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In Taiwan, hospice nurses often take family members of terminally ill patients on hospice ward tours and provide information on transfers. We conducted a study to investigate the tour’s effectiveness in encouraging family members to transfer their loved ones to hospice. We conceptualized our study framework based on the Andersen healthcare utilization model. The hospice nurses invited family members who participated in the tour to complete the survey to investigate the tour and hospice facilities’ influence on their willingness to transfer. A total of 87 participants responded to the study, with an average age of 48.84 ± 12.08 years. Most participants were women (78.16%) and the children of patients (55.17%). The results showed that the tour significantly increased willingness scores (before 4.46 ± 0.73, after 4.74 ± 0.58, p = .0036). Practical and activity-related facilities had the highest influence scores. However, binary logistic regression revealed that patients aged ≥65 years (odds ratio [OR]: 0.281, 95% confidence interval [CI] [0.099, 0.797]) and higher influence scores for psychospiritual care features (OR: 0.182, 95% CI [0.040, 0.821]) negatively affected the change in willingness score, possibly due to family members’ anticipatory grief. Hospice tour guides should be able to identify, assess, and deal with this issue. Overall, hospice tours can effectively encourage transfer to the hospice ward, but addressing psychological barriers such as anticipatory grief is crucial for success.

Background:. There is no consensus on the duration of prophylactic antibiotic use for autologous breast reconstruction after mastectomy. We attempted to standardize the use of prophylactic antibiotics after mastectomy using a deep inferior epigastric perforator flap for the breast reconstruction procedure. Methods:. This retrospective case series included 108 patients who underwent immediate breast reconstruction with a deep inferior epigastric perforator flap at the Ditmanson Medical Foundation Chia-Yi Christian Hospital between 2012 and 2019. Patients were divided into three groups based on the duration of prophylactic antibiotic administration (1, 3, and >7 days) for patients with drains. Data were analyzed between January and April 2021. Results:. The prevalence of surgical site infection in the breast was 0.93% (1/108), and in the abdomen it was 0%. The patient groups did not differ by age, body mass index, smoking status, or neoadjuvant chemotherapy. Only one patient experienced surgical site infection in the breast after half-deep necrosis of the inferior epigastric perforator flap. There were no significant differences in surgical site infection based on the duration of prophylactic antibiotic use. The operation time, methods of breast surgery, volume of fluid drainage in the first 3 days of the abdominal and breast drains, and day of removal of the abdominal and breast drains did not affect surgical site infection. Conclusion:. Based on these data, we do not recommend extending prophylactic antibiotics beyond 24 hours in deep inferior epigastric perforator reconstruction.

BackgroundStroke survivors are prone to osteoporosis and fractures. However, bone mineral density (BMD) testing and osteoporosis treatment were underutilized in patients with recent stroke. We aimed to examine whether stroke has an impact on the utilization of BMD testing and osteoporosis treatment as well as the determinants of their utilization in stroke patients using nationwide population-based data in Taiwan.MethodsWe identified patients aged 55 years and older who were hospitalized for hemorrhagic or ischemic stroke as the stroke cohort, and age- and sex-matched patients hospitalized for reasons other than stroke, fracture, or fall as the non-stroke cohort. We used the Fine-Gray sub-distribution hazard competing risk regression model to determine the predictors for BMD testing and osteoporosis treatment.ResultsA total of 32997 stroke patients and 32997 age- and sex-matched controls comprised the stroke and non-stroke cohorts, respectively. BMD testing and osteoporosis treatment were performed in 1.0% and 5.2% of the stroke patients, respectively, within one year after hospitalization while these measures were performed in 0.8% and 4.7% of the controls. Stroke patients were more likely to receive BMD testing (adjusted hazard ratio [HR] 1.33; 95% confidence interval [CI] 1.11–1.58) and osteoporosis treatment (adjusted HR 1.19; 95% CI 1.11–1.29). Female sex, osteoporosis, prior BMD testing, and low-trauma fractures after stroke increased the likelihood of using BMD testing and osteoporosis treatment whereas greater stroke severity reduced the likelihood of receiving both measures.ConclusionsBoth BMD testing and osteoporosis treatment were underutilized among stroke survivors even though they had a higher chance of receiving both measures than non-stroke patients.

