The Research on Establishment of “Clinical Practice Guide of Blood Specimen Collection, Preservation and Delivery for Clinical Nurse”: Protocol Description

INTRODUCTION AND OBJECTIVE: The correctness of the blood test is closely related to the sample. According to the recent reported data, 80 percentage unsatisfactory results of the clinical test are due to the poor quality of sample, especially the blood sample. Clinical practice guide (CPG) is directly to instruct the clinical nursing practice. And the recommendations in the clinical practice guide are based on the best available study evidences. There is lack of CPG about blood sample specimen collection, preservation and delivery (BSCPD) in China. Additionally, related published clinical studies are accumulated in a great deal. Therefore, establishing a CPG is necessarily and practicable. The detailed objectives are: 1) to describe and analyze the research status of BSCPD in China; 2) to describe and analyze the practice status of BSCPD in China; 3) to systematic appraise the available evidences of BSCPD; 4) to establish the clinical practice guide of BSCPD; 5) to judge the clinical practice guide of BSCPD. METHODS: Objective 1): Bibliometric analysis is applied, the database include China National Knowledge Infrastructure Database (CNKI) and Sino-med and the research period is from the year of 2003 to 2013; Objective 2): Questionnaire survey for all the registered clinical nurses in a grade three hospital; objective 3): Systematic review according to Cochrane collaboration handbook 5.1.0 is applied which includes assessment of risk of bias, data extraction, data analysis; Objective 4) and 5): Using the appraising guidelines research and evaluation (AGREE) to evaluate of the draft of CPG of BSCPD. RESULTS: Bibliometric analysis started in 2013, and search strategies have been established. Questionnaire survey setting and depth interviewees have been identified and communicated. CONCLUSIONS: The CPG of BSCPD will serve as an important resource in instructing and modifying clinical nursing practice. Given this CPG of BSCPD will be a draft version, the applicability and suitability of it will need a further evaluated in the real clinical nursing world

Estimation of tomato water status with photochemical reflectance index and machine learning: Assessment from proximal sensors and UAV imagery

Tracking plant water status is a critical step towards the adaptive precision irrigation management of processing tomatoes, one of the most important specialty crops in California. The photochemical reflectance index (PRI) from proximal sensors and the high-resolution unmanned aerial vehicle (UAV) imagery provide an opportunity to monitor the crop water status efficiently. Based on data from an experimental tomato field with intensive aerial and plant-based measurements, we developed random forest machine learning regression models to estimate tomato stem water potential (ψstem), (using observations from proximal sensors and 12-band UAV imagery, respectively, along with weather data. The proximal sensor-based model estimation agreed well with the plant ψstem with R2 of 0.74 and mean absolute error (MAE) of 0.63 bars. The model included PRI, normalized difference vegetation index, vapor pressure deficit, and air temperature and tracked well with the seasonal dynamics of ψstem across different plots. A separate model, built with multiple vegetation indices (VIs) from UAV imagery and weather variables, had an R2 of 0.81 and MAE of 0.67 bars. The plant-level ψstem maps generated from UAV imagery closely represented the water status differences of plots under different irrigation treatments and also tracked well the temporal change among flights. PRI was found to be the most important VI in both the proximal sensor- and the UAV-based models, providing critical information on tomato plant water status. This study demonstrated that machine learning models can accurately estimate the water status by integrating PRI, other VIs, and weather data, and thus facilitate data-driven irrigation management for processing tomatoes

Symmetry-protected higher-order exceptional points in staggered flatband rhombic lattices

Higher-order exceptional points (EPs), which appear as multifold degeneracies in the spectra of non-Hermitian systems, are garnering extensive attention in various multidisciplinary fields. However, constructing higher-order EPs still remains as a challenge due to the strict requirement of the system symmetries. Here we demonstrate that higher-order EPs can be judiciously fabricated in PT -symmetric staggered rhombic lattices by introducing not only on-site gain/loss but also nonHermitian couplings. Zero-energy flatbands persist and symmetry-protected third-order EPs (EP3) arise in these systems owing to the non-Hermitian chiral/sublattice symmetry, but distinct phase transitions and propagation dynamics occur. Specifically, the EP3 arises at the Brillouin zone (BZ) boundary in the presence of on-site gain/loss. The single-site excitations display an exponential power increase in the PT -broken phase. Meanwhile, a nearly flatband sustains when a small lattice perturbation is applied. For the lattices with non-Hermitian couplings, however, the EP3 appears at the BZ center. Quite remarkably, our analysis unveils a dynamical delocalization-localization transition for the excitation of the dispersive bands and a quartic power increase beyond the EP3. Our scheme provides a new platform towards the investigation of the higher-order EPs, and can be further extended to the study of topological phase transitions or nonlinear processes associated with higher-order EPs.Comment: 10 pages, 10 figure

Barriers to Research Utilization among Registered Nurses in Traditional Chinese Medicine Hospitals: A Cross-Sectional Survey in China

Background. As there might be relevant differences with regard to research utilization in the general hospitals, we aimed to study research utilization among registered nurses working in traditional Chinese medicine hospitals. Methods. A total of 648 registered nurses from 4 tertiary-level hospitals in China were recruited for participation. A modified BARRIERS Scale and self-designed questionnaires were used for data collection. Data were analyzed with descriptive statistics, t-tests, and one-way ANOVAs and Spearman correlation analysis. Results. Overall, items which belong to the subscale “Research” were identified as the most important barriers. Among the individual items, the lack of time on the job was ranked as the top barrier, followed by the lack of knowledgeable colleagues and by overwhelming research publications. Clinical experience, working pressure, job satisfaction, and research experience could be identified as associated factors for barriers to research utilization. Conclusions. Registered nurses in traditional Chinese medicine hospitals felt high barriers to research utilization. Reducing registered nurses’ working pressure, promoting their positive attitude to nursing, and improving research training might be helpful for increasing research utilization. Close cooperation between clinical and nursing schools or academic research centres might facilitate the necessary change in nursing education and routine

Advances on mechanisms of regulated cell death in neurotoxicity of aluminum

Aluminum is a light metal which is rich in the earth's crust and widely used. Recently, the adverse health effects of environmental and occupational aluminum exposure on human have attracted more and more attention. Aluminum exposure has toxic effects on the central nervous system and is believed to be closely related to the development and progression of Alzheimer's disease. The neurotoxic mechanism of aluminum is complex, especially the role of regulated cell death (RCD) in aluminum-induced neuronal death remains to be further studied. RCD refers to all modes of cell death regulated by multiple intracellular signal transduction pathways under physiological and pathological conditions, including apoptosis, necroptosis, autophagy, pyroptosis, and ferroptosis. This review summarized the morphological characteristics and mechanisms of each RCD mode in the process of aluminum-induced neuronal death, and discussed the relationship and transformation between different RCD modes, providing a new scientific basis for future studies on the treatment and intervention of neurotoxicity induced by aluminum exposure

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment