Professional attractiveness among long-term care workers in nursing homes in China: a cross-sectional study.

BACKGROUND: The population aging trend and the shortage of elderly care workers require the long-term care profession to become more attractive. However, the professional attractiveness among long-term care workers has yet to be extensively studied. This study aims to identify the factors that influence the attractiveness of the long-term care profession for nursing home (NH) care workers.. METHODS: A cross-sectional study was conducted in more than 50 NHs. Perception of professional attractiveness among long-term care workers and potential associated factors were measured using the Attractive Work Questionnaire (AWQ) and structural instruments including the Fraboni Scale of Ageism (FSA) and the Maslach Burnout Inventory (MBI). A multiple linear regression method was employed to explore the influence of potential independent variables on professional attractiveness. RESULTS: The overall response rate was 99%. The results showed the score of professional attractiveness (185.37 ± 20.034), as well as the scores of each component (99.26 ± 11.258 for work condition, 30.13 ± 3.583 for work content, and 55.99 ± 7.074 for job satisfaction). Findings of multiple linear regression analysis indicated that age(ß = 0.129, p<.05), years of work(ß = 0.156, p<.05), 12-hour shifts(ß = 0.185, p<.05), and training times per year(ß = 0.148, p<.05) positively associated with long-term care workers perceived professional attractiveness. Whereas only ageism(ß=-0.267, p<.05) significantly and negatively influenced professional attractiveness. CONCLUSIONS: The perceived professional attractiveness of long-term care workers in NHs was acceptable. Age, years of work, shifts, training opportunities, and ageism contributed to the professional attractiveness of nursing home care workers in China. Target intervention measures should be taken to enhance the attractiveness of long-term care careers so as to avoid the shortage of long-term care workers.

Cognitive frailty and its association with disability among Chinese community-dwelling older adults: a cross-sectional study.

BACKGROUND: There are a variety of determinants that are key to functional disability of older adults. However, little is known regarding the relationship between cognitive frailty and disability among older people. The aims of this study were to examine the associations between cognitive frailty and its six components with instrumental activities of daily living (IADL) functioning in community-dwelling older adults. METHODS: A total of 313 community-dwelling older adults (aged ≥ 65 years) were recruited from eight community centers in central China. Cognitive frailty was operationalized using the Mini-Mental State Examination for the evaluation of cognitive status and the Fried criteria for the evaluation of physical frailty. The outcome was functional disability assessed by the IADL scale. The association between cognitive frailty, as well as its components, and IADL limitations was identified by conducting binary logistic regression analysis. RESULTS: The prevalence of cognitive frailty was 8.9% in this study. The results showed that cognitive frailty (OR = 22.86) and frailty without cognitive impairment (OR = 8.15) were associated with IADL limitations. Subdimensions of cognitive frailty, exhaustion, weakness, low physical activity and cognitive impairment components were independently associated with IADL limitations. CONCLUSION: Cognitive frailty was associated with a higher prevalence of disability. Interventions for improving cognitive frailty should be developed to prevent IADL disability among community-dwelling older adults in China.

Single-cell characterization of deformation and dynamics of mesenchymal stem cells in microfluidic systems: A computational study.

Understanding the homing dynamics of individual mesenchymal stem cells (MSCs) in physiologically relevant microenvironments is crucial for improving the efficacy of MSC-based therapies for therapeutic and targeting purposes. This study investigates the passive homing behavior of individual MSCs in micropores that mimic interendothelial clefts through predictive computational simulations informed by previous microfluidic experiments. Initially, we quantified the size-dependent behavior of MSCs in micropores and elucidated the underlying mechanisms. Subsequently, we analyzed the shape deformation and traversal dynamics of each MSC. In addition, we conducted a systematic investigation to understand how the mechanical properties of MSCs impact their traversal process. We considered geometric and mechanical parameters, such as reduced cell volume, cell-to-nucleus diameter ratio, and cytoskeletal prestress states. Furthermore, we quantified the changes in the MSC traversal process and identified the quantitative limits in their response to variations in micropore length. Taken together, the computational results indicate the complex dynamic behavior of individual MSCs in the confined microflow. This finding offers an objective way to evaluate the homing ability of MSCs in an interendothelial-slit-like microenvironment.

