Bioleaching of available silicon from coal tailings using Bacillus mucilaginosus: a sustainable solution for soil improvement.

In China, a large amount of soil lack available silicon, which leads to a decrease in crop yield. Furthermore, the solid waste coal tailings contain abundant minerals that are rich in silicon, which have not been fully utilized. In this work, we used Bacillus mucilaginosus as the leaching agent to convert insoluble silicon in coal tailings into available silicon for crop. After single-factor experiments, the optimal leaching conditions with bacterial dosage, coal tailings weight, initial pH, leaching temperature, and shaking speed were obtained. Kinetic analysis showed that the controlling process of the leaching was a chemical reaction. The leaching process was characterized by X-ray diffraction (XRD), scanning electron microscopy with energy-dispersive spectroscopy (SEM-EDS), Fourier transform infrared spectrometer (FT-IR), and high-performance liquid chromatography (HPLC). The results showed that bioleaching is a feasible and efficient method to extract silicon from coal tailings, with a maximum leaching amount of 260 mg L-1 after 16 days, which occupied 93% of the total effective silicon. In conclusion, this work demonstrates that bioleaching technology can effectively solve the problem of the environmental utilization of coal tailings by converting them into a soil improver that can provide beneficial nutrients for crop growth.

The relationship between professional quality of life and work environment among ICU nurses in Chinese: a cross-sectional study.

Objective: To explore the relationship between the professional quality of life and work environment among intensive care unit nurses, and identify the influencing factors of intensive care unit nurses' professional quality of life. Methods: This study design is cross-sectional and correlational descriptive. Four hundred fourteen intensive care unit nurses from Central China were recruited. Data were collected from three questionnaires of self-designed demographic questions, the professional quality of life scale and the nursing work environment scale. Descriptive statistics, Pearson's correlation, bivariate analysis and multiple linear regression were used to analyze the data. Results: A total of 414 questionnaires was collected, for an effective recovery rate of 98.57%. The original scores of the three sub-scales of professional quality of life were 33.58 ± 6.43, 31.83 ± 5.94, and 32.55 ± 5.74. Compassion satisfaction was positively correlated with the nursing working environment (p < 0.05), job burnout, and secondary trauma were negatively correlated with nursing work in environment (p < 0.05). Multiple linear regression analysis results show that, the nursing working environment entered into the influential factor model of professional quality of life scale (p < 0.001). The nursing working environment independently explained 26.9% of the changes in compassion satisfaction, 27.1% of the changes in job burnout, and 27.5% of the changes in secondary trauma. The nursing work environment is an important factor affecting the professional quality of life. Conclusion: The better the nursing working environment, the higher the professional quality of life of intensive care unit nurses. Decision makers and managers can focus on improving the working environment of nurses, which may be a new perspective for managers to improve the professional quality of life of nurses and stabilize the nursing team.

Gut microbiome alterations in ICU patients with enteral nutrition-related diarrhea.

Enteral Nutrition-related Diarrhea (END) is an extremely common complication in Intensive Care Unit (ICU) patients. However, it is currently unclear whether the patient's gut microbiota is disturbed. Our study aimed to explore the characteristics of gut microbiota changes in END patients. We divided ICU patients into no-END group (n = 7) and END group (n = 7) according to whether they had END, then stool samples were collected separately. The V3-V4 region of stool bacterial 16S rRNA gene was amplified by PCR and sequenced on an Illumina MiSeq PE300 platform. Microbiome data obtained by quality control were analyzed, including microbial community composition, diversity and gene function prediction.The results showed that the dominant gut microbiota in ICU patients who were given total enteral nutrition were Firmicutes, Proteobacteria, Bacteroidetes, Actinobacteria, and Verrucomicrobia. Bacterial richness and diversity in END patients were all significantly lower than those in no-END patients. In addition, END caused significant changes in bacterial composition. LEfSe found 34 biomarkers represented by Bacteroidetes and Subdoligranulum in the no-END group as well as 11 biomarkers represented by Enterococcus and Klebsiella in the END group. Finally, through PICRUST function prediction, we found that diarrhea led to abnormal changes in numerous KEGG pathways mainly related to immunity and metabolism. In short, ICU patients with END have severe gut dysbiosis, and our study provides a reliable experimental basis for the patient's microbiota therapy.

