Vapor pressure deficit(VPD)plays a crucial role in determining plant physiological functions and exerts a substantial influence on vegetation,second only to carbon dioxide(CO_(2)).As a robust indicator of atmospheric ...Vapor pressure deficit(VPD)plays a crucial role in determining plant physiological functions and exerts a substantial influence on vegetation,second only to carbon dioxide(CO_(2)).As a robust indicator of atmospheric water demand,VPD has implications for global water resources,and its significance extends to the structure and functioning of ecosystems.However,the influence of VPD on vegetation growth under climate change remains unclear in China.This study employed empirical equations to estimate the VPD in China from 2000 to 2020 based on meteorological reanalysis data of the Climatic Research Unit(CRU)Time-Series version 4.06(TS4.06)and European Centre for Medium-Range Weather Forecasts(ECMWF)Reanalysis 5(ERA-5).Vegetation growth status was characterized using three vegetation indices,namely gross primary productivity(GPP),leaf area index(LAI),and near-infrared reflectance of vegetation(NIRv).The spatiotemporal dynamics of VPD and vegetation indices were analyzed using the Theil-Sen median trend analysis and Mann-Kendall test.Furthermore,the influence of VPD on vegetation growth and its relative contribution were assessed using a multiple linear regression model.The results indicated an overall negative correlation between VPD and vegetation indices.Three VPD intervals for the correlations between VPD and vegetation indices were identified:a significant positive correlation at VPD below 4.820 hPa,a significant negative correlation at VPD within 4.820–9.000 hPa,and a notable weakening of negative correlation at VPD above 9.000 hPa.VPD exhibited a pronounced negative impact on vegetation growth,surpassing those of temperature,precipitation,and solar radiation in absolute magnitude.CO_(2) contributed most positively to vegetation growth,with VPD offsetting approximately 30.00%of the positive effect of CO_(2).As the rise of VPD decelerated,its relative contribution to vegetation growth diminished.Additionally,the intensification of spatial variations in temperature and precipitation accentuated the spatial heterogeneity in the impact of VPD on vegetation growth in China.This research provides a theoretical foundation for addressing climate change in China,especially regarding the challenges posed by increasing VPD.展开更多
Knowledge of pore-water pressure(PWP)variation is fundamental for slope stability.A precise prediction of PWP is difficult due to complex physical mechanisms and in situ natural variability.To explore the applicabilit...Knowledge of pore-water pressure(PWP)variation is fundamental for slope stability.A precise prediction of PWP is difficult due to complex physical mechanisms and in situ natural variability.To explore the applicability and advantages of recurrent neural networks(RNNs)on PWP prediction,three variants of RNNs,i.e.,standard RNN,long short-term memory(LSTM)and gated recurrent unit(GRU)are adopted and compared with a traditional static artificial neural network(ANN),i.e.,multi-layer perceptron(MLP).Measurements of rainfall and PWP of representative piezometers from a fully instrumented natural slope in Hong Kong are used to establish the prediction models.The coefficient of determination(R^2)and root mean square error(RMSE)are used for model evaluations.The influence of input time series length on the model performance is investigated.The results reveal that MLP can provide acceptable performance but is not robust.The uncertainty bounds of RMSE of the MLP model range from 0.24 kPa to 1.12 k Pa for the selected two piezometers.The standard RNN can perform better but the robustness is slightly affected when there are significant time lags between PWP changes and rainfall.The GRU and LSTM models can provide more precise and robust predictions than the standard RNN.The effects of the hidden layer structure and the dropout technique are investigated.The single-layer GRU is accurate enough for PWP prediction,whereas a double-layer GRU brings extra time cost with little accuracy improvement.The dropout technique is essential to overfitting prevention and improvement of accuracy.展开更多
