Conectar
by Yaosen Du, Yiyong Yang, Xiaolong Wu, Pengju Gao, Hanchen Ma
To enhance the efficiency, safety, and data accuracy of drilling engineering, this study developed an integrated business management platform for drilling engineering grassroots units based on the Business Model Driven (BMD) approach. The platform is built on a “five horizontal, three vertical” cloud computing architecture, establishing a five-layer system from the infrastructure layer to the user layer horizontally, and supported by standard specifications, safety, and maintenance systems vertically, enabling collaboration across multiple business scenarios and data integration. Currently, four major modules with over 20 functionalities have been developed, supporting applications such as task coordination, engineering supervision, data analysis, and accident handling. Operational results demonstrate that the platform effectively promotes integrated management of drilling engineering through real-time data sharing, full-process quality control, and intelligent decision-making, thereby enhancing operational quality and safety, reducing accident risks, and providing critical technological support for the digital transformation and upgrading of the drilling industry.by Yanan Fu, YuXin Wei, ZiKun Pang, Jie Yang, XinGang Sun
PurposeThis study outlines the changes in the age- and sex-specific burden of motor neuron disease (MND) in China from 1990 to 2021, focusing on the prevalence, incidence, number of disability-adjusted life years and mortality. Additionally, these trends are evaluated in comparison to the Global Burden of Disease data.
MethodsPublic data from the Global Burden of Disease database covering the period from 1990 to 2021 were analyzed to explore the burden of motor neuron disease in China and worldwide. Trends in prevalence, incidence, disability-adjusted life years (DALYs) and mortality were examined in the analysis. The average annual percentage change was calculated using Joinpoint, and the relevant 95% confidence intervals (95% CIs) were examined to identify changes in the MND burden over time. Additionally, a thorough comparative analysis was performed to investigate the differences in the MND burden between China and other regions worldwide, considering factors such as age, sex, and time periods.
ResultsFrom 1990 to 2021, the age-standardized incidence rate (ASIR) of motor neuron disease (MND) in China declined from 0.65 per 100,000 to 0.46 per 100,000, whereas the global ASIR decreased slightly from 0.81 per 100,000 to 0.77 per 100,000. In contrast, the age-standardized prevalence rate (ASPR) in China increased from 2.131 per 100,000 to 2.298 per 100,000, whereas the global ASPR decreased slightly from 3.356 per 100,000 to 3.31 per 100,000. The age-standardized mortality rate (ASMR) in China increased from 0.151 per 100,000 to 0.181 per 100,000; the global ASMR also increased from 0.38 per 100,000 to 0.46 per 100,000 during this period. Moreover, the age-standardized disability-adjusted life year (ASDR) rate in China decreased slightly from 7.995 per 100,000 to 7.672 per 100,000, whereas the global ASDR increased from 11.221 per 100,000 to 12.167 per 100,000. The average annual percentage changes (AAPCs) for the ASPR, ASIR, ASDR, and ASMR in China were −1.10%, 0.25%, 0.57%, and −0.14%, respectively. In contrast, the global AAPCs were −0.16%, −0.04%, 0.58%, and 0.26%, respectively. Age and sex played distinct roles in shaping MND burden. The ASIR of MND decreased but then increased for both sexes, remaining higher for males. Its ASPR trends differed: a slight increase in males versus an increase then decrease in females. While the ASMR was consistently higher for males, the DALYs for males started to decrease but surpassed those for females. Global MND rates have remained stable.
ConclusionThe prevalence, incidence, DALYs and mortality of motor neuron disease in China decreased between 1990 and 2021, suggesting a relative decrease in the total burden of MND in the country. Age influences the burden of MND, with a higher occurrence incidence in children and middle-aged individuals; the prevalence of MND is highest in the younger population, whereas MND-related mortality is the highest within the middle-aged and senior populations. Compared with females, males are more likely to be affected by MND and have a greater likelihood of death. Given the rapid population aging in China, MND is expected to remain a significant public health issue.
To evaluate the prognostic significance of tumour deposit (TD) across different N stages in patients with stage III colon cancer and to develop and validate a novel N staging system that incorporates TD count to improve prediction of cancer-specific survival (CSS).
Retrospective cohort study based on population-based data and external validation.
Secondary and tertiary care settings; data from the SEER database, a population-based cancer registry capturing cancer incidence and survival information (USA, 2010–2017); and a single-centre validation cohort from South China (2015–2019).
