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1.
Artigo em Inglês | MEDLINE | ID: mdl-38687183

RESUMO

Three Gram-positive, obligately anaerobic bacterial strains, namely CSJ-1T, CSJ-3T, and CSJ-4T, were isolated from faeces of healthy persons. They were characterized through a combination of whole-genome sequencing, phenotypic traits, and metabolomic analysis. The genome sizes of CSJ-1T, CSJ-4T, and CSJ-3T were 3.3, 3.8, and 6.1 Mbp, with DNA G+C contents of 47.2, 48.3, and 48.8 mol%, respectively. Strain CSJ-3T was identified as representing a novel species, Diplocloster hominis (type strain CSJ-3T=CGMCC 1.18033T=JCM 36512T) of the genus Diplocloster. The 16S rRNA gene sequence similarity and whole genome average nucleotide identity (gANI) of CSJ-4T to its closest related species, Diplocloster modestus ASD 4241T, were 98.3 and 91.4 %, respectively. Comparative analysis of 16S rRNA gene sequences showed 91.6 % similarity between CSJ-1T and its closest phylogenetic neighbour, Catenibacillus scindens DSM 106146T, and 93.3 % similarity between CSJ-4T and its closest relative strain, Clostridium fessum SNUG30386T. Based on the polyphasic taxonomic results, we proposed two novel genera and three novel species. Strain CSJ-1T was identified as representing a novel species of novel genus, Anaerolentibacter hominis gen. nov. sp. nov. (type strain CSJ-1T=CGMCC 1.18046T=JCM 36511T) of the family Lachnospiraceae, and strain CSJ-4T was identified as representing a novel species of novel genus Pilosibacter fragilis gen. nov. sp. nov. (type strain CSJ-4T=CGMCC 1.18026T= JCM 36513T) of the family Clostridiaceae.


Assuntos
Técnicas de Tipagem Bacteriana , Composição de Bases , DNA Bacteriano , Fezes , Filogenia , RNA Ribossômico 16S , Análise de Sequência de DNA , RNA Ribossômico 16S/genética , Fezes/microbiologia , DNA Bacteriano/genética , Humanos , Ácidos Graxos/análise , Genoma Bacteriano , Sequenciamento Completo do Genoma
2.
BMC Health Serv Res ; 24(1): 44, 2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38195476

RESUMO

BACKGROUND: Hospital Examination Reservation System (HERS) was designed for reducing appointment examination waiting time and enhancing patients' medical satisfaction in China, but implementing HERS would encounter many difficulties. This study would investigate the factors that influence patients' utilization of HERS through UTAUT2, and provide valuable insights for hospital managements to drive the effective implementation of HERS. It is helpful for improving patients' medical satisfaction. METHODS: We conducted a survey through the Sojump platform, targeting patients were who have already used HERS. We collected questionnaire information related to factors behavior intention, performance expectancy, and effort expectancy. Subsequently, we employed a structural equation model to analyze the factors influencing patients' utilization of HERS. RESULTS: A total of 394 valid questionnaires were collected. Habit was the main direct positive factor influencing the behavioral intention of HERS (ß = 0.593; 95%CI: 0.072, 1.944; P = 0.002), followed by patient innovation (ß = 0.269; 95%CI: 0.002, 0.443; P < 0.001), effort expectancy (ß = 0.239; 95%CI: -0.022, 0.478; P = 0.048). Patient innovation and facilitating conditions also have an indirect effect on behavioral intention. Perceived privacy exposure has a significantly negative effect on behavioral intention (ß=-0.138; 95%CI: -0.225, -0.047; P < 0.001). The above variables explained 56.7% of the variation in behavioral intention. CONCLUSIONS: When HERS is implemented in hospitals, managements should arrange volunteers to guide patients to bring up the habit and solve the using difficulties, and managements could invite patients with high innovation to recommend HERS to others, what's more, it is a valid way to retain the old form of appointment to pass the transition period to the new system. HERS utilization and patients' medical satisfaction will be enhanced through the guidance of hospital management means.