Nurses' practice and educational needs in oral care for postoperative patients with oral cancer in ICUs: a multicenter cross-sectional study.

BACKGROUND: Surgical incision, endotracheal intubation, structural changes in the oral cavity, and other factors lead to a divergence in oral care between patients after oral surgery and ordinary inpatients. High-quality oral care can reduce the incidence of incision infection and ventilator-associated pneumonia. However, there is a lack of guidelines or expert consensus on oral care after oral cancer surgery. Therefore, the aim of this study was to assess the practicing situation of nurses in the intensive care unit (ICU) for postoperative patients with oral cancer and their need for training. METHODS: A multicenter cross-sectional study design was conducted in 19 ICUs of 11 tertiary hospitals from Henan province in China. Data were collected from 173 nurses and 19 head nurses online using a structured questionnaire. Mann-Whitney U and Kruskal-Wallis H tests were performed to analyze the data using SPSS (Version 25.0). RESULTS: Seven ICUs (36.8%) developed evaluation regulations for the oral care of postoperative patients with oral cancer, and eight ICUs (42.1%) described the operating standards. A total of 173 nurses completed the questionnaire, and the median score was 75 (68, 78). Almost all of the examined nurses (91.2%) assessed patients' oral hygiene at a fixed time, while in 52.0% and 28.3% of nurses, the first oral care and frequency of oral care after surgery was determined based on the individual patient's situation. More than half of the nurses (55.5%) spent approximately 5-10 min conducting oral care for patients. Physiological saline solution (82.7%), swabbing (91.9%), and oral care package with cotton ball (86.1%) were the most popular oral care mouthwash, method, and tool, respectively. Nurses sought help from senior nurses (87.3%) and doctors (83.8%), mostly to solve difficulties of oral care. Moreover, 76.9% of the nurses believed that the lack of knowledge and skills surrounding oral care was the main barrier for nurses to implement oral care. The majority of participants (69.4%) had never received continuing education or training in oral care for postoperative patients with oral cancer, and almost all (98.8%) of the respondents stated their preference to receive training in standardized oral care skills. Indications and contraindications (84.4%), tools (81.5%), and mouthwash (80.9%) of oral care were the items that the respondents were most eager to learn about. Approximately three quarters of nurses preferred scenario simulation practice as the training method. CONCLUSION: Although the participants had high oral care scores for postoperative patients with oral cancer, there was great diversity in the practice. The lack of oral care knowledge was deemed the main barrier in delivering quality oral care, and the educational need was stated by almost all participants. We suggest that a standard protocol or clinical practice guidelines for oral care for postoperative patients with oral cancer should be developed, and nurses should be educated to equip them with professional knowledge and skills.

Knowledge, attitudes and practices of ICU nurses regarding subsyndromal delirium among 20 hospitals in China: a descriptive cross-sectional survey.

OBJECTIVES: This study sought to investigate nurses' knowledge, attitudes and practices, and analyse the influencing factors for subsyndromal delirium (SSD). DESIGN: A descriptive cross-sectional survey. SETTING: E-questionnaires were distributed to intensive care unit (ICU) nurses from 20 tertiary-grade, A-class hospitals in Henan Province, China. PARTICIPANTS: A total of 740 ICU nurses participated in the questionnaire survey. MAIN OUTCOME MEASURES: Each dimension score is converted to a percentage scale. A score of ≤60% on each dimension of the questionnaire was considered a negative score, <80% was considered a intermediate score and ≥80% was considered an excellent score. RESULTS: A total of 733 questionnaires were included in the study. More than half of the nurses were at the intermediate level, and a few nurses were at the excellent level. Nurses self-assessed their level of knowledge was intermediate. In the attitudes dimension, nurses' attitudes were negative. The results of the practical dimension showed that most nurses could carry out the clinical practice. Multiple linear regression analysis showed that educational level and received SSD training were influencing factors. CONCLUSIONS: ICU nursing staff overestimated their knowledge of SSD and showed a negative attitude towards it. Various forms of education and training are necessary.

