Stress is a major risk factor for the development of mental illness,such as major depression disorder (MDD)[1].Despite decades of progress,including findings that stressinduced depression corresponds with numerous mor...Stress is a major risk factor for the development of mental illness,such as major depression disorder (MDD)[1].Despite decades of progress,including findings that stressinduced depression corresponds with numerous morphological and functional neuronal changes within brain structures associated with cognition and mood,such as the medial prefrontal cortex (mPFC)[1-3],a thorough understanding of how stress induces the core symptoms of depression,such as hopelessness,is still lacking.In an exciting new paper in mice,Yin et al.show that astrocyteneuronal metabolic coupling in the mPFC is critically involved in the stress-induced passive coping response in mice [4].展开更多
Extreme heat events contribute to high mortality[1,2]and overwhelm emergency medical services through increased ambulance calls and overcrowded emergency departments.[3]Because morbidity and mortality are directly rel...Extreme heat events contribute to high mortality[1,2]and overwhelm emergency medical services through increased ambulance calls and overcrowded emergency departments.[3]Because morbidity and mortality are directly related to both the degree and duration of hyperthermia,timely recognition and management of heat exhaustion and heat stroke are critical for preventing death and reducing healthcare burdens.展开更多
Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff...Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff retention.[1,2]Emergency physicians(EPs)face unique pressures,including shift work,high patient volumes and acuities,overcrowding,and systemic inefficiencies that escalate their risk of burnout.As a result,EPs have reported the highest rates of burnout among physician specialties.展开更多
Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmenta...Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.展开更多
[Objectives]To provide a reference for the efficient use of wild Paeonia suffruticosa germplasm resources and the scientific selection of parents.[Methods]This study systematically evaluated cross-compatibility by con...[Objectives]To provide a reference for the efficient use of wild Paeonia suffruticosa germplasm resources and the scientific selection of parents.[Methods]This study systematically evaluated cross-compatibility by conducting interspecific crosses among the major wild species subsect.Delavayanae(Paeonia delavayi,Paeonia lutea,Paeonia potaninii,and Paeonia ludlowii)as well as reciprocal crosses between these species and cultivated varieties from the subsect.Vaginatae.[Results]Crosses among P.delavayi,P.lutea,and P.potaninii generally exhibited good seed set,with the resulting seeds showing a high emergence rate.In contrast,crosses involving P.ludlowii as a parent produced only a limited number of seeds,none of which germinated.In crosses with cultivated varieties where the wild species served as the maternal parent,the average seed set ranked as follows:P.lutea>P.delavayi>P.ludlowii>P.potaninii.When wild species were used as paternal parent,the average seed set ranked as follows:P.potaninii>P.lutea>P.delavayi>P.ludlowii.On the whole,most crosses between wild species of subsect.Delavayanae and cultivated varieties achieved normal seed set,demonstrating a certain degree of cross-compatibility.However,when the wild species served as the maternal parent,both the seed set and seedling emergence rate were superior to those in the reciprocal crosses(with wild species as the paternal parent).[Conclusions]Significant differences in cross-compatibility were observed among species within Paeonia subsect.Delavayanae.In addition,a significant maternal effect was identified in crosses between wild species of this subsection and cultivated varieties.These findings suggest that by selecting highly compatible combinations,there remains considerable potential for utilizing these wild species in peony breeding.展开更多
BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making ...BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.展开更多
BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and...BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.展开更多
BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suita...BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.展开更多
Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching t...Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.展开更多
