According to the physics of tokamak start-up,this study constructs a zero-dimensional(0D)model applicable to electron cyclotron(EC)wave assisted start-up in NCST spherical torus(spherical tokamak)and CN-H1 stellarator...According to the physics of tokamak start-up,this study constructs a zero-dimensional(0D)model applicable to electron cyclotron(EC)wave assisted start-up in NCST spherical torus(spherical tokamak)and CN-H1 stellarators.Using the constructed 0D model,the results obtained in this study under the same conditions are compared and validated against reference results for pure hydrogen plasma start-up in tokamak.The results are in good agreement,especially regarding electron temperature,ion temperature and plasma current.In the presence of finite Ohmic electric field in the spherical tokamak,a study on the EC wave assisted start-up of the NCST plasma at frequency of 28 GHz is conducted.The impact of the vertical magnetic field B_(v)on EC wave assisted start-up,the relationship between EC wave injection power P_(inj),Ohmic electric field E,and initial hydrogen atom density n_(H0)are explored separately.It is found that under conditions of Ohmic electric field lower than ITER(~0.3 V m^(-1)),EC wave can expand the operational space to achieve better plasma parameters.Simulating the process of28 GHz EC wave start-up in the CN-H1 stellarator plasma,the plasma current in the zerodimensional model is replaced with the current in the poloidal coil of the stellarator.Plasma startup can be successfully achieved at injection powers in the hundreds of kilowatts range,resulting in electron densities on the order of 10^(17)-10^(18)m^(-3).展开更多
Single-shot X-ray phase-contrast imaging is used to take high-resolution images of laser-driven strong shock waves.Employing a two-grating Talbot interferometer,we successfully acquire standard absorption,differential...Single-shot X-ray phase-contrast imaging is used to take high-resolution images of laser-driven strong shock waves.Employing a two-grating Talbot interferometer,we successfully acquire standard absorption,differential phase-contrast,and dark-field images of the shocked target.Good agreement is demonstrated between experimental data and the results of two-dimensional radiation hydrodynamics simulations of the laser-plasma interaction.The main sources of image noise are identified through a thorough assessment of the interferometer’s performance.The acquired images demonstrate that grating-based phase-contrast imaging is a powerful diagnostic tool for high-energy-density science.In addition,we make a novel attempt at using the dark-field image as a signal modality of Talbot interferometry to identify the microstructure of a foam target.展开更多
The circular explosion wave produced by the abrupt discharge of gas from a high-temperature heat source serves as a crucial model for addressing explosion phenomena in compressible flow.The reflection of the primary s...The circular explosion wave produced by the abrupt discharge of gas from a high-temperature heat source serves as a crucial model for addressing explosion phenomena in compressible flow.The reflection of the primary shock and its propagation within a confined domain are studied both theoretically and numerically in this research.Under the assumption of strong shock,the scaling law governing propagation of the main shock is proposed.The dimensionless frequency of reflected shock propagation is associated with the confined distance.The numerical simulation for the circular explosion problem in a confined domain is performed for validation.Under the influence of confinement,the principal shock wave systematically undergoes reflection within the domain until it weakens,leading to the non-monotonic attenuation of kinetic energy in the explosion fireball and periodic oscillations of the fireball volume with a certain frequency.The simulation results indicate that the frequency of kinetic energy attenuation and the volume oscillation of the explosive fireball align consistently with the scaling law.展开更多
We investigate the dynamics of convergent shock compression in solid cylindrical targets irradiated by an ultrafast relativistic laser pulse.Our particle-in-cell simulations and coupled hydrodynamic simulations reveal...We investigate the dynamics of convergent shock compression in solid cylindrical targets irradiated by an ultrafast relativistic laser pulse.Our particle-in-cell simulations and coupled hydrodynamic simulations reveal that the compression process is initiated by both magnetic pressure and surface ablation associated with a strong transient surface return current with density of the order of 10^(17) A/m^(2) and lifetime of 100 fs.The results show that the dominant compression mechanism is governed by the plasma β,i.e.,the ratio of thermal pressure to magnetic pressure.For targets with small radius and low atomic number Z,the magnetic pressure is the dominant shock compression mechanism.According to a scaling law,as the target radius and Z increase,the surface ablation pressure becomes the main mechanism generating convergent shocks.Furthermore,an indirect experimental indication of shocked hydrogen compression is provided by optical shadowgraphy measurements of the evolution of the plasma expansion diameter.The results presented here provide a novel basis for the generation of extremely high pressures exceeding Gbar(100 TPa)to enable the investigation of high-pressure physics using femtosecond J-level laser pulses,offering an alternative to nanosecond kJ-laser pulse-driven and pulsed power Z-pinch compression methods.展开更多
Background:Severe trauma is associated with systemic inflammation and organ dysfunction.Preclinical rodent trauma models are the mainstay of postinjury research but have been criticized for not fully replicating sever...Background:Severe trauma is associated with systemic inflammation and organ dysfunction.Preclinical rodent trauma models are the mainstay of postinjury research but have been criticized for not fully replicating severe human trauma.The aim of this study was to create a rat model of multicompartmental injury which recreates profound traumatic injury.Methods:Male Sprague-Dawley rats were subjected to unilateral lung contusion and hemorrhagic shock(LCHS),multicompartmental polytrauma(PT)(unilateral lung contusion,hemorrhagic shock,cecectomy,bifemoral pseudofracture),or na?ve controls.Weight,plasma toll-l ike receptor 4(TLR4),hemoglobin,spleen to body weight ratio,bone marrow(BM)erythroid progenitor(CFU-GEMM,BFU-E,and CFU-E)growth,plasma granulocyte colony-stimulating factor(G-CSF)and right lung histologic injury were assessed on day 7,with significance defined as p values<0.05(*).Results:Polytrauma resulted in markedly more profound inhibition of weight gain compared to LCHS(p=0.0002)along with elevated plasma TLR4(p<0.0001),lower hemoglobin(p<0.0001),and enlarged spleen to body weight ratios(p=0.004).Both LCHS and PT demonstrated suppression of CFU-E and BFU-E growth compared to naive(p<0.03,p<0.01).Plasma G-CSF was elevated in PT compared to both na?ve and LCHS(p<0.0001,p=0.02).LCHS and PT demonstrated significant histologic right lung injury with poor alveolar wall integrity and interstitial edema.Conclusions:Multicompartmental injury as described here establishes a reproducible model of multicompartmental injury with worsened anemia,splenic tissue enlargement,weight loss,and increased inflammatory activity compared to a less severe model.This may serve as a more effective model to recreate profound traumatic injury to replicate the human inflammatory response postinjury.展开更多
