BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nu...BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.展开更多
Inflammatory bowel disease(IBD),encompassing Crohn’s disease and ulcerative colitis,manifests as a chronic,recurrent,and refractory intestinal inflammatory condition significantly impacting patients’quality of life....Inflammatory bowel disease(IBD),encompassing Crohn’s disease and ulcerative colitis,manifests as a chronic,recurrent,and refractory intestinal inflammatory condition significantly impacting patients’quality of life.Despite ongoing research,its etiology and pathogenesis remain incompletely understood.Recent advancements in medical research highlight the critical role of drug combination therapies in managing IBD.This paper employs the strengths,weaknesses,opportunities,and threats framework to evaluate the four strategic elements(strengths,weaknesses,opportunities,and threats)pertaining to combination therapies for IBD.Among the strengths,the paper underscores the efficacy of multi-targeted strategies,the advancement of personalized medicine,and the mitigation of drug resistance.Nonetheless,the analysis identifies significant weaknesses,including the prohibitive cost of treatment,issues with patient compliance,and the necessity for comprehensive long-term safety data.The paper also delineates opportunities to augment therapeutic success through the incorporation of biomarkers,the application of artificial intelligence,and extensive international collaborative efforts.In contrast,the paper does not shy away from addressing the threats,which include the potential for therapeutic resistance and the logistical challenges inherent in global therapy deployment.These initiatives aim to refine future therapeutic practices,fostering safer,more effective,and personalized treatment paradigms for IBD patients.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length...Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,which are closely related to ICU-acquired weakness(ICUAW).It is suggested that the length of ICU stay and the duration of mechanical ventilation are the main factors.ICU-AW is the most common neuromuscular injury in the ICU,which affects clinical progression and outcomes of patients.This manuscript helps to improve the early recognition of ICU-AW,thereby reducing mortality and improving prognosis.展开更多
In this editorial,comments are made on an interesting article in the recent issue of the World Journal of Clinical Cases by Wang and Long.The authors describe the use of neural network model to identify risk factors f...In this editorial,comments are made on an interesting article in the recent issue of the World Journal of Clinical Cases by Wang and Long.The authors describe the use of neural network model to identify risk factors for the development of intensive care unit(ICU)-acquired weakness.This condition has now become common with an increasing number of patients treated in ICUs and continues to be a source of morbidity and mortality.Despite identification of certain risk factors and corrective measures thereof,lacunae still exist in our understanding of this clinical entity.Numerous possible pathogenetic mechanisms at a molecular level have been described and these continue to be increasing.The amount of retrievable data for analysis from the ICU patients for study can be huge and enormous.Machine learning techniques to identify patterns in vast amounts of data are well known and may well provide pointers to bridge the knowledge gap in this condition.This editorial discusses the current knowledge of the condition including pathogenesis,diagnosis,risk factors,preventive measures,and therapy.Furthermore,it looks specifically at ICU acquired weakness in recipients of lung transplantation,because–unlike other solid organ transplants-muscular strength plays a vital role in the preservation and survival of the transplanted lung.Lungs differ from other solid organ transplants in that the proper function of the allograft is dependent on muscle function.Muscular weakness especially diaphragmatic weakness may lead to prolonged ventilation which has deleterious effects on the transplanted lung–ranging from ventilator associated pneumonia to bronchial anastomotic complications due to prolonged positive pressure on the anastomosis.展开更多
In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(I...In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.展开更多
In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World J...In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes.展开更多
