Exosomal-miR-522-3p derived from cancer-associated fibroblasts accelerates tumor metastasis and angiogenesis via repression bone morphogenetic protein 5 in colorectal cancer.

BACKGROUND: Colorectal cancer (CRC) is a gastrointestinal tract malignancy. Exosomes secreted by cancer-associated fibroblasts (CAFs) are reported to participate in tumor progression by delivering noncoding RNA or small proteins. However, the function of exosomal miR-522-3p in CRC remains unclear. METHODS: CAFs were derived from tumor tissues, and exosomes were identified by western blot or TEM/NTA and originated from CAFs/NFs. The viability, invasion, and migration of HUVECs and CRC cells was examined using MTT, Transwell, and wound healing assays, respectively. The molecular interactions were validated using dual luciferase reporter assay and RIP. Xenograft and lung metastasis mouse models were generated to assess tumor growth and metastasis. RESULTS: Exosomes extracted from CAFs/NFs showed high expression of CD63, CD81, and TSG101. CAF-derived exosomes significantly increased the viability, angiogenesis, invasion, and migration of HUVECs and CRC cells, thereby aggravating tumor growth, invasion, and angiogenesis in vivo. miR-522-3p was upregulated in CAF-derived exosomes and CRC tissues. Depletion of miR-522-3p reversed the effect of exosomes derived from CAFs in migration, angiogenesis, and invasion of HUVECs and CRC cells. Furthermore, bone morphogenetic protein 5 (BMP5) was identified as a target gene of miR-522-3p, and upregulation of BMP5 reversed the promoting effect of miR-522-3p mimics or CAF-derived exosomes on cell invasion, migration, and angiogenesis of HUVECs and CRC cells. CONCLUSION: Exosomal miR-522-3p from CAFs promoted the growth and metastasis of CRC through downregulating BMP5, which might provide new strategies for the treatment of CRC.

Managing the quality of primary health care in urban China: the impact of organizational and physician features.

BACKGROUND: Global health care quality improvement efforts have focussed on management practices. However, knowledge in primary care settings, especially in developing countries, such as China, is lacking. OBJECTIVE: To examine the organizational and physician features associated with health care quality in China's community health centres (CHCs). METHODS: We conducted a cross-sectional survey of 224 primary care physicians (PCPs) in 38 CHCs in Jinan, Tianjin, Shenzhen, and Shanghai. Clinical and prevention care quality with a 5-level scale (1 = never, 5 = always) reported by the PCPs were used to measure the quality of care. Two-level hierarchical linear models were estimated to examine the organization and physician-level variables associated with primary care quality. RESULTS: The average clinical care quality score was 4.08 and 3.59 for preventative care out of 5. At the organizational level, organizational culture and organizational support were the strongest predictors of physician-reported quality of care. At the physician level, professional fulfilment, psychological safety, and organizational citizenship behaviour were positively associated with care quality. CONCLUSIONS: Chinese CHCs clinical quality ranked high by PCPs, but the quality of preventative care provision required improvement. To improve primary care quality, managers of CHCs should implement optimal organizational structures, supportive organizational cultures, and strong organizational support at the organization level and cultivate high professional fulfilment, safe, and trustful relationships with colleagues at the physician level.

Subhealth Status of Nursing Staff and Its Influencing Factors in Shaanxi Province.

Background: The concept of subhealth, defined as a state between health and illness characterized by diminished vitality and adaptability, is emerging as a significant concern, particularly among nursing staff. In Shaanxi Province, there is a notable prevalence of subhealth conditions among nurses, influenced by various factors, including lifestyle, work environment, and psychological stress. Purpose: This study aims to investigate the level of subhealth status among nursing staff in Shaanxi hospitals, identify the primary causes and risk factors affecting their subhealth, and propose relevant countermeasures. The goal is to provide a scientific basis for developing strategies to enhance nursing staff's physical and mental well-being. Methods: A comprehensive questionnaire survey was conducted among 1068 nursing staff members from different hospitals in Shaanxi Province. The survey assessed various dimensions of subhealth, including physical, psychological, and social aspects. Data were analyzed to determine the relationships between subhealth status and factors like exercise frequency, dietary habits, smoking and alcohol consumption, occupational injuries, work situation, and stress levels. Results: Most respondents were female, aged between 21 and 40 years. The study found no significant gender-related differences in subhealth scores. Key factors affecting subhealth included physical exercise, dietary habits, occupational stress, and work conditions. The data revealed higher physical subhealth but lower psychological subhealth among nursing staff compared to regional norms. Notable relationships were observed between lifestyle choices, work-related factors, and the subhealth status of nursing staff. Conclusion: The subhealth status of nursing staff in Shaanxi hospitals is influenced by a combination of lifestyle, occupational, and psychological factors. The study underscores the need for targeted interventions focusing on lifestyle modifications, stress management, and improved work conditions to enhance the overall health status of nursing staff. This research provides valuable insights for healthcare policymakers and administrators to develop effective strategies for managing subhealth conditions among nursing professionals.

