Patient Repositioning during Hospitalization and Prevention of Pressure Ulcers: a Narrative Review / Reposicionamiento de pacientes en hospitalización y prevención de úlceras por presión: una revisión narrativa / Reposicionamento de pacientes na internação e prevenção de úlceras por pressão: uma revisão narrativa

Objective. This article presents a literature review to explore and analyze the current situation of pressure ulcers or lesions or decubitus ulcers, pathophysiological, epidemiological aspects, and risk factors. The progress in evidence of the effectiveness of preventive repositioning in the appearance of these lesions in vulnerable hospitalized patients is also evaluated. Methods. Databases were reviewed in non-systematic manner, including the Cochrane Wounds Specialized Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, SciELO, and Lilacs. The general search terms included [pressure ulcers or pressure lesions or decubitus ulcers] and [prevention or preventive] and [repositioning or positioning or position changes or postural change] and [patient at risk or vulnerable] and [hospitalized or ICU or intensive care]. Systematic literature reviews, randomized clinical trials, observational studies, cost-effectiveness and qualitative studies in English or Spanish were included. Results. Although globally, the incidence, prevalence, and years of disability associated to these lesions has diminished between 1990 and 2019, the high impact on health persists. Evidence found on the effectiveness of repositioning in preventing pressure ulcers and health associated costs has been evaluated with certainty between low and very low, as a result of conducting research with serious methodological limitations that report results with high inaccuracy. Conclusion.The findings reported present that these lesions persist at hospital level and continue being a global social and health problem with high impact on health budgets. Likewise, there is a need to develop greater quality research on prevention strategies, such as repositioning, which validate their effectiveness, and justify their use.

Objetivo. Este artículo presenta una revisión de la literatura con el objetivo de explorar y analizar la situación actual de las úlceras o lesiones por presión o úlceras por decúbito, aspectos fisiopatológicos, epidemiológicos, y factores de riesgo. Se evalúa además el progreso en la evidencia de la eficacia del reposicionamiento preventivo en la aparición de estas lesiones en pacientes vulnerables hospitalizados. Métodos. Se revisaron bases de datos de forma no sistemática, incluyendo The Cochrane Wounds Specialised Register; Medline, Scopus, PubMed, the Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, Scielo, y Lilacs. Los términos de búsqueda generales incluyeron [úlceras por presión o lesiones por presión o úlceras por decúbito] y [prevención o preventivo] y [reposicionamiento o posicionamiento o cambios de posición o cambio postural] y [paciente en riesgo o vulnerable] y [hospitalizado o UCI o cuidados intensivos]. Se incluyeron revisiones sistemáticas de la literatura, ensayos clínicos aleatorizados, estudios observacionales, estudios de costo-efectividad y cualitativos en idioma inglés o español. Resultados. Aunque globalmente la incidencia, prevalencia y años de incapacidad asociado a estas lesiones ha disminuido entre 1990 y 2019, el impacto en salud persiste de forma elevada. La evidencia encontrada sobre la eficacia del reposicionamiento en prevención de úlceras por presión y costos asociados en salud ha sido evaluada con certeza entre baja y muy baja, como resultado de la realización de investigaciones con serias limitaciones metodológicas que reportan resultados con alta imprecisión. Conclusión.Los hallazgos reportados presentan que estas lesiones persisten a nivel hospitalario y continúan siendo un problema social y de salud mundial con alto impacto en los presupuestos en salud. Así mismo se presenta la necesidad de desarrollar mayor investigación de calidad en estrategias preventivas como el reposicionamiento, que validen su eficacia, y justifiquen su utilización.

Objetivo. Este artigo apresenta uma revisão da literatura com o objetivo de explorar e analisar a situação atual das úlceras por pressão ou úlceras de decúbito, os aspectos fisiopatológicos e epidemiológicos e os fatores de risco. Também avalia o progresso na evidência da eficácia do reposicionamento preventivo no desenvolvimento dessas lesões em pacientes hospitalizados vulneráveis. Métodos.Foram revisados bancos de dados não específicos do local, incluindo The Cochrane Wounds Specialised Register; Medline, Scopus, PubMed, Cochrane Central Register of Controlled Trials; MEDLINE (Ovid); EMBASE (Ovid), Web of Science, Scielo e Lilacs. Os termos gerais de pesquisa incluíram [úlceras de pressão ou lesões por pressão ou úlceras de pressão ou úlceras de decúbito] e [prevenção ou preventivo] e [reposicionamento ou posicionamento ou mudanças de posição ou mudança postural] e [paciente em risco ou vulnerável] e [hospitalizado ou UTI ou terapia intensiva]. Foram incluídas revisões sistemáticas da literatura, ensaios clínicos randomizados, estudos observacionais, estudos de custo-efetividade e qualitativos em inglês ou espanhol. Resultados. Embora, em geral, a incidência, a prevalência e os anos de incapacidade associados a essas lesões tenham diminuído entre 1990 e 2019, o impacto na saúde continua alto. As evidências encontradas sobre a eficácia do reposicionamento na prevenção de úlceras por pressão e os custos de saúde associados foram avaliadas com certeza baixa a muito baixa, como resultado de pesquisas com sérias limitações metodológicas que relataram resultados altamente imprecisos. Conclusão. Os resultados relatados mostram que essas lesões persistem em nível hospitalar e continuam a ser um problema social e de saúde global com alto impacto nos orçamentos de saúde. Também há necessidade de mais pesquisas de qualidade sobre estratégias preventivas, como o reposicionamento, para validar sua eficácia e justificar seu uso.

