A universal design of restructured dimer antigens: Development of a superior vaccine against the paramyxovirus in transgenic rice.

The development of vaccines, which induce effective immune responses while ensuring safety and affordability, remains a substantial challenge. In this study, we proposed a vaccine model of a restructured "head-to-tail" dimer to efficiently stimulate B cell response. We also demonstrate the feasibility of using this model to develop a paramyxovirus vaccine through a low-cost rice endosperm expression system. Crystal structure and small-angle X-ray scattering data showed that the restructured hemagglutinin-neuraminidase (HN) formed tetramers with fully exposed quadruple receptor binding domains and neutralizing epitopes. In comparison with the original HN antigen and three traditional commercial whole virus vaccines, the restructured HN facilitated critical epitope exposure and initiated a faster and more potent immune response. Two-dose immunization with 0.5 µg of the restructured antigen (equivalent to one-127th of a rice grain) and one-dose with 5 µg completely protected chickens against a lethal challenge of the virus. These results demonstrate that the restructured HN from transgenic rice seeds is safe, effective, low-dose useful, and inexpensive. We provide a plant platform and a simple restructured model for highly effective vaccine development.

Nebulized milk exosomes loaded with siTGF-ß1 ameliorate pulmonary fibrosis by inhibiting EMT pathway and enhancing collagen permeability.

Pulmonary Fibrosis (PF) is a fatal disease in the interstitial lung associated with high mortality, morbidity, and poor prognosis. Transforming growth factor-ß1 (TGF-ß1) is a fibroblast-activating protein that promotes fibrous diseases. Herein, an inhalable system was first developed using milk exosomes (M-Exos) encapsulating siRNA against TGF-ß1 (MsiTGF-ß1), and their therapeutic potential for bleomycin (BLM)-induced PF was investigated. M-siTGF-ß1 was introduced into the lungs of mice with PF through nebulization. The collagen penetration effect and lysosomal escape ability were verified in vitro. Inhaled MsiTGF-ß1 notably alleviated inflammatory infiltration, attenuated extracellular matrix (ECM) deposition, and increased the survival rate of PF mice by 4.7-fold. M-siTGF-ß1 protected lung tissue from BLM toxicity by efficiently delivering specific siRNA to the lungs, leading to TGF-ß1 mRNA silencing and epithelial mesenchymal transition pathway inhibition. Therefore, M-siTGF-ß1 offers a promising avenue for therapeutic intervention in fibrosis-related disorders.

Different effects of CO2 laser and estrogen treatment on vaginal mucosa microbiota and function in genitourinary syndrome of menopause patients.

AIM: To characterize the effects of CO2 laser treatment and estrogen treatment on vaginal microbiota in patients with genitourinary syndrome of menopause (GSM). METHODS: Sixty-four patients with genitourinary syndrome were divided into the estrogen group, the CO2 laser group, and the control group. The control group did not receive any treatment. Vaginal mucosa was collected after 3 and 12 months of treatment. The former was used for 16S rRNA sequencing, and the latter was used for pathological evaluation. Vaginal health and voiding function were assessed using the vaginal health index (VHI) scale and the UDI-6 scale at 3 and 12 months after treatment. RESULTS: The results showed that both treatments reduced alpha diversity in the vaginal flora. Additionally, the abundance of 65 genera differed significantly between the treatment and control groups, with an increase in potentially beneficial bacteria such as Lactobacillus, IheB3_7, Mycoplasma urealyticum, and Streptococcus. In addition, the VHI and UDI-6 scores improved in both treatment groups compared to the control group after 3 months. Whereas VHI and UDI-6 scores were close to baseline in the estrogen group, and remained significantly improved in the CO2 laser group after 12 months. Pathological results showed that both methods improved the vaginal health status of patients with GSM after 12 months of treatment. However, the CO2 group exhibited a more significant increase in type III collagen. CONCLUSIONS: Both CO2 laser and estrogen therapies can regulate the vaginal flora imbalance of GSM and improve the corresponding symptoms. However, the long-term efficacy of CO2 laser therapy is superior compared to estrogen therapy.

