Aggregation-induced barrier to oxygen-a new AIE mechanism for metal clusters with phosphorescence.

Metal clusters are useful phosphors, but highly luminescent examples are quite rare. Usually, the phosphorescence of metal clusters is hindered by ambient O2 molecules. Transforming this disadvantage into an advantage for meaningful applications of metal clusters presents a formidable challenge. In this work, we used ligand engineering to judiciously prepare colour-tuneable and brightly emitting Cu(I) clusters that are ultrasensitive to O2 upon dispersion in a fluid solution or in a solid matrix. When the O2 scavenger dimethyl sulfoxide (DMSO) was used as the solvent, joint photo- and oxygen-controlled multicolour switches were achieved for the first time for metal cluster-based photopatterning and photo-anticounterfeiting. More importantly, an aggregation-induced barrier to oxygen, a new aggregation-induced emission mechanism for metal clusters, was proposed, providing a new pathway to realizing the intense emission of metal clusters in the aggregated state. These results are expected to promote the application of metal clusters and enrich the luminescence theory of metal cluster aggregates.

PFKFB4 Overexpression Facilitates Proliferation by Promoting the G1/S Transition and Is Associated with a Poor Prognosis in Triple-Negative Breast Cancer.

BACKGROUND: 6-Phosphofructo-2-kinase/fructose-2,6-biphosphate-4 (PFKFB4) is a key factor that plays an important role in tumorigenesis. However, its role in triple-negative breast cancer (TNBC) progression needs to be further validated. We investigated whether PFKFB4 is directly involved in the oncogenic signaling networks of TNBC. METHODS: First, we assessed the expression level of PFKFB4 in tumor tissue specimens by immunohistochemistry and evaluated its prognostic value. Next, the effect of PFKFB4 on TNBC cell growth and associated mechanisms were investigated. Finally, the results were further verified in vivo. RESULTS: We found that PFKFB4 overexpression was associated with an unfavorable prognosis in TNBC patients. PFKFB4 was overexpressed in TNBC cell lines in hypoxic environments, and its overexpression promoted tumor progression in vitro and in vivo. Further analyses demonstrated that the possible mechanism might be that PFKFB4 overexpression facilitates TNBC progression by enhancing the G1/S phase transition by increasing the protein level of CDK6 and phosphorylation of Rb. CONCLUSIONS: These data suggest that PFKFB4 plays significant roles in the tumorigenesis and development of TNBC.

Photoresponsive Propeller-like Chiral AIE Copper(I) Clusters.

A pair of propeller-like chiral trinuclear CuI clusters (R/S-Cu3) with unique photoinduced fluorescence enhancement were prepared. R/S-Cu3 showed intense variable luminescence after UV light irradiation, which was attributed to the stepwise oxidation of ligand in the clusters. It exhibited typical aggregation-induced emission (AIE) (αAIE =17.3). Mechanism studies showed that metal cluster-centered (MCC) and triplet metal-to-ligand charge-transfer (3 MLCT) processes are the origin of the luminescence; the processes are regulated by a restriction of intramolecular motions mechanism in a different state. The chiral structure and AIE feature endow R/S-Cu3 with remarkable circularly polarized luminescence (glum =2×10-2 ) in the aggregated state. It shows good capability for producing reactive oxygen species. This work enriches the kinds of atomically precise AIE clusters, gains insight into their luminescence mechanism, and offers the prospect of application in multifunctional materials.

A Type of Atypical AIEgen Used for One-Photon/Two-Photon Targeted Imaging in Live Cells.

