Physical activity with or without dietary intervention for the prevention of cardiovascular diseases

We and others have published extensively on the benefits of physical activity(PA),exercise training,and cardiorespiratory fitness(CRF)to decrease the prevalence of cardiovascular diseases(CVDs)and CVD and all-cause morbidity and mortality.^(1-5)Both PA and CRF are important;however,CRF,which is mostly obtained through PA,although there is a genetic component,seems to be even more important than PA for predicting prognosis.^(1,4-6)Certainly,the wealth of data from across the world has indicated that increasing PA to enhance CRF while mitigating sedentary behavior would go a long way to lessen the world-wide obesity epidemic and reduce CVD and all-cause mortality.

Dietary Lipid Intervention in the Prevention of Brain Aging

As people live longer,the burden of aging-related brain diseases,especially dementia,is increasing.Brain aging increases the risk of cognitive impairment,which manifests as a progressive loss of neuron function caused by the impairment of synaptic plasticity via disrupting lipid homeostasis.Therefore,supplemental dietary lipids have the potential to prevent brain aging.This review summarizes the important roles of dietary lipids in brain function from both structure and mechanism perspectives.Epidemiological and animal studies have provided evidence of the functions of polyunsaturated fatty acids(PUFAs)in brain health.The results of interventions indicate that phospholipids—including phosphatidylcholine,phosphatidylserine,and plasmalogen—are efficient in alleviating cognitive impairment during aging,with plasmalogen exhibiting higher efficacy than phosphatidylserine.Plasmalogen is a recognized nutrient used in clinical trials due to its special vinyl ether bonds and abundance in the postsynaptic membrane of neurons.Future research should determine the dose-dependent effects of plasmalogen in alleviating brain-aging diseases and should develop extraction and storage procedures for its clinical application.

Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity:Implications for prevention and intervention

BACKGROUND Childhood obesity is a growing global concern with far-reaching health implications.This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity.Despite the increasing prevalence of childhood obesity worldwide,this issue remains inadequately addressed in the Moroccan context.AIM To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity.METHODS The research encompasses a comprehensive survey of practicing physicians,revealing significant gaps in awareness and practices related to maternal obesity.RESULTS Notably,a significant portion of doctors do not provide adequate guidance to overweight pregnant women,highlighting the urgency for targeted educational programs.CONCLUSION In conclusion,this research illuminates critical areas for improvement in tackling childhood obesity in Morocco.By addressing these gaps,fostering awareness,and enhancing medical practices,the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.

Meta-analysis of new intervention measures for preventing side effects of artificial joint replacement

BACKGROUND Intertrochanteric fracture of the femur occurs mostly among older people,and seriously affects daily life and quality of life.At present,physical intervention,drug treatment,routine intervention and rehabilitation training are widely used for prevention of side effects,but it is still inconclusive which intervention has the best effect.AIM To compare the effects of new intervention measures for preventing side effects of artificial joint replacement.METHODS We searched the Chinese and English literatures for comparative studies on the prevention of side effects of new interventions for artificial joint replacement from July 2013 to June 2023 in China HowNet,PubMed,Wanfang,Weipu and other databases.Study quality was evaluated by improved Jadad scoring standard,and the effects of different interventions on preventing different complications were analyzed by meta-analysis of evidence-based medicine with Review Manager 5.0 software.RESULTS Ten articles,including 869 cases,were finally included.The preventive effects of different interventions on the side effects of artificial joint replacement were studied,and valid data were extracted.There were two articles on the preventive effects of drug intervention,four on comparison of the preventive effects of combined and single interventions,and three on the preventive effects of physical intervention,rehabilitation training and routine intervention.Meta-analysis showed that the preventive effect of rivaroxaban was significantly better than low molecular weight heparin calcium[mean difference(MD)=-0.16,95%CI:-0.28 to-0.04,P<0.05].The effect of combined intervention was significantly better than that of single intervention(MD=-0.08,95%CI:-0.16 to-0.01,P<0.001).Physical intervention was significantly better than routine intervention and rehabilitation training(MD=0.26,95%CI:0.16–0.36,P<0.001).CONCLUSION Rivaroxaban combined with rehabilitation training is preferred for preventing deep vein thrombosis after artificial joint replacement.In the prevention of pulmonary embolism,rivaroxaban drug intervention is given priority.The effect of combined intervention is better than that of single intervention.

