Impact of stage-specific limb function exercises guided by a selfmanagement education model on arteriovenous fistula maturation status

BACKGROUND The exercise of limb function is the most economical and safe method to promote the maturation of arteriovenous fistula(AVF).However,due to the lack of a uni-fied exercise standard in China,many patients have insufficient awareness of the importance of AVF,leading to poor effectiveness of limb function exercise.The self-management education model can effectively promote patients to take pro-active health-related actions.This study focuses on the characteristics of patients during the peri-AVF period and conducts a phased limb function exercise under the guidance of the self-management education model to observe changes in fac-tors such as the maturity of AVF.AIM To assess the impact of stage-specific limb function exercises,directed by a self-management education model,on the maturation status of AVFs.METHODS This study is a randomized controlled trial involving 74 patients with forearm AVFs from the Nephrology Department of a tertiary hospital in Sichuan Province,China.Patients were randomly divided into an observation group and a control group using a random number table method.The observation group underwent tailored stage-specific limb func-tion exercises,informed by a self-management education model which took into account the unique features of AVF at various stages,in conjunction with routine care.Conversely,the control group was given standard limb function exercises along with routine care.The assessment involves the maturity of AVFs post-intervention,post-operative complications,and the self-management level of the fistula in both groups patients.Analyses were conducted using SPSS version 23.0.Count data were represented by frequency and percentage and subjected to chi-square test comparisons.Measurement data adhering to a normal distribution were presented as mean±SD.The independent samples t-test was utilized for inter-group comparisons,while the paired t-test was used for intra-group comparisons.For measurement data not fitting a normal distribution,the median and interquartile range were presented and analyzed using the Wilcoxon rank sum test.RESULTS At the 8-wk postoperative mark,the observation group demonstrated significantly higher scores in AVF symptom recognition,symptom prevention,and self-management compared to the control group(P<0.05).However,the variance in symptom management scores between the observation and control groups lacked statistical signi-ficance(P>0.05).At 4 wk after the operation,the observation group displayed a superior vessel diameter and depth from the skin of the drainage vessels in comparison to the control group(P<0.05).While the observation group did manifest elevated blood flow rates in the drainage vessels relative to the control group,this distinction was not statistically significant(P>0.05).By the 8-wk postoperative interval,the observation group outperformed the control group with notable enhancements in blood flow rates,vessel diameter,and depth from the skin of drainage vessels(P<0.01).Seven days following the procedure,the observation group manifested significantly diminished limb swelling and an overall reduced complication rate in contrast to the control group(P<0.05).The evaluation of infection,thrombosis,embolism,arterial aneurysm stenosis,and incision bleeding showed no notable differences between the two groups(P>0.05).By the 4-wk postoperative juncture,complications between the observation and control groups were statistically indistinguishable(P>0.05).CONCLUSION Stage-specific limb function exercises,under the guidance of a self-management education model,amplify the capacity of AVF patients to discern and prevent symptoms.Additionally,they expedite AVF maturation and miti-gate postoperative limb edema,underscoring their efficacy as a valuable method for the care and upkeep of AVF in hemodialysis patients.

Non-Gaussianity detection of single-mode rotationally symmetric quantum states via cumulant method

The non-Gaussianity of quantum states incarnates an important resource for improving the performance of continuous-variable quantum information protocols.We propose a novel criterion of non-Gaussianity for single-mode rotationally symmetric quantum states via the squared Frobenius norm of higher-order cumulant matrix for the quadrature distribution function.As an application,we study the non-Gaussianities of three classes of single-mode symmetric non-Gaussian states:a mixture of vacuum and Fock states,single-photon added thermal states,and even/odd Schr¨odinger cat states.It is shown that such a criterion is faithful and effective for revealing non-Gaussianity.We further extend this criterion to two cases of symmetric multi-mode non-Gaussian states and non-symmetric single-mode non-Gaussian states.

An NT-3-releasing bioscaffold supports the formation of TrkC-modified neural stem cell-derived neural network tissue with efficacy in repairing spinal cord injury

The mechanism underlying neurogenesis during embryonic spinal cord development involves a specific ligand/receptor interaction,which may be help guide neuroengineering to boost stem cell-based neural regeneration for the structural and functional repair of spinal cord injury.Herein,we hypothesized that supplying spinal cord defects with an exogenous neural network in the NT-3/fibroin-coated gelatin sponge(NF-GS)scaffold might improve tissue repair efficacy.To test this,we engineered tropomyosin receptor kinase C(TrkC)-modified neural stem cell(NSC)-derived neural network tissue with robust viability within an NF-GS scaffold.When NSCs were genetically modified to overexpress TrkC,the NT-3 receptor,a functional neuronal population dominated the neural network tissue.The pro-regenerative niche allowed the long-term survival and phenotypic maintenance of the donor neural network tissue for up to 8 weeks in the injured spinal cord.Additionally,host nerve fibers regenerated into the graft,making synaptic connections with the donor neurons.Accordingly,motor function recovery was significantly improved in rats with spinal cord injury(SCI)that received TrkC-modified NSC-derived neural network tissue transplantation.Together,the results suggested that transplantation of the neural network tissue formed in the 3D bioactive scaffold may represent a valuable approach to study and develop therapies for SCI.

Military-related posttraumatic stress disorder and mindfulness meditation:A systematic review and meta-analysis

Purpose:Posttraumatic stress disorder(PTSD)is a significant global mental health concern,especially in the military.This study aims to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD,by synthesizing evidences from randomized controlled trials.Methods:Five electronic databases(Pubmed,EBSCO Medline,Embase,PsychINFO and Cochrane Library)were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD.The selection of eligible studies was based on identical inclusion and exclusion criteria.Information about study characteristics,participant characteristics,intervention details,PTSD outcomes,as well as potential adverse effects was extracted from the included studies.Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool.R Statistical software was performed for data analysis.Results:A total of 1902 records were initially identified and screened.After duplicates removal and title&abstract review,finally,19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria.The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions,such as treatment as usual,present-centered group therapy and PTSD health education(standardized mean difference(SMD)=-0.33;95%CI[-0.45,-0.21];p<0.0001).Mindfulness interventions with different control conditions(active or non-active control,SMD=-0.33,95%CI[-0.46,-0.19];SMD=-0.49,95%CI[-0.88,-0.10],respectively),formats of delivery(group-based or individual-based,SMD=-0.30,95%CI[-0.42,-0.17],SMD=-0.49,95%CI[-0.90,-0.08],respectively)and intervention durations(short-term or standard duration,SMD=-0.27,95%CI[-0.46,-0.08],SMD=-0.40,95%CI[-0.58,-0.21],respectively)were equally effective in improving military-related PTSD symptoms.Conclusion:Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD.Further evidence with higher quality and more rigorous design is needed in the future.