Multi-level pressure source system is a novel hydraulic system with distinct advantage of energy saving. In order to balance each pressure level of the multi-level pressure source system, a pump motor energy transfer ...Multi-level pressure source system is a novel hydraulic system with distinct advantage of energy saving. In order to balance each pressure level of the multi-level pressure source system, a pump motor energy transfer unit is usually equipped. However, the pump motor energy transfer has the characteristics of poor starting and low response, which cause long time of pressure adjustment and large pressure jitter when the transformer is switched to system suddenly and the motor-side pressure has pressure impact when rail of the pump-side is switched. To address these problems, this paper proposes a compound control strategy of feedforward compensation control with Fuzzy-PID to improve the controllability of the multi-level pressure source system. A test rig of the pump motor energy transfer unit is built and the controllability of compound controller and PID controller are compared. The experiment results show that, compared with the traditional PID, the adjustment time and the pressure impact are reduced by 20% and 25% with the proposed compound control strategy. Therefore, the presented compound control strategy can be used to improve starting performance and robustness of the pump motor energy transfer unit control system.展开更多
The pressure-sensitive effect on the pore structure of sandstone was investigated using X-ray computed micro-tomography and QEMSCAN quantitative mineral analysis. In a physical simulation study, we extracted the pore ...The pressure-sensitive effect on the pore structure of sandstone was investigated using X-ray computed micro-tomography and QEMSCAN quantitative mineral analysis. In a physical simulation study, we extracted the pore network model from digital cores at different confining pressures and evaluated the effect of pressure sensitivity on the multiphase displacement process. In both the pore network model and QEMSCAN scanning, the pore structure was observed to be damaged under a high confining pressure. Due to their different scales, the pores and throats exhibited inhomogeneous changes; further, the throats exhibited a significant variation compared to that exhibited by the pores. Meanwhile, the heterogeneity of the pore structure under the two aforementioned activities was aggravated by the elastic-plastic deformation of the pore structure.The pressure-sensitive effect increased the proportion of mineral particles, such as quartz(the main component of the core skeleton), and reduced the proportion of clay minerals. The clay minerals were originally attached to the pore walls or interspersed in the pores; however, as the pressure increased, the clay minerals accumulated in the pores resulting in blockage of the pores. While simulating the multiphase displacement process, increasing the confining pressure was observed to severely restrict the flowability of oil and water. This study promises to improve the efficiency of reservoir development in terms of oil and gas exploitation.展开更多
BACKGROUND More than ten special scales are available to predict the risk of pressure ulcers in children.However,the performances of those scales have not yet been compared in China.AIM To compare the Waterlow,Braden ...BACKGROUND More than ten special scales are available to predict the risk of pressure ulcers in children.However,the performances of those scales have not yet been compared in China.AIM To compare the Waterlow,Braden Q,and Glamorgan scales,and identify more suitable pressure ulcer evaluation scale for the pediatric intensive care unit(PICU).METHODS Trained nurses used the Waterlow,Braden Q,and Glamorgan scales to assess pediatric patients at Sun Yat-sen Memorial Hospital(China)within 24 h of admission from May 2017 to December 2020 in two stages.Skin examination was carried out to identify pressure ulcers every 3 d for 3 wk.RESULTS The incidence of pressure ulcers was 3/28(10.7%)in the PICU and 5/314(1.6%)in the general pediatric ward.For children in the general ward,the Waterlow,Braden Q,and Glamorgan scales had comparable area under the operating characteristic curve(AUC)of 0.870,0.924,and 0.923,respectively,and optimal cut-off values of 14,14,and 29 points.For PICU,the Waterlow,Braden Q,and Glamorgan scales had slightly lower AUC of 0.833,0.733,and 0.800,respectively,and optimal cut-off values of 13,16,and 27 points.Braden Q demonstrated a satisfactory specificity,and during the second stage of the study for PICU patients,the AUC of the Braden Q scale was 0.810,with an optimal cut-off value of 18.35 points.CONCLUSION The Waterlow,Braden Q,and Glamorgan scales have comparable performance while the Braden Q scale demonstrates a better specificity and can be successfully used by pediatric nurses to identify patients at high risk of pressure ulcers in PICU.展开更多
