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
Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not complet...Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not completely understood.Among the molecular mediators of synaptic and cognitive dysfunction occurring after Herpes simplex virus type-1 infection and reactivation in the brain neuroinflammatory cytokines seem to occupy a central role.Here,we specifically reviewed literature reports dealing with the impact of neuroinflammation on synaptic dysfunction observed after recurrent Herpes simplex virus type-1 reactivation in the brain,highlighting the role of interleukins and,in particular,interleukin 1βas a possible target against Herpes simplex virus type-1-induced neuronal dysfunctions.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 Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses...BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.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
Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against her...Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against herpes simplex virus 1(HSV-1).By examining different phases of viral infection in human corneal epithelial cells(HCECs),we found that 30μmol/L quercetin inhibits HSV-1 replication primarily by disrupting viral attachment.RNA-sequencing and subsequent analyses revealed that the nuclear factor E2-related factor 2(Nrf2)was upregulated by quercetin in a dose-dependent manner.Knocking down Nrf2 partially compromised quercetin's antiviral effect.Importantly,topical application of 100μmol/L quercetin alleviated HSK severity in mice,reduced viral titers in tears,and inhibited VP16 expression in the cornea and trigeminal ganglia.These findings demonstrate the antiviral effect of quercetin against HSV-1 and provide a foundation for mechanistic studies to elucidate its therapeutic potential in HSK.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
Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfe...Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.展开更多
A unitized regenerative fuel cell(URFC)is a device that may function reversibly as either a fuel cell(FC)or water elec-trolysis(WE).An important component of this device is the Membrane electrode assembly(MEA).Therefo...A unitized regenerative fuel cell(URFC)is a device that may function reversibly as either a fuel cell(FC)or water elec-trolysis(WE).An important component of this device is the Membrane electrode assembly(MEA).Therefore,this study aimed to compare the performance outcomes of MEA using electrodes with single and three catalyst layers.This study measured Electrochemical Surface Area(ECSA),Electrochemical Impedance Spectroscopy(EIS),X-ray Diffraction analysis(XRD),and X-ray Fluorescence(XRF).Furthermore,the round-trip efficiency(RTE)of the MEA,as w ell as the performance in FC and WE mode,was measured.In comparison,The ECSA values of Pt-Ru/C and Pt/C with three catalyst layers were higher than the single catalyst layer.This result was supported by electrode characterization data for XRD and XRF.The respective electrical conductivity values of Pt-Ru/C and Pt/C with three catalyst layers are also higher than the single cata-lyst layer,and the performance of URFC using MEA with three catalyst layers has the highest value of RTE among the MEA performances of URFC,which is 100%at a current density of 4 mA·cm-2.展开更多
Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions r...Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.展开更多
This study provides an in-depth comparative evaluation of landslide susceptibility using two distinct spatial units:and slope units(SUs)and hydrological response units(HRUs),within Goesan County,South Korea.Leveraging...This study provides an in-depth comparative evaluation of landslide susceptibility using two distinct spatial units:and slope units(SUs)and hydrological response units(HRUs),within Goesan County,South Korea.Leveraging the capabilities of the extreme gradient boosting(XGB)algorithm combined with Shapley Additive Explanations(SHAP),this work assesses the precision and clarity with which each unit predicts areas vulnerable to landslides.SUs focus on the geomorphological features like ridges and valleys,focusing on slope stability and landslide triggers.Conversely,HRUs are established based on a variety of hydrological factors,including land cover,soil type and slope gradients,to encapsulate the dynamic water processes of the region.The methodological framework includes the systematic gathering,preparation and analysis of data,ranging from historical landslide occurrences to topographical and environmental variables like elevation,slope angle and land curvature etc.The XGB algorithm used to construct the Landslide Susceptibility Model(LSM)was combined with SHAP for model interpretation and the results were evaluated using Random Cross-validation(RCV)to ensure accuracy and reliability.To ensure optimal model performance,the XGB algorithm’s hyperparameters were tuned using Differential Evolution,considering multicollinearity-free variables.The results show that SU and HRU are effective for LSM,but their effectiveness varies depending on landscape characteristics.The XGB algorithm demonstrates strong predictive power and SHAP enhances model transparency of the influential variables involved.This work underscores the importance of selecting appropriate assessment units tailored to specific landscape characteristics for accurate LSM.The integration of advanced machine learning techniques with interpretative tools offers a robust framework for landslide susceptibility assessment,improving both predictive capabilities and model interpretability.Future research should integrate broader data sets and explore hybrid analytical models to strengthen the generalizability of these findings across varied geographical settings.展开更多
