Understanding the combustion behavior of electric bicycle batteries and unveiling its relationship with fire extinguishing

In this study,a detailed analysis of the combustion behaviors of the lithium iron phosphate(LFP)and lithium manganese oxide(LMO)batteries used in electric bicycles was conducted.This research included quantitative measurements of the combustion duration,flame height,combustion temperature,heat release rate,and total heat release.The results indicated that LMO batteries exhibited higher combustion temperatures of 600–700°C,flame heights of 70–75 cm,a significantly higher heat release rate of40.1 k W(12 Ah),and a total heat release of 1.04 MJ(12 Ah)compared to LFP batteries with the same capacity.Based on these experimental results,a normalized total heat release(NORTHR)parameter was proposed,demonstrating good universality for batteries with different capacities.Utilizing this parameter,quantitative calculations and optimization of the extinguishing agent dosage were conducted for fires involving these two types of batteries,and the method was validated by extinguishing fires for these two types of battery packs with water-based extinguishing fluids.

Enhancing Fire Safety in Commercial Vehicles: Assessing the Efficacy and Advantages of Exploding Fire Extinguishing Balls

Fire incidents in commercial vehicles pose significant risks to passengers, drivers, and cargo. Traditional fire extinguishing systems, while effective, may have limitations in terms of response time, coverage, and human intervention [1]. This study investigates the efficacy of a novel fire suppression technology—the Exploding Fire Extinguishing Ball (EFEB) —as an alternative and complementary fire safety solution for commercial vehicles. The research employs a multidisciplinary approach, encompassing engineering, materials science, fire safety, and human factors analysis. A systematic literature review establishes a comprehensive understanding of existing fire suppression technologies, including EFEBs. Subsequently, this study analyzes the unique features of EFEBs, such as automatic activation, as well as manual activation upon exposure to fire, and their potential to provide rapid, localized, and autonomous fire suppression. The study presents original experimental investigations to assess the performance and effectiveness of EFEBs in various fire scenarios representative of commercial vehicles. Experiments include controlled fires in confined spaces and dynamic simulations to emulate real-world fire incidents. Data on activation times, extinguishing capability, and coverage area are collected and analyzed to compare the efficacy of EFEBs with traditional fire extinguishing methods. Furthermore, this research shows the practical aspects of implementing EFEBs in commercial vehicles. A feasibility study examines the integration challenges, cost-benefit analysis, and potential regulatory implications. The study also addresses the impact of EFEBs on vehicle weight, stability, and overall safety. Human factors and user acceptance are crucial elements in adopting new safety technologies. Therefore, this research utilizes an experimental design to assess the performance and effectiveness of EFEBs in various fire scenarios representative of commercial vehicles. This dissertation presents original controlled experiments to emulate real-world fire incidents, including controlled fires in confined spaces and dynamic simulations. The experimental approach ensures rigorous evaluation and objective insights into EFEBs’ potential as an autonomous fire suppression system for commercial vehicles. This includes the perspectives of drivers, passengers, fleet operators, insurance agencies, and regulatory bodies. Factors influencing trust, perceived safety, and willingness to adopt EFEBs are analyzed to provide insights into the successful integration of this technology. The findings of this research will contribute to the knowledge of fire safety technology and expand the understanding of the applicability of EFEBs in commercial vehicles.

Research Progress of Polymer Fire Extinguishing Gel and Its Application in Forest Fire Prevention

The paper summarizes the structure and water-absorbing mechanism,classification,and preparation method of polymer fire extinguishing gel,and prospects for its application in aerial firefighting,forest ground fire extinguishing,opening of firebreaks,and mitigating human casualties in forest fire extinguishing.

基于Self-Attention-BiLSTM网络的西瓜种苗叶片氮磷钾含量高光谱检测方法

元素含量无损检测技术可以为植物生长发育的环境精准调控提供关键实时数据。以西瓜苗为例,提出了一种基于图谱特征融合的氮磷钾含量深度学习检测方法。首先,使用高光谱仪拍摄西瓜苗叶片的高光谱图像,使用连续流动化学分析仪测定叶片的3种元素含量。然后,采用基线偏移校正(BOC)叠加高斯平滑滤波(GF)的光谱预处理方法和随机森林算法(RF)建立预测模型,基于竞争性自适应重加权采样(CARS)和连续投影算法(SPA)2种算法初步筛选出特征波长,再综合考虑波长数和建模精度设计了一种最优波长评价方法,将波长数进一步减少到3~4个。最后,提取使用U-Net网络分割的彩色图像颜色和纹理特征,和光谱反射率特征一起作为输入,基于自注意力机制-双向长短时记忆(Self-Attention-BiLSTM)网络构建了3种元素含量的预测模型。实验结果表明,氮磷钾含量预测的R2分别为0.961、0.954、0.958,RMSE分别为0.294%、0.262%、0.196%,实现了很好的建模效果。使用该模型对另2个品种西瓜进行测试,R2超过0.899、RMSE小于0.498%,表明该模型具有很好的泛化性。该高光谱建模方法使用少量波长光谱即实现了高精度检测,在精度和效率上达成了很好的平衡,为后续便携式高光谱检测装备开发奠定了理论基础。

