A variety of metals, e.g., lead (Pb), cadmium (Cd), and lithium (Li), are in the environment and are toxic to humans. Hematopoietic stem cells (HSCs) reside at the apex of hematopoiesis and are capable of generating all kinds of blood cells and self-renew to maintain the HSC pool. HSCs are sensitive to environmental stimuli. Metals may influence the function of HSCs by directly acting on HSCs or indirectly by affecting the surrounding microenvironment for HSCs in the bone marrow (BM) or niche, including cellular and extracellular components. Investigating the impact of direct and/or indirect actions of metals on HSCs contributes to the understanding of immunological and hematopoietic toxicology of metals. Treatment of HSCs with metals ex vivo, and the ensuing HSC transplantation assays, are useful for evaluating the impacts of the direct actions of metals on the function of HSCs. Investigating the mechanisms involved, given the rarity of HSCs, methods that require large numbers of cells are not suitable for signal screening; however, flow cytometry is a useful tool for signal screening HSCs. After targeting signaling pathways, interventions ex vivo and HSCs transplantation are required to confirm the roles of the signaling pathways in regulating the function of HSCs exposed to metals. Here, we describe protocols to evaluate the mechanisms of direct and indirect action of metals on HSCs. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Identify the impact of a metal on the competence of HSCs Basic Protocol 2: Identify the impact of a metal on the lineage bias of HSC differentiation Basic Protocol 3: Screen the potential signaling molecules in HSCs during metal exposure Alternate Protocol 1: Ex vivo treatment with a metal on purified HSCs Alternate Protocol 2: Ex vivo intervention of the signaling pathway regulating the function of HSCs during metal exposure.

OBJECTIVE: To identify and reach consensus on dimensions and criteria of a competence assessment instrument for health professionals in relation to the process of evidence-based healthcare.
METHODS: A two-round Delphi survey was carried out from April to June 2023.
METHODS: Consensus was sought from an expert panel on the instrument preliminarily established based on the JBI Model of Evidence-Based Healthcare and a rapid review of systematic reviews of relevant literature. The level of consensus was reflected by the concentration and coordination of experts\' opinions and percentage of agreement. The instrument was revised significantly based on the combination of data analysis, the experts\' comments and research group discussions.
RESULTS: Sixteen national and three international experts were involved in the first-round Delphi survey and 17 experts participated in the second-round survey. In both rounds, full consensus was reached on the four dimensions of the instrument, namely evidence-generation, evidence-synthesis, evidence-transfer and evidence-implementation. In round-one, the instrument was revised from 77 to 61 items. In round-two, the instrument was further revised to have 57 items under the four dimensions in the final version.
CONCLUSIONS: The Delphi survey achieved consensus on the instrument. The validity and reliability of the instrument needs to be tested in future research internationally.
UNASSIGNED: Systematic assessment of nurses and other health professionals\' competencies in different phases of evidence-based healthcare process based on this instrument provides implications for their professional development and multidisciplinary team collaboration in evidence-based practice and better care process and outcomes.
CONCLUSIONS: This study addresses a research gap of lacking an instrument to systematically assess interprofessional competencies in relation to the process of EBHC. The instrument covers the four phases of EBHC process with minimal criteria, highlighting essential aspects of ability to be developed. Identification of health professionals\' level of competence in these aspects helps strengthen their capacity accordingly so as to promote virtuous EBHC ecosystem for the ending purpose of improving global healthcare outcomes.
UNASSIGNED: This study was reported in line with the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies.
UNASSIGNED: No patient or public contribution.

BACKGROUND: Extensive research has been conducted treating burnout as an independent variable and performance as a dependent variable to proffer possible solutions to burnout and job performance among academics. Despite this, the burnout crises persist and are exacerbated by the ongoing global proliferation of higher education. Acknowledging this, the current study explored whether performance may contribute to the emergence of burnout.
METHODS: The study\'s sample population comprised 689 academics from Jiangsu province, China. Key Performance Indicator (KPI) results served to measure performance. Psychological counselling and Burnout were calculated using mental health results garnered from the universities. Data was collected on respondents\' demographic characteristics and work situations. The mean scores were 0.517 (SD = 0.5) for gender and 1.586 (SD = 1.103) for age. The relationship among performance, job burnout, and psychological counselling was analysed via a cross-sectional survey deploying grouped regression.
RESULTS: Academics\' job performance was found to regulate their burnout (β = -0.058, P < 0.01). Higher performance of academics was significantly associated with lower job burnout and psychological counselling. Furthermore, psychological counselling significantly moderated job burnout (β = -0.012, P < 0.05) among academics without regulating their job performance.
CONCLUSIONS: The paper supplements the discourse on job burnout and academic performance by suggesting a pre-counselling measure as a strategy to address the crises of burnout. The paper argued that the continued competence of employees should prevent burnout in Higher education and ensure better job performance.

