L-selenomethionine affects liver development and glucolipid metabolism by inhibiting autophagy in zebrafish embryos.

Selenium plays a vital role in cancer prevention, antioxidation, and the growth of humans and other vertebrates. Excessive selenium can cause liver injury and metabolic disorders, which can lead to hepatic disease, but few studies have shown the effects of excessive selenium on liver development and its mechanism in zebrafish embryos. In this study, liver development and glucolipid metabolism were investigated in selenium-stressed zebrafish embryos. Under selenium treatment, transgenic fabp10a-eGFP zebrafish embryos showed reduced liver size, and wild-type zebrafish embryos exhibited steatosis and altered lipid metabolism-related indexes and glucose metabolism-related enzyme activities. In addition, selenium-stressed embryos exhibited damaged mitochondria and inhibited autophagy in the liver. An autophagy inducer (rapamycin) alleviated selenium-induced liver injury and restored the expression of some genes related to liver development and glucolipid metabolism. In summary, our research evaluated liver developmental toxicity and metabolic disorders under selenium stress, and confirmed that autophagy and oxidative stress might involve in the selenium-induced hepatic defects.

Authoritarian leadership and nurse presenteeism: the role of workload and leader identification.

BACKGROUND: Nurses' health in the workplace is crucial for ensuring the quality of healthcare. However, presenteeism, the behavior of working in a state of ill health, is widespread in the nursing industry. Considering that the origin of authoritarian leadership and the prevalence of presenteeism are inseparable from Chinese workplace culture, this study aimed to explore the impact and mechanism of authoritarian leadership on presenteeism. METHODS: A total of 528 nurses were recruited from four grade III level A hospitals in the present survey, which was distributed across 98 nursing teams. Participants were required to complete self-report measures on authoritarian leadership, presenteeism, workload, and leader identification. Description, correlation, and multilevel linear regressions were applied for data analysis. RESULTS: The present study found that presenteeism was significantly related to participants' demographic characteristics, such as marital status, educational level, technological title, and general health. There was a positive relationship between authoritarian leadership and presenteeism, and workload acted as a mediator in authoritarian leadership and presenteeism. Furthermore, leader identification moderated the relationship between authoritarian leadership and workload. When nurses were under high leader identification, the positive impact of authoritarian leadership on workload was reinforced. CONCLUSIONS: This study revealed the potential antecedents and mechanisms of nurse presenteeism from the perspective of workplace culture. Results indicated that the excessive authoritarianism of leaders and the heavy workload faced by nurses may be the significant triggers for nurses' presenteeism. The role of leader identification is not always protective, which may heighten the relationship between dark leadership and its outcomes. These observations contribute to enriching research on presenteeism and authoritarian leadership, and provide valuable insights for cultivating healthy working behaviors.

Transient Receptor Potential Melastatin 7 Promotes Vascular Adventitial Fibroblasts Phenotypic Transformation and Inflammatory Reaction Induced by Mechanical Stretching Stress via p38 MAPK/JNK Pathway.

Remodeling of the arteries is one of the pathological bases of hypertension. We have previously shown that transient receptor potential melastatin 7 (TRPM7) aggravates the vascular adventitial remodeling caused by pressure overload in the transverse aortic constriction (TAC) model. In this study, we sought to explore the functional expression and downstream signaling of TRPM7 in vascular adventitial fibroblasts (AFs) stimulated by mechanical stretching stress (MSS). The expression of TRPM7 was upregulated with a concomitant translocation to the cytoplasm in the AFs stimulated with 20% MSS. Meanwhile, the expression of α-smooth muscle actin (α-SMA), a marker of transformation from AFs to myofibroblasts (MFs) was also increased. Moreover, AF-conditioned medium caused a significant migration of macrophages after treatment with MSS and contained high levels of monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α). Pharmacological and RNA interference approaches using the TRPM7 inhibitor 2-aminoethoxydiphenyl borate (2-APB) and specific anti-TRPM7 small interfering RNA (si-RNA-TRPM7) abrogated these changes significantly. Further exploration uncloaked that inhibition of TRPM7 reduced the phosphorylation of p38 MAP kinase (p38MAPK) and c-Jun N-terminal kinase (JNK) in the AFs stimulated with MSS. Furthermore, inhibition of the phosphorylation of p38MAPK or JNK could also alleviate the MSS-induced expression of α-SMA and secretion of inflammatory factors. These observations indicate that activated TRPM7 participates in the phenotypic transformation and inflammatory action of AFs in response to MSS through the p38MAPK/JNK pathway and suggest that TRPM7 may be a potential therapeutic target for vascular remodeling caused by hemodynamic changes in hypertension.

