Role of cognitive reserve in ischemic stroke prognosis: A systematic review.

Objective: This systematic review was performed to identify the role of cognitive reserve (CR) proxies in the functional outcome and mortality prognostication of patients after acute ischemic stroke. Methods: PubMed, Embase, Web of Science, and Cochrane Library were comprehensively searched by two independent reviewers from their inception to 31 August 2022, with no restrictions on language. The reference lists of reviews or included articles were also searched. Cohort studies with a follow-up period of ≥3 months identifying the association between CR indicators and the post-stroke functional outcome and mortality were included. The outcome records for patients with hemorrhage and ischemic stroke not reported separately were excluded. The Quality In Prognosis Studies (QUIPS) tool was used to assess the quality of included studies. Results: Our search yielded 28 studies (n = 1,14,212) between 2004 and 2022, of which 14 were prospective cohort studies and 14 were retrospective cohort studies. The follow-up period ranged from 3 months to 36 years, and the mean or median age varied from 39.6 to 77.2 years. Of the 28 studies, 15 studies used the functional outcome as their primary outcome interest, and 11 of the 28 studies included the end-point interest of mortality after ischemic stroke. In addition, two of the 28 studies focused on the interest of functional outcomes and mortality. Among the included studies, CR proxies were measured by education, income, occupation, premorbid intelligence quotient, bilingualism, and socioeconomic status, respectively. The quality of the review studies was affected by low to high risk of bias. Conclusion: Based on the current literature, patients with ischemic stroke with higher CR proxies may have a lower risk of adverse outcomes. Further prospective studies involving a combination of CR proxies and residuals of fMRI measurements are warranted to determine the contribution of CR to the adverse outcome of ischemic stroke. Systematic review registration: PROSPERO, identifier CRD42022332810, https://www.crd.york.ac.uk/PROSPERO/.

Current Situations and Challenges in the Development of Health Information Literacy.

Health information literacy (HIL) is a significant concept that has gradually become known to the broader public in recent years. Although the definitions of HIL and health literacy seem to overlap, as an independent subconcept, HIL still shows a unique influence on improvements in people's health and health education. Remarkable evidence indicates that online health information (OHI) can effectively enrich people's knowledge and encourage patients to actively join the medical process, which is also accompanied by the emergence of various assessment tools. Although the current assessment tools, to a certain extent, can help people identify their shortcomings and improve their HIL, many studies have indicated that the deficiencies of the scales induce incomplete or unreal results of their HIL. In addition, continuing research has revealed an increasing number of influencing factors that have great effects on HIL and even regulate the different trends in doctor-patient relationships. Simultaneously, most of the uncensored OHI broadcasts have also affected the improvement in HIL in various ways. Thus, this review aims to summarize the assessment tools, influencing factors and current situations and challenges related to HIL. Further studies are required to provide more trusted and deeper references for the development of HIL.

Demand analysis of telenursing among empty-nest elderly individuals with chronic diseases based on the Kano model.

Aim: The increase in empty-nest elderly individuals with chronic diseases poses a major challenge to the provision of public health services in China. Telenursing can effectively relieve the pressure of public health services to a certain extent. This study aims to explore the telenursing needs of empty-nest elderly individuals with chronic diseases based on the Kano model to provide references for improving the quality of telenursing. Methods: Participants were selected from five rural communities and five urban communities in Yangzhou and Nantong, Jiangsu Province, China. A total of 348 empty-nest elderly individuals with chronic diseases were included. The participants received a sociodemographic characteristics questionnaire, and their telenursing needs were surveyed and analyzed based on the Kano model. Results: Of the 15 quality attributes evaluated by the participants, 3 telenursing services were categorized as "must-be quality", 5 were categorized as "one-dimensional quality", 5 were categorized as "attractive quality", and 2 were categorized as "indifferent quality". The proportion of individuals who desired telenursing services ranged from 47.41 to 83.62%, the better values (satisfaction) ranged from 35.29-83.98%, and the worse values (dissatisfaction) ranged from 10.91 to 63.27%. There were no significant differences in any items of telenursing needs for between participants in Yangzhou and Nantong (all P > 0.05), and there were also no significant differences in all items between rural and urban communities (all P > 0.05). Conclusion: Based on the Kano model, it was found that empty-nest elderly individuals with chronic diseases had a positive attitude toward telenursing and that they had different levels of need for different telenursing services. These findings provided a theoretical basis for medical decision-makers to formulate medical policies and provided a scientific foundation for nursing managers to improve telenursing services to meet the needs of the empty-nest elderly individuals with chronic diseases.

Contributing Factors and Induced Outcomes of Psychological Stress Response in Stroke Survivors: A Systematic Review.

