The Effects of Acupressure on Improving Health and Reducing Cost for Patients Undergoing Thoracoscopic Surgery.

OBJECTIVES: This study aimed to assess the effectiveness of practicing acupressure on the Shenmen and Neiguan acupoints with a view to reduce anxiety and improve the comfort and physical health of patients undergoing thoracoscopic surgery. METHODS: A total of 100 hospitalized patients undergoing thoracoscopic surgery were assigned randomly into the experimental (n = 49) and control groups (n = 51). Subjects in the experimental group received routine care plus acupressure on the Shenmen and Neiguan acupoints, while those in the control group received regular routine care. The data were collected using demographic information, physical and surgical data, the Visual Analog Scale (VAS)-A, the State-Trait Anxiety Inventory Y Form (STAI-Y1), and Shortened General Comfort Questionnaire scores. The linear mixed model was used to examine the influences of acupressure on VAS-A and STAI-Y1 scores at different time points before and after the surgery to observe group-by-time interactions. RESULTS: The mean age of the subjects was 60.97 years. All subjects had mild-to-moderate anxiety after surgery and showed a statistically significant decline in regression coefficients on the first and second days after the intervention (ß = -11.61, p = 0.002; ß = -18.71, p < 0.001). Similarly, for STAI-YI scores, the data showed a significant difference in the pre-test and post-test interactions between the two groups (ß = 4.72, p = 0.031). Conversely, acupressure did not have a statistically significant difference on comfort (F = 2.953, p = 0.057). Compared with the control subjects, the experimental subjects used less morphine and developed side effects less frequently (p < 0.01). They were also able to get out of bed after surgery 163.79 min earlier (p < 0.05). CONCLUSIONS: Acupressure is a simple and easy-to-practice treatment. Acupressure on the Shenmen and Neiguan acupoints reduces anxiety and improves recovery in patients after undergoing thoracoscopic surgery.

Cluster Nanozymes with Optimized Reactivity and Utilization of Active Sites for Effective Peroxidase (and Oxidase) Mimicking.

Single-atom catalysts have attracted attention in the past decade since they maximize the utilization of active sites and facilitate the understanding of product distribution in some catalytic reactions. Recently, this idea has been extended to single-atom nanozymes (SAzymes) for the mimicking of natural enzymes such as horseradish peroxidase (HRP) often used in bioanalytical applications. Herein, it is demonstrated that those SAzymes without constructing the reaction pocket of HRP still undergo the OH radical-mediated pathway like most of the reported nanozymes. Their positively charged single-atom centers resulting from support electronegative oxygen/nitrogen hinder the reductive conversion of H2 O2 to OH radicals and hence display low activity per site. In contrast, it is found that this step can be facilitated over their metallic counterparts on cluster nanozymes with much higher site activity and atom efficiency (cf. SAzymes with 100% atom utilization). Besides the mimicking of HRP in glucose detection, cluster nanozymes are also demonstrated as a better oxidase mimetic for glutathione detection.

A Qualitative Study on the Care Experience of Emergency Department Nurses during the COVID-19 Pandemic.

BACKGROUND: The rapid spread of the disease has severely impacted healthcare systems around the world. There is a lack of evidence related to the care experience of emergency department nurses. OBJECTIVE: To understand the care experience and thoughts of emergency department nurses during the COVID-19 epidemic. METHODS: Purposive sampling was used to recruit 16 emergency department nurses from a medical center, and a semi-structured interview was used for data collection. The enrollment period was from 28 July 2021 to 30 October 2021. Thematic content analysis was used for data analysis. RESULTS: The care experiences of emergency department nurses during the COVID-19 epidemic can be classified into three themes and six sub-themes. Theme 1: I am the gatekeeper; theme 2: Care and environment challenges: difficulties with equipment and environment, managing patient's and family members' emotions, insufficient manpower of care; theme 3: Conflicting emotions: worrying about being infected or transmitting the disease, needs of effective support and empathy, and lack of understanding and discrimination towards the occupation. CONCLUSION: Emergency department nurses adhered to professional awareness and responsibility during the epidemic and play a critical role in epidemic prevention.

Rapid Interchangeable Hydrogen, Hydride, and Proton Species at the Interface of Transition Metal Atom on Oxide Surface.

Hydrogen spillover is the phenomenon where a hydrogen atom, generated from the dissociative chemisorption of dihydrogen on the surface of a metal species, migrates from the metal to the catalytic support. This phenomenon is regarded as a promising avenue for hydrogen storage, yet the atomic mechanism for how the hydrogen atom can be transferred to the support has remained controversial for decades. As a result, the development of catalytic support for such a purpose is only limited to typical reducible oxide materials. Herein, by using a combination of in situ spectroscopic and imaging technique, we are able to visualize and observe the atomic pathway for which hydrogen travels via a frustrated Lewis pair that has been constructed on a nonreducible metal oxide. The interchangeable status between the hydrogen, proton, and hydride is carefully characterized and demonstrated. It is envisaged that this study has opened up new design criteria for hydrogen storage material.