Prediction of brucellosis incidence in Urumqi / 公共卫生与预防医学

Objective To explore the application of seasonal autoregressive integrated moving average (ARIMA) model in the prediction of brucellosis in Urumqi, and to use this model to predict the incidence trend of brucellosis in Urumqi. Methods The monthly incidence data of brucellosis in Urumqi from January 2010 to December 2021 were selected to construct the ARIMA prediction model. The prediction effect of the model was evaluated by mean standard deviation (RMSE) and mean absolute error (MAE). The monthly incidence of brucellosis in Urumqi in 2022 was predicted by the constructed model. Results The incidence of brucellosis in Urumqi had obvious seasonal distribution, and the cases were concentrated from May to July. ARIMA(1,1,1)(1,0,1)12 was the optimal prediction model, with RMSE=0.883 and MAE=5.24. The monthly incidence of brucellosis in Urumqi in 2022 was predicted to be 7, 4, 4, 6, 9, 9, 10, 7, 7, 5, 5, and 5 cases, respectively. Conclusion ARIMA model can well fit and predict the monthly incidence of brucellosis in Urumqi and provide a basis for the monitoring and prevention of brucellosis.

Relationship between serum reproductive hormones and sperm parameters and surgical outcomes in Micro-TESE / 现代泌尿外科杂志

【Objective】 To investigate the relationship between serum reproductive hormones and sperm parameters and outcomes of micro-testicular sperm extraction (Micro-TESE). 【Methods】 Clinical data of 1 091 patients treated in our hospital during Jan. and Dec.2021 were retrospectively analyzed. According to the sperm concentration,the patients were divided into non-obstructive azoospermia (NOA) group (group A,n=418),normal sperm concentration group (group B,n=615),mild to moderate oligospermia group (group C,n=18),severe oligospermia group (group D,n=18),and obstructive azoospermia group (group E,n=22). In group A,244 cases treated with Micro-TESE were grouped into the sperm-acquired group (Micro-TESE positive group,n=82) and non-sperm-acquired group (Micro-TESE negative group,n=162),and according to the pathological types of testicular tissue,the patients were divided into normal testicular tissue with hypospermatogenesis group (HYPO group,n=129),maturation arrest group (MA group,n=10),and support-only cell syndrome group (SCO group,n=122). Differences in semen parameters and reproductive hormone levels were compared,and relationship between reproductive hormones and sperm parameters and Micro-TESE outcomes was determined with Pearson correlation analysis. 【Results】 In the sperm concentration subgroup,the testicular volume of group A was lower than that of group B and group E (P<0.05); the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in group A were the highest (P<0.05),but the level of testosterone (T) was the lowest (P<0.05); the levels of anti-mullerian hormone (AMH) and serum inhibin B (INHB) in group A were lower than those in group B and group E (P<0.05),the normal sperm morphology rate in group B was higher than that in group A and group E (P<0.05); the percentage of forward moving sperm in group B was the highest (P<0.05). Pearson correlation analysis revealed that sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm were negatively correlated with age,FSH,LH (P<0.05),and positively correlated with testicular volume,T,AMH,and INHB (P<0.05). NOA patients were grouped according to testicular histology and pathology. The INHB in the SCO group was the smallest of the three groups (P<0.05); the FSH and LH levels in the SCO group were higher than those in the MA group (P<0.05),while the 17β-estradiol (E2) levels in the HYPO group were higher than those in the SCO group (P<0.05). NOA patients were grouped according to the results of Micro-TESE surgical treatment. There was a statistically significant difference in AMH and INHB levels between the Micro-TESE positive and negative groups (P<0.05). The binary logistic regression analysis of factors affecting the Micro-TESE outcomes of NOA patients showed AMH was negatively correlated with the Micro-TESE outcome (OR=0.904,95%CI:0.91-1.08,P<0.05). 【Conclusion】 Age,FSH,LH,AMH,and INHB are correlated with sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm. The INHB level was the lowest in the SCO group. The results of Micro-TESE in patients with NOA can be predicted by serum AMH level.