BACKGROUND: Dementia care competence is defined as the ability, acquired through practical experience, to deliver high-quality care services to persons with dementia (PWD). However, many studies only focus on one aspect of competence using qualitative or quantitative research design and have small sample sizes of care staff with dementia. This study aims to conduct a mixed-methods systematic review of the factors influencing the competence of dementia care staff, and explore the relationship between these factors and competence.
METHODS: This review was designed following the PRISMA-P 2015 statement and methodological guidance for the conduct of mixed-methods systematic reviews from the Joanna Briggs Institute (JBI). Seven English and four Chinese databases will be searched to systematically review the existing eligible studies. JBI Critical Appraisal Checklist for Qualitative Research and Analytical Cross-Sectional Studies will be used to assess the methodological quality of each study. A JBI Mixed-Methods Data Extraction Form will be applied for data extraction. The JBI convergent integrated approach will be used for data synthesis and integration. The synthesized findings will be graded according to the JBI ConQual approach as high, moderate, low, or very low. The protocol was registered with PROSPERO in October 2023 (CRD42023474093).

BACKGROUND: This study aimed to assess the impact of the pandemic of the coronavirus disease 2019 (COVID-19) on neonatology residency training in a tertiary children\'s hospital in Chongqing, located in southwest China. Specifically, the study encompassed the effects on residents\' education, lived experiences, well-being, and the quality of neonatal care delivered. As higher educational institutions adapt to the post-COVID-19 era after the pandemic disruption, it is imperative that educational designers/academics learn from their experiences and challenges in curriculum design and delivery, ensuring quality and relevance in education.
METHODS: This study employed a mixed-methods approach to investigate the influence of the COVID-19 pandemic on neonatology residency training at a tertiary children\'s hospital in Chongqing. The first phase surveyed residents\' perceptions and experiences of their clinical education and well-being during the crisis. The second phase compared the quality of neonatal care between the pre-pandemic and pandemic periods.
RESULTS: The survey of 123 neonatology residents examines the effects of COVID-19 on their learning, training, and mental health. The survey showed that most residents adapted well to the situation. Still, some faced challenges in their clinical education and experiences, such as reduced clinical exposure and opportunities to see rare diseases and conditions. A retrospective analysis of clinical data revealed that 7,151 neonates were admitted to the neonatology department during the study period. There was a 27.6% decrease in neonatal admissions during COVID-19, with more premature births and transfers. Residents conducted fewer clinical procedures but managed more complex cases. During COVID, hospital stays and costs were higher, but antibiotic use was lower. Although the case-mix index (CMI) score increased during the pandemic (1.25 vs. 1.18, p < 0.05), there was no significant difference in the rates of readmission within 7 days or poor prognosis.
CONCLUSIONS: Despite reduced clinical exposure, the quality of neonatal care was maintained through innovative training methods that enhanced comprehensive residency programs. The study suggested that neonatology residency education remained effective and resilient during the crisis. Exceptional health professional education is vital to train qualified physicians and enhance healthcare systems for future challenges.

Competence development is essential for bacterial transformation since it enables bacteria to take up free DNA from the surrounding environment. The regulation of teichoic acid biosynthesis is tightly controlled during pneumococcal competence; however, the mechanism governing this regulation and its impact on transformation remains poorly understood. We demonstrated that a defect in lipoteichoic acid ligase (TacL)-mediated lipoteichoic acids (LTAs) biosynthesis was associated with impaired pneumococcal transformation. Using a fragment of tacL regulatory probe as bait in a DNA pulldown assay, we successfully identified several regulatory proteins, including ComE. Electrophoretic mobility shift assays revealed that phosphomimetic ComE, but not wild-type ComE, exhibited specific binding to the probe. DNase I footprinting assays revealed the specific binding sequences encompassing around 30 base pairs located 31 base pairs upstream from the start codon of tacL. Expression of tacL was found to be upregulated in the ΔcomE strain, and the addition of exogenous competence-stimulating peptide repressed the tacL transcription in the wild-type strain but not the ΔcomE mutant, indicating that ComE exerted a negative regulatory effect on the transcription of tacL. Mutation in the JH2 region of tacL upstream regulatory sequence led to increased LTAs abundance and displayed higher transformation efficiency. Collectively, our work identified the regulatory mechanisms that control LTAs biosynthesis during competence and thereby unveiled a repression mechanism underlying pneumococcal transformation.

