Effects of Maitland mobilization technique on upper extremity function in stroke survivors with spasticity: An experimental study.

BACKGROUND: The recovery of upper limb function is of great significance for stroke patients to regain their self-care ability, yet it is still a difficult point in clinical practice of neurological rehabilitation. This study aimed to investigate the effect of Maitland joint mobilization technique on the recovery of upper extremity function in patients with spasticity after stroke. METHODS: From August to December 2023, 71 patients with upper extremity flexor spasm after stroke were recruited and randomly divided into experimental group (n = 35) and control group (n = 36). The control group was given conventional rehabilitation treatment, while the experimental group was treated with Maitland mobilization technique treatment of upper extremity joints on the basis of the control group. The experiment lasted for 8 weeks. Participants of the 2 groups were observed for Fugl-Meyer motor assessment-upper extremity (FMA-UE), box and block test (BBT) and Brunnstrom stage, modified Ashworth scale (MAS), and functional independence measure (FIM) at pre- and post-8 weeks study. RESULTS: There was no significant difference in gender distribution, hemiplegic side, diagnosis, past history, age, duration, body mass index, and mini-mental state examination between the 2 groups (P > .05). After 8 weeks of intervention, both groups showed significant improvement in FMA-UE, Brunnstrom stage, BBT, FIM, and MAS of the shoulder (P < .05); however, there was no significant change in MAS of the elbow, wrist, and finger joints (P > .05). The posttreatment values showed a significant improvement in FMA-UE, BBT, and FIM in the experimental group compared to the control group. Comparing the changes in pretreatment and posttreatment, FMA-UE, BBT, and FIM in the experimental group were significantly improved compared with those in the control group (P < .05). CONCLUSION: Maitland joint mobilization can improve the motor function of upper extremity and the spasticity of shoulder joint complex in patients with stroke.

Multi-level magnetic microrobot delivery strategy within a hierarchical vascularized organ-on-a-chip.

Targeted microrobotic delivery within the circulatory system holds significant potential for medical theranostic applications. Existing delivery strategies of microrobots encounter challenges such as slow speed, limited navigation control, and dispersal under dynamic flow conditions. Furthermore, within the realm of microrobots, in vitro testing platforms often lack essential biological microenvironments, while in vivo studies conducted on animal models are constrained by limited detection resolution. In this study, we propose a multi-level magnetic delivery strategy that integrates a tethered microrobotic guidewire and untethered swimming microrobots. The amalgamation compensates for their inherent constraints, ensuring a robust and highly efficient delivery of microrobots under complex physiological conditions over extensive distances. Concurrently, a hierarchical vascular network encompassing engineered arteries/veins and capillary networks was constructed by integrating vasculogenesis and endothelial cell (EC) lining strategies, thereby providing an in vivo-like testing platform for microrobots. Experimental evidence demonstrates that the flexible microrobotic guidewire can be precisely directed to any entrance of the second-tier branches, with its inner lumen providing an "express lane" for rapid passage of microrobots through complex fluidic environments without direct contact. After release, dynamically assembled swarms could effectively locomote on the micro-topography of the EC-lined channel surface without becoming trapped and congregate within specified regions inside capillary lumens when guided collectively by a biologically safe magnetic field. Additionally, the superparamagnetic capabilities of microrobotic swarms ensure their dissolution into monodispersed entities upon withdrawal of the magnetic field, mitigating the risk of intravascular thrombosis. The hierarchical vascularized organ-on-a-chip platform establishes a comprehensive testing platform that integrates imaging, control, and a functional 3D microvascular environment, thereby enhancing its suitability for microrobotic applications encompassing targeted drug delivery, thrombus ablation, sensing and diagnosis, etc.

Effects of remote dignity therapy on mental health among patients with hematologic neoplasms and their significant others: A randomized controlled trial.

