•This network meta-analysis compared the relative efficacy of different types of exercise interventions on cognitive function for patients with MCI or dementia.•Resistance exercise had the highest ...probability of being the optimal exercise therapy to slow cognitive decline, especially for patients with dementia.•Subgroup analyses revealed that multi-component exercise tended to be the most effective exercise therapy for preventing the decline of global cognition and executive function in patients with MCI, but only resistance exercise showed significant effects on memory function.
Exercise is a promising nonpharmacological therapy for cognitive dysfunction, but it is unclear which type of exercise is most effective. The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment (MCI) or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.
We searched PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia. Primary outcomes included global cognition, executive cognition, and memory cognition. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, and quality of life. Pairwise analyses and network meta-analyses were performed using a random effects model.
A total of 73 articles from 71 trials with 5606 participants were included. All types of exercise were effective in increasing or maintaining global cognition, and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition (standard mean difference (SMD) = 1.05, 95% confidence interval (95%CI): 0.56−1.54), executive function (SMD = 0.85, 95%CI: 0.21−1.49), and memory function (SMD = 0.32, 95%CI: 0.01−0.63) in patients with cognitive dysfunction. Subgroup analyses for patients with MCI revealed different effects, and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition (SMD = 0.99, 95%CI: 0.44−1.54) and executive function (SMD = 0.72, 95%CI: 0.06−1.38). However, only resistance exercise showed significant effects on memory function for patients with MCI (SMD = 0.35, 95%CI: 0.01−0.69). Exercise interventions also showed various effects on the secondary outcomes.
Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive decline in patients with cognitive dysfunction, especially in patients with dementia. Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.
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The ATP-binding cassette (ABC) transporter ABCG2 is a significant urate transporter with a high capacity, and it plays a crucial role in the development of hyperuricemia and gout. Therefore, it has ...the potential to be targeted for therapeutic interventions. Cortex Fraxini, a traditional Chinese medicine (TCM), has been found to possess anti-hyperuricemia properties. However, the specific constituents of Cortex Fraxini responsible for this effect are still unknown, particularly the compound that is responsible for reducing uric acid levels in vivo. In this study, we propose a target screening protocol utilizing bio-affinity ultrafiltration mass spectrometry (BA-UF-MS) to expediently ascertain ABCG2 ligands from the plasma of rats administered with Cortex Fraxini. Our screening protocol successfully identified fraxin as a potential ligand that interacts with ABCG2 when it functions as the target protein. Subsequent investigations substantiated fraxin as an activated ligand of ABCG2. These findings imply that fraxin exhibits promise as a drug candidate for the treatment of hyperuricemia. Furthermore, the utilization of BA-UF-MS demonstrates its efficacy as a valuable methodology for identifying hit compounds that exhibit binding affinity towards ABCG2 within TCMs.
Dementia is prevalent in worldwide, and increases the care burden and potential costs. Physical activity (PA) has been increasingly shown to be beneficial for them. This was a cross-sectional ...observational study aiming to investigate the status of PA among community-dwelling older adults with dementia in Beijing or Hangzhou, China, and verify the relationships between neuropsychiatric symptoms, activities of daily living (ADL), caregivers’ fear of patients’ falling and their PA using a path analysis approach. The level of PA among 216 included people with dementia was low. PA was related to the neuropsychiatric symptoms, with ADL and caregivers’ fear of patients’ falling have mediation roles. The findings indicated that person-centered strategies related to the management of these symptoms might be helpful to improve ADL, relieve caregivers’ concerns about them falling and consequently foster positive participation in PA.
Accessible Summary
What is known on the subject?
The shortage of psychiatric nurses has become a focus problem attracting widespread concern. And the continuous improvement of quality of psychiatric ...care has always been a priority in psychiatric units.
Previous studies about nurses from general hospitals indicated nursing work environment was a key factor affecting work‐related outcomes, but little attention was paid to psychiatric nurses and few studies focused on the five specific dimensions of nursing work environment.
What the paper adds to existing knowledge?
Nurse participation in hospital affairs was the dimension with the highest proportion of participants dissatisfied.
Nursing work environment and all its five dimensions had significant effects on work‐related outcomes, which were partly mediated by work engagement.
For nurse‐perceived quality of care, collegial nurse‐physician relations showed the largest effect; while for turnover intention, the two dimensions of nurse participation in hospital affairs and nursing foundations for quality of care showed larger effects.
What are the implications for practice?
Corresponding measures should be taken to improve nursing work environment, especially in the aspect of nurse participation in hospital affairs by promoting nurses' ability to participate, arousing their motivation to participate and offering them more opportunities to participate.
Harmonious collegial relationship should be built by creating an atmosphere of equality, respect and collaboration, and enhancing the communication between doctors and nurses.
Nursing foundations for quality of care need to be further improved through setting appropriate rules and regulations to ensure the quality of care and offering more opportunities to support nursing staff's growth and development.
