Core competencies among nurses engaged in pallative care: A scoping review.

AIM: To synthesize available evidence about core competencies for nurses engaged in palliative care. DESIGN: A scoping review conducted according to the framework from Joanna Briggs Institute. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist was adopted to report this scoping review. The PubMed, Web of Science, Embase, ScienceDriect, CNKI, WangFang, VIP and Sinomed databases were used to systematically search for published studies from their inception to December 2023. Two researchers independently screened and selected relevant studies and performed the data charting. RESULTS: Twenty-six studies were included in this scoping review. Among these, 14 studies identified core competency assessment instruments among nurses engaged in palliative care, with the Palliative Care Core Competence Questionnaire was used most frequently; 13 studies investigated the status of core competencies of nurses engaged in palliative care, the majority of included studies indicated that nurse's core competencies were at moderate levels; 11 studies explored the factors influencing the core competencies of the nurses engaged in palliative care, which were classified as sociodemographic-related factors, palliative care education-related factors, death attitude, palliative care practice-related experience and others. CONCLUSION: This scoping review offers a comprehensive overview of the current landscape of core competencies among nurses in palliative care. Findings suggested that the clinical nursing leaders need to develop tailored strategies and interventions to address specific factors and promote the continuous development of nurses' competencies in palliative care. RELEVANCE TO CLINICAL PRACTICE: Core competency assessment instruments equip nurses and healthcare organizations with a range of validated tools for evaluating their proficiency in palliative care. Targeted core competency enhancement programmes need to be developed to foster a nursing workforce better equipped to improve the quality of life of end-of-life patients and their families. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Mutual connected IL-6, EGFR and LIN28/Let7-related mechanisms modulate PD-L1 and IGF upregulation in HNSCC using immunotherapy.

The development of techniques and immunotherapies are widely applied in cancer treatment such as checkpoint inhibitors, adoptive cell therapy, and cancer vaccines apart from radiation therapy, surgery, and chemotherapy give enduring anti-tumor effects. Minority people utilize single-agent immunotherapy, and most people adopt multiple-agent immunotherapy. The difficulties are resolved by including the biomarkers to choose the non-responders' and responders' potentials. The possibility of the potential complications and side effects are examined to improve cancer therapy effects. The Head and Neck Squamous Cell Carcinoma (HNSCC) is analyzed with the help of programmed cell death ligand 1 (PD-L1) and Insulin-like growth factor (IGF). But how IGF and PD-L1 upregulation depends on IL-6, EGFR, and LIN28/Let7-related mechanisms are poorly understood. Briefly, IL-6 stimulates gene expressions of IGF-1/2, and IL-6 cross-activates IGF-1R signaling, NF-κB, and STAT3. NF-κB, up-regulating PD-L1 expressions. IL-6/JAK1 primes PD-L1 for STT3-mediated PD-L1 glycosylation, stabilizes PD-L1 and trafficks it to the cell surface. Moreover, ΔNp63 is predominantly overexpressed over TAp63 in HNSCC, elevates circulating IGF-1 levels by repressing IGFBP3, and activates insulin receptor substrate 1 (IRS1).TP63 and SOX2 form a complex with CCAT1 to promote EGFR expression. EGFR activation through EGF binding extends STAT3 activation, and EGFR and its downstream signaling prolong PD-L1 mRNA half-life. PLC-γ1 binding to a cytoplasmic motif of elevated PD-L1 improves EGF-induced activation of inositol 1,4,5-tri-phosphate (IP3), and diacylglycerol (DAG) subsequently elevates RAC1-GTP. RAC1-GTP was convincingly demonstrated to induce the autocrine production and action of IL-6/IL-6R, forming a feedback loop for IGF and PD-L1 upregulation. Furthermore, the LIN28-Let7 axis mediates the NF-κB-IL-6-STAT3 amplification loop, activated LIN28-Let7 axis up-regulates RAS, AKT, IL-6, IGF-1/2, IGF-1R, Myc, and PD-L1, plays pivotal roles in IGF-1R activation and Myc, NF-κB, STAT3 concomitant activation. Therefore, based on a detailed mechanisms review, our article firstly reveals that IL-6, EGFR, and LIN28/Let7-related mechanisms mediate PD-L1 and IGF upregulation in HNSCC, which comprehensively influences immunity, inflammation, metabolism, and metastasis in the tumor microenvironment, and might be fundamental for overcoming therapy resistance.

MicroRNA-26b-5p suppresses the proliferation of tongue squamous cell carcinoma via targeting proline rich 11 (PRR11).

MicroRNAs (miRNAs) have been proved to be involved in many biological processes during tumorigenesis and progression, including cell proliferation and cell cycle progression. However, the potential role of miR-26b-5p in tongue squamous cell carcinoma (TSCC) remains unclear. In the present study, we demonstrated that miR-26b-5p was decreased in TSCC tissues in both TCGA-TSCC subset and eight paired samples from TSCC patients, while Proline Rich 11 (PRR11) was obviously increased. Transfection of miR-26b-5p mimics inhibited CALL7 cell proliferation by arresting the cells at the S/G2 transition. Meanwhile, miR-26b-5p inhibitor had the opposite biological functions. The results of luciferase activity and RNA-pulldown assays indicated that miR-26b-5p directly targeted the PRR11 3' -untranslated region in CAL27 cells. Furthermore, the effects of miR-26b-5p on cell cycle regulation were reversed after treatment with siRNA against PRR11. In summary, our findings indicate that miR-26b-5p induce cell cycle arrest in TSCC by targeting PRR11. Hence, targeting miR-26b-5p could be a promising therapeutic strategy for the treatment of TSCC.

[A comprehensive evaluation of the health services in Hunan Province].

OBJECTIVE: To establish a comprehensive evaluation system for the development of health services, and to assess the levels of health services in 2008 and 2009 in Hunan compared with seven other provinces in central China, so as to provide a basis for hygiene management decisions. METHODS: In order to establish a comprehensive evaluation system, a Delphi method, a boundary value method, and an RSR method were applied, respectively, to survey indices of health service development, to screen indices, and to determine index weights. A weighted TOPSIS method was used to evaluate the development status of health services of the eight provinces. RESULTS: The Cronbach's alpha coefficient of the questionnaire was 0.884, indicating a proper surface validity and a content validity. The expert positive coefficient, authority coefficient and Kendall coefficient were 93.75%, 0.8117, and 0.31, respectively. A comprehensive evaluation system, which consisted of 3 primary indices, 10 secondary indices and 52 tertiary indices, was established. The result of the comprehensive evaluation showed that the health services development of Hunan Province ranked 7th and 6th among the 8 central provinces for 2008 and 2009, respectively. CONCLUSION: The established, comprehensive evaluation system has a high reliability. Health services development of Hunan Province is relatively backward among the 8 central provinces.

[Development of health service in Hunan Province].

OBJECTIVE: To study the health service development in Hunan Province, and to find out the advantages and disadvantages, and to make tentative specific suggestions. METHODS: Comparison was made in Yunnan, Hunan, and Zhejiang Provinces in 4 major areas: health institutions, personnels, facilities, and funding. RESULTS: The overall health service of Hunan Province was good: The health resources increased, the allocations were reasonable, and the health expenditure decreased. Some problems appeared, such as backward primary health, shortage of medical talents, inefficient use of hospital beds, deducted government investment, increased business income, and large urban-rural gap. CONCLUSION: There is urgent need to further develop health institutions and increase personnels, particularly improving the primary health care and making use of traditional Chinese medicine; improving the management of hospital beds to increase efficiency, increasing financial support to reduce the patients' burden, and ensuring the need of rural health care.