Efficacy and safety of uncovered self-expandable metal stents for distal malignant biliary obstruction in unresectable non-pancreatic cancer.

Objectives: The efficacy of uncovered self-expandable metal stents (UCSEMS) versus fully covered self-expandable metal stents for distal malignant biliary obstruction remains controversial. Additionally, the heterogeneity of the disease conditions has been indicated in previous studies because pancreatic and non-pancreatic cancers have different characteristics in clinical course. Therefore, the etiology of biliary obstruction necessitates investigations stratified by primary disease. This study aimed to evaluate the outcomes of UCSEMS, specifically for non-pancreatic cancer-induced distal malignant biliary obstruction. Methods: We conducted a single-center retrospective review to evaluate the time to recurrent biliary obstruction and frequency of adverse events (AEs) in patients receiving UCSEMS for unresectable non-pancreatic cancer-induced malignant biliary obstruction. Results: Overall, 32 patients were enrolled in the study between January 2016 and December 2023. The median time to recurrent biliary obstruction was 140 days. AE rates were low at 3.1% for both pancreatitis and cholecystitis, suggesting a potential benefit of UCSEMS in reducing post-procedural AEs. Conclusion: UCSEMS may reduce the risk of post-procedural AEs and should be considered in patients at high risk of post-endoscopic retrograde cholangiopancreatography pancreatitis. However, the patency period may be shorter, necessitating future comparative research with fully covered self-expandable metal stents to determine the optimal stent choice.

Recent Advances in Nanodrug Delivery Systems Production, Efficacy, Safety, and Toxicity.

In the last three decades, the development of nanoparticles or nano-formulations as drug delivery systems has emerged as a promising tool to overcome the limitations of conventional delivery, potentially to improve the stability and solubility of active molecules, promote their transport across the biological membranes, and prolong circulation times to increase efficacy of a therapy. Despite several nano-formulations having applications in drug delivery, some issues concerning their safety and toxicity are still debated. This chapter describes the recent available information regarding safety, toxicity, and efficacy of nano-formulations for drug delivery. Several key factors can influence the behavior of nanoparticles in a biological environment, and their evaluation is crucial to design non-toxic and effective nano-formulations. Among them, we have focused our attention on materials and methods for their preparation (including the innovative microfluidic technique), mechanisms of interactions with biological systems, purification of nanoparticles, manufacture impurities, and nano-stability. This chapter places emphasis on the utilization of in silico, in vitro, and in vivo models for the assessment and prediction of toxicity associated with these nano-formulations. Furthermore, the chapter includes specific examples of in vitro and in vivo studies conducted on nanoparticles, illustrating their application in this field.

Identifying Putative Biomarkers of Foodborne Pathogens Using a Metabolomic Approach.

Metabolomics is the study of low molecular weight biochemical molecules (typically <1500 Da) in a defined biological organism or system. In case of food systems, the term "food metabolomics" is often used. Food metabolomics has been widely explored and applied in various fields including food analysis, food intake, food traceability, and food safety. Food safety applications focusing on the identification of pathogen-specific biomarkers have been promising. This chapter describes a nontargeted metabolite profiling workflow using gas chromatography coupled with mass spectrometry (GC-MS) for characterizing three globally important foodborne pathogens, Escherichia coli O157:H7, Listeria monocytogenes, and Salmonella enterica, from selective enrichment liquid culture media. The workflow involves a detailed description of food spiking experiments followed by procedures for the extraction of polar metabolites from media, the analysis of the extracts using GC-MS, and finally chemometric data analysis using univariate and multivariate statistical tools to identify potential pathogen-specific biomarkers.

Nanomaterials-based aptasensors for rapid detection and early warning of key food contaminants: A review.

The frequent occurrence of food safety incidents has aroused public concern about food safety and key contaminants. Foodborne pathogen contamination, pesticide residues, heavy metal residues, and other food safety problems will significantly impact human health. Therefore, developing efficient and sensitive detection method to ensure food safety early warning is paramount. The aptamer-based sensor (aptasensor) is a novel analytical tool with strong targeting, high sensitivity, low cost, etc. It has been extensively utilized in the pharmaceutical industry, biomedicine, environmental engineering, food safety detection, and in other diverse fields. This work reviewed the latest research progress of aptasensors for food analysis and detection, mainly introducing their application in detecting various key food contaminants. Subsequently, the sensing mechanism and performance of aptasensors are discussed. Finally, the review will examine the challenges and opportunities related to aptasensors for detecting major contaminants in food, and advance implementation of aptasensors in food safety and detection.

