Crop yields fail to rise in smallholder farming systems in sub-Saharan Africa.

Drawing on a harmonized longitudinal dataset covering more than 55,000 smallholder farms in six African countries, we analyze changes in crop productivity from 2008 to 2019. Because smallholder farmers represent a significant fraction of the world's poorest people, agricultural productivity in this context matters for poverty reduction and for the broader achievement of the UN Sustainable Development Goals. Our analysis measures productivity trends for nationally representative samples of smallholder crop farmers, using detailed data on agricultural inputs and outputs which we integrate with detailed data on local weather and environmental conditions. In spite of government commitments and international efforts to strengthen African agriculture, we find no evidence that smallholder crop productivity improved over this 12-y period. Our preferred statistical specification of total factor productivity (TFP) suggests an overall decline in productivity of -3.5% per year. Various other models we test also find declining productivity in the overall sample, and none of them finds productivity growth. However, the different countries in our sample experienced varying trends, with some instances of growth in some regions. The results suggest that major challenges remain for agricultural development in sub-Saharan Africa. They complement previous analyses that relied primarily on aggregate national statistics to measure agricultural productivity, rather than detailed microdata.

Image Domain Multi-Material Decomposition Noise Suppression Through Basis Transformation and Selective Filtering.

Spectral CT can provide material characterization ability to offer more precise material information for diagnosis purposes. However, the material decomposition process generally leads to amplification of noise which significantly limits the utility of the material basis images. To mitigate such problem, an image domain noise suppression method was proposed in this work. The method performs basis transformation of the material basis images based on a singular value decomposition. The noise variances of the original spectral CT images were incorporated in the matrix to be decomposed to ensure that the transformed basis images are statistically uncorrelated. Due to the difference in noise amplitudes in the transformed basis images, a selective filtering method was proposed with the low-noise transformed basis image as guidance. The method was evaluated using both numerical simulation and real clinical dual-energy CT data. Results demonstrated that compared with existing methods, the proposed method performs better in preserving the spatial resolution and the soft tissue contrast while suppressing the image noise. The proposed method is also computationally efficient and can realize real-time noise suppression for clinical spectral CT images.

Transpupillary-Guided Trans-Scleral Transplantation of Subretinal Grafts in a Retinal Degeneration Mouse Model.

Transplantation of photoreceptor cells and retinal pigment epithelial (RPE) cells provide a potential therapy for retinal degeneration diseases. Subretinal transplantation of therapeutic donor cells into mouse recipients is challenging due to the limited surgical space allowed by the small volume of the mouse eye. We developed a trans-scleral surgical transplantation platform with direct transpupillary vision guidance to facilitate the subretinal delivery of exogenous cells in mouse recipients. The platform was tested using retinal cell suspensions and three-dimensional retinal sheets collected from rod-rich Rho::EGFP mice and cone-rich OPN1LW-EGFP;NRL-/- mice, respectively. Live/dead assay showed low cell mortality for both forms of donor cells. Retinal grafts were successfully delivered into the subretinal space of a mouse model of retinal degeneration, Rd1/NS, with minimum surgical complications as detected by multimodal confocal scanning laser ophthalmoscope (cSLO) imaging. Two months post-transplantation, histological staining demonstrated evidence of advanced maturation of the retinal grafts into 'adult' rods and cones (by robust Rho::EGFP, S-opsin, and OPN1LW:EGFP expression, respectively) in the subretinal space. Here, we provide a surgical platform that can enable highly accurate subretinal delivery with a low rate of complications in mouse recipients. This technique offers precision and relative ease of skill acquisition. Furthermore, the technique could be used not only for studies of subretinal cell transplantation but also for other intraocular therapeutic studies including gene therapies.

Balancing low-carbon and eco-friendly development: coordinated development strategy for land use carbon emission efficiency and land ecological security.

