A data and physical model dual-driven based trajectory estimator for long-term navigation

Long-term navigation ability based on consumer-level wearable inertial sensors plays an essential role towards various emerging fields, for instance, smart healthcare, emergency rescue, soldier positioning et al. The performance of existing long-term navigation algorithm is limited by the cumulative error of inertial sensors, disturbed local magnetic field, and complex motion modes of the pedestrian. This paper develops a robust data and physical model dual-driven based trajectory estimation(DPDD-TE) framework, which can be applied for long-term navigation tasks. A Bi-directional Long Short-Term Memory(Bi-LSTM) based quasi-static magnetic field(QSMF) detection algorithm is developed for extracting useful magnetic observation for heading calibration, and another Bi-LSTM is adopted for walking speed estimation by considering hybrid human motion information under a specific time period. In addition, a data and physical model dual-driven based multi-source fusion model is proposed to integrate basic INS mechanization and multi-level constraint and observations for maintaining accuracy under long-term navigation tasks, and enhanced by the magnetic and trajectory features assisted loop detection algorithm. Real-world experiments indicate that the proposed DPDD-TE outperforms than existing algorithms, and final estimated heading and positioning accuracy indexes reaches 5° and less than 2 m under the time period of 30 min, respectively.

Mitigating the Prevalence of Diabetic Retinopathy in the United States: Utilization of the Chronic Care Model as a Public Health Framework

As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.

Development of a new Cox model for predicting long-term survival in hepatitis cirrhosis patients underwent transjugular intrahepatic portosystemic shunts

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)placement is a procedure that can effectively treat complications of portal hypertension,such as variceal bleeding and refractory ascites.However,there have been no specific studies on predicting long-term survival after TIPS placement.AIM To establish a model to predict long-term survival in patients with hepatitis cirrhosis after TIPS.METHODS A retrospective analysis was conducted on a cohort of 224 patients who un-derwent TIPS implantation.Through univariate and multivariate Cox regression analyses,various factors were examined for their ability to predict survival at 6 years after TIPS.Consequently,a composite score was formulated,encompassing the indication,shunt reasonability,portal venous pressure gradient(PPG)after TIPS,percentage decrease in portal venous pressure(PVP),indocyanine green retention rate at 15 min(ICGR15)and total bilirubin(Tbil)level.Furthermore,the performance of the newly developed Cox(NDC)model was evaluated in an in-ternal validation cohort and compared with that of a series of existing models.RESULTS The indication(variceal bleeding or ascites),shunt reasonability(reasonable or unreasonable),ICGR15,post-operative PPG,percentage of PVP decrease and Tbil were found to be independent factors affecting long-term survival after TIPS placement.The NDC model incorporated these parameters and successfully identified patients at high risk,exhibiting a notably elevated mortality rate following the TIPS procedure,as observed in both the training and validation cohorts.Additionally,in terms of predicting the long-term survival rate,the performance of the NDC model was significantly better than that of the other four models[Child-Pugh,model for end-stage liver disease(MELD),MELD-sodium and the Freiburg index of post-TIPS survival].CONCLUSION The NDC model can accurately predict long-term survival after the TIPS procedure in patients with hepatitis cirrhosis,help identify high-risk patients and guide follow-up management after TIPS implantation.

Research on the Establishment of a Long-Term Care System for the Elderly with Alzheimer’s Disease Under the Background of Long-Term Care Insurance: A Literature Review

With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.

The construction and practice of humanistic care teaching model based on 5C care theory

Objective:To construct a scientific and feasible teaching mode based on 5C caring theory and evaluate it,so as to provide a reference basis for future study about nursing humanistic quality education.Methods:Based on the 5C caring theory,the teaching design and teaching content were revising and implementing in the intervention group.Before and after the implementation of the course,a questionnaire survey was conducted using the Caring Ability Inventory(CAI).The results of the surveys were collected,and the data were statistically analysis using SPSS.Results:After the implementation of the course,the cognitive dimension,patience dimension,and humanistic caring ability scores of the nursing students in the intervention group improved compared with those before the implementation of the course(P<0.05).There were no significant difference in the control group(P>0.05).Conclusion:The humanistic caring teaching model based on 5C caring theory has a positive effect on improving nursing students'humanistic caring ability.In the future nursing teaching,the modules with the characteristics of humanistic caring ability can be increased,and carry out the educational reform throughout the humanistic caring ability.Actively guiding nursing students to establish the awareness of humanistic caring,so as to lay a solid foundation for high-quality clinical nursing work.

