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Wan G.-H.,Chang Gung University | Chung F.-F.,Chang Gung Institute of Technology | Tang C.-S.,Fu Jen Catholic University
American Journal of Infection Control | Year: 2011

Background: Maintenance of adequate indoor air quality (IAQ) in operating rooms (ORs) is critical to the prevention of nosocomial infection in hospitalized patients. This study evaluated the characteristics of IAQ in various ORs in a medical center. Methods: Air temperature, relative humidity, carbon dioxide (CO 2), particulate matter (PM), and bacterial concentrations were monitored in the ORs, and monthly variations were noted. Results: The mean CO 2 concentrations in the ORs were lower than the suggested level (600 ppm average over 8 hours) set by Taiwan's Environmental Protection Agency. Positive relationships were found among the number of persons, temperature (Spearman's rho coefficient [r s] = 0.19; P < .01), and CO 2 concentration (r s = 0.34; P < .01) in the OR. Bacterial concentration was significantly associated with PM level when adjusted for OR category and the number of persons in the room. Gram-positive bacteria (eg, Bacillus spp, Micrococcus spp, Staphylococcus spp) were frequently found in the monitored ORs. Conclusion: The IAQ in the ORs varied significantly from month to month. The number of persons in the OR affected IAQ, and a decreased PM level might indicate reduced microbial contamination in the OR. Copyright © 2011 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. Source


Wang H.-H.,Chang Gung University | Hsieh H.-L.,Chang Gung Institute of Technology | Yang C.-M.,Chang Gung University
Journal of Cellular Physiology | Year: 2011

The deleterious effects of endothelin-1 (ET-1) in the central nervous system (CNS) include disturbance of water homeostasis and blood-brain barrier (BBB) integrity. In the CNS, ischemic injury elicits ET-1 release from astrocytes, behaving through G-protein coupled ET receptors. These considerations raise the question of whether ET-1 influences cellular functions of astrocytes, the major cell type that provides structural and functional support for neurons. Uncontrolled nitric oxide (NO) production has been implicated in sterile brain insults, neuroinflammation, and neurodegenerative diseases, which involve astrocyte activation and neuronal death. However, the detailed mechanisms of ET-1 action related to NO release on rat brain astrocytes (RBA-1) remain unknown. In this study, we demonstrate that exposure of astrocytes to ET-1 results in the inducible nitric oxide synthase (iNOS) up-regulation, NO production, and matrix metalloproteinase-9 (MMP-9) activation in astrocytes. The data obtained with Western blot, reverse transcription-PCR (RT-PCR), and immunofluorescent staining analyses showed that ET-1-induced iNOS expression and NO production were mediated through an ETB-dependent transcriptional activation. Engagement of Gi/o- and Gq-coupled ETB receptors by ET-1 led to activation of c-Src-dependent phosphoinositide 3-kinase (PI3K)/Akt and p42/p44 mitogen-activated protein kinase (MAPK) and then activated transcription factor nuclear factor-κB (NF-κB). The activated NF-κB was translocated into nucleus and thereby promoted iNOS gene transcription. Ultimately, NO production stimulated by ET-1 enhanced the migration of astrocytes through the tyrosine nitration of MMP-9. Taken together, these results suggested that in astrocytes, activation of NF-κB by ETB-dependent c-Src, PI3K/Akt, and p42/p44 MAPK signalings is necessary for ET-1-induced iNOS gene up-regulation. © 2010 Wiley-Liss, Inc. Source


Hsu M.-H.,Chang Gung Institute of Technology
Expert Systems with Applications | Year: 2011

This paper proposes a recommender system to assist second-language nurses, especially student nurses, in patient care charting. Using data mining association rules, the system automatically provides optimal words or terms for the nurse to choose from as she or he proceeds with the documentation. The system, having been tested on Taiwanese nursing students who needed to chart in their practicum at hospitals, has been found to be highly effective for the intended purpose. © 2011 Published by Elsevier Ltd. Source


