BACKGROUND Accurate measurement of energy expenditure(EE)is critical for optimizing nutritional support in critically ill patients.Indirect calorimetry(IC)is the reference method used,but its availability at the bedsi...BACKGROUND Accurate measurement of energy expenditure(EE)is critical for optimizing nutritional support in critically ill patients.Indirect calorimetry(IC)is the reference method used,but its availability at the bedside is limited.As a result,numerous predictive equations have been devised to estimate EE in critically ill patients,along with other more novel methods recently proposed.AIM To evaluate current methods of measuring EE in critical care,focusing on practical challenges,accuracy,feasibility,and limitations.We will also discuss how these methods contribute to improving nutrition support strategies for intensive care unit patients for a more personalised and effective solution.METHODS A comprehensive search was conducted in PubMed and EMBASE for studies published from December 2014 to December 2024.Eligible studies compared EE measurement methods in critically ill populations.Data extraction and quality assessment followed PRISMA guidelines.Adherence to reporting standards was assessed using the TRIPOD questionnaire and risk of bias was evaluated using the PROBAST tool.RESULTS Twenty five original studies met the inclusion criteria and were analysed.CONCLUSION Each method has unique strengths and limitations.We found that while IC remains the reference standard,less accurate predictive equations have greater accessibility and ease of implementation.Emerging technologies show promise for bedside applicability.Future research should address practical barriers and validate newer approaches.展开更多
Amphiphiles,including surfactants,have emerged as indispensable elements in materials science and pharmaceutical science,and their functions are highly relying on the critical micelle concentration(CMC)[1,2].Numerous ...Amphiphiles,including surfactants,have emerged as indispensable elements in materials science and pharmaceutical science,and their functions are highly relying on the critical micelle concentration(CMC)[1,2].Numerous fluorimetry-based probes have been developed to measure CMCs[3](Fig.S1).However,CMC measurements using these probes suffer from a time-consuming and laborious procedure and large uncertainties,primarily due to their poor photo-stabilities and highly fluctuating fluorescence backgrounds.展开更多
This review examines the critical risks,barriers,and success factors in achieving sustainable affordable housing(SAH)by addressing environmental,economic,social and technical dimensions of sustainability.The aim of th...This review examines the critical risks,barriers,and success factors in achieving sustainable affordable housing(SAH)by addressing environmental,economic,social and technical dimensions of sustainability.The aim of this study is to identify different critical risks and barriers to the development of the Sustainable Affordable Housing(SAH)CSF framework.The objectives of this research are to define SAH(Sustainable Affordable Housing)and important factors for achieving SAH and to develop SAH Critical Success Factors(CSFs)frameworks.To achieve these objectives,there are two methods for reviewing and analyzing documents,i.e.,systematic review and bibliographic review.The years of publication are limited to 2014 to 2023 in the English language and restricted to open access.A total of 63 articles were retrieved and screened for relevance identified as directly relevant to our topic using the PRISMA systematic review process.The growth pattern aligns strongly with an exponential growth model,as evidenced by a high R^(2) value of 0.9133 indicating a robust correlation and demonstrating the accelerating interest in the field over the past decade.This comprehensive analysis led to the development of the sustainable affordable housing(SAH)critical success framework,providing a structured approach to understanding and implementing critical factors for sustainable and affordable housing initiatives.The findings emphasize the need for integrated policy reforms,innovative construction technologies,and collaborative stakeholder engagement to advance the SAH agenda.Future research directions include conducting longitudinal studies to assess the long-term impacts of SAH policies,comparative analyses of international best practices,and explorations into emerging construction technologies.展开更多
Deconfined quantum critical points(DQCPs)have been proposed as a class of continuous quantum phase transitions occurring between two ordered phases with distinct symmetry-breaking patterns,beyond the conventional fram...Deconfined quantum critical points(DQCPs)have been proposed as a class of continuous quantum phase transitions occurring between two ordered phases with distinct symmetry-breaking patterns,beyond the conventional framework of Landau-Ginzburg-Wilson(LGW)theory.At the DQCP,the system exhibits emergent gauge fields,fractionalized excitations,and enhanced symmetries.展开更多