Understanding the mechanism of safety attitude mitigates the turnover intention novice nurses via the person-centred method: A theory-driven, deductive cross-sectional study.

AIM: Examine profiles of safety attitudes among novices and explore whether profiles moderate the occupational identity-turnover pathway. BACKGROUND: Novice nurses face unique challenges in adopting positive safety attitudes, which influence outcomes like turnover. However, past research found only average levels of safety attitudes among novices, ignoring possible heterogeneity. Exploring whether meaningful subgroups exist based on safety perspectives and factors shaping them can provide insights to improve safety attitudes and retention. DESIGN: This study was designed as a cross-sectional investigation. METHODS: Data were collected through the distribution of questionnaires. Descriptive statistics were first conducted, followed by latent profile analysis. We then carried out univariate analysis and ordinal multinomial regression to explore the factors shaping the different profiles. Finally, we examine the moderating effect of nurses' safety attitudes with different latent profiles on the relationship between professional identification and turnover intention. RESULTS: A total of 816 novice nurses were included. Three profiles were identified: high, moderate and low safety attitudes - higher attitudes were associated with lower turnover intention. Interest in nursing, health status, identity and turnover predicted profile membership. Moderate profile had a stronger buffering effect on the identity-turnover link versus high profile. CONCLUSION: Multiple safety attitude profiles exist among novice nurses. Certain factors like interest in nursing and occupational identity are associated with more positive safety profiles. Targeting these factors could potentially improve safety attitudes and reduce turnover among novice nurses. The moderating effects suggest that tailored interventions matching specific subgroups may maximize impact. IMPACT: Assessing subgroup attitudes enables tailored training for novices' specific needs, nurturing continuous improvement. Supporting early career development and role identity may strengthen retention intentions.

A new classification for emergency critically ill patients and analysis of their adverse events during intrahospital transport: A cluster analysis.

BACKGROUND: Critical patients may experience various adverse events during transportation within hospitals. Therefore, quickly evaluating and classifying patients before transporting them from the emergency department and focusing on managing high-risk patients are critical. At present, no unified classification method exists; all the current approaches are subjective. AIMS: To ensure transportation safety, we conducted a cluster analysis of critically ill patients transferred from the emergency department to the intensive care unit. STUDY DESIGN: Single-centre cohort study. This study was conducted at a comprehensive first-class teaching hospital in Beijing. Convenience sampling and continuous enrolment were employed. We collected data from 1 January 2019, to 31 December 2021. All patients were transferred from the emergency department to the intensive care unit, and cluster analysis was conducted using five variables. RESULTS: A total of 584 patients were grouped into three clusters. Cluster 1 (high systolic blood pressure group) included 208 (35.6%) patients. Cluster 2 (high heart rate and low blood oxygen group) included 55 (9.4%) patients. Cluster 3 (normal group) included the remaining 321 (55%) patients. The oxygen saturation levels of all the patients were lower after transport, and the proportion of adverse events (61.8%) was the highest in Cluster 2 (p < .05). CONCLUSIONS: This study utilized data on five important vital signs from a cluster analysis to explore possible patient classifications and provide a reference for ensuring transportation safety. RELEVANCE TO CLINICAL PRACTICE: Before transferring patients, we should classify them and implement targeted care. Changes in blood oxygen levels in all patients should be considered, with a focus on the occurrence of adverse events during transportation among patients with high heart rates and low blood oxygen levels.

Health Management Service Models for the Elderly with Visual Impairment: A Scoping Review.

