Alexithymia in a Chinese Patient with Chronic Pain and Associated Factors: A Cross-Sectional Study.

BACKGROUND: Alexithymia is more prevalent among those with patients living with chronic pain. Information on the prevalence of alexithymia in Chinese patients with chronic pain and associated factors is limited. AIM: The primary objective of this study was to determine the prevalence of alexithymia, as defined by a score of 61 or greater in the 20-item Toronto Alexithymia Scale (TAS-20), in a Chinese patient with chronic pain. The secondary objective was to investigate the relationship between alexithymia and the clinical and psychological aspects of chronic pain. METHODS: A cross-sectional observational study used the TAS-20 to assess alexithymia of Chinese patients with chronic pain. Sociodemographic and clinical information were obtained and participants filled in the Fear Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and General Self-efficacy Scale. RESULTS: Of the 346 patients screened, 321 patients living with chronic pain were enrolled into the study. The prevalence of alexithymia among the study population (TAS-20 score ≥61) was 19.6% (95% confidence interval [CI]: 15.3-24.0). The findings showed anxiety (odds ratio [OR] = 2.474; 95% CI, 1.241-4.935), pain catastrophizing (2.649; 1.014-6.921), and self-efficacy (0.952; 0.908-0.988) as independent predictors of alexithymia in patients living with chronic pain. CONCLUSIONS: Patients with chronic pain exhibiting alexithymia were at higher risk of pain catastrophizing, anxiety, and lower self-efficacy, compared with patients without alexithymia. It is important to identify and pay a special attention in clinical practice to patients with chronic pain exhibiting alexithymia, as these individuals are unable to properly express their emotions.

Prevalence and risk factors of ischemic stroke-related headache in China: a systematic review and meta-analysis.

BACKGROUND: Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of ischemic stroke-related headaches and identify its risk factors in China. METHODS: PubMed, Embase, Cochrane Library database, Web of Science, PsycINFO, and four Chinese databases for the related publications were searched. Two researchers independently selected the literature, extracted the relevant data, and assessed its methodological quality. The meta-analysis applied a random-effects model with R software to calculate the pooled prevalence of ischemic stroke-related headaches in Chinese patients, and to merge the odds ratio (OR) of risk factors. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed by a funnel plot and Egger test. RESULTS: Ninety-eight studies were eligible for inclusion. The overall pooled prevalence of ischemic stroke-related headache was 18.9%. Subgroup analysis showed that the prevalence of ischemic stroke related-headaches was higher among studies using self-report to diagnosis headache (18.9%; 95%CI, 8.9% to 40.2%), and those focused on age ≥ 55 years (19.7%; 95%CI, 14.9% to 25.9%), rural settings (24.9%; 95%CI, 19.7% to 31.6%). There were no significant differences in the headache prevalence between studies in the south and north, and inland and coastal studies. The prevalence of pre onset headache (13.9%) and tension-type headache (15.5%) and was higher compared with other types. History of headache (OR = 3.24; 95%CI, 2.26 to 4.65.), female gender (OR = 2.06; 95%CI, 1.44 to 2.96.), midbrain lesions (OR = 3.56; 95%CI, 1.86 to 6.83.), and posterior circulation stroke (OR = 2.13; 95%CI, 1.14 to 4.32) were major risk factors. CONCLUSION: The prevalence of ischemic stroke-associated headache is high in China. In addition, women, presence of midbrain lesions, posterior circulation stroke and a history of migraine were high-risk factors for ischemic stroke-related headaches. Designing effective interventions to prevent or alleviated headaches is necessary to promote patients' neurological recovery and quality of life.

Upper gastrointestinal foreign bodies in adults: A systematic review.

