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Combined application of BNLF2b antibody with VCA-IgA, Rta-IgG, and Zta-IgA in nasopharyngeal carcinoma screening in the Guangxi region

by Ruilan Lin, Ru Qin, Yunlong Zhang, Yao Guan, Boheng Wu, Shangyang Li, Shenhong Qu, Yulin Yuan

Background

This study aims to assess the diagnostic value of the Epstein-Barr virus (EBV) BNLF2b antibody(P85-Ab), alone or in combination with VCA-IgA, Rta-IgG, and Zta-IgA antibodies, in the context of nasopharyngeal carcinoma (NPC).

Methods

The study included 100 NPC patients and 100 healthy controls. Chemiluminescent microparticle immunoassay was utilized to measure P85-Ab levels in the serum samples of both NPC patients and healthy controls. Additionally, the ELISA method was employed to detect serum levels of VCA-IgA, Rta-IgG, and Zta-IgA antibodies. The study analyzed the roles of serum P85-Ab in conjunction with VCA-IgA, Rta-IgG, and Zta-IgA antibodies in the diagnosis of NPC.

Results

Serum levels of P85-Ab, VCA-IgA, Rta-IgG, and Zta-IgA antibodies in NPC patients were significantly higher than those in the normal control group (P  Conclusion

The combined detection of P85-Ab with VCA-IgA, Rta-IgG, and Zta-IgA antibodies demonstrates high diagnostic value for nasopharyngeal carcinoma. Serum P85-Ab may serve as a potential marker for the diagnosis of NPC.

Choice of Primary Repair in Animal Bite Wound: A Novel Management Strategy

ABSTRACT

Animal bites, primarily from dogs and cats, pose a significant threat, especially to children. Wound infections are common complications caused by bacterial flora in the animal's mouth, making surgical debridement and delayed primary closure the standard treatment. However, recent studies reported no increased infection rates with primary closure compared to delayed closure after adequate debridement, particularly for facial wounds. Primary closure offers better cosmetic and functional outcomes. This study presents a case series to guide decision-making on primary suturing versus leaving wounds exposed. Thirty patients with animal bites underwent surgery, including 23 dog bites and seven cat bites. Eight patients with deep facial lacerations from dog bites received immediate debridement and primary closure with epidermal and subcutaneous sutures. None developed infections, and the cosmetic results were excellent. In contrast, all seven cat bite wounds and nine infected dog bite wounds involved high-risk factors, such as puncture wounds, hand injuries or diabetes. For high-risk wounds, early debridement and leaving the wound open after initial treatment proved effective. Primary repair of facial dog bite injuries, even complex ones, is safe and yields good aesthetic outcomes. For high-risk wounds, leaving them open after debridement is recommended to minimise infection risks.

Randomised, controlled, crossover clinical trial protocol of puerarin for the treatment of metabolic-associated fatty liver disease in China

Por: Cui · Y. · Ren · X. · Song · J. · Shang · Z. · Zhu · W. · Tang · Y. · Chen · B. · Yu · Z. · Gao · Y. · Huang · L.
Background

Although a number of preclinical studies have demonstrated the therapeutic potential of puerarin for metabolic-associated fatty liver disease (MAFLD), there is a lack of high-quality clinical evidence. This study aims to evaluate the safety and efficacy of puerarin in patients with MAFLD in a randomised, controlled, crossover trial.

Methods and analysis

This study will use the randomised, double-blind, placebo-controlled crossover trial design. We plan to enrol 50 patients diagnosed with MAFLD, and they will be randomly assigned in a 1:1 ratio to receive either puerarin or placebo (maltodextrin) after a 2-week adaptation period. Participants in the two groups will receive the daily intervention of puerarin (180 mg/day) and placebo (180 mg/day) for 12 weeks, respectively. After a 4-week washout period, puerarin-treated and placebo-treated participants will cross over to receive the daily intervention of placebo and puerarin for 12 more weeks. The primary outcome measure will be defined as the changes in liver fat content, which will be assessed using MRI-proton density fat fraction before and after 12 weeks of puerarin or placebo supplement in patients with MAFLD. The secondary outcome measures include liver and kidney function changes, lipid metabolism indicators, blood glucose levels, iron metabolism parameters, blood routine, serum high-sensitivity C-reactive protein and anthropometric measurements. Additionally, alterations in gut microbiota composition and metabolic activity will be evaluated using 16S ribosomal RNA gene sequencing and liquid chromatography-mass spectrometry.

