Revealing the True Features of Dalai——A German couple criticize Dalai

Ⅰ In October 2002, Alfred Stingl, the mayor of Graz, Austria (social party, retired in 2003), invited the 14th Dalai Lama to preside over what is known as Kalachakra initiation. For a time, some political dignitaries of Austria defied the protests by China all came on the scene. The governor of the State of Styria and mayor of Graz went in person to greet and fete him. The federal education and culture minister and state secretary for economic affairs all went to Graz to witness the activities by Dalai. Austrian foreign minister also took time out to make a special tour to meet him. The University of Graz went so far as to present Dalai with an honorary certificate. Austrian media all

Exploring the novel role of oligodendrocyte precursor cells in phagocytosis:beyond myelinogenesis

Roles of oligodendrocyte precursor cells in the central nervous system:Oligodendrocyte precursor cells(OPCs)have long been recognized for their critical role as precursors to oligodendrocytes,the primary myelin-producing cells.As precursors,OPCs mature and differentiate into oligodendrocytes,which contribute significantly to the formation of myelin sheaths around axons.This myelination,which is critical for the conduction of salutatory nerve impulses in the cerebral white matter,underscores the classical role of oligodendrocytes in central nervous system(CNS)functionality.Importantly,because oligodendrocytes are differentiated cells that cannot proliferate.

Tilting homeostatic and dyshomeostatic microglial balance in health and disease:transforming growth factor-beta1 as a critical protagonist

Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS),microglia display a unique molecular homeostatic signature(i.e.,Tmem119,P2ry12,Sall1,Siglech,Gpr34,and Hexb)(Figure 1A).

Unlocking hypoglycemia–associated brain microvascular dysfunction:critical insights from proteomic analysis

Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypoglycemia,classified as level 1 hypoglycemia,is defined by blood glucose levels below 70 mg/dL and can be effectively addressed through carbohydrate intake.Severe hypoglycemia,denoted by blood glucose levels less than 54 mg/dL,poses a life-threatening risk if left untreated.Individuals with type 1 and type 2 diabetes undergoing insulin treatment are particularly susceptible to hypoglycemia due to impaired counterregulatory mechanisms.

Deep eutectic solvents for separation and purification applications in critical metal metallurgy:Recent advances and perspectives

Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and flammability,causing a spectrum of hazards to human health and environmental safety.Neoteric solvents have been recognized as potential alternatives to these harmful organic solvents.In the past two decades,several neoteric solvents have been proposed,including ionic liquids(ILs)and deep eutectic solvents(DESs).DESs have gradually become the focus of green solvents owing to several advantages,namely,low toxicity,degradability,and low cost.In this critical review,their classification,formation mechanisms,preparation methods,characterization technologies,and special physicochemical properties based on the most recent advancements in research have been systematically described.Subsequently,the major separation and purification applications of DESs in critical metal metallurgy were comprehensively summarized.Finally,future opportunities and challenges of DESs were explored in the current research area.In conclusion,this review provides valuable insights for improving our overall understanding of DESs,and it holds important potential for expanding separation and purification applications in critical metal metallurgy.

Transient extreme insulin resistance in a critically ill patient:A case report

BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin infusion.However,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is rare.CASE SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of sepsis.Remarkably,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose level.CONCLUSION Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically transient.Clinicians should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.

Association of interleukin-6 with acute lung injury risk and disease severity in sepsis

Sepsis is a life-threatening condition caused by a dysregulated response of the body in response to an infection that harms its tissues and organs.Interleukin-6(IL-6)is a significant component of the inflammatory response as part of the pa-thogenesis of sepsis.It aids in the development of Acute lung injury and,subse-quently,multiple organ dysfunction syndrome.This letter probes into the corre-lation between plasma IL-6 levels and the risk of developing acute lung injury and multiple organ dysfunction syndrome in critically ill patients with sepsis.While it shows promising results,limitations like its observational study design,a limited sample size,a single center involvement,single-time-point measurement,and a lack of a control group restrain its cogency.The study is a big step in identifying IL-6 as a biomarker to improve patient care.

Prognostic impact of hypernatremia for septic shock patients in the intensive care unit

BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains uncertain.AIM To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic shock.METHODS In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were analyzed.Patients were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with normonatremia.Moreover,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of IAH.Notably,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the ICU.It is highly recommended that hypernatremia be considered a potentially important prognostic indicator for the outcome of septic shock.

