Uniaxial-Oriented Chiral Perovskite for Flexible Full-Stokes Polarimeter.

Full-Stokes polarization detection, with high integration and portability, offers an efficient path toward next-gen multi-information optoelectronic systems. Nevertheless, current techniques relying on optical filters create rigid and bulky configurations, limiting practicality. Here, a flexible, filter-less full-Stokes polarimeter featuring a uniaxial-oriented chiral perovskite film is first reported. It is found that, the strategic manipulation of the surfactant-mediated Marangoni effect during blade coating, is crucial for guiding an equilibrious mass transport to achieve oriented crystallization. Through this approach, the obtained uniaxial-oriented chiral perovskite films inherently possess anisotropy and chirality, and thereby with desired sensitivity to both linearly polarized light and circularly polarized light vectors. The uniaxial-oriented crystalline structure also improves photodetection, achieving a specific detectivity of 5.23 × 1013 Jones, surpassing non-oriented devices by 10×. The as-fabricated flexible polarimeters enable accurate capture of full-Stokes polarization without optical filters, exhibiting slight detection errors for the Stokes parameters: ΔS1 = 9.2%, ΔS2 = 8.6%, and ΔS3 = 6.5%, approaching the detection accuracy of optics-filter polarimeters. This proof of concept also demonstrates applications in matrix polarization imaging.

Doping with KBr to Achieve High-Performance CsPbBr3 Semitransparent Perovskite Solar Cells.

Wide-bandgap semitransparent perovskite photovoltaics are emerging as one of the ideal candidates for building-integrated photovoltaics (BIPV). However, surface defects in inorganic CsPbBr3 perovskite prepared by vapor deposition severely limit the optoelectronic performance of perovskite solar cells. To address this issue, a strategy of doping a trace amount of KBr into perovskite by vapor deposition is adopted, effectively improving the quality of the film, reducing surface defect concentration, and enhancing the transportation and extraction of charge carriers. Simultaneously, fully physical vapor deposition technology is employed to fabricate perovskite solar cells with an average visible light transmittance of 44%. These devices exhibited an ultrahigh open-circuit voltage of 1.55 V and a superior power conversion efficiency (PCE) of 7.28%, demonstrating excellent moisture and heat resistance. Moreover, the corresponding 5 cm × 5 cm modules achieve a PCE of 5.35% with great thermal insulation capability. This work provides an approach for fabricating highly efficient all-inorganic perovskite solar cells with high average visible light transmittance, demonstrating new insights into their application in building-integrated photovoltaics.

Comprehensive analysis reveals hub genes associated with immune cell infiltration in allergic rhinitis.

Objectives: Allergic rhinitis (AR) refers to a form of respiratory inflammation that mainly affects the sinonasal mucosa. The purpose of this study was to explore the level of immune cell infiltration and the pathogenesis of AR. Methods: We performed a comprehensive analysis of two gene expression profiles (GSE50223 and GSE50101, a total of 30 patients with AR and 31 healthy controls). CIBERSORT was used to evaluate the immune cell infiltration levels. Weighted gene coexpression network analysis was applied to explore potential genes or gene modules related to immune status, and enrichment analyses including gene ontology, Kyoto Encyclopedia of Genes and Genomes, gene set enrichment analysis, and gene set variation analysis, were performed to analyze the potential mechanisms in AR. A protein-protein interaction network was constructed to investigate the hub genes, and consensus clustering was conducted to identify the molecular subtypes of AR. Results: Compared to the healthy controls, patients with AR had high abundance levels and proportions of CD4+ memory-activated T cells. One hundred and eight immune-related differentially expressed genes were identified. Enrichment analysis suggested that AR was mainly related to leukocyte cell-cell adhesion, cytokine-cytokine receptor interaction, T-cell activation, and T-cell receptor signaling pathway. Ten hub genes, including TYROBP, CSF1R, TLR8, FCER1G, SPI1, ITGAM, CYBB, FCGR2A, CCR1, and HCK, which were related to immune response, might be crucial to the pathogenesis of AR. Three molecular subtypes with significantly different immune statuses were identified. Conclusion: This study improves our understanding of the molecular mechanisms in AR via comprehensive strategies and provides potential diagnostic biomarkers and therapeutic targets of AR.

