Research Progress on Self-Efficacy Level of Patients with Type 2 Diabetes Mellitus and Its Influencing Factors

Self-efficacy plays an important role in the management of type 2 diabetes mellitus (T2DM) patients, and it runs through the whole process of diabetes treatment, which is conducive to controlling and delaying the occurrence and development of complications, as well as improving the quality of life of patients. This paper mainly describes the concept of self-efficacy, the current situation of self-efficacy of diabetic patients at home and abroad, the functional aspects and their influencing factors, so as to take relevant measures on how to improve self-efficacy. It aims to provide a theoretical basis for the development of self-efficacy interventions for patients with type 2 diabetes mellitus.

The Improving Effects of Diabetes Education on Diabetes Awareness and Management in Children and Adolescents with T1DM

Background: Diabetes education is crucial in empowering persons with Type 1 diabetes (T1DM) and their families to properly manage the condition by providing comprehensive knowledge, tools, and support. It boosts one’s belief in their ability to succeed, encourages following medical advice, and adds to the general enhancement of health. Objective: This study is to investigate the effectiveness of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively manage the condition. Furthermore, it strives to improve nursing care for families whose children have been diagnosed with Type 1 Diabetes Mellitus (T1DM). Design: This research study investigates the efficacy of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively handle the condition. Materials and Methods: A systematic search was conducted between the years 2000 and 2022, utilizing the Medline and Google Scholar databases. The purpose of the search was to uncover relevant papers pertaining to diabetes education, management of Type 1 Diabetes Mellitus (T1DM), nurse care, and empowerment. The search focused on peer-reviewed research, clinical trials, and scholarly articles that evaluated the efficacy of diabetes education in empowering individuals and families. Results: Diabetes education is crucial for understanding and controlling T1DM. It includes personalized sessions, webinars, group classes, and clinics that provide customized therapies. Comprehensive education enhances glycemic control and family dynamics. Nevertheless, the implementation of diabetes education for families requires specific standards, especially in the field of nursing. Conclusion: Diabetes education is essential for effectively managing Type 1 Diabetes Mellitus (T1DM), providing patients and families with crucial knowledge, resources, and confidence. It encourages independence in-home care and provides explicit guidelines for diabetic nurses to improve nursing care.

Developing a Valid and Reliable Coping Self-Efficacy Scale (CSES) among Patients with Type 2 Diabetes: Iranian Version

Introduction: This study aimed to develop valid and reliable scale with the intention of measure Coping Self-efficacy (CSES) of Iranian type 2 diabetic patients. Patients and Methods: Validity and reliability of Iranian version of Coping Self-efficacy Scale (CSES) were measured by a cross-sectional study. Content validity, reliability and cultural equivalency were appraised through qualitative and quantitative study on 260 participants who have type 2 diabetes. Results: Reliability and validity of the scale and its four subscales, such as “stop unpleasant emotions and thoughts” (a = 0.92) “used problem-focused coping” (a = 0.71), Self-efficacy on diabetes problem solving (a = 0.74) and “get support from friends and family” (a = 0.67) were approved explicitly by a psychometric analysis;these show that the scale was slightly valid and reliable on the study setting. An intraclass correlation coefficient was satisfactory (p < 0.001). Criterion validity between total scale and metabolic control Index (HbA1c) of type 2 diabetic patients was significant (p < 0.001) and showed indirect correlation with the domains of the scale. Conclusion: Study findings supported the reliability and validity of the Iranian version of new Coping Self-efficacy-24 for measuring Coping Selfefficacy among Iranian type 2 diabetic patients. Based on our finding, we would like to recommend appropriate interventions in the future.

Turkish validity and reliability of the Diabetes Self-Efficacy Scale

Purpose:The aim of this methodological study was to determine the validity and reliability of the Diabetes Self-Efficacy Scale adapted to the Turkish community.Methods:The study sample was completed with 319 patients who had been diagnosed at least 1 year before and hospitalized in the Malatya Turgut Ozal Health Center and Malatya State Hospital in Turkey.A questionnaire that consists of items on sociodemographic characteristics,drug use and information about the disease of patients and the Diabetes Self-Efficacy Scale were used for data collection in the study.In reliability analysis of the scale,the Cronbach'sαcoefficient was calculated and item analysis method was utilized.Factor analysis was used for the construct validity,and Principal Component Analysis and Varimax Rotation method were used for analyzing the factor structures.Results:According to data obtained in the study,item-total correlation of the items of the scale was found to be at an adequate level(0.297-0.803).The scale's Cronbach'sαreliability coefficient was found to be 0.86,and there was one factor that explains 52.38%of the total variance with an eigenvalue was greater than 1.0.As a result of the analysis,the factor loadings of the items of the scale were found to bebetween 0.59 and 0.81.Conclusion:Diabetes Self-Efficacy Scale is a valid and reliable instrument for determining the self-efficacy of patients and providing a proper care.It can be suggested to investigate and evaluate the consistency of the scale by applying it to broader sample groups representing different socioeconomic levels.

