Conectar
To examine the relationship among leadership, clinical teaching competencies, and structural empowerment of nursing clinical instructors in China.
A cross-sectional study.
A total of 152 nurses who come from three Grade A tertiary hospitals located in Beijing, Kunming, and Liaoning Province, China, completed an online questionnaire that included general information, clinical teaching information, the Conditions of Work Effectiveness Questionnaire-II, nurse leadership, and structural empowerment. SPSS 26.0 and AMOS 26.0 were used for normality test, descriptive statistics, correlation analysis, regression analysis, and structural equation model.
The study revealed that nurse leadership (r = 0.402) and structural empowerment (r = 0.568) both positively correlated with clinical teaching competencies. Specifically, the level of nurse leadership exhibited a low but direct positive effect on these competencies (β = 0.22), while the level of structural empowerment demonstrated a moderate direct positive effect (β = 0.56).
Enhancing nurse leadership and structural empowerment positively influence the clinical teaching competencies of nursing instructors.
Constructing a structural equation model to describe the relationship between leadership, structural empowerment, and teaching ability can provide the most intuitive direction for future research, so as to better improve the teaching ability of clinical nursing teachers.
No patient or public contribution.
This study aims to identify key antecedents of quiet quitting across industries through a three-level meta-analysis, evaluate their relevance to nursing and highlight aspects that have been under-explored in the nursing field, with the goal of guiding future research and interventions to improve nurse retention and engagement.
A three-level meta-analytic design incorporating subgroup analyses and moderator analyses was used to integrate quantitative evidence from studies across different industries and professions to examine the antecedents of quiet quitting.
Data were sourced from EBSCO, Web of Science, ScienceDirect, Scopus, JSTOR, ProQuest, SpringerLink, Emerald and Google Scholar for articles published between January 2020 and January 2025. Preprints from Research Square were also included.
Perceived workplace support reduces the likelihood of quiet quitting. Conversely, workplace conflicts, perceived injustice, burnout and stress are positively correlated with quiet quitting, with nurses exhibiting a higher tolerance for these factors compared to other sectors. Negative traits and passive work orientations exacerbate quiet quitting, whereas positive traits and proactive orientations show no significant effect across sectors. Additionally, organisational involvement, job satisfaction and well-being significantly reduce quiet quitting behaviours.
Quiet quitting is a widespread issue across various industries, including nursing. The findings call for nursing research to expand its focus beyond emotional exhaustion and workplace conflict to include nurses' psychological contracts breach and violations, nurses' individual traits, the degree of embeddedness within healthcare organisations and the maintenance of reciprocal exchanges.
This study identifies the key factors influencing nurses' quiet quitting, providing evidence to support the development of effective retention strategies for nursing leaders and policymakers. This is expected to improve nurse retention and job satisfaction, which, in turn, can enhance care quality and patient safety, thereby contributing to the sustainable development of healthcare systems.
PRISMA reporting method has been followed.
This study did not include patient or public involvement in its design, conduct or reporting.
A protocol for this study is preregistered at Open Science Framework (https://osf.io/4z5hs).
The expenses associated with cancer treatment are increasing at a rapid pace. The financial strain of providing care is experienced worldwide, but is particularly pronounced in low and middle-income countries (LMICs). This has resulted in a growing acknowledgement of the importance of value-based cancer care. Choosing Wisely Africa (CWA) is an initiative aimed at reducing the excessive use and expenses associated with cancer treatment. In this study, we assessed adherence to CWA recommendations for the treatment of breast cancer in three high-volume cancer centres in Sub-Saharan Africa (SSA).
A cross-sectional study across Rwanda, Ghana and Tanzania was conducted, involving a review of medical records to assess adherence to five measurable CWA practices in breast cancer care. The study used inferential statistics, such as 2 tests, to compare adherence among these countries.
This study was conducted in three cancer centres (Ocean Road Cancer Institute, Rwanda Military Hospital and Korle Bu Teaching Hospital) in three countries (Tanzania, Rwanda and Ghana, respectively).
A total of 542 patients were recruited. Eligible patients were those with a breast cancer diagnosis and complete data as pertaining to five CWA recommendations.
A total of 542 participants with a mean age of 51 years were included. Participants were well distributed across Ghana (37%), Rwanda (34%) and Tanzania (29%). Female patients represented 97% of the study cohort. Half (51%) of the participants had some form of insurance. The study observed high adherence to cancer staging (94%) before treatment and histological confirmation (91%) before breast lump removal across all sites. Hypofractionation was used in 0% of cases in Rwanda, 42% in Ghana and 70% in Tanzania.
This study provides critical insights into the implementation of CWA recommendations in breast cancer care in SSA. It highlights the disparities in adherence to CWA recommendations across different centres, showing the need for policy-driven changes and healthcare infrastructure improvement to standardise cancer care practices in LMICs.
This study aimed to investigate the prevalence of brachydactyly type A3 (BDA3) and its associated epiphysial development abnormalities in Chinese children aged 3–17 years, and to explore differences based on gender, region and urban–rural demographics.
