Xingyue He

Aims: Prolonged intensive care unit (ICU) stays in heart failure patients are associated with poor prognosis and result in high medical expenses. To develop and validate a predictive model for prolonged ICU stays in heart failure patients. Methods and results: A retrospective cohort study was conducted involving ICU patients with a primary diagnosis of heart failure. The model development cohort comprised 5744 ICU heart failure patients from Beth Israel Deaconess Medical Center, while the external validation cohort included 4056 ICU heart failure patients from 208 hospitals across the USA. The primary outcome was prolonged ICU stay in heart failure patients. Feature selection was performed using Least Absolute Shrinkage and Selection Operator, univariate, and multivariate logistic regression. Nine machine learning algorithms were applied to develop the prediction models. Based on discrimination, calibration, and clinical utility metrics, the XGBoost emerged as the superior model. The top 10 predictive variables identified were malignant arrhythmia, acute kidney injury, Sequential Organ Failure Assessment (SOFA) score, breath sounds, valvular disease, systolic blood pressure, diuretics, blood urea nitrogen, SpO2, and cardiac catheterization. The area under the receiver operating characteristic curve for the XGBoost model was 0.861 [95% confidence interval (CI): 0.836–0.886] with a Kappa value of 0.518 in the internal validation set, and 0.815 (95% CI: 0.799–0.831) with a Kappa value of 0.437 in the external validation set. Conclusion: The XGBoost model exhibited robust discrimination, calibration, and clinical utility, making it a robust tool for risk stratification of prolonged ICU stays in heart failure patients.

Aims: Clarify and define the concept of professional bereavement in nursing.Design: Rodgers' evolutionary method was used to identify the attributes, antecedents, and consequences of professional bereavement in nursing.Data Sources: Literature from inception to May 20, 2024, was searched from PubMed, Embase, Web of Science, CINAHL, PsycINFO, Scopus, Medline, EBSCO host, Proquest, Ovid, and Cochrane.Reporting Methods: The preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines were adopted.Results: The 32 articles included in the study provided data on the concept of professional bereavement in nursing. We propose the concept of professional bereavement in nursing as follows: Professional bereavement in nursing is the experience of a patient or colleague's death in the workplace, influenced by contextual, internal, and external factors. Nurses perceive personal and professional losses, exhibit a multidimensional liminal state, and experience personal impacts (life and worldview) and professional impacts (health‐related productivity and professional ability).Conclusions: We developed a preliminary conceptual model of professional bereavement in nursing based on its attributes, antecedents, and consequences. This conceptual model promotes the development of theories related to professional bereavement.Impact: This is the first article to clarify and define professional bereavement in nursing. We have clarified the antecedents, attributes, and consequences of professional bereavement, which provides a conceptual framework for understanding professional bereavement. The conceptual framework guides the content of interventions and suggests future professional bereavement interventions from a dialectical perspective.Patient or Public Contribution: Not applicable.

Background: Vicarious trauma can significantly affect the physical and mental health of nurses, as well as their ability to provide quality of care. However, the concept of vicarious trauma has received limited attention and remains controversial in the nursing context.Objective: The purpose of this study was to clarify and define the concept of vicarious trauma as it pertains to the nursing context.Methods: The Schwartz and Kim's three‐stage hybrid concept analysis method was used to define the concept. In the theoretical phase, PubMed, CINAHL, OVID, Medline, Embase, Web of Science, Scopus, ProQuest, PsycINFO, CNKI database, VIP database and Wanfang database were used using keywords “nurs*”and “vicarious trauma*”, resulting in a total of 25 papers. In the fieldwork phase, we conducted participatory observations in three hospitals and semi‐structured in‐depth interviews with 18 clinical nurses from seven cities. In the analysis phase, the results of the previous two phases were integrated to develop a comprehensive concept of vicarious trauma in nursing.Results: Based on the results of the theoretical and field phases, we propose the concept of vicarious trauma in nursing as follows: vicarious trauma is a psychological trauma impacting nurses' cognitive schema which they may experience in clinical settings or on social media, resulting from deeply empathize with the physical or emotional trauma of patients, family, or colleagues, such as patients' physical injuries or death, family's grieving feelings and colleagues' received threats and attacks. Positively, vicarious trauma can transform into vicarious post‐trauma growth through repositioning and connection, nourishing nurses and promoting their personal and professional development.Conclusion: The concept of vicarious trauma in nursing is multidimensional and holistic. This study clarifies the concept of vicarious trauma in nursing using the hybrid concept analysis, providing a framework for future research and practice on vicarious trauma in the nursing field.Patient or Public Contribution: Nurses contributed to the conduct of the study by participating in the data collection via interviews.

Aim: To explore and describe nurses' self‐expression media image during COVID‐19 pandemic in China.Background: Nurses play an important role in COVID‐19 pandemic. Although nurses were widely reported by the media, which included praise for nurses and nursing work, the researches on how nurses expressed their self‐images were limited.Design: Qualitative media analysis.Methods: Qualitative media analysis was conducted from January to April 2020, the researchers collected images and texts of 16 Chinese nurses who take care of COVID‐19 patients. These images and texts were published on WeChat Moments by themselves. After analysed each image and text, researchers identified the denotative and connotative elements in each image and summarized each image in narrative way.Findings: This study analysed 219 pictures and 15 short videos of 16 nurses' self‐expression in WeChat moments. In this study, the media image self‐expression of nurses were mostly positive. The images expressed by nurses in this study included care image; hero image; soldier image; female image; hope image and team image. Nurses rarely showed negative images in the media; The negative nurses image were expressed in hidden way, which included exhausted nurses image and fragile nurses image. Moreover, the nurse self‐expression media image emphasized the nursing professionalism, but less showed the nursing connotation.Conclusions: The positive media image self‐expression of nurses should be encouraged. Nurse Managers should pay attention to the deficiency of nursing image expression and guide nurses to show the essence and connotation of nursing.

