Interlayer bond polarizability model for interlayer phonons in van der Waals heterostructures

Raman scattering provides essential insights into phonons, electronic structures and electron-phonon coupling within solids through the intensity of Raman peaks, which cannot be easily quantified using the classical bond polarizability model. The interlayer bond polarizability model (IBPM) had been developed to understand the Raman intensity of layer-breathing modes (LBMs) in two-dimensional materials. However, the quantitative understanding of the LBM intensity of a van der Waals heterostructure (vdWH) remains challenging. Here, in polynary vdWHs comprising twisted multilayer graphene (tMLG), MoS2 and hBN, we observed a series of LBMs, whose intensity is markedly dependent on the excitation energy and twist angle of the tMLG constituent. An improved IBPM is proposed to quantitatively understand the Raman intensity of LBMs in the tMLG-based vdWHs, including the emergence or absence of a specific LBM when the excitation energy is resonant with the electronic states of tMLG or MoS2 constituents. This work underscores the significant potential of the improved IBPM in accurately understanding and predicting the intensity profile of LBM in polynary vdWHs, even for the case of Raman scattering with excitation energies selectively resonant with the electronic states of the corresponding specific constituents.

Berry Curvature Dipole Induced Giant Mid-Infrared Second-Harmonic Generation in 2D Weyl Semiconductor

Due to its inversion-broken triple helix structure and the nature of Weyl semiconductor, 2D Tellurene (2D Te) is promising to possess a strong nonlinear optical response in the infrared region, which is rarely reported in 2D materials. Here, a giant nonlinear infrared response induced by large Berry curvature dipole (BCD) is demonstrated in the Weyl semiconductor 2D Te. Ultrahigh second-harmonic generation response is acquired from 2D Te with a large second-order nonlinear optical susceptibility (χ(2) ), which is up to 23.3 times higher than that of monolayer MoS2 in the range of 700-1500 nm. Notably, distinct from other 2D nonlinear semiconductors, χ(2) of 2D Te increases extraordinarily with increasing wavelength and reaches up to 5.58 nm V-1 at ≈2300 nm, which is the best infrared performance among the reported 2D nonlinear materials. Large χ(2) of 2D Te also enables the high-intensity sum-frequency generation with an ultralow continuous-wave (CW) pump power. Theoretical calculations reveal that the exceptional performance is attributed to the presence of large BCD located at the Weyl points of 2D Te. These results unravel a new linkage between Weyl semiconductor and strong optical nonlinear responses, rendering 2D Te a competitive candidate for highly efficient nonlinear 2D semiconductors in the infrared region.

Impact of the organic cation on the band-edge emission of two-dimensional lead-bromide perovskites

Organic-inorganic low-dimensional layered metal-halide perovskites are semiconductors in which the optoelectronic properties can be tuned by the material composition and the design of the layered architecture. While the electronic band structure is mainly determined by the inorganic octahedra lattice, the binding and conformation of the organic cations induces related lattice distortions that can break the symmetry and lead to the splitting of the exciton energy levels, and influence the dielectric confinement. Furthermore, organic-induced lattice deformations lead to offsets in k-space (where k is the wavevector) that go along with the exciton energy level splitting. Hence, the electronic transitions between these levels require the momentum contribution of phonons, and contributions of phonons in the exciton recombination dynamics result in thermal broadening of the emission linewidth. In this work, we investigate the band-edge emission of two-dimensional Ruddlesden-Popper lead-bromide perovskites synthesized with different organic cations that vary in their binding head group and their alkyl chain length. We find several peaks in the low-temperature photoluminescence spectra, and the number of peaks in the band-edge emission and their decay dynamics depend strongly on the type of organic cation in the material, which we relate to the difference in the inorganic lattice distortions that the cations induce. For two-dimensional layered perovskites with mainly in-plane distortions, induced by short primary ammonium molecules, we find a two-fold splitting of the band edge emission at low temperatures. If also out-of-plane distortions are present, as for the long-chain primary ammoniums, a three-fold splitting is observed. Interestingly, the low-energy peaks of the split series merge into the highest energy peak with increasing temperature. Thermal broadening analysis of the temperature-dependent photoluminescence linewidth in the structures with out-of-plane distortions yields energies that are larger than those reported for the inorganic lattice phonons. This indicates the involvement of either high-frequency oscillations involving the organic cations, or the broadening might be related to higher order phonon scattering processes in the excitonic recombination process. The strong directionality of the phonon modes in the octahedral lattice could promote the involvement of multiple electron-phonon scattering processes in the exciton relaxation dynamics, for example involving modes with orthogonal directionality.

Enhanced Layer-Breathing Modes in van der Waals Heterostructures Based on Twisted Bilayer Graphene

The characterization of interlayer coupling in two-dimensional van der Waals heterostructures (vdWHs) is essential to understand their quantum behaviors and structural functionalities. Interlayer shear and layer-breathing (LB) phonons carry rich information on interlayer interaction, but they are usually too weak to be detected via standard Raman spectroscopy due to the weak electron-phonon coupling (EPC). Here, we report a universal strategy to enhance LB modes of vdWHs based on twisted bilayer graphene (tBLG). In both tBLG/hBN and tBLG/MoS₂ vdWHs, the resonantly excited electrons in tBLG can strongly couple to LB phonons extended over the entire layers in the vdWHs, whose resonance condition is tunable by the twist angle of tBLG. In vdWHs containing twisted graphene layers with multiple twisted interfaces, the EPC of LB phonons coming from the collective LB vibrations of entire heterostructure layers can be tuned by resonant excitation of programmable van Hove singularities according to each twisted interface. The universality and tunability of enhanced LB phonons by tBLG make it a promising method to investigate EPC and interlayer interaction in related vdWHs.

Abnormal Out-of-Plane Vibrational Raman Mode in Electrochemically Intercalated Multilayer MoS2

Raman spectroscopy is a powerful technique to probe structural and doping behaviors of two-dimensional (2D) materials. In MoS₂, the always coexisting in-plane (E_2g¹) and out-of-plane (A_1g) vibrational modes are used as reliable fingerprints to distinguish the number of layers, strains, and doping levels. In this work, however, we report an abnormal Raman behavior, i.e., the absence of the A_1g mode in cetyltrimethylammonium bromide (CTAB)-intercalated MoS₂ superlattice. This unusual behavior is quite different from the softening of the A_1g mode induced by surface engineering or electric-field gating. Interestingly, under a strong laser illumination, heating, or mechanical indentation, an A_1g peak gradually appears, accompanied by the migration of intercalated CTA⁺ cations. The abnormal Raman behavior is mainly attributed to the constraint of the out-of-plane vibration due to intercalations and resulting severe electron doping. Our work renews the understanding of Raman spectra of 2D semiconducting materials and sheds light on developing next-generation devices with tunable structures.

Control of Raman Scattering Quantum Interference Pathways in Graphene

Graphene is an ideal platform to study the coherence of quantum interference pathways by tuning doping or laser excitation energy. The latter produces a Raman excitation profile that provides direct insight into the lifetimes of intermediate electronic excitations and, therefore, on quantum interference, which has so far remained elusive. Here, we control the Raman scattering pathways by tuning the laser excitation energy in graphene doped up to 1.05 eV. The Raman excitation profile of the G mode indicates its position and full width at half-maximum are linearly dependent on doping. Doping-enhanced electron-electron interactions dominate the lifetimes of Raman scattering pathways and reduce Raman interference. This will provide guidance for engineering quantum pathways for doped graphene, nanotubes, and topological insulators.

