In this paper,we study the uniqueness of positive solutions to the following semilinear equations{-Δu=λ|x|^(α)ue^(u^(2)),in B_(1),u=0,onδB_(1)ueu2;in B_(1);u=0;on@B_(1);whereλ>0,α>-2;B_(1)denotes the unit ...In this paper,we study the uniqueness of positive solutions to the following semilinear equations{-Δu=λ|x|^(α)ue^(u^(2)),in B_(1),u=0,onδB_(1)ueu2;in B_(1);u=0;on@B_(1);whereλ>0,α>-2;B_(1)denotes the unit disk in R^(2):By delicate and relatively complicated computation of radial solutions to the above equation and the asymptotic expansion of solutions near the boundary of B_(1),the uniqueness of positive solutions is obtained.The results of this paper extend the uniqueness result for the semilinear equation with critical exponential growth in CHEN et al.(2022)to the case that includes a Henon term.展开更多
To ensure the safe transportation of radioactive materials,numerous countries have established specific standards.For the transfer of fissile materials,it is imperative that the material within the packaging remains i...To ensure the safe transportation of radioactive materials,numerous countries have established specific standards.For the transfer of fissile materials,it is imperative that the material within the packaging remains in a subcritical state during routine,normal,and accidental transport conditions.In the event of an accident,the rods within the storage tank may become rearranged,introducing uncertainty that must be accounted for to ensure that criticality analysis results are conservative.Historically,this uncertainty was addressed overly conservatively due to limited research on non-uniform arrangement scenarios,which proved unsuitable for criticality safety analysis of spent fuel packages.This paper introduced three distinct methods to non-uniformly rearrange fuel rods—Uniform Arrangement by Blocks,Layer-by-Layer Determination,and Birdcage Deformation—and meticulously evaluates the influences of rod rearrangement on the effective multiplication factor of neutrons,k eff,utilizing the Monte Carlo method.Ultimately,this study presents a holistic method capable of encompassing the entire spectrum of potential effects stemming from the rearrangement of fuel rods during rods mispositioning accident.By augmenting the safety margin,this approach proves to be adeptly suited for the criticality safety analysis of nuclear fuel transport containers.展开更多
The Kibble-Zurek (KZ) effect offers an overarching description of dynamical scaling behavior near a critical point.[1,2] Originally proposed in a classical setup,the KZ effect has been generalized to quantum phase tra...The Kibble-Zurek (KZ) effect offers an overarching description of dynamical scaling behavior near a critical point.[1,2] Originally proposed in a classical setup,the KZ effect has been generalized to quantum phase transitions[3-5] and is actively explored on quantum simulation platforms.[6-9] Exploring how the KZ effect fares across different criticalities has proven to be a rewarding pursuit,significantly enriching our understanding of nonequilibrium quantum dynamics.[3-5,10-23]展开更多
BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring except...BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.展开更多
The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into...The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into its connection with the higher order thinking skills of human beings.The purpose of this systematic review is to investigate the relationship between AI utilization and the development of critical thinking(CT)in the field of education.A systematic literature search was performed in two databases,Web of Science and Scopus,with a focus on empirical studies related to AI and CT.The review process followed the PRISMA framework and adopted a bottom-up approach,Ultimately,the integrated review synthesized 21 eligible studies from a total of 649 articles.The systematic review identified three relationships between AI technologies and CT.The results suggest that AI technologies can help to enhance learners’CT skills(n=13).However,excessive or inappropriate utilization of AI may hinder CT development(n=7).Moreover,the cultivation of CT skills has been shown to positively influence the effectiveness of AI utilization(n=4).This article represents the first literature review to delve into the reciprocal relationship between AI implementation and CT development within the education field,striving to illuminate the ways in which learners can enhance their higher-order thinking skills through more effective utilization of AI technologies.展开更多
Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS)...Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS),microglia display a unique molecular homeostatic signature(i.e.,Tmem119,P2ry12,Sall1,Siglech,Gpr34,and Hexb)(Figure 1A).展开更多
Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypog...Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypoglycemia,classified as level 1 hypoglycemia,is defined by blood glucose levels below 70 mg/dL and can be effectively addressed through carbohydrate intake.Severe hypoglycemia,denoted by blood glucose levels less than 54 mg/dL,poses a life-threatening risk if left untreated.Individuals with type 1 and type 2 diabetes undergoing insulin treatment are particularly susceptible to hypoglycemia due to impaired counterregulatory mechanisms.展开更多
BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological ...BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.展开更多