Self-Healable and Stretchable PAAc/XG/Bi_(2)Se_(0.3)Te_(2.7) Hybrid Hydrogel Thermoelectric Materials

Thermoelectric power generators have attracted increasing interest in recent years owing to their great potential in wearable electronics power supply.It is noted that thermoelectric power generators are easy to damage in the dynamic service process,resulting in the formation of microcracks and performance degradation.Herein,we prepare a new hybrid hydrogel thermoelectric material PAAc/XG/Bi_(2)Se_(0.3)Te_(2.7)by an in situ polymerization method,which shows a high stretchable and self-healable performance,as well as a good thermoelectric performance.For the sample with Bi_(2)Se_(0.3)Te_(2.7)content of 1.5 wt%(i.e.,PAAc/XG/Bi2Se0.3Te27(1.5 wt%)),which has a room temperature Seebeck coefficient of-0.45 mV K^(-1),and exhibits an open-circuit voltage of-17.91 mV and output power of 38.1 nW at a temperature difference of 40 K.After being completely cut off,the hybrid thermoelectric hydrogel automatically recovers its electrical characteristics within a response time of 2.0 s,and the healed hydrogel remains more than 99%of its initial power output.Such stretchable and self-healable hybrid hydrogel thermoelectric materials show promising potential for application in dynamic service conditions,such as wearable electronics.

RepBoTNet-CESA:An Alzheimer’s Disease Computer Aided Diagnosis Method Using Structural Reparameterization BoTNet and Cubic Embedding Self Attention

Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on local features,thus encountering difficulties in handling global features.In contrast to natural images,Structural Magnetic Resonance Imaging(sMRI)images exhibit a higher number of channel dimensions.However,during the Position Embedding stage ofMulti Head Self Attention(MHSA),the coded information related to the channel dimension is disregarded.To tackle these issues,we propose theRepBoTNet-CESA network,an advanced AD-aided diagnostic model that is capable of learning local and global features simultaneously.It combines the advantages of CNN networks in capturing local information and Transformer networks in integrating global information,reducing computational costs while achieving excellent classification performance.Moreover,it uses the Cubic Embedding Self Attention(CESA)proposed in this paper to incorporate the channel code information,enhancing the classification performance within the Transformer structure.Finally,the RepBoTNet-CESA performs well in various AD-aided diagnosis tasks,with an accuracy of 96.58%,precision of 97.26%,and recall of 96.23%in the AD/NC task;an accuracy of 92.75%,precision of 92.84%,and recall of 93.18%in the EMCI/NC task;and an accuracy of 80.97%,precision of 83.86%,and recall of 80.91%in the AD/EMCI/LMCI/NC task.This demonstrates that RepBoTNet-CESA delivers outstanding outcomes in various AD-aided diagnostic tasks.Furthermore,our study has shown that MHSA exhibits superior performance compared to conventional attention mechanisms in enhancing ResNet performance.Besides,the Deeper RepBoTNet-CESA network fails to make further progress in AD-aided diagnostic tasks.

Research on the Control Cover against Solenopsis invicta and Rapid Extinguishment of Its Epidemic

Based on the biological characteristics of Solenopsis invicta and the structural characteristics of its ant nest,a fast and efficient closed treatment device was developed.Compared with the simple chemical treatment commonly used at present,the developed treatment device(the ant nest control cover)is a fast and efficient method to exterminate S.invicta in 7 d,featured by short course,quick results and good effect.

Unified Description of the Three Stable Particles in Self-Action Allows Determination of Their Relative Masses

The Dirac equation γμ(δμ-eAμ)Ψ=mc2Ψ describes the bound states of the electron under the action of external potentials, Aμ. We assumed that the fundamental form of the Dirac equation γμ(δμ-Sμ)Ψ=0 should describe the stable particles (the electron, the proton and the dark-matter-particle (dmp)) bound to themselves under the action of their own potentials Sμ. The new equation reveals that self energy is consequence of self action, it also reveals that the spin angular momentum is consequence of the dynamic structure of the stable particles. The quantitative results are the determination of their relative masses as well as the determination of the electromagnetic coupling constant.