Fucoidan, a natural sulfated polysaccharide, which can activate the immune response and lessen adverse effects, is expected to be an adjuvant agent in combination with chemotherapy. Using natural hydrophilic anticancer polysaccharides to simultaneously encapsulate hydrophobic anticancer drugs is feasible, and a reduced side effect can be achieved to amplify the therapeutic efficacy. In this study, a novel type of fucoidan-PLGA nanocarrier (FPN-DTX) was developed for the encapsulation of the hydrophobic anticancer drug, docetaxel (DTX), as a drug delivery system. From the comparison between FPN-DTX and the PLGA particles without fucoidan (PLGA-DTX), FPNs–DTX with fucoidan were highly stable with smaller sizes and dispersed well without aggregations in an aqueous environment. The drug loading and release can be further modified by modulating relative ratios of Fucoidan (Fu) to PLGA. The (FPN 3-DTX) nanoparticles with a 10:3 ratio of Fu:PLGA displayed uniform particle size with higher encapsulation efficiency than PLGA NPs and sustained drug release ability. The biocompatible fucoidan-PLGA nanoparticles displayed low cytotoxicity without drug loading after incubation with MDA-MB-231 triple-negative breast cancer cells. Despite lower cellular uptake than that of PLGA-DTX due to a higher degree of negative zeta potential and hydrophilicity, FPN 3-DTX effectively exerted better anticancer ability, so FPN 3-DTX can serve as a competent drug delivery system.

A recognition concept utilizing multiple-hydrogen-bond fine-tuned excited-state double-proton-transfer reaction is presented. The catalytic versus noncatalytic excited-state proton-transfer (ESPT) demonstrates its suitability in differentiating carboxylic acids and urea derivatives.

In this study, we investigate the device performance of bulk hetero-junction (BHJ) polymer solar cells (PSCs) fabricated from pristine chlorobenzene (CB) solution, CB solutions with different concentrations of solvent processing additive, chloronaphthalene (CN) which has a high boiling point temperature, and pristine CN solution. An efficiency of 7.12% is observed from PSCs processed from pristine CN solution as compared with 4.01% of that from pristine CB solution. The correlation between the efficiency of PSCs with the concentrations of CN was systematically studied by absorption spectra, atomic force microscopy and cross-section transmission electron microscopy images, wide angle X-ray diffraction and grazing incidence small angle X-ray patterns of BHJ active layers and impedance spectroscopies of BHJ PSCs. It was found that the addition of CN into CB solution does not affect the crystallization or the molecular packing of the donor polymer in BHJ layers, but it changes the film morphology of the BHJ layers. The phase separation between the donor polymer and fullerene derivatives was reduced and BHJ layers were redistributed as the concentration of CN is increased in CB solutions. As a result, increased ratios of the donor polymer to fullerene derivatives, and high hole mobilities of the donor polymer in BHJ layers were obtained for the resultant films. Consequently, a high efficiency was observed from PSCs processed from CN solution rather than from CB solution. Our findings provide a method to approach highly efficient PSCs. [ABSTRACT FROM AUTHOR]

Galaxy interaction is considered a key driver of galaxy evolution and star formation (SF) history. In this paper, we present an empirical picture of the radial extent of interaction-triggered SF along the merger sequence. The samples under study are drawn from the integral field spectroscopy survey SDSS-IV MaNGA, including 205 star-forming galaxies in pairs/mergers and ∼1350 control galaxies. For each galaxy in pairs, the merger stage is identified according to its morphological signatures: incoming phase, at first pericenter passage, at apocenter, in merging phase, and in final coalescence. The effect of interactions is quantified by the global and spatially resolved SF rate (SFR) relative to the SFR of a control sample selected for each individual galaxy (Δlog SFR and Δlog sSFR(r), respectively). Analysis of the radial Δlog sSFR(r) distributions shows that galaxy interactions have no significant impact on Δlog sSFR(r) during the incoming phase. Right after the first pericenter passage, the radial Δlog sSFR(r) profile decreases steeply from enhanced to suppressed activity for increasing galactocentric radius. Later on, SF is enhanced on a broad spatial scale out to the maximum radius we explore (∼6.7 kpc) and the enhancement is in general centrally peaked. The extended SF enhancement is also observed for systems at their apocenters and in the coalescence phase, suggesting that interaction-triggered SF is not restricted to the central region of a galaxy. Further explorations of a wide range in parameter space of merger configurations (e.g., mass ratio) are required to constrain the whole picture of interaction-triggered SF. [ABSTRACT FROM AUTHOR]