Objective To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit(ICU).Methods We analyzed 545 patients with hepatic coma in the ICU from the Me...Objective To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit(ICU).Methods We analyzed 545 patients with hepatic coma in the ICU from the Medical Information Mart for Intensive Care IV(MIMIC-IV)database.Associations between serum chloride levels and 28-day and 1-year mortality rates were assessed using restricted cubic splines(RCSs),Kaplan-Meier(KM)curves,and Cox regression.Subgroup analyses,external validation,and mechanistic studies were also performed.Results A total of 545 patients were included in the study.RCS analysis revealed a U-shaped association between serum chloride levels and mortality in patients with hepatic coma.The KM curves indicated lower survival rates among patients with low chloride levels(<103 mmol/L).Low chloride levels were independently linked to increased 28-day and 1-year all-cause mortality rates.In the multivariate models,the hazard ratio(HR)for 28-day mortality in the low-chloride group was 1.424(95%confidence interval[CI]:1.041–1.949),while the adjusted hazard ratio for 1-year mortality was 1.313(95%CI:1.026–1.679).Subgroup analyses and external validation supported these findings.Cytological experiments suggested that low chloride levels may activate the phosphorylation of the NF-κB signaling pathway,promote the expression of pro-inflammatory cytokines,and reduce neuronal cell viability.Conclusion Low serum chloride levels are independently associated with increased mortality in patients with hepatic coma.展开更多
Enhancement of the nonlinear optical(NLO)output power of lasers requires urgent development of an NLO crystal with a significant second-harmonic generation(SHG)response and sufficient birefringence for phase-matching ...Enhancement of the nonlinear optical(NLO)output power of lasers requires urgent development of an NLO crystal with a significant second-harmonic generation(SHG)response and sufficient birefringence for phase-matching capability;however,simultaneously optimizing these two key parameters remains a great challenge.In contrast to traditional single-anion units,the stereochemically-active lone pair Sb^(3+)ion is coordinated by S^(2-)and I^(-) ions to yield the mixed-anionic Sb SI chalcohalide that can enhance hyperpolarizability and anisotropic polarizability concurrently.As anticipated,Sb SI exhibited the largest SHG response(5.7×Ag Ga S_(2)@1.91μm)among phase-matching Sb-based sulfides,the favorable laser-induced damage threshold(LIDT,2.3×Ag Ga S_(2)@2.09μm),and the giant calculated birefringence(0.62@1.91μm).Structural analysis and computational simulations indicate that the highly polarizable mixed anion determine the enormous SHG response and birefringence.展开更多
The United States-Japan alliance was originally formed based on the US militar y occupation of Japan but has g radually evolved into a tool for the United States to maintain its hegemony in the Asia-Pacific. Currently...The United States-Japan alliance was originally formed based on the US militar y occupation of Japan but has g radually evolved into a tool for the United States to maintain its hegemony in the Asia-Pacific. Currently, a United States-Japan “axis” is rapidly surfacing primarily through the military integration between the two countries and a latticework of alliances the United States has been building in the region and even across the globe centered around the one with Japan. The emergence of a United States-Japan “axis” is driven by the strategic interests and needs of the United States wanting to sustain its hegemony in the Asia-Pacific through permanent troop deployment and also highlights Japan's realistic calculations aimed at enhancing its international status and gaining practical benefits. This trend will catalyze adjustments in the United States-Japan relations and the functions of their alliance, bring significant changes to Japan's role in regional security, and thus have far-reaching impacts on the Asia-Pacific landscape.展开更多
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.
基金supported by UniversitàCattolica(D1 intramural funds to RP)Italian Ministry of University and Research(PRIN 2022ZYLB7B,P2022YW7BP funds to CG).
文摘Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not completely understood.Among the molecular mediators of synaptic and cognitive dysfunction occurring after Herpes simplex virus type-1 infection and reactivation in the brain neuroinflammatory cytokines seem to occupy a central role.Here,we specifically reviewed literature reports dealing with the impact of neuroinflammation on synaptic dysfunction observed after recurrent Herpes simplex virus type-1 reactivation in the brain,highlighting the role of interleukins and,in particular,interleukin 1βas a possible target against Herpes simplex virus type-1-induced neuronal dysfunctions.
