Double network self-healing hydrogels based on carboxyethyl chitosan/oxidized sodium alginate/Ca2+: Preparation, characterization and application in dye absorption.

This paper presents the formation of a self-healing hydrogel prepared by carboxyethyl modification of chitosan and crosslinking with oxidized sodium alginate. Concurrently, the incorporation of Ca2+ facilitated the formation of "calcium bridges" through intricate coordination with carboxyl moieties, bolstering the attributes of the hydrogel. Various characterization methods, including scanning electron microscopy, texture analysis, and rheological measurements, demonstrated that the introduction of carboxyethyl groups resulted in a more compact hydrogel network structure and improved the hardness and elasticity. The addition of Ca2+ helped to further enhance the mechanical performance of the hydrogel and increase its thermal stability. Then, the adsorption capacity was also investigated, showing adsorption capacities of 46.17 mg/g methylene blue and 46.44 mg/g congo red for carboxyethyl chitosan/oxidized sodium alginate hydrogel, a four-fold increase for congo red versus chitosan/oxidized sodium alginate hydrogel. In addition, the adsorption behavior of CEC/OSA/2%Ca2+ hydrogel can be well described by pseudo-second-order kinetic model and Langmuir adsorption isothermal model. Compared to traditional hydrogels, CEC/OSA/2%Ca2+ hydrogel shows superior mechanical strength, enhanced thermal stability, and improved adsorption capacity, which can effectively adsorb not only methylene blue but also congo red. These advancements demonstrate our hydrogel's innovative properties.

Exploring the emulsification potential of chitosan modified with phenolic acids: Emulsifying properties, functional activities, and application in curcumin encapsulation.

This study successfully grafted caffeic acid and 3,4-dihydroxybenzoic acid into chitosan through a coupling reaction, yielding grafting ratio of 8.93 % for caffeic acid grafted chitosan (CA-GC) and 9.15 % for 3,4-dihydroxybenzoic acid grafted chitosan (DHB-GC) at an optimal concentration of 4 mmol phenolic acids. The characterization of modified chitosans through ultraviolet visible spectrometer (UV-vis), Fourier transform infrared spectrometer (FTIR), proton nuclear magnetic resonance (1H NMR), and x-ray photoelectron spectrometer (XPS) confirmed the successful grafting of phenolic acids. In the subsequent step of emulsion preparation, confocal laser scanning microscope images confirmed the formation of O/W (oil-in-water) emulsions. The phenolic acid-grafted chitosans exhibited better emulsification properties compared to native chitosan, such as reduced droplet size, more uniform emulsion droplet distribution, increased ζ-potential, and enhanced emulsifying activity and stability. Moreover, the modified chitosans demonstrated increased antioxidant activities (evidenced by DPPH and ß-carotene assays) and displayed greater antimicrobial effects against E. coli and S. aureus. Its efficacy in curcumin encapsulation was also notable, with improved encapsulation efficiency, sustained release rates, and enhanced storage and photostability. These findings hint at the potential of modified chitosans as an effective emulsifier.

Preparation of curcumin-loaded pectin-nisin copolymer emulsion and evaluation of its stability.

In the paper, Nisin was grafted onto native pectin by the 1-ethyl-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC·HCl) method. Structure characterisation showed that the carboxyl group of pectin interacted with the amino group of Nisin and formed an amide bond. The highest grafting ratio of the modified pectin was up to 24.89 %. The emulsifying property of modified pectin, significantly improved, and emulsification performance improved with increasing grafting ratio. Emulsifying activity, emulsion stability, Zeta potential, and droplet morphology data demonstrate a notable enhancement in pectin's emulsifying properties due to Nisin's introduction, with the degree of grafting showing a direct correlation with the improvement observed. Pectin-based emulsion is utilized to load curcumin, enhancing its stability and bioavailability. Research findings highlight that the incorporation of Nisin-modified pectin significantly elevates curcumin encapsulation efficiency, while decelerating its release rate. Moreover, the stability of curcumin loaded in the modified pectin under light exposure, alkaline conditions, and long-term storage is also significantly improved. Ultimately, the bioavailability of curcumin escalates from 0.368 to 0.785.

