Prevalence and potential influencing factors for social frailty among community-dwelling older adults: a systematic review and meta-analysis.

OBJECTIVE: To explore the prevalence and potential influencing factors of social frailty among community-dwelling older adults from a global perspective. METHODS: Systematic searches were conducted on multiple databases including CNKI, VIP, Wanfang Data, CBM, Pubmed, Cochrane Library, Web of Science, and Embase from inception to January 9, 2024. Two researchers performed a thorough literature search, gathered data, and independently evaluated the quality of the articles. RESULTS: 2,426 literatures were examined, 45 were found to meet the specified criteria for inclusion, encompassing 314,454 participants. The combined prevalence of social pre-frailty and social frailty among community-dwelling older adults were found to be 34.5% and 21.1%, respectively. Depression, activities of daily living (ADL), physical inactivity, motor deficits, cognitive impairment, and physical frailty are potential risk factors. CONCLUSIONS: Social pre-frailty and social frailty are frequent challenges faced by older adults living in the community. The prevalence of these conditions has been on the rise in recent years, underscoring the importance of implementing effective interventions. Early identification and intervention for individuals at risk of social frailty are essential for promoting healthy and active aging globally.

Prevalence, associated factors and clinical implications of medication literacy linked to frailty in hemodialysis patients in China: a cross-sectional study.

BACKGROUND: Maintenance hemodialysis (MHD) patients have complex medication regimens that require a high level of skill to interpret medication information. However, there is currently a lack of research evaluating the ability to read and understand medication labels in Chinese MHD patients. In addition, the relationship between frailty and medication literacy among MHD patients remains unclear. Therefore, this study aims to assess the potential factors affecting medication literacy in MHD patients and to explore the relationship between frailty and medication literacy. METHODS: This cross-sectional study was conducted using convenience sampling in West China Hospital of Sichuan University, China. Using a general questionnaire, we collected demographic, clinical and laboratory data. Medication literacy was assessed by the Chinese Medication Literacy Scale, and frailty was assessed by the FRAIL Scale. Univariate analyses examined potential factors associated with medication literacy. An ordered logistic regression was used to analyze the relationships between medication literacy and these factors. Spearman's correlation was used to assess the association between medication literacy and frailty. RESULTS: A total of 290 MHD patients were included in the analysis. Inadequate, marginal, and adequate medication literacy was found in 56 (19.3%), 153 (52.8%), and 81 (27.9%) patients, respectively. Ordered logistic regression revealed factors associated with inadequate medication literacy: age (OR = 0.281, 95% CI = 0.139-0.565, p < 0.001 for < 65 years); education (OR = 8.612, 95% CI = 3.524-21.046, p < 0.001 for ≤ primary school education; OR = 3.405, 95% CI = 1.683-6.887, p = 0.001 for junior high school education); presence of caregiver medication assistance (OR = 2.302, 95% CI = 1.173-4.516, p = 0.015); frailty (OR = 0.440, 95% CI = 0.216-0.893, p = 0.023 for frail patients); and high ß2-microglobulin (ß2-MG) (OR = 1.010, 95% CI = 1.002-1.019, p = 0.012). Spearman's analysis showed that medication literacy was negatively correlated with frailty in MHD patients (R=-0.189, p = 0.001). CONCLUSIONS: Medication literacy levels in MHD patients needed improvement and were associated with certain patient characteristics, including age, education level, presence of caregiver support, ß2-microglobulin levels, and risk of frailty. This study identified subgroups of MHD patients, such as those who were older, had lower education, had caregiver assistance, had high ß2-microglobulin levels, or were frail, to have inadequate medication literacy. These findings underscore the need for routine screening and targeted interventions to improve medication literacy in this population.

Use machine learning to help identify possible sarcopenia cases in maintenance hemodialysis patients.

