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Background: Hip fractures, commonly known as the "terminal fracture of life," frequently necessitate prompt surgical intervention and are accompanied by significant perioperative pain. Objective: This investigation was performed to assess the impact of fascia iliaca compartment block (FICB) on heart rate variability during the perioperative period in elderly individuals with hip fractures. Design: Single-center, randomized, controlled clinical trial. Setting: The study was conducted from September 2021 to February 2023 at one tertiary care hospital in China. Participants: Patients aged ≥60 years who underwent general anesthesia for hip fracture surgery were screened for enrollment. Eighty patients were initially assessed for eligibility, 70 underwent randomization, and 62 were included in the final analysis. Methods: Preoperatively, the patients were randomly allocated to either receive (Group F) or not receive (Group C) ultrasound-guided suprainguinal FICB. The primary endpoint was heart rate variability indicators at the corresponding time points. The secondary endpoints included the mean arterial pressure and heart rate measured at different time points [upon admission to the operating room (T1), during positioning (T2), at the time of skin incision (T3), 30 min after the start of surgery (T4), and 6 h postoperatively (T5)] and visual analogue scale (VAS) score, dose of oral pain medication over 24 h, and satisfaction scores were valued. Results: Compared with Group C, Group F had a significantly reduced low-frequency band, high-frequency band, and low-/high-frequency band ratio at T3, T4, and T5 (P < 0.05). Group F also had a lower heart rate at T2, T3, T4, and T5 (P < 0.05). Moreover, Group F had lower flurbiprofen dosages at 24 h postoperatively (P < 0.05) and lower resting VAS scores at 6 and 24 h postoperatively (P < 0.05). Conclusion: Utilization of ultrasound-guided FICB has the potential to yield efficacious analgesic effects, mitigate the pronounced fluctuations in heart rate induced by surgical stimulation, and maintain autonomic function stability to a certain degree.
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Since the advent of coronavirus disease 2019 (COVID-19), healthcare workers (HCWs) wearing personal protective equipment (PPE) has become a common phenomenon. COVID-19 outbreaks overlap with heat waves, and healthcare workers must unfortunately wear PPE during hot weather and experience excessive heat stress. Healthcare workers are at risk of developing heat-related health problems during hot periods in South China. The investigation of thermal response to heat stress among HCWs when they do not wear PPE and when they finish work wearing PPE, and the impact of PPE use on HCWs' physical health were conducted. The field survey were conducted in Guangzhou, including 11 districts. In this survey, HCWs were invited to answer a questionnaire about their heat perception in the thermal environment around them. Most HCWs experienced discomfort in their back, head, face, etc., and nearly 80% of HCWs experienced "profuse sweating." Up to 96.81% of HCWs felt "hot" or "very hot." The air temperature had a significant impact on thermal comfort. Healthcare workers' whole thermal sensation and local thermal sensation were increased significantly by wearing PPE and their thermal sensation vote (TSV) tended towards "very hot." The adaptive ability of the healthcare workers would decreased while wearing PPE. In addition, the accept range of the air temperature (T a) were determined in this investigation. Graphical Abstract.
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COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Equipo de Protección Personal , Personal de Salud , Temperatura , Respuesta al Choque TérmicoRESUMEN
RATIONALE: Focal segmental glomerulosclerosis (FSGS) describes a renal histologic lesion with diverse causes and pathogenicities. Monogenic abnormalities which are associated with impaired function of podocyte could result in FSGS. Most of genetic FSGS do not respond to immunosuppressive agents and often develop end-stage kidney disease. We reported a case of FSGS caused by myosin1e (MYO1E) mutation, alleviated by cyclosporine A (CsA) and low-dose glucocorticoid. PATIENT CONCERNS: The patient was a 38-year-old male with nephrotic range proteinuria. He didn't respond to prednisone 65mg/day. Kidney biopsy in our hospital showed FSGS with several hypoplasia and tiny loops. In addition, focal thickening and disorganization of the glomerular gasement membrane as well as diffuse foot process effacement were observed in electron microscope. DIAGNOSES: Genetic testing indicated homozygous deletion mutation of MYO1E. The patient was diagnosed with genetic FSGS caused by MYO1E homozygous mutation. INTERVENTIONS: The patient was treated with CsA 50mg twice a day and low-dose methylprednisolone. OUTCOMES: CsA and low-dose glucocorticoid dramatically reduced proteinuria, and partial remission was attained in 3 years follow-up. LESSONS: MYO1E autosomal recessive mutation was a rare FSGS causative mutation that might benefit from CsA treatment. However, the long-term effect of CsA on FSGS caused by this mutation should be investigated in the future.
