Aim
To explore nurses’ experiences in natural disaster response.
Background
Nurses are key to disaster response. There is a growing body of qualitative research exploring this emerging nursing issue. ...However, there is a need to synthesise and summarise this body of knowledge to identify the overarching elements of how nurses experience working in disaster situations to reflect on their experiences so that we may help shape future clinical practice, research and education.
Design
Qualitative meta‐synthesis.
Method
Following PROSPERO guidelines (Moher et al., 2015), an exhaustive and systematic literature search and quality appraisal was undertaken in December 2019 to reveal nurses’ experiences during natural disaster response. Sandelowski and Barroso's systematic retrieval, analysis and interpretation of findings method was used to produce a meta‐summary of findings from 10 papers evaluating experiences across 9 disasters. A meta‐aggregation was used to synthesise the findings from the studies and was methodically quality assessed with PRISMA and CASP.
Results
Our findings aggregated data from 42 sub‐themes, into the following four themes to capture nurses’ experiences after responding to disasters. These included agile response; leadership and innovative problem solving; building resilience; positive communication and need for psychological/emotional support.
Discussion
This meta‐synthesis provides evidence to illustrate nurses’ resilience and leadership capabilities as means to manage and perceive their disaster relief response. Factors such as emotional intelligence, capacity to react to changing situations, to manage scant resources in extreme situations were highlighted in nurses practising in highly stressful environments. Managers can use these examples to support ways to improve disaster management policies, but also, to engage in support for their staff.
Relevance to clinical practice
The role of nursing staff in disaster rescue is receiving significant attention. Understanding nurses’ experiences during disaster rescue can help future leaders to improve capacity to respond and nursing preparedness through education, training and management, but also for continuing emotional support after the event.
Some cancers evade targeted therapies through a mechanism known as lineage plasticity, whereby tumor cells acquire phenotypic characteristics of a cell lineage whose survival no longer depends on the ...drug target. We use in vitro and in vivo human prostate cancer models to show that these tumors can develop resistance to the antiandrogen drug enzalutamide by a phenotypic shift from androgen receptor (AR)–dependent luminal epithelial cells to AR-independent basal-like cells. This lineage plasticity is enabled by the loss of TP53 and RB1 function, is mediated by increased expression of the reprogramming transcription factor SOX2, and can be reversed by restoring TP53 and RB1 function or by inhibiting SOX2 expression. Thus, mutations in tumor suppressor genes can create a state of increased cellular plasticity that, when challenged with antiandrogen therapy, promotes resistance through lineage switching.
Necroptosis of macrophages is a necessary element in reinforcing intrapulmonary inflammation during acute lung injury (ALI). However, the molecular mechanism that sparks macrophage necroptosis is ...still unclear. Triggering receptor expressed on myeloid cells-1 (TREM-1) is a pattern recognition receptor expressed broadly on monocytes/macrophages. The influence of TREM-1 on the destiny of macrophages in ALI requires further investigation.
TREM-1 decoy receptor LR12 was used to evaluate whether the TREM-1 activation induced necroptosis of macrophages in lipopolysaccharide (LPS)-induced ALI in mice. Then we used an agonist anti-TREM-1 Ab (Mab1187) to activate TREM-1 in vitro. Macrophages were treated with GSK872 (a RIPK3 inhibitor), Mdivi-1 (a DRP1 inhibitor), or Rapamycin (an mTOR inhibitor) to investigate whether TREM-1 could induce necroptosis in macrophages, and the mechanism of this process.
We first observed that the blockade of TREM-1 attenuated alveolar macrophage (AlvMs) necroptosis in mice with LPS-induced ALI. In vitro, TREM-1 activation induced necroptosis of macrophages. mTOR has been previously linked to macrophage polarization and migration. We discovered that mTOR had a previously unrecognized function in modulating TREM-1-mediated mitochondrial fission, mitophagy, and necroptosis. Moreover, TREM-1 activation promoted DRP1
phosphorylation through mTOR signaling, which in turn caused surplus mitochondrial fission-mediated necroptosis of macrophages, consequently exacerbating ALI.
