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Deep venous thrombosis (DVT) is a common clinical vascular disease, and post-thrombotic syndrome is usually the complication of patients. This study was to explore the relationship between intraoperative hypothermia and DVT.Patients who were clinically diagnosed with intracranial tumors and underwent tumors resection from January 2019 to March 2021 were studied and divided into the DVT and non-DVT group. Prothrombin time, activated partial prothrombin time (ATPP), thrombin time, plasma fibrinogen, and venous flow velocity of both lower limbs were measured to observe DVT and the incidence of DVT. Univariate and multivariate logistic regression analyses were used to investigate the correlation between intraoperative hypothermia and DVT, and to analyze the DVT-related risk factors.A total of 462 patients were analyzed, of whom 231 patients were allocated to the DVT group and 231 were in the non-DVT group. Within the DVT group, 156 patients (33.8%) experienced intraoperative hypothermia. The risk factors that were significantly correlated with DVT were age, sex, operation time, ATPP value, and intraoperative hypothermia. The decreased ATPP value was found to be significantly associated with the increased incidence of DVT, and older ages (45 years) were highly associated with DVT. Low body temperature before operation and intraoperative hypothermia were statistically significant as well. In addition, significant association was also displayed between the patient's operation time (350 minutes) and DVT.Patients who underwent intracranial tumor resection experience a high incidence of DVT, and patients with intraoperative hypothermia are at greater risk of DVT.

Objectives Major infectious disease has become a serious threat to people’s health worldwide. As the world’s largest healthcare workforce and the core forces fighting against the epidemic, nurses are on the frontline of this battle. A number of ethical issues have given rise to numerous concerns that have largely affected nurses in different ways as they respond to the epidemic. In addition, excessive expectations from people can exert undue pressure, which can easily lead to burnout in nurses. Methods In this consensus, the expert panel method was used to develop and reach a consensus. The members involved in the formation of the consensus included an expert discussion panel and a consensus writing expert group, a methodologist, and four secretaries. After 16 rounds of online expert consultation and two rounds of expert panel meetings, the writing team analyzed and reviewed the 78 amendments suggested by the experts to develop a consensus on nursing ethics for prevention and control of major infectious disease outbreaks based on the ethical vision of life care. Results This expert consensus focuses on five essential domains: the responsibilities and rights of nurses, the nurse-patient relationship, the doctor-nurse relationship, and the relationship between society and nurses throughout the epidemic. Conclusions We hope this consensus can help nurses better understand and respond to the ethical issues and challenges in public health emergencies, and raise reasonable public expectations of the roles and responsibilities of nurses in these situations.

Li Li,1– 3 Jiangqi Zhou,3 Likun Luo,3 Xiaoqing Chen,3 Yinglan Li2,4 1Xinjiang Medical University,Urumqi, 830000,Xinjiang, People’s Republic of China; 2Nursing School, Xinjiang Medical University,Urumqi, 830000, Xinjiang, People’s Republic of China; 3Operating Room,The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, Xinjiang, People’s Republic of China; 4Xiangya Nursing School, Central South University, Changsha, 410000, Hunan Province, People’s Republic of ChinaCorrespondence: Yinglan Li School of Nursing, Xinjiang Medical University, Xuelianshan Campus of Xinjiang Medical University, No. 567 North Shangde Road, Hemaquan New District, Shuimogou District, Urumqi, 830000, Xinjiang, People’s Republic of ChinaEmail yuyan0202@sina.comBackground: To investigate the effect of the care bundle in the nursing care of the type A aortic dissection (TAAD).Methods: A total of 161 patients with TAAD were included in the study. They were divided into control group (n=79) and care bundle group (n=82). The patients in the control group received routine nursing, while the patients in the care bundle group received routine nursing and care bundle. IL-2, IL-6 and IL-10 levels in the three periods of T0 (before anesthesia), T1 (before anesthesia to 6 h after surgery) and T2 (6– 24 h after surgery), intraoperative blood loss, postoperative recovery, ICU stay time, intraoperative pressure ulcer rate, postoperative delirium rate, bloodstream infection rate and doctor satisfaction.Results: The postoperative T and pH levels in two groups were all in the normal range. The levels of IL-2, IL-6 and IL-10 in the care bundle group at different periods were also significantly different. The levels of IL-2 and IL-10 showed an increased trend, while that of IL-6 showed a downward trend. The intraoperative blood loss, postoperative recovery and ICU stay time, intraoperative pressure sore rate, postoperative delirium rate, and bloodstream infection rate were lower, whereas doctor satisfaction was all significantly higher in care bundle group.Conclusion: Care bundle increased the safety of the operation, and it was beneficial to the postoperative rehabilitation for TAAD patients.Relevance to Clinical Practice: Patients with TAAD who underwent operation need higher quality care during the entire operation. Cluster nursing is the kind of the nursing model that can better meet the requirements of the intraoperative nursing quality. The intervention methods in this study include 5 core nursing measures. These measures are implemented together in a synergistic manner to effectively improve the quality of nursing care in operating room and the health outcomes of patients with TAAD. Care bundle is worthy of clinical application.Keywords: care bundle, nursing care, type A aortic dissection

