Dynamic radiation steering with transmission-type coding metasurface.

In this paper, we integrate continuous transmission amplitude modulation and phase coding into a metasurface, and dynamic transmitted electromagnetic field manipulation is realized in microwave regime. The active metasurface is obtained by placing a PIN diodes loaded amplitude modulation metasurface on a binary phase coding metasurface whose coding matrix is optimized by genetic algorithm. Changing the bias voltage applied on the diodes, the transmission amplitude of the phase coding units covered by amplitude modulation units can be tuned continuously while other coding units are not affected, leading to the fact that the transmitted field pattern of the metasurface varies from strongly directional transmission to diffusion-like radiation. By this means, two degrees of freedom of dynamic amplitude modulation and predesigned phase coding are achieved to control the electromagnetic waves. Additionally, a bias network is designed to ensure the polarization-stability of the metasurface. The proposed concept is predicted by analytical model, and verified by numerical simulations and experiment. This design with low profile and diverse functionalities can yield potential applications ranging from radio frequency energy harvesting to wireless communication systems.

Impact of a long-term air pollution exposure on the case fatality rate of COVID-19 patients-A multicity study.

Evidence in the literature suggests that air pollution exposure affects outcomes of patients with COVID-19. However, the extent of this effect requires further investigation. This study was designed to investigate the relationship between long-term exposure to air pollution and the case fatality rate (CFR) of patients with COVID-19. The data on air quality index (AQI), PM2.5, PM10, SO2 , NO2 , and O3 from 14 major cities in China in the past 5 years (2015-2020) were collected, and the CRF of COVID-19 patients in these cities was calculated. First, we investigated the correlation between CFR and long-term air quality indicators. Second, we examined the air pollutants affecting CFR and evaluated their predictive values. We found a positive correlation between the CFR and AQI (1, 3, and 5 years), PM2.5 (1, 3, and 5 years), and PM10 (1, 3, and 5 years). Further analysis indicated the more significant correlation for both AQI (3 and 5 years) and PM2.5 (1, 3, and 5 years) with CFR, and moderate predictive values for air pollution indicators such as AQI (1, 3, and 5 years) and PM2.5 (1, 3, and 5 years) for CFR. Our results indicate that long-term exposure to severe air pollution is associated with higher CFR of COVID-19 patients. Air pollutants such as PM2.5 may assist with the prediction of CFR for COVID-19 patients.

Metamaterial-inspired optically transparent active dual-band frequency selective surface with independent wideband tunability.

This paper presents an optically transparent active bandstop frequency selective surface (FSS) with wideband tunability of two resonance frequencies using the concept of miniaturized element FSS (MEFSS). The proposed design consists of metallic square loop arrays on a new optically transparent substrate as the top layer, a glass interlayer, and periodic patterns of cross dipoles on the substrate as the bottom layer. Two kinds of resonant elements loaded with varactors and the designed bias networks achieve two independent tunable stopbands. The proposed FSS has two large tuning ranges, one is from 1.20 GHz to 2.63 GHz and another is from 2.0 GHz to 5.9 GHz (75% and 99% with respect to the center frequency, respectively). The wideband dual-tuning mechanism is theoretically analyzed and demonstrated by deriving its equivalent circuit (EC) model. The experiment results exhibit reasonable agreement with the numerical simulation responses. This proposed design, with low profile, angular stability, polarization insensitivity, optical transparency, and wideband dual-tunability can play an important role in manipulating electromagnetic wave propagation for manifold applications.

Current Status of Diagnostic Testing for SARS-CoV-2 Infection and Future Developments: A Review.

The coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, SARS-CoV-2, has infected more than 50.6 million individuals and caused over 1.2 million deaths globally, raising a major health concern. To date, no specific antiviral treatment or vaccine for COVID-19 has been approved by the Food and Drug Administration (FDA). Highly sensitive and specific laboratory diagnostics are therefore critical for controlling the rapidly evolving COVID-19 pandemic and optimizing clinical care, infection control, and public health interventions. The FDA has issued emergency use authorization (EUA) for hundreds of COVID-19 diagnostic tests of different classes. Whereas nucleic acid testing (NAT) such as RT-PCR remains the criterion standard for COVID-19 diagnosis, serological antibody and antigen tests are increasingly being developed. Tests based on the novel RNA sensing techniques (e.g., SHERLOCK, DETECTR, and Toehold Switch) are promising due to their relatively low cost, high accuracy, and rapid detection time. Diagnostic testing results for SARS-CoV-2 should be interpreted with caution, since they depend heavily on factors such as viral load, virus replication, the source and timing of sample collection, sample extraction, and characteristics of various testing methods. This review aims to present the current status of common diagnostic testing for SARS-CoV-2 infection, review the current regulatory requirements, and identify future directions in the development of improved diagnostics that are more accurate, accessible, and rapid.

