Senior nursing students' ageism and its associated factors: A national cross-sectional study.

BACKGROUND: Ageism is prejudice or discrimination against different age groups, particularly older people. As senior nursing students in the last year of their studies prepare to enter the workforce, it is imperative to understand their level of ageism because of the high probability that they will care for older people during their nursing careers due to the global aging population. However, most research has focused on nursing students' knowledge and attitudes regarding older adults, and few studies have specifically investigated ageism among senior nursing students. OBJECTIVE: This study aimed to understand ageism among senior nursing students and associated factors. DESIGN: This was a cross-sectional descriptive study. SETTINGS AND PARTICIPANTS: In total, 249 senior students from 16 four-year Bachelor of Science in Nursing programs in Taiwan were recruited. Inclusion criteria were (1) a senior student enrolled in a Bachelor of Science in Nursing program and (2) the ability to read Chinese. METHODS: Data were collected using an online questionnaire consisting of two parts: demographic characteristics and the Fraboni Scale of Ageism. The frequency, percentage, mean, standard deviation, t-test, one-way analysis of variance, Pearson product-moment correlation, and multiple linear regression were used to analyze data. RESULTS: The average score for ageism among senior nursing students was 61.60 ± 7.73, out of a maximum of 116. Having a higher level of concern about ageism issues and having had grandparents who were primary caregivers during childhood were linked to a lower degree of ageism. The only predictor of senior nursing students' ageism was the extent of their concern about ageism issues (F = 18.47, p < .001). CONCLUSIONS: Senior nursing students demonstrated a moderate level of ageism. Faculty members should develop strategies to increase nursing students' awareness of ageism issues and develop appropriate interventions to prevent and improve their ageist attitudes.

The traditional Chinese version of the Geriatric Anxiety Inventory: Psychometric properties and cutoff point for detecting anxiety.

The study aimed to translate the Geriatric Anxiety Inventory into traditional Chinese (GAI-TC), examine its psychometric properties, and identify the optimal cutoff point. This research recruited 337 older adults from two community activity centers. Structured questionnaires were used, including demographic information and characteristics, the GAI-TC, and the State-Trait Anxiety Inventory (STAI). Cronbach's α of the GAI-TC was 0.93. The intraclass correlation coefficient was 0.90. The content validity index was 1.0. An exploratory factor analysis revealed that three factors in the GAI-TC, including cognition anxiety, impact of anxiety, and somatic anxiety, explained 59.46 % of the variance. The criterion-related validity showed a significant positive correlation between the GAI-TC and STAI, with an optimal cutoff of 9/10 for detecting anxiety in older persons living in the community. The GAI-TC had good reliability and validity and can provide professionals with a tool for the early identification of anxiety among older adults.

Nucleus accumbens deep brain stimulation improves depressive-like behaviors through BDNF-mediated alterations in brain functional connectivity of dopaminergic pathway.

Major depressive disorder (MDD), a common psychiatric condition, adversely affects patients' moods and quality of life. Despite the development of various treatments, many patients with MDD remain vulnerable and inadequately controlled. Since anhedonia is a feature of depression and there is evidence of leading to metabolic disorder, deep brain stimulation (DBS) to the nucleus accumbens (NAc) might be promising in modulating the dopaminergic pathway. To determine whether NAc-DBS alters glucose metabolism via mitochondrial alteration and neurogenesis and whether these changes increase neural plasticity that improves behavioral functions in a chronic social defeat stress (CSDS) mouse model. The Lab-designed MR-compatible neural probes were implanted in the bilateral NAc of C57BL/6 mice with and without CSDS, followed by DBS or sham stimulation. All animals underwent open-field and sucrose preference testing, and brain resting-state functional MRI analysis. Meanwhile, we checked the placement of neural probes in each mouse by T2 images. By confirming the placement location, mice with incorrect probe placement (the negative control group) showed no significant therapeutic effects in behavioral performance and functional connectivity (FC) after receiving electrical stimulation and were excluded from further analysis. Western blotting, seahorse metabolic analysis, and electron microscopy were further applied for the investigation of NAc-DBS. We found NAc-DBS restored emotional deficits in CSDS-subjected mice. Concurrent with behavioral amelioration, the CSDS DBS-on group exhibited enhanced FC in the dopaminergic pathway with increased expression of BDNF- and NeuN-positive cells increased dopamine D1 receptor, dopamine D2 receptors, and TH in the medial prefrontal cortex, NAc, ventral hippocampus, ventral tegmental area, and amygdala. Increased pAMPK/total AMPK and PGC-1α levels, functions of oxidative phosphorylation, and mitochondrial biogenesis were also observed after NAc-DBS treatment. Our findings demonstrate that NAc-DBS can promote BDNF expression, which alters FC and metabolic profile in the dopaminergic pathway, suggesting a potential strategy for ameliorating emotional processes in individuals with MDD.

