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Diana TF Lee,1 Doris Yu,1 Margaret Ip,2 Jennifer YM Tang3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, 2Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, 3Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong Purpose: Old age homes (OAHs) represent a vulnerable community for influenza outbreaks. Effective implementation of respiratory protection measures has been identified as an effective prevention measure to reduce mortality and morbidity caused by such outbreaks. Yet, relatively little is known about this aspect in these homes. This study evaluated the implementation of respiratory protection measures among infection control officers (ICOs) and health care workers (HCWs) in these homes in Hong Kong.Patients and methods: A territory-wide, cross-sectional survey was conducted in 87 OAHs. A total of 87 ICOs and 1,763 HCWs (including nurses, health workers, care workers, allied HCWs and assistants) completed the questionnaires that evaluated the implementation at the organizational level and individual level, respectively. Generalized estimating equations with unstructured working correlation matrix were used to analyze the simultaneous influence of organizational and individual factors on the implementation.Results: At the organizational level, all homes had a policy on respiratory protection and implementation of such measures was generally adequate. Basic resources such as paper towels/hand dryers and equipment disinfectants, however, were rated as most inadequate by HCWs. Training opportunities were also identified as grossly inadequate. Only less than half of the ICOs and HCWs participated in training on infection control either at the initiation of employment or on a regular basis. Twenty-five percent of HCWs even indicated that they had never participated in any infection control training. At the individual level, hand hygiene, among other protection measures, was found to be less well implemented by HCWs. In terms of the association of various organizational and individual characteristics, private homes and health workers rated significantly higher scores in the implementation of various domains in respiratory protection.Conclusion: Addressing the unmet training needs and promoting hand hygiene practice are efforts suggested to further enhance the implementation of respiratory protection measures in OAHs. Keywords: influenza outbreaks, health care workers, long-term care, infection control

Janet WH Sit,1 Sek Ying Chair,1 Kai Chow Choi,1 Carmen WH Chan,1 Diana TF Lee,1 Aileen WK Chan,1 Jo LK Cheung,1 Siu Wai Tang,2 Po Shan Chan,2 Ruth E Taylor-Piliae3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, 2Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital, Hong Kong Hospital Authority, Causeway Bay, Hong Kong, People’s Republic of China; 3College of Nursing, The University of Arizona, Tucson, AZ, USA Background: Self-management after a stroke is a challenge because of multifaceted care needs and complex disabling consequences that cause further hindrance to patient participation. A 13-week stroke patient empowerment intervention (Health Empowerment Intervention for Stroke Self-management [HEISS]) was developed to enhance patients’ ability to participate in self-management.Purpose: To examine the effects of the empowerment intervention on stroke patients’ self-efficacy, self-management behavior, and functional recovery.Methods: This is a single-blind randomized controlled trial with stroke survivors assigned to either a control group (CG) receiving usual ambulatory rehabilitation care or the HEISS in addition to usual care (intervention group [IG]). Outcome data were collected at baseline (T0), 1 week (T1), 3 months (T2), and 6 months (T3) postintervention. Data were analyzed on the intention-to-treat principle. The generalized estimating equation model was used to assess the differential change of self-efficacy in illness management, self-management behaviors (cognitive symptom management, communication with physician, medication adherence, and self-blood pressure monitoring), and functional recovery (Barthel and Lawton indices) across time points (baseline = T0, 1 week = T1, 3 months = T2, and 6 months = T3 postintervention) between the two groups.Results: A total of 210 (CG =105, IG =105) Hong Kong Chinese stroke survivors (mean age =69 years, 49% women, 72% ischemic stroke, 89% hemiparesis, and 63% tactile sensory deficit) were enrolled in the study. Those in IG reported better self-efficacy in illness management 3-month (P=0.011) and 6-month (P=0.012) postintervention, along with better self-management behaviors at all follow-up time points (all P0.05). Those in IG had significantly better functional recovery (Barthel, all P

Abstract Background When aligning several hundreds or thousands of sequences, such as epidemic virus sequences or homologous/orthologous sequences of some big gene families, to reconstruct the epidemiological history or their phylogenies, how to analyze and visualize the alignment results of many sequences has become a new challenge for computational biologists. Although there are several tools available for visualization of very long sequence alignments, few of them are applicable to the alignments of many sequences. Results A multiple-logo alignment visualization tool, called Phylo-mLogo, is presented in this paper. Phylo-mLogo calculates the variabilities and homogeneities of alignment sequences by base frequencies or entropies. Different from the traditional representations of sequence logos, Phylo-mLogo not only displays the global logo patterns of the whole alignment of multiple sequences, but also demonstrates their local homologous logos for each clade hierarchically. In addition, Phylo-mLogo also allows the user to focus only on the analysis of some important, structurally or functionally constrained sites in the alignment selected by the user or by built-in automatic calculation. Conclusion With Phylo-mLogo, the user can symbolically and hierarchically visualize hundreds of aligned sequences simultaneously and easily check the changes of their amino acid sites when analyzing many homologous/orthologous or influenza virus sequences. More information of Phylo-mLogo can be found at URL http://biocomp.iis.sinica.edu.tw/phylomlogo.