Correctly identifying and handling the relationship between land use carbon emission efficiency (LUCEE) and land ecological security (LES) are important to promote carbon neutrality in the overall layout of ecological civilization construction. This study takes 30 provinces in China as the research unit and measures the level of LUCEE and LES in each province in the period from 2011 to 2020 via a super-efficient slack-based measure model considering undesirable output. The coupling coordination degree (CCD) of LUCEE and LES is calculated, and its spatiotemporal evolution pattern is explored by kernel density estimation and standard deviational ellipse (SDE). The Dagum Gini coefficient is used to study spatial regional differences and the sources of differences. Results show that (1) China's LUCEE exhibited a downward and then an upward trend, as well as a spatial pattern of "high in the west and low in the east" with obvious regional differences. The LES experienced a positive transformation of "less secure → basically secure → more secure" nationwide, with no apparent regional differences. (2) The kernel density curves showed a continuous increase in CCD in general, while interprovincial differences increased, then decreased, and shifted from multipolar to bipolar differentiation. (3) The migration of SDE centers in CCD demonstrated a path of "southeast → southwest → northeast," and the ellipticity increased from 0.167 to 0.173, showing a trend of concentrated distribution. (4) The overall Gini coefficient of the national CCD indicated a decreasing trend, but imbalances remained, with the largest annual average value in the western region (0.120) and the smallest in the northeast (0.044). The main source of regional disparity was the intensity of transvariation. Accordingly, this study proposes targeted regional development strategies to promote low-carbon sustainable land use and improve the ability of land ecosystems to prevent security risks.

Transition to Chronic Fibrosis in an Animal Model of Retinal Detachment With Features of Proliferative Vitreoretinopathy.

Purpose: Proliferative vitreoretinopathy (PVR) is the most common cause of failure of surgically repaired rhegmatogenous retinal detachment (RRD). Chemically induced and cell injection PVR models do not fully simulate the clinical characteristics of PVR in the post-RRD context. There is an unmet need for translational models in which to study mechanisms and treatments specific to RRD-PVR. Methods: RRD was induced in adult Dutch Belted rabbits. Posterior segments were fixed or processed for RNA sequencing at 6 hours and 2, 7, 14, and 35 days after induction. Histochemical staining and immunolabeling for glial fibrillary acidic protein, alpha smooth muscle actin, vascular endothelial growth factor receptor 2, CD68, and RPE 65 kDa protein were performed, and labeling intensity was scored. Single cell RNA sequencing was performed. Results: Acute histopathological changes included intravitreal and intraretinal hemorrhage, leukocytic vitritis, chorioretinitis, and retinal rarefaction. Chronic lesions showed retinal atrophy, gliosis, fibrotic subretinal membranes, and epiretinal fibrovascular proliferation. Fibrillar collagen was present in the fibrocellular and fibrovascular membranes in chronic lesions. Moderate to strong labeling of glia and vasculature was detected in chronic lesions. At day 14, most cells profiled by single cell sequencing were identified as Mϋller glia and microglia, consistent with immunolabeling. Expression of several fibrillar collagen genes was upregulated in chronic lesions. Conclusions: Histological and transcriptional features of this rabbit model simulate important features of human RRD-PVR, including the transition to chronic intraretinal and periretinal fibrosis. This animal model of RRD with features of PVR will enable further research on targeted treatment interventions.

Fluoxetine partially alleviates inflammation in the kidney of socially stressed male C57 BL/6 mice.

Stress-related illnesses are linked to the onset and progression of renal diseases and depressive disorders. To investigate stress-induced changes in the renal transcriptome associated with the development of depressive behaviors, we generated here a chronic social defeat stress (CSDS) model of C57 BL/6 male mice and then performed RNA sequencing of the kidneys to obtain an inflammation-related transcriptome. Administration of the antidepressant drug fluoxetine (10 mg·kg-1 ·day-1 ) during CSDS induction could partially alleviate renal inflammation and reverse CSDS-induced depression-like behaviors. Moreover, fluoxetine also modulated gene expression of stress-related hormone receptors, including prolactin and melanin-concentrating hormone. These results suggest that CSDS can induce gene expression changes associated with inflammation in the kidney of C57 BL/6 male mice, and this inflammation can be treated effectively by fluoxetine.

Comparative Analysis of Single-cell and Single-nucleus RNA-sequencing in a Rabbit Model of Retinal Detachment-related Proliferative Vitreoretinopathy.

