Biological research for nursing最新文献

Background and objectives: The effect of the ambient environment, sound, light, and movement, on the nighttime rest-activity of patients hospitalized with moderate-severe traumatic brain injury (TBI) is poorly understood. The purpose of this study was to examine how sound, light, and movement in these patients' hospital rooms may contribute to nighttime awakenings.

Methods: An observational design was used with 18 adult participants on a neuroscience step-down unit diagnosed with moderate-severe TBI. For up to five consecutive nights, actigraphy was used to capture nighttime awakenings while a custom-made multisensory device captured sound, light, and movement exposures in the participant's room.

Results: Participants were awake for 24% (or about 3 hr) of the time during the designated nighttime period of 8 pm to 8 am. Average nighttime exposures of sound was 52 dB, light was nine lumens, and movement, measured as a proportion, was 0.28% or 28%. With each stimuli exposure set at its average, there was a 20% probability of participant nighttime awakenings. Clinically meaningful reductions of movement in and out the participant's room and elevated sound significantly decreases the participant's probability of nighttime awakenings (p < .05), but reductions in light did not.

Conclusion: The ambient environment seems to impede restful sleep in immediate post-injury phase of patients with moderate-severe TBI.

Globally, there is increasing recognition that agricultural workers are at risk for chronic kidney disease of unknown etiology (CKDu). Recurrent heat exposure, physical exertion, dehydration, muscle damage, and inflammation are hypothesized to contribute to the development of CKDu, but the relative importance of these processes and the interactions among them remain unclear. Moreover, there is a need to identify biomarkers that could distinguish individuals who are at greatest risk for kidney damage to target preventative interventions for CKDu. In this study, we evaluated dehydration and markers of inflammation, muscle damage, and renal function in agricultural workers at a non-workday baseline assessment. Urine specific gravity and kidney function were measured before and after work shifts on three subsequent days, and heat index, core body temperature, and heart rate were monitored during the work shifts. A combination of direct comparisons and machine learning algorithms revealed that reduced levels of uromodulin and sodium in urine and increased levels of interleukin-6 and C-reactive protein in serum were indicative of dehydration at baseline, and that dehydration, high body mass index, reduced urine uromodulin, and increased serum interleukin-6, C-reactive protein, and lipopolysaccharide-binding protein at baseline were predictive of acute kidney injury on subsequent workdays. Our findings suggest a method for identifying agricultural workers at greatest risk for kidney injury and reveal potential mechanisms responsible for this process, including pathways overlapping in dehydration and kidney injury. These results will guide future studies confirming these mechanisms and introducing interventions to protect kidney health in this vulnerable population.

Objective: This study sought to evaluate prediction models for preterm birth (PTB) and to explore predictors frequently used in PTB prediction models.

Methods: A systematic review was conducted. We selected studies according to the PRISMA, classified studies according to TRIPOD, appraised studies according to the PROBAST, and extracted and synthesized the data narratively according to the CHARMS. We classified the predictors in the models into socio-economic factors with demographic, psychosocial, biomedical, and health behavioral factors.

Results: Twenty-one studies with 27 prediction models were selected for the analysis. Only 16 models (59.3%) defined PTB outcomes as 37 weeks or less, and seven models (25.9%) defined PTB as 32 weeks or less. The PTB rates varied according to whether high-risk pregnant women were included and according to the outcome definition used. The most frequently included predictors were age (among demographic factors), height, weight, body mass index, and chronic disease (among biomedical factors), and smoking (among behavioral factors).

Conclusion: When using the PTB prediction model, one must pay attention to the outcome definition and inclusion criteria to select a model that fits the case. Many studies use the sub-categories of PTB; however, some of these sub-categories are not correctly indicated, and they can be misunderstood as PTB (≤ 37 weeks). To develop further PTB prediction models, it is necessary to set the target population and identify the outcomes to predict.

Background: Disturbance of lipid, particularly omega-3 polyunsaturated fatty acid (PUFA), metabolism is associated with the etiology and symptoms of schizophrenia. Numerous clinical studies have tried to evaluate whether omega-3 PUFA supplementation can ameliorate the disorder, but the results are inconclusive.

Objectives: This systematic review integrates and refines the research evidence of the effectiveness of omega-3 PUFA nutritional supplementation on schizophrenia during the different developmental phases of the disease (prodromal, first-episode, and chronic phases) and examines whether different developmental stages modulate the efficacy of omega-3 PUFA supplementation.