The Experience of Emergency Nurses Caring for Patients with Mental Illness: A Qualitative Study.

BACKGROUND: The medical burden of psychiatric disorders continues to increase and has caused a major impact on health, society, human rights, and economy in the world. Patients with mental illness have a higher ratio of emergency department visits than non-psychiatric patients. Psychiatric disorder-related emergency department care is a stress-causing factor in emergency department work. Therefore, the purpose of this study was to explore the experience of emergency department nurses in caring for patients with mental illness. METHODS: A descriptive qualitative research design with purposive sampling was adopted. A total of 17 nurses working in the emergency department in central Taiwan were recruited. In-depth semi-structured interviews were conducted and thematic content analysis was performed. RESULTS: Four themes and six sub-themes emerged that described the experiences of emergency nurse caring for patients with mental illness: (1) Mindset; (2) The predicament of psychiatric care: Violence and isolation and helplessness, and lack of therapeutic communication skills; (3) The influence of open space: insufficient safety and privacy; and (4) The educational needs of psychiatric nursing: improving cognition in psychiatric patients and changing negative thinking into positive thinking. CONCLUSIONS: The results revealed the experience of emergency nurses in caring for patients with mental illness. Emergency psychiatric nursing training related to foundational psychiatric knowledge, communication skill, concept of recovery, coping with violence restraining are needed for nurses who work in emergency departments.

Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan.

This study collected 11 parameters regarding the labial and lingual strength for maximum isometric and swallowing tasks among 150 healthy Chinese adults in Taiwan. Measurements were performed using the Iowa Oral Performance Instrument (IOPI). All of the labial and lingual strength parameters were measured three times. The maximal value of three trials represents the pressure of every parameter. The overall mean (±standard deviation) and maximum isometric pressures of the lips, anterior tongue, and posterior tongue were 24.81 ± 5.64, 55.95 ± 14.13, and 53.23 ± 12.24 kPa, respectively. The mean value of posterior tongue strength was less than that of the anterior tongue by approximately 5%. The percentages of maximum isometric tongue pressure during the swallowing of saliva and water were 85% and 80% for the anterior tongue and 90% and 81% for the posterior tongue, respectively. The average endurances for the anterior tongue and posterior tongue were 13.86 ± 7.08 and 10.06 ± 5.40 s, respectively. The maximum isometric pressures were greater than both the saliva and water swallowing pressures, and the saliva swallowing pressures were greater than the water swallowing pressures. A value of 33 kPa in maximum isometric pressure could serve as a demarcation of weak tongue strength for healthy Chinese adults. As for the repeated trials of labial and lingual strength, there were no statistically significant differences for any of the pressures obtained from the 11 labial and lingual strength parameters. The normative data can be used for the objective assessment of labial and lingual strength in healthy Chinese adults.

Risk of Endometriosis and Subsequent Ovary and Breast Cancers in Nurses: A Population-Based Cohort Study in Taiwan.

BACKGROUND: Endometriosis has been associated with the subsequent development of ovarian and breast cancers. This study evaluated whether nurses were at increased risks of developing endometriosis and subsequent ovarian and breast cancers. METHODS: From Taiwan National Health Insurance Research Database during 2000 to 2011, we established 3 study cohorts, consisting of 23,801 nurses, 11,973 other hospital employees, and 143,096 general women free of endometriosis and cancer. Women in all cohorts were followed to the end of 2011 to measure the occurrences of endometriosis and subsequent ovarian and breast cancers. The incident endometriosis cases and related hazard ratio (HR) and 95% confidence interval (CI) were calculated. The incident cases of ovarian cancer and breast cancer and related odds ratio were calculated. RESULTS: The incidence of endometriosis was the highest in the nurse cohort (4.23 per 100, n = 966) followed by other health professionals (3.74 per 100, n = 427) and control cohort (3.06 per 100, n = 4193), with adjusted hazard ratios of 1.28 (95% CI = 1.20-1.38) and 1.13 (95% CI = 1.02-1.25), respectively, comparing to controls. Among those who developed endometriosis, nurses had higher subsequent ovarian cancer and lower breast cancer, but not significant. CONCLUSIONS: Nurses are at a higher risk of developing endometriosis. However, the link between endometriosis and subsequent cancers is weak.

TREM-1 regulates macrophage polarization in ureteral obstruction.

