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The Daya Bay experiment consists of functionally identical antineutrino detectors immersed in pools of ultrapure water in three well-separated underground experimental halls near two nuclear reactor complexes. These pools serve both as shields against natural, low-energy radiation, and as water Cherenkov detectors that efficiently detect cosmic muons using arrays of photomultiplier tubes. Each pool is covered by a plane of resistive plate chambers as an additional means of detecting muons. Design, construction, operation, and performance of these muon detectors are described.

A measurement of the energy dependence of antineutrino disappearance at the Daya Bay reactor neutrino experiment is reported. Electron antineutrinos (ν¯(e)) from six 2.9  GW(th) reactors were detected with six detectors deployed in two near (effective baselines 512 and 561 m) and one far (1579 m) underground experimental halls. Using 217 days of data, 41 589 (203 809 and 92 912) antineutrino candidates were detected in the far hall (near halls). An improved measurement of the oscillation amplitude sin(2)2θ(13)=0.090(-0.009)(+0.008) and the first direct measurement of the ν¯(e) mass-squared difference |Δm(ee)2|=(2.59(-0.20)(+0.19))×10(-3)  eV2 is obtained using the observed ν¯(e) rates and energy spectra in a three-neutrino framework. This value of |Δm(ee)2| is consistent with |Δm(μμ)2| measured by muon neutrino disappearance, supporting the three-flavor oscillation model.

The Daya Bay Reactor Neutrino Experiment was designed to achieve a sensitivity on the value of sin22θ13 to better than 0.01 at 90% CL. The experiment consists of eight antineutrino detectors installed underground at different baselines from six nuclear reactors. With data collected with six antineutrino detectors for 55 days, Daya Bay announced the discovery of a non-zero value for sin22θ13 with a significance of 5.2 standard deviations in March 2012. The most recent analysis with 139 days of data acquired in a six-detector configuration yields sin22θ13=0.089±0.010(stat.)±0.005(syst.), which is the most precise measurement of sin22θ13 to date. © 2013.

We report an improved measurement of the neutrino mixing angle θ13 from the Daya Bay Reactor Neutrino Experiment. We exclude a zero value for sin22θ13 with a significance of 7.7 standard deviations. Electron antineutrinos from six reactors of 2.9 GW th were detected in six antineutrino detectors deployed in two near (flux-weighted baselines of 470 m and 576 m) and one far (1648 m) underground experimental halls. Using 139 days of data, 28909 (205308) electron antineutrino candidates were detected at the far hall (near halls). The ratio of the observed to the expected number of antineutrinos assuming no oscillations at the far hall is 0.944±0.007(stat.)±0.003(syst.). An analysis of the relative rates in six detectors finds sin22θ13=0. 089±0.010(stat.)±0.005(syst.) in a three-neutrino framework. © 2013 Chinese Physical Society and the Institute of High Energy Physics of the Chinese Academy of Sciences and the Institute of Modern Physics of the Chinese Academy of Sciences and IOP Publishing Ltd.

Phase Doppler interferometry is providing detailed information about the structure of sprays. Such information is attractive to those developing numerical models that predict spray behavior. However, the inherent complexity of sprays and advanced diagnostics warrants the development of a reference point for measurements. Hence, a "standard" spray is evaluated in the current study which can be used to evaluate instrument and operator performance and, once sufficient data sets are generated, can provide a benchmark data set for modeling challenges. A comprehensive set of mean and variation in five sets of measurements is provided. In general, the results reveal reasonable reproducibility, especially in quantities which are dependent solely upon the number of drops (e.g., mean velocities). It is also shown that statistics derived from individual drop sizes reveal less variability than those derived from the entire spray population. Finally, it is observed that quantities whichdepend upon drop volume and/or sample volume area (e.g., Sauter mean diameter, volume flux) are subject to the greatest variability. © 1994, American Institute of Aeronautics and Astronautics, Inc., All rights reserved.

