Impact of an emergency department nursing intervention on continuity of care, self-care, and psychological symptoms.

BACKGROUND: The emergency department plays a crucial role in providing acute care to patients. Nursing interventions in this setting are essential for improving the continuity of care, enhancing patients' self-care abilities, and reducing psychological symp-toms. AIM: To evaluate the effect of nursing interventions in the emergency department on these indicators in an emergency department. METHODS: A retrospective analysis was conducted on 120 patients admitted to the emergency department between January 2022 and May 2023. The patients were divided into two groups: The control group (conventional nursing intervention) and the observation group (conventional nursing intervention + emergency department nursing intervention). The two groups were compared regarding continuity of care, self-care ability, psychological symptoms, and satisfaction with care. RESULTS: The emergency department nursing interventions significantly improved the continuity of care, enhanced patients' self-care abilities, and reduced psychological symptoms such as anxiety and depression. CONCLUSION: Nursing interventions in the emergency department positively impact continuity of care, self-care, and psychological symptoms. However, it is important to acknowledge the limitations of this study, including the small number of studies, variable methodological quality, and the heterogeneity of the study population. Future research should address these limitations and further explore the effects of different types of nursing interventions in the emergency department. Additionally, efforts should be made to enhance the application and evaluation of these interventions in clinical practice.

Staggered-peak production is a mixed blessing in the control of particulate matter pollution.

Staggered-peak production (SP)-a measure to halt industrial production in the heating season-has been implemented in North China Plain to alleviate air pollution. We compared the variations of PM1 composition in Beijing during the SP period in the 2016 heating season (SPhs) with those in the normal production (NP) periods during the 2015 heating season (NPhs) and 2016 non-heating season (NPnhs) to investigate the effectiveness of SP. The PM1 mass concentration decreased from 70.0 ± 54.4 µg m-3 in NPhs to 53.0 ± 56.4 µg m-3 in SPhs, with prominent reductions in primary emissions. However, the fraction of nitrate during SPhs (20.2%) was roughly twice that during NPhs (12.7%) despite a large decrease of NOx, suggesting an efficient transformation of NOx to nitrate during the SP period. This is consistent with the increase of oxygenated organic aerosol (OOA), which almost doubled from NPhs (22.5%) to SPhs (43.0%) in the total organic aerosol (OA) fraction, highlighting efficient secondary formation during SP. The PM1 loading was similar between SPhs (53.0 ± 56.4 µg m-3) and NPnhs (50.7 ± 49.4 µg m-3), indicating a smaller difference in PM pollution between heating and non-heating seasons after the implementation of the SP measure. In addition, a machine learning technique was used to decouple the impact of meteorology on air pollutants. The deweathered results were comparable with the observed results, indicating that meteorological conditions did not have a large impact on the comparison results. Our study indicates that the SP policy is effective in reducing primary emissions but promotes the formation of secondary species.

Non-invasive preimplantation genetic testing for conventional IVF blastocysts.

BACKGROUND: Previous studies suggested that non-invasive preimplantation genetic testing (niPGT) for intracytoplasmic sperm injection (ICSI) blastocysts can be used to identify chromosomal ploidy and chromosomal abnormalities. Here, we report the feasibility and performance of niPGT for conventional in vitro fertilization (IVF) blastocysts. METHODS: This was a prospective observational study. In the preclinical stage, whole genome amplification and NGS were performed using the sperm spent culture medium (SCM). Then, trophectoderm (TE) biopsies and corresponding SCM derived from 27 conventional IVF monopronuclear embryos were collected. In the clinical stage, samples from 25 conventional IVF cycles and 37 ICSI cycles from April 2020-August 2021 were collected for performance evaluation. RESULTS: Preclinically, we confirmed failed sperm DNA amplification under the current amplification system. Subsequent niPGT from the 27 monopronuclear blastocysts showed 69.2% concordance with PGT results of corresponding TE biopsies. In the clinical stage, no paternal contamination was observed in any of the 161 SCM samples from conventional IVF. While maternal contamination was observed in 29.8% (48/161) SCM samples, only 2.5% (4/161) samples had a contamination ratio ≥ 50%. Compared with that of TE biopsy, the performances of NiPGT from 161 conventional IVF embryos and 122 ICSI embryos were not significantly different (P > 0.05), with ploidy concordance rates of 75% and 74.6% for IVF and ICSI methods, respectively. Finally, evaluation of the euploid probability of embryos with different types of niPGT results showed prediction probabilities of 82.8%, 77.8%, 62.5%, 50.0%, 40.9% and 18.4% for euploidy, sex-chromosome mosaics only, low-level mosaics, multiple abnormal chromosomes, high-level mosaics and aneuploidy, respectively. CONCLUSIONS: Our research results preliminarily confirm that the niPGT approach using SCM from conventional IVF has comparable performance with ICSI and might broadening the application scope of niPGT.

