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Objectives: To evaluate the relationship between oral health and geriatric disorders, as well as its role in clinical outcomes among acutely admitted older patients. Design: A retrospective observational study was conducted. Setting: The study was conducted at a medical center in central Taiwan. Participants: A total of 1,141 patients (651 males and 490 females), aged 65 years or older, were admitted due to acute illness with geriatric syndromes from October 1, 2018, to March 31, 2023. Measurements: A comprehensive geriatric assessment (CGA) was conducted, covering the comorbidity index, cognitive status, mood, physical function, nutritional status, mobility, health-related quality of life, frailty, and oral health condition. Oral health was evaluated using a bedside oral examination with scores ranging from 8 to 24, where scores of 8–10 indicated normal oral health, 11–14 indicated moderate impairment, and 15–24 indicated severe impairment. The primary outcome observed was in-hospital mortality. Results: Among the participants, 40.5% experienced cognitive impairment, 24.8% exhibited depressive symptoms, 69.4% had low hand grip strength, 36.5% demonstrated low performance in mobility, and 78.9% were at risk of malnutrition. Severe impairment of oral health was found in 18.8% of the participants, while frailty was observed in 85.1%. Stratification of oral health severity revealed differences in various CGA parameters, including comorbidity, polypharmacy, cognitive impairment, depressive mood, physical activity, mobility, nutritional status, and quality of life, as well as clinical outcomes such as length of stay and in-hospital mortality between the groups. In univariable analysis, age, gender, frailty, oral health impairment, comorbidity index, nutritional status, and cognitive and physical functions were all significantly associated with in-hospital mortality. After adjusting for significant factors, severe oral health impairment remained significantly associated with mortality. Conclusion: In acutely admitted older patients, oral health was associated with geriatric disorders and was linked to in-hospital mortality. Early intervention in oral health may be necessary to improve outcomes.

Abstract Background Spiritual care plays a significant role in holistic patient care, addressing not only physical ailments but also attending to patients’ emotional and spiritual well-being. While the importance of spiritual care in nursing is widely recognized, there is often a gap in understanding nurses’ willingness to provide such care. This cross-sectional study aimed to explore the association between self-efficacy, spiritual well-being, and willingness to provide spiritual care among nursing staff. Methods The study conducted a cross-sectional survey of full-time registered nurses at a hospital in Taiwan from January 2019 to December 2019. A sample comprising 168 nurses was selected for participation in the study through a random sampling method. In addition to collecting demographic variables, the assessment tools used in the study include the General Self-Efficacy Scale (GSES) for measuring self-efficacy, the Spiritual Index of Well-Being Chinese Version (SIWB-C) for evaluating spiritual well-being, and the Spiritual Care Needs Inventory (SCNI) to gauge willingness to provide spiritual care. Results Most participants in the study were female, accounting for 98.2% (n = 165). The mean age of all 168 nurses was 37.1 ± 9.3 years. Additionally, most participants held a Bachelor’s degree (79.2%, n = 133) and possessed clinical experience was 10.5 ± 9.3 years. Through logistic regression analysis, it was found that regardless of whether participants have received sufficient spiritual care training, both GSES and SIWB-C remain influential factors in determining the provision of spiritual care. Conclusions Collaboration between healthcare management and nursing staff is essential for fostering a healthcare environment that not only appreciates the physical and spiritual dimensions of patient care but also prioritizes the enhancement of nurses ' self-efficacy and well-being.

Let b be an odd number. By using elementary methods, we prove that: (1) When x is an odd number and y is an even number, the Diophantine equation (2x−1)(by−1)=2z2 has no positive integer solution except when b is two special types of odd number. (2) When x is an odd number and b≡±3(mod8), the Diophantine equation (2x−1)(by−1)=2z2 has no positive integer solution except where b=3 and is another special type of the odd number.

