Cognitive appraisal of health and its influencing factors among pregnant women with gestational diabetes mellitus: A cross-sectional study.

AIM: To investigate the status quo of cognitive appraisal of health and its influencing factors among pregnant women with gestational diabetes mellitus. METHODS: A cross-sectional survey was conducted from June 2020 to November 2020. Participants were recruited from a tertiary hospital by a convenient sample method. A total of 300 pregnant women with gestational diabetes mellitus completed the survey, including self-compiled individual information questionnaire, Cognitive Appraisal of Health Scale, Pregnancy Stress Rating Scale and General Self-Efficacy Scale. RESULTS: For cognitive appraisal of health, the median score of challenge dimension was 3.75 (3.50, 4.00), benign/irrelevant was 2.75 (2.00, 3.50), harm/loss was 2.38 (2.00, 3.00) and threat was 2.40 (2.00, 2.80), respectively. Regression analyses showed that gestational age, mode of conception, history of abortion, insulin usage, pregnancy stress and self-efficacy were the predictors of cognitive appraisal of health. CONCLUSIONS: This study revealed that pregnant women with gestational diabetes mellitus tended to make positive cognitive appraisal of health. And healthcare providers need to make full use of their predictors of cognitive appraisal of health to improve cognitive appraisal to manage stress and ameliorate pregnancy outcomes.

Effects of decision aids on breast reconstruction: A systematic review and meta-analysis of randomised controlled trials.

AIMS AND OBJECTIVES: To systematically evaluate the effects of decision aids for women facing breast reconstruction decision on decision conflict, decision regret, knowledge, satisfaction, anxiety and depression. BACKGROUND: Breast reconstruction decision is not good or bad and should be guided by clinical evidence and patient preferences. Decision aids can increase the patient's decision-making enthusiasm and ability, improve the quality of decision and promote shared decision-making between patients and medical staff. DESIGN: Systematic review and meta-analysis. METHODS: Eight databases were conducted from the establishment of the database until October 2021. The PRISMA checklist was selected for analysis in this paper. The meta-analysis was conducted in Review Manager 5.3. The quality of the studies was assessed using the Cochrane risk-of-bias tool. The result is decision conflict, decision regret, knowledge and other secondary outcomes. Sensitivity analysis and subgroup analysis were also conducted. RESULTS: A total of twelve randomised controlled trials (RCTs) were included in the systematic review and meta-analysis. Meta-analysis revealed that decision aids could significantly reduce decision conflict and decision regret, improve knowledge, satisfaction and depression and had no influence on anxiety. CONCLUSIONS: The results of the systematic review and meta-analysis reviewed the positive effect of decision aids on the decision-making of women facing postmastectomy breast reconstruction. In the future, more well-designed RCTs are needed to confirm the effects of decision aids on the decision-making of breast reconstruction and nurses should be encouraged to take part in the development of decision aids in accordance with strict standards and apply them to breast cancer patients considering postmastectomy breast reconstruction. RELEVANCE TO CLINICAL PRACTICE: Our study provides evidence for the effectiveness of decision aids on breast reconstruction and points to the important role of healthcare providers in the use of decision aids and in facilitating shared decision-making.

Cognitive engagement of nursing undergraduates in blended learning: A parallel mixed method study.

BACKGROUND: Blended learning is being integrated into undergraduate nursing education at all levels and from all directions. Cognitive engagement is not only an embodiment and guarantee of students' engagement into the curriculum from a cognitive level, deep engagement and high-level thinking, but also an important indicator of whether students are effectively engaged in the blended learning curricula. However, no studies have been seen to investigate the cognitive engagement of nursing undergraduates in the blended learning curricula and its influential factors. OBJECTIVES: To explore nursing undergraduates' cognitive engagement during the blended learning curricula and its influential factors. DESIGN: A convergent parallel mixed-methods was used. Data were collected between November 2021 and May 2022, inclusive. SETTINGS AND PARTICIPANTS: The study was carried out in the nursing school at a university in China. Participants including students undertaking entry to the blended learning curricula. METHODS: In the quantitative component (n = 142), participants' cognitive engagement was investigated and factors associated with it were examined using univariate analysis, correlation analysis and multiple regression analysis. During this period, personal, semi-structured interviews were conducted with a subset of these participants (n = 15) to understand participants' cognitive engagement experiences. RESULTS: The cognitive engagement of nursing undergraduates was at a moderate level and the cognitive engagement experiences were reflected in the four themes of Reconstitution, Connection, Elaboration and Retention. The influential factors of cognitive engagement were learning activities (ß = 0.226, p = 0.004), autonomy (ß = 0.158, p = 0.047), academic self-efficacy (ß = 0.311, p < 0.001, ß = 0.271, p < 0.001) and social interaction (ß = 0.358, p < 0.001). CONCLUSIONS: The cognitive engagement of nursing undergraduates in the blended learning curricula needs to be improved. To maximize promote cognitive engagement of nursing undergraduates in the blended learning curricula, educators should design diverse learning activities, engage in high quality social interactions with students, and maximize students' autonomy and self-efficacy.

