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 pr...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.展开更多
Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length...Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,which are closely related to ICU-acquired weakness(ICUAW).It is suggested that the length of ICU stay and the duration of mechanical ventilation are the main factors.ICU-AW is the most common neuromuscular injury in the ICU,which affects clinical progression and outcomes of patients.This manuscript helps to improve the early recognition of ICU-AW,thereby reducing mortality and improving prognosis.展开更多
In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machin...In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machine learning methodologies.The study employed a multilayer perceptron neural network to accurately predict the incidence of ICU-AW,focusing on critical variables such as ICU stay duration and mechanical ventilation.This research marks a significant advancement in applying machine learning to clinical diagnostics,offering a new paradigm for predictive medicine in critical care.It underscores the importance of integrating artificial intelligence technologies in clinical practice to enhance patient management strategies and calls for interdisciplinary collaboration to drive innovation in healthcare.展开更多
In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(I...In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.展开更多
In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World J...In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes.展开更多
Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodolo...Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodologies to unearth key predictors of ICU-AW.Employing a sophisticated multilayer perceptron neural network,the research methodically assesses the predictive power for ICU-AW,pinpointing the length of ICU stay and duration of mechanical ventilation as pivotal risk factors.The findings advocate for minimizing these elements as a preventive approach,offering a novel perspective on combating ICU-AW.This research illuminates critical risk factors and lays the groundwork for future explorations into effective prevention and intervention strategies.展开更多
In this editorial,comments are made on an interesting article in the recent issue of the World Journal of Clinical Cases by Wang and Long.The authors describe the use of neural network model to identify risk factors f...In this editorial,comments are made on an interesting article in the recent issue of the World Journal of Clinical Cases by Wang and Long.The authors describe the use of neural network model to identify risk factors for the development of intensive care unit(ICU)-acquired weakness.This condition has now become common with an increasing number of patients treated in ICUs and continues to be a source of morbidity and mortality.Despite identification of certain risk factors and corrective measures thereof,lacunae still exist in our understanding of this clinical entity.Numerous possible pathogenetic mechanisms at a molecular level have been described and these continue to be increasing.The amount of retrievable data for analysis from the ICU patients for study can be huge and enormous.Machine learning techniques to identify patterns in vast amounts of data are well known and may well provide pointers to bridge the knowledge gap in this condition.This editorial discusses the current knowledge of the condition including pathogenesis,diagnosis,risk factors,preventive measures,and therapy.Furthermore,it looks specifically at ICU acquired weakness in recipients of lung transplantation,because–unlike other solid organ transplants-muscular strength plays a vital role in the preservation and survival of the transplanted lung.Lungs differ from other solid organ transplants in that the proper function of the allograft is dependent on muscle function.Muscular weakness especially diaphragmatic weakness may lead to prolonged ventilation which has deleterious effects on the transplanted lung–ranging from ventilator associated pneumonia to bronchial anastomotic complications due to prolonged positive pressure on the anastomosis.展开更多
This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patie...This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.展开更多
Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 pat...Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.展开更多
Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predomin...Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples.TCM(traditional Chinese medicine)syndrome differentiation found that they were all due to spleen and stomach weakness.They were randomly divided into two groups.Group A was treated with modified prescriptions of Shengyang Yiwei Decoction,while Group B was treated with Western medicine.The therapeutic effects in the two groups were compared.Results:The treatment efficacy in Group A was higher than that in Group B(P<0.05);the symptom scores of Group A such as loose stools,chills,physical weakness,poor appetite,and abdominal distension after meals were all lower than those in Group B(P<0.05);the SF-36(36-Item Short Form Health Survey)scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B(P<0.05);the treatment satisfaction of Group A was higher than that of Group B(P<0.05).Conclusion:Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms,improve the quality of life,and enhance treatment efficacy.Hence,it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.展开更多
