Association between self-efficacy, spiritual well-being and the willingness to provide spiritual care among nursing staff in Taiwan: a cross-sectional study

BACKGROUND

Spiritual care plays a significant role in holistic patient care, addressing not only physical ailments but also attending to patients' emotional and spiritual well-being. While the importance of spiritual care in nursing is widely recognized, there is often a gap in understanding nurses' willingness to provide such care. This cross-sectional study aimed to explore the association between self-efficacy, spiritual well-being, and willingness to provide spiritual care among nursing staff.

METHODS

The study conducted a cross-sectional survey of full-time registered nurses at a hospital in Taiwan from January 2019 to December 2019. A sample comprising 168 nurses was selected for participation in the study through a random sampling method. In addition to collecting demographic variables, the assessment tools used in the study include the General Self-Efficacy Scale (GSES) for measuring self-efficacy, the Spiritual Index of Well-Being Chinese Version (SIWB-C) for evaluating spiritual well-being, and the Spiritual Care Needs Inventory (SCNI) to gauge willingness to provide spiritual care.

RESULTS

Most participants in the study were female, accounting for 98.2% (n = 165). The mean age of all 168 nurses was 37.1 ± 9.3 years. Additionally, most participants held a Bachelor's degree (79.2%, n = 133) and possessed clinical experience was 10.5 ± 9.3 years. Through logistic regression analysis, it was found that regardless of whether participants have received sufficient spiritual care training, both GSES and SIWB-C remain influential factors in determining the provision of spiritual care.

CONCLUSIONS

Collaboration between healthcare management and nursing staff is essential for fostering a healthcare environment that not only appreciates the physical and spiritual dimensions of patient care but also prioritizes the enhancement of nurses ' self-efficacy and well-being.

Hexavalent chromate bioreduction by a magnetotactic bacterium Magnetospirillum gryphiswaldense MSR-1 and the effect of magnetosome synthesis

Magnetotactic bacteria (MTB) are receiving attention for heavy metal biotreatment due to their potential for biosorption with heavy metals and the capability of the magnetic recovery. In this study, we investigated the characteristics of Cr(VI) bioreduction and biosorption by an MTB isolate, Magnetospirillum gryphiswaldense MSR-1, which has a higher growth rate and wider reflexivity in culture conditions. Our results demonstrated that the MSR-1 strain could remove Cr(VI) up to the concentration of 40 mg L^-1 and with an optimal activity at neutral pH conditions. The magnetosome synthesis existed regulatory mechanisms between Cr(VI) reduction and cell division. The addition of 10 mg L^-1 Cr(VI) significantly inhibited cell growth, but the magnetosome-deficient strain, B17316, showed an average specific growth rate of 0.062 h^-1 at the same dosage. Cr(VI) reduction examined by the heat-inactivated and resting cells demonstrated that the main mechanism for MSR-1 strain to reduce Cr(VI) was chromate reductase and adsorption, and magnetosome synthesis would enhance the chromate reductase activity. Finally, our results elucidated that the chromate reductase distributes diversely in multiple subcellular components of the MSR-1 cells, including extracellular, membrane-associated, and intracellular cytoplasmic activity; and expression of the membrane-associated chromate reductase was increased after the cells were pre-exposed by Cr(VI).

Effects of oral stimulation with breast milk in preterm infants oral feeding: a randomized clinical trial

OBJECTIVES

This study was performed to evaluate the effect of oral stimulation with breast milk for preterm infants.

METHODS

A total of 68 subjects form neonatal intensive care unit were randomly assigned into control group (n=20), premature infant oral motor intervention (PIOMI) group (n=25) and premature infant oral motor intervention with breast milk (BM-PIOMI) group (n=23).

RESULTS

BM-PIOMI group had significant shorter initiation of oral feeding (IOF) time compared to PIOMI group (2.95 days, 95% CI [0.42-5.48]) or control group (9.79 days, 95% CI [7.07-12.51]). BM-PIOMI group had significant sooner transition time from IOF to full oral feeding (FOF) compared to control group (6.68 days, 95% CI [2.2-11.16]), but not to PIOMI group (2.09 days, 95% CI [-2.07 to 6.25]). Length of hospital stay (LOS) did not show statistical different between three groups (control 38.85 ± 14.40 vs. PIOMI 38.48 ± 11.76 vs. BM-PIOMI 38.04 ± 12.2). Growth mixture model identified improvement in non-nutritive sucking (NNS) score in BM-PIOMI group compared to control and PIOMI group (0.8293, p<0.0001, and 0.8296, p<0.0001, respectively).

CONCLUSIONS

Oral stimulation with breast milk can better promotes the oral feeding process of premature infants than the simple oral stimulation, by shorten IOF time and improve early NNS score, but does not shorten transition time from IOF to FOF and LOS.

Peplau’s interpersonal relationship theory combined with bladder function training on patients with prostate cancer

BACKGROUND

Prostate cancer is a major disease impacting men’s health worldwide. Peplau, who is known as “the mother of psychiatric society,” developed an interpersonal relationship theory for nursing. Implementation of this theory in practice has been shown to positively impact patients’ quality of life and reduce adverse symptoms after surgery.

AIM

To investigate the effects of a nursing model based on Peplau’s interpersonal relationship theory combined with bladder function training on patients with prostate cancer.

METHODS

Eighty-nine patients with prostate cancer who underwent transurethral resection of the prostate (TURP) participated in this study. These patients were admitted to The First Affiliated Hospital of Soochow University or Dushu Lake Hospital Affiliated to Soochow University between January 2020 and April 2021. Patients were randomized into either the Peplau nursing group (n = 44) or a routine nursing group (n = 45). The routine nursing group received routine care and bladder function training, while the Peplau care group received care that integrated concepts from the Peplau interpersonal relationship theory as well as bladder function training. The urinary incontinence symptoms of the two groups were recorded, and the respective International Prostate Symptom Scores (IPSS), Functional Assessment of Chronic Illness Therapy- Spiritual Well-Being (FACIT-Sp) scores, and quality of life (QOL) scores for each group were compared before and after three months of nursing intervention.

RESULTS

During the intervention period, the duration of urinary incontinence, frequency, number and amount of urinary incontinence were significantly greater in the routine nursing group compared to the Peplau care group (P < 0.05). The indicators of the routine nursing group were 7.13 ± 2.42 days, 8.23 ± 2.75 times, and 1.24 ± 0.42 L, while those of the Peplau care group were 4.74 ± 1.85 d, 4.21 ± 1.26 times, and 0.56 ± 0.11 L, respectively. After three months of intervention, the mean IPSS score of the routine nursing group was significantly reduced (P < 0.05), while the mean FACIT-Sp and QOL scores were significantly increased (P < 0.05). The mean IPSS score in the Peplau nursing group was significantly lower compared to the routine nursing group, while the FACIT-Sp and QOL scores were higher (P < 0.05).

CONCLUSION

A nursing model based on Peplau’s interpersonal relationship theory combined with bladder function training can significantly improve prostate function and urinary symptoms, resulting in the restoration of physiological function and improvement in the QOL of patients with prostate cancer following TURP.

