Academic resilience in nusing students: a concept analysis.

BACKGROUND: Academic resilience is a crucial concept for nursing students to cope with academic challenges. Currently, there is significant variation in the description of the concept attributes of academic resilience among nursing students, which impedes the advancement of academic research. Therefore, it is essential to establish a clear definition of the concept of academic resilience for nursing students. PURPOSE: The purpose of this paper is to report the results of concept analysis of academic resilience of nursing students. METHODS: The Rodgers evolutionary concept analysis was employed to test the attributes, antecedents, consequences and related concepts of academic resilience of nursing students. Walker and Avant's method was utilized to construct a model case and provide empirical referents. RESULTS: The findings indicate that the attributes of nursing students' academic resilience include self-efficacy, self-regulation and recovery, and the antecedents include internal factors and external environmental factors. The consequences include adaptability, career maturity, adversity quotient level, probability of academic success, a sense of belonging to school and low levels of psychological distress. CONCLUSION: The systematic understanding of academic resilience among nursing students provides a pathway for nursing educators and students to enhance academic resilience, promote academic success, and establish a foundation for the training of more qualified nurses.

The growth of nursing professional values - A grounded theory.

BACKGROUND: The formation of nursing professional values is crucial to the development of the nursing profession, but it is influenced by various factors. The process of shaping nursing professional values in different growth contexts has been overlooked. In order to establish professional values in the context of Chinese nursing, it is necessary to investigate the evolution of nursing professional values throughout history. PURPOSE: To develop a theory of professional values growth from a nursing context. Design: This study adopted a grounded theory approach from Strauss and Corbin. PARTICIPANTS: From November 2021 to March 2022, a total of 33 participants were included. METHODS: Data were collected using a semi-structured interview over telephone or online or face to face and were analysed using open, axial, and selective coding, with the help of MAXQDA 2020. ETHICAL CONSIDERATIONS: The research was approved by the Ethics Committee of the China Medical University. All participants signed the informed consent and agreed to be interviewed before the study. FINDINGS: The study has developed a theoretical construct of nursing professional values growth that consists of five dimensions: key aspects, decisive opportunities, drivers, embodiment, and shaping outcomes. And key aspects include four subcategories (the initial stage, the consciousness stage, the core stage, and the action stage). Decisive opportunities come from organisations and individuals. Drivers consist of social culture and self-trait, and embodiment covers two subcategories (humanism and ethical emotions). The last dimension is shaping outcomes, which consists of three subcategories (maintaining the original intention, professionalism, and instilling professional values). DISCUSSION: The theory demonstrates the individual development process of nursing professional values in different interactive contexts, the context of its interaction with social and personal values is revealed, and the dynamics and mechanisms of the formation of personal psychological qualities in professional values from a nursing context are discovered. CONCLUSIONS: This theory reveals the mechanisms that shape nursing professional values and can provide guidance for the growth of nursing students' professional values.

A modified quality control protocol for infectious disease serology based on the Westgard rules.

When traditional statistical quality control protocols, represented by the Westgard protocol were applied to infectious disease serology, the rejection limits were questioned because of the high rejection probability. We first define the probability of false rejection (Pfr) and error detection (Ped) for infectious disease serology. QC data in 6 months were collected and the Pfr of each rule in the Westgard protocol and Rilibak protocol was evaluated. Then, as improvements, we chose different rules for negative and positive QC data to constitute an asymmetric protocol, furthermore, while reagent lot changes, the mean value of QC protocol is reset with the first 15 QC results of new lot reagent. QC materials and Standard Reference Materials were tested synchronously in the next 6 months, to verify whether the Pfr and Ped of the asymmetric protocol could meet the requirement. Protocol 1 exhibited the higher level of rejection rate among the two protocols, especially after reagent lot changes; Pfr below the lower control limit (LCL) was 1.39-21.78 times higher than the upper control limit (UCL); false rejections were more likely to occur in negative QC data, with Pfr-total of 27-65%. The asymmetric protocol can significantly reduce the proportion of analytes with Pfr by over 20%. Systematic error due to reagent lot changes and random error due to routine QC data variation were considered potential factors for excessive Pfr. Asymmetric QC protocol that can reduce Pfr by different control limits for negative and positive QC data.

Network Medicine: A Potential Approach for Virtual Drug Screening.

