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Objective To explore the impacts of Xingnaojing Injection plus ulinastatin plus continuous renal replacement therapy （CRRT） on efficacy, immune function and hemodynamics of septic patients complicated with acute kidney injury （AKI）. Methods From May 1, 2019 to May 31, 2022, 104 septic patients complicated with AKI were selected and randomized into two groups of observation （n = 52） and control （n = 52）. Control group received ulinastatin plus CRRT. And observation group had Xingnaojing injection on the basis of control group. Physiological status was evaluated by APACHE Ⅱ score; the levels of T lymphocyte subsets （CD4+/CD8+） were measured by flow cytometry before and after treatment and ratio of CD4+/CD8+ was calculated; the levels of immunoglobulin IgA, IgM and IgG were measured by one-way immunodiffusion before and after treatment; central venous pressure （CVP）, mean arterial pressure （MAP） and heart rate （HR） were monitored with an electronic monitor before and after treatment; in addition, efficacies, changes of APACHE Ⅱ score, CD4+ and CD8+ levels, CD4+/CD8+, IgA/M/G, CVP, MAP and HR were compared between two groups. Results The efficacy of observation group was significantly higher than that of control group （90.39% vs 73.08%, χ2 = 5.216, P = 0.022）. APACHE Ⅱ score of observation and control group declined markedly after treatment [（20.57 ± 3.72） points, （19.74 ± 3.51） points vs （9.67 ± 2.24） points, （13.84 ± 3.11） points] （P＜0.05） and APACHE Ⅱ score of observation group was significantly lower than that of control group after treatment （P＜0.05）. CD4+ level [（30.73 ± 6.54）%, （29.46 ± 6.28）% vs （35.82 ± 6.59）%, （32.65 ± 6.74）%] and CD4+/CD8+ [（1.10 ± 0.24）, （1.12 ± 0.26） vs （1.84±0.31）、（1.52±0.29）] spiked obviously after treatment in observation and control groups. CD8+ level declined markedly [（27.94 ± 5.75）%, （26.30 ± 5.54）% vs （19.48 ± 4.21）%, （21.45 ± 4.54）%] （P＜0.05）.After treatment, the levels of CD4+ and CD4+/CD8+ were significantly higher in observation group than those in control group; CD8+ level was significantly lower than that in control group （P＜0.05）. The levels of IgA [（1.32 ± 0.31） g/L, （1.28 ± 0.29） g/L vs （1.96 ± 0.48） g/L, （1.63 ± 0.42）g/L], IgM [（0.95 ± 0.31） g/L, （0.91 ± 0.28） g/L vs （1.96 ± 0.51） g/L, （1.37 ± 0.36） g/L] and IgG [（5.82 ± 0.81） g/L, （5.77 ± 0.76） g/L vs （9.75 ± 1.43） g/L, （7.32 ± 1.24） g/L] in observation and control groups were significant after treatment. After treatment, the levels of IgA, IgM and IgG were significantly higher in observation group than those in control group （P＜0.05）. The levels of CVP [（6.47 ± 1.24） mmH2O, （6.42 ± 1.21） mmH2O vs （12.83 ± 2.85） mmH2O, （9.54 ± 2.32） mmH2O] and MAP [（56.53 ± 5.34） mmHg, （55.87 ± 5.21） mmHg vs （87.27 ± 6.83） mmHg, （71.92 ± 6.42） mmHg, 1 mmHg = 0.133 kPa] spiked markedly in observation and control groups after treatment. HR declined markedly [（117.56 ± 12.65） beat/min, （115.73 ± 12.57） beat/min vs （83.41 ± 8.73） beat/min, （98.65 ± 10.51） beat/min] （P＜0.05）. After treatment, CVP and MAP levels were significantly higher in observation group than those in control group and HR was significantly lower than that in control group （P＜0.05）. The levels of urea nitrogen [（10.38 ± 2.31） mmol/L, （10.42 ± 2.34） mmol/L vs （14.22 ± 3.34） mmol/L, （19.14±5.27） mmol/L] and serum creatinine [（125.87 ± 26.57） μmol/L, （125.76 ± 25.68） μmol/L vs （183.55 ± 36.81） μmol/L, （241.26 ± 42.79） μmol/L] spiked obviously （P＜0.05）. After treatment, the levels of urea nitrogen and blood creatinine were significantly lower in observation group than those in control group （P＜0.05）. Conclusions Xingnaojing injection combined with ulinastatin and continuous renal replacement therapy are effective in treating patients with sepsis complicated with AKI, which can effectively improve the immune function and hemodynamics of patients, and alleviate the condition of patients.

为提高蛋白基Pickering乳液稳定性，采用美拉德反应制备乳清分离蛋白（WPI）-葡聚糖（Dex）接枝物，然后利用该接枝物制得蛋白基固体颗粒，再与中链甘油三酯制备Pickering乳液，考察WPI-Dex接枝物对蛋白基固体颗粒乳化活性、乳化稳定性和蛋白基Pickering乳液乳析指数的影响，以及Pickering乳液在不同pH、加热温度、贮藏时间下粒径的变化。结果表明：扫描电镜观察到共价接枝Dex将WPI形貌结构由球状转变为片状，十二烷基硫酸钠-聚丙烯酰胺凝胶电泳证实干法美拉德反应成功制备了WPI-Dex接枝物；与WPI相比，WPI-Dex接枝物的乳化活性和乳化稳定性分别增加了57.8%和138.5%；WPI和WPI-Dex接枝物Pickering乳液贮藏30 d时的乳析指数分别为52.3%和36.0%，WPI-Dex接枝物使Pickering乳液的乳析稳定性提高了31.2%；WPI-Dex接枝物Pickering乳液具有良好的pH稳定性、热稳定性和贮藏稳定性。综上，蛋白质糖基化接枝修饰是提高天然蛋白质Pickering乳液稳定性的有效方法。In order to improve the stability of protein-based Pickering emulsion, Maillard reaction was used to prepare the whey protein isolate(WPI)-dextran(Dex) conjugate. The WPI-Dex conjugate was used to prepare protein-based solid particles, and then Pickering emulsion was prepared with medium-chain triglyceride. The effects of the WPI-Dex conjugate on the emulsification activity, emulsion stability of protein-base solid particles and creaming index of Pickering emulsion were investigated, as well as the change of diameter of Pickering emulsion under different pH, heating temperature and storage time. The results showed that scanning electron microscopy (SEM) observed the covalently grafted Dex transformed the morphologic structure of WPI from globular to flake. The WPI-Dex conjugate was successfully prepared by the dry state Maillard reaction, which was confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Compared with WPI, the emulsification activity and emulsion stability of WPI-Dex conjugate increased by 57.8% and 138.5%, respectively. The creaming indexes of WPI and WPI-Dex conjugate Pickering emulsion stored for 30 d were 52.3% and 36.0%, respectively, and the creaming stability of WPI-Dex conjugate Pickering emulsion increased by 31.2%. WPI-Dex conjugate Pickering emulsion had good pH stability, thermal stability and storage stability. In conclusion, the glycosylation graft modification of protein is an effective method to improve the stability of natural protein Pickering emulsions.

