Development of a Health Problem Prevention and Control Strategies Scale for Medical Rescuers Fighting Epidemics.

This study aimed to develop and validate a new scale to measure health problem prevention and control strategies employed by medical rescuers fighting epidemics. In Study I, a qualitative study, focus group discussion, and expert panel review were conducted to generate items that capture components of prevention and control strategies. In Study II, exploratory factor analysis was used to examine the scale's structure. In Study III, the scale's validity and reliability were assessed via confirmatory factor analysis, average variance extracted, composite reliability, and Cronbach's α. Data analysis was performed using Nvivo 12.0, SPSS 25.0, and Amos 23.0. The final scale was divided into three subscales (comprising 5 factors and 18 items on the Before Medical Rescue subscale, 6 factors and 28 items on the During Medical Rescue subscale, and 4 factors and 14 items on the After Medical Rescue subscale). The scale has excellent validity and reliability and can be used to measure the health problem prevention and control strategies of medical rescuers fighting epidemics.

Development and psychometric testing of physiopsychological disorders scale for medical rescuers fighting epidemics in China.

OBJECTIVE: Develop and psychometrically test the physiopsychological disorders scale for medical rescuers fighting epidemics (PDS-MRFE). METHOD: A three-phase approach was used to develop and test the physiopsychological disorders scale: (1) creating the item pool, (2) preliminarily evaluating items, and (3) refining the scale and estimating the psychometric properties. The items of the instrument were generated based on a comprehensive literature review and a qualitative study conducted with 31 medical rescuers (18 nurses and 13 doctors) fighting epidemics. A preliminary evaluation of items was conducted using content validity which was evaluated by a panel of 15 experts. Validity and reliability examinations were conducted to refine the scale and evaluate its psychometric properties. This was done using two different samples. Specifically, Sample A (360 medical rescuers) was employed for item reduction and exploratory factor analysis (EFA), and Sample B (287 medical rescuers) was employed for the confirmatory factor analysis (CFA) and determination of other psychometric properties (i.e., reliability, concurrent, convergent, and discriminant validity), which further confirmed the structure of the scale and evaluated its final psychometric properties. RESULTS: The final scale has 39 items with three subscales, including before, during, and after rescue. The exploratory factor analysis result indicated that the before-rescue scale of four items, during-rescue of 21 items, and after-rescue of 14 items explained 52.07%, 69.75%, and 52.30% of the cumulative variance, respectively. The confirmatory factor analysis result indicated that model fit indices of three subscales were acceptable and showed evidence of adequate content, convergent, discriminate, and concurrent validity. The Cronbach's α coefficients for each subscale and all dimensions ranged from 0.81 to 0.92, indicating good reliability for the PDS-MRFE. CONCLUSIONS: The physiopsychological disorders scale is a psychometrically valid and reliable instrument and can be used in both clinical practice and research to evaluate different physiopsychological disorders at different medical rescue stages among medical rescuers fighting epidemics.

Physical and mental health problems of Chinese front-line healthcare workers before, during and after the COVID-19 rescue mission: a qualitative study.

OBJECTIVE: To explore the physical and mental health problems of front-line healthcare workers fighting COVID-19 across the three phases of the epidemic rescue mission (before, during and after) in China. DESIGN: A qualitative study was adopted using face to face, in-depth semistructured interviews. Phenomenological research methods and Colaizzi's seven-step analysis method were used in the study. SETTING: The setting of the study was the offices of healthcare workers in 12 tertiary hospitals. PARTICIPANTS: Thirty-one front-line healthcare workers from 16 provinces in China, who carried out rescue missions in Hubei Province, were interviewed from October to November 2020. RESULTS: Physical and mental health problems existed before, during and after the COVID-19 rescue mission. Eleven themes emerged during the three phases. Two themes appeared before rescue mission: basic diseases, anxiety before rescue mission. Five themes appeared during rescue mission: basic physical function disorder, physical exhaustion, negative cognition, negative emotions and negative behaviour. Four themes appeared after rescue mission: physical dysfunction, negative emotions, stigmatisation and hypochondriasis. CONCLUSION: Both physical and mental health problems occurred throughout the three phases. The study results pointed that a comprehensive prevention and control system that addresses both physical and mental health problems of front-line healthcare workers throughout the three phases of epidemic rescue mission (before, during and after), and that involves themselves, their families, hospitals, the government and social organisations is needed.

