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As the frequency of infectious diseases rises, it's more important than ever to pay attention to the competency level of front-line nurses as the primary force in front-line rescue, which has an impact on the quality of anti-epidemic response. This paper aims to construct the competency evaluation index system for front-line nurses during the outbreak of major infectious diseases. This study combined literature review, critical incident technique interviews, and semi-structured in-depth interviews, as well as two rounds of Delphi expert correspondence, to construct a competence evaluation index system for front-line nurses during the outbreak of major infectious diseases. The study used purposive sampling to select 26 experts from 11 provinces and cities across China to conduct two rounds of Delphi expert consultation, and the indicators were selected based on the mean importance score > 3.5 and the coefficient of variation < 0.25, and the weights of the indicators were calculated by the Analytic Hierarchy Process. The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%. The effective recovery rates of the two rounds of correspondence questionnaires were 93.1% and 96%, the authority coefficients of experts were 0.96 and 0.98, the Kendall's coordination coefficients of the first, second, and third level indexes were 0.281, 0.132, and 0.285 (P < 0.001), 0.259, 0.158, and 0.415 (P < 0.001). The final index system includes 4 primary indicators (Knowledge System of Infectious Diseases, Nursing Skills for Infectious Diseases, Related Professional Abilities for Infectious Diseases, and Comprehensive Quality), 10 secondary indicators, and 64 tertiary indicators. The competency evaluation index system of front-line nurses during the outbreak of major infectious diseases is scientific, reasonable, and practical, which can provide a scientific basis for nursing managers to accurately understand, describe, analyze, and evaluate the competence level of nursing staff and scientifically implement the allocation of human resources in the future, as well as serve as a content framework for subsequent training programs.

Background Reduced supplies of oxygen and nutrients caused by vascular injury lead to difficult-to-heal pressure ulcers (PU) in clinical practice. Rapid vascular repair in the skin wound is the key to the resolution of this challenge, but clinical measures are still limited. We described the beneficial effects of extracellular vesicle-derived silk fibroin nanoparticles (NPs) loaded with milk fat globule EGF factor 8 (MFGE8) on accelerating skin blood vessel and PU healing by targeting CD13 in the vascular endothelial cells (VECs). Methods CD13, the specific targeting protein of NGR, and MFGE8, an inhibitor of ferroptosis, were detected in VECs and PU tissues. Then, NPs were synthesized via silk fibroin, and MFGE8-coated NPs (NPs@MFGE8) were assembled via loading purified protein MFGE8 produced by Chinese hamster ovary cells. Lentivirus was used to over-express MFGE8 in VECs and obtained MFGE8-engineered extracellular vesicles (EVs-MFGE8) secreted by these VECs. The inhibitory effect of EVs-MFGE8 or NPs@MFGE8 on ferroptosis was detected in vitro. The NGR peptide cross-linked with NPs@MFGE8 was assembled into NGR-NPs@MFGE8. Collagen and silk fibroin were used to synthesize the silk fibroin/collagen hydrogel. After being loaded with NGR-NPs@MFGE8, silk fibroin/collagen hydrogel sustained-release carrier was synthesized to investigate the repair effect on PU in vivo. Results MFGE8 was decreased, and CD13 was increased in PU tissues. Similar to the effect of EVs-MFGE8 on inhibiting ferroptosis, NPs@MFGE8 could inhibit the mitochondrial autophagy-induced ferroptosis of VECs. Compared with the hydrogels loaded with NPs or NPs@MFGE8, the hydrogels loaded with NGR-NPs@MFGE8 consistently released NGR-NPs@MFGE8 targeting CD13 in VECs, thereby inhibiting mitochondrial autophagy and ferroptosis caused by hypoxia and accelerating wound healing effectively in rats. Conclusions The silk fibroin/collagen hydrogel sustained-release carrier loaded with NGR-NPs@MFGE8 was of great significance to use as a wound dressing to inhibit the ferroptosis of VECs by targeting CD13 in PU tissues, preventing PU formation and promoting wound healing. Graphical Abstract

Multi-carbon alcohols such as ethanol are valued as fuels in view of their high energy density and ready transport. Unfortunately, the selectivity toward alcohols in CO 2 /CO electroreduction is diminished by ethylene production, especially when operating at high current densities (>100 mA cm −2 ). Here we report a metal doping approach to tune the adsorption of hydrogen at the copper surface and thereby promote alcohol production. Using density functional theory calculations, we screen a suite of transition metal dopants and find that incorporating Pd in Cu moderates hydrogen adsorption and assists the hydrogenation of C 2 intermediates, providing a means to favour alcohol production and suppress ethylene. We synthesize a Pd-doped Cu catalyst that achieves a Faradaic efficiency of 40% toward alcohols and a partial current density of 277 mA cm −2 from CO electroreduction. The activity exceeds that of prior reports by a factor of 2. The electrocatalytic upgrading of CO to higher-value fuels provides a promising route to multi-carbon alcohol products. Here, the authors show that high alcohol selectivity and activity can be achieved by incorporating palladium in copper.

