ObjectiveTo apply and systematically evaluate the care-need grading assessment tool for adults with disabilities in welfare institutions. MethodsFrom June to July, 2025, four disability care institutions in Shanghai were selected, and a total of 1 002 adults with disabilities were assessed using the self-developed care-need grading assessment tool for adults with disabilities in welfare institutions. The application effectiveness of the tool was evaluated by analyzing the classification results of care need grading and the reclassification in grade distribution. The application validity was assessed through score differences across functional dimensions, reduced-dimension clustering scatter plots for each grade, and external variables. The application efficiency was evaluated based on the average assessment duration and learning curves. The application utility value was assessed through the distribution characteristics and mapping relationships of service lists across different grades. ResultsThe distribution across disability levels was 84 in Level 1, 298 in Level 2, 92 in Level 3, 246 in Level 4, and 282 in Level 5, indicating a trend where individuals from higher levels in the original system shifted toward the middle and lower levels of the new system. The tool demonstrated strong discriminatory power across the four functional dimensions (P < 0.001), indicating favorable discriminant validity. The five classified levels exhibited clear clustering boundaries in the reduced-dimension space, reflecting robust structural validity. The classification results were consistent with theoretical expectations regarding external variables, including age, disability type, disability grade, number of comorbidities, and primary clinical diagnoses (P < 0.05), demonstrating sound external validity. The median assessment duration was 5.80 minutes, with a significant learning effect (P = 0.037), showcasing high efficiency. Finally, service lists tailored to different care levels were developed, where service content exhibited graded differences across care levels and accurately mapped the care-need characteristics of each grade, reflecting substantial utility value. ConclusionThis tool can classify the care needs of adults with disabilities into five levels, with sound validity and high assessment efficiency; while the resulting service lists for different care levels can be used to guide practical implementation, which can be used for the graded assessment of care needs among adults with disabilities.

Objective To quantify the lower limb coordination and coordination variability of children with spastic cerebral palsy(CP)during flat ground walking using vector coding technology.Methods From September to December,2023,eight children with spastic CP(patients)from Ji'nan Rehabilitation Hospi-tal and Ji'nan Special Education School,and eight healthy children(controls)from communities walked on a treadmill at a speed of 0.45 m/s.Lower limb kinematic data were collected using Vicon,a three-dimensional mo-tion capture system.Vector coding technology was used to quantify the temporal and spatial parameters of ipsilat-eral lower limb joints to calculate joint coupling angles and coupling angle variability(CAV).Results In the first and second double support phase,the hip-knee coupling angle was significantly larger in the patients than in the controls(|t|>2.317,P<0.05).In the swing phase,the hip-ankle and knee-ankle coupling angles were significantly larger in the patients(|t|>2.346,P<0.05).In the first double support phase and the single support phase,CAV of the hip-knee and hip-ankle were significantly larger in the patients(|t|>2.454,P<0.05),and they were smaller in the swing phase(t>2.560,P<0.05).In the second double support phase and the swing phase,CAV of the knee-ankle was significantly larger in the patients(|t|>2.909,P<0.05).Conclusion Coordination among hip,knee and ankle joints is poor for children with spastic CP during both the stance and swing phases of walking,and variability is more during the stance phase.

OBJECTIVE: To explore the clinical and genetic characteristics of five fetuses with Harlequin ichthyosis (HI). METHODS: Five fetuses with HI diagnosed at Guangdong Women and Children Hospital between 2017 and 2024 were selected as study subjects. Clinical and laboratory data were collected and reviewed. Whole exome sequencing (WES) was carried out, and candidate variants were verified by bioinformatic analysis. This study was approved by the Medical Ethics Committee of the hospital (Ethics No.: 202401024). RESULTS: The five fetuses had presented with ectropion, eclabium and contracture and flexion of fingers and toes. WES revealed that all had harbored compound heterozygous or homozygous variants of the ABCA12 gene. Among the eight types of variants, five were unreported previously. CONCLUSION The compound heterozygous or homozygous variants of the ABCA12 gene probably underlay the HI in the five fetuses. Clinicians should be vigilant about the possibility of HI in fetus with ectropion, eclabium, and contracture and flexion of fingers and toes.
Humans ; Ichthyosis, Lamellar/genetics* ; Female ; ATP-Binding Cassette Transporters/genetics* ; Pregnancy ; Genotype ; Phenotype ; Exome Sequencing ; Fetus ; Mutation ; Male ; Adult

