The association between anion gap and length of stay in patients undergoing hip fracture surgery: data from the MIMIC-IV database.

OBJECTIVE: To explore the relationship between anion gap (AG) and length of stay (LOS) in patients undergoing hip fracture surgery. METHODS: Clinical data of patients diagnosed with hip fracture and undergoing surgery were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Logistic regression analysis by adjusting different covariables and threshold effect analysis were used to analyze the relationship between AG and LOS. Subgroup analysis and interaction test were also performed to detect their relationship. Receiver Operating Characteristic (ROC) analysis was performed to identify the prediction performance and cutoff value of AG.Kaplan-Meier (KM) survival analysis was used to explore the influence of AG on overall survival. RESULTS: A total of 1508 patients were enrolled and the median LOS was 4.9 days. The correlation between AG and LOS > 7 days was observed among 3 regression models when regarding AG as continuous variables (all OR > 1, all P < 0.05). After stratifying samples with AG quartiles, their relationship was only presented in the Q4 group both in model 1 and model 2 (all P < 0.001). The risk of LOS > 7 days gradually increased with increasing AG quartiles (all P for trend < 0.05). Further, threshold effect analysis found that their association was mainly observed when AG ≥ 14 mEq/L (OR = 1.122, P < 0.001). Subgroup analysis showed that their correlation was not influenced by sex, age, BMI, ethnicity, classification of fracture, therapeutic method, CHD, hypertension, osteoporosis, diabetes and admitted to the ICU (all P for interaction > 0.05). ROC analysis identified 14.5 as the cutoff value of AG for predicted LOS > 7 days. Survival analysis found that patients in the AG < 14.5 group had better overall survival. CONCLUSION: In patients undergoing hip fracture surgery, the AG was positively correlated with LOS, and 14.5 mEq/L AG was the cutoff value for predicting LOS > 7 days. The cutoff value can favorably distinguish the survival difference of patients.

Efficacy and safety of sovleplenib (HMPL-523) in adult patients with chronic primary immune thrombocytopenia in China (ESLIM-01): a randomised, double-blind, placebo-controlled, phase 3 study.

BACKGROUND: Sovleplenib, a novel spleen tyrosine kinase (SYK) inhibitor, showed promising safety and activity in patients with primary immune thrombocytopenia in a phase 1b/2 trial. We aimed to evaluate the efficacy and safety of sovleplenib in patients with chronic primary immune thrombocytopenia. METHODS: This randomised, double-blind, placebo-controlled, phase 3 trial (ESLIM-01) was done in 34 clinical centres in China. Eligible patients, aged 18-75 years, had chronic primary immune thrombocytopenia, an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and received one or more previous treatments. Patients were randomly assigned (2:1) to receive oral sovleplenib or placebo, 300 mg once daily, for 24 weeks. Randomisation was stratified by baseline platelet counts, previous splenectomy, and concomitant treatment for anti-immune thrombocytopenia at baseline. The primary endpoint was durable response rate (proportion of patients with a platelet count of ≥50 × 109/L on at least four of six scheduled visits between weeks 14 and 24, not affected by rescue treatment) assessed by intention-to-treat. The trial is registered with ClinicalTrials.gov, NCT05029635, and the extension, open-label phase is ongoing. FINDINGS: Between Sept 29, 2021, and Dec 31, 2022, 188 patients were randomly assigned to receive sovleplenib (n=126) or placebo (n=62). 124 (66%) were female, 64 (34%) were male, and all were of Asian ethnicity. Median previous lines of immune thrombocytopenia therapy were 4·0, and 134 (71%) of 188 patients had received previous thrombopoietin or thrombopoietin receptor agonist. The primary endpoint was met; durable response rate was 48% (61/126) with sovleplenib compared with zero with placebo (difference 48% [95% CI 40-57]; p<0·0001). The median time to response was 8 days with sovleplenib compared with 30 days with placebo. 125 (99%) of 126 patients in the sovleplenib group and 53 (85%) of 62 in the placebo group reported treatment-emergent adverse events (TEAEs), and most events were mild or moderate. Frequent TEAEs of grade 3 or higher for sovleplenib versus placebo were platelet count decreased (7% [9/126] vs 10% [6/62]), neutrophil count decreased (3% [4/126] vs 0% [0/62]), and hypertension (3% [4/126] vs 0% [0/62]). Incidences of serious TEAEs were 21% (26/126) in the sovleplenib group and 18% (11/62) in the placebo group. There were no deaths in the study. INTERPRETATION: Sovleplenib showed a clinically meaningful sustained platelet response in patients with chronic primary immune thrombocytopenia, with a tolerable safety profile and improvement in quality of life. Sovleplenib could be a potential treatment option for patients with immune thrombocytopenia who received one or more previous therapy. FUNDING: HUTCHMED and Science and Technology Commission of Shanghai Municipality.