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 Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
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.
基金supported by the National Natural Science Foundation of China(No.81970848).
文摘Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against herpes simplex virus 1(HSV-1).By examining different phases of viral infection in human corneal epithelial cells(HCECs),we found that 30μmol/L quercetin inhibits HSV-1 replication primarily by disrupting viral attachment.RNA-sequencing and subsequent analyses revealed that the nuclear factor E2-related factor 2(Nrf2)was upregulated by quercetin in a dose-dependent manner.Knocking down Nrf2 partially compromised quercetin's antiviral effect.Importantly,topical application of 100μmol/L quercetin alleviated HSK severity in mice,reduced viral titers in tears,and inhibited VP16 expression in the cornea and trigeminal ganglia.These findings demonstrate the antiviral effect of quercetin against HSV-1 and provide a foundation for mechanistic studies to elucidate its therapeutic potential in HSK.
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Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.
基金support from the Ministry of Higher Education Malaysia under grant HICOE-2023-005.
文摘A unitized regenerative fuel cell(URFC)is a device that may function reversibly as either a fuel cell(FC)or water elec-trolysis(WE).An important component of this device is the Membrane electrode assembly(MEA).Therefore,this study aimed to compare the performance outcomes of MEA using electrodes with single and three catalyst layers.This study measured Electrochemical Surface Area(ECSA),Electrochemical Impedance Spectroscopy(EIS),X-ray Diffraction analysis(XRD),and X-ray Fluorescence(XRF).Furthermore,the round-trip efficiency(RTE)of the MEA,as w ell as the performance in FC and WE mode,was measured.In comparison,The ECSA values of Pt-Ru/C and Pt/C with three catalyst layers were higher than the single catalyst layer.This result was supported by electrode characterization data for XRD and XRF.The respective electrical conductivity values of Pt-Ru/C and Pt/C with three catalyst layers are also higher than the single cata-lyst layer,and the performance of URFC using MEA with three catalyst layers has the highest value of RTE among the MEA performances of URFC,which is 100%at a current density of 4 mA·cm-2.
文摘Intensive care unit(ICU)acquired sarcopenia and myosteatosis are increasingly recognized complications of critical illness,characterized by a rapid loss of ske-letal muscle mass,quality,and function.These conditions result from a complex interplay of systemic inflammation,immobilization,catabolic stress,mitochon-drial dysfunction,and immune dysregulation,often culminating in impaired recovery,prolonged hospitalization,and increased long-term mortality.First identified in survivors of sepsis and prolonged mechanical ventilation,these muscle abnormalities were initially described using computed tomography-based assessments of muscle area and density.Subsequent advances in imaging,biomarker discovery,and functional testing have enabled earlier detection and risk stratification across diverse ICU populations.While nutritional optimization and early mobilization form the cornerstone of current prevention and treatment strategies,the emergence of novel approaches,including automated artificial intelligence-based screening,neuromuscular electrical stimulation,and targeted pharmacologic therapies,has broadened the clinical scope of interventions.Despite their significant prognostic implications,ICU-acquired sarcopenia and myosteatosis remain under-recognized in routine critical care practice.This mini-review aims to synthesize current knowledge regarding their pathophysiology,available diagnostic modalities,prognostic relevance,and the evolving landscape of therapeutic strategies for long-term functional recovery in critically ill patients.
基金supported by a National Research Foundation of Korea(NRF)grant funded by the Korean government(MSIT)(RS-2023-00222536).
