A Randomized Trial of Postoperative Handgrip Exercises for Fistula Maturation in Patients With Newly Created Wrist Radiocephalic Arteriovenous Fistulas.

Introduction: We aimed to substantiate the benefit of postoperative handgrip exercises (HGEs) in enhancing the maturation of an arteriovenous wrist fistula. Methods: We randomly assigned 119 patients aged 20 to 80 years who had wrist arteriovenous fistulas (AVFs) to undergo either a basic HGE program (group A), an advanced program (group B), or an advanced-plus upper arm banding program (group C). Outcomes were assessed by ultrasonographic evaluation of the diameter and flow at each follow-up. The attending nephrologist decided the clinical use of the fistula. Results: We identified no significant differences among the HGE groups in the mean diameter and blood flow 14, 30, 60, and 90 days after the creation of the wrist AVF (P = 0.55, 0.88, 0.21, and 0.19 for the diameter; 0.94, 0.81, 0.49, and 0.56 for the flow, respectively). The intent-to-treat analysis also found no difference in the clinical use of fistulas for hemodialysis (HD) (P = 0.997). Conclusion: In patients with a newly created wrist AVF, advancing frequency, with or without adding intensity using an upper arm tourniquet, of postoperative HGEs did not enhance the growth of the fistula or increase the rate of clinical use over 3 months. (ClinicalTrials.gov ID: NCT03077815).

Research and Evaluation on an Optical Automatic Detection System for the Defects of the Manufactured Paper Cups.

In this paper, the paper cups were used as the research objects, and the machine vision detection technology was combined with different image processing techniques to investigate a non-contact optical automatic detection system to identify the defects of the manufactured paper cups. The combined ring light was used as the light source, an infrared (IR) LED matrix panel was used to provide the IR light to constantly highlight the outer edges of the detected objects, and a multi-grid pixel array was used as the image sensor. The image processing techniques, including the Gaussian filter, Sobel operator, Binarization process, and connected component, were used to enhance the inspection and recognition of the defects existing in the produced paper cups. There were three different detection processes for paper cups, which were divided into internal, external, and bottom image acquisition processes. The present study demonstrated that all the detection processes could clearly detect the surface defect features of the manufactured paper cups, such as dirt, burrs, holes, and uneven thickness. Our study also revealed that the average time for the investigated Automatic Optical Detection to detect the defects on the paper cups was only 0.3 s.

Change in Abdominal Aortic Aneurysm Sac Diameter After Endovascular Repair: A Single-Center Experience From Taiwan.

PURPOSE: The purpose of this study was to investigate the change in the diameter of infrarenal abdominal aortic aneurysm (AAA) sacs after endovascular aortic repair (EVAR) in Taiwanese patients and to depict its association with clinical outcomes. MATERIALS AND METHODS: This retrospective cohort study was conducted on patients who underwent EVAR for infrarenal AAA between January 2011 and December 2016. All preoperative and follow-up computed tomography (CT) images were reviewed. Postoperative CT angiography was arranged after 1 month and annually thereafter. The maximal diameter on the axial plane and the maximal diameter perpendicular to the centerline on the coronal and sagittal planes were measured. The study examined post-EVAR sac diameter change over time and compared the differences in adverse events (AEs) among groups. RESULTS: The survey included a total of 191 patients with a median follow-up duration of 2.5 (interquartile range: 1.1-2.9) years. Overall survival rates at 1, 2, and 5 years were 92%, 81%, and 76%, respectively. According to their last CT scans, the patients were categorized into 3 groups as follows: shrinkage, stationary, and enlargement, which comprised 58 (30.4%), 118 (61.8%), and 15 (7.9%) patients, respectively. Pre-EVAR characteristics and sac diameters were similar among the groups. Sac shrinkage was exclusively observed in the first 2 years, whereas sac enlargement developed at all follow-up periods. Patients with sac enlargement had higher incidence rates of endoleaks, complications, and reintervention than the other groups. CONCLUSION: Based on our observations, post-EVAR sac shrinkage only occurs in the first 2 years; however, post-EVAR sacs may enlarge at any point and even after 5 years. In our study, patients with sac enlargement had higher rates of adverse events and reintervention.

A Novel Synthesis of ZnO Nanoflower Arrays Using a Lift-Off Technique with Different Thicknesses of Al Sacrificial Layers on a Patterned Sapphire Substrate.

