The Perimenopausal Fatigue Self-Management Scale Is Suitable for Evaluating Perimenopausal Taiwanese Women's Vulnerability to Fatigue Syndrome

The purpose of this study was to test the feasibility of utilizing the established perimenopausal fatigue self-management scale (P-MFSMS) to evaluate perimenopausal Taiwanese women’s vulnerability to fatigue syndrome. A cross-sectional study design was adopted to survey 220 perimenopausal Taiwanese women with a mean age of 51.8 ± 4.64 years and a mean body mass index of 23.07 ± 3.04 kg/m², 75.9% of whom were married, 52.3% had a college education or above, 80.4% had salaries, 81.3% had small families, and 96.4% were not using hormone therapy. The P-MFSMS consists of 25 questions based on six categories: (1) strive to maintain work energy and efficiency; (2) seek self-help from medical resources (doctor shopping); (3) strive to maintain the normal operation of the family (seeking help and support from family or significant other); (4) make time for activities or exercise in busy life; (5) slow down or adjust lifestyle; (6) frustration. For all of these six categories, the minimum loading of each question on the factor was calculated to be over 0.50, with a Cronbach’s α of 0.78 and a corrected total-item correlation of >0.50. The goodness of fit of the model was determined to be acceptable, with a chi-square/df value of <3.0 (χ² = 503.45 and df = 260), a root mean square error of approximation (RMSEA) value of 0.065 (<0.08), as well as a Kaiser–Meyer–Olkin (KMO) value of 0.892. The Tucker–Lewis index (TLI = 0.91), Comparative Fit index (CFI = 0.92), and Incremental Fit index (IFI = 0.92) were all >0.90. There was no statistically significant difference in the difficulty between perimenopausal and postmenopausal women utilizing differential item function (DIF) analysis. Taken together, the 25-question P-MFSMS may be a potentially valid and reliable instrument for suitably evaluating perimenopausal Taiwanese women’s vulnerability to fatigue syndrome. Future studies will be conducted to test the effectiveness of the P-MFSMS for evaluating perimenopausal Taiwanese women’s vulnerability to fatigue syndrome in clinical practice.

[Study on the mechanisms of the intestinal tight-junction destruction caused by Blastocystis hominis infection in rats]

OBJECTIVE

To explore the mechanism of the intestinal barrier damage caused by Blastocystis hominis infections in rats.

METHODS

Thirty SD rats were randomly divided into the control group, and the 1-, 3-, 6- and 9-week-infection groups, of 6 rats in each group. Rats in each infection group were orally infected with B. hominis trophozoites at a density of 2 × 10⁸ parasites per rat, and the control group was given an equal volume of phosphate buffered saline solution. The 7-hour urine samples were collected 1, 3, 6 and 9 weeks post-infection for the measurement of the intestinal permeability. Then, rats were sacrificed using the cervical dislocation method, and the cecum specimens were collected for the detection of the intestinal epithelial cell permeability. The expression of tight junction-related Occludin and Claudin - 1 genes and apoptosis-related Bcl - 2 and Bax genes was quantified in cecum epithelial cells using the real-time fluorescent quantitative PCR (qPCR) assay, and cell apoptosis was detected in the rat cecum using the TdT-mediated dUTP nick-end labeling (TUNEL) assay.

RESULTS

The median urinary lactolose to mannitol ratios were 0.29, 0.72, 0.44, 0.46 and 0.38 in the control group, and the 1-, 3-, 6- and 9-week-infection groups, respectively, and the difference was statistically significant (H = 12.09, P < 0.05). B. hominis invasion and epithelial injury were observed in intestinal epithelial cells of rats infected with B. hominis, and transmission electron microscopy displayed the destruction of tight junctions between intestinal epithelial cells. The relative expression of Occludin, Claudin-1, Bcl-2 and Bax genes was 1.04, 0.62, 0.71, 0.68 and 0.96; 1.03, 0.61, 0.63, 0.76 and 0.86; 1.08, 0.70, 0.75, 0.74 and 1.03; and 1.00, 1.57, 1.33, 1.35 and 1.10 in the control group and the 1-, 3-, 6- and 9-week-infection groups, respectively, and all differences were statistically significant (F = 2.86, 2.85, 3.37 and 4.45, all P values < 0.05). The median number of positive staining cells were 1.00, 13.00, 9.00, 3.50 and 1.00 in rat cecum specimens in the control group, and the 1-, 3-, 6- and 9-week-infection groups, respectively, and the difference was statistically significant (H = 22.95, P < 0.01).

