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Background The comprehensive management of heart failure in conjunction with frailty necessitates a multidimensional approach to frailty assessment. However, the social frailty, despite being an incremental predictor of negative health outcomes in heart failure patients, has not been adequately addressed. Objective To understand the current status of social frailty in patients with chronic heart failure and analyze its influencing factors. Methods From September 2022 to July 2023, convenience sampling was used to select patients with chronic heart failure from the First Affiliated Hospital with Nanjing Medical University as the research objects, the general information questionnaire, the HALFT Scale, the Loneliness Scale, the Brief 2-Way Social Support Scale, Personal Mastery Scale, and the Patient Health Questionnaire were used to investigate. Univariate analysis and support vector machine-feature recursive elimination were used to filter the feature, SVM classification model was constructed, and SHAP value was introduced to analyze the influencing factors. Results A total of 228 patients were screened in this study, of which 8 patients refused to fill in. A total of 220 questionnaires were distributed and 213 valid questionnaires were returned, with an effective recovery rate of 96.81%. The proportion of pre-social frailty and social frailty in patients with chronic heart failure was 46.0% (98/213) and 17.8% (38/213), respectively. Statistically significant differences were observed among chronic heart failure patients with different degrees of social frailty in terms of education level, place of residence, working status, economic burden of disease, personal monthly income, course of disease, exercise habits, medical satisfaction, traffic, the UCLA Loneliness Scale score, the Brief 2-Way Social Support Scale score, the PMS score, and the PHQ-9 score. When the SVM-RFE model play the best performance, the optimal feature subset was used to construct the SVM classification prediction model and perform SHAP interpretability analysis. The accuracy of the model was 0.73 in the training set and 0.63 in the test set, respectively. At this time, the ranking of feature importance from high to low was no exercise habit (+), personal mastery (-), heavy economic burden of disease (+), 2-way social support (-), depression (+), loneliness (+), unemployment (+) . Conclusion Patients with chronic heart failure experiencing severe social frailty. Healthcare providers should prioritize identifying and addressing the resource deficits of patients and the underlying factors contributing to social frailty. Targeted interventions should be implemented to mitigate social frailty in patients with heart failure by enhancing external support systems, fostering positive beliefs, addressing negative emotional experiences, developing comprehensive management plans, coordinating medical resources, and implementing strategies to delay or reverse social frailty progression. These interventions aim to enhance the prognosis and quality of life for patients with heart failure.

Background Nowadays, cardiac rehabilitation is mostly transferred from the hospital to a home environment. Mobile health applications assist patients in bridging the support gap from hospital to home environment, which encourages home-based recovery processes. Unfortunately, numerous quality difficulties accompany its promise, and the service quality of cardiac rehabilitation applications must be ＂confirmed＂ as soon as possible. Objective To develop a quality assessment indicator system for home-based rehabilitation APP services for heart failure patients, and to provide a model for standardizing and increasing the quality of mobile health APP. Methods This study was conducted from July 2022 to January 2023, using semi-structured interviews, literature review, the expert consultation method and analytic hierarchy process (AHP) to determine the content of indicator system and the weight for each index. Results 2 rounds of expert consultations resulted in the effective response rates of 100%, with the authority coefficients of 0.867, and the coordination coefficients of 0.128-0.154 and 0.151-0.197 respectively (P

