Guidance For Interventions Research Articles

Development of a Screening Intervention for Dysphagia in Hospitalised Geriatric Patients.

Prevalence of dysphagia is high in hospitalised geriatric patients, posing risks of complications including malnutrition, dehydration, aspiration, and pneumonia. These complications may lead to reduced daily functioning, frailty, prolonged hospital stays, readmissions, and mortality. Diagnosing dysphagia in geriatric patients is often challenging due to the complex health conditions of this patient group, and overall these patients are at risk of lack of continuity in patient pathways and unnecessary hospitalisations. Recognising the critical importance of prompt diagnosis and treatment of dysphagia, we developed a dysphagia screening intervention aligned with clinical guidelines and the political focus to improve patient pathways and reduce preventable hospitalisations. This article outlines the development process of a dysphagia screening intervention to geriatric patients (≥ 65 years) admitted to medical inpatient wards. We applied a theory-, evidence- and implementation-based approach combined with stakeholder involvement in adherence to the IdentifyiNg and assessing different approaches to DEveloping compleX intervention (INDEX) guidance, encompassing eleven actions. We developed a dysphagia screening intervention comprising a screening procedure (the 4 Questionnaire Test (4QT), the 30ml water swallowing test, and an action algorithm) targeting the patient level. Moreover, we developed an implementation strategy (activities necessary for adequate delivery of the dysphagia screening procedure and activities supporting the delivery of the screening procedure) targeting health professionals and the organisational level. The dysphagia screening intervention is now ready for feasibility testing, promising improved health and healthcare services for hospitalised geriatric patients.

Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study

BackgroundThis study aimed to explore the risk factors for early intraventricular hemorrhage (IVH) in extremely low birth weight infants (ELBWIs) to provide guidance for early intervention, thereby improving survival rates and quality of life for these vulnerable infants.MethodsA retrospective study was conducted on 205 ELBWIs admitted to the Women and Children’s Medical Center of Guangzhou Medical University from January 2019 to December 2023. Standard head ultrasound screening (HUS) was used to assess the presence and severity of IVH on days 1–3 and 5–7 post-birth. Infants were categorized into either the IVH or non-IVH group based on HUS findings. Univariate analysis and logistic regression were employed to identify risk factors for IVH, and the efficacy of the model was evaluated using a receiver operating characteristic (ROC) curve.ResultsAmong the 205 ELBWIs (97 males, 108 females), 82 (40%) developed IVH, with 26 (12.7%) classified as severe IVH and 56 (27.3%) as mild IVH. IVH within the first three days occurred in 51 of the 82 cases. Severe IVH was more prevalent in the lower gestational age groups: 40.0% in infants at 23 + 1 to 26 weeks, 10.7% in infants at 26 + 1 to 28 weeks, and 1.4% in infants at 28 + 1 to 32 weeks (p < 0.001).Logistic regression analysis revealed two independent risk factors: failure to withdraw invasive ventilation within the first week (OR = 3.276, 95% CI = 1.465–7.324, p = 0.004) and the use of vasoactive drugs within the first week (OR = 2.112, 95% CI = 1.002–4.451, p = 0.049). The ROC curve showed a sensitivity of 68.3%, specificity of 81.3%, and an area under the curve (AUC) of 0.792.ConclusionThe incidence of IVH in ELBWIs is high, particularly within the first three days after birth. The use of vasoactive drugs and prolonged invasive ventilation are associated with increased risk, highlighting the need for careful management of respiratory and hemodynamic support in these infants.

Latent profile analysis of sense of coherence and relationship with meaning of life and professional identity among nursing undergraduate

