YY1 mediated DCUN1D5 transcriptional activation promotes triple-negative breast cancer progression by targeting FN1/PI3K/AKT pathway.

Triple-negative breast cancer (TNBC) is more aggressive and has a higher metastasis rate compared with other subtypes of breast cancer. Due to the lack of drug-targetable receptors, chemotherapy is now the only available systemic treatment for TNBC. However, some patients might still develop drug resistance and have poor prognosis. Therefore, novel molecular biomarkers and new treatment targets are urgently needed for patients with TNBC. To provide molecular insights into TNBC progression, we investigated the function and the underlying mechanism of Defective in cullin neddylation 1 domain containing 5 (DCUN1D5) in the regulation of TNBC. By TCGA dataset and surgical specimens with immunohistochemical (IHC) staining method, DCUN1D5 was identified to be significantly upregulated in TNBC tumor tissues and negatively associated with prognosis. A series of in vitro and in vivo experiments were performed to confirm the oncogenic role of DCUN1D5 in TNBC. Overexpression of FN1 or PI3K/AKT activator IGF-1 could restore the proliferative and invasive ability induced by DCUN1D5 knockdown and DCUN1D5 could act as a novel transcriptional target of transcription factor Yin Yang 1 (YY1). In conclusion, YY1-enhanced DCUN1D5 expression could promote TNBC progression by FN1/PI3K/AKT pathway and DCUN1D5 might be a potential prognostic biomarker and therapeutic target for TNBC treatment.

Additional prognostic value of polymorphisms within the 3'-untranslated region of programmed cell death pathway genes in early-stage breast cancer.

Introduction: The programmed cell death (PCD) pathway plays an important role in restricting cancer cell survival and proliferation. However, limited studies have investigated the association between genetic variants in the 3'-untranslated region of the PCD pathway genes and breast cancer outcomes. Methods: In this study, we genotyped 28 potentially functional single nucleotide polymorphisms (SNPs) in 23 PCD pathway genes in 1,177 patients with early-stage breast cancer (EBC) from a Han Chinese population. The median follow-up period was 174 months. Results: Among all the candidate SNPs, four independent SNPs (rs4900321 and rs7150025 in ATG2B, rs6753785 in BCL2L11, and rs2213181 in c-Kit) were associated with invasive disease-free survival (iDFS), distant disease-free survival (DDFS), breast cancer-specific survival (BCSS) and overall survival (OS), respectively. Further combined genotypes of these four SNPs revealed that the survival decreased as the number of unfavorable genotypes increased (Ptrend = 1.0 × 10-6, 8.5 × 10-8, 3.6 × 10-4, and 1.3 × 10-4 for iDFS, DDFS, BCSS, and OS, respectively). Receiver operating characteristic curve analysis demonstrated that incorporating unfavorable genotypes and clinicopathological variables improved the ability to predict EBC survival (P = 0.006, 0.004, 0.029, and 0.019 for iDFS, DDFS, BCSS, and OS, respectively). Additionally, rs6753785 and rs2213181 were associated with BCL2L11 and c-Kit mRNA expression, respectively. Conclusions: Our results suggest that these four SNPs may act as novel biomarkers for EBC survival, possibly by modulating the expression of the corresponding genes.

The core competencies in disaster nursing of new graduate nurses in Guangdong, China: A cross-sectional study.

