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The use and impact of virtual reality programs supported by aromatherapy for older adults: A scoping review protocol
Both virtual reality and aromatherapy have shown promising impacts on the health and well-being of older adults. Aromatherapy has been reported to enhance immersive experiences during virtual reality programs. However, studies on the combined use and impact of virtual reality and aromatherapy for older adults have not been systematically reviewed. Therefore, this scoping review will identify existing types of virtual reality programs supported by various forms of aromatherapy and their outcome measures and results on the well-being of older adults. This review will be conducted in accordance with the Joanna Briggs Institute methodology or scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The search strategy will encompass both published and unpublished papers. The databases to be searched are CINAHL, MEDLINE, Embase, Scopus, Web of Science, ACM digital library, IEEE Xplore digital library, Compendex, ProQuest, and Google Scholar. Two independent reviewers will perform title and abstract screening, full-text screening, and data extraction. Data analysis and synthesis will be discussed by the whole research team, mapped in the literature table and accompanied by a narrative summary. Scoping review data will be collected from publicly available articles; research ethics approval is not required. The findings will be disseminated through a peer-reviewed publication and conference presentations.
Methylome profiling of cell-free DNA during the early life course in (un)complicated pregnancies using MeD-seq: Protocol for a cohort study embedded in the prospective Rotterdam periconception cohort
Introduction Placental DNA methylation differences have been associated with timing in gestation and pregnancy complications. Maternal cell-free DNA (cfDNA) partly originates from the placenta and could enable the minimally invasive study of placental DNA methylation dynamics. We will for the first time longitudinally investigate cfDNA methylation during pregnancy by using Methylated DNA Sequencing (MeD-seq), which is compatible with low cfDNA levels and has an extensive genome-wide coverage. We aim to investigate DNA methylation in placental tissues and cfDNA during different trimesters in uncomplicated pregnancies, and in pregnancies with placental-related complications, including preeclampsia and fetal growth restriction. Identified gestational-age and disease-specific differentially methylated regions (DMRs) could lead to numerous applications including biomarker development. Methods and analysis Our study design involves three sub-studies. Sub-study 1 is a single-centre prospective, observational subcohort embedded within the Rotterdam Periconception cohort (Predict study). We will longitudinally collect maternal plasma in each trimester and during delivery, and sample postpartum placentas (n = 300). In sub-study 2, we will prospectively collect first and second trimester placental tissues (n = 10 per trimester). In sub-study 3 we will retrospectively collect plasma after non-invasive prenatal testing (NIPT) in an independent validation case-control cohort (n = 30–60). A methylation-dependent restriction enzyme (LpnPI) will be used to generate DNA fragments followed by sequencing on the Illumina NextSeq2000 platform. DMRs will be identified in placental tissues and cell types, and in cfDNA related to gestational-age or placental-related complications. (Paired) placental methylation profiles will be correlated to DMRs in cfDNA to aid tissue-of-origin analysis. We will establish a methylation score to predict associated diseases. Discussion This study will provide insights in placental DNA methylation dynamics in health and disease, and could lead to clinical relevant biomarkers.
Hybrid coating prepared with PMMA/Ti-O-Si tested under vacuum conditions for use in nanosatellites
A hybrid coating made of poly (methyl methacrylate) with SiO2-TiO2 particles (PMMA/SiO2-TiO2) has been developed for use as a coating on nanosatellites, evaluating its resistance to high vacuum by quantifying its weight loss. The coating was applied on an Al 7075 aluminum substrate used for the aerospace sector. PMMA/SiO2-TiO2 hybrid coatings were prepared using sol-gel reaction in situ assisted with sonochemistry. The SiO2 particles and TiO2 (50:50% wt. of rutile/anatase) particles by tetraethyl orthosilicate (TEOS), and Titanium (IV) Isopropoxide (TIPO). Radical polymerization of methyl methacrylate (MMA) monomer was conducted with (3-mercaptopropyl) trimethoxy silane (3-MPTS) used as a coupling molecular agent, and benzoyl peroxide as a catalyst. The coatings obtained have a thickness of 20 μm which were deposited by blade coating technique on the substrate, obtaining homogeneous and defect-free coatings. Adhesion and hardness were measured using ASTM standards required for this sector. To evaluate its resistance to ultra-high vacuum, it was done as close as possible to the ASTM E-595 norm [1], where it indicates that the coatings must be evaluated at vacuum conditions of 10−5 Torr and 125°C for a period of 24 hours. The coatings were evaluated before and after the test by spectroscopy analysis to determine a possible degradation in the chemical structure. The resulting weight loss not exceeding 0.02%, and the addition of Ti-O-Si particles led to an increase in chemical stability under vacuum conditions without affecting the chemical structure of the highly cross-linked PMMA/Ti-O-Si matrix, which was monitored by FTIR and Raman spectroscopy.
