Fatty acid profile variations after exposure to textile industry effluents in Indian Major Carps

Abstract Indian major carps are the widely consumed fish species of Pakistan, being a cheap source of proteins and unsaturated fatty acids, they are good for cardiovascular health. Water pollution due to discharge of untreated industrial waste water into water bodies contaminates this precious source of nutrients. The present study therefore, was aimed to assess deterioration of fatty acid profile of three Indian major carp species due to different concentrations of industrial wastes. The water samples were collected from the river Chenab at the site where it receives industrial wastewater via Chakbandi drain. After exposure to 1.5%, 3.0%, and 4.5% dilutions of collected water in different aquaria it was observed that proportion of unsaturated fatty acids in selected fish species were decreased significantly as the intensity of the dose increased (P 0.05). Conversely the level of saturated fatty acids increased with the increasing dose of treatment (P 0.05). These findings suggest that untreated wastewater not only deteriorate the fatty acid profile of aquatic animals but also these toxic substances can reach human body through fish meat and pose further health hazards. Therefore, it is highly recommended that industrial effluents should be treated before they are dumped into water bodies.

Resumo As carpas indianas são as espécies de peixes mais consumidas no Paquistão, sendo uma fonte barata de proteínas e de ácidos graxos insaturados e boa para a saúde cardiovascular. A poluição da água por causa do descarte de resíduos industriais não tratados em corpos dágua contamina essa preciosa fonte de nutrientes. Portanto, o presente estudo teve como objetivo avaliar a deterioração do perfil de ácidos graxos de três principais espécies de carpas indianas em diferentes concentrações de resíduos industriais. As amostras de água foram coletadas do rio Chenab no local onde recebe esgoto industrial via dreno de Chakbandi. Após a exposição a diluições de 1,5%, 3% e 4,5% da água coletada em diferentes aquários, foi observado que a proporção de ácidos graxos insaturados em espécies de peixes selecionadas diminuiu significativamente com o aumento da intensidade da dose (P 0,05). Por outro lado, o nível de ácidos graxos saturados aumentou com a elevação da dose de tratamento (P 0,05). Essas descobertas sugerem que águas residuais não tratadas não apenas deterioram o perfil de ácidos graxos dos animais aquáticos, mas também essas substâncias tóxicas podem atingir o corpo humano por meio da carne de peixe e representar mais riscos à saúde. Portanto, é recomendável que os efluentes industriais sejam tratados antes de serem despejados em corpos dágua.

Fatty acid profile variations after exposure to textile industry effluents in Indian Major Carps / Variações do perfil de ácidos graxos após exposição a efluentes da indústria têxtil nas principais carpas indianas

Abstract Indian major carps are the widely consumed fish species of Pakistan, being a cheap source of proteins and unsaturated fatty acids, they are good for cardiovascular health. Water pollution due to discharge of untreated industrial waste water into water bodies contaminates this precious source of nutrients. The present study therefore, was aimed to assess deterioration of fatty acid profile of three Indian major carp species due to different concentrations of industrial wastes. The water samples were collected from the river Chenab at the site where it receives industrial wastewater via Chakbandi drain. After exposure to 1.5%, 3.0%, and 4.5% dilutions of collected water in different aquaria it was observed that proportion of unsaturated fatty acids in selected fish species were decreased significantly as the intensity of the dose increased (P < 0.05). Conversely the level of saturated fatty acids increased with the increasing dose of treatment (P < 0.05). These findings suggest that untreated wastewater not only deteriorate the fatty acid profile of aquatic animals but also these toxic substances can reach human body through fish meat and pose further health hazards. Therefore, it is highly recommended that industrial effluents should be treated before they are dumped into water bodies.

Resumo As carpas indianas são as espécies de peixes mais consumidas no Paquistão, sendo uma fonte barata de proteínas e de ácidos graxos insaturados e boa para a saúde cardiovascular. A poluição da água por causa do descarte de resíduos industriais não tratados em corpos d'água contamina essa preciosa fonte de nutrientes. Portanto, o presente estudo teve como objetivo avaliar a deterioração do perfil de ácidos graxos de três principais espécies de carpas indianas em diferentes concentrações de resíduos industriais. As amostras de água foram coletadas do rio Chenab no local onde recebe esgoto industrial via dreno de Chakbandi. Após a exposição a diluições de 1,5%, 3% e 4,5% da água coletada em diferentes aquários, foi observado que a proporção de ácidos graxos insaturados em espécies de peixes selecionadas diminuiu significativamente com o aumento da intensidade da dose (P < 0,05). Por outro lado, o nível de ácidos graxos saturados aumentou com a elevação da dose de tratamento (P < 0,05). Essas descobertas sugerem que águas residuais não tratadas não apenas deterioram o perfil de ácidos graxos dos animais aquáticos, mas também essas substâncias tóxicas podem atingir o corpo humano por meio da carne de peixe e representar mais riscos à saúde. Portanto, é recomendável que os efluentes industriais sejam tratados antes de serem despejados em corpos d'água.