Observing Liquid Sloshing Based on a Multi-Degree-of-Freedom Pendulum Model and Free Surface Fluctuation Sensor.

Rollover prevention of partially filled tank trucks is an ongoing challenge in the road transportation industry, with the core challenge being real-time perception and observation of the liquid state inside the tank. In order to realize reliable observation of a sloshing liquid, this article first proposes a sloshing modeling method based on a multi-degree-of-freedom pendulum model and derives the double mass trammel pendulum model (DMTP, 2DOF) accordingly, which accurately reflects the sloshing dynamics under wider operating conditions. Second, a free surface fluctuation sensor is designed based on magnetostriction, capable of measuring the inclination and height of the liquid level inside tanks filled with hazardous chemicals. Finally, the unscented Kalman filter (UKF) is utilized to synthesize the information of the two, establishing a credible real-time observation of the sloshing liquid. Verified using a vehicle-fluid coupled co-simulation, under the condition of a consecutive double lane change, the observation error of the proposed method is only 25.9% of that of the open-loop calculation, providing a secure guarantee for the observation of the state variables of the single pendulum model (SP) used for most kinds of anti-rollover control.

In silico modeling of patient-specific blood rheology in type 2 diabetes mellitus.

Increased blood viscosity in type 2 diabetes mellitus (T2DM) is a risk factor for the development of insulin resistance and diabetes-related vascular complications; however, individuals with T2DM exhibit heterogeneous hemorheological properties, including cell deformation and aggregation. Using a multiscale red blood cell (RBC) model with key parameters derived from patient-specific data, we present a computational study of the rheological properties of blood from individual patients with T2DM. Specifically, one key model parameter, which determines the shear stiffness of the RBC membrane (µ) is informed by the high-shear-rate blood viscosity of patients with T2DM. At the same time, the other, which contributes to the strength of the RBC aggregation interaction (D0), is derived from the low-shear-rate blood viscosity of patients with T2DM. The T2DM RBC suspensions are simulated at different shear rates, and the predicted blood viscosity is compared with clinical laboratory-measured data. The results show that the blood viscosity obtained from clinical laboratories and computational simulations are in agreement at both low and high shear rates. These quantitative simulation results demonstrate that the patient-specific model has truly learned the rheological behavior of T2DM blood by unifying the mechanical and aggregation factors of the RBCs, which provides an effective way to extract quantitative predictions of the rheological properties of the blood of individual patients with T2DM.

Probing the Interaction Between Supercarrier RBC Membrane and Nanoparticles for Optimal Drug Delivery.

Red blood cell (RBC) membrane-hitchhiking nanoparticles (NPs) have been an increasingly popular supercarrier for targeted drug delivery. However, the kinetic details of the shear-induced NP detachment process from RBC in blood flow remain unclear. Here, we perform detailed computational simulations of the traversal dynamics of an RBC-NP composite supercarrier with tunable properties. We show that the detachment of NPs from RBC occurs in a shear-dependent manner which is consistent with previous experiment results. We quantify the NP detachment rate in the microcapillary flow, and our simulation results suggest that there may be an optimal adhesion strength span of 25-40 µJ/m2 for rigid spherical NPs to improve the supercarrier performance and targeting efficiency. In addition, we find that the stiffness and the shape of NPs alter the detachment efficiency by changing the RBC-NP contact areas. Together, these findings provide unique insights into the shear-dependent NP release from the RBC surface, facilitating the clinical utility of RBC-NP composite supercarriers in targeted and localized drug delivery with high precision and efficiency.

Quantifying Shear-induced Margination and Adhesion of Platelets in Microvascular Blood Flow.

