Effect of COVID-19 infection on pregnant women in plateau regions

OBJECTIVE

The present study aims to explore the effect of COVID-19 infection on pregnant women in plateau regions.

STUDY DESIGN

Data from 381 pregnant women infected with COVID-19 who underwent prenatal examination or treatment at Women and Children's Hospital of Tibet Autonomous Region between January 2020 and December 2022 and 314 pregnant women not infected with COVID-19 were retrospectively collected.

METHODS

The study participants were divided into an infected and non-infected group according to whether they were infected with COVID-19. Basic information (ethnicity, age, body mass index and gestational age [GA]), vaccination status, intensive care unit (ICU) admission and delivery outcomes were compared. Binary logistic regression was used to analyse the influencing factors of ICU admission.

RESULTS

The results revealed significant differences in the GA, vaccination rate, blood pressure, partial pressure of oxygen, white blood cell (WBC) count, ICU admission rate, preeclampsia rate, forearm presentation rate, thrombocytopenia rate, syphilis infection rate and placental abruption rate between the two groups (P < 0.05). A univariate analysis showed that COVID-19 infection, hepatitis B virus infection, the WBC count and hypoproteinaemia were risk factors for ICU admission. The results of the multivariate analysis of the ICU admission of pregnant women showed that COVID-19 infection (odds ratio [OR] = 4.271, 95 % confidence interval [CI]: 3.572-5.820, P < 0.05) was a risk factor for ICU admission and the WBC count (OR = 0.935, 95 % CI: 0.874-0.947, P < 0.05) was a protective factor for ICU admission.

CONCLUSION

Pregnant women are vulnerable to the adverse consequences of COVID-19 infection, and public health measures such as vaccination are needed to protect this population subgroup.

Effects of a temporal self-regulation theory-based intervention on self-management in hemodialysis patients: A randomized controlled trial

OBJECTIVE

To investigate the effects of a temporal self-regulation theory-based intervention on self-management in hemodialysis patients.

METHODS

A randomized controlled trial was carried out in Lanzhou, China. Participants were randomly allocated to either the intervention group (n = 42) or control group (n = 42). The outcomes of self-management level, interdialytic weight gain, serum potassium and serum phosphorus were collected at baseline (T0), 1 month after intervention (T1), and 2 months after follow-up (T2).

RESULTS

After intervention and follow-up, the self-management score of the intervention group was significantly higher than that of the control group, while the interdialytic weight gain, serum potassium, and serum phosphorus were significantly lower. The group and time interaction effects revealed that participants in the intervention group exhibited significantly greater improvement in self-management at T1 and T2. Interdialytic weight gain decreased significantly at T2. Serum potassium levels did not differ significantly at T1 or T2. The changes in serum phosphorus were both significant at T1 and T2.

CONCLUSION

This study demonstrated that the temporal self-regulation theory-based intervention was effective in improving hemodialysis patients' self-management.

PRACTICE IMPLICATIONS

The findings suggest popularizing and applying this intervention in the clinic to maintain the long-term effectiveness of the intervention effect.

Impacts of cognition of exercise on physical activity participation in hemodialysis patients

INTRODUCTION

Physical inactivity is a strong predictor of mortality in hemodialysis patients. Although regular physical activity reduces mortality, patients remain inactive. Comparing the cognition of exercise in hemodialysis patients with different physical activity status could highlight domains where inactive people experience heightened barriers to physical activity. We therefore assessed patients' perceived benefits and barriers to exercise using a standardized way, thereby informing future exercise interventions to address these barriers experienced by inactive patients.

METHODS

ESRD patients undergoing hemodialysis were recruited and asked to complete a human activity profile, wear a pedometer for seven consecutive days, and complete the Dialysis Patient-perceived Exercise Benefits and Barriers Scale (DPEBBS). Binominal Logistic regression analysis was conducted to determine which benefits and barriers are associated with physical activity. This cross-sectional observational study was registered as NCT05189795.

RESULTS

A total of 505 patients completed the survey, most of whom were male (67.1%), with an average age of 49.69 ± 13.96 years. And 52.67-76.63% patients on HAP questionnaire were inactive. The co-benefits in active patients were improving mood and prevention of muscle wasting but did not reach significance in physical activity level. Tiredness, muscle fatigue, and lack of knowledge of exercise were common barriers to patients, and all have a significant impact on a patient's physical activity level.