AIM: This study aimed to assess the level of core competencies in disaster nursing of New Graduate Nurses (NGNs) and explore its influencing factors. BACKGROUND: In recent years, the overall frequency of disasters around the world has been on the rise. As the emerging workforce in clinical settings, NGNs play an integral role in future disaster relief efforts. NGNs' level and influencing impact of core competencies in disaster nursing need to be understood. DESIGN: A cross-sectional design. METHODS: From June to September 2023, the Core Competencies in Disaster Nursing Scale - General Professional Nurse (CCDNS-GPN), designed according to the CCDN V2.0, was used to collect data from NGNs of six nursing schools and 15 hospitals in Guangdong, China. Descriptive analysis was conducted to examine the scores of core competencies in disaster nursing. Furthermore, one-way analysis of variance and multivariate linear regression analysis were used to explore the influencing factors. RESULTS: A total of 607 NGNs participated in this study. The scores of CCDNS-GPN of NGNs were 90.23 (SD 15.09) (score ratio: 51.56%), indicating a low level of core competencies in disaster nursing. The highest competency was the recovery (score ratio: 55.00%), while the lowest competency was the communication (score ratio: 45.44%). The predictor for core competencies in disaster nursing of NGNs were male (ß = 0.091, p < 0.05), below bachelor's degree (ß = -0.109, p < 0.05), had received disaster nursing education at school (ß = 0.087, p < 0.05), had participated in a disaster rescue drill at school (ß = 0.140, p < 0.05), had been to the ICU during internship (ß = 0.135, p < 0.05) and had the intention to be a disaster specialized nurse (ß = 0.114, p < 0.05). CONCLUSIONS: The NGNs exhibited insufficient core competencies in disaster nursing in Guangdong, China. Nursing schools and clinical institutions should collaborate and play their respective roles to enhance nurses' core competencies in disaster nursing, ensuring they can timely, safely and efficiently participate in disaster medical relief efforts.

Characterization and expression profiling of fadd gene in response to exogenous Aeromonas hydrophila or Edwardsiella tarda challenge in the hybrid yellow catfish (Pelteobagrus fulvidraco ♀ × P. vachelli ♂).

In mammals, fas-associated protein with death domain (FADD) is involved in the process of cell apoptosis and plays a key role in innate immune signaling. Nevertheless, its detailed molecular mechanisms underlying apoptosis and immune responses to exogenous bacterial infections in teleosts remain largely unknown. In this study, a group of 60 hybrid yellow catfish (with the body weight of 25 ± 0.5 g) were used in subsequent experiments, we examined the expression profiling of fadd gene through comparative genomics and comparative immunological methods. Our results showed that fadd in the hybrid yellow catfish (hycfadd) exhibited similar gene and spatial structures to those in other vertebrates, and formed an independent clade in phylogeny. An expression pattern analysis revealed that hycfadd widely transcribed in various tissues, with the highest transcription level in the liver. Furthermore, expression profiling of hycfadd when intraperitoneally infected with 50 µL of exogenous Aeromonas hydrophila (2.0 × 107 CFU/mL) or Edwardsiella tarda (2.0 × 107 CFU/mL) within 48 h were significantly up-regulated in the kidney, spleen, liver and intestine. Important genes in the toll like receptor (tlr) 1-tlr2- myeloid differentiation primary response 88 (MyD88)-fadd-caspase (casp) 8 cascades of TLR signaling pathway in liver were significantly up-regulated after the A. hydrophila stimulation, suggesting that apoptosis through the TLR signaling pathway may have been triggered and activated, which were further verified in the liver, kidney, spleen, intestine and gill by a TUNEL assay. Overall, this study provides solid evidence for the bacterial induction of fadd-related apoptosis in teleosts.

Comparative analysis of gut DNA viromes in wild and captive Himalayan vultures.

Introduction: Himalayan vultures (Gyps hinalayensis) are widely distributed on the Qinghai-Tibetan Plateau and play a crucial role in maintaining the ecological balance by feeding on decayed corpses of wild and domestic animals. Large-scale culture and metagenomics studies have broadened our understanding of viral diversity in animals' gastrointestinal tracts. However, despite the importance of gut viral communities in regulating bacterial diversity and performing symbiotic functions, no gut viral study has been conducted on Himalayan vultures. Furthermore, the impact of captivity on the gut virome of these vultures remains unknown. Methods: In this study, metagenomic sequencing methods targeting DNA of virus-like particles enriched from feces were used to characterize the gut DNA viromes of wild and captive Himalayan vultures. Results: In total, 22,938 unique viral operational taxonomic units (vOTUs) were identified and assigned to 140 viral genera in 41 viral families. These families included viruses associated with bacteria, animals, plants, insects, and archaea. Phage communities, including Siphoviridae, Microviridae, Myoviridae, Inoviridae, and Herelleviridae, dominated the gut virome of Himalayan vultures. Wild vultures exhibited higher viral richness and diversity compared with those in captivity. The functional capacity of the gut virome was characterized by identifying 93 KEGG pathways, which were significantly enriched in metabolism and genetic information processing. Abundant auxiliary metabolic genes, such as carbohydrate-active enzyme, and antibiotic resistance genes, were also found in the vultures' gut virome. Discussion: Our findings reveal the complex and diverse viral community present in the gut virome of Himalayan vultures, which varies between wild, and captive states. The DNA virome dataset establishes a baseline for the vultures' gut virome and will serve as a reference for future virus isolation and cultivation. Understanding the impact of captivity on the gut virome contributes to our knowledge of vultures' response to captivity and aids in optimizing their rehabilitation and implementing protective measures.

