κ-Carrageenan masking bitterness perception in surimi gels containing potassium chloride-based salt substitutes: Gel properties, oral processing, and sensory evaluation.

κ-Carrageenan (CG) was employed to mask the bitterness induced by 50% KCl in surimi gels to achieve salt reduction and gel performance improvement. The combination of KCl and CG (KCl + CG) yielded the increased textural characteristics and water-holding capacity (WHC) of surimi gels and facilitated the transition of free water to immobilized water. In addition, the KCl + CG supplement increased the turbidity and particle size of myofibrillar protein (MP) sols but decreased the surface hydrophobicity in a dose-dependent manner. The hydrophobic interactions and disulfide bonds played crucial roles in maintaining the stability of MP gels. The specific binding of potassium ions to the sulfate groups of CG limited the release and diffusion of potassium ions from the surimi gels during oral processing, effectively masking the bitterness perception and maintaining the saltiness perception. This study provides a promising strategy to reduce the utilization of sodium salt in surimi products.

Comparative efficacy and acceptability of different exercise patterns for reducing cardiovascular events in pre-diabetes: protocol for a systematic review and network meta-analysis of randomised controlled trials.

INTRODUCTION: Exercise has been used to reverse dysglycaemic states in patients with pre-diabetes. Systematic reviews show that exercise is an effective way to reduce the incidence of diabetes, but there is conflicting evidence for reducing the occurrence of cardiovascular events. Therefore, we present a systematic review and network meta-analysis protocol designed to compare the effectiveness of different forms of exercise in reducing cardiovascular events and their tolerability in different populations. METHODS AND ANALYSIS: We will include all randomised controlled trials and compare one exercise intervention to another. We will compare the following exercise patterns: standard endurance training, strength training, high-intensity interval training, mind-body exercise, and mixed strength and aerobic training. The primary outcomes are the occurrence of major cardiovascular events and the rate of patient attrition during the intervention. We will search major English and Chinese databases as well as trial registry websites for published and unpublished studies. All reference selection and data extraction will be conducted by at least two independent reviewers. We will conduct a random effects model to combine effect sizes and use the surface under the cumulative ranking curve and the mean ranks to rank the effectiveness of interventions. All data will be fitted at WinBUGS in a Bayesian framework and correlation graphs will be plotted using StataSE 14. We will also use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework to evaluate the quality of evidence for the study results. ETHICS AND DISSEMINATION: This study does not involve a population-based intervention, and therefore, does not require ethical approval. We will publish the findings of this systematic review in a peer-reviewed scientific journal, and the dataset will be made available free of charge. The completed review will be disseminated electronically in print and on social media, where appropriate. PROSPERO REGISTRATION NUMBER: CRD42023422737.

Prognostic factors in lung transplantation after extracorporeal membrane oxygenation bridging therapy: a systematic review and meta-analysis.

Background: Extracorporeal membrane oxygenation (ECMO) has recently emerged as a critical support system for lung function in patients awaiting lung transplantation. This meta-analysis investigates the prognostic factors of lung transplantation following ECMO bridging therapy. Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, and ProQuest databases from inception to August 11, 2023. Included were cohort or case-control studies focusing on prognostic factors of lung transplantation with ECMO bridging therapy. Data extraction was performed independently, and study quality was assessed. A meta-analysis was carried out using RevMan 5.4 and Stata17.0 software to aggregate mortality rates and pertinent prognostic factors of ECMO as a bridge to lung transplantation. Results: The search identified eight trials encompassing 1,086 participants. The prognosis of patients undergoing lung transplantation with ECMO bridging was significantly associated with several factors: prolonged ECMO support [odds ratio 1.07, 95% confidence interval (CI): 1.02-1.12, I2=77%], deterioration in liver and kidney function (odds ratio 3.62, 95% CI: 2.37-5.54, I2=0%), and complications during ECMO (odds ratio 2.24, 95% CI: 1.45-3.44, I2=5%). Conclusions: Prolonged ECMO support, declining liver and kidney functions, and complications during ECMO are vital prognostic factors in lung transplantation following ECMO bridging therapy.