BACKGROUND Delay in treatment of raised intracranial pressure(ICP)leads to poor clinical outcomes.Optic nerve sheath diameter(ONSD)by ultrasonography(US-ONSD)has shown good accuracy in traumatic brain injury and neuro...BACKGROUND Delay in treatment of raised intracranial pressure(ICP)leads to poor clinical outcomes.Optic nerve sheath diameter(ONSD)by ultrasonography(US-ONSD)has shown good accuracy in traumatic brain injury and neurosurgical patients to diagnose raised ICP.However,there is a dearth of data in neuro-medical intensive care unit(ICU)where the spectrum of disease is different.AIM To validate the diagnostic accuracy of ONSD in non-traumatic neuro-critically ill patients.METHODS We prospectively enrolled 114 patients who had clinically suspected raised ICP due to non-traumatic causes admitted in neuro-medical ICU.US-ONSD was performed according to ALARA principles.A cut-off more than 5.7 mm was taken as significantly raised.Raised ONSD was corelated with raised ICP on radiological imaging.Clinical history,general and systemic examination findings,SOFA and APACHE 2 score and patient outcomes were recorded.RESULTS There was significant association between raised ONSD and raised ICP on imaging(P<0.001).The sensitivity,specificity,positive and negative predictive value at this cut-off was 77.55%,89.06%,84.44% and 83.82% respectively.The positive and negative likelihood ratio was 7.09 and 0.25.The area under the receiver operating characteristic curves was 0.844.Using Youden’s index the best cut off value for ONSD was 5.75 mm.Raised ONSD was associated with lower age(P=0.007),poorer Glasgow Coma Scale(P=0.009)and greater need for surgical intervention(P=0.006)whereas no statistically significant association was found between raised ONSD and SOFA score,APACHE II score or ICU mortality.Our limitations were that it was a single centre study and we did not perform serial measurements or ONSD pre-and post-treatment or procedures for raised ICP.CONCLUSION ONSD can be used as a screening a test to detect raised ICP in a medical ICU and as a trigger to initiate further management of raised ICP.ONSD can be beneficial in ruling out a diagnosis in a low-prevalence population and rule in a diagnosis in a high-prevalence population.展开更多
The sulfide-based solid-state electrolytes(SEs)reactivity toward moisture and Li-metal are huge barriers that impede their large-scale manufactu ring and applications in all-solid-state lithium batteries(ASSLBs).Herei...The sulfide-based solid-state electrolytes(SEs)reactivity toward moisture and Li-metal are huge barriers that impede their large-scale manufactu ring and applications in all-solid-state lithium batteries(ASSLBs).Herein,we proposed an Al and O dual-doped strategy for Li_(3)PS_(4)SE to regulate the chemical/electrochemical stability of anionic PS_(4)^(3-)tetrahedra to mitigate structural hydrolysis and parasitic reactions at the SE/Li interface.The optimized Li_(3.08)A_(10.04)P_(0.96)S_(3.92)O_(0.08)SE presents the highestσLi+of 3.27 mS cm^(-1),which is~6.8 times higher than the pristine Li_(3)PS_(4)and excellently inhibits the structural hydrolysis for~25 min@25%humidity at RT.DFT calculations confirmed that the enhanced chemical stability was revealed to the intrinsically stable entities,e.g.,POS33-units.Moreover,Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE cycled stably in Li//Li symmetric cell over 1000 h@0.1 mA cm^(-2)/0.1 mA h cm^(-2),could be revealed to Li-Al alloy and Li_(2)Oat SE/Li interface impeding the growth of Li-dendrites during cycling.Resultantly,LNO@LCO/Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)/Li-In cell delivered initial discharge capacities of 129.8 mA h g^(-1)and 83.74%capacity retention over 300 cycles@0.2 C at RT.Moreover,the Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE presented>90%capacity retention over 200 and 300 cycles when the cell was tested with LiNi_(0.8)Co_(0.15)Al_(0.05)O_(2)(NCA)cathode material vs.5 and 10 mg cm^(-2)@RT.展开更多
Pressure ulcers(PUs)are localized injuries of the skin or underlying tissue caused by prolonged pressure,exposure to shear forces or friction.PUs represent a major concern for hospitalized patients and the health prof...Pressure ulcers(PUs)are localized injuries of the skin or underlying tissue caused by prolonged pressure,exposure to shear forces or friction.PUs represent a major concern for hospitalized patients and the health professionals responsible for their wellbeing.intensive care init(ICU)patients are at high risk of PU development,and the development of PUs can significantly extend the length of time a patient must remain in the ICU.Patients with PUs experience significantly increased morbidity,mortality and financial burden.A significant amount of evidence has accumulated indicating that PU prevention is an essential component of patient care.However,standardized guidelines and protocols for PU prevention in ICUs have not been universally implemented.This review aims to describe and analyze an optimized PU prevention care bundle based on the best available evidence and existing national guidelines.We distilled the available information into five main topics important for PU prevention:Risk Assessment,Skin Assessment,Support Surfaces,Nutrition and Repositioning.Further larger scale studies are needed to clinically verify the effectiveness of the care bundle.展开更多
