Sloanlist4190

People diagnosed with a neurodegenerative disorder often contend with a threat to independence and control, leading some to complete an advance care plan. Advance care plans are commonly associated with treatment limitations; however, key patient agents (such as doctors, allied health, nurses and family) may instead make temporal, best interests or good medical practice decisions on behalf of the patient. Accordingly, there is a need to better understand ancillary decision-maker's perspectives, particularly of doctors.

To explain how the potentially conflicting interests of bedside patient agents operates as a factor which influences doctors' application of advance care plans of people with a neurodegenerative disorder.

Using a constructivist grounded theory informed thematic analysis, 38 semi-structured interviews were conducted with hospital-based doctors, allied health, nurses and family of people with a neurodegenerative disorder who had an advance care plan. Data were inductively analysed using opeations to the effectiveness of advance care plans in practice, with application typically only occurring close to death. Despite the intentions of advance care planning, bedside agents may still experience considerable dissonance.

Lipid profile abnormalities are an integral part of metabolic syndrome (MetS) and major underlying causes of cardiovascular disease (CVD) and type-2 diabetes mellitus (T2DM). Lipid profile abnormalities in a patient with MetS are resulted due to the presence of central obesity and insulin resistance. In Ethiopia, the burden and predictors of lipid profile abnormalities in a patient with MetS are not well known. Thus, this study aimed to determine the prevalence of lipid profile abnormalities and predictors among patients with MetS in southwest Ethiopia.

A cross-sectional study was conducted among 381 patients with MetS from September to December 2019 with a response rate of 100%. A structured questionnaire was used to collect data on socio-demographic and behavioral factors. Waist circumference, height, weight, and blood pressures were measured. The venous blood sample was collected for glucose and lipid profile determination. Data were entered and analyzed by using SPSS version 21. Binary logistic regresong patients with MetS were recommended.

In this study area, a high (58%) prevalence of dyslipidemia was observed in study participants, and increasing age, higher BMI, central obesity, hypertension, and high blood glucose level were identified as independent predictors of dyslipidemia among patients with MetS. Prevention and control of dyslipidemia and its predictors among patients with MetS were recommended.

The aim of this study was to investigate the relationship between levels of glycosylated hemoglobin (HbA1c) with meibomian gland dysfunction (MGD) in patients with type 2 diabetes mellitus (T2DM) and to further explore the related influencing factors.

Totally, 167 patients with T2DM and 68 non-diabetic subjects were selected. Further, T2DM patients were divided into 2 groups based on 7% HbA1c. Standard patient evaluation of eye dryness (SPEED), lipid layer thickness (LLT), partial blink (PB) ratio, percentage of partial glands (MGP), meibomian gland yielding liquid secretion (MGYLS), meibomian gland yielding secretion score (MGYSS), line of marx (LOM), tear break up time (TBUT), tear meniscus height (TMH) and Schirmer I test (SIT) were applied to evaluate meibomian gland function. Finally, the correlation between HbA1c and various indicators was also analyzed.

Between HbA1c≥7% group and HbA1c<7% group, the differences in LLT (P=0.003), MGP (P<0.001), MGYLS (P=0.014) and TBUT (P=0.015) were all statistically significant. Compared with the non-diabetic group, LLT (P=0.020), MBP (P<0.001), MGYS (P< 0.001), TBUT (P<0.001), SIT (P=0.001), TMH (P=0.017) and LOM (P<0.001) were significantly different in HbA1c≥7% group, while the differences of MBP (P=0.031), MGYSS (P<0.001), SIT (P=0.001) and LOM (P<0.001) in HbA1c≤7% group were statistically significant. Besides, the prevalence of MGD in HbA1c≥7% group was evidently higher than that in non-diabetic group (P=0.002). this website Correlation analysis showed that HbA1c was significantly associated with the LTT and MGP.

HbA1c≥7% is likely to result in meibomian gland function dysfunctions in T2DM patients, especially related to LLT and MGP.

HbA1c≥7% is likely to result in meibomian gland function dysfunctions in T2DM patients, especially related to LLT and MGP.

To explore the rate of post-stroke disability and its associated factors in the third year following discharge from inpatient rehabilitation in Northeast China.

A prospective cohort study.

A total of 522 persons who were hospitalized with a diagnosis of stroke were recruited consecutively between April 2015 and December 2015 and followed for 3 years. The primary outcome was disability, which was assessed using the Modified Barthel Index (MBI), a cutoff score of ≤95 indicates disability. Plausible risk factors of disability were selected from available variables to perform multivariate logistic regression analysis.

The proportion of post-stroke patients with disability decreased from 63.8% to 46.7% at 3-year follow-up. The factors associated with post-stroke disability were age, neurological deficits, cognitive function, depression, and social support.

Disability continues to be a significant issue for individuals after a stroke, and community health workers should perform targeted assessments and interventions to decrease disability, and pay special attention to individuals who are at greatest risk of post-stroke disability.

