Exploring the Impact of COVID-19 Restrictions on Nursing Home Residents', Families', and Staff's Perceptions of Bioethical Principles: A Qualitative Study.

In this study, we employed a pre-interview survey and conducted interviews with nursing home staff members and residents/family members to understand their perceptions of whether the COVID-19 restrictions fulfilled obligations to nursing home residents under various principles, including autonomy, beneficence, nonmaleficence, justice, and privacy. We conducted 20 semi-structured interviews with staff members from 14 facilities, and 20 with residents and/or family members from 13 facilities. We used a qualitative descriptive study design and thematic analysis methodology to analyze the interviews. Findings from the pre-interview survey indicated that, compared to nursing home staff, residents and their families perceived lower adherence to bioethics principles during the pandemic. Qualitative analysis themes included specific restrictions, challenges, facility notifications, consequences, communication, and relationships between staff and residents/family members. Our study exposes the struggle to balance infection control with respecting bioethical principles in nursing homes, suggesting avenues for improving processes and policies during public health emergencies.

The mediating effects of social support and depressive symptoms on activities of daily living and social frailty in older patients with chronic heart failure.

OBJECTIVES: To investigate the level of social frailty (SF) in older patients with chronic heart failure (CHF) and examine the mediating role of social support and depressive symptoms between activities of daily living and SF. METHODS: Using a convenience sampling method, 205 older patients with CHF were recruited from China between November 2021 and May 2022. Activities of daily living, social support, depressive symptoms, and SF were assessed using a self-administered questionnaire. Data were analyzed using structural equation modeling. RESULTS: The final model obtained a good fit. Activities of daily living in older patients with CHF were directly related to SF. The multiple mediation analysis revealed that the relationship between activities of daily living and SF was mediated by social support (effect: -0.010, 95% CI [-0.021, -0.003]) and depressive symptoms (effect: -0.011, 95% CI [-0.019, -0.005) separately, and serially (effect: -0.007, 95% CI [-0.012, -0.003). CONCLUSIONS: Social support and depressive symptoms are multiple mediating variables in the relationship between activities of daily living and SF. Activities of daily living can improve patients' SF through social support and depressive symptoms.

A novel nomogram for predicting risk of malnutrition in patients with heart failure.

Background and aims: This study aimed to explore the risk factors of malnutrition in patients with heart failure and construct a novel nomogram model. Methods and results: A cross-sectional study based on the STROBE checklist. Patients with heart failure from July 2020 to August 2021 were included. Patients were divided into a malnutrition group and a normal nutrition group based on the Society's recommended AND-ASPEN standard. Logistic regression was used to analyze the independent risk factors for malnutrition. A new prediction model of nomogram was constructed based on the risk factors, and its fit and prediction performance were evaluated. Of 433 patients, 66 (15.2%) had malnutrition and 367 (84.8%) had normal nutrition, Logistic regression analyses showed that the risk factors for malnutrition were total protein, hemoglobin, triglyceride, and glucose levels. The regression model based on the above four variables showed an area under the curve of 0.858. The novel nomogram model had a sensitivity of 78.5% and a specificity of 77.3%. After 2000 bootstrap resampling iterations, AUC was 0.852. Conclusions: The novel nomogram model can predict the odds of malnutrition in patients with heart failure at the early stage of admission, and can provide a reference for nursing staff to optimize nutritional care for inpatient with heart failure and to develop a discharge nutritional care plan.

Prevalence of cognitive frailty among older adults in China: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to investigate the prevalence of cognitive frailty among older adults in China. DESIGN: Systematic review and meta-analysis. METHODS: We searched the Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure(CNKI), Wanfang, Chinese Biomedical Literature and Weipu (VIP) databases to collect information on the epidemiology of cognitive frailty among older adults in China. The study period was from the establishment of the database to March 2022. Two researchers independently screened the literature, extracted the data and assessed the risk of bias in the included studies. All statistical analyses were performed using Stata V.15.0. RESULTS: We screened 522 records, of which 28 met the inclusion criteria. The results of the meta-analysis showed that the prevalence of cognitive frailty among older adults in China was 15%(95%CI (0.13%,0.17%)). The prevalence of cognitive frailty was higher in hospitals and nursing homes than in communities. Moreover, the prevalence of cognitive frailty was higher in women than in men. Furthermore, the prevalence rates of cognitive frailty in North China Hospital, older adults aged≥80 years, and illiterate individuals were 25%, 29%, and 55%, respectively. CONCLUSIONS: In conclusion, in China, the prevalence of cognitive frailty is higher among older adults, is higher in women than in men, is higher in hospitals and nursing homes than in communities, and is higher in North China than other regions. Moreover, the higher the educational level, the lower the prevalence of cognitive frailty. Multimodal interventions for cognitive frailty, including increased exercise, nutritional support, increased socialisation opportunities and multifactorial strategies, may be effective in preventing cognitive frailty. These findings have important implications for adjusting healthcare and social care systems. PROSPERO REGISTRATION NUMBER: CRD42023390486.

Fiber Nanoarchitectonics for Pre-Treatments in Facile Detection of Short-Chain Fatty Acids in Waste Water and Faecal Samples.