Background and purpose: Acurhagin, a member of versatile metalloproteinase disintegrins from Agkistrodon acutus venom, has been identified as a platelet aggregation inhibitor, previously. Here, acurhagin-C, the C-terminal Glu-Cys-Asp (ECD)-containing fragment of acurhagin, was evaluated for its biological activities and potential applications in anti-angiogenic therapy. Experimental approach: Human umbilical vein endothelial cells (HUVECs) were treated with acurhagin-C to assay effects on viability, apoptosis, adhesion, migration, invasion, proliferation and angiogenesis. The recognition site and signalling involved for the interactions of acurhagin-C with HUVEC were determined using flow cytometric, electrophoresis and immunoblotting analyses. Key results: Acurhagin-C decreased viability and induced apoptosis in HUVEC. It also dose-dependently inhibited HUVEC adhesion to immobilized extracellular matrices fibronectin, collagen I and vitronectin with respective IC50 values of approximately 0.6, 0.3 and 0.1 μM. Acurhagin-C prevented migration and invasion of HUVEC through vitronectin- and Matrigel-coated barriers respectively. Furthermore, acurhagin-C attenuated fibroblast growth factor-2-primed angiogenesis both in vitro and in vivo, and specifically blocked the binding of anti-αvβ3 monoclonal antibody 23C6 to HUVEC in an ECD-dependent manner. However, purified αvβ3 also dose-dependently bound to immobilized acurhagin and acurhagin-C with a saturable pattern. Interference with integrin αvβ3-mediated functions and promotion of caspase-3 activation by acurhagin-C affected morphology of HUVEC and induced apoptosis. Conclusions and implications: Acurhagin-C elicited endothelial anoikis via disruption of αvβ3/focal adhesion kinase/ phosphatidylinositol 3-kinase/Akt survival cascade and subsequent initiation of the procaspase-3 apoptotic signalling pathway. © 2010 The British Pharmacological Society. Source


Liou S.-R.,Chang Gung Institute of Technology | Cheng C.-Y.,Taipei Medical University
Journal of Clinical Nursing | Year: 2010

Aims and objectives: To examine: (1) Taiwanese nurses' perceptions of organisational climate, levels of organisational commitment and intention to leave, as well as relationships between these three variables; (2) demographic differences in the levels of these variables; and (3) mediating effects of organisational commitment on the relationship between organisational climate and intention to leave. Background: Organisational climate is related to organisational commitment and affects nurses' performances and attitudes towards an organisation. Design: A cross-sectional, descriptive design. Method: Registered nurses working in eight hospitals in southern Taiwan for more than six months were recruited. Data were collected using the Litwin and Stringer's Organisational Climate Questionnaire, Organizational Commitment Questionnaire and a five-item scale measuring intention to leave. Questionnaires were distributed to 612 potential participants; 486 valid returned questionnaires were analysed. Results: The study's participants were generally satisfied with their hospital's climate and yet claimed low commitment to their organisation and, nevertheless, reported low intention to leave their job. Single nurses were more satisfied with their hospital's climate and were more committed to their hospital and had a lower intention to leave their job compared to married nurses. Nurses working in district hospitals perceived a better hospital climate and had a lower intention to leave than nurses working in teaching or regional hospitals. Staff nurses perceived a better organisational climate than did nurse managers. Organisational climate, organisational commitment and intention to leave were intercorrelated. Organisational climate had almost 60% indirect effect on organisational commitment related to intention to leave. Conclusions: Creating a good organisational climate may increase nurses' organisational commitment and, in turn, decrease their intention to leave. Relevance to clinical practice: To motivate nurses' positive organisational behaviours and to address their diverse needs, hospital administrators are encouraged to understand nurses' work-climate perceptions and to address nurses' varied demographic factors. © 2010 Blackwell Publishing Ltd. Source

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