Data sources: Scientific articles from 2000 to 2020 in PubMed/Medline, Allied Health Literature, PsychINFO, and SCOPUS following the Preferred Reporting Items for Systematic Reviews guidelines.

Methods: A systematic review was performed. We reviewed electronic databases and identified 1,266 clinical studies. Of these, 26 met the inclusion criteria.

Results: The effectiveness of omega-3 dietary supplementation on symptoms varies among different phases of illness. Omega-3 supplementation significantly improves positive and negative symptoms at the prodromal phase, improves mainly the negative symptoms in patients with the first-episode, and effects symptoms partly in patients with chronic schizophrenia.

Discussion: The effectiveness of omega-3 PUFA dietary supplementation is modulated by age, duration of untreated psychosis and illness, baseline levels of omega-3 fatty acids, and status of antioxidant capacity of patients. The important implications for psychiatric research and clinical practice developments as well as nursing care are presented and discussed.

Nausea and vomiting are consistently identified among the most distressing side effects of chemotherapy. In recent years, Olanzapine (OLZ) treatment was added to anti-emetic guidelines as a treatment for chemotherapy-induced nausea and vomiting (CINV), despite little available data supporting a mechanism behind the positive benefits of the drug. Here, we examine whether OLZ reduces cisplatin chemotherapy-induced side effects on food intake and pica behavior in rats (i.e., kaolin intake, a proxy for nausea/emesis). Behavioral experiments tested whether systemic or hindbrain administration of OLZ ameliorated cisplatin-induced pica, anorexia, and body weight loss in rats. We also tested whether systemic OLZ reduces cisplatin-induced neuronal activation in the dorsal vagal complex (DVC), a hindbrain region controlling emesis. Lastly, given their role in regulating feeding and emesis, circulating ghrelin levels and central mRNA expression levels of serotonin (HT) receptor subunits, including 5-HT2C, were measured in brain regions that regulate CINV and energy balance in an exploratory analysis to investigate potential mediators of OLZ action. Our results show that both systemic and hindbrain administration of OLZ attenuated cisplatin-induced kaolin intake and body weight loss, but not anorexia. Systemic OLZ decreased cisplatin-induced c-Fos immunofluorescence in the DVC and prevented cisplatin-induced reductions in circulating ghrelin levels. IP OLZ also blocked cisplatin-induced increases in Htr2c expression in DVC and hypothalamic micropunches. These data suggest hindbrain exposure to OLZ is sufficient to induce reductions in cisplatin-induced pica and that central serotonergic signaling, via 5-HT2C, and changes in circulating ghrelin may be potential mediators of olanzapine anti-emetic action.

Purposes: Women with diabetes (WD) are more severely impacted by the consequence of suboptimal diabetes control. This study aims to examine the impact of demographic and disease characteristics, baseline self-stigma, role strain, diabetes distress on Hemoglobin A1C (A1C) levels, quality of life (D-QoL) and 6-month A1C levels in younger WD.

Methods: This study was a 6-month prospective study. In total, 193 WD aged 20-64 years were selected by convenience sampling from three outpatient clinics in Taiwan. Demographic and disease characteristics, self-stigma, role strain, diabetes distress, A1C levels, and D-QoL were collected at baseline. A1C levels were further collected 6 months later. Structural equation modeling was conducted to test the hypothesized model.

Results: The final model supported that higher baseline D-QoL directly associated with lower concurrent A1C levels and indirectly associated with lower 6-month A1C levels through baseline A1C levels. Higher baseline self-stigma, role strain, and diabetes distress directly associated with lower baseline D-QoL, and indirectly associated with higher 6-month A1C levels through D-QoL.

Conclusion: Improving self-stigma, role strain, and diabetes distress should be considered as promising strategies to improve D-QoL in young WD. D-QoL plays a mediation role between baseline self-stigma, role strain, diabetes distress and subsequent glycemic control in younger WD. Enhancing baseline D-QoL is fundamental to improve subsequent glycemic control.

The incorporation of omics approaches into symptom science research can provide researchers with information about the molecular mechanisms that underlie symptoms. Most of the omics analyses in symptom science have used a single omics approach. Therefore, these analyses are limited by the information contained within a specific omics domain (e.g., genomics and inherited variations, transcriptomics and gene function). A multi-staged data-integrated multi-omics (MS-DIMO) analysis integrates multiple types of omics data in a single study. With this integration, a MS-DIMO analysis can provide a more comprehensive picture of the complex biological mechanisms that underlie symptoms. The results of a MS-DIMO analysis can be used to refine mechanistic hypotheses and/or discover therapeutic targets for specific symptoms. The purposes of this paper are to: (1) describe a MS-DIMO analysis using "Symptom X" as an example; (2) discuss a number of challenges associated with specific omics analyses and how a MS-DIMO analysis can address them; (3) describe the various orders of omics data that can be used in a MS-DIMO analysis; (4) describe omics analysis tools; and (5) review case exemplars of MS-DIMO analyses in symptom science. This paper provides information on how a MS-DIMO analysis can strengthen symptom science research through the prioritization of functional genes and biological processes associated with a specific symptom.

