Continuity of Care in Primary Health Care Affecting Control of Diabetes

Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect of continuity of care on control of diabetes mellites in primary health care centres. Objectives: 1) To assess the effect of Continuity of care on controlling haemoglobin (Hb A1C) and fasting blood Sugar (FBS);2) To compare the control of Diabetes by using (Hb A1C and FBS) indices on same patient before and after application of chronic illness clinic;3) To identify the relation between age and gender affecting continuity of care in diabetic patient. Methods: It is a Prospective cohort study design. Included both gender and diabetic patient age above 24 years old. The data extracted from health care specialty center (HCSC) clinics in National guard hospital at Riyadh, through HCSC data base on three phases: 1) Phase 1: the data extracted of diabetic patients from October to November 2022 including MRN, diabetic patient, age, Hb A1C, Fasting blood glucose. 2) Phase 2: the same MRN extracted from phase 1 was extracted again retrospectively for six months from April to September 2022, to compare the indices before implanting the chronic illness clinic including Hb A1C, Fasting blood glucose. 3) Phase 3: prospectively from December 2022 to September 2023. Results: Among diabetic patients aged 60 years old and above showed better control of HbA1C and FBS comparing to these patients below age of 60 years old, with significant improvement of HbA1C after implanting chronic illness clinic. Conclusion: The significant improvement in the control of diabetic patients followed in primary health care centers reinforce the evidence of the importance of continuity of care.

Continuity of truncated Hardy-Littlewood maximal function

This paper focuses on the continuity of the truncated Hardy-Littlewood maximal function.We first show that the truncated Hardy-Littlewood maximal function is lower semi-continuous.Then by investigating the behavior of the truncated Hardy-Littlewood maximal function when the truncated parameterγchanges,we obtain an equivalent condition of the continuity of the truncated Hardy-Littlewood maximal function.

GLOBAL CONVERGENCE OF A CAUTIOUS PROJECTION BFGS ALGORITHM FOR NONCONVEX PROBLEMS WITHOUT GRADIENT LIPSCHITZ CONTINUITY

A cautious projection BFGS method is proposed for solving nonconvex unconstrained optimization problems.The global convergence of this method as well as a stronger general convergence result can be proven without a gradient Lipschitz continuity assumption,which is more in line with the actual problems than the existing modified BFGS methods and the traditional BFGS method.Under some additional conditions,the method presented has a superlinear convergence rate,which can be regarded as an extension and supplement of BFGS-type methods with the projection technique.Finally,the effectiveness and application prospects of the proposed method are verified by numerical experiments.

THE HOLDER CONTINUITY OF THE LYAPUNOV EXPONENT FOR A QUASI-PERIODIC SZEGO COCYCLE

In this paper,I consider the Hölder continuity of the Lyapunov exponent for a quasi-periodic Szegö cocycle with weak Liouville frequency.I extend the existing results about the regularity of the Lyapunov exponent from the Schrödinger cocycle in[24]to a Szegö cocycle.

Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on Self-Management of Stroke Patients with Hypertension

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.

The Impact of Continuity of Care on Negative Emotions and Self-Efficacy in Patients Undergoing Digestive Endoscopic Tumor Resection

Objective:To explore the impact of a continuity of care model on negative emotions and self-efficacy in patients undergoing digestive endoscopic tumor resection.Methods:A retrospective analysis was conducted on 80 patients who underwent digestive endoscopic tumor resection in the Gastroenterology Department of Baoying County People’s Hospital between October 2022 and October 2024.Patients were randomly divided into a control group(n=40)and an observation group(n=40)using a random number table.The control group received routine nursing care,while the observation group was additionally provided with continuity of care interventions.After two months of intervention,the negative emotions and self-efficacy of the two groups were compared and statistically analyzed.Results:There was no statistically significant difference in baseline data between the two groups(P>0.05).After two months of intervention,the observation group demonstrated significantly lower HAMD and HAMA scores compared to the control group(both P=0.000),and significantly higher GSES scores(P=0.000).Conclusion:Applying a continuity of care model to patients undergoing digestive endoscopic tumor resection can alleviate negative emotions,enhance self-efficacy,and improve self-care abilities.

