The effect of telemedicine interventions on patients with diabetic foot ulcers: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The meta-analysis was performed to evaluate the effectiveness of telemedicine interventions on patients with diabetic foot ulcers(DFU). APPROACH: The authors conducted a comprehensive search across eight databases. The aim was to identify randomized controlled trials examining the effectiveness of telemedicine for patients with DFU. Methodological qualities of included studies were assessed using Cochrane Handbook for Systematic Reviews of Intervention.. Subsequently, a meta-analysis was conducted using RevMan 5.3 to synthesize the findings. RESULTS: Ten studies involving 1678 patients with DFU were included in the meta-analysis. In comparison to the face-to-face intervention group, telemedicine interventions significantly reduced the amputation rate (risk ratio (RR) = 0.64, 95% confidence interval (CI) = 0.44－0.92, p = 0.02), decreased costs (mean difference (MD) = -4158.51, 95% CI = -7304.69－-1012.34, p = 0.01), better controlled fasting blood glucose( FPG)(MD = -0.89, 95% CI = -1.43－-0.36, p = 0.001), achieved superior glycated hemoglobin(HbA1c) control (MD = -0.71, 95% CI = -1.01－-0.41, p ˂ 0.00001). No significant differences were observed between the telemedicine group and the face-to-face group in terms of healing rate, mortality, and healing time.  Innovations: Our study suggests that telemedicine is a viable strategy for managing DFU. CONCLUSIONS: The meta-analysis indicates that telemedicine interventions have a positive effect on DFU. Nevertheless, more well-designed and high-quality studies are needed to reach a conclusion with greater confidence.

A Natural Casein-Based Separator with Brick-and-Mortar Structure for Stable, High-Rate Proton Batteries.

Rechargeable aqueous proton batteries with small organic molecule anodes are currently considered promising candidates for large-scale energy storage due to their low cost, stable safety, and environmental friendliness. However, the practical application is limited by the poor cycling stability caused by the shuttling of soluble organic molecules between electrodes. Herein, a cell separator is modified by a GO-casein-Cu2+ layer with a brick-and-mortar structure to inhibit the shuttling of small organic molecules. Experimental and calculation results indicate that, attributed to the synergistic effect of physical blocking of casein molecular chains and electrostatic and coordination interactions of Cu2+, bulk dissolution and shuttling of multiple small molecules can be inhibited simultaneously, while H+ transfer across the separators is not almost affected. With the protection of the GO-casein-Cu2+ separator, soluble small molecules, such as diquinoxalino[2,3-a:2',3'-c]phenazine,2,3,8,9,14,15-hexacyano (6CN-DQPZ) exhibit a high reversible capacity of 262.6 mA h g-1 and amazing stability (capacity retention of 92.9% after 1000 cycles at 1 A g-1). In addition, this strategy is also proved available to other active conjugated small molecules, such as indanthrone (IDT), providing a general green sustainable strategy for advancing the use of small organic molecule electrodes in proton cells.

Energy-saving and CO2 reduction strategies for new energy vehicles based on the integration approach of voluntary advocacy and system dynamics.

The low-carbon development of new energy vehicles (NEVs) is critical to achieving the goals of carbon peaking and carbon neutrality. As such, combining gray model theory with system dynamics (SD-GM) and based on the bidirectional-cycle prediction theory, we propose a NEV annual average mileage algorithm considering the impact of the epidemic in China, taking private cars as an example. Then, combining a voluntary advocacy strategy (VA) with the SD-GM theory (VA-SD-GM integration), we establish an energy-saving and carbon-reduction management model. To evaluate the proposed algorithm, we performed a dynamic simulation. The results indicate that the enhanced green scenario enabled significant energy-saving and CO2 reduction performance but would cause side effects in the long term. Compared with the enhanced green scenario, the linkage mode reduced the impact of parking space tension, the number of NEV trips, and the intensification of traffic congestion by approximately 33%, 50%, and 34%, respectively. It effectively suppressed the continuous increase in side effects and had a synergistic effect of carbon reduction, energy conservation, congestion alleviation, and side-effect reduction. The study provides a theoretical basis for optimizing the energy-saving and CO2 reduction path of NEVs.