This editorial discusses an article recently published in the World Journal of Clinical Cases,focusing on risk factors associated with intensive care unit-acquired weak-ness(ICU-AW).ICU-AW is a serious neuromuscular c...This editorial discusses an article recently published in the World Journal of Clinical Cases,focusing on risk factors associated with intensive care unit-acquired weak-ness(ICU-AW).ICU-AW is a serious neuromuscular complication seen in criti-cally ill patients,characterized by muscle dysfunction,weakness,and sensory impairments.Post-discharge,patients may encounter various obstacles impacting their quality of life.The pathogenesis involves intricate changes in muscle and nerve function,potentially leading to significant disabilities.Given its global significance,ICU-AW has become a key research area.The study identified critical risk factors using a multilayer perceptron neural network model,highlighting the impact of intensive care unit stay duration and mechanical ventilation duration on ICU-AW.Recommendations were provided for preventing ICU-AW,empha-sizing comprehensive interventions and risk factor mitigation.This editorial stresses the importance of external validation,cross-validation,and model tran-sparency to enhance model reliability.Moreover,the application of machine learning in clinical medicine has demonstrated clear benefits in improving disease understanding and treatment decisions.While machine learning presents oppor-tunities,challenges such as model reliability and data management necessitate thorough validation and ethical considerations.In conclusion,integrating ma-chine learning into healthcare offers significant potential and challenges.Enhan-cing data management,validating models,and upholding ethical standards are crucial for maximizing the benefits of machine learning in clinical practice.展开更多
This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patie...This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.展开更多
In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machin...In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machine learning methodologies.The study employed a multilayer perceptron neural network to accurately predict the incidence of ICU-AW,focusing on critical variables such as ICU stay duration and mechanical ventilation.This research marks a significant advancement in applying machine learning to clinical diagnostics,offering a new paradigm for predictive medicine in critical care.It underscores the importance of integrating artificial intelligence technologies in clinical practice to enhance patient management strategies and calls for interdisciplinary collaboration to drive innovation in healthcare.展开更多
Intensive care unit-acquired weakness(ICU-AW)is a prevalent issue in critical care,leading to significant muscle atrophy and functional impairment.Aiming to address this,Neuromuscular Electrical Stimulation(NMES)has b...Intensive care unit-acquired weakness(ICU-AW)is a prevalent issue in critical care,leading to significant muscle atrophy and functional impairment.Aiming to address this,Neuromuscular Electrical Stimulation(NMES)has been explored as a therapy.This systematic review assesses NMES's safety and effectiveness in enhancing functional capacity and mobility in pre-and post-cardiac surgery patients.NMES was generally safe and feasible,with intervention sessions varying in frequency and duration.Improvements in muscle strength and 6-minute walking test distances were observed,particularly in preoperative settings,but postoperative benefits were inconsistent.NMES showed promise in preventing muscle loss and improving strength,although its impact on overall functional capacity remained uncertain.Challenges such as short ICU stays and body composition affecting NMES efficacy were noted.NMES also holds potential for other conditions like cerebral palsy and stroke.Further research is needed to optimize NMES protocols and better understand its full benefits in preventing ICU-AW and improving patient outcomes.展开更多
Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodolo...Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodologies to unearth key predictors of ICU-AW.Employing a sophisticated multilayer perceptron neural network,the research methodically assesses the predictive power for ICU-AW,pinpointing the length of ICU stay and duration of mechanical ventilation as pivotal risk factors.The findings advocate for minimizing these elements as a preventive approach,offering a novel perspective on combating ICU-AW.This research illuminates critical risk factors and lays the groundwork for future explorations into effective prevention and intervention strategies.展开更多
Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predomin...Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples.TCM(traditional Chinese medicine)syndrome differentiation found that they were all due to spleen and stomach weakness.They were randomly divided into two groups.Group A was treated with modified prescriptions of Shengyang Yiwei Decoction,while Group B was treated with Western medicine.The therapeutic effects in the two groups were compared.Results:The treatment efficacy in Group A was higher than that in Group B(P<0.05);the symptom scores of Group A such as loose stools,chills,physical weakness,poor appetite,and abdominal distension after meals were all lower than those in Group B(P<0.05);the SF-36(36-Item Short Form Health Survey)scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B(P<0.05);the treatment satisfaction of Group A was higher than that of Group B(P<0.05).Conclusion:Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms,improve the quality of life,and enhance treatment efficacy.Hence,it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.展开更多
Natural cemented calcareous sand and limestone are highly complex and not well understood in terms of the me-chanical behavior due to the difficulty of obtaining undisturbed samples from far sea.This paper proposes an...Natural cemented calcareous sand and limestone are highly complex and not well understood in terms of the me-chanical behavior due to the difficulty of obtaining undisturbed samples from far sea.This paper proposes an artificial method in a laboratory setting using microbial-induced carbonate precipitation(MICP)to simulate the natural process of cementation of limestone.The artificially cemented sand has a high degree of similarity with the natural weakly limestone in three aspects:(1)the mineral composition of the cemented material is also granular calcite and acicular aragonite;(2)the microstructure in interconnected open pore network can be gradually closed and contracted with cementation.The porosity reaches to approximately 9.2%;(3)both the stress-strain relationship and the unconfined strength closely resemble that of natural weakly limestone.Furthermore,both static and dynamic behaviors of artificial limestone were studied by quasi-static compression tests and Split Hopkinson Pressure Bar(SHPB)tests,finding that the unconfined strength of weakly artifical limestone exponentially increases with increasing strain rate.A rate-dependent bond strength was proposed and implemented in software to reveal the mechanism of strain rate effects.It is found that the loading velocity is too high to keep in sync with the initiation and propagation of cracks under impact loading.This delay-induced viscosity may restrict the movement of the surrounding balls,thus increasing resistance.展开更多
[Objective] This study aimed to explore the histological effects of Guchangcuzhang powder on intestine and spleen in experiment piglets with spleen weakness.[Method] The 12 piglets with diarrhea were divided into two ...[Objective] This study aimed to explore the histological effects of Guchangcuzhang powder on intestine and spleen in experiment piglets with spleen weakness.[Method] The 12 piglets with diarrhea were divided into two groups,namely the Guchangcuzhang powder group and the control group,six in each.On two and eight days after the drug discontinuance respectively,three piglets were selected from each of the group and killed by bloodletting from the jugular vein.Afterwards,paraffin sections of intestine and spleen were made and stained by HE staining solution,followed by observation of the histological changes.[Result] The structures of intestine and spleen in piglets drenched with Guchangcuzhang powder restored or approachedto normal.[Conlusion] Guchangcuzhang powder has the function of healing piglet diarrhea.展开更多
本文主要考虑可压欧拉方程组的初边值问题。研究了两类具有高阶精度的熵稳定有限体积格式的收敛性,通过对数值解建立合适的一致性估计,证明随着步长 h → 0,若数值解的密度是远离真空且有界的,则由这两类熵稳定数值格式构造的解可以生...本文主要考虑可压欧拉方程组的初边值问题。研究了两类具有高阶精度的熵稳定有限体积格式的收敛性,通过对数值解建立合适的一致性估计,证明随着步长 h → 0,若数值解的密度是远离真空且有界的,则由这两类熵稳定数值格式构造的解可以生成耗散测度值解。In this paper, we primarily consider the initial boundary value problem for compress-ible Euler equations. We study the convergence of two classes of high-order accurate entropy stable finite volume schemes. By establishing appropriate the priori esti-mates for the numerical solutions, we prove that as the step size h → 0, the solutionsconstructed by these two types of entropy stable numerical schemes can generate dissipative measure-valued solutions, provided that the density of the approximate solutions is bounded away from vacuum and bounded above.展开更多