Exploring the Roles of Nurses in Medication Reconciliation for Older Adults at Hospital Discharge: A Narrative Approach.

Medication reconciliation (MR) is the process of comparing a patient's medication orders to all of the medications that the patient has been taking in order to identify and resolve medication discrepancies. It is an effective means of risk management to avoid medication errors (eg, omissions, duplication, dosage errors, or drug interactions). Some guidelines explicitly state that MR is a pharmacist-led transition of care; however, there is a shortage of qualified pharmacists to meet the increasing clinical needs, and clinical nurses' roles have not been clearly described. This paper aimed to enable nurses to gain confidence in contributing to MR at discharge and to make the industry aware of the potential risks if nurses do not actively intervene in this area. A narrative approach was used to introduce experiences in identifying discrepancies and medication errors through MR at discharge in a geriatric ward of an academic medical center hospital in China. The nurses' main roles in MR involve chasing, checking, and education. Clinical nurses, an untapped hospital resource, can actively engage in MR at discharge if they receive effective training and motivation. Multidisciplinary collaboration at discharge allowed many discrepancies to be reconciled before harming older patients. It is worth conducting further research in MR when discharging older adults, such as the cost-effectiveness of nurses' efforts, the value of electronic tools and the impact of MR-targeted education and training for nursing students and nursing staff.

Visualization and analysis of knowledge domains for recent developments in coal mechanical properties studies.

To better understand the research progress and trends in the mechanical properties of coal, and to promote theoretical research on the prevention and control of dynamic disasters, we employed the bibliometric method to analyze the research progress in this field. A total of 3450 documents from the Web of Science (WOS) core database were reviewed and analyzed. Our analysis focused on the annual distribution of literature, the distribution by country/region, organization, and author, as well as the distribution of significant source journals. We also identified research hotspots and frontiers. The results indicate a significant increase in the number of research papers on the mechanical properties of coal. China, America, Australia, India, Spain, Poland, England, Japan, South Korea, and Turkey were found to be the most active countries in this research area. The research results from China, America, and Australia were found to be the most influential, and C&BM, FUEL, INT J ROCK MECH MIN, INT J COAL GEOL, RM&RE, C&CR, and JCP were identified as the primary sources of research publications on the mechanical properties of coal. The basic theory and research system of coal mechanical properties investigation have been established, and there are numerous future research directions and areas to explore. Some current hotspots include the development of coal mechanical property models, permeability models related to mechanical properties, establishment and prediction of coal strength-temperature relationships, investigation of the proportioning scheme of granite and coal bottom ash in concrete mixes, and research on the improvement effect of fly ash on concrete manufacturing properties.

Pulmonary rehabilitation protocols in urgent lung transplantation patients.

BACKGROUND: Prolonged invasive respiratory support and extracorporeal membrane oxygenation (ECMO) in patients requiring urgent lung transplantation (ULTx) present significant challenges to clinical practice due to severe underlying diseases and complex conditions. The aim of the study was to report the clinical outcomes of patients who received ULTx and followed the perioperative rehabilitation protocol implemented in a lung transplant center. METHODS: A retrospective analysis was conducted in ULTx patients who required preoperative invasive mechanical ventilation (IMV) and ECMO between January 2018 and January 2023. Data were retrieved from electronic medical records at our lung transplant center. RESULTS: Fourteen patients (mean age 57.43±10.97 years; 12 males, 2 females) underwent ULTx with bridging ECMO and IMV. The mean body mass index was 23.94±3.33 kg/m², and the mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 21.50±3.96. The Nutritional Risk Screening 2002 (NRS 2002) scores were ≥3. ULTx was performed after an 8.5-day waiting period (interquartile interval [IQR] 5.0-26.5 d). Following the surgeries, the average lengths of ECMO and IMV were 1.0 (IQR 1.0-2.0) d and 5.0 (IQR 3.0-7.3) d, respectively. The total length of hospital stay was 60.1±30.8 d, with an average intensive care unit stay of 38.3±22.9 d and post-operative hospitalization stay of 45.8±26.1 d. Two patients died within 30 d after ULTx, with a 30-day survival rate of 85.71%. CONCLUSION: Patients receiving ULTx showed an acceptable short-term survival rate, validating the practicality and safety of the treatment protocols implemented in our center.