Effectiveness of Internet-Based Cognitive Behavioral Therapy for Patients With Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Internet-based cognitive behavioral therapy (ICBT) is a relatively new therapy with unknown effectiveness in patients with cancer. In addition, therapist-guided and self-guided ICBT patient-specific outcomes for cancer patients remain to be explored. OBJECTIVE: To explore the effects of ICBT on psychological outcomes, physical outcomes, and daily life outcomes in patients with cancer. METHODS: Electronic databases such as PubMed, Web of Science, Cochrane Library, EMBASE, APA PsycINFO, ProQuest, and ClinicalTrials.gov were searched for relevant studies published from their inception to October 2022. Five GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) considerations were used to assess the quality of relevant evidence. Data analysis was performed via RevMan 5.4 (The Cochrane Collaboration, London, United Kingdom) and Stata 15.0 (StataCorp, College Station, Texas). RESULTS: Three thousand two hundred forty-nine participants from 20 studies were included in the meta-analysis. Statistically significant effects of ICBT were found on psychological distress, quality of life (QOL), anxiety, and depression, after the intervention. A separate analysis of follow-up data showed that ICBT had a sustainable effect on psychological distress, anxiety, and depression. Subgroup analyses showed that therapist-guided ICBT was more effective for psychological distress and QOL. CONCLUSION: Internet-based cognitive behavioral therapy can improve symptom management for patients with cancer. IMPLICATIONS FOR PRACTICE: Internet-based cognitive behavioral therapy effectively improves psychological distress, anxiety, and depression in patients with cancer after intervention and at follow-up. Internet-based cognitive behavioral therapy improved QOL for cancer patients postintervention but not during follow-up. Internet-based cognitive behavioral therapy did not relieve fatigue or fear of recurrence in cancer patients. Therapist-guided ICBT is recommended for its superior outcomes in alleviating psychological distress and improving overall QOL in adults with cancer when compared with self-guided ICBT.

The effectiveness of auricular acupressure on pain management during labor: A systematic review and meta-analysis of randomized controlled trials.

AIM: This meta-analysis aimed to systematically evaluate the effectiveness of auricular acupressure on pain management during labor. METHODS: Six English and three Chinese electronic databases were comprehensively searched from inception to 6 November 2021. The PRISMA checklist was followed. The methodological quality of the included studies was assessed with the Cochrane Collaboration Bias Risk Assessment Tool. The meta-analysis was performed using Review Manager 5.3 software. Heterogeneity between studies was calculated using I2 . RESULTS: Five studies comprising 312 participants were included. The labor pain scores of the auricular acupressure group were significantly lower than those of the usual care group at cervix dilations of 6, 8, and 10 cm, with mean differences (95% confidence intervals) of -1.05 (-1.41, -0.69), -1.44 (-2.07, -0.82), and -1.96 (-3.30, -0.61), respectively. Auricular acupressure can thus effectively improve the labor pain perception at cervix dilations of 6, 8, and 10 cm. Moreover, auricular acupressure shortened the active phase, and had the trend of shortening the second and third stages of labor. There was no evidence that auricular acupressure had an effect on the rate of cesarean section or the 1 and 5 min Apgar scores. CONCLUSION: Effective labor pain relief, better labor pain perception, and the lack of adverse effects support the use of auricular acupressure. More high-quality and rigorous trials are needed to verify our findings before we can make strong recommendations.

