Caring behaviours of student nurses: Effects of pre-registration nursing education

In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice. The findings based on student surveys indicated a statistically significant reduction in the overall level of caring behaviour in first to final year students. When compared with the findings of lecturers and nurses, less variance to lecturers than to nurses was found amongst the first years' score, and the lowest variance to nurses was demonstrated amongst the final year. A greater reduction was evidenced amongst Singaporean students, which was exaggerated with exposure to pre-enrolled nursing education and magnified with caring job experience. This study indicates more effort is necessary to harness student caring attributes in students' entire educational journey so that expressive caring is not subsumed in the teaching of students to meet demands of complicated contemporary care

Epidemiology of small-bowel obstruction beyond the neonatal period

Background: The aim of this study was to evaluate the etiologies causing intestinal obstruction beyond the neonatal period.Patients and methods: An observational study was conducted on children between 1 month and 17 years of age who underwent surgery for small-bowel obstruction (SBO) at this tertiary referral center between 1 January 2004 and 31 December 2013.Results: In total, 133 patients (38 female) with a median age of 3.4 (range 0.16–15.8) years were included in the study group. Forty-four patients (18 female) had intussusception, of whom seven presented with a pathological lead point. Thirty-nine individuals (12 female) had a postoperative SBO. The median formation time for the SBO was 1.75 years, and neonatal anomalies represented the most frequent cause of initial surgery. Primary SBO with no previous surgery was observed in 30 children (eight girls), including 12 (9%) with Meckel’s diverticulum, nine (7%) with congenital bands, and three (2%) with bezoars. Twenty patients (15%), all boys, presented with an irreducible inguinal hernia. During the surgery, a total of 43 (32%) patients underwent bowel  resection or enterotomy. Five patients (3.8%) died, four as a result of sepsis and one following parenteral nutritionrelated liver failure.Conclusion: Nearly a quarter of this cohort had a primary SBO. SBO in children is more prevalent among boys (M : F ratio, 2.5 : 1). Intussusception, postoperative adhesions, and irreducible inguinal hernias are the most common pathologies for SBO, followed by Meckel’s diverticulum and congenital adhesive bands.Keywords: congenital band, inguinal hernia, intussusception, Meckel’s diverticulum, postoperative adhesion, small bowel obstructio

Analysis of telephone network traffic based on a complex user network

The traffic in telephone networks is analyzed in this paper. Unlike the classical traffic analysis where call blockings are due to the limited channel capacity, we consider here a more realistic cause for call blockings which is due to the way in which users are networked in a real-life human society. Furthermore, two kinds of user network, namely, the fully-connected user network and the scale-free network, are employed to model the way in which telephone users are connected. We show that the blocking probability is generally higher in the case of the scale-free user network, and that the carried traffic intensity is practically limited not only by the network capacity but also by the property of the user network.Comment: 17 pages, 9 figures, accepted for Physica

Organ-Specific Alterations in Fatty Acid De Novo Synthesis and Desaturation in a Rat Model of Programmed Obesity

<p>Abstract</p> <p>Background</p> <p>Small for gestational age (SGA) leads to increased risk of adult obesity and metabolic syndrome. Offspring exposed to 50% maternal food restriction <it>in utero </it>are born smaller than Controls (FR), catch-up in growth by the end of the nursing period, and become obese adults. The objective of the study was to determine stearoyl-CoA desaturase activity (SCD1) and rates of de novo fatty acid synthesis in young FR and Control offspring tissues at the end of the nursing period, as possible contributors to catch-up growth.</p> <p>Methods</p> <p>From gestational day 10 to term, dams fed ad libitum (Control) or were 50% food-restricted to produce small FR pups. Control dams nursed all pups. At postnatal day 1 (p1) and p21, offspring body tissues were analyzed by GC/MS, and desaturation indices of palmitoleate/palmitate and oleate/stearate were calculated. SCD1 gene expression was determined by real-time PCR on adipose and liver. Offspring were enriched with deuterium that was given to dams in drinking water during lactation and de novo synthesis of offspring body tissues was determined at p21. Primary adipocyte cell cultures were established at p21 and exposed to U¹³C-glucose.</p> <p>Results</p> <p>FR offspring exhibited higher desaturation index in p1 and p21 adipose tissue, but decreased desaturation index in liver at p21. SCD1 gene expression at p21 was correspondingly increased in adipose and decreased in liver. FR subcutaneous fat demonstrated increased de novo synthesis at p21. Primary cell cultures exhibited increased de novo synthesis in FR.</p> <p>Conclusions</p> <p>Adipose tissue is the first site to exhibit increased de novo synthesis and desaturase activity in FR. Therefore, abnormal lipogenesis is already present prior to onset of obesity during the period of catch-up growth. These abnormalities may contribute to future obesity development.</p