The pigment characteristics and productivity shifting in high cell density culture of Monascus anka mycelia.

BACKGROUND: Monascus mycelia and pigments are promising sources of food and medicine with their potential pharmaceutical values and health-improving functions. Using high cell density fermentation of Monascus spp. to achieve higher mycelium and yellow pigment production is worthy to be researched. In this study, the characteristics and productivity shifting of pigments in high cell density culture of Monascus anka GIM 3.592 were investigated. RESULTS: The high yield of Monascus mycelia up to 39.77 g/L dry cell weight (DCW), which was achieved by fed-batch fermentation with the feeding medium containing C, N, P and trace elements, was four times higher than that of conventional batch culture. But the total pigment production decreased by 14.6 %, which suggested non-coupled growth. Potential novel yellow pigments accumulated constantly at the late stage of the fed-batch culture, which resulted in a shift in pigment characteristics so that yellow pigments became the dominant pigments. Citrinin production was extremely low and independent of feeding ingredients. CONCLUSIONS: This study provided a suitable fermentation strategy to produce functional Monascus mycelia with a high proportion of yellow pigments in high cell density culture. For the first time, it reported the pigment productivity and characteristics shifting in high cell density culture of Monascus.

Cytokine and cytokine receptor genes of the adaptive immune response are differentially associated with breast cancer risk in American women of African and European ancestry.

Disparities in breast cancer biology are evident between American women of African ancestry (AA) and European ancestry (EA) and may be due, in part, to differences in immune function. To assess the potential role of constitutional host immunity on breast carcinogenesis, we tested associations between breast cancer risk and 47 single nucleotide polymorphisms (SNPs) in 26 cytokine-related genes of the adaptive immune system using 650 EA (n = 335 cases) and 864 AA (n = 458 cases) women from the Women's Circle of Health Study (WCHS). With additional participant accrual to the WCHS, promising SNPs from the initial analysis were evaluated in a larger sample size (1,307 EAs and 1,365 AAs). Multivariate logistic regression found SNPs in genes important for T helper type 1 (Th1) immunity (IFNGR2 rs1059293, IL15RA rs2296135, LTA rs1041981), Th2 immunity (IL4R rs1801275), and T regulatory cell-mediated immunosuppression (TGFB1 rs1800469) associated with breast cancer risk, mainly among AAs. The combined effect of these five SNPs was highly significant among AAs (P-trend = 0.0005). When stratified by estrogen receptor (ER) status, LTA rs1041981 was associated with ER-positive breast cancers among EAs and marginally among AAs. Only among AA women, IL15 rs10833 and IL15RA rs2296135 were associated with ER-positive tumors, and IL12RB1 rs375947, IL15 rs10833 and TGFB1 rs1800469 were associated with ER-negative tumors. Our study systematically identified genetic variants in the adaptive immune response pathway associated with breast cancer risk, which appears to differ by ancestry groups, menopausal status and ER status.

Diagnostic utility of LUNX mRNA and VEGF mRNA in pleural fluid for differentiating benign from malignant origin.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic utility of lung-specific X protein (LUNX) mRNA and vascular endothelial growth factor mRNA in differentiating pleural effusion of different origin. METHODS: A total of 136 patients with pleural effusion (46 cases of malignant pleural effusion caused by lung cancer, 30 cases of malignant pleural effusion caused by other cancers and 60 cases of benign pleural effusion) were enrolled in this study. Levels of LUNX mRNA and vascular endothelial growth factor mRNA in pleural fluid were detected by real-time quantitative polymerase chain reaction. Pleural fluid carcinoembryonic antigen and Cyfra21-1 were also measured simultaneously. RESULTS: The LUNX mRNA level was significantly higher in malignant pleural effusion caused by lung cancer than in malignant pleural effusion caused by other cancers and in benign pleural effusion. In malignant pleural effusion caused by cancers of different origin, the vascular endothelial growth factor mRNA level was significantly higher than in benign pleural effusion. For the diagnosis of malignant pleural effusion caused by lung cancer, LUNX mRNA exhibited higher sensitivity (80%), when compared with vascular endothelial growth factor mRNA (65%), carcinoembryonic antigen (67%) and Cyfra21-1 (61%), with the same specificity (95%). The combination of LUNX mRNA and cytology achieved a sensitivity of 85%. The combined use of LUNX mRNA and vascular endothelial growth factor mRNA and cytology raised the sensitivity to 89%, with 95% specificity. In initial cytology-negative pleural effusion from lung cancer, LUNX mRNA achieved the highest positive result (65%) among the four markers. CONCLUSIONS: The detection of LUNX mRNA and vascular endothelial growth factor mRNA in pleural fluid may be a complementary tool for the diagnosis of malignant pleural effusion. In particular, pleural fluid LUNX mRNA provided a valuable adjunct in distinguishing malignant pleural effusion caused by lung cancer from benign pleural effusion.