We study the role of cold gas in quenching star formation in the green valley by analyzing ALMA 12CO (1–0) observations of three galaxies with resolved optical spectroscopy from the MaNGA survey. We present resolution-matched maps of the star formation rate and molecular gas mass. These data are used to calculate the star formation efficiency (SFE) and gas fraction () for these galaxies separately in the central “bulge” regions and outer disks. We find that, for the two galaxies whose global specific star formation rate (sSFR) deviates most from the star formation main sequence, the gas fraction in the bulges is significantly lower than that in their disks, supporting an “inside-out” model of galaxy quenching. For the two galaxies where SFE can be reliably determined in the central regions, the bulges and disks share similar SFEs. This suggests that a decline in is the main driver of lowered sSFR in bulges compared to disks in green valley galaxies. Within the disks, there exist common correlations between the sSFR and SFE and between sSFR and on kiloparsec scales—the local SFE or in the disks declines with local sSFR. Our results support a picture in which the sSFR in bulges is primarily controlled by , whereas both SFE and play a role in lowering the sSFR in disks. A larger sample is required to confirm if the trend established in this work is representative of the green valley as a whole. [ABSTRACT FROM AUTHOR]

We report the discovery of a mysterious giant Hα blob that is ∼8 kpc away from the main MaNGA target 1-24145, one component of a dry galaxy merger, and has been identified in the first-year SDSS-IV MaNGA data. The size of the Hα blob is ∼3–4 kpc in radius, and the Hα distribution is centrally concentrated. However, there is no optical continuum counterpart in the deep broadband images reaching ∼26.9 mag arcsec−2 in surface brightness. We estimate that the masses of the ionized and cold gases are and , respectively. The emission-line ratios indicate that the Hα blob is photoionized by a combination of massive young stars and AGNs. Furthermore, the ionization line ratio decreases from MaNGA 1-24145 to the Hα blob, suggesting that the primary ionizing source may come from MaNGA 1-24145, likely a low-activity AGN. Possible explanations for this Hα blob include the AGN outflow, the gas remnant being tidally or ram-pressure stripped from MaNGA 1-24145, or an extremely low surface brightness galaxy. However, the stripping scenario is less favored according to galaxy merger simulations and the morphology of the Hα blob. With the current data, we cannot distinguish whether this Hα blob is ejected gas due to a past AGN outburst, or a special category of “ultra-diffuse galaxy” interacting with MaNGA 1-24145 that further induces the gas inflow to fuel the AGN in MaNGA 1-24145. [ABSTRACT FROM AUTHOR]

Objective: Symptoms and treatment of venous leg ulcers (VLUs) adversely impact patients' quality of life (QoL). There is no QoL tool that considers the linguistic and cultural specificities of patients with VLU in Taiwan. This study aimed to evaluate the psychometric properties of the traditional Chinese version of the Venous Leg Ulcer Quality of Life Questionnaire (VLU-QoL)., Methods: The processes of translation and cultural adaptation of the VLU-QoL from English to traditional Chinese included forward translation, back translation, linguistic modification, and expert review. Using a sample of 167 patients with VLU from a hospital in southern Taiwan, the psychometric properties analyzed were internal consistency, test-retest reliability, content validity, convergent validity, and criterion-related., Results: The traditional Chinese version of the VLU-QoL demonstrated good overall internal consistency (Cronbach α = .95) and overall test-retest reliability coefficient (r = 0.98). Confirmatory factor analysis was used to assess the convergent validity of the scale; results showed that the Activity, Psychology, and Symptom Distress constructs had acceptable fit and a structure similar to that of the original scale. The scale had its criterion-related validity verified using the Taiwanese version of the 36-item Short-Form Health Survey, demonstrating a good correlation coefficient r that ranged from -0.7 to -0.2 (P < .001)., Conclusions: The Chinese version of the VLU-QoL is valid and reliable for assessing the QoL in patients with VLU, delivering a tool that nurses can use to deliver timely and appropriate care to improve patients' QoL., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)