Recent studies have shown that the processing of neutral facial expressions could be modulated by the valence and self-relevance of preceding verbal evaluations. However, these studies have not distinguished the dimension (i.e., morality and competence) from verbal evaluations. In fact, there is a hot controversy about whether morality or competence receives more weight. Therefore, using the ERP technique, the current study aimed to address this issue by comparing the influence of morality and competence evaluations on behavioral and neural responses to neutral facial expressions when these evaluations varied with contextual valence and self-relevance. Our ERP results revealed that the early EPN amplitudes were larger for neutral faces after receiving evaluations about self relative to evaluations about senders. Moreover, the EPN was more negative after a competence evaluation relative to a morality evaluation when these evaluations were positive, while this effect was absent when these evaluations were negative. The late LPP was larger after a morality evaluation compared to a competence evaluation when these evaluations were negative and directed to self. However, no significant LPP effect between morality and competence evaluations was observed when these evaluations were positive. The present study extended previous studies by showing that early and late processing stages of faces are affected by the evaluation dimension in a top-down manner and further modulated by contextual valence and self-relevance.

The rapid advancement of artificial intelligence (AI) has impacted society in many aspects. Alongside this progress, concerns such as privacy violation, discriminatory bias, and safety risks have also surfaced, highlighting the need for the development of ethical, responsible, and socially beneficial AI. In response, the concept of trustworthy AI has gained prominence, and several guidelines for developing trustworthy AI have been proposed. Against this background, we demonstrate the significance of psychological research in identifying factors that contribute to the formation of trust in AI. Specifically, we review research findings on interpersonal, human-automation, and human-AI trust from the perspective of a three-dimension framework (i.e., the trustor, the trustee, and their interactive context). The framework synthesizes common factors related to trust formation and maintenance across different trust types. These factors point out the foundational requirements for building trustworthy AI and provide pivotal guidance for its development that also involves communication, education, and training for users. We conclude by discussing how the insights in trust research can help enhance AI\'s trustworthiness and foster its adoption and application.

BACKGROUND: Strengthening obstetric nurses\' and midwives\' health education competence is the investment and guarantee for the population\'s future health. The purpose of study is to establish national norms for their health education competence, and explore possible influencing factors for providing an uniform criterion identifying levels and weaknesses.
METHODS: An online questionnaire with a standard process was used to collect data. Three normative models were constructed, and multiple linear regression analysis analyzed possible influencing factors.
RESULTS: The sample respondents (n = 3027) represented obstetric nurses and midwives nationally. Three health education competency normative norms (mean, percentile and demarcation norm) were constructed separately. Locations, hospital grade, department, marital status, training times and satisfaction with health education training influenced obstetrical nurses\' and midwives\' health education competence (P<0.05).
CONCLUSIONS: This study constructed the first national standard for assessing obstetric nurses\' and midwives\' health education competence, providing a scientific reference to evaluate the degree of health education competence directly. These known factors could help clinical and policy managers designate practice improvement measures. In future research, Grade I hospitals should be studied with larger sample sizes, and indicators need to improve to reflect health education\'s effect better.

Background: Various coping strategies have been shown to alleviate the negative effects of trauma, yet the significance of prosocial behaviour in this realm has been notably underexplored. The present study explored the hypothesis that engaging in prosocial behaviour mitigates the impacts of trauma by promoting a sense of competence and relatedness, post-traumatic growth (PTG), and reconstruction of meaning.Methods: Three consecutive studies were conducted with college students to compare differences in consequence of prosocial behaviours between a trauma group and a control group. Study 1 (N = 96) used self-reported experiences of traumatic vs non-traumatic events; Study 2 (N = 43) used exposure vs. no exposure to video of an earthquake; Study 3 (N = 20) used a randomized controlled trial (RCT) of a prosocial-themed intervention vs. no intervention. Outcomes in all studies were assessed by self-report questionnaires.Results: Trauma damaged participants\' sense of competence and meaningfulness. Prosocial behaviour relieved the impact of trauma on meaning, specifically manifested in the individuals\' sense of meaningfulness and their search for meaning. Group interventions with a prosocial theme (based on effect size results) reduced post-traumatic stress disorder (PTSD) and enhanced PTG in victims. The promoting effect on PTG persisted a month later, and its enhancing effect on meaning manifested with a delay.Conclusion: Prosocial behaviour can potentially serve as a beneficial strategy for individuals coping with trauma because it helps enhance meaning and promotes PTG in victims. This conclusion is supported by laboratory experiments and a tentative small-scale intervention study, which provide an innovative perspective for future trauma interventions.
Prosocial behaviour can potentially serve as a beneficial strategy for individuals coping with trauma.Prosocial behaviour relieved the impact of trauma on meaning.Prosocial-themed intervention reduced PTSD and enhanced PTG in victims (based on effect size results).