Abstract Background The significant advances in microarray and proteomics analyses have resulted in an exponential increase in potential new targets and have promised to shed light on the identification of disease markers and cellular pathways. We aim to collect and decipher the HCC-related genes at the systems level. Results Here, we build an integrative platform, the Encyclopedia of Hepatocellular Carcinoma genes Online, dubbed EHCO http://ehco.iis.sinica.edu.tw, to systematically collect, organize and compare the pileup of unsorted HCC-related studies by using natural language processing and softbots. Among the eight gene set collections, ranging across PubMed, SAGE, microarray, and proteomics data, there are 2,906 genes in total; however, more than 77% genes are only included once, suggesting that tremendous efforts need to be exerted to characterize the relationship between HCC and these genes. Of these HCC inventories, protein binding represents the largest proportion (~25%) from Gene Ontology analysis. In fact, many differentially expressed gene sets in EHCO could form interaction networks (e.g. HBV-associated HCC network) by using available human protein-protein interaction datasets. To further highlight the potential new targets in the inferred network from EHCO, we combine comparative genomics and interactomics approaches to analyze 120 evolutionary conserved and overexpressed genes in HCC. 47 out of 120 queries can form a highly interactive network with 18 queries serving as hubs. Conclusion This architectural map may represent the first step toward the attempt to decipher the hepatocarcinogenesis at the systems level. Targeting hubs and/or disruption of the network formation might reveal novel strategy for HCC treatment.

Abstract Background Deluged by the rate and complexity of completed genomic sequences, the need to align longer sequences becomes more urgent, and many more tools have thus been developed. In the initial stage of genomic sequence analysis, a biologist is usually faced with the questions of how to choose the best tool to align sequences of interest and how to analyze and visualize the alignment results, and then with the question of whether poorly aligned regions produced by the tool are indeed not homologous or are just results due to inappropriate alignment tools or scoring systems used. Although several systematic evaluations of multiple sequence alignment (MSA) programs have been proposed, they may not provide a standard-bearer for most biologists because those poorly aligned regions in these evaluations are never discussed. Thus, a tool that allows cross comparison of the alignment results obtained by different tools simultaneously could help a biologist evaluate their correctness and accuracy. Results In this paper, we present a versatile alignment visualization system, called SinicView, (for Sequence-aligning INnovative and Interactive Comparison VIEWer), which allows the user to efficiently compare and evaluate assorted nucleotide alignment results obtained by different tools. SinicView calculates similarity of the alignment outputs under a fixed window using the sum-of-pairs method and provides scoring profiles of each set of aligned sequences. The user can visually compare alignment results either in graphic scoring profiles or in plain text format of the aligned nucleotides along with the annotations information. We illustrate the capabilities of our visualization system by comparing alignment results obtained by MLAGAN, MAVID, and MULTIZ, respectively. Conclusion With SinicView, users can use their own data sequences to compare various alignment tools or scoring systems and select the most suitable one to perform alignment in the initial stage of sequence analysis.

Iris Fung-Kam Lee,1 Felix Ngok Yau,2 Sally Suk-Ha Yim,2 Diana Tze-Fan Lee1 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region; 2Nethersole Outreaching Rehabilitation Mission, Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong, Special Administrative Region Introduction: Previous studies evaluating home-based rehabilitation service (HBRS) merely focused on the period immediately after the patients’ discharge from hospitals. The present study focuses on HBRS that covers clients who have not been recently hospitalized. HBRS aims to meet older clients’ rehabilitation needs and support their caregivers in the community. This study intended to evaluate the impact of HBRS on the older clients’ health outcomes and hospital services utilization, and caregivers’ strain in providing care for clients.Methods: This study used a matched-control quasi-experimental design with a 3-month follow-up to evaluate HBRS. The health outcome measures used for the older clients included Elderly Mobility Scale, Timed Up and Go test, Modified Barthel Index, Lawton’s Instrumental Activities of Daily Living Scale, Mini-Mental State Examination, and World Health Organization Quality of Life Scale, Short Form, Hong Kong version (WHOQOL-BREF [HK]). Meanwhile, the Caregiver Strain Index was used to measure the caregivers’ caregiving strain. Data on clients’ hospital services utilization 3 and 6 months before and after the study were also collected and evaluated.Results: The final sample consisted of 122 pairs of older clients and caregivers who live in a community in Hong Kong. In the follow-up after 3 months, the intervention group showed immensely substantial improvements across all the health outcome measures compared with the control group. The intervention group also demonstrated substantial reduction in the clients’ hospital services utilization compared with the control group. However, no significant differences in the clients’ hospital services utilization exist between the two groups in the follow-up after 6 months.Conclusion: HBRS of this study is an effective intervention service to improve health outcomes and reduce hospital services utilization among older people living in the community. Moreover, HBRS of this study was effective in reducing the caregivers’ caregiving strain. Keywords: elderly, community, Elderly Mobility Scale, Caregiver Strain Index, hospital services utilization

Background: The significant advances in microarray and proteomics analyses have resulted in an exponential increase in potential new targets and have promised to shed light on the identification of disease markers and cellular pathways. We aim to collect and decipher the HCC-related genes at the systems level. Results: Here, we build an integrative platform, the Encyclopedia of Hepatocellular Carcinoma genes Online, dubbed EHCO http://ehco.iis.sinica.edu.tw, to systematically collect, organize and compare the pileup of unsorted HCC-related studies by using natural language processing and softbots. Among the eight gene set collections, ranging across PubMed, SAGE, microarray, and proteomics data, there are 2,906 genes in total; however, more than 77% genes are only included once, suggesting that tremendous efforts need to be exerted to characterize the relationship between HCC and these genes. Of these HCC inventories, protein binding represents the largest proportion (~25%) from Gene Ontology analysis. In fact, many differentially expressed gene sets in EHCO could form interaction networks (e.g. HBV-associated HCC network) by using available human protein-protein interaction datasets. To further highlight the potential new targets in the inferred network from EHCO, we combine comparative genomics and interactomics approaches to analyze 120 evolutionary conserved and overexpressed genes in HCC. 47 out of 120 queries can form a highly interactive network with 18 queries serving as hubs. [ABSTRACT FROM AUTHOR]