CONCLUSIONS

B. hominis infection may cause an increase in the rat intestinal permeability through triggering the apoptosis of intestinal epithelial cells to destroy the tight junction between intestinal epithelial cells, thereby destroying the intestinal barrier function.

[Research progress of neural precursor cells-expressed developmentally down-regulated protein-8 in liver diseases]

Neural precursor cells-expressed developmentally down-regulated protein-8 (NEDD8) is one of the important members of the ubiquitin family, which plays an important role in maintaining cell stability, cell cycle regulation, signal transduction, transcription, and translation, DNA repair, and tumorigenesis through covalently bound substrates (also known as neddylation modification). In recent years, studies have found that the dysfunction of NEDD8 and its related enzymes is common in liver diseases, and is widely involved in the biological processes of hepatitis, liver fibrosis, proliferation, invasion, apoptosis and autophagy of liver cancer cells. This article focuses on the research progress of NEDD8 in liver diseases.

A novel bacteriocin BM1029: physicochemical characterization, antibacterial modes and application

AIM

Bacteriocins with antimicrobial activity are considered as potential natural bio-preservatives to control the growth of food spoilage bacteria. The aim of this work was to characterize a novel bacteriocin BM1029 discovered from Lactobacillus crustorum MN047 and evaluate its antibacterial mechanism.

METHODS AND RESULTS

Bacteriocin BM1029 was purified by cation-exchange chromatography and reversed-phase chromatography. Antibacterial activity assay showed that BM1029 is antagonistic against both Gram-positive and Gram-negative bacteria. Furthermore, it was found that BM1029 showed low haemolysis with high stability to the pretreatment with different temperatures, pH and surfactants. Moreover electron microscopy and flow cytometry suggested that BM1029 inhibit indicator strains by damaging the cell envelope integrity. Cell cycle assay suggested that BM1029 arrested cell cycle in R-phase.

CONCLUSION

The novel bacteriocin BM1029 showed high bactericidal activity against Escherichia coli and Staphylococcus aureus through a cell envelope-associated mechanism.

SIGNIFICANCE AND IMPACT OF THE STUDY

Application of BM1029 inhibited the growth of indicator strains on beef meat storage at 4°C suggesting that this bacteriocin is promising to be used as a novel preservative in food processing and preservation.

Disaster Knowledge, Skills, and Preparedness Among Nurses in Bengkulu, Indonesia: A Descriptive Correlational Survey Study

INTRODUCTION

Registered nurses have to adequately prepare to respond to disasters, as they have become increasingly frequent worldwide. The aim of this study was to identify the factors influencing registered nurses' disaster preparedness in Bengkulu, Indonesia.

METHODS

This study used a descriptive correlational study design. A total of 130 registered nurses working in 2 governmental hospitals in Bengkulu, Indonesia, were recruited by using a convenience sampling technique. A self-administered questionnaire, the Disaster Preparedness Evaluation Tool, was used to determine their current levels of registered nurses' disaster preparedness.

RESULTS

The registered nurses reported a moderate level of disaster knowledge, skills and preparedness. Their knowledge and skills were significantly correlated with disaster preparedness (r = 0.39-0.71, P < 0.01). Three significant factors associated with disaster preparedness were identified in this study: educational level, disaster knowledge, and disaster skills (R² = 0.31, F = 12.60, P < 0.001).

DISCUSSION

Continuing disaster drills training and implementing a formal disaster educational program into nursing curriculum and professional development are recommended to achieve effective disaster preparedness in the hospital setting.

Psychometric testing of the support and control in birth scale

Background

The Support and Control in Birth (SCIB) scale primarily measures the perceived support and control of expectant mothers during childbirth, thereby obtaining an understanding of their birth experiences. The advantages of this scale are its good reliability and validity and that it consolidates birth support and control. However, a Chinese version of the scale has yet to be developed. Therefore, this study sought to evaluate the validity and reliability of a Chinese version of the Support and Control in Birth Scale (C-SCIB).