Genomic nursing science revealed the prolyl 4-hydroxylase subunit alpha 2 as a significant biomarker involved in osteosarcoma.

Backgrounds: This study aims to explore the clinical value of P4HA2 (prolyl 4-hydroxylase subunit alpha 2) in Osteosarcoma (OSC), and assess its potential to provide directions and clues for the practice of precision nursing. Methods: The GSE73166 and GSE16088 datasets were used to explore the P4HA2 expression in OSC. We then used the clinical data of patients obtaining from TARGET database to assess the prognostic value of P4HA2 in OSC. We also evaluated the predictive value of prognostic model based on P4HA2-related genes. Further, GSEA analysis was performed to explore related pathways. Results: The P4HA2 mRNA expression was higher in OSC than that in normal tissues and other bone cancer samples. Survival analysis found that P4HA2 high expression caused poor overall survival (OS) of patients with OSC and P4HA2 presented a favorable performance for predicting OS. Specifically, P4HA2 high expression statistically influenced the OS of patients with age≥15 years old and those with or without metastasis. Cox regression analysis indicated the independent prognostic value of P4HA2 in OSC, and nomogram analysis revealed its significant contribution to the survival probability of patients. We further established a prognostic model based on P4HA2-related genes, finding that prognostic model had a good prediction ability on OS. These results supported the clinical significance of P4HA2 in OSC. GSEA analysis suggested that P4HA2 was significantly related to the MAPK signaling pathway. In addition, P4HA2-associated natural killer cell-mediated cytotoxicity and T cell receptor signaling pathway were also predicted. Conclusions: This study revealed that P4HA2 can serve as an important prognostic biomarker for OSC patients, and it may become a promising therapeutic target in OSC treatment.

Fluorogenic RNA Aptamer-Based Amplification and Transcription Strategy for Label-free Sensing of Methyltransferase Activity in Complex Matrixes.

DNA methyltransferase is significant in cellular activities and gene expression, and its aberrant expression is closely linked to various cancers during initiation and progression. Currently, there is a great demand for reliable and label-free techniques for DNA methyltransferase evaluation in tumor diagnosis and cancer therapy. Herein, a low-background fluorescent RNA aptamer-based sensing approach for label-free quantification of cytosine-guanine (CpG) dinucleotides methyltransferase (M.SssI) is reported. The fluorogenic light-up RNA aptamers-based strategy exhibits high selectivity via restriction endonuclease, padlock-based recognition, and RNA transcription. By combining rolling circle amplification (RCA), and RNA transcription with fluorescence response of RNA aptamers of Spinach-dye compound, the proposed platform exhibited efficiently ultrahigh sensitivity toward M.SssI. Eventually, the detection can be achieved in a linear range of 0.02-100 U mL-1 with a detection limit of 1.6 × 10-3 U mL-1. Owing to these superior features, the method is further applied in serum samples spiked M.SssI, which delivers a recovery ranging from 92.0 to 107.0% and a relative standard deviation <7.0%, providing a promising and practical tool for determining M.SssI in complex biological matrices.

Sovleplenib (HMPL-523), a novel Syk inhibitor, for patients with primary immune thrombocytopenia in China: a randomised, double-blind, placebo-controlled, phase 1b/2 study.

