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Abstract Background Given the lack of valid and reliable instruments for evaluating the quality of communication between physicians and cancer patients and their family caregivers in China, this study translated and culturally adapted the Quality of Communication questionnaires for cancer patients (QOC-P) and their family caregivers (QOC-F) for use in the Chinese context and evaluated their psychometric properties. Methods The QOC-P and QOC-F were translated following an adapted version of Brislin’s translation model and culturally adapted according to a Delphi expert panel. We pretested and refined the Chinese versions of the QOC-P and QOC-F among 16 dyads of patients and their family caregivers. Subsequently, we administered the questionnaires to 228 dyads of patients and their family caregivers who were recruited from six tertiary hospitals. The content validity, construct validity, convergent validity, and reliability of the QOC-P and QOC-F were examined. Results Through exploratory factor analysis, The QOC-P and QOC-F were divided into two dimensions: general communication and end-of-life communication. The Cronbach’s coefficients ranged from 0.905 to 0.907 for the two subscales of the QOC-P and from 0.908 to 0.953 for the two subscales of the QOC-F. The two-week test-retest reliability was acceptable for both the QOC-P and QOC-F, with intraclass correlation coefficients of 0.993 and 0.991, respectively. The scale content validity index (QOC-P: 0.857, QOC-F: 1.0) and split-half reliability (QOC-P: 0.833, QOC-F: 0.935) were satisfactory. There was a negative correlation with anxiety and depression for both the QOC-P (r = -0.233 & -0.241, p

Abstract Background Nursing interns often experience lots of challenges during their clinical nursing internships, which can adversely affect career decisions and result in a squandering of nursing education resources. Patient safety attitudes, professional identity and climate of caring may affect nursing interns’ clinical experience. However, more evidence is requested to validate these relationships for nursing educators to develop effective education programs and facilitate interns’ successful transition. Methods This was a cross-sectional study, which used a convenience sampling method to recruit 387 nursing interns during December 2022 to April 2023 in university affiliated hospital in Hunan province, China. Data were collected using standardized scales. Spearman correlation and multiple regression analysis were employed to examine the relationship between transition shock, patient safety attitudes, professional identity, and climate of caring. Results Nursing interns experienced transition shock at a moderate level and the highest levels of transition shock in response to overwhelming practicum workloads, with the second being related to the conflict between theory and practice. Transition shock was negatively correlated with patient safety attitudes, professional identity and climate of caring among nursing interns. Conclusions Nursing managers and educators need to value the transition shock experienced by nursing interns. Our study suggests that developing a strong sense of professional identity and a positive attitude toward patient safety can be effective in reducing the level of transition shock among nursing interns. In addition, a caring climate within the nursing unit can significantly enhance the overall experience of nursing interns. This can be achieved by enhancing the support of clinical mentors, providing patient safety-focused education, and facilitating team communication among nurses.

The identification of significant gene biclusters with particular expression patterns and the elucidation of functionally related genes within gene expression data has become a critical concern due to the vast amount of gene expression data generated by RNA sequencing technology. In this paper, a Conserved Gene Expression Module based on Genetic Algorithm (CGEMGA) is proposed. Breast cancer data from the TCGA database is used as the subject of this study. The p-values from Fisher’s exact test are used as evaluation metrics to demonstrate the significance of different algorithms, including the Cheng and Church algorithm, CGEM algorithm, etc. In addition, the F-test is used to investigate the difference between our method and the CGEM algorithm. The computational cost of the different algorithms is further investigated by calculating the running time of each algorithm. Finally, the established driver genes and cancer-related pathways are used to validate the process. The results of 10 independent runs demonstrate that CGEMGA has a superior average p-value of 1.54 × 10−4 ± 3.06 × 10−5 compared to all other algorithms. Furthermore, our approach exhibits consistent performance across all methods. The F-test yields a p-value of 0.039, indicating a significant difference between our approach and the CGEM. Computational cost statistics also demonstrate that our approach has a significantly shorter average runtime of 5.22 × 100 ± 1.65 × 10−1 s compared to the other algorithms. Enrichment analysis indicates that the genes in our approach are significantly enriched for driver genes. Our algorithm is fast and robust, efficiently extracting co-expressed genes and associated co-expression condition biclusters from RNA-seq data.

