Compassion fatigue (operationally defined as a nursing student’s reduction in empathetic capacity or interest towards ‘bearing the suffering of clients’ manifesting as consequent emotional and behavioural responses to secondary exposure of others’ traumatic experiences) among nursing students affects not only their physical and mental health, but it may also spread and undermine the stability of the nursing profession as a whole. Therefore, this study aims to delve deeply into the causes and trends of compassion fatigue among undergraduate nursing students and gain a better understanding of nursing students’ feelings, experiences and coping mechanisms in relation to compassion fatigue.

This mixed-methods study will be conducted in two phases. This study will recruit 110 nursing students from a teaching hospital in China. Eligible participants will be asked to complete validated questionnaires. Student interns will also be asked to participate in semistructured qualitative interviews to investigate their feelings, experiences and coping mechanisms in relation to compassion fatigue. Statistical analysis of survey data will include descriptive and inferential statistics, as well as qualitative content analysis.

This study has been approved by the Ethics Committee of the Chinese Medical University. The findings will be disseminated at conferences and journal articles.

Current status and factors influencing compassion fatigue in clinical placement nursing students: a mixed study (ChiCTR2500097955; Pre-results).

To explore the challenges experienced by people with intellectual disability, their carers and health and social care professionals when using and managing medication.

A synthesis of qualitative research using meta-ethnography.

We searched seven databases: MEDLINE, Embase, CINAHL, Science, Social Science and Conference Proceedings Citation Indices (Web of Science), Cochrane Library, PsycINFO and Proquest Dissertations and Theses from inception to September 2022 (updated in July 2023).

We included studies exploring the challenges and perceptions of people with intellectual disability, their carers and health and social care professionals regarding medication management and use.

We reviewed 7593 abstracts and 475 full texts, resulting in 45 included papers. Four major themes were identified: (1) Medication-related issues, (2) navigating autonomy and relationships, (3) knowledge and training needs and (4) inequalities in the healthcare system. We formulated a conceptual framework centred around people with intellectual disability and described the interconnectedness between them, their carers and health and social care professionals in the process of managing and using medication. We identified challenges that could be associated with the person, the medication and/or the context, along with a lack of understanding of these challenges and a lack of capability or resources to tackle them. We developed an overarching concept of ‘collective collaboration’ as a potential solution to prevent or mitigate problems related to medication use in people with intellectual disability.

The effective management of medication for people with intellectual disability requires a collaborative and holistic approach. By fostering person-centred care and shared decision-making, providing educational and practical support, and nurturing strong relationships between all partners involved to form a collective collaboration surrounding people with intellectual disability, improved medication adherence and optimised therapeutic outcomes can be achieved.

CRD42022362903.

The optimal method for conducting spontaneous breathing trials (SBTs) remains a subject of ongoing debate. High-flow oxygen via endotracheal tube (HFOT) has emerged as a novel alternative for SBTs. However, studies investigating the associated physiological changes are lacking. Compared to high-flow nasal cannula (HFNC), HFOT has demonstrated diminished physiological effects, likely due to the bypassing of the upper airway, which may limit its widespread adoption as an SBT strategy. Two HFOT interfaces with different expiratory port diameters will be evaluated. It is hypothesised that the narrower interface would generate higher airway pressure and mitigate weakening physiological effects compared to the HFNC. This study aims to compare the physiological effects of two HFOTs compared to T-piece during SBTs.

This is a single-centre, prospective, physiological randomised crossover study in adult patients receiving mechanical ventilation for more than 24 hours who are deemed ready for SBT. After enrolment, each patient will be disconnected from the ventilator and undergo five SBT phases in random order: T-piece at 6 L/min, HFOT via interface with an expiratory port diameter of 9.8 mm at 40 L/min and 60 L/min and HFOT via interface with an expiratory port diameter of 6.9 mm at 40 L/min and 60 L/min. To reduce carryover effects, each phase will be separated by a 10-min washout period during which baseline mechanical ventilation is resumed. Key physiological parameters will be assessed in each study phase, including airway pressure, changes in end-expiratory lung volume, vital signs, oxygenation levels and inspiratory effort. Postextubation inspiratory effort will also be measured. Finally, 20 patients with the complete five SBT phases and postextubation datasets will be analysed

The study protocol has been approved by the Institutional Ethics Committee and Review Board of Beijing Shijitan Hospital, Capital Medical University (IIT2024-157-002). The data generated in the present study will be available from the corresponding author on reasonable request. The results of the trial will be submitted to international peer-reviewed journals.

NCT06816706.

The objective of this study was to identify risk factors for enema reduction failure and to establish a combined model that integrates deep learning (DL) features and clinical features for predicting surgical intervention in intussusception in children younger than 8 months of age.

A retrospective study with a prospective validation cohort of intussusception.

The retrospective data were collected from two hospitals in south east China between January 2017 and December 2022. The prospective data were collected between January 2023 and July 2024.

A total of 415 intussusception cases in patients younger than 8 months were included in the study.

