Pulse oximetry in pediatric care:Balancing advantages and limitations

BACKGROUND Pulse oximetry has become a cornerstone technology in healthcare,providing non-invasive monitoring of oxygen saturation levels and pulse rate.Despite its widespread use,the technology has inherent limitations and challenges that must be addressed to ensure accurate and reliable patient care.AIM To comprehensively evaluate the advantages,limitations,and challenges of pulse oximetry in clinical practice,as well as to propose recommendations for optimizing its use.METHODS A systematic literature review was conducted to identify studies related to pulse oximetry and its applications in various clinical settings.Relevant articles were selected based on predefined inclusion and exclusion criteria,and data were synthesized to provide a comprehensive overview of the topic.RESULTS Pulse oximetry offers numerous advantages,including non-invasiveness,real-time feedback,portability,and costeffectiveness.However,several limitations and challenges were identified,including motion artifacts,poor peripheral perfusion,ambient light interference,and patient-specific factors such as skin pigmentation and hemoglobin variants.Recommendations for optimizing pulse oximetry use include technological advancements,education and training initiatives,quality assurance protocols,and interdisciplinary collaboration.CONCLUSION Pulse oximetry is crucial in modern healthcare,offering invaluable insights into patients’oxygenation status.Despite its limitations,pulse oximetry remains an indispensable tool for monitoring patients in diverse clinical settings.By implementing the recommendations outlined in this review,healthcare providers can enhance the effectiveness,accessibility,and safety of pulse oximetry monitoring,ultimately improving patient outcomes and quality of care.

A Stroke-Limitation AMD Control System with Variable Gain and Limited Area for High-Rise Buildings

Collisions between a moving mass and an anti-collision device increase structural responses and threaten structural safety.An active mass damper(AMD)with stroke limitations is often used to avoid collisions.However,a strokelimited AMD control system with a fixed limited area shortens the available AMD stroke and leads to significant control power.To solve this problem,the design approach with variable gain and limited area(VGLA)is proposed in this study.First,the boundary of variable-limited areas is calculated based on the real-time status of the moving mass.The variable gain(VG)expression at the variable limited area is deduced by considering the saturation of AMD stroke.Then,numerical simulations of a stroke-limited AMD control system with VGLA are conducted on a high-rise building structure.These numerical simulations show that the proposed approach has superior strokelimitation performance compared with a stroke-limited AMD control system with a fixed limited area.Finally,the proposed approach is validated through experiments on a four-story steel frame.

Proteomic response of Phaeocystis globosa to nitrogen limitation

Phaeocystis globosa is an important unicellular eukaryotic alga that can also form colonies.P.globosa can cause massive harmful algal blooms and plays an important role in the global carbon or sulfur cycling.Thus far,the ecophysiology of P.globosa has been investigated by numerous studies.However,the proteomic response of P.globosa to nitrogen depletion remains largely unknown.We compared four protein preparation methods of P.globosa for two-dimensional electrophoresis(2-DE)(Urea/Triton X-100 with trichloroacetic acid(TCA)/acetone precipitation;TCA/acetone precipitation;Radio Immuno Precipitation Assay(RIPA)with TCA/acetone precipitation;and Tris buffer).Results show that the combination of RIPA with TCA/acetone precipitation had a clear gel background and showed the best protein spot separation effect,based on which the proteomic response to nitrogen depletion was studied using 2-DE.In addition,we identified six differentially expressed proteins whose relative abundance increased or decreased more than 1.5-fold(P<0.05).Most proteins could not be identified,which might be attributed to the lack of genomic sequences of P.globosa.Under nitrogen limitation,replication protein-like,RNA ligase,and sn-glycerol-3-phosphate dehydrogenase were reduced,which may decrease the DNA replication level and ATP production in P.globosa cells.The increase of endonucleaseⅢand transcriptional regulator enzyme may affect the metabolic and antioxidant function of P.globosa cells and induce cell apoptosis.These findings provide a basis for further proteomic study of P.globosa and the optimization of protein preparation methods of marine microalgae.

