Impact of High-Fidelity Simulation on Teaching Medical Nursing

Purpose:  The purpose of this study was to examine the High-Fidelity Simulation to improve disease-related knowledge level of junior students in a Bachelor of Science in Nursing program and to explore the students evaluation on High-Fidelity Simulation. Methods:  The study used a within-group, pre-post test design with twenty-three students of a nursing school in central city in the People’s Republic of China. Students were divided into four groups of five to six students. Facilitated by the same teacher, the four groups performed simulations in four different days. For each group, three simulation scenarios with high-fidelity simulator were implemented. In each group, students alternated to practice as the nurses in three scenarios. At the end of the simulations, every student performed as the nurse and the observer. The three scenarios were designed based on the case of a patient with Chronic Obstructive Pulmonary Disease (COPD). The objectives of the simulations were to take care of the COPD patient with acute exacerbation and perform individualized health education. COPD-related knowledge questionnaires were used to measure the knowledge level before and after the simulations. The Student Satisfaction and Self-confidence in Learning Scale (13 items), the Simulation Design Scale (20 items) and the Educational Practices in Simulation Scale (16 items) were completed at the end of the simulations to measure students’ perception of High-Fidelity Simulation. Results:   The student knowledge increased significantly from pretest to posttest. All the simulation scales are five-Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree). The means and standard deviation of the three scales were 4.28±0.45, 4.32±0.44 and 4.39±0.50 respectively. Conclusion:  In this study, High-Fidelity Simulation can significantly improve the disease-related knowledge of junior BSN students. High-Fidelity Simulation received relatively high scores for students’ satisfaction and self-confidence. Student perceived high-fidelity simulation as an effective teaching strategy. However, further study is needed to explore the specific way it integrates with baccalaureate curriculum

Sharp estimates, uniqueness and nondegeneracy of positive solutions of the Lane-Emden system in planar domains

We study the Lane-Emden system $$\begin{cases} -\Delta u=v^p,\quad u>0,\quad\text{in}~\Omega, -\Delta v=u^q,\quad v>0,\quad\text{in}~\Omega, u=v=0,\quad\text{on}~\partial\Omega, \end{cases}$$ where $\Omega\subset\mathbb{R}^2$ is a smooth bounded domain. In a recent work, we studied the concentration phenomena of positive solutions as $p,q\to+\infty$ and $|q-p|\leq \Lambda$. In this paper, we obtain sharp estimates of such multi-bubble solutions, including sharp convergence rates of local maxima and scaling parameters, and accurate approximations of solutions. As an application of these sharp estimates, we show that when $\Omega$ is convex, then the solution of this system is unique and nondegenerate for large $p, q$.Comment: 63 pages. This is a revised version of arXiv:2205.15055v1. We fix a gap in the previous version and add some details of the proo

Positive Least Energy Solutions and Phase Separation for Coupled Schrodinger Equations with Critical Exponent: Higher Dimensional Case

We study the following nonlinear Schr\"{o}dinger system which is related to Bose-Einstein condensate: {displaymath} {cases}-\Delta u +\la_1 u = \mu_1 u^{2^\ast-1}+\beta u^{\frac{2^\ast}{2}-1}v^{\frac{2^\ast}{2}}, \quad x\in \Omega, -\Delta v +\la_2 v =\mu_2 v^{2^\ast-1}+\beta v^{\frac{2^\ast}{2}-1} u^{\frac{2^\ast}{2}}, \quad x\in \om, u\ge 0, v\ge 0 \,\,\hbox{in \om},\quad u=v=0 \,\,\hbox{on \partial\om}.{cases}{displaymath} Here \om\subset \R^N is a smooth bounded domain, $2^\ast:=\frac{2N}{N-2}$ is the Sobolev critical exponent, -\la_1(\om)0 and $\beta\neq 0$, where \lambda_1(\om) is the first eigenvalue of $-\Delta$ with the Dirichlet boundary condition. When \bb=0, this is just the well-known Brezis-Nirenberg problem. The special case N=4 was studied by the authors in (Arch. Ration. Mech. Anal. 205: 515-551, 2012). In this paper we consider {\it the higher dimensional case $N\ge 5$}. It is interesting that we can prove the existence of a positive least energy solution (u_\bb, v_\bb) {\it for any $\beta\neq 0$} (which can not hold in the special case N=4). We also study the limit behavior of (u_\bb, v_\bb) as $\beta\to -\infty$ and phase separation is expected. In particular, u_\bb-v_\bb will converge to {\it sign-changing solutions} of the Brezis-Nirenberg problem, provided $N\ge 6$. In case \la_1=\la_2, the classification of the least energy solutions is also studied. It turns out that some quite different phenomena appear comparing to the special case N=4.Comment: 48 pages. This is a revised version of arXiv:1209.2522v1 [math.AP

