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.

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.

Frost deformation and microstructure evolution of porous rock under uniform and unidirectional freeze-thaw conditions

The frost deterioration and deformation of porous rock are commonly investigated under uniform freeze-thaw(FT)conditions.However,the unidirectional FT condition,which is also prevalent in engineering practice,has received limited attention.Therefore,a comparative study on frost deformation and microstructure evolution of porous rock under both uniform and unidirectional FT conditions was performed.Firstly,frost deformation experiments of rock were conducted under cyclic uniform and unidirectional FT action,respectively.Results illustrate that frost deformation of saturated rock exhibits isotropic characteristics under uniform FT cycles,while it shows anisotropic characteristics under unidirectional FT condition with both the frost heaving strain and residual strain along FT direction much higher than those perpendicular to FT direction.Moreover,the peak value and residual value of cumulative frost strain vary as logarithmic functions with cycle number under both uniform and unidirectional FT conditions.Subsequently,the microstructure evolution of rock suffered cyclic uniform and unidirectional FT action were measured.Under uniform FT cycles,newly generated pores uniformly distribute in rock and pore structure of rock remains isotropic in micro scale,and thus the frost deformation shows isotropic characteristics in macro scale.Under unidirectional FT cycles,micro-cracks or pore belts generate with their orientation nearly perpendicular to the FT direction,and rock structure gradually becomes anisotropic in micro scale,resulting in the anisotropic characteristics of frost deformation in macro scale.

Fractal Study on the Evolution of Micro-Pores in Concrete Under Freeze-Thaw

After exposure to freeze-thaw cycles, scanning electron microscopy(SEM) and nuclear magnetic resonance(NMR) were used to test the four mixtures. The microstructure is qualitatively analyzed from the 2D SEM image and the 3D pore distribution curve before and after freezing and thawing. The fractal dimension is utilized to characterize the two-dimensional topography image and the three-dimensional pore distribution, quantitatively. The results reveal that the surface porosity and volume porosity increase as the freeze-thaw action increases. Self-similarity characteristics exist in micro-damage inside the concrete. In the fractal dimension, it is possible to characterize pore evolution quantitatively. The fractal dimension correlates with pore damage evolution. The fractal dimension effectively quantitatively characterizes micro-damage features at various scales from the local to the global level.

Freeze-thaw cycles and associated geomorphology in a post-glacial environment:current glacial,paraglacial,periglacial and proglacial scenarios at Pico de Orizaba volcano,Mexico

The glacial history of Pico de Orizaba indicates that during the Last Glacial Maximum,its icecap covered up to~3000 m asl;due to the air temperature increasing,its main glacier has retreated to 5050 m asl.The retraction of the glacier has left behind an intense climatic instability that causes a high frequency of freeze-thaw cycles of great intensity;the resulting geomorphological processes are represented by the fragmentation of the bedrock that occupies the upper parts of the mountain.There is a notable lack of studies regarding the fragmentation and erosion occurring in tropical high mountains,and the associated geomorphological risks;for this reason,as a first stage of future continuous research,this study analyzes the freezing and thawing cycles that occur above 4000 m asl,through continuous monitoring of surface ground temperature.The results allow us to identify and characterize four zones:glacial,paraglacial,periglacial and proglacial.It was found that the paraglacial zone presents an intense drop of temperature,of up to~9℃ in only sixty minutes.The rock fatigue and intense freeze-thaw cycles that occur in this area are responsible for the high rate of rock disintegration and represent the main factor of the constant slope dynamics that occur at the site.This activity decreases,both in frequency and intensity,according to the distance to the glacier,which is where the temperature presents a certain degree of stability,until reaching the proglacial zone,where cycles are almost non-existent,and therefore there is no gelifraction activity.The geomorphological processes have resulted in significant alterations to the mountain slopes,which can have severe consequences in terms of risk and water.