Background: Venous thromboembolism (VTE) including Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE), is a serious cause of patient morbidity and mortality in hospitals. Neurosurgical hospitalized patients have higher rates of immobility and bed rest, thus increasing their risk of developing VTE. This highlights the need for their thromboprophylaxis regimens. Patients'awareness of VTE is essential for promoting strategies such as early ambulation and encouraging self-assessment and self-reporting of VTE signs and symptoms. This study evaluated neurosurgical hospitalized patients’ awareness of VTE and explored the influencing factors to provide a theoretical basis for nursing intervention. Methods: We selected one tertiary level hospital in Hunan Province and randomly sampled eligible patients from each five neurosurgical units. We conducted a cross-sectional survey of the hospitalized patients of neurosurgery using the VTE knowledge questionnaire, and the influencing factors were analyzed using SPSS 26.0. Results: A total of 386 neurosurgical hospitalized patients completed the survey. The score of VTE knowledge in neurosurgical hospitalized patients was 13.22 (SD=11.52). 36.0% and 21.2% of participants reported they had heard of DVT and PE, respectively. 38.9% of participants were unable to correctly identify any symptoms of VTE. The most frequently identified risk factor was ‘immobility or bed rest for more than three days’ (50.0% of participants), and 38.1% of patients agreed that PE could cause death. 29.5% of participants were unable to identify any prophylactic measures of VTE. The results of Negative Binomial Regression showed that the influencing factors of VTE knowledge in neurosurgical hospitalized patients were education level (PConclusions: This study demonstrates the lack of awareness of VTE among neurosurgical hospitalized patients. More attention must be paid to carrying out training on VTE knowledge according to different characteristics of neurosurgical hospitalized patients, so as to ensure safe and high-quality patient care.

Objective To identify the potential associations of patient-, treatment-, and central venous access device (CVAD)-related factors with the CVAD-related thrombosis (CRT) risk in hospitalized children. Methods A systematic search of PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP database was conducted. RevMan 5.3 and Stata 12.0 statistical software were employed for data analysis. Results In terms of patient-related factors, the patient history of thrombosis (odds ratio [OR] = 3.88, 95% confidence interval [CI]: 2.57–5.85), gastrointestinal/liver disease (OR = 1.85, 95% CI: 0.99–3.46), hematologic disease (OR = 1.45, 95% CI: 1.06–1.99), and cancer (OR = 1.58, 95% CI: 1.01–2.48) were correlated with an increased risk of CRT. In terms of treatment-related factors, parenteral nutrition (PN)/total PN (OR = 1.70, 95% CI: 1.21–2.39), hemodialysis (OR = 2.17, 95% CI: 1.34–3.51), extracorporeal membrane oxygenation (OR = 1.51, 95% CI: 1.31–1.71), and cardiac catheterization (OR = 3.92, 95% CI: 1.06–14.44) were associated with an increased CRT risk, while antibiotics (OR = 0.46, 95% CI: 0.32–0.68) was associated with a reduced CRT risk. In terms of the CVAD-related factors, CRT risk was more significantly increased by peripherally inserted central catheter than tunneled lines (OR = 1.81, 95% CI: 1.15–2.85) or totally implantable venous access port (OR = 2.81, 95% CI: 1.41–5.60). And subclavian vein catheterization significantly contributed to a lower CRT risk than femoral vein catheterization (OR = 0.36, 95% CI: 0.14–0.88). Besides, multiple catheter lines (OR = 4.06, 95% CI: 3.01–5.47), multiple catheter lumens (OR = 3.71, 95% CI: 1.99–6.92), central line-associated bloodstream infection (OR = 2.66, 95% CI: 1.15–6.16), and catheter malfunction (OR = 1.65, 95% CI: 1.07–2.54) were associated with an increased CRT risk. Conclusion The exact identification of the effect of risk factors can boost the development of risk assessment tools with stratifying risks.