Chronic kidney disease (CKD) is an emerging worldwide public health problem. Inflammatory cell infiltration and activation during the early stages in injured kidneys is a common pathologic feature of CKD. Here, we determined whether an important inflammatory regulator, triggering receptor expressed on myeloid cells (TREM)-1, is upregulated in renal tissues collected from mouse ureteral obstruction-induced nephritis. TREM-1 is crucial for modulating macrophage polarization, and has a pivotal role in mediating tubular injury and interstitial collagen deposition in obstructive nephritis. Lysates from nephritic kidneys triggered a TREM-1-dependent M1 polarization ex vivo, consistent with the observation that granulocyte-macrophage colony-stimulating factor (GM-CSF)-derived M1 macrophages express higher levels of TREM-1 in comparison with M-CSF-derived cells. Moreover, agonistic TREM-1 cross-link significantly strengthens the inductions of iNOS and GM-CSF in M1 cells. These observations are validated by a strong clinical correlation between infiltrating TREM-1-expressing/iNOS-positive macrophages and renal injury in human obstructive nephropathy. Thus, TREM-1 may be a potential diagnostic and therapeutic target in human kidney disease.

TREM-1 promotes survival during Klebsiella pneumoniae liver abscess in mice.

Klebsiella pneumoniae liver abscess (KPLA) is prevalent in East Asia. Liver abscess can develop after translocation of K. pneumoniae from a patient's bowel into the liver via the portal circulation. TREM-1 (triggering receptor expressed on myeloid cells 1) amplifies inflammatory signaling during infection, but its role in KPLA is poorly understood. We used an animal study to characterize the role of TREM-1 in KPLA. We compared survival rates, bacterial burdens in tissues, inflammatory cytokine levels, and histology findings between wild-type and Trem-1 knockout (KO) mice after oral inoculation of capsular type K1 K. pneumoniae. Translocation of K. pneumoniae to mesenteric lymph nodes and liver was examined, and intestinal permeability, antimicrobial peptide expression, and the clearance of K. pneumoniae in the small intestine were determined. In the absence of TREM-1, KPLA model mice showed increased K. pneumoniae dissemination, enhanced liver and systemic inflammation, and reduced survival. Impaired bacterial clearance in the small intestine causes enhanced K. pneumoniae translocation, which renders Trem-1 KO mice more susceptible to K. pneumoniae oral infection. In conclusion, TREM-1-mediated bacterial clearance in the small intestine is an important immune response against K. pneumoniae. TREM-1 deficiency enhances K. pneumoniae translocation in the small intestine and increases mortality rates in mice with KPLA.

Fiber optic biosensor for the detection of C-reactive protein and the study of protein binding kinetics.

Application of a fiber optic biosensor (FOB) to the real-time investigation of the interaction kinetics between FITC-conjugated monoclonal sheep anti-human C-reactive protein (CRP) antibody and CRP isoforms on the surface of optical fiber is described. Recently, both the native pentameric CRP (pCRP), an acute phase protein belonging to pentraxin family, and an isoform of pCRP, modified CRP (mCRP), have been suggested to have proinflammation effects on vascular cells in acute myocardial infarction (AMI). In current studies, we generate mCRP from pCRP, and use several methods including fluorescence spectral properties, circular dichroism, analytical ultracentrifuge, and Western blotting to demonstrate their differences in physical and chemical properties as well as the purity of pCRP and mCRP. In addition, we design and implement an FOB to study the real-time qualitative and quantitative biomolecular recognition of CRP isoforms. Specifically, the association and dissociation rate constants of the reaction between FITC-conjugated monoclonal sheep anti-human CRP antibody and the pCRP and mCRP are determined. The feasibility of our current approach to measure the association and dissociation rate constants of the reaction between tested CRP isoforms was successfully demonstrated.

The interaction of lipopolysaccharide with membrane receptors on macrophages pretreated with extract of Reishi polysaccharides measured by optical tweezers.

Lipopolysaccharide (LPS), one of the cell wall components of Gram-negative bacteria, is recognized by and interacted with receptors on macrophages. In this paper, we report the trapping of LPS-coated polystyrene particles via optical tweezers and measured its interaction with murine macrophages (J774A.1 cells) for cells pre-treated with extract of Reishi polysaccharides (EORP) vs. those without EORP treatment. Our experimental results indicate that the cellular affinity for LPS increases when the macrophage is pretreated with EORP. We demonstrate for the first time by conventional biological methods and by tracking the dynamics of optically-trapped LPS-coated particles interacting with J774A.1 cells, that EORP not only enhances J774A.1 cells surface expression of TLR4 and CD14, two receptors on macrophages, as well as LPS binding and phagocytosis internalization, but also reduces the adhesion time constant and increases the force constant of the binding interaction. The application of optical tweezers allows us to study the effect on a single cell quantitatively in real-time with a spatial resolution ~ 1 mum within a single cell.