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A systematic review of risk prediction models for diabetic foot infections

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Chinese j.urnal of Nursing 2024年第19期59卷 2346-2352页

作者： Zhu j. Chen X. Zhu Y. Zhou j. Bai j. 复旦大学附属华东医院护理部上海市200040 中国医学科学院皮肤病医院麻醉手术科复旦大学护理学院

Obj.ctive To systematically evaluate the risk prediction models of diabetic foot infections, and to explore its implications for clinical nursing care. Methods Relevant studies in the databases of CNKI, VIP, Wanfang, CBM, CINAHL, PubMed, Web of Science, Cochrane Library, Embase, ProQuest, and Ovid were searched for the timeframe of database construction to December 2023. Literature was screened independently by 2 investigators and the area under the model curve(AUC) and its 95% confidence interval(CI), calibration method and predictors were extracted, and the quality of the model was evaluated using the Predictive Modeling Study Risk of Bias Assessment Tool. Meta-analysis of the predictive value of model predictors was performed using RevMan 5.4 software. Results 7 studies were included, containing 8 risk prediction models, all of which reported the AUC(0.748-0.922), and 6 models underwent model calibration. The overall fit of the included studies was good, among which 1 model was low fit, and all 7 studies were at high risk of bias, mainly focusing on predictors and analysis. Meta-analysis showed that the area under the curve of the combined models was 0.831(95%CI:0.780~0.883);the disease duration(OR=2.460, 95%CI:1.850~3.270), vascular disease(OR=3.110, 95%CI:1.070~9.000), and neuropathy(OR=3.550, 95%CI:1.920~6.560) were effective predictors of diabetic foot infection. Conclusion The current diabetic foot infection risk prediction model is still in the developmental stage, and further optimization and external validation of the existing model is recommended for the future. © 2024 Chinese Nursing j.urnals Publishing House Co.,Ltd. All rights reserved.

关键词： Diabetic Foot Evidence-Based Nursing Infections Prediction Model Systematic Review

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德国历史哲学传统中的理念论及其批判

世界哲学 2024年第4期 54-62页

作者：尉佩云 [德]j.吕森山西大学历史文化学院埃森高等人文研究所

在德国的学术传统中,历史哲学具有漫长的学术历程,它伴随着历史学职业化的过程而形成、发展。在初创及此后的语境中,它成为一种思考过去的全新的学术领域和学术形式。在德国历史哲学开端之处,理念论便主导了这个思想传统,这种影响一直... 详细信息

在德国的学术传统中,历史哲学具有漫长的学术历程,它伴随着历史学职业化的过程而形成、发展。在初创及此后的语境中,它成为一种思考过去的全新的学术领域和学术形式。在德国历史哲学开端之处,理念论便主导了这个思想传统,这种影响一直延续至今。我们可以从四个方面来审视理念论在德国历史哲学中的影响,以启蒙运动之后的德国历史哲学演变的四个先后相序的阶段或形式为题,这分别是理念论的历史哲学,理念论的历史方法论,理念论的历史认识论和理念论视角下诗性与修辞的历史书写。在今天,理念论失去了在方法论上的合理性,但如果历史学还是建立在人类生活形式的解释学基础之上的学科,那么理念论的学术思考就仍然有必要进行批判性反思。将人类受难等现实主义思考纳入其中,在我们将这种现实主义进行人文化的时候,理念论在当下语境中应该获得进一步批判性思考。

关键词：理念论历史哲学史学职业化历史认识论诗性史学

A scoping review of health literacy interventions for type 2 diabetes patients

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Chinese j.urnal of Nursing 2024年第19期59卷 2420-2426页

