EMRS Adoption: Exploring the effects of information security management awareness and perceived service quality

Objectives

This study proposes a research model that combines information system (IS) continuance theory with the DeLone and McLean IS success model to more clearly comprehend the influences of system characteristics on electronic health record system (EMRS) adoption. As Information security management (ISM) awareness enables health workers to be better able to prevent security violations, this study further explores the effects of perceived service quality on the relationship between ISM awareness and system characteristics of EMRS.

PM<Subscript>10</Subscript> concentration in relation to clinic visits for anxiety disorders: a population-based study of a high river-dust episode region in Taiwan

PM₁₀ exposure has been found to have significant effects on a variety of physical conditions. However, whether it acts on psychopathology remains unclear. This study used 8-year data to examine the relationship between PM₁₀ concentration and daily clinic visits of anxiety disorders. All residents of Yunlin County, Taiwan, which is a high river-dust exposure area, were selected as subjects. Data from the Taiwan National Health Insurance Research Database (NHIRD), 2002–2009, were analyzed. Individuals with any ICD code of 300.0 and 300.2 were categorized as with anxiety disorders. PM₁₀ data were based on the Lunbei station (located at Yunlin County) of EPA, Taiwan. Time-series analysis showed that, during the observed 8 years, the number of daily clinic visits for anxiety disorders increased with PM₁₀ levels, and the relationship remained significant after unemployment rate, and the Weighted Price Index of Taiwan Stock Exchange in the same period were controlled for. In particular, we found that there is a linear dose-response effect between daily clinic visits and PM₁₀ levels when PM₁₀ <?300 μg/m³; whereas a dramatically elevated daily clinic visits of anxiety disorders was found when PM₁₀ >?300 μg/m³. Findings from this study highlight that high level of PM₁₀ exposure derived from severe weather or environment condition may affect the occurrence of anxiety disorders. In addition, there seems to have a threshold of PM₁₀ in elevating the risk of anxiety disorders.     

Clinicoepidemiologic characteristics of scrub typhus and murine typhus: A multi-center study in southern Taiwan

BackgroundThis study aimed to offer key features to differentiate scrub typhus (ST) and murine typhus (MT) at the early stage of the diseases and provide clinicoepidemiologic characteristics of ST and MT in southern Taiwan, a region where both diseases are endemic. Comparison of doxycycline treatment efficacy between the two diseases by matching disease severity and delayed treatment had never been investigated.MethodsWe reviewed the medical records of cases of ST and MT in four hospitals in southern Taiwan. Propensity-score matching was used to analyze the defervescence curves between patients with doxycycline-treated ST and MT by log-rank test.ResultsBetween 2004 and 2016, 265 ST and 63 MT cases were diagnosed. The number of cases of ST was significantly related to temperature (Rs = 0.77) and rainfall (Rs = 0.63). Island area exposure, arthropod bite, eschar, and lymphadenopathy were only recorded in ST patients. Multivariate analysis revealed that mountainous area exposure (odds ratio [OR], 11.0; 95% confidence interval [CI], 4.4–27.2) was an independent predictor for ST, while contact with rats (OR, 8.4; 95% CI, 3.3–21.3) was that for MT. After propensity-score matching, there was no difference in defervescence curves between these two rickettsioses treated with doxycycline (p = 0.24).ConclusionIn the present study, island area exposure, arthropod bite, eschar, and lymphadenopathy were unique manifestations of ST. Mountainous area exposure is a predictive factor for ST, while contact with rats predicted MT. There was no difference in defervescence time between these two rickettsioses after doxycycline treatment.     

Functional Silica and Carbon Nanocomposites Based on Polybenzoxazines

The preparation of organic/inorganic hybrid materials comprising a polybenzoxazine (PBZ) matrix incorporating silicon‐based species (e.g., polydimethylsiloxane [PDMS], layered silicates [clays], and polyhedral oligomeric silsesquioxanes [POSS]) and carbon‐based materials (e.g., carbon black, carbon fibers, carbon nanotubes, and graphene) has received much attention in recent years because these composites display low water absorption, low surface free energy, low dielectric constants, flame‐retardancy, and excellent thermal and mechanical properties. This short review article describes the chemical and physical approaches that are used to prepare PBZs incorporating silica and carbon nanocomposites. In addition, recent reports of their physical properties are discussed, covering their dielectric constants and dynamic mechanical, thermal, electrical, and surface properties.     

