An Intelligent Water Monitoring IoT System for Ecological Environment and Smart Cities.

Global precipitation is becoming increasingly intense due to the extreme climate. Therefore, creating new technology to manage water resources is crucial. To create a sustainable urban and ecological environment, a water level and water quality control system implementing artificial intelligence is presented in this research. The proposed smart monitoring system consists of four sensors (two different liquid level sensors, a turbidity and pH sensor, and a water oxygen sensor), a control module (an MCU, a motor, a pump, and a drain), and a power and communication system (a solar panel, a battery, and a wireless communication module). The system focuses on low-cost Internet of Things (IoT) devices along with low power consumption and high precision. This proposal collects rainfall from the preceding 10 years in the application region as well as the region's meteorological bureau's weekly weather report and uses artificial intelligence to compute the appropriate water level. More importantly, the adoption of dynamic adjustment systems can reserve and modify water resources in the application region more efficiently. Compared to existing technologies, the measurement approach utilized in this study not only achieves cost savings exceeding 60% but also enhances water level measurement accuracy by over 15% through the successful implementation of water level calibration decisions utilizing multiple distinct sensors. Of greater significance, the dynamic adjustment systems proposed in this research offer the potential for conserving water resources by more than 15% in an effective manner. As a result, the adoption of this technology may efficiently reserve and distribute water resources for smart cities as well as reduce substantial losses caused by anomalous water resources, such as floods, droughts, and ecological concerns.

Seroprevalence trend of human brucellosis and MLVA genotyping characteristics of Brucella melitensis in Shaanxi Province, China, during 2008-2020.

In this study, a total of 179,907 blood samples from populations with suspected Brucella spp. infections were collected between 2008 and 2020 and analyzed by the Rose Bengal plate test (RBPT) and serum agglutination test (SAT). Moreover, conventional biotyping, B. abortus-melitensis-ovis-suis polymerase chain reaction (AMOS-PCR), and multiple-locus variable-number tandem repeat analysis (MLVA) was applied to characterize the isolated strains. A total of 8103 (4.50%) samples were positive in RBPT, while 7705 (4.28%, 95% confidence interval (CI) 4.19-4.37) samples were positive in SAT. There was a significant difference in seroprevalence for human brucellosis over time, in different areas and different cities (districts) (χ2 = 2 = 32.23, 1984.14, and 3749.51, p < .05). The highest seropositivity (8.22% (4, 965/60393; 95% CI 8.00-8.44) was observed in Yulin City, which borders Inner Mongolia, Ningxia, and Gansu Province, China, regions that have a high incidence of human brucellosis. Moreover, 174 Brucella strains were obtained, including nine with B. melitensis bv. 1, 145 with B. melitensis bv. 3, and 20 with B. melitensis variants. After random selection, 132 B. melitensis were further genotyped using MLVA-16. The 132 strains were sorted into 100 MLVA-16 genotypes (GTs) (GT 1-100), 81 of which were single GTs represented by singular independent strains. The remaining 19 shared GTs involved 51 strains, and each GT included two to seven isolates from the Shaan northern and Guanzhong areas. These data indicated that although sporadic cases were a dominant epidemic characteristic of human brucellosis in this province, more than 38.6% (51/132) outbreaks were also found in the Shaan northern area and Guanzhong areas. The 47 shared MLVA-16 GTs were observed in strains (n = 71) from this study and strains (n = 337) from 19 other provinces of China. These data suggest that strains from the northern provinces are a potential source of human brucellosis cases in Shaanxi Province. It is urgent to strengthen the surveillance and control of the trade and transfer of infected sheep among regions.

Developing an assessment scale for long-term care reablement literacy in home care workers in Taiwan using a modified Delphi method.