Adenovirus-Mediated Overexpression of Septin 2 Attenuates α-Smooth Muscle Actin Expression and Adventitial Myofibroblast Migration Induced by Angiotensin II.

Phenotypic transformation from adventitial fibroblasts (AFs) to myofibroblasts (MFs) is critical for vascular remodeling. Septin 2 was found to be downregulated during the differentiation of AFs to MFs induced by angiotensin II (Ang II); however, the role of septin 2 in this process is still unknown. In this study, we investigate whether septin 2 contributes to the adventitial MF phenotypic modulation caused by Ang II. The decreased level of septin 2 and the increased expression of α-smooth muscle actin (α-SMA), a marker of MFs, were readily observed in Ang II-stimulated MF differentiation. After gene transfer of septin 2, the expression of α-SMA was markedly decreased and the MF migration response to Ang II was inhibited. Furthermore, the inhibition of RhoA, another molecule involved in MF phenotypic modulation, decreased the motility of MFs and the expression of septin 2 triggered in Ang II. Finally, transfection of septin 2 rescued the level of acetyl-α-tubulin in MFs. These findings demonstrate that, as a downstream molecule of RhoA, septin 2 blunted the responses of AFs to Ang II by protecting α-tubulin acetylation, which suggests that septin 2 may serve as a potential therapeutic target for vascular injury.

Cultural dilemmas of choice: Deconstructing consumer choice in health communication between maternity-care providers and ethnic Chinese mothers in New Zealand.

This article critically analyses the discourse of consumer choice embedded in health communication interactions between maternity-care providers and migrant ethnic Chinese mothers in New Zealand. Findings indicate that Chinese mothers, as the customers of the New Zealand maternity and health care services, are encouraged to "fit in" with the Western discourse of choice. However, the mothers' cultural predispositions for childbirth and communication have a significant impact on the ways in which they respond to and resist this discourse. Drawing on theoretical insights from postcolonialism and Third World feminism, this article contributes to the study of intercultural health communication by examining cultural dilemmas in the discourse of choice that is often taken for granted in Western health contexts. In doing so, it builds a platform for an inclusive maternity care and health environment in multicultural societies.

Barriers and facilitators to self-management among women with gestational diabetes: A systematic review using the COM-B model.

BACKGROUND: Gestational diabetes mellitus is a common complication during pregnancy, and its prevalence rates have increased dramatically in recent years. Treatment of gestational diabetes requires the active self-management, however, this can be challenging. Understanding the barriers and facilitators of adherence to self-management recommendations is essential for designing effective interventions. AIM: To identify and synthesize barriers and facilitators to self-management of gestational diabetes reported by pregnant women. METHODS: This was a mixed-methods systematic review, including qualitative, quantitative, and mixed-methods studies. A literature search was conducted in four databases (PubMed, Embase, CINAHL, and the Web of Science). Eligible studies explored the barriers and/or facilitators, experiences and/or perceptions to engage in self-management in women with gestational diabetes. The Capability, Opportunity, Motivation, Behaviour model was used to classify barriers and facilitators affecting self-management. RESULTS: Thirty-six studies (23 qualitative, 11 quantitative, and 2 mixed-methods) met the inclusion criteria. We identified barriers and facilitators relating to capability (e.g., physical discomforts and constraints; lack of knowledge of GDM and self-management behaviours; forgetfulness), opportunity (e.g., limited education and resources; social support from family, friends, and peer groups; conflict with existing lifestyles or cultural norms), and motivation (e.g., perceived negative consequence of self-management behaviours or not perceived benefits; negative emotion; concern the health of the baby). CONCLUSION: In this study, we identified the barriers and facilitators of self-management in women with gestational diabetes, which were explained by relevant theoretical models. Interventions should be developed with full consideration of these findings to ensure that pregnant women have the correct knowledge and confidence to self-manage their complications.