Long-range ordered porous carbons produced from C60

Carbon structures with covalent bonds connecting C₆₀ molecules have been reported^1-3, but their production methods typically result in very small amounts of sample, which restrict the detailed characterization and exploration necessary for potential applications. We report the gram-scale preparation of a new type of carbon, long-range ordered porous carbon (LOPC), from C₆₀ powder catalysed by α-Li₃N at ambient pressure. LOPC consists of connected broken C₆₀ cages that maintain long-range periodicity, and has been characterized by X-ray diffraction, Raman spectroscopy, magic-angle spinning solid-state nuclear magnetic resonance spectroscopy, aberration-corrected transmission electron microscopy and neutron scattering. Numerical simulations based on a neural network show that LOPC is a metastable structure produced during the transformation from fullerene-type to graphene-type carbons. At a lower temperature, shorter annealing time or by using less α-Li₃N, a well-known polymerized C₆₀ crystal forms owing to the electron transfer from α-Li₃N to C₆₀. The carbon K-edge near-edge X-ray absorption fine structure shows a higher degree of delocalization of electrons in LOPC than in C₆₀(s). The electrical conductivity is 1.17 × 10^-2 S cm^-1 at room temperature, and conduction at T < 30  K appears to result from a combination of metallic-like transport over short distances punctuated by carrier hopping. The preparation of LOPC enables the discovery of other crystalline carbons starting from C₆₀(s).

Superconductivity in Layered van der Waals Hydrogenated Germanene at High Pressure

The emergence of superconductivity in two-dimensional (2D) materials has attracted tremendous research efforts because the origins and mechanisms behind the unexpected and fascinating superconducting phenomena remain unclear. In particular, the superconductivity can survive in 2D systems even with weakened disorder and broken spatial inversion symmetry. Here, structural and superconducting transitions of 2D van der Waals (vdW) hydrogenated germanene (GeH) are observed under compression and decompression processes. GeH possesses a superconducting transition with a critical temperature (T_c) of 5.41 K at 8.39 GPa. A crystalline to amorphous transition occurs at 16.80 GPa, while superconductivity remains. An abnormal increase of T_c up to 6.11 K was observed during the decompression process, while the GeH remained in the 2D amorphous phase. A combination study of in situ high-pressure synchrotron X-ray diffraction, in situ high-pressure Raman spectroscopy, transition electron microscopy, and density functional theory simulations suggests that the superconductivity in 2D vdW GeH is attributed to the increased density of states at the Fermi level as well as the enhanced electron-phonon coupling effect under high pressure even in the form of an amorphous phase. The unique pressure-induced phase transition of GeH from 2D crystalline to 2D amorphous metal hydride provides a promising platform to study the mechanisms of amorphous hydride superconductivity.

Intralayer Phonons in Multilayer Graphene Moiré Superlattices

Moiré pattern in twisted multilayers (tMLs) induces many emergent phenomena by subtle variation of atomic registry to modulate quasiparticles and their interactions, such as superconductivity, moiré excitons, and moiré phonons. The periodic superlattice potential introduced by moiré pattern also underlies patterned interlayer coupling at the interface of tMLs. Although this arising patterned interfacial coupling is much weaker than in-plane atomic interactions, it is crucial in moiré systems, as captured by the renormalized interlayer phonons in twisted bilayer transitional metal dichalcogenides. Here, we determine the quantitative relationship between the lattice dynamics of intralayer out-of-plane optical (ZO) phonons and patterned interfacial coupling in multilayer graphene moiré superlattices (MLG-MS) by the proposed perturbation model, which is previously challenging for MLGs due to their out-of-phase displacements of adjacent atoms in one atomic plane. We unveil that patterned interfacial coupling introduces profound modulations on Davydov components of nonfolded ZO phonon that are localized within the AB-stacked constituents, while the coupling results in layer-extended vibrations with symmetry of moiré pattern for moiré ZO phonons. Our work brings further degrees of freedom to engineer moiré physics according to the modulations imprinted on the phonon frequency and wavefunction.

Spin-Phonon Coupling in Ferromagnetic Monolayer Chromium Tribromide

Novel 2D magnets exhibit intrinsic electrically tunable magnetism down to the monolayer limit, which has significant value for nonvolatile memory and emerging computing device applications. In these compounds, spin-phonon coupling (SPC) typically plays a crucial role in magnetic fluctuations, magnon dissipation, and ultimately establishing long-range ferromagnetic order. However, a systematic understanding of SPC in 2D magnets that combines theory and experiment is still lacking. In this work, monolayer chromium tribromide is studied to investigate SPC in 2D magnets via Raman spectroscopy and first principle calculations. The experimental Curie temperature and phonon shifts are found to be in good agreement with the numerical simulations. Specifically, it is demonstrated how magnetic exchange interactions affect phonon vibrations, which helps establish design fundamentals for 2D magnetic materials and other related devices.

Correlating Symmetries of Low-Frequency Vibrations and Self-Trapped Excitons in Layered Perovskites for Light Emission with Different Colors

The soft hybrid organic-inorganic structure of two-dimensional layered perovskites (2DLPs) enables broadband emission at room temperature from a single material, which makes 2DLPs promising sources for solid-state white lighting, yet with low efficiency. The underlying photophysics involves self-trapping of excitons favored by distortions of the inorganic lattice and coupling to phonons, where the mechanism is still under debate. 2DLPs with different organic moieties and emission ranging from self-trapped exciton (STE)-dominated white light to blue band-edge photoluminescence are investigated. Detailed insights into the directional symmetries of phonon modes are gained using angle-resolved polarized Raman spectroscopy and are correlated to the temperature-dependence of the STE emission. It is demonstrated that weak STE bands at low-temperature are linked to in-plane phonons, and efficient room-temperature STE emission to more complex coupling to several phonon modes with out-of-plane components. Thereby, a unique view is provided into the lattice deformations and recombination dynamics that are key to designing more efficient materials.

A tunable Raman system based on ultrafast laser for Raman excitation profile measurement

The measurement of the Raman excitation profile (REP) is of great importance to obtain the energies of van Hove singularities and the lifetime of the excited state involved in the Raman process of semiconductors. In this Note, we develop a simple tunable Raman system based on an ultrafast laser and tunable Raman filters for REP measurement. The system is testified by measuring REP of twisted bilayer graphene, and the corresponding energy of van Hove singularity is determined.

Phonon renormalization in reconstructed MoS2 moiré superlattices

In moiré crystals formed by stacking van der Waals materials, surprisingly diverse correlated electronic phases and optical properties can be realized by a subtle change in the twist angle. Here, we discover that phonon spectra are also renormalized in MoS₂ twisted bilayers, adding an insight to moiré physics. Over a range of small twist angles, the phonon spectra evolve rapidly owing to ultra-strong coupling between different phonon modes and atomic reconstructions of the moiré pattern. We develop a low-energy continuum model for phonons that overcomes the outstanding challenge of calculating the properties of large moiré supercells and successfully captures the essential experimental observations. Remarkably, simple optical spectroscopy experiments can provide information on strain and lattice distortions in moiré crystals with nanometre-size supercells. The model promotes a comprehensive and unified understanding of the structural, optical and electronic properties of moiré superlattices.

