Electroacupuncture improves apoptosis of nucleus pulposus cells via the IL-22/JAK2-STAT3 signaling pathway in a rat model of cervical intervertebral disk degeneration.

BACKGROUND: Cervical spondylosis (CS) is a prevalent disorder that can have a major negative impact on quality of life. Traditional conservative treatment has limited efficacy, and electroacupuncture (EA) is a novel treatment option. We investigated the application and molecular mechanism of EA treatment in a rat model of cervical intervertebral disk degeneration (CIDD). METHODS: The CIDD rat model was established, following which rats in the electroacupuncture (EA) group received EA. For overexpression of IL-22 or inhibition of JAK2-STAT3 signaling, the rats were injected intraperitoneally with recombinant IL-22 protein (p-IL-22) or the JAK2-STAT3 (Janus kinase 2-signal transducer and activator of transcription protein 3) inhibitor AG490 after model establishment. Rat nucleus pulposus (NP) cells were isolated and cultured. Cell counting kit-8 and flow cytometry were used to analyze the viability and apoptosis of the NP cells. Expression of IL-22, JAK2 and STAT3 was determined using RT-qPCR. Expression of IL-22/JAK2-STAT3 pathway and apoptosis related proteins was detected by Western blotting (WB). RESULTS: EA protected the NP tissues of CIDD rats by regulating the IL-22/JAK2-STAT3 pathway. Overexpression of IL-22 significantly promoted the expression of tumor necrosis factor (TNF)-α, IL-6, IL-1ß, matrix metalloproteinase (MMP)3 and MMP13 compared with the EA group. WB demonstrated that the expression of IL-22, p-JAK2, p-STAT3, caspase-3 and Bax in NP cells of the EA group was significantly reduced and Bcl-2 elevated compared with the model group. EA regulated cytokines and MMP through activation of IL-22/JAK2-STAT3 signaling in CIDD rat NP cells. CONCLUSION: We demonstrated that EA affected apoptosis by regulating the IL-22/JAK2-STAT3 pathway in NP cells and reducing inflammatory factors in the CIDD rat model. The results extend our knowledge of the mechanisms of action underlying the effects of EA as a potential treatment approach for CS in clinical practice.

Establishment of in-hospital nutrition support program for middle-aged and elderly patients with acute decompendated heart failure.

OBJECTIVE: To construct a nutrition support program for middle-aged and elderly patients with acute decompensated heart failure (ADHF) during hospitalization. METHODS: Based on the JBI Evidence-Based Health Care Model as the theoretical framework, the best evidence was extracted through literature analysis and a preliminary nutrition support plan for middle-aged and elderly ADHF patients during hospitalization was formed. Two rounds of expert opinion consultation were conducted using the Delphi method. The indicators were modified, supplemented and reduced according to the expert's scoring and feedback, and the expert scoring was calculated. RESULTS: The response rates of the experts in the two rounds of consultation were 86.7% and 100%, respectively, and the coefficient of variation (CV) for each round was between 0.00% and 29.67% (all < 0.25). In the first round of expert consultation, 4 items were modified, 3 items were deleted, and 3 items were added. In the second round of the expert consultation, one item was deleted and one item was modified. Through two rounds of expert consultation, expert consensus was reached and a nutrition support plan for ADHF patients was finally formed, including 4 first-level indicators, 7 s-level indicators, and 24 third-level indicators. CONCLUSION: The nutrition support program constructed in this study for middle-aged and elderly ADHF patients during hospitalization is authoritative, scientific and practical, and provides a theoretical basis for clinical development of nutrition support program for middle-aged and elderly ADHF patients during hospitalization.

Effect of a High-Fat Diet and Probiotic Supplementation on the Gut Microbiota of Maternal Mice at Term Pregnancy and Offspring at Three-Week Postpartum.

