Mechanisms and clinical landscape of N6-methyladenosine (m6A) RNA modification in gastrointestinal tract cancers.

Epigenetics encompasses reversible and heritable chemical modifications of non-nuclear DNA sequences, including DNA and RNA methylation, histone modifications, non-coding RNA modifications, and chromatin rearrangements. In addition to well-studied DNA and histone methylation, RNA methylation has emerged as a hot topic in biological sciences over the past decade. N6-methyladenosine (m6A) is the most common and abundant modification in eukaryotic mRNA, affecting all RNA stages, including transcription, translation, and degradation. Advances in high-throughput sequencing technologies made it feasible to identify the chemical basis and biological functions of m6A RNA. Dysregulation of m6A levels and associated modifying proteins can both inhibit and promote cancer, highlighting the importance of the tumor microenvironment in diverse biological processes. Gastrointestinal tract cancers, including gastric, colorectal, and pancreatic cancers, are among the most common and deadly malignancies in humans. Growing evidence suggests a close association between m6A levels and the progression of gastrointestinal tumors. Global m6A modification levels are substantially modified in gastrointestinal tumor tissues and cell lines compared to healthy tissues and cells, possibly influencing various biological behaviors such as tumor cell proliferation, invasion, metastasis, and drug resistance. Exploring the diagnostic and therapeutic potential of m6A-related proteins is critical from a clinical standpoint. Developing more specific and effective m6A modulators offers new options for treating these tumors and deeper insights into gastrointestinal tract cancers.

Process management program to prevent falls in hospitalized patients with neuropsychiatric disorders: a quality improvement program.

BACKGROUND: Falls were among the most common adverse nursing events. The incidence of falls in patients with neuropsychiatric disorders was high, and the occurrence of falls not only caused physical and psychological harm to patients but also led to medical disputes. Therefore, interventions for falls prevention were essential, but evaluations of the intervention process were lacking. METHODS: In this study, a process management program to prevent falls based on the "structure-process-outcome" quality evaluation model was designed and applied to the clinical practice of falls prevention in hospitalized patients with neuropsychiatric disorders. The process quality evaluation checklist to prevent falls was used to supervise the implementation effect of intervention measures to prevent falls, identify the problems in the intervention measures, and make continuous improvements, to reduce the incidence of falls in such hospitalized patients as the final index. RESULTS: The incidence of inpatient falls decreased from 0.199‰ (0.199 per 1000 patient-days) to 0.101‰ (0.101 per 1000 patient-days) before and after the implementation of the process management program for 12 months, 24 months, and 36 months, respectively, and the difference was statistically significant (P < .05). The probability of falls was reduced by 49% after 36 months of monitoring. Furthermore, the proportion of patients at high risk of falls exhibited a downward trend. CONCLUSION: This quality improvement program was feasible and effective at reducing falls in hospitalized patients with neuropsychiatric disorders. Therefore, attention should be given to monitoring process quality in the management of falls.

Effects of positive psychological interventions on positive and negative emotions in depressed individuals: a systematic review and meta-analysis.

BACKGROUND: Positive psychological interventions (PPIs) are known to be effective in alleviating depression. However, the effect of PPIs on positive and negative emotions in depressed participants is not unclear. AIMS: To systematically investigate the effects of PPIs on positive and negative emotions in depressed individuals. METHODS: 6 databases were searched for randomized controlled trials of PPIs in individuals with depressive disorders or depressive symptoms. Hedges' g value was computed using a random-effects model to determine effect sizes. RESULTS: 14 trials from 13 studies were included. Our meta-analysis showed that PPIs had significant but small effects on improving positive affect (g = 0.33, p = .02), life satisfaction (g = 0.26, p = .03), happiness (g = 0.62, p = .03) and depression (g = -0.32, p = .001), and negligible effects on improving well-being (g = 0.13, p = .24) and negative affect (g = -0.15, p = .31). Subgroup analyses of depression showed that PPIs have experienced benefits in improving depression in most subgroups. In addition, none of the subgroup analyses performed for outcomes other than depression found PPIs to be more effective than controls. CONCLUSION: PPIs can improve positive affect, life satisfaction, happiness and depression in depressed individuals, but further studies are needed to validate their effects on well-being, and negative affect.

