Neferine inhibits BMECs pyroptosis and maintains blood-brain barrier integrity in ischemic stroke by triggering a cascade reaction of PGC-1α.

Blood-brain barrier disruption is a critical pathological event in the progression of ischemic stroke (IS). Most studies regarding the therapeutic potential of neferine (Nef) on IS have focused on neuroprotective effect. However, whether Nef attenuates BBB disruption during IS is unclear. We here used mice underwent transient middle cerebral artery occlusion (tMCAO) in vivo and bEnd.3 cells exposed to oxygen-glucose deprivation/reoxygenation (OGD/R) injury in vitro to simulate cerebral ischemia. We showed that Nef reduced neurobehavioral dysfunction and protected brain microvascular endothelial cells and BBB integrity. Molecular docking, short interfering (Si) RNA and plasmid transfection results showed us that PGC-1α was the most binding affinity of biological activity protein for Nef. And verification experiments were showed that Nef upregulated PGC-1α expression to reduce mitochondrial oxidative stress and promote TJ proteins expression, further improves the integrity of BBB in mice. Intriguingly, our study showed that neferine is a natural PGC-1α activator and illustrated the mechanism of specific binding site. Furthermore, we have demonstrated Nef reduced mitochondria oxidative damage and ameliorates endothelial inflammation by inhibiting pyroptosis to improve BBB permeability through triggering a cascade reaction of PGC-1α via regulation of PGC-1α/NLRP3/GSDMD signaling pathway to maintain the integrity of BBB in ischemia/reperfusion injury.

Unveiling the Reaction Mechanism of Nitrate Reduction to Ammonia Over Cobalt-Based Electrocatalysts.

Electrocatalytic reduction of nitrate to ammonia (NRA) has emerged as an alternative strategy for sewage treatment and ammonia generation. Despite excellent performances having been achieved over cobalt-based electrocatalysts, the reaction mechanism as well as veritable active species across a wide potential range are still full of controversy. Here, we adopt CoP, Co, and Co3O4 as model materials to solve these issues. CoP evolves into a core@shell structured CoP@Co before NRA. For CoP@Co and Co catalysts, a three-step relay mechanism is carried out over superficial dynamical Coδ+ active species under low overpotential, while a continuous hydrogenation mechanism from nitrate to ammonia is unveiled over superficial Co species under high overpotential. In comparison, Co3O4 species are stable and steadily catalyze nitrate hydrogenation to ammonia across a wide potential range. As a result, CoP@Co and Co exhibit much higher NRA activity than Co3O4 especially under a low overpotential. Moreover, the NRA performance of CoP@Co is higher than Co although they experience the same reaction mechanism. A series of characterizations clarify the reason for performance enhancement highlighting that CoP core donates abundant electrons to superficial active species, leading to the generation of more active hydrogen for the reduction of nitrogen-containing intermediates.

Quantitative measurement of internal quality of carrots using hyperspectral imaging and multivariate analysis.

The study aimed to measure the carotenoid (Car) and pH contents of carrots using hyperspectral imaging. A total of 300 images were collected using a hyperspectral imaging system, covering 472 wavebands from 400 to 1000 nm. Regions of interest (ROIs) were defined to extract average spectra from the hyperspectral images (HIS). We developed two models: least squares support vector machine (LS-SVM) and partial least squares regression (PLSR) to establish a quantitative analysis between the pigment amounts and spectra. The spectra and pigment contents were predicted and correlated using these models. The selection of EWs for modeling was done using the Successive Projections Algorithm (SPA), regression coefficients (RC) from PLSR models, and LS-SVM. The results demonstrated that hyperspectral imaging could effectively evaluate the internal attributes of carrot cortex and xylem. Moreover, these models accurately predicted the Car and pH contents of the carrot parts. This study provides a valuable approach for variable selection and modeling in hyperspectral imaging studies of carrots.

Exploring the Usage Effectiveness of a Nursing Charge System.

