Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.

Influencing factors and solution strategies of chimeric antigen receptor T-cell therapy(CAR–T)cell immunotherapy

Chimeric antigen receptor T-cesll therapy(CAR–T)has achieved groundbreaking advancements in clinical application,ushering in a new era for innovative cancer treatment.However,the challenges associated with implementing this novel targeted cell therapy are increasingly significant.Particularly in the clinical management of solid tumors,obstacles such as the immunosuppressive effects of the tumor microenvironment,limited local tumor infiltration capability of CAR–T cells,heterogeneity of tumor targeting antigens,uncertainties surrounding CAR–T quality,control,and clinical adverse reactions have contributed to increased drug resistance and decreased compliance in tumor therapy.These factors have significantly impeded the widespread adoption and utilization of this therapeutic approach.In this paper,we comprehensively analyze recent preclinical and clinical reports on CAR–T therapy while summarizing crucial factors influencing its efficacy.Furthermore,we aim to identify existing solution strategies and explore their current research status.Through this review article,our objective is to broaden perspectives for further exploration into CAR–T therapy strategies and their clinical applications.

Study on the Influencing Factors of L2 Reading Ability and Its Regulation Strategies

This paper takes college students as research subjects to investigate the factors affecting L2 Reading ability and their regulation strategies through scale surveys.The findings are as follows:(1)Linguistic factors have significant impacts on L2 Reading ability,and the influence of non-linguistic factors,such as non-intellectual factors and cultural background knowledge,is also important;and(2)flexible use of reading regulation strategies according to the learning conditions(such as the information extraction strategy,the metacognitive reading regulation strategy,and the interactive reading strategy)can effectively improve learners’L2 Reading ability.The findings of this study have important theoretical and practical value for improving L2 learners’Reading ability.

On the Factors Hindering Chinese College Students＇ English Reading and Possible Strategies

Chinese college students reading in a foreign language seem to read with less understanding and at a considerably slower speed. The factors that hinder Chinese college students' English reading were analyzed at the lexical level, the syntactic level,and the discourse level. And then, several reading strategies were recommended to overcome such reading difficulties.

Gastric cancer: Epidemiology, risk factors and prevention strategies

Gastric cancer(GC) is a global health problem, with more than 1 million people newly diagnosed with GC worldwide each year. GC is more prevalent in less developed countries than in more developed countries. About half of all GC cases worldwide occur in East Asia, notably China. Globally, overall incidence rates of GC are declining, which is potentially attributed to a decrease in Helicobacter pylori(H. pylori) infection and the use of refrigeration to preserve foods rather than salt. GC is a multifactorial disease, and its occurrence and development were impacted by environmental and genetic factors. H. pylori infection is the primary risk factor for GC, especially for non-cardia. The prognosis of GC is poor due to stages at the first diagnosis. The 5-year survival rate is less than 10% when patients are diagnosed at an advanced stage, but the rate is as high as 85% if patients are detected at an earlier stage. Endoscopic screening can potentially prevent GC by early diagnosis and early treatment and has been widely adopted in screening programs in East Asian countries, such as Japan and Korea. This review summarizes updated epidemiological aspects, risk factors, and prevention strategies of GC in recent years to help researchers determine the most effective intervention strategies for reducing risk of GC.

Non-linguistic Factors and Strategies on the English-Chinese Translation of Humor

The text have an in-depth discussion of the non-linguistic factors on the English-Chinese Translation of humor,and according to different types of humor,summarized the corresponding translation strategies,including the naturalization,replacement and explanation.

Livelihood Factors and Household Strategies for an Unexpected Climate Event in Upland Northern Laos

Climate events pose major challenges to food production and the livelihoods of rural inhabitants in northern Laos, where upland rice using swidden production is an important crop. The onset of the rainy season in this area is one such climate event, and it has occurred earlier and with less regularity in recent years. Not all households are able to cope with these changes. This study examines the ability of local farmers to cope with rice insufficiency. This investigation also clarifies household strategies in dealing with the climate event. We randomly interviewed 63 of 95 household heads, and performed a paired sample t test to examine the significance of differences in three household groups between the 2010 normal climate and the 2011 climate event. The groups were categorized according to rice selfsufficiency in 2011: groups I are households with rice self-sufficiency, group II are those facing a rice shortage of up to 3 months, and group III are those with insufficient rice for over 3 months. We also conducted a one-way ANOVA to examine the significance of differences in livelihood strategies among the three groups. We found that the household labor force was the most important factor in enhancing the villagers' ability to deal with the climate event and that the level of impact of that event shaped their coping strategies. Households with substantial labor force had more options for coping strategies than those with smaller ones. The villagers faced different levels of impact and adopted differentcoping strategies accordingly. Non-timber forest product collection was the principle livelihood strategy in response to non-climate factors such as education, access to health services, provision of equipment and clothing, and overcoming the impact of the climate event. Households heavily affected by the early rainy season onset tended to engage in intensive activities such as off-farm activity and outside work, rather than their major livelihood activities in the village(upland crop and livestock production).

