[Interpersonal Communication Competence and Conflict Handling Styles of Nurses in Intensive Care Units].

BACKGROUND: Nurses in intensive care units (ICUs) must be capable of employing appropriate conflict handling styles in order to communicate with medical teams, patients, and patient family members effectively. There is a current lack of research on the interpersonal communication competence and conflict handling styles of ICU nursing staffs in Taiwan. PURPOSE: This study aimed to: (1) explore the interpersonal communication competence and conflict handling styles of ICU nurses and related factors and (2) examine the relationship between the interpersonal communication competence and conflict handling styles of ICU nurses. METHODS: A cross-sectional correlational research approach was adopted and convenience sampling was used to recruit 351 ICU nurses from three hospitals in southern Taiwan. Data were collected using a demographic questionnaire, interpersonal communication competence scale, and conflict handling styles scale. RESULTS: (1) ICU nurses demonstrated a moderate or higher level of overall interpersonal communication competence, with "integrating" identified as the most commonly used conflict handling style. (2) Higher educational attainment and job position were both associated with better interpersonal communication competence. (3) The adoption of "compromising" and "avoiding" styles was significantly affected by age; the adoption of "obliging", "compromising", "avoiding", and "integrating" styles was significantly affected by education level; the adoption of "obliging", "compromising", and "integrating" styles was significantly affected by job position; and the adoption of "dominating", "compromising", and "integrating" styles was significantly affected by seniority. (4) Interpersonal communication competence correlated significantly and positively with the adoption of "dominating", "obliging", "compromising", and "integrating" styles. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Future study of the views of ICU nurses toward their own styles in handling interpersonal conflicts is needed. Furthermore, holding training courses annually to orient ICU nurses with the advantages and disadvantages of interpersonal conflict handling styles is recommended.

Gallbladder stones and gallbladder polyps associated with increased risk of colorectal adenoma in men.

BACKGROUND AND AIMS: Most cases of colorectal cancer develop via an adenoma to carcinoma sequence. Gallbladder polyps share some risk factors with colorectal polyps. Little is known about the relationship between gallbladder diseases and different status of colorectal polyps by gender. This study was to investigate the association of gallbladder stones and polyps with colorectal adenomas by gender in a Taiwanese population. METHODS: A total of 7066 eligible subjects who underwent a total colonoscopy as a part of health check-up between January 2001 and August 2009 were recruited. Colonoscopic findings were classified into polyp-free, non-neoplastic polyps and colorectal adenomas. Gallbladder stones and gallbladder polyps were diagnosed based on ultrasonographic findings. RESULTS: There was a significant difference in the status of colon polyps between subjects with and without gallbladder polyps. However, the status of colon polyps was not significantly different between subjects with or without gallbladder stones. After adjusting obesity, fasting plasma glucose, and other variables, there was a positive relationship between gallbladder polyps and colorectal adenomas (odds ratio [OR]: 1.396, 95% confidence interval [CI]: 1.115-1.747) but not non-neoplastic polyps in all subjects. In men, gallbladder polyps (OR: 1.560, 95% CI: 1.204-2.019) and gallbladder stones (OR: 1.465, 95% CI 1.081-1.984) were positively associated with colorectal adenomas. In women, neither gallbladder polyps nor gallbladder stones were significantly related to colon polyps. CONCLUSIONS: Both gallbladder polyps and gallbladder stones were associated with an increased risk of colorectal adenomas in men but not in women. Gender difference was significant for the association between gallbladder lesions and colorectal polyps.

[The Relationship Between Fatigue and Uncertainty in Patients With Liver Cirrhosis].

BACKGROUND: Cirrhosis is a chronic, progressive, and currently incurable disease. Cirrhotic patients often experience uncertainty due to poor control of symptoms and disease recurrence. Although fatigue is a common symptom in patients with liver cirrhosis, this symptom is often ignored by healthcare professionals due to the lack of efficacious treatment options. Improper management of fatigue may trigger greater uncertainty and affect adaptation success. PURPOSE: To explore the relationship between fatigue and uncertainty and the factors that respectively relate to these two concepts in liver cirrhosis patients. METHODS: A cross-sectional, correlational design and convenience sampling were used to recruit 76 liver cirrhotic inpatients from one hospital. Three structured questionnaires, including the Personal Demographic Questionnaire, Brief Fatigue Inventory-Taiwan Form, and Mishel's Uncertainty in Illness Scale, were used for data collection. RESULTS: (1) The participants suffered from fatigue at a moderate or higher level, with an average score of 5.39 ± 2.34, which affected their daily activities and greatly impacted their recreational activities. Factors that were found to be associated with fatigue included disease severity, albumin level, total bilirubin level, ascites, and the degree to which fatigue affected the performance of daily activities. (2) Uncertainty was found to be at a moderate or higher level, with an average score of 71.81 ± 10.67. Level of fatigue, the degree to which fatigue affected the performance of daily activities, disease severity, and albumin level were found to relate significantly to level of uncertainty. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Fatigue and uncertainty are prevalent and distressing experiences for patients with liver cirrhosis. A comprehensive assessment and broad-based approach to nursing interventions are necessary in order to alleviate fatigue and uncertainty effectively.

