Activation of non-classical Wnt signaling pathway effectively enhances HLA-A presentation in acute myeloid leukemia.

Objective: The escape from T cell-mediated immune surveillance is an important cause of death for patients with acute myeloid leukemia (AML). This study aims to identify clonal heterogeneity in leukemia progenitor cells and explore molecular or signaling pathways associated with AML immune escape. Methods: Single-cell RNA sequencing (scRNA-seq) was performed to identified AML-related cellular subsets, and intercellular communication was analyzed to investigate molecular mechanisms associated with AML immune escape. Bulk RNA sequencing (RNA-seq) was performed to screen differentially expressed genes (DEGs) related to hematopoietic stem cell progenitors (HSC-Prog) in AML, and critical ore signaling pathways and hub genes were found by Gene Set Enrichment Analysis (GSEA), Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The mRNA level of the hub gene was verified using quantitative real-time PCR (qRT-PCR) and the protein level of human leukocyte antigen A (HLA-A) using enzyme-linked immuno sorbent assay (ELISA). Results: scRNA-seq analysis revealed a large heterogeneity of HSC-Prog across samples, and the intercellular communication analysis indicated a strong association between HSC-Prog and CD8+-T cells, and HSC-Prog also had an association with HLA-A. Transcriptome analysis identified 1748 DEGs, enrichment analysis results showed that non-classical wnt signaling pathway was associated with AML, and 4 pathway-related genes (RHOA, RYK, CSNK1D, NLK) were obtained. After qRT-PCR and ELISA validation, hub genes and HLA-A were found to be down-regulated in AML and up-regulated after activation of the non-classical Wnt signaling pathway. Conclusion: In this study, clonal heterogeneity of HSC-Prog cells in AML was identified, non-classical wnt signaling pathways associated with AML were identified, and it was verified that HLA-A could be upregulated by activation of non-classical wnt signaling, thereby increasing antigen presentation.

Chloroprocaine 3% for anesthesia during cesarean section in a patient with dopa-responsive dystonia: A case report.

RATIONALE: Dopa-responsive dystonia (DRD) is a rare autosomal dominant hereditary disorder with a prevalence of 0.5 per million population. The disease is characterized by onset of dystonia in childhood, progressive aggravation of the dystonia with diurnal fluctuation, and complete or near complete alleviation of symptoms with low-dose oral levodopa. The incidence of DRD is low, and only a few publications have described this disorder connected with anesthesia. PATIENT CONCERNS: We present a case involving a pregnant woman with DRD who continued levodopa/benserazide throughout the pregnancy. The perioperative anesthesia management was described. We used chloroprocaine 3% for epidural anesthesia during cesarean section. DIAGNOSES: Dopa-responsive dystonia. INTERVENTIONS: Levodopa/benserazide. OUTCOMES: In summary, levodopa/benserazide was continued throughout our patient's pregnancy with a good obstetric outcome, and chloroprocaine was safely used in epidural anesthesia without deterioration of her dystonic symptoms. LESSONS: Chloroprocaine was safely used in epidural anesthesia without deterioration of her dystonic symptoms.

Automated interpretation of retinal vein occlusion based on fundus fluorescein angiography images using deep learning: A retrospective, multi-center study.

Purpose: Fundus fluorescein angiography (FFA) is the gold standard for retinal vein occlusion (RVO) diagnosis. This study aims to develop a deep learning-based system to diagnose and classify RVO using FFA images, addressing the challenges of time-consuming and variable interpretations by ophthalmologists. Methods: 4028 FFA images of 467 eyes from 463 patients were collected and annotated. Three convolutional neural networks (CNN) models (ResNet50, VGG19, InceptionV3) were trained to generate the label of image quality, eye, location, phase, lesions, diagnosis, and macular involvement. The performance of the models was evaluated by accuracy, precision, recall, F-1 score, the area under the curve, confusion matrix, human-machine comparison, and Clinical validation on three external data sets. Results: The InceptionV3 model outperformed ResNet50 and VGG19 in labeling and interpreting FFA images for RVO diagnosis, achieving 77.63%-96.45% accuracy for basic information labels and 81.72%-96.45% for RVO-relevant labels. The comparison between the best CNN and ophthalmologists showed up to 19% accuracy improvement with the inceptionV3. Conclusion: This study developed a deep learning model capable of automatically multi-label and multi-classification of FFA images for RVO diagnosis. The proposed system is anticipated to serve as a new tool for diagnosing RVO in places short of medical resources.