Clinical Study on the Effect of Continuity of Care in CICU on Improving Cognitive Function and Psychological State in Patients with Heart Failure

Objective:To analyze the effect of continuity of care in the cardiac intensive care unit(CICU)on improving cognitive function and psychological state in patients with heart failure(HF).Methods:A total of 112 chronic HF patients admitted to the CICU of Xuzhou Traditional Chinese Medicine Hospital from July 2022 to August 2024 were selected and randomly divided into two groups using the red and blue ball method:a control group(n=56)and a study group(n=56).The control group received routine CICU nursing management,while the study group received routine CICU nursing combined with continuity of care management.Cognitive function(using the Montreal Cognitive Assessment,MoCA),psychological state(using the Self-Rating Depression Scale,SDS,and Self-Rating Anxiety Scale,SAS),and quality of life(using the Minnesota Living with Heart Failure Questionnaire,MLHFQ)were compared between the two groups.Results:After the intervention,the cognitive function scores of the study group were significantly higher than those of the control group(P<0.05).The SDS and SAS scores of the study group were significantly lower than those of the control group after the intervention(P<0.05).The quality of life in the study group was also significantly better than in the control group(P<0.05).Conclusion:CICU continuity of care can effectively improve cognitive function and psychological state in patients with HF,while also enhancing their quality of life.

Correlation between key indicators of continuous glucose monitoring and the risk of diabetic foot

BACKGROUND Continuous glucose monitoring(CGM)metrics,such as time in range(TIR)and glycemic risk index(GRI),have been linked to various diabetes-related complications,including diabetic foot(DF).AIM To investigate the association between CGM-derived indicators and the risk of DF in individuals with type 2 diabetes mellitus(T2DM).METHODS A total of 591 individuals with T2DM(297 with DF and 294 without DF)were enrolled.Relevant clinical data,complications,comorbidities,hematological parameters,and 72-hour CGM data were collected.Logistic regression analysis was employed to examine the relationship between these measurements and the risk of DF.RESULTS Individuals with DF exhibited higher mean blood glucose(MBG)levels and increased proportions of time above range(TAR),TAR level 1,and TAR level 2,but lower TIR(all P<0.001).Patients with DF had significantly lower rates of achieving target ranges for TIR,TAR,and TAR level 2 than those without DF(all P<0.05).Logistic regression analysis revealed that GRI,MBG,and TAR level 1 were positively associated with DF risk,while TIR was inversely correlated(all P<0.05).Achieving TIR and TAR was inversely correlated with white blood cell count and glycated hemoglobin A1c levels(P<0.05).Additionally,achieving TAR was influenced by fasting plasma glucose,body mass index,diabetes duration,and antidiabetic medication use.CONCLUSION CGM metrics,particularly TIR and GRI,are significantly associated with the risk of DF in T2DM,emphasizing the importance of improved glucose control.

Continuous-flow columns packed with zero-valent iron and iron sulfide as a feasible strategy to remediate the persistent contaminant nitroguanidine

The insensitive munitions compound nitroguanidine(NQ)is used by the U.S.Army to avoid unintended explosions.However,NQ also represents an emerging contaminant whose environmental emissions can cause toxicity toward aquatic organisms,indicating the need for effective remediation strategies.Thus,we investigated the feasibility of treating water contaminated with NQ in continuous-flow columns packed with zero-valent iron(ZVI)or iron sulfide(FeS).Initially,the impact of pH on NQ transformation by ZVI or FeS was evaluated in batch experiments.The pseudo first-order rate constant for NQ transformation(k_(1,NQ))by ZVI was 8-10 times higher at pH 3.0 compared to pH 5.5 and 7.0,whereas similar k_(1,NQ)values were obtained for FeS at pH 5.5-10.0.Based on these findings,the influent p H fed to the ZVIand Fe S-packed columns was adjusted to 3.0 and 5.5,respectively.Both reactors transformed NQ into nitrosoguanidine(Nso Q).Further transformation of Nso Q by ZVI produced aminoguanidine,guanidine,and cyanamide,whereas Nso Q transformation by Fe S produced guanidine,ammonium,and traces of urea.ZVI outperformed Fe S as a reactive material to remove NQ.The ZVI-packed column effectively removed NQ below detection even after 45 d of operation(490 pore volumes,PV).In contrast,NQ breakthrough(removal efficiency<85%)was observed after 18 d(180 PV)in the Fe S-packed column.The high NQ removal efficiency and long service life of the ZVI-packed column(>490 PV)suggest that the technology is a promising approach for NQ treatment in packed-bed reactors and in situ remediation.

