Waist-to-height ratio is a better predictor of hypertension in women during recovery from anesthesia compared to BMI, waist-to-hip ratio, and waist circumference.

This was an observational study of patients with benign breast tumors intended to investigate and compare the predictive value of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) for hypertension in the recovery room. Logistic regression analysis was used to determine the association between these body fat anthropometric indices and hypertension. Receiver operating characteristic curve (ROC) analysis was performed to assess the comparative predictive ability. A total of 689 women were evaluated. Patients with BMI ≥28 (kg/m2), WC > 85 cm, WHR ≥0.82, and WHtR ≥0.5 had a significantly higher probability of increased systolic blood pressure (SBP) and diastolic blood pressure (DBP) than patients with less than threshold values (all P < 0.05). The areas under the ROC curve (AUC) of BMI, WC, and WHtR where all modestly significant (all AUC ≥0.65) and nearly identical at 0.6592, 0.65, and 0.6724, respectively. Conclusion: body fat anthropometric indices are useful predicting hypertension during recovery from general anesthesia in patients with benign breast tumors undergoing day surgery; WHtR outperformed the other indices and nearly identical.

Evaluation of gut microbiota composition to screening for potential biomarker in AFB1-exposed sheep.

Aflatoxin B1 (AFB1) is an inevitable contaminant in animal feed and agricultural products, which seriously threatens the health of animals. However, there is currently no better diagnostic tool available than depending on clinical symptoms, pathophysiology, biochemical indicators, etc. Here, we profiled the fecal microbiomes of sheep exposed to and not exposed to AFB1 to identify potential non-invasive biomarkers of AFB1 intoxication by 16S rRNA gene sequencing technology, while measuring serum biochemical indexes. The results showed that the sheep exposed to AFB1 had significantly higher levels of the liver function indicators ALT (alanine transaminase) and AST (aspartate aminotransferase), and their microbial profiles were different from those of the CON (Control) group. In detail, the relative abundance of seven phyla and three genera were overrepresented in the AFB1 group from top 10 relative abundance. Importantly, we found that Prevotella and Bifidobacterium were significantly different in the CON and AFB1 groups (p = 0.032 and p = 0.021, respectively) based on linear discriminant analysis effect size (LEfSe) and random forest analysis. Additionally, the area under curve (AUC) of ALT was 1 (95% CI 1.00-1.00; p < 0.001) and that of Bifidobacterium was 0.95 (95% CI 0.81-1.00; p = 0.0275), suggesting that Bifidobacterium correlated with ALT (r = 0.783, p < 0.01) may be a potential biomarker for AFB1 exposure in sheep.

Comparison of anaesthesia-related outcomes in patients monitored by newly recruited nurse anaesthetists and anaesthesiologists: An observational study.

AIMS: To compare anaesthesia-related outcomes between patients monitored by newly recruited nurse anaesthetists and those monitored by newly recruited anaesthesiologists. DESIGN: This was a retrospective study. METHODS: We conducted a retrospective study that collected demographic information on newly recruited nurse anaesthetists and anaesthesiologists between 2017 and 2022 and recorded information on patients within 6 months of monitoring. Postoperative pain, emergency agitation, nausea, and vomiting were designated anaesthesia-related outcomes. Propensity score matching was used to adjust for covariates. The study adhered to the STROBE guidelines. RESULTS: The study's statistical analysis included 4483 patients monitored by 22 newly recruited nurse anaesthetists and 4959 patients monitored by 23 newly recruited anaesthesiologists. Compared with patients monitored by newly trained anaesthesiologists, the patients monitored by nurse anaesthetists were younger (42.07 ± 20.00 vs. 47.39 ± 18.45 years, p < 0.001) and had a lower body mass index (23.56 ± 4.46 vs. 24.19 ± 4.25, p < 0.001). Patients monitored by anaesthesiologists had a greater proportion of women (61.62% vs. 59.25%, p < 0.001), a high proportion of ASA III and ASA IV (17.1% vs. 8.88%, p < 0.001), and a longer mean surgery duration (78.65 ± 59.01 vs. 70.70 ± 60.65 min, p < 0.001). After propensity score matching was used to adjust for covariates, no statistically significant differences were found in the prevalence of postoperative pain, emergency agitation, or postoperative nausea and vomiting between the two groups (p < 0.05). CONCLUSION: Nurse anaesthetists monitoring alone during anaesthesia maintenance is feasible and safe. The two groups had no significant differences in the incidence of postoperative pain, emergency agitation, or postoperative nausea and vomiting. RELEVANCE TO CLINICAL PRACTICE: The shortage of anaesthesiologists leads to heavy work burden and high incidence of occupational burnout among anaesthesiologists. The study found that it was safe for nurse anaesthetists to perform anaesthetic monitoring alone in the operating room under the supervision of the attending anaesthesiologist and did reduce the burden of anaesthesiologists' work. The results of the current study contribute to the expansion of occupational categories for nurse anaesthetists in countries where anaesthesiologists are in short supply. It provides new ideas for hospital administrators and policy-makers to formulate medical and nursing service policies.

