Enhancing subthreshold slope and ON-current in a simple iTFET with overlapping gate on source-contact, drain Schottky contact, and intrinsic SiGe-pocket.

In this paper, we present a new novel simple iTFET with overlapping gate on source-contact (SGO), Drain Schottky Contact, and intrinsic SiGe pocket (Pocket-SGO iTFET). The aim is to achieve steep subthreshold swing (S.S) and high ION current. By optimizing the gate and source-contact overlap, the tunneling efficiency is significantly enhanced, while the ambipolar effect is suppressed. Additionally, using a Schottky contact at the drain/source, instead of ion implantation drain/source, reduces leakage current and thermal budget. Moreover, the tunneling region is replaced by an intrinsic SiGe pocket posing a narrower bandgap, which increases the probability of band-to-band tunneling and enhances the ION current. Our simulations are based on the feasibility of the actual process, thorough Sentaurus TCAD simulations demonstrate that the Pocket-SGO iTFET exhibits an average and minimum subthreshold swing of S.Savg = 16.2 mV/Dec and S.Smin = 4.62 mV/Dec, respectively. At VD = 0.2 V, the ION current is 1.81 [Formula: see text] 10-6 A/µm, and the ION/IOFF ratio is 1.34 [Formula: see text] 109. The Pocket-SGO iTFET design shows great potential for ultra-low-power devices that are required for the Internet of Things (IoT) and AI applications.

Association Among Work Characteristics, Role Transition, and Job Burnout in Nurse Practitioners in Taiwan.

Workplace burnout is common among nurse practitioners (NPs) and often occurs during role transition from a registered nurse to an NP. This study aimed to explore the predictors of job burnout in nurse practitioners (NPs). A quantitative cross-sectional design was conducted on 361 convenience sample of NPs from four hospitals in central Taiwan. Data on the demographic and working characteristics (hospital grade, years of experience as an RN and NP, practice setting, working shifts, working hours, average number of patients take care, salary, and performance bonus), Chinese version of the Nurse Practitioner Role Transition Scale, and Occupational Burnout Inventory were used. The enrolled NPs showed medium-level role transition scores (mean = 65.73, SD = 9.59), and the prevalence of personal burnout, client-related burnout, and over-commitment was 51.2%, 19.4%, and 49.9%, respectively. Role transition, hospital grade, practice setting, working hours, and number of patients take care were significant predictors of personal burnout, client-related burnout, and over-commitment after adjusting for cofounding variables, possibly explaining 52.8%, 42.1%, and 36.3% of variance, respectively. Hospital administrators should provide necessary assistance to help NPs transition to new role and ensure a positive work environment and reasonable workload so as to prevent the impact of job burnout on NPs.

The impact of organisational commitment and leadership style on job satisfaction of nurse practitioners in acute care practices.

AIM: This study aimed to determine the main factors that affect nurse practitioners' (NPs) job satisfaction, especially the relationship between organisational commitment and leadership styles in acute care practices. BACKGROUND: There is little known about the influence of organisational commitment and leadership on NPs' job satisfaction within acute care hospitals. METHODS: A cross-sectional design with a national online survey enrolled 1205 NPs from the Taiwan Association of Nurse Practitioners. A multiple regression model was applied to identify potential variables that associated with job satisfaction. RESULTS: Organisational commitment (mean = 59.47), job satisfaction (mean = 173.47) and leadership style (mean ranged from 13.29 to 28) were at a moderate level. Organisational commitment, leadership style, patient load and NP advancement levels explained 63% of the variance in NPs' job satisfaction. CONCLUSIONS: Organisational commitment and leadership styles, such as idealized influence and individual consideration, are major factors that impact NPs' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Health care organisations should develop policies targeting organisational commitment and managers' leadership styles to improve NPs' job satisfaction.

Prediction factors of weight control intention in Chinese young adults.