Safety and efficacy of Kaffes intraductal self-expanding metal stents in the management of post-liver transplant anastomotic strictures

BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic strictures.Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is scarce.Due to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy.This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.METHODS Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query.Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records.The main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 months.Stent efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 d.RESULTS During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course.In 33 ERCPs,the stent was removed or exchanged on a 3-month interval.No pancreatitis,perfor-ations or deaths occurred.Minor post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=0.40.All strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 months.The recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a single ERCP with Kaffes,21 with removal after 120 d and 7 within 120 d.There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course(71.0%vs 10.0%,P=0.01).CONCLUSION Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.

Correlation Analysis between Self-Disclosure and Social Support in Patients with Breast Cancer

Objective: Describe the status quo of self-disclosure and social support in breast cancer patients and analyze the correlation between them. Methods: General data questionnaire, distress disclosure Index scale and Chinese version of medical social support scale were used to investigate the correlation between self-disclosure and social support in breast cancer patients by Pearson correlation analysis. Results: 1) The total self-disclosure score was (38.75 ± 9.18);the total score of social support was (70.57 ± 14.04) scores, including emotional information support dimension (28.39 ± 6.06) scores, practical support dimension (15.62 ± 3.31) scores, elastic support dimension (14.85 ± 3.23) scores, and emotional support dimension (11.70 ± 2.56) scores. 2) Self-disclosure was positively correlated with social support (r = 0.433, p Conclusion: Breast cancer patients had a moderate level of self-disclosure, and the higher the level of self-disclosure, the better the social support. It is suggested that improving the self-disclosure level of breast cancer patients can help them obtain more social support.

Socio-Economic and Health Indicators’ Relation to Self-Assessed Health: A Case Study of Phai Tha Pho, Phichit Province, Thailand

Background: Self-assessed health (SAH) is used as a common method of sociology research to understand the implications of self-reported health and the link to social factors like education, income, and occupation. The paper explores the impact of socio-economic and health indicators on self-assessed health in the middle-aged to the senior population in a rural community in Thailand. Methods: Primary data were collected after conducting a randomized sampling for 100 people using direct interviews in two locations within the sub-district of Phai Tha Pho, Thailand. The target demographic was the middle-age to elderly population. A logit model was applied to the collected samples. Results: The study highlights that higher education, income, and sleep are high predictors for positive SAH while high blood sugar level has significant adverse effects on SAH. Detection of metabolic syndrome further indicates degraded overall health perception over time. Conclusion: The study demonstrated the relationship between socio-economic indicators and illnesses alongside individual SAH in rural Thailand. Accordingly, policies have been proposed that include targeted subsidies for healthy food alternatives, promoting work-rest balance at all levels, and an expansion of sub-district education up to secondary school. SAH can be performed regularly and expanded across communities including areas of low-income living due to its low implementation costs. It could also be used as a tool to support the government’s public health initiatives complementing the existing five-year direct health check-up programme. A comparative study of SAH across regions is recommended for future research.

Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.

基于BERT-SELFATT-CNN模型的垃圾邮件分类方法

针对传统垃圾邮件分类方法中使用静态词向量不能解决一词多义、长序列信息特征提取不足等问题,提出了一种基于BERT-SELFATT-CNN模型的垃圾邮件分类方法。使用动态文本表示方法BERT对邮件内容进行预训练,并生成带有上下语义信息的词向量,经过能够并行计算的自注意力机制层计算词与词之间的相似度去挖掘句子长距离信息,将生成的隐藏层向量输入到CNN网络提取向量局部特征。在中文垃圾邮件数据集上与已有模型进行对比实验,结果表明该模型在精确度、召回率和F1值上均有提高,模型训练速度也得到提升。

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.

基于Self-CGRU模型的地铁基坑周边地表沉降预测

为提升地铁基坑开挖引发的地表沉降的预测精度,基于自注意力机制和深度学习提出一种能捕捉沉降数据时空特性的深度注意力组合预测模型(self-attention convolutional gated recurrent units,Self-CGRU)。Self-CGRU模型由空间模块和时间模块搭建。空间模块中,选择卷积神经网络捕捉相邻监测点沉降数据的空间相关性;时间模块中,使用门控循环单元神经网络分析沉降数据的时间规律,并引入自注意力机制捕获沉降数据内部的自相关性,进而得到沉降预测值。选取中国深圳市地铁基坑周边地表沉降数据验证Self-CGRU模型,结果表明:相比现有模型,Self-CGRU模型预测性能更好,使预测精度提高了17.48%~29.17%。研究成果可为地铁基坑周边地表沉降预测提供一种准确且稳定的新模型。

Practice of Glycemic Self-Monitoring in Diabetic Patients Followed at the Endocrinology Department of Donka University Hospital in Guinea

Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.