Lipopolysaccharides protect mesenchymal stem cell against cardiac ischemia-reperfusion injury by HMGB1/STAT3 signaling.

BACKGROUND: Myocardial ischemia-reperfusion (I/R) is a serious and irreversible injury. Bone marrow-derived mesenchymal stem cells (MSCs) is considered to be a potential therapy for I/R injury due to the paracrine effects. High-mobility group box 1 (HMGB1) is a novel mediator in MSC and regulates the response of inflammation injury. Signal Transduction and Transcription Activator 3 (STAT3) is a critical transcription factor and important for release of paracrine factors. However, the relationship between HMGB1 and STAT3 in paracrine effect of MSC remains unknown. METHODS: In vitro, hypoxia/reoxygenation injury model was established by AnaeroPack System and examined by Annexin V flow cytometry, CCK8 assay and morphology observation. Detection of apoptotic proteins and protein expression of HMGB1 and STAT3 by Western blot. RESULTS: The conditioned medium of MSCs with or without LPS pretreatment was cocultured with H9C2 cells for 24 h before hypoxia treatment and MSC showed obvious cardiomyocytes protect role, as evidence by decreased apoptosis rate and improved cells viability, and LPS pretreated MSC exhibited better protect role than untreated MSC. However, such effect was abolished in HMGB1 deficiency group, silencing HMGB1 decreased the secretion of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor (IGF), cell viability, and the expression of STAT3. Furthermore, STAT3 silence attenuated the protective effect of LPS in MSC. CONCLUSIONS: These findings suggested that LPS improved MSC-mediated cardiomyocytes protection by HMGB1/STAT3 signaling.

A preparation method for mRNA-LNPs with improved properties.

The properties of mRNA lipid nanoparticles (mRNA-LNPs), including size, empty particles, morphology, storage stability, and transfection potency, are critically dependent on the preparation methods. Here, a Two-step tangential-flow filtration (TFF) method was successfully employed to improve the properties of mRNA-LNPs during the preparation process. This method involves an additional ethanol removal step prior to the particle fusion process. Notably, this innovative approach has yielded mRNA-LNPs with larger particles, a reduced proportion of empty LNPs, optimized storage stability (at least 6 months at 2-8 °C), improved in vitro transfection efficiency, and minimized distribution in the heart and blood in vivo. In summary, this study represents the implementation of the innovative Two-step TFF method in the preparation of mRNA-LNPs. Our findings indicate substantial enhancements in the properties of our mRNA-LNPs, specifically with regard to the percentage of empty LNPs, stability, transfection efficiency, and in vivo distribution. These improvements have the potential to optimize their industrial applicability and expand their clinical use.

[Effect of acupuncture on functional delayed gastric emptying after gastric cancer surgery based on enhance recovery after surgery].

OBJECTIVE: To observe the clinical effect of acupuncture for functional delayed gastric emptying after gastric cancer surgery on the basis of routine treatment. METHODS: A total of 80 patients with functional delayed gastric emptying after gastric cancer surgery were randomly divided into an observation group (40 cases, 3 cases dropped off) and a control group (40 cases, 1 case dropped off). The control group was treated with routine treatment, e.g. continuous gastrointestinal decompression. On the basis of the treatment in the control group, the observation group was treated with acupuncture at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Gongsun (SP 4), Sanyinjiao (SP 6), 30 min each time, once a day, 5 days as a course, 1-3 courses were required. The first exhaust time, remove gastric tube time, liquid food intake time and hospital stay were compared in the two groups, and the clinical effect was evaluated. RESULTS: The first exhaust time, remove gastric tube time, liquid food intake time and hospital stay in the observation group were shorter than the control group (P<0.001). CONCLUSION: On the basis of routine treatment, acupuncture could accelerate the recovery of patients with functional delayed gastric emptying after gastric cancer surgery.

