Assessment of factors influencing physicians' intention to prescribe transfusion using the theory of planned behavior.

BACKGROUND: Blood shortage is a persistent problem affecting Taiwan's health-care system. The theory of planned behavior (TPB) has been commonly used in studies of health advocacy. The purpose of this study was to develop a questionnaire measuring clinicians' intention to prescribe transfusion based on the TPB. METHOD: A questionnaire comprising 15 items for assessing clinicians' intention to prescribe blood transfusion was developed, and it collected demographic characteristics, tested patient blood management (PBM) and perceived knowledge of PBM. Furthermore, the questionnaire contained four subscales related to the TPB. A total of 129 clinicians participated in this pilot study between July and December2020. Item analysis and exploratory factor analysis were conducted to examine the validity and reliability of this measurement instrument. RESULTS: The results indicated no statistically significant correlations between the demographic characteristics and PBM test scores. Regarding perceived knowledge, the results of a one-way analysis of variance revealed that the effect of age, hierarchy of doctors, and education level were significant. In terms of subjective norms, a significant effect on education level was noted [t (129) = 2.28, p < 0.05], with graduate school graduates receiving higher scores than college graduates. An analysis of variance demonstrated the effects of hierarchy, education level, and medical specialty on perceived behavioral control. The results of the regression analyses revealed that perceived knowledge (ß = 0.32, p < 0.01) and subjective norms (ß = 0.22, p < 0.05) were significantly related to clinicians' behavioral intentions. CONCLUSIONS: This study revealed that factors affecting clinicians' blood transfusion management can be explained using the TPB-based questionnaire. This study demonstrated that physicians' perceptions of whether most people approve of PBM and their self-assessment of their PBM knowledge affect their intentions to proceed with PBM. According to this finding, a support system among physicians must be established and maintained to increase physicians' confidence in promoting PBM.

The trends in the incidence and thrombosis-related comorbidities of antiphospholipid syndrome: a 14-year nationwide population-based study.

BACKGROUND: This study aims to provide 14-year nationwide epidemiology data to evaluate the incidence ratio of APS in Taiwan and the condition of comorbidities by analyzing the National Health Insurance Research Database. METHODS: Nineteen thousand one hundred sixty-three patients newly diagnosed as having APS during the 2000-2013 period and 76,652 controls (with similar distributions of age and sex) were analyzed. RESULTS: The incidence of APS increased from 4.87 to 6.49 per 10,000 person-years in the Taiwan population during 2000-2013. The incidence of APS increased with age after 20 years old, especially in the female population, and it rose rapidly after age over 60 years old. In addition, APS cohorts presented a higher proportion of diabetes mellitus, hypertension, hyperlipidemia, stroke, heart failure, atrial fibrillation, myocardial infarction, PAOD, chronic kidney disease, COPD, deep vein thrombosis, pulmonary embolism, SLE, rheumatoid arthritis, Sjogren's syndrome, and polymyositis. CONCLUSIONS: Our study indicated an increasing trend in APS incidence among the Taiwanese population and a relationship between APS and potential comorbidities. This large national study found that the APS risk is heavily influenced by sex and age. Thus, the distinctive sex and age patterns might be constructive given exploring potential causal mechanisms. Furthermore, our findings indicate that clinicians should have a heightened awareness of the probability of APS, especially in women in certain age groups presenting with symptoms of APS.

Zwitterionized Nanofibrous Poly(vinylidene fluoride) Membranes for Improving the Healing of Diabetic Wounds.

This work presents nanofibrous membranes made of poly(vinylidene fluoride) (PVDF) and poly(2-methacryloyloxyethyl phosphorylcholine-co-methacryloyloxyethyl butylurethane) (PMBU) for promoting the healing of acute and chronic wounds. Membranes were prepared by an electrospinning process, which led to matrixes with a pore size mimicking the extracellular matrix. PMBU greatly improves the hydration of membranes, resulting in very low biofouling by protein or bacteria and enhanced blood compatibility while the cell viability remains close to 100%. This set of properties exhibited by the suitable combination of physical structure and material composition led to applying the zwitterionic nanofibrous membranes as wound-dressing materials for acute and chronic wounds. The results demonstrated that the zwitterionic membrane could compete with commercial dressings in terms of wound-healing kinetics and could outperform them with regard to the quality of new tissue. Histological analyses suggested that inflammation was reduced while proliferative and maturation phases were accelerated, leading to homogeneous re-epithelialization. This study unveils another potential biomedical application of antifouling zwitterionic membranes.

Rab11 activation by Ik2 kinase is required for dendrite pruning in Drosophila sensory neurons.

Neuronal pruning is a commonly observed phenomenon for the developing nervous systems to ensure precise wiring of neural circuits. The function of Ik2 kinase and its downstream mediator, Spindle-F (Spn-F), are essential for dendrite pruning of Drosophila sensory neurons during development. However, little is known about how Ik2/Spn-F signaling is transduced in neurons and ultimately results in dendrite pruning. Our genetic analyses and rescue experiments demonstrated that the small GTPase Rab11, especially the active GTP-bound form, is required for dendrite pruning. We also found that Rab11 shows genetic interactions with spn-F and ik2 on pruning. Live imaging of single neurons and antibody staining reveal normal Ik2 kinase activation in Rab11 mutant neurons, suggesting that Rab11 could have a functional connection downstream of and/or parallel to the Ik2 kinase signaling. Moreover, we provide biochemical evidence that both the Ik2 kinase activity and the formation of Ik2/Spn-F/Rab11 complexes are central to promote Rab11 activation in cells. Together, our studies reveal that a critical role of Ik2/Spn-F signaling in neuronal pruning is to promote Rab11 activation, which is crucial for dendrite pruning in neurons.

MoS2/graphene cathodes for reversibly storing Mg(2+) and Mg(2+)/Li(+) in rechargeable magnesium-anode batteries.

Commercial micron-scale low-cost MoS2 is subjected to an electrochemically derived 2H-to-1T phase transformation, which makes it capable of reversibly storing Mg(2+)/Li(+) and Mg(2+) in all-phenyl-complex (APC) electrolytes with and without Li(+), respectively. The MoS2/graphene composite shows a high capacity (225 mA h g(-1)) and great cyclic stability in the Li(+)-containing APC electrolyte.