To systematically interpret the "Guideline on positioning and early mobilisation in the critically ill by an expert panel".

The development background,evidence quality,and key recommendations of the guideline were systematically reviewed.The focus was placed on interpreting the core recommendations regarding positioning and early mobilisation,and clinical practice considerations aligned with China's national context were proposed accordingly.

The guideline put forward 46 recommendations,encompassing 23 on positioning management,19 on early mobilisation,4 on assistive devices,and 2 on neuromuscular electrical stimulation.Key recommendations included:head-of-bed elevation≥40° for intubated patients;early initiation of prone positioning ventilation(for at least 12 hours) in ARDS patients with PaO₂/FiO₂<150 mmHg;and commencement of early mobilisation within 72 hours of ICU admission.

This guideline provides an evidence-based foundation for positioning management and early mobilisation in ICU patients.It is recommended to enhance healthcare staff training,establish multidisciplinary collaboration mechanisms,and improve assessment and monitoring systems to ensure standardized implementation.

To construct a physical activity program for young and middle-aged patients during home-based rehabilitation after early-stage lung cancer surgery and to evaluate its application effects.

Literature related to physical activity during home-based rehabilitation after lung cancer surgery was extracted and analyzed. Focus group interviews were conducted to understand the physical activity intervention needs of young and middle-aged patients after early-stage lung cancer surgery.A preliminary version of the physical activity program was developed and reported using the TIDieR intervention template.The preliminary program was revised through two rounds of Delphi expert consultations.The final version of the physical activity program for young and middle-aged patients during home-based rehabilitation after early-stage lung cancer surgery was formed.Totally 50 young and middle-aged patients with early-stage lung cancer who were hospitalized in the thoracic surgery department of a grade A tertiary hospital in Suzhou from September to October 2023 and scheduled for lung cancer resection were recruited and randomly divided into control group and intervention group.The control group received routine discharge guidance,while the intervention group additionally received the developed physical activity program.The physical activity levels and physical function of the two groups were compared before the intervention and after 8 weeks of intervention. Intervention compliance,incidence of adverse events,and patient acceptance of the intervention program were also collected.

The effective response rates for both rounds of the Delphi survey were 100%.The expert authority coefficient in the second round was 0.86,The Kendall's coefficient of concordance was 0.337(all P<0.001).The coefficient of variation ranged from 0.00 to 0.11.The final program included 12 modules and 25 items.A total of 50 middle-aged and young patients with early-stage lung cancer were recruited in this study. After excluding 12 cases,38 patients were finally included,with 19 cases in the control group and 19 cases in the intervention group respectively.Application results showed that after 8 weeks of intervention,the physical activity levels and physical function of the intervention group were higher than those of the control group(P<0.05).No adverse events occurred in either group during the intervention.The intervention group demonstrated good compliance and high acceptance of the program.

The constructed program is scientific and practical.It could help to improve the physical activity levels and physical function of young and middle-aged patients during home-based rehabilitation after early-stage lung cancer surgery.The program is well-accepted by patients.It has demonstrated good applicability.

To compare the long-term trends in colorectal cancer(CRC) mortality rates in China and the United States(U.S.) from 1992 to 2021 and to provide scientific evidence for CRC prevention and control in China.

Based on data from the GBD2021 database,CRC mortality burden data for China and the U.S.from 1992 to 2021 were extracted.The Age-Period-Cohort(APC) model was used to evaluate the independent effects of age,period,and cohort,while decomposition analysis quantified the contributions of aging,population growth,and epidemiological changes to CRC mortality.

From 1992 to 2021,colorectal cancer deaths increased in both China and the United States.However,the age-standardized mortality rate(ASMR) declined in both countries,with males consistently bearing a higher mortality burden than females.According to the age-period-cohort(APC) model,colorectal cancer mortality rose sharply with age in both countries,particularly among individuals aged 50 years and older.In China,the overall mortality rate increased from 0.53 per 100 000 to 236.50 per 100 000,while in the United States it rose from 0.11 per 100 000 to 171.02 per 100 000. The period effect demonstrated a downward trend in both countries,with the period rate ratio decreasing from 1.10 to 0.91 in China and from 1.07 to 0.85 in the United States.The cohort effect also showed a continuous decline,with China's cohort rate ratio decreasing from 1.34 to 0.46 and the U.S.declining from 2.54 to 0.74.Although the U.S.exhibited higher cohort risks,its reduction was more pronounced.Decomposition analysis further indicated that the rise in colorectal cancer deaths in China was primarily driven by population aging and population growth,whereas the mortality changes in the United States were predominantly attributable to improvements in epidemiological factors.