A total of 8739 stage III colon cancer patients from the SEER database who underwent curative surgery were included; 1335 (15.3%) had TD. Patients with
The outcome was cancer-specific survival (CSS). The prognostic impact of tumour deposit (TD) and the comparative performance of the novel N staging system versus the AJCC system were evaluated using the Fine-Gray competing risks model, time-dependent area under the curve (AUC) and Brier score.
TD was independently associated with poorer CSS: 1 TD (SHR=1.23, 95% CI 1.04 to 1.47, p=0.017), 2–3 TDs (SHR=1.36, 95% CI 1.17 to 1.58, p3 TDs (SHR=2.02, 95% CI 1.73 to 2.35, pet al, TDs were converted to metastatic lymph nodes (mLNs) using the following weighting: 1 TD=3 mLNs (N1c), 1 TD=2 mLNs (N1) and 1 TD=1 mLN (N2). The novel N staging system stratified patients as nN1a (1 nLN), nN1b (2–3 nLNs), nN2a (4–6 nLNs) and nN2b (≥7 nLNs). This approach showed improved prognostic accuracy compared with AJCC N staging: 3-year AUC (0.623 vs 0.614) and Brier score (0.151 vs 0.157, p
TD significantly worsens prognosis in stage III colon cancer, particularly in lower N stages. Incorporating TD counts into the N staging system with different weightings based on N stage enhances prognostic accuracy and risk stratification within stage III disease, particularly for the heterogeneous AJC N1c category. This novel staging system provides better prognostic value and more accurate treatment guidance and should be considered for broader clinical use, subject to further (eg, prospective) validation.
Acute pain following pulmonary surgery can affect the recovery process of patients. The use of intrathecal morphine (ITM) injections offers a long-lasting analgesic effect, but its clinical application remains controversial. This study aims to investigate the impact of combining bupivacaine with ITM injections on the quality of postoperative recovery in patients who have undergone pulmonary surgery.
This multicentre, randomised, double-blind, controlled trial will enrol 254 patients undergoing elective lung surgery, who will be randomly assigned in a 1:1 ratio to either group IT (receiving an intrathecal injection of 3 mg bupivacaine and 0.25 mg morphine before general anaesthesia induction) or the control group (C group). The primary outcome includes postoperative recovery quality on day 1 (quality of recovery, QoR-15), with secondary outcomes encompassing postoperative recovery quality on days 2 and 3 (QoR-15), pain scores within 72 hours postoperatively, analgesic rescue, intraoperative haemodynamic parameters, opioid consumption, postoperative adverse reactions, recovery metrics, complications, chronic pain incidence and sleep quality.
The results will be disseminated through peer-reviewed publications. This study protocol (V.2.0, 30 October 2024) involves human participants and has been approved by the Ethics Committee of Affiliated Hospital of Yangzhou University (number 2024-08-02-2), Taicang Hospital Affiliated to Soochow University (number 2025 SR-041) and Yichang Central People’s Hospital (number 2024-513-02). Each individual who agrees to participate in the research will provide written informed consent after the objectives and procedures of this study are explained to them.
ChiCTR2400092935. Registered on 26 November 2024.
This study aimed to investigate the association between smoking behaviours during early pregnancy and the risk and severity of gestational diabetes mellitus (GDM), with a particular focus on smoking status, smoking intensity and secondhand smoke exposure.
Secondary analysis of prospectively collected cohort data.
Multi-centre study conducted in South Korea (Korean Pregnancy Outcome Study) between March 2013 and January 2017.
From 4537 pregnant women initially enrolled, 3457 singleton pregnancies were included after excluding cases with transfer, loss to follow-up, twin pregnancies, miscarriages and pre-existing diabetes mellitus. All participants were women of Korean ethnicity.
Primary outcome was GDM and its subtypes (A1GDM: diet-controlled; A2GDM: insulin-requiring). Secondary outcomes were associations with active smoking (before pregnancy and during early pregnancy), smoking intensity dose–response relationships (pack-years) and secondhand smoke exposure among never-smokers.