Prototype experiments were carried out on the explosion-proof performance of the RC blast wall.The mass of TNT detonated in the experiments is 5 kg and 20 kg respectively.The shock wave overpressure was tested in diff...Prototype experiments were carried out on the explosion-proof performance of the RC blast wall.The mass of TNT detonated in the experiments is 5 kg and 20 kg respectively.The shock wave overpressure was tested in different regions.The above experiments were numerically simulated,and the simulated shock wave overpressure waveforms were compared with that tested and given by CONWEP program.The results show that the numerically simulated waveform is slightly different from the test waveform,but similar to CONWEP waveform.Through dimensional analysis and numerical simulation under different working conditions,the equation for the attenuation rate of the diffraction overpressure behind the blast wall was obtained.According to the corresponding standards,the degree of casualties and the damage degree of the brick concrete building at a certain distance behind the wall can be determined when parameters are set.The above results can provide a reference for the design and construction of the reinforced concrete blast wall.展开更多
This work focuses on the effect of the interval between two shocks on the ejecta formation from the grooved aluminum(Al_(1100))surface by using smoothed particle hydrodynamics numerical simulation.Two unsupported shoc...This work focuses on the effect of the interval between two shocks on the ejecta formation from the grooved aluminum(Al_(1100))surface by using smoothed particle hydrodynamics numerical simulation.Two unsupported shocks are obtained by the plate-impact between sample and two flyers at interval,with a peak pressure of approximately 30 GPa for each shock.When the shock interval varies from 2.11 to 7.67 times the groove depth,the bubble velocity reduces to a constant,and the micro jetting factor R_(J) from spike to bubble exhibits a non-monotonic change that decreases initially and then increases.At a shock interval of 3.6 times the groove depth,micro jetting factor R_(J) from spike to bubble reaches its minimum value of approximately 0.6.While,the micro jetting factor R_(F) from spike to free surface decreases linearly at first,and stabilizes around 0.25 once the shock interval surpasses 4.18 times the groove depth.When the shock interval is less than 4.18 times the groove depth,the unloading wave generated by the breakout of the first shock wave is superimpose with the unloading part of the second shock wave to form a large tensile area.展开更多
By combination of the transient Raman spectroscopic measurement and the density functional theoretical calculations,the structural evolution and stability of TATB under shock compression was investigated.Due to the im...By combination of the transient Raman spectroscopic measurement and the density functional theoretical calculations,the structural evolution and stability of TATB under shock compression was investigated.Due to the improvement in synchronization control between two-stage light gas gun and the transient Raman spectra acquisition,as well as the sample preparation,the Raman peak of the N-O mode of TATB was firstly observed under shock pressure up to 13.6 GPa,noticeably higher than the upper limit of 8.5 GPa reported in available literatures.By taking into account of the continuous shift of the main peak and other observed Raman peaks,we did not distinguish any structural transition or any new species.Moreover,both the present Raman spectra and the time-resolved radiation of TATB during shock loading showed that TATB exhibits higher chemical stability than previous declaration.To reveal the detailed structural response and evolution of TATB under compression,the density functional theoretical calculations were conducted,and it was found that the pressure make N-O bond lengths shorter,nitro bond angles larger,and intermolecular and intra-molecular hydrogen bond interactions enhanced.The observed red shift of Raman peak was ascribed to the abnormal enhancement of H-bound effect on the scissor vibration mode of the nitro group.展开更多
Porous materials are widely used in the field of protection because of their excellent energy absorption characteristics.In this work,a series of polyurethane microscopic models are established and the effect of poros...Porous materials are widely used in the field of protection because of their excellent energy absorption characteristics.In this work,a series of polyurethane microscopic models are established and the effect of porosity on the shock waves is studied with classical molecular dynamics simulations.Firstly,shock Hugoniot relations for different porosities are obtained,which compare well with the experimental data.The pores collapse and form local stress wave,which results in the complex multi-wave structure of the shock wave.The microstructure analysis shows that the local stress increases and the local velocity decreases gradually during the process of pore collapse to complete compaction.Finally,it leads to stress relaxation and velocity homogenization.The shock stress peaks can be fitted with two exponential functions,and the amplitude of attenuation coefficient decreases with the increase of density.Besides,the pore collapse under shock or non-shock are discussed by the entropy increase rate of the system.The energy is dissipated mainly through the multiple interactions of the waves under shock.The energy is dissipated mainly by the friction between atoms under non-shock.展开更多
This paper is devoted to studying the stability of transonic shock solutions to the Euler-Poisson system in a one-dimensional nozzle of finite length.The background charge in the Poisson equation is a piecewise consta...This paper is devoted to studying the stability of transonic shock solutions to the Euler-Poisson system in a one-dimensional nozzle of finite length.The background charge in the Poisson equation is a piecewise constant function.The structural stability of the steady transonic shock solution is obtained by the monotonicity argument.Furthermore,this transonic shock is proved to be dynamically and exponentially stable with respect to small perturbations of the initial data.One of the crucial ingredients of the analysis is to establish the global well-posedness of a free boundary problem for a quasilinear second order equation with nonlinear boundary conditions.展开更多
BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking Univers...BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created.RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.展开更多