Dominating factors on well productivity and development strategies optimization in Weiyuan shale gas play, Sichuan Basin, SW China

Weiyuan shale gas play is characterized by thin high-quality reservoir thickness,big horizontal stress difference,and big productivity differences between wells.Based on integrated evaluation of shale gas reservoir geology and well logging interpretation of more than 20 appraisal wells,a correlation was built between the single well test production rate and the high-quality reservoir length drilled in the horizontal wells,high-quality reservoir thickness and the stimulation treatment parameters in over 100 horizontal wells,the dominating factors on horizontal well productivity were found out,and optimized development strategies were proposed.The results show that the deployed reserves of high-quality reservoir are the dominating factors on horizontal well productivity.In other words,the shale gas well productivity is controlled by the thickness of the high-quality reservoir,the high-quality reservoir drilling length and the effectiveness of stimulation.Based on the above understanding,the development strategies in Weiyuan shale gas play are optimized as follows:(1)The target of horizontal wells is located in the middle and lower parts of Longyi 11(Wei202 area)and Longyi 11(Wei204 area).(2)Producing wells are drilled in priority in the surrounding areas of Weiyuan county with thick high-quality reservoir.(3)A medium to high intensity stimulation is adopted.After the implementation of these strategies,both the production rate and the estimated ultimate recovery(EUR)of individual shale gas wells have increased substantially.

Language Factor and Translation Strategies

It is no exaggeration to say that all the problems in translation are connected with language.Therefore,if we want to explore the translation strategies,we should explore the similarities and differences between English and Chinese first and then the translation strategies.

Using Multiple Risk Factors and Generalized Linear Mixed Models with 5-Fold Cross-Validation Strategy for Optimal Carotid Plaque Progression Prediction

Background Cardiovascular diseases are closely linked to atherosclerotic plaque development and rupture.Plaque progression prediction is of fundamental significance to cardiovascular research and disease diagnosis,prevention,and treatment.Generalized linear mixed models(GLMM)is an extension of linear model for categorical responses while considering the correlation among observations.Methods Magnetic resonance image(MRI)data of carotid atheroscleroticplaques were acquired from 20 patients with consent obtained and 3D thin-layer models were constructed to calculate plaque stress and strain for plaque progression prediction.Data for ten morphological and biomechanical risk factors included wall thickness(WT),lipid percent(LP),minimum cap thickness(MinCT),plaque area(PA),plaque burden(PB),lumen area(LA),maximum plaque wall stress(MPWS),maximum plaque wall strain(MPWSn),average plaque wall stress(APWS),and average plaque wall strain(APWSn)were extracted from all slices for analysis.Wall thickness increase(WTI),plaque burden increase(PBI)and plaque area increase(PAI) were chosen as three measures for plaque progression.Generalized linear mixed models(GLMM)with 5-fold cross-validation strategy were used to calculate prediction accuracy for each predictor and identify optimal predictor with the highest prediction accuracy defined as sum of sensitivity and specificity.All 201 MRI slices were randomly divided into 4 training subgroups and 1 verification subgroup.The training subgroups were used for model fitting,and the verification subgroup was used to estimate the model.All combinations(total1023)of 10 risk factors were feed to GLMM and the prediction accuracy of each predictor were selected from the point on the ROC(receiver operating characteristic)curve with the highest sum of specificity and sensitivity.Results LA was the best single predictor for PBI with the highest prediction accuracy(1.360 1),and the area under of the ROC curve(AUC)is0.654 0,followed by APWSn(1.336 3)with AUC=0.6342.The optimal predictor among all possible combinations for PBI was the combination of LA,PA,LP,WT,MPWS and MPWSn with prediction accuracy=1.414 6(AUC=0.715 8).LA was once again the best single predictor for PAI with the highest prediction accuracy(1.184 6)with AUC=0.606 4,followed by MPWSn(1. 183 2)with AUC=0.6084.The combination of PA,PB,WT,MPWS,MPWSn and APWSn gave the best prediction accuracy(1.302 5)for PAI,and the AUC value is 0.6657.PA was the best single predictor for WTI with highest prediction accuracy(1.288 7)with AUC=0.641 5,followed by WT(1.254 0),with AUC=0.6097.The combination of PA,PB,WT,LP,MinCT,MPWS and MPWS was the best predictor for WTI with prediction accuracy as 1.314 0,with AUC=0.6552.This indicated that PBI was a more predictable measure than WTI and PAI. The combinational predictors improved prediction accuracy by 9.95%,4.01%and 1.96%over the best single predictors for PAI,PBI and WTI(AUC values improved by9.78%,9.45%,and 2.14%),respectively.Conclusions The use of GLMM with 5-fold cross-validation strategy combining both morphological and biomechanical risk factors could potentially improve the accuracy of carotid plaque progression prediction.This study suggests that a linear combination of multiple predictors can provide potential improvement to existing plaque assessment schemes.

