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Background: Poor disease control in patients with chronic obstructive pulmonary disease (COPD) is associated with suboptimal inhaler use. Purpose: This study was designed to explore the accuracy of inhaler use and related factors in elderly patients with COPD. Methods: A cross-sectional survey design was used to recruit patients with COPD from a medical centre in southern Taiwan who were over 65 years old and used inhalers regularly. All of the data as well as information on inhaler use accuracy were collected using a self-designed questionnaire and inhaler operation checklist. Multivariable logistic regression was used to analyse significant correlates of correct inhaler operation. Results: The average age of the 150 participants was 75.0 years (SD = 7.5) years. Most used one type of inhaler only (86.0%). The rate of accurate inhaler operation was 40.7% (n = 61) for the sample, with dry powder inhalers associated with the highest accuracy (64%) and pressurized metered-dose inhalers associated with the lowest accuracy (1.6%). Multivariate logistic regression analysis showed that using a soft mist inhaler (adjusted odds ratio, AOR = 23.29; 95% confidence interval, 95% CI [2.84, 191.07]), using a dry powder inhaler (AOR =15.60, 95% CI [1.99, 122.26]), and higher satisfaction with the inhaler were positively and independently associated with accurate inhaler use (AOR = 1.94, 95% CI [1.09, 3.44]). Conclusion/ Implications for Practice: Important factors related to inhaler use accuracy include inhaler type and level of patient satisfaction with their inhaler. Healthcare professionals should regularly confirm that older patients are able to use their inhalers correctly and are satisfied with their inhalers. [ABSTRACT FROM AUTHOR]

A general heat transfer model of a parallel plate channel filled with a porous medium was constructed based on the Brinkman-Darcy extended model and the local thermal non-equilibrium model in view of the internal heat sources in fluid and solid phases. The temperature field of the porous medium under the fully developed heat transfer condition was respectively formulated with the direct and indirect decoupling methods of solving the fluid-phase and solidphase energy equations. Compared to the direct decoupling method, the indirect one is more convenient to be employed to solve the 2nd-order differential equations under the original boundary conditions. The equivalence of the 2 decoupling methods was verified through comparison of the coefficients in the dimensionless temperature expressions and the temperature distributions between them. A good agreement was found between the temperature distributions obtained with the indirect decoupling method and those reported in the previous literatures in 2 limit cases, meanwhile the better generality of the proposed model was also proved to some extent. The parametric study shows that the temperature difference between the fluid and solid phases decreases with the Biot number or the effective thermal conductivity ratio, and the Nusselt number decreases with the internal heat source ratio. [ABSTRACT FROM AUTHOR]

Aiming at the direct effect of family refuge chamber cabin's anti-seismic performance on the structural stability and safety of the trapped inside, transient dynamic analysis of the cabin was analyzed by ANSYS Workbench finite element software based on the trait of seismic load. According to the displacement nephogram of the cabin, the maximum displacement and its response time was analyzed which could verify if the cabin meet the need of design. Further the weak part of cabin was found and the suggestion for improvement was adopted. The cabin thickness and the stiffener sizes were chosen as variables. The quality, the maximum stress and the maximum total deformation were chosen as optimization objective. So the multi-objective optimization model was built. Finally the cabin was optimized by Pro/E and AWE cosimulation optimization and optimized structure was analyzed again by transient dynamic analysis. The analyzing results indicate that both the strength and stiffness of the optimized structure are improved effectively. The research is valuable and helpful for the rescue capsule design and the anti-impact ability evaluation. [ABSTRACT FROM AUTHOR]

When dye penetrant testing method is used to detect ZG04Crl3Ni4Mo stainless steel castings machined surface quality we are able to observe round spots. In order to study whether such displayed dots indicate the presence of defect on machined surface, and which defect types they correspond to, penetrant testing methods have been adopted to detect machined surface defects of ZG04Crl3Ni4Mo stainless steel samples, and scanning electron microscope and metallurgical microscope are used to observe and analyze displayed dots. Test results show that displayed dots were observed on the sample surface. Dot size is in the range of 0. 07 ~ 1. 2 mm. After the samples are cleaned, scanning electron microscope was used to observe and analyze the imaging areas on sample surface. Defects are found on sample surface, which belong to inclusion defects. Defect size is in the range of 0. 07 ~ 1. 2 mm. These inclusions are rich in O, Si, Al, and Ca four elements. [ABSTRACT FROM AUTHOR]