The first pandemic wave of coronavirus disease 2019(COVID-19)induced a considerable increase in several antivirals and antibiotics in surface water.The common symptoms of COVID-19 are viral and bacterial infections,wh...The first pandemic wave of coronavirus disease 2019(COVID-19)induced a considerable increase in several antivirals and antibiotics in surface water.The common symptoms of COVID-19 are viral and bacterial infections,while comorbidities(e.g.,hypertension and diabetes)and mental shock(e.g.,insomnia and anxiety)are nonnegligible.Nevertheless,little is known about the long-term impacts of comorbidities and mental shock on organic micropollutants(OMPs)in surface waters.Herein,we monitored 114 OMPs in surface water and wastewater treatment plants(WWTPs)in Wuhan,China,between 2019 and 2021.The pandemic-induced OMP pollution in surface water was confirmed by significant increases in 26 OMP concentrations.Significant increases in four antihypertensives and one diabetic drug suggest that the treatment of comorbidities may induce OMP pollution.Notably,cotinine(a metabolite of nicotine)increased 155 times to 187 ngL1,which might be associated with increased smoking.Additionally,the increases in zolpidem and sulpiride might be the result of worsened insomnia and depression.Hence,it is reasonable to note that mental-health protecting drugs/behavior also contributed to OMP pollution.Among the observed OMPs,telmisartan,lopinavir,and ritonavir were associated with significantly higher ecological risks because of their limited WWTP-removal rate and high ecotoxicity.This study provides new insights into the effects of comorbidities and mental shock on OMPs in surface water during a pandemic and highlights the need to monitor the fate of related pharmaceuticals in the aquatic environment and to improve their removal efficiencies in WWTPs。展开更多
The benefits of using cryogenic liquid nitrogen shock to enhance coal permeability have been confirmed from experimental perspectives.In this paper,we develop a fully coupled thermo-elastic model in combination with t...The benefits of using cryogenic liquid nitrogen shock to enhance coal permeability have been confirmed from experimental perspectives.In this paper,we develop a fully coupled thermo-elastic model in combination with the strain-based isotropic damage theory to uncover the cooling-dominated cracking behaviors through three typical cases,i.e.coal reservoirs containing a wellbore,a primary fracture,and a natural fracture network,respectively.The progressive cracking processes,from thermal fracture initiation,propagation or cessation,deflection,bifurcation to multi-fracture interactions,can be well captured by the numerical model.It is observed that two hierarchical levels of thermal fractures are formed,in which the number of shorter thermal fractures consistently exceeds that of the longer ones.The effects of coal properties related to thermal stress levels and thermal diffusivity on the fracture morphology are quantified by the fracture fractal dimension and the statistical fracture number.The induced fracture morphology is most sensitive to changes in the elastic modulus and thermal expansion coefficient,both of which dominate the complexity of the fracture networks.Coal reservoir candidates with preferred thermal-mechanical properties are also recommended for improving the stimulation effect.Further findings are that there exists a critical injection temperature and a critical in-situ stress difference,above which no thermal fractures would be formed.Preexisting natural fractures with higher density and preferred orientations are also essential for the formation of complex fracture networks.The obtained results can provide some theoretical support for cryogenic fracturing design in coal reservoirs.展开更多
The article deals with the motion of the breech block carrier and the weapon casing of an automatic weapon mounted on a flexible carriage and the base of the weapon.Earlier works,which did not consider the dynamic pro...The article deals with the motion of the breech block carrier and the weapon casing of an automatic weapon mounted on a flexible carriage and the base of the weapon.Earlier works,which did not consider the dynamic properties of the base of the weapon,did not allow to reconcile the calculated and experimental results of the weapon casing displacement when shooting from firing rests.For the analysis of the motion of individual parts,the methods of mathematical modelling and firing experiments using a high-speed camera were chosen.Calculations show the best accord with experiment when modelling the system with 4 degrees of freedom.The oscillation of the system regarding the movement of the breech block carrier and the weapon casing was investigated under changed conditions of rate of fire,the use of a muzzle brake and different types of shock absorbers.The velocities and displacements of the weapon casing and the breech block carrier at different values of the impulse of the gases to the breech block carrier were determined.展开更多
In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting conse...In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting consequences.To investigate the protection ability and characteristics of flexible materials and structures under weak shock wave loading,the blast wave produced by TNT explosive is loaded on the polyurethane foam with the density of 200.0 kg/m3(F-200)and 400.0 kg/m3(F-400),polyurea with the density of 1100.0 kg/m^(3)(P-1100)and structures composed of the two materials,which are intended for individual protection.Experimental results indicate that the shock wave is attenuated to weak pressure disturbance after interacting with the flexible materials which are not damaged.The shock wave protective capability of single-layer materials is dependent on their thickness,density and microscopic characteristics.The overpressure,maximum pressure rise rate and impulse of transmitted wave decrease exponentially with increase in sample thickness.For the same thickness,F-400 provides better protective capability than F-200 while P-1100 shows the best protective capability among the three materials.In this study,as the materials are not destroyed,F-200 with a thickness more than10.0 mm,F-400 with a thickness more than 4.0 mm,and P-1100 with a thickness more than 1.0 mm can attenuate the overpressure amplitude more than 90.0%.Further,multi-layer flexible composites are designed.Different layer layouts of designed structures and layer thickness of the single-layer materials can affect the protective performance.Within the research range,the structure in which polyurea is placed on the impact side shows the optimal shock wave protective performance,and the thicknesses of polyurea and polyurethane foam are 1.0 mm and 4.0 mm respectively.The overpressure attenuation rate reached maximum value of 93.3%and impulse attenuation capacity of this structure are better than those of single-layer polyurea and polyurethane foam with higher areal density.展开更多
