Purpose:This study examined potential differences in strength,muscle morphology,and motor unit(MU)behavior of the abductor digiti minimi(ADM)between normal-fat(NF)and over-fat(OF)males.Methods:Dual-energy X-ray absorp...Purpose:This study examined potential differences in strength,muscle morphology,and motor unit(MU)behavior of the abductor digiti minimi(ADM)between normal-fat(NF)and over-fat(OF)males.Methods:Dual-energy X-ray absorptiometry assessed percent body fat(%BF).Ultrasonography determined muscle cross-sectional area(CSA),echo intensity(EI),and subcutaneous fat(s FAT).MU behavior was assessed during isometric muscle actions at 50%of maximal voluntary contraction(MVC)by analyzing the y-intercepts and slopes for the MU action potential amplitude(MUAPAMP)vs.recruitment threshold(RT)relationships,the A and B terms for the mean firing rate(MFR)vs.RT relationships,and normalized electromyographic amplitude(N-EMGRMS).MU firing times and waveforms were validated with reconstruct-and-test and spike trigger average procedures.Results:%BF was greater for OF(25.70%±5.40%)than NF(16.50%±2.20%;p<0.001).MVC was greater for NF(27.13±7.16)N than OF([19.89±4.96]N;p=0.014).CSA was greater for NF(2.48±0.39)cm^(2)than OF([1.95±0.47]cm^(2);p=0.011).The y-intercepts for the MUAPAMPvs.RT relationships were greater for NF(0.283±0.254)m V than OF([-0.221±0.659]m V;p=0.004).The B terms for the MFR vs.RT relationships were greater for NF(-0.024±0.003)pps/%MVC than OF([-0.031±0.009]pps/%MVC;p=0.038).N-EMGRMSwas similar between groups(p=0.463).Conclusion:Maximal strength,muscle size,and MU recruitment and firing rate patterns for a non-weight bearing muscle differed between normal-fat and over-fat males.展开更多
Apparel exports China:The decline in exports widened from January to September(-2.4%,compared to-0.2%in January-June).Exports to the EU increased(+5.9%),though the growth rate moderated.Exports to the US saw a larger ...Apparel exports China:The decline in exports widened from January to September(-2.4%,compared to-0.2%in January-June).Exports to the EU increased(+5.9%),though the growth rate moderated.Exports to the US saw a larger contraction(January-June:-1.6%,January-September:-8.2%).While exports to ASEAN countries still fell by over 10%(-17.7%),shipments to the Philippines(+6.9%),Indonesia(+19.0%),and Cambodia(+64.9%)demonstrated stronger growth performance within the year.Regarding tariffs,on October 30,China and the US agreed to lower the rates on goods subject to additional duties(effectively reducing the average tariff rate on Chinese imports to the US from about 57%to approximately 47%,though this remains significantly higher than the 19.5%overall average rate applied to other countries).展开更多
As a public basic course and the core general course of undergraduate education,moral education(ME)in College English is imperative.It is necessary to design specific teaching programs flexibly and creatively on the b...As a public basic course and the core general course of undergraduate education,moral education(ME)in College English is imperative.It is necessary to design specific teaching programs flexibly and creatively on the basis of fully understanding the ideas,objectives and tasks,basic principles and implementation methods of ME.This paper tries integrating literature reading into unit topic teaching as a new approach to ME in College English.The specific pathways of integration include:expansion of literary reading content,diversified teaching of literary reading,diversified media of literary reading,and diversified assessment system of literary quality.The integration of literature reading and unit topic teaching is conducive to the realization of the teaching goal of cultivating students’language ability,humanistic quality,and correct values.展开更多
Slope units are divided according to the real topography and have clear geological characteristics,making them ideal units for evaluating the susceptibility to geological disasters.Based on the results of automaticall...Slope units are divided according to the real topography and have clear geological characteristics,making them ideal units for evaluating the susceptibility to geological disasters.Based on the results of automatically and manually corrected hydrological slope unit division,the Longhua District,Shenzhen City,Guangdong Province,was selected as the study area.A total of 15 influencing factors,namely Fluctuation,slope,slope aspect,curvature,topographic witness index(TWI),stream power index(SPI),topographic roughness index(TRI),annual average rainfall,distance to water system,engineering rock group,distance to fault,land use,normalized difference vegetation index(NDVI),nighttime light,and distance to road,were selected as evaluation indicators.The information volume model(IV)and random points