From 1992 to 2021,the ASMR for CRC declined in both China and the U.S.;however,CRC mortality changes in China were primarily driven by aging and population growth,highlighting the need for enhanced screening and intervention for older males.Epidemiological improvements had more pronounced effect in the U.S.,emphasizing the need for China to strengthen CRC prevention and screening efforts for the aging population and further to improve the impact of epidemiological changes.

To develop a course outline for "Clinical integrated diagnosis and treatment for advanced practice nurses",aiming to bridge the training of master of nursing specialist(MNS) postgraduates with the cultivation of advanced practice nurses in China.

The "Clinical integrated diagnosis and treatment for advanced practice nurses" course outline was established through literature review,semi-structured interviews, and a modified Delphi method.

Twenty-six experts were selected for two rounds of correspondence.The positive response rates for the two rounds were 92.86% and 100.00%,respectively.The authority coefficients of the experts were 0.896 and 0.915,and Kendall's harmony coefficients were 0.147 and 0.358(both P<0.001).The finalized course outline included four dimensions:course objectives,course content,course arrangement,and teaching and assessment methods.

The constructed course outline for "Clinical integrated diagnosis and treatment for advanced practice nurses" demonstrates scientific validity and feasibility.And it could provide a new reference and reform strategies for training advanced,practice nurses in China.

To investigate the causal relationship between 11 trace elements(calcium,iron,zinc,selenium,magnesium,copper,vitamin A,vitamin C,vitamin D,vitamin E,carotene),22 common dietary factors(alcohol consumption,beef,bread,cereal,cheese,coffee,cooked vegetable,dried fruit,fresh fruit,lamb,non-oily fish,oily fish,pork,poultry,processed meat,raw vegetable,salt added to food,tea,hot drinks,carbonated beverage,garlic intake,Chinese chive) and hyperemesis gravidarum using Mendelian randomization.

All data were summarized by using Genome-Wide Association Studies(GWAS),with single nucleotide polymorphisms(SNPs) as instrumental variables.Analyses were performed using inverse variance weighting,weighted mode,MR Egger,and weighted median.Cochrane's Q test was used to identify heterogeneity of results.MR Egger intercept test and "leave-one-out" test were applied to evaluate the robustness of the associations between the 11 trace elements,22 dietary factors and hyperemesis gravidarum.

The results showed that vitamin D supplementation could reduce the risk of hyperemesis gravidarum[OR=0.48,95%CI(0.30,0.75)].No significant effects of the other 10 trace elements or 22 dietary factors on the risk of hyperemesis gravidarum were observed(P>0.05).There was no horizontal pleiotropy or heterogeneity(P>0.05),indicating the robustness of the results.

Vitamin D could reduce the risk of hyperemesis gravidarum.No effects of the other 10 trace elements or 22 dietary factors on increasing or decreasing the risk of hyperemesis gravidarum were found temporarily.

To explore the group characteristics of medical staff with occupational exposure in different positions of public hospitals and compare their differences.

A retrospective analysis was conducted on the occupational exposure data reported by 637 medical staff from 4 public hospitals in 2 districts(Jiangsu province and Xinjiang Production and Construction Corps) from January 1,2018,to December 31,2022.A portrait study was carried out from the dimensions of sociodemographic characteristics and occupational exposure characteristics.Co-occurrence analysis and Apriori algorithm were used to explore the strong correlation characteristics and map the portraits.