Background The maintenance of exercise rehabilitation effect in patients with chronic heart failure depends on good adherence to exercise rehabilitation. It is of great practical significance to evaluate the adherence to exercise rehabilitation effectively and scientifically, however, there is still a lack of accepted tools to evaluate the adherence to exercise rehabilitation in patients with chronic heart failure at home and abroad. Objective To develop an exercise rehabilitation adherence scale for patients with chronic heart failure, and provide a scientific and appropriate tool for the rapid and convenient evaluation of adherence to exercise rehabilitation in patients with chronic heart failure. Methods Based on the previous summary of the best evidence and qualitative research on exercise rehabilitation of patients with chronic heart failure, the initial pool of entries was formed through literature review, combining the opinions of the research group; the clinical test version of the scale was formed based on a small sample pre-survey and Delphi expert correspondence. Patients with stable chronic heart failure who were treated in the cardiovascular department from three tertiary-level hospitals in Jiangsu Province from November 2020 to January 2021 were selected as the study subjects using a convenience sampling method. In the first phase, 274 valid scales were recovered, aiming to screen the items of the scale and conduct exploratory factor analysis by combining item response theory and classical test theory to form the official version of the scale; in the second phase, 282 valid scales were recovered, aiming to perform confirmatory factor analysis and test on reliability and validity of the official version of the scale to form the final version of the scale. Results The formal scale consisted of 11 items in 2 dimensions. The difficulty of each item was reasonable without no inverse threshold, and the item differentiation, item information content, and item characteristic curve were all superior. The total Cronbach's α coefficient of the exercise rehabilitation adherence scale for patients with chronic heart failure was 0.905, of which the dimension of "prescription adherence" was 0.895, the dimension of "monitoring adherence" was 0.910. The total Spearman-Brown split reliability coefficient of the scale was 0.724, and the retest reliability was 0.902. The results of exploratory factor analysis showed that the two factors could explain 70.231% of the total variation. The results of further confirmatory factor analysis showed that the model was better fitted with each parameter. Conclusion The exercise rehabilitation adherence scale for patients with chronic heart failure developed in the study is reasonable in terms of item difficulty, differentiation, the information content of the items is good with high reliability and validity, which can be used as an evaluation tool for adherence to exercise rehabilitation in patients with chronic heart failure.

Background Telerehabilitation based on digital medical care can efficiently improve the health status of patients after radiofrequency ablation of atrial fibrillation. However, the current participation rate in telerehabilitation is low. Objective To analyse the reasons for refusal of exercise rehabilitation in patients after radiofrequency ablation of atrial fibrillation in the context digital medical care based on the theory of leisure constraints. Methods Patients after radiofrequency ablation of atrial fibrillation in the inpatient department or outpatient clinic of Department of Cardiology, at the First Affiliated Hospital of Nanjing Medical University from July to September 2022 were selected as the study subjects by using the purposive sampling method. The phenomenological approach was adopted to collect data from patients who refused exercise telerehabilitation after radiofrequency ablation through semi-structured interviews, and Colaizzi analysis was used to summarize the reasons. Results A total of 14 patients were finally included in this study. Three themes including self-limiting factors, interpersonal limiting factors, and structural limiting factors, and twelve sub-themes were extracted, namely, low level of digital literacy, negative illness perception, psychological distress caused by disease, digital medical trust crisis, deep-rooted personal exercise habits, alienation sense from rehabilitation team, insufficient social network establishment, economic burden related to equipment acquisition, harsh climate, low rehabilitation service capacity in primary care, constraints of available time by role pressure, and poor applicability of wearable devices. Conclusion The reasons for refusal to exercise telerehabilitation include lack of literacy and trust in digital medical care, high level of illness perception and psychological distress, poor exercise habits, rehabilitation team and peer alienation, economic burden, harsh climate, lack of capacity and personal time for rehabilitation service capacity in primary care, and inadequate applicability of existing wearable devices.

Background The prevalence of atrial fibrillation (AF) in China is increasing year by year, and the prognosis and quality of life of patients urgently need attention. Current studies have confirmed that exercise rehabilitation is a beneficial way to improve the prognosis and poor quality of life in patients with AF after radiofrequency catheter ablation (RFCA). Adherence is a key measure of whether the benefits of exercise rehabilitation persist, but its trajectory remains unknown. Objective To examine the development trajectory and predictors of strength-duration adherence to home-based exercise rehabilitation among patients with AF after RFCA using five-period follow-up data based on prospective longitudinal observation. Methods Convenience sampling method was used to select 246 patients with AF who attended the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University for RFCA from May to November 2020 for follow-up. The baseline survey was conducted 1 week after enrollment, and the follow-up survey was conducted at 3, 6, 9 and 12 months after enrollment. The general and clinical data of patients were collected. The strength-duration adherence was monitored and recorded using smart devices or fitness log to assess exercise adherence in terms of strength-duration adherence; Self-efficacy for Exercise Scale (SEE), Fear of Activity in Patients with Chronic Heart Failure (Fact-CHF), Perceived Social Support Scale (PSSS), Patient Activation Measure 13 (PAM13) were used for assessing self-efficacy of exercise, fear of activity, social support and motivation level. Mplus tool was used to construct latent class growth model (LCGM), and the optimal fitting model was selected to determine the development trajectory of strength-duration adherence to home-based exercise rehabilitation among patients with AF after RFCA. Logistic regression analysis was used to identify the predictors of trajectory categories. Results A total of 202 patients were included in the final analysis with 44 patients lost to follow-up. The number of patients at baseline, 3 months, 6 months, 9 months, and 12 months after exercise were 202, 201, 185, 174 and 159, respectively, and the strength-duration adherence were (0.83±0.55), (1.07±0.54), (0.99±0.57), (0.91±0.55) and (0.89±0.60). The LCGM results showed group heterogeneity in the process of change in strength-duration adherence to exercise rehabilitation in patients, which was divided into 3 latent classes based on their development trajectories, including 69 in slow decline-low level group (34.2%), 14 in rapid increase-high level group (6.9%), and 119 in sustained adherence group (58.9%). Multinomial unordered Logistic regression showed higher levels of intensity-time adherence in the rapid increase-high level group and sustained adherence group using the slow decline-low level group as the reference group (P

