Evaluating the effectiveness of illness script teaching on clinical reasoning skills in post-baccalaureate nursing students.

BACKGROUND: Typically, nurse education curricula are separated into the teaching of theoretical knowledge and practical skills. This separation may hinder nursing students' development of clinical reasoning skills, making it difficult for them to prioritize tasks and make decisions about interventions. Illness scripts have been shown to help medical students improve their clinical reasoning skills; however, they are rarely used in nurse education. OBJECTIVES: To evaluate the influence of illness script teaching method on post-baccalaureate nursing students' clinical reasoning skills. DESIGN: The study adopted a single-arm quantitative pre-experimental research design and incorporated qualitative focus group discussions. SETTINGS/PARTICIPANTS: This study was conducted at a university in northern Taiwan. Participants included 35 post-baccalaureate nursing students who were enrolled in an elective course focused on clinical skills. METHODS: To enhance nursing students' clinical reasoning skills, illness scripts for five clinical scenarios were developed and implemented as part of their curriculum. The Nurses Clinical Reasoning Scale was utilized to assess self-rated clinical reasoning abilities, while dual-teacher scoring was used to evaluate clinical reasoning objectively. The VARK learning preference questionnaire was used to examine how learning preferences affect learning outcomes. After the course, semi-structured focus groups were held to collect student feedback on the effectiveness of the teaching methods and the learning outcomes. RESULTS: This study's quantitative and qualitative results show that illness script-based teaching improves nursing students' clinical reasoning. Quantitative results showed significant objective reasoning score improvements. However, minimal changes in self-rated scores suggest a learning style-influenced gap between perceived and actual abilities. Qualitative findings showed that students valued linking clinical issues to practical applications but struggled with knowledge gaps and engagement. CONCLUSIONS: The illness script teaching method improved students' understanding of clinical scenarios and enhanced their clinical reasoning abilities. Incorporating illness scripts into nurse education was beneficial for nursing students.

Traditional Chinese-version reliability test of the Pieper-Zulkowski pressure ulcer knowledge: Psychometric and assessment.

This study was to translate the Pieper-Zulkowski pressure ulcer knowledge test (PZ-PUKT) into Traditional Chinese and evaluate its psychometric properties as well as identify the predictors of knowledge on pressure injury. The PZ-PUKT was translated into Traditional Chinese (TC-PZ-PUKT), and its content validity was evaluated. A total of 296 nurses participated in this study and completed the 72-item TC-PZ-PUKT online. The reliability of the TC-PZ-PUKT was analysed by evaluating its internal consistency and test-retest reliability. Hierarchical regression was used to determine factors associated with TC-PZ-PUKT scores. Content validity was achieved with a score of 0.986. Internal consistency was observed to be reliable, with a Cronbach's alpha of 0.858. The mean knowledge score on the TC-PZ-PUKT was 72.5%, with a 1-week test-retest reliability of r = 0.849. Education level, certification as a wound specialist and self-learning through reading articles, books or guidelines on pressure injury were significantly associated with TC-PZ-PUKT scores. The TC-PZ-PUKT is a valid and reliable tool. Education level, certification as a wound specialist and self-learning regarding pressure injury are related to knowledge of pressure injury.

Effects of Virtual Reality on Pain and Anxiety During Children's Circumcision: A Systematic Review and Meta-Analysis.

BACKGROUND: Circumcision-a common pediatric procedure-can cause significant pain and anxiety. Virtual reality has been proposed as a nonpharmacological intervention to alleviate these negative experiences. OBJECTIVE: This systematic review and meta-analysis was conducted to evaluate the effects of virtual reality interventions on pain and anxiety in children undergoing circumcision. METHODS: This study comprehensively searched PubMed, Embase, and Cochrane Library for articles published from database inception to October 2, 2023. Randomized controlled trials that investigated the effects of virtual reality interventions on pain and anxiety during circumcision in children were included. The Cochrane risk-of-bias tool was used to appraise the included studies. The primary outcomes were pain and anxiety scores. RESULTS: Three randomized controlled trials and four data sets involving a total of 224 children were included in our meta-analysis. Virtual reality interventions significantly reduced children's pain and anxiety scores. CONCLUSIONS: Virtual reality interventions are promising nonpharmacological strategies for alleviating children's pain and anxiety during circumcision. Pediatric healthcare professionals use virtual reality interventions to create a child-friendly and healthy healthcare environment.

