When and how does the practice environment most benefit the job outcomes of newly graduated nurses?

BACKGROUND: Providing a favourable practice environment has been regarded as an essential to improve the job outcomes of newly graduated nurses (NGNs). However, little is known about how and when NGNs can best utilize their practice environment to produce optimal job outcomes. AIM: The aim of this study, which is based on the Conservation of Resources Theory and the Social Cognitive Model of Career Self-Management, is to investigate whether NGNs who have a higher level of personal growth initiative are more likely to benefit from their practice environment and achieve better job outcomes by increasing their occupational self-efficacy. DESIGN: A cross-sectional study. METHODS: From 1 September 2022, to 30 September 2022, 279 NGNs from five Chinese state-owned hospitals were recruited for this study. The participants completed measures of practice environment, personal growth initiative, occupational self-efficacy, job stress, job satisfaction, turnover intention and quality of care. A descriptive analysis and a moderated mediation model were computed. Reporting adhered to the STROBE statement. RESULTS: The influence of the practice environment on job outcomes was significantly mediated by occupational self-efficacy, with personal growth initiative acting as a moderator of this mediation effect. CONCLUSIONS: NGNs who exhibited a higher degree of personal growth initiative were more likely to derive benefits from their practice environment and attain positive job outcomes by enhancing their occupational self-efficacy. To boost NGNs' occupational self-efficacy and achieve optimal job outcomes, hospital administrators may not only provide a supportive practice environment for them but also conduct interventions that promote their personal growth initiative. NO PATIENT OR PUBLIC CONTRIBUTION: This study was designed to examine the psychosocial factors associated with NGNs' job outcomes. The study was not conducted using suggestions from the patient groups or the public. IMPACTS: Our findings indicate that favourable practise contexts may not always benefit the nursing job outcome if NGNs do not exhibit a high level of personal growth initiative and produce increased occupational self-efficacy. Therefore, hospital administrators should consider implementing an intervention to improve the personal growth initiative of NGNs so that they can take full advantage of the practice environment and gain resources at work to create optimal job outcomes.

The Predictive Value of Inter Arm Blood Pressure Difference, Inter Leg Blood Pressure Difference and Ankle Brachial Index for Acute Aortic Dissection.

Introduction: Abnormal inter arm systolic blood pressure, inter leg systolic blood pressure and ankle brachial index (ABI) are related to vascular diseases. Our aim was to evaluate the correlation of inter arm systolic blood pressure difference (IASBPD), inter leg systolic blood pressure difference (ILSBPD), and ABI with acute aortic dissection (AAD) and their role in predicting AAD. Methods: In this prospective case-control study, 180 patients with AAD admitted to the emergency department were prospectively and consecutively collected in Tongji Hospital from October 2019 to December 2020. 180 healthy people matched by sex, age and BMI served as control group. All participants were adults over 18 years of age who underwent four-limb blood pressure measurements. IASBPD, ILSBPD and ABI were compared between the two groups and their associations with AAD were analyzed. Results: A total of 360 patients (180 cases and 180 controls) were analyzed. In case group IASBPD was larger [(15.23 ± 16.15) mm Hg vs. (4.19 ± 3.63) mm Hg] and ILSBPD was larger (13.00 mm Hg vs. 5.70 mm Hg). ABI was smaller [(0.98 ± 0.24) vs. (1.12 ± 0.09)], and the difference was statistically significant (all p < 0.05). According to the receiver operating characteristic curve (ROC), IASBPD ≥ 10 mm Hg (Sen 61.7%, Spe 88.9%), ILSBPD ≥ 13 mm Hg (Sen 50.6%, Spe 80.6%) and ABI ≤ 0.9 (Sen 53.3%, Spe 87.2%), showed significant correlation with AAD (all p < 0.001). Conclusions: Compared with healthy people, IASBPD and ILSBPD levels were higher and ABI levels were lower in patients with AAD. IASBPD ≥ 10 mm Hg and ILSBPD ≥ 13 mm Hg can be used as indicators for early screening of AAD, and IASBPD ≥ 10 mm Hg has better predictive value for the occurrence of AAD. In patients with typical chest pain, attention needs to be paid to measuring blood pressure in the extremities.