BACKGROUND: Spleen tyrosine kinase (Syk) inhibitor is a treatment option for primary immune thrombocytopenia. We aimed to evaluate the safety, tolerability, pharmacokinetics, preliminary activity, and recommended phase 2 dose of sovleplenib in patients with primary immune thrombocytopenia. METHODS: This randomised, double-blind, placebo-controlled, phase 1b/2 study was conducted at nine hospitals in China. Eligible patients were aged 18-75 years, had an ECOG performance score of 0-1, had primary immune thrombocytopenia for more than 6 months, and did not respond or relapsed after previous first-line treatment or had poor response or postoperative relapse after a splenectomy. Dose-escalation (100 mg, 200 mg, or 300 mg given orally once a day) and dose-expansion phases (recommended phase 2 dose) each consisted of an 8-week, double-blind, placebo-controlled period in which patients were randomly assigned (3:1) to receive sovleplenib or placebo with an interactive web response system followed by a 16-week, open-label period with sovleplenib. Patients, investigators, and the sponsor were masked to treatment allocation during the first 8 weeks. The main efficacy endpoint was the proportion of patients whose platelet count reached 30 × 109 platelets per L or higher and was double of the baseline at two consecutive visits during 0-8 weeks without rescue therapy. Efficacy was evaluated by intention-to-treat. This study is registered with ClinicalTrials.gov, NCT03951623. FINDINGS: Between May 30, 2019, and April 22, 2021, 62 patients were assessed for eligibility and 45 (73%) were randomly assigned. Patients received at least one dose of the study drug during the 8-week double-blind period (placebo [n=11] and sovleplenib 100 mg [n=6], 200 mg [n=6], 300 mg [n=16], and 400 mg [n=6]; this group was added following the observation of no protocol-specified safety events at the previous doses). All participants were Asian; 18 (40%) of 45 were male and 27 (60%) were female. The median age was 40·0 years (IQR 33·0-50·0). Ten (29%) of 34 patients in sovleplenib groups versus five (45%) of 11 in the placebo group received concomitant anti-primary immune thrombocytopenia therapy. The recommended phase 2 dose was determined as 300 mg once a day. The proportion of patients who met the main efficacy endpoint were three (50%; 95% CI 12-88) in the 100 mg group, three (50%; 12-88) in the 200 mg group, ten (63%; 35-85) in the 300 mg group, and two (33%; 4-78) in the 400 mg group compared with one (9%; 0-41) in the placebo group. The overall response rate in the 300 mg group was 80% (16 of 20 who received continuous sovleplenib plus those who crossed over from placebo) and the durable response rate was 31% (11-59; five of 16) in the continuous sovleplenib 300 mg and 75% (19-99; three of four) crossed from placebo to sovleplenib during 0-24 weeks. During the 28-day safety evaluation period, two grade 2 or worse treatment-related treatment-emergent adverse events occurred in the sovleplenib groups (hypertriglyceridaemia and anaemia). During 0-8 weeks, the most frequent treatment-emergent adverse events were an increase in blood lactate dehydrogenase, haematuria, and urinary tract infection (seven [21%] of 34 in sovleplenib groups vs one [9%] of 11 in the placebo group); and occult blood-positive and hyperuricaemia (four [12%] vs three [27%] for each). No fatal treatment-emergent adverse events were recorded. INTERPRETATION: Sovleplenib was well tolerated, and the recommended phase 2 dose showed a promising durable response in patients with primary immune thrombocytopenia, which provides evidence for future investigations. A phase 3 trial is ongoing (NCT05029635) to confirm the efficacy and safety of sovleplenib in patients with primary immune thrombocytopenia. FUNDING: HUTCHMED.

Effectiveness of health communication courses on professionalism and social media competence among nursing students: A randomized controlled trial.

BACKGROUND: The shaping and cultivation of professionalism of nursing students is very important for the improvement and retention of nursing workers' quality. In the context of social media, it is challenging for nursing students to use social media for health education. Health communication course has the potential to cultivate professionalism and social media competence of nursing students, but its role still needs to be explored. OBJECTIVE: To evaluate the effectiveness of health communication course intervention on improving the professionalism and social media competence of nursing students. DESIGN: A randomized controlled trial. METHODS: The recruited nursing students were randomly divided into the intervention group (N = 50) and the control group (N = 51). The control group received routine nursing education. Intervention group received routine nursing education and health communication education courses. Both groups were required to submit a health communication work on any topic. The Nursing Professionalism Scale、Social Media Self-efficacy Scale and Social Media Experience Scale were used to evaluate the professionalism and social media competence of nursing students. The primary analysis used linear mixed models and followed the intention-to-treat principle. RESULTS: The professionalism, social media self-efficacy and social media experience of students in the two groups were significantly improved, and the improvement of nursing students in the intervention group was higher than that in the control group. After the intervention of health communication course, there were significant differences in professionalism (p < 0.001), social media self-efficacy (p = 0.006) and social media experience (p = 0.013) between the two groups. Social media self-efficacy have an effect on professionalism (ꞵ = 0.22, p < 0.001, 95 % CI 0.17-0.26). CONCLUSION: The health communication course significantly improved social media competence and professionalism, which was significantly different from the control group, revealing the educational value of the intervention. TRIAL REGISTRATION NUMBER: ChiCTR2200058425.