Methods

A total of 228 postpartum women participated in this study. The C-SCIB scale was developed through a translation and back translation, followed by an evaluation of its content validity by a group of experts. Cronbach’s α internal consistency and test-retest reliability were used to test the reliability of the scale. In addition, criterion-related validity (predictive validity and concurrent validity) and construct validity were used to test the validity of the scale.

Results

The C-SCIB scale showed good results in terms of the item-level and scale-level content validity indices. The Cronbach’s α internal consistency was 0.81, and its test-retest reliability was 0.96. The confirmatory factor analysis results showed the overall goodness-of-fit was parsimony fit indices. The predictive validity analysis showed a significant positive correlation between the C-SCIB scale and the Questionnaire Measuring Attitudes About Labor and Delivery (r = 0.31, p < 0.01). Furthermore, the concurrent validity analysis showed a significant and moderate correlation between the C-SCIB and the Bryanton Adaptation of the Nursing Support in Labor Questionnaire (r = 0.49, p < 0.01) as well as the Labor Agentry Scale (r = 0.51, p < 0.01).

Conclusion

The C-SCIB scale was proven to have good reliability and validity, and thus can be used to measure the degree of support and the locus of control perceived by expectant women during labor.

Angiotensin Receptor Neprilysin Inhibitor for Patients With Heart Failure and Reduced Ejection Fraction: Real-World Experience From Taiwan

Background:

Angiotensin receptor neprilysin inhibitor (ARNI) was recommended by major guidelines as the frontline therapy for heart failure with reduced ejection fraction (HFrEF) since its clinical benefit was proved in the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM-HF) trial. However, little is known about its safety and effectiveness in real-world practice, often with sicker and more fragile patients. In addition, East Asia population is underrepresented in PARADIGM-HF trial.

Methods:

We performed a retrospective analysis of patients who received ARNI in 3 medical institutes located in Northern Taiwan. Patients who received a prescription of at least 30 days of ARNI were enrolled. The date of first prescription was defined as the index date, and a period of 12 months preceding the index date was defined as the baseline period.

Results:

A total of 452 patients were identified (age: 61.9 ± 15.0, male: 79.4%). Compared to PARADIGM-HF populations, our patients had higher values of baseline serum creatinine (mean: 1.5 vs 1.1 mg/dL) and B-type natriuretic peptide (BNP; median: 554.5 vs 255 pg/mL). After 12 months, 41.6% of the patients received less than half of the standard dose. Overall, all-cause death, cardiovascular death, and heart failure readmission rate were 3.0%, 1.1%, and 6.9% in 12 months, respectively. In those who had both baseline and 12-month data, renal function did not change (1.7-1.8 mg/dL, P = .091), left ventricular ejection fraction improved (30.8%-36.8%, P < .001), BNP decreased (777.0-655.8 pg/mL, P = .032), and uric acid decreased (7.5-7.1 mg/dL, P = .009).

Conclusion:

In our study, patients with HFrEF had higher BNP and serum creatinine level at baseline and had received lower dose of ARNI than the PARADIGM-HF populations. Angiotensin receptor neprilysin inhibitor appeared to be safe as regard renal function and effective in real-world practice. Left ventricular reverse remodeling was observed 1 year after heart failure medication treatment, including ARNI.

Sensitive detection of the concentrations for normal epithelial cells based on Fano resonance metamaterial biosensors in terahertz range

In this paper, we have cultured normal epithelial cells (HaCaT) as analytes to detect the sensitivity of a biosensor based on Fano resonance metamaterials (FRMMs). The frequency shift Δf of the transmission spectrum was experimentally measured at three different concentrations (0.2×10⁵, 0.5×10⁵, and 5×10⁵  cell/ml) of HaCaT cells. By employing the FRMMs-based biosensor, the detection concentration of HaCaT cells can approximately arrive at 0.2×10⁵  cell/ml; further, the corresponding Δf is 25 GHz, which reaches the measurement limit of the THz-TDS system. Additionally, the increase of HaCaT cell concentration causes a different redshift of Δf from 24-50 GHz, and the maximum of Δf can reach 50 GHz when the HaCaT cell concentration is at 5×10⁵ cell/ml. Similarly, the simulated results show that the Δf depends on the numbers of analytes with a semiball shape and the refractive index of analytes. The theoretical sensitivity was calculated to be 481 GHz/RIU. The proposed FRMMs-based biosensor paves a fascinating platform for biological and biomedical applications and may become a valuable complementary reference for traditional biological research.

