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Background: To compare the effects of proton pump inhibitor (PPI) and histamine‐2 receptor antagonist (H2RA) use on the occurrence of acute kidney injury (AKI) in septic patients at high risk for developing stress ulcers. Methods: Using the Medical Information Mart for Intensive Care IV version 2.2 database, septic patients with high‐risk factors for stress ulcers (i.e., shock, coagulopathy, invasive mechanical ventilation, or chronic liver diseases) were included. Exposures included PPIs and H2RAs within 24 h of intensive care unit (ICU) admission or prior to ICU admission. The primary end point was severe sepsis‐associated AKI as defined by the Kidney Disease Improving Global Outcomes criteria stage 3 (KDIGO‐3). Propensity score matching (PSM) was performed to balance baseline characteristics. Multivariable Cox proportional hazards regression was used to estimate the effect size. Results: 4731 PPI users and 4903 H2RA users were included. After PSM, there were 1785 pairs exposed to PPIs and H2RAs. In the PSM cohort, the cumulative incident KDIGO‐3 rate was higher in the PPI group than in the H2RA group (log‐rank test, p = 0.009). Regression analyses showed that PPI exposure [adjusted hazard ratio 1.32, 95% confidence interval (CI) 1.11–1.58, p = 0.002] was associated with incident KDIGO‐3 compared with H2RA use. This association remained consistent in sensitivity analyses. Additionally, the PPI group had a higher need for kidney replacement therapy compared with the H2RA group (3.6% vs. 2.1%, P = 0.012). Conclusions: Among septic patients at high risk for developing stress ulcers, PPI exposure was associated with incident KDIGO‐3 AKI compared with H2RA use. [ABSTRACT FROM AUTHOR]

The purpose of this study was to employ complexity theory as a theoretical framework and technology to facilitate the development of a life-long learning model for non-working time in the interdependent homes for adults with Autism Spectrum Disorders (ASD). A "Shining Star Sustainable Action Project" of the ROC Foundation for Autistic Children and Adults in Taiwan (FACT) was selected as the research target, and the staff of the FACT, the medical team of the Hualian Yuli Veteran Hospital, adults with autism and their families were interviewed, observed and analyzed to develop this model during four short-stays of the project from July 2009 to December 2010. Participant field observation and informal conversations were employed and qualitative data were analyzed by using the constant comparison method through application of QSR Nvivo 9. The results showed that dynamic interaction, mutual adaptation, self-organization and co-evolution are four key elements for developing a viable life-long learning model for non-working time in the interdependent homes for adults with ASD to adapt to the impact of an aging society, to improve the quality of medical services, and to enhance the quality of life for the medical teams, patients and their families. The present study also found that the model help medical teams to avoid burnout by learning leisure skills and relaxation techniques, ways to release stress and how to enhance life-long learning for themselves and caregivers/patients' families. (Contains 5 figures and 1 table.)

Using two kinds of targets (gallium and silicon dioxide) and the rf magnetron sputtering deposited technique, GdOx:SiO2 thin film RRAM devices were deposited on TiN/Si substrate to form a metal–insulator–metal (MIM) structure. In addition, different oxygen concentrations and rf sputtering power parameters were prepared for the GdOx:SiO2 thin films. Decrease of the defects and oxygen vacancies of the GdOx:SiO2 thin films were used and repaired by rapid thermal annealing technology. Indium tin oxide (ITO) as the top electrode on the GdOx:SiO2 thin film was prepared by the physical vapor deposition (PVD) method, and ITO/GdOx:SiO2/TiN/Si structures of the GdOx:SiO2 thin films' RRAM devices were also made. In addition, the current–voltage curves and devices' endurance properties were measured by an impedance analyzer. Finally, the crystalline style, the preferred phase, the grain size, and surface microstructure of the thin films were analyzed and observed from X-ray diffraction and field emission scanning electron microscope measurements. [ABSTRACT FROM AUTHOR]