BACKGROUND: Weight control is a widespread phenomenon among young adults, especially in women. AIM: This study aimed to determine the prediction factors of weight control intention in a young Chinese sample. METHODS: A cross-sectional study was conducted with 963 (276 male and 687 female; mean age 21.8 ± 4.4 years) adult students from a university in Taiwan. The data were collected from October 2016 to January 2017. Body mass index (BMI), the Chinese version of the Weight Self-Stigma Questionnaire, the Body Areas Satisfaction Scale and the Media Influence Questionnaire were used as data collection instruments. RESULTS: The participants with weight control intention had higher BMI, weight self-stigma and media influence scores and lower body satisfaction scores than those without the intention. Female sex, BMI, weight self-stigma, body satisfaction and media influence were significant predictors of weight control intention for all participants. CONCLUSION: Before conducting weight loss programmes, the perception of weight self-stigma and the influence of social media on body image should be confirmed, particularly in women with intention to lose weight.

Altered Mineral Metabolism and Disequilibrium Between Calcification Promoters and Inhibitors in Chronic Hemodialysis Patients.

Patients undergoing long-term hemodialysis (HD) are known to have abnormal blood concentrations of antioxidant minerals; concurrent oxidative stress can contribute to increased vascular calcification. This study aims to evaluate the associations between circulating antioxidant minerals and clinical biomarkers of vascular calcification in HD patients. Blood biochemical parameters, antioxidant minerals (selenium (Se), zinc (Zn), copper (Cu), and magnesium (Mg)), and several promoters and inhibitors of calcification (matrix Gla protein (MGP), fibroblast growth factor-23 (FGF-23), matrix metalloproteinases (MMP-2 and -9), and tissue inhibitors of metalloproteinase (TIMP-1 and -2)) were determined in HD patients (n = 62) and age- and sex-matched healthy individuals (n = 30). Compared with healthy subjects, HD patients had significantly lower plasma concentrations of Se and Zn, increased Cu and Mg, and higher levels of oxidative stress and inflammatory markers (Cu/Zn ratios, malondialdehyde (MDA), advanced glycation end products (AGEs), and C-reactive protein (CRP)). We observed that HD patients had significantly lower concentrations of MGP and higher levels of FGF-23, MMP-2 and -9, TIMP-1 and -2, and MMP-2/TIMP-2 and MMP-9/TIMP-1 ratios. We also observed significant relationships between the concentrations of these minerals and calcification biomarkers in HD patients. These results suggest that changes in the homeostasis of antioxidant minerals (Se, Zn, Cu, and Mg) may contribute to the effects of oxidative stress and inflammatory status, thereby participating in the mechanism for accelerated vascular calcification in patients undergoing long-term HD.

Prognostic association of demographic and clinical factors with the change rates of symptoms and depression among patients with hepatocellular carcinoma.

PURPOSE: To identify the predictive value of demographic and clinical factors for determining changes in physical and depressive symptom among hepatocellular carcinoma (HCC) patients over time. METHODS: We performed a prospective cohort study of 128 patients newly diagnosed with HCC in Taiwan. Each patient had four time-point data after the follow-up. Patients' physical symptoms were evaluated with the Edmonton Symptom Assessment System (ESAS). Psychological symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). Clinical factors and demographic characteristics were predictors of physical and psychological symptoms, as estimated by a generalized estimating equation (GEE). RESULTS: We found that patients who had a smoking habit and Barcelona Clinic Liver Cancer (BCLC) Stage B disease underwent radiofrequency ablation therapy (RFA) or liver resection, and those who had higher alanine aminotransferase (GPT) level reported more symptoms from baseline to 1 month. Symptoms increased from baseline to 3 months in elderly patients and patients with higher GPT levels. Additionally, patients who had jobs, underwent liver resection, and had BCLC Stage C disease had increased symptoms of depression from baseline to 1 month; in particular, BCLC Stage D disease had negative long-term effects on depression scores from baseline to four-time points following therapy. CONCLUSION: Advanced BCLC stage and undergoing RFA or liver resection were most closely associated with worsening physical and psychological symptoms over time. Clinical professionals should pay attention to these factors that affect physical and psychological symptoms during treatment.