The effects of probiotics on the gut microbiota in maternal mice-fed high-fat diet (HFD) during pregnancy and offspring are still unknown. We aimed to evaluate the effect of high-fat diet and probiotic supplementation on the gut microbiota of maternal mice at term pregnancy and offspring at three-week postpartum. Female pregnant Kunming mice were randomly divided into four groups: mice on a control diet (MC), mice on HFD (MHF), mice on a control diet and probiotics (MCP), and mice on HFD and probiotics (MHFP). The result showed that MHF had significantly reduced Bacteroidetes and Muribaculaceae (P < 0.05) and increased Firmicutes/Bacteroidetes ratio vs. MC. Lachnospiraceae_NK4A136_group and Alistipes reduced (P < 0.05), and Firmicutes/Bacteroidetes ratio significantly increased in MCP vs. MC. There was no significant difference between MHF and MHFP. Higher levels of Prevotella, Prevotellaceae, and Streptococcaceae were found in mice offspring on HFD (OHF) vs. mice offspring on a control diet (OC) (P < 0.05, respectively). Bacteroidia, Bacteroidota, Bacteroidales, and Muribaculaceae decreased markedly in mice offspring on a control diet and probiotics (OCP) vs. OC (P < 0.05, respectively), while Firmicutes, Lactobacillales, Lactobacillaceae, and Lactobacillus significantly increased in OCP (P < 0.05, respectively). There was no significant difference between the OHF and mice offspring on HFD and probiotics (OHFP). The findings suggest that the gut microbial composition of pregnant mice and offspring were altered to some extent due to HFD or probiotic intervention. Further, maternal mice on HFD and offspring were less affected by probiotic supplementation.

Promotion factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai: a qualitative study.

BACKGROUND: Since March 2022, Shanghai, China, has experienced a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The pandemic has severely constrained the local healthcare system. After treating critically ill COVID-19 patients, emergency nurses may experience some positive changes due to new insights or gains in their work, even if they have had traumatic experiences. This study aimed to explore the promoting factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai. We hoped to provide a new perspective and theoretical basis for intervening in and promoting the psychological rehabilitation of medical staff after traumatic circumstances. METHODS: This study employed a qualitative design based on the phenomenological approach. 18 participants from the emergency department of a third-level class-A hospital in Shanghai who participated in treating COVID-19 patients were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. The seven-step Colaizzi process was used for data analysis. RESULTS: The investigation uncovered two themes and six subthemes. Internal factors contained self-affirmation, deliberate rumination, and cognitive restructuring, which constituted attitudes and behaviours that participants could subjectively determine. External factors included social support, transformational leadership, and role modelling, which constituted factors influenced by others or the environment. CONCLUSIONS: The promoting factors of PTG of emergency nurses originated from different sources such as individuals, organizations, and society. In addition to good psychological adjustment of the individual, society, hospitals, and nursing managers should focus on establishing supportive PTG strategies. The ultimate purpose is to improve the retention rate and career growth of nurses.

Effects of cerebellar transcranial direct current stimulation on rehabilitation of upper limb motor function after stroke.

Background: The cerebellum is involved in the control and coordination of movements but it remains unclear whether stimulation of the cerebellum could improve the recovery of upper limb motor function. Therefore, this study aimed to explore whether cerebellar transcranial direct current stimulation (tDCS) therapy could promote the recovery of upper limb motor function in patients who suffered a stroke. Methods: In this randomized, double-blind, and sham-controlled prospective study, 77 stroke patients were recruited and randomly assigned to the tDCS group (n = 39) or the control group (n = 38). The patients received anodal (2 mA, 20 min) or sham tDCS therapy for 4 weeks. The primary outcome was the change in the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score from baseline to the first day after 4 weeks of treatment (T1) and 60 days after 4 weeks of treatment (T2). The secondary outcomes were the FMA-UE response rates assessed at T1 and T2. Adverse events (AEs) related to the tDCS treatment were also recorded. Results: At T1, the mean FMA-UE score increased by 10.7 points [standard error of the mean (SEM) = 1.4] in the tDCS group and by 5.8 points (SEM = 1.3) in the control group (difference between the two groups was 4.9 points, P = 0.013). At T2, the mean FMA-UE score increased by 18.9 points (SEM = 2.1) in the tDCS group and by 12.7 points (SEM = 2.1) in the control group (the difference between the two groups was 6.2 points, P = 0.043). At T1, 26 (70.3%) patients in the tDCS group had a clinically meaningful response to the FMA-UE score compared to 12 (34.3%) patients in the control group (the difference between the two groups was 36.0%, P =0.002). At T2, 33 (89.2%) patients in the tDCS group had a clinically meaningful response to the FMA-UE score compared with 19 (54.3%) patients in the control group (the difference between the two groups was 34.9%, P = 0.001). There was no statistically significant difference in the incidence of adverse events between the two groups. In the subgroup analysis of different hemiplegic sides, the rehabilitation effect of patients with right hemiplegia was better than that of patients with left hemiplegia (P < 0.05); in the age subgroup analysis, different age groups of patients did not show a significant difference in the rehabilitation effect (P > 0.05). Conclusion: Cerebellar tDCS can be used as an effective and safe treatment to promote recovery of upper limb motor function in stroke patients. Trial registration: ChiCTR.org.cn, identifier: ChiCTR2200061838.