The nursing charge system for inpatient accounting has been utilized in healthcare institutions for years. However, the level of its effectiveness in meeting the needs of nursing services, including further development, has not been systematically evaluated. A cross-sectional study based in Delone and McLean's information system success model was applied to explore the level of effective nursing charge system usage across the five dimensions of system quality, information quality, service quality, user satisfaction, and net benefits. We conducted a survey of the inpatient units of a medical center in Taiwan from June 23, 2021, to July 23, 2021. A total of 214 valid questionnaires were collected. Using a 5-point Likert scale, the dimension with the highest score was information quality (3.71), followed by service quality (3.37), user satisfaction (3.36), net benefits (3.31), and system quality (3.23). Older nurses (r = -0.176) and those with more clinical experience (r = -0.151) viewed the nursing charge system as having less information quality. The comfort level with using the computer was positively associated with system quality (r = 0.396), information quality (r = 0.378), service quality (r = 0.275), user satisfaction (r = 0.417), and net benefits (r = 0.355). The opinions of nurses are vital. User feedback and advice should be investigated regularly to achieve system optimization.

Increased Activity of ß-Lactam Antibiotics in Combination with Carvacrol against MRSA Bacteremia and Catheter-Associated Biofilm Infections.

ß-Lactam antibiotics are the mainstay for the treatment of staphylococcal infections, but their utility is greatly limited by the emergence and rapid dissemination of methicillin-resistant Staphylococcus aureus (MRSA). Herein, we evaluated the ability of the plant-derived monoterpene carvacrol to act as an antibiotic adjuvant, revitalizing the anti-MRSA activity of ß-lactam antibiotics. Increased susceptibility of MRSA to ß-lactam antibiotics and significant synergistic activities were observed with carvacrol-based combinations. Carvacrol significantly inhibited MRSA biofilms and reduced the production of exopolysaccharide, polysaccharide intercellular adhesin, and extracellular DNA and showed synergistic biofilm inhibition in combination with ß-lactams. Transcriptome analysis revealed profound downregulation in the expression of genes involved in two-component systems and S. aureus infection. Mechanistic studies indicate that carvacrol inhibits the expression of staphylococcal accessory regulator sarA and interferes with SarA-mecA promoter binding that decreases mecA-mediated ß-lactam resistance. Consistently, the in vivo experiment also supported that carvacrol restored MRSA sensitivity to ß-lactam antibiotic treatments in both murine models of bacteremia and biofilm-associated infection. Our results indicated that carvacrol has a potential role as a combinatorial partner with ß-lactam antibiotics to address MRSA infections.

[Analysis of the Environmental Risk of Livestock Manure Pollution and Resource Treatment Technology].

Rapid development of the livestock and poultry industry has greatly promoted the rural economic prosperity of China. However, the problems resulting from the livestock manure, such as large emissions, low utilization rate, and environmental pollution are also becoming increasingly serious. Based on the current situation of livestock manure discharge in China, the typical contaminants in livestock manure and their pollution characteristics in soil, water, and air were systematically analyzed in this study. Taking heavy metals and antibiotics as the characteristic pollutants, the common risk assessment methods for livestock manure pollution were described. Moreover, the main harmless disposal and recycling treatment technologies of livestock and poultry manure at home and abroad were compared and analyzed. The application prospect and value of these technologies such as the thermochemical conversion method and the biological method in energization or fertilization were evaluated. Furthermore, the prominent problems in the pollution control of livestock manure are discussed, and the development trends in the resource treatment technology of livestock manure were also prospected.

Pre- and post-pollination barriers between two exotic and five native Sagittaria species: Implications for species conservation.