BACKGROUND: Reablement is a philosophy of change in long-term care (LTC). Assessing the knowledge and competence of LTC professionals who provide reablement services is vital in LTC research. This study aimed to develop a scale for the assessment of long-term care reablement literacy (LTCRL) and employ this scale to assess the performance of home care workers in Taiwan. METHODS: To develop this scale, we employed the modified Delphi technique based on the theoretical framework of health literacy and the content of service delivery in reablement. Home care workers from northern, central, and southern Taiwan were selected through purposive sampling (N = 119). Participants answered a self-administered questionnaire that included items related to basic demographic characteristics and questions to assess LTCRL. RESULTS: Based on the experts' consensus on the procedure of the modified Delphi technique, the LTCRL assessment sale consists of 29 questions on four aspects of knowledge acquisition: the abilities to access/obtain, understand, process/appraise, and apply/use. The results revealed that higher education levels and better Chinese language proficiency are associated with higher LTCRL outcomes among home care workers. CONCLUSIONS: The LTCRL assessment scale based on a modified Delphi technique is useful and feasible for evaluating LTCRL in home care workers who provide reablement services in Taiwan.

Lactoferrin Protects Hyperoxia-Induced Lung and Kidney Systemic Inflammation in an In Vivo Imaging Model of NF-κB/Luciferase Transgenic Mice.

PURPOSE: High levels of oxygen are usually used in ventilatory support and extracorporeal membrane oxygenation (ECMO) in the intensive care unit of hospitals. Hyperoxia may induce the production of reactive oxygen species (ROS) that can cause lung damage and even systemic injury. In this study, the NF-κB/luciferase transgenic mouse model with non-invasive real-time in vivo imaging was established to test the functions of lactoferrin (LF) in antioxidant and anti-inflammation. PROCEDURES: The NF-κB/luciferase transgenic mice were used to assess the effects of oral administration of LF on attenuation of the systemic inflammatory response and organ damage after 72 h of hyperoxia (FiO2 > 95 %) exposure via monitoring using an in vivo imaging system (IVIS). RESULTS: Using luciferase IVIS imaging, we found that the lungs and kidneys were the most evidently affected organs after hyperoxia treatment. The groups treated with low dose (150 mg/kg) or high dose (300 mg/kg) of LF had lower luciferase expression and less injury, with a dose-dependent effect on the lungs and kidneys. Moreover, ROS, mitogen-activated protein kinases (MAPK), and pro-inflammatory cytokine (TNF-α, IL-1ß, and IL-6) expression levels were all significantly decreased (P < 0.01), and the protein level of IκB was statistically increased (P < 0.01) after LF treatment. CONCLUSIONS: Our results suggest that hyperoxia can induce systemic inflammation, and the oral administration of LF as a natural antioxidant decreases the production of ROS, attenuates inflammation, and lessens kidney and lung injuries from hyperoxia via the use of live image monitoring of the response in NF-kB/luciferase transgenic mice.

Extracellular superoxide dismutase ameliorates streptozotocin-induced rat diabetic nephropathy via inhibiting the ROS/ERK1/2 signaling.

AIM: Diabetic nephropathy is the leading cause of end stage renal disease in developed countries throughout the world. The imbalance between the production of reactive oxygen species (ROS) and the antioxidant defense system is the main problem that is responsible for the progression of diabetic kidney disease. In this study, we investigated whether human extracellular superoxide dismutase (hEC-SOD) can prevent diabetic nephropathy in the rat model. MAIN METHODS: Diabetic nephropathy symptoms were induced by intraperitoneal injection with 60 mg/kg streptozotocin (STZ) in male Sprague-Dawley (SD) rats. After daily supplement of rhEC-SOD (3200 U/kg/day) for 4 weeks, the serum or urine biochemical markers (glucose, creatinine, blood urea nitrogen, triglyceride, hemoglobin A1c, and microalbuminuria), histological changes, gene expressions (phox47, opn, and gapdh), and protein levels (TGF-ß, AT1-R, phospho-p42/p44 MAPK, and p42/p44 MAPK) were determined. KEY FINDINGS: Results showed that rhEC-SOD administration could reverse SOD activity measured in kidney and diabetic-associated changes, including the fibrosis change, expression of collagen I, transforming growth factor-beta (TGF-ß) and angiotensin II type I receptor (AT1-R), as well as the activation of the intracellular mitogen-activated protein kinase (MAPK) signaling pathway, associating with its inhibition of p42(MAPK)/p44(MAPK) (ERK1/2) phosphorylation. Additionally, diabetic nephropathy up-regulated the expression of the phox47 and opn genes, and these changes could also be suppressed. Though the proteinuria did not significantly reduce. Treatment with rhEC-SOD ameliorates STZ-induced diabetic nephropathy, leading to reduced death rates, kidney weight/body weight ratio, fibrosis change, and TGF-ß1 expression through the down-regulation of ROS/ERK1/2 signaling pathway. SIGNIFICANCE: We conclude that rhEC-SOD can act as a therapeutic agent to protect the progression of diabetic nephropathy.

