Factors influencing the continuity of evidence-based practice in perioperative airway management for elderly patients with fractures: A qualitative study.

BACKGROUND: More and more evidence-based practices are emerging, but researchers mostly focus on short-term effects, resulting in evidence-based practices not being applied in the clinic in the long term. In this study, we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic. AIM: To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures. METHODS: This study was qualitative research. Nine nurses who implemented evidence-based practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects. Semi-structured interviews were conducted with them, and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model. RESULTS: Three main themes and ten subthemes were identified: Process aspects (benefits to patients, benefits to nurses, lack of follow-up, complex processes); staff aspects (insufficient human resources, inadequate training and education, lack of leadership support); and organizational environment aspects (inadequate infrastructure, poor patient compliance, poor doctor cooperation). CONCLUSION: Human resources, training and education, leadership support, infrastructure, and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.

Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas.

BACKGROUND: This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs. Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer. However, the ileostomy is susceptible to peri-stoma skin complications, as well as fluid, electrolyte, and nutritional imbalances, posing challenges to effective management. The successful self-management of patients is intricately linked to their adjustment to temporary colostomy; nonetheless, there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront. AIM: To investigate the lived experiences, perceptions, and care requirements of temporary colostomy patients within their home environment, with the ultimate goal of formulating a standardized management protocol. METHODS: Over the period of June to August 2023, a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai, China. Employing a phenomenological research approach, a semi-structured interview guide was developed, and qualitative interviews were conducted using in-depth interview techniques. The acquired data underwent coding, analysis, organization, and summarization following Colaizzi's seven-step method. RESULTS: The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes: Firstly, Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression; secondly, patients exhibit limited self-care capabilities and face information deficits, resulting in heightened reliance on healthcare professionals; thirdly, patients demonstrate the potential for internal motivation through proactive self-adjustment; and finally, patients express a significant need for emotional and social support. CONCLUSION: Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens, inadequate self-care abilities, informational deficits, and emotional needs. Identifying factors influencing patients' self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Current state and influencing factors in airbag management among emergency department nurses: A multicenter study.

BACKGROUND: The emergency department (ED) plays a critical role in establishing artificial airways and implementing mechanical ventilation. Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia. Nonetheless, existing research has largely overlooked the understanding, beliefs, and practical dimensions of airway airbag management among ED nurses, with a predominant focus on intensive care unit nurses. AIM: To investigate the current status of ED nurses' knowledge, beliefs, and practical behaviors in airway airbag management and their influencing factors. METHODS: A survey was conducted from July 10th to August 10th, 2023, using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai. Pathway analysis was utilized to analyze the influencing factors. RESULTS: The scores for ED nurses' airway airbag management knowledge were 60.26 ± 23.00, belief was 88.65 ± 13.36, and behavior was 75.10 ± 19.84. The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training, department, and work experience in the department. Influencing factors of airbag management belief comprised knowledge, department, and participation in specialized nurse or mechanical ventilation training. Primary influencing factors of airbag management behavior included knowledge, belief, department, participation in specialized nurse or mechanical ventilation training, and professional title. The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior, with a total effect value of 0.513, and an indirect effect of 0.085, constituting 16.6% of the total effect. CONCLUSION: ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices, yet there remains room for improvement in their knowledge levels. Nursing managers should implement interventions tailored to the characteristics of ED nurses' airbag management knowledge, beliefs, and practices to enhance their airbag management proficiency.

[Research Progress on Remote Sensing Monitoring of Lake Water Quality Parameters].

Lakes are an important component of the hydrosphere and are important freshwater resources. The water environment of lakes has become increasingly polluted, and monitoring the dynamic changes in lake water quality is of great significance for ecological environment protection. Remote sensing can provide technical support for lake water quality monitoring, overcoming the low-cost and poor timeliness characteristics of manual sampling; thus, it has been widely used in lake water quality monitoring. Remote sensing can be used to monitor many indicators, including suspended solids, chlorophyll a, soluble organic matter, dissolved oxygen, transparency, etc. Although remote sensing provides a new method for lake water quality monitoring, there are still some problems in practical application. ① It is difficult to accurately retrieve the component changes in different substances in lake water from the signals received by remote sensing, resulting in the limitation of remote sensing accuracy. Atmospheric correction can eliminate the images reflected by factors such as atmosphere and light. In order to improve the accuracy of water quality monitoring, higher-accuracy atmospheric correction algorithms are needed. However, at present the atmospheric correction algorithm is not mature enough and lacks the portability between sensors. Therefore, atmospheric correction is still a difficult problem of remote sensing retrieval in lake water quality. ② Due to seasonal and spatial constraints, there are differences in surface optical properties of different lakes and biological optical properties, resulting in changes in remote sensing reflectance. There is also a lack of portability of the model established by using limited measured data. ③ The interference of aquatic plants and external forces (wind, fish, etc.) causes the error between the measured data and the model estimation, and the synchronization of the data is difficult to guarantee, which will introduce large errors to the lake water quality model, resulting in a decrease in the reliability of the model. ④ The spatio-temporal scale of measured data and remote sensing data do not match, and it is difficult to capture dynamic and fine changes in water quality. More precise observation of water quality is needed that can capture rapid changes in lakes. However, it is still challenging to obtain real-time measured data that meet the requirements. Therefore, it is necessary to further understand the spectral characteristics of water quality parameters, combining multi-source data and other hydrological models. In the future, a retrieval algorithm with low dependence will be developed, and migrated models will be constructed to break the regional limitations of the model. Additionally, remote sensing promotes the operational development and early warning for the water quality of lakes.

