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Resilience, the 6th Vital Sign: Conceptualizing, Contextualizing, and Operationalizing All Six Vital Signs

Health 2024年第7期16卷 657-673页

作者： Rose E. Constantino Betty J. Braxter chi ching vivian hui Larissa C. Allen Lillian J. Wolfe Katherine H. Endres Jezyl Cempron Cutamora Laurence L. Garcia Daisy R. Palompon Kathleen Thimsen Brayden N. Kameg Margarete L. Zalon Department of Health and Community Systems School of Nursing University of Pittsburgh Pittsburgh PA USA Undergraduate Affairs School of Nursing University of Pittsburgh Pittsburgh PA USA The Hong Kong Polytechnic University Hong Kong China School of Nursing Adjunct Faculty at the University of Pittsburgh Pittsburgh PA USA School of Nursing University of Pittsburgh Pittsburgh PA USA Department of Health Promotion and Development School of Nursing University of Pittsburgh Pittsburgh PA USA College of Nursing Cebu Normal University Cebu City Philippines School of Nursing University of Nevada Las Vegas USA Department of Health and Community Systems University of Pittsburgh PA USA Department of Nursing University of Scranton Scranton PA USA

There are five vital signs that healthcare providers assess: temperature, pulse, respiration, blood pressure, and pain. Normal levels for the five vital signs are published by the American Heart Association, and other specialty organizations, however, the sixth vital sign (resilience) which adopts the measure of immune resilience is suggested in this paper. Resilience is the ability of the immune system to respond to attacks and defend effectively against infections and inflammatory stressors, and psychological resilience is the capacity to resist, adapt, recover, thrive, and grow from a challenge or a stressor. Individuals with better optimal immune resilience had better health outcomes than those with minimal immune resilience. The purpose of this paper is to conceptualize, contextualize, and operationalize all six vital signs. We suggest measuring resilience subjectively and objectively. Subjectively, use a 5-item guided interview revised from the Connor-Davidson Resilience Scale (CDRC), a scale of 10 items. The revised CDRC scale is a 5-item scale. The scale is rated on a 5-point Likert scale from 0 (not true) to 4 (true all the time). The total score ranges from 0 to 20, with higher total scores indicating greater resilience. The scale demonstrated good construct validity and internal consistency (α = 0.85) during the development of the scale. The CD-RISC had a good Cronbach’s alpha level of 0.85. The Revised CD-RISC can be completed in 2 - 4 minutes. To measure resilience objectively, we suggest using Immune Resilience (IR) levels, the level of resilience to preserve and/or rapidly restore immune resilience functions that promote disease resistance and control inflammation and other inflammatory stress. IR levels are gauged with two peripheral blood metrics that quantify the balance between CD8 and CD4 T-cell levels and gene expression signatures tracking longevity-associated immunocompetence and mortality- or entropy-associated inflammation. IR deregulation i

关键词： Conceptualization Contextualization Operationalization Body Temperature Pulse Respiration Blood Pressure Pain Resilience

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Molecular Advances in Severe Acute Respiratory Syndrome-associated Coronavirus (SARS-CoV)

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Genomics, Proteomics & Bioinformatics 2003年第4期1卷 247-262页

作者： Raymond Kin Hi hui Raymond Tsz Yeung Wong chi Wai Yip Frederick chi ching Leung Department of Zoology The University of Hong Kong Hong Kong SAR China.Department of Zoology The University of Hong Kong Hong Kong SAR China.Department of Zoology The University of Hong Kong Hong Kong SAR China.Department of Zoology The University of Hong Kong Hong Kong SAR China.