Assuntos
Hospitais , Intenção , Humanos , Feminino , China , Satisfação do Paciente , Privacidade
3.
J Adv Nurs ; 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38622988

RESUMO

AIM: To understand the status quo of multiprofessional and multidisciplinary collaboration for early mobilization of mechanically ventilated patients in Chinese ICUs and identify any factors that may influence this practice. DESIGN: A multi-centre cross-sectional survey. METHODS: From October to November 2022, the convenience sampling method was used to select ICU multiprofessional and multidisciplinary early mobility members (including physicians, nurses and physiotherapists) from 27 tertiary general hospitals in 14 provinces, cities and autonomous regions of China. They were asked to complete an author-developed questionnaire on the status of collaboration and the Assessment of Inter-professional Team Collaboration Scale. A multiple linear regression model was used to analyse the factors associated with the level of collaboration. RESULTS: Physicians, nurses and physiotherapists mostly suffered from the lack of normative protocols, unclear division of responsibilities and unclear multiprofessional and multidisciplinary teams when using a collaborative approach to early activities. Multiple linear regression analysis showed that the number of ICU patients managed, the existence of norms and processes, the attitude of colleagues around them, the establishment of a team, communication methods and activity leaders were significant influences on the level of collaboration among members of the multiprofessional and multidisciplinary early activities. CONCLUSION: The collaboration of multiprofessional and multidisciplinary early activity members for mechanically ventilated patients in the ICU remains unclear, and the collaboration strategy needs to be constructed and improved, taking into account China's human resources and each region's economic development level. IMPACT: This study investigates the collaboration status of multiprofessional and multidisciplinary activity members from the perspective of teamwork, analyses the reasons affecting the level of collaboration and helps to develop better teamwork strategies to facilitate the implementation of early activities. PATIENT OR PUBLIC CONTRIBUTION: The participants in this study were multiprofessional and multidisciplinary medical staff who performed early activities for ICU patients.

4.
Prev Med ; 175: 107678, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37619950

RESUMO

BACKGROUND: Owing to the outbreak of the Omicron variant of SARS-CoV-2 in Shanghai, China, partitioned dynamic closure and control management plans were implemented on March 28, 2022. This created huge emergency pressure on Shanghai's medical and healthcare systems. However, the perceptions of job demands of healthcare workers (HCWs) and classification of frontline HCWs in mobile cabin hospitals are unknown. METHODS: In this study, we investigated the job demands of 1223 frontline HCWs working in mobile cabin hospitals during the COVID-19 pandemic April 2022 to May 2022. We performed latent class analysis to identify classification features of job demands. A binary multivariate logistic regression model was used to explore the influencing factors of latent class. RESULTS: The total mean job demand score was 132.26 (SD = 9.53), indicating a high level of job demand. A two-class model provided the best fit. The two classes were titled "middle-demand group" (17.66%) and "high-demand group" (82.34%). A regression analysis suggested that female HCWs, HCWs satisfied with the doctor/nurse-patient relationship, HCWs who believed that the risk of working in mobile cabin hospitals was high, and HCWs without physical discomfort during the pandemic were more likely to be in the "high-demand group". CONCLUSION: Characteristics of the "high-demand group" subtype suggest that attention should be paid to the physical condition of frontline HCWs and the job demands of female HCWs. Managers should strengthen the training of HCWs in terms of their communication skills as well as their knowledge and technical skills to aid epidemic prevention and control.

5.
Health Qual Life Outcomes ; 21(1): 100, 2023 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-37633882

RESUMO

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic and life-threatening disease. Health-related quality of life (HRQoL) is vital for individuals with T2DM. However, little is known about the impact of psychological stability factors on HRQoL among individuals with T2DM in mainland China. METHODS: This multicenter cross-sectional study was conducted in five tertiary grade-A hospitals in Chongqing, China, from January to December 2019. A total of 385 individuals with T2DM were included by the convenient sample method. Fear of Progression (FOP) Questionnaire-short Form, Hypoglycemia Fear Survey II, diabetes-management self-efficacy scale, and EuroQol-5 Dimensions were used for data collection. RESULTS: The mean age of the 385 individuals was 57.65 (SD = 15.15) years, three-quarters of whom had a high school or above education level. The participants in our study had moderate HRQoL and were more likely to have poor scores in the pain/discomfort dimension. The FOP level was moderate on average, and 23.1% of individuals suffered from psychological dysfunction. The participants had higher levels of fear of hypoglycemia (FOH) and self-efficacy (SE). Multiple steppage-regression analysis predicted that higher levels of FOP and FOH, reduced SE, older age, longer duration since diagnosis, lower educational attainment, higher levels of HbA1c, and living with comorbid conditions were related to lower HRQoL. CONCLUSION: This study showed that the HRQoL among Chinese T2DM patients may be impaired by increased FOP and FOH, decreased SE, and poor glycemic control. In addition, as the patient's age and duration since diagnosis increase, their HRQoL further declines. We recommend improving HRQoL by encouraging individuals to attain more health education and resilience skills to enhance SE and reduce negative emotions among individuals with T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Hipoglicemia , Humanos , Pessoa de Meia-Idade , Estudos Transversais , População do Leste Asiático , Qualidade de Vida , Adulto , Idoso
6.
BMC Geriatr ; 23(1): 117, 2023 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-36869322