Objective:To describe the effects of an early mobilization program in a critically ill patient with acquired muscle weakness in the intensive care unit(AMWICU).Methods:Case report of a 65-year-old male diagnosed with ...Objective:To describe the effects of an early mobilization program in a critically ill patient with acquired muscle weakness in the intensive care unit(AMWICU).Methods:Case report of a 65-year-old male diagnosed with pneumoperitoneum,septic shock,and multiple organ dysfunction.The patient underwent an early mobilization program between 13th and 30th of June 2022,based on expert consensus on safety criteria for mobilization in critically ill patients.The intervention was delivered by a rehabilitation nursing team.Results:The early mobilization program contributed to improvements in muscle strength,body mobility,and functional independence in the critically ill patient.Conclusions:Although there is no consensus on the ideal type,timing,or intensity of early mobilization in critically ill patients,this case study suggests that individualized early mobilization may promote functional recovery and should be considered in intensive care settings.展开更多
The paper is concerned with a class of elliptic equation with critical exponent and Dipole potential.More precisely,we make use of the refined Sobolev inequality with Morrey norm to obtain the existence and decay prop...The paper is concerned with a class of elliptic equation with critical exponent and Dipole potential.More precisely,we make use of the refined Sobolev inequality with Morrey norm to obtain the existence and decay properties of nonnegative radial ground state solutions.展开更多
A much more sustainable,cost effective and very flexible process for manufacturing critical fibres based on ultra high molecular weight polyethylene(UHMWPE)is being launched by the UK’s Fibre Extrusion Technologies(F...A much more sustainable,cost effective and very flexible process for manufacturing critical fibres based on ultra high molecular weight polyethylene(UHMWPE)is being launched by the UK’s Fibre Extrusion Technologies(FET).展开更多
Disordered ferromagnets with a domain structure that exhibit a hysteresis loop when driven by the external magnetic field are essential materials for modern technological applications.Therefore,the understanding and p...Disordered ferromagnets with a domain structure that exhibit a hysteresis loop when driven by the external magnetic field are essential materials for modern technological applications.Therefore,the understanding and potential for controlling the hysteresis phenomenon in thesematerials,especially concerning the disorder-induced critical behavior on the hysteresis loop,have attracted significant experimental,theoretical,and numerical research efforts.We review the challenges of the numerical modeling of physical phenomena behind the hysteresis loop critical behavior in disordered ferromagnetic systems related to the non-equilibriumstochastic dynamics of domain walls driven by external fields.Specifically,using the extended Random Field Ising Model,we present different simulation approaches and advanced numerical techniques that adequately describe the hysteresis loop shapes and the collective nature of the magnetization fluctuations associated with the criticality of the hysteresis loop for different sample shapes and varied parameters of disorder and rate of change of the external field,as well as the influence of thermal fluctuations and demagnetizing fields.The studied examples demonstrate how these numerical approaches reveal newphysical insights,providing quantitativemeasures of pertinent variables extracted from the systems’simulated or experimentally measured Barkhausen noise signals.The described computational techniques using inherent scale-invariance can be applied to the analysis of various complex systems,both quantum and classical,exhibiting non-equilibrium dynamical critical point or self-organized criticality.展开更多
Objective:This study’s purpose is to explore the application of the O-AMAS teaching model combined with the PBL teaching method in the clinical teaching of neurocritical care trainee nurses.Methods:The nursing studen...Objective:This study’s purpose is to explore the application of the O-AMAS teaching model combined with the PBL teaching method in the clinical teaching of neurocritical care trainee nurses.Methods:The nursing students who were doing internship in neurocritical care from June 2024 to September 2024 were set as the control group,and the traditional one-on-one teaching mode was adopted;From October 2024 to January 2025,the nursing students were set as the observation group and the course teaching based on the O-AMAS teaching model combined with PBL teaching was implemented.Results:The theoretical examination scores,operational assessment scores,teaching satisfaction,autonomous learning ability and clinical evaluation thinking ability of the two groups of nursing students were observed.The score of the experimental group was significantly higher than that of the control group(all P<0.01).Conclusion:The application of the O-AMAS teaching model combined with PBL teaching in the clinical teaching of neurocritical care intern nursing students can improve the teaching effect and cultivate the autonomous learning ability and clinical evaluation thinking ability of nursing students.展开更多
BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring except...BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.展开更多
BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological ...BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.展开更多
Objectives:Nurses working in critical care units may encounter substantial work-related strain,and elevated levels of stress can lead to burnout,ultimately impacting both the quality of nursing care and their overall ...Objectives:Nurses working in critical care units may encounter substantial work-related strain,and elevated levels of stress can lead to burnout,ultimately impacting both the quality of nursing care and their overall working experience.This study aimed to assess job burnout and determine the factors that contribute to it among critical care nurses in the Eastern Province of Saudi Arabia.Methods:This study employed a descriptive,exploratory,cross-sectional research design.A total of 220 nurses employed in the critical care units of 5 private hospitals in the eastern region were selected for participation in this study using a convenience sample method.An electronic survey was distributed to critical care nurses in the Eastern Province who satisfied the specified inclusion criteria.The job burnout questionnaire utilized in this study was derived from previously conducted research,which has been established as a reliable and valid survey instrument.The process of data analysis was conducted utilizing the SPSS program.The scientific research conducted on human subjects adhered rigorously to all ethical considerations.Results:The highest percentage of nurses at the critical care units reported experiencing moderate levels of job burnout.Nurses exhibiting greater levels of professional experience demonstrated a statistically significant reduction in overall burnout scores when compared to their less experienced counterparts.Furthermore,within the realm of sociodemographic factors,it was found that the only significant independent predictor for job burnout was the level of experience among critical care nurses.Conclusions:The prevalence of burnout among nurses in critical care settings was found to be significant,with most participants reporting moderate levels of burnout which can yield significant ramifications for nurses and healthcare professionals.Consequently,healthcare organizations must accord primacy to the welfare of their staff and adopt proactive strategies to mitigate job burnout.展开更多
BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effec...BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.展开更多
Based on the investigation of mechanical response and microstructure evolution of a commercial 7003 aluminum alloy under high-speed impact,a new simple and effective method was proposed to determine the critical strai...Based on the investigation of mechanical response and microstructure evolution of a commercial 7003 aluminum alloy under high-speed impact,a new simple and effective method was proposed to determine the critical strain required for the nucleation of adiabatic shear band(ASB).The deformation results of cylindrical and hat-shaped samples show that the critical strain required for ASB nucleation corresponds to the strain at the first local minimum after peak stress on the first derivative curve of true stress−true strain.The method of determining the critical strain for the nucleation of ASB through the first derivative of the flow stress curve is named the first derivative method.The proposed first derivative method is not only applicable to the 7003 aluminum alloy,but also to other metal materials,such as commercial purity titanium,WY-100 steel,and AM80 magnesium alloy.This proves that it has strong universality.展开更多
Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and ...Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and flammability,causing a spectrum of hazards to human health and environmental safety.Neoteric solvents have been recognized as potential alternatives to these harmful organic solvents.In the past two decades,several neoteric solvents have been proposed,including ionic liquids(ILs)and deep eutectic solvents(DESs).DESs have gradually become the focus of green solvents owing to several advantages,namely,low toxicity,degradability,and low cost.In this critical review,their classification,formation mechanisms,preparation methods,characterization technologies,and special physicochemical properties based on the most recent advancements in research have been systematically described.Subsequently,the major separation and purification applications of DESs in critical metal metallurgy were comprehensively summarized.Finally,future opportunities and challenges of DESs were explored in the current research area.In conclusion,this review provides valuable insights for improving our overall understanding of DESs,and it holds important potential for expanding separation and purification applications in critical metal metallurgy.展开更多