Values and preferences of health care professionals, policy-makers, patients and family members regarding recommendations of adapted physical restraint guidelines in critical care: A survey research.

BACKGROUND: The values and preferences of stakeholders are crucial in the development of guidelines. AIM: The aim of this study was to investigate stakeholders' values and preferences regarding draft recommendations for adapted physical restraint guidelines in China. STUDY DESIGN: This survey research was carried out at four university-affiliated comprehensive hospitals based in the eastern, central, western, and north eastern zones of China from January 5-30, 2022. A 48-item self-report questionnaire was distributed, and values and preferences were assessed on a 10-point Likert scale. One-way ANOVA was used to compare values and preference scores among stakeholders. As effect-size measures, partial η2 and Cohen's f values are reported for ANOVA results. RESULTS: A total of 1155 stakeholders were enrolled in the study. The mean value and preference scores were higher than seven for 46 draft recommendations. There was either no significant difference in the values and preferences of the stakeholders for the draft recommendations or there was a significant difference (p values ranged from <0.001 ∼ .048), but the effect size was small or very small (partial η2 value ranged from 0.011 ∼ .044; Cohen's f value ranged from 0.101 ∼ .214). The mean scores of patients for items related to cyber therapy and early tracheotomy were 6.84 and 6.60, respectively, which were lower than those of family members, policy-makers, and health care professionals and were statistically significant (p < 0.001). The partial η2 and Cohen's f values of the effect size were 0.083/0.062 and 0.302/0.256, respectively, which indicated that the differences were moderate. CONCLUSION: These recommendations were in line with the values and preferences of stakeholders. Patients were more supportive of implementing cyber therapy or hypnosis for pain management but did not support early tracheotomy to reduce the duration of mechanical ventilation. Guideline panels could use value and preference information to revise and endorse recommendations of adapted physical restraint guidelines in critical care. RELEVANCE TO CLINICAL PRACTICE: Practitioners should implement recommendations based on the values and preferences of stakeholders.

Attitudes and behavioral intentions of aortic dissection survivors towards exercise: an application of the health action process approach framework.

BACKGROUND: Exercise can help patients with aortic dissection (AD) control blood pressure, prevent further progression of AD, promote mental health, improve the prognosis of cardiovascular disease, and improve their overall quality of life. However, it is not clear what the attitudes and behavioral intentions of AD survivors are towards exercise. METHODS: This exploratory qualitative research was based on the Health Action Process Approach (HAPA) theory to explore the cognition, attitude, motivational factors, behavior intention, barriers and facilitators of exercise in patients with AD. Face-to-face and telephone semi-structured interviews were conducted in 24 AD patients from the Department of Cardio-Vascular Surgery of third-grade Class A hospitals in Wuhan, China from April 2021 to June 2021. The patient's current stage of behavior was evaluated according to the Patient-Centered Assessment and Counseling for Exercise (PACE) questionnaire. RESULTS: Among the 24 participants interviewed, 9 (37.5%) were in the pre-intention stage, 8 (33.3%) were in the intention stage, and 7 (29.2%) were in the action stage. The three groups were significantly different in terms of their history of previous cardiac surgery (Fisher's exact test, p = 0.043) and in the type of interview conducted (Fisher's exact test, p < 0.001). In-patients with a history of cardiac surgery were more likely to be in the pre-intention stage (post-hoc test, p < 0.05). Patients from different stages had different structures. AD patients in the pre-intention stage were more likely to express risk perception and negative results for exercise. The self-efficacy of this group was often low, and lacked exercise intention and clear action plans (post-hoc test, p < 0.05). CONCLUSIONS: More attention should be paid to in-patients with a history of cardiac surgery, including health advice on exercise after discharge and promotion of changes in their health behavior. Guidelines based on the available exercise data in AD patients should be established to provide recommendations for individualized exercise programs. This should provide a basis for promoting patient rehabilitation and improving postoperative quality of life.