BACKGROUND: Foreign body(FB) ingestion in the upper digestive tract is a common emergency that lacks sufficient attention in adult population. Improper management may bring additional injuries and financial burdens to patients. This review was performed to determine the clinical characteristics of upper gastrointestinal FBs, including the demographic of adult patients, the type and location of FBs, underlying diseases of patients and other risk factors, and outcomes. METHODS: We searched PubMed, MEDLINE, EMBASE and Cochrane databases with the terms "foreign body AND upper gastrointestinal NOT child". Finally, we got 7 articles between 2001 and 2020 and extracted the information. RESULTS: A total of 1391 patients were included. 736 (52.9%) patients were males and 655 (47.1%) were females. Fish bone was the most common type of FBs. Esophagus accounts for the most location in the upper digestive tract. 18.2% (235/1291) patients had the underlying diseases, and 11.7% (58/494) had other risk factors. The overall complication rate was 4.5% (63/1391).

Alexithymia, social support, depression, and burnout among emergency nurses in China: a structural equation model analysis.

BACKGROUND: Several factors are associated with the incidence of burnout, including alexithymia, social support, and depression. The relative importance of these three key parameters as mediators of burnout, however, is not well understood. In addition, there have been few studies to date specifically examining the association between alexithymia and burnout among nurses in China. PURPOSE: To evaluate the relationship of burnout with alexithymia, social support, and depression across emergency department nurses in China. METHODS: This descriptive, cross-sectional survey was conducted using a convenience sampling methodology to survey nurses responsible for direct emergency care (n = 413) from 18 tertiary hospitals in Western, Eastern, Northern, and Southern China between May 2020 and June 2020. A structural equation modeling approach was then used to assess a hypothetical model wherein alexithymia both directly and indirectly affects burnout among emergency nurses via impacting the incidence of depression and perceived social support. RESULTS: Results supported all driving hypotheses. Alexithymia was positive direct correlated with burnout (ß = 0.35; P < 0.001) and depression (ß = 0.50; P < 0.001), and exhibited a negative direct effect on social support (ß = - 0.14; P = 0.041). Depression was associated with burnout, both directly (ß = 0.24; P < 0.001) and indirectly (ß = 0.15; P < 0.001) through its relationship with social support. Alexithymia was the factor most strongly associated with burnout, and it was able to affect burnout indirectly through depression and social support. CONCLUSIONS: We found that among emergency nurses in China, alexithymia was correlated with burnout, depression, and social support. Alexithymia was the factor most strongly associated with burnout. These data suggest that providing better social support and alleviating alexithymia may decrease rates of burnout among emergency nurses.

Development of a nomogram for predicting nasogastric tube-associated pressure injuries in intensive care unit patients.

Here, we aimed to build a nomogram model to estimate the probability of nasogastric tube-associated pressure injuries (NTAPIs) in intensive care unit(ICU)patients. This prospective cohort study included 219ICU patients with nasogastric tube between September 2019 and January 2020.Univariate and multivariate logistic regression analyses were used to develop the nomogram model. The resulting nomogram was tested for calibration, discrimination, and clinical usefulness. Of the included patients, 58 developed NTAPIs, representing an incidence rate of 26.5%. Binary logistic regression analysis revealed that the prediction nomogram included C-reactive protein, vasopressor use, albumin level, nasogastric tube duration, and Sequential Organ Failure Assessment score. The value of these predictors was again confirmed using theLasso regression analysis. Internal validation presented a good discrimination of the nomogram, with an area under the curve value of 0.850, and good calibration (Hosmer-Lemeshow test, P = 0.177). The decision curve analysis also demonstrated preferable net benefit along with the threshold probability in the prediction nomogram. The nomogram model can accurately predict the risk factors for NTAPIs, to formulate intervention strategies as early as possible to reduce NTAPI incidence.

Knowledge, attitude, and practice of nurses in intensive care unit on preventing medical device-related pressure injury: A cross-sectional study in western China.

