The recombinant vaccine of Lactobacillus plantarum elicits immune protection against H1N1 and H9N2 influenza virus infection.

Influenza A virus (IAV) causes annual epidemics and occasional pandemics, resulting in significant economic losses and numerous fatalities. Current vaccines, typically administered through injection, provide limited protection due to the frequent antigenic shift and drift of IAV strains. Therefore, the development of alternative broad-spectrum vaccine strategies is imperative. Lactic acid bacteria (LAB) represent promising candidates for vaccine engineering due to their low cost, high safety profile, and suitability for oral administration. In this study, we identified a strain of Lactobacillus plantarum (Lp) that is resistant to acid and bile salts and capable of colonizing the intestines of mice. Subsequently, we employed the RecE/T gene editing system to integrate headless hemagglutinins (mini-HA) into the genome of Lp, generating Lp-mini-HA-SP. Remarkably, immunization with Lp-mini-HA-SP elicited serum IgG antibody responses and conferred immune protection against H9N2 and H1N1 influenza virus challenges. Collectively, our findings offer a novel approach for the development of orally administered IAV vaccines and hold significant potential for future drug development endeavors.

Efficacy of post-surgery family-based participatory cluster pain care in children with developmental dislocation of hip.

BACKGROUND: Developmental dislocation of the hip (DDH) is a common congenital deformity of the skeletal system in children. OBJECTIVE: To investigate the efficacy of post-surgery cluster nursing in children with DDH. METHODS: A total of 60 children with DDH who underwent hip joint orthopedic surgery in our hospital from September 2021 to September 2022 were enrolled as the research participants in this prospective study, and divided into the control group and the observation group according to the numerical table method, with 30 patients in each group. The control group was given routine pain care, and the observation group was given cluster pain care. The hip joint function scores, pain scores, self-rating anxiety score (SAS) were compared between the two groups and between before intervention and after intervention in the two groups. RESULTS: The pain score of the children and the SAS of the primary caregivers after the intervention in the observation group were lower than those in the control group (P< 0.05), and the hip joint function score and family satisfaction degree were higher than those in the control group (P< 0.05). CONCLUSION: Family-based cluster pain care can reduce pain in children with DDH after surgery, promote hip joint functional recovery, reduce the negative emotions of caregivers, and improve family satisfaction, and has clinical popularization value.

Expression of FoxO3a in sepsis mice and its association with lymphocyte apoptosis.

This study investigated forkhead box O3a (FoxO3a) expression in peripheral blood of sepsis mice and its correlation with lymphocyte apoptosis. Sixty male C57 mice were randomly assigned to sham, model, and intervention groups. Sepsis was induced via cecal ligation in the model and intervention groups, while sham mice underwent similar procedures excluding cecal ligation. Apoptosis proteins in lymphocytes were assessed by Western blotting, reactive oxygen species (ROS) levels by 2,7-Dichlorodi-hydrofluorescein diacetate (DCFH-DA), and serum interleukin-1ß (IL-1ß) and IL-10 content. The model group exhibited elevated mortality, increased lymphocyte apoptosis, higher Caspase3 expression, and lower Bcl-2/Bax ratio compared to sham and intervention groups. Additionally, the model group displayed decreased serum IL-10, elevated IL-1ß, heightened lymphocytic ROS, reduced FoxO3a expression, and increased levels of p-FoxO3a, p-PI3K, and p-Akt compared to sham. In sepsis mice, inhibited FoxO3a signaling in lymphocytes leads to enhanced apoptosis, elevated ROS, and immune cell dysfunction, contributing to increased mortality.

An investigation into the present status and influencing factors of nurse retention in grade-a tertiary general hospitals in Shanxi Province within the framework of the magnet hospital concept.

