A unitized regenerative fuel cell(URFC)is a device that may function reversibly as either a fuel cell(FC)or water elec-trolysis(WE).An important component of this device is the Membrane electrode assembly(MEA).Therefo...A unitized regenerative fuel cell(URFC)is a device that may function reversibly as either a fuel cell(FC)or water elec-trolysis(WE).An important component of this device is the Membrane electrode assembly(MEA).Therefore,this study aimed to compare the performance outcomes of MEA using electrodes with single and three catalyst layers.This study measured Electrochemical Surface Area(ECSA),Electrochemical Impedance Spectroscopy(EIS),X-ray Diffraction analysis(XRD),and X-ray Fluorescence(XRF).Furthermore,the round-trip efficiency(RTE)of the MEA,as w ell as the performance in FC and WE mode,was measured.In comparison,The ECSA values of Pt-Ru/C and Pt/C with three catalyst layers were higher than the single catalyst layer.This result was supported by electrode characterization data for XRD and XRF.The respective electrical conductivity values of Pt-Ru/C and Pt/C with three catalyst layers are also higher than the single cata-lyst layer,and the performance of URFC using MEA with three catalyst layers has the highest value of RTE among the MEA performances of URFC,which is 100%at a current density of 4 mA·cm-2.展开更多
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
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
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
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
BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA...BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.展开更多
Recently,one of the main challenges facing the smart grid is insufficient computing resources and intermittent energy supply for various distributed components(such as monitoring systems for renewable energy power sta...Recently,one of the main challenges facing the smart grid is insufficient computing resources and intermittent energy supply for various distributed components(such as monitoring systems for renewable energy power stations).To solve the problem,we propose an energy harvesting based task scheduling and resource management framework to provide robust and low-cost edge computing services for smart grid.First,we formulate an energy consumption minimization problem with regard to task offloading,time switching,and resource allocation for mobile devices,which can be decoupled and transformed into a typical knapsack problem.Then,solutions are derived by two different algorithms.Furthermore,we deploy renewable energy and energy storage units at edge servers to tackle intermittency and instability problems.Finally,we design an energy management algorithm based on sampling average approximation for edge computing servers to derive the optimal charging/discharging strategies,number of energy storage units,and renewable energy utilization.The simulation results show the efficiency and superiority of our proposed framework.展开更多
Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribu...Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.展开更多
Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluct...Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluctuation caused by new energy units,this paper proposes a new energy power system frequency regulation strategy with multiple units including the doubly-fed pumped storage unit(DFPSU).Firstly,based on the model predictive control(MPC)theory,the state space equations are established by considering the operating characteristics of the units and the dynamic behavior of the system;secondly,the proportional-differential control link is introduced to minimize the frequency deviation to further optimize the frequency modulation(FM)output of the DFPSU and inhibit the rapid fluctuation of the frequency;lastly,it is verified on theMatlab/Simulink simulation platform,and the results show that the model predictive control with proportional-differential control link can further release the FM potential of the DFPSU,increase the depth of its FM,effectively reduce the frequency deviation of the system and its rate of change,realize the optimization of the active output of the DFPSU and that of other units,and improve the frequency response capability of the system.展开更多
This article introduces a novel 20 V radiation-hardened high-voltage metal-oxide-semiconductor field-effect transistor(MOSFET)driver with an optimized input circuit and a drain-surrounding-source(DSS)structure.The inp...This article introduces a novel 20 V radiation-hardened high-voltage metal-oxide-semiconductor field-effect transistor(MOSFET)driver with an optimized input circuit and a drain-surrounding-source(DSS)structure.The input circuit of a conventional inverter consists of a thick-gate-oxide n-type MOSFET(NMOS).These conventional drivers can tolerate a total ionizing dose(TID)of up to 100 krad(Si).In contrast,the proposed comparator input circuit uses both a thick-gate-oxide p-type MOSFET(PMOS)and thin-gate-oxide NMOS to offer a high input voltage and higher TID tolerance.Because the thick-gate-oxide PMOS and thin-gate-oxide NMOS collectively provide better TID tolerance than the thick-gate-oxide NMOS,the circuit exhibits enhanced TID tolerance of>300 krad(Si).Simulations and experimental date indicate that the DSS structure reduces the probability of unwanted parasitic bipolar junction transistor activation,yielding a better single-event effect tolerance of over 81.8 MeVcm^(2)mg^(-1).The innovative strategy proposed in this study involves circuit and layout design optimization,and does not require any specialized process flow.Hence,the proposed circuit can be manufactured using common commercial 0.35μm BCD processes.展开更多