Background: Cellular replacement strategies using embryonic stem cells (ESCs) and their cardiac derivatives are emerging as novel experimental therapeutic paradigms for the treatment of post-myocardial infarction (MI) left ventricular (LV) dysfunction; however, their potential proarrhythmic risk remains unclear.Objective: The purpose of this study was to investigate the functional effect and proarrhythmic risk of ESC transplantation in a mouse model of MI.Methods: We compared the functional effects and proarrhythmic risk of direct intramyocardial transplantation of 3 × 10(5) undifferentiated mouse ESCs (MI+ESC group, n = 33) and mouse ESC-derived cardiomyocytes (MI+ESC-CM group, n = 40) versus culture medium (MI group, n = 33) at the infarct border zone in a mouse model of acute MI. LV performance was assessed with serial cardiac magnetic resonance imaging (MRI) at 1 and 3 week(s) post-MI, and invasive LV pressure measurement was assessed (dP/dt) at 4 weeks before sacrifice for histological examination. Furthermore, electrophysiological study was also performed in another set of animals in each group (n = 24) to assess for proarrhythmias after transplantation.Results: In vitro cellular electrophysiological study demonstrated that ESC-CMs exhibit arrhythmogenesis including automaticity, lengthened action potential duration, and depolarized resting membrane potential. At 4 weeks, the MI+ESC-CM group (21/40, 53%) had a higher mortality rate compared with those in the MI group (10/33, 30%, P = .08) and in the MI+ESC group (7/33, 21%, P = .012). Electrophysiological study showed a significantly higher incidence of inducible ventricular tachyarrhythmias in the MI+ESC-CM group (13/24, 54%) compared with in the MI group (6/24, 21%, P = .039) and in the MI+ESC group (5/24, 21%, P = .017). Cardiac MRI showed similar improvement in LV ejection fraction in the MI+ESC and MI+ESC-CM groups compared with in the MI group at 1 week (27.5% ± 3.8%; 30.3% ± 5.2% vs. 12.4% ± 1.4%; P < .05) and 3 weeks (29.8% ± 3.9%; 27.0% ± 4.8% vs. 10.6% ± 2.8%; P < .05) post-MI, respectively. Furthermore, invasive hemodynamic assessment at 4 weeks showed significant similar improvement in LV +dP/dt in the MI+ESC (2,644 ± 391 mmHg/s, P < .05) and MI+ESC-CM groups (2,539 ± 389 mmHg/s; P < .05) compared with in the MI group (2,042 ± 406 mmHg/s).Conclusions: Our results demonstrate that transplantation of undifferentiated ESCs and ESC-CMs provides similar improvement in cardiac function post-MI. However, transplantation of ESC-CMs is associated with a significantly higher prevalence of inducible ventricular tachyarrhythmias and early mortality than transplantations with ESCs. [ABSTRACT FROM AUTHOR]

Female athletes are more likely to sustain an anterior cruciate ligament (ACL) injury. Knee laxity, hyperextension and limb dominance have been suggested as possible factors contributing to the knee injury. The aims of this study were to investigate the physiological anterior knee laxity between the dominant and non-dominant limb and in healthy young females with and without hyperextension knees. Forty-two healthy young females, 21 with hyperextension knees, were recruited voluntarily for this study. The subjects were tested with KT-2000 knee ligament arthrometer at both knees with flexion 30 degrees to obtain the anterior tibial displacements at loadings of 45, 67, 89 and 134 N. The initial and terminal stiffnesses were further calculated and analyzed to demonstrate the differences in the characteristics of knee laxity between limbs and groups. The results showed that there was no significant displacement difference between hyperextension and non-hyperextension groups. However, different physiological anterior laxities were illustrated for the different limbs and groups. The non-dominant side of the hyperextension group had significantly smaller terminal stiffness than that of the non-hyperextension group. The dominant side of the hyperextension group had larger laxity than the non-dominant side in the higher loading conditions. These findings may explain hyperextension knees are at greater risk of sustaining an ACL injury. [ABSTRACT FROM AUTHOR]

