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Shih-Lung Cheng,1,2 Ping-Huai Wang,1 Cheng-Yu Chang,1 Hsu-Hui Wang,1 Chung-Jen Wang,1 Kuan-Ming Chiu2,3 1Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, 220, Taiwan; 2The Graduate Institute of Medicine, Yuan-Ze University, Taoyuan City, Taiwan; 3Division of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, 220, TaiwanCorrespondence: Kuan-Ming Chiu, Division of Cardiovascular Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banqiao District, New Taipei City, 220, Taiwan, Tel +886-2-89667000, Email kmchius@gmail.comBackground: Molnupiravir (MOL) is an oral antiviral medication that has recently been treated for COVID-19.Objectively: We perform a prospective and observational study to elucidate the efficacy and safety of MOL in healthcare patients with COVID-19.Materials and Methods: A observational, non-randomized study of patients diagnosed with COVID-19 in 46 healthcare facilities and treated with MOL started within 5 days after the onset of signs or symptoms. We recorded data for all patients, including demographic data, clinical features, and symptoms. Treatment response was classified into cure, stable, hospitalization and death. Multivariate analysis was performed with stepwise logistic regression for hospitalization and death risk factors.Results: In total, 856 patients were diagnosed as having COVID-19 and treated with MOL during the study period. Of those, 496 patients (57.9%) were cured, 256 patients (29.9%) in stable condition, 104 patients (12.2%) hospitalized, and 22 patients (2.6%) died, respectively. There was significant effectiveness (87.8%) in COVID-19 patients using MOL. Multivariate analysis was performed to confirm the risk factors for hospitalization and death and included elder age (> 80 years old) (odds ratio (OR) 2.2, 95% confidence interval (CI): 1.1– 6.9), old cerebrovascular accident (CVA) (OR=4.1, 95% CI: 1.3– 9.9), the presence of diabetes mellitus (DM) (OR=2.6, 95% CI: 1.2– 9.1) and chronic respiratory diseases (OR=2.4, 95% (CI): 1.3– 8.1).Limitations: This is an observational study, neither randomized study nor control group study.Conclusion: Initial treatment with MOL has the treatment benefits and is well tolerated for patients with COVID-19 in healthcare facilities. Older age, old CVA, DM, and chronic respiratory diseases were independent risk factors for hospitalization and mortality. The results demonstrate there are important clinical benefits of MOL beyond the reduction in hospitalization or death for these patients with more comorbidities in Taiwan.Keywords: molnupiravir, COVID-19, healthcare facility, clinical benefit, hospitalization, comorbidity

PurposeOn the basis of the hierarchical organizational structure, this study investigated how empowering leadership influences hotel employees' proactive work behavior through multiple cross-level mediation processes. This study also investigated whether psychological empowerment, positive psychological capital, job characteristics and job embeddedness can activate the linkage of the aforementioned trickle-down effects.Design/methodology/approachThis study draws data from 826 international tourist hotel employees at different times with hierarchical linear modeling (HLM) analyses.FindingsMultiple cross-level mediation analyses indicate that (1) psychological empowerment mediates the cross-level influences of empowering leadership on job characteristics and positive psychological capital; (2) positive psychological capital mediates the cross-level influences of empowering leadership on job embeddedness and proactive work behavior; and (3) job embeddedness mediates the cross-level influences of psychological empowerment and job characteristics on proactive work behavior.Practical implicationsIn the post-pandemic era, the valuable trickle-down effects of empowering leadership could spill over into employees' positive beliefs of psychological empowerment, which ultimately benefit working responsibility and organizational operations.Originality/valueThe results support and suggest that maximizing the benefits of empowering leadership could eventually foster proactivity and performance in the workplace under hospitality and tourism settings.