The Lifestyle Change Experiences of Cancer Survivors.

BACKGROUND: Leading a healthy lifestyle not only alleviates the physical problems but also improves the quality of life of cancer survivors. Healthcare professionals should understand the benefits of altering lifestyle behaviors to provide effective intervention programs to assist cancer survivors to improve their health. PURPOSE: The aim of this study was to understand the experiences of cancer survivors in changing their lifestyle after a cancer diagnosis. METHODS: A qualitative descriptive study was conducted on 13 cancer survivors who were sampled purposively from a regional teaching hospital in central Taiwan. Data were collected using in-depth interviews that were guided by semistructured, open-ended questions and analyzed using content analysis. RESULTS: The analysis of interview data revealed four main themes: motivation of lifestyle change, exploring ways toward a healthy lifestyle, making adjustments in lifestyle, and feeling the benefits of lifestyle changes. In striving for survival, an unwillingness to bear the suffering from treatment and their acceptance of responsibility and gratitude to family members prompted most of the participants to change their lifestyle proactively. They had received inadequate lifestyle guidance and sought health lifestyle information on their own. After a period of research and self-contemplation, most of the participants adopted a consistently healthy lifestyle, changed their dietary consumption habits, abstained from tobacco and alcohol, and managed emotional problems that were caused by the disease. Participants who changed to a healthy lifestyle realized benefits in the physical, emotional, and life domains. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: It is hoped that these findings help healthcare professionals to better appreciate that a cancer diagnosis is a critical opportunity to link the disease to lifestyle choices in the minds of cancer survivors. Healthcare professionals should ask cancer survivors about their lifestyle and then provide appropriate advice and education on healthy lifestyles and related benefits.

Validating a Chinese version of the Weight Self-stigma Questionnaire for use with obese adults.

BACKGROUND: Although weight-based stigmatization is pervasive in everyday life, a suitable measure of weight self-stigma is currently unavailable for the obese Chinese population. AIMS: The purpose of this study was to translate and test the psychometric properties of the Weight Self-stigma Questionnaire into Chinese (C-WSSQ) for use with obese Chinese people. METHODS: A cross-sectional study was conducted on 156 overweight or obese adults. The data were collected from September to December 2015. Data on the body mass index, C-WSSQ, and Multidimensional Body Self-relation Questionnaire were used. RESULTS: The reproducibility and Cronbach a of the C-WSSQ were .892 and .880, respectively, indicating acceptable reliability. The exploratory factor analysis revealed that 2 extracted factors identified to the domain structures of the C-WSSQ, as explained by the 67.05% total variance. The C-WSSQ also demonstrated that the 2-factor model, self-devaluation, and fear of enacted stigma fit the data on the basis of confirmatory factor analysis. Meanwhile, the C-WSSQ was correlated with body mass index and Multidimensional Body Self-relation Questionnaire, indicating an acceptable criterion-related validity. CONCLUSION: The C-WSSQ shows adequate reliability and validity. The health professionals can use the C-WSSQ to assess weight self-stigma of obese Chinese adults before and after intervention of a weight-loss program.

Associations among depression, obesity, and metabolic syndrome in young adult females.

Depression may be a risk factor for obesity or metabolic syndrome. The aims of this study were to determine the relationships among depression, obesity, and metabolic syndrome in young adult females as well as the role of depression in the components of metabolic syndrome. A cross-sectional study was conducted on 323 young adult females. Demographic characteristics, anthropometric measurements, and laboratory values were collected. The criteria of the Bureau of Health Promotion, Department of Health, Taiwan, were used to define metabolic syndrome. Depression was measured using the Center for Epidemiologic Studies Depression scale. The prevalence of depression in the sample was 17%, that of overweight and obesity was 17%, and that of metabolic syndrome was 6.8%. Depression showed significant associations with high body mass index (BMI), increased waist circumference and blood pressure (BP), and overweight and obesity (ß = 0.15, odds ratio [OR] = 1.17, 95% confidence interval [CI] = [1.11, 1.23], p < .001). No associations were observed between depression and metabolic syndrome (ß = -0.01, OR = 0.99, 95% CI = [0.92, 1.06], p = .69) or any of its individual components after adjustment for BMI and demographic variables. The findings show that depression was associated with increasing odds of overweight and obesity in young adult females and may also have increased the physiological risk associated with metabolic syndrome. Early detection of depression and obesity as part of metabolic syndrome is important in the health management of young adult females for decreasing the risks of cardiovascular disease and diabetes.

