Barriers and facilitators to physical activity participation in patients with head and neck cancer: a scoping review.

BACKGROUND: Patients with head and neck cancer (HNC) usually experienced disfigurement, dysfunction, and psychosocial distress, leading to a decline in their quality of life. Physical activity (PA) is recommended for such patients. Despite the proven benefits of participating in PA, the compliance of patients with HNC is still poor. Hence, the factors influencing PA participation and adherence in patients with HNC need to be explored. OBJECTIVES: This study aimed to (1) identify barriers and enablers of PA in adult patients living with HNC and (2) map barriers and facilitators to the Capability-Opportunity-Motivation-Behavior (COM-B) model. ELIGIBILITY CRITERIA: Types of studies: Studies with qualitative, quantitative, and mixed designs were included in this review. TYPES OF PARTICIPANTS: The current review takes into account patients with HNC aged 18 years or above. Types of interventions: This review considered all studies focusing on full-body PA. TYPES OF OUTCOMES: This scoping review focused on studies examining health behavior, patients' compliance, and facilitators and/or barriers to PA engagement. Five databases (Ovid Medline, Ovid Embase, CINAHL, Cochrane Library, and PsycINFO) were searched following the methodology for scoping reviews from inception to July 2021. DATA EXTRACTION: The extracted data included author(s)/year of publication, country, main purpose of the study, sample size/disease site and stage, methodology and methods, type of treatment, and main findings/barriers, or facilitators. RESULTS: A total of 22 studies were finally selected. The top three barriers were physical-related issues, time pressures, and low motivation or interest. Most facilitators included perceived psychological, health, and social benefits and preference for the model of PA. The most frequent COM-B model components were physical capability, automatic motivation, and physical opportunity. CONCLUSIONS: Patients with HNC have unique facilitators and barriers to participating in PA. Interventions must leverage facilitators and limit barriers to exercise so as to increase compliance with exercise. Future studies should test the effectiveness of behavioral change measures based on the factors influencing the COM-B model.

Effect and feasibility of gamification interventions for improving physical activity and health-related outcomes in cancer survivors: an early systematic review and meta-analysis.

BACKGROUND: Despite the well-documented advantages of regular physical activity (PA), patients with cancer show suboptimal participation. By using game design elements, gamification could be used to motivate individuals to engage in PA. It has been demonstrated that gamification interventions positively affect children, adolescents and older adults in health-related contexts. There are, however, inconsistent findings regarding the impact of gamification interventions on cancer survivors' PA and health-related outcomes, according to the literature. OBJECTIVES: The aim of this study is to examine the effectiveness and feasibility of gamification interventions for improving PA and health-related outcomes among cancer survivors. METHODS: A systematic review and meta-analysis were conducted following the Cochrane Handbook and PRISMA guidelines. Eight English databases and three Chinese databases were searched to identify eligible articles from inception to February 2022. Two reviewers independently performed the literature screening and data extraction. The Cochrane Risk of Bias tool was used to assess the risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) Working Group levels of evidence was used to evaluate the certainty of the findings. RESULTS: Ten randomised controlled trials (RCTs) published between 2014 and 2022 were included. The meta-analysis revealed no significant differences in the step counts and for moderate to vigorous PA, and the certainty of the findings was very low, according to GRADE. Meta-analysis for most outcomes could not be performed owing to the fewer included studies and significant heterogeneity. Most studies reported positive effects in improving moderate PA, sedentary behaviour, fatigue and at least one domain of quality of life. This review proved that gamified interactions are associated with low adverse event rates. CONCLUSION: Gamification interventions could be a feasible way to promote the adoption of mobile health (mHealth) technology in patients with cancer. Individual studies have demonstrated some positive effects of gamification interventions on PA and health-related outcomes. However, limited studies, small sample sizes and methodological heterogeneity weaken the evidence. Larger, well-designed RCTs are required to confirm the impact of gamification interventions on PA and health-related outcomes in cancer survivors.

Ecological function-oriented vegetation protection and restoration strategies in China's Loess Plateau.

