Enhanced X-ray Dose Response of Radio-fluorescent Hydrogels Enabled by Persulfate Salts.

Coumarin 3-carboxylic acid (CCA)-loaded radio-fluorescent hydrogels have attracted interest for ionizing radiation dosimeters, but their sensitivity needs to be improved. In this study, we added ammonium persulfate (APS) to a polyacrylamide (PAAm)-CCA hydrogel. The introduction of APS improved the hydrogel dose sensitivity to 336.02 Gy- 1, which is 1.8 times that of the counterpart without APS. Our hydrogel can measure the X-ray dose in a range of 0 - 15 Gy with a lower limit of detection (LOD) of 0.1 Gy. Additionally, the hydrogel can sense X-ray doses within a wide range of the dose rate and temperature, and the dose‒response can be well retained 7 days postirradiation. Therefore, we think this study provides a simple and robust method to improve the sensitivity of CCA hydrogel dosimeters, presenting great potential in clinical radiotherapy.

Enhanced Electrochemical Nitrate-to-Ammonia Performance of Cobalt Oxide by Protic Ionic Liquid Modification.

Electrochemical conversion of nitrate to ammonia is an appealing way for small-scale and decentralized ammonia synthesis and waste nitrate treatment. Currently, strategies to enhance the reaction performance through elaborate catalyst design have been well developed, but it is still of challenge to realize the promotion of reactivity and selectivity at the same time. Instead, a facile method of catalyst modification with ionic liquid to modulate the electrode surface microenvironment that mimic the role of the natural MoFe protein environment is found effective for the simultaneous improvement of NH3 yield rate and Faradaic efficiency (FE) at a low NaNO3 concentration of 500 ppm. Protic ionic liquid (PIL) N-butylimidazolium bis(trifluoromethylsulfonyl)imide ([Bim]NTf2 ) modified Co3 O4-x is fabricated and affords the NH3 yield rate and FE of 30.23±4.97 mg h-1 mgcat. -1 and 84.74±3.43 % at -1.71 and -1.41 V vs. Ag/AgCl, respectively, outperforming the pristine Co3 O4-x . Mechanistic and theoretical studies reveal that the PIL modification facilitates the adsorption and activation of NO3 - as well as the NO3 - -to-NH3 conversion and inhibits hydrogen evolution reaction competition via enhancing the Lewis acidity of the Co center, shuttling protons, and constructing a hydrogen bonded and hydrophobic electrode surface microenvironment.

Aligning perceptions of mistreatment among incoming medical trainees.

BACKGROUND: Learner mistreatment has been a long-standing example of unprofessional behavior in medical training. Alignment of perceptions of professional behavior is a critical component of developing a defined organizational culture. Clinical vignettes addressing learner mistreatment can help to achieve this goal. Our aim was to determine whether using clinical vignettes to address learner mistreatment during onboarding can reduce variability in the perceptions of mistreatment. MATERIALS AND METHODS: External experts in the field of labor and employment relations embedded in the clinical learning environment identified six thematic areas of potential mistreatment. Corresponding clinical case vignettes were developed and presented to incoming trainees during the onboarding process, followed by facilitated discussion. Perceptions of mistreatment before and after discussion were assessed on a Likert scale, with results compared using F-test and t-test. RESULTS: There were 145 participants. Most participants reported previously witnessing or experiencing episodes of mistreatment before matriculation (84%), with the majority reporting multiple events. The most common offenders were faculty (57%), residents/fellows (49%), and nurses (33%). Only 10% of incoming trainees reported a previous incident of mistreatment. Postintervention scores demonstrated decreased variability (P < 0.05) in perceptions of mistreatment in all but one vignette (withholding learning opportunities). Two vignettes demonstrated higher perception of mistreatment after intervention (noneducational tasks and gender or racial discrimination, P < 0.05). CONCLUSIONS: Mistreatment remains a prevalent phenomenon in medical training involving a wide cross-section of healthcare providers. Trainees arrive with discordant definitions of mistreatment. Alignment of individuals' definitions can be achieved through the use of carefully crafted clinical vignettes and facilitated discussion.

Perceptions of mistreatment among trainees vary at different stages of clinical training.

