Quality of Work Life, Nurses' Intention to Leave the Profession, and Nurses Leaving the Profession: A One-Year Prospective Survey.

PURPOSE: To examine the associations among quality of work life, nurses' intention to leave the profession, and nurses leaving the profession. DESIGN: A prospective study design was used. METHODS: Participants were 1,283 hospital nurses with a purposive sampling in Taiwan. The self-reported questionnaire consisted of three questionnaires: the Chinese version of the Quality of Nursing Work Life scale, an intention-to-leave profession questionnaire, and a demographic questionnaire. Records of nurses leaving the profession were surveyed 1 year later. Data were analyzed by descriptive statistics and inferential statistics. FINDINGS: As many as 720 nurses (56.1%) had tendencies to leave their profession. However, only 31 nurses (2.5%) left their profession 1 year later. Nurses' intention to leave the profession mediated the relationship between the milieu of respect and autonomy, quality of work life, and nurses leaving the profession. CONCLUSIONS: The milieu of respect and autonomy describing the quality of work life predicts the nurses' intention to leave the profession, and together these predict nurses leaving the profession. CLINICAL RELEVANCE: This study illustrates that nurse managers could provide effective interventions to ameliorate the milieu of respect and autonomy aspect of quality of work life to prevent nurses from leaving their profession.

[Testing the Reliability and Validity of the Taiwan Health-Related Quality of Life for Nausea and Vomiting During Pregnancy Scale].

BACKGROUND: Symptom distress related to pregnancy-related nausea and vomiting is known to impact quality of life in pregnant women. However, few reliable and valid assessment tools are available for research use. PURPOSE: To test the reliability and validity of the Taiwan health-related quality of life for nausea and vomiting during pregnancy (NVPQOL) scale. METHODS: A cross-sectional study design was conducted. A convenience sample of 416 pregnant women in their first and second trimesters were recruited from the prenatal clinics of one medical center and one regional teaching hospital in southern Taiwan. Chi-square tests, item analysis, and principal axis factor analysis were used to examine construct validity. Pearson's correlation coefficient was then conducted to compare the concurrent validity of the scale against the Chinese-language version of the World Health Organization Quality of Life Assessment [WHOQOL-BREF (TW)]. RESULTS: Four factors were extracted using factor analysis: "limitations" (10 items), "physical symptoms/aggravating factors" (9 items), "emotions" (6 items), and "fatigue" (4 items), which together accounted for 67.45% of the total variance. The NVPQOL showed good convergent (r = .78 ~ .85, p < .01), discriminate (r = .48 - .68, p < .01), and concurrent validities, with a -0.37 correlation coefficient between the WHOQOL-BREF (TW) and the NVPQOL (p < .01). The Cronbach's α of the NVPQOL was .95. The intraclass correlation coefficient for test-retest reliability of two weeks was .92 (n = 37, p < .001). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The NVPQOL may be used in future research and clinical assessment to measure quality of life in women who experience nausea and vomiting during pregnancy in order to provide appropriate nursing interventions in a timely manner to improve quality of life.

[A project to improve the completion rate of discharge-planning services for organ-transplant patients].

BACKGROUND & PROBLEMS: The average score for satisfaction with self-care instructions among transplant patients was 84 out of 100 in a 2010 survey of patient satisfaction with discharge-planning services. This score was significantly below the hospital average of 90. In addition, discharged patients made more frequent telephone inquiries to healthcare providers to ask questions about post-organ-transplantation self-care. A follow-up study targeted a sample of 30 discharged transplantation patients using hospital medical record reviews and telephone inquiries. This survey found a transplant instruction completion rate of 75% during discharge preparation and 69% accuracy among participants in answering self-care knowledge questions. Both figures were lower than expected. PURPOSE: The goal of this project was to increase the instruction completion rate from 75% to 100% and the percentage of correct answers to self-care knowledge questions self-care knowledge from 69% to 95%. RESOLUTIONS: This study integrated all relevant nursing information into a standardized discharge-planning service booklet that was given to inpatients for reference. Furthermore, a self-care checklist was developed and introduced. Finally, a standard procedure for delivering nursing instructions and a regular audit and follow-up monitoring system were established. RESULTS: The nurses' instruction completion rate rose to 100% and the percentage of questions on self-care knowledge correctly answered by patients increased to 98%. CONCLUSIONS: Adopting a patient-centered philosophy of care and a model of interdisciplinary collaboration effectively integrated resources and promotes nursing quality and quality of life for transplant patients. The project effectively improved the completing rate for post-transplant discharge-planning service instructions and enhanced the self-care knowledge of transplant patients.