The sudden outbreak of severe acute respiratory syndrome (SARS) in 2002 prompted the establishment of a global scientific network subsuming most of the traditional rivalries in the competitive field of virology. Within months of the SARS outbreak, collaborative work revealed the identity of the disastrous pathogen as SARS-associated coronavirus (SARS-CoV). However, although the rapid identifi-

关键词： severe acute respiratory syndrome SARS-CoV genome phylogenetics human leukocyte antigen (HLA) system molecular epidemiology

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Quantitative structure-activity relationships of antimicrobial fatty acids and derivatives against Staphylococcus aureus

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第2期13卷 83-93页

作者： hui ZHANG Lu ZHANG Li-juan PENG Xiao-wu DONG Di WU vivian chi-Hua WU Feng-qin FENG Department of Food Science and Nutrition Zhejiang UniversityHangzhou 310058China ZJU-ENS Joint Laboratory of Medicinal Chemistry College of Pharmaceutical SciencesZhejiang UniversityHangzhou 310058China Department of Food Science and Human Nutrition University of MaineOrono 04469USA

Fatty acids and derivatives(FADs)are resources for natural *** order to screen for additional potent antimicrobial agents,the antimicrobial activities of FADs against Staphylococcus aureus were examined using a microplate *** of fatty acids were the most potent class of fatty acids,among which monotridecanoin possessed the most potent antimicrobial *** conventional quantitative structure-activity relationship(QSAR)and comparative molecular field analysis(CoMFA)were performed to establish two statistically reliable models(conventional QSAR:R2=0.942,Q 2 LOO=0.910;CoMFA:R 2=0.979,Q 2=0.588,respectively).Improved forecasting can be achieved by the combination of these two models that provide a good insight into the structureactivity relationships of the FADs and that may be useful to design new FADs as antimicrobial agents.

关键词： Fatty acid derivatives Quantitative structure-activity relationship Comparative molecular field analysis Antimicrobial activity

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Amniotic membrane transplantation in a patient with impending perforated corneal ulcer caused by Streptococcus mitis: A case report and review of literature

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World Journal of Clinical Cases 2022年第12期10卷 3923-3929页

作者： Fang-chi Hsiao Yaa-Jyuhn James Meir Lung-Kun Yeh Hsin-Yuan Tan ching-Hsi Hsiao David hui-Kang Ma Wei-chi Wu Hung-chi Chen Department of Ophthalmology Chang Gung Memorial HospitalTaoyuan 333423Taiwan Biomedical Sciences College of MedicineChang Gung UniversityTaoyuan 33305Taiwan Department of Medicine College of MedicineChang Gung UniversityTaoyuan 33305Taiwan Center for Tissue Engineering Chang Gung Memorial HospitalTaoyuan 333423Taiwan

BACKGROUND Streptococcus mitis(***)is an opportunistic pathogen that can lead to severe ocular *** previous reports,penetrating keratoplasty(PK)was usually adopted for the treatment of persistent corneal *** report describes an unusual case of nonhealing descemetocele caused by *** treated by antibiotics plus amniotic membrane transplantation(AMT).CASE SUMMARY A 63-year-old woman presented with a right persistent corneal ulcer that she had suffered from for the past 9 *** culture of a corneal scraping yielded *** right eye descemetocele decreased in diameter from 3 to 0.8 mm after the continuous administration of topical vancomycin and ceftriaxone for 2 *** to the slow healing,AMT was *** corneal erosion healed and gradually became *** visual acuity recovered from initially counting fingers to 100/200 at the last follow-up,67 mo after *** Antibiotics plus AMT may be an effective alternative treatment other than PK to promote epithelializationand to reduce inflammation in the corneas complicated by S. mitis keratitis.

关键词： Persistent corneal ulcer Amniotic membrane transplantation Streptococcus mitis Case report

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Prostacyclin inhibition by indomethacin aggravates hepatic damage and encephalopathy in rats with thioacetamide-induced fulminant hepatic failure

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World Journal of Gastroenterology 2005年第2期11卷 232-236页

作者： chi-JenChu ching-chinHsiao Teh-FangWang Cho-YuChan Fa-YauhLee Full-YoungChang Yi-ChouChen hui-ChunHuang Sun-SangWang Shou-DongLee DivisionofGastroenterology DepartmentofMedicineTaipeiVeteransGeneralHospitalTaipeiTaiwanChina ArmedForcesSungshanHospital TaipeiTaiwanChina DepartmentofMedicalResearchandEducation TaipeiVeteransGeneralHospitalTaipeiTaiwanChina//NationalYang-MingUniversitySchoolofMedicineTaipeiTaiwanChina DivisionofGastroenterology DepartmentofMedicineTaipeiVeteransGeneralHospitalTaipeiTaiwanChina//DivisionofGeneralMedicineDepartmentofMedicineTaipeiVeteransGeneralHospitalTaipeiTaiwanChina TaipeiMunicipalGan-DauHospital TaipeiTaiwanChina//NationalYang-MingUniversitySchoolofMedicineTaipeiTaiwanChina DivisionofGastroenterology DepartmentofMedicineTaipeiVeteransGeneralHospitalTaipeiTaiwanChina//NationalYang-MingUniversitySchoolofMedicineTaipeiTaiwanChina

