National norms for the obstetric nurses' and midwives' health education competence, and its influencing factors: a nationwide cross-sectional study.

BACKGROUND: Strengthening obstetric nurses' and midwives' health education competence is the investment and guarantee for the population's future health. The purpose of study is to establish national norms for their health education competence, and explore possible influencing factors for providing an uniform criterion identifying levels and weaknesses. METHODS: An online questionnaire with a standard process was used to collect data. Three normative models were constructed, and multiple linear regression analysis analyzed possible influencing factors. RESULTS: The sample respondents (n = 3027) represented obstetric nurses and midwives nationally. Three health education competency normative norms (mean, percentile and demarcation norm) were constructed separately. Locations, hospital grade, department, marital status, training times and satisfaction with health education training influenced obstetrical nurses' and midwives' health education competence (P<0.05). CONCLUSION: This study constructed the first national standard for assessing obstetric nurses' and midwives' health education competence, providing a scientific reference to evaluate the degree of health education competence directly. These known factors could help clinical and policy managers designate practice improvement measures. In future research, Grade I hospitals should be studied with larger sample sizes, and indicators need to improve to reflect health education's effect better.

The mothers' breastfeeding behaviour within six weeks postpartum: new scale development and psychometric validation study.

BACKGROUND: The evaluation of mothers' breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers' breastfeeding behaviour scale within 6 weeks postpartum. METHODS: A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers. RESULTS: The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ2/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively. CONCLUSION: The newly developed mothers' breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.

Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months.

We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.

From concept to reality: computing visual vortex beam interferometer for displacement measurement.

In addition to the concept of picometer resolution, we discuss macro displacement measurement with a vortex beam interferometer. Three factors limiting large displacement measurement are resolved. Small topological charge numbers promise both high sensitivity and large displacement measurements. With a computing visual method, a virtual moiré pointer image immune to beam misalignment is proposed to calculate displacements. Interestingly, the absolute benchmark is found for cycle counting in the moiré pointer image of fractional topological charge. The vortex beam interferometer would not stop at the tiny displacement measurement in simulations. We report experimental measurements of nanoscale to hundred millimeter displacement in a vortex beam displacement measurement interferometer (DMI) for the first time, to the best of our knowledge.

Multifunctional Zinc Oxide Promotes Electrochemiluminescence of Porphyrin Aggregates for Ultrasensitive Detection of Copper Ion.

The design and exploration of highly efficient organic luminophores for an electrochemiluminescence (ECL) sensor is a fascinating and promising subject. Herein, we present a surfactant-assisted self-assembly of 5,10,15,20-tetrakis (4-carboxyphenyl) porphyrin (TCPP) J-aggregate as a robust organic luminophore to construct the solid-state ECL sensing platform with significantly enhanced and constantly stable signals, by using peroxydisulfate (S2O82-) as the coreactant, and l-cysteine capped zinc oxide nanoflowers (ZnO@Cys NFs) as the multifunctional energy donor and coreactant accelerator. Compared with TCPP monomer, this TCPP J-aggregate possesses a unique aggregation-induced electrochemiluminescence (AIECL) performance, which results in 5-fold enhancement in red-light ECL emission at 675 nm. The resonance energy transfer from the ZnO@Cys NFs (energy donor) to the TCPP J-aggregate (energy acceptor) substantially improves the ECL intensity and stability. ZnO@Cys NFs have also been used as a coreactant accelerator to promote the conversion of more S2O82- into SO4•-. The corresponding ECL mechanism has been investigated by UV-vis absorption spectrum, photoluminescence, ECL, and density functional theory. Since l-cysteine on ZnO@Cys NFs can efficiently realize bidentate chelation with Cu2+, the proposed ECL sensor shows a highly selective and sensitive quenching effect for the detection of Cu2+ with a wide linear range from 1.0 pmol·L-1 to 500 nmol·L-1 and a detection limit of 0.33 pmol·L-1, paving a bright research direction for the development of TCPP aggregates in ECL field.

Nitrogen-doped graphene quantum dots coated with gold nanoparticles for electrochemiluminescent glucose detection using enzymatically generated hydrogen peroxide as a quencher.