Phase-Changing in Graphite Assisted by Interface Charge Injection

Among many phase-changing materials, graphite is probably the most studied and interesting: the rhombohedral (3R) and hexagonal (2H) phases exhibit dramatically different electronic properties. However, up to now the only way to promote 3R to 2H phase transition is through exposure to elevated temperatures (above 1000 °C); thus, it is not feasible for modern technology. In this work, we demonstrate that 3R to 2H phase transition can be promoted by changing the charged state of 3D graphite, which promotes the repulsion between the layers and significantly reduces the energy barrier between the 3R and 2H phases. In particular, we show that charge transfer from lithium nitride (α-Li₃N) to graphite can lower the transition temperature down to 350 °C. The proposed interlayer slipping model potentially offers the control over topological states at the interfaces between different phases, making this system even more attractive for future electronic applications.

Intrinsic effect of interfacial coupling on the high-frequency intralayer modes in twisted multilayer MoTe2

The interfacial coupling at the interface makes the van der Waals heterostructures (vdWHs) exhibit many unique properties that cannot be realized in its constituents. Such a study usually starts with a twisted stack of two flakes exfoliated from the same layered materials to form twisted multilayers, in which the impact of interfacial coupling on the low-frequency interlayer modes had been well understood. However, it is not clear how interfacial coupling affects the high-frequency intralayer modes of twisted multilayers. Herein, we perform high-resolution resonance Raman spectroscopy of the high-frequency intralayer modes in twisted multilayer MoTe2 (tMLM). All the Davydov entities of the out-of-plane intralayer mode are observed and distinguished at 4 K. It is found that the out-of-plane intralayer modes in tMLM are sensitive to its interfacial layer-breathing coupling so that the out-of-plane intralayer modes in tMLM do not show a direct relationship with those of the two constituents. However, the case is quite different for the in-plane intralayer modes in tMLM, whose spectral profile can be fitted by those of the corresponding modes of its constituents. This indicates that the in-plane intralayer modes are localized within the constituents in tMLM because of its negligible interfacial shear coupling at the interface. All the results can be well understood using the vdW model in which only the nearest neighbor interlayer/interfacial interaction is taken into account. This work directly builds the relationship between the Davydov splitting of the high-frequency intralayer vibrations and the low-frequency interlayer vibrations in tMLM, which can be further extended to other twisted materials and the related vdWHs.

[Difficulties and Policy Recommendations Related to the Deployment of Long-Term Care Resources in Taiwan`s Indigenous Areas]

Changes in the demographic structure in Taiwan have increased the need for long-term care (LTC). Person-centered and community-based care is being advocated. The need to address the specific LTC needs of Taiwan`s indigenous peoples has been a part of national LTC policy since National Long-term Care Plan 2.0 was adopted in 2015. The provision of LTC services and the deployment of related resources in indigenous areas generally lag behind Taiwan`s other areas. Potential reasons for this disparity include lack of in-charge, dedicated units; exclusive use of normative service models in indigenous areas; and conflict between talent cultivation and rooted development. Future policy should focus more on providing cultural care in indigenous areas and on offering more flexible and diversified development possibilities. The implementation of these policies may promote the development of LTC and the successful deployment of LTC resources in Taiwan`s indigenous regions.

Understanding angle-resolved polarized Raman scattering from black phosphorus at normal and oblique laser incidences

The selection rule for angle-resolved polarized Raman (ARPR) intensity of phonons from standard group-theoretical method in isotropic materials would break down in anisotropic layered materials (ALMs) due to birefringence and linear dichroism effects. The two effects result in depth-dependent polarization and intensity of incident laser and scattered signal inside ALMs and thus make a challenge to predict ARPR intensity at any laser incidence direction. Herein, taking in-plane anisotropic black phosphorus as a prototype, we developed a so-called birefringence-linear-dichroism (BLD) model to quantitatively understand its ARPR intensity at both normal and oblique laser incidences by the same set of real Raman tensors for certain laser excitation. No fitting parameter is needed, once the birefringence and linear dichroism effects are considered with the complex refractive indexes. An approach was proposed to experimentally determine real Raman tensor and complex refractive indexes, respectively, from the relative Raman intensity along its principle axes and incident-angle resolved reflectivity by Fresnel's law. The results suggest that the previously reported ARPR intensity of ultrathin ALM flakes deposited on a multilayered substrate at normal laser incidence can be also understood based on the BLD model by considering the depth-dependent polarization and intensity of incident laser and scattered Raman signal induced by both birefringence and linear dichroism effects within ALM flakes and the interference effects in the multilayered structures, which are dependent on the excitation wavelength, thickness of ALM flakes and dielectric layers of the substrate. This work can be generally applicable to any opaque anisotropic crystals, offering a promising route to predict and manipulate the polarized behaviors of related phonons.

Observation of nonreciprocal magnetophonon effect in nonencapsulated few-layered CrI3

"Magneto-optical" effect refers to a rotation of polarization plane, which has been widely studied in traditional ferromagnetic metal and insulator films and scarcely in two-dimensional layered materials. Here, we uncover a new nonreciprocal magnetophonon Raman scattering effect in ferromagnetic few-layer CrI₃ We observed a rotation of the polarization plane of inelastically scattered light between -20^o and +60^o that are tunable by an out-of-plane magnetic field from -2.5 to 2.5 T. It is experimentally observed that the degree of polarization can be magnetically manipulated between -20 and 85%. This work raises a new magneto-optical phenomenon and could create opportunities of applying two-dimensional ferromagnetic materials in Raman lasing, topological photonics, and magneto-optical modulator for information transport and storage.

Directional Anisotropy of the Vibrational Modes in 2D-Layered Perovskites

The vibrational modes in organic/inorganic layered perovskites are of fundamental importance for their optoelectronic properties. The hierarchical architecture of the Ruddlesden-Popper phase of these materials allows for distinct directionality of the vibrational modes with respect to the main axes of the pseudocubic lattice in the octahedral plane. Here, we study the directionality of the fundamental phonon modes in single exfoliated Ruddlesden-Popper perovskite flakes with polarized Raman spectroscopy at ultralow frequencies. A wealth of Raman bands is distinguished in the range from 15 to 150 cm^-1 (2-15 meV), whose features depend on the organic cation species, on temperature, and on the direction of the linear polarization of the incident light. By controlling the angle of the linear polarization of the excitation laser with respect to the in-plane axes of the octahedral layer, we gain detailed information on the symmetry of the vibrational modes. The choice of two different organic moieties, phenethylammonium (PEA) and butylammonium (BA), allows us to discern the influence of the linker molecules, evidencing strong anisotropy of the vibrations for the (PEA)₂PbBr₄ samples. Temperature-dependent Raman measurements reveal that the broad phonon bands observed at room temperature consist of a series of sharp modes and that such mode splitting strongly differs for the different organic moieties and vibrational bands. Softer molecules such as BA result in lower vibrational frequencies and splitting into fewer modes, while more rigid molecules such as PEA lead to higher frequency oscillations and larger number of Raman peaks at low temperature. Interestingly, in distinct bands the number of peaks in the Raman bands is doubled for the rigid PEA compared to the soft BA linkers. Our work shows that the coupling to specific vibrational modes can be controlled by the incident light polarization and choice of the organic moiety, which could be exploited for tailoring exciton-phonon interaction, and for optical switching of the optoelectronic properties of such 2D layered materials.