Effect of sodium starch octenyl succinate-based Pickering emulsion on the physicochemical properties of hairtail myofibrillar protein gel subjected to multiple freeze-thaw cycles

A Pickering emulsion based on sodium starch octenyl succinate(SSOS)was prepared and its effects on the physicochemical properties of hairtail myofibrillar protein gels(MPGs)subjected to multiple freeze-thaw(F-T)cycles were investigated.The whiteness,water-holding capacity,storage modulus(G')and texture properties of the MPGs were significantly improved by adding 1%-2%Pickering emulsion(P<0.05).Meanwhile,Raman spectral analysis demonstrated that Pickering emulsion promoted the transformation of secondary structure,enhanced hydrogen bonds and hydrophobic interactions,and promoted the transition of disulfide bond conformation from g-g-g to g-g-t and t-g-t.At an emulsion concentration of 2%,theα-helix content decreased by 10.37%,while theβ-sheet content increased by 7.94%,compared to the control.After F-T cycles,the structure of the MPGs was destroyed,with an increase in hardness and a decrease in whiteness and water-holding capacity,however,the quality degradation of MPGs was reduced with 1%-2%Pickering emulsion.These findings demonstrated that SSOS-Pickering emulsions,as potential fat substitutes,can enhance the gel properties and the F-T stability of MPGs.

Surrounding rock pressure in the tunnel portal section through moraine under freeze-thaw action

Moraines,characterized by the accumulation of rock and soil debris transported by glacial activity,present unique challenges for tunnel construction,particularly in portal sections,due to prevailing geographical and climatic conditions that facilitate freeze-thaw action.Despite these challenges,there is a dearth of studies investigating the influence of freeze-thaw action and water content on the mechanical properties of moraines,and no research on calculating surrounding rock pressure in moraine tunnels subjected to freeze-thaw conditions.In this study,direct shear tests under freeze-thaw cycles were conducted to examine the effects of freeze-thaw cycles and water content on the mechanical properties of frozen moraine.A comprehensive parameter K,integrating the number of freeze-thaws and water content,was introduced to model cohesion c.Drawing on Terzaghi Theory,we propose an improved algorithm for calculating surrounding rock pressure at the portal section of moraine tunnels.Using a tunnel as a case study,surrounding rock pressure was calculated under various conditions to validate the Improved Algorithm's efficacy.The results show that:(1)Strength loss exhibits a linear trend with the number of freeze-thaw cycles at water content levels of 4%and 8%,while at 12%water content,previous freeze-thaw cycles induce more significant damage to the soil.(2)Moraine saturation peaks between 8%and 12%water content.Following repeated freeze-thaw cycles,moraine shear strength initially increases before decreasing with varying water content.(3)The internal friction angle of moraine experiences slight reductions with prolonged freeze-thaw cycles,but both freeze-thaw cycles and water content significantly influence cohesion.(4)Vertical surrounding rock pressure increases after the initial freeze-thaw cycle,particularly with higher water content,although freeze-thaw cycles have minimal effect on it.(5)Freeze-thaw cycles lead to a substantial increase in lateral surrounding rock pressure,necessitating reinforced support structures at the arch wall,arch waist,and arch foot in engineering projects to mitigate freeze-thaw effects.This study provides a foundation for designing and selecting tunnel support structures in similar geological conditions.

Coupling Effect of Cryogenic Freeze-Thaw Cycles and Chloride Ion Erosion Effect in Pre-Cracked Reinforced Concrete

Chloride (Cl−) ion erosion effects can seriously impact the safety and service life of marine liquefied natural gas(LNG) storage tanks and other polar offshore structures. This study investigates the impact of different low-temperaturecycles (20°C, –80°C, and −160°C) and concrete specimen crack widths (0, 0.3, and 0.6 mm) on the Cl−ion diffusion performance through rapid erosion tests conducted on pre-cracked concrete. The results show thatthe minimum temperature and crack width of freeze-thaw cycles enhance the erosive effect of chloride ions. TheCl− ion concentration and growth rate increased with the increasing crack width. Based on the experimental modeland in accordance with Fick’s second law of diffusion, the Cl− ion diffusion equation was modified by introducingcorrection factors in consideration of the freeze-thaw temperature, crack width, and their coupling effect.The experimental and fitting results obtained from this model can provide excellent reference for practical engineeringapplications.

