Non-pharmacological interventions for cognitive impairment in older adults with heart failure: A systematic review.

BACKGROUND: Cognitive impairment is a prevalent issue among older adults with heart failure, and non-pharmacological approaches are recommended as the first line of treatment. However, it remains unclear which non-pharmacological interventions are the most effective for achieving optimal cognitive and physical outcomes. The aim of this study is to summarize the available evidence on the impact of non-pharmacological interventions for optimizing cognitive function in older adults with HF. METHODS: A systematic research was carried out across multiple databases including PubMed, Embase, Scopus, Web of Science, PsycINFO, Cochrane Library, Chinese National Knowledge Infrastructure Database, and Wanfang Database up until May 2022. Randomized controlled trials that focused on non-pharmacological interventions for older adults with heart failure and cognitive impairment, and evaluated the impact on cognitive function were targeted. The risk bias of the selected articles was analyzed following the Cochrane handbook. Two independent reviewers were responsible for selecting the studies, extracting the data, and assessing their quality. The results were reported in a narrative format. RESULTS: A total of 11 studies, which involved 1,287 patients, were reviewed and showed an acceptable risk of bias. These studies evaluated various cognitive domains, including global cognition, delayed recall memory, working memory, and verbal memory. Non-pharmacological interventions that included cognitive intervention, cognitive training combined with exercise, exercise training, and self-care management, were shown to have a positive impact on cognitive function, physical performance, and depression levels in older adults with heart failure. One study explored the effects of electrical muscle stimulation therapy, but no significant improvement in cognitive abilities was observed. CONCLUSION: The available evidence for the effectiveness of non-pharmacological interventions for cognitive impairment in older adults with heart failure is limited, and further research with formal outcome measures and longer follow-up periods is necessary to provide more informed recommendations.

Gap between risk factors and prevention strategies? A nationwide survey of fall prevention among medical and surgical patients.

AIMS: This study aimed to determine the extent to which nurses report assessing evidence-based falls risk factors and implementing targeted prevention for medical and surgical patients in China. DESIGN: This study was a national online survey. METHODS: The respondents were registered nurses working in medical and surgical units in 662 Chinese hospitals. The data concerning the falls risk factor assessments and targeted interventions implemented by nurses were collected online by the Nursing Management Committee of the Chinese Nursing Association in China in 2019. RESULTS: In total, 68 527 valid questionnaires were returned (95.0%). In medical and surgical units, nurses were most likely to report assessing balance, mobility and strength (81.6%) and orthostatic hypotension (76.4%) in falls patients and least likely to report assessing continence (61.3%) and feet and footwear (55.8%). Ensuring the use of appropriate footwear (79.3%) and managing syncope, dizziness and vertigo (73.8%) were the most common multiple interventions, while managing postural hypotension (48.8%) and cognitive impairment (48.4%) was the least common. Nine falls risk factors with clearly matched multifactorial interventions were identified in medical and surgical units (68.2%-97.1%). CONCLUSIONS: The implementation of multifactorial interventions in medical and surgical wards is inconsistent as reported by nurses in medical and surgical wards. Throughout China, nurses are generally concerned about falls risk factors and prevention for their patients; however, limited attention has been focused on continence, feet and footwear assessment and the management of cognitive impairment. Evidence-based falls prevention should be further tailored to the specific risk factors of each patient. IMPACT: Best practice guidelines for falls prevention in hospitals have been developed and published, and it is important for nurses to use these guidelines to guide practice. Our findings identify that in routine care, healthcare providers and hospitals can prevent falls.

The effect of early tracheal extubation combined with physical training on pulmonary rehabilitation of patients after lung transplantation: a randomized controlled trial.