Vuilleumier machines are a promising technology for heating. Respective performances of Vuilleumier’s engine and cooler are generally unclear. In Stirling machines, performances can be determined based on PV power flow and heat flow methods. In this work, respective performances based on two methods in current Vuilleumier models were investigated. It was found that PV power flow and heat flow methods in current Vuilleumier models were ineffective for analysis of respective performances due to there being no piston as a boundary between Vuilleumier’s engine and cooler. Then, a virtual piston was assumed, and a virtual piston based Vuilleumier model (VPBVM) was developed. The relative Carnot efficiencies of the obtained engine and cooler were 53~64% and 43~49%, respectively, at conditions of 550 °C hot temperature, 50~70 °C warm temperature, and −20~10 °C cold temperature. The results indicated that respective performances obtained in VPBVM were reasonable. Moreover, the engine’s compression ratios could be obtained in VPBVM and were 1.2~1.24. Thus, VPBVM could be effective for the analysis of the Vuilleumier machine’s engine and cooler.

The dynamic response and failure characteristics of tunnels vary significantly under various dynamic disturbances. These characteristics are crucial for assessing structural stability and designing effective support for surrounding rock. In this study, the theoretical solution for the dynamic stress concentration factor (DSCF) of a circular tunnel subjected to cylindrical and plane P-waves was derived using the wave function expansion method. The existing equivalent blast stress wave was optimized and the Ricker wavelet was introduced to represent the seismic stress waves. By combining Fourier transform and Duhamel’s integral, the transient response of the underground tunnel under near-field blasts and far-field earthquakes was determined in both the frequency and time domains. The theoretical results were validated by comparing them with those obtained from numerical simulations using ANSYS LS-DYNA software. Numerical simulations were conducted to further investigate the damage characteristics of the underground tunnel and evaluate the effect of initial stress on structural failure under both types of disturbances. The theoretical and numerical simulation results indicated that the differences in the dynamic response and damage characteristics of the underground tunnel were primarily due to the curvature of the stress waves and transient load waveform. The locations of the maximum DSCF values differed between near-field blasts and far-field earthquakes, whereas the minimum DSCF values occurred at the same positions. Without initial stress, the blast stress waves caused spalling damage to the rock mass on the wave-facing side. Shear failure occurred near the areas with maximum DSCF values, and tensile failure occurred near the areas with minimum DSCF values. In contrast, damage occurred only near the areas with maximum DSCF values under seismic stress waves. Furthermore, the initial stress exacerbated spalling and shear damage while suppressing tensile failure. Hence, the blast stress waves no longer induced tensile failure on the tunnel sidewalls under initial stress.

Tiller number and grain size are important agronomic traits that determine grain yield in rice. Here, we demonstrate that DEFECTIVE TILLER GROWTH 1 (DTG1), a member of the casein kinase 1 protein family, exerts a co-regulatory effect on tiller number and grain size. We identified a single amino acid substitution in DTG1 (I357K) that caused a decrease in tiller number and an increase in grain size in NIL-dtg1. Genetic analyses revealed that DTG1 plays a pivotal role in regulation of tillering and grain size. The DTG1I357K allelic variant exhibited robust functionality in suppressing tillering. We show that DTG1 is preferentially expressed in tiller buds and young panicles, and negatively regulates grain size by restricting cell proliferation in spikelet hulls. We further confirm that DTG1 functioned in grain size regulation by directly interacting with Grain Width 2 (GW2), a critical grain size regulator in rice. The CRISPR/Cas9-mediated elimination of DTG1 significantly enhanced tiller number and grain size, thereby increasing rice grain yield under field conditions, thus highlighting potential value of DTG1 in rice breeding.

