Search

Abstract In 2022, the Event Horizon Telescope (EHT) collaboration has reported the first observations of Sagittarius A*(SgrA*). Applying the EHT observational results, we find out constraints on non-singular Hayward parameter of regular dark energy black hole. Considering these constraints and different thin disk accretion, we present a detailed investigation into influence of different dark energy and Hayward parameters on shadows from non-singular Hayward black holes. In the first second-order attenuation function model, corresponding shadow radius and peak for observed intensity from direct image decrease with increasing dark energy parameter and Hayward parameter. However, for the lensing ring and photon ring, corresponding peak become bigger as dark energy parameter increase in case of fixed Hayward parameter. In the second third-order attenuation function model, significantly different from model 1, above two rings completely overlay on the direct image, resulting in two distinct peaks in the observed intensity. As increase of Hayward and dark energy parameters, the difference between the two peaks decreases, and shadows and observed intensity decrease. In the final inverse trigonometric function attenuation model, the result shows corresponding lensing ring as well as photon ring can be distinguished within the superposition region, and the superposition region becomes larger. With the increase of the dark energy parameter, the shadow radius exhibits a decreasing trend, while observed intensity increases. However, with the increase of the Hayward parameter, both decreases. Compared with the first two models, the shadow radius becomes smaller, but the observed intensity becomes larger, making the bright ring wider and brighter. Therefore, different accretion models and non-singular Hayward parameters can give rise to interesting and distinguish characteristic for the black hole shadow and rings.

We research the mutual correlation and chaotic behavior in phantom Anti-de Sitter (AdS) black holes based mainly on shock wave geometry. In the static background of the phantom spacetime, by analyzing mutual correlation, we find out that the greater the phantom dark energy parameter is, the smaller the mutual correlation becomes, which implies phantom dark energy can destroy bilateral correlation of the two sub-regions from the AdS boundary. In the dynamic background, the results show that, the greater the applied energy perturbation is, the smaller the mutual correlation becomes. Especially, the bigger the phantom dark energy is exerted, the faster the mutual correlation destroys. This is similar to the butterfly effect of chaos theory.

Abstract SARS-CoV-2 induced marked lymphopenia in severe patients with COVID-19. However, whether lymphocytes are targets of viral infection is yet to be determined, although SARS-CoV-2 RNA or antigen has been identified in T cells from patients. Here, we confirmed that SARS-CoV-2 viral antigen could be detected in patient peripheral blood cells (PBCs) or postmortem lung T cells, and the infectious virus could also be detected from viral antigen-positive PBCs. We next prove that SARS-CoV-2 infects T lymphocytes, preferably activated CD4 + T cells in vitro. Upon infection, viral RNA, subgenomic RNA, viral protein or viral particle can be detected in the T cells. Furthermore, we show that the infection is spike-ACE2/TMPRSS2-independent through using ACE2 knockdown or receptor blocking experiments. Next, we demonstrate that viral antigen-positive T cells from patient undergone pronounced apoptosis. In vitro infection of T cells induced cell death that is likely in mitochondria ROS-HIF-1a-dependent pathways. Finally, we demonstrated that LFA-1, the protein exclusively expresses in multiple leukocytes, is more likely the entry molecule that mediated SARS-CoV-2 infection in T cells, compared to a list of other known receptors. Collectively, this work confirmed a SARS-CoV-2 infection of T cells, in a spike-ACE2-independent manner, which shed novel insights into the underlying mechanisms of SARS-CoV-2-induced lymphopenia in COVID-19 patients.

Abstract Background Hospice nurses may devote more emotional labor during the empathy process with patients, and this empathy can be used as a form of psychological behavior of emotional labor in the hospice care model. The aim of this study was to analyze hospice nurses’ empathy characteristics in the context of emotional labor theory, and explore the impact of empathy on patient care. Methods We conducted semi-participant observations from three hospitals and multicenter in-depth interviews with n = 26 hospice nurses from eight cities. Interviews were transcribed, and directed content analysis was applied. Results Two categories with four sub-categories were extracted from the data analysis. Category 1 described the “empathic labor” process which covers cognitive empathy (including empathic imagination, empathic consideration, and empathic perception) and affective empathy (including natural empathy, surface empathy, and deep empathy). The second category concerns the outcome of nurses’ “empathic labor” which incorporates both positive and negative effects. Conclusions The findings indicated that hospice nurses’ empathy process should be understood as emotional labor. Nursing managers should pay more attention to raising the ability of deep empathy with hospice nurses, and explore more sufficient active empowerment strategies to alleviate the negative impact of empathy on nurses and to strengthen nurses' deep empathy with terminal ill patients.