Role of Rho guanine nucleotide exchange factors in non-small cell lung cancer.

Conventionally, Rho guanine nucleotide exchange factors (GEFs) are known activators of Rho guanosine triphosphatases (GTPases) that promote tumorigenesis. However, the role of Rho GEFs in non-small cell lung cancer (NSCLC) remains largely unknown. Through the screening of 81 Rho GEFs for their expression profiles and correlations with survival, four of them were identified with strong significance for predicting the prognosis of NSCLC patients. The four Rho GEFs, namely ABR, PREX1, DOCK2 and DOCK4, were downregulated in NSCLC tissues compared to normal tissues. The downregulation of ABR, PREX1, DOCK2 and DOCK4, which can be attributfed to promoter methylation, is correlated with poor prognosis. The underexpression of the four key Rho GEFs might be related to the upregulation of MYC signaling and DNA repair pathways, leading to carcinogenesis and poor prognosis. Moreover, overexpression of ABR was shown to have a tumor-suppressive effect in PC9 and H1703 cells. In conclusion, the data reveal the unprecedented role of ABR as tumor suppressor in NSCLC. The previously unnoticed functions of Rho GEFs in NSCLC will inspire researchers to investigate the distinct roles of Rho GEFs in cancers, in order to provide critical strategies in clinical practice.

Effect of microwave radiation on antioxidant capacities of Tartary buckwheat sprouts.

This study aimed to investigate the effects of different microwave radiation power and treatment time on the antioxidant enzyme activities and radical scavenging potency in Tartary buckwheat sprouts. The results indicated that the optimal microwave irradiation conditions for superoxide dismutase, catalase, peroxidise and ascorbate peroxidise antioxidant enzymes was the power 300 W for 75 s, and their activities were all higher than those of the control and the ungerminated seeds. In addition, under the above microwave conditions, the total reducing power and the ability to scavenge DPPH, ABTS, O2- and •OH were also optimal. These results indicated that suitable microwave treatment could effectively improve the antioxidant enzyme activity in Tartary buckwheat sprouts and enhance the antioxidant capacity of sprouts.

[Application Value of Motion-correction Phase Sensitive Inversion Recovery (MOCO-PSIR) to Evaluate Myocardial Fibrosis in Patients with Heart Failure Caused by Dilated Cardiomyopathy].

OBJECTIVE: To study the application value of motion-correction phase sensitive inversion recovery (MOCO-PSIR) to evaluate myocardial fibrosis in the patients with heart failure caused by dilated cardiomyopathy (DCM). METHODS: A prospective study included 60 patients who underwent cardiac MRI enhanced scan from June 2017 to November 2018, including 38 patients who were clinically diagnosed with DCM and 22 patients in the normal control group. All patients were scanned with three late gadolinium enhancement (LGE) sequences: segmented-PSIR, single-shot-PSIR, MOCO-PSIR at the same time. The subjective quality score (level 4) and image signal-to-noise ratio (objective evaluation) of normal and abnormal myocardium were analyzed and compared in three scanning technique groups. The detection rate of myocardial fibrosis and image acquisition time of the three scanning techniques were recorded. RESULTS: In the normal control group (sinus rhythm), subjective score showed no statistical significance. Subjective scoring results in the patients with DCM: MOCO-PSIR>single-shot-PSIR> segmented-PSIR (P < 0.05). SNR results PSIR-LGE images in DCM patients as well as control group: segmented-PSIR>MOCO-PSIR> single-shot-PSIR (P < 0.05). In the whole 646 segments analysis of DCM patients, the ratio unable to judge in segmented-PSIR was up to 25.5%, but only 1.4% in MOCO-PSIR. Significant difference was found in the three groups. While in the 374 segments of control group, no statistical difference was found in comparison of incapability to judge. Acquisition time covered left ventricular: (5.6±1.7) min in segmented-PSIR, (0.4±0.2) min in single-shot-PSIR and (4.5±1.1) min in MOCO-PSIR. Pairwise comparison of acquisition time among three scanning techniques was statistically significant (P < 0.001). CONCLUSION: MOCO-PSIR-LGE has better clinical significance than conventional delayed enhanced scan sequences in the diagnosis of myocardial fibrosis in the patients with heart failure caused by dilated cardiomyopathy.