To ensure an uninterrupted power supply,mobile power sources(MPS)are widely deployed in power grids during emergencies.Comprising mobile emergency generators(MEGs)and mobile energy storage systems(MESS),MPS are capabl...To ensure an uninterrupted power supply,mobile power sources(MPS)are widely deployed in power grids during emergencies.Comprising mobile emergency generators(MEGs)and mobile energy storage systems(MESS),MPS are capable of supplying power to critical loads and serving as backup sources during grid contingencies,offering advantages such as flexibility and high resilience through electricity delivery via transportation networks.This paper proposes a design method for a 400 V–10 kV Dual-Winding Induction Generator(DWIG)intended for MEG applications,employing an improved particle swarmoptimization(PSO)algorithmbased on a back-propagation neural network(BPNN).A parameterized finite element(FE)model of the DWIG is established to derive constraints on its dimensional parameters,thereby simplifying the optimization space.Through sensitivity analysis between temperature rise and electromagnetic loss of the DWIG,the main factors influencing the machine’s temperature are identified,and electromagnetic loss is determined as the optimization objective.To obtain an accurate fitting function between electromagnetic loss and dimensional parameters,the BPNN is employed to predict the nonlinear relationship between the optimization objective and the parameters.The Latin hypercube sampling(LHS)method is used for random sampling in the FE model analysis for training,testing,and validation,which is then applied to compute the cost function in the PSO.Based on the relationships obtained by the BPNN,the PSO algorithm evaluates the fitness and cost functions to determine the optimal design point.The proposed optimization method is validated by comparing simulation results between the initial design and the optimized design.展开更多
The Journal of Acupuncture and Tuina Science,a peerreview journal with an international scope(ISSN 1672-3597,CN 31-1908/R,Bimonthly),is indexed in Emerging Sources Citation Index(ESCI),Western Pacific Region Index Med...The Journal of Acupuncture and Tuina Science,a peerreview journal with an international scope(ISSN 1672-3597,CN 31-1908/R,Bimonthly),is indexed in Emerging Sources Citation Index(ESCI),Western Pacific Region Index Medicus(WPRIM),Springer-Verlag GmbH Database,Index of Copernicus(IC),Chemical Abstracts(CA),Chinese Science Citation Database(CSCD),and Chinese Scientific and Technical Papers and Citations Database(CSTPCD).You can search the text on https://link.springer.com/journal/11726.展开更多
On January 5 New York time,Sun Lei,Charge d'Affaires a.i.of the Permanent Mission of the People's Republic of China to the United Nations,stated at the UN Security Council Emergency Meeting on Venezuela that C...On January 5 New York time,Sun Lei,Charge d'Affaires a.i.of the Permanent Mission of the People's Republic of China to the United Nations,stated at the UN Security Council Emergency Meeting on Venezuela that China is deeply shocked by and strongly condemns the unilateral,illegal,and bullying acts by the United States.One day earlier,during the seventh round of China-Pakistan Foreign Ministers’Strategic Dialogue held in Beijing,Chinese Foreign Minister Wang Yi noted in talks with Pakistani Deputy Prime Minister and Foreign Minister Mohammad Ishaq Dar that,China never believes that any country should act as a world policeman,nor does the Chinese side agree that any country should claim to bean international judge.展开更多
BACKGROUND Early renal artery thrombosis after kidney transplantation is rare but often leads to graft loss.Prompt diagnosis and intervention are essential,particularly in patients with inherited thrombophilias such a...BACKGROUND Early renal artery thrombosis after kidney transplantation is rare but often leads to graft loss.Prompt diagnosis and intervention are essential,particularly in patients with inherited thrombophilias such as factor V Leiden(FVL)mutation.CASE SUMMARY A kidney transplant recipient with FVL mutation developed an acute transplant renal artery thrombosis.The immediate post-operative Doppler ultrasonography revealed thrombosis of the main and inferior polar renal arteries.Emergent thrombectomy and separate arterial re-anastomoses were performed after cold perfusion with heparinized saline and vasodilator solution.Reperfusion was successful with immediate urine output and gradual improvement in renal function.The patient was discharged on direct oral anticoagulation therapy.CONCLUSION Early detection and surgical intervention can preserve graft function in posttransplant renal artery thrombosis even in patients at high risk.展开更多
Light-energy-driven semiconductor catalysis offers attractive ways to address environmental and energy crises.TiO_(2) is the most promising catalyst for photocatalysis,but the lack of charge-carrier separation efficie...Light-energy-driven semiconductor catalysis offers attractive ways to address environmental and energy crises.TiO_(2) is the most promising catalyst for photocatalysis,but the lack of charge-carrier separation efficiency severely limits its catalytic performance.In this study,we carried out crystal phase engineering to prepare in situ Z-scheme hetero-phase homojunction of anatase-rutile and clarified the structure-performance relationship.The efficiency of sulfamerazine removal by hetero-phase homojunction TiO_(2) nanotube arrays in a single-compartment photocatalytic fuel cell system was improved by 1.93 times compared to conventional anatase TiO_(2) nanotube arrays and the degradation pathways were revealed by the Fukui function combined with HP-LCMS.The successful construction of Z-scheme hetero-phase homojunction was confirmed by Raman,X-ray diffraction(XRD),and electron spin resonance(ESR),which combined with density functional theory(DFT)calculations revealed the key role of crystal phase engineering in the construction of hetero-phase homojunction.This work provides a novel strategy for the scientific design of titanium dioxide photocatalysts.展开更多