Abstract In the framework of holography, we discuss on the phase transition behavior from a novel Gauss–Bonnet AdS black hole discovered in [Phys. Rev. Lett. 124, 081301 (2020)] in both charged and neutral cases. First, we explore the thermodynamic behavior for the black hole entropy by investigating $$T-S$$ T-S diagram, specific heat capacity and free energy, and we find that, in the $$T-S$$ T-S plane, the black hole exhibits a van der Waals phase transition similar to that in $$P-V$$ P-V plane in extended phase space. Secondly, we detect thermodynamic phase transition for the two point correlation function, and find that, the van der Waals phase transition can also be displayed in the $$T-\delta L $$ T-δL plane which is completely similar to that of black hole entropy in the $$T-S$$ T-S plane. Our result turns out that, not only the charged but also neutral cases, we can observe holographic van der Waals phase transition for the novel Gauss–Bonnet AdS black hole by employing the black hole entropy and two point correlation function.

Abstract Background With the fast-paced aging and increasing digitalization of society, there has been a growing interest in the effect of mobile device use on cognitive function and depression in older adults. However, research examining this issue among older adults in residential care homes (RCHs) is scant. Therefore, this study aimed to examine the impact of mobile device use on the cognitive function and depressive symptoms of older adults living in RCHs. Methods A cross-sectional survey was conducted using a sociodemographic questionnaire, the Montreal Cognitive Assessment (MoCA) and the 15-item Geriatric Depression Scale (GDS-15). Results A total of 235 senior residents (aged 82.58 ± 5.54) in four RCHs were surveyed. Users of mobile devices had a significantly higher total MoCA score (25.02 ± 4.14) and a significantly lower GDS-15 score (3.28 ± 2.74) than non-users (MoCA: 19.34 ± 5.21, GDS-15: 4.69 ± 2.90). Multivariate linear regression indicate that mobile device use is significantly associated with total MoCA score, six of the seven sub-scores (visuospatial abilities and execution functions, attention, language, abstraction, delayed recall, and orientation)(P

In this paper, considering the influence of generalized uncertainty principle, we explore phase transitions of the Rutz-Schwarzschild black hole based on the Parikh-Wilczek tunneling method. First, we obtain the corrected Hawking temperature, local temperature, remnant of black hole, entropy, heat capacity and other thermodynamic quantities. Then, we analyzed the effects of generalized uncertainty parameter β on phase transition. And we investigate thermodynamic stability, the critical behavior and phase transition structure under the influence of generalized uncertainty principle at last. The results show that there are first-order and second-order phase transitions in the Rutz-Schwarzschild black hole of the Finsler genometry framework. In addition, the generalized uncertainty parameter has great influence on the generation of black hole remnant.

In this work, we intend to investigate the phase transition behavior in AdS spacetime of massive gravity. We found that it can exhibit different phase transitions in the T−S plane. We further study specific heat capacity and free energy of the spacetime, and Cq−S and F−T phase structures with different parameters are also plotted. The results show that the phase structures are related to the charge Q, the parameters γ and λ of the AdS spacetime of massive gravity. In addition, by utilizing two point correlation function, holographic phase transitions can also be displayed in the T−δL plane, which means phase transition behavior can be detected by the two point correlation function. Keywords: Van der Waals phase transition, Massive gravity, Specific heat capacity, Free energy, Two point correlation function

Abstract In this paper, taking into account a black hole solution of Finsler theory, we study the remnant and its phase transition close to the Planck scale. Based on the corrected Dirac equation, the quantum tunneling method is applied to derive a revised Hawking temperature-uncertainty relation. Further, with the generalized uncertainty principle(GUP), when the Finsler black hole reaches the Planck scale, the remnant after evaporation is calculated. Meanwhile, according to the phase transition and heat capacity, we analyze thermodynamic stability of the black hole remnant.

In order to give further insights into the holographic Van der Waals phase transition, it would be of great interest to investigate the behavior of Wilson loop across the holographic phase transition for a higher dimensional hairy black hole. We offer a possibility to proceed with a numerical calculation in order to discussion on the hairy black hole's phase transition, and show that Wilson loop can serve as a probe to detect a phase structure of the black hole. Furthermore, for a first order phase transition, we calculate numerically the Maxwell's equal area construction; and for a second order phase transition, we also study the critical exponent in order to characterize the Wilson loop's phase transition.

