Tailored extracellular matrix-mimetic coating facilitates reendothelialization and tissue healing of cardiac occluders.

Minimally invasive transcatheter interventional therapy utilizing cardiac occluders represents the primary approach for addressing congenital heart defects and left atrial appendage (LAA) thrombosis. However, incomplete endothelialization and delayed tissue healing after occluder implantation collectively compromise clinical efficacy. In this study, we have customized a recombinant humanized collagen type I (rhCol I) and developed an rhCol I-based extracellular matrix (ECM)-mimetic coating. The innovative coating integrates metal-phenolic networks with anticoagulation and anti-inflammatory functions as a weak cross-linker, combining them with specifically engineered rhCol I that exhibits high cell adhesion activity and elicits a low inflammatory response. The amalgamation, driven by multiple forces, effectively serves to functionalize implantable materials, thereby responding positively to the microenvironment following occluder implantation. Experimental findings substantiate the coating's ability to sustain a prolonged anticoagulant effect, enhance the functionality of endothelial cells and cardiomyocyte, and modulate inflammatory responses by polarizing inflammatory cells into an anti-inflammatory phenotype. Notably, occluder implantation in a canine model confirms that the coating expedites reendothelialization process and promotes tissue healing. Collectively, this tailored ECM-mimetic coating presents a promising surface modification strategy for improving the clinical efficacy of cardiac occluders.

Exploring antithrombotic mechanisms and effective constituents of Lagopsis supina using an integrated strategy based on network pharmacology, molecular docking, metabolomics, and experimental verification in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Thrombosis is a common cause of morbidity and mortality worldwide. Lagopsis supina (Stephan ex Willd.) Ikonn.-Gal. ex Knorring is an ancient Chinese herbal medicine used for treating thrombotic diseases. Nevertheless, the antithrombotic mechanisms and effective constituents of this plant have not been clarified. AIM OF THE STUDY: This work aimed to elucidate the pharmacodynamics and mechanism of L. supina against thrombosis. MATERIALS AND METHODS: Systematic network pharmacology was used to explore candidate effective constituents and hub targets of L. supina against thrombosis. Subsequently, the binding affinities of major constituents with core targets were verified by molecular docking analysis. Afterward, the therapeutic effect and mechanism were evaluated in an arteriovenous bypass thrombosis rat model. In addition, the serum metabolomics analysis was conducted using ultra-high performance liquid chromatography coupled with Q-Exactive mass spectrometry. RESULTS: A total of 124 intersected targets of L. supina against thrombosis were predicted. Among them, 24 hub targets were obtained and their mainly associated with inflammation, angiogenesis, and thrombosis approaches. Furthermore, 9 candidate effective constituents, including (22E,24R)-5α,8α-epidioxyergosta-6,22-dien-3ß-ol, aurantiamide, (22E,24R)-5α,8α-epidioxyergosta-6,9 (11),22-trien-3ß-ol, lagopsinA, lagopsin C, 15-epi-lagopsin C, lagopsin D, 15-epi-lagopsin D, and lagopsin G in L. supina and 6 potential core targets (TLR-4, TNF-α, HIF-1α, VEGF-A, VEGFR-2, and CLEC1B) were acquired. Then, these 9 constituents demonstrated strong binding affinities with the 6 targets, with their lowest binding energies were all less than -5.0 kcal/mol. The antithrombotic effect and potential mechanisms of L. supina were verified, showing a positively associated with the inhibition of inflammation (TNF-α, IL-1ß, IL-6, IL-8, and IL-10) and coagulation cascade (TT, APTT, PT, FIB, AT-III), promotion of angiogenesis (VEGF), suppression of platelet activation (TXB2, 6-keto-PGF1α, and TXB2/6-keto-PGF1α), and prevention of fibrinolysis (t-PA, u-PA, PAI-1, PAI-1/t-PA, PAI-1/u-PA, and PLG). Finally, 14 endogenous differential metabolites from serum samples of rats were intervened by L. supina based on untargeted metabolomics analysis, which were closely related to amino acid metabolism, inflammatory and angiogenic pathways. CONCLUSION: Our integrated strategy based on network pharmacology, molecular docking, metabolomics, and in vivo experiments revealed for the first time that L. supina exerts a significant antithrombotic effect through the inhibition of inflammation and coagulation cascade, promotion of angiogenesis, and suppression of platelet activation. This paper provides novel insight into the potential of L. supina as a candidate agent to treat thrombosis.

