Having all live in a better, more peaceful world has long been a dream of Kofi Annan, both during his 10-year service as sec- retary general of the UN and now. as chairman of the Kofi Annan Foundation. For this, Annan...Having all live in a better, more peaceful world has long been a dream of Kofi Annan, both during his 10-year service as sec- retary general of the UN and now. as chairman of the Kofi Annan Foundation. For this, Annan and the UN won the Nobel Peace Prize in 2001. To ＂make our world more harmonious, people-to-people understanding and cooperation is extremely impor- tant,＂ Kofi Annan told ChinAffica. ＂We often forget that there＇s more that unites us than divides us,＂ he said. In an exclusive inter- view during his recent visit to Beijing, he shared his views on issues of global importance. Edited excerpts of the interview follow展开更多
1 Introduction In the United States, the largest groups of acupuncture or traditional Chinese medicine （TCM） practitioners settled and still remain in California and New York, as these two states historically have...1 Introduction In the United States, the largest groups of acupuncture or traditional Chinese medicine （TCM） practitioners settled and still remain in California and New York, as these two states historically have the largest, most concentrated Asian populations. The TCM practitioners originally worked in a legal gray-zone, sometimes even being treated as illegal practitioners by the local governments, since TCM licensing laws did not exist until late 1973[1]. The first legal acupuncture clinic was established in Washington, D.C. in 1972[2], but Nevada was the first state that passed a full practicing law for acupuncture and TCM[3]. Under- standing the legal history of acupuncture in the U.S. will help us to see the road ahead more clearly.展开更多
Unifying quantum and classical physics has proved difficult as their postulates are conflicting. Using the notion of counts of the fundamental measures—length, mass, and time—a unifying description is resolved. A th...Unifying quantum and classical physics has proved difficult as their postulates are conflicting. Using the notion of counts of the fundamental measures—length, mass, and time—a unifying description is resolved. A theoretical framework is presented in a set of postulates by which a conversion between expressions from quantum and classical physics can be made. Conversions of well-known expressions from different areas of physics (quantum physics, gravitation, optics and cosmology) exemplify the approach and mathematical procedures. The postulated integer counts of fundamental measures change our understanding of length, suggesting that our current understanding of reality is distorted.展开更多
In conventional higher-order topological insulators(HOTIs),the emergence of topological states can be explained by using the nonzero bulk polarization index.However,corner states emerge in HOTIs with incomplete bounda...In conventional higher-order topological insulators(HOTIs),the emergence of topological states can be explained by using the nonzero bulk polarization index.However,corner states emerge in HOTIs with incomplete boundary unit cells(i.e.,boundary defects)even though the bulk polarization is zero,which challenges the conventional understanding of HOTIs.Here,based on a Kekul´e-distorted honeycomb lattice with incomplete unit cells,we reveal that incomplete unit cells exhibit fractional charges through the analysis of Wannier centers by developing a compensation method and creating the concept of Wannier center domain(WCD)which is the smallest region that one Wannier center occupies.This method compensates for the missing parts of these boundary incomplete unit cells with additional WCDs to make them complete.The compensated WCDs automatically carry the corresponding charge,and this charge together with that of the incomplete unit cell constitutes the total charge of the complete unit cell after compensation.We conclude that the emergence of corner states is attributed to the filling anomaly,which is a fundamental mechanism.Our results refresh the understanding of HOTIs,especially those with structural discontinuities,and provide a novel design for topological states which have application value in producing optical functional devices.展开更多
Safer,smarter,faster...In China,people prefer high-speed trains to flights if the journey time is under five hours.High-speed train travel is set to become even more attractive with the addition of a new member to the...Safer,smarter,faster...In China,people prefer high-speed trains to flights if the journey time is under five hours.High-speed train travel is set to become even more attractive with the addition of a new member to the high-speed train family:the CR450,the world’s fastest electric multiple unit(EMU).展开更多
On January 3,the United States launched a military operation against the sovereign nation of Venezuela.“capturing”its president,Nicolas Maduro.This event is far from a mere isolated"law enforcement operation&qu...On January 3,the United States launched a military operation against the sovereign nation of Venezuela.“capturing”its president,Nicolas Maduro.This event is far from a mere isolated"law enforcement operation";it represents a blatant challenge to the international legal system centered around the United Nations Charter and a thorough and dangerous trampling of the fundamental principles of intemmational relations.展开更多