CONCLUSIONS

For inactive patients, exercise during hemodialysis can not only improve physical activity but also reduce family burden. And improving physical activity is a long-term project that cannot be separated from the support of hemodialysis medical staff.

Applying self-determination theory towards motivational factors of physical activity in people undergoing haemodialyses: A qualitative interview study

INTRODUCTION

The level of physical activity of people undergoing haemodialyses is low, so understanding what factors underlie the motivation to be physically active in people undergoing haemodialyses is important. Therefore, this qualitative study aims to explore the different motivation types and corresponding basic psychological needs (BPNs) of people undergoing haemodialyses based on self-determination theory.

METHODS

We adopted the objective sampling method to select 19 patients with the end-stage renal disease aged from 28 to 66 years old from a tertiary hospital in Xi'an. They underwent haemodialyses five to six times every 2 weeks for more than 3 months. Then, we conducted semistructured one-on-one interviews with 19 people undergoing haemodialyses using qualitative content analysis. All interviews were recorded, transcribed verbatim and analyzed on a thematic analysis.

RESULTS

We analyzed four motivation types of patients, namely four themes, including entrenching in physical inactivity (Amotivation), breaking physical inactivity (Controlled motivation), finding one's way (Autonomous regulation) and enjoying the positive effects of physical activity (Intrinsic motivation). Each motivation is dominated by one or more BPNs. For example, inadequate Competence such as decreased physical function is the reason why the patient does not perform physical activities. Due to the lack of health education on physical activity, people undergoing haemodialyses often lack the motivation for controlled regulation. The motivation for self-regulation is generated by the patients' promotion of meeting BPNs, such as normal social interactions. The formation of patients' autonomous motivation can't be separated from the effective understanding felt by other patients, because their situations are similar. Enjoying physical activity promotes the formation of patients' intrinsic motivation and the maintenance of this behaviour.

CONCLUSION

Perceived Competence, Relatedness and Autonomous Motivation are important determinants for physical activity in people undergoing haemodialyses. Patients need to internalize the changed values and skills, so as to generate the motivation of self-regulation, rather than external or controlled forms of motivation regulation, to better maintain behaviour change.

PATIENT OR PUBLIC CONTRIBUTION

People undergoing haemodialyses were involved in the development of the interview topic guide to ensure all relevant topics were explored.

Self-management experiences of haemodialysis patients with self-regulatory fatigue: A phenomenological study

AIM

To understand the real experiences of self-management in haemodialysis patients with self-regulatory fatigue, and to explore the influencing factors and coping strategies for patients with decreased self-management.

DESIGN

A qualitative study was carried out using the phenomenological analysis method.

METHODS

From 5 January to 25 February, 2022, semi-structured interviews were conducted with 18 haemodialysis patients in Lanzhou, China. Thematic analysis of the data was performed using the NVivo 12 software based on the 7 steps of Colaizzi's method. The study reporting followed the SRQR checklist.

RESULTS

Five themes and 13 sub-themes were identified. The main themes were difficulties in fluid restrictions and emotional management, hard to adhere to long-term self-management, uncertainty about self-management, influencing factors are complex and diverse and coping strategies should be further improved.

CONCLUSION

This study revealed the difficulties, uncertainty, influencing facts and coping strategies of self-management among haemodialysis patients with self-regulatory fatigue. A targeted program should be developed and implemented according to the characteristics of patients to reduce the level of self-regulatory fatigue and improve self-management.

IMPACT

Self-regulatory fatigue has a significant impact on the self-management behaviour of haemodialysis patients. Understanding the real experiences of self-management in haemodialysis patients with self-regulatory fatigue enables medical staff to correctly identify the occurrence of self-regulatory fatigue in time and help patients adopt positive coping strategies to keep effective self-management behaviour.

PATIENT OR PUBLIC CONTRIBUTION

Haemodialysis patients who met the inclusion criteria were recruited to participate in the study from a blood purification centre in Lanzhou, China.

Barriers and facilitators to exercise in haemodialysis patients: A systematic review of qualitative studies

AIMS

The purpose of this systematic review is to synthesize the results of qualitative research and to identify the barriers and facilitators to exercise in haemodialysis patients from the perspectives of haemodialysis patients, caregivers and dialysis staff members.

