1. The Challenges in Using eHealth Decision Resources for Surrogate Decision-Making in the Intensive Care Unit.
Sun, W.-N., & Kao, C.-Y. (2024). J Med Internet Res, 26, e47017. Read this article
The mortality rate in intensive care units (ICUs) is notably high, with patients often relying on surrogates for critical medical decisions due to their compromised state. This study then introduces eHealth literacy and the assessment tools to evaluate users’ capability and literacy levels in using eHealth resources. A clinical scenario involving surrogate decision-making is presented. This simulated case involves a patient with a hemorrhagic stroke who has lost consciousness and requires medical procedures such as tracheostomy. However, due to the medical surrogate’s lack of familiarity with eHealth devices and limited literacy in using eHealth resources, difficulties arise in assisting the patient in making medical decisions. This scenario highlights challenges related to eHealth literacy and solution strategies are proposed. In conclusion, effective ICU decision-making with eHealth tools requires a careful balance between efficiency with inclusivity. Health professionals should adopt a patient-centered approach to enhance the decision-making experience, particularly for individuals with limited eHealth literacy.
2. Impact of Antenatal SARS-CoV-2 Exposure on SARS-CoV-2 Neutralization Potency.
Chiang, C.-J., Hsu, W.-L., Su, M.-T., Ko, W.-C., Hsu, K.-F., & Tsai, P.-Y. (2024). Vaccines, 12(2), 164. Read this article
A pregnancy booster dose significantly reduces the risk and severity of COVID-19, and it is widely recommended. A prospective cohort study was conducted to compare the transplacental passage of maternal antibodies from vaccination or infection during three trimesters against both the vaccine-targeted Wuhan strain and the Omicron strain of SARS-CoV-2. Maternal-infant dyads from vaccinated mothers were collected between 6 June 2022 and 20 September 2022. We analyzed 38 maternal-infant dyads from mothers who had been infected with COVID-19 and 37 from mothers without any previous infection. Pregnant women who received their last COVID-19 vaccine dose in the third trimester exhibited the highest anti-spike protein antibody levels and neutralizing potency against both the Wuhan strain and Omicron BA.2 variant in their maternal and cord plasma. Both second- and third-trimester vaccination could lead to a higher level of neutralization against the Wuhan and Omicron strains. COVID-19 infection had a negative effect on the transplacental transfer ratio of SARS-CoV-2 antibodies. A booster dose during the second or third trimester is encouraged for the maximum transplacental transfer of humoral protection against COVID-19 for infants.
3. Empirical dynamic modeling for sustainable benchmarks of short-lived species.
Tsai, C.-H., Munch, S. B., Masi, M. D., & Stevens, M. H. (2024). ICES Journal of Marine Science.Read this article
The paper introduces Empirical Dynamic Modeling (EDM) as a cutting-edge approach to improve sustainable management for short-lived species like Penaeidae brown shrimp, which exhibit highly fluctuating and chaotic dynamics. Traditional methods often overlook critical factors such as unobserved species interactions, leading to less accurate predictions. EDM stands out by effectively capturing these hidden interactions, providing more reliable forecasts of population responses to fishing pressures. Applied to U.S. Gulf of Mexico brown shrimp, EDM proved highly effective, leading to more sustainable and adaptive fisheries management that truly reflects the complexity of marine ecosystems.
4. Nurses’ Knowledge and Skills After Use of an Augmented Reality App for Advanced Cardiac Life Support Training: Randomized Controlled Trial.
Sun, W.-N., Hsieh, M.-C., & Wang, W.-F. (2024). J Med Internet Res, 26, e57327. Read this article
In a medical center in southern Taiwan, the study involved 102 nurses divided into an AR group and a control group receiving traditional lecture-based instruction. The AR group used an interactive crash cart learning system developed with AR technology. Both groups were assessed on knowledge and practical skills, with subgroup analyses focusing on nurses with less than two years of experience. Results demonstrated that the AR group significantly outperformed the control group in overall ACLS outcomes and crash cart usage (P = .002; P = .01). Nurses with less experience showed the most substantial improvements in knowledge and skills (P < .001). Additionally, the AR group reported higher motivation (IMMS mean: 141.65), better usability (SUS mean: 90.47), and reduced cognitive load (mean: 15.42) compared to traditional methods. These findings highlight AR as an effective tool for enhancing ACLS training, especially for less experienced nurses.
5. Molecular characterization of colistin-resistant Klebsiella pneumoniae isolates and their conjugative mcr-carrying plasmids.
Kao, C.-Y., Kuo, P.-Y., Lin, C.-C., Cheng, Y.-Y., Wang, M.-C., Chen, Y.-C., & Lin, W.-H. (2024). Journal of Infection and Public Health, 17(12), 102588. Read this article
This study investigates colistin-resistant Klebsiella pneumoniae (CoRKp) isolated from patients with urinary tract infections and bacteremia at a Taiwanese teaching hospital from 1999 to 2022. Among 1966 K. pneumoniae isolates, 21 were CoRKp, including 12 multidrug-resistant (MDR) and 4 extensively drug-resistant (XDR) strains. Whole genome sequencing revealed diverse sequence types (STs) and capsular types. Two isolates, SC-KP169 and SC-KP585, carried transferable mcr-1 and mcr-8 plasmids, respectively. The mcr-1-carrying plasmid enhanced virulence in K. pneumoniae, while mcr-8 did not affect virulence in Escherichia coli. Mutations in phoQ, pmrA, pmrB, and mgrB genes and insertion elements contributed to resistance mechanisms. The study highlights the potential public health risk posed by the spread of mcr-mediated resistance and emphasizes the need for surveillance and control strategies.