Biological characteristics of a new long-chain fatty acid transport protein 1 from Trichinella spiralis and its participation in lipid metabolism, larval moulting, and development.

Long-chain fatty acid transport protein 1 (FATP1) is a member of the fatty acid transporter family. It facilitates transmembrane transport of fatty acids and participates in lipid metabolism. Lipids are essential components of the cell and organelle membranes of Trichinella spiralis. The nematode has lost the capacity to synthesise the necessary lipids de novo and has instead evolved to obtain fatty acids and their derivatives from its host. This study aims to ascertain the primary biological characteristics and roles of T. spiralis FATP1 (TsFATP1) in lipid metabolism, larval moulting, and the development of this nematode. The results show that TsFATP1 is highly expressed at enteral T. spiralis stages, mainly localised at the cuticle, the stichosome and the intrauterine embryos of the parasite. The silencing of the TsFATP1 gene by TsFATP1-specific dsRNA significantly decreases the expression levels of TsFATP1 in the worm. It reduces the contents of ATP, triglycerides, total cholesterol, and phospholipids both in vitro and in vivo. RNAi inhibits lipid metabolism, moulting, and the growth of this nematode. The results demonstrate that TsFATP1 plays an essential role in lipid metabolism, moulting, and the development of T. spiralis. It could also be a target candidate for the anti-Trichinella vaccine and drugs.

Single cell RNA sequencing provides novel cellular transcriptional profiles and underlying pathogenesis of presbycusis.

Age-related hearing loss (ARHL) or presbycusis is associated with irreversible progressive damage in the inner ear, where the sound is transduced into electrical signal; but the detailed mechanism remains unclear. Here, we sought to determine the potential molecular mechanism involved in the pathogeneses of ARHL with bioinformatics methods. A single-cell transcriptome sequencing study was performed on the cochlear samples from young and aged mice. Detection of identified cell type marker allowed us to screen 18 transcriptional clusters, including myeloid cells, epithelial cells, B cells, endothelial cells, fibroblasts, T cells, inner pillar cells, neurons, inner phalangeal cells, and red blood cells. Cell-cell communications were analyzed between young and aged cochlear tissue samples by using the latest integration algorithms Cellchat. A total of 56 differentially expressed genes were screened between the two groups. Functional enrichment analysis showed these genes were mainly involved in immune, oxidative stress, apoptosis, and metabolic processes. The expression levels of crucial genes in cochlear tissues were further verified by immunohistochemistry. Overall, this study provides new theoretical support for the development of clinical therapeutic drugs.

Transcutaneous Pericardium 6 Acupoint Electrical Stimulation Provides Comparable Antiemetic Effect to Granisetron When Combined With Dexamethasone in Patients Undergoing Breast Cancer Surgery.

INTRODUCTION: Perioperative transcutaneous pericardium 6 (P6) electrical stimulation is effective for prevention of postoperative nausea and vomiting (PONV). The patients undergoing breast cancer surgery have a high PONV prevalence; however, the effectiveness of P6 stimulation in this surgical population has not been investigated. MATERIALS AND METHODS: A total of 198 patients undergoing mastectomy under general anesthesia were enrolled. They were randomly assigned to the one of three treatments: P6 stimulation + dexamethasone (group PD, n = 66), granisetron + dexamethasone (group GD, n = 66), and dexamethasone alone (group DM, n = 66). The primary endpoint was the incidence of postoperative vomiting (POV) within postoperative 48h. The secondary endpoints included the use of rescue antiemetic, severity of POV, and the incidence of postoperative nausea and other adverse events. RESULTS: The incidence of POV in group PD (9.1%) was similar to group GD (10.6%, P = 0.770), but significantly lower than that in the group DM (28.8%, P = 0.004) within postoperative 48 h. And, the incidence of postoperative nausea was similar between group PD and group GD but lower than that in group DM. The use of rescue antiemetics had no statistical differences among the three groups. The median (interquartile range) scores of POV severity were higher in group GD [6.0 (5.0, 7.0)] than in group DM [4.0 (3.0, 6.0), P = 0.012] within postoperative 48 h, but similar to group PD [5.5 (4.0, 6.3), P = 0.208]. CONCLUSIONS: Combined with dexamethasone, P6 stimulation has similar effectiveness for PONV prophylaxis with 5- hydroxytryptamine 3 antagonist granisetron but lower cost of antiemetic use. Moreover, both groups had a lower incidence of PONV and higher satisfaction than dexamethasone alone in patients undergoing breast cancer surgery.