Abstract Background The nutrient-absorbing villi of small intestines are renewed and repaired by intestinal stem cells (ISCs), which reside in a well-organized crypt structure. Genetic studies have shown that Wnt molecules secreted by telocytes, Gli1 + stromal cells, and epithelial cells are required for ISC proliferation and villus homeostasis. Intestinal stromal cells are heterogeneous and single-cell profiling has divided them into telocytes/subepithelial myofibroblasts, myocytes, pericytes, trophocytes, and Pdgfra low stromal cells. Yet, the niche function of these stromal populations remains incompletely understood. Results We show here that a Twist2 stromal lineage, which constitutes the Pdgfra low stromal cell and trophocyte subpopulations, maintains the crypt structure to provide an inflammation-restricting niche for regenerating ISCs. Ablating Twist2 lineage cells or deletion of one Wntless allele in these cells disturbs the crypt structure and impairs villus homeostasis. Upon radiation, Wntless haplo-deficiency caused decreased production of anti-microbial peptides and increased inflammation, leading to defective ISC proliferation and crypt regeneration, which were partially rescued by eradication of commensal bacteria. In addition, we show that Wnts secreted by Acta2 + subpopulations also play a role in crypt regeneration but not homeostasis. Conclusions These findings suggest that ISCs may require different niches for villus homeostasis and regeneration and that the Twist2 lineage cells may help to maintain a microbe-restricted environment to allow ISC-mediated crypt regeneration.

IntroductionSevoflurane, one of the most commonly used anesthetic agents in children, may induce neuronal dysfunction and cognitive impairment. Exposure to sevoflurane might induce an imbalance between neural excitation and inhibition which could be a mechanism behind anesthesia-induced cognitive and affective dysfunctions. However, the underlying mechanisms remain unclear.MethodsIn this study, we used two rhesus macaques in the control group, and one rhesus macaques in the anesthesia group. We employed single-nucleus RNA sequencing (snRNA-seq) technology to explore alterations in distinct types of inhibitory neurons involved in the long-term cognitive impairment caused by sevoflurane in young macaques.ResultsFollowing sevoflurane treatment, an upregulation was observed in the SST+ inhibitory neuron in the LHX6+ neighborhood in the hippocampus of rhesus macaques. This alteration might impact brain development by influencing interneuron migration and maturation. Additionally, we proposed a novel classification of inhibitory neurons, defined by CNR1 and LHX6 applicable to both humans and macaques.DiscussionOur study proposed a novel classification of inhibitory neurons defined by LHX6 and CNR1, relevant in macaques and humans. We also provide evidence that sevoflurane upregulated the SST+ inhibitory neuron in the LHX6+ neighborhood in the hippocampus of rhesus macaques, which may underlie the potential neurotoxic effects induced by general anesthetics. Our results also offer a more reliable approach for studying the structure and function of the human brain.

The efficiency and performance of proton exchange membrane fuel cells (PEMFCs) are primarily influenced by ORR electrocatalysts. In recent years, atomically dispersed metal–nitrogen–carbon (M-N-C) catalysts have gained significant attention due to their high active center density, high atomic utilization, and high activity. These catalysts are now considered the preferred alternative to traditional noble metal electrocatalysts. The unique properties of M-N-C catalysts are anticipated to enhance the energy conversion efficiency and lower the manufacturing cost of the entire system, thereby facilitating the commercialization and widespread application of fuel cell technology. This article initially delves into the origin of performance and degradation mechanisms of Fe-N-C catalysts from both experimental and theoretical perspectives. Building on this foundation, the focus shifts to strategies aimed at enhancing the activity and durability of atomically dispersed Fe-N-C catalysts. These strategies encompass the use of bimetallic atoms, atomic clusters, heteroatoms (B, S, and P), and morphology regulation to optimize catalytic active sites. This article concludes by detailing the current challenges and future prospects of atomically dispersed Fe-N-C catalysts.

