Role of 8-hydroxyguanine DNA glycosidase 1 deficiency in exacerbating diabetic cardiomyopathy through the regulation of insulin resistance.

Diabetic cardiomyopathy (DCM) is a heart failure syndrome, and is one of the major causes of morbidity and mortality in diabetes. DCM is mainly characterized by ventricular dilation, myocardial hypertrophy, myocardial fibrosis and cardiac dysfunction. Clinical studies have found that insulin resistance is an independent risk factor for DCM. However, its specific mechanism of DCM remains unclear. 8-hydroxyguanine DNA glycosylase 1(OGG1)is involved in DNA base repair and the regulation of inflammatory genes. In this study, we show that OGG1 was associated with the occurrence of DCM. for the first time. The expression of OGG1 was increased in the heart tissue of DCM mice, and OGG1 deficiency aggravated the cardiac dysfunction of DCM mice. Metabolomics show that OGG1 deficiency resulted in obstruction of glycolytic pathway. At the molecular level, OGG1 regulated glucose uptake and insulin resistance by interacting with PPAR-γ in vitro. In order to explore the protective effect of exogenous OGG1 on DCM, OGG1 adeno-associated virus was injected into DCM mice through tail vein in the middle stage of the disease. We found that the overexpression of OGG1 could improve cardiac dysfunction of DCM mice, indicating that OGG1 had a certain therapeutic effect on DCM. These results demonstrate that OGG1 is a new molecular target for the treatment of DCM and has certain clinical significance.

Trajectory of change in perceived stress, coping strategies and clinical competence among undergraduate nursing students during clinical practicum: a longitudinal cohort study.

BACKGROUND: Clinical practicum is crucial for strengthening nursing students' clinical competence. However, nursing students often experience considerable stress during clinical practicum, and so they employ coping strategies to alleviate it. There is almost no empirical evidence on the change trajectory of perceived stress, coping strategies, and clinical competence among nursing students during a one-year clinical practicum. This study aimed to investigate the trajectory of change in perceived stress, coping strategies, and clinical competence among undergraduate nursing students during a one-year clinical practicum. METHODS: This study used a longitudinal cohort design. Undergraduate nursing students were recruited from a science and technology university in Taiwan to participate from February 2021 to January 2022. Perceived stress, coping strategies, and clinical competence among students in basic training practicum (T1), advanced training practicum (T2), and comprehensive clinical nursing practicum (T3) were surveyed by using the Perceived Stress Scale (PSS), Coping Behaviour Inventory (CBI), and Clinical Competence Scale (CCS). PSS, CBI, and CCS in T1, T2, and T3 were compared using a generalized estimating equation (GEE) to deal with correlated data. The level of statistical significance was set at α = 0.05. RESULTS: A total of 315 undergraduate nursing students completed the questionnaire. The study results show that the overall perceived stress of the students is the highest in T2 and the lowest in T3. The main source of stress of the students is 'taking care of patients' at T1 and 'lack of professional knowledge and skills' at T2 and T3. Students' perceived stress in 'taking care of patients' gradually decreases over time. The four coping strategies of CBI, which are 'stay optimistic', 'problem-solving', 'transference' and 'avoidance' in this order, remain the same ranking in three surveys.The main stress coping strategy used by students is 'stay optimistic', while the coping strategy 'avoidance' is used more frequently in T2 than in T1 and T3. Students' mean scores of the overall clinical competence and in the 'general nursing' and 'management' subscales in T3 are higher than those in T1 and T2. However, their mean scores in 'self-growth' and 'positivity' subscales are the highest in T1 and the lowest in T2. CONCLUSIONS: The results show that through experiential learning in clinical practicum at different stages time after time, students' overall perceived stress is the lowest and their overall clinical competence is the highest in T3. The main coping strategy used when students managed stress is 'stay optimistic'. According to the results, we suggest that clinical educators provide students with appropriate guidance strategies at different stages of stress and continue to follow up the clinical competence and retention rates of these nursing students in the workplace in the future.

Apurinic/apyrimidinic endonuclease 1 regulates palmitic acid-mediated apoptosis in cardiomyocytes via endoplasmic reticulum stress.

