The trajectories of physical growth in 4 months postnatal corrected age among preterm infants discharged from neonatal intensive care units and associated factors: A prospective study.

Objectives: Growth retardation is a risk for premature infants. In addition to demographic and perinatal factors, preterm infants' physical growth may be affected by neonatal intensive care unit (NICU) stress, maternal postpartum depression, and mother-infant interaction. This study aimed to investigate the trajectories of physical growth in 4 months corrected age among preterm infants discharged from the NICU and the impactors on these trajectories. Methods: A prospective study was conducted among 318 preterm infants from September 2019 to April 2021 in Shanghai, China. Latent growth modeling was applied to identify the weight, length, and head circumference growth trajectories in 4 months corrected age and explore the effects of demographic and medical characteristics, infant stress during NICU stay, maternal postpartum depression, and mother-infant interaction on each trajectory. Results: Unconditional latent growth models showed curve trajectories with increasingly slower growth in weight, length, and head circumference until 4 months of corrected age. Conditional latent growth models showed that a longer length of stay in the NICU and more skin punctures were negatively associated with weight at 40 weeks corrected gestational age (ß = -0.43 and -0.19, respectively, P < 0.05). The maternal postpartum depression between 40 weeks corrected gestational age and 1 month corrected postnatal age was associated with a lower growth rate of length (ß = -0.17, P = 0.040), while between 2 and 3 months corrected postnatal age, there were lower growth rates of weight and head circumference (ß = -0.15 and -0.19, respectively, P < 0.05). The mother-infant interaction scores between 40 weeks corrected gestational age and 1 month corrected postnatal age negatively predicted the growth rate of weight (ß = -0.19, P = 0.020). Conclusion: The physical growth trajectories of preterm infants discharged from the NICU were influenced by infant stress during the NICU stay, maternal postpartum depression and mother-infant interaction.

Level of humanistic care ability and its influencing factors among nursing aides in long-term care facilities.

OBJECTIVE: To determine the level and influencing factors of the humanistic care ability (HCA) in nursing aides, thus providing a baseline for its improvement. METHODS: This study investigated 302 nursing aides in six long-term care facilities (LTCFs) in Suzhou between December 2021 and June 2022 by convenience sampling. A descriptive questionnaire and the Caring Ability Inventory were applied in this study. RESULTS: The HCA was at a low level, and its influencing factors were education level, marital status, personality, reason for employment, and the degree of perceived care from colleagues (p<0.05). CONCLUSIONS: Nursing aides' HCA needs to be strengthened urgently. Nursing aides with poor education, widowed, single, and an introversion type of personality should receive more attention. Additionally, creating a warm atmosphere among colleagues and cultivating the nursing aides' motivation for eldercare will help improve their HCA.

Quality indicators for the care of older adults with disabilities in long-term care facilities based on Maslow's hierarchy of needs.

Purpose: This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities (LTCFs) based on Maslow's hierarchy of needs. Methods: The draft of the quality indicators was drawn up based on a literature review and research group discussion. The quality indicators were finalized by two rounds of expert consultation (involving 15 experts) using the Delphi method. The Analytic Hierarchy Process was applied to calculate the indicators' weight. Results: The response rates of the two rounds of consultation were 100% and 93%, and the expert authority coefficients were 0.86 and 0.87. After two rounds of consultation, the expert opinion coordination coefficients of the first-, second- and third-level indicators were 0.42, 0.25, and 0.96, respectively (P < 0.05), and the variation coefficient was ≤0.25. The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level, 19 second-level, and 107 third-level indicators. Conclusion: The quality indicators for the care of older adults with disabilities in LTCFs are reliable, scientific, comprehensive, and practical and specify the content of person-centered care needs. This can provide a reference for evaluating and improving care quality in LTCFs.

Anisotropy in the Tensile Properties of a Selective Laser Melted Ti-5Al-5Mo-5V-1Cr-1Fe Alloy during Aging Treatment.