Dyadic effects of family-functioning and resilience on quality of life in advanced lung cancer patients and caregivers: An actor-partner interdependence mediation model.

PURPOSE: Lung cancer as a stressful event profoundly impacts the entire family, especially patients and their family caregivers. This study uses a dyadic analysis approach to explore the dyadic effects of family functioning on the quality of life (QoL), and whether resilience acts as a mediator in advanced lung cancer patient-caregiver dyads. METHODS: This was a cross-sectional study, and 287 dyads of advanced lung cancer patients and their caregivers were enrolled. Family-functioning, resilience, and QoL were assessed by the General Functioning subscale of the Family Assessment Device (FAD), the 10-item Connor-Davidson Resilience Scale, and the Short Form-8 (SF-8) Health Survey, respectively. Data were analyzed using the actor-partner interdependence mediation model. RESULTS: This study found that, for patients and caregivers, resilience mediates the actor effects of family-functioning on QoL. That is, family-functioning was positively related to their resilience, which improved QoL. Another important finding is that caregivers' family-functioning had significant indirect effects on patients' QoL through their resilience. CONCLUSIONS: Positive family functioning perceived by patients and caregivers can improve their QoL by developing their own resilience. Furthermore, family-functioning perceived by caregivers can also improve patients' QoL through their resilience. Medical staff should identify vulnerable patients and caregivers with poorer family-functioning and resilience, and make focused intervention to improve the QoL of both lung cancer patients and their family caregivers.

Identification of Enterotype and Its Effects on Intestinal Butyrate Production in Pigs.

Gut microbiota is thought to play a crucial role in nutrient digestion for pigs, especially in processing indigestible polysaccharides in the diets to produce short-chain fatty acids (SCFAs). However, the link between microbiota community structure and phenotypic performances are poorly understood. In the present study, the fecal samples of 105 Jinhua pigs at 105 days of age were clustered into three enterotypes (ETs, ET1, ET2, and ET3) that are subpopulations of distinct bacterial community composition by using 16S rRNA high throughput sequencing. The α-diversity indices (the OTU number and Shannon index) were significantly different among the ETs (p < 0.001). At the genus level, the ET1 group was over-represented by Lactobacillus (17.49%) and Clostridium sensu stricto 1 (11.78%), the ET2 group was over-represented by Clostridium sensu stricto 1 (17.49%) and Bifidobacterium (11.78%), and the ET3 group was over-represented by Bacteroides (18.17%). Significant differences in the fecal contents of butyrate were observed among ETs, with the highest level detected in ET3 and the lowest in ET2 (p < 0.05). Consistently, more copies of the terminal genes for butyrate synthesis, butyrate kinase (Buk) and butyryl coenzyme A (CoA): acetate CoA transferase (But) were detected by qPCR in the fecal samples of the ET3 group as compared to other two groups (p < 0.05). In addition, of the two genes, But was demonstrated to be more relevant to the butyrate content (R = 0.7464) than Buk (R = 0.4905) by correlation analysis. In addition, based on the taxonomic analysis, we found that Faecalibacterium was the most relevant butyrate-producing genera with fecal butyrate contents in Jinhua pigs, followed by Butyricicoccus, Eubacterium, Butyricimonas, Blautia, and Anaerostipes, all of which showed significantly higher richness in ET3 than as compared to ET1 and ET2 (p < 0.05). Collectively, this work presents a first overview of the enterotypes clustering in Jinhua pigs and will help to unravel the functional implications of ETs for the pig's phenotypic performance and nutrient metabolism.