In recent years,train-tail swaying of 160 km/h electric multiple units(EMUs)inside single-line tunnels has been heavily researched,because the issue needs to be solved urgently.In this paper,a co-simulation model of v...In recent years,train-tail swaying of 160 km/h electric multiple units(EMUs)inside single-line tunnels has been heavily researched,because the issue needs to be solved urgently.In this paper,a co-simulation model of vortex-induced vibration(VIV)of the tail car body is established,and the aerodynamics of train-tail swaying is studied.The simulation results were confirmed through a field test of operating EMUs.Furthermore,the influence mechanism of train-tail swaying on the wake flow field is studied in detail through a wind-tunnel experiment and a simulation of a reduced-scaled train model.The results demonstrate that the aerodynamic force frequency(i.e.,vortex-induced frequency)of the train tail increases linearly with train speed.When the train runs at 130 km/h,with a small amplitude of train-tail swaying(within 10 mm),the vortex-induced frequency is 1.7 Hz,which primarily depends on the nose shape of the train tail.After the tail car body nose is extended,the vortex-induced frequency is decreased.As the swaying amplitude of the train tail increases(exceeding 25 mm),the separation point of the high-intensity vortex in the train wake shifts downstream to the nose tip,and the vortex-induced frequency shifts from 1.7 Hz to the nearby car body hunting(i.e.,the primary hunting)frequency of 1.3 Hz,which leads to the frequency-locking phenomenon of VIV,and the resonance intensifies train-tail swaying.For the motor vehicle of the train tail,optimization of the yaw damper to improve its primary hunting stability can effectively alleviate train-tail swaying inside single-line tunnels.Optimization of the tail car body nose shape reduces the amplitude of the vortex-induced force,thereby weakening the aerodynamic effect and solving the problem of train-tail swaying inside the single-line tunnels.展开更多
BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevanc...BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains uncertain.AIM To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic shock.METHODS In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were analyzed.Patients were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with normonatremia.Moreover,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of IAH.Notably,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the ICU.It is highly recommended that hypernatremia be considered a potentially important prognostic indicator for the outcome of septic shock.展开更多
基金support from the Ministry of Higher Education Malaysia under grant HICOE-2023-005.
文摘A unitized regenerative fuel cell(URFC)is a device that may function reversibly as either a fuel cell(FC)or water elec-trolysis(WE).An important component of this device is the Membrane electrode assembly(MEA).Therefore,this study aimed to compare the performance outcomes of MEA using electrodes with single and three catalyst layers.This study measured Electrochemical Surface Area(ECSA),Electrochemical Impedance Spectroscopy(EIS),X-ray Diffraction analysis(XRD),and X-ray Fluorescence(XRF).Furthermore,the round-trip efficiency(RTE)of the MEA,as w ell as the performance in FC and WE mode,was measured.In comparison,The ECSA values of Pt-Ru/C and Pt/C with three catalyst layers were higher than the single catalyst layer.This result was supported by electrode characterization data for XRD and XRF.The respective electrical conductivity values of Pt-Ru/C and Pt/C with three catalyst layers are also higher than the single cata-lyst layer,and the performance of URFC using MEA with three catalyst layers has the highest value of RTE among the MEA performances of URFC,which is 100%at a current density of 4 mA·cm-2.
文摘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.
文摘BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.
基金supported in part by the National Natural Science Foundation of China under Grant No.61473066in part by the Natural Science Foundation of Hebei Province under Grant No.F2021501020+2 种基金in part by the S&T Program of Qinhuangdao under Grant No.202401A195in part by the Science Research Project of Hebei Education Department under Grant No.QN2025008in part by the Innovation Capability Improvement Plan Project of Hebei Province under Grant No.22567637H
文摘Recently,one of the main challenges facing the smart grid is insufficient computing resources and intermittent energy supply for various distributed components(such as monitoring systems for renewable energy power stations).To solve the problem,we propose an energy harvesting based task scheduling and resource management framework to provide robust and low-cost edge computing services for smart grid.First,we formulate an energy consumption minimization problem with regard to task offloading,time switching,and resource allocation for mobile devices,which can be decoupled and transformed into a typical knapsack problem.Then,solutions are derived by two different algorithms.Furthermore,we deploy renewable energy and energy storage units at edge servers to tackle intermittency and instability problems.Finally,we design an energy management algorithm based on sampling average approximation for edge computing servers to derive the optimal charging/discharging strategies,number of energy storage units,and renewable energy utilization.The simulation results show the efficiency and superiority of our proposed framework.
基金supported in part by the National Nat-ural Science Foundation of China(52177110)Key Pro-gram of the National Natural Science Foundation of China(U22B20106,U2142206)+2 种基金Shenzhen Science and Technology Program(JCYJ20210324131409026)the Science and Technology Project of the State Grid Corpo-ration of China(5200-202319382A-2-3-XG)State Grid Zhejiang Elctric Power Co.,Ltd.Science and Tech-nology Project(B311DS24001A).