Mortalidad Materna en Venezuela: aspectos médicos y Políticas (1940 - 2016) / Materna Mortality in Venezuela: medical issues and Public Policy (1940 - 2016)

En la actualidad Venezuela se encuentra en una crisis social y económica sin precedentes. La mortalidad materna(MM) es un indicador en salud importante, debido a que permite tener idea de la atención médica de un país; se mide a través de dos indicadores: Razón de Mortalidad Materna (RMM) y Tasa de Mortalidad Materna (TMM). Objetivo: Revisar y compararla evolución de ambos indicadores de MM desde la década de 1930 hasta la década 2000. Métodos: Se realizó una revisión de la literatura y de informes técnicos de organismos gubernamentales y no gubernamentales para el análisis de la situación previa y reciente de esta situación en Venezuela. Los resultados señalan que existe una notable disminución de las cifras de MM como ha de esperarse con el mejoramiento de la tecnología desde la década de 1930 hasta el año 2000; posteriormente ocurre un retroceso de la sanidad pública con cifras comparables a la década de 1960. Concluimos que la MM ha sido desde tiempos pasados un problema constante en la salud pública; al pasar los años y gobiernos, se han implementado numerosas políticas públicas para mejorar esta situación, muchas de estas estrategias han sido fallidas debido a la falta de su continuidad y de su cumplimiento pleno.

Venezuela is currently in an unprecedented socialand economic crisis. Maternal mortality is an important health indicator because it provides an idea of a country's medical care. Maternal mortality is usually measured through two indicators: Maternal Mortality Ratio (MMR) and Maternal Mortality Rate. Objective: Review and compare the evolution of both healthindicators from the 1930s to 2016. Methods: A review of the literature and technical reports from governmental andnon-governmental organizations was carried out to analyze theprevious and recent situation. of this situation in Venezuela. Theresults indicate that there is a notable decrease in the figures ofmaternal mortality, as should be expected with the improvementof technology from the 1930s to the year 2000. Subsequently, there is a decline in public health with figures comparable to the1960s. We conclude that maternal mortality has been a constant problem in public health since ancient times. Over the years and governments, numerous public policies have been implementedto improve this situation. Many of these strategies have beenfailed due to lack of continuity and in the absence of its full compliance.

Serum Ferritin as an Indicator of Neonatal Anaemia

Introduction:Haemoglobin levels are usually used to diagnose neonatal anaemia. By the time haemoglobin levels drop, body iron is depleted. Serum ferritinis the standard measure for assessment of iron levels in neonates and detects iron deficiency earlier than haemoglobin levels. Aims:To determine the prevalence of low haemoglobin and ferritin levels amongst term and preterm newborn babies. To determine the value of serum ferritin in the diagnosis of low iron stores amongst term and preterm newborns. Methodology:This was a cross sectional descriptive study carried out at the Neonatal Intensive Care Unit of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria between June and December 2014. The study included 140 newborns of all birth weights delivered at the UNTH. These were categorized into preterm (gestational age <37 completed weeks) and term (gestational age ≥37 completed weeks. Babies with C-reactive protein levels > 10mg/dl, who were intra-uterine growth restricted, and whose mothers had conditions associated with low iron stores were excluded from the study. Anthropometric measurements were done for all subjects. Haemoglobin estimation and ferritin assay were carried out and the prevalence of neonatal anaemia was determined using each of these. Results:The range of haemoglobin concentration in the study population was 12.22g/gl –22.80g/dl. The mean serum haemoglobin concentrations were 15.69mg/dl ± 1.58 and 16.45 ± 1.92 in the preterm and term babies respectively (t = 2.557, P= .0116). The prevalence of low haemoglobin concentrations amongst both preterm and term babies was zero= .024). The range of serum ferritin level in the studypopulation was 20.6μg/l -296μg/l. The mean serum ferritin levels were 63.13μg/l ± 23.93 and 133.67μg/l ± 50.14 in the preterm and term babies respectively (t = 10.623, P< .001). The prevalence of low serum ferritin in the study population was 22.14%, but was higher in preterm than term babies 35.7% vs 8.6%: (OR –5.926, 95% C.I OR = 2.248 –15.619)(P<.001).Conclusion:Serum ferritin assay is more useful than haemoglobin as an indicator of anaemia during the neonatal period.