Aggregation-induced emission luminogens (AIEgens) with a large electron donor and acceptor (D-A) conjugated system have been widely used in the development of organic light emitting diodes (OLEDs), chemosensors, and bioimaging materials due to their excellent properties such as high quantum yields, long emission wavelengths, controllable luminescence lifetimes, and nonlinear optics (NLO) properties. However, most of the AIE materials have been derived from limited classic AIE cores such as tetraphenylethene (TPE) and tetraphenylpyrazine (TPP), and thus, tedious syntheses or later modifications toward those AIEgens have always been unavoidable. In this report, a type of atypical AIEgens (designated as ASIQs) composed of large conjugated structures with a natural electron D-A system is disclosed, which shows large Stokes shifts, high photostabilities, excellent cell permeabilities, low biotoxicities, and good two-photon excited capacities, making them suitable for applications of one-photon/two-photon targeted imaging in live cells. In short, this work offers a type of atypical AIEgens which will possibly become an ideal platform leading to more structurally diverse and functionally excellent AIE-based luminescent materials.

Absorptive interactions of concurrent oral administration of (+)-catechin and puerarin in rats and the underlying mechanisms.

AIM: (+)-Catechin and puerarin are polyphenol and flavonoid, respectively, in green tea and foodstuffs. They exhibit potent antioxidant activity and are widely used for treating cardiocerebrovascular diseases. The aim of this work was to investigate the potential interactions between (+)-catechin and puerarin following concurrent oral administration in rats, and their absorption mechanisms in Caco-2 cell monolayers. METHODS: Pharmacokinetic studies were conducted in male rats received (+)-catechin (140 mg/kg, po) and/or puerarin (200 mg/kg, po). The cell uptake and transport behavior in Caco-2 cell monolayers and the interactions of the two compounds were analyzed. RESULTS: When (+)-catechin and puerarin were administered concurrently, the AUC0-12 h and Cmax values of puerarin were 2.48-fold and 3.91-fold, respectively, as large as those of puerarin alone; the AUC0-12 h and Cmax values of (+)-catechin were decreased to 57.62% and 77.55%, respectively, compared with those of (+)-catechin alone. In Caco-2 cell monolayers, (+)-catechin (300 and 600 µmol/L) significantly increased the cell uptake and transport of puerarin, whereas puerarin (300 and 600 µmol/L) significantly decreased the cellular uptake and transport of (+)-catechin. Furthermore, both cyclosporine A (P-glycoprotein inhibitor) and MK-571 (MRP-2 inhibitor) significantly increased the cellular uptake and transport of (+)-catechin and puerarin. CONCLUSION: Concurrent oral administration of (+)-catechin and puerarin significantly increased the absolute oral bioavailability of puerarin, but decreasing that of (+)-catechin. The competitive efflux of (+)-catechin and puerarin by P-glycoprotein and MRP-2 might lead to this interaction during their absorption process in the small intestine.

Perinatal and childhood risk factors for early-onset type 1 diabetes: a population-based case-control study in Taiwan.

BACKGROUND: Certain factors originating from the perinatal and childhood periods are suspected of contributing to the recent increasing trend of childhood type 1 diabetes (T1D) incidence. This study sought to investigate the relationships between various perinatal and childhood risk factors and T1D incidence in young children (<10 years). METHODS: We used a nested case-control design based on 1,478,573 live births born in 2000-05 in Taiwan. Cases were 632 incident cases of T1D between 2000 and 2008. Ten matched controls for each case were randomly selected. Information on various perinatal risk factors was also identified from claim data. Multiple conditional logistic regression was employed to estimate odds ratio (OR) and 95 confidence interval (CI) of T1D. RESULTS: Childhood infection was significantly associated with an increased risk of T1D (OR = 1.46, 95% CI = 1.23-1.73). Increased risk of T1D was also noted in children born to younger mothers (<25 years) (OR = 1.94, 95% CI = 1.34-2.81), older fathers (>30 years) (OR = 1.56 (95% CI = 1.16-2.10) to 1.57 (95% CI = 1.19-2.05), mothers with Caesarean section (CS) (OR = 2.35, 95% CI = 1.52-3.64), and mothers with gestational diabetes mellitus (OR = 4.36, 95% CI = 2.76-7.77). Fathers with T1D (OR = 7.36, 95% CI = 1.02-57.21) or type 2 diabetes (OR = 1.54, 95% CI = 1.04-2.26) were observed to substantially increase the risk of offspring T1D. CONCLUSIONS: Certain modifiable perinatal factors such as infection and CS may predispose incidence of T1D in young children.