The accelerating pace of population aging,the rising burden of chronic and non-communicable diseases,the increasing frequency of public health emergencies,and the growing imbalance and structural shortage of global he...The accelerating pace of population aging,the rising burden of chronic and non-communicable diseases,the increasing frequency of public health emergencies,and the growing imbalance and structural shortage of global healthcare resources are intensifying challenges.In the field of nursing,in particular,the latest State of the World’s Nursing Report[1]highlights that,although the current global number of nurses is approximately 29.8 million.展开更多
Oligodendrocytes and their cell-intrinsic gene regulatory network:Oligodendrocytes(OLs)are the myelinating glial cells of the vertebrate central nervous system.They are responsible for insulating neuronal axons with a...Oligodendrocytes and their cell-intrinsic gene regulatory network:Oligodendrocytes(OLs)are the myelinating glial cells of the vertebrate central nervous system.They are responsible for insulating neuronal axons with a lipid-rich myelin sheath,which enables the saltatory conduction of action potentials.During development,oligodendrocyte progenitor cells(OPCs)emerge from neural stem cells in the ventricular zone.They then proliferate,increase their number,and migrate to their final destination where they encounter unmyelinated neuronal axons and differentiate in a stepwise fashion into myelinating oligodendrocytes(mOLs)under the influence of environmental stimuli.展开更多
In conventional higher-order topological insulators(HOTIs),the emergence of topological states can be explained by using the nonzero bulk polarization index.However,corner states emerge in HOTIs with incomplete bounda...In conventional higher-order topological insulators(HOTIs),the emergence of topological states can be explained by using the nonzero bulk polarization index.However,corner states emerge in HOTIs with incomplete boundary unit cells(i.e.,boundary defects)even though the bulk polarization is zero,which challenges the conventional understanding of HOTIs.Here,based on a Kekul´e-distorted honeycomb lattice with incomplete unit cells,we reveal that incomplete unit cells exhibit fractional charges through the analysis of Wannier centers by developing a compensation method and creating the concept of Wannier center domain(WCD)which is the smallest region that one Wannier center occupies.This method compensates for the missing parts of these boundary incomplete unit cells with additional WCDs to make them complete.The compensated WCDs automatically carry the corresponding charge,and this charge together with that of the incomplete unit cell constitutes the total charge of the complete unit cell after compensation.We conclude that the emergence of corner states is attributed to the filling anomaly,which is a fundamental mechanism.Our results refresh the understanding of HOTIs,especially those with structural discontinuities,and provide a novel design for topological states which have application value in producing optical functional devices.展开更多
Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances ...Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances in imaging and surgical techniques,ASE has high morbidity and mortality rates,particularly when diagnosis or intervention is delayed.Here,we report two patients admitted to our center to increase awareness among emergency physicians.展开更多
Mention Shanghai, and the first thing that comes to mind is the image of an exotic and flourishing metropolitan city; stylishly old and gleaming new architectural marvels, end- less streams of people and traffic, clus...Mention Shanghai, and the first thing that comes to mind is the image of an exotic and flourishing metropolitan city; stylishly old and gleaming new architectural marvels, end- less streams of people and traffic, clusters of shopping malls, restaurants展开更多
文摘Stress is a major risk factor for the development of mental illness,such as major depression disorder (MDD)[1].Despite decades of progress,including findings that stressinduced depression corresponds with numerous morphological and functional neuronal changes within brain structures associated with cognition and mood,such as the medial prefrontal cortex (mPFC)[1-3],a thorough understanding of how stress induces the core symptoms of depression,such as hopelessness,is still lacking.In an exciting new paper in mice,Yin et al.show that astrocyteneuronal metabolic coupling in the mPFC is critically involved in the stress-induced passive coping response in mice [4].