Objective To develop a tool for assessing the needs for care services for adults with disabilities in welfare institutions,and formulate criteria for classifying care needs.Methods Based on the theory of the International Classification of Functioning,Disability and Health,the core contents of domestic and international care service assessment standards were analysed,and the first draft of the assess-ment tool was formed integrating with the current practice of welfare institutions.A total of eleven experts in the field of care services validated the first draft,and the assessment tool was revised according to the experts'opin-ions.From May to June,2024,340 adults with disabilities from Second Social Welfare Institute of Shanghai were graded to analyze the reliability and validity of the assessment tool.And then,1 046 subjects from Second Social Welfare Institute of Shanghai were graded using the assessment tool,and the scoring intervals for the five levels of care were determined using cluster analysis.Results The assessment tool included four first-level dimensions,eleven second-level dimensions,39 third-level dimen-sions and 43 indicators.The coefficients of variation of each dimension and indicator were less than 0.25 for ex-pert validation,while the average score of the importance of each indicator was above 4.63,with a full score rate more than 0.86.The overall Cronbach's α coefficient was 0.956,the test-retest reliability was 0.997,and the con-tent validity index of each indicator was 0.83 to 1.00.The exploratory factor analysis extracted four common fac-tors,with a cumulative variance contribution of 86.679%;the loading coefficients of indicators were 0.675 to 0.878,and the correlation coefficients among the dimensions were 0.325 to 0.476.Cluster analysis determined the level of institutional care needs as level 1(severe),level 2(medium-heavy),level 3(medium),level 4(light-moderate),and level 5(light).Conclusion The needs assessment tool for care services for adults with disabilities in welfare institutions developed in this study is good in reliability and validity,and can be used in guiding the care services provided for people with disabilities more efficient and targeted.

Objective:To investigate the activation characteristics of the cerebral cortex and the coordination characteris-tics of the lower limb joints in adolescents with spastic cerebral palsy during walking,and to provide a theo-retical basis for the rehabilitation training of their gait coordination.Method:A total of eight adolescents aged 12-18 years with spastic cerebral palsy were included as the spas-tic cerebral palsy group and eight normal adolescents aged 12-18 years were included as the control group.Both groups walked on a treadmill at a fixed speed of 0.45 m/s.A Vicon infrared high-speed motion capture system and a functional near-infrared spectroscopy system were applied to collect the kinematic data and hemo-dynamic signals in the sensory-motor cortical region of the two groups while walking on the treadmill.The mean absolute value of the continuous relative phase(MACRP)and the mean of the standard deviation of the relative phase(DP)were calculated to evaluate the coupling coordination characteristics of the lower limb links.The relative concentration change of oxygenated hemoglobin(HbO2)in the cerebral cortex was calculat-ed to evaluate the activation characteristics of the cerebral cortex.Result:①Comparison results of lower limb coordination ability:During walking,the MACRP value of cou-pling coordination of hip-knee joints within the left lower limb of the spastic cerebral palsy group was signifi-cantly smaller than that of the control group(P=0.043,Cohen's d=1.113).The DP value of coupled variability within the limb of the spastic cerebral palsy group was significantly larger than that of the control group for both the hip-knee(P=0.003,Cohen's d=1.755)and knee-ankle(P=0.009,Cohen's d=1.503)joints.②Compari-son results of brain activation levels:Channels 11(P=0.025,Cohen's d=1.258)and 12(P=0.02,Cohen's d=2.310)in the supplementary motor area,channels 6(P=0.043,Cohen's d=1.112),14(P=0.006,Cohen's d=1.633),and 15(P=0.002,Cohen's d=1.886)in the precentral gyrus,channels 6(P=0.043,Cohen's d=1.112),7(P=0.002,Cohen's d=1.837),15(P=0.002,Cohen's d=1.886),and 17(P=0.002,Cohen's d=1.933)in the postcentral gyrus,channels 9(P=0.016,Cohen's d=1.363),10(P=0.045,Cohen's d=1.101)and 18(P=0.001,Cohen's d=2.221)in the superior parietal lobule,the activation levels of the above chan-nels of the spastic cerebral palsy group were significantly greater than those of the control group.Conclusion:During walking,adolescents with spastic cerebral palsy had hyperactivation of the somatosensory-motor cortical area of the brain and an unstable pattern of joint coordination within the lower limbs,with a high degree of variability.