Do you have enough space? Habitat selection of insectivorous cave-dwelling bats in fragmented landscapes of Eastern Amazon
Individual movements of bats are triggered by their life requirements, limited by their recognition of the environment and risks of moving, and mediated by habitat selection. Mining adds fragmentation and heterogeneity to landscapes, with poorly understood consequences to the life activities of the bats. Cave dwelling bats spend most of their life cycles within caves, and as they constantly forage in external landscapes, their contribution in the input of organic matter to the caves is of paramount importance to the subterranean biodiversity. We investigated habitat selection by cave bats in a mosaic of Amazonian forests, iron-rich savannas and iron-caves, studying the movements of the aerial insect-catcher Furipterus horrens (Furipteridae) and of the foliage gleaning bat Lonchorhina aurita (Phyllostomidae), both cave-dependent in the area. We used radio telemetry to assess their use of habitats, under the prediction that these species prefer preserved habitats for their foraging bouts, avoiding human-modified habitats. We also anticipated larger areas and commuting distances for both species when foraging in disturbed landscapes. Thirty-one bats were monitored in conserved habitats, mining sites and pastures resulting in an average range of 415.1 ± 837.4 ha and average commuting distances of 2163 ± 2453 m ( F . horrens ) and 681.1 ± 1101 ha and 2781.5 ± 2333 m ( L . aurita ). Our results suggest that F . horrens are open space foragers, frequently recorded in cangas, and L . aurita are forest foragers that use all habitats proportionally to their availability in the landscape. We detected landscape-related effects mediated by seasonal variation in the maximum commuting distance performed by both species. These are the first radiotelemetry data available for F . horrens and L . aurita , delivering original baselines to understand their movement behaviors. This information sheds light into constraints related to the optimal and adjusted biological cycles of these two species and their range shifts under scenarios of disturbance and may subsidize programs for their conservation.
An interprofessional model to improve LGBTQ+ specific cultural competence in dental and pharmacy students
Background Disproportionate access to healthcare services among the Lesbian, Gay, Bisexual, Transgender, Queer or Questioning and others (LGBTQ+) population can be partially attributed to the lack of cultural competence among healthcare providers. The aim of this study was to evaluate the impact of an interprofessional model in improving cultural competence and clinical preparedness among dental and pharmacy students for providing LGBTQ+ specific care. Methodology This study is a retrospective observational study which used a novel interprofessional model of three different LGBTQ+ focused educational interventions within a group of dental and pharmacy students. The study used pre- and post-surveys, Assessment of Interprofessional Team Collaboration Scale (AITCS-II) and the Team Observed Structured Clinical Encounter (TOSCE) evaluations to assess the effectiveness of the interventions. Descriptive statistics, Fisher’s exact test, Wilcoxon signed-rank test, Welch test, Kruskal-Wallis Test, and pairwise Wilcox Test were employed to analyze quantitative data while qualitative insights were gathered from evaluator comments and student feedback. Results The study evaluated cultural competence among 154 dental and pharmacy students revealing improved cultural humility post-intervention, particularly for dental students although not statistically significant (p>0.05). Students participating in multiple interventions had higher mean scores, but the differences were not significant (p>0.05). Significant differences were found among interprofessional teams of students in the domains of roles and responsibilities (p = 0.039) and patient centered approach (p = 0.039). No significant differences were found in individual scores participation in the teams (p = 0.018). Students also provided positive feedback on the program’s impact on their understanding of LGBTQ+ health issues and inclusive care. Conclusion This program was a novel intervention aimed at improving cultural competence for health professional students in an interprofessional environment Further research in the direction can be useful in creating replicable programs.