RESUMO

BACKGROUND: Ageing in place is the preferred choice for most older adults worldwide. The role of the family as a core care resource has diminished as a result of changes in family structure, thus extending the responsibility for caring for older adults from within the family to outside it and requiring considerably more support from society. However, there is a shortage of formal and qualified caregivers in many countries, and China has limited social care resources. Therefore, it is important to identify home care patterns and family preferences to provide effective social support and reduce government costs. METHODS: Data were obtained from the Chinese Longitudinal Healthy Longevity Study 2018. Latent class analysis models were estimated using Mplus 8.3. Multinomial logistic regression analysis was adopted to explore the influencing factors with the R3STEP method. Lanza's method and the chi-square goodness-of-fit test were used to explore community support preferences among different categories of families of older adults with disabilities. RESULTS: Three latent classes were identified based on older adults with disabilities' characteristics (degree of disability, demand satisfaction), caregivers' characteristics (length of providing care, care performance) and living status: Class 1- mild disability and strong care (46.85%); Class 2- severe disability and strong care (43.92%); and Class 3- severe disability and incompetent care (9.24%). Physical performance, geographic region and economic conditions jointly influenced home care patterns (P < 0.05). Home visits from health professionals and health care education were the top two forms of community support that were most preferred by the older adults with disabilities' families (residual > 0). Families in the Class 3 subgroup preferred personal care support more than those in the other two subgroups (P < 0.05). CONCLUSION: Home care is heterogeneous across families. Older adults' degrees of disability and care needs may be varied and complex. We classified different families into homogeneous subgroups to reveal differences in home care patterns. The findings can be used by decision-makers in their attempts to design long-term care arrangements for home care and to adjust the distribution of resources for the needs of older adults with disabilities.


Assuntos
Pessoas com Deficiência , Serviços de Assistência Domiciliar , Idoso , Humanos , Apoio Comunitário , Análise de Classes Latentes , Vida Independente , China
7.
BMC Pediatr ; 23(1): 42, 2023 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694183

RESUMO

BACKGROUND: Nursing experts regularly visited the community to deliver safety education on the prevention of unintentional injuries in children to the parents of children aged 0-6 years and to pregnant women in a maternity school. This was undertaken to explore the effects of the measure on preventing unintentional injuries in children in Chizhou, China. METHODS: Using the convenience sampling method, the guardians(it means mother in this study)of children were investigated. The nursing experts visited communities in which the number of nursing experts is declining. Data on unintentional injuries in children in the previous year were collected retrospectively. RESULTS: After the nursing experts delivered safety education to the community, the scores of the questionnaire on unintentional injury prevention knowledge completed by children's guardians increased significantly (p < 0.01). Among the children whose guardians completed the questionnaire, there were 157 cases of unintentional injury in 2020 and 103 cases in 2021 (p < 0.05). The types of unintentional injuries included scratches, falls, sharp object injuries, swallowing of foreign bodies, burns and traffic accidents; there was no statistical difference (p > 0.05). However, there were significant differences in terms of gender ratio and location (p < 0.05). CONCLUSION: In conjunction with the maternity school for pregnant women and the vaccination programme, nursing experts delivered safety education regarding unintentional injuries in children; this may have promoted safety and protection awareness in the children's guardians and reduced unintentional injuries.


Assuntos
Lesões Acidentais , Queimaduras , Ferimentos e Lesões , Gravidez , Criança , Humanos , Feminino , Estudos Retrospectivos , Acidentes de Trânsito , Participação da Comunidade , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/prevenção & controle
8.
Acta Radiol ; 64(4): 1490-1499, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36120851

RESUMO

BACKGROUND: Ultrasound examination of the medial side of the hip joint has been rarely used to evaluate the status of developmental dysplasia of the hip (DDH) in Pavlik harness treatment according to the literature. PURPOSE: To analyze the effects of cartilaginous acetabulum, hip joint labrum, and acetabular tissue on the reduction of DDH. MATERIAL AND METHODS: A total of 50 cases (100 hips) were detected by the Graf method with a high-frequency linear transducer (L 5-12), and there were 59 dislocated hips and 41 non-dislocated hips. Patients were treated with a Pavlik harness. Ultrasound examination of the medial side of the hip joint was performed for follow-up. The hip joints were divided into three groups: the non-dislocated group; the reducible group; and the non-reducible group. RESULTS: The success rate of reduction was significantly higher when the acetabulum cartilage was located on the cephalic side (chi-square = 28.12, P < 0.001). The success rate was also significantly higher when the hip joint labrum was located on the cephalic side (chi-square = 17.21, P < 0.001). Type III and D had a higher success rate of reduction than type IV (P < 0.001). The pairwise comparison of the measurements of acetabular tissue between the non-dislocated group, the reducible group, and the non-reducible group showed statistical differences (P < 0.001). CONCLUSION: The present study confirmed that the location of acetabulum cartilage and hip joint labrum affected the outcome of treatment. The degree of dislocation and the amount of acetabular tissue were correlated with the success rate of treatment.