The microstructure and mechanical properties of pure W, sintered and swaged W-1.5ZrO2 composites after 1.5 × 1015 Au+/cm2 radiation at room temperature were characterized to investigate the impact of the ZrO2 phase on the irradiation resistance mechanism of tungsten materials. It can be concluded that the ZrO2 phase near the surface consists of two irradiation damage layers, including an amorphous layer and polycrystallization regions after radiation. With the addition of the ZrO2 phase, the total density and average size of dislocation loops, obviously, decrease, attributed to the reason that many more glissile 1/2 loops migrate to annihilate preferentially at precipitate interfaces with a higher sink strength of 7.8 × 1014 m−2. The swaged W-1.5ZrO2 alloys have a high enough density of precipitate interfaces and grain boundaries to absorb large numbers of irradiated dislocations. This leads to the smallest irradiation hardening change in hardness of 4.52 Gpa, which is far superior to pure W materials. This work has a collection of experiments and conclusions that are of crucial importance to the materials and nuclear communities.

Background: The role of fear-avoidance beliefs (FAB) in patients with chronic pain has been widely confirmed. However, few conclusions have been drawn about its role in postoperative patients. Objective: To explore the characteristics of FAB in postoperative patients after lung surgery as well as the effect of threat learning on FAB. Methods: Between May and September 2022, this study recruited 150 participants who had undergone thoracoscopic surgery. Variables such as age, gender, education, chronic pain, fear of pain, surgery method, pain intensity, FAB, cough, ambulation and threat learning were collected and subjected to correlation analysis and stepwise regression. Results: The correlation analysis revealed that FAB was associated with age (r = -0.183, p < 0.05), gender (r = -0.256, p < 0.01), and preoperative FOP-9 (r = 0.400, p < 0.01). Postoperative variables such as pain intensity (r = 0.574, p < 0.01), initiation day of ambulation (r = 0.648, p < 0.01), total numbers of ambulation (r = -0.665, p < 0.01), and cough performance (r = - 0.688, p < 0.01) were correlated with FAB. Furthermore, FAB was highly correlated with indicators of threat learning: direct (r = 0.556, p < 0.01), observation (r = 0.655, p < 0.01), and instruction (r = 0.671, p < 0.01). The highest variance explanation model of stepwise regression which explained 52.8% of the variance including instruction (B=1.751; p <0.01), direct (B=1.245; p <0.01), observation (B=0.768; p <0.01), age (B=-0.085; p <0.01), and surgery method (B=1.321; p <0.05). Conclusion: Patients commonly experience FAB after lung surgery, which can directly affect their recovery behaviors such as ambulation and active coughing. The formation of FAB is influenced by threat learning, which suggests that controlling threat learning is important in preventing postoperative FAB. Keywords: fear-avoidance, threat learning, fear of pain, postoperative pain, lung surgery

The microstructure and mechanical properties of pure W, sintered and swaged W-1.5ZrO2 composites after 1.5 × 1015 Au+/cm2 radiation at room temperature were characterized to investigate the impact of the ZrO2 phase on the irradiation resistance mechanism of tungsten materials. It can be concluded that the ZrO2 phase near the surface consists of two irradiation damage layers, including an amorphous layer and polycrystallization regions after radiation. With the addition of the ZrO2 phase, the total density and average size of dislocation loops, obviously, decrease, attributed to the reason that many more glissile 1/2 loops migrate to annihilate preferentially at precipitate interfaces with a higher sink strength of 7.8 × 1014 m−2. The swaged W-1.5ZrO2 alloys have a high enough density of precipitate interfaces and grain boundaries to absorb large numbers of irradiated dislocations. This leads to the smallest irradiation hardening change in hardness of 4.52 Gpa, which is far superior to pure W materials. This work has a collection of experiments and conclusions that are of crucial importance to the materials and nuclear communities.

Purpose: This study aimed to obtain a translation and validation of the Fear of Pain Questionnaire 9 Items (FOP-9) into simplified Chinese. Methods: The questionnaire was translated following the forward-backward method. The final version was filled out by (n = 300) patients. Cronbach's coefficient was calculated to test the internal consistency of simplified Chinese version of FOP-9 (sc-FOP-9), and 50 painless patients completed the sc-FOP-9 questionnaire within a 2-weeks interval to evaluate test-retest reliability. To verify the construct validity, exploratory factor analysis was used to explore the factor structure, and confirmatory factor analysis was conducted to evaluate the goodness fit of models. Results: Satisfactory psychometric qualities were obtained (Cronbach's [alpha] of the total score was 0.873 and intraclass correlation coefficient was 0.975). Three first-order models were tested and all show a good model fit and the 3-factor structure may be better due to its higher factor loading. Conclusion: The sc-FOP-9 is a reliable and valid instrument to evaluate the fear of pain among Chinese patients with or without pain. Fear of pain may have an important effect on perioperative pain and chronic pain, and this tool is a good complement to the measurement in mainland China. Keywords: fear of pain, reliability, validity, Chinese, pain-related fear