Background: The incidence of visual impairment(VI) in older people is gradually increasing. This review aimed to summarise the evidence on existing health management models and strategies for older adults with VI to improve health-related and vision-related quality of life (QoL) in older people. Methods: Based on the framework of the scoping review methodology of Arksey and O'Malley (2005), a comprehensive literature search of relevant literature published between January 2010 and June 2022 in PubMed, CINAHL, EMBASE, Web of Science, Cochrane Library, CNKI, VIP, Wanfang database, Sinomed and the grey literature. Results: Finally, 31 articles were included. The health management model had a multidisciplinary team low vision rehabilitation model, medical consortium two-way management model, low vision community comprehensive rehabilitation model, medical consortium-family contract service model, screening-referral-follow-up model, and three-level low vision care model. The health management strategy covers nine aspects, the combination of multi-element strategies is feasible, and network information technology has also shown positive results. Conclusion: In the future, under the Internet and hierarchical management model, we should provide demand-based personalized support to rationalize and scientifically achieve hierarchical management and improve resource utilization efficiency and eye health outcomes.

Development and validation of a prediction nomogram for depressive symptoms in gout patients.

Objective: The objective of the study was to explore the risk factors for depressive symptoms in patients with gout and to construct and validate a nomogram model. Methods: From October 2022 to July 2023, a total of 469 gout patients from a Class iii Grade A hospital in Northeast China were selected as the research objects by the convenience sampling method. The General Information Questionnaire, Self-Rating Depression Scale, Gout Knowledge Questionnaire, Self-Efficacy Scale for Managing Chronic Disease (SEMCD), and Social Support Rating Scale were used to conduct the survey. Univariate and multivariate logistic regression analyses were used to establish a depression risk prediction model and construct a nomogram. The bootstrap method was used to verify the performance of the model. Results: The detection rate of depressive symptoms in gout patients was 25.16%. Binary logistic regression analysis showed that male, the number of tophi, acute attack period, lack of knowledge about gout, the number of attacks in the past year, and the duration of the last attack were independent risk factors for post-gout depression. Female, interictal period, chronic arthritis period, knowledge of gout, and social support were protective factors for post-gout depression (p < 0.05). The calibration (χ2 = 11.348, p = 0.183, p > 0.05) and discrimination (AUC = 0.858, 95%CI: 0.818-0.897) of the nomogram model for depressive symptoms in gout patients were good. Conclusion: The prevalence of depressive symptoms in gout patients is high, and it is affected by gender, current disease stage, number of tophi, gout knowledge level, the number of attacks in the past year, and the last attack days. The nomogram model is scientific and practical for predicting the occurrence of depressive symptoms in gout patients.

Impact of Frailty on Survival and Neurological Outcomes After Cardiac Arrest: A Systematic Review and Meta-Analysis.

To synthesize the evidence on the associations of frailty with the risk of mortality and neurological outcomes in patients with cardiac arrest undergoing cardiopulmonary resuscitation. We conducted a literature search on PubMed, EMBASE, and Scopus. We included observational studies on adult participants (18 years or older) with cardiac arrest. The eligible studies reported frailty assessments using standard tools, and the comparator group comprised nonfrail participants. We used random-effects models for all analyses and expressed pooled effect sizes as odds ratios (ORs) with 95% confidence intervals (CIs). We included data from 12 studies in our analysis. Individuals with frailty exhibited a significantly higher risk of in-hospital mortality (OR, 2.18; 95% CI, 1.62-2.94), and increased 30-day mortality (OR, 1.43; 95% CI, 1.12-1.84) and 12-month mortality (OR, 4.16; 95% CI, 2.32-7.47) than the nonfrail individuals. Frail individuals also displayed lower odds of achieving favorable neurological outcomes upon hospital discharge (OR, 0.32; 95% CI, 0.20-0.50) and at the 30-day follow-up (OR, 0.42; 95% CI, 0.23-0.78). Additionally, they had lower odds of return of successful spontaneous circulation (OR, 0.49; 95% CI, 0.34-0.72). The observed associations between frailty and a higher risk of mortality reduced odds of favorable neurological outcomes, and lower odds of return of successful spontaneous circulation underscore the value of identifying frailty in individuals to achieve more accurate prognoses. Our findings highlight the importance of including frailty assessments as a component of the management plan for patients experiencing cardiac arrest.