The reaction of Mg^(2+)and 5-{1,3-dioxo-1H-benzo[de]isoquinolin-2(3H)-yl}terephthalic acid(H_(2)L)leads to two metal-organic frameworks,[Mg(L)(DMF)_(2)(H_(2)O)_(2)]_(2)·5DMF·2H_(2)O(1)with a 1D structure and...The reaction of Mg^(2+)and 5-{1,3-dioxo-1H-benzo[de]isoquinolin-2(3H)-yl}terephthalic acid(H_(2)L)leads to two metal-organic frameworks,[Mg(L)(DMF)_(2)(H_(2)O)_(2)]_(2)·5DMF·2H_(2)O(1)with a 1D structure and[Mg_(2)(L)_(2)(DMSO)_(3)(H_(2)O)](2)with a 2D(4,4)-net structure.Interestingly,the two compounds exhibit distinct luminescent responses to external mechanical stimuli.1 exhibited exceptional resistance mechanical chromic luminescence(RMCL),which can be attributed to the predominant hydrogen bonds and the presence of high-boiling-point solvent molecules within its structure.2 had a reversible MCL property,which can be attributed to the dominantπ-πweak interactions,coupled with the reversible destruction/restoration of its crystallinity under grinding/fumigation.CCDC:2410963,1;2410964,2.展开更多
In this article,the viscoelastic damped was equation in three-dimensional cylindrical domain were studied by using a second-order differential inequality.We proved a Phragm´en-Lindelof alternative results,i.e.,th...In this article,the viscoelastic damped was equation in three-dimensional cylindrical domain were studied by using a second-order differential inequality.We proved a Phragm´en-Lindelof alternative results,i.e.,the smooth solutions either grow or decay exponentially as the distance from the entry section tends to infinity.Our results can be seen as a version of the Saint-Venant principle.展开更多
The development of eco-agricultural sightseeing in Baise City shows a sound foundation and outstanding advantages as well as a rapid growth trend in recent years, however, there are also problems to be settled, such a...The development of eco-agricultural sightseeing in Baise City shows a sound foundation and outstanding advantages as well as a rapid growth trend in recent years, however, there are also problems to be settled, such as shortage of talents, insufficient planning, low level of development, limited products and lack of competitive products. In view of such a condition, development concepts should be reformed first, competitive and special products made, marketing and propaganda enhanced to promote the healthy, coordinated and ordered development of eco-agricultural sightseeing in Baise City, Guangxi Zhuang Nationality Autonomous Region.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
文摘BACKGROUND: This study aimed to explore the risk factors associated with intensive care unitacquired weakness(ICU-AW) in critically ill patients at risk of malnutrition and to evaluate the efficacy of early enteral nutrition(EEN) and the role of biomarkers in managing ICU-AW.METHODS: This retrospective, observational cohort study included 180 patients at risk of malnutrition admitted to the emergency intensive care unit of the First Affiliated Hospital of Xiamen University Hospital from January 2022 to December 2023. Patients were divided into ICU-AW group and non-ICU-AW group according to whether they developed ICU-AW, or categorized into EEN and parenteral nutrition(PN) groups according to nutritional support. ICU-AW was diagnosed using the Medical Research Council score. The primary outcome was the occurrence of ICU-AW.RESULTS: The significant factors associated with ICU-AW included age, sex, type of nutritional therapy, mechanical ventilation(MV), body mass index(BMI), blood urea nitrogen(BUN), and creatinine(Cr) levels(P<0.05). The PN group developed ICU-AW earlier than did the EEN group, with a significant difference observed(log-rank P<0.001). Among biomarkers for ICU-AW, the mean prealbumin(PAB)/C-reactive protein(CRP) ratio had the highest diagnostic accuracy(area under the curve [AUC] 0.928, 95% confidence interval [95% CI] 0.892–0.946), surpassing the mean Cr/BUN ratio(AUC 0.740, 95% CI 0.663–0.819) and mean transferrin levels(AUC 0.653, 95% CI 0.574–0.733).CONCLUSION: Independent risk factors for ICU-AW include female sex, advanced age, PN, MV, lower BMI, and elevated BUN and Cr levels. EEN may potentially delay ICU-AW onset, and the PAB/CRP ratio may be an effective diagnostic marker for this condition.