Therapeutic Potential of Olfactory Ensheathing Cells and Adipose-Derived Stem Cells in Osteoarthritis: Insights from Preclinical Studies.

Olfactory-ensheathing cells (OECs) are known for their role in neuronal regeneration and potential to promote tissue repair. Adipose-derived stem cells (ADSCs), characterized by mesenchymal stem cell (MSC) traits, display a fibroblast-like morphology and express MSC surface markers, making them suitable for regenerative therapies for osteoarthritis (OA). In this study, OECs and ADSCs were derived from tissues and characterized for their morphology, surface marker expression, and differentiation capabilities. Collagenase-induced OA was created in 10-week-old C57BL/6 mice, followed by intra-articular injections of ADSCs (1 × 105), OECs (1 × 105), or a higher dose of OECs (5 × 105). Therapeutic efficacy was evaluated using rotarod performance tests, MRI, histology, and immunohistochemistry. Both cell types exhibited typical MSC characteristics and successfully differentiated into adipocytes, osteoblasts, and chondrocytes, confirmed by gene expression and staining. Transplantation significantly improved rotarod performance and preserved cartilage integrity, as seen in MRI and histology, with reduced cartilage destruction and increased chondrocytes. Immunohistochemistry showed elevated type II collagen and aggrecan in treated joints, indicating hyaline cartilage formation, and reduced MMP13 and IL-1ß expression, suggesting decreased inflammation and catabolic activity. These findings highlight the regenerative potential of OECs and ADSCs in treating OA by preserving cartilage, promoting chondrocyte proliferation, and reducing inflammation. Further research is needed to optimize delivery methods and evaluate long-term clinical outcomes.

The hiPSC-derived corneal endothelial progenitor-like cell recovers the rabbit model of corneal endothelial dystrophy.

INTRODUCTION: Corneal endothelial dysfunction results in cornea opacity, damaging sightedness, and affecting quality of life. A corneal transplant is the current effective intervention. Due to the scarcity of donated cornea, such an unmet medical need requires a novel therapeutic modality. OBJECTIVES: Customizing patients' corneal endothelial progenitor cells with proliferative activity and lineage restriction properties shall offer sufficient therapeutic cells for corneal endothelial dystrophy. METHODS: The customized induced human corneal endothelial progenitor-like cell (iHCEPLC) was obtained through cell fate conversions starting from PBMC (peripheral blood mononuclear cell), hiPSC (human induced pluripotent stem cell), and hNCC (human neural crest cell), while it finally reached the iHCEPLC state via a series of induction. Several molecular diagnoses were applied to depict its progenitor state, including RNAseq, FlowCytometer, immunostainings, and rtPCR. Significantly, it can be induced to gain differentiation maturity through contact inhibition. In addition, a BAK-mediated rabbit model of corneal endothelial dystrophy was established in the present study to test the therapeutic effectiveness of the iHCEPLC. RESULTS: After inducing cell fate conversion, the specific HCEC markers were detected by rtPCR and immunostaining in iHCEPLC. Further, RNAseq was applied to distinguish its progenitor-like cell fate from primary human corneal endothelial cells (HECE). FlowCytometry profiled the heterogeneity subpopulation, consistently displaying a subtle difference from primary HCEC. A terminal differentiation can be induced in iHCEPLC, addressing its progenitor-like fate. iHCEPLC can restore the BAK-based rabbit model of corneal endothelial dystrophy. Immunohistochemistry verified that such acuity restoration of the BAK-treated cornea is due to the introduced iHCEPLC, and such therapeutic effectiveness is observed in the long term. CONCLUSION: Here, we demonstrated that customized iHCEPLC has long-term therapeutic efficacy. As a progenitor cell, our iHCEPLC has a restricted cell lineage nature and can proliferate in vitro, supporting sufficient therapeutic candidate cells. Due to the immune-privileged nature of the cornea, our iHCEPLC proves the principle of therapeutical feasibility in both autogenic and allogeneic modalities.

