Qualitative and quantitative evaluation of a standardized training model for improving patients' ability to use inhalers

ObjectiveTraining contributes to the effectiveness of aerosol inhalation therapy. However, qualitative and quantitative evaluation of effective training methods is rarely reported. This study aimed to evaluate the effectiveness of a standardized training model by pharmacists based on verbal instruction and physical demonstration in improving patients' ability to use inhalers using qualitative and quantitative methods. Risk or protective factors affecting correct inhaler use were also explored.Methods431 Outpatients with asthma or COPD were recruited and randomly divided into a standardized training group (n = 280) and a usual training group (control group, n = 151). A framework of qualitative (e.g., multi-criteria analysis) and quantitative comparisons [percentage of correct use (CU%), percentage of complete error (CE%), and percentage of partial error (PE%)] was established to evaluate the two training models. In addition, the changes of key factors (age, education level, adherence, device type, etc.) influencing patients' ability to use inhalers of two models were observed.ResultsThe multi-criteria analysis showed that the standardized training model had comprehensive advantages in qualitative indicators. The average correct use percentage (CU%) of the standardized training group was significantly higher than that of the usual training group (77.6% vs. 35.5%). A stratified analysis further demonstrated that the ORs (95%CI) in the usual training group of age and educational level was 2.263 (1.165–4.398) and 0.556 (0.379–0.815), while in the standardized training group, age and educational level were not the key factors influencing the ability to use inhaler devices (P > 0.05). Logistic regression analysis demonstrated that standardized training was a protective factor for inhalation ability.ConclusionThese findings indicate that the framework of qualitative and quantitative comparisons could be used to evaluate training models, and the standardized training model by pharmacists can significantly improve patients' ability to use inhalers correctly and address the influence of older age and lower education because of its methodological advantages. Further studies with more extended follow-up are needed to validate the role of the standardized training model by pharmacists in the correct use of inhalers.Clinical trial registrationchictr.org.cn, ChiCTR2100043592 (23-02-2021)

Minute-cadence Observations of the LAMOST Fields with the TMTS: III. Statistic Study of the Flare Stars from the First Two Years

Tsinghua University-Ma Huateng Telescopes for Survey (TMTS) aims to detect fast-evolving transients in the Universe, which has led to the discovery of thousands of short-period variables and eclipsing binaries since 2020. In this paper, we present the observed properties of 125 flare stars identified by the TMTS within the first two years, with an attempt to constrain their eruption physics. As expected, most of these flares were recorded in late-type red stars with $G_{\rm BP}-G_{\rm RP}$ > 2.0 mag, however, the flares associated with bluer stars tend to be on average more energetic and have broader profiles. The peak flux (F_peak) of the flare is found to depend strongly on the equivalent duration (ED) of the energy release, i.e., $F_{{\rm peak}} \propto {\rm ED}^{0.72\pm0.04}$, which is consistent with results derived from the Kepler and Evryscope samples. This relation is likely related to the magnetic loop emission, while -- for the more popular non-thermal electron heating model -- a specific time evolution may be required to generate this relation. We notice that flares produced by hotter stars have a flatter $F_{{\rm peak}} \propto {\rm ED}$ relation compared to that from cooler stars. This is related to the statistical discrepancy in light-curve shape of flare events with different colors. In spectra from LAMOST, we find that flare stars have apparently stronger H alpha emission than inactive stars, especially at the low temperature end, suggesting that chromospheric activity plays an important role in producing flares. On the other hand, the subclass having frequent flares are found to show H alpha emission of similar strength in their spectra to that recorded with only a single flare but similar effective temperature, implying that the chromospheric activity may not be the only trigger for eruptions.Comment: 17 pages, 15 figures, 2 tables, refereed version. For associated data files, see https://cdsarc.cds.unistra.fr/viz-bin/cat/J/MNRAS/523/219

Representation Learning for Motor Imagery Recognition with Deep Neural Network

This study describes a method for classifying electrocorticograms (ECoGs) based on motor imagery (MI) on the brain–computer interface (BCI) system. This method is different from the traditional feature extraction and classification method. In this paper, the proposed method employs the deep learning algorithm for extracting features and the traditional algorithm for classification. Specifically, we mainly use the convolution neural network (CNN) to extract the features from the training data and then classify those features by combing with the gradient boosting (GB) algorithm. The comprehensive study with CNN and GB algorithms will profoundly help us to obtain more feature information from brain activities, enabling us to obtain the classification results from human body actions. The performance of the proposed framework has been evaluated on the dataset I of BCI Competition III. Furthermore, the combination of deep learning and traditional algorithms provides some ideas for future research with the BCI systems

The kiss2/kiss2r system directly modulates the activity of the pituitary gland in largemouth bass (Micropterus salmoides)

The kisspeptin system, which involves hypothalamic neuropeptides, plays pivotal roles in the regulation of teleost reproduction. A previous study suggested that the kiss2/kissr2 system in largemouth bass (Micropterus salmoides) was involved in regulating gonadal development through the hypothalamus-pituitary-gonad (HPG) axis. However, whether the kiss2/kiss2r system directly regulates the activity of pituitary gland were not studied. This study aimed to elucidate the detailed mechanism of kisspeptin-induced effects on gonadotropin hormone-producing cells in vivo and in vitro. In situ hybridization analysis revealed very widespread expression of kiss2r mRNA in the optic tectum, hypothalamus and pituitary. In the pituitary, kiss2r-expressing cells were mainly located in the proximal pars distalis and pars intermedia, among which the fshβ- and lhβ-positive cells exhibited expression of kiss2r messengers. Furthermore, primary culture of pituitary cells and peptide administration experiments revealed that the Kiss2-10 peptide stimulates the expression of fshβ and lhβ and the secretion of FSH and LH in 24 h. In addition, histology analysis revealed that three injections of the Kiss2-10 peptide promoted ovary development and increased oocyte size but had little effect on testis development. These results suggested that the intrapituitary kisspeptinergic system, as a hypophysiotropic neuropeptide factor, directly modulates of gonadotroph function. This study will help uncover the reproductive endocrinology network and improve artificial breeding technology for largemouth bass