Facile fabrication of Au-Ag alloy nanoparticles/Ag nanowires SERS substrates with bimetallic synergistic effect for ultra-sensitive detection of crystal violet and alkali blue 6B.

The bimetallic nanostructure of Au and Ag can integrate two distinct properties into a novel substrate compared to single metal nanostructures. This work presents a rapid and sensitive surface-enhanced Raman scattering (SERS) substrate for detecting illegal food additives and dyes of crystal violet (CV) and alkali blue 6B (AB 6B). Au-Ag alloy nanoparticles/Ag nanowires (Au-Ag ANPs/Ag NWs) were prepared by solid-state ionics method and vacuum thermal evaporation method at 5µA direct current electric field (DCEF), the molar ratio of Au to Ag was 1:18.34. Many 40 nm-140 nm nanoparticles regularly existed on the surface of Ag NWs with the diameters from 80 nm to 150 nm. The fractal dimension of Au-Ag ANPs/Ag NWs is 1.69 due to macroscopic dendritic structures. Compared with single Ag NWs, the prepared Au-Ag ANPs/Ag NWs substrates show superior SERS performance because of higher surface roughness, the SERS active of Ag NWs and bimetallic synergistic effect caused by Au-Ag ANPs, so the limit of detections (LOD) of Au-Ag ANPs/Ag NWs SERS substrates toward detection of CV and AB 6B were as low as 10-16mol/L and 10-9mol/L, respectively. These results indicate that Au-Ag ANPs/Ag NWs substrates can be used for rapid and sensitive detection of CV and AB 6B and have great development potential for detection of illegal food additives and hazardous substances in the fields of environmental monitoring and food safety.

Nivel de cumplimiento de metas internacionales de seguridad en un Sanatorio privado 2023 / Level of compliance with international safety goals in a private Sanatorium 2023

La presente investigación pretende evaluar el nivel de cumplimiento de las metas internacionales, que representan el foco principal para la mejora de calidad y seguridad de atención de los pacientes. La seguridad del paciente involucra a todos los estudios, prácticas y acciones promovidas por las instituciones sanitarias para disminuir y eliminar los riesgos de daños innecesarios relacionados con el cuidado de la salud. Metodología: Estudio descriptivo, observacional y transversal. De fuentes primaria y secundaria, Resultados: se abordaron las metas N° 1 la cual consiste en Identificar a los pacientes correctamente y la meta N° 6 la cual se refiere a Reducir el riesgo de lesiones en pacientes como resultado de caídas. En primer lugar, se destaca el cumplimiento en la identificación correcta del paciente y en segunda instancia la mejora del cumplimiento de medidas de prevención de caídas. Conclusión: Esta proximidad de los valores obtenidos genera un aspecto positivo para mejorar la seguridad de los pacientes y que, si bien el cumplimiento de las metas no es el deseado, es cercano al porcentaje planteado. Lo que en definitiva hace a este estudio un antecedente importante en la mejora continua con vista al futuro cercano[AU]

This research aims to evaluate the level of compliance with international goals, which represent the main focus for improving the quality and safety of patient care. Patient safety involves all studies, practices and actions promoted by health institutions to reduce and eliminate the risks of unnecessary harm related to health care. Methodology: Descriptive, observational and transversal study. From primary and secondary sources, Results: goals No. 1 were addressed, which consists of Identifying patients correctly and goal No. 6, which refers to Reducing the risk of injuries in patients as a result of falls. Firstly, compliance with correct patient identification stands out and secondly, improvement in compliance with fall prevention measures. Conclusion: This proximity of the values obtained generates a positive aspect to improve patient safety and that, although the fulfillment of the goals is not as desired, it is close to the proposed percentage. Which ultimately makes this study an important precedent in continuous improvement for the near future[AU]