Potential natural vegetation (PNV) can provide a reference for vegetation protection and restoration. Previous studies often used PNV patterns as a reference; however, they ignored PNV ecological functions, impeding the establishment of function-oriented vegetation protection and restoration plans. To address this issue, this study used Loess Plateau of China as a case study to propose an ecological function-oriented vegetation protection and restoration framework based on PNV patterns and ecological functions. The results showed that PNV patterns, ecological functions, and their synergistic and trade-off relationships represented distinct spatial differences that would be largely influenced by climate change. This suggested that vegetation protection and restoration should be adapted to climate change. The protection and potential restoration regions for actual forest and grass were detected based on the stable PNV regions. Approximately 34.5%-41.4% of actual forest and 81.2%-82.3% of actual grass should be protected. Further, 13.9%-16.2% of actual forest and 14.7%-15.2% of actual grass have the potential to be restored to grass and forest, respectively, and lastly, the priority regions of forest and grass protection and potential restoration were determined according to a composite ecological functions index. Moreover, forest protection should be prioritized, followed by forest potential restoration, grass potential restoration, and grass protection. These results would be conducive to forest and grass protection and restoration of the Loess Plateau. The proposed framework is applicable to other regions of the world for developing vegetation protection and restoration strategies.

Nurse-led telephone follow-up according to the revised nursing outcomes classification for laryngeal carcinoma surgery patients: a randomized controlled trial.

BACKGROUND: This study used the revised nursing outcomes classification (NOC) outlined in our previous study, "Core nursing outcomes for otorhinolaryngology head-neck," for telephone follow-up of patients who had laryngeal carcinoma surgery in China. This randomized controlled trial aimed to compare nurse-led telephone follow-up according to the revised NOC with traditional telephone follow-up. METHODS: A total of 100 postoperative patients were recruited from March 2018‒March 2020. Patients were randomly assigned to nurse-led telephone follow-up groups as either revised NOC follow-up (n = 51) or traditional follow-up (n = 49). The investigated outcomes included nursing outcomes, quality of life, and self-care abilities. RESULTS: The baseline characteristics of patients were well balanced. We noted that improvements in nursing outcomes in the intervention group were significantly better than for those in the control group (P = 0.018), primarily regarding psychosocial health (P < 0.001) and health knowledge and behavior (P < 0.001). Moreover, patient outcomes in the intervention group were associated with greater improvements in quality of life than those in the control group (P < 0.001), especially for social conditions (P < 0.001), emotional health (P < 0.001), functional status (P < 0.001), and additional attention (P = 0.001). Finally, compared with the control group, significant improvements were observed in self-care abilities in the intervention group (P = 0.002), mainly regarding general self-care abilities (P = 0.016) and development self-care abilities (P < 0.001). CONCLUSION: This study found that nurse-led telephone follow-up according to the revised NOC improved nursing outcomes, quality of life, and self-care abilities. TRIAL REGISTRATION: ChiCTR2100045941.

Evaluation and revision of core postoperative nursing outcomes for laryngeal carcinoma in China.

BACKGROUND: The core nursing outcomes for laryngeal carcinoma in China needed further screening and revision. This study aimed to evaluate and revise a questionnaire according to the "Core Nursing Outcomes for Otorhinolaryngology Head-Neck" of the Nursing Outcomes Classification (NOC, 5th Edition), and determine suitable postoperative nursing outcomes for patients with laryngeal carcinoma in China. METHODS: The commonly used postoperative nursing outcomes for laryngeal carcinoma were screened using a questionnaire given to 93 nurses. An initial expert consultation questionnaire was constructed to discuss the indicators for each nursing outcome. A total of 20 experts were identified using the Delphi method, and their recommendations and revisions on the selected nursing outcomes were collected. RESULTS: A total of 14 postoperative core nursing outcomes and 69 indicators were identified for postoperative patients with laryngeal carcinoma, which are subordinate to 4 domains of the NOC: "Physiologic Health", "Psychosocial Health", "Health Knowledge & Behavior", and "Perceived Health". CONCLUSIONS: The screening and revision of the NOC outcomes and indicators of the Delphi method could be applied to assess the effect of nursing intervention and the quality of the nursing service in China.