Chemical inclusions significantly alter shock responses of crystalline explosives in macroscale gap experiments but their microscale dynamics origin remains unclear.Herein shock-induced energy localization,overall phy...Chemical inclusions significantly alter shock responses of crystalline explosives in macroscale gap experiments but their microscale dynamics origin remains unclear.Herein shock-induced energy localization,overall physical responses,and reactions in a-1,3,5-trinitro-1,3,5-triazinane(a-RDX)crystal entrained various chemical inclusions were investigated by the multi-scale shock technique implemented in the reactive molecular dynamics method.Results indicated that energy localization and shock reaction were affected by the intrinsic factors within chemical inclusions,i.e.,phase states,chemical compositions,and concentrations.The atomic origin of chemical-inclusions effects on energy localization is dependent on the dynamics mechanism of interfacial molecules with free space volume,which includes homogeneous intermolecular compression,interfacial impact and shear,and void collapse and jet.As introducing various chemical inclusions,the initiation of those dynamics mechanisms triggers diverse decay rates of bulk RDX molecules and hereby impacts on growth speeds of final reactions.Adding chemical inclusions can reduce the effectiveness of the void during the shock impacting.Under the shockwave velocity of 9 km/s,the parent RDX decay rate in RDX entrained amorphous carbon decreases the most and is about one fourth of that in RDX with a vacuum void,and solid HMX and TATB inclusions are more reactive than amorphous carbon but less reactive than dry air or acetone inclusions.The lessdense shocking system denotes the greater increases in local temperature and stress,the faster energy liberation,and the earlier final reaction into equilibrium,revealing more pronounced responses to the present intense shockwave.The quantitative models associated with the relative system density(RD_(sys))were proposed for indicating energy-localization mechanisms and evaluating initiation safety in the shocked crystalline explosive.RD_(sys)is defined by the density ratio of defective RDX to perfect crystal after dynamics relaxation and reveals the global density characteristic in shocked systems filled with chemical inclusions.When RD_(sys)is below 0.9,local hydrodynamic jet initiated by void collapse dominates upon energy localization instead of interfacial impact.This study sheds light on novel insights for understanding the shock chemistry and physical-based atomic origin in crystalline explosives considering chemical-inclusions effects.展开更多
BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We per...BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong.The primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED presentation.Using c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time points.RESULTS:We analyzed 601 patients,of whom 166(27.6%)developed sepsis.NEWS2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary outcome.However,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),respectively.The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.CONCLUSION:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.展开更多
Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin Ⅰ to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on child...Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin Ⅰ to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam.Detailed clinical histories,physical examinations,and laboratory parameters,including NT-pro BNP and troponin Ⅰ,were recorded.A comparison between survival and non-survival was carried out to identify factors influencing mortality.Results:A total of 107 patients with a median age of 9 years were included in the study.Among them,63.6%(68/107)presented with compensated shock,36.4%(39/107)had hypotensive shock,23.4%(25/107)required mechanical ventilation,and 12.1%(13/107)died.The NT-pro BNP levels were 3.9 pmol/L(IQR:1.9,10.3)and 15.2 pmol/L(5.8,46.3),while the median high sensitivity troponin Ⅰ levels were 20 pg/L(6,95)and 62 pg/L(12,325)at the first and second measurements,respectively.The mortality group exhibited higher rates of hypotensive shock,prolonged shock,lactate levels,liver damage,NT-pro BNP,and troponin Ⅰ levels.Hypotensive shock(OR 12.96,95%CI 2.70-62.30,P=0.004),prolonged shock(OR 39.40,95%CI 6.68-232.70,P<0.001),AST>1000 IU/L(OR 9.50,95%CI 2.63-34.34,P=0.041),and NT-pro BNP>7 pmol/L(OR 44.40,95%CI 5.44-362.20,P=0.001)were identified as predictive factors for mortality in dengue shock syndrome.Conclusions:The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.展开更多
Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar dat...Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar databases with keywords sepsis,septic shock,sepsis management,and sepsis complications.Articles published up to July 2023 in English were included.Diagnosis and management should be carried out without unnecessary delay.Cooperation between various medical specialties including intensive care doctors,neurologists,hepatologists,cardiologists,and pediatric doctors is needed if a child is affected.New strategies have to be implemented in low and middle-income countries to decrease the sepsis incidence and reduce mortality in the population.展开更多
Adopting the classical theory of hydrocodes,the constitutive relations of concretes are separated into an equation of state(EoS)which describes the volumetric behavior of concrete material and a strength model which d...Adopting the classical theory of hydrocodes,the constitutive relations of concretes are separated into an equation of state(EoS)which describes the volumetric behavior of concrete material and a strength model which depicts the shear properties of concrete.The experiments on the EoS of concrete is always challenging due to the technical difficulties and equipment limitations,especially for the specimen size effect on the EoS.Although some researchers investigate the shock properties of concretes by fly-plate impact tests,the specimens used in their tests are usually in one size.In this paper,the fly-plate impact tests on concrete specimens with different sizes are performed to investigate the size effect on the shock properties of concrete materials.The mechanical background of the size effect on the shock properties are revealed,which is related to the lateral rarefaction effect and the deviatoric stress produced in the specimen.According to the tests results,the modified EoS considering the size effect on the shock properties of concrete are proposed,which the bulk modulus of concrete is unpredicted by up to 20% if size effects are not accounted for.展开更多
基金supported by the National Key Research and Development Program of China(Nos.2022YFE03070000 and 2022YFE03070003)National Natural Science Foundation of China(Nos.12375220 and 12075114)。
文摘According to the physics of tokamak start-up,this study constructs a zero-dimensional(0D)model applicable to electron cyclotron(EC)wave assisted start-up in NCST spherical torus(spherical tokamak)and CN-H1 stellarators.Using the constructed 0D model,the results obtained in this study under the same conditions are compared and validated against reference results for pure hydrogen plasma start-up in tokamak.The results are in good agreement,especially regarding electron temperature,ion temperature and plasma current.In the presence of finite Ohmic electric field in the spherical tokamak,a study on the EC wave assisted start-up of the NCST plasma at frequency of 28 GHz is conducted.The impact of the vertical magnetic field B_(v)on EC wave assisted start-up,the relationship between EC wave injection power P_(inj),Ohmic electric field E,and initial hydrogen atom density n_(H0)are explored separately.It is found that under conditions of Ohmic electric field lower than ITER(~0.3 V m^(-1)),EC wave can expand the operational space to achieve better plasma parameters.Simulating the process of28 GHz EC wave start-up in the CN-H1 stellarator plasma,the plasma current in the zerodimensional model is replaced with the current in the poloidal coil of the stellarator.Plasma startup can be successfully achieved at injection powers in the hundreds of kilowatts range,resulting in electron densities on the order of 10^(17)-10^(18)m^(-3).