Traditional drug screening methods typically focus on a single protein target and exhibit limited efficiency due to the multifactorial nature of most diseases, which result from disturbances within complex networks of protein-protein interactions rather than single gene abnormalities. Addressing this limitation requires a comprehensive drug screening strategy. Network medicine is rooted in systems biology and provides a comprehensive framework for understanding disease mechanisms, prevention, and therapeutic innovations. This approach not only explores the associations between various diseases but also quantifies the relationships between disease genes and drug targets within interactome networks, thus facilitating the prediction of drug-disease relationships and enabling the screening of therapeutic drugs for specific complex diseases. An increasing body of research supports the efficiency and utility of network-based strategies in drug screening. This review highlights the transformative potential of network medicine in virtual therapeutic screening for complex diseases, offering novel insights and a robust foundation for future drug discovery endeavors.

GRK2 is critical for the cleavage of the porcine embryo by regulating HSP90 and the AKT pathway.

Among the family of GPCR kinases (GRKs) that regulate receptor phosphorylation and signaling termination, G-protein coupled receptor kinase 2 (GRK2) binds to HSP90 in response to hypoxia or other stresses. In the present study, we investigated the effects of GRK2 knockdown and inhibition on porcine embryonic development from the zygote stage. Immunofluorescence and western blotting were used to determine the localization and expression, respectively, of GRK2 and related proteins. First, GRK2 and p-GRK2 were expressed in both the cytoplasm and membrane and co-localized with HSP90 on the membrane. The mRNA level of GRK2 increased until the 8C- morula stage, suggesting that GRK2 may play an essential role during the early development of the porcine embryos. GRK2 knockdown reduced porcine embryo development capacity and led to significantly decreased blastocyst quality. In addition, inhibition of GRK2 also induced poor ability of embryo development at early stage, indicating that GRK2 is critical for embryonic cleavage in pigs. Knockdown and inhibition of GRK2 reduced HSP90 expression and AKT activation and cAMP levels. Additionally, GRK2 deficiency increased LC3 expression, suggesting enhanced autophagy during embryo development. In summary, we showed that GRK2 binds to HSP90 on the membrane to regulate embryonic cleavage and AKT activation during embryonic development in pigs.

In Vivo-Matured Oocyte Resists Post-Ovulatory Aging through the Hub Genes DDX18 and DNAJC7 in Pigs.

Assisted reproduction technology (ART) procedures are often impacted by post-ovulatory aging (POA), which can lead to reduced fertilization rates and impaired embryo development. This study used RNA sequencing analysis and experimental validation to study the similarities and differences between in vivo- and vitro-matured porcine oocytes before and after POA. Differentially expressed genes (DEGs) between fresh in vivo-matured oocyte (F_vivo) and aged in vivo-matured oocyte (A_vivo) and DEGs between fresh in vitro-matured oocyte (F_vitro) and aged in vitro-matured oocyte (A_vitro) were intersected to explore the co-effects of POA. It was found that "organelles", especially "mitochondria", were significantly enriched Gene Ontology (GO) terms. The expression of genes related to the "electron transport chain" and "cell redox homeostasis" pathways related to mitochondrial function significantly showed low expression patterns in both A_vivo and A_vitro groups. Weighted correlation network analysis was carried out to explore gene expression modules specific to A_vivo. Trait-module association analysis showed that the red modules were most associated with in vivo aging. There are 959 genes in the red module, mainly enriched in "RNA binding", "mRNA metabolic process", etc., as well as in GO terms, and "spliceosome" and "nucleotide excision repair" pathways. DNAJC7, IK, and DDX18 were at the hub of the gene regulatory network. Subsequently, the functions of DDX18 and DNAJC7 were verified by knocking down their expression at the germinal vesicle (GV) and Metaphase II (MII) stages, respectively. Knockdown at the GV stage caused cell cycle disorders and increase the rate of abnormal spindle. Knockdown at the MII stage resulted in the inefficiency of the antioxidant melatonin, increasing the level of intracellular oxidative stress, and in mitochondrial dysfunction. In summary, POA affects the organelle function of oocytes. A_vivo oocytes have some unique gene expression patterns. These genes may be potential anti-aging targets. This study provides a better understanding of the detailed mechanism of POA and potential strategies for improving the success rates of assisted reproductive technologies in pigs and other mammalian species.