Petrocodon Hance is one of the famous ornamental flowers, but most of them are assessed as extremely dangerous (CR), or at least above vulnerable (VU) due to climate turbulence and strong interference of human activities. To reconstruct the temporal and spatial changes of the potential suitable areas of Petrocodon since the last interglacial period, and explore the response of the suitable areas to environmental changes, which provided theoretical guidance for the origin of Petrocodon, the study of geographical differentiation, the conservation of unique germplasm resources in China, and the development and utilization of gardens. In this paper, combined with 120 distribution records and 17 environmental variables, the optimal MaxEnt model and geographic information technology (ArcGIS) were used to simulate the suitable areas and distribution pattern of Petrocodon in China and Indo-China Peninsula. Based on stepwise multiple linear regression analysis, redundancy analysis and Monte-Carlo test, the dominant variables affecting the current geographical distribution of Petrocodon were evaluated. The results were as follows: (1) The prediction accuracy of the optimized MaxEnt model was high, and the AUC value was greater than 0.96. The potential suitable areas of Petrocodon for the present distribution are continuous from Southwest China to North Vietnam, scattered in central and southern China and blocky in North Myanmar, of which the South Yunnan-Guizhou Plateau in China was the most suitable. (2) The environmental variables which restrict the geographical distribution of Petrocodon included precipitation of the driest month (bio14), precipitation of the warmest quarter (bio18), precipitation of the wettest quarter (bio16), SD of the temperature seasonality (bio4), min temperature of the coldest month (bio6) and altitude (alt). (3) Under the climate change scenario, the expansion and contraction areas of the suitable habitat of Petrocodon were located in the north and northeast of the current potential distribution area, which were sensitive areas susceptible to climate change. During the last interglacial period, the suitable area of Petrocodon expanded on a large scale, but there was almost no suitable distribution area of Petrocodon in the dry and cold environment during the last glacial maximum. After that, with the aggravation of climate warming, the suitable habitats of Petrocodon increased rapidly to high latitudes, while the suitable habitat in low latitudes decreased. (4) The centroid position of the suitable area for Petrocodon migrated northwards from Yongfu County, Guangxi (110.10° E, 24.69° N) to Chengbu County, Hunan (110.29° E, 26.05° N). To sum up, global warming has a positive impact on the potential distribution area of Petrocodon, but extreme warming will cause the suitable habitat of Petrocodon to shrink, and the niche of Petrocodon will narrow. Southwest China to North Vietnam, which has the advantage of mature karst landform, may be its main refuge.

There are a lot of endemic and narrowly distributed species in Gesneriaceae in China’s higher plants, 805 known species (including infraspecies, the same below), belong to 45 genera, before December 31st, 2021, and mainly found from Southwest toward South China. Apart from a few species, most species in China are specifically turned the certain micro-habitats so that they are easily influenced becoming endangered status by the own and external factors. For better understanding the endangered risks of known species of Gesneriaceae in China, we re-assessed the IUCN red list categories of China’s Gesneriaceae taxa, then calculated and analyzed the data based on consulting relevant literature, collecting the endangered data of new reported taxa in recent years, and coupling with detailed field investigations for Gesneriaceae in China. At the same time, relied on Gesneriad Committee of China Wild Plant Conservation Association, National Gesneriaceae Germplasm Resources Bank of GXIB and Gesneriad Conservation Center of China, we first created and formulated a new mode for the conservation of China’s Gesneriaceae plants, which executed simultaneously new taxa discoveries and formal publications, assessments of the taxon’s endangered status, immediately launching conservation programs and new horticultural variety cultivations. Analysis results demonstrate that it is necessary to enhance the attention degree of protection of Gesneriaceae biodiversity by relevant government departments. Thus, we suggest: (1) To further strengthen the understanding for the urgency of protection of China's Gesneriaceae germplasm resource; (2) To conduct series of researches about rescuing conservation, ex & in-situ conservation, re-introduction in similar habitats and development for those groups in CR & EN categories; (3) To promote the development of breeding of new horticultural varieties of Gesneriaceae. All are the important base and essential precondition of Gesneriaceae biodiversity conservation.

It is difficult to identify and locate the defects quickly when the long cable line cross-bonded box has defects such as grounding,water inflow and three-phase sequence error. Aiming at three types of typical defects of cross-bonded box,a cross-bonded model of long cable lines is established to analyze the amplitude and phase change rule of circulation under the defects. Then,the curve fitting of the ratio of circulation at both ends and the scatter data of defect box number are carried out to obtain the defect location formulas. Finally,it is verified by an example. The results show that the circulation amplitude of the defective phase increases and the non-defective phase is normal when the ground is grounded inside the box. When the phase sequence is wrong,the amplitude of two-phase circulation increases obviously,and the amplitude of the other phase circulation is smaller. When the tank is filled with water,the circulation amplitude of each phase increases and is basically equal. The fitting degree of the positioning formula is about 0.96,and the range of defect box number can be determined through the example verification. The proposed method is not affected by the change of wire core current and ground resistance,and can provide reference for the defect identification and location of long cable line cross-bonded box.

The bending torsion coupling model of elliptical gear pair is established， including the factors of tooth surface friction， time-varying stiffness， damping， backlash and so on. Different parameters are selected and solved by 4~5-step Runge-Kutta numerical method to analyze the nonlinear dynamic characteristics of elliptic gear pair. It can be seen from the analysis that， under certain conditions， when the speed is low， the elliptical gear system is in the stable and regular single period motion stage. The quasi periodic motion， appear with the unstable chaotic motion alternatively under the circumstance of the increasing of the rotational speed. The system motion can be more stable under the circumstance of increasing of friction coefficient and damping ratio， while the system motion can be more unstable under the circumstance of increasing of stiffness coefficient and eccentricity ratio.

