Objective: To analyze the time-related factors influencing daily blood donation attendance at fixed donation sites in Nanjing and the heterogeneity among sites, and to provide evidence for optimizing site layout and operational management. Methods: Based on daily attendance data from 17 fixed donation sites in Nanjing for the full year of 2025, matched with contemporaneous meteorological and air quality data, a two-stage negative binomial generalized linear mixed model (NB-GLMM) was constructed. In the second stage, site-level static characteristics (number of scenic spots, daily operating hours, number of shopping malls, public transport stops, hospitals, universities, and residential buildings) were additionally incorporated. Model comparison was performed using Akaike information criterion (AIC). Significance of random effects was tested by likelihood ratio test, and site-specific random effects were extracted using empirical Bayes estimation. Robustness of the results was verified through residual diagnostics and multiple sensitivity analyses. Results: The first-stage model showed that rainfall was associated with lower attendance (IRR=0.943, P<0.001); holidays were associated with higher attendance (IRR=1.162, P<0.001); Saturdays and Sundays showed higher attendance than Mondays, with the strongest association on Sundays (IRR=1.195, P<0.001). Temperature exhibited a non-linear relationship (linear term P=0.051, quadratic term P=0.036). The joint results of the linear and quadratic terms for temperature suggested a nonlinear relationship between attendance and temperature. After introducing static characteristics in the second stage, the number of scenic spots (IRR=1.372, P=0.008) and daily operating hours (IRR=1.823, P<0.001) were found to be positively associated with attendance, while the numbers of shopping malls, public transport stops, hospitals, universities, and residential buildings showed no significant effects. Conclusion: Daily blood donation attendance at fixed sites in Nanjing is influenced by multiple factors including weather, day of the week, holidays, and site surroundings. Substantial heterogeneity exists among different sites; extended operating hours and more nearby scenic spots are associated with increased attendance.

Objective: To evaluate the feasibility of re-entry for blood donors deferred for single-reagent reactive anti-TP ELISA results, to assess the ability of ELISA S/CO values of different kits to discriminate true-from false-positive samples and to determine the optimal cutoff value for each kit, thereby providing a scientific basis for improving blood donor reentry strategies. Methods: Data of two donor cohorts were retrospectively collected: (1) a re-entry cohort of 106 donors who applied for re-entry at Jiangsu Province Blood Center from January 1, 2018 to December 31, 2025, all previously deferred for single-reagent reactive anti-TP ELISA results (58 reactive with the Xinchuang kit and 48 with the Kehua kit); (2) a routine screening confirmation cohort of 39 donors found to be single-reagent reactive in routine donation screening and additionally tested by TPPA between April 2024 and June 2026 (17 Xinchuang and 22 Kehua). Using TPPA results as the gold standard, the two cohorts were pooled (75 Xinchuang, 70 Kehua), and receiver operating characteristic (ROC) curves were constructed separately for each kit. The 95% confidence interval (CI) of the area under the curve (AUC) was estimated with 2 000 bootstrap replicates, and the optimal S/CO cutoff of each kit was determined by the maximum Youden index; sensitivity analysis was performed by cohort source. In addition, TPPA-confirmed positivity rates were compared between single-and dual-reagent reactive samples at re-entry testing. Results: Of the 106 donors in the re-entry cohort, 73 were successfully requalified and 33 failed. The mean S/CO value at deferral testing in successfully requalified donors was 1.930 (median 1.570), significantly lower than 3.487 (median 2.592) in failed donors (P<0.001). Among the 33 donors who failed requalification, 16 samples were TPPA positive; at re-entry testing, 7 were dual-reagent reactive (6 TPPA positive), 25 remained single-reagent reactive (9 TPPA positive), and 1 was ELISA non-reactive (TPPA positive). The TPPA positivity rate of dual-reagent reactive samples at re-entry testing was 85.7% (6/7), significantly higher than 36.0% (9/25) of single-reagent reactive samples (P=0.033); the agreement between the two kits at re-entry testing was poor (Kappa=0.231). ROC analysis of pooled samples showed that for the Xinchuang kit (n=75, 14 TPPA positive), the AUC was 0.837 (95%CI:0.731-0.929) with an optimal cutoff of 2.025, corresponding to a sensitivity of 92.9% (13/14), a specificity of 65.6% (40/61) and a negative predictive value of 97.6% (40/41); for the Kehua kit (n=70, 13 TPPA positive), the AUC was 0.787 (95%CI:0.649-0.900) with an optimal cutoff of 1.733, corresponding to a sensitivity of 92.3% (12/13), a specificity of 56.1% (32/57) and a negative predictive value of 97.0% (32/33). Sensitivity analysis by cohort showed that the AUCs calculated separately for the re-entry and screening cohorts were consistent in direction with the pooled analysis. Conclusion: S/CO values of both the Xinchuang and Kehua ELISA kits can discriminate TPPA-confirmed true from false positives, but their optimal cutoffs differ. Dual-reagent reactivity at re-entry testing strongly indicates TPPA-confirmed positivity; the TPPA positivity rate of single-reagent reactive samples increases in a gradient with rising S/CO values, and single-reagent reactive samples with low S/CO values are mostly false positives. Incorporating kit-specific stratified management based on quantitative S/CO thresholds into the re-entry mechanism may help establish a fast-track re-entry pathway for low-risk false-positive donors.