Retina Fundus Photograph-Based Artificial Intelligence Algorithms in Medicine: A Systematic Review.

We conducted a systematic review of research in artificial intelligence (AI) for retinal fundus photographic images. We highlighted the use of various AI algorithms, including deep learning (DL) models, for application in ophthalmic and non-ophthalmic (i.e., systemic) disorders. We found that the use of AI algorithms for the interpretation of retinal images, compared to clinical data and physician experts, represents an innovative solution with demonstrated superior accuracy in identifying many ophthalmic (e.g., diabetic retinopathy (DR), age-related macular degeneration (AMD), optic nerve disorders), and non-ophthalmic disorders (e.g., dementia, cardiovascular disease). There has been a significant amount of clinical and imaging data for this research, leading to the potential incorporation of AI and DL for automated analysis. AI has the potential to transform healthcare by improving accuracy, speed, and workflow, lowering cost, increasing access, reducing mistakes, and transforming healthcare worker education and training.

Analysis of Elimination Effects of Inbreeding on Genotype Frequency in Larval Stages of Chinese Shrimp.

Marine animals possess genomes of considerable complexity and heterozygosity. Their unique reproductive system, characterized by high fecundity and substantial early mortality rates, increases the risk of inbreeding, potentially leading to severe inbreeding depression during various larval developmental stages. In this study, we established a set of inbred families of Fenneropenaeus chinensis, with an inbreeding coefficient of 0.25, and investigated elimination patterns and the manifestations of inbreeding depression during major larval developmental stages. Reduced-representation genome sequencing was utilized to explore the genotype frequency characteristics across two typical elimination stages. The results revealed notable mortality in hatching and metamorphosis into mysis and post-larvae stages. Inbreeding depression was also evident during these developmental stages, with depression rates of 24.36%, 29.23%, and 45.28%. Segregation analysis of SNPs indicated an important role of gametic selection before hatching, accounting for 45.95% of deviation in the zoea stage. During the zygotic selection phase of larval development, homozygote deficiency and heterozygote excess were the main selection types. Summation of the two types explained 82.31% and 89.91% of zygotic selection in the mysis and post-larvae stage, respectively. The overall distortion ratio decreased from 22.37% to 12.86% in the late developmental stage. A total of 783 loci were identified through selective sweep analysis. We also found the types of distortion at the same locus could change after the post-larvae stage. The predominant shifts included a transition of gametic selection toward normal segregation and other forms of distortion to heterozygous excess. This may be attributed to high-intensity selection on deleterious alleles and genetic hitchhiking effects. Following larval elimination, a greater proportion of heterozygous individuals were preserved. We detected an increase in genetic diversity parameters such as expected heterozygosity, observed heterozygosity, and polymorphic information content in the post-larvae stage. These findings suggest the presence of numerous recessive deleterious alleles and their linkage and suggest a major role of the partial dominance hypothesis. The results provide valuable insights into the mechanisms of inbreeding depression in marine animals and offer guidance for formulating breeding strategies in shrimp populations.

Association between dietary inflammation index and cataract: a population-based study from NHANES 2005-2008.

Importance: Various studies have widely explored the association between index of dietary inflammation (DII) and occurrence of diseases. Accumulating evidence have revealed that a lower DII seems to be protective against a variety of diseases. Nevertheless, the association between DII and age-related cataract remains unclear. Objective: To investigate the correlation between DII and age-related cataract in a representative sample of the American population. Design setting and participants: This cross-sectional population-based study comprised 6,395 participants from the National Health and Nutrition Examination Survey (NHANES) conducted in cycles from 2005 to 2008. DII was calculated using dietary recall information, with higher scores indicating greater inflammatory potential of the diet. Age-related cataract was evaluated using cataract surgery as a surrogate measure. Covariates included sociodemographic factors, lifestyle factors, physical measures, and comorbidities. Logistic regression models were employed to assess the association between DII and cataract. The presence of a non-linear relationship was examined using restricted cubic spline analysis. Subgroup analysis was conducted to explore potential interaction effects. Data analysis was performed from September 1 to December 30, 2022. Main outcomes and measures: Age-related cataract assessed through cataract surgery information obtained from a self-reported questionnaire. Results: A total of 6,395 participants were included, with a mean (standard deviation, SD) age of 48.7 (15.3) years. Of these, 3,115 (48.7%) were male, 3,333 (52.1%) were non-Hispanic white, and 683 (10.7%) had cataract. The mean (SD) DII was -4.78 (1.74). After adjusting for all included covariates, DII showed a positive association with cataract, both as a continuous variable (odds ratio (OR): 1.054, 95% confidence interval (CI): 1.007-1.103, p = 0.023) and in quartiles, with the highest quartile compared to the lowest (OR: 1.555, 95% CI: 1.233-1.967, p < 0.001). Restricted cubic spline analysis revealed no evidence of a non-linear relationship (p for non-linearity 0.085). Subgroup analysis indicated no interaction effects among the studied covariates. Conclusions and relevance: These findings suggest that a pro-inflammatory diet serves as a risk factor for the occurrence of cataracts.