Background: Caring practice for critically ill patients refers to the actions/behaviors/performance of nurses while caring for critically ill adult patients in the intensive care unit (ICU). Although the caring practice is vital in ICUs and complex due to the multitude of availabletechnologies, research on ICU nurses’ caring practice and its predictive factors are lacking. Objective: This study aimed to explore the level of nurses’ caring practice for critically ill patients in critical technological environments in China and its predictors. Methods: This was a cross-sectional online survey study with 218 ICU nurses in 29 tertiary hospitals of Guizhou province, China, from 1st to 30th April 2020. Data were collected by using e-questionnaires made in the Questionnaire Star program, including the Demographic Data Questionnaire (DDQ), Practice of Technological Competency as Caring in Nursing Instrument (P-TCCNI), Influence of Technology Questionnaire (ITQ), and Nurses’ Professional Value Scale (NPVS). The questionnaires were content validated by three experts. Cronbach’s alpha coefficient was 0.96 for the P-TCCNI, 0.70 for the ITQ, and 0.95 for the NPVS. Links to the questionnaires were distributed by research assistants to WeChat groups including target participants. Statistical Package for the Social Science (SPSS) program version 26 (IBM Corporation, Armonk, NY, USA) was used for data analysis. Descriptive and inferential statistics were used to analyze the data. Multiple linear regression analysis using stepwise solution analysis was performed to identify unique predictors of nurses’ caring practice. Results: The level of nurses’ caring practice for critically ill patients was high (mean = 87.30, standard deviation = 13.73). The professional value was a significant predictor of nurses’ caring practice (β = 0.41, p = 0.00). Conclusion: ICU nurses exhibited a high level of caring practice. Professional value was a significant predictor of ICU nurses’ caring practice. Nursing administrators should understand the current situation of caring practice in critical technological environments and design strategies to maintain and improve ICU nurses’ professional value to increase the level of caring practice. Funding: This study was financially supported by a thesis grant from Thailand’s Education Hub for Southern Region of ASEAN Countries (TEH-AC) Scholarship through Prince of Songkla University, Thailand.

Objective: This study aimed to evaluate Chinese tertiary hospital nurses’ research output, research ability, and their related training needs regarding scientific research methodology and analyze the relations among them. Methods: A nationwide survey was conducted in China on a large sample of tertiary hospital nurses (n = 27,335) recruited from 22 provinces, autonomous regions, and municipalities. A validated, self-designed questionnaire, consisted of a common questionnaire, the Science Research Skills Self-Rating Questionnaire (SRSQ) and the Scientific Research Training Needs Questionnaire (SRTNQ) were used to assess nurses’ research output, self-rated research skills and research-training needs. Results: The nurses’ scientific research participation rates (with 4.13%, 7.85%, 5.35%, and 2.04% in research projects, research attendance, papers published, and patent, respectively) and their self-rated research skills 25.00 (12.50, 37.50) were very low. However, the research training needs were relatively high 53.12(37.50, 75.00). Significant differences in research participation rates (research projects, research attendance, papers published, and patent), scientific research skills, and research-training needs were determined by age, highest education level, nursing experience, employment, technical title, administrative post, and clinical tutoring experience (P