Impact of body mass index in therapeutic response for HER2 positive breast cancer treated with neoadjuvant targeted therapy: a multi-center study and meta-analysis.

While overweight/obesity has become a major public health issue worldwide, any association between body mass index (BMI) and therapeutic response in neoadjuvant targeted therapy treated HER2 positive breast cancer patients remain unclear. The information from a total of four-hundred and ninety-one neoadjuvant targeted therapy treated HER2 positive breast cancer patients from four institutions were retrospectively collected. Univariate and multivariate logistic analysis was developed to determine the association between BMI and therapeutic response. A meta-analysis of published literature was then conducted to confirm the effect of overweight/obesity on pCR for patients treated with neoadjuvant targeted therapy. Restricted cubic spline (RCS) adjusted for confounding factors demonstrated a decrease pCR with increasing BMI (OR = 0.937, P = 0.045). Patients were then categorized into under/normal weight (n = 299) and overweight/obesity (n = 192). Overweight/obese patients were independently associated with a poor therapeutic response. In the subgroup analysis, a significant negative impact of overweight/obesity on pCR can be observed both in single-targeted (OR = 0.556; P = 0.02) and dual-targeted (OR = 0.392; P = 0.021) populations. Six eligible studies involving 984 neoadjuvant targeted therapy treated HER2 positive breast cancer patients were included in the meta-analysis. The meta-analysis also demonstrated that overweight/obesity was significantly associated with a poor response to neoadjuvant anti-HER2 therapy (OR = 0.68; P = 0.007). Our result show that overweight and obese HER2 positive breast cancer patients are less likely to achieve pCR after neoadjuvant targeted therapy.

Characterization of TLR1 and expression profiling of TLR signaling pathway related genes in response to Aeromonas hydrophila challenge in hybrid yellow catfish (Pelteobagrus fulvidraco ♀ × P. vachelli ♂).

Toll-like receptor 1 (TLR1) mediates the innate immune response to a variety of microbes through recognizing cell wall components (such as bacterial lipoproteins) in mammals. However, the detailed molecular mechanism of TLR1 involved in pathogen immunity in the representative hybrid yellow catfish (Pelteobagrus fulvidraco ♀ × P. vachelli ♂) has not been well studied. In the present study, we identified the TLR1 gene from the hybrid yellow catfish, and further comparative synteny data from multiple species confirmed that the TLR1 gene is highly conserved in teleosts. Phylogenetic analysis revealed distinguishable TLR1s in diverse taxa, suggesting consistence in evolution of the TLR1 proteins with various species. Structural prediction indicated that the three-dimensional structures of TLR1 proteins are relatively conserved among different taxa. Positive selection analysis showed that purifying selection dominated the evolutionary process of TLR1s and TLR1-TIR domain in both vertebrates and invertebrates. Expression pattern analysis based on the tissue distribution showed that TLR1 mainly transcribed in the gonad, gallbladder and kidney, and the mRNA levels of TLR1 in kidney were remarkably up-regulated after Aeromonas hydrophila stimulation, indicating that TLR1 participates in the inflammatory responses to exogenous pathogen infection in hybrid yellow catfish. Homologous sequence alignment and chromosomal location indicated that the TLR signaling pathway is very conserved in the hybrid yellow catfish. The expression patterns of TLR signaling pathway related genes (TLR1- TLR2 - MyD88 - FADD - Caspase 8) were consistent after pathogen stimulation, revealing that the TLR signaling pathway is triggered and activated after A. hydrophila infection. Our findings will lay a solid foundation for better understanding the immune roles of TLR1 in teleosts, as well as provide basic data for developing strategies to control disease outbreak in hybrid yellow catfish.