Background: This study aimed to explore the effect of early extubation combined with physical training on pulmonary rehabilitation of patients after lung transplantation. Methods: This is an open parallel randomized controlled trial. A total of 96 lung transplant patients admitted to Wuxi People's Hospital (July 2018 to June 2019) were included. Inclusion criteria: (I) aged 18-75; (II) lung transplantation; (III) communicate normally; (IV) voluntary participation. According to the random number method, they were divided into the control group (routine nursing intervention) and the observation group (early extubation combined with a physical training program). The indwelling tracheal intubation time, discharge time, intensive care unit (ICU) stay time, lung function, 6 Minutes Walk Distance (6MWD), Modified Barthel Index (MBI) and satisfaction rate were recorded and analyzed. Results: The observation group's first-time postoperative ambulation (t=2.10, P=0.039), indwelling tracheal intubation time (Z=2.864, P=0.004), and discharge time (t=3.111, P<0.001) were shorter than the control group, while the difference of ICU stay time was not statistically significant (Z=-1.658, P=0.097). Before treatment, there was no significant difference in the lung function, 6MWD, and MBI of the two groups (P>0.05). After treatment, the Forced Expiratory Volume In 1 s (FEV1)% (t=-2.707, P<0.001), forced vital capacity (FVC)% (t=-3.716, P<0.001), FEV1/FVC (t=-3.539, P<0.001), 6MWD (t=-5.567, P<0.001), and MBI indexes (t=-4.073, P<0.001) were better than in observation group. The satisfaction rate of the observation group was better than the control group (P<0.05). Conclusions: For lung transplant recipients, early extubation combined with a physical training program is scientific, safe, and feasible. This approach is helpful to promote the postoperative recovery of lung transplant patients, reduce the length of hospitalization, help patients improve their lung function and ability to engage in activities of daily living, and increase the satisfaction rate of postoperative recovery. Results show that the combination of early extubation and a physical training program is worthy of clinical promotion for lung transplant recipients. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100051954.

Evidence summary of human milk fortifier in preterm infants.

BACKGROUND: To search for and collect evidence on human milk fortifier in preterm infants, and to summarize the latest and best evidence, so as to provide reference for clinical work. METHODS: We searched the databases of UpToDate, American Guide Network, Cochrane Library, Joanna Briggs Institute (JBI), PubMed, ResearchGate, China National Knowledge Infrastructure (CNKI), Wan Fang, Chinese Biology Medicine disc (CBM), and Yi Maitong, and collected relevant guidelines, systematic reviews, evidence summaries, expert consensuses, and randomized controlled trials (RCTs). The retrieval time limit was from the database establishment to July 2021. The quality of the literature was independently evaluated by 2 researchers, who then extracted and summarized the evidence from qualifying articles. RESULTS: A total of 16 articles were selected, including 3 guidelines, 3 systematic reviews, 5 expert consensuses, 3 RCTs, and 1 best practice guideline, including indications, time for usage, methods, monitoring and management, time of cessation, health education, and post-discharge feeding. CONCLUSIONS: This study summarized the best evidence for human milk fortifier in preterm infants. Medical staff should assess the specific clinical conditions and parental wishes when applying the best evidence to ensure the effectiveness and safety of human milk fortifier, thus improving the quality of clinical nursing.

Assessing Dry Weight of Hemodialysis Patients via Sparse Laplacian Regularized RVFL Neural Network with L2,1-Norm.

Dry weight is the normal weight of hemodialysis patients after hemodialysis. If the amount of water in diabetes is too much (during hemodialysis), the patient will experience hypotension and shock symptoms. Therefore, the correct assessment of the patient's dry weight is clinically important. These methods all rely on professional instruments and technicians, which are time-consuming and labor-intensive. To avoid this limitation, we hope to use machine learning methods on patients. This study collected demographic and anthropometric data of 476 hemodialysis patients, including age, gender, blood pressure (BP), body mass index (BMI), years of dialysis (YD), and heart rate (HR). We propose a Sparse Laplacian regularized Random Vector Functional Link (SLapRVFL) neural network model on the basis of predecessors. When we evaluate the prediction performance of the model, we fully compare SLapRVFL with the Body Composition Monitor (BCM) instrument and other models. The Root Mean Square Error (RMSE) of SLapRVFL is 1.3136, which is better than other methods. The SLapRVFL neural network model could be a viable alternative of dry weight assessment.

Effect of peer support on improving self-management ability in peritoneal dialysis patients-a randomized controlled trial.

BACKGROUND: Peritoneal dialysis (PD) is an ideal method for the treatment of chronic kidney disease. Its survival rate and quality of life depend on the quality of dialysis. The quality of dialysis depends on the compliance of patients with drugs and dialysis treatment, the choice of diet, the detection of complications and the monitoring and management of the disease. Therefore, the self-management of PD patients is particularly important. This study explored the role of peer support in improving the self-management ability of PD patients. METHODS: A total of 105 PD patients in a Chinese tertiary hospital were enrolled and divided into a control group (35 cases), a WeChat group (intervention group 1; 35 cases), and a face-to-face group (intervention group 2; 35 cases). During the 6-month follow-up, the control group were given individualized education, and the intervention group was given peer support. RESULTS: After the 6-month intervention, the self-management ability of the intervention group was significantly different from that of the control group (P<0.01). There were significant differences between the WeChat group and the face-to-face group with respect to hemoglobin and blood phosphorus (P<0.05). There were significant differences in prealbumin, hemoglobin, blood phosphorus and calcium levels between the intervention and control groups after 3 months and 6 months of intervention (P<0.01). CONCLUSIONS: Peer support can effectively improve the self-management ability and biochemical indicators in PD patients.