Expression of CD44s, CD44v5, CD44v6 and CD44v7-8 in betel quid chewing-associated oral premalignant lesions and squamous cell carcinomas in Taiwan

Aberrant expression of the cell surface adhesion molecule CD44 and its variant forms has been shown to be associated with the invasive and metastatic potential of cancer cells, and with poor prognosis in several types of cancers. Expression of CD44 standard (CD44s) and variant (CD44v) forms in oral squamous cell carcinoma (SCC), epithelial dysplasia (ED), epithelial hyperkeratosis (EH) and normal buccal mucosa (NBM) have been examined using antibodies to CD44s, CD44v5, CD44v6 and CD44v7-8. Positive CD44s, CD44v5, CD44v6 and CD44v7-8 staining was detected in all the specimens from NBM, EH and ED. Positive staining of CD44s, CD44v5, CD44v6 or CD44v7-8 was detected in 55 (88.7%), 48 (77.4%), 59 (95.2%) and 22 (35.5%) of the 62 SCC specimens, respectively. The positive staining of CD44v7-8 in oral SCC was significantly less than that in NBM ( P <0.01). No significant correlation was found between CD44v7-8 expression and daily or total consumption of betel quids or cigarettes by the SCC patients. The 5-year survival rate for patients with CD44v7-8-positive tumours was significantly higher than that for the CD44v7-8-negative group ( P <0.03). These results indicate that loss of CD44v7-8 expression may be a valuable factor for determining prognosis in oral SCC patients.     

Endovascular therapy in the emergent management of intractable hemorrhage associated with head and neck neoplasms

Oral Radiology - To evaluate the feasibility, safety, and efficacy of endovascular interventions in the emergent management of life-threatening hemorrhage associated with head and neck neoplasm....     

Effect of mechanical loading on electrical conductivity in porcine TMJ discs

The objective of this study was to examine the impact of mechanical loading on solute transport in porcine temporomandibular joint (TMJ) discs using the electrical conductivity method. The electrical conductivity, as well as ion diffusivity, of TMJ discs was determined under confined compression with 3 strains in 5 disc regions. The average electrical conductivity over the 5 regions (mean ± SD) at 0% strain was 3.10 ± 0.68 mS/cm, decreased to 2.76 ± 0.58 mS/cm (-11.0%) at 10% strain, and 2.38 ± 0.55 mS/cm (-22.2%) at 20% compressive strain. Correspondingly, the average relative ion diffusivity (mean ± SD) at 0% strain was 0.273 ± 0.055, decreased to 0.253 ± 0.048 (-7.3%) at 10% strain, and 0.231 ± 0.048 (-15.4%) at 20% compressive strain. These results indicated that compressive strain impeded solute transport in the TMJ disc. Furthermore, our results showed that the transport properties of TMJ discs were region-dependent. The electrical conductivity and ion diffusivity in the anterior region were significantly higher than in the posterior region. This regional difference is likely due to the significant differences of tissue hydration between these 2 regions. This study provides important insight into the electrical and solute transport behaviors in TMJ discs under mechanical loading and aids in the understanding of TMJ pathophysiology related to tissue nutrition.     

A scoring system for the early detection of oral submucous fibrosis based on a self-administered questionnaire

OBJECTIVES: The aims of the present study were to evaluate the frequent clinical complaints of oral submucous fibrosis (OSF) and to develop a scoring system for early detection of the disease by a self-administered questionnaire. METHODS: A total of 296 subjects were recruited, including 123 OSF patients without oral cancer and 173 betel quid chewers without OSF or oral cancer. A self-administered questionnaire was used to collect the symptom profile from study subjects. Their maximal mouth opening (MMO) between upper and lower incisor edges was measured and recorded by well-trained nurses. A binary logistic regression model examining the likelihood of OSF based on the eight symptoms of interest was used to develop the scoring system. RESULTS: Among 79 OSF subjects with an MMO < 35 mm, the most frequent complaint was trismus (87.3%), followed by burning sensation (76.0%) and xerostomia (72.2%). Among 44 OSF subjects with an MMO > or = 35 mm, burning sensation (68.2%) was the most frequent complaint, followed by trismus (54.5%) and xerostomia (54.5%). Six frequent complaints including trismus, burning sensation, xerostomia, sore throat, numbness, and oral ulceration were utilized to develop a scoring system for the early detection of OSF. The scoring system had an area under the receiver operating characteristic curve of 0.90. CONCLUSION: This study suggests a screening questionnaire of frequent complaints for the early detection of OSF.     