Esta pesquisa tem como objetivo avaliar o nível de cumprimento das metas internacionais, que representam o foco principal para a melhoria da qualidade e segurança do atendimento ao paciente. A segurança do paciente envolve todos os estudos, e ações promovidas pelas instituições de saúde para reduzir e eliminar os riscos de danos desnecessários relacionados à assistência à saúde. Metodologia: Estudo descritivo, observacional e transversal. De fontes primárias e secundárias, dependendo do indicador e do objetivo para o qual a medição está sendo realizada. Resultados: Nesta pesquisa serão abordadas as metas nº1, que consiste em Identificar corretamente os pacientes e a meta nº 6, que es Reduzir o risco de lesões nos pacientes em decorrência de quedas. Foi realizado nos dois locais. Em primeiro lugar, destaca-se o cumprimento da correta identificação do paciente e, em segundo lugar, a melhoria no cumprimento das medidas de prevenção de quedas. Conclusão: Essa proximidade dos valores obtidos gera um aspecto positivo para melhorar a segurança do paciente e que, embora o cumprimento das metas não seja o desejado, está próximo do percentual proposto. O que acaba por tornar este estudo um precedente importante na melhoria contínua com vista ao futuro próximo.

Interrupções e distrações durante a preparação e administração de medicamentos de alto risco: Estudo transversal / Interruptions and distractions during the preparation and administration of high-risk medications: A cross-sectional study / Distracciones e interrupciones durante la preparación y administración de medicamentos de alto riesgo: Estudio transversal

Resumo Enquadramento: Estudos indicam que as interrupções contribuem para erros clínicos e falhas em procedimentos. Objetivo: Analisar as interrupções vivenciadas pelos enfermeiros durante a preparação e administração de medicamentos de alto risco. Metodologia: Foi realizado um estudo transversal numa unidade de cuidados intensivos e numa unidade de internamento. As interrupções vivenciadas pelos enfermeiros durante o processo de medicação foram observadas com a ajuda de duas checklists. A amostra foi selecionada por conveniência em abril e maio de 2019. Os dados quantitativos foram analisados através de estatística descritiva no programa IBM SPSS Statistics, versão 24.0, enquanto os dados qualitativos foram tratados por meio da análise de conteúdo. Resultados: Observaram-se 137 interrupções em 193 processos de medicação. A maioria das interrupções foi iniciada por outros membros da equipa de cuidados de saúde por meio de conversas. Estas interrupções foram maioritariamente prejudiciais e ocorreram durante a fase de preparação. A estratégia multitarefa foi utilizada para as gerir. Conclusão: As interrupções ocorridas durante o processo de medicação eram maioritariamente associadas com comunicações profissionais e sociais. A sua relevância diferiu consoante a fase do processo.

Abstract Background: Interruptions have been reported to contribute to clinical errors and procedural failures. Objective: To analyze the interruptions experienced by nurses during the preparation and administration of high-risk medications. Methodology: A cross-sectional study was conducted in an intensive care and inpatient unit. The interruptions experienced by nurses during the medication process were observed through two checklists. The sample was selected by convenience in April-May 2019. Descriptive statistics was used to analyze quantitative data in IBM SPSS Statistics software, version 24.0, while content analysis was used to analyze qualitative data. Results: In 193 medication processes, there were 137 interruptions. Other members of the healthcare team initiated most interruptions through conversations. These interruptions were mostly negative and occurred during the preparation phase. The multitasking strategy was used to manage them. Conclusion: Interruptions during the medication process were primarily associated with professional and social communications. The impact of these interruptions varied depending on the phase of the process.

Resumen Marco contextual: Se ha reportado la participación de distracciones en errores clínicos y fallos de procedimiento. Objetivo: Analizar las distracciones del personal de enfermería durante la preparación y administración de fármacos de alto riesgo. Metodología: Estudio transversal desarrollado en una unidad de cuidados intensivos y una unidad de hospitalización. Se observaron distracciones del personal de enfermería durante el proceso de medicación a través de dos listas de control. La muestra fue seleccionada por conveniencia (abril-mayo 2019). Los datos cuantitativos se analizaron mediante estadística descriptiva (IBM SPSS Statistics, versión 24.0). Los datos cualitativos se analizaron mediante análisis de contenido. Resultados: Hubo 137 distracciones en 193 procesos de medicación. La mayoría de las distracciones fueron iniciadas por otros miembros del equipo sanitario a través de conversaciones. La mayoría se produjeron en la fase de preparación y fueron negativas y se gestionaron mediante la estrategia multitarea. Conclusión: Las distracciones durante el proceso de medicación se referían principalmente a las comunicaciones profesionales y sociales. La importancia de esas distracciones variaba en función de la fase del proceso.

