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Background: Survivors and their families may face significant challenges as a result of the short- and long-term sequelae of pediatric brain tumours and treatment. There is a lack of clarity regarding whether existing approaches adequately address the needs of parent caregivers. Using a semistructured interview guide, we aimed to identify ways to further support the treatment of medulloblastoma. Methods: A qualitative exploratory study was conducted at an academic pediatric hospital in China. A total of 15 parents of children with medulloblastoma aged 3-14 years participated in this study. A semi-structured interview guide was used to interview eligible participants, which lasted approximately 30 to 40 minutes. We transcribed the interviews verbatim and used thematic analysis to identify factors related to the conflict and expectations of the parents. Results: Parents have outlined a number of difficulties they have encountered while seeking treatment, including delayed diagnoses, advanced disease at the time of presentation, a lack of effective multidisciplinary care, and an economic burden. Consequently, the families have a number of expectations regarding health services, social services, and economic support in order to reduce these burdens. It is expected that they will be able to communicate more effectively with their healthcare providers, which is very important to staying engaged in their treatment. Conclusion: Parents often encounter various difficulties during treatment courses, resulting in heavy economic and social burdens. The establishment of a diverse support network is recommended to ensure that the needs of patients are met in terms of medical care, family, social organizations, etc.

Despite the well-documented advantages of regular physical activity (PA), patients with cancer show suboptimal participation. By using game design elements, gamification could be used to motivate individuals to engage in PA. It has been demonstrated that gamification interventions positively affect children, adolescents and older adults in health-related contexts. There are, however, inconsistent findings regarding the impact of gamification interventions on cancer survivors' PA and health-related outcomes, according to the literature.The aim of this study is to examine the effectiveness and feasibility of gamification interventions for improving PA and health-related outcomes among cancer survivors.A systematic review and meta-analysis were conducted following the Cochrane Handbook and PRISMA guidelines. Eight English databases and three Chinese databases were searched to identify eligible articles from inception to February 2022. Two reviewers independently performed the literature screening and data extraction. The Cochrane Risk of Bias tool was used to assess the risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) Working Group levels of evidence was used to evaluate the certainty of the findings.Ten randomised controlled trials (RCTs) published between 2014 and 2022 were included. The meta-analysis revealed no significant differences in the step counts and for moderate to vigorous PA, and the certainty of the findings was very low, according to GRADE. Meta-analysis for most outcomes could not be performed owing to the fewer included studies and significant heterogeneity. Most studies reported positive effects in improving moderate PA, sedentary behaviour, fatigue and at least one domain of quality of life. This review proved that gamified interactions are associated with low adverse event rates.Gamification interventions could be a feasible way to promote the adoption of mobile health (mHealth) technology in patients with cancer. Individual studies have demonstrated some positive effects of gamification interventions on PA and health-related outcomes. However, limited studies, small sample sizes and methodological heterogeneity weaken the evidence. Larger, well-designed RCTs are required to confirm the impact of gamification interventions on PA and health-related outcomes in cancer survivors.

This study aims to identify and reach a consensus among experts on the specific gastroenterology drugs that a gastroenterology nurse may be able to prescribe.This study employs a modified Delphi design to reach a consensus among medical and nursing experts about the gastroenterology system drugs that nurses may prescribe medication.From August 2019-November 2019, a two-round study, consisting of 26 medical and nursing experts, was conducted using the Delphi method. IBM SPSS Ver. 22 and descriptive statistical software were used to analyse the results of the consultations.A total of 37 drugs across nine categories are identified as relevant to Chinese nurses working in gastroenterology departments. Among them, four drugs are generally prescribed independently, 24 tend to be prescribed collaboratively and nine are prescribed either independently, or in collaboration with others.This list is a fundamental and dependable instrument for identifying the gastroenterology drugs that could possibly be prescribed by gastroenterology nurses in China. The research results have important guiding significance for the formulation and implementation of relevant policies for nurses to prescribe medicines.Nurse prescribing has become a global trend and is slowly gaining attention in China under the development strategy of 'Healthy China'. As such, this list will give some reference for policy formulation and implementation of future nurse prescribing in mainland China.目的: 本研究旨在确定消化科护士可能开出的特定消化科药物, 并在专家之间达成共识。 设计: 本研究采用了改进的Delphi设计, 以使医学和护理专家对护士可能开出的消化科药物达成共识。 方法: 2019年8月至2019年11月, 采用Delphi方法进行了为期两轮的研究 (由26名医疗和护理专家组成)。使用IBM SPSS版本22和描述性统计软件来分析咨询结果。 结果: 共有9种类别的37种药物被确定与在消化科工作的中国护士有关。其中, 通常独立开出4种药物, 倾向于合作开出24种药物, 或者独立或与其他药物联用开出9种药物。 结论: 该清单是识别消化科药物的基础和可靠工具, 这些药物可能由中国的消化科护士开出处方。研究结果对制定和实施护士开具处方药相关政策具有重要的指导意义。 影响: 在“健康中国”的发展战略下, 护士开具处方药已成为全球趋势, 并在中国逐渐受到关注。因此, 该清单将对中国大陆未来护士开具处方药的政策制定和实施提供参考。.