BACKGROUND: The attrition of nursing staff significantly contributes to the shortage of healthcare professionals. This study entailed an examination of the propensity of nurses to sustain employment within Grade-A tertiary general hospitals and the various influencing factors. METHODS: A total of 2,457 nurses from three grade-A tertiary general hospitals were surveyed. The survey instruments included a general information questionnaire, a scale measuring their willingness to continue working, and a Chinese version of the Magnet Hospital Factor scale. RESULTS: The scores of the willingness to continue working scale and the Magnet Hospital Factor scale were 21.53 ± 4.52 and 145.46 ± 25.82, respectively. There were statistically significant differences in the scores of willingness of nurses to continue working across various factors, including the department, age, marital status, family location, length of service as nurses, professional title, position, and employment type, upon comparison (P < 0.001). The correlation analysis showed that there was a positive correlation between the willingness of nurses to continue working and the magnet hospital factors, with a correlation coefficient of 0.523 (P < 0.01). Regression analysis showed that department, length of service as nurses, professional title, position, average monthly income, number of night shifts, medical care relationship, educational support, and nursing manager support among the magnet hospital factors were important predictors of willingness to continue working (P < 0.001). CONCLUSION: The willingness of nurses to continue working in grade-A tertiary general hospitals in Shanxi Province was determined to be at an upper-middle level. The magnet status of grade-A tertiary general hospitals needs to be improved, and there are many factors that influenced willingness of nurses to continue working. To cultivate a more favorable environment and bolster nurse recruitment and retention, all healthcare institutions should strive to establish a magnet nursing environment, thereby fostering the robust development of the nursing team.

Protective effect of isoliquiritigenin in amiodarone-induced damage of human umbilical vein endothelial cells.

OBJECTIVE: Amiodarone (AM) is a drug commonly used in patients with ventricular arrhythmias. It can damage vascular endothelial cells and easily cause phlebitis. At present, the prevention and treatment of phlebitis induced by the use of AM is not clear due to the lack of corresponding primary research. Isoliquiritigenin (ISL) has an anti-inflammatory effect, but until now, has not been explored much in the field of research in primary care nursing. The purpose of this study is to investigate the efficacy and mechanism of action of ISL in treating phlebitis induced by AM. METHODS: In our study, we used human umbilical vein endothelial cells (HUVECs) that were divided into three groups: the NC group (normal), the AM group (AM 30 µmol/L for 24 h), and the ISL pretreatment group (isoliquiritigenin 10 µmol/L after 1 h of pretreatment with amiodarone for 24 h). We used CCK-8 to detect cell proliferation, cell scratch assay to detect the migration capability of cells, flow cytometry to measure apoptosis, angiogenesis assay to check the total length and total branches of angiogenesis, and PCR and WB to detect the expression of PCNA, casepase-3, and VEGFA. WB was used to detect NF-κBp65 and p-NF-κBp65 expression. RESULTS: Compared with the AM group, the ISL pretreatment promoted cell proliferation and migration, inhibited cell apoptosis, increased the total length and total branches of angiogenesis, and downregulated p-NF-κBp65 expression. CONCLUSION: ISL shows promise in the prevention and treatment of clinical phlebitis and can be used as a potential therapeutic drug to prevent phlebitis.

Relationship between photosystem activity and ultraweak luminescence excitation in Cerasus humilis leaves under salt stress.

Cerasus humilis (Bge.) Sok (C. humilis) is a wild fruit tree endemic to China. It mainly grows on saline land and often suffers from osmotic stress. Biophotons are ultraweak luminescence (UWL) radiations that are closely related to various biological processes and activities. UWL emission essentially originates from the oxidative stress process of organisms. However, it is unclear whether UWL production is related to the redox state of chloroplasts. Therefore, to understand the UWL emission mechanism in plants, we studied the effect of salt stress on the photosystem (PS) activity and UWL of C. humilis leaves and analyzed the correlation between PS activity and UWL. The results showed that salt stress severely inhibited the PS activity of C. humilis leaves and oxygen-evolving complex, damaged the integrity of the thylakoid membrane, decreased the photochemical efficiency of PSII, and hindered the QA-QB electron transfer. At the same time, the intensity of UWL also decreased. Further, correlation analyses of PS activity indices and UWL showed that UWL was significantly correlated with main parameters of photosystem activity such as PSII the maximum photochemical efficiency (Fv/Fm) and photosynthetic performance index based on absorbed light energy (PIABS), as well as the absorption, capture, and transfer of energy in the unit reaction center and unit leaf section. These results indicated that the PS activity of C. humilis was related to the production of UWL, and the intensity of UWL decreased with the decrease in PS activity.

Effectiveness of intensive versus regular or no exercise in older adults after hip fracture surgery: A systematic review and meta-analysis.