The effects of scenario-based simulation course training on nurses' communication competence and self-efficacy: a randomized controlled trial.

Studies have shown that an underappreciation of the importance of person-centered communication and inappropriate communication training could result in unsatisfactory communication performance from nurses. There are a large number of studies about communication training for nurses, but not so many about communication training in early stages of nursing career. The purpose of this study is to compare the effect of a traditional course versus scenario-based simulation training on nurses' communication competency, communication self-efficacy, and communication performance in discharge planning Objective Structured Clinical Examination (OSCE). A randomized controlled trial was used with a pretest and two posttests. The experimental group underwent the scenario-based simulation course, whereas the control group received the traditional course. A convenience sample of 116 nurses with qualifications ranging from N0 level (novice nurses) to N2 level (competent nurses) in Taiwan's clinical nursing ladder system was recruited from a medical center in northern Taiwan. Analysis of covariance was used to determine between-subjects effects on communication competency and self-efficacy, whereas independent t test and Mann-Whitney U test were used to examine between-subjects effects on learner satisfaction and discharge planning communication performance. Paired t test was used to determine communication self-efficacy. In this study, the nurses and independent raters found scenario-based simulation training more effective than traditional communication course. However, standardized patients reported no significant difference in communication performance between the two groups of nurses. Despite that traditional classroom lectures and simulation-based communication training could both produce enhanced communication competency and self-efficacy among nurses, this study has established that the latter may be better than the former in terms of learner satisfaction and communication performance improvement. Therefore, introduction of simulation-based training to in-service nursing education could enhance nurses' communication performance in clinical practice.

Comparison of solid-state-cultured and wood-cultured Antrodia camphorata in anti-inflammatory effects using NF-κB/luciferase inducible transgenic mice.

PURPOSE: Antrodia camphorata (AC), a highly valued polypore mushroom native only to Taiwan, has been traditionally used as a medicine for the treatment of food and drug intoxication, diarrhea, abdominal pain, hypertension, skin itching, and cancer. In this study, both of solid-state-cultured AC (S-AC) and wood-cultured AC (W-AC) were evaluated the anti-inflammatory effects on hyperoxia-induced lung injury in NF-κB-luciferase(+/+) transgenic mice. METHODS: The homozygous transgenic mice (NF-κB-luciferase(+/+)) were randomly assigned to four groups for treatment (n = 6) including Normoxia/DMSO group, Hyperoxia/DMSO group, Hyperoxia/S-AC group, and Hyperoxia/W-AC group. After 72 h of hyperoxia, we examined the bioluminescence images, reactive oxygen species (ROS), the mRNA and protein expression levels of inflammation factors, and histopathological analyses of the lung tissues. RESULTS: Hyperoxia-induced lung injury significantly increased the generation of ROS, the mRNA levels of IL-6, TNF-α, IL-1ß and IL-8, and the protein expression levels of IKKα/ß, iNOS and IL-6. Pulmonary edema and alveolar infiltration of neutrophils was also observed in the hyperoxia-induced lung tissue. However, treatment with either S-AC or W-AC obviously decreased hyperoxia-induced generation of ROS and the expression of IL-6, TNF-α, IL-1ß, IL-8, IKKα/ß and iNOS compared to hyperoxia treatment alone. Lung histopathology also showed that treatment with either S-AC or W-AC significantly reduced neutrophil infiltration and lung edema compared to treatment with hyperoxia treated alone. To find out their major compounds, eburicoic acid and dehydroeburicoic acid were both isolated and identified from S-AC and W-AC by using HPLC, MS, and NMR spectrometry. CONCLUSIONS: These results demonstrated that methanolic extracts both of S-AC and W-AC have excellent anti-inflammatory activities and thus have great potential as a source for natural health products.

[The use of OSCE to evaluate the competency of discharge nurses].

