Mimicking the electric microenvironment of natural tissue is a promising strategy for developing biomedical implants. However, current research has not taken biomimetic electrical functional units into consideration w...Mimicking the electric microenvironment of natural tissue is a promising strategy for developing biomedical implants. However, current research has not taken biomimetic electrical functional units into consideration when designing biomedical implants. In this research, ordered structures with Schottky heterojunction functional unit (OSSH) were constructed on titanium implant surfaces for bone regeneration regulation. The Schottky heterojunction functional unit is composed of periodically distributed titanium microdomain and titanium oxide microdomain with different carrier densities and surface potentials. The OSSH regulates the M2-type polarization of macrophages to a regenerative immune response by activating the PI3K-AKT-mTOR signal pathway and further promotes osteogenic differentiation of rat bone marrow mesenchymal stem cells. This work provides fundamental insights into the biological effects driven by the Schottky heterojunction functional units that can electrically modulate osteogenesis.展开更多
The control of gas fractionation unit(GFU) in petroleum industry is very difficult due to multivariable characteristics and a large time delay.PID controllers are still applied in most industry processes.However,the t...The control of gas fractionation unit(GFU) in petroleum industry is very difficult due to multivariable characteristics and a large time delay.PID controllers are still applied in most industry processes.However,the traditional PID control has been proven not sufficient and capable for this particular petro-chemical process.In this work,an incremental multivariable predictive functional control(IMPFC) algorithm was proposed with less online computation,great precision and fast response.An incremental transfer function matrix model was set up through the step-response data,and predictive outputs were deduced with the theory of single-value optimization.The results show that the method can optimize the incremental control variable and reject the constraint of the incremental control variable with the positional predictive functional control algorithm,and thereby making the control variable smoother.The predictive output error and future set-point were approximated by a polynomial,which can overcome the problem under the model mismatch and make the predictive outputs track the reference trajectory.Then,the design of incremental multivariable predictive functional control was studied.Simulation and application results show that the proposed control strategy is effective and feasible to improve control performance and robustness of process.展开更多
Solid polymer electrolytes have been considered as the promising candidates to improve the safety and stability of high-energy lithium metal batteries.However,the practical applications of solid polymer electrolytes a...Solid polymer electrolytes have been considered as the promising candidates to improve the safety and stability of high-energy lithium metal batteries.However,the practical applications of solid polymer electrolytes are still limited by the low ionic conductivity,poor interfacial contact with electrodes,narrow electrochemical window and weak mechanical strength.Here,a series of novel block copolymer electrolytes with three-dimensional networks are designed by cross-linked copolymerization of the polyethylene glycol soft segments and hexamethylene diisocyanate trimer hard segments.Their ionic migration performances and interface compatibilities with Li metal anode have been optimized delicately by tailoring the ratio of these functional units.The optimized block copolymer electrolyte has shown an amorphous crystalline structure,a high ionic conductivity of ~5.7×10^(-4)S cm^(-1),high lithium ion transference number(~0.49),wide electrochemical window up to ~4.65 V(vs.Li+/Li) and favorable mechanical strength at 55℃.Furthermore,the enhanced interface compatibility can well support the normal operations of lithium metal batteries using both LiFePO4 and LiNi0.8Co0.15Al0.05O2 cathodes.This study not only paves a new way to develop solid polymer electrolyte with optimizing functional units,but also provides a polymer electrolyte design strategy for the application demand of lithium metal battery.展开更多
