Inelastic two-wave mixing induced high-efficiency transfer of optical vortices.

A scheme for high-efficiency transfer of optical vortices is proposed by an inelastic two-wave mixing (ITWM) process in an inverted-Y four-level atomic medium, which is originally prepared in a coherent superposition of two ground states. The orbital angular momentum (OAM) information in the incident vortex probe field can be transferred to the generated signal field through the ITWM process. Choosing reasonable experimentally realizable parameters, we find that the presence of the off-resonance control field can greatly improve the conversion efficiency of optical vortices, rather than in the absence of a control field. This is caused by the broken of the destructive interference between two one-photon excitation pathways. Furthermore, we also extend our model to an inelastic multi-wave mixing process and demonstrate that the transfer efficiency between multiple optical vortices strongly depends on the superposition of the ground states. Finally, we explore the composite vortex beam generated by collinear superposition of the incident vortex probe and signal fields. It is obvious that the intensity and phase profiles of the composite vortex can be effectively controlled via adjusting the intensity of the control field. Potential applications of our scheme may exist in OAM-based optical communications and optical information processing.

The public's perception of the nursing profession: Validity and reliability of the Chinese version of the nursing image scale in Taiwan.

The public's perception of the nursing image deeply influences nurses' work and professional development. However, the Taiwanese public's perception of nursing remains unclear. This study aimed to determine the validity and reliability of a Chinese version of the Nursing Image Scale (NIS) in Taiwan. This was a psychometric study using a cross-sectional survey. Participants were recruited via the snowball sampling method through the online community software LINE from August 1 to 13, 2019. After data collection, the construction and validation of the NIS to measure public opinion were assessed, including content validity, corrected item-total correlation, exploratory factor analysis (EFA), and reliability. A total of 1331 valid responses were included in the analysis. After EFA analysis, the 20 scale items were divided across the four domains of prudence and care, innovation and cooperation, efficiency and division, and professionalism and respect. The NIS (Chinese version) was valid and reliable for measuring public opinion and may be used to examine changes in public perceptions of nursing.

Optical nonreciprocity and nonreciprocal photonic devices with directional four-wave mixing effect.

A scheme for magnetic-free optical nonreciprocity in an ensemble of four-level cold atoms is proposed by exploiting the directional four-wave mixing effect. Using experimentally achievable parameters, the nonreciprocal optical responses of the system can be observed and the conversion on nonreciprocal transmission and nonreciprocal phase shift can be implemented. These nonreciprocal phenomena originate from the directional phase matching, which breaks the time-reversal symmetry and dynamic reciprocity of the cold atomic system. Moreover, by embedding the cold atoms into a Mach-Zehnder interferometer and choosing proper parameters, a two-port optical isolator with an isolation ratio of 79.70 dB and an insertion loss of 0.35 dB and a four-port optical circulator with a fidelity of 0.9985 and a photon survival probability of 0.9278 can be realized, which shows the high performance of isolation and circulation. The proposal may enable a new class of optically controllable cavity-free nonreciprocal devices in optical signal processing at the low light level.

Coherent control of spatial and angular Goos-Hänchen shifts with spontaneously generated coherence and incoherent pumping.

We propose an efficient scheme to manipulate the Goos-Hänchen (GH) shift of a reflected beam from a metal-clad waveguide, where a coherent atomic medium with a Λ-type configuration is employed as the substrate. Using experimentally achievable parameters, we identify the conditions under which spontaneously generated coherence (SGC) allows us to enhance the spatial and angular GH shifts of the reflected beam. With the help of SGC, the relative phases of the probe and control fields can alter the absorption gain and refractive index of the atomic medium, thereby manipulating the magnitudes, signs, and positions of the spatial and angular shifts. Furthermore, the spatial and angular GH shifts can be coherently controlled via adjusting the incoherent pumping rate and the intensity of the control field. Our proposal provides an avenue for the manipulation of spatial and angular GH shifts and potential applications in optical switching and optical steering.

Developing a theory to help guide End-Stage Renal Disease Patients to adapt to Peritoneal Dialysis: A grounded theory study.