Role stress, occupational burnout and depression among emergency nurses: A cross-sectional study.

BACKGROUND: Emergency nurses are a professional group at a high risk of burnout and depression. This may influence their mental state and physical health. AIMS: The aim of the study was to explore the relationship between role stress, occupational burnout and depression among emergency nurses. METHODS: A cross-sectional study was carried out among 295 emergency nurses from eight tertiary hospitals in western China. The Role Stress Scale, the Maslach Burnout Inventory-Human Services Survey and the Center for Epidemiologic Studies Depression Scale were employed. Descriptive statistics, independent sample t-tests, one-way analysis of variance, Pearson's correlation analysis and regression analysis were performed. RESULTS: Of the study participants, 54.6% were found to have depressive symptoms and 48.1% had severe occupational burnout. Positive correlations were observed between the scores of role stress and burnout and depression. Approximately 37.1% of the variation in depression was explained by the components of occupational burnout. CONCLUSIONS: Emergency nurses experience high levels of role stress, occupational burnout and depression. Preventive approaches to role stress, burnout and depression are needed to improve their psychological condition and quality of work life.

Chlorogenic acid-chitosan copolymers: Synthesis, characterization and application in O/W emulsions for enhanced ß-carotene stability.

In this study, chlorogenic acid-chitosan (CA-CS) copolymers were prepared with varying Chitosan (CS): chlorogenic acid (CA)ratios and characterized for their water solubility, antioxidant capacity, and emulsions stability. Results showed that CA-CS samples exhibited up to 90.5 % increase in DPPH scavenging efficiency and 20 % increase in hydroxyl radical scavenging efficiency compared to CS alone. CA-CS copolymers used to stabilize oil in water (O/W) emulsions, which were evaluated for their potential in encapsulating and protecting ß-carotene. Microscopic observations revealed homogeneous spherical droplets in stable emulsions, suggesting effective interfacial structures. The selected CA-CS-stabilized O/W emulsions demonstrated encapsulation efficiencies of 74.8 % and 75.26 % for ß-carotene. The CA-CS stabilized O/W emulsions provided the most effective protection against ß-carotene degradation under UV exposure, retaining over 80 % of ß-carotene content after 12 h of testing. These findings indicate that CA-CS-based O/W emulsions show promise as carriers and protectors for bioactive compounds, due to their improved antioxidant capacity, emulsions stability, and protection against degradation.

Evaluation of amidated pectin as fat substitutes for minced chicken breast: Physicochemical properties and edible quality.

An investigation was conducted to assess the gelation characteristics of amino acid amidated pectin and its subsequent influence on the quality of minced chicken breast (MCB) when employed as a lipid substitute. Through experimentation, it was evidenced that amidated pectin, such as glycine amidated pectin (AP@Gly), glutamic amidated pectin (AP@Glu), and lysine amidated pectin (AP@Lys), demonstrated superior viscosity and gelation capacity in comparison to their native pectin (PE) counterpart. In contrast to PE, amidated pectin samples exhibited the potential to form high-strength hydrogels under conditions of minimal restriction. Additionally, evaluations conducted on all samples established that MCB samples enriched with pectin and amidated pectin demonstrated superior water retention capability. Before thermal processing, MCB samples fortified with amidated pectin showcased higher hardness and L* values in comparison to PE and the control group. However, upon thermal processing, no significant divergence was found in the chroma and texture profile analysis (TPA) attributes across all MCB samples, and the electronic tongue sensory evaluation was closely aligned with the control group. This evidence substantiates the effectiveness of amidated pectin samples as viable lipid substitutes in MCB products.

The use of 3D video in medical education: A scoping review.