BACKGROUND Mesenchymal stem cells(MSCs)are considered a promising therapy for various diseases due to their strong potential in regenerative medicine and immunomodulation.The tissue source of MSCs has gained attention...BACKGROUND Mesenchymal stem cells(MSCs)are considered a promising therapy for various diseases due to their strong potential in regenerative medicine and immunomodulation.The tissue source of MSCs has gained attention for its role in influencing their function,accessibility,and readiness for clinical use.AIM To identify the most suitable adipose source for MSC isolation and expansion for further applications.METHODS We isolated MSCs from solid adipose tissue and liposuction aspirates using the enzyme method.The MSCs were examined for their expansion using population doubling time,differentiation capacity using multilineage differentiation induction,surface markers using flow cytometry,and stability of chromosomes using the karyotyping method.Growth factors and cytokines in MSC-conditioned media were analyzed using the Luminex assay.RESULTS MSCs were isolated from solid adipose tissue and lipoaspirates and expanded from passage 0 to passage 2.All adipose-derived MSCs(AD-MSCs)exhibited the typical elongated,spindle-shaped morphology and comparable proliferation rate.They expressed positive surface markers(cluster of differentiation 73[CD73]:>97%,CD90:>98%,and CD105:>95%),and negative markers(<1%).All MSCs expressed similar levels of stemness genes(octamer-binding transcription factor 4,SRY-box 2,Krüppel-like factor,and MYC),colonyforming,and trilineage differentiation potential.Karyotyping analysis revealed normal chromosomal patterns in all samples,except one sample exhibiting a polymorphism(1qh+).Furthermore,the growth factors and cytokines of hepatocyte growth factor,vascular endothelial growth factor A,interleukin 6(IL-6),and IL-8 were detected in all AD-MSC conditioned media;but fibroblast growth factor-2 and keratinocyte growth factor were selectively expressed in conditioned media from solid or lipoaspirate AD-MSCs,respectively.CONCLUSION These findings indicate that AD-MSCs from both adipose sources possess all of the characteristic features of MSCs with source-specific secretome differences,which are suitable for further expansion and various clinical applications.展开更多
Dear Experts and Friends,Greetings to you all.It gives me great pleasure to join you again at the turn of the year to discuss the international situation and take stock of China’s foreign relations.The year 2025 mark...Dear Experts and Friends,Greetings to you all.It gives me great pleasure to join you again at the turn of the year to discuss the international situation and take stock of China’s foreign relations.The year 2025 marks the 80th anniversary of the victory of the World Anti-Fascist War and the founding of the United Nations.展开更多
Microelectromechanical systems(MEMS)technology has gained significant attention over the past decade for measuring inertial angular velocity.However,due to inherent complexity,MEMS gyroscopes typically feature up to t...Microelectromechanical systems(MEMS)technology has gained significant attention over the past decade for measuring inertial angular velocity.However,due to inherent complexity,MEMS gyroscopes typically feature up to ten times more parameters than traditional sensors,making selection a challenging task even for experts.This study addresses this challenge,focusing on defensive guidance,navigation,and control(GNC)systems where precise and reliable angular velocity measurement is critical to overall performance.A comprehensive mathematical model is introduced to encapsulate all key MEMS parameters,accompanied by discussions on calibration and Allan variance interpretation.For six leading MEMS gyroscope applications,namely inertial navigation,integrated navigation,autopilot systems,rotating projectiles,homing guidance,and north finding,the most critical parameters are identified,distinguishing suitable and unsuitable sensor choices.Special emphasis is placed on inertial navigation systems,where practical rules of thumb for error evaluation are derived using six degrees of freedom motion equations.Rigorous simulations demonstrate the influence of various sensor parameters through real-world case studies,including static navigation,multi-rotor attitude estimation,gimbal stabilization,and north finding via a turntable.This work aims to be a beacon for practitioners across diverse fields,empowering them to make more informed design decisions.展开更多
The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. Th...The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.展开更多
BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparosc...BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.展开更多
BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot program.Chron...BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot program.Chronic diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient outcomes.If proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid patients.AIM To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital care.METHODS The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.RESULTS The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.CONCLUSION This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary approach.The coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient complexity.The superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of care to be replicated.展开更多
