An investigation into the present status and influencing factors of nurse retention in grade-a tertiary general hospitals in Shanxi Province within the framework of the magnet hospital concept.

BACKGROUND: The attrition of nursing staff significantly contributes to the shortage of healthcare professionals. This study entailed an examination of the propensity of nurses to sustain employment within Grade-A tertiary general hospitals and the various influencing factors. METHODS: A total of 2,457 nurses from three grade-A tertiary general hospitals were surveyed. The survey instruments included a general information questionnaire, a scale measuring their willingness to continue working, and a Chinese version of the Magnet Hospital Factor scale. RESULTS: The scores of the willingness to continue working scale and the Magnet Hospital Factor scale were 21.53 ± 4.52 and 145.46 ± 25.82, respectively. There were statistically significant differences in the scores of willingness of nurses to continue working across various factors, including the department, age, marital status, family location, length of service as nurses, professional title, position, and employment type, upon comparison (P < 0.001). The correlation analysis showed that there was a positive correlation between the willingness of nurses to continue working and the magnet hospital factors, with a correlation coefficient of 0.523 (P < 0.01). Regression analysis showed that department, length of service as nurses, professional title, position, average monthly income, number of night shifts, medical care relationship, educational support, and nursing manager support among the magnet hospital factors were important predictors of willingness to continue working (P < 0.001). CONCLUSION: The willingness of nurses to continue working in grade-A tertiary general hospitals in Shanxi Province was determined to be at an upper-middle level. The magnet status of grade-A tertiary general hospitals needs to be improved, and there are many factors that influenced willingness of nurses to continue working. To cultivate a more favorable environment and bolster nurse recruitment and retention, all healthcare institutions should strive to establish a magnet nursing environment, thereby fostering the robust development of the nursing team.

Genome-Wide Identification and Drought Stress Response Pattern of the NF-Y Gene Family in Cymbidium sinense.

Cymbidium sinense, a type of orchid plant, is more drought-resistant and ornamental than other terrestrial orchids. Research has shown that many members of the NUCLEAR FACTOR Y (NF-Y) transcription factor family are responsive to plant growth, development, and abiotic stress. However, the mechanism of the NF-Y gene family's response to abiotic stress in orchids has not yet been reported. In this study, phylogenetic analysis allowed for 27 CsNF-Y genes to be identified (5 CsNF-YAs, 9 CsNF-YBs, and 13 CsNF-YC subunits), and the CsNF-Ys were homologous to those in Arabidopsis and Oryza. Protein structure analysis revealed that different subfamilies contained different motifs, but all of them contained Motif 2. Secondary and tertiary protein structure analysis indicated that the CsNF-YB and CsNF-YC subfamilies had a high content of alpha helix structures. Cis-element analysis showed that elements related to drought stress were mainly concentrated in the CsNF-YB and CsNF-YC subfamilies, with CsNF-YB3 and CsNF-YC12 having the highest content. The results of a transcriptome analysis showed that there was a trend of downregulation of almost all CsNF-Ys in leaves under drought stress, while in roots, most members of the CsNF-YB subfamily showed a trend of upregulation. Additionally, seven genes were selected for real-time reverse transcription quantitative PCR (qRT-PCR) experiments. The results were generally consistent with those of the transcriptome analysis. The regulatory roles of CsNF-YB 1, 2, and 4 were particularly evident in the roots. The findings of our study may make a great contribution to the understanding of the role of CsNF-Ys in stress-related metabolic processes.

Genome-Wide Identification and Expression Analysis of the GRAS Gene Family and Their Responses to Heat Stress in Cymbidium goeringii.