Pretreatment levels of circulating Th1 and Th2 cytokines, and their ratios, are associated with ER-negative and triple negative breast cancers.

Immune signatures in breast tumors differ by estrogen receptor (ER) status. The purpose of this study was to assess associations between ER phenotypes and circulating levels of cytokines that co-ordinate cell-mediated [T-helper type 1 (Th1)] and humoral [T-helper type 2 (Th2)] immunity. We conducted a case-case comparison of 523 women with newly diagnosed breast cancer to evaluate associations between 27 circulating cytokines, measured using Luminex XMap technology, and breast cancer phenotypes [ER(-) vs. ER(+); triple negative breast cancer (TNBC) vs. luminal A (LumA)]. Ratios of Th1 to Th2 cytokines were also evaluated. Levels of interleukin (IL)-5, a Th-2 cytokine, were higher in ER(-) than in ER(+) tumors. The highest tertile of IL-5 was more strongly associated with ER(-) (OR = 2.33, 95 % CI 1.40-3.90) and TNBCs (OR = 2.78, 95 % CI 1.53-5.06) compared to ER(+) and LumA cancers, respectively, particularly among premenopausal women (OR = 4.17, 95 % CI 1.86-9.34, ER(-) vs. ER(+); OR = 5.60, 95 % CI 2.09-15.01, TNBC vs. LumA). Elevated Th1 cytokines were also detected in women with ER(-) and TNBCs, with women in the highest tertile of interferon α2 (OR = 2.39, 95 % CI 1.31-4.35) or tumor necrosis factor-α (OR = 2.27, 95 % CI 1.21-4.26) being twice as likely to have TNBC versus LumA cancer. When cytokine ratios were examined, women with the highest ratios of Th1 cytokines to IL-5 levels were least likely to have ER(-) or TNBCs compared to ER(+) or LumA cancers, respectively. The strongest associations were in premenopausal women, who were up to 80 % less likely to have TNBC than LumA cancers (IL-12p40/IL-5, OR = 0.19, 95 % CI 0.07-0.56). These findings indicate that immune function is associated with ER(-) and TNBC and may be most relevant among younger women, who are likely to be diagnosed with these aggressive phenotypes.

Susceptibility loci affecting ERBB2/neu-induced mammary tumorigenesis in mice.

Twenty percent of breast cancers exhibit amplification or overexpression of ERBB2/neu and a poor prognosis. As the susceptibility genes controlling ERBB2 tumorgenesis are unknown, in a genetic mapping project we crossed transgenic mice expressing the neu oncogene under control of MMTV promoter with recombinant congenic (RC) strains, which provided a high mapping power. RC strains differed considerably in tumor latency (P = 0.0002), suggesting a strong genetic control of tumor development. Linkage analysis in neu-transgene carrying F2 hybrids between the most susceptible and most resistant RC strain revealed three mammary tumor susceptibility (Mts) loci with main effects, Mts1 (chr. 4), Mts2 (chr. 10), Mts3 (chr. 19), and two interacting loci Mts4 (chr.6) and Mts5 (chr. 8), significantly affecting mammary tumor latency. Suggestive significance levels indicated control of tumor numbers by Mts1 alone and in interaction with Mts5, and by two additional interacting loci on chromosomes 1 and 8. These loci combined explain to a large extent the tumor latency and number in individual F2 mouse. We also identified a suggestive locus on chromosome 17 controls metastasis to the lung. The loci Mts1, Mts1b, and Mts3 are located in the Naad4-4,5 and Naad19-2 LOH-regions of neu-induced mammary tumors, corresponding to the frequent human breast cancer LOH-regions 1p34/1p36, and 10q25, respectively. These results expand the knowledge of ERBB2 tumorigenesis and point to a combined control of specific tumor phenotypes by germ-line polymorphisms and somatic alterations.