Nutritional supplement therapy improves oxidative stress, immune response, pulmonary function, and quality of life in allergic asthma patients: an open-label pilot study.

OBJECTIVE: To examine the effects of nutritional supplement therapy on oxidant-antioxidant status, inflammation and immune system responses, pulmonary function, and health-related quality of life in patients with mild to moderate allergic asthma. METHODS: Adult asthma patients (n=30) received daily multiple nutrient supplements for two months. Age- and gender-matched healthy controls (n=30) did not receive any supplements. Enzymatic and non-enzymatic antioxidant status, malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), immunoglobulin E (IgE) and T-lymphocyte subsets, pulmonary function indices, as well as scores for asthma control and quality of life, were assessed at baseline, at one month of treatment, and at two months of treatment, which was also the end of the study. RESULTS: At baseline, asthma patients had significantly higher IgE, MDA, copper (Cu), hs-CRP, and CD19 and CD4/CD8 lymphocyte ratios, and decreased selenium (Se), zinc (Zn), ß-carotene, vitamins C and E, and catalase, glutathione peroxidase (GPx) and glutathione reductase (GR) activities compared to healthy controls (p < 0.05). During the study period, asthmatics showed non-significantly increased pulmonary function and a trend toward lower IgE levels, markedly reduced MDA, Cu, hs-CRP, and CD19 and CD4/CD8 ratios, and increases in levels of Se, Zn, ß-carotene, vitamins C and E, and enzymatic antioxidant activities. Also, their asthma control and health-related quality-of-life scores increased significantly by the end of the study. CONCLUSION: Our results indicate that nutritional supplement therapy may improve dysregulated oxidant and antioxidant status, inflammation and immune responses, pulmonary function, and health-related quality of life in patients with mild to moderate allergic asthma.

Trace metal imbalance associated with oxidative stress and inflammatory status in anti-hepatitis C virus antibody positive subjects.

Toxic and essential trace metals, oxidative stress, and inflammatory status were evaluated in anti-hepatitis C virus (HCV) antibody-positive subjects. Blood biochemical parameters were determined in anti-HCV antibody-positive (n=17) and -negative controls (n=46). Compared with controls, anti-HCV antibody-positive individuals had significantly lower concentrations of plasma zinc (Zn); higher copper (Cu), iron (Fe), lead (Pb), cadmium (Cd), and aluminum (Al); and lower activities of erythrocyte antioxidant enzymes glutathione peroxidase and catalase, and elevated superoxide dismutase. Significantly increased lipid peroxidation malondialdehyde (MDA), and inflammatory markers such as alanine aminotransferase (ALT), high sensitivity C-reactive protein (hs-CRP), ferritin, and Cu/Zn ratios, as well as decreased albumin and high density lipoprotein (HDL) concentrations were observed. We have found significant interactions between toxic (e.g., Pb, Cd, and Al) and essential metals (e.g., Zn, Cu, Fe), which correlated with MDA. In conclusion, anti-HCV antibody-positive subjects had abnormal distributions of trace metals that may aggravate oxidative stress and inflammation, and exacerbate hepatic damage.

[Psychiatric patient continuum community care in Taichung Country].

