Challenges of a negative work load and implications on morale,productivity and quality of service delivered in NHS laboratories in England

The National Health Service(NHS)is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom.There are several challenges militating against the effective laboratory service delivery in the NHS in England.Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients.They provide the"engine room"of modern medicine with 70%of diagnosis based on the laboratory results generated by them.This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England.Laboratory service delivery in the NHS in England faces numerous daunting challenges;staffing levels in the last few years have become dangerously low,less remunerated,relatively less experienced and predominantly band 5's,multidisciplinary rather than specialty based,associated with working more unsocial hours without adequate recovery time,de-banding of staff,high staff turnaround,profit and cost driven rather than quality.These factors has resulted in burn out,low morale,high sickness absences,increased error rate,poor team spirit,diminished productivity and suboptimal laboratory service delivery.There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix,ensuring adequate remuneralion of laboratory staff,implementing evidenced-based specialty oriented service,determining the root cause/s for the high staff turnover and implementing corrective action,identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

类Chen-Qi混沌系统的固定时间自适应同步控制

类Chen-Qi四维混沌系统的渐近稳定控制的同步误差不能在有限时间内收敛到零,有限时间控制的同步误差收敛到零的状况与初值有关.因此,本文应用固定时间控制技术,设计了自适应控制器和参数估计律,试图使得驱动系统与同类型的参数未知的响应系统在固定时间内达到同步,完成了理论证明.应用数值仿真考察同步误差收敛到零的状况.选取不同参数值,不同状态初值,考察状态时程图、同步误差曲线等.结果表明:混沌运动时,固定时间内同步误差收敛到零的效果较好,与状态初值无关,收敛时间符合理论计算值;周期运动时,固定时间内前三个状态的同步误差收敛到零的效果较好,收敛时间符合理论计算值,但第四个状态的同步误差的收敛时间不符合理论计算值,其原因是系统存在的三次非线性项的不平衡、不匹配.

Surgical Resident Attrition and the Menninger Morale Curve

BACKGROUND: Attrition in surgical residency programs continues to be a significant challenge. Ap-proximately 20% of residents who begin a categorical surgery residency fail to complete it. A number of studies speculated reasons for this including work hours, life style, family pressures, and resident feelings of inadequacy including fear of termination. To date no research has been conducted investigating the relation-ship between resident morale and attrition. This study sought to determine if this linkage exists in surgery residents. METHODS: The Morale Assessment in General Practice Index (MAGPI) was administered to 21 PGY 1, 2, 3, and 5 surgical residents to assess level of morale. Non-parametric methods were carried out to assess if there were differences in morale among the four PGY groups. Additionally, analyses of the four factors comprising the MAGPI were also conducted. RESULTS: Although differences did not reach statis-tical significance, analysis of the data reveals that residents demonstrate different trends in their levels of morale based on the amount of time they spend in a residency and in a way that approximates the morale curve described by W. Walter Menninger, M.D. Additionally, two of the four factors comprising the MAGPI also indicate trends similar to that described by the Menninger morale curve. CONCLUSIONS: Although no statistically significant results were achieved, the data reveal trends that approximate shifts in morale similar to those described by the Menninger morale curve, with residents at the PGY 2 and 3 levels present-ing lower morale levels than at the PGY 1 and 5 levels. This may be due in part to the size of the population studied. Future research should be continued in this area with a larger sample size.

