Decreased resting-state functional connectivity and brain network abnormalities in the prefrontal cortex of elderly patients with Parkinson's disease accompanied by depressive symptoms.

This study aimed to explore the brain network characteristics in elderly patients with Parkinson's disease (PD) with depressive symptoms. Thirty elderly PD patients with depressive symptoms (PD-D) and 26 matched PD patients without depressive symptoms (PD-NOD) were recruited based on HAMD-24 with a cut-off of 7. The resting-state functional connectivity (RSFC) was conducted by 53-channel functional near-infrared spectroscopy (fNIRS). There were no statistically significant differences in MMSE scores, disease duration, Hoehn-Yahr stage, daily levodopa equivalent dose, and MDS-UPDRS III between the two groups. However, compared to the PD-NOD group, the PD-D group showed significantly higher MDS-UPDRS II, HAMA-14, and HAMD-24. The interhemispheric FC strength and the FC strength between the left dorsolateral prefrontal cortex (DLPFC-L) and the left frontal polar area (FPA-L) was significantly lower in the PD-D group (FDR p < 0.05). As for graph theoretic metrics, the PD-D group had significantly lower degree centrality (aDc) and node efficiency (aNe) in the DLPFC-L and the FPA-L (FDR, p < 0.05), as well as decreased global efficiency (aEg). Pearson correlation analysis indicated moderate negative correlations between HAMD-24 scores and the interhemispheric FC strength, FC between DLPFC-L and FPA-L, aEg, aDc in FPA-L, aNe in DLPFC-L and FPA-L. In conclusion, PD-D patients show decreased integration and efficiency in their brain networks. Furthermore, RSFC between DLPFC-L and FPA-L regions is negatively correlated with depressive symptoms. These findings propose that targeting DLPFC-L and FPA-L regions via non-invasive brain stimulation may be a potential intervention for alleviating depressive symptoms in elderly PD patients.

Humic substances mediated superior photochemical pollutant conversion on defective TiO2 in environmentally relevant matrices: The key roles of oxygen vacancy in surface interactions, oxidant activation and radical generation.

Ubiquitous humic substances usually exhibit strong interfering effects on target pollutant removal in advanced water purification. This work aims to develop a photochemical conversion system on the nonstoichiometric TiO2 for pollutant removal in environmentally relevant matrices. In this synergistic reaction system, the redox-reactive humic substances and defective oxygen vacancies can serve as the organic electron transfer mediator and the key surface reactive sites, respectively. This system achieves a superior pollutant degradation in real surface water at low oxidant concentrations. Reactive oxygen vacancies on the TiO2 surface and sub-surface are of considerable interest for this photochemical reaction system. By engineering defective oxygen vacancies on high-energy {001} polar facet, the surface and electronic interactions between tailored TiO2 and humic substances are greatly strengthened for the promoted electron transfer and oxidant activation. Rendered by the strong surface affinity and molecular activation, defective oxygen vacancies thermodynamically and dynamically promote reactive chain reactions for free radical formation, including the selective O2 reduction to ·O2- and the H2O2 activation to ·OH. Our findings take new insights into environmental geochemistry, and provide an effective strategy to in-situ boost the humic substances-mediated water purification without secondary pollution. ENVIRONMENTAL IMPLICATION: Humic substances are widely distributed in aquatic environment, thus playing important roles in environmental geochemistry. For example, humic substances can achieve good surface adsorption through electrostatic adsorption, ligand exchange and electronic interactions with typical TiO2 to form reactive ligand-metal charge transfer complexes for pollutant degradation. Inspired by the unique properties of surface and sub-surface oxygen vacancies, the defective TiO2 was designed to refine the humic substances-mediated photochemical reactions. A superior reactivity was measured for pollutant degradation. Our findings provide an effective strategy to boost naturally photochemical decontamination in environmentally relevant matrices.

Association between toileting and falls in older adults admitted to the emergency department and hospitalised: a cross-sectional study.

OBJECTIVES: This study aimed to explore the potential risk factors associated with toileting-related falls in community-dwelling older adults who presented to the emergency department and were subsequently hospitalised. DESIGN: This was a cross-sectional study. SETTING AND PARTICIPANTS: This study was conducted in two teaching hospitals in Shanghai, China between October 2019 and December 2021 among community-dwelling adults aged ≥60 years. METHODS: In-person interviews, physical assessment and medical record review were performed to collect data on the characteristics and risk factors of falls. Associations of toileting-related falls with demographic characteristics and geriatric syndromes were examined using logistic regression models. MAIN OUTCOME MEASURES: Potential risk factors for toileting-related falls. RESULTS: This study included 419 older patients with a mean age of 73.8±9.7 years. Among 60 (14.3%) patients with toileting-related falls (mean age: 78.8±9.2 years), 63.3% of toileting-related falls, mainly occurred between 00:00 and 05:59 hours, compared with 17.3% of non-toileting-related falls, which primarily occurred during the daytime. The rate of recurrent falls (35%) was significantly higher in the toileting-related falls group than in the non-toileting-related falls group (21.2%) (p=0.02). Logistic regression showed that visual impairment (OR 2.7, 95% CI 1.1 to 7.1), cognitive impairment (OR 3.3, 95% CI 1.3 to 8.4), gait instability (OR 3.1, 95% CI 1.1 to 8.8) and urinary incontinence (OR 3.4, 95% CI 1.2 to 9.9) were strongly associated with toileting-related falls. Twenty-three (38.3%) patients in the toileting-related falls group had moderate and severe injuries, compared with 71.7% in the non-toileting-related falls group (p<0.05). CONCLUSIONS: This study revealed that patients who reported toileting-related falls were more likely to have cognitive impairment, urinary incontinence, gait instability, visual impairment than patients who fell during other activities. Social and healthcare professionals should prioritise the management of toileting activities in older patients and provide targeted interventions to those in the high-risk group.