BackgroundEnhancing nursing undergraduates’ sense of coherence is crucial for the growth of the nursing workforce. Yet, existing research primarily examines the aggregate level of sense of coherence among nursing undergraduates and its correlations with other variables, overlooking the individual heterogeneity in nursing undergraduates’ sense of coherence in nursing. This study aimed to identify different subgroups of nursing undergraduates’ sense of coherence and explore the influencing factors pertinent to each subgroup.MethodsA cross-sectional study was conducted from May to June 2020 among 1,251 nursing undergraduates using convenience sampling. Latent profile analysis was employed to identify subgroups of nursing undergraduates’ sense of coherence, and multiple logistic regression was utilized to analyze the factors associated with each subgroup.ResultsFour potential subtypes of nursing undergraduates’ sense of coherence were identified: low sensitivity-low coping group (25.7%), high sensitivity-high coping group (29.7%), moderate sensitivity-moderate coping group (17.8%), and high sensitivity-low coping group (26.8%). Multiple logistic regression analysis revealed that factors influencing nursing undergraduates’ sense of coherence included family financial situation, high school subject choice, religious beliefs, belief in having good interpersonal relationships, meaning in life, and professional identity.ConclusionThe heterogeneity of nursing undergraduates’ sense of coherence suggests that nursing educators should provide targeted intervention guidance according to the potential category characteristics of nursing undergraduates’ sense of coherence; at the same time, they should strengthen the cultivation of nursing undergraduates’ meaning of life and professional identity to improve their level of sense of coherence, so as to promote the growth of the nursing workforce.

An EEG-based framework for automated discrimination of conversion to Alzheimer's disease in patients with amnestic mild cognitive impairment: an 18-month longitudinal study.

As a clinical precursor to Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI) bears a considerably heightened risk of transitioning to AD compared to cognitively normal elders. Early prediction of whether aMCI will progress to AD is of paramount importance, as it can provide pivotal guidance for subsequent clinical interventions in an early and effective manner. A total of 107 aMCI cases were enrolled and their electroencephalogram (EEG) data were collected at the time of the initial diagnosis. During 18-month follow-up period, 42 individuals progressed to AD (PMCI), while 65 remained in the aMCI stage (SMCI). Spectral, nonlinear, and functional connectivity features were extracted from the EEG data, subjected to feature selection and dimensionality reduction, and then fed into various machine learning classifiers for discrimination. The performance of each model was assessed using 10-fold cross-validation and evaluated in terms of accuracy (ACC), area under the curve (AUC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), and F1-score. Compared to SMCI patients, PMCI patients exhibit a trend of "high to low" frequency shift, decreased complexity, and a disconnection phenomenon in EEG signals. An epoch-based classification procedure, utilizing the extracted EEG features and k-nearest neighbor (KNN) classifier, achieved the ACC of 99.96%, AUC of 99.97%, SEN of 99.98%, SPE of 99.95%, PPV of 99.93%, and F1-score of 99.96%. Meanwhile, the subject-based classification procedure also demonstrated commendable performance, achieving an ACC of 78.37%, an AUC of 83.89%, SEN of 77.68%, SPE of 76.24%, PPV of 82.55%, and F1-score of 78.47%. Aiming to explore the EEG biomarkers with predictive value for AD in the early stages of aMCI, the proposed discriminant framework provided robust longitudinal evidence for the trajectory of the aMCI cases, aiding in the achievement of early diagnosis and proactive intervention.

Family Function and Self-Management of Patients With Early Chronic Kidney Disease: The Mediating Roles of Self-Perceived Burden and Ego Depletion.

Effective self-management in the early stage of chronic kidney disease (CKD) is key to delaying disease progression. However, no studies have confirmed that the combined support of internal individual factors and external family environmental factors may play an important role in the self-management of patients with early CKD. This current study aims to explore the effect of family function on the self-management of patients with early CKD and examine the mediating roles of self-perceived burden and ego depletion. Three hundred and sixty patients with stage 1-3 CKD participated in the cross-sectional survey and completed structured questionnaires, including the family APGAR index, self-perceived burden scale, self-regulatory fatigue scale and chronic kidney disease self-management instrument. Mplus 8.3 was used to establish a structural equation model. Family function had a positive predictive effect on self-management (β = 0.231, P < 0.001). Self-perceived burden and ego depletion were not only single mediating variables between family function and self-management but also played a chain-mediating role. The total indirect effect was 0.304 (95% CI: 0.234 to 0.388, P < 0.001), accounting for 56.82% of the total effect (β = 0.535, 95% CI: 0.420 to 0.651, P < 0.001). This study highlights the importance of self-management for patients and their families and provides new important theoretical guidance for multiple interventions of improving family function, reducing self-perceived burden and ego depletion to improve self-management, which is of great value in delaying the progression of renal disease.

Correlation between self-efficacy, parental parenting patterns, and severe depression in adolescents.