The prognostic significance of POD24 in peripheral T-cell lymphoma.

BACKGROUND: Peripheral T-cell lymphomas (PTCL) are an aggressive group of mature T-cell neoplasms, often associated with poor outcomes, in part, due to frequent relapsed/refractory disease. The objective of this study was to assess the prognostic impact of disease progression within 24 months (POD24) on overall survival (OS) for patients diagnosed with PTCL. METHODS: A retrospective analysis was conducted on a cohort of patients with newly diagnosed PTCL who underwent chemotherapy at the Affiliated Hospital of Xuzhou Medical University between January 2010 and September 2021. Prognostic assessment was limited to patients who were evaluable for POD24. RESULTS: Records were reviewed for 106 patients with PTCL, of whom 66 patients experienced POD24 (referred to as the POD24 group) and 40 patients did not experience POD24 (referred to as the no POD24 group). Significant differences were observed between the POD24 group and the no POD24 group in regard to clinical stage, Eastern Cooperative Oncology Group (ECOG) performance status (PS), International Prognostic Index (IPI) score, lactate dehydrogenase (LDH) levels, ß2-microglobulin (ß2-MG) levels, prealbumin and albumin levels. Patients in the POD24 group had a significant shorter median OS compared to the no POD24 group (11.9 months vs not reached, respectively; P < 0.001). Non response (NR) to treatment and POD24 were identified as independent negative prognostic factors for survival in patients with PTCL. CONCLUSION: POD24 is a prognostic factor associated with unfavorable outcomes in patients with PTCL and can be used to identify high-risk patients and guide treatment decisions.

Association between proactive personality and professional identity of nursing undergraduates: The mediating role of resilience and irrational belief.

AIM: To examine the relationship between proactive personality and professional identity of undergraduate nursing students, including the role of psychological resilience and irrational belief as mediators. BACKGROUND: Personality has been shown to play a crucial role in determining professional identity. However, the influence of proactive personality on professional identity in the nursing field is poorly understood and requires further investigation. DESIGN: We conducted a cross-sectional study in China. Between July and December of 2021, 860 nursing undergraduates participated in an online questionnaire survey. METHODS: Four main variables (proactive personality, psychological resilience, irrational belief and professional identity) and two covariates (willingness to choose nursing profession and family attitude towards nursing) were assessed. The assessment tools chosen are both valid and reliable. To test the proposed multi-mediation model, linear regression analysis by Hayes's SPSS macro-PROCESS was used. RESULTS: The results revealed that PP, PR and PI were positively connected with one another, but negatively with IB. PP positively predicted PI through direct and indirect paths, after controlling for two covariates. The percentage of indirect path (78.72%) outweighed the direct path (21.28%). The indirect effect of PR (72.51%) was higher than that of PR and IB (6.21%). PI was also positively predicted by students' "Yes" willingness and families' "supportive" attitude towards nursing. CONCLUSION: This study stated that nursing educators should take nursing students' PP seriously, which would allow for activities to be taken to improve their PR and decrease their IB, hence continuously enhancing their PI. In addition, respecting students' professional aspirations and improving family support may also be valuable ways to boost their PI.

Genome-wide analysis of RNA-binding proteins co-expression with alternative splicing events in mitral valve prolapse.

