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BackgroundThe existing tools in China for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint do not sufficiently consider the specialty in psychiatric practice， and the scale items are somewhat cumbersome to use， which together restrict their further promotion and application. Accordingly， there is an urgent need for developing a more scientific assessment tool.ObjectiveTo construct a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint and to verify its reliability and validity， so as to provide a generic tool for the assessment.MethodsBased on the theoretical framework of the knowledge-attitude-practice model， the preliminary scale was formed through systematic literature review， qualitative interview and Delphi method. From July to December 2021， a stratified sampling was utilized to select 729 psychiatric nurses from tertiary， secondary and primary （including unclassified medical institutions and grassroots hospitals） psychiatric hospitals in Guangdong Province. The formal scale was developed through item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated by content validity and structure validity， and the reliability was verified by procedures including Cronbach's α coefficient， test-retest reliability， and split-half reliability.ResultsA total of 12 items of three dimensions （knowledge， attitude， practice） were included in the scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. The scale-level content validity index （S-CVI） was 0.941， and the item-level content validity index （I-CVI） ranged from 0.812 to 1.000. Exploratory factor analysis extracted three common factors， and the cumulative variance contribution rate was 62.948%. The confirmatory factor yielded adequate fit. Cronbach's α coefficient was found to be 0.887 for the scale， 0.819 for knowledge dimension， 0.842 for attitude dimension， and 0.831 for practice dimension. The split-half reliability and test-retest reliability for the scale were 0.712 and 0.922， respectively.ConclusionThe scale shows satisfactory reliability and validity， which can be used to assess psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. ［Funded by Guangdong Clinical Teaching Base Teaching Reform Research Project （number， 2021JD119）］

The aim of this study is to explore a novel classification and investigate the clinical significance of hepatocellular carcinoma (HCC) cells. We analyzed integrated single-cell RNA sequencing and bulk RNA-seq data obtained from HCC samples. Cell trajectory analysis divided HCC cells into three subgroups with different differentiation states: state 1 was closely related to phosphoric ester hydrolase activity, state 2 was involved in eukaryotic initiation factor 4E binding, translation regulator activity and ribosome, and state 3 was associated with oxidoreductase activity and metabolism. Three molecular classes based on HCC differentiation-related genes (HDRGs) from HCC samples were identified, which revealed immune checkpoint gene expression and overall survival (OS) of HCC patients. Moreover, a prognostic risk scoring (RS) model was generated based on eight HDRGs, and the results showed that the OS of the high-risk group was worse than that of the low-risk group. Further, potential therapeutic drugs were screened out based on eight prognostic RS-HDRGs. This study highlights the importance of HCC cell differentiation in immunotherapy, clinical prognosis, and potential molecular-targeted drugs for HCC patients, and proposes a direction for the development of individualized treatments for HCC.

This article gives a review on the application status and clinical effect of behavioral activation （BA） therapy for patients with late-life depression， in which the theoretical content， research status and the characteristics of clinical application of BA therapy for patients with late-life depression were introduced， and the existing limitations and possible directions for future research were summarized， so as to provide references for the localization of BA therapy for patients with late-life depression.

Change‐point detection studies the problem of detecting the changes in the underlying distribution of the data stream as soon as possible after the change happens. Modern large‐scale, high‐dimensional, and complex streaming data call for computationally (memory) efficient sequential change‐point detection algorithms that are also statistically powerful. This gives rise to a computation versus statistical power trade‐off, an aspect less emphasized in the past in classic literature. This tutorial takes this new perspective and reviews several sequential change‐point detection procedures, ranging from classic sequential change‐point detection algorithms to more recent non‐parametric procedures that consider computation, memory efficiency, and model robustness in the algorithm design. Our survey also contains classic performance analysis, which provides useful techniques for analyzing new procedures. This article is categorized under:Statistical Models > Time Series ModelsAlgorithms and Computational Methods > AlgorithmsData: Types and Structure > Time Series, Stochastic Processes, and Functional Data [ABSTRACT FROM AUTHOR]

The use of physical restraint had caused a series of unexpected impacts on patients, particularly psychological trauma. This qualitative study aimed to identify perspectives on physical restraint among patients with mental health conditions and to seek effective interventions targeting the psychological trauma which is caused by physical restraint. A semi‐structured interview was conducted in a public psychiatric hospital in China to explore perspectives on physical restraint among 26 patients who had undergone or witnessed physical restraint. The interview was conducted by experienced and qualified interviewers with mental health service backgrounds. The interviews were recorded and transcribed into words, and then preliminary themes were extracted and coded, finally thematic analysis was used to identify focused themes. Five themes were extracted: these were as follows: (1) The negative effects of physical restraint on patients; (2) The impairment of the relationship between nurse and patient due to physical restraint; (3) The decrease in patients' treatment adherence caused by physical restraint; (4) The positive outcomes of physical restraint; (5) The expectations of patients for improving the quality of nursing care. Conclusively, the use of physical restraint had critical impacts on patients, including psychological trauma, destruction of the nurse–patient relationship, and decreased adherence of treatment. These negative effects could impede clinical work. [ABSTRACT FROM AUTHOR]

Plant communities in urban wetland parks (UWP) have significant eco-healthcare benefits in terms of regulating the climate and improving the human living environment. However, factors influencing the regulation of eco-healthcare benefits are unclear. Taking Huaxi Ten Mile Beach National Urban Wetland Park as an example, the urban wetland park comprehensive healthcare index (UPCHI) was constructed based on an outdoor survey and indoor analysis to evaluate the UWP's eco-healthcare benefits. Pathway analysis was used to investigate how climatic, geographic, and plant factors interact to affect the UPCHI. The results show that, over the whole year, tree–shrub–herb showed the best performance in terms of reducing PM2.5, PM10, and noise, as well as raising negative air ion concentrations; however, human comfort performed the worst. The UPCHI was generally beyond level Ⅲ (0.49–0.58) in the spring and summer, indicating that there are eco-healthcare benefits. Overall, the deciduous tree–shrub–herb community had the highest annual mean UPCHI, and more than half of the plant communities' eco-healthcare benefits were class Ⅱ, which is very beneficial for eco-healthcare. The main direct factors on UPCHI were illumination intensity (0.68) and tree height (0.90), while canopy height (0.64–0.59) and tree crown radius/canopy height (0.72–0.14) directly or indirectly influenced UPCHI. The distance from the edge of the mountain (−0.39–−0.322) had a direct negative, but minor, effect on UPCHI. This study will assist residents with selecting suitable times and places for wetland recreation and healthcare activities, and it offers a valuable reference for the future planning and design of UWP plant communities. [ABSTRACT FROM AUTHOR]