Adolescence is a critical period marked by significant psychological changes. This study explores how self-efficacy and parental parenting styles may influence the risk of severe depression among teens. The hypothesis is that higher self-efficacy and authoritative parenting patterns will be negatively correlated with severe depression in adolescents. To investigate the correlation between self-efficacy, parenting patterns and major depression in adolescents, and to provide guidance for mental intervention. Using a cross-sectional survey design, the data were collected through a questionnaire survey. Patients with major depression and healthy adolescents in the hospital control group were selected as the study objects. The General Self-Efficacy Scale, the Parenting Style Evaluation Scale, and the Beck Depression Inventory were used as research instruments. Data input and statistical analysis were performed, including descriptive statistics, correlation analysis, through SPSS software. The study found that depressed patients had significantly lower self-efficacy than healthy controls, and parenting style was significantly associated with depressive symptoms in terms of emotional warmth and understanding, punishment severity, and denial. Specifically, parental emotional warmth and understanding were significantly negatively associated with depressive symptoms, while parental punishment severity and denial were significantly positively associated with depressive symptoms. Self-efficacy showed a significant negative correlation with depressive symptoms, indicating that higher self-efficacy had lower depressive symptoms. Adolescent major depressive disorder patient was significantly associated with their parenting style and self-efficacy. Higher self-efficacy is associated with decreased depressive symptoms, so improving adolescent self-efficacy and improving parenting style are important.

Superiority of photon-counting computed tomography for detecting high-risk unstable angina patients: two case reports.

Coronary artery disease is the leading cause of death among non-communicable diseases. The management strategy prioritizes early detection and optimal treatment, with emerging roles for imaging approaches. Photon-counting computed tomography is a new non-invasive diagnostic imaging tool that can detect high-risk plaques in coronary artery disease patients. Using photon-counting computed tomography in screening and intravascular ultrasound later in verifying diagnosis and intervention guidance could be a new technique to swiftly discover unstable plaques, prepare lesions for surgery, and determine the optimal percutaneous intervention strategy. However, there is no documentation available for this new approach. We reported two acute coronary syndromes managed with a combination of two imaging methods. Despite receiving medical therapy, the first case continued to experience chest pain, leading to the detection of plaque ulceration in the left anterior descending artery. On the other hand, two PCCT screenings within 6months revealed plaque progression in the second case. We then used IVUS to confirm the lesions and proceed to intervention. We successfully discharged both cases, and they showed no symptoms 6months after discharge.

The role of the school innovative climate in the relationship between proactive personality and creative behavior among students from Chinese normal colleges

As China advances towards becoming an innovation-driven nation, nurturing creativity in normal college students—future educators—is crucial, as it enhances their teaching strategies and supports the cultivation of innovative talents essential for national development. This study aims to explore the relationship between cognitive flexibility and school innovation climate in the context of normal college students’ proactive personality and creative behavior. A total of 1795 normal college students were assessed using the Proactive Personality Scale, Cognitive Flexibility Scale, School Innovation Climate Scale, and Creative Behavior Scale. The results of this study showed that normal college students’ proactive personality positively predicted creative behavior (β = 0.526, p < 0.001), and cognitive flexibility played an intermediary role in the relationship between normal college students’ proactive personality and creative behavior [CI: 0.200, 0.322].The interaction term between proactive personality and school innovation climate had a significant positive predictive effect on creative behavior (β = 0.094, p < 0.01). In both high and low school innovation climate groups, proactive personality positively predicted creative behavior through cognitive flexibility. However, the high-scoring group showed a more significant impact compared to the low-scoring group. This study enriches the theory of creative personality, emphasizing the positive influence of individual traits, cognitive processes, and environmental factors on creative behavior. Furthermore, it provides a deeper understanding of the mechanism through which proactive personality influences creative behavior, offering valuable insights and guidance for future interventions in creative behavior.

Recovery model for minimally invasive central cannulation, cardiopulmonary bypass, and cardioplegic arrest in quadrupeds.