BACKGROUND: Individuals commonly experience age-related systemic decreases in skeletal muscle strength, physical function, and mobility, leading to falls and potential associated hip fractures. OBJECTIVE: To evaluate whether intensive exercise can improve physical function, mobility, and independence in activities of daily living (ADL) and shorten the length of hospital stay in older adults after hip fracture surgery. METHODS: This systematic review was conducted under the PRISMA guidelines. Searches were performed on January 5, 2022 in eight databases. Randomized controlled trials (RCTs) were included. The participants included older adults with hip fracture, and the intervention studied was intensive exercise. The outcomes were physical function, mobility, ADLs, and the length of hospital stay. Meta-analyses were conducted using RevMan 5.3. RESULTS: Fifteen studies were included in this review. After hip fracture surgery, intensive exercise improved participants' physical function to a greater extent than regular or no exercise (standardized mean difference [SMD] = 0.74; 95% CI: 0.25, 1.23). Intensive exercise was particularly more effective for gait speed (SMD = 0.15, 95% CI: 0.01, 0.30), the timed up-and-go test results (mean difference [MD] = -4.34, 95%CI: -6.74, -1.94), balance (SMD =0.42, 95% CI: 0.38, 0.89), and ADLs (SMD = 0.55, 95% CI: 0.24, 0.87). The quality of the evidence was low due to risk of bias, inconsistency, and imprecision. CONCLUSIONS: Intensive exercise early post-operation provides potential additional benefits compared to no or regular exercises on older adults after hip fracture surgery.

Detection method and instrument of interfacial debonding inside a thermal barrier coating based on fluorescence imaging.

The interfacial delamination or debonding induced by local stress concentration is one of the kernel factors leading to spalling failure of thermal barrier coatings (TBC). In this work, for the rapid and accurate characterization of the interface delamination and debonding in TBC, the detection method and instrument were investigated based on fluorescence imaging. First, based on the principle of reflection-enhanced fluorescence, an experimental method was presented to detect interfacial debondings in TBC. A coaxial fluorescence-imaging instrument was established to realize the method above. In addition, an alkaline soluble method (ASM) was presented in this work to prepare prefabricated debondings with different transverse sizes, shapes, and thicknesses, which are basically consistent with the interfacial debondings in an actual TBC structure. Through a series of experiments, this paper verified that, using the proposed method and optical instrument, the resolutions to detect internal debonding are as small as 6 µm in the thickness dimension and less than 0.3 mm in the transverse dimension.

Investigation and analysis of occupational physical injuries among healthcare staffs during allopatric medical aid for the fight against COVID-19.

BACKGROUND: Occupational health impairment of medical personnel manifested as a prominent problem in COVID-19. The aim of this study is to investigate the occupational physical injuries of front-line medical staffs in Hubei province during the fight against COVID-19. MATERIAL AND METHODS: questionnaire survey was conducted among 476 medical staffs from 3 regions of Hubei Province, including general characteristics and the physical discomfort/damage suffered in the isolation wards during working hours. RESULTS: A total of 457 valid questionnaires were collected. The common physical discomfort/damage included skin injuries (22.76%), conjunctivitis (15.10%), falls (9.19%), intolerant unwell symptoms (8.53%) and sharp injuries (6.13%). Logistic regression analysis showed that: lack of protective work experience (OR = 2.049, 95% CI: 1.071-3.921), continuous working for 4 h (OR = 3.771, 95% CI: 1.858-7.654), and working >4 h (OR = 7.076, 95% CI: 3.197-15.663) were high-risk factors for skin injuries. Working continuously for 4 h (OR = 3.248, 95% CI: 1.484-7.110) and working >4 h (OR = 3.096, 95% CI: 1.232-7.772) were high-risk factors for conjunctivitis. Lack of protective work experience was a high risk factor for falls (OR = 5.508, 95% CI: 1.299-23.354). The high risk factors for intolerant unwell symptoms were continuous working for 4 h (OR = 5.372, 95% CI: 1.239-23.301) and working >4 h (OR = 8.608, 95% CI: 1.843-40.217). Working in a COVID-19 critical care unit (OR = 3.249, 95% CI: 1.344-7.854) and implementation of nursing (OR = 9.766, 95% CI: 1.307-72.984) were high risk factors for sharp injuries. CONCLUSIONS: Occupational physical injuries are universal in the COVID-19 ward. Those who take up nursing, work in a critical care ward, with no experience in an isolation ward for infectious diseases, and work continuously for ≥4 h on the same day should get more attention. Med Pr. 2022;73(3):209-18.