This study aims to explore college students’ learning and academic self-efficacy in self-regulated learning and the effectiveness of learner-centered education by integrating the bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary (BOPPPS) model and interactive response system (IRS) tool. Accordingly, learning self-efficacy includes five dimensions, namely, conceptual understanding, everyday application, practical work, higher-order cognitive skills, and science communication. Meanwhile, self-regulated learning represents six dimensions, namely, goal setting, environment structuring, task strategies, time management, help seeking, and self-evaluation. Questionnaire responses were collected from hospitality students in the university for the subject of hospitality cost control. Results showed that learners’ learning self-efficacy was positively associated with academic self-efficacy, while self-regulated learning mediated the relations between learners’ learning and academic self-efficacy. Moreover, results indicated that students who participate in class demonstrate substantially high learning and academic self-efficacy for integrating the BOPPPS model and IRS methods in their classroom, particularly in the post-test rather than in the pre-test. Lastly, results provide empirical evidence for learning and academic achievement of self-efficacy, self-regulated learning, and effective teaching design in the tourism and hospitality setting context.

Management of patients with asthma during the coronavirus disease 2019 (COVID-19) pandemic is a concern, especially since asthma predisposes patients to respiratory problems. Interestingly, asthma characterized by type 2 inflammation, also known as T-helper type 2-high endotype, displays a cellular and molecular profile that may confer protective effects against COVID-19. The results of experimental and clinical studies have established the actions of immunoglobulin E (IgE) in inducing airway hyperreactivity and weakening an interferon-mediated antiviral response following respiratory viral infection. Robust evidence supports the beneficial effect of the anti-IgE biologic treatment omalizumab on reducing respiratory virus-induced asthma exacerbations and reducing the frequency, duration, and severity of respiratory viral illness in patients with asthma. Indeed, accumulating reports of patients with severe asthma treated with omalizumab during the pandemic have reassuringly shown that continuing omalizumab treatment during COVID-19 is safe, and in fact may help prevent the severe course of COVID-19. Accordingly, guidance issued by the Global Initiative for Asthma recommends that all patients with asthma continue taking their prescribed asthma medications, including biologic therapy, during the COVID-19 pandemic. The impact of biologic treatments on patients with asthma and COVID-19 will be better understood as more evidence emerges.

Purpose The purpose of this study was based on the job demands -resources model (Bakker et al., 2004) and conservation of resources theory (Hobfoll, 1989) by using three levels of variables, namely, company (i.e., perceived organizational support), department (i.e., abusive supervision), and employee (i.e., deep acting, surface acting, and self-efficacy) levels, to investigate its interactions with contextual influences on service quality and its linkage with customer loyalty. Design/methodology/approach A three-level hierarchical linear model was examined in research settings by using a dyadic data set of 1,082 service employees and customers in international tourist hotels. Findings Findings revealed that deep acting relates positively to service quality, surface acting relates negatively to service quality, and service quality relates positively to customer loyalty. For the three-level interactions, the positive relationship between deep acting and service quality was strengthened by perceived organizational support (POS) and self-efficacy but weakened by abusive supervision. By contrast, the negative relationship between surface acting and service quality was mitigated by POS and self-efficacy but exacerbated by abusive supervision. Originality/value Given the importance of emotional labor research in the hospitality industry, the current study contributes to the areas of service quality and customer loyalty and suggests future directions for hospitality research.

Objectives The purpose of this study is to determine the relationship between depressive symptoms and nutritional status in the frail older adults. Methods This study uses a cross-sectional, descriptive, and correlational design. A questionnaire was used to collect demographic data, and the Taiwan International Physical Activity Questionnaire Form Geriatric Depression Scale-Short Form Charlson Comorbidity Index, and Mini-Nutritional Assessment Short-Form were used to measure depression and nutritional status, respectively. Data were analyzed by independent-t tests, chi-square tests, spearman correlations, and multiple linear regressions. Results Of the total of 94 frail older adults, 17 (18.09%) had depressive symptoms (GDS > 5). The average MNA-SF score was 11.38 (SD = 2.45), 31 (32.98%) participants had a risk of malnutrition and 12 (12.77%) were malnourished. Participants’ reports of dissatisfaction with their lives (72.1%) and feeling terrible about their lives (58.14%) were associated with a risk of malnutrition. Elderly age, multiple comorbidities, and high level of depressive symptoms were at increased risk of malnutrition. Conclusion When clinicians are faced with a high-risk group, such as elderly patients with multiple comorbidities and depressive symptoms, they should perform an immediate assessment of nutritional status. If a risk of malnutrition is found, adequate nutrition and health care should be provided.

