Development of training program for the Eye, Ear, Nose, and Throat emergency nurses in China based on core competency: a Delphi study.

BACKGROUND: Nursing work in the Eye, Ear, Nose, and Throat (EENT) emergency department is highly specialised and faces significant challenges. Therefore, a high level of nursing competence is necessary for nurses. To develop core competencies, a systematic and standardised training program is required. This study aims to construct a standardised, systematic, and professional training program for nurses working in the EENT emergency department in China. METHODS: Based on a literature review and semi-structured interviews, the training scheme draft was developed according to the theoretical framework of core competency for emergency nurses. From July 2023 to October 2023, a total of 21 experts including clinical experts, and nursing experts were selected to conduct 2 rounds of Delphi consultation to construct the training program for EENT emergency nurses. RESULTS: The effective response rate for 2 rounds of expert consultation was 100%. The expert authority coefficient was 0.905, and Kendall's W coefficients were found to be 0.359 and 0.340, respectively. The coefficients of variation for each item of the second round of expert consultation ranged from 0 to 0.19. The finalised training program for EENT emergency nurses consisted of 4 first-level indexes (training objectives, training management, training contents, and training assessment). The training objectives included 3 secondary indicators and 16 tertiary indicators. Training management included 5 secondary indicators and 8 tertiary indicators. Training contents included 4 secondary indicators and 16 tertiary indicators. Training assessment included 3 secondary indicators and 6 tertiary indicators. CONCLUSION: This study systematically and comprehensively explores the cultivation of nurses working in the EENT emergency department from the aspects of training objectives, training management, training contents, and training assessment. This training program is based on the theoretical framework of core competency standards for emergency nurses. It is in line with the actual needs of the clinic, and the training program is scientific and reliable, which can be promoted nationwide to provide a reference basis for the improvement of the training of emergency specialist nurses. TRIAL REGISTRATION: Not applicable.

Boosting stable lithium deposition via Li3N-Enriched inorganic SEI induced by a polycationic polymer layer.

Lithium (Li) metal is a promising anode material for future high-energy rechargeable batteries due to its remarkable properties. Nevertheless, excess Li in traditional lithium metal anodes (LMAs) reduces the energy density of batteries and increases safety risks. Electrochemical pre-lithiation is an effective technique for regulating the lithium content of the anodes. However, Cu foil or other non-Li based substrates used for pre-lithiation often have inhomogeneous surfaces and high nucleation barrier, leading to uneven tip deposition of lithium metal and fragile SEI. Herein, we have designed an interfacial layer composed of nano-Si particles and cationic polymer (poly (diallyldimethylammonium chloride)) (denoted as Si@PDDA) to induce the formation of Li3N-rich inorganic SEI and regulate the homogeneous plating/stripping of lithium. The uniformly dispersed nano-Si particles can decrease the Li+ nucleation overpotential through alloying reaction with lithium. The surface of Si nano-particles modified by PDDA contains numerous cationic sites, providing an electrostatic shielding layer to seeding the growth of Li metal and inhibiting dendrites formation. More promisingly, PDDA adsorbs electrolyte anions while transporting Li+, significantly accelerating the decomposition kinetics of inorganic salts within the electrolyte. Therefore, a SEI film rich in Li3N was formed on the anodes, ensuring the excellent interfacial stability and electrochemical cycling performance of LMAs. The symmetrical cells exhibit a cycle life of 900 h at 1 mA cm-2. Moreover, the practical full cells operate at a low negative/positive (N/P) capacity ratio (∼3) for over 160 cycles.

Synergistic effect of LixSi/Li3N artificial interface and 3D framework for enabling Dendrite-free, long-life lithium metal anodes.

Lithium metal is highly favored as an ideal anode material in future high-capacity lithium batteries due to its appealing properties. Nevertheless, the implementation of lithium metal batteries (LMBs) is severely plagued by challenges such as instable solid electrolyte interface (SEI), uncontrolled growth of dendrite, and severe volume expansion. Herein, to address the aforementioned issues, an artificial SEI layer is fabricated, which is comprised of LixSi alloy and Li3N. The in-situ generated LixSi/Li3N interface is formed on the carbon fiber (denoted as CF/LixSi/Li3N) through a spontaneous reaction between molten Li and Si3N4. Density functional theory (DFT) calculations reveal that LixSi alloy has low ion diffusion energy barrier, which facilitates the low nucleation overpotential of Li+ and enables homogeneous lithium deposition. Li3N can further promote the rapid Li+ transport due to the excellent Li+ conductivity. In addition, the reserved 3D space effectively mitigates the volume change along cycling procedure. Owing to the synergistic effect of the LixSi/Li3N protective layer and the 3D structure, the composite anode shows higher cycling stability with a lifetime of more than 3000 cycles at 1 mA cm-2. Furthermore, matched with commercial LiFePO4 (LFP) and LiNi5Co2Mn3O2 (NCM523) cathodes, the full cells also exhibit impressive electrochemical properties. This work introduces an ingenious approach for constructing stable lithium metal anodes and effective lithium metal batteries.

Effects of vestibular rehabilitation, with or without betahistine, on managing residual dizziness after successful repositioning manoeuvres in patients with benign paroxysmal positional vertigo: a protocol for a randomised controlled trial.

INTRODUCTION: Benign paroxysmal positional vertigo (BPPV) is recognised as the leading cause of peripheral vertigo in adults. The canalith repositioning procedure (CRP) can be used for effective treatment of BPPV. However, some patients experience residual dizziness (RD) even after successful CRP, resulting in a significant negative impact on their daily function and quality of life. Exercise-based vestibular rehabilitation (VR) has been proven as an effective method for managing dizziness and has been applied in patients with various vestibular disorders. However, the efficacy of VR to specifically target RD post-BPPV is unknown. This study aims to investigate the efficacy of VR, compared with betahistine or VR plus betahistine treatment, in the treatment of patients experiencing RD after successful CRP. METHODS AND ANALYSIS: A randomised single-blinded controlled trial will be carried out to determine the efficacy of VR compared with betahistine or VR plus betahistine treatment in mitigating RD and improving balance function. Patients with BPPV who experience RD after successful CRP will be recruited. Participants will be randomised into one of three groups to receive VR, betahistine or VR plus betahistine. There will be 61 participants in each group. The primary outcomes will be changes in the patient's daily function as measured by the Vestibular Activities and Participation questionnaire and balance ability assessed by computerised dynamic posturography. The secondary outcomes will be dizziness-related handicap, otolith function and duration of RD symptoms. Outcome measures will be noted at baseline and at 2, 4 and 8 weeks post-randomisation. This study has the potential to reduce unnecessary anti-vertigo drug prescriptions and may lead to a general consensus regarding the use of VR as a first-line treatment for RD in patients with BPPV. ETHICS AND DISSEMINATION: This trial received ethical approval from the Institutional Review Board of Eye and ENT Hospital of Fudan University (reference number 2017046). The study results will be disseminated via peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER: NCT03624283; Pre-results.