An Atrial Fibrillation Classification Method Study Based on BP Neural Network and SVM / 中国医疗器械杂志

Atrial fibrillation is a common arrhythmia, and its diagnosis is interfered by many factors. In order to achieve applicability in diagnosis and improve the level of automatic analysis of atrial fibrillation to the level of experts, the automatic detection of atrial fibrillation is very important. This study proposes an automatic detection algorithm for atrial fibrillation based on BP neural network (back propagation network) and support vector machine (SVM). The electrocardiogram (ECG) segments in the MIT-BIH atrial fibrillation database are divided into 10, 32, 64, and 128 heartbeats, respectively, and the Lorentz value, Shannon entropy, K-S test value and exponential moving average value are calculated. These four characteristic parameters are used as the input of SVM and BP neural network for classification and testing, and the label given by experts in the MIT-BIH atrial fibrillation database is used as the reference output. Among them, the use of atrial fibrillation in the MIT-BIH database, the first 18 cases of data are used as the training set, and the last 7 cases of data are used as the test set. The results show that the accuracy rate of 92% is obtained in the classification of 10 heartbeats, and the accuracy rate of 98% is obtained in the latter three categories. The sensitivity and specificity are both above 97.7%, which has certain applicability. Further validation and improvement in clinical ECG data will be done in next study.

Time series analysis and prediction model of percentage of influenza-like illness （ILI） cases in Shanghai / 上海预防医学

ObjectiveTo predict the incidence trend of influenza-like illness proportion （ILI%） in Shanghai using the seasonal autoregressive integrated moving average model （SARIMA）， and to provide an important reference for timely prevention and control measures. MethodsTime series analysis was performed on ILI% surveillance data of Shanghai Municipal Center for Disease Control and Prevention from the 15th week of 2015 to the 52nd week of 2019， and a prediction model was established. Seasonal autoregressive integrated moving average （SARIMA） model was established using data from the foregoing 212 weeks， and prediction effect of the model was evaluated using data from the latter 36 weeks. ResultsFrom the 15th week of 2015 to the 52nd week of 2019， the average ILI% in Shanghai was 1.494%， showing an obvious epidemic peak. SARIMA（1，0，0） （2，0，0） 52 was finally modeled. The residual of the model was white noise sequence， and the true values were all within the 95% confidence interval of the predicted values. ConclusionSARIMA（1，0，0） （2，0，0） 52 can be used for the medium term prediction of ILI% in Shanghai， and can play an early warning role for the epidemic and outbreak of influenza in Shanghai.

Application and efficacy of patient-based real-time quality control in intralaboratory comparison of various hematology analyzers / 中华检验医学杂志

Objective:To evaluate the application value of patient-based real-time quality control (PBRTQC) algorithms in intralaboratory comparison between various hematology analyzers.Method:From April 1 st 2020 to March 31 th 2021, data of white blood cell (WBC) counts and daily comparison results of fresh venous blood, measured by five hematology analyzers, were collected at the Department of Laboratory Medicine in Hebei Children′s Hospital. First, the professional intelligent PBRTQC software system was applied to conduct the parameter setting, program establishment, and performance verification. Three concentration ranges of WBC were selected, low concentration (2.5-4.5)×10 9/L, medium concentration (6.0-8.0)×10 9/L and high concentration (12.0-14.0)×10 9/L for the comparison. Next, WBC counts were calculated with both of the EWMA and median methods, the results were then analyzed by PBRTQC using the module of"intralaboratory comparison of hematology analyzers". Finally, bias of intralaboratory comparison among various hematology analyzers analyzed by means of EWMA and daily comparison results of fresh venous blood were compared. Based on the standard of WS/T 406-2012,allowable error ±7.50% in WBC counts was set as the relative bias standard among different instruments. Results:(1) A total of 38 313 sample results were included, there were 70 warning results out of these samples based on the EWMA quality control method established on the data of patients with white blood cell count in our laboratory, with an early warning rate of 0.183‰, a probability of error detection of 100%, and a probability of false loss of control of 0. EWMA quality control efficiency met the quality objectives. (2) In the comparison monitoring of the results of 5 blood cell analyzers at high concentrations, the coincidence rate between EWMA and median method were both 100% (46/46) in weekly and monthly comparison, and EWMA could maintain a relatively stable monitoring efficiency in daily comparison. (3) In the selected natural month, the consistency rate between EWMA method and fresh blood comparison method was 95.24% (20/21).Conclusion:PBRTQC can be used as a valuable supplementary tool of IQC to continuously and effectively monitor the consistency of data derived from intralaboratory hematology analyzers with different bands and types, which can not only reduce the risk of quality and operating costs, but also improve the efficiency of laboratory management.

Epidemiological characteristics and trend prediction of pulmonary tuberculosis in Ankang City, Shaanxi Province from 2011 to 2021 / 中国热带医学