BACKGROUND: Maintenance hemodialysis (MHD) patients often suffer from sarcopenia, which is strongly associated with their long-term mortality. The diagnosis and treatment of sarcopenia, especially possible sarcopenia for MHD patients are of great importance. This study aims to use machine learning and medical data to develop two simple sarcopenia identification assistant tools for MHD patients and focuses on sex specificity. METHODS: Data were retrospectively collected from patients undergoing MHD and included patients' basic information, body measurement results and laboratory findings. The 2019 consensus update by Asian working group for sarcopenia was used to assess whether a MHD patient had sarcopenia. Finally, 140 male (58 with possible sarcopenia or sarcopenia) and 102 female (65 with possible sarcopenia or sarcopenia) patients' data were collected. Participants were divided into sarcopenia and control groups for each sex to develop binary classifiers. After statistical analysis and feature selection, stratified shuffle split and Synthetic Minority Oversampling Technique were conducted and voting classifiers were developed. RESULTS: After eliminating handgrip strength, 6-m walk, and skeletal muscle index, the best three features for sarcopenia identification of male patients are age, fasting blood glucose, and parathyroid hormone. Meanwhile, age, arm without vascular access, total bilirubin, and post-dialysis creatinine are the best four features for females. After abandoning models with overfitting or bad performance, voting classifiers achieved good sarcopenia classification performance for both sexes (For males: sensitivity: 77.50% ± 11.21%, specificity: 83.13% ± 9.70%, F1 score: 77.32% ± 5.36%, the area under the receiver operating characteristic curves (AUC): 87.40% ± 4.41%. For females: sensitivity: 76.15% ± 13.95%, specificity: 71.25% ± 15.86%, F1 score: 78.04% ± 8.85%, AUC: 77.69% ± 7.92%). CONCLUSIONS: Two simple sex-specific sarcopenia identification tools for MHD patients were developed. They performed well on the case finding of sarcopenia, especially possible sarcopenia.

Treatment-related Problems and Countermeasures for Patients Undergoing Maintenance Hemodialysis Following Tropical Cyclones: A Scoping Review.

BACKGROUND: Patients undergoing maintenance hemodialysis face heightened vulnerability during disasters like tropical cyclones, yet there is sparse research on their treatment-related challenges and countermeasures. This scoping review aims to highlight the issues maintenance hemodialysis patients encounter following tropical cyclones. METHODS: A systematic scoping review of 19 articles from 2000 to 2023 was conducted, evaluating eligibility against predefined criteria. RESULTS: Hemodialysis patients encounter substantial challenges during and after tropical cyclones in the United States, Puerto Rico, Australia, and Taiwan. Thematic analysis identified 3 themes related to "challenges" (Hemodialysis health-related challenges, socially relevant challenges, and challenges of management inefficiencies). "Recommendations" comprised 4 themes and 4 phases across the "mitigation phase" (fortifying healthcare infrastructure and mobilizing community-focused risk mitigation initiatives), "preparedness" (emergency plan development, training, and patient education), "response" (activation of emergency plans and providing emergency healthcare services), and "recovery" (intersectoral collaboration for recovery and rebuilding). CONCLUSION: This scoping review underscores challenges confronted by patients undergoing maintenance hemodialysis post-tropical cyclones, highlighting the urgent need for targeted strategies to ensure the continuity of dialysis care during and after such disasters.

Factors related to the disaster preparedness of patients on haemodialysis from Sichuan, China, during COVID-19: A cross-sectional study.