were used to select non-geological disaster units,and then the random forest model(RF)was used to evaluate the susceptibility to geological disasters.The automatic slope unit and the hydrological slope unit were compared and analyzed in the random forest and information volume random forest models.The results show that the area under the curve(AUC)values of the automatic slope unit evaluation results are 0.931 for the IV-RF model and 0.716 for the RF model,which are 0.6%(IV-RF model)and 1.9%(RF model)higher than those for the hydrological slope unit.Based on a comparison of the evaluation methods based on the two types of slope units,the hydrological slope unit evaluation method based on manual correction is highly subjective,is complicated to operate,and has a low evaluation accuracy,whereas the evaluation method based on automatic slope unit division is efficient and accurate,is suitable for large-scale efficient geological disaster evaluation,and can better deal with the problem of geological disaster susceptibility evaluation.展开更多
1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconn...1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.展开更多
Modular truss space deployable antennas are key for future large aperture,high precision antennas,already proven in various in-orbit applications globally.This paper introduces a design method for a tetrahedral basic ...Modular truss space deployable antennas are key for future large aperture,high precision antennas,already proven in various in-orbit applications globally.This paper introduces a design method for a tetrahedral basic unit mechanism with dual height positioning nodes.A parametric model is established,and its DOF are analyzed to confirm the mechanism's validity.The new tetrahedral basic unit mechanism constructed by this method is a single DOF mechanism and can locate different parabolic node heights.In order to further adapt to the parabolic and large aperture requirements of the deployable antenna of the truss,a combination unit and modular unit mechanism are developed based on this tetrahedral unit.The DOF and deployment characteristics of the modular unit mechanism are analyzed and validated through simulations.Various networking methods for the modular units are proposed,followed by a comprehensive performance comparison of different modular truss deployable antenna mechanisms.A prototype model of the modular unit mechanism is also developed,with deployment experiments demonstrating the mechanism's simplicity,low DOF,and large deployment ratio.The findings of this study provide a theoretical and technical basis for the future design and development of truss deployable antenna mechanisms.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparosc...BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.展开更多
The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. Th...The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.展开更多
Despite advances in current anti-cancer therapies,challenges such as drug resistance,toxicity,and tumor heterogeneity persist.The limitations of traditional single-target drugs and simple combination therapies are bec...Despite advances in current anti-cancer therapies,challenges such as drug resistance,toxicity,and tumor heterogeneity persist.The limitations of traditional single-target drugs and simple combination therapies are becoming increasingly apparent1.To address these issues,a novel treatment strategy,the artificially intelligent synergistic engineered drug(AISED)paradigm,merits further exploration.This paradigm is based on the systematic engineered integration of multiple active ingredients into a unified single entity through artificial intelligence(AI).This strategy is aimed at developing new anti-cancer drug designs involving multiple ingredients,multiple molecular targets,and multiple biological effects,for multiple cancer types,thereby providing a novel theoretical paradigm for overcoming existing treatment bottlenecks.展开更多
本研究基于单元整体教学视角,旨在探索初中英语“教―学―评”一致性课堂构建策略。针对当前初中英语教学中的目标碎片化、内容割裂、评价模糊、闭环断裂等困境,文章以逆向设计与结构主义为理论支撑,以核心素养为导向,提出“目标锚定―...本研究基于单元整体教学视角,旨在探索初中英语“教―学―评”一致性课堂构建策略。针对当前初中英语教学中的目标碎片化、内容割裂、评价模糊、闭环断裂等困境,文章以逆向设计与结构主义为理论支撑,以核心素养为导向,提出“目标锚定―内容整合―标准研制―实践实施”四步策略,以重构层级化、主题化的单元目标体系。同时,本研究以“人教版”七年级上册Unit 3 My School为例进行实证检验,结果显示,上述策略能有效提升学生的语言、文化、思维、学习能力,实现核心素养的课堂转化,为教师提供可操作的单元整体教学设计指南。展开更多