The Auto-Transformer Rectifier Unit（ATRU） is one preferred solution for high-power AC/DC power conversion in aircraft. This is mainly due to its simple structure, high reliability and reduced k VA ratings. Indeed, t...The Auto-Transformer Rectifier Unit（ATRU） is one preferred solution for high-power AC/DC power conversion in aircraft. This is mainly due to its simple structure, high reliability and reduced k VA ratings. Indeed, the ATRU has become a preferred AC/DC solution to supply power to the electric environment control system on-board future aircraft. In this paper, a general modelling method for ATRUs is introduced. The developed model is based on the fact that the DC voltage and current are strongly related to the voltage and current vectors at the AC terminals of ATRUs. In this paper, we carry on our research in modelling symmetric 18-pulse ATRUs and develop a generic modelling technique. The developed generic model can study not only symmetric but also asymmetric ATRUs. An 18-pulse asymmetric ATRU is used to demonstrate the accuracy and efficiency of the developed model by comparing with corresponding detailed switching SABER models provided by our industrial partner. The functional models also allow accelerated and accurate simulations and thus enable whole-scale more-electric aircraft electrical power system studies in the future.展开更多
The sulfide-based solid-state electrolytes(SEs)reactivity toward moisture and Li-metal are huge barriers that impede their large-scale manufactu ring and applications in all-solid-state lithium batteries(ASSLBs).Herei...The sulfide-based solid-state electrolytes(SEs)reactivity toward moisture and Li-metal are huge barriers that impede their large-scale manufactu ring and applications in all-solid-state lithium batteries(ASSLBs).Herein,we proposed an Al and O dual-doped strategy for Li_(3)PS_(4)SE to regulate the chemical/electrochemical stability of anionic PS_(4)^(3-)tetrahedra to mitigate structural hydrolysis and parasitic reactions at the SE/Li interface.The optimized Li_(3.08)A_(10.04)P_(0.96)S_(3.92)O_(0.08)SE presents the highestσLi+of 3.27 mS cm^(-1),which is~6.8 times higher than the pristine Li_(3)PS_(4)and excellently inhibits the structural hydrolysis for~25 min@25%humidity at RT.DFT calculations confirmed that the enhanced chemical stability was revealed to the intrinsically stable entities,e.g.,POS33-units.Moreover,Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE cycled stably in Li//Li symmetric cell over 1000 h@0.1 mA cm^(-2)/0.1 mA h cm^(-2),could be revealed to Li-Al alloy and Li_(2)Oat SE/Li interface impeding the growth of Li-dendrites during cycling.Resultantly,LNO@LCO/Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)/Li-In cell delivered initial discharge capacities of 129.8 mA h g^(-1)and 83.74%capacity retention over 300 cycles@0.2 C at RT.Moreover,the Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE presented>90%capacity retention over 200 and 300 cycles when the cell was tested with LiNi_(0.8)Co_(0.15)Al_(0.05)O_(2)(NCA)cathode material vs.5 and 10 mg cm^(-2)@RT.展开更多
On February 25, the Unit 1 of Ling’ao Nuclear Power Plant phase II underwent a 41-day-long hot functional test successfully with its major systems satisfying the requirements for
In this paper, discussed are the problems about uniqueness of algebroidal functions in the unit disc with share-values in a sector domain instead of the whole disk. Results are obtained extending some uniqueness theor...In this paper, discussed are the problems about uniqueness of algebroidal functions in the unit disc with share-values in a sector domain instead of the whole disk. Results are obtained extending some uniqueness theorems of meromorphic functions.展开更多
We establish a precise Schwarz lemma for real-valued and bounded harmonic functions in the real unit ball of dimension n.This extends Chen's Schwarz-Pick lemma for real-valued and bounded planar harmonic mapping.
This paper deals with a Unit Commitment (UC) problem of a power plant aimed to find the optimal scheduling of the generating units involving cubic cost functions. The problem has non convex generator characteristics, ...This paper deals with a Unit Commitment (UC) problem of a power plant aimed to find the optimal scheduling of the generating units involving cubic cost functions. The problem has non convex generator characteristics, which makes it very hard to handle the corresponding mathematical models. However, Teaching Learning Based Optimization (TLBO) has reached a high efficiency, in terms of solution accuracy and computing time for such non convex problems. Hence, TLBO is applied for scheduling of generators with higher order cost characteristics, and turns out to be computationally solvable. In particular, we represent a model that takes into account the accurate higher order generator cost functions along with ramp limits, and turns to be more general and efficient than those available in the literature. The behavior of the model is analyzed through proposed technique on modified IEEE-24 bus system.展开更多
In this paper, the T points of meromorphic functions are defined and existence of the T points is showed in the Unit disk, we also prove T point must be J point.