Abstract Background Conventional perioperative analgesic modalities (e.g. opioids, epidural analgesia) have their own drawbacks, which limit their clinical application. This study investigated the opioid-sparing effectsof the oblique subcostal transversus abdominis plane (OSTAP) blockade with ropivacaine for the patients undergoing open liver resection with a Mercedes incision. Methods 126 patients who were scheduled for open liver resection were enrolled in this study. Patients were randomly assigned to receive bilateral ultrasound-guided OSTAPblocks with either 0.375% ropivacaine (groupT) or 0.9% isotonic saline (group C). Both groups also received intravenous patient-controlled analgesia and intravenous 40 mg parecoxib every 12 h for a total of 3 days. Preoperative and intraoperative parameters, plus intraoperative and postoperative cumulative sufentanil consumption, were recorded. Results 70 patients were enrolled in the study finally. There were no significant differences between the two groups with respect to preoperative parameters, and surgical and anesthetic characteristics. The intraoperative sufentanil use, cumulative sufentanil consumption at 5 min after extubation, 2 h, 4 h,12 h and 24 h after operation in group T was significantly less than that in group C (P = 0.001, 0.001, 0.000, 0.000, 0.001 and 0.044, respectively). Compared with group C, postoperative NRS pain scores at rest were significantly lower at 2 h and 4 h postoperatively in group T (P = 0.04and 0.02, respectively); NRS scores at the time of coughing were also significantly lower in group T than in group C at all time points except 5 min after extubation (all P

Abstract With motivation by holography, employing black hole entropy, two-point connection function and entanglement entropy, we show that, for the higher-dimensional Anti-de Sitter charged hairy black hole in the fixed charged ensemble, a Van der Waals-like phase transition can be observed. Furthermore, based on the Maxwell equal-area construction, we check numerically the equal-area law for a first order phase transition in order to further characterize the Van der Waals-like phase transition.

Patients with COVID-19 generally raise antibodies against SARS-CoV-2 following infection, and the antibody level is positively correlated to the severity of disease. Whether the viral antibodies exacerbate COVID-19 through antibody-dependent enhancement (ADE) is still not fully understood. Here, we conducted in vitro assessment of whether convalescent serum enhanced SARS-CoV-2 infection or induced excessive immune responses in immune cells. Our data revealed that SARS-CoV-2 infection of primary B cells, macrophages and monocytes, which express variable levels of FcγR, could be enhanced by convalescent serum from COVID-19 patients. We also determined the factors associated with ADE, and found which showed a time-dependent but not viral-dose dependent manner. Furthermore, the ADE effect is not associated with the neutralizing titer or RBD antibody level when testing serum samples collected from different patients. However, it is higher in a medium level than low or high dilutions in a given sample that showed ADE effect, which is similar to dengue. Finally, we demonstrated more viral genes or dysregulated host immune gene expression under ADE conditions compared to the no-serum infection group. Collectively, our study provides insight into the understanding of an association of high viral antibody titer and severe lung pathology in severe patients with COVID-19.

In this letter, we show that the dimensionless parameters in the generalized uncertainty principle (GUP) can be constrained by the gravitational wave event GW150914, which was discovered by the LIGO Scientific and Virgo Collaborations. Firstly, according to the Heisenberg uncertainty principle (HUP) and the data of gravitational wave event GW150914, we derive the standard energy–momentum dispersion relation and calculate the difference between the propagation speed of gravitons and the speed of light, i.e., Δυ. Next, using two proposals regarding the GUP, we also generalize our study to the quantum gravity case and obtain the modified speed of gravitons. Finally, based on the modified speed of gravitons and Δυ, the improved upper bounds on the GUP parameters are obtained. The results show that the upper limits of the GUP parameters β0 and α0 are 2.3×1060 and 1.8×1020.

Abstract In curved space-time, the Hamilton–Jacobi equation is a semi-classical particle equation of motion, which plays an important role in the research of black hole physics. In this paper, starting from the Dirac equation of spin 1/2 fermions and the Rarita–Schwinger equation of spin 3/2 fermions, respectively, we derive a Hamilton–Jacobi equation for the non-stationary spherically symmetric gravitational field background. Furthermore, the quantum tunneling of a charged spherically symmetric Kinnersly black hole is investigated by using the Hamilton–Jacobi equation. The result shows that the Hamilton–Jacobi equation is helpful to understand the thermodynamic properties and the radiation characteristics of a black hole.