Purpose: Although the long non-coding RNA (lncRNA) X inactive-specific transcript (XIST) has been reported to have an anti-tumor effect in multiple malignant tumors, its role in Wilms tumor (WT) progression has not been characterized. Thus, we investigated the underlying mechanism by which XIST regulates WT progression. Patients and Methods: We performed microarray analysis and real-time quantitative PCR (RT-qPCR) to detect the expression levels of XIST lncRNA, microRNA-194-5p (miR-194-5p), and YAP (yes-associated protein in Hippo pathway) in tumor and matched adjacent normal tissues and blood collected from 49 WT patients. We also conducted bioinformatics analyses to identify differentially expressed genes. We measured the effects of XIST overexpression and knockdown on cell proliferation, apoptosis, migration, and invasion, and its association with the miR-194-5p/YAP pathway in the rhabdoid G401cell line using flow cytometry, transwell assays, immunohistochemistry, Western blot analysis, and the dual luciferase reporter gene assay. Results: We found that XIST lncRNA levels were increased in blood and tissue samples of WT patients, and this upregulation was significantly correlated with TNM staging and shorter survival time. Notably, we found that XIST upregulation correlated with miR-194-5p downregulation and YAP upregulation in WT tissues, suggesting that XIST regulates the miR-194-5p/YAP pathway. Conversely, XIST downregulation inhibited WT cell proliferation, migration, and invasion and induced apoptosis. Our study revealed the oncogenic role of the lncRNA XIST in WT and demonstrated its role as a competitive endogenous RNA that regulates the miR-194-5p/YAP pathway. Conclusion: Our study demonstrates XIST’s potential as a clinical prognostic biomarker and therapeutic target for WT.

The successful transition of the Nedd8-activating enzyme inhibitor, MLN4924, into clinical trials has greatly increased optimism for the application of other E1-activating enzyme inhibitor therapies in cancer. UBA1 is an essential E1 enzyme that controls the first step in the activation of ubiquitin. Ubiquitin is a 9 KDa protein that is involved in multiple cellular processes through conjugation to a large range of target proteins. Several of these processes are important in cancer including ubiquitin-dependent protein turnover, cell cycle progression, apoptosis and the DNA damage response. Thus, inhibiting UBA1 with small molecule inhibitors may prove to be a viable anticancer strategy. To validate UBA1 as an oncology target we utilized a lentiviral vector-mediated inducible knockdown of UBA1 by a microRNA-based shRNA (shRNAmir) in cells and xenografts derived from human cancer cells. Our data show that shRNAmir-mediated knockdown of UBA1 is tightly regulated by the inducer doxycycline in a concentration- and time-dependent manner in HCT-116 cells. Furthermore, UBA1 expression is restored upon withdrawal of the inducing agent, which coincides with decreased shRNAmir expression as marked by turboRFP. The shRNAmir-mediated depletion of UBA1 in cells resulted in reduced abundance of ubiquitin conjugates and decreased proliferation of HCT-116 cells, ultimately resulting in apoptosis. Next, we established inducible shRNAmir HCT-116 xenograft models in nude mice to examine the in vivo efficacy of inhibiting UBA1. Our results showed knockdown of UBA1 protein levels, decreased abundance of ubiquitin conjugates and apoptosis in vivo following doxycycline administration to mice. The effects of UBA1 knockdown and inhibition of ubiquitin conjugation resulted in tumor xenograft regressions in all mice. Withdrawal of doxycycline treatment resulted in regrowth of tumors with concomitant recovery of UBA1 levels and detectable ubiquitin conjugates in tumor xenografts. This study demonstrates that UBA1 knockdown effectively inhibits tumor growth and mediates tumor regression in a human xenograft model, implicating UBA1 as a novel therapeutic target for cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr B196.

Protein SUMOylation is a conserved ubiquitin-like protein posttranslational modification pathway catalyzed by the SUMO enzymatic cascade. Previous studies have indicated SUMO pathway genes are highly expressed in cancer and are required for development and cell viability. We applied lentivirus based shRNA methods to efficiently knockdown SUMO pathway components in human cancer cells. shRNAs for SAE2 and UBC9 lead to reduced SUMO pathway activity as measured by cell based reporter assays. Knockdown of SUMO enzymes suppresses proliferation of human cancer cells including U2OS, HCT116 and HeLa cells. Multiple shRNAs for each gene showed a similar growth arrest phenotype suggesting that the results are not RNAi off target effects. Furthermore, SUMO pathway inhibition by RNAi sensitize U2OS cells to the DNA damage agent Camptothecin, indicating a chemo-sensitizing effect of SUMO pathway inhibition. To improve the reproducibility of our experiments and avoid an observed negative selection for the constitutively expressed shRNAs, we established a doxycycline inducible conditional shRNA (tet-on) system to achieve acute and reversible SUMO enzyme knockdown. Acute SAE2 knockdown in U2OS and HCT116 cells reduces S phase and slows cell growth in vitro. Our data demonstrate SUMO pathway is a potential therapeutic target to treat cancer and this study demonstrates that inducible shRNA systems are valuable for early stage drug discovery. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-371. doi:10.1158/1538-7445.AM2011-LB-371