Ethics and dissemination

The study protocol has been approved by the ethics committee of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (Approval Number 2024-1625-208-01). The findings will be published in international peer-reviewed journals and presented at relevant academic conferences.

Trial registration number

The trial has been registered with the Chinese Clinical Trial Registry (ChiCTR2400094017).

A Comparative Evaluation of Conceptual Frameworks for Examining Neighbourhood Socioeconomic Deprivation and Cancer Care Accessibility

ABSTRACT

Aim (s)

To identify and evaluate conceptual frameworks for studying neighbourhood deprivation and access to cancer services in nursing research.

Design

Discussion paper.

Methods

We searched the literature to identify conceptual models used in peer-reviewed articles that examined neighbourhood-level factors influencing access to cancer services. As a first step in the evaluation, the Theories, Models and Frameworks Comparison and Selection Tool (TCaST) was used to assess the rigour and applicability of eligible models. The two models with the highest TCaST scores were then further evaluated using Fawcett and DeSanto-Madeya's 2013 criteria.

Data Sources

A total of 546 articles were screened after searching PubMed, EBSCO Cumulated Index to Nursing and Allied Health Literature and Elsevier Co. Scopus from 2014 to 2025.

Results

Of eight eligible models, two met the criteria for further analysis. Revision 6 of Andersen's Behavioral Model (ABM) includes the full nursing metaparadigm and has been widely applied. It is logically and socially congruent, offers testable hypotheses and holds global significance. However, full utility requires familiarity with its unique vocabulary. The Concept of Access Model also demonstrates congruence, testable hypotheses and has greater parsimony than ABM, but its omission of the health metaparadigm limits its application in nursing research.

Conclusion

ABM most comprehensively provides clear and measurable concepts for neighbourhoods as well as realised, effective and equitable access for nursing research. It also supports the identification of highly mutable factors for clinical and policy intervention.

Implications for Nursing

Nurses can play a central role in applying frameworks to ensure research aligns with the holistic nature of profession values, captures contextual realities of patients and informs equitable care delivery.

Impact

Neighbourhood deprivation continues to drive disparities in cancer care, making it a pressing research priority. This evaluation equips nurses with a clear conceptual foundation to study access inequities and support actionable cancer care solutions.

Reporting Method

There are no relevant EQUATOR guidelines for this discursive paper.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

Effects of different electroacupuncture/ transcutaneous electrical acupoint stimulation parameters on the pregnancy outcomes of in vitro fertilisation-embryo transfer: a systematic review and meta-analysis

Por: Zhu · H. · Shang · Z. · Ji · R. · Li · C. · Zhang · J. · Su · Y. · Jiang · Z. · Du · J. · Li · Y. · Liu · Q. · Liu · J. · Zheng · X. · Yang · J.
Background

Extensive progress has been made in improving pregnancy outcomes for in vitro fertilisation and embryo transfer (IVF-ET) patients through the use of electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS). However, a clear and suitable recommendation for the parameter selection scheme of EA/TEAS remains elusive.

Objective

To evaluate evidence-based conclusions of different EA/TEAS parameters on improvement of pregnancy outcomes in patients undergoing IVF-ET and evaluate other factors that may affect pregnancy outcomes.

Method

This meta-analysis systematically searched eight databases from inception to 27 August 2024, focusing on randomised controlled trials (RCTs) that evaluated the effectiveness of EA/TEAS in improving IVF-ET outcomes, with the primary outcome defined as clinical pregnancy rate (CPR), and secondary outcomes including biochemical pregnancy rate (BPR) and live birth rate (LBR). We further explored CPR variations associated with EA/TEAS parameters: waveform (dilatational vs continuous wave), frequency (low vs high) and treatment duration (20, 25, 30, 40, 60 min). Additionally, seven subgroup variables were analysed to identify potential influencing factors: routine treatment, intervention dose, intervention modality, mean participant age, control type, randomisation risk and allocation concealment risk.

