Search

BackgroundMobile health (mHealth) provides a new opportunity for disease prediction and patient health self-management. However, privacy problems in mHealth have drawn significant attention to patients’ online health information disclosure and to the possibility that privacy concerns may hinder mHealth development. ObjectivePrivacy calculus theory (PCT) has been widely used to understand personal information disclosure behaviors with the basic assumption of a rational and linear decision-making process. However, cognitive behavior processes are complex and mutual. In an attempt to gain a fuller understanding of information disclosure behavior, we further optimize a PCT-based information disclosure model by identifying the mutual relationship between costs (privacy concerns) and benefits. Social support, which has been proven to be a distinct and significant disclosure benefit of mHealth, was chosen as the representative benefit of information disclosure. MethodsWe examine a structural equation model that incorporates privacy concerns, health information disclosure intention in mHealth, and social support from mHealth, all at the individual level. ResultsA validated questionnaire was completed by 253 randomly selected participants. The result indicated that perceived health information sensitivity positively enhances patients’ privacy concern (beta path coefficient 0.505, P

Background With the aging of the population and changes in the disease spectrum, the incidence of multimorbidity among the elderly remained high, and have become the focus of the family doctor contracting service at the primary level. At present, there are many studies promoting the signing of family doctors from the perspective of increasing "quantity", but there is still a lack of studies on the factors affecting the effectiveness of family doctor contract services for elderly multimorbidity patients after signing from the perspective of improving "quality". Objective To explore the important influencing factors of satisfaction and usefulness evaluation of elderly multimorbidity patients with family doctor contract services in urban communities of guangdong province, and to provide a basis for future improvement of multimorbidity management services at the grassroots level. Methods From September to December 2022, elderly patients with multiple chronic conditions in the community of Guangdong Province (Shenzhen, Zhanjiang and Meizhou) were selected by multi-stage stratified whole cluster random sampling method and surveyed by self-administered questionnaire. Multifactorial Logistic regression analysis was used to explore the influencing factors of satisfaction and usefulness evaluation of family doctor contracting services for elderly multimorbidity patients. Results A total of 636 valid questionnaires were collected, with effective recovery rate of 99.69% (636/638). There were 624 family doctors who were relatively satisfied/very satisfied, accounting for 98.11%; The service usefulness evaluation of family doctors was slightly helpful/greatly helpful to 625 people, accounting for 98.27%. The results of multivariate Logistic regression analysis showed that patients with general satisfaction of family doctor contract service were taken as reference. Patients with hyperlipidemia (OR=15.203), disease duration 30 000-50 000 yuan (OR50 000-100 000 yuan (OR100 000-200 000 yuan (P30 000-50 000 yuan (OR

Prolonged disorders of consciousness (pDoC) severely affects the patients' survival and quality of life, and causes an extremely heavy disease burden. At present, considerable resources and studies have focused on the acute care of patients with pDoC, and substantial progress has been made in detecting, predicting and promoting recovery of consciousness, but there is little research on post-acute rehabilitation outcomes and care. In views of this, we reviewed the definition, epidemiological surveys, clinical symptoms and diagnosis criteria of pDoC, summarized the associated factors, interventions and nursing regarding rehabilitation outcomes of pDoC. Then, we put forward the following recommendations relevant to future research and practice in China: (1) improving the epidemiological data related to pDoC to provide data for relevant decision-making; (2) studying and applying new technologies to interventions for pDoC rehabilitation, and integrating clinical practice, rehabilitation prediction and prognostic management; (3) further identifying key elements and trajectory for pDoC recovery to reduce the uncertainty of prognostic outcomes due to excessive disease duration; (4) establish a continuity of care system based on the pDoC rehabilitation trajectory from acute transition, sub-acute to chronic period to improve the quality of and access to care and achieve continuous improvement in the quality of care; (5) systematically reforming the current care system to further improve the continuity of care system that contributes to rehabilitation, and strengthening the participation of the patient's family, community, disability agencies and other stakeholders besides the multidisciplinary team and the cooperation between them. It is hoped that we can provide insights into the development of research and clinical practice of pDoC in China.

Background: There is growing evidence that the striatum plays a central role in cognitive dysfunction. However, it remains unclear whether and how the striatum contributes specifically to executive deficits in Alzheimer disease (AD). We sought to elucidate aberrations in the striatal subregion associated with executive function and its metabolic connectivity with the cortical regions to investigate its role in the pathogenesis of executive deficits in patients with AD. Methods: Patients with AD and healthy controls underwent a neuropsychological assessment battery, including assessment of executive function, and a hybrid positron emission tomography/magnetic resonance imaging (PET/ MRI) scan. We performed voxel-wise analyses of cerebral metabolism between patients and controls, focusing on the executive subregion of the striatum according to the Oxford-GSK-Imanova Striatal Connectivity Atlas. We assessed the correlation between the [[sup.18]F]fluorodeoxyglucose standardized uptake value ratio of the striatal executive subregion and clinical variables, and we analyzed seed-based metabolic connectivity of the striatal executive subregion with the dorsolateral prefrontal cortex (DLPFC) using [[sup.18]F]-fluorodeoxyglucose PET. Results: We included 50 patients with AD and 33 controls in our analyses. The patterns of striatal hypometabolism in patients with AD were specific to executive and caudal motor subregions. Metabolic activity in the executive subregion of the striatum correlated negatively with the severity of executive dysfunction, as measured with the Trial-Making Test (TMT) part B and the difference score TMT B-A, and correlated positively with Digit Span (backward) and Verbal Fluency Test scales, particularly on the left side. Compared with controls, patients with AD showed reduced metabolic connectivity between striatal executive subregions and the dorsolateral prefrontal cortex (DLPFC). Limitations: Our study was limited by small sample sizes and cross-sectional findings. Conclusion: Our findings show that patients with AD have impairments in the executive subregion of the striatum, and these deficits may be associated with a disconnection between the executive striatum and DLPFC, providing valuable insight into the pathogenesis of this disease., Introduction Alzheimer disease (AD), the most common cause of dementia, is pathologically characterized by an accumulation of amyloid-[beta] plaques, neurofibrillary t tangles and neurodegeneration in the brain. (1,2) Executive deficits [...]

Objective To investigate CT features and reasons for the misdiagnosis of nodular or mass-like type pulmonary cryptococcosis（PC）. Methods The clinical manifestations and imaging data of 60 cases with nodular or mass-like type PC confirmed by pathology in the Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to December 2021were analyzed retrospectively. Results Clinical manifestations: respiratory symptoms were associated with 28 cases, whereas 26 cases were asymptomatic. Imaging findings: 22 cases were in unilateral single lung lesion, 22 cases were in unilateral multiple lung lesions, 16 cases were in bilateral multiple lesions. Fifty-five cases with oval shape, including 38 cases with the long axis are parallel to the pleura, 28 cases with clustering and fusion tendency. Fifty-two cases were uniform in density. Thirteen cases with moderate enhancement, 4 cases with avid enhancement. Moreover, there were 24 cases with proximal air bronchogram, 45 cases with halo sign. Thirteen cases were followed and the volume doubling time ranged from 3.9 to 236.8 days, with the median 24.9 days. Thirty-seven cases were initially misdiagnosed. Conclusions Nodular or mass-like type of PC lesions usually occurs in the inferior lobe of both lungs and close to the pleura, and the long axis is parallel to the pleura. Halo sign and proximal air bronchogram are more specific manifestations. Multiple nodular masses with clustering and fusion tendency are highly suggestive of a PC. Cryptococcal capsular polysaccharide antigen detection can be used in clinical, and puncture biopsy can be performed if necessary.