Clustering of colon, lung, and other cancer susceptibility genes with protein tyrosine phosphatases and protein kinases in multiple short genomic regions.

Interactions of large gene families are poorly understood. We found that human, mouse, and rat colon and lung cancer susceptibility genes, presently considered as separate gene families, were frequently pairwise linked. The orthologous mouse map positions of 142 of 159 early discovered colon and lung cancer susceptibility genes formed 41 genomic clusters conserved >70 million years. These linked gene pairs concordantly affected both tumors and their majority was linked with two other gene families - protein tyrosine phosphatases and cancer driver protein kinases. 25% of both protein tyrosine phosphatases and protein kinases mapped <1 cM from a colon or lung cancer susceptibility gene, and 50% in <3 cM. Similar linkage was detected with most other human susceptibility genes that controlled 29 different cancer types. This concentration of tumor susceptibility genes with protein tyrosine phosphatases and driver protein kinases in multiple relatively short genomic regions suggests their possible functional diversity.

The effectiveness of intensive nursing care on seasonal variation of blood pressure in patients on peritoneal dialysis.

AIM: This article is a report of a study to reduce the seasonal variation of blood pressure in patients on peritoneal dialysis through an intensive programme of nursing care. BACKGROUND: The seasonal variation of blood pressure is a common phenomenon in patients on maintenance dialysis. Whether or not this variation can be reduced through a given intervention is unknown. METHODS: The programme of intensive nursing care including education on volume control, home blood pressure monitoring and intensified antihypertensive treatment, was implemented from December 2006. The blood pressure, fluid and sodium removal and defined daily doses of antihypertensive agents were measured at 1-monthly intervals and averagely quarterly for seasonal values for spring, summer, autumn and winter, respectively, before (December 2005-November 2006) and after intervention (December 2006-November 2007). FINDINGS: A total of 76 clinically stable patients on peritoneal dialysis were enrolled and finally analysed. The mean age was 60·6 years, and dialysis duration was 23·2 months. Before intervention, there were important seasonal variations in systolic and diastolic blood pressure. After intensive nursing care was implemented, the seasonal variation of systolic blood pressure disappeared. The diastolic blood pressure still represented a season pattern, but the discrepancy between winter and summer decreased. There were no seasonal patterns of total fluid and sodium removal before and after intervention. CONCLUSIONS: Intensive nursing care reduced the seasonal variation of blood pressure in patients on peritoneal dialysis. These data provided an evidence for implementing nurse-centred interventions in this population.

Ethyl 3-(4-chloro-phen-yl)-2-(dipentyl-amino)-4-oxo-5-phenyl-4,5-dihydro-3H-pyrrolo-[3,2-d]pyrimidine-7-carboxyl-ate.

In the title compound, C(31)H(37)ClN(4)O(3), the fused rings of the pyrrolo-[3,2-d]pyrimidine system form a dihedral angle of 5.80 (11)°. The phenyl and benzene rings are twisted with respect to the mean plane of the pyrrolo-[3,2-d]pyrimidine system [maximum deviation = 0.077 (2) Å], making dihedral angles of 61.05 (12) and 75.39 (10)°, respectively. The eth-oxy group is disordered over two positions with the site-occupancy ratio fixed at 0.54:0.46. In the crystal, mol-ecules are linked via C-H⋯O hydrogen bonds, forming a two-dimensional network lying parallel to the ab plane. There are also π-π [centroid-centroid distances = 3.5954 (17) and 3.965 (2) Å] and C-H⋯π inter-actions present.

How and when leader narcissism links to employees' objective career success: The roles of ingratiation and careerist orientation.

Previous researches have emphasized the value of leader narcissism on employees' career success, whereas we still know little about how and when this relationship will materialize. By integrating dramaturgical theory and leader narcissism literatures, we propose a theoretical model to explain the mechanism and boundary of leader narcissism in promoting employees' objective career success (e.g., salary increases and promotions). To test our hypotheses, we carried out a multi-wave research design and collected data from 299 employees in Chinese manufacturing firms. The results of multiple regression analysis showed that leader narcissism motivates employees' ingratiation, which in turn facilitates employees' objective career success, especially when those employees are high in careerist orientation. Theoretical and practical implications of the findings are discussed.

