Search

BackgroundTelemonitoring studies in chronic heart failure are characterized by mixed mortality and hospitalization outcomes, which have deterred the uptake of telemonitoring in clinical practice. These mixed outcomes may reflect the diverse range of patient management strategies incorporated in telemonitoring. To address this, we compared the effects of different telemonitoring strategies on clinical outcomes. ObjectiveThe aim of this systematic review and subgroup meta-analysis was to identify noninvasive telemonitoring strategies attributing to improvements in all-cause mortality or hospitalization outcomes for patients with chronic heart failure. MethodsWe reviewed and analyzed telemonitoring strategies from randomized controlled trials (RCTs) comparing telemonitoring intervention with usual care. For each strategy, we examined whether RCTs that applied the strategy in the telemonitoring intervention (subgroup 1) resulted in a significantly lower risk ratio (RR) of all-cause mortality or incidence rate ratio (IRR) of all-cause hospitalization compared with RCTs that did not apply this strategy (subgroup 2). ResultsWe included 26 RCTs (N=11,450) incorporating 18 different telemonitoring strategies. RCTs that provided medication support were found to be associated with a significantly lower IRR value than RCTs that did not provide this type of support (P=.01; subgroup 1 IRR=0.83, 95% CI 0.72-0.95 vs subgroup 2 IRR=1.02, 95% CI 0.93-1.12). RCTs that applied mobile health were associated with a significantly lower IRR (P=.03; IRR=0.79, 95% CI 0.64-0.96 vs IRR=1.00, 95% CI 0.94-1.06) and RR (P=.01; RR=0.67, 95% CI 0.53-0.85 vs RR=0.95, 95% CI 0.84-1.07). ConclusionsTelemonitoring strategies involving medication support and mobile health were associated with improvements in all-cause mortality or hospitalization outcomes. These strategies should be prioritized in telemonitoring interventions for the management of patients with chronic heart failure.

BackgroundTelemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but the objective assessment of patient compliance with self-management recommendations has seldom been studied. ObjectiveThis study aimed to evaluate patient compliance with self-management recommendations of an innovative telemonitoring enhanced care program for CHF (ITEC-CHF). MethodsWe conducted a multicenter randomized controlled trial with a 6-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nurse care services to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least 4 days per week, analyzed objectively from weight recordings on the scales. The intention-to-treat principle was used to perform the analysis. ResultsA total of 184 participants (141/184, 76.6% male), with a mean age of 70.1 (SD 12.3) years, were randomized to receive either ITEC-CHF (n=91) or usual care (control; n=93), of which 67 ITEC-CHF and 81 control participants completed the intervention. For the compliance criterion of weighing at least 4 days per week, the proportion of compliant participants in the ITEC-CHF group was not significantly higher than that in the control group (ITEC-CHF: 67/91, 74% vs control: 56/91, 60%; P=.06). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least 6 days a week was significantly higher than that in the control group (ITEC-CHF: 41/91, 45% vs control: 23/93, 25%; P=.005). ConclusionsITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care. Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12614000916640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366691

Corrosion problem resulting from alternating ambient salt spray and high temperature oxidation poses a great threat to the safe service of aircraft engine during frequent start-stop in marine environment. In the present study，Ni25Cr5AlY coating is prepared on top of GH4169 superalloy substrate by direct-current（DC） magnetron sputtering. Corrosion behavior of the Ni25Cr5AlY coating is systematically studied by designing three different test conditions： high temperature oxidation at 1000 ℃，ambient salt spray，and alternating ambient salt spray and high temperature oxidation. The phase constitution and morphology of the corrosion products are analyzed by X-ray diffraction（XRD） and scanning electron microscopy（SEM）. The results indicate that after 168 h oxidation at 1000 ℃，the coating forms a dense and continuous Al2O3 scale which resists well against the oxidizing environment，while the coating suffers from pitting locally after 168 h salt spray test. After 168 h exposure to alternating ambient salt spray and high temperature oxidation test，the Al2O3 scale formed on the coating is damaged owing to the chlorine induced active oxidation mechanism，eventually resulting in Cr2O3 scale formation. In addition，the Cr2O3 scale is porous and cracks locally，which causes accelerated corrosion of the coating and internal oxidation of the coating and substrate. The corrosion degradation of the coating is accelerated under the synergistic effect of salt spray and high temperature oxidation. The GH4169 superalloy without the coating experiences severe scale spallation after 168 h exposure to the alternating test，featured by forming a poorly protective NiO scale with prevalent internal oxidation.