Exposure to Mycotoxin Citrinin Promotes Carcinogenic Potential of Human Renal Cells.

Mycotoxin citrinin (CTN), commonly found in food and health supplements, may induce chromosomal instability. In this study, human renal proximal tubule epithelial cells (hRPTECs) that were exposed to CTN (10 and 20 µM) over 3 days exhibited numerical chromosomal aberrations. Short-term (3 days) and long-term (30 days) exposures to CTN significantly promoted mitotic spindle abnormalities, wound healing, cell migration, and anchorage-independent growth in human embryonic kidney 293 (HEK293) cells. Short-term exposure to 10 and 20 µM CTN increased the number of migrated cells on day 10 by 1.7 and 1.9 times, respectively. The number of anchorage-independent colonies increased from 2.2 ± 1.3 to 7.8 ± 0.6 after short-term exposure to 20 µM CTN and from 2.0 ± 1.0 to 12.0 ± 1.2 after long-term exposure. The transcriptomic profiles of CTN-treated HEK293 were subjected to over-representative analysis (ORA), gene set enrichment analysis (GSEA), and Ingenuity pathway analysis (IPA). Short-term exposure to CTN promoted the RTK/KRAS/RAF/MAPK cascade, while long-term exposure altered the extracellular matrix organization. Both short- and long-term CTN exposure activated cancer and cell cycle-related signaling pathways. These results demonstrate the carcinogenic potential of CTN in human cells and provide valuable insights into the cancer risk associated with CTN.

An Automatic Bleeding-Rank System for Transurethral Resection of the Prostate Surgery Videos Using Machine Learning.

Benign prostatic hyperplasia (BPH) is the main cause of lower urinary tract symptoms (LUTS) in aging males. Transurethral resection of the prostate (TURP) surgery is performed by a cystoscope passing through the urethra and scraping off the prostrate piece by piece through a cutting loop. Although TURP is a minimally invasive procedure, bleeding is still the most common complication. Therefore, the evaluation, monitoring, and prevention of interop bleeding during TURP are very important issues. The main idea of this study is to rank bleeding levels during TURP surgery from videos. Generally, to judge bleeding level by human eyes from surgery videos is a difficult task, which requires sufficient experienced urologists. In this study, machine learning-based ranking algorithms are proposed to efficiently evaluate the ranking of blood levels. Based on the visual clarity of the surgical field, the four ranking of blood levels, including score 0: excellent; score 1: acceptable; score 2: slightly bad; and 3: bad, were identified by urologists who have sufficient experience in TURP surgery. The results of extensive experiments show that the revised accuracy can achieve 90, 89, 90, and 91%, respectively. Particularly, the results reveal that the proposed methods were capable of classifying the ranking of bleeding level accurately and efficiently reducing the burden of urologists.

Integrating object detection and image segmentation for detecting the tool wear area on stitched image.

Flank wear is the most common wear that happens in the end milling process. However, the process of detecting the flank wear is cumbersome. To achieve comprehensively automatic detecting the flank wear area of the spiral end milling cutter, this study proposed a novel flank wear detection method of combining the template matching and deep learning techniques to expand the curved surface images into panorama images, which is more available to detect the flank wear areas without choosing a specific position of cutting tool image. You Only Look Once v4 model was employed to automatically detect the range of cutting tips. Then, popular segmentation models, namely, U-Net, Segnet and Autoencoder were used to extract the areas of the tool flank wear. To evaluate the segmenting performance among these models, U-Net model obtained the best maximum dice coefficient score with 0.93. Moreover, the predicting wear areas of the U-Net model is presented in the trend figure, which can determine the times of the tool change depend on the curve of the tool wear. Overall, the experiments have shown that the proposed methods can effectively extract the tool wear regions of the spiral cutting tool. With the developed system, users can obtain detailed information about the cutting tool before being worn severely to change the cutting tools in advance.