The impact of cardiac comorbidity sequence at baseline and mortality risk in type 2 Diabetes Mellitus: a retrospective population-based cohort study

Introduction: The presence of multiple comorbidities increases the risk of all-cause mortality, but the effects of the comorbidity sequence before the baseline date on mortality remain unexplored. This study investigated the relationship between coronary heart disease (CHD), atrial fibrillation (AF) and heart failure (HF) through their sequence of development and the effect on all-cause mortality risk in type 2 diabetes mellitus. Methods: This study included patients with type 2 diabetes mellitus prescribed antidiabetic/cardiovascular medications in public hospitals of Hong Kong between 1 January 2009 and 31 December 2009, with follow-up until death or 31 December 2019. The Cox regression was used to identify comorbidity sequences predicting all-cause mortality in patients with different medication subgroups. Results: A total of 249,291 patients (age: 66.0 ± 12.4 years, 47.4% male) were included. At baseline, 7564, 10,900 and 25,589 patients had AF, HF and CHD, respectively. Over follow-up (3524 ± 1218 days), 85,870 patients died (mortality rate: 35.7 per 1000 person-years). Sulphonylurea users with CHD developing later and insulin users with CHD developing earlier in the disease course had lower mortality risks. Amongst insulin users with two of the three comorbidities, those with CHD with preceding AF (hazard ratio (HR): 3.06, 95% CI: [2.60–3.61], p < 0.001) or HF (HR: 3.84 [3.47–4.24], p < 0.001) had a higher mortality. In users of lipid-lowering agents with all three comorbidities, those with preceding AF had a higher risk of mortality (AF-CHD-HF: HR: 3.22, [2.24–4.61], p < 0.001; AF-HF-CHD: HR: 3.71, [2.66–5.16], p < 0.001). Conclusions: The sequence of comorbidity development affects the risk of all-cause mortality to varying degrees in diabetic patients on different antidiabetic/cardiovascular medications

Local delivery of novel MRTF/SRF inhibitors prevents scar tissue formation in a preclinical model of fibrosis

The myocardin-related transcription factor/serum response factor (MRTF/SRF) pathway represents a promising therapeutic target to prevent fibrosis. We have tested the effects of new pharmacological inhibitors of MRTF/SRF signalling in a preclinical model of fibrosis. CCG-222740, a novel MRTF/SRF inhibitor, markedly decreased SRF reporter gene activity and showed a greater inhibitory effect on MRTF/SRF target genes than the previously described MRTF-A inhibitor CCG-203971. CCG-222740 was also five times more potent, with an IC50 of 5 μM, in a fibroblast-mediated collagen contraction assay, was less cytotoxic, and a more potent inhibitor of alpha-smooth muscle actin protein expression than CCG-203971. Local delivery of CCG-222740 and CCG-203971 in a validated and clinically relevant rabbit model of scar tissue formation after glaucoma filtration surgery increased the long-term success of the surgery by 67% (P < 0.0005) and 33% (P < 0.01), respectively, and significantly decreased fibrosis and scarring histologically. Unlike mitomycin-C, neither CCG-222740 nor CCG-203971 caused any detectable epithelial toxicity or systemic side effects with very low drug levels measured in the aqueous, vitreous, and serum. We conclude that inhibitors of MRTF/SRF-regulated gene transcription such as CCG-222740, potentially represent a new therapeutic strategy to prevent scar tissue formation in the eye and other tissues

Gender-specific clinical risk scores incorporating blood pressure variability for predicting incident dementia