Background:Females are typically less fatigable than males during sustained isometric contractions at lower isometric contraction intensities.This sex difference in fatigability becomes more variable during higher int...Background:Females are typically less fatigable than males during sustained isometric contractions at lower isometric contraction intensities.This sex difference in fatigability becomes more variable during higher intensity isometric and dynamic contractions.While less fatiguing than isometric or concentric contractions,eccentric contractions induce greater and longer lasting impairments in force production.However,it is not clear how muscle weakness influences fatigability in males and females during sustained isometric contractions.Methods:We investigated the effects of eccentric exercise-induced muscle weakness on time to task failure(TTF)during a sustained submaximal isometric contraction in young(18-30 years)healthy males(n=9)and females(n=10).Participants performed a sustained isometric contraction of the dorsiflexors at 35°plantar flexion by matching a 30%maximal voluntary contraction(MVC)torque target until task failure(i.e.,falling below 5%of their target torque for>2 s).The same sustained isometric contraction was repeated 30 min after 150 maximal eccentric contractions.Agonist and antagonist activation were assessed using surface electromyography over the tibialis anterior and soleus muscles,respectively.Results:Males were~41%stronger than females.Following eccentric exercise both males and females experienced an~20%decline in maximal voliuntary contraction torque.TTF was-34%longer in females than males prior to eccentic exercise-induced muscle weakness.However,following eccentric exercise-induced muscle weakness,this sex-related difference was abolished,with both groups having an"45%shorter TTF.Notably,there was~100%greater antagonist activation in the female group during the sustained isometric contraction following exercise-induced weakness as compared to the males.Conclusion:This increase in antagonist activation disadvantaged females by decreasing their TTF,resulting in a blunting of their typical fatigability advantage over males.展开更多
BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal stenosis.There have been several case reports of ligamentum flavum cysts.However,there is...BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal stenosis.There have been several case reports of ligamentum flavum cysts.However,there is yet to be a documented case report of a calcified ligamentum flavum cyst.Herein,we report the first case of a calcified ligamentum flavum cyst causing ankle and toe weakness.CASE SUMMARY A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg,all beginning two weeks prior.Physical examination revealed motor weakness of the left ankle dorsiflexion and great toe dorsiflexion.Lumbar spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 level.Magnetic reso-nance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 level.We performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 level.Intra-operatively,we found a firm and nodule like mass originating from the ventral surface of ligamentum flavum.Pathological examination suggested a calcified pseudocyst without a capsular lining.After the operation,the patient’s motor weakness in the ankle and great toe improved gradually.CONCLUSION The patient’s ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.展开更多
We propose an efficient scheme to produce ultrahigh-brightness tens of MeV electron beams by designing a density-tailored plasma to induce a wakefield in the weakly nonlinear regime with a moderate laser energy of 120...We propose an efficient scheme to produce ultrahigh-brightness tens of MeV electron beams by designing a density-tailored plasma to induce a wakefield in the weakly nonlinear regime with a moderate laser energy of 120 mJ.In this scheme,the second bucket of the wakefield can have a much lower phase velocity at the steep plasma density down-ramp than the first bucket and can be exploited to implement longitudinal electron injection at a lower laser intensity,leading to the generation of bright electron beams with ultralow emittance together with low energy spread.Three-dimensional particle-in-cell simulations are carried out and demonstrate that high-quality electron beams with a peak energy of 50 MeV,ultralow emittance of28 nm rad,energy spread of 1%,charge of 4.4 pC,and short duration less than 5 fs can be obtained within a 1-mm-long tailored plasma density,resulting in an ultrahigh six-dimensional brightness B6D,n of2×1017 A/m2/0.1%.By changing the density parameters,tunable bright electron beams with peak energies ranging from 5 to 70 MeV,a small emittance of B0.1 mm mrad,and a low energy spread at a few-percent level can be obtained.These bright MeV-class electron beams have a variety of potential applications,for example,as ultrafast electron probes for diffraction and imaging,in laboratory astrophysics,in coherent radiation source generation,and as injectors for GeV particle accelerators.展开更多
Weak measurement amplification,which is considered as a very promising scheme in precision measurement,has been applied to various small physical quantities estimations.Since many physical quantities can be converted ...Weak measurement amplification,which is considered as a very promising scheme in precision measurement,has been applied to various small physical quantities estimations.Since many physical quantities can be converted into phase signals,it is interesting and important to consider measuring small longitudinal phase shifts by using weak measurement.Here,we propose and experimentally demonstrate a novel weak measurement amplification-based small longitudinal phase estimation,which is suitable for polarization interferometry.We realize one order of magnitude amplification measurement of a small phase signal directly introduced by a liquid crystal variable retarder and show that it is robust to the imperfection of interference.Besides,we analyze the effect of magnification error which is never considered in the previous works,and find the constraint on the magnification.Our results may find important applications in high-precision measurements,e.g.,gravitational wave detection.展开更多