Unplanned Post-Anesthesia Care Unit to ICU Transfer Following Cerebral Surgery: A Retrospective Study.

Background: Unplanned transfer to intensive care unit (ICU) lead to reduced trust of patients and their families in medical staff and challenge medical staff to allocate scarce ICU resources. This study aimed to explore the incidence and risk factors of unplanned transfer to ICU during emergence from general anesthesia after cerebral surgery, and to provide guidelines for preventing unplanned transfer from post-anesthesia care unit (PACU) to ICU following cerebral surgery. Methods: This was a retrospective case-control study and included patients with unplanned transfer from PACU to ICU following cerebral surgery between January 2016 and December 2020. The control group comprised patients matched (2:1) for age (±5 years), sex, and operation date (±48 hours) as those in the case group. Stata14.0 was used for statistical analysis, and p < .05 indicated statistical significance. Results: A total of 11,807 patients following cerebral surgery operations were cared in PACU during the study period. Of the 11,807 operations, 81 unscheduled ICU transfer occurred (0.686%). Finally, 76 patients were included in the case group, and 152 in the control group. The following factors were identified as independent risk factors for unplanned ICU admission after neurosurgery: low mean blood oxygen (OR = 1.57, 95%CI: 1.20-2.04), low mean albumin (OR = 1.14, 95%CI: 1.03-1.25), slow mean heart rate (OR = 1.04, 95%CI: 1.00-1.08), blood transfusion (OR = 2.78, 95%CI: 1.02-7.58), emergency surgery (OR = 3.08, 95%CI: 1.07-8.87), lung disease (OR = 2.64, 95%CI: 1.06-6.60), and high mean blood glucose (OR = 1.71, 95%CI: 1.21-2.41). Conclusion: We identified independent risk factors for unplanned transfer from PACU to ICU after cerebral surgery based on electronic medical records. Early identification of patients who may undergo unplanned ICU transfer after cerebral surgery is important to provide guidance for accurately implementing a patient's level of care.

Morinda officinalis Polysaccharides Ameliorates Bone Growth by Attenuating Oxidative Stress and Regulating the Gut Microbiota in Thiram-Induced Tibial Dyschondroplasia Chickens.

Tibial dyschondroplasia (TD) occurs in chickens and other fast-growing birds, affecting their cartilage growth and leading to reduced meat quality in broilers. Morinda officinalis polysaccharide (MOP) is one of the chief active components of Morinda officinalis, which promotes bone formation, inhibiting bone loss and having anti-oxidant and anti-inflammatory properties. A total of 120 AA chickens were randomly divided into the CON group (basal diet), TD group (100 mg/kg thiram + basal diet), and MOP group (100 mg/kg thiram + basal diet + water with 500 mg/kg MOP). The experiment lasted 21 days. The results showed that MOP could alleviates broiler lameness caused by TD, restore the morphological structure of tibial growth plate (TGP), increase tibial weight (p < 0.05), balance the disorder of calcium and phosphorus metabolism, and promote bone formation by increasing the expression of BMP-2, Smad4, and Runx2 genes In addition, MOP supplementation stimulated the secretion of plasma antioxidant enzymes (T-SOD and GSH-Px) by regulating the expression of SOD and GPX-1 genes, thereby enhancing the antioxidant capacity of TD broilers. Interestingly, we observed MOP can also improve gut microbiota by increasing the beneficial bacteria count and decreasing the harmful bacteria count. These findings indicated that MOP can regulate bone formation through the BMP/Smads signaling pathway, attenuating oxidative stress and regulating the gut microbiota of TD broilers, so as to achieve the effect of treating TD. This suggests that MOP might be a potential novel drug in the treatment of TD in chickens.