Long-term Results of Comprehensive Clubfoot Release Versus the Ponseti Method: Which Is Better?

Background

Clubfoot can be treated nonoperatively, most commonly using a Ponseti approach, or surgically, most often with a comprehensive clubfoot release. Little is known about how these approaches compare with one another at longer term, or how patients treated with these approaches differ in terms of foot function, foot biomechanics, or quality-of-life from individuals who did not have clubfoot as a child.

Questions/purposes

We compared (1) focused physical and radiographic examinations, (2) gait analysis, and (3) quality-of-life measures at long-term followup between groups of adult patients with clubfoot treated either with the Ponseti method of nonsurgical management or a comprehensive surgical release through a Cincinnati incision, and compared these two groups with a control group without clubfoot.

Methods

This was a case control study of individuals treated for clubfoot at two separate institutions with different methods of treatment between 1983 to 1987. One hospital used only the Ponseti method and the other mainly used a comprehensive clubfoot release. There were 42 adults (24 treated surgically, 18 treated with Ponseti method) with isolated clubfoot along with 48 healthy control subjects who agreed to participate in a detailed analysis of physical function, foot biomechanics, and quality-of-life metrics.

Results

Both treatment groups had diminished strength and motion compared with the control subjects on physical examination measures; however, the Ponseti group had significantly greater ankle plantar flexion ROM (p < 0.001), greater ankle plantar flexor (p = 0.031) and evertor (p = 0.012) strength, and a decreased incidence of osteoarthritis in the ankle and foot compared with the surgical group. During gait the surgical group had reduced peak ankle plantar flexion (p = 0.002), and reduced sagittal plane hindfoot (p = 0.009) and forefoot (p = 0.008) ROM during the preswing phase compared with the Ponseti group. The surgical group had the lowest overall ankle power generation during push off compared with the control subjects (p = 0.002). Outcome tools revealed elevated pain levels in the surgical group compared with the Ponseti group (p = 0.008) and lower scores for physical function and quality-of-life for both clubfoot groups compared with age-range matched control subjects (p = 0.01).

Conclusions

Although individuals in each treatment group experienced pain, weakness, and reduced ROM, they were highly functional into early adulthood. As adults the Ponseti group fared better than the surgically treated group because of advantages including increased ROM observed at the physical examination and during gait, greater strength, and less arthritis. This study supports efforts to correct clubfoot with Ponseti casting and minimizing surgery to the joints, and highlights the need to improve methods that promote ROM and strength which are important for adult function.

Level of Evidence

Level III, prognostic study.     

Cachectin/tumor necrosis factor induces cachexia, anemia, and inflammation

Cachexia is a potentially lethal syndrome of unknown etiology characterized by anorexia, weight loss, and protein wasting that frequently complicates the treatment of chronic inflammation and cancer. Cachectin/TNF was isolated during the search for a humoral mediator of cachexia and found to stimulate the breakdown of energy stores from adipocytes and myocytes in vitro, but the chronic effects of the monokine in vivo are not known. Sublethal doses of recombinant human cachectin administered twice daily for 7-10 d caused cachexia in rats, as evidenced by reduced food intake, weight loss, and depletion of whole-body lipid and protein stores. Significant anemia is also observed and found to be the result of decreased red blood cell mass, not expanded plasma volume. Leukocytosis and histopathological evidence of tissue injury and inflammation are observed in several organs, including omentum, liver, spleen, and heart. These data suggests that the exposure of the normal host to cachectin is capable of inducing a pathophysiological syndrome of cachexia, anemia, and inflammation similar to that observed during inflammatory states or malignancy.