by Mi Lv, Hui Che, Jiayan Hu, Wenxi Yu, Zhaoxia Liu, Xiaolin Zhou, Binduo Zhou, Jinyi Xie, Fengyun Wang
BackgroundThe overlap between non-erosive reflux disease (NERD) and epigastric pain syndrome (EPS, a subtype of functional dyspepsia) is common, yet its associated factors remain poorly defined. We aimed to identify factors associated with symptom severity in NERD-EPS overlap, focusing on psychosocial and somatic factors.
MethodsIn this multicenter cross-sectional study, 800 patients meeting Rome IV criteria for NERD-EPS overlap were enrolled. Standardized questionnaires assessed gastrointestinal symptoms (GSRS), somatic symptoms (PHQ-15), anxiety/depression (PHQ-4), and sleep quality (SRSS). Multivariable regression models identified factors independently associated with GSRS scores, adjusted for demographics and clinical covariates. Interaction terms were tested to assess whether the association between one factor and GSRS scores varied across different levels of another factor.
ResultsOf the 800 patients, 67% were female, and the mean age was (44.50 ± 14.43) years. 67% had mild or more sleep problems, and 47% had anxiety or depression. Somatic symptoms (PHQ-15) showed the strongest association with GSRS scores (β = 0.617, P P P = 0.026). Urban residence (β = 0.071) and mixed labor type (β = −0.066) were also independently associated with symptom burden.
ConclusionSomatic symptoms, psychological distress, and sleep disturbances were the factors most strongly associated with symptom severity in NERD-EPS overlap, with additional contributions from younger age, male sex, and urban residence. Our findings advocate for integrated biopsychosocial interventions to alleviate symptom burden in this population.
by Yinli Shi, Shuang Guan, Sicun Wang, Muzhi Li, Yanan Yu, Jun Liu, Weibin Yang, Zhong Wang
BackgroundAlthough filgotinib, a selective Janus kinase 1 inhibitor, has been increasingly applied in the treatment of inflammatory diseases, its comprehensive safety profile remains insufficiently characterized. Using data from the FAERS database covering Q1 2014 to Q2 2024, this study attempts to analyze adverse event signals linked to filgotinib and provide guidance for the safe and sensible clinical usage of filgotinib.
MethodsFrom Q1 2014 to Q2 2024, information on adverse drug events (ADEs) associated with filgotinib was gathered. The reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS) were among the signal detection methods that were employed for analysis following data normalization.
ResultsFilgotinib was shown to be the main suspected medication in ADE reports, exposing 103 preferred terms (PTs) in 17 system organ classes (SOCs). Infections, gastrointestinal disorders, and musculoskeletal and connective tissue disorders were the most commonly reported adverse effects. Additionally, atrial fibrillation, alopecia, elevated serum creatinine, blood creatinine increased, pulmonary embolism, epididymitis, respiratory failure, and osteopenia were identified as potential disproportionate reporting signals for filgotinib, although these were not listed in the official drug label. Notable significant signals included large intestine erosion (ROR 2186.05, 95%CI(ROR): 1015.94–4703.86, PRR 2176.18, 95%CI(PRR): 1014.64–4667.42), mesenteric arterial occlusion (ROR 1832.17, 95%CI(ROR): 897.68–3739.48, PRR 1822.71, 95%CI(PRR): 896.17–3707.20), repetitive strain injury (ROR 1149.27, 95%CI(ROR): 363.16–3637.01, PRR 1147.05, 95%CI(PRR): 363.24–3622.15), oligoarthritis (ROR 755.02, 95%CI(ROR): 310.74–1834.54, PRR 752.59, 95%CI(PRR): 310.60–1823.51), and periostitis (ROR 676.03, 95%CI(ROR): 319.36–1431.06, PRR 672.98, 95%CI(PRR): 318.97–1419.87). The subgroup analysis identified obvious sex and age-specific trends in filgotinib-related adverse reactions, emphasizing a higher risk of renal disorders in females, a preponderance of gastrointestinal events in males, and age-dependent trends involving mesenteric occlusion, increased serum creatinine, and immunoglobulin reduction.
