Malnutrition elevates delirium and ICU stay among critically ill older adult COVID-19 patients.

Background and aim: Malnutrition among intensive care unit (ICU) patients is associated with a higher risk of mortality and prolonged hospitalization. However, the influence of malnutrition on severe outcomes of ICU patients with coronavirus disease 2019 (COVID-19) is unclear. By evaluating the effect of malnutrition on the outcomes of COVID-19 in the ICU in older adult patients, this study will contribute to new knowledge of assessing the nutritional status and recovery of these patients. Methods: In the current single center prospective study, 310 critically ill COVID-19 patients with an age range of ≥65 years were recruited. Data on demographic characteristics, laboratory parameters, comorbidities, medications, and types of mechanical ventilation were collected in the first 24 h of ICU admission. Malnutrition was defined based on the two-step approach of the Global Leadership Initiative on Malnutrition (GLIM) scale at baseline. During the 45 days after the baseline, we collected data on delirium incidence, mortality, invasive mechanical ventilation (IMV) requirement, length of ICU and hospital admission, and re-hospitalization. Results: In this study, the prevalence of malnutrition was 63.4% among critically ill COVID-19 patients. During the 45-day follow-up, 190 (61.3%) COVID-19 deaths were recorded among the baseline 310 patients. After controlling for potential confounders, malnutrition was associated with an increased risk of delirium so malnourished COVID-19 patients had a significantly 35% higher risk of delirium than those without malnutrition (HR: 1.35, 95% CI: 1.01-1.83). Such a significant association was not for COVID-19 mortality and IMV requirement. In addition, malnutrition was associated with a significantly 84% greater odds of prolonged ICU admission (OR: 1.84, 95% CI: 1.09-3.10). No significant association was seen between malnutrition and re-hospitalization and also prolonged hospital admission. Conclusion: Malnutrition was associated with an increased risk of delirium and prolonged ICU admission among critically ill older adult COVID-19 patients. Prevention, diagnosis, and treatment of malnutrition could be a key component in improving outcomes in these patients.

Chemically-stable flexible transparent electrode: gold-electrodeposited on embedded silver nanowires.

Silver nanowires (AgNWs) with a low diameter, high aspect ratio, stable suspension, and easy synthesis have recently attracted the optoelectronic industry as a low-cost alternative to indium tin oxide transparent conductive films. However, silver nanowires are not chemically stable, and their conductivity diminishes over time due to reactions with atmospheric components. This is a bottleneck for their wide industrial applications. In this study, we aim to address this issue by synthesizing silver nanowires with an average diameter of approximately 65 nm and a length of approximately 13 µm. The prepared Ag nanowires are then applied to fabricate transparent, flexible, and chemically stable conductive films. The fabrication includes spraying of silver nanowires suspension on a glass substrate followed by Dr. blade coating of polystyrene (PS) solution and delamination of the PS-AgNWs film. The resulting film exhibits an optimum sheet resistance of 24 Ω/□ and transmittance of 84%. To further enhance the stability of the transparent conductive film, the facial and scalable double pulse electrodeposition method is used for coating of gold on the exposed surface of the AgNWs embedded in PS. The final transparent film with gold coating demonstrates a remarkable stability under harsh conditions including long exposure to UV light and nitric acid solution. After 100 min of UV/Ozone treatment, the increase in sheet resistance of the optimal PS-AgNW@Au sample is 15.6 times lower than the samples without gold coating. In addition, the change in sheet resistance after 2000 bending cycles in the optimal PS-AgNW@Au electrode is measured and it showed an increase of only 22% of its initial sheet resistance indicating its good flexibility. The proposed electrode performs an excellent chemical stability, good conductivity, transparency, and flexibility that makes it a potential candidate for various optoelectronic devices.

Phosphodiesterase 5 (PDE-5) inhibitors (sildenafil, tadalafil, and vardenafil) effects on esophageal motility: a systematic review.