Development and preliminary testing of an instrument to measure healthiness of lifestyle among breast cancer survivors.

Monitoring lifestyle to maintain health is an important issue for breast cancer survivors. No multidimensional instrument has previously been available specifically for assessing overall healthiness of lifestyle among breast cancer survivors. This study aims (i) to establish the Healthy Lifestyle Instrument for Breast Cancer Survivors (HLI-BCS) and (ii) to examine the reliability and validity of the established scale. A quantitative cross-sectional design was used. This project was conducted in four phases. In phase I, using the Health-Promoting Lifestyle Profile as the core concept, we created 50 preliminary measurement items. In phase II, we invited 10 breast cancer survivors and five professional experts to conduct a content validity assessment. In phases III and IV, a total of 220 breast cancer survivors were enrolled to assess the construct validity and the internal consistency and reliability. The final HLI-BCS contains 20 items across five domains: dietary habits, environment and physiology, health responsibility and stress management, social and interpersonal relations and spiritual growth. Through the information presented in the HLI-BCS, breast cancer survivors can assess their lifestyles on multiple dimensions and subsequently adjust their lifestyles to enhance their recovery and quality of life.

The effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction of patients undergoing cardiac catheterisation.

AIMS AND OBJECTIVES: To evaluate the effectiveness of an accessibility-enhanced multimedia informational educational programme in reducing anxiety and increasing satisfaction with the information and materials received by patients undergoing cardiac catheterisation. BACKGROUND: Cardiac catheterisation is one of the most anxiety-provoking invasive procedures for patients. However, informational education using multimedia to inform patients undergoing cardiac catheterisation has not been extensively explored. DESIGN: A randomised experimental design with three-cohort prospective comparisons. METHODS: In total, 123 consecutive patients were randomly assigned to one of three groups: regular education; (group 1), accessibility-enhanced multimedia informational education (group 2) and instructional digital videodisc education (group 3). Anxiety was measured with Spielberger's State Anxiety Inventory, which was administered at four time intervals: before education (T0), immediately after education (T1), before cardiac catheterisation (T2) and one day after cardiac catheterisation (T3). A satisfaction questionnaire was administrated one day after cardiac catheterisation. Data were collected from May 2009-September 2010 and analysed using descriptive statistics, chi-squared tests, one-way analysis of variance, Scheffe's post hoc test and generalised estimating equations. RESULTS: All patients experienced moderate anxiety at T0 to low anxiety at T3. Accessibility-enhanced multimedia informational education patients had significantly lower anxiety levels and felt the most satisfied with the information and materials received compared with patients in groups 1 and 3. A statistically significant difference in anxiety levels was only found at T2 among the three groups (p = 0·004). CONCLUSIONS: The findings demonstrate that the accessibility-enhanced multimedia informational education was the most effective informational educational module for informing patients about their upcoming cardiac catheterisation, to reduce anxiety and improve satisfaction with the information and materials received compared with the regular education and instructional digital videodisc education. RELEVANCE TO CLINICAL PRACTICE: As the accessibility-enhanced multimedia informational education reduced patient anxiety and improved satisfaction with the information and materials received, it can be adapted to complement patient education in future regular cardiac care.

Participation in decision making as a property of complex adaptive systems: developing and testing a measure.