In this work, the anisotropic microstructure and mechanical properties of selective laser melted (SLMed) Ti-5Al-5Mo-5V-1Cr-1Fe (Ti-55511) alloy before and after aging treatment are investigated. Owing to the unique thermal gradient, the prior columnar ß grains with {001} texture component grow in the building direction, and the mechanical properties of the as-fabricated Ti-55511 alloy exhibit slight anisotropy. Aging treatment creates uniform precipitation of the α phase at the boundaries as well as the interior of ß grains. Due to the microstructure of the aged samples with a weak texture, the mechanical properties exhibit almost isotropic characteristics with an ultimate tensile strength of 1133 to 1166 MPa, yield strength of 1093 to 1123 MPa, and elongation from 13 to 16%, which meet the aerospace allowable specification very well. By XRD and EBSD analyses, the total dislocation density of the aged samples (~134.8 × 1013 m-2) is significantly lower than that of the as-fabricated samples (~259.4 × 1013 m-2); however, the aged samples exhibit a higher geometrically necessary dislocation (GND) density (~28.5 × 1013 m-2) compared with the as-fabricated samples GND density (~2.9 × 1013 m-2). Thus, a new approach to strengthening theory for estimating the anisotropic mechanical properties of AM alloys is proposed.

Bone response in vivo of Ti-45Zr alloy as dental implant material.

Ti-Zr alloys have gained increasing attention as a new metallic biomaterial, being used as implants for both orthopedics and dentistry. More recently, our group found promising results for the Ti-45Zr alloy, which presented a low elastic modulus, a pronounced and excellent mechanic character, and excellent cell compatibility in vitro. However, its biocompatibility and potential to promote osteogenesis in vivo remained unclear. In the present study, the biocompatibility, osteointegration ability, and immune response effects of the Ti-45Zr alloy were evaluated in animal experiments. The results showed that the alloy had good blood compatibility and no body side effects. After implantation in vivo, the inflammation turned out well and was beneficial to the polarization of macrophages. Additionally, the Ti-45Zr alloy presented a good osteointegration ability. Overall, these results confirmed that the Ti-45Zr alloy can be used as a dental implant material.

Microstructure, mechanical properties and osseointegration ability of Ta-20Zr alloy used as dental implant material.

The aim of this study was to evaluate the application prospect of a tantalum (Ta) and zirconium (Zr) alloy as a dental implant material. The Ta-20Zr (wt.%) alloy was prepared by powder metallurgy, and its microstructure and mechanical properties were analyzed by standard techniques. The effect of Ta-20Zr alloy on inflammation, bone remodeling and osseointegration was analyzed in rat and rabbit models by biochemical, histological and imaging tests. The Ta-20Zr alloy showed excellent mechanical compatibility with the bone tissue on account of similar elastic modulus (49.2 GPa), thereby avoiding the 'stress shielding effect'. Furthermore, Ta-20Zr alloy enhanced the inflammatory response by promoting secretion of interleukin-6 (IL-6) and IL-10, and facilitated the balance between the M1/M2 macrophage phenotypes. Finally, Ta-20Zr also showed excellent osseointegration and osteogenic ability without any systemic side effects, making it an ideal dental implant material.

Porous tantalum structure integrated on Ti6Al4V base by Laser Powder Bed Fusion for enhanced bony-ingrowth implants: In vitro and in vivo validation.

Despite the widespread application of Ti6Al4V and tantalum (Ta) in orthopedics, bioinertia and high cost limit their further applicability, respectively, and tremendous efforts have been made on the Ti6Al4V-Ta alloy and Ta coating to address these drawbacks. However, the scaffolds obtained are unsatisfactory. In this study, novel high-interface-strength Ti6Al4V-based porous Ta scaffolds were successfully manufactured using Laser Powder Bed Fusion for the first time, in which porous Ta was directly manufactured on a solid Ti6Al4V substrate. Mechanical testing revealed that the novel scaffolds were biomechanically compatible, and the interfacial bonding strength was as high as 447.5 MPa. In vitro biocompatibility assay, using rat bone marrow mesenchymal stem cells (r-BMSCs), indicated that the novel scaffolds were biocompatible. Alkaline phosphatase and mineralized nodule determination demonstrated that the scaffolds favored the osteogenic differentiation of r-BMSCs. Moreover, scaffolds were implanted into rabbits with femur bone defects, and imaging and histological evaluation identified considerable new bone formation and bone ingrowth, suggesting that the scaffolds were well integrated with the host bone. Overall, these results demonstrated good mechanical compatibility, biocompatibility, and osteointegration performance of the novel Ti6Al4V-based porous Ta scaffold, which possesses great potential for orthopedic clinical applications.