Effects of different reminder strategies on first-time mammography screening among women in Taiwan

Background

The study’s purpose was to examine the effectiveness of different reminder strategies on first-time free mammography screening among middle-aged women in Taiwan.

Methods

A quasi-experimental design with random assignment was adopted to divide the participants into three Reminder Strategies groups (mail reminder, telephone reminder, and combined mail and telephone reminders) and one control group. This study recruited 240 eligible middle-aged women, and 205 of them completed the study. Upon the completion of data collection, mail reminders were provided to women of the first group; telephone reminders were provided to the second group; mail followed by telephone reminders were provided to the third group, and the usual postcards were provided to the control group 1 month after the interventions. Two follow-up assessments were conducted 1 and 3 months after the intervention to collect mammography-screening behaviors from all groups.

Results

The findings showed that, compared to the control group, more participants in the intervention groups underwent mammography screening after receiving reminder interventions. Telephone contact as reminder was found to have the most significant influence among the interventions (OR = 5.0556; 95% CI = 2.0422–13.5722).

Conclusions

Government and healthcare providers are recommended to consider adopting the telephone reminder strategy to encourage women to undergo their first-time mammography screening.

Giant-Shell CdSe/CdS Nanocrystals: Exciton Coupling to Shell Phonons Investigated by Resonant Raman Spectroscopy

The interaction between excitons and phonons in semiconductor nanocrystals plays a crucial role in the exciton energy spectrum and dynamics, and thus in their optical properties. We investigate the exciton-phonon coupling in giant-shell CdSe/CdS core-shell nanocrystals via resonant Raman spectroscopy. The Huang-Rhys parameter is evaluated by the intensity ratio of the longitudinal-optical (LO) phonon of CdS with its first multiscattering (2LO) replica. We used four different excitation wavelengths in the range from the onset of the CdS shell absorption to well above the CdS shell band edge to get insight into resonance effects of the CdS LO phonon with high-energy excitonic transitions. The isotropic spherical giant-shell nanocrystals show consistently stronger exciton-phonon coupling as compared to the anisotropic rod-shaped dot-in-rod (DiR) architecture, and the 2LO/LO intensity ratio decreases for excitation wavelengths approaching the CdS band edge. The strong exciton-phonon coupling in the spherical giant-shell nanocrystals can be related to the delocalization of the electronic wave functions. Furthermore, we observe the radial breathing modes of the GS nanocrystals and their overtones by ultralow frequency Raman spectroscopy with nonresonant excitation, using laser energies well below the band gap of the heteronanocrystals, and highlight the differences between higher-order optical and acoustic phonon modes.

Stokes and anti-Stokes Raman scattering in mono- and bilayer graphene

Stokes and anti-Stokes Raman spectroscopy associated with the intervalley double resonance process in carbon materials is a unique technique to reveal the relationship between their characteristic electronic band structures and phonon dispersion. In graphene, the dominant resonant behavior for its 2D mode is an intervalley triple resonance Raman process. In this paper, we report the Stokes and anti-Stokes Raman scattering of the 2D mode in pristine graphene. The excitation energy (Eex)-dependent frequency discrepancy between anti-Stokes and Stokes components of the 2D mode (Δω(2D)) is observed, which is in good agreement with the theoretical results. This is attributed to the nonlinear dispersion of the in-plane transverse optical (iTO) phonon branch near the K point, confirmed by the nonlinear Eex-dependent frequency of the 2D mode (ω(2D)) in the range of 1.58-3.81 eV. The wavevector-dependent phonon group velocity of the iTO phonon branch is directly derived from Δω(2D). The Stokes and anti-Stokes Raman scattering of the D mode in defected graphene and the 2D mode in bilayer graphene associated with intervalley double resonance Raman processes is also reported.

Moiré Phonons in Twisted Bilayer MoS2

The material choice, layer thickness, and twist angle widely enrich the family of van der Waals heterostructures (vdWHs), providing multiple degrees of freedom to engineer their optical and electronic properties. The moiré patterns in vdWHs create a periodic potential for electrons and excitons to yield many interesting phenomena, such as Hofstadter butterfly spectrum and moiré excitons. Here, in the as-grown/transferred twisted bilayer MoS₂ (tBLMs), one of the simplest prototypes of vdWHs, we show that the periodic potentials of moiré patterns also modify the properties of phonons of its monolayer MoS₂ constituent to generate Raman modes related to moiré phonons. These Raman modes correspond to zone-center phonons in tBLMs, which are folded from the off-center phonons in monolayer MoS₂. However, the folded phonons related to crystallographic superlattices are not observed in the Raman spectra. By varying the twist angle, the moiré phonons of tBLM can be exploited to map the phonon dispersions of the monolayer constituent. The lattice dynamics of the moiré phonons are modulated by the patterned interlayer coupling resulting from periodic potential of moiré patterns, as confirmed by density functional theory calculations. The Raman intensity related to moiré phonons in all tBLMs are strongly enhanced when the excitation energy approaches the C exciton energy. This study can be extended to various vdWHs to deeply understand their Raman spectra, moiré phonons, lattice dynamics, excitonic effects, and interlayer coupling.

The phonon confinement effect in two-dimensional nanocrystals of black phosphorus with anisotropic phonon dispersions

The RWL model for the phonon confinement effect in nanocrystals (NCs) had been found to result in deviations and limitations for crystals exhibiting obvious anisotropic phonon dispersions and modified models have been proposed to overcome these deficiencies. Here, we examine this issue in black phosphorus (BP), a typical anisotropic two-dimensional crystal exhibiting pronounced anisotropy in phonon dispersions. A detailed study is performed on the Raman spectra of BP NCs prepared by the ion implantation technique. With decreasing NC size, the peak positions of the three characteristic Raman modes, Ag1, B2g and Ag2 modes, remain almost unchanged, while the Ag1 and Ag2 modes show significant asymmetrical broadening tails towards higher- and lower-frequency sides, respectively. It is found that the RWL model based on one-dimensional phonon dispersion along Γ-Y and Γ-X axes in the Brillouin zone (BZ) cannot interpret the unusual frequency invariance and inhomogeneous line shape broadening of these three modes. However, after considering the contribution of two-dimensional anisotropic phonon dispersions from the whole BZ, the frequency and asymmetrical broadening of the Ag1 and Ag2 modes can be well reproduced. This study demonstrates that the RWL model can be applicable for crystals with anisotropic phonon dispersions once the phonons in the whole two-dimensional or three-dimensional BZ are properly taken into account, and provides a physically sound route into understanding the phonon confinement effect for anisotropic systems.

