Impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery.

BACKGROUND: This study aimed to investigate the impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery. METHODS: A prospective observational study was conducted based on inclusion and exclusion criteria. A total of 384 elderly patients undergoing abdominal surgery under general anesthesia were enrolled in a grade A tertiary hospital in Chengdu, Sichuan Province from October 2021 and October 2022. After anesthesia induction, inflatable warming blankets were routinely used for active heat preservation, and nasopharyngeal temperature was monitored to observe the occurrence of intraoperative hypothermia. Patients were divided into hypothermia group and nonhypothermia group according to whether hypothermia occurred during the operation. Anesthesia recovery time and the incidence of adverse events or unwanted events during anesthesia recovery between the two groups were compared. RESULTS: The numbers (percentage) of 384 patients who underwent abdominal surgery developed intraoperative hypothermia occurred in 240 (62.5%) patients, all of whom had mild hypothermia. There were statistically significant differences between mild hypothermia after active warming and nonhypothermia in the occurrence of shivering (χ2 = 5.197, P = 0.023) and anesthesia recovery time (Z = -2.269, P = 0.02) in elderly patients undergoing abdominal surgery during anesthesia recovery, and there were no statistically significant differences in hypoxemia, nausea or vomiting, hypertension, hypokalemia, hypocalcemia, analgesic drug use,postoperative wound infection or postoperative hospitalization days. CONCLUSIONS: The incidence of intraoperative mild hypothermia after active warming was high in elderly patients who underwent abdominal surgery. Mild hypothermia increased the incidence of shivering and prolonged anesthesia recovery time in elderly patients undergoing abdominal surgery.

Art therapies and cognitive function in elderly with subjective cognitive decline: a protocol for a network meta-analysis.

INTRODUCTION: Subjective cognitive decline means a decline in the subjective perception of self-cognitive function, which is likely to evolve into mild cognitive impairment and dementia. The number of elderly with subjective cognitive decline has increased, bringing huge burdens and challenges to caregivers and society. With the increase in research on art therapies, some of them have gradually been proven to be effective for cognitive function. Therefore, this study aims to summarise the evidence and identify the best art therapy for elderly with subjective cognitive decline. METHODS AND ANALYSIS: We will include published randomised controlled trials written in English and Chinese if the intervention is one of the art therapies and applied in people aged 60 and above with subjective cognitive decline. Eight electronic databases, including the Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Elsevier, China BioMedical Literature Database, China National Knowledge Infrastructure, VIP Database and Wanfang Database, will be searched from January 2013 to December 2023. Art therapies will mainly include music therapy, reminiscence therapy, painting therapy, dance therapy, reading therapy, horticultural therapy, museum therapy, calligraphy therapy and so on. The outcome will be cognitive function. Study selection, data extraction and quality assessment will be performed by two reviewers. The risk of bias will be evaluated according to the Cochrane Collaboration's risk-of-bias tool, and the evidence quality will be assessed with the Grading of Recommendations Assessment, Development and Evaluation. Standard pairwise meta-analysis and Bayesian network meta-analysis will be conducted. The probabilities of each art therapy will be ranked based on the surface under the cumulative ranking curve. ETHICS AND DISSEMINATION: Ethical approval is not required for reviewing published studies. To provide important evidence for clinicians and guideline developers, the findings of this study will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42023443773.

The impact of reminiscent music therapy and robot-assisted rehabilitation on older stroke patients: a protocol for a randomized controlled trial.

