Current state and influencing factors in airbag management among emergency department nurses:A multicenter study

BACKGROUND The emergency department(ED)plays a critical role in establishing artificial airways and implementing mechanical ventilation.Managing airbags in the ED presents a prime opportunity to mitigate the risk of ventilator-associated pneumonia.Nonetheless,existing research has largely overlooked the understanding,beliefs,and practical dimensions of airway airbag management among ED nurses,with a predominant focus on intensive care unit nurses.AIM To investigate the current status of ED nurses'knowledge,beliefs,and practical behaviors in airway airbag management and their influencing factors.METHODS A survey was conducted from July 10th to August 10th,2023,using convenience sampling on 520 ED nurses from 15 tertiary hospitals and 5 sary hospitals in Shanghai.Pathway analysis was utilized to analyze the influencing factors.RESULTS The scores for ED nurses'airway airbag management knowledge were 60.26±23.00,belief was 88.65±13.36,and behavior was 75.10±19.84.The main influencing factors of airbag management knowledge included participation in specialized nurse or mechanical ventilation training,department,and work experience in the department.Influencing factors of airbag management belief comprised knowledge,department,and participation in specialized nurse or mechanical ventilation training.Primary influencing factors of airbag management behavior included knowledge,belief,department,participation in specialized nurse or mechanical ventilation training,and professional title.The belief in airbag management among ED nurses acted as a partial mediator between knowledge and behavior,with a total effect value of 0.513,and an indirect effect of 0.085,constituting 16.6%of the total effect.CONCLUSION ED nurses exhibit a positive attitude toward airbag management with relatively standardized practices,yet there remains room for improvement in their knowledge levels.Nursing managers should implement interventions tailored to the characteristics of ED nurses'airbag management knowledge,beliefs,and practices to enhance their airbag management proficiency.

Ruptured Ectopic Pregnancy: Epidemiology and Management in the General Surgery Department of the Ignace Deen National Hospital, Conakry University Hospital

Introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the Ignace Deen national hospital, Conakry University Hospital. Methodology: This was a retrospective, descriptive study lasting two years (January 1, 2020 to December 31, 2022), carried out in the general surgery and gyneco-obstetrics departments of the Ignace Deen national hospital, Conakry University Hospital. We included all patients with a ruptured ectopic pregnancy who received surgical treatment during the study period. Results: We collected 13,524 cases of surgical interventions in the two services, among them, we recorded 89 cases or 0.66% GEUR. The average age of the patients was 24.26 years. Brides were the most represented with 80.96% of cases. Women practicing a liberal profession were 51.69% (n = 46) and housewives 26.97% (n = 24). Clinically, amenorrhea was noted in all patients, i.e. 100%, abdominal-pelvic pain in 95.2% (n = 85) of cases, metrorrhagia in 94.08% (n = 84), abdominal-pelvic sensitivity in 97.44% (n = 87) of cases and anemia in 85.39% of cases. The GEUR was ampullary in 69.66% (n = 62) cases. Salpingectomy was performed in 90.72% (n = 81). The surgical outcomes were satisfactory in 98.87% (n = 88) of cases. We recorded one case of surgical site infection. We have not recorded any deaths. The average length of hospitalization was 4 days. Conclusion: GEUR is relatively high in our context. A good understanding of the prognostic factors of GEUR, awareness and family planning could reduce GEUR.

Effect of Health Management in Raising Awareness Rate of Disease Prevention and Treatment in Patients with Prehypertension

Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.