AIM: Vasodilatation and increased capillary permeability have been proposed to be involved in the pathogenesis of acute and chronic form of hepatic encephalopathy. Prostacyclin (PGI2) and nitric oxide (NO) are important contributors to hyperdynamic circulation in portal hypertensive states. Our previous study showed that chronic inhibition of NO had detrimental effects on the severity of encephalopathy in thioacetamide (TAA)-treated rats due to aggravation of liver damage. To date, there are no detailed data concerning the effects of PGI2 inhibition on the severity of hepatic encephalopathy during fulminant hepatic failure. METHODS: Male Sprague-Dawley rats weighing 300-350 g were used. Fulminant hepatic failure was induced by intraperitoneal injection of TAA (350 mg/(kg·d) for 3 d. Rats were divided into two groups to receive intraperitoneal injection of indomethacin (5 mg/(kg·d), n = 20) or normal saline (N/S, n = 20) for 5 d, starting 2 d before TAA administration. Severity of encephalopathy was assessed by the counts of motor activity measured with Opto-Varimex animal activity meter. Plasma tumor necrosis factor-α (TNF-α, an index of liver injury) and 6-keto-PGF1α (a metabolite of PGI2) levels were measured by enzyme-linked immunosorbent assay. RESULTS: As compared with N/S-treated rats, the mortality rate was significantly higher in rats receiving indomethacin (20% vs5%, P0.05), as compared with rats treated with N/S. CONCLUSION: Chronic indomethacin administration has detrimental effects on the severity of encephalopathy in TAA-treated rats and this phenomenon may be attributed to the aggravation of live

关键词： Hepatic Encephalopathy Fulminant hepatic failure Prostacyclin Indomethacin

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Poorly expandable common bile duct with stones on endoscopic retrograde cholangiography

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World Journal of Gastroenterology 2012年第19期18卷 2396-2401页

作者： chi-Liang Cheng Yung-Kuan Tsou Cheng-hui Lin Jui-Hsiang Tang hien-Fu Hung Kai-Feng Sung ching-Song Lee Nai-Jen Liu Division of Therapeutic Endoscopy Department of Gas-troenterology and Hepatology Chang Gung Memorial HospitalCollege of Medicine Chang Gung University Taoyuan 333Taiwan China Division of Radiology Department of Gastro-enterology and Hepatology College of Medicine Chang GungUniversity Taoyuan 333 Taiwan China

AIM： To describe characteristics of a poorly expandable （PE） common bile duct （CBD） with stones on en- doscopic retrograde cholangiography.METHODS： APE bile duct was characterized by a rigid and relatively narrowed distal CBD with retro- grade dilatation of the non-PE segment. Between 2003 and 2006, endoscopic retrograde cholangiography （ERC） images and chart reviews of 1213 patients with newly diagnosed CBD stones were obtained from the computer database of Therapeutic Endoscopic Centerin Chang Gung Memoria acteristic PE bile duct on Hospital. Patients with char ERC were identified from the database. Data of the patients as well as the safety and technical success of therapeutic ERC were collected and analyzed retrospectively.RESULTS： A total of 30 patients with CBD stones and characteristic PE segments were enrolled in this study. The median patient age was 45 years （range, 20 to 92 years）; 66.7% of the patients were men. The di ameters of the widest non-PE CBD segment, the PE segment, and the largest stone were 14.3 ± 4.9 mm, 5.8±1.6 mm, and 11.2±4.7 mm, respectively. The length of the PE segment was 39.7±15.4 mm （range, 12.3 mm to 70.9 mm）. To remove the CBD stone（s） completely, mechanical lithotripsy was required in 25 （83.3%） patients even though the stone size was not as large as were the difficult stones that have been described in the literature. The stone size and stone/ PE segment diameter ratio were associated with the need for lithotripsy. Post-ERC complications occurred in 4 cases： pancreatitis in 1, cholangitis in 2, and an im- pacted Dormia basket with cholangitis in 1. Two （6.7%） of the 28 patients developed recurrent CBD stones at follow-up （50±14 mo） and were successfully managed with therapeutic ERC.CONCLUSION： Patients with a PE duct frequently require mechanical lithotripsy for stones extraction, To retrieve stones successfully and avoid complications, these patients should be identified during ERC,