Efficacy and Safety of Intranasal Dexmedetomidine During Recovery From Sevoflurane Anesthesia in Children: A Systematic Review and Meta-analysis.

BACKGROUND: Intranasal drip of dexmedetomidine in children with sevoflurane anesthesia can reduce anesthesia and restlessness. However, there is still some controversy. We conducted a meta-analysis to explore the effect of intranasal infusion of dexmedetomidine on the quality of recovery during the recovery period, to provide certain guidance for clinical application. METHODS: Web of Science, PubMed, Embase, and the Cochrane Library were used for literature search. Systematic reviews were based on PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analysis). RESULTS: A total of 14 articles and 1123 patients were included. The results of the meta-analysis showed that the incidence of emergence agitation [risk ratio (RR), 0.32; 95% confidence interval (CI), 0.20-0.50; P < 0.0001], satisfactory sedation at parent separation (RR, 1.41; 95% CI, 1.031-93; P = 0.034), incidence of nausea and vomiting (RR, 0.41; 95% CI, 0.21-0.78; P = 0.007), and incidence of laryngospasm (RR, 0.23; 95% CI, 0.08-0.65; P = 0.006) of the intranasal dexmedetomidine group were different compared with the control group. However, the satisfactory sedation at mask induction in the intranasal dexmedetomidine group (RR, 1.16; 95% CI, 0.87-1.54; P = 0.319), postanesthesia care unit (PACU) stay time (standardized mean deviation, 0.51; 95% CI, -0.11 to 1.12; P = 0.107), and extubation time (standardized mean deviation, 1.64; 95% CI, -1.07 to 4.35; P = 0.235) were not statistically significant compared with those of the control group. CONCLUSION: Intranasal dexmedetomidine anesthesia with sevoflurane in children can reduce the incidence of emergence agitation, provide more satisfactory sedation when the parents are separated, reduce the incidence of nausea and vomiting, and reduce the incidence of laryngospasm. In addition, the 2 µg/kg dose of dexmedetomidine may be the best dose for clinical application.

Influence of transition readiness from paediatric to adult health care on quality of life in child-parent dyads with long-term conditions.

AIM: To delineate the impact of perspective of children's transition readiness from paediatric to adult health care on quality of life in child-parent dyads with long-term conditions. We used Actor-Partner Interdependence Model to identify actor effects (effect of one's own transition readiness on one's own quality of life) and partner effects (effect of one's own transition readiness on the partner's quality of life). DESIGN: A multi-centre cross-sectional survey. METHODS: The study was conducted in two paediatric hospitals in China from October 2018-August 2019. We used a researcher-designed questionnaire to collect demographic and clinical characteristics. Furthermore, we used four questionnaires assessing transition readiness and quality of life in child and parent respectively to collect data from 370 child-parent dyads. Structural equation modelling was applied to estimate the effect of actor-partner interdependence models. RESULTS: The total score of transition readiness had two actor effects on total child and parent quality of life controlling for age (ßchildren  = 3.335, p = .032 and ßparents  = 8.952, p < .001), while only one actor effect controlling for gender (ßparents  = 8.891, p < .001). Specific transition readiness dimensions had different partner effects on different domains of children and parents' quality of life. Moreover, younger children and fathers had a better quality of life. CONCLUSION: Our study verified inherently interpersonal relationship that transition readiness appeared to influence quality of life in child-parent dyads with long-term conditions. IMPACT: This study was the first to verify mutual influence of transition readiness and quality of life in child-parent dyad using actor-partner interdependence model. Nurses who design the transition promoting programs should consider the effective communication between healthcare provider and child-parent dyads and support parents' involvement to improve shared understanding about managing child's condition, especially for older children and mothers.

Nb-Ti-Zr alloys for orthopedic implants.