BACKGROUND As an important mineralization element, mercury is widely distributed in different geological bodies and participates in diagenesis and mineralization. With the rapid development of mass spectrometry technology, the field of mercury isotope geochemistry has made remarkable progress. Mercury isotopes have been widely used to trace the biogeochemical processes of the earth's surface and mercury pollution. In recent years, mercury isotopes have been applied to reveal the evolution of planets, identify large igneous provinces in geological history, and trace the sources of mineral deposits. OBJECTIVES To summarize the mercury isotope compositions of different geological reservoirs (meteorites, terrestrial rocks, coal, sediments, volcanic emissions, epithermal deposits) and investigate the factors controlling the Hg isotope fractionation during ore-forming processes in epithermal deposits. METHODS Literature reviewed that included published data from this research group and others. RESULTS Based on previous studies, the isotope composition of mercury in different geological reservoirs was systematically studied. The mercury isotopic composition of geological reservoirs such as meteorites, magmatic rocks, metamorphic rocks, sedimentary rocks, and volcanic gases varied greatly, and some samples also contained non-mass fractionation information. The occurrence and isotopic composition characteristics of low-temperature hydrothermal deposits (modern hot springs, mercury deposits, lead-zinc deposits, antimony deposits, gold deposits) was the focus of this review, and the basic framework of the mercury isotope system construction. Combined with the latest research results, a comprehensive summary of the mercury isotope fractionation mechanism that may have occurred in the mineralization process of the deposit was carried out. The mass fractionation of mercury isotopes in hydrothermal deposits may be caused by fluid volatilization or boiling, condensation, redox reactions, and sulfide precipitation. The non-mass fractionation of mercury isotopes in rocks and ores may be the product of mercury photochemistry during the geological history, or the inheritance of a specific source rock information. CONCLUSIONS In the future, mercury isotope has great application potential in tracing the ore-forming source of low-temperature hydrothermal deposits and characterizing the evolution of ore-forming fluids.

Fertilizer application is an important material basis to ensure crop growth, and special formula fertilizer for rapeseed is widely used in production as a key technology for light and simplified planting of rapeseed. The appropriate dosage of special formula fertilizer for rapeseed that clearly takes into account the dual objectives of abundant yield and high quality will provide key technical support for green and high-quality production of rape-seed. Five fertilizer dosages of 0, 450, 600, 750 and 900 kg/hm2 were set through field trials at three locations in Jiangling County, Shayang County and Honghu City, Hubei Province, in 2020-2021 to study the effects of different dedicated formula fertilizer dosages on rape yield, yield composition factors, nutrient content and quality. Application of the dedicated formula fertilizer significantly increased the number of corners per plant, the number of grains per corner and the thousand grain weight, which in turn enhanced the yield of rapeseed. Compared with the no-fertilizer treatment, the number of corms per plant, number of grains per corner and thousand grain weight increased by 277.4%, 17.9% and 9.2%, respectively, and the yield of rapeseed increased by 183%-300% when the special formula fertilizer was applied at a rate of 900 kg/hm ². The application of canola-specific formula fertilizer significantly affected the oil and protein content of rapeseed. Compared with the no-fertilizer treatment, the protein content of rapeseed was highest at the special formula fertilizer dosage of 900 kg/hm2, with a growth rate of 16.0%-34.6%; the oil content was lowest at the fertilizer dosage of 900 kg/hm2, with a decrease of 4.4%-11.6% compared to the no-fertilizer treatment. Correlation analysis showed that the increase of special fertilizer significantly increased rapeseed yield, water content, protein, erucic acid and fatty acid composition, and reduced glucosinolate content in rapeseed. Taking into account the yield, rapeseed quality and feed, a special fertilizer dosage of 750-900 kg/hm2 could achieve higher rapeseed yield and protein yield with less increase in the production of glucosinolate, erucic acid and saturated fatty acid in rapeseed and Increased oil production. Continue to pursue quality improvement on the basis of yield increase of rape. Medium and trace elements can be added appropriately in combination with different soil fertility conditions to further improve the oil content of rapeseed and the composition of fatty acids, so as to achieve the synergy between yield and quality. [ABSTRACT FROM AUTHOR]

BACKGROUND Reagent purification, sample pretreatment, environmental humidity, reactor cleanliness and experimental quality control are the main influence factors for determination of oxygen isotopic composition of silicates and oxide minerals by BrF5 method. OBJECTIVES To determine the optimal experimental conditions and improve the accuracy by selecting silicates and oxide minerals as laboratory raw materials for oxygen isotopic composition analysis. To discuss the influence factors for determination of oxygen isotopic composition of silicates and oxide minerals by BrF5 method. METHODS Using BrF5 analysis method and taking standard sample as the reference, oxygen isotopic compositions of silicates and oxide minerals were determined at different calcination temperatures. At the same time, the effects of environmental humidity and reactor cleanliness on the analytical results were also studied. RESULTS The results show that 650-750℃ is the best calcination temperature range for removing carbon components during oxygen isotope analysis, which can avoid the isotope fractionation caused by temperature. By reducing the relative environment humidity or the sample loading time within 0.5min, the lower δ18O values caused by vapor was improved. The new reactor, or the reactor with large yellow substance falling off, or the contaminated reactor will reduce the yield of oxygen and cause oxygen isotope fractionation, so the reactors should be fluorinated or purged in time. The sample and standard material is loaded alternately for each reactor to monitor the reliability of the isotopic composition of the sample. The results of oxygen isotopic composition of GBW04409 are consistent with the recommended values. The relative standard deviation is better than 0.1‰ for δ18O under the optimized conditions. CONCLUSIONS The proposed method can effectively control oxygen isotope fractionation and improve the applicability of BrF5 oxygen isotope analysis method.

The paper introduced usages and functions of workstation of monitoring system of mine-used beam tube, analyzed and compared workstations of monitoring system of beam tube of gas chromatograph type and combined type in term of hardware control and aided software, and drew a conclusion that the workstation of monitoring system of beam tube of gas chromatograph type has more functions, higher integration degree, easier to use. It pointed out development trend of workstation of monitoring system of beam tube.

Background: In response to the promotion of long-term care policies, nurses in hospitals must not only have professional knowledge related to disease care but also be equipped with care competencies related to long-term care. Purpose: The purpose of this study was to explore the self-perceived competencies of nurses working in acute care facilities with regard to long-term-care and related factors. Methods: A cross-sectional research design with quota sampling was used. The participants were recruited from registered nurses employed at a medical center in southern Taiwan, and data from 159 valid, returned questionnaires were used in the analysis. The research instruments used included the long-term care competency scale and long-term care-related knowledge, and care intention. T test, Chi-square, ANOVA, and Pearson correlation coefficient were used to examine the relationship between the targeted variables and long-term care competency. Regression analysis was used to determine the important determinants of long-term care competency. Results: The average age of the participants was 30.86 years (± 3.38). Most currently worked in the internal medicine department, 93.1% were educated to the university level, 44% had worked for fewer than 5 years, and 32.7% were N3 level nurses. Long-term care competency was found to be significantly and positively correlated with gender (t = 2.06, p = .041), seniority at the facility (F = 2.49, p = .046), job satisfaction (r = .28, p < .001), and long-term care service practices (r = .227, p < .001). After the regression analysis, self-perceived long-term care competency was found to be positively related to job satisfaction and long-term care service practices. Conclusions / Implications for Practice: The results of this study suggest that a long-term care training should be incorporated into the regular in-service education program to improve the knowledge and attitudes of nurses with regard to older and disabled patients and to develop their professional role in long-term care. Furthermore, the results may be referenced by nursing supervisors in acute care facilities when making arrangements for nurses to participation in the Clinical Nursing Ladder Program and when arranging nursing staff training and setting the direction of longterm care-related education and training in healthcare facilities. [ABSTRACT FROM AUTHOR]