Recognizing and preventing complications regarding bioresorbable scaffolds during coronary interventions

The evolution of coronary intervention techniques and equipment has led to more sophisticated procedures for the treatment of highly complex lesions.However,as a result,the risk of complications has increased,which are mostly iatrogenic and often include equipment failure.Stent dislodgement warrants vigilance for the early diagnosis and a stepwise management approach is required to either expand or retrieve the lost stent.In the era of bioresorbable scaffolds that are not radiopaque,increased caution is required.Intravascular imaging may assist in detecting the lost scaffold in cases of no visibility fluoroscopically.Adequate lesion preparation is the key to minimizing the possibility of equipment loss;however,in the case that it occurs,commercially available and improvised devices and techniques may be applied.

Delivering substance use prevention interventions for adolescents in educational settings:A scoping review

Currently,a proportion of adolescents use alcohol,tobacco,and illicit drugs,which inevitably harms their health and academic progress.Adolescence is a peak period for substance use initiation and a critical time for preventing substance use problems.Various entities,such as families,schools,and communities,have implemented a variety of interventions to alleviate adolescent substance use problems,and schools play a unique role.To explore the types,characteristics,and effectiveness of substance use interventions in educational settings for adolescents,we conducted a scoping review and identified 32 studies after screening.We divided the 32 studies according to intervention type,including curriculum interventions focusing on cognitive-behavioral skill enhancement,exercise interventions,peer interventions and family-school cooperation,and electronic interventions.Except for the mixed results on electronic interventions,the results showed that the other interventions were beneficial to different extents in alleviating adolescent substance use problems.In addition,we analyzed and summarized the advantages and challenges of intervening in adolescent substance use in educational settings.Schools can use equipment and human resources to provide adolescents with various types of intervention measures,but they also face challenges such as stigmatization,ineffective coordination among multiple resources,and poor implementation effects.In the future,school-based intervention measures can fully utilize big data and artificial intelligence technology and collaborate with families and communities to intervene appropriately while paying attention to the comorbidity risks of substance use disorders and psychological health issues.

Analysis of The Preventive Effect of Nursing Intervention on Complications After Whole Cerebral Angiography

Objective: To analyze the effect of nursing intervention in preventing complications after whole-brain angiography and reducing the risk of neurological dysfunction, infection, and vascular complications. Methods: One hundred patients who underwent whole-brain angiography in our hospital from December 2022 to December 2023 were selected and randomly divided into control and observation groups of 50 cases each. The control group received routine care, and the observation group received systematic care. The psychological status, complication rate, nursing quality, blood pressure, and nursing satisfaction of the two groups of patients were compared. Results: Before the intervention, there was no significant difference in psychological state between the two groups (P > 0.05). After the intervention, the positive effect (PA) and negative effect (NA) exhibited a significant correlation between the two groups (P < 0.05). The observation group had a lower incidence of postoperative complications as compared to the control group (P < 0.05). The nursing quality and satisfaction of the observation group were significantly higher than those of the control group (P < 0.05). There was no significant difference in blood pressure levels between the two groups before surgery (P > 0.05), while during and after surgery, the blood pressure levels of the two groups of patients showed a highly significant correlation (P < 0.05). Conclusion: Nursing intervention exhibited a significant preventive effect after whole-brain angiography. Scientific and reasonable nursing measures can effectively reduce the incidence of complications and improve the surgical safety and recovery of patients.

The Preventive Effect of Comprehensive Nursing Intervention on Arteriovenous Fistula Failure in Patients in the Hemodialysis Room

Objective:To explore the preventive effect of comprehensive nursing intervention on arteriovenous fistula failure in patients in the hemodialysis room.Methods:82 patients with arteriovenous fistula in the hemodialysis chamber treated in our hospital from July 2022 to October 2023 were selected as the research subjects.The random number table method divided them into a control group and an experimental group of 41 cases each.The control group received general nursing intervention measures,while the experimental group underwent comprehensive nursing intervention.The incidence of complications(internal fistula failure,bleeding,thrombosis,infection),psychological emotions(SAS scale,SDS scale),quality of life(physical pain,physiological function,emotional function,social function),and nursing satisfaction(very satisfied,basically satisfied,satisfied,dissatisfied)were compared between the two groups of patients.Results:The incidence of complications in the experimental group(4,9.76%)was significantly lower than that in the control group(29,70.73%);the SAS scores and SDS scores of the patients in the experimental group after intervention were both lower than those in the control group;the quality of life score(physical pain,physiological function,emotional function,and social function)was all higher than those of the control group;the post-intervention nursing satisfaction of the experimental group(40,97.57%)was also significantly higher than that of the control group(29,73.17%);and the listed differences were statistically significant(P<0.01).Conclusion:For patients with hemodialysis ventricular arteriovenous fistula failure,comprehensive nursing intervention can reduce the incidence of complications,relieve anxiety and stress,improve quality of life and nursing satisfaction,and achieve better preventive effects.

Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in Prevention and Control of Multi-drug Resistance Infection

Objective Contact precautions,especially the initiation of isolation,are important measures to prevent and control multidrug-resistant organisms(MDROs).However,the implementation in clinical practice remains weak.This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection,and determine the factors that affect the implementation of isolation measures.Methods A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1,2018.The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected.Then,the issuance of isolation orders was retrospectively analyzed.Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation.Results The overall issuance rate of isolation orders was 61.21%,which increased from 33.12%to 75.88%(P<0.001)after the implementation of the multidisciplinary collaborative intervention.The intervention(P<0.001,OR=0.166)was a promoting factor for the issuance of isolation orders,in addition to the length of stay(P=0.004,OR=0.991),department(P=0.004),and microorganism(P=0.038).Conclusion The isolation implementation remains far lower than policy standards.Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors,thereby promoting the standardized management of MDROs,and providing reference for further improving the quality of hospital infection management.

Key Road Injury Prevention Interventions and Their Effectiveness in Africa: Conclusions and What Can Be Done Better

Introduction: This study aimed to identify road safety interventions implemented in Africa and to analyze their effectiveness in reducing road crashes, injuries, disabilities and deaths. Materials and Methods: This is a systematic review including articles relating to the evaluation of road safety interventions implemented in Africa that were searched on electronic databases: PubMed, Scopus, Lissa, Google Scholar, and African Journals Online. Selection of articles and data extraction was conducted by two pairs of reviewers. Data quality was checked according to the type of study. A qualitative analysis of the data was carried out and a narrative approach was adopted to describe and synthesize the results. Results: A total of twenty-nine articles were selected including one cross-sectional study, seven time series, twenty-one quasi-experimental studies of which six randomised and fifteen non-randomised studies. The type of interventions evaluated was aimed at all types of users and was based on different interventions such as institutional strengthening, law enforcement, awareness raising, training or user education, vehicle maintenance and infrastructure improvements. For fourteen studies all the expected indicators had changed favourably and for twelve the indicators had partially changed. The studies that showed significant change were institutional strengthening, law enforcement, awareness raising, training, or user education interventions, development of Uber transport services, distribution of equipment, and a combination of interventions. Conclusion: This situation is indicative of insufficient policy investment in research but also in the field of road safety in general.

Analysis of the Role of Nursing Intervention in Operating Room in the Prevention of Incision Infection in Orthopedic Aseptic Surgery

Objective:To explore and analyze the role of nursing in the operating room in the prevention of incision infection in aseptic orthopedic surgery.Methods:68 patients that underwent aseptic orthopedic surgery in our hospital from January 2021 to December 2022.They were divided into a research group(n=34)and a control group(n=34)by the random number table method.The patients in the control group received conventional nursing intervention in the operating room,and the patients in the study group received the optimized and modified nursing intervention in the operating room;then,the related indicators of nursing intervention of the two groups were compared.Results:The incidence of incision infection in the study group was lower than that of the control group(P<0.05);the average duration of surgery and length of stay the study group were lower than those in the control group(P<0.05);the stress response indexes of patients in the study group were lower than those in the control group 24 hours after operation(P<0.05);the degree of satisfaction of the patients in the study group to the services provided by the nursing staff was significantly higher than that of the control group(P<0.05).Conclusion:High-quality nursing intervention in the operating room for aseptic orthopedic surgery patients can significantly reduce the incidence of incision infection,reduce the stress response caused by surgery,shorten the duration of surgery and length of stay,and improve nursing satisfaction,which makes it worthy of popularization.

Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P<0.05 each),but not with overall weight loss.A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake(>500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

Cervical cancer prevention in China: where are we now, and what's next?

Cervical cancer(CC) epidemiology CC, the fourth most frequently diagnosed malignancy in women worldwide, is a major global health challenge, particularly in low-resource regions. Approximately 88.1% of the 604,000 CC new cases occurred in low-and middle-income countries in 2020, and more than 90% of the 342,000 CC deaths occurred in low-and middle-income countries in 2020~1.