Background: Stroke is the main disease that causes the burden of neurological disease, leading to upper limb dysfunction and affecting their self-care abilities. Robot-assisted rehabilitation therapy has been gradually used in the rehabilitation of upper limb function after stroke. However, it would be beneficial to explore auxiliary interventions such as reminiscent music therapy, a combination of music and reminiscent, to relieve negative emotions and post-stroke fatigue and improve rehabilitation outcomes. This protocol aims to evaluate the effectiveness of reminiscent music therapy combined with robot-assisted rehabilitation in older stroke patients. Methods: This trial is a single-blind, three-arm randomized controlled trial. Older stroke patients with upper limb dysfunction will be recruited. Participants will be randomly assigned to receive usual rehabilitation treatment and care, usual rehabilitation treatment and care plus robot-assisted rehabilitation and reminiscent music therapy, or usual rehabilitation treatment and care plus robot-assisted rehabilitation. Robot-assisted rehabilitation will be conducted by rehabilitation doctors five times per week for 3 weeks. In experimental group 1, a reminiscent song list will be played for patients. The primary outcome is activities of daily living. All outcomes will be evaluated at baseline and in the week immediately post-intervention. Discussion: We are conducting the first randomized controlled trial on the effects of reminiscent music therapy combined with robot-assisted rehabilitation in older stroke patients. It is expected that this study, if proven effective in improving the activities of daily living in older stroke patients with upper limb dysfunction, will provide evidence-based rehabilitation strategies for medical staff.Clinical Trial Registration: ChiCTR2200063738.

Low TYROBP expression predicts poor prognosis in multiple myeloma.

BACKGROUND: Multiple myeloma (MM) is the second most common refractory hematologic cancer. Searching for new targets and prognostic markers for MM is significant. METHODS: GSE39754, GSE6477 and GSE24080 were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) in MM versus healthy people from GSE39754 and GSE6477 were screened using limma package, and MM-related module genes were chosen with the use of Weighted gene co-expression network analysis (WGCNA), and the two were intersected using ggVennDiagram for obtaining MM-related DEGs. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were carried out. Then, protein-protein interactions (PPI) analysis in String database was used to obtain hub genes, while prognosis was analyzed by survival package in GSE24080. Receiver operating characteristic (ROC) curve was adopted for evaluating diagnostic value of hub genes. Besides, univariable/multivariable Cox regression were employed to screen independent prognostic biomarkers. Gene set enrichment analysis (GSEA) was used to find possible mechanism. Finally, western-blotting and reverse transcription-polymerase chain reaction (RT-PCR) verify TYROBP expression within MM and healthy people. We performed cell adhesion and transwell assays for investigating TYROBP function in MM cell adhesion and migration. RESULTS: Through differential analyses, 92 MM-related DEGs were obtained. 10 hub genes were identified by PPI and CytoHubba. Their diagnostic and prognostic significance was analyzed. Down-regulation of genes like TYROBP, ELANE, MNDA, and MPO related to dismal MM prognosis. Upon univariable/multivariable Cox regression, TYROBP independently predicted MM prognosis. GSEA pathway was enriched, indicating that TYROBP expression affected MM development via cell adhesion molecular pathway. Upon Western-blotting and RT-PCR assays, TYROBP expression among MM patients decreased relative to healthy donors. Cell adhesion and transwell migration assays revealed increased MM cell adhesion and decreased migration upon TYROBP up-regulation. CONCLUSION: In summary, TYROBP is a potential prognostic marker for MM.

Development and validation of a major adverse limb events prediction model for peripheral arterial disease with frailty.