文摘Inflammatory bowel disease(IBD),encompassing Crohn’s disease and ulcerative colitis,manifests as a chronic,recurrent,and refractory intestinal inflammatory condition significantly impacting patients’quality of life.Despite ongoing research,its etiology and pathogenesis remain incompletely understood.Recent advancements in medical research highlight the critical role of drug combination therapies in managing IBD.This paper employs the strengths,weaknesses,opportunities,and threats framework to evaluate the four strategic elements(strengths,weaknesses,opportunities,and threats)pertaining to combination therapies for IBD.Among the strengths,the paper underscores the efficacy of multi-targeted strategies,the advancement of personalized medicine,and the mitigation of drug resistance.Nonetheless,the analysis identifies significant weaknesses,including the prohibitive cost of treatment,issues with patient compliance,and the necessity for comprehensive long-term safety data.The paper also delineates opportunities to augment therapeutic success through the incorporation of biomarkers,the application of artificial intelligence,and extensive international collaborative efforts.In contrast,the paper does not shy away from addressing the threats,which include the potential for therapeutic resistance and the logistical challenges inherent in global therapy deployment.These initiatives aim to refine future therapeutic practices,fostering safer,more effective,and personalized treatment paradigms for IBD patients.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
基金the National Natural Science Foundation of China,No.81801284and the National Natural Science Foundation of Jilin Province,No.YDZJ202201ZYTS091.
文摘Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,which are closely related to ICU-acquired weakness(ICUAW).It is suggested that the length of ICU stay and the duration of mechanical ventilation are the main factors.ICU-AW is the most common neuromuscular injury in the ICU,which affects clinical progression and outcomes of patients.This manuscript helps to improve the early recognition of ICU-AW,thereby reducing mortality and improving prognosis.
文摘In this editorial,comments are made on an interesting article in the recent issue of the World Journal of Clinical Cases by Wang and Long.The authors describe the use of neural network model to identify risk factors for the development of intensive care unit(ICU)-acquired weakness.This condition has now become common with an increasing number of patients treated in ICUs and continues to be a source of morbidity and mortality.Despite identification of certain risk factors and corrective measures thereof,lacunae still exist in our understanding of this clinical entity.Numerous possible pathogenetic mechanisms at a molecular level have been described and these continue to be increasing.The amount of retrievable data for analysis from the ICU patients for study can be huge and enormous.Machine learning techniques to identify patterns in vast amounts of data are well known and may well provide pointers to bridge the knowledge gap in this condition.This editorial discusses the current knowledge of the condition including pathogenesis,diagnosis,risk factors,preventive measures,and therapy.Furthermore,it looks specifically at ICU acquired weakness in recipients of lung transplantation,because–unlike other solid organ transplants-muscular strength plays a vital role in the preservation and survival of the transplanted lung.Lungs differ from other solid organ transplants in that the proper function of the allograft is dependent on muscle function.Muscular weakness especially diaphragmatic weakness may lead to prolonged ventilation which has deleterious effects on the transplanted lung–ranging from ventilator associated pneumonia to bronchial anastomotic complications due to prolonged positive pressure on the anastomosis.
文摘In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.
基金Supported by China Medical University,No.CMU111-MF-102.
文摘In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes.
文摘This editorial discusses an article recently published in the World Journal of Clinical Cases,focusing on risk factors associated with intensive care unit-acquired weak-ness(ICU-AW).ICU-AW is a serious neuromuscular complication seen in criti-cally ill patients,characterized by muscle dysfunction,weakness,and sensory impairments.Post-discharge,patients may encounter various obstacles impacting their quality of life.The pathogenesis involves intricate changes in muscle and nerve function,potentially leading to significant disabilities.Given its global significance,ICU-AW has become a key research area.The study identified critical risk factors using a multilayer perceptron neural network model,highlighting the impact of intensive care unit stay duration and mechanical ventilation duration on ICU-AW.Recommendations were provided for preventing ICU-AW,empha-sizing comprehensive interventions and risk factor mitigation.This editorial stresses the importance of external validation,cross-validation,and model tran-sparency to enhance model reliability.Moreover,the application of machine learning in clinical medicine has demonstrated clear benefits in improving disease understanding and treatment decisions.While machine learning presents oppor-tunities,challenges such as model reliability and data management necessitate thorough validation and ethical considerations.In conclusion,integrating ma-chine learning into healthcare offers significant potential and challenges.Enhan-cing data management,validating models,and upholding ethical standards are crucial for maximizing the benefits of machine learning in clinical practice.