[Expression and prognostic value of programmed cell death ligand 1 in patients with locally advanced and non-EGFR-mutated non-small cell lung cancer receiving concurrent chemoradiotherapy]

Objective: To explore the expression of programmed cell death ligand 1 (PD-L1) in patients with locally advanced and non-EGFR-mutated non-small cell lung cancer (LA-NSCLC) undergoing concurrent chemoradiotherapy (cCRT) and its association with clinical outcome of patients. Methods: The basic clinical information of 19 patients with unresectable, non-EGFR mutated LA-NSCLC receiving radical cCRT in Cancer Hospital Chinese Academy of Medical Sciences from January 2016 to December 2017 was retrospectively analyzed. The rabbit monoclonal antibody SP263 was used for immunohistochemical analysis to detect the expression of PD-L1 in LA-NSCLC tissues and the tumor proportion score (TPS) equal to or greater than 1% was defined as PD-L1 positive. The associations between PD-L1 ≥1% and PD-L1 ≥25% with the clinical characteristics and clinical outcome of LA-NSCLC patients were evaluated respectively. Results: Among 19 LA-NSCLC patients, 13 had PD-L1 positive expression, and 4 had PD-L1 expression greater than or equal to 25%. No significant difference was observed between patients with PD-L1 positive and negative expressions regarding the distribution of age, smoking history, pathological classification, and TNM staging (P>0.05). A total of 15 patients could be evaluated for therapeutic effect, including 7 patients with partial response (PR), 7 patients with stable disease (SD), and 1 patient with progressive disease (PD). In the group with PD-L1 expression<1%, 3 patients were in objective response, and 4 patients were in disease control. In the group with PD-L1 expression ≥1%, 4 patients were in objective response, and 10 patients were in disease control. When the PD-L1 expression was less than 25%, 6 patients gained the objective response, and 11 patients gained the disease control. When the PD-L1 expression was greater than or equal to 25%, 1 patient gained the objective response, and 3 patients gained the disease control. The median overall survival (OS) was 35 (95%CI: 12.7-57.3) months for patients with PD-L1 ≥1% and 40 (95%CI: not reaching the end point) months for patients with PD-L1<1% (P=0.284). Patients with PD-L1 ≥25% had a median survival time of 12 (95%CI:0.0-34.5) months, and patients with PD-L1<25% had a median survival time of 40 (95%CI: 27.4-52.6) months (P=0.241). Conclusions: The prognosis of LA-NSCLC patients with PD-L1 positive and no-EGFR mutation receiving concurrent chemoradiation has a trend of poor prognosis. A larger sample size study is warranted to explore the prognostic value of PD-L1 expression in inoperable LA-NSCLC patients and to further explore the effect of immunotherapy on patients with different PD-L1 expression levels.

[Impact of Toxoplasma gondii human infections on blood lipid levels]

OBJECTIVE

To evaluate the impact of Toxoplasma gondii human infections on blood lipid levels.

METHODS

A total of 1 000 healthy volunteers that were randomly sampled from a tertiary hospital during the period from December 2017 through December 2019 were enrolled, and assigned into the infection group and the control group according to the detection of serum anti-T. gondii antibody using enzyme-linked immunosorbent assay (ELISA). The serum levels of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglyceride (TG) were detected and compared between the two groups.

RESULTS

The seroprevalence of anti-T. gondii antibody was 8.40% in the study subjects, and there were no significant differences between the infection and control groups in terms of gender (χ² = 1.29, P > 0.05) or age (χ² = 1.41, P > 0.05). The mean serum LDL (t = 3.89, P < 0.05) and TC levels (t = 3.81, P < 0.05) were significantly higher in the infection group than in the control group, while no significant differences were seen between the two groups in terms of mean serum TG (t = 0.97, P > 0.05) or HDL levels (t = 0.75, P > 0.05). In addition, the proportions of abnormal LDL (χ² = 9.69, P < 0.01) and TC levels (χ² = 10.39, P < 0.01) were significantly greater in the infection group than in the control group, while no significant differences were found in the proportion of abnormal TG (χ² = 0.02, P > 0.05) or HDL level (χ² = 0.11, P > 0.05) between the two groups.

CONCLUSIONS

T. gondii human infections affect blood lipid levels, and the individuals sero-positive for anti-T. gondii antibody have higher mean serum LDL and TC, as well as higher proportions of abnormal TC and LDL than sero-negative individuals.

Inpatient Hospice Palliative Care Unit and Palliative Consultation Service Enhance Comprehensive Quality of Life Outcomes in Terminally Ill Cancer Patients: A Prospective Longitudinal Study

This study aimed to explore the effectiveness of an inpatient hospice palliative care unit (PCU) and palliative consultation service (PCS) on comprehensive quality of life outcome (CoQoLo) among terminally ill cancer patients. This was a prospective longitudinal study. Terminally ill cancer patients who met the inclusion criteria and received PCU or PCS in a northern Taiwanese medical center were recruited. The CoQoLo Inventory was used to measure CoQoLo level pre- and seven days following hospice care between August 2018 and October 2019. A total of 90 patients completed the study. No significant differences were found in CoQoLo levels between the PCU and PCS groups pre- and seven days following care. However, the CoQoLo level of patients significantly improved seven days following care in both PCU and PCS groups, compared with pre-hospice care. Patients' age, religious belief, marital status, closeness with family, palliative prognostic index (PPI), and symptom severity were significant concerning CoQoLo levels after adjusting for patients' baseline characteristics. PCU and PCS showed no difference in CoQoLo levels, but both of them can improve CoQoLo among terminally ill cancer patients. These patients could receive PCU or PCS to achieve a good CoQoLo at the end-of-life stage.

The Effect of Practice toward Do-Not-Resuscitate among Taiwanese Nursing Staff Using Path Modeling

This study aimed to elucidate the predictors and the effects of path modeling on the knowledge, attitude, and practice toward do-not-resuscitate (DNR) among the Taiwanese nursing staff. This study was a cross-sectional, descriptive design using stratified cluster sampling. We collected data on demographics, knowledge, attitude, and practice as measured by the DNR inventory (KAP-DNR), Mindful Attention Awareness Scale, General Self-Efficacy Scale, and Dispositional Resilience Scale. Participants were 194 nursing staff from a medical center in northern Taiwan in 2019. The results showed that participation in DNR signature and education related to palliative care were significant positive predictors of knowledge toward DNR. The DNR predictors toward attitude included DNR knowledge, mindfulness, self-efficacy, dispositional resilience, and religious belief of nurses. Generally, the critical predictors of DNR practice were DNR attitude, dispositional resilience, and male nurses. In path modeling, we identified that self-efficacy, dispositional resilience, master’s degree, and religious belief directly influenced practice constituting DNR. Based on the findings of this study, we propose that nurses should improve their self-efficacy and dispositional resilience through training programs. Encouraging staff to undertake further education and have religious beliefs can enhance the practice of DNR and provide better end-of-life care.