Transition metal nitrides have become a kind of promising alternative plasmonic materials. TixZr1−xNy ternary nitride films were prepared by magnetron co-sputtering method, and the effects of bias voltage and temperature on the structure and dielectric properties of the films were investigated. The experimental results show that all the films are fcc-structured, and high substrate bias and temperature can significantly improve the N and Ti content. Increasing substrate bias voltage or temperature can reduce the crossover frequency ωc at which the films transit from dielectric to metallic phase. Also, a high bias can greatly influence the energy loss of the films. Furthermore, the plasmonic quality factor can be effectively tailored by bias and temperature. Increasing bias can decrease the quality factor while high temperature (600 °C) can enhance the quality factor significantly. The study demonstrates that the TixZr1−xNy films, as one kind of alternative plamonic materials, have considerable performances, and their dielectric and plasmonic properties can be modulated by varying the bias voltage and temperature in a wide range.

Recently a SnS2 based NO2 gas sensor with a 30 ppb detection limit was demonstrated but this required high operation temperatures. Concurrently, SnS2 grown by chemical vapor deposition is known to naturally contain nanoscale defects, which could be exploited. Here, we significantly enhance the performance of a NO2 gas sensor based on SnS2 with nanoscale defects by photon illumination, and a detection limit of 2.5 ppb is achieved at room temperature. Using a classical Langmuir model and density functional theory simulations, we show S vacancies work as additional adsorption sites with fast adsorption times, higher adsorption energies, and an order of magnitude higher resistance change compared with pristine SnS2. More interestingly, when electron–hole pairs are excited by photon illumination, the average adsorption time first increases and then decreases with NO2 concentration, while the average desorption time always decreases with NO2 concentration. Our results give a deep understanding of photo-enhanced gas sensing of SnS2 with nanoscale defects, and thus open an interesting window for the design of high performance gas sensing devices based on 2D materials.

Manganese doped ZnO (Zn0.97Mn0.3Oy) thin films were deposited by magnetron pulsed co-sputtering. The oxygen content of the films was controlled by the gas flow ratio of oxygen to argon r. The influence of r on the structure, surface morphology, optical properties and resistivity of the films was studied. A preferential growth along c axis was found in all films. As r increases, the grain size decreases, but lattice constant c, compressive lattice stress σ, and the dislocation δ density increase. The absorption edge shifts toward the shorter wavelength with r increasing, and the optical band gap is narrowed by lower r values. The resistivity of the films is also reduced by lower oxygen partial pressure. The results indicate a possibility to fabricate multifunctional devices using manganese doped ZnO thin films.

This cross-sectional study investigated the prevalence and risk factors of work-related musculoskeletal disorders among intensive care nurses in the Hunan Province of China. Nurses working in mixed intensive care units of 20 tertiary hospitals in this province participated in an online survey regarding work-related musculoskeletal injuries. The seven-part questionnaire included basic demographics; job and workplace characteristics; risk perception; physical, psychosocial, and workplace organizational factors; and musculoskeletal symptoms. The response rate was 70.7% (702 of 993 nurses). Approximately 97% of the respondents reported experiencing at least one work-related musculoskeletal disorder within the previous year. Low back pain was the most commonly reported musculoskeletal disorder (80.1%), followed by neck (78.6%) and shoulder pain (70.4%). The multivariate logistic regression analysis indicated that work-related musculoskeletal disorders were significantly associated with female gender (odds ratio [OR] = 0.115), unmarried status (OR = 0.136), a greater perception of risk (OR = 2.352), and lack of a safe work environment (OR = 1.056). These findings underscore the need for nurses and managers to reinforce risk awareness, improve physical and psychosocial working conditions, and promote a safer work environment.