Background. The global toll of suicide is estimated to be one million lives per year, which exceeded the number of deaths by homicide and war combined. A key step to suicide prevention is to prevent less serious suicidal behaviour to preclude more lethal outcomes. Although 61% of the world's suicides take place in Asia and the suicide rates among middle age groups have been increasing since the economic crisis in many Asian countries, population-based studies of suicidal behaviour among working-age adults in non-western communities are scarce.Method. Data from a population-based survey with 2015 participants were used to estimate the prevalence of suicidal ideation and behaviour among the working-age population in Hong Kong, and to study the associated socio-economic and psychological correlates. We focused particularly on potential modulating factors between life-event-related factors and suicidal ideation.Results. Six per cent of the Hong Kong population aged 20-59 years considered suicide in the past year, while 1.4% attempted suicide. Hopelessness, reasons for living, and reluctance to seek help from family and friends had direct association with past-year suicidal ideation. Reasons for living were found to moderate the effect of perceived stress on suicidal ideation.Conclusions. Suicidality is a multi-faceted problem that calls for a multi-sectored, multi-layered approach to prevention. Prevention programmes can work on modulating factors such as reasons for living to reduce suicidal risk in working-age adults. [ABSTRACT FROM AUTHOR]

The American lifestyle of convenience and inactivity has taken a toll on health. Eating in fastfood estblishments accounts for much of the excess calorie consumption among Americans. Here's how to help your patients avoid the pitfalls of eating out. [ABSTRACT FROM AUTHOR]

Aileen WK Chan, Doris SF Yu, KC Choi, Diana TF Lee, Janet WH Sit, Helen YL Chan The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China Purpose: Age-related cognitive decline is a growing public health concern worldwide. More than a quarter of adults with cognitive impairment experience sleep disturbance. The objective of this pilot study was to evaluate the preliminary effects of tai chi qigong (TCQ) on improving the night-time sleep quality of older adults with cognitive impairment. Participants: Older adults with cognitive impairment who complain of sleep disturbance. Methods: A randomized controlled trial with two groups. Fifty-two subjects were recruited from two district elderly community centers and randomly assigned to either the TCQ group (n=27) or the control group (n=25). The intervention group received TCQ training consisting of two 60-minute sessions each week for 2 months. The control group was advised to maintain their usual activities. Sleep quality was measured by the Chinese Pittsburgh Sleep Quality Index. Quality of life was measured by Short-form 12, cognitive functions measured by mini-mental state examination, and subjective memory deficits measured by the memory inventory for Chinese. Results: Data were collected at baseline, 2 months, and 6 months. Significant results were noted at 6 months in the Chinese Pittsburgh Sleep Quality Index global score (P=0.004), sleep duration (P=0.003), habitual sleep efficiency (P=0.002), and the Short-form 12 mental health component (P

Doris Y P Leung,1 Diana Tze-Fan Lee,1 Iris F K Lee,1 Lai-Wah Lam,1 Susanna W Y Lee,2 May W M Chan,3 Yin-Ming Lam,4 Siu-Hung Leung,5 Pui-Chi Chiu,6 Nelly K F Ho,7 Ming-Fai Ip,8 May My Hui8 1The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong; 2Hospital Authority Head Office, 3Kowloon West Cluster, 4New Territories West Cluster, 5Kowloon East Cluster, 6United Christian Hospital, 7Kowloon Hospital, 8Tuen Mun Hospital, Hong Kong Hospital Authority, Kowloon, Hong Kong Introduction: Attendance at emergency departments and unplanned hospital readmissions are common for frail older patients after discharge from hospitals. A virtual ward service was piloted to deliver “hospital-at-home” services by community nurses and geriatricians to frail older patients immediately after their discharge from hospital to reduce emergency services utilization.Objectives: This study examined the impacts of the virtual ward service on changes in the patients’ emergency attendance and medical readmissions, and their quality of life (QOL).Methods: A matched-control quasi-experimental study was conducted at four hospitals, with three providing the virtual ward service (intervention) and one providing the usual community nursing care (control). Subjects in the intervention group were those who are at high risk of readmission and who are supported by home carers recruited from the three hospitals providing the virtual ward service. Matched control patients were those recruited from the hospital providing usual care. Outcome measures include emergency attendance and medical readmission in the past 90 days as identified from medical records, and patient-reported QOL as measured by the modified Quality-of-Life Concerns in the End of Life Questionnaire (Chinese version). Wilcoxon signed-rank tests compared the changes in the outcome variables between groups.Results: A total of 39 patients in each of the two groups were recruited. The virtual ward group showed a greater significant reduction in the number of unplanned emergency hospital readmissions (-1.41±1.23 versus -0.77±1.31; P=0.049) and a significant improvement in their overall QOL (n=18; 0.60±0.56 versus 0.07±0.56; P=0.02), but there was no significant difference in the number of emergency attendances (-1.51±1.25 versus -1.08±1.48; P=0.29).Conclusion: The study results support the effectiveness of the virtual ward service in reducing unplanned emergency medical readmissions and in improving the QOL in frail older patients after discharge. Keywords: elderly, emergency attendance, emergency medical readmission, emergency services utilization, quality of life, virtual ward

Presents a cohort study of burnout and attrition in nursing students. Level of stress that nursing students experience throughout their baccalaureate program; Development and evaluation of a graduate transition scheme; Objectives under the pilot project for nursing students.

Presents an article about the importance of promoting the quality of long-term care for older people worldwide. Projection on an increase in the number of older people who need assistance; Factors that influence the attitudes of Taiwanese elders toward long-term care; Similarities and differences in the perceptions of Taiwanese and Chinese elders on the important issues in long-term care provision.

