Factors Influencing the Willingness of Clinical Nurses to Participate in Narrative Nursing: A Cross-Sectional Study.

AIMS: Narrative nursing (NN) is a crucial component of modern medical humanistic care. It involves utilising storytelling as a means to guide nurses in devising future interventions for patients, and help patients in reconstructing positive psychological defences. The willingness of clinical nurses to engage in narrative nursing holds significant implications for both effective communication and the overall quality of care. However, there is limited knowledge regarding clinical nurses' willingness to engage in narrative nursing. This study aims to investigate the participation willingness of Chinese nurses, identify its predictors and explore its corresponding reasons. DESIGN: A cross-sectional study. METHODS: Clinical nurses were enrolled in Hunan province, Central South, China, and a convenience sampling strategy was used. A structured questionnaire was distributed to clinical nurses by an online survey platform. Information on sociodemographic characteristics, willingness and possible influencing factors (experience, ability, perceptions on narrative nursing) was collected. Binary logistic regression was conducted to identify the predictors of willingness to participate in narrative nursing. RESULTS: A total of 2310 nurses were recruited, of which 2092 nurses completed the questionnaire (response rate: 90.6%). One thousand seven hundred and thirty-four nurses (82.9%) were willing to participate in NN, and 358 (17.1%) were not. Binary logistic regression analysis identified nine predictors of participants' willingness to participate, including working departments, professional title, working position, experience of received mobilisation and training of NN, understanding of related knowledge, NCS level, affirmation of NN and positive attitude towards clinical application (all p values < 0.05). These indicators explained 17.1% of the variances in the dependent variable (p < 0.001). CONCLUSION: A high proportion of nurses in Hunan province were willing to practice in clinic using NN. Willingness to participate may be increased by a focus on nurses with low professional titles, no administrative position and working in specialised departments, such as emergency departments, infectious departments, critical care units and operating theatres. IMPACT: The study identified a high proportion of nurses in Hunan Province who were willing to use NN. However, the figure was slightly lower than expected. Influencing factors were analysed to give insights for managers to develop more effective NN outreach programs. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Asymmetric Divergent Synthesis of ent-Kaurane-, ent-Atisane-, ent-Beyerane-, ent-Trachylobane-, and ent-Gibberellane-type Diterpenoids.

A unified strategy toward asymmetric divergent syntheses of nine C8-ethano-bridged diterpenoids A1-A9 (candol A, powerol, sicanadiol, epi-candol A, atisirene, ent-atisan-16α-ol, 4-decarboxy-4-methyl-GA12, trachinol, and ent-beyerane) has been developed based on late-stage transformations of common synthons having ent-kaurane and ent-trachylobane cores. The expeditious assembly of crucial advanced ent-kaurane- and ent-trachylobane-type building blocks is strategically explored through a regioselective and diastereoselective Fe-mediated hydrogen atom transfer (HAT) 6-exo-trig cyclization of the alkene/enone and 3-exo-trig cyclization of the alkene/ketone, showing the multi-reactivity of densely functionalized polycyclic substrates with πC═C and πC═O systems in HAT-initiated reactions. Following the rapid construction of five major structural skeletons (ent-kaurane-, ent-atisane-, ent-beyerane-, ent-trachylobane-, and ent-gibberellane-type), nine C8-ethano-bridged diterpenoids A1-A9 could be accessed in the longest linear 8 to 11 steps starting from readily available chiral γ-cyclogeraniol 1 and known chiral γ-substituted cyclohexenone 2, in which enantioselective total syntheses of candol A (A1, 8 steps), powerol (A2, 9 steps), sicanadiol (A3, 10 steps), epi-candol A (A4, 8 steps), ent-atisan-16α-ol (A6, 11 steps), and trachinol (A8, 10 steps) are achieved for the first time.

Enantioselective synthesis of chiral α-alkynylated thiazolidones by tandem S-addition/acetalization of alkynyl imines.

A SPINOL-derived chiral phosphoric acid catalyzed asymmetric formal [2 + 3]-annulation of in situ generated alkynyl imines and 1,4-dithiane-2,5-diol has been developed to afford enantiopure α-alkynylated thiazolidones with up to 72% yield and 98.5 : 1.5 er. This tandem annulation involved a tandem S-addition of alkynyl imines/intramolecular acetalization, followed by PDC-mediated oxidation. The α-alkynylated thiazolidones could facilely afford the corresponding chiral α-alkynylated or α-alkenylated cyclic sulfoxides via further elaboration.

[Diagnostic value of combined detection of HNF-1ß and Napsin A in the diagnosis of ovarian clear cell carcinoma].

