To evaluate the efficacy and application potential of different large language models in health education consultation for stroke patients.

Using 21 common clinical questions of stroke and 2 sets of typical clinical scenario simulation cases,three rounds of tests were conducted on DeepSeek R1,ERNIE Bot X1,ChatGPT-4o,and Claude 3.7 Sonnet large language models.Three neurology department chief physicians were selected to evaluate the models from five dimensions:accuracy,comprehensiveness,understandability,humanistic care,and case analysis ability.

The overall performance of all models was good.DeepSeek R1 had the highest total score, followed by ChatGPT-4o,Claude 3.7 Sonnet, and ERNIE Bot X1.DeepSeek R1 and ChatGPT-4o performed outstandingly in complex clinical reasoning,evidence-based medical knowledge transmission,humanistic care,and case analysis.ERNIE Bot X1 had an advantage in the adaptability to the Chinese context.

Large language models showed positive auxiliary application value in the field of stroke health education.However,the clinical review mechanism needs to be combined to enhance the reliability of the information.The clinical application of these models could be promoted by optimizing the transparency of the algorithms and the adaptability to the local context.

To analyze the multidirectional prognosis and predictive factors of the motoric cognitive risk syndrome in the elderly in China.

The data were sourced from the China health and retirement longitudinal study(CHARLS) from 2011 to 2015.A total of 430 elderly people with the motoric cognitive risk syndrome were selected.Demographic,lifestyle,physical condition,and social psychological variables were collected.Unordered multinomial Logistic regression analysis was used to identify the predictive factors for the outcomes of the motoric cognitive risk syndrome.

During the 4-year follow-up period of the 430 elderly people with the motoric cognitive risk syndrome,the incidence rates of stable type,transient reverse type,progressive type-physical disability,and progressive type-dementia were 19.07%,70.00%,8.37%,and 2.56%,respectively.The probability of the elderly with motoric cognitive risk syndrome experiencing reversal towards non-motoric cognitive risk syndrome decreased when their grip strength reduced.Alcohol consumption behavior was significantly associated with the risk of progression from motoric cognitive risk syndrome to dementia in the elderly.

The outcomes of the motoric cognitive risk syndrome in the elderly in China showed multidirectionality and heterogeneity.It is recommended to strengthen the assessment of grip strength and alcohol intervention for the elderly with the motoric cognitive risk syndrome,so as to reduce the risk of adverse outcomes.

To explore the dynamic trajectory of estimated pulse wave velocity in middle-aged and elderly people and its relationship with cardiovascular diseases.

Based on the population cohort data from the China health and retirement longitudinal study(CHARLS),general information and laboratory indicators of the population were collected. The group-based trajectory model (GBTM) was used to construct the heterogeneous trajectories of the estimated pulse wave velocity dynamics in the community among the elderly. Logistic regression analysis was applied to explore the relationship between the estimated pulse wave velocity dynamic trajectory and cardiovascular diseases.

A total of 5 933 participants were included in the analysis, among whom 1 112 cases (18.7%) developed cardiovascular diseases.The GBTM analysis revealed four estimated trajectories of pulse wave velocity changes:the low-level stable group(30.0%),the medium-level ascending group(39.6%),the ascending and stable group(23.0%),and the high-level ascending group(7.4%).Logistic regression analysis showed that, after adjusting for confounding factors, compared with the low-level stable group,the risk of cardiovascular diseases significantly increased in the medium-level ascending group, the ascending and stable group,and the high-level ascending group.

The estimated pulse wave velocity trajectories of the elderly in the community showed population heterogeneity.The higher estimated pulse wave velocity trajectories was correlated with the occurrence of cardiovascular diseases.It is suggested that medical staff should pay attention to the changes in the estimated pulse wave velocity of the elderly and formulate corresponding intervention strategies based on different trajectories.

To develop the pulmonary rehabilitation training program for adolescent patients with severe pectus excavatum during the perioperative period,and to provide a reference for promoting the recovery of children undergoing pectus excavatum surgery.

Based on the concept of pulmonary rehabilitation,through literature analysis and semi-structured interviews,a questionnaire for the pulmonary rehabilitation training program for adolescent patients with severe pectus excavatum during the perioperative period was constructed.The final program was determined using the Delphi expert questionnaire method.

