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ObjectiveTo explore the chain-mediated role of sense of career benefit and sense of career mission in the mechanism of psychological flexibility’s effect on nurses’ work engagement.MethodsAdopting the convenience sampling method, 1032 nurses in 10 general hospitals in Sichuan Province were surveyed by questionnaires using the General Information Questionnaire, Sense of Occupational Benefit Scale, Sense of Occupational Mission Scale, Psychological Flexibility Scale, and work engagement Scale in August-October 2022, and the model of the chained-mediated effect was constructed and validated.ResultsThe total psychological resilience score of nurses in 10 general hospitals in Sichuan Province was (91.29 ± 17.38), the total score of sense of occupational benefit was (137.85 ± 21.02), the total score of sense of occupational mission was (40.27 ± 7.37), and the total score of work engagement was (34.99 ± 9.80). The total score of nurses’ work engagement was positively correlated with the total scores of psychological elasticity, sense of professional benefit, and sense of professional mission (all P < 0.05). The direct effect of psychological elasticity on nurses’ work engagement was significant, with an effect value of 0.321; the chain mediation effects of occupational benefit and occupational mission as separate mediators and the chain mediation effects of the two were 0.039, 0.032, and 0.062, respectively.ConclusionNurses’ work engagement in 10 general hospitals in Sichuan province is at a medium level, and occupational benefit and occupational mission play a significant role in the mechanism of the psychological elasticity’s effects on nurses’ work commitment, and the chain mediation effect of occupational mission in the mechanism of psychological elasticity is established. The chain mediation effect in the mechanism was established. Managers should pay attention to nurses with low psychological elasticity, improve their sense of occupational benefit, and enhance their sense of occupational mission in order to further promote the enhancement of work engagement.

BackgroundPost-stroke shoulder pain (PSSP) is characterized by shoulder pain on the hemiplegic side, which can limit physical activity in patients with stroke. Acupuncture combined with rehabilitation training (AR) has been widely used in PSSP, but the evidence of its effectiveness is still unclear.ObjectiveThe study aimed to evaluate the effect and safety of AR vs. rehabilitation training (RT) alone on PSSP.MethodsWe searched PubMed, the Cochrane Library, the Chinese Biological Medicine Database (CBM), the Chinese Scientific Journal Database (VIP), China National Knowledge Infrastructure (CNKI), and the WAN FANG database for relevant studies from their inception to February 2022. Only randomized controlled trials (RCTs) comparing the effect of AR with RT alone on PSSP were considered. The primary outcome was shoulder pain. Secondary outcomes included upper limb motor function, activities of daily living (ADL), shoulder range of motion (ROM), and adverse events (AEs). Subgroup analysis and sensitivity analysis were also conducted. Quality assessment was implemented based on Cochrane risk of bias (ROB) criteria, which consist of seven items. When more than four items in a study were judged as low ROB, the overall quality of this study was considered low risk.ResultsA total of 40 studies were included in the qualitative analysis, and 35 (87.5%) studies with 2,554 patients were included in the meta-analysis. Of the 40 studies, 14 (35.0%) were of moderate-to-high quality. The meta-analysis results showed that AR is better than RT alone in reducing shoulder pain (MD −1.32, 95% CI −1.58 to −1.07), improving upper limb motor function (MD 6.81, 95% CI 4.95–8.67), ADL (MD 11.17, 95% CI 9.44–12.91), and shoulder ROM (internal rotation: MD 10.48, 95% CI 8.14–12.83; backward extension: MD 7.82, 95% CI 6.00–9.64; anteflexion: MD 12.88, 95% CI 5.47–20.29; external rotation: MD 11.40, 95% CI 6.17–16.64; abduction: MD 16.96, 95% CI 8.61–25.31) without obvious AEs.ConclusionAR may be better than RT alone for the improvement of shoulder pain, upper limb motor function, ADL, and shoulder ROM, without obvious AEs in patients with PSSP. However, considering the clinical and statistical heterogeneity, our findings need to be interpreted with caution. More rigorous RCTs in this area should be conducted in the future.Systematic review registration[www.crd.york.ac.uk], identifier [CRD42022326763].