Short-chain fatty acids (SCFAs) are among the active metabolites in biological process both in the intestinal tract and the bioconversion of organic wastes, which has resulted in various human diseases and environmental problems. In order to accurately detect SCFAs, we introduced a novel extraction sorbent. Electrospun polyacrylonitrile (PAN) nanofiber membrane was synthesized, then poly (3, 4-Ethylenedioxythiophene) (PEDOT) was deposited onto the surface of electrospun PAN nanofibers by in situ polymerization. The morphology of the composite PAN/PEDOT nanofiber was characterized by scanning electronic microscopy (SEM) and FTIR spectrum. PAN/PEDOT was used to isolate and concentrate the SCFAs in waste water and fecal samples before gas chromatography mass spectrometry (GC-MS) analysis. The analytical method was evaluated systematically, and low limits of detection (LODs) of 0.34-0.87 µg/L and good linearity (R2 ≥ 0.9953) were obtained. The method was applied successfully for the determination of SCFAs in waste water and fecal samples, with good recovery (87.5-104.6%) and satisfactory reproducibility (relative standard deviation: 6.5-14.1%). The results indicated that the proposed method can be used as a potential approach for the determination of SCFAs with high sensitivity in waste water and biological samples.

[The effects of sustained military occupational activities on inhibitory control ability in low temperature environment].

Objective: To evaluate the effects of sustained military occupational activities on inhibitory control ability in low temperature environment, which could provide a basis for accurate military physical training. Methods: Twenty healthy male young cadets (mean age: (23. 32±1. 62)y; height: (175. 34±4. 14)cm; body weight: (68. 19±3. 12)kg) were enrolled in this experiment. A number of military tasks last 36 hours were completed in the ordinary (16℃～23℃) and low(-3℃～-1℃) temperature environment, and the RR interval and core temperature were recorded. The stroop-word-color test and critical frequency test were performed before and after the activities. Results: Compared with rest, the heart rate, excess post-exercise oxygen consumption and training impulse were increased significantly (P＜0. 05) in military occupational activities, however there was no significant difference between the two activities (P＞0. 05). Compared with the rest, the average and maximum core temperature were increased significantly (P＜0. 05), however, compared with the ordinary temperature environment, the average core temperature in the low temperature environment was increased significantly (P＜0. 05), and there was no significant difference in the maximum core temperature (P＞0. 05). Compared with rest, the inhibitory control ability after the two activities was significantly lower (P＜0. 05), which was much worse in the low temperature environment than that in the ordinary temperature environment (P＜0. 05). In addition, compared with rest, both activities led to obvious mental fatigue (P＜0. 05), which was more serious in low temperature environment (P＜0. 05). Conclusion: The sustained military activities can impair the inhibitory control ability, and cause the mental fatigue, in addition, the stress of low temperature can aggravate the negative effects.

[Effects of sustained military physical related activity on balance ability].

OBJECTIVE: To evaluate the effects of sustained military physical related activity on balance abilities and the role of visual system in it, so as to provide the basis for precise training. METHODS: Fifty-four healthy males (age: 20.28±3.72 y, height: 173.21±5.67 cm; weight: 64.29±5.12 kg) were recruited in this experiment. Multiple military subjects were completed within 36 hours, and the workload was recorded (randomly select 11 people). After military activity, the balance abilities with opened eyes (54 people) and closed eyes (randomly selected 27 people) were evaluated. RESULTS: In terms of internal load, the heart rates (HR), excess post-exercise oxygen consumption (EPOC) and training impulse (TRIMP) for all exercises were increased significantly in military activity compared with rest (P＜0.05). Regard to balance abilities, compared to the rest with eyes-opened, the sway path-total (SPT), sway path-A-P ( SPAP ), sway path-M-L (SPML), sway V-total (SVT), sway V-A-P (SVAP), and sway V-M-L (SVML)after sustained military activity with eyes-opened were increased significantly (P＜0.05), while sway maximal amplitude-A-P (SMAAP), sway maximal amplitude-M-L (SMAML), and area of 100% ellipse (AE) had no significant changes; Compared to the rest, all indicators after the military activity with eyes-closed were significantly increased (P＜0.05). So vision could control the amplitude and area after the military activity. CONCLUSION: Sustained military related activity can damage the balance ability. After sustained military activity, the degree of damage of the balance ability in the closed-eyes is greater than that of the open-eyes, the amplitude and range of the center of gravity are increased, indicates that the visual system plays major role in controlling attitude stability.

[Effect of lower-limb dominance and non-dominance shuttle runs under load carriage on the balance responses in young cadets].

OBJECTIVE: This test was designed to evaluate the effect of lower-limb dominance and non-dominance shuttle runs under load carriage during different exercise load at the same exercise intensity on the balance responses. METHODS: Ten healthy young males were joined in this experiment, they were (20.80±2.04) years old and (173.99±2.87) cm tall. In a randomized cross-over design, they performed four times shuttle runs under unilateral load carriage:20 m×5 at dominant side, 20 m×5 at non-dominant side, 20 m×10 at dominant side, 20 m×10 at non-dominant side respectively. Balance abilities were evaluated immediately and 20 minute post-exercise respectively, and R-R interval was recorded. RESULTS: The HR, EPOC and TRIMP for all exercise load were increased significantly after shuttle runs compared to rest (P<0.01), the EPOC and TRIMP for 20 m×10 shuttle runs were significantly higher than those for 20 m×5 shuttle runs at the dominant and non-dominant side (P<0.01). Compared to the rest, the instability indices (general, anteroposterior and mediolateral movement) for 20 m×5 and 20 m×10 shuttle runs immediately post-exercise at the dominant and non-dominant side were increased significantly (P<0.05), and the magnitude of the mediolateral movement for 20 m×10 shuttle runs was higher than that of 20 m×5 shuttle runs (P<0.05). While there were no obvious difference between the dominant and the non-dominant side (P>0.05), which showed symmetrical change. In addition, during 20 minute recovery, the balance ability for all exercise load was returned to the rest value (P>0.05). CONCLUSIONS: The shuttle runs could impair the trunk control ability immediately post-exercise, the magnitude of mediolateral movement was increased as the exercise load increased. The changes of balance responses were similar between the dominant and the non-dominant side, the dominant and the non-dominant side might show cross-effects.