Search

Digital transformation becomes the focus of all industries, governments are actively promoting it to increase the welfare of the people in the technological maturity era. Hospitals are highly relevant to people’s lives, and their continuous improvement is necessary. However, the promotion of progress is limited to the hospital culture, management, and health care system, which affects the development of various departments. Through literature review and in-depth interviews with relevant employees who implement electronic medical records and nursing information plans, this study demonstrates that the hospital has experienced many difficulties before reaching the digitization stage. Therefore, the dilemma that the hospital promotes in the digitization stage is all examples of digital transformation. The paper proposes seven digitization strategies: (1) constructing new digital transformation strategies and corresponding system development; (2) re-organize a new hospital culture according to the digital transformation strategy; (3) the hospital management understands and supports the digital transformation; (4) establish a dedicated team for digital transformation; (5) comprehensive process transformation and continuous improvement of user interaction experience; (6) strengthen the ability to use data and drive digital transformation; (7) refrain from regulatory restrictions on medical regulations. &nbsp

Purpose: To investigate the effect of sufentanil on anesthesia in patients undergoing cardiovascular surgery. Methods: The subjects comprised a total of 100 patients who were scheduled to undergo cardiovascular surgery in Taikang Tongji (Wuhan) Hospital from January 2021 to December 2021 and met the inclusion criteria. The eligible patients were assigned in a ratio of 1:1 to receive either remifentanil (control group) or sufentanil (study group) during cardiovascular surgery, with 50 patients in each group. The anesthetic effect of remifentanil and sufentanil was compared. Results: Patients treated with sufentanil experienced a faster onset of anesthesia and a shorter time-lapse before extubation, postoperative spontaneous breathing recovery, and postoperative anesthesia recovery when compared with those administered with remifentanil (p < 0.05). Sufentanil provided more potent pain mitigation for patients undergoing cardiovascular surgery than remifentanil, as shown by the lower visual analogue scale (VAS) scores of patients in the study group (p < 0.05). Patients administered with sufentanil showed better levels of mean arterial pressure (MAP) and oxygen saturation (SpO2) than remifentanil, suggesting better hemodynamic benefits provided by sufentanil (p < 0.01). During cardiovascular surgery performed in this study, sufentanil resulted in a higher safety profile by reducing significantly the incidence of adverse reactions (6 %) than remifentanil (30 %) (p < 0.01). Conclusions: Sufentanil exhibits a better anesthetic effect in patients undergoing cardiovascular surgery than remifentanil. It provides potent pain mitigation, effectively ameliorates patients’ hemodynamic status, and reduces the risk of adverse reactions. Future studies with larger sample sizes are required to validate these findings.

Taiwan is at present encountering both low rates of birth and a maturing populace, prompting decreased open doors for intergenerational contact. Chronic diseases, disability, and dementia are all consequences of physical decline with age. This study aims to investigate the impact of intergenerational learning strategies applied to the elderly sports instruction curriculum on instructors in order to improve and alter this situation. Through action research, instructors continuously reflect on and update the elderly sports instruction curriculum to help students design exercise programs that improve students' stereotypical perceptions of the elderly and promote intergenerational integration by promoting physical and mental health for the elderly. Purposive sampling and action research were used in this study. The subjects of the study were 16 elderly sports instruction curriculum students and one instructor. The primary objective is for students to consider and revise the course material based on elderly feedback. Through triangulation with outside experts, this study will conduct qualitative data analysis. which will also collect feedback and observe how the two generations interact with one another.

Abstract: In this research, we propose that belief in a just world (BJW) can be divided into two distinct beliefs: one addressing the notion that efforts are rewarded, that is, effort-based BJW, and another maintaining that the valence associated with moral character leads to particular consequences, that is, valence-based BJW (e.g., good people are rewarded and bad people are punished). We used culturally relevant proverbs to design measures in German and Chinese. Samples of college students and working adults from both countries were collected to assess the reliability, factor structure, validity, and the nomological consistency of the newly developed measures. Both measures demonstrated strong evidence of the existence of and distinction between effort- and valence-based BJW, and they displayed unique patterns in predicting different variables beyond the effect of personal BJW and BJW for others, which may elucidate the precise justice beliefs related to different phenomena.

The organization of an innovative climate is essential for the development of creativity. This study investigated the impact of an innovative climate on creativity among university teachers in Hebei, China, and examined feedback-seeking behavior as a mediating variable. An intermediary model was built to test the mediating role of feedback-seeking behavior in the relationship between an innovative climate and creativity, using AMOS software to analyze the questionnaire data of 356 university teachers in Hebei. The mediating model consists of three variables, which are an innovative climate, feedback-seeking behavior, and creativity. This study examines the relationship between an innovative climate, feedback-seeking behavior, and creativity among university teachers in Hebei, China. The study found that a positive innovative climate was significantly associated with higher levels of creative teaching and research skills among university teachers in Hebei, and that this relationship was partially mediated by feedback-seeking behavior. In conclusion, this study highlights the crucial role of an innovative climate and feedback-seeking behavior in promoting creativity among university teachers in Hebei and offers practical implications for higher education institutions to cultivate a more innovative and creative culture.