The mediating effects of adversity quotient and self-efficacy on ICU nurses' organizational climate and work engagement.

AIM: This study aimed to explore the mediating effects of adversity quotient and the moderating effect of self-efficacy on the relationship between the organizational climate and the work engagement of intensive care unit nurses. BACKGROUND: A good organizational climate can contribute to a high level of work engagement. Adversity quotient and self-efficacy are the key factors affecting nurses' work engagement, while the mechanism of these factors in the organizational climate and work engagement remains unclear. This study was conducted to contribute to the relevant field research. METHODS: The study used a cross-sectional research design and surveyed 323 intensive care unit nurses working in a public hospital in China. The data were analysed using descriptive statistical methods: Pearson correlation analysis and PROCESS macro Model 7 in the regression analysis. RESULTS: Organizational climate was positively correlated with work engagement and adversity quotient. The indirect effect of organizational climate on work engagement through adversity quotient was positive. Furthermore, self-efficacy moderated the relationship between the two factors. CONCLUSION: Cultivating organizational climate and adversity quotients is an important strategy to improve the work engagement of intensive care unit nurses, particularly for nurses with high self-efficacy. IMPLICATIONS FOR NURSING MANAGEMENT: Administrators should make efforts to create a good organizational climate and cultivate nurses' adversity quotients and self-efficacy to decrease their intent to leave.

[Application effect of 1-hour bundle in the treatment of patients with sepsis].

OBJECTIVE: To investigate the implementation and application effect of 1-hour bundle in the treatment of patients with sepsis. METHODS: A convenient sampling method was conducted. 102 patients with sepsis admitted to central intensive care unit (ICU) of Henan Provincial People's Hospital from January 2018 to February 2019 were enrolled. Thirty-five patients with 3-hour and 6-hour bundle from January to September in 2018 were served as the control group, and 67 patients who received 1-hour bundle from October 2018 to February 2019 were served as the observation group. The patients in the control group was treated with 3-hour and 6-hour bundle according to 2012 international guidelines for the diagnosis and treatment of severe sepsis and septic shock; and those in the observation group were treated and nursed according to the 1-hour bundle published by Surviving Sepsis Campaign (SSC) update 2018, and the sepsis cluster treatment medical team was established. The team members were trained in relevant knowledge and discussed the possible obstacles within the team and propose feasible measures. The implementation of the 1-hour bundle in the observation group was recorded. The general data of the patients in both groups including gender, age, acute physiology and chronic health evaluation II (APACHE II), etc. were collected, and the outcome indicators (duration of mechanical ventilation, length of ICU stay, 28-day mortality) were observed. RESULTS: In the observation group, 37 of 67 patients receiving 1-hour bundle met the target, with the overall achievement rate of 55.2% (37/67). Of the 37 eligible patients, 5 patients receiving 1-hour bundle met the target before the training of 1-hour bundle, accounting for only 33.3% (5/15) of the 15 patients who received 1-hour bundle during the same period. With the extension of training time, the achievement rate of sepsis 1-hour bundle was gradually increased [the achievement rate at 1 week and 4 weeks of training was 40.0% (4/10) and 52.4% (11/21), respectively], and increased to 81.0% (17/21) at the end of 12 weeks training. Thirty-seven patients who received 1-hour bundle and met the criteria were enrolled and compared with the control group. There was no significant difference in gender, age, or APACHE II score between the two groups. Compared with the control group, the duration of mechanical ventilation and length of ICU stay of the observation group were significantly shortened (days: 6.15±0.49 vs. 7.24±0.53, days: 8.21±1.49 vs. 9.51±1.92), and the 28-day mortality was decreased significantly [10.8% (4/37) vs. 31.4% (11/35)], with statistically significant differences (all P < 0.05). CONCLUSIONS: Through teamwork, discussion and improvement, the achievement rate of sepsis 1-hour bundle can be significantly improved. The use of sepsis 1-hour bundle can effectively decrease the duration of mechanical ventilation and length of ICU stay, and reduce the 28-day mortality.