Searching High-Potential Dihydroxynaphthalene Cathode for Rocking-Chair All-Organic Aqueous Proton Batteries.

The lack of acid-proof high-potential cathode largely limits the development and competitiveness of proton batteries. Herein, the authors systematically investigated six dihydroxynaphthalenes (DHNs) and found that 2,6-DHN delivered the best cathode performance in proton battery with the highest redox potential (0.84 V, vs SHE) and a specific capacity of 91.6 mAh g-1 at 1 A g-1 . In situ solid-state electropolymerization of DHNs is responsible for the voltage and capacity fading of DHNs, and 2,6-DHN's excellent electrochemical performance is derived from its high polymerization energy barrier. By compounding with rGO, the 2,6-DHN/rGO electrode can maintain a specific capacity of 89 mAh g-1 even after 12 000 cycles at 5 A g-1 . When it is paired with the 2,6-dihydroxyanthraquinone (DHAQ) anode, the assembled rocking-chair all-organic proton battery exhibited a high cell voltage of 0.85 V, and excellent energy/power densities (70.8 Wh kg-1 /850 W kg-1 ). This study showcases a new-type high-potential proton-containing organic cathode and paves the way for constructing a high-voltage rocking-chair proton battery. Also, in situ solid-state electropolymerization will inspire the further study of phenol-based small-molecule electrodes.

GR5 acts in the G protein pathway to regulate grain size in rice.

Grain size is an important determinant of grain yield in rice. Although dozens of grain size genes have been reported, the molecular mechanisms that control grain size remain to be fully clarified. Here, we report the cloning and characterization of GR5 (GRAIN ROUND 5), which is allelic to SMOS1/SHB/RLA1/NGR5 and encodes an AP2 transcription factor. GR5 acts as a transcriptional activator and determines grain size by influencing cell proliferation and expansion. We demonstrated that GR5 physically interacts with five Gγ subunit proteins (RGG1, RGG2, DEP1, GS3, and GGC2) and acts downstream of the G protein complex. Four downstream target genes of GR5 in grain development (DEP2, DEP3, DRW1, and CyCD5;2) were revealed and their core T/CGCAC motif identified by yeast one-hybrid, EMSA, and ChIP-PCR experiments. Our results revealed that GR5 interacts with Gγ subunits and cooperatively determines grain size by regulating the expression of downstream target genes. These findings provide new insight into the genetic regulatory network of the G protein signaling pathway in the control of grain size and provide a potential target for high-yield rice breeding.

Application of direct observation of operational skills in nursing skill evaluation of pressure injury: A randomized clinical trial.

This was a non-blinded, single-centre, randomized, controlled clinical trial that compared the effectiveness of direct observation of procedural skills (DOPSs)with traditional assessment methods in pressure injury (PI) care skills. The study population included 82 nursing professionals randomly assigned to the study group (n = 41) and the control group (n = 41). Both groups of nurses underwent a 6-month training in PI care skills and were subsequently evaluated. The main outcome variables were the PI skill operation scores and theoretical scores. Secondary outcome variables included satisfaction and critical thinking abilities. Independent sample t-tests and chi-square tests were used to assess differences between the two groups of nurses. The results showed no statistically significant difference in PI skill operation scores between the two groups of nurses (p > 0.05). When comparing the PI theoretical scores, the study group scored higher than the control group, and this difference was statistically significant (p < 0.05). In terms of satisfaction assessment, the study group and the control group showed differences in improving self-directed learning, enhancing communication skills with patients, improving learning outcomes and increasing flexibility in clinical application (p < 0.05). When comparing critical thinking abilities between the two groups of nurses, there was no statistically significant difference at the beginning of the training, but after 3 months following the training, there was a statistically significant difference between the two groups (p < 0.01).The results indicated that the DOPS was effective in improving PI theoretical scores, increasing nurse satisfaction with the training and enhancing critical thinking abilities among nurses.

Emerging Validation for the Adapted Chinese Version of Quick Aphasia Battery.