NPS (Net Promoter Score). Métrica de la experiencia del cliente: construcción y análisis del indicador de una cobertura médica privada / NPS (Net Promoter Score), Customer experience metrics.: construction and analysis of the indicator of private medical coverage

Introducción: el NPS (Net Promoter Score) es un indicador que se utiliza en los programas de experiencia del cliente para medir la satisfacción de dicho público objetivo y su lealtad. Nuestra finalidad fue consolidar el NPS por primera vez en una prepaga de un hospital de alta complejidad de Buenos Aires (PS-HIBA) en busca de establecer un indicador objetivo desde la perspectiva del cliente. Métodos: se realizó un estudio observacional analítico, de corte transversal. Se incluyeron en el estudio los datos obtenidos a partir de las respuestas de los afiliados al PS-HIBA. Resultados: se consolidó el primer indicador NPS del PS-HIBA: 22 puntos. Se visualizaron los tres perfiles de clientes, obteniendo un 45,7% promotores, 22,3% detractores y 32% pasivos o neutros. Complementariamente se identificaron los motivos de dichas calificaciones; las tres principales fueron: la problemática de accesibilidad a los turnos, la atención y los profesionales valorados positivamente. Conclusión: este estudio aporta un indicador objetivo, que facilita un lenguaje común en la organización y una comparación con el mercado desde la mirada del cliente. El NPS, como sistema, busca impulsar la construcción de una cultura centrada en el cliente, con el fin de mejorar su lealtad y permitir una retroalimentación donde se logra tener presente la voz del cliente, e identificar, priorizar y abordar los problemas percibidos. Nos permite establecer los lineamientos de oportunidades de mejora desde la perspectiva de los pacientes. (AU)

Introduction: the NPS (Net Promoter Score) is an indicator used in customer experience programs to measure the satisfaction of said target audience and their loyalty. Our purpose was to send the survey and consolidate the NPS for the first time in a high complexity prepaid hospital in Buenos Aires (PS-HIBA) in search of an objective indicator from the customer's perspective. Methods: an analytical, cross-sectional observational study was carried out. Data obtained from members' responses to the PS-HIBA were included in the study. Results: the first NPS indicator of PS-HIBA was consolidated: 22 points. The three customer profiles were displayed, obtaining 45.7% promoters, 22.3% detractors and 32% passive or neutral. Complementarily, the reasons for these qualifications were identified, being the three main ones: the problem of accessibility to medical appointments, the medical attention and the professionals valued positively. Conclusion: this study provides an objective indicator which facilitates a common language in the organization and a comparison with the market from the customer's point of view.The NPS as a system seeks to promote the construction of a customer-focused culture, in order to improve their loyalty and allow feedback. Thus, it is possible to keep the customer's voice in mind, identify, prioritize and address the perceived problems. It allows us to establish the guidelines for opportunities to improve from the patients' perspective. (AU)

Pandemia da COVID-19 e as consequentes alterações comportamentais de uma comunidade universitária / COVID-19 pandemic and the consequent behavioral changes of a university community

Objetivou-se avaliar as variações comportamentais, estilo de vida e indicador nutricional de uma comunidade acadêmica antes e durante a pandemia de COVID-19. Estudo transversal, epidemio-lógico, com 1655 integrantes da Universidade Federal de Viçosa, Minas Gerais, de ambos os sexos e idades entre 17 a 72 anos. Via Google Forms, aplicou-se o questionário adaptado do "ConVid: Pes-quisa de Comportamentos", e a versão curta do IPAQ. Utilizou-se o teste de McNemar para compa-ração dos indicadores entre estilo de vida antes e durante a pandemia (p < 0,05) e regressão logística binária para associação com diagnóstico da COVID-19. Observou-se que durante a pandemia houve uma prevalência de aumento (p < 0,001) de indivíduos que não atingiram as recomendações para caminhada (42,8% para 80,6%); atividade física moderada (74,3% para 80,6%) e vigorosa (64,6% para 71,8%). Além disso, aumento no tempo de uso considerado elevado (p < 0,001), para televisão (2,4% para 12,7%) e computador/tablet (58,1% para 81,8%). O consumo de álcool passou de 64,1% para 64,9% (p < 0,001), enquanto o uso de cigarros foi de 5,7% para 7,8% (p < 0,001). A classifica-ção do indicador nutricional também demonstrou mudanças significativas (p < 0,001), o percentual de obesidade (7,7% para 11,1%) e sobrepeso (22,6% para 28,1%). O risco de contaminação para COVID-19 foi maior entre aqueles menos ativos (OR = 1,34; IC95%: 1,04 ­ 1,64). Os resultados demonstraram diminuição do nível de atividade física, aumento do tempo sedentário, piora no estilo de vida e aumento do excesso de peso dos estudantes e servidores de uma comunidade acadêmica, devido às consequências impostas pelo período pandêmico, elevando fatores de risco à saúde