Effects of Ambient Humidity on Water Migration and Hydrate Change in Early-Age Hardened Cement Paste.

Ultra-low humidity environments will lead to changes in the microstructure of C-S-H, which will reduce the mechanical properties and service life of cement-based concrete. Thus, to further explore the mechanism on the microscale, this paper studied the water migration and the changes in the hydration products in white cement that was cured for 7 days at 20 °C and at different ambient relative humidities (RHs). The migration and transformation of different types of water in cement paste were studied by low-field nuclear magnetic resonance (NMR). At the same time, Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) were used to analyze semi-quantitatively the crystal phase in the hydration products. The results showed that in the first 7 days of the curing process, the content of the different types of water and the hydration products in the cement samples were influenced by the ambient RH. The total water content of the samples will decrease with the decrease in the RH; when the RH decreases to 54% or below, the chemically bound water in the samples will increase with the decline in the RH. Additionally, when the ambient RH is lower than 54%, the grossular will gradually transform into hydrogrossular crystals with the decrease in the RH, and the hibschite with less chemically bound water will transform into katoite with more chemically bound water. In future research, the water migration and hydrate changes under different curing ages, drying processes, and coupling effects should be explored.

The effects of positive psychological intervention on obstetric surgery patients' mental states, pain levels, and quality of life.

To explore the effect of positive psychological intervention (PPI) on the psychological state, pain levels, and quality of life of patients undergoing obstetric surgery. A total of 96 patients undergoing obstetric surgery in The Second Hospital of Shandong University from March 2018 to May 2019 were selected for this study. They were equally and randomly separated into a control and an observation group. We found the postoperative hospital stays, bleeding times, feeding times, and activity times of the observation group with PPI were shorter than they were in the control group without PPI (P<0.05). Moreover, the SAS and SDS scores, and the pain levels of the observation group were significantly lower than they were in the control group (P<0.05), resulting in improved quality of life scores in the observation group (P<0.05). Furthermore, the overall incidences of postpartum hemorrhage, infections, depression, constipation, and bedsores were significantly lower in the observation group than they were in the control group (25% vs 77.08%, P<0.05). In conclusion, PPI can improve the mental states of patients undergoing obstetric surgery and improve their quality of life.

Financial Self-Efficacy and General Life Satisfaction: The Sequential Mediating Role of High Standards Tendency and Investment Satisfaction.

Important strides have been made toward understanding the relationship between self-efficacy and life satisfaction. However, existing studies have largely focused on work and academic domains, leaving self-efficacy in the finance domain less frequently investigated. The present study applied the self-efficacy construct to the finance domain, namely "financial self-efficacy" (FSE), and tested the sequential mediating roles of high standards tendency and investment satisfaction in the relationship between FSE and general life satisfaction. A total of 323 employees from finance-related businesses completed anonymous questionnaires regarding FSE, high standards tendency, investment satisfaction, and general life satisfaction. Results indicated that FSE influenced general life satisfaction through investment satisfaction, and sequentially through high standards tendency and investment satisfaction. These results provide contributions to the current literature on life satisfaction, and positive psychology literature by shedding light on the roles of high standards tendency and investment satisfaction in the relation between FSE and general life satisfaction.

A locus on chromosome 8 controlling tumor regionality-a new type of tumor diversity in the mouse lung.

Regional specificity of lung tumor formation has rarely been studied in mouse or human. By using crosses of strains semi-congenic for lung cancer susceptibility locus Sluc20, we have analyzed the genetic influences of Sluc20 and 5 other loci on tumor regionality in the mouse lung. We have mapped Sluc20 to a 27.92-MB proximal region of chromosome 8 and found that it controls the number and load of only those tumors that surround or are directly adjacent to the bronchi or bronchioli (peribronchial tumors). These tumors lie outside the bronchial basement membrane and tend to reach a larger size than the tumors at other locations in the lung. Similar to tumors of alveolar lineage at other locations, peribronchial tumors stain with SP-C but not CC10 antibody. The effects of Sluc20 alleles are additive because the number of peribronchial tumors in heterozygotes is intermediate. These findings show that tumor regionality in the mouse lung, which represents a novel level of lung tumor heterogeneity, is under specific genetic control. The identification of genes controlling lung tumor regionality will provide novel insights into the biology of lung tumors and potentially improve the possibilities of individualized prognosis and treatment in human lung cancer.