Objective:To evaluate and integrate the evidence related to the prevention of unplanned readmission in elderly patients with ischemic stroke.Methods:A computerized search was conducted on various guideline websites and databases for clinical decisions, best practices, guidelines, evidence summaries, systematic reviews, and expert consensuses regarding the prevention of unplanned readmission in elderly patients with ischemic stroke. The search period was from the establishment of the databases to August 31, 2024. The literature quality evaluation criteria of the Joanna Briggs Institute Evidence-Based Health Care Centre and so on were used to evaluate the quality of different types of studies.Results:A total of 25 articles were included, consisting of one clinical decision, nine guidelines, six evidence summaries, eight systematic reviews, and one expert consensus. Evidence was integrated from two themes: discharge planning services (including five dimensions: principles, preliminary assessment, comprehensive assessment, plan formulation and implementation, tracking and evaluation) and early functional rehabilitation (including four dimensions: rehabilitation time, rehabilitation plan, rehabilitation intensity, and functional rehabilitation) , forming 39 pieces of best evidence.Conclusions:This study provides an evidence-based basis for the clinical nursing practice of preventing unplanned readmission in elderly patients with ischemic stroke. Evidence users need to select the best evidence according to the clinical reality to promote the smooth transition of patients and reduce the readmission rate.

Objective To systematically evaluate the factors that promote and hinder exercise in frail older adults,and to provide references for the formulation of exercise intervention programs.Methods We searched PubMed,Web of Science,Embase,CINAHL,Cochrane library,CNKI,Wanfang,VIP database,and China Biomedical Literature Database for qualitative studies on exercise facilitators and hindrances in frail older adults,and the search time period was from the establishment of the databases to September 1,2024.The quality of the literature was evaluated using the Joanna Brigg Institute Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated by integrating methods.Results A total of 18 studies were included,and 72 research results were extracted,and 10 categories were summarized.The final synthesis included 2 integrated results:the facilitators included personal exercise motivation,physical and psychological benefits,positive interpersonal interactions,multiple social support systems and person-centred exercise programme;the impediments included underlying diseases and somatic functional limitations,negative psychological status,low health literacy,family role conflicts and limits of the environment.Conclusion Exercise for frail older adults is affected by a variety of factors.Healthcare professionals should improve the positive perception of exercise for frail older people and help them overcome psychological barriers;establish an all-round support system to enhance the sense of social contact of the frail elderly;formulate a personalised exercise programme with a human-centred approach to enhance the motivation of the frail elderly.

Objective To systematically evaluate the factors that promote and hinder exercise in frail older adults,and to provide references for the formulation of exercise intervention programs.Methods We searched PubMed,Web of Science,Embase,CINAHL,Cochrane library,CNKI,Wanfang,VIP database,and China Biomedical Literature Database for qualitative studies on exercise facilitators and hindrances in frail older adults,and the search time period was from the establishment of the databases to September 1,2024.The quality of the literature was evaluated using the Joanna Brigg Institute Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated by integrating methods.Results A total of 18 studies were included,and 72 research results were extracted,and 10 categories were summarized.The final synthesis included 2 integrated results:the facilitators included personal exercise motivation,physical and psychological benefits,positive interpersonal interactions,multiple social support systems and person-centred exercise programme;the impediments included underlying diseases and somatic functional limitations,negative psychological status,low health literacy,family role conflicts and limits of the environment.Conclusion Exercise for frail older adults is affected by a variety of factors.Healthcare professionals should improve the positive perception of exercise for frail older people and help them overcome psychological barriers;establish an all-round support system to enhance the sense of social contact of the frail elderly;formulate a personalised exercise programme with a human-centred approach to enhance the motivation of the frail elderly.

Objective:To evaluate and integrate the evidence related to the prevention of unplanned readmission in elderly patients with ischemic stroke.Methods:A computerized search was conducted on various guideline websites and databases for clinical decisions, best practices, guidelines, evidence summaries, systematic reviews, and expert consensuses regarding the prevention of unplanned readmission in elderly patients with ischemic stroke. The search period was from the establishment of the databases to August 31, 2024. The literature quality evaluation criteria of the Joanna Briggs Institute Evidence-Based Health Care Centre and so on were used to evaluate the quality of different types of studies.Results:A total of 25 articles were included, consisting of one clinical decision, nine guidelines, six evidence summaries, eight systematic reviews, and one expert consensus. Evidence was integrated from two themes: discharge planning services (including five dimensions: principles, preliminary assessment, comprehensive assessment, plan formulation and implementation, tracking and evaluation) and early functional rehabilitation (including four dimensions: rehabilitation time, rehabilitation plan, rehabilitation intensity, and functional rehabilitation) , forming 39 pieces of best evidence.Conclusions:This study provides an evidence-based basis for the clinical nursing practice of preventing unplanned readmission in elderly patients with ischemic stroke. Evidence users need to select the best evidence according to the clinical reality to promote the smooth transition of patients and reduce the readmission rate.