AIM AND OBJECTIVES: The aim of this study was to develop a theory to help guide patients with end-stage renal disease to adapt to peritoneal dialysis. BACKGROUND: Taiwan ranks first worldwide in end-stage renal disease incidence and dialysis prevalence. Many patients cannot accept long-term dialysis treatment and thus face several physical and psychological suffering. No theory has yet been developed to help guide patients with end-stage renal disease to adapt to peritoneal dialysis. DESIGN: A grounded theory approach was used in this study. METHODS: A theoretical sampling was performed after interviewing 25 patients who had adapted to peritoneal dialysis at a medical centre in Taiwan from January 2018 to September 2018; data saturation was achieved. Data were analysed using open, axial and selective coding and while using the constant comparison technique. COREQ reporting guidelines were utilised. RESULTS: A substantive theory was developed to help guide patients with end-stage renal disease to adapt to peritoneal dialysis. The core category that emerged from the data collected was 'Confronting peritoneal dialysis to live and co-exist with peritoneal dialysis'. Other key categories linked to and embraced in this core category were as follows: positive self-regulation, regulation of daily life and the process of adaptation to dialysis method. CONCLUSION: The results could help healthcare professionals to better understand the process of end-stage renal disease patients' adaptation to peritoneal dialysis, thereby facilitating patients' adaptation to dialysis in their daily life, enhancing their quality of life and improving the quality of medical care. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals could use this theory as reference when providing care for peritoneal dialysis patients to assist them in adapting to life with peritoneal dialysis as soon as possible through positive self-regulation, daily life adjustments and the process of adapting to the dialysis method.

Effects of Alcell Lignin Methylolation and Lignin Adding Stage on Lignin-Based Phenolic Adhesives.

To investigate the effects of lignin methylolation and lignin adding stage on the resulted lignin-based phenolic adhesives, Alcell lignin activated with NaOH (AL) or methylolation (ML) was integrated into the phenolic adhesives system by replacing phenol at various adhesive synthesis stages or directly co-polymerizing with phenolic adhesives. Lignin integration into phenolic adhesives greatly increased the viscosity of the resultant adhesives, regardless of lignin methylolation or adding stage. ML introduction at the second stage of adhesive synthesis led to much bigger viscosity than ML or AL introduction into phenolic adhesives at any other stages. Lignin methylolation and lignin adding stage did not affect the thermal stability of lignin based phenolic adhesives, even though lignin-based adhesives were less thermally stable than NPF. Typical three-stage degradation characteristics were also observed on all the lignin-based phenolic adhesives. Three-ply plywoods can be successfully laminated with lignin based adhesives, and it was interesting that after 3 h of cooking in boiling water, the plywoods specimens bonded with lignin-based phenolic adhesives displayed higher bonding strength than the corresponding dry strength obtained after direct conditioning at 20 °C and 65% RH. Compared with NPF, lignin introduction significantly reduced the bonding strength of lignin based phenolic adhesives when applied for plywood lamination. However, no significant variation of bonding strength was detected among the lignin based phenolic adhesives, regardless of lignin methylolation or adding stages.

High-precision three dimensional atom localization via multiphoton quantum destructive interference.

We propose an effective scheme for high-precision three dimensional(3D) atom localization via measuring the population of excited state in a four-level atomic system driven by a probe field and three orthogonal standing-wave fields. In this scheme, the position-dependent multiphoton quantum destructive interference leads to multiphoton excitation of the excited state and enhances the fluorescence emission. We show that adjusting the frequency detuning and phase shifts associated with the standing-wave fields can modify the multiphoton quantum destructive interference and lead to a redistribution of the atoms. The maximal probability of finding the atom at the certain position in one period of the standing-wave fields can be 100% and the highest spatial precision is about 0.02λ.

Development and validation of a Chinese version of the Sleep Apnea Quality of Life Index.