Platelet margination and adhesion are two critical and closely related steps in thrombus formation. Using dissipative particle dynamics (DPD) method that seamlessly models blood cells, blood plasma, and vessel walls with functionalized surfaces, we quantify the shear-induced margination and adhesion of platelets in microvascular blood flow. The results show that the occurrence of shear-induced RBC-platelet collisions has a remarkable influence on the degree of platelet margination. We characterize the lateral motion of individual platelets by a mean square displacement analysis of platelet trajectories, and find that the wall-induced lift force and the shear-induced displacement in wall-bounded flow cause the variation in near-wall platelet distribution. We then investigate the platelet adhesive dynamics under different flow conditions, by conducting DPD simulations of blood flow in a microtube with fibrinogen-coated wall surfaces. We find that the platelet adhesion is enhanced with the increase of fibrinogen concentration level but decreased with the increase of shear rate. These results are consistent with available experimental results. In addition, we demonstrate that the adherent platelets have a negative impact on the margination dynamics of the circulating platelets, which is mainly due to the climbing effect induced by the adherent ones. Taken together, these findings provide useful insights into the platelet margination and adhesion dynamics, which may facilitate the understanding of the predominant processes governing the initial stage of thrombus formation.

The Relationship between Social Frailty and Depressive Symptoms in the Elderly: A Scoping Review.

BACKGROUND: Various studies have highlighted the correlation between social frailty and depressive symptoms in the elderly. However, evidence of how these two domains influence each other is not clear. The purpose of this scoping review is to summarize the current literature examining social frailty and depressive symptoms. METHOD: We conducted a scoping review allowing for the inclusion of multiple methodologies to examine the extent and range of this research topic. RESULT: The search initially yielded 617 results, 14 of which met the inclusion criteria. Five studies were identified from China, six were identified from Japan, two were identified from Korea, one was identified from Ghana, and one was from Asia. The evidence reviewed indicated that five studies met category 5 criteria, and the others met level 3 criteria. The findings from these studies showed that there is a significant relationship between social frailty and depressive symptoms. CONCLUSION: This scoping review shows that worse social frailty contributes to a significant degree of depression. Further research on screening social frailty and possible interventions in community and medical settings to prevent the elderly from developing depressive symptoms is needed.

The COVID-19 vaccination hesitancy among Chinese individuals with diabetes and the impact on glycemic control of vaccination: a questionnaire study.

OBJECTIVE: The study aimed to investigate the attitudes of people with diabetes mellitus (DM) on COVID-19 vaccination and its influence on the glycemic control. METHODS: Data were collected from a consecutive series of adults (age > 18 years) with type 2 diabetes under regular follow-ups in the Integrated Care Diabetes Outpatient Clinic of Peking University First Hospital from December 1st to December 31st 2021. An online interview questionnaire was conducted, and demographic data including age, sex category, history of drug allergy, history of hypertension, the duration of diabetes, reasons for vaccine hesitancy (VH) and adverse reactions after each injection of vaccines was collected. Glucose levels were collected from medical records. RESULTS: Thirty-nine (22.9%) subjects experienced VH and 131 (77.1%) people living with diabetes received inactivated vaccine against COVID-19. Hesitant individuals had a higher proportion of female gender (vaccinated group vs. VH group, 62/131 vs. 26/39, p = 0.044), higher baseline glycosylated hemoglobin A1c (HbA1c) (vaccinated group vs. VH group, 6.56 ± 0.95% vs. 7.54 ± 2.01%, p < 0.001) and elevated baseline postprandial blood glucose (PBG) (vaccinated group vs. VH group, 8.32 ± 1.97 mmol/L vs. 9.44 ± 2.94 mmol/L, p = 0.015). Subjects of male gender (p = 0.025) and history of hypertension (p = 0.021) were likely to get vaccinated, while higher HbA1c was negatively associated with an elevated propensity to receive anti-COVID-19 vaccine (p = 0.003). Most common reasons for hesitating to receive COVID-19 vaccination were worrying about the possibility of leading to other diseases (30.8%), followed by fearing of glucose variation (17.9%). Systemic adverse reactions were reported in 30.5% individuals after the first injection of inactivated vaccines, and resolved within 3 days in medium. Fasting blood glucose (FBG) decreased significantly after the third injection compared with FBG after the second dose (second vs. third, 6.78 ± 1.24 mmol/L vs. 6.41 ± 1.30 mmol/L, p = 0.027). HbA1c reduced significantly from 6.56% before vaccination to 6.35% after the second injection (p = 0.012). CONCLUSIONS: Our study demonstrated that vaccine hesitancy was lower among male subjects and people with hypertension, while vaccine confidence was reduced in people with poor glycemic control. HbA1c level was lower along with vaccination.

