Effect of proton pump inhibitors versus histamine-2 receptor antagonists on acute kidney injury in septic patients at high risk for developing stress ulcers.

BACKGROUND: To compare the effects of proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) use on the occurrence of acute kidney injury (AKI) in septic patients at high risk for developing stress ulcers. METHODS: Using the Medical Information Mart for Intensive Care IV version 2.2 database, septic patients with high-risk factors for stress ulcers (i.e., shock, coagulopathy, invasive mechanical ventilation, or chronic liver diseases) were included. Exposures included PPIs and H2RAs within 24 h of intensive care unit (ICU) admission or prior to ICU admission. The primary end point was severe sepsis-associated AKI as defined by the Kidney Disease Improving Global Outcomes criteria stage 3 (KDIGO-3). Propensity score matching (PSM) was performed to balance baseline characteristics. Multivariable Cox proportional hazards regression was used to estimate the effect size. RESULTS: 4731 PPI users and 4903 H2RA users were included. After PSM, there were 1785 pairs exposed to PPIs and H2RAs. In the PSM cohort, the cumulative incident KDIGO-3 rate was higher in the PPI group than in the H2RA group (log-rank test, p = 0.009). Regression analyses showed that PPI exposure [adjusted hazard ratio 1.32, 95% confidence interval (CI) 1.11-1.58, p = 0.002] was associated with incident KDIGO-3 compared with H2RA use. This association remained consistent in sensitivity analyses. Additionally, the PPI group had a higher need for kidney replacement therapy compared with the H2RA group (3.6% vs. 2.1%, P = 0.012). CONCLUSIONS: Among septic patients at high risk for developing stress ulcers, PPI exposure was associated with incident KDIGO-3 AKI compared with H2RA use.

Bipolar Switching Properties of the Transparent Indium Tin Oxide Thin Film Resistance Random Access Memories.

In this study, the bipolar switching properties and electrical conduction behaviors of the ITO thin films RRAM devices were investigated. For the transparent RRAM devices structure, indium tin oxide thin films were deposited by using the RF magnetron sputtering method on the ITO/glass substrate. For the ITO/ITOX/ITO/glass (MIM) structure, an indium tin oxide thin film top electrode was prepared to form the transparent RRAM devices. From the experimental results, the 102 On/Off memory ratio and bipolar switching cycling properties for set/reset stable states were found and discussed. All transparent RRAM devices exhibited the obvious memory window and low set voltage for the switching times of 120 cycles. The electrical transport mechanisms were dominated by the ohmic contact and space charge limit conduction (SCLC) models for set and reset states. Finally, the transmittances properties of the transparent ITO/ITOX/ITO RRAM devices for the different oxygen growth procedures were about 90% according to the UV-Vis spectrophotometer for the visible wavelength range.

Functional Outcomes in a Randomized Controlled Trial of Animal-Assisted Therapy on Middle-Aged and Older Adults with Schizophrenia.

Deficits in cognition, physical, and social functions in adults with schizophrenia may become salient with aging. While animal-assisted therapy (AAT) can benefit physical function in older adults and improve symptoms of psychotic disorders, the effect of AAT on middle-aged patients with schizophrenia is unclear. The current randomized controlled trial aimed to explore the efficacy of AAT for middle-aged patients with schizophrenia. Forty participants were randomly assigned to either the AAT or control group. The AAT group participated in one-hour sessions with dog-assisted group activities once a week for 12 weeks. The controls participated in dose-matched, non-animal-related recreational activities. Both groups remained on their usual psychotropic medication during the trial. Evaluations included the Chair Stand Test (CST), Timed Up-and-Go (TUG) test, Montreal Cognitive Assessment (MoCA), 5-Meter walk test (5MWT), and Assessment of Communication and Interaction Skills (ACIS). The increases in CST repetitions and ACIS scores were larger in the AAT group than in the controls. The two groups did not differ significantly in MoCA scores, TUG performance, or the 5MWT. The AAT group showed a greater increase in lower extremity strength and social skills, but no improvement in cognitive function, agility, or mobility. Further research with more sensitive evaluations and longer follow-up is needed.