The knowledge, attitude, and practice of nurses in intensive care units (ICUs) are determinants for the efficacy of preventing the medical device-related pressure injury (MDRPI). The aim of this study was to determine the level and factors of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI in western China. An annual cross-sectional study was conducted in hospitals of western China from May 2020 to September 2020. Nurses' knowledge and attitudes were assessed using Clinical Nurses Prevention MDRPI of Critically Ill Patients for the Knowledge, Attitude, Practice Assessment Scale. SPSS software version 25.0 and independent t-test, Chi-square, Fisher exact, one-way analysis of variance, and multiple linear regression tests were used for data analysis. A total of 1002 nurses in ICUs from 37 hospitals in Gansu Province, China, participated in this study. The scores of overall KAP, knowledge, attitudes, and practice were 149.17 ± 24.62, 53.83 ± 12.23, 37.24 ± 6.35 and 58.10 ± 9.83, respectively. There was a positive and significant relationship between three variables. Findings revealed that nurses' knowledge score in the Tertiary hospital was higher than scores of other hospitals as 3.840 units. Moreover, the knowledge score and practice score of nurses with bachelor's degree or above were higher than other nurses and are 0.978 and 1.106 units, respectively. Based on the findings, practice of nurses increased by 0.992 units, with a 1-year increase in work experience of nurses in the ICU. The levels of knowledge, attitude, and practice of nurse in ICUs on preventing MDRPI were acceptable. The findings of the study highlight that a comprehensive approach should be conducted for raising the level of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI, as well as improving the quality of care for critically ill patients.

Risk factors for necrosis of skin flap-like wounds after ED debridement and suture.

BACKGROUND: Skin flap-like wounds are common. These wound flaps are prone to avascular necrosis with simple debrided and sutured, and postoperative hyperplastic scarring and contracture of wound surfaces can adversely affect the patient's appearance. Here, we evaluate the data of cases with flap-like wounds to identify the causes of flap necrosis. METHODS: Six hundred patients with skin flap-like wounds between January 1, 2013 and December 31, 2016 were retrospectively reviewed. Their age, sex, injury reason, size of flap, length-width ratio of wound, thickness of pedicle, operation time, injury site, direction of blood perfusion in the flap and operating methods were recorded. The risks for flap necrosis were analyzed with one-factor analysis. RESULTS: A total success rate of 92.5% (555/600) for flap-like wound reconstruction was obtained. Among 67 flaps with vascular crisis, 22 were salvaged by subcutaneous injection of anisodamine, selective suture removal, and pressure dressing with elastic bandages. For the 45 patients with flap necrosis, there was no significant difference from patients without necrosis in terms of sex, age, and size of flap (P > 0.05). The incidence of flap necrosis was significantly different in terms of injury reason, length-width ratio of wound, thickness of pedicle, operation time, injury site, direction of blood perfusion in the flap and operating methods (P < 0.05). CONCLUSION: Injury reason, length-width ratio of wound, thickness of pedicle, operation time, injury site, direction of blood perfusion in the flap and operating methods, rather than age, sex and size of flap, were significant risk factors for necrosis of flap-like wounds.

Assessment of the Fluorescence Spectra Characteristics of Dissolved Organic Matter Derived from Organic Waste Composting Based on Projection Pursuit Classification (PPC).