Background: Poor disease control in patients with chronic obstructive pulmonary disease (COPD) is associated with suboptimal inhaler use., Purpose: This study was designed to explore the accuracy of inhaler use and related factors in elderly patients with COPD., Methods: A cross-sectional survey design was used to recruit patients with COPD from a medical centre in southern Taiwan who were over 65 years old and used inhalers regularly. All of the data as well as information on inhaler use accuracy were collected using a self-designed questionnaire and inhaler operation checklist. Multivariable logistic regression was used to analyse significant correlates of correct inhaler operation., Results: The average age of the 150 participants was 75.0 years (SD = 7.5) years. Most used one type of inhaler only (86.0%). The rate of accurate inhaler operation was 40.7% (n = 61) for the sample, with dry powder inhalers associated with the highest accuracy (64%) and pressurized metered-dose inhalers associated with the lowest accuracy (1.6%). Multivariate logistic regression analysis showed that using a soft mist inhaler (adjusted odds ratio, AOR = 23.29; 95% confidence interval, 95% CI [2.84, 191.07]), using a dry powder inhaler (AOR =15.60, 95% CI [1.99, 122.26]), and higher satisfaction with the inhaler were positively and independently associated with accurate inhaler use (AOR = 1.94, 95% CI [1.09, 3.44])., Conclusions / Implications for Practice: Important factors related to inhaler use accuracy include inhaler type and level of patient satisfaction with their inhaler. Healthcare professionals should regularly confirm that older patients are able to use their inhalers correctly and are satisfied with their inhalers.

The purpose of this study is to analyze the family's clinical data of 22 children who were given an intended clinical diagnosis of Duchenne muscular dystrophy (DMD), and to explore the clinical value of next-generation sequencing (NGS) in the molecular diagnosis of DMD. The probands were simultaneously tested by NGS for a gene panel associated with hereditary neuromuscular disease and multiplex ligation-dependent probe amplification (MLPA) for the Dystrophin gene. The exon deletion/repetition mutations of the Dystrophin gene determined by both methods were compared and the point mutations of the Dystrophin gene were verified by Sanger sequencing. Dystrophin gene mutations were found in all the 22 probands, including 14 exon deletion/repetition mutations and 8 point mutations/minor variations. The results of MLPA detection were consistent with those of NGS. The results of Sanger sequencing showed that the point mutations and minor variations determined by NGS were correct. One missense mutation (c.6290G>T), 1 nonsense mutation (c.3487C>T) and 4 minor deletion-induced frameshift mutations (c.1208delG, c.7497_7506delGGTGGGTGAC, c.9421_9422delAA and c.8910_8913delTCTC) had not been reported in the Human Gene Mutation Database, and thus were considered as novel mutations of the Dystrophin gene. The results of this study showed that NGS can detect variations in the Dystrophin gene, including exon deletion/repetition, point mutation, minor deletion and intron mutation. Therefore, NGS is of certain clinical value in the molecular diagnosis of DMD and is worthy of recommendation.

A device based on electrolyte cathode atmospheric glow discharge atomic emission spectroscopy (ELCAD-AES) has been developed to determine the metal ion Pb in water. The emission intensity of Ph was significantly enhanced with the increase concentration of Pb, and the emission intensity has a linear relationship with concentration while the concentration of Pb in the range of 10-80 mg x L(-1). The effects of discharge current and easily ionizable elements on the emission spectral of Pb were investigated, and the emission intensity reached greatest when the discharge current increased to 70 mA, and the easily ionizable elements generated weak effect on the emission spectral of Pb. The effect of acidification regent on emission spectral of Pb was discussed. It was found that it perform best when acidified with HNO3, and reducing the pH can improve the emission intensity of Pb effectively. The emission intensity of Pb at different region was detected near cathode region, thus obtained the best detection position. Under the optimized experimental parameters, the detection limit of Ph was 0.7 mg x L(-1) and relative standard deviation was 1.7%. The recovery of samples was 95%-106%, result and shows that this method has better accuracy. These results provide an available method for further research of detection trace heavy mental elements in water using ELCAD-AES.