Analysis of Amplitude Modulation of EEG Based on Holo-Hilbert Spectrum Analysis During General Anesthesia.

OBJECTIVE: The study aims to investigate the relationship between amplitude modulation (AM) of EEG and anesthesia depth during general anesthesia. METHODS: In this study, Holo-Hilbert spectrum analysis (HHSA) was used to decompose the multichannel EEG signals of 15 patients to obtain the spatial distribution of AM in the brain. Subsequently, HHSA was applied to the prefrontal EEG (Fp1) obtained during general anesthesia surgery in 15 and 34 patients, and the α-θ and α-δ regions of feature (ROFs) were defined in Holo-Hilbert spectrum (HHS) and three features were derived to quantify AM in ROFs. RESULTS: During anesthetized phase, an anteriorization of the spatial distribution of AMs of α-carrier in brain was observed, as well as AMs of α-θ and α-δ in the EEG of Fp1. The total power ([Formula: see text]), mean carrier frequency ([Formula: see text]) and mean amplitude frequency ([Formula: see text]) of AMs changed during different anesthesia states. CONCLUSION: HHSA can effectively analyze the cross-frequency coupling of EEG during anesthesia and the AM features may be applied to anesthesia monitoring. SIGNIFICANCE: The study provides a new perspective for the characterization of brain states during general anesthesia, which is of great significance for exploring new features of anesthesia monitoring.

A Hierarchical Multi-Dimensional Cognitive Training Program for Preventive Cognitive Decline in Acute Ischemic Stroke Patients: Study Protocol for a Randomized Controlled Trial.

Background: One of the most popular ways to address cognitive decline is cognitive training. The fact that cognitive deterioration is permanent is one of the main issues. This issue might be resolved by preventive cognitive training when it is acute. As a result, this study aims to design and assess how well stroke patients respond to hierarchical, multi-dimensional preventative cognitive training. Objective: To describe the study design of this center implementation trial. Methods: Participants in the study will be recruited from a hospital in China and randomly assigned to the intervention group or the usual care group. Interventions will include four-week hierarchical multi-dimensional preventive cognitive training through a WeChat program. for Primary outcome measures will be the Montreal Cognitive Assessment, Mini-Mental State Examination, and Post-Stroke Cognitive Impairment (PSCI) Incidence. The secondary outcome measure will include the Hamilton Depression Scale, Hamilton Anxiety Scale, Modified Barthel Index, and National Institutes of Health Neurological Deficit Score. Outcomes will be measured at baseline, 12 weeks, and 24 weeks from the baseline. Results: We expect that the hierarchical multi-dimensional preventive cognitive training program will be easy to implement, and the cognitive function, cognitive psychology, ability of daily living will vary in each setting. Conclusions: The results will provide evidence highlighting differences in a new strategy of cognitive training through the WeChat program, which allows the home-based practice, puts forward an advanced idea of preventive cognitive training in the acute stage, and has the highest effectiveness of reducing cognitive impairment, and Alzheimer's disease.

The Rate of Infusion Represents an Important Aspect of Administering Anticancer Agents.