This paper presents a new approach via composite cost function to solve the unit commitment problem. The unit com-mitment problem involves determining the start-up and shut-down schedules for generating units to meet ...This paper presents a new approach via composite cost function to solve the unit commitment problem. The unit com-mitment problem involves determining the start-up and shut-down schedules for generating units to meet the fore-casted demand at the minimum cost. The commitment schedule must satisfy the other constraints such as the generating limits, spinning reserve, minimum up and down time, ramp level and individual units. The proposed algorithm gives the committed units and economic load dispatch for each specific hour of operation. Numerical simulations were carried out using three cases: four-generator, seven-generator, and ten-generator thermal unit power systems over a 24 h period. The produced schedule was compared with several other methods, such as Dynamic programming, Branch and bound, Ant colony system, and traditional Tabu search. The result demonstrated the accuracy of the proposed method.展开更多
In this paper we obtained the asymptotic formula of the orthogonal rational function on the unit circle with respect to the weight function μ(z) with preasigned poles, which are in the exterior of the unit disk.
Results of analytical studies of the physical properties of the function and number of empirical macrohardness based on the standard experimental force diagram of kinetic macroindentation by a sphere.An analytical com...Results of analytical studies of the physical properties of the function and number of empirical macrohardness based on the standard experimental force diagram of kinetic macroindentation by a sphere.An analytical comparison method and a criterion for the similarity of the physical and empirical macrohardness of a material are proposed.The physical properties of the hardness measurement process using the Calvert-Johnson method are shown.The physical reasons for the size effect when measuring macrohardness are considered.The universal physical unit and standard of macrohardness of kinetic macroindentation by a sphere is substantiated.展开更多
BACKGROUND Prolonged immobility during intensive care unit(ICU)admission has been a cause of muscle atrophy and worsening functional outcomes with longer recovery times.Prior research has demonstrated that mobilizatio...BACKGROUND Prolonged immobility during intensive care unit(ICU)admission has been a cause of muscle atrophy and worsening functional outcomes with longer recovery times.Prior research has demonstrated that mobilization within a week of ICU admission potentially benefits physical function in critically ill patients.AIM To evaluate the effects of initiating mobilization within 72 hours of ICU admission in critically ill patients through an updated systematic review and meta-analysis.METHODS A systematic search was performed through MEDLINE,Scopus,and Cochrane Library from inception until September 2024 for randomized controlled trials(RCTs)comparing early mobilization(EM)with usual or conventional care in critically ill adult patients.Primary outcomes included length of ICU(days)and ventilation duration(days).Secondary outcomes included muscle strength,functional status,adverse events,all-cause mortality,and quality of life(QOL).A random effects meta-analysis was performed for pooled effect estimates and to derive risk ratios(RR)and corresponding 95%confidence intervals(CI).RESULTS Out of 3487 results,16 RCTs were included with a population of 2385 patients(1195 receiving EM and 1190 with usual care.)A significant reduction in the length of ICU stays[mean difference(MD)=-1.02,95%CI:-1.96 to-0.09;P=0.03;I2=60%]and ventilation duration(MD=-1.07,95%CI:-1.91 to-0.23,P=0.01;I2=57%)was observed in the EM group compared to usual care.EM significantly improved muscle strength[standard MD(SMD)=0.47,95%CI:0.18-0.75,P=0.001;I2=79%]and functional status(SMD=0.70,95%CI:0.40-1.00,P<0.00001;I2=81%)in ICU patients.No statistically significant difference was observed in adverse events(RR=1.72,95%CI:1.01-2.94,P=0.05;I2=31%),all-cause mortality(RR=1.10,95%CI:0.79-1.53,P=0.57;I2=30%),and QOL(SMD=0.04,95%CI:-0.07-0.15,P=0.50;I2=9%)between the two groups.CONCLUSION Initiating mobilization within 72 hours of ICU admission is associated with improved functional outcomes and reduced ICU length of stay and ventilation duration.These findings indicate that EM may be a safe option for ICU patients,contributing to lower recovery times and healthcare costs.Further extensive research is required to validate the long-term effects on survival and QOL.展开更多