Purpose: The quick aphasia battery (QAB) was designed to evaluate language disorder from multi-dimension efficiently, which had been translated into several languages but lacked in Chinese. This study conducted cross-cultural adaption for the Chinese version and verified its psychometric properties. Material and Methods: First, the Chinese Version of quick aphasia battery (CQAB) was adapted following WHO literature guidelines with steps of forward translation, expert panel, back-translation, pre-test, and interview, then develop the final version. Second, the psychometric properties tests were conducted in 128 post-stroke patients to identify if aphasia happens and verify the validity and reliability of CQAB. Results: The Cronbach's alpha coefficient of the CQAB is 0.962, test-retest reliability 0.849, and inter-rater reliability 0.998. Content validity 0.917, KMO 0.861, exploratory factor analysis extracted 2 factors named "language understanding" and "language program", cumulative variance contribution rate is 91.588% >50%. Calibration association validity 0.977. Sensitivity 0.977, specificity 0.932, with the optimal cutoff point is 8.86. Conclusion: The study supported CQAB, which adapted following standardized guidelines, is reliable and effective to assess language impairment in post-stroke patients.

Characterization of dynamical changes in vital signs during allogeneic human umbilical cord-derived mesenchymal stem cells infusion.

Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs), a kind of adult stem cell, were studied for clinical applications in regenerative medicine. To date, the safety evaluations of intravenous infusion of allogeneic hUC-MSCs were focused on fever, infection, malignancy, and death. However, the characteristics of dynamical changes in vital signs during hUC-MSCs infusion are largely unknown. In this study, twenty participants with allogeneic hUC-MSCs transplanted (MSC group) and twenty sex- and age-matched individuals with cardiovascular disease who treated with the equal volume of 0.9% normal saline were recruited (NS group). Heart rate, respiratory rate, oxygen saturation, systolic and diastolic blood pressure, and temperature were monitored at intervals of 15 min during infusion. Adverse events were recorded during infusion and within seven days after infusion. No adverse events were observed during and after infusion in both groups. Compared with the baseline, the mean systolic blood pressure (SBP) levels were significantly decreased at 15 min, 30 min, 45 min and 60 min in the MSC group (all P < 0.05) during infusion. In addition, SBP changed significantly from baseline during hUC-MSCs infusion when compared with that of NS group (P < 0.05). Repeated measures analysis of variance confirmed difference over time on the SBP levels (P < 0.05). Our results showed that the process of allogeneic hUC-MSCs intravenous infusion was safe and the vital signs were stable, whereas a slight decrease in SBP was observed.

Validation and reliability test of Chinese language patient-reported impact of symptoms in schizophrenia scale.

Background: Patient-reported outcomes, or subjective evaluations directly reflecting the patient's views, feelings, and judgments, are now being used to evaluate the outcomes of care and treatment of people with schizophrenia. In this study, we used an updated tool, the patient-reported impact of symptoms in schizophrenia scale (PRISS), translated into Chinese languages to assess the subjective experiences of schizophrenia patients. Objective: This study aimed to test the psychometrics of the Chinese languages PRISS (CL-PRISS). Method: This study used the Chinese version of PRISS (CL-PRISS), acquired from the harmonized English-language version. A total of 280 patients enrolled in this study were asked to complete the CL-PRISS, the positive and negative syndrome scale (PANSS), and the World Health Organization Disability Assessment Schedule (WHO-DAS). Construct and concurrent validity was tested using the confirmatory factor analysis (CFA) and Spearman correlation coefficient, respectively. The reliability of CL-PRISS was tested using Cronbach's α coefficient and the internal correlation coefficient. Results: Confirmatory factor analysis (CFA) analysis demonstrated three major factors in CL_PRISS: the first factor is productive experiences, the second factor is affective-negative, and the third factor experiences. The factor loadings between items and factors ranged from 0.436 to 0.899 (RMSEA = 0.029, TLI = 0.940, CFI = 0.921). The correlation coefficient between the CL_PRISS and PANSS was 0.845, and between the CL-PRISS and WHO-DAS was 0.886. The ICC of the total CL_PRISS was 0.913, and Cronbach's α was 0.903. Conclusion: The Chinese version of the PRISS (CL_PRISS) can be effectively used for assessing the subjective experience of Chinese patients with schizophrenia.