Review of Techniques for Integrating Security in Software Development Lifecycle

Software-related security aspects are a growing and legitimate concern,especially with 5G data available just at our palms.To conduct research in this field,periodic comparative analysis is needed with the new techniques coming up rapidly.The purpose of this study is to review the recent developments in the field of security integration in the software development lifecycle(SDLC)by analyzing the articles published in the last two decades and to propose a way forward.This review follows Kitchenham’s review protocol.The review has been divided into three main stages including planning,execution,and analysis.From the selected 100 articles,it becomes evident that need of a collaborative approach is necessary for addressing critical software security risks(CSSRs)through effective risk management/estimation techniques.Quantifying risks using a numeric scale enables a comprehensive understanding of their severity,facilitating focused resource allocation and mitigation efforts.Through a comprehensive understanding of potential vulnerabilities and proactive mitigation efforts facilitated by protection poker,organizations can prioritize resources effectively to ensure the successful outcome of projects and initiatives in today’s dynamic threat landscape.The review reveals that threat analysis and security testing are needed to develop automated tools for the future.Accurate estimation of effort required to prioritize potential security risks is a big challenge in software security.The accuracy of effort estimation can be further improved by exploring new techniques,particularly those involving deep learning.It is also imperative to validate these effort estimation methods to ensure all potential security threats are addressed.Another challenge is selecting the right model for each specific security threat.To achieve a comprehensive evaluation,researchers should use well-known benchmark checklists.

Anaesthesia in chronic dialysis patients:A narrative review

The provision of anaesthesia for individuals receiving chronic dialysis can be challenging.Sedation and anaesthesia are frequently managed by critical care clinicians in the intensive care unit or operating room.This narrative review summarizes the important principles of sedation and anaesthesia for individuals on long-term dialysis,with reference to the best available evidence.Topics covered include the pharmacology of anaesthetic agents,the impacts of patient characteristics upon the pre-anaesthetic assessment and critical illness,and the fundamentals of dialysis access procedures.

Forging an easier path through graduation:Improving the patient transition from paediatric to adult critical care

Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.

Patients admitted in the intensive care unit after solid organ or bone marrow transplantation:Retrospective cohort study

BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorders or those associated with a significant impairment in a patient's quality of life.AIM To investigate admission causes and treatment outcomes of patients after SOT or HSCT treated in a medical intensive care unit(ICU).METHODS We conducted a single-center,retrospective epidemiological study in the medical ICU at the University Hospital Centre Zagreb,Croatia covering the period from January 1,2018 to December 31,2023.RESULTS The study included 91 patients with either SOT[28 patients(30.8%)]or HSCT[63 patients(69.2%)].The median age was 56(43.2-64.7)years,and 60.4%of the patients were male.Patients with SOT had more comorbidities than patients after HSCT[χ^(2)(5,n=141)=18.513,P<0.001].Sepsis and septic shock were the most frequent reasons for admission,followed by acute respiratory insufficiency in patients following HSCT.Survival rate significantly differed between SOT and HSCT[χ^(2)(1,n=91)=21.767,P<0.001].ICU survival was 57%in the SOT and 12.7%in the HSCT group.The need for mechanical ventilation[χ^(2)(1,n=91)=17.081,P<0.001]and vasopressor therapy[χ^(2)(1,n=91)=36.803,P<0.001]was associated with survival.The necessity for acute renal replacement therapy did not influence patients'survival[χ^(2)(1,n=91)=0.376,P=0.54].In the subgroup of patients with infection,90%had septic shock,and the majority had positive microbiological samples,mostly Gram-negative bacteria.The ICU survival of patients with sepsis/septic shock cumulatively was 15%.The survival of SOT patients with sepsis/shock was 45%.CONCLUSION Patients with SOT or HSCT are frequently admitted to the ICU due to sepsis and septic shock.Despite advancements in critical care,the mortality rate of patients with refractory septic shock and multiorgan failure in this patient population is extremely high.Early recognition and timely ICU admittance might improve the outcome of patients,especially after HSCT.

Effect of dietary fibre on the gastrointestinal microbiota during critical illness:A scoping review

The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly recognised.Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise.While changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain uncertain.Dietary fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI microbiota.The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical illness.Randomised controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were identified.Studies show dietary fibres have an impact on faecal microbiota in health and disease.The fibre,inulin,has a marked and specific effect on increasing the abundance of faecal Bifidobacteria.Short chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient populations.Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness.More research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.