Assessment of the psychometric properties of the Vietnamese version of the Critical Thinking Disposition Scale.

BACKGROUND: The Critical Thinking Disposition Scale is a valid and reliable tool for assessing an individual's attitudes towards critical thinking. However, it is unclear if the scale can be used with Vietnamese nursing students. OBJECTIVES: This study aimed to translate the scale into Vietnamese and examine the psychometric properties of the Vietnamese version of the Critical Thinking Disposition Scale (CTDS-V). SETTINGS: Data were collected from senior nursing students at four universities in southern Vietnam in October and December 2022. PARTICIPANTS: In total, 398 senior nursing students participated in this study. METHODS: A cross-cultural adaptation of the CTDS-V was carried out with participants obtained through convenience sampling. Data were collected through an online survey. The study evaluated the validity of the CTDS-V by examining the content validity, concurrent validity, and construct validity, employing both Exploratory and Confirmatory Factor Analyses. The study also reported the internal consistency reliability using Cronbach's alpha and test-retest stability of the CTDS-V. RESULTS: The CTDS-V had a good content validity index with a score of at least 0.85 for each item and an excellent overall content validity index of 0.96. Exploratory Factor Analysis identified two factors, critical openness, and reflective scepticism, with 11 items. Confirmatory Factor Analysis provided an acceptable fit model and supported the factor structure of the original scale. Cronbach's alpha coefficient of the scale was 0.88, and those of the two subscales were each 0.84. The test-retest stability of the CTDS-V was good with an intraclass correlation coefficient of 0.98 (95 % confidence interval = 0.96, 0.99). CONCLUSIONS: This study indicated that the CTDS-V is a valid and reliable tool for assessing the critical thinking disposition of nursing students. The scale is short, rendering it feasible for regular use in education and research.

The Effect of Lifting-and-Thrusting Laser Acupuncture on Electrodermal Activity of Acupoints, Pulse Characteristics, and Brainwave.

Acupuncture has been shown as an effective traditional Chinese medicine treatment method, especially for pain relief. Recently, laser acupuncture is becoming increasingly popular, thanks to its noninvasive and painless nature and effectiveness in treating diseases, proven by many studies (for example, some previous studies showed that low-power laser stimulation is able to increase the power of alpha rhythms and theta waves). In our prior work, we developed a novel laser acupuncture model that emulates lifting-and-thrusting operation commonly used in traditional needle acupuncture and showed its benefit in improving cardiac output and peripheral circulation. By extending our previous studies, in this work, we perform extensive experiments to understand the effect of such a system on electrodermal activity (EDA) of acupoints, pulse characteristics, and brainwave, to further verify its efficacy. In particular, we found that laser stimulation could cause significant changes in EDA of acupoints, pulse amplitude, pulse-rate-variability (PRV), and acupoint conductance, as a function of laser power and stimulation time. In addition, laser acupuncture with the lifting-and-thrusting operation has more significant effect on increasing the power of alpha and theta frequency bands as compared to laser acupuncture without the lifting-and-thrusting operation. Finally, given sufficient stimulation time (e.g., > 20 min), the performance of a low-powered laser acupuncture with the lifting-and-thrusting operation could be comparable to that of traditional needle acupuncture.

Prevalence of depressive symptoms and associated factors among foreign caregivers: A cross-sectional study.