A validation study of the Job Crafting Scale among nurses in public hospitals in China.

PURPOSE: To verify the reliability and validity of the Job Crafting Scale among nurses in Chinese public hospitals. BACKGROUND: Job crafting is an important organisational variable for medical institutions. Although the Japanese and Spanish versions of the Job Crafting Scale are available, this scale has not been validated in Chinese nurses. METHODS: A convenience sample of 2,095 registered hospital nurses was recruited from 25 provinces in mainland China from June 2019 to July 2019. Descriptive analyses were performed. Reliability and correlation analyses, exploratory factor analyses and confirmatory factor analyses of data collected using the Chinese version of the Job Crafting Scale were also conducted. FINDINGS: The Chinese version of the Job Crafting Scale has good validity and reliability. The goodness-of-fit indices for confirmatory factor analysis were acceptable (CFI = 0.933, NFI = 0.927, TLI = 0.920, IFI = 0.933). The Cronbach α coefficient for the total scale was .920, and the coefficients for each dimension of this scale were between .804 and .894. CONCLUSION: The Chinese version of the Job Crafting Scale has good reliability and validity, which supports its use as an effective tool to measure the working level of job crafting among nurses in public hospitals in China. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers may use reliable and effective tools, including the Chinese version of the Job Crafting Scale, to determine the level of job crafting at their institutions and to develop effective interventions to improve it.

Nurses' mental health and patient safety: An extension of the Job Demands-Resources model.

AIM: We employed the job demands-resources model to examine the impacts of job demands and resources on Chinese nurses' mental health and patient safety. BACKGROUND: Employee mental health and patient safety represent important organisational goals in most hospitals. However, their relationships to insomnia, professional resources and job crafting, as related to the job demands-resources model among nurses, remain unclear. METHODS: A convenience sample of 2095 registered hospital nurses was recruited from 25 provinces of mainland China from June 2019 to July 2019. Data were collected using self-reported questionnaires that included the following instruments: the Chinese version of the Athens Insomnia Scale, the Practice Environment Scale of the Nursing Work Index, the Job Crafting Scale, the Emotional Exhaustion Scale, the Utrecht Work Engagement Scale, the General Health Questionnaire and the Safety Attitudes Questionnaire. RESULTS: The final model confirmed our hypotheses: burnout mediated the relationship between actual job demands and mental health; work engagement mediated the relationship between perceived job resources and attitudes with regard to patient safety; and job crafting enhanced work engagement and practice environment. CONCLUSION: The job demands-resources model was extended based on the nurses' job characteristics and mental health, as well as patient safety. IMPLICATIONS FOR NURSING MANAGEMENT: These findings may contribute to nursing management strategies that encourage employees to prevent burnout, promote work engagement and job crafting, and in turn promote nurses' mental health and patient safety.

Efficacy of laser surgery versus radiotherapy for treatment of glottic carcinoma: a systematic review and meta-analysis.

Laser surgery and radiotherapy are the two most common ways to treat glottic carcinomas, which is more efficacious and remains controversial. PubMed, Embase, and Cochrane Library were searched to identify relevant studies of laser surgery versus radiotherapy in patients with glottic carcinomas through April 2017. Sensitivity analysis and subgroup analysis were performed to evaluate heterogeneity. Eighteen studies were selected, which included 2480 patients. Patients who had laser surgery had higher rates of laryngeal preservation (OR 3.852; 95% CI 1.922-7.721) and overall survival (OR 1.388; 95% CI 1.063-1.811) versus who had radiotherapy. No significant differences were observed between laser surgery and radiotherapy on local control (OR 1.186; 95% CI 0.759-1.854), recurrence (OR 0.758; 95% CI 0.445-1.289), or disease-specific survival (OR 1.597; 95% CI 0.887-2.876). There were clinical benefits for patients with glottic carcinoma after laser surgery compared with radiotherapy with respect to survival and laryngeal preservation.

Developing a conceptual model for understanding caregiving experience and their impacts on quality of life for Chinese breast cancer family caregivers: A qualitative study.

