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Background: Most nurses in China have not been trained to take care of end-of-life patients appropriately due to lack of educational resources and insufficient training. A palliative care program was launched by the Jiangsu Nursing Association (JNA training program) and to identify gaps in palliative care training. The main aim of this study was to evaluate the training effects of the JNA training program on nurses' knowledge and attitudes to palliative care. Methods: A cross-sectional study was conducted with 10 048 registered nurses in all regions of Jiangsu. All participants completed an online questionnaire using the Chinese version of The Palliative Care Quiz for Nursing (PCQN-C) and the Frommelt Attitude Toward Care of the Dying scale (FATCOD-B-C). A propensity score matched analysis was performed between the nurses who had attended the JNA training program and whose who hadn't. Results: The average score of PCQN-C among all nurses was 8.79, while the mean score of the FATCOD-B-C was 103.62. Those participants who attended the JNA training program had significantly better scores than those who did not. Propensity score matching analysis showed that the palliative care training program failed to improve nurses' knowledge in psychosocial and spiritual care or their attitudes towards the necessity of family support although there was positive impact on other aspects of palliative care. Conclusions: Knowledge of palliative care among Chinese nurses remains low. Training programs may improve general knowledge and attitudes to palliative care. However, important aspects of knowledge such as communication skills, family support, and psychosocial aspects of care, are missing. These gaps should be filled in future palliative care training programs targeting nurses with oriental culture background. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the mental health status of nurses from low‐risk areas of novel coronavirus (COVID‐19) pandemic, its potential impact factors, and the main stressors under the normalized prevention and control in China. A mobile phone app‐based survey was conducted among registered nurses in Jiangsu province via a region‐stratified sampling method. The questionnaire consisted of items on the demographic characteristics of the nursing staff and their Depression, Anxiety, Stress Scale‐21 (DASS‐21) along with questions for self‐assessment of stressors that are associated with COVID‐19. STROBE guideline was used. Among 1803 nurses who were working in the low‐risk areas in Jiangsu, 22.0%, 29.8%, and 16.1% of them reported moderate to extreme levels of depression, anxiety, and stress, respectively. Having 11–15 years of working experience and being a fixed‐term contract nurse were associated with experiencing worse mental health outcomes while supporting‐Wuhan working experience and having mental health preparation course training were independent factors that had beneficial impact on their psychological well‐being afterward. In terms of source of pressure, a key finding of this study is that the main stressor among these nurses was the lack of patient's understanding and cooperation (71.2%) which calls for better psychosocial communication between nurses and patients. The present findings would provide information for other regions at low risk of COVID‐19 and may aid the provision of support and interventions for the benefit of the psychological well‐being of nurses who are exposed to life‐threatening occupational risks and are more vulnerable to the pandemic than others. [ABSTRACT FROM AUTHOR]

Lectin receptor-like protein kinases (LecRLKs) have been shown to be involved in plants' responses to various biotic and abiotic stresse factors. Cerasus humilis is an important fruit species widely planted for soil and water conservation in northern China due to its strong tolerance to drought and salinity stresses. In this study, a total of 170 LecRLK family genes (125 G-types, 43 L-types and 2 C-types) were identified in the newly released whole-genome sequences of C. humilis. Furthermore, nine representative LecRLK genes in young plants of C. humilis under varying drought and salinity stresses were selected for qRT-PCR analysis. Our systematic comparative analyses revealed the active participation of these nine LecRLK genes in the salt and drought stress responses of C. humilis. The results from our study have provided a solid foundation for future functional verification of these LecRLK family genes and will likely help facilitate the more rapid and effective development of new stress resistant Cerasus humilis cultivars. [ABSTRACT FROM AUTHOR]