ConclusionWhile filgotinib demonstrates therapeutic efficacy, it is associated with a range of potential adverse events, underscoring the need for vigilant clinical monitoring. Particular attention should be given to gastrointestinal, cardiovascular, respiratory, and metabolic complications.
by Qian Yue Tan, Kinda Ibrahim, Helen C. Roberts, Khaled Amar, Simon D.S. Fraser
BackgroundPeople with Parkinson’s (PwP) and their caregivers have to manage multiple daily healthcare tasks (treatment burden). This can be challenging and may lead to poor health outcomes.
ObjectiveTo assess the extent of treatment burden in Parkinson’s disease(PD), identify key modifiable factors, and develop recommendations to improve treatment burden.
MethodsA mixed-methods study was conducted consisting of: 1) a UK-wide cross-sectional survey for PwP and caregivers using the Multimorbidity Treatment Burden Questionnaire (MTBQ) to measure treatment burden levels and associated factors and 2) focus groups with key stakeholders to discuss survey findings and develop recommendations.
Results160 PwP (mean age = 68 years) and 30 caregivers (mean age = 69 years) completed the surveys. High treatment burden was reported by 21% (N = 34) of PwP and 50% (N = 15) of caregivers using the MTBQ. Amongst PwP, higher treatment burden was significantly associated with advancing PD severity, frailty, a higher number of non-motor symptoms, and more frequent medication timings (>3 times/day). Caregivers reporting higher treatment burden were more likely to care for someone with memory issues, had lower mental well-being scores and higher caregiver burden. Three online focus groups involved 11 participants (3 PwP, 1 caregiver and 7 healthcare professionals) recruited from the South of England. Recommendations to reduce treatment burden that were discussed in the focus groups include improving communication. clear expectation setting, and better signposting from healthcare professionals, increasing education and awareness of PD complexity, flexibility of appointment structures, increasing access to healthcare professionals, and embracing the supportive role of technology.
ConclusionsTreatment burden is common amongst PwP and caregivers and could be identified in clinical practice using the MTBQ. There is a need for change at individual provider and system levels to recognise and minimise treatment burden to improve health outcomes in PD.
by Zhongqun Guo, Qiangqiang Liu, Feiyue Luo, Shaojun Xie, Tianhua Zhou
The acidic leachate injected during the mining process of ion-type rare earth ores can damage the environmental characteristics of the soil, thereby triggering the activation and release of associated heavy metals. Severe Zn contamination has been found in the environment of ion-type rare earth mining areas, but the activation and release of Zn in the soil during the leaching process have not been fully understood. This study investigated the activation and release patterns and mechanisms of Zn in soil under different leaching agents ((NH4)2SO4, MgSO4, Al2(SO4)3) and varying concentrations of Al2(SO4)3 (1%, 3%, 5%, 7%) using a simulated leaching experimental system. The results show that the activation and release patterns of Zn in the soil vary significantly under the influence of the three leaching agents. During the entire leaching cycle, the peak Zn concentration in the leachate was highest under MgSO4 leaching, while the residual Zn content in the soil under Al2(SO4)3 leaching approached the high-risk environmental threshold. The high-concentration systems (5%, 7%) of Al2(SO4)3 significantly enhanced the activation and release efficiency of Zn in the soil compared to the low-concentration systems (1%, 3%) of Al2(SO4)3. (NH4)2SO4 mainly promotes the activation and release of Zn through ion exchange between NH4+ and Zn2+ and the acidification effect; Al2(SO4)3, on the other hand, dominates the activation and release of Zn by providing a strongly acidic environment and dissolving and damaging the mineral lattice; while MgSO4 not only exchanges ions between Mg2+ and Zn2+, but also alters the soil colloidal structure, facilitating Zn activation and release. The promoting effects of the three leaching agents on the transformation of Zn in soil follow the order of Al2(SO4)3> (NH4)2SO4 > MgSO4, with the environmental risk assessment index (RAC) being highest after Al2(SO4)3 leaching, indicating the greatest potential environmental risk. Compared to the other three concentrations (1%, 5%, 7%) of Al₂(SO4)3, the 3% concentration of Al2(SO4)3 had the most significant promoting effect on the transformation of Zn in soil. This study provides a theoretical basis for optimizing the green mining process of ion-type rare earth ores and preventing heavy metal pollution, and offers scientific support for revealing pollution mechanisms and formulating remediation and risk assessment strategies.This study aimed to identify potential categories of rotation stress among nurses undergoing standardised training and to explore the relevant factors associated with each profile.