Electromagnetically induced transparency-like metamaterials for detection of lung cancer cells

A biosensor based on electromagnetically induced transparent (EIT) metamaterials (MMs) is proposed owing to the low loss and high Q-factor. The theoretical sensitivity of the biosensor based on EIT-like MMs were evaluated up to 248.8 GHz/RIU (RIU, Refractive Index Unit). In experiments, the cancer cells A549, as an analyte, are cultured on EIT-like MMs surface. The results show that when the cell concentration increases from 0.5 × 10⁵ to 5 × 10⁵ cells/ml, the frequency shift Δf could change from 24 to 50 GHz. Moreover, the coupled oscillators model is applied to explain the effect of the refractive index of analyte in simulations and the cell concentration in experiments on the EIT-like MMs. The fitting results exhibit that the refractive index of analyte and cell concentration significantly affect the radiative damping of the bright mode resonator γ₁. The proposed EIT-like MMs biosensors show great potentials for cell measurement because any change that results in the lineshape variation in EIT-like MMs can only be attributed to the change of external dielectric environment due to the suppression of radiative losses.

[Advances in research on cell fate determinant Numb regulating liver cancer]

Liver cancer is one of the most common malignant tumors in China, ranking fifth in malignant tumors and the third in tumor-related deaths. As a membrane-related protein, the asymmetric distribution of cell fate determinant Numb plays a key role in cell differentiation. Research reports that Numb may be closely associated to the occurrence and development of tumors. Recently, scholars have gradually valued its important role in liver cancer. This article briefly reviews the structure of Numb molecule, relationship between Numb and tumorigenesis, the molecular mechanism of Numb-regulated tumors, and the role of Numb in the development of liver cancer.

[A concentration-response observation of hydromorphone combined with ropivacaine in labor analgesia]

Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone. The other 90 women were randomly divided and receieved 0.08% ropivacaine and 15 μg/ml hydromorphone(H1 group), 0.10% ropivacaine and 15 μg/ml hydromorphone (H2 group), 0.12% ropivacaine and 15 μg/ml hydromorphone (group H3) respectively for epidural labor analgesia. In the course of labor, block levels of epidural analgesia, the Bromage scores, analgesia scores and fetal heart rate-uterine concraction were monitored. In addition, onset time of anesthesia, labor time, mode of delivery, cases of increased oxytocin using, neonatal Apgar score, incidence of nausea and vomiting, itching and fetal heart reduction were recorded. Results: The ED(50) and ED(95) values of hydromorphone were 10.49 (95% CI: 8.89-11.79) and 15.15 (95% CI: 13.25-22.25) μg/ml respectively. The onset time in group H1 was significantly longer than those in group H2 and H3((14.23±3.82) , ( 11.32±2.16), (10.83±2.56)min, respectively), the difference was statistically significant (t=5.854, 6.212, all P<0.05). Analgesic VAS score at 30, 60 and 90 min time points in H1 group was significantly higher than that in H2 group and H3 group (all P<0.05). VAS score at withdrawal in H1 group was significantly higher than that in group H3 ( (3.25±0.75) vs (0.27±0.12) ), the difference was statistically significant ( t=9.314, P<0.05). VAS scores at the fourth, fifth, sixth contractions after analgesia in H1 group were significantly higher than those in H2 and H3 groups (all P<0.05). The incidence of motor nerve block in group H3 was higher than that in group H1 and group H2 (26.67%, 6.66%, 3.33%, respectively), the difference was statistically significant (χ(2)=6.413, 4.320, all P<0.05). Conclusions: 0.10% ropivacaine combined with 15 μg/ml hydromorphone has a good analgesic effect, slight motor block, high safety and worthy clinical application for labor analgesia.