Objectives: We investigated the role and molecular mechanisms of RNA-binding proteins (RBPs) and their regulated alternative splicing events (RASEs) in the pathogenesis of mitral valve prolapse (MVP). Methods: For RNA extraction, we obtained peripheral blood mononuclear cells (PBMCs) from five patients with MVP, with or without chordae tendineae rupture, and five healthy individuals. High-throughput sequencing was used for RNA sequencing (RNA-seq). Differentially expressed genes (DEGs) analysis, alternative splicing (AS) analysis, functional enrichment analysis, co-expression of RBPs, and alternative splicing events (ASEs) analysis were conducted. Results: The MVP patients exhibited 306 up-regulated genes and 198 down-regulated genes. All down- and up-regulated genes were enriched in both Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Furthermore, MVP was closely associated with the top 10 enriched terms and pathways. In MVP patients, 2,288 RASEs were found to be significantly different, and four suitable RASEs (CARD11 A3ss, RBM5 ES, NCF1 A5SS, and DAXX A3ss) were tested. We identified 13 RNA-binding proteins (RBPs) from the DEGs and screened out four RBPs (ZFP36, HSPA1A, TRIM21, and P2RX7). We selected four RASEs based on the co-expression analyses of RBPs and RASEs, including exon skipping (ES) of DEDD2, alternative 3' splice site (A3SS) of ETV6, mutually exclusive 3'UTRs (3pMXE) of TNFAIP8L2, and A3SS of HLA-B. Furthermore, the selected four RBPs and four RASEs were validated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and showed high consistency with RNA sequencing (RNA-seq). Conclusion: Dysregulated RBPs and their associated RASEs may play regulatory roles in MVP development and may therefore be used as therapeutic targets in the future.

Effectiveness of health communication courses on professionalism and social media competence among nursing students: A randomized controlled trial.

BACKGROUND: The shaping and cultivation of professionalism of nursing students is very important for the improvement and retention of nursing workers' quality. In the context of social media, it is challenging for nursing students to use social media for health education. Health communication course has the potential to cultivate professionalism and social media competence of nursing students, but its role still needs to be explored. OBJECTIVE: To evaluate the effectiveness of health communication course intervention on improving the professionalism and social media competence of nursing students. DESIGN: A randomized controlled trial. METHODS: The recruited nursing students were randomly divided into the intervention group (N = 50) and the control group (N = 51). The control group received routine nursing education. Intervention group received routine nursing education and health communication education courses. Both groups were required to submit a health communication work on any topic. The Nursing Professionalism Scale、Social Media Self-efficacy Scale and Social Media Experience Scale were used to evaluate the professionalism and social media competence of nursing students. The primary analysis used linear mixed models and followed the intention-to-treat principle. RESULTS: The professionalism, social media self-efficacy and social media experience of students in the two groups were significantly improved, and the improvement of nursing students in the intervention group was higher than that in the control group. After the intervention of health communication course, there were significant differences in professionalism (p < 0.001), social media self-efficacy (p = 0.006) and social media experience (p = 0.013) between the two groups. Social media self-efficacy have an effect on professionalism (ꞵ = 0.22, p < 0.001, 95 % CI 0.17-0.26). CONCLUSION: The health communication course significantly improved social media competence and professionalism, which was significantly different from the control group, revealing the educational value of the intervention. TRIAL REGISTRATION NUMBER: ChiCTR2200058425.

Nursing undergraduates' media competence in the context of health communication and its relationship to professionalism.

AIMS: To investigate the association between professionalism and social media competence among Chinese mainland nursing undergraduates. DESIGN: This study employed a cross-sectional descriptive correlation design. PARTICIPANTS: From June to July 2021, 797 nursing students from four nursing colleges in Jiangsu Province, China, were chosen using stratified cluster sampling. METHODS: The questionnaire included the Chinese version of the Nursing Professionalism Scale and the Social Media Competency Scale. The association between professionalism and social media competency was examined using Pearson's correlation analysis. RESULTS: The professionalism of nursing undergraduates (average scores:70.44 ± 8.82) was at a medium level. Social media self-efficacy, performance expectancy, facilitating conditions and social influence (3.76 ± 0.75, 3.87 ± 0.60, 3.53 ± 0.69, 3.41 ± 0.76) were at a medium-high level, while social media experience and effort expectancy (3.03 ± 0.72, 2.60 ± 0.59) were at medium and low levels. Among nursing undergraduates, professionalism was related to social media competence, among which, professionalism was positively correlated with social media self-efficacy (r = 0.40, p < 0.01), social media experience (r = 0.50, p < 0.01), performance expectancy (r = 0.34, p < 0.01), facilitating conditions (r = 0.41, p < 0.01), but negatively correlated with effort expectancy (r = -0.10, p < 0.01). CONCLUSION: The professionalism of nursing undergraduates is related to social media. The scores of social media self-efficacy, social media experience, performance expectancy and facilitating conditions of nursing students with high professionalism were higher than those of nursing students with low professionalism. IMPACT: This study suggests that developing a course on health communication on social media can help nursing students improve their professionalism. PATIENT OR PUBLIC CONTRIBUTION: Participants completed a survey via the online survey platform Wenjuangxing.

