Assessing patient safety culture in obstetrics ward: a pilot study using a modified Manchester Patient Safety Framework in China.

AIM: The primary objective of this study was to assess the patient safety culture in a general hospital in Shanghai, China, through a modified Manchester Patient Safety Framework (MaPSaF). DESIGN: This study has a qualitative interview design. Data were collected through group interviews and analyses performed through content analysis. METHODS: The MaPSaF was translated into Chinese and used to assess the patient safety culture in a large general hospital in Shanghai, China. Group interviews using the MaPSaF were conducted with 15 nurses in the obstetric ward. Participants rated their safety practice individually on each of the nine MaPSaF safety culture dimensions. The dimensions and scores were then collectively discussed and a practice-wide consensus score for each dimension was agreed. Discussions were recorded, transcribed and analysed to assess patient safety in the obstetric ward. RESULTS: It took about 2 hr to complete the discussion focusing on patients' safety employing the MaPSaF. Most participants recognized the process as acceptable and useful. The MaPSaF directed team discussion about patient safety issues and facilitated communication, prompting some practice changes. All participants responded positively to the discussion and perceived MaPSaF as a good safety culture assessment tool, with clear, comprehensive and understandable entries. The process demonstrated that the department of obstetrics in the hospital already had a positive patient safety culture, but certain areas were highlighted as still needing improvement. Based on participants' positive experience and perception of the MaPSaF, it can be concluded that there is potential benefit in its adaptation and use in obstetrics wards of Chinese hospitals. The MaPSaF has the potential to strengthen existing safety cultures and improve general safety through collaborative measures.

A network view of human immune system and virus-human interaction.

The immune system is highly networked and complex, which is continuously changing as encountering old and new pathogens. However, reductionism-based researches do not give a systematic understanding of the molecular mechanism of the immune response and viral pathogenesis. Here, we present HUMPPI-2022, a high-quality human protein-protein interaction (PPI) network, containing > 11,000 protein-coding genes with > 78,000 interactions. The network topology and functional characteristics analyses of the immune-related genes (IRGs) reveal that IRGs are mostly located in the center of the network and link genes of diverse biological processes, which may reflect the gene pleiotropy phenomenon. Moreover, the virus-human interactions reveal that pan-viral targets are mostly hubs, located in the center of the network and enriched in fundamental biological processes, but not for coronavirus. Finally, gene age effect was analyzed from the view of the host network for IRGs and virally-targeted genes (VTGs) during evolution, with IRGs gradually became hubs and integrated into host network through bridging functionally differentiated modules. Briefly, HUMPPI-2022 serves as a valuable resource for gaining a better understanding of the composition and evolution of human immune system, as well as the pathogenesis of viruses.

The effectiveness of governmental nonpharmaceutical interventions against COVID-19 at controlling seasonal influenza transmission: an ecological study.

BACKGROUND: A range of strict nonpharmaceutical interventions (NPIs) were implemented in many countries to combat the coronavirus 2019 (COVID-19) pandemic. These NPIs may also be effective at controlling seasonal influenza virus infections, as influenza viruses have the same transmission path as severe acute respiratory syndrome coronavirus 2. The aim of this study was to evaluate the effects of different NPIs on the control of seasonal influenza. METHODS: Data for 14 NPIs implemented in 33 countries and the corresponding influenza virological surveillance data were collected. The influenza suppression index was calculated as the difference between the influenza positivity rate during its period of decline from 2019 to 2020 and during the influenza epidemic seasons in the previous 9 years. A machine learning model was developed using an extreme gradient boosting tree regressor to fit the NPI and influenza suppression index data. The SHapley Additive exPlanations tool was used to characterize the NPIs that suppressed the transmission of influenza. RESULTS: Of all NPIs tested, gathering limitations had the greatest contribution (37.60%) to suppressing influenza transmission during the 2019-2020 influenza season. The three most effective NPIs were gathering limitations, international travel restrictions, and school closures. For these three NPIs, their intensity threshold required to generate an effect were restrictions on the size of gatherings less than 1000 people, ban of travel to all regions or total border closures, and closing only some categories of schools, respectively. There was a strong positive interaction effect between mask-wearing requirements and gathering limitations, whereas merely implementing a mask-wearing requirement, and not other NPIs, diluted the effectiveness of mask-wearing requirements at suppressing influenza transmission. CONCLUSIONS: Gathering limitations, ban of travel to all regions or total border closures, and closing some levels of schools were found to be the most effective NPIs at suppressing influenza transmission. It is recommended that the mask-wearing requirement be combined with gathering limitations and other NPIs. Our findings could facilitate the precise control of future influenza epidemics and other potential pandemics.