AIM: The purpose of this study was to understand the caregiving experiences of breast cancer family caregivers and explore the profound impacts of those experiences on their quality of life. DESIGN: A qualitative research method was used. METHODS: We extended invitations to 23 family caregivers of outpatients and inpatients receiving breast surgery and oncology treatments in Taiyuan, China, to participate in semi-structured interviews. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was employed to analyse the interview data. RESULTS: Four themes and associated categories were identified: (1) changes in family dynamics, (2) the socio-medical context, (3) interactions between family and society, (4) self-efficacy and nine subthemes and their related categories, where virtually all participants expressed future uncertainty, emotional contagion, and personal challenges, and self-efficacy had a moderating influence on the first three themes. PATIENT OR PUBLIC CONTRIBUTION: This study did not involve direct participation of patients or the public. However, their experiences and perspectives on caregiving were indirectly reflected through the insights provided by the family caregivers who participated in the interviews. Their valuable input contributed to a deeper understanding of the caregiving experience and its impact on the quality of life for Chinese breast cancer family caregivers.

Views of health care professionals on the implementation of preoperative advance care planning in older patients with head and neck cancer: Q methodology.

Objective: To investigate the views of health care professionals in a head and neck surgical department toward the implementation of advance care planning prior to surgery for older patients with head and neck cancer. Method: Q methodology was used to explore and analyze participants' views by combining quantitative and qualitative methods. Participants were asked to rank 35 Q statements generated via semi-structured interviews and a literature review and to explain the reasons for their ranking in subsequent interviews. The data was then analyzed and used to develop a factor series to illustrate participants' views. Results: This study surveyed 15 health care professionals, including eight doctors and seven nurses. The views of health care professionals toward preoperative implementation of advance care planning discussions were varied and could be categorized into three types: defending the autonomy of patients, patients' knowledge and the Chinese traditional cultural context hinder the implementation of preoperative advance care planning, and lack of confidence in performing preoperative advance care planning. Conclusions: Although the health care professionals in the head and neck surgical department in this study recognized the benefits of preoperative discussions regarding advance care planning, patients' knowledge level, traditional Chinese values, inadequate capacity among health care professionals, and unsound legal policies have caused these professionals to have misgivings about preoperative counseling and discussing advance care planning with patients. Further studies should be conducted, and strategies to overcome barriers to discussions of preoperative advance care planning should be developed.

Clinical validation of the nursing outcome "Swallowing status: pharyngeal phase" in patients with laryngeal cancer.

AIMS AND OBJECTIVES: This study aimed to clinically validate the nursing outcome "Swallowing status: pharyngeal phase" (1013). METHODS: A two-stage study was designed: (1) Chinese translation and cultural adaptation and (2) clinical validation. Internal consistency and interrater reliability tests were performed on 285 patients with laryngeal cancer, and an additional 130 patients were randomly selected from the 285 patients as an independent sample. Criterion-related validity tests were performed using the standardized swallowing assessment (SSA). Nursing outcome sensitivity was detected by scoring two time points. RESULTS: The Cronbach's alpha coefficients were 0.951 for the nursing outcome and 0.942-0.965 for each indicator. The interclass correlation coefficient (ICC) values for each indicator ranged from 0.73 to 0.929. The scores of the nursing outcome were negatively correlated with the SSA scores (r = -0.555, p < 0.01). With the exception of two indicators, there was a significant difference (p < 0.05) between the total scores of the scale and its 11 indicator scores for the two time points. The results indicated that the nursing outcome "Swallowing status: pharyngeal phase" (1013) exhibited satisfactory psychometric properties and high sensitivity to change. CONCLUSIONS: The nursing outcome "Swallowing status: pharyngeal phase" (1013) demonstrated good reliability, validity, and sensitivity in patients with laryngeal cancer. IMPLICATIONS FOR NURSING PRACTICE: The nursing outcome "Swallowing status: pharyngeal phase" (1013) can be used to assess swallowing function in patients with laryngeal cancer and provide guidance for the development of rehabilitation intervention plans and nursing care.

Application of NANDA-I nursing diagnoses, nursing interventions classification, and nursing outcomes classification in research and practice of cardiac rehabilitation nursing: A scoping review.