Health problems in older adults are often concomitant with multiple comorbidities and geriatric syndromes that involve the psychological and social domains. Traditional models of disease care address the health problems of older adults inadequately. Therefore, we applied a case management framework (assess, plan, act, coordinate, evaluate and interact) to discuss how to implement an elderly-centered approach to integrated care that integrates comprehensive, multidisciplinary, and continuous care. The Geriatrics Formulated by Outcome Related Care & Empowerment (Geri-FORCE) was developed by the Formosan Association of Care and Education for the Seniors to help establish a geriatric case management system grounded in precision health care. We propose developing an informatics technology system for older adults that integrates the Geri-FORCE model with case management. This system should accurately identify the main health problems in older adults and provide a care plan that is patient-tailored, integrated, and continuous. We expect that the developed Geri-FORCE case management system will improve quality of care and promote health while reducing care burdens and costs. [ABSTRACT FROM AUTHOR]

Background: Older adults have unique and complex care needs that are multifaceted, continuous, and integrated and that span prevention and treatment to long-term rehabilitation. Case managers are able to integrate healthcare and social resources to help older adults and their caregivers manage the needs of daily life. Therefore, identifying the role and core competencies of geriatric case managers in Taiwan is crucial. Purposes: To develop the role and core competencies of geriatric case managers in Taiwan. Methods: Based on a review of the literature, a two-round modified Delphi technique was used to evaluate the framework of the geriatric case manager role and core competencies. Experts were invited to join a panel to review and rank the importance of each role and competency within the context of the Delphi technique. Results: Four roles and 36 core competencies of geriatric case managers were identified, and 94.4% consensus was reached in round two. The roles and core competencies included care expert (18 competencies), coordinator (6 competencies), consultant (6 competencies), and evidence-based practitioner (6 competencies). Conclusion/Implications for Practice: Training programs may be developed for geriatric case managers based on the results of this study to further promote the quality of provided geriatric care. [ABSTRACT FROM AUTHOR]

Healthy aging is the primary goal of healthcare for older adults in aging societies. The prevention of physical disabilities and dementia is becoming more important. As frailty involves both the physical and cognitive domains, detecting and preventing cognitive frailty early on is key to reversing cognitive diseases such as dementia. In this study, a concept analysis strategy (Walker & Avant, 2019) was applied to define the concept of cognitive frailty in older adults and identify the attributes of (1) presence of subjective cognitive decline or mild cognitive impairment, (2) exclusion of concurrent Alzheimer's disease or other dementia, (3) concomitant physical frailty, and (4) it is revisable. Using the constructed model, borderline and contrary cases were used to explain the concept of cognitive frailty. Finally, the antecedent and consequence factors of cognitive frailty were identified and the empirical measurement tools were evaluated. This analysis may be used to improve nurses' understanding of cognitive frailty in older adults and to benefit clinical practice and further research. [ABSTRACT FROM AUTHOR]

Dense false target jamming has the dual characteristics of deception and suppression, which seriously affects the effectiveness of radar operations. Therefore, a jamming suppression algorithm based on frequency agility and waveform entropy is proposed. Firstly, the Kittler algorithm is used for binarization. Secondly, the waveform entropy is used to identify the target and interference. Then, the local outlier detection algorithm is used to eliminate the data with strong interference side lobes in the target echo. Finally, the sparse reconstruction algorithm is used to perform interpulse coherent processing. The results of digital simulation experiment and field measured data processing verify the effectiveness of the proposed algorithm. The algorithm performance analysis results show that when the interference signal ratio is 58 dB, the proposed algorithm can still effectively suppress the interference and correctly detect the target. [ABSTRACT FROM AUTHOR]

Background: Functional decline is a common complication in hospitalized older adults, and decline in the ability to walk is often the first change in physical functioning in this population. Decline in walking ability leads to a loss of independence in the activities of daily living in older adults after discharge from the hospital. Purpose: To explore the factors associated with the recovery of walking ability in older adults after discharge from the hospital. Methods: This study used a longitudinal research design. Potential participants were recruited from a tertiary medical center in southern Taiwan. Patients were eligible for inclusion if they were at least 65 years old and were affected by a decline in walking ability at discharge. The data collected at discharge included: demographic information, Charlson Comorbidity Index, Modified Katz Index of Independence in Activities of Daily Living (walking item), Mini Nutritional Assessment, Mini-Mental State Examination, and ambulation during hospital stay. The follow-up data collected at three months after discharge included: Modified Katz Index of Independence in Activities of Daily Living (walking item), exercise habit, rehabilitation, and social support. Results: A total of 78 older adults were enrolled as participants. Three-quarters (75.64%) of the participants had regained their ability to walk at three months after discharge. Moreover, nutritional status, cognitive function, and exercise habit were significantly associated with the recovery of walking ability. The results of multiple logistic regression analysis showed having an exercise habit to be significantly associated with the recovery of walking ability at three months after discharge (OR = 10.212, p = .004). Conclusions/Implications for Practice: In addition to treating the acute medical issues of older patients, healthcare professionals should screen and provide them with appropriate nutritional, cognitive, and physical care plans. Moreover, emphasizing the importance of an exercise habit in nursing discharge plans is also important. This effort may help older adults recover their walking ability and maintain their independence. [ABSTRACT FROM AUTHOR]

