Developing an entrustable professional activity for providing health education and consultation in occupational therapy and examining its validity.

BACKGROUND: Entrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity. METHODS: Nineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications. RESULTS: The TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed. CONCLUSION: The successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings.

Boosting the Interfacial Stability of the Li6PS5Cl Electrolyte with a Li Anode via In Situ Formation of a LiF-Rich SEI Layer and a Ductile Sulfide Composite Solid Electrolyte.

Due to its good mechanical properties and high ionic conductivity, the sulfide-type solid electrolyte (SE) can potentially realize all-solid-state batteries (ASSBs). Nevertheless, challenges, including limited electrochemical stability, insufficient solid-solid contact with the electrode, and reactivity with lithium, must be addressed. These challenges contribute to dendrite growth and electrolyte reduction. Herein, a straightforward and solvent-free method was devised to generate a robust artificial interphase between lithium metal and a SE. It is achieved through the incorporation of a composite electrolyte composed of Li6PS5Cl (LPSC), polyethylene glycol (PEG), and lithium bis(fluorosulfonyl)imide (LiFSI), resulting in the in situ creation of a LiF-rich interfacial layer. This interphase effectively mitigates electrolyte reduction and promotes lithium-ion diffusion. Interestingly, including PEG as an additive increases mechanical strength by enhancing adhesion between sulfide particles and improves the physical contact between the LPSC SE and the lithium anode by enhancing the ductility of the LPSC SE. Moreover, it acts as a protective barrier, preventing direct contact between the SE and the Li anode, thereby inhibiting electrolyte decomposition and reducing the electronic conductivity of the composite SE, thus mitigating the dendrite growth. The Li|Li symmetric cells demonstrated remarkable cycling stability, maintaining consistent performance for over 3000 h at a current density of 0.1 mA cm-2, and the critical current density of the composite solid electrolyte (CSE) reaches 4.75 mA cm-2. Moreover, the all-solid-state lithium metal battery (ASSLMB) cell with the CSEs exhibits remarkable cycling stability and rate performance. This study highlights the synergistic combination of the in-situ-generated artificial SE interphase layer and CSEs, enabling high-performance ASSLMBs.

Skin sympathetic nerve activity and ventricular arrhythmias in acute coronary syndrome.

BACKGROUND: Acute coronary syndrome (ACS) is major cause of ventricular arrhythmias (VAs) and sudden death. neuECG is a noninvasive method to simultaneously record skin sympathetic nerve activity (SKNA) and electrocardiogram. OBJECTIVE: The purpose of this study was to test the hypotheses that (1) ACS increases average SKNA (aSKNA), (2) the magnitude of aSKNA elevation is associated with VAs during ACS, and (3) there is a gender difference in aSKNA between patients without and with ACS. METHODS: We prospectively studied 128 ACS and 165 control participants. The neuECG was recorded with electrodes at Lead I configuration at baseline, during mental math stress, and during recovery (5 minutes for each phase). All recordings were done in the morning. RESULTS: In the control group, women have higher aSKNA than do men at baseline (0.82 ± 0.25 µV vs 0.73 ± 0.20 µV; P = .009) but not during mental stress (1.21 ± 0.36 µV vs 1.16 ± 0.36 µV; P = .394), suggesting women had lower sympathetic reserve. In comparison, ACS is associated with equally elevated aSKNA in women vs men at baseline (1.14 ± 0.33 µV vs 1.04 ± 0.35 µV; P = .531), during mental stress (1.46 ± 0.32 µV vs 1.33 ± 0.37 µV; P = .113), and during recovery (1.30 ± 0.33 µV vs 1.11 ± 0.30 µV; P = .075). After adjusting for age and gender, the adjusted odds ratio for VAs including ventricular tachycardia and ventricular fibrillation is 1.23 (95% confidence interval 1.05-1.44) for each 0.1 µV aSKNA elevation. aSKNA is positively correlated with plasma norepinephrine level. CONCLUSION: ACS is associated with elevated aSKNA, and the magnitude of aSKNA elevation is associated with the occurrence of VAs. Women have higher aSKNA and lower SKNA reserve than do men among controls but not among patients with ACS.

High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope.

(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is higher in subjects with tilt-positive than tilt-negative and the SKNA surges before syncope. (2) Methods: We recorded neuECG in 41 subjects who received HUT (according to the "Italian protocol"), including rest, tilt-up, provocation and recovery phases. Data were analyzed to determine the average SKNA (aSKNA, µV) per digitized sample. Electrocardiogram was used to calculate standard deviation of normal-to-normal beat intervals (SDNN). The "SKNA-SDNN index" was calculated by rest aSKNA multiplied by the ratio of tilt-up to rest SDNN. (3) Results: 16 of 41 (39%) subjects developed syncope. The aSKNA at rest phase is significantly higher in the tilt-positive (1.21 ± 0.27 µV) than tilt-negative subjects (1.02 ± 0.29 µV) (p = 0.034). There are significant surges and withdraw of aSKNA 30 s before and after syncope (both p ≤ 0.006). SKNA-SDNN index is able to predict syncope (p < 0.001). (4) Conclusion: Higher SKNA at rest phase is associated with positive HUT. The SKNA-SDNN index is a novel marker to predict syncope during HUT.