With the increasing competition in contemporary enterprise, sustainable human resource management is a powerful resource for workplace mental health. On the basis of job demands-recourses theory and conservation of resources theory, this study examined the relationship between empowering leadership and employees’ proactive work behavior. It also explored how job design inspires employees to be embedded in their work and to exhibit proactive work behavior. In addition, the research probed the mediating roles of job characteristics and job embeddedness in a serial mediation model within an integrated model. Data were collected from 461 employees of three- to five-star hotels through stratified random sampling. Results indicated that (1) empowering leadership has positive influences on job characteristics and proactive work behavior, (2) job characteristics have a positive influence on job embeddedness, (3) job embeddedness has a positive influence on proactive work behavior, (4) job characteristics mediate the effect of empowering leadership on proactive work behavior, (5) job embeddedness mediates the effect of empowering leadership on proactive work behavior, and (6) job characteristics and job embeddedness jointly mediate the effect of empowering leadership on proactive work behavior by bootstrapping analyses. Accordingly, this study suggests that promoting sustainable human resource management is needed for human health and organizational value at work, both of which enable empowering leadership to improve proactive work behavior via job characteristics and job embeddedness. The theoretical and managerial implications of empirical findings are also discussed.

Off-campus internships are among the policies implemented over the years to reduce the academic gap in the hospitality industry. Additionally, career decision making is unavoidable for college students, who can use different learning strategies in internships to gain knowledge beyond textbooks and determine their future direction. Our research aims to explore the mediating role of self-regulated learning in the relationship between deep learning approach (DLA) in hospitality internships and career self-efficacy. Moreover, it uses cognitive engagement as a moderator to explore the relationships between the three constructs. Data are collected through stratified sampling from hospitality college students in Taiwan who completed off-campus internships. Descriptive statistics are employed, and confirmatory factor analysis and structural equation modeling are conducted to analyze the data. Results indicate the following: (1) DLA has a positive influence on self-regulated learning. (2) Self-regulated learning has a positive influence on career self-efficacy. (3) DLA has a positive influence on career self-efficacy. (4) Self-regulated learning mediates the effect of DLA on career self-efficacy. (5) Cognitive engagement moderates the effect of DLA and self-regulated learning on career self-efficacy. Theoretical and practical implications are also discussed.

BACKGROUND A combination of physical and cognitive training appears to be the effective intervention to improve cognitive function in older adults with mild cognitive impairment (MCI). Computing technology such as virtual reality (VR) may have the potential to assist rehabilitation in shaping brain health. However, little is known about the potential of VR-based physical and cognitive training designed as an intervention for cognition and brain activation in elderly patients with MCI. Moreover, whether a VR program designed around functional tasks can improve their instrumental activities of daily living (IADL) requires further investigation. AIM This study investigated the effects of 12 weeks of VR-based physical and cognitive training on cognitive function, brain activation and IADL and compared the VR intervention with combined physical and cognitive training. DESIGN A single-blinded randomized controlled trial. SETTING Communities and day care centers in Taipei, Taiwan. POPULATION Older adults with mild cognitive impairment. METHODS Thirty-four community-dwelling older adults with MCI were randomized into either a VR-based physical and cognitive training (VR) group or a combined physical and cognitive training (CPC) group for 36 sessions over 12 weeks. Participants were assessed for their cognitive function (global cognition, executive function and verbal memory) and IADL at pre- and postintervention. Changes in prefrontal cortex activation during the global cognition test were also captured by functional near-infrared spectroscopy (NIRS) to identify the potential mediating pathway of the intervention. RESULTS Both groups showed improved executive function and verbal memory (immediate recall). However, only the VR group showed significant improvements in global cognition (P

