Relationship of High Work Engagement among Staff Midwives with Their Immediate Superiors’ Burnout on Maternity and Labor Wards in Japan

Introduction: Mental conditions for work among workers are related to clinical performance and influenced by colleagues within the same workplace. The aim of study was to examine the work engagement and burnout of staff midwives working on maternity and labor wards and to determine the factors related to high work engagement of staff midwives, including their immediate superiors’ work engagement and burnout. Methods: A cross-sectional questionnaire survey was employed in Japan. Questionnaires were distributed to 452 midwives/nurses working on maternity and labor wards of 20 hospitals and responses from 96 staff midwives and 17 of their immediate superiors were analyzed. Work engagement and burnout (exhaustion, cynicism, and professional efficacy) were assessed by the Utrecht Work Engagement Scale and the Maslach Burnout Inventory-General Survey, respectively. To examine the association of work engagement among staff midwives with their ages, marital status and work engagement and burnout of their superiors, logistic regression analysis was conducted. Results: Immediate superiors showed significantly higher level of work engagement than staff midwives, while there was no difference in the burnout. High work engagement of staff midwives was significantly correlated with the professional efficacy (AOR 1.93, 95% CI 1.12 - 3.33) and cynicism (AOR 2.01, 95% CI, 1.04 - 3.90) of their immediate superiors. There was no correlation of work engagement between them. Conclusions: High work engagement of staff midwives was correlated to high professional efficacy and cynicism of their immediate superiors, suggesting that there might be crossover effects on mental conditions for work between staff midwives and their immediate superiors.

颈部挫伤并发甲状腺上动脉破裂致咽喉后壁血肿1例

1临床资料患者,男,65岁,因“颈部闭合性损伤1 h”急诊收治入院,就诊时呈渐近性呼吸困难加重,伴有咽痛明显,无明显声嘶发作。查体:颈部肿胀明显,皮下有少许淤血样改变,颈部皮肤完整。3~4度阻塞性呼吸困难,不能平卧位。相关科室除外颅脑、胸腹并发伤后,急诊坐位下行气管切开术,术后呼吸有改善,但效果不明显。术前颈动脉血管造影发现左侧甲状腺上动脉破裂(图1A),颈部CT示血肿上至第2颈椎水平,下至第1胸椎水平(图1B、1C),咽喉后壁巨大血肿约500 ml,术前介入科行血管栓塞术。

Lower extremity peripherally inserted central catheter placement ectopic to the ascending lumbar vein:A case report

BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.

Comprehensive Evaluation of Flower Border Application Value of New and Superior Plants in Hefei Area

An analytic hierarchy process(AHP)was employed to assess the applicability of 18 new and superior varieties of flowers in Hefei City flower border applications.A total of 12 indicators were selected from three distinct aspects of adaptability,ornamental characteristics and use traits,in order to establish a comprehensive evaluation model.The results demonstrate that grade I(J≥2.685)exhibits excellent application value,encompassing six species of plants,such asHydrangeamacrophylla‘Endless Summer’;grade II(2.684≤J≤2.420)is also of notable application value,encompassing five species of plants,such asCallistemonrigidus;grade III(2.419≤J≤2.615)is of average application value,including five species of plants,such asCrocosmiacrocosmiflora;grade IV(J≤2.16)is of relatively poor application value.The evaluation results may be utilized as a theoretical reference for the promotion of new and superior varieties in the flower border of Hefei.

Comparative Orotomy of the Archean Superior,North China,and Phanerozoic Altaid Orogenic Systems Architecture

Geological maps encode vast amounts of data about rock types,ages,chemistry,orogenic architecture and deep-time history or different tectonic units,yet these are often difficult to extract because of the way different geologists portray their results at various scales.To understand orogenesis in 4D,it is essential to uniformly integrate map data,together with geophysical data and deep geochemical mapping(Wang et al.,2023).

Phase reconfiguration of heterogeneous CoFeS/CoNiS nanoparticles for superior battery-type supercapacitors

Developing advanced battery-type materials with abundant active sites,high conductivity,versatile morphologies,and hierarchically porous structures is crucial for realizing high-quality hybrid supercapacitors.Herein,heterogeneous FeS@NiS is synthesized by cationic Co doping via surface-structure engineering.The density functional theory(DFT)theoretical calculations are firstly performed to predict the advantages of Co dopant by improving the OH^(−)adsorption properties and adjusting electronic structure,benefiting ions/electron transfer.The dynamic surface evolution is further explored which demonstrates that CoFeS@CoNiS could be quickly reconstructed to Ni(Co)Fe_(2)O_(4)during the charging process,while the unstable structure of the amorphous Ni(Co)Fe_(2)O_(4)results in partial conversion to Ni/Co/FeOOH at high potentials,which contributes to the more reactive active site and good structural stability.Thus,the free-standing electrode reveals excellent electrochemical performance with a superior capacity(335.6 mA h g^(−1),2684 F g^(−1))at 3 A g^(−1).Furthermore,the as-fabricated device shows a quality energy density of 78.1 W h kg^(−1)at a power density of 750 W kg^(−1)and excellent cycle life of 92.1%capacitance retention after 5000 cycles.This work offers a facile strategy to construct versatile morphological structures using electrochemical activation and holds promising applications in energy-related fields.