Physical activities and influencing factors among public health nurses: a cross-sectional study

OBJECTIVES

Public health nurses are responsible for promoting and managing the health of community members, and if they do not have enough physical activity or ignore their own health, not only will their own health decline but the quality of life of the public will also be affected. This study investigated the physical activity of public health nurses and analysed the effects of attitudes, subjective norms, perceived behavioural control and behavioural intention to engage in physical activity.

METHODS

This study adopted a cross-sectional research design, and convenience sampling was used to select the research subjects. 198 public health nurses were invited to participate, and 172 completed the questionnaire. Multiple linear regression was used to analyse the influencing factors of physical activity intention and physical activity.

RESULTS

Attitudes towards physical activity and perceived behavioural control of physical activity affected physical activity intention. When they had higher behavioural intention, their physical activity behaviour also improved. The physical activity intention significantly influenced the number of days that they had engaged in vigorous physical activity (95% CI 0.1786 to 0.3060, p<0.0001), and significantly influenced the number of days that they walked daily for 10 min (95% CI 0.2158 to 0.4144, p<0.0001), and also significantly influenced their daily sedentary time (95% CI -0.3020 to 0.0560, p=0.0046).

CONCLUSIONS

Encouraging public health nurses to heed their own health and motivating them to engage in physical activity warrants attention from policy-makers and government health agencies.

Raman spectroscopy of graphene-based materials and its applications in related devices

Graphene-based materials exhibit remarkable electronic, optical, and mechanical properties, which has resulted in both high scientific interest and huge potential for a variety of applications. Furthermore, the family of graphene-based materials is growing because of developments in preparation methods. Raman spectroscopy is a versatile tool to identify and characterize the chemical and physical properties of these materials, both at the laboratory and mass-production scale. This technique is so important that most of the papers published concerning these materials contain at least one Raman spectrum. Thus, here, we systematically review the developments in Raman spectroscopy of graphene-based materials from both fundamental research and practical (i.e., device applications) perspectives. We describe the essential Raman scattering processes of the entire first- and second-order modes in intrinsic graphene. Furthermore, the shear, layer-breathing, G and 2D modes of multilayer graphene with different stacking orders are discussed. Techniques to determine the number of graphene layers, to probe resonance Raman spectra of monolayer and multilayer graphenes and to obtain Raman images of graphene-based materials are also presented. The extensive capabilities of Raman spectroscopy for the investigation of the fundamental properties of graphene under external perturbations are described, which have also been extended to other graphene-based materials, such as graphene quantum dots, carbon dots, graphene oxide, nanoribbons, chemical vapor deposition-grown and SiC epitaxially grown graphene flakes, composites, and graphene-based van der Waals heterostructures. These fundamental properties have been used to probe the states, effects, and mechanisms of graphene materials present in the related heterostructures and devices. We hope that this review will be beneficial in all the aspects of graphene investigations, from basic research to material synthesis and device applications.

Interfacial Interactions in van der Waals Heterostructures of MoS2 and Graphene

Interfacial coupling between neighboring layers of van der Waals heterostructures (vdWHs), formed by vertically stacking more than two types of two-dimensional materials (2DMs), greatly affects their physical properties and device performance. Although high-resolution cross-sectional scanning tunneling electron microscopy can directly image the atomically sharp interfaces in the vdWHs, the interfacial coupling and lattice dynamics of vdWHs formed by two different types of 2DMs, such as semimetal and semiconductor, are not clear so far. Here, we report the ultralow-frequency Raman spectroscopy investigation on interfacial couplings in the vdWHs formed by graphene and MoS₂ flakes. Because of the significant interfacial layer-breathing couplings between MoS₂ and graphene flakes, a series of layer-breathing modes with frequencies dependent on their layer numbers are observed in the vdWHs, which can be described by the linear chain model. It is found that the interfacial layer-breathing force constant between MoS₂ and graphene, α₀^⊥(I) = 60 × 10¹⁸ N/m³, is comparable with the layer-breathing force constant of multilayer MoS₂ and graphene. The results suggest that the interfacial layer-breathing couplings in the vdWHs formed by MoS₂ and graphene flakes are not sensitive to their stacking order and twist angle between the two constituents. Our results demonstrate that the interfacial interlayer coupling in vdWHs formed by two-dimensional semimetals and semiconductors can lead to new lattice vibration modes, which not only can be used to measure the interfacial interactions in vdWHs but also is beneficial to fundamentally understand the properties of vdWHs for further engineering the vdWHs-based electronic and photonic devices.

Confined Acoustic Phonons in Colloidal Nanorod Heterostructures Investigated by Nonresonant Raman Spectroscopy and Finite Elements Simulations

Lattice vibrational modes in cadmium chalcogenide nanocrystals (NCs) have a strong impact on the carrier dynamics of excitons in such confined systems and on the optical properties of these nanomaterials. A prominent material for light emitting applications are CdSe/CdS core-shell dot-in-rods. Here we present a detailed investigation of the acoustic phonon modes in such dot-in-rods by nonresonant Raman spectroscopy with laser excitation energy lower than their bandgap. With high signal-to-noise ratio in the frequency range from 5-50 cm^-1, we reveal distinct Raman bands that can be related to confined extensional and radial-breathing modes (RBM). Comparison of the experimental results with finite elements simulation and analytical analysis gives detailed insight into the localized nature of the acoustic vibration modes and their resonant frequencies. In particular, the RBM of dot-in-rods cannot be understood by an oscillation of a CdSe sphere embedded in a CdS rod matrix. Instead, the dot-in-rod architecture leads to a reduction of the sound velocity in the core region of the rod, which results in a redshift of the rod RBM frequency and localization of the phonon induced strain in vicinity of the core where optical transitions occur. Such localized effects potentially can be exploited as a tool to tune exciton-phonon coupling in nanocrystal heterostructures.

Factors associated with receiving Pap tests among married immigrant women of Vietnamese origin in southern Taiwan

The purpose of this study was to explore the factors associated with Pap testing among married immigrant women of Vietnamese origin residing in Taiwan, including demographics, knowledge of cervical cancer, knowledge of Pap tests, fatalism, attitudes toward cervical cancer, and barriers to receiving Pap tests. A cross-sectional correlational design was used. Data were collected from July 2012 to January 2013. Participants were recruited through snowball sampling in two communities in Southern Taiwan. A total of 451 married immigrant women of Vietnamese origin aged 30 years and over were invited to participate in the study and 427 participated. Data analysis included descriptive statistics and multivariate logistic regression. Participants with no children were significantly less likely to have received a Pap test (odds ratio = 0.278, 95% confidence interval [CI] = 0.135-0.569); each additional point of knowledge about Pap tests increased the likelihood of having a Pap test by 19% (odds ratio = 1.190, 95% CI = 1.093-1.297), and each additional point in barriers to receiving Pap tests decreased the chances of having received a Pap test (odds ratio = 0.714, 95% CI = 0.637-0.800). The results can provide governments with a reference for developing policies for cervical cancer prevention among married immigrant Vietnamese women.

The effects of group health education on childbearing knowledge, attitude, and behaviour among Southeast Asian immigrant women in Taiwan

OBJECTIVES

to explore the effects of a group health education programme on the childbearing knowledge, attitude, and behaviours among Southeast Asian immigrant women in Taiwan.

DESIGN

a quasi-experimental design with convenience sampling was used.

SETTING

participants living in Kaohsiung County, Taiwan, were randomly divided by districts into either the experimental group or the control group.