Animal-Assisted Therapy in Middle-Aged and Older Patients With Schizophrenia: A Randomized Controlled Trial.

Objective: Animal-assisted therapy (AAT) has the potential to improve the symptomology, negative emotions, and level of well-being in older adults, as well as patients with mental illness. However, there remains limited evidence supporting the treatment efficacy of AAT in middle-aged and older adults with schizophrenia. Therefore, this study implemented a randomized controlled trial to assess the efficacy of a 12-week AAT psychological intervention with dogs for middle-aged and older patients with chronic schizophrenia in a clinical setting. Method: Patients, age ≥ 40 years, with chronic schizophrenia were allocated randomly to either the AAT group or control group. Patients in the AAT group received an additional hour -long AAT session every week for 12 weeks. Patients in the control group received the usual treatment plus an hour long non-animal related intervention. All patients were assessed based on primary outcome measures before and after the 12-week intervention, including the Positive and Negative Syndrome Scale (PANSS), Depression Anxiety Stress Scales Assessment (DASS), and Chinese Happiness Inventory (CHI). Results: Patients who received AAT had greater improvements in the PANSS and DASS-stress subscale scores than the control group (p < 0.05). The effect was small (success ratio different, SRD = 0.25) for the PANSS and the DASS-stress subscale (SRD = 0.15). There were no significant differences in the change scores of the CHI between the AAT and control groups (p = 0.461). Conclusions: AAT seemed to be effective in reducing psychiatric symptoms and stress levels of middle-aged and older patients with schizophrenia. AAT could be considered as a useful adjunctive therapy to the usual treatment programs.

An online coronavirus analysis platform from the National Genomics Data Center.

Since the first reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in December 2019, coronavirus disease 2019 (COVID-19) has become a global pandemic, spreading to more than 200 countries and regions worldwide. With continued research progress and virus detection, SARS-CoV-2 genomes and sequencing data have been reported and accumulated at an unprecedented rate. To meet the need for fast analysis of these genome sequences, the National Genomics Data Center (NGDC) of the China National Center for Bioinformation (CNCB) has established an online coronavirus analysis platform, which includes de novoassembly, BLAST alignment, genome annotation, variant identification, and variant annotation modules. The online analysis platform can be freely accessed at the 2019 Novel Coronavirus Resource (2019nCoVR) (https://bigd.big.ac.cn/ncov/online/tools).

Factors influencing the self-perceived competencies in spiritual care of nurses in the long-term care facilities.

AIMS: To identify key factors influencing institutional nurses' self-perceived competencies in spiritual care. BACKGROUND: In the past decade, interest in spiritual care has been increasing; however, in long-term care facilities, limited knowledge is available about nurses' competencies in spiritual care. METHODS: The cross-sectional study was conducted with 202 nurses in 11 long-term care facilities. Data were collected in a survey using the Spirituality and Spiritual Care Rating Scale, the Nurse Spiritual Care Therapeutics Scale, the Spiritual Care Competence Scale and demographic questions. Data were analysed using stepwise linear regression. RESULTS: Study findings revealed that nurses' perceptions of spirituality and spiritual care, frequency of spiritual care provision and self-satisfaction with the spiritual care given all significantly predicted overall spiritual care competence, which together explain 58% of the total variance. CONCLUSIONS: Improving nurses' perceptions of spirituality and spiritual care and encouraging the performance of spiritual care may be an effective pathway to enhance the spiritual care competence of institutional nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Additional continuing education on spiritual care topics and the establishment of clear guidance and support from institutional administrators are required to enable nurses to deal with spiritual issues as they arise and improve the quality of holistic care.