Developing an Exercise Attitudes and Behavior Intentions Questionnaire for Survivors of Aortic Dissection: An Exploratory Factor Analysis.

Purpose: Our study aimed to develop a questionnaire to assess the reliability and validity of exercise attitudes and behavior intentions among survivors of an aortic dissection (AD). Methods: There were two phases to the study between April 2021 and April 2022. Phase I involved the development of an initial version of the Exercise Attitudes and Behavior Intentions Questionnaire (EABIQ) through literature reviews, qualitative interviews, Delphi expert consultations and a pre-experimental study. During Phase II, the reliability and validity of the questionnaire was assessed in 160 survivors with AD. Results: A 62-item EABIQ for AD survivors was developed. Eleven common components with eigenvalues larger than 1 were identified by exploratory factor analysis. The scale's variance explained cumulatively rate was 75.216%. The content validity index at the item level for the EABIQ varied from 0.813 to 1.000 and the S-CVI/Ave was 0.934. The correlation coefficients between each scale dimension and the overall scale ranged from 0.405 to 0.785, with all p-values less than 0.05. Cronbach's alpha for the whole scale was 0.929, with Cronbach's alpha for each domain ranging from 0.835 to 0.965. The overall scale split-half reliability coefficient was 0.960, with each domain's split-half reliability coefficient ranging from 0.844 to 0.962. Conclusions: The AD exercise attitudes and behavior intentions questionnaire has high reliability and validity and is generally consistent with the hypothetical theoretical framework. It can be used as a judgment tool to measure the exercise behavior for AD patients.

Preliminary evaluation of the Chinese version of the patient-reported outcomes measurement information system 29-item profile in patients with aortic dissection.

BACKGROUND: The Patient-Reported Outcomes Measurement Information System 29-item Profile (PROMIS-29) has been widely used to measure health outcomes from the patient's perspective. It has not been validated in adults with aortic disease. The aim of this study was to explore the reliability and validity of the Chinese PROMIS-29 among patients undergoing surgery for aortic dissection (AD). METHODS: A cross-sectional design was applied. Eligible patients completed a questionnaire that contained the PROMIS-29 and legacy measures, including the Short Form-12 Health Survey (SF-12), 8-item Somatic Symptom Scale (SSS-8), Generalized Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire-2 (PHQ-2). The structural validity of the PROMIS-29 was evaluated using confirmatory factor analysis (CFA). Reliability was evaluated with Cronbach's α. Construct validity was assessed by calculating Spearman's rank correlations and comparing known-group differences. RESULTS: In total, a sample of 327 AD patients was included in the final analysis. Most of them were male (89%) with a mean age of 52.7 (± 10.3). CFA revealed good model fit of the seven-factor structure within PROMIS-29, as well as most domains in single-factor analysis. Reliability was confirmed with Cronbach's α > 0.90. Correlations between comparable domains of the PROMIS-29 and those of legacy questionnaires and most know-group comparisons were observed as hypothesized. CONCLUSIONS: This study found evidence for acceptable structural validity, construct validity and internal consistency of the PROMIS-29 in a sample of AD patients. It can be applied to AD survivors by researchers or clinicians, measuring outcomes after surgery and identifying those with worse health status.

A scoping review of exercise-based cardiac rehabilitation for patients with aortic dissection.