Background and aims Renal dysfunction is a potent risk factor for cardiovascular diseases, including stroke. This study aimed to evaluate the impact of admission estimated glomerular filtration rate (eGFR) levels on short-term (1-month) and long-term (1-year) mortality in patients with acute ischemic stroke. Methods From the Taiwan Stroke Registry data, we classified ischemic stroke patients, identified from April 2006 to December 2015, into 5 groups by eGFR at admission: ≥ 90, 60–89, 30–59, 15–29, and Results Among 52,732 ischemic stroke patients, 1480 died within one month. The 1-month mortality rate was over 5-fold greater in patients with eGFR Conclusions After acute ischemic stroke, patients with reduced eGFR are at elevated risks of short-term and long-term deaths in a graded relationship.

Internships are increasingly being used in the hospitality industry, as these can provide students with opportunities to examine their abilities, interests, and career decisions in a workplace context, as well as help cultivate human resources within this sector. This study thus examines students’ career decision-making self-efficacy with regard to internships. Based on social cognitive theory and career decision-making self-efficacy theory, we developed the research constructs with a focus group interview and a review of the existing literature, and then verified their content validity and scale reliability. Using 782 student data from the hospitality management departments, we found the direct influence of career decision-making self-efficacy in relation to internships on the intention to stay in the hospitality industry. Most important of all, we also found the mediating roles of internship satisfaction and career commitment in the relationship between decision-making self-efficacy and intention to stay in the hospitality industry, as well as the moderating roles of intrinsic motivation in the relationships among career decision-making self-efficacy, internship satisfaction, career commitment, and intention to stay in the hospitality industry. The theoretical and practical implications of these results in the context of hospitality will be discussed.

We investigated the impact of serum cholesterol levels on 30-day mortality after ischemic stroke in dialysis patients.From the Taiwan Stroke Registry data, we identified 46,770 ischemic stroke cases, including 1101 dialysis patients and 45,669 nondialysis patients from 2006 to 2013.Overall, the 30-day mortality was 1.46-fold greater in the dialysis group than in the nondialysis group (1.75 versus 1.20 per 1000 person-days). The mortality rates were 1.64, .62, 2.82, and 2.23 per 1000 person-days in dialysis patients with serum total cholesterol levels of 120 mg/dL, 120-159 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively. Compared to dialysis patients with serum total cholesterol levels of 120-159 mg/dL, the corresponding adjusted hazard ratios of mortality were 4.20 (95% confidence interval [CI] = 1.01-17.4), 8.06 (95% CI = 2.02-32.2), and 6.89 (95% CI = 1.59-29.8) for those with cholesterol levels of 120 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively.Dialysis patients with serum total cholesterol levels of ≥160 mg/dL or 120 mg/dL on admission are at an elevated hazard of 30-day mortality after ischemic stroke.

PurposeThe purpose of this paper is to first integrate incorporated commitment, self-identity, and moral responsibility with the theory of planned behaviour (TPB) to predict the green food and beverage (GFB) behaviours in protecting food environment. Moreover, this study also identified the key influential factors of green behaviours and analysed the mediation effects of commitment in this extended TPB model.Design/methodology/approachThe structural equation modelling based on 793 college students was used to verified the goodness-of-fit and direct effects of the extended TPB model of GFBs, and bootstrap method was also used to examine the indirect effects.FindingsThe results of this study revealed commitment, perceived behavioural control (PBC), and perceived knowledge of GFBs were the most influential factors of GFBs. Furthermore, this study also verify that PBC influences civic behaviour pertaining to GFBs, and commitment mediated the effects of subjective social norms between PBC and GFBs.Originality/valueThis study provided value for GFBs that prompting people to exhibit civic behaviour pertaining and commitment to GFBs as well as ensuring environmentally sustainable development of GFBs.