Objective:To systematically synthesize and evaluate qualitative studies on the rehabilitation experience of stroke patients using virtual reality.Methods:A comprehensive search of databases including PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and SinoMed was conducted for qualitative studies on the rehabilitation experience of stroke patients using virtual reality, with studies included up to October 24, 2023. Two researchers independently assessed study quality using the Joanna Briggs Institute qualitative assessment tool, and a Meta-synthesis approach was used to integrate findings.Results:Fourteen studies were included, yielding 72 distinct results that were categorized into 13 themes, and further integrated into four main themes: stroke patients' experience with virtual reality-assisted rehabilitation, facilitators for virtual reality-assisted rehabilitation, barriers to virtual reality-assisted rehabilitation, and stroke patients' needs and expectations for virtual reality-assisted rehabilitation.Conclusions:Virtual reality is widely appreciated by stroke patients for its rehabilitation benefits. Future efforts should focus on patient training, system enhancement, and the development of diverse and personalized virtual reality content to improve the user experience.

Objective To systematically evaluate the real-life experience of stroke patients in the hospital-home transition period,and to provide a reference for better clinical development of transitional nursing practice.Methods We searched PubMed,Web of Science,Embase,CINAHL,Cochrane library,CNKI,Wanfang Data,VIP database,and China Biomedical Literature Database for qualitative studies on the real experience of stroke patients in the hospital-to-home transition period from the establishment of the database to October 2023.The quality of the literature was evaluated using the Joanna Brigg Institute(JBI)Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated using meta-integration methods.Results A total of 14 studies were included,and 48 research results were extracted and 9 categories were summarized.The final synthesis included 3 integrated results:the discharge preparation period was in contradiction;after being discharged from the hospital,life changed dramatically and there was a variety of transition barriers;active response to illness and the experience of self-growth.Conclusion The hospital-home transition period for stroke patients is a critical period for patients'rehabilitation,and medical staff should strengthen the implementation of the transitional discharge plan,strengthen the connection between hospitals and families and communities,pay attention to the psychological experience of patients,so as to help stroke patients achieve a smooth transition from hospital to home.

Objective To summarize the most robust evidence on application timing and management strategies for chronic wound oxygen therapy and to provide an evidence-based basis for standardizing clinical practice.Methods A systematic literature search of BMJ Best Practice,UpToDate,NICE,SIGN,GIN,NZGG,NGC,RNAO,WOCN,WUWHS,APWCA,IWII,WHS,WI,AWMA,WCET,ESVS,AAWC,Medlive,JBI,Cochrane Library,PubMed,Embase,Web of Science,CNKI,Wanfang and VIP was conducted to collect the literature including clinical decision resources,guidelines,expert consensuses,evidence summaries,systematic reviews,and meta-analyses related to the application timing and management strategies for chronic wound oxygen therapy.The search period spanned from October 13,2018,to October 13,2023.There were 2 researchers who assessed the quality of the included literature,extracted relevant data,and synthesized the evidence.Results In total,we included 28 pieces of literature,consisting of 6 guidelines,4 expert consensus papers,3 evidence summaries,and 15 systematic reviews.From these sources,we distilled 18 pieces of evidence including 7 aspects of indications,contraindications,application timing,assessment,management strategies,effectiveness,and adverse reactions of hyperbaric oxygen therapy;12 pieces of evidence from 6 aspects of indications,application time,assessment,management strategies,effectiveness,and adverse reactions of local oxygen therapy.Conclusion Oxygen therapy can be used as an adjunct therapy for chronic wound management.Clinical practitioners should fully evaluate the scope and timing of the application of oxygen therapy,consider the feasibility,suitability,clinical signific ance,and effectiveness of evidence based on the specific clinical situations,and apply evidence in combination with patient preferences to promote chronic wound healing.

Objective:To systematically synthesize and evaluate qualitative studies on the rehabilitation experience of stroke patients using virtual reality.Methods:A comprehensive search of databases including PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and SinoMed was conducted for qualitative studies on the rehabilitation experience of stroke patients using virtual reality, with studies included up to October 24, 2023. Two researchers independently assessed study quality using the Joanna Briggs Institute qualitative assessment tool, and a Meta-synthesis approach was used to integrate findings.Results:Fourteen studies were included, yielding 72 distinct results that were categorized into 13 themes, and further integrated into four main themes: stroke patients' experience with virtual reality-assisted rehabilitation, facilitators for virtual reality-assisted rehabilitation, barriers to virtual reality-assisted rehabilitation, and stroke patients' needs and expectations for virtual reality-assisted rehabilitation.Conclusions:Virtual reality is widely appreciated by stroke patients for its rehabilitation benefits. Future efforts should focus on patient training, system enhancement, and the development of diverse and personalized virtual reality content to improve the user experience.