PARTICIPANTS

one hundred Southeast Asian immigrant women were recruited as research participants. Among the 100 participants, 50 were in the experimental group and 50 were in the control group. A total of 99 participants completed the entire research procedure.

METHODS

a structured interview was used to evaluate the effects of a group health education programme.

MEASUREMENTS

the interview consisted of four measurements: the Demographic Inventory Scale, the Childbearing Knowledge Scale, the Childbearing Attitude Scale, and the Childbearing Planning Scale.

FINDINGS

after employing the group health education intervention, statistically significant changes from the pre-test to the post-test were found in the experimental group's scores for the Childbearing Knowledge Scale (P<0.0001), the Childbearing Attitude Scale (P<0.01), and the Childbearing Planning Scale (P<0.0001). The study's results indicated that providing education through group learning with guidance and support in childbearing health significantly improved Southeast Asian immigrant women's childbearing health knowledge, attitudes, and behaviours.

CONCLUSION

an appropriate, community-based group health education programme can create awareness for childbearing health among Southeast Asian immigrant women in Taiwan and improve their childbearing attitudes and behaviours.

Involvement of elevated expression of multiple cell-cycle regulator, DTL/RAMP (denticleless/RA-regulated nuclear matrix associated protein), in the growth of breast cancer cells

To investigate the detailed molecular mechanism of mammary carcinogenesis and discover novel therapeutic targets, we previously analysed gene expression profiles of breast cancers. We here report characterization of a significant role of DTL/RAMP (denticleless/RA-regulated nuclear matrix associated protein) in mammary carcinogenesis. Semiquantitative RT-PCR and northern blot analyses confirmed upregulation of DTL/RAMP in the majority of breast cancer cases and all of breast cancer cell lines examined. Immunocytochemical and western blot analyses using anti-DTL/RAMP polyclonal antibody revealed cell-cycle-dependent localization of endogenous DTL/RAMP protein in breast cancer cells; nuclear localization was observed in cells at interphase and the protein was concentrated at the contractile ring in cytokinesis process. The expression level of DTL/RAMP protein became highest at G(1)/S phases, whereas its phosphorylation level was enhanced during mitotic phase. Treatment of breast cancer cells, T47D and HBC4, with small-interfering RNAs against DTL/RAMP effectively suppressed its expression and caused accumulation of G(2)/M cells, resulting in growth inhibition of cancer cells. We further demonstrate the in vitro phosphorylation of DTL/RAMP through an interaction with the mitotic kinase, Aurora kinase-B (AURKB). Interestingly, depletion of AURKB expression with siRNA in breast cancer cells reduced the phosphorylation of DTL/RAMP and decreased the stability of DTL/RAMP protein. These findings imply important roles of DTL/RAMP in growth of breast cancer cells and suggest that DTL/RAMP might be a promising molecular target for treatment of breast cancer.

Prenatal examination behavior of Southeast Asian pregnant women in Taiwan: A questionnaire survey

BACKGROUND

There is growing concern about the factors affecting the prenatal examinations of immigrant women.

OBJECTIVES

The purpose of this study was to examine the relationships between the knowledge of pregnancy, attitude toward pregnancy and experience of medical services, and prenatal examination behavior of pregnant Southeast Asian women in Taiwan.

DESIGN

This was a cross-sectional study with a structured questionnaire administered to participants.

SETTING

Participants were recruited from the community health centers in Kaohsiung County, Taiwan.

PARTICIPANTS

The sampling criteria were as follows: each subject was to (a) have come from a Southeast Asian country, (b) be over 28 weeks pregnant to less than one year postpartum, (c) be able to communicate either in Mandarin or Taiwanese, and (d) be willing to participate in the research after hearing an explanation of it. As a result, 140 participants were recruited. A total of 132 participants completed the questionnaire and were used for data analysis.

METHODS

The participants completed structured questionnaires, which included the Demographic Inventory Scale, Knowledge of Pregnancy Scale, Attitudes toward Pregnancy Scale, Experience of Medical Services Scale and the Prenatal Examination Behavior Scale.

RESULTS

Findings show that 80.3% of the subjects attended their first-time prenatal examination during the first trimester and 59.1% of the subjects evaluated their prenatal examinations as being adequate. Their attitude toward childbearing was significantly correlated with their prenatal examination behavior, including the initial time of prenatal examination and frequencies of prenatal examinations during pregnancy. Positive attitudes toward childbearing and prenatal examination, and the number of years spent in Taiwan were all significant predictive factors of frequencies of prenatal examinations during pregnancy. The findings of this study can not only help healthcare professionals understand the prenatal examination behavior and related factors of the participants, but also provide guidance to healthcare professionals as they assist these pregnant Southeast Asian women in Taiwan in developing childbearing and family plans.

CONCLUSION

The attitude toward childbearing of the participants was significantly correlated with their prenatal examination behavior. They require professional help in seeking out appropriate medical services that will improve their healthcare quality during pregnancy.

The anticancer effect of protein-extract from Bidens alba in human colorectal carcinoma SW480 cells via the reactive oxidative species- and glutathione depletion-dependent apoptosis

Bidens alba has been used for healing cuts, injuries, swellings, hypertension, jaundice, and diabetes in some countries. However, the effect of B. alba on human cancer remains poorly understood. The goal of this study was to investigate whether B. alba protein-extract could have an anticancer property against human colorectal cancer. The human colorectal cancer SW 480 cells treated with the protein-extract of B. alba would cause marked DNA damages and apoptosis-related cellular morphologies. Treatment with 225 microg/ml B. alba protein-extract also led to the SW480 cells to produce readily intracellular reactive oxygen species (ROS) after 1h of treatment and last to 24 h. The intracellular glutathione (GSH) depletion occurred after 12-24h of treatment. The treatment of the protein-extract would also caused mitochondrial transmembrane potential (DeltaPsi(m)) to decrease and cytosolic cytochrome c to increase. The caspase 3/7 activities were activated from 3 to 6 h after the treatment. The percentages of apoptosis induced by the protein-extract of B. alba decreased 26.4%, 10.1%, and 29.4% when the SW 480 cells were pretreated with Vitamin C, N-acetylcysteine, and Boc-Asp(OMe)-fmk, respectively. Taken together, we demonstrated for the first time that the protein-extract of B. alba could induce apoptosis that was related to the ROS production and GSH depletion in human colorectal cancer. The protein-extract of B. alba might have therapeutic value against the human colorectal cancer.

Monoclonal antibodies against human ribosomal P proteins penetrate into living cells and cause apoptosis of Jurkat T cells in culture

OBJECTIVE

This study was designed to determine the role of autoantibodies to the ribosomal P protein (anti-P Abs) in the pathogenesis of systemic lupus erythematosus (SLE) using monoclonal anti-P antibodies (anti-P mAbs).

METHODS

Anti-P mAbs were prepared by a standard hybridoma procedure using recombinant human P1 and P2 proteins as immunogens. We studied the reactivities of these mAbs to P proteins, their binding and penetration capabilities in different cell lines and their apoptotic effects on Jurkat T cells.