Cardiomyocyte apoptosis caused by fat metabolism disorder plays an essential role in the pathogenesis of diabetic cardiomyopathy (DCM). Apurinic/apyrimidinic endonuclease 1 (APE1) has multiple functions, including regulating redox and DNA repair. However, the role of APE1 in the pathogenesis of DCM remains unclear. To investigate the mechanism of APE1 on high-fat induced apoptosis in H9C2 cells, we treated H9C2 cells with palmitic acid (PA) as an apoptosis model caused by hyperlipidemia. We found that PA reduced the viability and increased apoptosis of H9C2 cells by inducing up-regulation of APE1 protein and endoplasmic reticulum (ER) stress. APE1 knockdown enhanced PA-induced apoptosis, and ER stress and overexpression of APE1 demonstrated the opposite effect. Furthermore, APE1 regulated PA-induced apoptosis via ER stress. The APE1 mutant (C65A, lack of redox regulation) loses its protective effect against ER stress and apoptosis. These findings indicate that APE1 protects PA-induced H9C2 cardiomyocyte apoptosis through ER stress via its redox-regulated function. This study provided new insights into the therapy for DCM.

Structural Characterization of Boron Sheets beyond the Monolayer and Implication for Experimental Synthesis and Identification.

The successful synthesis of quasi-freestanding bilayer borophene has aroused much attention for its superior physical properties and holds great promise for future electronic devices. Herein, we comprehensively explore six boron sheets beyond the monolayer and structurally characterize them via various methods using first-principles calculations for experimental references. On the basis of atomic models of borophenes, simulated scanning tunneling microscope (STM) images show different morphologies at different bias voltages and are explained by the partial densities of states and the height differences in the vertical direction. Simulated transmission electron microscope images further probe the internal atomic arrangement of boron sheets and compensate for the shortcomings of STM images to better distinguish different phases of boron sheets. The interlayer coupling strength is stronger in bilayer borophenes than in the three-layer system via the electron localization function and Mulliken bond population. In addition, simulated X-ray diffraction and infrared spectra show different characteristic peaks and corresponding vibrational modes to further characterize these boron sheets. These theoretical results can decrease the prime cost and provide vital guidance for the experimental synthesis and identification of boron sheets beyond the monolayer.

Pressure-dependent structure and electronic properties of energetic NTO crystals dominated by hydrogen-bonding interactions.

3-Nitro-1,2,4-trihydroxy-5-one (NTO), a highly potential high-performance explosive with good thermal stability and low sensitivity, has attracted much attention for its physicochemical properties in recent years. In this work, the pressure effect of the vibrational and electronic properties is investigated to understand the intermolecular interaction of NTO under hydrostatic compression. From the pressure-dependent Raman and infrared spectra, we found that the red-shifts of high-wavenumber N-H stretching modes and the discontinuous shifts of all Raman modes occur at 3 and 6 GPa, indicating an evident change of molecular configuration and intermolecular interaction upon compression. Based on structural analysis, the changes of intra- and intermolecular hydrogen bonds (HBs) are closely relevant to the anomalous rotation of the nitro group and the lengthening of N-H bonds, which can be treated as an important step of a potential structural transformation of NTO. Moreover, intermolecular hydrogen-bonding interaction leads to the shrinkage of the band gap at 6 GPa, caused by the fast charge transfer of 0.07 e from the nitrogen heterocycle to the nitro group. These results manifest a non-covalent interaction mechanism for modulating the molecular configuration of EMs under pressure loading and provide vital insights into understanding the pressure effects for energetic molecular crystals.

Effect of MoSe2 nanoribbons with NW30 edge reconstructions on the electronic and catalytic properties by strain engineering.

Monolayer transition metal dichalcogenides (TMDs), typical two-dimensional semiconductors, have been extensively studied for their extraordinary physical properties and utilized for nanoelectronics and optoelectronics. However, the finite samples and discontinuity in the synthesis process of TMD materials definitely induce defect edges in nanoribbons and greatly influence the device performance. Here, we systematically studied the atomic structures, energetic and mechanical stability, and electronic and catalytic properties of MoSe2 nanoribbons on the basis of experiments. Clear benefits of ZZSe-Mo-NW30 edged nanoribbons were found to evidently increase the dynamic stability according to our first-principles calculations. Meanwhile, unsaturated Mo atoms at the edge sites induced local magnetic moments up to 0.54 µB and changed the chemical environments of adjacent Se atoms, which acted as active sites for the hydrogen evolution reaction (HER) with a lower onset potential of -0.04 eV. The external tensile strain on these nanoribbons can have negligible effects on the electronic and catalytic properties. The onset potential of the ZZSe-Mo-NW30 edged nanoribbons only changed 0.03 eV under critical tensile strain. The atomic-scale research of edge reconstructions in TMD materials provides new opportunities to modulate the synthesis mechanism for experiments and defect-engineering applications in electrochemical catalysts.