Purpose: Proliferative vitreoretinopathy (PVR) is the most common cause of failure of retinal reattachment surgery, and the molecular changes leading to this aberrant wound healing process are currently unknown. Our ultimate goal is to study PVR pathogenesis by employing single-cell transcriptomics to dissect cellular heterogeneity. Design: Here we aimed to compare single-cell RNA sequencing (scRNA-seq)  and single-nucleus RNA-sequencing (snRNA-seq) of retinal PVR samples in the rabbit model. Participants: Unilateral induction of PVR lesions in rabbit eyes with contralateral eyes serving as controls. Methods: Proliferative vitreoretinopathy was induced unilaterally in Dutch Belted rabbits. At different timepoints after PVR induction, retinas were dissociated into either cells or nuclei suspension and processed for scRNA-seq or snRNA-seq. Main Outcome Measures: Single cell and nuclei transcriptomic profiles of retinas after PVR induction. Results: Single-cell RNA sequencing and snRNA-seq were conducted on retinas at 4 hours and 14 days after disease induction. Although the capture rate of unique molecular identifiers and genes were greater in scRNA-seq samples, overall gene expression profiles of individual cell types were highly correlated between scRNA-seq and snRNA-seq. A major disparity between the 2 sequencing modalities was the cell type capture rate, however, with glial cell types overrepresented in scRNA-seq, and inner retinal neurons were enriched by snRNA-seq. Furthermore, fibrotic Müller glia were overrepresented in snRNA-seq samples, whereas reactive Müller glia were overrepresented in scRNA-seq samples. Trajectory analyses were similar between the 2 methods, allowing for the combined analysis of the scRNA-seq and snRNA-seq data sets. Conclusions: These findings highlight limitations of both scRNA-seq and snRNA-seq analysis and imply that use of both techniques together can more accurately identify transcriptional networks critical for aberrant fibrogenesis in PVR than using either in isolation. Financial Disclosures: Proprietary or commercial disclosure may be found after the references.

Investigation of excipients impact on polysorbate 80 degradation in biopharmaceutical formulation buffers.

A study on the polysorbate 80 stability in various formulation buffers commonly used in biopharmaceuticals was performed, to investigate the excipients influence on polysorbate 80 degradation. Polysorbate 80 is a common excipient in biopharmaceutical products. However, its degradation will potentially impact the drug product quality, and may trigger protein aggregation and particles formation. Due to the heterogeneity of the polysorbates and the mutual effects with other formulation compositions, the study of polysorbate degradation is challenging. Herein, a real-time stability study was designed and performed. The polysorbate 80 degradation trend was monitored by fluorescence micelle-based assay (FMA), reversed-phase-ultra-performance liquid chromatography-evaporative light scattering detector (RP-UPLC-ELSD) assay, and LC-MS assay. These assays provide orthogonal results to reveal both the micelle-forming capability and the compositional changes of polysorbate 80 in different buffer systems. The degradation occurred after a period of storage under 25 °C in different trend, which indicates the excipients could impact the degradation kinetics. Upon comparison, the degradation is prone to happen in histidine buffer than in acetate, phosphate or citrate buffers. LC-MS confirms oxidation as an independent degradation pathway with detection of the oxidative aldehyde. Thus, it is necessary to pay more attention to the excipients selection and their potential impact on polysorbate 80 stability to achieve longer shelf life for the biopharmaceuticals. Besides, the protective roles of several additives were figured out, which could be applied as potential industrial solutions to the polysorbate 80 degradation issues.

Additive manufacturing of vascular stents.