BACKGROUND: Studies have shown that long-term moderate-intensity regular exercise can improve the activity of mitochondrial respiratory chain complex enzymes in skeletal musde cells, thereby improving their power capability as well as the ability to resist fatigue. OBJECTIVE: To explore the effect of moderate-intensity training on prohibitin (PHB) expression and mitochondrial respiratory function in rat skeletal muscle. METHODS: Thirty-two healthy male Sprague-Dawley rats were randomly divided into two groups: quiet control group and moderate-intensity training group, each of 16 rats. In the moderate-intensity training group, the treadmill training was performed at a slope of 10•: in the 111 week, running at 1 0 m/min, 1 0 minutes per day, 6 days per week; in the 2nd week, running at 15 m/min, increased from 1 0 minutes per day to 60 minutes per day with an increase of 10 minute per day, 6 days per week; in the 3rd to 8th week, running at 15 m/min, 60 minutes per day, 6 days per week for a total of B weeks. Rats were sacrificed at 48 hours after the final experiment, and mitochondria were extracted from skeletal muscle samples. Mitochondrial respiration control rate, adenosine triphosphate content, reactive oxygen species level, complex V activity and PHB1 protein expression were measured. RESULTS AND CONCLUSION: Compared with the quiet control group, in the moderate-intensity training group, mitochondrial respiration control rate in the skeletal musde increased significantly (P < 0.001 ), adenosine triphosphate content increased significantly (P < 0.05), reactive oxygen species level decreased significantly (P < 0.001 ), the activity of complex V was significantly increased (P < 0.05) and PHB1 expression was significantly increased (P < 0.01). The correlation analysis showed that after 8 weeks of moderate-intensity training, the expression of PHB1 in the skeletal muscle of rats was positively correlated with adenosine triphosphate content and complex V activity, and negatively correlated with reactive oxygen species level. Therefore, moderate-intensity training improves mitochondrial oxidative phosphorylation, effectively maintains mitochondrial membrane structure and enhances mitochondrial respiratory function by increasing the expression of PHB1. [ABSTRACT FROM AUTHOR]

Background: The health problems of hospitalized older patients are complicated, with delirium a common neurocognitive disorder in this population. Delirium has been correlated with the longer periods of hospitalization, higher mortality, and higher rates of institutionalization. However, clinical practice guidelines for delirium management in hospitalized older patients are lacking. Purpose: The purpose of this study was to develop evidence-based practice guidelines for delirium management in hospitalized older patients. Methods: A multidisciplinary task group at a medical center in southern Taiwan was established. Team members reviewed current delirium practice guidelines. A revised set of practice guidelines was developed by constructing foreground questions on key issues and by systematically searching, appraising, and synthesizing the relevant evidence. After a new draft of the guidelines was established, the Delphi method was used to reach a consensus among experts. Finally, the developed guideline document was applied in a geriatric ward of a medical center in order to evaluate applicability. Results: The developed delirium guidelines address 3 issues with 35 recommendations. The panel of clinical and methodological experts recommended that these delirium guidelines be applied in practice. Most nurses in the targeted geriatric ward indicated that the guidelines were feasible and easy to implement. However, several of the procedures were identified as difficult to implement, including "provide a therapeutic environment", "promote good sleep patterns and sleep hygiene", and "consider psychotropic medication as a last resort for agitation". Conclusion/Implications for Practice: The evidence-based delirium management guidelines for hospitalized older patients that were developed in this study integrates the recommendations from the best available evidence and earned a high consensus among clinical experts. Thus, these guidelines are recommended for clinical application. [ABSTRACT FROM AUTHOR]

Based on the analysis of water requirement and water deficit during development stage of winter wheat in recent 30 years (1981–2010) in Henan Province, the effective precipitation was calculated using the U.S. Department of Agriculture Soil Conservation method, the water requirement (ETc) was estimated by using FAO Penman-Monteith equation and crop coefficient method recommended by FAO, combined with the climate change scenario A2 (concentration on the economic envelopment) and B2 (concentration on the sustainable development) of Special Report on Emissions Scenarios (SRES), the spatial and temporal characteristics of impacts of future climate change on effective precipitation, water requirement and water deficit of winter wheat were estimated. The climatic impact factors of ETc and WD also were analyzed. The results showed that under A2 and B2 scenarios, there would be a significant increase in anomaly percentage of effective precipitation, water requirement and water deficit of winter wheat during the whole growing period compared with the average value from 1981 to 2010. Effective precipitation increased the most in 2030s under A2 and B2 scenarios by 33.5% and 39.2%, respectively. Water requirement increased the most in 2010s under A2 and B2 scenarios by 22.5% and 17.5%, respectively, and showed a significant downward trend with time. Water deficit increased the most under A2 scenario in 2010s by 23.6% and under B2 scenario in 2020s by 13.0%. Partial correlation analysis indicated that solar radiation was the main cause for the variation of ETc and WD in future under A2 and B2 scenarios. The spatial distributions of effective precipitation, water requirement and water deficit of winter wheat during the whole growing period were spatially heterogeneous because of the difference in geographical and climatic environments. A possible tendency of water resource deficiency may exist in Henan Province in the future. [ABSTRACT FROM AUTHOR]

The research focused on how to provide scientific, efficient and personalized real-time evacuation and navigation under indoor emergency response. This paper built an indoor navigation location model that fused a variety of context for emergency evacuation. In combination with the actual environment dynamic context, the model used the improved Dijkstra algorithm to calculate the real-time evacuation navigation path in order to provide different users with customized services such as map navigation, voice navigation, text message navigation and assistant decision. Experiments were carried out in a hospital. The results show that the model and algorithm can efficiently compute the real-time evacuation navigation path that satisfies different types of user needs, and can be applied for emergency evacuation, navigation and rescue under the situations like hospitals or department stores. [ABSTRACT FROM AUTHOR]

In this study, grass carp (Ctenopharyngodon idellus) lymphocytes were used as the vitro test object to demonstrate the joint effects of microcystins (MC-LR) and bacterial lipopolysaccharides (LPS) on fish immune system. The results showed that MC-LR and LPS in the single and combined exposure groups could both induce grass carp lymphocytes apoptosis with typical ladderlike DNA electrophoresis characteristics. However, comparing the apoptosis rate of the combined and single exposure groups, it was suggested that bacterial LPS could cooperate with MC-LR causing a higher rate of fish lymphocytes apoptosis (2. 1 and 3. 3-fold of that for the single exposure group ?(MC-LR) and II (LPS), respectively), and there existed a significant dose-response relationship. The MC-LR cooperating with bacterial LPS decreased the activity of glutathione S-transferase (GST), increased the levels of intracellular reactive oxygen species (ROS) and malondialdehyde (MDA), resulted in DNA damage and cell arrest in G0 phase, which inhibited cell proliferation and accelerated apoptosis. It was proved that MC-LR exacerbated fish immunotoxicity by collaborating with LPS, which had a serious adverse effect on aquaculture industry. [ABSTRACT FROM AUTHOR]