Effectiveness of palliative care consultation service on caregiver burden over time between terminally ill cancer and non-cancer family caregivers

PURPOSE

The responsibility of taking care of terminal patients is accepted as a role of family members in Taiwan. Only a few studies have focused on the effect of palliative care consultation service (PCCS) on caregiver burden between terminal cancer family caregivers (CFCs) and non-cancer family caregivers (NCFCs). Therefore, the purpose of this study is to address the effect of PCCS on caregiver burden between CFC and NCFC over time.

METHODS

A prospective longitudinal study was conducted in a medical center in northern Taiwan from July to November 2017. The participants were both terminally ill cancer and non-cancer patients who were prepared to receive PCCS, as well as their family caregivers. Characteristics including family caregivers and terminal patients and Family Caregiver Burden Scale (FCBS) were recorded pre-, 7, and 14 days following PCCS. A generalized estimating equation model was used to analyze the change in the level of family caregiver burden (FCB) between CFC and NCFC.

RESULTS

The study revealed that there were no statistically significant differences in FCB between CFC and NCFC 7 days and 14 days after PCCS (p > 0.05). However, FCB significantly decreased in both CFC and NCFC from pre-PCCS to 14 days after PCCS (β = - 12.67, p = 0.013). PPI of patients was the key predictor of FCB over time following PCCS (β = 1.14, p = 0.013).

CONCLUSIONS

This study showed that PCCS can improve FCB in not only CFC but also NCFC. We suggest that PCCS should be used more widely in supporting family caregivers of terminally ill patients to reduce caregiver burden.

[Effect of perioperative dexamethasone on nausea, vomiting and pain after total knee arthroplasty]

OBJECTIVE

To investigate the effect of perioperative dexamethasone on nausea, vomiting and pain after unilateral total knee arthroplasty and to evaluate its safety.

METHODS

From February 2014 to June 2016, 100 patients with unilateral advanced osteoarthritis treated by total knee arthroplasty were divided into two groups: 50 patients in dexamethasone group including 27 males and 23 females, aged (72.30±7.02) years, were given intravenous drip of dexamethasone 10 mg before operation; 50 patients in saline group, including 26 males and 24 females, aged (71.30±6.08) years, were given the same amount of saline at the corresponding time. The VAS scores of pain at rest and at 45 degrees of knee flexion were recorded at 2, 4, 6, 8, 12, 24, 36 and 48 h after operation. Vomiting, antiemetic drugs and opioids were recorded at 0 to 24 h and 24 to 48 h after operation. The side effects and complications were recorded.

RESULTS

All the 100 patients were followed up for an average of 14.5 months. VAS score of pain at rest in dexamethasone group was lower than that in saline group at 8, 24 and 48 h after operation (P<0.05); VAS score of dexamethasone group at 45 degrees after knee flexion was lower than that of saline group at 8 and 48 h after operation(P<0.05); VAS score of dexamethasone group at rest and 45 degrees after knee flexion was lower than that of saline group(P<0.05). The dosage of opioids and total opioids in dexamethasone group was lower than that in saline group at 0 to 24 h, 24 to 48 h after operation (P<0.05). The proportion of nausea and vomiting occurred at 0 to 24 h and 24 to 48 h after operation, and the proportion of antiemetic required at 0 to 24 h after operation had statistical significance between two groups(P<0.05). The total antiemetic dosage of dexamethasone group was less than that of saline group(P<0.05). As of the last follow-up, no complications such as infection, gastrointestinal ulcer and bleeding occurred in the two groups.

CONCLUSIONS

Preoperative systemic application of dexamethasone can effectively reduce pain and nausea and vomiting after TKA without increasing postoperative complications.

Using the seasonal FGM(1,1) model to predict the air quality indicators in Xingtai and Handan

The air pollution problem in Xingtai and Handan is the focus of public attention. The seasonal gray model with fractional order accumulation is proposed to predict the quarterly concentrations of PM_2.5, PM₁₀, NO₂, and CO in Xingtai and Handan. The new model has higher forecasting performance and can describe the characteristics of seasonal fluctuation very well. The forecasting results indicated that except for the PM₁₀ in Xingtai that will increase slowly, the other indicators in the two places will decrease. The changes of the air quality indicator concentration in different quarters are obvious, and in the same quarter tend to be stable. Except for CO and NO₂ in some seasons, other indicators are in the state of exceeding the standard. The effect of air pollution control is not good. The governance needs to be further strengthened.

Path modeling of knowledge, attitude and practice toward palliative care consultation service among Taiwanese nursing staff: a cross-sectional study

Background

The Taiwanese government has promoted palliative care consultation services (PCCS) to support terminally ill patients in acute ward settings to receive palliative care since 2005. Such an intervention can enhance the quality of life and dignity of terminally ill patients. However, research focusing on the relationship between the knowledge, attitude and practice of a PCCS using path modelling in nursing staff is limited. Therefore, the aim of this study was to elucidate the effect of path modeling on the knowledge, attitude and practice toward PCCS in Taiwanese nursing staff.

Methods

This was a cross-sectional, descriptive study design using convenience sampling. Data collected included demographics, knowledge, attitude and practice as measured by the PCCS inventory (KAP-PCCSI). Two hundred and eighty-four nursing staff from a medical center in northern Taiwan participated in the study in 2013. We performed descriptive statistics, regression analysis, and path modeling using SPSS 19.0 and set p < 0.05 as the statistical significance threshold.

Results

The results showed that the identical factor significantly associated with knowledge, attitude, and practice toward PCCS among nurses was the frequency of contact with PCCS. In addition, higher level of knowledge toward PCCS was associated with working in haematology and oncology wards, and participation in education related to palliative care. A more positive attitude toward PCCS was associated with working in a haematology and oncology ward, and experience of friends or relatives dying. Higher level of practice toward PCCS was associated with nurses who participated in education related to palliative care. In the path modeling, we found that holders of a master’s degree indirectly positive affected practice toward PCCS. Possession of a bachelor degree or above, being single, working within a haematology and oncology ward, and frequency of contact with PCCS positively affected practice toward PCCS.

Conclusions

Based on this study, it is proposed that consultation with PCCS has a positive impact on the care of terminally ill patients. Encouragement of staff to undertake further education can improve the practice of ward staff providing palliative care.

A set of novel microsatellite markers developed for an economically important tree, Dracontomelon duperreanum, in China

Dracontomelon duperreanum, the most representative species of the family Anacardiaceae, is an important multipurpose tree in China and Vietnam. However, no genetic diversity studies have been reported on this species. In this study, we identified 11 microsatellite markers for D. duperreanum by using the restriction-site-associated DNA sequencing (RAD-seq) method and examined their polymorphisms in 22 samples obtained from the South China Botanical Garden, South China. We could detect only two or three alleles for each microsatellite marker. The mean observed and expected heterozygosities were 0.41 and 0.39, respectively, which were lower than those reported for the species with similar life history forms. These relatively low genetic diversities in this common plant species are unexpected and might have resulted from its extensive cultivation. To our knowledge, this is the first report of microsatellite markers in the genus Dracontomelon. These microsatellite markers will be valuable for studying the genetic diversities and structures in D. duperreanum and other Dracontomelon species.