Results

A total of 27 RCTs (3786 participants) were included, with the quality of evidence ranging from moderate to very low. Compared with control groups, the use of dilatational waves significantly increased CPR (RR=1.36, 95% CI [1.17 to 1.58], p2=0). Similarly, low-frequency currents demonstrated a significant positive association with CPR (RR=1.38, 95% CI [1.25 to 1.51], p2=0) and a treatment duration of 30 min per session was associated with elevated CPR (RR=1.30, 95% CI [1.19 to 1.42], p2=0). Subgroup analyses revealed that the effect of EA/TEAS on CPRs varied significantly depending on therapeutic dose (p=0.029), with stronger associations observed in studies involving patients receiving high therapeutic dose compared with those receiving low therapeutic dose.

Conclusion

Current evidence suggests that dilatational waves, low-frequency currents and 30-minute treatment duration may improve CPRs, though findings require validation in larger trials. While parameter optimisation shows promise, stronger evidence is needed before standardising protocols. Future research should focus on rigorous RCTs to determine optimal parameters and dose-response relationships.

Hyperosmolar therapy for severe subarachnoid haemorrhage: a protocol for a multicentre prospective observational study (OSMO-SAH study)

Por: Jiang · L. · Qi · M. · Xu · Y. · Qu · X. · Chen · W. · Cheng · W. · Zhao · H. · Shang · F. · Fu · X. · Wang · C. · Jiang · R. · Wang · N.
Introduction

Hyperosmolar therapy is crucial for the management of cerebral oedema and high intracranial pressure. Mannitol and hypertonic saline (HTS) at different concentrations are commonly used in clinical practice, but evidence of their use is mostly derived from studies about traumatic brain injury. The aim of this study was to evaluate the efficacy and safety of hyperosmolar therapy for severe aneurysmal subarachnoid haemorrhage (SAH).

Methods and design

This is a prospective multicentre observational study in which adult patients with severe aneurysmal SAH (Hunt–Hess score ≥3) will be enrolled. At least 124 patients will be enrolled over 2 years. Each enrolled patient will be treated in accordance with relevant management guidelines. The hypertonic agent used will be 20% mannitol (3 mL/kg) or 10% sodium chloride (HTS) (1 mL/kg). The choice and daily dose of the hypertonic agent will be determined by the attending doctor. The primary outcome will be the modified Rankin scale (mRS) score at 30 days after ictus. The secondary outcomes will be the mRS score at 6 months and the incidence of complications during hospitalisation, including phlebitis, acute kidney injury (AKI), hypokalaemia, hyperkalaemia, hyponatraemia, hypernatraemia, vessel spasm, delayed cerebral ischaemia (DCI), subdural effusion and hydrocephalus. An mRS score 0–2 will indicate a favourable outcome, whereas an mRS score 3–6 will indicate an unfavourable outcome. Logistic analysis will be performed to evaluate the association between the hyperosmolar agent and outcome (favourable or unfavourable).

Discussions

The aim of this multicentre observational study is to provide evidence on the efficacy and safety of hyperosmolar therapy for severe aneurysmal SAH.

Ethics and dissemination

This study was approved by the Ethics Committee of Xuanwu Hospital (approval date: 10 July 2023) under protocol V.2.0 (version date: 26 April 2023) (reference number: [2023]086). The results will be published in a peer-reviewed journal and reported at relevant professional conferences.

Trial registration number

NCT05858060.

Machine learning model for postpancreaticoduodenectomy haemorrhage prediction: an international multicentre cohort study

Por: Zhang · Z. · Zhao · X. · Shang · M. · Xu · Q. · Wang · X. · Zhang · J. · Wang · C. · Gu · Z.
Objectives

To develop and validate a machine learning model for precise risk stratification of postpancreaticoduodenectomy haemorrhage (PPH), enabling early identification of high-risk patients to guide clinical intervention.

Design

Retrospective international multicentre cohort study with model development and external validation.