The 2019 novel coronavirus resource.

An ongoing outbreak of a novel coronavirus infection in Wuhan, China since December 2019 has led to 31,516 infected persons and 638 deaths across 25 countries (till 16:00 on February 7, 2020). The virus causing this pneumonia was then named as the 2019 novel coronavirus (2019-nCoV) by the World Health Organization. To promote the data sharing and make all relevant information of 2019-nCoV publicly available, we construct the 2019 Novel Coronavirus Resource (2019nCoVR, https://bigd.big.ac.cn/ncov). 2019nCoVR features comprehensive integration of genomic and proteomic sequences as well as their metadata information from the Global Initiative on Sharing All Influenza Data, National Center for Biotechnology Information, China National GeneBank, National Microbiology Data Center and China National Center for Bioinformation (CNCB)/National Genomics Data Center (NGDC). It also incorporates a wide range of relevant information including scientific literatures, news, and popular articles for science dissemination, and provides visualization functionalities for genome variation analysis results based on all collected 2019-nCoV strains. Moreover, by linking seamlessly with related databases in CNCB/NGDC, 2019nCoVR offers virus data submission and sharing services for raw sequence reads and assembled sequences. In this report, we provide comprehensive descriptions on data deposition, management, release and utility in 2019nCoVR, laying important foundations in aid of studies on virus classification and origin, genome variation and evolution, fast detection, drug development and pneumonia precision prevention and therapy.

Prevalence of dyslipidemia and prediction of 10-year CVD risk among older adults living in southeast coastal regions in China: a cross-sectional study.

Objective: This study aims to analyze the prevalence of dyslipidemia and identify the cardiovascular disease (CVD) risk stratification among older adults living in Quanzhou, China's southeast coastal region, where the ancient Maritime Silk Road starts. Methods: A population-based cross-sectional survey of 2,018 adults was conducted in 60-98-year-old residents in Quanzhou from September 2016 to March 2018 using multistage stratified cluster random sampling. The 10-year CVD risk was also estimated by applying the Chinese model recommended by the Chinese Guidelines for Prevention of Cardiovascular Diseases. Results: The overall prevalence of dyslipidemia among older adults was 56.8%. The prevalence of high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C) and high triglyceride (TG) were 8.4%, 13.9%, 23.1% and 11.4%, respectively. The mean levels of TC, LDL-C, HDL-C and TG were 5.12±1.18, 3.37±0.81, 1.03±0.27 and 1.65±0.76 mmol/L, respectively. Older adults had low risk, moderate risk and high risk for CVD, which were 49.7%, 36.8% and 13.5%, respectively. Age, body mass index and abdominal obesity were significantly associated with the risk of increasing LDL-C levels and were positively correlated to CVD risk. Conclusion: The prevalence of high TC, high LDL-C, low HDL-C and high TG was relatively low among older adults in Quanzhou, but their lipid levels were high. Approximately half of the elderly adults had moderate or high CVD risk. The personalized primary prevention and control of CVD are recommended for elderly people to identify high-risk individuals.

Dielectric, Piezoelectric, and Vibration Properties of the LiF-Doped (Ba0.95Ca0.05)(Ti0.93Sn0.07)O3 Lead-Free Piezoceramic Sheets.