The aim of this study is to explore the relationship between soil nutrients and berry quality for the wine grape Vitis vinifera cv. Cabernet Franc in the eastern foothills of the Helan Mountains, and subsequently to optimize soil nutrient conditions for optimal berry quality, thus providing guidance for vineyard soil management. Based on the basic data on soil nutrients and berry quality indicators, a partial least squares regression method was used to screen for major soil nutrient factors affecting the grape quality index. Then, the selected soil nutrient factors were taken as independent variables and the corresponding grape quality indicators were taken as dependent variables and a multilinear regression equation was formulated by the method of multivariate linear regression. Finally, the optimal solution for fruit quality and soil nutrients was solved using linear programming equations. The results showed that there was a lack of total nitrogen, organic matter, nitrate nitrogen, ammonium nitrogen, and available phosphorus in the soil nutrients, and an alkaline soil. There is a significant positive correlation between some soil nutrient indices, and there is also a multivariate linearity problem. Among all berry quality indices, titratable acid, tannin, and anthocyanin were negatively correlated with eleven and ten soil indices, respectively, while other berry quality indices were positively correlated with most soil nutrient indices. The optimal parameters for grape quality were determined using the method of linear programming equations, and the corresponding soil nutrient indicators content were defined.

Proton Exchange Membrane Water Electrolysis (PEMWE) under acidic conditions outperforms alkaline water electrolysis in terms of less resistance loss, higher current density, and higher produced hydrogen purity, which make it more economical in long-term applications. However, the efficiency of PEMWE is severely limited by the slow kinetics of anodic oxygen evolution reaction (OER), poor catalyst stability, and high cost. Therefore, researchers in the past decade have made great efforts to explore cheap, efficient, and stable electrode materials. Among them, the RuO2 electrocatalyst has been proved to be a major promising alternative to Ir-based catalysts and the most promising OER catalyst owing to its excellent electrocatalytic activity and high pH adaptability. In this review, we elaborate two reaction mechanisms of OER (lattice oxygen mechanism and adsorbate evolution mechanism), comprehensively summarize and discuss the recently reported RuO2-based OER electrocatalysts under acidic conditions, and propose many advanced modification strategies to further improve the activity and stability of RuO2-based electrocatalytic OER. Finally, we provide suggestions for overcoming the challenges faced by RuO2 electrocatalysts in practical applications and make prospects for future research. This review provides perspectives and guidance for the rational design of highly active and stable acidic OER electrocatalysts based on PEMWE.

The traditional classical sampling statistics method ignores the spatial location relationship of survey samples, which leads to many problems. This study aimed to propose a spatial sampling method for sampling estimation and optimization of forest biomass, achieving a more efficient and effective monitoring system. In this paper, we used Sequential Gaussian Conditional Simulation (SGCS) to obtain the biomass of four typical forest types in Shangri-La, Yunnan Province, China. In addition, we adopted a geostatistical sampling method for sample point layout and optimization to achieve the purpose of improving sampling efficiency and accuracy, and compared with the traditional sampling method. The main results showed that (1) the Gaussian model, exponential model, and spherical model were used to analyze the variogram of the four typical forests biomass, among which the exponential model had the best fitting effect (R2 = 0.571, RSS = 0.019). The range of the exponential model was 8700 m, and the nugget coefficient (C0/(C0 + C)) was 11.67%, which showed that the exponential model could be used to analyze the variogram of forest biomass. (2) The coefficient of variation (CV) based on 323 biomass field plots was 0.706, and the CV based on SGCS was 0.366. In addition, the Overall Estimate Consistency (OEC) of the simulation result was 0.871, which can be used for comparative analysis of traditional and spatial sampling. (3) Based on the result of SGCS, with 95% reliability, the sample size of traditional equidistant sampling (ES) was 191, and the sampling accuracy was 95.16%. But, the spatial sampling method based on the variation scale needed 92 samples, and the sampling accuracy was 93.12%. On the premise of satisfying sampling accuracy, spatial sampling efficiency was better than traditional ES. (4) The accuracy of stratified sampling (SS) of four typical forest areas based on 191 samples was 97.46%. However, the sampling accuracy of the biomass variance stratified space based on the SGCS was 93.89%, and the sample size was 52. Under the premise of satisfying the sampling accuracy, the sampling efficiency was obviously better than the traditional SS. Therefore, we can obtain the conclusion that the spatial sampling method is superior to the traditional sampling method, as it can reduce sampling costs and solve the problem of sample redundancy in traditional sampling, improving the sampling efficiency and accuracy, which can be used for sampling estimation of forest biomass.

