Risk factors and prediction models for cardiovascular complications of hypertension in older adults with machine learning: A cross-sectional study.

Background: Hypertension has emerged as a chronic disease prevalent worldwide that may cause severe cardiovascular complications, particularly in older patients. However, there is a paucity of studies that use risk factors and prediction models for cardiovascular complications associated with hypertension in older adults. Objectives: To identify the risk factors and develop prediction models for cardiovascular complications among older patients with hypertension. Methods: A convenience sample of 476 older patients with hypertension was recruited from a university-affiliated hospital in China. Demographic data, clinical physiological indicators, regulatory emotional self-efficacy, medication adherence, and lifestyle information were collected from participants. Binary logistic regression analysis was performed to screen for preliminary risk factors associated with cardiovascular complications. Two machine learning methods, Back-Propagation neural network, and random forest were applied to develop prediction models for cardiovascular complications among the study cohort. The sensitivity, specificity, accuracy, receiver operating characteristic curve, and area under the curve (AUC) values were used to assess the performance of the prediction models. Results: Binary logistic regression identified nine risk factors for cardiovascular complications among older patients with hypertension. The machine learning models displayed excellent performance in predicting cardiovascular complications, with the random forest model (AUC 0.954) outperforming the Back-Propagation neural network model (AUC 0.811), as confirmed by model comparison analysis. The sensitivity, specificity and accuracy of the Back-Propagation neural network model compared to the random forest model were 74.2% vs. 86.5%, 75.2% vs. 94.3%, and 74.7% vs. 90.4%, respectively. Conclusion: The machine learning methods employed in this study demonstrated feasibility in predicting cardiovascular complications among older patients with hypertension, with the random forest model based on nine risk factors exhibiting excellent prediction performance. These models could be used to identify high-risk populations and suggest early interventions aimed at preventing cardiovascular complications in such cohorts.

Role function and job satisfaction of community nurses in China: A cross-sectional study.

AIM: To evaluate role function and job satisfaction, determine their relationship, and explore the factors influencing job satisfaction among community nurses in China. DESIGN: Cross-sectional study. METHODS: This study was conducted between March and June 2020 on a cluster random sampling of 302 community nurses from 24 community health centres and stations in Xi'an, China. Self-reported data were collected using the Demographics Questionnaire, Role Function of Community Nurses Questionnaire, and Job Satisfaction of Community Nurses Scale. Descriptive statistics, Pearson's correlation analysis, and multiple linear regression analyses were performed to analyse data. RESULTS: Community nurses' main role function was organiser and manager (M = 2.56, SD = 0.987) and coordinator (M = 2.43, SD = 0.971). The lowest job satisfaction was for salary and benefits (M = 3.12, SD = 0.891) and personal development (M = 3.65, SD = 0.738). A positive correlation was found between the roles of caregiver, educator, navigator, and salary and benefits (p < 0.05) among community nurses. Multiple linear regression analyses indicated that monthly income and working experience in nursing explained 61.1% of the variance in job satisfaction.

Effectiveness of nurse-led electronic health interventions on illness management in patients with chronic heart failure: A systematic review and meta-analysis.

BACKGROUND: Chronic heart failure (CHF) is a global health concern, and nurse-led electronic health is an effective management strategy for this condition. OBJECTIVE: This systematic review and meta-analysis aimed to identify current patterns and strategies for nurse-led electronic health interventions and examine the effects of nurse-led electronic health interventions for illness management in patients with chronic heart failure. DESIGN: This study combined a systematic review and meta-analyses. PARTICIPANTS: Twenty-four articles, involving a total of 3660 patients, met the inclusion criteria. METHODS: We conducted a large amount of literature review using seven English databases: namely PubMed, Embase, Web of Science, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and SCOPUS, along with three Chinese databases: China National Knowledge Infrastructure(CNKI), WanFang, and the VIP Database. Databases were searched from inception until September 2022. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The studies were independently screened by two reviewers who extracted of the details of those meeting the inclusion criteria study. The Joanna Briggs Institute randomized controlled trial checklist was used to evaluate the methodological value of each incorporation study. Meta-analysis was performed by the use of Manager 5.3. RESULTS: The main patterns of electronic health intervention involve smartphone, Internet and specialized (portable) electronic monitoring devices that are used for the illness management of patients with chronic heart failure, mainly including providing self-management guidance for chronic heart failure, and tracking of the patient's health information, providing peer support, and facilizing medical and health resources. The collective findings of 9 studies reported that electronic health interventions improved self-care (MD: 15.30, 95 % CI: 1.59 to 29.02, p < 0.05). Regarding psychosocial well-being outcomes, the incorporative conclusions indicated that electronic health interventions effectively increased quality of life, reduced depression and anxiety, and improved patient satisfaction. Regarding disease-related examinations, electronic health interventions significantly increased cardiac function during the 6-minute walk test. Regarding healthy economic outcomes, electronic health interventions significantly decreased the rehospitalization rate and the cost of medical care services. CONCLUSIONS: The findings of this review suggest that nurse-led electronic health interventions involving multiple patterns have an active influence on managing patients with chronic heart failure, including enhancing self-care, and medication adherence; increasing quality of life; reducing depression, anxiety, and improved patient satisfaction; increasing cardiac function, and reducing rehospitalization rate and hospitalization costs. Thus, it could be a promising alternative in the clinical settings. REGISTRATION: CRD42023389450.

OTUB2 Promotes Homologous Recombination Repair Through Stimulating Rad51 Expression in Endometrial Cancer.

