Porous carbon microspheres are widely regarded as a superior CO_(2) adsorbent due to their exceptional efficiency and affordability.However,better adsorption performance is very attractive for porous carbon microspher...Porous carbon microspheres are widely regarded as a superior CO_(2) adsorbent due to their exceptional efficiency and affordability.However,better adsorption performance is very attractive for porous carbon microspheres.And modification of the pore structure is one of the effective strategies.In this study,multi-cavity mesoporous carbon microspheres were successfully synthesized by the synergistic method of soft and hard templates,during which a phenolic resin with superior thermal stability was employed as the carbon precursor and a mixture of silica sol and F108 as the mesoporous template.Carbon microspheres with multi-cavity mesoporous structures were prepared,and all the samples showed highly even mesopores,with diameters around 12 nm.The diameter of these microspheres decreased from 396.8 nm to about 182.5 nm with the increase of silica sol.After CO_(2) activation,these novel carbon microspheres(APCF0.5-S1.75)demonstrated high specific surface area(983.3 m^(2)/g)and remarkable CO_(2) uptake of 4.93 mmol/g at 0℃ and1 bar.This could be attributed to the unique multi-cavity structure,which offers uniform mesoporous pore channels,minimal CO_(2) transport of and a greater number of active sites for CO_(2) adsorption.展开更多
BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparosc...BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.展开更多
The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. Th...The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.展开更多
The pinching of n-dimensional closed hypersurface Mwith constant mean curvature H in unit sphere S^（n＋1）（ 1） is considered. Let A = ∑i,j,k h（ijk）~2（ λi＋ nH）~2,B = ∑i,j,k h（ijk）~2（ λi＋ nH） ·（ ...The pinching of n-dimensional closed hypersurface Mwith constant mean curvature H in unit sphere S^（n＋1）（ 1） is considered. Let A = ∑i,j,k h（ijk）~2（ λi＋ nH）~2,B = ∑i,j,k h（ijk）~2（ λi＋ nH） ·（ λj＋ nH）,S = ∑i（ λi＋ nH）~2, where h（ij）= λiδ（ij）. Utilizing Lagrange＇s method, a sharper pointwise estimation of 3（A- 2B） in terms of S and ｜▽h｜~2 is obtained, here ｜▽h｜~2= ∑i,j,k h（ijk）~2. Then, with the help of this, it is proved that Mis isometric to the Clifford hypersurface if the square norm of the second fundamental form of Msatisfies certain conditions. Hence, the pinching result of the minimal hypersurface is extended to the hypersurface with constant mean curvature case.展开更多
This paper studies two isometric problems between unit spheres of Banach spaces.In the first part,we introduce and study the Figiel type problem of isometric embeddings between unit spheres.However,the classical Figie...This paper studies two isometric problems between unit spheres of Banach spaces.In the first part,we introduce and study the Figiel type problem of isometric embeddings between unit spheres.However,the classical Figiel theorem on the whole space cannot be trivially generalized to this case,and this is pointed out by a counterexample.After establishing this,we find a natural necessary condition required by the existence of the Figiel operator.Furthermore,we prove that when X is a space with the T-property,this condition is also sufficient for an isometric embedding T:S_(X)→S_(Y) to admit the Figiel operator.This answers the Figiel type problem on unit spheres for a large class of spaces.In the second part,we consider the extension of bijectiveε-isometries between unit spheres of two Banach spaces.It is shown that every bijectiveε-isometry between unit spheres of a local GL-space and another Banach space can be extended to be a bijective 5ε-isometry between the corresponding unit balls.In particular,whenε=0,this recovers the MUP for local GL-spaces obtained in[40].展开更多
The aim of this paper is to discuss whether the increasing intervention of the state in the private sphere-as is evidenced in labor laws, consumer rights, bioethics, and Internet crimes-is compatible with the liberal ...The aim of this paper is to discuss whether the increasing intervention of the state in the private sphere-as is evidenced in labor laws, consumer rights, bioethics, and Internet crimes-is compatible with the liberal ideal of neutrality, or, on the contrary, whether it can be seen as a turning point towards the position of communitarian or republican authors, for whom the state must endorse a substantive good. Such a turning point could lead to a reformulation of the public and private spheres, and of course, raise questions over which values justify which kinds of intervention. This paper will cover these debates in three parts： First, by presenting briefly the history of the liberal conception of rights, I will try to show that, from a starting point based mostly on individual protection, the liberal tradition has become more interventionist, which can be seen through the notion of ＂claim rights.＂ Departing from John Rawls＇s work, I will argue that this notion allows for some level of intervention, without betraying liberal neutrality. Subsequently, I will discuss the difference between this kind of intervention and the ones proclaimed by communitarians and republicans authors： The former will be illustrated by Michael Sandel＇s criticism of Rawls in Liberalism and the Limits of Justice, and the later by Richard Dagger＇s position in Civic Virtues, Citizenship, and Republican Liberalism. Finally, in the third part, we＇ll discuss whether liberal principles can be harmonized with the republican and communitarian focus on civic virtues and good life.展开更多
