Stigmatized Stroke? A Qualitative Study of Perception of Stroke Among Community Residents With Hypertension.

Objectives: To understand the perception of stroke in the hypertensive population. Hypertension is the primary risk factor for stroke, and current approaches to stroke prevention are inadequate and often fragmented. Understanding the perception of stroke among individuals with hypertension is crucial for a targeted approach. However, empirical evidence on this perception is limited. Methods: A qualitative design involved thematic analysis of focus groups and interview data from urban China with hypertension. Audio recordings were transcribed and subjected to thematic analysis. Results: Three themes were identified. Hypertensive participants first identified stroke patients by their obvious physical disability, and then identified the disease as a negative thing. Finally, they wanted to stay away from stroke, but paradoxically, there is a contradictory approach to avoidance and prevention, such as being willing to prevent the disease or simply avoiding socializing with stroke patients. Conclusion: Hypertensive patients hold complex and diverse perceptions of stroke, including a certain stigma. Future public health education should prioritize improving media promotion and fostering interaction between patients with hypertension and stroke in the community.

Effect of interferon therapy on quality of life in patients with chronic hepatitis B.

Interferon therapy is the most effective treatment for achieving clinical cure in chronic hepatitis B (CHB) patients. However, the treatment outcomes of interferon therapy are uncertain, multiple side effects can occur during treatment, and the treatment is expensive. Although these characteristics may affect patients' quality of life, research examining this topic is limited. We used a cross-sectional design to examine 100 CHB patients receiving interferon, 100 receiving nucleoside/nucleotide analogues, and 87 receiving non-antiviral treatment. Characteristic information, the Hepatitis B Quality of Life Instrument, Connor Davidson Resilience Scale, and Work Productivity and Activity Impairment Questionnaire were used to collect information. We found that quality of life in the interferon treatment group was higher than that in the non-antiviral treatment and nucleoside/nucleotide analogue treatment groups (p < 0.05). The factors influencing quality of life were resilience, presenteeism, hair loss, and antiviral treatment (p < 0.05). Although interferon therapy has some potential side effects, the results suggested that it did not negatively affect quality of life. Overall, interferon therapy did not have a major impact on CHB patients' daily lives and work.

Oral magnesium prevents acetaminophen-induced acute liver injury by modulating microbial metabolism.

Acetaminophen overuse is a common cause of acute liver failure (ALF). During ALF, toxins are metabolized by enzymes such as CYP2E1 and transformed into reactive species, leading to oxidative damage and liver failure. Here, we found that oral magnesium (Mg) alleviated acetaminophen-induced ALF through metabolic changes in gut microbiota that inhibit CYP2E1. The gut microbiota from Mg-supplemented humans prevented acetaminophen-induced ALF in mice. Mg exposure modulated Bifidobacterium metabolism and enriched indole-3-carboxylic acid (I3C) levels. Formate C-acetyltransferase (pflB) was identified as a key Bifidobacterium enzyme involved in I3C generation. Accordingly, a Bifidobacterium pflB knockout showed diminished I3C generation and reduced the beneficial effects of Mg. Conversely, treatment with I3C or an engineered bacteria overexpressing Bifidobacterium pflB protected against ALF. Mechanistically, I3C bound and inactivated CYP2E1, thus suppressing formation of harmful reactive intermediates and diminishing hepatocyte oxidative damage. These findings highlight how interactions between Mg and gut microbiota may help combat ALF.

Polymyxin B-targeted liposomal photosensitizer cures MDR A. baumannii burn infections and accelerates wound healing via M1/M2 macrophage polarization.

Multidrug-resistant (MDR) Acinetobacter baumannii infections pose a significant challenge in burn wound management, necessitating the development of innovative therapeutic strategies. In this work, we introduced a novel polymyxin B (PMB)-targeted liposomal photosensitizer, HMME@Lipo-PMB, for precise and potent antimicrobial photodynamic therapy (aPDT) against burn infections induced by MDR A. baumanni. HMME@Lipo-PMB-mediated aPDT exhibited enhanced antibacterial efficacy by specifically targeting and disrupting bacterial cell membranes, and generating increased intracellular ROS. Remarkably, even at low concentrations, this targeted approach significantly reduced bacterial viability in vitro and completely eradicated burn infections induced by MDR A. baumannii in vivo. Additionally, HMME@Lipo-PMB-mediated aPDT facilitated burn infection wound healing by modulating M1/M2 macrophage polarization. It also effectively promoted acute inflammation in the early stage, while attenuated chronic inflammation in the later stage of wound healing. This dynamic modulation promoted the formation of granulation tissue, angiogenesis, and collagen regeneration. These findings demonstrate the tremendous potential of HMME@Lipo-PMB-mediated aPDT as a promising alternative for the treatment of burn infections caused by MDR A. baumannii.

Loss of TP53 cooperates with c-MET overexpression to drive hepatocarcinogenesis.