[Study on the accuracy of oxygen concentration of modified oxygen treatment with Venturi and humidity system].

OBJECTIVE: To verify the accuracy of oxygen concentration (FiO2) of modified oxygen treatment with Venturi and humidity system. METHODS: Patients just after ventilator weaning and before the removal of tracheal intubation/tracheotomy tube, who admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from May 1st to December 15th in 2017, were enrolled. All patients were given a modified oxygen treatment with Venturi and humidity system, and the oxygen flow rate (Flow) of the Venturi device and the oretical value of FiO2 were adjusted according to the patient's condition. Patients were divided into five groups based on doctor's orders: Flow 3 L/min FiO2 0.24, Flow 3 L/min FiO2 0.26, Flow 6 L/min FiO2 0.28, Flow 6 L/min FiO2 0.30, Flow 9 L/min FiO2 0.35. The value of FiO2 at the inhalation end of patients of each group was measured by TSI airflow analyzer, and the consistency between the measured value of FiO2 at the inhalation end and the FiO2 marked value of Venturi was compared and analyzed. RESULTS: When the FiO2 theoretical value of Venturi were adjusted to 0.24, 0.26, 0.28, 0.30, and 0.35, the measured values of FiO2 at the inhalation end of patients were 0.38±0.05, 0.38±0.05, 0.40±0.04, 0.41±0.04, and 0.77±0.11, respectively, which were all significantly higher than the theoretical value of FiO2 (all P < 0.01). The difference between the measured value of FiO2 at the inhalation side and the FiO2 value of the Venturi annotated and the difference rate were both "V"-shaped, both of which decreased with the increase in theoretical value of FiO2 to a Flow of 9 L/min and a theoretical value of FiO2 0.35, the accuracy was the worst, with the FiO2 difference of 0.42±0.11, and the FiO2 difference rate of (121.6±36.5)%. CONCLUSIONS: There is a difference between the measured value and the theoretical value of FiO2 at the inhalation end of the modified Venturi oxygen therapy humidification system, which needs to be paid attention to during clinical oxygen therapy.

A correlation between sickness or injury within two weeks, chronic diseases and fatigue among adults aged 18-45 years.

To investigate the prevalence of fatigue, the relationship between sickness or injury within two weeks, chronic diseases and fatigue among adults aged 18-45 years. Thousand five hundred and seventy nine individuals were included in this cross-sectional study. The Chalder Fatigue Scale (CFS) was used to assess fatigue defined as CFS score ≥4. The prevalence of fatigue was 25% in this study. Our results showed that only sickness or injury within two weeks (odds ratio [OR]: 2.440) and chronic diseases (OR: 1.727) were significantly related to fatigue. Moreover, their ORs for fatigue remained the same in all models (binary logistic regression models with adjusting for demographic and health-related characteristics one by one). In conclusion, fatigue was prevalent among adults aged 18-45 years. Sickness or injury within two weeks and chronic diseases were the risk factors for fatigue independent of demographic and health-related characteristics.

The Relationship between C-Reactive Protein Level and Discharge Outcome in Patients with Acute Ischemic Stroke.