Accurate detection of severe acute respiratory syndrome coronavirus 2 is not only necessary for viral load monitoring to optimize treatment in hospitalized coronavirus disease 2019 patients, but also critical for deciding whether the patient could be discharged without any risk of viral shedding. Digital droplet PCR (ddPCR) is more sensitive than reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) and is usually considered the superior choice. In the current study, we compared the clinical performance of RT-qPCR and ddPCR using oropharyngeal swab samples from patients hospitalized in the temporary Huoshenshan Hospital, Wuhan, Hubei, China. Results demonstrated that ddPCR was indeed more sensitive than RT-qPCR. Negative results might be caused by poor sampling technique or recovered patients, as the range of viral load in these patients varied significantly. In addition, both methods were highly correlated in terms of their ability to detect all three target genes as well as the ratio of copies of viral genes to that of the IC gene. Furthermore, our results evidenced that both methods detected the N gene more easily than the ORF gene. Taken together, these findings imply that the use of ddPCR, as an alternative to RT-qPCR, is necessary for the accurate diagnosis of hospitalized coronavirus disease 2019 patients. [ABSTRACT FROM AUTHOR]

• Loop-mediated isothermal amplification assay for prevalent human respiratory adenoviruses. • Coupling with instrument-free DNA extraction device facilitating treating clinical samples. • A diagnostic platform enabling reliable screening test in resource-limited settings. Three human adenovirus (HAdV) genotypes, HAdV-7, HAdV-14, and HAdV-55, emerged as the most prevalent variants in China over the past decade and caused both sporadic, fatal cases and frequent, large outbreaks. Early diagnosis is essential to control infections and endemics. Here, we established a loop-mediated isothermal amplification (LAMP) assay coupled with an instrument-free nucleic acid extraction device recently developed by our group; the assay could detect all the 3 prevalent HAdV genotypes. Specificity analysis showed no cross-reactivity with other common respiratory pathogens and the analytical sensitivity was as low as 10 copies/μL. All detection steps could be completed within 1 hour. The assay's performance was evaluated using clinical samples and compared with the gold standard RT-PCR method, showing highly consistent results. The LAMP assay developed here could be readily used in basic laboratory facilities and with minimal DNA extraction equipment, and as a reliable screening test in a resource-limited setting. [ABSTRACT FROM AUTHOR]

Background: Symptomatic lumbar disc herniation (LDH) and lumbar isthmic spondylolisthesis (LIS) present significant challenges for military pilots, which may result in grounding if not effectively managed. Surgical treatment for LDH and LIS may offer a pathway to return to flight duty (RTFD), but recent data on this crucial topic is lacking. This study seeks to address this gap by investigating the RTFD outcomes among Chinese military pilots who have undergone lumbar spine surgery for symptomatic LDH and LIS., Methods: A retrospective review was conducted on active-duty military pilots who underwent isolated decompressive or fusion procedures at an authorized military medical center from March 1, 2007, to March 1, 2023. The analysis utilized descriptive statistics to examine demographic, occupational, surgical, and outcome data, with a particular focus on preoperative flight status, recommended clearance by spine surgeons, and actual RTFD outcomes and time., Results: Among the identified cases of active-duty military pilots with LDH or LIS treated by lumbar surgery (n = 24), 70.8% (17 of 24) consistently maintained RTFD status without encountering surgical complications or medical issues during the follow-up period. Of the seven pilots who did not RTFD, one retired within a year of surgery, two had anterior cruciate ligament injuries, three had residual radicular symptoms, and one had chronic low back pain. Excluding pilots who retired and did not RTFD for reasons unrelated to their lumbar conditions, the RTFD rate stood at 81.0% (17 of 21). The median time for recommended clearance by spine surgeons was 143.0 days (inter-quartile range, 116.5-196.0), while the median duration for actual RTFD attainment was 221.0 days (inter-quartile range, 182.0-300.0). The median follow-up post-lumbar surgery was 1.7 years (inter-quartile range, 0.4-2.9)., Conclusion: Most military pilots diagnosed with symptomatic LDH and LIS can continue their careers and regain active-duty flight status following lumbar spine surgery, as reflected by the high RTFD rate. Lumbar spine surgery can successfully alleviate the physical constraints associated with spinal conditions, facilitating the return of military pilots to their demanding profession., (© 2024. The Author(s).)

