Two Difficult Pandemics: Tuberculosis and COVID-19.

BACKGROUND: The coinfection of Mycobacterium tuberculosis and SARS-CoV-2 is called tuberculosis and COVID-19 coinfection (TB-COVID-19). We aimed to share the clinical, radiological, and laboratory findings and treatment processes of our patients with TB-COVID-19 coinfection in our tertiary reference hospital. METHODS: Patients aged 18 years and over and hospitalized in the tuberculosis service between March 2020 and September 2022 were included. All coinfected patients whose COVID-19 polymerase chain reaction results were positive while receiving tuberculosis treatment or who were diagnosed with tuberculosis while receiving treatment for COVID-19 were included. RESULTS: The number of patients was 39; 61.6% of males; the mean age was 52 ± 17.1 years; 20% were foreign nationals; 92.5% were Asian; 69.5% had a bacteriological diagnosis; 84.6% had pulmonary tuberculosis; 10% had received antituberculosis treatment before; and 87.5% were sensitive to the first-line antituberculosis drugs. The most common comorbidities were diabetes and hypertension. 87.5% of the patients were diagnosed with tuberculosis and were superinfected with COVID-19 while receiving tuberculosis treatment. 49.5% of patients had received at least one dose of COVID-19 vaccine. The most common presenting symptom was cough and sputum; the prominent laboratory parameter was C-reactive protein increase, and thorax computed tomography finding was consolidation, tree-in-bud, and cavitation. While 45.9% of the patients were still under treatment, 1 (2.5%) patient also resulted in mortality. CONCLUSION: In this study, attention was drawn to two infectious diseases seen with respiratory tract symptoms. The mortality rate was found to be low. Neither disease was found to be a factor aggravating the course of each other.

The Effect of a Repeated Standardized Patient-Based End-of-Life Care Training Program on Nursing Students' Knowledge, Attitudes, and Emotions Toward End-of-Life Patients.

BACKGROUND: Sufficient knowledge of end-of-life care, positive attitudes, and emotions regarding death and dying are essential criteria for showcasing favorable palliative care educational results to undergraduate nursing students. However, nursing students have negative attitudes toward end-of-life care and know little about it. AIM: This study aimed to examine the effect of a repeated standardized patient-based training program (intervention) on nursing students' knowledge, attitudes, and emotions about end-of-life patients. METHOD: This study adopted a pretest-posttest quasi-experimental research design. The sample consisted of 50 fourth-year nursing students divided into intervention (n = 25) and control (n = 25) groups. All participants attended the intervention. The intervention group attended the intervention twice, while the control group attended it only once. Data were collected using a personal information form, the Frommelt Attitudes Toward Care of the Dying Scale, the Positive and Negative Affect Schedule, and the End-of-Life Care Nursing Questionnaire. The data were analyzed using descriptive statistics, Pearson's Chi-square test, dependent groups t test, Pearson-Spearman, Mann-Whitney test, Wilcoxon test, and Friedman test. RESULTS: The intervention helped participants learn more about end-of-life care (χ2 = 27.167, P = .000; F = 42.725, P = .000) and develop more positive attitudes toward end-of-life patients (F = 13.279, P = .000; F = 6.934, P = .000). The intervention also helped participants develop communication skills. CONCLUSION: Universities should integrate repeated standardized patient-based into nursing curricula.

Ongoing Effects of SARS-CoV-2 Infection on Arterial Stiffness in Healthy Adults.

There are limited data on the arterial stiffness changes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The present study evaluated the changes in arterial stiffness in completely healthy patients who had a SARS-CoV-2 infection using the cardio-ankle vascular index (CAVI). The study included 70 patients with SARS-CoV-2 infection between December 2020 and June 2021. A cardiac evaluation was carried out, including chest X-ray, electrocardiography (ECG), and echocardiography in all patients. Within the 1st month and 7th month CAVI was measured. Mean age was 37.8 ± 10.0 years, and 41/70 were female. Mean height was 168.6 ± 9.5 cm, mean weight 73.2 ± 15.1 kg, and mean body mass index (BMI) of the group was 25.6 ± 4.2, respectively. CAVI results from the right arm were 6.45 ± .95 at 1-month follow-up and 6.68 ± 1.05 at 7 months follow-up (P = .016) and from the left arm were 6.43 ± 1.0 at 1-month follow-up, 6.70 ± 1.05 at 7-month follow-up (P = .005). Our results showed an ongoing injury in the arterial system after healthy SARS-COV-2 patients during 7 months, as represented by CAVI measurements.

Essential Oil and Supercritical Carbon Dioxide Extract of Grapefruit Peels Formulated for Candida albicans Infections: Evaluation by an in Vitro Model to Study Fungal-Host Interactions.