Background: Human polyomaviruses (HPyVs), JC polyomavirus (JCPyV) and BK polyomavirus (BKPyV), have been found in upper tract urothelial carcinoma UTUC; however, the association of the viral oncogenic factors and clinical characteristics of UTUC remains unclear. This study aimed to investigate the prevalence of JCPyV and BKPyV in UTUC and their correlation with cancer progression among the southwest Taiwanese population from 2020 to 2022., Methods: A total of 72 paraffin-embedded UTUC tissue samples and 41 adjacent tissue samples were collected from 72 patients. Nested polymerase chain reaction and DNA sequencing were used to detect viral DNA and genotypes. Immunohistochemistry was performed using anti- large T (LT) and anti-p53 monoclonal antibodies to detect the expression of viral early LT protein and cellular p53 protein, respectively., Results: The overall prevalence of JCPyV and BKPyV were higher in UTUC than in adjacent tissue samples (65.3% [47/72] vs. 17.1% [7/41]). JCPyV and BKPyV were detected in 95.7% (45/47) and 4.3% (2/47) of the HPyVs-positive UTUC samples, respectively. JCPyV-TW-3 was the predominant strain of JCPyV infection. In UTUC samples, the LT protein of JCPyV and BKPyV positivity rate was 65.3%, while that of mutant p53 protein was 52.7%. JCPyV infection and LT protein expression increased the odds ratio (OR) of UTUC by 9.13-fold. The OR of UTUC was higher by 10.34-fold in patients with mutant p53 and by 10.37-fold in those with simultaneous LT and mutant p53 expression. The presence of LT protein in UTUC patients may increase the OR of mutant p53 protein expression by 2.93-fold compared to its absence. Women had a 5.19-fold higher superiority of JCPyV infection and LT expression than men. Patients with chronic kidney disease (CKD) had a 3.15-fold higher OR for mutant p53 protein expression than those without it. In the UTUC advanced stages, the OR of virus and LT expression was 3.18-fold higher compared to those who do not require chemotherapy., Conclusions: JCPyV infection is highly prevalent in UTUC, and the presence of CKD concurrent with high expressions of LT and mutant p53 proteins in patients may be a useful indicator for chemotherapy and poor prognosis., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the review board of the Chia-Yi Christian Hospital (IRB number 2021103). This study was conducted in accordance with the guidelines prescribed in Good Clinical Practice Procedures and the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Chronic diseases are known to detrimentally impact an individual's quality of life (QOL) and well-being. Therefore, this study aims to evaluate the QOL and overall well-being among both healthy individuals and those with diverse primary diagnoses., Methods: This is a cross-sectional study and data collection took place from May 2022 to May 2023. Information regarding healthy participants was gathered from healthcare workers without any comorbidities. Data for non-healthy participants were collected from individuals diagnosed with various conditions across four specialist clinics: nephrology, oncology, psychiatry, and cardiology. All participants completed the Significant Quality of Life Measures (SigQOLM), a comprehensive assessment tool consisting of 69 items that evaluate 18 domains of QOL and well-being., Results: The study included a total of 452 participants, with 284 (62.8%) classified as healthy. Among the non-healthy participants, 41 (9.1%) had end-stage renal diseases (ESRD), 48 (10.6%) were diagnosed with cancer, 40 (8.8%) had depressive disorder, and the remaining had heart disease (8.6%). Statistical analysis revealed significant differences (p < 0.001) between healthy and non-healthy participants in both overall SigQOLM scores and across all 18 domains of SigQOLM., Conclusion: Generally, healthy participants also experienced excellent QOL and well-being. However, disparities in both QOL and overall well-being were evident among patients with various diagnoses. These findings provide valuable insights for medical practitioners and policy makers by enabling them to tailor interventions to enhance the QOL and well-being of their patients., Competing Interests: Declarations. Ethics approval and consent to participate: This study received ethics approval and obtained prior written consent from research participants. Only individuals who had given their written informed consent would be eligible for participation in the study. Ethical approval for this study was granted by the Medical Research and Ethics Committee (MREC), Ministry of Health, Malaysia under the registration number of NMRR ID-21-01979-XDL (IIR). All the authors of this paper have confirmed that this study has adhered to the relevant guidelines and regulations pertaining to the reporting of experiments on humans and/or the use of human tissue samples. Consent for publication: We have obtained the formal approval for publication of this article from the Director-General of the Ministry of Health, Malaysia. Therefore, we thank the Director-General of Health of the Ministry of Health, Malaysia for his kind permission to publish these findings. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Aim: Participant recruitment has always been a major challenge in clinical trials. This study aimed to develop and validate the Join Clinical Trial Questionnaire (JoinCT), exploring the willingness to join a clinical trial and associated factors in patients., Methods: This questionnaire development study involved four phases: (i) exploring and understanding the subject matter, (ii) questionnaire development, (iii) content validity testing, and lastly, (iv) field-testing of the questionnaire. For the field-testing phase, a cross-sectional self-administered survey of JoinCT was conducted among cancer patients with various socio-demographic backgrounds and medical conditions. Besides content validity, Cronbach's alpha was used to evaluate the internal consistency of domains, and confirmatory factor analysis was used to evaluate the model fit of the JoinCT framework., Results: A total of 389 respondents participated in the survey. Based on the results obtained from a field data collection phase, JoinCT consisted of four independent variables domains, namely "knowledge", "perception of benefits", "perception of risks", and "confidence". The only dependent variable was the willingness to participate in a clinical trial. The minimum Cronbach's alpha was 0.937, and the model fit for the overall framework of JoinCT is also excellent with Comparative Fit Index (> 0.90), root mean square error approximation (< 0.08), and Standardized Root Mean Square Residual (< 0.08)., Conclusions: The Join Clinical Trial Questionnaire (JoinCT) was successfully validated with excellent reliability and validity, and a good model fit. The main factors that contribute to willingness to participate in clinical trials are knowledge, perception of benefits, perception of risks, and confidence., (© 2023 The Authors. Asia‐Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd.)

Despite the expanding landscape of clinical trials, there is a lack of study concerning Malaysian patients' participation and perspectives. This study addresses these gaps by assessing patients' willingness, knowledge, perceptions, confidence, and religious barriers related to clinical trial participations at Sarawak General Hospital. We conducted a cross-sectional survey from March to September 2022 on 763 cancer and non-cancer patients. We collected patients' responses and calculated scores for willingness to participate (40.5/100), knowledge (29.9/100), perceived benefits (66.5/100) and risks (72.4/100) of participations, confidence in clinical trial conducts (66.3/100), and religious barriers (49.8/100). The higher scores indicated greater willingness, better knowledge, stronger perceptions of benefits and risk, increased confidence, and stronger religious barriers. Cancer patient demonstrated significantly greater willingness for trials involving new drugs (31.9/100 vs. 27.4/100, p = 0.021) but slightly higher religious barriers compared to non-cancer cohort (51.4/100 vs. 48.3/100, p = 0.006). Multivariable logistic regression identified female gender, unemployment, poor knowledge, low perceived benefits, high perceived risks, and low confidence as significant factors associated with reduced willingness to participate (p < 0.05). This study underscores the challenges in engaging Malaysian patients in clinical trials, particularly in Sarawak, emphasising the need for targeted strategies to raise awareness, effective communication, and enhancing public confidence in clinical trials., Competing Interests: Declarations. Conflicting Interests: The authors declare that there is no conflict of interest., (© 2025. The Author(s).)