Incidência de obstrução em cateteres periféricos intravenosos em adultos e fatores relacionados / Incidence of obstruction in peripheral intravenous catheters in adults and related factors / Incidencia de obstrucción en catéteres intravenosos periféricos en adultos y factores relacionados

Objetivo: analisar a incidência e os fatores relacionados à obstrução de cateter intravenoso periférico em adultos hospitalizados. Método: uma coorte prospectiva, realizada a partir da observação de 203 cateteres, entre fevereiro de 2019 e maio de 2020, em hospital público e de ensino brasileiro. Foram consideradas variáveis clínicas e do cateter. Os dados foram analisados descritivamente e por estatística inferencial. Resultados: o tempo de permanência variou entre um a 15 dias e a obstrução ocorreu em 7,5% das observações. Houve aumento do risco de obstrução em relação ao sexo (RR=0,49 / p=0,186), à idade (RR=1,20/ p=0,732), aos cateteres de maior calibre (RR=0,53/ p=0,250), à inserção no dorso da mão até antebraço (RR=2,33/ p=0,114) e ao tempo do cateter in situ (RR=033/ p=0,433). Conclusão: O cuidado diário e observação do cateter intravenoso periférico são importantes para minimizar o surgimento de complicações locais e sistêmicas e manter a patência do dispositivo.

Objective: to analyze the incidence and factors related to peripheral intravenous catheter obstruction in hospitalized adults. Method: a prospective cohort, based on the observation of 203 catheters, between February 2019 and May 2020, in a Brazilian public teaching hospital. Clinical and catheter variables were taken into account. The data was analyzed descriptively and using inferential statistics. Results: the length of stay ranged from one to 15 days and obstruction occurred in 7.5% of the observations. There was an increased obstruction risk in relation to gender (RR=0.49 / p=0.186), age (RR=1.20/ p=0.732), larger catheters (RR=0.53/ p=0.250), insertion in the back of the hand up to the forearm (RR=2.33/ p=0.114) and the time length the catheter was in situ (RR=033/ p=0.433). Conclusion: Daily care and observation of the peripheral intravenous catheter is important to minimize the appearance of local and systemic complications and maintain the patency of the device.

Objetivo: analizar la incidencia y los factores relacionados con la obstrucción del catéter intravenoso periférico en adultos hospitalizados. Método: cohorte prospectiva, realizada mediante la observación de 203 catéteres, entre febrero de 2019 y mayo de 2020, en un hospital escuela público brasileño. Se consideraron variables clínicas y del catéter. Los datos se analizaron de forma descriptiva y mediante estadística inferencial. Resultados: el tiempo de permanencia varió entre uno y 15 días y la obstrucción ocurrió en el 7,5% de las observaciones. Hubo mayor riesgo de obstrucción en relación con el sexo (RR=0,49 / p=0,186), la edad (RR=1,20 / p=0,732), los catéteres de mayor calibre (RR=0,53 / p= 0,250), la inserción en el dorso de la mano hasta el antebrazo (RR=2,33/ p=0,114) y el tiempo del catéter in situ (RR=033/ p=0,433). Conclusión: el cuidado diario y la observación del catéter intravenoso periférico son importantes para minimizar la aparición de complicaciones locales y sistémicas y mantener la permeabilidad del dispositivo.

Structural Requirements for the Outpatient Treatment of Benign Diseases of the Uterus.

In many cases, outpatient surgical treatment of benign diseases of the uterus has advantages over inpatient care. This has been demonstrated by the healthcare situation in other countries. However, the prerequisite for the provision of outpatient services is that this does not lead to any impairment in the quality of care or of patient safety. The ultimate goal should not be to reduce costs but rather to maintain and, ideally, improve the quality of care. This requires that services are not just defined by the surgical procedure but also by the entire treatment chain, including, for example, psychosocial support, and are remunerated accordingly. It is particularly worrying that the final decision as to whether an outpatient operation is possible is not the responsibility of the operating unit, but of the "Medizinischer Dienst," with the corresponding options and threats of sanctions. This situation is unique internationally and requires a paradigm shift. Furthermore, structural prerequisites must be maintained which currently only exist inadequately in Germany. Since a substantial proportion of planned outpatient operations require immediate or secondary inpatient treatment, there must be a barrier-free transition between the outpatient and inpatient sectors. This will require the creation of networks between outpatient service providers and one or more hospitals that are equipped and competent to manage even complex complications. It is important to create structures that, with intensive involvement of the operating unit, include adequate preoperative evaluation and patient education as well as needs-oriented postoperative care at home. The current separation of sectors is a significant hinderance. Moreover, when expanding and promoting outpatient surgery, the aspect of training and further education of specialist staff must be taken into account, as well as cross-sectoral quality assurance. Based on a review of the international literature, this article presents 13 recommendations for adequate structures when providing outpatient services which should serve as a prerequisite for the greatest possible guarantee of patient safety.

