Molecular-caged metal-organic frameworks for energy management.

Metal-organic frameworks (MOFs) hold great promise for diverse applications when combined with polymers. However, a persistent challenge lies in the susceptibility of exposed MOF pores to molecule and polymer penetration, compromising the porosity and overall performance. Here, we design a molecular-caged MOF (MC-MOF) to achieve contracted window without sacrificing the MOF porosity by torsional conjugated ligands. These molecular cages effectively shield against the undesired molecule penetration during polymerization, thereby preserving the pristine porosity of MC-MOF and providing outstanding light and thermal management to the composites. The polymer containing 0.5 wt % MC-MOF achieves an 83% transmittance and an exceptional haze of 93% at 550 nanometers, coupled with remarkable thermal insulation. These MC-MOF/polymer composites offer the potential for more uniform daylighting and reduced energy consumption in sustainable buildings when compared to traditional glass materials. This work delivers a general method to uphold MOF porosity in polymers through molecular cage design, advancing MOF-polymer applications in energy and sustainability.

Copper hexacyanoferrate/carbon sheet combination with high selectivity and capacity for copper removal by pseudocapacitance.

The efficient capture of copper ions (Cu2+) in wastewater has dual significance in pollution control and resource recovery. Prussian blue analog (PBA)-based pseudocapacitive materials with open frameworks and abundant metal sites have attracted considerable attention as capacitive deionization (CDI) electrodes for copper removal. In this study, the efficiency of copper hexacyanoferrate (CuHCF) as CDI electrode for Cu2+ treating was evaluated for the first time upon the successful synthesis of copper hexacyanoferrate/carbon sheet combination (CuHCF/C) by introducing carbon sheet as conductive substrate. CuHCF/C exhibited significant pseudocapacitance and high specific capacitance (52.92 F g-1) through the intercalation, deintercalation, and coupling of Cu+/Cu2+ and Fe2+/Fe3+ redox pairs. At 0.8 an applied voltage and CuSO4 feed liquid concentration of 100 mg L-1, the salt adsorption capacity was 134.47 mg g-1 higher than those of most reported electrodes. Moreover, CuHCF/C demonstrated excellent Cu2+ selectivity in multi-ion coexisting solutions and in actual wastewater experiments. Density functional theory (DFT) calculations were employed to elucidate the mechanism. This study not only reveals the essence of Cu2+ deionization by PBAs pseudocapacitance with promising potential applications but also provides a new strategy for selecting efficient CDI electrodes for Cu2+ removal.

Enabling Scalable Polymer Electrolyte with Dual-Reinforced Stable Interface for 4.5 V Lithium-Metal Batteries.

Hitherto, it remains a great challenge to stabilize electrolyte-electrode interfaces and impede lithium dendrite proliferation in lithium-metal batteries with high-capacity nickel-rich LiNx Coy Mn1- x-y O2 (NCM) layer cathodes. Herein, a special molecular-level-designed polymer electrolyte is prepared by the copolymerization of hexafluorobutyl acrylate and methylene bisacrylamide to construct dual-reinforced stable interfaces. Verified by X-ray photoelectron spectroscopy depth profiling, there are favorable solid electrolyte interphase (SEI) layers on Li metal anodes and robust cathode electrolyte interphase (CEI) on Ni-rich cathodes. The SEI enriched in lithiophilic N-(C)3 guides the homogenous distribution of Li+ and facilitates the transport of Li+ through LiF and Li3 N, promoting uniform Li+ plating and stripping. Moreover, the CEI with antioxidative amide groups can suppress the parasitic reactions between cathode and electrolyte and the structural degradation of cathode. Meanwhile, a unique two-stage rheology-tuning UV polymerization strategy is utilized, which is quite suited for continuous electrolyte fabrication with environmental friendliness. The fabricated polymer electrolyte exhibits a high ionic conductivity of 1.01 mS cm-1 at room temperature. 4.5 V NCM622//Li batteries achieve prolonged operation with a retention rate of 85.0% after 500 cycles at 0.5 C. This work provides new insights into molecular design and processibility design for polymer-based high-voltage batteries.

Cytochrome P450 gene CYP6BQ8 mediates terpinen-4-ol susceptibility in the red flour beetle, Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae).