Based on the comprehensive study of geology and geophysics in African continent,three types of lithosphere(craton-type,orogenic-type and rift-type)can be identified.Considering lithosphere discontinuities as the bound...Based on the comprehensive study of geology and geophysics in African continent,three types of lithosphere(craton-type,orogenic-type and rift-type)can be identified.Considering lithosphere discontinuities as the boundary,two first-order tectonic units(mainly cratonic-type in the west and rift-type in the east)are proposed.Different types of lithosphere can be divided into secondary-order and third-order structural units,and the blocks within lithosphere can be further divided into fourth-order structural units.The geological history,the formation process and significance of different types of lithosphere in African continent are briefly discussed.展开更多
The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,...The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,photovoltaic power generation is unstable and random,resulting in a low utilization rate and directly affecting the stability of the power grid.To solve this problem,this paper proposes a coordinated control strategy for a newenergy power generation system with a hybrid energy storage unit based on the lithium iron phosphate-supercapacitor hybrid energy storage unit.Firstly,the variational mode decomposition algorithm is used to separate the high and low frequencies of the power signal,which is conducive to the rapid and accurate suppression of the power fluctuation of the energy storage system.Secondly,the fuzzy control algorithm is introduced to balance the power between energy storage.In this paper,the actual data is used for simulation,and the simulation results show that the strategy realizes the effective suppression of the bus voltage fluctuation and the accurate control of the internal state of the energy storage unit,effectively avoiding problems such as overshoot and over-discharge,and can significantly improve the stability of the photovoltaic power generation systemand the stability of the Direct Current bus.It is of great significance to promote the development of collaborative control technology for photovoltaic hybrid energy storage units.展开更多
BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA...BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.展开更多
BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’...BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.展开更多
Exploring efficient and nonprecious metal electrocatalysts of oxygen reduction reaction(ORR)and oxygen evolution reaction(OER)is crucial for developing rechargeable zinc-air batteries(ZABs).Herein,an alloying-degree c...Exploring efficient and nonprecious metal electrocatalysts of oxygen reduction reaction(ORR)and oxygen evolution reaction(OER)is crucial for developing rechargeable zinc-air batteries(ZABs).Herein,an alloying-degree control strategy was employed to fabricate nitrogen-doped carbon sphere(NCS)decorated with dual-phase Co/Co_(7)Fe_(3)heterojunctions(CoFe@NCS).The phase composition of materials has been adjusted by controlling the alloying degree.The optimal CoFe_(0.08)@NCS electrocatalyst displays a half-wave potential of 0.80 V for ORR and an overpotential of 283 mV at 10 mA·cm^(-2)for OER in an alkaline electrolyte.The intriguing bifunctional electrocatalytic activity and durability is attributed to the hierarchically porous structure and interfacial electron coupling of highly-active Co_(7)Fe_(3)alloy and metallic Co species.When the CoFe_(0.08)@NCS material is used as air-cathode catalyst of rechargeable liquid-state zinc-air battery(ZAB),the device shows a high peak power-density(157 mW·cm^(-2))and maintains a stable voltage gap over 150 h,outperforming those of the benchmark(Pt/C+RuO_(2))-based device.In particular,the as-fabricated solid-state flexible ZAB delivers a reliable compatibility under different bending conditions.Our work provides a promising strategy to develop metal/alloy-based electrocatalysts for the application in renewable energy conversion technologies.展开更多
Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluct...Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluctuation caused by new energy units,this paper proposes a new energy power system frequency regulation strategy with multiple units including the doubly-fed pumped storage unit(DFPSU).Firstly,based on the model predictive control(MPC)theory,the state space equations are established by considering the operating characteristics of the units and the dynamic behavior of the system;secondly,the proportional-differential control link is introduced to minimize the frequency deviation to further optimize the frequency modulation(FM)output of the DFPSU and inhibit the rapid fluctuation of the frequency;lastly,it is verified on theMatlab/Simulink simulation platform,and the results show that the model predictive control with proportional-differential control link can further release the FM potential of the DFPSU,increase the depth of its FM,effectively reduce the frequency deviation of the system and its rate of change,realize the optimization of the active output of the DFPSU and that of other units,and improve the frequency response capability of the system.展开更多
Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribu...Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.展开更多
在一个经过篡改的视频可以传播虚假信息、欺凌他人和煽动负面情绪的时代,加州大学河滨分校和谷歌的研究人员联合开发了“通用篡改与合成视频识别网络”(Universal Network for Identifying Tampered and synth Etic videos, UNITE)的新...在一个经过篡改的视频可以传播虚假信息、欺凌他人和煽动负面情绪的时代,加州大学河滨分校和谷歌的研究人员联合开发了“通用篡改与合成视频识别网络”(Universal Network for Identifying Tampered and synth Etic videos, UNITE)的新系统来揭露这些伪造视频。即使在人脸不可见的情况下,该系统依然能检测深度伪造视频。通过扫描背景、运动和细微线索来识别视频是否伪造。随着虚假内容越来越容易生成且越来越难以检测,该工具可能成为新闻编辑室和社交媒体平台努力捍卫真相的必备武器。展开更多
Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medicati...Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.展开更多
On March 24,the international symposium themed“Strengthen the Role of the United Nations and Promote Multilateralism”was held in Beijing.The event was hosted by the Ministry of Foreign Affairs of China,and supported...On March 24,the international symposium themed“Strengthen the Role of the United Nations and Promote Multilateralism”was held in Beijing.The event was hosted by the Ministry of Foreign Affairs of China,and supported by China Institute of International Studies(CIIS),the United Nations Association of China.展开更多
The challenge of this work is to provide new data on the lithostratigraphy and tectono-stratigraphic evolution of two units belonging to the ophiolitic Ligurian-Piedmont zone of the Western Alps,i.e.the Albergian unit...The challenge of this work is to provide new data on the lithostratigraphy and tectono-stratigraphic evolution of two units belonging to the ophiolitic Ligurian-Piedmont zone of the Western Alps,i.e.the Albergian unit and the Lago Nero unit,exposed in the upper Susa and Chisone valleys(Northwestern Italy).展开更多
BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevanc...BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains uncertain.AIM To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic shock.METHODS In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were analyzed.Patients were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with normonatremia.Moreover,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of IAH.Notably,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the ICU.It is highly recommended that hypernatremia be considered a potentially important prognostic indicator for the outcome of septic shock.展开更多
Intensivists are often plagued with the challenges of managing critically ill patients in the neurocritical intensive care unit(neuro ICU);one such challenge is the level of illness and the need for sedation,inhibitin...Intensivists are often plagued with the challenges of managing critically ill patients in the neurocritical intensive care unit(neuro ICU);one such challenge is the level of illness and the need for sedation,inhibiting the provider’s ability to adequately assess the patient.Most sedatives alter neurological and physical exam findings,only compounding potential barriers to providing the best care for each patient.It is important to emphasize that even in the altered mentation of these patients,physical and neurological exams reign supreme as diagnostic tools and should be used in conjunction with multimodal neuromonitoring methods,rather than labs or imaging alone.Additionally,selecting the appropriate analgesic(s)and sedative(s)based on these findings are highly important when determining the best course of individualized management.Thus,providers in the neuro ICU should be highly familiar with the appropriate analgesic and sedative options available in order to determine not only which may be best for each patient,but to also better understand how each drug may impact assessment findings.This comprehensive review aims to provide a structured overview of the pertinent sedatives commonly used in neuro ICUs,their risks and benefits,and how providers can best utilize each in practice to further improve patient outcomes.The novel contribution of this work provides comparative drug tables,dosing guidance for pediatric and very elderly(>85-years-old)populations,and an exploration into the future possibilities of utilizing artificial intelligence and the human gut microbiome to further enhance the prospects of precision medicine.展开更多
基金supported by the National Key R&D Program of China(No.2021YFB3501102).
