Systemic lupus erythematosus (SLE) is prevalent among young female adults, particularly in Asia. In Taiwan, features of end-of-life SLE patients remain unclear.
Data regarding SLE patients whose ...hospitalization ended up with death were collected and analyzed from the repository of the National Health Insurance Research Database, Taiwan, from 2005 to 2007.
A total of 302 subjects were enrolled and the majority of these were young to middle-aged women (45.8 ±18.5 years); only one third of them were treated by rheumatologists. Eight patients (2.6%) with comorbid cancers received hospice care. Sepsis/bacteremia (42.1%) was the major acute comorbidity. Nephropathy/nephritis (35.1%) represented the major chronic comorbidity. Among 27 subjects with comorbid cancers, gynecological cancers were the most common (18%). Among the inpatient costs, the cost of prescriptions accounted for the majority (21.7 ±11.5%). Under a multivariate logistic regression, advanced age (≥ 65 years) correlated positively with acute lower respiratory conditions (ALRC) and diabetes mellitus (DM), and male gender correlated negatively with nephropathy/nephritis. The nephropathy/nephritis correlated positively with hospital stays > 14 days. The ALRC was closely associated with acute respiratory failure, but not with shock. However, shock was closely associated with hospital stays ≥ 14 days and sepsis/bacteremia. Cancer development was inversely correlated to nephropathy/nephritis, acute respiratory failure, and shock (all p < 0.05).
The end-of-life SLE patients revealed aforementioned characteristics and relationships. Sepsis/bacteremia, acute respiratory failure, and ALRC contributed most frequently to the ultimate death of acutely ill SLE patients.
Abstract Background This study investigated the impact of hospice care on end-of-life elderly patients with lung cancer in Taiwan. Methods Data were collected from deceased inpatients with lung ...cancer who were at least 65 years old, using the National Health Insurance Research Database of 2004. Results A total of 1282 patients were enrolled, of whom 277 (21.6%) received hospice care (hospice-care group) and the other 1005 (78.4%) received general acute ward care (control group). The patients' age, gender, and institution of hospitalization did not differ significantly between the two groups, and most of the patients had chosen medical centers and their affiliated hospices for terminal care. The hospice-care group had a significantly shorter hospital stay and lower costs of hospitalization than the control group, with patients cared for primarily by family physicians and radiation oncologists (all p < 0.05). The hospice-care group had an elevated incidence of co-morbid diabetes mellitus, higher scores on the Charlson Comorbidity Index, fewer acute lower respiratory conditions, and fewer invasive procedures than the control group (all p < 0.05). Natural opium alkaloids were the most commonly prescribed drugs in the hospice-care group, whereas parenteral solutions were most frequently requested in the control group. Conclusion Hospice care has provided a humane and cost-efficient pathway for end-of-life elderly patients with lung cancer. Parenteral nutrition/hydration should be limited for terminal care patients. Opioids should be promoted for the relief of pain and dyspnea in acute ward care. Family physicians and radiation oncologists play important roles in hospice care. Compared with the prevalence of hospice care in the United Kingdom and other developed countries, hospice care in Taiwan is in the position to be expanded.