ObjectiveWith the improvement in health awareness, humanistic care ability of nurses has become a focus of public attention. The aim of the study was to confirm the relationship between psychological capital and humanistic care ability of nurses, and to provide suggestions on improving the humanistic care ability of nurses.MethodsA cross-section survey was conducted. Three hundred thirty-nine nurses were recruited from a tertiary general hospital in Taizhou, China. Psychological capital and humanistic care ability were measured using a self-reported questionnaire. Correlation analysis and stepwise multiple regression analysis were performed to analyze the correlation between psychological capital and humanistic care ability.ResultsThe psychological capital and humanistic care ability scores were 91.57 ± 13.96 and 189.08 ± 20.37, respectively. Differences in psychological capital scores across professional titles (F = 4.88, p = 0.01), departments (F = 3.69, p

BackgroundSocial support is an important factor affecting individual mental health. However, the relationship between social support and mental health in frontline healthcare workers (FHW) during the coronavirus disease 2019 (COVID-19) pandemic has garnered less attention. In this study, we aimed to investigate the level of social support and the prevalence of depression and anxiety in FHW during the COVID-19 pandemic and determine the factors affecting the relationship between social support, depression, and anxiety.MethodsA cross-sectional study using an online survey was conducted to collect data from FHW between 15 February and 31 March 2020 in China. The data included demographic factors, Self-rated Depression Scale (SDS), Self-rated Anxiety Scale (SAS), and Social Support Rate Scale (SSRS). Spearman correlation test was performed to determine the correlation among SAS, SDS, and SSRS scores. Multiple linear regression analysis was performed to determine the relationship among demographic factors, social support, depression, and anxiety in FHW.ResultsOf all 201 participants, 44 (21.9%) had depressive symptoms and 32 (15.9%) had anxiety symptoms. The average total SSRS scores among FHW were lower than that of the norms of the Chinese general population (37.17 ± 7.54 versus 44.38 ± 8.38, P < 0.001). Marital status positively affected the SSRS score (β = 7.395, P < 0.01). Age over 40 years old negatively affected the SSRS score (β = −5.349, P = 0.017). The total SSRS score, subjective social support score, objective social support score, and support utilization score among FHW negatively correlated with the SAS score and SDS score (P < 0.05). A lower support utilization score was significantly associated with high anxiety and depressive symptoms (β = −0.869, P = 0.024; β = −1.088, P = 0.035, respectively).ConclusionDuring the COVID-19 pandemic, FHW experienced depression, anxiety, and inadequate social support. The marital status and age had a major impact on social support. Social support was inversely associated with depression and anxiety. Improving the mental health of FHW by strengthening social support is crucial. Future studies are needed to investigate how to improve the level of social support and mental health condition of FHW facing public health emergencies in the future.

ObjectiveThe low detection rate of early and small tumors remains a clinical problem that urgently needs to be solved in the accurate diagnosis and treatment of upper urinary tract urothelial carcinoma (UTUC). The objective of this study is to evaluate the feasibility of CD47 as a target for optical molecular imaging of human UTUC and conduct preliminary ex vivo imaging experiments.MethodsWe firstly analyzed the genome-wide mRNA expression data from Gene Expression Omnibus (GEO). Paraffin-embedded tissue specimens comprising UTUC and normal urothelium were collected. All tissue specimens were used for immunohistochemistry to compare CD47 protein expression in normal and cancer tissue. Meanwhile, 12 patients undergoing radical nephroureterectomy were prospectively included in ex vivo imaging experiments. Freshly isolated upper urinary tract specimens were incubated with anti-CD47-Alexa Fluor 790 and then imaged under white light and near-infrared (NIR) light. Standard histopathologic evaluation was performed, and findings were correlated with CD47-targeted NIR molecular imaging.ResultsThe GEO data revealed that CD47 mRNA expression was higher in UTUC specimens than that in paracancer normal tissue. In immunohistochemical analysis, the CD47 protein expression level was higher in both non-muscle-invasive and muscle-invasive (stage ≥T2) UTUCs than that in normal uroepithelium, and the localization of CD47 protein was the tumor cell membrane. In the ex vivo imaging experiments, all patients were pathologically diagnosed with UTUC, and no adverse effects of anti-CD47-Alexa Fluor 790 on the histological structure of the tumor and normal uroepithelium were observed. In the NIR grayscale images, the mean fluorescence intensity of the tumor tissue was significantly higher than that of the adjacent normal background tissue, which greatly improved the visualization of the tumor.ConclusionsCD47-targeted NIR molecular imaging could be a feasible and powerful strategy for the accurate diagnosis of UTUC. Larger-scale randomized trials are needed.

