Effects of a culturally tailored low-glycaemic index dietary educational intervention on reducing cardiometabolic risk among Chinese adults with obesity: a randomised controlled trial.

AIMS: An assessor-blinded randomised controlled trial was conducted to assess the effect of a culturally tailored low-glycaemic index (GI) dietary educational intervention on body mass index and cardiometabolic risks for Chinese people with obesity in Hong Kong. METHODS AND RESULTS: A total of 166 Chinese adults in Hong Kong with obesity were randomised to the intervention group (n=83) or the control group (n=83). The intervention group received the culturally sensitive low-GI dietary educational intervention based on the Health Belief Model, consisting of an educational booklet, one individual interactive educational session, and three follow-up telephone calls. The control group received general advice on a healthy diet, including a pamphlet, one individual education session, and three follow-up telephone calls. Outcome measures included body mass index, cardiometabolic risk-factors, dietary intake variables and sense of satiety. Data collection was conducted at baseline and post-intervention at 12-week. Generalized estimating equation model was used to compare the difference in changes in outcome variables between groups. Compared with the control group, the intervention group exhibited a significant reduction in dietary glycaemic load (ß=-6.963, p=0.026) at post intervention. No significant effects were found on other outcomes. CONCLUSION: A 12-week culturally tailored and Health Belief Model-based low-GI dietary educational intervention significantly reduced the dietary glycaemic load and showed the feasibility of the low-GI dietary intervention in Chinese adults in Hong Kong with obesity. A longer intervention period and follow-up might be required to achieve improvements in reducing cardiometabolic risk factors in people with obesity. REGISTRATION: ClinicalTrials.gov Identifier: NCT04152213.

Ni-based catalysts supported on Hbeta zeolite for the hydrocracking of waste polyolefins.

Polyolefin plastics are the most popular polymer materials worldwide, and the catalytic degradation of post-consumer polyolefins has attracted increased attention as a viable process. In this study, two types of Ni-based catalysts supported on Hbeta zeolite, Ni-Hbeta and NiS2-Hbeta, have been successfully synthesized for the hydrocracking of waste polyolefin. The experimental results indicated that the synergistic effect between Ni or NiS2 and the acidic sites of Hbeta zeolites can significantly enhance the tandem cracking and hydrogenation of polyolefin plastics, which suppresses the formation of gas products and coke. Ni-Hbeta employed as a catalyst can effectively degrade HDPE into high value liquid and gas products with high yield of 94% under 523 K and 3 MPa H2, while also exhibiting excellent cycle stability. In particular, Ni-Hbeta shows better catalytic performance than NiS2-Hbeta during the hydrocracking of HDPE at a relatively low temperature of 523 K. Furthermore, Ni-Hbeta catalyst also exhibits a remarkable capability for efficient depolymerization of unsorted post-consumer polyolefin plastics (HDPE, LDPE, PP) containing various additives and pollutants. These findings underscore the application potential of employing noble metal-free and recyclable catalysts for hydrocracking plastic waste, thereby facilitating the realization of a circular economy for plastics.

Study on anionic-nonionic mixed surfactant for enhanced oil recovery in a hypersaline reservoir.

Hypersaline reservoirs are characterized by high salinity and high calcium and magnesium concentration. In order to enhance oil recovery of the hypersaline reservoirs, a specialized ternary mixed surfactant system composed of nonionic alkanolamide surfactants and anionic surfactant was developed in this study. Through careful analysis and optimization, lauric acid diethanolamide (LDEA), octanoic acid diethanolamide (ODEA), and sodium dodecyl sulfonate (SDS) were identified as promising candidates for the surfactant compounding system, and formed a ternary surfactant system composed of LDEA, ODEA, and SDS with the mass ratio of 4.64 : 0.66 : 1.00. Experimental results revealed that the interfacial tension of the system was consistently below 10-2 mN m-1 and could even reach ultra-low levels (10-3 mN m-1) under conditions of calcium and magnesium ion content of 2000 mg L-1, surfactant concentrations ranging from 0.05 to 0.3 wt%, temperature ranging from 50 to 80 °C, and salinity ranging from 20 000 to 50 000 mg L-1. Furthermore, the mixed surfactant system exhibited favorable wetting capacity and emulsifying power. The static adsorption capacities of the mixed surfactant on oil sands were less than 2 mg g-1. This study offered a novel strategy for the actual exploitation of reservoirs with high calcium-magnesium and high salinity.