Osteoporotic fractures have a tremendous impact on quality of life and may contribute to fatality, but half of patients may discontinue their anti-osteoporosis medication. The study aimed to investigate the factors associated with the persistence of anti-osteoporosis medication. Between June 2016 and June 2018, we recruited 1195 participants discontinuing prior anti-osteoporosis medication. Telephone interviews were conducted to discern the reasons for discontinuation. Comparisons among groups and risks of self-discontinuation were analyzed. Among 694 patients who have no records of continuing anti-osteoporosis medication, 374 (54%) self-discontinued, 64 (9.2%) discontinued due to physicians’ suggestion, and 256 (36.8%) with unintended discontinuation. Among patients with self-discontinuation, 173 (46.3%) forgot to visit outpatient clinics; 92 (24.5%) discontinued because of medication-related factors; 57 (15.2%) thought the severity of osteoporosis had improved and therefore discontinued; 30 (8%) stopped due to economic burden; 22 (5.9%) were lost to follow-up because of newly diagnosed diseases other than osteoporosis. Additionally, older age, male gender, calcium supplement, teriparatide therapy and hip fractures in teriparatide users were associated with adherence to anti-osteoporosis drugs. In conclusion, our results indicate that younger age, female gender, non-use of calcium supplements, and anti-resorptive medication were independent risk factors associated with drug discontinuation. Identifying high-risk patients and providing timely health education are crucial for adherence to anti-osteoporosis medication.

Background: Little is known about the gaps between expectation and the perception of service quality in the care setting of prolonged mechanical ventilation (MV). Methods: We conducted this prospective study at the Respiratory Care Center (RCC) of a medical center from February 2017 to January 2018. Family members of the patients admitted to the RCC completed a questionnaire based on the SERVQUAL instrument in two sections – expectation and perception, consisting of 22 questions each in five dimensions. We analyzed the gaps between paired items, used important-performance analysis (IPA) to identify priority items for improvement, and performed multivariate logistic regression analysis. Results: A total of 167 respondents participated in the survey. The average length of patient stay in the RCC was 19.4 days, and 70.7% were successfully liberated from MV. The overall mean SERVQUAL scores for the two sections were similar (4.50 ± 0.52 and 4.51 ± 0.54 for expectation and perception, respectively; p = 0.808). IPA identified four items, including one “tangible,” one “reliability” and two “empathy” with an undesired expectation/perception gap indicating a priority for improvement. Multivariate logistic regression analysis showed that male respondents, patients older than 75 years, tracheostomy, and the need for physical training or dialysis were associated with an increased gap in these priority items. Conclusion: Gaps exist between expectation and perception in multiple dimensions of the quality of healthcare service in the care setting of prolonged MV, indicating unmet needs and priorities for improvement. Keywords: Respiratory care center, Service quality, Satisfaction, Gap, Expectation, Perception

Mushrooms belong to the family “Fungi” and became famous for their medicinal properties and easy accessibility all over the world. Because of its pharmaceutical properties, including anti-diabetic, anti-inflammatory, anti-cancer, and antioxidant properties, it became a hot topic among scientists. However, depending on species and varieties, most of the medicinal properties became indistinct. With this interest, an attempt has been made to scrutinize the role of edible mushrooms (EM) in diabetes mellitus treatment. A systematic contemporary literature review has been carried out from all records such as Science Direct, PubMed, Embase, and Google Scholar with an aim to represents the work has performed on mushrooms focuses on diabetes, insulin resistance (IR), and preventive mechanism of IR, using different kinds of mushroom extracts. The final review represents that EM plays an important role in anticipation of insulin resistance with the help of active compounds, i.e., polysaccharide, vitamin D, and signifies α-glucosidase or α-amylase preventive activities. Although most of the mechanism is not clear yet, many varieties of mushrooms’ medicinal properties have not been studied properly. So, in the future, further investigation is needed on edible medicinal mushrooms to overcome the research gap to use its clinical potential to prevent non-communicable diseases.

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Background Intra-hospital transportation (IHT) might compromise patient safety because of different care settings and higher demand on the human operation. Reports regarding the incidence of IHT-related patient safety events and human failures remain limited. Objective To perform a retrospective analysis of IHTrelated events, human failures and unsafe acts. Setting A hospital-wide process for the IHT and database from the incident reporting system in a medical centre in Taiwan. Participants All eligible IHT-related patient safety events between January 2010 to December 2015 were included. Main outcome measures Incidence rate of IHT-related patient safety events, human failure modes, and types of unsafe acts. Results There were 206 patient safety events in 2 009 013 IHT sessions (102.5 per 1 000 000 sessions). Most events (n=148, 71.8%) did not involve patient harm, and process events (n=146, 70.9%) were most common. Events at the location of arrival (n=101, 49.0%) were most frequent; this location accounted for 61.0% and 44.2% of events with patient harm and those without harm, respectively (p<0.001). Of the events with human failures (n=186), the most common related process step was the preparation of the transportation team (n=91, 48.9%). Contributing unsafe acts included perceptual errors (n=14, 7.5%), decision errors (n=56, 30.1%), skill-based errors (n=48, 25.8%), and non-compliance (n=68, 36.6%). Multivariate analysis showed that human failure found in the arrival and hand-off sub-process (OR 4.84, p<0.001) was associated with increased patient harm, whereas the presence of omission (OR 0.12, p<0.001) was associated with less patient harm. Conclusions This study shows a need to reduce human failures to prevent patient harm during intra-hospital transportation. We suggest that the transportation team pay specific attention to the sub-process at the location of arrival and prevent errors other than omissions. Long-term monitoring of IHT-related events is also warranted. [ABSTRACT FROM AUTHOR]