The annual number of reported occupational exposure cases among medical staff was 139.0(109.0,140.0).Co-occurrence analysis showed that there were 5-7 high-intensity co-occurrence factors for doctors,nurses,standardized training interns,and logistics staff.For doctors,the co-occurrence intensity between "exposure during operation" and "standardized disposal" was the highest;for the other groups,the co-occurrence intensity between "sharp instrument injury" and "hand as the exposure site" was the highest.Association rule analysis yielded a total of 75 rules(confidence=0.70-1.00,lift=1.529-14.108),among which there were 2,42,27,and 4 rules strongly correlated with doctors,nurses,standardized training interns,and logistics staff,respectively.Portrait characteristics showed that the common characteristics of medical staff in all positions were sharp instrument injury,hand as the exposure site,and standardized disposal;the heterogeneous characteristics were reflected in age,gender,exposure location,exposure timing,and exposure source.

There are differences in key populations and typical characteristics of medical staff with occupational exposure in different positions.Analyzing and comparing their group characteristics could provide references for occupational safety and protection work.

To analyze the attribute characteristics of Traditional Chinese Medicine(TCM) health management needs among people with high-normal blood pressure based on the Kano model,providing a reference for improving TCM health services.

A total of 345 individuals with high-normal blood pressure registered at a grade A tertiary hospital and its community health center in Guangxi were selected as the study subjects.The Kano model was applied to identify the attributes of their TCM health management needs into must-be quality(M),one-dimensional quality(O),attractive quality(A),indifferent quality(I),and reverse quality(R).

Among the 36 demand items,12 were classified as must-be attributes,while 8 each were identified as one-dimensional,attractive,and indifferent attributes.Furthermore,26 indicators were screened for improvement.Prominent areas for enhancement included explanations of TCM concepts and knowledge related to high-normal blood pressure,the establishment of a TCM health information official network platform for high-normal blood pressure,and preventive monitoring of risk indicators.Within the same attribute category,the strongest improvement demands were for:convenient access to TCM diagnosis and treatment services with must-be attributes;explanations of TCM concepts and knowledge related to high-normal blood pressure with one-dimensional attributes; and collaboratively developing TCM health management plans with attractive attributes.

People with high-normal blood pressure have relatively high and multi-faceted demands for TCM health management,yet overall services remain insufficient.Future efforts should strengthen the convenience of TCM services to benefit communities and families,while addressing regional and demographic disparities.Furthermore,targeted measures should address deficiencies in areas such as TCM health education and shared decision-making.This includes gradually adjusting relevant talent training models,focusing on individual preferences,enhancing the promotion and application of TCM information platforms,and ultimately promoting the transformation of health awareness and behaviors in this population to effectively delay or curb disease progression.

To analyze the influencing factors of preoperative frailty in breast cancer patients and to develop a risk prediction model.

A total of 583 inpatients scheduled for surgical treatment in the breast surgery departments of two Grade A tertiary hospitals in Binzhou city,Shandong province,were selected between August 2024 and January 2025.They were randomly divided into a training set(408 cases) and a validation set(175 cases) in a 7∶3 ratio.Variables were screened using both Lasso regression and the Boruta algorithm.Four machine learning algorithms-support vector machine,decision tree,light gradient boosting machine,and extreme gradient boosting-were employed to develop prediction models.Model performance was compared based on accuracy,precision,sensitivity,specificity,F1-score,and the area under the receiver operating characteristic(ROC) curve(AUC).And the optimal model was interpreted using the SHAP method.

The incidence of preoperative frailty in breast cancer patients was 26.93%.Compared to the support vector machine,decision tree,and light gradient boosting machine models,the extreme gradient boosting model demonstrated the best performance,with an AUC of 0.909,accuracy of 0.829,precision of 0.646,sensitivity of 0.857,specificity of 0.818, and an F1-score of 0.737.The SHAP bar plot identified the top five influencing factors as age,hemoglobin,albumin,neutrophil percentage,and comorbidities.

The extreme gradient boosting model exhibits the best predictive performance and can serve as a reliable tool for healthcare providers to effectively assess and scientifically manage preoperative frailty in breast cancer patients.

To analyze the latent profiles of dementia fear among rural older adults and its influencing factors,aiming to provide a basis for developing targeted intervention strategies to promote healthy aging.

Using convenience sampling, 349 older adults from three rural areas in Hunan Province were selected from July to August 2023.A general information questionnaire, the Fear of Dementia Scale,and the Self-Perception of Aging Scale were used for investigation.Latent profile analysis was conducted to identify subgroups of dementia fear.Logistic regression analysis was applied to explore influencing factors.