The Essential Role of Zheng Qi in Promoting Health: From the Perspective of Chinese Medicine and Modern Medicine

The concept of Zheng Qi in traditional Chinese medicine (TCM) refers to the vital energy produced by the interaction of Yin and Yang forces in the body. Zheng Qi performs two main functions: Wei Qi (defensive Qi), which shields the body from external pathogens, and Ying Qi (nutritive Qi), which sustains the internal organs and enhances their functionality. In TCM, Chinese tonifying herbs can help restore the balance of Yin/Yang and Qi/Blood function in visceral organs (i.e., optimal physiological functions), thereby fostering the efficient production of Zheng Qi and enhancing health. To ensure the quality of Chinese herbal products, functional assays to measure Yin/Yang, Qi/Blood functions, and Zheng Qi production should be implemented. The efficacy of Yang and Qi herbs can be evaluated by their ability to increase mitochondrial ATP in cultured mouse cardiomyocytes, while Yin and Blood herbs are tested through their immunostimulatory effects on antigen-induced T/B cell proliferation in mouse splenocytes and the production of erythropoietin/nitric oxide in hepatocytes/vascular endothelial cells, respectively. Additionally, Zheng Qi’s effect can be gauged by examining natural killer cell activity and antigen-induced T/B cell proliferation in mice ex vivo. These assays act as biomarkers for assessing the quality and effectiveness of herbal health products within TCM theory.

TCM-HIN2Vec:A strategy for uncovering biological basis of heart qi deficiency pattern based on network embedding and transcriptomic experiment

Objective:To elucidate the biological basis of the heart qi deficiency(HQD)pattern,an in-depth understanding of which is essential for improving clinical herbal therapy.Methods: We predicted and characterized HQD pattern genes using the new strategy,TCM-HIN2Vec,which involves heterogeneous network embedding and transcriptomic experiments.First,a heterogeneous network of traditional Chinese medicine(TCM)patterns was constructed using public databases.Next,we predicted HQD pattern genes using a heterogeneous network-embedding algorithm.We then analyzed the functional characteristics of HQD pattern genes using gene enrichment analysis and examined gene expression levels using RNA-seq.Finally,we identified TCM herbs that demonstrated enriched interactions with HQD pattern genes via herbal enrichment analysis.Results: Our TCM-HIN2Vec strategy revealed that candidate genes associated with HQD pattern were significantly enriched in energy metabolism,signal transduction pathways,and immune processes.Moreover,we found that these candidate genes were significantly differentially expressed in the transcriptional profile of mice model with heart failure with a qi deficiency pattern.Furthermore,herbal enrichment analysis identified TCM herbs that demonstrated enriched interactions with the top 10 candidate genes and could potentially serve as drug candidates for treating HQD.Conclusion: Our results suggested that TCM-HIN2Vec is capable of not only accurately identifying HQD pattern genes,but also deciphering the basis of HQD pattern.Furthermore our finding indicated that TCM-HIN2Vec may be further expanded to develop other patterns,leading to a new approach aimed at elucidating general TCM patterns and developing precision medicine.

Exploring the Path of Implementing the Home-School Co-education Model from the Perspective of Moral Education Field

As a social psychological field derived from the concept of physical field,the moral education field plays a very important role in guiding the construction of a home-school co-education model.In this paper,by analyzing the internal power system of the moral education field,with a policy oriented approach and combined with contemporary factors,it aims to empower the traditional home-school co-education model.Only by combining home education and school education,supplemented by social policy guidance,strengthening the construction of the"trinity"community,creating a harmonious and stable ecological interactive moral education field,expanding the path of home-school cooperation,strengthening the boundary of home and school responsibility,and innovating the form of home-school co-education,can it support the bright future of education.

Exploring the therapeutic potential of Qi Teng Mai Ning recipe in ischemic stroke and vascular cognitive impairment