By the conventional solid state reaction method, a small amount of lithium fluoride (LiF) was used as the sintering promoter to improve the sintering and piezoelectric characteristics of (Ba0.95Ca0.05)(Ti0.93Sn0.07)O3 (BCTS) lead-free piezoceramic sheets. Using X-ray diffraction (XRD) and a scanning electron microscope (SEM), the inferences of the crystalline and surface microstructures were obtained and analyzed. Then, the impedance analyzer and d33-meter were used to measure the dielectric and piezoelectric characteristics. In this study, the optimum sintering temperature of the BCTS sheets decreased from 1450 °C to 1390 °C due to LiF doping. For the 0.07 wt % LiF-doped BCTS sheets sintered at 1390 °C, the piezoelectric constant (d33) is 413 pC/N, the electric-mechanical coupling coefficient (kp) is 47.5%, the dielectric loss (tan δ) is 3.9%, and the dielectric constant (εr) is 8100, which are all close to or even better than that of the pure undoped BCTS ceramics. The Curie temperature also improved, from 85 °C for pure BCTS to 140 °C for BCTS-0.07 LiF sheets. Furthermore, by using the vibration system and fixing 1.5 g tip mass at the end of the sheets, as the vibration frequency is 20 Hz, the proposed piezoelectric ceramic sheets also reveal a good energy harvesting performance at the maximum output peak voltage of 4.6 V, which is large enough and can be applied in modern low-power electronic products.

Comparison of microsatellite status detection methods in colorectal carcinoma.

There are two commonly accepted methods for detecting microsatellite status. One is to detect amplified microsatellite loci by polymerase chain reaction (PCR) and the other is to detect mismatch repair gene (MMR) protein expression by immunohistochemistry (IHC). PCR detection is considered to be accurate in clinical operations while IHC is widely used due to ease of operation and lesser expense. In order to compare IHC with PCR in detecting microsatellite status in colorectal carcinoma, a total of 569 samples of colorectal carcinoma resection were collected in the Department of Pathology, Nanjing Drum Tower Hospital, between June 2014 and June 2017. In all samples, IHC and PCR was used to detect microsatellite status and the consistency of results between the two methods was compared. We found that 48 cases of microsatellite instability (MSI) were detected by PCR including 37 cases of microsatellite instability high (MSI-H), 11 cases of microsatellite instability low (MSI-L), and 521 cases of MSS. MSI accounted for 8.44% of all cases and MSI-H accounted for 6.50%. IHC results of the 569 patients showed that 69 cases were deficient mismatch repair (dMMR) and 500 cases were proficient mismatch repair (pMMR). dMMR accounted for 12.13% of all cases. Loss expression of PMS2 protein was the most common while MSH6 was rare. The coincidence rate of the two methods for detecting microsatellite states was 91.92%. IHC and the PCR method had high consistency in microsatellite status. Compared with PCR, the IHC method is more economical and more convenient for clinical operations. When the 4 repair proteins were without deficiency detected by IHC, it could be diagnosed as MSS/MSI-L and further PCR was not necessary. When any repair protein was found to be deficient, PCR detection was needed to determine whether MSI existed. Our conclusion will save a lot of time and costs in clinical work.

Molecular Identification of Diphyllobothrium latum from a Pediatric Case in Taiwan.

Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.

The Relationship of Physiopsychosocial Factors and Spiritual Well-Being in Elderly Residents: Implications for Evidence-Based Practice.

BACKGROUND: Older adults in residential settings frequently suffer from functional decline, mental illness, and social isolation, which make them more vulnerable to spiritual distress. However, empirical evidence of the interrelationships between physiopsychosocial variables and spiritual well-being are still lacking, limiting the application of the biopsychosocial-spiritual model in institutional healthcare practice. AIMS: To explain the mechanisms by which these variables are linked, this cross-sectional study tested a causal model of predictors of spiritual well-being among 377 institutionalized older adults with disability using a structural equation modeling approach. METHODS: The primary variables in the hypothesized model were measured using the Barthel Index for functional ability, the Geriatric Depression Scale-short form for depression, the Personal Resources Questionnaire 85-Part 2 for perceived social support, and the Spiritual Well-Being Scale for spiritual well-being. RESULTS: The model fit indices suggest that the hypothesized model had a reasonably adequate model fit (χ2 = 12.18, df = 6, p = .07, goodness-of-fitness index [GFI] = 0.99, adjusted GIF index [AGFI] = 0.93, nonnormed fit index [NFI] = 0.99, comparative fit index [CFI] = 0.99). In this study, perceived social support and depression directly affected spiritual well-being, and functional ability indirectly affected spiritual well-being via perceived social support or depression. In addition, functional ability influenced perceived social support directly, which in turn influenced depression and ultimately influenced spiritual well-being. DISCUSSION: This study results confirm the effect of physiopsychosocial factors on institutionalized older adults' spiritual well-being. However, the presence and level of functional disability do not necessarily influence spiritual well-being in late life unless it is disruptive to social relationships and is thus bound to lead to low perceived social support and the onset of depression. LINKING EVIDENCE TO ACTION: The findings address the fact that the practice of spirituality is multidimensional and multileveled. Psychosocial interventions for institutionalized elders with disabilities should focus on increasing nurse-patient interaction and providing access to meaningful social activities to improve mental health and spiritual well-being.