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Ciclosporina , Glomeruloesclerosis Focal y Segmentaria , Masculino , Adulto , Humanos , Ciclosporina/uso terapéutico , Glomeruloesclerosis Focal y Segmentaria/tratamiento farmacológico , Glomeruloesclerosis Focal y Segmentaria/genética , Glucocorticoides/uso terapéutico , Pueblos del Este de Asia , Homocigoto , Eliminación de Secuencia , Mutación , Proteinuria/tratamiento farmacológicoRESUMEN
Over the last few decades, increase in global temperatures have led to a deterioration in the quality of open spaces, urban vitality, and public health. Strenuous physical training under hot conditions outdoors increases the potential for developing heat illnesses. It is therefore necessary to examine the relationships between human physiological indices, psychological responses, and outdoor thermal indices to predict and evaluate human thermal safety in hot environments. A 9-day experiment was conducted in September 2019, which tested the thermal comfort and cognitive ability of 1102 students. Their physiological parameters (Heart rate, Auditory canal temperature) were recorded before and after physical training. Results showed that there were significant differences in the thermal sensation vote before and after physical training. The classification of heat stress was modified based on the MTSV regression model and PET. The maximum acceptable PET was 23.0 °C before physical training and 21.7 °C after physical training. When PET ≥ 40.1 °C, a reduction in physical training intensity is recommended. When PET ≥ 45.7 °C, cessation of physical training should take place and sun exposure should be reduced to avoid health hazards. It is important to use the auditory canal temperature instead of the core temperature to calculate the physiological strain index (PSI). More than 15% of the subjects had a PSI ≥ 7.0 during the test. When the body is in a thermally neutral state (MTSV = -0.5- 0.5), PSI ≤ 2.0. When the MTSV ≥3.2, PSI ≥ 7.0, physical training intensity should be reduced, and warning information should be provided. According to the expected distribution of physical training time and rest time, it is recommended that the time of each physical training session should be within 30 min, with a resting period of more than 30 min in hot environments.
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Trastornos de Estrés por Calor , Sensación Térmica , Ejercicio Físico , Trastornos de Estrés por Calor/prevención & control , Humanos , Estudiantes , TemperaturaRESUMEN
AIM: This study aimed to explore the factors associated with attitudes towards the older adults among nursing students, to clarify the impact of empathy and end-of-life care on the attitude of the older adults, and to provide a basis for the follow-up of education courses related to older adults care and the training of older adults care talents. DESIGN: A cross-sectional study. METHODS: A cross-sectional survey on nursing students' knowledge and attitudes towards older adults was conducted from 24 December 2020-24 February 2021. The Chinese versions of the end-of-life Attitudes Scale, Jefferson Empathy Scale-Nursing Version and Kogan Attitudes Scale for the Elderly were used for this cross-sectional study. We used the purposive sampling method to conduct a questionnaire survey on nursing students at Heilongjiang Nursing College (n = 371, effective response rate: 64.52%). RESULTS: The average score of FATCOD-B was 99.04 (7.71), and the score of C-JSE-HPS was 100.67 (12.90). The total average score of nursing students' attitudes towards older adults was 139.91 (15.79). The hierarchical regression analysis showed that education (ß = -.125, p = .025) and personal experience (ß = -.132, p = .008) correlated negatively with attitudes towards the older adults, while the end-of-life care (ß = .140, p = .013) and empathy (ß = .285, p < .001) correlated positively with attitudes towards the older adults. CONCLUSIONS: Religion, end-of-life care and empathy were positively correlated with nursing students' attitudes towards older adults. It is necessary to set up end-of-life care, empathy and education related to the older adults, and combine a variety of training forms, increasing humanistic assessments and reducing the employment pressure on nursing students by relevant departments can improve their attitudes towards the older adults.
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Estudiantes de Enfermería , Cuidado Terminal , Anciano , Actitud del Personal de Salud , Estudios Transversales , Empatía , HumanosRESUMEN
Highly selective, sensitive, and stable biosensors are essential for the molecular level understanding of many physiological activities and diseases. Electrochemical aptamer-based (E-AB) sensor is an appealing platform for measurement in biological system, attributing to the combined advantages of high selectivity of the aptamer and high sensitivity of electrochemical analysis. This review summarizes the latest development of E-AB sensors, focuses on the modification strategies used in the fabrication of sensors and the sensing strategies for analytes of different sizes in biological system, and then looks forward to the challenges and prospects of the future development of electrochemical aptamer-based sensors.