Psychometric Properties of the Traditional Chinese Version of the Venous Leg Ulcer Quality of Life Questionnaire.

OBJECTIVE: Symptoms and treatment of venous leg ulcers (VLUs) adversely impact patients' quality of life (QoL). There is no QoL tool that considers the linguistic and cultural specificities of patients with VLU in Taiwan. This study aimed to evaluate the psychometric properties of the traditional Chinese version of the Venous Leg Ulcer Quality of Life Questionnaire (VLU-QoL). METHODS: The processes of translation and cultural adaptation of the VLU-QoL from English to traditional Chinese included forward translation, back translation, linguistic modification, and expert review. Using a sample of 167 patients with VLU from a hospital in southern Taiwan, the psychometric properties analyzed were internal consistency, test-retest reliability, content validity, convergent validity, and criterion-related. RESULTS: The traditional Chinese version of the VLU-QoL demonstrated good overall internal consistency (Cronbach α = .95) and overall test-retest reliability coefficient (r = 0.98). Confirmatory factor analysis was used to assess the convergent validity of the scale; results showed that the Activity, Psychology, and Symptom Distress constructs had acceptable fit and a structure similar to that of the original scale. The scale had its criterion-related validity verified using the Taiwanese version of the 36-item Short-Form Health Survey, demonstrating a good correlation coefficient r that ranged from -0.7 to -0.2 (P < .001). CONCLUSIONS: The Chinese version of the VLU-QoL is valid and reliable for assessing the QoL in patients with VLU, delivering a tool that nurses can use to deliver timely and appropriate care to improve patients' QoL.

Potential predictors of quality of life in patients with venous leg ulcers: A cross-sectional study in Taiwan.

Internationally, the impact of venous leg ulcers (VLUs) on the quality of life is well recognised; however, in Taiwan, the focus is only on chronic wound management. This cross-sectional correlational study conducted at the cardiovascular and plastic surgery clinics of a regional teaching hospital between August 2019 and June 2020 investigates venous clinical severity, pain, fatigue, depression, sleep quality, quality of life, and related factors among 167 patients with VLUs. The potential predictors of the quality of life in terms of activities were venous clinical severity (P < 0.001), pain (P = 0.004), and fatigue (P < 0.001) after adjusting for covariates. The potential predictors of the quality of life in terms of the psychological domain were marital status (single/divorced) (P = 0.016), marital status (widowed) (P = 0.027), venous clinical severity (P < 0.001), pain (P = 0.001), and fatigue (P = 0.002). The potential predictors of the quality of life with regard to symptoms were venous clinical severity (P < 0.001), pain (P < 0.001), fatigue (P = 0.001), and depression (P = 0.038). These potential predictors can serve as the basis of interventions for patients with VLUs, such as those related to nutrition or training in wound dressing.

Post-craniotomy fever and its associated factors in patients with traumatic brain injury.

BACKGROUND: Fever frequently occurs in patients with traumatic brain injury and can cause secondary damage to the brain. Critical care nurses play essential roles in assessing and managing fever in these patients. AIM: The study aimed to (a) examine the fever causes in and condition of neurosurgical patients with traumatic brain injury in intensive care, (b) identify the factors associated with fever, and (c) determine the effects of fever on hospital stay and prognosis. STUDY DESIGN: This study is a retrospective observational design. METHODS: Data were collected through chart reviews of 93 traumatic brain injury patients admitted to a teaching hospital's intensive care unit for postoperative care. Fever was defined as at least one episode of body temperature >38°C. RESULTS: Of the 93 patients, 76 developed a fever within 1-week post-craniotomy. Of these, 49 were infection-related and 27 were unexplained. Results of logistic regression showed that the preoperative Glasgow coma scale score (ß = -.323; P = .013) and length of intubation (ß = .480; P = .005) were the key predictors of unexplained post-craniotomy fever, and these two variables (ß = -.494; P < .001 and ß = .479; P = .006, respectively) were also the key predictors of infection-related fever. CONCLUSION: A significant portion of patients developed a fever during the first post-craniotomy week. Patients with a lower pre-craniotomy Glasgow coma scale score and a longer intubation length were at a greater risk for both infection-related fever and unexplained fever. Patients with fever had a bad outcome score. RELEVANCE TO CLINICAL PRACTICE: Critical care nurses should closely monitor traumatic brain injury patients' body temperatures and employ evidence-based infection prevention and control measures to minimize their infection risks. Respiratory care and intensive care unit Liberation Bundle should be reinforced to liberate these patients from mechanical ventilation and its associated complications.

