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Game-based teaching strategies enrich nursing education by enhancing the appeal and practicality of teaching activities. Different from the high-pressure and serious nature of traditional nursing education, interactive and entertaining teaching strategies that employ board games, card games, escape rooms, virtual reality, scratch cards, Kahoot quiz competitions, and other innovative methods better motivate learners to engage actively with learning content and retain nursing knowledge and practices, resulting in better learning outcomes. Game-based teaching strategies not only strengthen learners' mastery of core nursing concepts but also enhance their decision-making and criticalthinking abilities. In this article, practical applications of game-based teaching are introduced, in hopes that, by applying these instructional approaches, educators can alleviate the stress of the learning process and make learning more efficient and enjoyable for students. [ABSTRACT FROM AUTHOR]

Objectives: Social exchange theory (SET) explores social exchange behavior. Electronic medical record (EMR) exchange includes social exchange behaviors and knowledge sharing behaviors. This study used SET as the theoretical foundation and explored the mediating effect of physicians' knowledge sharing behavior on SET factors and physicians' intent to exchange cross-hospital EMRs. Methods: A total of 260 questionnaires were distributed to the physicians of a medical center in southern Taiwan and 220 were returned, yielding a response rate of 84.62%. The data were analyzed with the partial least squares method. The Sobel test was used to determine the mediating effect. Results: Commitment, dependence and reciprocity, and communication had a positive effect on knowledge sharing behavior. Dependence and reciprocity had a positive effect on the intent to exchange cross-hospital EMRs. Knowledge sharing behavior had a mediating effect on commitment, dependence and reciprocity, and the intent to exchange cross-hospital EMRs. Conclusions: Commitment and dependence and reciprocity can enhance physicians' intent to exchange cross-hospital EMRs by increasing knowledge sharing behavior. This study suggested that conferences, a cloud platform for professional knowledge, and a community of knowledge can increase physicians' knowledge sharing behavior, and enhance the performance of cross-hospital EMR exchange to improve work efficiency and the quality of health care. [ABSTRACT FROM AUTHOR]

Many technology developments hold the potential to improve the quality of life of people and make life easier and more comfortable. New technologies have been well accepted by most people. Information sharing in particular is a major catalyst of change in our current technology-based society. Technology has widely innovated life and drastically changed lifestyles. The Technology Acceptance Model (TAM), a model developed to address the rapid advances in computer technology, is used to explain and predict user acceptance of new information technology. In the past, businesses have used the TAM as an assessment tool to predict user acceptance when introducing new technology products. They have also used external factors in the model to inluence user perceptions and beliefs and to ensure the successful spread of new technologies. Informatization plays a critical role in healthcare services. Due to the rapid aging of populations and upward trends in the incidence of chronic illness, requirements for long-term care have increased in both quality and quantity. Therefore, there has been an increased emphasis on integrating healthcare and information technology. However, most elderly are signiicantly less adept at technology use than the general population. Therefore, we reexamined the effect that the essential concepts in a TAM exerted on technology acceptance. In the present study, the technology acceptance experience with regard to telehealth of the elderly was used as an example to explain how the revised technology acceptance model (TAM 2) may be effectively applied to enhance the understanding of technology care among nurses. The results may serve as a reference for future research on healthcare-technology use in long-term care or in elderly populations. [ABSTRACT FROM AUTHOR]

Background: Insulin therapy is critical in the care of diabetes patients. The insulin pen has become popular due to its convenience and simplicity of implementation. Effective education methods are necessary to improve patient competence and compliance in using the insulin pen. Purpose: This study studies the comparative efficacy of using a multimedia CD-ROM and using a traditional insulin pen injection on injection competency, teaching time, blood glucose control, and patient satisfaction. Methods: A quasi-experimental design was conducted. Subjects were divided into the experimental group (multimedia CD-ROM) and the control group (traditional education group), with 40 subjects in each group. Results: Our study showed no significant difference between the two groups in terms of injection competency, blood glucose control, and glycosylated hemoglobin (HbA1C). However, experimental group patients indicated higher satisfaction (t = -16.765, p = .000) than their control group peers. In addition, the multimedia CD-ROM education significantly reduced the time spent on health education by nurses (t = 3.60, p = .001). Conclusions: In light of the current nursing shortage and the heavy workloads of nurses, using multimedia CDROMs for patient education is not only cost-effective but also may improve patient satisfaction. Healthcare institutions may use the findings of this study to plan patient education related to insulin-pen injections. [ABSTRACT FROM AUTHOR]