The reconstruction on the game networks with binary-state and multi-state dynamics.

Reconstruction of network is to infer the relationship among nodes using observation data, which is helpful to reveal properties and functions of complex systems. In view of the low reconstruction accuracy based on small data and the subjectivity of threshold to infer adjacency matrix, the paper proposes two models: the quadratic compressive sensing (QCS) and integer compressive sensing (ICS). Then a combined method (CCS) is given based on QCS and ICS, which can be used on binary-state and multi-state dynamics. It is found that CCS is usually a superior method comparing with compressive sensing, LASSO on several networks with different structures and scales. And it can infer larger node correctly than the other two methods. The paper is conducive to reveal the hidden relationship with small data so that to understand, predicate and control a vast intricate system.

Clinical Breakpoint of Apramycin to Swine Salmonella and Its Effect on Ileum Flora.

The purpose of this study was to establish the clinical breakpoint (CBP) of apramycin (APR) against Salmonella in swine and evaluate its effect on intestinal microbiota. The CBP was established based on three cutoff values of wild-type cutoff value (COWT), pharmacokinetic-pharmadynamic (PK/PD) cutoff value (COPD) and clinical cutoff value (COCL). The effect of the optimized dose regimen based on ex vivo PK/PD study. The evolution of the ileum flora was determined by the 16rRNA gene sequencing and bioinformatics. This study firstly established the COWT, COPD in ileum, and COCL of APR against swine Salmonella, the value of these cutoffs were 32 µg/mL, 32 µg/mL and 8 µg/mL, respectively. According to the guiding principle of the Clinical Laboratory Standards Institute (CLSI), the final CBP in ileum was 32 µg/mL. Our results revealed the main evolution route in the composition of ileum microbiota of diarrheic piglets treated by APR. The change of the abundances of Bacteroidetes and Euryarchaeota was the most obvious during the evolution process. Methanobrevibacter, Prevotella, S24-7 and Ruminococcaceae were obtained as the highest abundance genus. The abundance of Methanobrevibacter increased significantly when APR treatment carried and decreased in cure and withdrawal period groups. The abundance of Prevotella in the tested groups was significantly lower than that in the healthy group. A decreased of abundance in S24-7 was observed after Salmonella infection and increased slightly after cure. Ruminococcaceae increased significantly after Salmonella infection and decreased significantly after APR treatment. In addition, the genera of Methanobrevibacter and Prevotella were defined as the key node. Valine, leucine and isoleucine biosynthesis, D-Glutamine and D-glutamate metabolism, D-Alanine metabolism, Peptidoglycan and amino acids biosynthesis were the top five Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways in the ileum microbiota of piglets during the Salmonella infection and APR treatment process. Our study extended the understanding of dynamic shift of gut microbes during diarrheic piglets treated by APR.

Time to Occurrence of Phlebitis After Continuous Infusion of Total Nutrient Admixture Through Peripheral Veins: An Experimental Animal Study.

OBJECTIVE: To study the limit time of phlebitis caused by continuous infusion of KabivenTM Pl and TNA (KabivenTM Pl+ alanyl glutamine + potassium aspartate) through a peripheral vein, and to provide a reference for clinical formulation of preventive measures for phlebitis. METHODS: White rabbits (n = 72) were randomly divided into three groups: group A (Normal saline), group B (Kabiven™ Pl), and group C (TNA). Blood was collected from the ear margin vein before administration and after three hours, four hours, five hours, and six hours of administration. CRP and TNF-ɑ were measured by enzyme-linked immunosorbent assay. Hematoxylin and eosin staining and immunohistochemical staining were performed on tissue samples taken from the insertion point of the indwelling needle, the tip of the indwelling needle, and 1 cm from the tip of the indwelling needle, closer to the heart, to analyze early pathological changes in blood vessels. RESULTS: (1) There were no visible inflammatory symptoms in groups A, B, or C within 6 hours. (2) Four hours after starting intravenous administration, the levels of inflammatory markers in groups B and C were higher than in group A, and (3) the degree of inflammatory cell infiltration in groups B and C was more severe than in group A. (4) In all groups, the inflammatory reaction at the tip of the indwelling needle was more severe than at the other two sites. CONCLUSION: When the emulsions TNA and Kabiven™ Pl are infused through a peripheral vein, (1) four hours may be considered as the maximum time for continuous intravenous infusion in the same vein before inflammatory changes become evident, and (2) systematic assessment of the tip of the indwelling needle should be considered for inclusion in the nursing plan for phlebitis monitorings.