[Prognostic factors of postoperative delayed gastric emptying after pancreaticoduodenectomy: a predictive model]

Objective: To study the prognostic factors of delayed gastric emptying(DGE) after pancreaticoduodenectomy(PD) and construct a prognostic predictive model for clinical application. Methods: Clinic data of 401 consecutive patients who underwent PD between January 2012 and July 2016 in the First Affiliated Hospital of Harbin Medical University were retrospectively collected and analyzed. The patients were randomly selected to modeling group(n=299) and validation group(n=102) at a ratio of 3∶1. The data of modeling group were subjected to univariate and multivariate analysis for prognostic factors and to construct a prognostic predictive model of DGE after PD. The data of validation group were applied to test the prognostic predictive model. Results: DGE after PD occurred in 35 of 299 patients(11.7%) in the modeling group. The multivariate analysis of the modeling group showed that upper abdominal operation history(χ(2)=6.533, P=0.011), diabetes mellitus(χ(2)=17.872, P=0.000), preoperative hemoglobin <90 g/L(χ(2)=14.608, P=0.000) and pylorus-preserving pancreaticoduodenectomy(PPPD)(χ(2)=8.811, P=0.003) were associated with DGE after PD independently. A prognostic predictive model of DGE after PD was constructed based on these factors and successfully tested. The area under the receiver operating characteristic(ROC) curve was 0.761(95%CI: 0.666-0.856) of the modeling group and 0.750(95% CI: 0.577-0.923) of the validation group. Conclusions: Upper abdominal operation history, diabetes mellitus, preoperative hemoglobin<90 g/L and PPPD are associated with DGE after PD independently. The preoperative assessment of a patient's prognostic for DGE after PD is feasible. The model is a valid tool to take precautions against DGE after PD.

BRIEF-REPORT New set of microsatellites for Chinese tallow tree, Triadica sebifera

Chinese tallow (Triadica sebifera) is an important crop and ornamental tree. After it was introduced into the USA, it gradually became a noxious invasive tree in south-eastern America since the middle of the 1900s. Because only six microsatellites were reported previously in T. sebifera, to better understand the genetic diversity and population dynamics of such species, we reported here 28 new microsatellite markers. For these 28 microsatellites, the number of alleles per locus ranged from 2-16. The expected heterozygosity and the expected heterozygosity corrected for sample size varied from 0.0796 to 0.9081 and from 0.0805 to 0.9176, respectively. These microsatellites will provide additional choice to investigate the genetic diversity and structure in T. sebifera.

Long-Term Effectiveness of Two Educational Methods on Knowledge, Attitude, and Practice Toward Palliative Care Consultation Services Among Nursing Staff: A Longitudinal Follow-Up Study

This experimental study investigated long-term effectiveness of two educational methods on knowledge, attitude, and practice (KAP) about palliative care consultation services (PCCS) among nurses, recruited from a medical center located in Northern Taiwan in 2015, using a stratified cluster sampling method, with 88 participants in multimedia (experimental) and 92 in traditional paper education (control) group. Data were collected using KAP-PCCS questionnaire before education, immediately after, and 3rd and 6th month after education. Results showed that both K-PCCSI and P-PCCSI significantly increased immediately after, and at the 3rd month after education for the experimental group; the K-PCCSI remained significantly higher for the experimental group at the 6th month. The highest increase in scores for both K-PCCSI and P-PCCSI was observed at the 3rd month. There was no significant change in A-PCCS in both groups after follow-up periods, when compared before education. Therefore, using multimedia every 3 months to continue strengthening their knowledge may increase the referrals of terminal patients to PCCS.

Psychometric properties of the Chinese version of Spiritual Index of Well-Being in elderly Taiwanese

Background

Spiritual well-being has become an increasingly important issue for the elderly people. The 12-item Spirituality Index of Well-Being (SIWB) is a well-validated instrument for assessing a patient’s current spiritual state. However, the psychometric properties of the SIWB in the Chinese elderly populations are not known. Therefore, this study translated the SIWB into Chinese and evaluated its psychometric properties.

Methods

The English version of the SIWB was first translated into Chinese based on the Brislin’s translation model. The psychometric properties of the translated version of the SIWB (SIWB-C) was evaluated in 416 elderly Taiwanese recruited using a purposive sampling procedure from a medical center, a long-term care institution, and a community health center. Convergent validity was accessed using Pearson’s correlation coefficients of the SIWB-C, the EQ-5D-3 L health-related quality of life scale, and the Geriatric Depression Scale-5 (GDS-5). Exploratory factor analysis with Varimax rotation was performed to determine the construct validity. Confirmatory factor analysis was conducted for verification of the quality of the factor structures and demonstrating the convergent validity of the SIWB-C. An internal consistency test based on the Cronbach’s alpha coefficient and a stability test based on the Guttman split-half coefficient were also performed. Test-retest reliability was evaluated with intraclass correlation coefficient.

Results

Exploratory factor analysis confirmed the original two-dimensional structure of the scale. Confirmatory factor analysis indicated a well-fitting model and a fine convergent validity of the SIWB-C. The Cronbach’s alpha coefficient and the Guttman split-half coefficient for the SIWB-C were 0.94 and 0.84, respectively. The correlations between the SIWB-C with EQ-5D-3 L and GDS-5 were 0.22 (p < 0.01) and 0.45 (p < 0.05), respectively. The intraclass correlation coefficient of the SIWB-C over a test-retest interval of two weeks was 0.989.

Conclusions

The SIWB-C was found to be a potential useful measure of subjective spiritual well-being in elderly Taiwanese. Its application in assessing the spiritual well-being in Mandarin-speaking elderly population warrants further investigation.

Electronic supplementary material

The online version of this article (doi:10.1186/s12877-016-0392-1) contains supplementary material, which is available to authorized users.

Nurse education and willingness to provide spiritual care

BACKGROUND

Spiritual care is a critical part of holistic care, and nurses require adequate preparation to address the spiritual needs of patients. However, nurses' willingness to provide such care has rarely been reported. Hence, nurses' education, and knowledge of spiritual care, as well as their willingness to provide it require further study.

METHODS

A convenience sample of 200 nurses participated in the study. Quantitative data were collected using a 21-item Spiritual Care Needs Inventory (content validity index=.87; Cronbach's alpha=.96).

RESULTS

The majority of participants were female (96.5%, n=193) between 21 and 59years old (mean=35.1years). Moreover, the majority of participants had a Bachelor's degree (74.0%, n=148) and 1-36years of clinical experience (mean=12.13years). Regarding religious beliefs, 63 (31.5%) had no religious belief, and 93 (46.5%) did not engage in any religious activity. Overall, the nurses were willing to provide spiritual care, although only 25 (12.5%) felt that they had received adequate education.

CONCLUSION

The findings of this study indicate the need for further educational preparation in spiritual care for nurses. Specifically, additional teaching materials are required that are more directly related to spiritual care. Greater emphasis should be placed on different subject areas in school-based education, continuing education, and self-learning education according to the needs of nurses. Since spiritual care education needs policy support, in-depth discussions should take place regarding the approach and cultural environment for providing spiritual care in future nursing courses. Moreover, further studies should investigate barriers in providing spiritual nursing care to patients and whether they are the results of a lack of relevant knowledge or other factors.