Electrically driven green, olivine, and amber color nanopyramid light emitting diodes.

We report the fabrication and studies of electrically driven green, olivine, and amber color nanopyramid GaN light emitting diodes (LEDs). InGaN/GaN multiple quantum wells (MQWs) were grown on the nanopyramid semipolar facets. Compared with the commonly used (0001) c-plane MQWs, the semipolar facet has lower piezoelectric field, resulting in much faster radiative recombination efficiency. This is important for high In content MQWs. The measured internal quantum efficiencies for green, olivine, and amber color LED are 30%, 25%, and 21%, respectively. The radiative and non-radiative lifetime of the semipolar MQWs are also investigated.

Lasing at exciton transition in optically pumped gallium nitride nanopillars.

We report the observation of room temperature lasing action in optically pumped GaN nanopillars. The nanopillars were fabricated by patterned etching and crystalline regrowth from a GaN substrate. When nanopillars were optically excited, a narrow emission peak emerged from the broad spontaneous emission background. The increasing rate is nine times faster than that of the spontaneous emission background, showing the onset of lasing action. The lasing occurs right at the center of spontaneous emission rather than the often reported redshifted wavelength. A spectroscopic ellipsometry analysis indicates that the gain of lasing action is provided by exciton transition.

Play Effects on Hospitalized Children With Acute Respiratory Infection: An Experimental Design Study.

Acute respiratory infection is a major health issue and a primary cause of morbidity and mortality among preschool-aged children worldwide. Disease and hospitalization are chief stressors for children during their development. Therapeutic play has been used in pediatric care processes and has been demonstrated to be effective by most studies that have targeted children undergoing surgeries or invasive medical treatments. Currently, few published studies have focused on children receiving acute inpatient care. Additionally, not all types of therapeutic play produce significant results, and few studies have elaborated on the purposes, principles, and concrete measures of therapeutic play. Therefore, this study aimed to design therapeutic play that would reduce the stress responses of preschool-aged children hospitalized with acute respiratory infection. An experimental design with a pretest/posttest was conducted with 105 preschool children recruited from a regional teaching hospital in southern Taiwan. The children in the experimental group received the therapeutic play, while those in the control group received routine nursing care. Children in the experimental group showed significantly greater reductions in their physiological, psychological, and behavioral stress responses than those in the control group. Future studies could apply therapeutic play to children from different age groups with diverse health issues before recommending it be used in pediatric health settings.

Unexpected identification of a bupivacaine analog from smuggling by using single-crystal X-ray diffraction analysis: N-(2,6-dimethylphenyl)-1-phenethylpiperidine-2-carboxamide.

The identification of new psychoactive substances (NPSs) is essential against drug abuse, especially for "new" drugs that are not regulated by international drug conventions. A suspicious powder seized by the officers of Taipei Customs Administration of Taiwan was sent to this laboratory for analysis by using gas chromatography-mass spectrometry (GCMS), liquid chromatography-high resolution mass spectrometry (LCHRMS), proton nuclear magnetic resonance (1H NMR), carbon-13 nuclear magnetic resonance (13C NMR) with distortionless enhancement by polarization transfer (DEPT) at proton pulses of 45°, 90°, and 135°, two-dimensional correlation NMR measurements (2D_COSY), and heteronuclear single-quantum correlation NMR measurements (2D_HSQC). However, the structure of this "unknown" sample was difficult to identify. Alternatively, single-crystal X-ray crystallography was applied for structural determination after the crystallization of the compound in methanol. The structure was thus identified as N-(2,6-dimethylphenyl)-1-phenethylpiperidine-2-carboxamide (NDMPPPC), an analog of bupivacaine with similar pharmacological effects to those of cocaine, ketamine and morphine. The identification of NDMPPPC is in accordance with all mass fragments and NMR signal data, demonstrating that single-crystal X-ray diffraction can be used for structural determination, especially for complicated structures of "new" drugs or "unknown" samples. The seizure of NDMPPPC from smuggling indicates a great potential to become part of the next generation of NPSs.