@#Abstract: Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Ankang City from 2011 to 2021, so as to provide a scientific basis for the formulation of PTB prevention and control strategy. Methods Descriptive statistics were used to analyze the epidemiological characteristics of PTB in Ankang City from 2011 to 2021, and a time series model was established to quantitatively predict the incidence of pulmonary tuberculosis in 2023. Results The incidence rate in Ankang City showed a significant upward trend from 2011 to 2017, and a more obvious downward trend in 2017-2021 (P<0.05), and the decrease rate in 2021 was 40.36% compared with that in 2017. The proportion of etiological positivity increased from 12.5% in 2014 to over 50.00% after 2019. The incidence season was mainly concentrated in the first quarter, accounting for 28.39% of the annual incidence. High incidence areas were concentrated in the south of Ankang: Langao County, Ziyang County and Zhenping County, with 128.32/100 000, 117.07/100 000 and 110.44/100 000, respectively. Low incidence areas were located in the north of Ankang: Ningshan County, with 60.62/100 000. Farmers and students were the high incidence groups, accounting for 81.80% and 4.97% of the total cases respectively. The incidence of young children was relatively low, but cases were reported every year. The incidence rate of male was 2.39 times that of female. The age of onset increased significantly from 15 years old, and the peak incidence was in the age group of 60-<80 years old, followed by the age group of 45-<60 years old, the average annual incidence was 136.44/100 000 and 104.47/100 000, respectively. The model ARIMA(0,1,1)(0,1,1)12 predicted that the incidence of the disease generally increased from October 2022 to March 2023, then steadily decreased, and increased again in December. Conclusions The incidence of tuberculosis varies in different areas of Ankang City, and males, farmers, students and the elderly are all factors of high incidence of tuberculosis. Therefore, different prevention and control strategies should be adopted according to the characteristics of population in different areas. The number of cases in Ankang City in 2023 showed an overall downward trend, which can provide a reference for the prevention and control of PTB.

A Case Report of Painful Legs and Moving Toes Syndrome and Painful Arms and Moving Fingers Syndrome with Severe Blood Stasis and Panic Disorder Successfully Treated with Tokakujokito-Based Kampo Prescriptions / 日本東洋医学雑誌

The patient was a 47-year-old woman. Four years previously, she began to suffer from left lower leg pain and numbness, and involuntary movements. She received further examination in the department of neurology at other hospitals, but had an uncertain etiology and was provisionally diagnosed with restless legs syndrome. She was treated with Western medicine such as gabapentin and gabapentin enacarbil, but they were ineffective. She subsequently visited our hospital and was hospitalized. She was diagnosed with painful legs and moving toes syndrome, and painful arms and moving fingers syndrome after further examination. We prescribed tokakujokito because she had severe blood stasis and panic disorder on Kamp medical findings. As a result, her left lower leg numbness disappeared and pain was reduced. We report a case of a patient who could not be effectively treated using Western medicine and was successfully treated with tokakujokito-based Kampo prescriptions.

An Easily Compatible Eye-tracking System for Freely-moving Small Animals / 神经科学通报·英文版

Measuring eye movement is a fundamental approach in cognitive science as it provides a variety of insightful parameters that reflect brain states such as visual attention and emotions. Combining eye-tracking with multimodal neural recordings or manipulation techniques is beneficial for understanding the neural substrates of cognitive function. Many commercially-available and custom-built systems have been widely applied to awake, head-fixed small animals. However, the existing eye-tracking systems used in freely-moving animals are still limited in terms of their compatibility with other devices and of the algorithm used to detect eye movements. Here, we report a novel system that integrates a general-purpose, easily compatible eye-tracking hardware with a robust eye feature-detection algorithm. With ultra-light hardware and a detachable design, the system allows for more implants to be added to the animal's exposed head and has a precise synchronization module to coordinate with other neural implants. Moreover, we systematically compared the performance of existing commonly-used pupil-detection approaches, and demonstrated that the proposed adaptive pupil feature-detection algorithm allows the analysis of more complex and dynamic eye-tracking data in free-moving animals. Synchronized eye-tracking and electroencephalogram recordings, as well as algorithm validation under five noise conditions, suggested that our system is flexibly adaptable and can be combined with a wide range of neural manipulation and recording technologies.

Comparison of the application effects of SARIMA, GAM and LSTM in prediction of hemorrhagic fever with renal syndrome / 中华地方病学杂志

Objective:To analyze the effects of seasonal autoregressive integrated moving average model (SARIMA), generalized additive model (GAM), and long-short term memory model (LSTM) in fitting and predicting the incidence of hemorrhagic fever with renal syndrome (HFRS), so as to provide references for optimizing the HFRS prediction model.Methods:The monthly incidence data of HFRS from 2004 to 2017 of the whole country and the top 9 provinces with the highest incidence of HFRS (Heilongjiang, Shaanxi, Jilin, Liaoning, Shandong, Hebei, Jiangxi, Zhejiang and Hunan) were collected in the Public Health Science Data Center (https://www.phsciencedata.cn/), of which the data from 2004 to 2016 were used as training data, and the data from January to December 2017 were used as test data. The SARIMA, GAM, and LSTM of HFRS incidence in the whole country and 9 provinces were fitted with the training data; the fitted model was used to predict the incidence of HFRS from January to December 2017, and compared with the test data. The mean absolute percentage error ( MAPE) was used to evaluate the model fitting and prediction accuracy. When MAPE < 20%, the model fitting or prediction effect was good, 20%-50% was acceptable, and > 50% was poor. Results:From the perspective of overall fitting and prediction effect, the optimal model for the whole country and Heilongjiang, Shaanxi, Jilin, Liaoning and Jiangxi was SARIMA ( MAPE was 19.68%, 20.48%, 44.25%, 19.59%, 23.82% and 35.29%, respectively), among which the fitting and prediction effects of the whole country and Jilin were good, and the rest were acceptable. The optimal model for Shandong and Zhejiang was GAM ( MAPE was 18.29% and 21.25%, respectively), the fitting and prediction effect of Shandong was good, and Zhejiang was acceptable. The optimal model for Hebei and Hunan was LSTM ( MAPE was 26.52% and 22.69%, respectively), and the fitting and prediction effects were acceptable. From the perspective of fitting effect, GAM had the highest fitting accuracy in the whole country data, with MAPE = 10.44%. From the perspective of prediction effect, LSTM had the highest prediction accuracy in the whole country data, with MAPE = 12.23%. Conclusions:SARIMA, GAM, and LSTM can all be used as the optimal models for fitting the incidence of HFRS, but the optimal models fitted in different regions show great differences. In the future, in the establishment of HFRS prediction models, as many alternative models as possible should be included for screening to ensure higher fitting and prediction accuracy.