Objectives: Sternotomy is rarely performed for veterinary therapeutic or recovery models in quadrupeds because of difficulties with breathing, ambulation, and pain control. Central cannulation for cardiopulmonary bypass (CPB) is infrequent and typically performed through full thoracotomies. Experienced clinical surgeons and perfusionists should provide guidance for new therapeutic interventions and translational research. We sought to develop, validate, and detail a contemporary model for minimally-invasive central cannulation, CPB, and cardioplegic arrest. Methods: After induction of anesthesia and sterile preparation, a right second-interspace parasternal mini-thoracotomy was performed, the ascending aorta was cannulated using Seldinger technique, and a cardioplegia needle was placed. A dual-stage cannula was introduced through the right atrial appendage and CPB commenced. The aorta was clamped and Buckberg 4:1 induction cardioplegia was administered. Arrest was maintained for 30minutes. CPB was discontinued after 2hours and the great vessels were decannulated. Hemostasis was achieved and the wound was closed. Initial recovery was accomplished in intensive care with subsequent transfer to the vivarium.Results: Ten consecutive Yorkshire swine (45 ± 5kg) were minimally invasively placed on CPB including cardioplegic arrest using central cannulation through a right parasternal mini-thoracotomy. There was no operative or late mortality. Morbidity appeared minimal. Planned euthanasia and scheduled necropsy were performed to exclude clinically-occult major complications. None were identified. Following initial supervision, veterinary and resident surgeons completed the procedures autonomously with excellent results.Conclusion: The described protocols should facilitate safe veterinary cardiac surgical care and humane translational research.

Research Progress on the Measurement Methods and Clinical Significance of Capillary Refill Time.

The monitoring of peripheral circulation, as indicated by the capillary refill time, is a sensitive and accurate method of assessing the microcirculatory status of the body. It is a widely used tool for the evaluation of critically ill patients, the guidance of therapeutic interventions, and the assessment of prognosis. In recent years, there has been a growing emphasis on microcirculation monitoring which has led to an increased focus on capillary refill time. The International Sepsis Guidelines, the American Academy of Pediatrics, the World Health Organization, and the American Heart Association all recommend its inclusion in the evaluation of the system in question. Furthermore, the methodology for its measurement has evolved from a traditional manual approach to semiautomatic and fully automatic techniques. This article presents a comprehensive overview of the current research on the measurement of capillary refill time, with a particular focus on its clinical significance. The aim is to provide a valuable reference for clinicians and researchers and further advance the development and application of microcirculation monitoring technology.

Prevalence and risk factors of osteopenia in adults with short bowel syndrome: a retrospective longitudinal cohort study.

Metabolic Bone Disease (MBD) is common in patients with short bowel syndrome (SBS). This study was to investigate the incidence and risk factors of osteopenia in adult SBS patients. Hospital records from January 2010 to December 2019 were used to identify all eligible patients. Logistic regression and a nomogram were used to analyze the data. A total of 120 patients with SBS were included in this study, and 76 patients (63.3%) developed osteopenia during the 10-year observation period, The multivariate analysis using the logistic regression model demonstrated that age (OR = 1.070; 95%CI: 1.016-1.126, p = 0.010), female (OR = 5.098; 95%CI: 1.211-21.456, p = 0.026), tumor history (OR = 4.481; 95%CI: 1.125-17.854, p = 0.033), duration of SBS (OR = 1.0862; 95%CI: 1.022-1.103, p = 0.002) and remnant ileum (OR = 4.260; 95%CI: 1.210-15.002, p = 0.024) were independent risk factors for osteopenia in adults with SBS. The area under the curve (AUC) for the joint model (age, female, tumor history, duration of SBS, remnant ileum) was 0.848 and the corresponding sensitivity and specificity were 0.855 and 0.705, respectively. The C-index was 0.849 (95% CI: 0.778-0.917); thus, the predictions made by the model were close to the actual outcomes. In the decision curve analysis, the nomogram performed well and was feasible to make beneficial clinical decisions. This study reveals the high prevalence of osteopenia in SBS patients and highlights the importance of early identification and treatment of osteopenia. A nomogram may provide personalized prediction and guidance for medical intervention.

Anesthesiologists Cross the Quality Chasm with Point of Care Ultrasound (POCUS) Among Perioperative Patients