Objective To develop a tool for assessing the needs for care services for adults with disabilities in welfare institutions,and formulate criteria for classifying care needs.Methods Based on the theory of the International Classification of Functioning,Disability and Health,the core contents of domestic and international care service assessment standards were analysed,and the first draft of the assess-ment tool was formed integrating with the current practice of welfare institutions.A total of eleven experts in the field of care services validated the first draft,and the assessment tool was revised according to the experts'opin-ions.From May to June,2024,340 adults with disabilities from Second Social Welfare Institute of Shanghai were graded to analyze the reliability and validity of the assessment tool.And then,1 046 subjects from Second Social Welfare Institute of Shanghai were graded using the assessment tool,and the scoring intervals for the five levels of care were determined using cluster analysis.Results The assessment tool included four first-level dimensions,eleven second-level dimensions,39 third-level dimen-sions and 43 indicators.The coefficients of variation of each dimension and indicator were less than 0.25 for ex-pert validation,while the average score of the importance of each indicator was above 4.63,with a full score rate more than 0.86.The overall Cronbach's α coefficient was 0.956,the test-retest reliability was 0.997,and the con-tent validity index of each indicator was 0.83 to 1.00.The exploratory factor analysis extracted four common fac-tors,with a cumulative variance contribution of 86.679%;the loading coefficients of indicators were 0.675 to 0.878,and the correlation coefficients among the dimensions were 0.325 to 0.476.Cluster analysis determined the level of institutional care needs as level 1(severe),level 2(medium-heavy),level 3(medium),level 4(light-moderate),and level 5(light).Conclusion The needs assessment tool for care services for adults with disabilities in welfare institutions developed in this study is good in reliability and validity,and can be used in guiding the care services provided for people with disabilities more efficient and targeted.

Objective:To investigate the activation characteristics of the cerebral cortex and the coordination characteris-tics of the lower limb joints in adolescents with spastic cerebral palsy during walking,and to provide a theo-retical basis for the rehabilitation training of their gait coordination.Method:A total of eight adolescents aged 12-18 years with spastic cerebral palsy were included as the spas-tic cerebral palsy group and eight normal adolescents aged 12-18 years were included as the control group.Both groups walked on a treadmill at a fixed speed of 0.45 m/s.A Vicon infrared high-speed motion capture system and a functional near-infrared spectroscopy system were applied to collect the kinematic data and hemo-dynamic signals in the sensory-motor cortical region of the two groups while walking on the treadmill.The mean absolute value of the continuous relative phase(MACRP)and the mean of the standard deviation of the relative phase(DP)were calculated to evaluate the coupling coordination characteristics of the lower limb links.The relative concentration change of oxygenated hemoglobin(HbO2)in the cerebral cortex was calculat-ed to evaluate the activation characteristics of the cerebral cortex.Result:①Comparison results of lower limb coordination ability:During walking,the MACRP value of cou-pling coordination of hip-knee joints within the left lower limb of the spastic cerebral palsy group was signifi-cantly smaller than that of the control group(P=0.043,Cohen's d=1.113).The DP value of coupled variability within the limb of the spastic cerebral palsy group was significantly larger than that of the control group for both the hip-knee(P=0.003,Cohen's d=1.755)and knee-ankle(P=0.009,Cohen's d=1.503)joints.②Compari-son results of brain activation levels:Channels 11(P=0.025,Cohen's d=1.258)and 12(P=0.02,Cohen's d=2.310)in the supplementary motor area,channels 6(P=0.043,Cohen's d=1.112),14(P=0.006,Cohen's d=1.633),and 15(P=0.002,Cohen's d=1.886)in the precentral gyrus,channels 6(P=0.043,Cohen's d=1.112),7(P=0.002,Cohen's d=1.837),15(P=0.002,Cohen's d=1.886),and 17(P=0.002,Cohen's d=1.933)in the postcentral gyrus,channels 9(P=0.016,Cohen's d=1.363),10(P=0.045,Cohen's d=1.101)and 18(P=0.001,Cohen's d=2.221)in the superior parietal lobule,the activation levels of the above chan-nels of the spastic cerebral palsy group were significantly greater than those of the control group.Conclusion:During walking,adolescents with spastic cerebral palsy had hyperactivation of the somatosensory-motor cortical area of the brain and an unstable pattern of joint coordination within the lower limbs,with a high degree of variability.

