Treatment Scores Research Articles

Impact of autologous platelet-rich plasma therapy vs. hyaluronic acid on synovial fluid biomarkers in knee osteoarthritis: a randomized controlled clinical trial.

Observe the effects of platelet-rich plasma (PRP) therapy on inflammatory cytokines in the synovial fluid of the knee joint of patients with KOA, and explore the effects of PRP intra-articular injection on the inflammation of the knee joint environment and the possible mechanism of action. Seventy patients were randomized to undergo three blinded weekly intra-articular injections of PRP or hyaluronic acid (HA). The concentrations of inflammatory cytokines, including interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, IL-8, IL-17A, IL-17F, IL-4, IL-5, and IL-10, in the synovial fluid were evaluated before the intervention and 1 month after the third injection. The Western Ontario and McMaster University (WOMAC) and visual analog scale (VAS) scores were used to assess pain and functional status of the knee joints in both groups before the intervention, immediately post-intervention, and 1, 3, 6, and 12 months after the intervention. Baseline characteristics were similar in both groups with no statistical difference. The IL-6, IL-1β, TNF-α, IL-17A, and IL-10 levels in the synovial fluid of the observation group decreased significantly after, vs. before, the intervention (p < 0.05), whereas the IL-8, IL-17F, and IL-4 levels decreased (p > 0.05) and IL-5 levels increased (p > 0.05). There was no statistically significant difference between inflammatory cytokine levels in the synovial fluid of the samples from the control group before and after the intervention (p > 0.05). There were no statistically significant differences between the two groups immediately after intervention (p > 0.05). At 1, 3, 6, and 12 months after intervention, the WOMAC and VAS scores were significantly better in the observation group than in the control group (p < 0.05). Platelet plasma therapy can reduce the concentrations of inflammatory cytokines IL-6, IL-1β, TNF-α, IL-17A, and IL-10 in the synovial fluid of KOA patients, reduce the expression levels of IL-8, IL-17F, and IL-4, clear the pro-inflammatory factors, improve the inflammatory environment of the affected knee joint, and alleviate pain caused by inflammation. Thus, alleviating pain and improving knee function in patients with KOA.

The integration path of ideological and political education and mental health construction of college students with depression from the perspective of educational psychology

BackgroundIn the current social environment, school students are facing a very serious situation in terms of learning and employment. How to use education to help students alleviate pressure is the main direction of education. Especially in the online environment, a good political orientation can help college students cultivate correct fertilization concepts, thus laying a good ideological foundation for their future development.Subjects and Methods The study selected 50 college students with depression as the research subjects and divided them into two groups on average using random numbers. There are two groups, the experimental group and the control group. Both groups of patients received routine drug treatment, while the experimental group received teaching and treatment designed by the research institute to integrate ideological and political education with mental health construction. After 12 weeks of treatment, SAS and SDS scores were analyzed for both groups of patients.ResultsThe study selected SPSS23.0 statistical software for data analysis of the final results. The analysis results showed that there was no significant difference in various scores between the two groups of patients before intervention (P&gt;0.05). After the intervention, the depression and anxiety scores of both groups of patients significantly decreased (P&lt;0.05), with the experimental group scoring significantly lower than the control group (P&lt;0.05).ConclusionsThe educational path of integrating emotional psychology with ideological and political education can effectively alleviate the life pressure of depressed college students and help them overcome difficulties.