Evaluation of the efficacy and safety of first- and second-line immunotherapy in patients with metastatic colorectal cancer: a systematic review and network meta-analysis based on randomized controlled trials.

Background: A multitude of randomized controlled trials (RCTs) conducted in both the initial and subsequent treatment settings for patients diagnosed with metastatic colorectal cancer (mCRC) have provided clinical evidence supporting the efficacy of immunotherapy with the use of immune checkpoint inhibitors (ICIs). In light of these findings, the U.S. Food and Drug Administration (FDA) has authorized the use of several ICIs in specific subpopulations of mCRC patients. Nevertheless, there remains a dearth of direct comparative RCTs evaluating various treatment options. Consequently, the most effective ICI therapeutic strategy for microsatellite-stable (MSS) subgroup and microsatellite instability (MSI) subgroup in the first- and second-line therapies remains undefined. To address this gap, the present study employs a Bayesian network meta-analysis to ascertain the most effective first- and second-line ICI therapeutic strategies. Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, with the retrieval date ranging from the databases' inception to August 20, 2024. A total of 875 studies were identified, and seven were ultimately included in the analysis after a screening process. A systematic review and network meta-analysis were conducted on the basis of the search results. Results: This comprehensive analysis, comprising seven RCTs, evaluated first-line and second-line immunotherapy regimens in 1,358 patients diagnosed with mCRC. The treatments under investigation consisted of five initial treatments, including three focusing on MSS patients and two on MSI patients, as well as two secondary immunotherapy regimens, both focusing on MSS patients. A total of 1051 individuals underwent first-line treatment, while 307 received second-line treatment. The application of ICIs proved to offer varying degrees clinical benefits when compared to standard-of-care therapy alone, both in two subgroups of the first and the second treatment phases. Of particular note is the performance of Nivolumab combination with ipilimumab, which demonstrated superior efficacy in improving progression-free survival (PFS) (HR=0.21; 95% CI, 0.13-0.34),. Moreover, the treatment demonstrated an optimal safety profile, with a relatively low risk of adverse events (OR = 0.33; 95% CI, 0.19-0.56), compared to other first-line treatment modalities for MSI subgroup. Regarding MSS subgroup, the improvement of PFS by Nivolumab plus standard-of-care (SOC) was relatively significant (HR = 0.74; 95% CI, 0.53-1.02). In the realm of second-line therapies for MSS subgroup, the administration of Atezolizumab plus SOC has proven to be an effective approach for prolonging PFS, exhibiting an HR of 0.66 (95% CI, 0.44-0.99). These findings underscore the clinical benefits and safety profiles of ICIs in the treatment of mCRC across various treatment lines. Conclusions: The clinical application of ICIs in both first- and second-line treatment strategies for patients with mCRC yields substantial therapeutic benefits. A detailed assessment in this study indicates that first-line treatment with Nivolumab combination with ipilimumab may represent an efficacious and well-tolerated therapeutic approach for MSI subgroup. In terms of MSS subgroup in first-line therapy, Nivolumab plus SOC may be a relative superior choice. In the context of second-line therapy for MSS subgroup, it is evident that a combination of Atezolizumab and SOC represents a preferable option for enhancing PFS. Furthermore, it is noteworthy that other ICIs treatment regimens also exhibit great value in various aspects, with the potential to inform the development of future clinical treatment guidelines and provide a stronger rationale for the selection of ICIs in both first- and second-line therapeutic strategies for mCRC. Systematic review registration: https://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD42024543400.

Comparison of efficacy and safety of sarpogrelate-based anti-platelet therapy with non-sarpogrelate-based anti-platelet therapy following arterial endovascular therapy: a systematic review.

