Improvement of the nutritional support management system for patients in intensive care units

BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.

The Alzheimer’s Dementia Patients’ Observed Illness Course and Experience in Ghana and Care Lessons to Be Learnt: A Mental Health Professional’s Perspective

Alzheimer’s disease (AD) and associated dementia patient numbers continue to increase globally with associated economic costs to healthcare systems. Of note is the increase in numbers in lower and middle-income countries (LMICs) including Sub-Saharan African (SSA) countries, which already face challenges with their health budgets from communicable and non-communicable diseases. Ghana, an SSA country, faces the problem of healthcare budgetary difficulties and the additional impact of AD as a consequence of increasing population strata of old aged persons (OAPs) due to the demographic transition effect. This article uses examples of known patients’ illness courses to give a perspective on the lived experience of patients with dementia (PWD) in Ghana, living amongst a populace with a culture of stigmatization of PWD, and a relatively fragile public mental health system (PMHS) for those with mental illness, including AD. The lived experience of AD patients is characterised by stigmatisation, discrimination, non-inclusiveness, diminished dignity and human rights abuses in the face of their mental disability, and eventually death. This article is an advocacy article giving voice to the voiceless and all persons suffering from AD and other dementias in Ghana, whilst pleading for a call to action from healthcare professionals and responsible state agencies.

Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery at the National Institute of Neurology and Neurosurgery

Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

A Review of Index Case Testing Induced Intimate Partner Violence and Electronic Management of Information in HIV Care

Intimate Partner Violence (IPV) is a form of Gender Base Violence (GBV) where an intimate partner perpetrates violence. In the HIV care continua which has the aim of achieving epidemic control based on the goals defined by UNAIDS, 95% of people living with HIV (PLHIV) have to know their HIV status, 95% initiated ARV treatment and 95% are virally suppressed in order to achieve epidemic control. One of the evidence-based strategies used for achieving an optimal number of PLHIV who know their HIV status is the Index Case Testing Strategy (ICT). While the ICT strategy helps the achievement of epidemic control, its implementation increases the incidence of IPV among either serodiscordant or concordant couples. Tackling information about IPV is very sensitive. A review of the literature on the management of HIV patient information has shown that shifting from paper-based management of HIV patient information to computerized Electronic Medical Records (EMR) systems, using software such as OPEN MRS has significantly improved the management of HIV patient information with high-level confidentiality of patient information. The reviews showed that the EMR systems put in place to manage HIV patient information need to integrate the stages used for the management of IPV among PLHIV.

From Black Holes to Information Erasure: Uniting Bekenstein’s Bound and Landauer’s Principle

This research aims to integrate Bekenstein’s bound and Landauer’s principle, providing a unified framework to understand the limits of information and energy in physical systems. By combining these principles, we explore the implications for black hole thermodynamics, astrophysics, astronomy, information theory, and the search for new laws of nature. The result includes an estimation of the number of bits stored in a black hole (less than 1.4 × 1030 bits/m3), enhancing our understanding of information storage in extreme gravitational environments. This integration offers valuable insights into the fundamental nature of information and energy, impacting scientific advancements in multiple disciplines.

Inflammatory bowel disease patient profiles are related to specific information needs: A nationwide survey

