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Aims: Psychological insulin resistance is a common barrier to initiation and persistence with insulin therapy that affects approximately 42.7% of people living with type II diabetes mellitus, which may negatively impact self‐management. This study aimed to assess patients' levels of psychological insulin resistance and to identify factors associated with self‐management in patients with type II diabetes mellitus treated with insulin therapy. Methods: We adopted a cross‐sectional design. Subjects from the metabolism and endocrinology outpatient departments of a regional teaching hospital in central Taiwan were recruited by consecutive sampling. Patients were assessed for psychological insulin resistance and self‐management using the barriers to insulin treatment questionnaire and the partners in health scale. Results: A total of 222 patients with type II diabetes mellitus were recruited. Patients had an average psychological insulin resistance score of 3.14 (maximum of 8). Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age. Conclusion: Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy. Insulin therapy education should be offered to improve patients' beliefs about insulin therapy and enhance patients' ability to perform self‐management. Summary statement: What is already known about this topic? Psychological insulin resistance is a common psychological barrier to initiation and persistence with insulin therapy.Psychological insulin resistance causes poor glycaemic control and diabetes‐related complications.Psychological insulin resistance may negatively impact self‐management in patients with type II diabetes mellitus. What is the contribution of this paper? Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age.Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy.Patients with poor self‐management had statistically significantly higher levels of overall psychological insulin resistance, fear of injections and self‐testing, expectations regarding positive insulin‐related outcomes, and stigmatization by insulin injections, compared to those with appropriate self‐management. What are the implications of this paper? Knowing in advance the factors associated with diabetes self‐management will allow healthcare professionals prevent psychological insulin resistance in patients with type II diabetes mellitus treated with insulin therapy.Healthcare professionals can design and provide patient‐centred diabetes education based on education level to enhance self‐management. [ABSTRACT FROM AUTHOR]

By using the machine learning of artificial intelligence to explore the application business opportunities of the Metaverse in the MMORPG (Massively Multiplayer Online Role-Playing Game) interactive game market, we study the supply and demand laws of buyers and sellers at the market economy level, future trends, and business opportunities. The feasibility of its new products and services is explored under a pragmatic, cooperative model of the game community platform "Key to the Desert" case for the application level and business opportunities of Taiwan's Metaverse markets. Online and offline integration (OMO; Online Merge Offline), precision marketing, and the customer management data platform (Customer Data Platform) are also explored in the application business opportunities of the Metaverse market. By combining the NFT (Non-Fungible Token) Monopoly game and MMORPG interactive games, we study the laws of supply and demand of buyers and sellers at the market economy level to provide third-party payment, electronic payment, mobile payment, and other transaction method certifications such as NFT (Non- Fungible Token). We also evaluation the future and security issues of cryptocurrency. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study's purpose was to identify the correlates of sleep quality in older adults with chronic disease. Background: Sleep quality is a common problem in older adults that may be affected by physical and mental status. Design: A cross‐sectional correlational design was employed. Methods: The study was conducted between July 2019 and April 2020 in a teaching hospital of southern Taiwan. The Geriatric Depression Scale, Pittsburgh Sleep Quality Index and Numerical Rating Scale were used to assess depression, sleep quality and physical pain respectively. Results: Of the 120 older adults (age >65 years) with chronic disease, the average Pittsburgh Sleep Quality Index score was 5.67. A total of 45.8% subjects had sleep disturbance. Older adults who were living with a partner and those who urinated at night were significantly more likely to report sleep disturbance. The presence of sleep disturbance was associated with greater levels of depression and higher levels of physical pain. Conclusion: Living with a partner, nocturia, physical pain and depression were associated with the presence of sleep disturbance in older adults with chronic disease. Relevance to clinical practice: The results of this study can help healthcare providers understand the factors associated with sleep disturbance in older adults with chronic disease, thereby facilitating the early resolution of sleep disturbance issues in this population. [ABSTRACT FROM AUTHOR]