Lipopolysaccharide Preconditioning Restricts Microglial Overactivation and Alleviates Inflammation-Induced Depressive-like Behavior in Mice.

Overactive microglia and severe neuroinflammation play crucial roles in the development of major depressive disorder. Preconditioning with lipopolysaccharide (LPS) provides protection against severe neuroinflammation. However, administering high doses of LPS to mice triggers depressive symptoms. Therefore, the optimal dose of LPS preconditioning needs to be determined by further experiments. LPS preconditioning is an effective agent in anti-inflammation and neuroprotection, but the mechanism by which LPS preconditioning acts in depression remain unclear. This study finds that the anti-inflammation mechanism of low-dose LPS preconditioning is mainly dependent on G-protein-coupled receptor 84 (GPR84). We use low-dose LPS for preconditioning and re-challenged mice or BV2 microglia with high-dose LPS. In addition, RNA-seq is used to explore underlying changes with LPS preconditioning. Low-dose LPS preconditioning reduces the expression of pro-inflammatory mediators and inhibits microglial activation, as well as suppresses the depressive-like behavior when the mice are re-challenged with high-dose LPS. Further investigation reveals that the tolerance-like response in microglia is dependent on the GPR84. Here, we show that low-dose LPS preconditioning can exert anti-inflammation effects and alleviates inflammation-induced depressive-like behavior in mice. As a potential therapeutic target for depression, LPS preconditioning needs to be given further attention regarding its effectiveness and safety.

Validity and reliability of a Chinese language suicide screening questionnaire-observer rating (CL-SSQ-OR) assessment for children/adolescents.

Background: A Suicide Screening Questionnaire-Observer Rating (SSQ-OR) has been used to assess risk of suicide among individuals and to help clinicians identify and rescue individuals attempting suicide. To prevent the risk of suicide in China, a Chinese language SSQ-OR (CL-SSQ-OR) needs to be introduced. Objective: To test the validity and reliability of a CL-SSQ-OR. Method: A total of 250 individuals were enrolled in this study. Each completed a CL-SSQ-OR assessment, Patient Health Questionnaire-9, and the Beck Scale for Suicide Ideation. Confirmatory factor analysis (CFA) was adopted to determine structural validity. Spearman correlation coefficients were adopted to determine criterion validity. An internal correlation coefficient (ICC) was used to test inter-consistency and Cronbach's α coefficient was used to test split-half reliability. Results: CFA was conducted with use of the maximum variance method to evaluate the item results. All of the items received scores >0.40. In addition, good model fit indices were observed for the two-factor structure RMSEA = 0.046, TLI = 0.965, CFI = 0.977. The items' factor loading of the CL-SSQ-OR in the first factor ranged from 0.443 to 0.878. The items' factor loading of the CL-SSQ-OR in the second factor ranged from 0.400 to 0.810. The ICC of the total CL-SSQ-OR was 0.855. Cronbach's α was 0.873. Conclusion: The CL-SSQ-OR described here demonstrates ideal psychometric properties and is found to be a suitable tool for screening Chinese children/adolescents who are at risk of suicide.

Fe Powder Catalytically Synthesized C3N3 toward High-Performance Anode Materials of Lithium-Ion Batteries.

Recently, carbon nitrides and their carbon-based derivatives have been widely studied as anode materials of lithium-ion batteries due to their graphite-like structure and abundant nitrogen active sites. In this paper, a layered carbon nitride material C3N3 consisting of triazine rings with an ultrahigh theoretical specific capacity was designed and synthesized by an innovative method based on Fe powder-catalyzed carbon-carbon coupling polymerization of cyanuric chloride at 260 °C, with reference to the Ullmann reaction. The structural characterizations indicated that the as-synthesized material had a C/N ratio close to 1:1 and a layered structure and only contained one type of nitrogen, suggesting the successful synthesis of C3N3. When used as a lithium-ion battery anode, the C3N3 material showed a high reversible specific capacity up to 842.39 mAh g-1 at 0.1 A g-1, good rate capability, and excellent cycling stability attributed to abundant pyridine nitrogen active sites, large specific surface area, and good structure stability. Ex situ XPS results indicated that Li+ storage relies on the reversible transformation of -C=N- and -C-N- groups as well as the formation of bridge-connected -C=C- bonds. To further optimize the performance, the reaction temperature was further increased to synthesize a series of C3N3 derivatives for the enhanced specific surface area and conductivity. The resulting derivative prepared at 550 °C showed the best electrochemical performance, with an initial specific capacity close to 900 mAh g-1 at 0.1 A g-1 and good cycling stability (94.3% capacity retention after 500 cycles at 1 A g-1). This work will undoubtedly inspire the further study of high-capacity carbon nitride-based electrode materials for energy storage.