The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,...The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,photovoltaic power generation is unstable and random,resulting in a low utilization rate and directly affecting the stability of the power grid.To solve this problem,this paper proposes a coordinated control strategy for a newenergy power generation system with a hybrid energy storage unit based on the lithium iron phosphate-supercapacitor hybrid energy storage unit.Firstly,the variational mode decomposition algorithm is used to separate the high and low frequencies of the power signal,which is conducive to the rapid and accurate suppression of the power fluctuation of the energy storage system.Secondly,the fuzzy control algorithm is introduced to balance the power between energy storage.In this paper,the actual data is used for simulation,and the simulation results show that the strategy realizes the effective suppression of the bus voltage fluctuation and the accurate control of the internal state of the energy storage unit,effectively avoiding problems such as overshoot and over-discharge,and can significantly improve the stability of the photovoltaic power generation systemand the stability of the Direct Current bus.It is of great significance to promote the development of collaborative control technology for photovoltaic hybrid energy storage units.展开更多
Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluct...Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluctuation caused by new energy units,this paper proposes a new energy power system frequency regulation strategy with multiple units including the doubly-fed pumped storage unit(DFPSU).Firstly,based on the model predictive control(MPC)theory,the state space equations are established by considering the operating characteristics of the units and the dynamic behavior of the system;secondly,the proportional-differential control link is introduced to minimize the frequency deviation to further optimize the frequency modulation(FM)output of the DFPSU and inhibit the rapid fluctuation of the frequency;lastly,it is verified on theMatlab/Simulink simulation platform,and the results show that the model predictive control with proportional-differential control link can further release the FM potential of the DFPSU,increase the depth of its FM,effectively reduce the frequency deviation of the system and its rate of change,realize the optimization of the active output of the DFPSU and that of other units,and improve the frequency response capability of the system.展开更多
BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
Unplanned intensive care unit(ICU)admissions(UP-ICU)following initial general ward placement are associated with poor patient outcomes and represent a key quality indicator for healthcare facilities.Healthcare facilit...Unplanned intensive care unit(ICU)admissions(UP-ICU)following initial general ward placement are associated with poor patient outcomes and represent a key quality indicator for healthcare facilities.Healthcare facilities have employed numerous predictive models,such as physiological scores(e.g.,Acute Physiology and Chronic Health Evaluation II,Revised Trauma Score,and Mortality Probability Model II at 24 hours)and anatomical scores(Injury Severity Score and New Injury Severity Score),to identify high-risk patients.Although physiological scores frequently surpass anatomical scores in predicting mortality,their specificity for trauma patients is limited,and their clinical applicability may be limited.Initially proposed for ICU readmission prediction,the stability and workload index for the transfer score has demonstrated inconsistent validity.Machine learning offers a promising alternative.Several studies have shown that machine learning models,including those that use electronic health records(EHR)data,can more accurately predict trauma patients’deaths and admissions to the ICU than traditional scoring systems.These models identify unique predictors that are not captured by existing methods.However,challenges remain,including integration with EHR systems and data entry complexities.Critical care outreach programs and telemedicine can help reduce UP-ICU admissions;however,their effectiveness remains unclear because of costs and implementation challenges,respectively.Strategies to reduce UP-ICU admissions include improving triage systems,implementing evidence-based protocols for ICU patient management,and prioritizing prehospital intervention and stabilization to optimize the“golden hour”of trauma care.To improve patient outcomes and reduce the burden of UPICU admissions,further studies are required to validate and implement these strategies and refine machine learning models.展开更多
BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA...BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.展开更多
BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’...BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.展开更多
Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribu...Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.展开更多
