Developing an entrustable professional activity for providing health education and consultation in occupational therapy and examining its validity.

BACKGROUND: Entrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity. METHODS: Nineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications. RESULTS: The TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed. CONCLUSION: The successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings.

Boosting the Interfacial Stability of the Li6PS5Cl Electrolyte with a Li Anode via In Situ Formation of a LiF-Rich SEI Layer and a Ductile Sulfide Composite Solid Electrolyte.

Due to its good mechanical properties and high ionic conductivity, the sulfide-type solid electrolyte (SE) can potentially realize all-solid-state batteries (ASSBs). Nevertheless, challenges, including limited electrochemical stability, insufficient solid-solid contact with the electrode, and reactivity with lithium, must be addressed. These challenges contribute to dendrite growth and electrolyte reduction. Herein, a straightforward and solvent-free method was devised to generate a robust artificial interphase between lithium metal and a SE. It is achieved through the incorporation of a composite electrolyte composed of Li6PS5Cl (LPSC), polyethylene glycol (PEG), and lithium bis(fluorosulfonyl)imide (LiFSI), resulting in the in situ creation of a LiF-rich interfacial layer. This interphase effectively mitigates electrolyte reduction and promotes lithium-ion diffusion. Interestingly, including PEG as an additive increases mechanical strength by enhancing adhesion between sulfide particles and improves the physical contact between the LPSC SE and the lithium anode by enhancing the ductility of the LPSC SE. Moreover, it acts as a protective barrier, preventing direct contact between the SE and the Li anode, thereby inhibiting electrolyte decomposition and reducing the electronic conductivity of the composite SE, thus mitigating the dendrite growth. The Li|Li symmetric cells demonstrated remarkable cycling stability, maintaining consistent performance for over 3000 h at a current density of 0.1 mA cm-2, and the critical current density of the composite solid electrolyte (CSE) reaches 4.75 mA cm-2. Moreover, the all-solid-state lithium metal battery (ASSLMB) cell with the CSEs exhibits remarkable cycling stability and rate performance. This study highlights the synergistic combination of the in-situ-generated artificial SE interphase layer and CSEs, enabling high-performance ASSLMBs.

Low-Temperature Methanolysis of Polycarbonate over Solid Base Sodium Aluminate.

Herein, a low-cost and readily available sodium aluminate (NaAlO2) was used as a solid base catalyst for the depolymerization of polycarbonate (PC) via methanolysis in the presence of tetrahydrofuran (THF) as a solvent. NaAlO2 was highly active for the reaction, and the performance was comparable to that of soluble strong base SrO and much higher than those of MgO and CaO. By the reaction over the catalyst, a highly pure and crystalline bisphenol A (BPA) was obtained. Among tested organic solvents, THF was the best in aiding PC methanolysis over NaAlO2 due to the polarity similar to PC according to Hansen solubility parameters (HSPs). At 60 °C, 98.1% PC conversion and 96.8% BPA yield were achieved within just 2 h. NaAlO2 was reusable without any severe catalyst deactivation in at least four runs. The mechanistic study revealed that the reaction proceeded via the methoxide pathway, with THF aiding the dissolution of PC. The reaction over NaAlO2 possessed a low apparent activation energy (Ea) of 75.1 kJ mol-1, which is the lowest ever reported so far for the reaction over solid catalysts.

Skin sympathetic nerve activity and ventricular arrhythmias in acute coronary syndrome.

BACKGROUND: Acute coronary syndrome (ACS) is major cause of ventricular arrhythmias (VAs) and sudden death. neuECG is a noninvasive method to simultaneously record skin sympathetic nerve activity (SKNA) and electrocardiogram. OBJECTIVE: The purpose of this study was to test the hypotheses that (1) ACS increases average SKNA (aSKNA), (2) the magnitude of aSKNA elevation is associated with VAs during ACS, and (3) there is a gender difference in aSKNA between patients without and with ACS. METHODS: We prospectively studied 128 ACS and 165 control participants. The neuECG was recorded with electrodes at Lead I configuration at baseline, during mental math stress, and during recovery (5 minutes for each phase). All recordings were done in the morning. RESULTS: In the control group, women have higher aSKNA than do men at baseline (0.82 ± 0.25 µV vs 0.73 ± 0.20 µV; P = .009) but not during mental stress (1.21 ± 0.36 µV vs 1.16 ± 0.36 µV; P = .394), suggesting women had lower sympathetic reserve. In comparison, ACS is associated with equally elevated aSKNA in women vs men at baseline (1.14 ± 0.33 µV vs 1.04 ± 0.35 µV; P = .531), during mental stress (1.46 ± 0.32 µV vs 1.33 ± 0.37 µV; P = .113), and during recovery (1.30 ± 0.33 µV vs 1.11 ± 0.30 µV; P = .075). After adjusting for age and gender, the adjusted odds ratio for VAs including ventricular tachycardia and ventricular fibrillation is 1.23 (95% confidence interval 1.05-1.44) for each 0.1 µV aSKNA elevation. aSKNA is positively correlated with plasma norepinephrine level. CONCLUSION: ACS is associated with elevated aSKNA, and the magnitude of aSKNA elevation is associated with the occurrence of VAs. Women have higher aSKNA and lower SKNA reserve than do men among controls but not among patients with ACS.