文摘This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.
文摘In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machine learning methodologies.The study employed a multilayer perceptron neural network to accurately predict the incidence of ICU-AW,focusing on critical variables such as ICU stay duration and mechanical ventilation.This research marks a significant advancement in applying machine learning to clinical diagnostics,offering a new paradigm for predictive medicine in critical care.It underscores the importance of integrating artificial intelligence technologies in clinical practice to enhance patient management strategies and calls for interdisciplinary collaboration to drive innovation in healthcare.
文摘Intensive care unit-acquired weakness(ICU-AW)is a prevalent issue in critical care,leading to significant muscle atrophy and functional impairment.Aiming to address this,Neuromuscular Electrical Stimulation(NMES)has been explored as a therapy.This systematic review assesses NMES's safety and effectiveness in enhancing functional capacity and mobility in pre-and post-cardiac surgery patients.NMES was generally safe and feasible,with intervention sessions varying in frequency and duration.Improvements in muscle strength and 6-minute walking test distances were observed,particularly in preoperative settings,but postoperative benefits were inconsistent.NMES showed promise in preventing muscle loss and improving strength,although its impact on overall functional capacity remained uncertain.Challenges such as short ICU stays and body composition affecting NMES efficacy were noted.NMES also holds potential for other conditions like cerebral palsy and stroke.Further research is needed to optimize NMES protocols and better understand its full benefits in preventing ICU-AW and improving patient outcomes.
文摘Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodologies to unearth key predictors of ICU-AW.Employing a sophisticated multilayer perceptron neural network,the research methodically assesses the predictive power for ICU-AW,pinpointing the length of ICU stay and duration of mechanical ventilation as pivotal risk factors.The findings advocate for minimizing these elements as a preventive approach,offering a novel perspective on combating ICU-AW.This research illuminates critical risk factors and lays the groundwork for future explorations into effective prevention and intervention strategies.
文摘Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples.TCM(traditional Chinese medicine)syndrome differentiation found that they were all due to spleen and stomach weakness.They were randomly divided into two groups.Group A was treated with modified prescriptions of Shengyang Yiwei Decoction,while Group B was treated with Western medicine.The therapeutic effects in the two groups were compared.Results:The treatment efficacy in Group A was higher than that in Group B(P<0.05);the symptom scores of Group A such as loose stools,chills,physical weakness,poor appetite,and abdominal distension after meals were all lower than those in Group B(P<0.05);the SF-36(36-Item Short Form Health Survey)scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B(P<0.05);the treatment satisfaction of Group A was higher than that of Group B(P<0.05).Conclusion:Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms,improve the quality of life,and enhance treatment efficacy.Hence,it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.
基金The authors would like to acknowledge the support of the National Natural Science Foundation of China(No.52279097,No.51779264)Blue and Green Project of Jiangsu Province.
文摘Natural cemented calcareous sand and limestone are highly complex and not well understood in terms of the me-chanical behavior due to the difficulty of obtaining undisturbed samples from far sea.This paper proposes an artificial method in a laboratory setting using microbial-induced carbonate precipitation(MICP)to simulate the natural process of cementation of limestone.The artificially cemented sand has a high degree of similarity with the natural weakly limestone in three aspects:(1)the mineral composition of the cemented material is also granular calcite and acicular aragonite;(2)the microstructure in interconnected open pore network can be gradually closed and contracted with cementation.The porosity reaches to approximately 9.2%;(3)both the stress-strain relationship and the unconfined strength closely resemble that of natural weakly limestone.Furthermore,both static and dynamic behaviors of artificial limestone were studied by quasi-static compression tests and Split Hopkinson Pressure Bar(SHPB)tests,finding that the unconfined strength of weakly artifical limestone exponentially increases with increasing strain rate.A rate-dependent bond strength was proposed and implemented in software to reveal the mechanism of strain rate effects.It is found that the loading velocity is too high to keep in sync with the initiation and propagation of cracks under impact loading.This delay-induced viscosity may restrict the movement of the surrounding balls,thus increasing resistance.