BACKGROUND Stress-induced hyperglycemia(SIH)is common in critically ill patients and has been associated with adverse cardiovascular outcomes.Intensive insulin therapy(IIT)has been proposed to mitigate these risks by ...BACKGROUND Stress-induced hyperglycemia(SIH)is common in critically ill patients and has been associated with adverse cardiovascular outcomes.Intensive insulin therapy(IIT)has been proposed to mitigate these risks by achieving tighter glycemic control.AIM To evaluate the efficacy of IIT for managing SIH in critically ill patients and to explore its potential effect on cardiac function.METHODS A retrospective study was conducted at our hospital from January 2021 to December 2024,adhering to STROBE guidelines.A total of 186 critically ill pa-tients were divided into normal glycemia(n=85)and SIH(n=101)groups.The SIH cohort was further subdivided into conventional treatment(n=50)and IIT(n=51)groups.Hemodynamic parameters-including right atrial pressure(RAP),pulmonary artery pressure(PAP),pulmonary capillary wedge pressure(PAWP),cardiac output(CO),cardiac index(CI),and B-type natriuretic peptide(BNP)-were measured at baseline and post-treatment.Clinical outcomes such as intensive care unit(ICU)length of stay,mechanical ventilation requirements,and mortality were also recorded.Statistical analyses were conducted using inde-pendent samples t-tests and χ^(2)/Fisher’s exact tests.RESULTS SIH markedly worsened haemodynamics versus normal glycaemia:RAP 9.8±5.1 vs 6.1±3.5 mmHg,PAP 35.2±16.0 vs 26.2±10.3 mmHg,PAWP 16.0±7.0 vs 8.6±6.4 mmHg,CO 3.3±2.3 vs 6.0±3.3 L/min,CI 1.88±0.24 vs 2.70±0.50 L/min/m2,BNP 465±250 vs 180±53 pg/mL(all P<0.001).Within the SIH cohort,IIT outperformed conventional therapy:RAP 7.0±2.2 vs 8.3±3.9 mmHg(P=0.04),PAP 21.6±3.7 vs 29.3±6.5 mmHg(P<0.001),PAWP 10.2±5.4 vs 13.8±5.3 mmHg(P=0.001),CO 4.9±2.2 vs 4.0±1.4 L/min(P=0.022),CI 2.58±0.32 vs 2.11±0.31 L/min/m2,P<0.001),BNP 202±62 vs 346±171 pg/mL(P<0.001).Clinically,IIT shortened ICU stay(10.3±3.4 vs 14.5±2.6 days,P<0.001),reduced ventilator use(56.9%vs 76.0%,P=0.042),and lowered mortality(23.5%vs 42.0%,P=0.048).CONCLUSION IIT significantly reduced cardiac filling pressures,improved cardiac function,and was associated with favorable clinical outcomes in SIH patients,suggesting potential benefits of stricter glycaemic control in critically ill patients.However,given the retrospective design and absence of glucose-variability monitoring,these findings should be interpreted with caution.展开更多
基金supported by the National Natural Science Foundation of China(Nos.52072127,52201297,U21A2055,and U22A20160)the China Postdoctoral Science Foundation(No.2022M711200)the Royal Society(No.IEC/NSFC/191344)(UK).
文摘Mimicking the electric microenvironment of natural tissue is a promising strategy for developing biomedical implants. However, current research has not taken biomimetic electrical functional units into consideration when designing biomedical implants. In this research, ordered structures with Schottky heterojunction functional unit (OSSH) were constructed on titanium implant surfaces for bone regeneration regulation. The Schottky heterojunction functional unit is composed of periodically distributed titanium microdomain and titanium oxide microdomain with different carrier densities and surface potentials. The OSSH regulates the M2-type polarization of macrophages to a regenerative immune response by activating the PI3K-AKT-mTOR signal pathway and further promotes osteogenic differentiation of rat bone marrow mesenchymal stem cells. This work provides fundamental insights into the biological effects driven by the Schottky heterojunction functional units that can electrically modulate osteogenesis.
基金Project(61203021)supported by the National Natural Science Foundation of ChinaProject(2011216011)supported by the Scientific and Technological Program of Liaoning Province,China+2 种基金Project(2013020024)supported by the Natural Science Foundation of Liaoning Province,ChinaProject(2012BAF05B00)supported by the National Science and Technology Support Program,ChinaProject(LJQ2015061)supported by the Program for Liaoning Excellent Talents in Universities,China
文摘The control of gas fractionation unit(GFU) in petroleum industry is very difficult due to multivariable characteristics and a large time delay.PID controllers are still applied in most industry processes.However,the traditional PID control has been proven not sufficient and capable for this particular petro-chemical process.In this work,an incremental multivariable predictive functional control(IMPFC) algorithm was proposed with less online computation,great precision and fast response.An incremental transfer function matrix model was set up through the step-response data,and predictive outputs were deduced with the theory of single-value optimization.The results show that the method can optimize the incremental control variable and reject the constraint of the incremental control variable with the positional predictive functional control algorithm,and thereby making the control variable smoother.The predictive output error and future set-point were approximated by a polynomial,which can overcome the problem under the model mismatch and make the predictive outputs track the reference trajectory.Then,the design of incremental multivariable predictive functional control was studied.Simulation and application results show that the proposed control strategy is effective and feasible to improve control performance and robustness of process.
