社区居家老年人跌倒经历的体验:质性研究的meta整合

目的系统评价和整合社区居家老年人跌倒经历的看法与体验,为后续发展跌倒预防及管理的干预提供信息,为健康照护实践提供建议。方法依据乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)质性系统评价方法论进行质性研究meta整合,在PubMed、CINAHL、PsycInfo、Embase、Web of science等数据库进行检索,发表时间限定为2010年1月至2023年5月,仅纳入经同行评审的英文文献。使用JBI质性研究质量评价标准评价纳入文献的方法学质量,按照ConQual评分准则检验整合结果的信度。本综述方案已在PROSPERO注册(CRD 42023421789)。结果共纳入10项研究,方法学质量评价得分为60%至90%。提炼59个完好明确的结果,将相似结果归纳组合形成7个类别,并综合成3个整合结果,在ConQual评分上,综合结果2评为中等,综合结果1和3评为低等。整合结果1:跌倒后老年人经历了身体的损伤和疼痛、日常活动受限、社交受限、独立性降低或丧失、并有恐惧和无助感。整合结果2:经历跌倒后,老年人反思跌倒的原因,并识别、解释风险因素。整合结果3:老年人对跌倒原因和后果有正面和负面的看法,其采取的应对跌倒的措施包括使用辅助器具、纠正风险因素、寻求医疗帮助、关注身体和心理状况等。结论医疗卫生提供者应重视老年人跌倒后的感受、经历,以及对跌倒原因和影响的反思,进行特定的干预。今后还需要进行纵向研究,以检测跌倒对老年人的长期影响,深入了解他们的反思、感知、态度和预防行为随时间的改变情况。

Electrochemical Surface Restructuring of Phosphorus-Doped Carbon@MoP Electrocatalysts for Hydrogen Evolution

The hydrogen evolution reaction(HER) through electrocatalysis is promising for the production of clean hydrogen fuel. However,designing the structure of catalysts,controlling their electronic properties,and manipulating their catalytic sites are a significant challenge in this field. Here,we propose an electrochemical surface restructuring strategy to design synergistically interactive phosphorus-doped carbon@MoP electrocatalysts for the HER. A simple electrochemical cycling method is developed to tune the thickness of the carbon layers that cover on MoP core,which significantly influences HER performance. Experimental investigations and theoretical calculations indicate that the inactive surface carbon layers can be removed through electrochemical cycling,leading to a close bond between the MoP and a few layers of coated graphene. The electronsdonated by the MoP core enhance the adhesion and electronegativity of the carbon layers;the negatively charged carbon layers act as an active surface. The electrochemically induced optimization of the surface/interface electronic structures in the electrocatalysts significantly promotes the HER. Using this strategy endows the catalyst with excellent activity in terms of the HER in both acidic and alkaline environments(current density of 10 mA cm^(-2) at low overpotentials,of 68 mV in 0.5 M H_(2)SO_(4) and 67 mV in 1.0 M KOH).