作者： Ma R. Hao W. Li j. 中国医学科学院北京协和医学院护理学院北京市100144

Obj.ctive This scoping review evaluates health literacy interventions for Type 2 diabetes patients, so as to provide a reference for further improvement of health literacy intervention programmes for people with type 2 diabetes mellitus. Methods Based on the Nutbeam health literacy theory as the framework, the Chinese Biomedical Literature Database, CNKI, Wanfang Database, VIP Chinese Science and Technology j.urnal Database, PubMed, CINAHL, MEDLINE, and Web of Science were searched for related studies by scope review. The search time limit was from the establishment of the databases to November 21, 2023, and the relevant information such as intervention methods, intervention content, evaluation indicators and other relevant information of the included literature was extracted. Results A total of 15 articles were included, including 10 randomized controlled studies, 4 quasi-experimental studies, and 1 experimental plan. 4 studies were based on the ability, opportunity, motivation and behavior model, theory of planned behavior, Nutbeam health literacy theory and social cognitive theory and behavior stage change model, respectively. The intervention levels of the 11 studies involved functional and interactive levels, with less emphasis on the critical levels. The intervention methods were one-to-one intervention, group-focused intervention or one-to-one combined with group-focused intervention. The health literacy of 15 studies was evaluated by self-designed questionnaire, Functional, Interactive and Critical Health Literacy Scale, and Adult Functional Health Literacy Test Scale series questionnaire. Conclusion Existing interventions effectively enhance functional and interactive health literacy but have limitations in addressing critical literacy. While meeting basic needs, they do not significantly develop higher-level skills. Further research is needed to personalize interventions and improve critical health literacy. © 2024 Chinese Nursing j.urnals Publishing House

关键词： Diabetes Mellitus Health Literacy Nursing Care Nutbeam Health Literacy Theory Scoping Review Type 2

Importance of timely and adequate source control in sepsis and septic shock

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j.urnal of Intensive Medicine 2024年第3期4卷 281-286页

作者： j.n j.De Waele Department of Intensive Care Medicine Ghent University HospitalGhentBelgium Department of Internal Medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium

Source control is defined as the physical measures undertaken to eliminate the source of infection and control ongoing contamination, as well as restore anatomy and function at the site of infection. It is a key component of the management of patients with sepsis and septic shock and one of the main determinants of the outcome of infections that require source control. While not all infections may require source control, it should be considered in every patient presenting with sepsis;it is applicable and necessary in numerous infections, not only those occurring in the abdominal cavity. Although the biological rationale is clear, several aspects of source control remain under debate. The timing of source control may impact outcome;early source control is particularly relevant for patients with abdominal infections or necrotizing skin and soft tissue infections, as well as for those with more severe disease. Percutaneous procedures are increasingly used for source control;nevertheless, surgery—tailored to the patient and infection—remains a valid option for source control. For outcome optimization, adequate source control is more important than the strategy used. It should be acknowledged that source control interventions may often fail, posing a challenge in this setting. Thus, an individualized, multidisciplinary approach tailored to the infection and patient is preferable.

关键词： Sepsis Septic shock Source control Drainage Debridement

Editorial for the Special Issue on Emerging Technology and Advanced Application of Nondestructive Detection for Power Equipment

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Chinese j.urnal of Electrical Engineering 2024年第1期10卷 1-2页

作者： Li j. Mei H. Li S. Tianj.n University China Tsinghua Shenzhen International Graduate School China Lanzhou j.aotong University China

The rapid development of clean and renewable energy technologies represented by wind and solar energy,as well as the continuous growth of load demand,have put forward higher requirements for the safe operation of the power *** performance of power equipment based on traditional dielectric materials is often limited by various defects generated during molding,transportation,assembly,and operation,which cannot meet the reliability requirements of power systems in the new *** detection is an essential technical method in industrial development,which can detect and evaluate the defect and damage status of in-service equipment,key components,and materials without damaging the obj.ct.

关键词： service Application operation

Demand-Responsive Transportation Vehicle Routing Optimization Based on Two-Stage Method

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Computers, Materials and Continua 2024年第1期81卷 443-469页

作者： Ma j. Liu H. Chen L. School of Railway Transportation Shanghai Institute of Technology Shanghai 201418 China

Demand-responsive transportation (DRT) is a flexible passenger service designed to enhance road efficiency, reduce peak-hour traffic, and boost passenger satisfaction. However, existing optimization methods for initial passenger requests fall short in addressing real-time passenger needs. Consequently, there is a need to develop real-time DRT route optimization methods that integrate both initial and real-time requests. This paper presents a two-stage, multi-obj.ctive optimization model for DRT vehicle scheduling. The first stage involves an initial scheduling model aimed at minimizing vehicle configuration, and operational, and CO2 emission costs while ensuring passenger satisfaction. The second stage develops a real-time scheduling model to minimize additional operational costs, penalties for time window violations, and costs due to rej.cted passengers, thereby addressing real-time demands. Additionally, an enhanced genetic algorithm based on Non-dominated Sorting Genetic Algorithm-II (NSGA-II) is designed, incorporating multiple crossover points to accelerate convergence and improve solution efficiency. The proposed scheduling model is validated using a real network in Shanghai. Results indicate that real-time scheduling can serve more passengers, and improve vehicle utilization and occupancy rates, with only a minor increase in total operational costs. Compared to the traditional NSGA-II algorithm, the improved version enhances convergence speed by 31.7% and solution speed by 4.8%. The proposed model and algorithm offer both theoretical and practical guidance for real-world DRT scheduling. © 2024 The Authors.