AIM: This study aimed to investigate personal preparedness among patients on haemodialysis (HD) and to examine the relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours during natural disaster incidents. DESIGN: A cross-sectional survey was conducted. METHODS: A convenience sampling method was used. A total of 446 participants from six areas of Sichuan province completed the online questionnaire study from February 27 to March 13, 2022. Sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were measured. Descriptive statistics were used to analyse sociodemographic characteristics and attitudes toward disaster preparedness. The relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were assessed using ordinal regression. Statistical significance was defined as p < 0.05. RESULTS: A total of 446 participants completed the survey. Of these, 42.15% (N = 188) were poorly prepared, 26.23% (N = 117) were moderately prepared and 31.61% (N = 141) were highly prepared. Ordinal regression showed that knowing about disaster preparedness (Odds Ratio (OR) = 1.691, 95% Confidence Interval (CI) = 1.081-2.644, p = 0.021), participating in disaster evacuation exercises (OR = 2.519, 95% CI = 1.595-3.977, p < 0.001) and learning about disaster preparedness (OR = 2.421, 95% CI = 1.542-3.802, p < 0.001) were associated with high preparedness. Compared to patients with a university degree or higher, patients with a junior high school education or lower (OR = 3.491, 95% CI = 1.760-6.925, p < 0.001) and senior high school degree (OR = 2.052, 95% CI = 1.038-4.057, p = 0.039) were associated with high preparedness. Patients who felt very confident and could deal with all their needs (OR = 3.878, 95% CI = 2.904-7.181, p < 0.001) or patients who felt confident and could meet some of their needs (OR = 1.949, 95% CI = 1.124-3.379, p = 0.017) had higher preparedness than those who felt less confident and were not well prepared to take care of their needs. PATIENT OR PUBLIC CONTRIBUTION: After obtaining each participant's consent, they filled out the online questionnaire using their own or a relative's cell phone while undergoing HD. IMPLICATION FOR PRACTICE: It is essential that patients should be educated not only on medical specialty topics, but also on general disaster preparedness. Medical institutions should improve and reinforce preparation training among targeted populations. The low level of preparedness is partly due to the lack of participation of patients in disaster preparedness programs. Dialysis center managers should be urged to implement such programs at their centers.

Knowledge, attitude, and practice toward nutrition support and management among hemodialysis patients.

Nutrition support is an important care component for patients on hemodialysis. Also, patient self-management is important to maintaining proper nutritional intake during hemodialysis. This cross-sectional study investigated the knowledge, attitude, and practice (KAP) towards nutrition support and management among hemodialysis patients treated at the West China Hospital of Sichuan University between January and March 2023. Among 445 (95.91%) valid questionnaires, 58.43% were filled out by male patients. The knowledge, attitude, and practice scores were 11.44 ± 1.80 (possible range: 0-13), 30.29 ± 3.22 (possible range: 8-40), and 31.27 ± 5.67 (possible range: 8-40), respectively. Age > 60 years (OR = 0.487, 95%CI: 0.260-0.913, P = 0.025) and junior college or undergraduate or above (OR = 2.606, 95%CI: 1.621-4.189, P < 0.001) were independently associated with adequate knowledge. The knowledge (OR = 1.151, 95%CI: 1.024-1.294, P = 0.018) and female gender (OR = 0.632, 95%CI: 0.419-0.953, P = 0.029) were independently associated with positive attitude. The knowledge (OR = 1.404, 95%CI: 1.221-1.614, P < 0.001), attitude (OR = 1.146, 95%CI: 1.069-1.227, P < 0.001), age 51-60 years (OR = 1.879, 95%CI: 1.093-3.229, P = 0.022), and BMI of 24.0-27.9 kg/m2 (OR = 0.434, 95%CI: 0.269-0.700, P = 0.001) were independently associated with proactive practice. Hemodialysis patients showed adequate knowledge, positive attitudes, and proactive practice; however, there were also several gaps in knowledge and misconceptions regarding proper nutritional self-management. Accordingly, addressing these gaps and misconceptions through carefully designed and effectively implemented education is crucial for providing comprehensive guidance on optimal nutrition and self-management strategies.

Investigating the complex relationship and influencing factors of frailty on nutritional status in maintenance hemodialysis patients.

INTRODUCTION: Given the high prevalence and significant challenges of frailty, a state of increased vulnerability to adverse health outcomes, among maintenance hemodialysis (MHD) patients, this cross-sectional study aimed to investigate its prevalence and explore its association with nutritional status and other relevant factors. METHODS: The study involved 290 MHD patients with an average age of 52.98 ± 13.65 years. Frailty assessments, nutritional evaluations, and medical status measurements were performed. Data analysis involved descriptive statistics, correlation analyses, and multivariate logistic regression. RESULTS: Among the patients, 70.3% were identified with frailty (16.9% frail, 53.4% pre-frail). Frailty was more prevalent in female patients compared to males and correlated positively with age, marital status, caregiving needs, comorbidities, dialysis duration, and higher nutritional risk scores. Negative correlations were observed with serum albumin, hemoglobin, body weight, and height. CONCLUSION: A significant prevalence of frailty was found in MHD patients, with notable associations to various demographic, clinical, and nutritional factors.