Experimental study on the movement of oil spill under freeze-thaw action

Oil leakages cause environmental pollution,economic losses,and even engineering safety accidents.In cold regions,researchers urgently investigate the movement of oil spill in soils exposed to freeze-thaw cycles.In this study,a series of laboratory model experiments were carried out on the migration of oil leakage under freeze-thaw action,and the distributions of the soil temperature,unfrozen water content,and displacement were analyzed.The results showed that under freeze-thaw action,liquid water in soils migrated to the freezing front and accumulated.After the pipe cracked,oil pollutants first gathered at one side of the leak hole,and then moved around.The pipe wall temperature affected the soil temperature field,and the thermal influence range below and transverse the pipe wall(35–40 cm)was larger than that above the pipe wall(8 cm)owing to the soil surface temperature.The leaked oil's temperature would make the temperature of the surrounding soil rise.Oil would inhibit the cooling of the soils.Besides,oil migration was significantly affected by the gravity and water flow patterns.The freeze-thaw action would affect the migration of the oil,which was mainly manifested as inhibiting the diffusion and movement of oil when soils were frozen.Unfrozen water transport caused by freeze-thaw cycles would also inhibit oil migration.The research results would provide a scientific reference for understanding the relationship between the movement of oil pollutants,water,and soil temperature,and for establishing a waterheat-mass transport model in frozen soils.

Repair of Second-Generation Recycled Fine Aggregate of Waste Concrete from Freeze-Thaw Environment by Carbonation Treatment

The reuse of waste recycled concrete from harsh environments has become a research hotspot in the field of construction.This study investigated the repair effect of carbonation treatment on second-generation recycled fine aggregate(SRFA)obtained from recycled fine aggregate concrete(RFAC)subjected to freeze-thaw(FT)cycles.Before and after carbonation,the properties of SRFA were evaluated.Carbonated second-generation recycled fine aggregate(CSRFA)at five substitution rates(0%,25%,50%,75%,100%)to replace SRFA was used to prepare carbonated second-generation recycled fine aggregate concrete(CSRFAC).The water absorption,porosity and mechanical properties of CSRFAC were tested,and its frost-resisting durability was evaluated.The results showed after carbonation treatment,the physical properties of SRFA was improved and met the requirements of II aggregate.The micro-hardness of the interfacial transition zone and attached mortar in CSRFA was 50.5%and 31.2%higher than that in SRFA,respectively.With the increase of CSRFA replacement rate,the water absorption and porosity of CSRFAC gradually decreased,and the mechanical properties and frost resistance of CSRFAC were gradually improved.Carbonation treatment effectively repairs the damage of SRFA caused by FT cycles and improves its application potential.

Machine learning in metal-ion battery research: Advancing material prediction, characterization, and status evaluation

Metal-ion batteries(MIBs),including alkali metal-ion(Li^(+),Na^(+),and K^(3)),multi-valent metal-ion(Zn^(2+),Mg^(2+),and Al^(3+)),metal-air,and metal-sulfur batteries,play an indispensable role in electrochemical energy storage.However,the performance of MIBs is significantly influenced by numerous variables,resulting in multi-dimensional and long-term challenges in the field of battery research and performance enhancement.Machine learning(ML),with its capability to solve intricate tasks and perform robust data processing,is now catalyzing a revolutionary transformation in the development of MIB materials and devices.In this review,we summarize the utilization of ML algorithms that have expedited research on MIBs over the past five years.We present an extensive overview of existing algorithms,elucidating their details,advantages,and limitations in various applications,which encompass electrode screening,material property prediction,electrolyte formulation design,electrode material characterization,manufacturing parameter optimization,and real-time battery status monitoring.Finally,we propose potential solutions and future directions for the application of ML in advancing MIB development.