Predicting early cessation of exclusive breastfeeding using machine learning techniques
Background Identification of mother-infant pairs predisposed to early cessation of exclusive breastfeeding is important for delivering targeted support. Machine learning techniques enable development of transparent prediction models that enhance clinical applicability. We aimed to develop and validate two models to predict cessation of exclusive breastfeeding within one month among infants born after 35 weeks gestation using machine learning techniques. Methods Utilizing a nationwide dataset from Statistics Denmark, including infants born between the 1st of January 2014 and the 31st of December 2015, we employed random forest machine learning to develop two predictive models. The first model included 11 well-established factors associated with cessation of exclusive breastfeeding within one month. The second model was expanded to include 21 additional factors associated with complications during pregnancy and delivery that potentially impede breastfeeding. Feature importance was applied to elucidate the factors driving model predictions. Results The dataset comprised 110,206 infants and 106,835 mothers. The first model predicted cessation of exclusive breastfeeding within one month with an area under the receiver operating curve of 62.0% (95% confidence interval 61.3% - 62.7%) and an accuracy of 60.4% (95% confidence interval 59.8% - 61.0%). The second model predicted cessation of exclusive breastfeeding within one month with an area under the receiver operating curve of 62.2% (95% confidence interval 61.5% - 62.9%) and an accuracy of 60.0% (95% confidence interval 59.3% - 60.6%). In both models, birthplace, maternal education, delivery mode, and maternal body mass index were the most important factors influencing the overall model performance. Conclusions The two models could not accurately predict cessation of exclusive breastfeeding within one month among infants born after 35 weeks gestation. Contrary to our expectations, including additional factors in the model did not increase model performance.
Cervical cancer care at a tertiary oncology facility in Uganda: Comparing daily practice with national treatment targets on cervical cancer control
Objective Treatment of cervical cancer patients in Uganda is hampered by late diagnosis due to the unavailability of timely screening and limited availability of advanced cancer care. This study evaluated the clinical presentation and management of cervical cancer patients presenting at the Uganda Cancer Institute (UCI) in Kampala, the tertiary oncology facility in Uganda with access to radiotherapy and reflected on daily clinical practice to identify priority areas for improving cervical cancer care in Uganda. Patients and methods We retrospectively analyzed medical records of all cervical cancer patients presenting to UCI between January 2017 and March 2018 for sociodemographic characteristics and clinical variables with descriptive statistics. The clinical management of patients with early and advanced stage disease who initiated treatment at UCI was evaluated using the national targets formulated in the Uganda strategic plan for cervical cancer prevention and control. Results Medical records of 583 patients were included, representing less than 10% of the annual estimated incidence in Uganda. The majority (86%) of patients presented with advanced stage of disease. More than half of patients never initiated (31%) or interrupted (30%) treatment. The national treatment targets for surgery (10%) and palliative care (25%) were achieved for eligible patients at UCI, however, the target for chemoradiotherapy (65%) was not met. Conclusion Daily clinical practice differed from the ambitions formulated in the national treatment targets on cervical cancer control. While most women presented in advanced stage requiring chemoradiotherapy, the target was not met due to limited availability of radiotherapy. Although targets for surgery and palliative care were achieved at UCI facility level, they mask the unmet need of the majority of cervical cancer patients who never initiated or completed treatment. This demands for further expansion of oncological surgical capacity, chemotherapy and radiotherapy and warrants to focus on accessible prevention programs.