Cellulose acetate-coated capacitive sensor for determining carbon-cycle enzymes activity and as a microbial Indicator for soil health.

This study demonstrates cellulose acetate (CA)-coated screen-printed carbon electrodes (SPCEs) for soil microbial activity detection. A capacitive sensor design utilizes a coated CA layer for effective insulation in electrolytes, eliminating the need for additional signal protection. Optimization involved comparing spin and dip coating methods, with a one-layer 10-second dip coating identified as the best balance between quality and yield. These CA/SPCEs exhibited remarkable stability over a month, suggesting their potential for long-term use in monitoring agricultural soils. Analysis of CA/SPCE profile and thickness provided insights into surface characteristics and the impact of the CA coating on electrode roughness. ATR-FTIR analysis, along with capacitive sensing, demonstrated superior sensitivity and precision for monitoring CA film degradation compared to mechanical gauges. Chemical degradation studies suggest CA's potential immunity in near-neutral environments, while enzymatic degradation investigations revealed dominance by enzymes, particularly in the initial stages. The CA/SPCE sensor responds to both enzymatic and chemical degradation, potentially serving as an indicator of total soil microbial activity. Soil experiments explored CA/SPCE with Cap-S for microbial activity sensing. Significant differences in the long-term degradation rate were observed in mycorrhizal fungi-enriched soil compared to controls, highlighting microbial influences. This study underscores the adaptability and versatility of this technology, particularly for assessing C-cycle microbial activity in agricultural fields.

Brusatol alleviates pancreatic carcinogenesis via targeting NLRP3 in transgenic Krastm4Tyj Trp53tm1Brn Tg (Pdx1-cre/Esr1*) #Dam mice.

BACKGROUND: Pancreatic cancer (PanCa), ranked as the 4th leading cause of cancer-related death worldwide, exhibits an dismal 5-year survival rate of less than 5 %. Chronic pancreatitis (CP) is a known major risk factor for PanCa. Brusatol (BRT) possesses a wide range of biological functions, including the inhibition of PanCa proliferation. However, its efficacy in halting the progression from CP to pancreatic carcinogenesis remains unexplored. METHODS: We assess the effects of BRT against pancreatic carcinogenesis from CP using an experimentally induced CP model with cerulein, and further evaluate the therapeutic efficacy of BRT on PanCa by employing Krastm4TyjTrp53tm1BrnTg (Pdx1-cre/Esr1*) #Dam/J (KPC) mouse model. RESULTS: Our finding demonstrated that BRT mitigated the severity of cerulein-induced pancreatitis, reduced pancreatic fibrosis and decreased the expression of α-smooth muscle actin (α-SMA), which is a biomarker for pancreatic fibrosis. In addition, BRT exerted effects against cerulein-induced pancreatitis via inactivation of NLRP3 inflammasome. Moreover, BRT significantly inhibited tumor growth and impeded cancer progression. CONCLUSIONS: The observed effect of BRT on impeding pancreatic carcinogenesis through targeting NLRP3 inflammasome suggests its good potential as a potential agent for treatment of PanCa.

Effect of artificial natural light on the development of myopia among primary school-age children in China: a three-year longitudinal study.