Transformation of quality of life in prenatal women with nausea and vomiting.

PROBLEM: Nausea and vomiting not only cause physical discomfort in pregnant women but also impact their quality of life. BACKGROUND: Few longitudinal studies have been conducted to investigate QOL of women over the course of pregnancy. AIM: To examine the transformation of health-related QOL and related factors among pregnant women with NV during three trimesters. METHODS: A longitudinal research design with convenience sampling was used. A structural questionnaire was used to repeatedly measure the data of 101 pregnant women with NV during the first, second, and third trimesters. A generalized estimating equation (GEE) was used to analyze the collecting data. FINDINGS: The results showed significant differences in symptom distress, prenatal stress, and health-related QOL among the three trimesters in pregnant women with NV (p<0.001). The scores of symptom distress, prenatal stress, and health-related QOL in the first trimester were significantly higher than those in the second and third trimesters (p<0.001). The GEE indicated that the trimester of pregnancy, severity of NV, symptom distress, and prenatal stress were key factors for the transformation of health-related QOL of women with NV during pregnancy. DISCUSSION: The findings of this study are seminal in terms of understanding the relationships between symptom distress, prenatal stress and health-related QOL in pregnant women with NV over the course of a pregnancy. CONCLUSION: This study can serve as a reference for designing interventions (i.e., professional support) for women in different pregnancy stages to improve their health-related QOL during pregnancy.

Identification of a liver-specific cAMP response element in the human argininosuccinate synthetase gene.

Argininosuccinate synthetase (ASS), a key enzyme in the urea cycle, participates in many metabolic processes including arginine biosynthesis and the citrulline-nitric oxide (NO) cycle. Factors like diets, hormones and pro-inflammatory stimuli are known to regulate ASS gene expression primarily at the transcription level. However, little is known about the cis-elements for transcriptional regulation of the ASS gene. In this study, we employed DNase I hypersensitive sites mapping to identify potential regulatory sites of the gene and revealed a site located at 10 kb upstream of the transcription start site which is responsible for liver-specific cAMP induction. Furthermore, a cAMP response element (CRE) highly conserved among mammals was identified and was experimentally verified. Our results show that liver-specific enhancement of ASS gene expression is mediated in part by the cAMP signaling pathway through a distal CRE site.

Optimization of reprogramming culture conditions for the generation of induced pluripotent stem cells from Col1a1 4F2A-Oct4-GFP mice with high efficiency.

A reprogrammable transgenic mouse strain, called Col1a1 4F2A-Oct4-GFP, was bred for the present study. Because the somatic cells of this mouse strain contain only two copies of each Yamanaka factor, these animals are inefficient at producing induced pluripotent stem cells (iPSCs; approx. 0.005%) under traditional culture conditions. With an optimized culture condition, the iPSC production rate of mouse embryonic fibroblasts (MEFs) of Col1a1 4F2A-Oct4-GFP mice (MEFCol1a14F2A-Oct4-GFP ) was increased to approximately 8%. Further, promotion of cell proliferation by serum supplementation did not enhance iPSC production. Inhibition of transforming growth factor ß (TGF-ß) in the serum by SB431542 neither affected the growth rate of MEFCol1a14F2A-Oct4-GFP nor promoted iPSC production. However, the use of the gamma-irradiated STO-NEO-LIF (γSNL) cells to serve as feeders for iPSC production resulted in a 5-fold higher rate of iPSC production than the use of γMEFICR feeders. Interestingly, the use of SB431542 with the γMEFICR -adopted system could eliminate this difference. RT-PCR-based comparative analysis further demonstrated that TGF-ß expression was 10-fold higher in γMEFICR than in γSNL cells. Consistent with previous reports, mesenchymal to epithelial transition was found to participate in the initial steps of reprogramming in the specific context of MEFCol1a14F2A-Oct4-GFP . Moreover, we found that the initial seeding density is one of the pivotal factors for determining a high efficiency of iPSC generation. The iPSCs efficiently generated from our MEFCol1a14F2A-Oct4-GFP resembled mouse embryonic stem cells (mESCs) in aspects of teratoma formation and germline transmission. Depending on the culture conditions, our Col1a1 4F2A-Oct4-GFP mouse system can generate bona fide iPSCs with variable efficiencies, which can serve as a tool for interrogating the route taken by cells during somatic reprogramming.