BACKGROUND: Families of patients with hematologic neoplasms involved in dignity therapy have exhibited a remarkable improvement in psychological well-being and family functioning. However, the applicability and generalizability of family participatory dignity therapy are limited as it is influenced by factors such as intervention time, place, and participants. Whether remote support from significant others is feasible and effective remains unknown. OBJECTIVES: This study aimed to confirm the efficacy of significant others participating in remote dignity therapy (r-DT) on hope, dignity loss, meaning of life, and sense of stigma among patients with hematologic neoplasms as well as their significant others' depression and anxiety. DESIGN: A randomized, single-blinded, two-arm, parallel-group controlled trial. SETTING(S) AND PARTICIPANTS: Participants included patients with hematologic neoplasms and their significant others, who were recruited from Fujian Medical University Union Hospital from May 2021 to January 2022. METHODS: A total of 72 eligible participants (patients and significant others) agreed to participate, and were randomly assigned to an intervention group (n = 35) or a control group (n = 37). Each pair of participants in the intervention group participated in two or three conversations based on the online video function of the WeChat platform, performed by one therapist in accordance with a specific communication outline. To evaluate the effects of the intervention, we assessed the patients' degree of dignity loss, hope level, meaning of life, and sense of stigma, as well as their significant others' depression, anxiety, and intimacy at baseline (T0), 15 days (T1), 30 days (T2), and 60 days (T3), and compared the scores between the two groups after the completion of the intervention. The Generalized Estimation Equation Model (GEE) was used to examine the effects of time, group, and their interaction. RESULTS: The intervention group statistically significantly differed in lower dignity loss (t = 2.190, p = 0.032), higher hope level (t = -2.010, p = 0.049), and higher meaning of life (t = -2.066, p = 0.043) than the control group at T1. Regarding their significant others, the results of the comparison between the two groups showed that significant others in the intervention group had reduced levels of anxiety and depression at T1 and T2 (p < 0.05). The majority of patients (84.38 %) and significant others (75.00 %) provided positive evaluations of the program. CONCLUSIONS: The r-DT showed a short-term positive effect on decreasing patients' dignity loss and promoting patients' hope and meaning of life; among their significant others, it decreased anxiety and depression. TRIAL REGISTRATION: Registered in the China Clinical Trial Registry on 17 March 2021(ChiCTR2100044374). TWEETABLE ABSTRACT: Remote dignity therapy decreased patients' dignity loss and promoted their hope and meaning of life; among their significant others, it decreased anxiety and depression.

Multifunctional cardiac microphysiological system based on transparent ITO electrodes for simultaneous optical measurement and electrical signal monitoring.

Drug-induced cardiotoxicity is a significant contributor to drug recalls, primarily attributed to limitations in existing drug screening platforms. Traditional heart-on-a-chip platforms often employ metallic electrodes to record cardiomyocyte electrical signals. However, this approach hinders direct cardiomyocyte morphology observation and typically yields limited functionality. Consequently, this limitation may lead to an incomplete understanding of cardiomyocyte characteristics. To address these challenges, we introduce a multifunctional cardiac microphysiological system featuring transparent indium tin oxide electrodes. This innovative design aims to overcome the limitations of conventional heart-on-a-chip systems where metal electrodes interfere with the observation of cells and increase the difficulty of subsequent image processing of cell images. In addition to facilitating optical measurement combined with image processing capabilities, this system integrates a range of electrodes with diverse functionalities. These electrodes can realize cellular electrical stimulation, field potential monitoring, and impedance change tracking, enabling a comprehensive investigation of various cardiomyocyte traits. To demonstrate its versatility, we investigate the effects of four cardiac drugs with distinct pharmacological profiles on cardiomyocytes using this system. This platform provides a means for quantitatively and predictively assessing cardiac toxicity, which could be applied to conduct a comprehensive evaluation during the drug discovery process.

Engineering vascularised organoid-on-a-chip: strategies, advances and future perspectives.