Background/Objective: POCUS is an invaluable tool for anatomical variation assessment, guidance of invasive interventions, and diagnosis of critical conditions that may change the anesthesiologist’s plan of care. This technology increases success rate, decreases time to surgery, and maximizes outcomes. The objective of this pilot program evaluation was to identify the anesthesiologists’ systems and processes for utilizing POCUS in clinical decision-making for patients during the perioperative phases of care for improved outcomes. Materials/Methods: A Multivariate Analysis of Variance (MANOVA) was conducted to identify differences across groups (scan type). The independent variable was the type of POCUS examination. The dependent variables included the patient’s: (1) Perioperative Status; (2) Cardiothoracic Anesthesiologist’s Review of Patient History and Formulating the Clinical Question; (3) Overall Risk Potential; (4) Aspiration Potential; (5) Issues Related to Cardiovascular Hemodynamics; (6) Issues Related to Volume Status; (7) Clinical Question Answered by POCUS; (8) Change in Plan of Care; (9) Interventions; and (10) Pharmacological Interventions. Results: MANOVA findings (Wilks’ λ) identified a statistically significant interaction between POCUS scan type and the cardiothoracic anesthesiologist’s clinical decision-making (p &lt; 0.0001). The following four criteria were statistically significant: (1) patients (64%) were examined with POCUS preoperatively (p &lt; 0.05); (2) patients (95%) identified as having some type of overall risk potential (p &lt; 0.05); (3) patients (36%) specifically identified as an aspiration risk (p &lt; 0.0001); and (4) patients (41%) identified with issues related to cardiovascular hemodynamics (p &lt; 0.001). Conclusions: POCUS is a proven imaging modality that is easy, portable, sensitive, and specific for identifying various anatomical landmarks. POCUS utilization in the perioperative setting has potential to have a profound impact on successful surgical completion.

The relationships among illness perceptions, dyadic coping and illness management in breast cancer patients and their spouses: A dyadic longitudinal mediation model.

To describe and compare dyads' illness perceptions, dyadic coping and illness management among breast cancer patients and their spouses. In addition, we explore the direct actor and partner effects of illness perception on illness management, and whether this association is mediated by dyadic coping. A descriptive and longitudinal study. Baseline illness perceptions and dyadic coping during hospitalization were measured by using the Illness Perception Questionnaire-revised (IPQ-R) and the Dyadic Coping Inventory (DCI). At the 3rd month after discharge, the Cancer Self-Management Assessment Scale (CSMAS) and the Caregiver's Contribution to the Cancer Patient's Self-Management Scale (CC-CPSMS) were used to test the dyads' illness management. Then, the actor-partner interdependence mediation model (APIMeM) was constructed to explore intrapersonal and interpersonal effects. A total of 225 postsurgical breast cancer patients and their spouses completed the questionnaires. It revealed that patients' or spouses' illness perceptions had both positive and negative direct actor effects on their own illness management (positive: personal control and illness coherence dimension; and negative: timeline acute/chronic, consequence, emotional representation and causes-uncontrollable factors dimension). The significant direct partner effects were only displayed in the timeline acute/chronic dimension. Moreover, dyadic coping had mediating effects on these paths, and only the actor-actor and partner-actor indirect effects were statistically significant. This study demonstrates the significance of illness perceptions in influencing dyads' illness management and reveals the underlying mediating mechanism of dyadic coping. It can provide more specific guidance for dyadic interventions to optimize dyads' behaviour among breast cancer patients and their spouses.

Temporal Stages of Burnout: How to Design Prevention?

Burnout, a major concern defined most commonly in the literature with a symptoms-based classification, can also be described as a temporal process with various stages experienced by workers, each composed of unique characteristics and challenges. This intricate process of burnout emphasizes pivotal moments, such as engagement and enthusiasm with a high job ideal (Stage 0), weakening of the ideal (Stage 1), protective withdrawal (Stage 2) and confirmed burnout (Stage 3). Through an opinion review, the objective of this article is to examine which prevention level, and more specifically which prevention actions, can be developed at each stage of this temporal process of burnout. The review criteria allow for the integration of both individual- and organization-focused interventions, ranging from early organizational-level strategies (primary prevention) to clinical consultations addressing the erosion of professional ideals (secondary prevention), as well as psychoeducational sessions aimed at promoting worker well-being. In conclusion, the article underscores the need for a holistic approach, combining organization-focused interventions with individual-focused interventions. Through a comprehensive review, this research provides insights into evidence-based practices, identifies gaps in current research, and offers guidance for future interventions for better support of workers facing burnout.

Three-Dimensional Rotational Angiography to Guide Cardiac Catheterization in Critical Infants Below 5kg of Body Weight.