Association of Pulmonary Function Decline over Time with Longitudinal Change of Glycated Hemoglobin in Participants without Diabetes Mellitus.

Pulmonary damage and function impairment were frequently noted in patients with diabetes mellitus (DM). However, the relationship between lung function and glycemic status in non-DM subjects was not well-known. Here, we evaluated the association of longitudinal changes of lung function parameters with longitudinal changes of glycated hemoglobin (HbA1c) in non-DM participants. The study enrolled participants without prior type 2 DM, hypertension, and chronic obstructive pulmonary disease (COPD) from the Taiwan Biobank database. Laboratory profiles and pulmonary function parameters, including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were examined at baseline and follow-up. Finally, 7055 participants were selected in this study. During a mean 3.9-year follow-up, FVC and FEV1 were significantly decreased over time (both p < 0.001). In the multivariable analysis, the baseline (unstandardized coefficient ß = -0.032, p < 0.001) and longitudinal change (unstandardized coefficient ß = -0.025, p = 0.026) of FVC were negatively associated with the baseline and longitudinal change of HbA1c, respectively. Additionally, the longitudinal change of FVC was negatively associated with the risk of newly diagnosed type 2 DM (p = 0.018). During a mean 3.9-year follow-up, our present study, including participants without type 2 DM, hypertension, and COPD, demonstrated that the baseline and longitudinal change of FVC were negatively and respectively correlated with the baseline and longitudinal change of HbA1c. Furthermore, compared to those without new-onset DM, participants with new-onset DM had a more pronounced decline of FVC over time.

One-Pot Synthesis of Chlorophyll-Assisted Exfoliated MoS2/WS2 Heterostructures via Liquid-Phase Exfoliation Method for Photocatalytic Hydrogen Production.

Developing strategies for producing hydrogen economically and in greener ways is still an unaccomplished goal. Photoelectrochemical (PEC) water splitting using photoelectrodes under neutral electrolyte conditions provides possibly one of the greenest routes to produce hydrogen. Here, we demonstrate that chlorophyll extracts can be used as an efficient exfoliant to exfoliate bulk MoS2 and WS2 to form a thin layer of a MoS2/WS2 heterostructure. Thin films of solution-processed MoS2 and WS2 nanosheets display photocurrent densities of -1 and -5 mA/cm2, respectively, and hydrogen evolution under simulated solar irradiation. The exfoliated WS2 is significantly more efficient than the exfoliated MoS2; however, the MoS2/WS2 heterostructure results in a 2500% increase in photocurrent densities compared to the individual constituents and over 12 h of PEC durability under a neutral electrolyte. Surprisingly, in real seawater, the MoS2/WS2 heterostructure exhibits stable hydrogen production after solar illumination for 12 h. The synthesis method showed, for the first time, how the MoS2/WS2 heterostructure can be used to produce hydrogen effectively. Our findings highlight the prospects for this heterostructure, which could be coupled with various processes towards improving PEC efficiency and applications.

Solar Power Can Substantially Prolong Maximum Achievable Airtime of Quadcopter Drones.

Sunlight energy is potentially excellent for small drones, which can often operate during daylight hours and fly high enough to avoid cloud blockade. However, the best solar cells provide limited power, compared to conventional power sources, making their use for aerial vehicles difficult to realize, especially in rotorcraft where significant lift ordinarily generated by a wing is already sacrificed for the ability to hover. In recent years, advances in materials (use of carbon-fiber components, improvement in specific solar cells and motors) have finally brought solar rotorcraft within reach. Here, the application is explored through a concise mathematical model of solar rotorcraft based on the limits of solar power generation and motor power consumption. Multiple solar quadcopters based on this model with majority solar power are described. One of them has achieved an outdoor airtime over 3 hours, 48 times longer than it can last on just battery alone with the solar cells carried as dead weight and representing a significant prolongation of drone operation. Solar-power fluctuations during long flight and their interaction with power requirements are experimentally characterized. The general conclusion is that solar cells have reached high enough efficiencies and can outperform batteries under the right conditions for quadcopters.

An efficient approach to derive hydroxyl groups on the surface of barium titanate nanoparticles to improve its chemical modification ability.

Highly hydroxylated barium titanate (BaTiO(3)) nanoparticles have been prepared via an easy and gentle approach which oxidizes BaTiO(3) nanoparticles using an aqueous solution of hydrogen peroxide (H(2)O(2)). The hydroxylated BaTiO(3) surface reacts with sodium oleate (SOA) to form oleophilic layers that greatly enhance the dispersion of BaTiO(3) nanoparticles in organic solvents such as tetrahydrofuran, toluene, and n-octane. The results of Fourier transform infrared spectroscopy confirmed that the major functional groups on the surface of H(2)O(2)-treated BaTiO(3) nanoparticles are hydroxyl groups which are chemically active, favoring chemical bonding with SOA. The results of transmission electron microscopy of SOA-modified BaTiO(3) nanoparticles suggested that the oleate molecules were bonded to the surfaces of nanoparticles and formed a homogeneous layer having a thickness of about 2 nm. Furthermore, the improved dispersion capability of the modified BaTiO(3) nanoparticles in organic solvents was verified through analytic results of its settling and rheological behaviors.