Background: Several different questionnaires have been used to assess employee work attitudes and performance, with job satisfaction the most commonly used indicator. Chinese-version questionnaires able to assess work attitudes and performance in nursing still await development. This study evaluated the validity and reliability of Chinese versions of, respectively, work excitement (WE) and work frustration (WF) questionnaires originally developed by Erbin-Roesemann and Simms. The authors hope the Chinese-version WE and WF may be broadly applied in Taiwan as valid nursing and management research tools. Purpose: This study examined the reliability and validity of work excitement and work frustration in measuring factors that positively / negatively influence the work attitudes of nursing professionals in Taiwan. Methods: Chinese-version WE and WF questionnaires were back translated into English to assess validity. The authors recruited 887 nursing professionals from a hospital in southern Taiwan as participants. Factor analysis assessed internal reliability and construct validity. Results: In the Chinese version of the WE questionnaire, factor analysis identified the 3 factors of (1) usage and development of professional skills, (2) acquisition and development of knowledge, and (3) challenge and variation of the job. These three explained 72.12% of total variance; the Cronbach's α value was .93. Factor analysis of the Chinese version of the WF questionnaire identified the 3 factors of (1) interpersonal relationships, (2) resource application, and (3) work management. These three explained 65.27% of total variance; the Cronbach's α was .93. Conclusion: Examination of Chinese-version WE and WF questionnaires demonstrated high reliability and validity. These two questionnaires are valid for use in measuring positive and negative influences in clinical practice and appear applicable to all nursing staff levels. This result may be referenced in the future design of clinical nursing care models. [ABSTRACT FROM AUTHOR]

With the emergence of and competition between engravings and written copies in the printing business, the popularity of bibliographical information and the dissemination of knowledge had advanced and diversified greatly in the Song Dynasty. Moreover, it not only influenced the way people read, learned, wrote, and criticized, but also reshaped aesthetic tastes and the academic milieu. As a branch of discursive meta-poetry, poetic meta-poetry exemplified such an influence. The first thirty volumes of The Oeuvre of Song Poetry, comprising ninety two different subjects and one hundred thirty one poetry-oriented meta-poems in forty schools, epitomized the reading acceptance, aesthetic taste, and poetic canon of the Song Dynasty, and how Song people turned the wisdom of antiquity into their own. Regarding reading tendencies, Bai Juyi, Han Yu, and late Tang Dynasty poets were popular among the Northern Song poets. Consequently, the poetic style of the Song is actually derived from the emulation of Tang poetry. Although there was a profusion of poets reading Li Bai's work, they were mostly reading with the intention of comparing Li's poems with those of Du Fu. Tao Yuanming and Du Fu were renowned for their dignity and poetic beauty, which appealed to the expectations of Song people. Hence they were revered in the classic canon of Song poetry. So it is not a surprise that the engraving poetry collections of both Tao and Du flooded into the market at the end of the Song Dynasty. While examining Northern Song poetry-oriented meta-poetry, one can notice that the reading tendencies and aesthetic acceptance of poets is of great value for those wishing to study the theory of Song poetry. [ABSTRACT FROM AUTHOR]