Perspectives and experiences of newly registered nurses surrounding the objective structured clinical examination in an obstetrics and gynecology hospital: A qualitative study in Shanghai, China.

OBJECTIVES: Newly registered nurses in China are required to attend two years of standardized training programs after graduation, and an evaluation of the training program's effectiveness is critical. The objective structured clinical examination is a relatively new and objective approach to exploring the effectiveness of training programs and is increasingly being encouraged and used in clinics. However, the perspectives and experiences of newly registered nurses in obstetrics and gynecology regarding the objective structured clinical examination are unclear. Therefore, the objective of this study was to investigate newly registered nurses' perspectives and experiences of the objective structured clinical examination in an obstetrics and gynecology hospital. DESIGN: This qualitative study was conducted using a phenomenological approach. DATA SOURCES: Twenty-four newly registered nurses taking the objective structured clinical examination in a third-level obstetrics and gynecology hospital in Shanghai, China. REVIEW METHODS: Semi-structured face-to-face interviews were conducted between July and August 2021. The Colaizzi seven-step framework was applied for data analysis. RESULTS: Three main themes and six sub-themes emerged: 1) high satisfaction with the objective structured clinical examination; 2) gaining experience and growing as nurses; and 3) high pressure. CONCLUSION: The objective clinical structured examination can be used to assess the competence of newly registered nurses after training in an obstetrics and gynecology hospital. The examination not only enables an objective and comprehensive evaluation of others and self-evaluation but also leads to positive psychological experiences in newly registered nurses. However, interventions are needed to relieve examination pressure and to provide effective support for participants. The objective clinical structured examination can be incorporated into the training assessment system; this study provides a basis for improving training programs and the training of newly registered nurses.

Generation Z nursing students' online learning experiences during COVID-19 epidemic: A qualitative study.

In early 2022, the coronavirus disease 2019 (COVID-19) continued to spread quickly globally and broke out in some metropolitan areas. To stop the spread of infection, all colleges and universities were shifted to a closed model, and higher education was transformed into online learning (OL). These transitions posed numerous challenges for Generation Z students, especially those in the nursing profession that featured face-to-face practice courses. This study aimed to explore and understand the experiences of OL among Generation Z nursing students during COVID-19 epidemic. This qualitative phenomenological research design applied a purposive sampling approach to enroll 14 Generation Z nursing students from a college. Data were collected and analyzed using in-depth, semi-structured interviews and Colaizzi seven-step method. The analysis demonstrated four themes and eleven subthemes: challenges encountered during OL, advantages perceived during OL, experience of loneliness and stress, and developing resilience during OL. This study concluded that the sudden shift in learning styles presents challenges to Generation Z nursing students. Despite the adversity, the students showed tremendous resilience and endurance. During the pandemic, educators should provide support measures based on the characteristics of Generation Z to improve the effectiveness of OL and respond positively to stress.

Training load of newly recruited nurses in Grade-A Tertiary Hospitals in Shanghai, China: a qualitative study.