Simultaneous determination of quaternary phosphonium compounds and phosphine oxides in environmental water and solid samples by ultrahigh performance liquid chromatography-tandem mass spectrometry.

Quaternary phosphonium compounds (QPCs) and phosphine oxides (POs) are emerging contaminants that are attracting increasing attention. In the present study, a method for the quantification of QPCs and POs in multiple environmental media was developed using ultrahigh performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Analytes were extracted from water samples using solid phase extraction, and for the solid samples, ultrasonic extraction was employed. Compared with analytical methods established by previous studies, the approach developed in this study is more suitable for the quantitative analysis of compounds along with high sensitivity. The method quantification limit reached 0.12-2.55 ng⋅L-1 in water samples and 0.004-0.10 ng⋅g-1 in solid samples. The recoveries of target analytes spiked at low, medium and high concentrations in water and solid samples were in the range of 56.4-120 %, with relative standard deviations below 20 % (n = 6). Furthermore, the validated method succeeded in applying to analyse of eight QPCs and four POs in real environmental samples. At least five QPCs and two POs were detected in each environmental medium. This quantitative method would assist in further investigations on the occurrence, migration and the source of QPCs and POs.

The ß1-adrenoreceptor gene Arg389Gly and Ser49Gly polymorphisms and hypertension: a meta-analysis.

The gene encoding ß1-adrenoreceptor is regarded as a hypertension-susceptibility candidate gene. The association of ß1-adrenoreceptor gene Arg389Gly and Ser49Gly polymorphisms with hypertension has been exhaustively investigated; however, the studies have yielded inconsistent results. We sought to shed some light on this inconsistency by performing a systemic meta-analysis. Data were extracted from 17 articles (cases/controls: 7,586/8,441) for Arg389Gly, and eight articles (3,582/2,998) for Ser49Gly. The random-effects model was applied irrespective of between-study heterogeneity. Overall results indicated significance for Ser49Gly under both allelic (odds ratio = 1.13; 95 % confidence interval [95 % CI] 1.03-1.26; P = 0.011) and dominant (1.19; 1.04-1.28; 0.011) models, without evidence of heterogeneity (I (2) = 0.0 %). Grouping studies by ethnicity observed marginally significant association for Arg389Gly (0.82; 0.66-1.0; 0.049) and Ser49Gly (1.3; 1.0-1.68; 0.048) polymorphisms in Caucasians under allelic model. Association was strikingly potentiated for both polymorphisms after restricting analyses to studies published in English journals. When only large studies (≥500 subjects) were considered, 389Gly allele decreased the odds of developing hypertension by 16 % (0.84; 0.74-0.95; 0.007). There was no observable publication bias for both polymorphisms. Taken together, our results provide clarification to the logical candidacy of ß1-adrenoreceptor gene in the development of hypertension.

Apocynin attenuates oxidative stress and cardiac fibrosis in angiotensin II-induced cardiac diastolic dysfunction in mice.

