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Malnutrition is prevalent among individuals with acute ischaemic stroke (AIS) and may worsen clinical outcomes. There is no consensus on the best tool for nutritional screening in this population. The present study compared four screening tools and one diagnostic tool in terms of their prognostic significance in predicting short-term and long-term outcomes in AIS patients.
We included patients admitted to five major hospitals in Wenzhou and diagnosed with a primary diagnosis of AIS from October 1 to December 31, 2018. The Controlling Nutritional Status (CONUT) score, the Geriatric Nutritional Risk Index (GNRI), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Screening Tool 2002 (NRS-2002) and the European Society for Clinical Nutrition and Metabolism diagnostic criteria for malnutrition (ESPEN-DCM) were assessed at admission. The clinical outcomes were evaluated by the modified Rankin Scale (mRS) and mortality at 3 months and 12 months after discharge.
Five hundred and ninety-threhose for the other tools. The optimal cut-off values of the MUST and NRS-2002 to predict poor outcomes were scores of ≥2 and≥3 points, respectively.
Our data supported a deleterious effect of inadequate nutrition, as evidenced by the nutrition screening tools or ESPEN-DCM, on clinical outcomes during and beyond the acute phase of AIS. We recommended the use of the MUST and NRS-2002 in guiding nutritional support in AIS patients, as they have higher predictive power and can predict both short-term and long-term outcomes.
Our data supported a deleterious effect of inadequate nutrition, as evidenced by the nutrition screening tools or ESPEN-DCM, on clinical outcomes during and beyond the acute phase of AIS. We recommended the use of the MUST and NRS-2002 in guiding nutritional support in AIS patients, as they have higher predictive power and can predict both short-term and long-term outcomes.
Whole-body vibration (WBV) has emerged as a potential intervention paradigm for improving motor function and bone growth in children with disabilities. Merbarone nmr However, most evidence comes from adult studies. It is critical to understand the mechanisms of children with and without disabilities responding to different WBV conditions. This study aimed to systematically investigate the acute biomechanical and neuromuscular response in typically developing children aged 6-11years to varying WBV frequencies and amplitudes.
Seventeen subjects participated in this study (mean age 8.7years, 10M/7F). A total of six side-alternating WBV conditions combining three frequencies (20, 25, and 30Hz) and two amplitudes (1 and 2mm) were randomly presented for one minute. We estimated transmission of vertical acceleration across body segments during WBV as the average rectified acceleration of motion capture markers, as well as lower-body muscle activation using electromyography. Following WBV, subjects performed countermovement jumps to assess neuromuscular facilitation.
Vertical acceleration decreased from the ankle to the head across all conditions, with the greatest damping occurring from the ankle to the knee. Acceleration transmission was lower at the high amplitude than at the low amplitude across body segments, and the knee decreased acceleration transmission with increasing frequency. In addition, muscle activation generally increased with frequency during WBV. There were no changes in jump height or muscle activation following WBV.
WBV is most likely a safe intervention paradigm for typically developing children. Appropriate WBV intervention design for children with and without disabilities should consider WBV frequency and amplitude.
WBV is most likely a safe intervention paradigm for typically developing children. Appropriate WBV intervention design for children with and without disabilities should consider WBV frequency and amplitude.
Both graft type and surgical technique for anterior cruciate ligament reconstruction can affect knee biomechanics. Several studies reported the influence of graft type, but few have controlled the surgical technique and fully investigated stair ambulation. This study aimed to compare knee biomechanics during stair ambulation between patients treated with hamstring tendon graft and those treated with patellar tendon graft when anterior medial portal technique was used to drill femoral tunnel.
Two groups of patients (patellar tendon, n=18; hamstring tendon, n=18) at average 12months after reconstruction surgery were recruited to ascend and descend a customized staircase in a gait lab. Joint kinematics and kinetics were calculated for both operated and contralateral intact limbs based on kinematic analysis and inverse dynamics. The influence of graft type on knee flexion angle and moment was identified using one-way mixed (graft type and limb side) analysis of variance with post-hoc paired t-test.
Significant interaction between graft and limb was found for knee flexion and range of motion. Only the hamstring tendon group had significant kinematic deficits on the operated limb than the contralateral limb during stair ascent and descent. No significant interaction was found for knee flexion moment. Both graft groups had significant deficits in peak knee flexion moment on the operated side during stair ascent and descent.
While the choice of graft type does not affect the restoration of knee dynamic loading, patellar tendon graft better restores knee flexion-extension kinematics during stair ambulation.
While the choice of graft type does not affect the restoration of knee dynamic loading, patellar tendon graft better restores knee flexion-extension kinematics during stair ambulation.
Many academics and clinicians who assess nursing students as part of their work-integrated learning experiences encounter difficulties with awarding a failing grade to students who do not meet fitness for practice standards.
The aim of this study was to explore and further our understanding of assessors' experiences of failure-to-fail of nursing students within work-integrated learning.
This aim was achieved through an exploratory, sequential, mixed methods research project.
Guided by Invitational Theory, this programme of work included an integrated systematic review, one-on-one and focus group interviews, and finished with a survey.
The results of each of the phases of this mixed methods study were integrated to provide a greater understanding of the enablers and barriers for assessors managing poor performing students to ameliorate failure to fail. Enablers identified included assessor supports, programme flexibility, and organisational culture. The barriers included grade inflation, in appropriate student responses, organisational processes and workload.
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