Prudent Use of Tylosin for Treatment of Mycoplasma gallisepticum Based on Its Clinical Breakpoint and Lung Microbiota Shift.

The aim of this study was to explore the prudent use of tylosin for the treatment of chronic respiratory infectious diseases in chickens caused by Mycoplasma gallisepticum (MG) based on its clinical breakpoint (CBP) and its effect on lung microbiota. The CBP was established based on the wild-type/epidemiological cutoff value (COWT/ECV), pharmacokinetics-pharmacodynamics (PK-PD) cutoff value (COPD), and clinical cutoff value (COCL) of tylosin against MG. The minimum inhibitory concentration (MIC) of tylosin against 111 MG isolates was analyzed and the COWT was 2 µg/ml. M17 with MIC of 2 µg/ml was selected as a representative strain for the PK-PD study. The COPD of tylosin against MG was 1 µg/ml. The dosage regimen formulated by the PK-PD study was 3 days administration of tylosin at a dose of 45.88 mg/kg b.w. with a 24-h interval. Five different MIC MGs were selected for clinical trial, and the COCL of tylosin against MG was 0.5 µg/ml. According to the CLSI decision tree, the CBP of tylosin against MG was set up as 2 µg/ml. The effect of tylosin on lung microbiota of MG-infected chickens was analyzed by 16S rRNA gene sequencing. Significant change of the lung microbiota was observed in the infection group and treatment group based on the principal coordinate analysis and the Venn diagrams of the core and unique OTU. The phyla Firmicutes and Proteobacteria showed difference after MG infection and treatment. This study established the CBP of tylosin against MG. It also provided scientific data for the prudent use of tylosin based on the evaluation of MG infection and tylosin treatment on the lung microbiota.

Study on Protection of Human Umbilical Vein Endothelial Cells from Amiodarone-Induced Damage by Intermedin through Activation of Wnt/ß-Catenin Signaling Pathway.

Amiodarone (AM) is one of the most effective antiarrhythmic drugs and normally administrated by intravenous infusion which is liable to cause serious phlebitis. The therapeutic drugs for preventing this complication are limited. Intermedin (IMD), a member of calcitonin family, has a broad spectrum of biological effects including anti-inflammatory effects, antioxidant activities, and antiapoptosis. But now, the protective effects of IMD against amiodarone-induced phlebitis and the underlying molecular mechanism are not well understood. In this study, the aim was to investigate the protective efficiency and potential mechanisms of IMD in amiodarone-induced phlebitis. The results of this study revealed that treatment with IMD obviously attenuated apoptosis and exfoliation of vascular endothelial cells and infiltration of inflammatory cells in the rabbit model of phlebitis induced by intravenous infusion of amiodarone compared with control. Further tests in vitro demonstrated that IMD lessened amiodarone-induced endothelial cell apoptosis, improved amiodarone-induced oxidative stress injury, reduced inflammatory reaction, and activated the Wnt/ß-catenin signal pathway which was inhibited by amiodarone. And these effects could be reversed by Wnt/ß-catenin inhibitor IWR-1-endo, and si-RNA knocked down the gene of Wnt pathway. These results suggested that IMD exerted the protective effects against amiodarone-induced endothelial injury via activating the Wnt/ß-catenin pathway. Thus, IMD could be used as a potential agent for the treatment of phlebitis.

The effectiveness of faecal collection devices in preventing incontinence-associated dermatitis in critically ill patients with faecal incontinence: A systematic review and meta-analysis.