AIM: To understand the prevalence of depressive symptoms among foreign caregivers and the associated factors. DESIGN: A cross-sectional study. METHODS: Data from 178 Indonesian foreign caregivers, selected based on convenience and snowball sampling in Taiwan, were collected between July 2019 and February 2020 using questionnaires. Stepwise multiple linear regression was used to identify the factors associated with depressive symptoms. RESULTS: Approximately 30.3% of the foreign caregivers displayed depressive symptoms. The symptoms were more prevalent among the participants who were younger; had more social support; shared a bed with others; and experienced higher work-related stress, more loneliness and physical discomfort. The findings suggest that nurses or nurse practitioners visiting patients at home should not only deliver care for them but also show concern for the psychological well-being of the foreign caregivers of these patients. Moreover, interventions should be developed to alleviate or prevent the emergence of depressive symptoms among foreign caregivers.

An Initial Study on Multi-Point Laser Acupuncture Based on 2-D Galvo Mirror.

Currently, the majority of commercially available laser acupuncture instruments are still hand-held and only support single-point stimulation. Simultaneous multi-point stimulation improves the therapeutic efficacy of laser acupuncture by stimulating multiple acupoints at the same time. A "2-dimensional (2-D) galvo mirror" was utilized as a positioning laser acupuncture device for multi-acupoints stimulation. Due to its ability to perform 2-D fast scanning, a single laser beam was reflected by the mirror and stimulated multiple acupuncture points simultaneously. This introduction to the new system, presents its architecture, and shows some initial results. This initial stage of development was focused on the acupoints of the human forearm. This proposed system is the first low-cost, noncontact laser acupuncture system that enables continuous multi-acupoint stimulation with a single laser beam. Notably, it is technically feasible to develop this technique into a whole-body laser acupuncture stimulation system.

An Initial Study on Automated Acupoint Positioning for Laser Acupuncture.

Acupuncture plays an important role in traditional Chinese medicine (TCM) and is one kind of an inexpensive and effective treatment. However, some people might be reluctant to receive acupuncture treatment due to fear of pain. Laser acupuncture, thanks to its painless and infection-free advantages, has recently become an alternative choice to traditional acupuncture. The accuracy of acupuncture point positioning has a decisive influence on the quality of laser acupuncture. In this study, built on top of our prior work, we proposed a low-cost automated acupoint positioning system for laser acupuncture. By integrating several machine learning algorithms and computer vision techniques, we design and implement a robot-assisted laser acupuncture system on top of a smartphone. Our contributions include the following: (a) development of an effective acupoint estimation algorithm with a localization error less than 5 mm; (b) implementation of a smartphone-controlled automated laser acupuncture system with lift-thrust function, as a point-of-care device, that can be used by patients to relieve their symptoms at home.

Effects of the New Lift-Thrust Operation in Laser Acupuncture Investigated by Thermal Imaging.

Acupuncture manipulation is one of the key factors affecting the performance of acupuncture in Traditional Chinese Medicine. Lift-thrust and twirl-twist are two of the most commonly used manipulation methods for needle acupuncture. We previously have developed a novel laser acupuncture model that emulates lift-thrust operation. In this study, we intend to show the effectiveness of such a model by applying it on the Neiguan acupoint (PC6). Stimulation was reported to be beneficial for improving cardiac output and peripheral circulation. Therefore, we hypothesized that the stimulation of laser acupuncture may increase the temperature of the subjects' fingertip due to increased peripheral blood flow. A thermal imager was used to measure the temperature change of subjects' fingertips. Through regression analysis, it has been shown that while PC6 is stimulated, laser acupuncture with lift-thrust operation caused a more rapid, stable, and lasting temperature rise of fingertip than that without lift-thrust operation. On the contrary, we observe no significant temperature change when a sham point nearby PC6 (a point which is not traditionally defined as the acupoint) was stimulated. Our results suggest the emulation of manipulation methods such as the lift-thrust operation could be a potential direction for the future development of laser acupuncture.

Complementary therapy of traditional Chinese medicine for blood sugar control in a patient with type 1 diabetes.