Among 3457 participants, 231 women (6.7%) were diagnosed with GDM (198 A1GDM, 33 A2GDM). Active smoking before pregnancy (adjusted OR (aOR) 3.98, 95% CI 1.58 to 9.30) and during early pregnancy (aOR 9.90, 95% CI 2.97 to 29.45) were significantly associated with A2GDM, while no significant association was observed with A1GDM. A clear dose-response relationship was observed, with smoking intensity >4 pack-years markedly increasing A2GDM risk (aOR 20.68, 95% CI 6.75 to 59.39). Detailed pack-year analysis showed 4–6 pack-years (aOR 20.57, 95% CI 5.80 to 65.46) and >6 pack-years (aOR 25.98, 95% CI 3.21 to 146.45). Among never-smokers, secondhand smoke exposure showed a borderline association with overall GDM risk (aOR 1.33, 95% CI 0.98 to 1.81).
Maternal active smoking before and during early pregnancy, as well as higher smoking intensity, was associated with an increased risk of pharmacologically treated GDM (A2GDM). Although secondhand smoke exposure did not reach statistical significance, the trend suggested a potential association with GDM risk among never-smokers. These findings provide important evidence for public health strategies for prenatal care, as smoking cessation and environmental smoke avoidance during prenatal and early antenatal care in women reduce the risk of gestational diabetes.
Type 2 diabetes mellitus has been associated with an increased risk of cognitive decline and dementia, with patients being 1.5–2 times more likely to develop these conditions. While both sodium-glucose co-transporter 2 (SGLT2) inhibitors and thiazolidinediones (TZDs) have shown potential neuroprotective effects in previous studies, their comparative effectiveness for preventing neurodegenerative outcomes has not been established. This study aimed to compare the risk of stroke, dementia and Alzheimer’s disease (AD) between patients treated with SGLT2 inhibitors and those treated with TZDs.
Multicentre, retrospective, observational, new-user, active-comparator cohort study.
Electronic health record-based databases from 11 secondary and tertiary institutions in South Korea from 1 January 2014 to 31 July 2025. The study period began in 2014, following the post-marketing surveillance initiation of SGLT2 inhibitors in Korea (November 2013), to ensure adequate drug availability and clinical adoption.
Patients aged 40 years or older who were newly prescribed either SGLT2 inhibitors or TZDs without prior exposure.
Propensity score matching (1:1) was performed using sex as the primary covariate due to data availability constraints in the Observational Medical Outcomes Partnership Common Data Model framework. The HRs with 95% CIs were measured via Cox regression analysis.
The study analysed 24 172 matched pairs for stroke outcomes (40 483 person-years in the SGLT2 inhibitor group and 39 363 person-years in the TZD group), 25 111 matched pairs for dementia (41 924 person-years in the SGLT2 inhibitor group and 40 726 person-years in the TZD group) and 25 237 matched pairs for AD (42 139 person-years in the SGLT2 inhibitor group and 40 895 person-years in the TZD group) across 11 participating hospitals. After a 1:1 propensity score matching, the SGLT2 inhibitors showed no significant difference in stroke risk (HR 1.18, 95% CI 0.62 to 2.23, p=0.62), while having significant reductions in dementia risk (HR 0.66, 95% CI 0.45 to 0.98, p=0.04) and AD risk (HR 0.54, 95% CI 0.35 to 0.83, p=0.005). Moreover, these protective effects for neurodegenerative outcomes were shown to be consistent across multiple hospital sites.
SGLT2 inhibitors are associated with a reduced risk of dementia and AD compared with TZDs in patients aged 40 years or older with type 2 diabetes and have neutral effects on stroke risk. These findings confirm the potential selective neuroprotective benefits of SGLT2 inhibitors for neurodegenerative outcomes, which may inform therapeutic decision-making for diabetic patients at risk of cognitive decline.
The WHO Package of Essential Non-communicable Diseases Interventions (WHO PEN) provides a core set of measures to prevent, detect and manage non-communicable diseases (NCDs) in low-resource settings. Many countries have adopted WHO PEN to strengthen primary healthcare, yet there is limited consolidated evidence on what components have been implemented and how WHO PEN has been implemented across different contexts. Understanding both the ‘what’ (disease modules, intervention activities, tools) and the ‘how’ (strategies, approaches, target populations and contextual factors) is crucial to assess the short-term to medium-term effects on health system readiness, provider performance, patient outcomes and long-term population health impact.
This protocol outlines a systematic review that will be updated as new evidence emerges and additional countries adopt or adapt WHO PEN. It represents the first systematic review focused on the implementation of the multifaceted interventions under WHO PEN. Findings will support efforts to sustain and scale up NCD interventions at the primary healthcare level and inform future updates of WHO PEN and related WHO guidance.