Setting

Training data from the American College of Surgeons-National Surgical Quality Improvement Program database (USA, 2014–2017) and external validation data from the National Cancer Center (China, 2014–2019).

Participants

3609 patients in the training cohort and 1347 in the validation cohort undergoing pancreaticoduodenectomy. Patients with missing data or non-relevant variables were excluded.

Primary and secondary outcome measures

Primary outcome: clinically relevant PPH (International Study Group of Pancreatic Surgery grades B/C). Secondary outcomes: model discrimination (area under the curve (AUC)), calibration (Hosmer-Lemeshow test), clinical utility (decision curve analysis) and risk stratification performance.

Results

The least absolute shrinkage and selection operator (Lasso)-gradient boosting machine model identified eight predictors: albumin, haematocrit (HCT), American Society of Anesthesiologists (ASA) class, operative time, vascular resection, sepsis, reoperation and pancreatic fistula. It achieved AUCs of 0.84 (95% CI 0.82 to 0.86) in training and 0.82 (95% CI 0.78 to 0.85) in validation, outperforming logistic regression and other machine learning models. Risk stratification into low-risk, medium-risk and high-risk groups showed strong discriminatory power (AUCs: 0.72–0.75). Decision curve analysis confirmed net clinical benefit, and SHapley Additive exPlanations values highlighted HCT and operative time as top contributors. The model was deployed as an interactive application for real-time risk assessment.

Conclusions

This novel machine learning model for PPH prediction integrates interpretable risk stratification and demonstrates robust performance across international cohorts. Its deployment as a clinical tool may facilitate proactive management of high-risk patients. Prospective validation is warranted prior to broad implementation.

Volumetric choice experiment to estimate the impact of e-cigarette and heated tobacco product characteristics on substitution and complementary use among adults who smoke cigarettes and recently initiated e-cigarette use

Por: Do · V. V. · Shang · C. · Huang · J. · Islam · T. · Pechacek · T. F. · Weaver · S. R.
Background

This study addresses the limited evidence of the impact of product characteristics on demand for and the substitutability of electronic cigarettes (e-cigarettes) or heated tobacco products for combusted cigarettes among people who smoke and have newly begun to use e-cigarettes.

Methods

A sample of 318 adults who smoke and recently initiated/reinitiated e-cigarette use participated in an online volumetric choice experiment in 2020–2021 to assess stated preferences for consumption and own and cross-price elasticities of three e-cigarette options (cig-a-like, vape pen or tank, closed pod system), heated tobacco product (IQOS) and their usual brand of cigarettes. Product attributes manipulated were price, flavour, level of harm, how well the product reduces cravings to smoke, and how discretely the product can be used. Multilevel zero-inflated negative binomial models were used to model the purchased quantities.

Results

Cigarettes were preferred over all alternatives. However, demand for cig-a-likes, but not IQOS, increased when cigarette prices were higher. Higher prices for e-cigarettes and IQOS did not increase demand for cigarettes. The odds of buying e-cigarettes/IQOS were higher when their harm was stated as low or unknown versus being similar to cigarettes (ie, very high). Other attributes (including various flavour options) were not significantly associated with demand for e-cigarettes or IQOS.

Conclusions

People who smoke and recently began using e-cigarettes might substitute cig-a-likes for cigarettes when cigarette prices are higher. Policies to increase the cost of combusted cigarettes as well as communicate lower relative harm and low absolute harm of e-cigarettes may facilitate switching behaviour.

Uptake of the IMMPACT-recommended core outcome set in randomised controlled trials on chronic neck or shoulder pain: a cross-sectional study

Por: Li · W. · Li · G. · Shang · J. · Zhan · S. · Zeng · L.
Objective

To analyse the uptake rate of Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT)-recommended core outcome set (COS) in randomised controlled trials (RCTs) on chronic neck or shoulder pain and its potential influencing factors.

Design

A cross-sectional study.

Setting

WHO International Clinical Trials Registry Platform, involving 15 registries.

Participants

RCT registrations on chronic neck or shoulder pain.

Primary outcome measures

The uptake rate of IMMPACT-recommended COS in RCTs focusing on chronic neck or shoulder pain.