Impact of frailty on outcomes of elderly patients undergoing percutaneous coronary intervention: A systematic review and metaanalysis

BACKGROUND Frailty is a common condition in elderly patients who receive percutaneous coronary intervention(PCI).However,how frailty affects clinical outcomes in this group is unclear.AIM To assess the link between frailty and the outcomes,such as in-hospital complic-ations,post-procedural complications,and mortality,in elderly patients post-PCI.METHODS The PubMed/MEDLINE,EMBASE,Cochrane Library,and Web of Science databases were screened for publications up to August 2023.The primary outcomes assessed were in-hospital and all-cause mortality,major adverse cardiovascular events(MACEs),and major bleeding.The Newcastle-Ottawa Scale was used for quality assessment.RESULTS Twenty-one studies with 739693 elderly patients undergoing PCI were included.Frailty was consistently associated with adverse outcomes.Frail patients had significantly higher risks of in-hospital mortality[risk ratio:3.45,95%confidence interval(95%CI):1.90-6.25],all-cause mortality[hazard ratio(HR):2.08,95%CI:1.78-2.43],MACEs(HR:2.92,95%CI:1.85-4.60),and major bleeding(HR:4.60,95%CI:2.89-7.32)compared to non-frail patients.CONCLUSION Frailty is a pivotal determinant in the prediction of risk of mortality,development of MACEs,and major bleeding in elderly individuals undergoing percutaneous coronary intervention.

Unlocking the potential-vitamin D in prostate cancer prevention

Prostate cancer poses a significant health challenge globally,demanding proactive prevention strategies.This editorial explores the emerging role of vitamin D in prostate cancer prevention.While traditionally associated with bone health,vitamin D is increasingly recognized for its broader impact on immune function,cellular signaling,and cancer prevention.Epidemiological studies suggest an intriguing link between vitamin D deficiency and elevated prostate cancer risk,particularly in regions with limited sunlight exposure.Mechanistically,vitamin D regulates cellular processes,inhibiting unchecked cancer cell growth and bols-tering immune surveillance.Personalized prevention strategies,considering individual factors,are deemed essential for harnessing the full potential of vitamin D.To unlock this potential,the future calls for robust research,public awareness campaigns,dietary improvements,and vigilant medical guidance.Collaborative efforts are poised to pave the way toward a future where vitamin D stands as a sentinel in prostate cancer prevention,ushering in hope and improved health for men worldwide.

Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

Pharmacological interventions targeting the microcirculation following traumatic spinal cord injury

Traumatic spinal cord injury is a devastating disorder chara cterized by sensory,motor,and autonomic dysfunction that seve rely compromises an individual's ability to perform activities of daily living.These adve rse outcomes are closely related to the complex mechanism of spinal cord injury,the limited regenerative capacity of central neurons,and the inhibitory environment fo rmed by traumatic injury.Disruption to the microcirculation is an important pathophysiological mechanism of spinal cord injury.A number of therapeutic agents have been shown to improve the injury environment,mitigate secondary damage,and/or promote regeneration and repair.Among them,the spinal cord microcirculation has become an important target for the treatment of spinal cord injury.Drug inte rventions targeting the microcirculation can improve the microenvironment and promote recovery following spinal cord injury.These drugs target the structure and function of the spinal cord microcirculation and are essential for maintaining the normal function of spinal neuro ns,axons,and glial cells.This review discusses the pathophysiological role of spinal cord microcirculation in spinal cord injury,including its structure and histopathological changes.Further,it summarizes the progress of drug therapies targeting the spinal cord mic rocirc ulation after spinal cord injury.

Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma

Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.

Optimization of nursing interventions for postoperative mental status recovery in patients with cerebral hemorrhage

BACKGROUND Hypertensive cerebral hemorrhage(HCH),the most common chronic diseases,has become a topic of global public health discussions.AIM To investigate the role of rehabilitative nursing interventions in optimizing the postoperative mental status recovery phase and to provide clinical value for future rehabilitation of patients with HCH.METHODS This randomized controlled study included 120 patients with cerebral HCH who were contained to our neurosurgery department between May 2021–May 2023 as the participants.The participants have randomly sampled and grouped into the observation and control groups.The observation group received the rehabilitation nursing model,whereas the control group have given conventional nursing.The conscious state of the patients was assessed at 7,14,21,and 30 d postoperatively.After one month of care,sleep quality,anxiety,and depression were compared between the two groups.Patient and family satisfaction were assessed using a nursing care model.RESULTS The results showed that the state of consciousness scores of the patients in both groups significantly increased(P<0.05)after surgical treatment.From the 14th day onwards,differences in the state of consciousness scores between the two groups of patients began to appear(P<0.05).After one month of care,the sleep quality,anxiety state,and depression state of patients were significantly better in the observation group than in the control group(P<0.05).Satisfaction with nursing care was higher in the observation group than in the control group(P<0.05).CONCLUSION The rehabilitation nursing model has a more complete system compared to conventional nursing,which can effectively improve the postoperative quality of life of patients with cerebral hemorrhage and improve the efficiency of mental state recovery;however,further analysis and research are needed to provide more scientific evidence.

Adolescent suicide risk factors and the integration of socialemotional skills in school-based prevention programs

Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.