Study on the Effect of Web-Based Real-Time Interactive Intervention Teaching Model on Self-Efficacy of Gestational Diabetes Mellitus Patients

Object: To explore the effect of web-based real-time interactive intervention teaching model on self-efficacy of Gestational Diabetes Mellitus (GDM) patients. Method: Based on the hospital’s antenatal check-up archives from June 2018 to January 2019, patients diagnosed with GDM in the second trimester were randomly divided into the control group (100 cases) and the experimental group (121 cases). Patients in the control group received routine care following the diabetes mellitus one-day outpatient guidance, while patients in the experimental group received social media real-time interactive teaching intervention based on routine care, and accepted a nursing intervention scheme based on knowledge-attitude-practice mode. The knowledge of GDM, self-efficacy and self-management behavior indicators were compared between the two groups. Results: After the intervention, the self-efficacy scores, the blood glucose monitoring times and the blood glucose compliance rates of the experimental group were significantly higher than those of the control group (P < 0.05). The post-intervention GDM knowledge scores of the experimental group were higher than those of the control group, and the difference was not statistically significant (P = 0.072). Conclusion: Web-based real-time interactive intervention teaching model can effectively improve the self-efficacy of GDM patients and promote the formation of healthy behaviors.

Psychometric properties and characteristics of the Diabetes Self Management Scale

Objective:Assessing diabetes self care management is essential for nursing care for diabetes.There is a need to have valid and reliable scales that assess the actual performance of diabetes self management,The purpose of this study was to revise and conduct psychometric testing and analysis of the Diabetes Self Management Scale(DSMS).Methods:A cross-sectional methodological design was used.A convenience sample was used and 78 adults with diabetes and taking insulin from five sites in the Midwest area of the U.S participated in the study.Reliability analysis was done using Ferketich techniques to make decisions about whether any given item should be retained or deleted.Results:A descriptive analysis for the 60 items of the scale was conducted;several items had low variability compared to the other items on the scale.The correlation matrices showed that a total of 20 items had poor item characteristics.These 20 items were deleted resulting in developing 40-item version of the scale.The 40-item scale had high level of internal consistency(Cronbach'sα=0.947).The validity testing of the 40-item scale was guided by the Research Model for Diabetes Self Care Management;results were congruent with the model and showed strong correlation with self efficacy,moderate correlation with self care agency,and weak correlation with diabetes knowledge.Conclusion:The items and the scale(DSMS)have undergone careful psychometric testing.The 40-item DSMS is a reliable and valid instrument to measure diabetes self care management among people with diabetes.

The Effect of an Educational Program Based on the Health Belief Model on Self-Efficacy among Patients with Type 2 Diabetes Referred to the Iranian Diabetes Association in 2014

Background: Patient self-efficacy is one of the most important factors in treating and overcoming disease. Objective: The aim of this study was to evaluate the effect of an educational program based on the health belief model on self-efficacy among patients with type 2 diabetes referred to the Iranian Diabetes Association in 2014. Method: A randomized controlled clinical trial was conducted. Eighty patients with type 2 diabetes were selected randomly by the double block sample method. They were then divided into two groups of intervention and control (40 patients in each group) by random allocation. Data were collected by a questionnaire based on the Health Belief Model and self-efficacy. The data were gathered two months after the educational program was held. The educational program was designed on the basis of data collected in the pre-test phase. Then, the educational program was executed for the intervention group in 8 sessions (each 30 minutes) using lectures and an educational booklet. Data analysis was done with Chi-square Test, Pearson’s correlation, Independent samples T-test and paired T-test. The significance level was considered at 0.05. Results: Before intervention, no significant difference was detected between the two groups. However, after intervention all variables were significantly different except for perceived threat. Moreover, there were significant linear relationships between Self-efficacy and all Health Belief Model components after the educational intervention in both groups (p < 0.05). Conclusion: The educational program based on the health belief model increased self-efficacy in type 2 diabetes mellitus patients.