With the advancement of additive manufacturing (AM), customized vascular stents can now be fabricated to fit the curvatures and sizes of a narrowed or blocked blood vessel, thereby reducing the possibility of thrombosis and restenosis. More importantly, AM enables the design and fabrication of complex and functional stent unit cells that would otherwise be impossible to realize with conventional manufacturing techniques. Additionally, AM makes fast design iterations possible while also shortening the development time of vascular stents. This has led to the emergence of a new treatment paradigm in which custom and on-demand-fabricated stents will be used for just-in-time treatments. This review is focused on the recent advances in AM vascular stents aimed at meeting the mechanical and biological requirements. First, the biomaterials suitable for AM vascular stents are listed and briefly described. Second, we review the AM technologies that have been so far used to fabricate vascular stents as well as the performances they have achieved. Subsequently, the design criteria for the clinical application of AM vascular stents are discussed considering the currently encountered limitations in materials and AM techniques. Finally, the remaining challenges are highlighted and some future research directions are proposed to realize clinically-viable AM vascular stents. STATEMENT OF SIGNIFICANCE: Vascular stents have been widely used for the treatment of vascular disease. The recent progress in additive manufacturing (AM) has provided unprecedented opportunities for revolutionizing traditional vascular stents. In this manuscript, we review the applications of AM to the design and fabrication of vascular stents. This is an interdisciplinary subject area that has not been previously covered in the published review articles. Our objective is to not only present the state-of-the-art of AM biomaterials and technologies but to also critically assess the limitations and challenges that need to be overcome to speed up the clinical adoption of AM vascular stents with both anatomical superiority and mechanical and biological functionalities that exceed those of the currently available mass-produced devices.

Single-cell transcriptome analysis of xenotransplanted human retinal organoids defines two migratory cell populations of nonretinal origin.

Human retinal organoid transplantation could potentially be a treatment for degenerative retinal diseases. How the recipient retina regulates the survival, maturation, and proliferation of transplanted organoid cells is unknown. We transplanted human retinal organoid-derived cells into photoreceptor-deficient mice and conducted histology and single-cell RNA sequencing alongside time-matched cultured retinal organoids. Unexpectedly, we observed human cells that migrated into all recipient retinal layers and traveled long distances. Using an unbiased approach, we identified these cells as astrocytes and brain/spinal cord-like neural precursors that were absent or rare in stage-matched cultured organoids. In contrast, retinal progenitor-derived rods and cones remained in the subretinal space, maturing more rapidly than those in the cultured controls. These data suggest that recipient microenvironment promotes the maturation of transplanted photoreceptors while inducing or facilitating the survival of migratory cell populations that are not normally derived from retinal progenitors. These findings have important implications for potential cell-based treatments of retinal diseases.

Mechanical isolation of neonatal and adult mouse dura leukocytes for flow cytometry analysis.

The meninges, consisting of the pia, arachnoid, and dura layers, provide immunosurveillance of the central nervous system with both innate and adaptive immune cells. Here we present an optimized protocol for isolating dura leukocytes from neonatal and adult mice. We describe steps for harvesting the skull cap, extracting the dura mater, mechanical isolation of dura leukocytes, and flow cytometry analysis. Unlike the time-consuming enzymatic digestion isolation which makes dura hematopoietic stem cells (HSCs) undetectable, this rapid and simplified technique permits dura HSC identification. For complete details on the use and execution of this protocol, please refer to Niu et al. (2022).1.

Development of a flexible film made of polyvinyl alcohol with chitosan based thermosensitive hydrogel.

Background/purpose: A challenge that arises with periodontal regeneration surgery has been associated with the future development of periodontal regeneration membrane to prevent gingiva and fibroblasts invade the wound and allow alveolar bone successfully regenerated. Materials and methods: Chitosan (CS) has the advantages of non-toxicity, biodegradation, biocompatibility, and has been widely used in wound dressings. A flexible film was made using polyvinyl alcohol (PVA) blending CS based thermosensitive hydrogel. Results: The proposed 2% PVA/CS hydrogel has the highest swelling ratio about 720% after 60 min incubation and keeps its area after 10 min incubation for surgery suture. The elastic modulus of 0%, 1%, 2%, and 4% PVA/CS hydrogel were 7.75 ± 1.96, 0.91 ± 0.16, 0.75 ± 0.21, and 0.37 ± 0.06 MPa, respectively. The maximum strain of 2% PVA/CS hydrogel was 101.00 ± 28.03 (%). After 8 weeks biodegradation, the remain weight of 2% PVA/CS hydrogel was 71.36 ± 0.79 (%). Conclusion: In vitro cytotoxicity tests were performed and demonstrated PVA/CS hydrogel significantly improving cell proliferation. This study realized a promising flexible film for periodontal regeneration membrane that can prevent the rapid growth of fibroblasts to invade the wound and be used for periodontal regeneration surgery.