Bifurcation Asymmetry of Small Coronary Arteries in Juvenile and Adult Mice.

Background: Microvascular bifurcation asymmetry is of significance for regulation of coronary flow heterogeneity during juvenile and adult growth. The aim of the study is to investigate the morphometric and hemodynamic variation of coronary arterial bifurcations in mice of different ages. Methods: Pulsatile blood flows were computed from a Womersley-type model in the reconstructed left coronary arterial (LCA) trees from Micro-CT images in normal mice at ages of 3 weeks, 6 weeks, 12 weeks, 5-6 months, and >8 months. Diameter and flow ratios and bifurcation angles were determined in each bifurcation of the LCA trees. Results: The blood volume and inlet flow rate of LCA trees increase and decrease during juvenile and adult growth, respectively. As vessel diameters decrease, the increased ratios of small to large daughter vessel diameters (Ds /Dl ) result in more uniform flows and lower velocities. There are significant structure-functional changes of LCA trees in mice of >8 months compared with mice of < 8 months. As Ds /Dl increases, the variation trend of bifurcation angle during juvenile growth is different from that during adult growth. Conclusions: Although inlet flows are different in adult vs. juvenile mice, the adult still have uniform flow and low velocity. This is accomplished through a decrease in diameter. The design ensures ordered dispersion of red cells through asymmetric branching patterns into the capillaries.

Hepatic Hemangiomas Alter Morphometry and Impair Hemodynamics of the Abdominal Aorta and Primary Branches From Computer Simulations.

Background: The formation of hepatic hemangiomas (HH) is associated with VEGF and IL-7 that alter conduit arteries and small arterioles. To our knowledge, there are no studies to investigate the effects of HH on the hemodynamics in conduit arteries. The aim of the study is to perform morphometric and hemodynamic analysis in abdominal conduit arteries and bifurcations of HH patients and controls. Methods: Based on morphometry reconstructed from CT images, geometrical models were meshed with prismatic elements for the near wall region and tetrahedral and hexahedral elements for the core region. Simulations were performed for computation of the non-Newtonian blood flow using the Carreau-Yasuda model, based on which multiple hemodynamic parameters were determined. Results: There was an increase of the lumen size, diameter ratio, and curvature in the abdominal arterial tree of HH patients as compared with controls. This significantly increased the surface area ratio of low time-averaged wall shear stress (i.e., SAR-TAWSS [Formula: see text] 100%) (24.1 ± 7.9 vs. 5 ± 6%, 11.6 ± 12.8 vs. < 0.1%, and 44.5 ± 9.2 vs. 21 ± 24% at hepatic bifurcations, common hepatic arteries, and abdominal aortas, respectively, between HH and control patients). Conclusions: Morphometric changes caused by HH significantly deteriorated the hemodynamic environment in abdominal conduit arteries and bifurcations, which could be an important risk factor for the incidence and progression of vascular diseases.

Gold nanorods contained polyvinyl alcohol/chitosan nanofiber matrix for cell imaging and drug delivery.

Gold nanorods (AuNRs) that contained polyvinyl alcohol/chitosan (PVA/CS) hybrid nanofibers with dual functions are successfully fabricated by a simple electrospinning method. The results of transmission electron microscopy (TEM), X-ray diffraction (XRD) and energy dispersive X-ray (EDX) spectroscopy indicate that AuNRs are indeed encapsulated into the PVA/CS hybrid nanofibers. FTIR spectra results demonstrate that the chemical structures of PVA and CS are not affected when the AuNRs are introduced into the fibers. In vitro cytotoxicity test reveals that the hybrid fibers involving AuNRs are completely biocompatible. The as-prepared fibers can be used as a carrier for anticancer agent doxorubicin (DOX), and the drug is delivered into the cell nucleus. The AuNRs and DOX incorporated fibers are effective for inhibiting the growth and proliferation of ovary cancer cells and they can also be used as the cell imaging agent due to the unique optical properties of AuNRs. The nanofiber matrix combining two functions of cell imaging and drug delivery may be of great application potential in biomedical-related areas.