OBJECTIVE: A Chinese version of the Sleep Apnea Quality of Life Index (SAQLI) for patients with obstructive sleep apnea (OSA) undergoing treatment with continuous positive airway pressure (CPAP) was developed and validated. No Chinese versions of the SAQLI have been previously validated. METHODS: A convenience sample of 78 patients with OSA who received CPAP therapy at a Taiwanese teaching hospital was enrolled. The SAQLI is organized into four domains: daily functioning, social interactions, emotional functioning, and symptoms. This study evaluated the equivalence (forward translation and back translation), validity, and reliability of a Chinese version of the SAQLI. RESULTS: The content validity index (CVI) values of the daily functioning, social interactions, emotional functioning, and symptom domains were .93, .93, .96, and 1.00, respectively. Construct validity of one factor was generated by exploratory factor analysis, and the factor explained the following: (A) daily functioning 54%, (B) social interactions 59%, (C) emotional functioning 64%, and (D) symptoms 75% of total explained variance. The Cronbach's α internal consistency values for the daily functioning, social interactions, emotional functioning, and symptom domains were 0.68, 0.94, 0.93, and 0.92, respectively. The repeatability of the SAQLI at 7 days and 30 days after the first administration showed reliability coefficients of .94 and .93 (p = 0.001), respectively. CONCLUSIONS: The results indicate that the Chinese version of the SAQLI has good reliability and validity, as well as refined indicators for assessing the tool's accuracy. Clinicians may thus use the scale to examine the quality of life in Chinese-speaking patients with OSA undergoing CPAP therapy.

Perfectly asymmetric Raman-Nath diffraction in disordered atomic gratings.

We investigate the effects of geometrical and structural disorders on perfectly asymmetric diffraction (PAD) in Raman-Nath regime. The two types of disorders are realized by introducing random fluctuations in the position and width of one-dimensional (1D) driven atomic lattices. Raman-Nath diffraction is modified differently with respect to the geometrical and structural disorders. It is shown that the PAD is observed with a certain strength range of geometrical disorder, exceeding which it can be destroyed, while the PAD is rather robust against structural disorder. The different behaviors originate from the disorder-induced random variations of the spatial phase shifts of the standing-wave (SW) coupling field and atomic lattices with Gaussian profile. Furthermore, we find that, in the presence of geometrical disorder, the PAD is more susceptible to correlated disorder than to uncorrelated disorder. Our scheme may be useful for understanding the effects of disorder on the diffraction of light and matter waves in disordered potentials..

Lop-sided Raman-Nath diffraction in PT-antisymmetric atomic lattices.

Two-dimensional (2D) optical lattices of driven cold atoms can provide a useful platform to construct 2D electromagnetically induced grating (EIG) with parity-time (PT) antisymmetry. This atomic grating is achieved by the spatial modulations of the atomic density and frequency detunings in the four-level double-Λ atomic system. Gain-assisted PT antisymmetry allows us to realize lop-sided Raman-Nath diffraction with high diffraction efficiency at the exception point. It is shown that the nontrivial phenomenon originates from non-Hermitian degeneracy of PT antisymmetry. Our scheme may provide the possibility for active all-optical control and conversion of the spatial beam in optics.

Quadrature squeezing of a higher-order sideband spectrum in cavity optomechanics.

We propose an efficient scheme to generate quadrature squeezing of a higher-order sideband spectrum in an optomechanical system. This is achieved by exploiting a well-established optomechanical circumstance, where a second-order nonlinearity is embedded into the optomechanical cavity driven by a strong control field and a weak probe pulse. Using experimentally achievable parameters, we demonstrate that the second-order nonlinearity intensity and the frequency detuning of a control field allow us to modify the amplitude of higher-order sidebands and improve the amount of squeezing of a higher-order sideband spectrum. Furthermore, in the presence of a strong second-order nonlinearity, an optimizing quadrature squeezing of a higher-order sideband spectrum can be achieved, which provides a practical opportunity to design the squeezed frequency combs and other precision measurements.

The effects of integrated nursing education on quality of life and health-related outcomes among obstructive sleep apnea patients receiving continuous positive airway pressure therapy.

