Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.

Influencing factors of self-management ability among dry eye patients in west China

AIM:To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China.METHODS:A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University.All participants completed the rating scale of health self-management skill for adults(AHSMSRS),Huaxi Emotional-Distress Index(HEI),e-health literacy scale(e-HEALS)and Brief Illness Perception Questionnaire(Brief-IPQ).A generalized linear model was employed to establish a multivariate linear model with demographic data,psychological state,e-HEALS,and illness perception as independent variables and health selfmanagement skill score as the dependent variable.RESULTS:The mean score for health self-management skill was 165.58±15.79.Multivariate analysis revealed that advanced age,better illness perception and improved psychological state were associated with better health selfmanagement ability among dry eye patients.Furthermore,the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y.CONCLUSION:The health self-management ability of dry eye patients in west China is relatively high.Age,duration of disease,illness perception and psychological state are the influencing factors on the health selfmanagement ability of dry eye patients.

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.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Self-management in patients with diabetic foot ulcer:a concept analysis

Objective:This paper presents an analysis of the concept of patient outcomes.Methods:The present study conducted searches on various databases,including Wanfang,Sinomed,CNKI,Pub Med,Cochrane Library,Embase,Web of Science,and Ovid.The paper followed the Walker and Avant concept-analysis approach.Results:Initially,899 pieces of literature were identified through the search process,and after screening,41 of them were ultimately included in the analysis.The identified attributes of the concept included(1)capability,(2)decision making,and(3)action.These antecedents were shaped by factors such as illness perception,self-efficacy,and family and social.The consequences included(1)physiological effects,(2)psychological effects,and(3)social influence.Conclusions:The concept analysis of self-management in patients with diabetic foot ulcers(DFUs)not only aids in clinical practice and suppor ts interventions,but also contributes to the development of self-management theory.The common goal of clinical medical staff is to assist DFU patients in improving cognitive ability,making correct self-management decisions,and enhancing self-management behavior.

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

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

Conceptual Analysis of Self-Management in Patients with Hypertension

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

PAD Class教学模式对英语专业学生写作焦虑影响的实证研究

本研究以英语专业大一120名学生为实验对象,进行了为期16周的实证研究,以探讨PAD class教学模式对英语专业学生写作焦虑的影响。基于《二语写作焦虑量表》调查问卷结果表明:英语专业学生总体焦虑处于中等焦虑水平,PAD Class能有效降低学生的写作总体焦虑,其中课堂焦虑、构思焦虑、自信焦虑明显降低,但回避焦虑没有达到显著水平;PAD Class模式对高中低不同写作水平学生的写作焦虑都有影响,对中、低水平学生的写作焦虑缓解比对高水平学生的影响效果更明显。

Factors related to self-management behavior among persons with mild-to-moderate chronic obstructive pulmonary disease in Wenzhou,China

Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived social support,and SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Methods:A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou,China.Research instruments include a demographic data questionnaire,COPD SM scale,COPD knowledge questionnaire,6-item chronic disease self-efficacy scale,and perceived social suppor t scale.Descriptive statistics and Pearson's Correlation were used for data analysis.Results:The findings show that the mean score of COPD SM scale was 2.70(SD=0.45).The Pearson correlation analysis revealed that the COPD knowledge(r=0.47,P<0.001),self-efficacy(r=0.28,P=0.001),and perceived social support(r=0.48,P<0.001)were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Conclusions:The findings indicate that disease knowledge,self-efficacy,and perceived social support were related to SM behavior in persons with mild-to-moderate COPD,which provides a theoretical basis for developing SM interventions for persons with mildto-moderate COPD and improving this population's SM behavior.

Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders:A case report and review of literature

BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.

Class Imbalanced Problem:Taxonomy,Open Challenges,Applications and State-of-the-Art Solutions

The study of machine learning has revealed that it can unleash new applications in a variety of disciplines.Many limitations limit their expressiveness,and researchers are working to overcome them to fully exploit the power of data-driven machine learning(ML)and deep learning(DL)techniques.The data imbalance presents major hurdles for classification and prediction problems in machine learning,restricting data analytics and acquiring relevant insights in practically all real-world research domains.In visual learning,network information security,failure prediction,digital marketing,healthcare,and a variety of other domains,raw data suffers from a biased data distribution of one class over the other.This article aims to present a taxonomy of the approaches for handling imbalanced data problems and their comparative study on the classification metrics and their application areas.We have explored very recent trends of techniques employed for solutions to class imbalance problems in datasets and have also discussed their limitations.This article has also identified open challenges for further research in the direction of class data imbalance.

BLS-identification:A device fingerprint classification mechanism based on broad learning for Internet of Things

The popularity of the Internet of Things(IoT)has enabled a large number of vulnerable devices to connect to the Internet,bringing huge security risks.As a network-level security authentication method,device fingerprint based on machine learning has attracted considerable attention because it can detect vulnerable devices in complex and heterogeneous access phases.However,flexible and diversified IoT devices with limited resources increase dif-ficulty of the device fingerprint authentication method executed in IoT,because it needs to retrain the model network to deal with incremental features or types.To address this problem,a device fingerprinting mechanism based on a Broad Learning System(BLS)is proposed in this paper.The mechanism firstly characterizes IoT devices by traffic analysis based on the identifiable differences of the traffic data of IoT devices,and extracts feature parameters of the traffic packets.A hierarchical hybrid sampling method is designed at the preprocessing phase to improve the imbalanced data distribution and reconstruct the fingerprint dataset.The complexity of the dataset is reduced using Principal Component Analysis(PCA)and the device type is identified by training weights using BLS.The experimental results show that the proposed method can achieve state-of-the-art accuracy and spend less training time than other existing methods.