To analyse the current status and publication trends of funded studies in nursing-related research from 2008 to 2018, available in the Web of Science.A longitudinal bibliometric analysis of publications of funded studies in nursing-related research, obtained from the Web of Science, was conducted.On 10 May 2019, we accessed 77,772 funded studies (2008-2018) from the Web of Science. Bibliometric methods and indicators were used to classify the publications and summarize the overall number, countries/regions, institutions, journals, and other parameters of the publications.The global output of nursing-related funded research publications increased significantly over time. The three leading countries with the highest number of funded publications were the United States, Australia, and the United Kingdom, with the United States accounting for 15 of the top 20 institutions associated with funded publications, which mostly included institutions of higher education. The most common disciplines of these publications were oncology, psychiatry, and paediatrics. The top three journals that published the largest number of nursing-related funded publications were the Journal of Clinical Nursing, the Journal of Advanced Nursing, and the International Journal of Nursing Studies. Keywords with the highest frequency of occurrence included "nurses," "qualitative research," "older people," "quality of life," "depression," "cancer," and "children."Nursing-related research has been drawing increasing attention over the years. Analysing the output of funded publications and monitoring the new dynamics of the international development of academic research in the field of nursing are crucial for determining future directions of nursing-related research development.The results of this study will provide a reference for scholars to evaluate the current utilization efficiency of global nursing-related research funding and demonstrate the development and trends in nursing-related research.目标: 分析2008年至2018年科学网上护理相关研究方面获资助论文的现状和发表趋势。 设计: 对科学网护理相关研究方面获资助论文发表进行纵向文献计量分析。 方法: 2019年5月10日,我们查阅了科学网上77,772篇获资助论文(2008年至2018年)。采用文献计量学方法和指标对发表文章进行分类,并对发表文章的总数、国家/地区、机构、期刊等参数进行汇总。 结果: 随着时间的推移,获资助的护理相关研究文章的全球产出显著增加。获资助文章数量最多的三个主要国家是美国、澳大利亚和英国,在与获资助文章有关的前20所院校中,美国占15所,其中大部分是高等教育机构。这些文章中最常见的学科是关于肿瘤学、精神病学和儿科学。发表获资助的护理相关文章数量最多的三大期刊是《临床护理杂志》、《高级护理期刊》和《国际护理研究杂志》。出现频率最高的关键词包括“护士”、“定性研究”、“老年人”、“生活质量”、“抑郁”、“癌症”和“儿童”。 结论: 近年来,护理相关研究越来越受到重视。分析获资助文章的产出并监测护理领域的国际学术研究发展的新动态,对于确定未来护理相关研究发展方向至关重要。 影响: 本研究的结果将为学者们评价当前全球护理相关研究经费的利用效率,展示护理相关研究的发展和趋势提供参考。.

Background: Clinical research publications have become the dominant source and basis of clinical evidence-based decision-making, and the PubMed database has the most extensive application foundation in the world. Exploring the type and quantity of clinical research publications in the PubMed database is useful for clarifying the changing trends of clinical research development in recent years. Therefore, a longitudinal analysis of the type and quantity of clinical research publications in the PubMed database over three decades was conducted and combined with evidence-based medicine to provide reference for the rational allocation of clinical research resources in future.Methods: The PubMed database was searched to retrieve clinical research according to the type and year of publication from January 1, 1991 to December 31, 2020. The research types were classified as primary and secondary literature using randomized controlled trial (RCT), non-randomized controlled trial (non-RCT), and pragmatic clinical trial (PCT); cohort, case control, and cross-sectional study; case report/series; guideline; expert consensus; narrative, systematic, umbrella, and scoping review; traditional meta-analysis (Tra-meta), systematic review and meta-analysis (Sys-meta), and network meta-analysis (Net-meta). The statistical analyses focused on identifying the changes in the quantity, annual growth rate, and 30-year average growth rate of each specific study type in primary and secondary literature between 1991 and 2020; changes in the constituent proportion of each specific study type in primary and secondary literature; and changes in the ratio of the quantity of guidelines and meta-analysis to primary literature.Results: A total of 1,078,404 primary literatures were retrieved and the constituent proportions were ranked from high to low as case report/series (27.54%), RCT (23.62%), cohort study (21.05%), cross-sectional study (17.49%), case control study (9.15%), non-RCT (1.01%), and PCT (0.15%). Correspondingly, 1,302,173 secondary literatures were retrieved and ranked as narrative review (70.88%), systematic review (15.02%), Sys-meta (13.89%), Tra-meta (4.48%), expert consensus (2.31%), guidelines (1.49%), scoping review (0.68%), Net-meta (0.40%), and umbrella review (0.04%). The average annual growth rate for the primary literature was 10.28%, and ranked from high to low as PCT (83.68%), cohort study (17.74%), cross-sectional study (17.61%), non-RCT (12.11%), case control study (8.86%), RCT (7.68%), case report/series (7.51%); while that for the secondary literature was 10.57%, and ranked from high to low as Net-meta (48.97%), umbrella review (47.09%), scoping review (41.92%), Sys-meta (33.44%), systematic review (33.05%), Tra-meta (12.49%), expert consensus (9.22%), narrative review (8.72%), and guidelines (2.82%). The analysis based on the ratio of the number of secondary literature to the primary literature, the guidelines to primary literature ratio decreased year by year, from 12.08% in 1991 to 1.39% in 2020, for a total ratio of 3.28%, while the meta-analysis to primary literature ratio increased year by year, from 4.59% in 1991 to 27.76% in 2020, for a total ratio of 21.04%.Conclusion: Both the structure and number of clinical studies changed significantly from 1991 to 2020. Based on the trend, the case report/series, case control study, and narrative review are on the decline, while cohort study, cross-sectional study, systematic review, and Sys-meta have increased. Combined with the grade standard of evidence-based medicine, we recommend enhancing the focus on RCT and cohort study when allocating research resources, as well as improving the quality rather than quantity of Sys-meta and systematic reviews in future.