OBJECTIVE: To study the diagnostic value of HNF-1ß and Napsin A for ovarian clear cell carcinomas, serous carcinomas, endometrioid adenocarcinomas and metastatic Krukenberg tumors. METHODS: Immunohistochemical EnVision method was used to detect the expression of HNF-1ß and Napsin A in 38 cases of ovarian clear cell carcinoma, 30 cases of high-grade serous carcinoma, 22 cases of endometrioid adenocarcinoma and 16 cases of metastatic Krukenberg tumor. Expression of HNF-1ß and Napsin A were compared, and sensitivity and specificity of clear cell carcinoma of the ovary were analysed. RESULTS: The positive rate of HNF-1ß in the ovarian clear cell carcinoma was 100%(38/38), higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.05), although significant difference was not observed from that of metastatic Krukenberg tumor (P>0.05). Napsin A expressed in 97.4% (37/38) of ovarian clear cell carcinoma, 6.7% (2/30) of high-grade serous carcinoma, 22.7% (5/22) of endometrioid adenocarcinoma. Napsin A expression in clear cell carcinoma was higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.01), and no expression of Napsin A was seen in metastatic Krukenberg tumor (P>0.05). The sensitivity and specificity of HNF-1ß in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, those of Napsin A were 97.4% and 91.2%, those of both HNF-1ß and Napsin A were 97.4% and 91.2%, respectively. The sensitivity and specificity of HNF-1ß or Napsin A in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, respectively. CONCLUSIONS: HNF-1ß is a more sensitive marker for the diagnosis of ovarian clear cell carcinoma, whereas Napsin A is a more specific marker. The combined detection of HNF-1ß and Napsin A may be helpful for the diagnosis of clear cell carcinoma of the ovary.

Turn-on luminescent sensing of metal cations via quencher displacement: rational design of a highly selective chemosensor for chromium(III).

A highly selective luminescent chemosensor for Cr(3+) in aqueous solution was assembled by a low-selectivity luminogenic receptor with Cu(2+) as a metal quencher. Three tetranitrogen chelating sites were integrated into the multichannel receptor with a tris(1,10-phenanthroline)ruthenium(II) luminophore at the core. This receptor (2) exhibits chelating affinity for many transition-metal cations, among which Cu(2+) efficiently quenches the emission. The further addition of Cr(3+) into the Cu(2+)-titrated solution of 2 results in a metal-exchange reaction and a sensitive turn-on luminescence response highly selective over other metal cations. The quencher displacement sensing strategy in this design can be a simple but efficient approach for OFF-ON luminescent sensing of metal cations that inherently lack selective ligands.

Primary myelolipoma of the lung: a case of report and review of literature.

Myelolipoma of the lung is a rare benign tumor composed of mature adipose tissue and normal hematopoietic cells. Only 8 cases of primary myelolipoma of the lung have been reported up to date. We report here the ninth case which was misdiagnosed as a malignant tumor and relevant literature is reviewed.

Behavior of pentacene initial nucleation on various dielectrics and its effect on carrier transport in organic field-effect transistor.

The influence of dielectric surface energy on the initial nucleation and the growth of pentacene films as well as the electrical properties of the pentacene-based field-effect transistors are investigated. We have examined a range of organic and inorganic dielectrics with different surface energies, such as polycarbonate/SiO2, polystyrene/SiO2, and PMMA/SiO2 bi-layered dielectrics and also the bare SiO2 dielectric. Atomic force microscopy measurements of sub-monolayer and thick pentacene films indicated that the growth of pentacene film was in Stranski-Kranstanow growth mode on all the dielectrics. However, the initial nucleation density and the size of the first-layered pentacene islands deposited on different dielectrics are drastically influenced by the dielectric surface energy. With the increasing of the surface energy, the nucleation density increased and thus the average size of pentacene islands for the first mono-layer deposition decreased. The performance of fabricated pentacene-based thin film transistors was found to be highly related to nucleation density and the island size of deposited Pentacene film, and it had no relationship to the final particle size of the thick pentacene film. The field effect mobility of the thin film transistor could be achieved as high as 1.38 cm2Ns with on/off ratio over 3 x 10(7) on the PS/SiO2 where the lowest surface energy existed among all the dielectrics. For comparison, the values of mobility and on/off ratio were 0.42 cm2Ns and 1 x 10(6) for thin film transistor deposited directly on bare SiO2 having the highest surface energy.

Expression and prognostic value of serum VitD,FRT and HB-EGF in sep-sis patients / 中国感染控制杂志