High Skin Sympathetic Nerve Activity in Patients with Recurrent Syncope.

(1) Background: The autonomic imbalance plays a role in vasovagal syncope (VVS) diagnosed by head-up tilting test (HUT). neuECG is a new method of recording skin electrical signals to simultaneously analyze skin sympathetic nerve activity (SKNA) and electrocardiogram. We hypothesize that SKNA is higher in subjects with tilt-positive than tilt-negative and the SKNA surges before syncope. (2) Methods: We recorded neuECG in 41 subjects who received HUT (according to the "Italian protocol"), including rest, tilt-up, provocation and recovery phases. Data were analyzed to determine the average SKNA (aSKNA, µV) per digitized sample. Electrocardiogram was used to calculate standard deviation of normal-to-normal beat intervals (SDNN). The "SKNA-SDNN index" was calculated by rest aSKNA multiplied by the ratio of tilt-up to rest SDNN. (3) Results: 16 of 41 (39%) subjects developed syncope. The aSKNA at rest phase is significantly higher in the tilt-positive (1.21 ± 0.27 µV) than tilt-negative subjects (1.02 ± 0.29 µV) (p = 0.034). There are significant surges and withdraw of aSKNA 30 s before and after syncope (both p ≤ 0.006). SKNA-SDNN index is able to predict syncope (p < 0.001). (4) Conclusion: Higher SKNA at rest phase is associated with positive HUT. The SKNA-SDNN index is a novel marker to predict syncope during HUT.

Lignin Biopolymer for the Synthesis of Iron Nanoparticles and the Composite Applied for the Removal of Methylene Blue.

In the current study, lignin, an abundant natural polymer, was dissolved in ethylene glycol and acidic H2O to form nanoscale lignin. Then, zero-valent iron (ZVI) nanoparticles were synthesized in nanoscale lignin, producing a nZVI/n-lignin composite, via the borohydride reduction method. The use of nZVI/n-lignin for environmental remediation was tested by the removal of methylene blue in aqueous solutions at room temperature. The nZVI/n-lignin composite achieved a higher methylene blue removal ratio than that achieved by traditional nZVIs. Moreover, its excellent dispersibility in water and stability against oxidation in the air were observed. The functions of the nanoscale lignin in the composite material are (1) prevention of further growth and aggregation of the nZVI nanoparticles, (2) protection of nZVI from serious oxidation by H2O/O2, and (3) allowing better dispersibility of nZVI in aqueous solutions. These three functions are important for the field applications of nZVI/n-lignin, namely, to travel long distances before making contact with environmental pollutants. The present method for producing nZVI/n-lignin is straightforward, and the combination of nZVI and lignin is an efficient and environmentally friendly material for environmental applications.

Association of Pulmonary Function Decline over Time with Longitudinal Change of Glycated Hemoglobin in Participants without Diabetes Mellitus.

Pulmonary damage and function impairment were frequently noted in patients with diabetes mellitus (DM). However, the relationship between lung function and glycemic status in non-DM subjects was not well-known. Here, we evaluated the association of longitudinal changes of lung function parameters with longitudinal changes of glycated hemoglobin (HbA1c) in non-DM participants. The study enrolled participants without prior type 2 DM, hypertension, and chronic obstructive pulmonary disease (COPD) from the Taiwan Biobank database. Laboratory profiles and pulmonary function parameters, including forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were examined at baseline and follow-up. Finally, 7055 participants were selected in this study. During a mean 3.9-year follow-up, FVC and FEV1 were significantly decreased over time (both p < 0.001). In the multivariable analysis, the baseline (unstandardized coefficient ß = -0.032, p < 0.001) and longitudinal change (unstandardized coefficient ß = -0.025, p = 0.026) of FVC were negatively associated with the baseline and longitudinal change of HbA1c, respectively. Additionally, the longitudinal change of FVC was negatively associated with the risk of newly diagnosed type 2 DM (p = 0.018). During a mean 3.9-year follow-up, our present study, including participants without type 2 DM, hypertension, and COPD, demonstrated that the baseline and longitudinal change of FVC were negatively and respectively correlated with the baseline and longitudinal change of HbA1c. Furthermore, compared to those without new-onset DM, participants with new-onset DM had a more pronounced decline of FVC over time.