Background. Elderly people often suffer from disturbed sleep. Because traditional Chinese medicine indicates that acupressure therapy may induce sedation, testing the effectiveness of acupressure in enhancing the quality of sleep of institutionalized residents with a well-designed scientific study is needed. Methods. A randomized block experimental design was used. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used as a screening tool to select subjects with sleep disturbance. By matching the effects of hypertension, hypnosis, naps, and exercise, subjects were randomly assigned to an acupressure group, a sham acupressure group, and a control group. Each group had 28 subjects for a total of 84 subjects. The same massage routine was used in the acupressure group and the sham acupressure group, whereas only conversation was employed in the control group. Results. There were significant differences in PSQI subscale scores of the quality, latency, duration, efficiency, disturbances of sleep, and global PSQI scores among subjects in the three groups before and after interventions. Furthermore, there was a significant reduction in the frequencies of nocturnal awakening and night wakeful time in the acupressure group compared to the other two groups. Conclusions. This study confirmed the effectiveness of acupressure in improving the quality of sleep of elderly people and offered a nonpharmacological therapy method for sleep-disturbed elderly people.

By the conventional solid state reaction method, a small amount of lithium fluoride (LiF) was used as the sintering promoter to improve the sintering and piezoelectric characteristics of (Ba0.95Ca0.05)(Ti0.93Sn0.07)O3 (BCTS) lead-free piezoceramic sheets. Using X-ray diffraction (XRD) and a scanning electron microscope (SEM), the inferences of the crystalline and surface microstructures were obtained and analyzed. Then, the impedance analyzer and d33-meter were used to measure the dielectric and piezoelectric characteristics. In this study, the optimum sintering temperature of the BCTS sheets decreased from 1450 °C to 1390 °C due to LiF doping. For the 0.07 wt % LiF-doped BCTS sheets sintered at 1390 °C, the piezoelectric constant (d33) is 413 pC/N, the electric–mechanical coupling coefficient (kp) is 47.5%, the dielectric loss (tan δ) is 3.9%, and the dielectric constant (εr) is 8100, which are all close to or even better than that of the pure undoped BCTS ceramics. The Curie temperature also improved, from 85 °C for pure BCTS to 140 °C for BCTS–0.07 LiF sheets. Furthermore, by using the vibration system and fixing 1.5 g tip mass at the end of the sheets, as the vibration frequency is 20 Hz, the proposed piezoelectric ceramic sheets also reveal a good energy harvesting performance at the maximum output peak voltage of 4.6 V, which is large enough and can be applied in modern low-power electronic products. [ABSTRACT FROM AUTHOR]

In this study, a series of Li0.058(K0.480Na0.535)0.966(Nb0.90Ta0.10)O3+ (x)LiF (x = 0, 0.1, 0.2, 0.3, 0.4, 0.5 wt%) lead-free piezoelectric ceramics were fabricated by a conventional solid-state reaction method. The incorporation of LiF could significantly improve the sintering ability of LKNNT ceramics by reducing the optimal sintering temperature from 1090°C to 1020°C. The crystal phases and micro-structures were analyzed by means of the X-ray diffraction and scanning electronic microscopy, respectively. The impedance analyzer was used to measure the Curie temperature, phase transition point, and electro-mechanical coupling factor. And the d33meter was used to measure the piezoelectric constants. From the results, due to the addition of 0.2 wt% LiF, uniform and condensed grains can be obtained and hence the sintering temperature can be lowered down. As the contents of LiF increased, the orthorhombic to tetragonal phase transition points TO-Twere almost no changed, but the Curie temperature TCdecreased from 425°C (x = 0) to 405°C (x = 0.5). And furthermore, the electro-mechanical coupling factor kpand piezoelectric constant d33were all decreased with increases of LiF contents. Hence, even though the reducing of little amount of piezoelectric characteristics, the LiF addition can improve the sintering ability of the LKNNT ceramics effectively. [ABSTRACT FROM PUBLISHER]