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Brian J Nguyen,1,2 William S Chen,3 Allison J Chen,1 Andrew Utt,4 Emily Hill,4 Ryan Apgar,5 Daniel L Chao1,2 1Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA; 2University of California San Diego, School of Medicine, La Jolla, CA, USA; 3Yale School of Medicine, New Haven, CT, USA; 4Aira Tech Corp, La Jolla, CA, USA; 5University of New England, College of Osteopathic Medicine, Biddeford, ME, USACorrespondence: Daniel L ChaoShiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA 92093, USATel +1 858 534 6290Fax +1 619 543 1975Email d6chao@ucsd.eduPurpose: To systematically evaluate the needs of low vision individuals through call data obtained through the Aira assistive technology system.Patients and methods: Aira (Aira Tech Corporation, La Jolla, CA, USA) is an on-demand assistive wearable technology designed for individuals with low vision. The user wears glasses with an integrated front-facing video camera that connects with a remote human agent who assists the user with the specified task. Call types, temporal characteristics, and duration of call were compared by gender and vision status (low vision, light perception, and blind). Chi-square tests, t-tests, ANOVA, linear regression and Poisson regression analyses were performed.Results: 878 subscribers placed 10,022 total calls (4759 female, 5263 male) over 3 months. The most common categories were reading (35%), navigation (33%), and home management (16%). The distribution of categories (χ2=49.3, p

Z Vivian Feng,1,* Wen Shuo Chen,2,* Khomson Keratithamkul,1 Michael Stoick,1 Brittany Kapala,3 Eryn Johnson,3 An-Chi Huang,2 Ting Yu Chin,4 Yui Whei Chen-Yang,2 Mong-Lin Yang3 1Chemistry Department, Augsburg College, Minneapolis, MN, USA; 2Department of Chemistry, Center for Nanotechnology, Center for Biomedical Technology, Chung Yuan Christian University, Chung Li, Taiwan, Republic of China; 3Department of Science, Concordia University Saint Paul, Saint Paul, MN, USA; 4Department of Bioscience Technology, Chung Yuan Christian University, Chung Li, Taiwan, Republic of China *These authors contributed equally to this work Abstract: In this work, silica nanofibers (SNFs) were prepared by an electrospinning method and modified with poly-D-lysine (PDL) or (3-aminopropyl) trimethoxysilane (APTS) making biocompatible and degradable substrates for neuronal growth. The as-prepared SNF, modified SNF-PDL, and SNF-APTS were evaluated using scanning electron microscopy, nitrogen adsorption/desorption isotherms, contact angle measurements, and inductively coupled plasma atomic emission spectroscopy. Herein, the scanning electron microscopic images revealed that dissolution occurred in a corrosion-like manner by enlarging porous structures, which led to loss of structural integrity. In addition, covalently modified SNF-APTS with more hydrophobic surfaces and smaller surface areas resulted in significantly slower dissolution compared to SNF and physically modified SNF-PDL, revealing that different surface modifications can be used to tune the dissolution rate. Growth of primary hippocampal neuron on all substrates led to a slower dissolution rate. The three-dimensional SNF with larger surface area and higher surface density of the amino group promoted better cell attachment and resulted in an increased neurite density. This is the first known work addressing the degradability of SNF substrate in physiological conditions with neuron growth in vitro, suggesting a strong potential for the applications of the material in controlled drug release. Keywords: silica nanofibers, electrospinning, dissolution, neurite density, surface modification

Yew Kong Lee,1 Chirk Jenn Ng,1 Ping Yein Lee,2 Ee Ming Khoo,1 Khatijah Lim Abdullah,3 Wah Yun Low,4 Azah Abdul Samad,5 Wei Seng Chen61Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Family Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 3Department of Nursing Sciences, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 4Faculty of Medicine Dean's Office, University of Malaya, Kuala Lumpur, Malaysia; 5Klinik Kesihatan Pantai, Kuala Lumpur, Malaysia; 6Klinik Alam Medic, Puchong, Selangor, MalaysiaBackground: Patients with type 2 diabetes often require insulin as the disease progresses. However, health care professionals frequently encounter challenges when managing patients who require insulin therapy. Understanding how health care professionals perceive the barriers faced by patients on insulin will facilitate care and treatment strategies.Objective: This study explores the views of Malaysian health care professionals on the barriers faced by patients using insulin.Methods: Semi-structured qualitative interviews and focus group discussions were conducted with health care professionals involved in diabetes care using insulin. Forty-one health care professionals participated in the study, consisting of primary care doctors (n = 20), family medicine specialists (n = 10), government policymakers (n = 5), diabetes educators (n = 3), endocrinologists (n = 2), and one pharmacist. We used a topic guide to facilitate the interviews, which were audio-recorded, transcribed verbatim, and analyzed using a thematic approach.Results: Five themes were identified as barriers: side effects, patient education, negative perceptions, blood glucose monitoring, and patient adherence to treatment and follow-up. Patients perceive that insulin therapy causes numerous negative side effects. There is a lack of patient education on proper glucose monitoring and how to optimize insulin therapy. Cost of treatment and patient ignorance are highlighted when discussing patient self-monitoring of blood glucose. Finally, health care professionals identified a lack of a follow-up system, especially for patients who do not keep to regular appointments.Conclusion: This study identifies five substantial barriers to optimizing insulin therapy. Health care professionals who successfully identify and address these issues will empower patients to achieve effective self-management. System barriers require government agency in establishing insulin follow-up programs, multidisciplinary diabetes care teams, and subsidies for glucometers and test strips.Keywords: primary care, focus groups, noncommunicable disease, diabetes, insulin, qualitative study