DESIGN

Systematic review of qualitative studies.

DATA SOURCES

Qualitative studies were extracted from MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, PubMed, CBM, CNKI and WanFang Database from inception of each database until July 2020. Qualitative research and mixed method research including barriers and/or facilitators to exercise in haemodialysis patients were included.

REVIEW METHODS

The systematic search method SPIDER (sample, phenomenon of interest, design, evaluation, research type) was used. Thematic synthesis of qualitative data was used.

RESULTS

284 studies were screened and 10 studies published between 2007 and 2020 were finally included in this review. The review included 180 patients, 70 dialysis staff members and seven caregivers. Five analytical themes were identified: disease distress, perception of exercise, environmental restrictions, spirit strength and hospital management. Barriers include disease distress, perception of exercise (security issue), environmental restrictions and hospital management. Facilitators include perception of exercise (exercise being considered beneficial, preference for exercise) and spirit strength (from religious beliefs). It is the spiritual strength (from family and friends, from dialysis staff members) that is both the barrier and the facilitator.

CONCLUSION

There are many barriers in popularizing exercise among haemodialysis patients. Future intervention measures and health policies should strengthen the facilitators and reduce the barriers, so as to promote the clinical practice of exercise for haemodialysis patients.

IMPACT

This review summarizes the barriers and facilitators to exercise in haemodialysis patients. The results of this study have an impact on research, practice and health policy setting. The exercise level of haemodialysis patients can be improved by using the facilitators and solving the barriers.

Barriers and facilitators to exercise in hemodialysis patients: A protocol for systematic review

BACKGROUND

Exercise training has a lot of potential benefits for hemodialysis patients. And some guidelines emphasize the importance of exercise for maintenance hemodialysis. However, there are many barriers to encourage hemodialysis patients to increase their level of physical activity. A broader understanding of the specific barriers is needed.

METHODS

MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, PubMed, CBM, CNKI, and WangFang will be searched electronically. The Reference lists of included studies will be retrieved manually. If the study is designed with qualitative or mixed methods and directly explores the factors related to the exercise of dialysis patients, the study will be selected. The Critical Appraisal Skills Programme Qualitative Checklist will be applied for the study appraisal. The study search, selection and evaluation of the study will be conducted by 2 independent reviewers. Thematic synthesis will be used for synthesizing the findings of the primary studies.

RESULTS

This study will provide a high-quality synthesis to examine the barriers and facilitators affecting exercise in hemodialysis patients from the perspective of patients, caregivers, and health care providers.

CONCLUSION

This systematic review will contribute to the in-depth understanding of barriers and facilitators affecting exercise in hemodialysis patients, and improve the prognosis of this population.

ETHIC AND DISSEMINATION

The content of this article does not involve moral approval or ethical review because no individual data will be collected.

PROSPERO REGISTRATION

CRD42020200278. (https://www.crd.york.ac.uk/prospero/#recordDetails).

Exercise Training and Outcomes in Hemodialysis Patients: Systematic Review and Meta-Analysis

BACKGROUND

Inadequate dialysis, renal hypertension, and impaired exercise capacity are factors that affect the quality of life (QoL) and mortality of adults with end-stage renal disease (ESRD) undergoing hemodialysis (HD). This systematic review provided valid evidence about the effect of exercise training on single-pool Kt/V (sp Kt/V), blood pressure, and peak uptake oxygen (VO2 peak).

METHOD

A systematic review and meta-analysis of published randomized controlled trials (RCTs) that evaluated the effects of no <8 weeks' exercise training on the physical fitness outcomes for adults with ESRD undergoing HD were accepted in this study.

RESULTS

Included 20 trials (677 participants) indicated that various exercise types improved aerobic capacity, walking capacity, and health-related QoL totally. Of note, aerobic exercise and combined exercise were the predominant exercise types.

CONCLUSION

Based on our evidence, aerobic exercise or combined exercise at least for 8 weeks to 12 months, 3 times weekly, will be beneficial to physical conditions of the patients with ESRD undergoing HD. The clinical staff can treat patients with the evidence above. Future studies need to provide more information basis for the construction of patient exercise system by adding various exercise combinations.

