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Background Understanding how patients interpret health education leaflets is essential in promoting equitable and effective health communication. This narrative thematic review synthesises current evidence and introduces a conceptual model to inform patient‐centred leaflet design. Methods Twenty‐eight English‐ and Chinese‐language studies (2010–2024) were identified via PubMed, CINAHL, ERIC, Airiti Library and Google Scholar. Boolean searches combined terms related to health literacy, patient education materials and information design. Eligible studies underwent open coding and thematic synthesis, guided by Nutbeam's three‐tier health literacy model (functional, interactive and critical) and cognitive learning theories (Cognitive Load, Multimedia Learning and Dual Coding). Results Patients frequently encountered dense text, medical jargon and poor text–image integration. Thematic mapping aligned barriers with literacy levels, generating two strategy tables. The proposed ‘Boiling Water Model’ depicts the progression from information gathering to value integration and a ‘boiling point’ of insight, supported by reflective prompts, risk–benefit comparisons and clarifying aids. Conclusions Embedding cognitive learning principles within leaflet design can facilitate patients' progression towards critical health literacy. A theory‐driven, user‐centred approach—incorporating plain language, interactive cues and reflective elements—can transform leaflets into dynamic tools that enhance comprehension and foster informed, value‐aligned health decisions. Patient or Public Contribution No patients or members of the public were directly involved in the design, conduct or analysis of this narrative review. The study focus and synthesis were guided by documented patient experiences and reported barriers to comprehension in the existing literature, informing patient‐centred health education material design. Clinical Trial Registration: Not applicable. This study is a narrative literature review and does not report results of a clinical trial.

Aims and Objectives. The purpose of this study was to investigate the prevalence of job burnout among Taiwanese nurses, specifically exploring the mediating role of workplace social support in the association between nurses’ stressors and this burnout. Background. Nurses confront high-stress, high-stakes work environments due to evolving disease patterns and growing healthcare needs. The nurse-patient ratio in Taiwan is higher than in other countries, necessitating effective strategies to mitigate nurse burnout and enhance the quality of patient care. Design. A cross-sectional study design was employed. Methods. From January to April 2019, 500 nurses were recruited from a medical center in Kaohsiung City, southern Taiwan. Participants completed a questionnaire addressing workplace social support, stressors faced by nurses, and job burnout. Data were analyzed using descriptive statistics, one-way analysis of variance, t-test evaluations, Pearson’s correlation analyses, and a structural equation model with maximum likelihood estimation. Results. The findings revealed that a portion of nurses experienced high rates of personal burnout (7.20%), work-related burnout (5.00%), and client-related burnout (4.80%). The relationships among workplace social support, nurses’ stressors, and job burnout were all substantial, exhibiting correlation coefficients ranging from −0.318 to 0.828. The direct effect of nurse stress on job burnout was 0.551, comprising 90.7% of the cumulative effect. In contrast, the indirect effect of nurse stress on job burnout, considering workplace social support, amounted to 9.3% of the total effect, with a value of 0.056. Conclusions. The study underscored the importance of addressing job burnout among nurses in Taiwan. Workplace social support may function as a mediating factor in the relationship between nurses’ stressors and job burnout. Implications for Nursing Management. The results suggest that healthcare administrators should prioritize workplace social support initiatives. These efforts could help identify and address nurses’ stressors, promote work-life balance, and reduce nurse-patient ratios and work overload.

Background Increasing childhood obesity has become a major health threat. This cross-sectional study reports associations between schoolchildren's waist circumference (WC) and risk of elevated blood pressure. Methods We measured height, weight, neck and waist circumference, and blood pressure in regular health examinations among children in grade 1 (ages 6-7 years) at six elementary schools in Taipei County, Taiwan. Elevated blood pressure was defined in children found to have mean systolic or diastolic blood pressure greater than or equal to the gender-, age-, and height-percentile-specific 95th-percentile blood pressure value. Results All 2,334 schoolchildren were examined (response rate was 100% in the six schools). The mean of systolic and diastolic blood pressure increased as WC quartiles increased (p < 0.0001). The prevalence of elevated blood pressure for boys and girls within the fourth quartile of waist circumference was 38.9% and 26.8%, respectively. In the multivariate logistic regression analyses, the adjusted odds ratios of elevated blood pressure were 1.78 (95% confidence interval [CI] = 1.13-2.80), 2.45 (95% CI = 1.56-3.85), and 6.03 (95% CI = 3.59-10.1) for children in the second, third, and fourth waist circumference quartiles compared with the first quartile. The odds ratios for per-unit increase and per increase of standard deviation associated with elevated blood pressure were 1.14 (95% CI = 1.10-1.18) and 2.22 (95% CI = 1.76-2.78), respectively. Conclusions Elevated blood pressure in children was associated with waist circumference. Not only is waist circumference easier to measure than blood pressure, but it also provides important information on metabolic risk. Further research is needed on effective interventions to identify and monitor children with increased waist circumference to reduce metabolic and blood pressure risks.