A novel method to synthesize large-scale ZnO nanoflower arrays using a protrusion patterned ZnO seed layer was investigated. Different thicknesses of aluminum (Al) film were deposited on the concave patterned sapphire substrate as a sacrificial layer. ZnO gel was layered onto the Al film as a seed layer and OE-6370HF AB optical glue was used as the adhesive material. A lift-off technique was used to transfer the protrusion patterned ZnO/AB glue seed layer to a P-type Si <100> wafer. The hydrothermal method using Zn(CH3COO)2 and C6H12N4 solutions as liquid precursors was used to synthesize ZnO nanoflower arrays on the patterned seed layer. X-ray diffraction spectra, field-effect scanning electron microscopy, focused ion beam milling (for obtaining cross-sectional views), and photoluminescence (PL) spectrometry were used to analyze the effects that different synthesis times and different thicknesses of Al sacrificial layer had on the properties of ZnO nanoflower arrays. These effects included an increased diameter, and a decreased height, density (i.e., number of nanorods in µm-2), total surface area, total volume, and maximum emission intensity of PL spectrum. We showed that when the synthesis time and the thickness of the Al sacrificial layer were increased, the emission intensities of the ultraviolet light and visible light had different variations.

Effects of Composition Variations on the Crystalline Phases and Photoluminescence Properties of Ca2+x MgSi2Eu0.025O7+x Phosphors.

A solid-state reaction method was used to synthesize Ca2+x MgSi2Eu0.025O7+x (x = 0-1.0) powders in the air atmosphere and in a reduction atmosphere (95% N2 + 5% H2) at 1350 °C and 4 h, and the reduction atmosphere was removed at 800 °C. Only the Ca2MgSi2O7 phase was found in the XRD pattern of the synthesized Ca2MgSi2Eu0.025O7 powder. The first important discovery was that when the x value of Ca2+x MgSi2Eu0.025O7+x powders was increased from 0.2 to 0.8, both Ca2MgSi2O7 and Ca3MgSi2O8 phases coexisted in the synthesized Ca2+x MgSi2Eu0.025O7+x powders, and the diffraction intensity of the Ca2MgSi2O7 (Ca3MgSi2O8) phase decreased (increased) with the x value. The second important discovery was that the Ca2MgSi2Eu0.025O7 phosphor exhibited stronger photoluminescence excitation (PLE), photoluminescence (PL), and decay curve properties than the Ca2.2MgSi2Eu0.025O7.2 phosphor, and the Ca3MgSi2Eu0.025O8 phosphor exhibited stronger PLE, PL, and decay curve properties than the Ca2+x MgSi2Eu0.025O7+x phosphors for x = 0.4, 0.6, and 0.8. For x = 0.2-0.8, the PL spectra of the Ca2+x MgSi2Eu0.025O7+x phosphors were a combination of the PL spectra of Ca2MgSi2Eu0.025O7 and Ca3MgSi2Eu0.025O8 phosphors. The third important discovery was that as the x value was increased, the maximum emission peak wavelengths of the Ca2+x MgSi2Eu0.025O7+x phosphors shifted to a lower value, the maximum emission intensity of the PL spectra increased, and the emission light changed from green and cyan to blue.

Impact of professional commitment on professional capability improvement and care quality dimensions: A multi-wave study.

AIMS AND OBJECTIVES: To examine how the three dimensions of professional commitment impact professional capabilities improvement and five key dimensions of care quality. BACKGROUND: While professional commitment is known to retain nurses, we do not know how its three dimensions-affective, continuance and normative commitment-formulate five care quality dimensions: assurance, reliability, responsiveness, empathy and tangibles. DESIGN: We used a three-wave, follow-up design to follow a sample of nurse participants. METHODS: We collected responses from 430 nurses who worked for a medical centre in Northern Taiwan during 2017-2019. Most (78.9%) of the respondents had an age between 20-40 years. We used Professional Commitment Scale of Meyer et al. (Journal of Applied Psychology, 1993, 78, 538) and Care Quality Scale of Teng et al. (Journal of Nursing Scholarship, 2010, 41, 301). STROBE statement was chosen as EQUATOR checklist. RESULTS: We found that affective professional commitment is positively related to intention to improve professional capabilities, action to improve professional capabilities and thus to four dimensions of care quality: assurance, reliability, responsiveness and empathy. CONCLUSIONS: Our model explains how three key dimensions of professional commitment contribute to care quality. Our findings support the link between action to improve professional capabilities and dimensions of care quality. RELEVANCE TO CLINICAL PRACTICE: Nursing managers can inform nurses of positive patient feedback, thus enhancing nurses' affective professional commitment, which would likely motivate their devotion to upgrading their professional capabilities, thus further contributing to the quality of the care they provide.

Influence of Microbial Transglutaminase on Physicochemical and Cross-Linking Characteristics of Individual Caseins.