We will search PubMed, Web of Science, Cochrane Library and Google Scholar for studies published up to June 2025, supplemented by grey literature and reference checking.
The review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Given the complexity, the review will be conducted in two stages. Stage 1 consists of an overview of review, mapping of existing review and evidence and guiding deeper inquiry of stage 2. Stage 2 will conduct a mixed-methods systematic review of the primary studies, forming the main output of this protocol.
Ethics approval is not required. The protocol and findings will be disseminated through peer-reviewed publications, webinars and conferences.
CRD420251064835.
To explore the lived experiences and daily interactions of older couples living with multimorbidity.
A descriptive-interpretive qualitative study based on a generic interpretive description framework.
A total of 20 dyads were recruited using a purposive sampling strategy, and 24 semi-structured in-depth interviews were conducted between May 2023 and January 2025. Reflexive thematic analysis was used to analyse data.
Four overarching themes were generated: (1) dynamic relationship structures; (2) diverse interaction patterns; (3) double burdens; and (4) double resilience. Dynamic relationship structures occurred in dyadic and triadic forms. Diverse interaction patterns involved independence, interdependence and dependence. Double burdens manifested as physical toll, financial hardship, emotional contagion and perceptual misalignment, whereas double resilience was reflected in the nudge effect, emotional resonance and promotion of family ownership of health.
This study adopted a dyadic perspective to explore the experiences and interactions of older couples living with multimorbidity. The caring dynamics and blurred roles of patient and care partner deviate from the traditional unidirectional, linear model of ‘one person caring for the other’. Formal or informal caregiving support from third parties, as well as the nudge effect and emotional resonance between spouses, may help orient older couples as they navigate the challenges associated with multimorbidity.
Our findings indicate that community nurses can play a proactive role in identifying older couples living with multimorbidity through routine care attendance and assessments, enabling early recognition of health management needs. Geriatric nurses can leverage insights into couples' interaction patterns to tailor more effective care plans at different stages of illness, monitor emerging risks and identify optimal timing for third-party support. By facilitating a responsive triadic network, nurses can help ensure continuous and sustainable health care.
Adhered to SRQR guidelines for qualitative research.
This study did not include patient or public involvement in its design, conduct, or reporting.
This study aims to explore the views and experiences of people with dementia, informal caregivers and professionals regarding eating and drinking difficulties.
A qualitative systematic review was conducted.
The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used to conduct this systematic review. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the data were thematically synthesised using Thomas and Harden's three-stage method.
Six electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL and PsycINFO) were searched from their respective inception dates to August 2025 to identify relevant studies.
Thematic analysis of the 16 included studies identified four key themes: (1) Physiological and psychological changes in people with dementia and caregivers; (2) factors influencing eating and drinking in people with dementia; (3) needs and recommendations for people with dementia, informal caregivers and professionals; (4) selection of eating methods for end-stage people with dementia.
Eating and drinking difficulties affect the well-being of both patients and caregivers. A good dining environment improves mealtime pleasure but demands caregivers' time and energy. All parties emphasised the importance of effective communication. In end-stage dementia, professional assistance is crucial for enteral nutrition decisions.
Collaboration among patients, caregivers and professionals is vital for creating tailored nutritional plans and improving mealtime environments, thereby enhancing nutritional intake. In advanced dementia, providers must provide balanced information on comfort feeding versus enteral nutrition to aid decision-making.
What problems were addressed in this study? This study addressed the lack of a consolidated, tri-perspective understanding of eating and drinking difficulties in dementia care settings. What are the main findings? Four key themes were identified: physiological and psychological changes, influencing factors, stakeholder needs and end-of-life decision-making. Where and on whom will the research have an impact? This will impact care practices for people with dementia and inform the training and support of informal caregivers and healthcare professionals.