Hypertension Associated with Atherosclerosis Risk Factors in Patients of Family Health Strategy Highlighting the Framingham Risk Score

The Systemic Arterial Hypertension (SAH) stands out among the chronic non-transmissible pathologies that impact the cause and/or aggravation of cardiovascular diseases (CVD) on a global level, as the disease is an underestimated disorder due to non-perceptive symptoms and associated with factors and risk markers of another CVD. Therefore, establishing the risk of progression and aggravation of the SAH, according the Framingham Risk Score (FRS), allows to reducing morbidity and improving preventative measures for DCVs. This observational and transversal study approaches the data collection of patient records at the Health Family Strategy of Senhor do Bonfim, BA, which established differences by descriptive and inferential statistical analysis (correlation and regression). The aspects of hypertension associated with risk factors for atherosclerosis were analyzed, determining the risk of developing cardiovascular events in 10 years by FRS. From 432 families, 746 patients were selected, of which 340 are hypertensive individuals (SAH = 45.57%) and 406 (NSAH = 54.42%) non-hypertensives. Among the SAH the majority (31.17%) was in the age range of 63 - 77, but, in both groups, women were in stronger number. There was greater prevalence in SAH for all the characteristics analyzed, smoking (13.20%), sedentary (29.41%) and cardiovascular accident (22.60%). The SAH group is more susceptive to the CVD progress in 10 years by FRS (P < 0.0001 ANOVA). In the NSAH group, there were significant associations among all the variables analyzed as was expected, without differences between the linear correlation and regression, indicating the physio-metabolic equilibrium of the factors and markers evaluated by FRS. Already in SAH group, despite the correlations have been significant too, the regression analysis revealed that only Total Cholesterol (P = 0.0086);LDL (P < 0.0001), Glucose (P < 0.0006) and Age (P < 0.0001) have significative association with FRS. So, these factors and markers deserve more attention upon the health staff of Health Family Strategy, in the SAH course at studied population, attempt the highest cardiovascular risk by FRS (2.5 to 2.8 times) to SAH. The monitoring of high-risk patients should prioritize the lifestyle changes, employing preventive measures to SAH and CVD and atherosclerosis.

Comparative Revenue, Obstacle Factors and Promoting Strategy of Sprinkling Irrigation in Wheat Field: A Case Study from Yanzhou, Shandong Province in China

This paper takes 30 hm2 wheat sprinkling irrigation land of Yunguo Family Farm in Yanzhou, Shandong Province, China as a sample, and draws a conclusion by comparing it with other households (including individual and large households). The conclusions are as follows: wheat sprinkling irrigation has a remarkable water-saving effect and comparative revenue. Water saving efficiency can reach 61.54% and a comprehensive income-increase rate can reach 38.67%. The main factors of increasing income and incentives of saving irrigation by sprinkling irrigation ranks as the following: saving land consolidation and water monitoring labors (accounts for 62.50%), saving land area of wheat bed to increase production and income (accounts for 23.44%), saving water bills (accounts for 14.06%). The incentive effect of water saving is not obvious mainly because the water price is low. The main obstacles to the promotion of sprinkling irrigation by individual household are the uneconomical scale and the barriers of coordination of proxy irrigation. Other large household’s (family farm) obstacles are mainly the instability of land tenure and mixed management. Suggestions on promoting sprinkling irrigation in wheat field: Accelerate land circulation and promote agricultural scale management to create basic scale conditions for spreading sprinkling irrigation;stabilizing farmland management rights as stabilizing farmland contractual rights, thus giving long-term business interests to all kinds of large household owners;guide the development of “scale + specialization” modern family farms;appropriate water saving subsidies should be given according to the positive externality of household water saving;confirm agricultural water rights to household and allow compensated transfer of “surplus water rights”.