Objectives: The use of 3D video in medical education has not been fully explored. This article aims to review the evidence on 3D video currently presented in the medical education literature, including its impact on curriculum activities, to reference future research in this field. Methods: According to the guidelines of Arksey and O'Malley, the authors used a systematic search strategy (the last search was in December 2022) to search nine literature databases published in English, and only primary studies were included. Two authors independently screened all articles based on the eligibility criteria and performed a thematic analysis of the included literature. Results: Of 1,302 articles identified, 23 were included for insights into how opportunities for 3D video in medical education are created, how they are experienced, and how they influence and manifest behavior demonstrated partial congruency. Three themes were identified: (a) advantages of using 3D video in medical education; (b) the effect of using 3D video in medical education on students' academic achievement and ability; and (c) students' experience of 3D video in medical education. Conclusions: The application of 3D video in medical education has won the support of most students and educators. However, the effect of using 3D video in medical education is still controversial. Medical educators should combine the curriculum's characteristics, the students' learning situation, and the existing educational resources and choose to use them after careful consideration.

Effects of psychosocial interventions for caregivers of breast cancer patients: A systematic review and meta-analysis.

Aim: The aim of this review was to determine whether the caregivers of breast cancer patients who undergo psychosocial interventions report improvements in quality of life (QOL), depression, and anxiety. Methods: This systematic review was conducted in accordance with the PRISMA guidelines. A systematic search was conducted in the CINAHL, Embase, PsycINFO, PubMed, Web of Science, CNKI and Wanfang databases from inception until March 1, 2022. Randomized controlled trials (RCTs) and quasiexperimental studies involving psychosocial interventions for caregivers of breast cancer patients were included. Cochrane's risk of bias tool and the Joanna Briggs Institute checklist were used to assess the risk of bias. Results: This systematic review included eight original studies involving 528 caregivers of breast cancer patients. According to the meta-analyses, psychosocial interventions contributed significantly to improvements in QOL (SMD = 1.00, 95% CI [0.47, 1.54], p < 0.01), depression (SMD = -0.72, 95% CI [-1.02, -0.42], p < 0.01) and anxiety (SMD = -0.56, 95% CI [-0.86, -0.27], p < 0.01). Significant differences of psychosocial interventions on the QOL of caregivers were found in face-to-face and mixed-method psychosocial interventions (SMD = 0.97, 95% CI [0.19,1.75], p = 0.02; SMD = 1.45, 95% CI [0.86,2.05], p < 0.01) in the ≥3 months subgroup (SMD = 1.22, 95% CI [0.58,1.86], p < 0.01) but not in the spouses or partners subgroup (SMD = 0.83, 95% CI [-0.10,1.75], p = 0.08). Conclusions: This systematic review revealed that breast cancer patients' caregivers who undergo psychosocial interventions report improvements in QOL and reduced levels of depression and anxiety. It is worthwhile to use face-to-face methods when psychosocial interventions are conducted for caregivers. Future studies should examine long-term psychosocial interventions for spouses or partners of breast cancer patients. However, because of the limited number of original studies and the low quality of some included studies, the results should be treated cautiously. To increase solid evidence in this field, higher quality, more original studies are needed.

Perceived stress, coping style and burnout of Chinese nursing students in late-stage clinical practice: A cross-sectional study.

AIM: The aim of this study was to examine the levels of stress, coping style and burnout among Chinese nursing students in late-stage clinical practice and to identify their relationships. BACKGROUND: High stress, passive coping and burnout among nursing students in late-stage clinical practice may contribute to severe psychological consequences. DESIGN: A descriptive and cross-sectional study was conducted in November and December 2020. METHODS: Participants completed the Perceived Stress Scale, Simplified Coping Style Questionnaire and Maslach Burnout Inventory-Human Service Survey to examine their stress levels, coping style and burnout. Intention to leave the profession was also assessed. RESULTS: Approximately 36.1 % of nursing students experienced emotional exhaustion and 85.3 % of nursing students perceived themselves to have moderate to high stress levels. A positive coping style can protect nursing students from depersonalization and reduced personal accomplishment. High stress and passive coping style predicted emotional exhaustion. Passive coping style and high stress were significant factors leading to intention to quit nursing education before graduation. CONCLUSIONS: Lowering the level of stress and using positive coping behaviors may help students during late internship to mitigate burnout and avoid leaving nursing education. Therefore, nurse educators and clinical nursing mentors need to consider developing strategies and interventions to reduce the decline in nursing students entering nursing education and prevent burnout.