We report an X-ray radiation-induced modification of the structure and gas permeation behavior of ZIF-8 membranes. With 300 min irradiation time, CO 2 permeance decreases by only 9 %, while N 2 and CH 4 permeances reduce by 75 and 65 %, respectively, leading to 3.7- and 2.6-fold enhancements in ideal selectivity for CO 2 /N 2 and CO 2 /CH 4 ., (© 2024 Wiley-VCH GmbH.)

Background Objectives: The purpose of this study is to investigate changes in gut microbiota related to metabolic diseases after moderate and high-intensity exercise. A total of 24 participants were divided into three groups: Non-Exercise Group (NEG, n = 8, 28.6 ± 5.3 years, 176.0 ± 7.8 cm, 81.3 ± 14.6 kg), Moderate Intensity Exercise Group (MIEG, n = 8, 26.5 ± 3.3 years, 176.9 ± 5.0 cm, 75.4 ± 9.5 kg), and Vigorous Intensity Exercise Group (VIEG, n = 8, 30.6 ± 5.9 years, 174.2 ± 3.5 cm, 77.8 ± 12.2 kg)., Methods: The participants were selected by assessing physical activity, gut health status, presence of diseases, recent disease diagnoses, and dietary disorders. Those who reported any presence disease or recent disease diagnosis were excluded from the current study. Stool samples were collected after a 10-h fast for gut microbiome analysis. MIEG participants trained at 40-59 % heart rate reserve (HRR) for at least 150 min per week, while VIEG participants trained at ≥ 60 % HRR for at least 90 min per week. After 4 weeks, all participants provided stool samples for gut microbiome analysis.Data analysis was conducted using the Wilcoxon test, with statistical significance set at ≤ 0.05., Results: The results indicated an increase in Prevotella in MIEG, while Veillonella, Dorea&#95;formicigenerans, and Dorea&#95;longicatena exhibited a decrease (p < 0.05). In VIEG, there was an increase in Bacteroides, Butyricimonas, Odoribacter, and Alistipes (p < 0.05)., Conclusion: These modified microbial groups were associated with factors related to metabolic diseases, including inflammatory bowel disease, obesity, colorectal cancer, diabetes, hypertension, metabolic liver diseases, and ischemic heart diseases. Additional research is essential to delve into the relationship between exercise and these alterations in the microbiome., Competing Interests: The author(s) have no conflicts of interest relevant to this article., (© 2024 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd.)

Objectives: Fractional ablative CO 2 laser (FLSR) is used to treat hypertrophic scars (HTSs) resulting from burn injuries, which are characterized by factors, such as erythema, contracture, thickness, and symptoms of pain and itch. Traditionally, waiting a year after injury for scar maturation before starting laser treatment has been recommended; however, the potential benefits of earlier intervention have gained popularity. Still, the optimal timing for beginning laser intervention in patients with HTSs remains uncertain. This study aims to evaluate the ideal timing for the initiation of FLSR for HTSs using several qualitative and quantitative assessment measures. It was hypothesized that early intervention would lead to similar improvement trends as later intervention, however, would be more ideal due to the shortened time without symptom relief for patients., Methods: Patients who received three or more laser treatment sessions and completed both pre- and posttreatment evaluations were included in this analysis (n = 69). FLSR treatment was administered at 4-8-week intervals. Patients starting treatment before 6 months after injury were classified as the early-stage intervention group and those beginning treatment at 6-12 months after injury were classified as the late-stage intervention group. Demographic data, including the age of patients at the time of first treatment, age of scars at the time of first treatment, biological sex, ethnicity, Fitzpatrick skin type, and use of laser-assisted drug delivery, were collected by retrospective chart review. Patients were evaluated on six subjective scales and objectively for scar stiffness with durometry. For all scales, higher scores indicate worse scars. A two-way ANOVA, Student's t-test, and Mann-Whitney U-test were used to compare scores from the pre- to posttreatment evaluations., Results: There were no significant differences between the groups for any of the demographic or scar-specific variables; thus, differences in outcome can be attributed to the timing of intervention. Both groups demonstrated an improvement in scars with treatment over time (p < 0.05). Both early- and middle-stage initiation showed scar symptom improvement in five out of six scales. In the late-stage intervention, the Patient and Observer Scar Assessment Scale-Patient average score did not show improvement. In the early-stage intervention, the Vancouver Scar Scale total did not show improvement. Quantitative evaluation of scar stiffness by durometry did not show symptom improvement in either group. The Scar Comparison Scale demonstrated the greatest improvement across groups., Conclusion: Laser treatment led to scar improvement in at least one scale at each stage of initiation. Both intervention timelines resulted in equivalent outcomes, and early intervention should be considered when initiating FLSR treatment in burn scars to alleviate symptoms earlier., (© 2024 The Author(s). Lasers in Surgery and Medicine published by Wiley Periodicals LLC.)

Inadequate management of blood glucose levels in gestational diabetes mellitus (GDM) poses risks for both pregnant women and the developing fetus. Attaining appropriate blood glucose control is crucial to mitigate potential adverse outcomes. This study aimed to consolidate the latest guidelines from representative professional societies, providing insights into exercise therapy for GDM patients and suggesting potential avenues for future research. The review was conducted with up-to-date exercise guidelines from prominent societies, such as the American College of Obstetricians and Gynecologists (ACOG), the Society of Obstetricians and Gynecologists of Canada (SOGC), the Canadian Society for Exercise Physiology (CSEP), the American College of Sports Medicine, the American Diabetes Association (ADA), and the Korean Diabetes Association. The ACOG and SOGC/CSEP recommend 150 min of low to moderate intensity exercise, 3-4 times a week, combining aerobic and resistance exercises. All guidelines advise against activities involving sudden directional changes, physical contact, a risk of falling, and exercises performed lying down. Despite cautions from the ADA and ACOG on blood glucose fluctuations during physical activity, the lack of specific methods and recommendations from other societies reveals a notable gap in evidence-based guidelines for GDM. For effective and safe blood glucose management in GDM patients, further research should be conducted on the exercise-related precautions outlined for GDM patients. Establishing ample evidence would facilitate the development of customized exercise guidelines for GDM patients.