Nitrogen-doped graphene quantum dots (N-GQDs) were prepared from dicyandiamide and then used as both an electrochemiluminescence (ECL) emitter and a reductant to produce gold nanoparticles (Au-N-GQDs) on their surface without using any reagent. In order to avoid resonance energy transfer, the Au-N-GQDs were stabilized with chitosan. Transmission electron microscopy (TEM), energy dispersive X-ray spectroscopy (EDX), UV-vis spectroscopy (UV-vis) and ECL methods were used to characterize the nanocomposite. The materials was placed on a glassy carbon electrode (GCE), and the ECL signals are found to be strongly quenched by hydrogen peroxide that is enzymatically produced by oxidation of glucose. With the applied typical potential of -1.7 V, the ECL of the Au-N-GQDs modified GCE decreases linearly in the 10 nM to 5.0 µM glucose concentration range, and the lower detection limit is 3.3 nM. The influence of H2O2 to the signal has been discussed and a possible mechanism has been presented. Graphical abstract Schematic presentation of the reduction of gold nanoparticles with nitrogen-droped graphene quantum dots (N-GQDs) to form Au-N-GQDs. They were used to detect glucose by electrochemiluminescence through a signal off strategy.

Simultaneous determination of 35 ultra-trace level organophosphorus pesticide residues in Sanjie Zhentong capsules of traditional Chinese medicine using ultra high performance liquid chromatography with tandem mass spectrometry.

The aim of this study was to develop an analytical method for the simultaneous determination of ultra-trace levels of 35 organophosphorus pesticide residues in Sanjie Zhentong capsules, a traditional Chinese medicine prescription. A method based on multiclass and multiresidue sample preparation was developed. First, samples were hydrated with water at 4°C. A ratio of 1:3 sample/water was used for each of the sample amounts. Then, different extraction solvents were screened. This step was followed by a dispersive solid-phase extraction clean-up procedure using both primary secondary amine and polyamide. A comprehensive sensitive multiresidue liquid chromatography tandem mass spectrometry method was investigated and validated. Good linearity was achieved in the range of 10-500 µg/kg for each analyte. The average recovery ranged from 70 to 120%, except for methamidophos, fonophos, diazinon, and chlorpyriphos-ethyl, the recoveries of which ranged from 60-70% at the lower concentration level. The precision values were lower than 10% for all the compounds in three concentration levels. The limits of detection and limits of quantification values were 0.01-2.1 and 0.05-3.4 µg/kg, respectively. The matrix effects were determined, and most of the compounds showed signal suppression. Finally, this optimized procedure was applied for the analysis of real samples.

[Quality analysis of Guizhi Fuling capsule before and after application of in-process quality control in pharmaceutical production].

The effects of application of in-process quality control in Guizhi Fuling capsule production were evaluated by 192 batches data analysis. Using a statistical analysis method, each batch of data were to be counted to research for the difference between 96 samples adopting the technologies of in-process control or not. According to quality standards of Guizhi Fuling capsule, all measurements of the 192 batches of the drugs before and after the application of process control technology were analyzed, and they were within the rules. There was a significant difference between adopting the technologies of process control or not. Application of in-process control technology can improve the uniformity of lot-to-lot for Guizhi Fuling capsule.

Which mothers' breastfeeding behaviours within six weeks postpartum do health workers need to notice? Developing an indicator system based on the Delphi method and analytic hierarchy process.