Nursing undergraduates' media competence in the context of health communication and its relationship to professionalism.

AIMS: To investigate the association between professionalism and social media competence among Chinese mainland nursing undergraduates. DESIGN: This study employed a cross-sectional descriptive correlation design. PARTICIPANTS: From June to July 2021, 797 nursing students from four nursing colleges in Jiangsu Province, China, were chosen using stratified cluster sampling. METHODS: The questionnaire included the Chinese version of the Nursing Professionalism Scale and the Social Media Competency Scale. The association between professionalism and social media competency was examined using Pearson's correlation analysis. RESULTS: The professionalism of nursing undergraduates (average scores:70.44 ± 8.82) was at a medium level. Social media self-efficacy, performance expectancy, facilitating conditions and social influence (3.76 ± 0.75, 3.87 ± 0.60, 3.53 ± 0.69, 3.41 ± 0.76) were at a medium-high level, while social media experience and effort expectancy (3.03 ± 0.72, 2.60 ± 0.59) were at medium and low levels. Among nursing undergraduates, professionalism was related to social media competence, among which, professionalism was positively correlated with social media self-efficacy (r = 0.40, p < 0.01), social media experience (r = 0.50, p < 0.01), performance expectancy (r = 0.34, p < 0.01), facilitating conditions (r = 0.41, p < 0.01), but negatively correlated with effort expectancy (r = -0.10, p < 0.01). CONCLUSION: The professionalism of nursing undergraduates is related to social media. The scores of social media self-efficacy, social media experience, performance expectancy and facilitating conditions of nursing students with high professionalism were higher than those of nursing students with low professionalism. IMPACT: This study suggests that developing a course on health communication on social media can help nursing students improve their professionalism. PATIENT OR PUBLIC CONTRIBUTION: Participants completed a survey via the online survey platform Wenjuangxing.

Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial.

BACKGROUND: Narrative medicine has become a solution to cultivate medical students' ability of empathy and humanistic care. However, the role of narrative medicine is lacking in the study of professionalism. The aim of this study was to analyze the effects of narrative medical theory learning and narrative writing on professionalism, empathy and humanistic care ability of nursing students. METHODS: This cluster randomized controlled trial was conducted between June 2021 and June 2022 in two universities in Jiangsu, China. The participants of this study were 85 nursing students who were randomly divided into the intervention group (n = 43) or the control group (n = 42). Participants in the intervention group were trained in narrative medical theory learning and narrative writing based on a Web-based platform, while those in the control group were not. Self-report questionnaires of professionalism, empathy and humanistic care ability were used before and after intervention. RESULTS: The results showed that the professionalism score of the intervention group was (68.7 ± 6.8 vs. 64.5 ± 7.5; P = 0.005), empathy (99.4 ± 15.7 vs. 92.2 ± 14.6; P = 0.014) and humanistic care ability (127.6 ± 20.0 vs. 113.3 ± 18.8; P = 0.004) were better than the control group. CONCLUSION: The results of this quantitative study suggest that narrative medical theory education and narrative writing based on the network platform can promote the development of professionalism, empathy and humanistic care ability of nursing undergraduates.

Mu-opioid receptor alleviated ferroptosis in hepatic ischemia-reperfusion injury via the HIF-1α/KCNQ1OT1 axis.