BACKGROUND: Mistreatment of trainees remains a frequently reported phenomenon in medical education. One barrier to creating an educational culture of respect and professionalism may be a lack of alignment in the perceptions of mistreatment among different learners. Through the use of clinical vignettes, our aim was to assess the perceptions of trainees toward themes of potential mistreatment at different stages of training. METHODS: Based on observations from external experts embedded in the clinical learning environment, six thematic areas of potential mistreatment were identified: verbal abuse, specialty-choice discrimination, non-educational tasks, withholding/denying learning opportunities, neglect and gender/racial insensitivity. Corresponding clinical vignettes were created and distributed to 1) medical students, 2) incoming interns, 3) residents/fellows. Perceptions of the appropriateness of the interactions depicted in the vignettes were measured on a 5-point Likert scale. Scores were categorized into neutral or appropriate (≤3) or inappropriate (i.e. mistreatment) (>3) and compared using chi-squared tests. RESULTS: Four hundred twenty seven trainees participated (182 students, 120 interns, 125 residents/fellows). Proportions of students perceiving mistreatment differed significantly from those of interns and residents/fellows in domains of verbal abuse, specialty discrimination and gender/racial insensitivity (p < 0.05). In scenarios comparing interns to residents/fellows, no significant differences were noted in perceptions of mistreatment in the domains of non-educational tasks, withholding learning and neglect. CONCLUSIONS: Perceptions of mistreatment differ at different developmental stages of medical training. After exposure to the clinical learning environment, perceptions of incoming interns did not differ from those of residents/fellows, implicating clinical rotations as a key period in indoctrinating students into the prevailing culture. More longitudinal studies are needed to confirm or better examine this phenomenon.

A rhodamine coumarin-derived fluorescence probe that selectively detects Fe3+ and measures radiation doses.

We synthesized a fluorescence ratiometric probe by combining coumarin and rhodamine B with ethylenediamine to sense Fe3+ and measure ionizing radiation doses. The presence of Fe3+ caused rhodamine to transition from a closed helical structure to an open-ring structure. Additionally, fluorescence resonance energy transfer (FRET) occurred between coumarin and rhodamine B. As a result, the fluorescence intensity at 405 nm (I405) due to coumarin was decreased, whereas that at 585 nm (I585) derived from open-ring structure rhodamine B was increased. The ratio of I585 and I405 (I585/I405) linearly increased as the Fe3+ concentration increased. The probe sensed Fe3+ in a 0-110 µM range, with a lower limit of detection (LOD) of 0.226 µM. Inspired by Fricke dosimeters, we extended the probe to measure X-ray doses using the fluorescence methodology. The probe measured X-ray doses in a 0-30 Gy range with a lower LOD of 0.5 Gy. Additionally, the dosing capability was independent of the dosing rates. Our probe showed potential for detecting Fe3+ and measuring ionizing radiation doses.

Silver nanocluster-based ratiometric fluorescence sensors for X-ray dose detection.

In this paper, we synthesized silver nanoclusters using bovine serum albumin (BSA) as a template (BSA@AgNCs). Then, we anchored hydroxyphenyl fluorescein (HPF) to yield HPF-BSA@AgNCs. When exposed to X-rays, hydroxyl (∙OH) radicals generated by radiolysis of water react with HPF to produce fluorescein, which emits enhanced fluorescence at 515 nm (λex = 480 nm). The fluorescence intensity of BSA@AgNCs at 685 nm (λex = 480 nm) remains stable when exposed to X-rays. This HPF-BSA@AgNCs ratiometric fluorescence sensor can rapidly detect 0.1-20 Gy (the energy deposited per unit mass, J/kg) of X-rays. In addition, HPF-BSA@AgNCs exhibit good durability and temperature stability. Finally, HPF-BSA@AgNCs were used to measure the absorbed doses of A549 cells and evaluate the cell irradiation damage.

Help-Seeking Behaviors and Related Factors in Chinese Patients With Major Depressive Disorder: A Community-Based Cross-Sectional Study.

Background: Although evidence-based and effective treatments are available for people with major depressive disorder (MDD), a substantial number do not seek or receive help. Therefore, this study aimed to (1) investigate the total help-seeking rate and first-time help-seeking choices; (2) explore the perceived helpfulness of 23 potential sources; and (3) evaluate the factors related to help-seeking behaviors among patients with MDD. Materials and Methods: Data came from the Tianjin Mental Health Survey (TJMHS), which included a representative sample of adult community residents (n = 11,748) in the Chinese municipality of Tianjin. Of these, 439 individuals were diagnosed with lifetime MDD according to the Diagnostic and Statistical Manual-fourth edition (DSM-IV) and administered a help-seeking questionnaire. Results: In a survey, 28.2% of patients with MDD living community reported that they had ever sought any help during their entire lifetime before the interview, with 8.2% seeking help in mental healthcare settings, 8.0% only in other healthcare settings, and 12.0% only in non-healthcare sources (e.g., family, friends, and spiritual advisor). Among help-seekers, the first help mainly was sought in non-healthcare sources (61.3%), followed by healthcare settings (25.8%) and mental healthcare settings (12.9%). The majority of MDD individuals thought the non-healthcare sources were not helpful and mental healthcare settings were helpful or possibly helpful to solve mental problems. Female, having 10-12 or higher education years, comorbid anxiety disorders were associated with increased help-seeking. Conclusion: A small percentage of individuals with MDD living in community of Tianjin sought help. They preferred non-healthcare sources to healthcare settings. Demographic and clinical features were associated with help-seeking behaviors.