Correlation between vitamin D metabolites and rheumatoid arthritis with osteoporosis by ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).

INTRODUCTION: Our aim is to study the correlation between vitamin D metabolites and osteoporosis in rheumatoid arthritis (RA) by ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). At the same time, other influencing factors and serum biomarkers of osteoporosis in patients with RA were studied. MATERIALS AND METHODS: Patients with RA admitted from January 2020 to December 2020 were selected at our hospital. The subjects were divided into the normal bone mineral density (BMD), osteopenia, and osteoporosis groups. The differences of vitamin D (VD) metabolites among groups were compared. The Pearson correlation coefficient was used to analyze the relationship between BMD and various parameters. The relationship between BMD and influencing factors was studied by a multiple linear regression equation. RESULTS: A total of 287 patients with RA were included. RA patients with 25-hydroxy vitamin D [25(OH)D] deficiency accounted for 43.63% and 25(OH)D insufficient levels accounted for 31.37%. There were 31 cases (10.80%) in the normal BMD group, 161 cases (56.10%) in the osteopenia group, and 95 cases (33.10%) in the osteoporosis group. The BMD of L1-4 (T- score) was negatively correlated with age (P < 0.05), course of disease (P < 0.05), and erythrocyte sedimentation rate (ESR) (P < 0.05), and positively correlated with 25(OH)D3 (P < 0.05). The multiple linear regression model results showed that age and 25(OH)D3 were independent predictors of BMD; this explained 22.11% of the total variation. CONCLUSIONS: VD deficiency and insufficient are common in RA patients. RA patients can be appropriately supplemented with VD. VD3 may be a better choice.

A Dual-Energy CT Radiomics of the Regional Largest Short-Axis Lymph Node Can Improve the Prediction of Lymph Node Metastasis in Patients With Rectal Cancer.

Objective: To explore the value of dual-energy computed tomography (DECT) radiomics of the regional largest short-axis lymph nodes for evaluating lymph node metastasis in patients with rectal cancer. Materials and Methods: One hundred forty-one patients with rectal cancer (58 in LNM+ group, 83 in LNM- group) who underwent preoperative total abdominal DECT were divided into a training group and testing group (7:3 ratio). After post-processing DECT venous phase images, 120kVp-like images and iodine (water) images were obtained. The highest-risk lymph nodes were identified, and their long-axis and short-axis diameter and DECT quantitative parameters were measured manually by two experienced radiologists who were blind to the postoperative pathological results. Four DECT parameters were analyzed: arterial phase (AP) normalized iodine concentration, AP normalized effective atomic number, the venous phase (VP) normalized iodine concentration, and the venous phase normalized effective atomic number. The carcinoembryonic antigen (CEA) levels were recorded one week before surgery. Radiomics features of the largest lymph nodes were extracted, standardized, and reduced before modeling. Radomics signatures of 120kVp-like images (Rad-signature120kVp) and iodine map (Rad-signatureImap) were built based on Logistic Regression via Least Absolute Shrinkage and Selection Operator (LASSO). Results: Eight hundred thirty-three features were extracted from 120kVp-like and iodine images, respectively. In testing group, the radiomics features based on 120kVp-like images showed the best diagnostic performance (AUC=0.922) compared to other predictors [CT morphological indicators (short-axis diameter (AUC=0.779, IDI=0.262) and long-axis diameter alone (AUC=0.714, IDI=0.329)), CEA alone (AUC=0.540, IDI=0.414), and normalized DECT parameters alone (AUC=0.504-0.718, IDI=0.290-0.476)](P<0.05 in Delong test). Contrary, DECT iodine map-based radiomic signatures showed similar performance in predicting lymph node metastasis (AUC=0.866). The decision curve showed that the 120kVp-like-based radiomics signature has the highest net income. Conclusion: Predictive model based on DECT and the largest short-axis diameter lymph nodes has the highest diagnostic value in predicting lymph node metastasis in patients with rectal cancer.