In recent years, advances in microfabrication technology and tissue engineering have propelled the development of a novel drug screening and disease modelling platform known as organoid-on-a-chip. This platform integrates organoids and organ-on-a-chip technologies, emerging as a promising approach for in vitro modelling of human organ physiology. Organoid-on-a-chip devices leverage microfluidic systems to simulate the physiological microenvironment of specific organs, offering a more dynamic and flexible setting that can mimic a more comprehensive human biological context. However, the lack of functional vasculature has remained a significant challenge in this technology. Vascularisation is crucial for the long-term culture and in vitro modelling of organoids, holding important implications for drug development and personalised medical approaches. This review provides an overview of research progress in developing vascularised organoid-on-a-chip models, addressing methods for in vitro vascularisation and advancements in vascularised organoids. The aim is to serve as a reference for future endeavors in constructing fully functional vascularised organoid-on-a-chip platforms.

The influence of perceived stress of Chinese healthcare workers after the opening of COVID-19: the bidirectional mediation between mental health and job burnout.

Objective: To explore the current status and interaction of perceived stress, job burnout and mental health among healthcare workers after the opening of COVID-19 which occurred in December 2022. Methods: A cross-sectional study of 792 healthcare workers from three tertiary hospitals in Wuxi was conducted from January 2023 to February 2023. Sociodemographic questionnaire, Perceived Stress Scale, Burnout Scale and Mental Health Self-Assessment Questionnaire were used for investigation. SPSS 26.0 was used to conduct data analysis. The significance of mediation was determined by the PROCESS macro using a bootstrap method. Results: The results showed that (1) The average scores of the participants for perceived stress, mental health and job burnout were 22.65 (7.67), 3.85 (4.21) and 1.88 (1.03), respectively. (2) The perceived stress score, mental health score and job burnout score of healthcare workers were positively correlated (r = 0.543-0.699, p < 0.05). (3) Mental health partially mediated the relationship between perceived stress and job burnout with a mediating effect of 17.17% of the total effect. Job burnout partially mediated the correlation between perceived stress and mental health with a mediating effect of 31.73% of the total effect. Conclusion: The results of this study suggested that perceived stress had an impact on job burnout and mental health, either directly or indirectly. Healthcare managers should intervene to reduce perceived stress to protect healthcare workers' mental health, thereby alleviating burnout under the opening COVID-19 pandemic environment.

Identifying barriers to resilience from the perspective of young and middle-aged patients with lymphoma: A qualitative exploration.

PURPOSE: This study aimed to understand and identify barriers to resilience in young and middle-aged patients with lymphoma in the context of Chinese culture. METHODS: A qualitative descriptive study was employed. Face-to-face, semi-structured, and in-depth individual interviews were conducted between May and July 2022. Purposive and differential sampling was used to select eligible participants. Conventional content analysis was used to analyze qualitative data and identify categories and subcategories. This study followed the COREQ checklist. RESULTS: Twenty patients aged 28-59 years completed the interviews. Three categories involving thirteen subcategories were identified from the interview data: (1) internal barriers-derived from individual cognitive, emotional, behavioral, spiritual, and physical distress, resulting in internal negative constructs, and reducing the motivation to overcome adversity; (2) unbalanced family functioning-families threatened by disease are incapable of maintaining normal functioning and fail to act effectively when facing crises; and (3) absent social support-insufficient or unavailable shielding protection from social support further inhibits resilience among patients with lymphoma. CONCLUSIONS: This study identified various barriers to the resilience of young and middle-aged patients with lymphoma in the context of Chinese culture. In addition to the patient's internal barriers of resilience, specific family and socio-cultural barriers should also be emphasized by healthcare professionals. Multidisciplinary and family-centered resilience intervention should be developed to help such patients cope with, adapt to the disease, and achieve good psychosocial returns.

Organoid-on-a-chip: Current challenges, trends, and future scope toward medicine.

In vitro organoid models, typically defined as 3D multicellular aggregates, have been extensively used as a promising tool in drug screening, disease progression research, and precision medicine. Combined with advanced microfluidics technique, organoid-on-a-chip can flexibly replicate in vivo organs within the biomimetic physiological microenvironment by accurately regulating different parameters, such as fluid conditions and concentration gradients of biochemical factors. Since engineered organ reconstruction has opened a new paradigm in biomedicine, innovative approaches are increasingly required in micro-nano fabrication, tissue construction, and development of pharmaceutical products. In this Perspective review, the advantages and characteristics of organoid-on-a-chip are first introduced. Challenges in current organoid culture, extracellular matrix building, and device manufacturing techniques are subsequently demonstrated, followed by potential alternative approaches, respectively. The future directions and emerging application scenarios of organoid-on-a-chip are finally prospected to further satisfy the clinical demands.