Effectiveness of Multidisciplinary Nursing Based on Fever, Blood Sugar, and Swallowing Function Management in Patients with Acute Stroke.

Purpose: The aim of this study was to assess the effectiveness of multidisciplinary nursing based on fever, blood sugar, and swallowing function management in patients with acute stroke (AS). Methods: A total of 200 AS patients who were treated in our hospital from January 2016 to January 2020 were recruited and randomized at a ratio of 1 : 1 into a control group and a study group. The control group received standardized early rehabilitation nursing, and the study group received multidisciplinary nursing based on fever, blood sugar, and swallowing function management plus standardized early rehabilitation nursing. The patients were also assigned different blood glucose levels upon admission to a high blood glucose group or a normal blood glucose group. The clinical endpoint is clinical efficacy. Results: Multidisciplinary nursing resulted in better clinical outcomes and treatment efficiency in the patients in the study group versus standardized early rehabilitation nursing. When compared with the control group, the patients in the study group showed lower National Institute of Health Stroke Scale (NIHSS) scores, higher Barthel Index (BI) scores, lower fasting blood glucose levels and body temperature 24 hours after admission, a lower incidence of swallowing dysfunction and aspiration pneumonia 30 days after nursing, and lower C-reactive Protein (CRP) levels 7 days after nursing. The NIHSS scores of the high blood glucose group were significantly higher than those of the normal blood glucose group. Conclusion: Multidisciplinary nursing based on fever, blood sugar, and swallowing function management for patients with AS improves the clinical outcome and treatment efficiency, restores the swallowing function and blood glucose level, and ameliorates the long-term prognosis of patients.

Measurement report of the change of PM2.5 composition during the COVID-19 lockdown in urban Xi'an: Enhanced secondary formation and oxidation.

Enhanced secondary aerosol formation was observed during the COVID-19 lockdown in Xi'an, especially for polluted episodes. More oxidized­oxygenated organic aerosol (MO-OOA) and sulfate showed the dominant enhancements, especially in large particle-mode. Meanwhile, relative humidity (RH) showed a positive promotion on the formation of sulfate and MO-OOA during the lockdown, but had no obvious correlation with less oxidized­oxygenated organic aerosol (LO-OOA) or nitrate. Organosulfurs (OS) displayed a higher contribution (~58%) than inorganic sulfate to total sulfate enhancement in the polluted episode during the lockdown. Although the total nitrate (TN) decreased during the lockdown ascribing to a larger reduction of inorganic nitrate, organic nitrate (ON) showed an obvious increase from pre-lockdown (0.5 ± 0.6 µg m-3 and 1 ± 2% of TN) to lockdown (5.3 ± 3.1 µg m-3 and 17 ± 9% of TN) in the polluted case (P < 0.05). In addition, RH also displayed a positive promotion on the formation of ON and OS, and the increases of both OS and ON were much efficient in the nighttime than in the daytime. These results suggest that higher RH and stagnant meteorology might facilitate the sulfate and MO-OOA enhancement, especially in the nighttime, which dominated the secondary aerosol enhancement in haze pollution during the lockdown.

Characteristics and sources of hourly elements in PM10 and PM2.5 during wintertime in Beijing.

Characteristics and sources of ambient particle elements in urban Beijing were studied by hourly observations in two size fractions (PM10 and PM2.5) during November and December 2017 using an online multi-element analyzer. The reconstructed oxide concentrations of 24 elements (from Al to Pb) comprise an appreciable fraction of PM10 and PM2.5, accounting for 37% and 17%, respectively on average. We demonstrate the benefit of using high-time-resolution chemical speciation data in achieving robust source apportionment of the total elemental PM10 (PM10el) and elemental PM2.5 (PM2.5el) mass using positive matrix factorization (PMF). Biomass burning, coal combustion, secondary sulfate, industry, non-exhaust traffic and dust were identified in both size fractions (with varying relative concentrations), which accounted on average for 4%, 12%, 5%, 2%, 14%, and 63%, respectively to the total PM10el, and 14%, 35%, 21%, 6%, 12% and 12%, respectively to the total PM2.5el. Biomass burning and coal combustion exhibited higher concentrations during haze episodes of the heating season. In contrast, secondary sulfate and industry contributed more to haze episodes during the non-heating season. The fractional contribution of dust was mostly high during clean days, while the fractional non-exhaust traffic emission contribution was similar throughout the measurement period. The non-exhaust traffic emissions contributed locally, while the remaining sources were dominated by neighboring areas. Furthermore, trajectory analysis showed that the origin of the industrial sources roughly agreed with the locations of the main point sources. Overall, this work provides detailed information on the characteristics of the elements during different haze events during heating and non-heating seasons.