OBJECTIVE: The six weeks postpartum is the high-incidence period of stopping breastfeeding. The clarity of the internal mechanism of behaviour was an effective way to promote breastfeeding. The aim was to reach a consensus on indicators what should be used and prioritised in evaluating mothers' breastfeeding behaviour within six weeks postpartum in order to provide a theoretical reference for health workers to take targeted strategies toward promoting breastfeeding practices. DESIGN: Two rounds of Delphi method and analytic hierarchy process was conducted in this study. The two-rounds Delphi was performed to select essential indicators and collect revised suggestion. The analytic hierarchy process was adopted for pairwise comparison to rank the significance of primary and secondary indicators. SETTING AND PARTICIPANTS: The panel included twenty experts with rich breastfeeding information and different general characteristics from China. FINDINGS: Consensus was achieved to include three primary indicators, seven secondary indicators, and forty-five tertiary indicators in the final indicators system of the mothers' breastfeeding behaviour within six weeks postpartum. The weight sequence of primary indicators was self-regulation behaviour (0.401), at-the-breast feeding behaviour (0.383), and resource utilisation behaviour (0.216). The rank of the secondary indicators was breastfeeding operation skills (0.267), self-decision behaviour (0.144), self-control behaviour (0.130), self-coping behaviour (0.127), breastfeeding self-perception (0.116), resource acquisition behaviour (0.115), and resource coordination behaviour (0.101). KEY CONCLUSION: The study builds a new and reliable indicators system that intuitively reflects the constituent elements of the mothers' breastfeeding behaviour within six weeks postpartum and provides priorities in primary indicators and secondary indicators. IMPLICATIONS FOR PRACTICES: The study helps form a clear and scientific cognition on mothers' breastfeeding behaviour within six weeks postpartum and provides a new perspective and intuitive theoretical reference for health workers to take targeted measures to promote breastfeeding practices and achieve substantial public health gains.

Prepregnancy body mass index and gestational weight gain are associated with maternal and infant adverse outcomes in Chinese women with gestational diabetes.

The gestational weight gain (GWG) range of Chinese women with gestational diabetes mellitus (GDM) remains unclear. Our objective was to identify the ranges of GWG in Chinese women with GDM and to investigate the associations between prepregnancy body mass index (BMI), GWG and maternal-infant adverse outcomes. Cases of GDM women who delivered singletons from 2013 to 2018 in a public hospital were collected. Logistic regression analysis was used to assess the joint effects of prepregnancy BMI and GWG on maternal-infant adverse outcomes. Ultimately, 14,578 women were collected. The ranges of GWG in Chinese women with GDM were different from the National Academy of Medicine's (NAM) recommendation. The ranges of GWG of Chinese women with GDM in the underweight, normal weight, overweight and obese groups were 5.95-21.95 kg, 4.23-21.83 kg, 0.88-21.12 kg and - 1.76 to 19.95 kg, respectively. The risks of large for gestational age (LGA), macrosomia and caesarean delivery were significantly increased with the increasing prepregnancy BMI. Furthermore, the risks of LGA, macrosomia and caesarean delivery were significantly higher in the normal weight group with a GWG higher than the NAM recommendation. Similarly, in the overweight group with a GWG higher than the NAM recommendation, the risks of LGA were significantly higher, while the risks of macrosomia were significantly lower. Overall, we determined the range of GWG in different prepregnancy BMI groups. And GDM women with high prepregnancy BMI and excessive GWG were associated with the higher risks of maternal-infants adverse outcomes in China.

Gestational Diabetes Mellitus and Risk of Delayed Onset of Lactogenesis: A Systematic Review and Meta-Analysis.

Background: Gestational diabetes mellitus (GDM) may be associated with delayed onset of lactogenesis (DOL), but it is still inconclusive. Objectives: The study aimed to evaluate the association between GDM and DOL, the prevalence and risk factors of DOL in GDM women. Materials and Methods: A comprehensive search was performed in 10 electronic databases from inception to June 1, 2020. To find more eligible studies, the references of finally eligible studies and relevant reviews were traced manually. A meta-analysis was conducted to calculate the pooled estimates of association, prevalence, and risk factors using random- or fixed-effects models. Results: Eleven eligible articles involving 8,150 women were included in this study. GDM women had a higher risk of DOL (odds ratio [OR] = 1.84, 95% confidence interval [CI] [1.34-2.52]). The prevalence of delayed lactogenesis onset in GDM women was 35.0% (effect size [ES] = 0.35, 95% CI [0.30-0.40]). Primipara (OR = 2.54, 95% CI [1.89-3.42]), advanced age (OR = 1.05, 95% CI [1.03-1.08]), prepregnancy obesity (OR = 1.55, 95% CI [1.19-2.03]), and insulin treatment (OR = 3.07, 95% CI [1.71-5.47]) were risk factors of delayed lactogenesis onset in GDM women. Conclusion: GDM negatively affects the timing of lactogenesis onset. The prevalence of delayed lactogenesis onset in GDM women is 35.0%. Primipara, advanced age, prepregnancy obesity, and insulin treatment are independent risk factors of delayed lactogenesis onset in GDM women.

