The Effect of a 20-Hour Baby-Friendly Hospital Initiative Training Program on Nurses' Breastfeeding Knowledge, Attitudes and Confidence, in a Tertiary Hospital in Singapore.

OBJECTIVE: The Baby-Friendly Hospital Initiative (BFHI) enables maternity units to be centers of breastfeeding support to increase breastfeeding rates. This study evaluates the impact of the 20-hour BFHI training course on nurses' breastfeeding knowledge, attitude, and confidence in breastfeeding practice in a tertiary hospital in Singapore. STUDY DESIGN: Seventeen sessions of the 20-hour BFHI training course were conducted by lactation consultants from 2010 to 2013 at the National University Hospital, Singapore. An anonymous self-administered survey on knowledge, attitude, and confidence in breastfeeding practices were distributed to nurses before (2009) and after (2014) the training courses to assess effectiveness of training. RESULTS: One-hundred forty nurses and one hundred forty-eight nurses participated in the surveys in 2009 and 2014, respectively. Majority were registered nurses who worked in the postnatal wards and the neonatal intensive care unit. After training, there were significant improvements for five of eight items in infant feeding knowledge, including greater awareness of the International Code of Marketing of Breastmilk Substitutes and medical contraindication for breastfeeding. Participants reported more confidence in assisting mothers on breastfeeding, 77.1 to 88.5% (p = 0.019); advising hand expressing breast milk, 75.7 to 86.5% (p = 0.012); and advising attachment to the breast, 75.7 to 89.2% (p = 0.004) in 2014 compared with 2009. However, despite having high levels of confidence, only about half the nurses reported being able to assist mothers in breastfeeding, mainly due to time constraints. CONCLUSION: Implementation of the 20-hour BFHI training program positively influenced nurses' breastfeeding knowledge, attitude, and confidence in breastfeeding practices. Hospital procedures and manpower requirements should be re-examined to overcome nursing constraints in providing breastfeeding help to postpartum mothers. KEY POINTS: · Nurses have low breastfeeding knowledge pretraining.. · The 20-hour BFHI training course is effective.. · Nurses have inadequate time to support breastfeeding..

Effect and Safety of Penetrating Moxibustion in Treatment of Migraine without Aura: A Randomized Controlled Trial.

OBJECTIVE: To observe the clinical effect of penetrating moxibustion on migraine without aura (MO) patients. METHODS: Totally 60 MO patients from the Acupuncture Clinic of the Third Affiliated Hospital of Henan University of Chinese Medicine were collected from November 2015 to February 2017. All patients were assigned to a treatment group and a control group using a random number table, 30 cases in each group. The treatment group was treated with penetrating moxibustion, and the control group was treated with mild moxibustion, thrice a week for 4 consecutive weeks. The total effective rate, Visual Analogue Scale (VAS) scores, headache intensity, and Migraine Specific Quality of Life Questionnaire (MSQ) scores of patients after treatment were compared between the two groups. The moxibustion sensation and reaction after moxibustion were observed, and the adverse reactions were evaluated. All patients were followed up at 4 and 16 weeks after treatment. RESULTS: The total effective rate of the treatment group was significantly higher than that of the control group (93.33% vs. 80.00%, P<0.05). The improvement of VAS scores, headache intensity, and the role restrictive and role preventive scores in MSQ in the treatment group was better than those in the control group (P<0.05). The person-time of moxibustion sensations of itching, numbness and cold as well as flushing and sweating after moxibustion in the treatment group was all significantly higher than that in the control group (P<0.01). There was no significant difference in safety evaluation between the two groups (P>0.05). CONCLUSIONS: Penetrating moxibustion can significantly relieve pain and improve quality of life of MO patients. After penetrating moxibustion, flushing and sweating of patients were obvious, and the curative effect was superior to the mild moxibustion.

Preparation of Lignin-Based Carbon Materials and Its Application as a Sorbent.

The purpose of this article was to explore the influences of synthetic methods on the lignin-based carbon materials. In this paper, the lignin-based activated carbon materials were comparatively researched in ZnCl2 solution using various methods, including the microwave-assisted method, ultrasound method, and UV irradiation method, respectively. Scanning electron microscopy (SEM), Fourier transform infrared spectrometry (FT-IR), thermogravimetric analysis (TGA), and differential thermal analysis (DTA) were used to characterize the as-prepared samples. The effects of the synthetic parameters including the types of lignin, activated solution concentration, types of activated solution, and synthetic methods on the morphologies, thermal stability, and specific surface area of samples were comparatively investigated in detail. The specific surface area of lignin-based activated carbon increased to 473.8, 765.3, and 211.2 m²âˆ™g-1 using the microwave-assisted method, ultrasound method, and UV irradiation method, respectively, compared with that of the control (113.4 m²âˆ™g-1). The lignin-based carbon materials displayed the enhanced absorptive capacity, compared with that of the control. These novel synthetic methods reported here maybe have a guiding significance for the synthesis of carbon materials using the lignin as precursors.

