The uptake of and adherence to cardiac rehabilitation remain suboptimal despite its apparent health benefits in modifying risk factors and slowing disease progression. eHealth refers to the use of ...information and communication technologies for health-related purposes. It is a promising approach for improving participation in cardiac rehabilitation by enabling instant contact, hypermedia information delivery, technology-monitored functionalities and individualised progress monitoring.
To evaluate the effects of a nurse-led eHealth cardiac rehabilitation (NeCR) system on health behaviours, cardiac self-efficacy, anxiety and depression, health-related quality of life, risk parameters and unplanned use of care services for people with coronary heart disease.
A single-blinded randomised controlled trial design was used.
The study randomly assigned 146 patients hospitalised for coronary heart disease to receive either the NeCR intervention or the usual care. Underpinned by social cognitive theory, the intervention commenced before hospital discharge with an in-person session by the nurse to identify individualised self-care needs, set goals and develop an action plan to enhance behavioural risk factor modification and orientate the patient to the use of the information and communication technology platform for cardiac rehabilitation. After discharge, the e-platform helped patients gain knowledge of disease management and monitor goal attainment for health behavioural changes. The nurse provided feedback on the patients’ goal attainment and lifestyle modifications on a weekly basis in a small group format through the WeChat platform, thus also mobilising peer influence. Data for lifestyle behaviours, physiological risk parameters and clinical outcomes were collected at baseline and at 6 and 12 weeks post-intervention.
At 6 weeks post-intervention, participants in the intervention group showed significant improvement in the number of steps/day (β = 2628.48, p = .022), the number of minutes/week sitting (β = −640.30, p = .006) and their health-promoting lifestyle profile (β = 25.17, p < .001) compared with the control group. Improvements in the number of steps/day (β = 2520.00, p = .006), the number of minutes/week sitting (β = −719.73, p = .004) and health-promoting lifestyle (β = 16.09, p < .001) were sustained until the 12-week post-intervention endpoint. Moreover, participants showed significantly greater improvement in self-efficacy (β = 0.61, p = .005) and health-related quality of life (mean difference = 0.56, p < .001) than the control group at the study endpoint.
The findings of this study demonstrate the effectiveness of the NeCR intervention in modifying behavioural risk factors and improving health-related quality of life. These findings also provide insights into the application of eHealth nursing interventions to enhance the rehabilitation of patients with coronary heart disease.
Trial registration: ChiCTR1800020411
A robust automatic micro-expression recognition system would have broad applications in national safety, police interrogation, and clinical diagnosis. Developing such a system requires high quality ...databases with sufficient training samples which are currently not available. We reviewed the previously developed micro-expression databases and built an improved one (CASME II), with higher temporal resolution (200 fps) and spatial resolution (about 280×340 pixels on facial area). We elicited participants' facial expressions in a well-controlled laboratory environment and proper illumination (such as removing light flickering). Among nearly 3000 facial movements, 247 micro-expressions were selected for the database with action units (AUs) and emotions labeled. For baseline evaluation, LBP-TOP and SVM were employed respectively for feature extraction and classifier with the leave-one-subject-out cross-validation method. The best performance is 63.41% for 5-class classification.
Micro-expression spotting is a fundamental step in the micro-expression analysis. This paper proposes a novel network based convolutional neural network (CNN) for spotting multi-scale spontaneous ...micro-expression intervals in long videos. We named the network as Micro-Expression Spotting Network (MESNet). It is composed of three modules. The first module is a 2+1D Spatiotemporal Convolutional Network, which uses 2D convolution to extract spatial features and 1D convolution to extract temporal features. The second module is a Clip Proposal Network, which gives some proposed micro-expression clips. The last module is a Classification Regression Network, which classifies the proposed clips to micro-expression or not, and further regresses their temporal boundaries. We also propose a novel evaluation metric for spotting micro-expression. Extensive experiments have been conducted on the two long video datasets: CAS(ME) 2 and SAMM, and the leave-one-subject-out cross-validation is used to evaluate the spotting performance. Results show that the proposed MESNet effectively enhances the F1-score metric. And comparative results show the proposed MESNet has achieved a good performance, which outperforms other state-of-the-art methods, especially in the SAMM dataset.
Micro-expressions are brief facial movements characterized by short duration, involuntariness and low intensity. Recognition of spontaneous facial micro-expressions is a great challenge. In this ...paper, we propose a simple yet effective Main Directional Mean Optical-flow (MDMO) feature for micro-expression recognition. We apply a robust optical flow method on micro-expression video clips and partition the facial area into regions of interest (ROIs) based partially on action units. The MDMO is a ROI-based, normalized statistic feature that considers both local statistic motion information and its spatial location. One of the significant characteristics of MDMO is that its feature dimension is small. The length of a MDMO feature vector is 36 × 2 = 72, where 36 is the number of ROIs. Furthermore, to reduce the influence of noise due to head movements, we propose an optical-flow-driven method to align all frames of a micro-expression video clip. Finally, a SVM classifier with the proposed MDMO feature is adopted for micro-expression recognition. Experimental results on three spontaneous micro-expression databases, namely SMIC, CASME and CASME II, show that the MDMO can achieve better performance than two state-of-the-art baseline features, i.e., LBP-TOP and HOOF.