Effects and mechanisms of the myocardial microenvironment on cardiomyocyte proliferation and regeneration.

The adult mammalian cardiomyocyte has a limited capacity for self-renewal, which leads to the irreversible heart dysfunction and poses a significant threat to myocardial infarction patients. In the past decades, research efforts have been predominantly concentrated on the cardiomyocyte proliferation and heart regeneration. However, the heart is a complex organ that comprises not only cardiomyocytes but also numerous noncardiomyocyte cells, all playing integral roles in maintaining cardiac function. In addition, cardiomyocytes are exposed to a dynamically changing physical environment that includes oxygen saturation and mechanical forces. Recently, a growing number of studies on myocardial microenvironment in cardiomyocyte proliferation and heart regeneration is ongoing. In this review, we provide an overview of recent advances in myocardial microenvironment, which plays an important role in cardiomyocyte proliferation and heart regeneration.

Ultrasonic-assisted preparation of SBS modified asphalt: Cavitation bubble numerical simulation and rheological properties.

SBS (styrene-butadiene-styrene block copolymer) is currently the most widely used asphalt modifier, and SBS modified asphalt is usually prepared by high-speed shearing. This paper combines the cavitation effect of ultrasonic to assist in the preparation of SBS modified asphalt, and conducts numerical simulation and rheological properties research on the cavitation bubbles in the molten SBS modified asphalt fluid. The cavitation bubbles in the modified asphalt fluid will expand and contract as the pressure changes inside and outside the bubbles. When the cavitation bubble is compressed to the minimum and the pressure inside the bubble reaches 1.94 × 105Pa, the direction of the velocity vector near the cavitation bubble will change with the expansion and compression of the bubble. The expansion-contraction process of a single cavitation bubble can release 6.41 × 10-7J of energy, thus breaking the long bonds in asphalt and generating a large number of free radicals react with the unsaturated C = C bonds in the SBS molecules. According to the preparation process of modified asphalt, the influence of ultrasonic wave on rheological property of modified asphalt was studied through experiments. The results show that ultrasonic treatment can enhance the elasticity of asphalt and improve the temperature sensitivity of asphalt. With the increase of ultrasonic treatment time, the anti-rutting deformation ability of SBS modified asphalt is greatly improved. At the same temperature, the recovery rate of asphalt also increases with the increase of ultrasonic treatment time, and the non-recoverable compliance (Jnr) decreases Combined with the numerical simulation of cavitation bubbles, the ultrasonic process is added to asphalt production, which is of great significance for the green production of modified asphalt and the improvement of the rheological properties of modified asphalt.

Semisynthesis and antitumor activity of endertiin B and related triterpenoids from Ganoderma lucidum.

Ganoderma lucidum, a fungus used in traditional Chinese medicine, is known for its medicinal value attributed to its active components called Ganoderma triterpenoids (GTs). However, the limited isolation rate of these GTs has hindered their potential as promising drug candidates. Therefore, it is imperative to achieve large-scale preparation of GTs. In this study, four GTs were effectively synthesised from lanosterol. The antitumor activity of these GTs was evaluated in vivo. Endertiin B exhibited potent inhibitory activity against breast cancer cells (9.85 ± 0.91 µM and 12.12 ± 0.95 µM). Further investigations demonstrated that endertiin B significantly upregulated p21 and p27 and downregulated cyclinD1 expression, arresting the cell cycle at the G0/G1 phase and inducing apoptosis by decreasing BCL-2 and increasing BAX and BAK levels. Additionally, endertiin B was found to reduce the expression of proteins associated with the PI3K-AKT signaling pathway. To summarize, endertiin B effectively inhibited cell proliferation by blocking the cell cycle and inducing apoptosis through the PI3K-AKT pathway.

A scoping review of hospital to home transitional care programmes for stroke survivors.