Cross-sectional study.
The study was conducted across 14 provinces (28 survey sites) in China, as part of a nationwide investigation on skeletal maturation. The population was selected using multistage stratified randomised cluster sampling.
A total of 17 850 children (8856 boys and 8994 girls) aged 3–17 years participated. The cohort was drawn from a large-scale survey conducted between 2019 and 2021. Selection criteria included children with no visible clinodactyly or hand function impairments.
Non-dominant hand-wrist radiographs were obtained using a portable X-ray device. A retrospective analysis of these radiographs was performed to identify BDA3 and epiphysial development abnormalities. Prevalence rates were calculated and compared across gender, regional and urban–rural groups.
The overall prevalence of BDA3 was 10.0%, with a higher prevalence in girls (12.9% vs 7.1%; p
This nationwide, multicentre study provides the first national epidemiologic data on BDA3 and associated epiphysial features in Chinese children and adolescents, establishing a prevalence of 10.0%. This baseline supports counselling that a straight, well-functioning short fifth finger is a common anatomic variant and may help reduce unnecessary concern.
by Shifa Geng, Yubao Luo
BackgroundNon–ST-segment elevation acute coronary syndrome (NSTE-ACS) is a major contributor to cardiovascular mortality, yet reliable tools for individualized mortality prediction remain limited. Machine learning offers the potential to enhance prognostic accuracy in this high-risk population.
MethodsA total of 1,495 patients with NSTE-ACS who underwent percutaneous coronary intervention (PCI) were retrospectively analyzed. Eight clinical and laboratory variables were selected through univariate and multivariate logistic regression. Five machine learning models-logistic regression, random forest, XGBoost, LightGBM, and naïve Bayes-were constructed. Model performance was evaluated using area under the curve (AUC) and calibration curves.
ResultsAge, diabetes mellitus, and ejection fraction were identified as independent predictors of all-cause mortality. Among all models, LightGBM achieved the highest AUC (0.847), followed by XGBoost (0.822), both of which demonstrated superior discrimination and calibration compared to traditional logistic regression and other algorithms. Calibration analysis showed excellent agreement between predicted and observed mortality in both training and test cohorts.
ConclusionGradient boosting models, particularly LightGBM and XGBoost, significantly improve mortality prediction in NSTE-ACS patients after PCI. These models may facilitate more accurate risk stratification and guide personalized post-procedural management strategies in clinical practice.
Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterised by varying degrees of inflammation and fibrosis. Among these, fibrotic interstitial lung disease (FILD) is receiving increasing attention. Many questions remain about FILD, such as identifying which ILDs are likely to progress to FILD, the timing of such progression, early recognition methods and biomarkers for FILD recognition and progression, highlighting the urgent need for a large multicentre FILD cohort to advance relevant studies.
The Fibrotic Interstitial Lung Disease Early Recognition and Strategic Therapy Study in China (FIRST) study is a prospective, multicentre cohort study of FILD conducted across 40 hospitals/centres in China, aiming to reveal clinical phenotype and further integrate multidimensional data to develop prediction models for fibrosis progression. The study will enrol more than 10 000 patients, using existing national ILD cohorts, and will collect comprehensive clinical, imaging, histological and biological data to support histopathological, imaging and biomarker-related studies. The primary outcome is fibrosis progression within 12 months, with secondary outcomes including the natural history, mortality, comorbidities and treatment conditions of FILD, using a standardised data collection and follow-up approach supported by an Electronic Data Capture system.
The study’s protocol has undergone a thorough review and received approval from the Ethics Committee of China-Japan Friendship Hospital and the other participating sites currently enrolling patients. The findings of the study will be shared with the broader scientific community through publication in peer-reviewed journals.
NCT06655090; Pre-results
by Gabriella Lillsunde Larsson, Jessica Carlsson, Gisela Helenius, Lovisa Bergengren
ObjectiveTo improve human papilloma virus (HPV) screening, more effective triage methods for HPV-positive samples need development and validation. Cytology, the most common triage method today, is subjective and can only be applied to professionally collected samples. Methylation status has been shown to be informative, as genes are highly methylated in HPV-induced cervical dysplasia and cancer. This study aimed to assess whether triaging HPV-positive samples using molecular methods, such as methylation and genotyping for high-risk HPV types, could be as effective as cytology in cervical screening.
MethodsA retrospective biobank study was conducted on HPV-positive samples collected in 2017–2018, analyzing FAM19A4/MiR-124-2 hypermethylation and HPV genotyping for types 16, 18, 31, 33, 45, 52, and/or 59, comparing these results to cytology triage for detecting histologically confirmed high-grade squamous intraepithelial lesions (HSIL) and cancer.
ResultsResults from 1915 positive screening samples were analyzed, including 1052 follow-up biopsies with 402 HSIL or cancer cases. Genotyping showed slightly higher sensitivity than cytology but lower specificity, while methylation had higher specificity but much lower sensitivity. Cytology’s positive predictive value (PPV) was 36%, with lower PPVs for the molecular methods. Combining molecular methods increased the PPV but significantly reduced sensitivity.