Context: Use of artificial intelligence (AI) to predict clinical outcomes in thyroid nodule diagnostics has grown exponentially over the past decade. The greatest challenge is in understanding the best model to apply to one's own patient population, and how to operationalize such a model in practice., Evidence Acquisition: A literature search of PubMed and IEEE Xplore was conducted for English-language publications between January 1, 2015 and January 1, 2023, studying diagnostic tests on suspected thyroid nodules that used AI. We excluded articles without prospective or external validation, nonprimary literature, duplicates, focused on nonnodular thyroid conditions, not using AI, and those incidentally using AI in support of an experimental diagnostic outside standard clinical practice. Quality was graded by Oxford level of evidence., Evidence Synthesis: A total of 61 studies were identified; all performed external validation, 16 studies were prospective, and 33 compared a model to physician prediction of ground truth. Statistical validation was reported in 50 papers. A diagnostic pipeline was abstracted, yielding 5 high-level outcomes: (1) nodule localization, (2) ultrasound (US) risk score, (3) molecular status, (4) malignancy, and (5) long-term prognosis. Seven prospective studies validated a single commercial AI; strengths included automating nodule feature assessment from US and assisting the physician in predicting malignancy risk, while weaknesses included automated margin prediction and interobserver variability., Conclusion: Models predominantly used US images to predict malignancy. Of 4 Food and Drug Administration-approved products, only S-Detect was extensively validated. Implementing an AI model locally requires data sanitization and revalidation to ensure appropriate clinical performance., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Zeolitic imidazolate framework (ZIF-8) is a promising material for gas separation applications. It also serves as a prototype for numerous ZIFs, including amorphous ones, with a broader range of possible applications, including sensors, catalysis, and lithography. It consists of zinc coordinated with 2-methylimidazolate (2mIm) and has been synthesized with methods ranging from liquid-phase to solvent-free synthesis, which aim to control its crystal size and shape, film thickness and microstructure, and incorporation into nanocomposites. Depending on the synthesis method and postsynthesis treatments, ZIF-8 materials may deviate from the nominal defect-free ZIF-8 crystal structure due to defects like missing 2mIm, missing zinc, and physically adsorbed 2mIm trapped in the ZIF-8 pores, which may alter its performance and stability. Infrared (IR) spectroscopy has been used to assess the presence of defects in ZIF-8 and related materials. However, conflicting interpretations by various authors persist in the literature. Here, we systematically investigate ZIF-8 vibrational spectra by combining experimental IR spectroscopy and first-principles molecular dynamics simulations, focusing on assigning peaks and elucidating the spectroscopic signals of putative defects present in the ZIF-8 material. We attempt to resolve conflicting assignments from the literature and to provide a comprehensive understanding of the vibrational spectra of ZIF-8 and its defect-induced variations, aiming toward more precise quality control and design of ZIF-8-based materials for emerging applications.

Objective: This study aimed to identify barriers and facilitators of premedication utilization for nonemergent neonatal intubations (NIs) in a level IV neonatal intensive care unit (NICU)., Study Design: Between November 2018 and January 2019, multidisciplinary providers at a level IV NICU were invited to participate in an anonymous, electronic survey based on Theoretical Domains Framework to identify influences on utilization of evidence-based recommendations for NI premedication., Results: Of 186 surveys distributed, 84 (45%) providers responded. Most agreed with premedication use in the following domains: professional role/identity (86%), emotions (79%), skills (72%), optimism (71%), and memory, attention, and decision process (71%). Domains with less agreement include social influences (42%), knowledge (57%), intention (60%), belief about capabilities (63%), and behavior regulation (64%). Additional barriers include environmental context and resources, and beliefs about consequences., Conclusion: Several factors influence premedication use for nonemergent NI and may serve as facilitators and/or barriers. Efforts to address barriers should incorporate a multidisciplinary approach to improve patient outcomes and decrease procedure-related pain., Key Points: · Premedication for NIs can optimize conditions and decrease rates of tracheal intubation adverse events but there is significant international and institutional variation for premedication use for NI.. · Guided by implementation science methods, the Theoretical Domains Framework was utilized to construct a novel assessment tool to determine potential barriers to and facilitators of the use of premedication for NI.. · Several factors influence premedication for nonemergent NI.., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: This study investigated step rates (SR) during overground walking to estimate the relative aerobic capacity that corresponds to a moderate intensity., Methods: The present study utilized a repeated measure, within-subjects design incorporating a counterbalanced order. A total of twenty-three healthy men walked on a 119-meter oval track with artificial turf at self-selected pace (FP), 100, 120, and 140 steps/min for 6 min each while oxygen uptake (VO 2 ), speed (in km/h), distance (in m), and steps (in steps/min) were measured., Results: During FP, participants walked an average cadence of 117 ± 9.3 steps/minclose to 120 steps/min, which corresponds to 4.7 metabolic equivalents (METs). The estimated VO 2 reserve was 30.5% of VO 2 reserve at the FP and was close to the 120 steps/min of 33.3%. At the 100 and 140 steps/min, the VO 2 reserve were 24.1% and 45.2%, respectively. The regression analysis revealed that an SR of 88.2 elicited 3METs and 17.1% of VO 2 reserve. Additionally, an SR of 129 elicited 5.9METs and 40% of VO 2 reserve., Conclusions: This study demonstrated that a moderate walking intensity for young, healthy men corresponded to 128.9 steps per minute. A range of 120 ~ 140 steps/min for walking could be recommended as a general guideline for moderate-intensity exercise. However, concerning providing public guidelines, caution should be taken regarding determining the moderate walking intensity due to the individual's fitness level., (© 2024. The Author(s).)