The national grid and other life-sustaining critical infrastructures face an unprecedented threat from prolonged blackouts,which could last over a year and pose a severe risk to national security.Whether caused by phy...The national grid and other life-sustaining critical infrastructures face an unprecedented threat from prolonged blackouts,which could last over a year and pose a severe risk to national security.Whether caused by physical attacks,EMP(electromagnetic pulse)events,or cyberattacks,such disruptions could cripple essential services like water supply,healthcare,communication,and transportation.Research indicates that an attack on just nine key substations could result in a coast-to-coast blackout lasting up to 18 months,leading to economic collapse,civil unrest,and a breakdown of public order.This paper explores the key vulnerabilities of the grid,the potential impacts of prolonged blackouts,and the role of AI(artificial intelligence)and ML(machine learning)in mitigating these threats.AI-driven cybersecurity measures,predictive maintenance,automated threat response,and EMP resilience strategies are discussed as essential solutions to bolster grid security.Policy recommendations emphasize the need for hardened infrastructure,enhanced cybersecurity,redundant power systems,and AI-based grid management to ensure national resilience.Without proactive measures,the nation remains exposed to a catastrophic power grid failure that could have dire consequences for society and the economy.展开更多
Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS)...Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS),microglia display a unique molecular homeostatic signature(i.e.,Tmem119,P2ry12,Sall1,Siglech,Gpr34,and Hexb)(Figure 1A).展开更多
Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypog...Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypoglycemia,classified as level 1 hypoglycemia,is defined by blood glucose levels below 70 mg/dL and can be effectively addressed through carbohydrate intake.Severe hypoglycemia,denoted by blood glucose levels less than 54 mg/dL,poses a life-threatening risk if left untreated.Individuals with type 1 and type 2 diabetes undergoing insulin treatment are particularly susceptible to hypoglycemia due to impaired counterregulatory mechanisms.展开更多
Given two graphs G and H,the Ramsey number R(G,H)is the smallest positive integer N such that every 2-coloring of the edges of K_(N)contains either a red G or a blue H.Let K_(N-1)■K_(1,k)be the graph obtained from K_...Given two graphs G and H,the Ramsey number R(G,H)is the smallest positive integer N such that every 2-coloring of the edges of K_(N)contains either a red G or a blue H.Let K_(N-1)■K_(1,k)be the graph obtained from K_(N-1)by adding anew vertexνconnecting k vertices of K_(N-1).A graph G withχ(G)=k+1 is called edge-critical if G contains an edge e such thatχ(G-e)=k.A considerable amount of research has been conducted by previous scholars on Ramsey numbers ofgraphs.In this study,we show that for an edge-critical graph G with x(G)=k+1,when k≥2,1≥2,and n is sufficiently large,R(G,K_(1)+nK_(t))=knt+1 and r,(G,K_(1)+nK_(t))=(k-1)nt+1.展开更多
Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic ...Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.展开更多
文摘BACKGROUND Accurate measurement of energy expenditure(EE)is critical for optimizing nutritional support in critically ill patients.Indirect calorimetry(IC)is the reference method used,but its availability at the bedside is limited.As a result,numerous predictive equations have been devised to estimate EE in critically ill patients,along with other more novel methods recently proposed.AIM To evaluate current methods of measuring EE in critical care,focusing on practical challenges,accuracy,feasibility,and limitations.We will also discuss how these methods contribute to improving nutrition support strategies for intensive care unit patients for a more personalised and effective solution.METHODS A comprehensive search was conducted in PubMed and EMBASE for studies published from December 2014 to December 2024.Eligible studies compared EE measurement methods in critically ill populations.Data extraction and quality assessment followed PRISMA guidelines.Adherence to reporting standards was assessed using the TRIPOD questionnaire and risk of bias was evaluated using the PROBAST tool.RESULTS Twenty five original studies met the inclusion criteria and were analysed.CONCLUSION Each method has unique strengths and limitations.We found that while IC remains the reference standard,less accurate predictive equations have greater accessibility and ease of implementation.Emerging technologies show promise for bedside applicability.Future research should address practical barriers and validate newer approaches.
基金supported by Shanghai Municipal Commission of Science and Technology,China(Grant No.:19XD1400300)the National Natural Science Foundation of China(Grant Nos.:821040821,82273867,and 82030107).
文摘Amphiphiles,including surfactants,have emerged as indispensable elements in materials science and pharmaceutical science,and their functions are highly relying on the critical micelle concentration(CMC)[1,2].Numerous fluorimetry-based probes have been developed to measure CMCs[3](Fig.S1).However,CMC measurements using these probes suffer from a time-consuming and laborious procedure and large uncertainties,primarily due to their poor photo-stabilities and highly fluctuating fluorescence backgrounds.