Objectives. To (1) describe participation in decision-making as a systems-level property of complex adaptive systems and (2) present empirical evidence of reliability and validity of a corresponding measure. Method. Study 1 was a mail survey of a single respondent (administrators or directors of nursing) in each of 197 nursing homes. Study 2 was a field study using random, proportionally stratified sampling procedure that included 195 organizations with 3,968 respondents. Analysis. In Study 1, we analyzed the data to reduce the number of scale items and establish initial reliability and validity. In Study 2, we strengthened the psychometric test using a large sample. Results. Results demonstrated validity and reliability of the participation in decision-making instrument (PDMI) while measuring participation of workers in two distinct job categories (RNs and CNAs). We established reliability at the organizational level aggregated items scores. We established validity of the multidimensional properties using convergent and discriminant validity and confirmatory factor analysis. Conclusions. Participation in decision making, when modeled as a systems-level property of organization, has multiple dimensions and is more complex than is being traditionally measured. Managers can use this model to form decision teams that maximize the depth and breadth of expertise needed and to foster connection among them.

Sleep Quality among Female Hospital Staff Nurses.

Purpose. To investigate sleep quality of hospital staff nurses, both by subjective questionnaire and objective measures. Methods. Female staff nurses at a regional teaching hospital in Northern Taiwan were recruited. The Chinese version of the pittsburgh sleep quality index (C-PSQI) was used to assess subjective sleep quality, and an electrocardiogram-based cardiopulmonary coupling (CPC) technique was used to analyze objective sleep stability. Work stress was assessed using questionnaire on medical worker's stress. Results. A total of 156 staff nurses completed the study. Among the staff nurses, 75.8% (117) had a PSQI score of ≥5 and 39.8% had an inadequate stable sleep ratio on subjective measures. Nurses with a high school or lower educational degree had a much higher risk of sleep disturbance when compared to nurses with a college or higher level degree. Conclusions. Both subjective and objective measures demonstrated that poor sleep quality is a common health problem among hospital staff nurses. More studies are warranted on this important issue to discover possible factors and therefore to develop a systemic strategy to cope with the problem.

[Progress in application of microbeam X-ray fluorescence spectroscopy in forensic science].

Microbeam X-ray fluorescence (micro-XRF) spectrometry has been raised as an analytical technique of microbeam during the recent years. With its advantages of high sensitivity, small sample requirement, high testing accuracy and non-destruction, the technique is widely utilized in forensic science. This review bases on recent researches at home and abroad, describes its applications including identification of gunshot residue, visualization of fingerprints, discrimination of drug source, production process, and other material evidences of analysis in crime scene. Thanks to the advances in technology, intelligent and portable micro-XRF equipment has appeared to be applied. It is believed that it may be more popular and frequent in administration of forensic science in the near future.

Age- and sex-specific risks of colorectal cancers in diabetic patients.

Diabetes has been reported to increase the risk of colorectal neoplasm in most but not all studies. However, the data on age- and sex-specific incidence rates and relative risks associated with diabetes are limited. We carried out this population-based cohort study to investigate the overall sex- and age-specific risks of colorectal cancer in association with diabetes. Diabetic patients (n = 615,532) and age- and sex-matched control individuals (n = 614,871), selected from the claim datasets, were followed up from 2000 to 2006. The rates of admission due to colon and rectum cancers were estimated using the person-years approach, and the age- and sex-specific hazard ratio (HR) for both the malignancies were determined using the Cox regression model. The overall incidence rate of colon cancer was 9.94 per 10,000 patient-years for the diabetic patients, as opposed to 7.84 per 10,000 patient-years for the control-group patients. The corresponding observation for rectal cancer was 7.16 and 6.28 per 10,000 patient-years. Diabetic patients aged ≥ 45 years had significantly high HRs for developing colon cancer (1.20-1.45-fold). We also noted a significantly high HR of rectal cancer in diabetic men (1.18-fold) aged ≥ 45 years, but not in diabetic women. In conclusion, diabetes may significantly increase the risk of colorectal cancer, especially in patients aged 45-64 years. Diabetologists should keep this relationship in mind while treating middle-aged diabetic men and should also advise these patients to undergo regular screening tests for colorectal cancer.

Risk of Parkinson disease onset in patients with diabetes: a 9-year population-based cohort study with age and sex stratifications.