Ferroptosis is the ideal therapeutic target for hepatic ischemia and reperfusion injury (HIRI). The µ opioid receptor (MOR) is associated with ferroptosis in HIRI. We aimed to determine the ferroptosis-related therapeutic mechanism of MOR in HIRI. A model of HIRI was established in BALB/c mice. Primary hepatocytes isolated from mice were stimulated by hypoxia/reoxygenation (H/R). Changes in histopathology were determined by H&E staining. Alterations in ferroptosis were evaluated by malondialdehyde (MDA), iron, glutathione (GSH), ACSL4, GPX4, and mitochondrial morphology. ALT and AST were used to determine hepatic function. First, we found that hepatic ischemia/reperfusion (I/R) induced the destruction of hepatic tissue structure and dead hepatocytes and determined that ferroptosis occurred in vivo and in vitro. During HIRI, the expression levels of HIF-1α and KCNQ1OT1 were significantly upregulated. We demonstrated that sufentanil improved the damage in the liver and hepatocytes undergoing I/R. Importantly, sufentanil inhibited ferroptosis in HIRI. In addition, sufentanil downregulated the expression levels of HIF-1α and KCNQ1OT1 in HIRI. Increases in HIF-1α and KCNQ1OT1 reversed the role of sufentanil in ferroptosis and HIRI. Subsequently, we determined that HIF-1α could activate the transcription of KCNQ1OT1 by binding to its promoter. In addition, KCNQ1OT1 was demonstrated to enhance ACSL4 stability by interacting with SRSF1. Finally, we observed that KCNQ1OT1 downregulation protected hepatocytes from hepatic I/R and inhibited ferroptosis. KCNQ1OT1 upregulation aggravated ferroptosis and hepatic injury during I/R. However, decreases in ACSL4 and SRSF1 reversed the harmful role of KCNQ1OT1 upregulation in HIRI. MOR alleviated ferroptosis in HIRI via the HIF-1α/KCNQ1OT1 axis.

Recent advances in electrochemical proximity ligation assay.

Proximity ligation assay (PLA) is a vigorously developed homogeneous immunoassay assisted by DNA combining dual recognition of target protein by pairs of proximity probes, in which the detection of protein is tactfully converted to the detection of DNA. The booming developments in PLA have enabled a variety of ultrasensitive assays for the detection of protein and this concept of PLA is also extended to the detection of nucleic acids and some small molecule. The association between PLA and electrochemical method, defined as electrochemical proximity ligation assay (ECPLA), has gained much interests in disease diagnosis, food safety and environmental assays with the advantages, such as broad range of targets, simplicity, low cost and rapid response. In this review, we took a different perspective to present the history of PLA, the classical ECPLA biosensing methodology as well as the developments of ECPLA based on several key parameters, such as sensitivity, selectivity, reusability and generalization. In addition, the developments of PLA with electrochemiluminescence as readout are also presented. Finally, perspective and some unresolved challenges in ECPLA that can potentially be addressed have also been discussed.

Silencing lncRNA KCNQ1OT1 reduced hepatic ischemia reperfusion injury-induced pyroptosis by regulating miR-142a-3p/HMGB1 axis.

BACKGROUND: Based on pre-existing evidence, KCNQ1OT1 has been pointed out to be closely related to myocardial and cerebral ischemia reperfusion injury diseases. Herein, the objective of our study is to probe into the potential function as well as the underlying mechanism of KCNQ1OT1 on hepatic ischemia reperfusion injury (HIRI). METHODS: Using C57BL/6 J mice and primary mouse hepatocytes were conducted to establish HIRI model in vivo and in vitro. Cell viability was examined using CCK-8 assay and EdU assay. Flow cytometric analysis was performed to evaluate the pyroptosis. Dual-luciferase reporter assay was employed to verify the interaction relationships. qRT-PCR and Western blot were adopted to analyze the mRNA and protein level. Histopathological alteration of liver tissue was evaluated by HE staining. Immunohistochemistry (IHC) was performed to measure NLRP3 and caspase 1. RESULTS: Our data revealed that KCNQ1OT1 expression was ascending in hepatic tissue of HIRI mouse. Moreover, deprivation of KCNQ1OT1 mitigated I/R-induced hepatic injury and pyroptosis in vivo. Further experiments demonstrated that silencing KCNQ1OT1 promoted proliferation and inhibited pyroptosis in hypoxia/reoxygenation (H/R)-induced primary mouse hepatocytes. Mechanistically, KCNQ1OT1 functioned as a competing endogenous RNA which sponged miR-142a-3p, therefore promoted HMGB1 expression to activate TLR4/NF-κB signaling pathway in HIRI. CONCLUSION: LncRNA KCNQ1OT1 elevated HMGB1 expression through binding to miR-142a-3p, thereby promoting pyroptosis in HIRI.

Perceived stress and symptoms of post-traumatic stress disorder in nurses: A moderated mediation model of maladaptive cognitive emotional regulation and psychological capital.

