Application of telemedicine system for older adults postoperative patients in community: a feasibility study.

Purpose: In response to the growing challenges posed by an aging society, a telemedicine system was developed specifically for older adults postoperative patients, and its effectiveness was thoroughly investigated. Methods: Between May 2020 and May 2022, a total of 88 older adults postoperative patients were enrolled and randomly allocated into an experimental group and a control group. The experimental group received telemedicine services after discharge, while the control group received conventional medical services following the traditional protocol. One month after discharge, various indicators were evaluated for both groups, including number of visits, medical expenditures, postoperative recovery, anxiety, depression and satisfaction. Results: The number of visits and medical expenditures of the experimental group were less than those of the control group [1 (0, 1) vs. 1 (1, 2), Z = -3.977, p < 0.001; 25.25 (0.00, 277.40) yuan vs. 174.65 (49.63, 446.10) yuan, Z = -2.150, p = 0.032]. In both groups, there were 2 cases of incision infection, respectively. No significant difference was observed between the two groups (Fisher χ2, p = 0.259). In both groups, there was no instance of incision bleeding, incision dehiscence, readmission, or reoperation. Additionally, there was no significant difference in physical status between the two groups at discharge and after discharge (66.06 ± 8.92 vs. 65.45 ± 7.39 t = 0.287, p = 0.775; 73.33 ± 9.97 vs. 70.91 ± 7.50, t = 1.202, p = 0.235). And there was no significant difference in the change of physical status between the two groups after discharge [10.00 (0.00, 10.00) vs. 5.00 (0.00, 10.00), Z = -1.077, p = 0.281]. There was no significant difference in body weight change between the two groups after discharge [1.05 (0.38, 1.60) Kg vs. 0.80 (0.50, 1.43) Kg, Z = -0.265, p = 0.791]. There was no significant difference in the levels of anxiety and depression between the two groups at discharge (45.64 ± 8.10 vs. 44.60 ± 8.24, t = 0.520, p = 0.604, 48.33 ± 8.46 vs. 47.50 ± 6.85, t = 0.418, p = 0.677). But the levels of anxiety and depression in the experimental group were lower than those in the control group after discharge (34.92 ± 7.38 vs. 39.03 ± 8.42, t = -2.183, p = 0.032, 37.86 ± 7.29 vs. 41.93 ± 7.13, t = -2.281, p = 0.025); The change of anxiety level and depression level of the experimental group were more than those of the control group [-10.00 (-11.25, -8.75) vs. -5.00 (-7.81, -3.75), Z = -5.277, p < 0.001; -10.00 (-12.50, -7.50) vs. -5.00 (-7.75, -3.44), Z = -4.596, p < 0.001]. The level of satisfaction regarding medical services, daily care, and psychological comfort was higher in the experimental group compared to the control group [3 (3, 3.25) vs. 2 (1, 2), Z = -5.931, p < 0.001; 3 (3, 4) vs. 3 (2, 3), Z = -2.286, p = 0.022; 2 (1, 3) vs. 1 (0.75, 2), Z = -2.081, p = 0.037]. Conclusion: In the context of an aging society, telemedicine system can offer improved healthcare to older adults postoperative patients. This includes benefits such as reducing number of visits, saving medical expenditures, enhancing psychological comfort and daily care.

A Roadmap to Low-Cost Hydrogen with Hydroxide Exchange Membrane Electrolyzers.

Hydrogen is an ideal alternative energy carrier to generate power for all of society's energy demands including grid, industrial, and transportation sectors. Among the hydrogen production methods, water electrolysis is a promising method because of its zero greenhouse gas emission and its compatibility with all types of electricity sources. Alkaline electrolyzers (AELs) and proton exchange membrane electrolyzers (PEMELs) are currently used to produce hydrogen. AELs are commercially mature and are used in a variety of industrial applications, while PEMELs are still being developed and find limited application. In comparison with AELs, PEMELs have more compact structure and can achieve higher current densities. Recently, however, an alternative technology to PEMELs, hydroxide exchange membrane electrolyzers (HEMELs), has gained considerable attention due to the possibility to use platinum group metal (PGM)-free electrocatalysts and cheaper membranes, ionomers, and construction materials and its potential to achieve performance parity with PEMELs. Here, the state-of-the-art AELs and PEMELs along with the current status of HEMELs are discussed in terms of their positive and negative aspects. Additionally discussed are electrocatalyst, membrane, and ionomer development needs for HEMELs and benchmark electrocatalysts in terms of the cost-performance tradeoff.