基金supported financially by the National Key R&D Program of China (Grant No. 2018YFB0104300)Beijing Natural Science Foundation (JQ19003, KZ201910005002 and L182009)+1 种基金National Natural Science Foundation of China (Grants 21875007, 51622202, and 21974007)the Project of Youth Talent Plan of Beijing Municipal Education Commission (CIT&TCD201804013)。
文摘Solid polymer electrolytes have been considered as the promising candidates to improve the safety and stability of high-energy lithium metal batteries.However,the practical applications of solid polymer electrolytes are still limited by the low ionic conductivity,poor interfacial contact with electrodes,narrow electrochemical window and weak mechanical strength.Here,a series of novel block copolymer electrolytes with three-dimensional networks are designed by cross-linked copolymerization of the polyethylene glycol soft segments and hexamethylene diisocyanate trimer hard segments.Their ionic migration performances and interface compatibilities with Li metal anode have been optimized delicately by tailoring the ratio of these functional units.The optimized block copolymer electrolyte has shown an amorphous crystalline structure,a high ionic conductivity of ~5.7×10^(-4)S cm^(-1),high lithium ion transference number(~0.49),wide electrochemical window up to ~4.65 V(vs.Li+/Li) and favorable mechanical strength at 55℃.Furthermore,the enhanced interface compatibility can well support the normal operations of lithium metal batteries using both LiFePO4 and LiNi0.8Co0.15Al0.05O2 cathodes.This study not only paves a new way to develop solid polymer electrolyte with optimizing functional units,but also provides a polymer electrolyte design strategy for the application demand of lithium metal battery.
文摘The Auto-Transformer Rectifier Unit（ATRU） is one preferred solution for high-power AC/DC power conversion in aircraft. This is mainly due to its simple structure, high reliability and reduced k VA ratings. Indeed, the ATRU has become a preferred AC/DC solution to supply power to the electric environment control system on-board future aircraft. In this paper, a general modelling method for ATRUs is introduced. The developed model is based on the fact that the DC voltage and current are strongly related to the voltage and current vectors at the AC terminals of ATRUs. In this paper, we carry on our research in modelling symmetric 18-pulse ATRUs and develop a generic modelling technique. The developed generic model can study not only symmetric but also asymmetric ATRUs. An 18-pulse asymmetric ATRU is used to demonstrate the accuracy and efficiency of the developed model by comparing with corresponding detailed switching SABER models provided by our industrial partner. The functional models also allow accelerated and accurate simulations and thus enable whole-scale more-electric aircraft electrical power system studies in the future.
基金supported by the National Natural Science Foundation of China(Nos.21203008,21975025,12274025)the Hainan Province Science and Technology Special Fund(Nos.ZDYF2021SHFZ232,ZDYF2023GXJS022)the Hainan Province Postdoctoral Science Foundation(No.300333)。
文摘The sulfide-based solid-state electrolytes(SEs)reactivity toward moisture and Li-metal are huge barriers that impede their large-scale manufactu ring and applications in all-solid-state lithium batteries(ASSLBs).Herein,we proposed an Al and O dual-doped strategy for Li_(3)PS_(4)SE to regulate the chemical/electrochemical stability of anionic PS_(4)^(3-)tetrahedra to mitigate structural hydrolysis and parasitic reactions at the SE/Li interface.The optimized Li_(3.08)A_(10.04)P_(0.96)S_(3.92)O_(0.08)SE presents the highestσLi+of 3.27 mS cm^(-1),which is~6.8 times higher than the pristine Li_(3)PS_(4)and excellently inhibits the structural hydrolysis for~25 min@25%humidity at RT.DFT calculations confirmed that the enhanced chemical stability was revealed to the intrinsically stable entities,e.g.,POS33-units.Moreover,Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE cycled stably in Li//Li symmetric cell over 1000 h@0.1 mA cm^(-2)/0.1 mA h cm^(-2),could be revealed to Li-Al alloy and Li_(2)Oat SE/Li interface impeding the growth of Li-dendrites during cycling.Resultantly,LNO@LCO/Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)/Li-In cell delivered initial discharge capacities of 129.8 mA h g^(-1)and 83.74%capacity retention over 300 cycles@0.2 C at RT.Moreover,the Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE presented>90%capacity retention over 200 and 300 cycles when the cell was tested with LiNi_(0.8)Co_(0.15)Al_(0.05)O_(2)(NCA)cathode material vs.5 and 10 mg cm^(-2)@RT.
