Patient's care bundle benefits to prevent stroke associated pneumonia: A meta-analysis with trial sequential analysis.

Background: Patient's care bundle has been found to have a beneficial effect on refractory diseases, but the preventive effect of this strategy on stroke-associated pneumonia (SAP) remains unclear. The purpose of this meta-analysis was to determine the role of the patient's care bundle in the prevention of SAP. Methods: A systematic search was conducted in five electronic databases to identify randomized controlled trials (RCTs) published before January 31, 2022. The incidence of SAP and aspiration and the length of hospital stay were assessed. Random pair-wise meta-analysis was conducted using Review Manager 5.4, and trial sequential analysis (TSA) was also performed. Results: Twenty eligible RCTs involving 1916 patients were included for data analysis. Pooled results suggested that patient's care bundle was associated with significantly lower incidence of SAP (risk ratio [RR], 0.37; 95% CI, 0.29-0.46; p < 0.001; I2 = 0%) and aspiration (RR, 0.23; 95% CI, 0.15-0.35; p < 0.001; I2 = 0%). Meanwhile, patient's care bundle also significantly shortened the length of hospital stay for general patients (mean difference [MD], -3.10; 95% CI, -3.83 to -2.37; p < 0.001; I2 = 16%) and the length of intensive care unit (ICU) stay for patients with severe stoke (MD, -4.85; 95% CI, -5.86-3.84; p < 0.001; I2 = 0%). Results of TSA confirmed that none of the findings could be significantly reversed by future studies. Conclusions: The patient's care bundle effectively prevents the occurrence of SAP and aspiration and shortens the hospital stay of stroke patients. However, it is necessary to design more high-quality studies to further validate our findings and investigate their applicability in other geographical regions.

Quantitative measurement to evaluate morphological changes of the corpus callosum in patients with subcortical ischemic vascular dementia.

BACKGROUND: Subcortical ischemic vascular dementia (SIVD) is a subtype of dementia associated with abnormalities in the subcortical white matter regions. Recent imaging techniques can be used to detect such abnormalities in vivo. PURPOSE: To examine morphological changes of the corpus callosum in patients with SIVD by using magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). MATERIAL AND METHODS: MRI was performed to explore changes of cerebral white matter, especially corpus callosum. Brain matter diffusivity was examined with DTI by measuring the fractional anisotropy (FA). Results of 30 patients diagnosed with SIVD and 30 healthy subjects were analyzed and compared. RESULTS: The thicknesses of the genu, the anterior third, middle, and posterior third of the body, and the splenium of the corpus callosum were smaller in SIVD patients compared to healthy controls (0.54 ± 0.08 vs. 0.68 ± 0.09 cm, P = 0.0011; 0.27 ± 0.06 vs. 0.38 ± 0.07 cm, P = 0.002; 0.28 ± 0.05 vs. 0.38 ± 0.08 cm, P = 0.009; 0.18 ± 0.04 vs. 0.26 ± 0.06 cm, P = 0.013; 0.54 ± 0.07 vs. 0.72 ± 0.09 cm, P = 0.003, respectively). The FA values of the genu and splenium of the corpus callosum in patients with SIVD were decreased compared to healthy controls (0.664 ± 0.042 vs. 0.778 ± 0.041, P < 0.001; 0.691 ± 0.038 vs. 0.786 ± 0.039, P = 0.001, respectively). CONCLUSION: Patients with SIVD exhibit corpus callosum atrophy and morphological changes, and these characteristics may be useful for diagnosis.

Ti-Si mixed oxides prepared by polymer in situ sol-gel chemistry with the aid of CO2.

A method to prepare titania-silica binary oxides is proposed in this work. In this route, inorganic precursors tetraethyl orthosilicate (TEOS) and titanium isopropoxide (TIP) were simultaneously or sequentially impregnated into a polypropylene (PP) matrix using supercritical carbon dioxide as a swelling agent and carrier. Hydrolysis and condensation reaction of the precursors confined in a polymer network were induced by treating the composites in 1 mol.dm(-3) (1 M) HCl. Then the PP matrix was decomposed at higher temperature, and titania-silica binary oxides were obtained. The mixed oxides were characterized by X-ray diffraction and Raman, FTIR, and X-ray photoelectron spectroscopy. It was demonstrated that the structure of the oxides depended strongly on the procedure to impregnate the precursors. The simultaneous method, in which the TEOS and TIP were simultaneously impregnated into a PP matrix, resulted in mixed oxides with highly dispersed titanium oxide species in the SiO2 matrix, while the sequential method produced the mixed oxide with separate SiO2 and TiO2 phases which were connected by Ti-O-Si bands at the interface. The method described in this work provides a new route to control the texture of TiO2-SiO2 mixed oxide simply by the impregnation sequence.

Solvatochromic behavior of phenol blue in CO2+ethanol and CO2+n-pentane mixtures in the critical region and local composition enhancement.

The UV-Vis spectra of probe phenol blue in CO(2)+ethanol and CO(2)+n-pentane binary mixtures were studied at 308.15 K and different pressures. The experiments were conducted in both supercritical region and subcritical region of the mixtures by changing the compositions of the mixed solvents. On the basis of the experimental results the local compositions of the solvents about phenol blue were estimated by neglecting the size difference of CO(2) and the cosolvents. Then the local composition data were corrected by a method proposed in this work, which is mainly based on Lennard-Jones sphere model. It was demonstrated that the local mole fraction of the cosolvents is higher than that in the bulk solution at all the experimental conditions. In the near critical region of the mixed solvents the local composition enhancement, defined as the ratio of cosolvent mole fraction about the solute to that in the bulk solution, increased significantly as pressure approached the phase boundary from high pressure. The local composition enhancement was not considerable as pressure was much higher than the critical pressure. In addition, in subcritical region the degree of composition enhancement was much smaller and was not sensitive to pressure in the entire pressure range as the concentration of the cosolvents in the mixed solvents was much higher than the concentration at the critical point of the mixtures.

Compressed-CO2-assisted patterning of polymers.

We report a facile route to pattern polymer surfaces with the aid of compressed CO(2), termed the compressed-CO(2)-assisted imprint method. In this method, compressed CO(2) serves as a plasticizer for polymers (such as poly(methyl methylate) and polystyrene), which leads to a tremendous reduction in the glass transition temperature and viscosity of the polymers. Nylon fabrics and anode aluminum oxide porous membranes are used as molds, respectively, to pattern the softened polymers at relatively low temperatures, resulting in patterns at the scale of micrometers and nanometers on the surface of polymer films. The patterned structures can be tuned by changing CO(2) pressure and temperature in the imprinting process. This method is simple and environmentally benign. It also can be operated at low temperatures, for instance, ambient temperature.

Effect of structure of PEO-PPO-PEO copolymers on reverse micelle formation induced by compressed CO2.

The micellization of PEO-PPO-PEO block copolymers in p-xylene has been studied in the presence of CO2. With the application of CO2, some copolymers with suitable molecular weights and EO ratios can form reverse micelles with critical micellization pressure up to 5.8 MPa. For the copolymers with the same length of PO block, higher EO ratios facilitate reverse micelle formation. For the copolymers with the same composition, higher molecular weight is favorable to form reverse micelles. With the suitable composition and molecular weight, the critical micelle pressure (CMP) of copolymers decreases with the increase in the lengths of PEO and PPO blocks due to the hydrophilic and folding effects, respectively. Both the EO ratios and the molecular weights are important for the formation of reverse micelle. The reverse micelle solution can solubilize water with W0 (molar ratio of water to EO segment) up to 3.3.