How and when perceived COVID-19 crisis strength impacts individuals' life satisfaction and sleep quality: A moderated mediation model.

The COVID-19 pandemic has caused millions of deaths, seriously hampering people's lives and their productivity. Drawing on social information processing theory, this research developed a moderated mediation model to investigate the influence of perceived COVID-19 crisis strength on individuals' well-being. The results from a sample of 441 suggest that individuals' perceived COVID-19 crisis strength indirectly affects their life satisfaction and sleep quality via their perceived risk of being infected. Moreover, both individuals' trust in local government and mindfulness trait can buffer the positive effect of perceived COVID-19 crisis strength on their perceived risk of being infected. At the same time, they also buffer the indirect impact of individuals' perceived COVID-19 crisis strength on life satisfaction and sleep quality through perceived risk of being infected. This research provides several practical implications for governments and individuals to mitigate the negative influences of the COVID-19 pandemic and help individuals boost life satisfaction and sleep quality.

Corrigendum: Total flavonoids of Rhizoma Drynariae ameliorate bone growth in experimentally induced tibial dyschondroplasia in chickens via regulation of OPG/RANKL axis.

[This corrects the article DOI: 10.3389/fphar.2022.881057.].

How to Realize Business Model Innovation for New Ventures? Psychological Capital and Social Capital Perspective.

Business model innovation has become a necessary means for enterprises to break through path constraints, achieve sustainable development, and obtain sustainable competitiveness, which has been paid more and more attention by entrepreneurs and scholars. Based on the resource conversation theory and signal theory, this study constructs a research model with psychological capital (PC) and social capital (SC) as independent variables and business model innovation as dependent variables along the logical path of "resource acquisition-resource utilization." By dividing business model innovation into pioneering business model innovation and perfect business model innovation, we use fuzzy-set qualitative comparative analysis (fsQCA) to explore the impact of dual capital on business model innovation of new ventures. This study takes entrepreneurs from the eastern part of China's seven entrepreneurship active provinces as investigation objects, based on the analysis of the collected 242 valid questionnaire results, emphasizing that any single antecedent can not be a sufficient and necessary condition for pioneering and perfect business model innovation. In this case, we carried out research with a certain antecedent variable as the core and supplemented with other antecedent variables to form seven different configurations. The results showed that the combination of the antecedent variables could effectively achieve the pioneering and perfect business model innovation. The theoretical contributions of this study are as follows: (1) it enriches the research on the antecedents of business model innovation in new ventures; (2) it expands the application scenarios of resource conversation theory and signal theory; and (3) it is emphasized that the innovation of business model of new ventures is the result of the interaction and value-added linkage of various internal and external resources.

Construction of Low-Carbon Ferry-A Case of Jingning, China.

As the Chinese government has pledged to reach its carbon peak by 2030 and carbon neutrality by 2060, it is necessary to investigate how regional sustainable development can be achieved. This paper used a 'bottom-up' model to calculate the ferry carbon emissions in Jingning, China, and proposed four measures to reduce carbon emissions, including renewing ferryboats, planting water-level-fluctuating zones, greening the ferries, and installing solar energy. Quantitative analyses were conducted to calculate the possible emissions reduction from 2021 to 2025, with the results indicating that the total emissions could be reduced by 392.67 t. Finally, a new low-carbon ferry concept is proposed, based on simultaneous carbon emission reduction and carbon sink enhancement. This study provided a theoretical and decision-making reference for the operation of green, beautiful, and low-carbon ferries.

Total Flavonoids of Rhizoma Drynariae Ameliorate Bone Growth in Experimentally Induced Tibial Dyschondroplasia in Chickens via Regulation of OPG/RANKL Axis.