We demonstrate a novel approach of utilizing a hierarchical microstructure design to improve the mechanical properties of an interstitial carbon doped high-entropy alloy (HEA) by cold rolling and ...subsequent tempering and annealing. Bimodal microstructures were produced in the tempered specimens consisting of nano-grains (∼50 nm) in the vicinity of shear bands and recovered parent grains (10–35 μm) with pre-existing nano-twins. Upon annealing, partial recrystallization led to trimodal microstructures characterized by small recrystallized grains (<1 μm) associated with shear bands, medium-sized grains (1–6 μm) recrystallized through subgrain rotation or coalescence of parent grains and retained large un-recrystallized grains. To reveal the influence of these hierarchical microstructures on the strength-ductility synergy, the underlying deformation mechanisms and the resultant strain hardening were investigated. A superior yield strength of 1.3 GPa was achieved in the bimodal microstructure, more than two times higher than that of the fully recrystallized microstructure, owing to the presence of nano-sized grains and nano-twins. The ductility was dramatically improved from 14% to 60% in the trimodal structure compared to the bimodal structure due to the appearance of a multi-stage work hardening behavior. This important strain hardening sequence was attributed to the sequential activation of transformation-induced plasticity (TRIP) and twinning-induced plasticity (TWIP) effects as a result of the wide variation in phase stability promoted by the grain size hierarchy. These findings open a broader window for achieving a wide spectrum of mechanical properties for HEAs, making better use of not only compositional variations but also microstructure and phase stability tuning.
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•Proteins can be modified by sonochemical and by sonomechanical means.•Ultrasound enhanced transport effects are unique ways to change the 3D folded structure of proteins.•Ultrasound ...effects enhances enzymatic reactions.
The review focus on the effect of ultrasound on protein functionality. The presence of transient ultrasonic mechanical waves induce various sonochemical and sonomechanical effects on a protein. Sonochemical effects include the breakage of chains and/or the modification of side groups of aminoacids. Sonomechanical modifications by enhanced molecular agitation, might lead to the transient or permanent modification of the 3D structure of the folded protein. Since the biological function of proteins depends on the maintenance of its 3D folded structure, both sonochemical and sonomechanical effects might affect its properties. A protein might maintain its 3D structure and functionality after minor sonochemical effects, however, the enhanced mass transfer by sonomechanical effects might expose internal hydrophobic residues of the protein, making protein unfolding to an irreversible denatured state. Ultrasound enhanced mass transport effects are unique pathways to change the 3D folded structure of proteins which lead to a new functionality of proteins as support shield materials during the formation microspheres. Enzymes are proteins and their reactions should be conducted in a reactor set-up where enzymes are protected from sonic waves to maximize their catalytic efficiency. In this review, focused examples on protein dispersions/emulsions and enzyme catalysis are given.
Aims
To evaluate the effects of eHealth cardiac rehabilitation (CR) on health outcomes of coronary heart disease patients and to identify programme design, which may lead to more effective health ...benefits.
Design
A systematic review and meta‐analysis following Cochrane Handbook for Systematic Reviews of Interventions.
Data sources
Medline, EMBASE, CLNAHL, Web of Science, Scopus, PsycINFO, Cochrane Central Register of Controlled Trails, PubMed and CNKI were searched over the period from 1806 to April 2019.
Review methods
A systematic review and meta‐analysis of randomized controlled trials to examine the effect of eHealth CR on health outcomes of coronary heart disease patients. We used RevMan 5.3 for risk of bias assessment and meta‐analysis and GRADE software for generating findings.
Results
In all, 14 trials with 1,783 participants were included. eHealth CR has significantly promoted duration of physical activity, daily steps, quality of life (QoL) and re‐hospitalization. Using comparative analysis of programme design elements, including mode of delivery, intervention content, motivational strategies and social support, between the effective and ineffective eHealth CR, it was found that comprehensive empowerment strategies and follow‐up care by tele‐monitoring may be the crucial characteristics leading to more favourable treatment effect.
Conclusion
eHealth CR is effective in engaging patients in active lifestyle, improving QoL and reducing re‐hospitalization. Future research needs to test the effects of comprehensive CR programmes by incorporating empowerment strategies and tele‐monitoring as active components.
Impact
eHealth has been increasingly applied to increase accessibility and uptake of CR. Integrative evidence to indicate its effects on health outcomes is lacking. This review identified its positive effects on some behavioural, psychosocial and health service use outcomes. Together with insights about which programme design elements may positively shape the outcomes, this review informs the role and practice of cardiovascular nurses in promoting evidence‐based eHealth CR.