Cross-sectional study.
Data were collected in November 2024 from three hospitals in Zunyi City, Guizhou Province, China.
Nurses undergoing standardised training were recruited for this study.
Convenience sampling method was used to recruit standardised training nurses in November 2024 from three hospitals in Zunyi City, Guizhou Province. The survey instruments used included demographic characteristics questionnaire, the Nursing Job Rotation Stress Scale and the Maslach Burnout Inventory. Latent profile analysis method was used to analyse rotation stress characteristics of nurses during standardised training. Additionally, logistic regression was performed to identify the factors influencing different characteristics.
A total of 493 nurses completed the questionnaires, of which 453 were valid, resulting in a validity rate of 91.88%. Rotation stress was classified into two profiles: ‘Low Emotional Response–Stress Adaptation Group’ (21.5%) and ‘High Emotional Response–Stress Distress Group’ (78.5%). Univariate analysis showed that highest degree (2=11.389, p=0.001), monthly night shifts (2=33.913, p2=20.858, p2=12.319, p2=35.754, p2=15.357, p=0.002) significantly influenced the two subgroups. Multivariable regression analysis revealed significant associations of monthly night shifts, pretraining work experience, training duration and burnout level (p
Nurses undergoing standardised training exhibit two distinct rotation stress profiles. Monthly night shifts, pretraining work experience, training duration and burnout are significant factors. Nursing managers should implement targeted interventions such as mindfulness, laughter therapy and emotional freedom techniques to mitigate stress and thereby enhance the quality of standardised training.
by Hailang Wei, Qingyun Wang
Janus kinase 3 (JAK3) is a hematopoietic-specific kinase implicated in cytokine signaling and immune dysregulation and has recently been associated with cancer progression. However, selective and potent JAK3 inhibitors remain underdeveloped. In this study, we established a machine learning (ML)-based pipeline to identify novel JAK3 inhibitors with anti-cancer potential. A curated ChEMBL dataset of JAK3 inhibitors was used to train multiple ML classifiers, with the Random Forest model achieving the highest performance (AUC = 0.80, F1-score = 0.92). This model was applied to virtually screen 25,084 ChEMBL compounds, yielding 400 high-confidence candidates (prediction score > 0.9). Docking analysis identified ten top binders (binding affinity ≤ –8.5 kcal/mol), of which three CHEMBL49087, CHEMBL4117527, and CHEMBL50064 exhibited optimal ADMET profiles. These compounds underwent 200 ns molecular dynamics simulations, showing low RMSD (0.10–0.20 nm), stable binding conformations, and preserved protein compactness. MM/GBSA calculations revealed that CHEMBL4117527 displayed the strongest binding free energy (–29.5 kcal/mol), surpassing even the co-crystallized ligand (–17.7 kcal/mol). Our integrative approach combining machine learning, docking, pharmacokinetics, molecular dynamics, and free energy analysis presents a robust computational strategy for JAK3 inhibitor discovery. These findings support CHEMBL4117527 as promising candidates for further experimental evaluation in cancer therapeutics.by Nailya Ibragimova, Arailym Aitynova, Seitzhan Turganbay, Marina Lyu, Alexandr Ilin, Tamari Gapurkhaeva, Galina Ponomareva, Karina Vassilyeva, Diana Issayeva, Amirkan Azembayev, Serzhan Mombekov, Aralbek Rsaliyev, Nurgul Sikhayeva, Yergali Abduraimov, Saki Raheem
Iodine-based antiseptics are essential in wound care but are often limited by cytotoxicity, instability, and rapid iodine release. Novostron is a novel polymer–iodine complex incorporating dextrin, polyvinyl alcohol, and metal ions, designed to enable controlled iodine release. Structural integrity and composition were confirmed by ¹H and 13C NMR spectroscopy and physicochemical analysis, indicating a molecular weight of ~9500 g/mol, a pH of 4.23, and an iodine content of 8.13%. Pharmacokinetic analysis in rabbits demonstrated that following a single dermal application, systemic iodine absorption was minimal, with peak blood iodine concentrations remaining within physiological limits and rapid elimination within 24 hours. Evaluation of thyroid function revealed no significant changes in serum T₃, T₄, or TSH levels compared with those of the controls, confirming that topical application of Novostron does not disrupt thyroid homeostasis. In compliance with OECD guidelines in rabbits, guinea pigs, and rats, Novostron