Construction of a nurses' interpersonal communication knowledge system: A Delphi study.

BACKGROUND: Effective communication is essential for nursing students to provide safe patient care. Many communication consensuses focus on physician-associated communication rather than nurses' interpersonal communication. However, studies on developing a systematic and comprehensive communication knowledge system for nursing students are scarce. OBJECTIVES: To explore the teaching content and teaching framework of nurses' interpersonal communication, construct a systematic and scientific knowledge system for interpersonal communication among nursing students and provide a theoretical basis for the training of nurses on interpersonal communication. METHODS: Based on the literature review and comparative research, this study explored the theoretical basis and basic principles of constructing an interpersonal communication knowledge system for nurses. Moreover, a correspondence questionnaire on nurses' interpersonal communication knowledge systems was initially constructed to clarify the related teaching content and structure. Finally, the Delphi method was used to establish the index of the nurses' interpersonal communication knowledge system according to the principle of expert selection and inclusion criteria. RESULTS: The Delphi method included 26 experts from nursing education, clinical nursing, nursing management and other fields for consultation. The effective response rate of the letter inquiry was 96.3 % in the first round and 100 % in the second round. The judgment basis, familiarity and authority coefficient of expert consultation were 0.907, 0.862 and 0.884, respectively. In the two rounds of inquiry, the coordination coefficients of the total questionnaire were 0.228 and 0.302, which was statistically significant (P < 0.001). Thereafter, a wheeled model of nurses' interpersonal communication knowledge system with 3 primary indicators, 13 secondary indicators and 58 tertiary indicators was constructed, which included professional ethics and attitude, communication knowledge and communication skills. CONCLUSION: Literature and comparative research methods along with Delphi expert consultation were used to construct a scientific and systematic knowledge system of nurses' interpersonal communication. The research methods were feasible, and the results were scientific and reliable, thereby providing a basis for the education of nurses' interpersonal communication among nurses and the compilation of related teaching materials in China and globally. Furthermore, special attention should be paid to the comprehensive cultivation of nursing students' professional ethics and attitude, communication knowledge and communication skills.

Basement Membrane Changes of Myofiber and Fibrosis in Sternocleidomastoid Muscle of Congenital Muscular Torticollis.

OBJECTIVE: To investigate the correlation between the features of basement membranes (BMs) of residual myofibers in the sternocleidomastoid muscle (SCM) and fibrosis of congenital muscular torticollis (CMT) in children, and to evaluate the relationship between BM changes and appearance of CMT. MATERIALS AND METHODS: We reviewed the CMT patients from 2017 to 2018 and performed pathological studies. Forty resected specimens were stained by hematoxylin and eosin and Masson collagen staining. Immunohistochemical staining of collagen IV and laminin was also performed. Five adductor muscle specimens from patients with developmental dysplasia of the hip were used as the control group. RESULTS: Hematoxylin and eosin staining revealed apparent interstitial fibrosis around residual myofibers in lesion specimens. However, the severity of fibrosis differed within the same samples. The average percent area of fibrous tissue in affected SCMs and controls were different significantly. Immunohistochemical staining of collagen IV and laminin showed these proteins were mostly expressed in the BM and vascular wall of affected SCM. However, BMs and myofibers from three different areas within the same SCM tissue exhibited significant differences in proteins expression. CONCLUSIONS: Therefore, the defective BMs are associated with myofiber and mesenchyme fibrosis in patients with CMT, which is crucial for understanding the histopathology of SCM.

Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing: A propensity score matching and paired study.

BACKGROUND: Endoscopy-related infections have caused multiple outbreaks. The importance of surveillance culture is gradually recognized, but sampling techniques are not consistent in many guidelines. It is unclear whether the Flush-Brush-Flush sampling method (FBFSM) is more sensitive than the conventional flush sampling method (CFSM) and whether different sampling brushes have different effects. METHODS: The propensity score matching method was done with two matching ways, 1:1 nearest neighbor propensity score matching and full matching was used to analyze the surveillance culture data collected by FBFSM and CFSM. We fit a confounder-adjusted multiple generalized linear logistic regression model to estimate the marginal odds ratio (OR). A paired study was applied to compare the sampling effect of polyurethane foam (PU) head brush and polyamide (PA) head brush. RESULT: From 2016 to 2020, 316 reprocessed endoscope samples were collected from all 59 endoscopy centers in Tianjin. About 279 (88.3%) reprocessed endoscopes met the threshold of Chinese national standards (<20 CFU/Channel). The qualified rate of reprocessed endoscopes sampling by CFSM (91.8%) and FBFSM (81.6%) was statistically different (p < 0.05). The adjusted OR by full matching for FBFSM was 7.98 (95% confidence interval: 3.35-21.78). Forty one pairs of colonoscopes, after reprocessing from 27 centers, were tested by PA and PU brushes, and no difference was found in microbial recovery. CONCLUSION: FBFSM was confirmed to be a more sensitive sampling technique. PU and PA brushes had no significant difference in sampling effect.