Background Late-life depression is common among elderly patients. Ignorance of the health problem, either because of under-diagnosis or under-treatment, causes additional medical cost and comorbidity. For a better health and quality of life (QoL), evaluation, prevention and treatment of late-life depression in elderly patients is essential. Methods This study examined (1) the differences of clinical characteristics, degree of improvement on QoL and functionality on discharge between non-depressed and depressed elderly inpatients and (2) factors associated with QoL on discharge. Four hundred and seventy-one elderly inpatients admitted to a geriatric evaluation and management unit (GEMU) from 2009 to 2010 were enrolled in this study. Comprehensive geriatric assessment including the activities of daily living (ADL), geriatric depression scale, and mini-mental state examination were conducted. QoL was assessed using the European Quality of Life-5 Dimensions and the European Quality of Life-5 Dimensions Visual Analog Scale on discharge. Information on hospital stay and Charlson comorbidity index were obtained by chart review. Chi-square tests, independent t-tests, Mann--Whitney U tests and multiple linear regressions were used in statistical analysis. Results Worse QoL and ADL on discharge were found among the depressed. Depressive symptoms, female gender, duration of hospital stay, and rehabilitation were significant factors affecting QoL on discharge in linear regression models. Conclusions The importance of the diagnosis and treatment of depression among elderly inpatients should not be overlooked during hospital stay and after discharge. Greater efforts should be made to improve intervention with depressed elderly inpatients. [ABSTRACT FROM AUTHOR]

Abstract  The use of mobile nodes to improve network system performance has drawn considerable attention recently. The movement-assisted model considers mobility as a desirable feature, where routing is based on the store-carry-forward paradigm with random or controlled movement of resource rich mobile nodes. The application of such a model has been used in several emerging networks, including mobile ad hoc networks (MANETs), wireless sensor networks (WSNs), and delay tolerant networks (DTNs). It is well known that mobility increases the capacity of MANETs by reducing the number of relays for routing, prolonging the lifespan of WSNs by using mobile nodes in place of bottleneck static sensors, and ensuring network connectivity in DTNs using mobile nodes to connect different parts of a disconnected network. Trajectory planning and the coordination of mobile nodes are two important design issues aiming to optimize or balance several measures, including delay, average number of relays, and moving distance. In this paper, we propose a new controlled mobility model with an expected polylogarithmic number of relays to achieve a good balance among several contradictory goals, including delay, the number of relays, and moving distance. The model is based on the small-world model where each static node has “short” link connections to its nearest neighbors and “long” link connections to other nodes following a certain probability distribution. Short links are regular wireless connections whereas long links are implemented using mobile nodes. Various issues are considered, including trade-offs between delay and average number of relays, selection of the number of mobile nodes, and selection of the number of long links. The effectiveness of the proposed model is evaluated analytically as well as through simulation. [ABSTRACT FROM AUTHOR]

Novel peripheral nerve conduits containing the negatively charged Tremella fuciformis polysaccharide (TF) were prepared, and their efficacy in bridging a critical nerve gap was evaluated. The conduits were made of poly(D,L-lactide) (PLA) with asymmetric microporous structure. TF was immobilized on the lumen surface of the nerve conduits after open air plasma activation. The TF-modified surface was characterized by the attenuated total reflection Fourier-transformed infrared spectroscopy and the scanning electron microscopy. TF modification was found to enhance the neurotrophic gene expression of C6 glioma cells in vitro. TF-modified PLA nerve conduits were tested for their ability to bridge a 15 mm gap of rat sciatic nerve. Nerve regeneration was monitored by the magnetic resonance imaging. Results showed that TF immobilization promoted the nerve connection in 6 weeks. The functional recovery in animals receiving TF-immobilized conduits was greater than in those receiving the bare conduits during an 8-month period. The degree of functional recovery reached ~90% after 8 months in the group of TF-immobilized conduits. [ABSTRACT FROM AUTHOR]