Attitudes of Front-Line Nurses Toward Hospice Care During the COVID-19 Pandemic.

OBJECTIVE: The aim of this study was to understand the attitudes of front-line clinical nurses toward hospice care in the fight against the COVID-19 pandemic, to provide a source of reference for hospice care education and training in hospitals treating patients with COVID-19. METHOD: Front-line nurses from a designated COVID-19 hospital in Wuhan, China, participated. Participants completed the Chinese versions of the General Information Questionnaire, the Frommelt Attitudes Toward Care of the Dying Scale, the Jefferson Scale of Empathy, and the General Self-Efficacy Scale. RESULTS: A total of 149 questionnaires were included in the analysis. The median total hospice care attitudes score was median 102.00(interquartile range, 95.5-120.50). The nurses' attitudes toward hospice care were significantly associated with their age, knowledge of hospice care, level of empathy, and self-efficacy. CONCLUSION: The attitudes of front-line nurses toward hospice care need to be improved. Hospital departments should establish an effective public health emergency strategy, provide training to increase front-line nurses' knowledge and practical experience of hospice care, cultivate nurses' empathy, and enhance their sense of self-efficacy, in order to improve the quality of hospice care for patients and their families.

Factors contributing to glycemic control in diabetes mellitus patients complying with home quarantine during the coronavirus disease 2019 (COVID-19) epidemic.

AIMS: This study assessed factors contributing to glycemic control among diabetes mellitus patients complying with home quarantine during the epidemic of coronavirus disease 2019 (COVID-19). METHODS: We conducted an analytical cross-sectional study by telephone with 1159 patients with type 2 diabetes mellitus (T2DM) and 96 patients with type 1 diabetes mellitus (T1DM) who were discharged from the endocrinology department of a hospital from January 1, 2019, to January 24, 2020. According to their fasting blood glucose (FBG) and 2-h postprandial BG (2hPBG) values, the patients were divided into the well-controlled BG group and the poorly controlled BG group. The main evaluation indicators included sociodemographic variables, health risk variables and adherence to self-management behaviors. RESULTS: In total, 74.46% of the T2DM patients and 64.89% of the T1DM patients had poor glycemic control. T2DM patients with poor glycemic control were more likely to be older (odds ratio (OR): 1.017 [95% confidence interval (CI) 1.003-1.030]; P = 0.013), have fewer than 12 years of education (OR: 1.646 [95% CI 1.202-2.255]; P = 0.002), lack a BG meter at home (OR: 2.728 [95% CI 1.205-6.179]; P = 0.016), have a lower degree of medicationcompliance (OR: 1.627 [95% CI 1.076-2.460]; P = 0.021), and engage in less self-monitoring of BG (SMBG) per week (OR: 10.884 [95% CI 5.883-20.139]; P < 0.001). Fewer than 12 years of education (OR: 3.031 [95% CI 1.112-8.263]; P = 0.030) was a risk factor for glycemic control in T1DM. CONCLUSIONS: Glycemic control among patients with T1DM and T2DM during home quarantine amid the COVID-19 pandemic is poor. Our results showed that more eduction, a higher frequency of SMBG, and improved medication compliance may contribute to glycemic control. Therefore, diabetic patients should be advised to increase the frequency of blood glucose measurements during home quarantine and be re-educated regarding the importance of medication compliance.

Controllable synthesis of graphene scrolls and their performance for supercapacitors.

A graphene scroll (GSC) is a new type of graphene-derivative material, that has widely attracted attention. However, the controllable preparation of GSCs is a major factor influencing their development and application. In this work, sodium citrate (SC) was added to a graphene oxide (GO) aqueous suspension and GSCs were controllably prepared on a large-scale by a cold quenching method. The results show that the number of scroll layers and the curling degree of the GSCs could be controlled by the quantity of SC added. The diameter of the GSCs increased when SC was added. Compared to the GSC without SC (265 nm), the average diameter of GSC(SC-40) (obtained by adding 40 mg SC to 100 mL GO solution (1 mg mL-1)) is 491 nm. When excessive SC was added, such as 100 mg, the average diameter reached 679 nm. Moreover, these GSCs were used as a supercapacitor electrode material and the electrochemical performance was tested. The specific capacitance of GSC(SC-40) (178 F g-1) is higher than that of the GSC without SC (107 F g-1) at the same current density of 1.0 A g-1. However, when a larger quantity of SC was added, the specific capacitance of the GSCs decreased. So, the number of scroll layers and the curling degree of the GSCs have a significant effect on the electrochemical properties of the supercapacitor.

Elevated phthalates' exposure in children with constitutional delay of growth and puberty.