Effect of anion-exchange membrane type for FCDI performance at different concentrations.

Brackish water was an important alternative source of freshwater. Desalination using flow electrode capacitive deionization (FCDI) needs to explore the role of ion exchange membranes (IEM) of FCDI. In this study, brackish water was desalinated using FCDI, and anion exchange membranes with different characteristics were used in the FCDI cell to investigate their influence. The result showed that the membrane polymer matrix was the main influencing factor for ion transport. Ion exchange capacity (IEC) has a huge impact that low IEC made the various ion transport priority. Low IEC not only limits ion transport but also leads to ion leakage in seawater. Resistance had a significant blockage to the effect with weak intensity.

Low-nitrite generation Cu-Co/Ti cathode materials for electrochemical nitrate reduction.

In order to reduce by-product nitrite, a more toxic compound than nitrate, and increase high value-added products ammonia in the electrochemical reduction nitrate process, the novel Cu-Co/Ti cathode material was applied in this process. In this paper, the electrochemical process was carried out in a single compartment electrolytic cell, and with Cu-Co/Ti electrode as cathode, identifying the effects of current density, pH, electrolytes in the nitrate reduction, and the distribution of products. The Cu-Co/Ti cathode exhibited 94.65% NO3--N (nitrate-N) removal, 0.18% NO2--N (nitrite-N) generation, and 40.86% NH4--N (ammonia-N) generation with the assistance of Na2SO4 electrolyte in 6 h at 10 mA cm-2 and pH 6. Compared with the Cu/Ti cathode, the higher nitrate removal ratio and lower nitrite generation ratio were obtained on the Cu-Co/Ti cathode. The excellent performance of Cu-Co/Ti cathode is ascribed to the synergy of Cu and Co, which couples the facilitation of nitrate conversion to nitrite and the acceleration of nitrite reduction on the Cu-Co/Ti cathode. The LSV curves showed that nitrate and nitrite might undergo indirect and direct reduction reactions on Cu-Co/Ti cathode. The possible pathways of nitrate reduction on the Cu-Co/Ti cathodes were proposed. These results highlight the viability of using the Cu-Co/Ti cathode developed at this work for the nitrate removal from contaminated waters. This study achieved low-nitrite generation by Cu-Co/Ti cathode during electrochemical nitrate reduction.

Associations of cardiorespiratory fitness, screen time and mental health among Chinese school children.

To assess the independent and joint associations between cardiorespiratory fitness (CRF), screen time and mental health among Chinese school-aged children, a cross-sectional study was conducted in 3 primary schools in Wuhan city, China. Children self-reported ST, and their height, weight and CRF were measured. Mental health (anxiety, depressive symptom, and self-esteem) was assessed by self-administered questionnaires. A total of 805 children aged 9.1 ±â€…0.6 years participated in this study. High ST was associated with significantly increased risk for anxiety and low self-esteem, while high CRF was associated with a decreased risk of low self-esteem. In the joint model, children with low ST and high CRF showed the lowest risk for anxiety (OR: 0.42, 95%CI: 0.20-0.89) and low self-esteem (OR:0.44, 95%CI: 0.24-0.82). High ST and low CRF were negatively associated with mental health in Chinese schoolchildren. Health care and interventions on limiting ST and improving CRF level are warranted to promote the mental health in this population.

Association between Serum Uric Acid and Hypertension in a Large Cross-Section Study in a Chinese Population.

