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This study examines the impact of Notoginsenoside R1 (NGR1), a compound from Panax notoginseng, on the maturation of porcine oocytes and their embryonic development, focusing on its effects on antioxidant levels and mitochondrial function. This study demonstrates that supplementing in vitro maturation (IVM) medium with NGR1 significantly enhances several biochemical parameters. These include elevated levels of glutathione (GSH), nuclear factor erythrocyte 2‐related factor 2 (NRF2) and mRNA expression of catalase (CAT) and GPX. Concurrently, we observed a decrease in reactive oxygen species (ROS) levels and an increase in JC‐1 immunofluorescence, mitochondrial distribution, peroxisome proliferator‐activated receptor‐γ coactivator‐1α (PGC1α) and nuclear NRF2 mRNA levels. Additionally, there was an increase in ATP production and lipid droplets (LDs) immunofluorescence. These biochemical improvements correlate with enhanced embryonic outcomes, including a higher blastocyst rate, increased total cell count, enhanced proliferative capacity and elevated octamer‐binding transcription factor 4 (Oct4) and superoxide dismutase 2 (Sod2) gene expression. Furthermore, NGR1 supplementation resulted in decreased apoptosis, reduced caspase 3 (Cas3) and BCL2‐Associated X (Bax) mRNA levels and decreased glucose‐regulated protein 78 kD (GRP78) immunofluorescence in porcine oocytes undergoing in vitro maturation. These findings suggest that NGR1 plays a crucial role in promoting porcine oocyte maturation and subsequent embryonic development by providing antioxidant levels and mitochondrial protection. [ABSTRACT FROM AUTHOR]

OBJECTIVE To investigate the characteristics of left ventricular layer-specific strain in patients with chronic kidney disease (CKD). METHODS Eighty-five patients of chronic kidney disease in the Department of Nephrology of our hospital from March 2020 to August 2021 were selected and divided into three groups according to the estimated GFR: Group A (CKD stage 1–2), Group B (CKD stage 3–4), and Group C (CKD stage 5), 40 hypertensive patients without renal insufficiency were gathered as hypertension (HT) group and 40 gender and age-matched healthy volunteers were selected as the control group. Then, (i) Routine echocardiographic parameters: left ventricular diameter, left atrium diameter, wall thickness, LVEF. (ii) Myocardial strain: global longitudinal strain (GLS), longitudinal strain in endocardium (SL-endo), longitudinal strain in average (SL-ave), longitudinal strain in epicardium (SL-epi), global circumferential strain (GCS), global circumferential strain in endocardium (SC-endo), global circumferential strain in average (SC-ave), global circumferential strain in epicardium (SC-epi), and global radial strain (GRS) were analyzed. RESULTS (i) Compared with the control group, the structure of the left heart and LVEF in groups A and B had no significant changes, left ventricular remodeling appeared, and diastolic function declined in HT group and group C, LVEF decreased in group C (all P  < 0.05). (ii) Only SL-endo decreased in the HT group. All of SL-endo, SL-ave, and SL-epi were reduced in the CKD group and were lowest in group C. Radial strain decreased only in group C (all P < 0.05). (iii) The global and layer-specific longitudinal strain were correlated with estimated glomerular filtration rate (eGFR) (r  = 0.541–0.559, all P < 0.05), LVEF was correlated with longitudinal and circumferential strain (r  = 0.406–0.424, all P < 0.05). Multiple linear regression analysis showed that longitudinal strain in different layers were independently correlated with different stages of CKD and the occurrence of secondary hypertension or not (β = −0.251 to −0.443, all P < 0.05). Circumferential strain in all layers were independently correlated with the appearance of secondary hypertension or not (β = −0.255 to −0.31, all P < 0.05). CONCLUSIONS The degree and range of the impairment of left ventricular strain in CKD patients are related to the stage of eGFR and secondary hypertension, which may affect the global systolic pump function by involving the circumferential strain. [ABSTRACT FROM AUTHOR]

Background: Pain assessments are an important aspect of health care quality because the high prevalence of pain in inpatients may contribute to complications. Several studies revealed a gap in the pain intensity evaluated by nurses (PEN) and patients (PEP). The aim of the present study was to analyze the correlation and agreement between pain assessments conducted by nurses and patients, and to determine patients at high risk of misestimated pain., Objectives: To compare the difference of pain intensity between the questionnaires conducted by additional assessors and electronic records by nursing staff., Study Design: A retrospective study., Setting: A medical center in Taichung, Taiwan., Methods: We approached 1,034 patients admitted from January 1, 2018 to December 31, 2018 in our hospital. We compared the assessments of pain intensity using questionnaires conducted by additional assessors with those entered into electronic records by nursing staff. Continuous data were reported as the mean (± standard deviation). The analysis of agreement and correlation were performed by kappa statistics or weighted kappa statistics, and correlation (Spearman rank correlation method)., Results: Among the 1,034 patients, 307 patients were excluded. Thus, the final analysis included 686 patients. Patients' median pain intensity was 5 in PEP and 1 in PEN. The patients' pain intensity was underestimated (PEN < PEP) in 539 patients (78.6%), matched (PEN = PEP) in 126 patients (18.3%), and overestimated (PEN > PEP) in 21 patients (3.1%). The surgical interventions (chi squared = 7.996, and P = 0.018) and pain in the past 24 hours (chi squared = 17.776, and P < 0.001) led to a significant difference., Limitations: The limitation of the study was the single-center and retrospective design., Conclusions: The gap in pain assessments between inpatients and nurses is an important issue in daily practice. The underestimations of pain were more common than overestimations (78.6% vs 3.1%). Surgical interventions and persistent pain lasting over 24 hours were high risk factors for underestimation, but patients' gender, receiving anesthesia, type of anesthesia, and patient-controlled analgesia did not contribute significantly to differences in pain estimation.