Background:This study aims to explore the therapeutic effects of the Qi Teng Mai Ning recipe on ischemic stroke and vascular cognitive impairment through its potential to modulate cellular autophagy,with a focus on identifying its active ingredients and their target proteins.Methods:The study began with the identification of active ingredients in the Qi Teng Mai Ning recipe.It proceeded to screen the gene expression omnibus database for ischemic stroke and vascular cognitive impairment-associated differentially expressed mRNAs and to identify cellular autophagy-related proteins via the Human Autophagy Database.These proteins were annotated with Gene Ontology and Kyoto Encyclopedia of Genes and Genomes functions and subjected to molecular docking with the recipe’s core active ingredients.In vitro cell experiments were conducted on hypoxic HT22 cells,involving CCK8 assay,lentiviral transfection to silence autophagy related 9B(ATG9B),immunofluorescence staining,and qPCR validation to investigate the effects of the recipe on autophagy.Results:The analysis identified 104 active ingredients targeting 408 proteins and forming a complex ingredient-target network.Intersecting 55 ischemic stroke-related and 909 vascular cognitive impairment-related differentially expressed mRNAs revealed 14 co-expressed mRNAs.Molecular docking showed quercetin,kaempferol,myrcene,and conferone as key ingredients targeting autophagy-related proteins.Cellular experiments indicated that the recipe significantly enhanced cell viability under hypoxic conditions,reduced apoptosis,and modulated the expression of autophagy-related factors,thereby decreasing apoptosis rates in HT22 cells.Conclusion:The Qi Teng Mai Ning recipe offers protective effects against ischemic stroke and vascular cognitive impairment by modulating autophagy-related proteins.Its efficacy highlights the potential of traditional Chinese medicine in treating these conditions,though further research is needed to fully understand its mechanisms and clinical applications.

Pharmacological Investigation on the Qi-Invigorating Action of Schisandrin B: Effects on Mitochondrial ATP Generation in Multiple Tissues and Innate/Adaptive Immunity in Mice

Schisandrae Fructus, containing schisandrin B (Sch B) as its main active component, is recognized in traditional Chinese medicine (TCM) for its Qi-invigorating properties in the five visceral organs. Our laboratory has shown that the Qi-invigorating action of Chinese tonifying herbs is linked to increased mitochondrial ATP generation and an enhancement in mitochondrial glutathione redox status. To explore whether Sch B can exert Qi-invigorating actions across various tissues, we investigated the effects of Sch B treatment on mitochondrial ATP generation and glutathione redox status in multiple mouse tissues ex vivo. In line with TCM theory, which posits that Zheng Qi generation relies on the Qi function of the visceral organs, we also examined Sch B’s impact on natural killer cell activity and antigen-induced splenocyte proliferation, both serving as indirect measures of Zheng Qi. Our findings revealed that Sch B treatment consistently enhanced mitochondrial ATP generation and improved mitochondrial glutathione redox status in mouse tissues. This boost in mitochondrial function was associated with stimulated innate and adaptive immune responses, marked by increased natural killer cell activity and antigen-induced T/B cell proliferation, potentially through the increased generation of Zheng Qi.

Clinical Observation of the Hot and Humid Compress Therapy of Traditional Chinese Medicine in the Treatment of Qi Stagnation and Blood Stasis Type of Lumbar Disc Herniation

Background: Although a number of studies have reported that the hot and humid compress from traditional Chinese medicine (TCM) is effective in treating lumbar disc herniation (LDH) with qi stagnation and blood stasis, clinical evidence is limited. Objective: The purpose of this study is to provide high-quality evidence to support the effectiveness of the traditional Chinese hot and humid compress in the treatment of LDH with qi stagnation and blood stasis. Methods: From October 2021 to November 2023, 86 patients with LDH of qi stagnation and blood stasis type were recruited in our hospital and divided into a control (n = 43) and an observation group (n = 43) according to the random number table method. The control group was given routine clinical treatment, and the observation group was treated with the hot and humid compress therapy for two weeks. The visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, TCM syndrome score, serum interleukin-6 (IL-6), serum interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) were observed and compared between the two groups before and after treatment, and the clinical efficacy of the two groups was evaluated. Results: After treatment, the VAS score, TCM symptom score, and serum IL-6, IL-1β, and TNF-α levels decreased in both groups (P P P P P Conclusions: The hot and humid compress of traditional Chinese medicine can effectively relieve pain, restore lumbar function, improve TCM syndromes, reduce the level of inflammatory factors, and have a curative effect in treating LDH.