Randomized controlled trial of a six-week spiritual reminiscence intervention on hope, life satisfaction, and spiritual well-being in elderly with mild and moderate dementia

OBJECTIVE

Reminiscence therapy has been reported to improve the well-being in patients with dementia. However, few studies have examined the effects of spiritual reminiscence, which emphasizes on reconnecting and enhancing the meaning of one's own experience, on patients with dementia. Therefore, this study aimed to investigate the effects of spiritual reminiscence on hope, life satisfaction, and spiritual well-being in elderly Taiwanese with mild or moderate dementia.

METHODS

A randomized controlled trial was conducted on 103 patients with mild or moderate dementia recruited from a medical center in central Taiwan. The patients were randomly assigned to either a 6-week spiritual reminiscence group (n = 53) or control group (n = 50). The Herth Hope Index, the Life Satisfaction Scale, the Spirituality Index of Well-Being were administered before and after the 6-week period.

RESULTS

The interaction terms between group and time for the three outcome measures were found to be significant (P < 0.001), indicating that the changes over time in them were different between the intervention and control groups.

CONCLUSIONS

Findings of this randomized controlled trial showed that hope, life satisfaction, and spiritual well-being of elderly patients with mild or moderate dementia could significantly be improved with a 6-week spiritual reminiscence intervention.

Predictors for Reconstruction and Mood Disorder Associated With Reconstruction in Patients With Breast Cancer and Mastectomy: A Retrospective Cohort Study

This study used Taiwan's National Health Insurance medical claims to investigate the predictors for operative modes chosen by early-stage breast cancer patients; as well as to assess whether operative modes are associated with risk of mood disorder. We included 36,377 patients with breast cancer who received surgery between 2000 and 2008, and were followed to the end of 2010; they were further classified into 3 groups: mastectomy alone (n = 34,900), along with early reconstruction (n = 1080), and along with delayed reconstruction (n = 397). The results showed that age, insurance premium, urbanization level, and postsurgery chemotherapy and radiotherapy were all significant predictors for the selection of operative modes. Breast cancer patients with mastectomy alone, early reconstruction, and delayed reconstruction showed a cumulative incidence rate of mood disorder of 36.90%, 41.56%, and 33.89%, respectively. The multiple cox proportional model further revealed that early (hazard ratio [HR] = 1.06, 95% confidence interval (CI) = 0.93-1.21) and delayed (HR = 1.17, 95% CI = 0.96-1.42) reconstruction were associated with a slightly higher but insignificant risk of mood disorder, as compared to the patients received no reconstruction.

Blumea balsamifera Oil for the Acceleration of Healing of Burn Injuries

Blumea balsamifera oil (BBO) is a main extract obtained from Blumea balsamifera (L.) DC (Ainaxiang) leaves, which are widely used as a traditional medicine by the Miao and Li Nations to promote skin trauma or burn injury healing. This study was initiated to investigate the healing efficacy in deep second-degree burn model in rats. The rats were treated by BBO for 21 consecutive days. The rate of healing, scabs dropped time and re-epithelialization time were observed every three days for 21 days after burn injury. The samples were collected from different treated rats by sacrificing the animals on the 1st, 2nd, 5th, 9th, 14th, and 21st day post-burn creation. Then, the water content of burn tissue was measured. Plasma interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-α) levels were evaluated, and the tissue expressions of basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β) were determined along with skin histopathology. The results showed that the water content of tissue was significantly reduced, the scabs dropped time shortened, and healing accelerated after treatment with BBO in the burn injury rats. Furthermore, the expressions of growth factors were significantly increased in the tissue; however, the levels of inflammatory factors on plasma decreased. This study confirms the efficacy of BBO consumption on burn injuries.

Relationship between palliative care consultation service and end-of-life outcomes

PURPOSE

Palliative care consultation service (PCCS) is currently utilized to provide care to terminal patients in Taiwan. However, there is little research on the relationship between PCCS and end-of-life outcomes. This study aimed to elucidate the association between PCCS and end-of-life outcomes in terminal cancer patients.

METHODS

Retrospective chart reviews of terminal cancer patients who consulted the PCCS of a medical center in Taiwan from January 2007 to December 2012 were performed. Data on 1369 patients were recorded, which included details of outcomes such as discharge from hospital, transfer to hospice ward, and death after PCCS termination. Other variables such as demographics, disease-related information, symptoms, and psychosocial needs were also evaluated. Logistic regression models were employed to estimate the adjusted odds ratios and related 95% confidence intervals.

RESULTS

The Eastern Cooperative Oncology Group performance status, timing of do-not-resuscitate (DNR) signature, constipation, and spiritual problems experienced by the patients were important predictors for terminal cancer patients who were discharged from the hospital or had expired at the time of PCCS termination. Age, gender, primary cancer diagnosis, timing of DNR signature, constipation, and other physical symptoms were the key predictors for patients who were transferred to the hospice ward or had expired.

CONCLUSIONS

This study confirms the outcomes of PCCS and highlights the important predictors for patients at PCCS termination. These factors can be targeted to improve and enhance the quality of PCCS rendered in the future.

Development and Validation of the Spiritual Care Needs Inventory for Acute Care Hospital Patients in Taiwan

Spiritual care is increasingly being recognized as an integral aspect of nursing practice. The aim of this study was to develop a new instrument, Spiritual Care Needs Inventory (SCNI), for measuring spiritual care needs in acute care hospital patients with different religious beliefs. The 21-item instrument was completed by 1,351 adult acute care patients recruited from a medical center in Taiwan. Principal components analysis of the SCNI revealed two components, (a) meaning and hope and (b) caring and respect, which together accounted for 66.2% of the total variance. The internal consistency measures for the two components were 0.96 and 0.91, respectively. Furthermore, younger age, female sex, Christian religion, and regularly attending religious activities had significantly higher mean total scores in both components. The SCNI was found to be a simple instrument with excellent internal consistency for measuring the spiritual care needs in acute care hospital patients.

Cloning and sequence analysis of the Blumea balsamifera DC farnesyl diphosphate synthase gene

Blumea balsamifera DC is a member of the Compositae family and is frequently used as traditional Chinese medicine. Blumea balsamifera is rich in monoterpenes, which possess a variety of pharmacological activities, such as antioxidant, anti-bacteria, and anti-viral activities. Farnesyl diphosphate synthase (FPS) is a key enzyme in the biosynthetic pathway of terpenes, playing an important regulatory role in plant growth, such as resistance and secondary metabolism. Based on the conserved oligo amino acid residues of published FPS genes from other higher plant species, a cDNA sequence, designated BbFPS, was isolated from B. balsamifera DC using polymerase chain reaction. The clones were an average of 1.6 kb and contained an open reading frame that predicted a polypeptide of 342 amino acids with 89.07% identity to FPS from other plants. The deduced amino acid sequence was dominated by hydrophobic regions and contained 2 highly conserved DDxxD motifs that are essential for proper functioning of FPS. Phylogenetic analysis indicated that FPS grouped with other composite families. Prediction of secondary structure and subcellular localization suggested that alpha helices made up 70% of the amino acids of the sequence.