Management Practices:Shaping Employee Satisfaction and Commitment in Large German Companies

The rapid evolution of the political,economic,and social landscape has generated increased interest in understanding the contextual application of management styles and behaviours toward employees.In this context,organizations must comprehend and assess employee satisfaction to enhance productivity and realize their strategic and economic goals.Therefore,this study aims to investigate the prevailing and significant management behaviours toward employees in large German companies and their impact on employee satisfaction and job commitment.To achieve the research objective,the study will employ a qualitative method to explore management behaviours toward employees.Data were collected through interviews with randomly selected managers from different companies and departments.The study aims to uncover discrepancies or variations in employee expectations regarding management behaviour.The findings will provide a better understanding of the most prevalent and significant management behaviours toward employees in large German companies and their impact on employee satisfaction and job commitment.The results will be valuable to management in adopting suitable leadership styles and improving employee satisfaction,leading to increased productivity and organizational performance.The research will contribute to the existing body of knowledge in the field of management and human resource management by providing insights into the impact of management behaviours on employees.It will also offer recommendations to management on how to enhance employee satisfaction and job commitment,leading to improved organizational performance.In conclusion,this study will investigate the prevailing management behaviours toward employees in large German companies and their impact on employee satisfaction and job commitment.

Innovative Strategies for Financial Investment Management Strategies of Enterprises in the New Era

With the in-depth development of economic globalization and the continuous emergence of new technologies,the importance of enterprise financial investment management strategy is becoming more and more prominent.The traditional financial investment management strategy can no longer meet the needs of enterprises in the new era and needs to be innovated with the times.For enterprises,the effectiveness and scientificity of financial investment management strategy will directly affect the competitiveness and long-term development of enterprises.Therefore,this study chooses the innovation based on the financial investment management strategy of enterprises in the new era as the research theme,aiming at exploring the innovative strategy to adapt to the needs of enterprises in the new era.

Imperative for long-term management and surveillance in Kawasaki disease

Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.

Enhancing perianal disease management with integrated physical and psychological approaches

This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.

Impacts of Nutlin-3a and exercise on murine double minute 2-enriched glioma treatment

Recent research has demonstrated the impact of physical activity on the prognosis of glioma patients,with evidence suggesting exercise may reduce mortality risks and aid neural regeneration.The role of the small ubiquitin-like modifier(SUMO)protein,especially post-exercise,in cancer progression,is gaining attention,as are the potential anti-cancer effects of SUMOylation.We used machine learning to create the exercise and SUMO-related gene signature(ESLRS).This signature shows how physical activity might help improve the outlook for low-grade glioma and other cancers.We demonstrated the prognostic and immunotherapeutic significance of ESLRS markers,specifically highlighting how murine double minute 2(MDM2),a component of the ESLRS,can be targeted by nutlin-3.This underscores the intricate relationship between natural compounds such as nutlin-3 and immune regulation.Using comprehensive CRISPR screening,we validated the effects of specific ESLRS genes on low-grade glioma progression.We also revealed insights into the effectiveness of Nutlin-3a as a potent MDM2 inhibitor through molecular docking and dynamic simulation.Nutlin-3a inhibited glioma cell proliferation and activated the p53 pathway.Its efficacy decreased with MDM2 overexpression,and this was reversed by Nutlin-3a or exercise.Experiments using a low-grade glioma mouse model highlighted the effect of physical activity on oxidative stress and molecular pathway regulation.Notably,both physical exercise and Nutlin-3a administration improved physical function in mice bearing tumors derived from MDM2-overexpressing cells.These results suggest the potential for Nutlin-3a,an MDM2 inhibitor,with physical exercise as a therapeutic approach for glioma management.Our research also supports the use of natural products for therapy and sheds light on the interaction of exercise,natural products,and immune regulation in cancer treatment.

Keynote trustmanagement及其在主动网络中的应用

随着Internet应用的迅速发展, 分布式计算机逐渐成为发展主流。传统的基于ACL的资源访问控制机制已经不能很好的适应分布式系统需要。本文在介绍了基于信任管理的访问控制机制后, 深入分析Keynotetrustmanagementsystem, 并在此基础上给出了Keynotetrustmanagementsystem在安全主动组播中的应用构架。该构架能较好解决传统IP组播中未能解决的组播组成员的访问控制与分布式授权问题。