PURPOSE: This study sought to examine the effects of a nursing education program on quality of life and sleep disturbance among obstructive sleep apnea (OSA) patients receiving continuous positive airway pressure (CPAP) therapy. METHODS: This study was a randomized controlled trial with an intervention group consisting of a nursing education program. The intervention group received the instruction of the CPAP nursing education program, and the control group received routine care. Data was collected for both groups before the intervention (pre-test), on the 7th day measurement after the intervention, and on the 30th day measurement after the intervention. RESULTS: The results showed, first, that the intervention group reported a significantly reduced level of disturbance from wearing CPAP compared with that of the control group after the intervention (ß = -1.83, p = .040). Second, the Calgary sleep apnea quality of life index (SAQLI) total scores significantly improved after the intervention (ß = 1.669, p = 0.014). Also, symptoms of the SAQLI sub-items were improved and significantly different (ß = 5.69, p = 0.007) after the intervention in the intervention group. CONCLUSIONS: According to the results of the study, the disturbance from wearing CPAP, the total score of the SAQLI and the symptoms of the SAQLI were significantly improved after the nursing education intervention. Therefore, an adequate nursing education program is recommended for the initial period of CPAP use among OSA patients.

Relieving my discomforts safely: the experiences of discontinuing HRT among menopausal women.

AIM AND OBJECTIVES: To generate a descriptive theoretical framework about the experiences of women who discontinued hormone replacement therapy. BACKGROUND: Some menopausal women would depend on hormone replacement therapy for relieving their menopausal symptoms. However, most of them feared of hormone replacement therapy's side effects and tried to discontinue hormone replacement therapy immediately. How did these women self-manage their discomforts without using dependent medicine--hormone replacement therapy? There are few studies conducted on this issue. DESIGN: A grounded theory research was applied. METHODS: Nineteen Taiwanese women discontinuing hormone replacement therapy for three months, aged 45 to 67 years, participated in face-to-face audio-taped interviews. Data collection, and coding of interviews, and data analysis occurred simultaneously. All conversations were audio-recorded and then transcribed as verbatim text. The constant comparative method was used to analyse the interview data. RESULTS: 'Relieving my discomforts safely' was the core theme for describing and guiding the process of discontinuing hormone replacement therapy. 'Immediately discontinuing hormone replacement therapy--it would hurt my body' was identified as the antecedent condition. Analyses showed five dimensions to the women's relieving my discomforts safely: (1) symptoms bothered me again, (2) negative emotions, (3) learning to let it go, (4) trying to use nonhormone replacement therapy or products and (5) choosing safely therapies as first priority. Finally, some women would choose their suitable nonhormone replacement therapy way, and some women would reuse hormone replacement therapy cautiously. CONCLUSIONS: 'Relieving my discomforts safely' was the first-priority consideration for the menopausal women discontinuing hormone replacement therapy. It is the challenge to establish the health programme or management for helping these women felt safety and security to relieve their menopausal symptoms by using hormone replacement therapy or nonhormone replacement therapy. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers need to empower women the rights of decision-making of using hormone replacement therapy and assist them in monitoring their health status to reduce their fear and uncertainty.

Life experiences among obstructive sleep apnoea patients receiving continuous positive airway pressure therapy.

AIMS AND OBJECTIVES: To generate a descriptive theoretical framework for experiences among obstructive sleep apnoea (OSA) patients undergoing continuous positive airway pressure (CPAP) therapy. BACKGROUND: Insufficient information is available about subjective experiences among OSA patients undergoing CPAP therapy. This study aims to address that lack of insight into patients' feelings. DESIGN: A qualitative study using the grounded theory method to establish a descriptive theory. METHODS: Twenty-two Taiwanese OSA patients undergoing CPAP therapy participated in comprehensive interviews. RESULTS: The patients, aged 37-68 years, participated in wide-ranging interviews. 'Living with CPAP' was the core theme describing the life experiences of OSA patients undergoing CPAP. Health warnings were identified as the antecedent condition, with subcategories including the following: severe snoring, choking and feelings of a terrible death during sleep, day and night sleepiness, easy tiredness, decreased memory, poor sleep, dry mouth, dry throat, headache, high blood pressure, poor blood sugar level control and falling asleep while driving. Analyses indicated seven subcategories of OSA patients with CPAP: (1) seeking medical information, (2) difficulties with CPAP, (3) trial and error for the 'right' CPAP, (4) long scheduled waiting times, (5) wondering, (6) high expectations, and (7) getting back good health. CONCLUSIONS: The results will assist healthcare providers with references for OSA health care based on patients' subjective perspectives. RELEVANCE TO CLINICAL PRACTICE: After interpreting and analysing results, suggestions include the following: (1) provide medical resource education for outpatients and inpatients to access self-care knowledge regarding OSA; (2) institute professional personnel for providing OSA health education in sleep clinics or sleep centres; (3) develop hospital standards for sleep examination processes to shorten waiting times; (4) establish case management for pursuing OSA patients receiving CPAP; (5) arrange regular forums for patients to share their experiences; and (6) provide community health education to promote awareness of snoring issues.