Comprehensive Analysis of the Relationships Between the Gut Microbiota and Fecal Metabolome in Individuals With Primary Sjogren's Syndrome by 16S rRNA Sequencing and LC-MS-Based Metabolomics.

The gut microbiota has been associated with primary Sjogren's syndrome (pSS), yet the biological implications of these associations are often elusive. We analyzed the fecal microbiota through 16S rRNA gene amplification and sequencing in 30 patients with pSS and 20 healthy controls (HCs); At the same time, the fecal metabolome was characterized by ultrahigh-performance liquid chromatography-mass spectrometry. In addition, correlation analyses of microbiota and metabolome data were performed to identify meaningful associations. We found that the microbiota composition of pSS patients was significantly different from that of HCs. The pSS gut microbiota is characterized by increased abundances of proinflammatory microbes, especially Escherichia-Shigella, and decreased abundances of anti-inflammatory microbes. Concerning the metabolome, a multivariate model with 33 metabolites efficiently distinguished cases from controls. Through KEGG enrichment analysis, we found that these metabolites were mainly involved in amino acid metabolism and lipid metabolism. The correlation analysis indicated that there were certain correlations between the microbiota and metabolism in pSS patients. In addition, an abundance of Escherichia-Shigella was found to be correlated with high levels of four metabolites (aflatoxin M1, glycocholic acid, L-histidine and phenylglyoxylic acid). Our research suggests that in pSS patients, the gut microbiota is characterized by a specific combination of proinflammatory changes and metabolic states. Escherichia-Shigella is a factor related to gut dysbiosis, which may promote intestinal damage and affect amino acid metabolism.

The influence of mobile phone addiction and work procrastination on burnout among newly graduated Chinese nurses.

PURPOSE: The study was conducted to explore the relationship between mobile phone addiction, work procrastination, and burnout among newly graduated nurses. DESIGN AND METHODS: A cross-sectional survey involving 220 newly graduated nurses in China was conducted from June to July 2020. FINDINGS: Approximately 60.9% of newly graduated nurses experienced occupational burnout; 72.7% of newly graduated nurses were characterized by moderate or greater procrastination and mobile phone addiction was at a moderate level. Mobile phone addiction and work procrastination were significant factors leading to emotional exhaustion and cynicism. Work procrastination was also an independent predictor of reduced professional efficacy. PRACTICE IMPLICATIONS: Reducing the level of mobile phone addiction and work procrastination among newly graduated nurses might be effective for burnout prevention.

Mobile phone addiction and its association with burnout in Chinese novice nurses: A cross-sectional survey.

AIM: To explore the levels of mobile phone addiction and burnout and their relationships among novice nurses. DESIGN: A cross-sectional investigation design. METHODS: Questionnaires were distributed to 400 novice nurses in five public hospitals in China. A total of 366 participants completed the survey. Data collected in 2020 were analysed by using descriptive statistics, an independent t test and Pearson's correlation analysis. RESULTS: The results showed that the frequency of nursing adverse events was associated with higher level of mobile phone addiction in novice nurses, and 52.46% of the participants (N = 366) presented a high level of occupational burnout. Moreover, the results indicated that there was a positive correlation between the novice nurses' mobile phone addiction level and burnout (r = .33, p < .01). CONCLUSION: The level of mobile phone addiction may affect nursing adverse events and nurses' burnout. Education on novice nurses' mobile phone use seems necessary to ensure patient safety and burnout prevention. IMPACT: Findings of this study expanded important knowledge about mobile phone addiction and its potential influence on nursing safety and nurse burnout and may place significant implications to staff nurse management and in-service education.

Myrothins A-F from Endophytic Fungus Myrothecium sp. BS-31 Harbored in Panax notoginseng.

Endophytic fungi play important roles for host's stress tolerance including invasion by pathogenic microbes. Small molecules are common weapons in the microbe-microbe interactions. Panax notoginseng is a widely used traditional Chinese medicinal plant and harbors many endophytes, some exert functions against pathogens. Here, we report six new compounds named myrothins A-F (1-6) produced by Myrothecium sp. BS-31, an endophyte isolated from P. notoginseng, and their antifungal activities against pathogenic fungi causing host root-rot disease. Their structures were elucidated with analysis of spectroscopic data including 1D and 2D NMR, HR-ESI-MS. Myrothins B (2) and E (5) showed the weak activity against Fusarium oxysporum and Phoma herbarum, and myrothins F (6) showed weak activity against F. oxysporum.