文摘On February 25, the Unit 1 of Ling’ao Nuclear Power Plant phase II underwent a 41-day-long hot functional test successfully with its major systems satisfying the requirements for
基金Supported by the NNSF of China(10471048)Supported by the Doctoral Foundation of the Education Committee of China(20050574002)
文摘In this paper, discussed are the problems about uniqueness of algebroidal functions in the unit disc with share-values in a sector domain instead of the whole disk. Results are obtained extending some uniqueness theorems of meromorphic functions.
基金Research supported by the National Natural Science Foundation of China(11201199,11071083,11671361)Jiangsu Overseas Visiting Scholar Program for University Prominent Young&Middle-aged Teachers and Presidents
文摘We establish a precise Schwarz lemma for real-valued and bounded harmonic functions in the real unit ball of dimension n.This extends Chen's Schwarz-Pick lemma for real-valued and bounded planar harmonic mapping.
文摘This paper deals with a Unit Commitment (UC) problem of a power plant aimed to find the optimal scheduling of the generating units involving cubic cost functions. The problem has non convex generator characteristics, which makes it very hard to handle the corresponding mathematical models. However, Teaching Learning Based Optimization (TLBO) has reached a high efficiency, in terms of solution accuracy and computing time for such non convex problems. Hence, TLBO is applied for scheduling of generators with higher order cost characteristics, and turns out to be computationally solvable. In particular, we represent a model that takes into account the accurate higher order generator cost functions along with ramp limits, and turns to be more general and efficient than those available in the literature. The behavior of the model is analyzed through proposed technique on modified IEEE-24 bus system.
文摘In this paper, the T points of meromorphic functions are defined and existence of the T points is showed in the Unit disk, we also prove T point must be J point.
文摘This paper presents a new approach via composite cost function to solve the unit commitment problem. The unit com-mitment problem involves determining the start-up and shut-down schedules for generating units to meet the fore-casted demand at the minimum cost. The commitment schedule must satisfy the other constraints such as the generating limits, spinning reserve, minimum up and down time, ramp level and individual units. The proposed algorithm gives the committed units and economic load dispatch for each specific hour of operation. Numerical simulations were carried out using three cases: four-generator, seven-generator, and ten-generator thermal unit power systems over a 24 h period. The produced schedule was compared with several other methods, such as Dynamic programming, Branch and bound, Ant colony system, and traditional Tabu search. The result demonstrated the accuracy of the proposed method.
文摘In this paper we obtained the asymptotic formula of the orthogonal rational function on the unit circle with respect to the weight function μ(z) with preasigned poles, which are in the exterior of the unit disk.
文摘Results of analytical studies of the physical properties of the function and number of empirical macrohardness based on the standard experimental force diagram of kinetic macroindentation by a sphere.An analytical comparison method and a criterion for the similarity of the physical and empirical macrohardness of a material are proposed.The physical properties of the hardness measurement process using the Calvert-Johnson method are shown.The physical reasons for the size effect when measuring macrohardness are considered.The universal physical unit and standard of macrohardness of kinetic macroindentation by a sphere is substantiated.