High leukocyte mitochondrial DNA copy number contributes to poor prognosis in breast cancer patients.

BACKGROUND: Compelling evidence has indicated a significant association between leukocyte mitochondrial DNA copy number (mtDNAcn) and prognosis of several malignancies in a cancer-specific manner. However, whether leukocyte mtDNAcn can predict the clinical outcome of breast cancer (BC) patients has not been well investigated. METHODS: The mtDNA copy number of peripheral blood leukocytes from 661 BC patients was measured using a Multiplex AccuCopy™Kit based on a multiplex fluorescence competitive PCR principle. Kaplan-Meier curves and Cox proportional hazards regression model were applied to investigate the association of mtDNAcn with invasive disease-free survival (iDFS), distant disease-free survival (DDFS), breast cancer special survival (BCSS), and overall survival (OS) of patients. The possible mtDNAcn-environment interactions were also evaluated by the Cox proportional hazard regression models. RESULTS: BC patients with higher leukocyte mtDNA-CN exhibited a significantly worse iDFS than those with lower leukocyte mtDNAcn (5-year iDFS: fully-adjusted model: HR = 1.433[95%CI 1.038-1.978], P = 0.028). Interaction analyses showed that mtDNAcn was significantly associated with hormone receptor status (adjusted p for interaction: 5-year BCSS: 0.028, 5-year OS: 0.022), so further analysis was mainly in the HR subgroup. Multivariate Cox regression analysis demonstrated that mtDNAcn was an independent prognostic factor for both BCSS and OS in HR-positive patients (HR+: 5-year BCSS: adjusted HR (aHR) = 2.340[95% CI 1.163-4.708], P = 0.017 and 5-year OS: aHR = 2.446 [95% CI 1.218-4.913], P = 0.011). CONCLUSIONS: For the first time, our study demonstrated that leukocyte mtDNA copy number might influence the outcome of early-stage breast cancer patients depending on intrinsic tumor subtypes in Chinese women.

Deterministic processes dominate microbial community assembly in artificially bred Schizothorax wangchiachii juveniles after being released into wild.

Fish artificial breeding and release is an important method to restore wild populations of endemic fish species around the world. Schizothorax wangchiachii (SW) is an endemic fish in the upper Yangtze River and is one of the most important species for the artificial breeding and release program implemented in the Yalong River drainage system in China. It is unclear how artificially bred SW adapts to the changeable wild environment post-release, after being in a controlled and very different artificial environment. Thus, the gut samples were collected and analyzed for food composition and microbial 16S rRNA in artificially bred SW juveniles at day 0 (before release), 5, 10, 15, 20, 25, and 30 after release to the lower reaches of the Yalong River. The results indicated that SW began to ingest periphytic algae from the natural habitat before day 5, and this feeding habit is gradually stabilized at day 15. Prior to release, Fusobacteria are the dominant bacteria in the gut microbiota of SW, while Proteobacteria and Cyanobacteria generally are the dominant bacteria after release. The results of microbial assembly mechanisms illustrated that deterministic processes played a more prominent role than stochastic processes in the gut microbial community of artificially bred SW juveniles after releasing into the wild. Overall, the present study integrates the macroscopic and microscopic methods to provide an insight into the food and gut microbial reorganization in the released SW. This study will be an important research direction to explore the ecological adaptability of artificially bred fish after releasing into the wild.

Development of a knowledge, attitude and practice questionnaire on urine leakage with an indwelling urethral catheter for nurses in China.

