Search

Solution-processable non-conjugated triarylamine-based polyamides with intrinsic microporous structure have been designed to investigate the diffusivity and the charge–discharge ability with distinct two-stage color changes to visualize the capacity.

Background Terminally ill patients often experience exacerbations of diseases that render mainstream medicine ineffective in relieving symptoms, prompting attempts at complementary and alternative medicine (CAM). This study collected data from terminally ill patients and their relatives to determine differences between CAM use, behavioral patterns, and perceptions of health information about CAM. Methods A cross-sectional design using a self-administered questionnaire was adopted. Eight medical institutions in Taiwan with inpatient hospice palliative care units were chosen. Ninety-two terminally ill patients and 267 relatives met the inclusion criteria. The questions concerned the experience of CAM use, the kinds of products/services CAM provided, the purpose of CAM use, the source of CAM information, and the perceptions and attitudes toward CAM. Results Both terminally ill patients and their relatives have a high proportion of lifetime and one-year prevalence of CAM use (88.0% vs. 88.4%; p = 0.929). CAM use for musculoskeletal and neurological discomfort is higher among terminally ill patients than among their relatives. Relatives/friends are the most frequent sources of information on CAM (53.3% vs. 62.2%; p = 0.133). The percentage of terminally ill patients who discontinued mainstream medical treatment because of CAM use was higher than that of their relatives (18.5% vs. 9.3%; p = 0.026). More than half the terminally ill patients and their relatives had never been asked about CAM by medical staff (64.1% vs. 66.7%), nor had they informed medical professionals about the use of CAM products and services (63% vs. 66.9%). Random inquiries by medical professionals may be associated with increased disclosure of CAM use (terminally ill patients: odds ratio, 9.75; 95% confidence interval, 1.97–48.35 vs. relatives: odds ratio, 5.61; 95% confidence interval, 2.66–11.83). Conclusions The high prevalence and concealment of CAM use in terminally ill patients should be considered. Medical professionals should establish a friendly and barrier-free communication model, encourage patients to share CAM experiences, and provide evidence-based information on the use of CAM products and services, to reduce the potential damage caused by harmful use.

OBJECTIVE We assessed the effect of glucagon-like peptide 1 receptor agonists (GLP-1RAs) on ischemic stroke prevention in the Asian population with type 2 diabetes (T2D) without established cardiovascular disease. RESEARCH DESIGN AND METHODS This retrospective cohort study examined data obtained from the Taiwan National Health Insurance Research Database for the period from 1998 to 2018. The follow-up ended upon the occurrence of hospitalization for ischemic stroke. The median follow-up period was 3 years. The effect of GLP-1RA exposure time on the development of hospitalization for ischemic stroke was assessed. RESULTS The GLP-1RA and non–GLP-1RA user groups both included 6,534 patients. Approximately 53% of the patients were women, and the mean age was 49 ± 12 years. The overall risk of ischemic stroke hospitalization for GLP-1RA users was not significantly lower than that for GLP-1RA nonusers (adjusted hazard ratio [HR] 0.69 [95% CI 0.47–1.00]; P = 0.0506), but GLP-1RA users with a >251-day supply during the study period had a significantly lower risk of ischemic stroke hospitalization than GLP-1RA nonusers (adjusted HR 0.28 [95% CI 0.11–0.71]). Higher cumulative dose of GLP-1 RAs (>1,784 mg) was associated with significantly lower risk of ischemic stroke hospitalization. The subgroup analyses defined by various baseline features did not reveal significant differences in the observed effect of GLP-1RAs. CONCLUSIONS Longer use and higher dose of GLP-1 RAs were associated with a decreased risk of hospitalization for ischemic stroke among Asian patients with T2D who did not have established atherosclerotic cardiovascular diseases, but who did have dyslipidemia or hypertension.

Design strategies of smart membranes for switchable gas separation performance.

PurposeThe purpose of the study is to clarify the quality of home delivery logistics services from the perspectives of customers and provide insight to aid the prioritization of service quality improvements and guide managerial strategic planning.Design/methodology/approachThe study used a three-dimensional model that integrated Kano model, goal difficulty (GD) and importance–performance analysis (IPA) for investigating service quality aspects emphasized by customers and determine which attributes should be prioritized according to an enterprise's resource and capability constraints. Data were collected through questionnaires administered to the customers and managers of five primary home delivery logistics service enterprises and six small to medium-sized enterprises in Taiwan. Improving the quality of home delivery logistics services has become of increased interest for enterprises.FindingsThe three most important attributes, ranked in order of priority for improvement, were the protection of customers' personal information, delivery of products without damage and reasonable compensation standards for product damage. The study concludes that enterprises should prioritize the improvement of these attributes. Implications, detailed explanations and directions for further investigations are also proposed.Originality/valueThe study discusses the importance and relevant satisfaction levels of service quality attributes from the perspective of customers while also considering the limitations of companies' resources and capabilities. The results indicate that the method can be used to identify service quality attributes of home delivery logistics and formulate strategies for enhancing customer satisfaction.