Background: Rhizoma Drynariae, traditional Chinese herb, is widely used to treat and prevent bone disorders. However, experimental evidence on the use of Rhizoma Drynariae extract, total flavonoids of Rhizoma Drynariae (TFRD) to treat tibial dyschondroplasia (TD) in chickens and its underlying mechanisms have not been investigated. Purpose: To evaluate the therapeutic effect of TFRD on leg disease caused by TD and elucidate its mechanisms in modulating the bone status. Methods: Thiram-induced chicken TD model has been established. The tibia status was evaluated by analyzing tibia-related parameters including tibial weight, tibial length and its growth plate width and by performing histopathological examination. The expression of tibial bone development-related genes and proteins was confirmed by western blotting and qRT-PCR. Results: The results showed that administration of TFRD mitigated lameness, increased body weight, recuperated growth plate width in broilers affected by TD and the increase of tibia weight and tibia length is significantly positively correlated with body weight. Compared with the TD group broilers, 500 mg/kg TFRD evidently reduced the damage width of the growth plate and improved its blood vessel distribution by elevating the gene expression levels of BMP-2 and Runx2 and OPG/RANKL ratio. Furthermore, correlation analysis found that the damage width of the growth plate was negatively correlated with the expression levels of BMP-2 and OPG. Conclusion: The present study revealed that TFRD could promote the bone growth via upregulating OPG/RANKL ratio, suggesting that TFRD might be a potential novel drug in the treatment of TD in chickens.

Integrated Fecal Microbiome and Metabolomics Reveals a Novel Potential Biomarker for Predicting Tibial Dyschondroplasia in Chickens.

Tibial dyschondroplasia (TD) is a metabolic tibial-tarsal disorder occurring in fast-growing poultry, and its diagnosis is mainly based on an invasive method. Here, we profiled the fecal gut microbiome and metabolome of broilers with and without TD to identify potential non-invasive and non-stress biomarkers of TD. First, TD broilers with the most pronounced clinical signs during the experiment were screened and faecal samples were collected for integrated microbiome and metabolomics analysis. Moreover, the diagnostic potential of identified biomarkers was further validated throughout the experiment. It was noted that the microbial and metabolic signatures of TD broilers differed from those of normal broilers. TD broilers were characterized by enriched bacterial OTUs of the genus Klebsiella, and depleted genera [Ruminococcus], Dorea, Ruminococcus, Oscillospira, Ochrobactrum, and Sediminibacterium. In addition, a total of 189 fecal differential metabolites were identified, mainly enriched in the purine, vitamin and amino acid metabolism, which were closely associated with differential microbiota and tibia-related indicators. Furthermore, three fecal metabolites were screened, including 4-hydroxybenzaldehyde, which distinguished TD from normal broilers with extremely high specificity and was superior to serum bone markers. These results indicated that gut microbiota equilibrium might influence the pathogenesis of TD by modulating host metabolism, and the identified fecal metabolite 4-hydroxybenzaldehyde might be a potential and non-invasive biomarker for predicting TD in chickens.

Aflatoxin B1 causes oxidative stress and apoptosis in sheep testes associated with disrupting rumen microbiota.

Aflatoxin B1 (AFB1) is an unavoidable environmental pollutant commonly found in feed and foodstuffs. It is the most toxic one of all the aflatoxins, which can cause severe impairment to testicular development and function. Yet, the underlying mechanisms of reproductive toxicity in rams sheep remain inconclusive. The study was designed to explore the effects of AFB1 on sheep testes through rumen-microbiota, oxidative stress and apoptosis. Six-month-old male Dorper rams (n = 6) were orally administrated with 1.0 mg/kg AFB1 (dissolved in 20 mL 4% ethanol) 24 h before the experiment. At the same time, rams in the control group (n = 6) were intragastrically administrated with 20 mL 4% ethanol. It was observed that acute AFB1 poisoning had significant (p < 0.05) toxin residue in the testis and could cause testicular histopathological damage. AFB1 stimulated the secretion of plasma testosterone level through regulating testosterone synthesis-related genes (StAR, 3ß-HSD, CYP11A1, and CYP17A1), which are accompanied by the increase of oxidative stress and testicular apoptosis that had a close relationship with the regulation of testosterone secretion. Interestingly, we observed rumen dysbacteriosis and decreased the abundances of Prevotella, Succiniclasticum, CF231, Ruminococcus, and Pseudobutyrivibrio in AFB1-exposed sheep, which were negatively correlated to the testosterone synthesis-related gene levels. Taken together, our findings indicated that AFB1 induced testicular damage and testicular dysfunction, which is related to testicular oxidative stress and apoptosis involved in rumen dysbacteriosis in sheep.