AIM: A knowledge, attitude and practice questionnaire on urine leakage (UL) with an indwelling urethral catheter (IUC) was developed for nurses in China and validated. DESIGN: Observational study. METHODS: A systematic literature review, the Delphi method and focus group evaluation were used to develop the questionnaire, which was administered to 304 registered nurses at two hospitals in Guangdong, China. The validity and reliability of the questionnaire were assessed. RESULTS: The 27-item questionnaire had four dimensions: knowledge I (aetiology), knowledge II (prevention and treatment), attitude and practice. The questionnaire showed excellent content validity and reliability. Four factors accounted for 70.526% of the variance. The data were well-fitted to the four-factor construct model. The questionnaire can be used to measure the knowledge of UL with an IUC among nurses in China, along with related attitudes and practices. This can improve nursing care of patients with IUCs. No patient or public contribution.

Factors associated with poor mental health outcomes in nurses in COVID-19-designated hospitals in the postepidemic period in Guangdong Province: a cross-sectional study.

OBJECTIVE: The early days of the COVID-19 pandemic placed enormous pressure and subsequent negative psychological problems on nurses, but at this stage of the year-long COVID-19 outbreak, the level of stress and negative emotions that nurses experience is unclear. Our study attempted to assess the factors influencing mental health status in nurses during the postepidemic period of COVID-19. DESIGN: Cross-sectional study. SETTING: COVID-19 designated hospitals. PARTICIPANTS: 1284 Chinese nurses. MAIN OUTCOME MEASURES: Electronic questionnaires, including the Chinese version of the Perceived Stress Scale (CPSS) and Symptom Checklist-90 (SCL-90), were distributed for self-evaluation. Regression analysis was used to analyse the associated factors of psychological stress among variables such as age, years of nursing experience, weekly working hours, anxiety symptoms, somatisation symptoms and compulsive symptoms. RESULTS: A total of 1284 respondents from COVID-19-designated hospitals in Guangdong Province were studied. The average CPSS score for all respondents was 22.91±7.12. A total of 38.5% of respondents scored ≥26 on the CPSS, indicating a significant degree of psychological stress. Nurses with high psychological stress had higher levels of anxiety symptoms (41.7% vs 8.0%), somatisation symptoms (31.4% vs 7.7%) and compulsion symptoms (62.3% vs 27.0%) than nurses with low psychological stress. Stepwise multiple linear regression revealed that weekly working hours, years of nursing experience, anxiety symptoms, somatisation symptoms and compulsion symptoms had a linear relationship with the participants' psychological stress scores. CONCLUSION: Nurses experienced significant physical and psychological risk while working in the postepidemic period. Our findings suggest that nurses still need support to protect their physical and mental health.

Progress on SARS-CoV-2 3CLpro Inhibitors: Inspiration from SARS-CoV 3CLpro Peptidomimetics and Small-Molecule Anti-Inflammatory Compounds.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) currently poses a threat to human health. 3C-like proteinase (3CLpro) plays an important role in the viral life cycle. Hence, it is considered an attractive antiviral target protein. Whole-genome sequencing showed that the sequence homology between SARS-CoV-2 3CLpro and SARS-CoV 3CLpro is 96.08%, with high similarity in the substrate-binding region. Thus, assessing peptidomimetic inhibitors of SARS-CoV 3CLpro could accelerate the development of peptidomimetic inhibitors for SARS-CoV-2 3CLpro. Accordingly, we herein discuss progress on SARS-CoV-2 3CLpro peptidomimetic inhibitors. Inflammation plays a major role in the pathophysiological process of COVID-19. Small-molecule compounds targeting 3CLpro with both antiviral and anti-inflammatory effects are also briefly discussed in this paper.

YTHDF3 facilitates triple-negative breast cancer progression and metastasis by stabilizing ZEB1 mRNA in an m6A-dependent manner.