Charlson Comorbidity Index is correlated with all-cause readmission within six months in patients with heart failure: a retrospective cohort study in China.

BACKGROUND: Charlson Comorbidity Index (CCI) is positively associated with all-cause readmission in patients with heart failure (HF) in western countries. However, there is a scarcity of strong scientific evidence supporting the correlation in China. This study aimed at testing this hypothesis in Chinese.   METHODS: We conducted a secondary analysis of 1,946 patients with HF in Zigong Fourth People's Hospital in China between December 2016 to June 2019. Logistic regression models were used to study the hypotheses, with adjustments for the four regression models. We also explore the linear trend and possible nonlinear relationship between CCI and readmission within six months. We further conducted subgroup analysis and tests for interaction to examine the possible interaction between CCI and the endpoint. Additionally, CCI alone and several combinations of variables based on CCI were used to predict the endpoint. Under the curve (AUC), sensitivity and specificity were reported to evaluate the performance of the predicted model. RESULTS: In the adjusted II model, CCI was an independent prognostic factor for readmission within six months in patients with HF (OR = 1.14, 95% CI: 1.03-1.26, P = 0.011). Trend tests revealed that there was a significant linear trend for the association. A nonlinear association was identified between them and the inflection point of CCI was 1. Subgroup analyses and tests for interaction indicated that cystatin played an interactive role in the association. ROC analysis indicated neither CCI alone nor combinations of variables based on CCI were adequate for prediction. CONCLUSION: CCI was independently positively correlated with readmission within six months in patients with HF in Chinese population. However, CCI has limited value on predicting readmission within six months in patients with HF.

Translation, cross-cultural adaptation, and psychometric investigation of Chinese version of the Orbach & Mikulincer Mental Pain Scale in patients with depressive disorder.

PURPOSE: This study aimed to translate, cross-culturally adapt, and preliminarily test the psychometric properties of the Chinese version of the Orbach & Mikulincer Mental Pain Scale (OMMP). METHODS: Psychometric investigation was performed on 240 depressed patients. The reliability of the Chinese version of the OMMP scale was expressed by internal consistency reliability and test-retest reliability (2-week interval), and confirmatory factor analysis (CFA) on the 8-factor, 31-item OMMP was conducted to examine the construct validity. RESULTS: The CFA showed that the modified model with 31 items had good reliability (Cronbach's α range = 0.691-0.871; ICC = 0.818). Criterion-related validity was also supported by significant and positive correlations between the eight factors and worst-ever suicidal ideation as well as depressive symptoms. CONCLUSION: The results indicated the usefulness of the OMMP-31 for Chinese depressed patients. It is necessary to estimate psychological pain to improve suicide management in the clinical setting.

Relationship between emotional intelligence and job stressors of psychiatric nurses: A multi-centre cross-sectional study.

AIM: To investigate the impact of socio-demographic factors and job stressors on the emotional intelligence of psychiatric nurses. BACKGROUND: Emotional intelligence plays a crucial role in enabling nurses to effectively manage their own emotions, comprehend the emotions of others and assist individuals in dealing with diverse stressors. Nevertheless, a comprehensive conceptualization of the relationship between job stressors and emotional intelligence remains lacking. DESIGN: This study employs a multi-centre cross-sectional design. METHODS: A multi-centre cross-sectional survey involving 1083 registered nurses from 11 psychiatric hospitals across four provinces in China was conducted. Non-probability sampling was utilised. The survey encompassed assessments of nurse job stressors, emotional intelligence using a scale and socio-demographic characteristics using a questionnaire. A multiple linear regression model was applied to identify significant variables associated with emotional intelligence based on demographic attributes and various nurse job stressors. The study adhered to the STROBE checklist. RESULTS: The findings revealed a noteworthy negative correlation between nurse job stressors and emotional intelligence. Socio-demographic factors and job stressors of certain nurses were able to predict emotional intelligence and its dimensions among psychiatric nurses, with percentages of 44.50%, 40.10%, 36.40%, 36.60% and 34.60%. CONCLUSION: Providing emotional intelligence training for psychiatric nurses could enhance their capacity to cope effectively with workplace stress, particularly among younger nurses who engage in limited physical activities. RELEVANCE TO CLINICAL PRACTICE: The analysis of the relationship between emotional intelligence and nurse job stressors could facilitate early detection and intervention by managers based on pertinent factors. This, in turn, could elevate the emotional intelligence level of psychiatric nurses. NO PATIENT OR PUBLIC CONTRIBUTION: This study did not recruit participants, so details of participants were not be involved.