PURPOSE: To describe the current application status of NANDA-I nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) in cardiac rehabilitation nursing and identify useful NANDA-I, NIC, and NOC (NNN) linkages for clinical nursing practitioners. METHODS: This scoping review was performed in accordance with the Joanna Briggs Institut guidelines. We systematically searched eight databases, and the literature search took place between June and July 2023. The characteristics and results of the studies were synthesized and analyzed in a narrative way. FINDINGS: The application of NANDA-I nursing diagnosis, NIC and NOC in cardiac rehabilitation nursing can be divided into three topics: the content, value and effect of NANDA-I nursing diagnosis, NIC and NOC. CONCLUSION: The application of NANDA-I, NIC, and NOC in the field of cardiac rehabilitation nursing shows positive effects on the whole, which can provide more standardized theoretical guidance, improve nursing outcomes in clinical settings, and enhance nursing quality. IMPLICATIONS FOR NURSING PRACTICE: This experience report will guide nurses to use NANDA-I, NIC, and NOC for better cardiac rehabilitation care.

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.

Development of mobile health-based interventions to promote physical activity in patients with head and neck cancer: a qualitative study.

Background: Despite the well-grounded benefits of physical activity (PA), poor compliance with the PA guidelines has been reported among head and neck cancer (HNC) patients. Mobile health (mHealth)-based interventions can help cancer survivors increase their PA levels and increase the reach or efficiency of rehabilitation services. However, there is limited knowledge about the needs and perceptions of HNC patients regarding these interventions. This study explored the perceptions and needs of HNC patients regarding mHealth-based PA programs before developing such interventions to ensure their improved effectiveness. Study design: A constructivist qualitative study. Methods: We purposively selected 17 adult HNC patients aged 40-80 years to determine their needs and perceptions of future mHealth-based PA programs. Semi-structured face-to-face interviews were conducted, and the data were analyzed via thematic analysis. The report followed the Consolidated Criteria for Qualitative Research Reports guidelines. Results: Four themes were analyzed from the interview transcripts regarding the needs and perceptions of mHealth-based PA programs: (1) functionality needs; (2) system usage requirements; (3) social support; and (4) perceived barriers and facilitators. HNC patients expect highly customized and specialized mHealth interventions that consider individual factors, address their concerns about security, network, and cost, and prefer improved comfort. Moreover, they expect to receive support from their healthcare providers, families, and peers. Conclusion: The study provides pragmatic ready-to-use recommendations to design interventions for inactive HNC patients to achieve the recommended PA levels. Future mHealth interventions should be tailored according to the needs of the HNC patients by utilizing perceived facilitators and removing perceived barriers to help them engage in PA actively.

Balloon Angioplasty vs. Stenting for Symptomatic Intracranial Arterial Stenosis.

Aims: We performed a meta-analysis to indirectly compare the treatment effectiveness of balloon angioplasty and stenting for patients with intracranial arterial stenosis. Methods: Literature searches were performed in well-known databases to identify eligible studies published before January 04, 2021. The incidence of restenosis, transient ischemic attack (TIA), stroke, death, and dissection after balloon angioplasty or stenting were pooled. An indirect comparison of balloon angioplasty vs. stenting was performed, and the ratios of incidence (RIs) with 95% confidence intervals (CIs) were calculated using the random-effects model. Results: 120 studies that recruited 10,107 patients with intracranial arterial stenosis were included. The pooled incidence of restenosis after balloon angioplasty and stenting were 13% (95%CI: 8-17%) and 11% (95%CI: 9-13%), respectively, with no significant difference between them (RI: 1.18; 95%CI: 0.78-1.80; P = 0.435). Moreover, the pooled incidence of TIA after balloon angioplasty and stenting was 3% (95%CI: 0-6%) and 4% (95%CI: 3%-5%), and no significant difference was observed (RI: 0.75; 95%CI: 0.01-58.53; P = 0.897). The pooled incidence of stroke after balloon angioplasty and stenting was 7% (95%CI: 5-9%) and 8% (95%CI: 7-9%), respectively, and the difference between groups was found to be statistically insignificant (RI: 0.88; 95%CI: 0.64-1.20; P = 0.413). Additionally, the pooled incidence of death after balloon angioplasty and stenting was 2% (95%CI: 1-4%) and 2% (95%CI: 1-2%), with no significant difference between groups (RI: 1.00; 95%CI: 0.44-2.27; P = 1.000). Finally, the pooled incidence of dissection after balloon angioplasty and stenting was 13% (95%CI: 5-22%) and 3% (95%CI: 2-5%), respectively, and balloon angioplasty was associated with a higher risk of dissection than that with stenting for patients with intracranial arterial stenosis (RI: 4.33; 95%CI: 1.81-10.35; P = 0.001). Conclusion: This study found that the treatment effectiveness of balloon angioplasty and stenting were similar for patients with symptomatic intracranial arterial stenosis.