Objectives: To compare the morbidity patterns in public and private primary care clinics; determine patients’ reasons forencounter (RFE) and diagnoses using the ICPC-2, and compare ten commonest diagnoses and RFEs.Methods: A cross-sectional study on randomly selected clinics was conducted nationwide. Doctors completed the PatientEncounter Record (PER) for systematically selected encounters for a week.Results: Response rate was 82.0% (public clinic) and 33% (private clinic) with 4262 encounters and 7280 RFE. Overall, thethree commonest disease categories encountered were respiratory (37.2%), general and unspecified (29.5%), and cardiovasculardiseases (22.2%). Public and private clinics handled 27% versus 50% acute cases and 20.0% versus 3.1% chronic cases i.e.33.7 and 5.6 chronic diseases per 100 RFE respectively.Conclusion: Doctors in public clinics saw more chronic and complex diseases as well as pregnancy related complaints andfollow-up cases while in private clinics more acute and minor illnesses were seen. Health services should be integrated andsupport given to co-manage chronic diseases in both sectors.

The Tatun geothermal system, located in northern Taiwan, is hosted by the Plio-Pleistocene Tatun volcanic group, consisting dominantly of andesitic lavas, domes and pyroclastic flows. During the late 1960s and early 1970s, geologic mapping, geochemical sampling, geophysical surveys, and the drilling of numerous exploration and temperature gradient wells were conducted at Tatun under the leadership of the Mineral Research and Service Organization (MRSO), the predecessor to the geothermal group at the Industrial Technology Research Institute (ITRI). Deep (1–2 km) wells encountered commercial temperatures (200–300 °C) in the Matsao area, but these initial exploration efforts were discouraged by the presence of very acidic (pH < 3.5) and highly corrosive fluids. Numerous geoscience studies conducted over the past 15 years at Tatun have shown that the central portion of the system is dominated by corrosive volcanic fluids, as evidenced by abundant SO2 as well as HCl. More reduced gases are encountered on the flanks of the system, suggesting that water-rock interaction may have at least partly neutralized the volcanic-derived fluids on the margins of this geothermal system.

Background: To investigate the impact of concurrent chemoradiotherapy (CCRT) on stage IV rectum cancer.Methods: Between 2000 and 2011, 297 consecutive patients diagnosed with stage IV rectum cancer (synchronous metastasis) were enrolled. Cox proportional hazard analyses were used for prognostic factors determination, and the Kaplan-Meier method was used for survival analyses. Propensity scores with the one-to-one nearest-neighbor matching model were used to select matched patients for validation studies.Results: In total, 63 patients received CCRT and 234 did not. The patients in the CCRT group were younger, had more low-lying lesions, and had more T4 lesions, lung metastases, metastasectomies, and oxaliplatin-based upfront chemotherapy. Before propensity-score matching, a younger age (HR = 0.662, P = 0.016), lower carcinoembryonic antigen (CEA) level (≤20 ng/ml) (HR = 0.531, P = 0.001), no metastasectomy (HR = 3.214, P < 0.001), and no CCRT (HR = 1.844, P = 0.019) were independent prognostic factors after controlling for other confounding factors. After matching, only CEA and metastasectomy, but not CCRT, were independent prognostic factors. The survival benefit of CCRT was restricted to patients who undergo subsequent metastasectomy.Conclusions: Upfront CCRT only provided a survival benefit in patients with stage IV rectum cancer who undergo subsequent metastasectomy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the effectiveness of functional electrical stimulation on the swallowing function of irradiated nasopharyngeal carcinoma patients with dysphagia.Materials and Methods: Twenty nasopharyngeal carcinoma subjects with dysphagia were divided into a functional electrical stimulation (FES) and a home rehabilitation program (HRP) group. Each subject completed a quality of life questionnaire on swallowing and a videofluoroscopic study at the commencement and the end of the procedures. The FES group received functional electrical stimulation of the supra-hyoid muscles over 15 sessions. The HRP group performed self-swallowing exercises at home. The evaluation parameters included the quality of life questionnaire scores, the penetration-aspiration scale (PAS), the movement of the hyoid bone, and the amount of pyriform sinuses stasis.Results: Most swallowing outcomes of the FES group improved after FES. The quality of life score (p=0.003), the duration of the movement of thin barium through the hyoid (p=0.001), the moving speed of paste barium through the hyoid (p=0.028), and the pyriform sinus stasis area of the paste barium (p=0.026) reached significant difference in the FES group. Most swallowing outcomes did not improve in the HRP group. The degree of improvement in the movement speed of the hyoid bone in the thin barium (p=0.018) and the PAS of the paste barium (p=0.016) were statistically significantly greater in the FES group than in the HRP group.Conclusion: FES will improve the swallowing function of NPC patients with dysphagia and bring about better quality of life. [ABSTRACT FROM AUTHOR]