On Evaluating University Teachers’ Morality and Ethics in the New Era

University teachers play an important role in promoting moral and political education among university students.Regular and long-term construction of teachers’morality and ethics will contribute to the success of the fundamental task of cultivating talents.The present study proposes that due to the multiple identities of university teachers,it is necessary to evaluate the construction of teachers’morality and ethics in terms of what to evaluate and how to evaluate?It is expected that the attempt will provide useful guidance for the construction of university teachers’morality and ethics.

Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

An Empirical Study on Students’Evaluation of Moral Education in Foreign Language Education in China

Students’evaluation of moral education is of great significance for improving the quality of teaching.Through a survey of 2715 undergraduates majoring in foreign languages,this paper analyzes their evaluation of the moral education.Findings show that students speak highly of teachers’competence in moral education,teaching methods and the integration of moral education in the textbooks,but not in the course assessment and the overall effect of moral education.Suggestions were proposed accordingly to improve moral education of foreign language education in China.

Moral Perspective as Depicted in the Archetypes on Divine-Human Perspective of Dianshizhai Pictorial

This article examines the archetypes related to the divine-human perspective in the Dianshizhai Pictorial and uses the basic theory of“Myth-Archetype Criticism”to analyze the concepts of moral perspective and the view of cause and effect reflected in the text.It summarizes the interactive modes and various archetypes of cause and effect in three contexts:gods to humans,humans to gods,and humans to humans,explores the social reality and the relevant views of moral perspective and causality reflected in the illustrated magazine,and reveals the archetype foundation of the narrative of moral perspective retribution in Dianshizhai Pictorial in the three dimensions of psychology,literature,and society.

Challenges and Countermeasures of Youth Moral Education in the Era of Big Data

Youth moral education is an extremely important work,which is related to the inheritance of traditional virtues of the Chinese nation,the fundamental plan of“successor,”and the construction of modern Chinese spiritual civilization.In the era of big data,the moral education of youth is facing new challenges and opportunities.The wide application of big data technology has brought about an information explosion,exposing young people to more diverse and complex social information.It not only brings opportunities for positive moral education but also many challenges.The main problems of youth moral education in the era of big data are neglected youth subjectivity,insufficient youth moral practice,and utilitarian youth value orientation.We should develop personalized moral education programs,strengthen the integration of moral knowledge and action,and pay more attention to moral practice to improve the pertinence and effectiveness of moral education for young people in the era of big data.

A Study of a Moral Dilemma Stories Teaching Model Focusing on the Development of Higher-Order Thinking --"Synthetic polymers" as an example

Cultivating students'higher-order thinking is one of the important goals of modern education,and innovative teaching model is an effective way to achieve this goal.Aiming at the inadequacy of the existing moral dilemma stories approach in the transformation of knowledge and behavior,this research constructs a new Project Based Learning-Ethical Dilemma Stories(PBL-EDS)Teaching Model applicable to China's secondary education stage based on the innovative features of the moral dilemma stories approach on the core competencies,taking the chemistry subject as an example to carry out practice,and puts forward suggestions for the implementation of the teaching model.Chemistry as an example to carry out the practice,and suggestions are made for the implementation of the teaching model.

Exploring the Effect of Qi Cross-Shaped Moxibustion on the Recovery of Gastrointestinal Function after Hip Fracture in the Elderly

Objective:To explore the effect of Qi cross-shaped moxibustion on the recovery of gastrointestinal function in elderly hip fracture patients after surgery.Methods:62 elderly hip fracture surgery patients were selected as the base analysis sample,enrolled in January 2023-May 2024,and divided into an observation group(n=31)and a control group(n=31)using the digital table random draw scheme.The patients in the control group underwent conventional dietary intervention,and the patients in the observation group underwent Qi cross-shaped moxibustion intervention,comparing the gastrointestinal function recovery time and quality of life scores(PAC-QOL)of patients with constipation between the two groups.Results:The gastrointestinal function recovery time of the observation group was lower than that of the control group(P<0.05);the PAC-QOL score of the observation group was lower than that of the control group after the intervention(P<0.05).Conclusion:Qi cross-shaped moxibustion can shorten the recovery time of gastrointestinal function and improve the quality of life of elderly hip fracture patients after surgery,and it has the value of promotion and application.