Assuntos
Luxação Congênita de Quadril , Humanos , Lactente , Luxação Congênita de Quadril/diagnóstico por imagem , Luxação Congênita de Quadril/terapia , Aparelhos Ortopédicos , Resultado do Tratamento , Estudos Retrospectivos , Fatores de Tempo , Acetábulo/diagnóstico por imagem
9.
J Med Internet Res ; 25: e43815, 2023 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-37023416

RESUMO

BACKGROUND: Numerous studies have identified risk factors for physical restraint (PR) use in older adults in long-term care facilities. Nevertheless, there is a lack of predictive tools to identify high-risk individuals. OBJECTIVE: We aimed to develop machine learning (ML)-based models to predict the risk of PR in older adults. METHODS: This study conducted a cross-sectional secondary data analysis based on 1026 older adults from 6 long-term care facilities in Chongqing, China, from July 2019 to November 2019. The primary outcome was the use of PR (yes or no), identified by 2 collectors' direct observation. A total of 15 candidate predictors (older adults' demographic and clinical factors) that could be commonly and easily collected from clinical practice were used to build 9 independent ML models: Gaussian Naïve Bayesian (GNB), k-nearest neighbor (KNN), decision tree (DT), logistic regression (LR), support vector machine (SVM), random forest (RF), multilayer perceptron (MLP), extreme gradient boosting (XGBoost), and light gradient boosting machine (Lightgbm), as well as stacking ensemble ML. Performance was evaluated using accuracy, precision, recall, an F score, a comprehensive evaluation indicator (CEI) weighed by the above indicators, and the area under the receiver operating characteristic curve (AUC). A net benefit approach using the decision curve analysis (DCA) was performed to evaluate the clinical utility of the best model. Models were tested via 10-fold cross-validation. Feature importance was interpreted using Shapley Additive Explanations (SHAP). RESULTS: A total of 1026 older adults (mean 83.5, SD 7.6 years; n=586, 57.1% male older adults) and 265 restrained older adults were included in the study. All ML models performed well, with an AUC above 0.905 and an F score above 0.900. The 2 best independent models are RF (AUC 0.938, 95% CI 0.914-0.947) and SVM (AUC 0.949, 95% CI 0.911-0.953). The DCA demonstrated that the RF model displayed better clinical utility than other models. The stacking model combined with SVM, RF, and MLP performed best with AUC (0.950) and CEI (0.943) values, as well as the DCA curve indicated the best clinical utility. The SHAP plots demonstrated that the significant contributors to model performance were related to cognitive impairment, care dependency, mobility decline, physical agitation, and an indwelling tube. CONCLUSIONS: The RF and stacking models had high performance and clinical utility. ML prediction models for predicting the probability of PR in older adults could offer clinical screening and decision support, which could help medical staff in the early identification and PR management of older adults.


Assuntos
População do Leste Asiático , Assistência de Longa Duração , Aprendizado de Máquina , Restrição Física , Idoso , Humanos , Estudos Transversais , População do Leste Asiático/estatística & dados numéricos , Assistência de Longa Duração/estatística & dados numéricos , Restrição Física/estatística & dados numéricos , Fatores de Risco , Masculino , Feminino , Idoso de 80 Anos ou mais , Algoritmos , Modelos Teóricos , Instituições de Cuidados Especializados de Enfermagem/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , China/epidemiologia
10.
Int J Mol Sci ; 24(19)2023 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-37833998