Ideological and political education in English courses of depression and anxiety students

BackgroundThe symptoms of depression and anxiety show a growing trend among college students, bringing serious negative effects on individuals and society. To explore the positive role of ideological and political education in relieving the symptoms of depression and anxiety in students.Subjects and MethodsSelect students from the same university as the research subjects and randomly assigned as observation group and control group. The experimental group added ideological and political education to the English course, while the control group only taught the regular English course. The study period was one semester, and Hamilton Depression Rating Scale (HAMD) and Profile of Mood States (POMS) measurements were conducted once a week, and students’ psychological test results were analyzed using SPSS23.0.ResultsAfter the intervention, the anxiety and depression symptoms scores were significantly decreased compared with the control group (P&lt;0.05). At the same time, the mental health level of the students in the experimental group has improved significantly (P&lt;0.05), showing a more positive attitude and better emotional control ability.ConclusionsThe integration of ideological and political education in college English courses has a positive effect on alleviating the symptoms of depression and anxiety. Combining ideological and political education with subject teaching is helpful to improve students’ mental health levels and help them better cope with psychological pressure. Therefore, college education departments should actively promote and implement this teaching mode to promote all-round development and mental health.AcknowledgementShanxi Provincial Education Department (No. J20220142).

Role of erector spinae plane block in transjugular intrahepatic portosystemic shunt procedure: A randomized controlled trial

ABSTRACT Background Anesthesia for transjugular intrahepatic portosystemic shunt (TIPS) for lowering raised portal pressure is clinically challenging. As patients, candidates for TIPS are medically complex due to chronic liver disease, adding to remote area anesthesia’s complexities. Multimodal analgesia, including erector spinae plane block (ESPB), can improve anesthesia quality with patient satisfaction. Methods Fifty-six patients scheduled for TIPS, aged 18–60 years and with Child classification A or B, were randomly allocated into two groups. The ESPB group experienced ESPB (n = 24), while the control group was introduced with sedation spontaneously breathing (n = 24). Primarily, we investigated the records of the hemodynamic profile and analgesia nociceptive index (ANI). As a secondary aim, we recorded the opioid consumption, complication incidence, and patient and interventional radiologist satisfaction scores. Results Heart rate was significantly lower in the ESPB group at the beginning of the procedure, liver puncture, and balloon dilatation events, while there were no significant differences in mean blood pressure. Analgesia assessment by ANI was significantly higher in the ESPB group indicating adequate analgesia. Opioid consumption was significantly lower in the ESPB group than in the control group. Statistical analysis for patient satisfaction showed better results in the ESPB group, while the surgeon satisfaction score showed no significant statistical differences. Conclusion ESPB could be recommended as an alternative to analgesia in TIPS and its vulnerable patients to improve safety by reducing sedation-related morbidity and complications with improving the patient’s degree of satisfaction.

Examining the Impact of the Whole-Process Companionship and Responsible Midwifery Model on Delivery Outcomes

Objective: To explore and analyze the impact of the whole-process companionship and responsible midwiferymodel on delivery outcomes. Methods: 200 women who were about to give birth admitted to Lianyungang Maternal and Child Health Hospital’s Obstetrics and Gynecology Department from May 2021 to May 2023 were recruited and divided into whole process and ordinary groups by flipping a coin, with 100 cases in each group. The whole process group implemented the whole process companionship and responsible midwifery model, while the ordinary group implemented the conventional midwifery model. The duration of labor, delivery outcomes, psychological status, postpartum bleeding volume, and incidence of adverse neonatal outcomes were compared between groups. Results: All three stages of labor in the whole process group were significantly shorter than those in the ordinary group (P &lt; 0.05). The natural delivery rate and cesarean section rate in the whole process group were significantly better than those in the ordinary group (P &lt; 0.05). The difference was not statistically significant after comparing the lateral incision rate between the whole process group and the ordinary group (P &gt; 0.05). Before the intervention, the anxiety and depression scores between the groups weresimilar (P &gt; 0.05); after the intervention, the anxiety and depression scores in the whole process group were significantly lower than in the ordinary group (P &lt; 0.05). The amount of postpartum hemorrhage and the incidence of adverse neonatal outcomes in the whole process group were significantly better than those in the ordinary group (P &lt; 0.05). Conclusion: The whole-process companionship and responsible midwifery model has specific positive significance for delivery outcomes, and this midwifery model deserves to be widely used and promoted in clinical practice.

