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IntroductionGuidelines for hip fracture care state that patients with hip fracture should be mobilised on the day after surgery and at least once a day thereafter. However, compliance with these guidelines is poor. One approach that would assist physiotherapists to meet mobility guidelines after hip fracture is to delegate the provision of daily mobilisation to allied health assistants under their supervision. Therefore, we plan to conduct a randomised controlled trial to determine the feasibility of an allied health assistant providing daily inpatient rehabilitation to patients with hip fracture.Methods and analysisUsing a parallel group randomised controlled design with one-to-one allocation, participants will be randomly allocated to an experimental group (allied health assistant management) or a comparison group (physiotherapist management). Inclusion criteria are: adult with diagnosis of hip fracture; inpatient in acute hospital; walked independently pre-hip fracture and able to communicate in conversational English. The experimental group will receive routine physiotherapy rehabilitation, including daily mobilisation, from an allied health assistant following initial physiotherapist assessment. The comparison group will receive routine rehabilitation from a physiotherapist. The primary outcome will be the feasibility of allied health assistant management of patients with hip fracture. Feasibility will be determined using the following areas of focus in Bowen’s feasibility framework: acceptability (patient satisfaction), demand (proportion of patients who participate), implementation (time allied health assistant/physiotherapist spends with participant, occasions of service) and practicality (cost, adverse events). Staff involved in the implementation of allied health assistant care will be interviewed to explore their perspectives on feasibility. Secondary outcomes include compliance with daily mobilisation guidelines, discharge destination, hospital readmission, falls, functional activity and length of stay. We aim to recruit 50 participants. Descriptive statistics will be used to describe feasibility and mobilisation rates will be calculated using Cox proportional hazards regression to compare compliance with mobilisation guidelines.Ethics and disseminationEthics approval was obtained from the Peninsula Health human research ethics committee (HREC/63 005/PH-2020). The findings will be disseminated in peer-reviewed journals and conference presentations.Trail registration numberAustralian and New Zealand Clinical Trial Registry; ACTRN12620000877987; Pre-results.

Objectives Significant variability exists in physical rehabilitation modalities and dosage used in the ICU. Our objective was to investigate the effect of physical rehabilitation in ICU on patient outcomes, the impact of task-specific training, and the dose-response profile. Data sources A systematic search of Ovid MEDLINE, Cochrane Library, EMBASE, and CINAHL plus databases was undertaken on the May 28, 2020. Study selection Randomized controlled trials and controlled clinical trials investigating physical rehabilitation commencing in the ICU in adults were included. Outcomes included muscle strength, physical function, duration of mechanical ventilation, ICU and hospital length of stay, mortality, and health-related quality of life. Two independent reviewers assessed titles, abstracts, and full texts against eligibility criteria. Data extraction Details on intervention for all groups were extracted using the template for intervention description and replication checklist. Data synthesis Sixty trials were included, with a total of 5,352 participants. Random-effects pooled analysis showed that physical rehabilitation improved physical function at hospital discharge (standardized mean difference, 0.22; 95% CI, 0.00-0.44), reduced ICU length of stay by 0.8 days (mean difference, -0.80 d; 95% CI, -1.37 to -0.23 d), and hospital length of stay by 1.75 days (mean difference, -1.75 d; 95% CI, -3.03 to -0.48 d). Physical rehabilitation had no impact on the other outcomes. The intervention was more effective in trials where the control group received low-dose physical rehabilitation and in trials that investigated functional exercises. Conclusions Physical rehabilitation in the ICU improves physical function and reduces ICU and hospital length of stay. However, it does not appear to impact other outcomes.