Background: Infusion rate is one of the essential elements that should be included in all intravenous orders. Patients may experience adverse consequences or risks associated with inappropriate infusion. Meanwhile, there is growing pressure on the chemotherapy unit to deliver treatment quickly, efficiently, and safely, and thus it is very necessary to improve the chemotherapy process and service to cancer patients. Clinicians should consider how to further standardize infusion therapy, and innovate new infusion strategies to increase efficacy, reduce toxicity, improve patient satisfaction and save health resource costs. Sporadic studies have evaluated the effects of infusion rates of anticancer agents on clinical outcomes, economic benefits, and administration efficiency. However, an update review has not been available. Methods: Relevant literature was identified by search of PubMed until September 2023. Results: Infusion rates may have significant effect on the efficacy of anticancer agents (e.g., methotrexate, fluorouracil, and arsenic trioxide). Slow infusion is safer for platinum compounds, doxorubicin and carmustine, whereas fast infusion is safer than slow infusion of gemcitabine. Optimal flow rates of paclitaxel and fluorouracil are based on the balance between multiple risks of toxicity. Optimal infusion rate may bring economic benefits. If efficacy and safety are not compromised, shortened infusion may result in higher patient satisfaction, improved institutional efficiency and more nursing time available for other activities (e.g., biosimilar products, endostar). Other concerns about infusion rate include clinical indications (eg, paclitaxel and rituximab, methotrexate), severity and type of hypersensitivity reactions (e.g., platinum compounds), formulation features (e.g., paclitaxel, doxorubicin), and genetic polymorphism (e.g., gemcitabine, methotrexate). Conclusion: The latest knowledge of infusion rate concerns will enhance the appropriateness and accuracy in intravenous administration. Interdisciplinary teams should collaborate and implement relevant risk management and healthcare policy. It is worthwhile to conduct comparative studies of intravenous therapy with different infusion speeds.

Reliability and validation of the Chinese version of the epilepsy surgery satisfaction questionnaire.

OBJECTIVE: To evaluate the reliability and validity the Chinese version of 19-item Epilepsy Surgery Satisfaction Questionnaire (C-ESSQ-19) in Chinese mainland patients. METHODS: Patients with epilepsy who had epilepsy surgery in our hospital one year earlier were included. Internal consistency and test-retest reliability were assessed by using Cronbach alpha and intraclass correlation coefficient (ICC). Confirmatory factor analysis was used for construct validity. Discriminant validity was assessed using receiver operating characteristic curve analysis. RESULTS: A total of 132 patients participated in our study, consisting of 59 females and 73 males. The C-ESSQ-19 yielded a median summary score of 86.5 (IQR=72.7-98.0). The Cronbach's alpha of the four domains of the C-ESSQ-19 ranged from 0.746 to 0.973. The test-retest reliability evaluated by ICC were good to excellent, ranging from 0.71 to 0.90 (P < 0.001). The C-ESSQ-19 demonstrated excellent construct validity, as indicated by the satisfactory goodness-of-fit of the data (SRMR = 0.046; CFI = 1.000). It exhibited acceptable discriminant validity for differentiating between patients excised or not (AUC = 0.72; 95% CI = 0.59-0.86) and self-rated severity of epilepsy (AUC = 0.76, 95% CI = 0.67-0.86), but poor discriminant validity for other factors, such as being seizure-free or not (AUC = 0.66, CI = 0.56-0.75), depressed or not (AUC = 0.66, 95% CI = 0.54-0.79), and self-rated disability related to seizures (AUC = 0.65, 95% CI = 0.50-0.80). CONCLUSIONS: The C-ESSQ-19 has proven to be a reliable and valid self-rated questionnaire for assessing the satisfaction of Chinese mainland epilepsy patients with surgery.

The impact of medication belief on adherence to infliximab in patients with Crohn's disease.

