With the development of urbanization,the problem of neurological diseases brought about by population aging has gradually become a social problem of worldwide concern.Aging leads to gradual degeneration of the central...With the development of urbanization,the problem of neurological diseases brought about by population aging has gradually become a social problem of worldwide concern.Aging leads to gradual degeneration of the central nervous system,shrinkage of brain tissue,and decline in physical function in many elderlies,making them susceptible to neurological diseases such as Alzheimer’s disease(AD),stroke,Parkinson’s and major depressive disorder(MDD).Due to the influence of these neurological diseases,the elderly have troubles such as memory loss,inability to move,falling,and getting lost,which seriously affect their quality of life.Tracking and positioning of elderly with neurological diseases and keeping track of their location in real-time are necessary and crucial in order to detect and treat dangerous and unexpected situations in time.Considering that the elderly with neurological diseases forget to wear a positioning device or have mobility problems due to carrying a positioning device,device-free positioning as a passive positioning technology that detects device-free individuals is more suitable than traditional active positioning for the home-based care of the elderly with neurological diseases.This paper provides an extensive and in-depth survey of device-free indoor positioning technology for home-based care and an in-depth analysis of the main features of current positioning systems,as well as the techniques,technologies andmethods they employ,fromthe perspective of the needs of the elderly with neurological conditions.Moreover,evaluation criteria and possible solutions of positioning techniques for the home-based care of the elderly with neurological conditions are proposed.Finally,the opportunities and challenges for the development of indoor positioning technology in 6G mobile networks for home-based care of the elderly with neurological diseases are discussed.This review has provided comprehensive and effective tracking and positioning techniques,technologies and methods for the elderly,by which we can obtain the location information of the elderly in real-time and make home-based care more comfortable and safer for the elderly with neurological diseases.展开更多
Objective:To systematically evaluate the willingness rate of the community to provide for the aged at home and analyze its influencing factors.Methods:By searching the CNKI,VIP,Wanfang,we collected literature on the w...Objective:To systematically evaluate the willingness rate of the community to provide for the aged at home and analyze its influencing factors.Methods:By searching the CNKI,VIP,Wanfang,we collected literature on the willingness of the elderly in the community to provide for the aged from 2011 to 2021,extracted the data,and evaluated the quality of the included literature.Then,CMA 2.0 software was used for Meta-analysis.Results:A total of 13 articles were included in this study,and 16,402 people over 60 years old were surveyed,1782 people were willing to provide for the aged at home in the community,with a total willingness rate of 11%(95%CI:9%to 26%).The results of subgroup analysis showed that there was a statistically significant difference in the community home care willingness rate of elderly people with different gender,education levels,marital status,monthly income,living alone,the number of children,and residence(P<0.05).There was not any statistically significant difference in the willingness rate of the elderly with different ages,chronic diseases,self-care ability,and loneliness(P>0.05).Conclusion:The overall willingness rate of the elderly in the community of the elderly is relatively low in China.Gender,education level,marital status,monthly income,living alone,number of children,and residence are factors affecting the prediction of community elderly will.展开更多
Smart home-based care for elderly is the product of the “Internet+” era, along with the information technology and the growing needs for a better elderly life. In order to understand the influencing factors of smart...Smart home-based care for elderly is the product of the “Internet+” era, along with the information technology and the growing needs for a better elderly life. In order to understand the influencing factors of smart home care in Hengshui city, this paper selected 183 elderly people through a questionnaire survey. The conclusion of the study showed that education level, economic status, sleep quality and residence conditions are the influencing factors affecting the needs of smart home care of the elderly (p 0.05). Smart home care products for the elderly have a high willingness to use them, especially in terms of life care, medical services and emotional talk, but the compliance still needs to be improved. Development countermeasures suitable for Hengshui city can be put forward through the publicity of smart elderly care services, promoting the construction of demand-oriented big data, and promoting the participation of various forces.展开更多