Our objective was to provide evidence for exercise-based cardiac rehabilitation (ECR) for patients with aortic dissection (AD), so as to better improve the prognosis of patients and improve the quality of life (QoL) after discharge. The database PubMed, Embase, MEDLINE, Web of Science, Cochrane Library, WanFang Chinese database, ZhiWang Chinese database, Chinese Clinical Trials Registry from establishment of each database until February 2021 were included. A total of 1684 records were found by searching the database and clinical trial registry, 178 duplicate records were deleted, and 11 records met the inclusion criteria according to the screening process. We can conclude that ECR for patients with AD can effectively reduce complications and shorten the course of the disease. In addition, it is very safe because there are no serious adverse events occurring. Further research should be developed from three aspects, including the development of systematic evaluation indicators and standardized clinical exercise rehabilitation pathway, more randomized controlled trials, and the development of individualized exercise program so as to help patients with AD better improve the prognosis and QoL.

How to rapidly convert general wards to ICUs during the COVID-19 epidemic: Experience from Wuhan, China.

BACKGROUND: Critically ill patients with coronavirus disease 2019 (COVID-19) were surging and far outnumbered existing beds. AIMS: To describe how to rapidly convert general wards to intensive care units for critically ill patients with COVID-19. MATERIALS AND METHODS: Comprehensive assessment and analysis of available resources and standard requirements. RESULTS: The ICUs were successfully assembled in 4 days. The conversion included environment reconstruction, configuration and management of equipment, information system construction and human resource allocation. A total of 172 critically ill patients had been admitted to the contemporary ICUs and none medical staff was infected. DISCUSSION: The epidemic situation of COVID-19 poses a great challenge to various management departments of the hospital, especially for critically ill patients with a high mortality rate. To save more critically ill patients, the conversion of a general ward to a quarantine ICU ward must be completed in a short time, and the optimal allocation of resources must be appropriate to ensure that the medical team works effectively and is of high quality. In face of the overloaded medical system, the ideal non-negative pressure ward is hard to achieve. However, we have demonstrated with evidence that our conversions are effective in both providing care to critical patients and protecting the safety of our staff. CONCLUSION: The conversion is successful and the running experience would be a reference for hospitals in other areas nationally or globally.

Monitoring and Management of Home-Quarantined Patients With COVID-19 Using a WeChat-Based Telemedicine System: Retrospective Cohort Study.

BACKGROUND: Most patients with coronavirus disease (COVID-19) who show mild symptoms are sent home by physicians to recover. However, the condition of some of these patients becomes severe or critical as the disease progresses. OBJECTIVE: The aim of this study was to evaluate a telemedicine model that was developed to address the challenges of treating patients with progressive COVID-19 who are home-quarantined and shortages in the medical workforce. METHODS: A telemedicine system was developed to continuously monitor the progression of home-quarantined patients with COVID-19. The system was built based on a popular social media smartphone app called WeChat; the app was used to establish two-way communication between a multidisciplinary team consisting of 7 medical workers and 188 home-quarantined individuals (including 74 confirmed patients with COVID-19). The system helped patients self-assess their conditions and update the multidisciplinary team through a telemedicine form stored on a cloud service, based on which the multidisciplinary team made treatment decisions. We evaluated this telemedicine system via a single-center retrospective study conducted at Tongji Hospital in Wuhan, China, in January 2020. RESULTS: Among 188 individuals using the telemedicine system, 114 (60.6%) were not infected with COVID-19 and were dismissed. Of the 74 confirmed patients with COVID-19, 26 (35%) recovered during the study period and voluntarily stopped using the system. The remaining 48/76 confirmed patients with COVID-19 (63%) used the system until the end of the study, including 6 patients whose conditions progressed to severe or critical. These 6 patients were admitted to hospital and were stabilized (one received extracorporeal membrane oxygenation support for 17 days). All 74 patients with COVID-19 eventually recovered. Through a comparison of the monitored symptoms between hospitalized and nonhospitalized patients, we found prolonged persistence and deterioration of fever, dyspnea, lack of strength, and muscle soreness to be diagnostic of need for hospitalization. CONCLUSIONS: By continuously monitoring the changes in several key symptoms, the telemedicine system reduces the risks of delayed hospitalization due to disease progression for patients with COVID-19 quarantined at home. The system uses a set of scales for quarantine management assessment that enables patients to self-assess their conditions. The results are useful for medical staff to identify disease progression and, hence, make appropriate and timely treatment decisions. The system requires few staff to manage a large cohort of patients. In addition, the system can solicit help from recovered but self-quarantined medical workers to alleviate shortages in the medical workforce and free healthy medical workers to fight COVID-19 on the front line. Thus, it optimizes the usage of local medical resources and prevents cross-infections among medical workers and patients.