The GRAS gene family, responsible for encoding transcription factors, serves pivotal functions in plant development, growth, and responses to stress. The exploration of the GRAS gene family within the Orchidaceae has been comparatively limited, despite its identification and functional description in various plant species. This study aimed to conduct a thorough examination of the GRAS gene family in Cymbidum goeringii, focusing on its physicochemical attributes, phylogenetic associations, gene structure, cis-acting elements, and expression profiles under heat stress. The results show that a total of 54 CgGRASs were pinpointed from the genome repository and categorized into ten subfamilies via phylogenetic associations. Assessment of gene sequence and structure disclosed the prevalent existence of the VHIID domain in most CgGRASs, with around 57.41% (31/54) CgGRASs lacking introns. The Ka/Ks ratios of all CgGRASs were below one, indicating purifying selection across all CgGRASs. Examination of cis-acting elements unveiled the presence of numerous elements linked to light response, plant hormone signaling, and stress responsiveness. Furthermore, CgGRAS5 contained the highest quantity of cis-acting elements linked to stress response. Experimental results from RT-qPCR demonstrated notable variations in the expression levels of eight CgGRASs after heat stress conditions, particularly within the LAS, HAM, and SCL4/7 subfamilies. In conclusion, this study revealed the expression pattern of CgGRASs under heat stress, providing reference for further exploration into the roles of CgGRAS transcription factors in stress adaptation.

Anxiety, depression, and sleep quality among breast cancer patients in North China: Mediating roles of hope and medical social support.

BACKGROUND: Sleep disorders are highly prevalent among breast cancer patients and have a detrimental impact on their quality of life. This study aims to investigate the serial multiple mediating roles of social support and hope in the relationship between anxiety, depression, and sleep quality in breast cancer patients. METHODS: A cross-sectional study was conducted in China from October 2021 to February 2022. A total of 315 breast cancer patients were assessed using self-reported questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Medical Outcomes Study Social Support Survey (MOS-SSS), Herth Hope Index (HHI), and Hospital Anxiety and Depression Scale (HADS). Mediation analysis was performed using the R Statistical Software. RESULTS: Sleep quality exhibited a negative correlation with hope and medical social support (P < 0.01), and a positive correlation with anxiety and depression (P < 0.01). Anxiety and depression accounted for 18.8% and 12.8% of the variance in sleep quality, respectively. Bootstrap analyses of the anxiety-medical social support-hope-sleep quality pathway indicated the presence of direct effects [B = 0.331, 95%CI (0.215, 0.493)] and indirect effects of anxiety on sleep quality mediated solely by medical social support [B = 0.054, 95%CI (0.015, 0.108)] and hope [B = 0.041, 95%CI (0.018, 0.073)], as well as combined effects [B = 0.012, 95%CI (0.004, 0.025)]. Similarly, the depression-medical social support-hope-sleep quality pathway revealed direct effects [B = 0.235, 95%CI (0.104, 0.372)] and indirect effects of depression on sleep quality mediated solely by medical social support [B = 0.078, 95%CI (0.016, 0.150)] and hope [B = 0.049, 95%CI (0.018, 0.086)], as well as combined effects [B = 0.017, 95%CI (0.004, 0.034)]. CONCLUSIONS: This research validates the hypothesis that medical social support and hope serve as mediators between anxiety, depression, and sleep quality in breast cancer patients. Interventions targeting anxiety, depression, medical social support, and hope have the potential to effectively enhance sleep quality.

Efficient and unique cobarcoding of second-generation sequencing reads from long DNA molecules enabling cost-effective and accurate sequencing, haplotyping, and de novo assembly.

Here, we describe single-tube long fragment read (stLFR), a technology that enables sequencing of data from long DNA molecules using economical second-generation sequencing technology. It is based on adding the same barcode sequence to subfragments of the original long DNA molecule (DNA cobarcoding). To achieve this efficiently, stLFR uses the surface of microbeads to create millions of miniaturized barcoding reactions in a single tube. Using a combinatorial process, up to 3.6 billion unique barcode sequences were generated on beads, enabling practically nonredundant cobarcoding with 50 million barcodes per sample. Using stLFR, we demonstrate efficient unique cobarcoding of more than 8 million 20- to 300-kb genomic DNA fragments. Analysis of the human genome NA12878 with stLFR demonstrated high-quality variant calling and phase block lengths up to N50 34 Mb. We also demonstrate detection of complex structural variants and complete diploid de novo assembly of NA12878. These analyses were all performed using single stLFR libraries, and their construction did not significantly add to the time or cost of whole-genome sequencing (WGS) library preparation. stLFR represents an easily automatable solution that enables high-quality sequencing, phasing, SV detection, scaffolding, cost-effective diploid de novo genome assembly, and other long DNA sequencing applications.

An extinct and deeply divergent tiger lineage from northeastern China recognized through palaeogenomics.