The objective was to evaluate the behavioral variations, lifestyle and nutritional indicator of an academic community before and during the COVID-19 pandemic. Cross-sectional, epidemiological study with 1655 members of the Federal University of Viçosa, Minas Gerais, of both sexes, and aged between 17 and 72 years. Using Google Forms, the questionnaire adapted from "ConVid: Research of Behaviors" and the short version of the IPAQ were applied. The McNemar test was used to compare indicators between lifestyle before and during the pandemic (p < 0.05) and binary logistic regression for association with the diagnosis of COVID-19. It was observed that during the pandemic there was an increase in the prevalence (p < 0.001) of individuals who did not meet the recommendations for walking (42.8% to 80.6%); moderate (74.3% to 80.6%) and vigorous (64.6% to 71.8%) physical activity. In addition, an increase in the time of use consid-ered high (p < 0.001) for television (2.4% to 12.7%) and computer/tablet (58.1% to 81.8%). Alcohol con-sumption went from 64.1% to 64.9% (p < 0.001), while cigarette use went from 5.7% to 7.8% (p < 0.001). The classification of the nutritional indicator also showed significant changes (p < 0.001), the percentage of obesity (7.7% to 11.1%) and overweight (22.6% to 28.1%). The risk of contamination for COVID-19 was higher among those less active (OR = 1.34; 95%CI: 1.04 ­ 1.64). The results showed a decrease in the level of physical activity, an increase in sedentary time, a worsening lifestyle, and an increase in overweight among students and employees of an academic community, due to the consequences imposed by the pandemic period, increasing health risk factors

Turnaround time for the issuing of packed red cells: A retrospective study in a tertiary care hospita

Introduction: Turnaround time (TAT) is one of the most crucial performance indicators for blood transfusion and laboratory services. It is especially crucial in transfusion services due to its seminal role as a determining factor in patient care outcomes. We examined our institution’s TAT for issuing blood units. Materials and Methods: The Department of Immunohematology and Blood Transfusion, MGM Medical College and Hospital in Navi Mumbai, Maharashtra, India, undertook this retrospective noninterventional study over 12 months from January 01, 2020 to December 31, 2020. TAT was determined using a random audit of 10% of all monthly requests at the blood center. All requests for packed red cells (PRCs) received in the blood center during the study period were included in the evaluation. All requests for other blood components such as fresh-frozen plasma, random donor platelets, and cryoprecipitates were excluded along with all reservations for PRCs. A team of investigators tracked 369 requests for packed red cells over the year, noting the turnaround time. The standard TAT was set depending on the nature of the clinical case. Any significant deviation from institutionally established TAT was investigated, and root cause analysis was done. Results: The majority of transfusion requests were routine (72%) followed by emergency (23%) and lifesaving (5%). For routine cases, the average TAT was observed at 104 minutes. For emergency cases, the average TAT was observed at 39 minutes. For lifesaving cases, the average TAT was observed at 12 minutes. The highest number of cases were categorized under routine, followed by emergency cases and lifesaving categories. Conclusion: It was observed that there were no significant variations in turnaround time in routine, emergency, or lifesaving cases. Overall, as per our blood center standards, TAT for the issue of packed red cells was observed to fall under the normal range for routine, emergency, and lifesaving. Any outliers observed during the duration of the study were mainly due to inadequate samples or patient details received at the blood center or the presence of irregular antibodies encountered during the crossmatch.

Dachengqi decoction reduces inflammatory response and promotes recovery of gastrointestinal function in patients with mild acute pancreatitis by regulating the intestinal microbiota / 中华危重病急救医学

