Extracellular vesicle-mediated ferroptosis, pyroptosis, and necroptosis: potential clinical applications in cancer therapy.

Extracellular vesicles (EVs) have gained increasing recognition as significant regulators of intercellular communication in various physiological and pathological processes. These vesicles play a pivotal role in cancer progression by facilitating the transfer of diverse cargoes, including lipids, proteins, and nucleic acids. Regulated cell death (RCD), the orderly and autonomous death of cells, is controlled by a variety of biomacromolecules and, in turn, influences various biological processes and cancer progression. Recent studies have demonstrated that EV cargoes regulate diverse oncogenes and tumor suppressors to mediate different nonapoptotic forms of RCD, notably ferroptosis, pyroptosis, and necroptosis. Nevertheless, comprehensive exploration of EV-mediated nonapoptotic RCD forms in the context of cancer has not been performed. This review summarizes the progress regarding the biological functions and underlying mechanisms of EVs in mediating nonapoptotic RCD by delivery of cargoes to regulate tumor progression. Additionally, the review delves into the potential clinical applications of EV-mediated cell death and its significance in the areas of cancer diagnosis and therapy.

[People, the environment and health: the "Oneness" of human health from the perspective of universal life presented in "Changes"].

This paper aimed to expand the paradigm of nursing and expand the essential factors of nursing theories beyond "environment" to encompass universal life. While individuals live between the sky and earth, we are an inseparable part of the universe. "Health" is derived from a oneness that embraces the body, mind and spirit. The human body contains the wisdom of the universe, known in Chinese philosophy as the wisdom of "Changes". The body has its own consciousness and possesses great powers of self-healing. Healthiness is the original condition of life. Modern medicine assumes sickness to be a natural phenomenon, with the essential nature of "Changes" neglected as a universal law for maintaining health. Dr. Sun, a renowned physician from the Tang Dynasty, was quoted as saying "Knowing Changes is the prerequisite of knowing medicine." Another saying holds that, "Every word and every sentence in the Book of Changes is an indicator of medicine." Much emphasis has been placed on the relationship between "Changes" and "medicine" in the past. This paper elaborates the relationship between nature and human health in order to provide a clear understanding of the nature of true health, described from the perspectives of medicine and "Changes", an evaluation of modern medical science and the oneness of body-mind-spirit, which is the reality of health. The human body is thus a reflection of the mind and spirit, while the mind and spirit is the "inner body". The body is a highly intelligent organism that truly reflects our inner world. Our inner world is also displayed through physical symptoms. As human suffering is caused by separation from our inner life, the only path to enjoying a healthy and joyful life is to achieve a oneness between our body-mind-spirit. Such is a universal law, which is called "Changes" or "Oneness".

Fibrosis of collagen I and remodeling of connexin 43 in atrial myocardium of patients with atrial fibrillation.

BACKGROUND: Fibrosis in atrial myocardium is a common phenomenon for patients with atrial fibrillation (AF). Remodeling of connexins was found accompanying with AF. The aim of the study is to investigate whether it is by causing the remodeling of connexin 43 (Cx43) that the fibrosis of atrial muscle plays an important role during the initiation and maintenance of AF. METHODS: Samples of right atrial appendage were taken from 24 patients with rheumatic valvular disease during surgery. Fibrosis and remodeling of Cx43 was examined by microscopy and ultramicroscopy technique and analyzed by image analyzer. The collagen volume fraction of type I (CVF-I) and the volume fraction of Cx43 (Cx43VF) were studied between AF and sinus rhythm (SR) groups. RESULTS: (1) Microscopic examination demonstrated that CVF-I significantly increased and Cx43VF decreased in patients with AF compared to those with SR. (2) The CVF-I was negatively correlated with the Cx43VF. CONCLUSION: The results suggest that fibrosis and remodeling of Cx43 are involved in the pathophysiologic mechanism of human AF. Fibrosis of atrial muscle may play an important role in the process of AF by means of interfering with remodeling of connexins.

A study of nurses' spiritual intelligence: a cross-sectional questionnaire survey.

