The effects of rear-wheel camber on the kinematics of upper extremity during wheelchair propulsion

BACKGROUND: The rear-wheel camber, defined as the inclination of the rear wheels, is usually used in wheelchair sports, but it is becoming increasingly employed in daily propulsion. Although the rear-wheel camber can increase stability, it alters physiological performance during propulsion. The purpose of the study is to investigate the effects of rear-wheel cambers on temporal-spatial parameters, joint angles, and propulsion patterns. METHODS: Twelve inexperienced subjects (22.3±1.6 yr) participated in the study. None had musculoskeletal disorders in their upper extremities. An eight-camera motion capture system was used to collect the three-dimensional trajectory data of markers attached to the wheelchair-user system during propulsion. All participants propelled the same wheelchair, which had an instrumented wheel with cambers of 0°, 9°, and 15°, respectively, at an average velocity of 1 m/s. RESULTS: The results show that the rear-wheel camber significantly affects the average acceleration, maximum end angle, trunk movement, elbow joint movement, wrist joint movement, and propulsion pattern. The effects are especially significant between 0° and 15°. For a 15° camber, the average acceleration and joint peak angles significantly increased (p < 0.01). A single loop pattern (SLOP) was adopted by most of the subjects. CONCLUSIONS: The rear-wheel camber affects propulsion patterns and joint range of motion. When choosing a wheelchair with camber adjustment, the increase of joint movements and the base of support should be taken into consideration

Innovative digital technology adapted in nursing education between Eastern and Western countries: a mini-review

Advanced digital technologies have overcome the limitation of on-site teaching, especially after the COVID-19 epidemic. Various newly-developed digital technologies, such as e-learning, virtual reality, serious games, and podcasts, have gained renewed interest and come into the spotlight. Podcasts are becoming increasingly popular in nursing education as they provide a convenient and cost-effective way for students to access educational content. This mini-review article provides an overview of the development of podcasts in nursing education in Eastern and Western countries. It explores potential future trends in the use of this technology. The literature review demonstrates that nursing education in Western countries has already integrated podcasts into curriculum design, using the podcast to convey nursing education knowledge and skills and to improve students’ learning outcomes. However, few articles address nursing education in Eastern countries. The benefits of integrating podcasts into nursing education appear far greater than the limitations. In the future, the application of podcasts can serve not only as a supplement to instructional methodologies but also as a tool for clinical practicing students in nursing education. In addition, with the aging population increasing in both Eastern and Western countries, podcasts have the potential to serve as an effective delivery modality for health education in the future, particularly for the older adult, whose eyesight declines with age, and those populations with visual impairments

Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

AbstractEndometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities

Thrombotic Microangiopathy and Leukoerythroblastosis Associated with Metastatic Infiltrating Lobular Carcinoma

A 56-year-old female presenting with vaginal bleeding and exertional dyspnea for 2 weeks was admitted to hospital. The clinical course and blood analysis revealed several uncommon signs of thrombotic microangiopathy: microangiopathic hemolytic anemia (schistocytes, decreased haptoglobin, and a negative direct Coombs’ test), thrombocytopenia, leukoerythroblastic blood film, creatinine, lactate dehydrogenase, and alkaline phosphatase were also elevated. Bone marrow biopsy revealed metastatic infiltrating lobular carcinoma and focal bone marrow necrosis; and the primary lesion was subsequently identified in the right breast. We concluded that microangiopathic hemolytic anemia, thrombocytopenia, leukoerythroblastic blood film, lactate dehydrogenase, and alkaline phosphatase strongly indicated a disseminated malignancy with bone marrow involvement rather than thrombotic thrombocytopenic purpura or disseminated intravascular coagulation, which are also common in a disseminated malignancy. In breast cancer cases with hematological signs, prompt the bone marrow examination is more improtant than tranditional systemic hormone or systemic chemotherapy or ineffective supportive treatment such as plasma exchange in order to obtain hematological repsonse

Analysis of Medical Resource Utilization and Outcome of Inhaled Nitric Oxide in Patients Undergoing Mechanical Ventilation

Background: Inhaled nitric oxide (iNO) is a potent selective pulmonary vasodilator, which is used in critically ill patients to improve oxygenation. It avoids systemic hypotension and ventilator-induced lung injury in patients using ventilators. This study explored the medical resource utilization and outcome, and predicted risk factors for mortality in patients using ventilators with iNO. Methods: The database was from the National Health Insurance hospital claims data in Taiwan from 2004 to 2009. The patients using ventilators with iNO were collected and stratified by age to 20–44 years, 45–64 years, 65–74 years, and ≥ 75 years. Results: Seven hundred and thirty ventilator patients with iNO were enrolled (63.15% male, mean age 60 years). Mechanical ventilation (MV) weaning rate was 18.25%, intensive care unit (ICU) readmission rate was 5.75%, and ICU mortality rate was 74.52%. ICU mortality rate was lower, case-mix index, MV weaning rate, and hospital costs were higher for patients aged 20–44 years and 45–64 years than in those aged 65–74 years and ≥ 75 years (p < 0.05). Sex, case-mix index, Charlson comorbidity index, whether MV weaning (p < 0.001), different age group, and implementation of tracheostomy (p < 0.05) were all significant risk factors in predicting mortality of patients using ventilators with iNO. Conclusion: This study showed that the outcome differed with age in patients using ventilators with iNO

Developing an Integrated and Comprehensive Traditional Chinese Corpus Based on Multi-CharacterWords for Studying relations between words and lexicons

Most of Chinese corpus were created for single-character words with indexes, such as frequency, stroke number, and phonetic information, for the purposes of basic research. However, multi-character Chinese words are recognized of referring alterations of meaning and more useful for investigating reading processes and comprehension. Therefore, for studying complete relations between words and lexicons of Chinese, a corpus requires statistics based on more than single-character words with valid and reliable indexes. In this study, we illustrate a corpus of Traditional Chinese providing five word indexes, including word sound, word position, word form, semantics, and competence of forming multi-character words by integrating current credible corpus. The integration approach of the present study is beneficial not only for minimizing inconsistencies of word entities between corpus, but also for calculating quantitative properties of character-to-character relationship. The utilization of the present corpus will significantly impact the studies of Chinese words and reading comprehension

Genotoxic, teratotoxic and oral toxic assessments of Antrodia cinnamomea health food product (Leader Deluxe Antrodia cinnamomea®)

Antrodia cinnamomea is a rare and endemic medicinal mushroom native to Taiwan. The pharmacological effects of A. cinnamomea have been extensively studied. The aim of the present study was to assess the genotoxic, oral toxic and teratotoxic effects of A. cinnamomea health food product “Leader Deluxe Antrodia cinnamomea (LDAC)’’ using in vitro and in vivo tests. The Ames test with 5 strains of Salmonella typhimurium showed no signs of increased reverse mutation upon exposure to LDAC up to concentration of 5 mg/plate. Exposure of Chinese Hamster Ovary cells (CHO-K1) to LDAC did not produce an increase in the frequency of chromosomal aberration in vitro. In addition, LDAC treatment did not affect the proportions of immature to total erythrocytes and the number of micronuclei in the immature erythrocytes of ICR mice. Moreover, 14-days single-dose acute toxicity and 90-days repeated oral dose toxicity tests with rats showed that no observable adverse effects were found. Furthermore, after treatment with LDAC (700–2800 mg/kg/day) there was no evidence of observable segment II reproductive and developmental toxic effects in pregnant SD rats and their fetuses. These toxicological assessments support the safety of LDAC for human consumption