by Dandan Feng, Yakun Song, Zuqi Wu, Wuruo Liu, Yuting Pu, Yangcan Gao, Yuying Sun, Jiquan Zhang
Trypsin, a canonical serine protease in crustaceans, plays a crucial role in ontogeny and antibacterial defense. Whether these biological functions correlate with its catalytic characteristics remains unresolved in the freshwater shrimp Neocaridina denticulata sinensis. To address this gap, we characterized a trypsin gene from N. denticulata sinensis (NdTryp) and assessed both its biological roles and its prospective utility. NdTryp was predominantly expressed in the hepatopancreas, where it localized to storage cells (R-cells) and tubule-lining epithelial cells (ECTs). Across development, NdTryp transcripts were essentially absent during early embryogenesis but rose sharply at late stages, temporally coincident with hatching and the onset of feeding. After a challenge with Vibrio parahaemolyticus, the expression of NdTryp was induced, with the expression level significantly increased relative to the baseline expression level. RNA interference-mediated knockdown rendered shrimp more susceptible to infection and was accompanied by extensive hepatopancreatic injury, including epithelial detachment and disruption of the basement membrane. Biochemically, recombinant NdTryp (rNdTryp) displayed proteolytic activity over a broad temperature and pH span. Activity was differentially tuned by metal ions, with several divalent cations producing marked enhancement, whereas ferric iron exerted strong inhibition. Overall, our results showed that NdTryp functions as a multifunctional protease involved in both late embryonic development and innate antimicrobial defense. Furthermore, the robust stability of rNdTryp underscores its potential as an aquafeed additive and candidate for enzymatic biotransformation.by Lin Yang, Jie He
BackgroundChronic obstructive sleep apnea (OSA) drives systemic inflammation; the role of the JAK1-STAT1 pathway is unclear.
ObjectiveTo elucidate JAK1-STAT1 involvement in OSA-related inflammation using a chronic intermittent hypoxia (CIH) model.
MethodsSprague-Dawley rats underwent 8-week CIH (FiO₂ cycling 5–21%, 8h/day) or normoxia (Sham). Serum cytokines (ELISA) and lung p-JAK1/p-STAT1 (Western blot/IHC) were analyzed. A CIH subset received JAK1 inhibitor filgotinib. Airway resistance was assessed via forced oscillation.
ResultsCIH elevated serum IL-6/TNF-α versus Sham (p Conclusion
JAK1-STAT1 signaling critically mediates CIH-induced inflammation. JAK1 inhibition attenuates inflammatory responses, demonstrating therapeutic potential for OSA comorbidities.
Atrial fibrillation (AF), with a prevalence of 1–2%, is the most common cardiac arrhythmia. AF is associated with a fivefold increased risk of cardioembolic events; approximately 20% of all strokes are caused by AF. Pulmonary vein isolation (PVI) has become the first-line treatment for AF. However, PVI cannot eliminate the residual stroke risk. Current guidelines recommend that anticoagulation be continued in this specific group of patients, regardless of the presence or absence of AF. In this large AF population post-PVI, who are considered to be in an earlier stage of AF, it is unknown whether left atrial appendage closure (LAAC) offers an alternative to direct oral anticoagulant (DOAC) therapy.
The trial will be a prospective, randomised, multicentre non-inferiority study comparing two treatment strategies in AF patients after atrial ablation. Patients will be randomly assigned to either percutaneous LAAC (group A) or DOAC treatment (group B) in a 1:1 ratio; both sequential and concomitant planned ablation with or without LAAC are accepted. Randomisation will be conducted using web-based randomisation software. A total of 1012 participants (506 patients per group) will be enrolled. The primary effectiveness measure will be the occurrence of any of the specified events within 24 months after randomisation: stroke/transient ischaemic attack/systemic thromboembolism, cerebral haemorrhage, other major haemorrhages (Bleeding Academic Research Consortium ≥2), cardiovascular mortality and all-cause mortality.
The study was approved by the Ethical Review Board of Shanghai Chest Hospital, China (KS(Y)20287). Written informed consent will be obtained from all participants. The trial will follow the Declaration of Helsinki and Good Clinical Practice. Confidentiality will be maintained with anonymised, securely stored data. Findings will be disseminated through peer-reviewed publications and conferences.
ChiCTR2000036538.
To explore the relationship between sleep and cognitive frailty in older adults.
A systematic review and meta-analysis.
The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.
Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.
This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.
This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.
The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.
No patient or public contribution.
To investigate diabetes family involvement, including supportive and nonsupportive family behaviours in China, and explore the relationships among opposite forms of family involvement, diabetes self-management and glycaemic control.
A cross-sectional study.
Type 2 diabetes patients were recruited from hospitals in Nanjing, Shanghai and Jinan, and communities across China, between April 2023 and August 2023. A total of 1648 patients completed questionnaires regarding diabetes family involvement, diabetes self-management, perceived glycaemic control and patient characteristics. Data analysis was conducted using SPSS 26.0 and PROCESS macro.