Dementia fear among rural older adults could be divided into two latent profiles:no dementia fear group(32.67%) and moderate dementia fear group(67.33%). Logistic regression analysis showed that self-perception of aging(OR=1.113),age(OR=2.395,3.295),and exercise habits per week(OR=4.413) were influencing factors of latent profiles of dementia fear(P<0.05).

Dementia fear among rural older adults is at a moderate to low level with significant group heterogeneity.Individualized interventions should be implemented based on the characteristics of different subtypes to improve dementia fear of older adults.

To explore the current status and latent profiles of nurses' perception of interpersonal exchange communication in the pediatric intensive care unit(PICU),and to analyze its influencing factors.

From December 2024 to January 2025,a stratified sampling method was used to select 542 PICU nurses from 15 Grade-A tertiary hospitals in 13 regions of Hubei province as the research subjects.A general information questionnaire,the Nurses' Perception of Interpersonal Exchange Communication Questionnaire,the Information Competence Scale,and the Professional Quality of Life Scale were used for investigation.The latent profiles of nurses' perception of interpersonal exchange communication and the influencing factors of different profiles were analyzed.

The score of nurses' perception of interpersonal exchange communication in Hubei province was(76.31±12.68),which was at a moderately high level. The perceived nurse-physician interpersonal exchange of PICU nurses could be divided into 3 latent profiles:low-perception type (11.07%),medium-perception type(42.25%),and high-perception type(46.68%).Logistic regression analysis showed that compared with the low-perception type,nurses with higher information competence,no compassion fatigue,or mild compassion fatigue had a higher probability of belonging to the medium-perception type and high-perception type(P<0.05).

The PICU nurses' perception of interpersonal exchange communication in Hubei province is at a moderately high level.There is group heterogeneity.Nursing managers should identify the characteristics of nurses in each profile at an early stage and adopt targeted management strategies to improve the level of perception of interpersonal exchange communication and the quality of team interaction among PICU nurses.

To explore the relationship between social activity level and the risk of frailty among older adults in China.

This older adults aged ≥60 years without frailty were selected from the CHARLS database.A baseline survey was conducted in 2013,with follow-ups on frailty occurrence in 2015 and 2018. Poisson regression was used to analyze the impact of social activity level on frailty incidence.Subgroup analyses were further conducted based on gender,alcohol consumption, and life satisfaction.

A total of 3 287 older adults were included,with a frailty incidence of 19.17%.After controlling for variables such as age,gender,marital status,education level,and smoking status,older adults with a high level of social activity had a 34.9% lower risk of frailty compared to those with low to moderate levels[RR=0.651,95%CI(0.545,0.778)].Subgroup analysis showed that,except for older adults dissatisfied with their lives,where the association between social activity level and frailty risk was not statistically significant,the risk of frailty was significantly reduced in older adults with high social activity levels across different genders,alcohol consumption status,and those satisfied with their lives(P<0.05).

A high level of social activity is an important protective factor in delaying the onset of frailty.Additionally,we should pay attention to psychological and social changes in male older adults,those who consume alcohol,and those with high life satisfaction,so as to helping them build strong social networks and provide psychological interventions when necessary.

To clarify the conceptual connotation of plant-based diets and to provide theoretical guidance for research and practice related to plant-based diets.

Literature related to plant-based diets were systematically searched in databases including CNKI,Wanfang Data,VIP,CBM,PubMed,EMbase,Web of Science,and Scopus,with the search period ranging from the inception of each database to December 30,2024.Concept analysis of plant-based diets was performed according to the Walker and Avant method.

A total of 48 articles were included.Plant-based diets encompass three defining attributes:primary food sources being plant-based,diverse food choices,and potential restriction or exclusion of animal products.Antecedents include personal factors,social factors,and economic factors;consequences include health benefits,potential health risks,and environmental impacts.

The conceptual attributes of plant-based diets were clarified through concept analysis.Future research should focus on the positive impacts of plant-based diets to enhance public acceptance,and conduct more systematic and in-depth studies on personalized interventions for plant-based diets.

To define the conceptual connotation of social camouflaging in individuals with autism spectrum disorder using the Walker and Avant classic concept analysis method.