Gestational diabetes causes hyperactivity of the sympathetic nervous system and hypertension in adult mice offspring.

BACKGROUND: Gestational diabetes can lead to increased blood pressure in offspring, accompanied by impaired renal sodium excretion function and vasoconstriction and diastole dysfunction. However, there are few studies on whether it is accompanied by increased sympathetic nerve activity. METHODS: Pregnant C57BL/6 mice were intraperitoneally injected with streptozotocin (35 mg/kg) or citrate buffer at day 0 of gestation. The mice of control mother offspring (CMO) and diabetic mother offspring (DMO) at 16 weeks of age were infused with vehicle (artificial cerebrospinal fluid, aCSF, 0.4 µL/h) or tempol (1 mmol/L, 0.4 µL/h) into the bilateral paraventricular nucleus (PVN) of mice for 4 weeks, respectively. RESULTS: Compared with CMO group, SBP and peripheral sympathetic nerve activity (increased heart rate, LF/HF and plasma norepinephrine and decreased SDNN and RMSSD) were increased in DMO group, which was accompanied by increased angiotensin II type-1 receptor (AT1R) expression and function in PVN. The increase in AT1R expression levels was attributed to a decrease in the methylation level of the AT1R promoter region, resulting in an increase in AT1R mRNA levels in PVN of DMO. Moreover, compared with CMO group, the levels of oxidative stress were increased and DNMT1 expression was decreased in PVN of DMO. Bilateral PVN infusion of tempol attenuated oxidative stress increased the level of DNMT1 expression and the binding of DNMT1 to the AT1R promoter region, which reduced mRNA and protein expression level of AT1R, heart rate and SBP in DMO, but not in CMO. CONCLUSIONS: The present study provides evidence for overactive sympathetic nervous systems in the pathogenesis of gestational diabetes-induced hypertension in offspring. Central antioxidant intervention in the PVN may be an important treatment strategy for fetal-programmed hypertension.

Mesenchymal stem cells in tumor microenvironment: drivers of bladder cancer progression through mitochondrial dynamics and energy production.

Mesenchymal stem cells (MSCs) in tumor microenvironment (TME) are crucial for the initiation, development, and metastasis of cancer. The impact and mechanism of MSCs on bladder cancer are uncertain. Here we analyzed 205 patient samples to explore the relationships between tumor-stroma ratio and clinicopathological features. A co-culture model and nude mouse transplantation were used to explore the biological roles and molecular mechanisms of MSCs on bladder cancer cells. We found that a high tumor-stroma ratio was significantly associated with a larger tumor size and higher T stage, pathological grade, number of vascular invasions, and poor overall survival. MSCs in TME promoted the ability of bladder cancer cells to proliferate, migrate, and invade in vitro and in vivo. Next, we demonstrated that MSCs enhance mitochondrial autophagy and mitochondrial biogenesis of bladder cancer cells, and increase energy production, thereby promoting bladder cancer cell progression. Kynurenine (Kyn) produced by MSCs could enhance mitochondrial function by activating the AMPK pathway. IDO1 inhibitor could reverse the tumor­promoting effects of MSCs in vitro and in vivo. Our results demonstrated that tryptophan metabolites Kyn of MSCs in TME could enhance mitochondrial function by activating the AMPK pathway, thereby promoting bladder cancer cell progression.

[Effect of Sijunzi Decoction on intestinal barrier of type 2 diabetic mice].