The mean scores for supportive and nonsupportive family behaviours were 19.14 out of 40 and 12.47 out of 30, respectively, resulting in an overall family involvement score of 6.67. Overall family involvement, especially supportive family behaviours, was positively related to diabetes self-management and perceived glycaemic control, whereas nonsupportive family behaviours were not. Diabetes self-management partially mediated the relationships between both overall family involvement and supportive family behaviours with perceived glycaemic control.
Diabetes family involvement was suboptimal. Overall family involvement, especially supportive family behaviours, could not only directly improve glycaemic control but also indirectly enhance it through promoting diabetes self-management.
The findings highlight the importance of promoting supportive family involvement and patient self-management in diabetes management.
This study endorses the necessity for healthcare professionals to integrate the family unit into diabetes management and implement interventions at the family unit level, to address the neglect of families in current interventions. It also advocates for promoting supportive family involvement rather than all family involvement in future interventions. Promoting supportive family involvement and patient self-management can better improve patients' glycaemic control and alleviate the burden on medical and social systems.
This study adheres to the STROBE guideline of reporting.
No Patient or Public Contribution.
To clarify the role performance of gerontological nurse specialists (GNSs) and identify associated factors.
A cross-sectional survey.
A self-designed questionnaire based on the Donabedian model was developed to assess structure, process, and outcome variables using a 5-point Likert scale. The questionnaire was administered to 230 GNSs. Descriptive statistics (e.g., means, standard deviations, frequencies) were calculated in SPSS to summarise GNSs' role performance, and multiple regression analysis identified factors influencing GNSs' role performance.
Ninety-six GNSs (response rate of 44.3%) scored 3.15 to 3.81 out of 5 in GNSs' role performance, including clinical practice, education and guidance, consultation, research, leadership and coordination. High self-ratings were observed in clinical practice and consultation, whereas research and leadership scored lower. Education and guidance, as well as consultation, were primarily performed among hospital nurses, with GNSs' role performance largely confined to the hospital. Multiple regression revealed that GNSs' role performance was significantly associated with factors such as GNS competency, identification of stakeholder needs and perceived social recognition of GNS.
To enhance the role performance of GNSs, it is necessary to expand their activities outside the hospital, improve gerontological nursing competency, and promote the social recognition of their role. The results also suggest that it is important for GNSs to understand the needs of patients, nurses, and other related healthcare workers, and enhance collaboration with multiple professionals.
Clarifying the role performance of GNSs in China enables future outcome evaluations. Identifying influencing factors provides insights for effective support, which will further contribute to the success and development of GNSs.
No public or patient involvement.
(1) To determine the mediating effects of children's transition readiness, which reflects self-management skill acquisition, and family resilience on the relationship between parenting stress and the quality of life (QOL) of parents and children with spina bifida (SB). (2) To conduct an exploratory analysis of the differences in the mediating pathways based on the presence of SB-related clinical characteristics.
A cross-sectional study.
Data were collected from a single centre in South Korea between October 2022 and July 2024. Participants included children aged 7–13 years diagnosed with myelomeningocele, lipomyelomeningocele or tethered cord syndrome, along with their parents. Statistical analysis was conducted using SPSS and the MEDYAD macro for actor–partner interdependence mediation model analysis.
Family resilience significantly mediated the relationship between parenting stress and both child and parent QOL. However, transition readiness was not a significant mediator in the overall sample. Among children with SB-related clinical characteristics, transition readiness significantly mediated the association between parenting stress and child QOL. In contrast, family resilience mediated the relationship between parenting stress and parent QOL. No significant mediators were found in children without SB-related clinical characteristics.
This study highlights the mediating role of family resilience and transition readiness in improving the QOL of children with SB, particularly those with clinical characteristics. The findings suggest that interventions should be tailored to address both family resilience and transition readiness, especially for children with SB-related clinical challenges.
These findings are valuable for nurses supporting children with SB, as the results highlight the importance of transition education tailored to SB-related clinical characteristics. In particular, nurse-led transition education may play a key role in enhancing transition readiness and improving the QOL of children with SB who have clinical characteristics.
None.
STROBE Checklist for cross-sectional studies.
Symptom networks offer a new approach to explore the relationships among various symptoms and provide information for optimising precise symptom management strategies. However, no previous studies have identified the central symptoms of multidimensional frailty.
A cross-sectional study was conducted from December 2023 to March 2024 in China.
A total of 933 community-dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling.