The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,...The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,photovoltaic power generation is unstable and random,resulting in a low utilization rate and directly affecting the stability of the power grid.To solve this problem,this paper proposes a coordinated control strategy for a newenergy power generation system with a hybrid energy storage unit based on the lithium iron phosphate-supercapacitor hybrid energy storage unit.Firstly,the variational mode decomposition algorithm is used to separate the high and low frequencies of the power signal,which is conducive to the rapid and accurate suppression of the power fluctuation of the energy storage system.Secondly,the fuzzy control algorithm is introduced to balance the power between energy storage.In this paper,the actual data is used for simulation,and the simulation results show that the strategy realizes the effective suppression of the bus voltage fluctuation and the accurate control of the internal state of the energy storage unit,effectively avoiding problems such as overshoot and over-discharge,and can significantly improve the stability of the photovoltaic power generation systemand the stability of the Direct Current bus.It is of great significance to promote the development of collaborative control technology for photovoltaic hybrid energy storage units.展开更多
BACKGROUND: 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
BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
Management of patients with acute hemorrhage requires addressing the source of bleeding,replenishing blood volume,and addressing any coagulopathy that may be present.Assessing coagulopathy and predicting blood require...Management of patients with acute hemorrhage requires addressing the source of bleeding,replenishing blood volume,and addressing any coagulopathy that may be present.Assessing coagulopathy and predicting blood requirements in real-time in patients experiencing ongoing bleeding can pose substantial challenges.In these patients,transfusion concepts based on ratios do not effectively address coagulopathy or reduce mortality.Moreover,ratio-based concepts do not stop bleeding;instead,they just give physicians more time to identify the bleeding source and plan management strategies.In clinical practice,standard laboratory coagulation tests(SLCT)are frequently used to assess various aspects of blood clotting.However,these tests may not always offer a comprehensive under-standing of clinically significant coagulopathy and the severity of blood loss.Furthermore,the SLCT have a considerable turnaround time,which may not be ideal for making prompt clinical decisions.In recent years,there has been a growing interest in point-of-care viscoelastic assays like rotational thromboelast-ometry,which provide real-time,dynamic information about clot formation and dissolution.展开更多
BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’...BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.展开更多
Atrial fibrillation(AF)/atrial flutter(AFL)is the most common sustained cardiac arrhythmia.The known risk factors for developing AF/AFL include age,structural heart disease,hypertension,diabetes mellitus,or hyperthyro...Atrial fibrillation(AF)/atrial flutter(AFL)is the most common sustained cardiac arrhythmia.The known risk factors for developing AF/AFL include age,structural heart disease,hypertension,diabetes mellitus,or hyperthyroidism.This study aims to attribute the trends in AF/AFL-related mortalities over the past two decades 1999-2020 concerning race and sex and disparity among them.To the best of our knowledge,this is the first study that estimates the trends and mortality due to AF/AFL from 1999-2020 in older adults in the United States.In this 21-year analysis of mortality data,we found a constant increase in mortality rates due to AF/AFL in older adults.From 1999 to 2020,the overall mortality in older adults aged 65 and above,regardless of sex and race,is found to be almost doubled i.e.about a 50.2%increase in the number of deaths due to AF/AFL.Furthermore,other confounding risk factors such has obesity,prior myocardial infarction,inflammation,hypertension,birth weight,diabetes mellitus,hyperthyroidism,hormone replacement therapy in menopausal women increases the risk in the occurrence or recurrent occurrence of AF.展开更多
文摘Having all live in a better, more peaceful world has long been a dream of Kofi Annan, both during his 10-year service as sec- retary general of the UN and now. as chairman of the Kofi Annan Foundation. For this, Annan and the UN won the Nobel Peace Prize in 2001. To ＂make our world more harmonious, people-to-people understanding and cooperation is extremely impor- tant,＂ Kofi Annan told ChinAffica. ＂We often forget that there＇s more that unites us than divides us,＂ he said. In an exclusive inter- view during his recent visit to Beijing, he shared his views on issues of global importance. Edited excerpts of the interview follow
文摘1 Introduction In the United States, the largest groups of acupuncture or traditional Chinese medicine （TCM） practitioners settled and still remain in California and New York, as these two states historically have the largest, most concentrated Asian populations. The TCM practitioners originally worked in a legal gray-zone, sometimes even being treated as illegal practitioners by the local governments, since TCM licensing laws did not exist until late 1973[1]. The first legal acupuncture clinic was established in Washington, D.C. in 1972[2], but Nevada was the first state that passed a full practicing law for acupuncture and TCM[3]. Under- standing the legal history of acupuncture in the U.S. will help us to see the road ahead more clearly.
文摘Unifying quantum and classical physics has proved difficult as their postulates are conflicting. Using the notion of counts of the fundamental measures—length, mass, and time—a unifying description is resolved. A theoretical framework is presented in a set of postulates by which a conversion between expressions from quantum and classical physics can be made. Conversions of well-known expressions from different areas of physics (quantum physics, gravitation, optics and cosmology) exemplify the approach and mathematical procedures. The postulated integer counts of fundamental measures change our understanding of length, suggesting that our current understanding of reality is distorted.