Analysis of the Application Effect of Family Collaborative Care Model on Elderly Patients with Type 2 Diabetes Mellitus and the Situation of Self-Care Ability

Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.

Analysis of the Effect of Integrated Extended Care Model in Improving the Quality of Life of Elderly Patients with Type 2 Diabetes Mellitus

Objective: To analyze the impact of an integrated extended care model on improving the quality of life of elderly patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 176 patients admitted to the hospital from March 2015 to February 2018 were selected and randomly assigned to an observation group and a control group, with 88 patients each. The control group implemented conventional nursing interventions, and the observation group carried out an integrated extended-care model. The level of glycemic control, quality of life, and daily medication adherence between both groups were compared. Results: The observation group showed significant improvement in the level of glycemic control, and their fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels were significantly lower as compared with those in the study group (P < 0.05). The quality of life of the patients in the observation group was higher than that of the control group (P < 0.05). The observation group had a higher compliance score (95.48 ± 7.45) than the control group (81.31 ± 8.72) (t = 8.909, P < 0.05). Conclusion: The integrated extended care model allows patients to receive comprehensive and individualized nursing services after discharge, which improves the effect of drug therapy and the quality of life of patients.

A review of uncertain factors and analytic methods in long-term energy system optimization models

A larger number of uncertain factors in energy systems influence their evolution.Owing to the complexity of energy system modeling,incorporating uncertainty analysis to energy system modeling is essential for future energy system planning and resource allocation.This study focusses on long-term energy system optimization model.The important uncertain parameters in the model are analyzed and divided into policy,economic,and technical factors.This study specifically addresses the challenges related to carbon emission reduction and energy transition.It involves collecting and organizing relevant research on uncertainty analysis of long-term energy systems.Various energy system uncertainty modeling methods and their applications from the literature are summarized in this review.Finally,important uncertainty factors and uncertainty modeling methods for long-term energy system modeling are discussed,and future research directions are proposed.

Review of multi-objective optimization in long-term energy system models

Modeling and optimizing long-term energy systems can provide solutions to various energy and environmental policies involving public-interest issues.The conventional optimization of long-term energy system models focuses on a single economic goal.However,the increasingly complex demands of energy systems necessitate the comprehensive consideration of multiple dimensional objectives,such as environmental,social,and energy security.Therefore,a multi-objective optimization of long-term energy system models has been developed.Herein,studies pertaining to the multi-objective optimization of long-term energy system models are summarized;the optimization objectives of long-term energy system models are classified into economic,environmental,social,and energy security aspects;and the multi-objective optimization methods are classified and explained based on the preferential expression of decision makers.Finally,the key development direction of the multi-objective optimization of energy system models is discussed.

个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用

目的:探讨个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用效果。方法:采用便利取样法将2022年6月1日~2023年12月31日就诊于耳鼻喉门诊的256例患者作为研究对象,将2022年6月1日~2023年1月31日就诊的128例作为对照组,将2023年2月1日~12月31日就诊的128例作为实验组;对照组给予常规耳鼻喉门诊护理,实验组给予个性化护理联合CICARE沟通模式;比较两组护理前后护理质量、护理满意度。结果:护理后,实验组有形性感知、可靠性感知、响应性感知、保证性感知评分均高于对照组(P<0.05,P<0.01),两组移情性感知比较差异无统计学意义(P>0.05);护理后,实验组服务态度、沟通能力、就诊秩序、专业素质、护理安全、护理满意度总分均高于对照组(P<0.05,P<0.01)。结论:将个性化护理联合CICARE沟通模式应用于耳鼻喉门诊患者中,能够提高护理质量和护理满意度。

Physical modeling of long-term dynamic characteristics of the subgrade for medium-low-speed maglevs