文摘Porous carbon microspheres are widely regarded as a superior CO_(2) adsorbent due to their exceptional efficiency and affordability.However,better adsorption performance is very attractive for porous carbon microspheres.And modification of the pore structure is one of the effective strategies.In this study,multi-cavity mesoporous carbon microspheres were successfully synthesized by the synergistic method of soft and hard templates,during which a phenolic resin with superior thermal stability was employed as the carbon precursor and a mixture of silica sol and F108 as the mesoporous template.Carbon microspheres with multi-cavity mesoporous structures were prepared,and all the samples showed highly even mesopores,with diameters around 12 nm.The diameter of these microspheres decreased from 396.8 nm to about 182.5 nm with the increase of silica sol.After CO_(2) activation,these novel carbon microspheres(APCF0.5-S1.75)demonstrated high specific surface area(983.3 m^(2)/g)and remarkable CO_(2) uptake of 4.93 mmol/g at 0℃ and1 bar.This could be attributed to the unique multi-cavity structure,which offers uniform mesoporous pore channels,minimal CO_(2) transport of and a greater number of active sites for CO_(2) adsorption.
文摘BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.
文摘The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.
文摘The pinching of n-dimensional closed hypersurface Mwith constant mean curvature H in unit sphere S^（n＋1）（ 1） is considered. Let A = ∑i,j,k h（ijk）~2（ λi＋ nH）~2,B = ∑i,j,k h（ijk）~2（ λi＋ nH） ·（ λj＋ nH）,S = ∑i（ λi＋ nH）~2, where h（ij）= λiδ（ij）. Utilizing Lagrange＇s method, a sharper pointwise estimation of 3（A- 2B） in terms of S and ｜▽h｜~2 is obtained, here ｜▽h｜~2= ∑i,j,k h（ijk）~2. Then, with the help of this, it is proved that Mis isometric to the Clifford hypersurface if the square norm of the second fundamental form of Msatisfies certain conditions. Hence, the pinching result of the minimal hypersurface is extended to the hypersurface with constant mean curvature case.
基金the National Nature Science Foundation of China(11671214,11971348,12071230)the Hundred Young Academia Leaders Program of Nankai University(63223027,ZB22000105)+1 种基金the Undergraduate Education and Teaching Project of Nankai University(NKJG2022053)the National College Students’Innovation and Entrepreneurship Training Program of Nankai University(202210055048)。
文摘This paper studies two isometric problems between unit spheres of Banach spaces.In the first part,we introduce and study the Figiel type problem of isometric embeddings between unit spheres.However,the classical Figiel theorem on the whole space cannot be trivially generalized to this case,and this is pointed out by a counterexample.After establishing this,we find a natural necessary condition required by the existence of the Figiel operator.Furthermore,we prove that when X is a space with the T-property,this condition is also sufficient for an isometric embedding T:S_(X)→S_(Y) to admit the Figiel operator.This answers the Figiel type problem on unit spheres for a large class of spaces.In the second part,we consider the extension of bijectiveε-isometries between unit spheres of two Banach spaces.It is shown that every bijectiveε-isometry between unit spheres of a local GL-space and another Banach space can be extended to be a bijective 5ε-isometry between the corresponding unit balls.In particular,whenε=0,this recovers the MUP for local GL-spaces obtained in[40].