RESULTS

In addition to recognizing human P0, P1 and P2 proteins, the anti-P mAb 9B6-4 bound to 20-40% and penetrated 50-90% of astrocytes, Jurkat T cells and lung cancer cells via the P0 surface protein. Treatment with the mAb 9B6-4 also caused increases in the percentages of Jurkat T cells in the sub-G1 phase of the cell cycle (14.8%) and undergoing apoptosis (21.3%).

CONCLUSION

Anti-P autoantibodies may play a role in the pathogenesis of lymphopenia or lymphocyte dysfunction in SLE.

p55Cdc/Cdc20 Overexpression Promotes Early G1/S Transition in Myeloid Cells

p55Cdc/Cdc20 is expressed in cycling mammalian cells and has been shown to be an activator of the mitotic spindle assembly checkpoint. We previously showed that overexpression of p55Cdc/Cdc20 in myeloid cells resulted in accelerated apoptosis and inhibition of granulocyte differentiation in the murine myeloid cell line 32Dcl3. p55Cdc/Cdc20 protein expression is detected in cells at late G1 phase of the cell cycle but is maximal during G2 phase. We report in this paper that inducible expression of p55Cdc/Cdc20 in 32Dcl3 cells results in premature transition from G1 to S phase. To characterize the mechanism of this early transition, we examined the expression of critical regulatory proteins during the cell cycle. Although expression of cyclin D, cyclin E, cdk2, and cdc2 did not change significantly between p55Cdc/Cdc20-overexpressing and control cells, p27Kip1 protein levels were lower and cdk2 activity higher during G1 to S transition in p55Cdc/Cdc20-overexpressing cells compared to control cells. Cyclin B1 levels were lower at early G1 phase in cells overexpressing p55Cdc/Cdc20. Our results suggest that p55Cdc/Cdc20 may play an important role in G1 to S transition during myelopoiesis.

Novel point mutation within intron 10 of FMR-1 gene causing fragile X syndrome

The majority of cases involving fragile X syndrome are due to expansion of a (CGG)n trinucleotide repeat at the 5' untranslated region of the FMR-1 gene. Deletion and intragenic loss of function mutations of the FMR-1 gene also have been reported. Here, we report a C to T point mutation at the 14th nucleotide in intron 10 of the FMR-1 gene in three unrelated fragile X patients. However, the (CGG)n repeat of FMR-1 in those patients does not expand. To determine the effect of this mutation on the patients' FMR-1 transcripts, total RNA from peripheral blood cells was reverse transcribed and amplified by polymerase chain reaction (RT-PCR). Direct and subcloned sequencing of the RT-PCR products revealed that the transcripts from the allele with C to T mutation skip exon 10 entirely, resulting in a joining of exons 9 and 11. Deletion of exon 10 results in frame-shift and premature termination of translation, which removes the highly conserved region that encoding the KH2 and RGG box domains of FMRP. Interestingly, a male of the three patients has another G to A substitution in exon 15. However, the intron 10 mutation is sufficient for development of fragile X syndrome.

In vitro activity of quinupristin/dalfopristin against gram-positive bacteria Haemophilus influenzae and Branhamella catarrhalis in Taiwan

BACKGROUND

Over the past decade, resistance of Gram-positive cocci to common antibiotics has steadily increased. New antibacterial agents that are active against multidrug-resistant pathogens are urgently needed for the treatment of these pathogens. We conducted an in vitro study on the activity of quinupristin/dalfopristin and other antibiotics against common clinical isolates of the gram-positive cocci, Haemophilus influenzae and Branhamella catarrhalis.

METHODS

The agar dilution method described by the National Committee for Clinical Laboratory Standards was used to determine the minimum inhibitory concentrations (MICs) of bacterial isolates from clinical specimens obtained from patients in a medical center.

RESULTS

All Staphylococcus aureus isolates were inhibited by quinupristin/dalfopristin (< or = 2 micrograms/ml). The MIC90s were 1 mg/ml for both methicillin-sensitive and -resistant S aureus. Quinupristin/dalfopristin inhibited streptococci at a concentration of 1 microgram/ml or less. The MIC90s were 1 microgram/ml for Streptococcus pneumoniae, S pyogenes and viridans streptococci. Ampicillin-resistant Enterococcus faecium was inhibited by quinupristin/dalfopristin at 0.5 to 4 micrograms/ml, with an MIC90 of 1 microgram/ml. H influenzae was inhibited by quinupristin/dalfopristin at 0.25 to 8 micrograms/ml, with an MIC90 of 4 micrograms/ml. B catarrhalis was inhibited by quinupristin/dalfopristin at 0.25 to 1 microgram/ml, with an MIC90 of 1 microgram/ml.

CONCLUSIONS

We found that quinupristin/dalfopristin showed good in vitro activity against staphylococci, streptococci and B catarrhalis but less in vitro activity against H influenzae.

Molecular diagnosis of fragile X syndrome and distribution of CGG repeats in the FMR-1 gene in Taiwanese

BACKGROUND AND PURPOSE

Fragile X syndrome, the most frequent form of inherited mental retardation, is caused by abnormal expansion of the CGG trinucleotide repeats in the 5' untranslated region of the FMR-1 gene. In this study, we describe the prenatal diagnosis of fragile X syndrome and the distribution of CGG repeat numbers in the FMR-1 gene, which has not been previously reported in Taiwanese.

METHODS

Using polymerase chain reaction (PCR), we determined the range of the CGG repeats in the FMR-1 gene in 316 normal individuals (350 X chromosomes) and 349 mentally retarded patients (429 X chromosomes). For prenatal diagnosis of fragile X syndrome, DNA extracted from amniotic fluid cells was used for PCR determination of CGG repeats.

RESULTS

Because there were no significant differences between the distribution of the (CGG)n alleles between the mentally retarded and normal subjects, the data were pooled. Among the 779 X chromosomes studied, 24 different alleles were identified with a low of 16 and a high of 45 CGG repeats. The 29 repeat allele was the most common, followed by the 30 and the 28 repeat alleles. We effectively amplified slightly expanded premutation alleles of up to about 90 CGG repeats. In the prenatally diagnosed fetus, a normal 29 repeat allele was found.

CONCLUSIONS

Determination of the distribution of the CGG repeats in the FMR-1 gene in Taiwanese is useful in genetic counseling regarding fragile X syndrome. Prenatal molecular diagnosis of the syndrome can be successfully performed using amniotic fluid cells.

A non-radioactive polymerase chain reaction method for diagnosis of Machado-Joseph disease

Machado-Joseph disease (MJD)/spinocerebellar ataxia type 3 (SCA3) is caused by unstable CAG trinucleotide repeat expansion in the coding region of the MJD gene. In this study, we describe a non-radioactive polymerase chain reaction (PCR) method to detect the CAG repeat range of the MJD gene. This technique allows direct visualization of the PCR products on ethidium bromide-stained agarose gels within hours. In this study, genomic DNA samples isolated from peripheral lymphocytes, amniotic fluid cells, and chorionic villi were tested with two sets of commonly used MJD primers. PCR conditions were optimized, which resulted in clear visualization of both the primer sets on 3% agarose gels. Ten out of 25 candidate MJD patients have been identified with this method to date, with no false-positive or false-negative diagnoses. This simple, reliable, and cost-effective method can be used for patient diagnosis, pre-symptomatic diagnosis, and prenatal diagnosis.