Total flavonoids of Rhizoma Drynariae protect hepatocytes against aflatoxin B1-induced oxidative stress and apoptosis in broiler chickens.

Aflatoxin B1 (AFB1) is a common mycotoxin in food and in the environment that lead to multi-organ injury in humans and animals. The objective of this study was to evaluate the detoxification properties of dietary total flavonoids of Rhizoma drynariae (TFRD), a Chinese herbal, on aflatoxin B1 (AFB1)-induced hepatic oxidative damage and apoptosis of liver of broiler chickens. A total of 160 healthy specific pathogen free (SPF) 21-day-old broilers were randomly allocated to 4 groups, including the CON group (basal diet), TFRD group (basal diet with 125 mg/kg TFRD), AFB1 group (100 µg/kg body weight), and AFB1 (100 µg/kg body weight) + TFRD (basal diet with 125 mg/kg TFRD) group. The exposure of AFB1 continued for seven days. The results showed that TFRD treatment alleviated the abnormal changes of growth performance and liver morphology, reduced serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Moreover, TFRD promoted the antioxidant capacity of serum, increased the activities of total superoxide dismutase (T-SOD), oxidized glutathione (GSSG) and glutathione (GSH) (p < 0.05), while decreased MDA contents (p > 0.05). Meanwhile, supplementation of TFRD significantly increased the expression of antioxidant-related genes (SOD, CAT, GST, and GPX1) in liver (p < 0.05). Furthermore, we found that AFB1 was involved in the regulation of PI3K/AKT signaling pathway, leading to hepatocyte apoptosis. At the same time, TFRD treatment inhibited AFB1-induced apoptosis and significantly changed mRNA expression of apoptosis-related genes, including PI3K, AKT, Bax, and Bcl-2 (p < 0.05). The results indicated that TFRD could alleviate AFB1-induced liver injury in broiler chickens.

Investigations on Fatigue Life of Tube Connections Based on International Codes of Pressure Vessel.

The fatigue assessment of tube connections under cyclic pressure is discussed using four kinds of methods from ASME VIII-2 and EN 13445-3. FEA results are compared to the fatigue test, and some conclusions are obtained. Method 1 is the most widely used traditional method and can be used in both welded structures and unwelded structures. This method has simple operation, safety and reliability. Method 2 adopts the effective strain range to assess the fatigue for both the welded and the unwelded structure. This method is with high accuracy, good stability, safety and reliability, but the elastic-plastic analysis is very complicated. Method 3 adopts the equivalent structure stress to assess the fatigue of the welded, it is developed from fracture mechanics, and the procedure is also very complicated. Method 4 is a detailed assessment procedure for the welded and unwelded, and it is the most accurate, stable and reliable among the four methods.

Comparison of intravenous and oral administration of acetaminophen in adults undergoing general anesthesia.