Changes in Health-Related Quality of Life During the First Year in Lung Transplant Recipients.

BACKGROUND: Health-related quality of life (HRQOL) has increasingly been accepted as a supplementary outcome measure for patients before and after lung transplantation (LT). This longitudinal study was conducted to recognize the tracks of HRQOL during the first year after transplantation and the main factors associated with HRQOL of LT recipients. The research was conducted in accordance with the 2000 Declaration of Helsinki and the Declaration of Istanbul 2008. The transplant organs were from volunteer donation, and next of kin provided written informed consents of their own free will. No prisoners were used, and donors were neither paid nor coerced. METHODS: A total of 118 patients were investigated before and 3, 6, 9, and 12 months post-transplantation. The Medical Outcomes SF-36 (Chinese version) was used to measure the HRQOL. The recipients' demographic characteristics and clinical data were evaluated to determine the relative contributions to HRQOL outcomes. RESULTS: Recipients reported a mean physical component summary of 39.62 ± 6.57, 57.90 ± 9.99, 59.15 ± 8.73, 58.79 ± 8.52, and 58.72 ± 8.99 before transplantation and at 3, 6, 9, and 12 months after LT (F = 64.960, P < .001). By 3 months after transplant, patients experienced significant improvement in physical component summary (MD = 18.27, SE = 1.52, P < .001); but between 3 and 12 months, no significant improvement was observed (MD = 0.82, SE = 1.77, P = .645). Patients reported a continuous rise with means of 44.63 ± 5.35, 51.13 ± 10.25, 51.92 ± 9.72, 53.23 ± 10.34, and 55.40 ± 8.83 for the mental component summary before LT and at 3, 6, 9, and 12 months after transplant (F = 13.059, P < .001). By 3 months after transplant, patients experienced significant improvement in mental component summary (MD = 6.50, SE = 1.50, P < .001). Between 3 and 12 months, a continuous significant improvement was observed (MD = 4.27, SE = 1.92, P = .030). The generalized estimated equation showed that age, marital status, residence, disease diagnosis, transplant type, sleep disorders, gastrointestinal complications, and BODE index (body mass index, obstruction, dyspnea, exercise) were all found to be related to HRQOL. CONCLUSION: The HRQOL of LT patients improved significantly at 3 months after transplantation, but between 3 and 12 months after transplantation, the changes were not obvious. Health practitioners should pay more attention to elderly patients, unmarried patients, patients living in urban areas, patients diagnosed with pneumoconiosis, patients with left single-lung transplantation, patients with sleep disorders, patients with high BODE indexes, and patients with gastrointestinal complications.

Multiple Laplacian Regularized RBF Neural Network for Assessing Dry Weight of Patients With End-Stage Renal Disease.

Dry weight (DW) is an important dialysis index for patients with end-stage renal disease. It can guide clinical hemodialysis. Brain natriuretic peptide, chest computed tomography image, ultrasound, and bioelectrical impedance analysis are key indicators (multisource information) for assessing DW. By these approaches, a trial-and-error method (traditional measurement method) is employed to assess DW. The assessment of clinician is time-consuming. In this study, we developed a method based on artificial intelligence technology to estimate patient DW. Based on the conventional radial basis function neural (RBFN) network, we propose a multiple Laplacian-regularized RBFN (MLapRBFN) model to predict DW of patient. Compared with other model and body composition monitor, our method achieves the lowest value (1.3226) of root mean square error. In Bland-Altman analysis of MLapRBFN, the number of out agreement interval is least (17 samples). MLapRBFN integrates multiple Laplace regularization terms, and employs an efficient iterative algorithm to solve the model. The ratio of out agreement interval is 3.57%, which is lower than 5%. Therefore, our method can be tentatively applied for clinical evaluation of DW in hemodialysis patients.

The effects of add-on self-care education on quality of life and fatigue in gastrointestinal cancer patients undergoing chemotherapy.