Objective:To explore the therapeutic effect and mechanism of Dachengqi decoction on patients with mild acute pancreatitis (MAP).Methods:A parallel randomized controlled trial was conducted. Sixty-eight patients with acute pancreatitis (AP) admitted to Shanghai Traditional Chinese Medicine (TCM)-Integrated Hospital from March 2018 to February 2021 were enrolled. Referring to the condition on admission of the patients and whether they agreed to receive the Dachengqi decoction or not, they were divided into conventional treatment group and Dachengqi decoction group according to the principle of 1∶1 equal randomness. Meanwhile, 20 healthy volunteers were recruited as controls. Both groups of patients were treated with octreotide, fasting, gastrointestinal decompression, antipyretic and analgesic, anti-inflammatory, inhibition of gastric acid and pancreatic juice secretion, maintenance of electrolyte balance and other western conventional medicine. The patients in the Dachengqi decoction group received Dachengqi decoction orally on the basis of routine treatment, 100 mL each time, twice a day, for seven consecutive days. The inflammation parameters [white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6)] before and after treatment and the recovery time of gastrointestinal function (first exhaust time, time to recover bowel sounds, first defecation time) of patients were recorded. 16S rRNA gene sequencing of stool samples was recorded, and normalized data were obtained after quality control and other related processing. The data were subjected to diversity analysis (Alpha diversity and Beta diversity) and linear discriminant analysis effect size analysis (LEfSe analysis) to observe changes in the gut microbiota of MAP patients. Spearman rank correlation coefficient was used to analyze the correlation between inflammatory indexes and microorganisms at the intestinal genus level. Blood, urine, stool samples, renal function, and electrocardiogram (ECG) during treatment of MAP patients were detected to assess the safety of the treatment.Results:Of the 68 patients with AP, 16 were excluded from moderate-severe AP, 4 were not collected or voluntarily abandoned treatment. Finally, 48 patients with MAP were enrolled, 24 in the conventional treatment group and 24 in the Dachengqi decoction group. The inflammation parameters levels at 7 days of treatment in both groups were significantly lower than those before treatment. CRP, PCT and IL-6 levels in the Dachengqi decoction group were significantly lower than those in the conventional treatment group [CRP (mg/L): 8.50 (3.50, 13.00) vs. 16.00 (9.25, 29.75), PCT (μg/L): 0.06 (0.03, 0.08) vs. 0.09 (0.05, 0.11), IL-6 (ng/L): 6.36 (3.96, 10.79) vs. 13.24 (6.69, 18.87), all P < 0.05]. The first exhaust time, time to recover bowel sounds and first defecation time in the Dachengqi decoction group were significantly shorter than those in the conventional treatment group [first exhaust time (days): 1.62±0.65 vs. 2.80±0.65, time to recover bowel sounds (days): 1.13±0.58 vs. 2.31±0.76, first defecation time (days): 3.12±0.75 vs. 4.39±0.76, all P < 0.05]. The analysis of intestinal microflora diversity showed that both the diversity and abundance of microbial communities were the highest in the healthy control group and the lowest in the conventional treatment group. In addition, the coincidence degree of microbial communities in healthy controls and MAP patients was small, while the coincidence degree of MAP patients among different treatment methods was relatively large. LEfSe analysis showed that Dachengqi decoction reduced the relative abundance of Escherichia coli-Shigella and Clostridium erysipelae, and increased the relative abundance of three beneficial bacteria, namely Lactobacillus, Rombutzia and Brutella. In the intestines of MAP patients, Lactobacillus mucilaginus and Lactobacillus conjunctus were significantly enriched. Correlation analysis showed that positive correlations between Escherichia coli- Shigella and the four inflammatory indicators including WBC, CRP, PCT, IL-6 were statistically significant ( r value was 0.31, 0.41, 0.57, 0.43, respectively, all P < 0.05). There was no significant correlation between other bacteria and inflammatory indicators. During the treatment, there was no obvious abnormality in blood, urine and feces, renal function and ECG of MAP patients. Conclusions:Dachengqi decoction could reduce inflammatory responses and promote recovery of intestinal microecological balance and gastrointestinal function in patients with MAP by regulating the composition of intestinal flora. No significant adverse effects were observed during the treatment period.

Research progress on sensitivity, resistance and mechanism of plague infected animals to Yersinia pestis / 中华地方病学杂志

The sensitivity and resistance of host animals to Yersinia pestis are different among species and regions, and the indicator animals have natural resistance to Yersinia pestis. This article reviews the research progress on sensitivity, resistance and mechanism of plague infected animals to Yersinia pestis, in order to help improve the ecological research of plague and the prevention and control of plague.

Application of virtual intelligent system in bronchoscopy theory and operation training for PCCM physicians / 中华医学教育探索杂志

Objective:To evaluate the role of virtual bronchoscopy intelligent system in improving the theory and operation level of bronchoscopy in pulmonary and critical care medicine (PCCM) teaching for standardized training specialists.Methods:A total of 50 PCCM physicians who had participated in virtual bronchoscopy training in Xijing Hospital, Air Force Medical University from 2018 to 2021 were selected as research subjects. In this study, self-controlled method was adopted to evaluate the change of assessment indicators after 1 week and 2 weeks of training. Questionnaire survey was also used to evaluate the training effect. SPSS 23.0 software was used for paired t-test and Chi-square test. Results:All the 50 PCCM physicians successfully completed the training of virtual bronchoscopy operation. The theoretical score was significantly improved after the training [(80.0±5.2) points vs. (92.4±3.8) points]. The basic operation time [(1 050.9±103.3) s vs. (386.4±47.7) s], and the number of hitting the bronchial wall [(88.3±12.7) times vs. (27.0±5.3) times] were significantly reduced. The recovery rate of alveolar lavage fluid [(27.6±7.4)% vs. (58.0±8.2)%] and the positive rate of biopsy [(19.2±13.1)% vs. (86.8±10.8)%] were significantly increased. The learning curve of the final score indicated that the score improved more rapidly in the first week of training, and the score improved more slowly in the second week of training. Questionnaires before and after the training indicated that virtual intelligent training could significantly improve the confidence and proficiency of students in bronchoscopy.Conclusion:Through the systematic training of virtual bronchoscopy intelligent system, the PCCM physicians have significantly improved their theoretical knowledge and operational proficiency. Therefore, the virtual bronchoscopy training system has practical significance for improving the overall training effect of clinical bronchoscopy for PCCM trainees, which is worthy of promotion.