Previous studies showed that C-reactive protein (CRP), an inflammatory marker, was associated with stroke severity and long-term outcome. However, the relationship between the acute-phase CRP level and discharge outcome has received little attention. We prospectively studied 301 patients with acute ischemic stroke (over a period of two weeks) from two hospital stroke wards and one rehabilitation department in Henan, China. Patients' demographic and clinical data were collected and evaluated at admission. Poor discharge outcome was assessed in patients at discharge using the Modified Rankin Scale (MRS > 2). Multivariate logistic regression analysis was performed to determine the risk factors of poor discharge outcome after adjusting for potential confounders. Poor discharge outcome was observed in 78 patients (25.9%). Univariate analyses showed that factors significantly influencing poor discharge outcome were age, residence, recurrent acute ischemic stroke, coronary heart disease, the National Institutes of Health Stroke Scale (NIHSS) score at admission, non-lacunar stroke, time from onset of stroke to admission, CRP, TBIL (total bilirubin), direct bilirubin (DBIL), ALB (albumin), FIB (fibrinogen) and D-dimer (p < 0.05). After adjusting for age, residence, recurrent ischemic stroke, coronary heart disease, NIHSS score at admission, lacunar stroke, time from onset of stroke to admission, CRP, TBIL, DBIL, ALB, FIB and D-dimer, multivariate logistic regression analyses revealed that poor outcome at discharge was associated with recurrent acute ischemic stroke (OR, 2.115; 95% CI, 1.094-4.087), non-lacunar stroke (OR, 2.943; 95% CI, 1.436-6.032), DBIL (OR, 1.795; 95% CI, 1.311-2.458), and CRP (OR, 4.890; 95% CI, 3.063-7.808). In conclusion, the CRP level measured at admission was found to be an independent predictor of poor outcome at discharge. Recurrent acute ischemic stroke, non-lacunar stroke and DBIL were also significantly associated with discharge outcome in acute ischemic stroke.

H-Type Hypertension and C Reactive Protein in Recurrence of Ischemic Stroke.

Hypertension with high homocysteine (HHcy) (H-type hypertension) and C reactive protein (CRP) can increase the incidence of ischemic stroke. However, it is not clear whether recurrent ischemic stroke (RIS) is related to H-type hypertension and CRP. The present study investigated the correlation of H-type hypertension and CRP level with RIS. Totally, 987 consecutive patients with acute ischemic stroke were recruited in a teaching hospital in Henan province, China during March 2014 to March 2015. The demographic and clinical characteristics and blood biochemical parameters of patients were analyzed. Elevated levels of CRP and homocysteine (Hcy) were defined as >8.2 mg/L and 10 µmol/L, respectively. Among the 987 patients, 234 were RIS. Thirty-eight percent of RIS patients had elevated CRP level and 91.5% of RIS patients had HHcy. In multivariate analysis, adjusted odds ratio (OR) of RIS in patients aged ≥60 years was 1.576 (95% CI: 1.125-2.207), in male patients 1.935 (95% CI: 1.385-2.704), in patients with diabetes 1.463 (95% CI: 1.037-2.064), CRP levels 1.013 (95% CI: 1.006-1.019), simple hypertension 3.370 (95% CI: 1.15-10.183), and H-type hypertension 2.990 (95% CI: 1.176-7.600). RIS was associated with older age, male, diabetes, H-type hypertension and CRP. Controlling H-type hypertension and CRP level may reduce the risk of RIS.

Reliability and Construct Validity of Two Versions of Chalder Fatigue Scale among the General Population in Mainland China.

The 14-item Chalder Fatigue Scale (CFS) is widely used, while the 11-item version is seldom to be found in current research in mainland China. The objectives of the present study is to compare the reliability and construct validity between these two versions and to confirm which may be better for the mainland Chinese setting. Based on a cross-sectional health survey with a constructive questionnaire, 1887 individuals aged 18 years or above were selected. Socio-demographic, health-related, gynecological data were collected, and 11-item and 14-item Chalder Fatigue Scale (CFS) were used to assess fatigue. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were performed to test the fit of models of the two versions. Confirmatory factor analysis of the two versions of CFS did not support the two-factor theorized models. In addition, a three-factor ESEM model of the 11-item version, but not the 14-item version, showed better factor structure and fitness than the other models examined. Both the versions had good internal consistency reliability and a satisfactory internal consistency (Ω = 0.78-0.96, omega coefficient indicates the internal consistency reliability) was obtained from the optimal model. This study provided evidence for satisfactory reliability and structural validity for the three-factor model of the 11-item version, which was proven to be superior to the 14-item version for this data.

