BackgroundProviding intensive care is increasingly expensive, and the aim of this study was to construct a risk column line graph (nomograms)for prolonged length of stay (LOS) in the intensive care unit (ICU) for patients with chronic obstructive pulmonary disease (COPD).MethodsThis study included 4,940 patients, and the data set was randomly divided into training (n = 3,458) and validation (n = 1,482) sets at a 7:3 ratio. First, least absolute shrinkage and selection operator (LASSO) regression analysis was used to optimize variable selection by running a tenfold k-cyclic coordinate descent. Second, a prediction model was constructed using multifactorial logistic regression analysis. Third, the model was validated using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow tests, calibration plots, and decision-curve analysis (DCA), and was further internally validated.ResultsThis study selected 11 predictors: sepsis, renal replacement therapy, cerebrovascular disease, respiratory failure, ventilator associated pneumonia, norepinephrine, bronchodilators, invasive mechanical ventilation, electrolytes disorders, Glasgow Coma Scale score and body temperature. The models constructed using these 11 predictors indicated good predictive power, with the areas under the ROC curves being 0.826 (95%CI, 0.809–0.842) and 0.827 (95%CI, 0.802–0.853) in the training and validation sets, respectively. The Hosmer-Lemeshow test indicated a strong agreement between the predicted and observed probabilities in the training (χ2 = 8.21, p = 0.413) and validation (χ2 = 0.64, p = 0.999) sets. In addition, decision-curve analysis suggested that the model had good clinical validity.ConclusionThis study has constructed and validated original and dynamic nomograms for prolonged ICU stay in patients with COPD using 11 easily collected parameters. These nomograms can provide useful guidance to medical and nursing practitioners in ICUs and help reduce the disease and economic burdens on patients.

BACKGROUND Cardiovascular disease has become the leading cause of death for patients worldwide, and deaths due to cardiovascular disease accounted for one-third of all deaths worldwide in 2019. Percutaneous Coronary Intervention (PCI), as the most commonly used revascularization method for clinical treatment of coronary artery disease, can effectively improve myocardial ischemia and hypoxia symptoms. Telemedicine can enhance patient monitoring, facilitate early identification and analysis of patient conditions, enhancing patient management and quality of care. The European Society of Cardiology (ESC) state that postoperative management such as lipid-lowering therapy, anticoagulation therapy and lifestyle changes can reduce the rate of coronary restenosis in patients. However, patients with low medication adherence and poor self-management after PCI are prone to complications such as restenosis . Studies have shown that home-based telehealth interventions in the postoperative management of PCI patients can effectively improve the lack of post-treatment management , improve patients' medication adherence, and lead to a significant decrease in coronary heart disease mortality and rehospitalization rates. Telemedicine is the support of medical and public health services through mobile wireless network devices, such as the use of cell phones, wearable systems, Personal Digital Assistant, and other wireless devices for patient health management. OBJECTIVE The purpose of this study was to evaluate the effectiveness of telemedicine intervention on patients after percutaneous coronary intervention (PCI). METHODS PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and four Chinese databases were searched to 1 July 2022. We included randomized controlled trials (RCTs), comparing the prognostic effect of conventional care and telemedicine intervention on patients after PCI.  RESULTS Totally 11 studies with 2360 participants were included. The results showed that telemedicine versus conventional treatment led to a reduction in cardiovascular events(Risk Ratio-RR 0.62;95% confidence interval-CI 0.42–0.91; P=.02) and smoking cessation status(RR 1.56; 95 % CI 1.06–2.30; P=.02), improving quality of life(Standard Mean Difference-SMD 2.91; 95% CI 1.22–4.59; P<.001). Both total cholesterol (Mean Difference-MD -0.33; 95%CI -0.54 –-0.12; P<.002) and triglycerides (MD, -0.23; 95% CI -0.31 – -0.14; P<.001) were significantly lower in the telemedicine group than in the control group. There was no significant effect on systolic blood pressure, diastolic blood pressure, low-density lipoprotein, high-density lipoprotein, or body mass index(P＞.05). CONCLUSIONS Telemedicine-based nursing interventions effectively improve cardiovascular events and quality of life in patients after PCI. However, due to the limitations of the number and quality of included studies, the above findings require further investigation.

Objective: To appraise research evidence on the effects of balance training on balance and fall efficacy in patients with osteoporosis.Methods: Six electronic databases were searched from inception of the database to 1 August 2022, with no language restrictions, and randomized controlled trials of balance training in patients with osteoporosis were included in this meta-analysis. Two authors independently screened and reviewed the articles and assessed the methodological quality using the Cochrane risk-of-bias tools. Trial sequential analysis was conducted.Results: A total of 10 randomized controlled trials with 684 patients were included. Three of the studies that were included had low risk of bias, 5 had moderate risk of bias, and 2 had high risk of bias. A meta-analysis demonstrated that balance training improves dynamic balance measured using the Timed Up and Go Test (mean difference (MD) = –1.86, 95% CI (–2.69, –1.02), Z = 4.38, p < 0.0001) and the Berg Balance Scale (MD = 5.31, 95% CI (0.65, 9.96), Z = 2.23, p < 0.03), static balance measured using One-Leg Standing Time (MD = 4.10, 95% CI (2.19, 6.01), Z = 4.21, p < 0.0001), and fall efficacy measured using the Falls Efficacy Scale International (MD = –4.60, 95% CI (–6.33, –2.87), Z = 5.20, p < 0.00001) were also significantly improved. Trial sequential analysis showed reliable evidence ofthe effects of balance training on dynamic and static balance improvement. The conclusions of this review are supported by the statistical and clinical significance of all outcomes in the meta-analysis, based on the advised minimal clinically significant differences and minimum detectable changes.Conclusion: Balance training may be effective in improving balance ability and reducing fear of falling in patients with osteoporosis. LAY ABSTRACTInsufficient balance will limit activities and impair physical and mental capabilities, which will increase the risk of falling and reduce quality of life. The study evidence on the effects of balance training in people with osteoporosis is summarized in this paper. The investigations identified 10 related studies that tested the effects of balance training. The data from these trials shows that balancing training can decrease patients’ fear of falling and improve their balancing abilities. For patients and therapists hoping to enhance the effectiveness of rehabilitation, these findings are crucial.