Behaviors and influencing factors of Chinese oncology nurses towards frailty care: A cross-sectional study based on knowledge-attitude-practice theory in 2024
Background The demand for frailty care is continuously increasing in hospitalized tumor patients with the aging of the population. Nurses are the primary care providers of hospitalized tumor patients with frailty but research on exploring their behavior and associated factors is limited. This study aims to describe the current situation of frailty care behaviors in oncology nurses and to explore the factors influencing frailty care behaviors. Methods From August 1, 2023, to March 31, 2024, this cross-sectional study was conducted among nurses from oncology-related departments in 5 Secondary A (mid-tier hospitals providing comprehensive care) or above hospitals in South China. Convenience sampling was employed to recruit participants. In China, a "Secondary A hospital is a mid-tier hospital that provides comprehensive medical care and handles more complex cases than primary hospitals but is smaller and less specialized than tertiary hospitals. Data were collected using the standardized frailty-knowledge, attitudes, and practices questionnaire (F-KAP) and general information questionnaire including sociodemographic and work-related details. The sub-scale scores of knowledge, attitude, and practice were calculated by summing up the items within each sub-scale. Student’s independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and two kinds of multiple linear regression models were used for data analysis. Results We included a total of 17 (3.70%) male and 443 (96.30%) female participants in this study. The mean total score of oncology nurses for frailty care behaviors was 33.26±6.61. The three lowest scoring behaviors were “conduct frailty measurements and screening for patients (3.30±1.12)”, “accumulate frailty-related knowledge in daily work (3.59±0.87)”, and “actively pay attention to the patient’s debilitating condition”. Pearson’s correlations analysis showed that nursing grades (r = 0.13), frailty-related training willingness (r = 0.18), nursing frail patients experience (r = 0.22), frailty-related knowledge learning experience (r = 0.33), frailty-related training experience (r = 0.17), frailty care knowledge (r = 0.23), and hospice care attitudes (r = 0.54) were positively associated with frailty care behaviors. Two kinds of multiple linear regression models both showed that the factors most significantly associated with the oncology nurses’ frailty care behaviors are their self-rated subjective knowledge and attitudes towards frailty identification. Conclusion Oncology nurses practiced relatively low-frequency frailty in daily work. Our findings provide theoretical support for improving frailty care attitudes among nurses and enhancing patient quality of life.
Cellular therapy for the peripheral arterial disease treatment: Protocol for a systematic review and meta-analysis
Cellular therapy is a promising treatment option for Peripheral Arterial Disease (PAD). Different cell types can be used to regenerate and repair tissues affected by PAD. Many studies have proposed the use of stem cells, such as mesenchymal stem cells, or even mononuclear cells isolated from peripheral blood or bone marrow, to treat PAD. This paper reports a protocol of systematic review and meta-analysis that aims to identify the effects of stem cell treatment in patients with peripheral arterial disease. The search will be conducted in the following database: PubMed/MEDLINE, Clinicaltrial.gov, Scopus, Embase, Epistemonikos, Web of Science and Cochrane Library. Studies will be selected independently by two reviewers and will include all published randomized and non-randomized clinical trials. The data extraction will include studies population characteristics, type of treatment and main outcomes. We will assess the methodological quality of the studies using the Cochrane Risk of Bias 2.0 and Risk of Bias in Non-randomized Studies of Interventions. The certainty of the evidence will be rate using the Grading of Recommendations, Assessment, Development, and Evaluations. The findings will be presented in narrative summary tables and in a meta-analysis.