This paper is concerned with the following attraction-repulsion chemotaxis system with p-Laplacian diffusion and logistic source:■The system here is under a homogenous Neumann boundary condition in a bounded domainΩ...This paper is concerned with the following attraction-repulsion chemotaxis system with p-Laplacian diffusion and logistic source:■The system here is under a homogenous Neumann boundary condition in a bounded domainΩ ■ R^(n)(n≥2),with χ,ξ,α,β,γ,δ,k_(1),k_(2)> 0,p> 2.In addition,the function f is smooth and satisfies that f(s)≤κ-μs~l for all s≥0,with κ ∈ R,μ> 0,l> 1.It is shown that(ⅰ)if l> max{2k_(1),(2k_(1)n)/(2+n)+1/(p-1)},then system possesses a global bounded weak solution and(ⅱ)if k_(2)> max{2k_(1)-1,(2k_(1)n)/(2+n)+(2-p)/(p-1)} with l> 2,then system possesses a global bounded weak solution.展开更多
Recently,weak supervision has received growing attention in the field of salient object detection due to the convenience of labelling.However,there is a large performance gap between weakly supervised and fully superv...Recently,weak supervision has received growing attention in the field of salient object detection due to the convenience of labelling.However,there is a large performance gap between weakly supervised and fully supervised salient object detectors because the scribble annotation can only provide very limited foreground/background information.Therefore,an intuitive idea is to infer annotations that cover more complete object and background regions for training.To this end,a label inference strategy is proposed based on the assumption that pixels with similar colours and close positions should have consistent labels.Specifically,k-means clustering algorithm was first performed on both colours and coordinates of original annotations,and then assigned the same labels to points having similar colours with colour cluster centres and near coordinate cluster centres.Next,the same annotations for pixels with similar colours within each kernel neighbourhood was set further.Extensive experiments on six benchmarks demonstrate that our method can significantly improve the performance and achieve the state-of-the-art results.展开更多
In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting conse...In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting consequences.To investigate the protection ability and characteristics of flexible materials and structures under weak shock wave loading,the blast wave produced by TNT explosive is loaded on the polyurethane foam with the density of 200.0 kg/m3(F-200)and 400.0 kg/m3(F-400),polyurea with the density of 1100.0 kg/m^(3)(P-1100)and structures composed of the two materials,which are intended for individual protection.Experimental results indicate that the shock wave is attenuated to weak pressure disturbance after interacting with the flexible materials which are not damaged.The shock wave protective capability of single-layer materials is dependent on their thickness,density and microscopic characteristics.The overpressure,maximum pressure rise rate and impulse of transmitted wave decrease exponentially with increase in sample thickness.For the same thickness,F-400 provides better protective capability than F-200 while P-1100 shows the best protective capability among the three materials.In this study,as the materials are not destroyed,F-200 with a thickness more than10.0 mm,F-400 with a thickness more than 4.0 mm,and P-1100 with a thickness more than 1.0 mm can attenuate the overpressure amplitude more than 90.0%.Further,multi-layer flexible composites are designed.Different layer layouts of designed structures and layer thickness of the single-layer materials can affect the protective performance.Within the research range,the structure in which polyurea is placed on the impact side shows the optimal shock wave protective performance,and the thicknesses of polyurea and polyurethane foam are 1.0 mm and 4.0 mm respectively.The overpressure attenuation rate reached maximum value of 93.3%and impulse attenuation capacity of this structure are better than those of single-layer polyurea and polyurethane foam with higher areal density.展开更多
In this paper,we establish some regularity conditions on the density and velocity fields to guarantee the energy conservation of the weak solutions for the three-dimensional compressible nematic liquid crystal flow in...In this paper,we establish some regularity conditions on the density and velocity fields to guarantee the energy conservation of the weak solutions for the three-dimensional compressible nematic liquid crystal flow in the periodic domain.展开更多
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘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.
基金the National Natural Science Foundation of China,No.81801284and the National Natural Science Foundation of Jilin Province,No.YDZJ202201ZYTS091.
文摘Wang et al reported 1063 cases from the initial 14 d of intensive care unit(ICU)stay,and analyzed relevant data such as age,comorbidities,recent dosages,vapor pressure dosages,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,which are closely related to ICU-acquired weakness(ICUAW).It is suggested that the length of ICU stay and the duration of mechanical ventilation are the main factors.ICU-AW is the most common neuromuscular injury in the ICU,which affects clinical progression and outcomes of patients.This manuscript helps to improve the early recognition of ICU-AW,thereby reducing mortality and improving prognosis.
