Adverse effects of fenpropathrin on the intestine of common carp (Cyprinus carpio L.) and the mechanism involved.

Fenpropathrin (FEN), a pyrethroid pesticide, is frequently detected in natural water bodies, unavoidable pose adverse effects to aquatic organisms. However, the harmful effects and potential mechanisms of FEN on aquatic species are poorly understood. In this study, common carp were treatment with FEN at 0.45 and 1.35 µg/L for 14 d, and the toxic effects and underlying mechanisms of FEN on the intestine of carp were revealed. RNA-seq results showed that FEN exposure cause a wide range of transcriptional alterations in the intestine and the differentially expressed genes were mainly enrichment in the pathways related to immune and metabolism. Specifically, FEN exposure induced pathological damage and altered submicroscopic structure of the intestine, elevated the levels of Bacteroides fragilis enterotoxin, altered the contents of claudin-1, occludin, and zonula occluden-1 (ZO-1), and causing injury to the intestinal barrier. In addition, inflammation-related index TNF-α in the serum and IL-6 in the intestinal tissues were generally increased after FEN exposure. Moreover, FEN exposure promoted an increase in reactive oxygen species (ROS), altered the levels of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH), upregulated the contents of malondialdehyde (MDA) in the intestines. The apoptosis-related parameter cytochrome c, caspase-9, and caspase-3 were significantly altered, indicating that inflammation reaction, oxidative stress, and apoptosis may be involved in the toxic mechanism of FEN on carp. Moreover, FEN treatment also altered the intestinal flora community significantly, which may affect the intestinal normal physiological function and thus affect the growth of fish. Overall, the present study help to clarify the intestinal reaction mechanisms after FEN treatment, and provide a basis for the risk assessment of FEN.

Fenpropathrin disrupted the gills of common carp (Cyprinus carpio L.) through oxidative stress, inflammatory responses, apoptosis, and transcriptional alterations.

Fenpropathrin (FEN) is an extensively utilized synthetic pyrethroid insecticide frequently found in aquatic ecosystems. However, the adverse effects and potential mechanisms of FEN on aquatic species are poorly understood. In this work, common carp were treated with FEN at concentrations of 0.45 and 1.35 µg/L FEN for 14 days, after which the tissue structure, physiological alterations, and mRNA transcriptome of the gills were evaluated. Specifically, FEN exposure caused pathological damage to the gills of carp, downregulated the levels of claudin-1, occludin, and zonula occluden-1 (ZO-1), and inhibited Na+-K+-ATPase activity in the gills. In addition, FEN exposure promoted an increase in reactive oxygen species (ROS) levels and significantly upregulated the levels of malondialdehyde (MDA), 8-hydroxy-2 deoxyguanosine (8-OHdG), and protein carbonyl (PC) in the gills. Moreover, the inflammation-related indices (TNF-α, IL-1ß, and IFN-γ) and the apoptosis-related parameter caspase-3 were generally increased, especially in the 1.35 µg/L FEN group, and these indices were significantly greater than those in the control group. These findings suggest that FEN exposure can cause oxidative stress, the inflammatory response, and apoptosis in carp gills. Importantly, the results of RNA-seq analysis showed that 0.45 and 1.35 µg/L FEN could significantly interfere with multiple immune and metabolic pathways, including the phagosome, NOD-like receptor (NLR) signalling pathway, Toll-like receptor (TLR) signalling pathway, necroptosis, and arachidonic acid metabolism pathways, indicating that the effects of FEN on the gills of fish are intricate. In summary, our findings confirm the toxic effects of FEN on common carp gills and provide additional comprehensive information for evaluating the toxicity and underlying molecular mechanisms of FEN in aquatic organisms.

The relationship between professional self-concept and career decision-making difficulties among postgraduate nursing students in China: the mediating role of career decision-making self-efficacy.