Tigers (Panthera tigris) are flagship big cats and attract extensive public attention due to their charismatic features and endangered status. Despite this, little is known about their prehistoric lineages and detailed evolutionary histories. Through palaeogenomic analyses, we identified a Pleistocene tiger from northeastern China, dated to beyond the limits of radiocarbon dating (greater than 43 500 years ago). We used a simulated dataset and different reads processing pipelines to test the validity of our results and confirmed that, in both mitochondrial and nuclear phylogenies, this ancient individual belongs to a previously unknown lineage that diverged prior to modern tiger diversification. Based on the mitochondrial genome, the divergence time of this ancient lineage was estimated to be approximately 268 ka (95% CI: 187-353 ka), doubling the known age of tigers' maternal ancestor to around 125 ka (95% CI: 88-168 ka). Furthermore, by combining our findings with putative mechanisms underlying the discordant mito-nuclear phylogenetic placement for the South China tigers, we proposed a more complex scenario of tiger evolution that would otherwise be missed using data from modern tigers only. Our study provides the first glimpses of the genetic antiquity of tigers and demonstrates the utility of aDNA-based investigation for further understanding tiger evolution.

Exploring the Influence of Inter- and Intra-crystal Diversity of Surface Barriers in Zeolites on Mass Transport by Using Super-Resolution Microimaging of Time-Resolved Guest Profiles.

The applications of nanoporous crystalline materials are closely related to the mass transfer of guest molecules. However, the fundamental knowledge of mass transfer, and in particular the surface barriers controlled by the permeation of guest molecules through the external surfaces of materials, is still incomplete. The diversity of surface permeability at the single-crystal level, caused by the varying origins of surface transport resistance, hinders the rational materials design and needs better understanding. Herein, we probe the molecular transport in single zeolite crystals with fluorescent 4-(4-diethylaminostyryl-1-methylpyridinium iodide) (DAMPI) using super-resolution structured illumination microscopy (SIM). It showed that both the inter- and intra-crystal diversity of surface barriers could be monitored by detecting the diffusion behaviors on the center and surface planes in single crystals. This adds a new perspective for studying the origins of the surface barriers as well as the molecular transport mechanisms in nanoporous materials.

Realizing Fast Synthesis of High-Silica Zeolite Y with Remarkable Catalytic Performance.

High-silica zeolite Y (FAU) plays a vital role in (petro)chemical industries. However, the slow nucleation and growth kinetics of the high-silica FAU framework limit its direct synthesis and the improvement of framework SiO2 /Al2 O3 ratio (SAR). Here, a facile strategy is developed to realize the fast crystallization of high-silica zeolite Y, which involves the combination of high crystallization temperature, ultra-stable Y (USY) seeds and efficient organic-structure directing agent (OSDA). The synthesis can be finished in 5-16 h at 160 °C and with tunable SAR up to 18.2, and the key factors affecting crystallization kinetics and phase purity are elucidated. Moreover, the crystallization process was monitored to reveal the fast crystal growth mechanism. The high-silica products possess high (hydro)thermal stability and abundant strong acid sites, which endow them excellent catalytic cracking performance, obviously superior to commercial USY.

Increasing the Number of Aluminum Atoms in T3 Sites of a Mordenite Zeolite by Low-Pressure SiCl4 Treatment to Catalyze Dimethyl Ether Carbonylation.

Controlling the location of aluminum atoms in a zeolite framework is critical for understanding structure-performance relationships of catalytic reaction systems and tailoring catalyst design. Herein, we report a strategy to preferentially relocate mordenite (MOR) framework Al atoms into the desired T3 sites by low-pressure SiCl4 treatment (LPST). High-field 27 Al NMR was used to identify the exact location of framework Al for the MOR samples. The results indicate that 73 % of the framework Al atoms were at the T3 sites after LPST under optimal conditions, which leads to controllably generating and intensifying active sites in MOR zeolite for the dimethyl ether (DME) carbonylation reaction with higher methyl acetate (MA) selectivity and much longer lifetime (25 times). Further research reveals that the Al relocation mechanism involves simultaneous extraction, migration, and reinsertion of Al atoms from and into the parent MOR framework. This unique method is potentially applicable to other zeolites to control Al location.