文摘In the research published in the World Journal of Clinical Cases,Wang and Long conducted a quantitative analysis to delineate the risk factors for intensive care unit-acquired weakness(ICU-AW)utilizing advanced machine learning methodologies.The study employed a multilayer perceptron neural network to accurately predict the incidence of ICU-AW,focusing on critical variables such as ICU stay duration and mechanical ventilation.This research marks a significant advancement in applying machine learning to clinical diagnostics,offering a new paradigm for predictive medicine in critical care.It underscores the importance of integrating artificial intelligence technologies in clinical practice to enhance patient management strategies and calls for interdisciplinary collaboration to drive innovation in healthcare.
文摘In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.
基金Supported by China Medical University,No.CMU111-MF-102.
文摘In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes.
文摘Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodologies to unearth key predictors of ICU-AW.Employing a sophisticated multilayer perceptron neural network,the research methodically assesses the predictive power for ICU-AW,pinpointing the length of ICU stay and duration of mechanical ventilation as pivotal risk factors.The findings advocate for minimizing these elements as a preventive approach,offering a novel perspective on combating ICU-AW.This research illuminates critical risk factors and lays the groundwork for future explorations into effective prevention and intervention strategies.
文摘In this editorial,comments are made on an interesting article in the recent issue of the World Journal of Clinical Cases by Wang and Long.The authors describe the use of neural network model to identify risk factors for the development of intensive care unit(ICU)-acquired weakness.This condition has now become common with an increasing number of patients treated in ICUs and continues to be a source of morbidity and mortality.Despite identification of certain risk factors and corrective measures thereof,lacunae still exist in our understanding of this clinical entity.Numerous possible pathogenetic mechanisms at a molecular level have been described and these continue to be increasing.The amount of retrievable data for analysis from the ICU patients for study can be huge and enormous.Machine learning techniques to identify patterns in vast amounts of data are well known and may well provide pointers to bridge the knowledge gap in this condition.This editorial discusses the current knowledge of the condition including pathogenesis,diagnosis,risk factors,preventive measures,and therapy.Furthermore,it looks specifically at ICU acquired weakness in recipients of lung transplantation,because–unlike other solid organ transplants-muscular strength plays a vital role in the preservation and survival of the transplanted lung.Lungs differ from other solid organ transplants in that the proper function of the allograft is dependent on muscle function.Muscular weakness especially diaphragmatic weakness may lead to prolonged ventilation which has deleterious effects on the transplanted lung–ranging from ventilator associated pneumonia to bronchial anastomotic complications due to prolonged positive pressure on the anastomosis.
文摘This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.
文摘Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.
文摘Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples.TCM(traditional Chinese medicine)syndrome differentiation found that they were all due to spleen and stomach weakness.They were randomly divided into two groups.Group A was treated with modified prescriptions of Shengyang Yiwei Decoction,while Group B was treated with Western medicine.The therapeutic effects in the two groups were compared.Results:The treatment efficacy in Group A was higher than that in Group B(P<0.05);the symptom scores of Group A such as loose stools,chills,physical weakness,poor appetite,and abdominal distension after meals were all lower than those in Group B(P<0.05);the SF-36(36-Item Short Form Health Survey)scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B(P<0.05);the treatment satisfaction of Group A was higher than that of Group B(P<0.05).Conclusion:Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms,improve the quality of life,and enhance treatment efficacy.Hence,it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.