AIM: To assess the efficacy of artificial natural light in preventing incident myopia in primary school-age children. METHODS: This is a prospective, randomized control, intervention study. A total of 1840 students from 39 classes in 4 primary schools in Foshan participated in this study. The whole randomization method was adopted to include classes as a group according to 1:1 randomized control. Classrooms in the control group were illuminated by usual light, and classrooms in the intervention group were illuminated by artificial natural light. All students received uncorrected visual acuity and best-corrected visual acuity measurement, non-cycloplegic autorefraction, ocular biometric examination, slit lamp and strabismus examination. Three-year follow-up, the students underwent same procedures. Myopia was defined as spherical equivalent refraction ≤ -0.50 D and uncorrected visual acuity <20/20. RESULTS: There were 894 students in the control group and 946 students in the intervention group with a mean±SD age of 7.50±0.53y. The three-year cumulative incidence rate of myopia was 26.4% (207 incident cases among 784 eligible participants at baseline) in the control group and 21.2% (164 incident cases among 774 eligible participants at baseline) in the intervention group [difference of 5.2% (95%CI, 3.7% to 10.1%); P=0.035]. There was also a significant difference in the three-year change in spherical equivalent refraction for the control group (-0.81 D) compared with the intervention group [-0.63 D; difference of 0.18 D (95%CI, 0.08 to 0.28 D); P<0.001]. Elongation of axial length was significantly different between in the control group (0.77 mm) and the intervention group [0.72 mm; difference of 0.05 mm (95%CI, 0.01 to 0.09 mm); P=0.003]. CONCLUSION: Artificial natural light in the classroom of primary schools can result in reducing incidence rate of myopia during a period of three years.

Comparison of continuous 24-hour and 14-day ECG monitoring for the detection of cardiac arrhythmias in patients with ischemic stroke or syncope.

BACKGROUND: Previous studies show that using 12-lead electrocardiogram (ECG) or 24-h ECG monitor for the detection of cardiac arrhythmia events in patients with stroke or syncope is ineffective. HYPOTHESIS: The 14-day continuous ECG patch has higher detection rates of arrhythmias compared with conventional 24-h ECG monitoring in patients with ischemic stroke or syncope. METHODS: This cross-sectional study of patients with newly diagnosed ischemic stroke or syncope received a 24-h ECG monitoring and 14-day continuous cardiac monitoring patch and the arrhythmia events were measured. RESULTS: This study enrolled 83 patients with ischemic stroke or syncope. The detection rate of composite cardiac arrhythmias was significantly higher for the 14-day ECG patch than 24-h Holter monitor (69.9% vs. 21.7%, p = .006). In patients with ischemic stroke, the detection rates of cardiac arrhythmias were 63.4% for supraventricular tachycardia (SVT), 7% for ventricular tachycardia (VT), 5.6% for atrial fibrillation (AF), 4.2% for atrioventricular block (AVB), and 1.4% for pause by 14-day ECG patch, respectively. The significant difference in arrhythmic detection rates were found for SVT (45.8%), AF (6%), pause (1.2%), AVB (2.4%), and VT (9.6%) by 14-day ECG patch but not by 24-h Holter monitor in patients with ischemic stroke or syncope. CONCLUSIONS: A 14-day ECG patch can be used on patients with ischemic stroke or syncope for the early detection of AF or other cardiac arrhythmia events. The patch can be helpful for physicians in planning medical or mechanical interventions of patients with ischemic stroke and occult AF.

Case Report: Imaging features of a new type double inferior vena cava malformation and review.

Background: Double inferior vena cava (DIVC) is a rare vascular malformation. With advances in radiological techniques and diagnosis, more and more types of DIVC were identified and diagnosed. Recognition of the variety of DIVC seen on imaging is essential for subsequent venous interventions. Case presentation: A 77-year-old man presented with low back pain with left lower limb pain for 1 month. Scattered petechiae above the skin surface on the left lower leg, especially on the extensor surface, with flaking and mild tingling of the skin, were noted 3 weeks ago. Ultrasound revealed deep vein thrombosis (DVT) in the left lower limb. Computed tomography pulmonary angiography (CTPA) suggested no significant thrombus in the pulmonary artery. Computed tomography venography (CTV) of bilateral lower limbs showed that iliac vein compression syndrome with formation of deep and superficial venous traffic branches in bilateral lower limbs, predominantly on the left side. CTV of the inferior vena cava (IVC) suggested that the left common iliac vein crossed the common iliac artery bifurcation from dorsal to ventral and continued to travel cranially as a ventral vessel, and connected with the ventral IVC anterior to the right common iliac artery. The right common iliac vein extended cephalad as a dorsal vessel, which was narrowed at the level of 4th lumbar vertebra by compression of the hyperplastic bone and the osteophyte. The patient was discharged after right and left common iliac vein angiography and balloon dilation of bilateral common iliac vein. Conclusion: The formation of both ventrally and dorsally aligned DIVC is rarer. It should be clarified the effects of DIVC on DVT formation, and the importance of imaging for preoperative planning.

