large-scale (0.1 pc) expanding shell driven by the wind or outflow from XZ Tau, as suggested in the literature. The estimated expanding velocity of the shell is comparable to the relative velocity between HL Tau and its envelope in our kinematical model. These results hints that the large-scale expanding motion likely impacts the protostellar envelope around HL Tau and affects its gas kinematics. We found that the mass infalling rate from the envelope onto the HL Tau disk can be decreased by a factor of two due to this impact by the large-scale expanding shell.Comment: Accepted by A&

    JCMT POL-2 and ALMA polarimetric observations of 6000-100 au scales in the protostar B335: linking magnetic field and gas kinematics in observations and MHD simulations

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    We present our analysis of the magnetic field structures from 6000 au to 100 au scales in the Class 0 protostar B335 inferred from our JCMT POL-2 observations and the ALMA archival polarimetric data. To interpret the observational results, we perform a series of (non-)ideal MHD simulations of the collapse of a rotating non-turbulent dense core, whose initial conditions are adopted to be the same as observed in B335, and generate synthetic polarization maps. The comparison of our JCMT and simulation results suggests that the magnetic field on a 6000 au scale in B335 is pinched and well aligned with the bipolar outflow along the east-west direction. Among all our simulations, the ALMA polarimetric results are best explained with weak magnetic field models having an initial mass-to-flux ratio of 9.6. However, we find that with the weak magnetic field, the rotational velocity on a 100 au scale and the disk size in our simulations are larger than the observational estimates by a factor of several. An independent comparison of our simulations and the gas kinematics in B335 observed with the SMA and ALMA favors strong magnetic field models with an initial mass-to-flux ratio smaller than 4.8. We discuss two possibilities resulting in the different magnetic field strengths inferred from the polarimetric and molecular-line observations, (1) overestimated rotational-to-gravitational energy in B335 and (2) additional contributions in the polarized intensity due to scattering on a 100 au scale.Comment: Accepted by Ap

    Associations between child maltreatment, PTSD, and internet addiction among Taiwanese students

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    AbstractThis study examines (1) the associations between multiple types of child maltreatment and Internet addiction, and (2) the mediating effects of post-traumatic stress disorder (PTSD) on these associations. We collected data from a national proportionately stratified random sample of 6233 fourth-grade students in Taiwan in 2014. We conducted bivariate correlations and sets of multiple regression analyses to examine the associations between multiple types of maltreatment (5 types in total) and Internet addiction, and to identify the mediating role of PTSD. The results reveal that being male and experiencing abuse (psychological neglect, physical neglect, paternal physical violence, sexual violence) were associated with increased risk among children of developing PTSD and Internet addiction. Moreover, PTSD mediated the associations between multiple types of maltreatment (except maternal physical violence) and Internet addiction. This study demonstrates (1) the effects of multiple types of maltreatment on the PTSD and Internet addiction of children and (2) the importance of early prevention and intervention in addressing related public-health concerns

    Whole pelvic helical tomotherapy for locally advanced cervical cancer: technical implementation of IMRT with helical tomothearapy

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    <p>Abstract</p> <p>Background</p> <p>To review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer.</p> <p>Methods</p> <p>Between November 1st, 2006 and May 31, 2009, 10 cervical cancer patients histologically confirmed were enrolled. All of the patients received definitive concurrent chemoradiation (CCRT) with whole pelvic HT (WPHT) followed by brachytherapy. During WPHT, all patients were treated with cisplatin, 40 mg/m<sup>2 </sup>intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0).</p> <p>Results</p> <p>The mean survival was 25 months (range, 3 to 27 months). The actuarial overall survival, disease-free survival, locoregional control and distant metastasis-free rates at 2 years were 67%, 77%, 90% and 88%, respectively. The average of uniformity index and conformal index was 1.06 and 1.19, respectively. One grade 3 of acute toxicity for diarrhea, thrombocytopenia and three grade 3 leucopenia were noted during CCRT. Only one grade 3 of subacute toxicity for thrombocytopenia was noted. There were no grade 3 or 4 subacute toxicities of anemia, leucopenia, genitourinary or gastrointestinal effects. Compared with conventional whole pelvic radiation therapy (WPRT), WPHT decreases the mean dose to rectum, bladder and intestines successfully.</p> <p>Conclusion</p> <p>HT provides feasible clinical outcomes in locally advanced cervical cancer patients. Long-term follow-up and enroll more locally advanced cervical carcinoma patients by limiting bone marrow radiation dose with WPHT technique is warranted.</p

    Caffeic acid phenethyl amide ameliorates ischemia/reperfusion injury and cardiac dysfunction in streptozotocin-induced diabetic rats