Predictors of Fatigue among Female Patients on Hemodialysis

The purposes of this study were to identify the level of fatigue and to examine the predictors of fatigue in female patients on hemodialysis. The subjects for this study were 130 female patients at one hemodialysis unit in northern Taiwan. On univariate analyses, patients with higher levels of fatigue were more likely to be older, and have less education, lower serum albumin levels, sleep disturbances, and perceived higher level of hemodialysis stressors. The findings of this study can help nephrology nurses recognize fatigue as an important nursing issue for female patients on hemodialysis. It is necessary to provide support, information, and alternative solutions for improving their fatigue.

[The Life Impacts and Symptom Distress in Women With Pelvic Organ Prolapse Syndrome Before Pelvic Reconstruction Surgery]

BACKGROUND

The decision whether or not to undergo pelvic reconstructive surgery is difficult for women suffering from pelvic organ prolapse. However, little research has examined the symptom distress and life impacts that these women face prior to this surgery. Thus, it is crucial that gynecology nurses learn about these life impacts and symptom distresses in order to help these women make the best decisions with regard to surgery.

PURPOSE

To explore the life impacts and degree of symptom distress in pre-surgery women with pelvic organ prolapse; to explore the relationships between demographic data and the variables of life impact and degree of symptom distress; and to identify the factors that relate to the explainable variance in the life impacts of these women.

METHODS

A cross-sectional and correlational research design was used and a total of 110 women with pelvic organ prolapse who had not yet undergone pelvic reconstruction surgery were recruited in the gynecological clinics of one medical center in Taiwan.

RESULTS

Daytime urination frequency was the most prevalent urinary tract symptom noted by the participants; vaginal protrusion was the most prevalent pelvis-related symptom noted; and depression and anxiety were the most prevalent life impacts noted. Moreover, greater lower-urinary-tract symptom distress was associated with greater pelvic-symptom distress. Furthermore, greater lower urinary tract and pelvic symptom distresses were associated with a greater negative impact on life. Education background and pelvis-related symptoms were the explained variances in pre-surgery life impacts.

CONCLUSIONS

Women with pelvic organ prolapse should pay particular attention to symptoms that include: daytime urinary frequency, vaginal protrusion, and emotional problems including depression and anxiety. Education background and level of symptom distress should be taken into consideration when caring for the life impacts of this vulnerable group of women.

[Determination of 1-hydroxy-2-butanone in urine by gas chromatography]

Objective: To establish a method for the determination of 1-hydroxy-2-butanone in urine by gas chromatography. Methods: Urine samples were acidified with hydrochloric acid, and then stored in the refrigerator . After thawing under natural conditions, urine volume of 2.0 ml was extracted by C₁₈ solid phase, using methanol volume of 2.0 ml elution, detected by gas chromatography with FID detector and quantified by external standard method. Results: The measurement range of method is 0.986 ~32.88 μg/ml, correlation coefficient (r) =0.999 7, detection limit is 0.13 μg/ml; The recovery is 88.1% ~92.2% ; The precision is 1.4% ~3.2%. Conclusion: This method has a high sensitivity and simple processing. All technical indicators can meet the requirements of the determination method.

Reduced expression of serum miR-204 predicts poor prognosis of gastric cancer

Deregulation of microRNAs (miRNAs) is implicated in the initiation and progression of gastric cancer (GC). Previous studies have demonstrated that miR-204 was downregulated in GC tissues. However, its expression profile in serum samples and its potential for clinical value remain unknown. Real-time PCR was performed to evaluate the expression level of serum miR-204 in patients with GC. The association between serum miR-204 expression level and the clinical outcome of GC was then investigated. Our results showed that the expression of miR-204 in serum samples from GC patients was significantly lower than that in the healthy controls (P < 0.01). Serum miR-204 expression level of GC patients was significantly upregulated after receiving surgical resection (P < 0.01). In addition, serum miR-204 was associated with lymph node metastasis (P = 0.016), tumor differentiation (P = 0.001), and TNM stage (P = 0.005). GC patients with low serum miR-204 expression had shorter overall survival than those with high serum miR-204 expression (P = 0.004). Multivariate analysis revealed that serum miR-204 expression level was an independent risk factor for this malignant disease (HR = 3.629, 95%CI = 2.828-8.146, P = 0.015). In conclusion, our findings indicate that serum miR-204 may be employed as a novel biomarker for monitoring the treatment response and predicting the prognosis of GC.