Effects of nutrient limitations on the sinking velocity of Thalassiosira weissflogii

The sinking of diatoms is critic al to the formation of oceanic biological pumps and coastal hypoxic zones.However,little is known about the effects of different nutrient restrictions on diatom sinking.In this study,we measured the sinking velocity(SV) of Thalassiosira weissflogii using a new phytoplankton video observation instrument and analyzed major biochemical components under varying nutrient conditions.Our results showed that the SV of T.weissflogii under different nutrient limitation conditions varied substantially.The highest SV of(1.77±0.02) m/d was obtained under nitrate limitation,signific antly surpassing that under phosphate limitation at(0.98±0.13) m/d.As the nutrient limitation was released,the SV steadily decreased to(0.32±0.03) m/d and(0.15±0.05) m/d,respectively.Notably;under conditions with limited nitrate and phosphate concentrations,the SV values of T.weissflogii significantly positively correlated with the lipid content(P <0.001),with R^(2) values of 0.86 and 0.69,respectively.The change of the phytoplankton SV was primarily related to the intracellular compo sition,which is controlled by nutrient conditions but did not significantly correlate with transparent extracellular polymer and biosilica contents.The results of this study help to understand the regulation of the vertical sinking process of diatoms by nutrient restriction and provide new insights into phytoplankton dynamics and their relationship with the marine nutrient structure.

Effects of phosphorus limitation on sinking velocities of phytoplankton during summer in the Changjiang River Estuary

The sinking of phytoplankton is critical to organic matter transportation in the ocean and it is an essential process for the formation of coastal hypoxic zones.This study was based on a field investigation conducted during the summer of 2022 in the Changjiang River(Yangtze River) Estuary(CJE) and its adjacent waters.The settling column method was employed to measure the sinking velocity(SV) of different size fractions of phytoplankton at the surface of the sea and to analyze their environmental control mechanisms.The findings reveal significant spatial variation in phytoplankton SV(-0.55-2.41 m/d) within the CJE.High-speed sinking was predominantly observed in phosphate-depleted regions beyond the CJE front.At the same time,an upward trend was more commonly observed in the phosphate-rich regions near the CJE mouth.The SV ranges for different sizefractionated phytoplankton,including micro-(>20 μm),nano-(2-20 μm),and picophytoplankton(0.7-2 μm),were-0.50-4.74 m/d,-1.04-1.59 m/d,and-1.24-1.65 m/d,respectively.Correlation analysis revealed a significant negative correlation between SV and dissolved inorganic phosphorus(DIP),implying that the influence of DIP contributes to SV.The variations in phytoplankton alkaline phosphatase activity suggested a significant increase in SV across all size fractions in the event of phosphorus limitation.Phytoplankton communities with limited photo synthetic capacity(maximum photochemical efficience,Fv/Fm <0.3) were found to have higher SV than that of communities with strong capacity,suggesting a link between sinking and alterations in physiological conditions due to phosphate depletion.The findings from the in situ phosphate enrichment experiments confirmed a marked decrease in SV following phosphate supplementation.These findings suggest that phosphorus limitation is the primary driver of elevated SV in the CJE.This study enhances the comprehension of the potential mechanisms underlying hypoxic zone formation in the CJE,providing novel insights into how nearshore eutrophication influences organic carbon migration.