This study aims to explore the improvement effect of Sijunzi Decoction on intestinal barrier in diabetic mice. A type 2 diabetes mellitus(T2DM) model was established in C57BL/6J mice by feeding them with high-sugar and high-fat diet combined with streptozotocin(STZ). The T2DM mice were randomly divided into a control group, a T2DM group, a donepezil(DON) group, a rosiglitazone(RGZ) group, and Sijunzi Decoction groups(7. 5, 15, and 30 g·kg~(-1)), and orally administered for six weeks. The body weight and fasting plasma glucose(FBG) of mice were recorded. Fasting plasma insulin(FINS) and insulin resistance index(HOMA-IR) were observed to assess insulin resistance(IR). Intestinal flora and levels of serotonin(5-HT), lipopolysaccharide(LPS), and short-chain fatty acids(SCFAs) in serum were analyzed. Changes in colonic structure and tight junction proteins occludin, claudin-1,and ZO-1 were observed through HE staining and immunohistochemistry. Spontaneous alternation test was conducted to observe the effect on spatial memory ability. Compared with the results in the control group, FBG and HOMA-IR in the T2DM group were significantly increased(P< 0. 01); species richness index(Sobs index), Shannon diversity index(Shannon index), and species abundance estimate index(Chao index) were decreased; LPS was significantly increased(P< 0. 001), while the levels of 5-HT,SCFAs, occludin, claudin-1, and ZO-1 were significantly decreased(P< 0. 01), indicating impaired colonic barrier function;spontaneous alternation accuracy was significantly decreased(P<0. 05). After 6 weeks of Sijunzi Decoction treatment, compared with the results in the T2DM group, FBG and HOMA-IR in the Sijunzi Decoction 15 g·kg~(-1) group were significantly decreased(P<0. 01);Sobs index, Shannon index, and Chao index were increased; LPS was significantly decreased(P<0. 01), while the levels of 5-HT,SCFAs, occludin, claudin-1, and ZO-1 were significantly increased(P< 0. 05), indicating improved colonic barrier function;spontaneous alternation accuracy was increased(P<0. 001). In conclusion, Sijunzi Decoction has the effect of improving intestinal barrier in diabetic mice.

Radiomics to predict PNI in ESCC.

OBJECTIVE: This study aimed to investigate whether contrast-enhanced computed tomography (CECT) based radiomics analysis could noninvasively predict the perineural invasion (PNI) in esophageal squamous cell carcinoma (ESCC). METHODS: 398 patients with ESCC who underwent resection between February 2016 and March 2020 were retrospectively enrolled in this study. Patients were randomly divided into training and testing cohorts in a 7:3 ratio. Radiomics analysis was performed on the arterial phase images of CECT scans. From these images, 1595 radiomics features were initially extracted. The intraclass correlation coefficient (ICC), wilcoxon rank-sum test, spearman correlation analysis, and boruta algorithm were used for feature selection. Logistic regression (LR), random forest (RF), and support vector machine (SVM) models were established to preidict the PNI status. The performance of these radiomics models was assessed by the area under the receiver operating characteristic curve (AUC). Decision curve analysis (DCA) was conducted to evaluate their clinical utility. RESULTS: Six radiomics features were retained to build the radiomics models. Among these models, the random forest (RF) model demonstrated superior performance. In the training cohort, the AUC value of the RF model was 0.773, compared to 0.627 for the logistic regression (LR) model and 0.712 for the support vector machine (SVM) model. Similarly, in the testing cohort, the RF model achieved an AUC value of 0.767, outperforming the LR model at 0.638 and the SVM model at 0.683. Decision curve analysis (DCA) suggested that the RF radiomics model exhibited the highest clinical utility. CONCLUSIONS: CECT-based radiomics analysis, particularly utilizing the RF, can noninvasively predict the PNI in ESCC preoperatively. This novel approach could enhance patient management by providing personalized information, thereby facilitating the development of individualized treatment strategies for ESCC patients.

Perioperative and functional outcomes of single-port versus multi-port robotic-assisted radical cystectomy: evidence-based on controlled studies.

To compare perioperative outcomes of robot-assisted radical cystectomy (RARC) using a single-port (SP) or multi-port (MP) robotic platform. We conducted a comprehensive search of the PubMed, Web of Science, Scopus, and Google Scholar databases until June 2024. For a combined analysis of the data using random effects, Review Manager 5.4 was employed. To compare continuous and categorical variables, the weighted mean difference (WMD) and odds ratio (OR) were employed, respectively. Three original studies were included, comprising a total of 170 patients (SP-RARC: 73 versus MP-RARC: 93).Recovery of bowel function was faster in SP-RARC (WMD -1.02 days, 95% CI - 1.33 to - 0.17; p < 0.001), and lymph-node yield was lower than in MP-RARC patients (WMD - 6.32, 95% CI - 8.90 to - 3.75; p < 0.00001).There were no significant differences between the SP-RARC and MP-RARC groups in terms of other perioperative outcomes such as surgery duration, length of hospital stay, estimated blood loss, major complication rate, positive surgical margin rate, readmission rate, and recurrence rate. The SP robot offers a safe alternative surgical approach to RARC, providing similar postoperative outcomes compared to the MP robot. The SP system remains an attractive option that will require longer follow-up and cohort validation in the future.

