Anesthesia nurses' self-perceived roles, competencies, and attitudes toward patient safety culture.

AIM: This study aimed to explore anesthesia nurses' (ANs) perceptions of roles, competencies, and attitudes towards patient safety culture, along with predictive factors for patient safety culture. INTRODUCTION: The 2021 guidelines from the International Council of Nurses aim to ensure global access to safe surgical and anesthesia care by 2030. However, in Taiwan, the roles and competencies of ANs are still evolving. Many have a limited understanding, posing potential risks to patient safety. METHODS: A cross-sectional study was conducted, involving ANs from five hospitals within a healthcare foundation. ANs' self-perceived roles and competencies were assessed using a structured questionnaire based on the CanMEDS framework from the International Federation of Nurse Anesthetists. Additionally, data were collected using the Chinese version of the Safety Attitudes Questionnaire. Reporting followed the STROBE guideline. RESULTS: Among 200 ANs, a consensus emerged favored all roles and competencies, with positive attitudes toward patient safety culture. Remarkably, self-perceived competencies, working in regional hospitals, and working in medical centers significantly predicted ANs' attitude toward patient safety culture. DISCUSSION: The study results can assist ANs in gaining a deeper understanding of their roles and competencies. Considering predictive factors, strengthening ANs' competencies may contribute to enhancing patient safety culture. CONCLUSION AND IMPLICATION FOR NURSING AND HEALTH POLICY: Our results informed nursing leaders and policymakers in Taiwan and other countries regarding ANs' perceptions of roles and competencies. Nurse managers could consider the specific factors influencing ANs' attitudes toward patient safety culture and make great efforts to develop strategies aimed at enhancing their competencies.

A Selective Histone Deacetylase Inhibitor Induces Autophagy and Cell Death via SCNN1A Downregulation in Glioblastoma Cells.

Glioblastoma multiforme (GBM) is a grade IV, highly malignant brain tumor. Because of the heterogeneity of GBM, a multitarget drug is a rational strategy for GBM treatment. Histone deacetylase inhibitors (HDACis) regulate the expression of numerous genes involved in cell death, apoptosis, and tumorigenesis. We found that the HDAC4/HDAC5 inhibitor LMK235 at 0.5 µM significantly reduced the cell viability and colony formation of patient-derived, temozolomide-resistant GBM P#5 TMZ-R, U-87 MG, and T98G cells. Moreover, LMK235 also significantly increased TUBA acetylation, which is an indicator of HDAC inhibition. Interestingly, LMK235 induced MAP1LC3 robust readout and puncta accumulation but did not enhance PARP1 cleavage or the proportion of annexin V-positive cells, suggesting that LMK235-induced cell death occurred via autophagy activation. Further RNA-seq analysis after LMK235 treatment showed that 597 different expression genes compared to control. After bioinformatic analysis by KEGG and STRING, we focused on 34 genes and validated their mRNA expression by qPCR. Further validation showed that 2 µM LMK235 significantly reduced the mRNA and protein expression of SCNN1A. Cell viability of SCNN1A-silenced cells were reduced, but cells were rescued while treated with an autophagy inhibitor bafilomycin A1. Conclusively, SCNN1A plays a role in LMK235-induced autophagy and cell death in GBM cells.

Emphysematous pyometra secondary to Enterococcus avium infection in a dog.

A 5-year-old female intact Mastiff dog was presented with a history of vaginal discharge for 1 day. Physical examination revealed a sanguineo-purulent vaginal discharge and systemic inflammatory response syndrome. Abdominal radiographs showed several dilated and gas- filled tubular loops. The differential diagnoses included emphysematous pyometra or small intestinal mechanical ileus. Surgical exploration of the abdomen demonstrated a severely dilated and gas-filled uterus, and emphysematous pyometra was confirmed. The patient's clinical signs resolved after ovariohysterectomy. Histopathology revealed mild endometrial cystic hyperplasia with infiltration of inflammatory cells in the superficial endometrial epithelia. Enterococcus avium, an α-hemolytic gram-positive coccus, was isolated from the uterus. This paper highlights the radiographic features of emphysematous pyometra and a pathogen that has never been reported to be associated with canine pyometra previously.

Cannabidiol induced a contrasting pro-apoptotic effect between freshly isolated and precultured human monocytes.

It has been documented that cannabidiol (CBD) induced apoptosis in a variety of transformed cells, including lymphocytic and monocytic leukemias. In contrast, a differential sensitivity between normal lymphocytes and monocytes to CBD-mediated apoptosis has been reported. The present study investigated the pro-apoptotic effect of CBD on human peripheral monocytes that were either freshly isolated or precultured for 72h. CBD markedly enhanced apoptosis of freshly isolated monocytes in a time- and concentration-dependent manner, whereas precultured monocytes were insensitive. By comparison, both cells were sensitive to doxorubicin-induced apoptosis. CBD significantly diminished the cellular thiols and glutathione in freshly isolated monocytes. The apoptosis induced by CBD was abrogated in the presence of N-acetyl-L-cysteine, a precursor of glutathione. In addition, precultured monocytes contained a significantly greater level of glutathione and heme oxygenase-1 (HO-1) compared to the freshly isolated cells. The HO-1 competitive inhibitor zinc protoporphyrin partially but significantly restored the sensitivity of precultured monocytes to CBD-mediated apoptosis. Collectively, our results demonstrated a contrasting pro-apoptotic effect of CBD between precultured and freshly isolated monocytes, which was closely associated with the cellular level of glutathione and the antioxidative capability of the cells.