OBJECTIVE: Using a case study to discuss the effects of traditional Chinese medicine (TCM) treatments on Type 1 diabetes mellitus. CLINICAL FEATURES: A 4-year-old girl with sudden polyuria and nocturia (fasting plasma glucose level: 270mg/dL) was diagnosed with type 1 diabetes. Although multiple daily insulin injections were applied, her plasma glucose levels were still unstable. Therefore, she received a complementary TCM therapy by taking modified Liu-Wei-Di-Huang-Wan (3.0g/day; three times daily) for 3 months. After the treatments, her plasma glucose levels appeared to be more stable. HbA1c 6.5% and insulin injections were reduced to only once a day. CONCLUSIONS: The results suggest that complementary TCM therapy has the ability to assist some patients with type 1 diabetes mellitus in controlling their plasma glucose levels.

Implementation of laser acupuncture with lifting-thrusting through the use of mechanically immobile components.

Lifting and thrusting constitute an important manipulation method in traditional Chinese acupuncture. Lifting and thrusting enables the implementation of various features, such as reinforcement and reduction, which enhance acupuncture effectiveness. Laser acupuncture stimulates acupoints through laser light, which is a noninvasive treatment, but can still achieve effects similar to those obtained from traditional acupuncture. Lifting and thrusting can be achieved by moving the laser focal point back and forth, thus concentrating the energy, as does the tip of the acupuncture needle when it is moved upward and downward in the acupoint. This article presents a novel optical design of a laser acupuncture device, in which a focus-tunable lens is used to move the position of the focused light in order to achieve the lifting and thrusting mechanism through programmable changes to the control current of the focus-tunable lens. The device employs an infrared laser with a wavelength of 808 nm and a maximum power of 150 mW. The focus-tunable lens used in this study had a diopter of -10 to +5. The results revealed that by controlling the lens diopter, the focused light can be moved from 4.5 to 9.5 cm. Therefore, the range of the lift and thrust for the laser acupuncture device was 5 cm. The area of the focal point was approximately 6×10(-3) mm2, which is comparable to that of the commonly used traditional acupuncture needle tip. Because the components are immobile, no additional space is required for the moving lens. Therefore, the size of the laser acupuncture head can be minimized, and the effectiveness of focus tuning can be improved.

Synthesis and anti-fungal effect of silver nanoparticles-chitosan composite particles.

Silver nanoparticles have been used in various fields, and several synthesis processes have been developed. The stability and dispersion of the synthesized nanoparticles is vital. The present article describes a novel approach for one-step synthesis of silver nanoparticles-embedded chitosan particles. The proposed approach was applied to simultaneously obtain and stabilize silver nanoparticles in a chitosan polymer matrix in-situ. The diameter of the synthesized chitosan composite particles ranged from 1.7 mm to 2.5 mm, and the embedded silver nanoparticles were measured to be 15 ± 3.3 nm. Further, the analyses of ultraviolet-visible spectroscopy, energy dispersive spectroscopy, and X-ray diffraction were employed to characterize the prepared composites. The results show that the silver nanoparticles were distributed over the surface and interior of the chitosan spheres. The fabricated spheres had macroporous property, and could be used for many applications such as fungicidal agents in the future.

Emulated laser-acupuncture system.

A novel laser-acupuncture system was developed that can be used to implement the manipulation methods of traditional acupuncture, such as lifting and thrusting. A 780 nm laser diode with a maximum power of 90 mW was used as the light source. The focus point of the laser beam was adjustable by changing the position of the lens, facilitating the implementation of the lifting and thrusting methods of traditional Chinese medicine and achieving various stimulation depths at the acupuncture point. The images for the light spots from the outlet of the emulated laser acupuncture were captured at various distances and their sizes were calculated. The result showed that the diameter of the focused light spot (i.e., at the focus point) was 0.11 mm, which is close to the diameter of commonly used needles (with diameters of approximately 0.22 mm). The area of the light spot 1 cm from the focus point was approximately 50 times larger, indicating that the unit power might be 1/50 of the power of the focus point. To study the effect of emulated laser acupuncture on human meridians, after stimulating the Shenmen point (HT7) of five subjects and obtaining their Ryodoraku values of the heart meridian and the small-intestine meridian, a paired t test showed that the laser stimulation incorporating lifting and thrusting was significantly higher than the laser stimulation without lifting and thrusting (p<0.05). The result is consistent with traditional acupuncture in that acupuncture incorporating lift and thrust is more effective than that without lift and thrust.

Vegetation effects on floating treatment wetland nutrient removal and harvesting strategies in urban stormwater ponds.