Analysis of genetic relationships and identification of lily cultivars based on inter-simple sequence repeat markers

Inter-simple sequence repeat (ISSR) markers were used to discriminate 62 lily cultivars of 5 hybrid series. Eight ISSR primers generated 104 bands in total, which all showed 100% polymorphism, and an average of 13 bands were amplified by each primer. Two software packages, POPGENE 1.32 and NTSYSpc 2.1, were used to analyze the data matrix. Our results showed that the observed number of alleles (NA), effective number of alleles (NE), Nei's genetic diversity (H), and Shannon's information index (I) were 1.9630, 1.4179, 0.2606, and 0.4080, respectively. The highest genetic similarity (0.9601) was observed between the Oriental x Trumpet and Oriental lilies, which indicated that the two hybrids had a close genetic relationship. An unweighted pair-group method with arithmetic means dendrogram showed that the 62 lily cultivars clustered into two discrete groups. The first group included the Oriental and OT cultivars, while the Asiatic, LA, and Longiflorum lilies were placed in the second cluster. The distribution of individuals in the principal component analysis was consistent with the clustering of the dendrogram. Fingerprints of all lily cultivars built from 8 primers could be separated completely. This study confirmed the effect and efficiency of ISSR identification in lily cultivars.

[The role of the chinese medicine nurse in Taiwan: professional or assistant?]

Personal participation in first line Chinese medicine nursing practice made the author aware of a significant gap between learning and practice in traditional Chinese medicine nursing. For this paper, she interviewed physicians, nurses and patients, researched hospital system and regulatory requirements. She found that "an assistant" is what Chinese medicine physicians expect of nurses, while patients expect a nurse to be able to help them complete treatment while having a good attitude. In order to distinguish clearly nursing from medicine, nursing scholars, with the help of the Chinese Medicine Committee have designed a Chinese medicine nursing training program. Administration is the main content of front-line nurses in this field. They typically have limited responsibilities related to health problem assessment, prevention, or providing guidance / advice. This article raised difficulties and contradictions between the role and practice of Chinese medicine nurses. Three suggestions are provided, including: clearer demarcation of job responsibilities; renewed respect for nurses as professionals; and including traditional Chinese medicine nursing into the formal nursing curricula in order to support a better future for Chinese medicine nurses.

[Cultivating nursing core competencies in college students]

Departments of nursing in Taiwan junior colleges teach a comprehensive range of core competency skills; provide the healthcare system with entry level nursing professionals able to deliver complete care services; and help students prepare for and earn their nursing licenses. Framed by current junior college nursing department curricula and considerations of professional core competency, this paper examines the role of core nursing competencies in college education goals as they influence college curriculum design and clinical practicum programs. The achieved result should be a professional curriculum that incorporates general education, basic medical, and professional nursing elements that is capable of nurturing professional nursing school graduates able to execute their professional duties and earn the respect of patients, their families and society.

First Report of Pyricularia grisea Causing Gray Leaf Spot on Lily in Korea

Lily is an economically important ornamental crop in Korea. In August 2008, severe leaf spot symptoms were observed on an oriental Lily 'Action' in a plant nursery in Daegu, Korea. Disease incidence was 20 to 30%. Initial symptoms were olive green-to-brown lesions on the leaf that developed into tan, elliptical, necrotic lesions. On severely infected leaves, lesions coalesced and killed the entire leaf blade. Infected leaves were surface disinfested with 70% ethanol for 30 s and 2% chlorox for 15 min before plating 1 cm² sections onto potato dextrose agar. Hyphae appeared 5 days after inoculation and pure culture. Conidia were hyaline, transversely septate with one to three septa; most had two. Conidia were obpyriform and measured 29 to 46 μm long and 7 to 17 μm wide. Mycelia morphology and conidia production were consistent with that described previously for Pyricularia grisea (1). Koch's postulates were fulfilled by spraying five, healthy, vegetative-stage plants with 2 × 10⁵ conidia per ml of sterile distilled water plus 0.05% Tween 20. As a control, five similar plants were sprayed with sterile water plus 0.05% Tween 20 only. Plants were placed inside plastic bags to maintain high relative humidity and incubated in a growth chamber at 25°C under fluorescent light for 14 h and at 20°C in darkness for 10 h. After 3 days, the plastic bags were removed and plants were maintained under the same conditions. Initial symptoms were observed 7 days after inoculation. Ten days after inoculation, disease symptoms on inoculated plants were similar to those previously described in the nursery. Control plants did not show any symptoms. Fungi isolated from these lesions had the same morphological characteristics as the ones isolated previously from plants in the nursery. To our knowledge, this is the first report of gray leaf spot on lily caused by P. grisea in Korea. References: (1) M. B. Ellis. Dematiaceous Hyphomycetes. CMI, Kew, Surrey, UK, 1971.

Assemblies of aligned magnetotactic bacteria and extracted magnetosomes: what is the main factor responsible for the magnetic anisotropy?

The origin of the magnetic anisotropy is explained in an assembly of aligned magnetic nanoparticles. For that, nanoparticles synthesized biologically by Magnetospirillum magneticum AMB-1 magnetotactic bacteria are used. For the first time, it is possible to differentiate between the two contributions arising from the alignment of the magnetosome easy axes and the strength of the magnetosome dipolar interactions. The magnetic anisotropy is shown to arise mainly from the dipolar interactions between the magnetosomes.

Using chest vibration nursing intervention to improve expectoration of airway secretions and prevent lung collapse in ventilated ICU patients: a randomized controlled trial

BACKGROUND

Almost 80% of patients in the intensive care unit are intubated and on mechanical ventilation. Thus, their airway clearance ability is compromised and their risk of lung collapse increased. A variety of interventions are used to enhance airway clearance with the goal of preventing atelectasis and infection. The purpose of this study was to evaluate the effect of a chest vibration nursing intervention on the expectoration of airway secretions and in preventing lung collapse among ventilated critically ill patients.

METHODS

This was a randomized, single-blind experimental study. A total of 95 patients were enrolled from 2 ICUs and randomly assigned into either the experimental group (n = 50) or control group (n = 45). Patients in the control group received routine positioning care, which consisted of a change in body position every 2 hours. Patients in the experimental group received routine positioning care plus the use of chest vibration nursing intervention for 72 hours. This intervention consisted of placing a mechanical chest wall vibration pad on the patients back for 60 minutes when the patient was in a supine position. The chest vibration intervention was performed 6 times a day. Outcome variables were dry sputum weight (DSW) per 24 hours and lung collapse index (LCI); these were measured at 24, 48 and 72 hours.

RESULTS

Patients who received the chest vibration nursing intervention had greater DSW and lower LCI after 24 hours. Pre-test DSW and group could explain 48.2% of the variance in DSW at 24 hours. The LCI at 24, 48 and 72 hours were all significantly improved in the intervention group compared to the control group. The previous LCI measured was the most significant predictor of the next LCI measured. A significant difference was found between the control and experimental groups in their 24-, 48- and 72-hour DSW and LCI after vibration, when monitored by the generalized estimating equation in time sequence.