Aims. To explore the study of the relationship between the level of gut flora in childhood obese people and normal healthy people based on the analysis of machine learning. Materials and Methods. The stools of 54 normal weight, 53 overweight, and 59 obese children from May 2021 to May 2022 were selected. And DNA was extracted, and primers specific for the four bacteria were designed according to the specificity of the four bacteria to the 16 S rDNA gene sequences of the bacteria to be tested, and real-time fluorescence quantitative PCR reactions were performed to compare whether there was any difference in the number of the four bacteria between the three groups. Results. The results of agarose gel electrophoresis showed that the PCR amplification products of all four target bacteria showed clear bands at the corresponding positions, and no nonspecific bands appeared. When compared with the marker, the size matched with the target fragment, indicating good primer specificity. The comparison between normal body recombinant, super recombinant, and obese groups was statistically significant ( P < 0.05 ) for rectal eubacteria, polymorphic anaplasma, bifidobacteria spp., and lactobacilli. The median number of bifidobacteria in the three groups was significantly higher than the median number of rectal eubacteria, polymorphomycetes, and lactobacilli. The difference in comparison was statistically significant ( P < 0.05 ). Stratified analysis of children’s age revealed that normal body composition of Lactobacillus decreased with increasing age, and the difference was statistically significant ( P < 0.05 ). Conclusion. An increase in rectal eubacteria and a decrease in polymorphomycetes, bifidobacteria spp., and lactobacilli may be associated with the development of obesity. The numbers of rectal eubacteria, polymorphic methanobacteria, bifidobacteria spp., and lactobacilli in the intestine of normal weight and obese children were less affected by sex and age.

This study aimed at exploring the concentration‐effect relationship of adalimumab and early adalimumab and anti‐adalimumab antibody (AAA) levels in predicting primary nonresponse in a real‐world pilot cohort of patients with ankylosing spondylitis. Thirty‐one patients were included. The Ankylosing Spondylitis Disease Activity Score improved with increasing adalimumab trough level at week 12 and reached a major improvement with levels between 8 and 12 μg/mL. Moreover, weeks 4 and 2 adalimumab levels below 4.28 and 3.37 μg/mL were predictive of primary nonresponse (area under the curve (AUC) = 0.89, 0.88; P = 0.0003, P = 0.034, respectively). Week 4 AAA signal‐to‐noise levels were significantly higher among primary nonresponders, and the cutoff for primary nonresponse prediction was above 5.31 (AUC = 0.81; P = 0.004). Adalimumab trough levels in a range of 8–12 μg/mL are optimum to reach major improvement, and lower adalimumab with higher AAA levels at the early stage (week 4) predict primary nonresponse by supporting proactive monitoring to optimize adalimumab therapy.

To analyze the cause and pregnancy outcome for non-reportable cell-free DNA (cfDNA) results during non-invasive prenatal testing (NIPT).cfDNA was extracted from maternal plasma from 5898 singleton pregnancies at 12 to 22 gestational weeks and underwent NIPT with strict quality control standards. For those with sub-standard results, redraw or invasive prenatal procedures were recommended.Among the 5898 cases, 32 have failed for the initial NIPT, including 17 cases with substandard cffDNA%, 10 cases with data fluctuation after twice library constructing and sequencing, and 5 cases with unidentifiable sex chromosome abnormalities. For these 32 cases, 2 directly underwent amniocentesis, and karyotyping analysis showed both were normal. Six of the 30 redrawn cases finally turned out to be nonreportable. The final nonreportable rate was therefore 0.1% (8/5898). Of the redrawn cases, 1 trisomy 21, 1 trisomy 18 and 1 trisomy 13 high risk-cases were identified, which were all confirmed to be false positive. Among the 6 nonreportable cases, 2 women underwent invasive prenatal testing, and 1 was found to have a normal fetal karyotype, while another was found to have an abnormal karyotype of mos45,X[32]/46,XY[18]. The other 4 nonreportable cases who did not accept invasive prenatal testing have all reported normal child development at follow-up.The main reason for nonreportable NIPT results was low cffDNA%. The high success rate of the redrawn cases has effectively increased the overall NIPT success rate and reduced the number of the cases necessitating invasive prenatal diagnosis. The initially nonreportable women may consider retesting after careful counseling with informed consent.