Keywords were used to search both Chinese and English databases,including PubMed, Web of Science,the Cochrane Library,OVID,EMbase,CNKI,VIP Chinese Journal Service Platform,Wanfang Data Knowledge Service Platform,and the Chinese Biomedical Literature Database.Manual searches of related literature were also conducted.Literature published from the inception of the databases until March 1,2025 concerning social camouflaging in autism spectrum disorder was systematically screened and analyzed using the Walker and Avant classic concept analysis method.

A total of 58 articles were included.The defining attributes of social camouflaging in individuals with autism spectrum disorder were identified as: masking characteristics,compensatory strategies,assimilation behaviors,and internalized stigma.Antecedents included socio-cultural factors, individual psychological factors, demographic factors, and social environmental factors.Consequences included both positive and negative impacts on autistic individuals, specifically facilitating social adaptation, impairing mental health,and hindering social support and interpersonal relationships.

The concept analysis of social camouflaging in autism spectrum disorder helps healthcare professionals accurately understand related symptoms in autistic patients,optimize diagnosis and treatment approaches, comprehend patients' social strategies and behaviors, and provides a basis for personalized interventions.

To retrieve and to summarize the best evidence on non-pharmacological weight management for overweight or obese patients with type 2 diabetes(T2DM).

Evidence was retrieved from databases and websites including BMJ Best Practice, UpToDate,JBI Centre for Evidence-Based Healthcare,National Institute for Health and Care Excellence(NICE),Guidelines International Network(GIN),Agency for Healthcare Research and Quality(AHRQ),World Health Organization(WHO) guidelines,Registered Nurses' Association of Ontario(RNAO),International Diabetes Federation(IDF),American Diabetes Association(ADA),MedLive,Cochrane Library,EMbase,CINAHL,Scopus,PubMed,Chinese Medical Association database,Wanfang Data,CNKI,CBM,and VIP databases,from inception to February 5,2025.After quality appraisal by two researchers,the best evidence for non-pharmacological weight management in overweight or obese T2DM patients was extracted and summarized.

A total of 20 articles were included,comprising 1 clinical practice article,1 clinical decision article,5 guidelines,5 expert consensuses,and 8 systematic reviews.Finally,23 best evidence items were summarized across four aspects: benefits of weight management,weight management goals,assessment and monitoring,and lifestyle interventions.

The summarized best evidence on non-pharmacological weight management for overweight or obese patients with T2DM is scientific and practical.It could provide a reference for healthcare professionals in managing the weight of this patient population.

To explore the differences in the application of interview method among grounded theory research, phenomenological research,and Q methodology in nursing qualitative research,so as to improve nursing researchers' ability to distinguish these three methods and provide references for method selection.

From the perspective of the interview method,a systematic collation and comparative analysis were conducted on the differences among grounded theory research,phenomenological research,and Q methodology in five aspects:application scope,interview sample selection,data collection,content analysis,and result presentation.

There were significant differences in interview strategies among the three methods.Grounded theory emphasizes theory generation and adopts theoretical sampling and constant comparative analysis;phenomenology focuses on the essence of life experience,with an emphasis on in-depth description and theme extraction;Q methodology integrates qualitative and quantitative methods to reveal subjective structures through statement sorting and factor analysis.Each method has its own focus in sample selection,data processing,and result expression,and should be selected reasonably according to the research question.

Nursing researchers should accurately grasp the methodological differences in the application of interview method among grounded theory,phenomenological research,and Q methodology,and select appropriate methods according to the research purpose.This will help improve the scientificity and rigor of research and promote the standardized application of qualitative research in the field of nursing.

To establish norms for the Professional Identity Scale of nursing undergraduates in China.

Using the Professional Identity Scale for nursing students as the assessment tool,a stratified cluster sampling method was adopted to survey 26 108 full-time nursing undergraduates from 46 universities across 23 provinces in China in May 2024.The mean norm,percentile norm,demarcation norm,and classification norm for the scale were developed.