Examining the Influence of Accompanying Midwifery with Position Guidance on Delivery Outcomes

Objective: To explore and analyze the influence of accompanying midwifery with position guidance on deliveryoutcomes. Methods: A total of 68 puerpera who were admitted to Dafeng People’s Hospital from April 2021 to April 2023 were recruited, grouped using odd and even number draw methods, and divided into cooperation and regular groups with 34 cases in each group. The patients in the cooperation group cooperated with the process of accompanying midwifery and position guidance, whereas the patients in the regular group had routine midwifery intervention. The delivery outcome, the duration of each labor process, the psychological state, and the amount of postpartum hemorrhage were compared between the groups. Results: The delivery outcomes of vaginal delivery and cesarean section in the cooperation group were significantly better than those in the regular group (P &lt; 0.05). The difference was not statistically significant when comparing the cooperation group with the regular group through a lateral vaginal incision (P &gt; 0.05). The duration of each labor process in the cooperation group was significantly shorter than in the regular group (P &lt; 0.05). Before the intervention, the HAMD and HAMA scores of the two groups were insignificant (P &gt; 0.05); but the HAMD and HAMA scores of the cooperation group were significantly lower than the regular group after the intervention (P &lt; 0.05). The amount of postpartum bleeding in the cooperation group was markedly lower than that in the regular group (P &lt; 0.05). Conclusion: Accompanying midwifery and position guidance throughout the delivery process can improve delivery outcomes and increase the natural delivery rate.

The effect of midwife-oriented breastfeeding counseling on self-efficacy and performance of adolescent mothers: a clinical trial study

BackgroundBreastfeeding behaviors are strongly influenced by self-efficacy. This research aimed to determine the effect of breastfeeding counseling based on the Ready Set Baby (RSB) education program on self-efficacy and breastfeeding performance in adolescent mothers.MethodsIn 2022, a parallel randomized clinical trial was carried out in Hamadan city's comprehensive health centers, involving 64 pregnant teenagers. The block randomization method was employed to divide the participants into two groups. The data collection instruments were a demographic characteristics questionnaire, a breastfeeding self-efficacy questionnaire, and the Bristol breastfeeding checklist. Three individual counseling sessions during pregnancy were conducted based on the "RSB" program. The ANCOVA was used for comparing groups. The statistical analyst was blinded to the group assignment.ResultsThe study included 64 participants with a mean age of 16.97(1.30) years, data from 60 participants were analyzed. The demographic and clinical characteristics of the two groups were relatively similar (P > 0.05). Following the intervention, self-efficacy and breastfeeding performance scores were measured and adjusted for confounding factors. The mean scores for self-efficacy were 116.03(20.64) and 100.02(20.64) (P < 0.005), with effect size 0.77 [MD = 16.01 (95% CI: 5.34,26.67)], and the mean scores for breastfeeding performance were 6.30(2.07) and 4.12(2.07) (P < 0.002), with effect size 1.05 [MD = 2.18 (95% CI: 1.11,3.24)] in the intervention and control groups, respectively.ConclusionsThe Ready Set Baby education program's breastfeeding counseling for primiparous adolescent pregnant women significantly boosted their self-efficacy and performance in breastfeeding. Given the crucial role of breastfeeding in ensuring the well-being of both mother and child, further research is imperative to identify suitable and impactful interventions that can encourage breastfeeding practices among adolescents.Trial registrationThe trial protocol of this study has been registered in Iranian Registry of Clinical Trials at 08/09/2021. The registration reference is IRCT20200530047596N3.

The ISSG-AO Complication Intervention Score, but Not Major/Minor Designation, is Correlated With Length of Stay Following Adult Spinal Deformity Surgery.