BACKGROUND: Nurse's spiritual well-being may assure a positive attitude toward spiritual care, and assist patients in overcoming spiritual distress. Spirituality is often related to one's belief system. Spirituality on the part of nurses is yet largely unheard of in a society with materialism which is one of the most destructive belief systems on the world. OBJECTIVES: The objective of the study was to explore the profile of spiritual intelligence among nurses, and to examine the effect of religions on nurses' spiritual intelligence in China. DESIGN: This is a cross-sectional descriptive and inferential designed study. SETTINGS: The study was carried out in a medical center in China. Subjects were widely distributed, throughout seven provinces, with 16 hospital settings. PARTICIPANTS: A total of 130 registered hospital nurses, who were taking part in a 3-day, national nursing quality conference held by the target medical center in China, were recruited by convenience sampling. METHODS: Wolman's (2001) four-point Likert-type Psycho-Matrix Spirituality Inventroy (PSI) was distributed collaboratively during the period of the conference. Upon receiving oral approval from nursing administrators, the author ensured that subjects' responses would remain confidential and that filling out the questionnaire was to be construed as willingness to participate in this study. RESULTS: 1. The majority of nurses (90%) tended to experience numerous instances of physical emotional pain and suffering throughout life. 2. Among the 130 subjects, only seven nurses clearly specified their religions, and religious beliefs accounted for most of the variance in the criterion variable in the study. CONCLUSIONS: Exploring nurses' spiritual profiles, especially for those who seem to be unfamiliar with spiritual matters, is a starting point on the journey to delivering spiritual care. Chinese nurses' spiritual intelligence is only to be excavated. The study draws attention to the diverse culture of the nurses' concepts of spirituality, which is fundamental to the delivery of truly holistic care of humans in a multi-faith society.

The spiritual intelligence of nurses in Taiwan.

The purposes of the study included: (1) defining the profile of nurses' spiritual intelligence; (2) examining the relationship between nurses' demographic characteristics and spiritual intelligence; and (3) exploring the mode of nurses' spiritual intelligence and related factors, among nurses in Taiwan. A cross-sectional descriptive study was designed and administered to 299 hospital registered nurses, who were distributed throughout metropolitan Taipei. Wolman's (2001) PsychoMatrix Spirituality Inventory, a 4-point scaled, self-reported, 49-item questionnaire covering seven spiritual factors (divinity, mindfulness, extrasensory perception, community, intellectuality, trauma, and childhood spirituality) was used to measure nurses' spiritual intelligence. Results showed that nurses' spiritual intelligence was centralized in a moderate degree, while trauma and childhood spirituality were either moderate or high. Age and childhood spirituality were the most significant variables affecting nurses' spiritual intelligence, accounting for 61.4% of the variance in nurses' spiritual intelligence. This study may contribute to a better understanding of the spiritual intelligence profile of nurses and may also help facilitate a program for nurses' spiritual development as well as improve the quality of spiritual care.

[Protective effect of puerarin on endothelial dysfunction of heat shock protein 60 induced specific immunity in apolipoprotein E-null mice].

OBJECTIVE: To investigate the influence of endothelial dysfunction induced by inoculated dendritic cells (DCs) loaded heat shock protein 60 (HSP60) in apolipoprotein (Apo) E-null mice, and the effect of Puerarin on it. METHODS: HSP60 DC (DChsp) acquired after prepared bone marrow-derived DCs of ApoE-null mice and treated with HSP60. In vitro, the function of DCs and the effect of Puerarin were detected. While in vivo, ApoE-null mice fed with high-cholesterol forage were divided into two groups and intravenous inoculated with DCh-sp or normal saline via vein twice respectively. The mice in the two groups were subdivided into the Puerarin group and non-treated group, and they were injected intraperitoneally with Puerarin and normal saline at the beginning of inoculation and the following 3 weeks, respectively. In addition, C57BL/6 mice without inoculation were taken as the normal control group. Two weeks after the last time inoculated, the response of T lymphocytes to HSP60 and endothelial-dependent diastolic function of aortic ring were detected. RESULTS: HSP60 could promote DCs expressed CD86 and stimulate T lymphocytes proliferation in vitro, while Puerarin had significantly inhibitory effect. After inoculated, DChsp activated inflammatory response in vivo and aggravated endothelium-dependent dilation in mice. Puerarin could significantly inhibit inflammatory reaction caused by DChsp and improve endothelium dilation. CONCLUSION: Hsp60 could activate DCs in vitro and in vivo, Puerarin could significantly inhibit specific immunity induced by HSP60 and improve vascular endothelium-dependent dilation.