Engineered Janus hydrogels: biomimetic surface engineering and biomedical applications.

Hydrogel bioadhesives, when applied to dysfunctional tissues substituting the epidermis or endothelium, exhibit compelling characteristics that enable revolutionary diagnostic and therapeutic procedures. Despite their demonstrated efficacy, these hydrogels as soft implants are still limited by improper symmetric surface functions, leading to postoperative complications and disorders. Janus hydrogel bioadhesives with unique asymmetric surface designs have thus been proposed as a reliable and biocompatible hydrogel interface, mimicking the structural characteristics of natural biological barriers. In this comprehensive review, we provide guidelines for the rational design of Janus hydrogel bioadhesives, covering methods for hydrogel surface chemistry and microstructure engineering. The engineering of Janus hydrogels is highlighted, specifically in tuning the basal surface to facilitate instant and robust hydrogel-tissue integration and modulating the apical surface as the anti-adhesion, anti-fouling, and anti-wear barrier. These asymmetric designs hold great potential in clinical translation, supporting applications including hemostasis/tissue sealing, chronic wound management, and regenerative medicine. By shedding light on the potential of Janus hydrogels as bioactive interfaces, this review paper aims to inspire further research and overcome current obstacles for advancing soft matter in next-generation healthcare.

Dynamic Wavelength-Selective Diffraction and Absorption with Direct-Patterned Hydrogel Metagrating.

Hydrogel nanophotonic devices exhibit attractive tunable capabilities in structural coloration and optical display. However, current hydrogel-based tunable strategies are mostly based on a single physical mechanism, and it remains a challenge to merge multiple mechanisms for active devices with integrated functionalities. Here, a hydrogel metagrating combining Fabry-Pérot (FP) resonance and diffraction effects is proposed for achieving tunable absorption and dynamic wavelength-selective beam steering. Through exploiting hydrogel shrinkage under electron-beam exposure, a hydrogel nanocavity composed of Ag/Hydrogel/Ag three-layer films can be directly printed with arbitrary patterns, enabling the direct-pattering technique of metagrating. The hydrogel nanocavity performs as an FP-type absorber, and its absorption peak rapidly shifts with humidity variation due to the hydrogel layer scaling. The response speed is <320 ms, and the absorption peak shift range is >150 nm. It is further demonstrated that the hydrogel metagrating exclusively deflects light at the resonance wavelength, and its operating wavelength can be actively switched by regulating ambient humidity. The proposed tunable hydrogel metagrating can promote new technologies of tunable metasurfaces for optical filtering, gas sensing, and optical imaging.

Planar Deposition via In Situ Conversion Engineering for Dendrite-Free Zinc Batteries.

Owing to the considerable capacity, high safety, and abundant zinc resources, zinc-ion batteries (ZIBs) have been garnering much attention. Nonetheless, the unsatisfactory cyclic lifespan and poor reversibility originate from side reactions and dendrite obstacles to their practical applications. In addition to inhibiting the corrosion of aqueous electrolytes, regulating planar deposition is a key strategy to enhance their long-term stability. Herein, an in situ conversion strategy is reported to construct a protective "dual-layer" structure (VZSe/V@Zn) on zinc metal, consisting of the VSe2-ZnSe outer layer with low lattice mismatch to Zn (002) plane, and corrosion-resistant nanometallic V inner layer. Such design integrates superior interfacial ionic/electronic transfer, corrosion resistance, and unique planar deposition regulation capability. The as-prepared VZSe/V@Zn demonstrates remarkable durability of 238 h at 50 mA cm-2 with a high depth of discharge (68.3% DOD) in the Zn||Zn symmetric cell. Even in the anode-free system, the as-prepared protective layer can extend the cycle life up to 2000 cycles, with an outstanding capacity retention of 93.1% and ultra-high average coulombic efficiency of 99.998%. This work delineates an effective strategy for fabricating lattice-matching protective layers, with profound implications for elucidating zinc deposition mechanisms and paving the way for the development of high-performance zinc batteries.