Phosphorus limitation on CO_(2)fertilization effect in tropical forests informed by a coupled biogeochemical model

Tropical forests store more than half of the world's terrestrial carbon(C)pool and account for one-third of global net primary productivity(NPP).Many terrestrial biosphere models(TBMs)estimate increased productivity in tropical forests throughout the 21st century due to CO_(2)fertilization.However,phosphorus(P)liaitations on vegetation photosynthesis and productivity could significantly reduce the CO_(2)fertilization effect.Here,we used a carbon-nitrogen-phosphorus coupled model(Dynamic Land Ecosystem Model;DLEM-CNP)with heterogeneous maximum carboxylation rates to examine how P limitation has affected C fluxes in tropical forests during1860-2018.Our model results showed that the inclusion of the P processes enhanced model performance in simulating ecosystem productivity.We further compared the simulations from DLEM-CNP,DLEM-CN,and DLEMC and the results showed that the inclusion of P processes reduced the CO_(2)fertilization effect on gross primary production(GPP)by 25%and 45%,and net ecosystem production(NEP)by 28%and 41%,respectively,relative to CN-only and C-on ly models.From the 1860s to the 2010s,the DLEM-CNP estimated that in tropical forests GPP increased by 17%,plant respiration(Ra)increased by 18%,ecosystem respiration(Rh)increased by 13%,NEP increased by 121%per unit area,respectively.Additionally,factorial experiments with DLEM-CNP showed that the enhanced NPP benefiting from the CO_(2) fertilization effect had been offset by 135%due to deforestation from the 1860s to the 2010s.Our study highlights the importance of P limitation on the C cycle and the weakened CO_(2)fertilization effect resulting from P limitation in tropical forests.

Defining Quantum Advantage for Building a Sustainable MVP to Deliver Quantum Computing Services

Quantum Computing (QC) is hailed as the future of computers. After Google’s claim of achieving Quantum Supremacy in 2019, several groups challenged the claim. Some QC experts attribute catastrophic risks that unrestrained QC may cause in the future by collapsing the current cryptographic cybersecurity infrastructure. These predictions are relevant only if QC becomes commercially viable and sustainable in the future. No technology can be a one-way ticket to catastrophe, and neither can the definition of superiority of that technology be. If there are catastrophic risks, large-scale QC can never enter the public domain as a minimum viable product (MVP) unless there are safeguards in place. Those safeguards should obviously become an integral part of the definition of its superiority over the legacy systems. NIST (National Institute of Standards & Technology) is pursuing the standardization of Post Quantum Cryptography (PQC) as that safeguard. However, with all the 82 candidate PQCs failing and companies already offering QC as a service, there’s an urgent need for an alternate strategy to mitigate the impending Q-Day threat and render QC sustainable. Our research proposes a novel encryption-agnostic cybersecurity approach to safeguard QC. It articulates a comprehensive definition of an MVP that can potentially set a sustainable gold standard for defining commercially viable quantum advantage over classical computing.

Familial hypercholesterolemia:Current limitations and future breakthroughs

Familial hypercholesterolemia(FH)is characterized by elevated low-density lipoprotein cholesterol levels due to genetic mutations,presenting with xanthomas,corneal arch,and severe cardiovascular diseases.Early identification,diagnosis,and treatment are crucial to prevent severe complications like acute myocardial infarction.Statins are the primary treatment,supplemented by Ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors,though their effectiveness can be limited in severe cases.Over 90%of FH cases remain undiagnosed,and current treatments are often inadequate,underscoring the need for improved diagnostic and management systems.Future strategies include advancements in gene testing,precision medicine,and novel drugs,along with gene therapy approaches like AAV-mediated gene therapy and clustered regularly interspaced short palindromic repeats.Lifestyle modifications,including health education,dietary control,and regular exercise,are essential for managing FH and preventing related diseases.Research into FH-related gene mutations,especially LDLR,is critical for accurate diagnosis and effective treatment.