showed no signs of dermal irritation, skin sensitization, or systemic toxicity (LD₅₀ > 2000 mg/kg). In a rat cotton pellet granuloma model, Novostron significantly reduced the inflammatory mass (23.65% inhibition), supporting its anti-inflammatory potential. In a murine burn model, Novostron accelerated wound contraction (25.95% at day 10), increased epidermal thickness, and enhanced collagen deposition (~44%), outperforming controls and matching or exceeding betadine. These findings suggest that Novostron promotes tissue repair by modulating inflammation. Overall, Novostron demonstrated a favourable preclinical safety and efficacy profile, and its polymer–iodine composition, which enables controlled release and localized activity highlights its potential as a promising topical therapeutic. However, the study was limited to animal models and short-term observation; further long-term and clinical investigations are needed to confirm its translational potential in human wound healing.To examine the relationship between nurse managers' empowering leadership, nurses' resilience and organisational learning from incidents.
Cross-sectional observational study.
Secondary data from a study conducted in June–July 2022 was used. The sample included 1049 nurses working in three special-functioning hospitals. The self-administered questionnaires assessed nurse managers' empowering behaviours, nurses' resilience and attitudes and behaviours fostering organisational learning from incidents. The analysis employed multilevel analysis with hierarchical linear modelling.
Nurse managers' empowering behaviours and nurses' resilience were significantly positively associated with attitudes and behaviours fostering organisational learning from the following incident subscales: make efforts to identify the problem, discuss safety in the workplace, identify and give feedback to address the at-risk behaviour. The interaction of empowering behaviours and resilience was not significant.
Nurse managers' empowering behaviours and nurses' resilience can contribute to attitudes and behaviours that foster organisational learning, even when nurses face stressful incidents.
Fostering empowering leadership in nurse managers and resilience in nurses enhances organisational learning and improves safety and care quality.
The reporting is based on the STROBE guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
First-degree relatives of colorectal cancer (CRC) patients have a twofold to fourfold increased risk of CRC. Tailored communication interventions have shown efficacy in improving their risk awareness and screening participation. While computer-based tailoring systems offer convenience, they often overlook the integration of healthcare professionals’ verbal input, potentially limiting effectiveness and long-term impact. To address this gap, we developed ScreenTalk, an intelligent voice-interactive tailored communication system that employs intelligent speech interaction to automate the tailoring process, enhance message credibility and improve scalability within CRC screening workflows.
This study is a two-arm, cluster-randomised controlled trial with a hybrid type I design involving 314 participants across three tertiary general hospitals in Guangzhou, China. Participants in both groups will receive usual care. Additionally, the intervention group will receive a 1-month tailored intelligent voice-interactive intervention, whereas the control group will receive unrelated health education to control for attention. Screening uptake (primary outcomes) and health beliefs (secondary outcomes) are measured at baseline and at 3 months, 6 months, 9 months and 12 month post the intervention. Implementation outcomes including reach, implementation, adoption and maintenance will be assessed through questionnaire, qualitative interviews and tailored system record.
The trial has been approved by the Ethics Committee of the Sun Yat-sen University (IRB No. L2024SYSU-HL-054). Information on the purpose and process of this study will be provided to the participants before recruitment, and written signatures will be collected from all participants to ensure their voluntary participation and protection of their rights and privacy.
NCT06710860 on ClinicalTrials.gov. Registered 26 November 2024. Date and version: 3.0, 14 July 2025.
To examine the association between socioeconomic status (SES), financial subsidies and awareness-related factors such as age, cancer stage and family history, and the uptake of cancer genetic testing, with a focus on equitable access to care.