In vitro assay to estimate tea astringency via observing flotation of artificial oil bodies sheltered by caleosin fused with histatin 3.

Astringency, a sensory characteristic of food and beverages rich in polyphenols, mainly results from the formation of complexes between polyphenols and salivary proteins, causing a reduction of the lubricating properties of saliva. To develop an in vitro assay to estimate the astringency of oolong tea infusion, artificial oil bodies were constituted with sesame oil sheltered by a modified caleosin fused with histatin 3, one of the human salivary small peptides. Aggregation of artificial oil bodies was induced when they were mixed with oolong tea infusion or its major polyphenolic compound, (-)-epigallocatechin gallate (EGCG) of 100µM as observed in light microscopy. The aggregated artificial oil bodies gradually floated on top of the solution and formed a visible milky layer whose thickness was in proportion to the concentrations of tea infusion. This assay system was applied to test four different oolong tea infusions with sensory astringency corresponding to their EGCG contents. The result showed that relative astringency of the four tea infusions was correlated to the thickness of floated artificial oil bodies, and could be estimated according to the standard curve generated by simultaneously observing a serial dilution of the tea infusion with the highest astringency.

Comparison of Whole-Genome Sequences from Two Colony Morphovars of Burkholderia pseudomallei.

The entire genomes of two isogenic morphovars (vgh16W and vgh16R) of Burkholderia pseudomallei were sequenced. A comparison of the sequences from both strains indicates that they show 99.99% identity, are composed of 22 tandem repeated sequences with <100 bp of indels, and have 199 single-base variants.

Determination of unbound theophylline in rat blood and brain by microdialysis and liquid chromatography.

To investigate the mechanism by which theophylline crosses the blood-brain barrier (BBB) and its disposition, we determined unbound theophylline in rat blood and brain using microbore liquid chromatography coupled with microdialysis. Microdialysis probes were inserted into the jugular vein and the brain striatum of male Sprague-Dawley rats. Then theophylline at dosage of 10 or 30 mg/kg was administered through the femoral vein. Theophylline and dialysates were separated using a microbore phenyl-hexyl column (150 mm x 1 mm, 5 microm). The mobile phase comprised of acetonitrile-methanol-10 mM monosodium phosphate (pH 3.0) (10:20:70, v/v/v). The UV wavelength was set at 270 nm. The concentration-response relationship was linear over a concentration range of 0.05-50 microg/ml; intra-assay and inter-assay precision and accuracy of theophylline fell within 10%. Average in vivo recoveries were 0.74 +/- 0.06 in blood and 0.27 +/- 0.07 in brain with theophylline at concentrations 1, 2 and 5 microg/ml. This biological sampling method thereby allowed the determination of theophylline levels in blood and brain tissues. The disposition of theophylline in the blood and brain tissue suggests that there was rapid exchange and equilibration between the blood and brain system. The drug-drug interaction results indicate that theophylline was able to cross BBB, but that it might not be regulated by p-glycoprotein to the pharmacokinetics of theophylline.

Determination of extracellular hesperidin in blood and bile of anaesthetized rats by microdialysis with high-performance liquid chromatography: a pharmacokinetic application.