Development of a Cloud-Based Image Processing Health Checkup System for Multi-Item Urine Analysis.

With the busy pace of modern life, an increasing number of people are afflicted by lifestyle diseases. Going directly to the hospital for medical checks is not only time-consuming but also costly. Fortunately, the emergence of rapid tests has alleviated this burden. Accurately interpreting test results is extremely important; misinterpreting the results of rapid tests could lead to delayed medical treatment. Given that URS-10 serve as a rapid test capable of detecting 10 distinct parameters in urine samples, the results of assessing these parameters can offer insights into the subject's physiological condition. These parameters encompass aspects such as metabolism, renal function, diabetes, urinary tract disorders, hemolytic diseases, and acid-base balance, among others. Although the operational procedure is straightforward, the variegated color changes exhibited in the outcomes of individual parameters render it challenging for lay users to deduce causal factors solely from color variations. Moreover, potential misinterpretations could arise due to visual discrepancies. In this study, we successfully developed a cloud-based health checkup system that can be used in an indoor environment. The system is used by placing a URS-10 test strip on a colorimetric board developed for this study, then using a smartphone application to take images which are uploaded to a server for cloud computing. Finally, the interpretation results are stored in the cloud and sent back to the smartphone to be checked by the user. Furthermore, to confirm whether the color calibration technology can eliminate color differences between different cameras, and also whether the colorimetric board and the urine test strips can perform color comparisons correctly in different light intensity environments, indoor environments that could simulate a specific light intensity were established for testing purposes. When comparing the experimental results to real test strips, only two groups failed to reach an identification success rate of 100%, and in both of these cases the success rate reached 95%. The experimental results confirmed that the system developed in this study was able to eliminate color differences between camera devices and could be used without special technical requirements or training.

The effects of paroxetine therapy on depressive symptom and motor function in the treatment of depression with Parkinson's disease: A meta-analysis.

BACKGROUND: Paroxetine therapy has been used for treatment of patients with depression and Parkinson's disease (dPD) in many clinical studies, but, the effects of paroxetine in dPD patients are not completely understood. The aim of this study was to systematically evaluate the effects of paroxetine therapy on depressive symptom and motor function in the treatment of dPD, in order to confer a reference for clinical practice. METHODS: Randomized controlled trials (RCTs) of paroxetine for dPD published up to October, 2022 were retrieved. Standardised mean difference (SMD), odds ratio (OR), and 95% confidence interval (CI) were calculated and heterogeneity was measured with the I2 test. The outcomes of interest were as follows: the efficacy, Hamilton depression rating scale score, unified Parkinson's disease rating scale score, Hamilton anxiety rating scale score or adverse events. RESULTS: Thirty-four RCTs with 2819 participants were included. Compared with control group, the pooled effects of paroxetine therapy on depression were (22 trials; OR 3.62, 95% CI 2.63 to 4.98, P < .00001) for antidepressant response (25 trials; SMD -2.14, 95% CI -2.73 to -1.56, P < .00001) for Hamilton depression rating scale score, the pooled effects of paroxetine therapy on motor function were (10 trials; OR 4.63, 95% CI 3.15 to 6.79, P < .00001) for anti-PD efficacy (18 trials; SMD -2.02, 95% CI -2.48 to -1.55, P < .00001) for total unified Parkinson's disease rating scale score. The Hamilton anxiety rating scale score showed significant decrease in the paroxetine treatment group compared to control group (10 trials; SMD -1.93, 95% CI -2.65 to -1.22, P < .00001). In addition, paroxetine therapy reduced the number of any adverse events obviously in dPD patients (twenty trials; OR 0.42, 95% CI 0.31 to 0.57, P < .00001). CONCLUSIONS: Paroxetine therapy has clinical benefits for improvement of depressive symptom and motor function in dPD patients, moreover, it is of high drug safety. Further well-designed, multi-center RCTs needed to identify these findings.