Surface and Content Validity of an Advanced Beginner Nurse’s Self-Monitoring Scale While Multitasking

Background: Self-monitoring is important for recognizing the situations one is facing and assessing one’s own competence to respond appropriately to situations that require multitasking. Purpose: This study aimed to examine the surface and content validity of the Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking and refine the scale items accordingly. It is expected that the development of such scale will allow for reflection on advanced beginner nurses’ response to multitasking, leading to further capacity building. Methods: The surface validity of 96 items of the Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking was examined at a meeting with five expert researchers. Five researchers and five nurses examined the items’ content using an item-level content validity index through a questionnaire survey. Results and Conclusion: The Advanced Beginner Nurses’ Self-Monitoring Scale While Multitasking was organized into 73 items that were refined into scales with surface and content validity. Consequently, five sub-concepts were identified: recognizing the situation one’s facing, seeing one’s self from multiple perspectives, devising concrete strategies depending on the situation, considering a predictable time schedule, and being aware of the situation surrounding one’s self. In the future, it will be necessary to examine the reliability and validity of the scale.

On the Adaptability Range, Self-Selection, and Economic Nature of Biological Evolution

This article employs a combined approach of biology and economics to reveal that biological evolution has an economic nature, evolving towards improved energy efficiency. The orthodox Darwinian theory of evolution describes evolution as the random variation of organisms and their survival through natural selection. In fact, the natural environment itself is a constantly changing context, and the strategy to adapt to this change is to enhance behavioral capabilities, thereby expanding the range and dimensions of behavior. Therefore, the improvement of behavioral capabilities is an important aspect of evolution. The enhancement of behavioral capabilities expands the range of adaptation to the natural environment and increases the space for behavioral choices. Within this space of behavioral choices, some options are more effective and superior to others;thus, the ability to select is necessary to make the improved behavioral capabilities more beneficial to the organism itself. The birth and development of the brain serve the purpose of selection. By using the brain to make selections, at least the “better” behavior will be chosen between two alternatives. Once the better behavior yields better results, and the organism can associate these results with the corresponding behavior, it will persist in this behavior. The persistent repetition of a behavior over generations will form a habit. Habits passed down through generations constitute a new environment, causing the organism’s genes to activate or deactivate certain functions, ultimately leading to genetic changes that are beneficial to that habit. Since the brain’s selection represents the organism’s self-selection, it differs from random variation;it is also a rational selection, choosing behaviors that either obtain more energy or reduce energy consumption. Thus, this evolution possesses an economic nature.

Awareness, Practice and Intention to Practice Testicular Self-Examination among Professional Working Males in Ghana

Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, urogenital malformations, testicular atrophy, and infertility. Given the lack of scientific data on the causes of the disease, it has been asserted in previous studies that the promotion of awareness and early detection are prerequisites to mitigating risks of metastasis as well as improving survival. This study is to assess the awareness, practice, and intention to practice testicular self-examination among professional working males in Accra. Methods: A quantitative cross-sectional design with a structured research instrument was used to collect data from respondants. The purposive and convenience sampling techniques were used to collect data from 300 men at Accra in Ghana. The study was conducted at two (2) Universities and a Senior High school at Accra in Ghana. The data was then analysed using descriptive statistics, logistic regression, multiple linear regression, and structural equation modeling. Results: From the study findings, 37% of male participants rated their knowledge of testicular self-examination and related symptoms as good, 28% of participants practised testicular self-examination monthly, while 65% of respondents expressed their intention to practice monthly testicular self-examination. The findings from logistic regression demonstrated that level of education, age, and marital status of participants had a significant influence on testicular self-examination. Additionally, the multiple linear regression results revealed knowledge and self-efficacy significantly predict testicular self-examination intention. The path coefficient results from the structural equation model are consistent with results from the regression models. Conclusion: This research is the first to investigate testicular self-examination among men in Ghana. The findings revealed awareness and practice of TSE are low among participants. Therefore, the research findings would improve the expertise of physicians and nurses in providing counsel, intervention, and support for patients at risk of testicular cancer.

Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.