Higher Grain-Filling Rate in Inferior Spikelets of Tolerant Rice Genotype Offset Grain Yield Loss under Post-Anthesis High Night Temperatures

Increased nighttime respiratory losses decrease the amount of photoassimilates available for plant growth and yield. We hypothesized that the increased respiratory carbon loss under high night temperatures(HNT) could be compensated for by increased photosynthesis during the day following HNT exposure. Two rice genotypes, Vandana(HNT-sensitive) and Nagina 22(HNT-tolerant), were exposed to HNT(4 ℃ above the control) from flowering to physiological maturity. They were assessed for alterations in the carbon balance of the source(flag leaf) and its subsequent impact on grain filling dynamics and the quality of spatially differentiated sinks(superior and inferior spikelets). Both genotypes exhibited significantly higher night respiration rates. However, only Nagina 22 compensated for the high respiration rates with an increased photosynthetic rate, resulting in a steady production of total dry matter under HNT. Nagina 22 also recorded a higher grain-filling rate, particularly at 5 and 10 d after flowering, with 1.5- and 4.0-fold increases in the translocation of ^(14)C sugars to the superior and inferior spikelets, respectively. The ratio of photosynthetic rate to respiratory rate on a leaf area basis was negatively correlated with spikelet sterility, resulting in a higher filled spikelet number and grain weight per plant, particularly for inferior grains in Nagina 22. Grain quality parameters such as head rice recovery, high-density grains, and gelatinization temperature were maintained in Nagina 22. An increase in the rheological properties of rice flour starch in Nagina 22 under HNT indicated the stability of starch and its ability to reorganize during the cooling process of product formation. Thus, our study showed that sink adjustments between superior and inferior spikelets favored the growth of inferior spikelets, which helped to offset the reduction in grain weight under HNT in the tolerant genotype Nagina 22.

Lithium-Metal Free Sulfur Battery Based on Waste Biomass Anode and Nano-Sized Li_(2)S Cathode

The realization of a stable lithium-metal free(LiMF)sulfur battery based on amorphous carbon anode and lithium sulfide(Li_(2)S)cathode is here reported.In particular,a biomass waste originating full-cell combining a carbonized brewer's spent grain(CBSG)biochar anode with a Li_(2)S-graphene composite cathode(Li_(2)S70Gr30)is proposed.This design is particularly attractive for applying a cost-effective,high performance,environment friendly,and safe anode material,as an alternative to standard graphite and metallic lithium in emerging battery technologies.The anodic and cathodic materials are characterized in terms of structure,morphology and composition through X-ray diffraction,scanning and transmission electron microscopy,X-ray photoelectron and Raman spectroscopies.Furthermore,an electrochemical characterization comprising galvanostatic cycling,rate capability and cyclic voltammetry tests were carried out both in half-cell and full-cell configurations.The systematic investigation reveals that unlike graphite,the biochar electrode displays good compatibility with the electrolyte typically employed in sulfur batteries.The CBSG/Li_(2)S70Gr30 full-cell demonstrates an initial charge and discharge capacities of 726 and 537 mAh g^(-1),respectively,at 0.05C with a coulombic efficiency of 74%.Moreover,it discloses a reversible capacity of 330 mAh g^(-1)(0.1 C)after over 300 cycles.Based on these achievements,the CBSG/Li_(2)S70Gr30 battery system can be considered as a promising energy storage solution for electric vehicles(EVs),especially when taking into account its easy scalability to an industrial level.

Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant—a computed tomography scan and topographic study

AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic sockets.METHODS:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric implants.High-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were evaluated.Demographic data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P<0.05.RESULTS:The anophthalmic orbits had a significantly shorter LPS length(P=0.01)and significantly thicker SR(P=0.02)than the normal orbit.Lagophthalmos was present in anophthalmic sockets but not in normal orbits(P=0.002),while levator function was normal in both(P>0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal orbits.The relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome:Two case reports and review of literature

BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been noted.In this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient.CASE SUMMARY Case 1:A 90-year-old man with nausea and vomiting.Following diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal contents.However,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content passage.Additionally,US indicated enhanced passage upon abdominal massage on the right side.By day 2,the patient could eat comfortably with the optimal position and massage.Case 2:An 87-year-old woman with vomiting.After the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal position.CONCLUSION The optimal position for SMA syndrome varies among individuals.Dynamic US appears to be a valuable tool in improving patient outcomes.