Cytochrome P450 proteins (CYPs) in insects can encode various detoxification enzymes and catabolize heterologous substances, conferring tolerance to insecticides. This study describes the identification of a P450 gene (CYP6BQ8) from Tribolium castaneum (Herbst) and investigation of its spatiotemporal expression profile and potential role in the detoxification of terpinen-4-ol, a component of plant essential oils. The developmental expression profile showed that TcCYP6BQ8 expression was relatively higher in early- and late-larval stages of T. castaneum compared with other developmental stages. Tissue expression profiles showed that TcCYP6BQ8 was mainly expressed in the head and integument of both larvae and adults. The expression profiling of TcCYP6BQ8 in developmental stages and tissues is closely related to the detoxification of heterologous substances. TcCYP6BQ8 expression was significantly induced after exposure to terpinen-4-ol, and RNA interference against TcCYP6BQ8 increased terpinen-4-ol-induced larval mortality from 47.78 to 66.67%. This indicates that TcCYP6BQ8 may be involved in T. castaneum's metabolism of terpinen-4-ol. Correlation investigation between the CYP6BQ8 gene and terpinen-4-ol resistance in T. castaneum revealed that the TcCYP6BQ8 gene was one of the factors behind T. castaneum's resistance to terpinen-4-ol. This discovery may provide a new theoretical foundation for future regulation of T. castaneum.

Design of Imide Oligomer-Mediated MOF Clusters for Solar Cell Encapsulation Systems by Interface Fusion Strategy.

Dielectric encapsulation materials are promising for solar cell areas, but the unsatisfactory light-management capability and relatively poor dielectric properties restrict their further applications in photovoltaic and microelectronic devices. Herein, an interface fusion strategy to engineer the interface of MOF (UiO-66-NH2 ) with anhydride terminated imide oligomer (6FDA-TFMB) is designed and a novel MOF cluster (UFT) with enhanced forward scattering and robust porosity is prepared. UFT is applied as an optical and dielectric modifier for bisphenol A epoxy resin (DGEBA), and UFT epoxy composites with high transmittance (>80%), tunable haze (45-58%) and excellent dielectric properties can be prepared at low UFT contents (0.5-1 wt%), which delivers an optimal design for dielectric encapsulation systems with efficient light management in solar cells. Additionally, UFT epoxy composites also show excellent UV blocking, and hydrophobic, thermal and mechanical properties. This work provides a template for the synthesis of covalent bond-mediated nanofillers and for the modulation of haze and dielectric properties of dielectric encapsulation materials for energy systems, semiconductors, microelectronics, and more.

Complete Solution-Processed Semitransparent and Flexible Organic Solar Cells: A Success of Polyimide/Ag-Nanowires- and PH1000-Based Electrodes with Plasmonic Enhanced Light Absorption.

Organic solar cells (OSCs) have been widely studied due to the advantages of easy fabrication, low cost, light weight, good flexibility and sufficient transparency. In this work, flexible and semitransparent OSCs were successfully fabricated with the adoption of both polyimide/silver nanowires (PI/AgNW) and a conducting polymer PEDOT:PSS named PH1000 as the transparent conductive electrodes (TCEs). It is demonstrated that PI/AgNW is more suitable as a cathode rather than an anode in the viewpoint of its work function, photovoltaic performance, and simulations of optical properties. It is also found that the light incidence from PH1000 TCE can produce more plasmonic-enhanced photon absorption than the PI/AgNW electrode does, resulting in more high power conversion efficiency. Moreover, a high light transmittance of 33.8% and a decent efficiency of 3.88% are achieved for the whole all-flexible semitransparent device with only 9% decrease of resistance in PI/AgNW after 3000 bending cycles. This work illustrates that PI/AgNW has great potential and bright prospect in large-area OSC applications in the future.

Enabling Scalable Polymer Electrolyte with Synergetic Ion Conductive Channels via a Two Stage Rheology Tuning UV Polymerization Strategy.

Lithium metal batteries with polyethylene oxide (PEO) electrolytes are considered as one of the ideal candidates for next generation power sources. However, the low ambient operation capability and conventional solvent-based fabrication process of PEO limit their large-scale application. In this work, a comb-like quasi-solid polymer electrolyte (QPE) reinforced with polyethylene glycol terephthalate nonwoven is fabricated. Combining the density functional theory calculation analysis and polymer structure design, optimized and synergized ion conductive channels are established by copolymerization of tetrahydrofurfuryl acrylate and introduction of plasticizer tetramethyl urea. Additionally, a unique two-stage solventless UV polymerization strategy is utilized for rheology tuning and electrolyte fabrication. Compared with the conventional one-step UV process, this strategy is ideally suited for the roll-to-roll continuous coating fabrication process with environmental friendliness. The fabricated QPE exhibits high ionic conductivity of 0.40 mS cm-1 and Li+ transference number (t = 0.77) at room temperature. LiFePO4 //Li batteries are assembled to evaluate battery performance, which deliver excellent discharge capacity (144.9 mAh g-1 at 0.5 C) and cycling stability (with the retention rate 94.5% at 0.5 C after 200 cycles) at room temperature. The results demonstrate that it has high potential for solid-state lithium metal batteries.