Results

A total of 1057 RCT registrations were included between 2 February 2004 and 8 February 2023. The most used domains were pain (n=1003, 94.9%) and physical functioning (n=971, 91.9%), while the remaining four core domains and supplementary domains received less attention (

Conclusions

Although the pain and physical functioning domains were widely reported by RCTs on chronic neck or shoulder pain since the publication of IMMPACT-recommended COS, the uptake rate was low for other domains and outcome measures. The study period, blinding status, prospective registration, follow-up duration and sample size may influence COS uptake across domains.

Trial registration number

http://www.comet-initiative.org/Studies/Details/3213.

Association between emergency department to intensive care units time and in-hospital mortality: an analysis of the MIMIC-IV database

Por: Qian · J. · Yuan · Y. · Shang · Z. · Zhou · K. · Lu · Q. · Zhou · L. · Zhou · W. · Jiang · X. · Chen · M.
Objectives

The association between the duration from the emergency department (ED) to the intensive care units (ICUs) and in-hospital mortality among patients admitted directly to the ICUs from the ED remains controversial. This study aimed to use data from the Medical Information Mart for Intensive Care-IV database to explore the relationship between the ED to ICUs time and patient outcomes.

Design

Retrospective observational study.

Setting

Admissions to the Beth Israel Deaconess Medical Center intensive care from 2008 to 2019.

Participants

A total of 15 246 adult patients were identified as admitted directly from the ED to the ICUs during their first hospitalisation. After excluding those without recorded ED registration times and those with a hospital-to-ICU admission interval exceeding 6 hours (n=2432), the final analysis cohort comprised 12 703 patients.

Primary and secondary outcome measures

The primary outcome was in-hospital all-cause mortality. Secondary outcomes included 28-day all-cause mortality and length of stay in ICU and hospital.

Results

The median ED to ICUs time was 3.98 hours. Longer ED to ICUs times were associated with lower in-hospital mortality, decreasing from 17.6% in the shortest to 12.2% in the longest interval group, and shorter ICU stays. After propensity score weighting, adjusted logistic regression models confirmed the inverse association between longer ED to ICUs time and in-hospital mortality (OR: 0.75, 95% CI: 0.69 to 0.82, p

Conclusions

Longer ED to ICUs time is linked to lower mortality and shorter ICU length of stay, suggesting that appropriately extending ED stays may benefit critically ill patients.

Acute skin failure knowledge, attitudes and practices amongst intensive care unit nurses in China: A multicentre cross‐sectional survey

Abstract

Purpose

To investigate the knowledge, attitudes and practices of intensive care unit (ICU) nurses regarding acute skin failure (ASF) and analyse the influencing factors thereof.

Methods

From 22 December 2023 to 24 January 2024, a cross-sectional study was conducted amongst ICU nurses from 21 hospitals in eight provinces in China. The ASF knowledge, attitude and practice scores were determined using questionnaires, and multiple linear regression was used for further analysis.

Results

Overall, 304 ICU nurses completed the survey. The knowledge, attitude and practice scores were 24.89 ± 10.93, 40.67 ± 5.93 and 43.47 ± 9.19, with scoring rates of 45.25%, 81.34% and 72.45%, respectively. Multiple linear regression analysis showed that being a wound ostomy specialist nurse was positively correlated with the knowledge dimension score (p < 0.05). Nurses' professional titles significantly affected attitude scores (p < 0.05); the higher the professional title, the more positive the attitude towards ASF.

Conclusion

The attitudes and practices of ICU nurses in China towards ASF were found to be positive; however, their knowledge levels need improvement. Nursing managers should conduct targeted training, especially for entry-level nurses.

Burden of chronic obstructive pulmonary disease in adults aged 70 years and older, 1990–2021: Findings from the Global Burden of Disease Study 2021

by Kaifang Meng, Xu Chen, Zhishang Chen, Jing Xu

Background

Life expectancy at age 70 has continued to rise globally over the past 30 years. However, a comprehensive assessment of the burden of COPD in older adults is lacking. We aimed to estimate the burden of COPD and its attributable risk factors among adults aged ≥70 years.