Background: The association of serum uric acid (SUA) with hypertension has been well established in Caucasian populations. However, its association with hypertension in Chinese remained to be clarified. Methods: Consecutive patients, homogeneous in Chinese Han ethnicity, aged ≥18 years, abstracted from the database, admitted from 1 January 2010 to 31 December 2013, were included for potential analysis. The patients were grouped according to the presence or absence of hypertension. Unconditional logistic regression was performed to estimate the association between SUA and hypertension. Its possible interactions with risk factors on hypertension were also explored. Results: A total of 9587 patients were finally analyzed in the current study, where 5692 were with hypertension and 3895 were without hypertension. Per 100 µmol/L higher SUA concentration was associated with multivariable-adjusted odds ratios (95% CI) of 1.25 (1.08−1.22) in males, 1.10 (1.01−1.20) in females, and 1.19 (1.13−1.24) in total. On a categorical scale, when compared with the first quintile, the multivariable-adjusted odds ratios (95% CI) were 1.40 (1.20−1.64) for the 2nd quintile, 1.48 (1.27−1.74) for the 3rd quintile, 1.55 (1.32−1.82) for the 4th quintile, and 1.92 (1.63−2.26) for the 5th quintile, with a p for trend < 0.01. Conclusions: SUA is associated with hypertension in a dose-response manner among the Chinese hospitalized population. Management of SUA could help to the prevention and control of hypertension.

LPS preconditioning of MSC-CM improves protection against hypoxia/reoxygenation-induced damage in H9c2 cells partly via HMGB1/Bach1 signalling.

Mesenchymal stem cell-derived conditioned medium (MSC-CM) improves cardiac function after myocardial infarction; however, this cardioprotective effect is moderate and transient. Lipopolysaccharide (LPS) pretreatment partially improves MSC-CM-mediated cardioprotective effects owing to the presence of paracrine factors. However, the mechanism underlying these improved effects remains unknown. To study the effect of LPS-pretreated MSC-CM on hypoxia/reoxygenation (H/R)-induced injury, MSCs were treated with or without LPS (400 ng/mL) for 48 h, and the supernatant was collected (MSC-CM). Subsequently, H9c2 cells were co-cultured with Nor-CM (CM derived from LPS-untreated MSCs) and LPS-CM (CM derived from LPS-pretreated MSCs) for 24 h and subjected to H/R. MSC-CM inhibited the progression of H/R-induced injury in H9c2 cells, and this protective effect was enhanced via LPS pretreatment as evidenced by the improved apoptosis assessment index (i.e. caspase-3 and B-cell lymphoma-2 [Bcl-2] expression) and decreased levels of lactic dehydrogenase (LDH) and cardiac troponin (cTn). In addition, the results of haematoxylin-eosin staining (H&E), transmission electron microscopy (TEM) and TdT-mediated dUTP nick-end labelling (TUNEL) validated that MSC-CM inhibited H/R-induced injury in H9c2 cardiomyocytes. LPS pretreatment downregulated the expression of high mobility group box-1 (HMGB1) and BTB and CNC homology-1 (Bach1) proteins in MSCs but upregulated the expression of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF) and insulin-like growth factor (IGF). HMGB1 knockdown (MSC/siHMGB1-CM) significantly decreased the expression of Bach1 and increased the expression of VEGF, HGF and IGF. Bach1 knockdown (MSC/siBach1-CM) did not alter the production of HMGB1 but increased the expression of VEGF and IGF. LPS pretreatment did not alter the expression of the paracrine factors VEGF and HGF in the MSC/siHMGB1 group but increased their expression in the MSC/siBach1 group. The myocyte anti-apoptotic effects of MSCs/siBach1-CM were similar to those of untreated MSCs, which were not enhanced by LPS. LPS-pretreated MSC-CM protects H9c2 cells against H/R-induced injury partly through the HMGB1/Bach1 signalling pathway.

Lipopolysaccharide-pretreated mesenchymal stem cell-conditioned medium optimized with 10 kDa filter attenuates the injury of H9c2 cardiomyocytes in a model of hypoxia/reoxygenation.