Deinstitutionalization and the implementation of community psychiatry rehabilitation models define the future of psychiatric medical care in Taiwan. As such, managing and caring for psychiatric patients at the community level are increasingly important public health issues for county and city governments. A local public health authority in Taichung County established a collaborative relationship with a university-level nursing department during 2007 - 2008 in order to provide more effective continuous community care for psychiatric patients. This cooperative arrangement provided continuous community care for psychiatric patients in the County by implementing aftercare for psychiatric patients that was delivered through community-level public health centers, which conducted patient visits, developed discharge notifications for severe psychiatric patients in mental health institutions, and strengthened connections among related resources. To establish continuous community care for psychiatric patients, it is necessary to enhance training and support for health recipients as well as nursing staff in public health centers through measures that include: implementing discharge preparations and notifications in mental health institutions, improving the quality of community-based psychiatric patient visits, and connecting and integrating relevant resources effectively.

[Discharge planning: practical implementation in psychiatric care].

Care extension programs that bridge hospitals into the community are today a mainstream component of psychiatric care around the world. Stronger linkages amongst community resources can help patients and their families transition successfully through the hospital discharge process and reenter the community. Discharge planning is a service that provides the needs-oriented care necessary to link the hospital and community. Such planning, handled in accordance with case management procedures, focuses on medical team cooperation, follow-up services and recovery evaluation. Using a review of the literature and a real case study, this article demonstrates the practical use of discharge planning services, analyzes problems frequently encountered during the discharge process and related interventions. By increasing the proper disease management knowledge of patients and their families, strengthening staff support to families through the creation of "medical leagues", establishing community care and better support networks, and implementing a discharge process evaluation procedure, discharge planning services may provide efficient and continuous medical care essential to prevent re-admission, reduce hospitalization expenses, and strike a better balance between medical service quality and cost.

The relationship between serum uric acid concentration and metabolic syndrome in university freshmen.

BACKGROUND: Serum uric acid (SUA) level is often elevated in participants with metabolic syndrome (MS), and hyperuricemia appears linked inextricably to the presence of MS. PURPOSE: Aims of this study included conducting a comparison of SUA concentrations in university students with and without MS and exploring the relationship between hyperuricemia and MS. METHODS: A cross-sectional study was conducted on 1,096 freshmen students, who received a health examination at a university. Data were collected on demographics, body mass index, waist circumference, blood pressure, fasting plasma glucose, and lipid profile. Criteria used in this study for MS and hyperuricemia were those published by the Bureau of Health Promotion, Department of Health, Taiwan, ROC, and in Taiwan's Nutritional and Health Survey. RESULTS: The prevalence of hyperuricemia and MS in all participants was 16.97% and 8.10%, respectively. The prevalence of both was significantly higher in male than in female participants. Covariance analysis showed that SUA levels were significantly higher in participants with MS than in those without,after adjusting for confounding variables. The components of MS increased significantly with increased SUA levels. Participants with hyperuricemia faced a higher risk of MS than did those with normal SUA levels. In terms of MS analysis components, male participants with hyperuricemia faced higher risks of abdominal obesity and hypertension than did their peers with normal SUA concentrations, and female participants with hyperuricemia faced higher risks of abdominal obesity, hypertension, and low high-density lipoprotein cholesterol. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Hyperuricemia may trigger certain health problems and has been positively related with MS. To improve these concurrent conditions, school nurses should make use of education resources to develop optimal intervention strategies to facilitate effective lifestyle changes in students and reduce the incidence of MS and hyperudicemia.

[The experiences of resuming smoking among medical college students].

The aim of this qualitative study was to explore the experiences of medical college students who resume smoking and their needs and suggestions for assistance. Low-structured, in-depth, audiotaped interviews and were conducted of sixteen medical college students. The content analysis method was used to analyze the collected data. The major findings were: temptation from friends and social environment, uncontrollable addiction, negative consequences of, alongside positive expectations for smoking, and uncomfortable feelings of failure, etc. In order to prevent resumption of smoking, it's very important to teach quitters how to deal effectively with situations of high temptation, coping with stress, defensive restructuring of cognitions, and how to increasing their confidence and motivation. The government should raise cigarette prices, extend school and work place prohibitions on smoking, and strictly enforce its regulations. The government should also reduce the age for tobacco control education, and bring all ethnic groups within the scope of its smoking prevention policies in order to reduce the harm done to healthy people by smoking.