Spatiotemporal variation and freeze-thaw asymmetry of Arctic sea ice in multiple dimensions during 1979 to 2020

Arctic sea ice is broadly regarded as an indicator and amplifier of global climate change.The rapid changes in Arctic sea ice have been widely concerned.However,the spatiotemporal changes in the horizontal and vertical dimensions of Arctic sea ice and its asymmetry during the melt and freeze seasons are rarely quantified simultaneously based on multiple sources of the same long time series.In this study,the spatiotemporal variation and freeze-thaw asymmetry of Arctic sea ice were investigated from both the horizontal and vertical dimensions during 1979–2020 based on remote sensing and assimilation data.The results indicated that Arctic sea ice was declining at a remarkably high rate of–5.4×10^(4) km^(2)/a in sea ice area(SIA)and–2.2 cm/a in sea ice thickness(SIT)during 1979 to 2020,and the reduction of SIA and SIT was the largest in summer and the smallest in winter.Spatially,compared with other sub-regions,SIA showed a sharper declining trend in the Barents Sea,Kara Sea,and East Siberian Sea,while SIT presented a larger downward trend in the northern Canadian Archipelago,northern Greenland,and the East Siberian Sea.Regarding to the seasonal trend of sea ice on sub-region scale,the reduction rate of SIA exhibited an apparent spatial heterogeneity among seasons,especially in summer and winter,i.e.,the sub-regions linked to the open ocean exhibited a higher decline rate in winter;however,the other sub-regions blocked by the coastlines presented a greater decline rate in summer.For SIT,the sub-regions such as the Beaufort Sea,East Siberian Sea,Chukchi Sea,Central Arctic,and Canadian Archipelago always showed a higher downward rate in all seasons.Furthermore,a striking freeze-thaw asymmetry of Arctic sea ice was also detected.Comparing sea ice changes in different dimensions,sea ice over most regions in the Arctic showed an early retreat and rapid advance in the horizontal dimension but late melting and gradual freezing in the vertical dimension.The amount of sea ice melting and freezing was disequilibrium in the Arctic during the considered period,and the rate of sea ice melting was 0.3×10^(4) km^(2)/a and 0.01 cm/a higher than that of freezing in the horizontal and vertical dimensions,respectively.Moreover,there were notable shifts in the melting and freezing of Arctic sea ice in 1997/2003 and 2000/2004,respectively,in the horizontal/vertical dimension.

Antibody Levels and Infection Status of Pertussis in the Population under Pertussis Resurgence in Guangxi in 2018:A Cross-Sectional Survey

Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population.Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA).Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively).Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.

Assessement of Nutritional Status of Households Using Weighed Food Intake in North West Region of Cameroon

This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.

Changes of China’s Status in the Global System and Its Influencing Factors:A Multiple Contact Networks Perspective

Clarifying China’s position in the global system is an important logical basis for developing national diplomacy.Although much research has been done on China’s development status,most studies have been based on country comparisons or institutional en-vironment.In today’s networked era in which the global economy,trade,personnel,and information are closely connected,studies on China’s global position and its status changes and influencing factors in multiple contact networks are still insufficient.In this study,from the perspective of diverse global contact networks,we constructed economic,cultural,and political influence indices to explore the changes and influencing factors on China’s status in the global system from 2005 to 2018.The results show that during the study period,China’s global influence in the fields of economic ties,cultural exchanges,and political contacts increased significantly,but its influ-ence in the fields of cultural exchanges and political contacts lagged far economic ties.The pattern of China’s economic influence on various economies around the world has shown a transformation from an‘upright pyramid’to an‘inverted pyramid’structure.The proportion of these economies in low-influence zones has decreased from more than 60%in 2005 to less than 20%in 2018.China’s cultural and political influence on various economies around the world has increased significantly;however,for the former,the percentage of high-influence areas is still less than 20%,whereas for the latter the percentage of these economies in medium-and high-influence areas is still less than 50%.Analyses such as a scatter plot matrix show that geographical proximity,economic globalization,close cooperation with developing countries,and a proactive and peaceful foreign policy are important factors in improving China’s status in the diverse global network system.

