The influence of heart failure high-fidelity simulation education based on NLN Jeffries simulation framework in the prelicensure nursing program: A quasi-experimental study.

Objectives: To examine the influence of heart failure high-fidelity simulation education based on the National League for Nursing (NLN) Jeffries Simulation Framework in prelicensure nursing education. Methods: A heart failure high-fidelity simulation (HFHFS) education pilot project was carried out at Carrington College Sacramento. Twenty-three students participated in the study. This study used a quasi-experimental design. Students' Self-Efficacy, Satisfaction, and Knowledge in Heart Failure Clinical Knowledge were measured pre- and post-HFHFS education. Results: The results of the high-fidelity simulation education for heart failure showed that students achieved a mean score of 45.39 (SD = 7.88) in self-efficacy, 18.70 (SD = 3.38) in satisfaction, and 64.09 (SD = 10.86) in knowledge after the intervention. The paired-sample t-test significantly improved between the pre- and post-intervention scores (P < 0.001). The students highly rated self-efficacy, student satisfaction, and knowledge because of the positive impact on the teaching effectiveness of simulation design (i.e., objectives, problem-solving, student support, fidelity, debriefing) activity that included the application of quality safety education for nurses (QSEN) three competencies safety, patient-centered care, and teamwork and collaboration during nursing care for patients with acute heart failure. The teaching effectiveness of the heart failure high-fidelity simulation education is closely correlated with student satisfaction, self-efficacy, and improvement of participant knowledge in clinical nursing skills performance and critical thinking. Conclusion: A heart failure high-fidelity simulation education established upon the National League for Nursing (NLN) Jeffries framework enhanced student knowledge, satisfaction, self-efficacy, application of safety, patient-centered care, and teamwork and collaboration. Nurse educators should consider simulation planning to include the five simulation design characteristics, i.e., objectives, problem-solving, student support, fidelity, and debriefing, while integrating safety, patient-centered care, and teamwork and collaboration to bring about education effectiveness.

Cu2In alloy-embedded ZrO2 catalysts for efficient CO2 hydrogenation to methanol: promotion of plasma modification.

Cu1In2Zr4-O-C catalysts with Cu2In alloy structure were prepared by using the sol-gel method. Cu1In2Zr4-O-PC and Cu1In2Zr4-O-CP catalysts were obtained from plasma-modified Cu1In2Zr4-O-C before and after calcination, respectively. Under the conditions of reaction temperature 270°C, reaction pressure 2 MPa, CO2/H2 = 1/3, and GHSV = 12,000 mL/(g h), Cu1In2Zr4-O-PC catalyst has a high CO2 conversion of 13.3%, methanol selectivity of 74.3%, and CH3OH space-time yield of 3.26 mmol/gcat/h. The characterization results of X-ray diffraction (XRD), scanning electron microscopy (SEM), and temperature-programmed reduction chemisorption (H2-TPR) showed that the plasma-modified catalyst had a low crystallinity, small particle size, good dispersion, and excellent reduction performance, leading to a better activity and selectivity. Through plasma modification, the strong interaction between Cu and In in Cu1In2Zr4-O-CP catalyst, the shift of Cu 2p orbital binding energy to a lower position, and the decrease in reduction temperature all indicate that the reduction ability of Cu1In2Zr4-O-CP catalyst is enhanced, and the CO2 hydrogenation activity is improved.

Effect of a group-based acceptance and commitment therapy (ACT) intervention on self-esteem and psychological flexibility in patients with schizophrenia in remission.

The present study explored whether acceptance and commitment therapy (ACT), a cognitive behavioral therapy approach, could improve the symptoms of schizophrenia spectrum disorders among patients with schizophrenia in remission. A pre- and post-treatment design with two evaluation time points was employed. Sixty outpatients with schizophrenia in remission were randomly divided into two groups: the ACT plus treatment as usual (ACT+TAU) and treatment as usual (TAU) groups. The ACT+TAU group participated in 10 group-based ACT interventions and TAU in the hospital, and the TAU group only received TAU interventions. General psycho-pathological symptoms, self-esteem, and psychological flexibility were assessed before intervention (baseline; pre-test) and after intervention (five weeks; post-test). Results indicated that, compared to the TAU group, the ACT+TAU group exhibited a more significant improvement in general psychopathological symptoms, self-esteem, cognitive fusion, and acceptance and action at post-test. ACT intervention could effectively decrease the general psycho-pathological symptoms and increase self-esteem level and psychological flexibility in people with schizophrenia in remission.

Potential Mechanisms and Clinical Effectiveness of Acupuncture in Depression.