Peer Support in Improving Self-Efficacy of Rural Patients with Type 2 Diabetes and the Application of Drugs to Reduce the Pain from Diabetes

Objective: This study aims to explore the effect of peer support in improving self-efficacy of rural patients with type 2 diabetes and the application of drugs to reduce the pain from diabetes. Methods: Patients with type 2 diabetes in the rural area were selected and they were divided into the peer group and control group with voluntary. The patients in peer support group applied six kinds of activity patterns, while the control group was carried out with routine activities. Results: Comparison indexes for the two groups are mastering degree of related knowledge to diabetes, control compliance rate of indicators related to diabetes, and management of diabetes self-efficacy. Comparing with the control group, indexes in peer support group were significantly increased (P < 0.01). Meanwhile, in the table of diabetes distress, 17 items have been improved and the occurrence rate of painful diabetic decreased significantly (P < 0.01). Conclusion: Peer support can improve the rural patients’ self-efficacy of type 2 diabetes and decrease patients’ pain from type 2 diabetes mellitus.

Diabetes empowerment scores among type 2 diabetes mellitus patients and its correlated factors: A cross-sectional study in a primary care setting in Malaysia

BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients,particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.METHODS This is a cross sectional study involving 322 patients with type 2 diabetes mellitus(DM)followed up in a primary care clinic.Systematic sampling method was used for patient recruitment.The Diabetes Empowerment Scale(DES)questionnaire was used to measure patient empowerment.It consists of three domains:(1)Managing the psychosocial aspect of diabetes(9 items);(2)Assessing dissatisfaction and readiness to change(9 items);and(3)Setting and achieving diabetes goal(10 items).A score was considered high if it ranged from 100 to 140.Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.RESULTS The median age of the study population was 55 years old.56%were male and the mean duration of diabetes was 4 years.The total median score of the DES was 110[interquartile range(IQR)=10].The median scores of the three subscales were 40 with(IQR=4)for"Managing the psychosocial aspect of diabetes";36 with(IQR=3)for"Assessing dissatisfaction and readiness to change";and 34 with(IQR=5)for"Setting and achieving diabetes goal".According to multiple linear regressions,factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level(P<0.001),diabetes education exposure(P=0.003),lack of ischemic heart disease(P=0.017),and lower glycated hemoglobin(HbA1c)levels(P<0.001).CONCLUSION Diabetes empowerment scores were high among type 2 diabetes patients in this study population.Predictors for high empowerment scores included above secondary education level,diabetes education exposure,lack of ischemic heart disease status and lower HbA1c.

Constipation, hard stools, fecal urgency, and incomplete evacuation, but not diarrhea is associated with diabetes and its related factors

AIM: To determine the bowel symptoms associated with diabetes and diabetes-related factors after excluding gastrointestinal (GI) organic diseases.METHODS: Participants were 4738 (603 diabetic and 4135 non-diabetic) patients who underwent colonoscopy and completed a questionnaire. On the day of pre-colonoscopy, 9 symptoms (borborygmus, abdominal distension, increased flatus, constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) were prospectively evaluated on a 7-point Likert scale. The test-retest reliability of the bowel symptom scores from the baseline and second questionnaires was analyzed using kappa statistics. Associations between bowel symptom scores and diabetes or diabetes-related factors were analyzed by a rank-ordered logistic model adjusted for related confounders, and odds ratios (ORs) were estimated.RESULTS: In multivariate analysis, constipation [adjusted odds ratio (AOR) = 1.57, CI: 1.33-1.85, P &#x0003c; 0.01] and hard stools (AOR = 1.56, CI: 1.33-1.84, P &#x0003c; 0.01) were associated with diabetes, and fecal urgency (AOR = 1.16, CI: 0.99-1.37, P = 0.07) and incomplete evacuation (AOR = 1.16, CI: 1.00-1.36, P = 0.06) were marginally associated with diabetes. These symptoms remained associated even after excluding organic GI diseases on colonoscopy. Test-retest reliability of symptom score with a mean duration of 3.2 mo was good (mean kappa, 0.69). Associations of symptoms with diabetes-related factors were found; constipation with HbA1c &#x02265; 8.0% (AOR = 2.11, CI: 1.19-3.73), body mass index (BMI) &#x0003c; 25 (AOR = 2.11, CI: 1.22-3.66), and insulin use (AOR = 1.90, CI: 1.08-3.36); hard stools with diabetes duration (AOR = 1.03, CI: 1.00-1.07); fecal urgency with BMI &#x0003c; 25 (AOR = 1.73, CI: 1.00-2.98); and incomplete evacuation with BMI &#x0003c; 25 (AOR = 2.60, CI: 1.52-4.43), serum creatinine level (AOR = 1.27, CI: 1.10-1.47), and insulin use (AOR = 1.92, CI: 1.09-3.38).CONCLUSION: Diabetes is associated with constipation, hard stools, fecal urgency, and incomplete evacuation, and poor glycemic control, duration, leanness, and nephropathy affect the risk of these symptoms.

Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough?

Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the &#x0201c;sixth&#x0201d; major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A &#x0201c;two way&#x0201d; relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.

Therapeutic potential of human embryonic stem cells in type 2 diabetes mellitus

AIM:To evaluate the safety and efficacy of human embryonic stem cells(h ESCs)for the management of type 2 diabetes mellitus(T2DM).METHODS:Patients with a previous history of diabetes and its associated complications were enrolled and injected with hE SC lines as per the defined protocol.The patients were assessed using Nutech functional score(NFS),a numeric scoring scale to evaluate the patients for 11 diagnostic parameters.Patients were evaluated at baseline and at the end of treatment period 1(T1).All the parameters were graded on the NFS scale from 1to 5.Highest possible grade(HPG)of 5 was considered as the grade of best improvement.RESULTS:Overall,94.8%of the patients showed improvement by at least one grade of NFS at the end of T1.For all the 11 parameters evaluated,54%of patients achieved HPG after treatment.The four essential parameters(improvement in glycated hemoglobin(HbA 1c)and insulin level,and fall in number of other oral hypoglycemic drugs with and without insulin)are presented in detail.For Hb A1c,72.6%of patients at the end of T1 met the World Health Organization cut off value,i.e.,6.5%of HbA 1c.For insulin level,65.9%of patients at the end of T1 were able to achieve HPG.After treatment,the improvement was seen in 16.3%of patients who required no more than two medications along with insulin.Similarly,21.5%of patients were improved as their dosage regimen for using oral drugs was reduced to 1-2 from 5.CONCLUSION:hE SC therapy is beneficial in patients with diabetes and helps in reducing their dependence on insulin and other medicines.

Psychometric properties of the Chinese version of the Infertility Self-Efficacy Scale

Objective:To translate the English version of Infertility Self-Efficacy Scale into Chinese and to validate the psychometric properties of the Chinese version of the Infertility Self-Efficacy Scale(CISE).Method(s):Participants were recruited from the Gynecology Department of two city hospitals.Five main processes were involved in the formation of CISE[1]:scale translation based on expert consultation[2];pre-test questionnaire development with infertile women's feedback(N=20)[3];factor structure assessed by exploratory and confirmatory factor analysis(N=177)[4];assessment of reliability by internal consistency(N=177)and test-retest reliability(N=21);and[5]assessment of convergent validity with Self-rating Anxiety Scale,Self-rating Depression Scale,and Simplified Coping Style Questionnaire(N=177).Results:This study established a 16-item CISE.Factor analyses confirmed a onecomponent solution,which explained 54.59% of total variances and showed an acceptable model fit.Cronbach's a and test-retest correlation coefficients for the scale were 0.94 and 0.84,respectively.The CISE score was significantly correlated with anxiety(r=0.47),depression(r=0.60),positive coping style(r=0.37),and certain negative coping style items.Conclusion:This 16-item CISE is a reliable and valid measure to evaluate perceived selfefficacy among a sample of Chinese women who underwent infertility treatment.

Measurement invariance and latent mean differences of the Chinese version physical activity self-efficacy scale across gender and education levels

Background: Self-efficacy has been identified as an important determinant of youth's behavior change including physical activity(PA) participation. However, the dimensionality check of a PA self-efficacy scale has rarely been conducted in China. The current study aims to examine(1) the unidimensionality of a shortened Chinese version of PA self-efficacy scale(S-PASESC);(2) the measurement invariance of S-PASESC across gender and levels of education;(3) the latent factor mean difference between gender and levels of education;(4) the direct effects of self-efficacy on PA by different gender and education levels; and(5) the comparisons of the direct effects of self-efficacy on PA across gender and education levels.Methods: The participants were 5 th through 11 th grade public school students recruited from 7 cities located in different geographic regions of China. The final data include a total of 3003 participants(49.7% boys) who have completed the scales.Results: Confirmatory factor analysis(CFA) test supported the unidimensionality of S-PASESC. The S-PASESC is invariant across gender and 3 levels of education at both configural, full metric, and full scalar levels. Findings from latent mean comparisons showed that boys reported higher PA self-efficacy than girls. Students' perceived PA self-efficacy tend to decrease from elementary to high school. Finally, self-efficacy positively related to PA by groups of different gender and education levels and the relationship between self-efficacy and PA is stronger among middle school boys than girls.Conclusion: Findings suggest S-PASESC is a valid scale for measuring Chinese students' PA self-efficacy.

