Objective:To evaluate the detection rate, anatomical distribution, and influencing factors of bone marrow edema-like signal (BMELS) in the knees of amateur marathon runners.Methods:This was a cross-sectional study. This study publicly recruited amateur marathon runners through the Hangzhou Long-distance Running Association from January 2019 to December 2024. Based on knee magnetic resonance imaging (MRI) results, participants were divided into a BMELS-positive group (BMELS present in at least one knee) and a BMELS-negative group. General clinical information was collected from participants using a questionnaire. All participants underwent a knee MRI scan to screen for the presence of BMELS and to assess its severity. Logistic regression models were used to analyze the associated factors of BMELS in amateur marathon runners, while Spearman′s correlation analysis assessed the correlation between BMELS grade and these factors.Results:A total of 60 subjects (120 knee joints) were enrolled, including 39 males (65%), aged (40.0±8.4) years. Of these, 39 were in the BMELS-positive group, and 21 were in the BMELS-negative group. The BMELS detection rate for the 120 knee joints of these 60 subjects was 53.3% (64/120). BMELS were detected in 43.3%(52/120) of the femur, 34.2% (41/120) of tibia and 17.5% (21/120) of patella. Multivariate logistic regression analysis showed an independent positive correlation between monthly running volume and knee BMELS in amateur marathon runners ( OR=1.007, 95% CI: 1.000-1.013, P=0.035). Spearman′s correlation analysis showed a weak positive correlation between the BMELS grade of the knees and the monthly running volume of amateur marathon runners ( r s=0.360, P=0.005). Conclusions:The detection rate of knee BMELS is high in amateur marathon runners, and they are distributed in a way that is characteristic of the region, with a higher incidence in the medial femoral condyle. In this population, monthly running volume is independently associated with knee BMELS, with a higher grade associated with greater monthly running volume.

Objective:To analyze the pangenome, pan drug resistance genes, pan virulence genes, pan replicons, and others of the plasmids carried by hypervirulent Klebsiella pneumoniae (hvKP) in the world and their evolutionary trends over time, and provide evidence for more comprehensive understanding of the evolution of genetic diversity, drug resistance genes, and virulence genes of the plasmids. Methods:From the National Center for Biotechnology Information database, a total 1 738 plasmids were screened from 524 strains with completed genome sequences in 2 136 strains of hvKP carrying plasmids. Through pangenome, pan drug resistance gene, and pan-virulence gene composition and functional analyses, the curves of pangenome size and new gene size against plasmid isolation time were established, revealing the diversity of the plasmid pangenome and its evolutionary patterns.Results:The homologous genes, homologous drug resistance genes, homologous virulence genes, and replicons of the plasmids carried by hvKP comprised of 12 906, 149, 107 and 89 types, respectively. The fitting curves for the number of new genes, new drug resistance genes and new replicons increased with the increase of plasmids in an open state, while the curve for novel virulence genes was in a closed state. A obvious increase in new drug resistance genes was observed during 2018-2019. Among the newly added drug resistance genes during 2021-2023, beside those conferring aminoglycoside resistance, they were mainly new subtypes conferring carbapenem resistance.Conclusions:The pangenome of plasmids carried by hvKP exhibited high diversity, with the plasmid pan genes, pan drug resistance genes, and pan replicon types gradually expanding, while the pan virulence genes remains stable. The increase in novel drug resistance genes in specific years and the emergence of new carbapenem-resistant gene subtypes during 2021-2023 suggested the need for strengthened drug resistance surveillance and prevention efforts, with particular attention to carbapenem resistance.

Objective:To conduct a scoping review on the critical values for lifestyle risk factors in young and middle-aged patients with prediabetes progressing to diabetes, so as to provide a reference for clinical screening, prevention, intervention, and patient self-management.Methods:Guided by the scoping review methodology and framework developed by Arksey et al., research questions were identified. Through systematic searches of Chinese and English literature databases, studies on risk factors in young and middle-aged patients with prediabetes progressing to diabetes published from the establishment of the database to August 11, 2024 were screened. Studies examining critical values for lifestyle risk factors were selected for data extraction, summary of findings, and qualitative analysis.Results:A total of 19 articles were ultimately included. Lifestyle risk factors encompassed diet, exercise, smoking, drinking, and step count. Specific indicators included daily sugar intake >25 grams, weekly exercise time <150 min, daily exercise time <30 min, weekly drinking ≥3 times with ≥180 ml of clear liquor per session, and daily step count <5 000 steps.Conclusions:There are different characteristics and critical values of the influence of various factors on the progress of diabetes. Future research should further standardize criteria and conduct large-scale, multicenter, long-term follow-up studies to establish optimal critical values for lifestyle factors, thereby providing evidence for diabetes screening, prevention, and intervention.