关键词： Common bile duct stone Difficult stone Endoscopic retrograde cholangiography Mechanicallithotripsy

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Numerical study of the effects of check dams on erosion and sedimentation in the Pachang River

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International Journal of Sediment Research 2013年第3期28卷 304-315页

作者： hui-ming HSIEH ching-ruey LUO Jinn-chuang YANG Rou-fei CHEN Department of Computer Science and Multimedia Design Taiwan Shoufu University Department of Civil Engineering National Chi-Nan University Dept.of Civil Engineering National Chiayio Tung University Department of Geology Chinese Culture University

Scouring and deposition processes resulting from variable rainfall and typhoon occurrence in tropical climatic conditions induce significant changes in the riverbeds of *** the Pachang River of western Taiwan,severe damage occurs during typhoons due to large and sudden variations in discharge,erosion,sediment transport and *** order to simulate this process,the NETSTARS numerical modeling tool was used in the present *** influence of existing and planned check dam structures on flow control was also analyzed to determine their capacity to resist river erosion or to not be buried beneath *** only does the modeling tool allow calculation of the erosion-deposition behavior at the scale of the whole river,but it also provides local determination of the optimum location and characteristics such as foundation depth and lateral encroachment of future check *** results of a 10-year,long-term modeling simulation in terms of riverbed stability and scouring potential thus provide insights about unsafe future behavior at 4 *** numerical model provides a better general understanding and useful information for the optimal prevention of both the scouring damage and the burial related to sediment deposition with large changes in discharge and sediment transport.

关键词： NETSTARS model River bed erosion Check dam Pachang River

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Implications of anti-parietal cell antibodies and anti-Helicobacter pylori antibodies in histological gastritis and patient outcome

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World Journal of Gastroenterology 2005年第30期11卷 4715-4720页

作者： ching-Chu Lo Ping-I Hsu Gin-Ho Lo Kwok-Hung Lai hui-Hwa Tseng chiun-Ku Lin Hoi-Hung Chan Wei-Lun Tsai Wen-chi Chen Nan-Jing Peng Division of Gastroenterology Department of Internal Medicine Kaohsiung Veterans General Hospital and St. Martin De Porres HospitalNational Yang-Ming University Kaohsiung Taiwan China Department of Pathology Kaohsiung Veterans General Hospital and National Yang-Ming University KaohsiungTaiwan China Department of Nuclear Medicine Kaohsiung Veterans General Hospital and National Yang-Ming University Kaohsiung Taiwan China

AIM： To develop a serum or histological marker for early discovery of gastric atrophy or intestinal metaplasia. METHODS： This study enrolled 44 patients with gastric adenocarcinoma, 52 patients with duodenal ulcer, 14 patients with gastric ulcer and 42 consecutive healthy adults as controls. Each patient received an endoscopy and five biopsy samples were obtained. The degrees of histological parameters of gastritis were categorized following the Updated Sydney System. Anti-parietal cell antibodies （APCA） and anti- Helicobacter pylori （ H pylori） antibodies （AHPA） were analyzed by immunoassays. Hpyloriinfection was diagnosed by rapid unease test and histological examination. RESULTS： Patients with gastric cancer and gastric ulcer are significantly older than healthy subjects, while also displaying higher frequency of APCA than healthy controls. Patients with positive APCA showed higher scores in gastric atrophy and intestinal metaplasia of corpus than patients with negative APCA. Patients with positive AHPA had higher scores in gastric atrophy, intestinal metaplasia, and gastric inflammation of antrum than those patients with negative AHPA. Elderly patients had greater prevalence rates of APCA. Following multivariant logistic regression analysis, the only significant risk factor for antral atrophy is positive AHPA, while that for corpus atrophy is positive APCA. CONCLUSION： The existence of positive APCA correlates with glandular atrophy in corpus and the presence of positive AHPA correlates with glandular atrophy in antrum. The existence of serum APCA and AHPA betokens glandular atrophy and requires further examination for gastric cancer.

