This diagnostic study aimed to assess the efficacy of ultrasound deep tissue evaluation in predicting hospital-acquired pressure injuries (HAPIs). We performed a prospective analysis of 110 patients at risk for HAPIs between March 2023 and December 2024. All study participants underwent ultrasound deep tissue evaluations and the diagnosis of HAPIs. In addition, the Braden Scale, the Norton Scale, and the Waterlow Scale were all used for predicting HAPIs and compared with ultrasound deep tissue evaluation. Differences in some potential risk factors for HAPIs between the non-HAPI group (n = 41) and HAPI group (n = 69) were observed. The results of ROC analysis showed that in ultrasound deep tissue evaluation, the area under the curve for predicting HAPIs was 0.898, superior to those in the Norton Scale score, the Braden Scale score, the Waterlow Scale score, and age. Meanwhile, its maximum Youden index, cutoff, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio values were 0.665, 1.5, 0.884, 0.781, 0.871, 0.800, 4.03, and 0.15, respectively. We can see that ultrasound deep tissue evaluation may be a valuable method for early predicting HAPIs. However, it should also be recognized that the popularization of this technology and the homogenization of its operators will be the core links in promoting this technology among more patients.

Identifying clinical predictive factors related to the prognosis of septic patients with heart failure is crucial for guiding their treatment. The present study explored prognostic factors in septic patients with heart failure using retrospective data from the Medical Information Mart for Intensive Care IV database. Among 567 septic patients with heart failure included, 166 died, and 401 exhibited survival at 28 days. Univariate analysis showed that in the 28-day mortality group, age, white blood cell count, total bilirubin, blood urea nitrogen, serum creatinine, lactate, 72-hour overall fluid balance, 72-hour total dosage of norepinephrine, and 72-hour serum potassium variability were significantly higher (all P < .05), while body mass index, pH value, and arterial partial pressure of oxygen were significantly lower (all P < .05). Binary logistic regression analysis identified age [ OR = 1.054 (1.032–1.078)], total bilirubin [ OR = 1.169 (1.016–1.346)], and 72-hour serum potassium variability [ OR = 1.617 (1.456–1.794)] as independent predictors of 28-day mortality (all P < .05). Internal validation with ROC analysis in a total of 245 patients showed that the combination of the 3 indicators yielded a higher AUROC value [0.888 (0.841–0.924)] than that of any single indicator [age: AUROC = 0.637 (0.574–0.698); total bilirubin: AUROC = 0.548 (0.484–0.612); 72-hour serum potassium variability: AUROC = 0.868 (0.819–0.908)], indicating good predictive performance. These findings suggest that 72-hour serum potassium variability, age, and total bilirubin are independent risk factors for 28-day mortality in septic patients with heart failure, and their combination significantly enhances prognostic prediction.

This study investigates the relationships among perceived value, satisfaction, and behavioral intention in home care for older adult patients in the context of doctor-patient disputes and examines the moderating role of trust. This cross-sectional observational study used convenience sampling to recruit 306 older adult patients who had received home care services within the past year. Data were collected via a structured questionnaire comprising 26 items across 7 constructs (functional, emotional, efficiency, and social value; satisfaction; behavioral intention; and trust), each rated on a 5-point Likert scale. The questionnaire demonstrated good reliability and validity. Structural equation modeling was performed using AMOS 24.0 to test path relationships, with model fit evaluated by multiple indices (chi-square to degrees of freedom ratio = 1.289, root mean square error of approximation = 0.031, comparative fit index = 0.983, Tucker-Lewis index = 0.980). Mediation effects were examined using the bootstrap method (5000 resamples), and moderation effects of trust were tested using PROCESS macro (Model 1) in SPSS 26.0. The results showed that social value most strongly predicts satisfaction (β = 0.330, P < .001), followed by emotional (β = 0.236, P < .001) and functional value (β = 0.192, P < .01); efficiency value is nonsignificant (β = 0.080, P > .05). For behavioral intention, emotional value has the strongest direct effect (β = 0.208, P < .01), followed by functional (β = 0.172, P < .01) and efficiency value (β = 0.159, P < .05), social value is nonsignificant (β = 0.114, P > .05). Satisfaction significantly predicted behavioral intention (β = 0.285, P < .001), and partially mediated the relationship between perceived value and behavioral intention. The indirect effect between efficiency value and behavioral intention was not significant (0.027, P > .05), and the 95% CI was 0 (–0.011, 0.115), thus not playing a mediating role. Trust moderates perceived value’s effect on satisfaction, but not for efficiency value (β = –0.043, P > .05). Findings suggest a need for human-centered home care models emphasizing emotional support and social recognition, moving beyond technology-driven approaches. This research supports policymakers in evaluating older adult care services and building trust-based, satisfaction-centered, and value-driven doctor-patient interactions for healthy aging and high-quality elder care.

Objectives: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of phrenic nerve stimulation (PNS) in mechanically ventilated adult patients. Methods: PubMed, Web of Science, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) up to 21 February 2026, without language restrictions. Two reviewers independently screened studies, extracted data, and evaluated the risk of bias using the Cochrane RoB 2 tool. The certainty of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using fixed-effects or random-effects models according to heterogeneity. Results: Five RCTs involving 431 patients were included. PNS was associated with a higher weaning success rate (OR = 2.96, 95% CI: 1.04 to 8.40, p = 0.04), a shorter duration of mechanical ventilation (MD = −2.63, 95% CI: −3.90 to −1.35, p < 0.001), higher maximal inspiratory pressure (MD = 2.95, 95% CI: 1.10 to 4.79, p = 0.002), and higher diaphragm thickening fraction (MD = 15.67, 95% CI: 4.84 to 26.50, p = 0.005). No statistically significant differences were observed in ICU length of stay, rapid shallow breathing index, or tracheostomy rate. Noninvasive stimulation was generally tolerated in the included studies, whereas transvenous stimulation was associated with procedure-related serious adverse events. The certainty of evidence ranged from high to low across outcomes. Conclusions: PNS was associated with improved weaning outcomes and diaphragm function in mechanically ventilated patients. However, the evidence remains limited by the small number of RCTs, clinical heterogeneity, and uncertainty regarding long-term outcomes. Further large-scale, multicenter RCTs with standardized protocols are needed to assess the efficacy and safety of PNS.