Three-dimensional rotational angiography (3DRA) is a promising advancement to guide cardiac catheterizations. It is used with restraint in critically ill infants with congenital heart disease (CHD) due to the lack of research conducted within this patient group. Data of all infants with CHD and a body weight <5 kg who underwent cardiac catheterization with the use of 3DRA between November 2011 and April 2021 were retrospectively analyzed. Primary outcome measures were 3DRA-related periprocedural deaths or major adverse events (MAEs). Secondary outcome measures were 3DRA-related minor adverse events (MiAEs), the amount of radiation exposure and contrast agent, and whether 3DRA led to important new findings. The case-based workflow of 3DRA in vulnerable infants is explained. Eighty-six patients underwent 109 cardiac catheterizations in which 132 3DRA scans were performed. Median age and weight were 50.0 days (IQR, 20.0-98.5) and 3.8 kg (IQR, 3.2-4.5). There were no periprocedural deaths or MiAEs, and only 2 MAEs occurred, both concerning ventricular fibrillation. The median radiation exposure was 160.0 cGy⋅cm2 (IQR, 81.3-257.5), of which 28.0 cGy⋅cm2 (IQR, 19.4-43.0) was derived from 3DRA. The mean amount of contrast agent used was 4.8 ± 1.6 mL/kg. In 70.6%, 3DRA imaging led to important new findings. Multivariate binary logistic regression analysis showed the presence of comorbidity to be associated with a lower odds of receiving a 3DRA-derived radiation dose ≥15 cGy⋅cm2 (P = .01). Additionally, the interval between surgery and cardiac catheterization was significantly associated with higher odds of a contrast dye consumption ≥6 mL/kg (P = .046). 3DRA proved to be safe in vulnerable infants with CHD weighing <5 kg, enabling visualization of anatomical substrates often invisible in conventional angiography. However, when an advanced computed tomography scanner is available, the diagnostic purposes for 3DRA are few. The greatest benefit of 3DRA usage is interventional guidance (3D roadmap).

Constraint-Aware Learning for Fractional Flow Reserve Pullback Curve Estimation from Invasive Coronary Imaging.

Estimation of the fractional flow reserve (FFR) pullback curve from invasive coronary imaging is important for the intraoperative guidance of coronary intervention. Machine/deep learning has been proven effective in FFR pullback curve estimation. However, the existing methods suffer from inadequate incorporation of intrinsic geometry associations and physics knowledge. In this paper, we propose a constraint-aware learning framework to improve the estimation of the FFR pullback curve from invasive coronary imaging. It incorporates both geometrical and physical constraints to approximate the relationships between the geometric structure and FFR values along the coronary artery centerline. Our method also leverages the power of synthetic data in model training to reduce the collection costs of clinical data. Moreover, to bridge the domain gap between synthetic and real data distributions when testing on real-world imaging data, we also employ a diffusion-driven test-time data adaptation method that preserves the knowledge learned in synthetic data. Specifically, this method learns a diffusion model of the synthetic data distribution and then projects real data to the synthetic data distribution at test time. Extensive experimental studies on a synthetic dataset and a real-world dataset of 382 patients covering three imaging modalities have shown the better performance of our method for FFR estimation of stenotic coronary arteries, compared with other machine/deep learning-based FFR estimation models and computational fluid dynamics-based model. The results also provide high agreement and correlation between the FFR predictions of our method and the invasively measured FFR values. The plausibility of FFR predictions along the coronary artery centerline is also validated.

Research progress on the application of end-tidal carbon dioxide monitoring in prehospital emergency care

Prehospital emergency care is the primary stage in the treatment of critically ill patients, where efficient and accurate monitoring methods are crucial for patient survival and prognosis. End-tidal carbon dioxide (EtCO2) monitoring is a real-time, non-invasive method that can sensitively capture the status of respiratory, circulatory, and metabolic functions, particularly in the urgent and complex pre-hospital environment, a immediate detection and non-invasive method, can sensitively capture the respiratory, circulatory, and metabolic status of patients. It provides valuable guidance for rapid decision-making and precise interventions. This is particularly valuable in the complex and urgent prehospital environment, providing critical data for rapid decision-making and precise intervention. This paper systematically reviews the advancements in the application of EtCO2 monitoring across various fields, including sepsis identification, trauma assessment, cardiac arrest, respiratory critical care, endotracheal intubation confirmation, and management of metabolic diseases, aiming to explore its application value and prospects in pre-hospital emergency care.