Introduction: The present study examined the gender-specific prognostic value of blood pressure (BP) and its variability in the prediction of dementia risk and developed a score system for risk stratification. Materials and Methods This was a retrospective, observational population-based cohort study of patients admitted to government-funded family medicine clinics in Hong Kong between January 1, 2000 and March 31, 2002 with at least 3 blood pressure measurements. Gender-specific risk scores for dementia were developed and tested. Results The study consisted of 74 855 patients, of whom 3550 patients (incidence rate: 4.74%) developed dementia over a median follow-up of 112 months (IQR= [59.8–168]). Nonlinear associations between diastolic/systolic BP measurements and the time to dementia presentation were identified. Gender-specific dichotomized clinical scores were developed for males (age, hypertension, diastolic and systolic BP and their measures of variability) and females (age, prior cardiovascular, respiratory, gastrointestinal diseases, diabetes mellitus, hypertension, stroke, mean corpuscular volume, monocyte, neutrophil, urea, creatinine, diastolic and systolic BP and their measures of variability). They showed high predictive strengths for both male (hazard ratio [HR]: 12.83, 95% confidence interval [CI]: 11.15–14.33, P value &amp;lt; .0001) and female patients (HR: 26.56, 95% CI: 14.44–32.86, P value &amp;lt; .0001). The constructed gender-specific scores outperformed the simplified systems without considering BP variability (C-statistic: 0.91 vs 0.82), demonstrating the importance of BP variability in dementia development. Conclusion Gender-specific clinical risk scores incorporating BP variability can accurately predict incident dementia and can be applied clinically for early disease detection and optimized patient management

Neogenin recruitment of the WAVE regulatory complex maintains adherens junction stability and tension

To maintain tissue integrity during epithelial morphogenesis, adherens junctions (AJs) must resist the mechanical stresses exerted by dynamic tissue movements. Junctional stability is dependent on actomyosin contractility within the actin ring. Here we describe a novel function for the axon guidance receptor, Neogenin, as a key component of the actin nucleation machinery governing junctional stability. Loss of Neogenin perturbs AJs and attenuates junctional tension. Neogenin promotes actin nucleation at AJs by recruiting the Wave regulatory complex (WRC) and Arp2/3. A direct interaction between the Neogenin WIRS domain and the WRC is crucial for the spatially restricted recruitment of the WRC to the junction. Thus, we provide the first example of a functional WIRS-WRC interaction in epithelia. We further show that Neogenin regulates cadherin recycling at the AJ. In summary, we identify Neogenin as a pivotal component of the AJ, where it influences both cadherin dynamics and junctional tension

Microwave Assisted Formation of Monoreactive Perfluoroalkylsilane-based Self-Assembled Monolayers

We demonstrate the use of microwave radiation as a tool to accelerate the formation of perfluoroalkylsilane based self-assembled monolayers (SAMs) on silicon oxide surfaces. Surface coverage of these SAMs of monoreactive perfluoroalkylsilanes increased in proportion to the duration over which the solutions were heated by microwave radiation.&nbsp

High Throughput Lattice-based Signatures on GPUs: Comparing Falcon and Mitaka

The US National Institute of Standards and Technology initiated a standardization process for post-quantum cryptography in 2017, with the aim of selecting key encapsulation mechanisms and signature schemes that can withstand the threat from emerging quantum computers. In 2022, Falcon was selected as one of the standard signature schemes, eventually attracting effort to optimize the implementation of Falcon on various hardware architectures for practical applications. Recently, Mitaka was proposed as an alternative to Falcon, allowing parallel execution of most of its operations. These recent advancements motivate us to develop high throughput implementations of Falcon and Mitaka signature schemes on Graphics Processing Units (GPUs), a massively parallel architecture widely available on cloud service platforms. In this paper, we propose the first parallel implementation of Falcon on various GPUs. An iterative version of the sampling process in Falcon, which is also the most time-consuming Falcon operation, was developed. This allows us to implement Falcon signature generation without relying on expensive recursive function calls on GPUs. In addition, we propose a parallel random samples generation approach to accelerate the performance of Mitaka on GPUs. We evaluate our implementation techniques on state-of-the-art GPU architectures (RTX 3080, A100, T4 and V100). Experimental results show that our Falcon-512 implementation achieves 58, 595 signatures/second and 2, 721, 562 verifications/second on an A100 GPU, which is 20.03× and 29.51× faster than the highly optimized AVX2 implementation on CPU. Our Mitaka implementation achieves 161, 985 signatures/second and 1, 421, 046 verifications/second on the same GPU. Due to the adoption of a parallelizable sampling process, Mitaka signature generation enjoys ≈ 2 – 20× higher throughput than Falcon on various GPUs. The high throughput signature generation and verification achieved by this work can be very useful in various emerging applications, including the Internet of Things