Cellulose-based Nanocarriers as Platforms for Cancer Therapy.

Cellulose is an important environmentally-friendly renewable polymer on the earth. Cellulose has been widely used as feedstocks for the synthesis of biomaterials, biofuels and biochemicals. Recently, cellulose and cellulose derivatives have received intense attention in biomedical applications, such as tissue engineering, scaffold, artificial blood vessel, skin grafts, artificial skin, drug carrier, and chronic skin diseases, many of which are somehow related to cancer therapy. In this mini-review, we focus on the up-to-date development of cellulosebased nanocarriers used for cancer therapy. Various cellulose-based nanocarriers such as bacterial cellulose (BC), cellulose acetate, microcrystalline cellulose, carboxymethyl cellulose, cellulose nanocrystals, cellulose nanofibrills, etc, are reviewed in terms of being used in drug delivery systems for cancer treatment. Different strategies for the synthesis of cellulose-based nanocarriers are summarized. Special attention is paid on the structure and properties of cellulose-based drug carriers for cancer therapy via some representative examples. Finally, the problems and future developments of these promising polymeric nanocarriers are raised and proposed.

How To Light Special Hot Spots in Multiparticle-Film Configurations.

The precise control over the locations of hot spots in a nanostructured ensemble is of great importance in plasmon-enhanced spectroscopy, chemical sensing, and super-resolution optical imaging. However, for multiparticle configurations over metal films that involve localized and propagating surface plasmon modes, the locations of hot spots are difficult to predict due to complex plasmon competition and synergistic effects. In this work, theoretical simulations based on multiparticle-film configurations predict that the locations of hot spots can be efficiently controlled in the particle-particle gaps, the particle-film junctions, or in both, by suppressing or promoting specific plasmonic coupling effects in specific wavelength ranges. These findings offer an avenue to obtain strong Raman signals from molecules situated on single crystal surfaces and simultaneously avoid signal interference from particle-particle gaps.

Synthetic self-assembled homogeneous network hydrogels with high mechanical and recoverable properties for tissue replacement.

Development of hydrogels with high mechanical and recoverable properties under physiological conditions is of great importance for broadening and improving their potential applications in load-bearing artificial soft tissues. Inspired by the self-assembly of chemical entities, homogeneous network hydrogels, which contain over 90 wt% water, were synthesized via covalent cross-linking of poly(vinyl alcohol) (PVA) and poly(vinyl pyrrolidone) (PVP) triggered by microwave-assisted treatment. A structurally homogeneous network results in an evenly distributed stress that endures high strains with minimal energy dissipation, which enable the hydrogels to withstand up to 1.16 MPa of tensile stress, over seven-fold stretch length with negligible hysteresis, and sustain cyclic compression following high amplitude deformation. It is of importance for tissue replacement that the hydrogels retain these excellent properties under physiological conditions.

"Smart" Ag Nanostructures for Plasmon-Enhanced Spectroscopies.

Silver is an ideal candidate for surface plasmon resonance (SPR)-based applications because of its great optical cross-section in the visible region. However, the uses of Ag in plasmon-enhanced spectroscopies have been limited due to their interference via direct contact with analytes, the poor chemical stability, and the Ag(+) release phenomenon. Herein, we report a facile chemical method to prepare shell-isolated Ag nanoparticle/tip. The as-prepared nanostructures exhibit an excellent chemical stability and plasmonic property in plasmon-enhanced spectroscopies for more than one year. It also features an alternative plasmon-mediated photocatalysis pathway by smartly blocking "hot" electrons. Astonishingly, the shell-isolated Ag nanoparticles (Ag SHINs), as "smart plasmonic dusts", reveal a ∼1000-fold ensemble enhancement of rhodamine isothiocyanate (RITC) on a quartz substrate in surface-enhanced fluorescence. The presented "smart" Ag nanostructures offer a unique way for the promotion of ultrahigh sensitivity and reliability in plasmon-enhanced spectroscopies.

Electrochemical Tip-Enhanced Raman Spectroscopy.

