Targeting starvation therapy for diabetic bacterial infections with endogenous enzyme-triggered hyaluronan-modified nanozymes in the infection microenvironment.

The high-glycemic microenvironment of diabetic wounds promotes bacterial proliferation, leading to persistent infections and delayed wound healing. This poses a significant threat to human health, necessitating the development of new nanodrug visualization platforms. In this study, we designed and synthesized cascade nano-systems modified with targeted peptide and hyaluronic acid for diabetic infection therapy. The nano-systems were able to target the site of infection using LL-37, and in the microenvironment of wound infection, the hyaluronic acid shell of the nano-systems was degraded by endogenous hyaluronidase. This precise degradation released a cascade of nano-enzymes on the surface of the bacteria, effectively destroying their cytoskeleton. Additionally, the metals in the nano-enzymes provided a photo-thermal effect, accelerating wound healing. The cascade nano-visualization platform demonstrated excellent bactericidal efficacy in both in vitro antimicrobial assays and in vivo diabetic infection models. In conclusion, this nano-system employs multiple approaches including targeting, enzyme-catalyzed therapy, photothermal therapy, and chemodynamic therapy to kill bacteria and promote healing. The Ag@Pt-Au-LYZ/HA-LL-37 formulation shows great potential for the treatment of diabetic wounds.

The relationship between uncertainty and acute procedure anxiety among surgical patients in Chinese mainland: the mediating role of resilience.

BACKGROUND: Surgery, as one of the main diagnostic and treatment methods, is a routine work in medical settings. Patients undergoing surgery often experience acute procedure anxiety due to uncertainty. There is ample evidence showing that uncertainty is a risk factor for the acute procedure anxiety in surgical patients. However, little is known about the psychological processes mediating this relationship. Therefore, this study aims to evaluate resilience as a mediator of the association between uncertainty and anxiety. METHODS: A population-based cross-sectional survey with a convenience sampling method was conducted, involving 243 surgical patients in Jiaxing, Zhejiang province of China was carried out. Relevant data were collected by self-reporting questionnaires, including demographic characteristics questionnaire, Amsterdam Preoperative Anxiety and Information Scale (APAIS-C), Mishel's Illness Uncertainty Scale (MUIS), Connor-Davidson Resilience Scale (CD-RISC). Pearson correlation analysis was employed to examine correlations between various variables. A path model was used to assess the mediation effect of resilience with respect to uncertainty and acute procedure anxiety. RESULTS: In the path model, uncertainty have an indirect effect on acute procedure anxiety through resilience. The results suggest that resilience has a mediating role in uncertainty and acute procedure anxiety among surgical patients. CONCLUSIONS: These findings call for the development of interventions targeting the role of resilience in effectively predicting and preventing acute procedure anxiety and uncertainty among surgical patients.

Workplace violence and burnout among Chinese nurses during the COVID-19 pandemic: does the sense of coherence mediate the relationship?

BACKGROUND: Workplace violence has always been a critical issue worldwide before and after the COVID-19 pandemic, which can lead to burnout and turnover. In addition, the burnout and mental stress of nurses during the COVID-19 period have been widely described. To our knowledge, no studies have examined the mediating effect of the sense of coherence on the relationship between workplace violence and burnout among Chinese nurses over time. Therefore, this study aimed to explore the relationship between workplace violence and burnout among Chinese nurses and how the sense of coherence mediates the association. METHODS: Using a convenience sampling method, 1190 nurses from 4 tertiary grade-A comprehensive hospitals were investigated between September 2021 and December 2021 in 3 provinces of China. The Workplace Violence Scale, Burnout Inventory, and Sense of Coherence scale were used to collect data. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis. RESULTS: The mean total scores for workplace violence and burnout were 1.67 ± 1.08 and 47.36 ± 18.39, respectively. Workplace violence was significantly negatively correlated with the sense of coherence (r = -0.25) and positively correlated with burnout (r = 0.27). Additionally, a higher level of workplace violence was associated with higher burnout (ß = 1.13, 95% CI: 0.68 ~ 1.56). A higher sense of coherence was also associated with lower burnout (ß = -0.98, 95% CI: -1.03 ~ -0.92). Workplace violence showed an effect on burnout through a sense of coherence. The direct, indirect and total effects were 1.13, 1.88 and 3.01, respectively. The mediating effect of the sense of coherence accounted for 62.45% of the relationship between workplace violence and burnout. CONCLUSION: We found that the sense of coherence mediated most workplace violence on burnout. It is imperative for hospital managers to improve nurses' sense of coherence to reduce the occurrence of burnout during COVID-19. Future intervention studies should be designed to strengthen nurses' sense of coherence.

Type VII Aplasia Cutis Congenita in Neonates Related to Maternal HBV Infection? Case Report and Literature Review.