BACKGROUND: This study aimed to provide insight into the training load of newly recruited nurses in grade-A tertiary hospitals in Shanghai, China. The lack of nurses in hospitals across China has resulted in newly recruited nurses in grade-A tertiary hospitals in Shanghai having to integrate into the work environment and meet the needs of the job quickly; thus, they undergo several training programs. However, an increase in the number of training programs increases the training load of these nurses, impacting the effectiveness of training. The extent of the training load that newly recruited nurses have to bear in grade-A tertiary hospitals in China remains unknown. METHODS: This qualitative study was conducted across three hospitals in Shanghai, including one general hospital and two specialized hospitals, in 2020. There were 15 newly recruited nurses who were invited to participate in semi-structured in-depth interviews with the purpose sampling method. A thematic analysis approach was used to analyze the data. The COREQ checklist was used to assess the overall study. RESULTS: Three themes emerged: external cognitive overload, internal cognitive overload, and physical and mental overload. CONCLUSION: Through qualitative interviews, this study found that the training of newly recruited nurses in Shanghai's grade-A tertiary hospitals is in a state of overload, which mainly includes external cognitive overload, internal cognitive overload, physical and mental overload, as reflected in the form of training overload, the time and frequency of training overload, the content capacity of training overload, the content difficulty of training overload, physiological load overload, and psychological load overload. The intensity and form of the training need to be reasonably adjusted. Newly recruited nurses need to not only improve their internal self-ability, but also learn to reduce internal and external load. Simultaneously, an external social support system needs to be established to alleviate their training burden and prevent burnout.

Experience in the development of nurses' personal resilience: A meta-synthesis.

AIM: Nurses play roles in hospitals, families, society and other aspects and often face stress sources, such as heavy workload, doctor-patient conflict and medical accidents. Resilience can help the nurses to avoid or reduce various adverse consequences caused by stress sources; however, this phenomenon remains ill-defined and under-researched. The aim of this review was to summarize the experiences of development of nurses' resilience and explore the reasons for the formation of resilience by examining the findings of the existing qualitative studies. DESIGN: The review is a systematic review and meta-synthesis of qualitative studies. DATA SOURCES: PubMed, Cochrane Library, CINAHL, Web of Science, Embase, and Ovid and Chinese databases include the following: Chinese National Knowledge Infrastructure (CNKI), Wanfang Database (CECDB), VIP Database and China Biomedical Database (CBM). REVIEW METHODS: Relevant publications were identified by systematic searches across 11 databases in June 2021. All qualitative and mixed-method studies in English and Chinese that explored the experiences of development of nurses' resilience were included. The qualitative meta-synthesis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two independent reviewers selected the studies and assessed the quality of each study. Meta-synthesis was performed to integrate the results. RESULTS: A total of nine studies revealed 10 sub-themes and three descriptive themes: being psychologically strong, physical positive coping and adoption of external support. CONCLUSION: Several factors contributed to the development of nurses' resilience, and various supporting strategies in the nursing management and education are helpful to their adaption ability. However, it is necessary to focus on the cultivation of nurses' resilience to improve the quality of clinical nursing. Leaders or organizations are required to establish and sustain multifaceted strategies to improve nurse' resilience through scientific resilience training programmes and improved organizational support.

Analysis of clinical application effects and challenges of early warning system for the high-risk obstetric women of China: A scoping review.

BACKGROUND: Obstetric critical illness is an important factor that leads to an increase in maternal mortality. Early warning assessment can effectively reduce maternal and neonatal mortality and morbidity. However, there are multiple early warning systems, and the effect and applicability of each system in China still need to be explored. OBJECTIVES: To elaborate on the application, effectiveness and challenges of the existing early warning systems for high-risk obstetric women in China and to provide a reference for clinical practice. DESIGN: A scoping review guided by the Arksey and O'Malley framework and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping review (PRISMA-ScR) guidelines. ELIGIBILITY CRITERIA: We included original studies related to early warning and excluded those that were guidelines, consensus and reviews. The included studies were published in Chinese or English by Chinese scholars as of June 2021. DATA SOURCES: CNKI, Wanfang, VIP, Cochrane, CINAHL, Embase, PubMed and Web of Science databases were searched systematically, and the reference sections of the included papers were snowballed. RESULTS: In total, 598 articles were identified. These articles were further refined using keyword searches and exclusion criteria, and 17 articles met the inclusion criteria. We extracted data related to each study's population, methods and results. Early warning tools, outcome indices, effects and challenges are discussed. CONCLUSIONS: Although all studies have shown that early warning systems have good application effects, the use of early warning systems in China is still limited, with poor regional management and poor sensitivity for specific obstetric women. Future research needs to develop more targeted early warning tools for high-risk obstetric women and address the current challenges in clinical applications.

Probiotic supplementation during pregnancy alters gut microbial networks of pregnant women and infants.