Two rounds of expert questionnaires were conducted.The effective recovery rate of the questionnaire was 94.44% and 100.00% respectively.The expert questionnaire authority coefficient was 0.859.The importance of each item was 3.76-4.88 and 4.06-4.88 respectively.The coefficients of variation were 0.068-0.238 and 0.070-0.183 respectively.The Kendall coefficients were 0.484 and 0.328(P<0.001).The final perioperative pulmonary rehabilitation training program for adolescents with severe pectus excavatum included 8 primary items,25 secondary items,and 29 tertiary items.

The constructed pulmonary rehabilitation training program for adolescent patients with severe pectus excavatum during the perioperative period was scientifically and operationally sound.It could provide reference for guiding the recovery of children during the perioperative period and promote their rapid recovery after surgery.

To construct the evaluation index system for service quality of designated long-term care institutions.

The evaluation index system for the service quality of designated long-term care institutions was constructed by literature summary and semi-structured interview period expert consultation.Its weights were determined.

Two rounds of expert inquiries were conducted.The positive coefficients of the experts were 91.3% and 100.0% respectively.The authority coefficient was 0.90.The Kendall's coefficient of concordia in the second round was 0.291(P<0.001).The importance scores of each evaluation index in the first round of expert inquiries ranged from 4.20 to 4.95 points,and the coefficient of variation ranged from 0.04 to 0.19.The importance scores of each evaluation index in the second round of expert inquiries ranged from 4.38 to 4.95,and the coefficient of variation ranged from 0.05 to 0.13.The final constructed evaluation index system for service quality of designated long-term care institutions included 4 first-level indicators,12 second-level indicators and 35 third-level indicators.

The constructed evaluation index system for service quality of designated long-term care institutions has good scientificity and practicality.It could provide references for the quality supervision of long-term care services,the renewal of institution agreements,the disbursement of expenses and the management of fund payments.

To investigate the changing trajectory of oral frailty in elderly stroke patients and its associated influencing factors, and to provide reference for targeted clinical interventions.

A convenience sample of 300 elderly stroke patients admitted to the neurology department of a tertiary grade A hospital in Shandong province were enrolled in this study.Data were collected using a general information questionnaire and standardized assessment tools,including the Oral Frailty Index-8(OFI-8),the Oral Health Assessment Tool(OHAT),the Geriatric Self-Efficacy in Oral Health Scale(GSEOH),and the Perceived Social Support Scale(PSSS).Oral frailty levels were evaluated based on these instruments.

The changing trajectory of oral frailty in elderly stroke patients was categorized into two distinct patterns:a high-level slow increase group(49.7%) and a low-level slow increase group(50.3%).Logistic regression analysis revealed that age,smoking history,prior cerebral infarction,number of remaining teeth,subjective chewing difficulty,oral health status,and perceived social support were significant predictors of oral frailty(all P<0.05).The decision tree model identified four key clinical variables:wearing dentures,oral health status,subjective masticatory difficulty,and prior cerebral infarction.The areas under the receiver operating characteristic curves for the decision tree and Logistic regression models were 0.939 and 0.943,respectively,indicating strong predictive performance.

Oral frailty in elderly stroke patients generally progresses gradually over time,with notable heterogeneity among subgroups.Both the decision tree and logistic regression models demonstrate considerable predictive accuracy.Healthcare professionals can develop intervention plans based on these two models to achieve early identification of oral frailty and precise care.

To develop the integrated traditional Chinese and western medicine health education program for Parkinson's disease based on the chronic illness trajectory framework,and to provide evidence-based guidance for clinical nurses.

Guided by the framework of chronic illness trajectory,the draft plan was formed based on evidence-based research.The final plan was determined through the Delphi method.A total of 192 nurses from tertiary grade A hospitals specializing in neurology were selected for the feasibility assessment of the plan.

Two rounds of expert inquiries were conducted.The expert authority coefficients were 0.815 and 0.855 respectively.The coefficient of variation was less than 0.25 for two rounds of expert inquiries.The Kendall's coefficients of agreement were 0.420 and 0.481 respectively(P<0.01).Finally, the integrated traditional Chinese and western medicine health education program for Parkinson's disease based on the chronic illness trajectory framework was formed.It covered 7 stages of disease trajectory:pre-disease,onset,diagnosis,treatment,stability,deterioration,and death.The feasibility assessment of the plan showed that the average scores in four dimensions(structure rationality,content scientificity,implementation feasibility,and overall evaluation) were all above 4.5 points.

The constructed the integrated traditional Chinese and western medicine health education program for Parkinson's disease based on the chronic illness trajectory framework was scientifically sound,reliable,and feasible.It could provide standardized tools for the whole-process health management of Parkinson's disease.It provides evidence-based guidance for clinical nurses in conducting health education for Parkinson's disease.