In situ high-valued transformation of nonmetals in waste printed circuit boards into supercapacitor electrodes with excellent performance.

Nonmetals in waste printed circuit boards after metal separation containing brominated resin and fiberglass are considered hazardous and low-recoveryvalue e-waste. However, if these nonmetals are not treated or are improperly treated, they can cause serious environmental pollution. Therefore, there is an urgent and significant need to develop an efficient recycling process for these nonmetals. Based on the concept of high-valued recycling of waste, this study in situ utilized such nonmetals to prepare a porous supercapacitor electrode through a facile carbonization, activation, and carbon thermal reduction process. The results indicated that the activation was a key role in constructing a porous structure. The optimal parameters for activation were a temperature of 800 °C, mass ratio of KOH to pyrolytic residues of 2, and an activation time of 1 h. The electrode materials exhibited a surface area of 589 m2 g-1 and hierarchical porous structures. In addition, the supercapacitors exhibited a capacitance of 77.14 mF cm-2 (62.5 mF cm-2) at 0.5 mA cm-2 (100 mV s-1). Moreover, the supercapacitors had excellent temperature resistance and adaptability. The capacitance retention was 89.36% and 90% at -50 °C and 100 °C after 10 000 cycles, respectively. This study provides a high-valued recycling strategy to utilize the nonmetals in e-waste as energy materials.

Effects of nurse-led self-care interventions on health outcomes among people with heart failure: A systematic review and meta-analysis.

AIM: To estimate the effects of nurse-led self-care interventions on people with heart failure (HF). BACKGROUND: Research evidence of the effects of nurse-led HF self-care interventions on patient outcomes is scant. DESIGN: A systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES: Six databases (MEDLINE, Embase, Web of Science, CENTRAL, CINAHL and PsycINFO) were searched from the inception to December 2022 to identify eligible studies. METHODS: RCTs published in English that evaluated the impact of nurse-led HF self-care interventions on quality of life, anxiety, symptom burden, sleep quality, healthcare service utilisation and mortality were included. The risk of bias in included studies was assessed using RoB 2.0. We conducted data syntheses using the R software and graded the quality of the evidence using the GRADE approach. The systematic review was conducted in accordance with the PRISMA. RESULTS: Twenty-five studies with 2746 subjects were included. Our findings demonstrated, that compared to the controls, nurse-led self-care interventions improved QOL (SMD: .83, 95% CI: .50-1.15, moderate evidence), anxiety (MD: 1.39, 95% CI: .49-2.29, high evidence) and symptom burden (SMD: .81, 95% CI: .24-1.38, low evidence) in people with HF. No significant effects were found in all-cause hospital readmission and all-cause emergency department visit. Research evidence on sleep quality, cardiac-related hospital readmission, cardiac-related emergency department visit and all-cause mortality remained unclear. CONCLUSIONS: Our review suggests that nurse-led HF self-care interventions have favourable effects on the QOL, anxiety and symptom burden. Further, well-designed RCTs are warranted to address the gaps identified in this review. RELEVANCE TO CLINICAL PRACTICE: The results indicated that nurse-led HF self-care interventions could improve QOL, anxiety and symptom burden in people with HF. Nurse-led self-care intervention could be integrated into current HF management practices.

Nickel Sulfide/Hierarchical Porous Carbon from Spent Residue Hydrocracking Catalyst as Electrocatalyst for the Oxygen Evolution Reaction.