Purpose This paper aims to integrate leader–member exchange (LMX), creativity and performance research and to develop a model to investigate the relationships among LMX, task motivation, creativity and performance in the hospitality industry. Design/methodology/approach Structural equation modeling (SEM) with bootstrap estimation was conducted with a sample of 312 leader–employee dyadic data from international tourist hotels in Taiwan. Findings The results revealed that LMX positively affected performance and creativity. Most important of all, task motivation was found to mediate the relationship between LMX and creativity, while both task motivation and creativity were found to mediate the relationship between LMX and performance. Research limitations/implications With efforts to combine research variables into a unified theoretical model, this study is the first in the field of hospitality research which explores the two-path mediating effects of these relationships in an integrated SEM framework. More specifically, this study provides a synthesized perspective with bootstrap analyses to broaden hotel research with regard to LMX and examine its influences on employees’ creativity and performance. Practical implications The results of this study suggest that human resource departments in hotel companies should provide training programs for supervisors and employees to enhance their reciprocal relationships, and establish reward mechanisms to encourage the development of more creative services at work. Originality/value This study added to the literature with its use of a non-Western sample, and extended the prior research in the context of the hospitality industry. Overall, the conclusions provide empirical evidence in an integrated model that task motivation can strengthen the influence of LMX on creativity and can also nourish the influence of creativity on employee performance.

This study examines how the quality of social exchange relationships at work with a leader (leader-member exchange; LMX) and team members (team-member exchange; TMX) can predict employee TQM involv...

This study aims to explore hospitality college students' learning and academic self-efficacy in self-regulated learning and the effectiveness of learner-centered education by integrating the bridge...

This study aims is to unify the concepts of emotional labor and service quality on the basis of job demands–resources theory, which is associated with engagement and burnout in working environments. This study draws upon a sample of data on 863 subordinate–supervisor dyads in 92 service teams at 46 international tourist hotels. The results of hierarchical linear modeling showed that emotional deep acting is positively related to work engagement and eventually leads to a high level of service quality. Conversely, emotional surface acting is positively related to work burnout and ultimately causes a low level of service quality. In addition, this study found cross-level interactions between perceived organizational support (POS) and abusive supervision on the relationships among emotional labor, engagement, burnout, and service quality. The positive effects of deep acting on work engagement and service quality were found to be significantly higher for the moderating effects of POS. However, the negative effects of surface acting on work burnout and service quality were found to be significantly higher for the moderating effects of abusive supervision. Finally, the theoretical and practical implications of this study for the hospitality industry are also discussed.

Purpose – The purpose of this study is to investigate the influences of Maignan et al.’s (1999) four-dimension model of corporate citizenship (based on economic, ethical, legal and discretionary responsibilities) on business performance in the hospitality sector. Design/methodology/approach – This study obtained its empirical evidence from international tourist hotels in Taiwan and applied structural equation modeling (SEM) analyses. Findings – The results show that ethical and sustainable practices of corporate citizenship have positive effects on employee affective organizational commitment, organizational innovation and customer loyalty, while affective organizational commitment, innovation and customer loyalty all have positive effects on business performance. Most important of all, bootstrap estimations based on SEM show that corporate citizenship has indirect positive effects on business performance through the mediating roles of affective organizational commitment, innovation and customer loyalty. Originality/value – While most prior studies were conducted in Western contexts, based on this work’s empirical investigation of international hotels in Taiwan, it is concluded that proactive corporate social responsibility strategies and practices, such as corporate citizenship, can ultimately increase the overall effectiveness of the hospitality industry in a Chinese context.