Introduction
With the increasing demand for high‐quality psychiatric care, it is imperative to improve psychiatric nurses' work engagement and work‐related outcomes. Nursing work environment has been identified as a protective factor in non‐psychiatric nurses, but little was known about psychiatric nurses.
Aims
To identify the situation of nursing work environment, work engagement, nurse‐perceived quality of care and turnover intention among psychiatric nurses, and examine the relationship among them.
Methods
A cross‐sectional design was adopted. Questionnaire investigation was implemented among psychiatric nurses from 43 clinical units. Structural equation modelling and path analysis were used to examine the causal relationship among variables.
Results
The results showed 19.06% of participants were not satisfied with the overall work environment and 24.34% were not satisfied with the dimension of nurse participation in hospital affairs. Hypothesis testing results indicated that nursing work environment and its five dimensions had positive effects on nurse‐perceived quality of care and negative effects on turnover intention, which were both partly mediated by work engagement.
Discussion
Supportive nursing work environment could improve nurses' work engagement, enhance nurse‐perceived quality of care and reduce nurses' turnover intention.
Implications for Practice
Continuous efforts should be paid to the improvement of nursing work environment in psychiatric hospitals.
To investigate the therapeutic effects of vitamin A (VitA) or vitamin D (VitD) against bronchopulmonary dysplasia (BPD) and the underlying mechanism from the perspective of macrophage polarization.
A ...BPD model was established on rats. Hematoxylin and eosin staining was used to evaluate the pathological state of lung tissues. The expression of CD68 was determined by immunohistochemistry assay. The infiltration of M1 and M2 macrophages was marked by immunofluorescence. The expression levels of tumor necrosis factor (TNF)-α, interleukin (IL)-10, nitric oxide synthase (NOS), and arginase-1 (Arg-1) were evaluated by quantitative reverse transcription polymerase chain reaction assay, and the ratio of M1/M2 in the bronchoalveolar lavage fluid was determined by flow cytometry.
Disordered alveolar structure in the lung tissue, thickened alveolar septa, and infiltration of inflammatory cells around the alveolar cavity and pulmonary septa were observed in lipopolysaccharide (LPS)-treated rats. On day 21 post-natal (PN21), the pathological state was aggravated, alveolar simplification was observed, and the expression level of CD68 in the lung tissues was significantly elevated, and these results were dramatically alleviated in the VitA, VitD, and VitA+VitD groups. However, no significant synergistic effect was observed between VitA+VitD and VitA or VitD groups. After the administration with VitA or VitD, IL-10 and Arg-1 were up-regulated on PN10. TNF-α and NOS were up-regulated on PN21. The ratio of macrophage polarization and M2 macrophages increased considerably after the stimulation with LPS, and this result was significantly reversed by VitA or VitD. A significant difference was observed on the effect of different dosages of VitA or VitD on macrophage polarization, among which moderate dosages of VitA or VitD exerted the most significant influence on macrophage polarization.
The BPD-linked pulmonary injury stimulated by LPS can be ameliorated by the introduction of VitA or VitD.
VitA or VitD suppressed the macrophage polarization and M2 macrophages population induced by LPS in the lung tissues of BPD rats. The pathological state of lung tissues of BPD rats induced by LPS was significantly alleviated by VitA or VitD, accompanied by amelioration of inflammation state. The present study claimed the potential therapeutic property of VitA or VitD against BPD on an animal model. Display omitted
•M2 polarization in the LPS-induced BPD rat model were significantly reversed by VitA or VitD.•The pathological state of lung tissues of BPD rats induced by LPS was significantly alleviated by VitA or VitD.•The severe inflammation induced by LPS in the lung tissues of BPD animals was improved by VitA or VitD.
Aim
To analyse the structural associations among job characteristics, organizational justice, work engagement and nursing care quality in Chinese nurses.
Background
Nursing care quality helps ensure ...patient safety, which are core concerns. The explicit relationships among the study's variables from a management perspective can help hospital managers to implement effective strategies to improve nursing care quality.
Methods
This cross‐sectional study was conducted to investigate the relationships among the variables in 1,615 nurses in eight Chinese tertiary hospitals. Structural equation modelling was used to test a proposed model of these relationships.
Results
The scores of job characteristics, organizational justice, work engagement and nursing care quality were 3.55 ± 0.41, 3.84 ± 0.77, 4.67 ± 1.30 and 3.42 ± 0.70. Job characteristics and organizational justice had direct effects on nursing care quality. Work engagement mediated the relationship of nursing care quality with job characteristics and organizational justice. The final model explained 24% of nursing care quality.
Conclusion
The results provide a better understanding of the associations between the study's variables. Perceived job characteristics and organizational justice can improve nursing care quality through work engagement.
Implications for Nursing Management
Reconfiguring work design to strengthen nurses' positive perceptions of job characteristics and organizational justice can enhance nursing care quality.
This study is aimed to screen, identify and detect illegal additives from healthcare products which claim or imply to have weight-loss effects.