Relationship between diabetes and periodontal infection

Periodontal disease is a high prevalent disease.In the United States 47.2% of adults ≥ 30 years old have been diagnosed with some type of periodontitis.Longitudinal studies have demonstrated a two-way relationship between diabetes and periodontitis,with more severe periodontal tissue destruction in diabetic patients and poorer glycemic control in diabetic subjects with periodontal disease.Periodontal treatment can be successful in diabetic patients.Short term effects of periodontal treatment are similar in diabetic patients and healthy population but,more recurrence of periodontal disease can be expected in no well controlled diabetic individuals.However,effects of periodontitis and its treatment on diabetes metabolic control are not clearly defined and results of the studies remain controversial.

The moderating effect of social cognitive factors on self-management activities and HbA1c in Thai adults with type-2 diabetes

Background: Diabetes mellitus (DM) has become a serious chronic disease.Self-management strategies help persons with DM make choices which will develop skills needed to reach their goal of blood glucose control and allow them to be successful in reaching goals.Objective: To examine the impact of self-management activities on HbA1c for persons with DM and to examine the impact of social support,self-efficacy and Buddhist values as moderators on the relationship between the self-management activities and HbA1c.Method: This study is a cross-sectional design.The sample included 401 Thai adults diagnosed with type 2 diabetes,aged 20-65 years old who had at least one HbA1c test in the last three months were recruited.Participants completed four questionnaires to measure self-management activities,as well as self-efficacy,Buddhist values and social support as moderating factors on self-management activities and HbA1 c,Results: The self-management activities were negatively associated (β =-2.05,p ≤ 0.001) with HbA1c.The Social support,self-efficacy and Buddhist values had a significant interaction effect between selfmanagement activities and HbA1c (β =-0.97,p ≤ 0.05,β =-0.18,p ≤ 0.05 and β =-2.76,p ≤ 0.001).Conclusion: The diabetes self-management activities were more strongly associated with HbA1c under conditions of high social support,self-efficacy and health beliefs with Buddhist values.Future interventions for T2DM self-management programs should incorporate mechanisms to measure and support these factors.

Investigating Physical Exercise among Jordanians with Diabetes Mellitus

This study is aimed to investigate exercise behaviors (frequency and duration) among Jordanian diabetic patients, and their correlation with their physical characteristics and perceived exercise benefits and barriers, exercise self efficacy, and exercise planning. An exploratory descriptive design was utilized using the cross-sectional survey with self-reported questionnaires (Demographics, Charlson Comorbidity Index, Exercise Self-Efficacy Scale, Exercise Benefits and Barriers Scale, and Commitment to a Plan for Exercise Scale). A convenience sample of 115 Jordanians with diabetes mellitus was recruited from diabetes outpatient clinics. Participants reported an average number of 3.2 physical activities per week (average of 2.9 hours), with walking being the most common activity. Participant’s body mass index, comorbidity index, and exercise self-efficacy were correlated with both frequency and duration of exercise (r = -0.393, -0.286, 0.219 and -0.272, 0.383, 0.260, respectively). A predictive model of five predictors (age, BMI, CCI, exercise self efficacy, and perceived exercise barriers) that significantly predicted exercise duration (R2 = 0.34, F = 9.14, P < 0.000) was found. Diabetic patients were found to exercise less than optimum. Illness itself was not a cause of not exercising compared to lack of time and desire. Factors that can enhance or inhibit participants’ engagement in exercise should be included in designing tailored exercise educational programs.