Anthropogenic introduction of species has resulted in a breakdown of geographical barriers and hybridization in previously allopatric species. Thus, examining hybridization proneness of exotic species contributes to revealing its potential threat. Moreover, reproductive barriers may be strengthened or weakened due to long-term geographical isolation for these newly sympatric species. However, few studies have evaluated multiple barriers between alien and native species. In this study, we quantified the importance of four pre-pollination barriers (phenological, floral traits, pollen production, and floral constancy) and four post-pollination barriers (pollen-pistil incompatibility, seed set, seed viability, and seedling survival) between two introduced and five native Sagittaria species. Results showed that introduced S. platyphylla was cross-compatible with two native species, whereas introduced S. montevidensis was incapable of hybridizing with any native species. Different barriers were asymmetric within species pairs and multiple barriers acted in concert to maintain species boundaries. Post-pollination barriers contributed more to total reproductive isolation in native species, whereas pre-pollination barriers played a stronger role in total reproductive isolation for two introduced species. Seed set was the only barrier that was positively correlated with genetic distance. Our results provide a perspective to better understand reproductive barriers for secondary contact species. We highlight the importance of monitoring hybridization events before human introduction and the possible conservation strategies to remove invasive species with hybridization proneness.

Optimizing lettuce yields and quality by incorporating movable downward lighting with a supplemental adjustable sideward lighting system in a plant factory.

Background: Lettuce is a vegetable that is increasingly consumed globally, given its nutritional quality. Plant factories with artificial lighting can produce high-yield and high-quality plants. High plant density in these systems speeds up leaf senescence. Wasted energy and lower yield raised labor expenses are some of the bottlenecks associated with this farming system. In order to increase lettuce yields and quality in the plant factory, it is essential to develop cultivating techniques using artificial lighting. Methods: Romaine lettuce was grown under a developed "movable downward lighting combined with supplemental adjustable sideward lighting system" (C-S) and under a system without supplemental sideward lighting (N-S) in a plant factory. The effects of C-S on lettuce's photosynthetic characteristics, plant yield, and energy consumption relative to plants grown under a system without N-S were studied. Results: Romaine lettuce growth and light energy consumption in the plant factory were both influenced favorably by supplementary adjustable sideward lighting. The number of leaves, stem diameter, fresh and dry weights, chlorophyll a and b concentration, and biochemical content (soluble sugar and protein) all increased sharply. The energy consumption was substantially higher in the N-S treatment than the C-S.

Involvement of baroreflex deficiency in the age-related loss of estrogen efficacy against cerebral ischemia.

For post-menopausal women, stroke is complicated by the variable effects of estrogen therapy and the age-related therapeutic consequences involved. Estrogen therapy has been shown to have an age-dimorphic effect, which is neuroprotective in young females, but non-neuroprotective, even neurotoxic in acyclic females. We hypothesized that arterial baroreflex (ABR) and its downstream acetylcholine-α7 nicotinic acetylcholine receptor (α7nAChR) anti-inflammatory pathways are involved in estrogen efficacy toward cerebral ischemic damage. Our data showed that estrogen supplements contributed to ABR improvement and neuroprotection in adult, not aged, ovariectomized (OVX) rats. In adult rats, OVX-induced estrogen deficiency aggravated middle cerebral artery occlusion (MCAO), which induced brain infarction and reduced ABR function, with decreased α7nAChR expression of the brain and exaggerated inflammation following MCAO; these effects were significantly prevented by supplementation with estrogen. ABR impairment by sinoaortic denervation partly attenuated the estrogen effect on baroreflex sensitivity (BRS) and ischemic damage in adult rats, as well as α7nAChR expression and inflammatory response. These data suggested that ABR and acetylcholine-α7nAChR anti-inflammatory pathways are involved in the neuroprotection of estrogen in adult OVX rats. In contrast, aged rats exhibited more severe ischemic damage and inflammatory response than adult rats, as well as poorer baroreflex function and lower α7nAChR expression. Estrogen supplements did not improve BRS or confer neuroprotection in aged rats without affecting brain α7nAChR and post-ischemic inflammation. Most importantly, ketanserin restored ABR function and significantly postponed the onset of stroke in aged female strokeprone spontaneously hypertensive rats, whereas estrogen treatment failed to delay the development of stroke. Our findings reveal that estrogen is protective against ischemic stroke (IS) in adult female rats and that ABR played a role in this beneficial action. Dysfunction of ABR and unresponsiveness to estrogen in aged female rats may contribute to a reduced estrogen efficacy against cerebral ischemia.