[Network Meta-analysis of efficacy and safety of Chinese patent medicines in treatment of ankylosing spondylitis].

To evaluate the efficacy and safety of Chinese patent medicines in the treatment of ankylosing spondylitis(AS) by frequency network Meta-analysis. Randomized controlled trials(RCTs)of Chinese patent medicines for AS were retrieved from CNKI, Wanfang, VIP, CBM, PubMed, EMbase and Cochrane Library databases from the time of database establishment to January 2021. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 12 kinds of Chinese patent medicines in 55 RCTs were included. According to Meta-analysis, in term of the effectiveness, the top three optimal medication regimens were Biqi Capsules, Yishen Juanbi Pills and Yaobitong Capsules combined with western medicine. The top three interventions to reduce the erythrocyte sedimentation rate(ESR)were Yishen Juanbi Pills, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. The top three interventions to reduce the C-reactive protein(CRP)were Biqi Capsules, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. In terms of the safety, top three optimal medication regimens were Total Glucosides of Paeony Capsules, Yishen Juanbi Pills, and Wangbi Tablets combined with western medicine. This network Meta-analysis suggests that Chinese patent medicines combined with conventional western medicine can effectively improve the joint pain symptoms of AS patients and reduce the acute inflammatory indicators, with high safety. However, the literature included in this study is generally of low methodological quality, and the conclusion needs to be verified by high-quality research.

Evaluation of a self-management intervention for adults with epilepsy in Taiwan: A longitudinal randomized controlled trial.

PURPOSE: Epilepsy is a neurological disease that causes recurrent seizures and can have a significant impact on a person's quality of life (QOL). A self-management intervention (SMI) can allow adults with epilepsy to modify behaviors in order to manage their seizures and evaluate the impact of medication and treatments on their daily lives. The purpose of this study was to investigate the effects of a SMI for adults with epilepsy. METHODS: This was a longitudinal randomized controlled trial. Adults with epilepsy between the age of 20 and 65 years were recruited from a medical center in northern Taiwan. Participants were assigned to an intervention group (IG) or control group (CG) through simple randomization. Data regarding demographic and clinical characteristics were collected at baseline (T0). In addition, participants answered nine validated self-report questionnaires, which were used as outcome measures. Following collection of baseline data, the CG received routine monthly counseling over the next 3 months. The IG received the routine monthly counseling, as well as individual face-to-face health counseling on self-management 1 h/month and remote counseling via the phone or computer network at least twice per month. After the first month (T1) and at the end of the third (T2) and sixth months (T3) participants answered the nine questionnaires again. Differences in outcomes between the IGs and CGs were analyzed by comparing scores for the nine outcome variables at T0 with scores at T1, T2, and T3 with generalized estimating equations. RESULTS: A total of 210 adults agreed to participate in the study; however, only 155 participants completed the questionnaires for all three time points: 75 in the CG and 80 in the IG. The mean age of the 155 participants was 39.6 years (SD = 10.9). There was no significant difference between demographic or clinical variables between the two groups. The only difference in baseline scores (T0) among the nine self-report questionnaires was in epilepsy knowledge, measured with the Epilepsy Knowledge Profile questionnaire, which were significantly higher for the CG (mean = 32.28, SD = 3.92) than the IG (mean = 23.01, SD = 2.79) (p < 0.001). Generalized estimating equations (GEE) analysis showed scores decreased significantly at T3 from baseline for the CG for epilepsy knowledge and QOL (p < 0.001). Improvements in scores for sleep quality, anxiety, depression, self-efficacy, coping, and social support did not differ between groups. Classification of the IG by gender showed a significantly greater increase for males compared with females from baseline to T3 for epilepsy knowledge (p < 0.001). If we further classified the IGs by seizure frequency, participants with a seizure frequency of ≥1 per year had a more significant increase in epilepsy knowledge and increase in QOL compared with participants with a seizure frequency of <1 per year at T3 compared with T0. CONCLUSION: The lack of improvement in health-related quality of life (HRQoL) following the SMI may indicate that additional time is required to change behaviors that impact this variable for patients with epilepsy. Additional research should focus on variables associated with medication compliance, epilepsy knowledge, medicine symptom distress, self-efficacy, anxiety, and HRQoL.