·OH plays a crucial role in many fields, having aroused wide public concern in the world. Atmospheric Pressure Plasma Jet, which can be achieved by portable device due to working without the vacuum environment, has the advantages of high concentration of reactive species, high electron temperature and low gas temperature. It has become an important research topic in the field of gas discharge with a strong prospect. Especially, how to induce plasma jet to produce ·OH has become a new hotpot in the field of low-temperature plasma. It has been reported that mass ·OH can be induced successfully when water vapor is added to the working gas, but it will be unstable when the concentrate of water reaches a certain degree. Thus, a device of argon plasma jet with a Ring-to-Ring Electrode Configuration has been designed to interact with water in the surrounding air to generate ·OH under atmospheric pressure. In order to increase the production of ·OH, ultrasonic atomizing device is introduced to promote water concentration around the plasma plume. The generating rule of OH(A2J) induced by water has been extensively studied under different voltages and flow rate. ·OH output induced by the plasma has been tested by emission spectrometry, and at the meanwhile, Ar atomic spectral lines at 810.41 and 811.48 nm are also recorded in order to calculate the electron temperature in argon plasma plume. The results show that the water surrounding the plasma plume can be induced to produce ·OH, and OH(A2 ∑+) output increases with the electrode voltage rising from 20 to 28 kV. When the flow rate increases from 100 to 200 L x h(-1), the OH(A2∑+) output increases, but from 200 to 600 L x h(-1), it decreases. The production rules of OH(A2∑+) is the same as that of electron temperature. Therefore, the presumption is proved that ·OH output mainly affected by electron temperature.

The Rana grylio virus (RGV) is a member of the genus Ranavirus. It belongs to the family Iridoviridae, and contains the gene 67R encoding dUTPase. In order to investigate the function of 67R in the replication and infection of RGV, we constructed Δ67R-RGV, a recombinant virus with deletion of 67R. First, we constructed the plasmid pGL3-67RL-p50-EGFP-67RR which carried an enhanced green fluorescence gene (EGFP) as a selectable marker. After homologous recombination between pGL3-67RL-p50-EG- FP-67RR and the RGV genome, Epithelioma papulosum cyprini (EPC) cells were infected with the resulting mixture. Through ten successive rounds of plaque isolation via EGFP selection, all plaques emitted green fluorescence, and finally Δ67R-RGV was generated. Total DNA of Δ67R-RGV infected cells was extracted for PCR analyses. Simulateously, mock infected and wild-type RGV (wt-RGV) infected cells were used as a comparison. Results showed that 67R could be detected in wt-RGV infected cells, but that only the EGFP gene was detected in Δ67R-RGV infected cells. Furthermore, one-step growth curves of wt-RGV and Δ67R-RGV were similar. Therefore, 67R and its encoding product dUTPase might not be essential for the growth of RGV. These results suggest that, homologous recombination and recombinant rana- virus could be used to study the gene function of viruses in aquatic animals.

The advanced treatment of petrochemical secondary wastewater by ozone- aerated biological filter was carried out in this study. The effect of pH on ozonation and the removal of COD and UV254 by the ozone-aerated biological filter combined process were investigated. In addition, the variation of relative molecular mass distribution of organics and the characteristics of three-dimensional fluorescence spectra of the wastewater were also investigated. The results showed that the suitable operating conditions of the ozonation unit were: ozone dosage 10 mg x L(-1), contact time 4 min and slightly alkaline pH. Ozonation can transfer macromolecular organics into small molecular organics, resulting in a 15% increase in the percentage of the organics with small relative molecular mass (less than 1 000). The biodegradability of the petrochemical secondary effluent was significantly improved by ozonation, making it more suitable for the treatment by aerated biological filter. The removal efficiency of COD and UV254 were 40.8% and 45.8% when the hydraulic retention time was 3 hours and the gas to water ratio was 3:1 for BAF. The average COD of the petrochemical wastewater was 86.5 mg x L(-1) while the average COD of the effluent of the combined process was 49.4 mg x L(-1) when it was operated under optimal conditions.

Japanese encephalitis virus (JEV) is a single-stranded and positive-sense RNA, which has a single ORF (open reading frame), encoding a polyprotein precursor. Non-structural protein 3 (NS3) plays an important role in processing the polyprotein precursor and has become an important drug target of flavivirus. In this study, NS2BH-NS3 gene was amplified by PCR and subcloned to the prokaryotic expression plasmid, resulting pET30a-NS2BH-NS3. The fusion protein was expressed in Escherichia coli BL21 (DE3) in soluble form after induction by Isopropyl beta-D-1-Thiogalactopyranoside (IPTG). The recombinant protein was purified by Ni-NTA affinity column. Then a fluorescence resonance energy transfer (FRET) method was used to determine enzymatic activity and the assay conditions were optimized. After screening 113 compounds, we found two compounds inhibiting the activity of NS2BH-NS3. This study provides a convenient and cost-effective method for screening of JEV NS3 protease inhibitor.