OBJECTIVE: To investigate the risk factors for major limb adverse events (MALE) in peripheral arterial disease (PAD) combined with frailty and to develop and validate a risk prediction model of MALE. METHODS: This prospective study was performed in the vascular surgery department of patients in six hospitals in southwest China. Prospective collection of patients with PAD combined with frailty from February 1 to December 20, 2021, with MALE as the primary outcome, and followed for 1 year. The cohort was divided into a development cohort and a validation cohort. In the development cohort, a multivariate risk prediction model was developed to predict MALE using random forests for variable selection and multivariable Cox regression analysis. The model is represented by a visualized nomogram and a web-based calculator. The model performance was tested with the validation cohort and assessed using the C-statistic and calibration plots. RESULTS: A total of 1179 patients were prospectively enrolled from February 1 to December 20, 2021. Among 816 patients with PAD who were included in the analysis, the median follow-up period for this study was 9 ± 4.07 months, the mean age was 74.64 ± 9.43 years, and 249 (30.5%) were women. Within 1 year, 222 patients (27.2%) developed MALE. Target lesion revascularizations were performed in 99 patients (12.1%), and amputations were performed in 131 patients (16.1%). The mortality rate within the whole cohort was 108 patients (13.2%). After controlling for competing risk events (death), the cumulative risk of developing MALE was not statistically different. Prealbumin (hazard ratio [HR], 0.6; 95% confidence interval [CI], 0.41-0.89; P = .010), percutaneous coronary intervention (HR, 2.31; 95% CI, 1.26-4.21; P = .006), Rutherford classification (HR, 1.77; 95% CI, 1.36-2.31; P < .001), white blood cell (HR, 1.85; 95% CI, 1.20-2.87; P = .005), high altitude area (HR, 3.1; 95% CI, 1.43-6.75; P = .004), endovascular treatment (HR, 10.2; 95% CI, 1.44-72.5; P = .020), and length of stay (HR, 1.01; 95% CI, 1.00-1.03; P = .012) were risk factors for MALE. The MALE prediction model had a C-statistic of 0.76 (95% CI, 0.70-0.79). The C-statistic was 0.68 for internal validation and 0.66 for external validation for the MALE prediction model. The MALE prediction model for PAD presented an interactive nomogram and a web-based network calculator. CONCLUSIONS: In this study, the MALE prediction model has a discriminative ability to predict MALE among patients with PAD in frailty. The MALE model can optimize clinical decision-making for patients in PAD with frailty.

Structure-based design and synthesis of BML284 derivatives: A novel class of colchicine-site noncovalent tubulin degradation agents.

Our previous studies have demonstrated that BML284 is a colchicine-site tubulin degradation agent. To improve its antiproliferative properties, 45 derivatives or analogs of BML284 were designed and synthesized based on the cocrystal structure of BML284 and tubulin. Among them, 5i was the most potent derivative, with IC50 values ranging from 0.02 to 0.05 µM against the five tested tumor cell lines. Structure-activity relationship studies verified that the N1 atom of the pyrimidine ring was the key functional group for its tubulin degradation ability. The 5i-tubulin cocrystal complex revealed that the binding pattern of 5i to tubulin is similar to that of BML284. However, replacing the benzodioxole ring with an indole ring strengthened the hydrogen bond formed by the 2-amino group with E198, which improved the antiproliferative activity of 5i. Compound 5i effectively suppressed tumor growth at an intravenous dose of 40 mg/kg (every 2 days) in paclitaxel sensitive A2780S and paclitaxel resistant A2780T ovarian xenograft models, with tumor growth inhibition values of 79.4% and 82.0%, respectively, without apparent side effects, showing its potential to overcome multidrug resistance. This study provided a successful example of crystal structure-guided discovery of 5i as a colchicine-targeted tubulin degradation agent, expanding the scope of targeted protein degradation.

Appraising the quality standard of clinical practice guidelines related to central venous catheter-related thrombosis prevention: a systematic review of clinical practice guidelines.

OBJECTIVE: To evaluate the quality and analyse the content of clinical practice guidelines regarding central venous catheter-related thrombosis (CRT) to provide evidence for formulating an evidence-based practice protocol and a risk assessment scale to prevent it. DESIGN: Scoring and analysis of the guidelines using the AGREE II and AGREE REX scales. DATA SOURCES: Pubmed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature, and the relevant websites of the guideline, were searched from 1 January 2017 to 26 March 2022. ELIGIBILITY CRITERIA: Guidelines covering CRT treatment, prevention, or management were included from 1 January 2017 to 26 March 2022. DATA EXTRACTION AND SYNTHESIS: Three independent reviewers systematically trained in using the AGREE II and AGREE REX scales were selected to evaluate these guidelines. RESULTS: Nine guidelines were included, and the quality grade results showed that three were at A-level and six were at B-level. The included guidelines mainly recommended the prevention measure of central venous CRT from three aspects: risk screening, prevention strategies, and knowledge training, with a total of 22 suggestions being recommended. CONCLUSION: The overall quality of the guidelines is high, but there are few preventive measures for central venous CRT involved in the guidelines. All preventive measures have yet to be systematically integrated and evaluated, and no risk assessment scale dedicated to this field has been recommended. Therefore, developing an evidence-based practice protocol and a risk assessment scale to prevent it is urgent.