Objective:To develop a home-based care plan for the elderly person with chronic diseases based on the status of their home-based care needs and relevant literature.Methods:The clinical data consisted of 132 patients w...Objective:To develop a home-based care plan for the elderly person with chronic diseases based on the status of their home-based care needs and relevant literature.Methods:The clinical data consisted of 132 patients who were 60-year-old or older with chronic diseases from June 2019 to May 2020 were selected and categorized into control and treatment groups of 66 patients each.For the experimental group,a care team for chronically ill elderly receiving regular post-treatment bome-based care.Meanwhile,a general clinical care team for chronically ill elderly receiving regular treatment for the control group.The effectiveness of these two healthcare models was evaluated and analyzed.Results:Results showed that satisfaction and effectiveness of home-based care among the elderly with chronic diseases were statistically better(P<0.05)than those in the usual care group.Conclusion:Providing home-based care services to elderly patients with chronic illnesses helps them to improve their chronic disease condition,patients are more receptive to home care,and patients have higher rates of recovery and treatment satisfaction.展开更多
In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(I...In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.展开更多
Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for...Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.展开更多
Background: The goal of preconception care is to improve the outcome of a mother’s pregnancy and childbirth. Nevertheless, in most developing nations;Zambia included, there are still issues with implementation of pre...Background: The goal of preconception care is to improve the outcome of a mother’s pregnancy and childbirth. Nevertheless, in most developing nations;Zambia included, there are still issues with implementation of preconception care. Therefore, the aim of this study was to establish the provision of preconception care by midwives, nurses and doctors at Ndola Teaching Hospital in Zambia. Methods: A concurrent embedded mixed methodology utilising a descriptive explorative study design, where 107 respondents were randomly selected using the lottery technique for quantitative part and two focused group discussions for qualitative part of the study was used. A self-administered questionnaire was used to collect quantitative data and a focus group discussion guide was used for the focus group discussions. Statistical Package of Social Sciences version 26 with significance set at 0.05 and at 95% confidence level and thematic analysis were used for data analysis. Results: 75% of the respondents in this study were not providing preconception care and only 25% of respondents were providing preconception care;however, this was provided randomly because there were no guidelines to follow. Among the respondents, 81.3% had medium knowledge, 70.1% had good practices and 92.5% had positive attitudes towards preconception care. Further analysis showed that the association between preconception care and knowledge, practices and attitudes was not statistically significant (p = values 0.336;0.344;1.000 respectively). Multivariate logistic regression revealed that participants with high knowledge were five times more likely to provide preconception care (OR = 5.00, CI = 0.42 - 59.7, P = 0.203). Generally, all the participants acknowledged that preconception care was an important package that could prevent maternal and child morbidities and mortalities. Conclusions: The study revealed that most of the respondents were not providing preconception care. Provision of preconception was done by a small fraction of the respondents and it was done in an unorderly manner due to lack of set standards and guidelines. Despite medium levels of knowledge and generally good practices and positive attitudes towards preconception care, its random provision indicates a need for established standards to enhance maternal and child health outcomes.展开更多
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. Neurobeha...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.展开更多
Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, ac...Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. Methods and Material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (M/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. Mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.展开更多
In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combi...In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.展开更多
Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive Care Unit (ICU). Material and Methods: An observational ...Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive Care Unit (ICU). Material and Methods: An observational retrospective study was conducted on intoxicated patients who admitted to ICU between January 2022 and January 2024. Data were collected from the patients medical records. The demographic characteristics, causes of intoxications, clinical parameters, the mean stay in the ICU, treatment modalities and prognosis were recorded. Results: A total of 2875 critically ill patients were admitted during the study period, and 109 (3.79%) of them were acute intoxications. Their mean of ages was 38.09 ± 12.29. The female-to-male ratio was 1.37/1. Drugs were found to be the primary cause (62.39%) of intoxications, and analgesics, antidepressants, and antibiotics were the most frequent agents. Suicidal attempts were present in 66 patients, most of them were female (62.13%) and between 17 - 24 years (40.91%). The other common causes of intoxications were carbon monoxide (CO) (22.02%), methyl/ethyl alcohol (8.26%) and mushroom (5.50%). The mean stay in the ICU was 2.69 ± 0.89 days. Mechanical ventilation was applied to 10 of our patients. Renal replacement therapy was required in 6 patients. Despite all treatments, 6 of our patients died, and we found the mortality rate to be 5.50%. Conclusion: Intoxications were more frequent in young female patients and drugs were the most common cause with suicidal intent. Unfortunately, CO poisoning continues to be a very important problem in our city. These findings provided significant information about the characteristics of intoxications in Karabuk.展开更多
Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) ...Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.展开更多
Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts o...Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts of ozone in the air through lightning to purify the ecological environment. The product of ozone decomposition is oxygen, without secondary pollution. Ozone sterilizer is widely used in the epidemic prevention and control of intensive breeding farms and achieved remarkable results. If the concentration and action time of ozone can be accurately controlled, then ozone can quickly eliminate pathogens, without harming the normal cells in the human body. How to use medical ozone for epidemic prevention, treatment and health care is a subject worthy of serious study, which should arouse the attention of the experts in the field.展开更多
Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest d...Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic landscape in critical care medicine,where technology,research,and patient-centered approaches converge to improve the quality of care and save lives in ICUs.The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.展开更多
BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly co...BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Curren...Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.展开更多
BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modi...BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.展开更多
In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machin...In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machine learning methodologies.The study employed a multilayer perceptron neural network to accurately predict the incidence of ICU-AW,focusing on critical variables such as ICU stay duration and mechanical ventilation.This research marks a significant advancement in applying machine learning to clinical diagnostics,offering a new paradigm for predictive medicine in critical care.It underscores the importance of integrating artificial intelligence technologies in clinical practice to enhance patient management strategies and calls for interdisciplinary collaboration to drive innovation in healthcare.展开更多
The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend...The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend beyond traditional confines of the operating theatres,finding diverse applications in intensive care settings.In the dynamic landscape of intensive care,volatile anesthetics emerge as a promising avenue for addressing complex sedation requirements,managing refractory lung pathologies including acute respiratory distress syndrome and status asthmaticus,conditions of high sedative requirements including burns,high opioid or alcohol use and neurological conditions such as status epilepticus.Volatile anesthetics can be administered through either inhaled route via anesthetic machines/devices or through extracorporeal membrane oxygenation circuitry,providing intensivists with multiple options to tailor therapy.Furthermore,their unique pharmacokinetic profiles render them titratable and empower clinicians to individualize management with heightened accuracy,mitigating risks associated with conventional sedation modalities.Despite the amounting enthusiasm for the use of these therapies,barriers to widespread utilization include expanding equipment availability,staff familiarity and training of safe use.This article delves into the realm of applying inhaled volatile anesthetics in the intensive care unit through discussing their pharmacology,administration considerations in intensive care settings,complication considerations,and listing indications and evidence of the use of volatile anesthetics in the critically ill patient population.展开更多
基金supported by the National Natural Science Foundation of China under Grant No.61701284the Innovative Research Foundation of Qingdao under Grant No.19-6-2-1-CG+5 种基金the Elite Plan Project of Shandong University of Science and Technology under Grant No.skr21-3-B-048the Sci.&Tech.Development Fund of Shandong Province of China under Grant Nos.ZR202102230289,ZR202102250695,and ZR2019LZH001the Humanities and Social Science Research Project of the Ministry of Education under Grant No.18YJAZH017the Taishan Scholar Program of Shandong Province,the Shandong Chongqing Science and Technology Cooperation Project under Grant No.cstc2020jscx-lyjsAX0008the Sci.&Tech.Development Fund of Qingdao under Grant No.21-1-5-zlyj-1-zc,SDUST Research Fund under Grant No.2015TDJH102the Science and Technology Support Plan of Youth Innovation Team of Shandong higher School under Grant No.2019KJN024.