基金supported by the Natural Sciences and Engineering Research Council of Canada(NSERC)。
文摘Background:Females are typically less fatigable than males during sustained isometric contractions at lower isometric contraction intensities.This sex difference in fatigability becomes more variable during higher intensity isometric and dynamic contractions.While less fatiguing than isometric or concentric contractions,eccentric contractions induce greater and longer lasting impairments in force production.However,it is not clear how muscle weakness influences fatigability in males and females during sustained isometric contractions.Methods:We investigated the effects of eccentric exercise-induced muscle weakness on time to task failure(TTF)during a sustained submaximal isometric contraction in young(18-30 years)healthy males(n=9)and females(n=10).Participants performed a sustained isometric contraction of the dorsiflexors at 35°plantar flexion by matching a 30%maximal voluntary contraction(MVC)torque target until task failure(i.e.,falling below 5%of their target torque for>2 s).The same sustained isometric contraction was repeated 30 min after 150 maximal eccentric contractions.Agonist and antagonist activation were assessed using surface electromyography over the tibialis anterior and soleus muscles,respectively.Results:Males were~41%stronger than females.Following eccentric exercise both males and females experienced an~20%decline in maximal voliuntary contraction torque.TTF was-34%longer in females than males prior to eccentic exercise-induced muscle weakness.However,following eccentric exercise-induced muscle weakness,this sex-related difference was abolished,with both groups having an"45%shorter TTF.Notably,there was~100%greater antagonist activation in the female group during the sustained isometric contraction following exercise-induced weakness as compared to the males.Conclusion:This increase in antagonist activation disadvantaged females by decreasing their TTF,resulting in a blunting of their typical fatigability advantage over males.
文摘BACKGROUND Ligamentum flavum cysts,which are most common in mobile junctional levels of the spine,can be a rare cause of spinal stenosis.There have been several case reports of ligamentum flavum cysts.However,there is yet to be a documented case report of a calcified ligamentum flavum cyst.Herein,we report the first case of a calcified ligamentum flavum cyst causing ankle and toe weakness.CASE SUMMARY A 66-year-old male visited our hospital complaining of claudication as well as thigh and calf pain in his left leg,all beginning two weeks prior.Physical examination revealed motor weakness of the left ankle dorsiflexion and great toe dorsiflexion.Lumbar spinal computed tomography scans showed spinal stenosis combined with a calcified mass at the left side of the L4-5 level.Magnetic reso-nance imaging showed dural sac compression caused by the calcified mass at the left ligamentum flavum of the L4-5 level.We performed decompressive laminectomy and excision of the calcified mass combined with posterior lumbar interbody fusion at the L4-5 level.Intra-operatively,we found a firm and nodule like mass originating from the ventral surface of ligamentum flavum.Pathological examination suggested a calcified pseudocyst without a capsular lining.After the operation,the patient’s motor weakness in the ankle and great toe improved gradually.CONCLUSION The patient’s ankle and great toe weakness were improved successfully after surgical removal of the calcified cyst.
基金This work was supported by the National Natural Science Foundation of China(Grant Nos.11974251,12105180,12074397,11904377,and 12005137)the Innovation Program of Shanghai Municipal Education Commission(Grant No.2021-01-07-00-02-E00118)the National Key Research and Development Program(Grant No.2023YFA1406804).
文摘We propose an efficient scheme to produce ultrahigh-brightness tens of MeV electron beams by designing a density-tailored plasma to induce a wakefield in the weakly nonlinear regime with a moderate laser energy of 120 mJ.In this scheme,the second bucket of the wakefield can have a much lower phase velocity at the steep plasma density down-ramp than the first bucket and can be exploited to implement longitudinal electron injection at a lower laser intensity,leading to the generation of bright electron beams with ultralow emittance together with low energy spread.Three-dimensional particle-in-cell simulations are carried out and demonstrate that high-quality electron beams with a peak energy of 50 MeV,ultralow emittance of28 nm rad,energy spread of 1%,charge of 4.4 pC,and short duration less than 5 fs can be obtained within a 1-mm-long tailored plasma density,resulting in an ultrahigh six-dimensional brightness B6D,n of2×1017 A/m2/0.1%.By changing the density parameters,tunable bright electron beams with peak energies ranging from 5 to 70 MeV,a small emittance of B0.1 mm mrad,and a low energy spread at a few-percent level can be obtained.These bright MeV-class electron beams have a variety of potential applications,for example,as ultrafast electron probes for diffraction and imaging,in laboratory astrophysics,in coherent radiation source generation,and as injectors for GeV particle accelerators.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 92065113, 11904357, 62075208, and 12174367)the Innovation Programme for Quantum Science and Technology (Grant No. 2021ZD0301604)+1 种基金the National Key Research and Development Program of China (Grant No. 2021YFE0113100)supported by Beijing Academy of Quantum Information Sciences
文摘Weak measurement amplification,which is considered as a very promising scheme in precision measurement,has been applied to various small physical quantities estimations.Since many physical quantities can be converted into phase signals,it is interesting and important to consider measuring small longitudinal phase shifts by using weak measurement.Here,we propose and experimentally demonstrate a novel weak measurement amplification-based small longitudinal phase estimation,which is suitable for polarization interferometry.We realize one order of magnitude amplification measurement of a small phase signal directly introduced by a liquid crystal variable retarder and show that it is robust to the imperfection of interference.Besides,we analyze the effect of magnification error which is never considered in the previous works,and find the constraint on the magnification.Our results may find important applications in high-precision measurements,e.g.,gravitational wave detection.