Background: The YTH domain family protein 3 (YTHDF3) is an important N6-methyladenosine (m6A) reader which is involved in multiple cancers. However, the biological role and mechanisms of action for YTHDF3 in triple-negative breast cancer (TNBC) remains to be elucidated. Methods: The expression of YTHDF3 in TNBC tissues was evaluated using The Cancer Genome Atlas (TCGA) database, BC-GenExMiner, and immunohistochemistry (IHC) staining. Cell migration, invasion, and epithelial-mesenchymal transition (EMT) were validated by wound healing assays, transwell assays, and Western blot (WB) analyses. The association between YTHDF3 and zinc finger E-box-binding homeobox 1 (ZEB1) was confirmed by Pearson correlation analysis. RNA-binding protein immunoprecipitation (RIP) assays and mRNA actinomycin stability analyses were applied to confirm whether YTHDF3 could interact with ZEB1in an m6A-dependent manner. Results: The expression of YTHDF3 was correlated with poorer disease-free survival (DFS) and overall survival (OS) in TNBC patients. Functional experiments indicated that YTHDF3 positively regulated cell migration, invasion, and EMT in TNBC cells. Moreover, ZEB1 was identified as a key downstream target for YTHDF3 and YTHDF3 could enhance ZEB1 mRNA stability in an m6A-dependent manner. Inhibition of YTHDF3 reduced migration, invasion, and EMT, all of which were reversed by rescue experiments overexpressing ZEB1. Conclusions: The findings herein confirmed that the YTHDF3/ZEB1 axis plays an important role in the progression and metastasis of TNBC. YTHDF3 is a promising prognosis biomarker and potential therapeutic target for patients with TNBC.

Two-Dimensional Fillers Induced Superior Electrostatic Energy Storage Performance in Trilayered Architecture Nanocomposites.

Dielectric capacitors with ultrahigh power densities and fast charging/discharging rates are of vital relevance in advanced electronic markets. Nevertheless, a tradeoff always exists between breakdown strength and polarization, which are two essential elements determining the energy storage density. Herein, a novel trilayered architecture composite film, which combines outer layers of two-dimensional (2D) BNNS/poly(vinylidene fluoride-co-hexafluoropropylene) (P(VDF-HFP)) with high breakdown strength and an intermediate layer made of blended 2D MoS2 nanosheets/P(VDF-HFP) with large polarization, is fabricated using the layer-by-layer casting method. The insulating BNNS with a wide band gap is able to largely alleviate the distortion of the local electric field, thereby suppressing the leakage current and effectively reducing the conductivity loss, while the 2D MoS2 nanosheets act as microcapacitors in the polymer composites, thus significantly increasing the permittivity. A finite element simulation is carried out to further analyze the evolution process of electrical treeing in the experimental breakdown of the polymer nanocomposites. Consequently, the nanocomposites possess an excellent discharged energy density of 25.03 J/cm3 accompanied with a high charging/discharging efficiency of 77.4% at 650 MV/m, which greatly exceeds those of most conventional single-layer films. In addition, the corresponding composites exhibit an outstanding reliability of energy storage performance under continuous cycling. The excellent performances of these polymer-based nanocomposite films could pave a way for widespread applications in advanced capacitors.

Association of Adjuvant Hormone Therapy Timing With Overall Survival Among Patients With Hormone Receptor-Positive Human Epidermal Growth Factor Receptor-2-Negative Early Breast Cancer Without Chemotherapy.