To evaluate if metaphase I (MI) oocytes completing maturation in vitro to metaphase II ("MI-MII oocytes") have similar developmental competence as the sibling metaphase II (MII) oocytes that reached maturity in vivo.Retrospective cohort study.A total of 1124 intracytoplasmic sperm injection (ICSI) cycles from 800 patients at a single academic center between April 2016 and Dec 2020 with at least one MII oocyte immediately after retrieval and at least one sibling "MI-MII oocyte" that was retrieved as MI and matured to MII in culture before ICSI were included in the study.A total of 7865 MII and 2369 sibling MI-MII retrieved from the same individuals were compared for fertilization and blastocyst formation rates. For patients undergoing single euploid blastocyst transfers (n=406), the clinical pregnancy, spontaneous pregnancy loss rate and live birth rate were compared between the two groups.The fertilization rate was significantly higher in MII oocytes than delayed matured MI-MII oocytes (75.9% vs 56.1%, p0.001). Similarly, the blastocyst formation rate was higher in embryos derived from MII oocytes as compared to those from MI-MII oocytes (53.8% vs 23.9%; p0.001). The percentage of euploid embryos derived from MII oocytes was significantly higher than those from MI-MII oocytes (49.2% vs 34.7%; p0.001). Paired comparison of sibling oocytes within the same cycle showed higher developmental competence of the MII oocytes than MI-MII oocytes. However, the pregnancy, spontaneous pregnancy loss and live birth rate after a single euploid blastocyst transfer showed no statistically significant difference between the two groups (65.7% vs 74.1%: 6.4% vs 5.0%: 61.5% vs 70.0%, respectively, MII vs MI-MII group, p0.05).Compared to oocytes that matured in vivo and were retrieved as MII, the oocytes that were retrieved as MI and matured to MII in vitro before ICSI showed lower developmental competence, including lower fertilization, blastocyst formation, and euploidy rates. However, euploid blastocysts from either cohort resulted in similar live birth rates, indicating the MI oocytes with delayed maturation can still be useful even though the overall developmental competence was lower than their in vivo matured counterparts.

PURPOSE To report the efficacy and safety of postoperative adjuvant hepatic arterial infusion chemotherapy (HAIC) with 5-fluorouracil and oxaliplatin (FOLFOX) in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI). PATIENTS AND METHODS In this randomized, open-label, multicenter trial, histologically confirmed HCC patients with MVI were randomly assigned (1:1) to receive adjuvant FOLFOX-HAIC (treatment group) or routine follow-up (control group). The primary end point was disease-free survival (DFS) by intention-to-treat (ITT) analysis while secondary end points were overall survival, recurrence rate, and safety. RESULTS Between June 2016 and August 2021, a total of 315 patients (ITT population) at five centers were randomly assigned to the treatment group (n = 157) or the control group (n = 158). In the ITT population, the median DFS was 20.3 months (95% CI, 10.4 to 30.3) in the treatment group versus 10.0 months (95% CI, 6.8 to 13.2) in the control group (hazard ratio, 0.59; 95% CI, 0.43 to 0.81; P = .001). The overall survival rates at 1 year, 2 years, and 3 years were 93.8% (95% CI, 89.8 to 98.1), 86.4% (95% CI, 80.0 to 93.2), and 80.4% (95% CI, 71.9 to 89.9) for the treatment group and 92.0% (95% CI, 87.6 to 96.7), 86.0% (95% CI, 79.9 to 92.6), and 74.9% (95% CI, 65.5 to 85.7) for the control group (hazard ratio, 0.64; 95% CI, 0.36 to 1.14; P = .130), respectively. The recurrence rates were 40.1% (63/157) in the treatment group and 55.7% (88/158) in the control group. Majority of the adverse events were grade 0-1 (83.8%), with no treatment-related death in both groups. CONCLUSION Postoperative adjuvant HAIC with FOLFOX significantly improved the DFS benefits with acceptable toxicities in HCC patients with MVI.

Antidepressants, while effective in treating depression and anxiety disorders, also induce deficits in sensory (particularly auditory) processing, which in turn may exacerbate psychiatric symptoms. How antidepressants cause auditory signature deficits remains largely unknown. Here, we found that fluoxetine-treated adult female rats were significantly less accurate when performing a tone-frequency discrimination task compared with age-matched control rats. Their cortical neurons also responded less selectively to sound frequencies. The degraded behavioral and cortical processing was accompanied by decreased cortical perineuronal nets, particularly those wrapped around parvalbumin-expressing inhibitory interneurons. Furthermore, fluoxetine induced critical period-like plasticity in their already mature auditory cortices; therefore, a brief rearing of these drug-treated rats under an enriched acoustic environment renormalized auditory processing degraded by fluoxetine. The altered cortical expression of perineuronal nets was also reversed as a result of enriched sound exposure. These findings suggest that the adverse effects of antidepressants on auditory processing, possibly because of a reduction in intracortical inhibition, can be substantially alleviated by simply pairing drug treatment with passive, enriched sound exposure. They have important implications for understanding the neurobiological basis of antidepressant effects on hearing and for designing novel pharmacological treatment strategies for psychiatric disorders.SIGNIFICANCE STATEMENTClinical experience suggests that antidepressants adversely affect sensory (particularly auditory) processing, which can exacerbate patients' psychiatric symptoms. Here, we show that the antidepressant fluoxetine reduces cortical inhibition in adult rats, leading to degraded behavioral and cortical spectral processing of sound. Importantly, fluoxetine induces a critical period-like state of plasticity in the mature cortex; therefore, a brief rearing under an enriched acoustic environment is sufficient to reverse the changes in auditory processing caused by the administration of fluoxetine. These results provide a putative neurobiological basis for the effects of antidepressants on hearing and indicate that antidepressant treatment combined with enriched sensory experiences could optimize clinical outcomes.