Brain tumors are mainly treated with surgery. However, patients still experience many symptoms and nursing needs due to disease and treatment-related factors that, if not improved in a timely manner, may result in depression. The purpose of this study was to examine the effectiveness of supportive caring on symptom distress, nursing needs, and depressive symptoms in patients with brain tumor after surgery. This study adopted a two-group, pre- and post-test experimental design. The enrolled participants were randomized into two groups. Those in the experimental group received a phone-based supportive caring intervention twice at 1 and 3 months after surgery. Those in the control group received usual discharge care. The measurement outcomes included a supportive care needs survey, symptom distress scales, and the center for epidemiological studies of depression. Baseline data was collected prior to hospital discharge (T0), with follow-up data collected at one month (T1), three months (T2), and six months (T3) a

背景：腦瘤治療以手術為主，然手術後病人仍因疾病與治療因素產生諸多症狀困擾和護理需求，若未及時改善則容易產生憂鬱情緒。目的：探討支持關懷介入措施對腦腫瘤術後病人之症狀困擾、護理需求與憂鬱之成效。方法：本研究採雙組前、後測實驗設計，以隨機抽樣將參與者分配到兩組，實驗組接受術後1個月和3個月的支持性關懷，對照組接受常規性出院衛教。成果測量包括支持性護理需求量表、症狀困擾量表和流行病學研究中心憂鬱量表。資料收集時間包括：出院前（T0）、術後1個月（T1）、3個月（T2）和6個月（T3）。結果：由廣義估計模式分析顯示，支持性關懷介入後，實驗組護理需求在T1（β=-23.61,p＜.001）、T2（β=-22.51,p＜.001）、T3（β=-22.26,p＜.001）顯著低於對照組。症狀困擾在T1（β=-7.03,p=.019）、T2（β=-8.39,p=.003）顯著低於對照組。憂鬱情緒僅在T2（β=-8.55,p=.005）顯著低於對照組。結論：本研究顯示支持性關懷有助改善腦瘤病人手術後護理需求、症狀困擾和憂鬱情緒，醫護團隊人員應注意腦瘤病人術後護理需求、症狀困擾和憂鬱情緒狀況，必要時提供訊息，以提高護理的照護品質。

The process of 180°domain switching in PbTiO_3 single crystal under an antiparallel electric field was investigated by the three-dimensional phase field simulation,especially the effect of electric field on the type and duration of domain switching.It is found that the polarization reversal of domains takes place under an antiparallel electric field in PbTiO_3 single crystal.The results of the phase field simulation indicate that there is only 90°domain switching under a weak electric field.With the rise of the electric field,180°domain switching appears.If the electric field is strengthened further,90°domain switching disappears and the duration of domain switching is shortened.

A numerical investigate of unsteady (rotor 37) based on dual time step is carried out .Results were used to identify the existence of an interface between the approach fluid and the tip-leakage flow. This paper discusses mechanism of spike stall.

Background： Some ultrasonographic （US） signs overlap between benign and malignant nodules. The purpose of this study was to raise a special US sign of benign thyroid nodules, termed the ＂onion skin-liked sign.＂ Methods： Twenty-seven patients with 27 nodules who shrank naturally and the ＂onion skin-liked sign＂ appeared on the final US images were enrolled in the study. The ultrasound characters and risk stratifications at the start and end of observation were compared. Then, thirty goiters with fibrosis and thirty papillary thyroid carcinomas （PTC） were randomly selected from the database of our hospital, matched the sizes of 27 nodules at the end point of observation. The differences of ＂onion skin-liked sign＂ between the two groups were analyzed. Results： The average duration of follow-up of 27 nodules was 24.0 ± 12.2 months （range, 12-65 months）. At the end of the follow-up, the size of the nodules decreased on average by 1.26 ± 0.82 cm （range, 0.3-3.4 cm） and calcification was found in 21 nodules, compared with only 2 nodules with calcification at the start of the follow-up. In addition, only negligible or no blood flow signal could be detected at the periphery of all the nodules and 100% （27/27） were high suspicion at the end of observation. In matched groups, all PTC showed high suspicion of malignancy, 18/30 （60%） goiters with fibrosis were high suspicion and 11/30 （37%） were intermediate suspicion. Twenty-two patients in the group of nodular fibrosis presented ＂onion skin-liked sign,＂ which was not shown in any patient of PTC group. The sensitivity, specificity, positive predictive value, and negative predictive value of ＂onion skin-liked sign＂ in predicting nodular goiter with fibrosis were 73.3%, 100%, 100%, and 78.9%, respectively. Conclusions： The ＂onion skin-liked sign＂ was a characteristic US feature of benign thyroid nodules detected in the follow-up of thyroid nodules. It is useful to differentiate PTCs and nodular goiters with fibrosis.

Background： The clinical behavior and management of poorly differentiated thyroid carcinoma （PDTC） are very different from papillary thyroid carcinoma （PTC）. By comparing the clinical and ultrasonographic features between the two tumors, we proposed to provide more possibilities for recognizing PDTC before treatment. Methods： The data of 13 PDTCs and 39 ageand gender-matched PTCs in Peking Union Medical College Hospital between December 2003 and September 2013 were retrospectively reviewed. The clinical and ultrasonic features between the two groups were compared. Results： The frequencies of family history of carcinoma, complication with other thyroid lesions, lymph node metastases, recurrent laryngeal nerve injuries, and distant metastases were higher in PDTCs （30.8%, 61.6%, 69.2%, 23.1%, and 46.2%, respectively） than those in PTCs （2.6%, 23.1%, 25.6%, 2.6%, and 2.6%, respectively） （P 〈 0.05）. The mortality rate of PDTCs was greatly higher than PTCs （P 〈 0.01）. Conventional ultrasound showed that the size of PDTCs was larger than that of PTCs （3.1±1.9 cm vs. 1.7± 1.0 cm）. Clear margins and rich and/or irregular blood flow were found in 92.3% of PDTCs, which differed substantially from PTCs （51.7% and 53.8%, respectively） （P 〈 0.05）. Conclusions： PDTC is more aggressive and its mortality rate is higher than PTCs. Accordingly, more attention should be given to suspicious thyroid cancer nodules that show large size, regular shape, and rich blood flow signals on ultrasound to exclude the possibility of PDTCs.

Background： The endovascular strategy of the huge dissecting aneurysms involving the basilar artery （BA） is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping （IT） technique. Methods： We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. Results： All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months alter the endovascular treatment （median 8 months）, 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. Conclusions： The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.