The effects of staff nurses' morale on patient satisfaction.

This study, designed by descriptive and inferential methods, study aimed to examine staff nurses' morale and its effect on patient satisfaction, the most commonly used variable to measure patient outcomes. Data were collected with structured questionnaires from 332 nurses and 265 inpatients in 21 medical-surgical units of a medical center in Taiwan. All registered nurses (RN) among the 21 sample units were recruited and administered with Litwin and Stringerm's (1968) Work Morale Scale, which was modified by Hsu in 1981. A convenience sampling was implemented to select those patients who had been admitted for at least 3 days and were ready to be discharged. Yang's (1997) Nursing-Sensitive Patient Satisfaction Scale was used to measure patient outcomes. The results showed that job position and pay had a significant effect on nurses' work morale. Nurses' work morale may not necessarily be an impact factor on patient satisfaction, but it accounts for 66.7 percent of the discriminate power to predict nursing-sensitive patient satisfaction. In view of the findings, every attempt should be made to highlight the nature of a caring profession. Nursing leaders should put effort into improving nurses' involvement and identification with their organizations, both of which are significant factors associated with nursing unit morale. The findings of this study may contribute to a body of knowledge regarding nurses' work morale and nursing-sensitive patient outcomes.

[Core of the philosophy of management: self-management].

Philosophy is an aspect of metaphysics; while management, by contrast is a practical matter. In this century, this is especially crucial that management philosophy focuses on value and spiritual intelligence. However, the core of pragmatic management is the manager's emotional intelligence. The purpose of this paper is to expound a manager's own positive values and philosophy, as well as the manager's capacity for the management of his or her own emotions. Ultimately, under a spiritually and emotionally intelligent manager, all aspects of an organization--personnel, business issues, physical assets--will interact harmoniously and the organization will advance.

Nursing turnover in Taiwan: a meta-analysis of related factors.

A meta-analytic study was conducted to investigate the causal relationships among individual, organizational and environmental factors related to nurses' intention to stay at or leave their jobs in Taiwanese hospitals. A total of 129 studies related to nursing turnover from 1978-1998 were reviewed. A total of 4032 subjects were selected for the study. Data were integrated by estimation of parametric correlation coefficients, and analyzed using Friedman's two-way analysis of variance by ranks following weight adjustment of sample size and estimation of correlation effect on size of variables. The results of this study merit attention by nursing administrators in order to develop strategies for stabilizing the nursing work force.

Relationships between nurse staffing and patient outcomes.

Nursing studies have shown that nursing care delivery changes affect staff and organizational outcomes, but the effects on client outcomes have not been studied sufficiently. The purpose of this study was thus to examine the effect of nurse staffing variables- daily average hours of care, ratio of RNs to average patient census, workload, and skill mix- on patient outcomes as measured by five adverse occurrences. The adverse patient occurrences included unit rates of patient falls, pressure ulcers, respiratory and urinary tract infections, and patient/family complaints. Variables were measured retrospectively using consistently available data from each month of fiscal year 2000 from 21 medical-surgical nursing care units in a 1394-bed medical center in Taiwan. Data were analyzed by descriptive and multivariate inferential statistics while controlling for patient acuity level. Results showed that workload of nurses is the most powerful predictor of nosocomial infections and hours of care best predicted the five adverse patient outcome indices. Lower adverse outcome rates were more consistently related to a higher proportion of N3 level of RNs. Patients could fare better when N3s play a significant role in the staffing mix. The findings provide further empirical support for the context of implications that patient outcomes are correlated to organizational structure. It obviously illustrates the relationships between nurse staffing and the quality of nursing practice.

Promoting physical activity among Taiwanese and American adolescents.