文摘This study provides an in-depth comparative evaluation of landslide susceptibility using two distinct spatial units:and slope units(SUs)and hydrological response units(HRUs),within Goesan County,South Korea.Leveraging the capabilities of the extreme gradient boosting(XGB)algorithm combined with Shapley Additive Explanations(SHAP),this work assesses the precision and clarity with which each unit predicts areas vulnerable to landslides.SUs focus on the geomorphological features like ridges and valleys,focusing on slope stability and landslide triggers.Conversely,HRUs are established based on a variety of hydrological factors,including land cover,soil type and slope gradients,to encapsulate the dynamic water processes of the region.The methodological framework includes the systematic gathering,preparation and analysis of data,ranging from historical landslide occurrences to topographical and environmental variables like elevation,slope angle and land curvature etc.The XGB algorithm used to construct the Landslide Susceptibility Model(LSM)was combined with SHAP for model interpretation and the results were evaluated using Random Cross-validation(RCV)to ensure accuracy and reliability.To ensure optimal model performance,the XGB algorithm’s hyperparameters were tuned using Differential Evolution,considering multicollinearity-free variables.The results show that SU and HRU are effective for LSM,but their effectiveness varies depending on landscape characteristics.The XGB algorithm demonstrates strong predictive power and SHAP enhances model transparency of the influential variables involved.This work underscores the importance of selecting appropriate assessment units tailored to specific landscape characteristics for accurate LSM.The integration of advanced machine learning techniques with interpretative tools offers a robust framework for landslide susceptibility assessment,improving both predictive capabilities and model interpretability.Future research should integrate broader data sets and explore hybrid analytical models to strengthen the generalizability of these findings across varied geographical settings.
文摘Objective To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit(ICU).Methods We analyzed 545 patients with hepatic coma in the ICU from the Medical Information Mart for Intensive Care IV(MIMIC-IV)database.Associations between serum chloride levels and 28-day and 1-year mortality rates were assessed using restricted cubic splines(RCSs),Kaplan-Meier(KM)curves,and Cox regression.Subgroup analyses,external validation,and mechanistic studies were also performed.Results A total of 545 patients were included in the study.RCS analysis revealed a U-shaped association between serum chloride levels and mortality in patients with hepatic coma.The KM curves indicated lower survival rates among patients with low chloride levels(<103 mmol/L).Low chloride levels were independently linked to increased 28-day and 1-year all-cause mortality rates.In the multivariate models,the hazard ratio(HR)for 28-day mortality in the low-chloride group was 1.424(95%confidence interval[CI]:1.041–1.949),while the adjusted hazard ratio for 1-year mortality was 1.313(95%CI:1.026–1.679).Subgroup analyses and external validation supported these findings.Cytological experiments suggested that low chloride levels may activate the phosphorylation of the NF-κB signaling pathway,promote the expression of pro-inflammatory cytokines,and reduce neuronal cell viability.Conclusion Low serum chloride levels are independently associated with increased mortality in patients with hepatic coma.
基金supported by the National Natural Science Foundation of China(Nos.21921001,22075283,92161125,22175172,21827813,U21A20508)the Youth Innovation Promotion Association of Chinese Academy of Sciences(Nos.2020303,2021300)the Fujian Science&Technology Innovation Laboratory for Optoelectronic Information of China(No.2020ZZ108)。
文摘Enhancement of the nonlinear optical(NLO)output power of lasers requires urgent development of an NLO crystal with a significant second-harmonic generation(SHG)response and sufficient birefringence for phase-matching capability;however,simultaneously optimizing these two key parameters remains a great challenge.In contrast to traditional single-anion units,the stereochemically-active lone pair Sb^(3+)ion is coordinated by S^(2-)and I^(-) ions to yield the mixed-anionic Sb SI chalcohalide that can enhance hyperpolarizability and anisotropic polarizability concurrently.As anticipated,Sb SI exhibited the largest SHG response(5.7×Ag Ga S_(2)@1.91μm)among phase-matching Sb-based sulfides,the favorable laser-induced damage threshold(LIDT,2.3×Ag Ga S_(2)@2.09μm),and the giant calculated birefringence(0.62@1.91μm).Structural analysis and computational simulations indicate that the highly polarizable mixed anion determine the enormous SHG response and birefringence.
文摘The United States-Japan alliance was originally formed based on the US militar y occupation of Japan but has g radually evolved into a tool for the United States to maintain its hegemony in the Asia-Pacific. Currently, a United States-Japan “axis” is rapidly surfacing primarily through the military integration between the two countries and a latticework of alliances the United States has been building in the region and even across the globe centered around the one with Japan. The emergence of a United States-Japan “axis” is driven by the strategic interests and needs of the United States wanting to sustain its hegemony in the Asia-Pacific through permanent troop deployment and also highlights Japan's realistic calculations aimed at enhancing its international status and gaining practical benefits. This trend will catalyze adjustments in the United States-Japan relations and the functions of their alliance, bring significant changes to Japan's role in regional security, and thus have far-reaching impacts on the Asia-Pacific landscape.
