A new computer-aided detection scheme is proposed, the 3D U-Net convolutional neural network, based on multiscale features of transfer learning to automatically detect pulmonary nodules from the ...thoracic region containing background and noise. The test results can be used as reference information for doctors to assist in the detection of early lung cancer. The proposed scheme is composed of three major steps: First, the pulmonary parenchyma area is segmented by various methods. Then, the 3D U-Net convolutional neural network model with a multiscale feature structure is built. The network model structure is subsequently fine-tuned by the transfer learning method based on weight, and the optimal parameters are selected in the network model. Finally, datasets are extracted to train the fine-tuned 3D U-Net network model to detect pulmonary nodules. The five-fold cross-validation method is used to obtain the experimental results for the LUNA16 and TIANCHI17 datasets. The experimental results show that the scheme not only has obvious advantages in the detection of medium and large-sized nodules but also has an accuracy rate of more than 70% for the detection of small-sized nodules. The scheme provides automatic and accurate detection of pulmonary nodules that reduces the overfitting rate and training time and improves the efficiency of the algorithm. It can assist doctors in the diagnosis of lung cancer and can be extended to other medical image detection and recognition fields.
IntroductionDepression and anxiety are common mental health disorders among adolescents and negatively impact their physical and mental health. Depression and anxiety also exert a tremendous economic ...burden to society. But in China, there is no systematic review to state the exact prevalence of adolescent depression and anxiety; there is also a lack of systematic reviews of factors that influence depression and anxiety. Hence, in this systematic review, we aim to summarise the current evidence of the prevalence of and factors influencing depression and anxiety among Chinese adolescents.Methods and analysisThis protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We will comprehensively search four English databases (PubMed, Web of Science, CINAHL in EBSCO interface, PsycINFO in ProQuest interface) and three Chinese databases (China National Knowledge Infrastructure, WanFang and SinoMed) for studies from inception to 31 August 2022. Screening for eligible studies and data extraction will be conducted by two reviewers independently, and all discrepancies will be resolved through group discussion.Ethics and disseminationBecause this is a review of published studies, no ethical approval is required. The results will be reported in a peer-reviewed journal or disseminated at relevant conferences.PROSPERO registration numberCRD42022299943.
Hydrogen (H
) has been considered an ideal alternative energy source for solving energy supply security and greenhouse gas reduction. Although platinum group metal (PGM) catalysts have excellent ...performance in hydrogen electrocatalysis, their scarcity and high cost limit their industrial application. Therefore, it is necessary to develop low-cost and efficient non-PGM catalysts. Transition metal nitrides (TMNs) have attracted much attention because of their excellent catalytic performance in hydrogen electrochemistry, including hydrogen evolution reaction (HER)/hydrogen oxidation reaction (HOR). In this paper, we review and discuss the mechanism of HER/HOR in alkaline media. We compare and evaluate electrocatalytic performance for the HER/HOR TMN catalysts recently reported. Finally, we propose the prospects and research trends in sustainable alkaline hydrogen electrocatalysis.
IntroductionHealth education, as a crucial strategic measure of disease prevention and control in the 21st century, has become an important part of healthcare. As the main deliverers of patient ...health education, nursing personnel’s patient health education competence (PHEC) has received much attention. Instruments for assessing the PHEC of nursing personnel have been developed internationally, but there is a lack of systematic reviews and evaluations of the psychometric properties of these instruments. To effectively select appropriate PHEC assessment instruments in specific contexts, a systematic and comprehensive review and evaluation of these measurement instruments are needed. The goal of this systematic review is to systematically evaluate the psychometric properties of existing PHEC instruments.Methods and analysisIn this study, eight databases will be searched between 1 March 2023 and 31 2023 to retrieve studies that include instrument(s) measuring the PHEC of nursing personnel. Two researchers will independently perform literature screening, data extraction and literature evaluation. In case of disagreement, a third researcher will be involved in the resolution. The measurement properties of PHEC assessment instruments will be systematically reviewed based on the consensus-based standards for the selection of health measurement instruments (COMSIN) methodology and guideline.Ethics and disseminationEthical approval is not applicable for this study. We will share the findings from the study at national and/or international conferences and in a peer-reviewed journal in the fields of health education and/or patient education.PROSPERO registration numberCRD42023393293.