Identifying genetic susceptibility loci associated with human coronary artery disease
Coronary artery disease (CAD) is a multigenic condition influenced by both nature and nurture (60% to 40%). Prognosis of CAD is based on familial patterns. This study examined and analyzed the susceptibility of CAD to genetic variants in various Pakistani families. A total of 50 families, 308 participants (79 affected and 229 unaffected were genotyped for NOS3 (rs1799983, rs2070744), PON1 (rs662), LPA-PLA2 (rs105193, rs1805017), APOE (rs429358, rs7412), PCSK9 (rs505151), MEF2A (rs325400), TNF (rs1800629) and LDLR (rs1122608, rs2228671) genes. The family-based association in CAD associated genes SNPs were NOS3 (rs1799983), PON1 (rs662), LPA-PLA2 (rs1805017), MEF2A (rs325400), and LDLR (rs1122608, rs222867) showed transmission within families p≤ 0.05 whereas NOS3 (rs2070744), APOE (rs429358, rs7412) and TNF (rs1800629) showed no association TDT asymptotic p-value >0.05. In DFAM and QFAM test NOS3 (rs1799983), PON1 (rs662), MEF2A (rs325400), and LDLR (rs1122608, rs222867) showed positive association p≤ 0.05 in both whereas NOS3 (rs2070744), APOE (rs429358, rs7412), LPA-PLA2 (rs1805017) and TNF (rs1800629) showed low risk of transmission asymptotic p-value >0.05 in DFAM but NOS3(rs2070744), APOE(rs7412), LPA-PLAG2(rs1805017) also showed association p≤ 0.05 whereas APOE (rs429358) and TNF (rs1800629) showed no association EMP1 p-value >0.05 in QFAM. In linkage analysis Chromosome 6 (Position 70.810): LOD = 3.16, Chromosome 7 (Position 107.190): LOD = 3.16, and chromosome 19 (Position 31.470): LOD = 3.90 also showed significant association with disease as p < 0.05. This discovery enhances the understanding about genetic variants of CAD and also facilitates early detection, targeted interventions, pattern of inheritance in population. This ultimately improving patient outcomes and guiding future research to highlight its significance as a potential diagnostic marker.
Deploying large language models for discourse studies: An exploration of automated analysis of media attitudes
This study aims to provide an LLM (Large Language Model)-based method for the discourse analysis of media attitudes, and thereby investigate media attitudes towards China in a Hong Kong-based newspaper. Analysis of attitudes in large amounts of media data is crucial for understanding public opinions, market trends, social dynamics, etc. However, corpus-based approaches have traditionally focused on explicit linguistic expressions of attitudes, leaving implicit expressions unconsidered. To address this gap, the present study explored the possibility of using LLMs for the automated identification and classification of both explicit and implicit attitudes and evaluated the feasibility of implementing this approach on personal computers. The analysis was based on the framework proposed by Martin and White, which provides a structured approach for describing different aspects of media attitudes [1]. Meta’s open-source Llama2 (13b) was used for automated attitude analysis and was quantised for deployment on personal computers. The quantised LLM was used to analyse 40,000 expressions about China in a corpus of news reports from Oriental Daily News, a top-selling newspaper in Hong Kong. The results demonstrated that the quantised LLM can accurately capture both explicit and implicit attitudes, with a success rate of approximately 80%, comparable to that of proficient human coders. Challenges encountered during the implementation process and potential coping strategies were also discussed.
Electric field stimulation directs target-specific axon regeneration and partial restoration of vision after optic nerve crush injury
Failure of central nervous system (CNS) axons to regenerate after injury results in permanent disability. Several molecular neuro-protective and neuro-regenerative strategies have been proposed as potential treatments but do not provide the directional cues needed to direct target-specific axon regeneration. Here, we demonstrate that applying an external guidance cue in the form of electric field stimulation to adult rats after optic nerve crush injury was effective at directing long-distance, target-specific retinal ganglion cell (RGC) axon regeneration to native targets in the diencephalon. Stimulation was performed with asymmetric charged-balanced (ACB) waveforms that are safer than direct current and more effective than traditional, symmetric biphasic waveforms. In addition to partial anatomical restoration, ACB waveforms conferred partial restoration of visual function as measured by pattern electroretinogram recordings and local field potential recordings in the superior colliculus—and did so without the need for genetic manipulation. Our work suggests that exogenous electric field application can override cell-intrinsic and cell-extrinsic barriers to axon regeneration, and that electrical stimulation performed with specific ACB waveforms may be an effective strategy for directing anatomical and functional restoration after CNS injury.