Objective: Crohn's disease (CD) is an incurable chronic disease that requires long-term treatment. As an anti-tumor necrosis factor (TNF) agent, Infliximab (IFX) is widely used in the treatment of Crohn's disease, while the adherence is not high. The purpose of this study was to investigate the adherence to IFX among CD patients in China and evaluate the association between medication belief and IFX adherence. Methods: Demographic data, clinical information and patients' medication beliefs were collected using an online questionnaire and reviewing electronic medical records (EMRs). The Beliefs about Medicines Questionnaire (BMQ)-specific was used to assess medication beliefs which contains the BMQ-specific concern score and the BMQ-specific necessity score. An evaluation of adherence factors was conducted using univariate and multidimensional logistic regression analyses. Results: In all, 166 CD patients responded the online questionnaire among which 77 (46.39%) patients had high adherence. The BMQ-specific concern score in patients in low adherence was 30.00 and in high adherence patients was 27.50, and patients with lower BMQ-specific concern score had higher adherence (p = 0.013). The multiple regression analysis showed that the BMQ-specific concern score (OR = 0.940, 95% CI: 0.888-0.996) significantly affected the IFX adherence in CD patients. Otherwise, gender, marital status, time spent on the way (including the waiting time in infusion center) and accommodation to the center were also the influencing factors of adherence. Conclusion: The IFX adherence to CD in China was not high. Medicine concerns may be predictive factor of adherence. Education, the duration of IFX therapy and experience of adverse effects were not significantly associated with IFX adherence. By enhancing knowledge and relieving medicine concerns, we may increase patients' adherence to IFX.

Barriers and facilitators of adherence to awake prone positioning: a qualitative study using the COM-B model.

BACKGROUND: Awake prone positioning (APP) is a recommended therapy for non-intubated ARDS patients, but adherence can be challenging. Understanding the barriers and facilitators of adherence to APP is essential to increase the adherence of therapy and improve patient outcomes. The objective of this study was to explore the barriers and facilitators of adherence to awake prone ventilation using a qualitative approach and the Capability, Opportunity, Motivation-Behavior (COM-B) model. METHODS: Semi-structured, in-depth interviews were conducted with patients involved in awake prone ventilation. Data were analyzed using an adapted inductive thematical approach and mapped onto the COM-B model to identify barriers and facilitators to adherence of APP. RESULTS: Nineteen patients were interviewed (aged 55-92 years). Fifteen themes were identified and mapped directly on to the six COM-B constructs, with "physical challenges" related to physical capability being the primary barrier. These COM-B sub-items reflected five other barriers, including low self-efficacy(M), treatment environment(O), availability of time(O), misconceptions about the treatment(C), and insufficient knowledge(C). Key facilitators in adhering to APP were ability to identify and overcome obstacles(C), availability and affordability of treatment(O), family influences(O), beliefs and trust in treatment(M), fear about the disease(M), and perceived benefits(M). In addition, three factors played the role of both facilitator and barrier, such as media influences(O), healthcare influences(O), and behavioral habits(M). CONCLUSION: The COM-B model was proved to be a useful framework for identifying the barriers and facilitators of adherence to awake prone ventilation. The findings suggest that adherence behavior is a dynamic and balanced process and interventions aimed at improving adherence to APP should address the barriers related to capability, opportunity, and motivation. Healthcare providers should focus on providing proper guidance and training, creating a comfortable environment, and offering social support to improve patients' capability and opportunity. Additionally, promoting patients' positive beliefs and attitudes towards the treatment and addressing misconceptions and fears can further enhance patients' motivation to adhere to the treatment plan.

Values and preferences of health care professionals, policy-makers, patients and family members regarding recommendations of adapted physical restraint guidelines in critical care: A survey research.