Evaluating a Nurse Training Program in the Emergency Surgery Department Based on the Kirkpatrick's Model and Clinical Demand During the COVID-19 Pandemic.

Objective:To analyze the application of Kirkpatrick's model in the nurse training program among the emergency surgery department based on clinical demand during the COVID-19 (coronavirus disease-2019). To provide reference for the training of emergency surgical nurses during the outbreak of COVID-19.Design:Guided by Kirkpatrick's model, 35 nurses in the emergency surgery department were trained according to a program that resulted from the clinical demand during the pandemic. The trainees were observed in terms of their performance at reaction level and learning level.Results:At reaction level, the degree of satisfaction scored by nurses was relatively high, with its total score achieving (18.77 ± 3.09). At learning level, the differences between theoretical and operational scores of tested nurses before and after training proved to be statistically significant (p < 0.001).Conclusion:The application of Kirkpatrick's model based on clinical demand during the COVID-19 confirms to be effective for the training program of nurses in the emergency surgery department. It is also beneficial to improve nurses' knowledge and skills during the pandemic, which serves as a positive influence for clinical reference.

The Distance Teaching Practice of Combined Mode of Massive Open Online Course Micro-Video for Interns in Emergency Department During the COVID-19 Epidemic Period.

Objective:To observe and analyze the application effect of the combined mode of Massive Open Online Course (MOOC) micro-video during the COVID-19 epidemic period in the distance teaching practice of interns in the emergency department.Materials and Methods:The subjects of this study were 60 trainee nurses who conducted emergency nursing practice in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 1 to February 29, 2020. At the time of the COVID-19 outbreak in Wuhan, they were divided into two groups: (1) the experimental group (combined mode of MOOC micro-video) and (2) the control group (traditional theory teaching combined with clinical practice teaching). The differences of theoretical and practical examination scores and teaching satisfaction between the two groups were compared.Results:There was no significant difference in theoretical, practical, and total examination scores between the two groups, but in terms of teaching satisfaction, the overall satisfaction, the degree of easy understanding, the evaluation of teachers and learning results in the experimental group were higher than those in the control group, with statistical difference (p < 0.05).Conclusion:Compared with the traditional teaching methods, the effect of combined mode of MOOC micro-video in emergency nursing practice is the same as that of traditional teaching methods, but the satisfaction is higher, so it is more suitable to be used in nursing practice during the COVID-19 epidemic period, so as to effectively reduce the cross-infection between doctors, nurses, and teaching staff.

Implications for Online Management: Two Cases with COVID-19.

Satisfactory outcome was observed in one mild case and one severe case of COVID-19 pneumonia after the use of the online/offline multidisciplinary quarantine observation form, online monitoring, and classified diagnosis and treatment, as well as strict compliance with quarantine measures. Conditions of both patients were improved, and cross-infection and disease onset clustering were not observed. The multidisciplinary self-quarantine model provides early judgment, identification, and treatment of disease, improves compliance with early rehabilitation, increases confidence in recovery, and enhances self-management capabilities. This model is applicable to the current novel coronavirus pneumonia epidemic and can actively promote the management of suspected or confirmed mild cases, monitoring of critical cases, and self-management of discharged patients. The application of this new management model is worthy of being promoted in our specialized treatment facilities and in countries with severe epidemics.

Improving adherence to facility protocol and reducing blood culture contamination in an intensive care unit: A quality improvement project.