Gender differences in geriatric depressive symptoms in urban China: the role of ADL and sensory and communication abilities.

Objectives: ADL and Sensory and Communication Abilities are important indicators of the quality of life of the elderly which are significant determinants of health, particularly in developing countries. The present cross-sectional study investigated effect of ADL and Sensory and Communication Abilities on depressive symptoms, as well as the the role of gender in these effects. Design: This is a cross-sectional study. Setting: A nationally representative cross-sectional survey among the Chinese population aged 60 years and over. Participants: A total of 163296 females and 148724 males aged 65 and over in 2019 in urban China. Outcome measures: Prevalence, risk factors and gender differences in geriatric depressive symptoms among urban elderly. Results: Approximately 95.69% of the participants had depressive symptoms according to the CESD-10, with no statistically significant gender difference of 52.15% in females and 47.85% in males. Logistic regression findings suggest that geriatric depressive symptoms are significantly associated with the lack of eldercare (OR=2.427, female; OR=1.426, male), living alone(OR= 1.430, female; OR= 1.179, male), ADL dysfunction (OR=1.528, female; OR=1.246, male), and impaired sensory and communication ability (OR=1.338, female; OR=1.185, male) among both female and male participants. Remarkably, geriatric depressive symptoms are only significantly associated with age (≥75, OR = 1.327), marital status (unmarried, OR=1.598), the number of children (no children, OR=2.271), and the living arrangement (living alone, OR= 1.430) among female participants. Conclusion: Significant gender differences in these associations were found for living alone, ADL dysfunction and impaired sensory and communication ability. Moreover, the study emphasized that the gender difference exists in terms of geriatric depression in urban China. Females are more likely to experience depressive than males with the same circumstances.

Barriers and facilitators to feeling safe for inpatients: a model based on a qualitative meta-synthesis.

Objectives: To review and synthesize qualitative research exploring patients' safe experience and construct a model to present barriers and facilitators to feeling safe for inpatients. Design: A qualitative met-synthesis. Methods: We conducted a systematic electronic search of articles published in English with no date limitation across five databases (Ovid MEDLINE, EMBASE, Web of Science, CINAIL via EBSCO, and PsyINFO) in May 2023. Qualitative research focused on the safe experiences of inpatients was considered. Systematic searches yielded 8,132 studies, of which 16 articles were included. Two reviewers independently extracted and analyzed data. Qualitative meta-synthesis was performed through line-by-line coding of original texts, organizing codes into descriptive themes, and generating analytical themes. Results: We identified four themes and 11 sub-themes. Across the four themes, control included a barrier (Uncertainty) and two facilitators (Patient participation and safe care); responsible included three facilitators (Confidence in the profession, care for, and responsive); dignity included two barriers (Privacy and Neglect); stability included a barrier (Potential risk), and two facilitators (Harmonious and safe culture). We constructed a model to present the logical connection between these themes and related barriers and facilitators. Conclusion: Feeling safe for inpatients is a complex perception, including four themes: control, responsible, dignity, and stability. Surrounding four themes and related barriers and facilitators, we outline principles for creating a safe environment and present strategies for improving patients' hospitalization experience and ensuring patient safety. Clinical relevance: This review provides valuable insight into the clinical practice and health policy and helps medical staff to identify and overcome the potential barriers to implementing interventions in safe care. In addition, the model comprehensively describes the nature and dimensions of feeling safe, informing high-quality care service and related research. Systematic review registration: Identifier, CRD42023435489.

Corrigendum: Moderate-to-high risk of obstructive sleep apnea with excessive daytime sleepiness is associated with postoperative neurocognitive disorders: a prospective one-year follow-up cohort study.

[This corrects the article DOI: 10.3389/fnins.2023.1161279.].

Study on the impact of central environmental protection inspection on the health of the older adult population-A quasi-natural experiment in China.