Structural, magnetic, and electronic properties of iron selenide Fe6-7Se8 nanoparticles obtained by thermal decomposition in high-temperature organic solvents.

Iron selenide nanoparticles with the NiAs-like crystal structure were synthesized by thermal decomposition of iron chloride and selenium powder in a high-temperature organic solvent. Depending on the time of the compound processing at 340 °C, the nanocrystals with monoclinic (M)-Fe3Se4 or hexagonal (H)-Fe7Se8 structures as well as a mixture of these two phases can be obtained. The magnetic behavior of the monoclinic and hexagonal phases is very different. The applied-field and temperature dependences of magnetization reveal a complicated transformation between ferrimagnetic (FRM) and antiferromagnetic (AFM) structures, which can be related to the spin rotation process connected with the redistribution of cation vacancies. From XRD and Mössbauer data, the 3c type superstructure of vacancy ordering was found in the hexagonal Fe7Se8. Redistribution of vacancies in Fe7Se8 from random to ordered leads to the transformation of the magnetic structure from FRM to AFM. The Mössbauer data indicate that vacancies in the monoclinic Fe3Se4 prefer to appear near the Fe(3+) ions and stimulate the magnetic transition with the rotation of the Fe(3+) magnetic moments. Unusually high coercive force Hc was found in both (H) and (M) nanocrystals with the highest ("giant") value of about 25 kOe in monoclinic Fe3Se4. This is explained by the strong surface magnetic anisotropy which is essentially larger than the core anisotropy. Such a large coercivity is rare for materials without rare earth or noble metal elements, and the Fe3Se4-based compounds can be the low-cost, nontoxic alternative materials for advanced magnets. In addition, an unusual effect of "switching" of magnetization in a field of 10 kOe was found in the Fe3Se4 nanoparticles below 280 K, which can be important for applications.

The discrimination of using the short physical performance battery to screen frailty for community-dwelling elderly people.

PURPOSE: This study explored the risk factors, cut-off points, sensitivity, specificity, positive predictive values, and negative predictive values of physical performance testing among community-dwelling frail elderly people in Taiwan. ORGANIZING CONSTRUCT: The empirical measurement of frailty is based on the following five indicators: weight loss, weakness, exhaustion, slow responses, and minimal physical activity. The frail phenotype is considered present if three or more of the indicators are observed. Meanwhile, a short battery of physical performance tests was conducted to assess the balance, mobility, and flexibility among elderly people. METHODS: A cross-sectional research design was executed. Participants were evaluated using a short battery of physical performance tests to assess their physical performance. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed. FINDINGS: The logistic regression results showed that the factors significantly correlated to frailty included falls in the previous year, smoking, hypertension, and bone and joint disease. Physical performance test scores were analyzed using the ROC curves to discriminate frailty statuses. The analysis results showed that the areas under the ROC curves for the diagnostic accuracy of right-hand grip, left-hand grip, and the 8-foot up-and-go test reached 0.70, and the optimal cut-off points determined using Youden's index were 17.25 kg, 20.75 kg, and 8.13 s, respectively. CONCLUSIONS: The research findings suggest that physical performance variables can be used to effectively screen elderly people at risk for frailty in the community. CLINICAL RELEVANCE: The findings offer reference values for physical performance tests specific to community-dwelling frail elderly people. The information can enable health practitioners to achieve early identification of frailty among elderly people with anthropometric characteristics similar to those associated with people in Asian countries.