基金funded by the Deutsche Forschungsgemeinschaft(DFG)under Grant No.452935060(“Einzelschuss Rontgen-Phasenkonstrast Abbildung von dichten Plasmen,”https://gepris.dfg.de/gepris/projekt/452935060)supported by Laserlab-Europe with GrantNo.PID20536supported by the Alexander von Humboldt Foundation.
文摘Single-shot X-ray phase-contrast imaging is used to take high-resolution images of laser-driven strong shock waves.Employing a two-grating Talbot interferometer,we successfully acquire standard absorption,differential phase-contrast,and dark-field images of the shocked target.Good agreement is demonstrated between experimental data and the results of two-dimensional radiation hydrodynamics simulations of the laser-plasma interaction.The main sources of image noise are identified through a thorough assessment of the interferometer’s performance.The acquired images demonstrate that grating-based phase-contrast imaging is a powerful diagnostic tool for high-energy-density science.In addition,we make a novel attempt at using the dark-field image as a signal modality of Talbot interferometry to identify the microstructure of a foam target.
基金the National Natural Science Foundation of China(Nos.11988102,92052201,11825204,12032016,12372220,and 12372219)。
文摘The circular explosion wave produced by the abrupt discharge of gas from a high-temperature heat source serves as a crucial model for addressing explosion phenomena in compressible flow.The reflection of the primary shock and its propagation within a confined domain are studied both theoretically and numerically in this research.Under the assumption of strong shock,the scaling law governing propagation of the main shock is proposed.The dimensionless frequency of reflected shock propagation is associated with the confined distance.The numerical simulation for the circular explosion problem in a confined domain is performed for validation.Under the influence of confinement,the principal shock wave systematically undergoes reflection within the domain until it weakens,leading to the non-monotonic attenuation of kinetic energy in the explosion fireball and periodic oscillations of the fireball volume with a certain frequency.The simulation results indicate that the frequency of kinetic energy attenuation and the volume oscillation of the explosive fireball align consistently with the scaling law.
文摘We investigate the dynamics of convergent shock compression in solid cylindrical targets irradiated by an ultrafast relativistic laser pulse.Our particle-in-cell simulations and coupled hydrodynamic simulations reveal that the compression process is initiated by both magnetic pressure and surface ablation associated with a strong transient surface return current with density of the order of 10^(17) A/m^(2) and lifetime of 100 fs.The results show that the dominant compression mechanism is governed by the plasma β,i.e.,the ratio of thermal pressure to magnetic pressure.For targets with small radius and low atomic number Z,the magnetic pressure is the dominant shock compression mechanism.According to a scaling law,as the target radius and Z increase,the surface ablation pressure becomes the main mechanism generating convergent shocks.Furthermore,an indirect experimental indication of shocked hydrogen compression is provided by optical shadowgraphy measurements of the evolution of the plasma expansion diameter.The results presented here provide a novel basis for the generation of extremely high pressures exceeding Gbar(100 TPa)to enable the investigation of high-pressure physics using femtosecond J-level laser pulses,offering an alternative to nanosecond kJ-laser pulse-driven and pulsed power Z-pinch compression methods.
基金supported by the National Institutes of Healthsupported by NIH NIGMS R01 GM105893+2 种基金supported by postgraduate training grant NIH NIGMS T32 GM-008721 in burnstraumaand perioperative injury。
文摘Background:Severe trauma is associated with systemic inflammation and organ dysfunction.Preclinical rodent trauma models are the mainstay of postinjury research but have been criticized for not fully replicating severe human trauma.The aim of this study was to create a rat model of multicompartmental injury which recreates profound traumatic injury.Methods:Male Sprague-Dawley rats were subjected to unilateral lung contusion and hemorrhagic shock(LCHS),multicompartmental polytrauma(PT)(unilateral lung contusion,hemorrhagic shock,cecectomy,bifemoral pseudofracture),or na?ve controls.Weight,plasma toll-l ike receptor 4(TLR4),hemoglobin,spleen to body weight ratio,bone marrow(BM)erythroid progenitor(CFU-GEMM,BFU-E,and CFU-E)growth,plasma granulocyte colony-stimulating factor(G-CSF)and right lung histologic injury were assessed on day 7,with significance defined as p values<0.05(*).Results:Polytrauma resulted in markedly more profound inhibition of weight gain compared to LCHS(p=0.0002)along with elevated plasma TLR4(p<0.0001),lower hemoglobin(p<0.0001),and enlarged spleen to body weight ratios(p=0.004).Both LCHS and PT demonstrated suppression of CFU-E and BFU-E growth compared to naive(p<0.03,p<0.01).Plasma G-CSF was elevated in PT compared to both na?ve and LCHS(p<0.0001,p=0.02).LCHS and PT demonstrated significant histologic right lung injury with poor alveolar wall integrity and interstitial edema.Conclusions:Multicompartmental injury as described here establishes a reproducible model of multicompartmental injury with worsened anemia,splenic tissue enlargement,weight loss,and increased inflammatory activity compared to a less severe model.This may serve as a more effective model to recreate profound traumatic injury to replicate the human inflammatory response postinjury.