In Taiwan, breast cancer ranks as the most prevalent form of cancer in the female population. Some breast cancer patients are genetically predisposed to this disease. To assess the risk of hereditary breast cancer for breast cancer patients, nurses should collect client breast cancer family histories back to three to four generations. Nurses should also comprehensively assess client psychosocial problems prior to and after genetic testing, and employ appropriate communications skills to provide clients adequate information regarding the disease. Nurses should ensure that clients are adequately informed prior to deciding whether or not to proceed with BRCA1/BRCA2 testing. When a client is identified as a gene mutation carrier, nurses should explain to her regarding the implementation of a monitoring program and of the importance of long-term follow-up. Nurses should explain to carriers the possible effects and impacts of preventive surgery and preventive chemotherapy so that they may make considered decisions regarding whether and how to implement preventive procedures. Furthermore, nurses should treat client families as a unit, and encourage all family members to participate together in genetic counseling. Nurses should also provide family members with an understanding of preventive strategies. Nurses should improve their knowledge and skills in genomic nursing. We hope this article can provide useful information for nurses to provide care for hereditary breast cancer patients and their families.

Toxic metal elements in waters and wastewaters contaminate the environment and greatly threaten the health of human beings, therefore developing a rapid monitor for metal residues in aqueous solutions is urgently required. In the present work, a new homemade apparatus of electrolyte cathode atmospheric glow discharge emission spectroscopy was developed and described. It can detect and discriminate many kinds of trace mental elements by atomic emission spectrum from atmospheric pressure liquid cathode glow discharge. In order to estimate the analytical performance of the present atmospheric pressure electrolyte cathode glow discharge emission spectroscopy system, the detection limit values for Na, Li, Cu, Pb and Mn were obtained based on 3sigma of the background signal, and the current limits of detection were 0.008, 0.005, 1.1, 2.06 and 1.95 mg L(-1), respectively. It demonstrates that the atmospheric pressure electrolyte cathode glow discharge emission spectroscopy has a promising application in real time measurements of metal residues in aqueous solutions.

In the present work, a simply designed and easy made micrometer plasma jet device operating under atmospheric pressure was characterized. The microplasma jet operates in many kinds of working gas at atmospheric pressure, such as Ar, He, N2 etc, and is powered by a direct current power source. It can generate high current density glow discharge. In order to identify various excited species generated by the direct current microplasma jet device, the optical emission spectra of the jet with argon or nitrogen as working gas were studied. Based on the optical emission spectroscopy analysis of argon microplasma jet, the electron excitation temperature was determined to be about 3 000 K by the intensity ratio of two spectral lines. It is much lower than the electron excitation temperature of atmospheric pressure plasma torch, and hints that the atmospheric pressure direct current microplasma jet is cold compared with the atmospheric pressure plasma torch. The emission spectra of the N2 second positive band system were used to determine the vibrational temperature of the atmospheric pressure direct current microplasma jet. The experimental result shows that the molecular vibrational temperature of N2 is about 2 500 K. The electron density of the microplasma jet is about 10(13) cm(-3), which can be estimated from the electrical parameters of the discharge in the microplasma jet. A simple example of application of the microplasma jet is given. General print paper surface was modified with the microplasma jet and afterwards a droplet test was carried out. It was shown that the microplasma jet is more efficient in changing the hydrophilicity of general print paper.

Microhollow cathode discharge or microdischarge is an efficient method to generate plasma in a high pressure gas. In the present work, the emission spectra were observed in an atmospheric pressure argon direct current microdischarge apparatus, using a stainless steel capillary as the cathode, and a stainless steel mesh as the anode. It was shown that all of the seventeen argon spectral lines arose from electronically excited argon atom 4p-4s transition in the wavelength range of 690-860 nm. The dependences of emission intensity on the discharge current, gas pressure and argon flow rate were investigated. The experimental results show that the emission intensity increased with discharge current from 1 to 6 mA and argon flow rate from 100 to 700 mL x min(-1). The dependence of emission intensity on gas pressure exhibited different characteristics, i.e., spectral signal increased with the gas pressure, but reached the intensity maximum at 13.3 kPa, and decreased afterwards. The argon atom spectral lines 763.51 and 772.42 nm were chosen to measure the electron excitation temperature by the intensity ratio of two spectral lines. The electron excitation temperature was determined to be in the range of 2000 to 2800 K in the atmospheric pressure argon microdischarge. The changes in electron excitation temperature with discharge current, gas pressure and argon flow rate were explored, indicating that the electron excited temperature increased with the discharge current, but decreased when gas flow rate or argon pressure increased.