Hepatocellular carcinoma (HCC) is a deadly malignancy with high genetic heterogeneity. TP53 mutation and c-MET activation are frequent events in human HCCs. Here, we discovered that the simultaneous mutations in TP53 and activation of c-MET occur in ~20% of human HCCs, and these patients show a poor prognosis. Importantly, we found that concomitant deletion of Trp53 and overexpression of c-MET (c-MET/sgp53) in the mouse liver led to HCC formation in vivo. Consistent with human HCCs, RNAseq showed that c-MET/sgp53 mouse HCCs were characterized by activated c-MET and Ras/MAPK cascades and increased tumor cell proliferation. Subsequently, a stably passaged cell line derived from a c-MET/sgp53 HCC and corresponding subcutaneous xenografts were generated. Also, in silico analysis suggested that the MEK inhibitor trametinib has a higher inhibition score in TP53 null human HCC cell lines, which was validated experimentally. We consistently found that trametinib effectively inhibited the growth of c-MET/sgp53 HCC cells and xenografts, supporting the possible usefulness of this drug for treating human HCCs with TP53-null mutations. Altogether, our study demonstrates that loss of TP53 cooperates with c-MET to drive hepatocarcinogenesis in vivo. The c-MET/sgp53 mouse model and derived HCC cell lines represent novel and useful preclinical tools to study hepatocarcinogenesis in the TP53 null background.

Development and psychometric evaluation of public stigma of stroke scale (PSSS).

Stroke patients suffer from public stigma because strokes cause visible disability and heavy social burden. However, existing tools measuring stroke-related stigma do not consider public stigma. The aim of this study was to develop and evaluate a public stigma of stroke scale (PSSS). This cross-sectional study recruited 730 participants, aged above 18 years, with no diagnosis of stroke before. Scale items were generated after reviewing relevant literature and conducting interviews. An expert panel evaluated the validity and reliability of a preliminary scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), bifactor CFA (B-CFA), Exploratory structural equation modelling (ESEM), bifactor-ESEM (B-ESEM) were performed to extract factors and evaluate fit on the factor structures. The Omega coefficient was 0.93, and the test-retest reliability coefficient was 0.721. The EFA extracted four factors: inherent ideology, aesthetic feelings, avoidance behaviour, and policy attitudes. These explained 61.57% of the total variance in the data. The four-factor model was confirmed by B-CFA, and met the fitness criteria. The PSSS yields satisfactory psychometric properties and can be used to assess stroke-related public stigma.

Psychometric Evaluation of the Disaster Preparedness Evaluation Tool© (DPET) on Emergency Nurses in Mainland China: Two Cross-Sectional Studies.

BACKGROUND: Emergency nurses play a major role in disaster relief in mainland China, but there is no valid instrument to measure the extent of their disaster preparedness. The Disaster Preparedness Evaluation Tool© is a reliable instrument to assess the disaster preparedness of nurse practitioners. The tool has been translated and validated in Saudi Arabia, Taiwan, China and the United States of America. OBJECTIVES: This study aimed at translating and adapting the Disaster Preparedness Evaluation Tool© (DPET) for emergency nurses in mainland China and determining its psychometric properties. DESIGN, SETTINGS AND PARTICIPANTS: A total of 2 cross-sectional online surveys were conducted in the emergency departments of 26 public grade III-A hospitals in Guangdong, mainland China. In the first study, 633 emergency nurses were recruited from May to August, 2018. In the second study, 205 were recruited in April 2019. METHODS: The instrument was adapted through rigorous forward-backward translation, face validity, and pre-test processes. Exploratory factor and parallel analyses were used in the first study. Confirmatory factor analysis, internal consistency and split-half reliability were used in the second study. RESULTS: Exploratory factor and parallel analyses extracted a 5-factor solution comprising of 34 items that accounted for 64.06% of the total variance. The fit indices indicated a good model fit. The reliability was good, as indicated by a Cronbach's alpha of 0.97 and a split-half reliability coefficient of 0.97. CONCLUSION: The mainland China version of the DPET (DPET-MC) was a reliable and valid instrument and can be used in practice.

Disaster Preparedness and Associated Factors Among Emergency Nurses in Guangdong Province, China: A Descriptive Cross-Sectional Study.

OBJECTIVE: The purpose of this study was to examine the prevalence of disaster preparedness and to explore associated factors among emergency nurses in Guangdong Province, China. METHODS: In this descriptive, cross-sectional study, the mainland China version of the Disaster Preparedness Evaluation Tool was used to collect data from 633 nurses working in 26 emergency departments, in August 2018. Descriptive analyses were used to examine the disaster preparedness, and multiple linear regression analysis was used to investigate associated factors. RESULTS: The perceived disaster preparedness of emergency nurses was at a moderate level. Among the 5 dimensions, the score for disaster management was lowest. Emergency nurses' disaster training (r = .26; P < 0.001) and drill experiences (r = .22; P < 0.001) were significantly correlated with disaster preparedness. Six significant factors associated with disaster preparedness were identified in this study: age, gender, disaster training experience, disaster drill experience, willingness, and educational level (R2 = .14; F = 18.20; P < 0.001). CONCLUSIONS: Hospitals and nurse managers should carry out interdisciplinary and multidisciplinary cooperation to improve emergency nurses' disaster preparedness, especially disaster management. Organizing disaster simulation exercises, providing psychological support and safety considerations, and formulating disaster nursing training programs may be beneficial for emergency nurses' disaster preparedness.