Mesenchymal stem cell-derived conditioned medium (MSC-CM) improves cardiac function, which is partly attributed to the released paracrine factors. Since such cardioprotection is moderate and transient, it is essential that MSC-CM's effective components are optimized to alleviate myocardial injury. To optimize MSC-CM, MSCs were treated with or without lipopolysaccharides (LPSs) for 48 h (serum-free), and the supernatant was collected. Then, LPS-CM (MSC stimulated by LPS) was further treated with LPS remover (LPS Re-CM) or was concentrated with a 10 kDa cutoff filter (10 kDa-CM). Enzyme-linked immunosorbent assay showed that all the pretreatments increased the levels of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), and insulin growth factor (IGF) except LPS Re-CM; 10 kDa-CM was superior to the other CMs. Cell Counting Kit-8 displayed that the viability of injured H9c2 cells was enhanced with the increase in the MSC-CM concentration. We also found that the 10 kDa-CM significantly alleviated H9c2 hypoxia/reoxygenation (H/R) injury, as evidenced by the increased Bcl-2/Bax ratio, and decreased the levels of lactate dehydrogenase and cardiac troponin. Transmission electron microscopy (TEM), TdT-mediated dUTP nick-end labelling (TUNEL), and hematoxylin and eosin staining (H&E) confirmed that 10 kDa-CM inhibited H/R-induced H9c2 morphological changes. Proteomic analysis identified 41 differentially expressed proteins in 10 kDa-CM, among which anti-inflammation, proangiogenesis, and antiapoptosis were related to cardiac protection. This study indicates that 10 kDa-CM protects H9c2 cardiomyocytes from H/R injury by preserving most of the protective factors, such as VEGF, HGF, and IGF, in MSC-CM.

Endoscopic dacryocystorhinostomy for refractory nasolacrimal duct obstruction with a small lacrimal sac (≤ 5 mm in diameter).

BACKGROUND: Although endoscopic dacryocystorhinostomy (DCR) is a standard procedure for nasolacrimal duct obstruction (NLDO), the failure rate remains approximately 10%. A small lacrimal sac is considered the main reason for surgical failure. We explored the efficacy of endoscopic DCR for the treatment of NLDO with a small lacrimal sac. METHODS: The clinical data of 72 patients (88 eyes) diagnosed with NLDO and undergoing endoscopic DCR from 2012 to 2020, with at least 24 months of follow-up were retrospectively collected. Intraoperatively, the Rosenmüller valves were fully exposed, mucosal flaps were preserved to cover the naked bone, and a silicone tube was implanted if necessary. Postoperative intervention was performed if necessary. The main outcome measures were symptomatic improvement and objective ostium patency. RESULTS: Eighty-eight eyes of 72 patients were divided into two groups: the refractory group (34 patients, 47 eyes), with a small lacrimal sac (≤ 5 mm in diameter), and the simple group (38 patients, 41 eyes). Patients with small lacrimal sacs were more prone to bilateral eye disease than those in the simple group (P = 0.014) and required a longer postoperative follow-up (P < 0.001). Refractory NLDO and simple NLDO had a success rate of 91.5% and 95.1%, respectively, with no significant difference. CONCLUSION: Endoscopic DCR for refractory NLDO with a small lacrimal sac could achieve a beneficial result by exposing the Rosenmüller valves, preserving mucosal flaps, implanting necessary intubation, and intervening postoperatively. Thus, a small lacrimal sac should not be regarded as a contraindication to surgery.

Simulation in disaster nursing education: A scoping review.