Zwitterion-like, Charge-Balanced Ultrathin Layers on Polymeric Membranes for Antifouling Property.

Zwitterions of charge-balanced units have super-low fouling properties induced by ionic solvation, but their extensive applications in polymeric substrates are strictly constrained by current constructing strategies. A zwitterion-like, charge-balanced ultrathin layer with high antifouling capacity was covalently constructed on delicate aromatic polyamide (PA) reverse osmosis (RO) membranes via a mild and solvent-free grafting-to strategy. Two oppositely charged commercial short-chain carbonyl alkenes, 2-acrylamido-2-methylpropanesulfonic acid (AMPS) and methacryloxyethyltrimethylammonium chloride (DMC), were directly mixed-grafted with amino groups on PA RO membrane surface via Michael addition. Under ambient temperature and pressure, these oppositely charged compounds were assembled into a zwitterion-like, charge-balanced ultrathin layer. The dynamic fouling experiments indicated that the modified membrane exhibited strong antifouling properties and excellent permeation recovery abilities. Surface characterization revealed that the selective layer thickness and surface roughness were not measurably changed. More meaningful is that the typical ridge-and-valley surface structure and the excellent separation performance were both well preserved after modification. This opens a universal avenue to construct a zwitterion-like, ultrathin antifouling layer on the delicate polymer substrate without compromising its original matrix structure and performance, which has promising application in areas of biosensors, tissue engineering, and biomaterials.

Chlorine-Resistant Polyamide Reverse Osmosis Membrane with Monitorable and Regenerative Sacrificial Layers.

Improving chlorine stability is a high priority for aromatic polyamide (PA) reverse osmosis (RO) membranes especially in long-term desalination. In this Research Article, PA RO membranes of sustainable chlorine resistance was synthesized. Glycylglycine (Gly) was grafted onto the membrane surface as a regenerative chlorine sacrificial layer, and the zeta-potential was used to monitor the membrane performance and to conduct timely regeneration operations for chlorinated Gly. The Gly-grafted PA membrane exhibited ameliorative chlorine resistance in which the N-H moiety of glycylglycine served as sacrificial pendants against chlorine attacks. Cyclic chlorination experiments, combined with FT-IR and XPS analysis, were carried out to characterize the membrane. Results indicated that the resulting N-halamines could be fast regenerated by a simple alkaline reduction step (pH 10). A synchronous relationship between the zeta-potential and the chlorination extent of the sacrificial layer was observed. This indicated that the zeta-potential can be used as an on-site sensor to conduct a timely regeneration operation. The intrinsic mechanism of the surface sacrificial process was also studied.

4-Dimethylaminopyridine promoted interfacial polymerization between hyperbranched polyesteramide and trimesoyl chloride for preparing ultralow-pressure reverse osmosis composite membrane.

We have presented a concept of ultralow-pressure reverse osmosis membrane based on hyperbranched polyesteramide through interfacial reaction promoted by pyridine derivate. In this strategy, a key catalyst of 4-dimethylaminopyridine, which can both eliminate the steric hindrance of acyl transfer reaction and facilitate the phase transfer in interfacial polymerization, is adopted to drive the formation of a thin film composite membrane from the hyperbranched polyesteramide and trimesoyl chloride. The results of the characterization demonstrate that a dense, rough, and hydrophilic active layer with a thickness of about 100 nm is formed when the 4-dimethylaminopyridine catalyst is used. The salt rejections for Na2SO4, NaCl, and MgSO4 of the as-prepared composite membrane are higher than 92%, especially for Na2SO4 with 98% rejection. The water fluxes reach about 30-40 L·m(-2)·h(-1) even at an operation pressure of 0.6 MPa. The membrane exhibits good chlorine-resistance ability but poor resistance abilities to acidic and alkaline solutions in the physical-chemical stability experiment. It is also found that the resultant membrane possesses excellent separation performance for PEG-200, showing a promising way to separate small organic molecules from water.