The Role of Digitalization in Enhancing Outward Foreign Direct Investment:New Advantages for Chinese Enterprises

With the rapid development of big data,cloud computing,artificial intelligence,and other technologies,digital construction has gradually become a crucial means of enterprise development,significantly impacting the operation and management activities of enterprises.Outward Foreign Direct Investment(OFDI)is one of the key pathways for Chinese enterprises to“go global,”contributing to improved economic efficiency and promoting national economic development.Therefore,studying the advantages of digitalization in OFDI activities will aid in exploring effective methods for Chinese enterprises to engage in OFDI within the digital economy and provide an important foundation for strategic enterprise planning and national policy formulation.This paper combines the current state of OFDI among Chinese enterprises,analyzes the advantages and roles of digital construction in OFDI,and explores relevant countermeasures,aiming to provide theoretical references for enterprises’OFDI activities in the context of digitalization.

Evaluation of the Clinical Advantages of Laparoscopic Transverse Abdominal Wall Suspension in the Treatment of Pelvic Organ Prolapse

Objective:To evaluate the clinical advantages of laparoscopic transverse abdominal wall suspension in treating pelvic organ prolapse.Methods:Sixty patients diagnosed with moderate to severe pelvic organ prolapse and underwent surgical treatment in our hospital between January 2022 and December 2023 were selected.According to different surgical methods,they were divided into an observation group(given laparoscopic transverse abdominal wall suspension)and a control group(given transvaginal mesh implantation),with 30 subjects/group.The data on perioperative-related indicators,quality of life scores,postoperative recurrence,and complications of the two groups of patients were collected.Results:The postoperative hospitalization days and intraoperative bleeding volume of the observation group were significantly lower than those of the control group,but had longer operation time than that of the control group(P<0.05).The differences between the two groups were statistically significant 6 months after surgery,and the Pelvic Floor Disease Quality of Life Impact Questionnaire(PFIQ-7)score of the observation group was significantly higher than the control group(P<0.05).Both groups of patients completed 12 months of follow-up without any postoperative recurrence.The number of complications in the observation group was slightly lower than that of the control group(P>0.05).Conclusion:Laparoscopic transverse abdominal wall suspension was more effective in treating pelvic organ prolapse and is an ideal surgical procedure.

Advantages and Limitations of Translation Memory in Translation Teaching

With the rapid development of translation technology, great changes have taken place in translation teaching. The traditional translation teaching can not meet the needs of the market, and the market is in urgent need of translators who are proficient in information technology. Therefore, translation memory is gradually applied to translation teaching. Translation teaching has been liberated by translation memory to some extent. And translation memory makes translation teaching avoid a lot of repeated knowledge and processes of translation. It is no doubt that translation memory has some limitations. As a result, the advantages and limitations of translation memory in translation teaching are discussed.

Fully Distributed Nash Equilibrium Seeking for High-Order Players With Actuator Limitations

This paper explores the problem of distributed Nash equilibrium seeking in games, where players have limited knowledge on other players' actions. In particular, the involved players are considered to be high-order integrators with their control inputs constrained within a pre-specified region. A linear transformation for players' dynamics is firstly utilized to facilitate the design of bounded control inputs incorporating multiple saturation functions. By introducing consensus protocols with adaptive and time-varying gains, the unknown actions for players are distributively estimated. Then, a fully distributed Nash equilibrium seeking strategy is exploited, showcasing its remarkable properties: (1) ensuring the boundedness of control inputs;(2) avoiding any global information/parameters;and (3) allowing the graph to be directed. Based on Lyapunov stability analysis, it is theoretically proved that the proposed distributed control strategy can lead all the players' actions to the Nash equilibrium. Finally, an illustrative example is given to validate effectiveness of the proposed method.

Potential and limitations of ChatGPT and generative artificial intelligence in medical safety education

The primary objectives of medical safety education are to provide the public with essential knowledge about medications and to foster a scientific approach to drug usage.The era of using artificial intelligence to revolutionize medical safety education has already dawned,and ChatGPT and other generative artificial intelligence models have immense potential in this domain.Notably,they offer a wealth of knowledge,anonymity,continuous availability,and personalized services.However,the practical implementation of generative artificial intelligence models such as ChatGPT in medical safety education still faces several challenges,including concerns about the accuracy of information,legal responsibilities,and ethical obligations.Moving forward,it is crucial to intelligently upgrade ChatGPT by leveraging the strengths of existing medical practices.This task involves further integrating the model with real-life scenarios and proactively addressing ethical and security issues with the ultimate goal of providing the public with comprehensive,convenient,efficient,and personalized medical services.