Retrospective review. The International Spine Study Group-AO (ISSG-AO) Adult Spinal Deformity (ASD) Complication Classification System was developed to improve classification, reporting, and study of complications among patients undergoing ASD surgery. The ISSG-AO system classifies interventions to address complications by level of invasiveness: grade zero (none); grade 1, mild (e.g., medication change); grade 2, moderate (e.g., ICU admission); grade 3, severe (e.g., reoperation related to surgery of interest). To evaluate the efficacy of the ISSG-AO ASD Complication Classification System, we aimed to compare correlations between postoperative length of stay (LOS) and complication severity as classified by the ISSG-AO ASD and traditional major/minor complication classification systems. Patients age ≥18 in a multicenter ASD database who sustained in-hospital complications were identified. Complications were classified with the major/minor and ISSG-AO systems and correlated with LOS using an ensemble-based machine learning algorithm (conditional random forest) and a generalized linear mixed model. 490 patients at 19 sites were included. 64.9% of complications were major, and 35.1% were minor. By ISSG-AO classification, 20.4%, 66.1%, 6.7%, and 6.7% were grades 0-3, respectively. ISSG-AO complication grading demonstrated significant correlation with LOS, whereas major/minor complication classification demonstrated inverse correlation with LOS. In conditional random forest analysis, ISSG-AO classification had the greatest relative importance when assessing correlations across multiple variables with LOS. The ISSG-AO system may help identify specific complications associated with prolonged LOS. Targeted interventions to avoid or reduce these complications may improve ASD surgical quality and resource utilization.

Short-Term Brain-Based Growth Mindset Pilot Intervention Indicates Potential of Diversion Programs For Early Offenders in the Juvenile Justice System

The goal of the present research was to determine if a Brain-Based Growth Mindset Pilot Intervention implemented in a juvenile detention facility could change a set of beliefs surrounding self-efficacy and knowledge over one’s brain. Previous studies show that growth mindset interventions are most effective with youth from low socioeconomic households, and targeting changes in beliefs is particularly effective during adolescence because of the developmental milestones that accompany puberty. Detained juveniles tend to be adolescent minorities of low-income backgrounds with a higher number of adverse childhood experiences. Twenty-six detained juveniles participated in the pilot intervention. The intervention consisted of four, 30-minute lessons on neuroanatomy of the brain, neural plasticity, emotional regulation, and long-term neuronal development. Impact of the intervention was quantified by a Brain Health Intervention Scale (BHIS). The scale consisted of 31 affirm/deny statements that were designed to measure the knowledge gained or opinion changed by the participant about the brain. Analysis of pre- and postintervention scores on the BHIS indicate that this pilot intervention was a success with significant increases in knowledge from preintervention scores to post- intervention scores. Success in the intervention was negatively correlated with the number of previous detainments. Interventions that occur within the context of juvenile detentions must occur early, before multiple detainments have made it difficult to reverse the fixed mindset in previously detained youth. Results add further evidence that successful growth mindset interventions can be low-cost and light-touch. Brain-based growth mindset interventions must be explored early on as a diversion alternative for juvenile offenders.

A scaled-up mathematics intervention in preschool classes

ABSTRACT We report on a scaled-up mathematics intervention in preschool classes (children age six) in Sweden. In the intervention, teachers at seven schools in four municipalities implemented the Thinking, Reasoning and Counting in Preschool Class (TRC) teacher guide in their teaching of 254 students. Results are compared to a previous randomized experimental small-scale intervention based on TRC showing a significant positive effect on students’ learning. Pre- and post-test scores for the present scaled-up intervention indicate even higher learning gains compared to the original small-scale intervention. Low-performing students were given extra tutoring time in the scaled-up intervention, but the learning gains for this group cannot be shown to be significantly higher compared to the treatment group in the small-scale study.