Objective To explore and analyze the expression and prognostic value of serum vitamin D(VitD),fer-ritin(FRT)and heparin-binding epidermal growth factor(HB-EGF)in sepsis patients.Methods 86 sepsis patients who were admitted to the intensive care unit(ICU)of a hospital from January 2021 to January 2022 were selected as the case group,and 60 non-sepsis patients in the ICU were selected as the control group.According to the prognosis of sepsis patients one month later,patients were divided into survival group and death group.Patient's serum upon admission was taken,levels of serum VitD,FRT and HB-EGF were detected,the correlation with the prognosis of sepsis patients was analyzed,and the prognostic value was evaluated by area under curve(AUC)of receiver opera-ting characteristic curve.Results Levels of white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β and FRT of case group were all higher than those of non-sepsis patients in the control group,while the VitD and HB-EGF levels were lower than those of non-sepsis patients in the control group,differences were all statistically significant(all P＜0.05).One month follow-up on the prognosis of sepsis patients showed that 55 patients survived and 31 died.Acute physiology and chronic health evaluationⅡ(APACHE IⅡ)score,sequential organ failure assessment(SOFA)score,PCT,TNF-α,L-1βand FRT score in patients in the death group were all higher than those in patients in the survival group,while VitD and HB-EGF were lower than patients in the survival group,differences were all statistically significant(all P＜0.05).The Pearson correlation analysis results showed that VitD were negatively correlated with APACHE Ⅱ score,SOFA score,WBC,CRP,PCT and TNF-α(all P＜0.05),HB-EGF was negatively correlected with APACHE Ⅱ,score,CRP,PCT,TNF-α,IL-6 and IL-1β(all P＜0.05);while FRT was positively correlated with APACHE Ⅱscores,CRP,PCT,TNF-α,IL-6 and IL-1β(all P＜0.05).The AUC,sensitivity,and specificity of combined de-tection of serum VitD,FRT and HB-EGF in predicting the prognosis of sepsis patients were 0.82(95％CI:0.72-0.86),84.39％,and 69.35％,respectively.Conclusion Serum levels of VitD and HB-EGF are lower and FRT is higher in sepsis patients,their expression levels are closely related to patient prognosis,and have good predictive value for predicting the prognosis of sepsis patients.

Assessment of atrial electromechanical coupling and influential factors in nonrheumatic paroxysmal atrial fibrillation.

BACKGROUND: Sequential analysis of atrial electromechanical coupling (P-A) by Doppler tissue imaging (DTI) might provide important insight into the mechanisms of paroxysmal atrial fibrillation (PAF). HYPOTHESIS: The purpose of this study was to evaluate P-A and the dispersion of P-A, and to analyze the influential factors of P-A. METHODS: One hundred and ten patients with PAF and 87 normal controls were enrolled. Using DTI, the time intervals from the beginning of P-wave to the onset of atrioventricular ring motion related to atrial contraction were measured. RESULTS: Atrial electromechanical coupling at the interventricular septum atrioventricular annulus (P-A1), left lateral mitral annulus (P-A2) and right lateral tricuspid annulus (P-A3) in PAF group were significantly longer than those in control (p < 0.001). The difference between P-A2 and P-A1 (T1), P-A2 and P-A3 (T3) in PAF group were greater than those in control before age correction (p < 0.05). The linear regression analysis showed that the duration of PAF episodes and age were the greatest influential factors of P-A1 (r = 0.564). Left atrial anterior-posterior dimension (LAD) and age were the greatest influential factors of P-A2 (r = 0.459). The LAD was the greatest influential factors of T1 and T3 (r = 0.408, 0.542). CONCLUSIONS: The atrial electromechanical coupling was significantly longer and the dispersion of P-A at left lateral mitral annulus was greater in PAF patients. The prolongation of P-A may be related to left atrial enlargement, long episodes of PAF and aging and the dispersion of P-A at left lateral mitral annulus to LAD.

Association between hypertensive disorders of pregnancy and risk of autism in offspring: a systematic review and meta-analysis of observational studies.

BACKGROUND: Autism spectrum disorder (ASD) is a common severe pervasive neurodevelopmental disorder of undetermined etiology. Environmental exposures, especially pregnancy complications, have been increasingly recognized as a potential risk factor for ASD. Our aim was to (1) systematically evaluate the association between hypertensive disorders of pregnancy (HDP) and the risk of ASD in offspring, (2) specifically draw a subgroup analysis of disease severity in patients with HDP to achieve more sufficient evidence on this issue. RESULTS: A total of 21 studies were identified with more than 6.5 million participants, including 31,027 ASD probands. A comparative meta-analysis established that offspring born premature to HDP were significantly associated with ASD than matched controls (OR = 1.42, 95% CI: 1.34-1.50). Subgroup analysis of clinical classification include: (1) gestational hypertension, (2) pre-eclampsia, (3) chronic hypertension complicating pregnancy (CHP). The offspring of mothers with pre-eclampsia and CHP have slightly higher risk (OR = 1.43; OR = 1.48, respectively) of ASD than those of mothers with gestational hypertension (OR = 1.37). In consistence with most previous researches, higher ASD prevalence was observed in male than female (OR = 1.38), indicating a potential role for gender in the pathophysiology of ASD. MATERIALS AND METHODS: We conducted a systematic literature search on PubMed, EMBASE, Web of Science, PsycINFO database and China National Knowledge Infrastructure up to Jun. 2017. Statistical analysis was performed using Stata 10.0. CONCLUSIONS: This meta-analysis implies a possible link between HDP and the risk of ASD in offspring. However, further investigation should be conducted to confirm this conclusion, and intensive prenatal surveillance and early prediction for ASD is needed.