To improve the durability of underwater rotating products,the corrosion characteristics in harsh marine environment were evaluated through various electrochemical experiments on the Al2O3-3TiO2 and CoNiCrAlY coating l...To improve the durability of underwater rotating products,the corrosion characteristics in harsh marine environment were evaluated through various electrochemical experiments on the Al2O3-3TiO2 and CoNiCrAlY coating layers by atmospheric pressure plasma spray coating process.By evaluating the corrosion resistance of these materials,their applicability to environmentally friendly power generation equipment such as blades of tidal current turbines was examined.According to the Tafel analysis for micro-areas including the coating layer,the coating/metal interlayer and the base metal,the Al2O3-3TiO2 coating layer and the CoNiCrAlY coating layer show markedly lower corrosion current density than the base metal.The corrosion current density of the CoNiCrAlY coating layer (9.75316×10-8A/cm2) is about 1.6 times more than that of the Al2O3-3TiO2 coating layer (6.13139×10-8A/cm2).展开更多
The novel coronavirus,which was declared a pandemic by the World Health Organization in early 2020 has brought with itself major morbidity and mortality.It has increased hospital occupancy,heralded economic turmoil,an...The novel coronavirus,which was declared a pandemic by the World Health Organization in early 2020 has brought with itself major morbidity and mortality.It has increased hospital occupancy,heralded economic turmoil,and the rapid transmission and community spread have added to the burden of the virus.Most of the patients are admitted to the intensive care unit(ICU)for acute hypoxic respiratory failure often secondary to acute respiratory distress syndrome(ARDS).Based on the limited data available,there have been different opinions about the respiratory mechanics of the ARDS caused by coronavirus disease 2019(COVID-19).Our article provides an insight into COVID-19 pathophysiology and how it differs from typical ARDS.Based on these differences,our article explains the different approach to ventilation in COVID-19 ARDS compared to typical ARDS.We critically analyze the role of positive end-expiratory pressure(PEEP)and proning in the ICU patients.Through the limited data and clinical experience are available,we believe that early proning in COVID-19 patients improves oxygenation and optimal PEEP should be titrated based on individual lung compliance.展开更多
1.楼下那个人睡不着觉。[误]The downstairs man couldn’t go to sleep.[正]The man downstairs couldn’t go to sleep.[析]以today,here,there,downstairs,upstairs, below,above等作定语修饰名词时常放在名词之后。2我正想出去,铃...1.楼下那个人睡不着觉。[误]The downstairs man couldn’t go to sleep.[正]The man downstairs couldn’t go to sleep.[析]以today,here,there,downstairs,upstairs, below,above等作定语修饰名词时常放在名词之后。2我正想出去,铃响了。[误]I just went out when the bell rang.[正]I was just going out when the bell rang.[析]由when连接的两个分句,其中—个谓语动词是延续性,另一个谓语是终止性动词时,此处的when是并列连词,意为“这时 (突然)”,所以要将went out改为was going out.展开更多
I.单项选择:从A、B、C、D四个选项中,选出可以填入空白处的正确答案。1.Are you__ the 100-metre race today? A.on B.to C.for D.in2.I’m afraid you didn’t do your homework__ A.careful enough B.carefully enough C.enough caref...I.单项选择:从A、B、C、D四个选项中,选出可以填入空白处的正确答案。1.Are you__ the 100-metre race today? A.on B.to C.for D.in2.I’m afraid you didn’t do your homework__ A.careful enough B.carefully enough C.enough careful D.enough carefully3.They__a class meeting last Friday. A.hold B.held C.take D.took4.__Jack came a moment__ . -Why did he come__? A.late;later B.late;late C.later;late D.later;展开更多
1.你必须尽快把书还到图书馆。[误]You must return the book to the library as quickly as possible.[正]You must return the book to the library as soon as possible.[析]as quickly as possible与as soon as possible都可表“尽...1.你必须尽快把书还到图书馆。[误]You must return the book to the library as quickly as possible.[正]You must return the book to the library as soon as possible.[析]as quickly as possible与as soon as possible都可表“尽快”地,但前者是指做事的速度快,可以用as fast as possible来替换;而后者则指做事的时间尽可能早。展开更多
基金This research was supported by the National Natural Science Foundation of China(42161058).