Clinical significance of preoperative nutritional status in elderly gastric cancer patients undergoing radical gastrectomy:A singlecenter retrospective study

BACKGROUND The population of elderly patients with gastric cancer is increasing,which is a major public health issue in China.Malnutrition is one of the greatest risk factors for adverse clinical outcomes in elderly patients with gastric cancer.AIM To investigate the preoperative nutritional status and its association with delayed discharge of elderly gastric cancer patients following radical gastrectomy.METHODS A total of 783 patients aged 65 years and older harboring gastric adenocarcinoma and following radical gastrectomy were retrospectively analyzed from the prospectively collected database of Zhongshan Hospital of Fudan University between January 2018 and May 2020.RESULTS The overall rate of malnutrition was 31.8%.The incidence of postoperative complications was significantly higher in the malnourished group compared to the well-nourished group(P<0.001).Nutritional characteristics in the malnourished group,including body mass index,prognostic nutritional index(PNI),albumin,prealbumin,and hemoglobin,were all significantly lower than those in the well-nourished group.The percentage of patients who received postoperative total nutrient admixture was lower in the malnourished group compared to the wellnourished group(22.1%vs 33.5%,P=0.001).Age≥70 years(HR=1.216,95%CI:1.048-1.411),PNI<44.5(HR=1.792,95%CI:1.058-3.032),operation time≥160 minutes(HR=1.431,95%CI:1.237-1.656),and postoperative complications grade III or higher(HR=2.191,95%CI:1.604-2.991)were all recognized as independent risk factors associated with delayed discharge.CONCLUSION Malnutrition is relatively common in elderly patients undergoing gastrectomy.Low PNI is an independent risk factor associated with delay discharge.More strategies are needed to improve the clinical outcome of these patients.

Implementation Status and Development Strategies of Study Tour in Primary Schools in Nanchang City : A Case Study of L Primary School

In recent years,with the support and promotion of relevant policies such as the Opinions on Promoting Study Tour for Primary and Secondary School Students jointly issued by the Ministry of Education and 11 other departments,a wave of study tour has been sparked nationwide from individual pilot projects to gradual promotion.In this paper,students and teachers from grades 4 to 6 of L Primary School in Nanchang City,Jiangxi Province were selected as the survey objects.Combining the survey questionnaire,the current situation of conducting study tour in the primary school was sorted out and analyzed in depth from several aspects such as study tour cognition,study tour participation,study tour implementation,etc.Based on the survey results and relevant research,the current problems in conducting study tours in primary schools were summarized,and targeted improvement measures were proposed,in order to promote the healthy development of study tours in primary schools.

Preoperative controlling nutritional status as an optimal prognostic nutritional index to predict the outcome for colorectal cancer

BACKGROUND The controlling nutritional status(CONUT)score effectively reflects a patient’s nutritional status,which is closely related to cancer prognosis.This study invest-igated the relationship between the CONUT score and prognosis after radical surgery for colorectal cancer,and compared the predictive ability of the CONUT score with other indexes.AIM To analyze the predictive performance of the CONUT score for the survival rate of colorectal cancer patients who underwent potentially curative resection.METHODS This retrospective analysis included 217 patients with newly diagnosed colorectal.The CONUT score was calculated based on the serum albumin level,total lymphocyte count,and total cholesterol level.The cutoff value of the CONUT score for predicting prognosis was 4 according to the Youden Index by the receiver operating characteristic curve.The associations between the CONUT score and the prognosis were performed using Kaplan-Meier curves and Cox regression analysis.RESULTS Using the cutoff value of the CONUT score,patients were stratified into CONUT low(n=189)and CONUT high groups(n=28).The CONUT high group had worse overall survival(OS)(P=0.013)and relapse-free survival(RFS)(P=0.015).The predictive performance of CONUT was superior to the modified Glasgow prognostic score,the prognostic nutritional index,and the neutrophil-to-lymphocyte ratio.Meanwhile,the predictive performances of CONUT+tumor node metastasis(TNM)stage for 3-year OS[area under the receiver operating characteristics curve(AUC)=0.803]and 3-year RFS(AUC=0.752)were no less than skeletal muscle mass index(SMI)+TNM stage.The CONUT score was negatively correlated with SMI(P<0.01).CONCLUSION As a nutritional indicator,the CONUT score could predict long-term outcomes after radical surgery for colorectal cancer,and its predictive ability was superior to other indexes.The correlation between the CONUT score and skeletal muscle may be one of the factors that play a predictive role.