In the framework of holography, we survey the phase structure for a higher dimensional hairy black hole including the effects of the scalar field hair. It is worth emphasizing that, not only black hole entropy, but also entanglement entropy and two point correlation function exhibit the Van der Waals-like phase transition in a fixed scalar charge ensemble. Furthermore, by making use of numerical computation, we show that the Maxwell's equal area law is valid for the first order phase transition. In addition, we also discuss how the hair parameter affects the black hole's phase transition.

Letter to the Editor

The very low birth weight (VLBW) infant is at great risk for marked dysbiosis of the gut microbiota. In the present study, a total of 36 VLBW infants were randomly divided into two groups, who were treated with combined probiotics and placebo, and 72 fecal specimens on days 14 and 28 of life were collected from them. Finally, 32 fecal specimens extracted from 16 preterm VLBW infants were qualified and analyzed using 16S rRNA gene sequencing. The primary outcome was to evaluate the change of gut microbiota in VLBW infants after combined probiotic supplement. The secondary outcome was to analyze the correlation gut microbial composition and levels of cytokines. We found that probiotic treatment, but not placebo, decreased the α-diversity of gut microbiota in VLBW infants. At the phylum level, probiotic treatment strongly increased the abundance of Firmicutes, whereas that of Proteobacteria was significantly reduced. At the family level, Streptococcaceae and Lactobacillaceae became prevalent after probiotic treatment, while the relative abundance of Enterobacteriaceae was reduced in the meantime. Most notably, significant correlations were observed between Lactobacillaceae abundance and serum cytokine levels. Further studies are required to shed more light on the characteristics of gut microbiota of VLBW neonates. And the modulation of microbiota should be considered to improve the survival rate of VLBW infants.

Our data shows the regional coronary artery calcium scores (lesion CAC) on multidetector computed tomography (MDCT) and the cross-section imaging on MDCT angiography (CTA) in the target lesion of the patients with stable angina pectoris who were scheduled for percutaneous coronary intervention (PCI). CAC and CTA data were measured using a 128-slice scanner (Somatom Definition AS+; Siemens Medical Solutions, Forchheim, Germany) before PCI. CAC was measured in a non-contrast-enhanced scan and was quantified using the Calcium Score module of SYNAPSE VINCENT software (Fujifilm Co. Tokyo, Japan) and expressed in Agatston units. CTA were then continued with a contrast-enhanced ECG gating to measure the severity of the calcified plaque condition. We present that both CAC and CTA data are used as a benchmark to consider the addition of rotational atherectomy during PCI to severely calcified plaque lesions. Keywords: Coronary artery calcium scores, Multidetector computed tomography, CT angiography, Rotational atherectomy, Percutaneous coronary intervention

Searching alternative feed antibiotics is always a study hotspot in the field of animal production. In this study, the anti-pathogenic activities and probiotics stimulatory effects of 30 kinds of herbs were screened through Oxford cup method and Hungate roll method. 15 herbs showed significantly antibacterial activities (P

In this article, close to the Planck scale, we discuss the remnant and residue entropy from a Rutz-Schwarzschild black hole in the frame of Finsler geometry. Employing the corrected Hamilton-Jacobi equation, the tunneling radiation of a scalar particle is presented, and the revised tunneling temperature and revised entropy are also found. Taking into account generalized uncertainty principle (GUP), we analyze the remnant stability and residue entropy based on thermodynamic phase transition. In addition, the effects of the Finsler perturbation parameter, GUP parameter, and angular momentum parameter on remnant and residual entropy are also discussed.

The experimental (simulated) transverse momentum spectra of negatively charged pions produced at midrapidity in central nucleus-nucleus collisions at the Heavy-Ion Synchrotron (SIS), Relativistic Heavy-Ion Collider (RHIC), and Large Hadron Collider (LHC) energies obtained by different collaborations are selected by us to investigate, where a few simulated data are taken from the results of FOPI Collaboration which uses the IQMD transport code based on Quantum Molecular Dynamics. A two-component standard distribution and the Tsallis form of standard distribution are used to fit these data in the framework of a multisource thermal model. The excitation functions of main parameters in the two distributions are analyzed. In particular, the effective temperatures extracted from the two-component standard distribution and the Tsallis form of standard distribution are obtained, and the relation between the two types of effective temperatures is studied.