The characteristics of fluorescence spectra of dissolved organic matter (DOM) derived from composting is one of the key ways to assess the compost maturity. However, the existing methods mainly focus on the qualitative description for the humification degree of compost. In this paper, projection pursuit classification (PPC) was conducted to quantitative assess the grades of compost maturity, based on the characteristics of fluorescence spectra of DOM. Eight organic wastes (chicken manure, swine manure, kitchen waste, lawn waste, fruits and vegetables waste, straw, green waste, and municipal solid waste) composting were conducted, the germination percentage (GI) and fluorescence spectra of DOM were measured during composting. Statistic analysis with all fluorescence parameters of DOM indicated that I436/I383 (a ratio between the fluorescence intensities at 436 and 383 nm in excitation spectra), FLR (an area ratio between fulvic-like region from 308 to 363 nm and total region in emission spectra), P(HA/Pro) (a regional integration ratio between humic acid-like region to protein-like region in excitation emission matrix (EEM) spectra), A4/A1 (an area ratio of the last quarter to the first quarter in emission spectra), r(A,C) (a ratio between the fluorescence intensities of peak A and peak C in EEM spectra) were correlated with each other (p < 0.01), suggesting that this fluorescence parameters could be considered as comprehensive evaluation index system of PPC. Subsequently, the four degrades of compost maturity included the best degree of maturity (I, GI > 80%), better degree of compost maturity (II, 60% < GI < 80%), maturity (III, 50% < GI < 60%), and immaturity (IV, GI < 50%) were divided according the GI value during composting. The corresponding fluorescence parameter values were calculated at each degrade of compost maturity. Then the projection values were calculated based on PPC considering the above fluorescence parameter values. The projection value was 2.01 - 2.22 for I grade, 1.21 - 2.0 for II grade, 0.57 - 1.2 for III grade, and 0.10 - 0.56 for IV grade. Model validation was then carried out with composts samples, the results indicated that the simulated values were agreed with the observed values, and the accuracy of PPC was 75% for four grades of maturity, and 100% for maturity and immaturity, suggesting that PPC could meet the need of the assessment of compost maturity.

[Using UV-Vis Absorbance for Characterization of Maturity in Composting Process with Different Materials].

The present study was conducted to assess the degree of humification in DOM during composting using different raw materials, and their effect on maturity of compost based on UV-Vis spectra measurements and chemometrics method. The raw materials of composting studied included chicken manure, pig manure, kitchen waste, lawn waste, fruits and vegetables waste, straw waste, green waste, sludge, and municipal solid waste. During composting, the parameters of UV-Vis spectra of DOM, including SUVA254 , SUVA280 , E250/E365, E4/E6, E2/E4, E2/E6, E253/E203, E253/E220, A226-400, S275-295 and S350-400 were calculated, Statistical analysis indicated that all the parameter were significantly changed during composting. SUVA254 and SUVA280 of DOM were continuously increased, E250/E365 and E4/E6 were continuously decreased in DOM, while A226-400, S275-295 and S350-400 of DOM at the final stage were significantly different with those at other stages of composting. Correlation analysis indicated that the parameters were significantly correlated with each other except for E2/E4 and E235/E203. Furthermore, principal component analysis suggested that A226-400, SUVA254, S350-400, SUVA280 and S275~295 were reasonable parameters for assessing the compost maturity. To distinguish maturity degree among different composts, hierarchical cluster analysis, an integrated tool utilizing multiple UV-Vis parameters, was performed based on the data (A226-400, SUVA254, S350-400, SUVA280 and S275-295) of DOM derived from the final stage of composting. Composts from different sources were clustered into 2 groups. The first group included chicken manure, pig manure, lawn waste, fruits and vegetables waste, green waste, sludge, and municipal solid waste characterized by a lower maturity degree, and the second group contained straw waste and kitchen waste associated with a higher maturity degree. The above results suggest that a multi-index of UV-Vis spectra could accurately evaluate the compost maturity, and A226-400, SUVA254, S350-400, SUVA280 and S275-295 of DOM could serve as primary parameters when the compost maturity was assessed using UV-Vis spectra.

The level of life space mobility among community-dwelling elderly: A systematic review and meta-analysis.