One-Pot Synthesis of Chlorophyll-Assisted Exfoliated MoS2/WS2 Heterostructures via Liquid-Phase Exfoliation Method for Photocatalytic Hydrogen Production.

Developing strategies for producing hydrogen economically and in greener ways is still an unaccomplished goal. Photoelectrochemical (PEC) water splitting using photoelectrodes under neutral electrolyte conditions provides possibly one of the greenest routes to produce hydrogen. Here, we demonstrate that chlorophyll extracts can be used as an efficient exfoliant to exfoliate bulk MoS2 and WS2 to form a thin layer of a MoS2/WS2 heterostructure. Thin films of solution-processed MoS2 and WS2 nanosheets display photocurrent densities of -1 and -5 mA/cm2, respectively, and hydrogen evolution under simulated solar irradiation. The exfoliated WS2 is significantly more efficient than the exfoliated MoS2; however, the MoS2/WS2 heterostructure results in a 2500% increase in photocurrent densities compared to the individual constituents and over 12 h of PEC durability under a neutral electrolyte. Surprisingly, in real seawater, the MoS2/WS2 heterostructure exhibits stable hydrogen production after solar illumination for 12 h. The synthesis method showed, for the first time, how the MoS2/WS2 heterostructure can be used to produce hydrogen effectively. Our findings highlight the prospects for this heterostructure, which could be coupled with various processes towards improving PEC efficiency and applications.

Solar Power Can Substantially Prolong Maximum Achievable Airtime of Quadcopter Drones.

Sunlight energy is potentially excellent for small drones, which can often operate during daylight hours and fly high enough to avoid cloud blockade. However, the best solar cells provide limited power, compared to conventional power sources, making their use for aerial vehicles difficult to realize, especially in rotorcraft where significant lift ordinarily generated by a wing is already sacrificed for the ability to hover. In recent years, advances in materials (use of carbon-fiber components, improvement in specific solar cells and motors) have finally brought solar rotorcraft within reach. Here, the application is explored through a concise mathematical model of solar rotorcraft based on the limits of solar power generation and motor power consumption. Multiple solar quadcopters based on this model with majority solar power are described. One of them has achieved an outdoor airtime over 3 hours, 48 times longer than it can last on just battery alone with the solar cells carried as dead weight and representing a significant prolongation of drone operation. Solar-power fluctuations during long flight and their interaction with power requirements are experimentally characterized. The general conclusion is that solar cells have reached high enough efficiencies and can outperform batteries under the right conditions for quadcopters.

Assessment of agricultural waste-derived activated carbon in multiple applications.

To minimize waste production and reduce reliance on fossil fuels, agricultural waste such as rice straw has been actively used in biochemical production. In Taiwan, cellulosic waste has been used in anaerobic digestion for bioethanol production. This process produces a large amount of biomass-associated sludge that may become a serious environmental issue. Therefore, in this study, the anaerobic digestion sludge was recycled for the production of activated carbon via pyrolysis and activation by KOH. Surface characterization showed increased surface area and development of microporous structure upon activation. The FTIR image showed that high temperature activation eliminated most functional groups in the activated carbon, except for CO and C-O groups. The results showed that the activated carbon could be used for pollutant adsorbents such as molecular dyes (methylene blue: 217 mg g-1) and metal ions (copper: 169 mg g-1) from aqueous solution. In addition, the as-synthesized activated carbon can be used for CO2 capture and capacitor. Instead of focusing on one single application, we proposed that centralized production of activated carbon could be used in various applications, while further modification could be adopted depending on the need of its specific application.

Application of aluminum-supported Pd, Rh, and Rh-Pd nanoparticles in supercritical carbon dioxide system for hydrodebromination of polybrominated diphenyl ethers.