Lymphangiogenesis contributes to exercise-induced physiological cardiac growth

Background:Promoting cardiac lymphangiogenesis exerts beneficial effects for the heart.Exercise can induce physiological cardiac growth with cardiomyocyte hypertrophy and increased proliferation markers in cardiomyocytes.However,it remains unclear whether and how lymphangiogenesis contributes to exercise-induced physiological cardiac growth.We aimed to investigate the role and mechanism of lymphangiogenesis in exercise-induced physiological cardiac growth.Methods:Adult C57 BL6/J mice were subjected to 3 weeks of swimming exercise to induce physiological cardiac growth.Oral treatment with vascular endothelial growth factor receptor 3(VEGFR3) inhibitor SAR1 3 1 675 was used to investigate whether cardiac lymphangiogenesis was required for exercise-induced physiological cardiac growth by VEGFR3 activation.Furthermore,human dermal lymphatic endothelial cell(LEC)-conditioned medium was collected to culture isolated neonatal rat cardiomyocytes to determine whether and how LECs could influence cardiomyocyte proliferation and hypertrophy.Results:Swimming exercise induced physiological cardiac growth accompanied by a remarkable increase of cardiac lymphangiogenesis as evidenced by increased density of lymphatic vessel endothelial hyaluronic acid receptor 1-positive lymphatic vessels in the heart and upregulated LYVE-1 and Podoplanin expressions levels.VEGFR3 was upregulated in the exercised heart,while VEGFR3 inhibitor SAR131675 attenuated exercise-induced physiological cardiac growth as evidenced by blunted myocardial hypertrophy and reduced proliferation marker Ki67 in cardiomyocytes,which was correlated with reduced lymphatic vessel density and downregulated LYVE-1 and Podoplanin in the heart upon exercise.Furthermore,LEC-conditioned medium promoted both hypertrophy and proliferation of cardiomyocytes and contained higher levels of insulinlike growth factor-1 and the extracellular protein Reelin,while LEC-conditioned medium from LECs treated with SAR131675 blocked these effects.Functional rescue assays further demonstrated that protein kinase B(AKT) activation,as well as reduced CCAAT enhancer-binding protein beta(C/EBPβ) and increased CBP/p300-interacting transactivators with E(glutamic acid)/D(aspartic acid)-rich-carboxylterminal domain 4(CITED4),contributed to the promotive effect of LEC-conditioned medium on cardiomyocyte hypertrophy and proliferation.Conclusion:Our findings reveal that cardiac lymphangiogenesis is required for exercise-induced physiological cardiac growth by VEGFR3 activation,and they indicate that LEC-conditioned medium promotes both physiological hypertrophy and proliferation of cardiomyocytes through AKT activation and the C/EBPβ-CITED4 axis.These results highlight the essential roles of cardiac lymphangiogenesis in exercise-induced physiological cardiac growth.

Magnetic resonance imaging diagnosis of acute Guillain-Barré syndrome in children

The present study examined 24 children with acute Guillain-Barre syndrome using magnetic resonance imaging （MRI） plain scans and fat-suppressed enhanced Tl-weighted imaging （T1WI） scans. Axial MRI plain scans centering on the medullary conus were positive in nine patients （38%）. These displayed variable thickening involving the cauda equina with isointensity on T1WI and isointensity or slight hyperintensity on T2WI. False negatives were obtained in patients with cervical and cranial nerve symptoms. Contrast enhancement of T1WI with fat suppression was positive in all patients in the cauda equina with varied thickening and enhancement centering on the medullary conus. Five patients （36%） were positive in the cervical nerves and 3 patients （50%） were positive in the cranial nerves. These patients had corresponding cervical and cranial nerve symptoms, respectively. Patients with serious clinical symptoms in the lower limbs exhibited obvious involvement of the cauda equina by MRI. Statistical analysis revealed a positive correlation between the extent of enlargement of the cauda equina, centering on the medullary conus, and cerebrospinal fluid protein concentration.

S1PR1 serves as a viable drug target against pulmonary fibrosis by increasing the integrity of the endothelial barrier of the lung

Idiopathic pulmonary fibrosis(IPF)is a progressive lung disease with unclear etiology and limited treatment options.The median survival time for IPF patients is approximately 2–3 years and there is no effective intervention to treat IPF other than lung transplantation.As important components of lung tissue,endothelial cells(ECs)are associated with pulmonary diseases.However,the role of endothelial dysfunction in pulmonary fibrosis(PF)is incompletely understood.Sphingosine-1-phosphate receptor 1(S1PR1)is a G protein-coupled receptor highly expressed in lung ECs.Its expression is markedly reduced in patients with IPF.Herein,we generated an endothelial-conditional S1pr1 knockout mouse model which exhibited inflammation and fibrosis with or without bleomycin(BLM)challenge.Selective activation of S1PR1 with an S1PR1 agonist,IMMH002,exerted a potent therapeutic effect in mice with bleomycin-induced fibrosis by protecting the integrity of the endothelial barrier.These results suggest that S1PR1 might be a promising drug target for IPF therapy.