CONCLUSION

The results suggest that chest vibration may contribute to expectoration and thus improve lung collapse among ventilated patients in an ICU. Chest vibration nursing intervention is a safe and effective alternative pulmonary clearance method and can be used on patients who are on ventilators in ICUs.

[Comprehensive geriatric assessment and nursing practice]

The elderly now constitute 9.86% of the population of Taiwan. Seventy-three percent of them have at least one chronic disease. The medical costs of the elderly are double those of young adults. This article introduces the concept of the comprehensive geriatric assessment, which has been defined as, " multidimensional, often interdisciplinary, diagnostic process intended to determine a frail elderly person's medical, psychosocial, and functional capability and problems, with the objective of developing an overall plan for treatment and long-term follow-up." The article introduces geriatric physiological diseases, mental states and physical functions, and the multi-disciplinary, comprehensive geriatric assessment itself, with its multi-dimensional diagnoses and procedures, the population at which it is targeted , the principles under which it is carried out, its content and outcomes, and a brief explanation of its relevance to nurses. The value of the comprehensive geriatric assessment is similar to that of a health advancement and disease prevention strategy for elderly people. Only by adhering to the theory and insisting on care of the whole person, providing comprehensive geriatric care in groups, can the best quality of care be achieved for elderly patients.

The Effect of Intermittent Nasogastric Feeding on Preventing Aspiration Pneumonia in Ventilated Critically Ill Patients

This randomized, controlled study employed two feeding protocols for 107 participants in two intensive care units (ICUs) of a medical center to investigate the efficacy of intermittent nasogastric (NG) feeding in preventing aspiration pneumonia in critically ill patients on ventilators. The participants were randomly assigned to receive continuous (51 patients) or intermittent (56 patients) feeding. The primary outcomes, including gastric emptiness index and pulmonary aspiration index, were examined on Day 0 and Day 7 of the intervention. In addition, patients were followed up to the 21st day to evaluate the secondary outcomes, which included length of stay (LOS) in the ICU and airway status. The results showed that the patients in the intermittent feeding group had a higher total intake volume at Day 7 (p = .000), had been extubated earlier at Day 21 (p = .002), and had a lower risk of aspiration pneumonia (odds ratios: 0.146, 95% CI = 0.062-0.413, p = .000) than the patients in the control group. Participants being treated with a high dose of dopamine were 2.95 times more likely to get aspiration pneumonia than those receiving a low dose of dopamine (95 % CI = 1.076-8.107, p = .035). However, there was no significant difference between the two groups'; LOS. The results of this study provide evidence that clinical caregivers may use to make better decisions in terms of feeding methods for critically ill patients.

Predictive Factors of Self-Care Capacity in Veterans' Care Institution Residents

The aim of this research is to determine which factors affect the self-care capacity of veterans self-pay care institution residents and to build a predictive model of their level of independence. Our study included 404 residents of a veterans care institution. Our data collection involved an integrated, multidisciplinary approach. The tools used by each group were all of high validity and reliability. The resulting data was entered into SPSS statistic software, and then analyzed by related coefficients, Mann- Whitney test, Kruskal-Wallis H test, and stepwise multiple regression. This analysis showed that 12.1% of residents were self-care dependent. Residents medical conditions (stoke, arthritis), physical function (tinnitus, fall), cognitive function (Mini-Mental State Examination score, Geriatric Depression Scale Short-Form score, Acute Confusion Behavior Scale score), and social function (frequency of exercise per week, frequency of visitors), showed correlation with self-care capacity. The predictive model of self-care capacity was built as follows: Self-care predictive value = 93.022 -.274 x GDS score +.196 x MMSE score - 3.222 x Stroke - 1.262 x Arthritis +.225 x Exercise per week. This model explained 10.5% of the total variance. The results of this research can act as a basis for elderly admission to and transfer from veterans care institutions and can be a reference for recommending relevant nursing service. This research also provides important information for those who wish to improve the self-care capacity of care institution residents.

Use of colicin-based genetic tools for studying bacterial protein transport

Transport of proteins across the envelope of Gram-negative bacteria is a very challenging domain of investigation, which involves membrane-embedded proteinaceous complexes at which specific targeting occurs. These transporters (translocon or secreton) have been studied both with genetics and biochemistry. In this review we report recent developments that should help to identify novel interactions that exist within these complexes, and to decipher the signals that specifically direct transported proteins to the cognate system. These developments are exclusively based on the re-routing of colicins to these molecular machineries. The re-routing induces a lethal situation in the case of efficient or inefficient transport, depending on the system, thus creating a genetic tool for selection of mutations that correct or generate a transport default.

Effect of O2, H2 and redox potential on the activity and synthesis of hydrogenase 2 in Escherichia coli

The aim of this work was to study the influence of O2 with special emphasis on low oxygen tension, the effect of H2 under various conditions of oxygen tension and the influence of the redox potential in the growth medium on hydrogenase 2 of Escherichia coli. The hydrogenase activity and the content of the large (HybC) and small (HybO) subunits of hydrogenase 2 were compared during turbidostat cultivation in a wild strain and mutant HDK103 lacking hydrogenases 1 and 3. No hydrogenase 2 activity in the mutant HDK103 was observed under aerobic conditions, but it was maximal under anaerobic conditions and half-maximal at an oxygen tension of approximately 4 mbar as is common for enzymes of anaerobic respiration. The content of hydrogenase 2 in both the strains was maximal under anaerobic conditions. In the wild strain, H2 addition enhanced hydrogenase activity and the HybO content under microaerobic conditions only. Under anaerobic conditions endogenous H2 production hindered this effect. Under aerobic conditions, the 02-related negative effect seemed to dominate over the H2-related positive effect. By contrast, in the mutant HDK103, hydrogen influenced neither hydrogenase 2 activity nor its content. A possible role of hydrogenase I in the response of hydrogenase 2 to hydrogen is discussed. Under conditions of different O2 tension, hydrogenase activity in both strains correlated inversely with the value of the redox potential of the medium. The presence of H2 changed this dependence. Thus, the value of the redox potential itself is not a controlling factor for hydrogenase 2.

[Establishment of a method for GUS gene transferring into wheat (Triticum astivum L.) embryos by low energy ion beam implantation]

Physical parameters influencing transformation of wheat mediated by low energy ion beam, including type of ion, parameters of ion energy, dose and dose rate, were studied. Ar+ was regarded as suitable ions implanted in transformation. 20-25 keV of energy, 4.68 x 10(16) ions/cm2 of dose, 2.6 x 10(15) ions/cm2 of dose rate were chosen as appropriate implantation parameters. The suitable culture conditions for induction and growth of callus and the optimal selection scheme were established, After implantation and selection, resistant calli and hygromycin-resistant plantlets were obtained from three varieties. Molecular analysis data proved that GUS gene had integrated into the wheat genome. The mature embryo transformation efficiency of wherat variety Yangmai 5, Yangmai 158, Wanmai 32 reached 9.5%, 10.8%, 11.2% measured in produced hygromycin-resistant callus and 1.4%, 3.4%, 1.7% measured in regenerated plants, respectively, This experiment provides a basis for further investigation of wheat transformation system. Low energy ion beam mediated transformation can be extended to other plant recalcitrant to Agrobacterium tumefaciens as soon as methodological parameters are optimized.