BACKGROUND: Multiple countries have conducted surveys on the level of life space mobility for community-dwelling elderly through the Life-Space Assessment, the results vary greatly, from 41.7 to 88.6. However, there is no meta-analysis on the current situation of community-dwelling elderly life space mobility. OBJECTIVE: To systematically assess the global level of life space mobility for community-dwelling elderly, to identify potential covariates such as geographical regions, survey years, gender, and age that contribute to the heterogeneity between the studies, and to identify the dynamic trend based on survey years. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Two reviewers searched the following 8 electronic bibliographic databases from inception until May 28, 2023: PubMed, The Cochrane Library, Web of Science, Embase, Chinese Biomedical Database, China Knowledge Resource Integrated Database, WanFang, and Weipu Database. REVIEW METHODS: This review was conducted using the Stata 14.1 and R 4.3.1. The Cochrane's Q statistical and I2 index were used to test for heterogenicity and assess the degree of heterogenicity, respectively. Studies were appraised using the Agency for Healthcare Research and Quality tool, the Newcastle-Ottawa Scale for the quality of cross-sectional studies, cohort studies, respectively. RESULTS: A total of 29 studies were selected from databases and reference lists. The pooled score of Life-Space Assessment was 66.84 (95% CI: 63.30-70.39) and the prevalence of restricted life space was 42% (95% CI: 0.27-0.57). The geographical regions, survey years, gender were found to be a significant covariate of the pooled score of life space mobility estimate in the subgroup analysis. The mean score of Life-Space Assessment gradually achieved stability after 2017. CONCLUSIONS: The life space mobility of community-dwelling elderly in the global is at a moderate level, with 42% of them experiencing restricted life space. South America, females and earlier survey years have a lower level of life space mobility. In the future, the government should identify vulnerable groups for targeted intervention to promote the level of LSM in the community-dwelling elderly. REGISTRATION: PROSPERO [CRD42023443054].

Knowledge, attitude and practice of registered nurses toward ICU patients' transfer anxiety in China: A cross-sectional study.

Introduction: Transfer anxiety has effect many critically ill patients in ICU around the world. Nurses must take care of the psychological adjustments that patients and families face when ICU patients transferred to general ward. During this period, basic knowledge, positive attitude, and correct practice are necessary for nurses to address the issue of transfer anxiety and seek to reduce it whenever possible. However, there were few investigations have been performed the knowledge, attitudes, and practice of registered nurses toward ICU patients' transfer anxiety. Aim: The purpose of the paper is to explore the level and influencing factors of knowledge, attitude and practice of registered nurses toward ICU patients' transfer anxiety in China. Methods: From February 1 to March 17, 2023, a cross-sectional study was adopted in China. An electronic questionnaire was used to collect data. Registered nurses' knowledge, attitudes and practice toward ICU patients' transfer anxiety were assessed using The Knowledge, Attitude and Practice Questionnaire for Chinese Registered nurses in ICU regarding the prevention of transfer anxiety. In the end, in this study involved 381 registered nurses from Lanzhou University Second Hospitals in China. SPSS 26.0 for mac, independent T-test, one-way ANOVA test, Scheffe's test, Pearson correlation coefficient and multiple linear regression tests were used for data analysis. Results: The scores of total KAP, knowledge, attitude, and practice are 135.21 ± 24.504, 45.58 ± 13.903, 56.94 ± 10.690 and 32.87 ± 6.393 separately. Study results show that there was a statistically significant correlation among the three variables. According to the results of independent t-test or one-way ANOVA test, there is a correlation between gender(P = 0.001), highest educational attainment (P = 0.005) and knowledge; type of department(P = 0.003) and attitude; gender (P = 0.003), marital status (P = 0.002), clinical work experience (P = 0.002), type of department (P = 0.005) and practice. According to the results of linear regression analysis in this study, the variables of gender (P = 0.006), highest educational attainment (P = 0.032), scores of attitudes (P = 0.006), and scores of practice (P = 0.000) were associated with the scores of knowledge; the variables of scores of knowledge (P = 0.004), and scores of practice (P = 0.000) were associated with the scores of attitudes; the variables of scores of knowledge (P = 0.000), and scores of attitudes (P = 0.000) were associated with the scores of practice. Conclusion: The findings of the study emphasize that comprehensive measures of knowledge, attitude and practice should be taken to improve nurses' knowledge, attitudes, and practices regarding transfer anxiety in intensive care unit patients in order to reduce its adverse effects on ICU patients.