Shiliang Ji,1 Fei Xu,2 Ruifang Zhu,1 Cheng Wang,2,3 Dongkai Guo,1 Yiguo Jiang1 1Laboratory of Clinical Pharmacy, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, People’s Republic of China; 2College of Pharmacy, Nanjing Medical University, Nanjing, People’s Republic of China; 3The Health Supervision Institute of Suzhou High-Tech Zone, Suzhou, People’s Republic of ChinaCorrespondence: Dongkai Guo; Yiguo JiangLaboratory of Clinical Pharmacy, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, No. 1 Li Jiang Road, High-Tech District, Suzhou, 215153, People’s Republic of ChinaTel +86-512-69584330Fax +86-512-69584513Email dongkaiguo@126.com; jiangyiguo0515@126.comBackground: Yinqin oral liquid (YOL) has curative effect for upper respiratory tract infections, especially for chronic pharyngitis (CP). Since the traditional Chinese herbal formulae are complicated, the pharmacological mechanism of YOL remains unclear. The aim of this work was to explore the active ingredients and mechanisms of YOL against CP.Methods: First, the profile of putative target of YOL was predicted based on structural and functional similarities of all available YOL components, which were obtained from the Drug Bank database, to the known drugs using TCMSP. The chemical constituents and targets of honeysuckle, scutellaria, bupleurum and cicada were searched by TCMSP, CTD, GeneCards and other databases were used to query the CP-related genes, which were searched by UniProt database. Thereafter, the interactions network between compounds and overlapping genes was constructed, visualized, and analyzed by Cytoscape software. Finally, pathway enrichment analysis of overlapping genes was carried out on Database for Annotation, Visualization, and Integrated Discovery (DAVID) platform.Results: The pathway enrichment analysis showed 55 compounds and 113 corresponding targets in the compound-target network, and the key targets involved PTGS1, ESR2, GSK3β, NCOA2, ESR1. The PPI core network contained 30 proteins, including VEGFA, IL6, ESR1, RELA and HIF1A. A total of 148 GO items were obtained (p< 0.05), 102 entries on biological process (BP), 34 entries on biological process (BP) and 12 entries on cell composition (CC) were included. A total of 46 signaling pathways were obtained by KEGG pathway enrichment screening (p< 0.05), involving cancer, PI3K-AKT, hepatitis, proteoglycans, p53, HIF-1 signaling pathways.Conclusion: These results collectively indicate YOL (including the main ingredients luteolin and baicalein) as a highly effective therapeutic agent for anti-inflammation, through the NF-kB pathway.Keywords: Yinqin oral liquid, chronic pharyngitis, network pharmacology, NF-kB, multi-target analysis

Based on the concept and research status of big data, we analyze and examine the importance of constructing the knowledge system of nursing science for the development of the nursing discipline in the context of big data and propose that it is necessary to establish big data centers for nursing science to share resources, unify language standards, improve professional nursing databases, and establish a knowledge system structure. Keywords: Artificial intelligence, Data mining, Knowledge bases, Nursing

As nursing becomes a first-level discipline, the central focus of the development process of nursing science is the independent exploration of the future path of nursing care. Although many countries have made efforts to develop nursing as an independent discipline, no remarkable advancement has been achieved due to the incorrect understanding of the relationship between nursing and medicine and the improper comprehension of other factors involved in the process of nursing reform. Teaching and practicing nursing also face many problems. Based on our understanding of the relationship between nursing and medicine and through a careful analysis of the existing problems in the current nursing discipline, this paper provides some insights into the future directions of nursing development by exploring the independently developing nursing discipline in foreign countries.