A comparative study of audiology and cone beam computed tomography in TMD patients with otological symptoms through occlusal splint therapy.

INTRODUCTION: To investigate the changes of audiological tests and the cone beam computed tomography (CBCT) measurements of temporomandibular joint (TMJ) and middle-inner ear structure after occlusal splint therapy in temporomandibular disorders (TMD) patients with otological symptoms, and explore the etiological mechanism between TMD and otological symptoms. METHODS: The 25 subjects aged 18 to 40 years who diagnosed with TMD combined the otological symptoms enrolled in the study.They all had received orthodontic treatment in the outpatient clinic of the orthodontic department in Beijing Stomatological Hospital. All the subjects underwent the audiological tests of pure tone audiometry (PTA) and CBCT before and after the occlusal splint therapy. RESULTS: After the stabilization occlusal splint therapy, subjects with improvement or complete remission in TMD and otological symptoms accounted for 84% and 80% in all subjects respectively. There were statistically differences in the distances between condylar center (CoC) and sella (S) in sagittal and vertical directions before and after treatment, and statistically difference between ATM and S in sagittal direction. The threshold of PTA at 8000Hz were negatively correlated with the sagittal displacement of condyle and positively correlated with the coronal displacement of condyle. The thickness of top 1/3 of anterior wall of tympanum in sagittal were positively correlated with the threshold of PTA at 4000Hz. CONCLUSION: The changes in the TMJ position through occlusal splint therapy might cause the changes in structure of middle-inner ear, which might be one of the reasons for the improvement in otological symptoms. KEY WORDS: Audiology, CBCT, Otological symptoms, TMD.

Association of Radioiodine for Differentiated Thyroid Cancer and Second Breast Cancer in Female Adolescent and Young Adult.

Background: Exposure to radiation is related to breast cancer occurrence. While whether the radioiodine (RAI) increases the risk of second breast cancer (SBC) in female differentiated thyroid cancer (DTC) patients is not well addressed. Methods: All patients were identified from Surveillance, Epidemiology, and End Results database. At least a 5-year latency was guaranteed since exposure to RAI. Fine and Gray model was used to calculate the cumulative incidence and hazards ratios (HR) and 95% confidence interval (CI). Standardized incidence ratio (SIR) was calculated by Poisson regression analysis. Propensity score matching was used for match analysis. Survival analyses were performed by the Kaplan-Meier method and the log-rank test. Results: A total of 406 out of 16,850 patients in the RAI group and 733 out of 22,135 patients in the no RAI group developed SBC. The cumulative incidences of SBC were higher in patients with RAI compared with patients without RAI in the adolescent and young adult (AYA) group and the middle-aged adult group. In the AYA group, patients with RAI had increased HR (1.65; 95% CI, 1.33-2.05, p < 0.001) compared with those without RAI, and the HR increased slightly with latency. In addition, the SIR (1.21; 95% CI, 1.02-1.44, p < 0.05) increased compared with the general population. Whereas, in the middle-aged adult group, only a slightly higher HR (1.18) was found. The survival after SBC was inferior to those with matched only primary breast cancer. Conclusions: RAI treatment increased the risk of SBC in female AYA DTC patients. A long-term follow-up should be performed in this population.