Objectives: Health-Significant Quality of Life Measure (Health-SigQOLM) provides a generic and dynamic assessment of Health-related quality of life (HRQOL). This study aims to assess the HRQOL among healthy and non-healthy participants with varying chronic diseases., Results: Comparisons between healthy and non-healthy participants revealed statistically significant differences (p < 0.001) in the mean overall HRQOL score as well as across all its nine domains. Therefore, the Health-SigQOLM, along with its nine domains, is demonstrated to have adequate sensitivity in distinguishing between healthy and non-healthy study participants. This had supported the evidence that the Health-SigQOLM is a reliable and valid scale for measuring both generic and dynamic HRQOL., Competing Interests: Declarations. Ethics approval and consent to participate: All respondents have provided written informed consent to participate in this study. Ethical approval for this study was granted by the Medical Research and Ethics Committee (MREC), Malaysia. The ethical approval number for this study is NMRR ID-21-01979-XDL (IIR). The study adhered to the Declaration of Helsinki. Confidentiality was ensured and maintained throughout the process. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Second victim experience (SVE) refers to the emotional and psychological impact experienced by healthcare providers who are involved in patient safety incidents (PSIs). Despite growing awareness of patient safety in healthcare organizations, remedial actions often focus only on the first victim, the patient. Therefore, it is important to recognize and address the emotional and physical toll that PSIs to ensure the well-being of and to promote a culture of safety in healthcare settings. Hence, this study was initiated to determine the prevalence of SVE, assess symptoms related to SVE and evaluate the level of support needed by healthcare providers., Materials and Methods: The Second Victim Experience and Support Tool for Recovery (SVEST-R) questionnaire was utilized to conduct an anonymous survey on the healthcare providers in Sarawak General Hospital (SGH) from August to October 2018., Results: A total of 482 respondents participated in the survey and 46.1% of the respondents reported SVE following their involvement in PSIs. Notably, symptoms such as flashbacks, fear, and stress tend to persist for longer durations compared to other symptoms. It is worth noting that non-work-related support received the highest mean (medical doctors = 3.83; nurses = 3.70), indicating that respondents preferred to seek emotional support from their friends and families. Furthermore, nurses reported a significantly higher experience of absenteeism following PSIs than doctors (p=0.003). In addition, most respondents expressed a desire for discussion or counselling with a respected peer or supervisor following their involvement in PSIs., Conclusion: Present study reported a relatively high prevalence of SVE among healthcare providers at SGH. Hence, proactive measures, including non-work related and supervisor support, are essential in facilitating their overall well-being and successful recovery.

Background/Objectives: The HRQ-6D is a newly developed instrument to measure Health-related quality of life (HRQOL) and EQ-5D is the gold standard for measuring HRQOL. This study aims to test the concurrent validity between EQ-5D and HRQ-6D measures among patients with different primary diagnoses. Methods : This cross-sectional study uses two HRQOL measurement instruments, EQ-5D-3L and HRQ-6D. Data collection was performed between January 2023 and May 2023. All the necessary data for this study were collected from actual patients who presented with any one of the four different types of primary diagnoses: heart disease, cancer, depressive disorders, and end-stage renal disease (ESRD). They were recruited from the four specialist clinics that cater to the treatment of each of the four different types of primary diagnoses in a tertiary hospital. Results : There were 149 patients who participated in the study wherein 40 (26.8%) of them were ESRD patients, 39 (26.2%) of them were cancer patients, 38 (25.5%) of them were mentally depressed, and the remaining were patients with heart diseases. The domains in HRQ-6D, except for the perception of future health, are significantly associated with domains in EQ-5D-3L after having controlled for patients' primary diagnoses (i.e., p < 0.001). The HRQ-6D replaces the domain "Usual activities" with "Physical energy," and the association between these two domains is significant ( p < 0.001). The correlation between the overall HRQ-6D and EQ-VAS scores is also significant (coefficient = 0.445, p < 0.001). Conclusions : The HRQ-6D is demonstrated to have concurrent validity with EQ-5D. Therefore, clinicians and researchers can use HRQ-6D to measure patient outcomes for interventional and observational studies. (Total word count = 265 words).

Phosphonate-based electrolytes with the merits of low cost and intrinsic nonflammability are promising candidates to realize the safe operation of sodium-ion batteries. However, they generally suffer from poor interfacial chemistry because of the solvent-dominated solvation structure induced by the strong ion-dipole interactions between cations and phosphonate molecules. Herein, we report an electrolyte design strategy that selectively improves the competitive coordination of low-solvating-power molecules, achieving stable interfacial chemistry with a non-flammable, low-cost and fluorine-free electrolyte. By improving the ion-ion interaction between cation and anion, weakly coordinated molecules can enter the Na + solvation shell, thereby promoting more adjustable and advantageous interfacial chemistry. As a result, the fluorine-free Prussian blue||hard carbon pouch cell, with a high cathode mass loading of ∼20 mg cm -2 , reaches a high capacity retention with an energy density of over 221.7 Wh kg -1 based on electrode mass and 115.1 Wh kg -1 based on battery mass., (© The Author(s) 2024. Published by Oxford University Press on behalf of China Science Publishing & Media Ltd.)