BACKGROUND: The values and preferences of stakeholders are crucial in the development of guidelines. AIM: The aim of this study was to investigate stakeholders' values and preferences regarding draft recommendations for adapted physical restraint guidelines in China. STUDY DESIGN: This survey research was carried out at four university-affiliated comprehensive hospitals based in the eastern, central, western, and north eastern zones of China from January 5-30, 2022. A 48-item self-report questionnaire was distributed, and values and preferences were assessed on a 10-point Likert scale. One-way ANOVA was used to compare values and preference scores among stakeholders. As effect-size measures, partial η2 and Cohen's f values are reported for ANOVA results. RESULTS: A total of 1155 stakeholders were enrolled in the study. The mean value and preference scores were higher than seven for 46 draft recommendations. There was either no significant difference in the values and preferences of the stakeholders for the draft recommendations or there was a significant difference (p values ranged from <0.001 ∼ .048), but the effect size was small or very small (partial η2 value ranged from 0.011 ∼ .044; Cohen's f value ranged from 0.101 ∼ .214). The mean scores of patients for items related to cyber therapy and early tracheotomy were 6.84 and 6.60, respectively, which were lower than those of family members, policy-makers, and health care professionals and were statistically significant (p < 0.001). The partial η2 and Cohen's f values of the effect size were 0.083/0.062 and 0.302/0.256, respectively, which indicated that the differences were moderate. CONCLUSION: These recommendations were in line with the values and preferences of stakeholders. Patients were more supportive of implementing cyber therapy or hypnosis for pain management but did not support early tracheotomy to reduce the duration of mechanical ventilation. Guideline panels could use value and preference information to revise and endorse recommendations of adapted physical restraint guidelines in critical care. RELEVANCE TO CLINICAL PRACTICE: Practitioners should implement recommendations based on the values and preferences of stakeholders.

Frailty-originated early rehabilitation reduces postoperative delirium in brain tumor patients: Results from a prospective randomized study.

Objective: To investigate the impact of frailty-originated, evidence-based early activity training on postoperative delirium in patients who have undergone brain tumor resection. Methods: A randomized controlled trial was conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine, from July 2019 to June 2020. Data on the patients' general information, incidence and duration of delirium, duration of hospital stay, and activities of daily living were collected. From the first day after surgery, the patients were randomly assigned to either the traditional care group or the frailty-originated rehabilitation towards intracranial tumors using distinct evidence (FORTITUDE) group. Non-parametric, chi-square, and log-rank tests were used to compare the onset time and duration of postoperative delirium and activities of daily living performed by the participants between the two groups. Results: In total, 291 patients, 150 and 141 in the control group and FORTITUDE group, respectively, participated in the study. Patients in the FORTITUDE group had a lower incidence of postoperative delirium (15.6% vs. 28.7%, P â€‹= â€‹0.007), delayed onset of delirium (Z â€‹= â€‹-2.108, P â€‹= â€‹0.035), shorter duration of postoperative delirium (χ2 â€‹= â€‹26.67, P â€‹< â€‹0.001), shorter hospital stay (Z â€‹= â€‹-2.037, P â€‹= â€‹0.042), and higher scores in the activities of daily living one week (Z â€‹= â€‹-2.304, P â€‹= â€‹0.021) and one month (Z â€‹= â€‹-2.724, P â€‹= â€‹0.006) after surgery than in the control group. Conclusions: The FORTITUDE program was safe and effective in reducing the incidence and duration of postoperative delirium and improving the quality of life of patients who underwent brain tumor resection.

Effects of Simulated In Vitro Digestion on the Structural Characteristics, Inhibitory Activity on α-Glucosidase, and Fermentation Behaviours of a Polysaccharide from Anemarrhena asphodeloides Bunge.