Background: Intensive care unit (ICU) nurses are at high risk for work-related musculoskeletal disorders (WRMDs). Data on occupational injuries indicate the significance of WRMDs among ICU nurses. Intervention programs have previously been developed to reduce WRMDs, but different intervention methods need to be adopted for different groups of people. This study aimed to evaluate the effectiveness of a multidimensional intervention program to prevent and reduce WRMDs in ICU nurses.Methods: This study was designed as a two-armed cluster-controlled trial with an intervention group and a control group. The clusters were independent hospital ICUs, and the participants consisted of registered nurses in China. By cluster random sampling, 89 nurses from two ICUs were assigned to the intervention group, and 101 nurses from two other ICUs were assigned to the control group. A multidimensional intervention program based on previous studies was designed. This program combined improving risk perception, health behavior training, and promoting a safe working environment. The multidimensional intervention program was implemented in the intervention group, whereas routine specialist training was implemented in the control group. Baseline and follow-up (3 and 6 months) data were collected using self-reported online questionnaires. The primary outcome was the report rate of WRMDs in the past 7 days. Secondary outcomes were risk perception, application of health behavior, and perception of a safe working environment. The data were statistically analyzed using SPSS 19.0.Results: A total of 190 nurses provided three recorded outcome measurements (intervention group, N = 89 (94.68%); control group, N = 101 (94.39%)). After 6 months, the intervention group experienced significant improvement relative to the control group in the report rate of WRMDs in the past 7 days (OR = 1.953, p = 0.037), risk perception (OR = 0.517, p < 0.001), application of health behavior (OR = 0.025, p < 0.001), and perception of a safe working environment (OR = 1.637, p = 0.024).Conclusion: The multidimensional intervention program was superior to routine specialist training in preventing the occurrence of WRMDs in ICU nurses. WRMD training should include multifaceted approaches and pay increased attention to specific department functions.

Background Intensive care unit (ICU) nurses are at high risk for work-related musculoskeletal disorders (WRMDs). Data on occupational injuries indicate the significance of WRMDs among ICU nurses. Intervention programs have previously been developed to reduce WRMDs, but different intervention methods need to be adopted for different groups of people. This study aimed to evaluate the effectiveness of a multidimensional intervention program to prevent and reduce WRMDs in ICU nurses. Methods This study was designed as a two-armed cluster-controlled trial with an intervention group and a control group. The clusters were independent hospital ICUs, and the participants consisted of registered nurses in China. By cluster random sampling, 89 nurses from two ICUs were assigned to the intervention group, and 101 nurses from two other ICUs were assigned to the control group. A multidimensional intervention program based on previous studies was designed. This program combined improving risk perception, health behavior training, and promoting a safe working environment. The multidimensional intervention program was implemented in the intervention group, whereas routine specialist training was implemented in the control group. Baseline and follow-up (3 and 6 months) data were collected using self-reported online questionnaires. The primary outcome was the report rate of WRMDs in the past 7 days. Secondary outcomes were risk perception, application of health behavior, and perception of a safe working environment. The data were statistically analyzed using SPSS 19.0. Results A total of 190 nurses provided three recorded outcome measurements (intervention group, N = 89 (94.68%); control group, N = 101 (94.39%)). After 6 months, the intervention group experienced significant improvement relative to the control group in the report rate of WRMDs in the past 7 days (OR = 1.953, p = 0.037), risk perception (OR = 0.517, p p p = 0.024). Conclusion The multidimensional intervention program was superior to routine specialist training in preventing the occurrence of WRMDs in ICU nurses. WRMD training should include multifaceted approaches and pay increased attention to specific department functions.

Ternary nitride gives high diversity and tunability of the plasmonic materials. In this work, highly crystallized ternary (Ti, Zr)N x films were prepared by magnetron co-sputtering with different nitrogen gas flow ratio R n . The structural and plasmonic properties of the films tuned by R n were investigated. All the films are solid solutions of TiN x and ZrN x with a rocksalt structure and (111) preferred orientation. The films are nitrogen-overstoichiometric and the main defects are cation vacancies. Increased R n reduces the zirconium content, and therefore leads to the reduction of lattice constant and enhancement of the crystallinity. As R n increases, the screened plasma frequency decreases for the reduction of free electron density. The maximum of the energy loss spectra of (Ti, Zr)N x films shifts to long-wavelength with R n increasing. The calculated electronic structure shows that increased nitrogen content enhances the electronic density of states of nitrogen and reduces that of metal, and therefore elevates the energy level at which interband transition is exited. The results show that (Ti, Zr)N x films give a relatively high plasmonic quality in the visible and near-infrared region, and the film properties can be significantly tuned by the nitrogen content.