Retinal fluid is associated with cytokines of aqueous humor in age-related macular degeneration using automatic 3-dimensional quantification.

Background: To explain the biological role of cytokines in the eye and the possible role of cytokines in the pathogenesis of neovascular age-related macular degeneration (nAMD) by comparing the correlation between cytokine of aqueous humor concentration and optical coherence tomography (OCT) retinal fluid. Methods: Spectral-domain OCT (SD-OCT) images and aqueous humor samples were collected from 20 nAMD patient's three clinical visits. Retinal fluid volume in OCT was automatically quantified using deep learning--Deeplabv3+. Eighteen cytokines were detected in aqueous humor using the Luminex technology. OCT fluid volume measurements were correlated with changes in aqueous humor cytokine levels using Pearson's correlation coefficient (PCC). Results: The patients with intraretinal fluid (IRF) showed significantly lower levels of cytokines, such as C-X-C motif chemokine ligand 2 (CXCL2) (p = 0.03) and CXCL11 (p = 0.009), compared with the patients without IRF. And the IRF volume was negatively correlated with CXCL2 (r = -0.407, p = 0.048) and CXCL11 (r = -0.410, p = 0.046) concentration in the patients with IRF. Meanwhile, the subretinal fluid (SRF) volume was positively correlated with vascular endothelial growth factor (VEGF) concentration (r = 0.299, p = 0.027) and negatively correlated with interleukin (IL)-36ß concentration (r = -0.295, p = 0.029) in the patients with SRF. Conclusion: Decreased level of VEGF was associated with decreased OCT-based retinal fluid volume in nAMD patients, while increased levels of CXCL2, CXCL11, and IL-36ß were associated with decreased OCT-based retinal fluid volume in nAMD patients, which may suggest a role for inflammatory cytokines in retinal morphological changes and pathogenesis of nAMD patients.

Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial.

BACKGROUND: Narrative medicine has become a solution to cultivate medical students' ability of empathy and humanistic care. However, the role of narrative medicine is lacking in the study of professionalism. The aim of this study was to analyze the effects of narrative medical theory learning and narrative writing on professionalism, empathy and humanistic care ability of nursing students. METHODS: This cluster randomized controlled trial was conducted between June 2021 and June 2022 in two universities in Jiangsu, China. The participants of this study were 85 nursing students who were randomly divided into the intervention group (n = 43) or the control group (n = 42). Participants in the intervention group were trained in narrative medical theory learning and narrative writing based on a Web-based platform, while those in the control group were not. Self-report questionnaires of professionalism, empathy and humanistic care ability were used before and after intervention. RESULTS: The results showed that the professionalism score of the intervention group was (68.7 ± 6.8 vs. 64.5 ± 7.5; P = 0.005), empathy (99.4 ± 15.7 vs. 92.2 ± 14.6; P = 0.014) and humanistic care ability (127.6 ± 20.0 vs. 113.3 ± 18.8; P = 0.004) were better than the control group. CONCLUSION: The results of this quantitative study suggest that narrative medical theory education and narrative writing based on the network platform can promote the development of professionalism, empathy and humanistic care ability of nursing undergraduates.

'It turned my life upside down': Parents' emotional experience of the transition with their preterm infant from birth to discharge Home-A qualitative study.