Extensive numerical simulations on competitive growth between the Edwards–Wilkinson and Kardar–Parisi–Zhang universality classes

Extensive numerical simulations and scaling analysis are performed to investigate competitive growth between the linear and nonlinear stochastic dynamic growth systems, which belong to the Edwards–Wilkinson(EW) and Kardar–Parisi–Zhang(KPZ) universality classes, respectively. The linear growth systems include the EW equation and the model of random deposition with surface relaxation(RDSR), the nonlinear growth systems involve the KPZ equation and typical discrete models including ballistic deposition(BD), etching, and restricted solid on solid(RSOS). The scaling exponents are obtained in both the(1 + 1)-and(2 + 1)-dimensional competitive growth with the nonlinear growth probability p and the linear proportion 1-p. Our results show that, when p changes from 0 to 1, there exist non-trivial crossover effects from EW to KPZ universality classes based on different competitive growth rules. Furthermore, the growth rate and the porosity are also estimated within various linear and nonlinear growths of cooperation and competition.

World Class Elite Breaststrokers Downward Kick EMG Muscle Activity of the Gluteus Maximus, Quadriceps Femoris, Hamstring, Gastrocnemius Medialis, Rectus Abdominal, and Erector Spinae

This study analyzed the difference between using a downward breaststroke kick and a horizontal breaststroke kick in a sample of world class elite swimmers.We compared average muscle activity of the gluteus maximus,quadriceps femoris(vastus medialis and rectus femoris),hamstring/long head of the biceps femoris,gastrocnemius medialis,rectus abdominal,and erector spinae when using the downward breaststroke kick technique.We find that when this sample of swimmers utilized the downward breaststroke kick,max speed and velocity per stroke increased,measured by 12,788 EMG samples,where the results are highly correlated to duration of the aerodynamic buoyant force in breaststroke kick technique.The increases in performance observed from measuring the world class elite swimmers is highly correlated to the duration of the kick aerodynamic buoyant force.Among this sample of elite swimmers,the longer a swimmer demonstrates a buoyant force breaststroke kick,the lower the time in a 100 breaststroke.

Simple and effective method for treating severe adult skeletal class II malocclusion: A case report

BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.

Research and Practice of Flipped Classroom Teaching Mode of Integrated Business English Course Under MOOC Environment

As an online course-teaching mode,Massive Open Online Course(MOOC)has drawn great attention from both teachers and students.It is necessary to give full play to the advantages of MOOC resources and to enhance teachers’consciousness of“identity remodeling”in the process of Integrated Business English flipping classroom teaching.Combining the advantages of MOOC and flipped classroom teaching during before-,during-,and after-class will greatly help promote the overall quality of business English teaching in universities.

Thin-Shell Wormholes Admitting Conformal Motions in Spacetimes of Embedding Class One

This paper discusses the feasibility of thin-shell wormholes in spacetimes of embedding class one admitting a one-parameter group of conformal motions. It is shown that the surface energy density σis positive, while the surface pressure is negative, resulting in , thereby signaling a violation of the null energy condition, a necessary condition for holding a wormhole open. For a Morris-Thorne wormhole, matter that violates the null energy condition is referred to as “exotic”. For the thin-shell wormholes in this paper, however, the violation has a physical explanation since it is a direct consequence of the embedding theory in conjunction with the assumption of conformal symmetry. These properties avoid the need to hypothesize the existence of the highly problematical exotic matter.

幼儿园自然探究活动中师幼互动的提升策略——基于CLASS评估调研分析

自然探究活动在培养幼儿实践能力与创造力方面具有显著优势,而活动中的师幼互动是保障活动质量的关键。使用CLASS评估系统,对广州市南沙区两所公办幼儿园教师在自然探究活动中的师幼互动情况展开实证调研的结果显示,教师在情感支持方面表现出积极态度,但在教育支持,尤其是促进幼儿概念发展和语言示范方面仍有待加强。其原因在于,教师科学素养较低,科学领域核心经验匮乏;教师组织管理能力存在短板,亟需深化有效教学策略;情感支持得分虚高,教师敏感性差异明显。基于此,需要加强专业培训,优化探究体验;提升师幼互动知识技能,补齐活动组织短板;优化情感支持策略,提升教师敏感性。

The Integration Strategy of Class Teacher Management and Mathematics Teaching

The professional and moral education of high school mathematics teachers will make classroom management work better,but their work pressure will also lead to classroom management problems.To do a good job in high school class teacher management and organically integrate it with mathematics teaching,we need to start from two aspects:mathematics teaching class teachers and class teacher work teaching,and penetrate mathematical thinking into daily classroom management,moral education,and classroom culture construction.Based on the attributes of the subject,we guide high school students to reflect after class to stimulate their self-management initiative through the cultivation of qualified class representatives.In addition,it is necessary to skillfully resolve classroom generative problems,change the roles of teachers and students,and integrate classroom management with mathematics teaching.

CLASS理论视域下幼儿园区域活动中师幼互动水平的提升

CLASS理论以其显著的优势评价新时期幼儿园区域活动师幼互动情况,其践行有利于在落实国家政策时践行素质教育,在和谐师生关系中促进身心健康。当前幼儿园区域活动中师幼互动的浅层化,削弱区域活动主题;情感支持不足制约幼儿园开展区域活动的连续性。教师应以CLASS理论为抓手,采用精准化的语言引导,善用教学机智,组织多种形式的师幼互动等,持续深化区域活动主题。教师应营造平等亲切的氛围,认真观察幼儿的有意义行为,有序推进幼儿的有意义行为,持续提升新时期区域活动师幼互动水平,促使幼儿全面发展,身心健康成长。