A parabrachial-hypothalamic parallel circuit governs cold defense in mice.

Thermal homeostasis is vital for mammals and is controlled by brain neurocircuits. Yet, the neural pathways responsible for cold defense regulation are still unclear. Here, we found that a pathway from the lateral parabrachial nucleus (LPB) to the dorsomedial hypothalamus (DMH), which runs parallel to the canonical LPB to preoptic area (POA) pathway, is also crucial for cold defense. Together, these pathways make an equivalent and cumulative contribution, forming a parallel circuit. Specifically, activation of the LPB → DMH pathway induced strong cold-defense responses, including increases in thermogenesis of brown adipose tissue (BAT), muscle shivering, heart rate, and locomotion. Further, we identified somatostatin neurons in the LPB that target DMH to promote BAT thermogenesis. Therefore, we reveal a parallel circuit governing cold defense in mice, which enables resilience to hypothermia and provides a scalable and robust network in heat production, reshaping our understanding of neural circuit regulation of homeostatic behaviors.

Burn-out, emotional labour and psychological resilience among gastroenterology nurses during COVID-19: a cross-sectional study.

OBJECTIVES: To investigate the relationship between burn-out, emotional labour and psychological resilience of gastroenterology nurses during the COVID-19 pandemic and explore the factors associated with these specific variables. DESIGN: A multicentre cross-sectional study with anonymous self-reporting was conducted from 24 November 2021 to 26 December 2021. SETTING: The study was conducted in Fujian Province, China. PARTICIPANTS: The participants were 345 gastroenterology nurses from 7 tertiary hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES: Burn-out, emotional labour and psychological resilience were the primary outcome measures. Using a convenience sampling method, the data were collected using Questionnaire Star (a tool for questionnaire surveys) via WeChat. The Chinese version of the Maslach Burnout Inventory, the Chinese version of the Emotional Labour Scale and the Chinese version of the Psychological Resilience Scale were used to evaluate burn-out, emotional labour and psychological resilience, respectively. RESULTS: The total scores for burn-out, emotional labour and psychological resilience in gastroenterology nurses were 53.07±19.63, 38.79±12.22 and 69.97±22.38, respectively, with less use of deep acting and more use of surface acting. Pearson correlation analysis showed that burn-out was positively correlated with two dimensions of emotional labour; surface acting and emotional expression, and negatively correlated with deep acting. There was a negative correlation between emotional labour and all three dimensions of psychological resilience. CONCLUSIONS: Greater adoption of deep acting by nurses can be promoted by improving their psychological resilience during events such as the COVID-19 pandemic, which can help improve emotional labour, thereby reducing burn-out and decreasing turnover rates. Senior management in hospitals must pay attention to nurses' psychological status. Further interventional studies could be conducted in the future to explore relevant measures.

Effect of modified CeO2 on the performance of PdCu/Ce1-xTixO2 catalyst for methanol purification.

In this paper, we prepared a series of Ce1-xTixO2 (x = 0-0.20) nanorods by hydrothermal method, which were used to construct the PdCu/Ce1-xTixO2 catalysts. The Ce1-xTixO2 and PdCu/Ce1-xTixO2 samples were characterized by transmission electron microscope (TEM), X-ray photoelectron spectroscopy (XPS), N2 adsorption-desorption, X-ray diffraction (XRD), inductively coupled plasma optical emission spectrometer (ICP-OES), etc. Catalytic activity, stability, and repeatability of the catalysts for methanol oxidation were investigated. The results show that doping a proper amount of titanium could strengthen the interaction between Ce1-xTixO2 support and PdCu nanoalloy, thus increasing the oxygen vacancy concentration and promoting Pd species with a higher oxidation state. These modified properties are beneficial for the deep oxidation of methanol. The light-off temperature (T50) and full-conversion temperature (T90) of methanol over the PdCu/CeO2 catalyst are 108 °C and 159 °C, respectively. The greatest activity improvement is found for PdCu/Ce0.9Ti0.1O2, which shows the lowest T50 of 88 °C and T90 of 138 °C. Furthermore, neither PdCu/CeO2 nor the modified PdCu/CeO2 catalyst produces by-products and exhibit excellent stability and repeatability throughout the whole test period. This study provides a reference for in-depth understanding and designing of efficient and stable CeO2-based oxidation catalysts.