Genetic instability, raised from dysregulation of DNA repair, is involved in tumor development. OTUB2 (ovarian tumor domain protease domain-containing ubiquitin aldehyde-binding protein 2), which is responsible for DNA double-strand break (DSB), is implicated in carcinogenesis of various tumors. The effect of OTUB2 on endometrial cancer progression was then investigated. First, OTUB2 was found to be upregulated in endometrial cancer tissues and cell lines, and was closely associated with overall survival of endometrial cancer patients. Cell Counting Kit-8 and flow cytometry assay results revealed that overexpression of OTUB2 enhanced cell viability of endometrial cancer cells, while knockdown of OTUB2 inhibited cell viability. Moreover, as demonstrated by promoting cell viability and suppression of cell apoptosis, cisplatin-induced cell damage was reversed by OTUB2. Mechanistically, OTUB2 could activate Yes-associated protein/transcriptional co-activator with PDZ-binding motif (TAZ) to promote homologous recombination repair via depletion of γH2AX (phosphorylation of histone H2AX) and accumulation of Rad51. In vivo xenograft model also showed that silence of OTUB2 suppressed the growth of endometrial cancer and increased tumor sensitivity to antitumor drugs. In conclusion, OTUB2 promoted homologous recombination repair in endometrial cancer via YAP/TAZ-mediated Rad51 expression, providing a potential therapeutic target for endometrial cancer.

Long noncoding RNA TUSC7 inhibits cell proliferation, migration and invasion by regulating SOCS4 (SOCS5) expression through targeting miR-616 in endometrial carcinoma.

BACKGROUND: Long non-coding RNA (lncRNA) is emerging as an important regulator in various physiological and pathological processes. Recently, it was found that lncRNA long non-coding RNA tumor suppressor candidate 7 (TUSC7) could play tumor suppressive roles in several cancers. However, the function and underlying regulatory mechanism of lncRNA TUSC7 in endometrial carcinoma (EC) remains largely unclear. METHODS: The expression levels of TUSC7 and microRNAs-616 (miR-616) were analyzed by real-time PCR and in situ hybridization. Cell cycle and cell metastasis associated protein expressions were determined by western blotting. Cell proliferation, cycle and metastasis were determined by CCK-8 cell viability, colony formation, flow cytometer, wound scratch and transwell assays respectively in vitro. RNA pull-down, luciferase and western blotting assays were used to examine the target relationship between TUSC7 and miR-616 or that between miR-616 and suppressors of cytokine signaling 4 (5) (SOCS4 (SOCS5)). The functional effects of TUSC7 through sponging miR-616 were further examined using a xenograft tumor mouse model in vivo. RESULTS: TUSC7 was downexpressed in EC tissues and cell lines, and TUSC7 upregulation could remarkably inhibit cell proliferation, cycle progression and metastasis in EC cells. Mechanistic investigations demonstrated that TUSC7 can interact with miR-616 and decrease its expression, thereby upregulating the expression of miR-616's targets SOCS4 (SOCS5). Additionally, in vivo experiments using a xenograft tumor mouse model revealed that TUSC7 can serve as a tumor suppressor through sponging miR-616, and upregulating SOCS4 (SOCS5) in EC. CONCLUSIONS: In this study, a newly identified regulatory mechanism of lncRNA TUSC7/miR-616/ SOCS4 (SOCS5) axis was systematically studied, which may hold promise as a promising target for EC treatment.

Metformin is associated with reduced cell proliferation in human endometrial cancer by inbibiting PI3K/AKT/mTOR signaling.

Metformin recently gained traction as potential anti-endometrial cancer agent for its new applications. However, the underlying mechanisms of the anti-cancer effect of metformin in the endometrial cancer have not yet been fully elucidated. Sixty-five patients diagnosed as endometrial carcinoma were grouped into (n = 33) and non-treatment mixed (n = 32) for analysis. Thirty healthy donors were recruited as controls. We attempt to investigate the effect of metformin on Ki-67, PI3K, p-AKT, p-S6K1, and p-4EBP1 staining in human endometrial cancer by immunohistochemical staining. We found that increased Ki-67 expression in women with endometrial cancer, which were reversed by conventional anti-diabetic doses of metformin in present work. In parallel, the reduced PI3K, p-AKT, p-S6K1, and p-4EBP1 staining induced by metformin appeared to play an important role for the anti-proliferative effects of metformin in endometrial cancer patients. Metformin significantly decreased proliferation in human endometrial cancer may by inhibiting PI3K/AKT/mTOR signaling. Our present results add to the growing body of evidence supporting metformin as a potential anti-cancer agent in endometrial cancer.

Maternal PTSD following Exposure to the Wenchuan Earthquake Is Associated with Impaired Mental Development of Children.

The purpose of this study was to explore whether earthquake-related maternal Post-Traumatic Stress Disorder (PTSD) is associated with impaired development of infants. Participants included 86 women who were pregnant during or after the earthquake in Ningqiang county, and their children. Data were collected from February to March of 2012. PTSD questionnaire (PTSD Checklist, Civilian Version (PCL-C)) was used to measure the effect of the earthquake on mothers, and that the scores greater than 50 were used to indicate presence of PTSD. Each child was assessed using the mental Developmental Screening Test (DST) according to age. Among the 86 women, PTSD scores equal to or greater than 50 accounted for 20.93%. Among the 86 children, 25.60% of development quotient (DQ) scores and 19.80% of mental index (MI) scores were less than 85. The correlation coefficient analysis showed that PTSD scores were inversely related to DQ and MI scores. Maternal PTSD following earthquake exposure is associated with relatively lower intellectual development in children age 0-3 years. Further research is needed to assess the persistent effects of this influence on offspring of mothers exposed to earthquake.