AIMS To investigate patient safety culture and its relationship with obstacles to adverse event reporting in Chinese nursing homes. BACKGROUND Reporting obstacles are related to high incidences and unreported rates of adverse events. Patient safety culture is also associated with adverse events. However, the relationship between reporting obstacles and patient safety culture in nursing homes is unclear. METHODS A cross-sectional survey was conducted with a random sampling method among 549 staff members in six nursing homes using instruments of the Nursing Home Survey on Patient Safety Culture and the Adverse Event Reporting Obstacle Scale. The Pearson correlation coefficient, independent t tests, ANOVA tests and multivariate regression analysis were used. RESULTS Patient safety culture in nursing homes was associated with facility ownership (p

Summary: Purpose: This study explored the direct and indirect effects of risk factors of work-related musculoskeletal disorders (WRMDs) in nurses working in intensive care units (ICUs). Methods: A cross-sectional study design was used. ICU nurses from 28 tertiary hospitals in the Hunan and Guangdong provinces participated in a survey conducted via a self-reported online questionnaire. A structural equation model was used to fit the data and to evaluate associations among WRMDs and risk factors. Results: Valid questionnaire samples were submitted by 984 ICU nurses. The prevalence of WRMDs within the previous year among ICU nurses was 96.8%. A valid structural equation model was constructed, and a good fit was shown: Chi-square value/degrees of freedom = 2.248; comparative fit index = .931; normal fit index = .905; goodness-of-fit index = .978; adjusted goodness-of-fit index = .966; and root mean square error of approximation = .036. All regression coefficients for direct effect reached significant levels (critical ratio > 1.96 and p

In this study, the author considers an operation strategy of energy hubs for commercial buildings based on tiered temperature control, with the objective of balancing the operation cost and comfort level. A tiered temperature deviation penalty tariff is formulated to measure different levels of temperature deviation. Considering a set of uncertain factors, including photovoltaic output, load demand and outside temperature, this stochastic optimisation model can be converted into a mixed-integer linear program, solved by commercial optimisation solver, CPLEX. Numerical simulations verify the efficiency of the proposed operation strategy.

Titanium oxynitride ( $${\hbox {TiO}}_{x}{\hbox {N}}_{y}$$ ) thin films were fabricated by ion beam-assisted sputtering deposition. Effects of oxygen contribution, assisting ion energy ( $$E_{\mathrm{a}}$$ ), assisting ion beam current ( $$I_{\mathrm{a}}$$ ) on the microstructure and dielectric behavior of the films were analyzed. The results show that increasing O content made the films to turn from fcc-TiN (111)-oriented to fcc $${\hbox {TiO}}_{x}{{\hbox {N}}}_{y}$$ (220)-oriented. Proper $$E_{\mathrm{a}}$$ and low $$I_{\mathrm{a}}$$ can enhance the (220) orientation in $${\hbox {TiO}}_{x}{{\hbox {N}}}_{y}$$ thin films. The increase in oxygen content leads to the red-shift of plasmonic resonant frequency and makes the films more dielectric. Higher $$E_{\mathrm{a}}$$ and $$I_{\mathrm{a}}$$ make the $${\hbox {TiO}}_{x}{{\hbox {N}}}_{y}$$ films more metallic. Atomic composition is an important factor underlying the results. The study provides a method to control the plasmonic properties of oxynitride films in a wide range by atomic composition and assisting ions.