BACKGROUND: Esophageal motility disorders are a group of disorders associated with dysfunctional swallowing resulting from impaired neuromuscular coordination. Phosphodiesterase 5 (PDE-5) inhibitors induce smooth relaxation and are proposed as a treatment option for esophageal motility disorders such as achalasia. METHODS: This study is conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched MEDLINE/ PubMed, Scopus, EMBASE, and Web of Science databases for esophageal outcomes of individuals treated with PDE5 inhibitors. A random effect meta-analysis was conducted. RESULTS: A total of 14 studies were included. They were conducted in different countries, with Korea and Italy having the highest number of articles. The main drug assessed was sildenafil. PDE-5 inhibitors resulted in a significant reduction in lower esophageal sphincter pressure (SMD - 1.69, 95% CI: -2.39 to -0.99) and the amplitude of contractions (SMD - 2.04, 95% CI: -2.97 to -1.11). Residual pressure was not significantly different between the placebo and sildenafil groups (SMD - 0.24, 95% CI: -1.20 to 0.72). Furthermore, a recent study reported contractile integral, stating that ingestion of sildenafil leads to a significant reduction in distal contractile integral and a significant increase in proximal contractile integral. CONCLUSION: PDE-5 inhibitors significantly reduce LES resting pressure and esophageal peristaltic vigor, decreasing esophageal body contractility and contraction reserve. Therefore, using these drugs in patients affected by esophageal motility disorders may potentially improve their condition regarding symptom relief and prevention of further associated complications. Future reports investigating larger sample size is necessary in order to establish definite evidence regarding the efficacy of these drugs.

Inkjet Printing of MnO2 Nanoflowers on Surface-Modified A4 Paper for Flexible All-Solid-State Microsupercapacitors.

Printing technologies are gaining growing attention as a sustainable route for the fabrication of high-performance and flexible power sources such as microsupercapacitors (MSCs). Here, the inkjet printing method is utilized for the fabrication of manganese dioxide (MnO2)-based, flexible all-solid-state MSCs on surface-modified A4 paper substrate. The appropriate rheology of the formulated ethanol-based ink (Fromm number <10) and the proper dimensions of MnO2 nanoflowers (average size ∼600 nm) ensure a reliable inkjet printing process. Moreover, the underlying graphene/Ag nanowire pattern serves as a primer and highly conductive (Rs < 2 Ω sq-1) layer on top of the paper to facilitate the anchoring of MnO2 nanoflowers and rapid electron transportation. The resulting all-solid-state MSCs deliver a maximum areal capacitance of 0.68 mF cm-2 at a current density of 25 µA cm-2, reasonable durability (>80% of capacity remained after 3000 cycles), and remarkable foldability. Additionally, the inkjet-printed MSC devices deliver a superior areal energy density of 0.01 µWh cm-2 and also a power density of 1.19 µW cm-2. This study demonstrates the power of the inkjet printing method to produce MSCs on flexible substrates, which have great potential for flexible/wearable electronics.

Some results on the multipartite Ramsey numbers m j (C 3,C m ,n 1 K 2,n 2 K 2, ,n i K 2).

The graph K j × t is a graph which is complete and multipartite which includes j partite sets and t vertices in each partite set. The multipartite Ramsey number (M-R-number) m j ( G 1 , G 2 , … , G n ) is the smallest integer t for the mentioned graphs G 1 , G 2 , … , G n , in a way which for each n-edge-coloring ( G 1 , G 2 , … , G n ) of the edges of K j × t , G i contains a monochromatic copy of G i for at least one i. The size of M-R-number m j ( n K 2 , C 7 ) for j ≥ 2 , n ≤ 6 , the M-R-number m j ( n K 2 , C 7 ) for j = 2 , 3 , 4 , n ≥ 2 , the M-R-number m j ( n K 2 , C 7 ) for each j ≥ 5 , n ≥ 2 , the M-R-number m j ( C 3 , C 3 , n 1 K 2 , n 2 K 2 , … , n i K 2 ) for j ≤ 6 , and i , n i ≥ 1 , and the size of M-R-number m j ( C 3 , C 3 , n K 2 ) for j ≥ 2 and n ≥ 1 have been calculated in various articles hitherto. We acquire some bounds of M-R-number m j ( C 3 , C 3 , n 1 K 2 , n 2 K 2 , … , n i K 2 ) in this essay in which i , j ≥ 2 , and n i ≥ 1 , also the size of M-R-number m 4 ( C 3 , C 4 , n K 2 ) for each n ≥ 1 is computed in this paper.

Identification of the Range of Nursing Skills Used to Provide Social Support for Mothers of Preterm Infants in Neonatal Intensive Care.

BACKGROUND: Hospitalization of preterm infants in neonatal intensive care units (NICUs) is a stressful experience for parents. Iranian NICUs do not have specified levels of care, nor do they integrate supportive methods of parent support such as family-centered care approaches. This study investigated the range and types of neonatal nursing support, as perceived by mothers of preterm infants, and its association with mothers' satisfaction with infant care in the NICU. METHODS: This is a descriptive, correlational study of mothers of preterm infants who were hospitalized in three different NICUs in Iran. A convenience sampling method was used. Data were collected using three questionnaires that identified (i) demographic information; (ii) social support available; and (iii) parent satisfaction with infant care. RESULTS: Mothers (N = 110) generally rated the support from nurses as being moderate. Correlation analysis identified a moderate association of neonatal nurse social support domains for affirmational (r = 0.44) and concrete aid (r = 0.41), a moderately strong association for affectional support (r = 0.64), and total social support (r = 0.60) with mothers' satisfaction. CONCLUSION: There were positive associations between social support from nurses and mothers' satisfaction with the care of their infants. Therefore, planning to promote and create opportunities for neonatal nurses to support mothers in NICU is important to promote increased maternal satisfaction in infant care.