Biomass holds significant potential for large-scale synthesis of hard carbon (HC), and HC is seen as the most promising anode material for sodium-ion batteries (SIBs). However, designing a HC anode with a rich pore structure, moderate graphitization and synthesis through a simple process using a cost-effective precursor to advance SIBs has long been a formidable challenge. This is primarily because high temperatures necessary for pore regulation invariably lead to excessive graphitization. Herein, innovative guidelines for designing such HC structures are reported by leveraging the inherent potassium in biomass to optimize the pore structure and alleviate graphitization through a novel carbothermal shock (CTS) method. During CTS, potassium-related compounds are effectively released and counteract the tendency of the carbon layers to graphitize by competing for thermal adsorption, thus forming pore channels while mitigating graphitization. The resulting HC anode exhibits an outstanding sodium storage capacity of 357.1 mA h g -1 and a high initial coulombic efficiency of 90.7% at 50 mA g -1 . This work provides a new insight into balancing the pore structure and the degree of graphitization of HC to keep sufficient space for Na + diffusion., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Rechargeable batteries have been indispensable for various portable devices, electric vehicles, and energy storage stations. The operation of rechargeable batteries at low temperatures has been challenging due to increasing electrolyte viscosity and rising electrode resistance, which lead to sluggish ion transfer and large voltage hysteresis. Advanced electrolyte design and feasible electrode engineering to achieve desirable performance at low temperatures are crucial for the practical application of rechargeable batteries. Herein, the failure mechanism of the batteries at low temperature is discussed in detail from atomic perspectives, and deep insights on the solvent-solvent, solvent-ion, and ion-ion interactions in the electrolytes at low temperatures are provided. The evolution of electrode interfaces is discussed in detail. The electrochemical reactions of the electrodes at low temperatures are elucidated, and the approaches to accelerate the internal ion diffusion kinetics of the electrodes are highlighted. This review aims to deepen the understanding of the working mechanism of low-temperature batteries at the atomic scale to shed light on the future development of low-temperature rechargeable batteries., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

This study evaluated the acceptability and tolerability of three alcohol-based hand rubs (ABHRs) at Sarawak General Hospital, Malaysia. Conducted from 12-26 November 2021 using a modified WHO Protocol, it involved a survey among health workers and concessionaires, with a 35% response rate (1,598 of 4,628 participants). The majority were nurses (60.8%), with the medical division most represented (28.4%). Most respondents (93.2%) used ABHRs at least five days a week and found them easily accessible (72.3%). Product B was the preferred ABHR (65%), primarily for its color and fragrance, surpassing WHO's 50% approval rate in these aspects. However, no other product features met WHO criteria. There were no significant differences in self-reported skin tolerability across the products, and none achieved overall WHO approval. These results offer important insights for ABHR selection in developing countries and highlight the value of the WHO Protocol in assessing product acceptability and tolerability.

Background/Objectives: This study aims to compare the health-related quality of life (HRQOL) between healthcare providers without chronic diseases and participants with chronic diseases presenting with one of the four different primary diagnoses on the health-related quality of life with six domains (HRQ-6D) scale. Methods: This is a cross-sectional study to compare the HRQOL between healthcare providers without chronic diseases and participants with chronic diseases. Data collection was performed from May 2022 to May 2023. Data for the comparison group were taken from healthcare providers without chronic diseases, and for the participant group with chronic diseases, the data were collected from actual patients with one of four types of primary diagnoses who were recruited from specialist cardiology, oncology, psychiatry, and nephrology clinics. All the participants of this study filled in the HRQ-6D. Results: There were 238 (58.6%) healthcare providers without chronic diseases who participated in this study, as well as 41 (10.1%) patients with end-stage renal disease (ESRD), 48 (11.8%) patients with cancer, and 40 (9.9%) patients who were depressed, and the remaining patients had heart disease. The means (SD) of HRQ-6D scores among healthcare providers without chronic diseases for pain, physical strength, emotion, mobility, self-care, perception of future health, and overall HRQ-6D score were 75.3% (19.8), 74.5% (21.1), 85.6% (18.4%), 93.0% (12.3), 91.6% (13.9), 74.2% (23.3), and 82.4% (13.6), respectively. In comparisons between healthcare providers without chronic diseases and participants with chronic diseases, all mean differences of the overall HRQ-6D score and its domains and dimensions were statistically significant ( p < 0.001). Conclusions: The overall score of the HRQ-6D, as well as its domains and dimensions are sensitive in detecting the study participants with chronic diseases from among those without chronic diseases. Therefore, the HRQ-6D is a reliable and valid scale to measure HRQOL. Future studies may use this scale for interventional, observational, and cost-effectiveness studies.