The assessment of returning to work following treatment and the associated personal, disease, and treatment factors among breast cancer survivors in central China.

PURPOSE: To assess the status of returning to work (RTW) following breast cancer treatment and to explore its associated factors among female patients. METHODS: Four-hundred-forty-two eligible patients admitted in a tertiary hospital since 2012 were followed up in 2018. Information about working status after treatment, date of RTW or reason for not RTW was obtained during a 30-min interview. Patients' sociodemographic, disease, and treatment characteristics were retrieved from the hospital record. Overall prevalence rate and probability of RTW during the follow-up were estimated using Kaplan-Meier method. Factors associated with RTW were identified using regression analyses. RESULTS: Three-hundred-ninety-six patients (89.6%) completed the follow-up. The median follow-up was 31 months. Among them, 141 patents (35.6%) RTW of whom 68.1% (n = 96) were back within 12 months after cancer treatment. The reported reasons for not RTW included: prolonged fatigue, low self-esteem, lack of support from family and working unit, or voluntarily quitting. Patients aged under 50 years, being single, having higher level of education, not having extensive axillary node procedure, or without any comorbidities were more likely to RTW. CONCLUSION: The rate of RTW after cancer treatment in this cohort was lower than those reported in others. Both personal and treatment factors were associated with RTW.

Flexible silver nanowire/carbon fiber felt metacomposites with weakly negative permittivity behavior.

Recently, flexible metacomposites with negative permittivity have triggered extensive interest owing largely to their promising applications in areas such as sensors, cloaking, and wearable and flexible electronic devices. In this paper, flexible silver nanowire/carbon fiber felt (AgNW/CFF) metacomposites with weakly negative permittivity were fabricated by adjusting their composition and microstructure. Along with the formation of a conductive AgNW network, the resulting composites gradually presented metal-like behavior. Interestingly, weakly negative permittivity with a small absolute value (as low as about 6.4) and good flexibility were observed in the composites with 3.7 wt% AgNWs. The one-dimensional silver nanowires contribute to reducing the overall electron density of the resulting composites, which is responsible for the weakly negative permittivity. As the AgNWs increased, the Drude-like negative permittivity got stronger owing to the enhancement of the electron density. Further investigation from the perspective of microelectronics revealed that the negative permittivity is dependent on the inductive characteristic. The proposed design strategy for AgNW/CFF composites with tunable negative permittivity opens up a new approach to flexible metacomposites.

Cortical Reorganization in Patients Recovered from Bell's Palsy: An Orofacial and Finger Movements Task-State fMRI Study.

Objective. To explore cortical reorganization of patients recovered from Bell's palsy (BP) by task-state functional magnetic resonance imaging (fMRI) during finger and orofacial movements and provide more evidence for acupuncture clinical treatment of BP. Methods. We collected 17 BP patients with complete clinical recovery (BP group) and 20 healthy volunteers (control group) accepted the task-state fMRI scans with lip pursing movements and finger movements, respectively. Results. It was found that there were significant differences of brain functional status between the two groups. Conclusions. The results showed that there was cortical reorganization in the brain of patients recovered from BP after acupuncture treatment, which also suggested the relationship between the hand motor areas and facial motor areas of BP patients.

Counteractive effects of predator invasion and habitat destruction on predator-prey systems.

Alien species invasion and habitat destruction are among the primary threats to native animal communities, particularly for native predator-prey systems. However, when predator invasion and habitat destruction co-occur, it remains unclear whether their respective threats to native systems compensate each other or accumulate, as well as how these effects respond to the different characteristics of predator invasion and habitat destruction. In this study, we developed a spatially explicit simulation model with one prey species and one predator species and exposed it to invasive predators and habitat destruction with different properties. The results revealed the following insights: (1) Habitat destruction can compensate threats to native predator-prey systems from global predator invasion only when native predators possess predation capability similar to those of the invaders. In other scenarios, cumulative effects arise from predator invasion and habitat destruction. (2) Low levels of habitat destruction occurring at a faster rate, in conjunction with a substantial number of global invasive predators being present, can better compensate their respective threats to native predator-prey systems than the other scenarios. These findings provide valuable insights into situations where habitat destruction and alien species invasion coincide. They raise the question of whether we can leverage the interaction between them to reduce threats to biodiversity.