RESUMO

Ningxiang pigs are a renowned indigenous pig breed in China, known for their meat quality, disease resistance, and environmental adaptability. In recent decades, consumer demand for meats from indigenous breeds has grown significantly, fueling the selection and crossbreeding of Ningxiang pigs (NXP). The latter has raised concerns about the conservation and sustainable use of Ningxiang pigs as an important genetic resource. To address these concerns, we conducted a comprehensive genomic study using 2242 geographically identified Ningxiang pigs. The estimated genomic breed composition (GBC) suggested 2077 pigs as purebred Ningxiang pigs based on a ≥94% NXP-GBC cut-off. The remaining 165 pigs were claimed to be crosses, including those between Duroc and Ningxiang pigs and between Ningxiang and Shaziling pigs, and non-Ningxiang pigs. Runs of homozygosity (ROH) were identified in the 2077 purebred Ningxiang pigs. The number and length of ROH varied between individuals, with an average of 32.14 ROH per animal and an average total length of 202.4 Mb per animal. Short ROH (1-5 Mb) was the most abundant, representing 66.5% of all ROH and 32.6% of total ROH coverage. The genomic inbreeding estimate was low (0.089) in purebred Ningxiang pigs compared to imported western pig breeds. Nine ROH islands were identified, pinpointing candidate genes and QTLs associated with economic traits of interest, such as reproduction, carcass and growth traits, lipid metabolism, and fat deposition. Further investigation of these ROH islands and candidate genes is anticipated to better understand the genomics of Ningxiang pigs.


Assuntos
Genoma , Polimorfismo de Nucleotídeo Único , Humanos , Suínos/genética , Animais , Homozigoto , Cruzamento , Endogamia , Genômica , Genótipo
11.
J Integr Plant Biol ; 65(11): 2416-2420, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37698072

RESUMO

The lack of genome editing platforms has hampered efforts to study and improve forage crops that can be grown on lands not suited to other crops. Here, we established efficient Agrobacterium-mediated clustered regularly interspaced palindromic repeats (CRISPR)/CRISPR-associated nuclease 9 (Cas9) genome editing in a perennial, stress-tolerant forage grass, sheepgrass (Leymus chinensis). By screening for active single-guide RNAs (sgRNAs), accessions that regenerate well, suitable Agrobacterium strains, and optimal culture media, and co-expressing the morphogenic factor TaWOX5, we achieved 11% transformation and 5.83% editing efficiency in sheepgrass. Knocking out Teosinte Branched1 (TB1) significantly increased tiller number and biomass. This study opens avenues for studying gene function and breeding in sheepgrass.


Assuntos
Sistemas CRISPR-Cas , Edição de Genes , Sistemas CRISPR-Cas/genética , RNA Guia de Sistemas CRISPR-Cas , Melhoramento Vegetal , Poaceae/genética , Agrobacterium/genética
12.
J Environ Sci (China) ; 126: 387-395, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36503765

RESUMO

This study examined the effectiveness for degradation of hydrophobic (HPO), transphilic (TPI) and hydrophilic (HPI) fractions of natural organic matter (NOM) during UV/H2O2, UV/TiO2 and UV/K2S2O8 (UV/PS) advanced oxidation processes (AOPs). The changing characteristics of NOM were evaluated by dissolved organic carbon (DOC), the specific UV absorbance (SUVA), trihalomethanes formation potential (THMFP), organic halogen adsorbable on activated carbon formation potential (AOXFP) and parallel factor analysis of excitation-emission matrices (PARAFAC-EEMs). In the three UV-based AOPs, HPI fraction with low molecular weight and aromaticity was more likely to degradate than HPO and TPI, and the removal efficiency of SUVA for HPO was much higher than TPI and HPI fraction. In terms of the specific THMFP of HPO, TPI and HPI, a reduction was achieved in the UV/H2O2 process, and the higest removal rate even reached to 83%. UV/TiO2 and UV/PS processes can only decrease the specific THMFP of HPI. The specific AOXFP of HPO, TPI and HPI fractions were all able to be degraded by the three UV-based AOPs, and HPO content is more susceptible to decompose than TPI and HPI content. UV/H2O2 was found to be the most effective treatment for the removal of THMFP and AOXFP under given conditions. C1 (microbial or marine derived humic-like substances), C2 (terrestrially derived humic-like substances) and C3 (tryptophan-like proteins) fluorescent components of HPO fraction were fairly labile across the UV-based AOPs treatment. C3 of each fraction of NOM was the most resistant to degrade upon the UV-based AOPs. Results from this study may provide the prediction about the consequence of UV-based AOPs for the degradation of different fractions of NOM with varied characteristics.