Critical care nurses’ knowledge and attitudes toward pressure injury prevention: A pre and post intervention study

ObjectiveTo explore nurses’ knowledge and attitudes towards pressure injury prevention before and after implementing an educational intervention. Design/MethodA pre-and post-intervention study. Pre-intervention data collection involved administering an instrument, including demographic information, the Pressure Ulcer Knowledge Assessment Tool version 2, and the Attitudes towards Pressure Ulcer Prevention instruments. Following the analysis of pre-intervention data, an educational intervention was implemented. Post-intervention data were collected using the same instrument. SettingIntensive care units at three Saudi Arabian hospitals. Main outcome measuresNurses’ knowledge and attitudes towards pressure injury prevention. ResultsThe pre-intervention phase included 190 participants, and the post-intervention phase included 195 participants. Participants completed a paper-based survey at two different time points between June 2021 and March 2022. The mean pre-intervention scores for nurses’ knowledge and attitudes towards pressure injury prevention were 43.22% and 74.77%, respectively. Following the educational intervention, the knowledge and attitude scores increased significantly to 51.22% and 79.02%, respectively. Higher knowledge of pressure injury prevention was positively associated with positive attitudes towards prevention practices. Age, clinical nursing experience, and experience in intensive care units were identified as factors correlated with knowledge of pressure injury prevention. A Bachelor’s qualification or higher predicted better knowledge and attitudes towards pressure injury prevention. ConclusionsNurses’ knowledge and attitudes towards pressure injury prevention greatly improved following tailored, evidence-based education. The educational intervention featured multiple on-site bedside discussions, case studies, small-group presentations, and the provision of printed resources. Implications for Clinical PracticeNurses’ knowledge and attitudes towards pressure injury prevention should be examined, and education provided to ensure evidence-based prevention practices are implemented. Tailored small-group education sessions delivered conveniently could be an effective approach. Efforts should focus on attracting and retaining experienced, highly qualified nurses to ensure the adoption of evidence-based prevention practices.

Effect of a comprehensive nutrition education program on nutritional behavior and food security of female-headed households who receive welfare support in Zanjan Province, Iran

BackgroundIn recent years, the food security and dietary quality of many Iranian families have deteriorated due to unprecedented inflation. Nutrition education programs can be an effective and inexpensive method to improve food quality and security. The present study aimed to investigate the effect of a comprehensive nutrition education program for low-income women who are heads of households and are covered by the Zanjan province’s welfare.MethodsThe food security of 2600 female-headed households covered by the Welfare of Zanjan province was evaluated using a standard 6-item questionnaire. A total of 600 women with the highest food insecurity scores were selected for the comprehensive nutrition education program. The participants received six sessions of 1.5 h of courses about how to improve the quality of their diets and manage their budgets and be physically active. At the beginning of the study and one month after the completion of the intervention, the participants were asked to complete a questionnaire designed and validated by the investigators. The scores of each section before and after the intervention were compared using paired t-test method and p values ​​of < 0.05 were considered statistically significant.ResultsThe prevalence of severe food insecurity among female-headed households who receive welfare support in Abhar, Khodabandeh, and Zanjan cities was 59.5%, 75%, and 62%, respectively. A total of 505 participants successfully completed the courses. After completion of the educational intervention, diet quality, physical activity, budgeting, and food safety scores of the participants increased by 6%, 4%, 4%, and 5%, respectively, which were statistically significant (p < 0.001). However, no significant difference was observed in the food insecurity scores.ConclusionThe comprehensive nutrition education program without financial or nutritional support can have a small but significant impact on the improvement of the nutritional behaviors and dietary quality of low-income people.

Effectiveness of an Emergency Department-Based Machine Learning Clinical Decision Support Tool to Prevent Outpatient Falls Among Older Adults: Protocol for a Quasi-Experimental Study.