基金funded by Key R&D Projects in Hubei Province (Grant No.2020BCA084)Innovative Group Project of Hubei Natural Science Foundation (Grant No.2020CFA043)。
文摘Prototype experiments were carried out on the explosion-proof performance of the RC blast wall.The mass of TNT detonated in the experiments is 5 kg and 20 kg respectively.The shock wave overpressure was tested in different regions.The above experiments were numerically simulated,and the simulated shock wave overpressure waveforms were compared with that tested and given by CONWEP program.The results show that the numerically simulated waveform is slightly different from the test waveform,but similar to CONWEP waveform.Through dimensional analysis and numerical simulation under different working conditions,the equation for the attenuation rate of the diffraction overpressure behind the blast wall was obtained.According to the corresponding standards,the degree of casualties and the damage degree of the brick concrete building at a certain distance behind the wall can be determined when parameters are set.The above results can provide a reference for the design and construction of the reinforced concrete blast wall.
基金supported by the Doctoral Research Launch Foundation of Liaoning Province(Grant No.2022-BS-185),Chinathe Science Challenge Project(Grant No.TZ2016001),China+2 种基金the National Natural Science Foundation of China(Grant Nos.11972092,12172056,12002049),Chinathe key Laboratory of Computational Physics(Gant No.HX02021-24)720-24)Shenyang Ligong University Talent Introduction Support Fund,China。
文摘This work focuses on the effect of the interval between two shocks on the ejecta formation from the grooved aluminum(Al_(1100))surface by using smoothed particle hydrodynamics numerical simulation.Two unsupported shocks are obtained by the plate-impact between sample and two flyers at interval,with a peak pressure of approximately 30 GPa for each shock.When the shock interval varies from 2.11 to 7.67 times the groove depth,the bubble velocity reduces to a constant,and the micro jetting factor R_(J) from spike to bubble exhibits a non-monotonic change that decreases initially and then increases.At a shock interval of 3.6 times the groove depth,micro jetting factor R_(J) from spike to bubble reaches its minimum value of approximately 0.6.While,the micro jetting factor R_(F) from spike to free surface decreases linearly at first,and stabilizes around 0.25 once the shock interval surpasses 4.18 times the groove depth.When the shock interval is less than 4.18 times the groove depth,the unloading wave generated by the breakout of the first shock wave is superimpose with the unloading part of the second shock wave to form a large tensile area.
基金supported by the National Natural Science Foundation of China(Grant Nos.12072299,11902276)the Natural Science Foundation of Sichuan Province(Grant No.2022NSFSC1802)+1 种基金the Basic Research Project of Southwest Jiaotong University(Grant No.2682023ZTPY009)the National Key Laboratory for Shock Wave and Detonation Physics of China(Grant No.JCKYS2019212007)。
文摘By combination of the transient Raman spectroscopic measurement and the density functional theoretical calculations,the structural evolution and stability of TATB under shock compression was investigated.Due to the improvement in synchronization control between two-stage light gas gun and the transient Raman spectra acquisition,as well as the sample preparation,the Raman peak of the N-O mode of TATB was firstly observed under shock pressure up to 13.6 GPa,noticeably higher than the upper limit of 8.5 GPa reported in available literatures.By taking into account of the continuous shift of the main peak and other observed Raman peaks,we did not distinguish any structural transition or any new species.Moreover,both the present Raman spectra and the time-resolved radiation of TATB during shock loading showed that TATB exhibits higher chemical stability than previous declaration.To reveal the detailed structural response and evolution of TATB under compression,the density functional theoretical calculations were conducted,and it was found that the pressure make N-O bond lengths shorter,nitro bond angles larger,and intermolecular and intra-molecular hydrogen bond interactions enhanced.The observed red shift of Raman peak was ascribed to the abnormal enhancement of H-bound effect on the scissor vibration mode of the nitro group.
基金financial support from National Natural Science Foundation of China(Grant No.12172325)。
文摘Porous materials are widely used in the field of protection because of their excellent energy absorption characteristics.In this work,a series of polyurethane microscopic models are established and the effect of porosity on the shock waves is studied with classical molecular dynamics simulations.Firstly,shock Hugoniot relations for different porosities are obtained,which compare well with the experimental data.The pores collapse and form local stress wave,which results in the complex multi-wave structure of the shock wave.The microstructure analysis shows that the local stress increases and the local velocity decreases gradually during the process of pore collapse to complete compaction.Finally,it leads to stress relaxation and velocity homogenization.The shock stress peaks can be fitted with two exponential functions,and the amplitude of attenuation coefficient decreases with the increase of density.Besides,the pore collapse under shock or non-shock are discussed by the entropy increase rate of the system.The energy is dissipated mainly through the multiple interactions of the waves under shock.The energy is dissipated mainly by the friction between atoms under non-shock.
基金supported by the National Natural Science Foundation of China(11871134,12171166)the Fundamental Research Funds for the Central Universities(DUT23LAB303)。
文摘This paper is devoted to studying the stability of transonic shock solutions to the Euler-Poisson system in a one-dimensional nozzle of finite length.The background charge in the Poisson equation is a piecewise constant function.The structural stability of the steady transonic shock solution is obtained by the monotonicity argument.Furthermore,this transonic shock is proved to be dynamically and exponentially stable with respect to small perturbations of the initial data.One of the crucial ingredients of the analysis is to establish the global well-posedness of a free boundary problem for a quasilinear second order equation with nonlinear boundary conditions.