[Research Progress on the Remediation Technology of Herbicide Contamination in Agricultural Soils].

Asthe most-used pesticides in the agricultural production process, herbicides are mainly applied to protect crops from weeds. However, with the increased global demand for food, the dosage of herbicides is rising annually, and the efficacy of herbicides is getting stronger, which can cause some environmental issues including the accumulation, migration and transformation, and toxic effects of herbicides in agricultural soils. According to the characteristics of herbicide contamination and regional agricultural production, developing green and low-carbon technologies to reduce the ecological risks of herbicides to the soil-crop systems is a current concern in the ecological environment field. In this paper, relevant studies in recent years on herbicide pollution management in agricultural soils were identified and reviewed, the research progress and application cases of remediation technologies for herbicide pollution was analyzed and demonstrated, and future research and development tendency regarding the remediation of herbicides pollution was also prospected. Current remediation technologies for herbicides mainly include bioremediation technologies (e.g., microbial remediation, enzyme remediation, and phytoremediation), adsorption, and immobilization technologies (e.g., biochar-based materials). The bioremediation technologieswere rather mature and had been applied to the herbicide-contaminated soil in fields. Additionally, many successful bioremediation cases have been reported. Moreover, in order to enhance the remediation effect on herbicide pollution in agriculture soils, remediation technologies have been gradually developed from a single model to a coupled model with physical,chemical, and biological technology, which can maximize the synergy of the multi-technology application.

Effects of outsider witness practice on a support group for parents of children with autism spectrum disorder.

PURPOSE: Providing effective support to parents of children with autism spectrum disorder (ASD) is an important part of clinical work. This study used outsider witnesses in group counselling for parents of children with ASD and explored the mechanism through which the therapeutic effects occurred. METHOD: Parents of children diagnosed with ASD participated in an eight-session group activity. Two outsider witnesses were introduced into some of the sessions. The participants were interviewed to collect their experiences of and reflections on the outsider-witness practice. Texts were analysed using the categorical content approach. RESULTS: The intervention was effective because the participants shifted their subjective experiences to an objective position, leading them to reflect on their previous limited perspectives, thus resulting in self-redefinition. These therapeutic effects may arise due to physical displacement, experience resonance, and externalization of subjective experiences. The results of this study have important implications for parents and practitioners.

Visual analysis of Chinese medicine nursing of coronary heart disease research based on CiteSpace / 中国实用护理杂志

Objective:To provide a reference for in-depth application and research in the field of coronary heart disease traditional Chinese medicine (TCM) nursing. Based on the CiteSpace software, the development trend and research hotspots of the literature are displayed and analyzed in this field.Methods:The China Knowledge Network (CNKI) database was used to retrieve the literature related to the research in this field published in the past 20 years from January 1st 2001 to October 5th 2021, and CiteSpace was used to visually analyze the number of articles, research institutions, authors and keywords, and to interpret its meaning in combination with the content of the atlas.Results:The amount of research literature in this field was generally on the rise, but the cooperation between various research institutions and authors needs to be strengthened. Research hotspots mainly focused on five areas: coronary heart disease-related symptom care, the application of characteristic TCM nursing techniques, the outcome indicators of the research, the TCM health management of patients with coronary heart disease, and the application model of TCM nursing.Conclusions:It is recommended to strengthen multidisciplinary and teamwork in this field, carry out high-quality randomized controlled studies, and focus on related research on multiple nursing models, evaluation tools, and symptom management.

[Clinical efficacy of shallow-needle therapy combined with estazolam on insomnia of liver stagnation transforming into fire pattern: a randomized controlled trial].