Major depressive disorder is the most common mental disorder with significant economic burden and limited treatments. Acupuncture has emerged as a promising non-pharmacological treatment for reducing depressive symptoms. However, the potential mechanisms and clinical effectiveness of acupuncture are not fully understood. This review aimed to: (1) summarize the available evidence on the mechanisms and clinical effectiveness of acupuncture for depression, and then (2) compare with pharmacological interventions, guiding future studies. Studies with animal models of depression and patients have shown that acupuncture could increase hippocampal and network neuroplasticity and decrease brain inflammation, potentially to alleviating depressive disorders. Overall clinical studies indicated that acupuncture could relieve primary depression, particularly milder cases, and was helpful in the management of post-stroke depression, pain-related depression, and postpartum depression both as an isolated and adjunct treatment. It was emphasized that acupuncture combined with antidepressant pharmacological treatment not only enhanced the improvement of primary and secondary depressive symptoms but also reduced the side effects of the medical treatment, which is the main cause for high dropout rates with drug treatment. In summary, substantial evidence from animal and human researches supported the beneficial effect of acupuncture in depression. However, most clinical trials of acupuncture were small, and it is unclear whether their findings can be generalized, so more studies are needed.

Acupuncture for insomnia after ischemic stroke: an assessor-participant blinded, randomized controlled trial.

BACKGROUND: To date, there has been little focus on research into acupuncture for insomnia after ischemic stroke. Insomnia is one of the most common sequelae after ischemic stroke, and it is the most unrecognized modifiable risk factor. OBJECTIVE: To evaluate the efficacy and safety of acupuncture for insomnia after ischemic stroke. METHODS: In this assessor-participant blinded, randomized, controlled trial, 144 ischemic stroke patients with insomnia meeting Diagnostic and Statistical Manual of Mental Disorders (fifth edition, DSM-5) criteria were assigned to verum or sham acupuncture treatment (n = 72 per group) for three sessions per week over 4 weeks. The outcomes were the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), stroke-specific quality of life (SSQoL), and Hospital Anxiety and Depression Scale (HADS) scores. Multiple objective sleep variables were recorded using actigraphy. Assessment was conducted at baseline, and thereafter once biweekly for the 4-week treatment and at 4 weeks of follow-up. RESULTS: The verum acupuncture group had significantly greater improvements than the sham acupuncture group in sleep quality from 2 weeks into treatment throughout the follow-up, indicated by ISI scores and actigraphic variable SE (sleep efficiency). This greater improvement was also observed in the PSQI after 4 weeks of treatment throughout follow-up, as well as actigraphic variable TST (total sleep time), SSQoL and HADS scores at the end of treatment, and SSQoL and depression scores at follow-up. There was no significant difference between groups in the actigraphic variable SA (sleep awakenings). Adverse events were mild in severity, and their incidence was not significantly different between the two groups. CONCLUSION: Acupuncture appears to be efficacious, in terms of improving insomnia, related quality of life, and affective symptoms, for patients with ischemic stroke. TRIAL REGISTRATION NUMBER: ChiCTR-IIC-16008382 (Chinese Clinical Trial Registry).

Effects of Acupuncture on Vascular Cognitive Impairment with No Dementia: A Randomized Controlled Trial.

BACKGROUND: Acupuncture has been used for treating vascular cognitive impairment, but evidence for its effectiveness remains limited. OBJECTIVE: This single-center, patient-accessor blinded, randomized controlled trial was designed to assess whether acupuncture could improve the cognitive function of patients with vascular cognitive impairment with no dementia (VCIND). METHODS: 120 VCIND patients were randomly assigned to the electro-acupuncture (EA) or sham acupuncture (SA) group at a 1 : 1 ratio, with treatment conducted thrice weekly for 8 weeks. The primary outcome was the changes of cognitive function measured by the Montreal Cognitive Assessment (MoCA) from baseline to week 8. The secondary outcomes included the scores of the Mini-Mental State Examination (MMSE), the Modified Barthel Index (MBI) and the Self-rating Depression Scale (SDS). Follow-up assessments were performed with MoCA and MMSE at week 16 and 32. Linear mixed-effects models were used for analysis and all statistical tests were two-sided. RESULTS: The results showed that patients in the EA group had a significantly greater improvement in MoCA score (23.85±4.18) than those in the SA group (21.48±4.44) at week 8 (95% CI = 0.80, 3.92, p = 0.04), as well as higher MoCA scores over time (p < 0.001 for interaction). Patients who received EA showed a greater increase in MMSE scores (26.41±3.47) than those who received SA (24.40±3.85) along 8 weeks (95% CI = 0.69, 3.34, p = 0.004). However, results diminished over time. No serious adverse events occurred during the trial. CONCLUSION: EA is a safe and effective technique to improve cognition over the short term of 8 weeks in VCIND patients.

Evaluation of mercury speciation and removal through air pollution control devices of a 190 MW boiler.

Air pollution control devices (APCDs) are installed at coal-fired power plants for air pollutant regulation. Selective catalytic reduction (SCR) and wet flue gas desulfurization (FGD) systems have the co-benefits of air pollutant and mercury removal. Configuration and operational conditions of APCDs and mercury speciation affect mercury removal efficiently at coal-fired utilities. The Ontario Hydro Method (OHM) recommended by the U.S. Environmental Protection Agency (EPA) was used to determine mercury speciation simultaneously at five sampling locations through SCR-ESP-FGD at a 190 MW unit. Chlorine in coal had been suggested as a factor affecting the mercury speciation in flue gas; and low-chlorine coal was purported to produce less oxidized mercury (Hg2+) and more elemental mercury (Hg0) at the SCR inlet compared to higher chlorine coal. SCR could oxidize elemental mercury into oxidized mercury when SCR was in service, and oxidation efficiency reached 71.0%. Therefore, oxidized mercury removal efficiency was enhanced through a wet FGD system. In the non-ozone season, about 89.5%-96.8% of oxidized mercury was controlled, but only 54.9%-68.8% of the total mercury was captured through wet FGD. Oxidized mercury removal efficiency was 95.9%-98.0%, and there was a big difference in the total mercury removal efficiencies from 78.0% to 90.2% in the ozone season. Mercury mass balance was evaluated to validate reliability of OHM testing data, and the ratio of mercury input in the coal to mercury output at the stack was from 0.84 to 1.08.