Background/objective: The purpose of this study was to compare finger flexor strength (FS), finger flexor muscle recovery (FR), and forearm circumference (FC) across three different climbing classes in male lead sport climbers., Methods: A total of 37 male lead sport climbers were classified into low (LC), intermediate (IC), and advanced classes (AC) categories according to the International Rock Climbing Research Association (IRCRA) Scale. All participants measured FS three times for both open grip (OG) and crimp grip (CG). Following FS measurement, the FR was observed immediately after the all-out training. The FC was measured twice using an inelastic tape., Results: The FS differed significantly across climbing classes for both grip styles and hands, regardless of dominant hand, with the higher classes showing greater FS (all, p ≤ 0.001). FR was significantly higher in AC compared to IC and LC at 5 min (all, p ≤ 0.001), 10 min (all, p ≤ 0.005) and 15 min (all, p ≤ 0.005). The FC showed significant differences with climbing classes for both forearms., Conclusion: Climbing classes are associated with differences in FS, with higher class corresponding to greater FS. Similarly, climbing classes are linked to FR and FC, with higher classes being associated with faster recovery and larger FC., Competing Interests: Declaration of competing interest The author(s) have no conflicts of interest relevant to this article., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Two experiments investigated broiler growth performance and processing characteristics when fed increasing Gly concentrations in reduced CP diets fed from 0 to 48 d. In experiment 1, birds were allocated to 1 of 4 dietary treatments: a control (CTL) diet containing feed-grade L-Met, L-Lys, and L-Thr, a reduced CP (RCP) diet with additions of feed-grade L-Val and L-Ile, or the RCP diet with moderate (M Gly) or high Gly (H Gly) inclusion levels to achieve a total Gly + Ser of 100 or 112%, respectively, of the CTL diet. Birds in experiment 2 were assigned to 1 of 6 dietary treatments: a CTL diet, a RCP diet, or a low CP (LCP) diet without or with added Gly to achieve 88, 100, 112, or 124% total Gly + Ser concentrations of the RCP diet. For experiment 1, 0 to 14 d broiler performance was similar (P > 0.05) among dietary treatments. From 0 to 48 d, broilers fed the H Gly diet had the lowest (P = 0.006) body weight gain (BWG) and highest (P = 0.003) feed conversion ratio (FCR). Feeding either the RCP or M Gly diet resulted in similar (P > 0.05) growth and processing characteristics to the CTL. For experiment 2, increasing Gly levels in the LCP diet linearly reduced (P ≤ 0.027) 0 to 14 d FI and FCR. From 0 to 48 d, broilers had similar (P > 0.05) performance when fed the CTL or RCP diet, but had a higher (P < 0.001) FCR when fed the LCP88 diet. Increasing Gly levels linearly reduced (P = 0.033) FCR. Total breast meat yield was negatively affected (P ≤ 0.020) when feeding the LCP88 diet and did not respond to Gly levels. In conclusion, effects of increasing total Gly + Ser levels on 0 to 48 d broiler performance are likely dependent on the content of dietary CP and other potentially interacting nutrients., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

In the last decade, zeolitic imidazolate frameworks (ZIFs) have been studied extensively for their potential as selective separation membranes. In this review, we highlight unique structural properties of ZIFs that allow them to achieve certain important separations, like that of propylene from propane, and summarize the state of the art in ZIF thin-film deposition on porous substrates and their modification by postsynthesis treatments. We also review the reported membrane performance for representative membrane synthesis approaches and attempt to rank the synthesis methods with respect to potential for scalability. To compare the dependence of membrane performance on membrane synthesis methods and operating conditions, we map out fluxes and separation factors of selected ZIF-8 membranes for propylene/propane separation. Finally, we provide future directions considering the importance of further improvements in scalability, cost effectiveness, and stable performance under industrially relevant conditions.

Surface characterization is critical for understanding the processes used for preparing catalysts, sorbents, and membranes. Nonthermal plasma (NTP) is a process that achieves high reactivity at low temperatures and is used to tailor the surface properties of materials. In this work, we combine the capabilities of infrared reflection absorption spectroscopy (IRRAS) with NTP for the in situ interrogation of zeolitic imidazolate framework-8 (ZIF-8) thin films to probe modifications in the material induced by oxygen and nitrogen plasmas. The IRRAS measurements in oxygen plasma reveal etching of organic ligands with sequential removal of the methyl group and imidazole ring and with the formation of carbonyl moieties (C═O). In contrast, nitrogen plasma induces mild etching and grafting of nitrile groups (-C≡N). Scanning electron microscopy imaging shows that oxygen plasma, at prolonged times, significantly degrades the ZIF-8 film at the grain boundaries. Treatment of ZIF-8 membranes using mild plasma conditions yields a fivefold enhancement for H 2 /N 2 and CO 2 /CH 4 ideal selectivities and an eightfold enhancement for CO 2 /N 2 ideal selectivity. Additionally, the new tools described here can be used for spectroscopic in situ tracking of plasma-induced chemistry on thin films in general.