文摘Extreme heat events contribute to high mortality[1,2]and overwhelm emergency medical services through increased ambulance calls and overcrowded emergency departments.[3]Because morbidity and mortality are directly related to both the degree and duration of hyperthermia,timely recognition and management of heat exhaustion and heat stroke are critical for preventing death and reducing healthcare burdens.
文摘Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff retention.[1,2]Emergency physicians(EPs)face unique pressures,including shift work,high patient volumes and acuities,overcrowding,and systemic inefficiencies that escalate their risk of burnout.As a result,EPs have reported the highest rates of burnout among physician specialties.
文摘Acute exposure to high altitude can cause acute altitude illnesses and is associated with impaired cognitive and physical performance.The most effective preventive strategies currently recommended include environmental acclimatization(slow ascent and/or pre-acclimatization)or pharmacological support of acclimatization using acetazolamide.However,these strategies are not practical for high-altitude exposures that require rapid and unplanned ascent,high physical and mental performance,such as rescue missions or military operations.Dexamethasone and other modulators of the glucocorticoid system take effect quickly and are effective alternatives for preventing acute altitude illnesses when rapidly ascending to high altitudes.As the efficacy of dexamethasone in preventing acute mountain illnesses remains controversial,a review of existing studies on the use of dexamethasone for the prevention of acute mountain sickness was conducted,aiming to determine the best strategy.Possible mechanisms of protection against acute altitude illnesses are discussed based on the results of clinical trials.The data indicate that dexamethasone is most effective at altitudes above 4000 m at doses of 8–16 mg/d.Appropriately designed and powered trials are needed to obtain more evidence-based results on the dosage and timing of dexamethasone administration,and to provide optimized recommendations for the application of this powerful pharmacological tool.
文摘[Objectives]To provide a reference for the efficient use of wild Paeonia suffruticosa germplasm resources and the scientific selection of parents.[Methods]This study systematically evaluated cross-compatibility by conducting interspecific crosses among the major wild species subsect.Delavayanae(Paeonia delavayi,Paeonia lutea,Paeonia potaninii,and Paeonia ludlowii)as well as reciprocal crosses between these species and cultivated varieties from the subsect.Vaginatae.[Results]Crosses among P.delavayi,P.lutea,and P.potaninii generally exhibited good seed set,with the resulting seeds showing a high emergence rate.In contrast,crosses involving P.ludlowii as a parent produced only a limited number of seeds,none of which germinated.In crosses with cultivated varieties where the wild species served as the maternal parent,the average seed set ranked as follows:P.lutea>P.delavayi>P.ludlowii>P.potaninii.When wild species were used as paternal parent,the average seed set ranked as follows:P.potaninii>P.lutea>P.delavayi>P.ludlowii.On the whole,most crosses between wild species of subsect.Delavayanae and cultivated varieties achieved normal seed set,demonstrating a certain degree of cross-compatibility.However,when the wild species served as the maternal parent,both the seed set and seedling emergence rate were superior to those in the reciprocal crosses(with wild species as the paternal parent).[Conclusions]Significant differences in cross-compatibility were observed among species within Paeonia subsect.Delavayanae.In addition,a significant maternal effect was identified in crosses between wild species of this subsection and cultivated varieties.These findings suggest that by selecting highly compatible combinations,there remains considerable potential for utilizing these wild species in peony breeding.