Divergent upgrading pathways of sulfones with primary alcohols: nickel-catalyzed α-alkylation under N2 and metal-free promoted ß-olefination in open air.

We report here our findings on the diverse reaction results of sulfones and alcohols. In the presence of NiCl2/P(t-Bu)3 and under a N2 atmosphere, α-C-alkylation of sulfones with alcohols occurs through a borrowing-hydrogen mechanism; when the reaction was carried out in the open air without nickel, the product was not the predicted α,ß-unsaturated sulfone, but the ß-alkenyl sulfone, which is a useful building block in organic synthesis.

Higher benefit-risk ratio of COVID-19 vaccination in patients with schizophrenia and major depressive disorder versus patients with bipolar disorder when compared to controls.

Patients with major psychiatric disorders (MPD) that include schizophrenia (SCH), bipolar disorder (BP), and major depressive disorder (MDD) are at increased risk for coronavirus disease 2019 (COVID-19). However, the safety and efficacy of COVID-19 vaccines in MPD patients have not been fully evaluated. This study aimed to investigate adverse events (AEs)/side effects and efficacy of COVID-19 vaccines in MPD patients. This retrospective study included 2034 patients with SCH, BP, or MDD who voluntarily received either BBIBP-CorV or Sinovac COVID-19 vaccines, and 2034 matched healthy controls. The incidence of AEs/side effects and the efficacy of COIVD-19 vaccinations among the two groups were compared. The risk ratio (RR) of side effects in patients with MPD was 0.60 (95% confidence interval [CI]: 0.53-0.68) after the first dose and 0.80 (95% CI: 0.65-0.99) following the second dose, suggesting a significantly lower risk in the MPD group versus healthy controls. The RRs of AEs did not differ between patients and controls. Notably, fully vaccinated patients exhibited a decreased risk of influenza with or without fever compared with controls (RR=0.38, 95% CI: 0.31-0.46; RR=0.23, 95% CI: 0.17-0.30; respectively). Further subgroup comparisons revealed a significantly lower risk of influenza with fever in MDD (RR=0.13, 95% CI: 0.08-0.21) and SCH (RR=0.24, 95% CI: 0.17-0.34) than BP (RR=0.85, 95% CI: 0.69-1.06) compared to controls. We conclude that the benefit-risk ratio of COVID-19 vaccination was more favorable in SCH or MDD versus BP when compared with controls. These data indicate that COVID-19 vaccines are safe and protective in patients with MPD from COVID-19.

Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders.