OBJECTIVES: Disasters are gradually increasing in type and frequency throughout the globe. Simulation is being used in disaster nursing teaching and training. The aim of this scoping review was to systematically map the extent and application of simulation in disaster nursing education. DESIGN, DATA SOURCES AND METHODS: A scoping review was conducted using the model of Arksey and O'Malley as the methodological framework, extended by Levac. The following databases were systematically searched to identify relevant literature: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsychINFO from the launch of the databases to June 14, 2020, with a supplemental search on October 12, 2020. Two researchers independently screened the relevant articles selected and extracted the data. RESULTS: Twenty-four studies were included in the scoping review. The research purpose varied widely. The 24 included studies examined nine disaster simulation scenarios. Eight types of simulation methods were identified, of which simulated patients and a mixed-simulation approach were the main methods. Only two studies used a randomized controlled trial design, and none of the rest studies were set up with control groups. Only 10 studies reported validated questionnaires with reliability tests being used. Debriefing was performed in 19 studies, and in 4 of those studies, the debriefing was structured. The reported outcomes were concentrated in Kirkpatrick's levels 1 (participants' satisfaction with the training experience) and 2 (whether participants actually benefited from the training). CONCLUSION: This review found that simulation was well-recognised in disaster nursing education and training. However, insufficient designs and methods indicated that there was a lack of strong evidence, and high-level research on the application of simulation is needed in the field of disaster care.

Experimental study on the effects of blending PODEn on performance, combustion and emission characteristics of heavy-duty diesel engines meeting China VI emission standard.

To study the influence of diesel fuel blended with polyoxymethylene dimethyl ethers (PODEn), a new alternative fuel with a high oxygen content and large cetane number, on the combustion characteristics, fuel economies, and emission characteristics of heavy-duty diesel engines that meet China VI emission standards, relevant tests were conducted on a supercharged intercooled high-pressure common-rail diesel engine. The PODEn were blended with diesel fuel at three different ratios (volume fractions of 10%, 20%, and 30%). The test results showed that the PODEn could optimize the combustion process of diesel engines that met the China VI emission standards, effectively improve the thermal efficiencies of diesel engines, and reduce the emissions of hydrocarbon (HC), carbon monoxide (CO), and soot. With an increase in the PODEn blending ratio, the peak values of the in-cylinder pressure, average in-cylinder temperature, and instantaneous heat release rate gradually decreased, and each peak progressively moved forward. As the start of combustion gradually moved forward, the combustion duration was shortened by 0.7-2.8°CA, the heat release process became more concentrated, and the effective thermal efficiency was increased by up to 2.57%. The effective fuel consumption gradually increased, yet the equivalent effective fuel consumption gradually decreased, with the largest drop being as high as 4.55%. The nitrogen oxides (NOx) emission increased slightly, and the emissions of HC, CO, and soot gradually decreased. The emissions of CO and soot declined significantly under high-speed and high-load conditions, with the highest reductions reaching 66.2% and 76.3%, respectively.

Three learning modalities' impact on clinical judgment and perceptions in newly graduated registered nurses: A quasi-experimental study.

Newly graduated registered nurses face numerous challenges stemming from high patient workload, complicated interpersonal relationships, and a lack of nursing competence, which can lead to transitional shocks. Clinical judgment and confidence are well-known keys to successful role transitions for these nurses. Simulation training is proposed as a new modality for enhancing comprehensive clinical competence of nurses, but current evidence on the impact of different simulations on nurses' clinical judgment and confidence are still limited or inconsistent. This study compared the impact of three types of learning modalities on newly graduated registered nurses' clinical judgment, perceptions of self-confidence, and evaluations of the design features of the learning modalities. A quasi-experimental design was used. Fifty-nine participants were randomly assigned to three groups: (1) high-fidelity simulation, (2) virtual simulation, and (3) case study. Scales were used after the simulation. The virtual simulation group showed a higher level of clinical judgment. The high-fidelity simulation group felt more confident than the virtual simulation and case study groups. Both the high-fidelity simulation group and virtual simulation group reported higher scores in the domain of fidelity.

The Evaluation of the Distance Learning Combining Webinars and Virtual Simulations for Senior Nursing Students during the COVID-19 Period.

