Caregiver Burden and Readiness in Patients with Moderate and Severe Traumatic Brain Injury: The Chain Mediation Effect of Disease Uncertainty and Mental Resilience.

OBJECTIVE: To analyze the mediating effects of caregiver illness uncertainty and psychological resilience in caregiver burden and readiness in patients with moderate-to-severe traumatic brain injuries (TBIs). This can help improve caregiver readiness in patients with moderate-to-severe TBIs. METHODS: A purposive sampling method was used to recruit patients with moderate-to-severe TBIs, and their caregivers, who were hospitalized in the Department of Neurosurgery of the Affiliated Hospital of Yangzhou University between October 2022 and August 2023. The Zarit Caregiver Burden Interview, Mishel Uncertainty In Scale for Family Member, Connor-Davidson Resilience Scale, and Caregivers Preparedness Scale, as well as general information questionnaire, were used to conduct the survey. RESULTS: Caregiver readiness correlated with caregiver burden, illness uncertainty, and psychological resilience in patients with moderate-to-severe TBI (P < 0.01). Caregiver readiness was not only directly affected by caregiver burden (95% confidence interval: -0.510, -0.196) but was also affected through the chain mediation of illness uncertainty and psychological resilience (95% confidence interval: -0.146, -0.011). CONCLUSIONS: Caregiver burden in patients with moderate-to-severe TBI influences caregiver readiness levels and is mediated by illness uncertainty and psychological resilience. By improving caregivers' illness uncertainty and increasing their psychological resilience, the impact of low caregiver readiness caused by high caregiver burden could be reduced.

Taming heat with tiny pressure.

Heat is almost everywhere. Unlike electricity, which can be easily manipulated, the current ability to control heat is still highly limited owing to spontaneous thermal dissipation imposed by the second law of thermodynamics. Optical illumination and pressure have been used to switch endothermic/exothermic responses of materials via phase transitions; however, these strategies are less cost-effective and unscalable. Here, we spectroscopically demonstrate the glassy crystal state of 2-amino-2-methyl-1,3-propanediol (AMP) to realize an affordable, easily manageable approach for thermal energy recycling. The supercooled state of AMP is so sensitive to pressure that even several megapascals can induce crystallization to the ordered crystal, resulting in a substantial temperature increase of 48 K within 20 s. Furthermore, we demonstrate a proof-of-concept device capable of programable heating with an extremely high work-to-heat conversion efficiency of ∼383. Such delicate and efficient tuning of heat may remarkably facilitate rational utilization of waste heat.

An Empirical Study of Feedforward Control in Unplanned Extubation of Nasogastric Tube.

Objective: To explore the effect of feedforward control on reducing the incidence of unplanned extubation and improving the quality of catheter nursing. Methods: A total of 186 patients with nasogastric tube after gastrointestinal surgery in the eastern region of our hospital from September 2020 to September 2021 were selected as the control group; 186 patients with nasogastric tube after gastrointestinal surgery in the western region of our hospital at the same period were selected as the experimental group. The influencing factors of unplanned extubation in patients with long-term postoperative nasogastric tube were analyzed, and effective preoperative and postoperative health education was conducted. The ratio of unplanned extubation of nasogastric tube and nursing satisfaction of patients in the two groups were compared. Results: Patient constraint, perceived pressure score, anxiety score, nasal gastrointestinal canal health education feedback score and indwell tube comfort score were independent risk factors for unplanned extubation. The restraint rate and the incidence of unplanned extubation in the experimental group were lower than those in the control group after intervention, with statistical significance (P < 0.05). The nursing satisfaction of the experimental group was significantly higher than that of the control group after feedforward cognitive intervention. After intervention, serum albumin and gastric PH in the experimental group were significantly higher than those in the control group (P < 0.05). Conclusion: The safe nursing management method of feed forward control can effectively reduce the incidence of unplanned extubation in inpatients, which is worth further promoting in nursing work.

Risk factors for postoperative urinary retention in patients undergoing colorectal surgery: a systematic review and meta-analysis.

PURPOSE: Postoperative urinary retention (POUR) is a common complication following colorectal surgery. The incidence of POUR among colorectal surgery patients varies widely, and the risk factors and outcomes of POUR are also debatable. This meta-analysis aims to systematically evaluate the risk factors for POUR in patients after colorectal surgery. METHODS: PubMed, Web of Science, the Cochrane Library, Embase, Medline, and Chinese databases (CBM, CNKI, and WanFang Databases) were searched to identify relevant cohort studies (from inception to August 2022). Two researchers independently conducted literature quality evaluation and data extraction. All data were analyzed by using the Review Manager 5.4 software. RESULTS: Nineteen studies with 101,025 patients were included in this meta-analysis. The risk factors for POUR in colorectal surgery patients were male sex, older age, diabetes mellitus, urological diseases, tumor location in the lower rectum, APR, laparoscopic surgery, operation time ≥ 4 h, postoperative date of urinary catheter removal, excessive intraoperative intravenous fluid volume, and postoperative ileus. The postoperative anastomotic leak, on the other hand, was not a risk factor for POUR. CONCLUSIONS: Multiple risk factors influence the incidence of POUR in patients undergoing colorectal surgery. To reduce the incidence of POUR in colorectal surgery patients, medical staff should identify risk factors early and enforce interventions to prevent them.

Social Support and Spiritual Well-Being of Patients With Esophageal Cancer Aged Over 50 Years: The Mediating Role of Rumination.