ZnO films codoped by copper and nitrogen were prepared by magnetron cosputtering. The effects of this codoping on the structural and optical properties of ZnO films were systematically studied. The results show that Cu–N codoping didn’t affect the optimal orientation. Cu–N codoping can enlarge the grain size, enhance the crystallinity, reduce the stress and lead to denser and smoother surface. A significant red shift of absorption edge and gap-narrowing effect resulting from codoping were found in ZnO films. Cu-doping, N-doping, and oxygen vacancy are the main factors leading to property modification of the ZnO films. By Cu–N codoping, we can modulate the microstructure and optical properties of ZnO films in a wider range.

Introduction Triage is implemented to facilitate timely and appropriate treatment of patients, and is typically conducted by senior nurses. Triage accuracy and consistency across emergency departments remain a problem in mainland China. This study aimed to investigate the current status of triage practice and knowledge among emergency nurses in Changsha, Hunan Province, China. Method A sample of 300 emergency nurses was selected from 13 tertiary hospitals in Changsha and a total of 193 completed surveys were returned (response rate = 64.3%). Surveys were circulated to head nurses, who then distributed them to nurses who met the selection criteria. Nurses were asked to complete the surveys and return them via dedicated survey return boxes that were placed in discreet locations to ensure anonymity. Results Just over half (50.8%) of participants reported receiving dedicated triage training, which was provided by their employer (38.6%), an education organisation (30.7%) or at a conference (26.1%). Approximately half (53.2%) reported using formal triage scales, which were predominantly 4-tier (43%) or 5-tier (34%). Conclusions The findings highlight variability in triage practices and training of emergency nurses in Changsha. This has implications for the comparability of triage data and transferability of triage skills across hospitals. Refereed/Peer-reviewed

Titanium nitride ( TiN x ) is regarded as a kind of promising plasmonic material for its high performances. We studied the influence of nitrogen partial pressure p n and deposition temperature T d on the structural and plasmonic properties of the TiN x thin films prepared by ion beam assisted deposition (IBAD). The results show that IBAD is an effective method to tailor the plasmonic properties of TiN x films in visible and near-IR region. The plasmonic properties of the films have significant T d and p n dependence. Higher p n and lower T d can reduce the plasma frequency and the plasmon resonance. Higher p n and higher T d can reduce the optical loss of the samples. The modification of the plasmonic properties is related to the variation of nitrogen content.

Application of dexmedetomidine combined with sufentanil in colon cancer resection and its effect on immune and coagulation function of patients was studied. Colon cancer cases (n=176) admitted to Xiangya Hospital Central South University were selected into the study. They were divided into group A (n=92) and group B (n=84). In group A, patients underwent surgery anesthesia with dexmedetomidine combined with sufentanil. In group B, patients underwent surgery anesthesia only with sufentanil. The anesthesia induced intubation, operation time and incidence of postoperative adverse reaction of patients were compared between the two groups. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed and recorded before induction, before intubation and after intubation. Blood coagulation analyzer was used to detect four items of coagulation before and after operation. FACSCalibur flow cytometry was used to detect T lymphocyte subsets in peripheral blood of patients in the two groups. The pain scores (VAS) of patients in the two groups were measured and recorded after surgery at 4, 24 and 48 h. There was a difference in anesthesia induced intubation and operation time of patients in both groups (P

IntroductionChronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease. It has adverse effects on patients’ physical health, mental well-being and quality of life. The purpose of mindfulness-based interventions (MBIs) is to raise non-judgemental awareness and attention to current internal and external experiences. This means the attention is shifted from perceived and involuntary inner activities to current experience, keeping more curious, open and accepting attitudes towards current experience. Although some studies on the intervention effect of MBIs in patients with COPD have been conducted, the results are controversial, especially on dyspnoea, level of mindfulness and quality of life. Therefore, a systematic review of MBIs in patients with COPD is required to provide available evidence for further study.Methods and analysisIn this study, different studies from various databases will be involved. Randomised controlled trials(RCTs)/quantitative studies, qualitative studies and case studies on the effect of MBIs in patients with COPD aged over 18 years will be included. We will search the literature in the databases of PubMed, Excepta Medica Base (EMBASE), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, PsycINFO and China National Knowledge Infrastructure(CNKI). The primary outcomes will include efficacy of MBIs for patients with COPD in terms of dyspnoea, depression and anxiety. The secondary outcomes will include efficacy of MBIs in terms of quality of life, mindful awareness, 6-minute walk test(6MWT) and nutritional risk index. Data extraction will be conducted by two researchers independently, and risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0.Ethics and disseminationSince this study is a systematic review, the findings are based on the published evidence. Therefore, examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations.PROSPERO registration numberCRD42018102323.