文摘Purpose:This study examined potential differences in strength,muscle morphology,and motor unit(MU)behavior of the abductor digiti minimi(ADM)between normal-fat(NF)and over-fat(OF)males.Methods:Dual-energy X-ray absorptiometry assessed percent body fat(%BF).Ultrasonography determined muscle cross-sectional area(CSA),echo intensity(EI),and subcutaneous fat(s FAT).MU behavior was assessed during isometric muscle actions at 50%of maximal voluntary contraction(MVC)by analyzing the y-intercepts and slopes for the MU action potential amplitude(MUAPAMP)vs.recruitment threshold(RT)relationships,the A and B terms for the mean firing rate(MFR)vs.RT relationships,and normalized electromyographic amplitude(N-EMGRMS).MU firing times and waveforms were validated with reconstruct-and-test and spike trigger average procedures.Results:%BF was greater for OF(25.70%±5.40%)than NF(16.50%±2.20%;p<0.001).MVC was greater for NF(27.13±7.16)N than OF([19.89±4.96]N;p=0.014).CSA was greater for NF(2.48±0.39)cm^(2)than OF([1.95±0.47]cm^(2);p=0.011).The y-intercepts for the MUAPAMPvs.RT relationships were greater for NF(0.283±0.254)m V than OF([-0.221±0.659]m V;p=0.004).The B terms for the MFR vs.RT relationships were greater for NF(-0.024±0.003)pps/%MVC than OF([-0.031±0.009]pps/%MVC;p=0.038).N-EMGRMSwas similar between groups(p=0.463).Conclusion:Maximal strength,muscle size,and MU recruitment and firing rate patterns for a non-weight bearing muscle differed between normal-fat and over-fat males.
文摘Apparel exports China:The decline in exports widened from January to September(-2.4%,compared to-0.2%in January-June).Exports to the EU increased(+5.9%),though the growth rate moderated.Exports to the US saw a larger contraction(January-June:-1.6%,January-September:-8.2%).While exports to ASEAN countries still fell by over 10%(-17.7%),shipments to the Philippines(+6.9%),Indonesia(+19.0%),and Cambodia(+64.9%)demonstrated stronger growth performance within the year.Regarding tariffs,on October 30,China and the US agreed to lower the rates on goods subject to additional duties(effectively reducing the average tariff rate on Chinese imports to the US from about 57%to approximately 47%,though this remains significantly higher than the 19.5%overall average rate applied to other countries).
文摘As a public basic course and the core general course of undergraduate education,moral education(ME)in College English is imperative.It is necessary to design specific teaching programs flexibly and creatively on the basis of fully understanding the ideas,objectives and tasks,basic principles and implementation methods of ME.This paper tries integrating literature reading into unit topic teaching as a new approach to ME in College English.The specific pathways of integration include:expansion of literary reading content,diversified teaching of literary reading,diversified media of literary reading,and diversified assessment system of literary quality.The integration of literature reading and unit topic teaching is conducive to the realization of the teaching goal of cultivating students’language ability,humanistic quality,and correct values.
文摘Slope units are divided according to the real topography and have clear geological characteristics,making them ideal units for evaluating the susceptibility to geological disasters.Based on the results of automatically and manually corrected hydrological slope unit division,the Longhua District,Shenzhen City,Guangdong Province,was selected as the study area.A total of 15 influencing factors,namely Fluctuation,slope,slope aspect,curvature,topographic witness index(TWI),stream power index(SPI),topographic roughness index(TRI),annual average rainfall,distance to water system,engineering rock group,distance to fault,land use,normalized difference vegetation index(NDVI),nighttime light,and distance to road,were selected as evaluation indicators.The information volume model(IV)and random points were used to select non-geological disaster units,and then the random forest model(RF)was used to evaluate the susceptibility to geological disasters.The automatic slope unit and the hydrological slope unit were compared and analyzed in the random forest and information volume random forest models.The results show that the area under the curve(AUC)values of the automatic slope unit evaluation results are 0.931 for the IV-RF model and 0.716 for the RF model,which are 0.6%(IV-RF model)and 1.9%(RF model)higher than those for the hydrological slope unit.Based on a comparison of the evaluation methods based on the two types of slope units,the hydrological slope unit evaluation method based on manual correction is highly subjective,is complicated to operate,and has a low evaluation accuracy,whereas the evaluation method based on automatic slope unit division is efficient and accurate,is suitable for large-scale efficient geological disaster evaluation,and can better deal with the problem of geological disaster susceptibility evaluation.