Spent residue slurry-phase hydrocracking catalyst coated with coke have been classified as hazardous solid waste, presenting serious economic and environmental issues to refiners. Herein, the spent catalysts with a nickel sulfide nanoparticle/coke hierarchical structure (NiSX /C) from our previous work were used to prepare nickel sulfide/hierarchical porous carbon (NiSX /HPC) for the oxygen evolution reaction (OER) through the method of carbonization, activation, and sulfurization. The results indicate that the NiSX /C converts into Ni/HPC after carbonization and activation, and then transform into NiSX /HPC by sulfurization. The optimized NiSX /HPC-8 possesses the crystal phase of NiS2 , and the high specific surface area of 1134.9 m2 g-1 with the hierarchical micro-mesoporous structure. Besides, NiSX /HPC-8 achieves a low overpotential of 236 mV at 10 mA cm-2 , a low Tafel slope of 64.1 mV dec-1 , and excellent stability. This work provides a viable method for upcycling spent catalysts to re-constructed OER catalysts with high catalytic performance and durability.

The effects of message framing on self-management behavior among people with type 2 diabetes: A randomized controlled trial.

BACKGROUND: Message framing describes how information is communicated and demonstrated to influence its effect on future attitudes and behaviors. Message content can be structured as 'gain-framed', emphasizing the benefits of engagement as recommended, whereas 'loss-framed' describes the negative consequences of not engaging as recommended. However, the impact of message framing on behavior change in people with chronic diseases like diabetes is not well understood. OBJECTIVE: Analyze the impact of message framing in diabetes education on self-management in people with type 2 diabetes, and identify potential moderating effects of patient activation on message framing. DESIGN: A three-arm randomized controlled trial was performed. SETTING(S): Participants were recruited from inpatients in the endocrine and metabolic unit of a university-affiliated hospital in Changchun. PARTICIPANTS: A total of 84 adults with type 2 diabetes were equally randomized into gain-, loss-, or no-message framing groups and received a 12-week intervention. METHODS: Both the message framing groups received 30 video messages. One group of participants received the gain-framed messages emphasizing desirable outcomes from effective diabetes self-care. The other group of participants received the loss-framed messages emphasizing the undesirable consequences of ineffective diabetes self-care. The control group received 30 videos about diabetes self-care without message framing. Self-management behavior, self-efficacy, patient activation, diabetes knowledge, attitudes, and quality of life were measured at baseline and 12 weeks. RESULTS: Compared with the control group, participants who watched either gain or loss-framed messages had significant increases in self-management behavior and quality of life after the intervention. The scores of self-efficacy, patient activation, knowledge, and attitudes of the loss-framing group were considerably higher than the control group. Further analysis revealed an interaction between patient activation and message framing (P = 0.002), with gain and loss message framing interventions more effective in increasing self-management behaviors in people with type 2 diabetes who had a higher and lower activation level, respectively. CONCLUSIONS: Using message framing in diabetes education is a promising strategy to build and foster self-management behavior. It also suggests that appropriate message framing be chosen to enhance self-management behavior based on the level of patient activation. REGISTRATION NUMBER: ChiCTR2100045772.

The Mediating Role of Alexithymia: Social Support and Depression among Colorectal Cancer Patients.

Purpose: The purpose of this study was to investigate the relationship among depression, alexithymia, and social support and examine the main influence factors of depression in patients with colorectal cancer (CRC). In addition, the mediating role of alexithymia between social support and depression was analyzed. Methods: Patients with CRC were recruited in two tertiary hospitals in Changchun via a convenience sampling method. All survivors were asked to complete self-report questionnaires assessing medical and demographic variables, depression, alexithymia, and social support. Results: A total of 183 patients with CRC were included. The results showed that education level and family monthly income were the main factors affecting depression patients with in CRC. Alexithymia was positively correlated with depression (r = 0.389, P < 0.01). Social support was negatively correlated with alexithymia (r = -0.322, P < 0.01) and depression (r = -0.316, P < 0.01). Moreover, alexithmia partially mediated the relationship between social support and depression, and the ratio of mediating effect with total effect was 23.82%. Conclusions: To sum up, there is a correlation between depression, social support, and alexithymia in patients with CRC; alexithymia plays a partially intermediary role in the impact of social support on depression. Our findings remind clinicians to treat the depression of patients with CRC from multiple perspectives, such as by increasing social support and reducing alexithymia.