AIM: The study was aimed at exploring the current scope of hospital to home transitional care programmes for stroke survivors. BACKGROUND: Stroke survivors face the dilemma of solving many complex problems that leave survivors at high risk for readmission as they discharge from hospital. The transitional care model has proved to be effective in reducing readmissions and mortality, thereby improving health outcomes and enhancing patient satisfaction for survivors with stroke. DESIGN: A scoping review. METHODS: Conducted in accordance with the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews. DATA SOURCES: A comprehensive search was conducted in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, Medline, China Knowledge Net-work, Wanfang Database and China Biomedical Literature Database (SinoMed) from January 2014 to June 2023. RESULTS: Title and abstract screening was performed on 10,171 articles resulting in 287 articles for full-text screening. Full-text screening yielded 49 articles that met inclusion criteria. CONCLUSION: This study identified transitional care programmes for stroke survivors, as well as areas for future consideration to be explored in more depth to help improve transitional care for stroke survivors as they transition from hospital to home. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study demonstrates that multidisciplinary collaboration becomes an integral part of the transitional care model for stroke survivors, which provides comprehensive and precise medical care to them. REPORTING METHOD: PRISMA checklist for scoping reviews. PATIENT AND PUBLIC CONTRIBUTION: No patient or public contribution was part of this study.

Spatiotemporal transcriptomic landscape of rice embryonic cells during seed germination.

Characterizing cellular features during seed germination is crucial for understanding the complex biological functions of different embryonic cells in regulating seed vigor and seedling establishment. We performed spatially enhanced resolution omics sequencing (Stereo-seq) and single-cell RNA sequencing (scRNA-seq) to capture spatially resolved single-cell transcriptomes of germinating rice embryos. An automated cell-segmentation model, employing deep learning, was developed to accommodate the analysis requirements. The spatial transcriptomes of 6, 24, 36, and 48 h after imbibition unveiled both known and previously unreported embryo cell types, including two unreported scutellum cell types, corroborated by in situ hybridization and functional exploration of marker genes. Temporal transcriptomic profiling delineated gene expression dynamics in distinct embryonic cell types during seed germination, highlighting key genes involved in nutrient metabolism, biosynthesis, and signaling of phytohormones, reprogrammed in a cell-type-specific manner. Our study provides a detailed spatiotemporal transcriptome of rice embryo and presents a previously undescribed methodology for exploring the roles of different embryonic cells in seed germination.

Small water body significantly contributes to nitrous oxide emissions in China's aquaculture.

Aquaculture systems are expected to act as potential hotspots for nitrous oxide (N2O) emissions, largely attributed to substantial nutrient loading from aquafeed applications. However, the specific patterns and contributions of N2O fluxes from these systems to the global emissions inventory are not well characterized due to limited data. This study investigates the patterns of N2O flux across 127 freshwater systems in China to elucidate the role of aquaculture ponds and lakes/reservoirs in landscape N2O emission. Our findings show that the average N2O flux from aquaculture ponds was 3.63 times higher (28.73 µg N2O m-2 h-1) than that from non-aquaculture ponds. Additionally, the average N2O flux from aquaculture lakes/reservoirs (15.65 µg N2O m-2 h-1) increased 3.05 times compared to non-aquaculture lakes/reservoirs. The transition from non-aquaculture to aquaculture practices has resulted in a net annual increase of 7589 ± 2409 Mg N2O emissions in China's freshwater systems from 2003 to 2022, equivalent to 20% of total N2O emissions from China's inland water. Particularly, the robust negative regression relationship between N2O emission intensity and water area suggests that small ponds are hotspots of N2O emissions, a result of both elevated nutrient concentrations and more vigorous biogeochemical cycles. This indicates that N2O emissions from smaller aquaculture ponds are larger per unit area compared to equivalent larger water bodies. Our findings highlight that N2O emissions from aquaculture systems can not be proxied by those from natural water bodies, especially small water bodies exhibiting significant but largely unquantified N2O emissions. In the context of the rapid global expansion of aquaculture, this underscores the critical need to integrate aquaculture into global assessments of inland water N2O emissions to advance towards a low-carbon future.

Nutrient requirements determined by grain yield and protein content to optimize N, P, and K fertilizer management in China.

