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Alternative Therapies in Health and... Jun 2024Stroke is a major cause of long-term disability in adults. Routine nursing mainly meets the life needs of patients through the intervention of patients' general life but...
BACKGROUND
Stroke is a major cause of long-term disability in adults. Routine nursing mainly meets the life needs of patients through the intervention of patients' general life but only provides the most basic services for patients, which makes it difficult to meet the requirements of patients' physical exercise and other aspects, affecting the prognosis. Early rehabilitation after a stroke is important for the recovery of bodily functions in stroke patients. However, the impacts of early rehabilitation nursing on motor function, swallowing function as well as quality of life in stroke patients remain to be further explored.
OBJECTIVE
To investigate the effects of early rehabilitation nursing on motor function, swallowing function as well as quality of life in stroke patients.
DESIGN
This was a randomized, single-blind, controlled experiment.
SETTING
This study was carried out in the neurology department at Xuzhou Central Hospital.
PARTICIPANTS
A total of 116 acute stroke patients validated by craniocerebral computed tomography (CT) and magnetic resonance imaging (MRI) from January 2021 to December 2022 were chosen and separated into the control group (n=58) and research group (n=58) following the random number method.
INTERVENTIONS
The control group was given routine nursing. The research group implemented early rehabilitation nursing 24 hours after admission on the basis of the control group.
PRIMARY OUTCOME MEASURES
(1) recovery of swallowing dysfunction (2) recovery of limb function (3) self-care ability (4) sleep quality (5) quality of life and (6) total satisfaction of patients.
RESULTS
The research group had an elevated total effective rate of swallowing dysfunction recovery in contrast to the control group after nursing (P < .05). The recovery of limb function, self-care ability, sleep quality, and quality of life were promoted in both groups, followed by nursing (P < .05), and those in the research group were higher relative to the control group (P < .05). The total satisfaction of patients in the research group presented higher relative to the control group (P < .05).
CONCLUSION
The application effect of early rehabilitation nursing in acute stroke patients is outstanding, and the swallowing dysfunction and limb dysfunction of patients can be effectively improved, which has a high nursing value and is worth promoting and applying. Therefore, an early physical rehabilitation program for acute stroke inpatients should be considered for implementation in clinical settings.
PubMed: 38940785
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024Traumatic brain injury (TBI) can result in lifelong cognitive, emotional, and motor impairments. The emergency department is the first stop for diagnosing and treating...
CONTEXT
Traumatic brain injury (TBI) can result in lifelong cognitive, emotional, and motor impairments. The emergency department is the first stop for diagnosing and treating patients with acute TBI, and the quality of nursing care can greatly influence the prognosis and progression of a patient's condition. Currently, standardized evaluation tools are lacking in the world for assessment of the quality of nursing care.
OBJECTIVE
The study intended to construct a nursing-sensitive indicator system for TBI patients, based on the scientific method of evidence-based nursing and the Delphi method, to provide a quantitative tool for emergency-nursing personnel to manage the quality of care for those patients.
DESIGN
Based on the Joanna Briggs Institute's evidence-based healthcare model, the research team performed a literature search and consulted reference guidelines, conducted two rounds of consultations with experts. sensitive indicators for quality of care, and constructed the sensitive indicator system. The team then conducted a retrospective study.
SETTING
The study took place in the department of emergency surgery at Shanxi Norman Bethune Hospital in Taiyuan, Shanxi, China.
PARTICIPANTS
Participants were 56 patients with TBI who had been admitted to the emergency department between January 2022 and December 2022 and 44 patients with TBI who had been admitted to the emergency department between January 2023 and December 2023.
INTERVENTIONS
The research team assigned: (1) the 56 patients in the first group to the control group, who received routine nursing care and (2) the 44 patients in the second group to the intervention group, who received treatment using the sensitive indicator system for the quality of emergency care for TBI patients as well as routine care.
OUTCOME MEASURES
In the verification study, the research team compared the group's rescue effects and satisfaction with emergency care.
RESULTS
In the first and second rounds of inquiries to experts, the research team distributed 25 questionnaires each time, with 25 valid questionnaires collected both times. The response rate for both rounds of inquiries was 100%. The expert authority coefficients for the first and second rounds of inquiries are 0.844 and 0.878, respectively. The sensitive indicator system's final construction included three primary indicators, seven secondary indicators, and 17 tertiary indicators. The AUC for the sensitive indicators was 0.8355882. The indicator system's use found that the intervention group had a shorter time to diagnosis (P < .001), emergency-department stay (P < .001), and emergency-department-to-surgery time (P < .001) compared to the control group. The intervention group also has a higher success rate for the emergency treatment (P = .014) and a higher nursing satisfaction with nurse-patient communications (P = .003), first-aid operations (P < .001), nursing attitudes (P < .001), and emergency environment (P < .001) compared to the control group.