Disability continues to be a significant issue for individuals after a stroke, and community health workers should perform targeted assessments and interventions to decrease disability, and pay special attention to individuals who are at greatest risk of post-stroke disability.Chronic insomnia disorder, which affects 6-10% of the population, is diagnostically characterized by ongoing difficulties with initiating or maintaining sleep occurring at least three times per week, persisting for at least 3 months, and associated with daytime impairment. While chronic insomnia is often considered a condition primarily related to impaired sleep, the disorder can also adversely affect domains of physical and mental health, quality of life, and daytime function, which highlights the importance of treating the multidimensional sleep disorder. Owing to misperceptions about the safety and effectiveness of treatment options, many individuals with insomnia may not seek professional treatment, and alternatively use ineffective home remedies or over-the-counter medications to improve sleep. Some physicians may even believe that insomnia is remediated by simply having the patient "get more sleep". Unfortunately, treatment of insomnia is not always that simple. The disorder's complex underlying pathophysiology warrants consideration of different nonpharmacologic and pharmacologic treatment options. Indeed, recent insights gained from research into the pathophysiology of insomnia have facilitated development of newer treatment approaches with more efficacious outcomes. This narrative review provides a summary of the diagnostic criteria and pathophysiology of insomnia and its subtypes. link2 Further, this review emphasizes new and emerging nonpharmacologic and pharmacologic treatments for chronic insomnia, including recent enhancements in approaches to cognitive behavioral therapy for insomnia (CBT-I) and the new dual orexin receptor antagonist (DORA) pharmacologics. These advances in treatment have expanded the treatment options and are likely to result in improved outcomes in patients with chronic insomnia.

Post-traumatic stress disorder (PTSD) has an adverse impact on the emotional health of prenatal maternal women and their offspring. During the Coronavirus Disease 2019 (COVID-19) pandemic, pregnant women are vulnerable to traumatic events and are prone to PTSD symptoms. link3 The aim of the study was to explore the predictive effects of insomnia and somatization on PTSD in pregnant women by utilizing generalized additive model (GAM).

A total of 1638 pregnant women from three local cities in China underwent online survey on sleep quality, somatization, and PTSD symptoms tested by the Insomnia Severity Index (ISI), the subscale somatization of Symptom Checklist-90 (SCL-90-S) and the Checklist for DSM-5 (PCL-5), respectively.

Insomnia was positively correlated with PTSD symptoms in pregnant women (

= 1.79×10

). Interestingly, insomnia and somatization showed a complex non-primary linear interaction in predicting PTSD (

= 2.00×10

).

Our results suggest that insomnia is a prominent predictor of PTSD symptoms in pregnant women in the context of public emergencies. In addition, the effects of insomnia and somatization on PTSD symptoms are characterized by complex non-primary linear relationships.

Our results suggest that insomnia is a prominent predictor of PTSD symptoms in pregnant women in the context of public emergencies. In addition, the effects of insomnia and somatization on PTSD symptoms are characterized by complex non-primary linear relationships.

Mesoporous hydroxylapatite (MHAP) might be important for bone regeneration, and ursolic acid (UA) has anti-inflammatory effects. Accordingly, we developed, for the first time, ursolic acid-loaded MHAP-chitosan (MHAP-CS-UA) scaffolds to treat bone defects.

In vitro, we synthesize biomaterial scaffolds. By SEM, XRD, EDS and FTIR, we test the performance of the hybrid scaffolds. By drug release, flow cytometry, immunofluorescence, alizarin red staining, and Western blotting, we test the anti-inflammatory and osteo-inductive properties of scaffolds. In vivo, we verify osseointegration ability and bone regeneration.

The MHAP is a rod-shaped structure with a length of 100~300nm and a diameter of 40~60nm. The critical structure gives the micro-scaffold a property of control release due to the pore sizes of 1.6~4.3 nm in hydroxyapatite and the hydrogen bonding between the scaffolds and UA drugs. The released UA drugs could notably inhibit the polarization of macrophages to pro-inflammatory macrophages (M1 type) and promote the expression of osteogenic-related genes (COL1, ALP and OPG) and osteogenic-related proteins (BMP-2, RUNX2 and COL1).

The MHAP-CS-UA scaffolds have good anti-inflammatory, osseointegration, osteo-inductivity and bone regeneration. And they will be the novel and promising candidates to cure the bone disease.

The MHAP-CS-UA scaffolds have good anti-inflammatory, osseointegration, osteo-inductivity and bone regeneration. And they will be the novel and promising candidates to cure the bone disease.

Mild cognitive impairment and gender can impact different aspects of driving performance and behaviour in older drivers. However, there is little evidence on how these may affect naturalistic speeding behaviour. Therefore, the aim of this study was to examine the relationship between speeding events and cognitive status for older male and female drivers.

A naturalistic driving study collected objective driving information over a two-week period using an in-vehicle monitoring device from 36 older drivers with suspected mild cognitive impairment and 35 older drivers without cognitive impairment. The outcome of interest examined was the number of speeding events, defined as travelling 5+ km/h over the posted speed limit for at least a minute.

The majority of participants (n=58, 81.69%) did not have a speeding event during the two-week monitoring period. Twenty-three speeding events were recorded among seven drivers with suspected mild cognitive impairment and six drivers without cognitive impairment. The majority of speeding events (82.