Observation on the Nursing Effect of Ginger Moxibustion on Gastrointestinal Symptoms in Patients with Heart Failure Due to Yang Qi Deficiency

Objective:To evaluate the nursing measures and effects of ginger moxibustion in the treatment of heart failure(yang qi deficiency type)with gastrointestinal symptoms.Methods:86 patients with heart failure(yang qi deficiency type)accompanied by gastrointestinal symptoms who were admitted to the hospital between January 2023 and January 2024 were selected and divided into 43 cases in each group by random number table grouping;Group I implemented integrated care,while Group II adopted conventional care.The indicators of care were compared between the two groups.Results:After the nursing care,the digestive symptom scores of Group I were lower than those of Group I,and the psychological scores were lower than those of Group II(P<0.05).Conclusion:Ginger moxibustion can improve gastrointestinal symptoms and enhance the psychological health of patients with heart failure(yang qi deficiency type)with gastrointestinal symptoms.

A study on the treatment of chloasma with moxibustion based on the theory of“Yang transforming Qi,and Yin shaping”

Background:“Yang Transforming Qi and Yin shaping”comes from“Plain Question Yin and Yang should be like the theory”.Chinese medicine believes that the imbalance of yin and yang is the cause of human diseases.One of the strengths of TCM in treating diseases is holistic regulation.The theory of“Yang transforming Qi,and Yin shaping”implies a strong holistic view.Chloasma,one of the common skin diseases,seriously affects the physical and mental health of patients due to its unclear etiology,difficult treatment and easy recurrence.The occurrence and development of chloasma are closely related to internal organs.This paper is based on the theory of internal meridian,“Yang transforming Qi,and Yin shaping”which attaches importance to the concept of“Yang Qi”,from a new understanding of the pathogenesis etiology of chloasma.Methods:The author believes that the incidence of the disease is the deficiency of Yang Qi,which can’t promote the movement of Qi and blood to nourish the face,resulting in tangible material condensation,so proposes that this disease needs to be promoted by Yang transforming Qi and warm to dissipate.Moxibustion belongs to the fire,and its warming effect can dissipate the tangible evil.Results:Combined with clinical practice and the theory of internal meridian,the author elaborated that moxibustion is one of the effective methods for treating chloasma,which provides a new way of thinking for the treatment of chloasma.Conclusion:“Yang Transforming Qi and Yin shaping”can be used to guide the treatment of chloasma.

An Empirical Evaluation of the Impact of Moral and Law Course Teaching on the Effectiveness of University Students’Ideals and Beliefs Education

The Moral and Law course serves as a critical platform for educating university students about ideals and beliefs,and it has a significant impact on the effectiveness of ideals and beliefs education.This paper establishes a mechanism through which Moral and Law course teaching influences the effectiveness of ideals and beliefs education and conducts an empirical evaluation.The results reveal that factors such as the relevance and applicability of the teaching content,the integration of theory and practice,the innovation,interactivity,and participation of teaching methods,as well as classroom atmosphere,teaching facilities,and campus culture,all have a significant positive impact on the effectiveness of ideals and beliefs education for university students.

Collaborative Cultivation of Ideological and Political Education and Undergraduate Management in Colleges and Universities Under the Guidance of Moral Education

Guided by moral education,improving the ideological and moral quality of college students is an important goal of college education.To achieve this goal,it is necessary to strengthen ideological and political education and continuously improve the level of undergraduate management.This paper outlines the feasibility of collaborative cultivation of ideological and political education and undergraduate management in colleges and universities and analyzes its significance and the specific implementation strategies,with a view to providing valuable references for relevant colleges and universities to carry out educational work.