Antagonizing CDK8 Sensitizes Colorectal Cancer to Radiation Through Potentiating the Transcription of e2f1 Target Gene apaf1.

Radiotherapy is an essential curative treatment modality for colorectal cancer. Apoptosis is the major mechanism of IR-induced cell death and aberrant apoptotic signaling results in radioresistance, which is a hallmark of most, perhaps all, types of human cancers. Potentiating the induction of apoptosis is an emerging strategy for cancer radiotherapy. Here, we determined that targeting CDK8 selectively radiosensitized colorectal cancer through the mitochondria-dependent intrinsic apoptotic signaling, which was mediated through the induction of the transcription of apaf1 that was e2f1- and not p53-dependent. Importantly, the enhanced transcriptional activity of e2f1 was dependent on the kinase activity of CDK8 itself and not on the assembling of the mediator complex. In addition, clinical inhibitor, and in vivo studies confirmed the radiosensitizing effect of CDK8. Our results provide a new targeting strategy to improve the radiotherapy of CRC.

Pan-Cancer Analysis of Radiotherapy Benefits and Immune Infiltration in Multiple Human Cancers.

Response to radiotherapy (RT) in cancers varies widely among patients. Therefore, it is very important to predict who will benefit from RT before clinical treatment. Consideration of the immune tumor microenvironment (TME) could provide novel insight into tumor treatment options. In this study, we investigated the link between immune infiltration status and clinical RT outcome in order to identify certain leukocyte subsets that could potentially influence the clinical RT benefit across cancers. By integrally analyzing the TCGA data across seven cancers, we identified complex associations between immune infiltration and patients RT outcomes. Besides, immune cells showed large differences in their populations in various cancers, and the most abundant cells were resting memory CD4 T cells. Additionally, the proportion of activated CD4 memory T cells and activated mast cells, albeit at low number, were closely related to RT overall survival in multiple cancers. Furthermore, a prognostic model for RT outcomes was established with good performance based on the immune infiltration status. Summarized, immune infiltration was found to be of significant clinical relevance to RT outcomes. These findings may help to shed light on the impact of tumor-associated immune cell infiltration on cancer RT outcomes, and identify biomarkers and therapeutic targets.

Radiation induces apoptosis primarily through the intrinsic pathway in mammalian cells.

Radiation-induced tumor cells death is the theoretical basis of tumor radiotherapy. Death signaling disorder is the most important factor for radioresistance. However, the signaling pathway(s) leading to radiation-triggered cell death is (are) still not completely known. To better understand the cell death signaling induced by radiation, the immortalized mouse embryonic fibroblast (MEF) deficient in "initiator" caspases, "effector" caspases or different Bcl-2 family proteins together with human colon carcinoma cell HCT116 were used. Our data indicated that radiation selectively induced the activation of caspase-9 and caspase-3/7 but not caspase-8 by triggering mitochondrial outer membrane permeabilization (MOMP). Importantly, the role of radiation in MOMP is independent of the activation of both "initiator" and "effector" caspases. Furthermore, both proapoptotic and antiapoptotic Bcl-2 family proteins were involved in radiation-induced apoptotic signaling. Overall, our study indicated that radiation specifically triggered the intrinsic apoptotic signaling pathway through Bcl-2 family protein-dependent mitochondrial permeabilization, which indicates targeting mitochondria is a promising strategy for cancer radiotherapy.

N-(3-oxo-acyl) homoserine lactone induced germ cell apoptosis and suppressed the over-activated RAS/MAPK tumorigenesis via mitochondrial-dependent ROS in C. elegans.