Objective: Sarpogrelate is a selective serotonin/5-hydroxytryptamine 2A receptor antagonist used in the management of peripheral artery disease (PAD). The drug has emerged as a promising choice for medical management post-endovascular therapy (EVT) due to its anti-platelet aggregation, vasoconstriction, and anti-vascular smooth muscle proliferation properties. The aim of the meta-analysis is to evaluate the efficacy and safety of sarpogrelate-based APT following arterial EVTs in PAD. Material and methods: PubMed, Google Scholar, Scopus, and the Cochrane were systematically searched from inception to December 2023. Any randomized controlled trial studies in English that evaluated the efficacy and safety of sarpogrelate-based APT after EVT in patients with PAD was included. Data on the restenosis rate, target lesion revascularization (TLR), and safety parameters were extracted and studied. The pooled differences in efficacy and safety parameters between sarpogrelate-based APT and non-sarpogrelate-based APT was calculated using the relative risk (RR) with a 95% CI. Results: A total of three randomized controlled trials were included out of 354 articles obtained through a literature search. No significant differences were observed in the risk of restenosis (RR=0.74, 95% CI= 0.55-1.00, P=0.954) and TLR (RR=0.76, 95% CI= 0.47-1.23, P=0.476) among patients being treated with sarpogrelate and non-sarpogrelate-based APT. Likewise, sarpogrelate-based APT had a similar safety profile as non-sarpogrelate-based APT. Conclusion: Sarpogrelate-based APT can be considered an effective alternative to clopidogrel-based conventional APT after EVTs. However, there is a huge need for a larger multicenter, multinational, and multiethnic global trial with sufficient participants in order to produce generalizable findings.

The European Researchers' Network Working on Second Victim (ERNST) Policy Statement on the Second Victim Phenomenon for Increasing Patient Safety.

Background: The second victim phenomenon refers to the emotional trauma healthcare professionals experience following adverse events (AEs) in patient care, which can compromise their ability to provide safe care. This issue has significant implications for patient safety, with AEs leading to substantial human and economic costs. Analysis: Current evidence indicates that AEs often result from systemic failures, profoundly affecting healthcare workers. While patient safety initiatives are in place, the psychological impact on healthcare professionals remains inadequately addressed. The European Researchers' Network Working on Second Victims (ERNST) emphasizes the need to support these professionals through peer support programs, systemic changes, and a shift toward a just culture in healthcare settings. Policy Options: Key options include implementing peer support programs, revising the legal framework to decriminalize honest errors, and promoting just culture principles. These initiatives aim to mitigate the second victim phenomenon, enhance patient safety, and reduce healthcare costs. Conclusion: Addressing the second victim phenomenon is essential for ensuring patient safety. By implementing supportive policies and fostering a just culture, healthcare systems can better manage the repercussions of AEs and support the wellbeing of healthcare professionals.

Precision prevention in occupational health: a conceptual analysis and development of a unified understanding and an integrative framework.

Introduction: Precision prevention implements highly precise, tailored health interventions for individuals by directly addressing personal and environmental determinants of health. However, precision prevention does not yet appear to be fully established in occupational health. There are numerous understandings and conceptual approaches, but these have not yet been systematically presented or synthesized. Therefore, this conceptual analysis aims to propose a unified understanding and develop an integrative conceptual framework for precision prevention in occupational health. Methods: Firstly, to systematically present definitions and frameworks of precision prevention in occupational health, six international databases were searched for studies published between January 2010 and January 2024 that used the term precision prevention or its synonyms in the context of occupational health. Secondly, a qualitative content analysis was conducted to analyze the existing definitions and propose a unified understanding. Thirdly, based on the identified frameworks, a multi-stage exploratory development process was applied to develop and propose an integrative conceptual framework for precision prevention in occupational health. Results: After screening 3,681 articles, 154 publications were reviewed, wherein 29 definitions of precision prevention and 64 different frameworks were found, which can be summarized in eight higher-order categories. The qualitative content analysis revealed seven themes and illustrated many different wordings. The proposed unified understanding of precision prevention in occupational health takes up the identified themes. It includes, among other things, a contrast to a "one-size-fits-all approach" with a risk- and resource-oriented data collection and innovative data analytics with profiling to provide and improve tailored interventions. The developed and proposed integrative conceptual framework comprises three overarching stages: (1) data generation, (2) data management lifecycle and (3) interventions (development, implementation and adaptation). Discussion: Although there are already numerous studies on precision prevention in occupational health, this conceptual analysis offers, for the first time, a proposal for a unified understanding and an integrative conceptual framework. However, the proposed unified understanding and the developed integrative conceptual framework should only be seen as an initial proposal that should be critically discussed and further developed to expand and strengthen both research on precision prevention in occupational health and its practical application in the workplace.

Contextualizing toxic elements in the diet: a case for integration of toxic element data into food databases.