Chinese jujube (Ziziphus jujuba Mill.) and sour jujube (Ziziphus spinosa Hu.) fruits have health benefits because they contain bioactive compounds such as flavonoids. However, differences in the flavonoid metabolites of these two fruits remain unclear. We determined the flavonoids present in Z. jujuba cv. Hupingzao (HPZ) and Z. spinosa cv. Taigusuanzao (TGSZ) from two different harvest periods fruits: HPZ white period (HW) and HPZ red period (HR) as well as TGSZ white period (SW) and TGSZ red period (SR). We identified 123 flavonoid metabolites: 40 flavonols, 37 flavones, 12 anthocyanins, 9 dihydroflavones, 8 flavanols, 7 flavonoid carbonosides, 5 dihydroflavonols, 3 isoflavones, and 2 chalcones. The total flavonoid content of both HPZ and TGSZ decreased with fruit development and was significantly higher in TGSZ than in HPZ fruits. Moreover, we detected 63, 81, 56, and 63 differential flavonoid metabolites (DFMs) between HW and HR (two upregulated and 61 downregulated), SW and SR (four upregulated and 77 downregulated), HW and SW (54 upregulated and two downregulated), and HR and SR (62 upregulated and one downregulated), respectively. KEGG pathway annotation and enrichment analysis showed that 22 DFMs were annotated seven relevant metabolic pathways, among which flavonoid biosynthesis pathway and secondary metabolites biosynthesis pathway were the main pathways, and flavanols were the primary metabolites that influenced the difference in flavonoid accumulation between the fruits. To our knowledge, this is the first study to reveal the differences in flavonoid metabolism between Chinese jujube and sour jujube. Our findings may facilitate the comprehensive use of functional flavonoids. PRACTICAL APPLICATION: Chinese jujube (Ziziphus jujuba Mill.) and sour jujube (Ziziphus spinosa Hu.) fruits have health benefits because they contain bioactive compounds such as flavonoids. However, differences in the flavonoid metabolites of these two fruits remain unclear. We determined the flavonoids present in Z. jujuba cv. Hupingzao (HPZ) and Z. spinosa cv. Taigusuanzao (TGSZ) from two different harvest periods. Our findings may facilitate the comprehensive use and product research of functional flavonoids of jujube., (© 2022 Institute of Food Technologists.)

The composition and content of phenolic acids and flavonoids among the different varieties, development stages, and tissues of Chinese jujube (Ziziphus jujuba Mill.) were systematically examined using ultra-high-performance liquid chromatography to provide a reference for the evaluation and selection of high-value resources. Five key results were identified: (1) Overall, 13 different phenolic acids and flavonoids were detected from among the 20 excellent jujube varieties tested, of which 12 were from the fruits, 11 from the leaves, and 10 from the stems. Seven phenolic acids and flavonoids, including (+)-catechin, rutin, quercetin, luteolin, spinosin, gallic acid, and chlorogenic acid, were detected in all tissues. (2) The total and individual phenolic acids and flavonoids contents significantly decreased during fruit development in Ziziphus jujuba cv.Hupingzao. (3) The total phenolic acids and flavonoids content was the highest in the leaves of Ziziphus jujuba cv.Hupingzao, followed by the stems and fruits with significant differences among the content of these tissues. The main composition of the tissues also differed, with quercetin and rutin present in the leaves; (+)-catechin and rutin in the stems; and (+)-catechin, epicatechin, and rutin in the fruits. (4) The total content of phenolic acid and flavonoid ranged from 359.38 to 1041.33 μg/g FW across all examined varieties, with Ziziphus jujuba cv.Jishanbanzao having the highest content, and (+)-catechin as the main composition in all 20 varieties, followed by epicatechin, rutin, and quercetin. (5) Principal component analysis showed that (+)-catechin, epicatechin, gallic acid, and rutin contributed to the first two principal components for each variety. Together, these findings will assist with varietal selection when developing phenolic acids and f lavonoids functional products., Competing Interests: The authors have declared that no competing interests exist.