Comparison of three kinds of frailty screening instruments in the elderly with diabetes mellitus

Purpose:To evaluate the reliability and validity of the Frailty Phenotype(FP),Tilburg Frailty Indicator(TFI)and Frail Scale(FS)in elderly diabetic patients,and to provide a scientific basis for selecting appropriate frailty screening instruments for medical staff.Design:A cross-sectional study.Participants and Methods:A convenience sample of 169 elderly diabetic patients was selected from a diabetes special hospital in Tianjin,China.We assessed the reliability and validity of the full FP,TFI and FS as well as their domains.The structural validity of the scale was tested by Spearman correlation analysis of items,dimensions and total scores of scales.The predictive validity of FP,TFI and FS was evaluated by calculating the correlation coefficient between the total scores of FP,TFI and FS and the scores of diabetes specific quality of life scale(QSDL).We assessed the test-retest reliability of 17 elderly diabetic patients twice.Results:A total of 169 patients were included,with a mean age 66.53±7.24 years,and 53.8%were female.The prevalence of frailty was 23.1%according to FP,38.5%according to FS and 78.7%according to TFI with a mean score 6.86±3.05.The test-retest reliability of FP,TFI and FS were 0.915,0.942 and 0.956 respectively.The correlation coefficients between each item or dimension and its total frailty score were r=0.293~0.618,0.174~0.753 and 0.255~0.706 respectively(P<0.01).The total scores of the three frailty screening instruments were the strongest correlation with the physiological dimension of DSQL and the worst correlation of social relations.The area under the receiver operating characteristic(ROC)curve for predicting the decline of quality of life of diabetic patients was 0.805,0.500 and 0.816,respectively.Conclusion:The test-retest reliability of FP,TFI and FS is good and the structural validity of TFI and the ability of predicting the decline of quality of life are better than those of FP and FS.Therefore,compared with the other two scales,the TFI is a reliable and valid instrument to assess frailty in elderly diabetic patients.

Machine Learning Based Diagnosis for Diabetic Retinopathy for SKPD-PSC

The study aimed to apply to Machine Learning(ML)researchers working in image processing and biomedical analysis who play an extensive role in compre-hending and performing on complex medical data,eventually improving patient care.Developing a novel ML algorithm specific to Diabetic Retinopathy(DR)is a chal-lenge and need of the hour.Biomedical images include several challenges,including relevant feature selection,class variations,and robust classification.Although the cur-rent research in DR has yielded favourable results,several research issues need to be explored.There is a requirement to look at novel pre-processing methods to discard irrelevant features,balance the obtained relevant features,and obtain a robust classi-fication.This is performed using the Steerable Kernalized Partial Derivative and Platt Scale Classifier(SKPD-PSC)method.The novelty of this method relies on the appropriate non-linear classification of exclusive image processing models in har-mony with the Platt Scale Classifier(PSC)to improve the accuracy of DR detection.First,a Steerable Filter Kernel Pre-processing(SFKP)model is applied to the Retinal Images(RI)to remove irrelevant and redundant features and extract more meaningful pathological features through Directional Derivatives of Gaussians(DDG).Next,the Partial Derivative Image Localization(PDIL)model is applied to the extracted fea-tures to localize candidate features and suppress the background noise.Finally,a Platt Scale Classifier(PSC)is applied to the localized features for robust classification.For the experiments,we used the publicly available DR detection database provided by Standard Diabetic Retinopathy(SDR),called DIARETDB0.A database of 130 image samples has been collected to train and test the ML-based classifiers.Experimental results show that the proposed method that combines the image processing and ML models can attain good detection performance with a high DR detection accu-racy rate with minimum time and complexity compared to the state-of-the-art meth-ods.The accuracy and speed of DR detection for numerous types of images will be tested through experimental evaluation.Compared to state-of-the-art methods,the method increases DR detection accuracy by 24%and DR detection time by 37.

一种融合多尺度技术和并行网络的DR检测方法

针对糖尿病视网膜病变(DR)检测模型在下采样过程中关键信息丢失和模型鲁棒性差的问题,构建一个PM-Net模型(Parallel Multi-scale Network)。在下采样过程中,利用信息增强的方式设计了多尺度最大池化和多尺度卷积模块并对ResNet-50改进。进一步,为了提高模型的鲁棒性,使用双分支的架构对模型进行扩展。提出的多尺度模块使得模型在下采样的过程中获得了更加丰富的视网膜眼底图像特征,从而提高了DR检测的性能,同时提出的双分支模型在DR检测过程中用局部信息辅助全局信息保证了模型的鲁棒性。模型在EyePACS、DDR和私有数据集进行了实验验证。实验结果表明:与主流的模型相比,本模型在EyePACS数据集上的准确率和二次加权Kappa分数分别提高了2.58%和1.31%。