In 2015, the central government of China established the Central Environmental Protection Inspection (CEPI) system for oversight of local governments. It enhanced local government enforcement of environmental regulations, which had a considerable influence on the health of the local older adult population. This study quantifies the effects of local government regulation brought about by CEPI on the health of the older adult. It examines the impact mechanism using the DID model and panel data from the China Health and Retirement Longitudinal Study (CHARLS). The results show that (1) local governments' environmental protection regulations implemented by CEPI have a positive impact on the general health of the older adult. The results of the study passed the parallel trend test, PSM test, replacement variable test, and placebo test and remained significant; (2) in terms of the impact mechanism, CEPI has promoted local governments' environmental governance initiatives, which has reduced industrial wastewater emissions, industrial sulfur dioxide emissions, and industrial fumes emissions. This has improved air quality, thereby creating a good living environment for the older adult and improving their overall health; (3) according to heterogeneity research, the health of older adult living in the Yangtze River Basin, urban older adult, and older adult without chronic diseases is more significantly affected by the environmental protection regulations of the local governments brought about by CEPI.

Multiple geriatric syndromes in community-dwelling older adults in China.

This study aims to assess the prevalence of geriatric syndromes and identify factors associated with multiple geriatric syndromes in community-dwelling older adults in China. We utilized a convenience sampling method to recruit older adults and from one rural and one urban community in Chengdu, China, from October 2022 to March 2023. A total of 706 older adults aged 60 years or older were included. Ten geriatric syndromes were investigated including two mental disorders: depressive symptoms, cognitive impairment; and eight somatic disorders: pain, falls, sleep disturbance, constipation, polypharmacy, multimorbidity, malnutrition and frailty. Multiple geriatric syndromes were defined as an individual having two or more geriatric syndromes. The data obtained were analysed using descriptive statistics. The independent risk factors for multiple geriatric syndromes were assessed using a logistic regression model. This study found that 90.5% of the participants had at least one geriatric syndrome, with 72.8% experiencing multiple geriatric syndromes. The top four geriatric syndromes in our study were polypharmacy (58.5%), malnutrition/at risk of malnutrition (43.1%), multimorbidity (42.1%), and frailty/prefrailty (34.3%). Of the older adults, 368(52.1%) had only somatic disorders, 18(2.5%) had only mental disorders and 253 (35.8%) had somatic-mental disorders. According to the logistic regression analysis, residence, age, marriage, BMI, and self-related health were significantly associated with multiple geriatric syndromes among older adults. This study highlights that multiple geriatric syndromes are prevalent among community-dwelling older adults in China, and underscores the significance of certain demographic factors in their occurrence. Future longitudinal studies are needed to establish the temporal relationship between multiple geriatric syndromes and these demographic factors, as well as to explore causal relationships and effective prevention strategies for geriatric syndrome.

Selective autophagy in cancer: mechanisms, therapeutic implications, and future perspectives.

Eukaryotic cells engage in autophagy, an internal process of self-degradation through lysosomes. Autophagy can be classified as selective or non-selective depending on the way it chooses to degrade substrates. During the process of selective autophagy, damaged and/or redundant organelles like mitochondria, peroxisomes, ribosomes, endoplasmic reticulum (ER), lysosomes, nuclei, proteasomes, and lipid droplets are selectively recycled. Specific cargo is delivered to autophagosomes by specific receptors, isolated and engulfed. Selective autophagy dysfunction is closely linked with cancers, neurodegenerative diseases, metabolic disorders, heart failure, etc. Through reviewing latest research, this review summarized molecular markers and important signaling pathways for selective autophagy, and its significant role in cancers. Moreover, we conducted a comprehensive analysis of small-molecule compounds targeting selective autophagy for their potential application in anti-tumor therapy, elucidating the underlying mechanisms involved. This review aims to supply important scientific references and development directions for the biological mechanisms and drug discovery of anti-tumor targeting selective autophagy in the future.

Reminiscent music therapy combined with robot-assisted rehabilitation for elderly stroke patients: a pilot study.

