Dysphagia is common after stroke. Patients with dysphagia have a higher risk of stroke-associated pneumonia (SAP) and poor outcomes. Early detection of dysphagia is necessary to identify and manage ...patients at high risk of aspiration. The aim of the study was to assess the impact of the systematic administration of the volume-viscosity swallow test (V-VST) in patients with acute ischaemic stroke.
This was a retrospective observational study that enrolled patients with acute ischaemic stroke in two consecutive time periods: pre-V-VST, when the 30-mL water-swallowing test (WST) was systematically administered, and V-VST, when all patients underwent the WST and the V-VST test was systematically administered if the patient failed the WST.
Two hundred and 42 patients were enrolled. The mean age of the participants was 68.8 ± 10.88 years, 61.2% were male, and the median National Institutes of Health Stroke Scale score was 3 (IQR, 1-6). A total of 147 patients were enrolled during the pre-V-VST period and 95 were enrolled during the V-VST period. There was a significant difference in the occurrence of SAP (21.8% vs. 10.5%, p = 0.024) and the rate of nasogastric tube feeding (25.9% vs. 14.7%, p = 0.040) between the two groups, and no differences were found in the length of hospital stay (p = 0.277) or the total cost of hospitalization (p = 0.846).
The V-VST was a better clinical screening tool, and it can also provide detailed suggestions regarding dietary modifications to prevent aspiration and SAP.
Background: Paroxetine therapy has been used for treatment of patients with depression and Parkinson’s disease (dPD) in many clinical studies, but, the effects of paroxetine in dPD patients are not ...completely understood. The aim of this study was to systematically evaluate the effects of paroxetine therapy on depressive symptom and motor function in the treatment of dPD, in order to confer a reference for clinical practice. Methods: Randomized controlled trials (RCTs) of paroxetine for dPD published up to October, 2022 were retrieved. Standardised mean difference (SMD), odds ratio (OR), and 95% confidence interval (CI) were calculated and heterogeneity was measured with the I 2 test. The outcomes of interest were as follows: the efficacy, Hamilton depression rating scale score, unified Parkinson’s disease rating scale score, Hamilton anxiety rating scale score or adverse events. Results: Thirty-four RCTs with 2819 participants were included. Compared with control group, the pooled effects of paroxetine therapy on depression were (22 trials; OR 3.62, 95% CI 2.63 to 4.98, P < .00001) for antidepressant response (25 trials; SMD -2.14, 95% CI -2.73 to -1.56, P < .00001) for Hamilton depression rating scale score, the pooled effects of paroxetine therapy on motor function were (10 trials; OR 4.63, 95% CI 3.15 to 6.79, P < .00001) for anti-PD efficacy (18 trials; SMD -2.02, 95% CI -2.48 to -1.55, P < .00001) for total unified Parkinson’s disease rating scale score. The Hamilton anxiety rating scale score showed significant decrease in the paroxetine treatment group compared to control group (10 trials; SMD -1.93, 95% CI -2.65 to -1.22, P < .00001). In addition, paroxetine therapy reduced the number of any adverse events obviously in dPD patients (twenty trials; OR 0.42, 95% CI 0.31 to 0.57, P < .00001). Conclusions: Paroxetine therapy has clinical benefits for improvement of depressive symptom and motor function in dPD patients, moreover, it is of high drug safety. Further well-designed, multi-center RCTs needed to identify these findings.
Purpose
The purpose of this paper is to identify the factors that explain the acceptance of self-service ordering systems (SOSs) for restaurants and to explore the effects of “self-service system ...service quality” (SSQ) and “interpersonal service quality” (ISQ) on the acceptance factors extended from the Unified Theory of Acceptance and Use of Technology model.
Design/methodology/approach
This study targets customers who have recently used SOSs to order foods in middle-class restaurants. In total, 402 valid survey samples were obtained. Partial least squares (PLS) analysis was used to examine the factors of user acceptance of using SOSs.
Findings
The results of the PLS-SEM analysis indicate that SSQ has a significant effect on accuracy expectancy, speed expectancy and effort expectancy; ISQ has a significant effect on accuracy expectancy, speed expectancy, effort expectancy and facilitating conditions; and accuracy expectancy, speed expectancy, effort expectancy, social influence, facilitating conditions and budget expectancy significantly influence user acceptance of SOSs. Furthermore, user experiences moderate the effect of speed expectancy and effort expectancy on user acceptance.
Originality/value
This study introduces three technology acceptance factors (accuracy, speed and budget) for researchers to consider in the future. It also extends the knowledge about the human service factor when middle-class restaurants adopt self-service technologies (SSTs). Recommendations are provided for system developers to improve the system quality of SSTs and service staff to rethink their roles in adopting SSTs in the service industry.