Synchronized nonpharmaceutical interventions for the control of COVID-19.

The world is experiencing an ongoing pandemic of coronavirus disease-2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In attempts to control the pandemic, a range of nonpharmaceutical interventions (NPIs) has been implemented worldwide. However, the effect of synchronized NPIs for the control of COVID-19 at temporal and spatial scales has not been well studied. Therefore, a meta-population model that incorporates essential nonlinear processes was constructed to uncover the transmission characteristics of SARS-CoV-2 and then assess the effectiveness of synchronized NPIs on COVID-19 dynamics in China. Regional synchronization of NPIs was observed in China, and it was found that a combination of synchronized NPIs (the travel restrictions, the social distancing and the infection isolation) prevented 93.7% of SARS-CoV-2 infections. The use of synchronized NPIs at the time of the Wuhan lockdown may have prevented as much as 38% of SARS-CoV-2 infections, compared with the unsynchronized scenario. The interconnectivity of the epicenter, the implementation time of synchronized NPIs, and the number of regions considered all affected the performance of synchronized NPIs. The results highlight the importance of using synchronized NPIs in high-risk regions for the control of COVID-19 and shed light on effective strategies for future pandemic responses. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11071-021-06505-0.

Delivering an online course in emergency nursing education during the pandemic: What are the effects on students' learning?

BACKGROUND: Online learning emerged as an auxiliary approach in 2013 when MOOCs were imported and popularized in Chinese universities, particularly in the duration of pandemic outbreaks worldwide. World health organization (WHO) had recommended online education to keep social distance which still needs further evaluation. This study aimed to examine whether an open online course is superior to conventional education in emergency nursing during the COVID-19 pandemic. METHODS: Two groups of conventional education students (CG) and two groups of students participating in an online course that utilized an application (called SuperStar) as the SuperStar Group (SSG) were studied to compare their abilities in the process of new knowledge acquisition. The SSG was divided into a blended group (S1) and an online group (S2). The emergency nursing course was scheduled in 16 independent classes, which contained stochastic tests at least eight times. RESULTS: The CG group showed better performance on the final exam than the SSG group, but there was no statistically significant difference. The CG group obtained better scores on the memory capacity tests while the SSG had better scores on the application capacity tests. The SSG group scored higher on the later tests during the process of education compared to the CG group. CONCLUSIONS: Comprehension of an emergency nursing course was stronger in the SSG group than in the CG group. Horizontal comparison of subentry tests discriminated between the groups, with a better trend for the SSG group in application ability. There are potential effects on chronological learning through the use of the online course for emergency nursing education, not only during COVID-19 but also in the post-pandemic era.

Antiviral Bafilomycins from a Feces-Inhabiting Streptomyces sp.

A new bafilomycin derivative (1) and another seven known bafilomycins (2-8) were isolated from feces-derived Streptomyces sp. HTL16. The structure of 1 was elucidated by 1D and 2D NMR spectroscopic analysis. Biological testing demonstrated that these bafilomycins exhibited potent antiviral activities against the influenza A and SARS-CoV-2 viruses, with IC50 values in the nanomolar range, by inhibiting the activity of endosomal ATP-driven proton pumps.

Salivary extracellular vesicles inhibit Zika virus but not SARS-CoV-2 infection.

Zika virus (ZIKV) is mainly transmitted via mosquitos, but human-to-human transmissions also occur. The virus is shed into various body fluids including saliva, which represents a possible source of viral transmission. Thus, we here explored whether human saliva affects ZIKV infectivity. We found that physiological concentrations of pooled saliva dose-dependently inhibit ZIKV infection of monkey and human cells by preventing viral attachment to target cells. The anti-ZIKV activity in saliva could not be abrogated by boiling, suggesting the antiviral factor is not a protein. Instead, we found that purified extracellular vesicles (EVs) from saliva inhibit ZIKV infection. Salivary EVs (saEVs) express typical EV markers such as tetraspanins CD9, CD63 and CD81 and prevent ZIKV attachment to and infection of target cells at concentrations that are naturally present in saliva. The anti-ZIKV activity of saliva is conserved but the magnitude of inhibition varies between individual donors. In contrast to ZIKV, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), predominantly spreading via respiratory droplets, is not affected by saliva or saEVs. Our findings provide a plausible explanation for why ZIKV transmission via saliva, i.e. by deep kissing have not been recorded and establish a novel oral innate immune defence mechanism against some viral pathogens.