OBJECTIVE: The objective of this study was to investigate the effects of different types of faecal collection devices on incontinence-associated dermatitis (IAD) in critically ill patients with faecal incontinence. REVIEW METHOD USED: This was a systematic review and meta-analysis. DATA SOURCES: A comprehensive electronic literature search was performed in PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and WeiPu. All the databases were searched from their inception to July 31, 2019, and the data were updated on November 2, 2019. REVIEW METHODS: Randomised controlled trials (RCTs) and quasi-experimental studies were included. Participants were critically ill patients with faecal incontinence, and the interventions involved care with faecal collection devices. Comparisons were usual care, and the outcome was the incidence of IAD. Odds ratios (ORs) were used to calculate the pooled effect sizes. Heterogeneity was tested using the inconsistency index (I2) method. RESULTS: Nineteen studies were included in this systematic review including 16 RCTs and three quasi-experimental studies. Twelve RCTs were included in the meta-analysis, which showed that the use of faecal collection devices significantly reduced the incidence of IAD. Subgroup analyses based on device type showed significant effects for anal pouch collection devices (OR, 0.14; 95% confidence interval [CI], 0.07-0.26; P < 0.00001), anal pouch connected to negative-pressure suction devices (OR, 0.18; 95% CI, 0.08-0.42; P < 0.00001), anal catheter/tube collection devices (OR, 0.24; 95% CI, 0.13-0.44; P < 0.00001), and anal catheter/tube connected to negative-pressure suction devices (OR, 0.20; 95% CI, 0.07-0.59, P < 0.00001). CONCLUSIONS: Faecal collection devices can reduce the incidence of IAD in critically ill patients with faecal incontinence. It is suggested that when using a device to care for critically ill patients with faecal incontinence, an anal pouch connected to continuous low-negative-pressure suction device should be preferred. Further high-quality research is still needed regarding anal catheter/tube collection devices and anal catheter/tube connected to continuous low-negative-pressure suction devices.

A novel splicing pathogenic variant in COL1A1 causing osteogenesis imperfecta (OI) type I in a Chinese family.

BACKGROUND: Osteogenesis imperfecta (OI), a rare autosomal inheritable disorder characterized by bone fragility and skeletal deformity, is caused by pathogenic variants in genes impairing the synthesis and processing of extracellular matrix protein collagen type I. With the use of next-generation sequencing and panels approaches, an increasing number of OI patients can be confirmed and new pathogenic variants can be discovered. This study sought to identify pathogenic gene variants in a Chinese family with OI I. METHODS: Whole-exome sequencing was used to identify pathogenic variants in the proband, which is confirmed by Sanger sequencing and cosegregation analysis; MES, HSF, and Spliceman were used to analyze this splicing variant；qRT-PCR was performed to identify the mRNA expression level of COL1A1 in patient peripheral blood samples; Minigene splicing assay was performed to mimic the splicing process of COL1A1 variants in vitro; Analysis of evolutionary conservation of amino acid residues and structure prediction of the mutant protein. RESULTS: A novel splicing pathogenic variant (c.3814+1G>T) was identified in this OI family by using whole-exome sequencing, Sanger sequencing, and cosegregation analysis. Sequencing of RT-PCR products from the COL1A1 minigene variant reveals a 132-nucleotide (nt) insertion exists at the junction between exons 48 and exon 49 of the COL1A1 cDNA. Splicing assay indicates that the mutated minigene produces an alternatively spliced transcript which may cause a frameshift resulting in early termination of protein expression. The molecular analysis suggested that the altered amino acid is located at the C-terminus of type I procollagen. CONCLUSION: Our study reveals the pathogenesis of a novel COL1A1 splicing pathogenic variant c.3814+1G>T in a Chinese family with OI I.

The prevalence, characteristics, and related factors of pressure injury in medical staff wearing personal protective equipment against COVID-19 in China: A multicentre cross-sectional survey.

Since December 2019, the medical staff fighting against COVID-19 frequently reported the device-related pressure injury (DRPI) caused by personal protective equipment (PPE). We conducted a cross-sectional survey online to investigate the prevalence and characteristics of DRPI among medical staff. Univariate and multivariate logistic regression analyses were employed to explore the risk factors associated with DRPI. A total of 4308 participants were collected and 4306 participants were valid from 161 hospitals in China. The overall prevalence of DRPI caused by PPE among medical staff was 30.03% (95% CI 28.69%-31.41%). The prevalence of male was more than that of female (42.25%, 95% CI 37.99-46.51% vs 26.36%, 95% CI 26.93-29.80%, P < .001).The categories were mainly stages 1 and 2, and the common anatomical locations were nose bridge, cheeks, ears, and forehead. Logistic regression analysis revealed that the risk factors were sweating (OR = 43.99, 95% CI 34.46-56.17), male (OR = 1.50, 95% CI 1.12-1.99), level 3 PPE (OR = 1.44, 95% CI 1.14-1.83), and longer wearing time (OR = 1.28, 95% CI 0.97-1.68). The prevalence of DRPI was high among medical staff wearing PPE against COVID-19, and the risk factors were sweating, male, wearing level 3 PPE, and longer wearing time. Comprehensive preventive interventions should be taken.