Constructing conductive titanium carbide nanosheet (MXene) network on polyurethane/polyacrylonitrile fibre framework for flexible strain sensor.

HYPOTHESIS: MXenes (two-dimensional early transition metal carbides and carbonitrides) possess both excellent conductivity and surface hydrophilicity, enabling more diverse potential applications. However, in flexible strain sensors, the flexible substrates are usually composed of hydrophobic elastomers such as thermoplastic polyurethane (TPU). To enhance the interactions between MXenes and hydrophobic. substrates, it is wiser to change the composition of the flexible substrate than to modify the surface of MXenes, so as to improve the interactions between the flexible substrate and MXenes without losing the excellent conductivity of MXene. EXPERIMENTS: We introduce polyacrylonitrile (PAN) into TPU, and then fabricate a flexible TPU/PAN mat through electrospinning. A highly conductive and stretchable Ti3C2 MXene/TPU/PAN mat was then prepared by a simple dip-coating process. The interaction mechanism between Ti3C2 MXene nanosheets and TPU/PAN mat was investigated by XPS and FT-IR. Finally, we build the MXene/TPU/PAN mat into a flexible strain sensor with excellent properties. FINDINGS: By introducing PAN into flexible substrate, the interaction between Ti3C2 MXene and the flexible substrate was effectively improved without compromising Ti3C2 MXene's excellent conductivity. The MXene/TPU/PAN strain sensor possesses a wide sensing range (0-80%), a fast response (<140.6 ms), a low limit of detection (<0.1%), splendid coating adhesion and excellent durability (>1750 cycles). All of these properties are demanded in wearable electronics.

Human menstrual blood-derived stem cells promote functional recovery in a rat spinal cord hemisection model.

Spinal cord injury (SCI) is associated with a dismal prognosis including severe voluntary motor and sensory deficits in the presence of the current therapies, thus new and efficient treatment strategies are desperately required. Along with several advantages, such as easy accessibility, high-yield, potential of enormous proliferation, menstrual blood-derived mesenchymal stem cells (MenSCs) have been proposed as a promising strategy in regeneration medicine. In this study, the MenSCs were transplanted into incomplete thoracic (T10) spinal cord injury (SCI) rats, all rats were sacrificed at 7, 14, and 28 days after surgery. Based on the results, we found that MenSCs transplantation improved the hind limb motor function. Besides, H&E staining showed that MenSCs treatment markedly reduced cavity formation in the lesion site. Furthermore, treatment by MenSCs showed more MAP2-positive mature neurons, as well as axonal regeneration manifested by NF-200 and less expression of chondroitin sulfate proteoglycans (CSPGs) than the non-treatment in the lesion site. Additionally, immunofluorescence, Western blot, and qRT-PCR methods showed that levels of brain-derived neurotrophic factor (BDNF) were significantly higher in the injured spinal cord after implantation of MenSCs. Results of qRT-PCR indicated that inflammatory factors, including TNF-α and IL-1ß were inhibited after MenSCs transplantation. The improved motor function of hind limb and the increased cell body area of motor neurons were suppressed by blocking of the BDNF-TrkB signaling. It was eventually revealed that MenSCs implantation had beneficial therapeutic effects on the rehabilitation of the rat spinal cord hemisection model, mainly by enhancing the expression of BDNF. MenSCs transplantation may provide a novel therapeutic strategy for patients with SCI in the future.