文摘The aim of this paper is to discuss whether the increasing intervention of the state in the private sphere-as is evidenced in labor laws, consumer rights, bioethics, and Internet crimes-is compatible with the liberal ideal of neutrality, or, on the contrary, whether it can be seen as a turning point towards the position of communitarian or republican authors, for whom the state must endorse a substantive good. Such a turning point could lead to a reformulation of the public and private spheres, and of course, raise questions over which values justify which kinds of intervention. This paper will cover these debates in three parts： First, by presenting briefly the history of the liberal conception of rights, I will try to show that, from a starting point based mostly on individual protection, the liberal tradition has become more interventionist, which can be seen through the notion of ＂claim rights.＂ Departing from John Rawls＇s work, I will argue that this notion allows for some level of intervention, without betraying liberal neutrality. Subsequently, I will discuss the difference between this kind of intervention and the ones proclaimed by communitarians and republicans authors： The former will be illustrated by Michael Sandel＇s criticism of Rawls in Liberalism and the Limits of Justice, and the later by Richard Dagger＇s position in Civic Virtues, Citizenship, and Republican Liberalism. Finally, in the third part, we＇ll discuss whether liberal principles can be harmonized with the republican and communitarian focus on civic virtues and good life.
基金supported by the International Science&Technology Cooperation Program of China(ISTCP)(2011DFA22460)China Geological Survey(DD20190370)Geological Exploration Fund Project of Inner Mongolia Autonomous Region,P.R.China([2020]YS-01).
文摘Based on the comprehensive study of geology and geophysics in African continent,three types of lithosphere(craton-type,orogenic-type and rift-type)can be identified.Considering lithosphere discontinuities as the boundary,two first-order tectonic units(mainly cratonic-type in the west and rift-type in the east)are proposed.Different types of lithosphere can be divided into secondary-order and third-order structural units,and the blocks within lithosphere can be further divided into fourth-order structural units.The geological history,the formation process and significance of different types of lithosphere in African continent are briefly discussed.
基金supported by the State Grid Corporation of China Science and Technology Project,grant number 52270723000900K.
文摘The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,photovoltaic power generation is unstable and random,resulting in a low utilization rate and directly affecting the stability of the power grid.To solve this problem,this paper proposes a coordinated control strategy for a newenergy power generation system with a hybrid energy storage unit based on the lithium iron phosphate-supercapacitor hybrid energy storage unit.Firstly,the variational mode decomposition algorithm is used to separate the high and low frequencies of the power signal,which is conducive to the rapid and accurate suppression of the power fluctuation of the energy storage system.Secondly,the fuzzy control algorithm is introduced to balance the power between energy storage.In this paper,the actual data is used for simulation,and the simulation results show that the strategy realizes the effective suppression of the bus voltage fluctuation and the accurate control of the internal state of the energy storage unit,effectively avoiding problems such as overshoot and over-discharge,and can significantly improve the stability of the photovoltaic power generation systemand the stability of the Direct Current bus.It is of great significance to promote the development of collaborative control technology for photovoltaic hybrid energy storage units.
文摘BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
文摘BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.
文摘BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.
基金financially supported by the National Natural Science Foundation of China(No.22279047)the Instrumental Analysis Center of Jiangsu University of Science and Technology。
文摘Exploring efficient and nonprecious metal electrocatalysts of oxygen reduction reaction(ORR)and oxygen evolution reaction(OER)is crucial for developing rechargeable zinc-air batteries(ZABs).Herein,an alloying-degree control strategy was employed to fabricate nitrogen-doped carbon sphere(NCS)decorated with dual-phase Co/Co_(7)Fe_(3)heterojunctions(CoFe@NCS).The phase composition of materials has been adjusted by controlling the alloying degree.The optimal CoFe_(0.08)@NCS electrocatalyst displays a half-wave potential of 0.80 V for ORR and an overpotential of 283 mV at 10 mA·cm^(-2)for OER in an alkaline electrolyte.The intriguing bifunctional electrocatalytic activity and durability is attributed to the hierarchically porous structure and interfacial electron coupling of highly-active Co_(7)Fe_(3)alloy and metallic Co species.When the CoFe_(0.08)@NCS material is used as air-cathode catalyst of rechargeable liquid-state zinc-air battery(ZAB),the device shows a high peak power-density(157 mW·cm^(-2))and maintains a stable voltage gap over 150 h,outperforming those of the benchmark(Pt/C+RuO_(2))-based device.In particular,the as-fabricated solid-state flexible ZAB delivers a reliable compatibility under different bending conditions.Our work provides a promising strategy to develop metal/alloy-based electrocatalysts for the application in renewable energy conversion technologies.
基金supported by the National Natural Science Foundation of China(Project No.52377082)the Scientific Research Program of Jilin Provincial Department of Education(Project No.JJKH20230123KJ).
