The association of sociodemographic factors and needs of haemodialysis patients according to Maslow's hierarchy of needs.

AIM: To explore the association between the sociodemographic factors and the needs of patients undergoing haemodialysis in Taiwan. BACKGROUND: Concomitant discomfort, including physical and mental aspects, affects the patients' quality of life and their willingness to undergo haemodialysis. Maslow's hierarchy of needs is a well-known tool to assess different levels of human needs. METHOD: We conducted a small-scale cross-sectional observational study using a structured needs assessment questionnaire on 159 patients from the Taipei Veterans General Hospital haemodialysis unit. RESULTS: The overall mean scores of physical, mental, spiritual, other needs and needs in relation to medical staff care were 4.0 ± 0.8, 3.2 ± 0.8, 2.7 ± 1.0, 3.1 ± 0.9 and 4.1 ± 0.7, respectively. The results showed that the patients' highest need was in relation to medical staff care, followed by physical needs. Further analysis showed that patients who are still employed during the treatment process have higher mental, spiritual and other needs. Patient who is financially supported by their family has higher physical needs. Patients taken care of by paid caregivers have lower spiritual needs and other needs. This is also the same with patients who are religious as opposed to those who are nonreligious. Patients who have attained tertiary education have higher other needs compared with patients who have only achieved up to primary or secondary education. CONCLUSION: The study is the first in Taiwan to identify and quantify the needs of patients undergoing haemodialysis. When the needs of the patients are identified in relation to their sociodemographic factors, the medical staff can give the appropriate treatment in order to meet the needs and improve the patients' well-being. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should not only focus on the patients' physiological needs, but should determine and address their other needs in various aspects in order to improve the quality and efficacy of the dialysis care process.

Assessing the ecological risk and ecotoxicity of the microbially mediated restoration of heavy metal-contaminated river sediment.

Anthropogenic activities such as mining, smelting industries, and the application of pesticides in agriculture might result in contamination of multiple heavy metals in the environment. Heavy metal contamination of sediment is a serious environmental problem, and thus the remediation of contaminated sediment is a worldwide challenge. Several strategies have been developed for the remediation of contaminated sediment, however the ecological risk and ecotoxicity of the restored sediment have rarely been evaluated. We assessed whether river sediment highly contaminated with heavy metals could be restored using microbial bioleaching followed by evaluating the residual toxicity and ecological risk of the microbially remediated sediment. Sequential extraction revealed that the bioavailable levels of Cu, Ni, and Zn in the contaminated sediment exceeded sediment quality guideline (SQG) thresholds. It was consequently found that acidophilic sulfur-oxidizing Acidicaldus sp. SV5 effectively bioleached Cu, Ni, and Zn from the contaminated sediment, reducing the bioavailable fraction of these elements below SQG thresholds. The ecological risk assessment indicated that SV5-driven remediation significantly reduced the potential ecological risk of the contaminated sediment. The residual ecotoxicity of the microbially remediated sediment was also tested with the soil nematode Caenorhabditis elegans. There was a significant decrease in the body burden of Cu, Ni, and Zn in C. elegans and a reduction in the toxicological effect on survival, growth, and reproduction in the microbially remediated sediment. Our study suggests that a combination of chemical analysis, chemical-based ecological risk assessment, and ecotoxicity tests would be helpful for the development of efficient and eco-friendly strategies for the restoration of contaminated sediment, which could be incorporated into sediment quality management practices.

Chronic exposure to di(2-ethylhexyl) phthalate (DEHP) weakens innate immunity and leads to immunosenescence in C. elegans.

Di(2-ethylhexyl) phthalate (DEHP), a widespread contaminant, has numerous adverse impacts on human health and ecosystems. Chronic DEHP exposure has been found to accelerate aging; however, its potential threat to age-dependent innate immune decline remains unknown. This study aims to evaluate the effects of chronic DEHP exposure on innate immunosenescence in Caenorhabditis elegans. We show that the length of the exposure period significantly impacts DEHP-induced age-related declines, which is linked to immunosenescence and oxidative stress. We found that the DEHP-caused immunosenescence is accompanied with downregulation of an antimicrobial gene lys-7 as well as an enhancement of the nuclear translocation of HLH-30, an orthologue of mammalian transcription factor EB (TFEB). Moreover, DEHP exposure increases the expression of riok-1, a human RIO kinase homolog, which is associated with DEHP-induced HLH-30/TFEB translocation. Our findings suggest that early-life and chronic exposure to DEHP, mostly due to parent compound rather than its metabolite mono(2-ethylhexyl) phthalate (MEHP), may weaken the innate immunity in C. elegans and may enhance susceptibility to infections or promote immunosenescence in aged populations.

Chronic di(2-ethylhexyl) phthalate exposure leads to dopaminergic neuron degeneration through mitochondrial dysfunction in C. elegans.