Experience is well known to affect sensory-guided behaviors in many herbivorous insects. Here, we investigated the effects of natural feeding experiences of Helicoverpa armigera larvae on subsequent preferences of larval approaching and feeding, as well as the effect of host-contacting experiences of mated females on subsequent ovipositional preference. The results show that the extent of experience-induced preference, expressed by statistical analysis, depended on the plant species paired with the experienced host plant. Larval feeding preference was much easier to be induced by natural feeding experience than larval approaching preference. Naïve larvae, reared on artificial diet, exhibited clear host-ranking order as follows: tobacco ≥ cotton > tomato > hot pepper. Feeding experiences on hot pepper and tobacco could always induce positive feeding preference, while those on cotton often induced negative effect, suggesting that the direction of host plant experience-induced preference is not related to innate feeding preference. Inexperienced female adults ranked tobacco as the most preferred ovipositional host plant, and this innate preference could be masked or weakened but could not be reversed by host-contacting experience after emergence.

The modified entropic force law is studied by using a new kind of generalized uncertainty principle which contains a minimal length, a minimal momentum, and a maximal momentum. Firstly, the quantum corrections to the thermodynamics of a black hole are investigated. Then, according to Verlinde’s theory, the generalized uncertainty principle (GUP) corrected entropic force is obtained. The result shows that the GUP corrected entropic force is related not only to the properties of the black holes but also to the Planck length and the dimensionless constants α0 and β0. Moreover, based on the GUP corrected entropic force, we also derive the modified Einstein’s field equation (EFE) and the modified Friedmann equation.

Abstract Background Crop-associated microorganisms play a crucial role in soil nutrient cycling, and crop growth, and health. Fine-scale patterns in soil microbial community diversity and composition are commonly regulated by plant species or genotype. Despite extensive reports in different crop or its cultivar effects on the microbial community, it is uncertain how rhizoma peanut (RP, Arachis glabrata Benth.), a perennial warm-season legume forage that is well-adapted in the southern USA, affects soil microbial community across different cultivars. Results This study explored the influence of seven different RP cultivars on the taxonomic composition, diversity, and functional groups of soil fungal communities through a field trial in Marianna, Florida, Southern USA, using next-generation sequencing technique. Our results showed that the taxonomic diversity and composition of the fungal community differed significantly across RP cultivars. Alpha diversity (Shannon, Simpson, and Pielou’s evenness) was significantly higher in Ecoturf but lower in UF_Peace and Florigraze compared to other cultivars (p

Abstract Background Multisystem childhood Langerhans cell histiocytosis (LCH) patients, especially those with risk organ (RO) involved, had not been satisfactorily treated under the international traditional schemes as high incidences of reactivation with late sequelae were largely reported. Over years, we have observed that LCH patients with varied clinical symptoms responded differently to different drugs, suggesting the current grouping strategies based only on the number of organs involved might be inadequate. LCH has been defined as an inflammatory myeloid tumor, thus this study has innovatively divided LCH pediatric patients into inflammatory or malignant symptoms group, and given different intensity treatment regimens to different groups. Aim This clinical study aimed to explore a more appropriate patient grouping system according to the LCH symptom presentations and examine the clinical outcomes of treatment strategies in different groups. Methods According to the clinical manifestations, 37 cases of children were divided into Group A (only inflammatory symptoms) and Group B (malignant symptoms with or without inflammatory symptoms). Patients in Group A and B were initially treated with vindesine (VDS) and methylprednisolone (PSL), and VDS, PSL, pirarubicin (THP) and cyclophosphamide (CTX), respectively. Treatment responses were evaluated six weeks after the induction therapy in all patients, and the criteria were disease status and clinical scores of symptoms. Results Pre- and post-treatment scores were 1.22 ± 0.547 and 0.00 ± 0.00 in Group A, and 14.79 ± 1.686 and 1.00 ± 1.563 in Group B, respectively. All patients had subsequentlly received maintenance therapy without progressive disease. The 4-year overall survival (OS) rate was 100% in both groups and the 4-year event-free survival (EFS) was 94.4% in Group A and 89.5% in Group B, respectively. There were no obvious adverse events (AE) in Group A, whereas the main AE in Group B were alopecia and non-lethal hematological toxicity. Conclusion Stratification according to patients’ clinical symptoms, with low-intensity treatment for inflammatory symptoms (mild manifestations) and intensive treatment with multiple drugs for malignant symptoms (severe manifestations), is a positive exploration that simplifies stratification method, achieves good long-term remission of the disease, and obtains a higher survival rate and quality of life, which seemed to be more appropriate for LCH patients.