A randomized controlled trial of a nurse-led psychological pain solution-focused intervention for depressed inpatients: study protocol.

BACKGROUND: Depressed patients commonly experience psychological pain. Research pointed to positive psychological interventions as an effective means of ameliorating psychological pain, although the exact effect is unclear. Based on the hope theory and solution-focused brief therapy (SFBT), this study combines hope theory with solution-focused brief therapy to develop a nurse-led psychological pain solution-focused (PPSF) intervention in depressed patients. METHODS: This is an assessor-blinded randomized controlled trial following the SPIRIT guidance. A total of 84 depressed patients will be recruited from the inpatient wards of a psychiatric hospital and randomly assigned to the control and experimental groups. Patients in the control group will be treated as usual. In contrast, patients in the experimental group will receive 6 sessions of the PPSF intervention for two weeks on top of the routine care. Primary outcomes are psychological pain, hope, cognitive distortions. Secondary outcomes are depression and suicidal ideation. Data will be collected at 5-time points: baseline, 1 and 2 weeks (post-intervention), 1 month (follow up), and 6 months after baseline. Generalized equation evaluation will be used to assess the effectiveness of the PPSF intervention. DISCUSSION: From a positive psychology perspective, there remains much room for developing psychological pain interventions in depressed patients. SFBT and hope theory are both based on positive psychology. With hope theory as the general framework and SFBT questions as the practical guide, the PPSF intervention program is designed that nursing staff can implement. If the intervention is effective, it will advance the development of psychological pain interventions for patients with depression. TRIAL REGISTRATION: ChiCTR2100048223.

The mediating and moderating role of psychological resilience between occupational stress and mental health of psychiatric nurses: a multicenter cross-sectional study.

BACKGROUND: The particular occupational stress of psychiatric nurses has a negative impact on their mental health. There is evidence that psychological resilience can promote mental health; however, the relationship between resilience in occupational stress and mental health of psychiatric nurses is unclear, and mental health was assessed from a psychopathological perspective, neglecting the role of positive psychology. Therefore, this study was based on a dual-factor model of mental health, describing mental health in terms of both positive well-being and psychiatric symptoms. We aimed to investigate the level of psychiatric nurses' mental health and whether resilience plays a mediating or moderating role between occupational stress and mental health in psychiatry nurses. METHODS: A cross sectional survey of 450 psychiatric nurses in five hospitals in Jiangsu Province was conducted using a convenience sampling method, of which 413 were valid questionnaires with an effective rate of 91.8%. The evaluation included the Chinese Nurses' Stress Scale, the Connor-Davidson Resilience Scale, the Warwick-Edinburgh Mental Well-being Scale, and the General Health Questionnaire. Descriptive and Spearman correlation analyses were performed using SPSS25.0 while mediating and moderating effects were performed using SmartPLS3.0. RESULTS: Based on a dual-factor model of mental health, this study found that psychiatric nurses had a low general state of mental health, with 54.5% positive mental health, 7% vulnerable, 21.8% symptomatic but content, and 16.7% completely troubled. In addition, we found that resilience plays a mediating role in stress and mental health [ß = -0.230, 95% CI of (-0.310, -0.150)] and does not play a moderating role [ß = -0.018, 95%CI (-0.091, 0.055)]. CONCLUSIONS: Psychiatric nurses are in a poor state of mental health, and psychological resilience partly mediates occupational stress and mental health. This study suggests that attention should be paid to both positive and negative aspects of psychiatric nurses' mental health, and strategies should be developed to reduce occupational stress and develop psychological resilience.

Albumin levels predict mortality in sepsis patients with acute kidney injury undergoing continuous renal replacement therapy: a secondary analysis based on a retrospective cohort study.