文摘1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.
基金sponsored by the National Natural Science Foundation of China(No.52075467)Hebei Province Fund Outstanding Youth Fund Project,China(No.E2024203107)。
文摘Modular truss space deployable antennas are key for future large aperture,high precision antennas,already proven in various in-orbit applications globally.This paper introduces a design method for a tetrahedral basic unit mechanism with dual height positioning nodes.A parametric model is established,and its DOF are analyzed to confirm the mechanism's validity.The new tetrahedral basic unit mechanism constructed by this method is a single DOF mechanism and can locate different parabolic node heights.In order to further adapt to the parabolic and large aperture requirements of the deployable antenna of the truss,a combination unit and modular unit mechanism are developed based on this tetrahedral unit.The DOF and deployment characteristics of the modular unit mechanism are analyzed and validated through simulations.Various networking methods for the modular units are proposed,followed by a comprehensive performance comparison of different modular truss deployable antenna mechanisms.A prototype model of the modular unit mechanism is also developed,with deployment experiments demonstrating the mechanism's simplicity,low DOF,and large deployment ratio.The findings of this study provide a theoretical and technical basis for the future design and development of truss deployable antenna mechanisms.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
文摘BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.
文摘The rise of the aging population parallels the rapidly increasing cases of neurological disorders. This puts pressure on scientists and physicians to find novel methods that can prevent and treat neurodegeneration. The brain is made up of a complex network of different cell types that work in tandem to maintain systemic homeostasis.
文摘Despite advances in current anti-cancer therapies,challenges such as drug resistance,toxicity,and tumor heterogeneity persist.The limitations of traditional single-target drugs and simple combination therapies are becoming increasingly apparent1.To address these issues,a novel treatment strategy,the artificially intelligent synergistic engineered drug(AISED)paradigm,merits further exploration.This paradigm is based on the systematic engineered integration of multiple active ingredients into a unified single entity through artificial intelligence(AI).This strategy is aimed at developing new anti-cancer drug designs involving multiple ingredients,multiple molecular targets,and multiple biological effects,for multiple cancer types,thereby providing a novel theoretical paradigm for overcoming existing treatment bottlenecks.
文摘本研究基于单元整体教学视角,旨在探索初中英语“教―学―评”一致性课堂构建策略。针对当前初中英语教学中的目标碎片化、内容割裂、评价模糊、闭环断裂等困境,文章以逆向设计与结构主义为理论支撑,以核心素养为导向,提出“目标锚定―内容整合―标准研制―实践实施”四步策略,以重构层级化、主题化的单元目标体系。同时,本研究以“人教版”七年级上册Unit 3 My School为例进行实证检验,结果显示,上述策略能有效提升学生的语言、文化、思维、学习能力,实现核心素养的课堂转化,为教师提供可操作的单元整体教学设计指南。
基金supported by the State Grid Corporation of China Science and Technology Project,grant number 52270723000900K.
