The current status and influencing factors of oral frailty in elderly maintenance hemodialysis patients based on the Andersen Oral Health Outcome Model.

OBJECTIVES: To analyse the elements that influence oral frailty in elderly maintenance hemodialysis patients and to comprehend the present state of this condition. METHODS: A survey of 325 elderly maintenance hemodialysis patients from three hospitals in Huzhou City was conducted using a general information questionnaire, the Oral Health Assessment Tool, the Knowledge, Attitude, and Practice of Oral Health Questionnaire, the Social Frailty, the Frail Scale, and the Oral Frailty Index. RESULTS: In elderly maintenance hemodialysis patients, the prevalence of oral frailty was 45.2%. Factors influencing it include the Oral Health Knowledge Score (OR = 0.84, 95% CI 0.72-0.98), Oral Health Behavior Score (OR = 0.95, 95% CI 0.92-0.98), insufficient dialysis (OR = 0.30, 95% CI 0.14-0.63), social frailty (OR = 3.72, 95% CI 1.57-8.83), physical frailty (OR = 3.12, 95% CI 1.55-6.30), number of missing teeth (OR = 1.09, 95% CI 1.03-1.15), swallowing abnormalities (OR = 2.84, 95% CI 1.26-6.38), and oral health scores (OR = 1.34, 95% CI 1.14-1.57) (P < 0.05). CONCLUSION: Patients on elderly maintenance hemodialysis are more susceptible to oral frailty. Nursing staff should develop scientifically sound, effective, and targeted oral management strategies for these patients.

Effectiveness of smartphone app-based interventions after surgery on quality of recovery among cancer patients: a systematic review and meta-analysis.

BACKGROUND: Postoperative recovery in patients with cancer is a complex process that influences quality of life, functional recovery, and mental well-being. Smartphone app-based interventions have emerged as potential tools for improving various aspects of health and well-being in cancer patients. However, the existing literature lacks a consensus on the efficacy of these interventions, leading to conflicting outcomes. METHODS: We searched multiple databases, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, and MEDLINE Complete (EBSCO). We exclusively selected randomized controlled trials meeting the inclusion criteria for our systematic review and meta-analysis. Utilizing a random-effects model, we derived the pooled effect size estimates for the meta-analysis. Where applicable, we calculated the pooled standardized mean difference (SMD) with 95% confidence interval (CI). The Cochrane Collaboration tool (Cochrane ROB) was used to evaluate bias in randomized trials. The primary outcome was the quality of life. The secondary outcomes were psychological symptoms, health conditions, satisfaction, and self-efficacy. RESULTS: Of 731 screened articles, 15 were included, comprising 1,831 participants. Our meta-analysis revealed that app-based interventions potentially improved quality of life (SMD =  -0.58, 95% CI -1.00 to -0.16), alleviated psychological symptoms (SMD =  -0.43, 95% CI -0.72,-0.15; p = .003), and enhanced self-efficacy (SMD = 0.90, 95% CI 0.26 to 1.53; p  =  0.001). However, there was no statistically significant effect on satisfaction (SMD = 1.25, 95% CI-1.06 to 3.57; p  =  0.23). CONCLUSIONS: Our findings suggest that mobile health apps hold promise in improving the well-being of cancer patients after surgery by enhancing their quality of life, health status, and self-efficacy, while also reducing anxiety and depression.

Many smartphone apps focus on managing health, particularly for activities such as exercise and preventing diseases such as obesity, diabetes, and mental health; however, there is a noticeable absence of specialized health management apps tailored for cancer patients after surgery. Smartphone app-based interventions have the potential to enhance quality of life, health status, self-efficacy, and decrease feelings of anxiety and depression in adult cancer patients after surgery.

Safeguarding China's long-term sustainability against systemic disruptors.

China's long-term sustainability faces socioeconomic and environmental uncertainties. We identify five key systemic risk drivers, called disruptors, which could push China into a polycrisis: pandemic disease, ageing and shrinking population, deglobalization, climate change, and biodiversity loss. Using an integrated simulation model, we quantify the effects of these disruptors on the country's long-term sustainability framed by 17 Sustainable Development Goals (SDGs). Here we show that ageing and shrinking population, and climate change would be the two most influential disruptors on China's long-term sustainability. The compound effects of all disruptors could result in up to 2.1 and 7.0 points decline in the China's SDG score by 2030 and 2050, compared to the baseline with no disruptors and no additional sustainability policies. However, an integrated policy portfolio involving investment in education, healthcare, energy transition, water-use efficiency, ecological conservation and restoration could promote resilience against the compound effects and significantly improve China's long-term sustainability.

Global analysis of the COVID-19 policy activity levels and evolution patterns: A cross-sectional study.

Background and Aims: Since the beginning of the coronavirus disease 2019 (COVID-19), a large number of government policies have been implemented worldwide in response to the global spread of COVID-19. This paper aims at developing a data-driven analysis to answer the three research questions: (a) Compared to the pandemic development, are the global government COVID-19 policies sufficiently active? (b) What are the differences and characteristics in the policy activity levels at the country level? (c) What types of COVID-19 policy patterns are forming? Methods: Using the Oxford COVID-19 Government Response Tracker data set, we present a global analysis of the COVID-19 policy activity levels and evolution patterns from January 1, 2020 to June 30, 2022, based on the differential expression-sliding window analysis (DE-SWAN) algorithm and the clustering ensemble algorithm. Results: Within the period under study, the results indicate that (a) the global government policy responses to COVID-19 are very active, and the policy activity levels are significantly higher than those of global pandemic developments; (b) a high activity of policy is positively correlated to pandemic prevention at the country level; and (c) a high human development index (HDI) score is negatively correlated to the country policy activity level. Furthermore, we propose to categorize the global policy evolution patterns into three categories: (i) Mainstream (152 countries); (ii) China; and (iii) Others (34 countries). Conclusion: This work is one of the few studies that quantitatively explores the evolutionary characteristics of global government policies on COVID-19, and our results provide some new perspectives on global policy activity levels and evolution patterns.