There has been limited studies examining treatment-induced heavy menstrual bleeding (HMB) in women with severe mental illnesses. The aim of this study was to examine HMB prevalence and HMB-associated factors in young women (18-34 years old) diagnosed with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia (SCZ) who have full insight and normal intelligence. Eighteen-month menstruation histories were recorded with pictorial blood loss assessment chart assessments of HMB. Multivariate analyses were conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Drug effects on cognition were assessed with the MATRICS Consensus Cognitive Battery (MCCB). HMB prevalence were: BP, 25.85%; MDD, 18.78%; and SCH, 13.7%. High glycosylated hemoglobin (HbA1c) level was a strong risk factor for HMB [BP OR, 19.39 (16.60-23.01); MDD OR, 2.69 (4.59-13.78); and SCZ OR, 9.59 (6.14-12.43)]. Additional risk factors included fasting blood sugar, 2-h postprandial blood glucose, and use of the medication valproate [BP: OR, 16.00 (95%CI 12.74-20.22); MDD: OR, 13.88 (95%CI 11.24-17.03); and SCZ OR, 11.35 (95%CI 8.84-19.20)]. Antipsychotic, antidepressant, and electroconvulsive therapy use were minor risk factors. Pharmacotherapy-induced visual learning impairment was associated with HMB [BP: OR, 9.01 (95%CI 3.15-13.44); MDD: OR, 5.99 (95%CI 3.11-9.00); and SCZ: OR, 7.09 (95%CI 2.99-9.20)]. Lithium emerged as a protective factor against HMB [BP: OR, 0.22 (95%CI 0.14-0.40); MDD: OR, 0.30 (95%CI 0.20-0.62); and SCZ: OR, 0.65 (95%CI 0.33-0.90)]. In SCZ patients, hyperlipidemia and high total cholesterol were HMB-associated factors (ORs, 1.87-2.22). Psychiatrist awareness of HMB risk is concerningly low (12/257, 2.28%). In conclusion, prescription of VPA should be cautioned for women with mental illness, especially BP, and lithium may be protective against HMB.

Metabolic risk factors of cognitive impairment in young women with major psychiatric disorder.

Background: Cognitive performance improves clinical outcomes of patients with major psychiatric disorder (MPD), but is impaired by hyperglycemia. Psychotropic agents often induce metabolism syndrome (MetS). The identification of modifiable metabolic risk factors of cognitive impairment may enable targeted improvements of patient care. Objective: To investigate the relationship between MetS and cognitive impairment in young women with MPD, and to explore risk factors. Methods: We retrospectively studied women of 18-34 years of age receiving psychotropic medications for first-onset schizophrenia (SCH), bipolar disorder (BP), or major depressive disorder (MDD). Data were obtained at four time points: presentation but before psychotropic medication; 4-8 and 8-12 weeks of psychotropic therapy; and enrollment. MATRICS Consensus Cognitive Battery, (MCCB)-based Global Deficit Scores were used to assess cognitive impairment. Multiple logistic analysis was used to calculate risk factors. Multivariate models were used to investigate factors associated with cognitive impairment. Results: We evaluated 2,864 participants. Cognitive impairment was observed in 61.94% of study participants, and was most prevalent among patients with BP (69.38%). HbA1c within the 8-12 week-treatment interval was the most significant risk factor and highest in BP. Factors in SCH included pre-treatment waist circumference and elevated triglycerides during the 8-12 weeks treatment interval. Cumulative dosages of antipsychotics, antidepressants, and valproate were associated with cognitive impairment in all MPD subgroups, although lithium demonstrated a protect effect (all P < 0.001). Conclusions: Cognitive impairment was associated with elevated HbA1c and cumulative medication dosages. Pre-treatment waist circumference and triglyceride level at 8-12 weeks were risk factors in SCH. Monitoring these indices may inform treatment revisions to improve clinical outcomes.

The moderating effect of cultural intelligence between nurses' relationship conflict and teamwork.

AIMS: To determine if there is a moderating effect of cultural intelligence between the conflict of nursing relationships and teamwork. BACKGROUND: Relationship conflicts that exist in the nursing teamwork cannot be ignored. It would lead to poor teamwork and impact on patients' poor outcomes. In the meantime, cultural intelligence has been proven that people who have a higher cultural intelligence can do better at the work. METHODS: The sample included 550 clinic nurses from five different hospitals in Shanghai. The Cultural Intelligence Scale, the Relationship Conflict Scale, and the Nursing Teamwork Survey Scale were used to investigate. Through the Johnson-Neyman method and SPSS Process Macro, the moderating effect of cultural intelligence was analysed. RESULTS: The findings showed that cultural intelligence was founded to be significant (b = 2.03, p < 0.01). When the cultural intelligence score is greater than or equal to 90.8, the relationship conflict between nurses will not affect teamwork. CONCLUSIONS: The findings of this study may provide data to improve nurses' performance in team cooperation. IMPLICATION FOR NURSING MANAGEMENT: Nursing managers should pay attention to the construction of the nurse's cultural intelligence. Nursing managers should guide nurses in daily work to continuously develop their own cultural intelligence. Enable nurses to effectively transfer social skills from one culture to another, and improve teamwork skills.