The effects of microbial transglutaminase (MTGase) cross-linking on the physicochemical characteristics of individual caseins were investigated. MTGase was used to modify three major individual caseins, namely, κ-casein (κ-CN), αS-casein (αS-CN) and ß-casein (ß-CN). The SDS-PAGE analysis revealed that MTGase-induced cross-linking occurred during the reaction and that some components with high molecular weights (>130 kDa) were formed from the individual proteins κ-CN, αS-CN and ß-CN. Scanning electron microscopy (SEM) and particle size analysis respectively demonstrated that the κ-CN, αS-CN and ß-CN particle diameters and protein microstructures were larger and polymerized after MTGase cross-linking. The polymerized κ-CN (~749.9 nm) was smaller than that of ß-CN (~7909.3 nm) and αS-CN (~7909.3 nm). The enzyme kinetics results showed KM values of 3.04 × 10-6, 2.37 × 10-4 and 8.90 × 10-3 M for κ-CN, αS-CN and ß-CN, respectively, and, furthermore, kcat values of 5.17 × 10-4, 1.92 × 10-3 and 4.76 × 10-2 1/s, for κ-CN, αS-CN and ß-CN, respectively. Our results revealed that the cross-linking of ß-CN catalyzed by MTGase was faster than that of αS-CN or κ-CN. Overall, the polymers that formed in the individual caseins in the presence of MTGase presented a higher molecular weight and larger particles.

Outcome of surgical intervention for aortic root abscess: a meta-analysis.

OBJECTIVES: Aortic root abscess (ARA) is a catastrophic complication of aortic root endocarditis, involving both native and prosthetic valves, which often warrants surgical intervention. Currently, aortic valve replacement (AVR) and aortic root replacement (ARR) are the most widely employed techniques. However, evidence that directly compares these methods is scarce. In this meta-analysis, we aimed to describe the surgical outcome of ARA when using different surgical methods. METHODS: In this meta-analysis, we performed literature searches in the EMBASE and PubMed databases and reviewed articles describing postoperative results of ARA that were published before 30 June 2016. After extracting the published data, we used a random-effects model to perform meta-analysis and compare the postoperative outcomes of ARA after management with AVR or ARR. RESULTS: Seven published studies were included in this meta-analysis, which includes 781 episodes of infective endocarditis complicated with ARA. There was no significant difference in the 30-day postoperative mortality rate among patients receiving ARR [23.8%, 95% confidence interval (CI) 17.8-30.6] compared with AVR (19.1%, 95% CI 13.3-26.1%), with a relative risk ratio of 1.30 (95% CI 0.84-2.00). However, patients receiving ARR were associated with statistically significant lower rates of reoperation within 1 year (relative risk 0.50, 95% CI 0.26-0.94). CONCLUSIONS: In our meta-analysis, ARR was associated with a 50% risk reduction of reoperation within 1 year among patients with ARA. There was no significant difference in the 30-day postoperative mortality rate between patients receiving ARR and patients receiving AVR; comparison of the long-term outcomes after these 2 procedures warrants further investigation.

Time distortion associated with smartphone addiction: Identifying smartphone addiction via a mobile application (App).

BACKGROUND: Global smartphone penetration has brought about unprecedented addictive behaviors. AIMS: We report a proposed diagnostic criteria and the designing of a mobile application (App) to identify smartphone addiction. METHOD: We used a novel empirical mode decomposition (EMD) to delineate the trend in smartphone use over one month. RESULTS: The daily use count and the trend of this frequency are associated with smartphone addiction. We quantify excessive use by daily use duration and frequency, as well as the relationship between the tolerance symptoms and the trend for the median duration of a use epoch. The psychiatrists' assisted self-reporting use time is significant lower than and the recorded total smartphone use time via the App and the degree of underestimation was positively correlated with actual smartphone use. CONCLUSIONS: Our study suggests the identification of smartphone addiction by diagnostic interview and via the App-generated parameters with EMD analysis.

Development and validation of the Smartphone Addiction Inventory (SPAI).

OBJECTIVE: The aim of this study was to develop a self-administered scale based on the special features of smartphone. The reliability and validity of the Smartphone Addiction Inventory (SPAI) was demonstrated. METHODS: A total of 283 participants were recruited from Dec. 2012 to Jul. 2013 to complete a set of questionnaires, including a 26-item SPAI modified from the Chinese Internet Addiction Scale and phantom vibration and ringing syndrome questionnaire. There were 260 males and 23 females, with ages 22.9 ± 2.0 years. Exploratory factor analysis, internal-consistency test, test-retest, and correlation analysis were conducted to verify the reliability and validity of the SPAI. Correlations between each subscale and phantom vibration and ringing were also explored. RESULTS: Exploratory factor analysis yielded four factors: compulsive behavior, functional impairment, withdrawal and tolerance. Test-retest reliabilities (intraclass correlations  = 0.74-0.91) and internal consistency (Cronbach's α = 0.94) were all satisfactory. The four subscales had moderate to high correlations (0.56-0.78), but had no or very low correlation to phantom vibration/ringing syndrome. CONCLUSION: This study provides evidence that the SPAI is a valid and reliable, self-administered screening tool to investigate smartphone addiction. Phantom vibration and ringing might be independent entities of smartphone addiction.