Methods

Data on the prevalence, incidence, deaths, disability-adjusted life years (DALYs), and risk factors of COPD among adults aged ≥70 years from 1990 to 2021 across 204 countries and territories, were sourced from the Global Burden of Disease Study 2021. Estimated annual percentage change (EAPC) was used to illustrate temporal trends at global and regional levels from 1990 to 2021.

Results

In 2021, the global numbers of prevalent and incident COPD cases among older adults were 99.7 and 7.4 million, increasing by 162.2% and 157.4% from 1990. The prevalence and incidence rates increased from 18823.5 (95% uncertainty interval (UI) 16324.4–21208.4) to 20165.6 (17703.8–22549.4) and 1429.0 (1224.2–1613.0) to 1502.7 (1309.0–1677.9) per 100,000 population (EAPC 0.31, 95% CI 0.28–0.33; 0.17, 95% CI 0.16–0.19). The global numbers of COPD-associated deaths and DALYs in 2021 reached 2.9 and 45.4 million, increasing by 70.7% and 70.0% from 2019, while the corresponding rates declined (both EAPC Conclusion

COPD in older adults has progressively become a global health challenge with rising prevalence and incidence rates. Although the death and DALY rates attributed to COPD have globally decreased in older adults, the absolute counts are rapidly increasing. The inequalities across different regions and countries underscore a multi-faceted approach to COPD management in older adults.

Association between normal weight obesity and comorbidities and events of cardiovascular diseases among adults in South China

by Miaomiao Ma, Deliang Lv, Xiaobing Wu, Yuqing Chen, Shimiao Dai, Yutian Luo, Hui Yang, Wei Xie, Fengzhu Xie, Qinggang Shang, Ziyang Zhang, Zhiguang Zhao, Ji-Chang Zhou

Background

The increased risks for cardiovascular comorbidities and cardiovascular diseases (CVD) in populations with normal weight obesity (NWO) have not been well-identified. We aimed to study their associations in an adult population in South China.

Methods

Based on the CVD prevalence of 4% in Shenzhen and a calculated sample size of 6,000, a cross-sectional study with a multi-stage stratified cluster sampling method was conducted in Shenzhen City. The cardiovascular comorbidities being studied were abdominal obesity (AO), diabetes, hypertension, dyslipidemia, metabolic syndrome, and chronic kidney disease, while the CVD events were occurrences of myocardial infarction and strokes. Questionnaire surveys, physical examinations, and laboratory tests were performed. NWO was defined as a condition with the highest tertile of body fat percentage (BF%) among the normal body mass index (BMI) range (18.5–23.9 kg/m2). Continuous data were reported as mean [standard deviation (SD)] and categorical data as percentages (%). CVD comorbidities and CVD events and their detection rates in different groups were compared using ANONA analysis and Chi-squared test. Spearman’s correlation coefficients between BF% and cardiometabolic abnormalities were calculated by partial correlation analysis. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for BF%, CVD comorbidities, and CVD events, adjusted for multiple confounders.

Results

Among the total 6,240 subjects who completed the study and had BMI and BF% data available, 3,086 had normal BMI. The prevalence of NWO was 16.36%, with 13.15% for men and 19.54% for women. With confounders adjusted, the risks of AO (OR = 6.05, 95%CI = 3.40–10.75), essential hypertension (OR = 1.56, 95%CI = 1.09–2.22), dyslipidemia (OR = 1.85, 95%CI = 1.49–2.29), and metabolic syndrome (OR = 4.61, 95%CI = 2.32–9.18) were significantly increased in the populations with NWO compared with the population without NWO (P Conclusion

NWO was found to be positively associated with CVD comorbidities but not with CVD events. The current study provides a ground to conduct further studies on whether body fat affects the risk of occurrence of CVD events and the underlying mechanisms in the future.

Effectiveness of peer support interventions in improving mothers' psychosocial well‐being during the perinatal period: A systematic review and meta‐analysis

Abstract

Background

Many mothers experience poor psychological outcomes during their perinatal period. The presence of depression and anxiety has a significant adverse impact on the mother's health and the infant's development.

Aim

This review aimed to examine the effectiveness of peer support interventions in improving depression, anxiety, and perceived social support among mothers during the perinatal period.