Background In China, aging has become a serious social problem, and the number of empty-nest elderly is on the rise. The aim of this study is to clarify the prevalence of depressive symptoms among empty-nest elderly in Shanxi province and evaluate the effects of sociodemographic factors and health-promoting lifestyles so as to provide a scientific reference for preventing and intervening their depression. Methods A cross-sectional study, which used a multi-stage random cluster sampling way, was conducted among 4901 empty-nest elderly in Shanxi. An independent t-test and a chi square test were used to compare the sociodemographic factors, depression scores, and health-promoting lifestyle scores of the empty-nest elderly. Multinomial logistic regression was used to analyze the potential influencing factors for depression. Results The prevalence of depressive symptoms in the population was 64.2%. Among all participants 1,776 (36.2%) had mild depression, 1,236 (25.2%) had moderate depression, and 135 (2.8%) had severe depression. The health-promoting lifestyle of the empty nesters in this study was at the medium level (2.51 ± 0.47). Gender, education level, old-age provision model, exercise frequency, chronic disease, relationships with children, self-care ability, and health-promoting lifestyles were found to be influencing factors of depression and all variables had different effects on different degrees of depression. Limitations This was a cross-sectional study, so the results cannot establish causal relationships among the study variables. Conclusions Depression was prevalent among the empty-nest elderly in Shanxi. Maintaining good interpersonal relationships, developing extensive interests, and maintaining healthy lifestyles including good nutrition habits and regular exercises can reduce the incidence of depression among empty nesters.

Objectives This study aimed to investigate anxiety status and its relationship with body mass index (BMI) among empty nesters in China, so as to improve their quality of life and provide direction for further research. Methods A cross-sectional survey was conducted among 4901 empty nesters in Shanxi, China. Anxiety, weight, height, depression, socio-demographic variables, attention to daily nutritional health, social activities, and self-care ability were evaluated in the study. T-tests and chi-square tests were used to compare differences in categorical and continuous variables. Binary logistic regression was performed to explore the association between anxiety and BMI among male and female empty nesters. Results The results showed that 44.5% of empty nesters reported anxiety, of which, 43.2% were male participants and 45.9% were female participants. After adjusting for other variables, overweight empty nesters odds ratio (OR; 95% confidence interval [CI]) = 0.813 (0.692-0.954) were less likely to be anxious, compared with their normal-weight counterparts. Gender was a significant factor in the relationship, with the negative association between overweight and anxiety only found in female empty nesters OR (95%CI) = 0.718 (0.572-0.901). Income, education, complete self-care ability, and depression showed significant associations with anxiety. Conclusion The prevalence of anxiety was high in the study population. Gender is a significant factor in the relationship between anxiety and BMI among empty nesters. The results intend to inform the government and media that overweight is a protective factor for anxiety among female empty nesters, necessitating a move toward eliminating weight bias.

This study proposes the establishment of a knowledge-system ontology in the nursing field. It uses advanced data mining techniques, digital publishing technologies, and new media concepts to comprehensively integrate and deepen nursing knowledge and to aggregate sources of knowledge in specialized technical fields. This study applies all forms of media and transmission channels, such as personal computers and mobile devices, to establish a knowledge-transmission system that provides knowledge services such as knowledge search, update retrieval, evaluation, questions and answers (Q&As), online viewing, information subscription, expert services, push notifications, review forums, and online learning. In doing so, this study creates an authoritative and foundational knowledge service engine for the nursing field, which provides convenient, flexible, and comprehensive knowledge services to members of the nursing industry in a digital format.

Advanced lung cancer is becoming a chronic disease threatening human life and health. Cachexia has been recognized as the most common problem associated with advanced lung cancer. Lung cancer-induced cachexia seriously affects patients' quality of life. The present article summarizes the pathogenesis of advanced lung cancer-induced cachexia from three aspects: anorexia, cytokines, and energy and metabolic abnormalities. In addition, the present article proposes corresponding nursing measures based on cachexia pathogenesis to improve the quality of life and survival rate of cachectic patients with advanced lung cancer by combining continuously advancing treatment regimens and effective nursing. The present article also provides references for healthcare professionals when administering related treatments and nursing care.

Traditional Chinese medicine remains a valuable portal into an alternative way of perceiving health and illness. In view of holistic health care, this article supports nursing professionals embracing the concept and the skill of acupuncture as a great gift to empower them to expand on their already remarkable capacity in the nursing profession.

Aim To examine past Florence Nightingale Medal recipients’ parallels with the evolving nature of the nursing field as a whole. Design Descriptive research. Method The professional and demographic characteristics of 1,449 Florence Nightingale Medal recipients between 1920 and 2015 were analyzed to develop a high-level overview of the award recipient characteristics. Result Medal recipients were primarily female (98.07%), with 36% being Specialist nurses. Awards were mainly conferred for aid work (30.4%) in the context of war or armed conflict followed by Nursing education (17.2%) and disaster aid (14.9%). The majority of recipients were affiliated with the Red Cross and the majority of recipients were those conducting Red Cross duties. Conclusion Our results offer statistical validation for the dedication of these exceptional individuals, while also highlighting overall parallels with the ongoing development of the nursing field as it expands to better deliver culturally-sensitive care and to overcome outdated stereotypes that would otherwise constrain innovation.