The predictive value of time series forecasting model in prehospital emergency medical services demand in Guangzhou / 中华急诊医学杂志

Objective:To study the value of autoregressive integrated moving average (ARIMA) and autoregressive (AR) models in predicting the daily number of ambulances in prehospital emergency medical services demand in Guangzhou.Methods:Matlab simulation software was used to analyze the emergency dispatching departure records in Guangzhou from January 1, 2021 to December 31, 2021. A time series for the number of ambulances per day was calculated. After identifying the time series prediction model, ARIMA(1,1,1), AR(4) and AR(7) models were obtained. These models were used to predict the number of ambulances per day. ARIMA(1,1,1) model divided the time series into the training set and test set. Prony method was used for parameter calculation, and the demands of number of ambulances of the next few months were forecasted. AR(4) and AR(7) models used uniformity coefficient to forecast the demands of number of ambulances on that very day.Results:ARIMA(1,1,1), AR(4) and AR(7) can effectively predict the number of ambulances per day. The prediction fitting error of ARIMA (1,1,1) decreased with the extension of prediction time. The mean absolute percentage error (MAPE) of forecast results of daily vehicle output of emergency dispatching within two months was less than 6% and the predicted results were almost within the 95% confidence interval. The residual analysis of the model verified that the model was significantly effective.Conclusions:ARIMA model can make a long-term within two months and effective prediction fitting of the daily vehicle output of emergency dispatching, and AR model can make a short-term and effective prediction of the daily vehicle output of emergency dispatching.

Modelación matemática de los casos autóctonos de Covid-19. Municipio Bayamo. Febrero- Agosto 2021

El municipio Bayamo acumuló, 8162 casos positivos autóctonos de febrero a agosto en el año 2021, es el centro de la epidemia en la provincia de COVID-19 provocada por el SARS -CoV-2 determinado por el test de Proteína C Reactiva, representa el53,2 % del total de los casos en ese periodo en Granma, muy diferente a lo ocurrido en el año 2020 en el cual la provincia acumuló solamente 185personas contagiadas en nueve meses, con una tasa de 22.6 la más baja de Cuba. La provincia Granma acumuló 119 fallecidos en agosto/2021 que representa el 62,9 % de todos los muertos desde que comenzó la pandemia hasta agosto, lo que indica la alta incidencia de la epidemia que hay en estos momentos. Para la modelación matemática y el análisis de los casos positivos autóctonos de todos los ocurridos durante los meses de febrero a agosto en el año 2021 en Bayamo se obtuvieron polinomios de grado tres y cuatro que modelan el comportamiento de la epidemia durante los siete meses analizados, así como el de los fallecidos durante el mes de agosto en Granma con un carácter predictivo mayor al 98 % en todos los modelos.

The Bayamo municipality accumulated 8162 autochthonous positive cases from February to August in 2021, it is the center of the epidemic in the province of COVID-19 caused by SARS-CoV-2 determined by the C-Reactive Protein test, represents the 53.2% of the total cases in that period in Granma, very different from what happened in 2020 in which the province accumulated only 185 infected people in nine months, with a rate of 22.6, the lowest in Cuba. Granma province accumulated 119 deaths in August / 2021, which represents 62.9% of all deaths since the pandemic began until August, which indicates the high incidence of the epidemic that exists at the moment. For the mathematical modeling and analysis of the autochthonous positive cases of all those that occurred during the months of February to August in 2021 in Bayamo, polynomials of degree three and four were obtained that model the behavior of the epidemic during the seven months analyzed. as well as that of the deceased during the month of August in Granma with a predictive character greater than 98% in all models.

O município de Bayamo acumulou 8.162 casos autóctones positivos de fevereiro a agosto de 2021, é o centro da epidemia na província de COVID-19 causada pelo SARS-CoV-2 determinado pelo teste da Proteína C Reativa, representa 53,2% de o total de casos nesse período no Granma, muito diferente do que aconteceu em 2020 em que a província acumulou apenas 185 pessoas infectadas em nove meses, com uma taxa de 22,6, a mais baixa de Cuba. A província do Granma acumulou 119 mortes em agosto / 2021, o que representa 62,9% de todas as mortes desde o início da pandemia até agosto, o que indica a alta incidência da epidemia que existe no momento. Para a modelagem matemática e análise dos casos positivos autóctones de todos os ocorridos durante os meses de fevereiro a agosto de 2021 em Bayamo, foram obtidos polinômios de grau três e quatro que modelam o comportamento da epidemia durante os sete meses analisados. bem como o dos falecidos durante o mês de agosto no Granma com caráter preditivo superior a 98% em todos os modelos.