基金supported by the Natural Science Basic Research Program of Shaanxi Province (Grant Nos.2024JC-JCQN-06 and2025JC-QYCX-006)the National Natural Science Foundation of China (Grant No.12474337)Chinese Academy of Sciences Project (Grant Nos.E4BA270100,E4Z127010F,E4Z6270100,and E53327020D)。
文摘In conventional higher-order topological insulators(HOTIs),the emergence of topological states can be explained by using the nonzero bulk polarization index.However,corner states emerge in HOTIs with incomplete boundary unit cells(i.e.,boundary defects)even though the bulk polarization is zero,which challenges the conventional understanding of HOTIs.Here,based on a Kekul´e-distorted honeycomb lattice with incomplete unit cells,we reveal that incomplete unit cells exhibit fractional charges through the analysis of Wannier centers by developing a compensation method and creating the concept of Wannier center domain(WCD)which is the smallest region that one Wannier center occupies.This method compensates for the missing parts of these boundary incomplete unit cells with additional WCDs to make them complete.The compensated WCDs automatically carry the corresponding charge,and this charge together with that of the incomplete unit cell constitutes the total charge of the complete unit cell after compensation.We conclude that the emergence of corner states is attributed to the filling anomaly,which is a fundamental mechanism.Our results refresh the understanding of HOTIs,especially those with structural discontinuities,and provide a novel design for topological states which have application value in producing optical functional devices.
文摘Safer,smarter,faster...In China,people prefer high-speed trains to flights if the journey time is under five hours.High-speed train travel is set to become even more attractive with the addition of a new member to the high-speed train family:the CR450,the world’s fastest electric multiple unit(EMU).
文摘On January 3,the United States launched a military operation against the sovereign nation of Venezuela.“capturing”its president,Nicolas Maduro.This event is far from a mere isolated"law enforcement operation";it represents a blatant challenge to the international legal system centered around the United Nations Charter and a thorough and dangerous trampling of the fundamental principles of intemmational relations.
文摘BACKGROUND Mesenchymal stem cells(MSCs)are considered a promising therapy for various diseases due to their strong potential in regenerative medicine and immunomodulation.The tissue source of MSCs has gained attention for its role in influencing their function,accessibility,and readiness for clinical use.AIM To identify the most suitable adipose source for MSC isolation and expansion for further applications.METHODS We isolated MSCs from solid adipose tissue and liposuction aspirates using the enzyme method.The MSCs were examined for their expansion using population doubling time,differentiation capacity using multilineage differentiation induction,surface markers using flow cytometry,and stability of chromosomes using the karyotyping method.Growth factors and cytokines in MSC-conditioned media were analyzed using the Luminex assay.RESULTS MSCs were isolated from solid adipose tissue and lipoaspirates and expanded from passage 0 to passage 2.All adipose-derived MSCs(AD-MSCs)exhibited the typical elongated,spindle-shaped morphology and comparable proliferation rate.They expressed positive surface markers(cluster of differentiation 73[CD73]:>97%,CD90:>98%,and CD105:>95%),and negative markers(<1%).All MSCs expressed similar levels of stemness genes(octamer-binding transcription factor 4,SRY-box 2,Krüppel-like factor,and MYC),colonyforming,and trilineage differentiation potential.Karyotyping analysis revealed normal chromosomal patterns in all samples,except one sample exhibiting a polymorphism(1qh+).Furthermore,the growth factors and cytokines of hepatocyte growth factor,vascular endothelial growth factor A,interleukin 6(IL-6),and IL-8 were detected in all AD-MSC conditioned media;but fibroblast growth factor-2 and keratinocyte growth factor were selectively expressed in conditioned media from solid or lipoaspirate AD-MSCs,respectively.CONCLUSION These findings indicate that AD-MSCs from both adipose sources possess all of the characteristic features of MSCs with source-specific secretome differences,which are suitable for further expansion and various clinical applications.
文摘Dear Experts and Friends,Greetings to you all.It gives me great pleasure to join you again at the turn of the year to discuss the international situation and take stock of China’s foreign relations.The year 2025 marks the 80th anniversary of the victory of the World Anti-Fascist War and the founding of the United Nations.