Elucidating the Molecular Mechanism of Ischemic Stroke Using Integrated Analysis of miRNA, mRNA, and lncRNA Expression Profiles.

Objective: This study aimed to investigate the possible molecular mechanisms associated with ischemic stroke through the construction of a lncRNA-miRNA-mRNA network. miRNA expression profile in GSE55937, mRNA and lncRNA expression profiles in GSE122709, and mRNA expression profile in GSE146882 were downloaded from the NCBI GEO database. After the identification of the differentially expressed miRNA, lncRNA, and mRNA using GSE55937 and GSE122709 in ischemic stroke vs. control groups, a protein-protein interaction (PPI) network was constructed. The lncRNA-miRNA, lncRNA-mRNA, and miRNA-mRNA pairs were predicted, and a lncRNA-miRNA-mRNA network was constructed. Additionally, the gene-drug interactions were predicted. Characteristic genes were used to construct a support vector machine (SVM) model and verified using quantitative reverse transcription polymerase chain reaction. In total 38 miRNAs, 115 lncRNAs, and 990 mRNAs were identified between ischemic stroke and control groups. A PPI network with 371 nodes and 2306 interaction relationships was constructed. The constructed lncRNA-miRNA-mRNA network contained 7 mRNAs, 14 lncRNAs, such as SND1-IT1, NAPA-AS1, LINC01001, LUCAT1, and ASAP1-IT2, and 8 miRNAs, such as miR-93-3p and miR-24-3p. The drug action analysis of the seven differential mRNAs included in the lncRNA-miRNA-mRNA network showed that four genes (GPR17, ADORA1, OPRM1 and LPAR3) were predicted as molecular targets of drugs. The area under the curve of the constructed SVM model was 0.886. The verification results of the relative expression of RNA by qRT-PCR were consistent with the results of bioinformatics analysis. LPAR3, ADORA1, GPR17, and OPRM1 may serve as therapeutic targets of ischemic stroke. lncRNA-miRNA-mRNA regulatory axis such as SND1-IT1/NAPA-AS1/LINC01001-miR-24-3p-LPAR3/ADORA1 and LUCAT1/ASAP1-IT2-miR-93-3p-GPR17 may play important roles in the progression of ischemic stroke.

Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.

BACKGROUND: There have been inconsistent results regarding the use of carotid artery endarterectomy (CEA) versus carotid artery stenting (CAS) for contralateral carotid occlusion (CCO). This study aimed to determine the optimal revascularization technique for patients with CCO. METHODS: We systematically searched the PubMed, Embase, and Cochrane Library databases to identify eligible studies published from inception to January 2, 2021. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate pooled effect estimates using a random-effects model. Sensitivity, subgroup, and publication bias analyses were also performed. RESULTS: Six studies involving 6,953 patients were selected for inclusion in this meta-analysis. Our results showed that while CEA was not associated with an increased risk of stroke compared to CAS (OR: 1.07; 95% CI: 0.75-1.51; P = 0.713), CEA was associated with a reduced risk of death compared to CAS (OR: 0.45; 95% CI: 0.29-0.70; P < 0.001). Furthermore, there were no significant differences between CEA and CAS for the risks of myocardial infarction (OR: 1.38; 95% CI: 0.73-2.62; P = 0.319) or major adverse cardiovascular events (OR: 1.03; 95% CI: 0.56-1.88; P = 0.926). Finally, the risk of myocardial infarction for CEA versus CAS was affected by disease status, while the risk of major adverse cardiovascular events was affected by the proportions of patients with male gender, coronary artery disease, and current or prior smoking. CONCLUSION: This study found that CEA and CAS resulted in similar outcomes for patients with CCO, while the risk of death was reduced in patients treated with CEA. Further high-level evidence should be collected to verify the results of this study.