Interfacial properties are highly important to the performance of some energy-related systems. The in-depth understanding of the interface requires highly sensitive in situ techniques that can provide fingerprint molecular information at nanometer resolution. We developed an electrochemical tip-enhanced Raman spectroscopy (EC-TERS) by introduction of the light horizontally to the EC-STM cell to minimize the optical distortion and to keep the TERS measurement under a well-controlled condition. We obtained potential-dependent EC-TERS from the adsorbed aromatic molecule on a Au(111) surface and observed a substantial change in the molecule configuration with potential as a result of the protonation and deprotonation of the molecule. Such a change was not observable in EC-SERS (surface-enhanced), indicating EC-TERS can more faithfully reflect the fine interfacial structure than EC-SERS. This work will open a new era for using EC-TERS as an important nanospectroscopy tool for the molecular level and nanoscale analysis of some important electrochemical systems including solar cells, lithium ion batteries, fuel cells, and corrosion.

Surface Plasmon-Coupled Directional Enhanced Raman Scattering by Means of the Reverse Kretschmann Configuration.

Surface-enhanced Raman scattering (SERS) is a unique analytical technique that provides fingerprint spectra, yet facing the obstacle of low collection efficiency. In this study, we demonstrated a simple approach to measure surface plasmon-coupled directional enhanced Raman scattering by means of the reverse Kretschmann configuration (RK-SPCR). Highly directional and p-polarized Raman scattering of 4-aminothiophenol (4-ATP) was observed on a nanoparticle-on-film substrate at 46° through the prism coupler with a sharp angle distribution (full width at half-maximum of ∼3.3°). Because of the improved collection efficiency, the Raman scattering signal was enhanced 30-fold over the conventional SERS mode; this was consistent with finite-difference time-domain simulations. The effect of nanoparticles on the coupling efficiency of propagated surface plasmons was investigated. Possessing straightforward implementation and directional enhancement of Raman scattering, RK-SPCR is anticipated to simplify SERS instruments and to be broadly applicable to biochemical assays.

Formation of a salsolinol-like compound, the neurotoxin, 1-acetyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline, in a cellular model of hyperglycemia and a rat model of diabetes.

There are statistical data indicating that diabetes is a risk factor for Parkinson's disease (PD). Methylglyoxal (MG), a biologically reactive byproduct of glucose metabolism, the levels of which have been shown to be increase in diabetes, reacts with dopamine to form 1-acetyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline (ADTIQ); this formation may provide further insight into the connection between PD and diabetes. In this study, we investigated the role of ADTIQ in these two diseases to determine in an aim to enhance our understanding of the link between PD and diabetes. To this end, a cell model of hyperglycemia and a rat model of diabetes were established. In the cell model of hyperglycemia, compared with the control group, the elevated glucose levels promoted free hydroxyl radical formation (p<0.01). An ADTIQ assay was successfully developed and ADTIQ levels were detected and quantified. The levels of its precursors, MG and dopamine (DA), were determined in both the cell model of hyperglycemia and the rat model of diabetes. The proteins related to glucose metabolism were also assayed. Compared with the control group, ADTIQ and MG levels were significantly elevated not only in the cell model of hyperglycemia, but also in the brains of rats with diabetes (p<0.01). Seven key enzymes from the glycolytic pathway were found to be significantly more abundant in the brains of rats with diabetes. Moreover, it was found that adenosine triphosphate (ATP) synthase and superoxide dismutase (SOD) expression levels were markedly decreased in the rats with diabetes compared with the control group. Therefore, ADTIQ expression levels were found to be elevated under hyperglycemic conditions. The results reported herein demonstrate that ADTIQ, which is derived from MG, the levels of which are increased in diabetes, may serve as a neurotoxin to dopaminergic neurons, eventually leading to PD.

Fractional pretreatment of hybrid poplar for accelerated enzymatic hydrolysis: characterization of cellulose-enriched fraction.

The efficient production of fermentable sugars is a prerequisite for economic ethanol production from lignocellulosic biomass. A cellulose-enriched fraction was obtained by complete dissolution of ball-milled hybrid poplar wood in dimethyl sulfoxide and lithium chloride (DMSO/LiCl). The cellulose-enriched fraction was mainly composed of glucose and xylose. Spectral fitting analysis of CP/MAS (13)C NMR revealed that the cellulose-enriched fraction had para-crystalline structures with somewhat larger contents of crystalline cellulose І(ß) than І(α). The cellulose-enriched fraction was much easier to be converted into mono sugars by cellulases than the untreated sample. Scanning electron microscopy (SEM) indicated that the cellulose-enriched fraction was porous, which could likely explain the high enzymatic hydrolysis efficiency. This study provides a novel pretreatment method based on fractional separation of the three biopolymers via complete dissolution system for enhancement of conversion from ignocellulose to biofuels.