文摘With the development of urbanization,the problem of neurological diseases brought about by population aging has gradually become a social problem of worldwide concern.Aging leads to gradual degeneration of the central nervous system,shrinkage of brain tissue,and decline in physical function in many elderlies,making them susceptible to neurological diseases such as Alzheimer’s disease(AD),stroke,Parkinson’s and major depressive disorder(MDD).Due to the influence of these neurological diseases,the elderly have troubles such as memory loss,inability to move,falling,and getting lost,which seriously affect their quality of life.Tracking and positioning of elderly with neurological diseases and keeping track of their location in real-time are necessary and crucial in order to detect and treat dangerous and unexpected situations in time.Considering that the elderly with neurological diseases forget to wear a positioning device or have mobility problems due to carrying a positioning device,device-free positioning as a passive positioning technology that detects device-free individuals is more suitable than traditional active positioning for the home-based care of the elderly with neurological diseases.This paper provides an extensive and in-depth survey of device-free indoor positioning technology for home-based care and an in-depth analysis of the main features of current positioning systems,as well as the techniques,technologies andmethods they employ,fromthe perspective of the needs of the elderly with neurological conditions.Moreover,evaluation criteria and possible solutions of positioning techniques for the home-based care of the elderly with neurological conditions are proposed.Finally,the opportunities and challenges for the development of indoor positioning technology in 6G mobile networks for home-based care of the elderly with neurological diseases are discussed.This review has provided comprehensive and effective tracking and positioning techniques,technologies and methods for the elderly,by which we can obtain the location information of the elderly in real-time and make home-based care more comfortable and safer for the elderly with neurological diseases.
基金supported by Project of Henan Federation of Social Sciences in 2021(NO.SKL-2021-415)Anyang science and Technology development plan project in 2020(Project No.228).
文摘Objective:To systematically evaluate the willingness rate of the community to provide for the aged at home and analyze its influencing factors.Methods:By searching the CNKI,VIP,Wanfang,we collected literature on the willingness of the elderly in the community to provide for the aged from 2011 to 2021,extracted the data,and evaluated the quality of the included literature.Then,CMA 2.0 software was used for Meta-analysis.Results:A total of 13 articles were included in this study,and 16,402 people over 60 years old were surveyed,1782 people were willing to provide for the aged at home in the community,with a total willingness rate of 11%(95%CI:9%to 26%).The results of subgroup analysis showed that there was a statistically significant difference in the community home care willingness rate of elderly people with different gender,education levels,marital status,monthly income,living alone,the number of children,and residence(P<0.05).There was not any statistically significant difference in the willingness rate of the elderly with different ages,chronic diseases,self-care ability,and loneliness(P>0.05).Conclusion:The overall willingness rate of the elderly in the community of the elderly is relatively low in China.Gender,education level,marital status,monthly income,living alone,number of children,and residence are factors affecting the prediction of community elderly will.
文摘Smart home-based care for elderly is the product of the “Internet+” era, along with the information technology and the growing needs for a better elderly life. In order to understand the influencing factors of smart home care in Hengshui city, this paper selected 183 elderly people through a questionnaire survey. The conclusion of the study showed that education level, economic status, sleep quality and residence conditions are the influencing factors affecting the needs of smart home care of the elderly (p 0.05). Smart home care products for the elderly have a high willingness to use them, especially in terms of life care, medical services and emotional talk, but the compliance still needs to be improved. Development countermeasures suitable for Hengshui city can be put forward through the publicity of smart elderly care services, promoting the construction of demand-oriented big data, and promoting the participation of various forces.
文摘Objective:To develop a home-based care plan for the elderly person with chronic diseases based on the status of their home-based care needs and relevant literature.Methods:The clinical data consisted of 132 patients who were 60-year-old or older with chronic diseases from June 2019 to May 2020 were selected and categorized into control and treatment groups of 66 patients each.For the experimental group,a care team for chronically ill elderly receiving regular post-treatment bome-based care.Meanwhile,a general clinical care team for chronically ill elderly receiving regular treatment for the control group.The effectiveness of these two healthcare models was evaluated and analyzed.Results:Results showed that satisfaction and effectiveness of home-based care among the elderly with chronic diseases were statistically better(P<0.05)than those in the usual care group.Conclusion:Providing home-based care services to elderly patients with chronic illnesses helps them to improve their chronic disease condition,patients are more receptive to home care,and patients have higher rates of recovery and treatment satisfaction.