Nutrient requirement for crop growth, defined as the amount of nutrient that crops take up from soil to produce a specific grain yield, is a key parameter in determining fertilizer application rate. However, existing studies primarily focus on identifying nitrogen (N), phosphorus (P), and potassium (K) requirements solely in relation to grain yield, neglecting grain protein content, a crucial index for wheat grain quality. Addressing this gap, we conducted multi-site, multi-cultivar, and multi-year field trials across three ecological regions of China from 2016 to 2020 to elucidate variations in nutrient requirements for grain yield and grain protein. The research findings revealed that wheat grain yield ranged from 4.1 to 9.3 Mg ha-1 (average 6.9 Mg ha-1) and grain protein content ranged from 98 to 157 g kg-1 (average 127 g kg-1) across the three regions. Notably, the N requirement exhibited a nonlinear correlation with the wheat grain yield but a linear increase with increasing grain protein, while the P and K requirements positively correlated with grain yield and protein content. Regression models were formulated to determine the nutrient requirements (MENR), enabling the prediction of N, P, and K requirements for leading cultivars with varying grain yields and protein contents. Implementing nutrient requirements based on MENR projections resulted in substantial reductions in fertilizer rates: 22.0 kg ha-1 N (10.7 %), 9.9 kg ha-1 P (20.2 %), and 8.1 kg ha-1 K (16.3 %). This translated to potential savings of 0.4 Mt. N, 0.23 Mt. P, and 0.17 Mt. K, consequently mitigating 5.5 Mt. CO2 greenhouse-gas emission and yielding an economic benefit of 0.8 billion US$ annually in China. These findings underscore the significance of considering grain yield and protein content in estimating nutrient requirements for fertilizer recommendations to realize high-yielding, high-protein wheat production, and minimize overfertilization and associated environmental risks.

[Construction of a predictive model of death for sepsis-associated acute kidney injury].

OBJECTIVE: To establish a predictive model nomogram for 30-day death in patients with sepsis-associated acute kidney injury (SA-AKI) by using the data from the large international database, the Electronic Intensive Care Unit-Collaborative Research Database (eICU-CRD), and to validate its predictive performance. METHODS: A retrospective cohort study was conducted using data from the eICU-CRD. Data of SA-AKI patients were screened from the eICU-CRD database, including demographic characteristics, medical history, SA-AKI type, Kidney Disease: Improving Global Outcomes (KDIGO)-AKI staging, severity of illness scores, vital signs, laboratory indicators, and treatment measures; with admission time as the observation start point, death as the outcome event, and a follow-up time of 30 days. Relevant variables of patients with different 30-day prognoses were compared. Univariate Logistic regression analysis and multivariate Logistic regression forward likelihood ratio analysis were used to screen for risk factors associated with 30-day death in SA-AKI patients, and a predictive model nomogram was constructed. Receiver operator characteristic curve (ROC curve), calibration curve, and Hosmer-Lemeshow test were used to validate the predictive performance of the model. RESULTS: A total of 201 SA-AKI patients' data were finally enrolled, among which 51 survived for 30 days and 150 died, with a mortality of 74.63%. Compared with the survival group, patients in the death group were older [years old: 68 (60, 78) vs. 59 (52, 69), P < 0.01], had lower body weight, proportion of transient SA-AKI, platelet count (PLT) and blood glucose [body weight (kg): 79 (65, 95) vs. 91 (71, 127), proportion of transient SA-AKI: 61.33% (92/150) vs. 82.35% (42/51), PLT (×109/L): 207 (116, 313) vs. 260 (176, 338), blood glucose (mmol/L): 5.5 (4.4, 7.1) vs. 6.4 (5.1, 7.6), all P < 0.05] and higher proportion of persistent SA-AKI, sequential organ failure assessment (SOFA) score, lactic acid (Lac), and total bilirubin [TBil; proportion of persistent SA-AKI: 38.67% (58/150) vs. 17.65% (9/51), SOFA score: 7 (5, 22) vs. 5 (2, 7), Lac (mmol/L): 0.4 (0.2, 0.7) vs. 0.3 (0.2, 0.4), TBil (µmol/L): 41.0 (17.1, 51.3) vs. 18.8 (17.1, 34.2), all P < 0.05]. Univariate Logistic regression analysis showed that age [odds ratio (OR) = 1.035, 95% confidence interval (95%CI) was 1.013-1.058, P = 0.002], body weight (OR = 0.987, 95%CI was 0.977-0.996, P = 0.007), persistent SA-AKI (OR = 2.942, 95%CI was 1.333-6.491, P = 0.008), SOFA score (OR = 1.073, 95%CI was 1.020-1.129, P = 0.006), PLT (OR = 0.998, 95%CI was 0.996-1.000, P = 0.034), Lac (OR = 1.142, 95%CI was 1.009-1.292, P = 0.035), TBil (OR = 1.422, 95%CI was 1.070-1.890, P = 0.015) were associated with 30-day death risk in SA-AKI patients. Multivariate Logistic regression forward likelihood ratio analysis showed that age (OR = 1.051, 95%CI was 1.023-1.079, P = 0.000), body weight (OR = 0.985, 95%CI was 0.974-0.995, P = 0.005), cardiovascular disease (OR = 9.055, 95%CI was 1.037-79.084, P = 0.046), persistent SA-AKI (OR = 3.020, 95%CI was 1.258-7.249, P = 0.013), SOFA score (OR = 1.076, 95%CI was 1.013-1.143, P = 0.017), and PLT (OR = 0.997, 95%CI was 0.995-1.000, P = 0.030) were independent risk factors for 30-day death in SA-AKI patients. Based on the above risk factors, a predictive model nomogram for 30-day death in SA-AKI patients was constructed. ROC curve analysis showed that the area under the ROC curve (AUC) of the model was 0.798 (95%CI was 0.722-0.873), with a sensitivity of 86.7% and a specificity of 62.7%. Calibration curve showed that the fitted curve was close to the standard line, indicating that the predicted probability was close to the actual probability, suggesting good predictive performance of the model. Hosmer-Lemeshow test showed χ 2 = 6.393, df = 8, P = 0.603 > 0.05, suggesting that the model could fit the observed data well. The quality of model fitting was judged by the accuracy of model prediction. The results showed that the prediction accuracy rate of the model was 95.3%, and the overall prediction accuracy rate of the model was 81.6%, indicating good model fitting. CONCLUSIONS: A predictive model for 30-day death in SA-AKI patients based on risk factors can be successfully constructed, and the model has high accuracy, sensitivity, reliability, and certain specificity, which can help to early identify high-risk patients for death and adopt more proactive treatment strategies.