论餐饮业中基于自助订餐系统的整合服务质量
摘要
研究目的
本文研究目的有:（1）确认解释客人接受餐厅自助订餐系统（SOSs）的决定因素（2）探索自助系统服务质量（SSQ）和人机服务质量（ISQ）对于UTAUT模型科技接受因素的作用。
研究设计/方法/途径
本论文的目标受众为近期使用过SOSs在中等餐厅点餐过的客人。样本为402份有效问卷数据。本论文使用PLS分析检测用户接受SOSs的各项因素。
研究结果
PLS-SEM分析结果表明, SSQ对准确预期、速度预期、努力预期, 有显著作用; ISQ对于准确预期、速度预期、努力预期、以及辅助条件, 有显著作用; 准确预期、速度预期、努力预期、社会影响、辅助条件、以及预算预期对于SOSs用户接受有显著作用。此外, 用户体验调节速度预期和努力预期对于用户接受的作用。
研究原创性/价值
本论文新增了三种科技接受因子（准确度、速度、和预算）, 为未来的科研创造土壤。本论文还扩展了我们对于人员服务因子在中等餐厅采用SSTs的认知。本论文建议系统开发者应该提高SST系统质量, 以及建议服务人员重新审视在服务产业采用SST中自己的位置。
The efficacy of susceptible variants derived from genome-wide association studies (GWAs) optimizing discriminatory accuracy of colorectal cancer (CRC) in Chinese remains unclear. In the present ...validation study, we assessed 75 recently identified variants from GWAs. A risk predictive model combining 19 variants using the least absolute shrinkage and selection operator (LASSO) statistics offered certain clinical advantages. This model demonstrated an area under the receiver operating characteristic (AUC) of 0.61 during training analysis and yielded robust AUCs from 0.59 to 0.61 during validation analysis in three independent centers. The individuals carrying the highest quartile of risk score revealed over 2-fold risks of CRC (ranging from 2.12 to 2.90) compared with those who presented the lowest quartile of risk score. This genetic model offered the possibility of partitioning risk within the average risk population, which might serve as a first step toward developing individualized CRC prevention strategies in China.
•A 19 SNP-based risk predictive model offered certain clinical advantages.•The individuals who has over 2-fold risks should be considered at risk.•The risk model has the potential to improve CRC screening.
Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect ...the risk of COVID-19 remains unclear.
A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients’ medical records. Multivariable logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of the associations between comorbidities (cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19.
Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30–6.32), type 2 diabetes (T2DM) (3.57, 2.32–5.49), cardiovascular disease (CVD) (3.78, 1.81–7.89), fatty liver disease (7.53, 1.96–28.96), hyperlipidemia (2.15, 1.26–3.67), other lung diseases (6.00, 3.01–11.96), and electrolyte imbalance (10.40, 3.00–26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89–12.75), CVD (8.47, 6.03–11.89), and electrolyte imbalance (19.44, 11.47–32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25–9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46–29.64) within two weeks.
Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
The continuous spread of the COVID-19 pandemic is causing people to feel anxiety and stress. This study constructs a four-layer research model to examine how a 360° virtual tour can reduce people's ...psychological stress through two types of presence (the sense of presence and telepresence) and affective-motivational states (enjoyment and involvement) in this extraordinary period of the COVID-19 pandemic. In order to test the moderating effect of involvement, partial least squares (PLS) analysis is employed to analyse valid data collected from 235 individuals. The results of this study indicate that telepresence has a higher impact in generating affective-motivational states than the sense of presence. Among the factors, enjoyment shows the highest effect on satisfaction with the 360° virtual tour experience and stress reduction; involvement moderates the effect of telepresence on satisfaction with the 360° virtual tour experience. This study also contributes to virtual reality research by distinguishing the concepts of ‘sense of presence’ and ‘telepresence’ as well as demonstrating the mechanisms whereby virtual reality technology influences people's psychological well-being. Timely recommendations are provided for people in order to reduce psychological stress during and after COVID-19 pandemic.
•Sense of presence and telepresence influence affective-motivational states.•Telepresence has the highest total effect on the satisfaction with the 360° VR tour.•Telepresence has the highest total effect on stress reduction.•Involvement mediates and moderates the effect of telepresence on the satisfaction.
A prospective randomized trial was performed to evaluate the contribution of neoadjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma.
Patients with locoregionally ...advanced nasopharyngeal carcinoma were treated either with radiotherapy alone (RT group) or neoadjuvant chemotherapy plus radiotherapy (CT/RT group). Neoadjuvant chemotherapy consisting of two to three cycles of cisplatin (100 mg/m(2), day 1), bleomycin (10 mg/m(2), days 1 and 5), and fluorouracil (5-FU; 800 mg/m(2), days 1 through 5, continuous infusion) followed by radiotherapy was given to the CT/RT group. All patients were treated in a uniform fashion by definitive-intent radiation therapy in both groups.
Between July 1993 and July 1994, 456 patients were entered onto the study, with 228 patients randomized to each treatment arm, and 449 patients (225 in the RT group and 224 in the CT/RT group) were assessable. All 456 patients were included in survival analysis according to the intent-to-treat principle. The 5-year overall survival (OS) rates were 63% for the CT/RT group and 56% for the RT group (P =.11). The median relapse-free survival (RFS) time was 50 months for the RT group and not reached for the CT/RT group. The 5-year RFS rate was 49% for the RT group versus 59% for the CT/RT group (P =.05). The 5-year freedom from local recurrence rate was 82% for the CT/RT group and 74% for the RT group (P =.04). There was no significant difference in freedom from distant metastasis between the two treatment groups (CT/RT group, 79%; RT group, 75%; P =.40).
This randomized study failed to demonstrate any significant survival benefit with the addition of neoadjuvant chemotherapy for patients with locoregionally advanced nasopharyngeal carcinoma. Therefore, neoadjuvant chemotherapy for nasopharyngeal carcinoma should not be used outside of the context of a clinical trial.
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