BACKGROUND Inflammatory bowel diseases(IBD) is a heterogenous, lifelong disease, with an unpredictable and potentially progressive course, that may impose negative psychosocial impact on patients.While informed patients with chronic illness have improved adherence and outcomes, previous research showed that the majority of IBD patients receive insufficient information regarding their disease.The large heterogeneity of IBD and the wide range of information topics makes a one-size fits all knowledge resource overwhelming and cumbersome.We hypothesized that different patient profiles may have different and specific information needs, the identification of which will allow building personalized computer-based information resources in the future.AIM To evaluate the scope of disease-related knowledge among IBD patients and determine whether different patient profiles drive unique information needs.METHODS We conducted a nationwide survey addressing hospital-based IBD clinics.A Total of 571 patients completed a 28-item questionnaire, rating the amount of information received at time of diagnosis and the importance of information, as perceived by participants, for a newly diagnosed patient, and for the participants themselves, at current time.We performed an exploratory factor analysis of the crude responses aiming to create a number of representative knowledge domains(factors), and analyzed the responses of a set of 15 real-life patient profiles generated by the study team.RESULTS Participants gave low ratings for the amount of information received at disease onset(averaging 0.9/5) and high ratings for importance, both for the newly diagnosed patients(mean 4.2/5) and for the participants themselves at current time(mean 3.5/5).Factor analysis grouped responses into six informationdomains.The responses of selected profiles, compared with the rest of the participants, yielded significant associations(defined as a difference in rating of >0.5 points with a P < 0.05).Patients with active disease showed a higher interest in work-disability, stress-coping, and therapy-complications.Patients newly diagnosed at age > 50, and patients with long-standing disease(> 10 years)showed less interest in work-disability.Patients in remission with mesalamine or no therapy showed less interest in all domains except for nutrition and long-term complications.CONCLUSION We demonstrate unmet patient information needs.Analysis of various patient profiles revealed associations with specific information topics, paving the way for building patient-tailored information resources.

Information Needs of Breast Cancer Patients at Cancer Diseases Hospital, Lusaka, Zambia

Background: Breast cancer is the second most common cancer worldwide and the second most common among Zambian women. Breast cancer diagnosis being a stressful experience, causes psychological and emotional disruption that can be abated by meeting information needs of the affected patients. In light of the escalating cases of Breast cancer among the Zambian women, the study examined a special aspect of cancer management which is usually neglected in most cases. Aim: The main objective of the study was to assess information needs of breast cancer patients at the Cancer Diseases Hospital in Lusaka, Zambia using a modified structured interview schedule adopted from the Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC). Methods: A descriptive cross-sectional design was used to elicit the information needs of breast cancer patients. One hundred and ten (97% response rate) participants were selected using simple random sampling method and data was collected using a modified structured interview schedule adopted from the Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC). Stata 10.0 (StataCorp, 2008) was employed for all quantitative data analysis and graphical presentation of data. Results: The overall score for information needs was obtained by adding the scores across all the five information needs categories which were further divided into three categories namely: low important scores, of less than 50%, moderately important scores of 50% - 70% and highly important scores ranged above 70% of the 200 total scores. Out of the 110 participants recruited, 88 (80%) indicated that the information across the five categories was moderately important. Logistic regression of information needs and posited determinants revealed that anxiety levels;education level;presence of co-morbidity;and being on treatment were significant determinants of patients’ informational needs (Effect’s p ≤ 0.05). Conclusion: The findings of this study support the idea that breast cancer patients are seeking more information on their illness, hence information provision is one of the most important factors for providing high quality cancer care across the whole cancer continuum. Therefore, appreciating the information needs of breast cancer patients is substantial in improving care.

A Heterogeneous Information Fusion Method for Maritime Radar and AIS Based on D-S Evidence Theory

Maritime radar and automatic identification systems (AIS), which are essential auxiliary equipment for navigation safety in the shipping industry, have played significant roles in maritime safety supervision. However, in practical applications, the information obtained by a single device is limited, and it is necessary to integrate the information of maritime radar and AIS messages to achieve better recognition effects. In this study, the D-S evidence theory is used to fusion the two kinds of heterogeneous information: maritime radar images and AIS messages. Firstly, the radar image and AIS message are processed to get the targets of interest in the same coordinate system. Then, the coordinate position and heading of targets are chosen as the indicators for judging target similarity. Finally, a piece of D-S evidence theory based on the information fusion method is proposed to match the radar target and the AIS target of the same ship. Particularly, the effectiveness of the proposed method has been validated and evaluated through several experiments, which proves that such a method is practical in maritime safety supervision.