OBJECTIVE: We retrospectively assessed the age- and sex-specific incidence and relative risk of Parkinson disease (PD) in Taiwan's diabetic population. RESEARCH DESIGN AND METHODS: Study cohort included 603,416 diabetic patients and 472,188 nondiabetic control subjects. Incidence rate and relative risk of PD (ICD-9-CM 332.0) were evaluated. RESULTS: The incidence of PD was 3.59 and 2.15 per 10,000 person-years for the diabetic and control group, respectively, representing a covariate adjusted hazard ratio (HR) of 1.61 (95% CI 1.56-1.66), which was substantially reduced to 1.37 (1.32-1.41) after adjusting for medical visits. Diabetes was associated with a significantly elevated risk of PD in all sex and age stratifications except in young women, with the highest HR noted for young men aged 21-40 years (2.10 [1.01-4.42]), followed by women aged 41-60 (2.05 [1.82-2.30]) and >60 years (1.65 [1.58-1.73]). CONCLUSIONS: Diabetes is associated with an increased risk of PD onset in a Chinese population, and the relation is stronger in women and younger patients.

Incidence and recurrence of acute otitis media in Taiwan's pediatric population.

OBJECTIVE: To report the incidence and recurrence of acute otitis media (AOM) in Taiwan's pediatric population. METHODS: Information from children (aged <= 12 years) with a diagnosis of AOM was retrieved from the 2006 National Healthcare Insurance claims database. We calculated the cumulative incidence rate and the incidence density rate of recurrent AOM within one year after the initial diagnosis in 2006. We used a multivariate logistic regression model to assess the predictors for recurrence of AOM. RESULTS: The annual incidence rate of AOM was estimated to be 64.5 cases per 1,000 children. The overall one-year cumulative incidence rate of recurrence was 33.1%, and the incidence density rate was 33.5 cases per 100 person-years, with the highest figure (41.2 cases per 100 person-years) noted for children aged 0-2 years. Recurrence was significantly associated with age, gender, place of treatment, and physician specialty. CONCLUSION: AOM remains a major threat to children's health in Taiwan. Male children and very young children require more aggressive preventive strategies to reduce the risk of recurrence.

Prevalence and associated factors of sexual dysfunction in cervical cancer patients.

INTRODUCTION: Cervical cancer (CC), compared with other gynecological cancers, has critical implications for women's sexual lives. For most Asian people, the issue of sexual dysfunction (SD) is treated as a taboo especially in a conservative culture. As a result, little is known about the prevalence of SD among CC patients. AIMS: The purpose of this study was to investigate the prevalence of SD and associated factors among CC patients. METHODS: We used a cross-sectional correlation design with the purposive sampling to recruit 105 CC patients from a hospital in Northern Taiwan. A structured questionnaire was used in this study to collect demographic data, disease characteristics, and information provided by the Chinese version of the Female Sexual Function Index scale. Data were analyzed by descriptive statistics, independent t-test, chi-square test, and multiple logistic regression. MAIN OUTCOME MEASURE: The prevalence of SD and the main predictors for SD were determined. RESULTS: The crude prevalence and age-standardized prevalence of SD were 66.67% and 55%, respectively. CC patients with a lower level of education (≤9th grade) (adjusted odds ratio [AOR]: 3.14; 95% confidence interval [CI]: 1.51-10.37), who were older (AOR: 1.16; 95% CI: 1.07-1.25), who had received no sexual-counseling services prior to therapy or later (AOR: 4.98; 95% CI: 2.31-9.71), or were stage II or above (AOR: 4.34; 95% CI: 1.65-19.09) showed a significantly higher risk of SD compared with those without these conditions. CONCLUSIONS: Our findings are beneficial to health-care providers by identifying the prevalence of SD and by pinpointing those groups with a higher predisposition of having SD, which will allow the provision of appropriate rehabilitation.