Continuum of glucose and bone metabolism impairment across autonomous cortisol secretion: A cross-sectional study

BACKGROUND Autonomous cortisol secretion(ACS)is linked to a higher prevalence of metabolic abnormalities and an increased risk of major adverse cardiovascular events.AIM To evaluate glucose and bone metabolism in patients with ACS using a continuous glucose monitoring system(CGMS)and dual-energy X-ray absorptiometry(DXA).METHODS Patients diagnosed with ACS,including Cushing syndrome,mild ACS(MACS),and nonfunctional adrenal incidentaloma(NFAI),were recruited for this study.Glucose variability and glycemic status were assessed using CGMS.Regional bone mineral content(BMC),bone mineral density(BMD),and bone area(BA)were evaluated using DXA.CGMS-and DXA-derived parameters were compared across the subgroups of ACS.Correlation analysis was performed to examine relationships between varying degrees of cortisol secretion,measured by cortisol after 1 mg overnight dexamethasone suppression test(DST)or 24-hour urine free cortisol(24h UFC),and CGMS-or DXA-derived parameters.RESULTS A total of 64 patients with ACS were included in this study:19 with Cushing syndrome,11 with MACS,and 34 with NFAI.Glucose variability,time above range(TAR),and time in range(TIR)along with specific areal BMC,BMD,and BA,differed significantly between groups of Cushing syndrome and NFAI.A significant positive correlation was observed between glucose variability or TAR and cortisol after 1 mg overnight DST or 24h UFC.By contrast,TIR,along with regional BMC,BMD,and BA,were negatively correlated with varying degrees of cortisol secretion.CONCLUSION Glucose and bone metabolism impairments are on a continuum alteration from NFAI to MACS and Cushing syndrome.Prompt attention should be given to these patients with ACS,especially those with mild hormone secretion.Parameters of glucose variability and glycemic status along with bone condition in regions rich in cancellous bone will provide valuable information.

THE IMPLICIT CONTINUITY OF DISCONTINUOUS SYSTEMS

An example is presented to introduce the concept of implicit continuity proposed as contrasted with the explicit continuity.A sufficient and necessary condition of the implicit continuity is given and proved in forms of implicit system.This condition also offers the solution of initial values at the points where the dynamic system is discontinuous.Some discussions are contributed to the physical significance of implicit continuity.

G^2 Continuity Algorithms between Adjacent NURBS Patches along Common Cubic Boundary Curve

Non-uniform rational B-spline (NURBS) curves and surfaces are becoming increasingly widespread. The author have explored G^1 continuity condition between adjacent NURBS surface patches along common cubic boundary curve. On the basis of the research performed, this paper presents a G^2 continuity condition between adjacent NURBS patches along common cubic boundary curve and deduces a specific algorithm for contro1 points and weights of NURBS patch. For making another NURBS patch and one given NURBS patch to attain G^2, according to algorithm condition, one can adjust another patch control points and weights. It is much more convenient for engineers to apply.