OBJECTIVE: To observe the clinical efficacy of shallow-needle therapy combined with estazolam on insomnia differentiated as liver stagnation transforming into fire and its effect on adrenocorticotropic hormone (ACTH) and cortisol (CORT), so as to explore the mechanism of this combined treatment. METHODS: A total of 119 patients with insomnia of liver stagnation transforming into fire pattern were randomly divided into shallow-needle therapy group (n=40), medication group (n=39), and shallow-needle therapy combined with medication group (combined therapy group,n=40). In the shallow-needle therapy group, the patients were treated with finger pressure and operation with shallow stimulating at Zhenjing (Dong's extra point, sedative point) and Taichong (LR3). In the medication group, the patients were administered with estazolam (1 mg) orally. In the combined therapy group, both shallow-needle therapy and medication were administered. The treatment was given once daily in each group, 10 days as one session of treatment and 2 sessions were required. Before and after the treatment, Pittsburgh sleep quality index scale (PSQI) and Self-rating anxiety scale (SAS) were used to assess sleep and anxiety status. ELISA was used to detect the contents of ACTH and CORT in plasma. The clinical efficacy was evaluated in each group. RESULTS: In within-group comparison, PSQI scores, SAS scores and the concentrations of ACTH and CORT in plasma were all decreased (P<0.05) after treatment for the patients of three groups. After treatment, the total PSQI score, the score for sleep latency, sleep duration and daytime dysfunction, as well as SAS score in the combined therapy group were all lower than those of the shallow-needle therapy group (P<0.05); the total PSQI score, the score for sleep duration and sleep efficiency, as well as SAS score were lower when compared with the medication group (P<0.05). The total effective rates were 87.50% (35/40), 82.05% (32/39) and 95.00% (38/40) in the shallow-needle therapy group, the medication group and the combined therapy group, respectively. The total effective rate in the combined therapy group was higher than those of the shallow-needle therapy group and the medication group separately (P<0.05). CONCLUSION: Shallow-needle therapy combined with estazolam is effective on insomnia of liver stagnation transforming into fire pattern, and its underlying effect mechanism is related to the reduction of plasma ACTH and CORT levels.

Circadian rhythm-related factors of PER and CRY family genes function as novel therapeutic targets and prognostic biomarkers in lung adenocarcinoma.

The period (PER) and cryptochrome (CRY) families play critical roles in circadian rhythms. The imbalance of circadian factors may lead to the occurrence of cancer. Expressions of PER and CRY family members decrease in various cancers. Nevertheless, expression levels, genetic variations, and molecular mechanisms of PER and CRY family members in lung adenocarcinoma (LUAD) and their correlations with prognoses and immune infiltration in LUAD patients are still unclear. In this study, to identify their biological functions in LUAD development, comprehensive high-throughput techniques were applied to analyze the relationships of expressions of PER and CRY family members with genetic variations, molecular mechanisms, and immune infiltration. The present results showed that transcription levels of PER1 and CRY2 in LUAD were significantly downregulated. High expression levels of PER2, PER3, CRY1, and CRY2 indicated longer overall survival. Some cancer signaling pathways were related to PER and CRY family members, such as cell-cycle, histidine metabolism, and progesterone-mediated oocyte maturation pathways. Expressions of PER and CRY family members significantly affected the infiltration of different immune cells. In conclusion, our findings may help better understand the molecular basis of LUAD, and provide new perspectives of PER and CRY family members as novel biomarkers for LUAD.

Conspecific pollen advantage mediated by the extragynoecial compitum and its potential to resist interspecific reproductive interference between two Sagittaria species.