Background: Approximately 73% of catheterized inpatients are elderly, of which up to 33%-49% are improperly used. Indwelling of urinary catheters (IUCs) are not only associated with prolong length of hospital stay, increase cost of treatment, but also associated with increased mortality rate. There are no studies explored the use of IUCs in Taiwan. Purpose: The aim of this study was to explore the incidence rate of inappropriate use of IUCs and the reasons for use of IUCs. Methods: A cross-sectional and correlation study design was used in the study. The subjects were selected with a purposive sampling method at a medical center in Southern Taiwan. A total of one hundred and fifteen hospitalized elderly patients who used indwelling urinary catheters after admission were recruited. Instruments included demographic sheet and the scale of indications for use of IUCs. Data were collected during 48 hours after admission and analyzed through descriptive statistic, chi-square, and t-test, and content analysis. Results: The incidence rate of inappropriate use of IUCs was 37.4%. The most common indication for appropriate catheterization was surgical intervention (43.1%), the second was accurate assessment of urinary output (37.5%). Moreover, the most common reasons that inappropriate IUCs use was for convenience (62.8%), the second was used for manage acute urinary retention without assessment (18.6%) and others (18.6%). The finding also indicated that there is no statistically significant difference in demographic variables. Conclusions / Implications for Practice: The results of this study clearly disclosed more than one-third elderly patients in Taiwan are inappropriate use of IUCs. In order to make it easy to care, patients often ignore the compilations of use of IUCs. Therefore, education about appropriate use of IUCs should be available both for nurses, patients and caregivers. [ABSTRACT FROM AUTHOR]

Steel industry is the pillar industry of China. There exist three types of markets in domestic which are different from other foreign markets: bulk stock electronic market, futures market and spot market. China's steel electronic market is a unique' steel market. Its price discovery has been of concern to theorists and industry. Study on price discovery in domestic and abroad steel markets is of great use to the formation of steel pricing power, as well as the smoothy development of domestic steel markets. This paper uses two classical methods which belongs to common factor measurement model to measure the price discovery of three domestic steel markets and two foreign steel futures markets. The results show that: steel electronic market is the leading market in domestic steel markets. The price discovery of steel electronic market is more powerful than SHFE, LME and NCDEX; and abroad steel futures price is still not an effective steel price by now. [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce a new method of remaining major auricular nerve and parotid fascia in parotidectomy. METHODS: Traditional S-shaped incision was used, the skin flap was separated to the anterior border of the parotid gland on the superficial of parotid fascia, then the deep parotid fascia was cut longitudinal in front of the auricular lobule. After that, the skin flap was separated backward to the stem cleidomastoid muscles. The major auricular nerve and its two branches were kept in the skin flap. Finally, the fascia flap was freed forward, the two sides of the parotid fascia were drawn tight and sutured together. RESULTS: 45 out of 46 patients were followed up, 3 of them developed Frey's syndrome, and 11 months after surgery, respectively; 9 patients had temporary auricular lobule numb and recovered 1 to 3 months later. No salivary fistula was noted. CONCLUSIONS: The new approach can remain parotid fascia and major auricular nerve branches completely with minor complications. [ABSTRACT FROM AUTHOR]

Halliday holds that meaning can be expressed congruently and incongruently and that grammatical metaphor means the various incongruent possibilities in meaning expressions. Through the comparative analysis of the incongruencies in the three translated version of the poem "Niao Ming Chien", this paper intends to illustrate the feasibility of using grammatical metaphor as a new perspective for better interpretation of a poem in the original and better appreciation of its various translated versions. The paper also aims to show that the grammatical metaphor could help translators make the most appropriate decisions on diction when they are faced with more than one synonymous choices. The paper finally concludes that the hypothesis of grammatical metaphor proposed by Halliday has its peculiar advantages in assisting poem translations because the different incongruencies could carry different connotations, as shown in the three English versions of the poem translated by the three distinguished scholars. [ABSTRACT FROM AUTHOR]

Aiming at solving the problems of serious waste of water resources, air pollution and backward cleaning equipment in city garden working vehicles, a water-saving cleaning system for road green belt was investigated. After researches of new-type nozzle design, rotary mechanism design, automatically single chip microcomputer control, ranging and monitoring study, the system was established. The experiment indicates that the system shows cleaning condition and brings great convenience to workers because it is highly automated. Compared to traditional artificial gun cleaning devices, the system may realize adjustable water coning and outlet angle so as to control the water's spraying range. It can be applied to different green belts varied in widths and heights, which hardly need special operation but mak better irrigating effect and saves manpower. [ABSTRACT FROM AUTHOR]

Frequency agile radar has excellent low intercept and electronic countermeasures performance. In this paper, the research results of anti-main-lobes deceptive jamming of radar seeker are briefly reviewed, and the basic concepts and technical characteristics of frequency agile radar seeker are described. Then, the research results of frequency agile radar seeker at home and abroad are introduced, and the advantages and disadvantages of three frequency agile waveforms and the research progress of each signal processing technology are summarized. Finally, the development of adaptive frequency agility and multi-parameter combined agility radar seeker technology is prospected based on the future battlefield complex electromagnetic environment and seeker development trend.

Background: In response to the promotion of long-term care policies, nurses in hospitals must not only have professional knowledge related to disease care but also be equipped with care competencies related to long-term care., Purpose: The purpose of this study was to explore the self-perceived competencies of nurses working in acute care facilities with regard to long-term-care and related factors., Methods: A cross-sectional research design with quota sampling was used. The participants were recruited from registered nurses employed at a medical center in southern Taiwan, and data from 159 valid, returned questionnaires were used in the analysis. The research instruments used included the long-term care competency scale and long-term care-related knowledge, and care intention. T test, Chi-square, ANOVA, and Pearson correlation coefficient were used to examine the relationship between the targeted variables and long-term care competency. Regression analysis was used to determine the important determinants of long-term care competency., Results: The average age of the participants was 30.86 years (± 3.38). Most currently worked in the internal medicine department, 93.1% were educated to the university level, 44% had worked for fewer than 5 years, and 32.7% were N3 level nurses. Long-term care competency was found to be significantly and positively correlated with gender (t = 2.06, p = .041), seniority at the facility (F = 2.49, p = .046), job satisfaction (r = .28, p < .001), and long-term care service practices (r = .227, p < .001). After the regression analysis, self-perceived long-term care competency was found to be positively related to job satisfaction and long-term care service practices., Conclusions / Implications for Practice: The results of this study suggest that a long-term care training should be incorporated into the regular in-service education program to improve the knowledge and attitudes of nurses with regard to older and disabled patients and to develop their professional role in long-term care. Furthermore, the results may be referenced by nursing supervisors in acute care facilities when making arrangements for nurses to participation in the Clinical Nursing Ladder Program and when arranging nursing staff training and setting the direction of long-term care-related education and training in healthcare facilities.