文摘Microelectromechanical systems(MEMS)technology has gained significant attention over the past decade for measuring inertial angular velocity.However,due to inherent complexity,MEMS gyroscopes typically feature up to ten times more parameters than traditional sensors,making selection a challenging task even for experts.This study addresses this challenge,focusing on defensive guidance,navigation,and control(GNC)systems where precise and reliable angular velocity measurement is critical to overall performance.A comprehensive mathematical model is introduced to encapsulate all key MEMS parameters,accompanied by discussions on calibration and Allan variance interpretation.For six leading MEMS gyroscope applications,namely inertial navigation,integrated navigation,autopilot systems,rotating projectiles,homing guidance,and north finding,the most critical parameters are identified,distinguishing suitable and unsuitable sensor choices.Special emphasis is placed on inertial navigation systems,where practical rules of thumb for error evaluation are derived using six degrees of freedom motion equations.Rigorous simulations demonstrate the influence of various sensor parameters through real-world case studies,including static navigation,multi-rotor attitude estimation,gimbal stabilization,and north finding via a turntable.This work aims to be a beacon for practitioners across diverse fields,empowering them to make more informed design decisions.
文摘The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.
文摘BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.
基金Supported by Fundación Progreso y Salud,No.AP-0306-2022-C3-F2.
文摘BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot program.Chronic diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient outcomes.If proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid patients.AIM To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital care.METHODS The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.RESULTS The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.CONCLUSION This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary approach.The coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient complexity.The superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of care to be replicated.
基金supported by the State Grid Corporation of China Science and Technology Project,grant number 52270723000900K.
文摘The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,photovoltaic power generation is unstable and random,resulting in a low utilization rate and directly affecting the stability of the power grid.To solve this problem,this paper proposes a coordinated control strategy for a newenergy power generation system with a hybrid energy storage unit based on the lithium iron phosphate-supercapacitor hybrid energy storage unit.Firstly,the variational mode decomposition algorithm is used to separate the high and low frequencies of the power signal,which is conducive to the rapid and accurate suppression of the power fluctuation of the energy storage system.Secondly,the fuzzy control algorithm is introduced to balance the power between energy storage.In this paper,the actual data is used for simulation,and the simulation results show that the strategy realizes the effective suppression of the bus voltage fluctuation and the accurate control of the internal state of the energy storage unit,effectively avoiding problems such as overshoot and over-discharge,and can significantly improve the stability of the photovoltaic power generation systemand the stability of the Direct Current bus.It is of great significance to promote the development of collaborative control technology for photovoltaic hybrid energy storage units.
文摘BACKGROUND: 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BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
文摘Management of patients with acute hemorrhage requires addressing the source of bleeding,replenishing blood volume,and addressing any coagulopathy that may be present.Assessing coagulopathy and predicting blood requirements in real-time in patients experiencing ongoing bleeding can pose substantial challenges.In these patients,transfusion concepts based on ratios do not effectively address coagulopathy or reduce mortality.Moreover,ratio-based concepts do not stop bleeding;instead,they just give physicians more time to identify the bleeding source and plan management strategies.In clinical practice,standard laboratory coagulation tests(SLCT)are frequently used to assess various aspects of blood clotting.However,these tests may not always offer a comprehensive under-standing of clinically significant coagulopathy and the severity of blood loss.Furthermore,the SLCT have a considerable turnaround time,which may not be ideal for making prompt clinical decisions.In recent years,there has been a growing interest in point-of-care viscoelastic assays like rotational thromboelast-ometry,which provide real-time,dynamic information about clot formation and dissolution.
文摘BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.
文摘Atrial fibrillation(AF)/atrial flutter(AFL)is the most common sustained cardiac arrhythmia.The known risk factors for developing AF/AFL include age,structural heart disease,hypertension,diabetes mellitus,or hyperthyroidism.This study aims to attribute the trends in AF/AFL-related mortalities over the past two decades 1999-2020 concerning race and sex and disparity among them.To the best of our knowledge,this is the first study that estimates the trends and mortality due to AF/AFL from 1999-2020 in older adults in the United States.In this 21-year analysis of mortality data,we found a constant increase in mortality rates due to AF/AFL in older adults.From 1999 to 2020,the overall mortality in older adults aged 65 and above,regardless of sex and race,is found to be almost doubled i.e.about a 50.2%increase in the number of deaths due to AF/AFL.Furthermore,other confounding risk factors such has obesity,prior myocardial infarction,inflammation,hypertension,birth weight,diabetes mellitus,hyperthyroidism,hormone replacement therapy in menopausal women increases the risk in the occurrence or recurrent occurrence of AF.