OmniLog TM微生物鉴定系统在青海高原野生型鼠疫噬菌体宿主谱检测中的应用研究

目的采用两种微量法检测青海高原野生型鼠疫噬菌体的宿主谱,为今后噬菌体生态学研究和基于宿主范围噬菌体分类研究提供科学依据。方法基于OmniLog TM微生物鉴定系统微量法和微量点滴法,检测3株鼠疫噬菌体对2株鼠疫耶尔森菌(鼠疫疫苗株EV 76、614F)和4株非鼠疫耶尔森菌(假结核耶尔森菌PTB3、PTB5、大肠杆菌V517、小肠结肠炎耶尔森菌52302-2)的裂解情况。结果476号、087号和072204号鼠疫噬菌体均能成功感染鼠疫疫苗株EV 76、614F并依赖其生长繁殖,且基于OmniLog TM系统33℃培养48 h也能够观察到试验孔中四唑类染料颜色随着噬菌体数量的增加和宿主菌数量的减少而变淡。利用微量点滴法检测3株鼠疫噬菌体对4株非鼠疫耶尔森菌敏感性结果显示,28℃和37℃时476号鼠疫噬菌体对假结核耶尔森菌PTB5敏感,而087号和072204号对其不敏感;476号、087号和072204号鼠疫噬菌体对假结核耶尔森菌PTB3、大肠杆菌V517、小肠结肠炎耶尔森菌52302-2这3株非鼠疫耶尔森菌均不敏感,且基于OmniLog TM系统观察到试验孔与对照孔中细菌生长曲线和四唑类染料颜色分别呈现相似对应的结果。然而,以鼠疫疫苗株EV 76、614F为宿主菌,37℃时072204号鼠疫噬菌体微量点滴于固体培养基上不显示噬菌斑。结论基于OmniLog TM检测系统的噬菌体宿主范围测定法可以作为一种替代传统检测宿主谱的测定方法,在噬菌体与宿主菌相互作用研究中具有较好的应用价值。

稳定表达细胞色素P4502B6的Flp-In^(TM)CHO细胞系的建立及鉴定

目的构建稳定表达细胞色素P4502B6(CYP2B6)的Flp-In^(TM)CHO细胞系。方法将Flp-In^(TM)CHO细胞分为Flp-In^(TM)CHO组、Flp-In^(TM)CHO空载体组及Flp-In^(TM)CHO-CYP2B6组,通过Lipofectamine2000转染试剂,分别将pcDNA5/FRT空质粒和pcDNA5/FRT-CYP2B6重组质粒转染至Flp-In^(TM)CHO空载体组细胞和Flp-In^(TM)CHO-CYP2B6组细胞中,利用实时荧光定量PCR(qRT-PCR)、蛋白免疫印迹(Western blot)及荧光素酶实验检测转染细胞中CYP2B6 mRNA水平、蛋白表达水平及活性,用四氮唑盐(MTS)测定转染CYP2B6的Flp-In^(TM)CHO细胞对环磷酰胺的毒性敏感性。结果与Flp-In^(TM)CHO组和Flp-In^(TM)CHO空载体组相比,Flp-In^(TM)CHO-CYP2B6组细胞中CYP2B6的mRNA和蛋白表达水平显著升高(P<0.01)、酶活性显著增加(P<0.001),对环磷酰胺的毒性敏感度显著增加(P<0.001)。结论成功构建稳定表达CYP2B6的Flp-In^(TM)CHO细胞系,为研究药物代谢和筛选毒性药物提供工具。

DNATyper^(TM)21与Verifiler^(TM)Plus试剂盒对常规案件检材检验的比较

本文通过比较DNATyper^(TM)21与Verifi ler^(TM)Plus两种STR检测试剂盒对各类案件检材的检验能力,探讨DNATyper^(TM)21试剂盒在常规案件检验中应用的可靠性。取0.03125、0.0625、0.125、0.25、0.5、1.0 ng/μL基因组标准品对两种试剂盒进行灵敏度测试;应用DNATyper^(TM)21与Verifi ler^(TM)Plus试剂盒分别对1056例常规案件检材DNA进行检验;对同一样本等位基因进行一致性比较。结果表明,两种试剂盒均可以成功检测出模板浓度在0.0625 ng/μL以上的标准DNA。在检验的1056例样本中,DNATyper^(TM)21试剂盒共检出881例,检出率为83.4%;Verifi ler^(TM)Plus试剂盒检出892例,检出率为84.5%。统计学结果表明两种试剂盒检出率无统计学差异,且同一样本相同基因座得到的等位基因分型一致。综上,DNATyper^(TM)21试剂盒对各类常规检材具有良好的检验能力,可应用于日常案件检验。