BACKGROUND: Blood culture contamination (BCC) is a safety and quality indicator for intensive care units (ICUs). BCC rates in our ICU ranged from 2.90% to 6.70% in 2017. OBJECTIVE: This quality improvement project aimed to reduce the contamination rate from a mean of 4.52% to <3.0% in 1 year by improving the adherence of nurses to the facility protocol during blood collection. METHODS: This project used a before-after design. It was conducted by a leadership team in a 32-bed ICU where approximately 4000 cultures are drawn annually. We observed the performance of ICU nurses during blood collection, interviewed them regarding the difficulties they encountered with protocol adherence, and conducted a cause-and-effect analysis to identify the main problems. Based on a literature review, we developed and implemented a countermeasure protocol, including a standardised medical order, an online learning program, a weekly departmental report and individual feedback routine, and phlebotomy training to address these problems in 2 months. RESULTS: The interview results indicated that blood contamination resulted from the environment, difficult phlebotomy, and the inadequate knowledge and skill of the nurses. The countermeasure protocol reduced the average BCC rate from 4.52% to 2.59% during the intervention period and to 0.59% during the 10-month postintervention period. Nursing adherence to the standard protocol for blood culture collection also improved. CONCLUSIONS: BCC in ICUs is multifactorial. By optimising the work environment, offering skill training, and reinforcing education and individualised feedback, we successfully reduced BCC in our unit to a sustainable low rate.

Insecticides induce the co-expression of glutathione S-transferases through ROS/CncC pathway in Spodoptera exigua.

Glutathione S-transferases (GSTs) are a family of multifunctional enzymes that are involved in detoxification of electrophilic toxic compounds. Although the co-induced expression of GST genes by insecticides in insects has been documented in recent years, the underlying regulatory mechanisms are not understood. In this study, a total of thirty-one cytosolic S. exigua GSTs (SeGSTs) was cloned and identified. The bioinformatics and gene expression patterns were also analyzed. Out of them, SeGSTe9, SeGSTs6, SeGSTe1, SeGSTe6, SeGSTe8, SeGSTe14, and SeGSTd1 were significantly co-expressed following exposure to three insecticides (lambda-cyhalothrin, chlorpyrifos and chlorantraniliprole). The analysis of upstream sequences revealed that all of these seven SeGSTs harbored CncC/Maf binding site. The luciferase reporter assay showed that the pGL3-SeGST promoter construct exhibited a significant increase in luciferase activities after exposure to insecticides, and mutation of CncC/Maf binding site diminish the induction effect. These data indicate that CncC/Maf pathway regulates the co-expression of GST genes in response to different insecticides in S. exigua. Insecticides significantly enhanced the ROS content and treatment with the ROS inhibitor N-acetylcysteine (NAC) decreased the insecticide-induced luciferase activities of the PGL3-GSTe6 promoter construct, but not the CncC-mutated construct. These results indicate that ROS mediates GST gene expression after exposure to insecticides through CncC/Maf pathway. Overall, these data show that insecticides induce the co-expression of glutathione S-transferases through the ROS/CncC pathway in S. exigua.

Mobile Phone Training Platform for the Nursing Staff in the Emergency Department.

BACKGROUND: Continuous education is required for nursing staff, but continuous education can be complicated for nurses working shifts, such as those in the emergency department (ED). INTRODUCTION: To explore the effectiveness of the ED Training Platform of Tongji Hospital for conventional continuing education of emergency nurses. The training completion rate and training outcomes were validated. MATERIALS AND METHODS: This was a retrospective study of all in-service emergency nurses working at the Tongji Medical College of Huazhong University of Science and Technology between August 2016 and August 2017. The training results of the previous year of the same group were used as controls. The platform used was an online system called JikeXuetang ( www.jkxuetang.com/ ), using the WeChat application as a carrier. The training completion rate and pass rate were compared with the control data. RESULT: Among 124 nurses, the training completion rate increased from <60% to 100%, and the passing rate was 100%. Among 121 nurses, 92.5% considered that the mobile phone platform was more convenient than conventional training course; 89.7% believed it as an effective tool of learning, and intended to join public courses after completion; and 63.4% nurses expressed the wish to receive push services once or twice weekly for training course. CONCLUSION: The outcome of emergency nurse training was improved using the mobile training platform. This approach was more feasible and easier for training.