Retrospective cohort study.
Tertiary care cancer genetics service in Singapore.
The study population included 2687 individuals of all ages, genders and ethnicities who attended pretest counselling between 2014 and 2020 and were eligible for genetic testing for hereditary cancer syndromes.
The primary outcome was the uptake of genetic testing. The main explanatory variables were SES (proxied by Housing Index), subsidy status, age, cancer stage and family history. Analyses examined whether associations varied across SES and age subgroups.
Receipt of financial subsidies was strongly associated with testing uptake (adjusted OR 9.15, 95% CI 2.68 to 31.20). Uptake exceeded 90% among subsidised individuals across all socioeconomic strata, compared with 56–68% among non-subsidised individuals, with the largest gains in the lowest SES group (43 vs 28 percentage points (pp) in the highest). The level of subsidy was not associated with uptake. Younger patients (18–39 years) had higher uptake than those aged 60+ (66% vs 57%); patients with advanced cancer (stage IV) had the highest uptake (82% vs 57–66% in earlier stages); and family history was associated with increased uptake, strongest for having a child with cancer (+28 pp). Interaction analysis suggested that the additive effects of subsidies were greatest in lower SES groups and in older adults.
Financial subsidies were strongly associated with higher genetic testing uptake. Awareness indicators like age, cancer stage and family history were associated with higher uptake. The association between subsidies and uptake varied by SES and age, suggesting that subsidies may help reduce disparities and improve equitable access to genetic testing services.
Atrial fibrillation (AF) constitutes a growing public health challenge. Consequently, the exploration of modifiable risk factors is essential for advancing AF prevention and management. While obstructive sleep apnoea is established as a risk factor for AF recurrence following catheter ablation, and its treatment with continuous positive airway pressure therapy reduces recurrence rates, the influence of non-sleep apnoea-related sleep indicators remains unclear. This systematic review aims to elucidate the association between these non-sleep apnoea-related sleep indicators and AF recurrence to inform optimised management strategies.
A comprehensive search will be performed in databases, including PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database and Wanfang Data, covering publications from database inception to 27 August 2024. Study selection will be performed independently by two reviewers using predefined eligibility criteria, with the screening process documented in a referred Reporting Items for Systematic Review and Meta-Analysis-compliant flow diagram. Data will be extracted using standardised forms and risk of bias of included studies will be assessed with the Risk Of Bias In Non-randomised Studies-of Interventions tool. Non-sleep apnoea-related sleep indicators, including sleep duration, sleep quality, sleep latency, sleep efficiency, REM (Rapid Eye Movement)/NREM (Non-Rapid Eye Movement), etc, serve as exposure factors. The primary outcome is defined as AF recurrence, whereas the secondary outcome comprises quality of life measures among AF patients. Should sufficient data be available, a meta-analysis will be performed using appropriate statistical methods; otherwise, a narrative synthesis will be conducted.
This study uses publicly available data, so ethical approval is not required. The findings will be disseminated through peer-reviewed journals and scholarly platforms to inform clinical practice and future research.
CRD42024607124.
by Yizhe Yang, Ruifeng Liang, Yan Luo, Doudou Zhu, Yi Liu, Yuyan Guo, Jiafen Zhang, Qiao Niu
ObjectiveInvestigate the Knowledge-Attitude-Practice (KAP) of students from Medical College towards emerging infectious diseases, and assess their impact, can provide a scientific basis and practical guidance for enhancing medico’s prevention and control capabilities.
MethodsA total of 2,395 participants from various grades and majors at Medical University were randomly selected using a stratified cluster sampling method. This cross-sectional study was conducted between April 25 and May 31, 2020, using a self-administered questionnaire developed on the Wenjuanxing platform to assess COVID-19-related knowledge, attitudes, and practices (KAP) among medical students.