Retrieval and Ranking of Combining Ontology and Content Attributes for Scientific Document.

Traditional mathematical search models retrieve scientific documents only by mathematical expressions and their contexts and do not consider the ontological attributes of scientific documents, which result in gaps between the queries and the retrieval results. To solve this problem, a retrieval and ranking model is constructed that synthesizes the information of mathematical expressions with related texts, and the ontology attributes of scientific documents are extracted to further sort the retrieval results. First, the hesitant fuzzy set of mathematical expressions is constructed by using the characteristics of the hesitant fuzzy set to address the multi-attribute problem of mathematical expression matching; then, the similarity of the mathematical expression context sentence is calculated by using the BiLSTM two-way coding feature, and the retrieval result is obtained by synthesizing the similarity between the mathematical expression and the sentence; finally, considering the ontological attributes of scientific documents, the retrieval results are ranked to obtain the final search results. The MAP_10 value of the mathematical expression retrieval results on the Ntcir-Mathir-Wikipedia-Corpus dataset is 0.815, and the average value of the NDCG@10 of the scientific document ranking results is 0.9; these results prove the effectiveness of the scientific document retrieval and ranking method.

The influence of cultural competence of nurses on patient satisfaction and the mediating effect of patient trust.

AIMS: To test a path model evaluating the influence of cultural competence of nurses on patient satisfaction and the mediating role of patient trust. BACKGROUND: In China, there has been an increase in medical disputes, which at times has resulted in physical assaults on healthcare providers. Enhanced patient satisfaction may reduce disputes and can perhaps be bolstered by the improved cultural competence of providers. DESIGN: A cross-sectional path analytic research design was used. METHODS: A random sample of 583 hospitalized patients recruited from six tertiary comprehensive hospitals in Changsha, China in 2016 completed a face-to-face structured questionnaire. Measures included the Consumer Assessment of Healthcare Providers and Systems Cultural Competency Item Set, the Wake Forest Physician Trust Scale, the Patient Satisfaction with Primary Nurses Scale and the Patient Overall Satisfaction with the Hospital Scale. RESULTS: Significant associations among cultural competence of nurses, patient satisfaction and patient trust were confirmed, and path analyses supported the proposed mediating role of patient trust. Furthermore, the cultural competence subscales of communication-positive behaviours, trust-building behaviours and shared decision-making were positively and significantly correlated with patient satisfaction. CONCLUSION: Findings suggest interventions should be designed to improve nurse's cultural competence, especially in the domains of communication-positive behaviours, trust-building behaviours and shared decision-making, and trust, to improve patient satisfaction.

Factors associated with acceptance of provider-initiated HIV testing and counseling among pregnant women in Ethiopia.

INTRODUCTION: The global human immunodeficiency virus (HIV) epidemic disproportionately affects sub-Saharan African countries, including Ethiopia. Provider-initiated HIV testing and counseling (PITC) is a tool to identify HIV-positive pregnant women and an effective treatment and prevention strategy. However, its success depends upon the willingness of pregnant women to accept HIV testing. OBJECTIVES: To describe the level of acceptance of PITC and associated factors among pregnant women attending 8 antenatal care clinics in Adama, Ethiopia. METHODS: Trained nursing students and employees from an HIV clinic conducted face-to-face structured interviews in private offices at the clinics from August to September, 2016. RESULTS: Among the 441 respondents, 309 (70.1%) accepted PITC. Women with more antenatal care visits (odds ratio [OR] =2.59, 95% CI: 1.01-6.63), reported better quality of the PITC service (OR =1.91, 95% CI: 1.19-3.08), and higher level of knowledge on mother-to-child transmission (OR =1.82, 95% CI: 1.03-3.20), were more likely to accept PITC, while women who were older in age (OR =0.37, 95% CI: 0.19-0.74) and perceived negative attitudes from their partners toward HIV-positive results (OR =0.31, 95% CI: 0.10-0.94) were less likely to accept the PITC service. CONCLUSION: About one-third of pregnant women are not willing to accept PITC. When designing intervention program to improve the acceptance of PITC, we should take into consideration the personal factors, HIV-related knowledge, and attitude of women as well as institutional factors.