Magnetic solid-phase extraction coupled with LC-MS/MS methods for the simple extraction and rapid determination of sugammadex in human plasma.

Sugammadex (SUG) is a novel antagonist of neuromuscular blocking agents (NMBAs). The NMBA rocuronium is usually employed to obtain better surgical conditions in kidney transplant. Nevertheless, rocuronium has several disadvantages, such as an increased risk of pulmonary complications. Thus, SUG is vital to kidney-transplant surgery. However, because SUG is excreted by the kidneys in prototypes, the pharmacokinetics (PK) may be affected in patients with renal impairment. We developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to monitor SUG in plasma samples to investigate the PK of SUG in kidney-transplant patients. Due to the complexity and limitation of other methods of sample preparation, magnetic solid-phase extraction (MSPE) was adopted to purify samples. Chromatographic separation was obtained using a reversed-phase Polaris® C18 column and gradient elution with 0.1% formic acid (FA) in water as phase A and in methanol (MeOH) as phase B as mobile phases. The transitions 999.7 → 963.9 (m/z) and 1055.7 → 1012.2 (m/z) were used to quantify SUG and ORG26265, respectively, under negative electrospray ionization. A linear calibration curve was achieved in concentrations varying from 100 to 10 000 ng mL-1. The acceptable accuracy varied from 95.7% to 106.4%, and intra- and inter-precision did not exceed 15% (20% at the lower limit of quantitation (LLOQ)). The matrix effect, stability, dilution integrity, and carry-over were validated. This method was applied successfully for the PK study of 13 recipients and 12 donors of kidney transplant after intravenous injection of SUG (2 mL per kg bodyweight).

Risk factors for traumatic intracranial hemorrhage in mild traumatic brain injury patients at the emergency department: a systematic review and meta-analysis.

BACKGROUND: Mild traumatic brain injury (mTBI), i.e. a TBI with an admission Glasgow Coma Scale (GCS) of 13-15, is a common cause of emergency department visits. Only a small fraction of these patients will develop a traumatic intracranial hemorrhage (tICH) with an even smaller subgroup suffering from severe outcomes. Limitations in existing management guidelines lead to overuse of computed tomography (CT) for emergency department (ED) diagnosis of tICH which may result in patient harm and higher healthcare costs. OBJECTIVE: To perform a systematic review and meta-analysis to characterize known and potential novel risk factors that impact the risk of tICH in patients with mTBI to provide a foundation for improving existing ED guidelines. METHODS: The literature was searched using MEDLINE, EMBASE and Web of Science databases. Reference lists of major literature was cross-checked. The outcome variable was tICH on CT. Odds ratios (OR) were pooled for independent risk factors. RESULTS: After completion of screening, 17 papers were selected for inclusion, with a pooled patient population of 26,040 where 2,054 cases of tICH were verified through CT (7.9%). Signs of a skull base fracture (OR 11.71, 95% CI 5.51-24.86), GCS < 15 (OR 4.69, 95% CI 2.76-7.98), loss of consciousness (OR 2.57, 95% CI 1.83-3.61), post-traumatic amnesia (OR 2.13, 95% CI 1.27-3.57), post-traumatic vomiting (OR 2.04, 95% CI 1.11-3.76), antiplatelet therapy (OR 1.54, 95% CI 1.10-2.15) and male sex (OR 1.28, 95% CI 1.11-1.49) were determined in the data synthesis to be statistically significant predictors of tICH. CONCLUSION: Our meta-analysis provides additional context to predictors associated with high and low risk for tICH in mTBI. In contrast to signs of a skull base fracture and reduction in GCS, some elements used in ED guidelines such as anticoagulant use, headache and intoxication were not predictive of tICH. Even though there were multiple sources of heterogeneity across studies, these findings suggest that there is potential for improvement over existing guidelines as well as a the need for better prospective trials with consideration for common data elements in this area. PROSPERO registration number CRD42023392495.