Transcriptome profiling of the liver among the prenatal and postnatal stages in chickens.

The liver is an important organ that has pivotal functions in the synthesis of several vital proteins, the metabolism of various biologically useful materials, the detoxification of toxic substances, and immune defense. Most liver functions are not mature at a young age and many changes happen during postnatal liver development, which lead to differential functions of the liver at different developmental stages. However, the transcriptome details of what changes occur in the liver after birth and the molecular mechanisms for the regulation of the developmental process are not clearly known in chickens. Here, we used RNA-sequencing to analyze the transcriptome of chicken liver from the prenatal (at an embryonic day of 13) to the postnatal stages (at 5 wk and 42 wk of age). A total of approximately 161.17 Gb of raw data were obtained, with 4,127 putative and 539 differentially expressed lncRNAs, and with 13,949 putative and 6,370 differentially expressed mRNAs. Coexpression of lncRNAs-mRNAs in hepatic transcriptome analysis showed that the liver plays important roles in providing energy for organisms through the mitochondrial respiratory chain in chickens, meanwhile, acting as a crucial part of antioxidant stress. The developmental transcriptome date revealed that antioxidant defenses are likely to act on chicken embryo development and that significant functional changes during postnatal liver development are associated with the liver maturation of chickens. These results provide a timeline for the functional transcriptome transition from the prenatal to adult stages in chickens and will be helpful to reveal the underlying molecular mechanisms of liver development.

A Meta-analysis of Traffic-related Air Pollution and Risk of Childhood Leukemia.

BACKGROUND: Many studies have analyzed the association between traffic-related air pollution and risk of childhood leukemia, but the results are inconsistent. Therefore, we performed this meta-analysis to investigate the association between traffic-related air pollution and risk of childhood leukemia. METHODS: PubMed, Cochrane, and Embase databases were searched by the index words to identify eligible case-control studies, and relevant literature sources were also searched. The latest research was performed in September 2017. Odds ratio (OR) along with 95% confidence interval (95% CI) were used to analyzed the main outcomes. RESULTS: Twenty-one case-control studies were included in the meta-analysis. The results indicated that in the studies of overall traffic density (OR: 1.01, 95% CI: 0.98-1.04), high traffic density (OR: 1.04, 95% CI: 0.91-1.17), moderate exposure to NO2 (OR: 1.02, 95% CI: 0.93-1.10), and benzene (OR: 1.04, 95% CI: 0.71-1.37), the risks of childhood leukemia incidence were higher in the case group than the control group, but no significant difference was found. In other analysis, no significant difference was observed in the risk of childhood leukemia in the 2 groups. CONCLUSIONS: Current evidence suggests that childhood leukemia is associated with traffic density, and moderate exposure to NO2 and benzene. However, more high-quality studies are required to confirm the conclusions.

Human umbilical cord mesenchymal stem cells improve the immune-associated inflammatory and prothrombotic state in collagen type-â ¡-induced arthritic rats.

Human umbilical cord mesenchymal stem cells (hUC­MSCs) hold great potential in the search for therapies to treat refractory diseases, including rheumatoid arthritis (RA), due to their potential regenerative ability and extensive source. However, the role of hUC­MSCs in vivo and the repair mechanisms for RA remain to be fully elucidated. The present study aimed to determine whether hUC­MSCs exert immunomodulatory effects and have anti­inflammatory capabilities in the treatment of embolisms. Following the transplantation of hUC­MSCs into collagen type Ⅱ­induced arthritic (CIA) model rats, magnetic resonance imaging (MRI) in vivo was performed, and the levels of interleukin (IL)­1, IL­17, tumor necrosis factor (TNF)­α, vascular endothelial growth factor (VEGF), tissue factor (TF), CD4+CD25+ T cells (Treg) and antithrombin (AT) were measured. Bromodeoxyuridine staining was performed for histopathological examinations. As revealed by immunofluorescence and MRI experiments, the injected hUC­MSCs preferentially migrated to the inflammatory joint sites of the rats. The Treg cell percentage and AT levels in the hUC­MSC­treated group were markedly increased, whereas the levels of IL­1, IL­17, TNF­α, VEGF and TF were decreased compared with those in the CIA model group. The values determined for these parameters in the hUC­MSC­treated group returned to approximately the identical values as those of the control group on day 35 post­therapy. Superparamagnetic iron oxide nanoparticles (SPIONs) may serve as an effective, non­invasive method for tracking transplanted cells in vivo. The present study provided direct evidence that hUC­MSCs in the CIA rat model migrated to the inflammatory joint sites, effectively promoting recovery from collagen type II damage and thereby improving the immune­associated prothrombotic state.

