r than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture. Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture. Maintaining sufficient nursing personnel is critical for healthcare systems worldwide. Improving retention of nurses is one means of addressing this shortfall. To foster retention, some hospitals in Taiwan provide nursing scholarships contingent on recipients signing a 3-year employment contract. However, it is unclear what factors influence students' decisions to accept or reject a scholarship. The purpose of this exploratory qualitative descriptive study was to obtain an understanding of the subjective experiences of fourth-year nursing school students (N = 87) who accepted (n = 43) or declined (n = 44) a hospital-sponsored nursing school scholarship. Students were selected by purposive sampling from the department of nursing of a private university in northern Taiwan. Data were collected between 2013 and 2014 using face-to-face-in-depth interviews. The mean age of participants was 22.7 years; most (94%) were female (n = 82). Analysis of the interview data showed the choice to accept or decline the scerm career goals were important factors affecting the acceptance or rejection of the hospital scholarship. These results could provide insight into factors students consider important for making long-term commitments as a nursing professional, which could not only improve retention of nurses, but also serve as a guideline for career planning. Vascular mimicry (VM) was associated with the prognosis of cancers. The aim of the study was to explore the association between VM and anticancer therapy response in patients with lung adenocarcinoma. This was a single-center retrospective study of patients with lung adenocarcinoma between March 1st, 2013, to April 1st, 2019, at the Second People's Hospital of Taizhou City. All included patients were divided into the VM and no-VM groups according to whether VM was observed or not in the specimen. Vessels with positive PAS and negative CD34 staining were confirmed as VM. The main outcome was progression-free survival (PFS). Sixty-six (50.4%) patients were male. Eighty-one patients received chemotherapy as the first-line treatment, and 50 patients received TKIs. Forty-five (34.4%) patients were confirmed with VM. There was no difference regarding the first-line treatment between the VM and no-VM groups (P = 0.285). The 86 patients without VM had a median PFS of 279 (range, 90-1095) days, and 45 patients with VM had a median PFS of 167 (range, 90-369) days (P < 0.001). T stage (hazard ratio (HR) = 1.37, 95% confidence interval (CI) 1.10-1.71), N stage (HR = 1.43, 95%CI 1.09-1.86), M stage (HR = 2.85, 95%CI 1.76-4.61), differentiation (HR = 1.85, 95%CI 1.29-2.65), therapy (HR = 0.32, 95%CI 0.21-0.49), VM (HR = 2.12, 95%CI 1.33-3.37), and ECOG (HR = 1.41, 95%CI 1.09-1.84) were independently associated with PFS. The benefits of first-line TKIs for NSCLC with EGFR mutation are possibly better than those of platinum-based regimens in patients without VM, but there is no difference in the benefit of chemotherapy or target therapy for VM-positive NSCLC harboring EGFR mutations. The benefits of first-line TKIs for NSCLC with EGFR mutation are possibly better than those of platinum-based regimens in patients without VM, but there is no difference in the benefit of chemotherapy or target therapy for VM-positive NSCLC harboring EGFR mutations. The treatment strategies for Myelodysplastic Syndromes (MDS) are usually based on the risk stratification system. However, few risk signatures which integrate the revised international prognostic scoring system (IPSS-R) with gene mutations can be easily applied in the real world. The training cohort of 63 MDS patients was conducted at Zhongda Hospital of Southeast University from January 2013 to April 2020. The validation cohort of 141 MDS patients was obtained from GSE129828. The mutation scoring system was based on the number of mutations and a unique favorable prognostic factor, which is SF3B1 mutation. Univariate Cox, multivariate Cox, and LASSO regression analyses were used to determine the significant factors that influenced the overall survival. The receiver operating characteristic curve (ROC) was used to evaluate the efficiency of the prognostic model. A novel risk scoring system we named "mutation combined with revised international prognostic scoring system (MIPSS-R)" was developed based on tgrating IPSS-R and the mutation scores, which is more effective on prognosis and treatment guidance for MDS patients. A mutation scoring system was conducted based on the number of mutations and a unique favorable prognostic factor. MIPSS-R, the novel integral risk stratification system was developed by integrating IPSS-R and the mutation scores, which is more effective on prognosis and treatment guidance for MDS patients. The aim of this study was to describe barriers and facilitators for shared decision making (SDM) as experienced by older patients with multiple chronic conditions (MCCs), informal caregivers and health professionals. A structured literature search was conducted with 5 databases. Two reviewers independently assessed studies for eligibility and performed a quality assessment. The results from the included studies were summarized using a predefined taxonomy. Our search yielded 3838 articles. Twenty-eight studies, listing149 perceived barriers and 67 perceived facilitators for SDM, were included. Due to poor health and cognitive and/or physical impairments, older patients with MCCs participate less in SDM. https://www.selleckchem.com/products/nivolumab.html Poor interpersonal skills of health professionals are perceived as hampering SDM, as do organizational barriers, such as pressure for time and high turnover of patients. However, among older patients with MCCs, SDM could be facilitated when patients share information about personal values, priorities and preferences, as well as information about quality of life and functional status.