ResultsA total of 2,245 participants (aged 16–28 years) were included in the study, coming from five medical disciplines: Clinical Medicine, Preventive Medicine, Nursing, Clinical Pharmacy, Health Inspection and Quarantine. The average scores for the COVID-19 epidemiological knowledge and the control measures for the epidemic were 4.92 ± 1.03 and 4.50 ± 0.78, respectively. Among them, the scores of epidemiological knowledge exhibited significant differences in sex, nation, type of dwelling place, major, grade, annual per capita household income, and age. The scores of preventive knowledge significantly differed by sex, major, grade, physical condition, and age. Further, behavioral data indicated that 96.0% of the students thought the pandemic had severely affected their daily life, while >90% maintained consistent mask usage and >80% insisted on health-protective practices. Practice scores finally varied significantly by sex, family structure, and ethnicity.
ConclusionsAltogether, medical students possess certain basic knowledge in controlling emerging infectious diseases, but some still generally suffer from insufficient cognitive depth and anxiety. Colleges can systematically enhance students’ rational cognitive level which include offering specialized courses as well as promoting cutting-edge research achievements, and through standardized operations stabilize their psychological states.
by Berihun Agegn Mengistie, Getie Mihret Aragaw, Tazeb Alemu Anteneh, Kindu Yinges Wondie, Alemneh Tadesse Kassie, Alemken Eyayu Abuhay, Wondimnew Mersha Biset, Gebrye Gizaw Mulatu, Nuhamin Tesfa Tsega
BackgroundPrecancerous cervical lesions, or cervical intraepithelial neoplasia (CIN), represent a significant precursor to cervical cancer, posing a considerable threat to women’s health globally, particularly in developing countries. In Africa, the burden of premalignant cervical lesions is not well studied. Therefore, the main purpose of this systematic review and meta-analysis was to determine the overall prevalence of precancerous cervical lesions and identifying determinants among women who underwent cervical cancer screening in Africa.
MethodsThis study followed the Preferred Reporting Item Review and Meta-analysis (PRISMA) guidelines. The protocol for this systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42025645427). We carried out a systematic and comprehensive search on electronic databases such as PubMed and Hinari. In addition, Google Scholar and ScienceDirect were utilized to find relevant studies related to precancerous cervical lesions. Data from the included studies were extracted using an Excel spreadsheet and analyzed using STATA version 17. The methodological quality of the eligible studies was examined using the Joanna Briggs Institute (JBI) assessment tool. Publication bias was checked by using the funnel plot and Egger’s tests. A random-effects model using the Der Simonian Laird method was used to estimate the pooled prevalence of pre-cancerous cervical lesions in Africa. The I-squared and Cochrane Q statistics were used to assess the level of statistical heterogeneity among the included studies.
ResultsA total of 112 eligible articles conducted in Africa, encompassing 212,984 study participants, were included in the quantitative meta-analysis. Thus, the pooled prevalence of pre-cancerous cervical lesions in Africa was 17.06% (95% confidence interval: 15.47%−18.68%). In this review, having no formal education (AOR = 4.07, 95% CI: 1.74, 9.53), being rural dweller(AOR = 2.38, 95% CI: 1.64, 3.46), history of STIs (AOR = 3.94, 95% CI: 2.97, 5.23), history of having multiple partners (AOR = 2.73, 95% CI: 2.28, 3.28), early initiation of coitus (AOR = 2.77, 95% CI: 2.11, 3.62), being HIV-seropositive women (AOR = 3.33, 95% CI: 2.32, 4.78), a CD4 count Conclusions
In Africa, the overall prevalence of pre-cancerous cervical lesions is high (17%). The findings of this review highlight that health professionals, health administrators, and all other concerned bodies need to work in collaboration to expand comprehensive cervical cancer screening methods in healthcare facilities for early detection and treatment of cervical lesions. In addition, increasing community awareness and health education, expanding visual inspection of the cervix with acetic acid in rural areas, offering special attention to high-risk groups (HIV-positive women), encouraging adherence to antiretroviral therapy for HIV-positive women, overcoming risky sexual behaviors and practices, and advocating early detection and treatment of precancerous cervical lesions.
To examine older persons' experiences and participation in life-enhancement activities in a long-term care facility.
Convergent mixed-methods design.
Naturalistic observations of 20 life-enhancement activity sessions were conducted in a single long-term care facility that includes 111 older persons in September 2024. Data were collected through guiding questions and fieldnotes for systematic observation. We used Kruskal-Wallis and Mann–Whitney U tests for quantitative analysis. Fieldnotes were analyzed using a six-phase reflexive thematic analysis approach.
