Heart rate variability time and frequency indices are widely used in functional assessment for autonomic nervous system (ANS). However, this method merely analyzes the effect of cardiac dynamics, overlooking the effect of cardio-pulmonary interplays. Given this, the present study proposes a novel cardiopulmonary coupling (CPC) algorithm based on cross-wavelet transform to quantify cardio-pulmonary interactions, and establish an assessment system for ANS aging effects using wearable electrocardiogram (ECG) and respiratory monitoring devices. To validate the superiority of the proposed method under nonstationary and low signal-to-noise ratio conditions, simulations were first conducted to demonstrate the performance strength of the proposed method to the traditional one. Next, the proposed CPC algorithm was applied to analyze cardiac and respiratory data from both elderly and young populations, revealing that young populations exhibited significantly stronger couplings in the high-frequency band compared with their elderly counterparts. Finally, a CPC assessment system was constructed by integrating wearable devices, and additional recordings from both elderly and young populations were collected by using the system, completing the validation and application of the aging effect assessment algorithm and the wearable system. In conclusion, this study may offers methodological and system support for assessing the aging effects on the ANS.
Humans ; Autonomic Nervous System/physiology* ; Algorithms ; Aging/physiology* ; Electrocardiography/methods* ; Heart Rate/physiology* ; Wavelet Analysis ; Aged ; Signal Processing, Computer-Assisted ; Wearable Electronic Devices

Objective:The SARS-CoV-2 has a high natural mutation rate, and dynamic monitoring of virus variants remains a key focus in current COVID-19 prevention and control efforts.Methods:In this study, a sensitive and rapid method for detecting SARS-CoV-2 omicron variant nucleic acid was established based on the BMD-PCR technology.Results:This method showed good specificity, and had no cross-reactivity with 11 common viruses transmitted via the respiratory and gastrointestinal tracts, and the limit of detection is 555 copies/ml. Compared with SARS-CoV-2 whole-genome sequencing result, among 50 samples with original Ct values ≤32 tested for the Omicron variant, 49 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, achieving a concordance rate of 98.00%. For 30 samples JN.1 lineage, 29 samples tested positive for the K356T mutation site using BMD-PCR JN.1 lineage detection, with a concordance rate of 96.67%. For 10 samples with original SARS-CoV-2 detection Ct values between 35 and 32, 7 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, Resultsing in a detection rate of 70.00%. For samples with SARS-CoV-2 nucleic acid detection Ct values>35, the detection rate for the N679K mutation site in the BMD-PCR Omicron variant was 20.00%.Conclusions:This method can serve as a high-throughput supplementary approach for the preliminary identification of SARS-CoV-2 variant genotypes.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective:To explore the current status and influencing factors of non-verbal communication needs in mechanically ventilated patients in ICU using an interpretive sequential mixed research design to inform the future development of targeted non-verbal communication strategies for mechanically ventilated patients in the ICU.Methods:Convenience sampling was used to select 262 mechanically ventilated patients from the general ICUs of two Class Ⅲ Grade A hospitals in Shanghai, from January to June 2023 for the study. Patients were surveyed using the General Information Questionnaire and the Surgical ICU Tracheal Intubation Patient Communication Needs Scale. Multiple linear regression was used to analyze the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU. A total of 262 questionnaires were distributed in the quantitative study, and 256 valid questionnaires were recovered, with a valid recovery rate of 97.71% (256/262) . Purposive sampling was used to select 16 ICU mechanically ventilated patients for semi-structured in-depth interviews. The information was analyzed using the Colaizzi 7-step analysis method.Results:In 256 mechanically ventilated patients, the total non-verbal communication needs score was (144.33±12.82) , and the items average scores of physiological needs, safety needs, love and belongingness needs, and self-esteem needs were (3.39±1.83) , (3.35±0.98) , (3.32±1.21) , and (3.29±1.32) , respectively. Multiple linear regression analysis showed that the duration of mechanical ventilation, history of intubation, and education level were the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU ( P<0.05) . Five themes were distilled from the qualitative study, including communication needs for shared decision-making about disease trajectories, communication needs for accurate management of disease symptoms, communication needs for psychological stress adjustment, communication needs for social system support, and communication needs for dignity preservation. Integrating and analyzing the quantitative and qualitative results revealed that they complemented each other in explaining and validating ideas in elaborating the current status and intrinsic relationship of non-verbal communication needs of mechanically ventilated patients in ICU. Conclusions:The non-verbal communication needs of mechanically ventilated patients in the ICU are prevalent and influenced by a variety of factors. It is recommended that hospital administrators construct an effective non-verbal communication support system based on the status quo of patients' non-verbal communication needs in order to promote the whole process and multidimensional health management services for ICU mechanically ventilated patients and to improve patients' quality of life.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective:To explore the current status and influencing factors of non-verbal communication needs in mechanically ventilated patients in ICU using an interpretive sequential mixed research design to inform the future development of targeted non-verbal communication strategies for mechanically ventilated patients in the ICU.Methods:Convenience sampling was used to select 262 mechanically ventilated patients from the general ICUs of two Class Ⅲ Grade A hospitals in Shanghai, from January to June 2023 for the study. Patients were surveyed using the General Information Questionnaire and the Surgical ICU Tracheal Intubation Patient Communication Needs Scale. Multiple linear regression was used to analyze the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU. A total of 262 questionnaires were distributed in the quantitative study, and 256 valid questionnaires were recovered, with a valid recovery rate of 97.71% (256/262) . Purposive sampling was used to select 16 ICU mechanically ventilated patients for semi-structured in-depth interviews. The information was analyzed using the Colaizzi 7-step analysis method.Results:In 256 mechanically ventilated patients, the total non-verbal communication needs score was (144.33±12.82) , and the items average scores of physiological needs, safety needs, love and belongingness needs, and self-esteem needs were (3.39±1.83) , (3.35±0.98) , (3.32±1.21) , and (3.29±1.32) , respectively. Multiple linear regression analysis showed that the duration of mechanical ventilation, history of intubation, and education level were the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU ( P<0.05) . Five themes were distilled from the qualitative study, including communication needs for shared decision-making about disease trajectories, communication needs for accurate management of disease symptoms, communication needs for psychological stress adjustment, communication needs for social system support, and communication needs for dignity preservation. Integrating and analyzing the quantitative and qualitative results revealed that they complemented each other in explaining and validating ideas in elaborating the current status and intrinsic relationship of non-verbal communication needs of mechanically ventilated patients in ICU. Conclusions:The non-verbal communication needs of mechanically ventilated patients in the ICU are prevalent and influenced by a variety of factors. It is recommended that hospital administrators construct an effective non-verbal communication support system based on the status quo of patients' non-verbal communication needs in order to promote the whole process and multidimensional health management services for ICU mechanically ventilated patients and to improve patients' quality of life.

Objective:The SARS-CoV-2 has a high natural mutation rate, and dynamic monitoring of virus variants remains a key focus in current COVID-19 prevention and control efforts.Methods:In this study, a sensitive and rapid method for detecting SARS-CoV-2 omicron variant nucleic acid was established based on the BMD-PCR technology.Results:This method showed good specificity, and had no cross-reactivity with 11 common viruses transmitted via the respiratory and gastrointestinal tracts, and the limit of detection is 555 copies/ml. Compared with SARS-CoV-2 whole-genome sequencing result, among 50 samples with original Ct values ≤32 tested for the Omicron variant, 49 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, achieving a concordance rate of 98.00%. For 30 samples JN.1 lineage, 29 samples tested positive for the K356T mutation site using BMD-PCR JN.1 lineage detection, with a concordance rate of 96.67%. For 10 samples with original SARS-CoV-2 detection Ct values between 35 and 32, 7 samples tested positive for the N679K mutation site using BMD-PCR Omicron variant detection, Resultsing in a detection rate of 70.00%. For samples with SARS-CoV-2 nucleic acid detection Ct values>35, the detection rate for the N679K mutation site in the BMD-PCR Omicron variant was 20.00%.Conclusions:This method can serve as a high-throughput supplementary approach for the preliminary identification of SARS-CoV-2 variant genotypes.

Objective To explore the clinical significance of serum activated protein C(APC)and heme ox-ygenase-1(HO-1)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with type Ⅱ respiratory failure treated with non-invasive mechanical ventilation(NIV).Methods A total of 265 AECOPD patients with type Ⅱ respiratory failure admitted to the Second People's Hospital of Panzhihua City from April 2021 to April 2023 were selected as the study group,and another 200 stable chronic obstruc-tive pulmonary disease(COPD)patients and 200 healthy individuals were selected as the stable COPD group and healthy group.The serum APC and HO-1 levels of the three groups were compared.After receiving NIV treatment,the study group was divided into a poor prognosis group(40 cases)and a good prognosis group(225 cases)based on their prognosis within 28 days.General information,laboratory indicators,and serum APC and HO-1 levels were compared between the two groups.Multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum APC and HO-1 in predicting patient prognosis.Results Compared with the healthy group,serum APC levels decreased in the stable COPD group,serum HO-1 levels increased(P＜0.05).Compared with the stable COPD group,serum APC levels decreased in the study group,serum HO-1 levels increased(P＜0.05).Compared with the good prognosis group,serum APC,pH,arterial oxygen partial pressure(PaO2)before NIV decreased in the poor prognosis group,serum HO-1,arterial partial pressure of carbon dioxide(PaCO2)levels,acute physiology and chronic health evaluation(APACHE)Ⅱ scores increased(P＜0.05).The results of the multivariate Logistic regression model showed that PaCO2,APACHE Ⅱ score and HO-1 elevated were risk factors for poor patient prognosis,while the Forced Expiratory Volume in 1 Sec-ond/excepted value(FEV1％Pred),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),PaO2,APC,pH elevated were protective factors(P＜0.05).ROC curve results showed that the area under the curve,sensitivity and specificity of the combined detection of two indicators for predicting poor prognosis in AECOPD patients with type Ⅱ respiratory failure treated with NIV were 0.914,87.50％and 94.22％respectively,which were significantly better than those of single indicator detection.Conclusion The decrease of serum APC level and the increase of serum HO-1 level are relate to the poor prognosis of AECO-PD patients with type Ⅱ respiratory failure treated with NIV,detection of serum APC combine with HO-1 has relatively high predictive value for the poor prognosis of the patients.