To investigate the dynamic characteristics and long-term dynamic stability of the new subgrade structure of medium-low-speed(MLS)maglevs,cyclic vibration tests were performed under natural and rainfall conditions,and the dynamic response of the subgrade structure was monitored.The dynamic response attenuation characteristics along the depth direction of the subgrade were compared,and the distribution characteristics of the dynamic stress on the surface of the subgrade along the longitudinal direction of the line were analyzed.The critical dynamic stress and cumulative deformation were used as indicators to evaluate the long-term dynamic stability of the subgrade.Results show that water has a certain effect on the dynamic characteristics of the subgrade,and the dynamic stress and acceleration increase with the water content.With the dowel steel structure set between the rail-bearing beams,stress concentration at the end of the loaded beam can be prevented,and the diffusion distance of the dynamic stress along the longitudinal direction increases.The dynamic stress measured in the subgrade bed range is less than 1/5 of the critical dynamic stress.The postconstruction settlement of the subgrade after similarity ratio conversion is 3.94 mm and 7.72 mm under natural and rainfall conditions,respectively,and both values are less than the 30 mm limit,indicating that the MLS maglev subgrade structure has good long-term dynamic stability.

Investigating adverse events in long-term care facilities:a systematized review

Objective:This systematized review aimed to synthesize the results of empirical studies focused on the types and factors of adverse events(AEs)that contribute to them in long-term care(LTC)settings.Methods:The search was conducted in Pro Quest,Scopus,and Pub Med in January 2021 and resulted in 1057 records.The content analysis method was used in the data analysis.Results:In all,35 studies were identified as relevant for the review.The analysis revealed 133 different types of AEs and 60 factors that contributed to them.Conclusions:In LTC,various AEs occur,most of which are preventable,while many factors that influence their occurrence could be significantly modifiable.Through an effective analysis of AEs in LTC,it is possible to minimize their occurrence and,at the same time,minimize their negative impact on all par ties concerned.

A Survey on Channel Measurements and Models for Underground MIMO Communication Systems

The high reliability of the communication system is critical in metro and mining applications for personal safety,channel optimization,and improving operational performance.This paper surveys the progress of wireless communication systems in underground environments such as tunnels and mines from 1920 to 2022,including the evolution of primitive technology,advancements in channel modelling,and realization of various wireless propagation channels.In addition,the existing and advanced channel modeling strategies,which include the evolution of different technologies and their applications;mathematical,analytical,and experimental techniques for radio propagation;and significance of the radiation characteristics,antenna placement,and physical environment of multiple-input multiple-output(MIMO)communication systems,are analyzed.The given study introduces leaky coaxial cable(LCX)and distributed antenna system(DAS)designs for improving narrowband and wideband channel capacity.The paper concludes by figuring out open research areas for the future technologies.

Construction of Industrialization Development Model for"1+4+X"Community-Based Elderly Care in Gannan Old Revolutionary Base Area in the Context of Population Aging

In the context of controlling population development in a planned way,China entered an aging society in the early 21 st century.In this context,how to meet the needs of the elderly care and form an effective elderly care model has become a key problem to be solved urgently by local government departments.With the continuous advancement of the elderly care policy,the community-based elderly care has gradually become the mainstream and is in the stage of vigorous promotion.Taking the Gannan old revolutionary base area in Jiangxi Province as an example,this study puts forward"1+4+X"community-based elderly care model based on the policy system of community-based elderly care,the physical and mental health of the elderly,the material space and the construction of evaluation system,and explores how to promote the application of this community model efficiently in the form of industrialization,so as to drive the economic growth of the Gannan old revolutionary base area,promote the employment development and improve the community-based elderly care service.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