Early Post-Transplant Adaptation Experience in Young and Middle-Aged People With Kidney Transplant in China: A Qualitative Study.

BACKGROUND: Successful adaptation to post-transplantation life in patients who have undergone kidney transplants is crucial. The psychosocial needs of people with kidney transplants are closely related to the health of the transplanted kidney. If transplant recipients cannot adapt to the effects of the transplant, their physical and mental health will be seriously impaired. OBJECTIVE: The purpose of this study was to explore the early post-transplant adaptation experience of young and middle-aged persons with kidney transplants in China based on the Roy adaptation model. METHODS: A qualitative descriptive study was conducted using semi-structured interviews. Fifteen young and middle-aged persons with kidney transplant were recruited from a tertiary hospital in China between September 2022 and March 2023 through purposive sampling. Data were analyzed using a thematic analysis approach. RESULTS: This study identified 4 themes: (1) "two-sided" changes in physiological functioning, (2) "dawn and darkness" (conflicting perceived emotions about the future), (3) role functioning adaptation conflict and impairment, and (4) social isolation and the challenges of coping. CONCLUSIONS: This study found that early post-transplant adaptation in young and middle-aged people with kidney transplant included both positive and negative experiences, and these findings can provide new insights into research related to successful post-operative adaptation.

Effects of different exercise interventions on chemotherapy-related cognitive impairment in patients with breast cancer: a study protocol for systematic review and network meta-analysis.

INTRODUCTION: Breast cancer stands as the most prevalent type of cancer affecting women globally, and chemotherapy plays a pivotal role in its treatment by diminishing tumour recurrence and enhancing the survival rates of patients. However, chemotherapy-related cognitive impairment (CRCI) often occurs in patients undergoing treatment. Although multiple clinical trials have indicated that exercise therapy can improve CRCI in patients with breast cancer, there are variations in the types of exercise interventions and their effectiveness. We aim to perform a pioneering network meta-analysis (NMA) to assess and prioritise the effectiveness of various exercise interventions in enhancing cognitive function in patients with breast cancer undergoing chemotherapy. METHODS AND ANALYSIS: We will search multiple databases, including PubMed, Web of Science, Cochrane, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang and Sinomed databases, from their inception to May 2023. The main outcome is the cognitive function changes in patients with breast cancer, including subjective and objective results. We will specifically include randomised controlled trials reported in English and Chinese languages, whose primary outcome consists of an assessment of the cognitive function of patients with breast cancer using standardised and validated assessment tools, encompassing both subjective and objective outcomes. The quality of all the trials included will be evaluated based on 'Version 2 of the Cochrane tool for assessing the risk of bias in randomized controlled trials (RoB2)'. We will conduct a Bayesian NMA to thoroughly evaluate and compare the effectiveness of different exercise interventions. We will use cumulative ranking probability plots to estimate the ranking of the best interventions for various exercises. Network plots and funnel plots will be employed to display the study sizes and participants of each exercise intervention, as well as potential publication biases. ETHICS AND DISSEMINATION: The study findings will be shared via peer-reviewed journals to ensure the highest quality and credibility of the research. As the reporting will not include any private patient data, there are no ethical considerations associated with this protocol. PROSPERO REGISTRATION NUMBER: CRD42023406597.

Lipid-lowering effect and oral transport characteristics study of curculigoside.