Background: Researchers have developed machine learning-based ECG diagnostic algorithms that match or even surpass cardiologist level of performance. However, most of them cannot be used in real-world, as older generation ECG machines do not permit installation of new algorithms., Objective: To develop a smartphone application that automatically extract ECG waveforms from photos and to convert them to voltage-time series for downstream analysis by a variety of diagnostic algorithms built by researchers., Methods: A novel approach of using objective detection and image segmentation models to automatically extract ECG waveforms from photos taken by clinicians was devised. Modular machine learning models were developed to sequentially perform waveform identification, gridline removal, and scale calibration. The extracted data were then analysed using a machine learning-based cardiac rhythm classifier., Results: Waveforms from 40 516 scanned and 444 photographed ECGs were automatically extracted. 12 828 of 13 258 (96.8%) scanned and 5399 of 5743 (94.0%) photographed waveforms were correctly cropped and labelled. 11 604 of 12 735 (91.1%) scanned and 5062 of 5752 (88.0%) photographed waveforms achieved successful voltage-time signal extraction after automatic gridline and background noise removal. In a proof-of-concept demonstration, an atrial fibrillation diagnostic algorithm achieved 91.3% sensitivity, 94.2% specificity, 95.6% positive predictive value, 88.6% negative predictive value and 93.4% F1 score, using photos of ECGs as input., Conclusion: Object detection and image segmentation models allow automatic extraction of ECG signals from photos for downstream diagnostics. This novel pipeline circumvents the need for costly ECG hardware upgrades, thereby paving the way for large-scale implementation of machine learning-based diagnostic algorithms., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Mild sleep deprivation is widespread in many societies worldwide. Electroencephalography (EEG) microstate analysis provides information on spatial and temporal characteristics of resting brain network, serving as an indicator of neurophysiological activities at rest. This study seeks to investigate potential neural markers in EEG following mild sleep deprivation of a single night using EEG microstate analysis. Six-minute resting EEG was conducted on thirty healthy adults within 6 hours of waking in the morning and after at least 18 h of sleep deprivation. Translated and validated Malay language Karolinska Sleepiness Scale was used to assess the participants' degree of sleepiness. Microstate characteristics analysis was conducted on the final 24 subjects based on four standard microstate maps. Microstate C shows a significant increase in mean duration, coverage and occurrence, while microstate D has significantly higher occurrence after sleep deprivation. This study demonstrates notable changes in resting state EEG microstates following mild sleep deprivation. Present findings deepen our understanding of the brain's spatiotemporal dynamics under this condition and suggest the potential utility of neural markers in this domain as components of composite markers for sleep deprivation., (© 2024. The Author(s).)

Ventilator-associated pneumonia (VAP) is a critical hospital-acquired infection following non-cardiac surgeries, leading to poor outcomes. This study identifies VAP risk factors in non-cardiac surgical patients and determines the causative pathogens. A retrospective analysis with 1:4 propensity-score matching was conducted on patients in a surgical intensive care unit (ICU) from 2010 to 2020 at a private tertiary medical center. Among 99 VAP patients, the mortality rate was 64.7%. VAP risk factors included prolonged mechanical ventilation (odds ratio [OR] 6.435; p < 0.001), repeat intubation (OR 6.438; p < 0.001), lower oxygenation levels upon ICU admission (OR 0.950; p < 0.001), and undergoing gastrointestinal surgery (OR 2.257; p = 0.021). The 30-day mortality risk factors in the VAP group were late-onset VAP (OR 3.450; p = 0.022), inappropriate antibiotic treatment (OR 4.083; p = 0.041), and undergoing gastrointestinal surgeries (OR 4.776; p = 0.019). Nearly half of the Gram-negative infections were resistant strains, and a third were polymicrobial infections. Non-cardiac surgical patients with VAP face adverse hospital outcomes. Identifying high-risk patients and understanding VAP's resistant and microbial nature are crucial for appropriate treatment and improved health outcomes.