Methods

This study was a systematic review and meta-analysis of randomized controlled trials. The reporting of this review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Cochrane's Risk of Bias Tool for randomized controlled trials was used to examine the methodological quality of the included studies. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A comprehensive search was conducted from inception till May 2024 across seven databases: Pubmed, Scopus, CINAHL, Web of Science, ProQuest, PsycINFO, and Embase.

Results

The results of the meta-analysis of the 12 included studies showed that peer support interventions could reduce depression and anxiety levels but not perceived social support levels. Sub-group analyses based on the mode of intervention delivery showed significant reductions on depression levels in online and face-to-face groups but not telephone call groups. Follow-up data analyses showed that peer support interventions could improve depression, anxiety, and perceived social support across a duration of 1–6 months post-intervention.

Linking Evidence to Action

This review provides a deeper understanding of the effect of peer support interventions on mothers in the perinatal period. This can have a positive impact on current knowledge aimed at improving the well-being of mothers and thus, their infants, partners, and entire family unit. Findings showed that peer support interventions can positively improve psychological well-being of mothers in the perinatal period in the short and long term. Peer support can ultimately be considered as a standardized part of perinatal care. Future recommendations include implementing a combination of face-to-face and online approaches to peer support interventions delivered with both individual and group components.

The triglyceride glucose index as a sensitive predictor for the risk of MACCEs in patients with diabetic foot ulcers: An ambispective longitudinal cohort study

Abstract

The triglyceride glucose (TyG) index has been confirmed a predictive value for type 2 diabetes mellitus (T2DM). However, no research has yet confirmed whether there is a linear correlation between the TyG index and MACCEs in DFUs. The present study aimed to delve into the association between the TyG index and the risk of MACCEs in patients with DFUs. A total of 960 inpatients with DFUs were recruited. All participants were followed up every 6 months for 11 years with a median of 83 months. According to the cut-off value of the TyG index acquired from receiver operating characteristic (ROC) analysis, the subjects were divided into two groups: low-level (<9.12, n = 480) and high-level (≥9.12, n = 480). The relationship between the TyG index and MACCEs was evaluated by the multivariable Cox regression model, restricted cubic spline (RCS) model, stratified analysis and the Kaplan–Meier survival analysis. Out of 960 participants, 271 experienced MACCEs (28.22%), of whom 79 (29.15%) died. ROC analysis got the optimal TyG index cut-off value of 9.12. Multivariable Cox regression analysis combined with the RCS model showed that the TyG index was positively associated with MACCEs in an S-shaped non-linear dose-dependent manner within the range of TyG index 7.5–9.5 (p < 0.001). The Kaplan–Meier survival analysis indicated the higher the TyG index, the greater the cumulative incidence of MACCEs (log-rank, p < 0.001). The study first confirmed an S-shaped non-linear dose-dependent positive relationship between the TyG index and the risk of MACCEs in DFUs. Consequently, lowering the TyG index level aids in improving the prognosis of patients with DFUs.

Hyperbaric oxygen therapy promotes the browning of white fat and contributes to the healing of diabetic wounds

Abstract

Non-healing wounds are one of the chronic complications of diabetes and have remained a worldwide challenge as one of the major health problems. Hyperbaric oxygen (HBO) therapy is proven to be very successful for diabetic wound treatment, for which the molecular basis is not understood. Adipocytes regulate multiple aspects of repair and may be therapeutic for inflammatory diseases and defective wound healing associated with aging and diabetes. Endothelial cell-derived extracellular vesicles could promote wound healing in diabetes. To study the mechanism by which HBO promotes wound healing in diabetes, we investigated the effect of HBO on fat cells in diabetic mice. A diabetic wound mouse model was established and treated with HBO. Haematoxylin and eosin (H&E) staining and immunofluorescence were used for the analysis of wound healing. To further explore the mechanism, we performed whole-genome sequencing on extracellular vesicles (EVs). Furthermore, we conducted in vitro experiments. Specifically, exosomes were collected from human umbilical vein endothelial cell (HUVEC) cells after HBO treatment, and then these exosomes were co-incubated with adipose tissue. The wound healing rate in diabetic mice treated with HBO was significantly higher. HBO therapy promotes the proliferation of adipose precursor cells. HUVEC-derived exosomes treated with HBO significantly promoted fat cell browning. These data clarify that HBO therapy may promote vascular endothelial cell proliferation and migration, and promote browning of fat cells through vascular endothelial cells derived exosomes, thereby promoting diabetic wound healing. This provides new ideas for the application of HBO therapy in the treatment of diabetic trauma.