BACKGROUND: Albumin (ALB) levels are negatively associated with mortality in patients with sepsis. However, among sepsis patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT), there has been no similar study on the correlation between ALB levels and mortality alone. This study tested the hypothesis that ALB levels are negatively associated with mortality among such patients. METHODS: We conducted a secondary analysis of 794 septic patients who were diagnosed with AKI and underwent CRRT in South Korea. For the Kaplan-Meier survival analysis, Cox proportional hazards models were used to study the hypotheses, with adjustments for the pertinent covariables. We also explore the possible nonlinear relationship and conducted sensitivity analyses including subgroup analyses and tests for interactions to investigate the association further. Additionally, ALB was used to construct model and we then compared the performance of ALB with that of APACHE II and SOFA in predicting mortality. RESULTS: The ALB level was an independent prognostic factor for death at 28 and 90 days after CRRT initiation (HR = 0.75, 95% CI: 0.62-0.90, P = 0.0024 for death at 28 days and HR = 0.73, 95% CI: 0.63-0.86, P < 0.0001 for death at 90 days). A nonlinear association was not identified between ALB levels and the endpoints. Subgroup analyses and tests for interactions indicated that HCO3 and CRP played an interactive role in the association. ROC analysis indicated ALB, SOFA and APACHE-II were separately inadequate for clinical applications. CONCLUSION: A 1 g/dL increase in ALB levels was independently associated with a 25 and 27% decrease in the risk of death at 28 and 90 days, respectively. However, this conclusion needs to be taken with caution as this study has several limitations.

Expression, Prognostic Value, and Functional Mechanism of Polarity-Related Genes in Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is a common malignant tumor with high mortality and poor prognoses around the world. Within-cell polarity is crucial to cell development and function maintenance, and some studies have found that it is closely related to cancer initiation, metastasis, and prognosis. The aim of our research was to find polarity-related biomarkers which improve the treatment and prognosis of HCC. For the knowledge-driven analysis, 189 polarity-related genes (PRGs) were retrieved and curated manually from the molecular signatures database and reviews. Meanwhile, in the data-driven part, genomic datasets and clinical records of HCC was obtained from the cancer genome atlas database. The potential candidates were considered in the respect to differential expression, mutation rate, and prognostic value. Sixty-one PRGs that passed the knowledge and data-driven screening were applied for function analysis and mechanism deduction. Elastic net model combing least absolute shrinkage and selection operator and ridge regression analysis refined the input into a 12-PRG risk model, and its pharmaceutical potency was evaluated. These findings demonstrated that the integration of multi-omics of PRGs can help us in untangling the liver cancer pathogenesis as well as illustrate the underlying mechanisms and therapeutic targets.

Distress, support and psychological resilience of psychiatric nurses as second victims after violence: A cross-sectional study.

AIM: The aim is to explore the impact of violence and psychological resilience on psychiatric nurses as second victims. BACKGROUND: Workplace violence is a public health concern, seriously influencing medical staff's physical and mental health. However, few pieces of research have concentrated on psychiatric nurses as second victims. METHOD: The socio-demographic data, violence-related data, psychological resilience scale, the Chinese version of the Second Victim Experience and Support Tool were applied to conduct a cross-sectional survey on nurses from psychiatric hospitals. The multiple linear regression model identified significant variables associated with violence-related injury and resilience. RESULTS: A total of 683 nurses completed the survey, of whom 88.3% were women. The average scores of the second victims' experience and support, support and distress were 3.45 ± 0.43, 3.71 ± 0.57 and 3.19 ± 0.67, respectively. Physical violence, psychological violence, psychological influence and nursing work environment were positively correlated with the experience and support of the second victims, and innocuous violence was a negative factor, which explains 20.6% of the variation. Moreover, physical injury, nursing work environment, resilience restructuring, physical violence, psychological violence, psychological impact and disagreement about the existence of violence explained 14.8% of the distress. The innocuous violence, psychological violence and nursing work environment explained 46.2% of the support. CONCLUSIONS: Our findings suggest that nurses who are second victims after the violence mainly suffer from severe psychological distress and receive the least support for the same. IMPLICATION FOR NURSING MANAGEMENT: The study provides clues to help nursing managers' emphasis on the distress and support of second victims and provides targeted intervention based on the relevant factors and these results. The article is a cross-sectional study of psychiatric nurses, which has been approved by the ethics committee of the hospital before the survey. All the nurses who participated in the survey have been informed and agreed.