Background: The kidney-brain crosstalk has been involved in Alzheimer’s disease (AD) with the mechanism remaining unclear. The anti-aging factor Klotho was reported to attenuate both kidney injury and AD pathologies. Objective: To investigate whether plasma Klotho participated in kidney-brain crosstalk in AD. Methods: We enrolled 33 PiB-PET-positive AD patients and 33 amyloid-β (Aβ)-negative age- and sex-matched cognitively normal (CN) controls from the Chongqing Ageing & Dementia Study (CADS). The levels of plasma Klotho, Aβ, and tau in the cerebrospinal fluid (CSF) were measured by enzyme-linked immunosorbent assay. Results: We found higher plasma Klotho and lower estimated glomerular filtration rate (eGFR) levels in AD patients compared with CN. The eGFR was positively associated with Aβ42, Aβ40 levels in CSF and negatively associated with CSF T-tau levels. Plasma Klotho levels were both negatively correlated with CSF Aβ42 and eGFR. Mediation analysis showed that plasma Klotho mediated 24.96% of the association between eGFR and CSF Aβ42. Conclusion: Renal function impacts brain Aβ metabolism via the kidney-brain crosstalk, in which the plasma Klotho may be involved as a mediator. Targeting Klotho to regulate the kidney-brain crosstalk provides potential therapeutic approaches for AD.

Doublesex (DSX) proteins are members of the Doublesex/mab-3-related (DMRT) protein family and play crucial roles in sex determination and differentiation among the animal kingdom. In the present study, we identified two Doublesex (Dsx)-like mRNA isoforms in the brine shrimp Artemia franciscana (Kellogg 1906), which are generated by the combination of alternative promoters, alternative splicing and alternative polyadenylation. The two transcripts exhibited sex-biased enrichment, which we termed AfrDsxM and AfrDsxF. They share a common region which encodes an identical N-terminal DNA-binding (DM) domain. RT-qPCR analyses showed that AfrDsxM is dominantly expressed in male Artemia while AfrDsxF is specifically expressed in females. Expression levels of both isoforms increased along with the developmental stages of their respective sexes. RNA interference with dsRNA showed that the knockdown of AfrDsxM in male larvae led to the appearance of female traits including an ovary-like structure in the original male reproductive system and an elevated expression of vitellogenin. However, silencing of AfrDsxF induced no clear phenotypic change in female Artemia. These results indicated that the male AfrDSXM may act as inhibiting regulator upon the default female developmental mode in Artemia. Furthermore, electrophoretic mobility shift assay analyses revealed that the unique DM domain of AfrDSXs can specifically bind to promoter segments of potential downstream target genes like AfrVtg. These data show that AfrDSXs play crucial roles in regulating sexual development in Artemia, and further provide insight into the evolution of sex determination/differentiation in sexual organisms.

Renal fibrosis is a hallmark of chronic kidney disease, while efficient therapy against renal fibrosis is still lacking. In this study, we investigated the role of a novel small-molecule compound VCP979 on renal fibrosis and inflammation in a rat model of unilateral ureteral obstruction (UUO). One week after the UUO surgery, rats were administered VCP979 by gavage for one week, and after treatment, magnetic resonance imaging of T1rho mapping and histopathological analysis were performed to evaluate renal fibrosis in vivo and ex vivo. This study showed that treatment with VCP979 effectively reduced renal fibrosis, extracellular matrix accumulation, and alleviated epithelial–mesenchymal transition in UUO rats, as well as improved renal function. In vivo T1rho mapping displayed increased T1rho values in the UUO rats, which was decreased after VCP979 treatment, and a positive correlation was detected between the T1rho values and the percentage of fibrotic area. Moreover, the administration of VCP979 also ameliorated the inflammatory cytokines expression and the infiltration of macrophages in renal tissues. Mechanistically, VCP979 treatment inhibited the activation of p38 mitogen–activated protein kinase, nuclear factor-kappa B, and transforming growth factor-β1/Smads signaling pathways. These results indicated that VCP979 could be an effective therapeutic agent for alleviating renal fibrosis and inflammation in the rat model of UUO via its antifibrotic and anti-inflammatory effects.