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Wearing masks to study and work places has become a daily protective measure during the COVID-19 pandemic. In the summer of 2021, environmental parameters were monitored, and students in a university library in Guangzhou, China, were surveyed to analyze the possible symptoms of wearing masks for a long time, and to assess the sensitivity of various body parts to the environmental parameters. Concurrently, the preference of subjects wearing masks for various environmental parameters was also analyzed. Additionally, the relationship between thermal sensation and thermal index was analyzed to identify acceptable and comfortable temperature ranges. The expected duration of wearing masks was counted. Subjects wearing masks had greater requirements for environmental comfort, and reported increased thermal discomfort of the face and head, compared to those without masks. More than 70% of the subjects wearing masks reported that they experienced discomfort on their faces. Among the subjects who experienced discomfort, 62.7% reported that facial fever was the main symptom; while some reported symptoms of dyspnea (25.4%) and rapid heartbeat (9.1%). More than 75% of the subjects were expected to wear masks for 2.0 h or less. Evaluation of environmental thermal sensation, including overall, facial, and head thermal sensation, differed among subjects who wore and did not wear masks. The indexes of neutral Operative temperature/Standard Effective Temperature (T op /SET*) and preferred T op /SET* were lower among subjects with masks than among those without masks. The neutral T op /SET* deviation was 0.3 °C, and the preferred T op /SET* deviation was 0.5 °C. Additionally, the acceptable and comfortable temperature zones differed between the two cases. The subjects who wore masks preferred colder temperatures. These findings indicated that the environmental parameters should be adjusted to improve the thermal comfort of the human body while wearing masks in work or study places.
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BACKGROUND: Internet medical care has been advancing steadily, especially during the coronavirus disease 2019 pandemic, the development momentum of Internet medical care in China is more vigorous. This study aimed to explore the factors associated with using the Internet for medical information, to examine the popularisation and implementation of Internet medical treatment and feasible strategies, and promote the further development of Internet medical treatment. METHODS: A cross-sectional study was conducted on 408 medical patients who had used online medical services. The one-way analysis of variance or independent samples t-test was used to compare the differences in the influence of demographic characteristics on behavioural intentions of different people seeking medical care. Pearson's correlation was used to evaluate the correlation between different measurement variables. A mediation regression analysis was used to explore the mediating role of trust in Internet medical care. RESULTS: The difference in the influence of Internet medical use frequency on the behavioural intention of different participants was statistically significant (F = 3.311, P = 0.038). Among the influencing factors, personal trust propensity (r = 0.387, P < 0.01), website credibility (r = 0.662, P < 0.01), hospital credibility (r = 0.629, P < 0.01), doctor's credibility (r = 0.746, P < 0.01), and online patient trust (r = 0.874, P < 0.01) were positively correlated with patients' behavioural intentions. In the analysis of intermediary factors, the total effect of the credibility of the diagnosis and treatment website on the behavioural intention of patients was 0.344. The total effect of the credibility of the diagnosis and treatment hospital on the behavioural intention of patients was 0.312; the total effect of the service doctor's credibility on the patient's behavioural intention was 0.385; the total effect of the personal trust tendency on the patient's behavioural intention was 0.296. CONCLUSIONS: This study found defects in various factors that produce distrust in Internet medical treatment. It also reveals the positive effect of trust factors on the development and implementation of Internet medical treatment and provides some ideas for improving the use of Internet medical treatment by the masses.
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COVID-19 , Confianza , Estudios Transversales , Humanos , Internet , SARS-CoV-2RESUMEN
Exotic phenomena can be achieved in quantum materials by confining electronic states into two dimensions. For example, relativistic fermions are realized in a single layer of carbon atoms1, the quantized Hall effect can result from two-dimensional (2D) systems2,3, and the superconducting transition temperature can be considerably increased in a one-atomic-layer material4,5. Ordinarily, a 2D electronic system can be obtained by exfoliating the layered materials, growing monolayer materials on substrates, or establishing interfaces between different materials. Here we use femtosecond infrared laser pulses to invert the periodic lattice distortion sectionally in a three-dimensional (3D) charge density wave material (1T-TiSe2), creating macroscopic domain walls of transient 2D ordered electronic states with unusual properties. The corresponding ultrafast electronic and lattice dynamics are captured by time-resolved and angle-resolved photoemission spectroscopy6 and ultrafast electron diffraction at energies of the order of megaelectronvolts7. Moreover, in the photoinduced 2D domain wall near the surface we identify a phase with enhanced density of states and signatures of potential opening of an energy gap near the Fermi energy. Such optical modulation of atomic motion is an alternative path towards realizing 2D electronic states and will be a useful platform upon which novel phases in quantum materials may be discovered.
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We present the development of a time- and angle-resolved photoemission spectroscopy based on a Yb-based femtosecond laser and a hemispherical electron analyzer. The energy of the pump photon is tunable between 1.4 and 1.9 eV, and the pulse duration is around 30 fs. We use a KBe2BO3F2 nonlinear optical crystal to generate probe pulses, of which the photon energy is up to 6.7 eV, and obtain an overall time resolution of 1 ps and energy resolution of 18 meV. In addition, ß-BaB2O4 crystals are used to generate alternative probe pulses at 6.05 eV, giving an overall time resolution of 130 fs and energy resolution of 19 meV. We illustrate the performance of the system with representative data on several samples (Bi2Se3, YbCd2Sb2, and FeSe).