Translocation of jellyfish green fluorescent protein via the Tat system of Escherichia coli and change of its periplasmic localization in response to osmotic up-shock

The bacterial twin arginine translocation (Tat) pathway is capable of exporting cofactor-containing enzymes into the periplasm. To assess the capacity of the Tat pathway to export heterologous proteins and to gain information about the property of the periplasm, we fused the twin arginine signal peptide of the trimethylamine N-oxide reductase to the jellyfish green fluorescent protein (GFP). Unlike the Sec pathway, the Tat system successfully exported correctly folded GFP into the periplasm of Escherichia coli. Interestingly, GFP appeared as a halo in most cells and occasionally showed a polar localization in wild type strains. When subjected to a mild osmotic up-shock, GFP relocalized very quickly at the two poles of the cells. The conversion from the halo structure to a periplasmic gathering at particular locations was also observed with spherical cells of the DeltarodA-pbpA mutant or of the wild type strain treated with lysozyme. Therefore, the periplasm is not a uniform compartment and the polarization of GFP is unlikely to be caused by simple invagination of the cytoplasmic membrane at the poles. Moreover, the polar gathering of GFP is reversible; the reversion was accelerated by glucose and inhibited by azide and carbonyl cyanide m-chlorophenylhydrazone, indicating an active adaptation of the bacteria to the osmolarity in the medium. These results strongly suggest a relocalization of periplasmic substances in response to environmental changes. The polar area might be the preferential zone where bacteria sense the change in the environment.

Experimental annotation of the human genome using microarray technology

The most important product of the sequencing of a genome is a complete, accurate catalogue of genes and their products, primarily messenger RNA transcripts and their cognate proteins. Such a catalogue cannot be constructed by computational annotation alone; it requires experimental validation on a genome scale. Using 'exon' and 'tiling' arrays fabricated by ink-jet oligonucleotide synthesis, we devised an experimental approach to validate and refine computational gene predictions and define full-length transcripts on the basis of co-regulated expression of their exons. These methods can provide more accurate gene numbers and allow the detection of mRNA splice variants and identification of the tissue- and disease-specific conditions under which genes are expressed. We apply our technique to chromosome 22q under 69 experimental condition pairs, and to the entire human genome under two experimental conditions. We discuss implications for more comprehensive, consistent and reliable genome annotation, more efficient, full-length complementary DNA cloning strategies and application to complex diseases.

Membrane targeting and translocation of bacterial hydrogenases

Periplasmic or membrane-bound bacterial hydrogenases are generally composed of a small subunit and a large subunit. The small subunit contains a peculiar N-terminal twin-arginine signal peptide, whereas the large subunit lacks any known targeting signal for export. Genetic and biochemistry data support the assumption that the large subunit is cotranslocated with the small subunit across the cytoplasmic membrane. Indeed, the signal peptide carried by the small subunit directs both the small and the large subunits to the recently identified Mtt/Tat pathway, independently of the Sec machinery. In addition, the twin-arginine signal peptide of hydrogenase is capable of directing protein import into the thylakoidal lumen of chloroplasts via the homologous deltapH-driven pathway, which is independent of the Sec machinery. Therefore, the translocation of hydrogenase shares characteristics with the deltapH-driven import pathway in terms of Sec-independence and requirement for the twin-arginine signal peptide, and with protein import into peroxisomes in a "piggyback" fashion.

Bacterial twin-arginine signal peptide-dependent protein translocation pathway: evolution and mechanism

The recently identified bacterial Tat pathway is capable of exporting proteins with a peculiar twin-arginine signal peptide in folded conformation independently of the Sec machinery. It is structurally and mechanistically similar to the delta pH-dependent pathway used for importing chloroplast proteins into the thylakoid. The tat genes are not ubiquitously present and are absent from half of the completely sequenced bacterial genomes. The presence of the tat genes seems to correlate with genome size and with the presence of important enzymes with a twin-arginine signal peptide. A minimal Tat system requires a copy of tatA and a copy of tatC. The composition and gene order of a tat locus are generally conserved within the same taxonomy group but vary considerably to other groups, which would exclude an acquisition of the Tat system by recent horizontal gene transfer. The tat genes are also found in the genomes of chloroplasts and plant mitochondria but are absent from animal mitochondrial genomes. The topology of evolution trees suggests a bacterial origin of the Tat system. In general, the twin-arginine signal peptide is capable of targeting any passenger protein to the Tat pathway. However, a structural signal carried by the mature part of a passenger protein can override targeting information in a signal peptide under certain circumstances. Tat systems show a substrate-Tat component specificity and a species specificity. The pore size of the Tat channel is estimated as being between 5 and 9 nm. Operational models of the Tat system are proposed.

Glycine betaine-assisted protein folding in a lysA mutant of Escherichia coli

Osmoprotectants exogenously supplied to a hyperosmotic culture medium are efficiently imported and amassed by stressed cells of Escherichia coli. In addition to their evident role in the recovery and maintenance of osmotic balance, these solutes should play an important role on the behavior of cellular macromolecules, for example in the process of protein folding. Using a random chemical mutagenesis approach, a conditional lysine auxotrophic mutant was obtained. The growth of this mutant was restored by addition of either lysine or osmoprotectants including glycine betaine (GB) in the minimal medium. The growth rate increased proportionally with the augmentation of the intracellular GB concentration. The mutation was located in the lysA gene and resulted in the substitution of the Ser at position 384 by Phe of the diaminopimelate decarboxylase (DAPDC), which catalyzes the conversion of meso-diaminopimelate to L-lysine. We purified both the wild type DAPDC and the mutated DAPDC-sf and demonstrated that GB was capable of activating DAPDC-sf in vitro, thus confirming the in vivo results. Most importantly, we showed that the activation was correlated with a conformational change of DAPDC-sf. Taken together, these results show, for the first time, that GB may actively assist in vivo protein folding in a chaperone-like manner.

Discrimination between SRP- and SecA/SecB-dependent substrates involves selective recognition of nascent chains by SRP and trigger factor

Besides SecA and SecB, Escherichia coli cells possess a signal recognition particle (SRP) to target exported proteins to the SecY translocon. Using chemical and site-specific cross-linking in vitro, we show that SRP recognizes the first signal anchor sequence of a polytopic membrane protein (MtlA) resulting in cotranslational targeting of MtlA to SecY and phospholipids of the plasma membrane. In contrast, a possible interaction of SRP with the secretory protein pOmpA is prevented by the association of trigger factor with nascent pOmpA. Trigger factor also prevents SecA from binding to the first 125 amino acids of pOmpA when they are still associated with the ribosome. Under no experimental conditions was SecA found to interact with MtlA. Likewise, virtually no binding of trigger factor to ribosome-bound MtlA occurs even in the complete absence of SRP. Collectively, our results indicate that at the stage of nascent polypeptides, polytopic membrane proteins are selected by SRP for co-translational membrane targeting, whereas secretory proteins are directed into the SecA/SecB-mediated post-translational targeting pathway by means of their preferential recognition by trigger factor.