執行靜脈滴注化療藥品給藥流程若使用密閉給藥裝置（closed system transfer devices, ...CSTD），可降低護理人員自身之暴露化療藥品危害和降低工作環境汙染。研究目的為探討護理人員對於使用密閉給藥裝置與原流程（即藥師完成輸液套管排氣並調配完成之化療藥品）執行化療給藥之感受差異，以及影響護理人員對於使用密閉給藥裝置執行化療給藥感受的相關因素。本研究採橫斷式研究設計，以臺灣北部某醫學中心19個單位之護理人員為研究對象。由研究者自行發展結構式問卷收集資料，問卷內容包括四個部分，分別為：使用效能感受、暴露化療藥品感受、CSTD操作感受與個人特性。共收集242份有效問卷，結果顯示護理人員對使用CSTD執行化療給藥之使用效能感受顯著高於原流程（t=4.0, p ＜0.001）；而對暴露化療藥品感受顯著低於原流程（t=-8.04, p ＜0.001）。護理人員每天執行化療給藥筆數會影響其對於使用CSTD的效能感受、暴露化療藥品感受、CSTD操作感受。護理人員若有參加面授課程或網路數位課程，其使用CSTD之操作感受程度較高。護理人員以兩種學習管道學習使用CSTD，其對CSTD操作感受高於僅由一種學習管道者。建議未來醫療機構管理者在導入新醫療設備或流程時，可深入了解頻繁操作特定工作流程之使用者觀點。此外，提供使用者操作說明與多元教育訓練管道，讓使用者安排自我學習的時間，以提升其對於使用新醫療設備或流程感受，進而順利導入提升病人安全與員工安全之新醫療設備與流程。
Severe acute respiratory syndrome (SARS), a new disease with symptoms similar to those of atypical pneumonia, raised a global alert in March 2003. Because of its relatively high transmissibility and ...mortality upon infection, probable SARS patients were quarantined and treated with special and intensive care. Therefore, instant and accurate laboratory confirmation of SARS-associated coronavirus (SARS-CoV) infection has become a worldwide interest. For this need, we purified recombinant proteins including the nucleocapsid (N), envelope (E), membrane (M), and truncated forms of the spike protein (S1-S7) of SARS-CoV in Escherichia coli. The six proteins N, E, M, S2, S5, and S6 were used for Western blotting (WB) to detect various immunoglobulin classes in 90 serum samples from 54 probable SARS patients. The results indicated that N was recognized in most of the sera. In some cases, S6 could be recognized as early as 2 or 3 days after illness onset, while S5 was recognized at a later stage. Furthermore, the result of recombinant-protein-based WB showed a 90% agreement with that of the whole-virus-based immunofluorescence assay. Combining WB with existing RT-PCR, the laboratory confirmation for SARS-CoV infection was greatly enhanced by 24.1%, from 48.1% (RT-PCR alone) to 72.2%. Finally, our results show that IgA antibodies against SARS-CoV can be detected within 1 week after illness onset in a few SARS patients.
We demonstrate an 8-layer 3D Vertical Gate NAND Flash with WL half pitch =37.5nm, BL half pitch=75nm, 64-WL NAND string with 63% array core efficiency. This is the first time that a 3D NAND Flash can ...be successfully scaled to below 3Xnm half pitch in one lateral dimension, thus an 8-layer stack device already provides a very cost effective technology with lower cost than the conventional sub-20nm 2D NAND. Our new VG architecture has two key features: (1) To improve the manufacturability a new layout that twists the even/odd BL's (and pages) in the opposite direction (split-page BL) is adopted. This allows the island-gate SSL devices 1 and metal interconnections be laid out in double pitch, creating much larger process window for BL pitch scaling; (2) A novel staircase BL contact formation method using binary sum of only M lithography and etching steps to achieve 2 M contacts. This not only allows precise landing of the tight-pitch staircase contacts, but also minimizes the process steps and cost. We have successfully fabricated an 8-layer array using TFT BE-SONOS charge-trapping device. The array characteristics including reading, programming, inhibit, and block erase are demonstrated.
Developments of ultra fine pitch and high density solder microbumps for advanced 3D stacking technologies are discussed in this paper. CuSn solder microbumps with 25 ¿m in pitch are fabricated at ...wafer level by electroplating method and the total thicknesses of the platted Cu and Sn are 10 ¿m. After plating, the micro bumps on the Si chip are reflowed at 265°C and the variation of bump height measured within a die is less than 5%. The under bump metallurgy (UBM) layer on the Si carrier used is electroless plated nickel and immersion gold (ENIG) with total thickness less than 5 ¿m. Assembly of the Si chip and the Si carrier is conducted with the FC150 flip chip bonder at different temperatures, times, and pressures and the optimized bonding conditions are obtained. After assembly, underfill process is carried out to fill the gap and a void free underfilling is achieved using an underfill material with fine filler size.
HER2-ECD (human epidermal growth factor receptor 2 - extracellular domain) is a prominent therapeutic target validated for treating HER2-positive breast and gastric cancer, but HER2-specific ...therapeutic options for treating advanced gastric cancer remain limited. We have developed antibody-drug conjugates (ADCs), comprising IgG1 linked via valine-citrulline to monomethyl auristatin E, with potential to treat HER2-positive gastric cancer in humans. The antibodies optimally selected from the ADC discovery platform, which was developed to discover antibody candidates suitable for immunoconjugates from synthetic antibody libraries designed using antibody-antigen interaction principles, were demonstrated to be superior immunoconjugate targeting modules in terms of efficacy and off-target toxicity. In comparison with the two control humanized antibodies (trastuzumab and H32) derived from murine antibody repertoires, the antibodies derived from the synthetic antibody libraries had enhanced receptor-mediated internalization rate, which could result in ADCs with optimal efficacies. Along with the ADCs, two other forms of immunoconjugates (scFv-PE38KDEL and IgG1-AL1-PE38KDEL) were used to test the antibodies for delivering cytotoxic payloads to xenograft tumor models in vivo and to cultured cells in vitro. The in vivo experiments with the three forms of immunoconjugates revealed minimal off-target toxicities of the selected antibodies from the synthetic antibody libraries; the off-target toxicities of the control antibodies could have resulted from the antibodies' propensity to target the liver in the animal models. Our ADC discovery platform and the knowledge gained from our in vivo tests on xenograft models with the three forms of immunoconjugates could be useful to anyone developing optimal ADC cancer therapeutics.
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