Epidemiology,pathogenesis,and management of coronavirus disease 2019-associated stroke

The coronavirus disease 2019(COVID-19)epidemic has triggered a huge impact on healthcare,socioeconomics,and other aspects of the world over the past three years.An increasing number of studies have identified a complex relationship between COVID-19 and stroke,although active measures are being implemented to prevent disease transmission.Severe COVID-19 may be associated with an increased risk of stroke and increase the rates of disability and mortality,posing a serious challenge to acute stroke diagnosis,treatment,and care.This review aims to provide an update on the influence of COVID-19 itself or vaccines on stroke,including arterial stroke(ischemic stroke and hemorrhagic stroke)and venous stroke(cerebral venous thrombosis).Additionally,the neurovascular mechanisms involved in SARS-CoV-2 infection and the clinical characteristics of stroke in the COVID-19 setting are presented.Evidence on vaccinations,potential therapeutic approaches,and effective strategies for stroke management has been highlighted.

FeOOH上掺入Ni和Cu引起的羟基和含氮中间物的共吸附行为实现加速氨氧化反应中的脱氢过程

氨是一种很有前途的能源载体,由于其高氢含量和无碳的特点,可用于燃料电池,并可作为电解水制氢装置中水的替代氧化底物.然而,人们对氨电氧化反应(AOR)的机理认识不足,且缺乏廉价、高效的AOR催化剂,因而阻碍了氨基能源系统的发展.在这项工作中,我们通过光诱导化学沉淀法合成的新型Ni和Cu共掺杂的多孔FeOOH纳米棒(NiCu-FeOOH)可以作为AOR催化剂,其具有高效的催化活性(阳极电流密度达到10 mA cm^(-2)时执行电压为1.41 V)和在氨碱溶液中优异的稳定性.实验数据和理论计算结果表明,异质的Ni和Cu原子的协同作用使得NiCu-FeOOH表面的Ni和Fe位点表现出更合适的电子结构,他们可以共同吸附含氮中间产物和羟基,并使其吸附自由能位于火山形曲线的顶部,从而加速AOR脱氢.决速步骤的后移(*NH_(2)+*OH形成步骤移至*N_(2)H_(3)+*OH形成步骤)和决速步骤较低的能垒(0.86 eV)揭示了Ni和Cu的共掺策略使FeOOH晶体对催化AOR更具活性.本文创新地提出了涉及含氮中间物和羟基的共吸附反应途径,以更好地描述和模拟AOR过程,这为设计低成本和稳定的AOR催化剂开辟了新的路径.

Cr^(3+)/Y^(3+)co-doped persistent luminescence nanoparticles with biological window activation for in vivo repeatable imaging

The near-infrared(NIR)persistent luminescence materials(PLMs)can remain long-lasting luminescence after removal of the excitation light,which permits bioimaging with high sensitivity owing to the absence of background fluorescence interference from in situ excitation.Recently,the NIR PLMs have aroused intensive research interest in bioimaging.However,the optimal excitation wavelength of current NIR PLMs is located in the ultraviolet region with shallow tissue penetration,making it difficult to activate effectively in vivo,and seriously hindering their further application in bioimaging.Herein,we report a novel kind of Cr^(3+)ions and Y^(3+)ions co-doped NIR PLM,Zn_(1.3)Ga_(1.4)Sn_(0.3)O_(4):Cr^(3+),Y^(3+)(ZGSCY),which emits NIR persistent luminescence at 696 nm.Compared with Zn_(1.3)Ga_(1.4)Sn_(0.3)O_(4):Cr^(3+)(ZGSC)excited by the light with a wavelength in the biological window(>650 nm),after being co-doped with Y^(3+)ions,the NIR persistent luminescence performance of ZGSCY is significantly improved because of the increase of trap concentration in the matrix.In addition,we synthesized ZGSCY nanoparticles(NPs)by the combustion method,which exhibit excellent optical properties after being excited by the light with a wavelength in the biological window.After surface modification with PEG,the ZGSCY NPs present low cytotoxicity.Notably,due to the co-doping of Y^(3+)ions,the signal-to-noise ratio(SNR)of ZGSCY NPs in vivo imaging is about 1.8 times higher than that of the ZGSC NPs.Furthermore,the rechargeable in vivo imaging and passive tumor-targeted imaging are successfully achieved by activating with a lightemitting diode(LED,659 nm)after intravenous injection of ZGSCY.Thus,this kind of NIR PLM with high excitation efficiency performance in the biological window is expected to promote its biomedical application in deep tissues.