[Functions of inflammatory factor in non-tumor deep venous thrombosis of lower extremity].

OBJECTIVE: To explore the functions of inflammatory cytokine, tissue factor (TF) and cancer procoagulant (CP) in non-tumor deep venous thrombosis (NT-DVT). METHODS: A total of 17 NT-DVT patients (5 males and 12 females) were selected for NT-DVT group while 20 voluntary (10 males and 10 females) blood donors for control group from May 2012 to March 2013. The levels of inflammatory cytokines interleukin 1ß (IL-1 ß), IL-18, tumor necrosis factor alpha (TNF-α), TF and CP were tested by enzyme-linked immunosorbent assay (ELISA) before and after treatment. Also the correlations of inflammatory cytokines and TF were determined. RESULTS: The levels of inflammatory cytokines and TF were higher in NT-DVT than those in control group pre-treatment ((153.13 ± 2.30) vs (59.26 ± 1.57) ng/L, (364.27 ± 1.46) vs (67.46 ± 1.48) ng/L, (363.51 ± 1.85) vs (216.42 ± 1.55) µg/L, (66.90 ± 1.44) vs (14.55 ± 1.52) ng/L, all P < 0.05). And after anticoagulant therapy, the levels decreased (all P < 0.05). Also the levels of IL-1ß,IL-18 and TNF-α were positively correlated with TF pre-treatment. And the correlation coefficients were 0.492 (P = 0.045), 0.652 (P = 0.005) and 0.511(P = 0.036) respectively. Compared with control group, the plasma level of CP had no obvious change before and after treatment (both P > 0.05). CONCLUSION: A high level of inflammatory cytokines is an important risk factor for NT-DVT.

[Immunomodulatory effect of UC-MSC on function of immunocytes of rats with collagen type II induced arthritis].

This study was purposed to observe the influence of umbilical cord mesenchymal stem cells (UC-MSC) on the peripheral blood CD4(+)CD25(+)regulatory T cells (Treg), Th17 cells and neutrophils in rats with collagen type II-induced arthritis(CIA), and to explore the regulating effect of UC-MSC transplantation on immunocyte subgroup. The rats wee divided into 3 groups: CIA group (model group), UC-MSC treated group and blank control group. The CIA rats were injected with UC-MSC via tail vein. The percentage of CD4(+)CD25(+) cells in peripheral blood and the expression of NCD11b on neutrophil surface in CIA rates was detected by flow cytometry (FCM), and the serum interleukin-17 (IL-17) was observed by enzyme-linked immunosorbent assay (ELISA). The results showed that the mean fluorescence intensity(MFI) of NCD11b and the level of IL-17 in the model group were significantly higher than those in the blank control group, and the ratio of CD4(+)CD25(+) cells were significantly lower (P < 0.05). The MIF of NCD11b and the level of IL-17 in the UC-MSC treated group were significantly lower than that in the model group (P < 0.05), while the proportion of CD4(+)CD25(+) Treg increased (P < 0.05). Since the fifth week, the above indicators in the UC-MSC group have almostly approached the control group. It is concluded that the UC-MSC can increase peripheral blood Treg proportion in CIA rat, inhibit the secretion of Th17 and the activity of neutrophils, reduce the immune inflammation reaction, decrease the release of proinflammatory factor, and induce immune reconstruction.