Introduction ChatGPT can serve as an adjunct informational tool for ophthalmologists and their patients. However, the reliability and readability of its responses to myopia-related queries in the Chinese language remain underexplored. Purpose This study aimed to evaluate the ability of ChatGPT to address frequently asked questions (FAQs) about myopia by parents and caregivers. Method Myopia-related FAQs were input three times into fresh ChatGPT sessions, and the responses were evaluated by 10 ophthalmologists using a Likert scale for appropriateness, usability, and clarity. The Chinese Readability Index Explorer (CRIE) was used to evaluate the readability of each response. Inter-rater reliability among the reviewers was examined using Cohen's kappa coefficient, and Spearman's rank correlation analysis and one-way analysis of variance were used to investigate the relationship between CRIE scores and each criterion. Results Forty-five percent of the responses of ChatGPT in Chinese language were appropriate and usable and only 35% met all the set criteria. The CRIE scores for 20 ChatGPT responses ranged from 7.29 to 12.09, indicating that the readability level was equivalent to a middle-to-high school level. Responses about the treatment efficacy and side effects were deficient for all three criteria. Conclusions The performance of ChatGPT in addressing pediatric myopia-related questions is currently suboptimal. As parents increasingly utilize digital resources to obtain health information, it has become crucial for eye care professionals to familiarize themselves with artificial intelligence-driven information on pediatric myopia.

Soil microorganisms, including soil bacteria and fungi, play important roles in pasture systems. They contribute to enhanced soil structure, nutrient cycling, and plant resilience. This publication discusses effects of bahiagrass and rhizoma perennial peanut integration on soil microbial diversity. Written by Hui-Ling Liao and Adesuwa S. Erhunmwunse, and published by the UF/IFAS Department of Agronomy, July 2024.

Backgroud: This prospective randomized trial evaluated the clinical efficacy of inhaled colistin administered through two distinct nebulizer types, a vibrating mesh nebulizer (VMN) and a jet nebulizer (JN), in the treatment of ventilator-associated pneumonia caused by multidrug-resistant bacteria. In addition, an in vitro model was used to determine the optimal delivery of colistin. Method: Thirty-two patients prescribed intravenous (IV) colistin inhalation were randomized to receive either a VMN (n = 17) or a JN (n = 15), then compared to the control group (IV alone) over a 7-to 10-day period. The primary endpoint was the clinical pulmonary infection score (CPIS), and the secondary endpoints were the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACE) score, and duration of ventilator use. Results: Results from in vitro testing demonstrated that VMN delivered a significantly higher colistin dose than JN (35.68 ± 3.55% vs. 23.56 ± 3.31%; p < 0.001) when positioned at the humidifier inlet. Compared to the IV alone group, the IV with inhalation group yielded significant improvements in CPIS, SOFA score, and APACHE score on day 7; nevertheless, clinical outcomes between the two nebulizers were statistically indistinguishable. Conclusions: In conclusion, although VMN delivers a higher dose in vitro, both nebulizers yielded comparable clinical outcomes. This study was registered at US Clinical Trial Registration (NCT04633317).

Cultural competence is a continuously developing process that requires transition-to-practice program training to enable new graduate nurses (NGNs) to transfer their knowledge and skills to clinical practice in a culturally sensitive manner. The development and implementation of residency programs, including a cultural competence curriculum, could support this transition. This study aimed to evaluate the preliminary effects of a hybrid learning module of cultural competence for NGNs. A quasi-experimental design was used in a 3,000-bed hospital in North Taiwan. We randomly allocated 37 NGNs to the experimental and control groups. The Cultural Competence Scale for Pre-Graduate Students to Licensed Professionals (CS-SP) was adopted to measure cultural competence before and after the intervention. We evaluated the correlations between learning time and cultural competence scores using a paired t -test, chi-square test, and Mann–Whitney test for statistical analysis. The curriculum for the learning application comprised three courses covering six topics. The experimental group scored significantly higher in awareness and skills after the intervention ( p

Objectives: To evaluate the diagnostic performance of different brands of immunochromatographic test (ICT) reagents for Chlamydia trachomatis using homogenized samples to provide a reference for reagent quality control. Methods: Eight commercially available ICT reagents were evaluated, of which three used the latex method and five used the colloidal gold method. Analytical performance evaluation using a pure culture broth of C. trachomatis, as well as clinical application validation using cervical epithelial cell samples acquired from the research subjects, were conducted. The concentration of C. trachomatis was quantified using a nucleic acid amplification test. Results: The limit of detection (LOD) of different ICT reagents in the analytical performance evaluation varied from 9.5 × 103 to 1 × 105 IFU/mL, and only one reagent met the LOD specified in the manufacturer's instructions. Likewise, only one reagent in the clinical application validation achieved the analytical LOD, four reagents were 2.1–4.2-fold of the analytical LODs, and three reagents failed to detect positive results in clinical samples. Conclusions: The diagnostic performance of different methods and different brands of ICT reagents in clinical practice was different from the manufacturer's instructions and the results of laboratory evaluation. The diagnostic performance of reagents should be evaluated before they are actually used in clinical practice.