Al-powder-supported Pd, Rh, and Rh-Pd catalysts were synthesized through a spontaneous redox reaction in aqueous solutions. These catalysts hydrodebrominated 4- and 4,4'-bromodiphenyl ethers in supercritical carbon dioxide at 200 atm CO2 containing 10 atm H2 and 80 °C in 1 h. Diphenyl ether was the major product of Pd/Al. Rh/Al and Rh-Pd/Al further hydrogenated two benzene rings of diphenyl ether to form dicyclohexyl ether. The hydrogenolysis of CO bonds on diphenyl ether over Rh/Al and Rh-Pd/Al was observed to generate cyclohexanol and cyclohexane (<1%). With respect to hydrodebromination efficiency and catalyst stability, Rh-Pd/Al among three catalysts is suggested to be used for ex situ degradation of polybrominated diphenyl ethers in supercritical carbon dioxide.

Degradation of lindane and hexachlorobenzene in supercritical carbon dioxide using palladium nanoparticles stabilized in microcellular high-density polyethylene.

Palladium nanoparticles stabilized in microcellular high-density polyethylene prepared through supercritical foaming, supercritical impregnation, and H2 reduction are used for the hydrodechlorination of lindane and hexachlorobenzene in supercritical carbon dioxide below 100 °C. Both lindane and hexachlorobenzene can be almost 100% transformed to cyclohexane in 1 h. Reaction intermediates, such as lower chlorinated products or benzene, are not observed or exist in trace amount indicating that most of them may undergo reactions without leaving the metal surface.

Carbonate-H2O2 leaching for sequestering uranium from seawater.

Uranium adsorbed on amidoxime-based polyethylene fiber in simulated seawater can be quantitatively eluted at room temperature using 1 M Na2CO3 containing 0.1 M H2O2. This efficient elution process is probably due to the formation of an extremely stable uranyl-peroxo-carbonato complex in the carbonate solution. After washing with water, the sorbent can be reused with minimal loss of uranium loading capacity. Possible existence of this stable uranyl species in ocean water is also discussed.

Removing perfluorooctane sulfonate and perfluorooctanoic acid from solid matrices, paper, fabrics, and sand by mineral acid suppression and supercritical carbon dioxide extraction.

The removal of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) from solid matrices has received considerable attention because of the environmental persistence, bioaccumulation, and potential toxicity of these compounds. This study presents a simple method using concentrated HNO(3) as a suppression agent, and methanol-modified supercritical carbon dioxide (Sc-CO(2)) extraction for removing PFOS and PFOA from solid matrices. The optimal conditions were 16 M HNO(3) and 20% (v/v) methanol containing Sc-CO(2), under a pressure of 20.3 MPa and a temperature of 50 °C. Extraction time was set at 70 min (40 min for static and 30 min for dynamic extraction). PFOA and PFOS were identified and quantitated by liquid chromatography/mass spectrometry. The extraction efficiencies (with double extractions) were close to 100% for PFOA and 80% for PFOS for both paper and fabric matrices. The extraction efficiencies for sand were approximately 77% for PFOA and 59% for PFOS. The results show that this method is accurate, and effective, and that it provides a promising and convenient approach to remediate the environment of hazardous PFOA and PFOS contamination.

Fabrication of a form- and size-variable microcellular-polymer-stabilized metal nanocomposite using supercritical foaming and impregnation for catalytic hydrogenation.

This article presents the fabrication of size-controllable and shape-flexible microcellular high-density polyethylene-stabilized palladium nanoparticles (Pd/m-HDPE) using supercritical foaming, followed by supercritical impregnation. These nanomaterials are investigated for use as heterogeneous hydrogenation catalysts of biphenyls in supercritical carbon dioxide with no significant surface and inner mass transfer resistance. The morphology of the Pd/m-HDPE is examined using scanning electron microscopy images of the pores inside Pd/m-HDPE catalysts and transmission electron microscopy images of the Pd particles confined in an HDPE structure. This nanocomposite simplifies industrial design and operation. These Pd/m-HDPE catalysts can be recycled easily and reused without complex recovery and cleaning procedures.

Catalytic hydrodechlorination of dioxins over palladium nanoparticles in supercritical CO2 swollen microcellular polymers.