Background The glycemic fluctuation in peri-percutaneous coronary intervention (PCI) period is closely related to the short-term and long-term prognosis in patients with coronary heart disease (CHD). At present, there are few studies on glycemic fluctuation and its influencing factors in peri- PCI period in these patients. Objective To explore the characteristics and influencing factors of glycemic fluctuation during peri-PCI period in patients with CHD and type 2 diabetes (T2DM) . Methods One hundred and fifty-six patients undergoing PCI in the cardiology ward of Jiangsu Provincial People's Hospital from April 2021 to November 2021 were selected. General demographics were collected by general demographics questionnaire. Perioperative glycemic fluctuation was collected by glycemic data questionnaire. The patients were stratified according to the normal reference value range of blood glucose fluctuation evaluation indicators: normal standard deviation of blood glucose level (SDBG) group (

Atrial fibrillation (AF) is one of common clinical arrhythmias, among which asymptomatic AF is insidious, poorly understood, and prone to adverse outcomes, bringing a serious burden to patients. As disease screening is a measure that should be implemented prior to the prevention of disease-related complications, it is crucial to carry out asymptomatic AF screening and scientific management. Current hot issues in screening for AF include the selection of the most appropriate screening population, the selection of screening devices and modalities, the improvement of screening participation, standard indications of anticoagulation therapy for those diagnosd, and the evaluation of the best economic screening option. We included twenty-five articles related to screening for atrial fibrillation, and systematically reviewed the AF screening section in AF management guidelines published in recent five years and opinions of relevant experts, then gave a summary of the latest advances in AF screening, involving screening strategies, screening devices, screening participation, anticoagulation treatment participation and monitoring duration and monitoring modalities in post-stroke screening, and the association of screening strategies on cost-effectiveness of the screening analyzed using a perspective in health economics, as well as economic impact of patient participation in screening and anticoagulation treatment. All these are beneficial to the guidance for clinical practice. The more internationally recognised guidelines for the screening and management of atrial fibrillation are the European Heart Rhythm Society guidelines and the North American Heart Rhythm Society guidelines. Most studies on the cost-effectiveness of AF screening have used Markov models for lifetime simulation. Health economics analyses include stroke events, bleeding events, quality-adjusted life year (QALY) , and incremental cost-effectiveness ratio (ICER) . Most guidelines recommend routine screening with newer devices, such as portable single-lead ECGs in high-risk groups aged 65-75 years, to facilitate continuous monitoring and improve AF detection rates; for post-stroke screening, national and international guidelines emphasize screening for AF in patients with cryptogenic transient ischemic attacks (TIA) /stroke, with the main focus on Long-range ECG and implantation of an insertable cardiac monitor (ICM) . In summary, although some progress has been made in understanding the cost-effectiveness of AF screening, many differences still need to be fitted, and the health economics of AF screening are poorly understood in China. This will provide an evidence-based basis for improving life expectancy and quality of life and reducing the economic burden of healthcare.

