Experiences and perceptions of stroke patients living with dysphagia: A qualitative meta-synthesis.

AIMS: To systematically review and synthesise the findings of qualitative research exploring experiences of dysphagia from stroke patients' perspectives. BACKGROUND: Poststroke patients with dysphagia are suffering from impaired physical functions and heavy psychological burden, and they are living with compromised quality of life. Through synthesising qualitative studies to fully portrait the experiences of poststroke patients living with dysphagia, we can care better for this population. DESIGN: A systematic review and synthesis of qualitative studies reported by following ENTREQ. REVIEW METHODS: Five electronic databases (CINAHL, Embase, PubMed, Web of Science and Cochrane Library) and three Chinese databases (CNKI, VIP and Wanfang) were searched from inception until January 2021. Qualitative studies were included if they were related to the experiences of poststroke patients with dysphagia. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to appraise study quality. Data were synthesised using the Thomas and Harden method thematic and content analysis. RESULTS: Five studies were included in the meta-synthesis. Four analytical themes were identified: life changes after dysphagia, coping with social events, rebuilding a normal life and limited professional services. CONCLUSIONS: More attention should be given to psychological health and social interaction in poststroke dysphagia patients. Healthcare professionals, especially nurses, should make joint efforts to provide patients with dysphagia-related knowledge and long-term individualised support. To improve the quality of life of dysphagia patients, further research should implement high-quality interventions based on dysphagia experience and clinical treatment. RELEVANCE TO CLINICAL PRACTICE: These findings outline the changes in poststroke patients with dysphagia. Nurses as the first-line force, should deliver comprehensive and individualised intervention for managing physiological and psychosocial symptoms of patients.

A Microfluidic Device for Multiplex Single-Nucleotide Polymorphism Genotyping.

Single-nucleotide polymorphisms (SNPs) are the most abundant type of genetic variations; they provide the genetic fingerprint of individuals and are essential for genetic biomarker discoveries. Accurate detection of SNPs is of great significance for disease prevention, diagnosis and prognosis, and for prediction of drug response and clinical outcomes in patients. Nevertheless, conventional SNP genotyping methods are still limited by insufficient accuracy or labor-, time-, and resource-intensive procedures. Microfluidics has been increasingly utilized to improve efficiency; however, the currently available microfluidic genotyping systems still have shortcomings in accuracy, sensitivity, throughput and multiplexing capability. To address these challenges, we developed a multi-step SNP genotyping microfluidic device, which performs single-base extension of SNP specific primers and solid-phase purification of the extension products on a temperature-controlled chip. The products are ready for immediate detection by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), providing identification of the alleles at the target loci. The integrated device enables efficient and automated operation, while maintaining the high accuracy and sensitivity provided by MS. The multiplex genotyping capability was validated by performing rapid, accurate and simultaneous detection of 4 loci on a synthetic template. The microfluidic device has the potential to perform automatic, accurate, quantitative and high-throughput assays covering a broad spectrum of applications in biological and clinical research, drug development and forensics.

Design and synthesis of cleavable biotinylated dideoxynucleotides for DNA sequencing by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)-based methods have been widely explored for DNA sequencing. We report here the design, synthesis, and evaluation of a novel set of chemically cleavable biotinylated dideoxynucleotides, ddNTPs-N3-biotin, for the DNA polymerase extension reaction and its application in DNA sequencing by mass spectrometry (MS). These nucleotide analogs have a biotin moiety attached to the 5 position of the pyrimidines (C and U) or the 7 position of the purines (A and G) via a chemically cleavable azido-based linker, with different length linker arms serving as mass tags that contribute to large mass differences among the nucleotides. We demonstrate that these modified nucleotides are efficiently incorporated by DNA polymerase, and the DNA strand bearing biotinylated nucleotides is captured by streptavidin-coated beads and efficiently released using tris(2-carboxyethyl)phosphine in aqueous solution, which is compatible with DNA and downstream procedures. We performed Sanger sequencing reactions using these nucleotides to generate DNA fragments for MALDI-TOF MS analysis. Both synthetic DNA and polymerase chain reaction (PCR) products were accurately decoded, and a read length of approximately 37 bases was achieved using these nucleotides in MS sequencing.

Mitochondrial single nucleotide polymorphism genotyping by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry using cleavable biotinylated dideoxynucleotides.

Characterization of mitochondrial DNA (mtDNA) single nucleotide polymorphisms (SNPs) and mutations is crucial for disease diagnosis, which requires accurate and sensitive detection methods and quantification due to mitochondrial heteroplasmy. We report here the characterization of mutations for myoclonic epilepsy with ragged red fibers syndrome using chemically cleavable biotinylated dideoxynucleotides and a mass spectrometry (MS)-based solid phase capture (SPC) single base extension (SBE) assay. The method effectively eliminates unextended primers and primer dimers, and the presence of cleavable linkers between the base and biotin allows efficient desalting and release of the DNA products from solid phase for MS analysis. This approach is capable of high multiplexing, and the use of different length linkers for each of the purines and each of the pyrimidines permits better discrimination of the four bases by MS. Both homoplasmic and heteroplasmic genotypes were accurately determined on different mtDNA samples. The specificity of the method for mtDNA detection was validated by using mitochondrial DNA-negative cells. The sensitivity of the approach permitted detection of less than 5% mtDNA heteroplasmy levels. This indicates that the SPC-SBE approach based on chemically cleavable biotinylated dideoxynucleotides and MS enables rapid, accurate, and sensitive genotyping of mtDNA and has broad applications for genetic analysis.

CdSe/ZnS core shell quantum dot-based FRET binary oligonucleotide probes for detection of nucleic acids.

We report the design, synthesis, and characterization of a binary oligonucleotideprobe for selective DNA or RNA detection. The probe is based on fluorescence resonance energy transfer (FRET) from quantum dot (CdSe/ZnS core shell) DNA conjugates to organic dye (cyanine-5) DNA conjugates. Selective hybridization of the donor/acceptor DNA conjugates to target DNA enhances FRET and a change in fluorescence signature was observed.

Interactions of daidzin with intramolecular G-quadruplex.

The potential interaction of daidzin, an ingredient of soy isoflavones, with human telomeric antiparallel G-quadruplex dAG(3)(T(2)AG(3))(3) was studied using ESI-MS, PAGE, CD and molecular simulation. Experimental studies indicated that daidzin molecules interacted with dAG(3)(T(2)AG(3))(3) and formed DNA-daidzin complex with the stoichiometric ratio of 1:1 and 1:2. The transition temperature of the G-quadruplex increased at higher ratio of daidzin to DNA. Under molecular crowding conditions the interactions between daidzin and the G-quadruplex become much stronger. Combining computational simulation and experimental results, it is demonstrated that the dAG(3)(T(2)AG(3))(3)/daidzin complex with a stoichiometric ratio of 1:1 is stabilized through the pi-pi conjugacy interactions and hydrogen bondings between daidzin and the bases of G-quadruplex. This work provides guidance not only on exploring the molecular anti-cancer mechanism of dietary isoflavones, but also searching small natural products as promising anticancer candidates that can inhibit telomerase activity.