2D Heterostructure of Amorphous CoFeB Coating Black Phosphorus Nanosheets with Optimal Oxygen Intermediate Absorption for Improved Electrocatalytic Water Oxidation.

The oxygen evolution reaction (OER) plays a paramount role in a variety of electrochemical energy conversion devices, and the exploration of highly active, stable, and low-cost electrocatalysts is one of the most important topics in this field. The exfoliated black phosphorus (EBP) nanosheet with a two-dimensional (2D) layered structure has high carrier mobility but is limited by excessive oxygen-containing intermediate absorption and fast deterioration in air. We here report the fabrication of nanohybrids of amorphous CoFeB nanosheets on EBP nanosheets (EBP/CoFeB). The 2D/2D heterostructure, thanks to the electronic interactions and oxygen affinity difference between EBP and CoFeB nanosheets, is capable of balancing the oxygen-containing intermediate absorption to an optimal status for facilitating the OER process. While the crystalline EBP contributes to the improved conductivity, the amorphous coating protects EBP and thus ensures the catalytic stability. The EBP/CoFeB electrocatalyst shows excellent OER performance with an ultralow overpotential of 227 mV at 10 mA cm-2 with an ultrasmall Tafel slope of 36.7 mV dec-1 with excellent stability. This study may inspire more researches to develop heterostructured nanohybrid electrocatalysts for a diversity of electrochemical reactions.

In situ growth of Z-scheme CuS/CuSCN heterojunction to passivate surface defects and enhance charge transport.

Copper thiocyanate (CuSCN) has been considered as a promising hole transport material (HTMs), attributing to its inherent stability, low-cost, and suitable energy levels. To make it more attractive in practical applications, the drawbacks of CuSCN in poor charge transport and serious defect recombination are bottlenecks that need to be overcome. In this work, we propose an effective strategy of in-situ decorating CuSCN with copper sulfide quantum dots (CuS QDs), a simple one-step electrochemical deposition process, to solve these issues. Compared with the pristine CuSCN, the constructed Z-Scheme heterojunction of CuS QDs/CuSCN can significantly promote charge transport and restrict recombination. In addition, the decorated CuS QDs can not only passivate defects of CuSCN, but also provide more contacting sites to facilitate hole injection when employing as HTM. As a result, the average bulk charge lifetime was improved from 0.37 ms to 0.47 ms, and the surface recombination rate constant was suppressed. We believe that the excellent performances will pave it toward practical device applications, including solar cells, photocatalysis, photoelectrochemical sensors, and light-emitting diodes.

Road traffic injury mortality and morbidity by country development status, 2011-2017.

PURPOSE: This research examined road traffic injury mortality and morbidity disparities across of country development status, and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 - to halve the number of global deaths and injuries from road traffic accidents by 2020. METHODS: Data for road traffic mortality, morbidity, and socio-demographic index (SDI) were extracted by country from the estimates of the Global Burden of Disease study, and the implementation of the three types of national actions (legislation, prioritized vehicle safety standards, and trauma-related post-crash care service) were extracted from the Global Status Report on Road Safety by World Health Organization. We fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to 2017. RESULTS: Age-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017 (by 7.52%-16.08%). Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period, while age-adjusted morbidity generally increased as SDI increased. Subgroup analysis by road user yielded similar results, but with two major differences during the study period of 2011 to 2017: (1) pedestrians in the high SDI countries experienced the lowest mortality (1.68-1.90 per 100,000 population) and morbidity (110.45-112.72 per 100,000 population for incidence and 487.48-491.24 per 100,000 population for prevalence), and (2) motor vehicle occupants in the high SDI countries had the lowest mortality (4.07-4.50 per 100,000 population) but the highest morbidity (428.74-467.78 per 100,000 population for incidence and 1025.70-1116.60 per 100,000 population for prevalence). Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SDI countries. Lower income nations comprise the heaviest burden of global road traffic injuries and deaths. CONCLUSION: Global road traffic deaths would decrease substantially if the large mortality disparities across country development status were reduced through full implementation of proven national actions including legislation and law enforcement, prioritized vehicle safety standards and trauma-related post-crash care services.