Assessment of mycophenolate mofetil for treatment of frequently relapsing nephrotic syndrome in children.

OBJECTIVE: To investigate the efficacy and adverse effect of mycophenolate mofetil (MMF) in the treatment of frequently relapsing nephrotic syndrome in children. METHODS: The study population consisted of 37 children (24 simple nephrotic syndrome and 13 nephritis-type syndrome) suffering from frequently relapsing nephrotic syndrome. Patients received 20-30 mg/(kg d) of MMF in conjunction with 1 mg/(kg d) prednisone for 3-6 months. RESULTS: Out of 24 patients suffered from simple nephrotic syndrome, 17 patients (70.8%) with complete relief, 4 patients (16.7%) with partial relief and 3 patients (12.5%) with non-relief, whereas out of 13 patients suffered from nephritis-type syndrome 6 patients (46.2%) with complete relief, 3 patients (23.1%) with partial relief and 4 patients (30.7%) with non-relief. Eight patients with Minimal Change Disease (MCD) achieved complete relief. Of 23 patients with Mesangial Proliferative Glomerulonephritis (MsPGN) or Membranoproliferative Glomerulonephritis (MPGN), complete relief was observed in 17 patients (73.9%), partial relief in 4 patients (17.4%) and non-relief in 2 patients. CONCLUSION: These Results suggest that MMF has better efficacy against simple renal disease than against nephritis-type syndrome, and MMF may be more suitable for the treatment of frequently relapsing nephrotic syndrome characterized by proliferative lesions.

Prediction of octreotide efficacy by electrogastrography in the treatment of patients with esophageal variceal hemorrhage.

Our aim is to investigate the significance of electrogastrography in the treatment of esophageal variceal hemorrhage with octreotide. Electrogastrography was performed in patients with esophageal variceal hemorrhage before and during the treatment consisting of various doses of octreotide (25 ug h(-1) group and 50 ug h(-1) group). The dominant power of electrogastrography and its relationship with the hemostatic efficacy of octreotide treatment were evaluated. Dominant power of electrogastrography decreased significantly during treatment with octreotide (P < 0.05). The reduction in the amplitude of dominant power in the 50 ug h(-1) group was significantly larger than in the 25 ug h(-1) group (P < 0.05), and it was correlated with hemostatic efficacy of octreotide treatment. We conclude that octreotide treatment in patients with esophageal variceal hemorrhage can result in a significant decrease of dominant power, which correlates with the hemostatic efficacy of octreotide, so the change of dominant power could be used as a predictor of evaluating the treatment efficacy of octreotide in esophageal variceal hemorrhage patients.

[Correction of minor exophthalmos by enlargement of orbital volume through conjunctive approach].

OBJECTIVE: To investigate the treatment of minor exophthalmos by enlargement of orbital volume through conjunctive approach. METHODS: Through the conjunctive approach medial to the eye ball, the dissection was performed subperiosteally to expose the ethmoid bone at the medial orbital wall. The exposure bone was 2.5-3.0 cm in length and 2.0-2.5 cm in width. Then the ethmoid bone was fractured to enlarge the orbital volume. From June 2006 to April 2008, 3 cases were treated. RESULTS: The patients recovered in a short time with no visible skin scar. The technique was mini-invasive, and didn't affect the function of eyeball. CONCLUSION: It is easy and effective way to correct the minor exophthalmos by enlargement of orbital volume through conjunctive approach.

[Transformation of sulfur forms during coal pyrolysis and partial gasification in a fixed bed reactor].

The development of various process to the pre-desulfurization of coal was drawn more attention. In present study, the transformation of sulfur forms of three different ranks high sulfur coals during coal pyrolysis and partial gasification were investigated in a fixed bed reactor. The sulfur and carbon content analysis of original coal and coal char produced were determined by LECO SC-444 and wet chemical analysis according to Sugawara's method. The results showed that half of inorganic sulfur and partial of organic sulfur were removed during coal pyrolysis. And the sulfur removal was much more than carbon during pyrolysis process; and the sulfur in the coal char, especially the sulfide sulfur was removed completely during partial gasification process for both Datong coal and Xishan coal, the degree of sulfide sulfur removal could be increased with increasing temperature. At the same time, the results of Yima coal showed that the effect of fixed-sulfur by alkaline metals increased when the temperature was higher than 700 degrees C, which attribute to the increase of the fixed sulfur reaction rate and the decrease of mass-transfer limitation.