Investigation of MMP-1 genetic polymorphisms and protein expression and their effects on the risk of Kashin-Beck disease in the northwest Chinese Han population

BACKGROUND

The etiology of Kashin-Beck disease (KBD), an endemic osteochondropathy, is largely unknown. Matrix metalloproteinase-1 (MMP-1) plays a central role in the initiation and progression of cartilage destruction; however, no study has reported on the relationship between KBD and MMP-1. This study was to investigate the role of MMP-1 in the pathogenesis and progression of KBD.

METHODS

Single nucleotide polymorphism (SNP) genotyping was conducted for 274 KBD cases and 248 healthy controls using the Sequenom MassARRAY system. Additionally, the expression of MMP-1 in the knee articular cartilage of 22 KBD patients and 21 controls was analyzed by immunohistochemistry, and the concentration of MMP-1 in their joint fluid was also measured by enzyme-linked immunosorbent assay (ELISA).

RESULTS

The results showed that two SNPs (rs470221 and rs1144396) had a weak association with increased KBD risk; however, the significance of these results did not survive Bonferroni's correction. Moreover, the percentages of cells expressing MMP-1 in each layer of cartilage were significantly higher in the KBD group than in the controls (F = 11.41-28.31, P = 0.002-0.000). The concentration of MMP-1 in KBD joint fluid was significantly higher than that in the controls (t = 9.83, P < 0.0001).

CONCLUSIONS

The increased expression of MMP-1 has a potential effect on the risk of KBD in the northwest Chinese Han population. However, six selected SNPs in the MMP-1 gene might not be useful as significant markers for predicting KBD susceptibility in Chinese Han population. Therefore, future studies in the association of MMP-1 with KBD should focus on other candidate SNPs.

COL9A1 gene polymorphism is associated with Kashin-Beck disease in a northwest Chinese Han population

Objective

We sought to determine whether genomic polymorphism in collagen IX genes (COL9A) was associated with Kashin-Beck disease (KBD).

Methods

Twenty seven single nucleotide polymorphisms (SNPs) in COL9AI, COL9A2 and COL9A3 were genotyped in 274 KBD cases and 248 healthy controls using the Sequenom MassARRAY system. Associations between the COL9A polymorphism and KBD risk were detected using an unconditional logistic regression model. Linkage disequilibrium (LD) and haplotypes analysis were performed with the Haploview software.

Results

After Bonferroni correction, the frequency distribution of genotypes in rs6910140 in COL9A1 was significantly different between the KBD and the control groups (X² = 16.74, df = 2, P = 0.0002). Regression analysis showed that the allele “C” in SNP rs6910140 had a significant protective effect on KBD [odds ratio (OR) = 0.49, 95% confidence interval (CI) = 0.34–0.70, P = 0.0001]. The frequencies of alleles and genotypes in rs6910140 were significantly different among subjects of different KBD stages (allele: X² = 7.82, df = 2, P = 0.02, genotype: X² = 14.81, df = 4, P = 0.005). However, haplotype analysis did not detect any significant association between KBD and COL9A1, COL9A2 and COL9A3.

Conclusions

We observed a significant association between rs6910140 of COL9A1 and KBD, suggesting a role of COL9A1 in the development of KBD.

454 EST analysis detects genes putatively involved in ginsenoside biosynthesis in Panax ginseng

Panax ginseng C.A. Meyer is one of the most highly valued medicinal plants in the world. To analyze the transcriptome of P. ginseng and discover the genes involved in ginsenoside biosynthesis, cDNAs derived from the total RNA of 11-year-old, wood-grown P. ginseng roots were analyzed by 454 sequencing. A total of 217,529 high quality reads (expressed sequence tags, ESTs), with an average length of 409 bases, were generated from a one-quarter run to yield 31,741 unique sequences. The majority (20,198; 63.6%) of the unique sequences were annotated using BLAST similarity searches. A total of 16,810 and 16,577 unique sequences were assigned to functional classifications and biochemical pathways based on Gene Ontology analysis and the Kyoto Encyclopedia of Genes and Genomes assignment, respectively. Nine genes involved in the biosynthesis of ginsenoside skeletons and many candidate genes putatively responsible for modification of the skeletons, including 133 cytochrome P450s and 235 glycosyltransferases, were identified. From these candidates, six transcripts encoding UDP-glycosyltransferases that were most likely to be involved in ginsenoside biosynthesis were selected. These results open a new avenue by which to explore and exploit biosynthetic and biochemical properties that may lead to drug improvement. These 454 ESTs will provide the foundation for further functional genomic research into the traditional herb P. ginseng or its closely related species.