Determining soil conservation strategies: Ecological risk thresholds of arsenic and the influence of soil properties.

The establishment of ecological risk thresholds for arsenic (As) plays a pivotal role in developing soil conservation strategies. However, despite many studies regarding the toxicological profile of As, such thresholds varying by diverse soil properties have rarely been established. This study aims to address this gap by compiling and critically examining an extensive dataset of As toxicity data sourced from existing literature. Furthermore, to augment the existing information, experimental studies on As toxicity focusing on barley-root elongation were carried out across various soil types. The As concentrations varied from 12.01 to 437.25 mg/kg for the effective concentrations that inhibited 10% of barley-root growth (EC10). The present study applied a machine-learning approach to investigate the complex associations between the toxicity thresholds of As and diverse soil properties. The results revealed that Mn-/Fe-ox and clay content emerged as the most influential factors in predicting the EC10 contribution. Additionally, by using a species sensitivity distribution model and toxicity data from 21 different species, the hazardous concentration for x% of species (HCx) was calculated for four representative soil scenarios. The HC5 values for acidic, neutral, alkaline, and alkaline calcareous soils were 80, 47, 40, and 28 mg/kg, respectively. This study establishes an evidence-based methodology for deriving soil-specific guidance concerning As toxicity thresholds.

Hydroxypropyl methyl cellulose reinforced conducting polymer hydrogels with ultra-stretchability and low hysteresis as highly sensitive strain sensors for wearable health monitoring.

Conducting polymer hydrogels have emerged as promising materials to fabricate highly sensitive strain sensors. However, due to weak bindings between conducting polymer and gel network, they usually suffer from limited stretchability and large hysteresis, failing to achieve wide-range strain sensing. Herein, we combine hydroxypropyl methyl cellulose (HPMC), poly (3,4-ethylenedioxythiophene):poly (styrene sulfonic acid) (PEDOT: PSS) with chemically cross-linked polyacrylamide (PAM) to prepare a conducting polymer hydrogel for strain sensors. Owing to abundant hydrogen bonds between HPMC, PEDOT:PSS and PAM chains, this conducting polymer hydrogel exhibits high tensile strength (166 kPa), ultra-stretchability (>1600 %) and low hysteresis (<10 % at 1000 % cyclic tensile strain). The resultant hydrogel strain sensor shows ultra-high sensitivity, wide strain sensing ranges of 2-1600 %, and excellent durability and reproducibility. Finally, this strain sensor can be used as wearable sensor to monitor vigorous human movement and fine physiological activity, and services as bioelectrodes for electrocardiograph and electromyography monitoring. This work provides new horizons to design conducting polymer hydrogels for advanced sensing devices.

Preparation and performance of chlorfenapyr microcapsules with a degradable polylactide-based polyurethane wall material.

To improve the utilization rate of chlorfenapyr and make the wall material of chlorfenapyr microcapsules easily degradable, polylactide diol, toluene diisocyanate and 1,4-butanediol were used to prepare a chlorfenapyr microcapsule suspension by interfacial polymerization. The product was characterized by the methods of optical microscopy, scanning electron microscopy and Fourier-transform infrared spectroscopy. The results indicated that the microcapsule particles were spherical, with an encapsulation efficiency of 84.20%. The diluted product had good wetting and spreading abilities on cabbage leaves. Compared with other commercial formulations, the slow-release effect of the microcapsule suspension was more obvious and the release mechanisms conform to Fickian diffusion, with the release rate controllable by adjusting the external pH conditions. Furthermore, the wall material of the microcapsules showed good degradation performance in a phosphate-buffered solution. Microencapsulation by this method significantly increased the validity period of chlorfenapyr and the wall material was also degraded easily.