Low-Power Magnetic Displacement Sensor Based on RISC-V Embedded System.

With the emergence of RISC-V architecture in embedded devices, its inherent low-power features have propelled its extensive adoption across various industrial settings. Displacement sensors leveraging Hall sensors and magnetic flux measurement present notable benefits including cost-effectiveness and compact design. This study undertakes the porting of Hall sensors onto RISC-V architecture embedded devices, validating their functionality within displacement sensors. Empirical investigations substantiate that the ported system consistently delivers comparable outcomes to those obtained from x86 architecture systems employing PM-MFM methods, affirming its reliability and performance in practical applications.

Impact of narrative nursing cognition, self-efficacy, and social support on the practices of registered nurses in China: a structural equation modeling analysis.

BACKGROUND: Narrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive. DESIGN: This was an observational, cross-sectional study using convenience sampling method. METHODS: After obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established. RESULTS: The score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (ßsocial support = 0.08, P < 0.001; ßattitude = 0.54, P < 0.001) and indirectly influence it via self-efficacy (ßsocial support = 0.04, P < 0.001; ßattitude = 0.06, P < 0.001). In addition, narrative nursing knowledge (ß = 0.08, P < 0.001) and the nurses' growth environment (ß=-0.06, P < 0.001) also affected the practice of narrative nursing. CONCLUSION: Narrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices.

Organisation-level and individual-level predictors of nurse-reported quality of care in primary care: A multilevel study in China.

OBJECTIVES: Knowledge of the predictors of nursing quality and safety remains a gap in global primary care research. This study examines organisational-level and nurse-level predictors of nurse-reported quality of care from a management perspective. METHODS: We recruited 175 primary care nurses in 38 community health centres (CHCs) varying by size and ownership in Jinan, Tianjin, Shenzhen and Shanghai. Guided by the Systems Engineering Initiative for Patient Safety model, the organisation-level predictors comprised organisational structure, organisational culture, psychological safety and organisational support, while the nurse-level predictors included organisational commitment and organisational citizenship behaviour. Nurse-reported quality of care was measured by two questions: "How do you rate the quality of care that you provide?" and "Do you often receive complaints from patients or their family members at work?" Multilevel linear regression models were used to examine the predictors of nurse-reported quality of care. RESULTS: Among the four organisation-level predictors, organisational structure, psychological safety and organisational support were positive predictors of nurse-reported quality of care. Nurses working in CHCs with highly hierarchical organisational structures (Coef. = 0.196, p = 0.000), a high level of organisational support (Coef. = 0.158, p = 0.017) and a high level of psychological safety (Coef. = 0.159, p = 0.035) were more likely to report high quality of care or less likely to receive medical complaints. In terms of nurse-level predictors, nurses willing to increase their knowledge through continuous education were more likely to report good quality of care (Coef. = 0.107, p = 0.049) and less likely to receive medical complaints from patients (Coef. = 0.165, p = 0.041). CONCLUSIONS: Potential management levers to improve quality of nursing care include formalised organisational structures, strong organisational support and a psychologically safe environment as well as the provision of training to facilitate continuous education. Implementing these recommendations is likely to enhance the nursing quality in primary care.

Clinical Features and Blood Indicators for Severity and Prognosis in COVID-19 Patients.

BACKGROUND: This study aimed to analyze the clinical manifestations and blood indicators to deepen the understanding of Coronavirus disease 2019 (COVID-19). METHODS: COVID-19 patients admitted to C10 West Ward, Tongji Hospital in Wuhan City ("West Ward") between January 31 and March 28, 2020, were retrospectively analyzed. RESULTS: A total of 61 COVID-19 patients were hospitalized, wherein the non-critical Group had 30 cases, while the critical group had 31 (including 14 survivors and 17 deaths). Age, the proportion of fever cases, white blood cell (WBC), basophils, red blood cell (RBC), hemoglobin, lactate dehydrogenase (LDH), C-reactive protein (CRP), high-sensitivity troponin, pro-BNP (brain natriuretic peptide), prothrombin time (PT), and D-dimer were higher in the critical group while lymphocytes, eosinophils, albumin were lower compared with those of the non-critical group (all p < 0.05). WBC (p = 0.008), basophils (p = 0.034), and LDH (p = 0.005) of the death subgroup climbed remarkably in comparison with those of the survival subgroup. CONCLUSIONS: Advanced age, high fever, increases in indicators such as WBC, basophils, CRP, LDH, high-sensitivity troponin, pro-BNP, and D-dimer, and decreases in indicators, including lymphocytes, eosinophils, and albumin, might forebode a critical condition.