BACKGROUND: Gastrointestinal cancer is one of the most common malignancies and imposes heavy burdens on both individual health and social economy. We sought to survey the effect of a self-care education program on quality of life and fatigue in gastrointestinal cancer patients who received chemotherapy. METHODS: Ninety-one eligible gastrointestinal cancer patients were enrolled in this study and 86 valid samples were analyzed. Data were acquired with a demographics questionnaire, endpoint multidimensional questionnaire and the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire QLQ-C30. The collected data were analyzed using SPSS software. RESULTS: The self-care education intervention significantly improved the quality of life with respect to emotional function (p = 0.018), role function (p = 0.041), cognitive function (p = 0.038) and alleviated side effects such as nausea/vomiting (p = 0.028) and fatigue (p = 0.029). Further analysis demonstrated that the self-care education benefited total fatigue, affective fatigue and cognitive fatigue in gastrointestinal cancer patients regardless of baseline depression. CONCLUSION: Our results suggested the beneficial effects of the self-care education in both quality of life and anti-fatigue in gastrointestinal cancer patients under chemotherapy. The self-care education could be considered as a complementary approach during combination chemotherapy in gastrointestinal cancer patients.

[Simultaneous determination of 15 water-holding functional drugs in animal tissues using ultra performance liquid chromatography-tandem mass spectrometry].

A method based on ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was developed for the determination of 15 water-holding functional drugs in animal tissues.The analytes were extracted with acetonitrile containing 1.0%(v/v) methanol, purified by Oasis PRiME HLB SPE column, and analyzed by Acquity UPLC BEH C18 column (50 mm×2.1 mm, 1.7 µm) using methanol and 0.1%(v/v) formic acid aqueous solution as the mobile phases.The analytes were detected using an electrospray ionization (ESI) source under the MRM mode.The calibration curves of the analytes were linear in the range of 1.0-50.0 µg/kg (r ≥ 0.9949), and the limits of quantification were all less than 1.0 µg/kg in animal tissues.The recoveries of the 15 water-holding functional drugs ranged from 60.0%-111.0% in animal tissue samples, with the intra and inter RSDs of 0.56%-11.5% and 2.31%-14.8%, respectively.The method can meet the requirements for the determination of the drug residues in animal tissues.It provides a new idea to identify potential hazards in animal-derived foods and to monitor illegal addition.

Erratum to "Effect of High Dietary Tryptophan on Intestinal Morphology and Tight Junction Protein of Weaned Pig".

[This corrects the article DOI: 10.1155/2016/2912418.].

Draft Genome Sequence of Escherichia coli Strain SEC470, Isolated from a Piglet Experiencing Diarrhea.

Escherichia coli strain SEC470 is a diarrhea-causing strain, isolated from a piglet experiencing serious diarrhea in Jingxi Province, China. Here, we present the draft genome of this strain, which provides the genetic basis for exploring the mechanism of enterotoxigenic E. coli infections.

Effect of High Dietary Tryptophan on Intestinal Morphology and Tight Junction Protein of Weaned Pig.

Tryptophan (Trp) plays an essential role in pig behavior and growth performances. However, little is known about Trp's effects on tight junction barrier and intestinal health in weaned pigs. In the present study, twenty-four (24) weaned pigs were randomly assigned to one of the three treatments with 8 piglets/treatments. The piglets were fed different amounts of L-tryptophan (L-Trp) as follows: 0.0%, 0.15, and 0.75%, respectively, named zero Trp (ZTS), low Trp (LTS), and high Trp (HTS), respectively. No significant differences were observed in average daily gain (ADG), average daily feed intake (ADFI), and gain: feed (G/F) ratio between the groups. After 21 days of the feeding trial, results showed that dietary Trp significantly increased (P < 0.05) crypt depth and significantly decreased (P < 0.05) villus height to crypt depth ratio (VH/CD) in the jejunum of pig fed HTS. In addition, pig fed HTS had higher (P < 0.05) serum diamine oxidase (DAO) and D-lactate. Furthermore, pig fed HTS significantly decreased mRNA expression of tight junction proteins occludin and ZO-1 but not claudin-1 in the jejunum. The number of intraepithelial lymphocytes and goblet cells were not significantly different (P > 0.05) between the groups. Collectively, these data suggest that dietary Trp supplementation at a certain level (0.75%) may negatively affect the small intestinal structure in weaned pig.