Notch3 overexpression associates with poor prognosis in human non-small-cell lung cancer.

Notch3 receptor is one of the mammalian Notch family receptors (Notch1-4) which plays an important role in the regulation of cellular proliferation, differentiation, and apoptosis. Overexpression of Notch3 is associated with tumorigenesis. In order to assess the expression of Notch3 in Chinese non-small-cell lung cancer (NSCLC) patients and determine its association with prognosis, we designed a prospective study with five years of follow-up to evaluate Notch3 expression in NSCLC tissues and adjacent non-cancerous normal lung tissues from 131 patients undergoing surgical treatment by immunohistochemistry and western blot analysis. Notch3 had high expression in 67 of 131 cases of NSCLC (51.1 %), which was significantly higher than in adjacent noncancerous lung tissues. Moreover, Notch3 overexpression was significantly correlated with TNM stage (P = 5.41e-07 in squamous cell carcinoma, P = 5.338e-07 in adenocarcinoma) and lymph node metastasis (P = 0.00764 in squamous cell carcinoma, P = 0.01491 in adenocarcinoma). Kaplan-Meier survival analysis showed that the overall survival times in patients expressing Notch3 in NSCLC were shorter. Multivariate analysis further demonstrated that Notch3 was an independent prognostic factor for patients with NSCLC. Therefore, Notch3 might be a useful biomarker to predict the prognosis of patients with NSCLC.

Multiple interacting factors corresponding to repetitive use of complementary and alternative medicine.

OBJECTIVE: To examine the factors correlating with repetitive use of complementary and alternative medicine (CAM). RESEARCH DESIGN: In 2006, a community-based epidemiological survey was conducted in Taiwan. A total of 2457 participants (1237 men and 1220 women) aged 18 and over participated in the study. RESULTS: From the application of regression tree analysis and the Health Belief Model, we have noticed the following findings. First, demand motive was the most dominant discriminator factor for the repetitive use of CAM. Second-layer discriminators were evaluated on the basis of action benefits and barriers, as well as sources of action information. Another predominant factor is the heterogeneity of individual background. When participants used CAM for treatment of illness, their household income was ≥ 1000 US dollars per month, they had past experience of western medicine seeking without effects and aged between 30 and 60 years, the predicted mean values for all types of CAM use is 5.62 (the highest). By contrast, when participants used CAM for maintenance of health, their household income was <2000 US dollars per month, they are male, with moderate or good self-rated health who had less than 9 education years, the predicted mean values for all types of CAM use is 1.36 (the lowest). CONCLUSION: Upon the above components, it assists us to understand the multiple interactive reasons on people's repetitive use of CAM. It also provides essential information for specific CAM issues. Furthermore, from the different perspectives; it stimulates the thoughts for the future medical care projects.

Development of a new prototype for an educational partnership in nursing.

The purpose of this 2-year study was to evaluate a new educational partnership for a nurse-managed community center in Taiwan. This project provided care to senior residents in an apartment complex and was integrated into a nursing educational program in Taiwan. In collaboration with these organizations, an educational partnership model was developed and evaluated. Three goals were accomplished: to provide health care to elderly residents, practical learning experience for nursing students, and practical experience for nursing faculty. The findings indicated that teachers, students, and residents in the apartment complex presented a high level of satisfaction with this model. The model created a vivid, practical, community-based resource and applied the principles of service-learning into practical nursing education in Taiwan. The model not only facilitated the empowerment of involved organizations, but also served as a reference for developing other community center-based nursing educational partnerships.