The importance of sampling technique and rinse water for assessing flexible gastrointestinal endoscope reprocessing: A 3-year study covering 59 centers.

BACKGROUND: Various guidelines recommend several sampling techniques to verify endoscope reprocessing, but a comparative study of the efficiency for recovering microorganisms was rare. Our goal was to compare different sampling techniques for the postreprocessing endoscope to assess residual bacterial contamination and analysis of the critical factors affecting the endoscope reprocessing failure. METHODS: From 2016 to 2018, 3 techniques, the conventional flushing sampling method, flush-brush-flush sampling method (FBFSM), and pump-assisted sampling method (PASM), were compared covering all 59 endoscope units in Tianjin, China. RESULTS: A total of 237 (84.64%) flushing channel samples and 110 (61.11%) final rinse water samples met the Chinese national standard. The univariate analysis showed that the qualified rates of endoscope reprocessing sampled by PASM (65.52%) and FBFSM (75%) were significantly lower than those of the conventional flushing sampling method (91.38%). Five other factors, including the final rinse water, dry, and hospital level, were potential factors besides sample technique. The multivariate logistic analysis indicated only 2 factors (sampling technique and final rinse water) remained in the model. FBFSM, PASM, and the purified water were significantly associated with the odds of endoscope reprocessing failure, with the odds ratio (95% confidence interval) of which were 4.206 (1.757-10.067), 5.326 (2.463-11.645), and 0.309 (0.137-0.695), respectively. CONCLUSIONS: The problem of residual microorganisms of the postreprocessing endoscope was severe. Sampling technique and final rinse water were critical for endoscope reprocessing verification.

c-Jun regulates the promoter of small subunit hemocyanin gene of Litopenaeus vannamei.

Hemocyanin (HMC) is a respiratory glycoprotein, which also plays multifunctional non-specific innate immune defense functions in shrimp. However, the transcriptional regulatory mechanisms of the hemocyanin gene expression have not been reported. In the present study, we cloned a 4324 bp fragment of small subunit hemocyanin (HMCs) gene of Litopenaeus vannamei including the 5'-flanking region, from upstream 2475 bp to downstream 1849 bp (exon 1-intron 1-exon 2) by genome walking method. Four deletion constructs were then generated and their promoter activity assessed using the luciferase reporter system. Interestingly, we identified an alternative promoter (+1516/+1849 bp) located in exon 2, which has stronger promoter activity than the full-length or the other constructs. Bioinformatics analyses revealed that the alternative promoter region contains two conserved binding sites of the transcription factor c-Jun. Mutational analysis and electrophoretic mobility shift assay showed that Litopenaeus vannamei c-Jun (Lvc-Jun) binds to the region +1582/+1589 bp and +1831/+1837 bp of the alternative promoter. Furthermore, overexpression of Lvc-Jun significantly increased the alternative promoter activity, while co-transfection with dsRNA-Lvc-Jun significantly reduced the alternative promoter activity of HMCs. Taken together, our present data indicate that the transcription factor Lvc-Jun is essential for the transcriptional regulation of the HMCs gene expression.

Evaluation of effectiveness on a new chemotherapy regimen for the initial treatment of smear-positive tuberculosis in the elderly / 中华老年医学杂志

Objective To evaluate the efficacy of the new treatment regimen versus the standardized scheme for the initial treatment of smear-positive tuberculosis in the elderly.Methods A total of 302 elderly patients meeting the inclusion and exclusion criteria were selected from 14 tuberculosis-designated medical institutions in Beijing.The patients received the initial treatment of smear-positive tuberculosis from January 2014 to August 2016 in the combined prospective and retrospective study.All patients were divided into observation group(n=63)receiving treatment with 6L2 HELfx regimen from August 1,2015 to August 31,2016,and control group (n =239) receiving treatment with 6L2HELfx regimen from January 1,2014 to January 31,2015.The nation-unified standard chemotherapy regimen 2RHZE/4RH was used in tuberculosis medical service institutions for all patients.The differences between the two groups were analyzed and compared in the completion of treatment,negative conversion of sputum culture or smear,adverse drug reactions and treatment outcome.Results The completion rate of long-course therapy was significantly higher in the observation group than in control group [90.5％ (57/63) vs.79.5％ (190/239),x2 =4.034,P =0.045].The rate of negative conversion of sputum culture or smear at the end of the 2nd month was higher in the observation group than in control group,but had no significant difference[87.0％ (47/54)vs.81.6％(155/190),x2 =0.879,P=0.349].The incidence of adverse reactions was much lower in observation group than in control group[46.0％ (29/63) vs.65.3％ (156/239),x2 =7.777,P =0.005].The success rate of treatment(cure or completion of long-course therapy)was higher in observation group than in control group [90.5％ (57/63) vs.77.4％ (185/239),x2 =5.350,P =0.021].ConclusioNS As compared with the standard chemotherapy regimen,the L and Lfxcontaining treatment regimen has better effects,higher success rate of treatment and less adverse reactions in elderly patients with the initial treatment of smear-positive tuberculosis.