文摘This review examines the critical risks,barriers,and success factors in achieving sustainable affordable housing(SAH)by addressing environmental,economic,social and technical dimensions of sustainability.The aim of this study is to identify different critical risks and barriers to the development of the Sustainable Affordable Housing(SAH)CSF framework.The objectives of this research are to define SAH(Sustainable Affordable Housing)and important factors for achieving SAH and to develop SAH Critical Success Factors(CSFs)frameworks.To achieve these objectives,there are two methods for reviewing and analyzing documents,i.e.,systematic review and bibliographic review.The years of publication are limited to 2014 to 2023 in the English language and restricted to open access.A total of 63 articles were retrieved and screened for relevance identified as directly relevant to our topic using the PRISMA systematic review process.The growth pattern aligns strongly with an exponential growth model,as evidenced by a high R^(2) value of 0.9133 indicating a robust correlation and demonstrating the accelerating interest in the field over the past decade.This comprehensive analysis led to the development of the sustainable affordable housing(SAH)critical success framework,providing a structured approach to understanding and implementing critical factors for sustainable and affordable housing initiatives.The findings emphasize the need for integrated policy reforms,innovative construction technologies,and collaborative stakeholder engagement to advance the SAH agenda.Future research directions include conducting longitudinal studies to assess the long-term impacts of SAH policies,comparative analyses of international best practices,and explorations into emerging construction technologies.
基金supported by the National Natural Science Foundation of China(Grant Nos.12134020 and 12374156)the National Key Research and Development Program of China(Grant No.2023YFA1406500)。
文摘Deconfined quantum critical points(DQCPs)have been proposed as a class of continuous quantum phase transitions occurring between two ordered phases with distinct symmetry-breaking patterns,beyond the conventional framework of Landau-Ginzburg-Wilson(LGW)theory.At the DQCP,the system exhibits emergent gauge fields,fractionalized excitations,and enhanced symmetries.
文摘Objective:To describe the effects of an early mobilization program in a critically ill patient with acquired muscle weakness in the intensive care unit(AMWICU).Methods:Case report of a 65-year-old male diagnosed with pneumoperitoneum,septic shock,and multiple organ dysfunction.The patient underwent an early mobilization program between 13th and 30th of June 2022,based on expert consensus on safety criteria for mobilization in critically ill patients.The intervention was delivered by a rehabilitation nursing team.Results:The early mobilization program contributed to improvements in muscle strength,body mobility,and functional independence in the critically ill patient.Conclusions:Although there is no consensus on the ideal type,timing,or intensity of early mobilization in critically ill patients,this case study suggests that individualized early mobilization may promote functional recovery and should be considered in intensive care settings.
基金supported by the Natural Science Research Project of Anhui Educational Committee(2023AH040155)Zhisu Liu's research was supported by the Guangdong Basic and Applied Basic Research Foundation(2023A1515011679+2 种基金2024A1515012704)the Fundamental Research Funds for the Central Universities,China University of Geosciences(Wuhan)(CUG2106211CUGST2).
文摘The paper is concerned with a class of elliptic equation with critical exponent and Dipole potential.More precisely,we make use of the refined Sobolev inequality with Morrey norm to obtain the existence and decay properties of nonnegative radial ground state solutions.
文摘A much more sustainable,cost effective and very flexible process for manufacturing critical fibres based on ultra high molecular weight polyethylene(UHMWPE)is being launched by the UK’s Fibre Extrusion Technologies(FET).
基金Djordje Spasojevic and Svetislav Mijatovic acknowledge the support from the Ministry of Science,TechnologicalDevelopment and Innovation of the Republic of Serbia(Agreement No.451-03-65/2024-03/200162)S.J.ibid.(Agreement No.451-03-65/2024-03/200122)Bosiljka Tadic from the Slovenian Research Agency(program P1-0044).
文摘Disordered ferromagnets with a domain structure that exhibit a hysteresis loop when driven by the external magnetic field are essential materials for modern technological applications.Therefore,the understanding and potential for controlling the hysteresis phenomenon in thesematerials,especially concerning the disorder-induced critical behavior on the hysteresis loop,have attracted significant experimental,theoretical,and numerical research efforts.We review the challenges of the numerical modeling of physical phenomena behind the hysteresis loop critical behavior in disordered ferromagnetic systems related to the non-equilibriumstochastic dynamics of domain walls driven by external fields.Specifically,using the extended Random Field Ising Model,we present different simulation approaches and advanced numerical techniques that adequately describe the hysteresis loop shapes and the collective nature of the magnetization fluctuations associated with the criticality of the hysteresis loop for different sample shapes and varied parameters of disorder and rate of change of the external field,as well as the influence of thermal fluctuations and demagnetizing fields.The studied examples demonstrate how these numerical approaches reveal newphysical insights,providing quantitativemeasures of pertinent variables extracted from the systems’simulated or experimentally measured Barkhausen noise signals.The described computational techniques using inherent scale-invariance can be applied to the analysis of various complex systems,both quantum and classical,exhibiting non-equilibrium dynamical critical point or self-organized criticality.