Emergency department (ED) providers are important collaborators in preventing falls for older adults because they are often the first health care providers to see a patient after a fall and because at-home falls are often preceded by previous ED visits. Previous work has shown that ED referrals to falls interventions can reduce the risk of an at-home fall by 38%. Screening patients at risk for a fall can be time-consuming and difficult to implement in the ED setting. Machine learning (ML) and clinical decision support (CDS) offer the potential of automating the screening process. However, it remains unclear whether automation of screening and referrals can reduce the risk of future falls among older patients. The goal of this paper is to describe a research protocol for evaluating the effectiveness of an automated screening and referral intervention. These findings will inform ongoing discussions about the use of ML and artificial intelligence to augment medical decision-making. To assess the effectiveness of our program for patients receiving the falls risk intervention, our primary analysis will be to obtain referral completion rates at 3 different EDs. We will use a quasi-experimental design known as a sharp regression discontinuity with regard to intent-to-treat, since the intervention is administered to patients whose risk score falls above a threshold. A conditional logistic regression model will be built to describe 6-month fall risk at each site as a function of the intervention, patient demographics, and risk score. The odds ratio of a return visit for a fall and the 95% CI will be estimated by comparing those identified as high risk by the ML-based CDS (ML-CDS) and those who were not but had a similar risk profile. The ML-CDS tool under study has been implemented at 2 of the 3 EDs in our study. As of April 2023, a total of 1326 patient encounters have been flagged for providers, and 339 unique patients have been referred to the mobility and falls clinic. To date, 15% (45/339) of patients have scheduled an appointment with the clinic. This study seeks to quantify the impact of an ML-CDS intervention on patient behavior and outcomes. Our end-to-end data set allows for a more meaningful analysis of patient outcomes than other studies focused on interim outcomes, and our multisite implementation plan will demonstrate applicability to a broad population and the possibility to adapt the intervention to other EDs and achieve similar results. Our statistical methodology, regression discontinuity design, allows for causal inference from observational data and a staggered implementation strategy allows for the identification of secular trends that could affect causal associations and allow mitigation as necessary. ClinicalTrials.gov NCT05810064; https://www.clinicaltrials.gov/study/NCT05810064. DERR1-10.2196/48128.

The Effective Use of Online Resources in Improving Students’ English Grammar Skills in the EFL Classes at the Tertiary Level

The research objective of this study was to explore the effectiveness of online resources in teaching English grammar skills to English as foreign language (EFL) students at the tertiary level. The aim was to assist EFL teachers in maximising the efficiency of their English grammar lessons through the use of online resources. The sample for the study constituted of 250 first-year English Programme students. Present simple and past simple were selected as testing items. Data were collected using students’ entry-level test scores prior to the intervention and exit-level test scores after intensive training and practise using various online resources. An important variance was identified between the results of the entry-level and exit-level tests. Also, the participants’ perceptions about the effectiveness of online resources in the language learning process were analysed using a quantitative method. The outcomes confirmed that a vast majority of the participants were in favour of integrating online resources. This research also provides valuable suggestions and potential implications for the current study.

The Impact of Brief Text Messages on Critical Care Nurses’ Ability to Interpret Arrhythmia: A Randomized Controlled Trial

Background: A lack of electrocardiogram (ECG) interpretation competency could threaten patient safety, and there is an urgent need to improve nurses’ abilities to identify life-threatening arrhythmias. Aim: To check the hypothesis that Coronary Care Units (CCUs) nurses who received Short Message Service (SMS) data concerning irregular cardiac rhythms can better interpret cardiac arrhythmias than the control group. Methods: WhatsApp messages were sent to the intervention group two times a week for 10 weeks. At the baseline line, the test was given to both groups, while reassessment was done on the same day as the last WhatsApp SMS. Results: The intervention score increased after receiving SMS messages compared to the control group (M[SD]; 16.60 ± 2.23 vs. 11.40 ± 3.10, t=10.40, p &lt;0.001). Implications for Nursing: Text messaging is a cost-effective, time-saving, and practical tool of mobile learning and enhance nurses’ ECG interpretation skills. Conclusion: The study demonstrated that sending SMS messages using WhatsApp is practical and useful for improving nurses’ cardiac arrhythmia interpretation skills. Clinical Trial Study Registration Number: NCT 05419554

Clinical study on the influence of continuous nursing via WeChat on patients undergoing partial or total laryngectomy.