Objectives: This study aimed to explore the stressors along with coping strategies in Chinese family caregivers whose relative with dementia had been placed into a long-term care facility., Methods: A qualitative descriptive study was conducted with 17 Chinese family caregivers of institutionalised older adults with dementia, recruited via purposeful sampling. Information regarding stressors along with coping strategies was collected through face-to-face semi-structured individual interviews. The interviews were audio-recorded, transcribed, anonymised and imported into MAXQDA 2018.2. Data were analysed with qualitative content analysis., Findings: Three categories of stressors emerged: socioeconomic pressure, hassles arising from continuing caregiving and suboptimal care provided by the facility. In particular, the family caregivers' experienced tremendous pressure of negative comments from people around since long-term care placement was traditionally viewed as unfilial in Chinese societies. Various coping strategies were adopted by Chinese family caregivers to deal with the stressors; however, they were not always adaptive., Implications: Health care authorities and professionals should recognise family caregivers' stressors after long-term care placement of a relative with dementia with the consideration of the unique socio-cultural needs. Appropriate and effective interventions should be developed and implemented to facilitate family caregivers to cope with stressful situations after long-term care placement and further to safeguard their psychosocial well-being.

Poultry nutritionists continually strive for more "precision" nutritional programs that provide the exact balance of nutrients that maximize broiler growth performance without economically and environmentally costly excesses. Many factors affect the precise amount and balance of nutrients needed by the broiler, including genetics, age, sex, and environment. Furthermore, broilers in intensive rearing environments will almost always be subjected to some degree of enteric stress that can alter nutrient needs. Exposure to enteric pathogens such as Eimeria spp., the intestinal parasites that cause avian coccidiosis, induces physical damage to the intestinal epithelium and activates immune responses, ultimately resulting in the repartitioning of amino acids (AA) in response to these prioritized demands. Even without any pathogenic challenge, the intestine has an already high demand for many AA, with 30 to 100% of dietary AA extracted during first pass intestinal metabolism. In many cases, increasing dietary protein from intact proteins has been shown to be a viable option to ameliorate impaired AA digestion and absorption and heightened need for certain AA of birds under an enteric stress. However, increasing dietary protein often results in concomitant increases in indigestible protein and carbohydrates that can stimulate the overgrowth of pathogenic bacteria (i.e., Clostridium perfringens). Alternative options to increase dietary AA levels are to increase all feed-grade, free AA (e.g., Met, Lys, Thr, Val), or specific individual feed-grade AA. Therefore, the objectives of this paper are to discuss precision nutrition, the dietary AA demands of the intestine, consequences of coccidiosis on AA needs of the intestine, and formulation approaches to meet these altered needs. In summary, increased dietary protein met by intact proteins has consistently demonstrated its benefits during an Eimeria spp. infection; however, to further the goal of precision nutritional programs, feeding higher levels of a specific AA to support desired functions such as intestinal recovery or immune function for birds experiencing an enteric stress still require further evaluation., Competing Interests: DISCLOSURES There are no conflicts of interest to declare., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Patterning metal-organic frameworks (MOFs) at submicrometer scale is a crucial yet challenging task for their integration in miniaturized devices. Here we report an electron beam (e-beam) assisted, bottom-up approach for patterning of two MOFs, zeolitic imidazolate frameworks (ZIF), ZIF-8 and ZIF-67. A mild pretreatment of metal oxide precursors with linker vapor leads to the sensitization of the oxide surface to e-beam irradiation, effectively inhibiting subsequent conversion of the oxide to ZIFs in irradiated areas, while ZIF growth in non-irradiated areas is not affected. Well-resolved patterns with features down to the scale of 100 nm can be achieved. This developer-free, all-vapor phase technique will facilitate the incorporation of MOFs in micro- and nanofabrication processes., (© 2022. The Author(s).)

Consonants and vowels have been considered to fulfill different functions in language processing, vowels being more important for prosodic and syntactic processes and consonants for lexically related processes (Nespor, Peña, & Mehler, 2003). This C-bias hypothesis in lexical processing is supported by studies with adults and infants in many languages such as English, French, Spanish, although a few studies, on Danish and Mandarin, suggest the existence of cross-linguistic variation. The present study explores whether a C-bias exists in a tone language with a complex tone system, Cantonese, by comparing the relative weight given to consonants, vowels, and also tones during word learning. To do so, looking behaviors of Cantonese-learning 20- and 30-month-olds (24 children per age/condition, 6 groups) were recorded by an eyetracker while they watched animated cartoons in Cantonese to learn pairs of novel words. The words differed minimally by either a consonant (e.g., /tœ6/ vs. /kœ6/), a vowel (e.g., /k h im3/ vs. /k h ɛm3/), or a tone (e.g., T2 vs. T5). Analyses on proportional looking times revealed significant learning in 30-month-olds only, and at that age, only for the vowel contrasts. Growth curve analyses revealed better performance for the vowel condition compared to the other two conditions. The present findings establish a V-bias in Cantonese-learning 30-month-olds, adding new evidence from that tone language that the C-bias in lexical processing is not language-general. Implications for theoretical discussions on the origins of this phonological bias, and the impact of tones in early language acquisition, are discussed., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Modification of the gas permeation properties of ZIF-8 membranes using electron beam irradiation is reported. 3.8 and 3.2 fold enhancements in ideal selectivity for CO2/N2 and CO2/CH4 can be achieved with less than 1 min exposure time.