CONCLUSIONS
The process of constructing quality-sensitive indicators for the nursing care of TBI patients was scientific. The constructed quality-sensitive indicator system for the care of patients with TBI covers key factors that influence the quality of care. It's highly practical and has the ability to transform certain indicators, which can better guide the management of quality of care for TBI.
PubMed: 38940780
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024The objective of this study is to develop a prediction model for the pathological upgrading of low-grade dysplasia (LGD) in gastric mucosa. The study aims to compare the...
OBJECTIVE
The objective of this study is to develop a prediction model for the pathological upgrading of low-grade dysplasia (LGD) in gastric mucosa. The study aims to compare the performance of a traditional model based on clinical and endoscopic factors with an enhanced model that incorporates AMACR staining of biopsy tissues.
METHODS
The study utilized a training dataset of 405 LGD cases to establish and compare the traditional and enhanced prediction models. Factors associated with upgrading were identified, and the traditional model was based on these factors. The enhanced model incorporated AMACR staining. The models' performances were evaluated using the area under the curve (AUC), bootstrap resampling, and decision curve analysis. External validation was performed using 171 LGD cases. Statistical techniques such as logistic regression and resampling methods were employed to assess the models' predictive abilities and robustness.
RESULTS
In the training dataset, the traditional model achieved an AUC of 0.824 (95% confidence interval [CI]: 0.783-0.865) for predicting pathological upgrading. However, the enhanced model, which incorporated AMACR staining, exhibited a significantly improved performance with an AUC of 0.878 (95% CI: 0.843-0.913). This increase in AUC by 0.054 (95% CI: 0.015-0.093) demonstrates a statistically significant enhancement provided by the inclusion of AMACR staining in the prediction model for pathological upgrading of LGD lesions in gastric mucosa.
CONCLUSION
The findings of this study highlight the practical implications of the enhanced prediction model incorporating AMACR staining for low-grade gastric mucosal dysplasia (LGD). The significantly improved performance of the enhanced model in predicting pathological upgrading emphasizes its potential to revolutionize the management and treatment strategies for patients with LGD. By providing a more accurate prediction of upgrading, the enhanced model enables early intervention and timely decision-making, leading to improved outcomes and prognosis for patients. The incorporation of AMACR staining in the prediction model holds promise for enhancing diagnostic strategies and reducing the incidence of postoperative pathological upgrading. This research underscores the importance of leveraging advanced techniques to improve the early detection rate of gastric cancer and ultimately benefit patient care.
PubMed: 38940773
DOI: No ID Found -
Journal of Chemical Information and... Jun 2024Sigma-1 receptor (S1R) is involved in a large array of biological functions due to its ability to interact with various proteins and ion channels. Crystal structures of...
Sigma-1 receptor (S1R) is involved in a large array of biological functions due to its ability to interact with various proteins and ion channels. Crystal structures of human S1R revealed the trimeric organization for which each protomer comprises the ligand binding pocket. This study applied a multistep computational procedure to develop a pharmacophore model obtained from molecular dynamics simulations of available cocrystal structures of well-known S1R ligands. Apart from the well-established positive ionizable and hydrophobic features, the obtained model included an additional specific hydrophobic feature and different excluded volumes, thus increasing the selectivity of the model as well as a more detailed determination of the distance between two essential features. The obtained pharmacophore model passed the validation test by receiver operating characteristic (ROC) curve analysis of active and inactive S1R ligands. Finally, the pharmacophoric performance was experimentally investigated through the synthesis and binding assay of new 4-phenylpiperazine-based compounds. The most active new ligand 2-(3-methyl-1-piperidyl)-1-(4-phenylpiperazin-1-yl)ethanone () showed an S1R affinity close to the reference compound haloperidol ( values of 4.8 and 2.6 nM, respectively). The proposed pharmacophore model can represent a useful tool to design and discover new potent S1R ligands.
PubMed: 38940754
DOI: 10.1021/acs.jcim.4c00500 -
Food Additives & Contaminants. Part A,... Jun 2024Bakery products, including biscuits, cakes and breads, generally present a high content of simple sugars of rapid absorption, high fat content and low amount of dietary...