Background: Remarkable evidence indicates that psychological stress is significantly associated with stroke. However, a uniform recommendation to identify and alleviate poststroke psychological stress responses and improve postmorbid outcomes is not currently available. Thus, this systematic review aimed to summarize the types of poststroke psychological stress, measurement tools, contributing factors, and outcomes. Methods: This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted in PubMed, Web of Science, Embase, CNKI, WanFangData, and CQVIP from database inception to November 2021. Cross-sectional and longitudinal studies were included in this research. Quality assessment was performed based on the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: Eighteen quantitative, peer-reviewed studies were included for analysis. Selected articles mainly investigated perceived stress and posttraumatic stress disorder after stroke. We classified the contributing factors into four categories: sociodemographic factors, clinical disease factors, psychological factors, and behavioral and lifestyle factors. The postmorbid outcomes were divided into three categories: clinical disease outcomes, psychological outcomes, and behavioral and quality of life outcomes. Conclusions: Compared to common patients, stroke survivors with the following characteristics suffered an increased psychological stress response: younger age, the presence of caregivers, depression, unsuitable coping strategies, etc. Meanwhile, lower quality of life, worse drug compliance, worse functional independence, and more severe mental disorders were significantly associated with increased psychological stress symptoms. Further studies are required to provide more trustworthy and meaningful references for mitigating the damage caused by psychological stress after stroke.

Risk factors for delayed hemorrhage after colonoscopic postpolypectomy: Polyp size and operative modality.

BACKGROUND AND AIM: Delayed postpolypectomy hemorrhage is relatively common, with occasional extensive blood loss, endangering life. This study aimed to determine the factors associated with postoperative hemorrhage. METHODS: The study was a retrospective cohort study of patients hospitalized for colonoscopic polypectomy at the Department of Gastroenterology and Hepatology, Tenth People's Hospital of Tongji University, China, between January and December 2015. Data on gender, age, bowel preparation, location, size, number of polyps, operative modality, pathology, and operation practitioner were collected. Patients were divided into two groups based on the presence or absence of postoperative hemorrhage. RESULTS: A total of 1962 polyps were detected in patients and they underwent polypectomy; hemorrhage occurred in 41 cases. A correlation was demonstrated between postpolypectomy hemorrhage and each of the following factors: polyp size and operative modality. The odds ratio (OR) was 4.535 (95% confidence interval [CI], 2.331-8.823) for 1-2-cm polyps, 4.008 (95% CI, 0.904-17.776) for 2-3-cm polyps, and 22.407 (95% CI, 5.783-86.812) for ≥3-cm polyps. Compared with argon plasma coagulation, OR was 9.128 (95% CI, 3.548-23.486) for endoscopic mucosal resection and 31.257 (95% CI, 7.009-139.395) for endoscopic submucosal dissection. CONCLUSIONS: The independent risk factors for delayed postpolypectomy hemorrhage include polyp size and operative modality.

A Randomized Clinical Trial of Berberine Hydrochloride in Patients with Diarrhea-Predominant Irritable Bowel Syndrome.

We aimed to evaluate clinical symptoms in diarrhea predominant irritable bowel syndrome (IBS-D) receiving berberine hydrochloride in a randomized double-blind placebo-controlled clinical trial. Overall, 196 patients with IBS-D were recruited for this study; consequently, 132 patients randomized to receive daily 400 mg of berberine hydrochloride, delivered twice daily or placebo for 8 weeks followed by a 4-week washout period. After a 2-week run-in period, diarrhea, abdominal pain, urgent need for defecation frequency and any adverse events were recorded daily. Prior to administration of the medication and after completing the treatment, assessment of IBS symptom scores, depression and anxiety scale scores and the IBS scale for quality of life (QOL) was carried out. The effects of berberine hydrochloride on IBS-D, defined by a reduction of diarrhea frequency (P = 0.032), abdominal pain frequency (P < 0.01) and urgent need for defecation frequency (P < 0.01), were significantly more pronounced in the berberine group than the placebo group in the 8 weeks of treatment. A trend of improvement (P < 0.05) was observed with berberine hydrochloride for IBS symptom score, depression score and anxiety score and the IBSQOL, compared with placebo. At last, berberine hydrochloride was well tolerated. So we concluded that berberine hydrochloride is well tolerated and reduces IBS-D symptoms, which effectively improved patients QOL.

Chemopreventive effects of 5-amino salicylic acids on inflammatory bowel disease-associated colonic cancer and colonic dysplasia: a meta-analysis.

PURPOSE: To study the effects of 5-amino salicylic acids (5-ASAs) on the incidence rates of inflammatory bowel disease (IBD)-associated colonic cancer (IBDACa) and colonic dysplasia (IBDADys), as well as to evaluate the chemopreventive effects of 5-ASAs on IBDACa/Dys. METHODS: Searches for officially published clinical studies on the effects of 5-ASAs on the chemoprevention of IBDACa/Dys were conducted in both foreign-language databases, including PubMed (Medline), EMCC, OVID, and the Cochrane Library, and Chinese databases, including Wanfang, Weipu (VIP), and CNKI, as well as using Google Scholar. For literature matching the selection criteria, the statistical software RevMan was employed to calculate odds ratio (OR) values and 95% confidence intervals (CIs). Sub-group analysis was performed for different study design types and IBD types. RESULTS: A total of fourteen papers were included in this study. The results of the analysis showed that compared with patients not using 5-ASAs, patients using 5-ASAs showed only 49% of the occurrence rate of IBDACa and IBDADys, OR = 0.49 (95% CI: 0.33-0.73). The OR of ulcerative colitis (UC) patients using 5-ASAs exhibiting UCCa/Dys was 0.44 (95% CI: 0.26-0.76). CONCLUSION: The use of 5-ASAs exerts a chemopreventive effect against IBDACa/Dys.