Effects of message framing on self-management behaviour among patients with type 2 diabetes: a randomised controlled trial protocol.

INTRODUCTION: Accumulating evidence has indicated successful diabetes health education can potentially help to improve blood sugar levels in people with diabetes. However, with a rapid rise in the number of people with diabetes cases and the increasing burden on healthcare, it is often difficult for healthcare providers to find suitable time to provide health education to meet their needs. Thus, more novel and effective ways are needed to conduct education. The message frame provides a new perspective for implementation of a more effective health education in the form of changing information presentation, and the same objective content is described in either positive or negative language or outcomes. Gain framing emphasises the positive consequences of adhering to useful recommendations, while loss framing highlights the negative consequences of the non-adherence. The purpose of our research is to potentially explore the effectiveness of diabetes education based on message framing on the self-management behaviour. METHODS AND ANALYSIS: A single-blind, three-arm randomised controlled trial involving 84 participants will be conducted. The participants will be assigned into three groups randomly in a 1:1:1 ratio and will receive 12-week intervention. Patients in group 1 will be provided gain framing education videos about the self-management skills for type 2 diabetes, patients in group 2 will be given education videos based on loss framing and patients in group 3 will receive education with no specific message framing. The primary outcome is self-management behaviour. The secondary outcomes will be self-efficacy, patient activation, diabetes-related knowledge and attitude, quality of life and blood glucose level. All outcomes will be measured at baseline and 12 weeks. ETHICS AND DISSEMINATION: This study was approved by the Ethics Committee of School of Nursing, Jilin University (No. 2020101501). The research results will be published in peer-reviewed publications and presented in international conferences. TRIAL REGISTRATION NUMBER: ChiCTR 2100045772; Pre-results.

The spectrum of kidney biopsy findings in Chinese HIV-infected patients.

OBJECTIVES: HIV-associated kidney disease is common but data on the pathology spectrum of kidney biopsy in China is lacking. This study aimed to illustrate the clinical presentation, laboratory findings and pathological spectrum of different subtypes of HIV-associated kidney disease in China. METHODS: Eighteen HIV patients with renal biopsy indications at the Peking Union Medical College Hospital from January 2002 to October 2021 were retrospectively enrolled. All had CD4 counts and HIV viral load measurements. Renal biopsies were examined with light microscopy, immunofluorescence, and electron microscopy. Shapiro-Wilk test was used to test whether the data was normally distributed. The data is presented as medians (interquartile range), number (%), or means (±SD) according to their distribution. RESULTS: Seventeen patients had glomerular disease, and one patient had interstitial nephritis. Membranous nephropathy was present in eight patients (47.1%), and IgA nephropathy in four patients (23.5%). The difference in urine protein and serum albumin before and after treatment was statistically significant and no deaths or dialysis were observed to the end of follow-up. CONCLUSION: This study found that classic HIV-associated nephropathy (HIVAN) was uncommon in Chinese HIV patients. HIV immune complex kidney (HIVICK) disease, such as membranous or IgA nephropathy, was more common, and associated with better prognosis. Antiretroviral therapy, ACE inhibitors, and angiotensin II receptor blockers were effective in decreasing proteinuria and preserving renal function. The use of corticosteroids and immunosuppressive agents seems safe. However, the nephrotoxic effect of antiretroviral agents and other medications should be carefully monitored.

The effects of health behaviours and beliefs based on message framing among patients with chronic diseases: a systematic review.