Objectives:Nurses working in critical care units may encounter substantial work-related strain,and elevated levels of stress can lead to burnout,ultimately impacting both the quality of nursing care and their overall ...Objectives:Nurses working in critical care units may encounter substantial work-related strain,and elevated levels of stress can lead to burnout,ultimately impacting both the quality of nursing care and their overall working experience.This study aimed to assess job burnout and determine the factors that contribute to it among critical care nurses in the Eastern Province of Saudi Arabia.Methods:This study employed a descriptive,exploratory,cross-sectional research design.A total of 220 nurses employed in the critical care units of 5 private hospitals in the eastern region were selected for participation in this study using a convenience sample method.An electronic survey was distributed to critical care nurses in the Eastern Province who satisfied the specified inclusion criteria.The job burnout questionnaire utilized in this study was derived from previously conducted research,which has been established as a reliable and valid survey instrument.The process of data analysis was conducted utilizing the SPSS program.The scientific research conducted on human subjects adhered rigorously to all ethical considerations.Results:The highest percentage of nurses at the critical care units reported experiencing moderate levels of job burnout.Nurses exhibiting greater levels of professional experience demonstrated a statistically significant reduction in overall burnout scores when compared to their less experienced counterparts.Furthermore,within the realm of sociodemographic factors,it was found that the only significant independent predictor for job burnout was the level of experience among critical care nurses.Conclusions:The prevalence of burnout among nurses in critical care settings was found to be significant,with most participants reporting moderate levels of burnout which can yield significant ramifications for nurses and healthcare professionals.Consequently,healthcare organizations must accord primacy to the welfare of their staff and adopt proactive strategies to mitigate job burnout.展开更多
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
With the increasingly prominent trend of globalization,English,as the common language of international communication,plays an increasingly important role in university education.As a key link in English teaching,the c...With the increasingly prominent trend of globalization,English,as the common language of international communication,plays an increasingly important role in university education.As a key link in English teaching,the college English audio-visual oral course not only imparts language knowledge and skills,but also shoulders the important task of cultivating students’critical thinking.As one of the essential core qualities of modern talents,critical thinking ability plays an irreplaceable role in students’in-depth understanding of English knowledge,improving intercultural communication ability and cultivating innovative thinking.This paper expounds the significance of cultivating students’critical thinking ability in college English audio-visual and oral teaching,and puts forward a series of innovative teaching strategies to cultivate students’critical thinking ability combined with practical teaching experience and cutting-edge education theory,in order to provide new ideas and practical guidance for the improvement of college English teaching quality and the development of students’comprehensive quality.展开更多
Based on the investigation of mechanical response and microstructure evolution of a commercial 7003 aluminum alloy under high-speed impact,a new simple and effective method was proposed to determine the critical strai...Based on the investigation of mechanical response and microstructure evolution of a commercial 7003 aluminum alloy under high-speed impact,a new simple and effective method was proposed to determine the critical strain required for the nucleation of adiabatic shear band(ASB).The deformation results of cylindrical and hat-shaped samples show that the critical strain required for ASB nucleation corresponds to the strain at the first local minimum after peak stress on the first derivative curve of true stress−true strain.The method of determining the critical strain for the nucleation of ASB through the first derivative of the flow stress curve is named the first derivative method.The proposed first derivative method is not only applicable to the 7003 aluminum alloy,but also to other metal materials,such as commercial purity titanium,WY-100 steel,and AM80 magnesium alloy.This proves that it has strong universality.展开更多
Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and ...Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and flammability,causing a spectrum of hazards to human health and environmental safety.Neoteric solvents have been recognized as potential alternatives to these harmful organic solvents.In the past two decades,several neoteric solvents have been proposed,including ionic liquids(ILs)and deep eutectic solvents(DESs).DESs have gradually become the focus of green solvents owing to several advantages,namely,low toxicity,degradability,and low cost.In this critical review,their classification,formation mechanisms,preparation methods,characterization technologies,and special physicochemical properties based on the most recent advancements in research have been systematically described.Subsequently,the major separation and purification applications of DESs in critical metal metallurgy were comprehensively summarized.Finally,future opportunities and challenges of DESs were explored in the current research area.In conclusion,this review provides valuable insights for improving our overall understanding of DESs,and it holds important potential for expanding separation and purification applications in critical metal metallurgy.展开更多
This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the au...This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the authors for their comprehensive study design and execution,which included a clear delineation of study groups and a robust set of outcome measures.We suggest that future studies incorporate additional biomarkers,such as serum levels of liver enzymes and bilirubin,to provide a more nuanced understanding of liver function changes post-intervention.The study's focus on short-term survival rates is appreciated,but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes.Additionally,the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes.From a critical care perspective,we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications.We believe that incor-porating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes,influ-encing future clinical guidelines and practice.展开更多
BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effec...BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.展开更多
Given two graphs G and H,the Ramsey number R(G,H)is the smallest positive integer N such that every 2-coloring of the edges of K_(N)contains either a red G or a blue H.Let K_(N-1)■K_(1,k)be the graph obtained from K_...Given two graphs G and H,the Ramsey number R(G,H)is the smallest positive integer N such that every 2-coloring of the edges of K_(N)contains either a red G or a blue H.Let K_(N-1)■K_(1,k)be the graph obtained from K_(N-1)by adding anew vertexνconnecting k vertices of K_(N-1).A graph G withχ(G)=k+1 is called edge-critical if G contains an edge e such thatχ(G-e)=k.A considerable amount of research has been conducted by previous scholars on Ramsey numbers ofgraphs.In this study,we show that for an edge-critical graph G with x(G)=k+1,when k≥2,1≥2,and n is sufficiently large,R(G,K_(1)+nK_(t))=knt+1 and r,(G,K_(1)+nK_(t))=(k-1)nt+1.展开更多
Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic ...Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.展开更多
Objective:To describe the effects of an early mobilization program in a critically ill patient with acquired muscle weakness in the intensive care unit(AMWICU).Methods:Case report of a 65-year-old male diagnosed with ...Objective:To describe the effects of an early mobilization program in a critically ill patient with acquired muscle weakness in the intensive care unit(AMWICU).Methods:Case report of a 65-year-old male diagnosed with pneumoperitoneum,septic shock,and multiple organ dysfunction.The patient underwent an early mobilization program between 13th and 30th of June 2022,based on expert consensus on safety criteria for mobilization in critically ill patients.The intervention was delivered by a rehabilitation nursing team.Results:The early mobilization program contributed to improvements in muscle strength,body mobility,and functional independence in the critically ill patient.Conclusions:Although there is no consensus on the ideal type,timing,or intensity of early mobilization in critically ill patients,this case study suggests that individualized early mobilization may promote functional recovery and should be considered in intensive care settings.展开更多
The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly recognised.Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promis...The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly recognised.Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise.While changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain uncertain.Dietary fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI microbiota.The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical illness.Randomised controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were identified.Studies show dietary fibres have an impact on faecal microbiota in health and disease.The fibre,inulin,has a marked and specific effect on increasing the abundance of faecal Bifidobacteria.Short chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient populations.Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness.More research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.展开更多
The NIST Cybersecurity Framework (NIST CSF) serves as a voluntary guideline aimed at helping organizations, tiny and medium-sized enterprises (SMEs), and critical infrastructure operators, effectively manage cyber ris...The NIST Cybersecurity Framework (NIST CSF) serves as a voluntary guideline aimed at helping organizations, tiny and medium-sized enterprises (SMEs), and critical infrastructure operators, effectively manage cyber risks. Although comprehensive, the complexity of the NIST CSF can be overwhelming, especially for those lacking extensive cybersecurity resources. Current implementation tools often cater to larger companies, neglecting the specific needs of SMEs, which can be vulnerable to cyber threats. To address this gap, our research proposes a user-friendly, open-source web platform designed to simplify the implementation of the NIST CSF. This platform enables organizations to assess their risk exposure and continuously monitor their cybersecurity maturity through tailored recommendations based on their unique profiles. Our methodology includes a literature review of existing tools and standards, followed by a description of the platform’s design and architecture. Initial tests with SMEs in Burkina Faso reveal a concerning cybersecurity maturity level, indicating the urgent need for improved strategies based on our findings. By offering an intuitive interface and cross-platform accessibility, this solution aims to empower organizations to enhance their cybersecurity resilience in an evolving threat landscape. The article concludes with discussions on the practical implications and future enhancements of the tool.展开更多
基金Supported by the Natural Science Foundation of China(12571122,12061010)。
文摘In this paper,we study the uniqueness of positive solutions to the following semilinear equations{-Δu=λ|x|^(α)ue^(u^(2)),in B_(1),u=0,onδB_(1)ueu2;in B_(1);u=0;on@B_(1);whereλ>0,α>-2;B_(1)denotes the unit disk in R^(2):By delicate and relatively complicated computation of radial solutions to the above equation and the asymptotic expansion of solutions near the boundary of B_(1),the uniqueness of positive solutions is obtained.The results of this paper extend the uniqueness result for the semilinear equation with critical exponential growth in CHEN et al.(2022)to the case that includes a Henon term.