Nurses often face a variety of work-related and life-related stresses that make them more prone to symptoms of post-traumatic stress disorder (PTSD), yet the underlying mechanism of this association is poorly understood. To address this research gap, we investigated the mediating role of maladaptive cognitive emotion regulation strategies in the relationship between perceived stress and PTSD symptoms, and explored whether psychological capital could moderate the direct or indirect effects between perceived stress and PTSD symptoms. Nurses (N = 723) completed a questionnaire about perceived stress, PTSD symptoms, maladaptive cognitive emotion regulation strategies and psychological capital. After controlling for gender, age and work department, perceived stress was positively correlated with PTSD symptoms. Maladaptive cognitive emotion regulation strategies partially mediated this relationship. Psychological capital moderates the effects of perceived stress and maladaptive cognitive emotion regulation strategies on PTSD symptoms. Specifically, the positive correlation between perceived stress and PTSD symptoms was stronger among nurses with low levels of psychological capital than among nurses with high levels of psychological capital. At the same time, the positive correlation between maladaptive cognitive emotion regulation strategies and PTSD symptoms was stronger in nurses with a low level of psychological capital. Therefore, cognitive strategies and interventions oriented toward psychological capital may alleviate the PTSD symptoms of nurses in stressful situations.

Clinical Effect of Application of Interventional Treatment Models for Improvement of Quality of Postoperative Recovery in Elderly Patients with Total Hip Arthroplasty.

Objective: To investigate the application value of the interventional treatment model for improving the recovery of elderly patients after total hip arthroplasty (THA). Methods: A total of 50 patients who received THA were randomly divided into the control group (25 cases) undergoing traditional treatment and the experimental group (25 cases) undergoing intervention of cognition, emotion, environment, education, nutrition, and sleep. The mini-mental state examination (MMSE) score, the incidence and duration of postoperative cognitive dysfunction (POCD), the out-of-bed activity time, hospital stays, and the satisfaction degree of patients were compared between the two groups. Results: There was no statistically significant difference in basic information between the two groups. On days 7 and 14 after surgery, the MMSE score of the control group was significantly lower than that of the experimental group (P <0.05). The incidence of POCD in the experimental group was lower and its duration was shorter than in the control group but without statistical significance. Besides, the significantly decreased out-of-bed activity time, the reduced length of hospital stay, and the higher satisfaction degree were observed in the experimental group (P <0.05). Conclusion: Interventional treatment model could significantly increase the MMSE score, accelerate the recovery of elderly patients after THA, and increase their satisfaction degree.

The relationship between eHealth literacy, social media self-efficacy and health communication intention among Chinese nursing undergraduates: A cross-sectional study.

Background: With the popularization of the Internet, it has become possible to widely disseminate health information via social media. Medical staff's health communication through social media can improve the public's health literacy, and improving the intention of health communication among nursing undergraduates is of great significance for them to actively carry out health communication after entering clinical practice. Objective: To explore the relationship among eHealth literacy, social media self-efficacy, and health communication intention and to determine the mediating role of social media self-efficacy in the relationship between eHealth literacy and health communication intention. Design: A cross-sectional descriptive correlation design was used in this study. Participants: Stratified cluster sampling was used to select 958 nursing students from four nursing colleges in Jiangsu Province, China, from June to July 2021. Methods: Data were collected using the eHealth Literacy Scale, the Social Media Self-efficacy Scale, and the Health Communication Intention Questionnaire. Sociodemographic data were also collected. Correlation analysis and regression analysis were used to determine the relationship between eHealth literacy, social media self-efficacy, and health communication intention. Results: Health communication intention is positively correlated with eHealth literacy and social media self-efficacy. There is a significant positive correlation between eHealth literacy and health communication intention (ß = 0.57, p < 0.001), and social media self-efficacy played a mediating role in the influence of eHealth literacy on health communication intention (the mediating effect accounted for 37.2% of the total effect). Conclusion: The study found that eHealth literacy and social media self-efficacy had an impact on health communication intention. Because there is a correlation between eHealth literacy and social media self-efficacy and health communication intention, in order to promote health communication intention of nursing students, it is also important to cultivate eHealth literacy and social media self-efficacy of nursing students. In view of these results, targeted educational programs must be developed to improve eHealth literacy and social media self-efficacy among nursing undergraduates, thereby promoting their health information transmission.

Research trends in college students' sleep from 2012 to 2021: A bibliometric analysis.