The purpose of this study is to investigate the effects of the simulated saliva-gastrointestinal digestion of AABP-2B on its structural features, inhibitory α-glucosidase activity, and human gut microbiota. The salivary-gastrointestinal digestion results show that there is no significant change in the molecular weight of AABP-2B, and no free monosaccharides are released. This indicates that, under a simulated digestive condition, AABP-2B is not degraded and can be further utilized by gut microbiota. AABP-2B still possessed good inhibitory activity on α-glucosidase after salivary-gastrointestinal digestion, which may be attributed to the largely unchanged structural characteristics of AABP-2B after simulated digestion. Furthermore, in vitro fecal fermentation with AABP-2B after salivary-gastrointestinal digestion showed that AABP-2B modulated the gut microbiota structure and increased the relative proportions of Prevotella, Faecalibacterium, and Megasphaera. AABP-2B can also modify the intestinal flora composition by inhibiting pathogen growth. Moreover, the AABP-2B group resulted in a significant increase in short-chain fatty acid (SCFAs) content during fermentation. These findings demonstrate that AABP-2B can be used as a prebiotic or functional food to promote gut health.

Structural characteristics and antioxidant and hypoglycemic activities of a heteropolysaccharide from Anemarrhena asphodeloides Bunge.

In this study, an acid polysaccharide (AABP-1B) was extracted from the rhizome of Anemarrhena asphodeloides Bunge and purified using 60 % alcohol precipitation and DEAE-52 cellulose. The molecular weight of AABP-1B was 105 kDa, and it consisted of mannose (Man), rhamnose (Rha), galacturonic acid (GalA), glucose (Glc), galactose (Gal), and arabinose (Ara) in a ratio of 6.3:1.3:1.1:0.2:0.4:0.7. Methylation and NMR analyses revealed that the backbone of AABP-1 consists of 4)-ß-D-Manp-(1 and 4)-2-O-acetyl-ß-D-Manp-(1. In addition, the biological activity assays showed that AABP-1B not only displays potential antioxidant activity but also exhibits the α-glucosidase and α-amylase inhibitory effect. Moreover, AABP-1B enhanced glucose consumption and glycogen synthesis in insulin-resistant (IR) HepG2 cells. These results suggest that AABP-1B has potential hypoglycemic activity.

The controlling nutritional status score and risk factors associated with malnutrition in patients with acute ischemic stroke.

Objectives: Malnutrition is an independent risk factor for poor outcomes in patients who suffered an acute ischemic stroke (AIS). The controlling nutritional status (CONUT) score can provide information for nutritional management in AIS patients. However, the risk factors associated with the CONUT score have not been established to date. Therefore, in this study, we aimed to investigate the CONUT score of patients with AIS and explore the potential risk factors associated with it. Methods: We conducted a retrospective review of the data from consecutive AIS patients who were recruited in the CIRCLE study. Within 2 days of admission, we gathered the CONUT score, the Nutritional Risk Screening 2002, the Modified Rankin Scale, the National Institutes of Health Neurological Deficit Score (NIHSS), and demographic data from medical records. We used chi-squared tests to examine admission, and a logistic regression analysis was performed to explore the risk factors associated with CONUT in patients with AIS. Results: A total of 231 patients with AIS participated in the study, with a mean age of 62.32 ± 13.0 years and a mean NIHSS of 6.77 ± 3.8. Of these patients, 41(17.7%) had hyperlipidemia. In terms of nutritional assessment, 137(59.3%) patients with AIS had high CONUT scores, 86(37.2%) patients with AIS had low or high BMI, and 117(50.6%) patients with AIS had NRS-2002 scores below 3. The chi-squared tests showed that age, NIHSS, body mass index (BMI), and hyperlipidemia were associated with the CONUT score (P < 0.05). The logistic regression analysis showed that low NIHSS scores (OR = 0.055 95% CI: 0.003-0.893), younger age (OR = 0.159 95% CI: 0.054-0.469), and hyperlipidemia (OR = 0.303 95% CI: 0.141-0.648) were independently associated with lower CONUT scores (P < 0.05), whereas BMI was not found to be independently associated with the CONUT. Conclusions: More than half of the patients with AIS were at risk of malnutrition, with age and neurological deficits being identified as risk factors for nutritional control. Hyperlipidemia was found to be a protective factor of the CONUT, while NRS-2002 and BMI did not affect the nutritional control in patients with AIS.