Diabetes, a chronic non-communicable disease, has become one of the most serious and critical public health problems with increasing incidence trends. Chronic vascular complications are the major causes of disability and death in diabetic patients with endothelial dysfunction. Diabetes is intimately associated with endothelial mitochondrial dysfunction, indicated by increased oxidative stress, decreased biogenesis, increased DNA damage, and weakened autophagy in mitochondria. All these morphological and functional changes of mitochondria play important roles in diabetic endothelial dysfunction. Herein, we reviewed the roles and mechanisms of endothelial mitochondrial dysfunction, particularly mitochondrial dynamics in the vascular complications of diabetes and summarized the potential mitochondria-targeted therapies in diabetic vascular complications.

This study aimed to investigate the factors impacting time to diagnosis in pediatric central nervous system tumors. A descriptive, cross-sectional design was used in this study. A self-developed questionnaire for health-seeking behavior and influencing factors was used in children with intracranial tumors. The factors related to time to diagnosis and the long-term prognosis of children were analyzed. A total of 433 families replied to the questionnaire. The median parental interval was 50 days (range 0 ~ 884), the median diagnostic interval was 97 days (range 4 ~ 1646), and the median prediagnostic symptomatic interval (PSI) was 123 days (range 8 ~ 1844). Higher education was associated with a shorter parental interval (mother: P = 0.048; father: P = 0.035). The diagnostic interval was shortened in patients with dizziness (P = 0.022), abnormal eye movement (P = 0.034), or drowsiness (P = 0.021). A shorter PSI was observed in patients who presented with high intracranial pressure such as headache (P = 0.016), dizziness (P = 0.009), or drowsiness (P = 0.023) and those who went to a higher-level health institution or patients who went to neurology or neurosurgery department as the first medical consultation. No statistically significant difference was found in the interval time (parental interval, diagnostic interval, and PSI) regarding patients’ outcomes. Different time intervals showed different factors influencing the long delay in diagnosing central nervous system tumors, highlighting the need for increased awareness to improve the treatment efficacy.

Objective To assess the overall trends in the development and citation impact of high-impact papers in nursing research worldwide to gain insight into the focus areas of nursing research. Background Bibliometric method is proved to be effective in analysing the papers' characteristics, and it gained considerable interest from the scientific community in recent years. An analysis of the characteristics and intrinsic patterns of high-impact papers in nursing research will provide an objective reflection of the research hot spots. Nursing managers can pointedly increase funding amount and strengthen research cooperation in order to put the scientific results into management practice. Methods Bibliometric methods and visualization software were used to comprehensively analyse high-impact papers in nursing research in terms of development trends, countries/regions, distribution of subject areas, research institutes, collaborative networks and subject terms. Results There were 6,886 papers between 2008 and 2018. The number of papers increased from 528 in 2008 to 723 in 2015, and then remained above 600 in 2016 and 2017. These papers were mainly distributed in nursing, oncology, paediatrics, gynaecology, teaching and education, and cardiac and cardiovascular systems and were cited by 128,845 papers that came from 89 Web of Science subject areas. Papers in nursing research accounted for the largest share of these citations. The top five countries in the world in terms of the number of high-impact papers were the United States, Australia, the United Kingdom, Canada and Sweden. The research institutions with the highest number of high-impact papers worldwide were the University of California System, the University of Pennsylvania, the University of North Carolina, the University of London and the University of Technology Sydney. In this data set, it was shown that research collaborative circles have been formed in the United States, Australia, Canada and Europe; the subject-term analysis indicated that 'women' and 'students' have always been high-interest populations for high-impact papers and that cancer is still one of the greatest threats to human health. Furthermore, the subject terms of high-impact papers in nursing research have gradually evolved from 'disease' and 'therapy' to 'symptoms'. Conclusion In recent years, the number of high-impact papers published each year in nursing research has grown over time. Nursing has been shown to be a highly specialized subject, and the majority of its high-impact papers have been published by research institutions. Although cross-regional collaborations are beginning to emerge, there is much room for improvement in this regard. Finally, women, students, cancer and symptomatic care are the current focus areas in nursing research. Implications for nursing management This study informs nursing managers within the nursing research field about subject areas, collaborative networks and hot topics. It is beneficial to pay attention to studies, manage scientific outputs, allocate resources, seek cooperation and improve the work efficiency of scientific research management.