BACKGROUND: Phthalates have been proven to be antiandrogenic, which may interfere with the timing of puberty. Children with Constitutional Delay of Growth and Puberty (CDGP) typically display short stature and pubertal delay. This study investigated whether phthalate's exposure was associated with CDGP, and evaluated the potential mediator role of testosterone. METHODS: In this case-control study, a total of 167 boys, including 57 boys with CDGP (cases) and 110 controls were enrolled. We measured six major phthalate metabolites in urine samples using high-performance liquid chromatography and tandem mass spectrometry (LC-MS/MS). The serum testosterone level was determined by radioimmunoassay. RESULTS: Children in the CDGP group were determined to have significantly elevated urinary phthalates concentration compared with control subjects (total phthalates median: case, 107.00 ng/ml; control, 62.22 ng/ml, p = 0.001). After adjustment for BMI and other confounding factors: mono-n-butyl phthalate (MBP), monoethyl phthalate (MEP) and total phthalate concentrations were significantly negatively associated with serum testosterone level (MBP: ß = -45.7, p = 0.017; MEP: ß = -31.6, p = 0.022; total phthalates: ß = -24.6, p = 0.011); MBP, MEP, mono (2-ethylhexyl) phthalate (MEHP) and total phthalates were significantly associated with CDGP (odds ratio: MBP: 8.30, p = 0.002; MEP: 5.43, p = 0.002; MEHP: 3.83, p = 0.017; total phthalates: 9.09, p = 0.001). Serum testosterone level acted as a mediator of the association between phthalates' exposure and CDGP (p = 0.002) (proportion mediated: 34.4%). CONCLUSIONS: In this case-control study, elevated phthalates' level was detected in children with CDGP in Shanghai, China and phthalate level was associated with CDGP, which appeared to be mediated by circulating testosterone level.

[Study on the mechanism of di-2-ethylhexyl phthalate and cypermethrin inducing gonadal dysgenesis in the prepubertal male rats].

OBJECTIVE: To investigate the mechanism of di-2-ethylhexyl phthalate (DEHP) and cypermethrin (CYP) inducing gonadal dysgenesis in prepubertal male rats. METHODS: A total of 40 healthy 3-week-old specific pathogen-free male Sprague-Dawley rats were randomly and equally divided into four groups: control group (corn oil), DEHP group (500 mg/kg, dissolved in corn oil), CYP group (80 mg/kg, dissolved in corn oil), and combined exposure group (exposed to 500 mg/kg DEHP and 80 mg/kg CYP, dissolved in corn oil). Rats were treated by gavage administration once a day for 30 days. Twenty-four hours after the last exposure, the animals were sacrificed. The body weight and the wet weight of testis were determined, and the weight coefficient of testis was calculated. Radioimmunoassay was used to determine serum testosterone level. Ultrastructural-level histopathological changes of the testis were examined by transmission electron microscopy. The mRNA and protein expression of follicle stimulating hormone receptor (FSHR), androgen binding protein (ABP), inhibin beta-B (INHBB) and vimentin (VIM) were analyzed by real-time PCR and Western blot, respectively. Factorial design analysis of variance was used to compare differences between groups; interaction diagrams were used to determine the interaction between DEHP and CYP. RESULTS: Compared with those of the control group, the testis weights and testis coefficients of the DEHP, CYP, and combined exposure groups significantly decreased by 39.3-59.2%and 19.7-58.6%, respectively, and all exposure groups showed significant reductions in serum level of testosterone, ranging from 49.1% to 62.7% (P < 0.05 or P < 0.01). And all the exposure groups showed different levels of ultrastructural damages in the testes. Compared with that in the control group, the mRNA expression of FSHR, ABP, INHBB, and VIMin the DEHP group was down-regulated by 1.72, 2.64, 2.83 and 1.79 times, and their protein levels were significantly reduced by 65.2%, 53.7%, 70.1%, and 51.9% (P < 0.05 or P < 0.01). Significant decreases in mRNA expression of ABP (down 1.72 times) and INHBB (down 2.06 times) were observed in the CYP group, and their protein levels decreased by 38.3% and 49.7%, respectively (P < 0.05). The combined exposure to both DEHP and CYP resulted in big decreases in the mRNA levels of FSHR (down 1.62 times), ABP (down 2.00 times), INHBB (down 2.35 times), and VIM (down 1.54 times) and protein levels of FSHR (down 52.1%), INHBB (down 53.9%), and VIM (down 58.8%) (P < 0.05). Factorial design analysis of variance showed that the combination of two substances had an antagonistic effect on the expression of ABP and INHBB (P < 0.05). CONCLUSION: DEHP and CYP, alone or combined, can lead to gonadal dysgenesis in prepubertal male rats. Both of them can disrupt functional mRNA and protein expression in Sertoli cells to certain levels. The combination of DEHP and CYP shows antagonistic effects, and DEHP has a stronger reproductive toxicity than CYP.