Insight into interactions between microplastics and fulvic acid: Mechanisms affected by microplastics type.

Microplastics (MPs) can interact with dissolved organic matter (DOM), a common component found in the environment. However, the effect of MPs type on its interaction with DOM has not been systematically studied. Therefore, the binding properties of different MPs with fulvic acid (FA) were explored in this study. The results showed that polypropylene (PP) and polyethylene (PE) had higher adsorption affinity for FA than polystyrene (PS) and polyvinyl chloride (PVC). The interaction between MPs and FA conformed to the pseudo-first-order model and Freundlich model (except PS). The interaction mechanisms between various MPs tested in this paper and FA are considered to be different. PP, PE and PS interacted with the aromatic structure of FA and were entrapped in the FA polymers by the carboxyl groups and CO bonds, resulting in a highly conjugated co-polymer, suggesting that oxygen-containing functional groups played a key role. However, it was assumed that the interaction between PVC and FA was more likely to be caused by hydrophobic interaction. This research will help to enhance our comprehension of the environmental behavior of MPs and their interaction with the DOM specifically.

Prevalence and associated factors of alexithymia in intensive care unit nurses.

AIMS: The aim of this study was to investigate the incidence of alexithymia in intensive care unit nurses and determine the associated factors. DESIGN: A multi-center, cross-sectional study. METHODS: In total, 485 nurses in intensive care unit were recruited from 53 hospitals in China. Data collection tools used in the study included demographic characteristics, the Social Support Rating Scale (SSRS), Emotional Intelligence Scale (EIS), and the 20-item Toronto Alexithymia Scale (TAS-20). SPSS 25.0 software (Corp., Armonk, NY, USA) was used to preform data analysis. RESULTS: About 43.7% of intensive care unit nurses were classified as alexithymia in the whole sample (males: 50%, females: 43%). The median TAS-20 score was 60 (interquartile range = 9). The study found that alexithymia was significantly associated with marital status, whether living alone, working years, and social support (Adjusted R Squared = 0.194, F = 6.466, p < 0.01), while emotional intelligence was not statistically significant with alexithymia. CONCLUSIONS: Alexithymia is a psychological problem with high incidence in intensive care unit nurses. In this study, being unmarried or divorced, living alone, and having fewer years of work (≤5 years) were associated with a higher risk of alexithymia. Interventions that strengthen social support may also help improve the mental health of ICU nurses.

[Application of noninvasive brain-edema dynamic monitoring in critically ill patients with traumatic brain injury].

Brain edema could be secondary to cerebral lesion caused by a variety of reasons, severe cases may result in brain herniation or even death. Accurate real-time monitoring of cerebral edema, rational application of dehydrating drugs, and timely treatment of cerebral edema were very important for patients. However, there were defects in the monitoring methods commonly used in clinical practice. Noninvasive brain-edema monitoring was a new method, which can quantify the degree of brain edema by electromagnetic disturbance and directly reflect the state of brain edema. This article reviews the application of noninvasive brain-edema monitoring in the treatment of in critically ill patients with traumatic brain injury.

Whole-course care in photodynamic therapy of colorectal cancer: A short communication.

Photodynamic therapy is now widely used in different oncologic fields. It is feasible for the treatment of early, non-surgical and non-obstructive cancers. Also, in gastroenterology, where it was a few attempts to treat both the premalignant lesion and advanced colorectal cancer. Photodynamic therapy provides a new treatment option for advanced colon cancer patients with severe obstruction and elderly patients whose cardiopulmonary function cannot tolerate surgery, and effective nursing support throughout the treatment is the key to ensure successful treatment. This study reported the effect of whole-course care for colorectal cancer patients undergoing photodynamic therapy in the Department of Surgical Oncology, Lanzhou University Second Hospital, Lanzhou, China.

Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis.