Background: The outbreak of COVID-19 has forced many schools to adopt distance teaching. This study developed a distance learning program that combines webinars and virtual simulations to meet students' learning needs. Methods: A descriptive and quasi-experimental design was used. Thirty-five students participated in this distance learning program. Toward the middle and the end of the webinars, computer-based examinations were conducted to assess students' theoretical knowledge. The Clinical Thinking Ability Scale was administered before and after virtual simulation. Academic Self-efficacy, Student Engagement, and Students' Satisfaction Scales were administered after completing the learning program. Results: The students obtained high scores on the theoretical knowledge examinations and virtual simulation scenarios. The virtual simulation led to an improvement in clinical thinking ability. Students displayed high levels of academic self-efficacy and student engagement and expressed high satisfaction with this program. Moreover, there were significant differences between genders in learning behavior self-efficacy, and learning effectiveness. Conclusion: This distance learning program could meet the learning requirements of senior nursing students, in a flexible manner, in a safe environment during the COVID-19 outbreak.

Baccalaureate nursing students' experiences with high-fidelity simulation: protocol for a qualitative systematic review.

INTRODUCTION: High-fidelity simulation (HFS) can bridge the gap between theoretical knowledge and nursing practice and improve safety and quality of patient care in baccalaureate nursing education. Although inconsistent assessment instruments or lack of high-quality research designs affect the strength of the evidence and limit the generalisability of the results, quantitative studies generally demonstrate the effectiveness of HFS in baccalaureate nursing education. Synthesis of the existing evidence of baccalaureate nursing students' experiences with HFS is crucial for the improvement and revision of simulation design and teaching. METHODS AND ANALYSIS: A comprehensive search for qualitative studies on baccalaureate nursing students' experiences with HFS will be conducted in the following databases: PubMed, Embase, CINAHL, ProQuest, Web of Science, PsycINFO, the Cochrane library, China Biology Medicine disc, China National Knowledge Infrastructure and VIP Database for Chinese Technical Periodicals. This review considered studies reported in English or Chinese, and studies that were conducted between January 2000 and December 2019 in view of the launch of International Nursing Association for Clinical Simulation and Learning. The literature search will be conducted by two independent reviewers, and any disagreement will be adjudicated by discussion or with a third reviewer. The two independent reviewers will use the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research to assess the methodological validity, following which the JBI standardised data extraction tools will be used to extract relevant data. The JBI meta-aggregation method will be subsequently used to synthesise the data, eventually forming themes, categories and synthesised findings. The final synthesised findings will establish confidence levels based on the JBI ConQual approach. ETHICS AND DISSEMINATION: This review does not require formal ethical review since it is based on available published literature. Findings will be disseminated through publication in a peer-reviewed journal, and, if possible, presented in scientific conferences.

The metabolites and biotransformation pathways in vivo after oral administration of ocotillol, RT5 , and PF11.

Ocotillol, pseudo-ginsenoside RT5 (RT5 ), and pseudo-ginsenoside F11 (PF11 ) are ocotillol-type saponins that have the same aglycone structure but with different numbers of glucose at the C-6 position. In this study, the metabolites of ocotillol, RT5 , and PF11 in rat plasma, stomach, intestine, urine, and feces after oral administration were investigated by ultra-performance liquid chromatography coupled with time-of-flight mass spectrometry. The results showed that RT5 was easily biotransformed into metabolites in vivo, whereas PF11 and RT5 were difficult to be biotransformed. Hydrogenation, dehydrogenation, dehydration, deglycosylation, deoxygenation, hydration, phosphorylation, deoxidation, glucuronidation, and reactions combining amino acid were speculated to be involved in the biotransformation of ocotillol, RT5 , and PF11 . Based on the structural analysis of metabolites, it was deduced that hydrogenation, dehydration, deoxidation, and reactions combining amino acid occurred on the aglycone structure, whereas deglycosylation, hydration, and phosphorylation occurred on the glycosyl chain. Further, metabolites in plasma, urine, feces, and tissues were different: First, glucuronidation products were found in urine, stomach, intestine, and feces, but not in plasma. Second, the ocotillol prototype was not identified in urine samples. Third, the RT5 prototype was found in stomach, intestine, feces, and urine, but not in plasma.