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Background: This study formulated clinical guidelines for assessing nasogastric tube placement and for health education guidance according to evidence-based recommendations. Method: This study used a single group, pre- and postintervention design. Purposive sampling was used to recruit participants from nursing institutions in Taiwan. Results: Sixty-two individuals in charge of nursing institutions were recruited to participate in the in-service training program. Statistically significant differences were observed in the four major items in the self-directed learning readiness scale ( t = 3.85, p < .00; t = 3.99, p < .00; t = 2.94, p < .01; t = 4.13, p < .00). With regard to program satisfaction, the mean score was 4.88 to 4.9 points. The mean score for teaching satisfaction was 4.94 to 4.9 points. Furthermore, the participants scored more than 80 points in the online course test and the nasogastric tube placement skill. Conclusion: The individuals in-charge are expected to be willing to apply and promote methods of literature collation and recommendation in their respective institutions. [ J Contin Educ Nurs . 2021;52(7):326–334.]

Background/purpose Elevated monocyte chemoattractant protein-1 (MCP-1) is related to severe periodontal destruction. Furthermore, MCP-1 -2518 A/G gene polymorphism affects MCP-1 after inflammatory stimuli. This study analyzed the association between MCP-1 -2518 gene polymorphism and the outcome of nonsurgical periodontal treatment. Methods Forty periodontal patients were recruited and MCP-1 -2518 A/G gene polymorphisms were analyzed using polymerase chain reaction-restriction fragment length polymorphism assay. The clinical periodontal parameters, including probing depth (PD), clinical attachment level (CAL), gingival index (GI), bleeding index (BI) and plaque index (PI), were recorded before and six weeks after nonsurgical periodontal therapy. Patients were divided into chronic periodontitis (CP) or aggressive periodontitis (AP). Multiple linear regression analysis was performed to investigate certain predictors of the therapy outcome. Results The frequency of MCP-1 -2518 genotype-positive (carrying allele G) was 42.5%. Poor treatment outcome in PD, GI and BI improvement could be predicted with MCP-1 -2518 A/G genotype and aggressive periodontitis status as the predictor variables. In contrast, MCP-1 -2518 A/A genotype and aggressive periodontitis status could predict better treatment response in PD and BI improvement. However, MCP-1 -2518 genotype did not affect the treatment outcome in patients with chronic periodontitis. Conclusion MCP-1 -2518 A/G genotype might be useful in predicting less favorable nonsurgical treatment outcome in patients with aggressive periodontitis. However, MCP-1 -2518 gene polymorphism may not play a role in patients with chronic periodontitis. This study suggests that MCP-1 -2518 genotype may influence the outcome of nonsurgical periodontal treatment in aggressive periodontitis patients.

The recycling of abandoned containers from the export/import business becomes an important issue of city regeneration in the context of sustainable development. Here we explore the design syntax for a place configured by shipping containers. Employing the 3T concept, i.e. topos, typos and tectonics, initiated by Frampton, we construct a framework of spatial practice for the reuse of containers in Taiwan. Our study shows that 1. Integrating the container architecture with the existing content is an efficient approach to a sustainable redevelopment; 2. the diversity in functions provided by a container architecture is an excellent tool to enriching public life; and 3. remodeling container space with local material can serve as a catalyst to the development of creative culture and urban economics.

In physical examinations, hemodialysis access stenosis leading to dysfunction occurs at the venous anastomosis site or the outflow vein. Information from the inflow stenosis, such as blood pressure, pressure drop, and flow resistance increases, allows dysfunction screening from the stage of early clots and thrombosis to the progression of outflow stenosis. Therefore, this study proposes dysfunction screening model in experimental arteriovenous grafts (AVGs) using the fractional-order extractor (FOE) and the color relation analysis (CRA). A Sprott system was designed using an FOE to quantify the differences in transverse vibration pressures between the inflow and outflow sites of an AVG. Experimental analysis revealed that the degree of stenosis (DOS) correlated with an increase in fractional-order dynamic errors (FODEs). Exponential regression was used to fit a non-linear curve and can be used to quantify the relationship between the FODEs and DOS (R (2) = 0.8064). The specific ranges were used to evaluate the stenosis degree, such as DOS:50, 50-80, and80%. A CRA-based screening method was derived from the hue angle-saturation-value color model, which describes perceptual color relationships for the DOS. It has a flexibility inference manner with color visualization to represent the different stenosis degrees, which has average accuracy90% superior to the traditional methods. This in vitro experimental study demonstrated that the proposed model can be used for dysfunction screening in stenotic AVGs.