FXYD proteins regulate Na super(+)/K super(+)-ATPase (NKA), which is a primary active pump that provides the driving force that triggers osmoregulatory systems in teleosts. To explore the regulatory ...mechanisms between FXYD and NKA in euryhaline teleosts, the expression of NKA (mRNA, protein, and activity) and FXYD11 and their interaction were examined in the gills of brackish medaka (Oryzias dancena) when transferred from brackish water (BW; 15ppt) to fresh water (FW) or seawater (SW; 35ppt). The mRNA expression of Odfxyd11 and Odnka- alpha was elevated 48 h post-hypoosmotic transfer. Moreover, FXYD11 protein and NKA activity were upregulated 12 h after transfer to FW. When transferred to SW, the protein abundance of FXYD11 and the NKA alpha -subunit did not show apparent changes, while Odfxyd11 and Odnka- alpha mRNA expression and NKA activity increased significantly 12 h and 1 h post-transfer, respectively. To clarify the FXYD11 mechanisms involved in modulating NKA activity via their interaction, co-immunoprecipitation was further applied to O. dancena gills. The results revealed that the levels of protein-protein interaction between branchial NKA and FXYD11 increased acutely 12 h after the transfer from BW to FW. However, immediate upregulation of NKA activity 1 h following post-exposure to SW, without the elevation of protein-protein interaction levels, was found. Hence, branchial NKA activity of O. dancena was suggested to be rapidly regulated by FXYD11 interaction with NKA when acclimated to hypoosmotic environments. To the best of our knowledge, this is the first study that focuses on the efficacy of interactions between FXYD11 and NKA in the gills of euryhaline teleosts.
Platinum complexes featuring pyridine bis-N-heterocyclic-imidazol-2-ylidene/-mesoionic-triazol-5-ylidene donors as pincer ligands and chloro (-Cl), acetonitrile (-NCCH
3
) or cyano (-CN) groups as ...auxiliary ligands are prepared as highly strained organometallic phosphors. X-ray structures of four of these complexes confirm a distorted square planar geometry, where the pincer ligand and its mesityl wingtips occur in a twisted conformation to each other. Electrochemical and photophysical characterization have been carried out and the experimental results are interpreted with the aid of density functional theory calculations. Emission responses of complexes under exposure to different vapors and mechanical shear are reported. Notably, the platinum complex featuring pyridine bis-imidazol-2-ylidene and a weakly donating acetonitrile auxiliary ligand exhibited strong aquachromic and mechanochromic emission responses, showing color changes from sky blue to green or yellow-green.
Platinum complexes featuring pyridine bis-N-heterocyclic imidazol-2-ylidene/triazol-5-ylidene donors are prepared and screened for vapo/mechanochromic attributes.
Pb(Zr,Ti)O3-Pb(Fe2/3W1/3)O3-Pb(Mn1/3Nb2/3)O3 (PZT-PFW-PMN) ceramics doped with BiFeO3 as sintering aids were manufactured in order to develop the low temperature sintering ceramics for piezoelectric ...devices, and phase structure, microstructure, dielectric, piezoelectric properties and the temperature stability were investigated. The results show that addition of BiFeO3 significantly improved the sinterability of PZT-PFW-PMN ceramics and could decrease the sintering temperature from 1200 to 1020 deg C. The 0.20wt.% BiFeO3-added PZT-PFW-PMN ceramics sintered at 1020 deg C exhibited the favorable piezoelectric and dielectric properties, which were listed as follows: d33=309 pC/N, Kp=0.59, Qm=1551, tandelta=0.0056, r=1723, Tc=308 deg C, Deltafr/fr25 deg C=0.331% and DeltaKp/Kp25 deg C=-0.564%. The obtained properties make this composition to be a good candidate for high power piezoelectric devices.
Conclusions: Radial forearm free flap (RFFF)-accompanied phonation tube (PT) for voice and speech restoration after pharyngolaryngectomy is promising, especially in phonation efficacy and ...intelligibility. It offers not only another safe surgical option but also a satisfactory result for such patients with advanced hypopharyngeal cancer. Objectives: We use RFFF with RFFF-accompanied PT for one-stage reconstruction both for tissue defect and voice reconstruction in patients undergoing total pharyngolaryngectomy. Methods: Eight male patients with advanced hypopharyngeal cancer underwent total pharyngolaryngectomy. Voice restoration was done with RFFF-accompanied PT. Phonation outcomes and speech outcomes of the patients were evaluated and scored. Results: The mean follow-up time was 13.7 months. All free flaps were successful without perioperative mortality. All the patients were able to produce sound. Phonation efficacy ranged from 70% to >90% postoperatively and 40% to >90% at the last follow-up. The speech intelligibility was graded as moderately good. Adapted from the source document
The switchgear, which is directly oriented the needs of the distribution network and the users, is an important kind of facilities whose operation condition is straight relevant to the quality and ...reliability of power supply. In contrast to the traditional routine maintenance or break maintenance, the condition based maintenance has been developed rapidly recent years as an advanced method, where one of the most critical issues is to build a state estimation model of the switchgear. The typical state quantities and their change trend are researched and the overall process of the states evolution is modeled in this article, whereby a method of switchgear state estimation based on the hidden Markov model is proposed, which could not only identify the current state but forecast the risks ahead.