Integrin-mediated migration of murine B82L fibroblasts is dependent on the expression of an intact epidermal growth factor receptor

To evaluate the mechanisms by which epidermal growth factor (EGF) regulates actin-based cellular processes such as cell migration, we first examined the effects of EGF on cell adhesion, which is essential for cell migration. In mouse B82L fibroblasts transfected with the full-length EGF receptor, EGF promotes cell rounding and attenuates cell spreading on fibronectin, laminin, and vitronectin, and thus appears to reduce the strength of cell adhesion. Moreover, EGF synergizes with multiple extracellular matrix (ECM) components in the promotion of integrin-mediated cell migration of several different cell types, including fibroblasts and various carcinoma and osteosarcoma cell lines. Interestingly, co-presentation (co-positioning) of EGF with laminin or fibronectin is essential for EGF-stimulated migration. When EGF is mixed with the cells instead of the ECM components, it has little effect on cell migration. These results suggest that co-presentation of EGF with ECM components can enhance the polarization events required for directional cell movement. To identify the EGF receptor elements critical for the EGF stimulation of cell migration, B82L fibroblasts were transfected with either mutated or wild-type EGF receptors. Surprisingly, we found that B82L-Parental cells that lack the EGF receptor are not able to migrate to fibronectin, even though they can adhere to fibronectin. However, the introduction of wild-type EGF receptors into these fibroblasts enables them to migrate toward fibronectin even in the absence of EGF. The requirement of the EGF receptor for cell migration does not appear to result from the secretion of EGF or TGF-alpha by the cells transfected with the EGF receptor. Furthermore, cells expressing EGF receptors that are kinase-inactive, or C-terminally truncated, exhibit little migration toward fibronectin, indicating that an intact EGF receptor kinase is required for fibronectin-induced cell migration. In addition, neutralizing anti-EGF receptor antibodies attenuate cell migration in the presence of EGF, and inhibit migration to fibronectin or laminin alone. These results further suggest that the EGF receptor is downstream of integrin activation in the signal transduction pathways leading to fibroblast migration.

Application of spinal pain mapping in the diagnosis of low back pain--analysis of 104 cases

BACKGROUND

Low back pain is probably the most common pain problem seen in a general pain clinic and the cause of low back pain can be enigmatic at times. Often the pain sources are difficult to identify with the conventional diagnostic modalities. Spinal pain mapping is a sequence of well organized nerve block procedures. We undertook this study to evaluate the usefulness of this modality in diagnosing low back pain of uncertain etiology.

METHODS

In this prospective study, 104 consecutive adult patients who underwent spinal pain mapping were examined and analyzed. All patients had intractable low back pain of undetermined etiology after medical history, physical examination and 4-view roentgenographic evaluation of the lumbar spine had been undertaken to locate it. In addition, 41 patients (39%) had one or more of the following tests done, which included CT, MRI, EMG/NC but all failed to delineate the causes of the pain. All patients failed to respond to the conservative therapies.

RESULTS

With pain mapping the source of pain was found to be caused by sacro-iliac joint in 6%, lumbar nerve root in 20%, facet joint in 24%, combined lumbar nerve root and facet disease in 24%, internal disc disorder in 7%, combined facet and sacro-iliac joint in 4% and lumbar sympathetic dystrophy in 2% of patients. Pain mapping failed to demonstrate the causes of the pain in the remaining 13% of the patients.

CONCLUSIONS

Considering the difficult nature of this group of patients, spinal pain mapping provided a useful functional approach to the diagnosis of low back pain with obscure etiology in 87% of patients in our series.

Validation of a frequency-weighted filter for continuous biomechanical stress in repetitive wrist flexion tasks against a load

This experiment validates a frequency-weighted filter for continuous measurements of force, posture and repetition using a stimulated industrial task. A peg transfer task was used requiring subjects to repetitively insert pegs into holes with controlled resistance. Ten subjects performed the task for six conditions. All wrist flexion angular data were recorded continually using an electrogoniometer and processed through the filter. Subjective discomfort was reported after performing the task for 1 h using a 10 cm visual analogue scale. Results from linear regression analysis showed that the instrument reliably estimated subjective discomfort (r2 = 0.873). Applications and limitations of this instrument are explored.

Agreement between a frequency-weighted filter for continuous biomechanical measurements of repetitive wrist flexion against a load and published psychophysical data

A previous pilot study demonstrated that a force and frequency-weighted filter network could be developed for processing continuous biomechanical measures of repetitive wrist motions and exertions. The current study achieves the objective by modelling subjective discomfort for repetitive wrist flexion using controlled posture, pace and force. A three-level fractional factorial experiment was conducted involving repetitive wrist flexion (2 s/motion, 6 s/motion, 10 s/motion) from a neutral posture to a given angle (10 degrees, 28 degrees, 45 degrees) against a controlled resistance (5 N, 25 N, 50 N) using a Box Behnken design. Ten subjects participated. Discomfort was reported on a 10 cm visual analogue scale. Results of response surface regression analysis revealed that main effects of force, wrist flexion angle, and repetition were all significant (p < 0.05) and that no second-order effects were observed. Linear regression analysis on these factors established a discomfort model on which the filter characteristics were based. The pure error test model revealed no significant lack of fit (p > 0.05). The continuous model was compared and agreed with discrete psychophysical data from other published studies. The model was used for generating parameters for a force and frequency-weighted digital filter that weighs continuous wrist postural signals with corresponding force in proportion to the equal discomfort function as a function of frequency of repetition. These filters will enable integration of large quantities of biomechanical data in field studies.

Efficacy of a stress management program for patients with hepatocellular carcinoma receiving transcatheter arterial embolization

Transcatheter arterial embolization (TAE), a common treatment for patients with unresectable hepatocellular carcinoma (HCC), can provoke severe physical discomfort and psychologic stress. The purpose of this study was to investigate the effect of a combination of health education, muscle relaxation, and back massage on reducing physical and psychologic stress in HCC patients receiving TAE. A quasi-experimental design was used. Forty patients with HCC (30 men and 10 women) with a mean age of 57 +/- 12 years were recruited and randomly assigned to the control or experimental group. The effectiveness of the stress management program was evaluated using a knowledge questionnaire, a worry inventory, a state-trait anxiety inventory, and a physical distress scale. After completing the stress management program, the experimental group had a greater mean increase in knowledge score than the control group (5.1 vs 0.8, p < 0.0001) and a greater mean decrease in worry score (-8.2 vs 1.1, p < 0.0001). The mean decrease in the anxiety score in the experimental group was also significantly greater than in the control group before TAE (-5.8 vs 3.2, p < 0.001) and 2, 4, 6, and 7 days after TAE (-8.2 vs 7.1, p < 0.001; -8.7 vs 3.2, p < 0.001; -9.8 vs -2.1, p < 0.05; -11 vs -0.9, p < 0.05). The patients in the experimental group had a smaller mean increase in physical distress score than the control group at 2, 4, 6, and 7 days after TAE (34.7 vs 50.2, 20.9 vs 29.6, 10.6 vs 18.2, 3.9 vs 11.2, all p < 0.05). This stress management program effectively reduces the stress of HCC patients undergoing TAE.