Assuntos
Água Potável , Peróxido de Hidrogênio , Trialometanos , Oxirredução , Raios Ultravioleta , Substâncias Húmicas
13.
Nano Lett ; 21(7): 3318-3324, 2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33792310

RESUMO

Strongly coupled, epitaxially fused colloidal nanocrystal (NC) solids are promising solution-processable semiconductors to realize optoelectronic devices with high carrier mobilities. Here, we demonstrate sequential, solid-state cation exchange reactions to transform epitaxially connected PbSe NC thin films into Cu2Se nanostructured thin-film intermediates and then successfully to achieve zinc-blende, CdSe NC solids with wide epitaxial necking along {100} facets. Transient photoconductivity measurements probe carrier transport at nanometer length scales and show a photoconductance of 0.28(1) cm2 V-1 s-1, the highest among CdSe NC solids reported. Atomic-layer deposition of a thin Al2O3 layer infiltrates and protects the structure from fusing into a polycrystalline thin film during annealing and further improves the photoconductance to 1.71(5) cm2 V-1 s-1 and the diffusion length to 760 nm. We fabricate field-effect transistors to study carrier transport at micron length scales and realize high electron mobilities of 35(3) cm2 V-1 s-1 with on-off ratios of 106 after doping.

14.
J Nurs Manag ; 30(1): 318-327, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34448285

RESUMO

AIM: To examine the effectiveness of implementing the evidence in preventing medical device-related pressure injury (MDRPI) in intensive care patients. BACKGROUND: MDRPI is a common problem that significantly complicates patients' medical condition. However, evidence in preventing MDRPI is not properly implemented in clinical practice. METHODS: A pre- and post-implementation study was conducted using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. A baseline survey was implemented; barriers and enablers of evidence implementation were analysed to inform facilitation support strategies, such as training nursing staff and developing resources and tools. Changes in nurses, patients and the system were assessed after evidence implementation. RESULTS: Nurses' knowledge scores and evidence compliance significantly improved. The incidence of MDRPI in patients decreased from 24.39% to 4.26%. Standardized care and workflows to prevent MDRPI were established. CONCLUSION: The i-PARIHS framework supported effective implementation of the evidence in preventing MDRPI, narrowing the gap between evidence and clinical practice. IMPLICATIONS FOR NURSING MANAGEMENT: We provide an effective case of transforming evidence into practice based on the i-PARIHS framework. It can be used as a reference for colleagues in intensive care unit (ICU) or other settings to implement MDRPI prevention.


Assuntos
Competência Clínica , Enfermeiras e Enfermeiros , Úlcera por Pressão , Humanos , Cuidados Críticos , Serviços de Saúde , Unidades de Terapia Intensiva
15.
Lab Invest ; 101(10): 1371-1381, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34239033

RESUMO

Sepsis is an acute inflammatory reaction and a cause of acute respiratory distress syndrome (ARDS). In the present study, we explored the roles and underlying mechanism of the lncRNA Nuclear enriched abundant transcript 1 (NEAT1) in ARDS. The expression levels of genes, proteins and pro-inflammatory cytokines in patients with ARDS, LPS-stimulated cells and septic mouse models were quantified using qPCR, western blotting and ELISA assays, respectively. The molecular targeting relationship was validated by conducting a dual-luciferase reporter assay. Cell proliferation was assessed using the Cell Counting Kit-8 (CCK-8) assay. The cell cycle phase was determined by flow cytometry assay. The expression levels of NEAT1 and pro-inflammatory cytokines were higher in patients with ARDS and septic models than in controls. Knockdown of NEAT1 significantly increased cell proliferation and cycle progression and prolonged mouse survival in vitro and in vivo. Mechanistically, miR-27a was identified as a downstream target of NEAT1 and directly inhibited PTEN expression. Further rescue experiments revealed that inhibition of miR-27a impeded the promoting effects of NEAT1 silence on cell proliferation and cycle progression, whereas inhibition of PTEN markedly weakened the inhibitory effects of NEAT1 overexpression on cell proliferation and cycle progression. Altogether, our study revealed that NEAT1 plays a promoting role in the progression of ARDS via the NEAT1/miR-27a/PTEN regulatory network, providing new insight into the pathologic mechanism behind ARDS.


Assuntos
MicroRNAs/metabolismo , PTEN Fosfo-Hidrolase/metabolismo , RNA Longo não Codificante , Síndrome do Desconforto Respiratório/metabolismo , Sepse/metabolismo , Adulto , Animais , Linhagem Celular , Modelos Animais de Doenças , Técnicas de Silenciamento de Genes , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , MicroRNAs/genética , PTEN Fosfo-Hidrolase/genética , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Transdução de Sinais/genética
16.
Health Expect ; 24(6): 2087-2097, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34510675