Background: Probiotic supplementation has been popular and widespread, yet we still lack a comprehensive understanding of how probiotic supplementation during pregnancy affects the gut microbial networks of pregnant women and infants. In this study, we firstly used network analysis to compare the gut microbiota of pregnant women with and without probiotic supplementation, as well as their infants. Methods: Thirty-one pairs of healthy pregnant women and infants were recruited and randomly divided into the probiotic group (15 mother-infant pairs) and the control group (16 mother-infant pairs). Pregnant women in the probiotic group consumed combined probiotics from 32 weeks to delivery. Fecal samples were collected from pregnant women and infants at several time points. Gut microbiota was evaluated using 16S rRNA gene sequencing. Intestinal microbial network and topological properties were performed using the molecular ecological network analysis. Results: No significant difference was found between the probiotic and control groups on the microbial alpha and beta diversity. As the gestational age increased, the total links, average degree, average clustering coefficient, robustness, and the proportion of positive correlations were increased in pregnant women with probiotics administration. In contrast, these indices were decreased in infants in the probiotic group. Conclusion: Probiotic supplement does not change the microbial diversity of pregnant women and infants, but significantly alters the intestinal microbial network structure and properties. Although pregnant women have more complicated and stable networks after probiotic administration, their infants have less stable networks.

The effects of a set amount of regular maternal exercise during pregnancy on gut microbiota are diet-dependent in mice and do not cause significant diversity changes.

Background: Diet and exercise can affect the gut microbiota (GM); however, the effects of the same amount of exercise on gut microbiota changes in people on a low-fat diet (LFD) and high-fat diet (HFD) during pregnancy are unknown. Do different nutritional conditions respond equally to exercise intervention? This study aimed to investigate the effects of regular maternal exercise during pregnancy on the GM in mice fed different diets during pregnancy. Methods: Six-week-old nulliparous female KunMing mice were fed either a HFD or LFD before and during pregnancy. Each group of mice were then randomly divided into two groups upon confirmation of pregnancy: sedentary (HFD or LFD; n = 4 and 5, respectively) and exercised (HFDex or LFDex, n = 5 and 6, respectively). Mice were sacrificed on day 19 of gestation and their colon contents were collected. We then performed 16S rDNA gene sequencing of the V3 and V4 regions of the GM. Results: The pregnancy success rate was 60% for LFDex and 100% for HFDex. Both Chao1 and Simpson indices were not significantly different for either LFD vs. LFDex or HFD vs. HFDex. Desulfobacterota, Desulfovibrionia Desulfovibrionales, Desulfovibrionaceae, Desulfovibrio, Coriobacteriia, Coriobacteriales, and Eggerthellaceae were markedly decreased after exercise intervention in LFDex vs. LFD, whereas Actinobacteria, Bifidobacteriales, Bifidobacteriaceae, Bifidobacterium, and Bifidobacterium pseudolongum were significantly increased in LFDex vs. LFD. Furthermore, decreased Peptostreptococcales-Tissierellales and Peptostreptococcaceae and increased Bacteroides dorei were identified in the HFDex vs. HFD group. p_Desulfobacterota, c_Desulfovibrionia, o_Desulfovibrionales, f_Desulfovibrionaceae and g_Desulfovibrio were markedly decreased in the LFDex group vs. HFDex group. Conclusions: Our data suggested that quantitative maternal exercise during pregnancy resulted in alterations in GM composition, but did not significantly change the diversity of the GM. These findings may have important implications when considering an individual's overall diet when recommending exercise during pregnancy.

Stress and coping experience in Nurse Residency Programs for new graduate nurses: A qualitative meta-synthesis.

Objectives: To determine the stress experience and coping styles of new nurses during Nurse Residency Programs (NRPs) by identifying, appraising, and synthesizing data from the qualitative studies. Design: A systematic review and meta-synthesis of qualitative studies. Review methods: Eleven databases were systematically searched for relevant publications in March 2022. All qualitative and mixed-method studies in English and Chinese that explored the stress and coping experience during NRPs of new graduate nurses were included. The qualitative meta-synthesis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two independent reviewers selected the studies and assessed the quality of each study. Meta-synthesis was performed to integrate the results. Results: A total of 13 studies revealed 13 sub-themes and three descriptive themes: multi-dimensional stressors, somatic and emotional responses, coping resources and coping methods. Conclusion: New nurses faced a lot of physical and emotional stress during NRPs, which had a negative impact on their physical and mental health. NRPs are a critical period for the career growth of new nurses. Effective management strategies must be implemented to improve nurse capacity, meet their needs, improve self-efficacy, and build organizational support, as this can improve the quality of clinical nursing and keep the enthusiasm and stability of the nursing team.