In this study, we reported that TREM-1 acted as a necroptotic stimulus of AlvMs, fueling inflammation and aggravating ALI. We also provided compelling evidence suggesting that mTOR-dependent mitochondrial fission is the underpinning of TREM-1-triggered necroptosis and inflammation. Therefore, regulation of necroptosis by targeting TREM-1 may provide a new therapeutic target for ALI in the future.
The Chinese agricultural sector has experienced a substantial increase in total output since dramatic reforms were introduced in 1978. This paper uses the index method to measure agricultural total ...factor productivity (TFP) for China’s crop and livestock industries, based on the gross output model from 1978 to 2016. We construct production accounts for the industries using input‐output relationships for the 26 main agricultural commodities and commodity groups, which account for over 90 per cent of the total agricultural inputs and outputs. The results show that China’s agricultural TFP grew at a rate of approximately 2.4 per cent a year before 2009, which is comparable to the main OECD countries and is double the world average. TFP growth accounts for approximately 40 per cent of output growth, suggesting that input growth was the main driver of output growth in the past. However, average productivity growth slowed down after 2009 though it has gradually recovered since 2012. The slowdown reflects the emerging challenges to existing farm production practices in Chinese agriculture, suggesting the need for further institutional reform.
A loss-of-function mutation in ATPase phospholipid transporting 11-B (putative) (ATP11B) gene causing cerebral small vessel disease (SVD) in vivo, and a single intronic nucleotide polymorphism in ...ATP11B: rs148771930 that was associated with white matter hyperintensities burden in European patients with SVD, was recently identified. Our results suggest that ATP11B may not play an essential role in SVD in the Chinese population.
We performed target region sequencing including ATP11B gene in 182 patients with sporadic SVD, and identified five rare variants and two novel variants of ATP11B. A case-control study was then performed in 524 patients and matched 550 controls to investigate the relationship between ATP11B and sporadic SVD in the Chinese Han population. Although none of these variants were significantly associated with SVD in our samples, it is important to mention that we identified a novel variant, p. G238W, which was predicted to be pathogenic in silico. This variant was present in our cohort of patients with an extremely low frequency and was absent in the controls.
Our results suggest that ATP11B may not play an essential role in SVD in the Chinese population.
This study presents a large‐strain analysis for cylindrical cavity unloading–contraction problem in strain‐softening geomaterials. Based on the unified strength theory (UST) and non‐associated flow ...rule, the process of cavity contraction in cohesive‐frictional geomaterials is regarded as a large‐strain problem by introducing the UST parameters and the volumetric force of seepage into the conventional cylindrical cavity contraction analysis, the effects of strain‐softening characteristic, intermediate principal stress, large‐strain, and seepage are considered. Finally, according to the comparison of the results of the radius ratio with those in the published literature, the correctness and reliability of the theoretical method are proved. The results show that it is necessary to consider the effect of volume force of seepage in the stability of excavation problem in geomaterial, the larger the volume force of seepage, the smaller the plastic radius. The traditional two‐dimensional cavity contraction solution overestimates the plastic radius. The results provide a theoretical basis for the elasto‐plastic analysis of excavation in rich water geomaterial and have a certain reference value for engineering design.
Objective
Cephalic arch stenosis (CAS) causes repeated dysfunction and failure of arteriovenous access. Percutaneous transluminal angioplasty is the standard initial treatment for CAS, but its ...outcome is unsatisfactory. This study aimed to evaluate the outcome of stent graft placement for CAS in patients on hemodialysis.
Methods
A retrospective chart review from a tertiary medical center was performed in patients receiving stent graft placement for CAS between January 2012 and 2016. Patency was analyzed using the Kaplan–Meier method.
Results
Twenty-one patients received stent graft placement for CAS. Technical and clinical success rates were 100%. Primary target lesion patency was 95% (95% confidence interval CI, 86%–100%), 76% (95% CI, 58%–94%), and 43% (95% CI, 22%–64%) at 3, 6, and 12 months, respectively. No significant difference in patency was observed between the arteriovenous fistula and arteriovenous graft groups. Assisted primary patency was 95% (95% CI, 86%–100%), 71% (95% CI, 52%–91%), and 57% (95% CI, 36%–78%) at 3, 6, and 12 months, respectively. Secondary patency was 100% at 3, 6, and 12 months.
