Gender Differences in Personal and Situational Risk Factors for Traumatic Brain Injury Among Older Adults

Method of bed exit intention based on the internal pressure features in array air spring mattress

With the population ages, many patients are unable to receive comprehensive care, leading to an increase in hazardous incidents, particularly falls occurring after getting out of bed. To address this issue, this paper proposes a method for recognizing bed-exit intentions using an array air spring mattress. The method integrates convolutional neural networks with feature point matching techniques to identify both global and local features of the array air spring. For global features, a one-dimensional focal loss convolutional neural network (1D-FLCNN) model is employed to classify eight internal pressure time series and determine bed-exit status based on global features. For local features, the distribution matrix and feature point matrix of the internal pressure features are extracted to represent the spatial distribution of bed-exit postures. Euclidean distance is utilized to measure the similarity between these matrices and match bed-exit postures. Finally, the recognition results from both feature types are combined using a logical OR operation to produce the final result. Experimental validation confirms that the proposed method greatly improves the anti-interference capability and effectively avoids the problem of non-recognition due to body position and external environment.

Sex differences in mortality of older adults with falls after emergency department consultation: FALL-ER registry

BACKGROUND

To investigate if sex is a risk factor for mortality in patients consulting at the emergency department (ED) for an unintentional fall.

METHODS

This was a secondary analysis of the FALL-ER registry, a cohort of patients ≥65 years with an unintentional fall presenting to one of 5 Spanish EDs during 52 predefined days (one per week during one year). We collected 18 independent patient baseline and fall-related variables. Patients were followed for 6 months and all-cause mortality recorded. The association between biological sex and mortality was expressed as unadjusted and adjusted hazard ratios (HR) with the 95% confidence interval (95% CI), and subgroup analyses were performed by assessing the interaction of sex with all baseline and fall-related mortality risk variables.

RESULTS

Of 1315 enrolled patients (median age 81 years), 411 were men (31%) and 904 women (69%). The 6-month mortality was higher in men (12.4% vs. 5.2%, HR = 2.48, 95% CI = 1.65-3.71), although age was similar between sexes. Men had more comorbidity, previous hospitalizations, loss of consciousness, and an intrinsic cause for falling. Women more frequently lived alone, with self-reported depression, and the fall results in a fracture and immobilization. Nonetheless, after adjustment for age and these eight divergent variables, older men aged 65 and over still showed a significantly higher mortality (HR = 2.19, 95% CI = 1.39-3.45), with the highest risk observed during the first month after ED presentation (HR = 4.18, 95% CI = 1.31-13.3). We found no interaction between sex and any patient-related or fall-related variables with respect to mortality (p > 0.05 in all comparisons).

CONCLUSIONS

Male sex is a risk factor for death following ED presentation for a fall in the older population adults aged 65 and over. The causes for this risk should be investigated in future studies.

Fall Direction Detection in Motion State Based on the FMCW Radar

Accurately detecting falls and providing clear directions for the fall can greatly assist medical staff in promptly developing rescue plans and reducing secondary injuries during transportation to the hospital. In order to facilitate portability and protect people's privacy, this paper presents a novel method for detecting fall direction during motion using the FMCW radar. We analyze the fall direction in motion based on the correlation between different motion states. The range-time (RT) features and Doppler-time (DT) features of the person from the motion state to the fallen state were obtained by using the FMCW radar. We analyzed the different features of the two states and used a two-branch convolutional neural network (CNN) to detect the falling direction of the person. In order to improve the reliability of the model, this paper presents a pattern feature extraction (PFE) algorithm that effectively eliminates noise and outliers in RT maps and DT maps. The experimental results show that the method proposed in this paper has an identification accuracy of 96.27% for different falling directions, which can accurately identify the falling direction and improve the efficiency of rescue.

Preventive strategies for feeding intolerance among patients with severe traumatic brain injury: A cross-sectional survey

Objectives

This study aimed to investigate the application status of preventive measures for feeding intolerance in patients with severe traumatic brain injury (STBI) in China and analysis the differences and their causes.

Methods

A cross-sectional survey was conducted. From December 2019 to January 2020, ICU nurses and physicians of 89 hospitals in China were surveyed by using a questionnaire on preventive strategies for feeding intolerance in patients with STBI. The questionnaire included two parts: the general information of participants (10 items) and application of preventive measures for feeding intolerance in STBI patients (18 items).

Results

Totally 996 nurses and physicians completed the questionnaire. Among various methods, gastrointestinal symptoms(85.0%) and injury severity (71.4%) were mostly used to assess gastrointestinal functions and risk of feeding intolerance among STBI patients, respectively. Initiating enteral nutrition (EN) within 24–48 h (61.5%), nasogastric tubes (91.2%), 30°–45° of head-of-bed elevation (89.5%), continuous feeding by pump (72.9%), EN solution temperature of 38–40 °C (65.5%), <500 ml initial volume of EN solution (50.0%), monitoring gastric residual volume with a syringe (93.7%), and assessing gastric residual volume every 4 h (51.5%) were mostly applied for EN delivery among STBI patients. Prokinetic agents (73.3%), enema (73.6%), probiotics (79.0%), antacid agents (84.1%), and non-nutritional preparations as initial EN formula (65.6%) were commonly used for preventing feeding intolerance among STBI patients.

Conclusions

The survey showed that nurses and clinicians in China have a positive attitude towards preventive strategies for feeding intolerance. However, some effective new technologies and methods have not been timely applied in clinical practice. We suggest that managers, researchers, clinicians, nurses, and other health professionals should collaborate to explore effective and standard preventive strategies for feeding intolerance among patients with STBI.