Membrane separation has been an efficient and energy saving technique in dealing with greenhouse gases, but the traditional membrane designs might not be able to handle the concomitant environmental pollution due to their fixed properties. Correspondingly, the use of an active-responsive smart membrane appears to be a new trend for membrane development in the coming future, which shows great potential to deal with the obstacles. In this research, we demonstrate a smart graphene-organic framework membrane to enable reversed electrical-switchable permselectivity in CO2 separation. The addition of polydopamine (PDA) to the polyvinylidene fluoride/Graphene (PVDF/G) membranes was done to (i) induce the β-phase of PVDF, since –NH2-functionalized graphene has specific interactions (dipole induced dipole interaction) between graphene-PDA and PVDF; (ii) modify the organic PVDF-inorganic graphene interface; and (iii) facilitate CO2 selective separation. Permeability and permselectivity was increased after applying voltage that resulted in the increase of gas permselectivity in response to the lowest applied voltage range (0–3 V) to the membrane. Digital image correlation method depicted the response of the membrane to voltage and proved that the membrane has high piezoelectric properties that is switchable. Furthermore, PALS studies confirmed the free volume and interlayers in the membrane. This membrane has unique properties because the pore changes from bimodal to single pore distribution.

BackgroundAcute ST-elevation myocardial infarction (STEMI) elicits a robust cardiomyocyte death and inflammatory responses despite timely revascularization.ObjectivesThis phase 1, open-label, single-arm, first-in-human study aimed to assess the safety and efficacy of combined intracoronary (IC) and intravenous (IV) transplantation of umbilical cord-derived mesenchymal stem cells (UMSC01) for heart repair in STEMI patients with impaired left ventricular ejection fraction (LVEF 30-49%) following successful reperfusion by percutaneous coronary intervention.MethodsConsenting patients received the first dose of UMSC01 through IC injection 4-5 days after STEMI followed by the second dose of UMSC01 via IV infusion 2 days later. The primary endpoint was occurrence of any treatment-related adverse events and the secondary endpoint was changes of serum biomarkers and heart function by cardiac magnetic resonance imaging during a 12-month follow-up period.ResultsEight patients gave informed consents, of whom six completed the study. None of the subjects experienced treatment-related serious adverse events or major adverse cardiovascular events during IC or IV infusion of UMSC01 and during the follow-up period. The NT-proBNP level decreased (1362 ± 1801 vs. 109 ± 115 pg/mL, p = 0.0313), the LVEF increased (52.67 ± 12.75% vs. 62.47 ± 17.35%, p = 0.0246), and the wall motion score decreased (26.33 ± 5.57 vs. 22.33 ± 5.85, p = 0.0180) at the 12-month follow-up compared to the baseline values. The serial changes of LVEF were 0.67 ± 3.98, 8.09 ± 6.18, 9.04 ± 10.91, and 9.80 ± 7.56 at 1, 3, 6, and 12 months, respectively as compared to the baseline.ConclusionThis pilot study shows that combined IC and IV transplantation of UMSC01 in STEMI patients with impaired LVEF appears to be safe, feasible, and potentially beneficial in improving heart function. Further phase 2 studies are required to explore the effectiveness of dual-route transplantation of UMSC01 in STEMI patients.

Although the past research results have provided many effective tools for evaluating public bus service quality, they still lack the concept of risk. This study assessed the quality risk for city bus service by constructing a quality risk assessment model that integrated Kano’s model, IPA, and FMEA. The online questionnaire was distributed to commuters who use BMTA’s bus service in Bangkok with 429 samples. This study analyzed the service quality attributes of bus services via Kano’s model, an IPA, and an FMEA. For the results of Kano’s model, this study identified nine one-dimensional and three attractive attributes. The results of the IPA showed that the safety of boarding and disembarking from the bus, the cleanliness of vehicles, and the punctuality of buses according to the schedule were the top three attributes that had a large gap between importance and satisfaction. According to the results of the FMEA, the safety of boarding and disembarking from the bus, the cleanliness of vehicles, and the punctuality of buses according to the schedule were the top three attributes that had a high service quality risk and considered a priority improvement. These attributes belonged to interaction with passengers, tangible service equipment, and operating management support dimensions. Therefore, the government should take action and improve service quality to make Bangkok commuters consider switching from driving cars to using a bus. Finally, this study provides practical improvement strategies for managers to improve passenger experiences and enhance the quality of bus services.