FMNL2 regulates actin for endoplasmic reticulum and mitochondria distribution in oocyte meiosis.

During mammalian oocyte meiosis, spindle migration and asymmetric cytokinesis are unique steps for the successful polar body extrusion. The asymmetry defects of oocytes will lead to the failure of fertilization and embryo implantation. In present study, we reported that an actin nucleating factor Formin-like 2 (FMNL2) played critical roles in the regulation of spindle migration and organelle distribution in mouse and porcine oocytes. Our results showed that FMNL2 mainly localized at the oocyte cortex and periphery of spindle. Depletion of FMNL2 led to the failure of polar body extrusion and large polar bodies in oocytes. Live-cell imaging revealed that the spindle failed to migrate to the oocyte cortex, which caused polar body formation defects, and this might be due to the decreased polymerization of cytoplasmic actin by FMNL2 depletion in the oocytes of both mice and pigs. Furthermore, mass spectrometry analysis indicated that FMNL2 was associated with mitochondria and endoplasmic reticulum (ER)-related proteins, and FMNL2 depletion disrupted the function and distribution of mitochondria and ER, showing with decreased mitochondrial membrane potential and the occurrence of ER stress. Microinjecting Fmnl2-EGFP mRNA into FMNL2-depleted oocytes significantly rescued these defects. Thus, our results indicate that FMNL2 is essential for the actin assembly, which further involves into meiotic spindle migration and ER/mitochondria functions in mammalian oocytes.

Professional values education for undergraduate nursing students: developing a framework based on the professional values growth theory.

BACKGROUND: Education has been recognised as necessary in forming and internalising professional values. The system and instructors' content in existing educational institutions focus on developing students' knowledge, skills and practices. Still, the development of values has yet to achieve significant effects, leading to a crisis in students' professional identity. AIMS: To construct a professional values growth theory for undergraduate nursing students and develop a corresponding education framework. METHODS: Through the review, some databases(PubMed、CINAHL、Web of Science、Wiley and Google Scholars)were searched using a systematic search strategy to collect relevant literature on professional values education. Based on the nursing professional values growth theory (Li and Li, Nursing Ethics In press, 2022), a theory of professional values growth of nursing undergraduates was developed using the method of theory derivation. Two rounds of expert meetings were conducted to review and revise an education framework of professional values of nursing undergraduates derived from that theory. FINDINGS: A total of 10 studies were included. The contents of two themes were analysed: theories and models and the current status of the professional values development of nursing students. The resulting professional values growth theory for undergraduate nursing students consists of five parts: key aspects, decisive opportunities, drivers, embodiment (humanistic sentiments, moral emotions), and outcomes. A total of five experts in the relevant fields were invited to this study. After two rounds of expert meetings, an education framework for undergraduate nursing students was finally developed, which consists of four parts: education objectives, education process and content, environment and conditions, and evaluation. CONCLUSION: The education framework developed in this study has practical implications for the development of professional values of undergraduate nursing students, providing educational strategies and methods for the growth and internalisation of professional values of undergraduate nursing students.