文摘The new energy power generation is becoming increasingly important in the power system.Such as photovoltaic power generation has become a research hotspot,however,due to the characteristics of light radiation changes,photovoltaic power generation is unstable and random,resulting in a low utilization rate and directly affecting the stability of the power grid.To solve this problem,this paper proposes a coordinated control strategy for a newenergy power generation system with a hybrid energy storage unit based on the lithium iron phosphate-supercapacitor hybrid energy storage unit.Firstly,the variational mode decomposition algorithm is used to separate the high and low frequencies of the power signal,which is conducive to the rapid and accurate suppression of the power fluctuation of the energy storage system.Secondly,the fuzzy control algorithm is introduced to balance the power between energy storage.In this paper,the actual data is used for simulation,and the simulation results show that the strategy realizes the effective suppression of the bus voltage fluctuation and the accurate control of the internal state of the energy storage unit,effectively avoiding problems such as overshoot and over-discharge,and can significantly improve the stability of the photovoltaic power generation systemand the stability of the Direct Current bus.It is of great significance to promote the development of collaborative control technology for photovoltaic hybrid energy storage units.
基金supported by the National Natural Science Foundation of China(Project No.52377082)the Scientific Research Program of Jilin Provincial Department of Education(Project No.JJKH20230123KJ).
文摘Large-scale new energy grid connection leads to the weakening of the system frequency regulation capability,and the system frequency stability is facing unprecedented challenges.In order to solve rapid frequency fluctuation caused by new energy units,this paper proposes a new energy power system frequency regulation strategy with multiple units including the doubly-fed pumped storage unit(DFPSU).Firstly,based on the model predictive control(MPC)theory,the state space equations are established by considering the operating characteristics of the units and the dynamic behavior of the system;secondly,the proportional-differential control link is introduced to minimize the frequency deviation to further optimize the frequency modulation(FM)output of the DFPSU and inhibit the rapid fluctuation of the frequency;lastly,it is verified on theMatlab/Simulink simulation platform,and the results show that the model predictive control with proportional-differential control link can further release the FM potential of the DFPSU,increase the depth of its FM,effectively reduce the frequency deviation of the system and its rate of change,realize the optimization of the active output of the DFPSU and that of other units,and improve the frequency response capability of the system.
文摘BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
文摘Unplanned intensive care unit(ICU)admissions(UP-ICU)following initial general ward placement are associated with poor patient outcomes and represent a key quality indicator for healthcare facilities.Healthcare facilities have employed numerous predictive models,such as physiological scores(e.g.,Acute Physiology and Chronic Health Evaluation II,Revised Trauma Score,and Mortality Probability Model II at 24 hours)and anatomical scores(Injury Severity Score and New Injury Severity Score),to identify high-risk patients.Although physiological scores frequently surpass anatomical scores in predicting mortality,their specificity for trauma patients is limited,and their clinical applicability may be limited.Initially proposed for ICU readmission prediction,the stability and workload index for the transfer score has demonstrated inconsistent validity.Machine learning offers a promising alternative.Several studies have shown that machine learning models,including those that use electronic health records(EHR)data,can more accurately predict trauma patients’deaths and admissions to the ICU than traditional scoring systems.These models identify unique predictors that are not captured by existing methods.However,challenges remain,including integration with EHR systems and data entry complexities.Critical care outreach programs and telemedicine can help reduce UP-ICU admissions;however,their effectiveness remains unclear because of costs and implementation challenges,respectively.Strategies to reduce UP-ICU admissions include improving triage systems,implementing evidence-based protocols for ICU patient management,and prioritizing prehospital intervention and stabilization to optimize the“golden hour”of trauma care.To improve patient outcomes and reduce the burden of UPICU admissions,further studies are required to validate and implement these strategies and refine machine learning models.
文摘BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.
文摘BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.
基金supported in part by the National Nat-ural Science Foundation of China(52177110)Key Pro-gram of the National Natural Science Foundation of China(U22B20106,U2142206)+2 种基金Shenzhen Science and Technology Program(JCYJ20210324131409026)the Science and Technology Project of the State Grid Corpo-ration of China(5200-202319382A-2-3-XG)State Grid Zhejiang Elctric Power Co.,Ltd.Science and Tech-nology Project(B311DS24001A).
文摘Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.