文摘Vapor pressure deficit(VPD)plays a crucial role in determining plant physiological functions and exerts a substantial influence on vegetation,second only to carbon dioxide(CO_(2)).As a robust indicator of atmospheric water demand,VPD has implications for global water resources,and its significance extends to the structure and functioning of ecosystems.However,the influence of VPD on vegetation growth under climate change remains unclear in China.This study employed empirical equations to estimate the VPD in China from 2000 to 2020 based on meteorological reanalysis data of the Climatic Research Unit(CRU)Time-Series version 4.06(TS4.06)and European Centre for Medium-Range Weather Forecasts(ECMWF)Reanalysis 5(ERA-5).Vegetation growth status was characterized using three vegetation indices,namely gross primary productivity(GPP),leaf area index(LAI),and near-infrared reflectance of vegetation(NIRv).The spatiotemporal dynamics of VPD and vegetation indices were analyzed using the Theil-Sen median trend analysis and Mann-Kendall test.Furthermore,the influence of VPD on vegetation growth and its relative contribution were assessed using a multiple linear regression model.The results indicated an overall negative correlation between VPD and vegetation indices.Three VPD intervals for the correlations between VPD and vegetation indices were identified:a significant positive correlation at VPD below 4.820 hPa,a significant negative correlation at VPD within 4.820–9.000 hPa,and a notable weakening of negative correlation at VPD above 9.000 hPa.VPD exhibited a pronounced negative impact on vegetation growth,surpassing those of temperature,precipitation,and solar radiation in absolute magnitude.CO_(2) contributed most positively to vegetation growth,with VPD offsetting approximately 30.00%of the positive effect of CO_(2).As the rise of VPD decelerated,its relative contribution to vegetation growth diminished.Additionally,the intensification of spatial variations in temperature and precipitation accentuated the spatial heterogeneity in the impact of VPD on vegetation growth in China.This research provides a theoretical foundation for addressing climate change in China,especially regarding the challenges posed by increasing VPD.
基金supported by the Natural Science Foundation of China(Grant Nos.51979158,51639008,51679135,and 51422905)the Program of Shanghai Academic Research Leader by Science and Technology Commission of Shanghai Municipality(Project No.19XD1421900)。
文摘Knowledge of pore-water pressure(PWP)variation is fundamental for slope stability.A precise prediction of PWP is difficult due to complex physical mechanisms and in situ natural variability.To explore the applicability and advantages of recurrent neural networks(RNNs)on PWP prediction,three variants of RNNs,i.e.,standard RNN,long short-term memory(LSTM)and gated recurrent unit(GRU)are adopted and compared with a traditional static artificial neural network(ANN),i.e.,multi-layer perceptron(MLP).Measurements of rainfall and PWP of representative piezometers from a fully instrumented natural slope in Hong Kong are used to establish the prediction models.The coefficient of determination(R^2)and root mean square error(RMSE)are used for model evaluations.The influence of input time series length on the model performance is investigated.The results reveal that MLP can provide acceptable performance but is not robust.The uncertainty bounds of RMSE of the MLP model range from 0.24 kPa to 1.12 k Pa for the selected two piezometers.The standard RNN can perform better but the robustness is slightly affected when there are significant time lags between PWP changes and rainfall.The GRU and LSTM models can provide more precise and robust predictions than the standard RNN.The effects of the hidden layer structure and the dropout technique are investigated.The single-layer GRU is accurate enough for PWP prediction,whereas a double-layer GRU brings extra time cost with little accuracy improvement.The dropout technique is essential to overfitting prevention and improvement of accuracy.