A method coupled with microdialysis technique and liquid chromatography was applied in the continuous and concurrent in vivo monitoring of extracellular hesperidin in the blood and bile of anaesthetized rats. Hesperidin was intravenously administered via the femoral vein. Sampling was achieved using two microdialysis probes, which were implanted into the jugular vein and into the bile duct. Dialysates of blood and bile were both directly injected onto the liquid chromatographic system, so no further clean-up procedures were required. Separation was performed using a reversed phase ODS-2 microbore column 150 mm x 1 mm i.d., particle size 5 microm with mobile phase of acetonitrile-0.1M ammonium acetate (30:70, v/v) at flow-rate of 0.05 ml/min. The UV detection for hesperidin was set at a wavelength of 283 nm. This method was used to determine the pharmacokinetics of hesperidin and its interaction in the presence of cyclosporin A, which is a P-glycoprotein modulator. The results indicate that the curve of area under the concentration versus time (AUC) for hesperidin in bile was significantly greater than that for hesperidin in blood at the dose of 30 mg/kg. The blood-to-bile distribution ratio (k = AUC(bile)/AUC(blood)) was 8.9 +/- 2.5 for hesperidin at 30 mg/kg. Following cyclosporin A treatment, the distribution ratio was reduced to 3.2 +/- 0.6. In conclusion, hesperidin goes through hepatobiliary elimination against the concentration gradient from blood to bile, and this hepatobiliary excretion of hesperidin may be regulated by the P-glycoprotein.

Effects of professional support on nausea, vomiting, and quality of life during early pregnancy.

The purpose of this study was to examine the effectiveness of a professional support (PS) intervention (including individualized health education and supportive phone calls) in reducing the severity of nausea and vomiting (NV) and improving the quality of life (QOL) of women in early pregnancy. An experimental pretest/posttest design with a control group was used. Participants were recruited from a regional teaching hospital in southern Taiwan. The women in the experimental group (n = 40) received the PS intervention, while those in the control group (n = 39) only received routine nursing care. Analysis of covariance and mixed models were used to compare the experimental and control groups while adjusting for covariates. The severity of NV and the perceived level of symptom distress were significantly lower in the experimental group than in the control group during weeks 2 and 4, and the women in the experimental group showed a significant improvement in their QOL in week 4 (p < .05). However, there was no significant difference between the two groups in body weight at week 4 (p = .501). These findings provide empirical evidence in support of the effectiveness of PS in reducing the severity of NV and improving QOL for women during early pregnancy. This intervention could be routinely applied in prenatal nursing health education. Future studies could apply the concept of PS to different populations and health issues.

Gallic acid selectively induces the necrosis of activated hepatic stellate cells via a calcium-dependent calpain I activation pathway.

AIMS: The activation of hepatic stellate cells (HSCs) in response to liver injury is critical to the development of liver fibrosis, thus, the blockage of the activation of HSCs is considered as a rational approach for anti-fibrotic treatment. In this report, we investigated the effects and the underlying mechanisms of gallic acid (GA) in interfering with the activation of HSCs. MAIN METHODS: The primary cultured rat HSCs were treated with various doses of GA for different time intervals. The morphology, viability, caspase activity, calcium ion flux, calpain I activity, reactive oxygen species generation and lysosomal functions were then investigated. KEY FINDINGS: GA selectively killed HSCs in both dose- and time-dependent manners, while remained no harm to hepatocytes. Besides, caspases were not involved in GA-induced cell death of HSCs. Further results showed that GA toxicity was associated with a rapid burst of reactive oxygen species (ROS) and a subsequent increase of intracellular Ca(2+) and calpain activity. Addition of calpain I but not calpain II inhibitor rescued HSCs from GA-induced death. In parallel, pretreatment with antioxidants or an intracellular Ca(2+) chelator eradicated GA responses, implying that GA-mediated cytotoxicity was dependent on its pro-oxidative properties and its effect on Ca(2+) flux. Furthermore, application of ROS scavengers also reversed Ca(2+) release and the disruption of lysosomal membranes in GA-treated HSCs. SIGNIFICANCE: These results provide evidence for the first time that GA causes selective HSC death through a Ca(2+)/calpain I-mediated necrosis cascade, suggesting that GA may represent a potential therapeutic agent to combat liver fibrosis.