Ultra-high performance liquid ...chromatography-quadruple-time-of-flight mass spectroscopy (UPLC-Q-TOF/MS) was employed to perform non-targeted screening of illegal additives from a total of 26 batches of healthcare products with weight-loss effects. A novel oxyphenisatin dipropionate analog was discovered in a fruit-flavored jelly that was not clearly labeled as containing added drugs. After being separated and purified by silica gel column chromatography, the analog was unambiguously characterized by one-dimensional (1D) and two-dimensional (2D) nuclear magnetic resonance (NMR) spectroscopies. The molecular structure of the analog was finally identified by comparing the spectra of the analog with those of suspected candidates prepared by de novo synthesis strategy. Thereafter, a sensitive and precise reversed phase ultra performance liquid chromatography coupled with photodiode array (UPLC-PDA) detection method was developed and verified for the determination of the analog in 15 batches of real samples.
In the MS/MS spectra, the signal intensity of mass/charge ratios (m/z, 242 and 214) of the novel analog fragments was highly similar to that of mass/charge ratios (m/z, 224 and 196) of oxyphenisatin dipropionate fragments. Additionally, the 1D NMR spectrum of the analog was completely consistent with that of one of the suspected candidates prepared by the de novo synthesis strategy. Based on the above analysis, the structure of the analog was determined as 3,3-bis4'-(propionyloxy)phenyl-6-fluoro-2-oxoindoline, which was briefly named 6-F oxyphenisatin dipropionate. A developed quantitative method showed good linearity (R2 > 0.999) in a concentration range of 1.0–100 μg/mL. The limits of detection (LOD) and quantification (LOQ) for the analog was 3 mg/kg and 10 mg/kg, respectively. The average recoveries of the analog from spiked three different matrix samples in low (1 time of LOQ), medium (2 times of LOQ), and high (10 times of LOQ) concentrations were varied from 93.9 % to 107.8 % with a precision of 0.03–1.56 %. Results of quantitative analysis in 15 batches of healthcare products revealed that the content of 6-F oxyphenisatin dipropionate in a fruit-flavored jelly and a solid beverage was 118 mg/kg and 330 mg/kg, respectively.
In terms of its structure, 6-F oxyphenisatin dipropionate replaces hydrogen atom by the fluorine atom at position 6 on the indolinone fragment in oxyphenisatin dipropionate. To our best knowledge, 6-F oxyphenisatin dipropionate has never been detected as an illegal additive in foods. Such illegal addition of the analog to foods is more concealing, thus the supervision and testing departments should attach great importance to its application in food markets.
•A new oxyphenisatin dipropionate analog was detected from a fruit-flavored jelly.•HRMS and NMR were utilized to characterize the structure of this analog.•All suspected candidates were prepared by de novo synthesis pathway for comparison.•Analog with an additional fluorine atom was named 6-F oxyphenisatin dipropionate.
ObjectiveThis study aimed to achieve rapid qualitative and quantitative analysis of the respective contents of glutamine （Gln） enantiomers in functional foods by establishing a water-soluble ...lanthanide shift reagent-identified method based on the 1H-qNMR technique.MethodsThe internal standard disodium terephthalate was added to the samples dissolved in ultrapure water. After vertexing and centrifuging， an appropriate amount of supernatant was taken into the NMR tube with deuterium water as a field-locking solvent and the water-soluble lanthanide shift reagent samarium （Ⅲ）-propylenediaminetetraacetate as the chiral selector. The 1H-NMR spectrum was collected by a 600 MHz nuclear magnetic resonance spectrometer for the direct determination of the contents of Gln enantiomers in functional foods.ResultsThe Gln enantiomers and DT quantitative peaks were well-separated. The mass concentration of D- and L-glutamine has a good linearity in the range of 100.0-2 000.0 µg/mL with R2>0.99. The limit of detection was 30.0
Aims and objectives
To identify the situation of organisational justice, organisational support, work engagement and turnover intention among community nurses and clarify the relationship among them.
...Background
Nurse shortage has become a worldwide issue, and the shortage of community nurses is more serious. Nurse turnover is one important factor for this situation. While previous studies about turnover intention mostly focused on hospital nurses, few involved community nurses.
Design
A descriptive, cross‐sectional design was adopted.
Methods
Questionnaire investigation was implemented among 410 community nurses to collect data about organisational justice, organisational support, work engagement and turnover intention. Structural equation modelling was applied to test the hypothesised model. The STROBE statement for observational studies was followed.
Results
Results showed the average score of turnover intention was 2.50 ± 0.75. The final model indicated: (a) work engagement had a direct negative effect on turnover intention; (b) organisational support had both direct and indirect effects on turnover intention, and the indirect effect was mediated by work engagement; and (c) organisational justice had an indirect effect on turnover intention mediated by organisational support.
Conclusion
Turnover intention could be reduced directly or indirectly by improving work engagement, organisational support and organisational justice.
Relevance to clinical practice
This study provides evidence for community health centre managers and policymakers to improve the level of nurses' engagement and to retain more nurses in primary healthcare service.
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