BACKGROUND: Acetaminophen is a widely clinically used analgesic. However, the clinical effect of the route of administration on postoperative analgesia as well as on postoperative nausea and vomiting in patients undergoing general anesthesia remains unclear. This study aimed to explore whether the route of administration of acetaminophen affects postoperative analgesia, nausea, and vomiting in patients undergoing general anesthesia. METHODS: We included all randomized controlled trials investigating the effects of the route of administration of acetaminophen on postoperative pain, nausea, and vomiting in patients undergoing general anesthesia. Independent examiners reviewed the literature and extracted data, with disagreements resolved through negotiation or the involvement of a third party. The Cochrane risk assessment tool was used to evaluate the quality of the included randomized controlled trials. A narrative synthesis was conducted to summarize the qualitative information from the included studies. A meta-integration of quantitative data was performed using RevMan 5.4. RESULTS: Ten studies met the inclusion criteria. Eight studies assessed postoperative pain, whereas two assessed postoperative nausea and vomiting. Data from the eight studies assessing postoperative pain confirmed that there was no difference between intravenously and orally administered acetaminophen in adults (OR = -0.13; 95% CI, -0.36 to 0.11; p = 0.3). Data from the two studies assessing postoperative nausea and vomiting revealed no difference between intravenously and orally administered acetaminophen in adults (OR = 0.89; 95% CI, 0.64-1.25; p = 0.51). The included studies were of poor quality, with a heterogeneity of 68%. CONCLUSIONS: No differences in postoperative analgesia or postoperative nausea and vomiting were observed between the routes of administration (intravenous vs. oral) of acetaminophen in adult patients undergoing general anesthesia. There is a need for future large sample studies to increase the reliability of the results.

Probiotics Treatment of Leg Diseases in Broiler Chickens: a Review.

Normal development and growth of bones are critical for poultry. With the rapid growth experienced by broiler chickens, higher incidences of leg weakness and lameness are common problems in adolescent meat-type poultry that present huge economic and welfare issues. Leg disorders such as angular bone deformities and tibial dyschondroplasia have become common in broilers and are associated with poor growth, high mortality rates, increased carcass condemnation, and downgrading at slaughter. Probiotics have shown promise for a variety of health purposes, including preventing diarrhea, elevating carcass quality, and promoting growth of the poultry. In addition, recent studies have indicated that probiotics can maintain the homeostasis of the gut microbiota and improve the health of the gastrointestinal tract, which confers a potentially beneficial effect on bone health. This review mainly describes the occurrence of broiler leg disease and the role of probiotics in bone health through regulating the gut microbiota and improving intestinal function, thus providing a relevant theoretical basis for probiotics to hinder the development of skeletal disorders in broiler chickens.

Aflatoxin B1 alters meat quality associated with oxidative stress, inflammation, and gut-microbiota in sheep.

Aflatoxin B1 (AFB1) is an unavoidable contaminant in animal feed and agricultural products. AFB1 has been found to impair the liver and kidney function of sheep. However, few data are available, which explain the toxic damage of AFB1 exposure on meat quality. In the study, male Dorper RAMS sheep (6-month-old) were orally administrated with AFB1 at the dose of 1 mg/kg body weight once. The body temperature, serum biochemistry, meat quality-related parameters, oxidation indicators in meat and serum, the mRNA expression of pro-inflammatory cytokines and anti-inflammatory, and microbiota composition of feces were measured 24 h after AFB1 exposure. The results showed that the body temperature was slightly increased, the mental state of mutton sheep was suppressed, and biochemical indicators were significantly changed after AFB1 exposure. AFB1 impaired mutton quality reflected by the structure of muscle fibers was changed, and increased muscle drip loss and lightness (L*), and decreased muscle redness (a*). Moreover, we found that AFB1 caused changes in the oxidative stress indicators T-SOD, T-AOC, MDA, GSH level, and GSH/GSSG ratio, and inflammation damage of mutton reflected by increasing pro-inflammatory TNF-α and reducing anti-inflammatory IL-10 mRNA levels, disrupts the secretion of inflammatory factors, and changed the composition of gut microbiota reflected by significantly increased Firmicutes/Bacteroidetes ratio and decreased the abundances of Butyrivibrio, which are related to the quality of the mutton. In summary, gut microbiota participates in AFB1 to damage mutton quality, which may be co-mediated by oxidative stress, inflammation, and gut microbiota.

Risk factors of role stress and professional burnout among nurse anesthetists: A multicenter cross-sectional study.