Patients who undergo a partial or total laryngectomy experience severe negative effects. The present study aimed to explore the impact of continuous nursing care via WeChat on patients undergoing partial or total laryngectomies. A total of 86 patients who underwent partial or total laryngectomies were enrolled in this study and divided into two groups: an observation group and a control group. The observation group received continuous nursing via WeChat, while the control group received routine nursing care. Psychological status, degree of cancer fatigue, and changes in quality of life before and after intervention were compared using a satisfaction questionnaire, self-rating depression scale (SDS), self-rating anxiety scale (SAS), piper fatigue scale (PFS), and the quality-of-life questionnaire of the European Organisation for Cancer Therapy and Research. The total satisfaction rate of the observation group (95.35%) was higher than that of the control group (74.42%) (P < 0.05). After intervention, the SDS, SAS, and cognitive, sensory, emotional, and behavioral scores of both groups were lower than before intervention (P < 0.05), with those of the observation group being lower than those of the control group (P < 0.05). The quality-of-life scores after intervention were higher in both groups than before intervention (P < 0.05), with those of the observation group being higher than those of the control group (P < 0.05). Continuous nursing via WeChat has a significant effect on patients who have undergone a partial or total laryngectomy, and it can improve a patient's psychological status, alleviate cancer fatigue, and improve quality of life.

COVID-19 Is an Independent Risk Factor for Detrimental Invasive Fungal Disease in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: A Retrospective Study.

Invasive fungal disease (IFD) is associated with the mortality of patients on extracorporeal membrane oxygenation (ECMO). Several risk factors for IFD have been identified in patients with or without ECMO. Here, we assessed the relevance of coronavirus disease (COVID-19) for the occurrence of IFD in patients on veno-venous (V-V) ECMO for respiratory failure. In a retrospective analysis of all ECMO cases between January 2013 and December 2022 (2020-2022 for COVID-19 patients), active COVID-19 and the type, timing and duration of IFD were investigated. Demographics, hospital, ICU length of stay (LoS), duration of ECMO, days on invasive mechanical ventilation, prognostic scores (Respiratory ECMO Survival Prediction (RESP) score, Charlson Comorbidity Index (CCI), Therapeutic Intervention Scoring System (TISS)-10, Sequential Organ Failure Assessment (SOFA) score and Simplified Acute Physiology Score (SAPS)-II) and length of survival were assessed. The association of COVID-19 with IFD was investigated using propensity score matching and uni- and multivariable logistic regression analyses. We identified 814 patients supported with ECMO, and 452 patients were included in further analyses. The incidence of IFD was 4.8% and 11.0% in patients without and with COVID-19, respectively. COVID-19 status represented an independent risk factor for IFD (OR 4.30; CI 1.72-10.85; p: 0.002; multivariable regression analysis). In patients with COVID-19, 84.6% of IFD was candidemia and 15.4% represented invasive aspergillosis (IA). All of these patients died. In patients on V-V ECMO, we report that COVID-19 is an independent risk factor for IFD, which is associated with a detrimental prognosis. Further studies are needed to investigate strategies of antifungal therapy or prophylaxis in these patients.

The Impact of Speech Therapy Combined with Audiovisual Integration Rehabilitation Training on the Intelligence and Language Recovery of Children with Global Developmental Delay

Objective: To analyze the impact of speech therapy combined with audiovisual integration rehabilitation training on the intelligence and language recovery of children with global developmental delay. Methods: A total of 60 children with global developmental delay treated in our hospital from January 2021 to December 2022 were selected as the research subjects. The children were divided into two groups according to the intervention method: the control group (n=30) and the study group (n=30). The control group received speech therapy intervention, while the study group received speech therapy combined with audiovisual integration rehabilitation training. The intelligence, language, quality of life, developmental quotient changes and family satisfaction of the children in both groups were compared before and after the intervention. Results: After the intervention, the CDCC, GDS, and PedsQL scores of the children in the study group were higher than those in the control group. The developmental quotient scores of language ability, adaptability, fine motor skills, gross motor skills, and personal social behavior were also higher in the study group than in the control group. The overall satisfaction rate of the children's families was 96.67% in the study group, which was higher than the 86.67% in the control group (P&lt;0.05). Conclusion: Speech therapy combined with audiovisual integration rehabilitation training can promote the intelligence and language recovery of children with global developmental delay, improve their quality of life, developmental quotient and family satisfaction.