Vapor-phase treatment of ZIF-8 membranes with manganese(II) acetylacetonate (Mn(acac) 2 ) allows permselectivity tuning. Propylene/propane selectivity increases from 31 to 210 after the Mn(acac) 2 treatment at 165 °C for 30 min, while selectivities increase from 14.6 to 242 for H 2 /CH 4 , from 2.9 to 38 for CO 2 /CH 4 , from 2.4 to 29 for CO 2 /N 2 , and from 2.9 to 7.5 for O 2 /N 2 , after Mn(acac) 2 treatment at 175 °C for 30 min. Stable equimolar propylene/propane mixture selectivity of 165 at ambient temperature and 4 bar equimolar feed with a propylene flux of 8.3×10 -4  mol m -2  s -1 is established. A control experiment excludes thermal treatment alone causing these changes. XPS analysis reveals the presence of Mn(acac) 2 on the outer surface of the vapor-treated ZIF-8 membranes while no other changes are detectable by X-ray diffraction and infrared spectroscopy., (© 2021 Wiley-VCH GmbH.)

Background: Frailty is a natural consequence of the aging process. With the increasing aging population in Mainland China, the quality of life and end-of-life care for frail older people need to be taken into consideration. Advance Care Planning has also been used worldwide in long-term facilities, hospitals and communities to improve the quality of end-of-life care, increase patient and family satisfaction, and reduce healthcare costs and hospital admissions in Western countries. However, it has not been practiced in China., Research Objective: This study aimed to evaluate the effectiveness of a modified Advance Care Planning intervention in certainty of end-of-life care, preferences for end-of-life care, quality of life concerns, and healthcare utilization among frail older people., Research Design: This study used a quasi-experimental design, with a single-blind, control group, pretest and repeated posttest approach., Participants and Research Context: A convenience sample of 74 participates met the eligibility criteria in each nursing home. A total of 148 frail older people were recruited in two nursing homes in Zhejiang Province, China., Ethical Considerations: The study received ethical approval from the Clinical Research Ethics Committee, the Faculty of Medicine, and The Chinese University of Hong Kong, CREC Ref. No: 2016.059., Findings: The results indicated the Advance Care Planning programme was effective at increasing autonomy in decision making on end-of-life care issues, decreasing decision-making conflicts over end-of-life care issues, and increasing their expression about end-of-life care., Discussion: This study promoted the participants' autonomy and broke through the inherent custom of avoiding talking about death in China., Conclusion: The modified Advance Care Planning intervention is effective and recommended to support the frail older people in their end-of-life care decision in Chinese society.

Background  This article reviews the results of a surgical technique using three iterations of drilling , autologous cancellous bone grafting ( filling ), and use of an intraosseous compression screw for the treatment of nondisplaced or minimally displaced scaphoid delayed unions or nonunions. Methods  Part 1-Cadaveric study: Three cadaveric scaphoids underwent stained cancellous bone graft packing and headless cannulated compression screw placement using a single iteration of drilling and graft packing. Three additional scaphoids were allocated to the triple "drill and fill" group, and underwent three iterations of drilling and graft packing before screw insertion. Graft particle distribution on mid-sagittal sections was assessed under fluorescence microscopy. Comparison of normalized areas between the single and triple "drill and fill" groups was performed using repeated measures ANOVA and Tukey's post hoc test. Part 2-Clinical study: Twelve patients with minimally displaced scaphoid delayed unions and nonunions treated between April 2007 and December 2013 with the triple "drill and fill" technique were included. The average follow-up was 60.4 weeks. Two fellowship-trained musculoskeletal radiologists independently reviewed images for fracture healing. Results  By the histomorphometric analysis, there was improved autograft distribution along the screw tract, particularly within the proximal pole, with three iterations of drilling and filling. Clinically, 11 of 12 delayed unions and nonunions had healed. Conclusion  Our results support the use of the "drill and fill" technique as an option for the treatment of select nondisplaced or minimally displaced scaphoid nonunions and delayed unions at the waist without avascular necrosis of the proximal pole. Level of Evidence  This is a Level IV study., Competing Interests: Conflict of Interest None declared., (© Thieme Medical Publishers.)

Background: Listeriosis may cause severe disease in fetuses and neonates. The outcomes of critically ill neonates with early-onset listeriosis requiring extracorporeal membrane oxygenation (ECMO) from 1975 to 1991 have been reported., Objective: To update the characteristics and outcomes of neonates with listeriosis supported by ECMO., Study Design: Retrospective study of neonates with culture-proven listeriosis reported to the Extracorporeal Life Support Organization Registry between 1991 and 2017. Comparisons were made between this cohort and the case series from 1975-1991., Results: Twenty-two neonates had culture-proven Listeria monocytogenes infection and required ECMO support. Eight-six percent survived to discharge, compared with 67% in the previous cohort (p = 0.2). The median ECMO duration was 131 h, compared with 209 h in the previous cohort (p = 0.1). Nonsurvivors had a significantly lower pre-ECMO pH (6.91 vs 7.31, p = 0.0006)., Conclusion: The survival of neonates with listeriosis supported with ECMO is high, supporting the use of ECMO as rescue therapy for this condition.

As the aging population, including frail older people, continues to grow in Mainland China, quality of life and end-of-life care for frail older people has attracted much attention. Advance care planning is an effective way to improve end-of-life care for people with advanced diseases, and it is widely used in developed countries; however, it is a new concept in Mainland China. The effects of advance care planning and its acceptability in Mainland China are uncertain because of its culture-sensitive characteristics. The objective of this article is to discuss the serious social issue of caring for frail older people and illustrate the possibility of implementing advance care planning in nursing homes in Mainland China through a review of relevant literature, which will focus on legislation, healthcare system engagement, public engagement, and cultural issues. Recommendations to promote and implement advance care planning include choosing nursing homes as a proper setting, establishing an ethical climate, and enhancing public awareness.