Dynamic changes in flavonoid, total phenol, and antioxidant potential in different Prunus humilis accessions during fruit development stages were studied in order to provide a reference for the optimum harvest time for flavonoid extraction. 'Nongda 4', 'Nongda 5', 'DS-1' and '02-16' were selected as plant materials to determine the content of flavonoid, total phenol and antioxidant indices during six fruit development stages. Changes in total flavonoid content (TFC) and total phenol content (TPC) in different accessions of P. humilis were slightly different depending on the development stage of P. humilis fruit. TFC and TPC in 'Nongda 5' fruit showed a trend of continuous decline. There was a small increase in TFC and TPC from the young fruit stage to the stone hardening stage, followed by a decreasing trend, and then to the lowest level at the ripening stage of 'Nongda 4', 'DS-1', and '02-16' fruits. The trend of antioxidant capacity (ABTS, FRAP, DPPH) with the TFC and TPC of P. humilis fruit was basically the same, and the correlation analysis results showed that the TFC of P. humilis fruit was positively correlated with the antioxidant indices (P<0.01). Catechin (CC), rutin (RT), and quercetin-7-O-β-D-glucopyranoside (Q7G) were detected in all the fruit development stages of the four P. humilis fruits. Among them, catechin was the most abundant component, accounting for approximately 10%. Myricetin (MC) and quercetin (QC) were generally detected only in the early fruit development stage, but not in the later fruit development stage. Correlation analysis showed that the flavonoid components with TFC, TPC, and antioxidant indices differed between the different accessions. RT, CC, and liquiritigenin (LR) had a stronger correlation with TFC and antioxidant indices. Cyanidin-3-O-glucoside (C3G) was not detected until the coloring stage in two red P. humilis accessions ('Nongda 4' and 'DS-1'), and so it is better to choose a red P. humilis fruit to extract C3G at the ripening stage. Selecting an early stage of fruit development, especially the stone hardening stage, was important for extracting flavonoids, total phenols and other components. We believe that our results will provide basic information and reference for evaluation of fruit nutrition and health benefits, breeding of functional new varieties, and efficient utilization of P. humilis fruit., Competing Interests: The authors have declared that no competing interests exist.

Study Design: A retrospective clinical study of 19 cases of ossification of ligamentum flavum (OLF) in Chinese population., Objective: To inspect the epidemiology, clinical presentation, pathology, radiologic findings, and treatment outcome in 19 Chinese patients of OLF at a single institution., Summary of Background Data: OLF in the thoracic region causing neurological impairment is a rare pathologic entity described mainly in Japanese literature. The present study represents a series of Chinese patients with OLF at the thoracic spine., Methods: Nineteen patients (7 male and 12 female; ages ranging between 39 and 73 y) were included in this study. All patients have been treated by posterior thoracic extensive decompressive laminectomy. Neurological status was evaluated using the Japanese Orthopedic Association (JOA) score, the recovery rate, and the Oswestry Disability Index (ODI) before and after surgery. Patients' pain relief was evaluated using a visual analog scale (VAS) pain score., Results: Mean JOA score was 3.16±1.05 before surgery to 8.34±3.28 after surgery. Mean recovery rate was 61.4%±32.5%. Mean ODI scores had significantly decreased from 66.36%±10.91% before surgery to 25.45%±12.19% after surgery. The result of VAS score were 6.29±1.83 before the operation and 2.18±1.90 at final follow-up. All patients improved at the end of the evaluation period. There was no recurrence., Conclusions: Early diagnosis and sufficient surgical treatment play key roles in improving functional outcomes. Posterior thoracic extensive decompressive laminectomy gives satisfactory results and leads to significant clinical improvement.