Engagement levels (self-initiative, assistance-seeking frequency, and social interaction frequency) significantly differed across 16 different life-enhancement activities. Social interaction frequency also varied by mobility status (wheelchair, walker, independent). Participants displayed significantly more distractions in the TV Room than in the Activity Room. Four themes emerged from thematic analysis: (1) participation barriers, (2) activity contextual factors, (3) facilitator support strategies, and (4) social interactions and emotional well-being.
Structural elements (purposefully designed rooms, activity design and complexity, and the resident-preferred music), relational elements (facilitators' hands-on support, conflict resolution, and positive reinforcement), and individual factors (mobility status) influence older persons' participation in life-enhancement activities. Life-enhancement activities benefit older persons when they are provided with choices and adaptive equipment.
Findings support allocating distraction-free spaces for life-enhancement activities, incorporating resident-preferred music and game-layered physical exercises, and providing facilitator training in adaptive coaching, hands-on support, and conflict resolution.
Life-enhancement programs can promote psychosocial well-being among older persons in long-term care facilities by transforming routine recreational activities into personalized and socially engaging experiences that may reduce feelings of loneliness.
Journal Article Reporting Standards for Mixed Methods Research.
No Patient or Public Contribution.
To develop and evaluate the psychometric properties of the Forensic Nursing Competency Scale-Short Form (FNCS-SF) for hospital nurses.
Nurses who care for victims of sexual abuse, domestic violence and elder or child abuse require forensic nursing competencies. However, few valid and reliable tools exist to assess these competencies in hospital settings.
A cross-sectional study.
The study was conducted in two phases. Phase 1 involved the development and refinement of the FNCS-SF with input from 10 nurses. Phase 2 tested the tool's psychometric properties. A total of 420 nurses from two tertiary hospitals in South Korea participated. Participants were divided into two groups: Study 1 (n = 200) for exploratory factor analysis and Study 2 (n = 220) for confirmatory factor analysis.
The FNCS-SF consists of 27 items across six factors: awareness of the medicolegal problem, evidence-based practice in forensic nursing, collaborative forensic nursing with community partners, safety and security, professional career development and multidisciplinary integrated knowledge. An item analysis revealed significant correlations between each item and the total scale score. Criterion validity was supported by significant correlations between the FNCS-SF and attitudes and beliefs towards forensic nursing and the performance of the forensic nursing role. Confirmatory factor analysis supported a six-factor model with good fit indices. Cronbach's alpha indicated strong internal consistency.
The FNCS-SF is a valid and reliable tool for assessing hospital nurses' forensic nursing competencies, which can improve patient safety and treatment outcomes. Further validation in diverse clinical settings is recommended.
The FNCS-SF can be used to improve forensic nursing competency through professional development.
None.
The FNCS-SF provides a standardised framework to evaluate nurses' forensic competency, guiding education and practice to enhance clinical preparedness and deliver victim-centred care.
STROBE guidelines.
With little known about the impact of acculturation on cardiovascular disease (CVD) self-care among immigrants, this study examined acculturation among Chinese immigrants and investigated its association with CVD self-care behaviours in this population.
A cross-sectional study was conducted, employing multiple acculturation indices and the Self-Care of Coronary Heart Disease Inventory to collect data from Chinese immigrants with CVD via Chinese Community Centres, social media and cardiac clinics. Descriptive statistics and multiple linear regression analyses were employed. The study adhered to the STROBE guidelines.
Altogether 260 participants were recruited; 47.7% were female; the mean age was 71.8 years, the mean age at migration was 55.1 years and their mean duration of residence in Australia was 16.7 years; 41.2% could not speak English. Participants reported low acculturation levels via the Suinn Lew Asian Self-Identity Acculturation scale (mean score 1.8), but perceived high self-efficacy in coping with acculturation stressors relating to their health management (mean score 33.6). Their attitudes scored as slight agreement with Traditional Chinese Medicine (TCM) beliefs (mean score 3.4). Proxy acculturation measures revealed lower levels of acculturation associated with better CVD self-care behaviours. Higher perceived self-efficacy in coping with acculturation stress was linked with better CVD self-care maintenance and monitoring and better self-care management was observed among participants holding a stronger belief in TCM.