Changes of peripheral perfusion index in very low birth weight infants with late-onset sepsis / 中国小儿急救医学

Objective:To analyze the changes of peripheral perfusion index (PPI) with late-onset sepsis (LOS) in very low birth weight infants during hospitalization.Methods:Very low birth weight infants admitted to the neonatal intensive care unit of Children′s Hospital of Fudan University from August 1, 2021 to August 31, 2022 were consecutively included.Infants with admission age ≥three days and unstable circulation, or positive blood culture within three days after birth were excluded.From the day of admission, the PPI values of the right hand and either foot of the infants were measured with Masimo SET Radical-7 everyday while whether LOS occurred during hospitalization was observed.The mean PPI curve of very and extremely low birth weight infants without LOS was plotted.For those with LOS confirmed by blood culture, the PPI change trajectory three days before and after the occurrence of LOS was drawn, and the change trend of PPI before the occurrence of LOS was analyzed by trend chi-square test.Non-parametric test was used to analyze the effect of LOS on pre- and post-ductal PPI values.Results:A total of 107 very low birth weight infants were included in the final analysis.Among them, there were 11 infants confirmed as LOS by blood culture, 37 infants diagnosed as clinical LOS, and 59 infants without LOS.Pre-and post-ductal PPI values of very low birth weight infants without LOS were 2.06±1.30 and 1.72±0.92, respectively; those with clinical LOS were 1.90±0.94 and 1.58±0.83, respectively; those with LOS confirmed by blood culture were 1.92±1.11 and 1.62±0.82, respectively.For infants with LOS confirmed by blood culture, the pre-and post-ductal PPI values showed a continuous downward trend during three days before the onset of disease, with the lowest PPI values on the first day before the diagnosis of blood culture.The downtrend of pre-ductal PPI was statistically significant ( χtrend2=5.57, P<0.05). Conclusion:The PPI value of very low birth weight infants show a downward trend when LOS occurs.It should be observed dynamically in clinical practice, which is helpful to suspect or identify LOS as early as possible.

Construction of evaluation index system of core competence of specialized gynecological nurses / 中国实用护理杂志

Objective:To construct the evaluation index system of core competence of specialized gynecological nurses, and to provide reference for the curriculum setting and effect evaluation of standardized training for specialized gynecological nurses.Methods:The draft evaluation index system was prepared through literature research and group discussion. From May to June 2021, two rounds of Delphi letter consultation was used among 18 experts, to complete the selection and modification of evaluation index, and to determine the index weight.Results:The effective response rate of the two rounds of Delphi expert consultation was 100%, the expert authority coefficient was 0.938, and the Kendall harmony coefficient of the two rounds of expert letter consultation was 0.117 and 0.304, respectively (both P<0.01). Finally, the evaluation index system of core competence of specialized gynecological nurses was formed, including 4 first-level indexes, 11 second-level indexes and 48 third-level indexes. Conclusions:The evaluation index system of core competence of specialized gynecological nurses established in this study is scientific and reliable, which can provide reference for the curriculum setting and effect evaluation of standardized training for specialized gynecological nurses.

Feasibility analysis of inferior vena cava variability combined with rectus femoris atrophy fraction in predicting the outcome of weaning from invasive mechanical ventilation / 中华急诊医学杂志

Objective:To identify the feasibility of inferior vena cava variability (ΔDIVC) combined with rectus femoris atrophy fraction in predicting the outcome of weaning from invasive mechanical ventilation (IMV).Methods:From January to December 2021, the patients with the need for IMV admitted to the Affiliated Yixing Hospital of Jiangsu University were recruited into prospective case-control study. The patients who met the withdrawal criteria were treated with a 2-h spontaneous breathing trial (SBT) and then extubated immediately. Patients with stable spontaneous breathing after extubation for more than 48 h were classified as successful weaning group, and on the contrary, the other patients were classified as failed weaning group. The clinical data and withdrawal indexes of the two groups were evaluated. The correlation between ΔD IVC and rectus femoris atrophy fraction was assessed. The influencing factors of weaning outcome were observed. The diagnostic value of ΔD IVC, rectus femoris atrophy fraction and the combination of two indexes in predicting weaning success were calculated by a plotting receiver operating characteristic (ROC) curve. Results:Sixty IMV patients were included in this study, including 38 cases of successful weaning and 22 cases of failed weaning. The two groups were comparable with regard to clinical data (all P>0.05). The rectus femoris cross-sectional area in the two groups diminished gradually with the length of ICU stay ( F=3.266, 3.625, both P<0.05). The rectus femoris cross-sectional area at the first SBT was significantly lower than that on the first day of admission in both groups [the successful weaning group: (2.54±0.88) cm 2vs. (3.08±0.98) cm 2; the failed weaning group: (2.22±0.87) cm 2vs. (3.02±1.10) cm 2, both P<0.05], but there was no significant difference between the two groups (all P>0.05). Patients in the successful weaning group had higher ΔD IVC and higher rectus femoris atrophy fraction than those in the weaning failure group [ΔD IVC: (25.02±4.65)% vs. (20.30±3.16)%; rectus femoris atrophy fraction: (81.89±5.09)% vs. (72.68±8.98)%, both P<0.05]. There was a positive correlation between ΔD IVC and rectus femoris atrophy fraction ( r=0.346, P=0.007). Both ΔD IVC and rectus femoris atrophy fraction played an important role in affecting weaning success (all P<0.05). The area under the curve (AUC) of ΔD IVC combined with rectus femoris atrophy fraction for predicting the weaning success was 0.880, which was significantly higher than that of ΔD IVC (AUC=0.791) or rectus femoris atrophy fraction (AUC=0.826). Conclusions:The predictive value of ΔD IVC combined with rectus femoris atrophy fraction for successful weaning of patients undergoing IMV is relatively accurate, which can be used to guide weaning.