Integrating transformational leadership, creativity and social cognitive theories, we explore the relationships among transformational leadership, creative role identity, creative self-efficacy, job complexity and creativity. Structural equation modeling (SEM) with bootstrapping estimation was conducted using data from 395 supervisor–employee dyads from international tourist hotels in Taiwan. The results show that supervisors' transformational leadership positively influenced employee creative self-efficacy and creativity. Moreover, creative role identity was found to mediate the relationship between transformational leadership and employee creative self-efficacy, while both creative role identity and creative self-efficacy were found to mediate the relationship between transformational leadership and employee creativity. Specifically, job complexity was found to moderate the relationship between transformational leadership and employee creative role identity, the relationship between employee creative role identity and creative self-efficacy, and the relationship between employee creative self-efficacy and creativity. We discuss the implications of these results for research and practice in hospitality context.

The emotional intelligence preparation of students is one of the key focuses in hospitality, tourism, and leisure education. Accordingly, this study developed an 18-h curriculum to enhance the emotional intelligence of students and investigated pre-post course differences under the framework, which integrates technological, pedagogical, and content knowledge (TPACK). Echoing the proposition by Mayer, Caruso, and Salovey's (1999) four-branch model, the current study results verified that this curriculum module effectively promoted the emotional intelligence of students in terms of self-emotion appraisal, others' emotion appraisal, use of emotion, and regulation of emotion. Furthermore, in line with Koehler and Mishra's (2009) proposition, this study provided support to the scales validity of TPACK components. Using structural equation modeling (SEM) analyses, this study also proved the positive contextual influences of components of content knowledge, pedagogical knowledge, technology knowledge, technological content knowledge, and technological pedagogical knowledge on TPACK (Boschman, McKenney, & Voogt, 2015; Ching, Yang, Baek, & Baldwin, 2016; Koh & Chai, 2014; Koh, Chai, & Tsai, 2014). Consequently, this study verified that the implementation of TPACK framework could bridge tacit content knowledge, practice of teaching, and usage of adequate technological methods together for learning effectiveness.

This paper aims to investigate the mediating role of work engagement for the effects of deep acting, S, and self-efficacy on service quality under the conservation of resources (COR) theory and the job demands&ndash, resources (JD-R) model. Questionnaires were rigorously distributed by stratified random sampling. Data were collected from hospitality frontline employees (HFLEs) of hotels and restaurants in Taiwan during a period of two months. Structural equation modeling analyses were conducted to assess the data. Empirical results demonstrated work engagement is a significant mediator, enriching the antecedents and consequences of work engagement in hospitality literature. The findings suggest hospitality practitioners should consider a high-performance work system (HPWS) as an employee management tactic to implement sustainable human resource management (HRM). This practice can augment hospitality frontline employees&rsquo, willingness to stay in organizations in the long term and to maintain a satisfying service quality.

This research proposed and investigated a mediated moderation research framework that links employee job satisfaction, knowledge sharing, innovation capability, and job performance for sustainable human resource management in hospitality. Data from 395 Taiwanese hospitality companies with structural equation modeling (SEM) analyses, and the results showed that job satisfaction had significantly positive influences on knowledge sharing, both job satisfaction and knowledge sharing were significantly and positively related to innovation capability, while innovation capability had significantly positive influences on job performance. Support was also found for the significant and positive mediating effects of knowledge sharing between job satisfaction and innovation capability, and different organizational forms have moderating effects on the relationship between job satisfaction, knowledge sharing and innovation capability. The implications of these findings for sustainable human resource management in hospitality are also discussed.

This study proposes a non-recursive model based on Amabile’s (Res Organ Behav 10:123–167, 1988) componential theory of organizational creativity and innovation to explain how resources, management practices, organizational motivation, expertise, creativity skills, and intrinsic motivation affect innovation and creativity in organizations. Based on the results of a longitudinal survey, with 586 leader–follower dyadic data drawn from firms in the service industries in Taiwan, we found that resources, management practices, and organizational motivation have unique positive direct effects on innovation, while expertise, creativity skills, and intrinsic motivation have unique positive direct effects on creativity. Most important of all, the results of this empirical study provide evidence for the reciprocal relationship between organizational innovation and creativity in the service context. The theoretical and practical implications of these findings are discussed.