OBJECTIVE: Even though 32%-83% for fear of falling (FoF) in patients with stroke, very little is known about the predictors of the problems. Therefore, we systematically reviewed the literature on risk factors for FoF in patients with stroke. DESIGN: A systematic review and meta-analysis DATA SOURCES: PubMed, Embase, Cochrane Library database, Web of Science, CINAHL, PsycINFO, Grey literature and other relevant databases for related publications were searched (from inception to 17 July 2021). RESULTS: Eight studies involving 1597 participants were selected to analyse risk factors for patients with stroke with FoF. The quality of all included studies was assessed and categorised as medium or high quality. Review Manager V.5.3 merged the OR value and 95% CI of the potential risk factors. Meta-regression and Egger's test were performed by Stata V.15.1. The risk factors for FoF in patients with stroke were women (OR=2.13, 95% CI 1.47 to 3.09), impaired balance ability (OR=5.54; 95% CI 3.48 to 8.81), lower mobility (OR=1.12; 95% CI 1.05 to 1.19), history of falls (OR=2.33; 95% CI 1.54 to 3.53) and walking aid (OR=1.98; 95% CI 1.37 to 2.88), anxiety (OR=2.29; 95% CI 1.43 to 3.67), depression (OR=1.80; 95% CI 1.22 to 2.67), poor lower limb motor function (OR=1.14; 95% CI 1.00 to 1.29) and physically inactiveness (OR=2.04; 95% CI 1.01 to 4.12). Measurement of heterogeneity between studies was high for all outcomes (I2 =0%-93%), indicating that the substantial interstudy heterogeneity in estimated proportions was not attributed to the sampling error. Sensitivity analysis (leave-one-out method) showed that the pooled estimate was stable. CONCLUSION: This meta-analysis indicated that female population, impaired balance ability, lower mobility, history of falls and walking aid in patients with stroke might be at greater risk for FoF. Future studies are recommended to determine other risk factors specific to patients with stroke.

Machine Learning-Based Prediction Models for Delirium: A Systematic Review and Meta-Analysis.

OBJECTIVE: To critically appraise and quantify the performance studies by employing machine learning (ML) to predict delirium. DESIGN: A systematic review and meta-analysis. SETTING AND PARTICIPANTS: Articles reporting the use of ML to predict delirium in adult patients were included. Studies were excluded if (1) the primary goal was only the identification of various risk factors for delirium; (2) the full-text article was not found; and (3) the article was published in a language other than English/Chinese. METHODS: PubMed, Embase, Cochrane Library database, Web of Science, Grey literature, and other relevant databases for the related publications were searched (from inception to December 15, 2021). The data were extracted using a standard checklist, and the risk of bias was assessed through the prediction model risk of bias assessment tool. Meta-analysis with the area under the receiver operating characteristic curve, sensitivity, and specificity as effect measures, was performed with Metadisc software. Cochran Q and I2 statistics were used to assess the heterogeneity. Meta-regression was performed to determine the potential effect of adjustment for the key covariates. RESULTS: A total of 22 studies were included. Only 4 of 22 studies were quantitatively analyzed. The studies varied widely in reporting about the study participants, features and selection, handling of missing data, sample size calculations, and the intended clinical application of the model. For ML models, the overall pooled area under the receiver operating characteristic curve for predicting delirium was 0.89, sensitivity 0.85 (95% confidence interval 0.84‒0.85), and specificity 0.80 (95% confidence interval 0.81-0.80). CONCLUSIONS AND IMPLICATIONS: We found that the ML model showed excellent performance in predicting delirium. This review highlights the potential shortcomings of the current approaches, including low comparability and reproducibility. Finally, we present the various recommendations on how these challenges can be effectively addressed before deploying these models in prospective analyses.

Spatial Distributions and Intrinsic Influence Analysis of Cr, Ni, Cu, Zn, As, Cd and Pb in Sediments from the Wuliangsuhai Wetland, China.