Outcomes of Heart Transplantation From Donation After Circulatory Death: An Up-to-Date Systematic Meta-analysis.

BACKGROUND: Donation after circulatory death (DCD) heart transplantation (HTx) significantly expands the donor pool and reduces waitlist mortality. However, high-level evidence-based data on its safety and effectiveness are lacking. This meta-analysis aimed to compare the outcomes between DCD and donation after brain death (DBD) HTxs. METHODS: Databases, including MEDLINE, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials, were systematically searched for randomized controlled trials and observational studies reporting the outcomes of DCD and DBD HTxs published from 2014 onward. The data were pooled using random-effects models. Risk ratios (RRs) with 95% confidence intervals (CIs) were used as the summary measures for categorical outcomes and mean differences were used for continuous outcomes. RESULTS: Twelve eligible studies were included in the meta-analysis. DCD HTx was associated with lower 1-y mortality rate (DCD 8.13% versus DBD 10.24%; RR = 0.75; 95% CI, 0.59-0.96; P = 0.02) and 5-y mortality rate (DCD 14.61% versus DBD 20.57%; RR = 0.72; 95% CI, 0.54-0.97; P = 0.03) compared with DBD HTx. CONCLUSIONS: Using the current DCD criteria, HTx emerges as a promising alternative to DBD transplantation. The safety and feasibility of DCD hearts deserve further exploration and investigation.

The Therapeutic Potential of Four Main Compounds of Zanthoxylum nitidum (Roxb.) DC: A Comprehensive Study on Biological Processes, Anti-Inflammatory Effects, and Myocardial Toxicity.

Zanthoxylum nitidum (Roxb.) DC. (Z. nitidum) is a traditional Chinese medicinal plant that is indigenous to the southern regions of China. Previous research has provided evidence of the significant anti-inflammatory, antibacterial, and anticancer properties exhibited by Z. nitidum. The potential therapeutic effects and cardiac toxicity of Z. nitidum remain uncertain. The aim of this research was to investigate the potential therapeutic properties of the four main compounds of Z. nitidum in cardiovascular diseases, their impact on the electrical activity of cardiomyocytes, and the underlying mechanism of their anti-inflammatory effects. We selected the four compounds from Z. nitidum with a high concentration and specific biological activity: nitidine chloride (NC), chelerythrine chloride (CHE), magnoflorine chloride (MAG), and hesperidin (HE). A proteomic analysis was conducted on the myocardial tissues of beagle dogs following the administration of NC to investigate the role of NC in vivo and the associated biological processes. A bioinformatic analysis was used to predict the in vivo biological processes that MAG, CHE, and HE were involved in. Molecular docking was used to simulate the binding between compounds and their targets. The effect of the compounds on ion channels in cardiomyocytes was evaluated through a patch clamp experiment. Organ-on-a-chip (OOC) technology was developed to mimic the physiological conditions of the heart in vivo. Proteomic and bioinformatic analyses demonstrated that the four compounds of Z. nitidum are extensively involved in various cardiovascular-related biological pathways. The findings from the patch clamp experiments indicate that NC, CHE, MAG, and HE elicit a distinct activation or inhibition of the IK1 and ICa-L in cardiomyocytes. Finally, the anti-inflammatory effects of the compounds on cardiomyocytes were verified using OOC technology. NC, CHE, MAG, and HE demonstrate anti-inflammatory effects through their specific interactions with prostaglandin-endoperoxide synthase 2 (PTGS2) and significantly influence ion channels in cardiomyocytes. Our study provides a foundation for utilizing NC, CHE, MAG, and HE in the treatment of cardiovascular diseases.