Post-traumatic growth experience of first-line emergency nurses infected with COVID-19 during the epidemic period-A qualitative study in Shanghai, China.

Background: In March 2022, Shanghai, China, was hit by a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The medical staff was greatly infected during this period, which posed a traumatic event for them. Meanwhile, they also experience post-traumatic growth under introspection and positive change. However, the psychological coping and growth after infection with COVID-19 among medical staff have rarely been investigated. Objectives: To explore the process and influencing factors of post-traumatic growth among emergency nurses infected with coronavirus disease (COVID-19) so as to provide a new perspective and theoretical basis for psychological rehabilitation or intervention for medical staff who experienced traumatic events. Methods: The study used a qualitative design based on the phenomenological approach. A purposive sampling method was used to explore the subjective feelings and post-traumatic growth among 13 first-line emergency nurses infected with COVID-19 in Shanghai, China. Semi-structured face-to-face interviews were conducted in June 2022. A Seven-step Colaizzi process was used for data analysis. Results: Themes were described and extracted from the experience and insights at different stages during the fight against the virus. Three main themes, i.e., stress period, adjustment period, and growth period, as well as several sub-themes, were identified. Conclusion: First-line emergency nurses infected with COVID-19 are a sensitive group that should be given more attention. Investigating how they achieve psychological adjustment and growth in the case of severe trauma can provide valuable references for nursing management and education in the future. Society, hospital and nursing managers should pay more attention to the PTG of nurses and establish supportive PTG strategies, which will benefit the retention rate and career development of nurses.

Nursing students' experience during their practicum in an intensive care unit: A qualitative meta-synthesis.

Background: Clinical practicum provides nursing students with more opportunities to learn their professional knowledge and develop basic nursing skills. Intensive care unit (ICU) is often used as one of the clinical practicum departments for nursing students. Due to the characteristic fast-paced working environments, high acuity of patient care, and technical complexities of an ICU, nursing students are more susceptible to experiencing stress and lack of confidence in these settings, which hinders their professionalization and affects patient care. Objective: The study aimed to summarize and evaluate the nursing students' experience in an ICU during their practicum and to provide a supportive ICU clinical practicum environment for them. One of the main objectives was to increase the ICU specialty nurse reserve and improve nursing care in the ICU. Methods: The following databases were searched for related qualitative publications in Chinese and English by systematic searches across January 2022, including the nursing students' experience in ICU during their practicum: PubMed, Cochrane Library, Web of Science, and so on. The qualitative meta-synthesis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two reviewers independently selected these studies and carefully evaluated the quality of each study. Meta-synthesis was then used to summarize the results. Results: Eleven sub-themes and 3 themes were revealed in 9 studies: challenges of clinical practicum in the ICU, the expectation of support from multiple sources, and the importance and necessity of practicum in the ICU. Conclusion: Performing one's practicum in ICU was considered by the nursing students in this review as a beneficial practicum despite the challenges involved. The appropriate guidance and monitoring should be given by hospital managers and college educators.

Occupational benefit perception of acute and critical care nurses: A qualitative meta-synthesis.