Niobium (Nb), Titanium (Ti), and Zirconium (Zr) have attracted much attention as implant materials due to it's excellent mechanical properties and biocompatibility. However, little attention has been paid to high Nb-containing biomedical alloys. Here, the 50 wt.%Nb-XTi-Zr ternary alloy(x = 20wt.%, 30 wt.%, 40 wt.%) with relative density over 90% was prepared by powder metallurgy method. The massive α(Zr) distributed along the grain boundaries and lamellar ß(Zr) appeared in the grains of ß(Nb) in the 50 wt.%Nb-20wt.%Ti-Zr alloy. The acicular α phase is mainly distributed in the ß-grain of 50 wt.%Nb-30wt.%Ti-Zr alloy. And α(Ti)-colonies in the ß-grains and continuous α(Ti)GB at ß-grain boundary can be observed in the 50 wt.%Nb-40wt.%Ti-Zr alloy. Comparing with Nb-20wt.%Ti-Zr alloy and 50 wt.%Nb-40wt.%Ti-Zr alloy, the 50 wt.%Nb-30wt.%Ti-Zr alloy showed lower Vickers hardness and elastic modulus. Furthermore, the as-sintered 50 wt.%Nb-XTi-Zr alloy promoted the cell proliferation and cell adhesion of MG-63 cells on the surface of alloys. In conclusion, the 50 wt.%Nb-XTi-Zr alloy combines excellent mechanical and biological properties, and the 50 wt.%Nb-30wt.%Ti-Zr alloy with lower elastic modulus (close to the bone) is a more promising candidate for bone implant material.

Psychometric properties of the 'Self-Management and Transition to Adulthood with Rx = Treatment Questionnaire' in Chinese children and young people with chronic diseases.

AIMS: The aims of this work were to translate, culturally adapt and evaluate the reliability and validity of the Chinese version of the Self-Management and Transition to Adulthood with Rx = Treatment Questionnaire. BACKGROUND: Children and young people with chronic diseases are expected to start self-managing their diseases and have a smooth and coordinated transition from paediatric- to adult-oriented care. DESIGN: This study involved the cultural adaptation of a questionnaire into Chinese and examined its factor structure. METHODS: This was a multicentre cross-sectional study of children and young people/adolescents (8-18 years) who were diagnosed with chronic diseases in China from June 2016 to December 2018. Exploratory and confirmatory factor analyses were performed to analyse the questionnaire's validity. RESULTS: Four major factors were identified in the Chinese version of the questionnaire, and it had a good fit to the target population. The internal reliability was good. All factors were positively and strongly correlated with the total score. The t test revealed that the Medication Management score was not significantly different between two age groups (8-11 and 12-18 years), but the scores of the other factors and overall scale were lower in the 8-11 years age group. CONCLUSION: The Chinese version of the questionnaire has good reliability and validity in the Chinese context.

Evaluation of biocompatibility and osseointegration of Nb-xTi-Zr alloys for use as dental implant materials.

The aim of this study was to evaluate the biocompatibility and osteogenic potential of 50%Nb-xTi-Zr (NTZ,x= 20%, 30%, 40% by weight) alloys as compared with dental commercial pure titanium (cpTi). Cell cytotoxicity assay, fluorescence microscopy and electron microscopy were used to measure thein vitrobiocompatibility of NTZ. The expression of alkaline phosphatase (ALP), integrin ß1, osteocalcin (OC), Ki67 and collagen-I (Col-I) at the mRNA level was measured by real-time reverse transcription-polymerase chain reaction. Osseointegration ability was determined using x-ray evaluation and histological analysisin vivo. Compared with the MG63 cells grown on cpTi on day 3, the viability, adherence and proliferation rates of cells cultured on NTZ alloys were significantly improved (p< 0.05). Furthermore, similar expression levels of Ki67, Col-I, OC and ALP were found in the MG63 cells grown on NTZ alloys and those grown on cpTi. The Cbfα1 level was significantly higher for the 50%Nb-30%Ti-Zr (NTZ3) than for the cpTi group on day 6 (p< 0.01), indicating that NTZ alloys can induce osteogenesis. A considerable amount of new bone formation and osseointegration was observed around NTZ3 implants compared with cpTi implantsin vivo. Collectively, NTZ3 showed superior biocompatibility and osteogenic activity; therefore, NTZ3 may be an excellent replacement for dental Ti implants.

The influence of perinatal and maternal factors on physical growth at 12 months in prematurely born infants treated in the neonatal intensive care unit: A retrospective chart review and a prospective cohort study.

