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Hypertension is a common complication of pregnancy, and studies show that pregnant women are more likely to suffer from restless legs syndrome (RLS). Pregnant women with hypertension and RLS often experience disrupted sleep patterns because of activation of the nervous system. The present study aimed to clarify the relationship between hypertension and RLS in pregnant women, and their impact on sleep. We enrolled 3,781 pregnant women who were admitted at our hospital for delivery between May 2011 and May 2014. The face-to-face questionnaire used to gather data included the International RLS Study Group criteria for diagnosis, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and hypertension diagnosis. Depending on the time of occurrence of hypertension, it was divided into two different types: pregnancy-induced hypertension and chronic hypertension in pregnancy. Out of 3,781 patients, 453 fulfilled the diagnostic criteria for RLS and 486 met the diagnostic criteria for hypertension. Among patients with RLS, prophylactic iron supplementation was less frequently taken during pregnancy. Pregnancy-induced hypertension, rather than chronic hypertension in pregnancy, was found to be more frequent in patients with RLS; pregnant women with RLS had higher PSQI and ESS scores than pregnant controls. In our study, RLS was frequent in pregnant women, especially in those without prophylactic iron supplementation. Patients with RLS described more serious sleep disruption and excessive daytime sleepiness (EDS). In addition, pregnancy-induced hypertension was more common in patients with RLS. [ABSTRACT FROM AUTHOR]

Aim: To examine first‐line nurse managers’ perceptions of safety culture and explore relationships between their safety attitudes and safety factors in Henan Province, China. Background: Health providers’ perceptions of patient safety culture have been studied widely, but little is known about first‐line nurse managers’ safety attitudes. Methods: A cross‐sectional survey was conducted with a convenience sample of 823 first‐line nurse managers in 216 hospitals across Henan Province, China. The Safety Attitudes Questionnaire (Chinese version) was distributed to first‐line nurse managers during training meetings; responses were returned in a sealed envelope in person or by mail. ANOVAs were used to analyse the differences in Safety Attitudes Questionnaire (Chinese version) scores between first‐line nurse managers’ attitudes and safety factors. Results: The mean scores across the six domains of Safety Attitudes Questionnaire (Chinese version) ranged from 56.6 to 79.4 on a 100‐point scale. First‐line nurse managers: ≥45 years of age perceived better safety climate (p < .05); those with higher professional ranks and medical centre positions reported higher mean scores for teamwork climate (p < .01) and stress recognition (p < .01); and those with baccalaureate degrees or higher had significantly higher mean scores for stress recognition (p < .01). Conclusion: First‐line nurse managers’ safety attitudes were not satisfactory and there is great potential to improve patient safety culture. Age, hospital level, educational background and professional rank are positively related to first‐line nurse managers’ attitudes. Implications for Nursing Management: Hospital administrators and nurse directors should focus on the safety factors identified in this study and enact a variety of strategies to create a strong patient safety culture in China. [ABSTRACT FROM AUTHOR]