Acupuncture-assisted therapy for prolonged disorders of consciousness: study protocol for a randomized, conventional-controlled, assessor-and-statistician-blinded trial.

Background: Acupuncture is a promising non-pharmaceutical complementary therapy in treating prolonged Disorders of consciousness (pDOC), but solid evidence to support its effectiveness and safety is still lacking. Thus, the purpose of this study is to investigate the efficacy and safety of acupuncture-assisted therapy for pDOC patients. Methods: A single-center, prospective, randomized, conventional-controlled, assessor-and-statistician-blinded trial has been designed and is being conducted at West China Hospital of Sichuan University. A total of 110 participants will be randomly assigned to the experimental group and the control group in a 1:1 allocation ratio and evaluated using Coma Recovery Scale-Revised (CRS-R) at 8 a.m., 12 p.m., and 4 p.m. on 2 consecutive days before enrollment to determine the consciousness level. The experimental group will receive acupuncture combined with conventional treatment, while the control group will receive only conventional treatment during the trial observation period. The treatment duration of both groups will be 20 days. Among them, the frequency of acupuncture-assisted therapy is once a day, with 10 consecutive sessions followed by a day's rest for a total of 24 days. Data will be collected separately during baseline and after the final treatment. For data analysis, both Full Analysis Set (FAS) and Per Protocol Set (PPS) principles will be performed together by applying SPSS 27.0 software. The primary outcome measures are the changes of CRS-R before and after treatment, while the secondary outcome measures are the changes of Full Outline of Unresponsiveness Scale (FOUR), the changes of Nociception Coma Scale-Revised (NCS-R), the changes of Disability Rating Scale (DRS), the changes of Mismatch Negativity (MMN) and P300 before and after treatment, respectively. Discussion: This trial aims to rationally assess the consciousness level from multiple 2 perspectives through subjective evaluation and objective detection by selecting several standardized clinical scales combined with Event-Related Potential (ERP) detection technology. In this way, we will be able to reduce the subjectivity of consciousness assessment and objectively evaluate the clinical efficacy of acupuncture-assisted therapy for pDOC. The study, if proven to be effective and safe enough, will provide a favorable evidence to guide medical decision-making choices and future researches. Clinical trial registration: https://www.chictr.org.cn/, identifier ChiCTR2300076180.

Development and clinical validation of a novel detection kit for α-thalassemia in southern Chinese.

Objective: This study aimed to develop and assess a novel reverse dot blot assay for the simultaneous detection of 10 types of α-thalassemia alleles in the Chinese population, including six common variants of-SEA, -α3.7, -α4.2, αCS, αQS, and αWS, and four rare variants of αααanti-4.2, αααanti-3.7, --FIL deletion and--THAI deletion. Methods: The novel thalassemia gene assay utilized a two-tier multiplex polymerase chain reaction amplification system and one round of hybridization. Genomic DNA samples were sourced from three hospitals in southern China. Each clinically validated DNA sample was re-evaluated using the new multiplex polymerase chain reaction/reverse dot blot assay Ⅲ (M-PCR/RDB Ⅲ). Results: The study analyzed a total of 1,148 unrelated participants, consisting of 810 thalassemia patients and 338 healthy control subjects. Valid hybridization results were obtained for 1,147 samples, with one case (thalassemia carrier) being excluded from the study due to the poor quality of DNA. All 1,147 samples, including those with α heterozygous thalassemia, α homozygous thalassemia, α compound heterozygous thalassemia, and control subjects were accurately genotyped, showing 100% concordance with the reference assays. Conclusion: The novel M-PCR/RDB Ⅲ assay proved to be simple, rapid, and precise, indicating its potential for genetic screening and clinical diagnosis of both common and rare α-thalassemia variants in Chinese populations.

The Mediation Impact of Compassion Competence on the Link Between Mindfulness and Job Burnout in Nurses: A Cross-Sectional Study.