Exploration of designing an automatic classifier for questions containing code snippets—A case study of Oracle SQL certification exam questions
This study uses the Oracle SQL certification exam questions to explore the design of automatic classifiers for exam questions containing code snippets. SQL’s question classification assigns a class label in the exam topics to a question. With this classification, questions can be selected from the test bank according to the testing scope to assemble a more suitable test paper. Classifying questions containing code snippets is more challenging than classifying questions with general text descriptions. In this study, we use factorial experiments to identify the effects of the factors of the feature representation scheme and the machine learning method on the performance of the question classifiers. Our experiment results showed the classifier with the TF-IDF scheme and Logistics Regression model performed best in the weighted macro-average AUC and F1 performance indices. The classifier with TF-IDF and Support Vector Machine performed best in weighted macro-average Precision. Moreover, the feature representation scheme was the main factor affecting the classifier’s performance, followed by the machine learning method, over all the performance indices.
The association of financial resources and loneliness among older adults during a state of emergency
This study focuses on the initial wave of the COVID-19 pandemic in Spring 2020 in the United States to assess how liquidity constraints were related to loneliness among older adults. Data are from the COVID Impact Survey, which was used to collect data in April, May and June 2020 across the U.S. (n = 5,664). We use means comparison tests and linear regressions and find that emergency savings, rather than household income, predict loneliness among older adults during the initial COVID-19 wave. Emergency savings, especially enough to avoid using credit cards, was most predictive of older adult loneliness levels. Income and access to emergency savings did not influence the relationship between actions taken and personal plans changed as a result of COVID-19. Easing lockdown restrictions was unrelated to the relationship between loneliness and liquidity constraints, actions taken and personal plans changed due to the COVID-19 pandemic. Findings suggest that, in the early months of the COVID-19 pandemic, loneliness associated with the actions taken to avoid COVID-19 and personal plans changed was experienced across all socio-economic groups of older adults in this sample in similar ways, regardless of income levels and wealth. In addition, a better understanding of loneliness in older age during the COVID-19 pandemic may require a fuller analysis of households’ financial situation beyond income, and points to the central role of credit card debt for loneliness in older age.
English major students’ satisfaction with ELSA Speak in English pronunciation courses
Clear and accurate pronunciation plays an essential role in communicating effectively and significantly affects English learners’ proficiency. ELSA Speak has been used in some schools due to its benefits to help learners improve English pronunciation. However, to optimize the application, a better understanding of EFL learners’ satisfaction with ELSA Speak is essential. The novelty of this study is assessing how English major students were satisfied with using ELSA Speak to enhance their pronunciation and explore key factors that contributed to positive users’ experience. Two hundred and five English major students at a Vietnamese higher education institution were surveyed by a 23-item questionnaire classified into four variables: perceived usefulness, perceived ease of use, confirmation, and satisfaction. The findings recorded a high level of satisfaction among participants. Moreover, although both perceived ease of use and confirmation showed a considerable impact on learners’ satisfaction, confirmation was reported to be the determining antecedent of satisfaction. Perceived usefulness was directly influenced by perceived ease of use and had a stronger influence on confirmation compared to perceived ease of use. However, perceived usefulness did not have a directly significant correlation with learners’ satisfaction. These results can add evidence of learners’ satisfaction with using ELSA Speak, explain some elements affecting satisfaction, and suggest employing ELSA Speak in pronunciation courses with careful consideration of the content and teacher support as a facilitator.