Prognostic value of hypoxia-inducible factor-1 alpha and prolyl 4-hydroxylase beta polypeptide overexpression in gastric cancer.

AIM: To investigate the relationship between hypoxia-inducible factor-1α (HIF-1α), prolyl 4-hydroxylase beta (P4HB) expression, and clinicopathologic parameters, as well as the prognostic value of these genes for patients with gastric cancer (GC). METHODS: Hypoxia is a critical factor that shapes the GC microenvironment. In previous reports, we have demonstrated that P4HB is a potential target of HIF-1α. In the present study, gene expression profiling interactive analysis (GEPIA) was used to analyze the relationship between P4HB and hypoxia-associated genes. To this end, 428 GC tissue samples were used to analyze the expression of HIF-1α and P4HB via immunohistochemical staining. Patient samples were classified as having weak-expression or over-expression both in terms of HIF-1α and P4HB. Correlations between biomarkers and clinicopathological factors were analyzed to predict survival. RESULTS: P4HB demonstrated a positive correlation with hypoxia-associated genes (P < 0.05). HIF-1α and P4HB overexpression have a significant correlation with TNM staging (χ2 = 23.32, P = 0.00; χ2 = 65.64, P = 0.00) and peritoneum cavity metastasis (χ2 = 12.67, P = 0.00; χ2 = 39.29, P = 0.00). In univariate analysis, patients with a high HIF-1α expression trend had a shorter disease-free survival (DFS: 44.80 mo vs 22.06 mo) and overall survival (OS: 49.58 mo vs 39.92 mo). P4HB overexpression reflected similar results: patients with over-expression of P4HB had a shorter survival time than those with weak-expression (DFS: 48.03 mo vs 29.64 mo, OS: 52.48 mo vs 36.87 mo). Furthermore, HIF-1α is also a clinicopathological predictor of dismal prognosis according to multivariate analysis (DFS, 95%CI: 0.52-0.88, P < 0.00; OS, 95%CI: 0.50-0.85, P < 0.00). However, P4HB was meaningful in DFS (95%CI: 0.58-1.00, P < 0.05) but not in OS (95%CI: 0.72-1.23, P > 0.05). CONCLUSION: Overexpression of HIF-1α and P4HB is associated with poor prognosis in patients with GC. Thus, these genes may be potential prognostic biomarker candidates in GC.

Microbiologic assessment of flexible gastrointestinal endoscope reprocessing using a pump-assisted sampling technique: an investigation involving all endoscopy units in Tianjin, China.

BACKGROUND: Microbiologic surveillance of flexible gastrointestinal endoscopes is recommended in several guidelines as the primary means of identifying reprocessing failures. This study aimed to evaluate the contamination level and prevalence of bacteria of post-reprocessing endoscopes and to access whether using a pump-assisted sampling method (PASM) improves the sensitivity of culture. METHODS: All 59 endoscopy units in Tianjin, China, were investigated. The PASM and the conventional flushing sampling method (CFSM) were used to compare the results of the microbial culture. Logistic regression analysis was used to identify the influencing factors. RESULTS: One hundred four (56.52%) flushing channel samples of gastrointestinal endoscopes were positive for culture, and the maximum bacterial concentration was 14,100 colony-forming units (CFU)/channel. One hundred fifty-one (82.07%) flushing samples were qualified according to the national standard of China (≤ 20 CFU/channel). The qualified rate of the samples collected by PASM was significantly lower than the qualified rate by CFSM (65.52% vs 89.68%). Using PASM (odds ratio [OR]: 4.257; 95% confidence interval [CI]: 1.870-9.690) would increase the sensitivity of culture. The use of purified water (OR: 0.288; 95% CI: 0.102-0.814) could reduce the risk of endoscope reprocessing failure. CONCLUSION: Many endoscopes fail to meet the national standard for microbial culture after reprocessing. Our results suggest that using a pump-assisted method could increase the sensitivity of the test.