BackgroundAn ongoing challenge for smart homes research for aging-in-place is how to make sense of the large amounts of data from in-home sensors to facilitate real-time monitoring and develop reliable alerts. ObjectiveThe objective of our study was to explore the usefulness of a routine-based approach for making sense of smart home data for the elderly. MethodsMaximum variation sampling was used to select three cases for an in-depth mixed methods exploration of the daily routines of three elderly participants in a smart home trial using 180 days of power use and motion sensor data and longitudinal interview data. ResultsSensor data accurately matched self-reported routines. By comparing daily movement data with personal routines, it was possible to identify changes in routine that signaled illness, recovery from bereavement, and gradual deterioration of sleep quality and daily movement. Interview and sensor data also identified changes in routine with variations in temperature and daylight hours. ConclusionsThe findings demonstrated that a routine-based approach makes interpreting sensor data easy, intuitive, and transparent. They highlighted the importance of understanding and accounting for individual differences in preferences for routinization and the influence of the cyclical nature of daily routines, social or cultural rhythms, and seasonal changes in temperature and daylight hours when interpreting information based on sensor data. This research has demonstrated the usefulness of a routine-based approach for making sense of smart home data, which has furthered the understanding of the challenges that need to be addressed in order to make real-time monitoring and effective alerts a reality.

BackgroundThe high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (Web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males’ physical activity and dietary practices. ObjectiveThis study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention. MethodsParticipants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants’ physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months. ResultsA total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (P≥.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp(β)=1.45, 95% CI 1.09-1.95; exp(β)=1.61, 95% CI 1.17-2.22) and 9 months (exp(β)=1.55, 95% CI 1.14-2.10; exp(β)=1.51, 95% CI 1.15-2.00). Overall dietary behaviors improved at 3 months (exp(β)=1.07, 95% CI 1.03-1.11) and 9 months (exp(β)=1.10, 95% CI 1.05-1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp(β)=2.25, 95% CI 1.29-3.92; exp(β)=1.65, 95% CI 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp(β)=0.48, 95% CI 0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp(β)=1.70, 95% CI 1.02-2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively. ConclusionsThe ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes. Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12611000081910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910 (Archived by WebCite at http://www.webcitation.org/6QHIWad63).

BackgroundLifespace is a multidimensional construct that describes the geographic area in which a person lives and conducts their activities, and reflects mobility, health, and well-being. Traditionally, it has been measured by asking older people to self-report the length and frequency of trips taken and assistance required. Global Positioning System (GPS) sensors on smartphones have been used to measure Lifespace of older people, but not with people with Parkinson’s disease (PD). ObjectiveThe objective of this study was to investigate whether GPS data collected via smartphones could be used to indicate the Lifespace of people with PD. MethodsThe dataset was supplied via the Michael J Fox Foundation Data Challenge and included 9 people with PD and 7 approximately matched controls. Participants carried smartphones with GPS sensors over two months. Data analysis compared the PD group and the control group. The impact of symptom severity on Lifespace was also investigated. ResultsVisualization methods for comparing Lifespace were developed including scatterplots and heatmaps. Lifespace metrics for comparison included average daily distance, percentage of time spent at home, and number of trips into the community. There were no significant differences between the PD and the control groups on Lifespace metrics. Visual representations of Lifespace were organized based on the self-reported severity of symptoms, suggesting a trend of decreasing Lifespace with increasing PD symptoms. ConclusionsLifespace measured by GPS-enabled smartphones may be a useful concept to measure the progression of PD and the impact of various therapies and rehabilitation programs. Directions for future use of GPS-based Lifespace are provided.

Abstract Campus basketball culture is gradually affecting students’ sports spirit and sports accomplishment. As for the evaluation of basketball teaching achievements, the method of specified items is generally used for testing, which is highly subjective. It’s completely teacher-led, and teachers make relevant evaluations of students’ basketball behavior. Teachers can’t be absolutely fair and just in the evaluation, because teacher evaluation can be affected by many factors, such as teachers’ mood on that day, teachers’ affection for students, and so on, the traditional way of teacher basketball evaluation is easy to cause negative emotional impact on some students, so that students have negative emotions on basketball activities, and even affect their sports quality, and finally affect their health. Based on the evaluation method of basketball teaching, this paper introduced a reliability intelligent evaluation model based on swarm intelligence and edge computing and used this model to evaluate students’ performance in basketball teaching classes. Moreover, this paper designed a related experiment, the experimental results showed that boys and girls in basketball level gap was more obvious. As far as dribbling skills were concerned, the highest score of boy A was 91 points, while the lowest score of girl C was 54 points. The gap was quite large. At the same time, the introduction results of the reliability intelligent evaluation model were studied by using the questionnaire survey method. As can be seen from the results of the questionnaire, the number of people who are very interested in basketball teaching activities is obviously high, and the number of people who are still not interested in the six activities is no more than 2. Through the change data of students’ interests and attitudes, it was proved that the reliability intelligent evaluation model could improve the students’ enthusiasm for learning basketball courses, thus improving their sports quality. This study provided a reference value for the application of swarm intelligence and edge computing in the intelligent evaluation model of basketball teaching reliability, and provided a direction for the future development of basketball teaching.