Investigation of electronic and vibrational properties of dihydroxylammonium 5,5'-bistetrazole-1,1'-diolate under high-pressure conditions.

Dihydroxylammonium 5,5'-bistetrazole-1,1'-diolate (TKX-50), a newly found ionic energetic material with excellent performance and low sensitivity, has attracted much attention. In this work, the high-pressure response of vibrational properties in conjunction with structural and electronic properties are investigated to understand its stability under hydrostatic and uniaxial compressions. From our calculations, the band gap of TKX-50 broadens up to 0.5 GPa, then gradually shrinks at 0.5-10 GPa due to the unusual evolution of the a-axis. Analysis of the Mulliken population implies that the pressure dependence of the band gap is weak due to the inhibition of charge transfer under hydrostatic pressure. The Raman spectra of TKX-50 under uniaxial and hydrostatic compressions were simulated. The results suggest that TKX-50 undergoes multiple possible structural transformations under uniaxial compressions through discontinuous modifications of bond lengths in the cation moieties, whereas it maintain structural stability up to 10 GPa under hydrostatic conditions. Overall, the investigation of the electronic properties and uniaxial compression responses increases knowledge of TKX-50 under high-pressure conditions.

Compression Behavior and Vibrational Properties of New Energetic Material LLM-105 Analyzed Using the Dispersion-Corrected Density Functional Theory.

The 2,6-diamino-3,5-dinitropyrazine-1-oxide (LLM-105) is a newly energetic material with an excellent performance and low sensitivity and has attracted considerable attention. On the basis of the dispersion-corrected density functional theory (DFT-D), the high-pressure responses of vibrational properties, in conjunction with structural properties, are used to understand its intermolecular interactions and anisotropic properties under hydrostatic and uniaxial compressions. At ambient and pressure conditions, the DFT-D scheme could reasonably describe the structural parameters of LLM-105. The hydrogen bond network, resembling a parallelogram shape, links two adjacent molecules and contributes to the structure stability under hydrostatic compression. The anisotropy of LLM-105 is pronounced, especially for Raman spectra under uniaxial compression. Specifically, the red-shifts of modes are obtained for [100] and [010] compressions, which are caused by the pressure-induced enhance of the strength of the hydrogen bonds. Importantly, coupling modes and discontinuous Raman shifts are observed along [010] and [001] compressions, which are related to the intramolecular vibrational redistribution and possible structural transformations under uniaxial compressions. Overall, the detailed knowledge of the high-pressure responses of LLM-105 is established from the atomistic level. Uniaxial compression responses provide useful insights for realistic shock conditions.

Learning outcomes of a flipped classroom teaching approach in an adult-health nursing course: a quasi-experimental study.

BACKGROUND: New teaching strategies must be developed not only to enhance nurse's competence but also to allow nurses to respond to the complex health care needs of today's society. The purpose of this study was to explore the learning outcomes of a flipped classroom teaching approach in an adult-health nursing course for students in a two-year Bachelor of Science in Nursing program. METHODS: The study had a quasi-experimental design. An 18-week flipped classroom teaching approach was applied in an adult-health nursing course. In total, 485 nursing students enrolled in the study, with 287 in the experimental group and 198 in the control group. The Self-Evaluated Core Competencies Scale, Metacognitive Inventory for Nursing Students, Self-Directed Learning Readiness Scale, and self-designed learning satisfaction questionnaire were used to evaluate the students' learning outcomes. RESULTS: The experimental group showed a statistically significant increase in the overall scores for self-evaluated core competencies, the "self-modification" subscale of the Metacognitive Inventory for Nursing Students, and in overall self-directed learning readiness; further, they also showed high levels of course satisfaction. CONCLUSIONS: A flipped classroom teaching approach had a positive impact on student's learning motivation and contributed to better learning outcomes in an adult-health nursing course. The flipped classroom combined with hybrid teaching methods is a suitable and effective learning strategy for a registered nurse (RN) to Bachelor of Science in Nursing (BSN) program to tackle today's complex revolution in nursing curricula, and may enhance nursing students' abilities to address numerous challenges.