RESUMO

BACKGROUND: The most common and severe type of nosocomial infection in patients with colorectal cancer is surgical site infection (SSI). Patient-related factors are an important components of SSI. So it is necessary to participate in SSI prevention and control. It is important to identify the factors that influence patients' participation behaviour and to explore the mechanism of these effects. METHODS: A total of 580 patients with colorectal cancer completed relevant measures. Based on the extended theory of planned behaviour, a structural equation model was used to analyse the relationship among the influencing factors. RESULTS: The factors influencing participation of patients with colorectal cancer in SSI prevention and control were participation intention, participation ability, self-efficacy, participation attitude, perceived medical staff support, trust in physicians and social support. The direct effect coefficients of participation intention, participation ability and physician trust on SSI prevention and control behaviour were 0.67, 0.21 and 0.11, respectively. Self-efficacy, participation attitude, perceived medical staff support and social support indirectly affect participation behaviour through participation intention, and their effect values are 0.21, 0.11, 0.11 and 0.08, respectively. CONCLUSIONS: Based on the structural equation model developed in this study, targeted intervention measures should be implemented to mobilize the intention and enthusiasm of patients with colorectal cancer to participate in the prevention and control of SSI. PATIENT OR PUBLIC CONTRIBUTION: Patients or public contribute to spreading research findings, and promote broad participation in the implementation of policies or strategies.


Assuntos
Neoplasias Colorretais , Infecção da Ferida Cirúrgica , Atitude , Neoplasias Colorretais/cirurgia , Humanos , Intenção , Apoio Social , Infecção da Ferida Cirúrgica/prevenção & controle
17.
J Adv Nurs ; 77(1): 266-274, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33074555

RESUMO

AIMS: To assess the prevalence and associated factors of psychological distress among patients with chronic hepatitis B receiving oral antiviral therapy and explore the association between psychological distress and self-management behaviours among this population. DESIGN: A cross-sectional study. METHODS: A convenience sample of 188 patients with chronic hepatitis B receiving oral antiviral therapy was recruited from March-October 2018 to complete a self-report questionnaire including the Chinese version of Depression Anxiety Stress Scale-21 and Chronic Hepatitis B Self-Management Scale. Logistic regression analysis and hierarchical multiple regression analysis were used to determine the factors associated with psychological distress and the association between psychological distress and self-management behaviours respectively. RESULTS: The prevalence of depression, anxiety, and stress symptoms were 33.0%, 38.3% and 17.6% respectively. Depression was associated with older age, female gender, lower education level and longer treatment duration; anxiety was associated with female gender and longer treatment duration; and stress was associated with age of 31-40 years, female gender and unmarried status. There were significant associations between depression and anxiety symptoms and self-management behaviours. CONCLUSION: Psychological distress was prevalent among patients with chronic hepatitis B receiving oral antiviral therapy and had a negative impact on self-management. Interventions targeting depression and anxiety symptoms may be beneficial to improve self-management behaviours for this population. IMPACT: This study explored the factors associated with psychological distress in patients with chronic hepatitis B receiving oral antiviral therapy. The findings showed psychological distress was more common in patients who were with older age, female, less educated, unmarried and receiving longer duration of treatment and psychological distress was significantly associated with self-management behaviours. Nurses and other healthcare providers should provide interventions to reduce the risk of psychological distress and improve self-management behaviours for this population.


Assuntos
Hepatite B Crônica , Angústia Psicológica , Autogestão , Adulto , Idoso , Antivirais/uso terapêutico , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Hepatite B Crônica/tratamento farmacológico , Humanos , Estresse Psicológico , Inquéritos e Questionários
18.
J Perianesth Nurs ; 36(6): 724-729, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34663532

RESUMO

PURPOSES: Inadvertent intraoperative hypothermia (core temperature <36°C) is a common surgical complication with several adverse events. Hypothermia prediction models can be a tool for providing the healthcare staff with information on the risk of inadvertent hypothermia. Our systematic review aimed to identify, demonstrate, and evaluate the available intraoperative hypothermia risk prediction models in surgical populations. DESIGN: This study is a systematic review of literature. METHODS: We systematically searched multiple databases (Ovid MEDLINE, Web of Science, Embase, and Cochrane Center Register of Controlled Trials). Two reviewers independently examined abstracts and the full text for eligibility. Data collection was guided by the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS checklist), and methodological quality and applicability were assessed by the Prediction model Risk Of Bias ASsessment Tool (PROBAST). FINDINGS: A total of 3,672 references were screened, of which eight articles were included in this study. All the models had a high risk of bias since most of them lacked model validation. Also, they failed to report the model performance and final model presentations, which restricted their clinical application. CONCLUSIONS: The researchers should present models in a more standard way and improve the existing models to increase their predictive values for clinical application.