The purpose of this paper is to present a comparative analysis of the determinants of physical activity among adolescents in Taiwan and in the United States. Pender's Health Promotion Model (HPM) served as the theoretical framework for both studies (Pender, 1996). The major determinants of health behavior in the HPM are perceived benefits, perceived barriers, self-efficacy, activity-related affect, interpersonal influences, situational influences, commitment to a plan of action, and immediate competing demands. In Taiwan, 969 middle school students (55% males; 45% females) from Taipei provided data for the study. In the United States, the sample was collected from 286 late elementary and middle school students (48% males; 52% females). Results showed the gender differences in activity levels were apparent in the youths from both countries. In both Taiwanese and American youths, boys were more active than girls. Cross-cultural differences in the importance of barriers to physical activity emerged. Among Taiwanese adolescents, barriers did not emerge as a significant direct predictor of physical activity as they did among US adolescents. Perceived efficacy directly predicted physical activity among Taiwanese youths while it indirectly predicted physical activity and appeared to be mediated by beliefs regarding exercise benefits and barriers among American youths. In addition, the paths of effect for interpersonal influences were different when Taiwanese and US youths were compared. The findings from this paper have important and culturally-relevant information that can inform future physical activity intervention studies with diverse adolescents.

Spiritual intelligence of nurses in two Chinese social systems: a cross-sectional comparison study.

BACKGROUND: The spirituality of healthcare providers and their clients is becoming a crucial issue in a world increasingly preoccupied with material issues. In light of such, how do nurses enhance their spiritual intelligence against such materialist pressures? After a 60-year separation of Chinese on both sides of the Taiwan Strait and the rancor between their two governments, what are the similarities and the differences in nurse spirituality profiles between these two different societies? With increasing contact between the two, this issue should be examined and explored, as it has the potential to become an essential unspoken element underpinning holistic care quality. PURPOSE: The purpose of this study was to compare spiritual intelligence between nurses in two different Chinese societies. METHODS: A cross-sectional descriptive and inferential study was conducted at five medical centers in China and Taiwan. A total of 524 registered hospital nurses were recruited as participants. We used R. N. Wolman's (2001) self-reported PsychoMatrix Spirituality Inventory to measure participant levels of spiritual intelligence. The PsychoMatrix Spirituality Inventory incorporated seven factors, including divinity, mindfulness, extrasensory perception, community, intellectuality, trauma, and childhood spirituality. RESULTS: Results showed that social systems did have an impact on nurses' spiritual intelligence. Childhood spirituality and religious beliefs and activities greatly affected and effectively predicted nurses' spiritual intelligence. Nurses on either side of the Taiwan Strait all reported a need to deal with their daily lives pragmatically, objectively, and rationally and relied on empirical evidence in work settings. CONCLUSIONS: As social and economic contacts increase across the Taiwan Strait, it is imperative that nurses adopt cultural awareness and sensitivity as they provide holistic care to clients. This study opens doors to dialogue about and a better understanding of nurses' spiritual intelligence in Taiwan and China.

The effect of meditation on physical and mental health in junior college students: a quasi-experimental study.

BACKGROUND: Physical stress and mental stress are increasingly common phenomena in our rapidly changing and stressful modern society. Research has found meditation to produce positive and demonstrable stress reduction effects on brain and immune functions. This study is grounded in traditional Chinese philosophical mores that teach a process summarized by the keynote activities of "calm, still, quiet, consider, and get" and the potential of this process to reduce stress in adolescents. PURPOSE: The purpose of this study was to examine the effects of meditation on the physical and mental health of junior college students. METHODS: This research employed a quasi-experimental design. Participants included 242 freshmen from a junior college in Taiwan selected using a convenience sampling technique. Participants were then randomly separated into experimental (n = 119) and control (n = 123) groups. The project duration was 18 weeks, during which the experimental group received 2 hours of meditation treatment per week, for a total of 36 hours. Both groups completed pretest and posttest Life Adaptation Scale forms, which included questionnaires addressing information on physical and mental distress and positive and negative coping strategies. Data were analyzed using analysis of covariance. RESULTS: Findings showed that the effect of the experiment treatment was significant when student physical and mental distress pretest scores were controlled. Physical and mental symptoms in the experimental group were lower than those in the control group. CONCLUSIONS: Meditation can help students to adapt to life stressors. This study also provides support for traditional Chinese wisdom, which promotes meditation as one way to improve health.