基金Supported by the National Natural Science Foundation of China(No.51575471)the Key Project of Science and Technology Plan of Higher Education of Hebei Education Department(No.ZD2017077)
文摘Multi-level pressure source system is a novel hydraulic system with distinct advantage of energy saving. In order to balance each pressure level of the multi-level pressure source system, a pump motor energy transfer unit is usually equipped. However, the pump motor energy transfer has the characteristics of poor starting and low response, which cause long time of pressure adjustment and large pressure jitter when the transformer is switched to system suddenly and the motor-side pressure has pressure impact when rail of the pump-side is switched. To address these problems, this paper proposes a compound control strategy of feedforward compensation control with Fuzzy-PID to improve the controllability of the multi-level pressure source system. A test rig of the pump motor energy transfer unit is built and the controllability of compound controller and PID controller are compared. The experiment results show that, compared with the traditional PID, the adjustment time and the pressure impact are reduced by 20% and 25% with the proposed compound control strategy. Therefore, the presented compound control strategy can be used to improve starting performance and robustness of the pump motor energy transfer unit control system.
文摘The pressure-sensitive effect on the pore structure of sandstone was investigated using X-ray computed micro-tomography and QEMSCAN quantitative mineral analysis. In a physical simulation study, we extracted the pore network model from digital cores at different confining pressures and evaluated the effect of pressure sensitivity on the multiphase displacement process. In both the pore network model and QEMSCAN scanning, the pore structure was observed to be damaged under a high confining pressure. Due to their different scales, the pores and throats exhibited inhomogeneous changes; further, the throats exhibited a significant variation compared to that exhibited by the pores. Meanwhile, the heterogeneity of the pore structure under the two aforementioned activities was aggravated by the elastic-plastic deformation of the pore structure.The pressure-sensitive effect increased the proportion of mineral particles, such as quartz(the main component of the core skeleton), and reduced the proportion of clay minerals. The clay minerals were originally attached to the pore walls or interspersed in the pores; however, as the pressure increased, the clay minerals accumulated in the pores resulting in blockage of the pores. While simulating the multiphase displacement process, increasing the confining pressure was observed to severely restrict the flowability of oil and water. This study promises to improve the efficiency of reservoir development in terms of oil and gas exploitation.
基金the ethics committee of Sun Yat-sen Memorial hospital[approval number:2017(23)]。
文摘BACKGROUND More than ten special scales are available to predict the risk of pressure ulcers in children.However,the performances of those scales have not yet been compared in China.AIM To compare the Waterlow,Braden Q,and Glamorgan scales,and identify more suitable pressure ulcer evaluation scale for the pediatric intensive care unit(PICU).METHODS Trained nurses used the Waterlow,Braden Q,and Glamorgan scales to assess pediatric patients at Sun Yat-sen Memorial Hospital(China)within 24 h of admission from May 2017 to December 2020 in two stages.Skin examination was carried out to identify pressure ulcers every 3 d for 3 wk.RESULTS The incidence of pressure ulcers was 3/28(10.7%)in the PICU and 5/314(1.6%)in the general pediatric ward.For children in the general ward,the Waterlow,Braden Q,and Glamorgan scales had comparable area under the operating characteristic curve(AUC)of 0.870,0.924,and 0.923,respectively,and optimal cut-off values of 14,14,and 29 points.For PICU,the Waterlow,Braden Q,and Glamorgan scales had slightly lower AUC of 0.833,0.733,and 0.800,respectively,and optimal cut-off values of 13,16,and 27 points.Braden Q demonstrated a satisfactory specificity,and during the second stage of the study for PICU patients,the AUC of the Braden Q scale was 0.810,with an optimal cut-off value of 18.35 points.CONCLUSION The Waterlow,Braden Q,and Glamorgan scales have comparable performance while the Braden Q scale demonstrates a better specificity and can be successfully used by pediatric nurses to identify patients at high risk of pressure ulcers in PICU.
