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Objective To screen the evidence related to acute pericardial tamponade nursing and summarize the best evidence applied in nursing practice. Methods To establish the evidence-based questions according to the PIPOST model, perform computer searches of UpToDate, JBI Evidence-Based Health Care Center of Australia, National Guideline Clearinghouse of USA, NGC), Registered Nurses Association of Ontario (RNAO), Cochrane Library, PubMed, Embase, CNKI, Wanfang Database. The search period is from January 1, 2012 to October 31, 2022. The quality of the selected literatures was evaluated by two researchers respectively, and the literatures meeting the criteria were included and the evidence was summarized. Results Twelve literatures were included, including 2 guidelines, 1 expert consensus, 1 evidence summary, 4 clinical decisions, and 4 case series studies. Sixteen pieces of evidence were formed, including two themes: early identification and emergency care. Conclusion This study summarized the best evidence of acute cardiac tamponade nursing, and provided evidence-based evidence for improving the success rate of rescue and nursing quality of patients with cardiac tamponade. (目的 筛选急性心包填塞护理的相关证据, 并总结应用于护理实践的最佳证据。方法 根据PIPOST模式确立循证问题, 计算机检索UpToDate、澳大利亚JBI循证卫生保健中心、美国国立指南库(NGC)、加拿大安大略注册护士协会网站(RNAO)、Cochrane Library、PubMed、Embase、中国知网(CNKI)、万方数据库。检索时限为2012年1月1日至2022年10月31日。由2 名研究者分别对筛选后的文献进行质量评价, 对符合标准的文献纳入并进行证据的总结。结果 最终纳入文献12篇, 包括指南2篇, 专家共识1篇, 证据总结1篇, 临床决策4篇, 病例系列研究4篇。形成16条证据, 包括2个主题: 早期识别、急救护理。结论 本研究总结了急性心包填塞护理的最佳证据, 为提高心包填塞患者的抢救成功率及护理质量提供循证依据。)

BACKGROUND. Corticosteroids are widely used in patients with COVID 19, although their benefit-to-risk ratio remains controversial. METHODS. Patients with severe COVID-19-related acute respiratory distress syndrome (ARDS) were included from December 29, 2019 to March 16, 2020 in 5 tertiary Chinese hospitals. Cox proportional hazards and competing risks analyses were conducted to analyze the impact of corticosteroids on mortality and SARS-CoV-2 RNA clearance, respectively. We performed a propensity score (PS) matching analysis to control confounding factors. RESULTS. Of 774 eligible patients, 409 patients received corticosteroids, with a median time from hospitalization to starting corticosteroids of 1.0 day (IQR 0.0-3.0 days) . As compared with usual care, treatment with corticosteroids was associated with increased rate of myocardial (15.6% vs. 10.4%, P = 0.041) and liver injury (18.3% vs. 9.9%, P = 0.001), of shock (22.0% vs. 12.6%, P < 0.001), of need for mechanical ventilation (38.1% vs. 19.5%, P < 0.001), and increased rate of 28-day all-cause mortality (44.3% vs. 31.0%, P < 0.001). After PS matching, corticosteroid therapy was associated with 28-day mortality (adjusted HR 1.46, 95% CI 1.01-2.13, P = 0.045). High dose (>200 mg) and early initiation ([less than or equal to] 3 days from hospitalization) of corticosteroid therapy were associated with a higher 28-day mortality rate. Corticosteroid use was also associated with a delay in SARS-CoV-2 coronavirus RNA clearance in the competing risk analysis (subhazard ratio 1.59, 95% CI 1.17-2.15, P = 0.003). CONCLUSION. Administration of corticosteroids in severe COVID-19-related ARDS is associated with increased 28-day mortality and delayed SARS-CoV-2 coronavirus RNA clearance after adjustment for time-varying confounders. FUNDING. None., Introduction SARS-CoV-2 has spread worldwide (1). As of July 17, there were more than 13 million cases and 585,727 deaths worldwide, including over 4000 reported deaths in China (1). There [...]

Solubility of aerosol trace elements, which determines their bioavailability and reactivity, is operationally defined and strongly depends on the leaching protocol used. Ultrapure water batch leaching is one of the most widely used leaching protocols, while the specific leaching protocols used in different labs can still differ in agitation methods, contact time, and filter pore size. It is yet unclear to which extent the difference in these experimental parameters would affect the aerosol trace element solubility reported. This work examined the effects of agitation methods, filter pore size, and contact time on the solubility of nine aerosol trace elements and found that the difference in agitation methods (shaking vs. sonication), filter pore size (0.22 vs. 0.45 µ m), and contact time (1 vs. 2 h) only led to small and sometimes insignificant difference in the reported solubility. We further compared aerosol trace element solubility determined using four ultrapure water leaching protocols, which are adopted by four different labs and vary in agitation methods, filter pore size, and/or contact time, and observed good agreement in the reported solubility. Therefore, our work suggests that although ultrapure water batch leaching protocols used by different labs vary in specific experimental parameters, the determined aerosol trace element solubility is comparable. We recommend that ultrapure water batch leaching be one of the reference leaching schemes and emphasize that additional consensus in the community on agitation methods, contact time, and filter pore size is needed to formulate a standard operating procedure for ultrapure water batch leaching. [ABSTRACT FROM AUTHOR]

This work investigated seasonal variation of aerosol iron (Fe) solubility for coarse (>1 µ m) and fine (<1 µ m) particles at Xi'an, a megacity in northwestern China impacted by anthropogenic emission and desert dust. Total Fe concentrations were lowest in summer and were similar in other seasons for coarse particles but lowest in summer and highest in spring for fine particles; for comparison, dissolved Fe concentrations were higher in fall and winter than spring and summer for coarse particles but highest in winter and lowest in spring and summer for fine particles. Desert-dust aerosol was always the major source of total Fe for both coarse and fine particles in all four seasons, but it may not be the dominant source of dissolved Fe. Fe solubility was lowest in spring for both coarse and fine particles and highest in winter for coarse particles and in fall for fine particles. In general, aerosol Fe solubility was found to be higher in air masses originating from local and nearby regions than those arriving from desert regions after long-distance transport. Compared to coarse particles, Fe solubility was similar for fine particles in spring but significantly higher in the other three seasons, and at a given aerosol pH range, Fe solubility was always higher in fine particles. Aerosol Fe solubility was well correlated with relative abundance of aerosol acidic species, implying aerosol Fe solubility enhancement by acid processing; moreover, such correlations were better for coarse particles than fine particles in all four seasons. Fe solubility was found to increase with relative humidity and acid acidity for both coarse and fine particles at Xi'an, underscoring the importance of aerosol liquid water and aerosol acidity in regulating Fe solubility via chemical processing. [ABSTRACT FROM AUTHOR]

In this paper, we study the thermal dissipation of Raman fiber laser and amplifier utilizing pure passive fiber as gain medium for the first time. Take into account the convective and conductive heat transferring process in the fiber, we consider the heat transferring and Raman conversion model based on the thermal conduction equations and the Raman coupled equations in the fiber. With the simulation of power distribution, the thermal profiles of Raman fiber laser are analyzed, including the transverse and longitudinal distributions of the heat load density, temperature, and thermal-induced refractive index change in the fiber. Meanwhile, the heat dissipation in multimode graded-index fiber and step-index fiber are also calculated and compared. The results show that the amplifier is superior to the resonator in heat alleviation, and the forward pumping scheme is also better to ease the thermal load than the backward and bidirectional pumping schemes, which have consult meaning for the suppression of thermal effects and the power scaling in Raman fiber lasers. [ABSTRACT FROM AUTHOR]