Valoración de las respuestas conductuales al dolor durante el cambio postural en pacientes sedados orointubados / Assessment of behavioral responses to pain during postural change in intubated sedated patients

Introducción: los pacientes críticos, bajo sedación y apoyo ventilatorio invasivo presentan dolor, la barrera más grande para su detección es la incapacidad de comunicarse; sin embargo, el hecho de que el paciente no pueda referir su dolor, no significa que no lo padezca. Objetivo: describir las respuestas conductuales al dolor durante el cambio postural en pacientes sedados oro intubados. Material y métodos: estudio cuantitativo, descriptivo, observacional, longitudinal. Muestra n= 50 pacientes, se utilizó la escala BPS (Behavioral Pain Scale) como instrumento de valoración del dolor, se midió en tres momentos: 1 minuto antes, durante y 10 minutos después del cambio postural. Resultados: el cambio postural del paciente con sedación y ventilación mecánica provocó dolor en 56% de los pacientes; antes de realizar el cambio postural se identificó una media del dolor de 4.6, durante el cambio postural aumento a 6.5 y posterior al cambio disminuyo a una media de 4, siendo un factor protector. Conclusiones: la movilización del paciente sedado oro intubado requiere de la participación del equipo multidisciplinar, para el manejo de la ventilación mecánica, el cuidado de sondas y catéteres, cuidados de la piel, prevención de caídas y aplicación correcta de la técnica de movilización, la cual demanda experiencia clínica del personal que participa en la valoración y manejo de las respuestas conductuales al dolor.

Introduction: critical patients, under sedation and invasive ventilatory support present pain, the greatest barrier to its detection is the inability to communicate, however, the fact that the patient cannot report their pain does not mean that they do not suffer from it. Objective: to describe the behavioral responses to pain during postural change in sedated or intubated patients. Material and Methods: quantitative, descriptive, observational, longitudinal study. Sample n = 50 patients, the BPS scale (Behavioral Pain Scale) was used as an instrument for assessing pain, it was measured at three moments: 1 minute before, during and 10 minutes after the postural change. Results: the postural change of the patient with sedation and mechanical ventilation caused unacceptable pain in 56% of the patients; Before making the postural change, a mean pain of 4.6 was identified, during the postural change it increased to 6.5 and after the change it decreased to a mean of 4, being a protective factor. Conclusions: the mobilization of the sedated or intubated patient requires the participation of the multidisciplinary team, for the management of mechanical ventilation, care of tubes and catheters, skin care, prevention of falls and correct application of the mobilization technique, which It demands clinical experience from the personnel involved in the assessment and management of behavioral responses to pain.

Application of an autoregressive integrated moving average model in prediction of cardiovascular disease mortality / 上海预防医学

Objective:To use autoregressive integrated moving average （ARIMA） model for predicting the mortality of cardiovascular diseases in residents in Yushui District， Jiangxi Province， and to provide basis for developing the prevention and control strategies as well as to promote the continuous optimization of chronic disease prevention and treatment demonstration area. Methods:Based on the cardiovascular death monitoring data of residents in Yushui District， Jiangxi Province from 2014 to 2018， Econometrics View 9.0 software was used to construct the ARIMA seasonal adjustment model to predict the monthly cardiovascular death in this area. Results:The monthly death rate of cardiovascular diseases in Yushui showed a long-term rising trend， with an apparent seasonal pattern （a peak of cardiovascular death from December to January each year）. After the original sequence was subjected to first-order difference and first-order seasonal difference， the difference sequence showed good stationarity （P<0.05）. All the theoretical models were listed and their model parameters were calculated respectively. After statistical test （P<0.05）， 7 alternative models for seasonal adjustment of ARIMA were selected. Among them， ARIMA（1，1，1）（1，1，1）12 is the optimal model selected in this study （R2=0.749， Adjustment R2=0.724， AIC=8.454， SC=8.633， HQ=8.515）.And its residual sequence was tested by white noise test （P>0.05）， indicating that the prediction effect was good. Conclusion:ARIMA（1，1，1）（1，1，1） 12 model can accurately simulate the long-term trend and seasonal pattern of cardiovascular disease death in Yushui， and make a scientific prediction of the trend and monthly distribution of cardiovascular disease death in the next three years.