Probiotic Supplements Improve Blood Glucose and Insulin Resistance/Sensitivity among Healthy and GDM Pregnant Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Probiotic supplements may be seen as a promising way to improve glucose metabolism. This study aimed to evaluate the effects of probiotic supplements on blood glucose, insulin resistance/sensitivity, and prevention of gestational diabetes mellitus (GDM) among pregnant women. METHODS: Eleven electronic databases were searched from inception to May 2020. Two authors independently identified randomized controlled trials (RCTs), assessed the eligibility and quality of the included studies, and then extracted data. The primary outcomes were fasting plasma glucose (FPG), 1 h and 2 h plasma glucose after 75 g oral glucose tolerance test (OGTT), HbA1c, fasting plasma insulin, insulin resistance, and insulin sensitivity. Fixed and random effect models were used to pool the results. RESULTS: A total of 20 RCTs involving 2972 participants were included according to the inclusion and exclusion criteria. The pooled results of this research showed that probiotic supplements could reduce the level of FPG (mean difference (MD) = -0.11; 95% CI = -0.15 to -0.04; P=0.0007), serum insulin (MD = -1.68; 95% CI = -2.44 to -0.92; P < 0.00001), insulin resistance (MD = -0.36; 95% CI = -0.53 to -0.20; P < 0.00001), and insulin sensitivity (MD = -21.80; 95% CI = -31.92 to -11.67; P < 0.00001). Regarding the subgroup analysis of different pregnant women, the effects of probiotics on FPG, insulin, and insulin resistance were more obvious among GDM and healthy women than among overweight/obese women. Furthermore, the differences were not significant in HbA1c (MD = -0.05; 95% CI = -0.12 to 0.03; P=0.23), 1 h OGTT (MD = -0.07; 95% CI = -0.25 to 0.10; P=0.42), and 2 h OGTT (MD = -0.03; 95% CI = -0.17 to 0.12; P=0.72). CONCLUSION: This review found that probiotic supplements had certain functions to reduce the level of FPG and improve insulin, insulin resistance, and insulin sensitivity, especially for GDM and healthy pregnant women.

A three-dimensional DNA nanomachine with target recycling amplification technology and multiple electrochemiluminescence resonance energy transfer for sensitive microRNA-141 detection.

An electrochemiluminescence (ECL) three-dimensional (3D) DNA nanomachine is developed for microRNA-141 (miRNA-141) detection by coupling Pb2+ dependent DNAzyme assisted target recycling amplification technology with multiple ECL resonance energy transfer (ECL-RET) system. Firstly, Pb2+ dependent DNAzyme is formed by three single strand DNA (ssDNA): A1, A2 and the target miRNA-141. In the presence of Pb2+, the specific recognition site of the DNAzyme is cleaved and a large number of secondary targets (A3) are released. Secondly, the 3D DNA nanomachine consists of four ssDNA: H1, H2, H3 and the probe (two ends are labeled with alexa fluor (AF) and a nanocomposite (PtNCs@Ru(dcbpy)32+) which is prepared by polyethyleneimine platinum nanoclusters and tris(4,4'-dicarboxylicacid-2,2'-bipyridyl) ruthenium(II) dichloride). Then, the 3D DNA nanomachine is assembled on the gold nanoparticles modified glassy carbon electrode. Afterwards, A3 is employed to hybridize with the probe, triggering the movement of the nanomachine and forming the multiple ECL-RET system. In this system, AF, serves as an effective energy transfer donor, which can transfer energy to PtNCs and Ru(dcbpy)32+directly. Meanwhile, PtNCs, both as the acceptor and donor, can accept energy from AF and transfer it to Ru(dcbpy)32+. As a result, The biosensor achieves enhanced ECL efficiency, which is 1.78 times that of the classic tris(2,2'-bipyridyl)ruthenium(II) dichloride (Ru(bpy)32+) and exhibits good responses to miRNA-141 in the linear range from 10 aM to 100 nM with a detection limit of 3.3 aM. Also, the obtained biosensor can be employed to detect miRNA-141 in human serum samples, which will be of great significance in bioanalysis.