Health problems in older adults are often concomitant with multiple comorbidities and geriatric syndromes that involve the psychological and social domains. Traditional models of disease care address the health problems of older adults inadequately. Therefore, we applied a case management framework (assess, plan, act, coordinate, evaluate and interact) to discuss how to implement an elderly-centered approach to integrated care that integrates comprehensive, multidisciplinary, and continuous care. The Geriatrics Formulated by Outcome Related Care & Empowerment (Geri-FORCE) was developed by the Formosan Association of Care and Education for the Seniors to help establish a geriatric case management system grounded in precision health care. We propose developing an informatics technology system for older adults that integrates the Geri-FORCE model with case management. This system should accurately identify the main health problems in older adults and provide a care plan that is patient-tailored, integrated, and continuous. We expect that the developed Geri-FORCE case management system will improve quality of care and promote health while reducing care burdens and costs.

Background: Older adults have unique and complex care needs that are multifaceted, continuous, and integrated and that span prevention and treatment to long-term rehabilitation. Case managers are able to integrate healthcare and social resources to help older adults and their caregivers manage the needs of daily life. Therefore, identifying the role and core competencies of geriatric case managers in Taiwan is crucial., Purpose: To develop the role and core competencies of geriatric case managers in Taiwan., Methods: Based on a review of the literature, a two-round modified Delphi technique was used to evaluate the framework of the geriatric case manager role and core competencies. Experts were invited to join a panel to review and rank the importance of each role and competency within the context of the Delphi technique., Results: Four roles and 36 core competencies of geriatric case managers were identified, and 94.4% consensus was reached in round two. The roles and core competencies included care expert (18 competencies), coordinator (6 competencies), consultant (6 competencies), and evidence-based practitioner (6 competencies)., Conclusions / Implications for Practice: Training programs may be developed for geriatric case managers based on the results of this study to further promote the quality of provided geriatric care.

Healthy aging is the primary goal of healthcare for older adults in aging societies. The prevention of physical disabilities and dementia is becoming more important. As frailty involves both the physical and cognitive domains, detecting and preventing cognitive frailty early on is key to reversing cognitive diseases such as dementia. In this study, a concept analysis strategy (Walker & Avant, 2019) was applied to define the concept of cognitive frailty in older adults and identify the attributes of (1) presence of subjective cognitive decline or mild cognitive impairment, (2) exclusion of concurrent Alzheimer's disease or other dementia, (3) concomitant physical frailty, and (4) it is revisable. Using the constructed model, borderline and contrary cases were used to explain the concept of cognitive frailty. Finally, the antecedent and consequence factors of cognitive frailty were identified and the empirical measurement tools were evaluated. This analysis may be used to improve nurses' understanding of cognitive frailty in older adults and to benefit clinical practice and further research.

To promote the application of ANAMMOX process in landfill leachate treatment, a pilot reactor based on the ANAMMOX process was established at a landfill site. In this paper, we aim to further analyze the influence of different coupling modes of denitrification (DN) and partial nitrification and ANAMMOX (PN-ANAMMOX) on the diversity of microbial community. The DN+(PN-ANAMMOX) process could effectively treat the mature leachate. However, with an increase in organic matter in the influent, the oxygen demand of PN zone increased, and the enrichment of Nitrosomonadaceae in the PN zone was limited. The lack of substrate supply for ANAMMOX zone further limited the enrichment of Brocadiaceae as well; thus, the total nitrogen removal rate (TNRR) remained at 0.44 kg ·(m 3 ·d) -1 . In the DN-(PN-ANAMMOX) process, Saprospiraceae with denitrifying ability was enriched in the DN zone, and the organic matter was gradually degraded and removed; thus, a good low-carbon environment was provided for the subsequent PN-ANAMMOX process. Nitrosomonadaceae and Brocadiaceae were enriched in the functional zones, and the TNRR and total nitrogen removal efficiency (TNRE) of the DN-(PN-ANAMMOX) were further elevated to 0.55 kg ·(m 3 ·d) -1 and 94.65%, respectively. Moreover, the direct treatment of mature leachate with 2233 mg ·L -1 NH 4 + -N and 2712 mg ·L -1 COD was finally realized. In addition, Candidatus Kuenenia was better adapted to leachate and high substrate concentration wastewater, and it became the dominant genus in the ANAMMOX zone.

In order to enhance the removal of NO 3 - -N in the ANAMMOX process, an element sulfur-based autotrophic short-cut denitrification (short-cut S 0 -SADN) was introduced by adding elemental sulfur to an ANAMMOX continuous flow reactor. The effects of different influent NH 4 + -N/NO 2 - -N ratios on the nitrogen conversion and NO 2 - -N competitive characteristics in the coupled system were investigated at (33±2)℃ and a pH of 7.8-8.2. The results showed that under different influent NH 4 + -N/NO 2 - -N ratios (1:1.3, 1:1.5, 1:1, and 1:1.1), the average total nitrogen (TN) removal efficiency of the coupled system reached 96.78%, 97.21%, 94.68%, and 97.72%, respectively, which were much higher than the highest TN removal efficiency of the ANAMMOX theory (89%). Among them, the stable operation of deep nitrogen removal of the short-cut S 0 -SADN coupled with ANAMMOX was successfully achieved with an influent NH 4 + -N/NO 2 - -N ratio of 1:1 or 1:1.1. Under the optimal influent NH 4 + -N/NO 2 - -N ratio of 1:1.1, the concentrations of influent NH 4 + -N and NO 2 - -N were 240 mg·L -1 and 265 mg·L -1 , respectively, the TN removal rate reached 1.50 kg·(m 3 ·d) -1 , and the TN removal efficiency of ANAMMOX and S 0 -SADN pathways were stable at (95.68±1.22)% and (2.04±0.77)%, respectively. During the entire operational process, ANAMMOX always occupied an absolute advantage in the competition of substrate NO 2 - -N, and the activity of ANAMMOX bacteria (NH 4 + -N/VSS) was stable at (0.166±0.008)kg·(kg·d) -1 .

Macrobenthos from 20 sites of 17 rivers in Beijing were investigated in the spring of 2019, and the relationship between community structure characteristics and environmental factors was analyzed. A total of 64 classification units (species) of macrobenthos from 3 phyla, 6 classes, and 32 families were identified. We found that there were large spatial differences between the density composition and dominant species of macrobenthos. Mountainous river area had the highest density of aquatic insects (33.95 ind.·m -2 ), and the main dominant species were Simuliidae sp., Hydropsyche sp., and Paraciadius alpicola . In suburban areas, Chironomidae and Oligochaeta showed the largest average density, which was 82.58 ind.·m -2 and 36.21 ind.·m -2 , respectively, and Polypedilum nubeculosum and Chironomus pallidivittatus were the dominant species in this area. Furthermore, macrobenthos in urban rivers were mainly Gastropods (88.75 ind.·m -2 ), and the dominant species were Bellamya aeruginosa and Bellamya purificata . Fourteen more species were found in the urban and suburban river areas than in mountain areas. According to the results of the canonical correspondence analysis, there were many factors affecting the community structure of macrobenthos, including water temperature, TN, Chl-a, pH, and human activity. Nutrient concentration was the main factor affecting the community structure of macrobenthos in the suburban river area, while human activities and water temperature were the major determinants of the macrobenthos community structure in mountainous and urban rivers.