Background: In the context of a global shortage, uneven distribution, and structural imbalance of nursing talent, postgraduate nursing students must make appropriate decisions about their careers not only for the nursing profession but also for society as a whole. However, little research has been reported on the current status and factors influencing career decision-making difficulties among postgraduate nursing students. Objectives: Exploring the mediating role of career decision-making self-efficacy between professional self-concept and career decision-making difficulties among postgraduate nursing students in China based on the social cognitive career theory. Methods: 276 postgraduate nursing students from 25 universities in seven administrative regions of China were selected by stratified random sampling. Data were collected with the Career decision-making difficulties Questionnaire, Career Decision-making Self-Efficacy Scale, and Nursing Professional Self-concept Scale through an online survey, and were analyzed by univariate analysis, correlation analysis, multiple linear regression analysis, and PROCESS macro. Results: The score for career decision-making difficulties was 2.84 (SD = 0.54). Professional self-concept (r = -0.496, p < 0.01) and career decision-making self-efficacy (r = -0.551, p < 0.01) were negatively associated with career decision-making difficulties. Career decision-making self-efficacy played a partial mediating role between professional self-concept and career decision-making difficulties (p < 0.01), with the mediating effect (Effect Value = -0.253, Bootstrap 95% CI: -0.349, -0.156) accounting for 53.82% of the total effect. Conclusion: The high scores of career decision-making difficulties among postgraduate nursing students demand widespread attention. Nursing educators need to develop a complete and standardized career counseling curriculum for postgraduate nursing students, and should pay attention to the cultivation and development of positive professional self-concept and career decision-making self-efficacy of postgraduate nursing students to reduce their career decision-making difficulties and help them make effective career decision-making.

Risk factors and the nomogram model for intraoperatively acquired pressure injuries in children with brain tumours: A retrospective study.

This study aimed to investigate the clinical features and incidence of Intraoperatively Acquired Pressure Injuries (IAPIs) of brain tumours in children, to screen the risk factors and to establish a nomogram model for making prevention strategies against the development of IAPIs. Clinical data of 628 children undergoing brain tumour surgery from August 2019 to August 2021 were extracted from the adverse events and the electronic medical systems. They were randomly divided into a training cohort(n = 471) and a validation cohort(n = 157). The univariate and multivariate analysis was performed to identify the risk factors in training cohort; R software was used to construct a nomogram model; the area under the receiver operator characteristic curve (AUC) and calibration plots were used to judge the predictive performance of the nomogram model; decision curve analysis (DCA) was used to assess the clinical usefulness of the nomogram model. Age, haemorrhage, use of vasopressor, temperature, operation time and operation position were considered as significant risk factors, and enrolled to construct a nomogram model. The results of AUC showed satisfactory discrimination of the nomogram; the calibration plots indicated favourable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts; DCA showed better net benefit and threshold probability of the nomogram model. The nomogram model illustrates significant predictive ability, which can provide scientific and individual guidance for preventing development of IAPIs.

Application effect for a care bundle in optimizing nursing of patients with severe craniocerebral injury.

BACKGROUND: Severe craniocerebral injury (STBI) is a critical physical trauma caused by a sudden external force acting on the head. The condition is complex and changeable, and disability and mortality rates are high. Although the life of STBI patients can be saved through treatment, the sequelae of consciousness, speech, cognitive impairment, stiffness, spasm, pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a family. In the past, routine nursing was often used to treat/manage STBI; however, problems, such as improper cooperation and untimely communication, reduced therapeutic effectiveness. AIM: To investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with STBI. METHODS: From January 2019 to December 2020, 126 STBI patients were admitted to the emergency department of Chongqing Emergency Medical Center. These patients were retrospectively selected as the research participants in the current study. The study participants were then divided into a control group (61 cases) and a study group (65 cases). The control group was treated with routine nursing. The study group adopted the proposed care bundle. The National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale (GCS) were used to evaluate neurological function before and after emergency treatment. After 3 mo of rehabilitation, experimental outcomes were assessed. These included the GCS, Barthel Index, complication rate, muscle strength grade and satisfaction. RESULTS: There was no significant difference in gender, age, cause of injury and GCS between the two groups. After emergency, the National Institutes of Health Stroke Scale/Score of the study group (10.23 ± 3.26) was lower than that of the control group (14.79 ± 3.14). The GCS score of the study group (12.48 ± 2.38) was higher than that of the control group (9.32 ± 2.01). The arrival time of consultation in the study group was 20.56 ± 19.12, and the retention time in the emergency room was 45.12 ± 10.21, which were significantly shorter than those in the control group. After 3 mo of rehabilitation management, the GCS and Barthel Index of the study group were 14.56 ± 3.75 and 58.14 ± 12.14, respectively, which were significantly higher than those of the control group. The incidence of complications in the study group (15.38%) was significantly lower than that in the control group (32.79%). The proportion of muscle strength ≥ grade III in the study group (89.23%) was significantly higher than that in the control group (50.82%). The satisfaction of patients in the study group was significantly higher than that in the control group. CONCLUSION: Care bundles are used to optimize the nursing process. During first-aid, care bundles can effectively improve the rescue effect and improve neurological function of STBI patients as well as shorten the treatment time. In early rehabilitation, they can effectively improve the consciousness of STBI patients, improve the activities of daily living, reduce the risk of complications, accelerate the recovery of muscle strength and improve their satisfaction.