OBJECTIVE: The effectiveness of integrating message framing into educational interventions to promote the health behaviour of patients with chronic diseases is still being debated in nursing research. The objective of this study was to assess the impact of educational interventions based on gain and loss frames on the health behaviours and beliefs of patients with chronic diseases and to identify the frame that achieves better outcomes. DESIGN: The systematic review was based on PRISMA guidelines for comprehensively searching, appraising and synthesising research evidence. DATA SOURCES: We searched the PubMed, Web of Science, PsycINFO and CINAHL databases for reports published from database inception until 26 March 2021. ELIGIBILITY CRITERIA: Intervention studies, published in English, with adult patients with chronic disease conditions, and with intervention contents involved in the implementation of message framing, were considered. The outcomes were health behaviours or beliefs, such as knowledge, self-efficacy, intention or attitudes. DATA EXTRACTION AND SYNTHESIS: Data extraction and entry were performed using a predesigned data extraction form and assessed independently by two reviewers using the Cochrane Collaboration Risk of Bias I. RESULTS: A total of 11 intervention studies were included. We found that educational intervention based on both gain and loss frames could enhance the positive effects of communication, and promote healthy behaviours and beliefs in patients with chronic disease. Many of the studies we included here showed the advantage of loss framing messages. Due to the limited number of articles included and without quantitative analysis, this result should be interpreted cautiously. CONCLUSIONS: Integrating message framing into health education might be a promising strategy to motivate patients with chronic disease to improve their health behaviours and beliefs. More extensive and well-designed trials are needed to support the conclusions and discuss the effective framing, moderators and mediators of framing. PROSPERO REGISTRATION NUMBER: CRD42021250931.

Efficacy of web-based self-management interventions for depressive symptoms: a meta-analysis of randomized controlled trials.

BACKGROUND: The incidence of depression is increasing worldwide. Depression can lead to poor physical health and even suicide. However, in high-income countries, only about 50% of the people with depression receive appropriate therapy, and the detection rate of depression in low- and middle-income countries is relatively lower. Web-based self-management enables remote treatment and solves the problem of insufficient psychological treatment resources. Many past studies have evaluated the effectiveness of web-based self-management of depression, but there has been no synthesis of evidence. Therefore, this study conducted a meta-analysis of the effectiveness of web-based self-management for depressive symptoms. METHOD: Six electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Embase, CINAHL, and PsycINFO) were searched in September 2020. All literature referring to the effects of web-based self-management on depression were shortlisted by performing the medical subject headings (MeSH) search combined with a text word search. RESULTS: A total of 18 eligible randomized controlled trials were identified, and the results from 3055 participants were consolidated. The web-based self-management group exhibited a greater reduction in depressive symptoms than the control group (g = - 0.46; 95% CI: 0.62,0.30), and there was no evidence of publication bias. Subgroup analysis revealed that patients with moderate-to-severe depression benefited from web-based self-management interventions. In terms of interventions, those based on cognitive behavioral therapy (CBT) were highly effective. We noted that the longer the intervention time, the better was the improvement in the status of depression. Furthermore, it was established that participants who communicated with therapists and showed greater adherence to the intervention experienced significant improvement in their symptoms. The results of the intervention group were better than those of the waiting-list, treatment-as-usual, and online psychoeducation groups. CONCLUSIONS: Web-based self-management is a promising therapy for depression. Future research should aim to refine these aspects of the intervention to achieve a beneficial impact.

Catalytic effect and mechanism of coexisting copper on conversion of organics during pyrolysis of waste printed circuit boards.

Pyrolysis is a promising technology for recycling organic materials from waste printed circuit boards (WPCBs). Nevertheless, the generated organic bromides are toxic and urgently needed to be removed. The coexisting copper (Cu) of WPCBs has potential performance on debromination. However, the catalytic effect and mechanism of Cu on pyrolysis process and products were still unclear. To clarify the in-situ catalysis of Cu, the analysis on kinetics and pyrolysis products was performed. The results showed that Cu can change the mechanism function of pyrolysis, which reduced the apparent activation energy (Ea). The mechanism function of Cu-coated WPCBs was obtained by Sesták-Berggren model and expressed as: dαdt=1.65×107×1-α-1.30α6.09-ln1-α-6.03exp⁡-202.45KJ/molRT. Product analysis suggested that Cu promoted the conversion of organic bromides to Br2 and HBr. During the process of pyrolysis, bromide atoms interacted with Cu to form coordination compound, which can weaken the strength of C-Br bond and generate bromide free radical (Br*). Besides, Cu can promote the conversion of aromatic-Br to Br2 as the catalyst for Ullmann cross-coupling reaction. Therefore, the presence of Cu was beneficial to pyrolysis. This work provided the theoretical basis for the improvement and application of pyrolysis technology.