AIM: To investigate whether apocynin, a NADPH oxidase inhibitor, produced cardioproteictive effects in Ang II-induced hypertensive mice, and to elucidate the underlying mechanisms. METHODS: C57BL/6 mice were subcutaneously infused Ang II for 4 weeks to mimic cardiac remodeling and fibrosis. Concomitantly the mice were administered apocynin (100 mg·kg(-1)·d(-1)) or/and the aldosterone receptor blocker eplerenone (200 mg·kg(-1)·d(-1)) via gavage for 4 weeks. Systolic blood pressure (SBP) and heart rate were measured, and transthoracic echocardiography was performed. For in vitro study, cardiac fibroblasts were treated with Ang II (10(-7) mol/L) in the presence of apocynin (10(-5) mol/L) or/and eplerenone (10(-5) mol/L). Immunohistochemistry and Western blotting were used to quantify the expression levels of NADPH oxidase and osteopontin (OPN) proteins in the cells. RESULTS: Both apocynin and eplerenone significantly decreased SBP, and markedly improved diastolic dysfunction in Ang II-induced hypertensive mice, accompanied with ameliorated oxidative stress and cardiac fibrosis. In the Ang II-treated cardiac fibroblasts, the expression levels of NOX4 and OPN proteins were markedly upregulated. Both Apocynin and eplerenone significantly suppressed the increased expression levels of NOX4 and OPN proteins in the Ang II-treated cells. In all the experiments, apocynin and eplerenone produced comparable effects. Co-administration of the two agents did not produce synergic effects. CONCLUSION: Apocynin produces cardioproteictive effects comparable to those of eplerenone. The beneficial effects of apocynin on myocardial oxidative stress and cardiac fibrosis might be mediated partly through a pathway involving NADPH oxidase and OPN.

Numerical investigations of influence on thermal conductive heating in DNAPL-impacted soils by heterogeneity.

The treatment of dense non-aqueous phase liquid (DNAPL) source zones is challenging, particularly in heterogeneous media. Thermal conductive heating (TCH) has the potential to treat DNAPL source zones for its ability to enhance mass transfer. This study uses numerical modeling combined with Monte Carlo simulation to examine the influence of heterogeneity of the permeability field on the DNAPL distribution and TCH remediation. It is found that the longer horizontal correlation length of high-permeable clay lens would contribute to accelerate multiphase convection and then heat conduction in horizontal direction. The presence of DNAPL (both in NAPL phase and dissolved), pressure, and permeability are all contributory factors to phase change. Realizations with shorter horizontal correlation lengths always have a larger vertical spreading of DNAPL. As a shallow vapor extraction well was applied in this study, higher TCE removal rate can be obtained in the realizations with a shorter horizontal correlation length when NAPL phase of TCE is existed in the domain.

A Large-Scale Survey on Perceived Risk, Risk Emotions and Humanistic Care Needs Among Nurses During the Covid-19 Pandemic.

Purpose: The purpose of this study is to understand the risk perception, risk emotions and humanistic care needs of nursing staff during the Novel Coronavirus 2019 (Covid-19) pandemic. Methods: A cross-sectional survey was conducted on the perceived risk, risk emotions and humanistic care needs of 35,068 nurses in 18 cities of the Henan Province, China.We collected a total of 35,188 questionnaires, of which 35,068 were effectively returned, with an effective return rate of 99.7%. The collected data were summarized and statistically analyzed using Excel 97 2003 and IBM SPSS software. Results: Nurses' risk perceptions and emotions vary during the covid-19 pandemic. In order to provide nurses with targeted psychological intervention to prevent nurses from suffering from unhealthy mental states.The results show that the total score of the nurses' risk perceptions of Covid-19 was 3.66 ± 0.39, the highest score of nurses' risk perception part is 5 points, and ≥3 points represent high risk and 88.3% of nurses believed that the Covid-19 risk was high. There were significant differences in the nurses' total perceived risk scores for Covid-19 based on gender, age, prior contact with patients with suspected or confirmed Covid-19 and previous participation in other similar public health emergencies (P < 0.050). Of the nurses included in the study, 44.8% had some level of fear relating to Covid-19 and 35.7% were able to remain calm and objective. There were significant differences in the total scores for risk emotions relating to Covid-19 based on gender, age and prior contact with patients with suspected or confirmed Covid-19 (P < 0.050). Of the nurses included in the study, 84.8% were willing to receive humanistic care and 77.6% of these expected to be provided with humanistic care by institutions in the healthcare sector. Conclusion: Nurses with different basic data have different risk cognition and risk emotions. Different psychological needs should be considered, and targeted multi-sectoral psychological intervention services should be provided to help prevent nurses from developing unhealthy psychological states.