The impact of the second victim's experience and support on the career success of psychiatric nurses: The mediating effect of psychological resilience.

AIMS: We explored the mediating role of psychological resilience in the experience and support of psychiatric nurses as the second victims and their career success. BACKGROUND: Psychiatric nurses, as the primary victims of workplace violence, experience physical and psychological distress, which leads to high resignation rate and job burnout. However, not much is known about the mediating role of psychological resilience between the second victims of workplace violence and their career success. METHODS: A cross-sectional study was conducted among 683 psychiatric nurses. The participants were scored according to the Chinese career success scale, Chinese version of the psychological resilience scale for nurses and Chinese version of the second victim experience and support tool. The t-test and one-way analysis of variance were used to compare the factors affecting career success. RESULTS: Career success scores differed among nurses of different ages having different employment forms, role and working years (p < .05). Mediating effect analysis revealed that psychological resilience played a full mediating role in the experience and support of second victims and their career success. CONCLUSION: Psychological resilience-based interventions should be developed to improve the psychological adjustment ability of psychiatric nurses and to strengthen their career success. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should create more opportunities and a harmonious working environment and enhance the management system for dealing with workplace violence.

The more developmental assets, the less internet gaming disorder? Testing the cumulative effect and longitudinal mechanism during the COVID-19 pandemic.

The COVID-19 pandemic has triggered the dramatical development and prosperity of online games, while worldwide people are suffering from it. Considering the high prevalence, serious impacts, and huge development potential of internet gaming disorder (IGD), it is extremely necessary to develop a protective model to prevent and intervene with it among young people. Based on the developmental assets theory, the present study adopted a two-wave longitudinal design to evaluate the cumulative effects of developmental assets on IGD, as well as the underlying mechanisms during this specific period. Data were collected from a sample of 1023 adolescents in Hubei province, Central China through self-report questionnaires. The results indicated that (1) developmental assets were negatively associated with adolescents' IGD concurrently and longitudinally; (2) the overall developmental assets had cumulative effects in linear patterns on adolescents' IGD, concurrently and longitudinally; and (3) internal developmental assets mediated the relationship between external developmental assets and adolescents' IGD longitudinally. Theoretically, the present study supports the developmental assets theory and expands the literature about developmental assets and IGD in younger generations. Practically, the present study provides guidance for prevention and intervention of IGD among adolescents during and after the COVID-19 pandemic. Comprehensive measures should be taken to assist in developing positive internal and external resources to promote youth thriving.

Off-label use of letrozole in Chinese short pubertal boys: Effectiveness, safety, and exposure-response analysis.

AIMS: Recently, letrozole has been used off-label to treat short pubertal boys. The experience on letrozole effectiveness and safety has been obtained primarily from Caucasian children. A simple extrapolation of the data to Chinese paediatric populations is questionable because of the substantial ethnic differences between the two populations. Therefore, the present study aimed to determine the effectiveness and safety of letrozole use in Chinese short pubertal boys as well as to establish an exposure-response relationship. METHODS: Forty-one Chinese boys were included in the study. Patients were given letrozole tablets (2.5 mg) once daily in combination with growth hormone, and follow-up visits were made after 1, 3, 6 and 12 months of treatment. Plasma samples were taken from clinical examinations and analysed using high performance liquid chromatography with fluorescence detection. RESULTS: After 1 year of treatment, 35 (88%) boys showed increased predicted adult heights. However, possible adverse drug reactions were seen in nine boys (22%). Predicted adult heights increased significantly from 168.4 ± 3.7 to 173.0 ± 4.2 cm, while oestrogen levels dropped from 33.2 ± 7.4 to 21.6 ± 7.3 pg/mL. Increments in predicted adult height were significantly correlated with trough letrozole concentrations (r = 0.39, P = .01). CONCLUSION: Letrozole treatment in Chinese pubertal populations should be further optimized, and more personalized therapies should be developed.

Anxiety, depression and cognitive emotion regulation strategies in Chinese nurses during the COVID-19 outbreak.