Influenza incidence prediction based on ARIMAX model including meteorological factors / 预防医学

Objective@#To evaluate the feasibility of autoregressive integrated moving average with explanatory variables ( ARIMAX ) model including meteorological factors on the prediction of influenza-like illness ( ILI ), so as to provide a basis for the monitoring and early warning of influenza.@*Methods@#The ILI data reported by four sentinel hospitals in Yuhang District of Hangzhou from the 1st week of 2014 to the 26th week of 2018 was collected, as well as the meteorological data during the same period. The ARIMAX model was established using the percentage of ILI cases in total outpatients ( ILI% ) data from the 1st week of 2014 to the 52nd week of 2017 and the meteorological factors selected by Lasso regression model. The ILI% from the 1st to 26th week of 2018 was predicted and compared with the actual values to verify the ARIMAX model.@*Results@#From the 1st week of 2014 to the 26th week of 2018, a total of 60 419 cases of ILI were reported by the four sentinel hospitals of Yuhang District, with ILI% of 1.29%. Lasso regression analysis showed that there was a positive correlation between weekly average absolute humidity and ILI% ( r=27.769 ), and a negative correlation between weekly average temperature and ILI% ( r=-0.117 ). The ARIMAX (1, 0, 0) ( 1, 0, 0 )12 with weekly average temperature and absolute humidity was selected as the optimal model, with the Bayesian information criterion (BIC) value of 81.30 and the mean absolute percentage error (MAPE) value of 15.77%. The MAPE value of the ARIMAX model predicting the ILI% from 1st to 26th week of 2018 were 43.75%.@*Conclusion@#The ARIMAX model including meteorological factors can be used to predict the prevalence of ILI, but the accuracy needs to be promoted.

The epidemic trend of viral hepatitis in Nanjing from 1989 to 2020 / 预防医学

Objective@#To analyze the epidemic trend of viral hepatitis in Nanjing from 1989 to 2019 and predict the incidence in 2020, so as to provide reference for the prevention and control of viral hepatitis.@*Methods@#The incidence data of viral hepatitis in Nanjing from 1989 to 2019 was retrieved from Nanjng Center for Disease Control and Prevention and National Infectious Disease Reporting System. The epidemic trend was analyzed by estimating the annual percent change ( APC ) and the average annual percent change ( AAPC ). The seasonal incidence of different types of viral hepatitis was analyzed by seasonal index. The autoregressive integrated moving average model ( ARIMA ) was built to predict monthly incidence rate of viral hepatitis in 2020. @*Results@#The annual incidence rate of viral hepatitis was 62.00/100 000 in Nanjing from 1989 to 2019, showing a downward trend ( AAPC=8.4%, P<0.05 ). From 1998 to 2019, the annual incidence rates of hepatitis A, B, C and E were 1.98/100 000, 14.31/100 000, 2.30/100 000 and 2.60/100 000. The incidence of hepatitis A and B showed downward trends ( AAPC=-11.81%, -6.02%, both P<0.05 ); the incidence trend of hepatitis C was not obvious ( P>0.05 ); the incidence of hepatitis E showed an increasing trend ( AAPC=4.82%, P<0.05 ). From 2015 to 2019, the third and fourth quarters were the epidemic seasons of hepatitis A, B and C, while the first and second quarters were the epidemic seasons of hepatitis E. The ARIMA model predicted that the monthly incidence rates of viral hepatitis in 2020 would range from 1.26/100 000 to 3.69/100 000, among which hepatitis B ranged from 1.21/100 000 to 2.58/100 000, hepatitis C from 0.20/100 000 to 0.48/100 000, hepatitis E from 0.09/100 000 to 0.25/100 000. @*Conclusions@#The incidence of viral hepatitis in Nanjing shows a downward trend. Among different types of hepatitis, hepatitis B has a higher incidence. All types of hepatitis have epidemic seasons. It is predicted that the monthly incidence rates of viral hepatitis will be 1.26/100 000 to 3.69/100 000 in 2020.

Research on high-efficiency electrocardiogram automatic classification based on autoregressive moving average model fitting / 生物医学工程学杂志

The automatic detection of arrhythmia is of great significance for the early prevention and diagnosis of cardiovascular diseases. Traditional arrhythmia diagnosis is limited by expert knowledge and complex algorithms, and lacks multi-dimensional feature representation capabilities, which is not suitable for wearable electrocardiogram (ECG) monitoring equipment. This study proposed a feature extraction method based on autoregressive moving average (ARMA) model fitting. Different types of heartbeats were used as model inputs, and the characteristic of fast and smooth signal was used to select the appropriate order for the arrhythmia signal to perform coefficient fitting, and complete the ECG feature extraction. The feature vectors were input to the support vector machine (SVM) classifier and K-nearest neighbor classifier (KNN) for automatic ECG classification. MIT-BIH arrhythmia database and MIT-BIH atrial fibrillation database were used to verify in the experiment. The experimental results showed that the feature engineering composed of the fitting coefficients of the ARMA model combined with the SVM classifier obtained a recall rate of 98.2% and a precision rate of 98.4%, and the

Current Status and Prospects of Non-Invasive Central Arterial Pressure Measurement / 医用生物力学

Cardiovascular disease is one of the important factors that threaten the health of residents, ranking the first among various causes of death, so the monitoring and diagnosis of human cardiovascular health is particularly important. Compared with traditional brachial artery pressure, central arterial pressure (CAP) has a higher correlation with the occurrence of many cardiovascular events. The measurement of CAP can more accurately reflect the real situation of human blood pressure, and provide an important basis for diagnosis and disease prevention. Therefore, the realization of high-precision, high-generalization ability and low-cost non-invasive measurement of CAP has always been the research focus in this field. This article combines the relevant literature in China and abroad to summarize the current status of CPA measurement, introduces related research progress from two aspects, namely parameter measurement and waveform measurement, and discusses the characteristics of the existing methods and the future development.

