Early Enteral Nutrition and Sepsis-Associated Acute Kidney Injury: A Propensity Score Matched Cohort Study Based on the MIMIC-III Database.

PURPOSE: We aimed to analyze the optimal timing of enteral nutrition (EN) in the treatment of sepsis and its effect on sepsis-associated acute kidney injury (SA-AKI.). MATERIALS AND METHODS: The MIMIC-III database was employed to identify patients with sepsis who had received EN. With AKI as the primary outcome variable, receiver operating characteristic (ROC) curves were utilized to calculate the optimal cut-off time of early EN (EEN). Propensity score matching (PSM) was employed to control confounding effects. Logistic regressions and propensity score-based inverse probability of treatment weighting were utilized to assess the robustness of our findings. Comparisons within the EEN group were performed. RESULTS: 2364 patients were included in our study. With 53 hours after intensive care units (ICU) admission as the cut-off time of EEN according to the ROC curve, 1212 patients were assigned to the EEN group and the other 1152 to the delayed EN group. The risk of SA-AKI was reduced in the EEN group (odds ratio 0.319, 95% confidence interval 0.245-0.413, p<0.001). The EEN patients received fewer volumes (mL) of intravenous fluid (IVF) during their ICU stay (3750 mL vs. 5513.23 mL, p<0.001). The mediating effect of IVF was significant (p<0.001 for the average causal mediation effect). No significant differences were found within the EEN group (0-48 hours vs. 48-53 hours), except that patients initiating EN within 48 hours spent fewer days in ICU and hospital. CONCLUSION: EEN is associated with decreased risk of SA-AKI, and this beneficial effect may be proportionally mediated by IVF volume.

Resilience Improves the Sleep Quality in Disabled Elders: The Role of Perceived Stress.

The current research aims to prove the impact of resilience on sleep quality and to investigate the mediating function of perceived stress in the paths from resilience to sleep quality among disabled Chinese elders. The participants were 196 elders with visual and physical disability who resided in the nursing houses in Shanghai, including 102 males and 94 females whose mean age was 74.5 years old (standard deviation = 6.81). All the elders were measured with the 10-item Connor-Davidson Resilience Scale, Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale. The results showed that all the demographic variables were significantly related to perceived stress and PSQI scores. High levels of resilience could significantly enhance the quality of sleep in disabled Chinese elders. In addition, the two-step mediation models also confirmed the impact of resilience on sleep quality as mediated through perceived stress in this special aged population. Better knowledge on the mechanisms of sleep quality among older adults could benefit the prevention and treatment of some geriatric diseases.

Religion Affiliation and Depression Risk: Factory Workers Working in Hi-Tech Companies in Shanghai, China.

This study examines factors contributing to depression among migrant factory workers in Shanghai. A survey was designed with mental health questions under a framework explaining: (1) social capital, (2) migratory stress, and (3) mental health consequences. With a return rate of 98.3%, 1966 individuals completed the survey. Only 11.1% of the respondents indicated having a religious affiliation. The findings are not surprising about the relationship between trust, economic condition, and depression. However, it is surprising to find that not having a religious affiliation is significantly connected to better mental health. The effect of religious beliefs should be examined as a trust factor to remove the barrier of perceiving religion as an added stressor.

Functional role of EMMPRIN in the formation and mineralisation of dental matrix in mouse molars.

Our previous research has shown that the extracellular matrix metalloproteinase inducer (EMMPRIN) is expressed during and may function in the early development of tooth germs. In the present study, we observed the specific expression of EMMPRIN in ameloblasts and odontoblasts during the middle and late stages of tooth germ development using immunohistochemistry. Furthermore, to extend our understanding of the function of EMMPRIN in odontogenesis, we used an anti-EMMPRIN function-blocking antibody to remove EMMPRIN activity in tooth germ culture in vitro. Both the formation and mineralisation of dental hard tissues were suppressed in the tooth germ culture after the abrogation of EMMPRIN. Meanwhile, significant reductions in VEGF, MMP-9, ALPL, ameloblastin, amelogenin and enamelin expression were observed in antibody-treated tooth germ explants compared to control and normal serum-treated explants. The current results illustrate that EMMPRIN may play a critical role in the processing and maturation of the dental matrix.