文摘BACKGROUND Delay in treatment of raised intracranial pressure(ICP)leads to poor clinical outcomes.Optic nerve sheath diameter(ONSD)by ultrasonography(US-ONSD)has shown good accuracy in traumatic brain injury and neurosurgical patients to diagnose raised ICP.However,there is a dearth of data in neuro-medical intensive care unit(ICU)where the spectrum of disease is different.AIM To validate the diagnostic accuracy of ONSD in non-traumatic neuro-critically ill patients.METHODS We prospectively enrolled 114 patients who had clinically suspected raised ICP due to non-traumatic causes admitted in neuro-medical ICU.US-ONSD was performed according to ALARA principles.A cut-off more than 5.7 mm was taken as significantly raised.Raised ONSD was corelated with raised ICP on radiological imaging.Clinical history,general and systemic examination findings,SOFA and APACHE 2 score and patient outcomes were recorded.RESULTS There was significant association between raised ONSD and raised ICP on imaging(P<0.001).The sensitivity,specificity,positive and negative predictive value at this cut-off was 77.55%,89.06%,84.44% and 83.82% respectively.The positive and negative likelihood ratio was 7.09 and 0.25.The area under the receiver operating characteristic curves was 0.844.Using Youden’s index the best cut off value for ONSD was 5.75 mm.Raised ONSD was associated with lower age(P=0.007),poorer Glasgow Coma Scale(P=0.009)and greater need for surgical intervention(P=0.006)whereas no statistically significant association was found between raised ONSD and SOFA score,APACHE II score or ICU mortality.Our limitations were that it was a single centre study and we did not perform serial measurements or ONSD pre-and post-treatment or procedures for raised ICP.CONCLUSION ONSD can be used as a screening a test to detect raised ICP in a medical ICU and as a trigger to initiate further management of raised ICP.ONSD can be beneficial in ruling out a diagnosis in a low-prevalence population and rule in a diagnosis in a high-prevalence population.
基金supported by the National Natural Science Foundation of China(Nos.21203008,21975025,12274025)the Hainan Province Science and Technology Special Fund(Nos.ZDYF2021SHFZ232,ZDYF2023GXJS022)the Hainan Province Postdoctoral Science Foundation(No.300333)。
文摘The sulfide-based solid-state electrolytes(SEs)reactivity toward moisture and Li-metal are huge barriers that impede their large-scale manufactu ring and applications in all-solid-state lithium batteries(ASSLBs).Herein,we proposed an Al and O dual-doped strategy for Li_(3)PS_(4)SE to regulate the chemical/electrochemical stability of anionic PS_(4)^(3-)tetrahedra to mitigate structural hydrolysis and parasitic reactions at the SE/Li interface.The optimized Li_(3.08)A_(10.04)P_(0.96)S_(3.92)O_(0.08)SE presents the highestσLi+of 3.27 mS cm^(-1),which is~6.8 times higher than the pristine Li_(3)PS_(4)and excellently inhibits the structural hydrolysis for~25 min@25%humidity at RT.DFT calculations confirmed that the enhanced chemical stability was revealed to the intrinsically stable entities,e.g.,POS33-units.Moreover,Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE cycled stably in Li//Li symmetric cell over 1000 h@0.1 mA cm^(-2)/0.1 mA h cm^(-2),could be revealed to Li-Al alloy and Li_(2)Oat SE/Li interface impeding the growth of Li-dendrites during cycling.Resultantly,LNO@LCO/Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)/Li-In cell delivered initial discharge capacities of 129.8 mA h g^(-1)and 83.74%capacity retention over 300 cycles@0.2 C at RT.Moreover,the Li_(3.08)Al_(0.04)P_(0.96)S_(3.92)O_(0.08)SE presented>90%capacity retention over 200 and 300 cycles when the cell was tested with LiNi_(0.8)Co_(0.15)Al_(0.05)O_(2)(NCA)cathode material vs.5 and 10 mg cm^(-2)@RT.