Aplasia cutis congenita (ACC) is a rare disease with an unclear pathogenic mechanism. ACC has been suggested to result from the disrupted development or degeneration of skin in the uterus. This study describes two cases that may have underlying pathogenic cause that have not been previously reported. Two neonates who were admitted to the neonatal intensive care unit due to "skin lesions on the limbs" without other deformities or complications were diagnosed with type VII ACC by dermatologist. The mothers showed positivity for hepatitis B virus (HBV) surface antigen and elevated level of HBV DNA copies, which may be related to ACC. But this association could be a coincidence. Both neonates were treated with antibacterial dressings and achieved satisfactory healing.

The effect of life events, resilience, self-esteem, and coping styles on aggressive behavior among left-behind adolescents: Structural equation modeling.

Introduction: Without parental support, left-behind adolescents are more likely than their peers to experience negative emotions and demonstrate aggressive behavior in the same frustrating situation. However, research on this subject has been sparse. To fill this gap and identify potential targets for intervention, this study sought to examine the relationships among factors influencing left-behind adolescents' aggressive behavior. Methods: A total of 751 left-behind adolescents were enrolled in a cross-sectional survey, with data collected using the Adolescent Self-Rating Life Events Checklist, Resilience Scale for Chinese Adolescents, Rosenberg Self-Esteem Scale, Coping Style Questionnaire, and Buss-Warren Aggression Questionnaire. The structural equation model was used for data analysis. Results: The results showed that left-behind adolescents reported higher levels of aggression. Further, the factors found to have a direct or indirect effect on aggressive behavior included life events, resilience, self-esteem, positive coping, negative coping, and household income. The results of confirmatory factor analysis indicated goodness of fit. In the face of negative life events, left-behind adolescents with high resilience, self-esteem, and positive coping were less likely to exhibit aggressive behavior (P < 0.05). Discussion: Left-behind adolescents can reduce their aggressive behavior by assuaging the adverse effects of life events via increased resilience and self-esteem as well as the adoption of positive coping strategies.

Research progress in decision-making aids for breast cancer patients. / ä¹³è ºç™Œæ‚£è€ å†³ç­–è¾ åŠ©çš„ç ”ç©¶è¿›å±•.

Decision-making aid for cancer patients is of great significance in the diagnosis and treatment for diseases. Breast cancer is one of the most common malignant tumors in women all over the world, and breast cancer patients have become the main target population for decision-aided research. Application of decision-making assistance for patients in Western countries has developed to a certain extent, while relevant research in China is still at the early stage. There are kinds of intervention forms for patients' decision aids, including traditional brochures and videos, decision aids systems, decision coaching, multidisciplinary breast cancer teams, etc. The tools for decision-making quality evaluation include the patients' awareness for decision-making, participation, decision-making conflict, decision-making satisfaction, decision-making regret, which can provide important guidance for the application of decision-making aid treatment in breast cancer patients in the future.

Resilience in Patients With Lung Cancer: Structural Equation Modeling.

BACKGROUND: Resilience is important for patients with cancer. However, the relationships among factors affecting the resilience of patients with lung cancer have not been studied sufficiently. OBJECTIVE: The aim of this study was to clarify the relationships among social support, resilience, self-efficacy, and symptom distress among patients with lung cancer. METHODS: Through simple random sampling, 303 patients with lung cancer from 4 tertiary hospitals in Changsha, China, were recruited for a cross-sectional descriptive correlational survey. Data were collected using demographic and disease-related information, the Connor-Davidson Resilience Scale, Strategies Used by People to Promote Health, the Perceived Social Support Scale, and the Symptom Distress Scale. RESULTS: Patients' mean total resilience score was 50.01 ± 15.25. The fit indices for the model indicated a good fit. Social support had multiple effects on resilience; specifically, it had direct and indirect effects through the mediating role of self-efficacy. Symptom distress had only an indirect effect on resilience through self-efficacy. CONCLUSIONS: Social support, symptom distress, and self-efficacy are key factors associated with resilience in patients with lung cancer. These factors had direct and indirect effects on each other and on resilience. IMPLICATIONS FOR PRACTICE: To enhance resilience among patients with lung cancer, interventions that strengthen self-efficacy, provide social support, and reduce symptom distress should be developed.

The Mediating Role of Resilience and Self-Esteem Between Life Events and Coping Styles Among Rural Left-Behind Adolescents in China: A Cross-Sectional Study.

Objective: This study aims to explore the association between life events and coping styles, and how resilience and self-esteem mediate the association. Methods: A cross-sectional study was conducted among 981 left-behind adolescents (LBAs) in five junior high schools in Hunan Province, China, from April 13 to April 20, 2020. We utilized self-designed sociodemographic questionnaire, Adolescent Self-Rating Life Events Checklist, Resilience Scale Chinese Adolescent, Rosenberg Self-Esteem Scale, and Simplified Coping Style Questionnaire to assess the mental health of LBAs. Statistic description, Pearson correlation analysis, and structural equation model were adopted to analyze the data. Results: Results revealed that life events could negatively predict resilience (ß = -0.29, P < 0.001) and self-esteem (ß = -0.39, P < 0.001) and positively predict LBAs' positive coping style (ß = 0.28, P < 0.001) and negative coping style (ß = 0.21, P < 0.001). Self-esteem could also positively predict the resilience of LBAs (ß = 0.62, P < 0.001); resilience could negatively predict the negative coping style (ß = -0.21, P < 0.001) and positively predict the positive coping style (ß = 0.79, P < 0.001). Life events not only have direct effects on negative coping style (ß = 0.21) and positive coping style (ß = 0.28) but also have indirect effects on coping styles by affecting resilience (ß = -0.29) and self-esteem (ß = -0.39). The total effect of life events on coping styles was 0.32, where 34.37% was mediated by resilience and self-esteem. Conclusion: We proved that resilience and self-esteem mediated most of the effects of life events on coping styles. The findings had important implications for interventions to promote mental health of LBAs, particularly the enhancement of resilience and self-esteem.