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    BACKGROUND: Caffeic acid phenethyl ester (CAPE) has been shown to protect the heart against ischemia/reperfusion (I/R) injury by various mechanisms including its antioxidant effect. In this study, we evaluated the protective effects of a CAPE analog with more structural stability in plasma, caffeic acid phenethyl amide (CAPA), on I/R injury in streptozotocin (STZ)-induced type 1 diabetic rats. METHODS: Type 1 diabetes mellitus was induced in Sprague–Dawley rats by a single intravenous injection of 60 mg/kg STZ. To produce the I/R injury, the left anterior descending coronary artery was occluded for 45 minutes, followed by 2 hours of reperfusion. CAPA was pretreated intraperitoneally 30 minutes before reperfusion. An analog devoid of the antioxidant property of CAPA, dimethoxyl CAPA (dmCAPA), and a nitric oxide synthase (NOS) inhibitor (Nω-nitro-l-arginine methyl ester [l-NAME]) were used to evaluate the mechanism involved in the reduction of the infarct size following CAPA-treatment. Finally, the cardioprotective effect of chronic treatment of CAPA was analyzed in diabetic rats. RESULTS: Compared to the control group, CAPA administration (3 and 15 mg/kg) significantly reduced the myocardial infarct size after I/R, while dmCAPA (15 mg/kg) had no cardioprotective effect. Interestingly, pretreatment with a NOS inhibitor, (l-NAME, 3 mg/kg) eliminated the effect of CAPA on myocardial infarction. Additionally, a 4-week CAPA treatment (1 mg/kg, orally, once daily) started 4 weeks after STZ-induction could effectively decrease the infarct size and ameliorate the cardiac dysfunction by pressure-volume loop analysis in STZ-induced diabetic animals. CONCLUSIONS: CAPA, which is structurally similar to CAPE, exerts cardioprotective activity in I/R injury through its antioxidant property and by preserving nitric oxide levels. On the other hand, chronic CAPA treatment could also ameliorate cardiac dysfunction in diabetic animals

    Prevalence of latent tuberculosis infection in persons with and without human immunodeficiency virus infection using two interferon-gamma release assays and tuberculin skin test in a low human immunodeficiency virus prevalence, intermediate tuberculosis-burden country

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    BackgroundThe risk of tuberculosis (TB) is higher in human immunodeficiency virus (HIV)-infected patients and intravenous drug users (IDUs). We determined the prevalence and risk factors of latent TB infection (LTBI) in individuals with or without HIV infection, including IDUs, in a country with a low HIV prevalence, an intermediate TB burden, and a high Bacillus Calmette-Guérin (BCG) vaccine coverage using two interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST).MethodsFor this prospective, cross-sectional study, HIV-infected and -uninfected patients from a regional hospital and medical center in Taiwan were enrolled. Results of the two IGRAs [QuantiFERON-TB Gold (QFT-G) and QuantiFERON-TB Gold In-Tube (QFT-GIT)] and the TST were compared. Risk factors for positivity were analyzed.ResultsWe recruited 233 patients [198 (85%) men; mean age, 39.4 years]. Most patients (74%) were BCG vaccinated. The prevalence of LTBI was estimated to be 22.8% by TST, 15.9% by QFT-G, and 20.6% by QFT-GIT. HIV-infected individuals had fewer positive QFT-GIT [7.0% vs. 28.6%, p < 0.001, adjusted odds ratio (aOR) = 0.28, p = 0.05] and TST results, and more indeterminate QFT-G responses (9.3% vs. 0.7%, p = 0.002). Concordance between IGRAs and TST was very poor in HIV-infected patients (κ < 0.05). Independent risk factors for IGRA positivity were increasing age (QFT-G: aOR = 1.98, p = 0.03; QFT-GIT: aOR = 2.00, p = 0.01) and IDUs (aOR = 4.33, p = 0.05 by QFT-G).ConclusionHIV-infected persons had a significantly lower response to both IGRAs and TST. High discordance was found between the two generations of IGRAs and between IGRAs and TST. Increasing age, a known risk factor for LTBI, was significantly associated with IGRAs, but not with TST

    Relationships between Parent-Reported Parenting, Child-Perceived Parenting, and Children’s Mental Health in Taiwanese Children

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    The current study examines the relationship between parents’ and children’s reports of parenting and their effects on children’s mental health symptoms. Six hundred and sixty-six parent-child dyads in Taiwan participated in this study. The parents and the children filled out the parenting questionnaires, and the children also reported their general mental health. The results demonstrated that parental-reported and child-perceived parenting were positively correlated, but parents tended to report lower scores on authoritarian parenting and higher scores on Chinese parenting than did their children. There were also significant gender differences: The mothers reported higher authoritative parenting than did the fathers; and the boys perceived higher authoritarian and Chinese-culture specific parenting than did the girls. Moreover, the Chinese parenting had a negative effect on children’s mental health outcomes. Finally, our results showed that children’s perception of parenting had a stronger effect on children’s mental health symptoms than did parental reports on parenting, urging future research to include the children’s report when investigating the effects of parenting on children’s mental health outcomes
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