Litopenaeus vannamei notch affects lipopolysaccharides induced reactive oxygen species.

Notch signaling pathway was originally discovered in the development stage of drosophila but has recently been found to play essential roles in innate immunity. Most previous studies on Notch have focused on mammals, whereas, in this study, we employed the shrimp Litopenaeus vannamei as a model to study the functions of Notch in invertebrate innate immune system. Our results showed that LvNotch was highly expressed in hemocytes and could be strongly induced by lipopolysaccharides (LPS) injection. Small interfering RNA (siRNA)-mediated knockdown of LvNotch could significantly increase LPS induced L. vannamei mortality, which might be due to the fact that LPS induced ROS was greatly enhanced in LvNotch knockdown shrimps. Further, quantitative polymerase chain reaction (qPCR) analysis revealed that LvNotch could affect the expression of multiple genes, including dorsal, relish, anti-lipopolysaccharide factor 1 (ALF1), ALF3 and NADH dehydrogenases which were upregulated, and Hypoxia-inducible factor (HIF, α/ß) which were downregulated in LPS treated shrimps. In summary, LvNotch is important in the control of inflammation-induced ROS production in shrimp.

Characterization and comparison of interferon reference standards using UPLC-MS / 药学学报

The study aims to characterize and compare interferon reference standards from 5 manufacturers. By testing molecular mass and trypsin-digested peptide mass mapping, the amino acid sequence was verified and post-translational modifications such as disulfide bond were identified. Results show that the molecular mass and amino acid sequence were consistent with theory; the disulfide bonds of 4 lots of interferon were Cys1-Cys98/Cys29-Cys138, 1 lot was Cys29-Cys139/Cys86-Cys99; N-terminal "+Met", acetyl N-terminal and Met oxidation were identified in part of the sample. UPLC-MS can be used to characterize and compare interferon reference standards from different manufacturers.

The brain's heart - therapeutic opportunities for patent foramen ovale (PFO) and neurovascular disease.

Patent foramen ovale (PFO), a common congenital cardiac abnormality, is a connection between the right and left atria in the heart. As a "back door to the brain", PFO can serve as a conduit for paradoxical embolism, allowing venous thrombi to enter the arterial circulation, avoiding filtration by the lungs, and causing ischemic stroke. PFO-related strokes affect more than 150,000 people per year in the US, and PFO is present in up to 60% of migraine patients with aura, and in one out of four normal individuals. So, in such a highly prevalent condition, what are the best treatment and prevention strategies? Emerging studies show PFO-related neurovascular disease to be a multi-organ condition with varying individual risk factors that may require individualized therapeutic approaches - opening the field for new pharmacologic and therapeutic targets. The anatomy of PFO suggests that, in addition to thrombi, it can also allow harmful circulatory factors to travel directly from the venous to the arterial circulation, a concept important in finding novel therapeutic targets for PFO-related neurovascular injury. Here, we: 1) review emerging data on PFO-related injuries and clinical trials; 2) discuss potential mechanisms of PFO-related neurovascular disease in the context of multi-organ interaction and heart-brain signaling; and 3) discuss novel therapeutic targets and research frontiers. Clinical studies and molecular mapping of the circulatory landscape of this multi-organ disease will both be necessary in order to better individualize clinical treatment for a condition affecting more than a quarter of the world's population.

Measurement of the amino acid sequence for the fusion protein FP3 with LC-MS/MS / 药学学报

The amino acid sequence of the fusion protein FP3 was measured by two types of LC-MS/MS and its primary structure was confirmed. After reduction and alkylation, the protein was digested with trypsin and glycosyl groups in glycopeptide were removed by PNGase F. The mixed peptides were separated by LC, then Q-TOF and Ion trap tandem mass spectrometry were used to measure b, y fragment ions of each peptide to analyze the amino acid sequence of fusion protein FP3. Seventy-six percent of full amino acid sequence of the fusion protein FP3 was measured by LC-ESI-Q-TOF with the remaining 24% completed by LC-ESI-Trap. As LC-MS and tandem mass spectrometry are rapid, sensitive, accurate to measure the protein amino acid sequence, they are important approach to structure analysis and identification of recombinant protein.