文摘To ensure the safe transportation of radioactive materials,numerous countries have established specific standards.For the transfer of fissile materials,it is imperative that the material within the packaging remains in a subcritical state during routine,normal,and accidental transport conditions.In the event of an accident,the rods within the storage tank may become rearranged,introducing uncertainty that must be accounted for to ensure that criticality analysis results are conservative.Historically,this uncertainty was addressed overly conservatively due to limited research on non-uniform arrangement scenarios,which proved unsuitable for criticality safety analysis of spent fuel packages.This paper introduced three distinct methods to non-uniformly rearrange fuel rods—Uniform Arrangement by Blocks,Layer-by-Layer Determination,and Birdcage Deformation—and meticulously evaluates the influences of rod rearrangement on the effective multiplication factor of neutrons,k eff,utilizing the Monte Carlo method.Ultimately,this study presents a holistic method capable of encompassing the entire spectrum of potential effects stemming from the rearrangement of fuel rods during rods mispositioning accident.By augmenting the safety margin,this approach proves to be adeptly suited for the criticality safety analysis of nuclear fuel transport containers.
文摘The Kibble-Zurek (KZ) effect offers an overarching description of dynamical scaling behavior near a critical point.[1,2] Originally proposed in a classical setup,the KZ effect has been generalized to quantum phase transitions[3-5] and is actively explored on quantum simulation platforms.[6-9] Exploring how the KZ effect fares across different criticalities has proven to be a rewarding pursuit,significantly enriching our understanding of nonequilibrium quantum dynamics.[3-5,10-23]
文摘BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.
基金funded by Macao Polytechnic University grant number RP/FCA-08-2023.
文摘The advancement of Artificial Intelligence(AI)has garnered significant attention within the academic research community,reflecting the prevailing zeitgeist.However,there is a paucity of literature that has delved into its connection with the higher order thinking skills of human beings.The purpose of this systematic review is to investigate the relationship between AI utilization and the development of critical thinking(CT)in the field of education.A systematic literature search was performed in two databases,Web of Science and Scopus,with a focus on empirical studies related to AI and CT.The review process followed the PRISMA framework and adopted a bottom-up approach,Ultimately,the integrated review synthesized 21 eligible studies from a total of 649 articles.The systematic review identified three relationships between AI technologies and CT.The results suggest that AI technologies can help to enhance learners’CT skills(n=13).However,excessive or inappropriate utilization of AI may hinder CT development(n=7).Moreover,the cultivation of CT skills has been shown to positively influence the effectiveness of AI utilization(n=4).This article represents the first literature review to delve into the reciprocal relationship between AI implementation and CT development within the education field,striving to illuminate the ways in which learners can enhance their higher-order thinking skills through more effective utilization of AI technologies.
基金supported by NIH grants(R01NS125074,R01AG083164,and R21NS127177)(to YL).
文摘Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS),microglia display a unique molecular homeostatic signature(i.e.,Tmem119,P2ry12,Sall1,Siglech,Gpr34,and Hexb)(Figure 1A).
基金generously supported by the faculty startup funds from Auburn University at Montgomery (to SSVPS)。
文摘Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypoglycemia,classified as level 1 hypoglycemia,is defined by blood glucose levels below 70 mg/dL and can be effectively addressed through carbohydrate intake.Severe hypoglycemia,denoted by blood glucose levels less than 54 mg/dL,poses a life-threatening risk if left untreated.Individuals with type 1 and type 2 diabetes undergoing insulin treatment are particularly susceptible to hypoglycemia due to impaired counterregulatory mechanisms.