LY6D as a Chemoresistance Marker Gene and Therapeutic Target for Laryngeal Squamous Cell Carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is a common head and neck cancer that is unresponsive to chemotherapy; therefore, understanding the causes of chemotherapy resistance is important. The cancer stem cell (CSC) theory postulates that CSCs are the source of tumor chemoresistance. We enrich laryngeal CSCs to overcome chemoresistance of LSCC. A laryngeal cancer xenograft model was established, and a low dose of cisplatin was administered until chemoresistance arose. A next-generation xenograft model was established using surviving tumor cells, and the test was repeated four times to screen for CSCs. Cell function experiments were performed on each tumor cell generation (m1, m2, m3, and m4). The m3 line, with the highest stemness, was selected for transcriptome sequencing. LY6D was selected for clinical sample validation and functional verification. LY6D expression was detected in 107 laryngeal cancer samples, with high expression in 91 of these samples. LY6D expression was correlated with pathological T and clinical stages, and with cervical lymph node metastasis. The siLY6D group exhibited reduced adhesion and chemoresistance to cisplatin, 5-fluorouracil, and paclitaxel. LY6D is upregulated in laryngeal cancer and may serve as a biomarker for chemoresistance in CSCs. Moreover, LY6D could serve as an alternative antigenic peptide in the targeted treatment of laryngeal cancer.

Probiotics ingestion prevents HDAC11-induced DEC205+ dendritic cell dysfunction in night shift nurses.

It is known that the day-night shift-rotation has a negative impact on the immune system. The underlying mechanism remains to be further investigated. Probiotics have regulatory effects on immune functions. This study aims to investigate the role of probiotic ingestion in preventing the DEC205+ dendritic cell (decDC) dysfunction in day-night shift-engaging nurses. In this study, blood samples were collected from day-night shift-rotating nurses who took or did not take yogurt (containing C. Butyricum) during the night shift (NS). decDC functions were evaluated with pertinent immunological approaches. We observed that the immune tolerogenic functions and interleukin (IL)-10 expression were impaired in decDCs of nurses after NS. HDAC11 was detected in decDCs that was markedly up regulated after NS. The HDAC11 levels were negatively correlated with the immune tolerogenic functions in decDCs. Ingestion of probiotic-containing yogurt during NS efficiently suppressed Bmal1 and HDAC11 levels as well as up regulated the immune regulatory functions in decDCs. In conclusion, NS has a negative impact on decDC immune tolerogenic functions, which can be prevented by ingesting probiotics-containing yogurt during NS.

Practice and effectiveness of web-based problem-based learning approach in a large class-size system: A comparative study.

Problem-based learning (PBL) is an effective and highly efficient teaching approach that is extensively applied in education systems across a variety of countries. This study aimed to investigate the effectiveness of web-based PBL teaching pedagogies in large classes. The cluster sampling method was used to separate two college-level nursing student classes (graduating class of 2013) into two groups. The experimental group (n = 162) was taught using a web-based PBL teaching approach, while the control group (n = 166) was taught using conventional teaching methods. We subsequently assessed the satisfaction of the experimental group in relation to the web-based PBL teaching mode. This assessment was performed following comparison of teaching activity outcomes pertaining to exams and self-learning capacity between the two groups. When compared with the control group, the examination scores and self-learning capabilities were significantly higher in the experimental group (P < 0.01) compared with the control group. In addition, 92.6% of students in the experimental group expressed satisfaction with the new web-based PBL teaching approach. In a large class-size teaching environment, the web-based PBL teaching approach appears to be more optimal than traditional teaching methods. These results demonstrate the effectiveness of web-based teaching technologies in problem-based learning.