文摘Pressure ulcers(PUs)are localized injuries of the skin or underlying tissue caused by prolonged pressure,exposure to shear forces or friction.PUs represent a major concern for hospitalized patients and the health professionals responsible for their wellbeing.intensive care init(ICU)patients are at high risk of PU development,and the development of PUs can significantly extend the length of time a patient must remain in the ICU.Patients with PUs experience significantly increased morbidity,mortality and financial burden.A significant amount of evidence has accumulated indicating that PU prevention is an essential component of patient care.However,standardized guidelines and protocols for PU prevention in ICUs have not been universally implemented.This review aims to describe and analyze an optimized PU prevention care bundle based on the best available evidence and existing national guidelines.We distilled the available information into five main topics important for PU prevention:Risk Assessment,Skin Assessment,Support Surfaces,Nutrition and Repositioning.Further larger scale studies are needed to clinically verify the effectiveness of the care bundle.
基金Project supported by the Ministry of Education,Science Technology(MEST)Korea Industrial Technology Foundation(KOTEF)through the Human Resource Training Project for Regional Innovation
文摘To improve the durability of underwater rotating products,the corrosion characteristics in harsh marine environment were evaluated through various electrochemical experiments on the Al2O3-3TiO2 and CoNiCrAlY coating layers by atmospheric pressure plasma spray coating process.By evaluating the corrosion resistance of these materials,their applicability to environmentally friendly power generation equipment such as blades of tidal current turbines was examined.According to the Tafel analysis for micro-areas including the coating layer,the coating/metal interlayer and the base metal,the Al2O3-3TiO2 coating layer and the CoNiCrAlY coating layer show markedly lower corrosion current density than the base metal.The corrosion current density of the CoNiCrAlY coating layer (9.75316×10-8A/cm2) is about 1.6 times more than that of the Al2O3-3TiO2 coating layer (6.13139×10-8A/cm2).
文摘The novel coronavirus,which was declared a pandemic by the World Health Organization in early 2020 has brought with itself major morbidity and mortality.It has increased hospital occupancy,heralded economic turmoil,and the rapid transmission and community spread have added to the burden of the virus.Most of the patients are admitted to the intensive care unit(ICU)for acute hypoxic respiratory failure often secondary to acute respiratory distress syndrome(ARDS).Based on the limited data available,there have been different opinions about the respiratory mechanics of the ARDS caused by coronavirus disease 2019(COVID-19).Our article provides an insight into COVID-19 pathophysiology and how it differs from typical ARDS.Based on these differences,our article explains the different approach to ventilation in COVID-19 ARDS compared to typical ARDS.We critically analyze the role of positive end-expiratory pressure(PEEP)and proning in the ICU patients.Through the limited data and clinical experience are available,we believe that early proning in COVID-19 patients improves oxygenation and optimal PEEP should be titrated based on individual lung compliance.
文摘1.楼下那个人睡不着觉。[误]The downstairs man couldn’t go to sleep.[正]The man downstairs couldn’t go to sleep.[析]以today,here,there,downstairs,upstairs, below,above等作定语修饰名词时常放在名词之后。2我正想出去,铃响了。[误]I just went out when the bell rang.[正]I was just going out when the bell rang.[析]由when连接的两个分句,其中—个谓语动词是延续性,另一个谓语是终止性动词时,此处的when是并列连词,意为“这时 (突然)”,所以要将went out改为was going out.
文摘I.单项选择:从A、B、C、D四个选项中,选出可以填入空白处的正确答案。1.Are you__ the 100-metre race today? A.on B.to C.for D.in2.I’m afraid you didn’t do your homework__ A.careful enough B.carefully enough C.enough careful D.enough carefully3.They__a class meeting last Friday. A.hold B.held C.take D.took4.__Jack came a moment__ . -Why did he come__? A.late;later B.late;late C.later;late D.later;
文摘1.你必须尽快把书还到图书馆。[误]You must return the book to the library as quickly as possible.[正]You must return the book to the library as soon as possible.[析]as quickly as possible与as soon as possible都可表“尽快”地,但前者是指做事的速度快,可以用as fast as possible来替换;而后者则指做事的时间尽可能早。