Diagnostic and prognostic value of autophagy-related key genes in sepsis and potential correlation with immune cell signatures

Background: Autophagy is involved in the pathophysiological process of sepsis. This study was designed to identify autophagy-related key genes in sepsis, analyze their correlation with immune cell signatures, and search for new diagnostic and prognostic biomarkers.Methods: Whole blood RNA datasets GSE65682, GSE134347, and GSE134358 were downloaded and processed. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were used to identify autophagy-related key genes in sepsis. Then, key genes were analyzed by functional enrichment, protein-protein interaction (PPI), transcription factor (TF)-gene and competing endogenous RNA (ceRNA) network analysis. Subsequently, key genes with diagnostic efficiency and prognostic value were identified by receiver operating characteristic (ROC) curves and survival analysis respectively. The signatures of immune cells were estimated using CIBERSORT algorithm. The correlation between significantly different immune cell signatures and key genes was assessed by correlation analysis. Finally, key genes with both diagnostic and prognostic value were verified by RT-qPCR.Results: 14 autophagy-related key genes were identified and their TF-gene and ceRNA regulatory networks were constructed. Among the key genes, 11 genes (ATIC, BCL2, EEF2, EIF2AK3, HSPA8, IKBKB, NLRC4, PARP1, PRKCQ, SH3GLB1, and WIPI1) had diagnostic efficiency (AUC > 0.90) and 5 genes (CAPN2, IKBKB, PRKCQ, SH3GLB1 and WIPI1) were associated with survival prognosis (p-value < 0.05). IKBKB, PRKCQ, SH3GLB1 and WIPI1 had both diagnostic and prognostic value, and their expression were verified by RT-qPCR. Analysis of immune cell signatures showed that the abundance of neutrophil, monocyte, M0 macrophage, gamma delta T cell, activated mast cell and M1 macrophage subtypes increased in the sepsis group, while the abundance of resting NK cell, resting memory CD4+ T cell, CD8+ T cell, naive B cell and resting dendritic cell subtypes decreased. Most of the key genes correlated with the predicted frequencies of CD8+ T cells, resting memory CD4+ T cells, M1 macrophages and naive B cells.Conclusion: We identified autophagy-related key genes with diagnostic and prognostic value in sepsis and discovered associations between key genes and immune cell signatures. This work may provide new directions for the discovery of promising biomarkers for sepsis

Knowledge, attitudes, and support needs of obstetric and gynecological nurses and midwives toward perinatal mental health disorders screening in Central China: a multicenter cross-sectional survey

BackgroundThe perinatal period is a time of increased vulnerability regarding maternal mental health status. Although guidelines and policies have been published for perinatal mental health disorders (PMHDs) screening in China, the knowledge, attitudes, and support needs of nurses and midwives toward implementing mental health screening programs during pregnancy remain unclear. Thus, this study aimed to investigate the knowledge of PMHDs, attitudes and support needs related to implementing mental health screening during pregnancy among obstetrics and gynecology (OB/GYN) nurses and midwives in the central region of China while identifying the related influencing factors.MethodsA cross-sectional survey was conducted in 14 cities in Hubei, China, using convenience sampling from July to October 2023. The Chinese version of the Perinatal Mental Health Knowledge Questionnaire, the Chinese version of the Perinatal Mental Health Attitudes Scale, and the Health Care Facilities Support Needs Scale were used to investigate the PMHDs knowledge, attitudes, and support needs of OB/GYN nurses and midwives, respectively. Data were analyzed using SPSS version 27.0. Descriptive and inferential statistics were performed, with a p-value of <0.05 considered statistically significant.ResultsThe average scores for knowledge, attitudes, and support needs were 6.09 ± 1.99 (total score: 13), 47.67 ± 8.80 (total score: 80), and 29.35 ± 4.66 (total score: 35), respectively. After adjusting for years of nursing experience and years of obstetrics and gynecology nursing experience, the multivariate logistic regression analysis indicated that having mental health-related education or work experience [adjusted OR (aOR) = 1.43, p = 0.01], being midwives (aOR = 1.78, p < 0.001), and working in specialist maternity hospitals (aOR = 1.55, p < 0.001) were significantly associated with higher knowledge scores; having mental health related education or work experience (aOR = 1.59, p = 0.014) and working in specialist maternity hospitals (aOR = 1.42, p < 0.01) were significantly associated with higher support needs scores.ConclusionOB/GYN nurses and midwives demonstrated insufficient knowledge and moderate attitudes toward PMHDs screening, and have great support need for PMHDs screening. To address these issues, medical organizations and relevant government sectors should enhance training for nurses and midwives on PMHDs and provide professional support to promote routine maternal mental health screening programs and improve perinatal mental health outcomes