Evaluating the efficacy of standardized pressure ulcer management protocols in the prevention of pressure injuries among patients undergoing neurosurgical procedures

Abstract

Pressure injuries are a significant concern for patients undergoing neurosurgical procedures due to prolonged immobility and the complexity of care. This study evaluates the efficacy of standardized pressure ulcer management protocols in preventing pressure injuries and enhancing patient care in a neurosurgical context. A comprehensive retrospective analysis was conducted at a single institution from December 2020 to December 2023, comparing 50 patients who received standardized pressure ulcer management (intervention group) with 50 patients who received conventional care (control group). The study assessed the incidence of pressure ulcers, patient comfort levels using the Kolcaba Comfort Scale and sleep quality using the Richards-Campbell Sleep Questionnaire (RCSQ). Statistical analysis was performed using SPSS software, version 27.0, applying t-tests and chi-square tests as appropriate. The intervention group exhibited a significantly lower incidence of pressure ulcers at all measured time points post-surgery compared to the control group. Patient comfort levels in the intervention group were consistently higher across psychological, environmental, physiological and socio-cultural domains. Sleep quality metrics, including sleep depth, latency to sleep onset and overall sleep quality, were significantly improved in the intervention group. The implementation of standardized pressure ulcer management protocols in neurosurgical care significantly reduces the incidence of pressure injuries, enhances patient comfort and improves sleep quality. These findings highlight the importance of adopting structured care protocols to improve postoperative outcomes and patient well-being in neurosurgical settings.

Physical frailty trajectories in older stroke survivors: Findings from a national cohort study

Abstract

Background

Physical frailty (PF) is highly prevalent and associated with undesirable outcomes in stroke survivors aged 65 years or older. However, the long-term trajectories of PF are understudied in those older stroke survivors.

Aims

To identify PF trajectories and relative predictors associated with the PF trajectories in older stroke survivors.

Design

This is a secondary analysis of a population-based cohort study in the United States.

Methods

Six hundred and sixty-three older stroke survivors from the National Health and Ageing Trends Study from 2015 to 2021 were included. PF was operationally assessed based on the Fried Frailty Phenotype. Trajectories were identified by group-based trajectory modelling. The associations between sociodemographic characteristics, clinical factors, symptoms, cognitive factors and PF trajectories were examined using the design-based logistic regression method.

Results

Most older stroke survivors were 75 and older (63.32%), female (53.99%), white (80.54%) and partnered (50.64%). Two PF trajectory groups were identified (Group 1: low risk, robust; 49.47%; Group 2: high risk, deteriorating; 50.53%). Individuals were at a higher risk to be assigned to Group 2 if they were 75–84 years (adjusted odds ratio [aOR]: 2.16, 95% CI: 1.23–3.80) or 85+ years (aOR: 2.77, 95% CI: 1.52–5.04), had fair self-reported health (aOR: 2.78, 95% CI: 1.53–5.07) or poor self-reported health (aOR: 3.37, 95% CI: 1.51–7.52), had comorbidities (aOR: 8.44, 95% CI: 1.31–54.42), had breathing problems (aOR: 2.18, 95% CI: 1.18–4.02) and had balance problems (aOR: 1.70, 95% CI: 1.06–2.73).

Conclusion

PF trajectories in older stroke survivors were heterogeneous and were associated with age, self-rated health status, comorbidities, breathing problems and balance problems.

Implication to Clinical Practice

Early, routine, dynamic screening for stroke-related physical frailty (PF) and relative predictors might be beneficial for identifying the most vulnerable individuals. Our findings might help develop strategies to manage PF progression.

Reporting Method

The reporting followed the STROBE guideline.

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