The goal of this study was to determine the osmoregulatory ability of a juvenile marine fish, silver moony (Monodactylus argenteus), for the purpose of developing a new experimental species for ...ecophysiological research. In this study, M. argenteus was acclimated to freshwater (FW), brackish water (BW), or seawater (SW). The salinity tolerance of this euryhaline species was effective, and the fish survived well upon osmotic challenges. The largest apical surface of mitochondrion-rich cells was found in the FW individuals. Immunohistochemical staining revealed that Na^sup +^, K^sup +^-ATPase immunoreactive (NKA-IR) cells were distributed in the interlamellar region of the gill filaments of the silver moony in all experimental groups. In addition to the filaments, NKA-IR cells were also found in the lamellae of the FW individuals. The number of NKA-IR cells in the gills of the FW individuals exceeded that of the BW and SW individuals. The NKA-IR cells of FW and SW individuals exhibited bigger size than that of BW fish. The NKA activities and protein expression of the NKA α-subunit in the gills of the FW individuals were significantly higher than in the BW and SW groups. Additionally, the relative amounts of Na^sup +^, K^sup +^, 2Cl^sup -^ cotransporter 1 (NKCC1) were salinity-dependent in the gills. Immunofluorescent signals of NKCC1 were localized to the basolateral membrane of NKA-IR cells in all groups. In the gills of the FW individuals, however, some NKA-IR cells did not exhibit a basolateral NKCC1 signal. In conclusion, the present study illustrated the osmoregulatory mechanisms of this easy- and economic-to-rear marine teleost with euryhaline capacity and proved the silver moony to be a good experimental animal.PUBLICATION ABSTRACT
The goal of this study was to determine the osmoregulatory ability of a juvenile marine fish, silver moony (Monodactylus argenteus), for the purpose of developing a new experimental species for ...ecophysiological research. In this study, M. argenteus was acclimated to freshwater (FW), brackish water (BW), or seawater (SW). The salinity tolerance of this euryhaline species was effective, and the fish survived well upon osmotic challenges. The largest apical surface of mitochondrion-rich cells was found in the FW individuals. Immunohistochemical staining revealed that Na super(+), K super(+)-ATPase immunoreactive (NKA-IR) cells were distributed in the interlamellar region of the gill filaments of the silver moony in all experimental groups. In addition to the filaments, NKA-IR cells were also found in the lamellae of the FW individuals. The number of NKA-IR cells in the gills of the FW individuals exceeded that of the BW and SW individuals. The NKA-IR cells of FW and SW individuals exhibited bigger size than that of BW fish. The NKA activities and protein expression of the NKA alpha -subunit in the gills of the FW individuals were significantly higher than in the BW and SW groups. Additionally, the relative amounts of Na super(+), K super(+), 2Cl super(-) cotransporter 1 (NKCC1) were salinity-dependent in the gills. Immunofluorescent signals of NKCC1 were localized to the basolateral membrane of NKA-IR cells in all groups. In the gills of the FW individuals, however, some NKA-IR cells did not exhibit a basolateral NKCC1 signal. In conclusion, the present study illustrated the osmoregulatory mechanisms of this easy- and economic-to-rear marine teleost with euryhaline capacity and proved the silver moony to be a good experimental animal.
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