The extragynoecial compitum formed by the incomplete fusion of carpel margins, while allowing intercarpellary growth of pollen tubes in apocarpous angiosperms, may also increase the risk of reproductive interference caused by heterospecific pollen (HP) deposition. In Sagittaria, congeneric HP tubes grow via different paths and enter the ovules later than conspecific pollen (CP) tubes. However, it is unclear how the growth advantage of the CP tube helps ensure reproductive success when HP is deposited on the stigmas. We performed molecular characterization of interspecies-pollinated seeds to examine the consequences of interspecific pollen deposition between Sagittaria pygmaea and S. trifolia. We also conducted CP-HP (1:1) mixed pollination and delayed CP pollination treatments to explore the seed-siring abilities of CP and HP. Our results showed that although HP could trigger the development of fruits, the interspecies-pollinated seeds contained partially developed embryos and could not germinate. More than 70% of the embryos in these seeds were molecularly identified as hybrids of both species, suggesting that HP tubes could enter the ovules and fertilize the egg cells. Moreover, CP could sire more offspring (≥70%) after the CP-HP (1:1) mixed pollination treatment, even when HP reached the stigma 0.5-1 h earlier than CP (≥50%). Following adequate CP vs. HP (1:1) pollination on carpels on two sides of the apocarpous gynoecium, both species produced > 70% conspecific seeds, indicating that the CP tubes could occupy ovules that should be occupied by HP via the extragynoecial compitum. Our results reveal that in Sagittaria, pollen deposition from co-existing congeneric heterospecies leads to interspecific seed discounting. However, the CP advantage mediated by the extragynoecial compitum is an effective strategy to mitigate the effects of interspecific pollen deposition. This study improves our understanding of how apocarpous angiosperms with an extragynoecial compitum can maintain species stability and mitigate the negative reproductive interference effect from sympatrically distributed related species.

Target isolation of cytotoxic diterpenoid esters and orthoesters from Daphne tangutica maxim based on molecular networking.

Guiding by LC-MS/MS analysis and the GNPS Molecular Networking, five undescribed daphnane diterpenoids, tanguticanines A-E, and eleven known analogues were discovered from the whole plants of Daphne tangutica Maxim. Their structures and absolute configurations were determined via extensive NMR spectroscopic analysis, ECD calculations, and X-ray diffraction crystallography. Tanguticanine E (5) exhibited promising cytotoxicity against the HepG2 cell line with an IC50 value of 9.93 ± 0.10 µM. Further flow cytometry experiment was performed to detect cell apoptosis, and the results indicated that cytotoxic diterpenoids (tanguticanines B, D and E, altadaphnan C, gniditrin, hirsein A and simplexin) exert their effects through induction of apoptosis.

The Impact of Signing Do-Not-Resuscitate Orders on the Use of Non-Beneficial Life-Sustaining Treatments for Intensive Care Unit Patients: A Retrospective Study.

Background: Intensive care medical technology increases the survival rate of critically ill patients. However, life-sustaining treatments also increase the probability of non-beneficial medical treatments given to patients at the end of life. Objective: This study aimed to analyse whether patients with a do-not-resuscitate (DNR) order were more likely to be subject to the withholding of cardiac resuscitation and withdrawal of life-sustaining treatment in the ICU. Methods: This retrospective study collected data regarding the demographics, illness conditions, and life-sustaining treatments of ICU patients who were last admitted to the ICU between 1 January 2016 and 31 December 2017, as determined by the hospital's electronic medical dataset. Results: We identified and collected data on 386 patients over the two years; 319 (82.6%) signed a DNR before the end. The study found that DNR patients were less likely to receive cardiac resuscitation before death than non-DNR patients. The cardiac resuscitation treatments included chest compressions, electric shock, and cardiotonic drug injections (p < 0.001). However, the life-sustaining treatments were withdrawn for only a few patients before death. The study highlights that an early-documented DNR order is essential. However, it needs to be considered that promoting discussions of time-limited trials might be the solution to helping ICU terminal patients withdraw from non-beneficial life-sustaining treatments.

Factors Related to Family Caregivers' Readiness for the Hospital Discharge of Advanced Cancer Patients.

Background: Many family caregivers of advanced cancer patients worry about being unable to provide in-home care and delay the discharge. Little is known about the influencing factors of discharge readiness. Methods: This study aimed to investigate the influencing factors of family caregivers' readiness, used a cross-sectional survey, and enrolled 123 sets of advanced cancer patients and family caregivers using convenience sampling from four oncology wards in a medical centre in northern Taiwan. A self-developed five-point Likert questionnaire, the "Discharge Care Assessment Scale", surveyed the family caregivers' difficulties with providing in-home care. Results: The study showed that the discharge readiness of family caregivers affects whether patients can be discharged home. Moreover, the influencing factors of family caregivers' discharge readiness were the patient's physical activity performance status and expressed discharge willingness; the presence of someone to assist family caregivers with in-home care; and the difficulties of in-home care. The best prediction model accuracy was78.0%, and the Nagelkerke R2 was 0.52. Conclusion: Discharge planning should start at the point of admission data collection, with the influencing factors of family caregivers' discharge readiness. It is essential to help patients increase the likelihood of being discharged home.