土壤施用TM36对甜菜幼苗的影响

【目的】为了探索不同TM36施用量(内含碳酸钙和缩节胺同系物等物质)对甜菜幼苗生长状况的影响。【方法】以甜菜品种‘KWS7748’为供试品种,进行土培试验,TM36施加量分别为0%、0.5%、1%、2%和3%,测量植株的生长指标、养分含量和一些生理指标,以及土壤养分含量、pH值。【结果】随着土壤中施用TM36比例的增加,甜菜幼苗的株高和茎长显著降低,茎粗、根面积和叶面积呈先上升后下降趋势,植株干鲜重差异不显著;植株的光合能力、叶绿素含量逐渐升高;植株全氮、全磷、全钾呈先上升后下降趋势;叶片中脯氨酸含量上升,根系中脯氨酸含量及植株中丙二醛含量呈先下降后上升趋势;施用TM36能够提高土壤pH、土壤中无机氮和有效磷含量,速效钾含量呈先减少后增加趋势。【结论】综合各项指标表明,土壤施用TM36对甜菜幼苗生长具有壮苗作用,施用浓度为1%时效果最佳。

基于TM2D1介导铁死亡探讨丙泊酚抑制结直肠癌的分子机制

目的:基于丙泊酚通过TM2D1介导铁死亡抑制结直肠癌的分子机制。方法:测定TM2D1在正常和CRC组织中的表达,将人CRC SW480细胞暴露于50μm丙泊酚中,检测细胞活力。用过表达TM2D1的载体转染SW480细胞并用丙泊酚处理,并评估异丙酚处理SW480细胞,观察细胞活力、集落形成、细胞增殖、铁水平、ROS生成和和铁死亡。结果:TM2D1在结直肠癌组织中高表达。异丙酚对SW480细胞活力有抑制作用,TM2D1在丙泊酚作用下显著下调,丙泊酚还能抑制结直肠癌细胞增殖和集落形成,提高细胞铁和ROS水平。此外,丙泊酚还改变了与铁死亡相关的蛋白的表达,包括CRC细胞中CHAC1和PTGS2的表达上调,以及GPX4的表达抑制,TM2D1过表达阻断了异丙酚对CRC细胞的作用,差异有统计学意义(P<0.05)。结论:丙泊酚可能通过下调TM2D1的表达引发CRC细胞铁死亡。

Digital management technology and its application to investment casting enterprises

With the advent of Industry 4.0, more and more investment casting enterprises are implementing production manufacturing systems, especially in the last two years. This paper summarizes three new common requirements of the digital management aspect in precision casting enterprises, and puts forward three corresponding techniques. They are: the production process tracking card technology based on the main-sub card mode; the workshop site production process processing technology based on the barcode; and the equipment data integration technology. Then, this paper discusses in detail the principle, application and effect of these technologies; to provide the reference for enterprises to move towards digital casting and intelligent casting.

Endoscopy in inflammatory bowel disease: Role in diagnosis, management, and treatment

Endoscopy plays a fundamental role in the diagnosis, management, and treatment of inflammatory bowel dis-ease(IBD). Colonoscopy, flexible sigmoidoscopy, and esophagogastroduodenoscopy have long been used in the care of patients with IBD. As endoscopic technologies have progressed, tools such as endoscopic ultrasound, capsule endoscopy, and balloon-assisted enteroscopy have expanded the role of endoscopy in IBD. Furthermore, chromoendoscopy has enhanced our ability to detect dys-plasia in IBD. In this review article, we will focus on the roles, indications, and limitations of these tools in IBD. We will also discuss the most commonly used endoscopic scoring systems, as well as special considerations in post-surgical patients. Lastly, we will discuss the role of endoscopy in the diagnosis and management of fistulae and strictures.