[Efficacy of photodynamic antimicrobial therapy for wound flora and wound healing of pressure sore with pathogen infection].

OBJECTIVE: To explore the efficacy of photodynamic antimicrobial therapy in the treatment of pressure sore with pathogen infection. METHODS: A total of 42 pressure sore patients with pathogen infection were divided randomly into experimental and control groups (n = 21 each). Fufanghuangbai liquid was used for external application with control group. In the experimental group, wound was treated with Fufanghuangbai liquid wet dressing and irradiated by semiconductor laser 30 min late. The distance from semiconductor laser probe to wound site was 10-15 cm, 20 min twice daily, continuous exposure to 7 days for 1 course. The results of bacterial culture and epidermal growth factor (EGF) expression of wound granulation tissue were observed before and after treatment. And the changes of healing rate of pressure sore were measured at post-treatment in each group. RESULTS: The positive rates of bacterial culture, rates of change around wound inflammation, healing rate of days 7 and 14, the high expression of EGF on healing wound granulation tissue was 9.75%, (32.2% ± 5.8%), (89.1% ± 5.6%), (12.4% ± 2.9%), (34.7% ± 3.6%), 14/21 in the treatment group versus 51.2%, (17.8% ± 2.0%), (57.3% ± 2.6%), (5.1% ± 1.1%), (10.5% ± 2.4%), 2/21 in the control group respectively. The inter-group differences were statistically significant (P < 0.05). CONCLUSION: Photodynamic antimicrobial therapy is an effective method for pressure sore with pathogen infection. Wound healing is promoted through an up-regulation of EGF.

Unraveling wheat's response to salt stress during early growth stages through transcriptomic analysis and co-expression network profiling.

BACKGROUND: Soil salinization is one of the vital factors threatening the world's food security. To reveal the biological mechanism of response to salt stress in wheat, this study was conducted to resolve the transcription level difference to salt stress between CM6005 (salt-tolerant) and KN9204 (salt-sensitive) at the germination and seedling stage. RESULTS: To investigate the molecular mechanism underlying salt tolerance in wheat, we conducted comprehensive transcriptome analyses at the seedling and germination stages. Two wheat cultivars, CM6005 (salt-tolerant) and KN9204 (salt-sensitive) were subjected to salt treatment, resulting in a total of 24 transcriptomes. Through expression-network analysis, we identified 17 modules, 16 and 13 of which highly correlate with salt tolerance-related phenotypes in the germination and seedling stages, respectively. Moreover, we identified candidate Hub genes associated with specific modules and explored their regulatory relationships using co-expression data. Enrichment analysis revealed specific enrichment of gibberellin-related terms and pathways in CM6005, highlighting the potential importance of gibberellin regulation in enhancing salt tolerance. In contrast, KN9204 exhibited specific enrichment in glutathione-related terms and activities, suggesting the involvement of glutathione-mediated antioxidant mechanisms in conferring resistance to salt stress. Additionally, glucose transport was found to be a fundamental mechanism for salt tolerance during wheat seedling and germination stages, indicating its potential universality in wheat. Wheat plants improve their resilience and productivity by utilizing adaptive mechanisms like adjusting osmotic balance, bolstering antioxidant defenses, accumulating compatible solutes, altering root morphology, and regulating hormones, enabling them to better withstand extended periods of salt stress. CONCLUSION: Through utilizing transcriptome-level analysis employing WGCNA, we have revealed a potential regulatory mechanism that governs the response to salt stress and recovery in wheat cultivars. Furthermore, we have identified key candidate central genes that play a crucial role in this mechanism. These central genes are likely to be vital components within the gene expression network associated with salt tolerance. The findings of this study strongly support the molecular breeding of salt-tolerant wheat, particularly by utilizing the genetic advancements based on CM6005 and KN9204.