Purpose: After suddenly stopping smoking after an initial oral cancer (OC) diagnosis, patients may restart smoking and nicotine dependence. This study sought to identify factors associated with high nicotine dependence in OC patients who restarted smoking post‐treatment. Design: A cross‐sectional study. Methods: A group of 220 OC patients who restarted smoking post‐treatment were recruited from the outpatient radiation department of a single cancer center in northern Taiwan. Demographic and clinical characteristics were recorded, and patients were assessed for nicotine and smoking dependence, physical activity and function, socio‐emotional function, social support, and depression. Results: Among patients who restarted smoking after treatment for OC, 75.9% reported low‐to‐moderate dependence on smoking, while 24.1% reported high nicotine dependence. Factors associated with high nicotine dependence included higher incidence of smoking per day, greater dependence on smoking, less physical activity per week, and poorer social–emotional function. Those highly dependent on nicotine were younger, unmarried, had less education, and had begun smoking earlier than those with low‐to‐moderate nicotine dependence. Conclusions: The amount of smoking per day, greater smoking behavioral dependence, less physical activity per week, and worse social–emotional function affected high nicotine dependence. Clinical relevance: Smoking cessation training and counseling for OC patients may help them better control their use of tobacco after treatment. [ABSTRACT FROM AUTHOR]

Purpose: Primary caregivers (PC) of patients with advanced head and neck cancer (HNC) report stress during caregiving time post‐treatment. We sought to identify the trajectories of resilience from initial completion of treatment to 1‐year post‐treatment in PC of patients with advanced HNC and to determine the factors associated with trajectories of resilience. Design: In this prospective cohort study with convenience sampling, patient–PC dyads were recruited from a medical center in northern Taiwan between August 2015 and July 2020. Methods: We recruited 120 patient–PC dyads and followed up at treatment completion and 1, 6, and 12 months post‐treatment. Generalized estimating equation analysis was performed to identified factors related to resilience. Findings: PCs' overall resilience increased from initial completion of treatment to peak at 1‐year post‐treatment. Patient factors associated with greater overall resilience included older age, higher performance status, and shorter time since cancer diagnosis; PC factors included reporting more social support, better physical health, and better mental health. Conclusions: PC mental health was the most important factor in the resilience trajectory of patients with advanced HNC cancer. Clinical relevance: Quantifying the relevant factors of trajectories of resilience will help to identify vulnerable PCs and guide survivorship care in the early stages of the post‐treatment period. [ABSTRACT FROM AUTHOR]

This study aimed to assess patients' levels of belief, benefits and barriers toward physical activity, and to identify factors associated with physical activity performance in patients with type II diabetes mellitus (T2DM). The study was carried out using cross-sectional correlation design. Subjects from the endocrinology and metabolism outpatient departments of a teaching hospital in northern Taiwan were recruited by consecutive sampling. A total of 149 patients with type II DM were recruited. More physical activity was associated with stronger physical activity beliefs, including recovery self-efficacy, action and coping planning, and maintenance self-efficacy, which explained 40.9% of variance in physical activity performance. Patient-centered physical activity programs (resistance exercise, daily walking, or Tai Chi exercise) can reduce patients' barriers toward performing physical activity. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a primary cause of cancer-related mortality, and, after treatment, cancer survivors often worry that disease recurrence may worsen their health. Nevertheless, limited research on fear of cancer recurrence (FCR) and treatment-related symptoms has been conducted on survivors of CRC., Purpose: This study was designed to explore (1) symptom distress severity and post-treatment FCR in CRC survivors and (2) the predictors of FCR., Methods: A cross-sectional correlational research design and convenience sampling approach were used to recruit patients at the colorectal surgery outpatient department of a medical center in central Taiwan. Basic demographic data, the Symptom Distress Scale - Chinese Modified Form, and Fear of Progression Questionnaire - Short Form were used as monitoring tools. Pearson's product-moment correlation analysis, independent t-tests, one-way ANOVA, and stepwise linear regression analysis were used for statistical analysis., Results: One hundred fourteen survivors of CRC with an average age of 63.44 were enrolled as participants. The top five symptoms of distress were numbness, bowel patterns, fatigue, insomnia, and dry mouth, and the average FCR score was 18.09. Gender, educational level, monthly disposable income, and symptom distress were identified as significant predictors of FCR, with an overall explanatory power of 41.4%., Conclusions: Level of post-treatment FCR in survivors of CRC is influenced by symptom distress severity. Early intervention by healthcare providers to control or alleviate physical symptoms can help prevent the emergence of negative emotions and improve quality of life in this patient group.