Abstract Background Nursing research training is important for improving the nursing research competencies of clinical nurses. Rigorous development of such training programs is crucial for ensuring the effectiveness of these research training programs. Therefore, the objectives of this study are: (1) to rigorously develop a blended emergent research training program for clinical nurses based on a needs assessment and related theoretical framework; and (2) to describe and discuss the uses and advantages of the ADDIE model (Analysis, Design, Development, Implementation, Evaluation) in the instructional design and potential benefits of the blended emergent teaching method. Methods This intervention development study was conducted in 2017, using a mixed-methods design. A theoretical framework of blended emergent teaching was constructed to provide theoretical guidance for the training program development. Nominal group technique was used to identify learners’ common needs and priorities. The ADDIE model (Analysis, Design, Development, Implementation, Evaluation) was followed to develop the research training program for clinical nurses based on the limitations of current nursing research training programs, the needs of clinical nurses, and the theoretical foundation of blended emergent teaching. Results Following the ADDIE model, a blended emergent research training program for clinical nurses to improve nursing research competence was developed based on the needs of clinical nurses and the theoretical framework of blended emergent teaching. Conclusions This study indicates that nominal group technique is an effective way to identify learners’ common needs and priorities, and that the ADDIE model is a valuable process model to guide the development of a blended emergent training program. Blended emergent teaching is a promising methodology for improving trainees’ learning initiative and educational outcomes. More empirical studies are needed to further evaluate blended emergent teaching to promote the development of related theories and practice in nursing education.

Accurately estimating forest biomass based on spaceborne lidar on a county scale is challenging due to the incomplete coverage of spaceborne lidar data. Therefore, this research aims to interpolate GEDI spots and explore the feasibility of approaches to improving Quercus forest biomass estimation accuracy in the alpine mountains of Yunnan Province, China. This paper uses GEDI data as the main information source and a typical mountainous area in Shangri-La, northwestern Yunnan Province, China, as the study area. Based on the pre-processing of light spots. A total of 38 parameters were extracted from the canopy and vertical profiles of 1307 light spots in the study area, and the polygon data of the whole study area were obtained from the light spot data through Kriging interpolation. Multiple linear regression, support vector regression, and random forest were used to establish biomass models. The results showed that the optimal model is selected using the semi-variance function for the Kriging interpolation of each parameter of GEDI spot, the optimal model of modis_nonvegetated is a linear model, and the optimal model for rv, sensitivity, and modis_treecover is the exponential model. Analysis of the correlation between 39 parameters extracted from GEDI L2B and three topographic factors with oak biomass showed that sensitivity had a highly significant positive correlation (p < 0.01) with Quercus biomass, followed by a significant negative correlation (p < 0.05) with aspect and modis_nonvegation. After variable selection, the estimation model of Quercus biomass established using random forest had R2 = 0.91, RMSE = 19.76 t/hm2, and the estimation accuracy was better than that of multiple linear regression and support vector regression. The estimated total biomass of Quercus in the study area was mainly distributed between 26.48 and 257.63 t/hm2, with an average value of 114.33 t/hm2 and a total biomass of about 1.26 × 107 t/hm2. This study obtained spatial consecutive information using Kriging interpolation. It provided a new research direction for estimating other forest structural parameters using GEDI data.