Global Continuity Adjustment and Local Shape Optimization Technique for Complex Trimmed Surface Model

Smoothly stitching multiple surfaces mainly represented by B-spline or NURBS together is an extremely important issue in complex surfaces modeling and reverse engineering. In recent years, a lot of progress has been made in smooth join of non-trimmed surface patches, while there has been seldom research on smoothly stitching trimmed surface patches together. This paper studies the problem of global continuity adjustment, damaged hole repair and local shape optimization for complex trimmed surface model, and presents a uniform scheme to deal with continuity adjustment of trimmed surfaces and geometric repair of local broken region. Constrained B-spline surface refitting technique and trim calculation are first utilized to achieve global G^1 continuity, and then local shape optimization functional is adopted to reduce fitting error and improve local quality of refitted surface patch. The proposed approach is applied to a discontinuity ship hull surface model with an irregular hole, and the result demonstrates the validation of our method. Furthermore, on the premise of global continuity, the proposed locally repairing damaged surface model provides a better foundation for following research work, such as topology recovery technique for complex surface model after geometric repair.

JOINT HOLDER CONTINUITY OF PARABOLIC ANDERSON MODEL

We obtain the H?lder continuity and joint H?lder continuity in space and time for the random field solution to the parabolic Anderson equation ■ in d-dimensional space, where ■ is a mean zero Gaussian noise with temporal covariance γ0 and spatial covariance given by a spectral density μ(ξ). We assume that ■ and ■ , where αi, i = 1, · · ·, d(or α) can take negative value.

Digital Continuity Guarantee Approach of Electronic Record Based on Data Quality Theory

Since the British National Archive put forward the concept of the digital continuity in 2007,several developed countries have worked out their digital continuity action plan.However,the technologies of the digital continuity guarantee are still lacked.At first,this paper analyzes the requirements of digital continuity guarantee for electronic record based on data quality theory,then points out the necessity of data quality guarantee for electronic record.Moreover,we convert the digital continuity guarantee of electronic record to ensure the consistency,completeness and timeliness of electronic record,and construct the first technology framework of the digital continuity guarantee for electronic record.Finally,the temporal functional dependencies technology is utilized to build the first integration method to insure the consistency,completeness and timeliness of electronic record.

Adaptive multiple subtraction using a constrained L1-norm method with lateral continuity

The Lt-norm method is one of the widely used matching filters for adaptive multiple subtraction. When the primaries and multiples are mixed together, the L1-norm method might damage the primaries, leading to poor lateral continuity. In this paper, we propose a constrained L1-norm method for adaptive multiple subtraction by introducing the lateral continuity constraint for the estimated primaries. We measure the lateral continuity using prediction-error filters （PEF）. We illustrate our method with the synthetic Pluto dataset. The results show that the constrained L1-norm method can simultaneously attenuate the multiples and preserve the primaries.

PRACTICAL G^2 CONTINUITY ALGORITHMS BETWEEN ADJACENT NURBS PATCHES

Non-uniform rationa1 B-spline (NURBS) curves and sdrices are becomingincreasingly widespread. 'The authors have explored G1 continuity condition between adja-cent NURBS surface patches along common boundary curve. This paper presents a G2continuity condition between adjacent NURBS patches along common quadratic boundarycurve and deduces a specific algorithm for control Points and weights of NURBS patch.For making another NURBS patch and one given NURBS patch to attain G2, according toalgorithms condition, one can adjust another patch control ponts and weights. It is muchmore convenient for engineers to apply.

SHARP H?LDER CONTINUITY OF THE INTEGRATED DENSITY OF STATES FOR EXTENDED HARPER’S MODEL WITH A LIOUVILLE FREQUENCY

In this article, the non-self dual extended Harper's model with a Liouville frequency is considered. It is shown that the corresponding integrated density of states is 1/2-Holder continuous. As an application, the homogeneity of the spectrum is proven.

Hlder continuity for a class of X-elliptic equations with singular lower order term

The regularity for a class of X-elliptic equations with lower order termLu＋vu=-∑i,j=1 mXj^＊（aij（x）Xiu）＋vu=μis studied, where X = {X1,..., Xm} is a family of locally Lipschitz continuous vector fields, v is in certain Morrey type space and μ a nonnegative Radon measure. The HSlder continuity of the solution is proved when μ satisfies suitable growth condition, and a converse result on the estimate of μ is obtained when u is in certain HSlder class.