This study sought to examine the reliability of two measurements; Calf Circumference (CC) and Mid-half Arm Span (MHAS). A sample of 130 elderly persons aged 60 years and above seen consecutively in the Kuala Lumpur Hospital outpatient clinic during the period of December 2005 to January 2006, upon consent, were recruited to the study. There was a high degree of reliability for both inter- and intra-examiner (r close to 1). For inter-examiner, on average the CC measurements taken by the first examiner were 0.3 cm lower than that of the second examiner. The upper and lower limit of the differences were +0.4 to -0.9 cm respectively. Inter-examiner MHAS measurements on average by the first examiner were 0.2 cm lower than that of the second examiner. The limits were +1.7 to -2.1 cm. By comparison, the inter-examiner CC measurements were more reliable than the MHAS measurements. For intra-examiner, on average the CC measurements at Time 1 were consistent with Time 2 (mean difference=0) with limits of the difference at ± 0.5 cm. MHAS measurements at Time 1 were on average 0.1 cm less than at Time 2 with limits at +1.7 and -1.8 cm. The technical error of measurement (TEM) and coefficient of variation of CC and MHAS for both inter- examiner and intra-examiner measurements were within acceptable limits with the exception of MHAS TEM. This study suggests that CC and MHAS measured in elderly persons 60 years and above, using Seca Circumference Tape ® 206, Germany (0.05 cm) are reliable and can be used in a community survey. [ABSTRACT FROM AUTHOR]

Digitally created visual images of pertinent patient data have been integrated with text information to formulate a visual evaluation and summary sheet (VESS) using computer processing. The VESS incorporates images of a patient's physical appearance, radiological images, pharmacokinetic graphs, and text information into a 1-page document of the patient's condition. Thus, computer processing of digital images and other information helps to refine patient data presentation, analysis, interpretation, and communication. This form of data management is especially valuable in oncological research, where clinical trials demand rapid, ongoing assessment of results and analysis of large amounts of data. The VESS is an effective mechanism for monitoring both the progress of individual patients and the endpoints of the overall clinical trial. Copyright © 2000 by W.B. Saunders Company [ABSTRACT FROM AUTHOR]

Adenosine triphosphate (ATP) assays have a faster turnaround time and higher sensitivity than traditional cultivation methods for microbial monitoring. Challenges implementing ATP testing include incompatibility with chlorine quenching agents and hold time sensitivity, which are not well-studied. Chlorinated distribution system samples were collected from two Canadian utilities, Metro Vancouver (n = 40 samples) and Halifax Water (n = 283). No significant correlations were observed between heterotrophic cell count (HPC) and cellular ATP, suggesting these do not correlate well in waters with low biological activity (median HPC < 2 CFU/mL). However, interpretation of HPC and cATP results (based on the HPC guideline of 100 CFU/mL and cATP of 10 pg/mL) yielded the same conclusion for 95% of samples, suggesting a potential decision-making framework to replace HPC with cATP. Moreover, cATP correlates better with free chlorine (p < 0.04) compared with HPC for one of the studied systems. Importantly, adding chlorine quench (10% sodium thiosulfate) did not produce significantly different cATP results, nor did analyzing at various hold times of 4-, 6-, and 24-h. This study supports the integration of ATP testing into existing sampling procedures for water utilities, as a sensitive, fast, and reliable monitoring method., (© 2024. The Author(s).)