In the online to offline (O2O) model, online marketing and online purchases drive offline (non-Internet) operations and offline consumption. E-commerce must use more effective methods in combination with offline physical stores for consumers to obtain better online services. However, if there are positive effects from offline from customers on the re-purchase, it can generate a positive power return to online. In addition, could online to offline moves on a path that have either stronger or weaker influence of re-purchase on chain stores with customers’ electronic word-of-mouth and online involvement? To understand the influence of O2O on chain stores, this study investigates the relationships between chain store brand images, perceived value, customer satisfaction and re-purchase intention on offline considerations in a Taiwan telecom chain store ( N = 1,602). The research results find that customer satisfaction plays a fully mediating role. In addition, electronic word-of-mouth and online involvement play two moderating roles on the relationships between chain store brand image, perceived value, customer satisfaction, and re-purchase intention respectively. Finally, theoretical and practical implications, conclusion, limitations and future research are presented.

Resumo Fundamento O infarto do miocárdio com elevação do segmento ST (IAMCSST) é uma das principais causas de doenças cardiovasculares fatais, que têm sido a principal causa de mortalidade em todo o mundo. O diagnóstico na fase inicial beneficiaria a intervenção clínica e o prognóstico, mas ainda falta a exploração dos biomarcadores do IAMCSST. Objetivos Neste estudo, conduzimos uma análise bioinformática para identificar potenciais biomarcadores cruciais no progresso do IAMCSST. Métodos Obtivemos GSE59867 para pacientes com IAMCSST e doença arterial coronariana estável (DACE). Genes diferencialmente expressos (GDEs) foram selecionados com o limiar de |log2fold change| > 0,5 e p < 0,05. Com base nesses genes, conduzimos análises de enriquecimento para explorar a relevância potencial entre genes e para rastrear genes centrais. Posteriormente, os genes centrais foram analisados para detectar miRNAs relacionados e DAVID para detectar fatores de transcrição para análise posterior. Finalmente, o GSE62646 foi utilizado para avaliar a especificidade dos GDEs, com genes demonstrando resultados de AUC superiores a 75%, indicando seu potencial como candidatos a biomarcadores. Posteriormente, os genes centrais foram analisados para detectar miRNAs relacionados e DAVID para detectar fatores de transcrição para análise posterior. Finalmente, o GSE62646 foi utilizado para avaliar a especificidade dos GDEs, com genes demonstrando resultados de AUC superiores a 75%, indicando seu potencial como candidatos a biomarcadores. Resultados 133 GDEs entre DACE e IAMCSST foram obtidos. Em seguida, a rede PPI de GDEs foi construída usando String e Cytoscape, e análises posteriores determinaram genes centrais e 6 complexos moleculares. A análise de enriquecimento funcional dos GDEs sugere que as vias relacionadas à inflamação, metabolismo e imunidade desempenham um papel fundamental na progressão de DACE para IAMCSST. Além disso, foram previstos miRNAs relacionados, has-miR-124, has-miR-130a/b e has-miR-301a/b regularam a expressão do maior número de genes. Enquanto isso, a análise dos fatores de transcrição indica que EVI1, AML1, GATA1 e PPARG são os genes mais enriquecidos. Finalmente, as curvas ROC demonstram que MS4A3, KLRC4, KLRD1, AQP9 e CD14 exibem alta sensibilidade e especificidade na previsão de IAMCSST. Conclusões Este estudo revelou que imunidade, metabolismo e inflamação estão envolvidos no desenvolvimento de IAMCSST derivado de DACE, e 6 genes, incluindo MS4A3, KLRC4, KLRD1, AQP9, CD14 e CCR1, poderiam ser empregados como candidatos a biomarcadores para IAMCSST.