Core Competence in Fundamental Nursing Practicum Scale: A validity and reliability analysis.

AIM: This study aimed to develop and examine the psychometric properties of validity and reliability of the Core Competence in Fundamental Nursing Practicum Scale. BACKGROUND: Fundamental nursing practicum is an initial practicum required for nursing students; however, no measurement tool is available to assess students' core competence during their first practicum. DESIGN: Cross-sectional design. METHODS: Nursing students from six nursing colleges in Southern Taiwan who completed their fundamental nursing practicum within 1 month were recruited. The initial 39-item Core Competence in Fundamental Nursing Practicum Scale was drafted and examined for its content, face and factorial validity. The data were randomly assigned into two subgroups and analyzed using exploratory and confirmatory factor analyses. Exploratory factor analysis was performed using principal-axis factoring and direct oblimin rotation and numbers of factors were extracted on the basis of eigenvalues > 1 and a scree plot. The exploratory factor analysis derived structure was then verified by a confirmatory factor analysis using maximum likelihood estimation. Reliability was examined in term of internal consistency. RESULTS: The exploratory factor analysis and confirmatory factor analysis samples comprised 405 and 513 students, respectively. Four items were omitted by content validity and another four items were omitted because of the ceiling effect. Six items were removed during the exploratory factor analysis because of their lower factor loadings (< 0.4). The final 25-item Core Competence in Fundamental Nursing Practicum Scale comprised 5 domains, namely communication (3 items), application of nursing process (6 items), basic biomedical science (4 items), nursing skills and ability to perform a care process (7 items), and professional attitude (5 items), which collectively explained 70.14% of total variance. The structure was then verified by a confirmatory factor analysis with satisfactory model fit. The Cronbach's alpha of the Core Competence in Fundamental Nursing Practicum Scale was 0.94. CONCLUSIONS: The 25-item Core Competence in Fundamental Nursing Practicum Scale reliably and validly measures nursing students' core competence during their fundamental nursing practicum. Instructors can use the scale to identify students' weak core competencies and refine their courses for novice nurses.

Exploration of the experiences of working stressors and coping strategies associated with menstrual symptoms among nurses with shifting schedules: a Q methodology investigation.

BACKGROUND: The essence and workload of nursing can easily lead to burdens associated with female nurses' menstrual symptoms, and consequently, result in decreased working performance. Without effective support this can lead to resignation due to maladaptation. This study adopted Q methodology to explore the experience of working stressors and coping strategies associated with menstrual symptoms among nurses with shifting schedules. METHODS: Data were collected in two stages. First, in-depth interviews were conducted to collect nurses' experiences. Sentences that best fit the study's purpose were extracted for the construction of Q statements. Second, nurses were allowed to subjectively rank these Q statements by using Q-sorts. A total of 90 participants ranked the designed Q statements. The Q factor analysis revealed a five-factor solution that accounted for 48.90% of the total variance. RESULTS: The five evident factors included: menstrual symptoms interfering in collaboration with colleagues, deficiency of professional function and stress due to symptoms burden, diverse experiences without a clear pattern, adapted self-management with and without medication use, and stress due to symptoms burden and using medication for self-management. CONCLUSIONS: The identification of these five groups may facilitate the development of responsive strategies to meet nurses' preferences. Furthermore, identifying workplace factors that are associated with the adverse effects of menstrual symptoms on nurses will be helpful for nursing supervisors and hospital managers. Additionally, strategies that can be implemented to create supportive work environments are discussed.