BACKGROUND: In China, there is no unified standard for the responsibilities and authority of nurse anesthetists, resulting in different professional expectations from anesthesiologists and nursing managers, which may result in high levels of role stress and burnout in nurse anesthetists. Additional factors such as high occupational risk and heavy work may also contribute to role stress and burnout. METHODS: In this multicenter cross-sectional study, an online questionnaire survey was conducted among 198 nurses from six tertiary hospitals in Shandong Province. The t test, analysis of variance, linear regression, and logistic regression were used to analyze the risk factors for role stress and professional burnout. RESULTS: The scores of role conflict and role ambiguity in role stress were 30.61 ± 9.53 and 31.89 ± 9.56, respectively; satisfaction with income and the working environment, the hospital's attention, years of experience as a nurse, clarity concerning the nurse anesthetist's occupational scope, and attitude to career prospects were independent risk factors for role stress. The burnout data were non-normally distributed and were expressed as medians and quartiles. The scores of emotional exhaustion, depersonalization, and personal achievement in professional burnout were 30 (26-34), 11 (8-14), and 23 (20-26) respectively. The number of working hours per week, attitude to career prospects, satisfaction with the working environment and income, physical health, gender, and education were independent risk factors for burnout. CONCLUSIONS: Chinese nurse anesthetists were found to be in danger of high role stress and professional burnout, a situation requiring the attention of managers.

Investigating the Influence of the Shared Decision-Making Perception on the Patient Adherence of the Home- and Exercise-Based Cardiac Rehabilitation After Percutaneous Coronary Intervention.

BACKGROUND: In 2016, the Global Burden of Disease study pointed out that cardiovascular disease (CVDs) were the most common causes of death and accounted for the largest disease burden worldwide. Percutaneous coronary intervention (PCI) is one of the main treatments for coronary artery disease (CAD). Moreover, home- and exercise-based cardiac rehabilitation (CR) is of great importance for improving the prognosis of patients undergoing PCI. However, poor adherence to CR remains a challenging problem in these patients. AIM: This study aimed to investigate the current status of adherence to home- and exercise-based CR in patients undergoing PCI and to explore the factors affecting patient adherence to home- and exercise-based CR. METHODS: This study was a prospective longitudinal survey that included 300 patients who met the established criteria. The selected patients completed a pre-hospital discharge questionnaire, which targeted factors that may affect patient adherence to home- and exercise-based CR. All patients were followed up 1 month after the discharge from hospitals. RESULTS: This study analyzed 283 questionnaires and found that only 64.66% of patients had good adherence to home- and exercise-based CR. Eight independent variables, namely, shared decision-making (SDM), age, dimension of risk factors, predisposing factors, treatment methods, secondary prevention in the Perceived Knowledge Scale for CAD, and dimension of life and emotional management in the Scale of Self-Management with Coronary Artery Disease, were identified as the main factors affecting patient adherence to home- and exercise-based CR, which explains 88.9% variation (Nagel kerke R2 = 0.889). CONCLUSION: Patients who underwent PCI had poor adherence to home- and exercise-based CR. Age, SDM, knowledge about CAD, and self-management behavior were identified as independent factors affecting patient adherence to CR after PCI.

Lactobacillus rhamnosus JYLR-005 Prevents Thiram-Induced Tibial Dyschondroplasia by Enhancing Bone-Related Growth Performance in Chickens.

Tibial dyschondroplasia (TD) is a leg disorder caused by the abnormal development of the tibia in fast-growing poultry. Lactobacillus rhamnosus (L. rhamnosus) strains have been reported to have effects on increasing bone growth and improving osteoporosis in animals. However, whether L. rhamnosus JYLR-005 can improve bone growth in TD chickens remains unclear. In this study, we noted that L. rhamnosus JYLR-005 could not reduce the suppression of the production performance of TD broilers (p > 0.05) but had a slight protective effect on the broiler survival rate (χ2 = 5.571, p = 0.062). However, for thiram-induced TD broiler chickens, L. rhamnosus JYLR-005 could promote tibia growth by increasing tibia-related parameters, including the tibia weight (day 11, p = 0.040), tibia length (day 15, p = 0.013), and tibia mean diameter (day 15, p = 0.035). Moreover, L. rhamnosus JYLR-005 supplementation improved the normal growth and development of the tibial growth plate by maintaining the morphological structure of the chondrocytes and restored the balance of calcium and phosphorus. Taken together, these findings provide a proof of principle that L. rhamnosus JYLR-005 may represent a therapeutic strategy to treat leg disease in chickens.