The overall mean score of professional identity among nursing undergraduates was(3.709±0.618),with dimension scores as follows:professional value(3.516±0.680),professional cognition (4.030±0.639),and professional status(3.583±0.870).A mean norm combining gender and grade was constructed.Percentile norms were established at 5% intervals.Using the normal distribution method,cutoff standards for professional identity levels were determined and categorized into three grades:"low" "medium" and "high". Classification norms were also developed based on school type,whether students were admitted via program adjustment,place of origin,and whether they were only children.

The established norms for the Professional Identity Scale of nursing undergraduates in China can serve as reference for evaluating the professional identity levels of nursing undergraduates.

To translate the Metaverse Perception Scale for Nursing Students(MPSNS) into Chinese and to evaluate its reliability and validity among nursing students.

Following the Brislin translation-back-translation model,the MPSNS underwent forward translation,back-translation,and cultural adaptation.A preliminary survey was conducted to form the Chinese version of the MPSNS.Using convenience sampling,516 nursing students from two medical colleges in Qingdao city,Shandong Province,and two medical colleges in Zhenjiang city,Jiangsu province,were selected as participants for reliability and validity testing.

The Chinese version of the MPSNS consists of 24 items,including four dimensions:education(9 items),technology(5 items),challenges(5 items),and lifestyle(5 items).Confirmatory factor analysis indicated a good model fit.The overall Cronbach's α coefficient of the scale was 0.958.The test-retest reliability was 0.949.

The Chinese version of the MPSNS demonstrates good reliability and validity.It is a reliable tool for assessing nursing students' perceptions of the metaverse.It could provide reference for future research aimed at improving teaching quality.

To develop and validate the Sexual Health Needs Scale for Patients with Gynecologic Malignancies.

Under the guidance of the sexual health model for cancer patients,the initial scale was developed through literature review,qualitative research,expert consultation,and cognitive interviews.A total of 426 patients with gynecologic malignancies from a tertiary hospital in Hubei Province were surveyed between September and December 2024 to assess the reliability and validity of the scale.

Exploratory factor analysis extracted four common factors with eigenvalues>1,with a cumulative variance contribution rate of 67.546%. The formed Sexual Health Needs Scale for Patients with Gynecologic Malignancies included four dimensions:psychosexual health needs, partner-relational health needs,physical sexual health needs,and sociocultural support needs,comprising a total of 16 items.Confirmatory factor analysis indicated good model fit.The content validity index(CVI) of the scale was 0.989,with item-level CVIs ranging from 0.882 to 1.000.The overall Cronbach's α coefficient was 0.889,split-half reliability was 0.813,and test-retest reliability was 0.807.

The scale demonstrates good reliability and validity,making it an effective tool for assessing sexual health needs in patients with gynecologic malignancies.

To evaluate the quality of DeepSeek's responses to questions related to insulin injection in patients with type 2 diabetes.

Based on expert consensus and clinical practice for type 2 diabetes patients, 10 frequently asked questions regarding insulin injection were selected and input into DeepSeek to obtain answers. The responses were scored based on the consensus report jointly issued by the American Diabetes Association(ADA) and the European Association for the Study of Diabetes(EASD),across three dimensions:effectiveness(1-4 points),safety(1-4 points),and practicality(1-4 points).

The average scores for DeepSeek's responses were 3.6 for effectiveness,4.0 for safety,and 4.0 for practicality.Incomplete information was identified in 40% of the responses,but no safety risks were found.

DeepSeek can serve as an auxiliary tool for insulin injection education;however,its responses should be supplemented with guidance from healthcare professionals to ensure information completeness.

To investigate the impact of comprehensive nursing intervention on postoperative blood glucose levels and complication rates in patients with diabetic cataract.

242 patients with diabetic cataract were randomly divided into a control group and an observation group,with 121 patients in each group.The control group received routine nursing care,while the observation group received targeted comprehensive nursing intervention in addition to routine care.The incidence of postoperative complications was compared between the two groups.

The postoperative blood glucose control rate in the observation group(84.30%) was higher than that in the control group(73.60%),the complication rate(4.1%) was lower than that in the control group(19.0%),and the satisfaction rate (96.69%) was higher than that in the control group(73.55%).The differences were statistically significant(P<0.05).

The application of comprehensive nursing intervention in patients with diabetic cataract helps stabilize patients' blood glucose levels,reduces the incidence of postoperative complications,and improves patient satisfaction.