Scatter correction for cone-beam CT via scatter kernel superposition-inspired convolutional neural network.

Objective.X-ray scatter leads to signal bias and degrades the image quality in Computed Tomography imaging. Conventional real-time scatter estimation and correction methods include the scatter kernel superposition (SKS) methods, which approximate x-ray scatter field as a convolution of the scatter sources and scatter propagation kernels to reflect the spatial spreading of scatter x-ray photons. SKS methods are fast to implement but generally suffer from low accuracy due to the difficulties in determining the scatter kernels.Approach.To address such a problem, this work describes a new scatter estimation and correction method by combining the concept of SKS methods and convolutional neural network. Unlike conventional SKS methods which estimate the scatter amplitude and the scatter kernel based on the value of an individual pixel, the proposed method generates the scatter amplitude maps and the scatter width maps from projection images through a neural network, from which the final estimated scatter field is calculated based on a convolution process.Main Results.By incorporating physics in the network design, the proposed method requires fewer trainable parameters compared with another deep learning-based method (Deep Scatter Estimation). Both numerical simulations and physical experiments demonstrate that the proposed SKS-inspired convolutional neural network outperforms the conventional SKS method and other deep learning-based methods in both qualitative and quantitative aspects.Significance.The proposed method can effectively correct the scatter-related artifacts with a SKS-inspired convolutional neural network design.

Does China's low-carbon action reduce pollution emissions? A quasi-natural experiment based on the low-carbon city construction.

To achieve the goal of "carbon peak and carbon neutrality", it is crucial for China to effectively control environmental pollution in low-carbon action (LCA). Based on the evidence from 283 cities in China from 2007 to 2019, the difference-in-differences (DID) method is applied to explore the impact of LCA on pollutant emissions represented by the pilot of low-carbon city construction (LCCC) in China. The main findings are as follows. First of all, the LCCC suppresses pollution emissions, and the basic conclusions are still stable after endogenous treatment and robustness testing. Secondly, the mechanism analysis reveals that the main path of LCCC affecting pollution reduction comes from the progress of green technology and the upgrading of industrial structure. Finally, the heterogeneity analysis shows that the pollution reduction effect of the LCCC is better in the eastern region and cities with higher level of green economy development. Based on the policy standpoint of environmental protection, the LCCC has opened up a reasonable exploration path for China and other countries in the world to carry out effective pollution reduction.

Cytotoxicity of nitrogenous disinfection byproducts: A combined experimental and computational study.

Nitrogenous disinfection byproducts (N-DBPs), such as halocetamides (HAcAms), haloacetonitriles (HANs) and halonitromethanes (HNMs), are emerging DBPs in drinking water. They are more toxic than currently regulated DBPs, attracting more attention to their toxic effects and mechanism. In this study, human embryonic kidney (HEK) 293T cells were employed to explore the cytotoxicity of 29 N-DBPs. The influence of molecular structures and different halogenations on cytotoxicity has been comparatively analyzed. As toxicity is the downstream of chemico-biological interactions, the thiol reactivity of 29 N-DBPs has thus been evaluated by using glutathione (GSH) as a model nucleophile, which is the most prevalent cellular thiol and acts as an antioxidant to protect cells by detoxifying electrophilic compounds. Results show that the cytotoxicity of N-DBPs follows by the order of HAcAms > HANs > HNMs, which is different from their reactivity with GSH (the median of kGSH ranks as HNMs > HAcAms > HANs). However, a significant correlation (p < 0.001) between log kGSH and log IC50 (concentration causing 50% inhibition) has been respectively observed for HAcAms and HANs subset and HNMs subset, indicating such chemical reaction is a probable trigger for these DBPs to result in cytotoxicity. Finally, two separate quantitative structure - activity relationship (QSAR) models based on HANs & HAcAms subset and HNMs subset have been developed for estimating IC50 values. The good statistical performance makes the models possible to quickly and accurately predict IC50 values of other N-DBPs, providing basic data for their health risk assessment and greatly reducing in vivo and in vitro experiments.