A colony-to-lawn method for efficient transformation of Escherichia coli

AIMS

To develop a fast, convenient, inexpensive and efficient Escherichia coli transformation method for changing hosts of plasmids, which can also facilitate the selection of positive clones after DNA ligation and transformation.

METHODS AND RESULTS

A single fresh colony from plasmid-containing donor strain is picked up and suspended in 75% ethanol. Cells are pelleted and resuspended in CaCl(2) solution and lysed by repetitive freeze-thaw cycles to obtain plasmid-containing cell lysate. The E. coli recipient cells are scraped from the lawn of LB plate and directly suspended in the plasmid-containing cell lysate for transformation. Additionally, a process based on colony-to-lawn transformation and protein expression was designed and conveniently used to screen positive clones after DNA ligation and transformation.

CONCLUSIONS

With this method, a single colony from plasmid-containing donor strain can be directly used to transform recipient cells scraped from lawn of LB plate. Additionally, in combination with this method, screening of positive clones after DNA ligation and transformation can be convenient and time-saving.

SIGNIFICANCE AND IMPACT OF THE STUDY

Compared with current methods, this procedure saves the steps of plasmid extraction and competent cell preparation. Therefore, the method should be highly valuable especially for high-throughput changing hosts of plasmids during mutant library creation.

Relationship between coping, self-esteem, individual factors and mental health among Chinese nursing students: a matched case-control study

PURPOSE

To investigate the relationship between ways of coping, self-esteem, individual factors and mental health among Chinese nursing students.

METHOD

A sample of 515 nursing students was selected from four public institutes and colleges in Xi'an of China by a random sampling method. They were surveyed by a self-evaluation questionnaire including the Symptom-Checklist 90 (SCL-90), the Simplified Coping Style Questionnaire, the Self-Esteem Scale and the Personal Data Form. On the basis of the total score of SCL-90 obtained in the survey, high and low score groups were formed, each consisting of 100 nursing students. Then a matched case-control design was carried out to explore the relationship between ways of coping, self-esteem, individual factors and mental health. Besides descriptive statistics, the Chi-square analysis, t-test and Multivariate Logistic Regression Analysis were also employed.

RESULTS

The active coping and self-esteem scores of the high score group were found to be much lower than those of the low score group (P<0.05), while it was the opposite for passive coping scores (P<0.01). Multivariate Logistic Regression Analysis suggested that study stress (OR=10.017, 95%CI: 3.273-30.654) and physical health problems in the past year (OR=4.384, 95%CI: 1.492-12.877) were independent risk factors of mental health among nursing students, whereas self-fulfillment satisfaction (OR=0.037, 95%CI: 0.014-0.097) and a higher level of self-esteem (OR=0.357, 95%CI: 0.152-0.838) were preventive factors.

CONCLUSION

The mental health of Chinese nursing students was related to the ways of coping, self-esteem, study stress and physical health problems in the past year. In order to improve the mental health of nursing students, aside from reducing the study stress and avoiding passive coping, it is very necessary for them to be supported to ensure that academic stress is minimized, autonomy is promoted, and self-esteem is developed.

[Molecular evolution of AdoMet synthetase by DNA recombination with a novel separate-mixing method]

We describe a new approach to in vitro DNA recombination termed Separate-Mixing method in this study. The reaction process of this method consists of two stages: at the first stage the reaction was implemented in two parallel teams, which generated random recombination by template-switching of growing polynucleotides from primers in the presence of unidirectional single-stranded DNA fragments used as templates, and then both teams were mixed together for further extension and recombination of DNA sequences at the second stage. Because of the particular strategy, the reaction process was also accompanied by the other two processes of DNA shuffling and StEP simultaneously. Two AdoMet synthetase genes sam2 from Saccharomyces cerevisiae and metK from Escherichia coli, which have only 56% homology on the DNA level were used for recombination with Separate-Mixing method. DNA recombination was available after a single round of reaction. With sequencing of 10 randomly selected recombinants, no unshuffled parental clone was found, and also no unexpected insertion, deletion or rearrangement was detected. An evolved gene sam' was obtained after screen and selection, which could obviously increase the accumulation of AdoMet in S. cerevisiae.