Multi-functional electrochemiluminescence aptasensor based on resonance energy transfer between Au nanoparticles and lanthanum ion-doped cadmium sulfide quantum dots.

Novel lanthanum ion-doped cadmium sulfide quantum dots (CdS:La QDs) were synthesized and characterized by transmission electron microscopy (TEM) and photoluminescence (PL). Based on CdS:La QDs as the electrochemiluminescence (ECL) luminophores, a distance-dependent ECL intensity enhanced or quenched system between CdS:La QDs and gold nanoparticles (Au NPs) was designed. Firstly, ssDNA 1 was linked to the CdS:La QDs modified glassy carbon electrode via amide bond. Then the prepared Au NP-ssDNA 2 conjugates were used to hybridize with ssDNA 1, the surface plasmon resonances (SPR) of Au NPs enhanced ECL intensity (signal on) while Au NPs and CdS:La QDs were separated at a certain distance. Secondly, In the presence of Hg2+, the oligonucleotide conformation changed from linear chain to hairpin due to the thymine-Hg2+-thymine (T-Hg2+-T) base pairs. ECL quenching (signal off) achieved lie in resonance energy transfer (RET) between the CdS:La QDs and the proximal Au NPs at a close distance. Finally, after being incubated with TB, a strong and stable TB-aptamer complex was generated, which led to the release of Au NP-ssDNA 2 conjugates. The ECL signal of the CdS:La QDs was ultimately recovered (signal on again). The "on-off-on" approach was used to detect Hg2+ and TB, sensitively and respectively. The line ranges were 1.00 × 10-12 -1.00 × 10-5 mol L-1 and 1.00 × 10-16 -1.00 × 10-6 mol L-1, respectively. The low limits of detection (S/N = 3) were at 3.00 × 10-13 mol L-1 and 3.00 × 10-17 mol L-1. Moreover, the ECL sensor exhibited high selectivity and good stability, and was successfully applied to the detection of TB in real sample.

A widened emission window of the peroxydisulfate-oxygen system for the detection of L-alanine.

Peroxydisulfate-oxygen (S2O82--O2) system has become one of the most used systems in electrogenerated chemiluminscence (ECL) field. Due to S2O82- can be used as Fenton Reagent, this work designed an ECL biosensor based on the S2O82--O2 system for the detection of L-alanine in a widened emission window and using hemin/G-quadruplex and platinum and palladium nanowires (Pt-Pd NWs) to in situ generate O2 to amplify the ECL intensity. The proposed ECL sensor showed an excellent analytical property for the detection of L-alanine in a linear range of 5.0 × 10-3 M to 1.0 × 10-8 M with the detection limit of 3.3 × 10-9 M (S/N = 3). This work with high selectivity, stability and reproducibility may open a new door to apply S2O82- in ECL field.

[Micro-plasma radio frequency treatment for facial post-burn hyperpigmentation].

OBJECTIVE: To observe the clinical effect of micro-plasma radio frequency treatment of facial post-burn hyperpigmentation. METHODS: From June 2012 to August 2013, a total of 25 cases with facial post-burn hyperpigmentation were treated with micro-plasma treatment for 3-5 times. The roller tip was used with setting of 60-90 watts and 3-4 passes were performed in different directions. Treatments were repeated at an interval of 8 weeks. RESULTS: All patients tolerated the pain. After treatment, the facial hyperpigmentation improved. Complete recovery was achieved in 4 cases; significant improvement in 11 cases; moderate in 7 cases and no effect in 3 cases. No hyperpigmentation, depigmentation and scar formation was observed. CONCLUSION: Micro-plasma radio frequency treatment is an ideal treatment for post-burn hyperpigmentation with lower side effect.