To explore the effects of future climate change on food production in Henan Province, the climate potential productivity and its change characteristics in Henan Province were calculated by agro-ecological zone (AEZ) model. This study was based on the production potential and climate resource carrying capacity of summer maize and winter wheat, combined with the observation data of 111 meteorological stations in Henan Province from 1961 to 2017 and the meteorological data under two emission scenarios of RCP4.5 and RCP8.5 in 2041-2080. With the grain demand index under different living standards, we analyzed climate carrying capacity and surplus space of Henan Pro-vince. The results showed that the average climatic potential productivity of maize was 18408.87 kg·hm -2 from 1961 to 2017, with high values in the middle and east, and low values in the west. Compared with the reference period (1981-2010), climatic potential productivity of maize under RCP4.5 and RCP8.5 decreased by 13.0% and 8.0% respectively, with the high value center shifting from the east to the southwest of Henan. The average climatic potential productivity of wheat was 10889.79 kg·hm -2 , which was high in the middle region and low in the north. Compared with the reference period, climatic potential productivity of wheat under RCP4.5 and RCP8.5 decreased by 18.6% and 21.7%, respectively. Under the current condition of subsistence and well-off food demand, the maximum carrying capacity of climate resources respectively could support 252 million and 183 million people. In 2070s (2071-2080), the average supporting population of the maximum climate resource carrying capacity (C max ) would decrease. Compared with the reference period, C max under the level of well-off and subsistence would decrease by 9.7% and 18.4% respectively in RCP4.5 scenario, and 7.7% and 16.6% respectively in RCP8.5 scenario. Under current climate condition, the relative surplus rate of climate resources in Henan Province ranged from -93.0% to 356.9%. Compared with the reference period, the relative residual rate of climate resources in the future would reduce nearly 40%.

Substrate exposure levels are vital for the growth and metabolism of ANAMMOX microorganisms, and their effects on growth characteristics of ANAMMOX sludge during the enrichment process have been rarely reported. Using two continuous flow stirred reactors and the process of a gradually developing nitrogen load, the changes in biomass and activity, as well as nitrogen removal efficiency of the reactors were investigated under high substrate exposure level culture mode (R1:effluent NH 4 + -N and NO 2 - -N concentrations were 40-60 mg·L -1 ) and low substrate exposure level culture mode (R2:effluent NH 4 + -N and NO 2 - -N concentrations were 0-20 mg·L -1 ). The results showed that the high substrate exposure level culture mode was more beneficial to the improvement of nitrogen removal performance of the ANAMMOX reactor. For comparison, the NLR (nitrogen load rate), which was 0.69 kg·(m 3 ·d) -1 , and the NRR (nitrogen remove rate), which was up to 0.41 kg·(m 3 ·d) -1 , was obtained in the high substrate exposure culture mode. These values were twice as high as those obtained in the low substrate exposure culture mode. Under the culture mode with high substrate exposure level, the sludge concentration (in VSS) and the total gene copy numbers of ANAMMOX reached 1805 mg·L -1 and 4.81×10 12 copies, respectively, which was conducive to the rapid enrichment of ANAMMOX microorganisms. In the low substrate exposure level culture mode, ANAMMOX sludge was more active,in N/VSS, 0.27 g·(g·d) -1 , which was conducive to the cultivation of ANAMMOX sludge with higher biological activity.

Background: The health problems of hospitalized older patients are complicated, with delirium a common neurocognitive disorder in this population. Delirium has been correlated with the longer periods of hospitalization, higher mortality, and higher rates of institutionalization. However, clinical practice guidelines for delirium management in hospitalized older patients are lacking., Purpose: The purpose of this study was to develop evidence-based practice guidelines for delirium management in hospitalized older patients., Methods: A multidisciplinary task group at a medical center in southern Taiwan was established. Team members reviewed current delirium practice guidelines. A revised set of practice guidelines was developed by constructing foreground questions on key issues and by systematically searching, appraising, and synthesizing the relevant evidence. After a new draft of the guidelines was established, the Delphi method was used to reach a consensus among experts. Finally, the developed guideline document was applied in a geriatric ward of a medical center in order to evaluate applicability., Results: The developed delirium guidelines address 3 issues with 35 recommendations. The panel of clinical and methodological experts recommended that these delirium guidelines be applied in practice. Most nurses in the targeted geriatric ward indicated that the guidelines were feasible and easy to implement. However, several of the procedures were identified as difficult to implement, including "provide a therapeutic environment", "promote good sleep patterns and sleep hygiene", and "consider psychotropic medication as a last resort for agitation"., Conclusions / Implications for Practice: The evidence-based delirium management guidelines for hospitalized older patients that were developed in this study integrates the recommendations from the best available evidence and earned a high consensus among clinical experts. Thus, these guidelines are recommended for clinical application.

Magnetite core/zirconia shell nanocomposite (abbreviated as Fe 3 O 4 @ZrO 2 hereafter) was obtained using one-step co-precipitation method and its performance for removal of fluoride ion from water was studied. The results showed that the Langmuir maximum adsorption capacity of fluoride ion by Fe 3 O 4 @ZrO 2 was 35.46 mg·g -1 , which was far higher than those of magnetite, activated alumina and activated carbon. Studies of adsorption kinetics indicated that the adsorption of fluoride ion by Fe 3 O 4 @ZrO 2 was fast and could be well described by the pseudo-second-order model. The adsorption process of fluoride ion was an endothermic reaction. The adsorption of fluoride ion by Fe 3 O 4 @ZrO 2 decreased with increasing pH. Chloride, nitrate and sulfate anions, which commonly coexist in drinking water, had little effect on F - adsorption, although the coexistence of HCO 3 - and CO 3 2- reduced the adsorption significantly by increasing the pH of the solution system. The fluoride adsorbed by Fe 3 O 4 @ZrO 2 could be successfully desorbed with 1 mol·L -1 NaOH solution as desorption agent. The desorption rate reached 99.5%-99.6%. The F - -desorbed Fe 3 O 4 @ZrO 2 could be reused for the removal of F - after regeneration via restoring the protonation status of surface hydroxyl groups on hydrous zirconia. The removal efficiency of fluoride by Fe 3 O 4 @ZrO 2 from actual well water was lower than that from pure water, but concentration limit for fluoride in drinking water could still be attained by increasing the dosage to a sufficiently high level. Fe 3 O 4 @ZrO 2 is a promising material for fluoride removal due to its good performance, simple preparation method and easy separation from water by providing an external magnetic field.