PARP inhibitors (PARPi) are known to exert anti-tumor effects in patients with BRCA-mutated (BRCAmut) or homologous recombination (HR)-deficient cancer, but recent clinical investigations have suggested that this treatment may also be beneficial in patients with HR-proficient tumors. In this study, we aimed to investigate how PARPi exerts anti-tumor effects in non-BRCAmut tumors. BRCA wild-type, HR-deficient-negative ID8 and E0771 murine tumor cells were treated in vitro and in vivo with olaparib, a clinically approved PARPi. The effects on tumor growth in vivo were determined in immune-proficient and -deficient mice and alterations of immune cell infiltrations were analyzed with flow cytometry. Tumor-associated macrophages (TAMs) were further investigated with RNA-seq and flow cytometry. In addition, we confirmed olaparib's effect on human TAMs. Olaparib did not affect HR-proficient tumor cell proliferation and survival in vitro. However, olaparib significantly decreased tumor growth in C57BL/6 and SCID-beige mice (defective in lymphoid development and NK cell activity). Olaparib increased macrophage numbers in the tumor microenvironment, and their depletion diminished the anti-tumor effects of olaparib in vivo. Further analysis revealed that olaparib improved TAM-associated phagocytosis of cancer cells. Notably, this enhancement was not solely reliant on the "Don't Eat Me" CD47/SIRPα signal. In addition, compared to monotherapy, the concomitant administration of αCD47 antibodies with olaparib improved tumor control. Our work provides evidence for broadening the application of PARPi in HR-proficient cancer patients and paves the way for developing novel combined immunotherapy to upgrade the anti-tumor effects of macrophages. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the prevalence and associated risk factors of lower urinary tract symptoms ( LUTS) in people with stroke. This was the first study that systematically surveyed the risk factors for LUTS in people with various lengths of stroke history in urban Chinese communities. Methods A community-based, cross-sectional study was performed on 1404 residents aged over 40 years, randomly selected in the urban area of Zhengzhou, China. A questionnaire including the subjects' general health information, sociodemographic background, medical history, and the overactive bladder symptom score ( OABSS) was filled by the subjects on site. Results Data from 706 (63.8.9 ± 8.9 years old) stroke subjects and 698 non-stroke subjects were analyzed. The prevalence of LUTS in stroke subjects was 62.6%, significantly higher than non-stroke subjects. The prevalence in men was higher than women ( P < 0.01). The stroke subjects with diabetes mellitus had higher odds for LUTS than those without diabetes ( P < 0.05). The prevalence of LUTS was also significantly correlated with increasing age, high educational level, living alone, snoring, hypertension and coronary heart diseases ( P < 0.01). Conclusions Our study identified not only putative risk factors for LUTS in middle-aged and elderly stroke patients, but genuine factors including snoring, living environment and educational background that increased the odds of storage symptoms as well. We identified that regular exercise and living with their children were protective factors for storage symptoms in stroke patients. [ABSTRACT FROM AUTHOR]

Background: Down-regulation of epidermal growth factor (EGF) in the renal parenchyma has been demonstrated in children who underwent pyeloplasty due to ureteropelvic junction obstruction (UPJO). Urine levels of EGF were confirmed to parallel this finding before and after surgery. The aim of our study was to evaluate the relationship between urinary EGF (uEGF) concentrations and Society of Fetal Urology (SFU) high-grade hydronephrosis in infants presenting unilateral antenatal hydronephrosis (ANH). Methods: This was a prospective study involving 45 infants (33 in the observational group, 12 in the surgical group) who presented with unilateral ANH. Postnatal evaluation included a clinical examination, renal ultrasonography, and voiding cystourethrography. Diuretic renal scans were performed in infants with an initial SFU grade 3 or 4 hydronephrosis or increasing hydronephrosis during follow-up. Pyeloplasty was performed when a well-tempered renogram showed an obstructive drainage curve with a half-life of >20 min and/or an obstructive washout curve pattern during the diuretic phase. We studied the longitudinal changes in SFU hydronephrosis grade and uEGF in each group and compared concentration levels at three time points in both groups. The enzyme-linked immunosorbent assay (ELISA) method was used to measure EGF concentrations in the urine. The results were normalized with urinary creatinine (Cr). Results: During the first 6 months, from 6 to 12 months, and in the second year of life, median SFU hydronephrosis grade and uEGF levels were 2, 2 ( p = 0.015), and 1 ( p < 0.01), and 50, 59 ( p = 0.015), and 69.5 ng/mg Cr ( p < 0.01), respectively, in the observational group. In the first 6 months, preoperatively and at 3-12 months postoperatively, the median SFU hydronephrosis grade and uEGF levels were 4, 4, and 3 ( p > 0.05), and 38, 46, ( p > 0.05), and 55 ng/mg Cr ( p < 0.01), respectively, in the surgical group. uEGF levels in the first 6 months of life were significantly lower in the surgical group than in the observational group ( p < 0.01). Patients in the observational group with SFU grade 3-4 hydronephrosis showed higher uEGF levels than those in the surgical group with SFU grade 3-4 in ( p = 0.048). Conclusions: Urinary EGF changes over time are associated with inverse changes in SFU hydronephrosis grade, which suggests a role for uEGF as a predictive marker of worsening hydronephrosis grades in infants with ANH. uEGF in the first 6 months of life may predict the need for surgery in infants with ANH. [ABSTRACT FROM AUTHOR]