Objective:To conduct a scoping review on the critical values for lifestyle risk factors in young and middle-aged patients with prediabetes progressing to diabetes, so as to provide a reference for clinical screening, prevention, intervention, and patient self-management.Methods:Guided by the scoping review methodology and framework developed by Arksey et al., research questions were identified. Through systematic searches of Chinese and English literature databases, studies on risk factors in young and middle-aged patients with prediabetes progressing to diabetes published from the establishment of the database to August 11, 2024 were screened. Studies examining critical values for lifestyle risk factors were selected for data extraction, summary of findings, and qualitative analysis.Results:A total of 19 articles were ultimately included. Lifestyle risk factors encompassed diet, exercise, smoking, drinking, and step count. Specific indicators included daily sugar intake >25 grams, weekly exercise time <150 min, daily exercise time <30 min, weekly drinking ≥3 times with ≥180 ml of clear liquor per session, and daily step count <5 000 steps.Conclusions:There are different characteristics and critical values of the influence of various factors on the progress of diabetes. Future research should further standardize criteria and conduct large-scale, multicenter, long-term follow-up studies to establish optimal critical values for lifestyle factors, thereby providing evidence for diabetes screening, prevention, and intervention.

Objective:To systematically evaluate and integrate qualitative studies on the disease experience and demands of psoriasis, and to provide reference for improving patients′ disease experience and formulating targeted nursing intervention strategies.Methods:Web of science, PubMed, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, Wanfang database, Weipu database and China Biology Medicine Disc were searched by computer from their inception to May 31, 2024 for the qualitative studies on experience of psoriasis patient experience. The literature quality was appraised by the evaluation criteria of the Evidence Based Healthcare Center at the Joanna Briggs Institute for qualitative research. Findings of included studies were synthesized using Meta-aggregation.Results:A total of 13 articles were included, and 48 research results were extracted, which were further formed into 9 categories, and finally summarized into the following 3 integrated results: disease infects life, and physical and mental difficulties were intertwined; response strategies varied, affecting disease outcome; multiple needs were not yet met, and multi-level support systems were urgently neededConclusions:Psoriasis patients suffer from the burden of symptoms and psychological pressure, medical personnel should pay attention to patients′ inner experience and nursing needs, provide multi-dimensional support to reduce disease distress, improve patients′ disease management level, and improve quality of life.

Objective:To systematically review the qualitative studies on the experience of self-empowerment in cancer patients, and provide evidence for better cancer care centered on patients.Methods:Computer searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, Wanfang, and VIP, China Biomedical Literature Database for qualitative studies on the experience of self-empowerment in cancer patients from database inception to April 2, 2024. The quality of the literature was evaluated according to the Joanna Briggs Institute Evidence-Based Practice Unit's quality assessment criteria for qualitative studies. Meta-synthesis was conducted using a centralized integration method.Results:Five studies were included, yielding 17 research findings, which were categorized into 16 categories and 4 synthesis results: cancer patients′ cognition of self-empowerment; barriers to self-empowerment; diversity of self-empowerment strategies; and the role of external support.Conclusions:Cancer patients recognize the value of self-empowerment, but there are multiple factors that hinder patients from self-empowering. Healthcare providers should understand the self-empowerment needs of patients and provide evidence-based care centered on patients to promote better health outcomes for patients.