Sociodemographic variables, clinical variables and scores on the Tilburg Frailty Indicator were assessed in all participants. The qgraph package and IsingFit package of R software were applied to construct the symptom network. Three node centrality indices (strength, betweenness and closeness) and the expected influence were calculated to identify the central symptoms of the multidimensional frailty network. All statistical analyses were performed in R.
A total of 933 individuals were surveyed in this study, including 472 (50.6%) females. The median age of all participants was 71.0 years. A total of 408 subjects were assessed as multidimensional frailty. The prevalence of multidimensional frailty was 43.7%. The centrality indices revealed that ‘difficulty in walking’, ‘difficulty in maintaining balance’, and ‘feeling down’ were the symptoms with the largest strength and expected influence values.
This study primarily utilised network analysis to construct a symptom network of multidimensional frailty among community-dwelling older adults. The findings revealed that difficulty in walking, difficulty in maintaining balance, and feeling down were the most central symptoms.
This study identified the central symptoms of multidimensional frailty in older adults, which may serve as primary intervention targets. Nursing staff could incorporate targeted physical and psychological interventions into person-centred care plans.
This study was reported in accordance with the STROBE guidelines.
No patient or public contribution was involved in this study.
Chronic non-specific low back pain (CNLBP) is a multifactorial disease involving physical dysfunction and psychological distress. Acupuncture and mindfulness-based stress reduction (MBSR) are two non-pharmacological therapies recommended by guidelines, which have been proven effective in improving the clinical symptoms of CNLBP. However, the efficacy of their combined use has yet to be explored. This study aims to explore whether the combination of acupuncture and MBSR would have different synergistic effects in patients with CNLBP compared with acupuncture or MBSR alone.
This protocol describes a randomised controlled trial with a 2x2 factorial design involving 120 CNLBP patients. Participants will be randomly allocated to four groups: (1) acupuncture, (2) MBSR, (3) acupuncture combined with MBSR, and (4) health education. The intervention period is 6 weeks. The outcome measurements will include the Visual Analogue Scale (VAS), Tactile Acuity Test, Short-form of McGill Pain Questionnairethe(SF-MPQ); Roland-Morris Functional Disability Questionnaire (RMDQ), Oswestry Disability Index(ODI), the Five Facet Mindfulness Questionnaire (FFMQ), the 21-item Depression Anxiety Stress Scales (DASS-21), the Regulatory Self-Efficacy Scale (RESE), the Beck Depression Inventory (BDI-II), the Beck Anxiety Inventory (BAI), the Fear-Avoidance Beliefs Questionnaire (FABQ) and the Pain Catastrophizing Scale (PCS);Pain Sensitivity Questionnaire(PSQ); Pittsburgh Sleep Quality Index(PSQI). All evaluations will be conducted at the baseline stage as well as 6 weeks and 4 months after the implementation of the intervention measures.
Ethics approval was obtained from the Ethics Committee of the Affiliated Rehabilitation Hospital of the Fujian University of Traditional Chinese Medicine (2024KY-041-04). The results of the study will be disseminated through peer-reviewed publications and at scientific conferences.
ITMCTR2025000764.
This retrospective study aimed to evaluate the clinical efficacy of double flap tibial transverse transport (dTTT) in the treatment of Wagner grade 3–4 diabetic foot ulcers (DFUs) and to assess its impact on peripheral nerve function in the affected limb. A total of 25 patients with DFUs who underwent dTTT at our institution were included. Baseline data were collected, and patients were systematically followed at 1, 3, 6 and 12 months postoperatively. Primary outcome measures included wound healing status, postoperative complications, microcirculatory indicators and nerve conduction parameters. All bone transport sites healed successfully, with no major complications observed except for one patient who died from COVID-19. At 12 months postoperatively, significant improvements were noted in foot skin temperature, transcutaneous oxygen partial pressure and the ankle-brachial index (all p < 0.001). Additionally, motor nerve conduction velocities of the posterior tibial and common peroneal nerves increased significantly (p < 0.001), and corresponding compound muscle action potential amplitudes rose to 4.91 ± 0.14 mV and 4.68 ± 0.29 mV, respectively (p < 0.001). These findings suggest that dTTT not only facilitates wound healing by improving local microcirculation but also enhances peripheral nerve function, offering a promising therapeutic approach for improving long-term outcomes and quality of life in patients with advanced DFUs.
FreshRSS 