Objective Aldosterone-producing adrenocortical carcinoma(ACC) is an uncommon disease.In this paper, the genetic mutations of aldosterone-producing ACC are studied by whole-exome sequencing. Methods Clinical data of the patient with aldosterone-producing ACC were collected. DNA was extracted from paraffin-embedded tissues and peripheral blood, then the whole-exome sequencing was carried out to identify germline and somatic mutations. Results There was no mutation associated with hereditary adrenocortical tumors and familial hyperaldosteronism in peripheral blood DNA. A total of 349 somatic mutations were found in tumor tissues, which were mainly enriched in tumorigenesis and calcium signaling pathways. Mutations related to the growth of adrenocortical tumor, CTNNB1, CDKN2A and MSH6, were detected, while no mutation related to aldosterone synthesis as KCNJ5, ATP1A1, ATP2B3 and CACNA1D was found in the tumor tissue. Conclusions The tumor- igenesis of aldosterone-producing ACC is related to CTNNB1, CDKN2A and MSH6, but the mechanism of promoting aldosterone production is still uncertain.

Based on the detailed observations of the whole core, bulk of organic geochemical analysis, and combined with regional geological characteristics, the evolution of depositional environments and enrichment pattern of organic matter of mudstone of the Meihe Formation in the Meihe Basin was studied, and this will be enriched the theory of oil shale and coal metallogenic mechanism of the Meihe Basin. Three types of sedimentary facies were identified in the Meihe Formation including alluvial fan, fan-delta and lake facies. Mid-fan subfacies of alluvial fan is developed in the bottom of Sandy-Conglomerate Member, and fan delta deposited in the Lower Coal-bearing Member. In the middle Mudstone Member, the mainly depositional environment is semi deep-deep lake. Lacustrine bog and shallow lake are developed in the Upper Coal-bearing Member and the Green-rock Member separately. It should be noted that, oil shale developed in the semi deep to deep lake, and coal layers deposited in the swamp. The organic matter content in mud-stone shows a decreasing trend after increasing upward, meanwhile the type of kerogen changes from type III to II2 and II1, then becomes to type III, and this caused the organic facies changes from E to A, and becomes E finally. Comprehensive studies show that, the base level, depositional environment evolution, organic matter supply and preservation conditions caused by tectonic and paleoclimate evolution result in different types and abundance of organic matter in mudstone. Due to the limit terrestrial debris supply, good preservation condition and explosion of higher plants, it is favorable for coal seam to occur in the stable shallow water area in the mid-stage of initial subsidence and the beginning of the basin shrinkage stage. While with the high lake productivity and good preservation conditions, oil shale deposited in the stable deep water area during the largest basin subsidence stage. [ABSTRACT FROM AUTHOR]

Clay mineral and inorganic geochemical characteristics of Eocene Huadian formation in Huadian basin have been found through X-ray diffraction, scanning electron microscopy and inorganic geochemical element tests. Clay minerals of Huadian formation of the study area contain montmorillonite, kaolinite and illite. The content of montmorillonite is the highest, and illite/smectite mixed layer is rare. Mn, Sr, P, Cd, Sr/Cu, B/Ga, Sr/Ba and Ca/(Ca+Fe) change with an exactly similar trend vertically, and Cu, Cs, Rb/Sr, V/(V+Ni) and 8Ce change with another similar trend. Clay minerals and inorganic geochemical evidence reveal the characteristics of paleoclimate and paleolimnology:the upper section containing coal and the lower section containing pyrite of Huadian formation belong to terrestrial sedimentary environment under the condition of warm and humid climate and low salinity ; the middle section containing oil shale belongs to frequently alternating freshwater and saltwater environment, alternating humid and drought climate. The largest expansion phase of lacustrine basin which was under reduction condition with alternating humid and drought climate and salinity stratification developed semi-deep lake and deep lake facies which formed oil shale; the shrinkage phase of lacustrine basin with warm and humid climate developed delta plain with peat swamp which formed coal. [ABSTRACT FROM AUTHOR]

The DNA fragment encoding β-hexosaminidase was synthesized, and cloned into pET-28a vector. The constructed plasmid pMD18-T-β-hexosaminidase was transformed into E. coli Top 10 and followed by expression of the protein induced by IPTG. SDS-PAGE result showed that the relative molecular mass of the recombinant protein was about M, 55 000. The full length of β-hexosaminidase gene was 1 410 bp. Bioinformatics analysis revealed that β-hexosaminidase was composed with 469 amino acid residues with a calculated molecular weight of Mr 55,000, and its secondary structure was composed of strand (14.71%), helix (30.70%), and loop (54.58%). β-hexosaminidase was a hydrophilic protein without signal peptide, and located in the extracellular space.