Study of reaction characteristics and controlling mechanism of chlorinating conversion of cathode materials from spent lithium-ion batteries.

Spent lithium-ion batteries (LIBs) recycling has attracted much attention because it is highly favorable to environment protection and sustainable development. Developing a cleaner method for metals extraction can greatly reduce risk of secondary pollution. Chlorinating technology has been proved as an efficient method for metals extraction instead of traditional hydrometallurgy. In this paper, cathode materials from spent LIBs could be rapidly converted into metal chlorides by NH4Cl roasting at 623 K for 20 min. The results indicated nearly 100% metal leaching rates were achieved. Further, in-depth study is performed to obtain the mechanism function of chlorinating conversion based on roasting and TGA experiments. The apparent activation energy as 73.40 kJ/mol was firstly obtained, and then the reaction model of chlorination reaction was determined by model fitting and verifying. Herein, sub-reactions of chlorination reaction were figured out and their contributions were used to determinate reaction controlling mechanisms of chlorination reaction. The results indicated that nucleation reaction played a leading role in the initial stage (0.05 <α < 0.43) while phase boundary reaction took the control in next stage (0.43 <α < 0.95), which gave a good explanation to activation energy change. Finally, our findings provided inspirations for studying the controlling mechanism of gas-solid reaction.

Serum TNF-α Level Is Associated with Disease Severity in Adult Patients with Immunoglobulin A Vasculitis Nephritis.

BACKGROUND: Tumor necrosis factor-α (TNF-α) is a proinflammatory factor involved in the pathogenesis of immunoglobulin A vasculitis (IgAV). The association between serum TNF-α and disease severity in adult patients with IgAV nephritis (IgAV-N) has been inadequately evaluated. METHODS: Serum TNF-α was measured by chemiluminescence immunoassay in 53 renal biopsy-proved IgAV-N patients, 53 healthy controls, and 53 IgA nephropathy (IgAN) patients. The correlations of clinicopathologic parameters of IgAV-N patients with serum TNF-α were analyzed. RESULTS: In this cross-sectional study, the median age of IgAV-N patients was 29 (25-37) years, and 67.9% were female. Serum TNF-α was significantly higher in the IgAV-N group than in the healthy group [7.4 (5.7-9.4) pg/mL vs. 5.9 (5.0, 7.1) pg/mL, P = 0.001], but comparable with sex, age, and estimated glomerular filtration rate (eGFR) grade-matched IgAN patients. Serum creatinine (P = 0.006) and serum cystatin C (P = 0.001) were positively correlated with serum TNF-α level, while albumin (P = 0.014) and eGFR (P = 0.021) were negatively correlated with serum TNF-α level. Multivariate linear regression analysis revealed that eGFR (P = 0.007) was an independent clinical predictor of serum TNF-α. Patients with higher pathological classification grade also had higher serum TNF-α. CONCLUSIONS: Serum TNF-α is associated with renal function and the pathological classification of adult patients with IgAV-N. TNF-α is a potential biomarker for the assessment of IgAV-N severity.

Effects of monitor alarm management training on nurses' alarm fatigue: A randomised controlled trial.