Progress of research on evaluation indicators and standards about high-speed train comfort / 中华劳动卫生职业病杂志

The rapid development of high-speed railway in China has proposed higher requests for the comfort level of high-speed trains. However, there is no internationally unified evaluation criterion for high-speed train comfort currently, which therefore substantially affects the comparability and standardization of research results for high-speed train comfort. This paper systematically reviews the research literature about evaluation indicators and standards related to high-speed train comfort, and finds that there is currently no unified definition, evaluation indicators, as well as evaluation criterion for high-speed train comfort. Most current evaluation criteria are based on a single indicator. Some indicators are simultaneously developed by different apartments and differ between each other, and there is no comprehensive indicator or criteria for high-speed train comfort, restricting the comparison of high-speed train comfort across regions. It is recommended that the administrative department of high-speed railroad in China should organize experts to establish a unified definition of high-speed train comfort, comprehensive evaluation indicators and relevant judgment criteria for high-speed train comfort, in face of the rapid development and globalization of high-speed trains.

Three-dimensional multi-component analysis of Aurantii Fructus quality and research on influencing factors / 中国中药杂志

The present study explored the consistency of the content proportions of active components of Aurantii Fructus and analyzed the influencing factors based on three-dimensional multi-component analysis. A total of 839 Aurantii Fructus samples in 65 research articles were analyzed using the three-dimensional multi-component analysis mode. The content data of flavonoid components(naringin, hesperidin, neohesperidin, narirutin, and nobiletin), coumarin components(meranzin and gluconolactone), and alkaloid(synephrine) in 386 samples which met the criteria of 2020 edition of the Chinese Pharmacopoeia were extracted and adjusted to percentages, and the content ratios between components were calculated. The influencing factors of Aurantii Fructus quality were analyzed. The results showed content ratios of components as follows: neohesperidin∶naringin in the range of 0.4-1.2; narirutin∶naringin in the range of 0.02-0.16; hesperidin∶naringin in the range of 0.01-0.3; nobiletin∶naringin in the range of 0.000 588 3-0.069 68; synephrine∶naringin in the range of 0.02-0.042; gluconolactone∶naringin in the range of 0.001-0.01; meranzin∶naringin in the range of 0.000 4-0.035. The quality of Aurantii Fructus was closely related to the origin, variety, harvesting time, and processing method of medicinal materials. Harvesting time had a greater impact on the quality of Aurantii Fructus, and the origin and variety had a certain impact on the quality of Aurantii Fructus. The findings of this study indicated that the ratios between flavonoid components, flavonoids and coumarin components, and flavonoids and alkaloids fluctuated. The production base should optimize the varieties, harvesting period, and processing methods of Aurantii Fructus to provide a scientific basis for the production of high-quality Aurantii Fructus.

Assessment on the implementation effect of basic public health service project in Jiangbei District of Chongqing / 上海预防医学

ObjectiveTo evaluate the implementation effect of the basic public health service project in Jiangbei District of Chongqing， so as to provide a basis for further improving the service content and social/economic benefits of the project. MethodsThe evaluation was conducted according to the “National Basic Public Health Service Regulations”， “National Basic Public Health Service Project Performance Evaluation Guidance Plan” and the assessment indicators， indicator requirements and weights of each project. The items were evaluated one by one， and each item was calculated and compared to obtain the trends in the three years from 2018 to 2020. ResultsThe evaluation results showed that the twelve contents of the basic public health service projects in Jiangbei District either met or exceeded the national requirements. The overall effect increased year by year， from 71.73 to 78.74 points. Eight of the twelve service contents have improved year by year， among which the report and processing of information related to infectious diseases and public health emergencies reached 100%， and the vaccination rate of “eight vaccines” reached 97%. Maternal and children （0-6 years old） health care increased significantly， rising by 39.89% and 36.62% respectively. Chronic disease health management was unsatisfactory. ConclusionThe effects of implementation of the basic public health service project is significant， and the service quality has improved year by year. The service content and assessment indicators are still imperfect and is worth of further research.