The Benefits of Patients’ Information regarding Dietary Habits before Percutaneous Coronary Intervention: A 3- and 6-Month Follow-Up

Aim: To evaluate the benefits of counseling intervention related to dietary habits changes on patients following percutaneous coronary intervention (PCI). Materials and Methods: A randomized counseling intervention study, with a 3- and 6-month follow-up was performed on 230 patients who underwent PCI. They were randomly allocated to the intervention (n = 93) or the control group (n = 137). A 3- and 6-month telephone follow-up was performed for dietary habits evaluation. Data analysis was performed by using the statistical package SPSS, ver. 20.?Results: Compared with control group, intervention group had higher prevalence of hypertension, history of diabetes and dyslipidemias and history of acute myocardial infraction, with no statistical difference. Moreover, patients in control group were more likely to be ex-smokers (p = 0.01). Post hoc tests using the Bonferroni correction revealed that mean TCHOL concentration while patients admitted to hospital differed statistically significantly between the time points of 3 and 6 months (209 ± 67 mg/dl vs 174 ± 34 mg/dl vs 176 ± 36 mg/dl), p= 0.005 and p = 0.042 respectively. However, there was no statistical significant difference between 3 months and 6 months measurements. Mean glucose concentration while patients admitted to hospital differed statistically significantly between the time points of 3 and 6 months (108 ± 40 mg/dl vs 95 ± 21 mg/dl vs 95 ± 23 mg/dl), p =0.009 and p = 0.012 respectively. However, there was no significant statistical difference between 3 months and 6 months measurements, (p = 1.000). Conclusion: A nurse-led program regarding dietary habits modifications on patients undergoing PCI should be performed along with a long-term follow up after hospital discharge.

Certainty of patient survival with reference to game information dynamic model

This paper is concerned with Hepato-Cellular Carcinoma (HCC) patients treated naturopathic agents. Patients treated with ≥4 agents survived significantly longer than patients treated with ≤3 agents. The great effect is seen in patients treated with at least 4 agents that include Cordyceps sinensis. This greater certainty of patient survival without toxic side effects is significant benefit comparing with the conventional therapy. Treatment of HCC with a regimen of ≥4 agents prepared from natural products is associated with greater certainty of patient survival in a substantial portion of patients. The information dynamic model for certainty of patient survival is derived based on fluid mechanics, where a series of approximate solutions of the flow between two parallel flat walls, one of which is at rest, the other is suddenly accelerated from the rest to a constant velocity are used. The kinetic energy of certainty of patient survival decreases with increasing time, while the potential energy increases with increasing time. Total mechanical energy of patients treated with 4 or more agents is smaller than that treated with 3 or fewer agents. The kinetic energy (potential energy) of patients treated with 4 or more agents decreases (increases) more slower than the kinetic energy (potential energy) of patients treated with 3 or fewer agents.

Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany

Purpose: Many studies demonstrate the importance of an empathic communication with prostate cancer patients and show various information needs. Most of the studies are cross sectional. The present analysis aims to 1) provide detailed prospective data on the actual quality of patient information provided by urologists in private practice in Germany;and 2) explore sociodemographic, communicative, and health- and treatment related determinants of the quality of provider-patient-communication. Methods: HAROW is a prospective, observational study designed to collect clinical data and patient reported outcomes of different treatment options (hormonal therapy, active surveillance, radiation, operation, watchful waiting) for newly diagnosed patients with localized prostate cancer under real conditions. At 6-month intervals, general clinical data, patient reported outcomes and patients’ assessment of patient-physician-communication are documented. A total of 1893 questionnaires at t0 (initial diagnosis) and t1 (six months after diagnosis) were analyzed. A linear regression model was estimated. Results: The mean age of the men was 68.38 years, and most lived with their spouse or partner (94.1%). Most patients were informed about treatment options (t0 96%, t1 93.2%), but much fewer received information about self-help groups (t0 36.4%, t1 45.8%), rehabilitation (t0 59.9%, t1 68%), and second medical opinion (t0 57.2%, t1 59.3%). Older men (p = 0.02) and men living alone (p = 0.048) received less information than others. Physician empathy (p = 0.000) and prostatectomy treatment (p = 0.020) were positively associated with receiving more information. Conclusion: There is room for improvement in terms of informing prostate cancer patients about rehabilitation, second medical opinion and self-help groups. Urologists being empathetic share more information with their patients. Some patients receive less information than others, especially older patients living alone.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