Next-generation sequencing protocol of hematopoietic stem cells (HSCs). Step-by-step overview and troubleshooting guide
Populations of very small embryonic-like stem cells (VSELs) (CD34+lin-CD45- and CD133+lin-CD45-), circulating in the peripheral blood of adults in small numbers, have been identified in several human tissues and together with the populations of hematopoietic stem cells (HSCs) (CD34+lin-CD45+) and CD133+lin-CD45+constitute a pool of cells with self-renewal and pluripotent stem cell characteristics. Using advanced cell staining and sorting strategies, we isolated populations of VSELs and HSCs for bulk RNA-Seq analysis to compare the transcriptomic profiles of both cell populations. Libraries were prepared from an extremely small number of cells; however, their good quality was preserved, and they met the criteria for sequencing. We present here a step-by-step NGS protocol for sequencing VSELs and HSC with a description of troubleshooting during library preparation and sequencing.
Effect of proprioceptive neuromuscular facilitation on patients with chronic ankle instability: A systematic review and meta-analysis
Objective This study conducts a rigorous meta-analysis of existing literature to rigorously examine the efficacy of Proprioceptive Neuromuscular Facilitation (PNF) in ameliorating functional deficits associated with Chronic Ankle Instability (CAI). Methods Literature searches were conducted in multiple databases including China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biology Medicine disc (CBM), PubMed, EBSCO (Medline, CINAHL, SPORTDiscus, and Rehabilitation & Sports Medicine Source), Embase, ScienceDirect, ProQuest, Cochrane Library, and Web of Science for randomized controlled trials assessing the effects of Proprioceptive Neuromuscular Facilitation interventions on patients with Chronic Ankle Instability. The publication timeframe spanned from the inception of each database until April 10, 2024. Meta-analysis was performed using STATA 12 software on the included studies. Results ① A total of 12 randomized controlled trials were included, encompassing 405 patients with Chronic Ankle Instability, demonstrating a generally high methodological quality of the literature.② Meta-analysis results indicate that compared to the control group, Proprioceptive Neuromuscular Facilitation (PNF) significantly enhanced the balance ability of patients with Chronic Ankle Instability as measured by the Y Balance Test (YBT) (Weighted Mean Difference (WMD) = 3.61, 95% CI [2.65, 4.56], z = 7.42, P<0.001) and the Star Excursion Balance Test (SEBT) (WMD = 5.50, 95% CI [3.80, 7.19], z = 6.36, P<0.001), with improvement in all eight directions of SEBT balance ability surpassing that of the control group (P<0.05); muscle strength around the ankle (SMD) = 0.19, 95% CI [0.03, 0.36], z = 2.26, P = 0.024), with both Plantar flexion and Dorsal flexion muscle strength improvements exceeding those of the control group (P<0.05); Visual Analog Scale (VAS) (WMD = -1.39, 95% CI [-1.72, -1.06], z = 8.23, P<0.001); Ankle instability questionnaire (WMD = 2.91, 95% CI [1.92, 3.89], z = 5.78, P<0.001).③Descriptive analysis results showed that the differences in Inversion Joint Position Sense and Dorsiflexion range of motion between the PNF and control groups were not statistically significant (P>0.05), however, the effects of PNF training persisted for a certain period even after cessation of treatment. Conclusion Proprioceptive Neuromuscular Facilitation (PNF) can significantly improve balance, muscle strength, and pain in patients with Chronic Ankle Instability (CAI). While PNF has shown improvements in joint position sense and dorsiflexion range of motion for CAI patients, with effects that remain for a period thereafter, these improvements were not significantly different when compared to the control group. Further research is required to substantiate these specific effects.
Developing and validating a cross-cultural competence scale for Japanese nurses
In recent years, Japan has experienced a significant increase in the number of foreign students and workers entering the country. This has resulted in a vast number of international patients in medical facilities. This shift emphasizes the immediate need for Japanese nurses who are both clinically proficient and culturally attuned. In response, our research developed and validated the Cross-cultural Competence Scale for Japanese Nurses (CCCSJN) to better equip nurses for diverse patient care. We conducted a cross-sectional study in Japan’s general hospitals using anonymous questionnaires with nurses and midwives. The scale, developed from data from 394 nurses, underwent both qualitative and quantitative evaluations to define its construct. We analyzed the data using exploratory factor analysis, criterion-related validity, internal consistency, and test-retest reliability, confirming the scale’s reliability and validity. The exploratory analysis revealed five factors: “cross-cultural understanding,” “cross-cultural communication ability,” “motivation for cross-cultural nursing,” “cooperation with multiple professions,” and “respect for foreign patients.” These factors explained 50.92% of the total variance. Cronbach’s α for the CCCSJN was 0.94, and the test-retest reliability correlation was 0.77. The construct validity, criterion-related validity, internal consistency, and test-retest reliability of the CCCSJN were verified. The CCCSJN can be used to assess the cross-cultural competencies of Japanese nurses and identify what skills need to be mastered, leading to improved cross-cultural competence and care.