Study on the Effect of Nano Albumin Paclitaxel Combined with Carboplatin in the Treatment of Lung Squamous Cell Carcinoma.

This study aims to compare the efficacy and side effects of albumin-binding paclitaxel plus carboplatin (NAB PC) and paclitaxel plus carboplatin (PC) in the first-line treatment of advanced non-small cell lung cancer (NSCLC). A total of 60 patients with advanced NSCLC diagnosed by histopathology or cytology were randomly divided into nab PC group (albumin-binding paclitaxel 130 mg/mL, D1, D; carboplatin AUC = 6, D1) and PC group (paclitaxel 175 mg/mL, D1; carboplatin AUC = 6, D1), one cycle every three weeks. RECIST 1.1 standard was used to evaluate the short-term objective efficacy, and who acute and subacute toxicity classification standard was used to evaluate the toxicity. The total effective rate (RR) and disease control rate (DCR) of NAB PC group were 40.0% and 80.0%, respectively, which were higher than 23.3% and 60.0% of the PC group, respectively. This difference was statistically significant (p < 0.05). In squamous cell carcinoma, the RR of NAB PC group and PC group were 57.1% (8/14) and 23.1% (3/13) respectively, with a statistically significant difference (p < 0.05); in non-squamous cell carcinoma, the RR of the two groups were 25.0% (4/16) and 23.3% (4/17) without statistical significance (p > 0.05). The median progression free survival time of the NAB PC group and PC group was 6.5 and 5.9 months, respectively, with no significant difference (p>0.05). No significant difference arose in the incidence of grade III-IV toxicity between the two groups (p > 0.05). The incidence of neutropenia in the NAB PC group was higher than that in the PC group (p < 0.05). The therapeutic effect of paclitaxel combined with carboplatin in the treatment of advanced NSCLC is better, the effect of paclitaxel combined with carboplatin is better, and the side effects can be tolerated, which is worthy of clinical application. Patients are more satisfied with their care.

The effectiveness of problem-based learning on development of nursing students' critical thinking: a systematic review and meta-analysis.

OBJECTIVES: The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing nursing students' critical thinking. DATA SOURCES: Searches of PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Proquest, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) were undertaken to identify randomized controlled trails from 1965 to December 2012, comparing problem-based learning with traditional lectures on the effectiveness of development of nursing students' critical thinking, with no language limitation. The mesh-terms or key words used in the search were problem-based learning, thinking, critical thinking, nursing, nursing education, nurse education, nurse students, nursing students and pupil nurse. REVIEW METHODS: Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using the Cochrane Collaboration's Risk of Bias Tool. We analyzed critical thinking scores (continuous outcomes) using a standardized mean difference (SMD) or weighted mean difference (WMD) with a 95% confidence intervals (CIs). Heterogeneity was assessed using the Cochran's Q statistic and I(2) statistic. Publication bias was assessed by means of funnel plot and Egger's test of asymmetry. RESULTS: Nine articles representing eight randomized controlled trials were included in the meta-analysis. Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students' critical thinking (overall critical thinking scores SMD=0.33, 95%CI=0.13-0.52, P=0.0009), compared with traditional lectures. There was low heterogeneity (overall critical thinking scores I(2)=45%, P=0.07) in the meta-analysis. No significant publication bias was observed regarding overall critical thinking scores (P=0.536). Sensitivity analysis showed that the result of our meta-analysis was reliable. Most effect sizes for subscales of the California Critical Thinking Dispositions Inventory (CCTDI) and Bloom's Taxonomy favored problem-based learning, while effect sizes for all subscales of the California Critical Thinking Skills Test (CCTST) and most subscales of the Watson-Glaser Critical Thinking Appraisal (WCGTA) were inconclusive. CONCLUSIONS: The results of the current meta-analysis indicate that problem-based learning might help nursing students to improve their critical thinking. More research with larger sample size and high quality in different nursing educational contexts are required.