基于B/S架构的远程会诊质控系统的设计与应用

目的研发远程会诊质控系统,在区域内实现远程会诊质控、管理、监管、考评、统计和持续改进的信息化。方法2020年,组建多学科团队,运用智力激励法和专题小组讨论法,基于B/S架构研发远程会诊质控系统,与既有远程会诊信息系统完全嵌合兼容,满足远程会诊全流程质量管理的功能需求。结果针对远程会诊质控工作要求,系统设计研发了质控管理、质控考评、实时监管、统计分析4个子模块,可满足远程会诊全流程质量管理的功能需求。结论该质控系统创新了远程会诊信息化质量管理模式,在区域内实现了远程会诊全流程的信息化管理,取得了较好的质量管理成效,有效促进区域内远程会诊工作的推进和发展。

基于B/S和SOA架构的LIMS系统设计与研究

为提升水质检测业务的专业化、智能化、系统化、自动化水平,针对新发展阶段下水利高质量发展对水质信息管理的需求,研究并开发基于B/S系统架构和SOA设计架构的新型综合性水质信息管理系统(LIMS),运用仪器谱图识别及数据提取、PHP与MySQL融合、仪器谱图与原始记录自动关联等技术,在一定程度上提高水质数据的电子化无纸化获取、处理、传输及应用等方面的管理水平,实现水质检测业务流程与资源的动态关联和闭环追溯,提升水质监测评价工作的管理效率和质量管理能力。基于B/S和SOA架构的LIMS在前沿高新技术中的应用研究,为水质检测和管理的各项活动提供智能、高效的数据支持平台,也为水利行业信息系统管理建设及水域功能监测监管提供技术支撑。

基于1DCNN和D-S多信息融合的光伏系统直流母线串联电弧故障检测

直流母线是光伏系统输出能源的主干道,由于长期曝晒、风化等作用,电缆、连接器等组件劣化,光伏系统直流母线中发生电弧的可能性急剧上升,极易引发火灾、触电等事故。在光伏系统中,串联电弧故障将使回路电流下降,传统的过流保护无法识别。因此,本文提出基于深度学习和证据理论(D-S)的方法来识别串联电弧故障,该方法基于并联电容器电流和电压信号,采用一维卷积神经网络(1DCNN)对检测数据进行电弧识别;在此基础上将基于单个传感数据的识别结果作为证据,运用D-S多信息合成法则计算得到信度分配,最后利用决策规则判断是否发生串联电弧故障。搭建多参数可调模型获取数据进行测试,结果表明:使用1DCNN识别方法,基于并联电容器电流和电压信号的串联电弧识别准确率分别为97.19%和94.98%,而基于1DCNN和D-S多信息融合的光伏系统直流串联电弧故障检测的识别准确率可提升至99%以上。

基于加权D-S证据理论的旋翼故障诊断

旋翼作为直升机的升力面和操作面,其健康状态对直升机的安全至关重要。旋翼故障诊断技术仍是直升机健康与使用监测系统(Health and usage monitoring system, HUMS)领域的薄弱环节,开发旋翼故障诊断技术具有重要价值。基于信息融合技术,首先分析了旋翼故障的诊断机理,建立了旋翼故障模型,通过流固耦合仿真获取了不同故障下桨叶、轮毂和机身的故障特征信息,生成数据集进行网络训练和验证。然后,利用遗传算法反向传播(Genetic algorithm-backpropagation, GA-BP)优化神经网络诊断3种类型的直升机旋翼故障,即后缘调整片误调、变距拉杆误调和桨叶质量不平衡。3个逐级神经网络分别对旋翼故障类型、故障位置和故障程度进行了诊断识别。最后采用加权的Dempster-Shafer(D-S)证据理论对旋翼故障进行诊断和分析。结果证明基于改进D-S证据理论的旋翼故障诊断方法能够成功应用到旋翼故障诊断中,并具有良好的识别效果。