基金supported by the National Natural Science Foundation of China(12301251,12271232)the Natural Science Foundation of Shandong Province,China(ZR2021QA038)the Scientific Research Foundation of Linyi University,China(LYDX2020BS014)。
文摘This paper is concerned with the following attraction-repulsion chemotaxis system with p-Laplacian diffusion and logistic source:■The system here is under a homogenous Neumann boundary condition in a bounded domainΩ ■ R^(n)(n≥2),with χ,ξ,α,β,γ,δ,k_(1),k_(2)> 0,p> 2.In addition,the function f is smooth and satisfies that f(s)≤κ-μs~l for all s≥0,with κ ∈ R,μ> 0,l> 1.It is shown that(ⅰ)if l> max{2k_(1),(2k_(1)n)/(2+n)+1/(p-1)},then system possesses a global bounded weak solution and(ⅱ)if k_(2)> max{2k_(1)-1,(2k_(1)n)/(2+n)+(2-p)/(p-1)} with l> 2,then system possesses a global bounded weak solution.
文摘Recently,weak supervision has received growing attention in the field of salient object detection due to the convenience of labelling.However,there is a large performance gap between weakly supervised and fully supervised salient object detectors because the scribble annotation can only provide very limited foreground/background information.Therefore,an intuitive idea is to infer annotations that cover more complete object and background regions for training.To this end,a label inference strategy is proposed based on the assumption that pixels with similar colours and close positions should have consistent labels.Specifically,k-means clustering algorithm was first performed on both colours and coordinates of original annotations,and then assigned the same labels to points having similar colours with colour cluster centres and near coordinate cluster centres.Next,the same annotations for pixels with similar colours within each kernel neighbourhood was set further.Extensive experiments on six benchmarks demonstrate that our method can significantly improve the performance and achieve the state-of-the-art results.
基金supported by the National Natural Science Foundation of China(Grant Nos.12221002,12102233)。
文摘In recent years,explosion shock wave has been considered as a signature injury of the current military conflicts.Although strong shock wave is lethal to the human body,weak shock wave can cause many more lasting consequences.To investigate the protection ability and characteristics of flexible materials and structures under weak shock wave loading,the blast wave produced by TNT explosive is loaded on the polyurethane foam with the density of 200.0 kg/m3(F-200)and 400.0 kg/m3(F-400),polyurea with the density of 1100.0 kg/m^(3)(P-1100)and structures composed of the two materials,which are intended for individual protection.Experimental results indicate that the shock wave is attenuated to weak pressure disturbance after interacting with the flexible materials which are not damaged.The shock wave protective capability of single-layer materials is dependent on their thickness,density and microscopic characteristics.The overpressure,maximum pressure rise rate and impulse of transmitted wave decrease exponentially with increase in sample thickness.For the same thickness,F-400 provides better protective capability than F-200 while P-1100 shows the best protective capability among the three materials.In this study,as the materials are not destroyed,F-200 with a thickness more than10.0 mm,F-400 with a thickness more than 4.0 mm,and P-1100 with a thickness more than 1.0 mm can attenuate the overpressure amplitude more than 90.0%.Further,multi-layer flexible composites are designed.Different layer layouts of designed structures and layer thickness of the single-layer materials can affect the protective performance.Within the research range,the structure in which polyurea is placed on the impact side shows the optimal shock wave protective performance,and the thicknesses of polyurea and polyurethane foam are 1.0 mm and 4.0 mm respectively.The overpressure attenuation rate reached maximum value of 93.3%and impulse attenuation capacity of this structure are better than those of single-layer polyurea and polyurethane foam with higher areal density.
基金support by the NSFC(12071391,12231016)the Guangdong Basic and Applied Basic Research Foundation(2022A1515010860)support by the China Postdoctoral Science Foundation(2023M742401)。
文摘In this paper,we establish some regularity conditions on the density and velocity fields to guarantee the energy conservation of the weak solutions for the three-dimensional compressible nematic liquid crystal flow in the periodic domain.