Background: A great proportion of college students experience various sleep problems, which damage their health and study performance. College students' sleep problems, which are caused by several factors, have been easily ignored before. In the past decade, more research has been published to expand our understanding of undergraduates' sleep. The purpose of the study is to explore the research hotspots and frontiers regarding college students' sleep using CiteSpace5.8.R3 and offer guidance for future study. Methods: We retrieved relevant literature from the Web of Science Core Collection Database and imputed the downloaded files into CiteSpace5.8.R3 for visualization analysis. We generated network maps of the collaborations between authors, countries, institutions, the cited journals, and co-occurrence keywords. The analysis of keywords clusters, timeline views, and keywords citation bursts help us identify the hotspots and research trends. Results: A total of 1,841 articles related to college students' sleep, published from 2012 to 2021, were selected. The number of publications gradually increased. Karl Peltzer was the most prolific authors with 15 publications. The United States and Harvard University separately contributed 680 and 40 articles and had the greatest impact in this field. SLEEP ranked first in the frequency of cited journals. The article published by Lund HG was the most influential publication. Based on the analysis of keywords, we summarized research hotspots as follows: current status, affecting factors, and adverse outcomes of college students' sleep. The frontiers were the further understanding of the relationships between sleep and mental and physical health, and various interventions for sleep disorders. Conclusion: Our study illustrates the research hotspots and trends and calls for more research to expand the findings. In the future, the cooperation between institutions and authors needs to be strengthened. The complex relationships between sleep and mental and physical health and problematic substance use disorders are necessary to be explored. Longitudinal studies or randomized controlled trials should be constructed to verify the current findings or assumptions.

Relationship between mutuality and depression in patients with chronic heart failure and caregivers in China: An actor-partner interdependence model analysis.

Background: Patients with chronic heart failure and their family caregivers may experience adverse emotional problems, such as depression. Mutuality, which refers to the relationship between caregivers and those they care for, is an important factor affecting depression in the dyads. The purpose of this study was to investigate the relationship between mutuality and depression in patients with CHF and their caregivers in China. Methods: In this cross-sectional study, we used the Mutuality Scale and the Self-Rating Depression Scale to measure mutuality and depression of patients and caregivers. We used SPSS version 26.0 and AMOS version 21.0 to analyze the data. An APIM was established to analyze the actor-partner effects of patient-caregiver mutuality and depression. Results: A total of 250 dyads of patients and caregivers were included in the study. There were statistically significant differences in mutuality and depression between CHF patients and caregivers. The 4 dimensions of patients' mutuality all have the actor effect on depression. There were 3 partner effects of caregivers' "pleasurable activities", "shared values", and "reciprocity" on depression. Regarding caregiver depression, we only found an actor effect of caregivers' "shared values" on depression. Conclusion: The relationship between patients and caregivers should be evaluated in the clinical setting, and it is very important to develop intervention measures to improve the adverse emotional problems affecting both patients and their caregivers.

Effects of rosuvastatin on serum glucose and insulin in hyperuricemic rats.

BACKGROUND: Hyperuricemia is a state in which the serum levels of uric acid (UA) are elevated. This study was to determine the roles of rosuvastatin in fasting blood glucose (FGB) and insulin levels in hyperuricemic rats. METHODS: Thirty-six Sprague-Dawley (SD) rats were randomized divided into the control, model and rosuvastatin groups: the control was given no intervention, the model group was established by administrating yeast extract powder and oxonic acid potassium salt, and the rosuvastatin group was given intravenous administration of rosuvastatin for 28 days in hyperuricemic rats. Serum uric acid (SUA), fasting blood glucose (FBG), fasting blood insulin (FBI), glutamic acid decarboxylase antibody (GADA), oral glucose tolerance test (OGTT) levels, and the ultrastructure of pancreatic ß-cells were measured. Also, homeostasis model assessment of insulin resistance (HOMA-IR) scores was computed in three groups. RESULTS: Compared to the model group, SUA were decreased, while the FBG, GADA, OGTT and HOMA-IR at week 4 were significantly increased in rosuvastatin group. However, FBI was not significantly changed between three groups. It was also showed that the structure of pancreatic ß-cells was damaged and the number of ß-cells was changed in hyperuricemic rats while they were aggravated in rosuvastatin group. CONCLUSION: Rosuvastatin has roles in inducing FGB, GADA, OGTT and pancreatic ß-cells damage in hyperuricemic rats.

Developing and validating a mortality prediction model for ICH in ITP: a nationwide representative multicenter study.