Purpose: This study was performed to determine the relationship between oral-mucosal pressure ulcer (PU) stage and mechanical conditions and individual susceptibility in intubated patients.

Methods: We collected 80 patient-days data from an intensive care unit of a 700-bed hospital in Korea. We analyzed oral-mucosal PUs, medical records, amount of saliva, and oral mucosal swabs. Bacterial abundance was enumerated by real-time polymerase chain reaction. The χ² or Fisher's exact test, t-test or Mann-Whitney U test, and Spearman's rho correlation analysis were performed.

Results: The incidence of overall oral-mucosal PUs was 31.3%, and in the maxillary and mandibular sites were 16.3% and 26.3%, respectively. There were significant correlations between the maxillary site PU stage and restraint use (r = .43, p < .001), albumin level (r = -.22, p = .046), and relative abundance of P. aeruginosa (r = .45, p < .001) and S. aureus (r = -.24, p = .033). In the mandibular sites, there were significant correlations between PU stage and restraint use (r = .30, p = .008), level of consciousness (r = .31, p = .005), and relative abundance of P. aeruginosa (r = .25, p = .028) and S. pneumoniae (r = .22, p = .046).

Conclusions: Frequent monitoring and repositioning the mechanical pressure on the oral-mucosa could be an effective preventive strategy against the development and advancement of oral-mucosal PUs. Additionally, monitoring the oral microorganisms can prevent advanced stage oral-mucosal PUs in intubated patients.

Vitamin D (VD) cannot be considered as a true vitamin, but rather as a hormone, which exerts its action via a vitamin D receptor (VDR). Many genes have been shown to be involved in the evolution of diabetes in various populations, such as the vitamin D receptor gene. The aim of our study was to investigate if BsmI, TaqI, ApaI, FokI, and Tru9I, polymorphisms of VDR gene have an impact on MODY diabetes and its clinical aspects in a Tunisian population. A total of 95 patients and 153 controls were genotyped using PCR-RFLP. The comparison of the allelic and genotypic frequencies of the five polymorphisms between MODY subjects and control groups revealed the association of MODY diabetes with TaqI, Tru9I and BsmI polymorphisms and no significant differences were observed in the distributions for the ApaI and FokI polymorphisms. After stratification with biochemical and clinical parameters and TaqI, Tru9I and BsmI polymorphisms, we found an association between the three SNPs and different parameters such as age of diagnosis, therapy, hsCRP and HDL-C levels. Our results revealed that TaqI, Tru9I and BsmI polymorphisms may be more related to the progression of MODY diabetes. The possible role of vitamin D in the pathogenesis of MODY is far from being completely understood. Further knowledge on this issue may identify new candidate targets in the treatment and prevention of the disease. Our findings suggest that the TaqI, Tru9I and BsmI polymorphisms may be more related to the progression of MODY diabetes.

Background: A systematic review was performed to identify the types of physical activities effective as interventions in preventing metabolic syndrome in middle-aged women.

Methods: Electronic databases (MEDLINE, EMBASE, the Cochrane Library, and CINAHL) served as the data sources. Cochrane's Risk of Bias 2 was applied to assess the risk of bias of the randomized controlled trials. Meta-analyses were performed on selected studies using Review Manager 5.3. Thirty-one trials enrolling 2,202 participants were included.

Results: Compared to controls, the effects of physical activity were indicated by pooled mean differences, which were -0.57 kg for body weight, -0.43 kg/m² for body mass index, -1.63 cm for waist circumference, -4.89 mmHg for systolic blood pressure (BP), and -2.71 mmHg for diastolic BP. The effects were greater on the measurements of waist circumference and BP than on body weight and BMI. The types of physical activities were further analyzed according to sub-groups. Only aerobic exercise did not affect body weight and resistance exercise did not significantly change any results. Contrarily, combined exercises significantly reduced measurements of waist circumference and BP.

Conclusion: This review can provide valuable information for research and implementation of measures to prevent metabolic syndrome in middle-aged women.