Nurses' perceptions of barriers and supportive behaviors in end-of-life care in the intensive care unit: a cross-sectional study.

BACKGROUND AND AIM: Patient deaths are common in the intensive care unit, and a nurse's perception of barriers to and supportive behaviors in end-of-life care varies widely depending upon their cultural background. The aim of this study was to describe the perceptions of intensive care nurses regarding barriers to and supportive behaviors in providing end-of-life care in a Chinese cultural context. METHODS: A cross-sectional survey was conducted among intensive care nurses in 20 intensive care units in 11 general hospitals in central and eastern China. Instruments used in this study were general survey and Beckstrand's questionnaire. Data were collected via online survey platform. Descriptive analysis was used to describe general characteristics of participants and mean and standard deviations of the barriers and supportive behaviors. The mean and standard deviation were used to describe the intensity and frequency of each barrier or supportive behavior following Beckstrand's method to calculate the score of barriers and supportive behaviors. Content analysis was used to analyze the responses to open-ended questions. RESULTS: The response rate was 53% (n = 368/700). Five of the top six barriers related to families and the other was the nurse's lack of time. Supportive behaviors included three related to families and three related to healthcare providers. Nurses in the intensive care unit felt that families should be present at the bedside of a dying patient, there is a need to provide a quiet, independent environment and psychological support should be provided to the patient and family. Nurses believe that if possible, families can be given flexibility to visit dying patients, such as increasing the number of visits, rather than limiting visiting hours altogether. Families need to be given enough time to perform the final rites on the dying patient. Moreover, it is remarkable that nurses' supportive behaviors almost all concern care after death. CONCLUSIONS: According to ICU-nurses family-related factors, such as accompany of the dying patients and acceptence of patient's imminent death, were found the major factors affecting the quality of end-of-life care. These findings identify the most prominent current barriers and supportive behaviors, which may provide a basis for addressing these issues in the future to improve the quality of end-of-life care.

Diagnostic accuracy of urine HE4 in patients with ovarian cancer: a meta-analysis.

Urine HE4 has been reported as the potential novel diagnostic biomarker for ovarian cancer in several studies, but their results were inconsistent. Therefore, we conducted a systematic analysis to evaluate the diagnostic value of urine HE4 in detecting ovarian cancer. A comprehensive electronic and manual search was conducted for relevant literatures through several databases up to May 5, 2016. The quality of the studies included in the systematic review was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. All analyses were conducted using Meta-DiSc 1.4 and STATA 12.0 software. A total of seven publications were included in this study, and these studies included 413 ovarian cancer patients and 573 controls. The summary estimates were: sensitivity 0.76 (95% confidence interval [CI]: 0.72-0.80), specificity 0.92 (95% CI: 0.89-0.94), positive likelihood ratio 8.39 (95%CI: 4.81-14.63), negative likelihood ratio 0.23 (95% CI: 0.13-0.39), diagnostic odds ratio 37.90 (95% CI: 18.69-76.83), and area under the curve 0.93. According to our results, urine HE4 has greater diagnostic value in detecting ovarian cancer. In addition, considering the high heterogeneity, further research studies with more well-designed and large sample sizes are needed in the future.

TGF-ß1 mediates estrogen receptor-induced epithelial-to-mesenchymal transition in some tumor lines.

More and more studies have reported that epithelial-mesenchymal transition (EMT) involved in the process of cancer development and progression occurs. The EMT also plays an important role in the movement and transfer of the tumors. Transforming growth factor-ß (TGF-ß) could induce the EMT in some cancer cell types. However, the mechanism underlying this transition process has also not been entirely clarified. In this study, the results indicated that TGF-ß1-mediated EMT in the tumor was associated with the estrogen receptor (ER). The decreased expression of vimentin and snail resulted in the decrease of the ER expression by small interfering RNA-mediated silencing and preventing the TGF-ß-induced EMT. In conclusion, our results indicated that TGF-ß1 is an estrogen receptor signaling and essential novel downstream targets and could act as an important factor in the TGF-ß-induced EMT.

[Research on the mineral phase and component of non-crystalline and nano-crystalline corrosion products on bronzes unearthed from Shang Tomb in Xingan].

The patinas on bronzes in Shang Tomb of Xingan were powdery, pale green, which were more like "bronze disease", but the mineral composition of patinas was not paratacamite or atacamite. Micro X-ray diffraction (XRD) and high performance transmission electroscope (HTEM) showed that the patinas were mainly composed of non-crystalline and nano-crystalline SnO2, and the size of nano-crystalline particle was in the range of 4-5.7 nm; Moreover, the energy-dispersive X-ray spectrometry showed that element tin is the primary ingredient of the sample, as well as little copper, silicon, lead and iron were detected. By studying the crystal lattice stripe image of the nanometer SnO2, it was deduced that the chemical formula of nano-crystalline SnO2 did not include other elements; The Raman spectrum of the sample showed that there were not any characteristic peaks of SnO2, the spectrum was more like non-crystalline SnO2, and the weak and broad peak of 973 cm(-1) indicated that the sample may contain silicate grains, It was inferred that little of copper, silicon, lead and iron should exist in the form of non-crystalline silicate particles.

[Micro and nondestructive analysis of blue dyes from silk fabrics and decorative painting of historic building].

Dye analysis is important to the understanding of fabric color degradation and technical development of ancient printing and dyeing. In the present study, thin layer chromatography and Raman spectroscopy were used for the analysis of blue dyes from 6 silk fabric of Tang dynasty and decorative painting of Jian Fu Gong, Forbidden City. The applicability of these two methods in the cultural heritages was also studied. The results indicate that all these blue substances are indigo; indigo was not only used as dye in ancient fabrics, but also as pigment in decorative painting of historic building, so it is used widely. Both analytic methods have advantages and disadvantages; Raman spectroscopy is nondestructive analysis; thin layer chromatography needs small amount of sample, but could give more information.

Single-channel current through nicotinic receptor produced by closure of binding site C-loop.

We investigated the initial coupling of agonist binding to channel gating of the nicotinic acetylcholine receptor using targeted molecular-dynamics (TMD) simulation. After TMD simulation to accelerate closure of the C-loops at the agonist binding sites, the region of the pore that passes through the cell membrane expands. To determine whether the structural changes in the pore result in ion conduction, we used a coarse-grained ion conduction simulator, Biology Boltzmann transport Monte Carlo, and applied it to two structural frames taken before and after TMD simulation. The structural model before TMD simulation represents the channel in the proposed "resting" state, whereas the model after TMD simulation represents the channel in the proposed "active" state. Under external voltage biases, the channel in the "active" state was permeable to cations. Our simulated ion conductance approaches that obtained experimentally and recapitulates several functional properties characteristic of the nicotinic acetylcholine receptor. Thus, closure of the C-loop triggers a structural change in the channel sufficient to account for the open channel current. This approach of applying Biology Boltzmann transport Monte Carlo simulation can be used to further investigate the binding to gating transduction mechanism and the structural bases for ion selection and translocation.