Gluteus medius muscle activation patterns during gait with Cerebral Palsy (CP): A hierarchical clustering analysis
Duchenne gait, characterized by an ipsilateral trunk lean towards the affected stance limb, compensates for weak hip abductor muscles, notably the gluteus medius (GM). This study aims to investigate how electromyographic (EMG) cluster analysis of GM contributes to a better understanding of Duchenne gait in patients with cerebral palsy (CP). We analyzed retrospective gait data from 845 patients with CP and 65 typically developed individuals. EMG activity of GM in envelope format were collected and examined with gait kinematics and kinetics parameters in frontal plane and hip abductor strength, and hip abduction passive range of motion. Six key EMG envelope features during ten gait phases were extracted and normalized. A hybrid K-means-PSO clustering algorithm was employed, followed by hierarchical clustering. The identified clusters were characterized by having a low (cluster_1), medium (cluster_2), and high (cluster_3) activity of GM during loading response. The patients in cluster_1 also exhibited pathological gait characteristics, including increased trunk lateral lean and weak hip abductor, which are associated with Duchenne gait. The patients in this cluster were subclustered according to their response to the intervention: SUB_1 with a significant improvement in trunk obliquity, pelvic obliquity, and hip abduction after intervention, and SUB_2 without such improvement. Comparing pre-treatment EMG and clinical exam of the sub_clusters, SUB_1 had significantly higher activity of GM during 50–87% of the gait cycle with a greater passive range of hip abduction compared to SUB_2. This study established a relationship between EMG of GM and frontal plane gait abnormalities in patients with CP, highlighting potential improvement in Duchenne gait with prolonged GM activity during swing after the intervention.
Chronic disease risk factors among hospital employees: A cross-sectional study in Türkiye
Introduction Chronic diseases have become a significant public health problem with the prolongation of human life. There are four main behavioral risk factors for mortality. This study evaluated the significant risk factors for chronic diseases in university hospital employees. Materials and methods The cross-sectional study population consisted of hospital employees working at Gazi University Hospital for at least one year. The sample size was calculated to be 285, with a 100% response rate. The study’s independent variables were age, gender, educational status, working department, and presence of chronic diseases. Dependent variables were smoking, alcohol use, physical inactivity, and body mass index (BMI) categories. Data on participants’ characteristics, habits, and behaviors were obtained from the hospital system or with open-ended questions. Their body weight and height were measured. The International Physical Activity Questionnaire (IPAQ) was used to assess physical inactivity. Results The smoking prevalence of hospital employees was 41.8%. Regular alcohol use was 19.3%. Based on the BMI values obtained, 37.9% of the participants were pre-obese, and 18.2% were obese. According to the results of the IPAQ, 13.7% were inactive. The prevalence of smoking was 50.4%, alcohol consume 11.6%, physical inactivity 50.4%, and overweight 65.3% among those who graduated from high school or lower. In contrast, the prevalences were 35.4%, 25.0%, 69.5%, and 49.4%, respectively, among those who graduated from university or higher. A one-unit increase in age of participants without chronic disease increased BMI by 1.06 times (p<0.05). When individuals with a high school education or lower are taken as the reference group, it was found that physical inactivity is 1.78 times higher among those with a university degree or higher (p<0.05). Conclusion The effect of education level on health habits and behaviors should be considered in terms of the target group and content of preventive health programs and awareness-raising studies.