To assess the effectiveness and safety of Traditional Chinese patent medicines (TCPMs) for managing impaired glucose tolerance (IGT).Seven databases were searched to identify eligible trials published from incepting to May 1, 2016. Randomized controlled trials (RCTs) involving TCPM for IGT with a minimum follow-up duration of 6 months were included for analysis. Data extraction and quality assessment were performed by two reviewers independently. Data synthesis was analyzed using Review Manager 5.3 software. Subgroup analysis was carried out to assess the robustness of results of meta-analysis.Eighteen trials with a total of 3172 participants met the inclusion criteria. The methodological quality of the RCTs was variable. Comparing with receiving lifestyle modification (LM) alone, TCPM plus LM was significantly better at reducing the incidence of diabetes (risk ratio [RR] 0.45; 95% confidence interval [CI] 0.36-0.57, p 0.00001) and normalizing the blood glucose (RR 0.72; 95% CI 0.64-0.82, p 0.00001). TCPM plus LM was superior in decreasing the levels of 2hPG, body mass index (BMI), fasting insulin, and 2 h insulin compared with LM alone (2hPG: mean difference [MD] -1.13; 95% CI -1.68 to -0.58, p 0.0001; BMI: MD -0.42; 95% CI -0.71 to -0.14, p = 0.004; fasting insulin: MD -2.44; 95% CI -3.79 to -1.09, p = 0.0004; and 2 h insulin: MD -8.26; 95% CI -8.47 to -8.05, p 0.00001). Compared with placebo plus LM, TCPM plus LM was superior in reducing diabetes (RR 0.54; 95% CI 0.42-0.69, p 0.00001) and normalizing blood glucose (RR 0.55; 95% CI 0.41-0.73, p 0.00001; the interventions were also associated with a decline in the two-hour postprandial blood glucose (2hPG) levels (MD -1.45; 95% CI -2.11 to -0.79, p 0.0001) and BMI levels (MD -1.12; 95% CI -2.00 to -0.24, p 0.0001). There were no significant differences in adverse events between two groups. Subgroup analysis found no significant difference in overall effects among all study characteristics, indicating that the overall effects were stable.The study indicated that TCPM combined with moderate lifestyle modification had significant effect on IGT. Further studies are needed to provide more reliable evidence. The PROSPERO registration is No. CRD42016039312.

The surface hydroxyl groups in TiO2 are crucial to many of its practical applications, but their controlled synthesis represents still a challenge. Herein, nanostructured TiO2 with rich surface hydroxyl species groups and high crystallinity (TiO2-OH) by high-temperature calcination have been developed by using the ionic liquid. Experimental measurements and theoretical calculations show a strong surface hydroxyl signal of two-dimensional 1H TQ-SQ MAS NMR, as well as clear changes of the charge density of TiO2 with the rich surface hydroxyl species. Moreover, the rich surface hydroxyl species groups in TiO2 not only significantly enhance its performances involving photogenerated current, photocatalysis and energy strorage but also show a bright future on marine applications because of its high activity and stability in simulation seawater. The characteristics and mechanism have been proposed to clarify the generation of surface hydroxyl species of TiO2 and the correponding directed hole-trapping at an atomic-/nanoscale.

A finite element algorithm based on characteristic based split (CBS) scheme, in combination with arbitrary Lagrangian-Eulerian (ALE) framework, is presented to deal with numerical oscillation and mesh moving, and the complicated flow patterns are given, as studying the flow around oscillating circular cylinders, which are the typical fluid-structure interaction and encountered frequently in the engineering. Following this method, the two-dimensional incompressible Navier-Stokes equations (NSEs) are derived under the ALE reference frame, and consequently the CBS scheme in ALE configuration is given to approach the NSEs in some details. After such transformation, the convective terms can be removed from the original NSEs and the resulting equations become simple diffusion equations, which can be efficiently approached by the standard finite element method. Then, the finite element method is applied to the governing equations obtained, with the aid of an improved moving mesh technique implemented by the modified spring analogy to deal with the coupling between fluid and structure surfaces. Finally, some numerical examples related to flows around stationary and oscillating circular cylinders are simulated with the presented method, in comparison with existing numerical and experimental results. Additionally, the flow patterns of the oscillating cylinder wake are analyzed tentatively to study the evolution of unsteady vortices, which can induce the oscillation of the structures. The results show that the presented algorithm is feasible and efficient for flow around moving bodies, which includes two main typical problems, namely, the numerical oscillation and mesh moving.