More than valve repair: Effect of cone reconstruction on right ventricular geometry and function in patients with Ebstein anomaly.

BACKGROUND: Cone reconstruction is a novel surgical procedure for tricuspid valve repair in Ebstein anomaly. This study examined the effect of cone reconstruction on right ventricle (RV) geometry, function, and synchronization. METHODS: Twenty-one patients (4-49 year-old) underwent cone reconstruction were enrolled, and matched with healthy individuals. Pre-operative and follow-up echocardiography was performed along with cardiac magnetic resonance (CMR) imaging in 18 patients. A new parameter, tricuspid annular movement synchronicity index (TAMSI), was used to describe global synchronization of RV in the annular plane. TAMSI was defined as standard deviation of the systolic excursion of the hinge points of the three leaflets divided by their average value. RESULTS: After 9.1 (range 1-12) months follow-up, there were no deaths; tricuspid regurgitation was reduced from moderate/severe to mild or less in 95.2% of patients. In 18 patients with both pre and post CMR data, functional RV volume decreased after repair (134.3 ± 58.3 ml/m(2) to 96.6 ± 29.6 ml/m(2); P=0.001), while ejection fraction was not significantly altered (38.2 ± 9.2% to 36.5 ± 8.5%; P=0.357). TAMSI was significantly reduced after surgery, from 0.613 ± 0.220 to 0.169 ± 0.088 (P<0.001). A value similar to the normal control (0.181 ± 0.081) indicated more synchronized RV movement pattern. CONCLUSIONS: Cone reconstruction yielded good short-term survival in Ebstein anomaly. It reduced functional RV volume, improved RV global synchronization, and restored RV geometry. As such, it may improve RV performance and long-term prognosis. In addition, our described TAMSI proved to be a useful adjunct to postoperative assessments.

[Reference Values for Left Ventricular Myocardial Strains Measured by Feature-tracking Magnetic Resonance Imaging in Chinese Han Population].

OBJECTIVES: To establish reference values for left ventricular (LV) myocardial strains in a cohort of healthy Chinese volunteers with feature tracking cardiac magnetic resonance imaging. METHODS: A total of 60 healthy volunteers were recruited, receiving a cardiac magnetic resonance imaging (CMR) examination at 3.0T scanner (Tim Trio, Magnetum, Siemens, Germany). A new feature tracking CMR software (Trufisp-strain, Siemens) was used to analyze left ventricular myocardial strain parameters, including radial, circumferential, longitudinal strain, systolic strain rate, and early diastolic strain rate. RESULTS: The image quality was sufficient to perform strain analysis.The reference values of global strain, global strain rate and segmental strains were obtained. A good inter- and intra-observer agreement was achieved in global strain analysis (except circumferential straininter-observer in apical level), with (37.7±9.6)% for LV global mean radial strain, (-18.4±3.3)% for circumferential strain and (-15.2±2.3%) for longitudinal strain, respectively.Age was positively correlated with global mean radial strain ( r=0.416, P<0.001) and negatively correlated with early diastolic strain rate (circumferential or longitudinal) and circumferential strain( r=-0.436, P<0.001; r=-0.326, P=0.011; r=-0.273, P=0.035, respectively). Women showed higher circumferential and longituinal strain values and lower systolic circumferential strain rate than men. The strain parameters were correlated with left ventricular ejection fraction (LVEF) ( P<0.05). CONCLUSIONS: FT-CMR (Trufisp-strain software) is a fast, convenient and highly reproducible method for analyzing left ventricular myocardial strains, which can sensitively detect gender and age differences. The reference values of LV myocardial strains can support further studies in the future.

POU2F2-oriented network promotes human gastric cancer metastasis.

BACKGROUND AND AIMS: Aberrant upregulation of POU2F2 expression has been discovered in metastatic gastric cancer (GC). However, the mechanisms underlying the aberrant upregulation and the potential functions of POU2F2 remain uncertain. DESIGN: The role and mechanism of POU2F2 in GC metastasis were investigated in gastric epithelial cells, GC cell lines and an experimental metastasis animal model by gain of function and loss of function. Upstream and downstream targets of POU2F2 were selected by bioinformatics and identified by luciferase reporter assay, electrophoretic mobility shift assay and chromatin immunoprecipitation PCR. The influence of miR-218 on its putative target genes (POU2F2, ROBO1 and IKK-ß) and GC metastasis was further explored via in vitro and in vivo approaches. RESULTS: Increased POU2F2 expression was detected in metastatic GC cell lines and patient samples. POU2F2 was induced by the activation of nuclear factor (NF)-κB and, in turn, regulated ROBO1 transcription, thus functionally contributing to GC metastasis. Finally, miR-218 was found to suppress GC metastasis by simultaneously mediating multiple molecules in the POU2F2-oriented network. CONCLUSIONS: This study demonstrated that NF-κB and the SLIT2/ROBO1 interaction network with POU2F2 as the central part may exert critical effects on tumour metastasis. Blocking the activation of the POU2F2-oriented metastasis network using miR-218 precursors exemplified a promising approach that sheds light on new strategies for GC treatment.

