Management of a Peristomal Abscess in a Patient With an Ileostomy: A Case Study.

BACKGROUND: Peristomal abscess (PA) is an uncommon but challenging peristomal skin complication. The initial treatment of the PA usually includes incision and drainage of the abscess, resulting in a peristomal wound. The presence of the wound makes it difficult to maintain a seal between the ostomy skin barrier and the peristomal skin resulting in frequent removal and application of the skin barrier to prevent leakage and allow for daily wound care. CASE: Ms T was a 52-year-old woman with an ileostomy resulting from a prior left hemicolectomy for colon cancer who developed a PA. Treatment of the PA was implemented, along with a modified 2-piece skin barrier that allowed access to the peristomal wound for daily dressing changes while maintaining a seal around the ostomy. CONCLUSION: The modified 2-piece skin barrier technique proved a successful treatment for the management of the PA without frequent changes of the ostomy pouching system.

The knowledge and attitude on the prevention of pressure ulcers in Chinese nurses: A cross-sectional study in 93 tertiary and secondary hospitals.

Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care.

The Chinese version of the skin tear knowledge assessment instrument (OASES): Cultural adaptation and validation.

BACKGROUND: Skin tear knowledge is an important predictor of the decreased incidence and management of skin tears, and the knowledge level among Chinese nurses is unknown so far. A validated instrument for measuring skin tear knowledge is urgent. OBJECTIVE: To culturally adapt the skin tear knowledge assessment instrument (OASES) into Chinese and verify its validity and reliability in the Chinese context. METHODS: The cultural adaptation process for OASES into Chinese was established on Beaton's translation model. Content validity was determined by the 8-expert group in wound care. A nationwide psychometric validation study was performed on a convenience sample of 3333 nurses from 113 tertiary hospitals, of whom 98 nurses finished the test-retest procedure for reliability analysis. Item validity (item difficulty and discriminating index) and construct validity (known-groups technique) were tested. RESULTS: The content validity index was 0.88-1.00. The item validity was as follows: Item difficulty ranged from 0.16 to 0.86, with an average value of 0.52; the discriminating index varied between 0.05 and 0.61. The known-group technique demonstrated excellent construct validity with a significant difference between predefined groups with theoretically expected higher knowledge scores and theoretically expected lower knowledge scores (P < 0.001). For the test-retest reliability, the Intraclass correction coefficient (ICC) during a 14-day interval for the overall tool was 0.79 (95% CI = 0.71-0.86), and Cohen's kappa value for each item varied from 0.17 to 0.62. CONCLUSIONS: The Chinese version of OASES was validated to be suitable for skin tear knowledge assessment with acceptable psychometric properties, through which the knowledge and training priorities of skin tear among Chinese nurses can be quantified.

An Inhibitory Role of Osthole in Rat MSCs Osteogenic Differentiation and Proliferation via Wnt/ß-Catenin and Erk1/2-MAPK Pathways.

BACKGROUND/AIMS: Bone marrow-derived mesenchymal stem cells (MSCs) are responsible for new bone formation during adulthood. Accumulating evidences showed that Osthole promotes the osteogenic differentiation in primary osteoblasts. The aim of this study was to investigate whether Osthole exhibits a potential to stimulate the osteogenic differentiation of MSCs and the underlying mechanism. METHODS: MSCs were treated with a gradient concentration of Osthole (6.25 µM, 12.5 µM, and 25 µM). Cell proliferation was assessed by western blotting with the proliferating cell nuclear antigen (PCNA) and Cyclin D1 antibodies, fluorescence activated cell sorting (FACS), and cell counting kit 8 (CCK8). MSCs were cultured in osteogenesis-induced medium for one or two weeks. The osteogenic differentiation of MSCs was estimated by Alkaline Phosphatase (ALP) staining, Alizarin red staining, Calcium influx, and quantitative PCR (qPCR). The underlying mechanism of Osthole-induced osteogenesis was further evaluated by western blotting with antibodies in Wnt/ß-catenin, PI3K/Akt, BMPs/smad1/5/8, and MAPK signaling pathways. RESULTS: Osthole inhibited proliferation of rat MSCs in a dose-dependent manner. Osthole suppressed osteogenic differentiation of rat MSCs by down-regulating the activities of Wnt/ß-catenin and Erk1/2-MAPK signaling. CONCLUSIONS: Osthole inhibits the proliferation and osteogenic differentiation of rat MSCs, which might be mediated through blocking the Wnt/ß-catenin and Erk1/2-MAPK signaling pathways.

Simulation of a Fully Digital Computing-in-Memory for Non-Volatile Memory for Artificial Intelligence Edge Applications.

In recent years, digital computing in memory (CIM) has been an efficient and high-performance solution in artificial intelligence (AI) edge inference. Nevertheless, digital CIM based on non-volatile memory (NVM) is less discussed for the sophisticated intrinsic physical and electrical behavior of non-volatile devices. In this paper, we propose a fully digital non-volatile CIM (DNV-CIM) macro with compressed coding look-up table (LUT) multiplier (CCLUTM) using the 40 nm technology, which is highly compatible with the standard commodity NOR Flash memory. We also provide a continuous accumulation scheme for machine learning applications. When applied to a modified ResNet18 network trained under the CIFAR-10 dataset, the simulations indicate that the proposed CCLUTM-based DNV-CIM can achieve a peak energy efficiency of 75.18 TOPS/W with 4-bit multiplication and accumulation (MAC) operations.

ISFET and Dex-AgNPs based portable sensor for reusable and real-time determinations of concanavalin A and glucose on smartphone.

In this paper, a portable real-time sensing device was built for Concanavalin A (Con A) and glucose detection using a smartphone. The ion-sensitive field-effect transistor (ISFET) functioning at a low working point was selected as a small-size, low-power transducer, and dextran-capped silver nanoparticles (Dex-AgNPs) served as sensitive nanoprobes on the ISFET gate. Using the affinity between Con A and carbohydrates, Con A can be captured, and thus directly detected by the ISFET/Dex-AgNPs unit; then glucose can be determined indirectly by removing Con A from the ISFET/Dex-AgNPs/Con A unit via competition with dextran. The mechanism of this competition does less harm to the sensor, allows the reusability of the sensing device, and overcomes the Debye screening of the FET device in saline solutions. Powered by a button cell, the handheld device attains excellent Con A (0.16 ng mL-1) and glucose (10 nM) detection limit, and can practically be used for at least 20 days.