Simultaneously Improving the Optical, Dielectric, and Solubility Properties of Fluorene-Based Polyimide with Silyl Ether Side Groups.

Three fluorene-based polyimides with silyl ether groups (Si-PIs) were successfully synthesized by a simple and efficient silicon etherification reaction of hydroxyl-containing polyimides (OH-PIs) and tert-butylchlorodiphenylsilane (TBDPSCl), and their structures were confirmed by 1H NMR and IR spectra. The bulky nonpolar tert-butyldiphenylsilyl (TBDPS) side groups in the modified PI unit instead of the strong electron donor -OH group is conducive to decreasing electronic conjugation and charge transfer (CT) interaction along the PI chain. Accordingly, the optical, dielectric, and solubility properties of the modified Si-PI films are simultaneously improved compared with the precursor OH-PI films. The modified Si-PI films demonstrate a meaningful enhancement in the transmittances at a wavelength of 400 nm (T 400 ) to 74-81% from 42 to 55% of OH-PI films and the regeneration of fluorescence characteristics. The dielectric constant and loss of Si-PI films are also obviously reduced to 2.63-2.75 and 0.0024-0.0091 at 1 kHz from 4.19 to 4.78 and 0.0173-0.0295 of OH-PI films, respectively, due to substituted with the bulky nonpolar TBDPS groups to increase the free volume and hydrophobicity of Si-PI films. The solubility of Si-PIs in low- or nonpolar solvents (such as CHCl3, CH2Cl2, acetone, and toluene) is significantly improved. Furthermore, Si-PI films still maintain relatively good thermal properties with the 5% weight loss temperature (T 5% ) in the range 470-491 °C under a nitrogen atmosphere and the glass transition temperature (T g ) in the range 245-308 °C.

The Fabrication of High-Hardness and Transparent PMMA-Based Composites by an Interface Engineering Strategy.

The high-hardness and transparent PMMA-based composites play a significant role in modern optical devices. However, a well-known paradox is that conventional PMMA-based composites with high loadings of nanoparticles usually possess high surface hardness at the cost of poor transparency and toughness due to the aggregation of nanoparticles. In this work, ideal optical materials (SiO2/PMMA composites) with high transparency and high surface hardness are successfully fabricated through the introduction of the flow modifier Si-DPF by conventional melt blending. Si-DPF with low surface energy and high transparency, which is located at the SiO2/PMMA interface, and nano-SiO2 particles are homogeneously dispersed in the PMMA matrix. As an example, the sample SiO2/PMMA/Si-DPF (30/65/5) shows outstanding transparency (>87.2% transmittance), high surface hardness (462.2 MPa), and notched impact strength (1.18 kJ/m2). Moreover, SiO2/PMMA/Si-DPF (30/65/5) also presents a low torque value of composite melt (21.7 N⋅m). This work paves a new possibility for the industrial preparation of polymer-based composites with excellent transparency, surface hardness, processability, and toughness.

Commonalities and differences in myopia prevention and control beliefs among primary school teachers and students in Hangzhou / 中国学校卫生

Objective@#To explore the commonalities and differences between primary school students and teachers in beliefs of myopia prevention and control, in order to provide a theoretical basis for the education programs of myopia prevention and control.@*Methods@#Convenient sampling method was used to select 14 students and 16 teachers from grades 3 and 4 in two elementary schools in Hangzhou for one to one in depth interviews, and the results were coded and analyzed by using Nvivo 11.0 software.@*Results@#There were commonalities in the perceived severity, benefits and barriers of myopia prevention and control beliefs among students and teachers, and the common keywords had been mentioned for 114 times, the commonalities of perceived severity, benefits and barriers were more obvious among them; there were differences in the specific attributions of perceived susceptibility, severity and barriers among students and teachers，the difference keywords had been mentioned for 63 times, the differences of perceived susceptibility, severity and barriers were more obvious among them.@*Conclusion@#There were commonalities in the perceived susceptibility, severity, benefits and barriers of myopia prevention and control beliefs between students and teachers; there were differences in the aspects of perceived susceptibility, severity and barriers between students and teachers. Adverse health outcomes of myopia and associated prevention knowledge should be enhanced among students. schools should carry out health education activities to improve the ability of teachers and students to prevent and control myopia; the government should implement the "double reduction" policy and improve the safety insurance system for outdoor activities.