The relationship between presenteeism among nurses and patients' experience in tertiary hospitals in China.

This study aims to observe the current situation of nurses' presenteeism and the relationship between presenteeism among nurses and patient perceptions and examine its implications for nursing management. The study design was quantitative, correlational and cross-sectional. The researchers used convenience samples of nurses and patients from five hospitals who agreed to participate in an online survey distributed using Sojump Survey Software. A total of 500 in-service nurses from five tertiary hospitals in Henan Province in China were recruited as the nurse participants. Among them, 433 met the inclusion criteria and completed the general information questionnaire and the presenteeism scale. Patients who were hospitalised for three days or more and were cared for by one or more nurse participants were included in the study. In total, 435 patient participants answered the Inpatient Experience Questionnaire. The responses collected from both groups were analysed using descriptive and inferential statistics.Nurses' presenteeism was a key factor that affected patient experience. Presenteeism among nurses is a common phenomenon. Although patients' experience was overall positive, there is still room for improvement. Reducing presenteeism among nurses is crucial for improving patient experience, creating harmonious nurse-patient relationships and sharing a common mission.

UV filter ethylhexyl salicylate affects cardiovascular development by disrupting lipid metabolism in zebrafish embryos.

Ethylhexyl salicylate (EHS) is an organic UV filter commonly used in sunscreens to protect people from the UV radiation. The widespread use of EHS will enter the aquatic environment along with human activities. EHS readily accumulates in adipose tissue as a lipophilic compound, but its toxic effects on lipid metabolism and cardiovascular system of aquatic organisms have not been studied. This study investigated the effects of EHS on lipid metabolism and cardiovascular development during zebrafish embryogenesis. The results showed that EHS caused defects such as pericardial edema, cardiovascular dysplasia, lipid deposition, ischemia, and apoptosis in zebrafish embryos. In addition, qPCR and whole-mount in situ hybridization (WISH) results indicated that EHS treatment significantly altered the expression of genes related to cardiovascular development, lipid metabolism, erythropoiesis, and apoptosis. The hypolipidemic drug rosiglitazone was able to alleviate the cardiovascular defects caused by EHS, indicating that EHS affected cardiovascular development by disrupting lipid metabolism. In addition, severe ischemia caused by cardiovascular abnormalities and apoptosis were observed in the EHS-treated embryos, which was likely to be the main cause of embryonic mortality. In conclusion, this study shows that EHS has toxic effects on lipid metabolism and cardiovascular formation. Our findings provide new evidence for assessing UV filter EHS toxicity and contribute to raising awareness of the safety risks of EHS.

Patient satisfaction with humanistic nursing in Chinese secondary and tertiary public hospitals: a cross-sectional survey.

Background: Humanistic care pertains to the abilities, attitudes, and behaviors central to patient-centered care, contributing to patients' sense of safety and wellbeing. This study aimed to assess the satisfaction of patients with humanistic nursing care in Chinese secondary and tertiary public hospitals. Methods: A national cross-sectional survey was conducted across 30 provinces and 83 hospitals in China. Patient satisfaction with humanistic care was assessed using the Methodist Health Care System Nurse Caring Instrument (NCI), which encompasses 20 items across 12 dimensions. Each item was rated on a 7-point Likert scale, yielding a total score of 140. Multiple linear regression analysis was employed to identify factors associated with patients' satisfaction. Results: Moderate satisfaction (mean score 91.26 ± 13.14) with humanistic nursing care was observed among the 17,593 participants. Factors significantly associated with patient satisfaction included age, hospital type, presence of children, educational attainment, place of residence, family monthly income, and medical insurance type. Conclusion: The study findings highlight the importance of tailored interventions, evidence-based practice guidelines, and patient-centered care in improving patients' satisfaction with humanistic nursing care. Continuous emphasis on nursing education and professional development is crucial for enhancing humanistic care and patient satisfaction.