The effects of psychological interventions on depression and anxiety among Chinese adults with cancer: a meta-analysis of randomized controlled studies.

BACKGROUND: Our previous studies found the high prevalence of depression and anxiety among Chinese cancer patients, and many empirical studies have been conducted to evaluate the effects of psychological interventions on depression and anxiety among Chinese cancer patients. This study aimed to conduct a meta-analysis in order to assess the effects of psychological interventions on depression and anxiety in Chinese adults with cancer. METHODS: The four most comprehensive Chinese academic database- CNKI, Wanfang, Vip and CBM databases-were searched from their inception until January 2014. PubMed and Web of Science (SCIE) were also searched from their inception until January 2014 without language restrictions, and an internet search was used. Randomized controlled studies assessing the effects of psychological interventions on depression and anxiety among Chinese adults with cancer were analyzed. Study selection and appraisal were conducted independently by three authors. The pooled random-effects estimates of standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Moderator analysis (meta-regression and subgroup analysis) was used to explore reasons for heterogeneity. RESULTS: We retrieved 147 studies (covering 14,039 patients) that reported 253 experimental-control comparisons. The random effects model showed a significant large effect size for depression (SMD = 1.199, p < 0.001; 95% CI = 1.095-1.303) and anxiety (SMD = 1.298, p < 0.001; 95% CI = 1.187-1.408). Cumulative meta-analysis indicated that sufficient evidence had accumulated since 2000-2001 to confirm the statistically significant effectiveness of psychological interventions on depression and anxiety in Chinese cancer patients. Moderating effects were found for caner type, patients' selection, intervention format and questionnaires used. In studies that included lung cancer, preselected patients with clear signs of depression/anxiety, adopted individual intervention and used State-Trait Anxiety Inventory (STAI), the effect sizes were larger. CONCLUSIONS: We concluded that psychological interventions in Chinese cancer patients have large effects on depression and anxiety. The findings support that an adequate system should be set up to provide routine psychological interventions for cancer patients in Chinese medical settings. However, because of some clear limitations (heterogeneity and publication bias), these results should be interpreted with caution.

[Image quality adapted thoracic diameters in CT coronary artery imaging].

OBJECTIVE: To evaluate the correlation between image quality and thoracic diameters, anteroposterior diameter (AP) and right-left diameter (RL) for the optimization of reducing radiation dose in coronary artery imaging with Dual-source CT. METHODS: 118 patients underwent CT coronary artery imaging (CTCA) were divided into two groups (A and B) according to body mass index (BMI). There were 58 patients in group A with BMI values > or = 25 kg/m2 and < 30 kg/m2; and 60 patients in group B with BMI values < 25 kg/m2. Scan parameters: collimation 64 X 0.6 mm, reconstruction slice thickness 0.75 mm, reconstructin interval 0.7 mm, FOV 150-180 mm, the pitch adjusted according to heart rate automatically. CT imagings were obtained with tube voltage 100 kV, tube current 330 mAs (group A) and 100 kV, tube current 220 mAs (group B). The contrast-noise ratio (CNR), signal to noise ratio (SNR), as well as blind correlation test score values were calculated to establish the relationship among BMI, AP, RL and CNR, SNR. RESULTS: RL of five levels in groups of A, B were correlated to CNRa (P < 0.05). In group A and B (except iii, iv level of Group A), AP were associated with CNRa (P < 0.05). In addition to ii, iv level of group A, v level of group B, BMI were associated with CNRa (P < 0.05). The correlation coefficient of CNRa and RL of group A except ii level was greater than that of CNRa and AP. The correlation coefficient of CNRa, SNRa and RL of group B was greater than that of CNRa, SNRa and AP. Except iii level, the correlation coefficient of CNRa, SNRa and AP of group A was greater than that of CNRa, SNRa and BMI. Except ii level, the correlation coefficient of CNRa and AP of group B was greater than that of CNRa and BMI. CONCLUSION: Thoracic diameter of RL can be used as a guider to select the appropriate scan protocol in the coronary imaging acqusition with dual-source CT.