BACKGROUND: Growth retardation during the first year of life is frequently observed in prematurely born infants. Few reports have considered the effects of maternal emotional distress and perceptions of care burden on the outcomes of these infants. OBJECTIVES: This study investigated the physical growth trajectories of prematurely born infants treated in neonatal intensive care unit and determined the effects of perinatal factors, maternal emotional distress and perceptions of care burden on growth retardation at 12 months' corrected age. DESIGN: Retrospective chart review and prospective cohort study. SETTING: Single neonatal intensive care unit and follow-up outpatient clinics at a maternity and neonatal hospital. PARTICIPANTS: 288 mother-infant pairs in the retrospective chart review and 169 dyads in the prospective cohort study. METHODS: Medical records of prematurely born infants, perinatal factors and physical growth over a 1-year period were retrospectively reviewed. For the prospective study, mothers completed the Self-Rating Anxiety Scale, Perinatal Post-traumatic Stress Disorder Questionnaire, and Condition Management Effort Scale when infants reached 3 months' corrected age. The generalized linear mixed model was applied to explore effects of maternal emotional disorders and perceptions of care burden on growth retardation at 12 months' corrected age. RESULTS: The retrospective data showed 13.9%, 10.1%, and 10.1% retardation for head circumference, length, and weight, respectively. Birth weight was negatively associated with physical growth retardation. Delayed breastfeeding initiation, younger mothers, and lower 5-min Apgar score were associated with head circumference retardation. Male sex, higher gestational age, and delayed breastfeeding initiation were risk factors for length retardation; male sex, higher gestational age, and younger mothers for weight. The prospective study showed that head circumference, length, and weight retardation rates were 18.3%, 10.3%, and 16.3%, respectively. Male sex and birth weight, were still significant, while others were not. Moreover, alternative models based on these included factors revealed that maternal perceptions of a higher care burden was a risk factor for overall growth retardation and maternal post-traumatic stress disorder only for a weight problem. CONCLUSIONS: Physical growth remained a significant problem for prematurely born infants during the first year. This study identified perinatal factors, the level of maternal emotional distress, and perceptions of care burden were related to adverse infant's growth outcomes. Multidisciplinary interventions targeting maternal emotional distress and perceptions of care burden should be developed to promote the growth of prematurely born infants within the first 3 months after birth.

Chinese family care patterns of childhood rheumatic diseases: A cluster analysis.

OBJECTIVES: The purpose is to distinguish family care (FC) patterns of childhood rheumatic diseases in Chinese families and to determine the predictors of FC patterns. METHODS: This secondary analysis contained two cross-section surveys with a convenient sample of totally 398 caregivers who have a child with rheumatic diseases from four pediatric hospitals. Caregivers were required to completed Family Management Measure questionnaire. Cluster analysis was used to distinguish patterns and multinomial logistic regression analysis was used to find predictors. RESULTS: Four patterns were identified: the normal-perspective and collaborative (28.4%), the effortless and contradictory (24.6%), the chaotic and strenuous (18.3%), and the confident and concerning (28.7%). Disease category (χ 2 = 21.23, P = 0.002), geographic location (χ 2 = 8.41, P = 0.038), maternal educational level (χ 2 = 12.69, P = 0.048) and family monthly income (χ 2 = 33.21, P < 0.001) predicted different patterns. CONCLUSIONS: FC patterns were different among families. Disease-related and family-related factors were vital predictors to distinguish patterns consistent with the Family Management Style Framework. The result assisted that clinicians recognize FC patterns and predictors effectively to provide tailored advice in time.

Microstructure, mechanical properties, and preliminary biocompatibility evaluation of binary Ti-Zr alloys for dental application.

The microstructure, mechanical properties, and in vitro biocompatibility of vacuum-sintered Ti-xZr binary alloys (x = 5, 15, 25, 35, 45 wt%) were investigated. The results indicated that α and α' phase existed in Ti-xZr alloys. The hardness of the Ti-Zr alloys increased as the contents increased and ranged from 473 HV (Ti-5Zr) to 525 HV (Ti-45Zr). Increasing Zr content could lead to an increase in compressive and bending strength. Additionally, the Ti-45Zr alloy exhibited the maximum bending strength of 867.1 MPa and the maximum compressive strength of 1599.8 MPa which were much larger than that of CP-Ti. Moreover, all Ti-Zr alloys showed a lower elastic modulus (ranging from 53.5 to 59.3 GPa) compared with CP-Ti (103 GPa). The in vitro cytotoxicity tests were carried out for biocompatibility evaluation. The alloys presented no cytotoxic effects and the surface of the alloys exhibited great growth conditions for MG-63 cells. The Ti-45Zr alloy exhibited better mechanical properties and biocompatibility. In conclusion, Ti-45Zr alloy is of great potential for dental applications.