Application Effect of Humanistic Care Time Checklist on Nursing Quality of ICU Patients.

Background: We aimed to explore the effect of humanistic care time checklist on nursing quality of intensive care unit (ICU) patients. Methods: Overall, 230 patients hospitalized in ICU of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China from June 2018 to May 2019 were included in this retrospective study. Overall, 115 patients were included in the control group. Another 115 patients were included in the observation group. The nurses communicated routinely with the patients in the control group, and communicated with the patients in the observation group according to the self-designed humanistic care time checklist. The results of the implementation of humanistic care measures were evaluated by "ICU patients' humanistic care time satisfaction questionnaire". Results: The satisfaction of humanistic care in the observation group was significantly higher than that in the control group (P<0.05). Conclusion: Communication between nurses and patients according to the requirements of humanistic care time checklist can improve patients' satisfaction with nursing care.

Developing a core competency training curriculum system for emergency trauma nurses in China: a modified Delphi method study.

OBJECTIVES: To develop a core competency training curriculum system for emergency trauma nurses in China. DESIGN: A modified Delphi study design. PARTICIPANTS: The selection criteria for participants identified in practitioner roles were to be currently engaged in trauma care for over 5 years, to serve as the manager of emergency or trauma surgery department, and to have a bachelor's degree or higher. A total of 15 trauma experts from three grade A tertiary hospitals were invited to participate in this study by email or face to face in January 2022. The expert group comprised four trauma specialist doctors and 11 trauma specialist nurses. There were 11 women and 4 men. The age ranged from 32 to 50 (40.27±5.120) years. The number of years worked ranged from 6 to 32 (15.87±7.110). RESULTS: Two rounds of questionnaires were issued to 15 experts in each round, and the effective recovery rate was 100.00%. In this study, expert judgement=0.947, expert familiarity with the content=0.807 and authority coefficient=0.877, and the results are highly reliable. The Kendall's W of the two rounds in this study ranged from 0.208 to 0.467, and the difference was statistically significant (p<0.05). In the two rounds of expert consultations, four items were deleted, five items were modified, two items were added and one item was merged. Ultimately, the curriculum system of core competency training for emergency trauma nurses includes training objectives (8 theoretical knowledge and 9 practical skills), training contents (6 first-level indicators, 13 second-level indicators and 70 third-level indicators), training methods (9), evaluation indicators (4) and evaluation methodologies (4). CONCLUSIONS: This study proposed a core competency training curriculum system with systematic and standardised courses for emergency trauma nurses, which could be applied to assess trauma care performance, highlight areas for improvement for emergency trauma nurses and contribute to the accreditation of emergency trauma specialist nurses.

Hotspots and development frontiers of postoperative complications of AD: Bibliometric analysis - a review.

The research on the postoperative complications of aortic dissection (AD) has received great attention from scholars all over the world, and the number of research articles in this field has consistently increased year after year. However, no bibliometric reports have been published yet to analyze the scientific output and the current situation in this field. The Bibliometrix R-package, VOSviewer, and CiteSpace software were used to conduct a bibliometric analysis of the hotspots and development frontiers of AD. A total of 1242 articles were retrieved. The USA, China, and Japan had the highest number of publications. The five keywords with the highest frequency were "analysis," "incidence," "acute type," "graft," and "risk factor." The results also indicated that the research in related fields had shifted from surgical treatment and utilizing experience to the evidence-based exploration of risk factors and the construction of prediction models to help better manage postoperative complications of AD. This is the first bibliometric analysis of global publications on the postoperative complications of AD. The current research hotspots focus on three areas: common postoperative complications of AD, exploration of the related risk factors, and management of complications. Future research could focus on identifying risk factors through meta-analysis and using a multicenter database for AD as well as building relevant models to predict the development of complications to better facilitate the clinical management of AD patients.