Background With the disintegration of the extended family in recent years, the empty-nest phenomenon is increasingly common in China and the health of empty nesters is attracting more attention. Lifestyles, accounting for 53% in determining death, play a vital role in improving the health of individuals. However, it was rarely studied in promoting the health of empty nesters. In this study, we proposed a “SMG” model in empty nesters, including the self-management, mutual management, and group management, to implement health-promoting lifestyles interventions among empty nesters to provide an effective means to improve their lifestyles and health. Methods We conducted a prospective intervention on 350 empty nesters in three communities located in Taiyuan, China. One hundred sixty-seven empty nesters were randomly assigned to the intervention group with SMG-based health-promoting lifestyles interventions used for 7-months, and 183 were randomly assigned to the control group with no measures imposed. The Health-Promoting Lifestyle Profile (HPLP-C) was used to rate the lifestyles of empty nesters. Generalized estimation model was used to analyze the differences between the intervention and control groups over time, adjusted for education and employment. Results After 7 months of health-promoting lifestyles intervention, HPLP-C score and each dimension score in the intervention group all increase from baseline. There were significant differences after intervention associated with time and group interaction effects in aspects of HPLP-C (mean score = 8.838, 95%CI:6.369–11.306), self-realization (mean score = 1.443, 95%CI:0.352–2.534), Health responsibility (mean score = 1.492, 95%CI:0.477–2.508), physical activity (mean score = 1.031, 95%CI:0.572–1.491), nutrition (mean = 0.827, 95%CI:0.177–1.476), interpersonal relations (mean = 2.917, 95%CI:2.365–3.469) and stress management (mean score = 0.729, 95%CI:0.131–1.327). And education is contributing to the effect of the health-promoting lifestyle intervention (Estimate:8.833, p Conclusions SMG-based health-promoting lifestyles intervention in empty nesters effectively improved the lifestyles of empty nesters, and the outcome was affected by education. Lifestyle change requires ongoing intervention, and community service centres must be involved in implementing the “SMG” model to provide ongoing support and improve the effect of interventions among empty nesters. Trial registration Chinese Clinical Trial ChiCTR1800015884. Registration date: 26–04-2018. Retrospectively registered.

Background: External ventricular drainage (EVD) is common after brain surgery. However, the incidence of EVD-related infection (ERI) is still relatively high and can increase morbidity and mortality.Objective: The objective of this study was to analyze ERI factors in pediatric population post-brain tumor surgery.Methods: From January 2016 to December 2017, 147 patients

In this paper, we develop the channel estimation algorithm for a massive multiple input multiple output (MIMO) system using one-bit analog-to-digital converters (ADCs). Although, one-bit quantization significantly reduces the deployment cost and power consumption of the massive MIMO, the great distortion induced by one-bit quantization makes channel estimation more difficult. Therefore, a channel estimation method by executing a deep neural network (DNN) over multiple signal segments is proposed for the uplink of one-bit massive MIMO. The average of the DNN’s outputs throughout all the segments is the final channel estimate for a transmission block. In order to improve the estimation accuracy without increasing the length of pilot, the data symbols got based on the initial channel estimates are used as the other part of pilots to refine the estimation result. Moreover, a sliding window based pilot segment method is adopted to increase the number of signal segments with a same pilot length. The simulation results show that the proposed scheme outperforms least squares (LS) and Bussgang linear minimum mean squared error (BLMMSE) channel estimators in the whole signal-to-noise-ratio (SNR) region.

At present, with the continuous development of the trend of population aging worldwide, more elderly people are increasingly facing serious life disorders caused by physical and mental disability. In this study, the common symptoms and the nursing practice related to diseases of the disabled elderly are reviewed with reference to the basic concepts of disability care and the current situation of domestic and foreign research, which is expected to provide the basis for the construction of a new model of disability nursing.

Objective This study aimed to explore the 100-year changes in regulations for the Florence Nightingale Medal. Methods We used the announcements of the Florence Nightingale Medal awards as the research object to analyze – via historical and inductive methods – the regulations for receiving the Florence Nightingale Medal. Results In the award years, the greatest number of winners per award year was 71 and the lowest was 12. The medal was initially exclusively awarded to living people but evolved to include both living and deceased people. The recipients were balanced among all countries. The gender of the winners showed a changing trend from being limited to only females to including both males and females. There was also a shift from emphasis on only dedication of the recipient to equal emphasis on both dedication and innovation. Conclusions The selection criteria for recipients of the Florence Nightingale Medal evolved from consideration of those showing only dedication to equal consideration of both dedication and innovation.

Objective To investigate the research hotspots and development trends of Chinese geriatric medicine by analyzing the high-frequency keywords, core authors, research institutions and their collaborations in papers published in the Chinese Journal of Geriatrics . Methods Bibliometric methods and information visualization software (CiteSpace III) were used to analyze the following 3 aspects: keywords, institutions and authors. Results Overall, the number of papers published in the Chinese Journal of Geriatrics grew between 1994 and 2015. The top 3 institutions with the greatest numbers of published papers were Beijing Hospital, People's Liberation Army General Hospital and the Second Xiangya Hospital of Central South University. The authors with high productivity were Pulin Yu, Jianye Wang and Xiaoying Li. The terms “Diabetes”, “hypertension” and “myocardial infarction” were hotspot words that drew sustained attention in this field. Conclusions Research on geriatric medicine is growing steadily in China. Hospitals and teaching hospitals are major contributors to publications. The collaboration of authors is more common within the same institutions or in the same regions. Clinical research is still the focus of current research. In the future, basic research should be strengthened, and collaborations between different institutions and regions should be promoted to achieve coordinated and integrated development in Chinese geriatric medicine.