基金Research and Practice on the Training Model of Clinical Medical Talents in the Context of“New Medicine”at Chengdu Medical College Educational Teaching Reform Project(Project No.:JG2023058)Research and Practice on the Training model of Clinical Medical Talents in the Context of“New Medical Science”(Project No.:JG2023057)。
文摘Objective:This study’s purpose is to explore the application of the O-AMAS teaching model combined with the PBL teaching method in the clinical teaching of neurocritical care trainee nurses.Methods:The nursing students who were doing internship in neurocritical care from June 2024 to September 2024 were set as the control group,and the traditional one-on-one teaching mode was adopted;From October 2024 to January 2025,the nursing students were set as the observation group and the course teaching based on the O-AMAS teaching model combined with PBL teaching was implemented.Results:The theoretical examination scores,operational assessment scores,teaching satisfaction,autonomous learning ability and clinical evaluation thinking ability of the two groups of nursing students were observed.The score of the experimental group was significantly higher than that of the control group(all P<0.01).Conclusion:The application of the O-AMAS teaching model combined with PBL teaching in the clinical teaching of neurocritical care intern nursing students can improve the teaching effect and cultivate the autonomous learning ability and clinical evaluation thinking ability of nursing students.
文摘BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.
基金Supported by Beijing Ditan Hospital Affiliated to Capital Medical University“Sailing Plan”,No.DTQH-202405.
文摘BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.
文摘Objectives:Nurses working in critical care units may encounter substantial work-related strain,and elevated levels of stress can lead to burnout,ultimately impacting both the quality of nursing care and their overall working experience.This study aimed to assess job burnout and determine the factors that contribute to it among critical care nurses in the Eastern Province of Saudi Arabia.Methods:This study employed a descriptive,exploratory,cross-sectional research design.A total of 220 nurses employed in the critical care units of 5 private hospitals in the eastern region were selected for participation in this study using a convenience sample method.An electronic survey was distributed to critical care nurses in the Eastern Province who satisfied the specified inclusion criteria.The job burnout questionnaire utilized in this study was derived from previously conducted research,which has been established as a reliable and valid survey instrument.The process of data analysis was conducted utilizing the SPSS program.The scientific research conducted on human subjects adhered rigorously to all ethical considerations.Results:The highest percentage of nurses at the critical care units reported experiencing moderate levels of job burnout.Nurses exhibiting greater levels of professional experience demonstrated a statistically significant reduction in overall burnout scores when compared to their less experienced counterparts.Furthermore,within the realm of sociodemographic factors,it was found that the only significant independent predictor for job burnout was the level of experience among critical care nurses.Conclusions:The prevalence of burnout among nurses in critical care settings was found to be significant,with most participants reporting moderate levels of burnout which can yield significant ramifications for nurses and healthcare professionals.Consequently,healthcare organizations must accord primacy to the welfare of their staff and adopt proactive strategies to mitigate job burnout.
文摘BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
基金National Natural Science Foundation of China (No. U20A20275)Natural Science Foundation of Hunan Province,China (No. 2021JJ40096)。
文摘Based on the investigation of mechanical response and microstructure evolution of a commercial 7003 aluminum alloy under high-speed impact,a new simple and effective method was proposed to determine the critical strain required for the nucleation of adiabatic shear band(ASB).The deformation results of cylindrical and hat-shaped samples show that the critical strain required for ASB nucleation corresponds to the strain at the first local minimum after peak stress on the first derivative curve of true stress−true strain.The method of determining the critical strain for the nucleation of ASB through the first derivative of the flow stress curve is named the first derivative method.The proposed first derivative method is not only applicable to the 7003 aluminum alloy,but also to other metal materials,such as commercial purity titanium,WY-100 steel,and AM80 magnesium alloy.This proves that it has strong universality.