文摘Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluctuation caused by new energy units,this paper proposes a new energy power system frequency regulation strategy with multiple units including the doubly-fed pumped storage unit(DFPSU).Firstly,based on the model predictive control(MPC)theory,the state space equations are established by considering the operating characteristics of the units and the dynamic behavior of the system;secondly,the proportional-differential control link is introduced to minimize the frequency deviation to further optimize the frequency modulation(FM)output of the DFPSU and inhibit the rapid fluctuation of the frequency;lastly,it is verified on theMatlab/Simulink simulation platform,and the results show that the model predictive control with proportional-differential control link can further release the FM potential of the DFPSU,increase the depth of its FM,effectively reduce the frequency deviation of the system and its rate of change,realize the optimization of the active output of the DFPSU and that of other units,and improve the frequency response capability of the system.
基金supported in part by the National Nat-ural Science Foundation of China(52177110)Key Pro-gram of the National Natural Science Foundation of China(U22B20106,U2142206)+2 种基金Shenzhen Science and Technology Program(JCYJ20210324131409026)the Science and Technology Project of the State Grid Corpo-ration of China(5200-202319382A-2-3-XG)State Grid Zhejiang Elctric Power Co.,Ltd.Science and Tech-nology Project(B311DS24001A).
文摘Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.
文摘在一个经过篡改的视频可以传播虚假信息、欺凌他人和煽动负面情绪的时代,加州大学河滨分校和谷歌的研究人员联合开发了“通用篡改与合成视频识别网络”(Universal Network for Identifying Tampered and synth Etic videos, UNITE)的新系统来揭露这些伪造视频。即使在人脸不可见的情况下,该系统依然能检测深度伪造视频。通过扫描背景、运动和细微线索来识别视频是否伪造。随着虚假内容越来越容易生成且越来越难以检测,该工具可能成为新闻编辑室和社交媒体平台努力捍卫真相的必备武器。
文摘Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.
文摘On March 24,the international symposium themed“Strengthen the Role of the United Nations and Promote Multilateralism”was held in Beijing.The event was hosted by the Ministry of Foreign Affairs of China,and supported by China Institute of International Studies(CIIS),the United Nations Association of China.
文摘The challenge of this work is to provide new data on the lithostratigraphy and tectono-stratigraphic evolution of two units belonging to the ophiolitic Ligurian-Piedmont zone of the Western Alps,i.e.the Albergian unit and the Lago Nero unit,exposed in the upper Susa and Chisone valleys(Northwestern Italy).
基金Supported by The National Natural Science Foundation of China,No.82072130Key Medical Research Projects in Jiangsu Province,No.ZD2022021Suzhou Clinical Medical Center for Anesthesiology,No.Szlcyxzxj202102。
文摘BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains uncertain.AIM To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic shock.METHODS In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were analyzed.Patients were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with normonatremia.Moreover,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of IAH.Notably,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the ICU.It is highly recommended that hypernatremia be considered a potentially important prognostic indicator for the outcome of septic shock.
文摘Intensivists are often plagued with the challenges of managing critically ill patients in the neurocritical intensive care unit(neuro ICU);one such challenge is the level of illness and the need for sedation,inhibiting the provider’s ability to adequately assess the patient.Most sedatives alter neurological and physical exam findings,only compounding potential barriers to providing the best care for each patient.It is important to emphasize that even in the altered mentation of these patients,physical and neurological exams reign supreme as diagnostic tools and should be used in conjunction with multimodal neuromonitoring methods,rather than labs or imaging alone.Additionally,selecting the appropriate analgesic(s)and sedative(s)based on these findings are highly important when determining the best course of individualized management.Thus,providers in the neuro ICU should be highly familiar with the appropriate analgesic and sedative options available in order to determine not only which may be best for each patient,but to also better understand how each drug may impact assessment findings.This comprehensive review aims to provide a structured overview of the pertinent sedatives commonly used in neuro ICUs,their risks and benefits,and how providers can best utilize each in practice to further improve patient outcomes.The novel contribution of this work provides comparative drug tables,dosing guidance for pediatric and very elderly(>85-years-old)populations,and an exploration into the future possibilities of utilizing artificial intelligence and the human gut microbiome to further enhance the prospects of precision medicine.