ConclusionsBased on these findings with molecular methods reducing sensitivity, we do not recommend adopting the molecular triage methods evaluated in this study in the Swedish setting. The trade-off between sensitivity and specificity does not support a change from the current cytology-based triage approach.
Oliceridine is a novel μ-opioid receptor selective agonist that provides analgesia while reducing μ-receptor-mediated adverse effects such as postoperative nausea and vomiting (PONV). Evidence in abdominal surgery remains limited. This study aims to determine whether oliceridine reduces PONV and improves recovery in abdominal surgery.
This is a prospective, multicentre, two-arm, randomised trial. Participants aged 18–65 years, with American Society of Anesthesiologists physical status I–III and a body mass index of 18.5–23.9 kg/m², undergoing elective major abdominal surgery, will be eligible for inclusion. Gynaecological surgeries are excluded. All patients must require postoperative intravenous patient-controlled analgesia (PCIA) and give written consent. 494 participants will be randomised to oliceridine group or sufentanil group. The primary outcome is the incidence of PONV within 48 hours postsurgery. Secondary outcomes include vomiting frequency, nausea severity score, use of rescue antiemetics, resting numerical rating scale (NRS) pain score, Quality of Recovery-15 (QoR-15) score, time to first postoperative flatus, intensive care unit (ICU) length of stay (LOS), hospital LOS and PCIA metrics (effective attempts and total volume used). Safety outcomes include other opioid-related adverse effects (ORAEs) (eg, respiratory depression, pruritus, dizziness, headache), complications related to PONV (eg, electrolyte disturbances, wound dehiscence) and other perioperative complications.
This protocol was approved (Version V3.0, 2025-01-14) by the Ethics Committee of Changhai Hospital (CHEC-2025–069), the Shanghai Public Health Clinical Centre (2025-S024-01) and the Wusong Central Hospital of Baoshan District, Shanghai (2025-17-01). It complies with the Declaration of Helsinki. Results will be shared via conferences and peer-reviewed journals.
Chinese Clinical Trial Registry (ID: ChiCTR2400089262).
This scoping review investigates the use of point-of-care infrared thermography devices for assessing various wound types. A comprehensive search across four databases yielded 76 studies published between 2010 and 2024 that met the inclusion criteria. The review highlights thermography applications in burns, surgical wounds, diabetic foot ulcers, pressure injuries, and other lower limb wounds. Key findings indicate its effectiveness in detecting early signs of inflammation and healing delays, facilitating timely interventions. The technology shows promise in accurately predicting wound healing trajectories and assessing treatment outcomes. Recent advancements have made thermographic devices more affordable and user-friendly, expanding their clinical potential. However, challenges persist, including reimbursement, training requirements, and integration with electronic medical records (EMRs), with EMR integration identified as a critical barrier to widespread adoption. While preliminary findings are promising, the current evidence base is constrained by small sample sizes, retrospective study designs, and limited consideration of skin tone variability. Large, prospective studies are essential to validate the clinical utility of thermography in wound care and to inform the development of standardised protocols that support equitable, bias-reduced assessment across diverse populations. Addressing these gaps is critical for advancing research, enhancing clinician training, and improving patient outcomes in wound care. Overall, point-of-care thermography demonstrates significant potential to enhance wound assessment and monitoring, thereby elevating care quality and patient outcomes.
To investigate symptom clusters and sentinel symptoms in breast cancer survivors based on self-reported outcomes, explore the impact of sentinel symptoms on patients' quality of life and psychological distress, provide a basis for implementing accurate symptom management.
A cross-sectional survey.
The study was conducted from September 2021 to December 2022. We recruited 281 patients who were re-examined in an outpatient department of a tertiary hospital in Hebei Province. The European Organization for the Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire - Core30 (QLQ-C30), the EORTC Quality-of-Life Questionnaire Breast Cancer - 23 (QLQ-BR23), the Hospital Anxiety and Depression Scale (HADS) were used to conduct the survey. Symptom clusters were explored using principal component analysis, sentinel symptoms were explored using the Apriori algorithm. Correlation analysis was used to explore the relationship between sentinel symptoms and quality of life, correlation with psychological distress. This paper adhered to the STROBE guidelines.
Breast cancer survivors have a wide range of self-reported symptoms in the form of four symptom clusters: a fatigue symptom cluster, a gastrointestinal symptom cluster, a sickness symptom cluster and a surgical trauma-related symptom cluster. Three sentinel symptoms were explored: pain, alopecia and limited function of the upper limbs. Except for sexual function, all of the sentinel symptoms were negatively correlated with patients' quality of life and positively correlated with psychological distress (p < .05).
Breast cancer survivors have a variety of symptoms in the form of four symptom clusters. Pain, alopecia and limited function of the upper limbs are the sentinel symptoms, which affect patients' quality of life and psychological distress.
FreshRSS 