基金financially supported by the Original Exploration Project of the National Natural Science Foundation of China(No.52150079)the National Natural Science Foundation of China(Nos.U22A20130,U2004215,and 51974280)+1 种基金the Natural Science Foundation of Henan Province of China(No.232300421196)the Project of Zhongyuan Critical Metals Laboratory of China(Nos.GJJSGFYQ202304,GJJSGFJQ202306,GJJSGFYQ202323,GJJSGFYQ202308,and GJJSGFYQ202307)。
文摘Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and flammability,causing a spectrum of hazards to human health and environmental safety.Neoteric solvents have been recognized as potential alternatives to these harmful organic solvents.In the past two decades,several neoteric solvents have been proposed,including ionic liquids(ILs)and deep eutectic solvents(DESs).DESs have gradually become the focus of green solvents owing to several advantages,namely,low toxicity,degradability,and low cost.In this critical review,their classification,formation mechanisms,preparation methods,characterization technologies,and special physicochemical properties based on the most recent advancements in research have been systematically described.Subsequently,the major separation and purification applications of DESs in critical metal metallurgy were comprehensively summarized.Finally,future opportunities and challenges of DESs were explored in the current research area.In conclusion,this review provides valuable insights for improving our overall understanding of DESs,and it holds important potential for expanding separation and purification applications in critical metal metallurgy.
文摘The national grid and other life-sustaining critical infrastructures face an unprecedented threat from prolonged blackouts,which could last over a year and pose a severe risk to national security.Whether caused by physical attacks,EMP(electromagnetic pulse)events,or cyberattacks,such disruptions could cripple essential services like water supply,healthcare,communication,and transportation.Research indicates that an attack on just nine key substations could result in a coast-to-coast blackout lasting up to 18 months,leading to economic collapse,civil unrest,and a breakdown of public order.This paper explores the key vulnerabilities of the grid,the potential impacts of prolonged blackouts,and the role of AI(artificial intelligence)and ML(machine learning)in mitigating these threats.AI-driven cybersecurity measures,predictive maintenance,automated threat response,and EMP resilience strategies are discussed as essential solutions to bolster grid security.Policy recommendations emphasize the need for hardened infrastructure,enhanced cybersecurity,redundant power systems,and AI-based grid management to ensure national resilience.Without proactive measures,the nation remains exposed to a catastrophic power grid failure that could have dire consequences for society and the economy.
基金supported by NIH grants(R01NS125074,R01AG083164,and R21NS127177)(to YL).
文摘Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS),microglia display a unique molecular homeostatic signature(i.e.,Tmem119,P2ry12,Sall1,Siglech,Gpr34,and Hexb)(Figure 1A).
基金generously supported by the faculty startup funds from Auburn University at Montgomery (to SSVPS)。
文摘Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypoglycemia,classified as level 1 hypoglycemia,is defined by blood glucose levels below 70 mg/dL and can be effectively addressed through carbohydrate intake.Severe hypoglycemia,denoted by blood glucose levels less than 54 mg/dL,poses a life-threatening risk if left untreated.Individuals with type 1 and type 2 diabetes undergoing insulin treatment are particularly susceptible to hypoglycemia due to impaired counterregulatory mechanisms.
基金supported by the National Key Research and Development Program of China(2023YFA1010200,2020YFA0713100)the National Natural Science Foundation of China(12071453)the Innovation Program for Quantum Science and Technology(2021ZD0302902).
文摘Given two graphs G and H,the Ramsey number R(G,H)is the smallest positive integer N such that every 2-coloring of the edges of K_(N)contains either a red G or a blue H.Let K_(N-1)■K_(1,k)be the graph obtained from K_(N-1)by adding anew vertexνconnecting k vertices of K_(N-1).A graph G withχ(G)=k+1 is called edge-critical if G contains an edge e such thatχ(G-e)=k.A considerable amount of research has been conducted by previous scholars on Ramsey numbers ofgraphs.In this study,we show that for an edge-critical graph G with x(G)=k+1,when k≥2,1≥2,and n is sufficiently large,R(G,K_(1)+nK_(t))=knt+1 and r,(G,K_(1)+nK_(t))=(k-1)nt+1.
文摘Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.