As a quorum-sensing molecule for bacteria-bacteria communication, N-(3-oxododecanoyl)-homoserine lactone (C12) has been found to possess pro-apoptotic activities in various cell culture models. However, the detailed mechanism of how this important signaling molecule function in the cells of live animals still remains largely unclear. In this study, we systematically investigated the mechanism for C12-mediated apoptosis and studied its anti-tumor effect in Caenorhabditis elegans (C. elegans). Our data demonstrated that C12 increased C. elegans germ cell apoptosis, by triggering mitochondrial outer membrane permeabilization (MOMP) and elevating the reactive oxygen species (ROS) level. Importantly, C12-induced ROS increased the expression of genes critical for DNA damage response (hus-1, clk-2 and cep-1) and genes involved in p38 and JNK/MAPK signaling pathway (nsy-1, sek-1, pmk-1, mkk-4 and jnk-1). Furthermore, C12 failed to induce germ cell apoptosis in animals lacking the expression of each of those genes. Finally, in a C. elegans tumor-like symptom model, C12 significantly suppressed tumor growth through inhibiting the expression of RAS/MAPK pathway genes (let-23/EGFR, let-60/RAS, lin-45/RAF, mek-2/MEK and mpk-1/MAPK). Overall, our results indicate that DNA damage response and MAPK activation triggered by mitochondrial ROS play important roles in C12-induced apoptotic signaling in C. elegans, and RAS/MAPK suppression is involved in the tumor inhibition effect of C12. This study provides in vivo evidence that C12 is a potential candidate for cancer therapeutics by exerting its pro-apoptotic and anti-tumor effects via elevating mitochondria-dependent ROS production.

Gas Permeability and Permselectivity of Poly(L-Lactic Acid)/SiOx Film and Its Application in Equilibrium-Modified Atmosphere Packaging for Chilled Meat.

A layer of SiOx was deposited on the surface of poly(L-lactic acid) (PLLA) film to fabricate a PLLA/SiOx layered film, by plasma-enhanced chemical vapor deposition (PECVD) process. PLLA/SiOx film showed Young's modulus and tensile strength increased by 119.2% and 91.6%, respectively, over those of neat PLLA film. At 5 °C, the oxygen (O2 ) and carbon dioxide (CO2 ) permeability of PLLA/SiOx film decreased by 78.7% and 71.7%, respectively, and the CO2 /O2 permselectivity increased by 32.5%, compared to that of the neat PLLA film. When the PLLA/SiOx film was applied to the equilibrium-modified atmosphere packaging of chilled meat, the gas composition in packaging reached a dynamic equilibrium with 6% to 11% CO2 and 8% to 13% O2 . Combined with tea polyphenol pads, which effectively inhibited the microbial growth, the desirable color of meat was maintained and an extended shelf life of 52 d was achieved for the chilled meat.

The Efficacy of Lidocaine in Laryngospasm Prevention in Pediatric Surgery: a Network Meta-analysis.

Higher incidence and worse outcomes of laryngospasm during general anesthesia in children than adults have been reported for many years, but few prevention measures are put forward. Efficacy of lidocaine in laryngospasm prevention has been argued for many years and we decided to design this network meta-analysis to assess the efficacy of lidocaine. We conducted an electronic search of six sources and finally included 12 Randomized Controlled Trials including 1416 patients. A direct comparison between lidocaine and placebo revealed lidocaine had the effect on preventing laryngospasm in pediatric surgery (RR = 0.46, 95% CI = [0.30, 0.70], P = 0.0002, I(2) = 0%). Both subgroup analysis and network analysis demonstrated that both intravenous lidocaine (subgroup: RR = 0.39, 95% CI = [0.18, 0.86], P = 0.02, I(2) = 38%; network: RR = 0.25, 95% CI = [0.04, 0.86]) and topical lidocaine (subgroup: RR = 0.37, 95% CI = [0.19, 0.72], P = 0.003, I(2) = 0%; network: RR = 0.14, 95% CI = [0.02, 0.55]) was effective in laryngospasm prevention, while no statistical difference was found in a comparison between intravenous and topical lidocaine. In conclusion, both intravenous and topical lidocaine are effective in laryngospasm prevention in pediatric surgery, while a comparison between them needs more evidences.