Introduction: The incidence of metabolic disorders during pregnancy is increasing year by year, with diseases including hypertension and hyperlipidemia. Statins are the primary drugs for treating hyperlipidemia or atherosclerosis, yet some patients remain unresponsive to them, and pregnant women are prohibited from taking statins. Curculigoside is the major biologically active natural product present in Curculigo orchioides. Methods: In this study, A high-fat mice model was developed to study the lipid-lowering effect of curculigoside. Using intestinal Caco-2 cell monolayer, the curculigoside transport properties at two temperatures and possible transporters were systemically studied. Results: Curculigoside at concentrations used during the experiments have no toxic effect to Caco-2 cells. The curculigoside transfer from the apical to the basolateral side was strongly influenced by temperature. P-glycoprotein, breast cancer resistance protein, and efflux transporters are crucial components of the human intestinal cell line Caco-2. The curculigoside can significantly affect the contents of total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in mice. Discussion: The transport properties and potential mechanism of curculigoside offer valuable insights for the design of development of hypolipidemic drugs like anti-atherosclerotic drugs and also be helpful to the further study of the pharmacological activity of curculigoside.

Sexual experience in patients with coronary heart disease: a descriptive phenomenological study.

Sex is an essential part of life and is a basic demand for human beings. Coronary heart disease can have an impact on patients' sexual lives; however, not much attention has been paid to it in China, and few studies have been conducted on this topic. Therefore, this study used a qualitative approach to understand the sexual experience of patients after the illness, thus laying the foundation for the development of relevant measures. Semi-structured interviews were conducted with 14 patients. Descriptive phenomenological methods were employed to collect data and explore the sexual experience of patients with coronary heart disease. A total of 4 thematic groups, 9 themes, and 23 subthemes were extracted. The four thematic groups were independent and cross-influenced. In these groups, alterations in the sexual experience, including the change in sexual physiology and psychological state, were affected by the lack of knowledge, age, disease, and other factors. Furthermore, the patient's perception of sexuality affected the quality of sexual life after the illness. The sexual experience of patients with coronary heart disease and its influencing factors, such as age, disease factors, and lack of related knowledge, were described. The findings are expected to aid in formulating targeted and personalized intervention measures.

A Practical Tool for Measuring Home-Based Cardiac Rehabilitation Self-Management Behavior: A Multiphase Cross-Sectional Study.

BACKGROUND: Optimal self-management is the key to home-based cardiac rehabilitation for patients with heart disease. At present, there is a lack of a specific assessment tool to evaluate the home-based cardiac rehabilitation self-management behavior in patients with heart disease. Therefore, the aim of this study was to develop the Home-Based Cardiac Rehabilitation Self-Management Scale and validate its psychometric properties among patients with coronary heart disease. METHODS AND RESULTS: A multiphase cross-sectional study was conducted that study covered 3 phases: (1) item generation and revision, (2) item evaluation and preliminary exploration, and (3) assessment of the psychometric properties of the scale. A scale with 21 items was developed to measure the home-based cardiac rehabilitation self-management behavior. The content validity index of the scale was 0.980. In exploratory factor analysis, the 5-factor structure supported by eigenvalues and screen plot explained 74.326% of the total variation. In confirmatory factor analysis, all fitting indicators were acceptable, further supporting the construct validity of the scale. The criterion validity of the scale was 0.783. In the reliability analysis, the Cronbach's α coefficient of the scale was 0.882, with a dimensionality range of 0.780 to 0.936. The split-half reliability coefficient and test-retest reliability coefficient were 0.774 and 0.770, respectively. CONCLUSIONS: This study is the first to develop and validate a practical tool. This scale can comprehensively and accurately assess the self-management behavior of patients with heart disease in a home-based cardiac rehabilitation environment.

A Path Analysis on Quality of Life of People With HIV: Validation and Refinement of the Self-Regulatory HIV/AIDS Symptom Management Model.