The acculturation of Chinese Australian immigrants contributed to the explanation of the variance in their CVD self-care behaviours.
Comprehensive assessment of acculturation in patients with culturally and linguistically diverse backgrounds can help nurses identify those likely to demonstrate poor CVD self-care behaviours, and culturally specific, individually tailored interventions may support improved self-care.
Patients were involved as participants in this study for data collection.
To determine the clinical characteristics and identify not only the Korean Triage and Acuity Scale levels of older patients with pneumonia in the emergency department but also the factors associated with their survival.
This study employed a retrospective observational design.
This study was conducted at the emergency department of a university hospital in Seoul, South Korea. It utilised medical data from January 1 to December 31, 2023. The study sample comprised 327 patients aged 65 years or older who received a pneumonia diagnosis (International Classification of Diseases: J10–J18). Binary logistic regression analysis was performed to identify independent factors associated with their survival.
Survival was significantly associated with and influenced by sex (specifically, male sex), initial Korean Triage and Acuity Scale level, oxygen supplementation in the emergency department, consciousness level (specifically, painful response), body temperature (> 37.5°C) and a diagnosis of solid or hematologic malignancies.
The findings highlight the need for improved triage protocols, emphasising consciousness level, body temperature and malignancies. Incorporating geriatric-specific age thresholds and oncologic status into Korean Triage and Acuity Scale classifications may enhance risk stratification, timely intervention and resource allocation in emergency department settings.
This study provides insight into triage accuracy for older pneumonia patients, emphasising early recognition of high-risk individuals and strengthening nursing assessment protocols. Improved Korean Triage and Acuity Scale classifications can optimise resource allocation and emergency care strategies, ultimately reducing mortality rates.
The study provides actionable insights for emergency nurses, triage clinicians and policymakers. The findings support the refinement of KTAS protocols to enhance risk stratification and guide resource allocation for older pneumonia patients, ultimately aiming to reduce mortality rates.
Adhered to STROBE guidelines for observational studies.
Although patients did not directly participate, the findings advocate for patient-centred triage improvements, enhancing early identification of high-risk older patients with pneumonia.
by Sompot Jantarawong, Wipapan Khimmaktong, Pharkphoom Panichayupakaranant, Yutthana Pengjam
Ternary complex of curcuminoid-rich extract (CRE-Ter) is a developed water-soluble Curcuma longa extract containing 14% w/w curcuminoids, hydroxypropyl-β-cyclodextrin, and polyvinylpyrrolidone K30. This study aimed to investigate the biomolecular effects of CRE-Ter on differentiation of bone cells (murine MC3T3-E1 preosteoblasts), muscle cells (murine dexamethasone-treated C2C12 myotubes) atrophy and irisin expression. In MC3T3-E1 preosteoblasts, CRE-Ter treatment increased alkaline phosphatase activity, calcium deposition, and expression of Bmp-2, Runx2, and collagen 1a significantly and dose-dependently. 5, 10, and 20 µg/mL CRE-Ter upregulated β-catenin expression significantly. CRE-Ter improved the atrophy of dexamethasone-treated C2C12 myotubes. CRE-Ter decreased proinflammatory cytokine (TNF-α and IL-6) expression but increased FNDC5 and irisin expression and nitric oxide production in dexamethasone-treated C2C12 myotubes significantly and dose-dependently. Dexamethasone promoted β-catenin and total p38 expression in C2C12 myotubes. CRE-Ter at 2.5–20 µg/mL reversed the increase in β-catenin expression, whereas 2.5 µg/mL reversed total p38 expression. Crosstalk experiments further revealed that conditioned medium from C2C12 myotubes enhanced osteocalcin expression in MC3T3-E1 osteoblasts. Molecular docking simulations using CB-Dock2 showed strong interactions between each curcuminoid molecule and irisin. Therefore, CRE-Ter may stimulate osteoblast differentiation, ameliorate myotube atrophy, and increase irisin expression, indicating its therapeutic potential in osteoporosis, sarcopenia, and osteosarcopenia.