Effects of Parental Involvement in a Preschool-Based Eye Health Intervention Regarding Children's Screen Use in China.

In this digital era, young children spend a considerable amount of time looking at telephone, tablet, computer and television screens. However, preventative eye health behavior education could help avoid and relieve asthenopia. The effects of parental influence on their children's eye health behavior through the preschool eye health education intervention program were examined. The Health Belief Model was used to develop parental involvement strategy and eye health curriculum. The study was conducted in a large public preschool with five branches in Beijing, China. A total of 248 parent-child pairs participated in the baseline and follow-up surveys, of which 129 were in the intervention group and 119 were in the comparison group. The generalized estimating equation analysis results indicated that parental involvement in preschool-based eye health intervention on screen uses had positive influence on parents' eye health knowledge, cues to action, and parenting efficacy. The intervention program also had positive effects on the increasing level of children's eye health knowledge, beliefs, cues to action, self-efficacy, and behaviors. The results supported the implementation of a preschool-based eye health intervention program with parental involvement, which could potentially enhance children's and parents' eye health beliefs and practices.

LBX2-AS1 as a Novel Diagnostic Biomarker and Therapeutic Target Facilitates Multiple Myeloma Progression by Enhancing mRNA Stability of LBX2.

Objective: Multiple myeloma (MM) represents a common age-associated malignancy globally. The function and underlying mechanism of antisense lncRNA LBX2-AS1 remain ambiguous in multiple myeloma (MM). Herein, we aimed to observe the biological implication of this lncRNA in MM. Methods: RT-qPCR was employed to examine circulating LBX2-AS1 and LBX2 in 60 paired MM and healthy subjects. Correlation between the two was analyzed by Pearson test. Under transfection with shLBX2-AS1, proliferation and apoptosis were evaluated in MM cells through CCK-8, colony formation and flow cytometry. LBX2 expression was examined in MM cells with shLBX2-AS1 or pcDNA3.1-LBX2 transfection. Following treatment with cycloheximide or actinomycin D, LBX2 expression was examined in pcDNA3.1-LBX2-transfected MM cells at different time points. Rescue assays were then presented. Finally, xenograft tumor models were established. Results: Circulating LBX2-AS1 was up-regulated in MM patients and positively correlated to LBX2 expression. Area under the curve (AUC) of LBX2-AS1 expression was 0.7525. Its up-regulation was also found in MM cells and primarily distributed in cytoplasm. LBX2-AS1 knockdown distinctly weakened proliferative ability and induced apoptosis in MM cells. Overexpressing LBX2-AS1 markedly strengthened LBX2 expression by increasing its mRNA stability. Rescue assays showed that silencing LBX2-AS1 distinctly weakened the pcDNA3.1-LBX2-induced increase in proliferation and decrease in apoptosis for MM cells. Silencing LBX2-AS1 markedly weakened tumor growth. Conclusion: Our data demonstrated that circulating LBX2-AS1 could be an underlying diagnostic marker in MM. Targeting LBX2-AS1 suppressed tumor progression by affecting mRNA stability of LBX2 in MM. Hence, LBX2-AS1 could be a novel therapeutic marker against MM.

Determinants of pro-environmental behavior among excessive smartphone usage children and moderate smartphone usage children in Taiwan.