To develop an intervention protocol for children's unintentional injury risk behaviors, and to evaluate the feasibility of the protocol. Methods: By theoretically analyzing the influential factors for children's unintentional injury risk behaviors, children's cognitive development characteristics and the social learning theory, an intervention protocol was established on the basis of changing the unintentional injury attribution and negative information transmission of risk behavior consequences. A primary school in Changsha city was selected by random cluster sampling. A community-based randomized controlled trial was conducted on the selected students once a week for 5 consecutive weeks. The scores of unintentional injury risk behavior before intervention, 3 months and 6 months after intervention, and the frequency before intervention and 6 months after intervention, were collected and compared. Results: A total of 194 children were included in the study: 98 in the intervention group; 96 in the control group; 96 (49.5%) boys and 98 (50.5%) girls between 7 and 8 years old. The scores of unintentional injury risk behavior for children in the intervention group at 3 and 6 months after intervention were 14.42±5.67 and 14.14±8.95, respectively, lower than those before the intervention (16.85±8.48) and in the control group (P=0.001). The number of minor unintentional injuries in the intervention group decreased from 119 to 56, and the number of children suffering 2 or more injuries dropped from 34 to 10 (P0.001) at 6 months after the intervention, while both of them were lower than that in the control group (P=0.011). Similar changes were observed in some slight or more serious unintentional injuries (P=0.030). Conclusion: The protocol for changing the attribution to unintentional injury and negative information transmission for risk behavior consequences was proved to effectively reduce children's unintentional injury risk behaviors and relevant events.目的：构建儿童非故意伤害危险行为干预方案，评价该方案的可行性，减少儿童非故意伤害危险行为及非故意伤害事件。方法：通过理论分析儿童非故意伤害危险行为的影响因素、儿童认知发展特征及社会学习理论，建立以改变非故意伤害归因、危险行为后果负性信息传递为基础的干预方案，采用随机整群抽样抽取一所长沙市市区小学，对抽取的学生进行连续5周，每周1次的社区随机对照试验。通过干预前、干预后3个月及干预后6个月非故意伤害危险行为得分的比较，以及干预前及干预后6个月非故意伤害次数比较评价干预效果。结果：194名儿童完成了随访，其中男童96人(49.5%)，女童98人(50.5%)，年龄7~8岁；干预组98人，对照组96人。干预后3个月、6个月干预组儿童非故意伤害危险行为得分分别是14.42±5.67和14.14±8.95，低于干预前的16.85±8.48，且低于对照组(P=0.001)；干预后6个月内，干预组的轻微非故意伤害的发生人次从干预前的119减至56，≥2次轻微伤害人数从34人减至10人(P0.001)，均低于对照组(P=0.011)；干预组的轻度及轻度以上非故意伤害发生人数少于对照组(P=0.030)。结论：以改变非故意伤害归因和危险行为后果负性信息传递为基础的干预方案可以有效减少儿童非故意伤害危险行为和非故意伤害事件。.

Ion beam assisted titanium nitride (TiN) film has attracted much attention because its fast texture and high conductivity can be effectively applied in all-conductive superconducting coated conductor. In this work, TiN films were prepared by ion beam sputtering deposition from a metal titanium target. Effects of sputtering ion energy, assisting ion energy, assisting ion current and deposition temperature on the orientation and surface morphology were analyzed. The results indicate that assisting ion is an important factor in orientation selection, and high assisting ions and low assisting ion current could enhance the crystallinity. However, too high assisting ion energy and current can destroy the crystallinity in IBAD–TiN. This orientation selection can be attributed to the energy exchange between assisting ions and adatoms.