The wheel hub is an important component of the wheel, and a good hub design can significantly improve vehicle handling, stability, and braking performance, ensuring safe driving. This article optimized the hub structure through morphological aspects, where reducing the hub weight contributed to enhanced fuel efficiency and overall vehicle performance. By referencing honeycombed structures, a bionic hub design is numerically simulated using finite element analysis and response surface optimization. The results showed that under the optimization of the response surface analytical model, the maximum stress of the optimized bionic hub was 109.34 MPa, compared to 119.77 MPa for the standard hub, representing an 8.7% reduction in maximum stress. The standard hub weighs 34.02 kg, while the optimized hub weight was reduced to 29.89 kg, a decrease of 12.13%. A fatigue analysis on the optimized hub indicated that at a stress of 109.34 MPa, the minimum load cycles were 4.217 × 105 at the connection point with the half-shaft, meeting the fatigue life requirements for commercial vehicle hubs outlined in the national standard GB/T 5334-2021. [ABSTRACT FROM AUTHOR]

BackgroundIgG4-related disease (IgG4-RD) is a rare fibro-inflammatory disease, which is prone to missed diagnosis or misdiagnosis due to nonspecific clinical manifestations.ObjectiveTo analyze the clinical characteristics of IgG4-related disease (IgG4-RD) .MethodsA retrospective design was adopted. Participants were 106 IgG4-RD patients recruited from the First Affiliated Hospital of Zhengzhou University from January 2015 to September 2019. Their clinical data were collected, including demographics, results of serological examinations, imaging examinations, histopathological examinations and treatment status. Data of follow-up conducted by telephone or checking medical history data as of January 1, 2020 were also collected.ResultsOf the 106 cases, 69 were male and 37 were female, with a mean age of onset of (54.6±13.1) years. The most common organs involved were lymph nodes (67.0%) , salivary glands (37.7%) , and pancreas (35.8%) . Single organ involvementoccurred in 17 patients (16.0%) . The median number of involved organs was 3 (2, 4) . Women had higher incidence of salivary gland involvement, lacrimal gland involvement as well as lower incidence of pancreatic involvement than men did (P

Background/Aims: Myeloid-derived suppressor cells (MDSCs) are increased in inflammatory and autoimmune disorders. This study aims to evaluate the significance of MDSCs in dilated cardiomyopathy (DCM) patients. Methods: In total, 42 newly hospitalized DCM patients and 39 healthy controls were enrolled in the study. The frequencies of circulating CD14+HLA-DR-/low MDSCs were determined by flow cytometry. Then, the functional properties of MDSCs in suppressing T cell proliferation and interferon-gamma (IFN-γ) production were measured in a co-culture model. Then, mRNA expression levels of various important molecules in peripheral blood mononuclear cells were measured by real time polymerase chain reaction. Furthermore, correlation analyses between MDSC frequencies and cardiac function parameters were also performed. Results: The frequencies of circulating CD14+HLA-DR-/low MDSCs were significantly elevated in DCM patients compared with healthy controls. It showed that MDSCs from DCM patients more effectively suppressed T cell proliferation and IFN-γ production compared with those from healthy controls, which was partially mediated by arginase-1 (Arg-1). In addition, the correlation analysis suggested that MDSC frequencies were negatively correlated with left ventricular ejection fraction (LVEF), while positively with N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with DCM. Conclusions: Circulating activated MDSCs might play significant immunomodulatory roles in the pathogenesis of DCM.

Because of the complexity of the residual orebody space form,the traditional cutting drawing method is difficult to show the orebody form intuitively and comprehensively,leading to difficulties in cutting engineering design,while SURPAC uses a 3D modeling method to solve this problem. An induced caving method of residual orebodies was investigated with Xishimen Iron Mine as the background. The trench's ore quantity,metal quantity and grade were calculated by SURPAC. The horizontal and vertical positions of a trench tunnel were taken as the optimization objects,and the trench tunnel in both directions was laid out by analyzing the critical caving span and the field engineering and technical conditions. According to the scope,a scheme of orthogonal test was designed.Taking extraction metal quantity and average grade as the assessment indexes,the range analysis and variance analysis of orthogonal test were conducted to obtain the position of a trench tunnel: double trench tunnels have a separation distance of 24 m,with a horizontal level of 118 m. Along with the scene implement,ideal test results have been achieved for refinement caving.

This article aims at caving corner residual orebody by trench bottom structure in Xishimen Iron Mine. SURPAC software was used to calculate the ore volume,amount of metal and grade. A mathematical model of multi-objective optimization was established to maximize the amount of metal and grade. According to the special situation of corner residual orebody mining,the amount of metal was selected to be the main object. SURPAC software was developed to automatically calculate by using TCL script. With the help of the script software,all factors in the constraint were tested. The optimum position of trench bottom structure was obtained,which is on the 103.1 m level and 18.65 m to the orebody. Compared with the original design,the amount of metal is increased by 27.79% after this optimal design.