The formation and evolution of secondary organic aerosol during summer in Xi'an: Aqueous phase processing in fog-rain days.

Secondary organic aerosol (SOA) is an important contributor to organic aerosol (OA), however, the model simulations of SOA concentrations and oxidation states remain significant uncertainties because of inadequate cognition of its formation and aging chemistry. In this study, SOA formation and evolution processes during summer in Xi'an were investigated, based on high-resolution online measurements of non-refractory PM2.5 (NR-PM2.5) species and OA source apportionment using positive matrix factorization. The results showed that the total SOA, including less oxidized-oxygenated OA (LO-OOA), more oxidized-oxygenated OA (MO-OOA), and aqueous-phase-processed oxygenated OA (aq-OOA), on average constituted 69% of OA, and 43% of NR-PM2.5, suggesting the high atmospheric oxidation capacity and the dominance of SOA during summer in Xi'an. Photochemical oxidation processes dominated the summertime SOA formation both during non-fog-rain days and fog-rain days, which were responsible for the formation of both LO-OOA and MO-OOA. Consistently, LO-OOA and MO-OOA in total contributed 59% to OA during non-fog-rain days and 56% to OA during fog-rain days, respectively. On the contrary, aq-OOA was mainly observed during fog-rain days, which increased dramatically from 2% of OA during non-fog-rain days to 19% of OA during fog-rain days with the mass concentration increasing accordingly from 0.3 µg m-3 to 2.5 µg m-3. Episodic analyses further highlighted the persistently high RH period with high aerosol liquid water content (ALWC) was the driving factor of aq-OOA formation, and high Ox condition could further enhance its formation. Meanwhile, air masses from east and southeast were much favorable for the formation of long-time fog-rain days, which facilitated aq-OOA production during summer in Xi'an.

Seasonal variations in the sources of organic aerosol in Xi'an, Northwest China: The importance of biomass burning and secondary formation.

The Guanzhong basin is a part of the three top priority regions in China's blue sky action as of 2019. Understanding the chemical composition, sources, and atmospheric process of aerosol in this region is therefore imperative for improving air quality. In this study, we present, for the first time, the seasonal variations of organic aerosol (OA) in Xi'an, the largest city in the Guanzhong basin. Biomass burning OA (BBOA) and oxidized OA (OOA) contributed >50% of OA in both autumn and winter. The average concentrations of BBOA in autumn (14.8 ± 5.1 µg m-3) and winter (11.6 ± 6.8 µg m-3) were similar. The fractional contribution of BBOA to total OA, however, decreased from 31.9% in autumn to 15.3% in winter, because of enhanced contributions from other sources in winter. The OOA fraction in OA increased largely from 20.9% in autumn to 34.9% in winter, likely due to enhanced emissions of precursors and stagnant meteorological conditions which facilitate the accumulation and secondary formation. A large increase in OOA concentration was observed during polluted days, by a factor of ~4 in autumn and ~6 in winter compared to clean days. In both seasons, OOA formation was most likely dominated by photochemical oxidation when aerosol liquid water content was <30 µg m-3 or by aqueous-phase processes when Ox was <35 ppb. A higher concentration of BBOA was observed for air masses circulated within the Guanzhong basin (16.5-18.1 µg m-3), compared to air masses from Northwest and West (10.9-14.5 µg m-3). Furthermore, compared with OA fraction in non-refractory PM1 in other regions of China, BBOA (17-19%) and coal combustion OA (10-20%) were major emission sources in the Guanzhong Basin and the BTH region, respectively, whereas OOA (10-34%) was an important source in all studied regions.

Chemical nature and sources of fine particles in urban Beijing: Seasonality and formation mechanisms.