Sensory nerve dysfunction is a common symptom in hemodialysis (HD) patients and to have a more objective diagnose is more and more important for clinician recently. The current perception threshold (CPT) is a method for evaluation sensory nerve function via pain feeling and which has been reported better than the conventional methods. In this study, we proposed a system based on Flexible Fuzzy Classifier (FFC) using CPT index to evaluate sensory nerve dysfunction in HD patients. All patients were recruited at Yong-Kang Veterans Hospital including 35 HD patients (20 male/15 female) versus 20 control patients (10 male/10 female) and measured from arm and above the ankles before HD therapy. The results indicated that CPT levels in HD patients were significantly higher than normal aged subjects (control group), and over 7 years of HD patients were appeared to be higher but not significant with other patients. Furthermore, FFC method could classify HD patients and controls group successfully with 100 % accuracy; 82 % accuracy for over 7 years HD patients and others. The FFC method with CPT index has high potential to be an automatic classification system for early stage detection of sensory nerve dysfunction.

The impact of globalization on the built environment is a transnational interconnection in every aspect of economy, society, culture and spatial developments. In response to the needs of the economical and industrial developments, this interconnectedness changes interactions between the people, the urban and the natural landscape. These changes not only include the transformation of people's attitudes toward lives, but also comprise the alteration in physical environments. Either types of change, whether physically or sensationally, are closely related to the lifestyle of local residents, the construction of the living space, and the attitude toward the man-made environment. With increases in pace and the scale of changes the tension to the daily life and the relationship between the city and the landscape has gradually formed. Accordingly, the pressure in the traditional city is largely extended due to the irreversible transformation caused by the spatial practice during the process of globalization and urbanization. Just as all environmental developments and redevelopments are embedded in their local context, the pressure stemmed from both the global and the local developments provides the linkage between the global and the local context. Consequently, re-examining people’s thinking about their own city has become a key issue for the future development of a contemporary city under the pressure of globalization and localization.

Developing awareness of environmental protection issues and rising costs of medical treatment are causing all medical treatment centers to reduce expenditure on the processing of infectious hazardous wastes. This has become a major matter of policy in most hospitals. This project was undertaken because, in one unit, expenditure on infectious hazardous waste processing began to cost 50% of the hospital's entire monthly spending on such processing. A specialist team was established, which put into practice a monitoring plan and improvement measures. The results were as follows. First, with guidance, staff members realized the importance of reducing the quantity of infectious hazardous wastes. Second, infectious hazardous wastes were reduced by reducing the quantity, recycling, and not being wasteful. Third, following this effort, the hemodialysis room in question was able to save NT 2,786 dollars per month in expenditure on hygienic materials and waste handling fees of NT 5,597 dollars per month. A total of NT 100,596 dollars was saved for the whole year. Fourth, the whole improvement project target completion rate was 240% and the progress rate was 13.3%.

The authors present a neural network approach to solving the problem of decoding graph theoretic codes (GTCs). The equivalence relation has first been established between the problem of maximum likelihood decoding (MLD) of graph theoretic codes and that of minimizing an energy function of the Hopfield networks associated with those graphs (J. Bruck and M. Blaum 1989). This, is turn, allows construction of a Hopfield neural network which performs a MLD function in a natural way. However, the existence of the local minima problem, although considerably relaxed in these nets, prevents the completeness of the new decoding approach. Therefore, the authors modify the traditional Hopfield model by adding a detection mechanism to overcome the problem. Statistical analysis and simulations are provided to show the effectiveness of the new model. >