目的
评价电子医疗心脏康复(CR)对冠心病患者健康结果的影响,并确定方案设计,以期带来更为有效的健康效益。
设计
根据《干预措施系统评估科克兰手册》开展系统评估与荟萃分析。
数据来源
通过Medline、EMBASE、CLNAHL、Web of Science、Scopus、PsycINFO、Cochrane 临床对照试验中心注册数据库、PubMed和中国知网数据库对1806年至2019年4月期间的文献进行检索。
评估方法
针对随机对照试验展开系统评估与荟萃分析,以研究电子医疗心脏康复对冠心病患者健康结果的影响。我们采用RevMan 5.3进行偏倚风险评估以及荟萃分析,同时应用GRADE软件生成发现结果。
结果
共纳入了14项试验,涉及1,783名受试者。电子医疗心脏康复可显著地提高体力活动时间、日常生活步数、生活质量(QoL)和再入院情况。通过对有效和无效电子医疗心脏康复之间的方案设计要素,包括释药行为、干预内容、激励策略和社会支持进行比较分析,结果发现综合授权策略以及远程监测的后续护理可能对产生更为有利的治疗效果起决定作用。
结论
电子医疗心脏康复可有效促使患者积极运动,提高生活质量,降低再住院率。今后的研究需将增强能力战略和远程监测作为有效方式来测试综合心脏康复方案的效果。
影响
电子医疗已不断应用于增加心脏康复的可及性和摄取量。尚无综合证据表明其对健康结果的影响。本次评估确定了其对某些行为、心理社会和卫生服务使用结果的积极影响。结合针对何种方案设计要素可能对结果产生积极影响的研究发现,本次评估说明了对心血管护士在促进循证电子医疗心脏康复方面的作用和实践。
Fluid mechanics has the applications in a wide range of disciplines, such as oceanography, astrophysics, meteorology, and biomedical engineering. Under investigation in this paper is the (
2
+
1
...)-dimensional generalized Caudrey–Dodd–Gibbon–Kotera–Sawada equation in fluid mechanics. Via the Pfaffian technique and certain constraint on the real constant
α
, the
N
th-order Pfaffian solutions are derived. One- and two-soliton solutions are obtained via the
N
th-order Pfaffian solutions. Based on the Hirota–Riemann method, one- and two-periodic wave solutions are constructed. With the help of the analytic and graphic analysis, we notice that: (1) of the one soliton, amplitude is irrelevant to
γ
, a real constant coefficient in the equation, velocity along the
x
direction is independent of
γ
, while velocity along the
y
direction is proportional to
γ
; (2) one soliton keeps its amplitude and velocity invariant during the propagation and total amplitude of the two solitons in the interaction region is lower than that of any soliton; (3) one-periodic wave can be viewed as a superposition of the overlapping solitary waves, placed one period apart; (4) periodic behaviors for the two-periodic wave exist along the
x
and
y
directions, respectively; (5) under certain limiting conditions, one-periodic wave solutions approach to the one-soliton solutions and two-periodic wave solutions approach to the two-soliton solutions.
The steady and healthy development of strategic emerging industries (SEI) can enable the Republic of China to smoothly transform its economic progression mode and realize the upgradation and ...optimization of its industrial organization. In this way, China can take the initiative in the process of globalization. The strategic emerging industry economy has long argued for the influence of resilient firm dynamic aptitudes on innovative product growth. This study takes strategic emerging industrial economies as an important part and establishes a comprehensive evaluation index system for economic efficiency of SEI in the Republic of China from the perception of interorganizational interactions and entrepreneurial coordination features. We use the Random Forest (RF) algorithm to perform multifeature fusion and establish an economic efficiency measurement algorithm for SET through survey data from several Chinese companies. We find, in addition, that entrepreneurial coordination affects the firms’ inclination and aptitude to exploit relationship profits and by this means significantly strengthening the effects of vertical interactions however weakening the effects of horizontal interactions. When compared with the BP and MLP approaches, the suggested approach has achieved 86.98% accuracy, while the other has 86.02% and 85.75%, respectively.
Investigated in this paper is a non-autonomous generalized
AB
system, which is used to describe certain baroclinic instability processes in the geophysical flows. We discover that the two short waves ...and mean flow can evolve in the forms of the multi-rogue waves on the condition that the nonlinearity effect
σ
is positive. Via the Darboux and generalized Darboux transformations, we obtain the first- and second-order rogue waves as well as the algorithm to derive the
N
th-order rogue waves. It is revealed that the perturbation function
δ
(
t
)
has no effect on the two short waves while affects the mean flow by changing its evolution background. When
σ
is negative, those rogue waves turn to be singular. In addition, we find that the two short waves and mean flow can also appear as the solitary waves, and they perform as the “bright” solitons under
σ
>
0
while perform as the “dark” solitons under
σ
<
0
. With the Hirota method, introducing the auxiliary function
α
(
t
)
, we derive the first- and second-order bright and dark solitary waves. Both solitary wave velocities are related to
δ
(
t
)
and
α
(
t
)
. Besides,
δ
(
t
)
and
α
(
t
)
have no effect on the amplitudes of the two short waves but bring about controllable backgrounds and deformations of the solitary waves for the mean flow.
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