基金Supported by Beijing Ditan Hospital Affiliated to Capital Medical University“Sailing Plan”,No.DTQH-202405.
文摘BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.
文摘Objectives:Nurses working in critical care units may encounter substantial work-related strain,and elevated levels of stress can lead to burnout,ultimately impacting both the quality of nursing care and their overall working experience.This study aimed to assess job burnout and determine the factors that contribute to it among critical care nurses in the Eastern Province of Saudi Arabia.Methods:This study employed a descriptive,exploratory,cross-sectional research design.A total of 220 nurses employed in the critical care units of 5 private hospitals in the eastern region were selected for participation in this study using a convenience sample method.An electronic survey was distributed to critical care nurses in the Eastern Province who satisfied the specified inclusion criteria.The job burnout questionnaire utilized in this study was derived from previously conducted research,which has been established as a reliable and valid survey instrument.The process of data analysis was conducted utilizing the SPSS program.The scientific research conducted on human subjects adhered rigorously to all ethical considerations.Results:The highest percentage of nurses at the critical care units reported experiencing moderate levels of job burnout.Nurses exhibiting greater levels of professional experience demonstrated a statistically significant reduction in overall burnout scores when compared to their less experienced counterparts.Furthermore,within the realm of sociodemographic factors,it was found that the only significant independent predictor for job burnout was the level of experience among critical care nurses.Conclusions:The prevalence of burnout among nurses in critical care settings was found to be significant,with most participants reporting moderate levels of burnout which can yield significant ramifications for nurses and healthcare professionals.Consequently,healthcare organizations must accord primacy to the welfare of their staff and adopt proactive strategies to mitigate job burnout.
文摘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.
基金A Study on the Teaching Reform of College English Audio-Visual Oral Course Oriented towards the Cultivation of Critical Thinking Ability(2501032339)。
文摘With the increasingly prominent trend of globalization,English,as the common language of international communication,plays an increasingly important role in university education.As a key link in English teaching,the college English audio-visual oral course not only imparts language knowledge and skills,but also shoulders the important task of cultivating students’critical thinking.As one of the essential core qualities of modern talents,critical thinking ability plays an irreplaceable role in students’in-depth understanding of English knowledge,improving intercultural communication ability and cultivating innovative thinking.This paper expounds the significance of cultivating students’critical thinking ability in college English audio-visual and oral teaching,and puts forward a series of innovative teaching strategies to cultivate students’critical thinking ability combined with practical teaching experience and cutting-edge education theory,in order to provide new ideas and practical guidance for the improvement of college English teaching quality and the development of students’comprehensive quality.
基金National Natural Science Foundation of China (No. U20A20275)Natural Science Foundation of Hunan Province,China (No. 2021JJ40096)。
文摘Based on the investigation of mechanical response and microstructure evolution of a commercial 7003 aluminum alloy under high-speed impact,a new simple and effective method was proposed to determine the critical strain required for the nucleation of adiabatic shear band(ASB).The deformation results of cylindrical and hat-shaped samples show that the critical strain required for ASB nucleation corresponds to the strain at the first local minimum after peak stress on the first derivative curve of true stress−true strain.The method of determining the critical strain for the nucleation of ASB through the first derivative of the flow stress curve is named the first derivative method.The proposed first derivative method is not only applicable to the 7003 aluminum alloy,but also to other metal materials,such as commercial purity titanium,WY-100 steel,and AM80 magnesium alloy.This proves that it has strong universality.
基金financially supported by the Original Exploration Project of the National Natural Science Foundation of China(No.52150079)the National Natural Science Foundation of China(Nos.U22A20130,U2004215,and 51974280)+1 种基金the Natural Science Foundation of Henan Province of China(No.232300421196)the Project of Zhongyuan Critical Metals Laboratory of China(Nos.GJJSGFYQ202304,GJJSGFJQ202306,GJJSGFYQ202323,GJJSGFYQ202308,and GJJSGFYQ202307)。
文摘Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and flammability,causing a spectrum of hazards to human health and environmental safety.Neoteric solvents have been recognized as potential alternatives to these harmful organic solvents.In the past two decades,several neoteric solvents have been proposed,including ionic liquids(ILs)and deep eutectic solvents(DESs).DESs have gradually become the focus of green solvents owing to several advantages,namely,low toxicity,degradability,and low cost.In this critical review,their classification,formation mechanisms,preparation methods,characterization technologies,and special physicochemical properties based on the most recent advancements in research have been systematically described.Subsequently,the major separation and purification applications of DESs in critical metal metallurgy were comprehensively summarized.Finally,future opportunities and challenges of DESs were explored in the current research area.In conclusion,this review provides valuable insights for improving our overall understanding of DESs,and it holds important potential for expanding separation and purification applications in critical metal metallurgy.