Background: TB is one of the top 10 causes of death and the leading cause from a single infectious agent. The study characterize the developmental trends and collaboration features in the field of tuberculosis (TB) at the national level and identify high-impact countries. Methods: Scientometrics and social network analysis methods were used to analyze the research situation and collaboration behaviors based on TB research indexed in Web of Science from 1998 to 2017. Results: The publication output, national collaborative rate, and collaborative level have steadily increased from 1998 to 2017. However, domestic publications still account for a substantial proportion of a nation's publications. Over time, the numbers of national publications and international collaborative publications have increased in total, but the growth trend of their share as a proportion of total national publications is not significant. The United States of America has the largest number of highly cited publications, while Denmark, the Netherlands, Switzerland, and Sweden have higher values of average relative citation than do other countries. Notably, the United Kingdom and South Africa have established the strongest and most stable collaboration. Conclusions: There was increasing research activity and collaboration in the field of TB during the period 1998 to 2017, but growth shows wide variability between countries. Further comprehensive and full collaboration should be promoted.

Aim To investigate the effect of sitagliptin on Wnt/β-catenin signalling in the tubulointerstitium of diabetic nephropathy. Methods Forty male Wistar rats were divided into normal control (NC), diabetic model (DM), low and high-dose sitagliptin intervention groups (ST1 and ST2, respectively). Changes in the biochemical parameters and tubulointerstitial fibrosis index were observed. The levels of protein and gene expression of different indicators were detected via immunohistochemistry and real-time polymerase chain reaction. NRK-52E cells were divided into the normal control group, mannitol control group, high glucose group (HG), high glucose plus sitagliptin intervention group (HG + ST) and high glucose plus Wnt/β-catenin inhibitor group (HG + XAV939). The relevant indicators were examined by Western blot or enzyme-linked immunosorbent assay. Results Compared with the NC group, the blood glucose, glycosylated haemoglobin, 24 h urinary albumin, creatinine clearance and tubulointerstitial fibrosis index were significantly increased in the DM group. These parameters were decreased in the ST1 and ST2 groups compared to the DM group. Compared with the NC group, the levels of Wnt4, β-catenin, dipeptidyl peptidase-4 and α-smooth muscle actin were higher and E-cadherin was lower in the DM group. Sitagliptin treatment reversed these changes. In the high glucose-stimulated NRK-52E cells, sitagliptin and XAV939 inhibited the elevated expression of Wnt4, β-catenin, dipeptidyl peptidase-4, α-smooth muscle actin, transforming growth factor-β and fibronectin and restored E-cadherin activity. Conclusion Sitagliptin may inhibit the tubulointerstitial Wnt/β-catenin signalling pathway in diabetic nephropathy and provide renal protection by alleviatinge renal tubulointerstitial transdifferentiation and fibrosis.

Holistic nursing practices holism and holistic modalities to create a healing space and optimize the healing process. Holistic nurses employ a complementary and integrative focus in their work and help patients access their greatest healing potential. This article supports that nursing professionals embrace acupuncture and alternative therapy as a great gift that inspire them to extend their already extraordinary healing power. An overview of the history of Traditional Chinese Medicine and the development and milestones of acupuncture and moxibustion in past dynasties is presented. In particular, the development of Traditional Chinese Medicine and acupuncture in the last 20 years, as well as how social and economic conditions have impacted their expansion, is discussed.

Background China has the world’s largest size of elderly population. Mental disorders of the elders deserve keen attention. This study aims to comparatively explore mental disorders and risk factors among empty and non-empty nesters. Methods Using the stratified random cluster sampling method, we recruited 8526 elders aged 60 years and above from 11 cities in Shanxi Province in central China, comprising 4901 empty and 3625 non-empty nesters. The mental disorders were assessed with the 12-item Chinese Health Questionnaire (CHQ-12). The binary logistic regression was performed to analyze the risk factors in the two groups. Results The prevalence of mental disorders in empty nesters was significantly higher than that in non-empty ones (26.9% vs 23.5%). Binary logistic regression showed that the empty nesters who lived alone or lived in an institution were more likely to suffer from mental disorders compared with the non-empty ones, empty nesters living with spouse showed no significant deviation. And single status, hardly or part self-care ability, having chronic diseases, having lower income, and paying less attention to daily healthy diet had positive associations with mental disorders for empty nesters, and no or partial self-care ability and having chronic diseases for non-empty nesters. Conclusions The study indicated that empty nesters had a higher prevalence of mental disorders than non-empty ones. Empty nesters living alone, with no or partial self-care ability, chronic disease, lower income and less attention to daily healthy diet were more vulnerable to mental disorders. And the lack of self-care ability and having chronic diseases were risk factors of mental disorders for non-empty nesters.

Additional file 2. Empty Nester Health Promotion Lifestyle Record.