BACKGROUND: Chaotic monitor alarm management generates a large number of alarms, which result in alarm fatigue. Intensive care unit (ICU) nurses are caretakers of critically ill patients, the effect of alarm management affect patient safety directly. OBJECTIVES: To evaluate the effect of monitor alarm management training based on the theory of planned behaviour for reducing alarm fatigue in intensive care unit nurses. DESIGN: A randomised, single-blind trial. This article follows the requirements of CONSORT statement. PARTICIPANTS: The study was conducted from February 2019-May 2019 in a tertiary A-level hospital. 93 ICU clinical nurses were included, and they were randomly assigned into two groups. INTERVENTION: Nurses in the experimental group (n = 47) received a 12-week alarm management training course based on the theory of planned behaviour. Nurses in the control group (n = 46) received regular training. All nurses' alarm fatigue scores were measured with a questionnaire before and after the study period. Total number of alarms, nonactionable alarms and true crisis alarms were recorded continuously throughout the study period. RESULTS: For baseline comparisons, no significant differences were found. By the analysis of independent samples one-way ANCOVAs, the nurses' adjusted alarm fatigue scores at the post-test in the experimental group were significantly lower than those in the control group (p < .001). After the study period, adjusted total number of alarms and nonactionable alarms recorded in the experimental group were both significantly lower than those recorded in the control group (p < .001). After the study period, no significant difference between the two groups was noted in the adjusted number of true crisis alarms (p > .05). The interventions did not cause adverse events in either group of patients and did not cause adverse events in patients. CONCLUSION: Intensive care unit nurses' alarm fatigue was effectively decreased by the monitor alarm management training based on the theory of planned behaviour. RELEVANCE TO CLINICAL PRACTICE: (1) Monitor alarm training based on the theory of planned behaviour is effective in reducing nonactionable alarms and lowering alarm fatigue in ICU nurses. (2) The intervention considering the social psychological aspects of behaviour is effective in rebuilding the nurses' awareness and behaviour of alarm management. (3) Nurses are the direct users of monitoring technology. Hospital administrators should attach importance to the role of nurses in the medical monitoring system. We suggest that nursing managers implement training programmes in more ICUs in the future to improve alarm management ability and lower alarm fatigue in ICU nurses.

Exercise intervention for post-treatment colorectal cancer survivors: a systematic review and meta-analysis.

PURPOSE: This study aimed to explore the effects of exercise on post-treatment colorectal cancer survivors through a systematic review and meta-analysis as the current information is limited and controversial. METHODS: We searched PubMed, Web of Science, Embase, and Cochrane Library databases for randomized controlled trials that focused on exercise intervention for adult colorectal cancer survivors who had completed primary cancer treatment. We extracted and pooled information regarding psychosocial outcomes, physical functions, body composition, metabolic growth factors, and/or tumor-related biomarkers. All data were assessed by two independent reviewers. The risk of bias was assessed using the Cochrane Collaboration's tool. RESULTS: A total of 20 studies, which presented data from 1223 post-treatment colorectal cancer survivors, matched the inclusion criteria. Compared with usual care or usual lifestyle, exercise intervention increased VO2peak (n = 107, SMD = 0.72, 95% CI = 0.32 to 1.11, I2 = 41%, P = 0.0004), reduced fasting insulin levels and insulin resistance (n = 150, SMD = - 0.55, 95% CI = - 0.88 to - 0.23, I2 = 0%, P = 0.0009; SMD = - 0.62, 95% CI = - 0.95 to - 0.29, I2 = 0%, P = 0.0002), and decreased levels of sICAM-1. Moderate-intensity exercise was associated with a more pro-inflammatory immune state, resulting in increased oxidative DNA damage. However, no evidence was found for effects of exercise on psychosocial outcomes or body composition. CONCLUSIONS: Our results revealed that exercise could be a feasible and effective option for improving cardiopulmonary fitness, metabolism, and tumor-related biomarkers in post-treatment colorectal cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Given the benefits of exercise for colorectal cancer survivors, they should be encouraged to become more physically active.

The Challenge of Cross-Cultural Care Encounters: Perspective of Imported Nurses in Lhasa, Tibet.