Background: With the development of society, nurses have an increasingly more important role in the medical team. At the same time, due to various reasons, the number of active nurses is continuously decreasing, and the shortage of nursing personnel is becoming ever more serious. The COVID-19 pandemic made these clinical problems more serious. As the department with the greatest work pressure and the most intense pace, acute and critical care nurses are already facing serious problems related to job burnout and dismission. In the context of the COVID-19 pandemic, these problems should be solved urgently. Furthermore, with the rise of positive psychology, many scholars are turning their research direction to the positive professional experience of nurses so as to get inspiration to encourage nurses to face work with an optimistic attitude and guide nursing managers to better retain nursing talents. Objective: The purpose of this paper is to summarize and evaluate the positive emotional experience and professional benefit of acute and critical care specialist nurses in the process of work. So as to better interpret their occupational benefit perception and guide nursing managers in adopting positive measures and promoting the development of high-quality nursing. Methods: Cinahl plus, Embase, Medline and other twelve databases were searched for relevant literature. Meta-aggregation was used to synthesize the findings of the included studies. Results: From a total of 12 articles included in this study, 55 main results were presented, 8 new categories were integrated, and three themes were formed: professional identity, social support, and personal growth. The professional identity included: being proud of professional ability and increasing professional value; social support included: friends and family support, organizational, environmental support, peer support, and support of patients and their families; personal growth included realizing self-worth and promoting self-development. Conclusion: Hospital managers should pay attention to the positive emotional experience of nurses in work and based on this, provide practical and beneficial protection for nurses from the aspects of salary, learning opportunities, working environment, social support and internal personality, stimulate work enthusiasm, guide nurses to correctly face negative emotions and occupational pressure, and improve the sense of professional benefit.

Psychological resilience of emergency nurses during COVID-19 epidemic in Shanghai: A qualitative study.

Background: In early 2022, an outbreak of Coronavirus Disease 2019 (COVID-19) occurred in Shanghai, China. The spread of the epidemic put a large amount of stress on the local healthcare system, especially emergency nurses (ENs), which may affect their well-being and performance. Enhancing the psychological resilience of ENs during COVID-19 pandemic may improve job satisfaction, retention, and public health emergency response. However, few studies have researched the perception and psychological resilience of ENs during COVID-19 pandemic. Objective: To understand ENs' perception and psychological resilience and their coping strategies with adversity during COVID-19 in Shanghai, as well as factors associated with psychological resilience. Methods: This qualitative study was conducted using a phenomenological approach. A total of 17 ENs from a 3rd level hospital in Shanghai were selected using a method of purposive sampling. Between April and May 2022, in-depth semi-structured interviews and Colaizzi seven-step method were performed for data collection and analysis. Results: The investigation discovered three themes and nine subthemes. The first theme is "risk factors." Risk factors for ENs to remain resilience are sudden multiplication of workload, stressful of screening of infected patients, and the support nurses being unfamiliar with the procedure. The second theme is "promoting factors." ENs emphasized the importance of management assurance and humanistic care, as well as social support. They recognized adversity and resilience, and used self-management strategies to cope with the situation. The third theme is "motivated by altruism." ENs were driven by altruism to respond to adversity with a positive attitude. They realized their self-worth by helping patients with a sense of sacred mission. Conclusions: Psychological resilience is not a stable psychological characteristic but a constantly changing process that is affected by internal and external factors. Enhancing resilience of ENs during the COVID-19 pandemic may improve work satisfaction, retention, and public health emergency response. Adequate preparation before a pandemic, reasonable arrangement, a trustworthy working atmosphere, encouragement and improvement of individual and collective strategies for nurses to cope with adversity, timely rewards, and nurse empowerment, as well as counseling and training, can be used to enhance psychological resilience of ENs.

Application of machine learning in predicting the risk of postpartum depression: A systematic review.

BACKGROUND: Postpartum depression (PPD) presents a serious health problem among women and their families. Machine learning (ML) is a rapidly advancing field with increasing utility in predicting PPD risk. We aimed to synthesize and evaluate the quality of studies on application of ML techniques in predicting PPD risk. METHODS: We conducted a systematic search of eight databases, identifying English and Chinese studies on ML techniques for predicting PPD risk and ML techniques with performance metrics. Quality of the studies involved was evaluated using the Prediction Model Risk of Bias Assessment Tool. RESULTS: Seventeen studies involving 62 prediction models were included. Supervised learning was the main ML technique employed and the common ML models were support vector machine, random forest and logistic regression. Five studies (30 %) reported both internal and external validation. Two studies involved model translation, but none were tested clinically. All studies showed a high risk of bias, and more than half showed high application risk. LIMITATIONS: Including Chinese articles slightly reduced the reproducibility of the review. Model performance was not quantitatively analyzed owing to inconsistent metrics and the absence of methods for correlation meta-analysis. CONCLUSIONS: Researchers have paid more attention to model development than to validation, and few have focused on improvement and innovation. Models for predicting PPD risk continue to emerge. However, few have achieved the acceptable quality standards. Therefore, ML techniques for successfully predicting PPD risk are yet to be deployed in clinical environments.