Limitations of Lightning Rods in Preventing Direct Lightning Strikes

Since ancient times,lightning disasters have undoubtedly been an unstoppable threat to humanity.During thunderstorms,lightning often damages objects on the ground,such as buildings and structures.Since Franklin invented the lightning rod in 1752,lightning rods have been used worldwide to prevent direct lightning strikes in various fields such as high-voltage power transmission lines,outdoor chemical sites,highways,land and sea wind farms,and forest lightning fire protection.It has been proven that lightning accidents still occur frequently in places where lightning rods are installed and the protective angle method is used.In order to further study the protective effect of lightning rods and identify the shortcomings of lightning rod protection,negative lightning strikes are taken as the research object,to analyze the limitations of lightning rods in preventing direct lightning strikes from the working principle of lightning rods.

Comparative Advantage and Latecomer Advantage

To achieve development,developing countries must capitalize on their relative advantages,including comparative advantage and latecomer advantages.A country must develop an industrial structure that is consistent with the comparative advantage of its factor structure in order to avoid the trap of“structural catch-up”that stifles development.The issue for developing countries is that their comparative advantage in core factors of production is unstable and tends to decrease and dissipate.Such a comparative advantage cannot provide adequate growth for convergence to occur.Developed countries,on the other hand,can sustain economic growth due to their comparative advantage in high-quality factors.Latecomer advantage refers to the ability of developing countries to increase their knowledge factor in a cost-effective manner by learning,importing,assimilating,and using knowledge and technology that already exist.Although comparative and latecomer advantages may have a combined effect,each has its distinct characteristics.Latecomer advantage is a special development factor that applies to latecomers.It is crucial at all stages of development,but especially so in the middle-income stage and beyond.Bringing latecomer advantage into full play is essential for developing nations to converge with the advanced countries.

Advantages and Development Prospects of Building Information Modelling(BIM)Technology Application in Highway Engineering

Based on the advantages of the application of Building Information Modelling(BIM)technology in highway engineering,this paper analyzes the difficulties of its in-depth application,grasps the pain points of the application of BIM technology in practice,and approaches from the integration of BIM design-construction.This paper also puts forward the integration of cross-stage information based on the BIM+Geographic Information System(GIS)construction information management system to realize the BIM whole life cycle management,and provides directional support for the continuous and efficient application of BIM technology in engineering practice.

A Multi-mode Electronic Load Sensing Control Scheme with Power Limitation and Pressure Cut-off for Mobile Machinery

In mobile machinery,hydro-mechanical pumps are increasingly replaced by electronically controlled pumps to improve the automation level,but diversified control functions(e.g.,power limitation and pressure cut-off)are integrated into the electronic controller only from the pump level,leading to the potential instability of the overall system.To solve this problem,a multi-mode electrohydraulic load sensing(MELS)control scheme is proposed especially considering the switching stability from the system level,which includes four working modes of flow control,load sensing,power limitation,and pressure control.Depending on the actual working requirements,the switching rules for the different modes and the switching direction(i.e.,the modes can be switched bilaterally or unilaterally)are defined.The priority of different modes is also defined,from high to low:pressure control,power limitation,load sensing,and flow control.When multiple switching rules are satisfied at the same time,the system switches to the control mode with the highest priority.In addition,the switching stability between flow control and pressure control modes is analyzed,and the controller parameters that guarantee the switching stability are obtained.A comparative study is carried out based on a test rig with a 2-ton hydraulic excavator.The results show that the MELS controller can achieve the control functions of proper flow supplement,power limitation,and pressure cut-off,which has good stability performance when switching between different control modes.This research proposes the MELS control method that realizes the stability of multi-mode switching of the hydraulic system of mobile machinery under different working conditions.