文摘BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.
文摘BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.
基金supported by the special fund of the National Clinical Key Specialty Construction Program[(2022)301-2305].
文摘BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.
文摘Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.
基金funded by the Science and Technology Projects of State Grid Corporation of China(Project No.J2024136).
文摘To ensure an uninterrupted power supply,mobile power sources(MPS)are widely deployed in power grids during emergencies.Comprising mobile emergency generators(MEGs)and mobile energy storage systems(MESS),MPS are capable of supplying power to critical loads and serving as backup sources during grid contingencies,offering advantages such as flexibility and high resilience through electricity delivery via transportation networks.This paper proposes a design method for a 400 V–10 kV Dual-Winding Induction Generator(DWIG)intended for MEG applications,employing an improved particle swarmoptimization(PSO)algorithmbased on a back-propagation neural network(BPNN).A parameterized finite element(FE)model of the DWIG is established to derive constraints on its dimensional parameters,thereby simplifying the optimization space.Through sensitivity analysis between temperature rise and electromagnetic loss of the DWIG,the main factors influencing the machine’s temperature are identified,and electromagnetic loss is determined as the optimization objective.To obtain an accurate fitting function between electromagnetic loss and dimensional parameters,the BPNN is employed to predict the nonlinear relationship between the optimization objective and the parameters.The Latin hypercube sampling(LHS)method is used for random sampling in the FE model analysis for training,testing,and validation,which is then applied to compute the cost function in the PSO.Based on the relationships obtained by the BPNN,the PSO algorithm evaluates the fitness and cost functions to determine the optimal design point.The proposed optimization method is validated by comparing simulation results between the initial design and the optimized design.
文摘The Journal of Acupuncture and Tuina Science,a peerreview journal with an international scope(ISSN 1672-3597,CN 31-1908/R,Bimonthly),is indexed in Emerging Sources Citation Index(ESCI),Western Pacific Region Index Medicus(WPRIM),Springer-Verlag GmbH Database,Index of Copernicus(IC),Chemical Abstracts(CA),Chinese Science Citation Database(CSCD),and Chinese Scientific and Technical Papers and Citations Database(CSTPCD).You can search the text on https://link.springer.com/journal/11726.
文摘On January 5 New York time,Sun Lei,Charge d'Affaires a.i.of the Permanent Mission of the People's Republic of China to the United Nations,stated at the UN Security Council Emergency Meeting on Venezuela that China is deeply shocked by and strongly condemns the unilateral,illegal,and bullying acts by the United States.One day earlier,during the seventh round of China-Pakistan Foreign Ministers’Strategic Dialogue held in Beijing,Chinese Foreign Minister Wang Yi noted in talks with Pakistani Deputy Prime Minister and Foreign Minister Mohammad Ishaq Dar that,China never believes that any country should act as a world policeman,nor does the Chinese side agree that any country should claim to bean international judge.
文摘BACKGROUND Early renal artery thrombosis after kidney transplantation is rare but often leads to graft loss.Prompt diagnosis and intervention are essential,particularly in patients with inherited thrombophilias such as factor V Leiden(FVL)mutation.CASE SUMMARY A kidney transplant recipient with FVL mutation developed an acute transplant renal artery thrombosis.The immediate post-operative Doppler ultrasonography revealed thrombosis of the main and inferior polar renal arteries.Emergent thrombectomy and separate arterial re-anastomoses were performed after cold perfusion with heparinized saline and vasodilator solution.Reperfusion was successful with immediate urine output and gradual improvement in renal function.The patient was discharged on direct oral anticoagulation therapy.CONCLUSION Early detection and surgical intervention can preserve graft function in posttransplant renal artery thrombosis even in patients at high risk.
基金supported by the National Natural Science Foundation of China(Nos.52370025,52372212)BUCEA Postgraduate Education and Teaching Quality Improvement Project(No.J2023016)the BUCEA Post Graduate Innovation Project(Nos.DG2023012 and PG2024073).