The spatial distributions of Cr, Ni, Cu, Zn, As, Cd and Pb (potentially toxic elements, PTEs) in sediments and intrinsic influence factors from the Wuliangsuhai wetland of the Hetao Irrigation District, China were studied in this work. The results showed that excluding Zn, the total contents of other PTEs were higher than the background values, of which As (39.26 mg·kg-1) and Cd (0.44 mg·kg-1) were six-fold and seven-fold higher, respectively. Especially, the high levels of Cd (70.17%), Pb (66.53%), and Zn (57.20%) in the non-residual fraction showed high bioavailability and mobility. It indicated that PTEs can enter the food chain more easily and produce much toxicity. Based on Igeo, ICF, and MRI, the contamination of As was the most serious in the middle areas (MDP) of the wetland, and its risk was up to moderately strong. Cd and Pb posed moderate and considerate risk, respectively. Furthermore, 29.50% and 55.54% risk contribution ratio of As and Cd, respectively, showed that they were the dominant contaminants. In addition, the positive correlation between sand, OM, and total contents and chemical fractions of PTEs by using PCM, RDA, and DHCA indicated that physicochemical properties could significantly influence the spatial distributions of PTEs. The work was useful for assessing the level of pollution in the study area and acquiring information for future and possible monitoring and remediation activities.

Protective Effect of Conditioned Media of Human Fetal Dermal Mesenchymal Stem Cells Can Inhibit Burn-induced Microvascular Hyperpermeability.

Burns often cause loss of skin barrier protection, fluid exudation, and local tissue edema, which hinder functional recovery. Effectively improving the quality of deep burn wound healing, shortening the wound healing time, and reducing tissue fluid leakage are urgent problems in the medical field. Human mesenchymal stem cells (MSCs) can effectively stabilize vascular endothelial injury. Fetal dermal MSCs (FDMSCs) are a newly discovered source of MSCs derived from the skin of accidentally aborted fetuses. However, the effect of FDMSCs on vascular permeability remains poorly understood. In this study, conditioned media from FDMSCs (F-CM) extracted from fetal skin tissue was prepared. The effect of F-CM on vascular permeability was evaluated using the internal circulation method FITC-dextran in vivo, and several in vitro assays, including cell viability assay, transwell permeability test, immunofluorescence, and western blotting. Altogether, our results demonstrate that F-CM could inhibit burn-induced microvascular hyperpermeability by increasing the protein expression levels of occludin and VE-cadherin, while restoring the expression of endothelial F-actin, and providing the foundation of a novel therapy for the treatment of burns with F-CM.

Biofabrication of AuNPs using Coriandrum sativum leaf extract and their antioxidant, analgesic activity.

In this work, Gold nanoparticles (AuNPs) were synthesized by reducing aqueous Au metal ions upon interaction with Coriandrum sativum (C. sativum) leaf extract. The optical absorption peak for the synthesized AuNPs was obtained by using UV-visible spectroscopy within a range of 540-550 nm. The formation of diffraction peaks found at 2θ values of 78.00°, 66.05°, 44.85° and 38.48° that corresponds to the index planes (311), (220), (200), and (111) validate the effective synthesis of AuNPs. Transmission electron microscopy (TEM) was utilized to measure the size range of the spherical shaped nanoparticles, which is obtained to be 32.96 ± 5.25 nm. The peaks obtained from the FTIR results are closely linked to anthocyanins, benzophenones, flavonoids and phenols, which indicated that these biomolecules may serve as reducing agents. Additionally, studies of antioxidant function in vitro revealed that the activities of ABTS (2, 2'-azino-bis 3-ethylbenzthiazoline-6-sulfonic acid) and DPPH (2,2-diphenyl-1-picrylhydrazyl) were improved dose-dependently. Further, the results of analgesic analysis showed that the cumulative action of AuNPs and the C. sativum leaf extract in pain relief is more efficient than independent C. sativum leaf extract and the aspirin drug.