Tuning the crystalline and electronic structure of ZrO_(2)via oxygen vacancies and nano-structuring for polysulfides conversion in lithium-sulfur batteries

The recent emergence of tetragonal phases zirconium dioxide(ZrO_(2))with vacancies has generated significant interest as a highly efficient and stable electrocatalyst with potential applications in trapping polysulfides and facilitating rapid conversion in lithium-sulfur batteries(LSBs).However,the reduction of ZrO_(2)is challenging,even under strong reducing atmospheres at high temperatures and pressures.Consequently,the limited presence of oxygen vacancies results in insufficient active sites and reaction interfaces,thereby hindering practical implementation.Herein,we successfully introduced abundant oxygen vacancies into ZrO_(2)at the nanoscale with the help of carbon nanotubes(CNTs-OH)through hydrogen-etching at lower temperatures and pressures.The introduced oxygen vacancies on ZrO_(2-x)/CNTs-OH can effectively rearrange charge distribution,enhance sulfiphilicity and increase active sites,contributing to high ionic and electronic transfer kinetics,strong binding energy and low redox barriers between polysulfides and ZrO_(2-x).These findings have been experimentally validated and supported by theory calculations.As a result,LSBs assembled with the ZrO_(2-x)/CNTs-OH modified separators demonstrate excellent rate performance,superior cycling stability,and ultra-high sulfur utilization.Especially,at high sulfur loading of 6 mg cm^(-2),the area capacity is still up to 6.3 mA h cm^(-2).This work provides valuable insights into the structural and functional optimization of electrocatalysts for batteries.

Unroofed coronary sinus,left-sided superior vena cava and mitral insufficiency:A case report and review of the literature

BACKGROUND Unroofed coronary sinus(UCS)is a rare subtype of atrial septal defect.It is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac malformation.CASE SUMMARY This report describes a rare case of an adolescent patient with UCS featuring atrial situs solitus,absence of the right superior vena cava and a persistent left superior vena cava draining into the left atrium consistent with total unroofing of the coronary sinus.This was associated with concurrent severe mitral insufficiency secondary to redundant and prolapsing leaflets,and a substantial left-to-right shunt across the coronary sinus orifice.A comprehensive examination of the existing literature is included,shedding light on the diagnostic challenges of UCS and describing the available surgical options within the context of mitral valve surgery.CONCLUSION UCS is a complex condition requiring careful consideration of associated anomalies and a tailored surgical approach.

Lateral clavicle fracture-plating options and considerations

Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed options.Within this construct,numerous choices exist for fixing the fracture.This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.

Accidental placement of venous return catheter in the superior vena cava during venovenous extracorporeal membrane oxygenation for severe pneumonia: A case report

BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.

Meningioma originating from the superior petrosal vein without dural attachment:A case report

BACKGROUND Meningioma in the cerebellopontine angle(CPA)without dural attachment is extremely rare.We report a unique case of meningioma derived from the superior petrosal vein without dural attachment.CASE SUMMARY A 44-year-old right-handed woman presented with a two-month history of headache and tinnitus.Brain magnetic resonance imaging showed a well-defined contrast-enhancing lesion in the right CPA without a dural tail sign.Tumor resection was performed using a right retro sigmoid approach.A dural attachment was not seen at the tentorium or posterior surface of the petrous pyramid.The tumor was firmly adherent to the superior petrosal vein.The origin site was cauterized and resected with the preservation of the superior petrosal vein.A diagnosis of meningothelial meningioma was made.The patient’s headache and tinnitus gradually disappeared,and a recurrence was not observed five years after the surgery.CONCLUSION The rare occurrence of meningioma without dural attachment makes it difficult to determine dural attachment before surgery.The absence of dural attachment makes it easy to completely resect such tumors.Vessels related to tumors should be removed carefully,considering the possible presence of tumor stem cells in the microvessels.

Emergency rescue of a patient with hemorrhagic shock caused by superior mesenteric artery rupture:A case report