Influence of the continuing COVID-19 epidemic on sleep quality and psychological status of healthcare workers in private institutions

BACKGROUND On January 22,2020,Macao reported its first case of coronavirus disease 2019(COVID-19)infection.By August 2021,the situation had escalated into a crisis of community transmission.In response,the government launched a recruitment campaign seeking assistance and services of healthcare workers(HCWs)from the private sector throughout Macao.These participants faced concerns about their own health and that of their families,as well as the responsibility of maintaining public health and wellness.This study aims to determine whether the ongoing epidemic has caused them physical and psychological distress.AIM To examine the influence of COVID-19 on the sleep quality and psychological status of HCWs in private institutions in Macao during the pandemic.METHODS Data were collected from December 2020 to January 2022.Two consecutive surveys were conducted.The Pittsburgh Sleep Quality Index(PSQI)scale,Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were employed as investigation tools.RESULTS In the first-stage survey,32%of HCWs experienced a sleep disorder,compared to 28.45%in the second-stage survey.A total of 31.25%of HCWs in the first-stage survey and 28.03%in the second had varying degrees of anxiety.A total of 50.00%of HCWs in the first-stage survey and 50.63%in the second experienced varying degrees of depression.No difference in PSQI scores,SAS scores,or SDS scores were observed between the two surveys,indicating that the COVID-19 epidemic influenced the sleep quality and psychological status of HCWs.The negative influence persisted over both periods but did not increase remarkably for more than a year.However,a positive correlation was observed between the PSQI,SAS,and SDS scores(r=0.428-0.775,P<0.01),indicating that when one of these states deteriorated,the other two tended to deteriorate as well.CONCLUSION The sleep quality,anxiety,and depression of HCWs in private institution in Macao were affected by the COVID-19 epidemic.While these factors did not deteriorate significantly,the negative effects persisted for a year and remained noteworthy.

Recipient functional status impacts on short and long-term intestinal transplant outcomes in United States adults

BACKGROUND Recipient functional status prior to transplantation has been found to impact post-transplant outcomes in heart,liver and kidney transplants.However,information on how functional status,before and after transplant impacts post-transplant survival outcomes is lacking.AIM To investigate the impact of recipient functional status on short and long term intestinal transplant outcomes in United States adults.METHODS We conducted a retrospective cohort study on 1254 adults who underwent first-time intestinal transplantation from 2005 to 2022.The primary outcome was mortality.Using the Karnofsky Performance Status,functional impairment was categorized as severe,moderate and normal.Analyses were conducted using Kaplan-Meier curves and multivariable Cox regression.RESULTS The median age was 41 years,majority(53.4%)were women.Severe impairment was present in 28.3%of recipients.The median survival time was 906.6 days.The median survival time was 1331 and 560 days for patients with normal and severe functional impairment respectively.Recipients with severe impairment had a 56%higher risk of mortality at one year[Hazard ratio(HR)=1.56;95%CI:1.23–1.98;P<0.001]and 58%at five years(HR=1.58;95%CI:1.24–2.00;P<0.001)compared to patients with no functional impairment.Recipients with worse functional status after transplant also had poor survival outcomes.CONCLUSION Pre-and post-transplant recipient functional status is an important prognostic indicator for short-and long-term intestinal transplant outcomes.