INTRODUCTION: Although there is evidence linking the relationships between smartphone usage with health, stress, and academic performance, there is still inadequate knowledge about the influence on pro-environmental behaviors. This study seeks to bridge this gap by adapting the theory of attribution framework to examine the effects of personal norms, social norms, perceived behavioral control on pro-environmental behavior of smartphone usage in children. METHODS: A total of 225 children aged between 11 to 12 from eight selected public primary schools at the Hsinchu Science and Industrial Park in Taiwan were surveyed. Two distinct groups (excessive versus moderate usage) were purposefully selected for comparison, of which 96 participants were excessive smartphone users while the remaining 129 were moderate smartphone users. RESULTS: Findings revealed significant differences between excessive and moderate smartphone usage children groups in personal norms (p < 0.001), social norms (p = 0.002), perceived behavioral control (p = 0.001), and pro-environmental behavior (p = 0.001). Findings for excessive smartphone usage children showed that social norms (ß = 0.428, t = 4.096***, p < 0.001) had a direct predictive impact on pro-environmental behavior. In contrast, while there was no direct path established between personal norms and pro-environmental behavior (ß = 0.177, t = 1.580, p > 0.05), as well as social norms and pro-environmental behavior for moderate smartphone usage children (ß = 0.181, t = 1.924, p > 0.05), but such a relationship could be developed through the mediating effect of perceived behavioral control (ß = 0.497, t = 4.471***, p < 0.001). DISCUSSION: The results suggested that excessive smartphone usage children lack positive perceived behavioral control, and their pro-environmental behavior could only be predicted through explicit social norms, whereas pro-environmental behavior of moderate smartphone usage children was implicitly influenced by personal norms through perceived behavioral control.

Hollow Lindqvist-like-Shaped {V6} Cluster-Based Metal-Organic Framework for the Highly Efficient Detoxification of Mustard Gas Simulant.

A polyoxovanadate-based nickel-organic framework, [Ni(bib)2]{V2O6}({V6}-MOF, bib = 1,4-bis(1H-imidazoly-1-yl)benzene), was facilely prepared under gentle hydrothermal conditions and structurally characterized. Single-crystal X-ray diffraction analysis indicates that the {V6} cluster in the {V6}-MOF is constructed of two VO5 tetragonal pyramids and four VO4 tetrahedrons via the apex sharing of O atoms, presenting a hollow Linqvist-like structure, which is different from these reported hexanuclear vanadium clusters. The {V6}-MOF not only expands the structure of polyoxovanadates (POVs) but also catalyzes the rapid detoxification of mustard gas simulant (2-chloroethyl ethyl sulfide, CEES) at 25 °C. The catalytic results were determined by means of GC, GC-MS, and 1H NMR. Using {V6}-MOF as a heterogeneous catalyst, CEES underwent catalyzed oxidation to only nontoxic product 2-chloroethyl ethyl sulfoxide (CEESO) within 40 min, and the conversion and selectivity were almost 100%. In addition, {V6}-MOF exhibits high sustainability, and no obvious reductions in conversion and selectivity are observed after five runs.

Parent-Child Discrepancies in Reports of Exposure to Violence/Pornography on Mobile Devices and the Impact on Children's Psychosocial Adjustment.

This study assessed the discrepancies between reports from parents and children concerning children's exposure to violence/pornography on mobile devices and the impact on the psychosocial adjustment of children. Data were obtained from a sample of 2,230 parent-child dyads recruited from 16 elementary schools (1,140 dyads) in Taiwan and 9 schools (1,090 dyads) in China. A self-administered questionnaire was used. The results showed that about 30 percent of children reported being exposed to violence on mobile devices. Approximately 70 percent of their parents were unaware of their child's exposure to violence on mobile devices. About 16 percent of children reported exposure to pornography on mobile devices, and 80 percent of their parents were unaware of this exposure. Multinomial logistic regression results showed that after controlling for parent and child sociodemographic variables, factors related to parental unawareness of child exposure to violence on mobile devices included a child's ownership of mobile devices, smartphone/tablet use time, a lower level of parental understanding, and a residence in China or in a rural area, whereas the parent-child relationship and a child's smartphone/tablet use time were associated with parents who were unaware of their child's exposure to pornography. Multiple regression results showed that children who were living with household poverty, had a poor parent-child relationship, spent much time using a smartphone/tablet, and with parents who were unaware of their exposure to violence/pornography on mobile devices were more likely to have emotional and behavioral problems.

Silencing of long non­coding RNA HRIM protects against myocardial ischemia/reperfusion injury via inhibition of NF­κB signaling.