Abstract Background Given the lack of valid and reliable instruments for evaluating the quality of communication between physicians and cancer patients and their family caregivers in China, this ...study translated and culturally adapted the Quality of Communication questionnaires for cancer patients (QOC-P) and their family caregivers (QOC-F) for use in the Chinese context and evaluated their psychometric properties. Methods The QOC-P and QOC-F were translated following an adapted version of Brislin’s translation model and culturally adapted according to a Delphi expert panel. We pretested and refined the Chinese versions of the QOC-P and QOC-F among 16 dyads of patients and their family caregivers. Subsequently, we administered the questionnaires to 228 dyads of patients and their family caregivers who were recruited from six tertiary hospitals. The content validity, construct validity, convergent validity, and reliability of the QOC-P and QOC-F were examined. Results Through exploratory factor analysis, The QOC-P and QOC-F were divided into two dimensions: general communication and end-of-life communication. The Cronbach’s coefficients ranged from 0.905 to 0.907 for the two subscales of the QOC-P and from 0.908 to 0.953 for the two subscales of the QOC-F. The two-week test-retest reliability was acceptable for both the QOC-P and QOC-F, with intraclass correlation coefficients of 0.993 and 0.991, respectively. The scale content validity index (QOC-P: 0.857, QOC-F: 1.0) and split-half reliability (QOC-P: 0.833, QOC-F: 0.935) were satisfactory. There was a negative correlation with anxiety and depression for both the QOC-P ( r = -0.233 & -0.241, p < 0.001) and QOC-F ( r = -0.464 & -0.420, p <0.001). The QOC-P showed a negative correlation with decision regret ( r = -0.445, p <0.001) and a positive correlation with shared decision-making ( r = 0.525, p <0.001), as hypothesized. Conclusion The QOC-P and QOC-F show acceptable psychometric properties for evaluating the quality of communication between physicians and cancer patients and their family caregivers in both clinical and research contexts. Future studies should use more diverse and inclusive samples to test the structure of the Chinese version of the QOC-P and QOC-F with confirmatory factor analysis.
Frailty is prevalent in older adults and has adverse effects on multiple health outcomes. Pain, insomnia, and depressive symptoms are commonly seen and treatable symptoms in older adults and are ...associated with frailty. However, it is unknown whether these symptoms are independently associated with frailty and how they interact with each other creating a greater impact on frailty than individual symptoms. It is important to understand these associations for nurses to provide high-quality patient-centered care for older adults with frailty.
To determine independent associations of pain, insomnia, and depressive symptoms with frailty and examine their synergistic impact on frailty among older adults.
A cross-sectional analysis of a cohort study.
Communities in the United States.
Community-dwelling older adults from the National Health and Aging Trend Study (N = 7,609), a nationally representative survey of Medicare Beneficiaries in the United States.
Frailty status was determined by five criteria of the Physical Frailty Phenotype: exhaustion, low physical activity, weakness, slowness, and shrinking. Pain was determined by self-reports of bothersome pain in the last month. Insomnia included self-reports of difficulty initiating sleep and difficulty maintaining sleep. Depressive symptom was assessed by the Patient Health Questionnaire-2. Logistic regression models were used adjusting for sociodemographic, health-related and behavioral covariates.
The sample was mainly under 80 years old (72%), female (57%), and non-Hispanic White (81%). Approximately 53% experienced bothersome pain, 11% had difficulty initiating sleep, 6% had difficulty maintaining sleep, and 15% had depressive symptom; 46% were pre-frail and 14% were frail. Independent associations with pre-frailty and frailty were found in pain (odds ratio OR: 1.81, 95% CI: 1.60, 2.04), difficulty initiating sleep (OR: 1.23, 95% CI: 1.04, 1.46) and depressive symptom (OR: 2.29, 95% CI: 1.85, 2.84). Interaction terms between pain and depressive symptom (OR: 1.87, 95% CI: 1.14, 3.07), and between difficulty initiating sleep and depressive symptom (OR: 2.66, 95% CI: 1.15, 6.13) were significant, suggesting a synergistic impact on pre-frailty and frailty.
Pain, difficulty initiating sleep, and depressive symptoms are independent risk factors of frailty and may have a synergistic impact on frailty. Interventions should be developed to address these symptoms to reduce the adverse effects of frailty.
The pattern of itching in patients with atopic dermatitis has not been systematically studied. Therefore, this study aimed to assess the pattern of itching in adults with atopic dermatitis using ...questionnaires to assess for a circadian rhythm of itching in participating patients at a single institution (n = 241). A self-report questionnaire was used to assess circadian rhythm and intensity of itching in patients. In addition, the patients’ disease severity (Eczema Area and Severity Index EASI) and quality of life (Dermatology Life Quality Index DLQI) were assessed. Itching occurred most frequently (74.69%) and with the greatest severity (62.66%) between 20:00 and 00:00, and the least number of patients (25.31%) experienced itching between 04:00 and 08:00. The DLQI and EASI scores both correlated with the average and maximum itch intensity (r = 0.582, r = 0.533, respectively; r = 0.539, r = 0.517, respectively; p < 0.001). The DLQI and EASI scores were associated with average itch intensity (B = 0.179, B = 0.204, respectively; 95% CI: 0.112 to 0.246, 95% CI: 0.096 to 0.313, respectively; p < 0.001), and the EASI score was associated with males and family history (B = 0.285, B = 0.287, respectively; 95% CI: 0.094 to 0.476, 95% CI: 0.096 to 0.478, respectively; p = 0.003). Adult patients with atopic dermatitis exhibited a circadian rhythm of itching; these study results could positively impact treatment approaches.