Treatment of Fracture of the Calcaneus via Bone Axial X-Ray Image-Based Minimally Invasive Approach.

To discuss the values of two bone axial X-ray image-based minimally invasive approach surgeries in the diagnosis and treatment of fracture of the calcaneus, 80 patients diagnosed with fracture of the calcaneus by bone axial X-ray examination were selected and divided equally into the minimally invasive longitudinal approach (MILA) group (40 cases) and the sinus tarsal approach (STA) group (40 cases). Besides, the duration of operation, the incidence of complications, the time-to-start weight training, and the American Orthopaedic Foot and Ankle Society (AOFAS) foot function scoring system between the patients in the two groups were compared. The results showed that the duration of operation and incidence of complications among the patients in the MILA group (42.87 ± 5.12 minutes, 20%) were both superior to those among the patients in the STA group (60.43 ± 7.31 minutes, 32.5%). The time-to-start weight training in the MILA group was 5.2 weeks, which was obviously shorter than that in the STA group (5.7 weeks). The difference in AOFAS scores between the two groups was not significant. The walking pavement score in the MILA group (4.2 ± 0.37 points) was slightly higher than that in the STA group (3.3 ± 0.45 points), and the differences demonstrated statistical meaning (P < 0.05). To sum up, the bone axial X-ray image is an essential examination method of diagnosing fracture of the calcaneus. The two minimally invasive methods both showed good clinical therapeutic effects. The operation of MILA was relatively shorter with fewer complications and is worthy of being promoted as an effective treatment method of fracture of the calcaneus.

The effect of ambient temperature on in-hospital mortality: a study in Nanjing, China.

To reduce the inpatient mortality and improve the quality of hospital management, we explore the relationship between temperatures and in-hospital mortality in a large sample across 10 years in Nanjing, Jiangsu. We collected 10 years' data on patient deaths from a large research hospital. Distributed lag non-linear model (DLNM) was used to find the association between daily mean temperatures and in-hospital mortality. A total of 6160 in-hospital deaths were documented. Overall, peak RR appeared at 8 °C, with the range of 1 to 20 °C having a significantly high mortality risk. In the elderly (age ≥ 65 years), peak RR appeared at 5 °C, with range - 3 to 21 °C having a significantly high mortality risk. In males, peak RR appeared at 8 °C, with the range 0 to 24 °C having a significantly high mortality risk. Moderate cold (define as 2.5th percentile of daily mean temperatures to the MT), not extreme temperatures (≤ 2.5th percentile or ≥ 97.5th percentile of daily mean temperatures), increased the risk of death in hospital patients, especially in elderly and male in-hospital patients.

Correlation between patients' power distance and their willingness to participate in patients' safety: A cross-sectional study.

AIMS: This study aimed to explore the correlation between patient power distance and their willingness to participate in patient safety. BACKGROUND: The positive significance of patient participation in patient safety has been widely recognized worldwide, but in clinical practice, patients' willingness to participate is uneven and lack of initiative. METHODS: This study is a cross-sectional survey of hospitalized patients (n = 660) from six tertiary hospitals in Shanghai. Pearson's correlation analysis analyzed data. RESULTS: Patients have a higher power distance (4.08 ± 0.59). The willingness of patients to participate in patient safety was moderate (3.50 ± 1.03). Pearson's correlation analysis shows that patients' power distance negatively and slightly affected their willingness of participation (r = -.134, p < .001). The perceived authority dimension of patients' power distance has no significant correlation with patients' willingness of participation (p > .05). The emotional communication dimension of patients' power distance negatively affects patients' disease-related willingness (r = -.077, p < .001). The decision-making participation dimension of patients' power distance negatively affects patients' willingness (R = -.201, p < .001). CONCLUSIONS: Medical staff should focus on patients' power distance in medical activities. In addition, appropriate communication methods should be selected according to patients' power distance, so as to help them improve their willingness of participation. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should educate nurses on the knowledge of power distance and its importance. By evaluating patients' power distance, humanistic care and meticulous communication are implemented to encourage patients to actively participate in patient safety.