Vinpocetine suppresses pathological vascular remodeling by inhibiting vascular smooth muscle cell proliferation and migration.

Abnormal vascular smooth muscle cell (SMC) activation is associated with various vascular disorders such as atherosclerosis, in-stent restenosis, vein graft disease, and transplantation-associated vasculopathy. Vinpocetine, a derivative of the alkaloid vincamine, has long been used as a cerebral blood flow enhancer for treating cognitive impairment. However, its role in pathological vascular remodeling remains unexplored. Herein, we show that systemic administration of vinpocetine significantly reduced neointimal formation in carotid arteries after ligation injury. Vinpocetine also markedly decreased spontaneous remodeling of human saphenous vein explants in ex vivo culture. In cultured SMCs, vinpocetine dose-dependently suppressed cell proliferation and caused G1-phase cell cycle arrest, which is associated with a decrease in cyclin D1 and an increase in p27Kip1 levels. In addition, vinpocetine dose-dependently inhibited platelet-derived growth factor (PDGF)-stimulated SMC migration as determined by the two-dimensional migration assays and three-dimensional aortic medial explant invasive assay. Moreover, vinpocetine significantly reduced PDGF-induced type I collagen and fibronectin expression. It is noteworthy that PDGF-stimulated phosphorylation of extracellular signal-regulated kinases 1/2 (ERK1/2), but not protein kinase B, was specifically inhibited by vinpocetine. Vinpocetine powerfully attenuated intracellular reactive oxidative species (ROS) production, which largely mediates the inhibitory effects of vinpocetine on ERK1/2 activation and SMC growth. Taken together, our results reveal a novel function of vinpocetine in attenuating neointimal hyperplasia and pathological vascular remodeling, at least partially through suppressing ROS production and ERK1/2 activation in SMCs. Given the safety profile of vinpocetine, this study provides insight into the therapeutic potential of vinpocetine in proliferative vascular disorders.

Angiotensin-converting enzyme gene deletion allele increases the risk of left ventricular hypertrophy: evidence from a meta-analysis.

Large panels of studies have examined the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and risk for left ventricular hypertrophy (LVH), yet with inconclusive results. We therefore sought to evaluate this association via a comprehensive meta-analysis. A random-effects model was applied irrespective of between-study heterogeneity. Data and study quality were independently assessed by two investigators. Total 52 studies encompassing 3,663 case-patients and 8,953 controls were meta-analyzed. Overall results indicated that carriers homozygous for DD genotype conferred 1.59 times (95 % confidence interval [95 % CI]: 1.31-1.92; P < 0.0005) more likely to develop LVH compared with those with II genotype, accompanying moderate evidence of heterogeneity (I (2) = 49.0 %). In subgroup analyses by ethnicity, DD homozygotes had a 90 % (95 % CI: 1.42-2.53; P < 0.0005) increased risk in East Asians, but merely a 33 % (95 % CI: 1.03-1.73; P = 0.032) increased risk in Caucasians. Moreover, differences in source of controls, cutoff for the definition of hypertension, and diagnostic method of LVH were also regarded as potential sources of heterogeneity. Further, the risk estimate associated with D allele was more pronounced in studies involving males (odds ratio [OR] = 1.47; 95 % CI: 1.2-1.8; P < 0.0005) and untreated subjects (OR = 1.39; 95 % CI: 1.2-1.62; P < 0.0005). The magnitude of publication bias was greatly improved in homozygous subgroups. Taken together, our results demonstrated significant association of ACE gene I/D polymorphism with LVH risk, especially in East Asians, and this association was more pronounced in studies involving males and untreated subjects.

