Delirium is a common complication in elderly inpatients which could result in cognitive impairment, and increase the risk of disability, fall and mortality. Moreover, it could cause heavy social burden. Even with multiple bedside screening scales to detect delirium, the rate of missed diagnosis is still high. Maybe it is associated with the acute fluctuation and nocturnal onset of delirium. With the development of the intelligence and automation of the electronic medical record (EMR), previous studies have explored the use of EMR to identify delirium patients, and this method provides help for delirium diagnosis and prevention. In this paper, we reviewed and summarized the current situation of research on delirium recognition by EMR, and put forward the development prospect in this method in order to provide basis and lay a foundation for intelligent diagnosis of delirium.
Complex interventions are commonly used in health and social care services, public health practice, and other areas of social and economic policy that have consequences for health. Due to the multiple components of interventions, the complicated mechanisms of change, the diversity of the population involved, and the interaction between the intervention and the context in which it is implemented, the appropriate development and evaluation of complex interventions has become increasingly critical. The UK Medical Research Council published a framework for developing and evaluating complex interventions. The aim of this article is to introduce and interpret the framework to provide guidance on the development and evaluation of complex interventions for domestic researchers.
Gut microbiota plays an important role in development of diabetes with frailty. Therefore, it is of great significance to study the structural and functional characteristics of gut microbiota in Chinese with frailty. Totally 30 middle-aged and the aged participants in communities with diabetes were enrolled in this study, and their feces were collected. At the same time, we developed a metagenome analysis to explore the different of the structural and functional characteristics between diabetes with frailty and diabetes without frailty. The results showed the alpha diversity of intestinal microbiota in diabetes with frailty was lower. Collinsella and Butyricimonas were more abundant in diabetes with frailty. The functional characteristics showed that histidine metabolism, Epstein-Barr virus infection, sulfur metabolism, and biosynthesis of type Ⅱ polyketide products were upregulated in diabetes with frailty. Otherwise, butanoate metabolism and phenylalanine metabolism were down-regulated in diabetes with frailty. This research provides theoretical basic for exploring the mechanism of the gut microbiota on the occurrence and development of diabetes with frailty, and provides a basic for prevention and intervention of it.