BACKGROUND: Although some studies suggest that robot-assisted technology can significantly improve upper limb function in stroke patients compared to traditional rehabilitation training, it is still necessary to incorporate an auxiliary intervention to alleviate negative emotions, thereby alleviating the post-stroke fatigue and encouraging patients to actively respond to rehabilitation. However, the effect of the auxiliary intervention is unknown. OBJECTIVE: To evaluate the effect of reminiscent music therapy combined with robot-assisted rehabilitation in elderly patients with upper limb dysfunction. METHODS: From November 2022 to March 2023, elderly patients with upper limb dysfunction after stroke were assigned to one of three groups, with group A receiving usual rehabilitation treatment and care plus robot-assisted rehabilitation and reminiscent music therapy, group B receiving usual rehabilitation treatment and care plus robot-assisted rehabilitation, and group C receiving only usual rehabilitation treatment and care. Thirty patients completed this study, with 10 participants in each group. Activities of daily living, self-esteem, rehabilitation self-efficacy, positive emotion and upper limb function were measured before and after the intervention. One-way analysis of variance, paired-sample t-test, Kruskal-Wallis H test, Wilcoxon signed rank sum test and Chi-square test were used to analyze the data. RESULTS: According to the intragroup comparisons, in the three groups, all outcome measurements were significantly higher than those at baseline (all P < 0.05). After the intervention, the differences in the self-management effectiveness, rehabilitation self-efficacy, and positive emotion score were statistically significant among the three groups (all P < 0.05). In accordance with the results of Bonferroni analysis, the self-management effectiveness score of group A was significantly higher than that of Group B and Group C (all P < 0.05). The rehabilitation self-efficacy score of group A was significantly higher than that of Group B and Group C (P < 0.05). The positive emotion score of group A was significantly higher than that of Group B and Group C (P < 0.05). CONCLUSION: Reminiscent music therapy combined with robot-assisted rehabilitation is a promising approach to improve rehabilitation self-efficacy and positive emotion, which is evidence that reminiscent music therapy may be an effective auxiliary intervention to improve rehabilitation outcomes.

Sleep at high altitude: A bibliometric study and visualization analysis from 1992 to 2022.

Background: As an important monitoring index for adaptation to hypoxia, sleep may reflect the adaptive state of the body at high altitudes. The literature has shown a link between altitude and sleep problems, and sleep changes have become a common problem for individuals at high altitudes, negatively impacting their physical and mental health. As research on high-altitude sleep has gained attention in recent years, the publishing volume has increased worldwide, necessitating a more comprehensive understanding of this field. This manuscript evaluates the key themes and emerging trends in high-altitude sleep over the past few decades and predicts future research directions. Methods: Articles related to high-altitude sleep published from 1992 to 2022 were retrieved from the Web of Science Core Collection, and the relevant literature characteristics were extracted after the screening. Then, bibliometric analyses and visualizations were performed using Microsoft Excel, CiteSpace, VOSviewer, and an online analysis platform (http://bibliometric.com). Results: A total of 1151 articles were retrieved, of which 368 were included in the analysis, indicating a gradually increasing trend. The United States, Switzerland, and China have made significant contributions in this field. Bloch KE from the University of Zurich was determined to be the most productive and academically influential author in this field. The highest-yielding journal was High Altitude Medicine & Biology. Initially, altitude training was the primary research topic. Currently, research focuses on sleep disorders and sleep apnea. In the coming years, keywords such as "sleep quality," "prevalence," and "obstructive sleep apnea" will attract more attention. Conclusion: Our findings will assist scholars to better understand the intellectual structure and emerging trends in this field. Future developments in high-altitude sleep research are highly anticipated, particularly in terms of sleep quality at high altitudes and its associated prevalence. This research is also crucial for the improvement and treatment of symptoms during nocturnal sleep in patients with chronic hypoxia due to cardiopulmonary diseases at high altitudes.

Targeted therapy for non-small-cell lung cancer: New insights into regulated cell death combined with immunotherapy.