BACKGROUND: A smooth transition from the neonatal intensive care unit (NICU) to home is critical for establishing parents' competence as primary caregivers and ensuring infant health. In the clinical context with a restrictive visiting policy, family-centred care is challenging to implement, prohibiting a smooth transition of care for the families. According to Meleis' Transition Theory, parents might experience emotional change initiated by critical events during this transition. OBJECTIVES: The aim of this study was to understand parents' emotional experience of their preterm infant's birth to discharge home from the NICU to facilitate the care transition better. METHODS: This qualitative descriptive study using semistructured interviews was conducted between June and August 2020. Purposive sampling was used to recruit 17 parents (6 fathers and 11 mothers) from the NICU of a tertiary hospital in eastern China. Data were analysed using content analysis. RESULTS: The following three situational themes characterised by three-phase emotions related to 16 critical events were obtained from the data and were used to describe parents' experiences during the transition: Theme 1, Life falling apart; Theme 2, Feeling anxious and struggling with uncertainty; and Theme 3, Feeling both hopeful and inadequate at discharge. CONCLUSIONS: Parents of preterm infants have distinctive emotional experiences in each phase during their infants' transition from the NICU to home. Awareness of parents' critical events and emotional experiences in each phase could help NICU staff anticipate and provide timely and targeted support for parents. The next step is to develop a family-centred intervention for healthcare providers to better prepare parents for the transition from the NICU to home.

Functional analysis of differently expressed ferroptosis-related genes in patients with mitral valve prolapse.

Background: The prevalence of mitral valve prolapse (MVP) in heart valvular diseases is globally increasing. However, the understanding of its etiology and pathogenesis is limited. So far, the relationship between ferroptosis-related genes and long non-coding RNAs (lncRNAs) in MVP remains unexplored. This study investigates the potential pathogenesis of ferroptosis-related genes in MVP and provides a therapeutic target for the disease. Methods: Blood samples from patients with MVP and healthy volunteers were collected for transcriptomic sequencing to analyze the expression of ferroptosis-related differentially expressed genes (DEGs) and differentially expressed long non-coding RNAs (DElncRNAs Co-expression network of ferroptosis-related DEGs and DElncRNAs. Furthermore, this work conducted GO and KEGG enrichment analyses. Results: CDKN2A, SLC1A4, ATF3, and other core genes related to the mitral valve prolapse were screened out. CDKN2A, SLC1A4, and ATF3 genes were at the core position of the network, regulated by numerous lncRNAs. Notably, these genes are primarily involved in the extracellular region and p53 signaling pathway. Conclusion: In summary, CDKN2A, SLC1A4, and ATF3 regulate the pathophysiological process of MVP and are potential therapeutic targets.

Perceived stress and symptoms of post-traumatic stress disorder in nurses: A moderated mediation model of maladaptive cognitive emotional regulation and psychological capital.

Nurses often face a variety of work-related and life-related stresses that make them more prone to symptoms of post-traumatic stress disorder (PTSD), yet the underlying mechanism of this association is poorly understood. To address this research gap, we investigated the mediating role of maladaptive cognitive emotion regulation strategies in the relationship between perceived stress and PTSD symptoms, and explored whether psychological capital could moderate the direct or indirect effects between perceived stress and PTSD symptoms. Nurses (N = 723) completed a questionnaire about perceived stress, PTSD symptoms, maladaptive cognitive emotion regulation strategies and psychological capital. After controlling for gender, age and work department, perceived stress was positively correlated with PTSD symptoms. Maladaptive cognitive emotion regulation strategies partially mediated this relationship. Psychological capital moderates the effects of perceived stress and maladaptive cognitive emotion regulation strategies on PTSD symptoms. Specifically, the positive correlation between perceived stress and PTSD symptoms was stronger among nurses with low levels of psychological capital than among nurses with high levels of psychological capital. At the same time, the positive correlation between maladaptive cognitive emotion regulation strategies and PTSD symptoms was stronger in nurses with a low level of psychological capital. Therefore, cognitive strategies and interventions oriented toward psychological capital may alleviate the PTSD symptoms of nurses in stressful situations.

The effects of combined spinal-epidural analgesia and epidural anesthesia on maternal intrapartum temperature: a randomized controlled trial.