[Challenges to the Nursing Practicum During the COVID-19 Pandemic].

The COVID-19 pandemic has greatly impacted first-line medical staff as well as nursing-student clinical practicum programs. How to cooperate with the government's pandemic-prevention policies and reduce the gap between education and clinical practice represent significant challenges. In this paper, Chang Gung University of Science and Technology (CCUST) is used as an example to show how schools in Taiwan have effectively adapted the fundamentals of nursing practicum programs to the current pandemic using e-learning, group discussions, case analysis, clinical skill practice, and clinical case simulation scenario exercises. The program at CCUST both takes into account the safety of students and has achieved all critical nursing practice goals. After implementation of these adjustments, satisfaction among nursing students with the practicum environment and the clinical instructors was found to be significantly higher for the on-campus clinical practicum than for the off-campus clinical practicum. Furthermore, the results of qualitative data analyses show that nursing students in the on-campus practicum gained significant knowledge and experience and commented positively on their experience. For example, the students indicated that they were satisfied with the simulated clinical environment of the CCC, the teaching strategies and adaptability of the instructor, and the application of virtual reality scenario cases to enhance skill proficiency and learning outcomes. The adjusted nursing clinical practicum described in this paper may be used as a reference to ensure the quality of nursing clinical practicum programs is maintained during epidemics.

Curcumin mitigates the epithelial-to-mesenchymal transition in biliary epithelial cells through upregulating CD109 expression.

Biliary epithelial cells (BECs) can secrete bile and the epithelial-to-mesenchymal transition (EMT) of BECs can cause fibrosis or damage interlobular bile ducts, leading to chronic cholangiopathies, such as primary biliary cholangitis (PBC). Transforming growth factor-ß1 (TGF-ß1) is a potent inducer of the EMT while curcumin, a diarylheptanoid, can inhibit the EMT of hepatocytes in many liver diseases. However, the protection and underlying mechanisms of curcumin against the EMT of BECs have not been clarified. Herein, we show that curcumin treatment significantly mitigates the EMT of BECs in vitro and in vivo. Mechanistically, curcumin significantly attenuated the TGF-ß1-induced Smad and Hedgehog signaling, and upregulated CD109 expression in BECs. Collectively, these findings highlighted the therapeutic potential of curcumin to counteract the EMT process in PBC.

Mesenchymal stem cells induced CD4+ T cell apoptosis in treatment of lupus mice.

Umbilical cord-derived mesenchymal stem cell transplantation (UCMSCT) has been used to treat human autoimmune diseases like lupus for example, but little is known about its effect on cell apoptosis. Here we evaluated the efficacy of UCMSCT for lupus treatment and explored the mechanism by which mesenchymal stem cells (MSCs) modulate T cell apoptosis in lupus mice. 1 × 106 human umbilical cord-derived mesenchymal stem cells (UC-MSCs) were injected into B6.MRL-Faslpr (B6.lpr) mice via tail vein. 6 h, 24 h or 4 weeks later, the mice were sacrificed and the apoptosis of lymphocytes in peripheral blood and spleen were detected by flow cytometry. The immune cell subpopulations in spleen were also measured at 6 h and 24 h, respectively. The therapeutic effects were assessed after 4 weeks. The frequency of peripheral blood CD4+ T cell apoptosis was reduced in lupus-prone B6.lpr mice. UCMSCT alleviated the disease phenotypes in B6.lpr mice, decreased the ratio of Th1 as well as Th2 cells, and increased percentages of apoptotic CD4+ T cells in vivo and vitro. Collectively, our findings unravel that UCMSCT alleviate lupus disease and reverse immune imbalance possibly by promoting T cell apoptosis in B6.lpr mice.