Background: Repetitive thoughts are usually associated with psychopathology. The Future-oriented Repetitive Thought (FoRT) Scale is a measure designed to capture frequency of repetitive thought about positive and negative future events. However, the validity of the scale in Chinese population and its application in the schizophrenia spectrum have not been examined., Methods: The current study aimed to examine the psychometric properties of the Chinese version of the FoRT scale and to apply it to the schizophrenia spectrum. In Study 1, three samples (total N = 1875) of university students were recruited for exploratory factor analysis, confirmatory factor analysis, and validity test, respectively. In Study 2, we identified subsamples with high schizotypal traits (N = 89) and low schizotypal traits (N = 89), and recruited 36 inpatients with schizophrenia and 41 matched healthy controls., Results: The three-factor (pessimistic repetitive future thinking, repetitive thinking about future goals, and positive indulging about the future) structure of the FoRT scale with one item deleted, fitted the Chinese samples. And the scale could distinguish patients with schizophrenia and individuals with high schizotypal traits from controls., Conclusion: These findings support that the Chinese version of the FoRT scale is a valid tool and provide evidence for the potential applications in the schizophrenia spectrum., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Stenotrophomonas maltophilia, a multidrug-resistant gram-negative bacteria (GNB), is an emerging nosocomial pathogen. This study assessed the clinical outcomes of GNB infections in surgical intensive care unit (SICU) patients post-abdominal surgery, focusing on the differences between S. maltophilia and other GNBs, including Pseudomonas aeruginosa., Methods: A retrospective study was conducted on SICU patients at Kaohsiung Chang Gung Memorial Hospital from 2010 to 2020, who developed GNB infections following abdominal surgery., Results: Of 442 patients, 237 had S. maltophilia and 205 had non-S. maltophilia GNB infections (including 81 with P. aeruginosa). The overall mortality rate was 44.5%, and S. maltophilia infection emerged as a significant contributor to the mortality rate in patients with GNB infections. S. maltophilia patients had longer mechanical ventilation and SICU stays, with a 30-day mortality rate of 35.4%, higher than the non-S. maltophilia GNB (22.9%) and P. aeruginosa (21%) groups. In-hospital mortality was also higher in the S. maltophilia group (53.2%) compared to the non-S. maltophilia GNB (34.6%) and P. aeruginosa groups (29.6%). Risk factors for acquiring S. maltophilia included a higher Sequential Organ Failure Assessment score and prior broad-spectrum antibiotics use. Older age, polymicrobial infections, and elevated bilirubin were associated with increased 30-day mortality in S. maltophilia patients., Conclusion: S. maltophilia infections in post-abdominal surgery patients are linked to higher mortality than non-S. maltophilia GNB and P. aeruginosa infections, emphasizing the need for early diagnosis and treatment to improve outcomes., (© 2024. The Author(s).)

Objective: The "Health" element is one of the elements in Significant Quality of Life Measure (SigQOLM) that measures quality of life and well-being of people. This study aims to evaluate the Health element (Health-SigQOLM) as a generic and dynamic scale to measure health-related quality of life (HRQOL) with a broader spectrum of coverage. This study used a secondary data that developed SigQOLM. Only the "Health" element with 33 items is used for analysis., Results: The construct of Health-SigQOLM has a minimum factor loading of 0.425 with excellent model fit. The health status among healthcare workers is significantly associated with the Health-SigQOLM (p < 0.001). The Health-SigQOLM score can clearly distinguish between healthy people and those who have been afflicted with some diseases but have never been hospitalized due to disease progression or other associated complications (p = 0.002). The Health-SigQOLM is a generic and dynamic tool for assessing various aspects of health-related quality of life., (© 2024. The Author(s).)

The catalytic activation of the Li-S reaction is fundamental to maximize the capacity and stability of Li-S batteries (LSBs). Current research on Li-S catalysts mainly focuses on optimizing the energy levels to promote adsorption and catalytic conversion, while frequently overlooking the electronic spin state influence on charge transfer and orbital interactions. Here, hollow NiS 2 /NiSe 2 heterostructures encapsulated in a nitrogen-doped carbon matrix (NiS 2 /NiSe 2 @NC) are synthesized and used as a catalytic additive in sulfur cathodes. The NiS 2 /NiSe 2 heterostructure promotes the spin splitting of the 3d orbital, driving the Ni 3+ transformation from low to high spin. This high spin configuration raises the electronic energy level and activates the electronic state. This accelerates the charge transfer and optimizes the adsorption energy, lowering the reaction energy barrier of the polysulfides conversion. Benefiting from these characteristics, LSBs based on NiS 2 /NiSe 2 @NC/S cathodes exhibit high initial capacity (1458 mAh·g⁻ 1 at 0.1C), excellent rate capability (572 mAh·g⁻ 1 at 5C), and stable cycling with an average capacity decay rate of only 0.025% per cycle at 1C during 500 cycles. Even at high sulfur loadings (6.2 mg·cm⁻ 2 ), high initial capacities of 1173 mAh·g⁻ 1 (7.27 mAh·cm⁻ 2 ) are measured at 0.1C, and 1058 mAh·g⁻ 1 is retained after 300 cycles., (© 2024 Wiley‐VCH GmbH.)

In this work, 2D ferromagnetic M 3 GeTe 2 (MGT, M = Ni/Fe) nanosheets with rich atomic Te vacancies (2D-MGT v ) are demonstrated as efficient OER electrocatalyst via a general mechanical exfoliation strategy. X-ray absorption spectra (XAS) and scanning transmission electron microscope (STEM) results validate the dominant presence of metal-O moieties and rich Te vacancies, respectively. The formed Te vacancies are active for the adsorption of OH* and O* species while the metal-O moieties promote the O* and OOH* adsorption, contributing synergistically to the faster oxygen evolution kinetics. Consequently, 2D-Ni 3 GeTe 2v exhibits superior OER activity with only 370 mV overpotential to reach the current density of 100 mA cm -2 and turnover frequency (TOF) value of 101.6 s -1 at the overpotential of 200 mV in alkaline media. Furthermore, a 2D-Ni 3 GeTe 2v -based anion-exchange membrane (AEM) water electrolysis cell (1 cm 2 ) delivers a current density of 1.02 and 1.32 A cm -2 at the voltage of 3 V feeding with 0.1 and 1 m KOH solution, respectively. The demonstrated metal-O coordination with abundant atomic vacancies for ferromagnetic M 3 GeTe 2 and the easily extended preparation strategy would enlighten the rational design and fabrication of other ferromagnetic materials for wider electrocatalytic applications., (© 2024 The Authors. Advanced Science published by Wiley‐VCH GmbH.)