关键词： artificial intelligence applications Demand responsive transit genetic algorithm muti-obj.ctive optimization

A Facial Expression Recognition Method Integrating Uncertainty Estimation and Active Learning

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Computers, Materials and Continua 2024年第1期81卷 533-548页

作者： Wang Y. Zhang j. Sun R. School of Computer Science and Engineering Chongqing University of Technology Chongqing 400054 China Data Space Research Institute of Hefei Comprehensive National Science Center Hefei 230088 China

The effectiveness of facial expression recognition (FER) algorithms hinges on the model’s quality and the availability of a substantial amount of labeled expression data. However, labeling large datasets demands significant human, time, and financial resources. Although active learning methods have mitigated the dependency on extensive labeled data, a cold-start problem persists in small to medium-sized expression recognition datasets. This issue arises because the initial labeled data often fails to represent the full spectrum of facial expression characteristics. This paper introduces an active learning approach that integrates uncertainty estimation, aiming to improve the precision of facial expression recognition regardless of dataset scale variations. The method is divided into two primary phases. First, the model undergoes self-supervised pre-training using contrastive learning and uncertainty estimation to bolster its feature extraction capabilities. Second, the model is fine-tuned using the prior knowledge obtained from the pre-training phase to significantly improve recognition accuracy. In the pre-training phase, the model employs contrastive learning to extract fundamental feature representations from the complete unlabeled dataset. These features are then weighted through a self-attention mechanism with rank regularization. Subsequently, data from the low-weighted set is relabeled to further refine the model’s feature extraction ability. The pre-trained model is then utilized in active learning to select and label information-rich samples more efficiently. Experimental results demonstrate that the proposed method significantly outperforms existing approaches, achieving an improvement in recognition accuracy of 5.09% and 3.82% over the best existing active learning methods, Margin, and Least Confidence methods, respectively, and a 1.61% improvement compared to the conventional segmented active learning method. © 2024 The Authors.

关键词： active learning Expression recognition self-supervised learning uncertainty estimation

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人类是如何将狼变成狗的？

英语世界 2024年第7期 81-87页

作者：劳伦·j.扬邓安儿

大部分养宠物的人可能都了解向“狗狗眼”屈服的感觉——无论狗狗年龄有多大。当狗狗皱着眉，忧郁地望向你，你很难不去给它一个爱的挠挠，或者请它吃肉肉大餐。何乐而不为呢？你和毛孩子历经数千年的进化，才成全了这一时刻。

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何谓新唯物主义:通向操演性新唯物主义

世界哲学 2024年第2期 33-45页

作者： [美]C.甘布 [美]j.哈南 [美]T.奈尔牛小雪(译) 华盛顿大学传播系丹佛大学传播系丹佛大学哲学系复旦大学哲学学院

当代西方新唯物主义的共识在于质疑人类中心主义预设,并要求恢复物质自身的活力。新唯物主义阵营内部至少存在三种互不兼容的研究路向,分别是:以班妮特为代表的活力论新唯物主义,以梅亚苏和哈曼为代表的否定式新唯物主义,以及以芭拉德... 详细信息

当代西方新唯物主义的共识在于质疑人类中心主义预设,并要求恢复物质自身的活力。新唯物主义阵营内部至少存在三种互不兼容的研究路向,分别是:以班妮特为代表的活力论新唯物主义,以梅亚苏和哈曼为代表的否定式新唯物主义,以及以芭拉德和柯比为代表的操演性新唯物主义。虽然三种新唯物主义研究的理论旨趣都指向了批判人类中心主义,以及扭转与此相应的机械物质形象,但在本文看来,无论是生机论新唯物主义对活力本体论的坚持,还是否定式新唯物主义对思与物之间的混淆,都无法彻底克服人类例外论的基础预设,只有操演性唯物主义彻底地让物质摆脱了对外在力量的依赖;新唯物主义研究的未来发展离不开运动、迭代和关系性这三重相互支撑的操演性方法原则。

关键词：生机论新唯物主义否定式新唯物主义操演性思辨实在论面向对象的本体论