The purpose of this study was to examine the key characteristics of sustainable service innovation in the hospitality industry. We conducted a content analysis based on the interview records for 17 experts (including three academic scholars, three government officers and 11 top-level managers) with an average of 20 years of experience in the hospitality management domain in Taiwan. The analytical results conform to Amabile’s (1988) componential theory of creativity and innovation and show that 11 characteristics are major indicators of sustainable service innovation in the hotel management field. These include the following characteristics: market position, customer satisfaction, service orientation, environmental thinking, employee involvement, incentive mechanism, human resource development, environmental services, cultural resource management, government policy and school education. Accordingly, using the integrated theory of sustainable service innovation and professional opinions from experts, we provide theoretical and practical implications for current and future trends on sustainability and innovation in the hospitality industry.

Background Discharge disposition planning is vital for poststroke patients. We investigated clinical factors associated with discharging patients to nursing homes, using the Taiwan Stroke Registry data collected from 39 major hospitals. Methods We randomly assigned 21,575 stroke inpatients registered from 2006 to 2008 into derivation and validation groups at a 3-to-1 ratio. We used the derivation group to develop a prediction model by measuring cumulative risk scores associated with potential predictors: age, sex, hypertension, diabetes mellitus, heart diseases, stroke history, snoring, main caregivers, stroke types, and National Institutes of Health Stroke Scale (NIHSS). Probability of nursing home care and odds ratio (OR) of nursing home care relative to home care by cumulative risk scores were measured for the prediction. The area under the receiver operating characteristic curve (AUROC) was used to assess the model discrimination against the validation group. Results Except for hypertension, all remaining potential predictors were significant independent predictors associated with stroke patient disposition to nursing home care after discharge from hospitals. The risk sharply increased with age and NIHSS. Patients with a cumulative risk score of 15 or more had an OR of 86.4 for the nursing home disposition. The AUROC plots showed similar areas under curves for the derivation group (.86, 95% confidence interval [CI], .85-.87) and for the validation group (.84, 95% CI, .83-.86). Conclusions The cumulative risk score is an easy-to-estimate tool for preparing stroke patients and their family for disposition on discharge.

N-dienyl-5-alkenyl-lactams can be prepared from succinimide. Heating leads to an intramolecular Diels-Alder cyclization that produces tricyclic products useful for the preparation of related alkaloids.

Background Microglial inflammation may significantly contribute to the pathology of Alzheimer’s disease. To examine the potential of Cudrania cochinchinensis to ameliorate amyloid β protein (Aβ)-induced microglia activation, BV-2 microglial cell line, and the ramified microglia in the primary glial mixed cultured were employed. Results Lipopolysaccharide (LPS), Interferon-γ (IFN-γ), fibrillary Aβ (fAβ), or oligomeric Aβ (oAβ) were used to activate microglia. LPS and IFN-γ, but not Aβs, activated BV-2 cells to produce nitric oxide through an increase in inducible nitric oxide synthase (iNOS) expression without significant effects on cell viability of microglia. fAβ, but not oAβ, enhanced the IFN-γ-stimulated nitric oxide production and iNOS expression. The ethanol/water extracts of Cudrania cochinchinensis (CC-EW) and the purified isolated components (i.e. CCA to CCF) effectively reduced the nitric oxide production and iNOS expression stimulated by IFN-γ combined with fAβ. On the other hand, oAβ effectively activated the ramified microglia in mixed glial culture by observing the morphological alteration of the microglia from ramified to amoeboid. CC-EW and CCB effectively prohibit the Aβ-mediated morphological change of microglia. Furthermore, CC-EW and CCB effectively decreased Aβ deposition and remained Aβ in the conditioned medium suggesting the effect of CC-EW and CCB on promoting Aβ clearance. Results are expressed as mean ± S.D. and were analyzed by ANOVA with post-hoc multiple comparisons with a Bonferroni test. Conclusions The components of Cudrania cochinchinensis including CC-EW and CCB are potential for novel therapeutic intervention for Alzheimer’s disease.