Importance: Studies have shown that delayed initiation of surgery and adjuvant chemotherapy is associated with lower rates of breast cancer survival. However, it remains unclear whether delayed initiation of adjuvant hormone therapy (AHT) is associated with survival. Objective: To assess the association of time to adjuvant hormone therapy (TTH) with breast cancer survival and evaluate the factors associated with AHT. Design, Setting, and Participants: This cohort study examined data from the National Cancer Database from 2004 through 2014 to assess the association of TTH (stratified as ≤150 and >150 days) with cancer survival. All patients included were diagnosed with stage I to stage III hormone receptor-positive, human epidermal growth factor receptor-2 (ERBB2; formerly HER2)-negative invasive breast cancer and underwent AHT without chemotherapy. Data were analyzed from April 2019 to May 2020. Exposures: AHT was administered at different time points following surgical procedures for breast cancer treatment. Main Outcomes and Measures: An inverse probability of treatment weighting (IPTW) model was constructed to evaluate overall survival by adjusting for treatment facility, patient demographics, tumor characteristics, and treatment; multivariable logistic regression was conducted to assess factors associated with delayed treatment. Results: A total of 144 103 patients (median [IQR] follow-up, 36.6 months [25.5-49.2 months]; mean [SD] age, 63.7 [11.6] years) were identified, which included 142 916 (99.2%) women, 11 574 (8.0%) Black patients, and 126 013 (87.4%) White patients. Of these, 134 873 patients (93.6%) had a TTH of 150 days or less and 9230 patients (6.4%) had a TTH longer than 150 days. The IPTW-based Cox model demonstrated that patients with delayed AHT (ie, a TTH past 150 days) were associated with decreased survival (hazard ratio [HR], 1.31; 95% CI, 1.26-1.35; P < .001) compared with those receiving the timely treatment (TTH ≤150 days). Several sensitivity analyses (including IPTW with stabilized weight [HR, 1.31; 95% CI, 1.19-1.45; P < .001], propensity score matching [HR, 1.41; 1.13-1.76; P = .002], and propensity score regression adjustment [HR, 1.29; 95% CI, 1.16-1.43; P < .001]) and exploratory subgroup analyses yielded similar trends. Factors associated with delayed AHT included Black racial identity (OR, 1.66; 95% CI, 1.55-1.77), nonprivate insurance (eg, no insurance: OR, 1.46; 95% CI, 1.26-1.70), living in large metropolitan or metropolitan areas (reference vs urban, less urban, or rural: OR, 0.82; 95% CI, 0.76-0.87), treatment in a community hospital (reference vs academic or research: OR, 0.91; 95% CI, 0.84-0.98), Charlson-Deyo Comorbidity Index score 2 or higher (OR, 1.17; 95% CI, 1.04-1.32), poor grade differentiation (OR, 1.42; 95% CI, 1.32-1.53), II and III pathological stage (stage III: OR, 3.13; 95% CI, 2.76-3.54), estrogen receptor-positive (ER+)/progesterone receptor-negative (PR-) or ER-/PR+ (OR, 1.22; 95% CI, 1.13-1.31), receiving breast conservation surgery (reference vs mastectomy: OR, 0.87; 95% CI, 0.79-0.94), and radiotherapy (reference vs no radiotherapy: OR, 0.56; 95% CI, 0.52-0.61). Conclusions and Relevance: The delay of the initiation of AHT past 150 days was associated with diminished survival in hormone receptor-positive, ERBB2-negative patients with breast cancer who did not receive chemotherapy. Efforts should be made to address factors associated with delayed treatment to improve survival.

Psychometric Evaluation of the Disaster Preparedness Evaluation Tool© (DPET) on Emergency Nurses in Mainland China: Two Cross-Sectional Studies.

BACKGROUND: Emergency nurses play a major role in disaster relief in mainland China, but there is no valid instrument to measure the extent of their disaster preparedness. The Disaster Preparedness Evaluation Tool© is a reliable instrument to assess the disaster preparedness of nurse practitioners. The tool has been translated and validated in Saudi Arabia, Taiwan, China and the United States of America. OBJECTIVES: This study aimed at translating and adapting the Disaster Preparedness Evaluation Tool© (DPET) for emergency nurses in mainland China and determining its psychometric properties. DESIGN, SETTINGS AND PARTICIPANTS: A total of 2 cross-sectional online surveys were conducted in the emergency departments of 26 public grade III-A hospitals in Guangdong, mainland China. In the first study, 633 emergency nurses were recruited from May to August, 2018. In the second study, 205 were recruited in April 2019. METHODS: The instrument was adapted through rigorous forward-backward translation, face validity, and pre-test processes. Exploratory factor and parallel analyses were used in the first study. Confirmatory factor analysis, internal consistency and split-half reliability were used in the second study. RESULTS: Exploratory factor and parallel analyses extracted a 5-factor solution comprising of 34 items that accounted for 64.06% of the total variance. The fit indices indicated a good model fit. The reliability was good, as indicated by a Cronbach's alpha of 0.97 and a split-half reliability coefficient of 0.97. CONCLUSION: The mainland China version of the DPET (DPET-MC) was a reliable and valid instrument and can be used in practice.