The Prevalence, Characteristics, and Prevention Status of Skin Injury Caused by Personal Protective Equipment Among Medical Staff in Fighting COVID-19: A Multicenter, Cross-Sectional Study.

Objective: To investigate the prevalence, characteristics, and preventive status of skin injuries caused by personal protective equipment (PPE) in medical staff. Approach: A cross-sectional survey was conducted online for understanding skin injuries among medical staff fighting COVID-19 in February 8-22, 2020. Participants voluntarily answered and submitted the questionnaire with cell phone. The questionnaire items included demographic data, grade of PPE and daily wearing time, skin injury types, anatomical sites, and preventive measures. Univariable analyses and logistic regression analyses were used to explore the risk factors associated with skin injuries. Results: A total of 4,308 respondents were collected from 161 hospitals and 4,306 respondents were valid. The overall prevalence of skin injuries was 42.8% (95% confidence interval [CI] 41.30-44.30) with three types of device-related pressure injuries, moist-associated skin damage, and skin tear. Co-skin injuries and multiple location injuries were 27.4% and 76.8%, respectively. The logistic regression analysis indicated that sweating (95% CI for odds ratio [OR] 87.52-163.11), daily wearing time (95% CI for OR 1.61-3.21), male (95% CI for OR 1.11-2.13), and grade 3 PPE (95% CI for OR 1.08-2.01) were associated with skin injuries. Only 17.7% of respondents took prevention and 45.0% of skin injuries were treated. Innovation: This is the first cross-sectional survey to understand skin injuries in medical staff caused by PPE, which is expected to be a benchmark. Conclusion: The skin injuries among medical staff are serious, with insufficient prevention and treatment. A comprehensive program should be taken in the future.

Correction to: The application of "upper-body yoga" in elderly patients with acute hip fracture: a prospective, randomized, and single-blind study.

In the original publication of this article [1], there are several errors that need to be corrected as below.

The application of "upper-body yoga" in elderly patients with acute hip fracture: a prospective, randomized, and single-blind study.

PURPOSES: Hip fracture leads to decreased activity and an increased risk of pulmonary complications. The main purpose of this study was to observe the lung capacity, cough capacity of the elderly patient with acute hip fracture, and assess the effects and the feasibility of using a special-designed "upper-body yoga" training to treat elderly patients with hip fracture. METHODS: This was a prospective, randomized, and single-blind study. Eighty-four subjects aged over 65 years were randomly divided into either a control group or a yoga group to undergo an abdominal breathing program or an "upper-body yoga" program until 4 weeks after surgery. The primary outcomes were forced vital capacity/predicted value (FVC%), peak cough flow (PCF), Barthel Index (BI), and the incidence of pneumonia. The secondary outcomes were the rates of right skills and inclination. RESULTS: Thirty-nine subjects in the yoga group and 40 subjects in the control group completed this study. At the end of the first training week, FVC% (74.14% ± 13.11% vs. 70.87% ± 10.46%, P = 0.231) showed no significant difference between the two groups, while the value of PCF (204.80 ± 33.45 L/min vs. 189.06 ± 34.80 L/min, P = 0.048) and BI (38.59 ± 8.66 vs. 33.00 ± 9.32, P = 0.009) in the yoga group was higher. After 4 weeks of treatment, FVC%, PCF, and BI were higher in the yoga group (78.83% ± 13.31 % vs. 72.20% ± 10.53%, P = 0.016; 216.16 ± 39.29 L/min vs. 194.95 ± 31.14 L/min, P = 0.008; 70.77 ± 10.23 vs. 65.75 ± 11.30, P = 0.019). One in the control group and nobody in the yoga group was diagnosed with pneumonia. There was no significant difference between the two groups in terms of the rates of right skills, whereas more elderly people preferred the training program of the "upper-body yoga." CONCLUSION: Elderly patients with acute hip fractures are at risk of impaired lung capacity and inadequate cough. "Upper-body yoga" training may improve the quality of daily life, vital capacity, and cough flow in elderly patients, making it a better choice for bedridden patients with hip fracture.