Food composition data plays a key role in the practice of nutrition. However, nutrition professionals may currently lack the resources they need to integrate information about toxic elements - such as arsenic, cadmium, and lead - in food into the advice they give consumers. Geographic, sociocultural, and individual factors may impact not only the toxic element content of food, but also how the balance between potentially toxic and health-promoting components of food must be weighed. Better integration and contextualization of toxic element data into key food databases could allow for more nuanced, comprehensive nutrition guidance.

The key to intestinal health: a review and perspective on food additives.

In this review, we explore the effects of food additives on intestinal health. Food additives, such as preservatives, antioxidants and colorants, are widely used to improve food quality and extend shelf life. However, their effects on intestinal microecology May pose health risks. Starting from the basic functions of food additives and the importance of intestinal microecology, we analyze in detail how additives affect the diversity of intestinal flora, oxidative stress and immune responses. Additionally, we examine the association between food additives and intestinal disorders, including inflammatory bowel disease and irritable bowel syndrome, and how the timing, dosage, and individual differences affect the body's response to additives. We also assess the safety and regulatory policies of food additives and explore the potential of natural additives. Finally, we propose future research directions, emphasizing the refinement of risk assessment methods and the creation of safer, innovative additives.

The influence of the personality traits of newly graduated nurses on the knowledge, skills and professional self-efficacy in standardized training: a cross-sectional study.

BACKGROUND: New graduate nurses often have certain potential safety hazards for patients due to insufficient knowledge and lack of clinical practice ability. To address these challenges, China has implemented a standardized training strategy. The improvements in the quality of this training involve not only the intervention of teaching methods but also the consideration of personality traits. METHODS: The application software based on the BFI-2 Chinese scale was utilized to administer personality tests to nursing students; nursing students were invited to scan the QR code and voluntarily fill in a questionnaire, including basic information, personality test results, and a professional self-efficacy test scale; offline paper-based theoretical examination results of nursing students were collected before and after training. The data was then analyzed using SPSS software version 26.0, which involved descriptive analysis, one-way between-groups analysis of variance (ANOVA) and Spearman correlation analysis. RESULTS: Based on the data, there were no observable differences in the theoretical results before and after training across different personality traits. In terms of skill assessment, conscientiousness exhibited the highest score at 78.91 ± 2.98 points, while negative emotionality showed the lowest score at 74.59 ± 2.12 points. These differences between different personality traits are statistically significant (P < 0.001). In terms of professional self-efficacy, conscientiousness scored the highest at 98.48 ± 12.69, while negative emotionality scored the lowest at 85.89 ± 11.71, with significant differences between different personality traits (P < 0.001). Professional self-efficacy was negatively correlated with agreeableness (r = -0.150, P = 0.044) and positively correlated with conscientiousness (r = -0.310, P < 0.001). Skill scores were negatively correlated with negative emotionality (r = -0.257, P < 0.001) and positively correlated with conscientiousness (r = 0.182, P = 0.014). CONCLUSIONS: This study shows that personality traits affect the skills test results and professional self-efficacy of nursing students. Conscientiousness scored the highest in this study, while negative emotionality scored the lowest. Therefore, personalized training plans are recommended to improve the quality of care for such nursing students and to further enhance patient safety.

The current status of nurses' psychological experience as second victims during the reconstruction of the course of event after patient safety incident in China: a mixed study.

BACKGROUND: Patient safety incidents are unavoidable and nurses, as parties involved, become second victims due to the incident itself and the way it is handled. In China, reconstructing the course of events is a crucial step in the aftermath of the incident; however, its impact on the emotional well-being of the second victim remains unclear. PURPOSE: The purpose of this study is to gain insight into the psychological experiences and current conditions of nurses who act as second victims during the process of reconstructing the sequence of events. Additionally, the study aims to provide justifications for supporting these individuals. METHODS: An exploratory mixed research method was adopted to understand the emotional experience of the second victim when reconstructing the passage of the incident through qualitative research. Fourteen nurses with experience as second victims were selected for semi-structured interviews using purposive sampling according to the maximum difference sampling strategy. Through quantitative research, we explored the negative psychology and support needs of the second victims when they reverted to the incident, and a self-developed questionnaire (the Cronbach's alpha coefficient was 0.895) was used to survey 3,394 nurses with experiences as second victims in 11 tertiary hospitals in Shanxi Province. RESULTS: In the qualitative part of the study, the emotional experience of the second victim's reconstruction of the course of events after a patient safety incident could be categorized into 3 themes: negative views as initial psychological impact, avoidance as part of psychological impact, and expectations and growth in overcoming negative psychological impact. The quantitative part of the study revealed that the emotions of guilt and self-blame accounted for the highest percentage after a patient safety incident. The second victim presented a high score of 39.58 ± 5.45 for support requirements. CONCLUSION: This study provides a better understanding of the true emotional experiences and the need for support of the second victim in the process of reconstructing the course of events. Following a patient safety incident, nursing administrators and healthcare institutions should consider the adverse psychological effects on the second victim, prioritize their support needs during the incident's reconstruction, create a positive safety culture, and reduce the risk of secondary victimization for these individuals.