AIMS: This study explores the link between mindfulness, compassion competence and job burnout among nurses, and analyses the mediating role that compassion competence plays in this relationship. BACKGROUND: Understanding nurses' mindfulness, compassion competence and job burnout is important, which could help devise interventions to relieve burnout in clinical nurses. METHODS: This study adopts convenience sampling method and descriptive design quantitative research. A cross-sectional study of 513 nurses was conducted from June to October 2023 in mainland China. The Socio-demographic Questionnaire, Mindful Attention Awareness Scale, Maslach Burnout Inventory-Human Service Survey and Compassion Competence Scale for the Nurses were utilised to gather basic demographic information on nurses and to evaluate their level of mindfulness, compassion competence and job burnout. Descriptive statistics, Spearman's correlation analyses and structural equation model were used to analyse the data. RESULTS: Five hundred and thirteen valid questionnaires were gathered. Spearman's correlation analysis revealed a strong negative link between mindfulness and job burnout, and between compassion competence and burnout, and a significant positive correlation between mindfulness and compassion competence. The results of the mediation analysis revealed that the relationship between mindfulness and job burnout was partially mediated by compassion competence, and the mediating effect accounted for 18.6% of the total effect. CONCLUSION: Compassion competence performed as a partial mediator between mindfulness and job burnout among nurses. Nursing managers could enhance nurses' mindfulness level and compassion competence through Mindfulness interventions and Compassion training to reduce their burnout. RELEVANCE TO CLINICAL PRACTICE: This study offers a fresh viewpoint on enhancing clinical nurses' compassion competence and reducing job burnout. Healthcare organisations and medical institutions can mitigate nurses' job burnout by improving their mindfulness levels and compassion competence. REPORTING METHOD: The study used the STROBE checklist for reporting. PATIENT OR PUBLIC CONTRIBUTION: All participants were nurses who completed an electronic questionnaire related to this study.

Corrigendum: Knowledge, attitude, and practice toward delirium and subtype assessment among Chinese clinical nurses and determinant factors: A multicentre cross-section study.

[This corrects the article DOI: 10.3389/fpsyt.2022.1017283.].

Association between weight-adjusted waist index and overactive bladder: a cross-sectional study based on 2009-2018 NHANES.

Background: The weight-adjusted waist index (WWI) is a novel obesity indicator that appears to outperform the body mass index (BMI) and waist circumference (WC) in assessing both overweight and obesity. Studies have demonstrated the relationship between obesity and overactive bladder (OAB). The purpose of this study is to examine the correlation between WWI and OAB. Methods: This research utilizes data from the National Health and Nutrition Examination Survey (NHANES) collected between 2009 and 2018. Each participant's WWI was calculated as their WC in centimeters by the square root of weight in kilograms. The Overactive Bladder Symptom Score (OABSS) questionnaire is used to determine whether a participant has OAB. Multivariate logistic regression and generalized additive model analysis were employed to investigate the relationship between WWI and OAB. We used smoothing curve fitting to explore non-linear relationships. Additionally, subgroup analysis and interaction tests are conducted. Results: In this cross-sectional study involving 35,950 subjects, we found that individuals with a higher WWI have a higher risk of OAB (OR = 1.41, 95% CI: 1.02-1.74). Subgroup analysis and interaction testing showed that the relationship between WWI and OAB is consistent across various population characteristics. Smoothing curve fitting reveals a positive non-linear relationship between WWI and OAB. Furthermore, the association between WWI and OAB is stronger than that of other obesity-related indicators. Conclusion: Weight-adjusted waist index may be able to predict the incidence of OAB and that WWI-based obesity management may help to reduce the risk of OAB.

The application of endoscopic purse-string suture in refractory non-variceal gastrointestinal bleeding:a multicenter study (with video).

BACKGROUND AND AIMS: Non-variceal gastrointestinal bleeding is a common medical emergency. Endoscopic hemostasis is recommended and some patients experienced rebleeding after conventional endoscopic hemostasis. Originally, the purse-string suture (PSS) was employed for lesion closure during endoscopic mucosal resection (EMR). We aimed to learn whether endoscopic PSS is effective in controlling the refractory bleeding. METHODS: We retrospectively collected data of patients who underwent endoscopic PSS for refractory non-variceal gastrointestinal bleeding from 3 hospitals. Clinical success was defined as no recurrent bleeding, and patients were discharged according to medical advice. RESULTS: From October 2017 to May 2024, 36 patients who received PSS treatments were included. 83.3% (30/36) of patients achieved clinical success. In refractory upper gastrointestinal bleeding, the clinical success rate was 81.25% (26/32), and it was 100% (4/4) in lower gastrointestinal bleeding. CONCLUSION: The endoscopic PSS is effective in treating refractory non-variceal gastrointestinal bleeding.