BACKGROUND: Clear directions and explanations from nurses related to health behaviors and discharge procedures have been shown to effectively reduce the risk of patient readmission. Nurses thus need to develop good communication skills in order to ensure that their communications help patients become better-informed and less anxious about discharge procedures. PURPOSE: This research evaluates the communication skills of nurses following two different education interventions. METHODS: Experimental design principles for education interventions were followed in this research. Medical nurses certified at the N to N2 level in a municipal hospital in Taipei City were enrolled as participants (N=78) and divided into an experimental group and control group using stratified purposive randomization. The experimental group received clinical scenario-based simulation education for communication. The control group received standard class-based education for communication. Both groups received a pre-test evaluation and an OSCE post-test evaluation. Results were analyzed using SPSS 17.0 software. RESULTS: Independent t-test results revealed significant increases in communication skills (t=3.406, p<.05) in both groups, with the increase in the experimental group (M=5.00, SD=0.82) significantly greater than the increase in the control group (M=4.11, SD=1.41). However, the mean scores from the post-test standardized patient survey found no significant differences between the two groups in terms of communication skills. CONCLUSIONS: The results indicate that the clinical scenario-based simulation education intervention is more effective than traditional class-based education in enhancing the communication skills of nurses.

[A creative approach to teaching diabetic foot examinations].

Foot infections are a common chronic complication and a major reason for hospitalization in patients with diabetes. Performing foot examinations correctly and thoroughly may reduce diabetic foot risks and save patients from amputation and death. To assist professional nurses to learn the procedures and tools involved in foot examination, this study proposes that nurse trainers use creative thinking methods, such as those of Mandala, and mind mapping to conduct divergent thinking and analysis of training content define feasible training strategies. This study also proposes the use of rhymes and graphics such as creative mnemonics to help professional nurses expedite their learning of foot examination and preventive foot care techniques.

Prolonged exposure to arecoline arrested human KB epithelial cell growth: regulatory mechanisms of cell cycle and apoptosis.

Arecoline, the main areca alkaloid in betel quid (BQ), is reported to have cytotoxic, genotoxic, and mutagenic effects in various cells. It shows strong correlation to the incidence of oral submucous fibrosis, leukoplakia, and oral cancer. To clarify the role of arecoline in BQ-induced carcinogenesis, primary human gingival keratinocyes (GK) and human KB epithelial cells were used for studying the molecular mechanisms of arecoline-mediated cell cycle deregulation for comparison. After 24 h of exposure, arecoline (0.2-0.8 mM) inhibited KB cell growth in a dose- and time-dependent manner with a reduction in cell number by 27-37 and 37-58%, respectively, as determined by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) and sulforhodamine B (SRB) assays. Incubation of KB cells with arecoline (0.1-0.4 mM) caused late-S and G2/M phases' cell cycle arrest. Western blot analysis revealed that arecoline induced cyclin Bl, Wee 1, and phosphorylated cdc2 protein levels whereas it declined p21 protein expression in KB cancer cells. Nevertheless, arecoline induced p21, but decreased cdc2 and cyclin B1 protein levels in GK. We demonstrated that higher concentrations of arecoline (0.2-1.2 mM) induced both cell necrosis and apoptosis as detected by DNA fragmentation and Annexin V-PI staining after long-term (48 h) treatment. Our results suggest that differential regulation of S and/or G2/M cell cycle-related proteins in the GK and KB cells play a crucial role in different stages of BQ-mediated carcinogenesis.

[Study on the presence of hepatitis B virus in first-trimester villi in pregnant women with hepatitis B surface antigen positive].

OBJECTIVE: To observe the presence of hepatitis B virus (HBV) in first-trimester villi cells from pregnant women carrying HBsAg. METHODS: Immunohistochemical streptavidin-biotin peroxidase complex (SABC) staining with monoclonal HBsAg, hepatitis B core antigen (HBcAg) and PCR, in situ hybridization were used for detection of HBV infection markers in villi. Positive villi ultramicrostructures were observed with transmission electron microscope. RESULTS: HBV was detected in 8 of 25 villi of HBsAg positive pregnant women, the positive rate was 32%. HBsAg was located in the decidual cell, trophoblastic cell and villous mesenchymal cell. HBV analog was detected in rough endoplasmic reticulum of trophoblastic cell. CONCLUSIONS: HBV may infect villous cells in first-trimester pregnancy. It would be impossible for HBV to transmit the desmosomes.