Nurses' and nursing students' knowledge and attitudes to pressure injury prevention: A meta-analysis based on APUP and PUKAT.

BACKGROUND: Morbidity and mortality among patients due to pressure injuries continue to rise. Nurses play a critical role in preventing pressure injuries. However, published results on nurses' knowledge and attitudes for pressure injury prevention are often contradictory. OBJECTIVES: To conduct a meta-analysis of nurses' and nursing students' knowledge and attitudes toward pressure injury prevention. DESIGN: A meta-analysis of cross-sectional studies. DATA SOURCES: Ten databases were queried for the meta-analysis. The search period was from the time of the databases' establishment to February 2023. REVIEW METHODS: This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies. Statistical analysis was conducted with the Stata 15.0 software, and the quantitative data of knowledge and attitude toward preventing PI in all studies were summarized. RESULTS: Thirteen studies from 9 countries were included. The meta-analysis showed that nurses and nursing students had low knowledge but positive attitudes toward pressure injury prevention. Subgroup analysis showed that the pooled proportion of both knowledge and attitudes was higher in Asia than in Europe. Nurses had higher knowledge than nursing students, however, the former had a more negative attitude than the latter. Sensitivity analyses were robust. Egger's test showed no significant publication bias. CONCLUSION: The knowledge of nurses and nursing students about pressure injury prevention is not promising and there is an urgent need for continuous learning. Attitudes are more positive but there is room for improvement. The relevant departments should strengthen nurses' and nursing students' knowledge of pressure injury prevention and further improve their attitudes toward pressure injury prevention.

Fortunella venosa (Champ. ex Benth.) C. C. Huang and F. hindsii (Champ. ex Benth.) Swingle as Independent Species: Evidence From Morphology and Molecular Systematics and Taxonomic Revision of Fortunella (Rutaceae).

Recently, the systematic status of Fortunella Swingle and its taxonomy has attracted much attention. Flora of China incorporates Fortunella into Citrus Linn. and treats all species of the traditional Fortunella as one species, namely Citrus japonica (Thunb.) Swingle. Furthermore, F. venosa (Champ. ex Benth.) C. C. Huang and F. hindsii (Champ. ex Benth.) Swingle are currently considered as synonyms of C. japonica. In this paper, morphological, palynological, and phylogenetic analyses were used to systematically explore the taxonomic status of traditional Fortunella. The key morphological features that differed among the Fortunella species were the leaf and the petiole hence could be key in its taxonomic classification of the species. Additionally, pollen morphological analysis based on the pollen size, germination grooves, polar, and equatorial axes also supported the separation of the species. The results of the phylogenetic analysis showed that each of the three species clustered separately, hence strongly supporting the conclusion of independent species. In addition, the phylogenetic analysis showed that the two genera clustered closely together hence our results support the incorporation of Fortunella into Citrus. Based on the above, this article has revised the classification of the traditional Fortunella and determined that this genus has three species, namely; F. venosa, F. hindsii, and F. japonica. F. venosa and F. hindsii are placed in the Citrus as separate species, and their species names still use the previous specific epithet. The revised scientific names of the new combinations of F. venosa and F. hindsii are as follows: Citrus venosa (Champ. ex Benth.) K. M. Liu, X. Z. Cai, and G. W. Hu, comb. nov. and Citrus hindsii (Champ. ex Benth.) K. M. Liu, G. W. Hu, and X. Z. Cai, comb. nov. F. venosa is the original species of Fortunella, F. venosa and F. hindsii are both listed as the second-class key protected wild plants in China. Therefore, the establishment of the taxonomic status of F. venosa and F. hindsii not only deepens our understanding, importance, and the complexity of the systematic classification of Fortunella, but is also significant for global biodiversity conservation, genetic resources for breeding purposes, and population genetics.

ß-sitosterol ameliorates influenza A virus-induced proinflammatory response and acute lung injury in mice by disrupting the cross-talk between RIG-I and IFN/STAT signaling.