Self-disclosure, perceived social support, and reproductive concerns among young male cancer patients in China: A mediating model analysis.

Objective: Many young male cancer patients experience reproductive concerns. Self-disclosure might be able to improve patients' perceived social support and reproductive concerns. Nevertheless, these relationships have not yet been confirmed among young male cancer patients. This study aims to investigate the level of reproductive concerns and to identify the mediating role of perceived social support between self-disclosure and reproductive concerns among young male cancer patients in China by developing a structural model. Methods: This study was a quantitative, cross-sectional design. We used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines to report this study. A total of 369 young male cancer survivors were recruited by convenience sampling from two tertiary hospitals in Taiyuan, Shanxi, China. Data were collected using a "general data questionnaire", "distress disclosure index" (DDI), "perceived social support scale" (PSSS), and "reproductive concerns after cancer-male" (RCAC-M) via the WeChat mini program "Questionnaire Star" and paper questionnaire. Descriptive statistics, Pearson correlation analyses, and structural equation models were adopted to analyze the data. Results: Reproductive concerns were at moderate levels and negatively associated with self-disclosure (r = -0.619, P < 0.01) and perceived social support (r = -0.599, P < 0.01). Self-disclosure indirectly influenced reproductive concerns (-0.328∼-0.159, P < 0.001) through perceived social support. Conclusions: Self-disclosure and perceived social support are closely associated with reproductive concerns in young male cancer patients, and perceived social support is a mediator between self-disclosure and reproductive concerns. Healthcare providers could reduce reproductive concerns by enhancing self-disclosure and improving perceived social support. Trial registration: This study was registered on ClinicalTrials.gov on June 13, 2023 (NCT05914181).

A qualitative study on the life experiences and discharge planning of family caregivers for the elderly with nasal feeding.

OBJECTIVE: To understand the discharge planning needs of family caregivers for the elderly with nasal feeding. METHODS: From May to August in 2021, in-depth interviews were conducted with eleven family caregivers for elderly patients with nasal feeding at a tertiary hospital in Shenzhen. The interviews were analyzed using phenomenological research methods and the Knowledge, Awareness, and Practice (KAP) theory to identify and refine key themes. RESULTS: The discharge planning needs of family caregivers for elderly with nasal feeding can be summarized into three themes: ① Learning needs related to nasal feeding knowledge and discharge planning (Knowledge), ② Factors affecting the family caregivers of elderly with nasal feeding (Awareness), and ③ Practical needs in caregiving (Practice). CONCLUSION: Discharge planning for family caregivers of elderly individuals receiving nasal feeding should focus on the accurate assessment of tube placement and patient condition, operational skills, emergency response, and complication management. Medical professionals should evaluate these needs to develop personalized discharge readiness service plans, ensuring the quality of care for elderly patients with nasal feeding at home.

Persistent urban heat.

Urban surface and near-surface air temperatures are known to be often higher than their rural counterparts, a phenomenon now labeled as the urban heat island effect. However, whether the elevated urban temperatures are more persistent than rural temperatures at timescales commensurate to heat waves has not been addressed despite its importance for human health. Combining numerical simulations by a global climate model with a surface energy balance theory, it is demonstrated here that urban surface and near-surface air temperatures are significantly more persistent than their rural counterparts in cities dominated by impervious materials with large thermal inertia. Further use of these materials will result in even stronger urban temperature persistence, especially for tropical cities. The present findings help pinpoint mitigation strategies that can simultaneously ameliorate the larger magnitude and stronger persistence of urban temperatures.