Objective: The aim of this study was to perform a systematic review and meta-analysis to assess whether cerebral small vessel disease (CSVD) on neuroimaging of patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) is associated with an increased risk of hemorrhagic transformation (HT), symptomatic intracranial hemorrhage (sICH), and poor functional outcome (PFO).Methods: A thorough search of several databases was carried out to identify relevant studies up to December 2020. We included studies of patients with AIS and neuroimaging markers of CSVD treated with IVT. The primary outcome was HT, and the secondary outcomes were sICH and 3-month PFO. The quality of the studies involved was evaluated using the Newcastle–Ottawa Scale (NOS). The meta-analysis with the fixed effects model was performed.Results: Twenty-four eligible studies (n = 9,419) were pooled in the meta-analysis. All included studies were regarded as high quality with the NOS scores of at least 6 points. The meta-analysis revealed associations between the presence of CSVD and HT, sICH, and the 3-month PFO after IVT. Compared with no CSVD, the presence of CSVD was associated with an increased risk of HT (OR: 1.81, 95% CI: 1.52–2.16), sICH (OR: 2.42, 95% CI: 1.76–3.33), and 3-month PFO (OR: 2.15, 95% CI: 1.89–2.44). For patients with AIS complicated with CSVD, compared with a CSVD score of 0–1, a CSVD score of 2–4 was associated with an increased risk of HT (OR: 3.10, 95% CI: 1.67–5.77), sICH (OR: 2.86, 95% CI: 1.26–6.49), and 3-month PFO (OR: 4.58, 95% CI: 2.97–7.06).Conclusion: Patients with AIS complicated with neuroimaging markers of CSVD are at increased risk of HT and 3-month PFO after IVT. However, it is still necessary to clarify the exact role of CSVD in the occurrence, development, and prognosis of AIS.Systematic Review Registration:www.ClinicalTrials.gov, identifier CRD4202123 3900.

ObjectiveTo evaluate the safety and efficacy of overnight continuous saline bladder irrigation (CSBI) for patients who have received thulium laser en bloc resection of bladder tumor (TmLRBT) combined with immediate intravesical chemotherapy previously.MethodsFrom October 2014 to June 2018, 235 patients with newly diagnosed non-muscle invasive bladder cancer (NMIBC) were included in this retrospective study. All patients received intravesical instillation of pirarubicin immediately after TmLRBT. The patients were divided into two groups according to the duration of postoperative bladder irrigation with normal saline. After immediate intravesical chemotherapy, patients in group 1 received overnight CSBI, while patients in group 2 did not receive overnight CSBI. Data on the time of initial tumor recurrence, recurrence-free survival (RFS) and progression-free survival (PFS) rates, and perioperative complications were collected and analyzed.ResultsOf 235 included patients (129 in group 1 and 106 in group 2), the median follow-up periods were 42 and 38 months, respectively. There were no significant differences in patients’ baseline characteristics between the two groups. The RFS rates of patients in group 1 were 90.7, 82.7, and 76.8% at the end of the first, third, and fifth years, while the corresponding RFS rates of patients in group 2 were 87.7, 78.9, and 73.3%, respectively. Four patients in group 1 and five patients in group 2 experienced tumor progression. No significant differences between the two groups were observed in the time of initial tumor recurrence, RFS, and PFS rates. Only Grade I complications occurred in the two groups, and no significant difference was reached between the two groups.ConclusionsFor patients with NMIBC who have previously received TmLRBT combined with immediate intravesical chemotherapy, overnight CSBI may not improve oncological outcomes and reduce perioperative complications.