Workplace Violence and Job Performance among Community Healthcare Workers in China: The Mediator Role of Quality of Life.

OBJECTIVE: To explore the impact of workplace violence on job performance and quality of life of community healthcare workers in China, especially the relationship of these three variables. METHODS: From December 2013 to April 2014, a total of 1404 healthcare workers were recruited by using the random cluster sampling method from Community Health Centers in Guangzhou and Shenzhen. The workplace violence scale, the job performance scale and the quality of life scale (SF-36) were self-administered. The structural equation model constructed by Amos 17.0 was employed to assess the relationship among these variables. RESULTS: Our study found that 51.64% of the respondents had an experience of workplace violence. It was found that both job performance and quality of life had a negative correlation with workplace violence. A positive association was identified between job performance and quality of life. The path analysis showed the total effect (ß = -0.243) of workplace violence on job performance consisted of a direct effect (ß = -0.113) and an indirect effect (ß = -0.130), which was mediated by quality of life. CONCLUSIONS: Workplace violence among community healthcare workers is prevalent in China. The workplace violence had negative effects on the job performance and quality of life of CHCs' workers. The study suggests that improvement in the quality of life may lead to an effective reduction of the damages in job performance caused by workplace violence.

Factors Associated with Fatigue among Men Aged 45 and Older: A Cross-Sectional Study.

BACKGROUND AND PURPOSE: Fatigue is one of the most common symptoms reported in several studies; but few studies have concentrated on the male population, especially for the middle-aged and older men who are exposed to greater fatigue risk. The purpose of this study was to explore the prevalence of fatigue and identify the risk factors of fatigue among men aged 45 and older in China. METHODS: This study was part of a cross-sectional study on community health in Shunde (Guangdong Province, China). A total sample of 1158 men aged 45 and older were included. Sociodemographic characteristics, health and lifestyle factors and the Chalder Fatigue Scale (CFS) were measured by structured questionnaires through face-to-face interviews. Multivariate logistic regression was applied to determine the risk factors of fatigue. RESULTS: Approximately 30% of participants experienced fatigue. Older age (≥75 years: adjusted OR 3.88, 95% CI 2.09-7.18), single marital status (1.94, 1.04-3.62), unemployed status (1.68, 1.16-2.43), number of self-reported chronic diseases (≥2 chronic diseases: 2.83, 1.86-4.31), number of individuals' children (≥4 children: 2.35, 1.33-4.15), hospitalization in the last year (1.61, 1.03-2.52) were all significantly associated with increased risk of fatigue, while regular exercise (0.46, 0.32-0.65) was a protective factor against fatigue. CONCLUSIONS: Fatigue was usual in males and several factors were associated with the fatigue. These findings may have implication in risk assessment of fatigue and help in developing and implementing targeted interventions in middle-aged and elderly males.

A community-based cross-sectional study of fatigue in middle-aged and elderly women.

BACKGROUND: Fatigue has been widely studied in the general population; however, limited studies have investigated it in the female population. The objectives of this community-based study were to (1) investigate the prevalence of fatigue, (2) explore the relationship between gynecological history and experiences of fatigue, and (3) identify risk factors for fatigue in middle-aged and elderly women. METHODS: Based on a cross-sectional health study that employed a multi-instrument questionnaire, 1272 women aged 45years or older dwelling in the community were included. The Chinese version of Chalder Fatigue Scale (CFS) was used to assess fatigue, and socio-demographic, health-related, and gynecological data were also collected. Fatigue was defined as a total CFS score≥4. RESULTS: The prevalence of fatigue among women aged over 45years was 33.9%. Multivariate logistic regression analysis identified that older age, single marital status, lower education level, the presence of chronic diseases, underweight, hospitalization in the last year, postmenopause, and a higher number of live births were associated with an increased risk of fatigue (P<0.05). CONCLUSIONS: Our results indicated that fatigue was common in middle-aged and elderly females. Being postmenopausal and having more than three live births were the particular gynecological factors contributing to fatigue in the general population.