The plasticizer di(2-ethylhexyl) phthalate (DEHP) is frequently detected in the environment due to the abundance of its use. These levels might be hazardous to human health and ecosystems. Phthalates have been associated with neurological disorders, yet whether chronic DEHP exposure plays a role in Parkinson's disease (PD) or its underlying mechanisms is unknown. We investigated the effects of chronic DEHP exposure less than an environmentally-relevant dose on PD hallmarks, using Caenorhabditis elegans as a model. We show that developmental stage and exposure timing influence DEHP-induced dopaminergic neuron degeneration. In addition, in response to chronic DEHP exposure at 5 mg/L, mitochondrial fragmentation became significantly elevated, reactive oxygen species (ROS) levels increased, and ATP levels decreased, suggesting that mitochondrial dysfunction occurs. Furthermore, the data show that mitochondrial complex I (nuo-1 and gas-1) and complex II (mev-1) are involved in DEHP-induced dopaminergic neuron toxicity. These results suggest that chronic exposure to DEHP at levels less than an environmentally-relevant dose causes dopaminergic neuron degeneration through mitochondrial dysfunction involving mitochondrial complex I and II. Considering the high level of genetic conservation between C. elegans and mammals, chronic DEHP exposure might elevate the risk of developing PD in humans.

Removal of nano-sized polystyrene plastic from aqueous solutions using untreated coffee grounds.

Nanoplastic (NP) pollution is an emerging global concern due to its adverse impact on aquatic ecosystems. Nevertheless, the removal of aqueous NPs from aquatic environments remains a significant challenge. This study aims to investigate whether polystyrene NP in aqueous solutions can be removed using coffee grounds. Due to the difficulty associated with directly measuring NP levels and monitoring the biosorption process, we used fluorescent-orange amine-modified polystyrene beads (fluo-NP, 100 nm) to evaluate the efficacy of the biosorption process. The factors including pH, coffee grounds concentration, initial fluo-NP concentration, and contact time were optimized on batch experiments. In addition, the isotherm and kinetic models were employed to clarify the adsorption behaviors and mechanisms. It was found that aqueous fluo-NP particles were effectively adsorbed onto the coffee grounds over a wide pH range (pH 2-12), with a coffee ground concentration of 25 g/L leading to the maximum adsorption efficiency (74%). The equilibrium adsorption capacity of the coffee grounds was 4 mg/g for a reaction time of 40 min. Coffee grounds demonstrated the highest removal efficiency when the initial fluo-NP concentration was 100-125 mg/L. The Dubinin-Radushkevich model and pseudo-second-order model described the adsorption isotherm and kinetics well, respectively, and the adsorption at high fluo-NP concentration range was favorable. Moreover, the results suggest that the mechanism lies in the electrostatic interactions and hydrogen bonding between surface functional groups of the coffee grounds and the fluo-NP particles. Given that there is an urgent need to remove NPs from aqueous systems, this study illustrates that it is possible to use coffee ground biowaste for this purpose.

A combined approach to remediate cadmium contaminated sediment using the acidophilic sulfur-oxidizing bacterial SV5 and untreated coffee ground.

Cadmium (Cd) contamination in sediment is an emerging concern for the sustainability of aquatic ecosystem due to the toxicity of Cd is correlated to different trophic levels. An effective and inexpensive remediation strategy for Cd-contaminated sediment is desirable. The feasibility of using a newly isolated acidophilic sulfur-oxidizing bacterium and untreated coffee ground to remediate Cd-contaminated sediment was evaluated. The bioleaching approach was firstly conducted with the acidophilic sulfur-oxidizing bacterial SV5, resulting in Cd(II) release from Cd(II)-contaminated sediment. Subsequently, Cd(II) in the acidic leachate was further removed using untreated agricultural wastes. Untreated coffee ground exhibited about 2-fold Cd(II) removal efficiency comparing to that of rice husk and peanut shell. Scanning electron microscope (SEM) and Fourier-transform infrared spectroscopy (FTIR) analysis were conducted to characterize the coffee ground after the adsorption of 0 or 200 mg/L Cd(II). At pH 4, the optimal coffee ground concentration was 30 g/L along with 100 mg/L Cd(II) concentration. Adsorption of Cd(II) by coffee ground was rapid and the adsorption kinetic followed pseudo-second order model. Cd(II) sorption by coffee ground was a favorable process and Langmuir isotherm model well described the experimental data. Taken together, even at pH 4, coffee ground still showed good biosorption capacity for Cd(II) with short equilibrium time. This study suggests that acidophilic sulfur-oxidizing bacterial SV5 and untreated coffee ground could be used as inexpensive and environment-friendly biomaterial and agricultural waste for the remediation of Cd-contaminated sediment.

Blue light phototherapy in the treatment of acne.

BACKGROUND: Blue light irradiation is known to be effective against acne. However, the profile of a good candidate is still unclear. METHODS: Thirty-one Taiwanese with symmetrical facial acne were irradiated with blue light on one side of the face selected randomly twice weekly for 4 consecutive weeks. The other half of the face was left untreated as control. Parameters, including scar type, pore size, and facial follicular porphyrin fluorescence intensity, were documented. The severity of acne was assessed before the treatment, after two, four, and eight sessions of treatment, and 1 month after the treatment was completed. RESULTS: Compared with the non-irradiation side, eight sessions of blue light irradiation were effective in acne treatment (P<0.001). Gender (P=0.471), scar type (P-values of pitted, atrophic, and hypertrophic type were 0.688, 0.572, and 0.802, respectively), pore size (P=0.755), and pretreatment fluorescence intensity (P=0.656) could not be used as predictive factors of therapeutic effectiveness. Compared with pretreatment, nodulocystic lesions tended to worsen despite treatment. In addition, the therapeutic effectiveness was not related to the fluorescence intensity change (P=0.812). CONCLUSIONS: Blue light irradiation is effective in acne treatment. Patients without nodulocystic lesions are better candidates for blue light irradiation.