Limb heaviness as a sensorimotor disorder alters rehabilitation adherence after a stroke.

Introduction: To the best of our knowledge, it is still unknown how perceived limb heaviness affects rehabilitation adherence. As rehabilitation adherence is very important for the functional recovery of patients with stroke, it is important to explore the relationship between perceived limb heaviness and rehabilitation adherence. Methods: We retrospectively reviewed the data of patients with consecutive stroke recruited in the CIRCLE study. The influence of age, gender, time from onset to enrollment, educational background, hypertension, diabetes, Modified Rankin Scale (MRS), and National Institutes of Health Stroke Scale (NIHSS) on rehabilitation adherence was analyzed. Multiple linear regression analysis was used to examine the association between perceived limb heaviness and rehabilitation adherence changes. Results: A total of 108 participants completed the study. About 40 (37.0%) participants felt limb heaviness. The mean scores on the Medical Research Council (MRC) scale for the upper affected limb strength were 3.05 ± 1.7, and the mean score on the exercise adherence questionnaire (EAQ) was 34.27 ± 8.9. Univariate analysis showed that rehabilitation adherence levels differed in upper limb muscle strength and whether they perceived limb heaviness. After adjustment for independent predictors, we found that perceived limb heaviness was associated with rehabilitation adherence (B = -9.681 ± 1.494, p < 0.05) and R 2 was 0.332 and 0.074 if the muscle strength of the upper limb and perceived limb heaviness were included in the model and the model was without perceived limb heaviness, respectively. Conclusion: By identifying patients with stroke with limb heaviness, it led to lower levels of motor functional rehabilitation adherence. We must pay more attention to limb heaviness and provide effective interventions to improve rehabilitation adherence and promote patient recovery.

Effect of Intelligent Operating Hole Towel in Cataract Patients.

Backgrounds: The eyeball and its ancillary tissues are important organs with the same shape and structure, and examining the surgical site is particularly important in ophthalmic surgery. A safe and easy-to-operate ophthalmic surgical hole towel is of great significance for improving the safety of ophthalmic surgery. Objective: To explore the effect of intelligent operating hole towel in cataract patients. Methods: From April 2020 to April 2021, 1220 cases of cataract patients who needed surgery in the second affiliated hospital Zhejiang University college of medicine, were recruited and randomly divided into the control group and the observation group. The control group adopted a disposable ophthalmic single-port operation cloth, and the intelligent surgical hole towel was used in the observation group. Incidences of surgical site errors, the amount of operation time, bacterial infections, and patient satisfaction were recorded. Results: The average operation time in the observation group had obviously reduced compared with the control group (p < 0.05). Moreover, patients' overall medical satisfaction in the observation group improved significantly compared with the control group (p < 0.05). Conclusions: The design and use of the new intelligent ophthalmic surgical hole towel can promote the efficiency of ophthalmic surgery, realize the intelligent verification of surgical eye, reduce the risk of surgical site errors and improve medical safety.

Chemical Characterization and In Vivo Toxicological Safety Evaluation of Emu Oil.

In this study, the physicochemical properties, fatty acid composition, antioxidant activities, and in vitro as well as in vivo toxicological safety of emu oil were investigated. Emu oil was shown to have a low acid and peroxide value, low amounts of carotenoid and phenolic compounds, and high doses of oleic acid and linoleic acid. Furthermore, in a bacterial reverse mutation assay, emu oil demonstrated no change in the amount of revertant colonies for all strains. In a chromosomal assay, no aberrations occurred in any of the emu oil treatment groups (1.25, 2.5, and 5 µg/mL). In the bone marrow micronucleus test, emu oil up to 20 mL/kg showed no significant increase in the incidence of micronucleated polychromatic erythrocytes. Moreover, emu oil up to 19.3 mg/kg body weight did not affect body weight in an acute oral toxicity study. These results are crucial for the adoption of emu oil as an alternative source of edible oil.