ß-Sitosterol (24-ethyl-5-cholestene-3-ol) is a common phytosterol Chinese medical plants that has been shown to possess antioxidant and anti-inflammatory activity. In this study we investigated the effects of ß-sitosterol on influenza virus-induced inflammation and acute lung injury and the molecular mechanisms. We demonstrate that ß-sitosterol (150-450 µg/mL) dose-dependently suppresses inflammatory response through NF-κB and p38 mitogen-activated protein kinase (MAPK) signaling in influenza A virus (IAV)-infected cells, which was accompanied by decreased induction of interferons (IFNs) (including Type I and III IFN). Furthermore, we revealed that the anti-inflammatory effect of ß-sitosterol resulted from its inhibitory effect on retinoic acid-inducible gene I (RIG-I) signaling, led to decreased STAT1 signaling, thus affecting the transcriptional activity of ISGF3 (interferon-stimulated gene factor 3) complexes and resulting in abrogation of the IAV-induced proinflammatory amplification effect in IFN-sensitized cells. Moreover, ß-sitosterol treatment attenuated RIG-I-mediated apoptotic injury of alveolar epithelial cells (AEC) via downregulation of pro-apoptotic factors. In a mouse model of influenza, pre-administration of ß-sitosterol (50, 200 mg·kg-1·d-1, i.g., for 2 days) dose-dependently ameliorated IAV-mediated recruitment of pathogenic cytotoxic T cells and immune dysregulation. In addition, pre-administration of ß-sitosterol protected mice from lethal IAV infection. Our data suggest that ß-sitosterol blocks the immune response mediated by RIG-I signaling and deleterious IFN production, providing a potential benefit for the treatment of influenza.

[Monthly changes in the benthic macro-invertebrate community structure in the habitats of Phragmites australis marsh in the Dongtan wetland of the Yangtze River estuary, China]. / é•¿æ±Ÿå£ä¸œæ»©æ¹¿åœ°èŠ¦è‹‡ç”Ÿå¢ƒå¤§åž‹åº•æ –æ— è„Šæ¤ŽåŠ¨ç‰©ç¾¤è½ç»“æž„çš„æœˆåŠ¨æ€.

Based on the data of the benthic macro-invertebrates community in the Phragmites australis marsh in the Dongtan Wetland of the Yangtze River estuary collected from May 2015 to April 2016, we evaluated the monthly variations in the species composition, biodiversity and community structure of the benthic macro-invertebrates. The results showed that the average height and degree of coverage for P. australis increased monthly from March to August, and then deceased from September. The density and aboveground biomass (dry mass, g) of P. australis peaked in July. A total of twenty species (including 2 species only identified to genus level and 2 species identified to family level) were found in the survey periods, including 11 Gastropoda, 5 Malacostraca, 2 Insecta and 2 Polychaeta. Three snail species (Assiminea latericea, Assiminea violacea and Cerithideopsis largillierti) dominated the benthic communities in terms of numerical abundance. The number of epifauna species was the most (11 species), followed by 5 burrowing species and 4 infauna species. There were significant monthly variations in the density and biomass of the macro-invertebrates. The density and biomass of benthic community reached the maximum in August. The Margalef's species richness index (D) and Shannon index (H) showed significant differences monthly, but Pielou's index (J) except in November. Three macro-zoobenthic assemblages were identified with the 42% similarity level. The non-Metric Multidimensional scaling plot indicates that the benthic community in May, October and November was distinct compared to that in the other months. The present study suggested the density of the benthic macro-invertebrates community in the P. australis marshes was somewhat correlated with water temperature, underground biomass and salinity. But those correlation were not significant (P>0.05). Because of the continuous impact of anthropogenic activities, the biodiversity of the benthic macro-invertebrate community has been decreasing for several years. More attention should be paid to the habitat value of the P. australis marshes in the future.

Serological positive markers of hepatitis B virus in femoral venous blood or umbilical cord blood should not be evidence of in-utero infection among neonates.