In this study, palladium nanoparticles embedded in monolithic microcellular high density polyethylene supports are synthesized as heterogeneous catalysts for remediation of 1,6-dichlorodibenzo-p-dioxin and 2,8-dichlorodibenzofuran in 200 atm of supercritical carbon dioxide containing 10 atm of hydrogen gas and at 50-90°C. Stepwise removal of chlorine atoms takes place first, followed by saturation of two benzene rings with slower reaction rates. The pseudo first order rate constant of initial hydrodechlorination for 2,8-dichlorodibenzofuran is 4.3 times greater than that for 1,6-dichlorodibenzo-p-dioxin at 78°C. The catalysts are easily separated from products and can be recyclable and reusable without complicated recovery and cleaning procedures.

Reductive dechlorination for remediation of polychlorinated biphenyls.

Technologies such as thermal, oxidative, reductive, and microbial methods for the remediation of polychlorinated biphenyls (PCBs) have previously been reviewed. Based on energy consumption, formation of PCDD/F, and remediation efficiency, reductive methods have emerged as being advantageous for remediation of PCBs. However, many new developments in this field have not been systematically reviewed. Therefore, reductive technologies published in the last decade related to remediation of PCBs will be reviewed here. Three categories, including catalytic hydrodechlorination with H(2), Fe-based reductive dechlorination, and other reductive dechlorination methods (e.g., hydrogen-transfer dechlorination, base-catalyzed dechlorination, and sodium dispersion) are specifically reviewed. In addition, the advantages of each remediation technology are discussed. In this review, 108 articles are referenced.

Uranium dioxide in ionic liquid with a tri-n-butylphosphate-HNO3 complex--dissolution and coordination environment.

Uranium dioxide can be dissolved directly in an imidazolium-based ionic liquid (IL) at room temperature with a tri-n-butylphosphate(TBP)-HNO(3) complex. The dissolution process follows pseudo first-order kinetics initially. Raman spectroscopic studies show the dissolved uranyl ions are coordinated with TBP in the IL phase with a molar ratio of (UO(2))(2+) : TBP = 1 : 2. The dissolved uranyl species can be effectively transferred to a supercritical fluid carbon dioxide (sc-CO(2)) phase. No aqueous phase is formed in either the IL dissolution or the supercritical fluid extraction process. Absorption spectra of the extracted uranyl species in the sc-CO(2) phase suggests the presence of a UO(2)(TBP)(2)(NO(3))(2) and HNO(3) adduct probably of the form UO(2)(TBP)(2)(NO(3))(2)·HNO(3). The adduct dissociates in a water-dodecane trap solution during pressure reduction resulting in UO(2)(TBP)(2)(NO(3))(2) collected in the dodecane phase.

Catalytic hydrogenation rate of polycyclic aromatic hydrocarbons in supercritical carbon dioxide containing polymer-stabilized palladium nanoparticles.

Catalytic hydrogenation of polycyclic aromatic hydrocarbons (PAHs) with up to four fused benzene rings over high-density-polyethylene-stabilized palladium nanoparticles in supercritical carbon dioxide via in situ UV/Vis spectroscopy is presented. PAHs can be efficiently converted to saturated polycyclic hydrocarbons using this green technique under mild conditions at 20 MPa of CO2 containing 1 MPa of H2 at 40-50°C. Kinetic studies based on in situ UV/Vis spectra of the CO2 phase reveal that the initial hydrogenation of a given PAH and the subsequent hydrogenations of its intermediates are pseudo-first-order. The hydrogenation rate of the latter is always much smaller than that of the former probably due to increasing steric hindrance introduced by the hydrogenated benzene rings of PAHs which impedes the adsorption process and hydrogen access to PAHs on catalyst surfaces.

Kinetic study of hydrodechlorination of chlorobiphenyl with polymer-stabilized palladium nanoparticles in supercritical carbon dioxide.

Hydrodechlorination of 4-chlorobiphenyl in supercritical fluid carbon dioxide (SF-CO(2)) catalyzed by palladium nanoparticles stabilized in high-density polyethylene beads proceeds by consecutive reactions to the final product bicyclohexyl. Each step of the reaction sequence, that is, 4-chlorobiphenyl --> biphenyl --> cyclohexylbenzene --> bicyclohexyl, follows pseudo-first-order kinetics. Arrhenius parameters of each reaction step were determined separately in SF-CO(2) by in situ absorption spectroscopy using a high-pressure fiber-optic cell. A simulation of product distributions using the first-order consecutive reaction equations was performed and compared with the experimental results obtained by GC/MS analysis of the 4-chlorobiphenyl reaction system. The differences are explained in terms of adsorption/desorption behavior of the intermediates on the catalytic metal surface with respect to the stereostructures of the molecules generated by a molecular mechanics method.