BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery ...BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.展开更多
Damage to electrical equipment in an earthquake can lead to power outage of power systems.Seismic fragility analysis is a common method to assess the seismic reliability of electrical equipment.To further guarantee th...Damage to electrical equipment in an earthquake can lead to power outage of power systems.Seismic fragility analysis is a common method to assess the seismic reliability of electrical equipment.To further guarantee the efficiency of analysis,multi-source uncertainties including the structure itself and seismic excitation need to be considered.A method for seismic fragility analysis that reflects structural and seismic parameter uncertainty was developed in this study.The proposed method used a random sampling method based on Latin hypercube sampling(LHS)to account for the structure parameter uncertainty and the group structure characteristics of electrical equipment.Then,logistic Lasso regression(LLR)was used to find the seismic fragility surface based on double ground motion intensity measures(IM).The seismic fragility based on the finite element model of an±1000 kV main transformer(UHVMT)was analyzed using the proposed method.The results show that the seismic fragility function obtained by this method can be used to construct the relationship between the uncertainty parameters and the failure probability.The seismic fragility surface did not only provide the probabilities of seismic damage states under different IMs,but also had better stability than the fragility curve.Furthermore,the sensitivity analysis of the structural parameters revealed that the elastic module of the bushing and the height of the high-voltage bushing may have a greater influence.展开更多
This article presents an adaptive fault-tolerant tracking control strategy for unknown affine nonlinear systems subject to actuator faults and external disturbances.To address the hyperparameter initialization challen...This article presents an adaptive fault-tolerant tracking control strategy for unknown affine nonlinear systems subject to actuator faults and external disturbances.To address the hyperparameter initialization challenges inherent in conventional neural network training,an improved self-organizing radial basis function neural network(SRBFNN)with an input-dependent variable structure is developed.Furthermore,a novel selforganizing RBFNN-based observer is introduced to estimate system states across all dimensions.Leveraging the reconstructed states,the proposed adaptive controller effectively compensates for all uncertainties,including estimation errors in the observer,ensuring accurate state tracking with reduced control effort.The uniform ultimate boundedness of all closed-loop signals and tracking errors is rigorously established via Lyapunov stability analysis.Finally,simulations on two different nonlinear systems comprehensively validate the effectiveness and superiority of the proposed control approach.展开更多
<strong>Objective:</strong> To observe the changes of fetal umbilical vein (UV) Doppler parameters in pregnant women with preeclampsia (PE) and analyze their predictive values for maternal PE. <strong&g...<strong>Objective:</strong> To observe the changes of fetal umbilical vein (UV) Doppler parameters in pregnant women with preeclampsia (PE) and analyze their predictive values for maternal PE. <strong>Methods:</strong> Forty-six patients with PE who underwent systematic ultrasound examination in our hospital from December 2017 to May 2021 were included as the subjects, which were divided into two groups according to the severity of the disease (23 cases in each group). And 120 normal pregnant women who underwent health examination in our hospital during the same period were enrolled as the control group. Color Doppler ultrasonography was used to monitor the umbilical vein flow (QUV), left portal vein flow (QLPV), venous catheter flow (QDV), left portal vein (LPV) shunt rate and venous catheter (DV) shunt rate. And the sensitivity and specificity of the related indexes were calculated and analyzed according to the gold standard for clinical diagnosis of PE. <strong>Results:</strong> As the severity of PE increased, the fetal QUV, QLPV and LPV shunt rates decreased, and the QDV and DV shunt rates increased, with statistically significant differences compared with the control group (P < 0.05). The specificity and sensitivity of the combination of fetal QUV, QLPV, QDV, LPV shunt rate and DV shunt rate in predicting PE were higher than those of the indexes used alone (P < 0.05). <strong>Conclusion:</strong> The fetal umbilical vein Doppler parameters QUV, QLPV, QDV, LPV shunt rate, and DV shunt rate have some value in predicting PE, but their combination showed greater value, as well as higher diagnostic and clinical significance.展开更多
基金supported by the National Nature Science Foundation of China(No.82370336&No.82330014)the Key Research and Development Plan of Heilongjiang Province(2022ZX06C23&JD2023SJ44)the Research Project of the First Affiliated Hospital of Harbin Medical University(No.2021M19).