BACKGROUND: Labor epidural analgesia has been suggested to be associated with intrapartum fever. We designed this study to investigate the effects of epidural analgesia and combined spinal-epidural analgesia on maternal intrapartum temperature. METHODS: Four hundred healthy nullipara patients were randomly assigned to receive either epidural analgesia (EA group) or combined spinal-epidural analgesia (CSEA group). Maternal temperature was measured hourly after analgesia administration. The primary outcome was the incidence of maternal fever, and the secondary outcomes were the duration of analgesia, analgesia to full cervical dilation and analgesia to delivery. Neonatal outcomes and other basic labor events were also recorded. RESULTS: Maternal temperature gradually increased with time in both analgesia groups during labor. However, the CSEA group had a lower incidence of maternal fever, and a lower mean maternal temperature at 5 h, 6 h, and 9 h after analgesia. In addtion, the CSEA group also had a shorter time of analgesia duration, analgesia to full cervical dilation, analgesia to delivery, and less dose of epidural local anesthetic than the EA group. CONCLUSION: Our findings suggest that combined spinal-epidural analgesia is associated with a lower risk of intrapartum fever than epidural analgesia. TRIAL REGISTRATION: ChiCTR1900026606 . Registered on 16/10/2019.

The relationship between eHealth literacy, social media self-efficacy and health communication intention among Chinese nursing undergraduates: A cross-sectional study.

Background: With the popularization of the Internet, it has become possible to widely disseminate health information via social media. Medical staff's health communication through social media can improve the public's health literacy, and improving the intention of health communication among nursing undergraduates is of great significance for them to actively carry out health communication after entering clinical practice. Objective: To explore the relationship among eHealth literacy, social media self-efficacy, and health communication intention and to determine the mediating role of social media self-efficacy in the relationship between eHealth literacy and health communication intention. Design: A cross-sectional descriptive correlation design was used in this study. Participants: Stratified cluster sampling was used to select 958 nursing students from four nursing colleges in Jiangsu Province, China, from June to July 2021. Methods: Data were collected using the eHealth Literacy Scale, the Social Media Self-efficacy Scale, and the Health Communication Intention Questionnaire. Sociodemographic data were also collected. Correlation analysis and regression analysis were used to determine the relationship between eHealth literacy, social media self-efficacy, and health communication intention. Results: Health communication intention is positively correlated with eHealth literacy and social media self-efficacy. There is a significant positive correlation between eHealth literacy and health communication intention (ß = 0.57, p < 0.001), and social media self-efficacy played a mediating role in the influence of eHealth literacy on health communication intention (the mediating effect accounted for 37.2% of the total effect). Conclusion: The study found that eHealth literacy and social media self-efficacy had an impact on health communication intention. Because there is a correlation between eHealth literacy and social media self-efficacy and health communication intention, in order to promote health communication intention of nursing students, it is also important to cultivate eHealth literacy and social media self-efficacy of nursing students. In view of these results, targeted educational programs must be developed to improve eHealth literacy and social media self-efficacy among nursing undergraduates, thereby promoting their health information transmission.

Research trends in college students' sleep from 2012 to 2021: A bibliometric analysis.

Background: A great proportion of college students experience various sleep problems, which damage their health and study performance. College students' sleep problems, which are caused by several factors, have been easily ignored before. In the past decade, more research has been published to expand our understanding of undergraduates' sleep. The purpose of the study is to explore the research hotspots and frontiers regarding college students' sleep using CiteSpace5.8.R3 and offer guidance for future study. Methods: We retrieved relevant literature from the Web of Science Core Collection Database and imputed the downloaded files into CiteSpace5.8.R3 for visualization analysis. We generated network maps of the collaborations between authors, countries, institutions, the cited journals, and co-occurrence keywords. The analysis of keywords clusters, timeline views, and keywords citation bursts help us identify the hotspots and research trends. Results: A total of 1,841 articles related to college students' sleep, published from 2012 to 2021, were selected. The number of publications gradually increased. Karl Peltzer was the most prolific authors with 15 publications. The United States and Harvard University separately contributed 680 and 40 articles and had the greatest impact in this field. SLEEP ranked first in the frequency of cited journals. The article published by Lund HG was the most influential publication. Based on the analysis of keywords, we summarized research hotspots as follows: current status, affecting factors, and adverse outcomes of college students' sleep. The frontiers were the further understanding of the relationships between sleep and mental and physical health, and various interventions for sleep disorders. Conclusion: Our study illustrates the research hotspots and trends and calls for more research to expand the findings. In the future, the cooperation between institutions and authors needs to be strengthened. The complex relationships between sleep and mental and physical health and problematic substance use disorders are necessary to be explored. Longitudinal studies or randomized controlled trials should be constructed to verify the current findings or assumptions.