文摘BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created.RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.
基金supported by the National Natural Science Foundation of China(52221004,52091542,and 51820105011)the Scientific Research Project of China Three Gorges Corporation(201903139)the Research Fund of Vanke School of Public Health(2021JC009),Tsinghua University.
文摘The first pandemic wave of coronavirus disease 2019(COVID-19)induced a considerable increase in several antivirals and antibiotics in surface water.The common symptoms of COVID-19 are viral and bacterial infections,while comorbidities(e.g.,hypertension and diabetes)and mental shock(e.g.,insomnia and anxiety)are nonnegligible.Nevertheless,little is known about the long-term impacts of comorbidities and mental shock on organic micropollutants(OMPs)in surface waters.Herein,we monitored 114 OMPs in surface water and wastewater treatment plants(WWTPs)in Wuhan,China,between 2019 and 2021.The pandemic-induced OMP pollution in surface water was confirmed by significant increases in 26 OMP concentrations.Significant increases in four antihypertensives and one diabetic drug suggest that the treatment of comorbidities may induce OMP pollution.Notably,cotinine(a metabolite of nicotine)increased 155 times to 187 ngL1,which might be associated with increased smoking.Additionally,the increases in zolpidem and sulpiride might be the result of worsened insomnia and depression.Hence,it is reasonable to note that mental-health protecting drugs/behavior also contributed to OMP pollution.Among the observed OMPs,telmisartan,lopinavir,and ritonavir were associated with significantly higher ecological risks because of their limited WWTP-removal rate and high ecotoxicity.This study provides new insights into the effects of comorbidities and mental shock on OMPs in surface water during a pandemic and highlights the need to monitor the fate of related pharmaceuticals in the aquatic environment and to improve their removal efficiencies in WWTPs。
基金funding support from the Natural Science Foundation of Sichuan,China(Grant No.2022NSFSC1227)the National Natural Science Foundation of China(Grant Nos.U1762216 and 51574270).
文摘The benefits of using cryogenic liquid nitrogen shock to enhance coal permeability have been confirmed from experimental perspectives.In this paper,we develop a fully coupled thermo-elastic model in combination with the strain-based isotropic damage theory to uncover the cooling-dominated cracking behaviors through three typical cases,i.e.coal reservoirs containing a wellbore,a primary fracture,and a natural fracture network,respectively.The progressive cracking processes,from thermal fracture initiation,propagation or cessation,deflection,bifurcation to multi-fracture interactions,can be well captured by the numerical model.It is observed that two hierarchical levels of thermal fractures are formed,in which the number of shorter thermal fractures consistently exceeds that of the longer ones.The effects of coal properties related to thermal stress levels and thermal diffusivity on the fracture morphology are quantified by the fracture fractal dimension and the statistical fracture number.The induced fracture morphology is most sensitive to changes in the elastic modulus and thermal expansion coefficient,both of which dominate the complexity of the fracture networks.Coal reservoir candidates with preferred thermal-mechanical properties are also recommended for improving the stimulation effect.Further findings are that there exists a critical injection temperature and a critical in-situ stress difference,above which no thermal fractures would be formed.Preexisting natural fractures with higher density and preferred orientations are also essential for the formation of complex fracture networks.The obtained results can provide some theoretical support for cryogenic fracturing design in coal reservoirs.
基金supported by the Research project VAROPS(Military autonomous and robotic assets)of the Ministry of Defence of The Czech Republicby the Specific Research Support Project(Grant No.SV22-201)financed from funds of the Ministry of Education,Youth and Sports of The Czech Republic。
文摘The article deals with the motion of the breech block carrier and the weapon casing of an automatic weapon mounted on a flexible carriage and the base of the weapon.Earlier works,which did not consider the dynamic properties of the base of the weapon,did not allow to reconcile the calculated and experimental results of the weapon casing displacement when shooting from firing rests.For the analysis of the motion of individual parts,the methods of mathematical modelling and firing experiments using a high-speed camera were chosen.Calculations show the best accord with experiment when modelling the system with 4 degrees of freedom.The oscillation of the system regarding the movement of the breech block carrier and the weapon casing was investigated under changed conditions of rate of fire,the use of a muzzle brake and different types of shock absorbers.The velocities and displacements of the weapon casing and the breech block carrier at different values of the impulse of the gases to the breech block carrier were determined.
基金supported by the National Natural Science Foundation of China(Grant Nos.12221002,12102233)。
文摘In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting consequences.To investigate the protection ability and characteristics of flexible materials and structures under weak shock wave loading,the blast wave produced by TNT explosive is loaded on the polyurethane foam with the density of 200.0 kg/m3(F-200)and 400.0 kg/m3(F-400),polyurea with the density of 1100.0 kg/m^(3)(P-1100)and structures composed of the two materials,which are intended for individual protection.Experimental results indicate that the shock wave is attenuated to weak pressure disturbance after interacting with the flexible materials which are not damaged.The shock wave protective capability of single-layer materials is dependent on their thickness,density and microscopic characteristics.The overpressure,maximum pressure rise rate and impulse of transmitted wave decrease exponentially with increase in sample thickness.For the same thickness,F-400 provides better protective capability than F-200 while P-1100 shows the best protective capability among the three materials.In this study,as the materials are not destroyed,F-200 with a thickness more than10.0 mm,F-400 with a thickness more than 4.0 mm,and P-1100 with a thickness more than 1.0 mm can attenuate the overpressure amplitude more than 90.0%.Further,multi-layer flexible composites are designed.Different layer layouts of designed structures and layer thickness of the single-layer materials can affect the protective performance.Within the research range,the structure in which polyurea is placed on the impact side shows the optimal shock wave protective performance,and the thicknesses of polyurea and polyurethane foam are 1.0 mm and 4.0 mm respectively.The overpressure attenuation rate reached maximum value of 93.3%and impulse attenuation capacity of this structure are better than those of single-layer polyurea and polyurethane foam with higher areal density.