Objective: To detect the percentage of Th17 cells in spleen and IL-17 level in bronchoalveolar lavage fluid in Dermatophagoides farinae allergic asthma mice., Methods: Twenty BALB/c mice were randomly divided into control group (n=10) and asthma group (n=10). Mice in control group were treated with PBS plus 2 mg Al(OH)3 and those in asthma group were sensitized with 200 µl solution [50 µg Dermatophagoides farinae crude extracts plus 2 mg Al (OH)3] on day 0, 7 and 14. One week after the last sensitization, all mice were intranasally challenged with 50 µg Dermatophagoides farinae crude extracts daily for 7 days. Twenty-four hours after the last challenge, mice were sacrificed. The sera, bronchoalveolar lavage fluid (BALF) and spleens were collected. The serum levels of IgE and IgG1, and IL-17 level in BALF were determined by ELISA. The percentage of Th17 cells in spleen was tested by flow cytometry., Results: The serum levels of IgG, and IgE in asthma group were (0.10 ± 0.01) pg/ml and (1.15 ± 0.10) pg/ml, respectively, which were higher than that of the control [(0.06 ± 0.01) pg/ml and (0.04 ± 0.01) pg/ml] (P < 0.05). IL-17 level in asthma group (85.13 ± 2.36) pg/ml was higher than that of the control [(48.27 ± 4.14) pg/ml] (P < 0.01). The percentage of Th17 cells in asthma group [(5.19 ± 0.68)%] was also higher than that of the control [(0.95 ± 0.19)%] (P < 0.01). Meanwhile, the percentage of Thl7 cells in spleen was positively correlated with IL-17 level in BALF (r = 0.851, P < 0.01)., Conclusion: Compared with healthy mice, both the percentage of Th17 cells in spleen and IL-17 level in BALF have increased significantly in Dermatophagoides farinae allergic asthma mice.

Objective: To observe the instant effect of "Balance Acupuncture" in relieving sore throat in patients with acute pharyngitis., Methods: A total of 74 acute pharyngitis patients with sore throat were randomly assigned to treatment group (Balance Acupuncture, n = 36) and placebo acupuncture group (sham acupoint, n = 38). Patients of the Balance Acupuncture group were treated by acupuncture stimulation of bilateral "Yantong" (sore throat) point (the mid-point of the second metacarpal bone on the radial side) and those of the sham acupoint group were treated by acupuncture stimulation of the sham point (the site 1 cm lateral to the mid-point between the ulnar endpoint of the cubic transverse striation and that of the wrist-palm transverse striation). After insertion, the acupuncture needle was manipulated repeatedly till "Deqi" for patients of the treatment group but not manipulated for patients of the placebo acupuncture group, then removed immediately. The VAS (Visual Analogue Scores) were assessed 1 min after the treatment in addition to safety index records., Results: Before the treatment, the VAS values of the treatment group and sham acupoint group were (5.25 +/- 1.51) points and (4.83 +/- 1.59) points, respectively, which had no significant differences between the two groups (P > 0.05). One minute after the treatment, VAS values of the treatment and sham acupoint groups were (2.11 +/- 1.88) points and (3.39 +/- 1.94) points, respectively, both decreasing significantly (P < 0.01). The effect of the former group was significantly superior to that of the sham acupoint group (P < 0.05)., Conclusion: Both Balance Acupuncture and sham-acupoint acupuncture treatments can relieve sore throat in acute pharyngitis patients, and the therapeutic effect of Balance Acupuncture treatment is obviously better.