BACKGROUND Superior mesenteric artery(SMA)injuries rarely occur during blunt abdominal injuries,with an incidence of<1%.The clinical manifestations mainly include abdominal hemorrhage and peritoneal irritation,which progress rapidly and are easily misdiagnosed.Quick and accurate diagnosis and timely effective treatment are greatly significant in managing emergent cases.This report describes emergency rescue by a multidisciplinary team of a patient with hemorrhagic shock caused by SMA rupture.CASE SUMMARY A 55-year-old man with hemorrhagic shock presented with SMA rupture.On admission,he showed extremely unstable vital signs and was unconscious with a laceration on his head,heart rate of 143 beats/min,shallow and fast breathing(frequency>35 beats/min),and blood pressure as low as 20/10 mmHg(1 mmHg=0.133 kPa).Computed tomography revealed abdominal and pelvic hematocele effusion,suggesting active bleeding.The patient was suspected of partial rupture of the distal SMA branch.The patient underwent emergency mesenteric artery ligation,scalp suture,and liver laceration closure.In view of conditions with acute onset,rapid progression,and high bleeding volume,key points of nursing were conducted,including activating emergency protocol,opening of the green channel,and arranging relevant examinations with various medical staff for quick diagnosis.The seamless collaboration of the multidisciplinary team helped shorten the preoperative preparation time.Emergency laparotomy exploration and mesenteric artery ligation were performed to mitigate hemorrhagic shock while establishing efficient venous accesses and closely monitoring the patient’s condition to ensure hemodynamic stability.Strict measures were taken to avoid intraoperative hypothermia and infection.CONCLUSION After 3.5 h of emergency rescue and medical care,bleeding was successfully controlled,and the patient’s condition was stabilized.Subsequently,the patient was transferred to the intensive care unit for continuous monitoring and treatment.On the sixth day,the patient was weaned off the ventilator,extubated,and relocated to a specialized ward.Through diligent medical intervention and attentive nursing,the patient made a full recovery and was discharged on day 22.The follow-up visit confirmed the patient’s successful recovery.

Multidetector computer tomography and magnetic resonance imaging of double superior mesenteric veins:A case report

BACKGROUND This study aimed to describe the findings of double superior mesenteric veins(SMVs),a rare anatomical variation,on multidetector computer tomography(MDCT)and magnetic resonance imaging(MRI)images.CASE SUMMARY We describe the case of a 34-year-old male,who underwent both MDC and MRI examinations of the upper abdomen because of liver cirrhosis.MDCT and MRI angiography images of the upper abdomen revealed an anatomic variation of the superior mesenteric vein(SMV),the double SMVs.CONCLUSION The double SMVs are a congenital abnormality without potential clinical manifestation.Physicians need to be aware of this anatomical variation during abdominal surgery to avoid iatrogenic injury.

Comprehensive interventions for adult cyclic vomiting syndrome complicated by superior mesenteric artery syndrome:A case report

BACKGROUND Cyclic vomiting syndrome(CVS)is a chronic functional gastrointestinal disorder involving the gut–brain interaction that is characterized by recurring episodes of nausea,vomiting,abdominal pain,and interspersed complete normal periods.Superior mesenteric artery(SMA)syndrome(SMAS)is a vascular condition in which the horizontal portion of the duodenum is compressed due to a reduced angle between the aorta and the SMA.This condition presents with symptoms similar to CVS,posing challenges in distinguishing between the two and often resulting in misdiagnosis or inappropriate treatment.CASE SUMMARY A 20-year-old female patient presented with recurrent episodes of vomiting and experienced a persistent fear of vomiting for the past 2 years.She adopted conscious dietary restrictions,which led to severe malnutrition.Initially,she was diagnosed with SMAS,as revealed by computed tomography angiography.Despite efforts to increase the angle between the aorta and the SMA through weight gain,her vomiting did not improve.Finally,she was diagnosed with comorbidities including CVS,SMAS and anxiety disorder.She underwent comprehensive interventions,including enteral and parenteral nutritional supplementation,administration of antiemetic and anti-anxiety agents,and participation in mindfulness-based cognitive therapy.The patient eventually experienced a notable improvement in both body weight and clinical symptoms.CONCLUSION We present a rare case of CVS in an adult complicated with SMAS and propose additional treatment with nutritional support,pharmacological intervention,and psychotherapy.

Preservation of superior rectal artery in laparoscopic colectomy:The best choice for slow transit constipation?

Laparoscopic colectomy with ileorectal anastomosis may be beneficial for patients with slow transit constipation who do not respond to conservative treatment,particularly if the superior rectal artery(SRA)is preserved.Several important concerns have been addressed in this commentary.It is important to first go over the definition of surgical procedure as it is used in this text.Second,the current study lacked a control group that had SRA preservation.Thirdly,it would be best to use a prospective,randomized controlled study.Lastly,a description of the mesenteric defect’s state following a laparoscopic colectomy is necessary.

No-touch isolation technique in emergency pancreaticoduodenectomy for neoplastic hemorrhage: Two case reports and review of literature

BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underwent EPD using a no-touch isolation technique,in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum.The operative times were 220 and 239 min,and the blood loss was 70 and 270 g,respectively.The patients were discharged on the 14^(th) and 10^(th) postoperative day,respectively.Thirty-two patients underwent EPD for the treatment of neoplastic bleeding.The mean operative time was 361.6 min,and the mean blood loss was 747.3 g.The comp-lication rate was 37.5%.The in-hospital mortality rate was 9.38%.CONCLUSION The no-touch isolation technique is feasible,safe,and effective for reducing intraoperative blood loss in EPD.