Objective: This article aimed to report the experience of developing a complex nurse-led, theory-driven, and evidence-based educational intervention program intended to manage the nutrition impact symptom cluster experienced by patients with nasopharyngeal carcinoma (NPC) during radiotherapy, based on the Medical Research Council (MRC) framework. Methods: The “development” and “feasibility and piloting” phases of the MRC framework were used to guide the intervention development. The development phase included identifying the evidence base through a systematic review, exploring the relevant and guiding theory to enhance the effectiveness of the intervention and conducting a qualitative study to identify the intervention modelling. For the feasibility and piloting phase, we conducted a pilot study to examine the feasibility and estimate the effectiveness of the intervention. Results: The systematic review revealed that nurse-led educational interventions were used commonly for symptom cluster management, with promising effectiveness. The theoretical foundation was provided by the Theory of Unpleasant Symptoms, which indicates that an educational intervention can help patients to manage symptom cluster by influencing psychological, situational, and physiological factors. The qualitative study further provided contents of the intervention based on the perspectives of NPC patients and health professionals. The resulting program involves a nurse-led, family caregiver involvement, educational intervention with two sessions that uses a booklet as a medium. The pilot study found that conducting the educational intervention program was feasible and it also had some favorable effects on managing the nutrition impact symptom cluster in NPC patients. Conclusions: The MRC framework provided a strong structure with which to develop a complex intervention for nutrition impact symptom cluster management through a theory-driven and evidence-based approach. The evaluation of the intervention, the delivery process and the mediation mechanism of change using a rigorous randomized controlled trial design is recommended.

Introduction Promoting the quality of death and achieving a good death is one of the most important goals of palliative care in cancer care. Few studies synthesised views of patients with cancer on the notion of a good death and its associated factors. By eliciting the core elements of a good death, the review aims to identify potential unmet needs of patients with cancer and reveal their common values and care preferences at the end of life. The review also has the potential to inform the development of guidelines for clinical care and shared decision-making in palliative care practice.Methods and analysis A qualitative systematic review will be conducted and reported according to the Joanna Briggs Institute (JBI) methodology for systematic review and synthesis of qualitative data and the Preferred Reporting Items for Systematic Review and Meta-Analysis. Comprehensive search will be performed in six English and two Chinese databases from inception to 30 April 2022 to retrieve relevant qualitative articles focusing on the notion of a good death from the perspective of patients with cancer. Data will be extracted using the JBI standardised data extraction tool for qualitative research. The quality of the included studies will be critically appraised using the JBI Qualitative Assessment and Review Instrument. Data extraction and quality appraisal will be conducted by two reviewers independently. A meta-aggregative approach and narrative summary will be used to synthesise data.Ethics and dissemination Ethical approval is not needed. We will disseminate the findings through international conferences related to cancer care or palliative care. The final review will be submitted and published in a peer-reviewed journal.PROSPERO registration number CRD42021266629.

Intestinal aging is associated with declines in structure and absorption of nutrients. Here, the authors show that aging related intestinal decline is mediated by activation of the mTORC1-p38MAPK-p53 pathway in intestinal stem cells and can be ameliorated by abrogating mTORC1 or p38MAPK activity.

The application of non-metal-oxide semiconductor materials as surface-enhanced Raman spectroscopy (SERS) substrates is impeded by their low SERS enhancement and detection sensitivity. Here, the authors develop a general oxygen incorporation strategy to magnify these parameters.

The effect of electrochemically active MnO2 as a coating material on the electrochemical properties of a Li1.2Mn0.54Ni0.13Co0.13O2 (LTMO) cathode material is explored in this article. The structural analysis indicated that the layered structure of the LTMO was unchanged after the modification with MnO2. The morphology inspection demonstrated that the rod-like LTMO particles were encapsulated by a compact coating layer. The MnO2 layer was able to hinder the electrolyte solution from corroding the LTMO particles and optimized the formation of a solid electrolyte interface (SEI). Meanwhile, lithium ions were reversibly inserted into and extracted from MnO2, which afforded an additional capacity. Compared with the bare LTMO, the MnO2-coated sample exhibited enhanced electrochemical performance. After the MnO2 coating, the first discharge capacity rose from 224.2 to 239.1 mAh/g, and the initial irreversible capacity loss declined from 78.2 to 46.0 mAh/g. Meanwhile, the cyclic retention climbed up to 88.2% after 100 cycles at 0.5 C, which was more competitive than that of the bare LTMO with a value of 71.1%. When discharging at a high current density of 2 C, the capacity increased from 100.5 to 136.9 mAh/g after the modification. These investigations may be conducive to the practical application of LTMO in prospective automotive Li-ion batteries.