AIMS: To explore the association between cognitive emotion regulation strategies and anxiety and depression among nurses during the COVID-19 outbreak. BACKGROUND: Nurses play a vital role in responding to the COVID-19 outbreak, but many of them suffer from psychological problems due to the excessive workload and stress. Understanding the correlation between cognitive emotion regulation strategies and anxiety and depression will promote targeted psychosocial interventions for these affected nurses. METHODS: This cross-sectional study of 586 nurses was conducted in Eastern China. Participants completed online questionnaires that investigated anxiety, depression and cognitive emotion regulation strategies. RESULTS: The prevalence of nurses' anxiety and depression was 27.6% and 32.8%, respectively. Lower self-blame, rumination and catastrophizing, as well as greater acceptance and positive refocusing, were related to fewer symptoms of anxiety or depression. CONCLUSION: The cognitive emotion regulation strategies of acceptance and positive refocusing contribute to reducing anxiety or depression. These strategies should be considered when implementing psychotherapeutic interventions to improve nurses' adverse emotional symptoms. IMPLICATIONS FOR NURSING MANAGEMENT: This study highlights the need to assess cognitive emotion regulation strategies use in screening for anxiety and depression. Nurse managers should develop psychosocial interventions including appropriate strategies to help nurses with adverse emotions during a pandemic.

Assessment of biological functions for C3A cells interacting with adverse environments of liver failure plasma.

BACKGROUND: For its better differentiated hepatocyte phenotype, C3A cell line has been utilized in bioartificial liver system. However, up to now, there are only a few of studies working at the metabolic alternations of C3A cells under the culture conditions with liver failure plasma, which mainly focus on carbohydrate metabolism, total protein synthesis and ureagenesis. In this study, we investigated the effects of acute liver failure plasma on the growth and biological functions of C3A cells, especially on CYP450 enzymes. METHODS: C3A cells were treated with fresh DMEM medium containing 10% FBS, fresh DMEM medium containing 10% normal plasma and acute liver failure plasma, respectively. After incubation, the C3A cells were assessed for cell viabilities, lactate dehydrogenase leakage, gene transcription, protein levels, albumin secretion, ammonia metabolism and CYP450 enzyme activities. RESULTS: Cell viabilities decreased 15%, and lactate dehydrogenase leakage had 1.3-fold elevation in acute liver failure plasma group. Gene transcription exhibited up-regulation, down-regulation or stability for different hepatic genes. In contrast, protein expression levels for several CYP450 enzymes kept constant, while the CYP450 enzyme activities decreased or remained stable. Albumin secretion reduced about 48%, and ammonia accumulation increased approximately 41%. CONCLUSIONS: C3A cells cultured with acute liver failure plasma showed mild inhibition of cell viabilities, reduction of albumin secretion, and increase of ammonia accumulation. Furthermore, CYP450 enzymes demonstrated various alterations on gene transcription, protein expression and enzyme activities.

[Vascular damage-related risk factors for erectile dysfunction in patients with type 2 diabetes mellitus: Analysis based on a nomogram model].