Background: Knee osteoarthritis is prevalent in older adults worldwide. Quality of life was negatively affected by the COVID-19 pandemic., Purpose: This study was designed to examine osteoarthritis severity and health-related quality of life (QOL) in older adults with knee osteoarthritis before total knee replacement during the COVID-19 pandemic and to identify the related predictors of QOL., Methods: This cross-sectional correlation study involved convenience sampling in the orthopedic ward of a regional teaching hospital in central Taiwan from June 2020 to June 2021 using the Western Ontario and McMaster Universities Arthritis Index and the SF-36v2 Health Survey. The data were analyzed using Pearson's correlation coefficient analysis, independent samples t test, and one-way analysis of variance to determine correlations among demographic variables, osteoarthritis severity, and QOL. The predictors of QOL were examined using stepwise multiple linear regression analysis., Results: A total of 60 older adults diagnosed with knee osteoarthritis were sampled. The average age was 70 years and the average osteoarthritis severity score was 70.45. Being male, having comorbidities, and having a relatively high level of monthly disposable income were associated with poorer QOL. Moreover, more severe knee pain, stiffness, and physical dysfunction were associated with better psychological QOL., Conclusions / Implications for Practice: During the COVID-19 pandemic, the severity of knee osteoarthritis affects preoperative quality of life in older adults. Clinicians should detect signs of pain and physical dysfunction in these patients in advance and intervene in a timely manner to improve their QOL before surgery.

Globally, every year about 11% of infants are born preterm, defined as a birth prior to 37 weeks of gestation, with significant and lingering health consequences. Multiple studies have related the vaginal microbiome to preterm birth. We present a crowdsourcing approach to predict: (a) preterm or (b) early preterm birth from 9 publicly available vaginal microbiome studies representing 3,578 samples from 1,268 pregnant individuals, aggregated from raw sequences via an open-source tool, MaLiAmPi. We validated the crowdsourced models on novel datasets representing 331 samples from 148 pregnant individuals. From 318 DREAM challenge participants we received 148 and 121 submissions for our two separate prediction sub-challenges with top-ranking submissions achieving bootstrapped AUROC scores of 0.69 and 0.87, respectively. Alpha diversity, VALENCIA community state types, and composition (via phylotype relative abundance) were important features in the top performing models, most of which were tree based methods. This work serves as the foundation for subsequent efforts to translate predictive tests into clinical practice, and to better understand and prevent preterm birth., Competing Interests: Competing Interests Antonio Parraga-Leo and Patricia Diaz-Gimeno are receiving hononaria from the IVI Foundation. The remaining authors declare no Competing Financial or Non-Financial Interests.

The gastrointestinal dysfunction and nutrient malabsorption associated with gastrointestinal tumors and related treatments may result in malnutrition in gastrointestinal (GI) cancer patients. Malnutrition has been associated with decreased treatment tolerance, poor quality of life, and increased mortality in this patient population. In this article, the relevant literature is reviewed and the factors, assessment tools, and management strategies related to malnutrition are summarized. In clinical care, healthcare providers should conduct early assessments of nutritional status and provide individualization nutritional counselling to promote treatment that effectively prolongs patient survival. This article may be used by nurses as a reference in caring for GI cancer patients.