ABSTRACT: This study explored the path affecting the quality of life (QOL) of people with HIV in China and clarified the applicability and interpretability of the Self-Regulatory HIV/AIDS Symptom Management Model. We conducted a cross-sectional survey in nine regions of China and collected information about demographics, symptom experience, social support, perceived symptom manageability, self-efficacy, and QOL. A total of 711 patients participated in this survey. After four rounds of path analysis were conducted, the most fit indices met the standards (χ 2 /df = 2.633, Root Mean Square Error of Approximation = 0.081, Goodness-of-Fit Index/Adjusted Goodness-of-Fit Index/Comparative Fit Index/Incremental Fit Index/Tucker-Lewis Coefficient > 0.9), and the relationships between variables were statistically significant ( p < .05). Among all the pathways, social support had the most significant impact on the QOL, with a total path coefficient of 0.665. Symptom experience, as a negative factor, had a total effect value of -0.361. This study showed how all the factors influencing QOL were interconnected, serving as a crucial theoretical foundation for intervention strategies in future clinical practice.

Drug development advances in human genetics-based targets.

Drug development is a long and costly process, with a high degree of uncertainty from the identification of a drug target to its market launch. Targeted drugs supported by human genetic evidence are expected to enter phase II/III clinical trials or be approved for marketing more quickly, speeding up the drug development process. Currently, genetic data and technologies such as genome-wide association studies (GWAS), whole-exome sequencing (WES), and whole-genome sequencing (WGS) have identified and validated many potential molecular targets associated with diseases. This review describes the structure, molecular biology, and drug development of human genetics-based validated beneficial loss-of-function (LOF) mutation targets (target mutations that reduce disease incidence) over the past decade. The feasibility of eight beneficial LOF mutation targets (PCSK9, ANGPTL3, ASGR1, HSD17B13, KHK, CIDEB, GPR75, and INHBE) as targets for drug discovery is mainly emphasized, and their research prospects and challenges are discussed. In conclusion, we expect that this review will inspire more researchers to use human genetics and genomics to support the discovery of novel therapeutic drugs and the direction of clinical development, which will contribute to the development of new drug discovery and drug repurposing.

[Retracted] Embelin-induced brain glioma cell apoptosis and cell cycle arrest via the mitochondrial pathway.

Following the publication of the above paper, it was drawn to the Editor's attention by a concerned reader that the flow cytometric data shown in Fig. 4A on p. 2475 were strikingly similar to data appearing in another article written by different authors at different research institutes which had already been published. Owing to the fact that the contentious data in the above article had already been published elsewhere prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 29: 2473­2478, 2013; DOI: 10.3892/or.2013.2369].

Effectiveness of a self-determination theory-based intervention for nursing home residents with depression: A randomized controlled trial.

Objective and rationale: The prevalence of depression among older adults residing in nursing homes has risen. While physical activity interventions based on the self-determination theory have been shown to reduce depressive symptoms among students and middle-aged adults, research in nursing home residents is scarce. This study aimed to investigate whether physical activity can alleviate depressive symptoms in nursing home residents over an extended period. Methods: Between September 2020 and August 2021, 46 nursing home residents in Shenyang were randomly assigned to either a control group (n = 23) or an intervention group (n = 23). The control group followed a standard physical activity programme, whereas the intervention group underwent a programme based on self-determination theory. Both groups were monitored for 24 weeks post-intervention. Depression scores were assessed using the Geriatric Depression Scale, sociodemographic data collected via a self-designed questionnaire, cognitive function evaluated using the Mini-Mental State Examination, and weight and body fat measured using the Omron KARADA Scan Body Composition and Scale. Results: Depression scores were measured at five time points: baseline (T0), weeks 12 (T1), and 24 (T2) of the intervention, and weeks 12 (T3) and 24 (T4) during follow-up. Both groups exhibited a trend of decline by more than five points. The intervention group demonstrated more favourable pre-to-post changes in depression scores compared to the control group. Conclusions: A physical activity intervention based on self-determination conceptual framework has been proven to be effective for nursing home residents with depressive symptoms, also aiding in the maintenance of their physical activity levels. This study offers a theoretical foundation for the development of intervention programmes by researchers and identifies potential intervention strategies for caregivers in nursing homes. Trial Registration: The Chinese Clinical Trial Registry (ChiCTR2200060598) (June 5, 2022).