Background: Workplace violence is a phenomenon that is prevalent around the world. Nursing personnel are one of the most frequent victims of workplace attacks. Beyond the harm done to physical health, mental health, and workplace morale, workplace violence also leads to the loss of personnel and causes severe injury to institutions and nursing professionals., Purpose: The aim of this study is to improve the awareness, attitudes, and self-confidence of nurses with regard to workplace violence using clinical simulation teaching and training courses., Methods: A total of 400 clinical nurses at a tertiary hospital in Taipei City were enrolled and randomly assigned into either the experimental group, which received the education intervention, or the control group, which received no intervention. A total of 392 enrolled participants completed the study, including 200 in the experimental group and 192 in the control group. Before and after the intervention, a structured questionnaire was used to collect data, which were analyzed using a GEE model with SPSS V.23., Results: After the clinical simulation teaching course, awareness of workplace violence as well as related attitudes and self-confidence were higher in the experimental group than the control group. Moreover, the posttest scores and pretest-posttest differences in scores were significantly higher in the experimental group than in the control group (p < .001). Advanced analysis of the data showed that cognition scores, being older in age, and having a registered nurse grade of N3 were all associated with earning a higher score. In addition, in terms of attitude, registered nurse grade was found to correlate positively with score. Further, male participants earned higher self-confidence scores than their female colleagues and participants who worked in either the emergency or psychiatric departments earned higher scores., Conclusions: The "Workplace Violence Clinical Simulation Teaching and Training Course" was shown to improve the awareness, attitudes, and self-confidence of clinical nurses with regard to workplace violence and may thus help reduce the risk and harm of violence in this category. In the future, contextual teaching courses on workplace violence prevention should be developed for different nursing levels, divisions, and units based on their specific characteristics and needs.

Background & Problems: Clinical ladder (CL)-3 nurses should have both an ability to integrate the clinical information of critically ill patients and to carry out the administrative work of the intensive care unit. However, in our unit, only 15.3% of nurses hold CL-3 certification, which is much lower than the hospital average of 23.1%. Thus, we initiated a project to raise this percentage in our unit. An analysis in January 2016 showed that the main obstacles to obtaining CL-3 certification in our unit were inability to write case reports, inadequate in-service education, and a lack of certified educators., Purpose: The purpose of this project was to increase the number of CL-3-certified nurses in our intensive care unit., Resolution: The resolution included holding courses on case report writing, briefings, and oral presentation techniques; assigning a preceptor to make nursing staff assignments; encouraging nurses to participate in the clinical nursing preceptor education training camp; and conducting practice tests using a multiple assessment tool., Results: After implementation of this project, the percentage of unit nurses who had passed CL-3 increased to 39.0%., Conclusions: This project not only allowed our fellow nurses to share in the joy of clinical ladder advancement but also improved the atmosphere in the unit by encouraging self-development. This project helped stimulate professional growth among our staff and improved the quality of clinical care.

Background: Patients with respiratory failure needing mechanical ventilation are common in the intensive care unit. These patients often require sedative and analgesic agents to alleviate their discomfort and to avoid causing associated safety issues. However, prolonged post-awakening confusion and changes in perception after withdrawal from sedatives and analgesic agents are common in daily practice. Thus, the optimal use of sedative and analgesic agents remains an important issue in the intensive care unit., Purpose: To optimize sedation by raising the rate of accuracy for administering analgesic and sedative agents in the intensive care unit from 30.44% to 60.88%., Methods: We first analyzed the problem from the current situation of the daily practice and revised the protocol of using analgesic and sedative agents. In order to achieve an optimal outcome, the authors further arranged staff education and bedside training and established an audit system to check and improve protocol adherence., Results: The rate of accuracy for administering sedatives and analgesics improved from 34% to 93%., Conclusions: With appropriately scaled protocols of sedatives and analgesics administration, intensive care nurses may easily target the consistent and optimal assessment and provide pain relief prior to sedation, which will improve the quality of sedation and patient safety.