Disaster Preparedness and Associated Factors Among Emergency Nurses in Guangdong Province, China: A Descriptive Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to examine the prevalence of disaster preparedness and to explore associated factors among emergency nurses in Guangdong Province, China. METHODS: In this descriptive, cross-sectional study, the mainland China version of the Disaster Preparedness Evaluation Tool was used to collect data from 633 nurses working in 26 emergency departments, in August 2018. Descriptive analyses were used to examine the disaster preparedness, and multiple linear regression analysis was used to investigate associated factors. RESULTS: The perceived disaster preparedness of emergency nurses was at a moderate level. Among the 5 dimensions, the score for disaster management was lowest. Emergency nurses' disaster training (r = .26; P < 0.001) and drill experiences (r = .22; P < 0.001) were significantly correlated with disaster preparedness. Six significant factors associated with disaster preparedness were identified in this study: age, gender, disaster training experience, disaster drill experience, willingness, and educational level (R2 = .14; F = 18.20; P < 0.001). CONCLUSIONS: Hospitals and nurse managers should carry out interdisciplinary and multidisciplinary cooperation to improve emergency nurses' disaster preparedness, especially disaster management. Organizing disaster simulation exercises, providing psychological support and safety considerations, and formulating disaster nursing training programs may be beneficial for emergency nurses' disaster preparedness.

Psychometric evaluation of undergraduate student nurses' learning perceived needs in disaster nursing: Two cross-sectional studies.

BACKGROUND: Disaster nursing education is a necessity for nurses and students to improve their disaster relief competencies. Determining undergraduate student nurses' learning perceived needs for disaster nursing can help improve curricula construction. In China there is currently no valid instrument available for the evaluation of influencing factors. A disaster nursing course content system was developed using the Delphi method in 2011. However, this system was unformed and lacked psychometric evaluation. OBJECTIVES: To adapt the disaster nursing course content system into an instrument, to evaluate its psychometric properties, and to investigate undergraduate student nurses' learning perceived needs for disaster nursing. DESIGN, SETTINGS AND PARTICIPANTS: Two cross-sectional studies were conducted in public higher education institutions in China. In the first study, a total of 1714 undergraduate student nurses were recruited in May to October 2016; in the second study, 68 were recruited in May 2019. METHODS: The instrument was adapted through literature review, face validity and pilot testing in preliminary studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis, parallel analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability. RESULTS: The exploratory factor analysis and parallel analysis extracted a three-factor solution comprising 19 items that accounted for 71.69% of the total variance, including discipline introduction, skills and knowledge in disaster relief, and disaster management. The fit indices indicated a good fit. The internal consistency and test-retest reliability was good, as indicated by a Cronbach's alpha of 0.89 and an intraclass correlation coefficient of 0.87. CONCLUSION: The Learning Needs for Disaster Nursing questionnaire exhibited good psychometric properties, thereby proving itself a valuable instrument for evaluating learning perceived needs in undergraduate student nurses.

[Effect of bone marrow mesenchymal stem cells on lipopolysacharide-induced secretion of inflammatory cytokines in rat macrophages in vitro].

OBJECTIVE: To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) on secretion of inflammatory cytokines in macrophages stimulated by lipopolysacharide (LPS). METHODS: Rat BMSCs and macrophages were isolated, cultured, and identified. The BMSCs and macrophages, cultured alone or in co-culture, were treated with LPS or PBS or without treatment and tested for interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) concentrations in the supernatants at 1, 3, 5, 7, 12, and 24 h after the treatment using enzyme-linked immunosorbent assay. RESULTS: Exposure to LPS caused significantly increased IL-10 and TNF-α concentrations in the supernatant of cultured macrophages but not in BMSC culture. Macrophages co-cultured with BMSCs showed significantly lowered IL-10 and TNF-α secretions in response to LPS exposure as compared with the macrophages cultured alone. CONCLUSION: BMSCs can reduce LPS-induced secretion of inflammatory cytokines by the macrophages to ameliorate inflammatory reactions.