Aims and objectives
To assist future offsite planning for pandemics, we documented lived experiences of cooperation among healthcare workers (HCWs) during the coronavirus disease (COVID‐19) pandemic.
...Background
The COVID‐19 pandemic poses a global health crisis. Most recent studies on the COVID‐19 focus on frontline HCWs' physio‐psychological experiences, with few studies examining their experiences of cooperation.
Design
A descriptive phenomenological design reported based on COREQ checklist.
Methods
25 HCWs (17 nurses and eight physicians) were interviewed, selected through convenience and purposive sampling, who participated in a medical aid mission in China during the COVID‐19 pandemic. Data were collected via semi‐structured online video interviews, and the transcripts were analysed using Colaizzi's phenomenological method.
Results
The HCWs experienced stressed and anxious, but rated their overall cooperation experience as positive. We categorised the reported experiences in five themes: (1) a multi‐level management structure; (2) nurse managers as internal and external team coordinators; (3) high morale and a mutual supportive context; (4) a continuous streamlined workflow; and (5) the value of multidisciplinary collaboration in care. Reasonable management structure and division of work were the basis for successful aid mission. High morale and a mutual supportive context were foundational for growth and stress mitigation. The HCWs continuously streamlined workflow through communication and met patients' individual need through multidisciplinary collaboration.
Conclusions
Planning for a pandemic aid mission is challenging, given the unpredictable nature of the working circumstances. Our results underline the importance of supportive strategies for COVID‐19 aid mission.
Relevance to clinical practice
Recommendations for future pandemic planning: (1) positive morale and supportive working text should be paid prioritised attention; (2) sufficient experienced and ancillary staff should be recruited; (3) multiple communication channels such as regular handover meetings, online chat applications and electronic recording devices are essential, and (4) multidisciplinary cooperation are is necessary in COVID‐19 wards.
Evidence is scarce on the trend in prevalence of physical frailty in China; the primary purpose of this study was to identify the prevalence and correlates of physical frailty among older nursing ...home residents in China.
Cross-sectional study in 20 nursing homes in Changsha, China. Physical frailty was defined based on the frailty phenotype including weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Participants with at least three affected criteria were defined as being frail. Participants with one or two affected criteria were considered as pre-frail, and those with no affected criteria were considered as robust. A total of 1004 nursing home residents aged 60 and over were included in this study. A multinomial logistic regression model was used to analyze the associations of physical frailty with its potential risk factors, including age, sex, education levels, marital status, type of institution, living status, current drinking, current smoking, regular exercise, and self-reported health.
The overall prevalence of physical frailty and prefrailty was 55.6, and 38.5%, respectively. The rate of physical frailty substantially increased with age, and was higher in women than in men (69.5% vs. 30.5%). The multinomial logistic regression analysis showed that older age, being women, living in a private institution, living alone or with unknown person, having no regular exercise (≤ 2 times/week), and poor self-reported health were significantly associated with increased odds of being physically frail.
We demonstrated physical frailty is highly prevalent among older residents in nursing homes in China, especially in women. The potential role of those associated factors of physical frailty warrant further investigations to explore their clinical application among elderly nursing home residents.
IntroductionAcademic-practice partnerships are a promising strategy that could strengthen the promotion and innovation of evidence-based nursing practice (EBNP). However, there is little evidence of ...how academic and clinical institutions and individuals should collaborate in each process of EBNP and the factors that influence academic-practice partnerships in EBNP. There is a pressing need to explore the extent of the literature on academic-practice partnerships in EBNP, as well as to classify, compare and summarise the results or opinions obtained from various types of literature to identify both existing knowledge and gaps in the research.Methods and analysisThe scoping review will be conducted following the methodological guidelines provided by the JBI. The scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Seven databases, including the Cochrane Library, PubMed, Web of Science, CINAHL, EMBASE, SCOPUS, Educational Resource Information Center and two Chinese databases (ie, CNKI and WANFANG DATA), will be searched. The grey literature will also be searched using the American Association of Colleges of Nursing, American Nurses Association, Open Grey, Grey Literature Report and the official website of JBI. The literature screening and data extraction will be conducted independently by two researchers. A third researcher will be involved when a consensus is needed.Ethics and disseminationEthics approval is not required. The findings of the scoping review will be disseminated in a conference and a peer-reviewed journal.
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