Assuntos
Hipotermia , Viés , Humanos , Hipotermia/etiologia , Medição de Risco
19.
Bioconjug Chem ; 31(10): 2404-2412, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-33001643

RESUMO

Development of nanoplatforms for targeted anticancer drug delivery for effective tumor therapy still remains challenging in the development of nanomedicine. Here, we present a facile method to formulate a LAPONITE (LAP) nanodisk-based nanosystem for anticancer drug doxorubicin (DOX) delivery to folic acid (FA) receptor-overexpressing tumors. In the current work, aminated LAP nanodisks were first prepared through silanization, then functionalized with polyethylene glycol-linked FA (PEG-FA) via 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride (EDC) chemistry, and finally employed to physically encapsulate DOX. The formed functional LAP nanodisks (for short, LM-PEG-FA) possess a high DOX loading efficiency (88.6 ± 1.2%) and present a pH-dependent release feature with a quicker DOX release under acidic pH conditions (pH 5.0) than under physiological pH conditions (pH 7.4). In vitro flow cytometry, confocal microscopic observation, and cell viability assay show that the LM-PEG-FA/DOX complexes can be specifically taken up by FAR-overexpressing human ovarian cancer cells (SK-OV-3 cells) and present a specific cancer cell therapeutic effect. Further tumor treatment results reveal that the LM-PEG-FA/DOX complexes can exert a specific therapeutic efficacy to a xenografted SK-OV-3 tumor model in vivo when compared with nontargeted LM-mPEG/DOX complexes. Therefore, the developed LM-PEG-FA nanodisks could be employed as a potential platform for targeted cancer chemotherapy.


Assuntos
Antibióticos Antineoplásicos/administração & dosagem , Doxorrubicina/administração & dosagem , Portadores de Fármacos/química , Sistemas de Liberação de Medicamentos , Neoplasias Ovarianas/tratamento farmacológico , Animais , Antibióticos Antineoplásicos/farmacocinética , Antibióticos Antineoplásicos/uso terapêutico , Linhagem Celular Tumoral , Doxorrubicina/farmacocinética , Doxorrubicina/uso terapêutico , Liberação Controlada de Fármacos , Feminino , Ácido Fólico/química , Humanos , Camundongos Endogâmicos BALB C , Camundongos Nus , Nanoestruturas/química , Neoplasias Ovarianas/patologia , Polietilenoglicóis/química
20.
Crit Care ; 24(1): 197, 2020 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375841

RESUMO

BACKGROUND: The use of an ultrasound-guided technique for radial arterial catheterization has not been well established in pediatric patients. We conducted a systematic review and meta-analysis to evaluate the efficacy of the ultrasound-guided technique for radial artery catheterization in pediatric populations. METHOD: A systematic review of PubMed, Medline, Embase, and the Cochrane library was performed from their date of inception to December 2019. In this meta-analysis, we conducted online searches using the search terms "ultrasonography," "ultrasonics," "ultrasound-guided," "ultrasound," "radial artery," "radial arterial," "catheter," "cannula," and "catheterization." The rate of the first-attempt and total success, mean attempts to success, mean time to success, and incidence of complications (hematomas) were extracted. Data analysis was performed with RevMan 5.3.5. RESULTS: From 7 relevant studies, 558 radial artery catheterizations were enrolled, including 274 ultrasound-guided and 284 palpation catheterizations. The ultrasound-guided technique could significantly improve the rate of first-attempt and total success (RR 1.78, 95% CI 1.46 to 2.18, P < 0.00001; RR 1.33; 95% CI 1.20 to 1.48; P < 0.00001). However, there was significant heterogeneity for the total success rate among the included studies (I2 = 67%). The ultrasound-guided radial artery catheterization was also associated with less mean attempts and mean time to success (WMD - 1.13, 95% CI - 1.58 to - 0.69; WMD - 72.97 s, 95% CI - 134.41 to - 11.52) and lower incidence of the hematomas (RR 0.17, 95% CI 0.07 to 0.41). CONCLUSIONS: The use of the ultrasound-guided technique could improve the success rate of radial arterial catheterization and reduce the incidence of hematomas in pediatric patients. However, the results should be interpreted cautiously due to the heterogeneity among the studies.


Assuntos
Cateterismo Periférico/métodos , Ultrassonografia de Intervenção/métodos , Cateterismo Periférico/instrumentação , Humanos , Pediatria/instrumentação , Pediatria/métodos , Artéria Radial/diagnóstico por imagem , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Ultrassonografia de Intervenção/tendências , Dispositivos de Acesso Vascular
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