Bakery products, including biscuits, cakes and breads, generally present a high content of simple sugars of rapid absorption, high fat content and low amount of dietary fiber, which make them highly caloric foods. Although sucrose is a very important ingredient in bakery products for its preservation characteristics and a significant source of energy, there is a growing interest in replacing this sugar with alternative substances, such as high-intensity sweeteners (HIS) that provide sweetness with no or low calories. In Brazil, there is no data on the use of HIS in this class of food. Therefore, the objective of this study was to evaluate the presence of HIS in baked food commercially available in the country and estimate the dietary exposure to these food additives. For that, an analytical method was established for the simultaneous determination of nine HIS in bakery products using ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Sample preparation steps were required based on mechanical kneading for homogenization, hexane extraction of fats, dilution in mobile phase and vortex homogenization, prior to injection into the system. The results obtained during validation showed that coefficients of variation (CV%) for precision were lower than 13.8% and the accuracy was between 91.6% and 109.1%. Aspartame, acesulfame potassium, sodium cyclamate, saccharin, sucralose and steviol glycosides were found in the samples, used alone or in combinations of up five substances. Steviol glycosides were the most found HIS in biscuit samples, while sucralose was the most common sweetener in cake and bread samples. Analysis of product labels revealed only three different claims, .i.e. 'no sugar', 'no added sugar' and 'zero sugar', with the latter being found in 70% of the samples. Exposure to HIS through the consumption of bakery products estimated per eating occasion showed no concerns regarding toxicological risk.
PubMed: 38940750
DOI: 10.1080/19440049.2024.2371929 -
Sarcoidosis, Vasculitis, and Diffuse... Jun 2024Cardiac sarcoidosis is associated with significant morbidity and mortality. Immunosuppressive treatment focuses on suppressing myocardial inflammation, which can lead to...
Cardiac sarcoidosis is associated with significant morbidity and mortality. Immunosuppressive treatment focuses on suppressing myocardial inflammation, which can lead to major adverse events especially when progressing to fibrosis. Conventional management usually includes steroids and steroid sparing agents such as methotrexate and azathioprine. Tumour necrosis factor alpha inhibitors are often reserved for those with a worsening clinical status and/or evidence of persistent inflammatory activity despite conventional therapy. Refractory cardiac sarcoidosis (CS) can be defined as the persistence or progression of active disease, evidenced either by lack of clinical response or persistence or progression of imaging abnormalities, despite being on conventional therapy. In the United Kingdom, tumour necrosis factor alpha inhibitors are currently not licensed for cardiac sarcoidosis as there are no randomised controlled trials to assess the efficacy of infliximab in this patient cohort. In this study, we present the outcomes of six patients treated with infliximab for refractory cardiac sarcoidosis at Royal Brompton Hospital and performed a systematic review of the existing literature on use of infliximab in cardiac sarcoidosis. We searched the Cochrane Library, OVID Medline, OVID Embase, Web of Science and Pubmed to identify 7 full-text studies assessing the role of infliximab in the management of cardiac sarcoidosis. Infliximab was found to play a vital role in stabilising refractory cardiac sarcoidosis by stemming clinical deterioration, arrythmia burden and even reducing steroids requirements. Further prospective trial data is necessary to validate these findings.
PubMed: 38940716
DOI: 10.36141/svdld.v41i2.14484 -
Aging & Mental Health Jun 2024Women are twice as likely to be diagnosed with major depressive disorder as men. Yet suicide rates are four times higher in men than women, increasing to six times when...
OBJECTIVES
Women are twice as likely to be diagnosed with major depressive disorder as men. Yet suicide rates are four times higher in men than women, increasing to six times when comparing older men to older women. Investigators have begun researching if depression presents differently in individuals who adhere to masculine norms, leading to the conceptualization of masculine depression. Despite validity evidence for the Male Depression Risk Scale-22 (MDRS-22) in mixed-age samples, few studies have investigated the possibility of age-related differences in masculine depression. The present study aimed to test for age invariance of the MDRS-22.
METHOD
Age invariance for the MDRS-22 was tested a multi-group confirmatory factor analysis with groups of younger (18-64 years) and older (65+ years) males ( = 469).
RESULTS
Age invariance for the MDRS-22 was not established, ΔX = 451.47, Δd = 16, < 0.001.
CONCLUSION
Results of the study indicate that masculine depression may present differently between younger and older men. To fully understand the construct of masculine depression, it is important to investigate how symptoms may present in individuals of all ages. Overall, the study highlights the importance of investigating how masculine depression may present differently in older men.
PubMed: 38940683
DOI: 10.1080/13607863.2024.2372706 -
Clinical Implant Dentistry and Related... Jun 2024The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
AIM
The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
METHODS
This protocol involves the acquisition of three-dimensional (3D) patient data through intraoral scanning (IOS) and cone beam computed tomography (CBCT). These data are loaded into AI software which automatically segments and aligns the patient's 3D models. These 3D models are loaded into MR software and used for planning implant surgery through holography. The files are then exported and used to design surgical guides via open-source software, which are 3D printed and used to prepare the implant sites through static computer-assisted implant surgery (s-CAIS). The case is finalized prosthetically through a fully digital protocol. The accuracy of implant positioning is verified by comparing the planned position with the actual position of the implants after surgery.