Objective:To analyze the pangenome, pan drug resistance genes, pan virulence genes, pan replicons, and others of the plasmids carried by hypervirulent Klebsiella pneumoniae (hvKP) in the world and their evolutionary trends over time, and provide evidence for more comprehensive understanding of the evolution of genetic diversity, drug resistance genes, and virulence genes of the plasmids. Methods:From the National Center for Biotechnology Information database, a total 1 738 plasmids were screened from 524 strains with completed genome sequences in 2 136 strains of hvKP carrying plasmids. Through pangenome, pan drug resistance gene, and pan-virulence gene composition and functional analyses, the curves of pangenome size and new gene size against plasmid isolation time were established, revealing the diversity of the plasmid pangenome and its evolutionary patterns.Results:The homologous genes, homologous drug resistance genes, homologous virulence genes, and replicons of the plasmids carried by hvKP comprised of 12 906, 149, 107 and 89 types, respectively. The fitting curves for the number of new genes, new drug resistance genes and new replicons increased with the increase of plasmids in an open state, while the curve for novel virulence genes was in a closed state. A obvious increase in new drug resistance genes was observed during 2018-2019. Among the newly added drug resistance genes during 2021-2023, beside those conferring aminoglycoside resistance, they were mainly new subtypes conferring carbapenem resistance.Conclusions:The pangenome of plasmids carried by hvKP exhibited high diversity, with the plasmid pan genes, pan drug resistance genes, and pan replicon types gradually expanding, while the pan virulence genes remains stable. The increase in novel drug resistance genes in specific years and the emergence of new carbapenem-resistant gene subtypes during 2021-2023 suggested the need for strengthened drug resistance surveillance and prevention efforts, with particular attention to carbapenem resistance.

Objective:To systematically evaluate the qualitative studies on nurses' knowledge and practice experience of grief counseling, providing a reference for the implementation and development of grief counseling.Methods:Computer-based searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc for qualitative studies on nurses' knowledge and practice experience of grief counseling, with the search limited to articles published until January 5, 2024. The quality of the literature was assessed using the quality evaluation criteria of the Evidence-Based Health Care Center of the Joanna Briggs Institute, Australia. A pooled integration approach was used to integrate the literature.Results:A total of seven studies were included, yielding 26 research findings, which were categorized into 10 categories, further integrated into four synthesis results, namely, nurses' perceptions of grief counseling, barriers to the implementation of grief counseling by nurses, strategies to promote nurses' implementation of grief counseling, and nurses' emotional experiences.Conclusions:The implementation of grief counseling faces challenges. Healthcare managers should understand nurses' knowledge and practice experience of grief counseling, provide relevant training, and strengthen organizational support to promote the practice and development of grief counseling.

Objective:To systematically evaluate and integrate qualitative studies on the disease experience and demands of psoriasis, and to provide reference for improving patients′ disease experience and formulating targeted nursing intervention strategies.Methods:Web of science, PubMed, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, Wanfang database, Weipu database and China Biology Medicine Disc were searched by computer from their inception to May 31, 2024 for the qualitative studies on experience of psoriasis patient experience. The literature quality was appraised by the evaluation criteria of the Evidence Based Healthcare Center at the Joanna Briggs Institute for qualitative research. Findings of included studies were synthesized using Meta-aggregation.Results:A total of 13 articles were included, and 48 research results were extracted, which were further formed into 9 categories, and finally summarized into the following 3 integrated results: disease infects life, and physical and mental difficulties were intertwined; response strategies varied, affecting disease outcome; multiple needs were not yet met, and multi-level support systems were urgently neededConclusions:Psoriasis patients suffer from the burden of symptoms and psychological pressure, medical personnel should pay attention to patients′ inner experience and nursing needs, provide multi-dimensional support to reduce disease distress, improve patients′ disease management level, and improve quality of life.

Objective:To systematically review the qualitative studies on the experience of self-empowerment in cancer patients, and provide evidence for better cancer care centered on patients.Methods:Computer searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, Wanfang, and VIP, China Biomedical Literature Database for qualitative studies on the experience of self-empowerment in cancer patients from database inception to April 2, 2024. The quality of the literature was evaluated according to the Joanna Briggs Institute Evidence-Based Practice Unit's quality assessment criteria for qualitative studies. Meta-synthesis was conducted using a centralized integration method.Results:Five studies were included, yielding 17 research findings, which were categorized into 16 categories and 4 synthesis results: cancer patients′ cognition of self-empowerment; barriers to self-empowerment; diversity of self-empowerment strategies; and the role of external support.Conclusions:Cancer patients recognize the value of self-empowerment, but there are multiple factors that hinder patients from self-empowering. Healthcare providers should understand the self-empowerment needs of patients and provide evidence-based care centered on patients to promote better health outcomes for patients.