Anesthetic management of the SRS^(TM) endoscopic stapling system for gastro-esophageal reflux disease

The SRS TM Endoscopic Stapling System(Medigus,Tel Aviv,Israel) is a new tool capable of creating a totally endoscopic fundoplication,combined with an endoscope,endoscopic ultrasound and a surgical stapler.SRS TM endoscopic stapling for gastro-esophageal reflux disease is a minimally invasive,outpatient procedure,which requires general anesthesia with positive-pressure ventilation.Keeping the patient on positive endexpiratory pressure(PEEP) may minimize the pressure gradient between the esophagus and the mediastinum,as well as help to prevent air from leaking around the screws and causing pneumomediastinum.In addition,in patients with hiatal hernia,higher PEEP levels may be required to increase intra-thoracic pressure and to force the stomach to slide into the abdomen for ease of endoscopy.We advise smoother emergence from anesthesia,taking precautions for retching,postoperative nausea and vomiting(PONV),while coughing and gagging during extubation and PONV may affect the success of the procedure.Total intravenous anesthesia with propofol and remifentanil seems to be a good choice for these reasons.

Influence of weight management on the prognosis of steatohepatitis in chronic hepatitis B patients during antiviral treatment

Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed to investigate the outcomes of NASH in CHB patients receiving antiviral treatment.Methods:In the post-hoc analysis of a multicenter trial,na?ve CHB patients receiving 72-week entecavir treatment were enrolled.We evaluated the biochemical,viral and histopathological responses of these patients.The histopathological features of NASH were also evaluated,using paired liver biopsies at baseline and week 72.Results:A total of 1000 CHB patients were finally enrolled for analysis,with 18.2%of whom fulfilling the criteria of NASH.A total of 727 patients completed entecavir antiviral treatment and received the second biopsy.Serum HBe Ag loss,HBe Ag seroconversion and HBV-DNA undetectable rates were similar between patients with or without NASH(P>0.05).Among patients with NASH,the hepatic steatosis,ballooning,lobular inflammation scores and fibrosis stages all improved during follow-up(all P<0.001),46%(63/136)achieved NASH resolution.Patients with baseline body mass index(BMI)≥23 kg/m2(Asian criteria)[odds ratio(OR):0.414;95%confidence interval(95%CI):0.190-0.899;P=0.012]and weight gain(OR:0.187;95%CI:0.050-0.693;P=0.026)were less likely to have NASH resolution.Among patients without NASH at baseline,22(3.7%)developed NASH.Baseline BMI≥23 kg/m2(OR:12.506;95%CI:2.813-55.606;P=0.001)and weight gain(OR:5.126;95%CI:1.674-15.694;P=0.005)were predictors of incident NASH.Conclusions:Lower BMI and weight reduction but not virologic factors determine NASH resolution in CHB.The value of weight management in CHB patients during antiviral treatment deserves further evaluation.

COVID-19 infection and liver injury:Clinical features,biomarkers,potential mechanisms,treatment,and management challenges

It is hypothesized that liver impairment caused by coronavirus disease 2019(COVID-19)infection might play a central role in severe clinical presentations.Liver injury is closely associated with severe disease and,even with antiviral drugs,have a poor prognosis in COVID-19 patients.In addition to the common hepatobiliary disorders caused by COVID-19,patients with pre-existing liver diseases demand special considerations during the current pandemic.Thus,it is vital that upon clinical presentation,patients with concurrent pre-existing liver disease associated with metabolic dysfunction and COVID-19 be managed properly to prevent liver failure.Careful monitoring and early detection of liver damage through biomarkers after hospitalization for COVID-19 is underscored in all cases,particularly in those with pre-existing metabolic liver injury.The purpose of this study was to determine most recent evidence regarding causality,potential risk factors,and challenges,therapeutic options,and management of COVID-19 infection in vulnerable patients with pre-existing liver injury.This review aims to highlight the current frontier of COVID-19 infection and liver injury and the direction of liver injury in these patients.

Risk management in radiology departments

Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as aresult of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients.