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Neuromuscular electrical stimulation (NMES) is a novel treatment method that stimulates patients' swallowing functions. This systemic review was designed to evaluate the impact of NMES on dysphagia in stroke patients. Databases including PubMed, Embase, Web of Science, and Cochrane Library were searched from the date of establishment to January 28th, 2022. Two investigators identified all included studies and compared the swallowing function after NMES treatment with traditional therapy (TT). The Cochrane risk bias assessment tool was utilized to analyze the quality of included studies. Research outcomes included Swallowing Quality of Life (SWAL-QoL), Penetration-Aspiration Scale (PAS), Functional Oral Intake Scale (FOIS), Dysphagia Outcomes and Severity Scale (DOSS), the Repeat Salivary Swallowing Test (RSST), and Water Swallowing Test (WST). We extracted the mean and standard deviation of specific outcomes at the baseline level and after the treatment in both NMES and TT groups for subsequent meta-analysis. 9 randomized controlled trials (RCTs) and quasi-RCTs were included, and remarkable differences were found between patients treated with or without NMES in respect of FOIS scores (SMD = 0.48; 95% CI 0.26-0.70, P < 0.0001), PAS scores (SMD = - 0.56; 95% CI 1.01-0.10, P = 0.02), and SWAL-QoL scores (SMD = 0.57; 95% CI 0.00-1.14, P = 0.05). No significant difference was manifested in WST, RSST, and DOSS (SMD: - 0.02; 95% CI 0.38-0.35, P = 0.93). Evidence suggests that NMES is more effective for post-stroke dysphagia patients than treatment without NMES.
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OBJECTIVE: Virtual reality (VR) and computer-assisted cognitive rehabilitation (CACR) are two emerging rehabilitation therapies for stroke patients. The aim of this study was to compare the rehabilitation efficacy of these two treatments for patients with post-stroke cognitive impairment (PSCI). METHODS: A network search of Embase, Web of Science, PubMed, Cochrane Library, VIP, WanFang Data, and CNKI databases was performed from their inception to February 2022 for screening randomized controlled trials related to VR and CACR in the treatment of PSCI. The quality of the included studies was assessed using the Cochrane risk bias assessment tool. The primary outcomes of the included studies contained at least one of the following clinical outcome measures: Mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MoCA). After screening the literature, assessing the quality and extracting the data, a network meta-analysis was performed with STATA software. RESULTS: A total of 21 randomized controlled trials were included, including 1,047 patients. The results of network meta-analysis showed that under MMSE index, VR group (p = 0.067) and CACR group (p = 0.054) tended to be superior to CT group, but it was not significant. Both the VR (p = 0.024) and CACR (p < 0.001) groups had significantly better outcomes compared to the conventional therapy group in terms of MoCA. The ranking results under both indicators showed that CACR had the best treatment effect, followed by VR. CONCLUSION: In general, VR and CACR have superior efficacy compared with conventional therapy, in which CACR may be the best treatment option.
Assuntos
Disfunção Cognitiva , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Realidade Virtual , Cognição , Computadores , Humanos , Metanálise em Rede , TecnologiaRESUMO
Myofibrillar protein (MPS) and myosin (MS) from grass carp was irradiated by γ-ray and electron beam (EB) irradiation with different dose (2, 4, 6, 8, and 10 kGy). The changes in the physicochemical properties (solubility, Ca2+ -ATPase activity, total and reactive sulfhydryl content, surface hydrophobicity [S0 -ANS]), and structure of MPS and MS were investigated in the present work. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis revealed that there were degradation and aggregation of MPS and MS caused by irradiation, and the disappearance of myosin heavy chains (MHC) irradiated by EB was earlier than that of irradiated by γ-ray. As compared with MPS, the extracted MS was more easily destroyed. With the increase of irradiation dose, the particle size, solubility, Ca2+ -ATPase activity, and SH content of MPS and MS decreased (p < .05), while the S0 -ANS first increased and then decreased. Two-way analysis of variance results suggested that the degree of protein denaturation depends on the irradiation mode and dose. Compared with γ-ray irradiation, the EB irradiation had a greater impact on the physicochemical properties of MPS and MS.
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Herein, we reported the successful development of novel nanocomposite films based on linear low density polyethylene (LLDPE) with enhanced anti-drop, optical, mechanical, thermal and water vapor barrier properties by introducing organophilic layered double hydroxides (OLDHs) nanosheets. OLDHs loadings were varied from 0-6 wt.%. Structural analyses using the Fourier transform infrared spectrum (FT-IR), X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) indicated that the OLDHs nanosheets were homogeneously dispersed with an ordered alignment in the LLDPE matrix. The LLDPE film containing 2 wt.% OLDHs (denoted as OLDHs-2) showed the optimal mechanical, thermal and water vapor barrier properties, whilst the anti-drop and optical performance of the films improved with increasing OLDHs content. The enhanced antidrop properties of the composite films relative to pristine LLDPE can be expected to effectively reduce agricultural losses to disease when the films are applied as agricultural films, whilst the superior light transmittance and water-retaining properties of the composite films will boost agricultural production. Results presented suggest that multifunctional LLDPE/OLDHs nanocomposites show great promise as low cost agricultural plastic films.