Interprofessional team training via telemedicine in medical and nursing education.

BACKGROUND: The use of information communication technologies such as telemedicine has increased over the years, offering access to specialized healthcare even in remote locations. However, telemedicine in interprofessional team training is seldom included in medical or nursing programs, and little is known about how to practise these scenarios. This study aimed to explore how medical and nursing students experience teamwork when one team member is participating remotely and digitally. METHODS: Following interprofessional team training in which one team member participated remotely, focus group interviews were conducted with three teams, each comprising one medical student and two nursing students (n = 9 students in total). The focus group interviews were analysed with thematic content analysis. The Systems Engineering Initiative for Patient Safety model was applied as a theoretical framework and served as a lens in the analysis. RESULTS: Three themes were identified in the analysis: challenging the dynamic of leadership, becoming familiar with a new setting, and finding new strategies to communicate. CONCLUSIONS: The results of this study suggest that future physicians and nurses need to enhance their knowledge of practicing teamwork through telemedicine during their education, as the use of telemedicine continues to grow.

Monofluorinated Phosphate with Unique P-F Bond for Nonflammable and Long-Life Lithium-Ion Batteries.

Lithium-ion batteries (LIBs) with conventional carbonate-based electrolytes suffer from safety concerns in large-scale applications. Phosphates feature high flame retardancy but are incompatible with graphite anode due to their inability to form a passivated solid electrolyte interphase (SEI). Herein, we report a monofluorinated co-solvent, diethyl fluoridophosphate (DEFP), featuring a unique P-F bond that allows a trade-off between safety and electrochemical performance in LIBs. The P-F bond in DEFP weakens ion-dipole interactions with Li+ ions, lowering the desolvation barrier, and simultaneously reduces the lowest unoccupied molecular orbital (LUMO) of DEFP, promoting the formation of a robust and inorganic-rich SEI. Additionally, DEFP exhibits improved thermal stability due to both robust SEI and the inherent flame-retardant properties of the P-F bond. Consequently, the optimized DEFP-based electrolyte exhibits improved cyclability and rate capacity in LiNi0.8Co0.1Mn0.1O2 || graphite full cells compared with triethyl phosphate-based electrolytes and commercial carbonate electrolytes. Even at a low E/C ratio of 3.45 g Ah-1, the 1.16 Ah NCM811||Gr pouch cells achieve a high capacity retention of 94.2% after 200 cycles. This work provides a promising approach to decouple phosphate safety and graphite compatibility, paving the way for safer and high-performance lithium-ion batteries.

Multi-confinement structured carbon dots with long room temperature phosphorescence lifetime and efficiency for sensing thiram residues assisted by copper ions.

Room temperature phosphorescent carbon dots (NCCDs@SiO2) were obtained by encapsulating hydrothermally synthesized CDs in a dense Si-O network structure after high-temperature calcination using silica as the matrix. This can avoid the quenching effect of dissolved oxygen in water and has a phosphorescence lifetime of up to 2.41 s. Using the phosphorescence property of NCCDs@SiO2, a phosphorescence quenching sensor was developed for the sensitive and selective detection of thiram with the assistance of Cu2+. Cu2+-thiram complexes led to a rapid phosphorescence quenching of NCCDs@SiO2 within 30 s through the inner filter effect. The linear range of phosphorescence for thiram was 0.5-100 µM with a detection limit of 0.121 µM. The proposed method was able to detect thiram in real samples and was validated by high-performance liquid chromatography (HPLC) confirming the potential of this phosphorescence sensing method for thiram detection. This work opens up a new avenue for the detection of thiram residues in fruits and vegetables and also provides a new idea for the design of a rapid detection platform using other room temperature phosphorescent materials.