Expression of sulfur uptake assimilation-related genes in response to cadmium,bensulfuron-methyl and their co-contamination in rice roots

The responses of sulfur （S） uptake assimilation-related genes＇ expression in roots of two rice cultivars to cadmium （Cd）, bensulfuron-methyl （BSM） and their co-contamination （Cd＋BSM） were investigated by gene-chip microarray analysis and quantitative real-time PCR （QRT-PCR） technology. Treatments of Cd and Cd＋BSM induced expression of sulfate transporter and permease genes, and promoted sulfate uptake in rice roots. Cd＋BSM could alleviate Cd toxicity to cv. Fengmeizhan seedlings, probably due to Cd＋BSM promoting greater S absorption by seedlings. Cd and Cd＋BSM induced expression of sulfate assimilation-related genes, and thus activated the sulfur assimilation pathway. Cd and Cd＋BSM induced expression of phytochelatin synthase and metallothionein genes, and induced expression of glutathione S-transferases （GSTs）, glutathione synthase （GS） and S- containing antioxidation enzyme genes, which detoxified Cd2＋. It is suggested that （to cope with the toxicity of Cd, BSM and their co-contamination） the S uptake and assimilation pathway was activated in rice roots by increased expression of related genes, thus enhancing the supply of organic S for synthesis of Cd or BSM resistance-related substances.

A multisite-binding fluorescent probe for simultaneous monitoring of mitochondrial homocysteine, cysteine and glutathione in live cells and zebrafish

Homocysteine(Hcy), cysteine(Cys) and glutathione(GSH) play crucial roles in redox homeostasis during mitochondria functions. Simultaneous differentiation and visualization of mitochondrial biothiols dynamics are significant for understanding cell metabolism and their related diseases. Herein, a multisitebinding fluorescent probe(MCP) was developed for simultaneous sensing of mitochondrial Cys, GSH and Hcy from three fluorescence channels for the first time. This novel probe exhibited rapid fluorescence turn-on, good water-solubility, high selectivity and large spectral separation for discriminating Cys, GSH and Hcy with 131-, 96-, 748-fold fluorescence increasement at 471, 520, 567 nm through different excitation wavelengths, respectively. Importantly, this probe was successfully applied to simultaneous monitoring of mitochondrial Cys, GSH, and Hcy in live cells and zebrafish from three fluorescence channels,promoting the understanding of the functions of Hcy, Cys and GSH.

A genomic association study revealing subphenotypes of childhood steroid-sensitive nephrotic syndrome in a larger genomic sequencing cohort

Dissecting the genetic components that contribute to the two main subphenotypes of steroid-sensitive nephrotic syndrome(SSNS)using genome-wide association studies(GWAS)strategy is important for understanding the disease.We conducted a multicenter cohort study(360 patients and 1835 controls)combined with a GWAS strategy to identify susceptibility var-iants associated with the following two subphenotypes of ssNS:steroid-sensitive nephrotic syn-drome without relapse(SSNswR,181 patients)and steroid-dependent/frequent relapse nephrotic syndrome(SDNS/FRNS,179 patients).The distribution of two single-nucleotide poly-morphisms(SNPs)in ANKRD36 and ALPG was significant between SSNSWR and healthy controls,and that of two SNPs in GAD1 and HLA-DQA1 was significant between SDNS/FRNS and healthy controls.Interestingly,rs1047989 in HLA-DQA1 was a candidate locus for SDNS/FRNS but not for SSNSWR.No significant SNPs were observed between SSNSWR and SDNS/FRNS.Meanwhile,chromosome 2:171713702 in GAD1 was associated with a greater steroid dose(>0.75 mg/kg/d)upon relapse to first remission in patients with SDNS/FRNS(odds ratio=3.14;95%confidence interval,0.97-9.87;P=0.034).rs117014418 in APOL4 was significantly associated with a decrease in eGFR of greater than 20%compared with the baseline in SDNS/FRNS patients(P=0.0001).Protein-protein intersection network construction suggested that HLA-DQA1 and HLA-DQB1 function together through GSDMA.Thus,SSNSWR belongs to non-HLA region-dependent nephropathy,and the HLA-DQA/DQB region is likely strongly associated with dis-ease relapse,especially in SDNS/FRNS.The study provides a novel approach for the GWAS strategy of SsNS and contributes to our understanding of the pathological mechanisms of SSNSWRandSDNS/FRNS.