文摘Light-energy-driven semiconductor catalysis offers attractive ways to address environmental and energy crises.TiO_(2) is the most promising catalyst for photocatalysis,but the lack of charge-carrier separation efficiency severely limits its catalytic performance.In this study,we carried out crystal phase engineering to prepare in situ Z-scheme hetero-phase homojunction of anatase-rutile and clarified the structure-performance relationship.The efficiency of sulfamerazine removal by hetero-phase homojunction TiO_(2) nanotube arrays in a single-compartment photocatalytic fuel cell system was improved by 1.93 times compared to conventional anatase TiO_(2) nanotube arrays and the degradation pathways were revealed by the Fukui function combined with HP-LCMS.The successful construction of Z-scheme hetero-phase homojunction was confirmed by Raman,X-ray diffraction(XRD),and electron spin resonance(ESR),which combined with density functional theory(DFT)calculations revealed the key role of crystal phase engineering in the construction of hetero-phase homojunction.This work provides a novel strategy for the scientific design of titanium dioxide photocatalysts.
文摘The accelerating pace of population aging,the rising burden of chronic and non-communicable diseases,the increasing frequency of public health emergencies,and the growing imbalance and structural shortage of global healthcare resources are intensifying challenges.In the field of nursing,in particular,the latest State of the World’s Nursing Report[1]highlights that,although the current global number of nurses is approximately 29.8 million.
基金supported by grants from the Deutsche Forschungsgemeinschaft(DFG)to MW.
文摘Oligodendrocytes and their cell-intrinsic gene regulatory network:Oligodendrocytes(OLs)are the myelinating glial cells of the vertebrate central nervous system.They are responsible for insulating neuronal axons with a lipid-rich myelin sheath,which enables the saltatory conduction of action potentials.During development,oligodendrocyte progenitor cells(OPCs)emerge from neural stem cells in the ventricular zone.They then proliferate,increase their number,and migrate to their final destination where they encounter unmyelinated neuronal axons and differentiate in a stepwise fashion into myelinating oligodendrocytes(mOLs)under the influence of environmental stimuli.
基金supported by the Natural Science Basic Research Program of Shaanxi Province (Grant Nos.2024JC-JCQN-06 and2025JC-QYCX-006)the National Natural Science Foundation of China (Grant No.12474337)Chinese Academy of Sciences Project (Grant Nos.E4BA270100,E4Z127010F,E4Z6270100,and E53327020D)。
文摘In conventional higher-order topological insulators(HOTIs),the emergence of topological states can be explained by using the nonzero bulk polarization index.However,corner states emerge in HOTIs with incomplete boundary unit cells(i.e.,boundary defects)even though the bulk polarization is zero,which challenges the conventional understanding of HOTIs.Here,based on a Kekul´e-distorted honeycomb lattice with incomplete unit cells,we reveal that incomplete unit cells exhibit fractional charges through the analysis of Wannier centers by developing a compensation method and creating the concept of Wannier center domain(WCD)which is the smallest region that one Wannier center occupies.This method compensates for the missing parts of these boundary incomplete unit cells with additional WCDs to make them complete.The compensated WCDs automatically carry the corresponding charge,and this charge together with that of the incomplete unit cell constitutes the total charge of the complete unit cell after compensation.We conclude that the emergence of corner states is attributed to the filling anomaly,which is a fundamental mechanism.Our results refresh the understanding of HOTIs,especially those with structural discontinuities,and provide a novel design for topological states which have application value in producing optical functional devices.
文摘Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances in imaging and surgical techniques,ASE has high morbidity and mortality rates,particularly when diagnosis or intervention is delayed.Here,we report two patients admitted to our center to increase awareness among emergency physicians.
文摘Mention Shanghai, and the first thing that comes to mind is the image of an exotic and flourishing metropolitan city; stylishly old and gleaming new architectural marvels, end- less streams of people and traffic, clusters of shopping malls, restaurants