Objective: To compare the haemodynamic effects of different ankle movements combined ankle and toe movements on the femoral vein of the lower extremity. Methods: 28 healthy volunteers participated in the study. Doppler ultrasound was used to measure peak systolic velocity and time-averaged mean velocity of the common femoral vein during ankle dorsiflexion, ankle dorsiflexion with simultaneous toe extension, ankle plantarflexion, and ankle plantarflexion with simultaneous toe flexion. Results: In comparison to the resting state, both ankle alone or ankle combined with toe movement showed statistically significant differences (p <.01). However, there were no significant difference in the velocity of the common femoral vein between ankle alone and ankle combined with toe movement (p >.05). It is noteworthy that dorsiflexion of the ankle resulted in the highest peak velocity of blood flow. Conclusion: The impact of ankle movement, with or without toe movement, the velocity of the common femoral vein is not significantly correlated. [ABSTRACT FROM AUTHOR]

The precise measurements of the magnetic field are essential for particle accelerators, and the harmonic coil measurement system is especially suitable for the multipole field because of its unique advantages. The accurate placement of magnets is essential for accurate magnetic field measurements. The current positioning technique employed for harmonic coil measurement is inefficient due to its labor-intensive and time-consuming nature. The aim of this study is to automate the positioning of the quadrupole magnet. Therefore, a close-range photogrammetry system is utilized to monitor the position of the magnet due to its non-contact feature, and an electrically driven Stewart platform is utilized to manipulate the magnet. Meanwhile, a control system has been developed to regulate the automatic positioning. The system is capable of receiving measurements from the close-range photogrammetry system in order to ascertain the displacements of the magnet from its current position to the target. Subsequently, it can transmit commands to Stewart platform to regulate its movement. The experiments indicate that the efficiency of the quadrupole magnet positioning has increased significantly by at least 5 times, and the final positioning accuracy was verified by the laser tracker. The study also addresses the potential application of this technology in high radiation environments that are otherwise inaccessible. [ABSTRACT FROM AUTHOR]

BACKGROUND: The main treatment method for end-stage renal disease (ESRD) is maintenance hemodialysis (MHD). With the continuous improvement of dialysis technology, the survival period of MHD patients has been effectively prolonged, but dialysis technology still cannot completely replace renal function. OBJECTIVE: To study the dietary compliance and its correlation with thirst in MHD patients and to provide guidance for clinical development of corresponding intervention countermeasures. METHODS: A total of 90 patients who received MHD treatment from March 2021 to March 2022 were selected as objects. The Renal Adherence Attitudes Questionnaire (RAAQ) and the Renal Adherence Behaviour Questionnaire (RABQ) were used to analyze the dietary compliance and thirst status of patients. Pearson correlation analysis was used to analyze the correlation between diet compliance and thirst. RESULTS: Positive correlations were found between VAS and DTI, SXI and TDS (P < 0.05). Social restrictive attitude was positively correlated with VAS, DTI, SXI, TDS, acceptance attitude and compliance in facing difficulties (P < 0.05), and negatively correlated with self-care compliance (r = - 0.35, P < 0.05). Health attitude was positively correlated with VAS, DTI and SXI (P < 0.05). Acceptance attitude was positively correlated with DTI, SXI and TDS (P < 0.05). High RAAQ was associated with high VAS (b = 0.11, 95% CI: 0.05, 0.18), DTI (b = 0.28, 95% CI: 0.17, 0.38), SXI (b = 0.24, 95% CI: 0.14, 0.34) and TDS (b = 0.26, 95% CI: 0.13, 0.4). CONCLUSION: The overall performance of dietary compliance in patients with MHD is at a moderate level, and dietary compliance is negatively correlated with disease perception. [ABSTRACT FROM AUTHOR]

Burning hydrogen-rich syngas fuels derived from various sources in combustion equipment is an effective pathway to enhance energy security and of significant practical implications. Emissions from the combustion of hydrogen-rich fuels have been a main concern in both academia and industry. In this study, the NO and CO emission characteristics of both laminar and turbulent counterflow premixed hydrogen-rich syngas/air flames were experimentally and numerically studied. The results showed that for both laminar and turbulent counterflow premixed flames, the peak NO mole fraction increased as the equivalence ratio increased from 0.6 to 1.0 and decreased as the strain rate increased. Compared with the laminar flames at the same bulk flow velocity, turbulent flames demonstrated a lower peak NO mole fraction but broader NO formation region. Using the analogy theorem, a one-dimensional turbulent counterflow flame model was established, and the numerical results indicated that the small-scale turbulence-induced heat and mass transport enhancements significantly affected NO emission. Considering NO formation at the same level of fuel consumption, the NO formation of the turbulent flame was significantly lower than that of the laminar flame at the same level of fuel consumption, implying that the turbulence-induced heat and mass transfer enhancement favored NOx suppression. [ABSTRACT FROM AUTHOR]