AIMS: The purpose of this study was to describe the challenge of cross-cultural care encounters from perspective of imported nurses in Lhasa, Tibet, as well as investigate the relationship of cross-cultural care encounters and its influencing factors. METHODS: A cross-sectional survey was designed among 300 imported nurses and 255 patients selected from four comprehensive hospitals (including two Grade III Class A hospitals and two Grade III Class B hospitals) in Lhasa. The average number, standard deviations, constituent ratios, T-tests, rank-sum tests, one-way ANOVAs, multiple stepwise regression analyses, and Pearson correlation analysis were used to analyze cross-cultural care encounters and its influencing factors. P < 0.05 was considered statistically significant. RESULTS: The cross-cultural care encounter of nurses was 61.73 ± 11.86, mainly relating to age, technical titles, Tibetan language ability, and participation in humanistic training. Age, gender, educational level, technical titles, Tibetan language ability, years working in Tibet, and participation in language and humanities training were the influencing factors (P < 0.05). The average total score of culturally competent care of imported nurses in Lhasa was 218 ± 31.09. Cross-cultural care encounters of nurses were positively correlated with culturally competent care (r = 0.126, P < 0.01) and the needs of patients' cultural care (r = 0.183). CONCLUSION: The scores of culturally competent care and cross-cultural care encounter of imported nurses were at a high level, and their culturally competent care was in the second stage of "conscious and incapable" status. The cross-cultural care encounter of nurses is positively related to culturally competent care and the needs of patients' cultural care. Abilities of language communication, understanding of Tibetan culture, and enhancement of the cultural ability needed optimization.

In-situ debromination mechanism based on self-activation and catalysis of Ca(OH)2 during pyrolysis of waste printed circuit boards.

Completely and deeply removed bromide from waste printed circuit boards (WPCBs) is necessary due to their toxicity and carcinogenicity. To achieve this purpose, calcium hydroxide (Ca(OH)2) as a debromination agent was added during pyrolysis process of WPCBs. The results showed that hydrogen bromide (HBr), 4-bromophenol, 2-bromophenol and 2,4-dibromophenol were the main bromide species in pyrolysis products. The Ca(OH)2 plays a significant role for removing HBr and organic bromide, but not affects products yield. Optimal removal efficiency for 4-bromophenol, 2-bromophenol and 2,4-dibromophenol reached 87.5 %, 74.6 % and 54.5 %, respectively. And debromination efficiency was related to the steric hindrance caused by bromide atoms. The Ca(OH)2 can be activated by captured HBr and its thermal decomposition. And the newly-generated calcium bromide and calcium oxide significantly facilitate debromination due to their high surface energy and reactivity. The debromination mechanism was clarified by experiments coupled with computational chemistry: the coordination of bromide and calcium to form [Ph-Br···Ca2+] or [Ph-Br···Caatom]. Then, electrons were delivered form bromide atom to Ca2+ or Caatom, which resulted in the stretch and weaken the C-Br bond. Hence, the C-Br bond was more easily to break. This work can provide support for designing novel and efficient debromination agents applied for high-temperature system.

Serum Soluble CD89-IgA Complexes Are Elevated in IgA Nephropathy without Immunosuppressant History.

PURPOSE: CD89 (FcαRI), the receptor of IgA, can shed from cells to form complexes with IgA in serum and is supposed to participate in the pathogenesis of IgA nephropathy (IgAN). There are contradictory results on their utility in clinical practice. This study is aimed at investigating whether sCD89-IgA complexes can help in the diagnosis or evaluation of the disease. METHODS: A sandwich ELISA was established using anti-CD89 as a capture antibody and HRP-conjugated anti-IgA as a detection antibody. This method was used to measure serum levels of sCD89-IgA complexes in IgAN patients without immunosuppressant history and healthy subjects. Correlations between serum levels of sCD89-IgA complexes and disease severity were analyzed. RESULTS: Serum sCD89-IgA complexes increased with age (P < 0.001). IgAN patients had higher sCD89-IgA complex levels compared with age- and gender-matched normal healthy individuals (P < 0.001). IgAN patients had higher sCD89-IgA complex levels compared with age- and gender-matched normal healthy individuals (P < 0.001). IgAN patients had higher sCD89-IgA complex levels compared with age- and gender-matched normal healthy individuals (. CONCLUSIONS: Serum sCD89-IgA complexes can guide diagnosis of IgAN in patients without immunosuppressant history, but provide limited help in clinicopathologic prediction.