Myocardial ischemia/reperfusion injury (MI/RI) following cardiac surgery is a leading cause of morbidity and mortality worldwide. The aim of the present study was to investigate the role of long non­coding RNA hypoxia/reoxygenation injury­related factor in myocytes (HRIM) on cardiac function following MI/RI. After establishing an MI/RI model, hemodynamic indices were detected via transthoracic echocardiography. The proliferative and apoptotic capacities of H9C2 cells subjected to oxygen­glucose deprivation/reoxygenation were detected via Cell Counting Kit­8 assay and flow cytometry, respectively. TNF­α, IL­1ß, IL­6, lactate dehydrogenase (LDH) and creatine kinase (CK) levels were measured via ELISA. The expression levels of NF­κB­associated proteins were detected via western blotting. The expression levels of HRIM were increased in the myocardial tissue of MI/RI rats and H9C2 cells. The infarct size was significantly increased following induction of MI/RI. Moreover, increased HRIM expression levels suppressed hemodynamics in MI/RI rats. Knockdown of HRIM increased cell proliferation and decreased apoptosis as well as the protein levels of phosphorylated (p)­NF­κB p65/NF­κB p65, p­IkBα/IkBα, TNF­α, IL­1ß, IL­6, LDH and CK in H9C2 cells; however, these effects were attenuated via activation of NF­κB signaling. Silencing of HRIM ameliorated MI/RI injury and alleviated inflammation via inactivating the NF­κB signaling pathway.

Antarctic Krill Oil Attenuates Oxidative Stress via the KEAP1-NRF2 Signaling in Patients with Coronary Heart Disease.

BACKGROUND: Antarctic krill oil (AKO) has strong antioxidant activities and is effective for alleviating coronary heart disease (CHD). Kelch-like ECH-associated protein 1-NF-E2-related factor 2 (KEAP1-NRF2) axis is a crucial antioxidant signaling pathway. Thus, AKO may exert its antioxidant effects on CHD patients via KEAP1-NRF2 signaling. METHODS: AKO fatty acid (FA) profiles were analyzed by using gas chromatography (GC). One hundred CHD patients were divided into the intervention (IG, AKO) and control (CG, placebo) groups. Before and after 1, 2, and 3 months of intervention, we measured serum levels of reactive oxygen species (ROS), 8-hydroxy-2-deoxyguanosine (8-OHdG), nitric oxide (NO), malondialdehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH), and glutathione peroxidase (GPx), and KEAP1 and NRF2 levels in peripheral blood leukocytes (PBLs). Serum FAs were measured by GC at baseline and after 3-month intervention. RESULTS: AKO contains rich eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which is more than 27% of total FA. The levels of EPA and DHA, KEAP1, and NRF2 in the IG group were higher than those in the CG group (p < 0.05). Serum levels of ROS, 8-OHdG, NO, and MDA in the IG group were lower than those in the CG group, whereas the levels of SOD, GSH, and GPx in the IG group were higher than those in the CG group (p < 0.05). Serum levels of saturated fatty acids (UFA) in the IG group were higher than those in the CG group, whereas reverse results were obtained for the levels of saturated fatty acids (SFA). Serum levels of EPA and DHA had a strong negative relationship with the level of ROS, whereas the ROS level had a strong negative relationship with the levels of KEAP1-NRF2. CONCLUSION: AKO increases antioxidant capacities of CHD patients via the KEAP1-NRF2 signaling in the PBL.

Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan.

BACKGROUND: Assessing patients' expectations and perceptions of health service delivery is challenging. To understand the service quality in intensive care units (ICUs), we investigated the expected and perceived service quality of ICU care. METHODS: We conducted this study at an ICU of a university-affiliated medical center in Taiwan from April to September 2019. Admitted patients or their family members responded to a questionnaire survey adopted from the SERVQUAL instrument consisting of 22 items in five dimensions. The questionnaire was provided on ICU admission for expectation and before ICU discharge for perception. We analyzed the quality gaps between the surveys and applied important-performance analysis (IPA). RESULTS: A total of 117 patients were included (62.4% males, average age: 65.9 years, average length of stay: 10.1 days, and 76.9% survival to ICU discharge). The overall weighted mean scores for the surveys were similar (4.57 ± 0.81 and 4.58 ± 0.52, respectively). The 'tangibles' dimension had a higher perception than expectation (3.99 ± 0.55 and 4.31 ± 0.63 for expectation and perception, respectively, p < 0.001). IPA showed that most of the items in 'reliability,' 'responsiveness' and 'assurance' were located in the quadrant of high expectation and high perception, whereas most of the items in 'tangibles' and 'empathy' were located in the quadrant of low expectation and low perception. One item (item 1 for 'tangibles') was found in the quadrant of high expectation and low perception. CONCLUSIONS: The SERVQUAL approach and IPA might provide useful information regarding the feedback by patients and their families for ICU service quality. In most aspects, the performance of the ICU satisfactorily matched the needs perceived by the patients and their families.