Burnout and associated occupational stresses among Chinese nurses: A cross-sectional study in three hospitals.

BACKGROUND: There is literature scarcity relating to burnout and other work stresses in relation to Chinese nursing-workforce performance. OBJECTIVES: To assess the relationship between self-esteem versus burnout; and effort-reward ratio versus favorability to the work environment, among Chinese nurses. METHODS: We employed four validated questionnaires in the assessment burnout, self-esteem, effort-reward ratio, and favorability of nursing workplace; Maslach-Burnout Inventory (MBI), Rosenberg's self-esteem (RS), Effort-Reward imbalance (ERI) and Work-Environment Scale questionnaires (WES). Linear and ordinal regression models were utilized to assess the relationships between the variables. Analyses were conducted by using SPSS at a 95% level of significance. RESULTS: We assessed 487 (Mean age: 38.8±7.1 years) nurses from three hospitals. Higher self-esteem was associated with a lower level of emotional exhaustion (Unstandardized coefficient: -0.579, p-Value<0.001); and a lower level of depersonalization (Unstandardized coefficient: -0.212, p-Value = 0.001). The relationship between self-esteem and personal achievement did not reach statistical significance. A higher effort-reward ratio was associated with less likelihood that nurses would consider their work environment favorable (Logit estimate of -0.832, p-Value = 0.014). CONCLUSION: Lower self-esteem is associated with increased burnout. A higher effort-reward ratio is associated with an enhanced perception work environment as unfavorable. We recommend psychosocial intervention programs and amendments in nursing policies to improve effort-reward imbalance among Chinese nurses.

Effects of a transtheoretical model - based intervention and motivational interviewing on the management of depression in hospitalized patients with coronary heart disease: a randomized controlled trial.

BACKGROUND: Depression is a major risk factor for the morbidity and mortality of cardiovascular disease. A transtheoretical model-based intervention and motivational interviewing have been used to change health risk behaviors and have demonstrated positive effects. To our knowledge, no studies of patients with coronary heart disease (CHD) have used a transtheoretical model-based intervention and motivational interviewing as an intervention to provide dynamic education. Therefore, this study aimed to determine the effects of the transtheoretical model-based intervention and motivational interviewing on the management of depression in hospitalized patients with CHD. METHOD: A randomized controlled trial was designed. A total of 110 participants were randomly divided into an intervention group (n = 55) and a control group (n = 55). The Hamilton Rating Scale for Depression and the Depression Prevention & Management Survey items (stages of change, perceived benefits, perceived barriers, process of change and self-efficacy) were used to collect data at all time points. Analysis of covariance, chi-square test and repeated measures analysis of variance were used to analyze the data. RESULTS: After the intervention, there were more positive changes in stages of change, higher scores for the cognitive and behavioral levels, the perceived benefits, and self-efficacy, and lower perceived barriers and depression in the intervention group than in the control group. Finally, there were statistically significant differences in the depression scores at different time points in the intervention group (F = 17.814, p = 0.000 < 0.01). CONCLUSIONS: The study showed that a transtheoretical model-based intervention and motivational interviewing exert positive effects on the management of depression in hospitalized patients with CHD. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03953924 (Date assigned: 16/5/2019). Retrospectively registered.

[Research progress in the relationship between depression and survival outcome in patients with lung cancer].

In recent years, with the high incidence of lung cancer and mortality, the disease-relevant mental health problems such as depression began to attract attention. A growing number of studies have also begun to hypothesize and confirm the relationship between depression and survival or mortality in patients with lung cancer, and have made some progress in basic research, prospective cohort research and intervention research. In basic research, cancer can cause depression due to mediating the production of inflammatory factors, and the genotype of tumor epidermis growth factor receptor (EGFR) can explain the high mortality and risk of depression in patients with lung cancer from a certain point of view. Different studies in prospective cohort studies argue that depression is an important predictor of survival in patients with lung cancer and need to be further studied. In the aspect of intervention research, although some studies have confirmed the potential of antidepressants in anti-tumor oxidative therapy, there is no enough evidence in psychological intervention and drug intervention to prove their effectiveness in improving the survival outcome of lung cancer. In the future, it is necessary to further explore the possible mechanisms for antidepressants and psychological intervention to improve the survival time of the patients.