CICARE沟通模式联合细节护理及呼吸训练在心脏磁共振检查患者中的应用

目的探讨CICARE沟通模式联合细节护理及呼吸训练在心脏磁共振检查患者中的应用效果。方法选取2022年1月—2022年12月在医院行心脏磁共振检查患者180例,按照组间基线资料可比的原则分为对照组和观察组,各90例,对照组给予常规护理,观察组在对照组基础上给予CICARE沟通模式联合细节护理及呼吸训练,比较两组患者护理前后的Zung焦虑自评量表(SAS)和汉密尔顿焦虑自评量表(HAMA)评分、检查相关情况、图像质量、患者满意度。结果护理干预后,观察组患者SAS、HAMA评分低于对照组,差异有统计学意义(P<0.05)。观察组患者检查时间短于对照组,差异有统计学意义(P<0.05),两组扫描成功率比较,差异无统计学意义(P>0.05)。观察组患者图像质量优于对照组,图像伪影发生率为18.89%,低于对照组的50.00%,差异有统计学意义(P<0.05)。观察组患者物理环境、护理、护理技术、安全、指导沟通满意度评分高于对照组,差异有统计学意义(P<0.05)。结论CICARE沟通模式联合细节护理及呼吸训练应用于心脏磁共振检查患者中,可有效缓解焦虑情况,提高图像质量、扫描成功率和患者满意度,提高检查效率。

Influence of perinatal factors on full-term low-birth-weight infants and construction of a predictive model

BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.

Adapting chronic care models for diabetes care delivery in low-and-middle-income countries:A review

A contextual review of models for chronic care was done to develop a context-adapted chronic care model-based service delivery model for chronic conditions including diabetes.The Philippines was used as the setting of a low-to-middle-income country.A context-based narrative review of existing models for chronic care was conducted.A situational analysis was done at thegrassroots level,involving the leaders and members of the community,the patients,the local health system and the healthcare providers.A second analysis making use of certain organizational theories was done to explore on improving feasibility and acceptability of organizing care for chronic conditions.The analyses indicated that care for chronic conditions may be introduced,considering the needs of people with diabetes in particular and the community in general as recipients of care,and the issues and factors that may affect the healthcare workers and the health system as providers of this care.The context-adapted chronic care model-based service delivery model was constructed accordingly.Key features are:incorporation of chronic care in the health system's services; assimilation of chronic care delivery with the other responsibilities of the healthcare workers but with redistribution of certain tasks; and ensuring that the recipients of care experience the whole spectrum of basic chronic care that includes education and promotion in the general population,risk identification,screening,counseling including self-care development,and clinical management of the chronic condition and any co-morbidities,regardless of level of control of the condition.This way,low-to-middle income countries can introduce and improve care for chronic conditions without entailing much additional demand on their limited resources.

Development and validation of a nomogram for predicting in-hospital mortality of intensive care unit patients with liver cirrhosis

BACKGROUND Liver cirrhosis patients admitted to intensive care unit(ICU)have a high mortality rate.AIM To establish and validate a nomogram for predicting in-hospital mortality of ICU patients with liver cirrhosis.METHODS We extracted demographic,etiological,vital sign,laboratory test,comorbidity,complication,treatment,and severity score data of liver cirrhosis patients from the Medical Information Mart for Intensive Care IV(MIMIC-IV)and electronic ICU(eICU)collaborative research database(eICU-CRD).Predictor selection and model building were based on the MIMIC-IV dataset.The variables selected through least absolute shrinkage and selection operator analysis were further screened through multivariate regression analysis to obtain final predictors.The final predictors were included in the multivariate logistic regression model,which was used to construct a nomogram.Finally,we conducted external validation using the eICU-CRD.The area under the receiver operating characteristic curve(AUC),decision curve,and calibration curve were used to assess the efficacy of the models.RESULTS Risk factors,including the mean respiratory rate,mean systolic blood pressure,mean heart rate,white blood cells,international normalized ratio,total bilirubin,age,invasive ventilation,vasopressor use,maximum stage of acute kidney injury,and sequential organ failure assessment score,were included in the multivariate logistic regression.The model achieved AUCs of 0.864 and 0.808 in the MIMIC-IV and eICU-CRD databases,respectively.The calibration curve also confirmed the predictive ability of the model,while the decision curve confirmed its clinical value.CONCLUSION The nomogram has high accuracy in predicting in-hospital mortality.Improving the included predictors may help improve the prognosis of patients.

Advancing critical care recovery:The pivotal role of machine learning in early detection of intensive care unit-acquired weakness

This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.