Identification of hematopoietic stem cells residing in the meninges of adult mice at steady state.

Steady-state extramedullary hematopoiesis during adulthood is an emerging field of great interest. The meninges contain both innate and adaptive immune cells, which provide immunosurveillance of the central nervous system (CNS). Hematopoietic progenitors that give rise to meningeal immune cells remain elusive. Here, we report that steady-state meninges of adult mice host hematopoietic stem cells (HSCs), as defined by long-term, efficient, multi-lineage reconstitution and self-renewal capacity in the meninges, blood, spleen, and bone marrow of sublethally irradiated adult recipients. HSCs lodge in the meninges after birth with local expression of pro-hematopoietic niche factors. Meningeal HSCs are locally maintained in homeostasis and get replenished from the blood only when the resident pool is reduced. With a tissue-specific expression profile, meningeal HSCs can provide the CNS with a constant supply of leukocytes more adapted to local microenvironment.

Co-doped amorphous NiMoS4 modified with rGO for high-rate performance and long-cycling stability of hybrid supercapacitors.

The electrochemical performance of hybrid capacitors is seriously affected by the slow charging and discharging of the bulk phase. Here, Co-doped amorphous NiMoS4 modified with reduced graphene oxide (rGO) was prepared by a simple one-step hydrothermal method, and the obtained Co-doped NiMoS4/rGO nanocomposite (Ni1-xCoxMoS4/rGO) exhibits a high specific surface area, realizing the redox reaction from the bulk to the surface. Owing to the doping of Co with abundant redox active sites and the support of rGO sheets with high conductivity and a stable structure, the Ni1-xCoxMoS4/rGO anode assembled with an oxidized needle coke (NCO) cathode shows an excellent energy density of 28.9 W h kg-1 at a power density of 968.3 W kg-1. In addition, the hybrid supercapacitor displays a superior cycling performance with a capacity retention of 92.4% after 10 000 cycles. The construction of the Co-doped NiMoS4/rGO nanocomposite provides an effective strategy to boost the activity and stability of amorphous NiMoS4 for high-performance hybrid supercapacitors.

Mice lacking 1,4,5-triphosphate inositol type III receptor demonstrate inhibition of hypoxic pulmonary hypertension.

Hypoxic pulmonary hypertension (HPH) is a respiratory disease characterized by increased pulmonary vascular resistance and pulmonary arterial pressure. Persistent hypoxia alters the metabolic and transport functions of endothelial cells and promotes thrombosis and inflammation. Type 3 inositol-1,4,5-trisphosphate receptor (IP3R3) controls the release of calcium ions from the endoplasmic reticulum to the cytoplasm and mitochondria and is involved in cell proliferation, migration, and protein synthesis. In this study, we investigated the role and function of IP3R3 in HPH. The results showed that the expression level of IP3R3 was increased in pulmonary artery endothelial cells (PAECs) in a rat HPH model. The pulmonary artery pressure indices of IP3R3(-/-) mice with persistent hypoxia were significantly lower than those of HPH mice. The expression level of IP3R3 was significantly increased in hypoxia-treated PAECs. Knockdown of IP3R3 significantly inhibited the proliferation, migration and mesenchymal transition of PAECs induced by hypoxia. In conclusion, knockdown of IP3R3 can inhibit hypoxia-induced dysfunctions in PAECs, thus enabling IP3R3(-/-) mice to avoid HPH development. IP3R3 plays a key role in HPH and can be used as a potential target for the prevention and treatment of HPH.

Effectiveness of a nurse-led coaching of self-care agency intervention for elderly patients with total laryngectomy: study protocol for a randomised controlled trial.