Loci controlling lymphocyte production of interferon c after alloantigen stimulation in vitro and their co-localization with genes controlling lymphocyte infiltration of tumors and tumor susceptibility.

Low infiltration of lymphocytes into cancers is associated with poor prognosis, but the reasons why some patients exhibit a low and others a high infiltration of tumors are unknown. Previously we mapped four loci (Lynf1­Lynf4) controlling lymphocyte infiltration of mouse lung tumors. These loci do not encode any of the molecules that are involved in traffic of lymphocytes. Here we report a genetic relationship between these loci and the control of production of IFNγ in allogeneic mixed lymphocyte cultures (MLC). We found that IFNγ production by lymphocytes of O20/A mice is lower than by lymphocytes of OcB-9/Dem mice (both H2pz) stimulated in MLC by irradiated splenocytes of C57BL/10SnPh (H2b) or BALB/ cHeA (H2d) mice, or by ConA. IFNγ production in MLCs of individual (O20 9 OcB-9)F2mice stimulated by irradiated C57BL/10 splenocytes and genotyped for microsatellite markers revealed four IFNγ-controlling loci (Cypr4-Cypr7), each of which is closely linked with one of the four Lynf loci and with a cluster of susceptibility genes for different tumors. This suggests that inherited differences in certain lymphocyte responses may modify their propensity to infiltrate tumors and their capacity to affect tumor growth.

Effect of the Tailored, Family-Involved Hospital Elder Life Program on Postoperative Delirium and Function in Older Adults: A Randomized Clinical Trial.

Importance: Postoperative delirium (POD) is a common condition for older adults, contributing to their functional decline. Objective: To investigate the effectiveness of the Tailored, Family-Involved Hospital Elder Life Program (t-HELP) for preventing POD and functional decline in older patients after a noncardiac surgical procedure. Design, Setting, and Participants: A 2-arm, parallel-group, single-blind, cluster randomized clinical trial was conducted from August 24, 2015, to February 28, 2016, on 6 surgical floors (gastric, colorectal, pancreatic, biliary, thoracic, and thyroid) of West China Hospital in Chengdu, China. Eligible participants (n = 281) admitted to each of the 6 surgical floors were randomized into a nursing unit providing t-HELP (intervention group) or a nursing unit providing usual care (control group). All randomized patients were included in the intention-to-treat analyses for the primary outcome of POD incidence. Statistical analysis was performed from April 3, 2016, to December 30, 2017. Interventions: In addition to receiving usual care, all participants in the intervention group received the t-HELP protocols, which addressed each patient's risk factor profile. Besides nursing professionals, family members and paid caregivers were involved in the delivery of many of the program interventions. Main Outcomes and Measures: The primary outcome was the incidence of POD, evaluated with the Confusion Assessment Method. Secondary outcomes included the pattern of functional and cognitive changes (activities of daily living [ADLs], instrumental activities of daily living [IADLs], Short Portable Mental Status Questionnaire [SPMSQ]) from hospital admission to 30 days after discharge, and the length of hospital stay (LOS). Results: Of the 475 patients screened for eligibility, 281 (171 [60.9%] male, mean [SD] age 74.7 [5.2] years) were enrolled and randomized to receive t-HELP (n = 152) or usual care (n = 129). Postoperative delirium occurred in 4 participants (2.6%) in the intervention group and in 25 (19.4%) in the control group, with a relative risk of 0.14 (95% CI, 0.05-0.38). The number needed to treat to prevent 1 case of POD was 5.9 (95% CI, 4.2-11.1). Participants in the intervention group compared with the control group showed less decline in physical function (median [interquartile range] for ADLs: -5 [-10 to 0] vs -20 [-30 to -10]; P < .001; for IADLs: -2 [-2 to 0] vs -4 [-4 to -2]; P < .001) and cognitive function (for the SPMSQ level: 1 [0.8%] vs 8 [7.0%]; P = .009) at discharge, as well as shorter mean (SD) LOS (12.15 [3.78] days vs 16.41 [4.69] days; P < .001). Conclusions and Relevance: The findings suggest that t-HELP, with family involvement at its core, is effective in reducing POD for older patients, maintaining or improving their physical and cognitive functions, and shortening the LOS. The results of this t-HELP trial may improve generalizability and increase the implementation of this program. Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR-POR-15006944.