Analysis and Review of the Countermeasures Required for Medical Staff's Cognition of Relevant Laws and Regulations in the Coronavirus 2019 Context.

Background: Novel coronavirus 2019 (COVID-19) infections are highly contagious and have spread worldwide. Healthcare workers must understand the laws and regulations related to major public health emergencies to work effectively within this environment. Through investigation and analysis, a review was conducted to help gain a better understanding of a Level-1 response to public health events and the relevant laws and regulations applicable to medical staff. Based on the results, this study formulated measures for working in the current COVID-19 healthcare context. Methods: A total of 42,490 medical personnel in 18 cities in Henan Province (China) were reviewed and analysed using the convenience sampling method. A questionnaire was employed to address two areas of cognitive status quo (25 items), ie, "general information" and "major public events and rules of the law". Results: More than 90% of medical staff had a good understanding related to knowledge about prevention and control in the pandemic context, as well as their due diligence and legal responsibility for controlling the pandemic and preventing others from being infected. However, 3.47-32.61% of medical staff still had a minimal understanding of a Level-1 response to public health events and its relevant laws and regulations. Conclusion: The response to public health events required strengthening at all levels through promotion and education, by implementing an optimised treatment system and establishing an improved legal mechanism for the treatment of major conditions, such as hierarchical, stratified and triaged infectious diseases.

Patient satisfaction with nurses' care is positively related to the nurse-patient relationship in Chinese hospitals: A multicentre study.

Background: The nurse-patient relationship and nursing care satisfaction are important factors that represent whether patients experience the care they expect from nurses. However, research is lacking on the relationship between nursing staff and patients, and the correlation between nursing care satisfaction and relationship care in China. Therefore, this study aimed to explore the correlation between the nurse-patient relationship and patients' satisfaction with nursing care, to form a basis for corresponding intervention measures. Methods: A total of 29,108 patients from 107 hospitals in 30 provinces/municipalities in China completed a general information questionnaire, the Nursing Care Satisfaction Scale, and Relational Care Scale. Results: The average nurse-patient relational care scale score was 4.38 ± 0.57, and the average patients' satisfaction with nursing care scale score was 5.40 ± 0.86. Nursing care satisfaction score was significantly related to differences among patients in different age, gender, marital status, education level, occupation, residence, family per capita monthly income, type of medical insurance, medical department, and regional patient characteristics. The correlation analysis showed that the total nurse-patient relational care score and its three dimensions of caring, trust, and professional ethics correlated positively with nursing care satisfaction scores. The multiple linear regression analysis showed that patients' age, marital status, region, department, income, type of medical insurance and the caring, trust, and professional ethics dimensions of relational care predicted nursing care satisfaction. Conclusion: Enhancing nurse-patient relational care improves nursing care satisfaction, reduces nurse-patient disputes, promotes early rehabilitation of patients, and ensures patient safety.

The genetic architecture of phenotypic diversity in the Betta fish (Betta splendens).

The Betta fish displays a remarkable variety of phenotypes selected during domestication. However, the genetic basis underlying these traits remains largely unexplored. Here, we report a high-quality genome assembly and resequencing of 727 individuals representing diverse morphotypes of the Betta fish. We show that current breeds have a complex domestication history with extensive introgression with wild species. Using a genome-wide association study, we identify the genetic basis of multiple traits, including coloration patterns, the "Dumbo" phenotype with pectoral fin outgrowth, extraordinary enlargement of body size that we map to a major locus on chromosome 8, the sex determination locus that we map to dmrt1, and the long-fin phenotype that maps to the locus containing kcnj15. We also identify a polygenic signal related to aggression, involving multiple neural system-related genes such as esyt2, apbb2, and pank2. Our study provides a resource for developing the Betta fish as a genetic model for morphological and behavioral research in vertebrates.