Effect of auricular acupressure on sleep quality in breast cancer patients: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: Sleep disturbance is a very common problem among breast cancer patients, and auricular acupressure is a non-pharmacologic intervention to improve the sleep quality. This study aimed to investigate the effectiveness and safety of auricular acupressure to improve sleep quality in breast cancer patients. METHODS: Overall, 8 electronic databases in English and Chinese were systematically searched from inception to August 12, 2023 to identify eligible randomized controlled trials (RCTs). The risk of bias was assessed by version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2.0). RESULTS: A total of 16 studies with 1199 participants were included. The synthesized results showed that compared with the control group, auricular acupressure had a significant effect on improving the effective rate of sleep quality improvement in patients with breast cancer (risk ratio [RR] 1.56, 95 % confidence interval [CI] 1.14 to 2.14; P < 0.001), and that significantly reduced the Pittsburgh Sleep Quality Index (PSQI) global score (mean difference [MD] -3.47, 95 % CI -4.37 to -2.58; P < 0.001). Subgroup analysis of effective rate and PSQI score showed similar significant effects. Additionally, the improvement of sleep quality was better when auricular acupressure was performed by nurses using Vaccaria seeds. Furthermore, the optimal intervention program was performed 1-2 times a day, 3-5 min each time, and lasted for 2-4 weeks. CONCLUSION: Auricular acupressure may effectively improve the sleep quality of patients with breast cancer. However, more rigorously designed, large-sample, multi-center RCTs are required to further validate the results.

Camelus knoblochi genome reveals the complex evolutionary history of Old World camels.

Extant Old World camels (genus Camelus) contributed to the economic and cultural exchanges between the East and West for thousands of years.1,2 Although many remains have been unearthed,3,4,5 we know neither whether the prevalent hybridization observed between extant Camelus species2,6,7 also occurred between extinct lineages and the ancestors of extant Camelus species nor why some populations became extinct while others survived. To investigate these questions, we generated paleogenomic and stable isotope data from an extinct two-humped camel species, Camelus knoblochi. We find that in the mitochondrial phylogeny, all C. knoblochi form a paraphyletic group that nests within the diversity of modern, wild two-humped camels (Camelus ferus). In contrast, they are clearly distinguished from both wild and domesticated (Camelus bactrianus) two-humped camels on the nuclear level. Moreover, the divergence pattern of the three camel species approximates a trifurcation, because the most common topology is only slightly more frequent than the two other possible topologies. This mito-nuclear phylogenetic discordance likely arose due to interspecific gene flow between all three species, suggesting that interspecific hybridization is not exclusive to modern camels but a recurrent phenomenon throughout the evolutionary history of the genus Camelus. These results suggest that the genomic complexity of Old World camels' evolutionary history is underestimated when considering data from only modern species. Finally, we find that C. knoblochi populations began declining prior to the last glacial maximum and, by integrating palaeoecological evidence and stable isotope data, suggest that this was likely due to failure to adapt to a changing environment.

Effects of flora deficiency on the structure and function of the large intestine.

The significant anatomical changes in large intestine of germ-free (GF) mice provide excellent material for understanding microbe-host crosstalk. We observed significant differences of GF mice in anatomical and physiological involving in enlarged cecum, thinned mucosal layer and enriched water in cecal content. Furthermore, integration analysis of multi-omics data revealed the associations between the structure of large intestinal mesenchymal cells and the thinning of the mucosal layer. Increased Aqp8 expression in GF mice may contribute to enhanced water secretion or altered hydrodynamics in the cecum. In addition, the proportion of epithelial cells, nutrient absorption capacity, immune function and the metabolome of cecum contents of large intestine were also significantly altered. Together, this is the first systematic study of the transcriptome and metabolome of the cecum and colon of GF mice, and these findings contribute to our understanding of the intricate interactions between microbes and the large intestine.

Qualitative study of the perceived experiences and needs coping of primary caregivers of patients with breast cancer during operation in central China.

PURPOSE: The purpose of this study is to gain an in-depth understanding of the intraoperative waiting period experience and needs response of primary caregivers of patients with breast cancer. METHOD: Using a purposive sampling method, 16 primary caregivers of patients with breast cancer admitted to the Department of Breast Surgery of Shanxi Bethune Hospital from January to May 2022 were selected as study subjects. Semistructured in-depth interviews were conducted using a qualitative research method. RESULTS: Five themes were extracted from the levels of safety and security, information transfer, emotion management, psychological adjustment and role adaptation: safety first and intraoperative care, lack of information and misdirection, negative emotions and tired of coping, ineffective worry and overthinking, and role multiplicity and bearing alone, respectively. CONCLUSION: The intraoperative waiting period for primary caregivers of patients with breast cancer felt multidimensional and had less than optimal needs satisfaction. Healthcare professionals should use the existing needs as an entry point to give appropriate interventions to enhance the coping ability of caregivers of patients with breast cancer.