BACKGROUND: Maternal-infant transmission of hepatitis B virus(HBV) occurs even after passive-active immunization. Some scholars speculate that in-utero infection may be the main cause of immunoprophylaxis failure. However, there is a lack of evidence about the possible occurrence periods of perinatal transmission. METHODS: From 2008 to 2012, 428 pairs of HBsAg-positive mothers and neonates were enrolled and 385 infants aged 8-12 months were followed. HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc, HBV-DNA) were performed on all subjects. RESULTS: Of mothers who were positive for HBsAg, HBeAg, HBV-DNA, 35.1 %, 94.3 %, 12.7 % of their neonates were positive for those indices, respectively. Neonates' mean titers of those indices were significantly lower than their mothers'. There were no significant differences in rates of positivity and mean titers of anti-HBe and anti-HBc between neonates and mothers. Most of the positive indices turned negative during the follow-up period. Immunoprophylaxis failed in seventeen infants: four infants had HBV-DNA > 6 log 10copies/mL both at birth and in follow-up; in six infants, mean viral load was 3.72 ± 0.17 log 10copies/mLat birth and 7.62 ± 0.14 log 10copies/mL at follow-up; seven infants were HBV-DNA negative at birth but were found to have > 6 log 10copies/mL during follow-up. Infants that were immunoprophylaxis failures were all born to HBeAg-positive mothers with HBV-DNA > 6 log 10copies/mL. CONCLUSIONS: The placental barrier can partly prevent maternal HBsAg, HBeAg, HBV-DNA from passing through to fetus. Performing HBsAg, HBeAg, HBV-DNA once at birth can neither diagnose nor exclude maternal-infant transmission. The diagnosis of infection period depends on the dynamic changes in viral load from birth through the follow-up period but whether the infection occurred in utero, at delivery or during the neonatal period could not be determined.

Up-regulation of NKG2A inhibitory receptor on circulating NK cells contributes to transfusion-induced immunodepression in patients with ß-thalassemia major.

Accumulating evidence has shown that allogeneic blood transfusions can induce significant immunosuppression in recipients, and thereby increase the risk of postoperative infection and/or tumor relapse. Although it is well known that natural killer (NK) cells are responsible for the immunodepression effects of transfusion, the underlying mechanisms remain obscure. In this study, we investigated the role of NK cells in transfusion-induced immunodepression in ß-thalassemia major. The proportion of circulating NK cells and the expression of NK receptors (NKG2A, CD158a, NKP30, NKP46 and NKG2D) as well as CD107a were detected by multicolor flow cytometry. IFN-γ production by circulating NK cells was detected by intracellular cytokine staining. Our results showed that the proportion and cytotoxicity (CD107a expression) of circulating NK cells in transfusion-dependent ß-thalassemia major patients were remarkably lower than those of ß-thalassemia minor patients or healthy volunteers. Expression of NKG2A inhibitory receptor on circulating NK cells in patients with ß-thalassemia major was remarkably up-regulated, but there were no significant differences in the expression levels of NKP30, NKP46, NKG2D, CD158a and IFN-γ. These results indicate NKG2A inhibitory receptor may play a key role in transfusion-induced immunodepression of NK cells in patients with ß-thalassemia major.

Genes underlying positive influence of prenatal environmental enrichment and negative influence of prenatal earthquake simulation and corrective influence of Chinese herbal medicine on rat offspring: Irf7 and Ninj2.

BACKGROUND: Prenatal environmental enrichment (EE) has been proven to positively affect but prenatal stress negatively influence the physiological and psychological processes in animals, whose trans-generational genetic mechanism remains unclearly defined. We aimed to investigate and find out key genes underlying the positive-negative effects derived from prenatal interventions. MATERIALS AND METHODS: Pregnant rats were randomized into EE group (EEG), earthquake simulation group (ESG), herbal group (HG) received herbal supplements in feed after earthquake simulation, and control group (CG). RESULTS: Light Box Defecation Test (LBDT) showed EEG offspring presented less fecal pellets than CG offspring, ESG's more than CG's, and HG's less than ESG (p's<0.05). Open-field Test (OFT) score of EEG was higher than CG offspring, of ESG's was lower than CG's, and HG's higher than ESG's. Irf7 and Ninj were screened, which were up-regulated in EEG, down-regulated in ESG (FC<0.5), and were neutralized in HG. Prenatal EE could positively promote the nervous system development, prenatal earthquake simulation could retard the nervous system development and Chinese herbal remedy (JKSQW) which could correct the retardation. CONCLUSION: The negative-positive prenatal effect could contribute to altered gene expression of Irf7 and Ninj2 which also could play a key role in the improving function of JKSQW for the kidneys.