文摘In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.
文摘Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.
文摘Background: The goal of preconception care is to improve the outcome of a mother’s pregnancy and childbirth. Nevertheless, in most developing nations;Zambia included, there are still issues with implementation of preconception care. Therefore, the aim of this study was to establish the provision of preconception care by midwives, nurses and doctors at Ndola Teaching Hospital in Zambia. Methods: A concurrent embedded mixed methodology utilising a descriptive explorative study design, where 107 respondents were randomly selected using the lottery technique for quantitative part and two focused group discussions for qualitative part of the study was used. A self-administered questionnaire was used to collect quantitative data and a focus group discussion guide was used for the focus group discussions. Statistical Package of Social Sciences version 26 with significance set at 0.05 and at 95% confidence level and thematic analysis were used for data analysis. Results: 75% of the respondents in this study were not providing preconception care and only 25% of respondents were providing preconception care;however, this was provided randomly because there were no guidelines to follow. Among the respondents, 81.3% had medium knowledge, 70.1% had good practices and 92.5% had positive attitudes towards preconception care. Further analysis showed that the association between preconception care and knowledge, practices and attitudes was not statistically significant (p = values 0.336;0.344;1.000 respectively). Multivariate logistic regression revealed that participants with high knowledge were five times more likely to provide preconception care (OR = 5.00, CI = 0.42 - 59.7, P = 0.203). Generally, all the participants acknowledged that preconception care was an important package that could prevent maternal and child morbidities and mortalities. Conclusions: The study revealed that most of the respondents were not providing preconception care. Provision of preconception was done by a small fraction of the respondents and it was done in an unorderly manner due to lack of set standards and guidelines. Despite medium levels of knowledge and generally good practices and positive attitudes towards preconception care, its random provision indicates a need for established standards to enhance maternal and child health outcomes.
文摘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.
文摘Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. Methods and Material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (M/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. Mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.
文摘In the last decade, the long-term survival among people living with HIV (PLHIV) has significantly improved. This is accompanied by an increased burden of non-communicable diseases such as hypertension due to the combined effect of the aging population and the metabolic effect of the Human Immuno-deficiency Virus (HIV) virion and antiretroviral therapy. This study aims to assess the prevalence and factors associated with hypertension among people living with HIV in three large health facilities in Nasarawa State, Nigeria. A descriptive cross-sectional study employed a multistage sampling technique to select 309 adults with HIV, 18 years and above, receiving HIV care in three large health facilities in Nasarawa State. The outcome variable was the participants’ self-reported history of hypertension, confirmed through a positive history of hypertension treatment. Exposure variables included the participant’s socio-demographic characteristics, lifestyle factors, and HIV care and treatment history. Data were presented using frequency tables. Factors associated with hypertension were assessed using binary logistic regression at a 0.05 level of statistical significance. A total of 309 adults living with HIV were sampled. A larger percentage of the participants were married 228 (73.8%), female, 191 (61.8%), within the age group 41 - 50 years, 141 (45.6%). Most of the participants had no family history of hypertension, 188 (60.8%). The prevalence of self-reported hypertension was 11.0% (34/309). Factors associated with hypertension at the bivariate level were age group 21 - 30 years, 41 - 50 years, being widow/widower, divorced, retired from employment or with family history of hypertension. Only participants age group 31 - 40 years [Adjusted Odd Ratio (AOR): 0.18, 95%CI: 0.04 - 0.91, p = 0.04] and family history of hypertension [(AOR): 83.44, 95%CI: 15.75 - 442.11, p < 0.01] were found to predict hypertension among the study participants after adjusting for confounders. In conclusion, Hypertension remains a public health issue among PLHIV. Factors associated with hypertension among PLHIV include age and family history of hypertension. Regular screening for hypertension, its appropriate treatment and optimal control are essential in PLHIV.