Satellite Navigation Spoofing Interference Detection and Direction Finding Based on Array Antenna.

Satellite navigation signals are feeble when they reach the ground, so they are vulnerable to attacks from outside interference signals. By emitting spoofing interference signals similar to real satellite signals, spoofing interference can make receivers give wrong navigation, position, and time information, and it is challenging to detect. This seriously affects the safe use of GNSS; therefore, it is essential to identify spoofing interference signals quickly and accurately. In our study, we proposed a novel six-array spoofing-interference-monitoring array antenna, which achieved the detection and identification of spoofing interference sources by monitoring the relevant peaks and combining an airspace-trapping algorithm. Moreover, we quickly accomplished our search for the whole circumferential ambiguity by using long- and short-baseline algorithms, which can realize the high-precision detection of spoofing interference sources. To verify this method's accuracy, we conducted outdoor real experiments using a special spoofing interference source, and our experimental results show that our proposed array antenna's directional accuracy for spoofing interference signals is kept within 2°, showing high spoofing interference direction-finding capability.

Nomogram for distant metastasis-free survival in patients with locoregionally advanced nasopharyngeal carcinoma.

OBJECTIVE: To develop and validate a nomogram to predict distant metastasis-free survival of patients with locoregionally advanced nasopharyngeal carcinoma. METHODS: We collected the total clinical data of 820 nasopharyngeal carcinoma (NPC) patients, of whom 482 formed the training cohort from one hospital and 328 made up the validation cohort from another hospital. By analyzing the prognosis of all patients after intensity-modulated radiotherapy by univariate and multivariate Cox regression models, a nomogram related to DMFS was created in the training cohort. The discriminatory and calibration power of the nomogram was successively assessed in the training and validation cohorts by the C­index and calibration curve. The predictive ability for 3­year DMFS was compared between the nomogram and TNM stage using ROC curves. Patients were divided into different risk groups based on scores calculated from the nomogram. RESULTS: Age, lymph node gross tumor volume (GTVnd), and gross tumor volume of the nasopharynx (GTVnx) were the factors included in the nomogram. The C­index of the nomogram was 0.721 in the training cohort and 0.750 in the validation cohort. The calibration curves were satisfactory. Patients in the high-risk group were more likely to develop metastases. CONCLUSION: A nomogram incorporating age, GTVnd, and GTVnx showed good performance for predicting DMFS in patients with locoregionally advanced NPC.

Public expectations of good primary health care in China: a national qualitative study.

BACKGROUND: China is currently making efforts to transform the current hospital-centric service delivery system to people-centred primary health care (PHC)-based delivery system, with service delivery organized around the health needs and expectations of people. To help direct China's PHC reform efforts, a profile of high-quality PHC from the public's perspective is required. OBJECTIVES: To profile high-quality PHC from the perspective of the Chinese public. METHODS: Semistructured interviews were conducted in 6 provinces (Henan, Shandong, Zhejiang, Shaanxi, Shanxi, and Heilongjiang) in China. In total, 58 interviewees completed the recorded interview. For transcription, trained research assistant listened to the recording of the interviews, summarizing each 30-s segment in English. Next, thematic analysis was performed on the narrative summaries to identify thematic families. RESULTS: Seven themes and 16 subthemes were generated from the analysis of our interview data. In order of their frequency, the interviewees expressed a high expectation for interpersonal communication and technical quality; followed by access, comprehensive care, cost, continuity, and coordination. CONCLUSIONS: Using qualitative data from 6 provinces in China, knowledge was generated to reveal the public's views and expectations for high-quality PHC. Our results confirm the urgent need for quality improvement efforts to improve patient experience and technical quality. The government also needs to further improve the delivery system and medical training programme to better meet public expectation in these areas, especially in establishing an innovative integrated primary care model, and strengthening interpersonal and clinical competency training for family doctors.