To mitigate air pollution in China, a legislative 'Air Pollution Prevention and Control Action Plan' has been implemented by the Chinese government since 2013. There is, however, a lack of investigations for long-term trends in the composition, sources and evolution processes of PM1 (particulate matter with diameter less than 1 µm) after the implementation. To evaluate the effectiveness of these control measures, we present a year-long real-time measurement of the chemical composition of PM1 at an urban site in Beijing from November 2014 to November 2015, and the results are compared with previous studies from 2008 to 2013 to gain insights into the variations of the chemical composition and sources of PM1 in Beijing. Large seasonal differences were observed in the mass concentrations of PM1 species and general declining trend was observed in the last seven years. Specifically, the annual averages of mass concentrations in 2014-2015 decrease by 16-43% (PM1), 23-43% (organic aerosol, OA), 38-68% (sulfate), 26-51% (nitrate), 18-33% (ammonium) and 27-38% (chloride) compared to those from 2008 to 2013. During winter and summer, the seasonal mass concentrations of sulfate and nitrate show more significant declines especially in summer 2008 (79% and 81%) and summer 2011 (76% and 77%). The nitrate-to-sulfate ratio is higher in 2014-2015 (1.5 ± 0.6) than that in 2013 (1.0 ± 0.3), largely due to significant reduction in SO2 emissions, suggesting that nitrate is becoming more important than sulfate in particulate pollution in Beijing. OA is the dominant PM1 fraction (>45%) in all seasons and the mass concentrations/contributions of both primary and secondary OA show different seasonality. As for the more oxidized oxygenated OA (MO-OOA) and less oxidized oxygenated OA (LO-OOA), the contributions of MO-OOA are much higher than those of LO-OOA (27-62% vs. 6-26%) in both high-pollution and low-pollution days. Aqueous-phase processes are found to facilitate the formation of MO-OOA while photochemical oxidation formation is a major contributor of LO-OOA in winter, and photochemical oxidation plays a major role in the formation of MO-OOA in summer and fall. The current study provides a comprehensive seasonal comparison of chemical composition and formation of PM1 in Beijing and a pacesetter in tackling PM pollution for other equally polluted megacities, after implementation of more stringent control measures after 2013.

Alterations of the Gut Microbiome in Hypertension.

Introduction: Human gut microbiota is believed to be directly or indirectly involved in cardiovascular diseases and hypertension. However, the identification and functional status of the hypertension-related gut microbe(s) have not yet been surveyed in a comprehensive manner. Methods: Here we characterized the gut microbiome in hypertension status by comparing fecal samples of 60 patients with primary hypertension and 60 gender-, age-, and body weight-matched healthy controls based on whole-metagenome shotgun sequencing. Results: Hypertension implicated a remarkable gut dysbiosis with significant reduction in within-sample diversity and shift in microbial composition. Metagenome-wide association study (MGWAS) revealed 53,953 microbial genes that differ in distribution between the patients and healthy controls (false discovery rate, 0.05) and can be grouped into 68 clusters representing bacterial species. Opportunistic pathogenic taxa, such as, Klebsiella spp., Streptococcus spp., and Parabacteroides merdae were frequently distributed in hypertensive gut microbiome, whereas the short-chain fatty acid producer, such as, Roseburia spp. and Faecalibacterium prausnitzii, were higher in controls. The number of hypertension-associated species also showed stronger correlation to the severity of disease. Functionally, the hypertensive gut microbiome exhibited higher membrane transport, lipopolysaccharide biosynthesis and steroid degradation, while in controls the metabolism of amino acid, cofactors and vitamins was found to be higher. We further provided the microbial markers for disease discrimination and achieved an area under the receiver operator characteristic curve (AUC) of 0.78, demonstrating the potential of gut microbiota in prediction of hypertension. Conclusion: These findings represent specific alterations in microbial diversity, genes, species and functions of the hypertensive gut microbiome. Further studies on the causality relationship between hypertension and gut microbiota will offer new prospects for treating and preventing the hypertension and its associated diseases.

Borealin is differentially expressed in ES cells and is essential for the early development of embryonic cells.

Maintaining undifferentiated state and self-renewal ability of embryonic stem cells is a process that many genes and factors participate in. Using bioinformatics analyses and suppression subtractive hybridization we cloned a novel human gene related to the proliferation of human embryonic stem (hES) cells and its mouse homologue and identified them as being borealin. Our data demonstrated that borealin was highly expressed in undifferentiated ES cells, mouse pre-implantation embryos and the brain of 8.5-9.5 day post-coitum mouse embryos. Furthermore, following Borealin depletion by microinjecting anti-Borealin antibody into the zygotes the mouse embryos were arrested at the 2 or 4-cell stage and chromosomes could not correctly localize at the equator plane of the mitotic spindle and most cells had two or more nuclei. Taken together, these results indicate that Borealin plays a crucial role in the early mouse embryonic development.