RESULTS
As a proof of principle, the present protocol seems to be to be reliable and efficient when used for planning simple cases of s-CAIS in partially edentulous patients. The clinician can plan the implants in an authentic 3D environment without using any radiology-guided surgery software. The precision of implant placement seems clinically acceptable, with minor deviations.
CONCLUSIONS
The present study suggests that AI and MR technologies can be successfully used in s-CAIS for an authentic 3D planning. Further clinical studies are needed to validate this protocol.
PubMed: 38940681
DOI: 10.1111/cid.13357 -
Alzheimer's & Dementia : the Journal of... Jun 2024This study investigated the potential of phosphorylated plasma Tau217 ratio (pTau217R) and plasma amyloid beta (Aβ) 42/Aβ40 in predicting brain amyloid levels measured...
BACKGROUND
This study investigated the potential of phosphorylated plasma Tau217 ratio (pTau217R) and plasma amyloid beta (Aβ) 42/Aβ40 in predicting brain amyloid levels measured by positron emission tomography (PET) Centiloid (CL) for Alzheimer's disease (AD) staging and screening.
METHODS
Quantification of plasma pTau217R and Aβ42/Aβ40 employed immunoprecipitation-mass spectrometry. CL prediction models were developed on a cohort of 904 cognitively unimpaired, preclinical and early AD subjects and validated on two independent cohorts.
RESULTS
Models integrating pTau217R outperformed Aβ42/Aβ40 alone, predicting amyloid levels up to 89.1 CL. High area under the receiver operating characteristic curve (AUROC) values (89.3% to 94.7%) were observed across a broad CL range (15 to 90). Utilizing pTau217R-based models for low amyloid levels reduced PET scans by 70.5% to 78.6%.
DISCUSSION
pTau217R effectively predicts brain amyloid levels, surpassing cerebrospinal fluid Aβ42/Aβ40's range. Combining it with plasma Aβ42/Aβ40 enhances sensitivity for low amyloid detection, reducing unnecessary PET scans and expanding clinical utility.
HIGHLIGHTS
Phosphorylated plasma Tau217 ratio (pTau217R) effectively predicts amyloid-PET Centiloid (CL) across a broad spectrum. Integrating pTau217R with Aβ42/Aβ40 extends the CL prediction upper limit to 89.1 CL. Combined model predicts amyloid status with high accuracy, especially in cognitively unimpaired individuals. This model identifies subjects above or below various CL thresholds with high accuracy. pTau217R-based models significantly reduce PET scans by up to 78.6% for screening out individuals with no/low amyloid.
PubMed: 38940656
DOI: 10.1002/alz.14073 -
Journal of Immunology (Baltimore, Md. :... Jun 2024Monocytes and macrophages (Mos/Mϕs) play diverse roles in wound healing by adopting a spectrum of functional phenotypes; however, the regulation of such heterogeneity...
Monocytes and macrophages (Mos/Mϕs) play diverse roles in wound healing by adopting a spectrum of functional phenotypes; however, the regulation of such heterogeneity remains poorly defined. We enhanced our previously published Bayesian inference TF activity model, incorporating both single-cell RNA sequencing and single-cell ATAC sequencing data to infer transcription factor (TF) activity in Mos/Mϕs during skin wound healing. We found that wound Mos/Mϕs clustered into early-stage Mos/Mϕs, late-stage Mϕs, and APCs, and that each cluster showed differential chromatin accessibility and differential predicted TF activity that did not always correlate with mRNA or protein expression. Network analysis revealed two highly connected large communities involving a total of 19 TFs, highlighting TF cooperation in regulating wound Mos/Mϕs. This analysis also revealed a small community populated by NR4A1 and NFKB1, supporting a proinflammatory link between these TFs. Importantly, we validated a proinflammatory role for NR4A1 activity during wound healing, showing that Nr4a1 knockout mice exhibit decreased inflammatory gene expression in early-stage wound Mos/Mϕs, along with delayed wound re-epithelialization and impaired granulation tissue formation. In summary, our study provides insight into TF activity that regulates Mo/Mϕ heterogeneity during wound healing and provides a rational basis for targeting Mo/Mϕ TF networks to alter phenotypes and improve healing.
PubMed: 38940624
DOI: 10.4049/jimmunol.2400172