Anatomical Targeting of the Superior Cervical Ganglion on CT imaging for Guidance of Endovascular Transmural Intervention

Endovascular transmural targeting of cervical and cranial perivascular structures is a novel approach for minimally invasive delivery of therapeutics. Components of the autonomic nervous system are in close anatomic proximity to major cervical vasculature and, therefore, represent potential targets for intervention. The superior cervical ganglion (SCG) is a discrete structure of interest for this approach, as sympathetic blockade may have therapeutic effects for various conditions. Variability of SCG location and its relationship to large cervical vessels, and the feasibility of endovascular transmural targeting has not been elucidated. In this retrospective study, computed tomography angiography of head and neck from patients with subarachnoid hemorrhage or cerebral aneurysms were reviewed. SCG dimensions and spatial relationship to cervical vessels were measured. Measured anatomic parameters were used to determine endovascular transmural accessibility of the SCG from various cervical vessels. A total of 159 SCGs were identified and measured from 314 unilateral neck images of sufficient quality. SCGs had an average radio-opacity of 49.6 Hounsfield Units, length of 1.91cm, and width of 0.71cm. Internal carotid artery (ICA) has the longest contact length with the SCG (mean= 1.80cm) compared to other major cervical vessels. A total of 95% of SCGs were accessible from ICA using an endovascular transmural approach, with the majority of SCGs located anteromedially to the ICA. This is the first anatomical study to provide pertinent targeting information for endovascular transmural access to the SCG using computed tomography angiography. In most cases, endovascular transmural access to the SCG is anatomically feasible from the proximal cervical ICA.

A075: Smartphone Dependency in College Students with Experiences of Being Bullied: A Moderated Mediation Model

Background and Objectives: Among college students, individuals who have experiences of being bullied often exhibit a higher tendency towards smartphone dependency and lower levels of self-control, which further intensifies the degree of smartphone dependency. However, physical exercise may play a moderating role in this relationship, weakening the association between experiences of being bullied and self-control. This study aimed to explore this complex relationship and construct a moderated mediation model to further investigate the underlying psychological and behavioral mechanisms of smartphone dependency among college students. Methods: A sample of 761 Chinese college students (age: 19.21 ± 0.99; 192 males, 569 females) was selected for this study. Data were collected through a questionnaire survey, which included measures of experiences of being bullied, smartphone dependency levels, self-control levels, and physical exercise levels. Data analysis was conducted using SPSS 26.0 software and the PROCESS plugin (model 7), including correlation analysis, mediation models, and moderation models, to examine the relationships between the main variables, the mediating role of anxiety between experiences of being bullied and smartphone dependency, and the moderating role of physical exercise between experiences of being bullied and self-control. Gender and age were included as covariates in the analysis. Results: The results showed a significant positive correlation between experiences of being bullied and smartphone dependency, as well as a significant negative correlation between experiences of being bullied and self-control. After controlling for the covariates and introducing the mediator and moderator variables, experiences of being bullied significantly predicted college students' smartphone dependency levels (β= 0.38, t = 13.24, p＜0.001), while self-control partially mediated this relationship (β= -0.47, t = -16.54, p＜0.001). However, physical exercise had a significant moderating effect on the relationship between experiences of being bullied and self-control among college students (interaction term between physical exercise and experiences of being bullied: β= -0.07, t = -2.11, p＜0.05), weakening this relationship. Conclusion: The moderated mediation model constructed in this study sheds light on the relationship between experiences of being bullied and smartphone dependency among college students. Self-control plays a mediating role between the two, while physical exercise weakens the association between experiences of being bullied and self-control, thereby playing an important moderating role in alleviating college students' smartphone dependency. These findings provide theoretical basis and practical guidance for intervention and prevention of smartphone dependency among college students.

Investigating the Impact of Different Diets on Metabolism and Related Diseases Based on Gut Microbiota

The gut microbiota, as a critical regulator of host metabolism, is significantly influenced by dietary patterns. This study explores the effects of different diets on gut microbiota and their relationship with metabolism and related diseases. First, the composition of gut microbiota and its role in metabolism are reviewed. Next, the impacts of high-fat diets, low-carbohydrate diets, and high-fiber diets on the structure and function of gut microbiota are analyzed, and how these changes affect the onset and progression of metabolic syndrome, diabetes, and obesity is discussed. Finally, theoretical models based on existing research are proposed to explain the interactions between gut microbiota, diet, and metabolic diseases, with a discussion on future research directions. This study aims to provide theoretical foundations and practical guidance for dietary interventions and the prevention of metabolic diseases.