Utilizing Dynamic Data to Quickly Evaluate Advantageous Channels and Applications

In response to the high cost and difficulty of high-speed development and testing data in offshore oil fields, this paper proposes to use the most easily available production performance data as the basis and use the grey correlation method to calculate the correlation coefficient between oil and water wells to characterize the degree of development of advantageous channels. The consistency between the calculated results of this method and the tracer test results is over 80%. Based on the fitting results, the correlation coefficient exceeds 0.74 to determine the existence of an advantageous channel. According to the research results of grey correlation method, Bohai K oilfield has completed the combined profile control and flooding measures, and the daily oil production has increased by 20 m3/d. This method is simple, fast, and can achieve quantitative evaluation, which saves time and investment compared to offshore testing. It has strong application and reference value for the development of other offshore water injection oilfields.

Assessment of the 2 Conventional Physiotherapy Sessions Alone versus One Session Associated to Kabat’s Method in the Rehabilitation of Buruli Ulcer Patients (PUB), with Functional Limitations in the District Hospital of Akonolinga, Cameroon

Buruli ulcer (BU) is a chronic, indolent necrotizing disease of the skin and underlying tissues caused by Mycobacterium ulcerans, which may result in functional disability. This disease is the third most frequent infection after leprosy and tuberculosis caused by a mycobacterium. The main objective of this study was to determine comparative effectiveness of conventional physiotherapy alone to its association with Kabat’s method in the management of post-Buruli ulcer functional limitations. This was an interventional randomized, comparative and prospective study. It took place at the district hospital of Akonolinga from the 12th June to 12th September 2016. The study was included, post-Buruli ulcer patients who matched the eligibility criteria, were under treatment in the physiotherapy unit, and who accepted to participate in our study. A questionnaire on the socio-demographic profile of participants, the ulcer localization, the limitation stage, previous medical history and functional mobility assessment scale was administered to the subjects before and after the intervention which lasted for twelve weeks. We had 2 groups: the case group received association of Kabat technique to conventional physiotherapy and the control group received conventional physiotherapy alone. We had 22 patients, 11 patients for the experimental group, 11 patients for the control group. The mean age was 26.18 years, 54.5% of female participation, 68.2% of leg localization, 59.1% patients with severe limitations of functional mobility, and preference for traditional medication 95.5%. After evaluation of efficiency, we concluded that there was no statistically significant difference between the two treatment protocols. Further studies with larger sample size are recommended.

Comparative advantages of chemical compositions of specific edible vegetable oils

As important supplementary to major edible oils, comparative chemical advantages of minor edible oils decidetheir development and usage. In this study, chemical composition of 13 kinds of specific edible vegetable oilswere investigated. The comparative advantages of chemical compositions of these edible oils were obtained asfollows: (1) camellia, tiger nut and almond oil were rich in oleic acid, the contents of which accounted for79.43%, 69.16% and 66.26%, respectively;(2) safflower oil contained the highest content of linoleic acid(76.69%), followed by grape seed (66.85%) and walnut oil (57.30%);(3) perilla seed, siritch, peony seed andherbaceous peony seed oil were rich in α-linolenic acid (59.61%, 43.74%, 40.83% and 30.84%, respectively);(4)the total phytosterol contents of these oils ranged from 91.46 mg/100 g (camellia oil) to 506.46 mg/100 g (siritchoil);and (5) The best source of tocopherols was sacha inchi oil (122.74 mg/100 g), followed by perilla seed oil(55.89 mg/100 g), peony seed oil (53.73 mg/100 g) and herbaceous peony seed oil (47.17 mg/100 g). Thecomparative advantages of these specific edible oils indicated that they possess the high potential nutritionalvalues and health care functions.