基金the financial support from National Natural Science Foundation of China(Grant Nos.11872119,12172051,and 11972329)Natural Science Foundation of Hubei Province(Grant No.2021CFB120)。
文摘Chemical inclusions significantly alter shock responses of crystalline explosives in macroscale gap experiments but their microscale dynamics origin remains unclear.Herein shock-induced energy localization,overall physical responses,and reactions in a-1,3,5-trinitro-1,3,5-triazinane(a-RDX)crystal entrained various chemical inclusions were investigated by the multi-scale shock technique implemented in the reactive molecular dynamics method.Results indicated that energy localization and shock reaction were affected by the intrinsic factors within chemical inclusions,i.e.,phase states,chemical compositions,and concentrations.The atomic origin of chemical-inclusions effects on energy localization is dependent on the dynamics mechanism of interfacial molecules with free space volume,which includes homogeneous intermolecular compression,interfacial impact and shear,and void collapse and jet.As introducing various chemical inclusions,the initiation of those dynamics mechanisms triggers diverse decay rates of bulk RDX molecules and hereby impacts on growth speeds of final reactions.Adding chemical inclusions can reduce the effectiveness of the void during the shock impacting.Under the shockwave velocity of 9 km/s,the parent RDX decay rate in RDX entrained amorphous carbon decreases the most and is about one fourth of that in RDX with a vacuum void,and solid HMX and TATB inclusions are more reactive than amorphous carbon but less reactive than dry air or acetone inclusions.The lessdense shocking system denotes the greater increases in local temperature and stress,the faster energy liberation,and the earlier final reaction into equilibrium,revealing more pronounced responses to the present intense shockwave.The quantitative models associated with the relative system density(RD_(sys))were proposed for indicating energy-localization mechanisms and evaluating initiation safety in the shocked crystalline explosive.RD_(sys)is defined by the density ratio of defective RDX to perfect crystal after dynamics relaxation and reveals the global density characteristic in shocked systems filled with chemical inclusions.When RD_(sys)is below 0.9,local hydrodynamic jet initiated by void collapse dominates upon energy localization instead of interfacial impact.This study sheds light on novel insights for understanding the shock chemistry and physical-based atomic origin in crystalline explosives considering chemical-inclusions effects.
基金supported by the Health and Medical Research Fund of the Food and Health Bureau of the Hong Kong Special Administrative Region(Project No.19201161)Seed Fund from the University of Hong Kong.
文摘BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong.The primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED presentation.Using c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time points.RESULTS:We analyzed 601 patients,of whom 166(27.6%)developed sepsis.NEWS2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary outcome.However,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),respectively.The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.CONCLUSION:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.
文摘Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin Ⅰ to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam.Detailed clinical histories,physical examinations,and laboratory parameters,including NT-pro BNP and troponin Ⅰ,were recorded.A comparison between survival and non-survival was carried out to identify factors influencing mortality.Results:A total of 107 patients with a median age of 9 years were included in the study.Among them,63.6%(68/107)presented with compensated shock,36.4%(39/107)had hypotensive shock,23.4%(25/107)required mechanical ventilation,and 12.1%(13/107)died.The NT-pro BNP levels were 3.9 pmol/L(IQR:1.9,10.3)and 15.2 pmol/L(5.8,46.3),while the median high sensitivity troponin Ⅰ levels were 20 pg/L(6,95)and 62 pg/L(12,325)at the first and second measurements,respectively.The mortality group exhibited higher rates of hypotensive shock,prolonged shock,lactate levels,liver damage,NT-pro BNP,and troponin Ⅰ levels.Hypotensive shock(OR 12.96,95%CI 2.70-62.30,P=0.004),prolonged shock(OR 39.40,95%CI 6.68-232.70,P<0.001),AST>1000 IU/L(OR 9.50,95%CI 2.63-34.34,P=0.041),and NT-pro BNP>7 pmol/L(OR 44.40,95%CI 5.44-362.20,P=0.001)were identified as predictive factors for mortality in dengue shock syndrome.Conclusions:The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.
文摘Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar databases with keywords sepsis,septic shock,sepsis management,and sepsis complications.Articles published up to July 2023 in English were included.Diagnosis and management should be carried out without unnecessary delay.Cooperation between various medical specialties including intensive care doctors,neurologists,hepatologists,cardiologists,and pediatric doctors is needed if a child is affected.New strategies have to be implemented in low and middle-income countries to decrease the sepsis incidence and reduce mortality in the population.
基金supported by the National Natural Science Foundation of China[Grant Nos.51938011 and 51908405]Australian Research Council。
文摘Adopting the classical theory of hydrocodes,the constitutive relations of concretes are separated into an equation of state(EoS)which describes the volumetric behavior of concrete material and a strength model which depicts the shear properties of concrete.The experiments on the EoS of concrete is always challenging due to the technical difficulties and equipment limitations,especially for the specimen size effect on the EoS.Although some researchers investigate the shock properties of concretes by fly-plate impact tests,the specimens used in their tests are usually in one size.In this paper,the fly-plate impact tests on concrete specimens with different sizes are performed to investigate the size effect on the shock properties of concrete materials.The mechanical background of the size effect on the shock properties are revealed,which is related to the lateral rarefaction effect and the deviatoric stress produced in the specimen.According to the tests results,the modified EoS considering the size effect on the shock properties of concrete are proposed,which the bulk modulus of concrete is unpredicted by up to 20% if size effects are not accounted for.