文摘Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive Care Unit (ICU). Material and Methods: An observational retrospective study was conducted on intoxicated patients who admitted to ICU between January 2022 and January 2024. Data were collected from the patients medical records. The demographic characteristics, causes of intoxications, clinical parameters, the mean stay in the ICU, treatment modalities and prognosis were recorded. Results: A total of 2875 critically ill patients were admitted during the study period, and 109 (3.79%) of them were acute intoxications. Their mean of ages was 38.09 ± 12.29. The female-to-male ratio was 1.37/1. Drugs were found to be the primary cause (62.39%) of intoxications, and analgesics, antidepressants, and antibiotics were the most frequent agents. Suicidal attempts were present in 66 patients, most of them were female (62.13%) and between 17 - 24 years (40.91%). The other common causes of intoxications were carbon monoxide (CO) (22.02%), methyl/ethyl alcohol (8.26%) and mushroom (5.50%). The mean stay in the ICU was 2.69 ± 0.89 days. Mechanical ventilation was applied to 10 of our patients. Renal replacement therapy was required in 6 patients. Despite all treatments, 6 of our patients died, and we found the mortality rate to be 5.50%. Conclusion: Intoxications were more frequent in young female patients and drugs were the most common cause with suicidal intent. Unfortunately, CO poisoning continues to be a very important problem in our city. These findings provided significant information about the characteristics of intoxications in Karabuk.
文摘Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.
文摘Ozone is a green broad-spectrum bactericidal disinfectant, and a trace amount of ozone in the atmosphere makes many viruses and bacteria lose their biochemical activity and infectivity. Nature produces trace amounts of ozone in the air through lightning to purify the ecological environment. The product of ozone decomposition is oxygen, without secondary pollution. Ozone sterilizer is widely used in the epidemic prevention and control of intensive breeding farms and achieved remarkable results. If the concentration and action time of ozone can be accurately controlled, then ozone can quickly eliminate pathogens, without harming the normal cells in the human body. How to use medical ozone for epidemic prevention, treatment and health care is a subject worthy of serious study, which should arouse the attention of the experts in the field.
文摘Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic landscape in critical care medicine,where technology,research,and patient-centered approaches converge to improve the quality of care and save lives in ICUs.The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.
文摘BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
文摘Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.
基金Supported by Research Project of Zhejiang Provincial Department of Education,No.Y202045115.
文摘BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.
文摘In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machine learning methodologies.The study employed a multilayer perceptron neural network to accurately predict the incidence of ICU-AW,focusing on critical variables such as ICU stay duration and mechanical ventilation.This research marks a significant advancement in applying machine learning to clinical diagnostics,offering a new paradigm for predictive medicine in critical care.It underscores the importance of integrating artificial intelligence technologies in clinical practice to enhance patient management strategies and calls for interdisciplinary collaboration to drive innovation in healthcare.
文摘The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend beyond traditional confines of the operating theatres,finding diverse applications in intensive care settings.In the dynamic landscape of intensive care,volatile anesthetics emerge as a promising avenue for addressing complex sedation requirements,managing refractory lung pathologies including acute respiratory distress syndrome and status asthmaticus,conditions of high sedative requirements including burns,high opioid or alcohol use and neurological conditions such as status epilepticus.Volatile anesthetics can be administered through either inhaled route via anesthetic machines/devices or through extracorporeal membrane oxygenation circuitry,providing intensivists with multiple options to tailor therapy.Furthermore,their unique pharmacokinetic profiles render them titratable and empower clinicians to individualize management with heightened accuracy,mitigating risks associated with conventional sedation modalities.Despite the amounting enthusiasm for the use of these therapies,barriers to widespread utilization include expanding equipment availability,staff familiarity and training of safe use.This article delves into the realm of applying inhaled volatile anesthetics in the intensive care unit through discussing their pharmacology,administration considerations in intensive care settings,complication considerations,and listing indications and evidence of the use of volatile anesthetics in the critically ill patient population.