Background: Spiritual well-being plays an important role in helping patients cope with disease. Previous studies have investigated the association between social support and spiritual well-being, whereas few studies have explored the relationship in patients with esophageal cancer (EC), and the mechanisms behind this pathway have not been thoroughly examined. Objective: This study aimed to explore the relationship between social support and spiritual well-being of Chinese patients with EC aged over 50 years and to analyze whether the relationship was mediated by rumination. Methods: A cross-sectional survey was conducted with 197 EC patients. Participants completed the general information questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Scale, the Chinese Event Related Rumination Inventory, and the Perceived Social Support Scale (PSSS). Results: Results demonstrated that social support of patients with EC aged over 50 years was positively correlated with spiritual well-being and deliberate rumination and negatively correlated with intrusive rumination; spiritual well-being was positively associated with deliberate rumination and negatively correlated with intrusive rumination. The effect of social support on spiritual well-being was partially mediated by deliberate rumination and intrusive rumination. Conclusions: The findings suggest that interventions directed toward enhancing social support and deliberate rumination and reducing the level of intrusive rumination may help patients with EC aged over 50 years improve spiritual well-being.

A novel inactivated whole-cell Pseudomonas aeruginosa vaccine that acts through the cGAS-STING pathway.

Pseudomonas aeruginosa infection continues to be a major threat to global public health, and new safe and efficacious vaccines are needed for prevention of infections caused by P. aeruginosa. X-ray irradiation has been used to prepare whole-cell inactivated vaccines against P. aeruginosa infection. However, the immunological mechanisms of X-ray-inactivated vaccines are still unclear and require further investigation. Our previous study found that an X-ray-inactivated whole-cell vaccine could provide protection against P. aeruginosa by boosting T cells. The aim of the present study was to further explore the immunological mechanisms of the vaccine. Herein, P. aeruginosa PAO1, a widely used laboratory strain, was utilized to prepare the vaccine, and we found nucleic acids and 8-hydroxyguanosine in the supernatant of X-ray-inactivated PAO1 (XPa). By detecting CD86, CD80, and MHCII expression, we found that XPa fostered dentritic cell (DC) maturation by detecting. XPa stimulated the cGAS-STING pathway as well as Toll-like receptors in DCs in vitro, and DC finally underwent apoptosis and pyroptosis after XPa stimulation. In addition, DC stimulated by XPa induced CD8+ T-cell proliferation in vitro and generated immunologic memory in vivo. Moreover, XPa vaccination induced both Th1 and Th2 cytokine responses in mice and reduced the level of inflammatory factors during infection. XPa protected mice in pneumonia models from infection with PAO1 or multidrug-resistant clinical isolate W9. Chronic obstructive pulmonary disease (COPD) mice immunized with XPa could resist PAO1 infection. Therefore, a new mechanism of an X-ray-inactivated whole-cell vaccine against P. aeruginosa infection was discovered in this study.

Phase-dependent dielectric properties and proton conduction of neopentyl glycol.

Phase-dependent dielectric properties and proton conduction of neopentyl glycol (NPG), which is an organic molecular plastic crystal, were studied via variable-temperature broadband dielectric spectroscopy (BDS). Permittivity and conductivity data show the phase transformations of NPG from the crystalline state to the plastic crystalline state at 315 K and then to the molten state at 402 K across the temperature range of 293-413 K. The Vogel temperatures (T v) fitted from the Vogel-Fulcher-Tammann (VFT) equation agree well with the values extrapolated by the Stickel plot (linearized Vogel plot). Impedance and modulus data display a separation of the -Z'' (the imaginary part of the complex impedance) and M'' (the imaginary part of the complex electric modulus) peaks in the crystalline phase. However, they overlap in both the plastic crystalline phase and the molten phase, indicating long-range proton conduction. In both the molten phase and the plastic crystalline phase, the temperature dependence of direct current conductivity (σ dc) obeys the VFT equation very well. While the vehicle mechanism (translational diffusion) is an intrinsic mechanism for ionic or protonic conduction in the molten phase, it is speculated that the Grotthuss mechanism also works due to the self-dissociation of NPG molecules, which are similar to water molecules. In the plastic crystalline phase, the proton hopping mechanism is most likely the underlying ion-conducting mechanism because of the rotational disorder and intrinsic defects (vacancies) of the NPG molecules. In the ordered crystalline phase, the proton conduction is presumed to follow the proton hopping mechanism as determined from the localized relaxation and the temperature dependence of σ dc (Arrhenius behavior).

Physicochemical study of diethylmethylammonium methanesulfonate under anhydrous conditions.

The protic ionic liquid diethylmethylammonium methanesulfonate ([DEMA][OMs]) was analyzed in depth by differential scanning calorimetry (DSC), nuclear magnetic resonance (NMR) spectroscopy, Fourier transform infrared (FT-IR) spectroscopy, Raman spectroscopy, and broadband dielectric spectroscopy (BDS) under anhydrous conditions. Karl Fischer titration, NMR, and FT-IR spectra confirmed the high purity of [DEMA][OMs]. The melting point (37.7 °C) and the freezing point (14.0 °C) obtained by DSC agree well with the values determined by BDS (40.0 °C and 14.0 °C). The dc conductivity (σdc) above the melting/freezing point obeys the Vogel-Fulcher-Tammann (VFT) equation well, and thus, the proton conduction in [DEMA][OMs] is assumed to be dominated by the vehicle mechanism. In contrast, the σdc below the melting/freezing point can be fitted by the Arrhenius equation separately, and therefore, the proton conduction is most likely governed by the proton hopping mechanism. The non-negligible influence of previously reported low water content on the physicochemical properties of [DEMA][OMs] is found, indicating the importance of reducing water content as much as possible for the study of "intrinsic" properties of protic ionic liquids.