Floating treatment wetlands (FTWs) consist of emergent macrophytes that are placed on a floating mat in a pond for water treatment and aesthetic purposes. FTWs may have unique advantages with respect to treating urban runoff within existing retention ponds for excess nutrients. However, research is lacking in providing guidance on performance of specific species for treating urban runoff, and on timing of harvest. Harvesting is needed to remove nutrients permanently from the retention pond. We investigated vegetation effects on FTWs on nitrogen (N) and phosphorus (P) removal performance and storage in above-ground FTW macrophyte tissues. The study evaluated pickerelweed (PW, Pontederia cordata L.) and softstem bulrush (SB, Schoenoplectus tabernaemontani) over time in microcosms flushed with water obtained from a nearby urban retention pond in northern Virginia near Washington, DC. While the literature exhibits a wide range of experimental sizes, using the term mesocosm, we have chosen the term microcosm to reflect the small size of our vessel; and do not include effects of sediment. The experiment demonstrated PW outperformed SB for P and N removal. Based upon analysis of the accumulated nutrient removal over time, a harvest of the whole PW and SB plants in September or October is recommended. However, when harvesting only the aerial parts, we recommend harvesting above-ground PW tissues in July or August to maximize nutrient removal. This is because PW translocates most of its nutrients to below-ground storage organs in the fall, resulting in less nutrient mass in the above-ground tissue compared to the case in the summer (vegetative stage). Further research is suggested to investigate whether vegetation can be overly damaged from multiple harvests on an annual basis in temperate regions.

Immobilization of Brassica oleracea chlorophyllase 1 (BoCLH1) and Candida rugosa lipase (CRL) in magnetic alginate beads: an enzymatic evaluation in the corresponding proteins.

Enzymes have a wide variety of applications in diverse biotechnological fields, and the immobilization of enzymes plays a key role in academic research or industrialization due to the stabilization and recyclability it confers. In this study, we immobilized the Brassica oleracea chlorophyllase 1 (BoCLH1) or Candida rugosa lipase (CRL) in magnetic iron oxide nanoparticles-loaded alginate composite beads. The catalytic activity and specific activity of the BoCLH1 and CRL entrapped in magnetic alginate composite beads were evaluated. Results show that the activity of immobilized BoCLH1 in magnetic alginate composite beads (3.36±0.469 U/g gel) was higher than that of immobilized BoCLH1 in alginate beads (2.96±0.264 U/g gel). In addition, the specific activity of BoCLH1 beads (10.90±1.521 U/mg protein) was higher than that immobilized BoCLH1 in alginate beads (8.52±0.758 U/mg protein). In contrast, the immobilized CRL in magnetic alginate composite beads exhibited a lower enzyme activity (11.81±0.618) than CRL immobilized in alginate beads (94.83±7.929), and the specific activity of immobilized CRL entrapped in magnetic alginate composite beads (1.99±0.104) was lower than immobilized lipase in alginate beads (15.01±1.255). A study of the degradation of magnetic alginate composite beads immersed in acidic solution (pH 3) shows that the magnetic alginate composite beads remain intact in acidic solution for at least 6 h, indicating the maintenance of the enzyme catalytic effect in low-pH environment. Finally, the enzyme immobilized magnetic alginate composite beads could be collected by an external magnet and reused for at least six cycles.

Core-shell structure microcapsules with dual pH-responsive drug release function.

We report dual pH-responsive microcapsules manufactured by combining electrostatic droplets (ESD) and microfluidic droplets (MFD) techniques to produce monodisperse core (alginate)-shell (chitosan) structure with dual pH-responsive drug release function. The fabricated core-shell microcapsules were size controllable by tuning the synthesis parameters of the ESD and MFD systems, and were responsive in both acidic and alkaline environment, We used two model drugs (ampicillin loaded in the chitosan shell and diclofenac loaded in the alginate core) for drug delivery study. The results show that core-shell structure microcapsules have better drug release efficiency than respective core or shell particles. A biocompatibility test showed that the core-shell structure microcapsules presented positive cell viability (above 80%) when evaluated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The results indicate that the synthesized core-shell microcapsules were a potential candidate of dual-drug carriers.

Assessment of the nutrient removal effectiveness of floating treatment wetlands applied to urban retention ponds.