Abstract Background Clinical practice of aerosol delivery in conjunction with respiratory support devices for critically ill adult patients remains a topic of controversy due to the complexity of the clinical scenarios and limited clinical evidence. Objectives To reach a consensus for guiding the clinical practice of aerosol delivery in patients receiving respiratory support (invasive and noninvasive) and identifying areas for future research. Methods A modified Delphi method was adopted to achieve a consensus on technical aspects of aerosol delivery for adult critically ill patients receiving various forms of respiratory support, including mechanical ventilation, noninvasive ventilation, and high-flow nasal cannula. A thorough search and review of the literature were conducted, and 17 international participants with considerable research involvement and publications on aerosol therapy, comprised a multi-professional panel that evaluated the evidence, reviewed, revised, and voted on recommendations to establish this consensus. Results We present a comprehensive document with 20 statements, reviewing the evidence, efficacy, and safety of delivering inhaled agents to adults needing respiratory support, and providing guidance for healthcare workers. Most recommendations were based on in-vitro or experimental studies (low-level evidence), emphasizing the need for randomized clinical trials. The panel reached a consensus after 3 rounds anonymous questionnaires and 2 online meetings. Conclusions We offer a multinational expert consensus that provides guidance on the optimal aerosol delivery techniques for patients receiving respiratory support in various real-world clinical scenarios.

Illicium difengpi (Schisandraceae), an endangered medicinal plant endemic to karst areas, is highly tolerant to drought and thus can be used as an ideal material for investigating adaptive mechanism to drought stress. The understanding of the drought tolerance of I. difengpi, especially at the molecular level, is lacking. In the present study, we aimed to clarify the molecular mechanism underlying drought tolerance in endemic I. difengpi plant in karst regions. The response characteristics of transcripts and changes in metabolite abundance of I. difengpi subjected to drought and rehydration were analyzed, the genes and key metabolites responsive to drought and rehydration were screened, and some important biosynthetic and secondary metabolic pathways were identified. A total of 231,784 genes and 632 metabolites were obtained from transcriptome and metabolome analyses, and most of the physiological metabolism in drought-treated I. difengpi plants recovered after rehydration. There were more upregulated genes than downregulated genes under drought and rehydration treatments, and rehydration treatment induced stable expression of 65.25% of genes, indicating that rehydration alleviated drought stress to some extent. Drought and rehydration treatment generated flavonoids, phenolic acids, flavonols, amino acids and their derivatives, as well as metabolites such as saccharides and alcohols in the leaves of I. difengpi plants, which alleviated the injury caused by excessive reactive oxygen species. The integration of transcriptome and metabolome analyses showed that, under drought stress, I. difengpi increased glutathione, flavonoids, polyamines, soluble sugars and amino acids, contributing to cell osmotic potential and antioxidant activity. The results show that the high drought tolerance and recovery after rehydration are the reasons for the normal growth of I. difengpi in karst mountain areas.

Background: Mechanical ventilation is the primary treatment for preterm infants with respiratory failure. Prolonged intubation may lead to complications; thus, early extubation is desirable. No standard criteria exist for determining the appropriateness of extubating very-low-birth-weight (VLBW) infants. This study explored the predictors of successful extubation in preterm VLBW infants. Methods: This retrospective cohort study included 60 preterm VLBW infants who underwent their first extubation in the neonatal intensive care unit in a regional hospital in Hsinchu, Taiwan, between January 2017 and November 2020. Successful extubation was defined as having no requirement of reintubation within 3 days of extubation. Potentially predictive variables, including demographics, prenatal characteristics, and ventilator parameters were compared between a successful extubation group and failed extubation group. Results: Of the 60 infants, 47 (78.33%) underwent successful extubation. The successful extubation group had higher Apgar scores at 1 (7 vs. 6, P = 0.02) and 5 min (9 vs. 7, P = 0.007) than those of the failed extubation group. Ventilator inspiratory pressure and mean airway pressure were significantly lower at 24, 16, 8, and 1 h before extubation and upon its completion in the successful extubation group. The areas under a number of the receiver operating characteristic curve curves in this study were moderate, specifically, 0.72, 0.74, and 0.69. Statistical analysis revealed an association between ventilator parameters before 1 h extubation (IP > 17.5cmH2O, MAP >7.5 cmH2O, RSS >1.82) and extubation failure (odds ratio 1.73, 2.27, 2.46 and 95% confidence interval:1.16–2.6, 1.26–4.08, 1.06–5.68, respectively). Conclusion: Higher Apgar scores at birth, lower ventilator inspiratory pressure, and mean airway pressure 24, 16, 8, and 1 h and 1 h RSS prior to extubation are associated with successful extubation in VLBW preterm infants.