Conclusions
After repeated failed angioplasty for cephalic arch stenosis, patients on hemodialysis who receive stent graft placement have effective and durable outcomes.
Tylophorine-based compounds exert broad spectral, potent inhibition of coronaviruses. NF-κB activation is a common pro-inflammatory response of host cells to viral infection. The aims of this study ...were to (i) find an effective combination treatment for coronaviral infections through targeting of the virus per se and cellular NF-κB activity; and (ii) to study the underling mechanisms. We found that tylophorine-based compounds target the TGEV viral RNA and effectively inhibit TGEV replication. NF-κB inhibition also leads to anti-TGEV replication. NF-κB activation induced by TGEV infection was found to be associated with two convergent pathways, IKK-2_IκBα/p65 and JAK2 mediated p65 phosphorylation, in swine testicular cells. JAK2 inhibition either by CYT387 (a JAK family inhibitor) or by silencing JAK2-expression revealed a dominant JAK2 mediated p65 phosphorylation pathway for NF-κB activation and resulted in NF-κB inhibition, which overrode the IκBα regulation via the IKK-2. Finally, tylophorine-based compounds work cooperatively with CYT387 to impart comprehensive anti-TGEV activities. The combination treatment, wherein a tylophorine compound targets TGEV and a JAK2 inhibitor blocks the alternative dominant NF-κB activation mediated by JAK2, is more effective and comprehensive than either one alone and constitutes a feasible approach for the treatment of SARS-CoV or MERS-CoV.
Microtubule affinity regulating kinase 4 (MARK4), an important member of the serine/threonine kinase family, regulates the phosphorylation of microtubule‐associated proteins and thus modulates ...microtubule dynamics. In human atherosclerotic lesions, the expression of MARK4 is significantly increased. Recently, accumulating evidence suggests that MARK4 exerts a proatherogenic effect via regulation of lipid metabolism (cholesterol, fatty acid, and triglyceride), inflammation, cell cycle progression and proliferation, insulin signaling, and glucose homeostasis, white adipocyte browning, and oxidative stress. In this review, we summarize the latest findings regarding the role of MARK4 in the pathogenesis of atherosclerosis to provide a rationale for future investigation and therapeutic intervention.
MARK4 exerts a proatherogenic effect via regulation of lipid metabolism (cholesterol, fatty acid, and triglyceride), inflammation, cell cycle progression and proliferation, insulin signaling and glucose homeostasis, white adipocyte browning, and oxidative stress. We summarize the latest findings regarding the role of MARK4 in the pathogenesis of atherosclerosis to provide a rationale for future investigation and therapeutic intervention.
High-quality long-distance entanglement is essential for both quantum communication and scalable quantum networks. Entanglement purification is to distill high-quality entanglement from low-quality ...entanglement in a noisy environment and it plays a key role in quantum repeaters. The previous significant entanglement purification experiments require two pairs of low-quality entangled states and were demonstrated in tabletop. Here we propose and report a high-efficiency and long-distance entanglement purification using only one pair of hyperentangled state. We also demonstrate its practical application in entanglement-based quantum key distribution (QKD). One pair of polarization spatial-mode hyperentanglement was distributed over 11 km multicore fiber (noisy channel). After purification, the fidelity of polarization entanglement arises from 0.771 to 0.887 and the effective key rate in entanglement-based QKD increases from 0 to 0.332. The values of Clauser-Horne-Shimony-Holt inequality of polarization entanglement arises from 1.829 to 2.128. Moreover, by using one pair of hyperentanglement and deterministic controlled-NOT gates, the total purification efficiency can be estimated as 6.6×10^{3} times than the experiment using two pairs of entangled states with spontaneous parametric down-conversion sources. Our results offer the potential to be implemented as part of a full quantum repeater and large-scale quantum network.
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