Potential Gradient-Driven Dual-Functional Electrochromic and Electrochemical Device Based on a Shared Electrode Design.

The integration of electrochromic devices and energy storage systems in wearable electronics is highly desirable yet challenging, because self-powered electrochromic devices often require an open system design for continuous replenishment of the strong oxidants to enable the coloring/bleaching processes. A self-powered electrochromic device has been developed with a close configuration by integrating a Zn/MnO2 ionic battery into the Prussian blue (PB)-based electrochromic system. Zn and MnO2 electrodes, as dual shared electrodes, the former one can reduce the PB electrode to the Prussian white (PW) electrode and serves as the anode in the battery; the latter electrode can oxidize the PW electrode to its initial state and acts as the cathode in the battery. The bleaching/coloring processes are driven by the gradient potential between Zn/PB and PW/MnO2 electrodes. The as-prepared Zn||PB||MnO2 system demonstrates superior electrochromic performance, including excellent optical contrast (80.6%), fast self-bleaching/coloring speed (2.0/3.2 s for bleaching/coloring), and long-term self-powered electrochromic cycles. An air-working Zn||PB||MnO2 device is also developed with a 70.3% optical contrast, fast switching speed (2.2/4.8 s for bleaching/coloring), and over 80 self-bleaching/coloring cycles. Furthermore, the closed nature enables the fabrication of various flexible electrochromic devices, exhibiting great potentials for the next-generation wearable electrochromic devices.

Development and Validation of the Interprofessional Collaboration Practice Competency Scale (IPCPCS) for Clinical Nurses.

Interprofessional collaborative practice is a core competency and is the key to strengthening health practice systems in order to deliver safe and high-quality nursing practice. However, there is no Interprofessional Collaboration Practice Competency Scale (IPCPCS) for clinical nurses in Taiwan. Therefore, the purposes of this study were to develop an IPCPCS and to verify its reliability and validity. This was a psychometric study with a cross-sectional survey using convenience sampling to recruit nurses from the seven hospitals of a medical foundation. A self-designed structured IPCPCS was rolled out via a Google survey. The data were analyzed using descriptive statistics, principal-axis factoring (PAF) with Promax rotation, Pearson correlation, reliability analysis, and one-way ANOVA. PAF analysis found that three factors could explain 77.76% of cumulative variance. These were collaborative leadership and interprofessional conflict resolution, interprofessional communication and team functioning, and role clarification and client-centered care. The internal consistency of the three factors (Cronbach's α) was between 0.970 to 0.978, and the Pearson correlation coefficients were between 0.814 to 0.883. Significant differences were presented in the IPCPCS score by age, education level, total years of work experience, position on the nursing clinical ladder, and participation in interprofessional education. In conclusion, the three factors used in the IPCPCS have good reliability and construct validity. This scale can be used as an evaluation tool of in-service interprofessional education courses for clinical nurses.

Probing interaction forces associated with calcite scaling in aqueous solutions by atomic force microscopy.

The prevention of calcite aggregation and scaling remains a challenging problem in aqueous based systems and environmental science. Decades of research studies have proposed microscopic mechanisms of aggregation control, but experiments at the nanoscale and molecular level are rarely conducted. Here we show that the nanoscale topographic features of calcite during its aggregation depend significantly on the intermolecular and surface forces involved in this process. By measuring the forces between a calcite or silica particle and a calcite surface in aqueous solutions using atomic force microscopy, we found that higher solution pH and inhibitor concentration and lower salinity resulted in a system of stronger repulsion and weaker adhesion, which is favorable for reducing the possibility of calcite aggregation and surface deposition. Conflicting roles of Mg2+ in calcite aggregation prevention, being positive in acidic pH and negative in alkaline pH, were also observed. The nanoscale structural changes of calcite, visualized by atomic force microscopy or scanning electron microscopy, indicated a size dependence of aggregated and deposited calcite crystals on the calcite-calcite and calcite-silica interactions, respectively. The generalized framework of the calcite aggregation mechanism achieved in this work can be extended to other types of systems and provides a basis for investigating the anti-aggregation strategy of calcite from industrial and environmental perspectives.