Hedge fund replication using strategy specific factors

Hedge funds have traditionally served wealthy individuals and institutional investors with the promise of delivering protection of capital and uncorrelated positive returns irrespective of market direction,allowing them to better manage portfolio risk.However,the financial crisis of 2008 has heightened investor sensitivity to the high fees,illiquidity,lack of transparency,and lockup periods typically associated with hedge funds.Hedge fund replication products,or clones,seek to answer these challenges by providing daily liquidity,transparency,and immediate exposure to a desired hedge fund strategy.Nonetheless,although lowering cost and adding simplicity by using a common set of factors,traditional replication products might offer lower risk-reward performance compared to hedge funds.This research explores hedge fund replication further by examining the importance of constructing clones with specific factors relevant to each hedge fund strategy,and then compares the strategy specific clone risk and reward performance against both actual hedge fund performance and hedge fund clones constructed using a more general set of common factors.Testing shows that using strategy specific factors to replicate common hedge fund strategies can offer superior risk-reward performance compared to previous general model clones.

Influencing Factors and Improvement Strategy to the Quality of Nursing Work Life: A Review

This review introduces the definition, influencing factors and improvement strategy to the quality of nursing work life, which can provide references for nursing managers to understand the factors affecting the quality of nursing work life and choose effective measures to improve the quality of nursing work life.

In-class language learning strategies used by Thai pre-university students： Factor analysis

The purpose of this study was to explore factors related to strategy use of Thai pre-university students in Thailand. The subjects of the investigation were selected based on convenience and availability. A researcher-generated language learning strategy questionnaire with the Alpha coefficient （α）. 96 were used as the main instrument for the data collection. The questionnaire was designed based on information taken from the students＇ interview. The variables for the present investigation include extra-class support and level of language proficiency. The four extracted factors emerged as a result of varimax rotation conducted on the correlations of 20 in-class language learning strategies, which varied significantly in relation to the two variables. The four factors includes Factor 1 strategies for strategies for the classroom preparation, Factor 2 strategies for learning new vocabulary in the classroom lessons, Factor 3 strategies for solving classroom problems, and Factor 4 strategies for concentrating while studying in class. The result of the varimax rotation shows that all of the four factors were found strongly related to extra-class support and level of language proficiency.

Analysis on the Factors Restricting the Entrepreneurship Quality Education for the Young Peasant Workers Back to Hometown in Yunnan Province and the Related Strategies

Entrepreneurship quality education is not only the standpoint and focus of entrepreneurship education, but also the key point in entrepreneurship education. In this paper, based on three aspects （the educated, the subjects implementing education, and external environment）, the main factors restricting the entrepreneurship quality education for the young peasant workers back to hometown in Yunnan province are analyzed, and also the governmental strategies of a clear purpose and a powerful applicability are further explored.

Derivation of Cultural Factors Involved in Publicity Translation Strategy

In the age of cultural variety,publicity translation has become a bridge of communication which is not purely an activity of lan-guage but conveys the original thoughts and culture.Derivation of cultural factors involved in translation,such as lexicon,sentence pat-terns,idiomatic expressions psychology and aesthetics are explored in order to contribute to the selection of translation strategy.

An Analysis and Corresponding Strategies of Memory Difficulties Caused by Psychological Factors in Consecutive Interpreting

This paper is composed of three parts.The first part presents Gile’s effort model and memory mechanism in consecutive interpreting.In the second part and the third part,the author analyzes the psychological factors that cause memory difficulties and proposes corresponding strategies on the basis of the analysis.At last,the author draws a conclusion based on the discussion of the whole paper that sufficient preparation,appropriate pressure and perceived memory can avoid memory difficulties caused by psychological factors.

The Research Self-Efficacy of Elementary Teachers:Current status,Factors,and Strategies for Improvement

Research self-efficacy is of great significance for teachers to improve their interest and achievements in scientific research.In this study,261 elementary teachers were surveyed through online questionnaires to understand their research self-efficacy.The results showed that most elementary teachers have good research self-efficacy;education background,years of teaching,research environment,and attitude toward research all had influence on the research self-efficacy of elementary teachers.Based on this situation,schools should make efforts,such as improving communication,providing financial support,establishing a scientific research support center,and helping teachers under unfavorable situations.For elementary teachers,they should realize the importance of education research and improve their research literacy。

Loan Strategies to Small and Medium Size Enterprises:An Analysis of Determining Factors of“Subsidiary Banks”in the Cameroonian Context

This paper proposes to present an overview of determining factors of the granting of loan to Small and Medium Size Enterprises(SMSE)by the subsidiaries of multinational banks in Cameroon.The analysis of the data collected following interviews with banking employees conducted in accordance with the method of thematic content analysis reveals that two categories of factors play a major role in the decision of the banker:parameters relating to the characteristics of the SMSE applying for a loan and elements specific to the context of study.The combination of these factors contributes to the reinforcement of the already transactional attitude of these subsidiary banks in the area of experimentation of the study.