关键词： Glandular atrophy Intestinal metaplasia Gastriccancer Anti-parietal cell antibody Anti-Helicobacter pylori antibodies

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Recently acquired hepatitis C virus infection among people living with human immunodeficiency virus at a university hospital in Taiwan

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World Journal of Gastroenterology 2021年第37期27卷 6277-6289页

作者： Miao-hui Huang Hsin-Yun Sun Shu-Yuan Ho Sui-Yuan Chang Szu-Min Hsieh Wang-Huei Sheng Yu-Chung Chuang Yu-Shan Huang Li-Hsin Su Wen-Chun Liu Yi-ching Su chien-ching Hung Department of Internal Medicine Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical Foundation and Tzu Chi UniversityHualien 970410Taiwan Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of MedicineTaipei 100008Taiwan Department of Laboratory Medicine National Taiwan University Hospital and National Taiwan University College of MedicineTaipei 100008Taiwan Department of Clinical Laboratory Sciences and Medical Biotechnology National Taiwan University College of MedicineTaipei 100233Taiwan Department of Tropical Medicine and Parasitology National Taiwan University College of MedicineTaipei 100233Taiwan Department of Medical Research China Medical University Hospital and China Medical UniversityTaichung 404394Taiwan

BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific *** the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in *** To investigate the care cascade of incident HCV infections among PLWH in *** PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and *** PLWH with incident HCV infections were followed until December 31,*** care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response *** who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed *** duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were *** During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood *** the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV *** those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieve

关键词： Recent hepatitis C virus infection Cascade of care Direct-acting antivirals People living with human immunodeficiency virus Sustained virologic response Sexually transmitted infections

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Complications and Costs Associated with Initiation of Anti-coagulation Therapy Using Warfarin--An Observation Study

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Journal of Pharmacy and Pharmacology 2015年第6期3卷 262-267页

作者： Jasmine chiat Ling Ong Seng Han Lim Chai Ling Ong Liping Chen Elicia Purnata Edmund Joo Sheng See Joel Cho-Lun chiang vivian Shi Yin Wong Loke Khee Siow Jin Shing Hon Ming Chai Kong chi Keong ching Department of Pharmacy Singapore General Hospital Outram Road Singapore 169608 Singapore Department of Pharmacy National Heart Centre Singapore 5 Hospital Drive Singapore 16960 Singapore Department of Cardiology National Heart Centre Singapore 5 Hospital Drive Singapore 169609 Singapore

To evaluate the safety and cost of anticoagulation therapy in patients newly initiated on warfarin in two institutions in Singapore. All patients newly started on warfarin between December 2011 and May 2012 were recruited and followed up for a period of 6 months. All hospitalization attributed to complications of warfarin therapy, number of INR （international normalized ratio） greater than 4 and total cost of warfarin therapy were collected and analysed. A total of 321 patients were newly initiated on warfarin for standard indications were recruited. At the end of 6 month period, 8.4% of patients were hospitalized for complication related to warfarin therapy. For patients who had stable INR while on warfarin, this rate was almost 2 times lower （3.8% vs 8.4%）. In our study group, patients started on warfarin as inpatients had higher rates of bleeding （15.1% vs 6.7%） and more 1NRs greater than 4 （0.7 per patient vs 0.11 per patient）. The cost of initating warfarin was USD660 over the first 6 months of therapy. Patients newly initiated on warfarin were at a heightened risk of bleeding complications as compared to patients already stable on warfarin therapy. This also translates to considerable costs of warfarin initiation.

关键词： Anticoagulation warfarin initiation complications cost.

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