Abstract The gastrointestinal tract is responsible for food digestion and absorption. The muscularis propria propels the foodstuff through the GI tract and defects in intestine motility may cause obstruction disorders. Our present genetic studies identified non-receptor tyrosine kinase c-Abl as an important regulator of the muscularis propria homeostasis and a risk factor for rectal prolapse. Mouse deficient for c-Abl showed defects in the muscularis propria of gastrointestinal tract and older c-Abl −/− mice developed megaesophagus and rectal prolapse. Inhibition of c-Abl with imatinib mesylate, an anti-CML drug, or ablation of c-Abl using Prx1-Cre, which marks smooth muscle cells, recapitulated most of the muscularis propria phenotypes. The pathogenesis of rectal prolapse was attributable to overproliferation of smooth muscle cells, which was caused by enhanced ERK1/2 activation. Administration of ERK inhibitor U0126 impeded the development of rectal prolapse in c-Abl deficient mice. These results reveal a role for c-Abl-regulated smooth muscle proliferation in the pathogenesis of rectal prolapse, and imply that long-term use of imatinib mesylate may cause gastrointestinal problems in patients while ERK inhibitor may be effective in treating rectal prolapse.

Aim: To explore challenges that Chinese head nurses confront on financial management from the perspective of different levels of nursing and non-nursing managers and to provide contemporary nurse managers with suitable supports. Methods: Eighteen nursing leaders in different levels were divided into two groups: Junior Leadership Group (head nurses) and Senior Leadership Group (nurse coordinator, nurse executive, and vice-president of the hospital). All the subjects were invited to participate in a semi-structured interview. The interviews were audio-taped and transcribed, and data were analyzed using a comparative content approach. Results: The four following challenges that head nurses confront on financial management practice were identified from the research findings: 1) lack of intrinsic motivation; 2) insufficient training and education on financial management and nursing economics; 3) desires for cross-uniting communication and cooperation; 4) insufficient reference managerial tool. Conclusions: The confusion confronted by head nurses in Changsha include three aspects: managerial roles, managerial training, and managerial tools. Cooperative management model, evidence-based management training, and data-driven tools will contribute to improving the financial management capacity of nurse managers.

Purpose: This study aimed to test the feasibility and estimate the effectiveness of a theory-driven and evidence-based educational intervention program to manage the nutrition impact symptom cluster in patients undergoing radiotherapy for nasopharyngeal carcinoma (NPC)., Methods: A pilot randomized controlled trial was performed. Forty patients were divided equally into the intervention and control groups. The patients in the intervention group attended 2 face-to-face individual instructional sessions to enhance their knowledge and skills in managing the cluster. The study outcomes were the severity of the nutrition impact symptom cluster, body weight, symptom interference, and quality of life (QOL). A generalized estimating equation model was used to compare the differences in the outcome variables between the groups over 3-time points., Results: The consent rate for the study was 95.2%, and the attrition rate was 5.0%. Although no significant differences between the groups were detected from T1 to T3, favorable effects on relieving the cluster itself (B [95% confidence interval (CI)] = -0.844 [-2.261, 0.572], p = 0.243, Cohen's d [95% CI] = -0.37 [-1.00, 0.28]) and improvements in physical well-being (B [95% CI] = 0.833 [-3.965, 5.632], p = 0.734, Cohen's d [95% CI] = -0.15 [-0.78, 0.49]) and in head and neck cancer-specific QOL (B [95% CI] = 0.061 [-4.061, 4.182], p = 0.977, Cohen's d [95% CI] = -0.05 [-0.68, 0.59]) were observed in the intervention group compared with the control., Conclusions: The educational intervention program is feasible and has promising effects on relieving the cluster., (Copyright © 2021 Elsevier Ltd. All rights reserved.)