基于Spring Boot的产教联合体信息平台设计

该文设计基于B/S架构的联合体信息平台,利用Spring Boot、MyBatis Plus、Vue等优秀框架实现高效的开发,集成Spring Security和JWT令牌机制,完成认证和权限控制。同时整合Redis缓存,将热点资源缓存至内存中,以实现快速查询操作,从而减轻MySQL数据库的负载压力。该系统稳定、兼容性强,能使联合体成员沟通更方便、信息的发布和维护的效率更高,实现人才共育共享。

Intensive care environment: Perspective of relatives of critically ill patient sustained by health technology

The intensive care unit(ICU)is a complex setting by nature,and some have described it as bizarre due to its numerous sirens that sound when anything is dangerous,constant activity,equipment,bright lights,and high fatality rate.The demands placed on nurses to care for critically ill patients in this environment frequently prevent nurses and other health‑care professionals from acknowledging the feelings of patient’s relatives or family caregivers,resulting in a hostile environment from the patient’s relative’s perspective.When a patient’s family enters the ICU,they feel that hospital administrators do little to nothing to alleviate their discomfort and fear.Despite research demonstrating the importance of providing a homely environment for patients’families,In Nigeria ICU is still far behind how a conventional ICU environment should be structured to accommodate patient’s relations in the unit.The goal of this study was to look at the patient’s relative’s perspective on providing care for a critically ill patient in an ICU,with a focus on the unit’s complexity and overall experience.Based on the findings of this study,we recommend that hospital administrators ensure that the environment of the upcoming ICU is designed to meet the needs of patient’s relatives by addressing identified environmental concerns,like caring neglect,by providing a friendly and stress‑free environment.

Relating Maxwell's demon and quantitative analysis of information leakage for practical imperative programs

Shannon observed the relation between information entropy and Maxwell demon experiment to come up with information entropy formula. After that, Shannon＇s entropy formula is widely used to measure information leakage in imperative programs. But in the present work, our aim is to go in a reverse direction and try to find possible Maxwell＇s demon experimental setup for contemporary practical imperative programs in which variations of Shannon＇s entropy formula has been applied to measure the information leakage. To establish the relation between the second principle of thermodynamics and quantitative analysis of information leakage, present work models contemporary variations of imperative programs in terms of Maxwell＇s demon experimental setup. In the present work five contemporary variations of imperative program related to information quantification are identified. They are： （i） information leakage in imperative program, （ii） imperative multi- threaded program, （iii） point to point leakage in the imperative program, （iv） imperative program with infinite observation, and （v） imperative program in the SOA-based environment. For these variations, minimal work required by an attacker to gain the secret is also calculated using historical Maxwell＇s demon experiment. To model the experimental setup of Maxwell＇s demon, non-interference security policy is used. In the present work, imperative programs with one-bit secret information have been considered to avoid the complexity. The findings of the present work from the history of physics can be utilized in many areas related to information flow of physical computing, nano-computing, quantum computing, biological computing, energy dissipation in computing, and computing power analysis.

Crohn’s disease in human immunodeficiency virus-infected patient:A case report

BACKGROUND Inflammatory bowel disease(IBD)is an autoimmune condition treated with immunosuppressive drugs.However,the need for immune system suppression becomes questionable when infection with the human immunodeficiency virus(HIV)occurs simultaneously and impacts the course of IBD.Our reported case represents the clinical course,prescribed treatment and its effect,as well as clinical challenges faced by physicians in a combination of such diseases.We also present a comprehensive literature review of similar cases.CASE SUMMARY A 49-year-old woman suffering from a newly diagnosed Crohn’s disease was hospitalized due to exacerbated symptoms(abdominal pain,fever,and weight loss).During her hospital stay,she tested positive for HIV.With conservative treatment,the patient improved and was discharged.In the outpatient clinic,her HIV infection was confirmed as stage C3,and antiretroviral treatment was initiated immediately.That notwithstanding,soon the patient was rehospitalized with pulmonary embolism and developed a series of complications because of the subsequent coexistence of IBD and HIV.After intensive and meticulous treatment,the patient’s condition has improved and she remains in remission.CONCLUSION The paucity of studies and data on the coexistence of HIV and IBD leaves clinicians doubting the optimal treatment options.