INTRODUCTION: Due to functional defects and structural destruction after total laryngectomy, patients experienced the poor quality of life, especially for elderly. The barriers to accessing self-care in elderly patients were considered to result from complex and multifaceted interactions of biologic and social factors. Therefore, specific efforts to improve elderly patients' quality of life are needed. The purpose of our study is to verify nurse-led coaching of elderly patient self-care approaches, which can reduce logistic burden of patients and obtain the successful functional rehabilitation ultimately. METHODS AND ANALYSIS: Elderly patients (n=60) scheduled for total laryngectomy will be randomly divided into the intervention group and the control group. Patients in the control group received routinely nursing during hospitalisation and thereby at home after discharge received conventional family care without regular supervision of nurses. Patients in the intervention group will receive a series of self-care intervention based on the transtheoretical model during hospitalisation. During home after discharge, nurses will additionally evaluate and supervise the self-care effect of patients. The two groups of patients' self-care agency, self-efficacy, quality of life and nutritional status will be recorded separately at different time points. Primary outcome is the improvement of patients' self-care agency, and secondary outcome is the improvements of patients' self-efficacy, quality of life, nutritional states and 3-month unplanned readmission rate. ETHICS AND DISSEMINATION: The Ethics Committee of Hubei Cancer Hospital has approved this protocol (KYLLBA2020006). The findings of the trial will be disseminated through peer-reviewed journals, national or international conferences. TRIAL REGISTRATION NUMBER: ChiCTR2100043731.

Application of Nursing Intervention Based on Intelligent Grip Strength System in Patients with Tumor PICC: A Case-Control Study on Promoting Functional Exercise and Quality of Life.

Objective: A case-control study was conducted to elucidate the impact of application of nursing intervention based on intelligent grip strength system in patients with tumor peripherally inserted central catheter (PICC) on promoting functional exercise and life quality. Methods: A total of 100 patients with tumor PICC treated in our hospital from April 2019 to April 2021 were enrolled. The patients were randomly assigned into control group and study group. The control group received routine nursing, and the study group received nursing intervention based on intelligent grip strength system. Results: First of all, we compared the nursing satisfaction between the two groups: the study group was very satisfied in 43 cases, satisfactory in 6 cases, and general in 1 case, and the satisfaction rate was 100.00%, while in the control group, 29 cases were very satisfied, 10 cases were satisfied, 6 cases were general, and 5 cases were dissatisfied. The satisfaction rate was 90.00%. As such, the nursing satisfaction of the study group was higher compared to the control (P < 0.05). Secondly, we compared the average blood flow velocity per unit time of axillary vein at different moments. Before catheterization, there exited no significant difference (P > 0.05). The average blood flow velocity per unit time of axillary vein in the study group was faster compared to the control at different time points (P < 0.05). In terms of the average blood flow velocity per unit time of axillary vein at different time points between the two groups, there exited no significant difference before catheterization (P > 0.05). But 14 and 28 days after catheterization, the average blood flow velocity per unit time of axillary vein in the study group was better when compared to the control (P < 0.05). Comparing the incidence of catheter-related complications, the incidence of catheter-related complications such as redness and swelling, phlebitis, catheter occlusion, and catheter slip in the study group (12.00%) was lower compared to the control (60.00%) (P < 0.05). There was no significant difference in vascular diameter, peak blood flow velocity, and vascular pressure between the two groups before nursing (P > 0.05), but after nursing, the vascular diameter and peak blood flow velocity group were higher, and the vascular pressure was lower in the study (P < 0.05). Comparing the scores of functional exercise compliance, the scores of grip exercise compliance, exercise monitoring compliance, active help seeking compliance, exercise attention compliance, and the total score of compliance in the study group were higher compared to the control (P < 0.05). Finally, we compared the scores of life quality. Before nursing, there exhibited no significant difference between the two groups (P > 0.05). The scores of physiological function, psychological function, social function, and health self-cognition in the study group were lower when compared to control (P < 0.05). Conclusion: The utilization of intelligent grip strength system can improve the functional exercise compliance of PICC patients, effectively facilitate the venous blood circulation of upper limbs, and strengthen the life quality, as well as reduce the incidence of catheter-related thrombosis. However, more multicenter, large sample, randomized controlled studies should be carried out to explore the impact of intelligent grip strength system on the long-term effect of functional exercise in patients with PICC.