Non-small-cell lung cancer (NSCLC), which has a high rate of metastatic spread and drug resistance, is the most common subtype of lung cancer. Therefore, NSCLC patients have a very poor prognosis and a very low chance of survival. Human cancers are closely linked to regulated cell death (RCD), such as apoptosis, autophagy, ferroptosis, pyroptosis, and necroptosis. Currently, small-molecule compounds targeting various types of RCD have shown potential as anticancer treatments. Moreover, RCD appears to be a specific part of the antitumor immune response; hence, the combination of RCD and immunotherapy might increase the inhibitory effect of therapy on tumor growth. In this review, we summarize small-molecule compounds used for the treatment of NSCLC by focusing on RCD and pharmacological systems. In addition, we describe the current research status of an immunotherapy combined with an RCD-based regimen for NSCLC, providing new ideas for targeting RCD pathways in combination with immunotherapy for patients with NSCLC in the future.

Nurses' preparedness, opinions, barriers, and facilitators in responding to intimate partner violence: A mixed-methods study.

INTRODUCTION: Intimate partner violence (IPV) is associated with multiple adverse health consequences. Nurses (including midwives) are well positioned to identify patients subjected to IPV, and provide care, support, and referrals. However, studies about nursing response to IPV are limited especially in low- and middle-income countries (LMICs). The study aimed to examine nurses' perceived preparedness and opinions toward IPV and to identify barriers and facilitators in responding to IPV. DESIGN: An explanatory sequential mixed-methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data. METHODS: The study was conducted in two tertiary general hospitals in northeastern (Shenyang city) and southwestern (Chengdu city) China with 1500 and 1800 beds, respectively. A total of 1071 survey respondents (1039 female [97.0%]) and 43 interview participants (34 female [79.1%]) were included in the study. An online survey was administered from September 3 to 23, 2020, using two validated scales from the Physician Readiness to Manage Intimate Partner Violence Survey. In-depth, semistructured interviews were conducted from September 15 to December 23, 2020, guided by the Consolidated Framework for Implementation Research. RESULTS: The survey respondents largely agreed with feeling prepared to manage IPV, e.g., respond to discourses (544 [50.8%] of 1071) and report to police (704 [65.7%] of 1071). The findings of surveyed opinions (i.e., Response competencies; Routine practice; Actual activities; Professionals; Victims; Alcohol/drugs) were mixed and intertwined with social desirability bias. The quantitative and qualitative data were consistent, contradicted, and supplemented. Key qualitative findings were revealed that may explain the quantitative results, including lack of actual preparedness, absence of IPV-related education, training, or practice, and socially desirable responses (especially those pertaining to China's Anti-domestic Violence Law). Commonly reported barriers (e.g., patients' reluctance to disclose; time constraints) and facilitators (e.g., patients' strong need for help; female nurses' gender advantage), as well as previously unreported barriers (e.g., IPV may become a workplace taboo if there are healthcare professionals known as victims/perpetrators of IPV) and facilitators (e.g., nurses' responses can largely meet the first-line support requirements even without formal education or training on IPV) were identified. CONCLUSIONS: Nurses may play a unique and important role in responding to IPV in LMICs where recognition is limited, education and training are absent, policies are lacking, and resources are scarce. Our findings support World Health Organization recommendations for selective screening. CLINICAL RELEVANCE: The study highlights the great potential of nurses for IPV prevention and intervention especially in LMICs. The identified barriers and facilitators are important evidence for developing multifaceted interventions to address IPV in the health sector.

Targeted regulated cell death with small molecule compounds in colorectal cancer: Current perspectives of targeted therapy and molecular mechanisms.

Colorectal cancer (CRC), a tumor of the digestive system, is characterized by high malignancy and poor prognosis. Currently, targeted therapy of CRC is far away from satisfying. The molecular mechanisms of regulated cell death (RCD) have been clearly elucidated, which can be intervened by drug or genetic modification. Numerous studies have provided substantial evidence linking these mechanisms to the progression and treatment of CRC. The RCD includes apoptosis, autophagy-dependent cell death (ADCD), ferroptosis, necroptosis, and pyroptosis, and immunogenic cell death, etc, which provide potential targets for anti-cancer treatment. For the last several years, small-molecule compounds targeting RCD have been a well concerned therapeutic strategy for CRC. This present review aims to describe the function of small-molecule compounds in the targeted therapy of CRC via targeting apoptosis, ADCD, ferroptosis, necroptosis, immunogenic dell death and pyroptosis, and their mechanisms. In addition, we prospect the application of newly discovered cuproptosis and disulfidptosis in CRC. Our review may provide references for the targeted therapy of CRC using small-molecule compounds targeting RCD, including the potential targets and candidate compounds.