The application of floating treatment wetlands (FTWs) in point and non-point source pollution control has received much attention recently. Although the potential of this emerging technology is supported by various studies, quantifying FTW performance in urban retention ponds remains elusive due to significant research gaps. Actual urban retention pond water was utilized in this mesocosm study to evaluate phosphorus and nitrogen removal efficiency of FTWs. Multiple treatments were used to investigate the contribution of each component in the FTW system with a seven-day retention time. The four treatments included a control, floating mat, pickerelweed (Pontederia cordata L.), and softstem bulrush (Schoenoplectus tabernaemontani). The water samples collected on Day 0 (initial) and 7 were analyzed for total phosphorus (TP), total particulate phosphorus, orthophosphate, total nitrogen (TN), organic nitrogen, ammonia nitrogen, nitrate-nitrite nitrogen, and chlorophyll-a. Statistical tests were used to evaluate the differences between the four treatments. The effects of temperature on TP and TN removal rates of the FTWs were described by the modified Arrhenius equation. Our results indicated that all three FTW designs, planted and unplanted floating mats, could significantly improve phosphorus and nitrogen removal efficiency (%, E-TP and E-TN) compared to the control treatment during the growing season, i.e., May through August. The E-TP and E-TN was enhanced by 8.2% and 18.2% in the FTW treatments planted with the pickerelweed and softstem bulrush, respectively. Organic matter decomposition was likely to be the primary contributor of nutrient removal by FTWs in urban retention ponds. Such a mechanism is fostered by microbes within the attached biofilms on the floating mats and plant root surfaces. Among the results of the four treatments, the FTWs planted with pickerelweed had the highest E-TP, and behaved similarly with the other two FTW treatments for nitrogen removal during the growth period. The temperature effects described by the modified Arrhenius equation revealed that pickerelweed is sensitive to temperature and provides considerable phosphorus removal when water temperature is greater than 25 °C. However, the nutrient removal effectiveness of this plant species may be negligible for water temperatures below 15 °C. The study also assessed potential effects of shading from the FTW mats on water temperature, DO, pH, and attached-to-substrate periphyton/vegetation.

Advances in bio-hybrid nanostructures with anti-pathogenic activity.

Bacterial and cancer cells that are resistant to current specific therapy have become an increasingly important public health problem over the past several decades. Consequently, the search for new anti-infection and anti-cancer treatments of drug resistant microbes has attracted a lot of attention. Recently, nanostructures have been shown to be efficient antimicrobial agents that do not induce drug-resistance. The present study reviews the advances in anti-pathogenic bio-hybrid nanostructures over the past decade. Three important issues are presented and discussed. First, the review focuses on the anti-pathogenic activity of the most common types of metallic / metal oxide nanoparticles. It not only reviews the progress of antimicrobial characteristics for various types of nanoparticles under different fabrication processes, but it also tabulates some specific findings over the past decade. Secondly, it reviews the use of polymeric, gold and iron-oxide nanoparticles as effective chemotheraputic drug carriers or for gene transduction in cancer treatment. Finally, some new advances made in Taiwan in anti-pathogenic research using nanotechnology were addressed in brief at the end of this paper. We highlighted the advances of the photo-controlled targeted drug-delivery system and the development of nanoparticles of traditional Chinese herbs, both of which representing important milestones in the last decade.

Microfluidic one-step synthesis of Fe3O4-chitosan composite particles and their applications.

This paper demonstrates a simple and easy approach for the one-step synthesis of Fe3O4-chitosan composite particles with tadpole-like shape. The length and diameter of the particles were adjustable from 638.3 µm to ca. 798 µm (length), and from 290 µm to 412 µm (diameter) by varying the flow rate of the dispersed phase. Mitoxantrone was used as the model drug in the drug release study. The encapsulation rate of the drug was 71% for chitosan particles, and 69% for magnetic iron oxide-chitosan particles, respectively. The iron oxide-chitosan composite particles had a faster release rate (up to 41.6% at the third hour) than the chitosan particles (about 24.6%). These iron oxide-chitosan composite particles are potentially useful for biomedical applications, such as magnetic responsive drug carriers, magnetic resonance imaging (MRI) enhancers, in the future.