280 cases collected from Centre 1 were randomly divided into two groups at a 7:3 ratio: the training cohort (n=196) and the internal validation cohort (n=84). 85 cases collected from Centre 2 were designed as external validation cohort. Pretrained DL networks were used to extract deep transfer learning features, with least absolute shrinkage and selection operator regression selecting the non-zero coefficient features. The clinical features were screened by univariate and multivariate logistic regression analyses. We constructed a combined model that integrated the selected two types of features, along with individual clinical and DL models for comparison. Additionally, the combined model was validated in a prospective cohort (n=50) collected from Centre 1.

In the internal and external validation cohorts, the combined model (area under curve (AUC): 0.911 and 0.871, respectively) demonstrated better performance for predicting surgical intervention in intussusception in children younger than 8 months of age than the clinical model (AUC: 0.776 and 0.740, respectively) and the DL model (AUC: 0.828 and 0.793, respectively). In the prospective validation cohort, the combined model also demonstrated impressive performance with an AUC of 0.890.

The combined model, integrating DL and clinical features, demonstrated stable predictive accuracy, suggesting its potential for improving clinical therapeutic strategies for intussusception.

The causal relationship between sleep characteristics and aortic aneurysm and dissection (AAD) is little known.

In this two-sample Mendelian randomisation (MR) study, we selected seven sleep-related traits (sleep duration, getting up in the morning, chronotype, nap during day, insomnia, snoring, and narcolepsy) from published genome-wide association study (GWAS)-related genetic variants as instrumental variables. Causality was assessed by two-sample MR analysis using inverse-variance weighting (IVW), MR-Egger regression, weighted median, weighted mode and simple model. Horizontal pleiotropy was tested using MR-Egger regression and MR-polytropic residuals and outliers, and heterogeneity was calculated by Cochran’s Q test.

There was no evidence of causality among sleep duration (IVW: OR=0.759, 95% CI: 0.489 to 1.177, p=0.218), getting up in the morning (IVW: OR=1.148, 95% CI: 0.768 to 1.716, p=0.502), chronotype (IVW: OR=0.960, 95% CI: 0.796 to 1.158, p=0.670), nap during day (IVW: OR=1.248, 95% CI: 0.771 to 2.020, p=0.367), sleeplessness/insomnia (IVW: OR=1.280, 95% CI: 0.678 to 2.414, p=0.447), snoring (IVW: OR=0.963, 95% CI: 0.770 to 1.203, p=0.738), narcolepsy (IVW: OR=1.025, 95% CI: 0.367 to 2.863, p=0.962) and aortic aneurysm. Moreover, there was no evidence to suggest a causal relationship among sleep traits and abdominal aneurysm, thoracic aneurysm and aortic dissection. Sensitivity analyses, including leave-one-out, horizontal pleiotropy and heterogeneity tests, indicated that our results were robust and reliable.

Overall, our study found no genetic evidence of a causal relationship between sleep characteristics and AAD. Large-scale randomised controlled trial experiments are also needed to further verify the causal relationship between sleep and AAD.

This study aimed to comprehensively assess the diagnostic accuracy of point shear wave elastography (pSWE) and vibration-controlled transient elastography (VCTE) in paediatric metabolic dysfunction-associated steatotic liver disease (MASLD).

Systematic review and meta-analysis of diagnostic test accuracy using the Grading of Recommendations Assessment, Development and Evaluation approach with random-effects models.

PubMed, Embase, Web of Science, Ovid (Medline), Cochrane, China National Knowledge Infrastructure, Wan Fang and OpenGrey were searched for publications from April 1989 to July 2024.

The study included relevant records on the application of pSWE and VCTE in diagnosing MASLD in children (

Two independent reviewers extracted data and assessed the risk of bias. Articles were assessed using Quality Assessment of Diagnostic Accuracy Studies 2 for diagnostic accuracy and potential biases, and bias risks were visually represented using the Risk of Bias Visualisation tool. Heterogeneity was assessed (Cochran Q statistic) and quantified (I² statistic). The analysis of the likelihood ratio graph (Fagan plot) indicates that both pSWE and VCTE provide valuable diagnostic support for MASLD.

The comprehensive literature search yielded four pSWE studies encompassing 968 children and seven VCTE studies encompassing 1934 children. In our meta-analysis, VCTE had a sensitivity of 0.89 (95% CI, 0.79 to 0.94) and a specificity of 0.90 (95% CI, 0.83 to 0.95), which showed superior diagnostic accuracy compared with pSWE (sensitivity, 0.89 (95% CI, 0.81 to 0.94); specificity, 0.85 (95% CI, 0.81 to 0.89)).

While both pSWE and VCTE demonstrated appreciable diagnostic efficacy in paediatric MASLD, VCTE showed similar sensitivity but superior specificity, emerging as the more effective technique particularly in non-obese children. However, further investigation is warranted to fully elucidate the influence of probe selection and racial prevalence on these diagnostic modalities.

CRD42024514246.