文摘[Objective] This study aimed to explore the histological effects of Guchangcuzhang powder on intestine and spleen in experiment piglets with spleen weakness.[Method] The 12 piglets with diarrhea were divided into two groups,namely the Guchangcuzhang powder group and the control group,six in each.On two and eight days after the drug discontinuance respectively,three piglets were selected from each of the group and killed by bloodletting from the jugular vein.Afterwards,paraffin sections of intestine and spleen were made and stained by HE staining solution,followed by observation of the histological changes.[Result] The structures of intestine and spleen in piglets drenched with Guchangcuzhang powder restored or approachedto normal.[Conlusion] Guchangcuzhang powder has the function of healing piglet diarrhea.
文摘本文主要考虑可压欧拉方程组的初边值问题。研究了两类具有高阶精度的熵稳定有限体积格式的收敛性,通过对数值解建立合适的一致性估计,证明随着步长 h → 0,若数值解的密度是远离真空且有界的,则由这两类熵稳定数值格式构造的解可以生成耗散测度值解。In this paper, we primarily consider the initial boundary value problem for compress-ible Euler equations. We study the convergence of two classes of high-order accurate entropy stable finite volume schemes. By establishing appropriate the priori esti-mates for the numerical solutions, we prove that as the step size h → 0, the solutionsconstructed by these two types of entropy stable numerical schemes can generate dissipative measure-valued solutions, provided that the density of the approximate solutions is bounded away from vacuum and bounded above.
文摘The reaction of Mg^(2+)and 5-{1,3-dioxo-1H-benzo[de]isoquinolin-2(3H)-yl}terephthalic acid(H_(2)L)leads to two metal-organic frameworks,[Mg(L)(DMF)_(2)(H_(2)O)_(2)]_(2)·5DMF·2H_(2)O(1)with a 1D structure and[Mg_(2)(L)_(2)(DMSO)_(3)(H_(2)O)](2)with a 2D(4,4)-net structure.Interestingly,the two compounds exhibit distinct luminescent responses to external mechanical stimuli.1 exhibited exceptional resistance mechanical chromic luminescence(RMCL),which can be attributed to the predominant hydrogen bonds and the presence of high-boiling-point solvent molecules within its structure.2 had a reversible MCL property,which can be attributed to the dominantπ-πweak interactions,coupled with the reversible destruction/restoration of its crystallinity under grinding/fumigation.CCDC:2410963,1;2410964,2.
基金Supported by the Guangdong Natural Science foundation(2023A1515012044)Special Project of Guangdong Province in Key Fields of Ordinary Colleges and Universities(2023ZDZX4069)+1 种基金the Research Team of Guangzhou Huashang College(2021HSKT01)Guangzhou Huashang College’s Characteristic Research Projects(2024HSTS09)。
文摘In this article,the viscoelastic damped was equation in three-dimensional cylindrical domain were studied by using a second-order differential inequality.We proved a Phragm´en-Lindelof alternative results,i.e.,the smooth solutions either grow or decay exponentially as the distance from the entry section tends to infinity.Our results can be seen as a version of the Saint-Venant principle.
基金Sponsored by Key Program of Baise University(2009KA04)~~
文摘The development of eco-agricultural sightseeing in Baise City shows a sound foundation and outstanding advantages as well as a rapid growth trend in recent years, however, there are also problems to be settled, such as shortage of talents, insufficient planning, low level of development, limited products and lack of competitive products. In view of such a condition, development concepts should be reformed first, competitive and special products made, marketing and propaganda enhanced to promote the healthy, coordinated and ordered development of eco-agricultural sightseeing in Baise City, Guangxi Zhuang Nationality Autonomous Region.
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.