Initial evaluation treatment results of laparoscopic pectopexy in the management of uterine prolapse

Background: In recent years, laparoscopic pectopexy has become increasingly prevalent in the treatment of pelvic organ prolapse; nonetheless, this technique has only been used at Khanh Hoa General Hospital since 2020.&#x0D; Objectives: To evaluate the effectiveness of laparoscopic pectopexy in patients with uterine prolapse and to evaluate the quality of life of patients after the surgery.&#x0D; Subjects and methods: A case series with follow-up on 58 patients with uterine prolapse ≥ grade 2, who had laparoscopic pectopexy at Khanh Hoa General Hospital between February 2020 and July 2021.&#x0D; Results: Complication rates during and after the procedure were low, blood loss was minimal, and there were no instances requiring blood transfusions during the procedure. During a 6-month follow-up, no patient had surgical infection, erosion, or transplant rejection. The typical procedure lasted between 90 and 120 minutes. Most postoperative patients only had minor discomfort. The recurrence rate was minimal (1.7%) during the 6-month follow-up period. 95% of patients were satisfied with the surgical procedure. Prior to surgery, the QoL of patients was relatively poor, with a mean PFDI-20 (Pelvic Floor Distress Intervention) score of 130 and a PFIQ-7 (Pelvic Floor Impact Questionnaire) score of 148. The worse the uterine prolapse, the worse the patient’s quality of life. Three months after surgery, the average PFDI-20 score was 8 and the average PFIQ-7 score was 10; six months after surgery, the average scores for these two indices were nearly 0.&#x0D; Conclusion: If there are no contraindications, laparoscopic pectopexy should be utilized to treat uterine prolapse.

The clinical effect evaluation of multidisciplinary collaborative team combined with palliative care model in patients with terminal cancer: a randomised controlled study

ObjectiveTo evaluate the clinical effect of a multidisciplinary collaboration team combined with a palliative care model in patients with terminal cancer.MethodA total of 84 patients diagnosed with terminal cancer in our hospital were included and randomly divided into an intervention group and a control group, with 42 cases in each group. Patients in the intervention group were treated by a multidisciplinary collaborative team combined with the palliative care model, and patients in the control group were treated by routine nursing intervention. The Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) were used to evaluate negative emotions and anxiety and depression of patients before and after intervention. The Quality of Life Scale (European Organization for Research and Treatment of Cancer [EORTC] QLQ-C30) and Social Support Scale (SSRS) were used to evaluate the quality of life and social support of patients. This study has been registered in 13/01/2023 (ClinicalTrials.gov Identifier: NCT05683236).ResultThe general data of the two groups were comparable. After intervention, the SAS (43.7 ± 7.4 vs. 54.2 ± 9.3) and SDS scores (38.4 ± 6.5 vs. 53.1 ± 8.4) of the intervention group were significantly lower than those of the control group. The total SSRS score, subjective support score, objective support score and utilisation of support of the intervention group were significantly higher than those of the control group (P < 0.05). The overall quality of life score of the intervention group was higher than that of the control group, and the difference was statistically significant (79.5 ± 4.5 vs. 73.2 ± 3.6, P < 0.05). The scores of each functional scale were significantly higher than those of the control group (P < 0.05).ConclusionCompared with conventional nursing, the application of the multidisciplinary collaborative team combined with tranquilisation therapy in patients with terminal cancer can significantly reduce the anxiety and depression of patients, enable patients to obtain comprehensive social support, and effectively improve the quality of life of patients.Trial registrationClinicalTrials.gov Identifier NCT05683236, 13/01/2023, Retrospectively registered.