A encenação da violência obstétrica: (dis)junções entre ficção e realidade / The representation of obstetric violence: (dis)junctions between fiction and reality / La representación de la violencia obstétrica: (dis)yuncións entre ficción y realidad

Este artigo se propõe a analisar cenas de parto exibidas em telenovelas brasileiras, criteriosamente selecionadas, com o objetivo de identificar as representações de diferentes formas de violência obstétrica, explícitas ou veladas. Para tanto, optamos por dois métodos complementares: a análise de conteúdo e a análise de imagens em movimento. Como resultado, identificamos três eixos que abarcam as diferentes expressões midiatizadas da violência contra a parturiente: violência pela situação, violência pelo abandono e violência direta. Na discussão, pontuamos consonâncias e dissonâncias entre ficção e realidade, além da falta de problematização acerca do tema, o que, de forma sintomática, contribui para a sua naturalização.

This article proposes to analyze scenes of childbirth broadcasted by Brazilian soap operas, carefully selected, aiming to identify the representation of different forms of obstetric violence, explicit or veiled. Therefore, we selected two complementary methods: the content analysis and the analysis of moving images. As a result, we have identified three axes that include the different expressions of the violence against the parturient by the media: violence by situation, violence by abandonment and direct violence. Through the discussion, we pointed consonances and dissonances between fiction and reality, as well as the lack of problematization regarding the theme, which, symptomatically, contributes to its naturalization.

Este artículo se propone a analizar escenas de parto exhibidas en telenovelas brasileñas, criteriosamente seleccionadas, con el objetivo de identificar las representaciones de diferentes formas de violencia obstétrica, explicitas o veladas. Para eso, optamos por dos métodos complementares: el análisis de contenido y el análisis de imágenes en movimiento. Como resultado, identificamos tres ejes que abarcan las diversas expresiones mediatizadas de la violencia contra la parturiente: violencia por la situación, violencia por abandono y violencia directa. En la discusión, puntuamos consonancias y disonancias entre ficción y realidad, además de la falta de problematización acerca del tema, lo que, de forma sintomática, contribuye para su naturalización.

A transformação didático-pedagógica da ginástica para as crianças pelo "brincar e se-movimentar" / The didactic-pedagogical transformation of gymnastics for children by the "play and self-moving" / La transformación didáctica-pedagógica de la gimnasia con niños por el "jugar y moverse"

O objetivo do ensaio é refletir e problematizar o "brincar e se-movimentar" na ginástica como possibilidade pedagógica de uma Educação Física centrada no sujeito, perspectivando a ampliação do campo existencial. Considerando que o agir humano é carregado de intencionalidade e conexão entre corpo-mundo, defende-se uma ginástica que fomente a realização de experiências corporais por meio da resolução de problemas e da participação das crianças nas aulas com autonomia, criatividade e liberdade, permitindo-lhes constituir sentidos outros naquilo que fazem, pensam e sentem, dialogando com o mundo numa aventura saudável que as convida para se desenvolver no decurso de infinitas possibilidades de ação.

The present text discusses theoretical and philosophical elements based on "play and move" as a pedagogical possibility of a subject-centered Physical Education, with a view to expanding the existential field. The goal is to expand knowledge about gymnastics practice that presupposes awakening new meanings and meanings of children, recognizing that human action weaves relationships of meanings to and with the world, through experiences that refer to the meanings attributed by the being that moves. Considering that human action is loaded with intentionality and connection between body and world, a gymnastics is defended that fosters the realization of body experiences through problem solving and the participation of children in classes with autonomy, creativity and freedom, allowing constitute them other senses in what they do, think and feel, dialoguing with the world in a healthy adventure that invites them to develop in the course of infinite possibilities of action.

El presente texto discute elementos teóricos y filosóficos basados en "jugar y moverse" como una posibilidad pedagógica de una Educación Física centrada en el tema, con miras a expandir el campo existencial. El objetivo es ampliar el conocimiento sobre la práctica de gimnasia que presupone despertar nuevos significados y significados de los niños, reconociendo que la acción humana entrelaza las relaciones de significados con y con el mundo, a través de experiencias que se refieren a los significados atribuidos por el ser que se mueve. Teniendo en cuenta que la acción humana está cargada de intencionalidad y conexión entre el cuerpo y el mundo, se defiende una gimnasia que fomenta la realización de experiencias corporales a través de la resolución de problemas y la participación de los niños en clases con autonomía, creatividad y libertad, permitiendo Los constituyen otros sentidos en lo que hacen, piensan y sienten, dialogando con el mundo en una sana aventura que los invita a desarrollarse en el curso de infinitas posibilidades de acción.