文摘Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.
基金supported by the National Natural Science Foundation of China(Project No.52377082)the Scientific Research Program of Jilin Provincial Department of Education(Project No.JJKH20230123KJ).
文摘Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluctuation caused by new energy units,this paper proposes a new energy power system frequency regulation strategy with multiple units including the doubly-fed pumped storage unit(DFPSU).Firstly,based on the model predictive control(MPC)theory,the state space equations are established by considering the operating characteristics of the units and the dynamic behavior of the system;secondly,the proportional-differential control link is introduced to minimize the frequency deviation to further optimize the frequency modulation(FM)output of the DFPSU and inhibit the rapid fluctuation of the frequency;lastly,it is verified on theMatlab/Simulink simulation platform,and the results show that the model predictive control with proportional-differential control link can further release the FM potential of the DFPSU,increase the depth of its FM,effectively reduce the frequency deviation of the system and its rate of change,realize the optimization of the active output of the DFPSU and that of other units,and improve the frequency response capability of the system.
基金supported by the National Natural Science Foundation of China(U2241221).
文摘This article introduces a novel 20 V radiation-hardened high-voltage metal-oxide-semiconductor field-effect transistor(MOSFET)driver with an optimized input circuit and a drain-surrounding-source(DSS)structure.The input circuit of a conventional inverter consists of a thick-gate-oxide n-type MOSFET(NMOS).These conventional drivers can tolerate a total ionizing dose(TID)of up to 100 krad(Si).In contrast,the proposed comparator input circuit uses both a thick-gate-oxide p-type MOSFET(PMOS)and thin-gate-oxide NMOS to offer a high input voltage and higher TID tolerance.Because the thick-gate-oxide PMOS and thin-gate-oxide NMOS collectively provide better TID tolerance than the thick-gate-oxide NMOS,the circuit exhibits enhanced TID tolerance of>300 krad(Si).Simulations and experimental date indicate that the DSS structure reduces the probability of unwanted parasitic bipolar junction transistor activation,yielding a better single-event effect tolerance of over 81.8 MeVcm^(2)mg^(-1).The innovative strategy proposed in this study involves circuit and layout design optimization,and does not require any specialized process flow.Hence,the proposed circuit can be manufactured using common commercial 0.35μm BCD processes.
基金supported by the National Natural Science Foundation of China(Nos.52372403 and U2268211)the Natural Science Foundation of Sichuan Province(No.2022NSFSC0034),China+1 种基金the National Railway Group Science and Technology Program(No.2023J071)the Traction Power State Key Laboratory of the Independent Research and Development Projects(No.2022TPL-T02),China.
文摘In recent years,train-tail swaying of 160 km/h electric multiple units(EMUs)inside single-line tunnels has been heavily researched,because the issue needs to be solved urgently.In this paper,a co-simulation model of vortex-induced vibration(VIV)of the tail car body is established,and the aerodynamics of train-tail swaying is studied.The simulation results were confirmed through a field test of operating EMUs.Furthermore,the influence mechanism of train-tail swaying on the wake flow field is studied in detail through a wind-tunnel experiment and a simulation of a reduced-scaled train model.The results demonstrate that the aerodynamic force frequency(i.e.,vortex-induced frequency)of the train tail increases linearly with train speed.When the train runs at 130 km/h,with a small amplitude of train-tail swaying(within 10 mm),the vortex-induced frequency is 1.7 Hz,which primarily depends on the nose shape of the train tail.After the tail car body nose is extended,the vortex-induced frequency is decreased.As the swaying amplitude of the train tail increases(exceeding 25 mm),the separation point of the high-intensity vortex in the train wake shifts downstream to the nose tip,and the vortex-induced frequency shifts from 1.7 Hz to the nearby car body hunting(i.e.,the primary hunting)frequency of 1.3 Hz,which leads to the frequency-locking phenomenon of VIV,and the resonance intensifies train-tail swaying.For the motor vehicle of the train tail,optimization of the yaw damper to improve its primary hunting stability can effectively alleviate train-tail swaying inside single-line tunnels.Optimization of the tail car body nose shape reduces the amplitude of the vortex-induced force,thereby weakening the aerodynamic effect and solving the problem of train-tail swaying inside the single-line tunnels.
基金Supported by The National Natural Science Foundation of China,No.82072130Key Medical Research Projects in Jiangsu Province,No.ZD2022021Suzhou Clinical Medical Center for Anesthesiology,No.Szlcyxzxj202102。
文摘BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains uncertain.AIM To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic shock.METHODS In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were analyzed.Patients were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with normonatremia.Moreover,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of IAH.Notably,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the ICU.It is highly recommended that hypernatremia be considered a potentially important prognostic indicator for the outcome of septic shock.