Resistance to currently available antifungal agents raises the need to develop alternative remedies. Candida albicans is the most common opportunistic pathogenic fungus of humans, colonizing in the genital and intestinal mucosa, skin, and oral-nasal cavity and reducing quality of life. Herein, essential oil from grapefruit (Citrus paradise) peels was obtained by hydrodistillation, and the remaining plant material was sequentially subjected to supercritical carbon dioxide (SC-CO2) extraction to determine the conditions for maximizing phenolic compounds. A statistical design was used to evaluate the effect of temperature (30, 50, 70 °C), pressure (80, 150, 220 bar), and ethanol as a cosolvent (0%, 10%, and 20% v/v). Essential oil and SC-CO2 extracts were mixed at various ratios to develop an effective antifungal formulation. Subsequently, fungal infection was modeled by coculturing C. albicans with human skin keratinocytes (HaCaT) to mimic dermal mycoses, endothelial cells (HUVEC) to evaluate vascular fate, and cervical adenocarcinoma (HeLa) cells to represent additional genital mycoses. Treatment with essential oil and extract (25:75%) formulation for 8 h exhibited slight cytotoxicity toward HeLa cells, no toxicity toward HaCaT and HUVECs, whereas inhibition of C. albicans. Considering the clinical significance, such in vitro models are essential to screen potential compounds for the treatment of opportunistic fungal infections.

Bilayered laponite/alginate-poly(acrylamide) composite hydrogel for osteochondral injuries enhances macrophage polarization: An in vivo study.

Addressing osteochondral defects, the objective of current study was to synthesize bilayered hydrogel, where the cartilage layer was formed by alginate (Alg)-polyacrylamide (PAAm) with and without the addition of TGF-ß3 and bone layer by laponite XLS/Alg-PAAm and characterize by in vitro and in vivo experiments. Exceeding the mechanical strength of Alg-PAAm (32.95 ± 1.23 kPa) and XLS based (317.5 ± 21.72 kPa) hydrogels, XLS/Alg-PAAm hydrogel (469.7 ± 6.1 kPa) activated macrophages towards M2 phenotype and stimulated the expression of anti-inflammatory factors. The addition of TGF-ß3 accelerated transition of macrophage polarization, especially between day 4 and 7. The expression levels of M1-related genes such as CD80, iNOS and TNF-α decreased gradually after day 4, reaching lowest values at day 13, whereas the expression levels of M2-related genes, CD206, Arg1 and STAT6 significantly increased promoting M2 macrophage polarization, which might be associated with accelerated bone repair. Moreover, bilayer structure exhibited a better cell viability as well as repairment thorough the XLS contents. In vivo histological examinations verified the significant surface regularity and hyaline like tissue formation employment, along with synchronized degradation profile of the hydrogel with tissue healing at the end of 12 weeks. A mechanically durable, biocompatible and immunocompatible hydrogel was formulated to be utilized in bone-cartilage engineering applications.

The effectiveness of serious games designed for infection prevention and promotion of safe behaviors of senior nursing students during the COVID-19 pandemic.

BACKGROUND: Reminding health care workers, especially senior students, of the critical role they play in preventing COVID-19 transmission is more important than ever, therefore it is vital to reinforce graduate students' intrinsic motivation to implement infection prevention and control guidelines. Serious games are an interesting intervention that could improve adherence to COVID-19 safe behaviors to lower the high prevalence of nosocomial infections. These games, as a type of technology-enhanced simulation, can increase student satisfaction and engagement while still conveying vital ideas. For this reason, this study aimed to develop a serious game and evaluate its effectiveness to prevent the spread of infection and develop safe behaviors during the COVID-19 pandemic. METHODS: In total, 62 nursing students completed a socio-demographic questionnaire, COVID-19 information form, and game usability form, with the students' responses analyzed pre-test and post-test. RESULTS: Serious game implementation significantly increased senior students' knowledge of infection and safe behaviors concerning COVID-19. The students also considered the practice of serious games an effective teaching strategy. Favorite aspects of the serious game according to students' statements; It was reported as reflecting the real hospital environment, including the nursing care process and roles, being informative, being compatible by phone, and each stage of the game tested a new knowledge. CONCLUSION: Employing serious games for nursing skills development is an appropriate teaching method for infection prevention and promotion of safe behaviors among senior nursing students during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes.

Metaphoric Perceptions of Covid-19 Patients Related to the Disease.

This study aimed to explore metaphoric perceptions of patients with COVID-19 including treatment process, family relationships, and mental health via using metaphors. Purposive sampling was used to include participants. Totally 46 patients diagnosed with COVID-19 were included in the study. The metaphor-based data collection process was carried out with three open-ended questions. The metaphors compiled according to questions and grouped by 13 themes according to analysis. Patients explained to COVID-19 process by using 91 different metaphors. Most frequently used metaphors by patients; black hole/dark for the treatment process of COVID-19, steel for family relationships, sea metaphor for mental health. This study, it was determined that individuals are afraid of death, have a serious perception of uncertainty, and their family relationships and this process negatively affected their family relationships and mental states. Nurses have important responsibilities to increase the quality of patient care.

Production of natural chitin film from pupal shell of moth: Fabrication of plasmonic surfaces for SERS-based sensing applications.

Commercially available types of chitin or chitin isolate are usually in powder form and are nanofibrous in microstructure. However, the surface characteristics of natural chitin in the body of insects are currently understudied. Herein, natural chitin film was successfully produced from bio-waste of insect pupae of the Japanese giant silkworm. Two different surface morphologies of the chitin film were observed. We report for the first time a micropapillary surface structure of chitin which was observed on the dorsal side of the film. To further potential of the micropapillary structured natural chitin in sensing applications, we develop a protocol for generating a nanoscopic film of Ag using thermal evaporation. The Ag-deposited natural chitin films exhibited surface-enhanced Raman scattering (SERS) activity to an extent depending on the structure of the film. In conclusion, materials science has been expanded by addition of a natural, three-dimensional chitin film with utilizable properties.