文摘BACKGROUND Prolonged immobility during intensive care unit(ICU)admission has been a cause of muscle atrophy and worsening functional outcomes with longer recovery times.Prior research has demonstrated that mobilization within a week of ICU admission potentially benefits physical function in critically ill patients.AIM To evaluate the effects of initiating mobilization within 72 hours of ICU admission in critically ill patients through an updated systematic review and meta-analysis.METHODS A systematic search was performed through MEDLINE,Scopus,and Cochrane Library from inception until September 2024 for randomized controlled trials(RCTs)comparing early mobilization(EM)with usual or conventional care in critically ill adult patients.Primary outcomes included length of ICU(days)and ventilation duration(days).Secondary outcomes included muscle strength,functional status,adverse events,all-cause mortality,and quality of life(QOL).A random effects meta-analysis was performed for pooled effect estimates and to derive risk ratios(RR)and corresponding 95%confidence intervals(CI).RESULTS Out of 3487 results,16 RCTs were included with a population of 2385 patients(1195 receiving EM and 1190 with usual care.)A significant reduction in the length of ICU stays[mean difference(MD)=-1.02,95%CI:-1.96 to-0.09;P=0.03;I2=60%]and ventilation duration(MD=-1.07,95%CI:-1.91 to-0.23,P=0.01;I2=57%)was observed in the EM group compared to usual care.EM significantly improved muscle strength[standard MD(SMD)=0.47,95%CI:0.18-0.75,P=0.001;I2=79%]and functional status(SMD=0.70,95%CI:0.40-1.00,P<0.00001;I2=81%)in ICU patients.No statistically significant difference was observed in adverse events(RR=1.72,95%CI:1.01-2.94,P=0.05;I2=31%),all-cause mortality(RR=1.10,95%CI:0.79-1.53,P=0.57;I2=30%),and QOL(SMD=0.04,95%CI:-0.07-0.15,P=0.50;I2=9%)between the two groups.CONCLUSION Initiating mobilization within 72 hours of ICU admission is associated with improved functional outcomes and reduced ICU length of stay and ventilation duration.These findings indicate that EM may be a safe option for ICU patients,contributing to lower recovery times and healthcare costs.Further extensive research is required to validate the long-term effects on survival and QOL.
文摘BACKGROUND Stress-induced hyperglycemia(SIH)is common in critically ill patients and has been associated with adverse cardiovascular outcomes.Intensive insulin therapy(IIT)has been proposed to mitigate these risks by achieving tighter glycemic control.AIM To evaluate the efficacy of IIT for managing SIH in critically ill patients and to explore its potential effect on cardiac function.METHODS A retrospective study was conducted at our hospital from January 2021 to December 2024,adhering to STROBE guidelines.A total of 186 critically ill pa-tients were divided into normal glycemia(n=85)and SIH(n=101)groups.The SIH cohort was further subdivided into conventional treatment(n=50)and IIT(n=51)groups.Hemodynamic parameters-including right atrial pressure(RAP),pulmonary artery pressure(PAP),pulmonary capillary wedge pressure(PAWP),cardiac output(CO),cardiac index(CI),and B-type natriuretic peptide(BNP)-were measured at baseline and post-treatment.Clinical outcomes such as intensive care unit(ICU)length of stay,mechanical ventilation requirements,and mortality were also recorded.Statistical analyses were conducted using inde-pendent samples t-tests and χ^(2)/Fisher’s exact tests.RESULTS SIH markedly worsened haemodynamics versus normal glycaemia:RAP 9.8±5.1 vs 6.1±3.5 mmHg,PAP 35.2±16.0 vs 26.2±10.3 mmHg,PAWP 16.0±7.0 vs 8.6±6.4 mmHg,CO 3.3±2.3 vs 6.0±3.3 L/min,CI 1.88±0.24 vs 2.70±0.50 L/min/m2,BNP 465±250 vs 180±53 pg/mL(all P<0.001).Within the SIH cohort,IIT outperformed conventional therapy:RAP 7.0±2.2 vs 8.3±3.9 mmHg(P=0.04),PAP 21.6±3.7 vs 29.3±6.5 mmHg(P<0.001),PAWP 10.2±5.4 vs 13.8±5.3 mmHg(P=0.001),CO 4.9±2.2 vs 4.0±1.4 L/min(P=0.022),CI 2.58±0.32 vs 2.11±0.31 L/min/m2,P<0.001),BNP 202±62 vs 346±171 pg/mL(P<0.001).Clinically,IIT shortened ICU stay(10.3±3.4 vs 14.5±2.6 days,P<0.001),reduced ventilator use(56.9%vs 76.0%,P=0.042),and lowered mortality(23.5%vs 42.0%,P=0.048).CONCLUSION IIT significantly reduced cardiac filling pressures,improved cardiac function,and was associated with favorable clinical outcomes in SIH patients,suggesting potential benefits of stricter glycaemic control in critically ill patients.However,given the retrospective design and absence of glucose-variability monitoring,these findings should be interpreted with caution.