Background. The model of interhemispheric competition after stroke has been established for the upper but not for the lower extremity. Repetitive transcranial magnetic stimulation (rTMS) of the brain has been shown to modulate cortical excitability. Objective. The purpose of this study was to investigate the effects of rTMS followed by task-oriented training on cortical excitability and walking performance in individuals with chronic stroke. Methods. A total of 24 patients with average Fugl-Meyer lower limb scores of 17.88 ± 5.27 and average walking speeds of 63.81 ± 18.25 cm/s were randomized into an experimental group and a control group. Participants received rTMS (experimental group) or sham rTMS (control group) followed by task-oriented training (30 minutes) for 10 sessions over 2 weeks. Repetitive TMS was applied at a 1-Hz frequency over the leg area of the motor cortex of the unaffected hemisphere for 10 minutes. Outcomes, including motor-evoked potential (MEP), lower-extremity Fugl-Meyer score, and gait performance, were measured before and after training. Results. Decreased interhemispheric asymmetry of the amplitude of the MEP was noted after rTMS and task-oriented training. Improvement in spatial asymmetry of gait was comparable with increased symmetry in interhemispheric excitability. Motor control and walking ability were also significantly improved after rTMS and task-oriented training. Conclusions. rTMS enhances the effect of task-oriented training in those with chronic stroke, especially by increasing gait spatial symmetry and corticomotor excitability symmetry.

N-Alkenyl and N-alkoxymethyl lactams are impervious to many reagents and are useful protecting groups for lactams. Conversion to the corresponding 2-ethoxy iminium salt and hydrolysis in neutral water removes the protecting group. Mild basification regenerates the lactam.

N-Alkenyl and N-alkoxymethyl lactams are impervious to many reagents and are useful protecting groups for lactams. Conversion to the corresponding 2-ethoxy iminium salt and hydrolysis in neutral water removes the protecting group. Mild basification regenerates the lactam.

Docetaxel (Taxotere(®)) is an agent that is indicated for the treatment of patients with locally advanced or metastatic non-small-cell lung cancer. In recent years, docetaxel-related interstitial lung disease (ILD) has been reported in several case series studies. The onset of ILD occurred ~10-20 days (median time: 18 days) after docetaxel administration. Here, we reported the case of a patient who had pulmonary toxicity of ILD within 3 days after using a relatively low-dose docetaxel administration. Although some articles have described patients who progressed to respiratory failure and needed intubation, this patient responded well to steroid treatment and discontinued docetaxel administration.

A procedure is presented for preparation of diffraction-quality crystals of a vertebrate mitochondrial respiratory complex II. The crystals have the potential to diffract to at least 2.0 A with optimization of post-crystal-growth treatment and cryoprotection. This should allow determination of the structure of this important and medically relevant membrane-protein complex at near-atomic resolution and provide great detail of the mode of binding of substrates and inhibitors at the two substrate-binding sites.

This study proposes a mediated non-recursive model based on Amabile's (1988) componential theory of organizational creativity and innovation to explain how resources, management practices, organizational motivation, expertise, creativity skills and intrinsic motivation affect innovation and creativity in organizations. Based on the results of a longitudinal survey, with 586 leader-follower dyadic data drawn from firms in the service industries in Taiwan, we found that resources, management practices and organizational motivation have unique positive direct effects on innovation, while expertise, creativity skills and intrinsic motivation have unique positive direct effects on creativity. Further, a bootstrapping estimation based on structural equation modeling (SEM) revealed that innovation mediates the positive indirect effects of resources, management practices and organizational motivation on creativity, while creativity mediates the positive indirect effects of expertise, creativity skills and intrins...

We developed and tested a model of individual performance, integrating leader-member exchange theory (LMX) and creativity research. Using structural equation modeling (SEM), we found mediating role...