文摘BACKGROUND Blood glucose and serum albumin have been associated with cardiovascular disease prognosis,but the impact of admission-blood-glucose-to-albumin ratio(AAR)on adverse outcomes in critical ill coronary artery disease(CAD)patients was not investigated.METHODS Patients diagnosed with CAD were non-consecutively selected from the MIMIC-IV database and categorized into quartiles based on their AAR.The primary outcome was 1-year mortality,and secondary endpoints were in-hospital mortality,acute kidney injury(AKI),and renal replacement therapy(RRT).A restricted cubic splines model and Cox proportional hazard models assessed the association between AAR and adverse outcomes in CAD patients.Kaplan-Meier survival analysis determined differences in endpoints across subgroups.RESULTS A total of 8360 patients were included.There were 726 patients(8.7%)died in the hospital and 1944 patients(23%)died at 1 year.The incidence of AKI and RRT was 63%and 4.3%,respectively.High AAR was markedly associated with in-hospital mortality(HR=1.587,P=0.003),1-year mortality(HR=1.502,P<0.001),AKI incidence(HR=1.579,P<0.001),and RRT(HR=1.640,P<0.016)in CAD patients in the completely adjusted Cox proportional hazard model.Kaplan-Meier survival analysis noted substantial differences in all endpoints based on AAR quartiles.Stratified analysis and interaction test demonstrated stable correlations between AAR and outcomes.CONCLUSIONS The results highlight that AAR may be a potential indicator for assessing in-hospital mortality,1-year mortality,and adverse renal prognosis in critical CAD patients.
基金National Key R&D Program of China under Grant Nos.2018YFC1504504 and 2018YFC0809404。
文摘Damage to electrical equipment in an earthquake can lead to power outage of power systems.Seismic fragility analysis is a common method to assess the seismic reliability of electrical equipment.To further guarantee the efficiency of analysis,multi-source uncertainties including the structure itself and seismic excitation need to be considered.A method for seismic fragility analysis that reflects structural and seismic parameter uncertainty was developed in this study.The proposed method used a random sampling method based on Latin hypercube sampling(LHS)to account for the structure parameter uncertainty and the group structure characteristics of electrical equipment.Then,logistic Lasso regression(LLR)was used to find the seismic fragility surface based on double ground motion intensity measures(IM).The seismic fragility based on the finite element model of an±1000 kV main transformer(UHVMT)was analyzed using the proposed method.The results show that the seismic fragility function obtained by this method can be used to construct the relationship between the uncertainty parameters and the failure probability.The seismic fragility surface did not only provide the probabilities of seismic damage states under different IMs,but also had better stability than the fragility curve.Furthermore,the sensitivity analysis of the structural parameters revealed that the elastic module of the bushing and the height of the high-voltage bushing may have a greater influence.
基金supported in part by the National Natural Science Foundation of China(62033008,62188101,62173343,62073339)the Natural Science Foundation of Shandong Province of China(ZR2024MF072,ZR2022ZD34)the Research Fund for the Taishan Scholar Project of Shandong Province of China.
文摘This article presents an adaptive fault-tolerant tracking control strategy for unknown affine nonlinear systems subject to actuator faults and external disturbances.To address the hyperparameter initialization challenges inherent in conventional neural network training,an improved self-organizing radial basis function neural network(SRBFNN)with an input-dependent variable structure is developed.Furthermore,a novel selforganizing RBFNN-based observer is introduced to estimate system states across all dimensions.Leveraging the reconstructed states,the proposed adaptive controller effectively compensates for all uncertainties,including estimation errors in the observer,ensuring accurate state tracking with reduced control effort.The uniform ultimate boundedness of all closed-loop signals and tracking errors is rigorously established via Lyapunov stability analysis.Finally,simulations on two different nonlinear systems comprehensively validate the effectiveness and superiority of the proposed control approach.
文摘<strong>Objective:</strong> To observe the changes of fetal umbilical vein (UV) Doppler parameters in pregnant women with preeclampsia (PE) and analyze their predictive values for maternal PE. <strong>Methods:</strong> Forty-six patients with PE who underwent systematic ultrasound examination in our hospital from December 2017 to May 2021 were included as the subjects, which were divided into two groups according to the severity of the disease (23 cases in each group). And 120 normal pregnant women who underwent health examination in our hospital during the same period were enrolled as the control group. Color Doppler ultrasonography was used to monitor the umbilical vein flow (QUV), left portal vein flow (QLPV), venous catheter flow (QDV), left portal vein (LPV) shunt rate and venous catheter (DV) shunt rate. And the sensitivity and specificity of the related indexes were calculated and analyzed according to the gold standard for clinical diagnosis of PE. <strong>Results:</strong> As the severity of PE increased, the fetal QUV, QLPV and LPV shunt rates decreased, and the QDV and DV shunt rates increased, with statistically significant differences compared with the control group (P < 0.05). The specificity and sensitivity of the combination of fetal QUV, QLPV, QDV, LPV shunt rate and DV shunt rate in predicting PE were higher than those of the indexes used alone (P < 0.05). <strong>Conclusion:</strong> The fetal umbilical vein Doppler parameters QUV, QLPV, QDV, LPV shunt rate, and DV shunt rate have some value in predicting PE, but their combination showed greater value, as well as higher diagnostic and clinical significance.