Incidence and recurrence of acute otitis media in Taiwan's pediatric population

OBJECTIVE: To report the incidence and recurrence of acute otitis media (AOM) in Taiwan's pediatric population. METHODS: Information from children (aged <= 12 years) with a diagnosis of AOM was retrieved from the 2006 National Healthcare Insurance claims database. We calculated the cumulative incidence rate and the incidence density rate of recurrent AOM within one year after the initial diagnosis in 2006. We used a multivariate logistic regression model to assess the predictors for recurrence of AOM. RESULTS: The annual incidence rate of AOM was estimated to be 64.5 cases per 1,000 children. The overall one-year cumulative incidence rate of recurrence was 33.1 percent, and the incidence density rate was 33.5 cases per 100 personyears, with the highest figure (41.2 cases per 100 person-years) noted for children aged 0-2 years. Recurrence was significantly associated with age, gender, place of treatment, and physician specialty. CONCLUSION: AOM remains a major threat to children's health in Taiwan. Male children and very young children require more aggressive preventive strategies to reduce the risk of recurrence.

A pilot study of a case management program for patients with chronic obstructive pulmonary disease (COPD).

The purpose of this study was to develop a case management program for patients with chronic obstructive pulmonary disease (COPD) and to test the effects of the developed program on patient length of stay in the hospital, medical costs, disease knowledge and level of satisfaction with nursing care received. This quasi-experimental study focused on a group of 50 COPD patients (24 in the control group and 26 in the experimental one), all treated in one hospital medical ward in northern Taiwan. The control group received routine care, while those in the experimental group received a COPD case management protocol. Data for the control group was collected between September of 2003 and January 2004. Data for the experimental group was collected between April and December 2004. Data collection instruments included medical records, the COPD Knowledge Measurement scale, and the Patient Satisfaction with Nursing Care Questionnaire. Descriptive and inferential statistical analyses were applied to describe demographics, length of stay, medical cost, patient disease-related knowledge, and patient satisfaction with nursing care. Results indicated that, while the study found no significant difference in length of stay and medical cost between the two groups, the use of case management procedures improved patient disease-related knowledge and satisfaction with nursing care. This conclusion supports the premise that case management improves patient care in these two dimensions and is, thus, an effective approach in the management of patients diagnosed with secondary COPD infections.

Retention and attrition of certified care assistants in the long-term care industry from the Taipei area: an interview survey.

BACKGROUND/OBJECTIVES: The question, "do certified care assistants (CCAs), after finishing their training, devote themselves to the long-term care industry in accordance with the original expectations?", is still unknown. Few studies have focused on CCAs who have left the long-term care industry. The purposes of this study were to identify the employment status of CCAs over the January 2000-July 2002 time period who had undergone a training program sometime in 1999 and to explore the factors affecting whether the CCAs stay or leave the long-term care industry in the Taipei area. Understanding retention and attrition of CCAs is important for developing the strategies of managing manpower in this industry. DESIGN/SETTING/PARTICIPANTS: A descriptive survey design was conducted to telephone interview 826 CCAs who had trained during the 1999 certification training program in Taipei area. Three hundred and thirteen participants (an interview-completed rate of 38%) provided usable data. METHODS: A structured interview schedule was developed by authors for interview. Descriptive statistics and chi(2) test were adopted to report the subjects' characteristics and factors that influenced his/her intention to stay or leave this industry. RESULTS: One hundred and sixty-eight respondents (53.7%) had still stayed in this industry, while 145 respondents (46.3%) had left already. Major reasons for staying were personal interest in caring elderly, good financial benefits from the facility, and supportive leadership. In contrast, low wages, heavy workloads, long working hours, a high level of stress, and poor financial benefits were factors contributing to careers leaving this industry. CONCLUSIONS: Many factors affected whether CCAs stayed or left, including personal factors, work-related factors, the welfare system, the managerial system, the leadership style and the work environment. However, the sequence of these factors and their importance were different between two groups. This study has significant implications for managing the manpower of the long-term care industry.