Room-temperature sodium-sulfur (RT-Na/S) batteries are promising alternatives for next-generation energy storage systems with high energy density and high power density. However, some notorious issues are hampering the practical application of RT-Na/S batteries. Besides, the working mechanism of RT-Na/S batteries under practical conditions such as high sulfur loading, lean electrolyte, and low capacity ratio between the negative and positive electrode (N/P ratio), is of essential importance for practical applications, yet the significance of these parameters has long been disregarded. Herein, it is comprehensively reviewed recent advances on Na metal anode, S cathode, electrolyte, and separator engineering for RT-Na/S batteries. The discrepancies between laboratory research and practical conditions are elaborately discussed, endeavors toward practical applications are highlighted, and suggestions for the practical values of the crucial parameters are rationally proposed. Furthermore, an empirical equation to estimate the actual energy density of RT-Na/S pouch cells under practical conditions is rationally proposed for the first time, making it possible to evaluate the gravimetric energy density of the cells under practical conditions. This review aims to reemphasize the vital importance of the crucial parameters for RT-Na/S batteries to bridge the gaps between laboratory research and practical applications., (© 2024 The Authors. Advanced Materials published by Wiley‐VCH GmbH.)

Linearly interlinked single atoms offer unprecedented physiochemical properties, but their synthesis for practical applications still poses significant challenges. Herein, linearly interlinked iron single-atom catalysts that are loaded onto interconnected carbon channels as cathodic sulfur hosts for room-temperature sodium-sulfur batteries are presented. The interlinked iron single-atom exhibits unique metallic iron bonds that facilitate the transfer of electrons to the sulfur cathode, thereby accelerating the reaction kinetics. Additionally, the columnated and interlinked carbon channels ensure rapid Na + diffusion kinetics to support high-rate battery reactions. By combining the iron atomic chains and the topological carbon channels, the resulting sulfur cathodes demonstrate effective high-rate conversion performance while maintaining excellent stability. Remarkably, even after 5000 cycles at a current density of 10 A g -1 , the Na-S battery retains a capacity of 325 mAh g -1 . This work can open a new avenue in the design of catalysts and carbon ionic channels, paving the way to achieve sustainable and high-performance energy devices., (© 2024 The Authors. Advanced Materials published by Wiley‐VCH GmbH.)

Subnanometer pores/channels (SNPCs) play crucial roles in regulating electrochemical redox reactions for rechargeable batteries. The delicately designed and tailored porous structure of SNPCs not only provides ample space for ion storage but also facilitates efficient ion diffusion within the electrodes in batteries, which can greatly improve the electrochemical performance. However, due to current technological limitations, it is challenging to synthesize and control the quality, storage, and transport of nanopores at the subnanometer scale, as well as to understand the relationship between SNPCs and performances. In this review, we systematically classify and summarize materials with SNPCs from a structural perspective, dividing them into one-dimensional (1D) SNPCs, two-dimensional (2D) SNPCs, and three-dimensional (3D) SNPCs. We also unveil the unique physicochemical properties of SNPCs and analyse electrochemical couplings in SNPCs for rechargeable batteries, including cathodes, anodes, electrolytes, and functional materials. Finally, we discuss the challenges that SNPCs may face in electrochemical reactions in batteries and propose future research directions.

The effective flow of electrons through bulk electrodes is crucial for achieving high-performance batteries, although the poor conductivity of homocyclic sulfur molecules results in high barriers against the passage of electrons through electrode structures. This phenomenon causes incomplete reactions and the formation of metastable products. To enhance the performance of the electrode, it is important to place substitutable electrification units to accelerate the cleavage of sulfur molecules and increase the selectivity of stable products during charging and discharging. Herein, we develop a single-atom-charging strategy to address the electron transport issues in bulk sulfur electrodes. The establishment of the synergistic interaction between the adsorption model and electronic transfer helps us achieve a high level of selectivity towards the desirable short-chain sodium polysulfides during the practical battery test. These finding indicates that the atomic manganese sites have an enhanced ability to capture and donate electrons. Additionally, the charge transfer process facilitates the rearrangement of sodium ions, thereby accelerating the kinetics of the sodium ions through the electrostatic force. These combined effects improve pathway selectivity and conversion to stable products during the redox process, leading to superior electrochemical performance for room temperature sodium-sulfur batteries., (© 2024. The Author(s).)

Negative association was found between the frontal theta/beta ratio and mind wandering in participants with high schizotypal traits, while no such association was found in participants with low schizotypal traits. These findings provide insights into the neural mechanism of mind wandering in individuals with high schizotypal traits., (© 2023 The Authors. PsyCh Journal published by Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)