OBJECTIVE: To analyze vascular damage-related risk factors for ED in patients with type 2 diabetes mellitus (DM) and develop a nomogram for the prediction of the factors. METHODS: A total of 181 patients with type 2 DM were included for sexual function assessment, and the clinical data on vascular damage were retrieved from the patients system. After preprocessing, the data were described by the number and percentage of different types of cases and subjected to statistical analysis with the R software. The Lasso regression model was used to optimize feature selection. On the premise of the sample size required for logistic regression analysis according to the number of events per variable, multivariable logistic regression analysis was performed on the selected variables and a nomogram was developed for diabetes-induced erectile dysfunction (DIED). Then, the performance of the nomogram was evaluated with respect to its calibration, discrimination and clinical utility using Harrell's concordance index (C-index), the calibration plot and decision curve analysis, as well as bootstrapping for internal validation. RESULTS: ED was diagnosed in 90 (49.7%) of the 181 patients. The risk factors subjected to logistic regression analysis included the duration of DM (OR = 4.440, 95% CI: 1.594－13.105; OR = 7.667, 95% CI: 1.444－48.733), status of carotid intima-media thickness (c-IMT) (OR = 3.767, 95% CI: 1.194－12.691), diabetic retinopathy (DR) (OR = 5.382, 95% CI: 1.373－28.301), diabetic kidney disease (DKD) (OR = 4.959, 95% CI: 1.156－27.728), low-density lipoprotein cholesterol (LDL-C) (OR = 8.210, 95% CI: 2.027－43.507), red blood cell distribution width (RDW) (OR = 2.418, 95% CI: 1.021－5.826), and plasma fibrinogen (Fbg) (OR = 4.649, 95% CI: 2.001－11.339). The C-index of the DIED model was 0.911 (95% CI: 0.869－0.954). The curve representing the performance of the nomogram fit in well with that representing a perfect prediction by the calibration plot. Decision curve analysis indicated that the nomogram was clinically useful for predicting DIED in the type 2 DM patients at the possibility threshold of 6% to 93%. CONCLUSIONS: A nomogram was preliminarily developed for predicting the risk of DIED in type 2 DM patients with respect to the seven independent influencing factors, including the duration of DM, status of c-IMT, DR, DKD, LDL-C, RDW, and Fbg.

Effective prediction of postoperative complications for patients after open hepatectomy: a simplified scoring system based on perioperative parameters.

BACKGROUND: The aim of the study was to develop a scoring system for the prediction of postoperative complications of open hepatectomy. METHOD: All consecutive patients receiving open hepatectomy from 2015 to 2017 were included in the study. Univariate and multivariate analyses were used to confirm the risk factors for postoperative complications. Afterwards, a novel scoring system was developed to predict the postoperative complications. RESULTS: The study included a total of 207 patients. For the test dataset, multivariate analysis indicated that diabetes, scale of surgery, serum potassium, and blood loss versus body weight were independent risk factors of the postoperative complications. The area under the curve (AUC) of the novel scoring system we proposed for prediction of postoperative complications of hepatectomy was 0.803, which is comparable with the AUCs of previous scoring systems. Furthermore, in the validation dataset, the corresponding AUC of the new scoring system was 0.717. CONCLUSION: This novel and simplified scoring system can effectively predict the postoperative complications of open hepatectomy and could help identify patients who are at high risk of postoperative complications.

Job burnout and quality of working life among Chinese nurses: A cross-sectional study.

AIM: To explore the relationship between job burnout and quality of working life, and identify influencing factors of nurses' quality of working life. BACKGROUND: Understanding the influencing factors of quality of working life is important to improve nursing retention strategies. Job burnout can negatively influence work efficiency and quality of work. However, studies examining the association between the two remain limited. METHODS: The cross-sectional survey of 2,504 nurses was performed in Eastern China. Nurses were invited to complete self-report questionnaires online. The collected data were analysed using Pearson's correlation and multiple regression. RESULTS: About 64.0% of nurses experienced job burnout, and their quality of working life was at a moderate level. Job burnout, hospital level, age, income, night shift and patient-to-nurse ratio were significant factors of quality of working life. CONCLUSION: Job burnout has a negative effect on nurses' quality of working life. Some demographic and work-related factors should be considered when developing interventions to improve nurses' quality of working life. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital and nurses managers should develop strategies to reduce nurses' job burnout and enhance their quality of working life, such as optimum nurse staffing, offer reasonable pecuniary compensation and establish an appropriate shift work schedule.

Association between Physical Activity and Telomere Length in a North Chinese Population: A China Suboptimal Health Cohort Study.

Several studies have demonstrated an association between physical activity and telomere length; however, the association remains inconsistent. A cross-sectional study consisting of 588 participants (375 females, median age of 33.8 years) was carried out to investigate the association between telomere length and physical activity in a general population from North China. The results show that relative telomere length is not significantly different in participants in the northern Chinese population with different levels of physical activity, either in the model only adjusted for age (F = 2.127, P = 0.120) or in the model adjusted for demographics and lifestyle (F = 1.227, P = 0.294). The gender-stratified analysis also produced insignificant results. Our study confirmed a non-significant association between physical activity and telomere length in the northern Chinese population, which adds to the inconsistent association between physical activity and telomere length across different ethnic populations.