口岸经济高质量发展水平评价指标体系构建与测度——基于云南的实证研究

加快口岸由“通道经济”转型为“产业经济”,是“一带一路”建设高质量发展的重要内容。基于高质量发展目标要求,对口岸经济高质量发展的内涵、特征进行学理性探讨,依托层次分析思想构建测度口岸经济高质量发展水平的评价指标体系。以边境口岸数量多、类型丰富的云南省为研究对象,选取2012—2021年数据,运用CRITIC权重法,对云南口岸经济高质量发展水平进行测度并分析其趋势特征。研究发现:样本期内云南口岸经济高质量发展水平总体呈现上升趋势,口岸经济协调发展和开放发展提升显著,创新发展有待加强,共享作用显现,绿色发展不平稳,岸城协调性不足。推动云南口岸经济高质量发展要转变发展理念,扩大高水平对外开放,建立岸岸、岸城协调发展机制,完善口岸基础设施,加强口岸开放发展能力,以此推进云南口岸现代化建设进程。

盾构施工诱发临近桥梁安全风险评价

针对地铁盾构施工诱发临近桥梁安全风险评估结果不完善、存在失真等问题,提出一种基于变权可拓云模型的盾构施工诱发临近桥梁安全风险评价方法。首先,结合以往研究基础和实际工程经验,建立盾构施工诱发临近桥梁安全事故机理模型,进而确定孕险环境、致险因子和承险体3个1级指标,其中包括有岩土层物理性能参数、隧道工程条件、盾构施工条件、盾构施工参数、施工管理风险、桥梁现状及桥梁自身条件7个2级指标和内摩擦角、弹性模量等27个3级指标为依据建立盾构施工诱发临近桥梁安全风险评价指标体系。其次,通过改进CRITIC客观赋权法获取评价指标权重,并采用变权可拓云模型构建盾构施工诱发临近桥梁安全风险评价模型,其中引入变权理论得到使评价结果更加科学合理的变化权重。最后,对某市轨道交通1号线一期工程Ⅱ标段沿线桥梁进行实例分析。研究结果表明,4座盾构施工临近桥梁安全风险等级分别为Ⅲ、Ⅱ、Ⅱ、Ⅰ级。其中,该施工场地各项土体指标、隧道覆跨比、隧道埋深、隧道直径及桥桩与隧道的相对位置等指标风险较大,即该段隧道盾构施工时对于桥梁自身情况及其施工场地环境需要重点监测,并严格做好周围土体加固等各项技术措施。研究结果可为盾构施工诱发临近桥梁安全风险防控提供科学有效的参考依据。

数据驱动儿童专科医院大型医疗设备运行评价体系建设

目的探索通过数据采集及分析评价儿童专科医院大型医疗设备运行水平的方法,提出大型医疗设备使用及配置建议。方法通过物联网终端采集设备运行数据,结合医院HIS、RIS、HRP等系统数据,建立儿童专科医院大型医疗设备评价指标体系,运用CRITIC法对单类、单台设备数据进行量化评价。结果医院大数据平台实现了对单台大型设备运行数据纵向分析并形成可视化图表,通过PC端及移动端展示。申康市级平台数据分析,实现对儿童专科医院大型设备运行水平的综合量化评价及使用配置建议。结论通过数据采集及分析,实现儿童专科医院大型设备运行评价体系建设,提升大型设备管理水平。

基于组合赋权与灰云模型的综合能源系统需求响应效益评价

考虑到当前综合能源系统研究缺乏完善的需求响应量化评估方案,难以在优化运行层面综合评估需求响应效益这一问题,提出了一种基于改进AHP群决策—CRITIC组合赋权与灰云模型的综合能源系统需求响应效益评价方法。首先,从综合能效性、社会经济性和需求侧互动性三个维度构建了需求响应效益评价指标体系。其次,采用一致性和权重拟合性更优的指数标度法构造判断矩阵,降低赋值误差,并通过AHP群决策法确定主观权重,从而削弱主观极值偏差对权重的影响;在由CRITIC法确定客观权重后,基于最小欧氏距离建立组合权重模型,并通过非线性规划求取最优组合权重;针对评价等级信息的模糊性与隶属等级的随机性,采用正态灰云白化权模型确定指标分类等级与场景评分。最后,以北方某综合能源系统为例,根据用户参与需求响应方式设置了4种运行场景,分析了不同需求响应对系统运行的影响与作用,算例结果表明所提指标体系与评价方法科学有效。