Comparison of different diagnostic modalities for isolation of Mycobacterium Tuberculosis among suspected tuberculous lymphadenitis patients / Comparação de diferentes modalidades de diagnóstico para isolamento de Mycobacterium tuberculosis entre pacientes com suspeita de linfadenite tuberculosa

Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.

A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados para o isolamento completo do Mycobacterium tuberculosis.

Comparison of different diagnostic modalities for isolation of Mycobacterium Tuberculosis among suspected tuberculous lymphadenitis patients

Abstract Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.

Resumo A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados para o isolamento completo do Mycobacterium tuberculosis.

Comparison of different diagnostic modalities for isolation of Mycobacterium Tuberculosis among suspected tuberculous lymphadenitis patients / Comparação de diferentes modalidades de diagnóstico para isolamento de Mycobacterium tuberculosis entre pacientes com suspeita de linfadenite tuberculosa

Abstract Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.

Resumo A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado ​​para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados ​​para o isolamento completo do Mycobacterium tuberculosis.

Hospital sustainability indicators and reduction of socio-environmental impacts: a scoping review / Indicadores de sostenibilidad hospitalaria y reducción de impactos socioambientales: una scoping review / Indicadores de sustentabilidade hospitalar e redução de impactos socioambientais: uma revisão de escopo

ABSTRACT Objective: To synthesize knowledge about hospital sustainability indicators and evidence of reduced socio-environmental impact. Method: Literature scoping review using Pubmed, Science Direct, Scielo and Lilacs databases. Studies in a time frame of 10 years, addressing hospital sustainability indicators and evidence of reduced socio-environmental impact published in any language were included. Results: A total of 28 articles were included, most were applied research, published in 2012, in English. Studies showed ways to save water and energy, as well as ways to monitor and mitigate the impact of activities related to effluents, waste and emissions. All studies had nursing work directly or indirectly involved in hospital sustainability. Conclusion: The possibilities of generating less impact on the environment and increasing the economy/efficiency of a hospital are countless. The particularities of each hospital must be taken into account and workers, especially nurses, should be involved.

RESUMEN Objetivo: Sintetizar conocimientos sobre indicadores de sostenibilidad hospitalaria y evidencias de reducción del impacto socioambiental. Método: Revisión de literatura, scoping review, utilizando las bases de datos Pubmed, Science Direct, Scielo y Lilacs. Se incluyeron estudios con un horizonte temporal de 10 años, publicados en cualquier idioma, que abordaran indicadores de sostenibilidad hospitalaria y evidencias de reducción del impacto socioambiental. Resultados: Se incluyeron un total de 28 artículos, la mayoría de investigación aplicada, publicados en 2012, en inglés. Los estudios mostraron formas de ahorrar agua y energía, así como formas de monitorear y mitigar el impacto de las actividades relacionadas con efluentes, desechos y emisiones. Todos los estudios tenían trabajo de enfermería involucrado directa o indirectamente en la sostenibilidad del hospital. Conclusión: Las posibilidades de generar un menor impacto en el medio ambiente y aumentar la economía/eficiencia de un hospital son innumerables. Hay que tener en cuenta las particularidades de cada hospital y se debe involucrar a los trabajadores, especialmente a los enfermeros.

RESUMO Objetivo: Sintetizar o conhecimento acerca dos indicadores de sustentabilidade hospitalar e evidências de redução do impacto socioambiental. Método: Revisão de literatura, do tipo scoping review, utilizando as bases de dados Pubmed, Science Direct, Scielo e Lilacs. Foram incluídos estudos com recorte temporal de 10 anos, publicados em qualquer idioma, que abordassem indicadores de sustentabilidade hospitalar e evidências de redução do impacto socioambiental. Resultados: Um total de 28 artigos foram incluídos, a maioria teve como tipo de estudo a pesquisa aplicada, publicados em 2012, no idioma inglês. Os estudos demonstraram maneiras de economizar água e energia, bem como, formas de monitorar e mitigar o impacto de atividades relacionadas a efluentes, resíduos e emissões. Todos os estudos tinham o trabalho da enfermagem envolvido de forma direta ou indireta na sustentabilidade hospitalar. Conclusão: As possibilidades de gerar menos impacto ao meio ambiente e aumentar a economia/eficiência de um hospital são inúmeras. Há de se levar em consideração as particularidades de cada hospital e envolver os trabalhadores, em especial a enfermagem.