Investigation of the effect of magnetic particles on the Crystal Violet adsorption onto a novel nanocomposite based on κ-carrageenan-g-poly(methacrylic acid).

A novel nanocomposite hydrogel prepared by incorporating Fe3O4 magnetic nanoparticles into the κ-carrageenan-g-poly (methacrylic acid) with in situ polymerization and was characterized by FT-IR, XRD, SEM, TEM and VSM. Synthesized nanocomposite was used to adsorb Crystal Violet (CV) (cationic dye) in aqueous solution in a batch system. The research studies showed that the adsorption of CV can be impressed as a function of contact time, initial concentration of CV, pH and molar ratio of κ-carrageenan to poly(methacrylic acid). CV adsorption tests disclosed that it only takes 15 min to reach the equilibrium and adsorption capacity for this dye was 28.24 mg g(-1). Langmuir isotherm for equilibrium adsorption data was fitted well and the pseudo-second-order model can describe the adsorption kinetics. Thermodynamic parameters of ΔG°, ΔH° and ΔS° showed the endothermic nature of adsorption and a spontaneous process.

Inhibitory effect ofThymus vulgaris extract on memory impairment induced by scopolamine in rat

Objective:To investigate the effect ofThymus vulgaris (T. vulgaris) on learning and memory functions in scopolamine-induced memory deficit in rats. Memory enhancing activity in scopolamine-induced amnesic rats was investigated by assessing the Morris water maze and passive avoidance paradigm. Methods:A total of 42 male Wistar rats were divided into 6 equal groups as follow: control group: received water, scopolamine treated group: received scopolamine 1 mg/kg for 15 days, two scopolamine+T. vulgaris treated groups: received scopolamine andT. vulgaris extract 50 and 100 mg/kg body weight per day for 15 days, two intact groups: receivedT. vulgaris extract 50 and 100 mg/kg body weight per day for 15 days. Results: Administration ofT. vulgaris extract significantly restored memory and learning impairments induced by scopolamine in the passive avoidance test and Morris water maze test. Conclusions:T. vulgaris extract has repairing effects on memory and behavioral disorders produced by scopolamine and may have beneficial effects in the treatment of Alzheimer's disease.

Synergy between glutathione peroxidase-1 and astrocytic growth factors suppresses free radical generation and protects dopaminergic neurons against 6-hydroxydopamine.

The degeneration of dopaminergic neurons in the course of Parkinson disease is largely blamed on oxidative damage in the brain. This study examined the potency of glutathione peroxidase-1 (GPX-1) to protect dopaminergic neurons against toxicity induced by the parkinsonian neurotoxin 6-hydroxydopamine (6-OHDA). We generated pLV-GPX1, a recombinant lentivirus vector carrying the coding sequence for human GPX-1, into the SK-N-MC neuroblastoma cell line. The pLV-GPX1-infected neurons showed an over 3-fold increase in enzyme expression and a 2.6-fold increase in enzyme activity compared to the pLV-EGFP-infected control cells. In the pLV-GPX1-infected cells, we also detected significantly increased neuronal survival and resistance to 6-OHDA-mediated toxicity compared to our controls (75 ± 4% versus 51 ± 7%, p < 0.001). To maximize this protection, the neurons were treated with conditioned medium taken from growing primary astrocytes (astro-CM). We found the treated pLV-GPX1-infected neurons even more significantly resistant to 6-OHDA toxicity compared to their untreated counterparts (86 ± 5% versus 75 ± 4%, p < 0.001). Concomitant with increased neuroprotection, co-presence of overexpressed GPX-1 and astro-CM significantly increased glutathione (GSH) levels compared to when either of the two was present (p < 0.001). Further analysis showed nearly 2.7-fold reduction, in the presence of astro-CM, of hydrogen peroxide (H(2)O(2)) levels released from the pLV-GPX1-infected neurons compared to control groups (p < 0.001). Finally, regression analysis between H(2)O(2) levels and cell viability showed that co-presence of GPX-1 and astro-CM reduced 33% of cell death rate (p < 0.05). These data highlight the antioxidant properties of GPX-1 in protecting dopaminergic neurons and further emphasize the capacity of astrocytes in pumping growth-inducing factors that may synergize with GPX-1 to accelerate neuroprotection.