考虑占用率的大型停车库泊位动态分配模型

为提高驾驶员泊车效率,本文考虑不同停车库占用率下的停车库运营者及驾驶员泊位分配需求,构建大型停车库泊位分配模型。本文引入停车库占用率将停车库空满等级划分为空闲泊位充裕时段、空闲泊位适中时段、空闲泊位紧缺时段,综合考虑停车库运营者运营管理需求与驾驶员快速寻泊需求,以寻位行驶时间、离开停车库行驶时间为参数构建运营管理时间效用函数,以寻位行驶时间、停车入位耗时、步行时间为参数构建驾驶员泊车耗时效用函数;将运营管理时间效用与驾驶员泊车耗时效用加权统一为总时间效用,以总时间效用最大化为目标,建立兼顾停车库运营者及驾驶员泊位分配需求的泊位分配模型;引入泊位利用率、停车总耗时量化模型性能。以西安市某大型商业停车库为例,选取9:00、11:30、13:00表征空闲泊位充裕、空闲泊位适中、空闲泊位紧缺时段进行泊位分配。不同停车库空满等级下,停车库内空闲泊位的总时间效用与停车总耗时均呈负显著相关,其中,空闲泊位充裕时段,停车库内空闲泊位的总时间效用与停车总耗时的相关性最弱,相关系数为-0.461;空闲泊位紧缺时段,停车库内空闲泊位的总时间效用与泊位利用率呈正显著相关,相关系数为0.710。研究表明本模型可在优选停车总耗时较小泊位的基础上,为停车高峰时段预留利用率较高的泊位,提高空闲泊位紧缺时段的泊车效率及驾驶员的泊车满意度。

东北黑土区典型县域耕地质量对耕地水田化的空间响应

[目的]耕地水田化过程对耕地质量具有至关重要的影响,明确东北黑土区耕地质量对耕地水田化的空间响应,是提升黑土耕地质量实现耕地可持续利用的重要前提。[方法]构建LESA耕地质量评价体系,采用CRITIC模型、双变量局部空间自相关模型,揭示耕地质量和耕地利用变化之间的空间响应关系。[结果](1)研究区耕地水田化现象剧烈,呈现出东部最强、西部次之、中部最弱的时空分异格局;(2)研究区耕地质量变化显著,耕地质量下降比例低于质量提升比例,表现出中部下降最高、西部下降次高、东部下降最低的时空格局;(3)研究区耕地质量对水田化的响应具有双重效应,负向响应更为敏感,整体呈现出东部耕地质量响应程度高于其他区域的空间格局。[结论]研究区耕地水田化对耕地质量具有正、负两种效应,依据效应方向进行耕地利用结构调整,是保护黑土耕地的重要途径。对于具有正向效应的区域应适度推进旱改水项目,而针对具有负向效应的区域应停止旱改水工程,积极进行水田休耕,并可适当地将其恢复为旱地。

湖北省城市洪涝灾害韧性时空演变及驱动因素分析

洪涝灾害是湖北省主要自然灾害之一。开展湖北省城市洪涝灾害韧性研究,可加快该地区韧性城市建设,促进城市的可持续健康发展。以湖北省17个城市为研究对象,选取2010-2021年为研究期,从压力、状态、响应等维度构建城市洪涝灾害韧性评价指标体系,运用CRITIC-熵权组合赋权法分析其洪涝灾害韧性时空演变,并利用空间自相关法分析其洪涝灾害韧性空间集聚特征,再用地理探测器模型分析其驱动因素。结果表明:①研究期内湖北省城市洪涝灾害韧性指数呈波浪式上升趋势,增幅达34.82%;②城市洪涝灾害韧性的空间分布主要呈现为“西高东低”和以武汉为高值向外递减,城市洪涝灾害韧性的空间集聚效应较强;③城市洪涝灾害韧性的空间分异性为多因素共同作用。其中,人口暴露程度、地形起伏情况、地表陡缓程度、医疗保障能力为主要驱动因素。研究结果可为城市防洪减灾政策提供参考。