Association of daily health behavior and activity of daily living in older adults in China.

This study aims to describe the activity of daily living (ADL) situation and determine the relationship between health behavior and ADL among older adults in China. A cross-sectional, observational study was conducted in one urban community and one rural community in Chengdu (a city located in Southwest China), China, from October 2022 to March 2023. A total of 706 older adults were included in this study. The associations between health behaviour and ADL were assessed by logistic regression model. Of the 706 older adults, 169 (23.9%) were disabled in ADL. According to the logistic regression analysis, age (60-69 years old: OR = 0.015, 95% CI 0.007 to 0.035, P < 0.001; 70-79 years old: OR = 0.116, 95% CI 0.060 to 0.227, P < 0.001), resident(OR = 0.568, 95% CI 0.330 to 0.976, P = 0.041), chronic disease (0 type: OR = 0.023, 95% CI 0.001 to 0.379, P = 0.008; 1-4 types: OR = 0.357, 95% CI 0.219 to 0.582, P < 0.001), no exercise (OR = 4.562, 95% CI 2.263 to 8.026, P < 0.001), and physical examination (OR = 2.217, 95% CI 1.294 to 3.496, P = 0.003) were significantly associated with ADL among older adults in Southwest China. This study showed that older adults had a higher ADL disability ratio. Age, resident, chronic disease, exercise and physical examination were associated with ADL among older adults. The study indicates that medium/high exercise maybe a protective factor for older adults, and nursing staff can encourage older adults to exercise when carrying out primary prevention measures. The government and public health institutions should give special attention to older adults and help them to acquire the habit of having an annual physical examination.

Evaluating the impact of an information-based education and training platform on the incidence, severity, and coping resources status of workplace violence among nurses: a quasi-experimental study.

BACKGROUND: Workplace violence among nurses has emerged as a critical issue, posing a significant threat to their occupational safety. Education and training are the primary measures employed to prevent and respond to workplace violence. However, the current approaches have proven ineffective, possibly due to a lack of consideration for the specific needs of clinical nurses. Therefore, it is essential to explore the effectiveness of an informational education and training platform tailored to nurses' requirements. This study aimed to investigate the impact of such a platform on the incidence, severity, and coping resources of WPV in nurses. METHODS: This research was a quasi-experimental study. An information-based education and training platform focused on nurse workplace violence was developed through literature reviews, expert meetings, consultations with software development companies, and a trial run. A tertiary general hospital in Suzhou was selected, in which hospital district A was the intervention group and hospital district B was the control group. A total of 276 nurses were recruited, 140 in the intervention group and 136 in the control group. The nurses' incidence, severity, coping resources status, and evaluation of the application were measured before the intervention and at 1, 3, and 6 months after the intervention. RESULTS: The overall incidence of workplace violence, verbal aggression, and verbal threat among nurses showed statistically significant differences (P < 0.05) for the time effect, while the incidence of physical aggression demonstrated statistically significant differences (P < 0.05) for the between-group effect and the time effect. The severity of physical violence among nurses exhibited statistically significant differences (P < 0.05) for the between-group effect and time effect, and the severity of psychological violence showed statistically significant differences (P < 0.05) for the time effect. Nurses' total coping resources score and dimensions also showed statistically significant differences in terms of group, time, and interaction effects (P < 0.001). The evaluation questionnaire for the mobile application indicated usefulness scores of 2 (1, 2); ease of learning scores of 2 (1, 2); ease of use scores of 2 (1, 2); trust scores of 2 (1, 2.75); acceptance score of 1 (1, 2); and satisfaction scores of 2 (1, 2). CONCLUSIONS: Implementing the nurse workplace violence information-based education and training platform proved beneficial in reducing the incidence and severity of workplace violence among nurses and enhancing their coping resources. This outcome suggested the platform's potential for further application and promotion in clinical settings.