Objective To quantify the lower limb coordination and coordination variability of children with spastic cerebral palsy(CP)during flat ground walking using vector coding technology.Methods From September to December,2023,eight children with spastic CP(patients)from Ji'nan Rehabilitation Hospi-tal and Ji'nan Special Education School,and eight healthy children(controls)from communities walked on a treadmill at a speed of 0.45 m/s.Lower limb kinematic data were collected using Vicon,a three-dimensional mo-tion capture system.Vector coding technology was used to quantify the temporal and spatial parameters of ipsilat-eral lower limb joints to calculate joint coupling angles and coupling angle variability(CAV).Results In the first and second double support phase,the hip-knee coupling angle was significantly larger in the patients than in the controls(|t|>2.317,P<0.05).In the swing phase,the hip-ankle and knee-ankle coupling angles were significantly larger in the patients(|t|>2.346,P<0.05).In the first double support phase and the single support phase,CAV of the hip-knee and hip-ankle were significantly larger in the patients(|t|>2.454,P<0.05),and they were smaller in the swing phase(t>2.560,P<0.05).In the second double support phase and the swing phase,CAV of the knee-ankle was significantly larger in the patients(|t|>2.909,P<0.05).Conclusion Coordination among hip,knee and ankle joints is poor for children with spastic CP during both the stance and swing phases of walking,and variability is more during the stance phase.

Compassion is an important part of nurses'professional quality,and it is also the basis of effective nurse-patient communication and humanistic care.Improving nurses'compassion is helpful to provide high-quality nursing services to patients.This study reviews the definition of compassion,the factors affecting compassion and the training methods to improve compassion,analyzes the shortcomings of existing training methods,and puts forward the prospects for future research,so as to provide a theoretical foundation for future compassion training among nurses.

During long-term electrocardiogram (ECG) monitoring, various types of noise inevitably become mixed with the signal, potentially hindering doctors' ability to accurately assess and interpret patient data. Therefore, evaluating the quality of ECG signals before conducting analysis and diagnosis is crucial. This paper addresses the limitations of existing ECG signal quality assessment methods, particularly their insufficient focus on the 12-lead multi-scale correlation. We propose a novel ECG signal quality assessment method that integrates a convolutional neural network (CNN) with a squeeze and excitation residual network (SE-ResNet). This approach not only captures both local and global features of ECG time series but also emphasizes the spatial correlation among ECG signals. Testing on a public dataset demonstrated that our method achieved an accuracy of 99.5%, sensitivity of 98.5%, and specificity of 99.6%. Compared with other methods, our technique significantly enhances the accuracy of ECG signal quality assessment by leveraging inter-lead correlation information, which is expected to advance the development of intelligent ECG monitoring and diagnostic technology.
Electrocardiography/methods* ; Humans ; Signal Processing, Computer-Assisted ; Neural Networks, Computer ; Algorithms