Intracranial hemorrhage (ICH) is a rare and life-threatening hemorrhagic event in patients with immune thrombocytopenia (ITP). However, its mortality and related risk factors remain unclear. Herein, we conducted a nationwide multicenter real-world study of ICH in adult ITP patients. According to data from 27 centers in China from 2005 to 2020, the mortality rate from ICH was 33.80% (48/142) in ITP adults. We identified risk factors by logistic univariate and multivariate logistic regression for 30-day mortality in a training cohort of 107 patients as follows: intraparenchymal hemorrhage (IPH), platelet count ≤10 × 109/L at ICH, a combination of serious infections, grade of preceding bleeding events, and Glasgow coma scale (GCS) level on admission. Accordingly, a prognostic model of 30-day mortality was developed based on the regression equation. Then, we evaluated the performance of the prognostic model through a bootstrap procedure for internal validation. Furthermore, an external validation with data from a test cohort with 35 patients from 11 other centers was conducted. The areas under the receiver operating characteristic (ROC) curves for the internal and external validation were 0.954 (95% confidence interval [CI], 0.910-0.998) and 0.942 (95% CI, 0.871-1.014), respectively. Both calibration plots illustrated a high degree of consistency in the estimated and observed risk. In addition, the decision curve analysis showed a considerable net benefit for patients. Thus, an application (47.94.162.105:8080/ich/) was established for users to predict 30-day mortality when ICH occurred in adult patients with ITP.

Analysis of Symptom Characteristics, Influencing Factors, and Their Predictive Value for Posttraumatic Stress Disorder in Nurses: A Cross-Sectional Questionnaire Study.

ABSTRACT: Nurses often face a variety of nursing-related stresses, making them more prone to symptoms of posttraumatic stress disorder (PTSD). We aimed to explore symptom characteristics, influencing factors, and their predictive value for PTSD in nurses, so as to prevent the occurrence of PTSD in nurses. This was a cross-sectional study conducted in two tertiary hospitals in Yangzhou. A total of 1290 valid questionnaires were received in our study, and 190 nurses (14.7%) were positive for PTSD symptoms. The results show that individuals with higher scores on the Perceived Stress Scale-10 (PSS-10), Patient Health Questionnaire-15 (PHQ-15), Generalized Anxiety Disorder Scale-7 (GAD-7), and maladaptive cognitive emotion regulation strategies questionnaire (maladaptive CERS) were more likely to experience PTSD symptoms, whereas those with lower scores on the Perceived Social Support Scale (PSSS) were more likely to experience PTSD symptoms. Compared with the PSS-10, PHQ-15, and PSSS, GAD-7 and maladaptive CERS had higher predictive value. This study provided the optimal threshold of relevant factors that may have a positive effect on the prevention of PTSD symptoms. This has guiding implications for active prevention and intervention in some institutions.

Octreotide ameliorates hepatic ischemia-reperfusion injury through SNHG12/TAF15-mediated Sirt1 stabilization and YAP1 transcription.

BACKGROUND: Hepatic ischemia-reperfusion (HIR) injury is a pathological condition initiated by interrupted hepatic blood supply and exaggerated after reperfusion, which is one of the most lethal risks in liver transplantation and other liver surgeries. We aimed to investigate the protective mechanism of octreotide (Oct) against HIR injury. METHODS: The function of Oct was evaluated in the in vivo mouse model of HIR injury. Histological examinations were performed to assess the pathological changes. Serum parameters including ALT and AST were measured to evaluate the liver damage. qRT-PCR and western blot analysis were employed to determine the levels of long non-coding RNA SNHG12 (SNHG12) and autophagy or apoptosis-related proteins. RNA pull-down and RIP assays were used to verify the interaction between SNHG12 and TAF15. The transcriptional regulation of TAF15 in YAP1 was validated by ChIP and luciferase reporter assays. RESULTS: In the in vivo HIR injury model, Oct efficiently alleviated HIR-caused hepatic damage by suppressing apoptosis and activating autophagy. However, silencing of SNHG12 abrogated the protective effects of Oct via inactivating autophagy. Further mechanism investigation revealed that SNHG12 promoted the stabilization of Sirt1 and increased YAP1 transcriptional activity via interacting with TAF15. Up-regulation of Sirt1 and YAP1 was essential for maintaining the protective effect of Oct against HIR injury through increasing autophagic flux and suppressing apoptosis. CONCLUSIONS: Oct-induced up-regulation of SNHG12 attenuated HIR injury via promoting Sirt1 stabilization and YAP1 transcription to activate autophagy and repress apoptosis.