文摘This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice(MOJ)by offering constructive feedback and suggestions for future research.We commend the authors for their comprehensive study design and execution,which included a clear delineation of study groups and a robust set of outcome measures.We suggest that future studies incorporate additional biomarkers,such as serum levels of liver enzymes and bilirubin,to provide a more nuanced understanding of liver function changes post-intervention.The study's focus on short-term survival rates is appreciated,but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes.Additionally,the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes.From a critical care perspective,we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications.We believe that incor-porating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes,influ-encing future clinical guidelines and practice.
文摘BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
基金supported by the National Key Research and Development Program of China(2023YFA1010200,2020YFA0713100)the National Natural Science Foundation of China(12071453)the Innovation Program for Quantum Science and Technology(2021ZD0302902).
文摘Given two graphs G and H,the Ramsey number R(G,H)is the smallest positive integer N such that every 2-coloring of the edges of K_(N)contains either a red G or a blue H.Let K_(N-1)■K_(1,k)be the graph obtained from K_(N-1)by adding anew vertexνconnecting k vertices of K_(N-1).A graph G withχ(G)=k+1 is called edge-critical if G contains an edge e such thatχ(G-e)=k.A considerable amount of research has been conducted by previous scholars on Ramsey numbers ofgraphs.In this study,we show that for an edge-critical graph G with x(G)=k+1,when k≥2,1≥2,and n is sufficiently large,R(G,K_(1)+nK_(t))=knt+1 and r,(G,K_(1)+nK_(t))=(k-1)nt+1.
文摘Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.
文摘Objective:To describe the effects of an early mobilization program in a critically ill patient with acquired muscle weakness in the intensive care unit(AMWICU).Methods:Case report of a 65-year-old male diagnosed with pneumoperitoneum,septic shock,and multiple organ dysfunction.The patient underwent an early mobilization program between 13th and 30th of June 2022,based on expert consensus on safety criteria for mobilization in critically ill patients.The intervention was delivered by a rehabilitation nursing team.Results:The early mobilization program contributed to improvements in muscle strength,body mobility,and functional independence in the critically ill patient.Conclusions:Although there is no consensus on the ideal type,timing,or intensity of early mobilization in critically ill patients,this case study suggests that individualized early mobilization may promote functional recovery and should be considered in intensive care settings.
文摘The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly recognised.Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise.While changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain uncertain.Dietary fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI microbiota.The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical illness.Randomised controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were identified.Studies show dietary fibres have an impact on faecal microbiota in health and disease.The fibre,inulin,has a marked and specific effect on increasing the abundance of faecal Bifidobacteria.Short chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient populations.Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness.More research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.
文摘The NIST Cybersecurity Framework (NIST CSF) serves as a voluntary guideline aimed at helping organizations, tiny and medium-sized enterprises (SMEs), and critical infrastructure operators, effectively manage cyber risks. Although comprehensive, the complexity of the NIST CSF can be overwhelming, especially for those lacking extensive cybersecurity resources. Current implementation tools often cater to larger companies, neglecting the specific needs of SMEs, which can be vulnerable to cyber threats. To address this gap, our research proposes a user-friendly, open-source web platform designed to simplify the implementation of the NIST CSF. This platform enables organizations to assess their risk exposure and continuously monitor their cybersecurity maturity through tailored recommendations based on their unique profiles. Our methodology includes a literature review of existing tools and standards, followed by a description of the platform’s design and architecture. Initial tests with SMEs in Burkina Faso reveal a concerning cybersecurity maturity level, indicating the urgent need for improved strategies based on our findings. By offering an intuitive interface and cross-platform accessibility, this solution aims to empower organizations to enhance their cybersecurity resilience in an evolving threat landscape. The article concludes with discussions on the practical implications and future enhancements of the tool.