Evaluation of Four eGFR Calculating Formulae in Predicting Postoperative Acute Kidney Injury in Adult Patients Undergoing Open-Heart Surgery with Cardiopulmonary Bypass.

Objective: There are four widely-used formulae to calculate the perioperative glomerular filtration rate (GFR) of patients undergoing cardiac surgery. We assessed the predictive values of these formulae in the occurrence of postoperative acute kidney injury (AKI). Methods: Patients who underwent open-heart valvular surgery with cardiopulmonary bypass from January 2015 to October 2017 were enrolled in this retrospective study. Demographic data and perioperative serum creatinine levels were collected. The estimated GFR (eGFR) was calculated using four formulae: Cockcroft Gault (CG), body surface area (BSA) corrected CG, simplified modification of diet in renal disease (MDRD), and chronic kidney disease-epidemiology collaboration (CKD-EPI) formula. The incidence of post-operative AKI was calculated and the predictive capability of these formulae was evaluated. Results: A total of 290 patients were included. 136 patients (46.90%) developed AKI after surgery. The eGFR in the AKI group was significantly lower than those in the non-AKI group at all investigated time points. In addition, the eGFR in the non-AKI group increased temporarily on the day of operation, then decreased on the following days, and returned to preoperative level about one week after surgery. However, in the AKI group, the eGFR decreased from the day of operation, which still did not recover to the preoperative level by the end of the first week after surgery. The eGFR calculated by the BSA-standardized CG formula had the highest AUC ROC curves of 0.699 and 0.774 before operation and on the day of operation, respectively. While eGFR calculated by CKD-EPI formula had the highest AUC ROC of 0.874 and 0.887 at the first and second postoperative day. Conclusions: The eGFR formula is a powerful tool for perioperative renal function assessment. The BSA-corrected CG and CKD-EPI formula have better performance in predicting postoperative AKI after cardiopulmonary bypass than serum creatinine level and other formulae.

Impact of endometrial scratching on reproductive outcome in patients: A systematic review and meta-analysis.

BACKGROUND: Endometrial scratching (ES) has demonstrated initial success in women with recurrent implantation failure, but the effect in women with 1 previous assisted reproductive technology (ART) failure is unknown. This meta-analysis aimed to evaluate the impact of ES as a treatment in clinical outcomes for women with at least 1 failed in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI)/Intrauterine Insemination (IUI). METHODS: PubMed, Medline, Embase, Cochrane Library, Web of Science, CNKI, and EMCC databases were searched for randomized controlled trial studies utilizing endometrial scratching for infertility women with at least 1 failed assisted reproductive technology (ART) to collect pregnancy outcomes, including clinical pregnancy rate (CPR), embryo implantation rate (IR), miscarriage rate (MR), live birth rate (LBR), and multiple pregnancy rate (MPR). RESULTS: Sixteen randomized controlled trial (RCT) studies were included in this meta-analysis, including 1770 women in the intervention group and 1934 women in the control group. Overall, the CPR, IR and LBR were significantly higher in the intervention group than in the control group (for CPR, n = 1430, 16 studies, P = .0002, risk ratio (RR) = 1.59, 95% confidence interval [CI] [1.24, 2.03]; for IR, n = 859, 10 studies, P = .0003, RR = 1.67, 95% CI [1.26, 2.21]; for LBR, n = 156, 6 studies, P = .0005, RR = 1.59, 95% CI [1.22, 2.06]). Nonetheless, there was no significant difference in MR (n = 344, 11 studies, P = .62, risk ratio (RR) = 0.92, 95% confidence interval [CI] [0.66, 1.29]) and MPR (n = 98, 3 studies, P = .39, risk ratio (RR) = 0.81, 95% confidence interval [CI] [0.51, 1.30]) between the intervention group and the control group. CONCLUSION: Endometrial scratching is considered to enhance the reproductive outcomes of embryo implantation. Additional randomized controlled studies are recommended to identify the appropriate time of invasion and the applicable population to confirm whether it can become a routine operation.