Although transurethral resection of bladder tumor is the golden standard for the treatment of non-muscle invasive bladder cancer, this surgical procedure still has some serious drawbacks. For example, piecemeal resection of tumor tissue results in exfoliated tumor cells dissemination and implantation, and fragmented tumor specimens make it difficult for pathologists to accurately assess the pathological stage and histologic grade. En bloc tumor resection follows the basic principle of oncological surgery and provides an intact tumor specimen containing detrusor muscle for pathologists to make accurate histopathological assessment. However, there is no robust clinical evidence that en bloc tumor resection is superior to conventional resection in terms of oncological outcomes. Considering the high recurrence rate, small or occult tumor lesions may be overlooked and incomplete tumor resection may occur during white light cystoscopy-assisted transurethral resection. Molecular fluorescent tracers have the ability to bind tumor cells with high sensitivity and specificity. Optical molecular imaging mediated by it can detect small or occult malignant lesions while minimizing the occurrence of false-positive results. Meanwhile, optical molecular imaging can provide dynamic and real-time image guidance in the surgical procedure, which helps urologists to accurately determine the boundary and depth of tumor invasion, so as to perform complete and high-quality transurethral tumor resection. Integrating the advantages of these two technologies, optical molecular imaging-assisted en bloc tumor resection shows the potential to improve the positive detection rate of small or occult tumor lesions and the quality of transurethral resection, resulting in high recurrence-free and progression-free survival rates.

Molecular property prediction is a crucial task in various fields and has recently garnered significant attention. To achieve accurate and fast prediction of molecular properties, machine learning (ML) models have been widely employed due to their superior performance compared to traditional methods by trial and error. However, most of the existing ML models that do not incorporate 3D molecular information are still in need of improvement, as they are mostly poor at differentiating stereoisomers of certain types, particularly chiral ones. Also,routine featurization methods using only incomplete features are hard to obtain explicable molecular representations. In this paper, we propose the Stereo Molecular Graph BERT (SMG-BERT) by integrating the 3D space geometric parameters, 2D topological information, and 1D SMILES string into the self-attention-based BERT model. In addition, nuclear magnetic resonance (NMR) spectroscopy results and bond dissociation energy (BDE) are integrated as extra atomic and bond features to improve the model’s performance and interpretability analysis. The comprehensive integration of 1D, 2D, and 3D information could establish a unified and unambiguous molecular characterization system to distinguish conformations, such as chiral molecules. Intuitively integrated chemical information enables the model to possess interpretability that is consistent with chemical logic. Experimental results on 12 benchmark molecular datasets show that SMG-BERT consistently outperforms existing methods. At the same time, the experimental results demonstrate that SMG-BERT is generalizable and reliable.

The majority of scholars believe that Shor’s algorithm is a unique and powerful quantum algorithm for RSA cryptanalysis, so current postquantum cryptography research has largely considered only the potential threats of Shor’s algorithm. This paper verifies the feasibility of deciphering RSA public key cryptography based on D-Wave, which is the second most effective RSA attack method after Shor’s algorithm. This paper proposes the influence of different column methods on the final integer factorization, puts forward a new dimension reduction formula, simplifies the integer factorization model based on quantum annealing, simulates it with the qbsolv quantum computing software environment provided by D-Wave, and factors the integer 1630729 (an 11-bit prime factor multiplied by an 11-bit prime factor). The research results show that choosing an appropriate number of columns and column width in the binary integer factorization multiplication table is very important for studying the optimization ability of the quantum annealing algorithm. In fact, Science, Nature, IEEE Spectrum, and the National Academies of Sciences (NAS) are consistent in asserting that the practical application of general-purpose quantum computers is far in the future. Therefore, although D-Wave computers were initially mainly purchased by Lockheed Martin, Google, etc., for purposes such as image processing, machine learning, combinatorial optimization, and software verification, post quantum cryptography research should further consider the potential of the D-Wave quantum computer in deciphering RSA cryptosystems in the future, and a discussion of this potential is one of the contributions of this paper.