Leflunomide monotherapy versus combination therapy with conventional synthetic disease-modifying antirheumatic drugs for rheumatoid arthritis: a retrospective study.

Leflunomide (LEF) is a conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) for the treatment of rheumatoid arthritis. However, there are few reports on the comparison of efficacy between LEF alone and combined with other csDMARDs. Here, the efficacy and safety of LEF monotherapy (88) and combination (361) therapy groups were evaluated. After 3 months, there were no significant differences in 28-joint disease activity score (DAS28), health assessment questionnaire (HAQ), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) between the monotherapy and combination groups (all P > 0.05). According to the European League Against Rheumatism (EULAR) response criteria, it was found that the DAS28 response rates were similar in the two groups (P > 0.05). Besides, the two groups presented similar safety profiles. Subgroup analysis found that there was no difference in efficacy among the three combined therapies (LEF + methotrexate (MTX), LEF + hydroxychloroquine (HCQ), and LEF + MTX + HCQ) and LEF monotherapy. Furthermore, when the dose of LEF was less than 40 mg/day, no significant difference in efficacy was observed between low and high doses. Overall, these results indicated that low dose LEF monotherapy was not inferior to the combination therapy.

The aggregation of aß42 induced by nano copper and the antagonistic action of polysaccharides.

The toxic effect of Aß42 induced by copper nanoparticle (Cu NPs) was studied by atomic force microscopy (AFM), circular dichroism (CD) spectroscopy, and Thioflavin T (ThT) fluorescence technique. Five hundred nanometers of copper nanoparticle capped with polyvinylpyrrolidone (PVP) was used to evaluate the aggregation and fibrils of Aß42. The morphologies of Aß42 incubated in the presence of Cu NPs changed gradually. The aggregation and fibrils were observed in AFM images. However, in the presence of polysaccharides, the Cu NPs-induced fibrillation of Aß42 was inhibited. Interestingly, the formed Cu NPs-polysaccharides complexes can even remodel the preformed Aß42 fibrils into the low neurotoxic amorphous aggregates, which were maybe ascribed to the higher affinity of polysaccharides for Aß42 than Cu NPs. Besides, it was found that the binding constant of Cu NPs to Aß42 is smaller than that of polysaccharides. The relationship among polysaccharides, copper nanoparticle, and Aß42 morphologies and its neurotoxicity were discussed, and the binding force was analyzed.

The interaction of polysaccharide from Auricularia polytricha with quantum dots and the protection of plasmid DNA from damage.

As a kind of folk medicine, edible mushrooms are known to be of medicinal characteristics, for example antitumor activity. However, the mechanism is not clear. In this study, the fluorescence (FL) spectroscopy was used to study the binding reactions of polysaccharide extracted from Auricularia polytricha with quantum dots (QDs). The modified Stern-Volmer quenching constant at different temperatures and corresponding thermodynamic parameters were calculated (∆G < 0, ∆H < 0, and ∆S < 0). The results show that the quenching constant is inversely correlated with temperature. It indicates that the quenching mechanism is the static quenching in nature rather than dynamic quenching. The negative values of free energy (∆G < 0) suggest that the binding process is spontaneous; ∆H < 0 and ∆S < 0 suggest that the binding of polysaccharide to QDs is enthalpy-driven. QDs were found to damage the plasmid DNA according to atomic force microscopy images. DNA damage is the important factor to induce tumor. Many chemical substances can induce tumor, which has been proved by modern medical science. In the presence of polysaccharide from A. polytricha, however, DNA was protected from damage due to polysaccharide winding around QDs, which is the basis for the bioeffect of polysaccharides. This study helps to understand that antitumor activity of edible mushrooms is attributed to protection of DNA from damage in the presence of harmful substances.