Trajectories and associated factors of quality of life, global outcome, and post-concussion symptoms in the first year following mild traumatic brain injury.

PURPOSE: To investigate the associated factors and change trajectories of quality of life (QoL), global outcome, and post-concussion symptoms (PCS) over the first year following mild traumatic brain injury (mTBI). METHODS: This was a prospective longitudinal study of 100 participants with mTBI from neurosurgical outpatient departments in Chiayi County District Hospitals in Taiwan. The checklist of post-concussion syndromes (CPCS) was used to assess PCS at enrollment and at 1, 3, and 12 months after mTBI; the glasgow outcome scale extended (GOSE), the quality of life after brain injured (QOLIBRI), Chinese version, and the Short Form 36 Health Survey (SF-36), Taiwan version, were used to assess mTBI global outcome and QoL at 1, 3, and 12 months after mTBI. RESULTS: Latent class growth models (LCGMs) indicated the change trajectories of QOLIBRI, PCS SF-36, MCS SF-36, GOSE, and PCS. Classes of trajectory were associated with age ≥40 years, unemployment at 1 month after injury, and educational level ≤12 years. Univariate analysis revealed that employment status at 1 month post-injury was correlated with the trajectories of QOLIBRI, PCS SF-36, MCS SF-36, and GOSE, but not PCS. CONCLUSIONS: Employment status was the most crucial associated factor for QoL in individuals with mTBI at the 1-year follow-up. Future studies should explore the benefits of employment on QoL of individuals with mTBI.

Illness Representations of Injury: A Comparison of Patients and Their Caregivers.

PURPOSE: This study examined the differences between illness representations of injured patients and those of their caregivers. DESIGN: A comparative descriptive survey was used. METHODS: The study setting was the surgical wards of a teaching hospital in Taiwan. Data were collected at 3 to 6 months after hospital discharge. Participants were 127 pairs of injured patients and their caregivers. The participants completed sociodemographic data and completed the Chinese Illness Perception Questionnaire Revised-Trauma, which is composed of eight subscales. Clinical data of the injured patients was obtained from medical records. RESULTS: Injured patients and their caregivers were pessimistic about the injury. Patients perceived significantly more physical symptoms than caregivers did. Caregivers for patients who were severely injured or admitted to an intensive care unit (ICU) had more negative perceptions than did those who were providing care for moderately injured patients or those not admitted to an ICU. Caregivers who did not share their caring responsibilities had more negative perceptions than did those who shared their caring responsibilities with others. CONCLUSIONS: This study found that patients and caregivers had negative illness representations several months after injury. Caregivers who provided care for severely injured patients or who did not share caring responsibilities perceived different extents of illness perceptions about the injury. The interventions should highlight the need to assist patients and caregivers after injury. CLINICAL RELEVANCE: Exploring the discrepancies in illness perceptions between injured patients and their caregivers can help clinicians to provide individualized care, and to design interventions that meet patients' and caregivers' needs.

Nurse practitioner job content and stress effects on anxiety and depressive symptoms, and self-perceived health status.

AIM: We explored the impact of job content and stress on anxiety, depressive symptoms and self-perceived health status among nurse practitioners (NPs). BACKGROUND: Taiwan's NP roles vary between hospitals as a result of the diverse demands and complex tasks that cause job-related stress, potentially affecting the health of the NP. METHODS: This study utilised a cross-sectional descriptive design with 161 NPs from regional hospitals participating. Data collection involved demographics, the Taiwan Nurse Stress Checklist, the Job Content Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, a General Health Status Checklist and salivary cortisol tests. RESULTS: NPs reported moderate job stress, similar job control to nurses, mild anxiety and depression, and below-average self-perceived health. Being a licensed NP, personal response, competence, and incompleteness of the personal arrangements subscales of job stress, and anxiety predicted self-perceived health after adjusting for other covariates. CONCLUSIONS: Job stress and anxiety affect NP health. IMPLICATIONS FOR NURSING MANAGEMENT: NPs are a valuable resource, and the healthcare system demand is growing. Reasonable NP staffing, working hours, proper promotion systems, the causes of job stress, job content clarification and practical work shift scheduling need to be considered. The occupational safety and physical and psychological health of NPs are strongly associated with the quality of patient care.